HMO giant, insurer become trailblazers.

Kaiser Permanente, Transamerica Life in lonely lead

Although many Los Angeles area companies have ignored AIDS as a corporate issue, two local firms -- Kaiser Permanente and Transamerica Occidental Life Insurance Co. -- have led the way in sensitive and responsible treatment of the disease, according to AIDS activists.

San Francisco-based companies, such as Levi Strauss, Wells Fargo and BankAmerica Corp., were among the first companies to respond to the issue by developing policies and practices to deal with AIDS in the workplace, and all those firms are among the 105 corporate members of the National Leadership Coalition on AIDS.

Rosalind Brannigan, director of workplace issues for the coalition, said she wishes more Los Angeles-based companies were members. Right now there is only one: Transamerica Life.

As a life insurance company, Transamerica as early as 1985 could foresee what an enormous impact AIDS would have in the workplace, said Chairman David R. Carpenter. The insurer formed a task force and began to implement in-company programs, as well as take a leadership role in the business community.

In 1986, Transamerica Life trained all supervisors on how to deal with employees with AIDS in a non-discriminatory manner and educated all 3,000 employees on how AIDS is and is not transmitted.

Also in that year, Carpenter joined with Los Angeles Mayor Tom Bradley to host an informational breakfast on AIDS for area CEOs at the Tower restaurant in the Transamerica Life building in downtown Los Angeles.

"We stepped out in front and it was a lonely place at the time," Carpenter said. "The repercussions were basically silence (from the rest of the business community). But that rapidly changed to respect."

Arlene Falk Withers, human resources manager for Transamerica, said that in 1986 the company also sent out an informational pamphlet to 500,000 policy holders titled "Fear is in the air. AIDS is not."

At the time of the printing and mass mailing, "It was a pretty gutsy move on our part," Withers said, noting that life insurance companies generally like to keep a low profile.

Because the company made clear that AIDS cannot be transmitted under normal working conditions, AIDS has not been an issue at Transamerica, Withers said. Since the mid-1980s, the company has had a number of employees with AIDS, but no co-worker has ever raised any concerns about working next to someone with AIDS, Withers said.

"We've never had anyone say, 'Can I have my desk changed?' We've never had anyone say, 'I will not use the same telephone,'" she said.

When a Transamerica employee with AIDS has died, the company has brought in a counselor to work with grieving co-workers. Because AIDS has been dealt with in such an open manner for several years, it has been a non-issue, Withers said.

Transamerica also has donated more than $1 million over the years to AIDS causes.

But Carpenter said, "The most important thing we did all along was just talking about it."

Ferd Eggan, executive director of Being Alive, an L.A.-based coalition of people with AIDS and HIV, said that in the mid-1980s, when Transamerica was taking the lead in AIDS awareness, "Kaiser (Permanente) had the attitude towards AIDS care that characterized the whole medical system -- dismay, confusion and frustration."

Members of Being Alive complained, and Pasadena-based Kaiser listened. About two years ago, Being Alive gave Kaiser an award for the work done in treating AIDS.

Kaiser's research, its charitable donations and general "sensitive" treatment of people with AIDS today are commendable, Eggan said.

Most notably, Kaiser is leading the way in the testing and development of new drugs to treat AIDS patients.

Dr. Paul Turner, director of Kaiser's HIV Unit in Hollywood, which currently treats 1,300 AIDS and HIV-positive patients (the largest AIDS population of Kaiser's 11 health maintenance organization facilities), headed a study in the late 1980s proving that an antibiotic called Bactrim could help prevent HIV-positive patients from contracting pneumocystic pneumonia, commonly called PPN.

Prior to this discovery, many AIDS patients died from PPN, Turner said. Today HIV-positive people all over the world take Bactrim pills three times a week, and as a result, "now we rarely see PPN. We can prevent it. We're able to keep people alive longer," Turner said.

The Bactrim study is probably the crowning achievement of Kaiser's research efforts, but it is not the only one, said Turner. Kaiser has participated in numerous studies, including testing AZT, with numerous universities, Rand Corp. and the Centers for Disease Control in Atlanta, Turner said.

In addition to medical research, Kaiser has set up an outpatient treatment program that provides the dual benefit of allowing AIDS patients to spend more time out of the hospital and helping the HMO to keep down the cost of treating people with AIDS, said Dr. Len Harvey.

He heads Kaiser's IV infusion unit, an out-patient facility on Sunset Boulevard in Hollywood, where AIDS patients are given drugs intravenously to prevent different AIDS-related diseases. Before 1989, in order to get such infusions, which can take up to six or eight hours, patients were checked into the hospital, Harvey said. Now, the treatments are given during the day at the infusion unit, a wing of Kaiser's Hollywood hospital, and patients then go home.

Due to the addition of the out patient program, the average number of days AIDS patients stay in the hospital has dropped from 16.6 in 1987 to 7.4 in 1990, and the cost savings to Kaiser over a two-year period is $5.4 million, Harvey noted.

Enid Eck, a registered nurse who heads Kaiser's regional AIDS task force, which meets regularly to discuss ways to provide better care for people with AIDS, said all of Kaiser's 11 HMO facilities provide similar HIV care, but "only the Sunset clinic is labeled as an HIV clinic," at the request of the patients there. Other clinics have names such as the internal medicine unit, so patients do not feel uncomfortable about sitting in the waiting room, Eck said.

"In fact, our San Diego patients asked specifically to have it called the internal medicine clinic," she said. "It's really geared to the comfort level of the patients who are going to them."