A nonprofit group that delivers services to people with HIV and AIDS wants voters to force the city of Los Angeles to create its own health department, separate from the county.
The AIDS Healthcare Foundation, a longtime critic of the county's health bureaucracy, wants the city to operate its own health agency rather than rely on the Los Angeles County Department of Public Health. The foundation has begun gathering signatures for a 2014 city ballot measure to do just that.
The county department is too big and does an abysmal job of disease control, foundation President Michael Weinstein said. A smaller, city-run agency would be more effective and accountable, said Weinstein, whose foundation won passage last year of a ballot measure requiring actors to wear condoms during shooting of pornographic movies.
City and county officials warn the proposal could reduce public health services for L.A. residents. City Administrative Officer Miguel Santana said the city simply doesn't have the money, facilities or expertise to enforce public health laws.
"It would be very difficult, if not impossible, for the city to get in the business of healthcare," said Santana, who noted that lawmakers are already struggling to maintain police, fire and other essential services in the face of looming budget deficits. "The city is simply not in a position to take this on."
The city disbanded its health department in the 1960s. The county Department of Public Health works to reduce chronic illnesses, avoid infectious disease outbreaks and maintain the safety of food and water in the city and county. The agency is also in charge of emergency preparedness for the county's 10 million residents.
Weinstein said a city department could be paid for by grants and fees. Currently, he said, "the money that would be going to the City of Los Angeles is being diverted to subsidize a bloated bureaucracy and wealthier cities."
County health department Director Jonathan Fielding said officials are studying the ballot proposal. "We are concerned that it could result in duplication of services and reduction of public health protection for L.A. city residents," he said in a statement.
The AIDS Healthcare Foundation is a longtime contractor with the county, but tensions between the entities have grown in recent years. Last fall, the county issued an audit criticizing the way the foundation tracked expenditures and said it overbilled the county by $1.7 million.
The foundation responded by filing a whistle-blower lawsuit alleging the county misused resources, wasted public funds and fabricated the audit. It took out ads in local newspapers that said, "LA County is a Danger to Your Health."
Fielding said Friday that the health department "rejects the false characterizations" made by the foundation.
The conflict may come down to differing priorities, said UCLA Medical School professor Jeffrey Klausner. He said the AIDS group has been focused on condom use in adult film production, while the county public health department has much broader concerns.
"When folks don't align with their goals, they seek every which way they can to achieve their aim," Klausner said.
A city health department would presumably enforce the condom requirement within its borders. The City Council adopted a regulation last year, before the countywide vote, requiring condoms on porn shoots within the city's borders.
Klausner said the proposal for a city health department is worth considering.
"Often we do see more success in public health areas when we can focus more locally," said Klausner, the former deputy health officer for the San Francisco Department of Public Health.
Four California cities — Long Beach, Berkeley, Pasadena and Vernon — have their own public health departments.
Michael Johnson, support services manager with the health department in Long Beach, said the department works closely with its residents and other city agencies to determine which programs to prioritize. "We are very connected to our local community," he said.
But, he said, creating a new department in Los Angeles would be a "significant undertaking."
kate.linthicum@latimes.com
anna.gorman@latimes.com
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