The Maryland Health Department, responding to the yearly doubling in the number of reported acquired immune deficiency syndrome cases, has announced that "four or five" nursing homes are willing to take patients with the fatal disease and that about 20 foster care homes will be established.

The health department, in its announcement Monday, said $40,000 had been earmarked to fund the foster care homes around the state, which will take AIDS patients who are not sick enough to require hospitalization or nursing care.

Maryland is believed to be the first state to reach such an agreement with nursing homes, department spokeswoman Lynn Guttenberger said yesterday. Because the disease can be so costly to treat -- government estimates range from $50,000 to $150,000 -- public health officials and gay organizations have sought ways that are cheaper than hospitalization to care for victims.

The participating nursing homes have not been identified, but health officials said they are all in the Baltimore area. Dr. Thomas Krajewski, assistant secretary of health, said they will be identified in about a month.

"They want to work this through with their boards, other patients and families," he said.

Guttenberger said that since January there have been 93 new cases of AIDS in the state and 30 deaths associated with the disease. Currently, two AIDS patients in hospitals need nursing home care and five to 15 more need a foster home, Guttenberger said.

State health secretary Adele Wilzack met with the directors of 10 nursing homes in June to discuss the problem, officials said. According to Guttenberger, "The four or five that have committed are some of the top nursing care facilities" in the state.

"With the trends in victims, the growth in cases, we will probably need more than this eventually," said Jack Stein, program coordinator for the Health Education Resource Organization, Baltimore's largest organization devoted to AIDS treatment and education.

"But this is a great start. The city and state responded admirably to a major crisis, and we are very pleased," Stein added.

AIDS is characterized by the slow disintegration of the body's ability to fight infection. While AIDS is most often found in homosexual men and intravenous drug abusers, anyone who receives tainted blood or comes into intimate sexual contact with a carrier is at risk.

Treating the disease has been complicated by the fear it arouses. "You can't get it just by being in the same room" as an AIDS patient, Guttenberger said. Medical researchers believe the disease is transmitted through contact with the blood, semen or saliva of those patients.

In fact, Guttenberger said, "It's unlikely that the AIDS patient will be a major threat to nursing home patients; however, the AIDS patient could be exposed to a cold from a regular patient and die from it," because the AIDS patient's immune system is so weak.

Clinical social worker Caitlin Ryan, who runs the District's Whitman Walker Clinic program for AIDS victims, has been making some of the same points during training sessions with medical personnel in Washington. Finding a place for the AIDS patient to go "is a serious problem," Ryan said, adding, "I think the news about Maryland is very good." Ryan said she was not aware of any District nursing homes that are accepting AIDS patients.

"Most of our cases are in hospitals," said Casey Riley, director of the state AIDS program in Virginia. "So far there has not been any involvement on the state level.

As of yesterday, a total of 115 cases of AIDS had been reported in Virginia, 193 in Maryland and 200 in the District, according to federal figures.