Health commissioner draws national focus Beilenson backs Norplant for teens


In a city where mayoral cabinet members are rarely recognized outside of City Hall, Baltimore Health Commissioner Peter Beilenson finds himself quoted on the front pages of national newspapers, pursued by television networks.

Not bad for a guy who's been in office just over a month.

Dr. Beilenson didn't think it was big news last week when The Sun reported that he's organized a consortium of Baltimore doctors, hospitals and foundations to promote Norplant, the five-year contraceptive, among teen-agers. Next thing he knew, the networks were calling.

In part, the publicity was sparked by the subject; birth control for teen-agers has been wildly controversial in many cities. But in part, it was Dr. Beilenson's style that generated the attention. At 32, he works like a man in a hurry.

Contraceptives in Baltimore school clinics are not new. Already, students can get birth control -- pills, condoms, foam or a referral for Norplant. The former acting health commissioner, Elias Dorsey, began that without fanfare a couple of years ago. Dr. Beilenson recommended the city do more.

Next month, students at the Laurence G. Paquin School, which serves pregnant girls and new mothers, can get Norplant right in their school clinic. Dr. Beilenson wants Norplant advertised for teen-agers and discussed in classrooms -- all the while stressing condom use to prevent the spread of diseases such as AIDS.

Only last week, amid the media storm, did City Hall realize that no other city in the country is targeting teen-agers with Norplant so aggressively.

Mayor Kurt L. Schmoke says he appointed Dr. Beilenson because of his creativity and energy. People familiar with Baltimore's problems say the health commissioner will need a lot of both.

"He's not walking into a position that a number of people would relish having," says David Shipee, head of the Chase-Brexton Clinic, which sees HIV-infected people.

Indeed, Dr. Beilenson faces a multitude of public-health crises: Teen-aged girls continue to have babies at record rates. AIDS is spreading. The homeless wander the streets. Tuberculosis has made a grim comeback. Children are poisoned by lead paint.

Meanwhile, budgets are being cut. So to make any progress on health issues, Dr. Beilenson says, the city has to build partnerships.

The Baltimore City Norplant Consortium, which drew so much attention last week, is an example. Dr. Beilenson says the city, hospitals and foundations must work together to provide Norplant to as many women as possible -- especially those who (( cannot afford the $350 cost or have no insurance.

But there are many other partnerships he envisions.

To supplement health department staff, Dr. Beilenson wants private doctors and nurses to donate time routinely to the city -- just as many law firms encourage their lawyers to do pro-bono work regularly for those who cannot pay. With just a couple dozen volunteers in clinics or visiting homes, he says, the health department could make up for many positions lost to budget cuts.

His deputy, Mr. Dorsey, is looking into trading services with surrounding counties to avoid duplication: A county might provide health inspectors to one part of the city, for example, while Baltimore would offer health care to children in some county ZIP codes.

In an effort to slow the spread of AIDS, Dr. Beilenson is hoping to start a needle-exchange program, modeled on a project in New Haven, Conn., which reduced the level of HIV infection among drug users by a third. If the legislature approves, drug-users would be able to turn in dirty needles and pick up new ones at certain sites.

To try to recoup some funds, the health department, under Mr. Dorsey, began billing more aggressively for services in city clinics. The result, Dr. Beilenson says, is a boost in revenues that will prevent layoffs in January.

And as always, the department is looking to the private sector for extra money. Soon, the Aetna Express, a van financed with a grant from the Aetna insurance company, will be traveling to poor neighborhoods to offer health care to the homeless, including immunizations for children.

Besides learning to run the agency, Dr. Beilenson still sees patients one day a week in city clinics.

"He has great ideas, excellent ideas," says Third District City Councilman Wilbur E. "Bill" Cunningham.

"When I heard Mayor Schmoke had appointed Dr. Beilenson, I could think of no one better," says Mark Shaw, the spokesman for the Baltimore chapter of the AIDS Coalition To Unleash Power (ACT UP).

Critics say Dr. Beilenson lacks humility and is constantly calculating the political effects of his moves. But admirers say he is the first health commissioner they've known who really listens, a man who conveys urgency when talking about the city and its health problems.

For years, Baltimore's health commissioners were career administrators who moved up quietly from within the agency. Dr. Beilenson has been in Baltimore only 5 1/2 years. He served in his previous health department post, director of school health, for just six months.

And until a year ago, Dr. Beilenson seemed determined to make a career not in public health but in politics -- like his father, U.S. Rep. Anthony C. Beilenson, who represents California's San Fernando Valley in Congress.

With a bachelor's degree from Harvard, a medical degree from Emory and a master's in public health from Johns Hopkins, Dr. Beilenson ran in 1990 for the House of Delegates and lost. Last year, he ran for the Baltimore City Council and lost again.

His campaigns were notable for the ground Dr. Beilenson covered. In the summer of 1990, he knocked on 10,000 doors. In 1991, he visited 12,000. "When people talk about rat eradication, I've seen the rat holes," Dr. Beilenson says. But his campaigns are remembered -- to his dismay -- for more. By the end of the race, Dr. Beilenson says, he was exhausted and frustrated. And though he calls himself "a pretty nice guy who likes to get along with people," he found himself in public tangles with other politicians.

At the polls, he protested to reporters that black campaign workers were telling black citizens not to vote for Dr. Beilenson, who is white.

"It's always been said about Baltimore that whites won't vote for blacks, but blacks will vote for whites," he said later. "But this time people only voted for their own race. It's a sad commentary."

He was angry when City Council President Mary Pat Clarke urged gay and lesbian groups that were supporting Dr. Beilenson to reject his independent bid for office and instead support her candidates. On Dr. Beilenson's behalf, Massachusetts Rep. Barney Frank, a leading gay congressman, called Baltimore friends to ask their support for the new candidate.

And the day after the primary, Dr. Beilenson sent an angry,

handwritten letter to U.S. Rep. Kweisi Mfume, D-7th, protesting Mr. Mfume's endorsement of Councilman Anthony J. Ambridge, who finished first in the 2nd District Democratic race. Dr. Beilenson finished fifth. Mr. Mfume responded with a pointed letter of his own.

Now, Dr. Beilenson rolls his eyes when asked about those episodes. "Please don't ask me about that," he pleads. "It was an exhausting campaign and basically I just sort of overheated."

A year later, Mr. Mfume and Mr. Ambridge say no permanent damage was done.

"He shot off a little letter to me and I shot off a little letter to him and a day later he called and apologized," Mr. Mfume says. "And I said I understood. We've had a very cordial relationship since then.

Mr. Ambridge attributes Dr. Beilenson's combativeness at the close of the campaign to "his sense of self-worth, which is very abundant. . . . He worked hard. He ran a good campaign. When he lost, he was very bitter.

"We mended it," Mr. Ambridge adds. "I've never had any problem with his positions. It was his attitude that bothered me. Now he's worked closely with the council -- which is unusual for FTC anyone in this administration. I think we're lucky to have somebody like him."

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