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HomeMy WebLinkAboutMINUTES - 06191990 - IO.1 TO: BOARD OF SUPERVISORS ,.mss Y Contra FROM: Costa County INTERNAL OPERATIONS COMMITTEE �.,. ._ County DATE: June 11, 1990 SrA coon SUBJECT: STATUS REPORT ON COUNTY'S THREE-YEAR AIDS RESPONSE PLAN SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECONIlIENDATIONS 1. Accept the attached report from the Health Services Director outlining the status of the AIDS epidemic in Contra Costa County. 2. Request the Health Services Director to make another report to our Committee in October, 1990 to update us on activities at that point in time. BACKGROUND: Our Committee has continued to receive periodic progress report from the Health Services Department on the progress which is being made is addressing the AIDS problem in this County. On June 11, 1990 we met with Dr. Wendel Brunner and Francine Wise from the Public Health Division of the Health Services Department. The attached report was highlighted by Dr. Brunner, indicating that there continues to be a disproportionate problem with minorities, whose incidence of AIDS far exceeds their proportion of the general population. Health Services is continuing to focus their outreach efforts in minority communities. While it appears that everything that can be done in the way of education CONTINUED ON ATTACHMENT:Yes YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTE APPROVE HER r SIGNATURE(S): SUNNE WRIGHT McPEAK _ 0 POWER ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE X UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. CC: ATTESTED /9 X990 PH VBATCHELOR,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR County Administrator Health Services Director �Q Director of Public Health BY DEPUTY M382 (10/88) and prevention efforts is being done the AIDS crisis continues to spread. The County now had has 445 AIDS cases confirmed, about 2/3 of whom have already died. Out Committee would also like to congratulate the Health Services Department for their very attractive and informative quarterly report brochure which offers some troubling statistics on AIDS cases in this County. The estimated time from HIV infection to AIDS now appears to be eleven years, a greater period of risk than has been seen previously. The statistics indicate that young people continue to be at tremendous risk of acquiring the HIV virus as teenagers, even if the disease does not develop into an actual AIDS case until the individual is in his or her mid to late 20 ' s. We would commend this quarterly statistical report to all of the Board members and all others who are concerned with the financial and emotional cost of the AIDS epidemic. We would like to have the Health Services Department report again to our Committee in October so that we can continue to be kept up to date with developments in this area. E s__._- _Contra Costa County Health Services Department Public Health Division Mark Finucane, Health Services Director Wendel Brunner, MD, Public Health Director o Contra Costa County AIDS Program QUARTERLY REPORT OF HIV/AIDS STATISTICS OST4_COi January- March 1990 wom en w t A ID In Con tra Costa Co un t Nineteen women have been diagnosed with AIDS in Contra Costa County (18 adults, 1 child). In 1988, there were eight Trends & Constants cases; the number doubled to 16 cases in 1989 and, in the first quarter of 1990, three new cases among women have been The estimated time from HIV infection to AIDS is 11 diagnosed. Of the adult cases, 14 (78%) were of reproductive years. Using this premise, it appears that, in Contra age (14-45) with a mean age of 40 years. Seven (39%) were Costa County, 73 men and two women were infected heterosexuals who had a history of intravenous drug use. Eight as teenagers (age 13-19). They represent 18% of all (44%) were sexual partners of people at risk (three were sex cases. partners of heterosexual IV drug users;two were sex partners of bisexual men; two were the sex partners of men with HIV Of these cases, 66 (88%). were homosexual or infection or AIDS and one had multiple sex partners of bisexual men. Six of these also had a history of IV undetermined risk). The remaining three (17%) received drug use. Seven (9.3%) were heterosexual with a contaminated blood transfusions. history of IV drug use (five men and two women). Of the remaining two, one was a person with hemophilia Six(33%) of the 18 adults were diagnosed at Merrithew Memorial and the other had undetermined risk. or County clinics. Eleven- (61%) had Pneumocistis carinii pneumonia when diagnosed. Nine (50%) of the adult women have died. Nine of the adult cases were Black 50% , five were Due to lack of proper preventive education, young ( ) men having unprotected sex with men may be White (28%) and four were Latina (22%). The child was Latina. particularly vulnerable to HIV infection. Concurrently, between 1985 and 1989, 97 women testing volun- .......... tarily at public clinics Contra Costa County have been found n d v i 0 t positive IV antibodies e (seroprevalence: of rH a bo s o be os o 1. 1.3%).. Of t o the P 4t3 CASES OF AIDS total, 43 (44%) reported IV drug use and the remainder were sex TN CONTRA:CQSTA, .:COUNTY....._..: f heterosexuals at ri k partners o s or had no reported risk. f rl file ft1 ...............St ...q .....t19941, total An HIV seroprevalence study in California of child bearing women Of 52 r1etNdS 'S 0 A6C1� �ntere (1988) showed that, in the San Francisco Bay area, 13 of 10,000 reported; 25 of v�thlah wiere women giving birth are infected with HIV. If that prevalence is d>agnQSed daring .. the Srne extended to all women of reproductive age living in the county, at least 230 may be infected. TeThe retnafnlnq 27 cases were diagtlOsed ttl preVtDUS HIV infection has spread among women through IV drug use and rTlOClthS through sexual contact. A rise in perinatal infection will inevitably follow. HIV risk assessments, prevention education and HIV antibody testing should be offered routinely to all women attending family planning and pre-natal clinics. A HIV TESTING The following statistics include persons tested anonymously or confidentially through the Contra Costa County Public Health Laboratory, the majority of whom were clients of the Alternative Test Sites, the Sexually Transmitted Disease Clinics and the County Hospital and Clinics. Table No. 1 contains totals of individuals tested and their results categorized by risk groups and time periods. For each time period,the first column indicates the number of people tested,the second column the number of people who tested positive and the third column the prevalence percentage. Data for 1985 through 1987 have been combined to represent the first time period. Data presented for year 1990 is cumulative for the first quarter. Table No. 2 contains numbers tested and results categorized by ethnicity and time periods. Note that data pertaining to ethnicity was not collected prior to August, 1988. Table No. 1: HIV Testing by Risk Groups 1985y1987 1988 T989 First Qtr. 1990 :::85=9Tota1 Test:' + % Test + % Test + % :; Test + % Test Homo/bisexual 786 148 `18 8 490 84 17.1 443 56 12 6 138 12 8 7 1857 300 16:.1 Homo/bi/IV Drug 23 9 39.1::: 16 6 37.5 =32 4 ]25; 18 1 5.5 89 20 ~:22.5 Hetero/IV Drug 510 . 15 2 9 702 48 6.8 821 57 65 378 22 5.8 2411 142 5 9. Blood Recipient 592 5. 0 8 222 1 0.4 176 D 43 1 2 3 1033 7 =0.7 Heterosexual 2333.:.; 6 0 2 2265 14 0.6 2028 7 Q 3 ;; 498 0 - 7.124 27 0.4. Sex Partners 131$ . 12 09 ;; 633 8 1.2 51$ 12 23: 186 2 1.1 2655 34 12< Other or Unknown :::A682':':::­ 101... 6.6::*'> 678 17 2.5 80412 )5 226 4 1.7 3390::: 134 3.9:: Totals 7244. :': 296 4.0 5006 178 3.5- 4822 148 3 ti.` 1487 42 2 8 .18559 664 3.6 . Table No. 2: HIV Testing by Race 1:.988 1989 Fc§t;tfr1990. '88-90 Total Test + % Test + % Test . +" % Test + % White 1554 51 3.3 3017 70 2.3 971:: 14: 14:' 5542 135 2.4 Black 425 35 8.2 ' 942 64 6.8 263: 23` 8 5 1636 122 7.5 ........ .... .......... ............. Latino 222 9 4 Q 566 12 2.1 149; 3'; 2 0 937 24 2.6 Asian 75 1 1.3 152 1 0.6 49 0.> 275 2 0.7 Native American 22 0 31 1 3.3 13< 0 65 1 1.5 Other or Unknown 2708 82 3.0. 114 0 - 36. 2 s 5 5. 2796 843.0 Total 5006 178 3:5 4822 148 3.0 1487 42' 2 8:;i 11251 368 3.3 As the data on this page indicate,42 people tested for HN antibodies were found to be seropositive for the first time during the first quarter of 1990. Of those 42 people, 12 are homosexual/bisexual men,one is a bisexual man with a history of N drug use, 22 are heterosexual with a history of N drug use,one received a contaminated blood transfusion,two were sex partners of people at risk and four had no reported risk_ Of the men found positive, 14 are White, 18 Black,one Latino and one did not report ethnicity. Of the females who tested positive,three are Black and one is Latina. Gender was not reported by four people. Fourteen of the persons testing positive are residents of West Contra Costa County, 12 reside in Central County and nine in East County. Three had residency in another county and four did not report their city of residency. The figures presented herein are representative of persons who self-select to take the test anonymously or confidentially. They do not represent the entire County population. Persons who report they are seropositive who are being retested have been excluded from this report. Contra The Board of Supervisors Costa Health Services Department Tom Powers,1st District County Nancy C.Fandan,2nd District OFFICE OF THE DIRECTOR Robert 1.Schroder,3rd District L 0 Sunne Wright McPeak,4th District - Mark Flnueane,Director Tom Torlakson,5th District Administrative Offices of 20 Allen Street County Administrator Martinez.California 94553 Phil Batchelor cosi y (415)646-4416 County Administrator May 29, 1990 To: Board of Supervisors Internal Operation - Co 1 ee 7 From: Mark FinucaH ervices irector by Wendel Brunner, M. D,, Public Health Director Subject: AIDS Update 1. Subvention Update In response to the county's decision.to participate in the State Office of-:'AIDS Subvention Funding Program, the Public Health Division, late last year, organized a county AIDS Advisory Committee to create an AIDS Subvention Plan and to advise the Director of Public Health on AIDS issues. That committee is active, dynamic and enthusiastic. Membership The Office of AIDS mandated that certain segments of the AIDS-provider network be included on the committee, and the Public Health AIDS Program elicited community input to create a committee which represented each program area of AIDS work, the geographic regions of the county, ethnic representation among those groups most affected by AIDS, and the HIV-infected community. A list of members of the committee is attached. Role of the Committee At its two initial meetings at the end of last year, the committee met to create the AIDS Subvention Plan for 1990-91. With that work complete, the committee was eager to continue to meet to network with others in the community doing AIDS work. The committee has now concisely defined its functions to be: A-9d5 111/871 2 • To advise the Director of Public Health, other responsible health officials and legislative bodies on AIDS issues • To advocate on behalf of the residents of Contra Costa County and partic- ularly the HIV-infected persons in the county for additional services • To provide opportunities to network for members of the committee both within the committee and among other Bay Area providers of AIDS services • To establish priorities of needed AIDS services in the county • To develop an updated comprehensive AIDS Plan for the county • To pursue funding opportunities related to high-ranking priorities Beginning immediately in its roles as advisory to responsible health officials and as advocates for increased services in the county, the Committee wrote to Dr. Kenneth B. Kizer, Director of California's Department of Health Services, expressing grave concern over the possibility of unspent funds at the Office of AIDS. To date Michael Hughes, Acting Chief of the Office of AIDS and Assemblyman Robert J. Campbell have responded to that letter. (The committee's letter to Dr. Kizer, the San Francisco Examiner article which precipitated it, and the replies are attached.) The Committee has now begun work on its task of establishing priorities of need to AIDS services in the county. Funding The State has accepted Contra Costa County as a subvention county. Funding levels for all projects included in subvention (Alternative Test Sites, AIDS Block Grant, HIV counseling at Sexually Transmitted Disease Clinics, and Education and Prevention activities) were funded at 1989-90 levels with an additional 5% funding ($23,285) to the Health Services Department for administration, including management of subcontracts to be granted under the funding process. The Health Services Department has attempted to make-the transition to subvention as smooth as possible for community-based organizations currently funded directly by the State, by funding existing contractors at their 1989-90 levels. Negotiations with the Contra Costa County AIDS Task Force, Familias Unidas, the Martin Luther King, Jr., Family Health Center, and Planned Parenthood Shasta-Diablo are underway with the goal of securing completed contracts with those agencies by July 1, 1990. 3 2. Update on Community Outreach to Minority Communities As I have previously reported to the Board, we continue to see alarming rates of increases in AIDS cases and in people testing HIV positive from the Black and Latino communities in the county. At the end of the first quarter of this year 16% of the AIDS cases in the county are among blacks (59 men and nine women). Nine percent of AIDS cases were among Latinos (31 men and five women). Of 18 adult women with AIDS, nine (50%) are Black women, four (22% are Latinas). And of Blacks receiving HIV tests at county clinics, from January 1988 to March 31, 1990, 7.5% have tested positive for the first time (compared with 2.4% of Whites and 2.6% of Latinos). These statistics have clearly demonstrated the need for focused prevention efforts in our minority communities. In May the AIDS Program was able to hire a health education specialist specifi- cally to target prevention efforts in West County. This new staff person will conduct public presentations and will organize community events. She will also develop contacts with existing service providers and train and assist them in the implementation of HIV prevention programs. She will also be a critical link between service providers in West County and individuals in West County who need services. Recruitment efforts are still underway for a bilingual (Spanish-speaking) health educator to target prevention efforts primarily in the bilingual communities in East and Central County. 3. State funds to provide voluntary partner notification services Contra Costa County is one of four health jurisdictions in the State to receive funds to assist in efforts to provide voluntary partner notification services to persons found to be HIV infected. A temporary employee has been selected to be stationed primarily at Sexually Transmitted Disease clinics to help individuals decide how best to notify sex or needle sharing partners of their potential exposure to HIV. Individuals may choose to notify their partners themselves or the new staff member, working under direction of the AIDS Program's Coordinator of Epidemiology and Testing, may assist with notification. The new employee will also be available to assist physicians from Hospital and Clinics Division in notifying HIV-positive individuals who have not returned to the clinic to learn their test result. 4 4. HIV Testing Mailing This month, the Public Health Division's AIDS Program will begin weekly mailing to selected zip codes in Richmond informing residents of free, anonymous HIV testing services. Concurrent with the mailings, the AIDS Program's Community Health Outreach Workers will spend their time talking with residents about testing and AIDS prevention in the same neighborhoods. They will also place posters advertising testing services on those streets which received flyers. Approximately 250 households per week for 33 weeks will be reached. Contra Costa.County AIDS ADVISORY . `COMMTTTEE Medical Kent Sack, M. D. Private Medical Providers Alan Johnson Kaiser Permanente Medical HIV Coordinator Center, Walnut Creek Public Health Rusty Keilch AIDS Program, Public Health Division, Contra Costa County Health Services Division Community-Based Organizations A.C. Hollister, M.D. AIDS Community Network Vice President Emmett Velten, Ph.D. Bay Area Addiction Clinical Supervisor Research, and Treatment Tina Young Bay Area Urban League AIDS Educator Robert Thompson Contra Costa County Education Coordinator AIDS Task Force Reverend Robert Freitas Diablo Valley AIDS Center Board of Directors Michael Siems East County Community Executive Director Detox Center Dolores Sanchez, Ph.D Familias Unidas Executive Director (continued on neat page) Contra Costa County AIDS ADVISORY COMMITTEE (continued) Communes-Based Ora anizations (continued) Elaine Askari Labor and Occupational AIDS Education Project Health Project Director Carol daSilva Martin Luther King, Jr. AIDS Program Coordinator Family Health Center Rev. Suhita Dharma Metta Vihara, A.B.C. Stella Padilla Planned Parenthood .AIDS Program Coodinator Shasta Diablo Richard Lujan United Council of Spanish Executive Director Speaking Organizations Mental Health Hector Rivera-Lopez Mental Health Program, Alcohol, Drug Abuse and Mental Health Division, Contra Costa County Health Services Department Drug Programs Adanna Henry Drug Program Administration, Alcohol, Drug Abuse and Mental Health Division, Contra Costa County Health Services Department (continued on next page) Contra Costa County AIDS ADVISORY COMMITTEE (continued) Religious Organizations Reverend Ronald Swisher Easter Hill Methodist Church and Greater Richmond Interfaith Project Reverend Larry Whitsell Diablo Valley Metropolitan Community Church Reverend Jim Schexnayder Catholic Charities AIDS/HIV Services Director Persons with HIV Infection Robert Fisher Judith Hoffman Greg Martin SACRAMeNTO ADDRESS: COMMITTEES: STATE CAPITOL C Q } � POLICY RESEARCH AND P.O.BOX 942849 jj ,�.j•` MANAGEMENT COMMITTEE SACRAMENTO,CA 94249-0001 / �( (� WAYS AND MEANS TEL AREA CODE 916 � yl-is y y�.y �i r Zgr -sl atur� JOINT LEGISLATIVE 445-7890 u �,`r u 1/�_j BUDGET COMMITTEE DISTRICT OFFICE ❑ JOINT COMMITTEE ON 2901 MAC DONALD AVENUE THE 1992 OUINCENTENNIAL RICHMOND,CALIFORNIA 948G4 ROBERT J. CAMPBELL JOINT COMMITTEE ON TEL AREA CODE 415 ASSEMBLYMAN,ELEVENTH DISTRICT SCHOOL FACILITIES 237-8171 STATE ALLOCATION BOARD DISTRICT OFFICE: ❑ CHAIRMAN 649 MAIN STREET,SUITE 105 WAYS&MEANS SUBCOMMITTEE ON EDUCATION MARTINEZ CAUFORNIA 94553 TEL AREA CODE 415 372-7990 DISTRICT OFFICE ❑ 2010 RAILROAD AVENUE A r i l 2 5 19 9 0 PITTSBURG.CALIFORNIA 94565 P TEL AREA CODE 415 432-0147 Nancy M. Warren Contra Costa AIDS Advisory Committee 1111- Ward Street Martinez, CA 94553 Dear Ms . Warren: Thank you for informing me-of your concern regarding the California Office of AIDS . I appreciate your taking the time to let me know of your views on this subject. I have been assured that the March 11, 1990 , San Francisco Examiner article ' s claim - that the Office of AIDS has not allocated $42 million of AIDS monies - is not true. Nevertheless , I have asked the Department of Health Services for confirmation on this issue. When I receive notification, I will inform you of the news . However, your concern is valid. The problem is not that the Office of AIDS is "sitting" on the monies . All expenditure funds have been committed. The immediate problem is that the Office of AIDS is slow at contracting programs . Hence, the dilatory contract review process makes it appear as if the Office of AIDS has not allocated money to specific programs . I feel the contracting procedure needs improvement. , SB 402 (Watson) is current legislation that responds to your concern. The bill expedites the contract review process and addresses the rolling-over of funds . For your information, I have enclosed a copy of the bill . Finally, you might want to ask the providers of your committee if they have assessed any undue delay with contracting programs . You may also want to share the information you obtain with Assemblywoman Watson and the legislature ' s Health Committees chairperson. Printed on Recycled Paper Hopefully, the material enclosed will help you. In the event you need more information or assistance, please feel free to contact me or Sophia Bucheli of my staff at (916) 445-7890 . Once again, thank you for contacting me. Hearing from you is a great help in more accurately representing my constituents on issues that confront me in the Legislature. I ..hope you will continue to let me know about concerns-:you might have. Sincerel ERT J. CAMPBELL Member of the Assembly RJC:sb Enclosure cc: Kenneth W. Rizer - Director, Department 6f Health Services STATE OF-CALIFORNIA—HEALTH AND WELFARE AGENCY GEORGE DEUKMEJIAN.Governor DEPARTMENT OF HEALTH SERVICES _ 714/744 P STREET e P.O,BOX 942732 SACRAMENTO,CA 94234-7320 (9 16) 323-7415 April 18 , 1990 Ms. Nancy M. Warren Contra Costa County AIDS Advisory Committee 1111 Ward Street Martinez, CA 94553 Dear Ms. Warren: I am writing in response to your letter of April 3 , 1990 Kenneth W. Kizer, M.D. , M.P.H. , Director, California Department of Health Services, regarding the March 11, 1990 article in the San Francisco Examiner. Unfortunately, the reporter of this story was not familiar with a very basic accounting principle - the difference between obligations and unliquidated encumbrances. The 11$42 million stash" represented unliquidated encumbrances. It does seem that the Office of AIDS (OA) has an excessive amount of unliquidated funds; but, keep in mind the majority of funds are awarded to local health jurisdictions who typically invoice at the end of each quarter. Many of these invoices are not received until 45-60 days into the next quarter. Let me give you an example. The OA obligated $558, 920 to Contra Costa County in the areas of alternative testing, block grant, home and community based care, education and counseling in sexually transmitted disease clinics, and education and prevention activities. As of April 10, 1990 the county had not submitted an invoice. These funds represent part of the "stash" . As of December 31, 1989 all but $1. 8 million of the available local assistance funds were fully obligated. The remaining funds are being utilized to continue the AIDS Drug program which would otherwise have to be discontinued by the end of June. As you are aware, state funding for various programs is appropriated and approved by the Governor and Legislature. Given no or limited funding increases for AIDS programs in the past two years, counties, community based organizations, or other funded agencies do not have a guarantee of continued or increased funding. Your subvention plan did indicate an increased need, but it was not possible to provide all of the requested dollars. Enclosed for your information is a funding display for fiscal year 1988-89 and 1989-90 showing the categorical funding areas. We are not anticipating any increase in the upcoming year. Ms. Nancy M. Warren Page 2 April 18, 1990 I hope this information has been helpful to you. If you need any further assistance, please contact Lura Franzella, of my staff, at (916) 323-3740. Sincerely, Michael Hughes Acting Chief Office of AIDS Enclosure cc: Governor' s Office State Capitol Sacramento, CA 95814 Clifford L. Allenby, Secretary Health & Welfare Agency 1600 Ninth Street, Room 450 Sacramento, CA 95814 The Honorable David Roberti Member of the Senate State Capitol, Room 205 Sacramento, CA 95814 The Honorable Daniel E. Boatwright Member of the Senate State Capitol, Room 3086 Sacramento, CA 95814 The Honorable Willie L. Brown, Jr. Member of the Assembly State Capitol, Room 219 Sacramento, CA 95814 The Honorable William P. Baker Member of the Assembly State Capitol, Room 3013 Sacramento, CA 95814 The Honorable Robert J. Campbell Member of the Assembly State Capitol, Room 2163 Sacramento, CA 95814 Ms. Nancy M. Warren Page 3 April 18, 1990 cc: The Honorable Phillip Isenberg Member of the Assembly State Capitol, Room 6005 Sacramento, CA 95814 Supervisor Tom Powers Contra Costa County County -Administrative Building 651 Pine Street Martinez, CA 94553 Supervisor Nancy C. Fanden Contra Costa County Supervisor Robert I. Schroder Contra Costa County Supervisor Sunne Wright McPeak Contra Costa County Supervisor Tom Torlakson Contra Costa County Andrea Aiello Association of• Bay Area Health Officials P. O. Box 2050 Oakland, CA 94604-2050 Mark Finucane, Director Contra Costa County Health Services Department 20 Allen Street Martinez, CA 94553 William B. Walker, M.D. Health Officer/Medical Director Contra Costa County Health Services Department Wendel Brunner, M.D. Director, Public Health Division Contra Costa County Health Services Department 1111 Ward Street Martinez, CA 94553 Ms. Nancy M. Warren Page 4 April 18, 1990 cc: Michael Allerton Regional Health Educational Consultant Kaiser Permanente Medical Center 1950 Franklin Street, 17th Floor Oakland, CA 94612 Chuck Deutschman Drug Program Administration Contra Costa County Health Services Department 595 Center Avenue Martinez, CA 94553 Heather Saunders Estes, Director Planned Parenthood, Shasta-Diablo 1291 Oakland Boulevard .Walnut Creek, CA 94596 Marilyn Griffin Martin Luther King, Jr. Family Health Center 101 Broadway Richmond, CA 94808 Ron Kletter BAART/Cal Detox Program 45 Franklin, Suite 2N San Francisco, CA 94102 Chris Romak Contra Costa County AIDS Task Force 70 Doray Drive Pleasant Hill, CA 94523 Michael Scott Bay Area Urban League 318-11th Street Richmond, CA 94804, Michael Siems Executive Director East County Community Detox Center 500 School Street Pittsburg, CA 94565 CALIFORNIA DEPARTMENT OF HEALTH SERVICES AIDS FUNDING FISCAL YEARS 1988-89 AND 1989-90 (Dollars in Thousands) 1988-89 1989-90 STATE PROGRAM SUPPORT: Office of AIDS $ 5,318 $8,692 Division of Laboratories 1,493 1,493 Environmental Health 429 512 STATE PROGRAM SUPPORT SUBTOTAL $ 7,240 $10,697_ LOCAL ASSISTANCE Information and Education $15,828 $15,828 San Francisco General Hospital 5,700 4,595 Home and Community-Based Pilot Care 6,449 ' 6,449 Alternative Test Sites 5,412 5,412 County Block Grants 5,488 5,488 Confidential Testing 2,400 2,200 Reappropriation of 1987-88 Projected Savings 3,121 0 Epidemiological Studies 1,199 1,199 Pediatric Care for CCS 1,100 1,100 Homeless Shelter 721 721 AIDS Medicaid Waiver 454. 461 Prevention and Follow-Up Centers 1,500 1,500 AZT Treatment 2,500 0 Reappropriation of 1988-89 Projected Savings -2,788 2,788 Early Intervention 0 3,500 Targeted Case Management 0 635 LOCAL ASSISTANCE SUBTOTAL $49,084 $51,876 STATE GENERAL FUND TOTAL $56,324 $62,573 FEDERAL FUNDS TOTAL 14,974 32,000 GRAND TOTAL 1988-89 AND 1989-90 $71,298 $94,573 CHRONOLOGY OF CALIFORNIA'S AIDS FUNDING* Agency 1983-84 11984-85 1985--86 1986-87 1987-88 1988-89 11989-90 Department of Health Services $ 500 $1,040 $7,621 $16,217 $47,830 $71,298 $ 94,573 University of California 2,900 3,094 7,597 9,618 9,857 9,857 9,857 Department of Mental Health 0 0 600 0 700 1,500 1,500 Department of Drug and 0 0 0 0 2,555 11,253 18,422 Alcohol Programs Department of Corrections 0 0 0 622 2,840 3,000 3,868 Youth Authority 0 0 0 0 200 200 200 Department of Social Services 0 0 0 0 0 63 125 TOTAL** $3,400 $4,134 $15,818 $26,457 $63,982 $97,171 $128,545 Dollars in thousands. - State General Fund and Federal Funds. **" $78,967 State General Fund and $49,578 Federal Fund (Special Projects $32,000, Department of Alcohol and Drug Programs$17,122,and Medi-Cal Home and Community-Based Care Waiver$456). 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I A C1 C C i c Gti i '= , i m I •C i -I A 4 +p A I G! !A C. 1 U!C, C I C• W !4 5r u 1 S? f C. ! C, C C. C. r,; 1 r C. .: n 1 00 u I Gd C.C• •, C. I r t i co C, - o 0 0 0 O O O O as 7t'M cast ;>Poo Caunty, Advisary. Cammittee 1111 Ward Street • Martinez, California 94553 (415) 646-1240 Proactive coalition Of public and Private April 3, 1990 HI[/ cure Providers and Kenneth W. Kizer, M. D., vl. P. H., Director comntunin• Department of-Health Services representatives 714 P Street, Room 1253 Sacramento, California 95814 Dear Dr. Kizer: The Contra Costa County AIDS Advisory Committee is deeply concerned about a recent report in the San Francisco Examiner concerning $42 million in unspent funds for AIDS services in the State (attached). As one of the California counties participating in the State-support- ed subvention process for AIDS funding in 1990-91, Contra Costa County has received no funding, increase for education and prevention activities next year. In fact, the County has received no increase for education and prevention activities for the last three consecutive years. Our committee, in order to participate in subvention, recently submitted to the Office of AIDS a plan which enumerates needs in Contra Costa County for education and prevention activities. As indicated in that plan with its accompanying budget, those activities aloTie would cost $1.16 million. We have been notified that our funding for next year for those activities will be $246,792. If the article is accurate or if there is any amount of unspent,. appropriated funds in the Office of AIDS, the Contra Costa County AIDS Advisory Committee urgently requests your immediate consideration of a funding increase for Contra Costa which will allow agencies in our county to begin to meet the critical needs for services in our communities. a The AIDS crisis affords no one the hucury of slow, overly cautious decision- making. Funds are urgently needed to save lives. Sincerely, Nancy M. Warren Staff to the Contra Costa County AIDS Advisory Committee Members of the Committee: Elaine Askari Richard Lujan Labor & Occupational Health Project United Council of Spanish Speaking University of California Organizations Carol daSilva Stella Padilla Martin Luther King, Jr. Family Health Planned Parenthood Shasta-Diablo Center Richard Reidy Reverend Suhita Dharma Contra Costa County AIDS Task Force Metta Vihara Residential AIDS Shelter Hector Rivera-Lopez Robert Fisher Contra Costa Co. Health Services Dept., Mental Health Reverend Robert Freitas Diablo Valley AIDS Center Kent Sack, M. D. Adanna Henry Dolores Sanchez, Ph. D. Sojourne Community Counseling Center, Familias Unidas Contra Costa Co. Health Services Dept. Peggy Sargent Judith Hoffman East County Community Detox Center A. C. Hollister, M. D. Reverend Jim Schexnayder AIDS Community Network Catholic Charities Center Alan Johnson, M. S. W. Emmett Velten, Ph.D. Kaiser Permanente Medical Centers BAART/Cal Detox Programs Rusty Keilch Reverend Larry Whitsell AIDS Program Contra Costa County Metropolitan Community Church Tina Young Bay Area Urban League 3 cc: Clifford Allenby, .Secretary, Health & Welfare Agency Governor George Deukmejian Senator David Roberti Assemblyman Willie Brown Michael Hughes, Acting Chief, Office of AIDS Senator Dan Boatwright Assemblyman William P. Baker Assemblyman Robert J. Campbell Assemblyman Phil Isenberg Supervisor Tom Powers Supervisor Nancy C. Fanden Supervisor Robert I. Schroder Supervisor Sunne Wright McPeak Supervisor Tom Torlakson Andrea Aiello, Association of Bay Area Health Officials Mark Finucane, Director, Contra Costa County Health Services Department William B. Walker, M. D., Health Officer/Medical Director, Contra Costa County Health Services Department Wendel Brunner, M. D., Director, Public Health Division, Contra Costa County Health Services Department Michael Allerton, Kaiser Permanente Chuck Deutschman, Drug Program Administration, Contra Costa County Health Services Department Heather Saunders Estes, Planned Parenthood, Shasta-Diablo Marilyn Griffin, Martin Luther King, Jr., Family Health Center Ron Kletter, BAART/Cal Detox Program Chris Romak, Contra Costa County AIDS Task Force Michael Scott, Bay Area Urban League Michael Siems, East County Community Detox Center -a CcunttAIDS Pr=Sraam C lira C.:st ": -%URC= CF C11-JIT-Pl-�G San Francisco Examiner. Pace A-1-1- ID A71 CFLZ `_:unday. March 1! !o'c N4 jA X"A AE CF T 2 During the araly-st'S eEbm -3 to 'o Rand Man; a 'lobby�ist card;n. deta=ine now the off_:c2pianned for an association of AIDS service a to stendI its money,employees were ago�c es. MA 31 :3 ordered not to talk to the anaiisr or He said. "It was longtime bu- the governor's Depar:=ent of Fi- reauc=Ls doing what longtime bu- narce wit.hout the'e%_ec-_-r.-;e di�1 _ n tors reauc:a-s do." mr3 approva.L. ..e executive d2r?c:0r, a hi;HiY -egar-_4ed career adr-ninistra- Cam i-In to &c3 tor li=d ---en after programs are ap- Z:ree years ago, is au E p-rove-a. =ours L­,quently -ac-- big i,- 0 1.L Sass 017 t4nq,leaving he agency"ea(He--'ess. =1 a k '-*a' con Zacts Zen,;n,, ti rate or ernwovee turn-. I he agency th -" .ICV . State a,--e C =,7 staff—40 stamembers --ave left =uZL, in the last 15 months — has made A i:ud-. conducted by the Cali- ByTupper Huil hard for locai agencies to know - -ence of Local Health it f6mia Co- SACPAM&4TC 8UREAU 'on of Bay whom to call when problemsarise. OfaAssociation and the Associa Ares 1-1--alth OfEcialis found that SACRA.-VM-.iTo—C,,�r_-.ias, C',Zca of A=S,the showcase Vv `;hey are all nice peopiey the Office of AEDS "has tremen- c:., for dealing witli the crisis, is "Our bi—st z)roblem is the ob- does pmblenis moving its multi- on a huge pile of stt-u-ctionist way they conduct dis- tude or contracts through the =_­Lzaa or=3cursirg,it to r-:12 ngenr cn=sions about these programs," stata'i iystem." cies z:.atba(ily need it. szd Linda Udail_assist-ant director 7-e study said a typical ccontract Acc-.rd .zt0 state wcrkars. leg- of --e Sazi L=_ncisco A.- S Office,' OFEce of AIMtS can be as isiazcrs aIci--'--cse an the:'.-,-nt ;-es WA-h is to get S2.3 =illion from on- vat-es and can take six,to of the.=_='S .var,the agenc-1:s slow i!:e this e!z�-r :=omhs to ccrz_pieta. and excessively bureauc.-atdc in In a recent:,er)o M. 'o t..e Legisla- -aid J John�ilacen.president of a I 'He .-stative anaivst dealingwitli the fast-moving prob- Los Angeles-basea'hospice pro. ieg; noted. lens it is charged with handling� that midway through 4_-':e budget gram: ''Iney are all nice people. "I think they've been over- But nobody-in that office wants to year, the Office of AMS was still whe—l-ed by the task,"said Asaem- cut through the crap." bl,,rman John NLI Burton,D-San Fisc- is president of Home.;" re-viewing contzactts for early-inter- cisco,referring to the 143 men and stead Hospice and Sheiter, which vention projects. women who work in the OT= of offers 10 beds for terminally ill Njeantime, say's the state con- AMS. Like state bureaucrats in AIDS patients at three homefiW` troller' office, as of Feb. 28 the w s other branches of government, be facilities.' The organization has Office of AIDS had in the bank said,their first instinct is cautiow "They think discretion is the been unable to get a license from*. more than$42 million of the S-50.5 the Office of AIDS that would allow. million it received July 1, 1989. better part of valor.But in a iitdi.. it to apply for state money. Ancl' Thelma Fraziear, the outgoing tion of this magnitude, you =iiht because the state won't license it, -thief of the Office of AIDS,strong- be better off erring on the side.or Homestead is losing the money it too valor." ly denied that her office moves gets from-Los Angeles County. now slowly.And she questioned the ac- The problems include: roblem isn't resolved' If the- ' , 9 Although given$50 mMoiibi p _ curacy of the controller*s figures. "If I've spent only S8 .million, the Legislature for local AWS isaid, Homestead w-jlj- then I have a problem,"she said. agencies last July, the Offifce:6.ts soon, Macen ....... AS has disbursed only $8 mbe forced to close.il--.. Last year, state lawmakers No claims for months at a tlme._... lion. That means three4ourths6f' passed a measure allocating money the way through its budget year,- for early-intervention programs, Fraziear said her office has ap- proved contracts worth$35 million the office has spent only 16 percent The money was intended to pro'-" so far this year. She said large or of its money. vide full-r' anae services to people� d city and =I anizacions, an county The office refL ,sed to give any who tested positive for HIV,which' a agenaes that receive much of the information-to the legislative ana- causes AIDS. lyst's office.doing its annual Inde- money, often submit no claims for pa,,=e.nts for months at a time. pendent'analysis of the governor's Months later, the staff at the Office of AIDS produced a man`d-al. Most likely, said Fraziear, the proposed 1990-91 speriding,plan.It of how these programs were to bi smailler, independent AIDS seen since delivered some of the in- of docurnenr 3 inches thick cies that relv on state funding to formation- ra requested. and near.:impossible to di-est,a survive are the ones that have go t- ten the .38 million already spent. 4fanv of -He =are people who MDS agencies would welcome' criticize F raz;ear'3 office also de- such a move.Their representatives fend per effor-s to L--iiect a sense of say San Francisco's response to the urgency into t e worit. Thev say AIDS epidemic has been superior Fraziear, who has worked in the to the state's response. state's Denar.^ent of Family Plan- Bruce Decker was chairman of nirg and the :Medi-Cal program, Gov, Deu.kmeiian's AIDS Task improved thin-as during her tenure. Force-when Fr='ear was hired in Fraziear conceded that the job - 1987.He remembers that the great- was not complete, and said: ".You est chailextge the office faced then have people here who are accus- was what to do with the ocean of toured to following tre mandates of money from the Legislature: the law. I have no problem with "The bureaucracy is not set up that. (But) I t:- to to tel them they to handle growth," he said. "The bureaucracy's role in government is are consultants. T`zay need to be to preserve itseif ,nom Cuts." flexible." But between 1983 and 1989, the Fraziear said she doesn't know state's AIDS bureaucracy found it- who will = the oi=cr when she self awash in monev. In that ti=e leaves at the end of the month to its budget grew from 5500,000 td begin wor%:_-:or stat2 Sen.Diane S94 million.Decker said the o owth Watson,D-T os Angeles. in money produced tremendous But sre and others in the de- strains on the office's staff. partment say there are rumors her Decker says California still has' successor will be Georg Rather- the best MDS response program in ford, who resigned last month as the world_"Yes..there are problems direcF.,or of San Francisco's AIDS and bottlenecks. It ain't perfect. Ot:tce to take over the state's infec- Buz it's a hell of a lot better than tious disease programs - anY_Lh3ng anyccay else hm got-' AGENCIES R£CEMNO FUNDS QOM OFFICE OF AIDS Following are the agencies and/or projects in San Francisco,both public and private. that receive money for AIDS programs from the state Cffice of AIDS,San Francisco agencies and projects receive a total of$4 million in state AIDS money out of a total statewide budget of$50.5 million. Figures are for the 1989-90 fiscal year. :: Local Assistance Efcck Grant Program-. Prevention and Education = City and County of San Francisco W20,7X- Asian American Recovery $90,COO Alternative Test Sites Cal Pep/Prostitutes $140,000 City and County of San Francisco $b42,548 Cal College of Podiatric Medicine. 540,000 Haight Ashbury Free Clinic $85,000 Residential AIDS shelters Instituto Familia de la Raza S85:a00 City and County of San Francisco ,• $110,808 Multi-cultural Resource Canter .$3151000 Home- and Community-Based Care San Francisco Aids Foundation $212,800. City and County of San Francisco _ $628,391 City and County of San Francisco $710,000 Westside Community Mental Health Clinic $350,748 . Curtis Jones—Robert Ross Community Center $85,000