flos Anacles Times A Times Mirror Newspaper fAGE | COLUMN ONE AIDS Adds to Ranks of Homeless = Two of the nation’s most intractable ills are converging. Long waits for — shelters compound the problem. By SHAWN HUBLER and VICTOR F. ZONANA TIMES STAFF WRITERS There is a man with AIDS who sleeps each night in an abandoned garage in Hawthorne. There is another who bunks at a Skid Row hotel—when he doesn’t squander his disability check on crack. There is still another who lived — for months in his car before social workers managed to squeeze him into a halfway house. And three more who were turned away from a Venice mission when workers learned that the three were infect- ed with the virus. As these sad cases illustrate, two of the nation’s most intractable ills—AIDS and homelessness—are converging. Too well to be admit- ted to hospitals or qualify for disability insurance but too sick to hang onto their jobs and apart- ments, a growing number of AIDS patients are being thrust into pov- erty at the same time that the virus continues its deadly march into the ranks of the already poor. By the thousands, they are end- ing up on the street, or in filthy, crime-ridden shelters. Only a lucky few make it into decent shelters or the all-too-scarce beds in group homes for people with AIDS. While accurate figures are hard to come by—AIDS patients drift in and out of health and homeless- ness—knowledgeablie officials esti- mate that homeless people with AIDS number in the tens of thou- sands. ‘ : “Whatever the numbers, the fact is that we are doing distress- ingly little for these people, and the Situation is worsening,” said Dr. @ NATIONAL AIDS PLAN Bipartisan panel recommends Cabinet-level task force to deal with disease. Al5 David Rogers, vice chairman of the National Commission on AIDS. “It is a national scandal.” The commission on Tuesday is- : sued its second report to President Bush, recommending that the fed- eral government create a cabinet- level task force to coordinate the national response to the epidemic. It also urged Bush to endorse a $600-million “disaster relief” bill that vould, among other things, - provide housing assistance to heavily impacted communities. “In New York City alone, there are 8,000 to 10,000 homeless people living with AIDS,” Virginia Shub- ert, AIDS project director of the National Coalition for the Home- _. less, told'a congressional panel last ‘month. AIDS patients are “the fastest growing segment of the homeless population in New York,” added Peter P. Smith, president of the Partnership for the Homeless. - In Los Angeles County, case- workers at Minority AIDS Project and AIDS Project Los Angeles (APLA) estimate that between 10% and 20% of their clients need housing assistance—a figure they say is climbing as the virus spreads among intravenous drug users and | the poor. “It’s appalling,” said Pam An- — _ derson, who manages residential ‘services for APLA. “People are dying in the streets.” ut the crisis isn’t limited to New York, Los Angeles and other hot spots of the epidemic. In Richmond, Va., 12% of the patients at a clinic for the homeless were found to be infected with the virus. In Birmingham, Ala. “Dolly,” a 27-year-old former nursing stu- dent, has bounced from hospital to shelter to the streets since she was. | diagnosed with AIDS in March. . Members of the National Com- mission on AIDS got a harrowing - look at the crisis last February in New York when they visited a Bowery flophouse and subway sta- . tions and crannies filled with homeless people. They also toured the Ft. Washington armory- turned-homeless shelter. The ar- mory houses 860 men, perhaps half of them infected with HIV. pert os “It was a living hell,” recalled commission member Larry Kes- sler, executive director of AIDS Action Committee of Massachu- setts. “A lot of the men at the shelter were coughing. Others were emaciated or had lesions. Some were demented, ranting and raving; others were stooped and shuffling due to neurological com- plications.” From a balcony above the ar- mory floor, Kessler gazed down upon row after row of beds. For this weary veteran of the war against AIDS, the sight evoked a ‘different rectangular grid symbol- izing the plague. “For a moment, I thought I was looking at the AIDS quilt,” he said, referring to the ever-growing Names Project quilt whose panels memorialize more than 10,000 indi- viduals who have died. As the visits made clear, the AIDS homeless pose a serious chal- lenge to overtaxed networks of social services that until now have dealt with AIDS and homelessness as separate problems. In an attempt to integrate the ‘federal response to AIDS and homelessness, a bill currently be- fore Congress would define people _ with AIDS as “handicapped” —and thus eligible for assistance under existing federal housing programs. Many of the federal housing assistance programs that currently deny help to people with AIDS were created under the McKinney Act. It is one of the crueler ironies of the epidemic that the act’s author, Rep. Stewart B. McKinney (R.-Conn.), died of AIDS in May, 1987, “Housing has been a problem since the beginning of the epidem- ic, but we’re seeing an escalation of need because there has been an increase in diagnosed cases and because people are living longer,” said Anne Lewis, spokeswoman for the National AIDS Network. in Washington. eople with AIDS now live an average of 22 months after diagnosis, compared to 10 months in 1983. But the infections, cancers and neurological complications that characterize advanced AIDS can rob even relatively well-off patients of their savings and their ability to remain productive and independent. — <¥? i , . A16 WEDNESDAY, APRIL 25, 1990 “~ EPIDEMIC: AIDS Taxes Agencies as It Swells Ranks of the Homeless Consider Allan Turner, a 43- year-old AIDS patient who lost his Hollywood apartment in August because his $600 monthly disability check was too small to cover the - $702-a-month rent. Caught up ina legal dispute with his landlady and desperately short of cash, Turner | found himself on the street. Two bouts of pneumocystis cari- nii pneumonia—one of the oppor- tunistic infections associated with AIDS—had long since rendered Turner incapable of holding a full- time job. Still, he said, he refused to take a room at a hospice “because I felt hospices were places where you went to die.” He slept for a while on a neigh- bor’s couch, until the neighbor was evicted too. For most of the four months it took for Turner to work his way through the APLA waiting lists and into a Lawndale shelter, he lived, he said—and social work- ers confirm—in the front seat of his 15-year-old Fiat convertible. “Do you know the feeling you get in an earthquake? Totally help- less? Well, that’s how I felt,” — “Whatever the numbers, the fact is that we are doing distressingly little for these people, and the situation is worsening. It is a national scandal.’ DR. DAVID ROGERS National Commission on AIDS oe Turner said. “You're totally dis- lodged from everything familiar to you. ... The night before Thanksgiving, I slept in my car. When I woke up, I could see people Starting their turkeys in their kitchens, and I started to cry.” Yet Turner is among the fortu- nate. Another man with AIDS, a military veteran who has spent the last six months sleeping on the floor of an abandoned garage near Inglewood Avenue and 120th Street, remains on the waiting list to enter the five-bed shelter where — Turner now lives. At work in the housing crisis are a number of factors, social workers. say, beginning with the official definition of AIDS. Social Security _ disability insurance, the major fed- . eral safety net for people with ._ AIDS, is generally limited to people whose disabling symptoms fit the official definition of full-blown AIDS established by the U.S. Cen- ters for Disease Control. The problem, social workers say, is that the definition covers only people whose systems have suc- cumbed to certain opportunistic infections that, because of early medical intervention against HIV, have in recent years become less prevaient. People who are sick but have not yet crossed the threshold of an official AIDS diag:iosis “can end up _ waiting six months or more to access public moneys,” said An- derson of APLA. Yet such people can be extreme- ly debilitated, “going through. the fatigue, the ups and downs in their health—all the things that pre- clude a person from holding down a full-time job,” she said. here are alternatives, Ander- son and others say, but they are limited. In Los Angeles, Aid for AIDS, a 7-year-old organization financed by private charitable con- tributions, offers grants of up to $2,000 to people with AIDS who earn less than $700 a month. Some people turn to relatives and friends, but those sources of help often have limits. “It’s an extreme burden for a roommate. You play caretaker an awful lot,” said Paul Self, executive director of Aid for AIDS. “Often the person with AIDS needs home health care or special treatment, and the stress can be so great that the other person may not want to deal with it.” Nor are families always emo- tionally equipped to cope with the ravages of AIDS. oo “My family doesn’t know about AIDS. All they know is that it’s a very dangerous and contagious disease,” said “Terry,” a soft-spo- ken, 34-year-old transvestite whose Mexican immigrant family refuses to touch him for fear of _ contracting the virus. “T’ve always wanted to be close to my family, but I guess it just isn’t to be,” he said quietly. “My sister came to see me {in a long-term AIDS residential shelter} last week, and she seemed to feel sorry for me, but I didn’t try to Rug or kiss her. I didn’t want her to push me away.” Joyce Carnes, senior social worker at the AIDS clinic at Los Angeles County-USC Medical Center, said it’s not uncommon for AIDS patients to go home to stay with their families only to be asked after a few months to leave. One man on Carnes’ caseload, a 20-year-old from East Los Angel- es, was allowed by his mother to come home after being discharged . from the hospital, but only as long as he agreed to sleep in the garage and avoid touching,anyone or any- thing around the house. For those who fall through the cracks, including a growing num- ber of AIDS patients who were on the streets to: begin with, the missions and shelters are the last resort. But those, too, are unpre- pared to house people with AIDS and HIV infection, said Marjorie Sa’adah, coordinator of AIDS edu- cation for the Los Angeles Home- less Health Care Project. Last fall, for example, three men — were turned away from the Bible Tabernacle shelter in Venice after they indicated on medical forms that they had been diagnosed with AIDS. Mona Iwanski, a supervisor at the shelter, said the three were driven to Harbor-UCLA Medical Center after two of the men said they needed to see a doctor. ar) A 66 V / e have to be very careful when anybody comes in, because we don’t have the facilities to really separate anyone who has AIDS,” she said. , Missions also present health problems, Sa’adah said. They are rife with bacteria and contagious diseases to which people with AIDS are easy prey. Pneumonia, tuberculosis, scabies and flu are rampant. People sleep dozens—in some cases, hundreds—to a room. Many shelters close during the day, forcing their HIV-infected resi- dents to cope on the street with fevers, exhaustion and chronic di- arrhea. “Peopie at the missions don’t cover their mouths when they cough,” complained a 34-year-old homeless man who learned he was infected with HIV five years ago when he tried to sell his plasma. ; “There's bedbugs all over the place. I carry my own spoon with me, sterilize it with hot water because I believe them plastic LOS ANGELES TIMES _ spoons attract germs.” The man, a Skid Row crack addict, said ne has made more of an .effort recently to use his monthly disability check for a hotel room before he buys cocaine. But he still misses most of his appointments at the County-USC AIDS clinic. _ “Every time I have an appoint- ment, it’s check day,” said the man, an ex-convict who spoke slowly around a mouthful of infected gums. Sitting alone in a $268-a- month, fly-infested hotel room, he alternately dealt himself elaborate games of solitaire and fingered the swollen knots on each side of his neck. “I say I’m going to go down to ‘the clinic, but I wind up getting high,” he said. “Last time my check came, I got mea room, then I got mea little strawberry {a prosti- tute], and then I: got me some cocaine.” | The time for his doctor's ap- pointment came and went, he said, while he and the prostitute had sexual intercourse— without a con- dom and without her knowing that he had tested positive for HIV. When the cocaine ran out, he said, he turned for solace to his Gideon Bible. : “I figure,” he said, “if I live righteously with disease, I won't face eternal damnation when | die,” Social workers point to people like that man when they say it is no simple matter to care for the . homeless who have AIDS. As if the epidemic itself weren’t serious enough, AIDS caseworkers in- creasingly are being asked to help patients cope with such deep-seat- ed problems as drug addiction, mental illness and chronic home- lessness. . , , HARRY CHASE / Los Angeles Times AIDS sufferer Allan Turner lived in his car nearly four months before a bed in a shelter opened up. In some situations, homeless AIDS patients have managed to cadge a bed in a hospice by per- _ suading their doctor to sign a .. prognosis giving them six months orlesstolive. . oo } Michael Weinstein, head of the AIDS Hospice Foundation, esti- ~ mated that a quarter of the people who have come to the Chris Brownlie Hospice since it opened near Elysian Park in 1988 have been referred that way. _ Meanwhile, as the epidemic wid- ens, social workers predict the shortage of appropriate housing will only get worse. “We're going to have to provide shelter to thousands of people with HIV infection over the next five years,” said Dave Johnson, AIDS coordinator for the city of Los Angeles. “And we're going to have to get ready for that.”