SAN FRANCISCO CHRONICLE (SF) - MONDAY September 26, 1988 Edition: FINAL Section: NEWS Page: A3 Word Count: 592
Lori Olszewski, Chronicle Staff Writer

"The staff is stretched to capacity," said Dr. Ken Dunnigan, health officer for Health Center One.

The center, operated by the San Francisco Department of Public Health on 17th Street between Noe and Sanchez streets, is in one of the neighborhoods hit heaviest by the epidemic of acquired immune deficiency syndrome.

The center provides outpatient, primary care for between 500 to 600 people infected with the HIV virus - the human immunodeficiency virus that causes AIDS.

The patients vary from people who test positive for AIDS antibodies but who still have no symptoms to those with full-blown AIDS and its many complications.

Many of the people served by the publicly financed clinic have no private health insurance, but they do not qualify for Medicaid, Dunnigan said. That puts them in an uninsured population that often has trouble finding private physicians who will accept them.

Dunnigan said he especially is concerned about the effect of his decision on infected people without symptoms - the group often called the "worried well" and known medically as asymptomatic seropositives.

There is increasing evidence that early intervention is advisable for people who test positive, but there are limited resources for that group, especially for people without insurance.

"The strain at Health Center One is symbolic of a much larger problem," Dunnigan said. "This cannot be entirely a city responsibility. The private sector must be willing to absorb more of that care."

"I think we need to be moving faster as a city to develop a plan," Dunnigan said.

David Werdegar, director of the San Francisco Department of Public Health, said he will schedule a meeting to discuss alternatives to the Castro center, such as developing AIDS services at the city's health center in the Sunset neighborhood.

"It never helps to cry wolf before you have all the facts," Werdegar said. "We need to examine capacity throughout the system."

The development at Health Center One comes on the heels of news that the city's plan to take over the U.S. Public Health Service Hospital in the Richmond district is uncertain. Less federal money than expected has been committed to the project. Outpatient clinics for people infected with the AIDS virus were among the services planned at the Public Health Service Hospital.

Another problem is that as the AIDS epidemic progresses, people who had mild or no symptoms a few years ago are becoming sicker, Dunnigan said.

That means it takes the same number of physicians and health care workers longer to treat a sicker and growing group of patients.

"We used to be able to see 40 patients during a four-hour, drop-in period, and now we can only serve 23 patients during the same time," Dunnigan said.

San Francisco General Hospital's Ward 86 outpatient clinic also serves a large number of uninsured people infected with the AIDS virus, but it too is feeling the strain of increased numbers and sicker patients.

"The bottom line is that we discourage asymptomatic seropositives from coming here," said J. B. Molaghan, acting head nurse at General's Ward 86, which serves 1,800 patients a month. In 1985, Ward 86 had about 300 patients.

People who have tested positive but who have no symptoms may have to wait six to eight weeks for a screening appointment at General's Ward 86, Molaghan said.

Always watch for outdated information. This article first appeared in 1988. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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