November 21, 2018 at 9:44 am PST | by Christopher Kane
Future of STD testing and treatment by the Los Angeles LGBT Center uncertain

Board Supervisor Sheila Kuehl on Nov. 20 (screen grab from BOS live stream)

The Los Angeles County Board of Supervisors unanimously passed a motion on Nov. 20 to approve the allocation of emergency reserve funds for organizations, including the Los Angeles LGBT Center, for public health initiatives like STD testing and treatment.

The motion, introduced by Supervisors Sheila Kuehl and Mark Ridley-Thomas, will add $5 million for public health programs, along with $1 million in grant funding for clients with substance abuse disorders, over a period of two years. Pending the Health Department’s decisions concerning the allocation of those funds, the Center might be able to maintain levels of service for programs that were threatened, according to reports, by the organization’s dispute with Los Angeles County over funding for existing contracts.

In the last fiscal year, STD programming cost the Center $1.5 million, which was covered by reserve funds and other sources including contracts with LA County—which has supplied a consistent, flat level of funding to the organization, including in this case. High demand for testing and treatment, however, has depleted available money from contracts with the County.

Requests for funding increases from the County were turned down, to the surprise of the Center’s Chief of Staff, Darrel Cummings. He told the Los Angeles Bladethe organization was forced to draw funds from other programs—like meal services for seniors and housing services for youth experiencing homelessness—to cover the costs: “Every service we provide is impacted by our having to redirect funds from one place to another.” 

The Board’s motion for emergency funding was introduced just as the Center was prepared to announce cuts in free STD testing and treatment, following the discovery of an internal email from the Center’s Chief of Staff, Darrel Cummings, which was printed in WEHOville.

LA County Supervisor Sheila Kuehl, author of the Board motion, told the Los Angeles Blade: “Local, state and federal governments have not been adequately investing in STD prevention. Funding has not kept up with the need and rising costs. Today the County voted to utilize our reserves to help The LGBT Center and other important community providers prevent STD infection, and we will do everything we can to find ways to invest even more money in preventing STD infection. We will continue to work with our local providers to advocate ever more effectively.”

Budgetary constraints have tightened amid a spike in STD rates nationwide, which has hit LA County especially hard. New gonorrhea cases nearly doubled from 2016 to 2017 among men who have sex with men (MSM), according to nationwide statistics from the Centers for Disease Control and Prevention (CDC).

Officials shared the latest data documenting the number of diagnoses in the County between Jan. and August 2018. They found 5,337 cases of syphilis, 30 cases of congenital syphilis, and 16,654 cases of gonorrhea.

If the emergency motion was not introduced by the LA County Board of Supervisors and the Center was forced to comply with funding limits set by existing contracts, Cummings explained that the organization would have to cut STD testing/treatment services by 50 percent.

“Epidemiologists here calculate, in a very conservative fashion, what that would look like in one year,” Cummings said. “It would mean 8,000 people with undiagnosed gonorrhea. That would obviously be contributing to what is already a crisis.”

Cummings said public health officials must redouble efforts to fund testing and treatment programs—including those performed by the Center—but instead feels the County voiced appreciation for the organization’s programs while ignoring their efficacy.

“We’re diagnosing 22 percent of all syphilis cases in Los Angeles County,” Cummings said. “And the County has 14 of their own facilities—none of which are targeting the LGBT community. And [the County] doesn’t have to hold bake sales to keep their operations open. They’re fully funded no matter how effective or not they are.”

The Center’s cultural competency respective to the LGBT community is in large part responsible for the rise in the number of patients whom the organization is testing and treating for STDs. LGBT Californians are disproportionately affected by the STD crisis while the number of diagnosed cases in the state has reached record highs for the third consecutive year. Michael Fraser, Ph.D., executive director of the Association of State and Territorial Health Officials (ASTHO), explained that local and community-based providers are often better trained to meet the needs of at-risk populations. For example, “The techniques you might use in the MSM community are really different from what you might use with pregnant women,” he explained.

The need to address public health challenges among underserved communities was addressed in the Board of Supervisors’ vote—which moved to, among other tasks, “Instruct the Director of the Department of Public Health to develop and release a solicitation within 45 days to support the delivery of STD screening and treatment services specifically targeting underserved geographic areas and sub-populations of the County.”

Cummings emphasized that the Center has historically worked well with the County on public health issues. “Even though I’ve been pretty angry with the County because of their lethargic response to this issue,” Cummings told the LA Blade, “that exists in the context of—generally speaking, over decades—having very good relationships with public health officials in Los Angeles and elected officials who care a great deal about these matters.”

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