San Francisco Chronicle (SF) - FRIDAY, December 2, 1994 Edition: FINAL Section: News Page: A22 Word Count: 489
Sabin Russell, Chronicle Staff Writer

Appointed by the Board of Supervisors and Mayor Frank Jordan, the joint committe workd for a year to draw up a blueprint for the city's response to a second decade of the epidemic, which in San Francisco alone has now claimed more than 11,000 lives.

According to the report, the city's sprawling network of 80 AIDS service organizations will have to pool resources, collaborate on programs and share patient information to maintain the level of care first developed largely by San Francisco's gay community when the disease appeared 13 years ago.

"We need to build a consensus on where consolidation makes sense. . . . We cannot compete against one another," warned Dr. Sandra Hernandez, director of the Department of Public Health and chairwoman of the task force.

A significant consolidation of AIDS service programs is already under way. For example, 13 programs to reach patients on the streets have been combined into a single program, Street Outreach Services.

The report observed that people infected with HIV are living longer and tend to be poorer than the largely gay and white males first struck with the disease in the early 1980s. As the epidemic moves from the upscale gay Castro district to the rough streets of the Tenderloin, new approaches to treatment and prevention are needed.

Among the 40 recommendations are calls for more aggressive attempts to bring treatment and prevention programs to blacks, Latinos and women -- groups left out of mainstream AIDS program tailored to gay men. Many of the ideas endorsed by the blue-ribbon panel have been suggested in the past, and the report is largely a reaffirmation of ideas long advocated by the community of AIDS patients and their service providers. The most significant recommendations call on the city to develop a web of AIDS services, so a patient seeking medical care, for example, can quickly be referred to housing services as well.

City Office of AIDS director Dr. Mitch Katz calls the idea "a system of citywide case management" that could avoid duplication of tasks and reduce confusion for needy patients. Case managers collect information about patients' needs and guide them to appropriate services.

"Some people today have three case managers, some people have none," said Katz. For years, various AIDS service agencies have rejected the notion of sharing information on patients, both to protect their turf and out of concerns about keeping records confidential.

But the task force report, drawn up largely by representatives of these same agencies, shows that a new consensus is building. "People have talked about doing this for a long time, but this is the first time anyone has said as policy that this is what we should do," said Katz.

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