Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
San Francisco Chronicle; Wednesday, August 14, 1991
Sabin Russell, Chronicle Staff Writer
While Department of Public Health Director Raymond Baxter and other city AIDS experts welcome the broadened definition of the disease, they concede that it is creating bureaucratic headaches and uncertainties over how much money will be available for newly qualified AIDS patients.
Although the broader definition is expected to add 4,000 new AIDS patients to San Francisco's rolls when it takes effect in January, the city plans to stick with its own, stricter, rules to determine who qualifies for such city support services as residential care.
The city's standard is that a person be infected with human immunodeficiency virus and have a "disabling illness." Although that definition is much broader than the current federal definition of AIDS, it is more restrictive than the forthcoming one.
City officials are concerned over the financial effect of the change. In 1990, San Francisco collected $12.8 million in emergency AIDS funds through the Ryan White CARE Act, a bill named after the Indiana teenager who succumbed to the disease in 1990.
But the new AIDS definition, expected to double or triple the official AIDS caseload, will also boost to 29 from 16 the number of cities eligible for that money.
Dr. Sandra Hernandez, director of the San Francisco Office of AIDS, said that the city could lose about $3 million in Ryan White money in 1993, the year the new definition would alter the fiscal formula. "Three million dollars represents a tremendous amount of services," she said.
San Francisco currently is spending about $60 million in city, state and federal money to battle the epidemic. AIDS has killed 7,500 city residents since 1980 and threatens the lives of 24,000 others who are infected with HIV.
Under the new rules, a person infected with HIV whose measure of infection-fighting T-cells in the blood falls below 200 will be considered to have AIDS. Currently, an AIDS diagnosis is based on HIV infection and the presence of a so-called "opportunistic infection."
In the long run, city officials believe San Francisco will benefit financially from the new definition if it allows more of its citizens to qualify for Medicare and MediCal coverage.
Nationwide, the new definition is expected to add 150,000 to 200,000 people to the ranks of those said to be living with AIDS.
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