justnews
AIDS and the (Oregon) state of
things to come
State HIV/AIDS Policy Committee may allow the insurance
industry to 4 ‘police itself regarding HIV antibody testing of
applicants; and has proposed an updated quarantine law.
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Contact notification. The committee re
commends that persons testing positive for
HIV antibodies be allowed themselves,
personally, to notify others at risk due to
contact, thus protecting the privacy of con
tact. The minority report mandated contact
notification by representatives of the state.
Employer-mandated HIV testing. The
Oregon Division of Labor and Industry
recently interpreted handicap protection
laws to include HIV infections, thus free
ing the committee from directly proposing
statutory restrictions of employer-
mandated HIV testing. Under handicap
laws, test positive individuals would be
determined to constitute a protected class,
and therefore protected from employer
discrimination.
Slate Ombudsman. The Health Division
will create an Ombudsman for AIDS, who
will oversee policy, and act as a clearing
house for information and direction in both
the private and public sector.
Reporting of HIV testing. One of the
major controversies within the committee
involved confidential vs. anonymous test
ing for HIV. The committee adopted the
majority report, which recommends that
A __ E
he HIV/AIDS Policy Committee on
January 8 concluded work on a
wide-ranging document that estab
lishes policy, funding and legislative
recommendations regarding Oregon’s
response to the AIDS health crisis. If
adopted by the legislature, the resolutions
of the committee, especially regarding in
surance and quarantine, will have immedi
ate impact upon risk groups, including gay
men. The 32-member committee is made
up of doctors, public health workers,
lawyers and community support group
representatives. The committee is chaired
by Kristine Ciebbie, Director of the State
Health Division. The policy committee
sought to balance legitimate medical and
epidemiological concerns with appropriate
sensitivity to delicate rights and discrimi
nation issues. However, the fullest
implementation of the former precludes
the full protection of the latter.
T
Policy recommendations
Recommendations of the committee in
specific areas are:
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positive results to an HIV test be reported
to the state using a system guaranteeing
anonymity of the testee. The minority re
port recommended that the tests be report-
able to the state by the name of the infected
individual.
Education. Money is to be made available
primarily for education of at-risk com
munities. The committee also recognized
the effectiveness of community-based
organizations (such as Cascade AIDS Pro
ject) to perform this education. However,
no money was budgeted for large scale
education of the so-called general public,
despite recommendations to that effect by
US Surgeon General Everett Koop. Such
attitudes perpetuate the view that the AIDS
crisis concerns only a minority of the
population.
Quarantine. Oregon law already contains
provisions that allow quarantine for HIV
infection. Members of the committee,
aware that Oregon’s quarantine laws were
outmoded, proposed rewriting the law.
AIDS-activists sought to disallow quaran
tine for HIV infections due to the difficulty
of transmission and the fear that the possi
bility of quarantine will hinder some from
seeking education. However, the commit
tee proposed a bill to allow public health
officials to quarantine for AIDS in cases of
extreme antisocial behavior. The final bill
was amended to include guarantees of due
process, which afford degrees of legal
protections absent in the former law.
Insurance. The committee, following
testimony from insurance and medical rep
resentatives, backed away from a majority
report which would have recommended a
ban on HIV antibody screening of health
insurance applicants. After the committee
had been convinced that it lacked the
necessary "expertise” to make decisions
regarding insurance, it voted to establish a
separate insurance committee to whom the
larger committee would “ punt” responsi
bility for writing specific recommenda
tions. The full policy committee agreed to
guidelines that will disallow HIV testing
for group insurance; that will follow the
recommendations of the National Associa
tion of Insurance Carriers forbidding dis
crimination against gay people in insur
ance; and that will explore the possibility
of “ risk pool” insurance programs for un-
insurable individuals, in which insurance
companies share the cost of high risk
coverage. The smaller, more “ expert” in
surance committee is to draft policy imple
menting these recommendations.
However, what the new committee will
do in reality is a matter for speculation. To
those skeptical of the good faith and flexi
bility of the insurance industry, the new
committee can easily be seen as a smoke
screen behind which the insurance industry
will decide any concessions they are
willing to make. The policy
committee charged the insurance commit
tee with worthwhile guidelines; nothing
bars the smaller committee from returning
the answer that they cannot implement
them. We trust that Ted Kulongoski,
newly-appointed State Insurance Com
missioner, will work to insure that the re
commendations of the policy committee
are maintained.
The matter of Gebbie
AIDS is more than a medical emergency.
It also impacts legally, socially, and ethi
cally upon those it affects. State Health
Division Director Kristine Gebbie has
drawn fire from many comers of the gay
community, and has been vilified for her
alleged inability to deal with AIDS as any
thing but a matter for epidemiologists.
Gebbie may not have sufficiently advocated
for the communities affected most by the
health crisis, and has not always shown
sensitivity to gays on traditional issues of
prejudice and social stigma. However, as
chair of a committee that has had to
balance doctors-on-a-misson with rights-
activists-in-a-heat, Gebbie managed to
gain from the policy committee a docu
ment that, for the most part, protects rights
and yet enables epidemiology. It could
have been much worse.
Public calls for Governor Goldschmidt
to defang Gebbie appear to have failed, as
has behind-the-scenes string pulling. It has
fallen to community members on the pol
icy committee to continue to advocate for
AIDS patients and the people at high risk
the hard way — face to face. Tia Plymp-
ton, Paul Starr, Darrell DuBois, Tom
Koberstein, and others deserve our thanks
for serving on the AIDS/HIV Policy Com
mittee. For them, activism means being
tenacious enough, or curmudgeon enough,
to stand up to Gebbie (and the-worse-than-
Gebbie), advocating for sensitivity and
civil liberties in the ditches of the health
crisis.
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