The Legal Pad

A Movement to Reform State Laws

2011-03-25T14:25:00.002-05:00

It seems the movement to reform state laws about HIV exposure -- you know, the laws that turn people with HIV into felons if they spit on the wrong people -- continues to pick up steam. Provincetown's Edge newspaper just published an interesting story on the subject. It highlights some of the more egregious prosecutions we've seen in recent years:

Among the most extreme examples of prosecutions ... are a Texas man with HIV who received a 35-year prison sentence for spitting at a police officer and an Iowa man with an undetectable viral load who was sentenced to 25 years after a one-time sexual encounter where he used a condom. Another man with HIV in Michigan was charged under the state’s "bioterrorism" law after he allegedly bit his neighbor.

It also quotes several legal advocates around the nation who are working to reverse this trend:

Alison Yager, a supervising attorney with the HIV Law Project in New York, told EDGE that HIV exposure laws not only "abandon basic human rights, perpetuate stigma and discrimination and undermine public health goals, but in some cases, like those laws that criminalize spitting by an HIV-positive person, they ignore the science of HIV transmission."

It makes for very interesting reading. Check it out here.

Poetry for the Council

2011-03-15T16:19:00.004-05:00

If you missed ALCC's Advocates of the Year awards ceremony last week, you not only missed a swanky evening honoring unsung heroes in the fight against HIV. You also missed a sterling performance by spoken word artist and former national poetry slam champion Lisa Buscani. She wrote a piece especially for our event. And it goes a little something like this:

Night Doctors

Death in the South is subtle and mundane.
Kudzu, better living through botany gone bad,
Consumes the soup that passes for Louisiana air,
Sinks its insolent roots down deep beyond reach and
Creeps its unrelenting way up into the trees,
choking the life out of weaker things.

It is not the only predator.
Poor people knew that all too well, back in the day.
They told stories of the Night Doctors,
Men with money on their minds
riding in ghostly clothes a top fearful thunder,
Whipping broken hides deeper into submission.
The Night Doctors sought the sick, the unprotected and
Conveniently sped them on their way to death,
Toward the substantial fees the med schools paid for dissection cadavers.
Folks spoke of The Needle Men,
Who came round October through March,
cloaking needles full of poison or some such
looking for the unfortunates ashy with illness
One poke and they were done.
Worst of all, they spoke of The Black Bottle Men
Over to the Charity Hospital, passing out bottles cradling
A brew of cascara and milk of magnesia.
If you were bad, you did not get better.
Instead you would shit yourself blind
And serve mankind under some third year’s knife,
A medical fledgling just dying to know what makes you tick.
People learned to sit with their sick,
Guard against the changes
And place hope in home remedies;
They viewed the hospital as a last-chance stop.
The way the poor told it then
Sick folks were worth more dead than alive.

But that was then
A time when such primitive vulgarity was acceptable.
Today the Night Doctors have stabled the horses,
They’ve hung bridles on their final hooks
And morphed into something more sophisticated
But just as vicious.
Far less filthy and in the trenches.
Far less dirt under the metaphorical finger nails.
Instead,
the Night Doctors have fragmented
into a byzantine maze of rules and regulations,
into a flurry of paperwork required
of someone too nauseous to hold a pen,
into the emergency policy that won’t cover a sight-threatening eye infection
because you still have a good one left.
The Night Doctors are the computer bug that annually
Sends your Medicaid card to a West Side address
Instead of your South Side home.
It will not matter how often you call.
They are the laws of a land
that’s not yours and does not want you;
A land that will resort to intimidation
to keep you from asking for help.
They are Aid office phones that ring and ring and ring and ring and ring
Because goddammit, the staff is tired . . .
Or the staff is simply not.
The Night Doctors are now the terror
that keeps you from getting tested
Or getting the help that’s available.
They are the fear that makes you lie on the job app
which costs you your benefits,
or a proper diagnosis,
or access to support.
They are now the grinding poverty or the chronic underfunding
That wears your will and patience and convinces you somehow
That you had this coming; that this
hat in hand, screaming at deadened ears,
this is all you deserve.
All this, all this,
when all you want to do is lie down.
And that is the Night Doctors’ most insidious victory.
When you think like that, you’re dead.

copyright 2011 Lisa Buscani

2011 Advocates of the Year Awards

2011-02-24T11:45:00.006-06:00

OK, kids, it's time for the season's swankiest event, the 2011 Advocates of the Year Awards. It'll be on Thursday, March 10 at 6:30 pm at the Joffrey Tower, 10 East Randolph Street, smack in the heart of the Loop. And we'll make it easy for you: order tickets right here.

Here are this year's honorees:

Arick Buckles
When Arick came to grips with his HIV diagnosis, he found himself embarking on a path of discovery that would allow him to overcome many personal challenges while becoming a fierce advocate for people with HIV. As a peer counselor, educator and advocate, Arick feels equally at home talking to policy makers about the needs of people with HIV as he does talking to clients about his own life, inspiring them to get the care they need. Arick Buckles personifies the spirit, commitment and hard work that define our Advocates of the Year.

Cathy Krieger
As The Children's Place Association commemorates 20 years of service, we pay tribute to its visionary president and CEO, Cathy Krieger. Under her leadership, The Children's Place Association has grown to provide an integrated array of services benefiting thousands of children, teens and mothers impacted by HIV. Its success in pediatric AIDS care has made The Children's Place Association an internationally renowned program with landmark projects around the world.

Blake Max, PharmD
Dedicated and hardworking hardly begin to describe Blake Max. As the HIV Clinical Pharmacist at the CORE Center, Blake has been an invaluable resource for patients, students and CORE Center providers who turn to him every day for his extraordinary knowledge on HIV medications and treatment. He is an advocate, an educator, a friend to his patients and colleagues and an unsung hero who brings expert, friendly, and compassionate care to people with HIV every day.

Jessica Terlikowski
As Policy Manager at the AIDS Foundation of Chicago, Jessica Terlikowski has led tough fights to promote sexual health, develop harm reduction strategies for drug users and help advocates in other Midwest and Southern states become more effective in their fight. She has fought to increase awareness and access to the female condom, and she played an instrumental role in forming the Illinois Coalition for Harm Reduction Providers to advance more effective health measures for people using drugs.

Kirkland & Ellis LLP
Friend of the Council Award
"Friend of the Council" cannot convey the special relationship between the law firm of Kirkland & Ellis LLP and the AIDS Legal Council. Kirkland & Ellis has been among the Council's earliest and strongest supporters, providing financial backing for our mission and pro bono legal services for our clients. It's commitment to community service has made Kirkland a source of outstanding board leadership at the Council, and we are delighted to show our gratitude with this special acknowledgement.

Special Performance by
Lisa Buscani
Lisa Buscani got her start in Chicago's performance poetry scene and ultimately became a National Poetry Slam Champion as well as a Pushcart Prize nominee for poetry. She has published one book of poetry, Jangle (Tia Chucha Press) and has been featured in numerous anthologies including Alive from the NuYorican Poets CafÃ© (Holt), The Complete Idiot's Guide to Slam Poetry (Alpha Penguin) and American Poetry: The Next Generation (Carnegie-Mellon Press). Lisa has produced three critically and publicly acclaimed solo shows ("Carnivale Animale," "At That Time" and "Solid Citizen") and has appeared on HBO, CNN, PBS, and NPR. She currently teaches at DePaul University.

Obama Who?

2011-02-10T15:36:00.002-06:00

Perhaps you recall last July the White House issued the first ever National HIV/AIDS Strategy for the United States. In it, the President called for the elimination of HIV criminal transmission laws, saying in part that such laws "may not have the desired effect and they may make people less willing to disclose their status by making people feel at even greater risk of discrimination" (you can read our post about the report here). Well, it seems the report hasn't had the effect President Obama might have wished.

In the past two months legislatures in three states -- Nebraska, Utah and Montana -- have been entertaining the idea of criminalizing the transmission of HIV.

Hooray for regressive social policy!

You can read an article about this disturbing trend here

ADAP to the Rescue!

2011-02-08T11:03:00.004-06:00

If you have private health insurance or Medicare, there are important changes in the Illinois AIDS Drug Assistance Program (ADAP) that may help you with some of your drug costs. Additionally, ADAP may make it possible for some people to afford comprehensive health insurance coverage under the new Illinois Pre-Existing Condition Insurance Plan (IPXP).

First and foremost: The income eligibility limit for Illinois ADAP is 500% of federal poverty. That means for 2011, your annual income must be less $54, 450 in order for you to enroll in any of ADAP's programs.

So let's dig in and explain.

For folks with private insurance:
ADAP used to pay drug copays for people with private health insurance, but only if the copays were more than 20% of the drug costs or if a drug's individual copay was more than $100. But now ADAP will enroll you no matter what your deductibles and copays are. Keep in mind that like always, your insurance plan must be able to coordinate with ADAP's pharmacy, CVS/Caremark. Additionally, ADAP can't fill a prescription for more than a one-month supply of drugs. So if your insurance plan requires you to use prescriptions for three-months supplies (for example), ADAP can't help you.

For folks on Medicare Part D:
Most people on Medicare with annual income under $26,917 can already get help with their drug costs either through Extra Help or Illinois Cares Rx. Usually that leaves people with very low drug copays -- about $6 per prescription. Now ADAP can pay these small copays for you.

Most people on Medicare but with annual incomes over $26,917 can't get Extra Help or Illinois Cares Rx, so they often have had to rely entirely on ADAP to provide them with their HIV medications. Beginning this year, the money that ADAP spends on your medications counts toward your Part D out-of-pocket costs. This means that ADAP money will help fill your Part D "donut hole" (the phase of the Part D program where you pay 100% of your drug costs) to get you to the phase of the Part D program where you pay only 5% of your drug costs.

As with all ADAP programs, your Part D plan must be able to coordinate with ADAP's pharmacy, CVS/Caremark, in order for you to enroll in these programs.

For folks who want to enroll in the Illinois Pre-Existing Condition Insurance Plan: The Illinois Pre-Existing Condition Insurance Plan (IPXP) is the newly-created program that can provide health insurance to people who have been uninsured for at least six months and whose pre-existing health conditions prevent them from getting individual insurance coverage. ADAP can pay up to $500 toward your monthly IPXP premiums and help with your copays and deductible for HIV medications.

Talk about a landslide of good news.

If you want to talk more about any of these programs, give us a ring at 312-427-8990.

You can get ADAP's info here.

You can get IPXP's info here.

Second Annual Disney Concert for ALCC!

2011-01-06T10:16:00.005-06:00

Last year Chicago crooner Justin Hayford presented his first evening-length benefit cabaret for AIDS Legal Council of Chicago, The Disney Songbook: Children's Songs for Grown-Ups. The show sold out, and reportedly everyone had a grand time while raising over $6500 for the Council.

So Justin's decided to turn that show into an annual event. And this month he's back with The Disney Songbook, Vol. 2: More Children's Songs for Grown-Ups. Here's the skinny:

When: Saturday, January 22 and Saturday, January 29
Where: Davenport's Piano Bar & Cabaret, 1383 N. Milwaukee Ave.
Showtimes: 8pm
Reservations: http://www.davenportspianobar.com/ or 773-278-1830

This year's show features tunes from classic Disney films like Alice in Wonderland, Snow White and Sleeping Beauty. You'll also hear ingenious, unheralded songs from the new generation of classics-to-be like The Princess and the Frog, Home on the Range and Toy Story 2.

For this special concert, you set the admission price. And whatever amount you decide to pay goes directly to benefit AIDS Legal Council of Chicago, a nonprofit agency providing direct legal services to impoverished people with HIV in the Chicago metropolitan area.

Illinois Civil Unions are Almost here.

2010-12-14T15:59:00.004-06:00

The AIDS Legal Council is excited about the recent passage of the Illinois Civil Union Act. Beginning in June of 2011 Illinois same-sex couples will be able to enter into legally-recognized civil unions “with all the obligations, responsibilities, protections, and benefits afforded or recognized by the law of Illinois to spouses.” Before entering into a civil union, it is important for low-income individuals to consider the impact their civil union may have on their public benefits.

Because the Civil Union Act is a state law, the changes will be primarily in state programs. But since it’s not always clear which programs are state and which are federal, this guide lists the main public benefits programs accessed by people with HIV and describes what effect, if any, the new law will have on them.

INCOME PROGRAMS

SOCIAL SECURITY -- SSDI
This is the Social Security check you get because you have a long work history, and you are either disabled or over age 65. Your regular monthly SSDI check will not be affected by your being in a civil union, regardless of your partner’s income or assets .

SSDI also provides a “survivor’s benefit” to some surviving children and spouses. However, a federal law called the Defense of Marriage Act, or DOMA, prohibits civil unions from being treated the same as marriages when it comes to federal benefits. So a widowed domestic partner could not receive SSDI survivor’s benefits. A child of one of the partners in a civil union could receive a survivor’s check only if he or she was the legal child, by birth or adoption, of the deceased or disabled partner.

SOCIAL SECURITY -- SSI
This is the monthly Social Security check for people who do not have much work history but are disabled or over 65. Normally people who are married lose some of their SSI benefits. But since SSI is a federal program, DOMA says the people who run SSI can’t treat a civil union the same as a marriage. As a result, being in a civil union shouldn’t cause any change in your SSI benefit, so long as nothing else changes in the way your household and finances are set up.

SOCIAL SECURITY -- EXTRA HELP
This is the benefit that helps pay for costs associated with the Medicare Part D prescription drug coverage. It’s a federal benefit, and because DOMA prohibits civil unions from being treated like marriages , your eligibility for Extra help should not be affect by your being in a civil union.

FOOD STAMPS
The Food Stamp program (now called the SNAP Program) was created by federal law, and is funded by federal money. The Food Stamp program considers “household income” to determine eligibility, and the program always considers the incomes of both spouses to determine the household income. But because DOMA prohibits same sex couples from being considered spouses , there will not be an automatic presumption that partners in a civil union are sharing household expenses.

HEALTH CARE PROGRAMS

MEDICARE
Medicare is a federal health insurance program for people over age 65 or who are disabled and receiving SSDI. Since Medicare is a federal program, not a state program, your Medicare benefits should remain unchanged if you enter into a civil union.

MEDICAID
Medicaid is created by federal law, but funded by both federal and state money. One part of Medicaid eligibility is “household income,” and for married couples both spouses’ incomes are always combined, even if only one spouse is applying for Medicaid. But because of DOMA, partners in a civil union can’t be considered “married” for the purposes of federal benefits. So your partner’s income should not be added to yours in order to calculate your household income.

If you are married, and you have a Medicaid spend-down, you can use your spouse’s medical bills to meet your spend-down. But if you are in a civil union, DOMA would not allow you to use your partner’s medical bills to meet spend-down.

Some states with domestic partnership laws have established entirely separate state-funded Medicaid programs for persons in Civil Unions to avoid conflicts between state and federal law.

ILLINOIS CARES RX
This program helps cover the costs of HIV medications for some people on Medicare. Illinois Cares Rx will consider your civil union to be just like a marriage. This means that Illinois Cares Rx will consider the combined income of you and your domestic partner. The annual income eligibility limit for married couples is $36,635. So if your income, added to your partner’s income, totals over $36,635 you will not be eligible for Illinois Cares Rx -- even though your individual income may be low enough to make you eligible as a ‘single person.’ On the other hand, if your income is currently above the Illinois Cares Rx limits but you enter into a civil union with someone with little or no income, you may become eligible for Illinois Cares Rx.

ADAP
This program, administered by the Illinois Department of Public Health, provides free HIV medications for people who have no other way to pay for them. ADAP will consider your civil union to be just like a marriage. The annual income eligibility for a household of two is $70,000. This means that if the combined income of you and your partner exceeds $70,000, you will not be eligible for ADAP, even if your individual income may be low enough to make you eligible as a household of one. Again, this can work both ways. If your income is currently too high for ADAP, entering into a civil union with a partner with little or no income may make you eligible for ADAP.

These are the general rules. It’s always a good idea to consult with a legal expert about the particular facts of your situation. AIDS Legal Council staff is happy to consult with you, free of charge. You can reach us at 312-427-8990.

Hot Off the Presses

2010-11-02T11:32:00.002-05:00

OK, maybe it's not The Da Vinci Code, but we like to think our stylish 2010 Annual Report still has some allure. You can read all about the work we did over the past year, including several compelling client stories. You can learn about the exhausting advocacy we did to make the Illinois ADAP program more accessible to more people. And you can marvel at the overall groovy design, done by our staffers Ricardo Cifuentes and Mary Hankey.

And best of all, it's posted on our website! You can read it here.

Our New Hero

2010-10-15T14:08:00.004-05:00

We're adding a new member to the AIDS Legal Council's Honor Roll of Really Groovy Attorneys We Love a Whole Bunch. Today we're singing the praises of Ian Ackerman, an attorney in the corporate practice group of Kirkland & Ellis (a law firm we've adored for a heck of a long time). I'm sure you too will love him a whole bunch after reading about the way he handled a particularly messy case for one of our clients.

Not long ago Anthony (not his real name) received a notice from Social Security informing him that his earnings records showed he had been working in 2008 and 2009, to the tune of nearly $10,000 a year. And since Anthony was receiving SSI during that time, Social Security believed it had overpaid him and wanted a big pile of money back, namely $7845.96.

But Anthony hasn't worked for over a decade. He's disabled and has been receiving SSI since he became too sick to continue working. Anthony believes someone stole his Social Security number and used it to claim self-employment income. The same thing had happened to him in 2006, when the IRS came after him for back taxes it said he owed. He had filed an appeal with IRS back then, but still had not received a final determination on his appeal of the 2006 tax bill when he got the notice of Social Security overpayment for 2008 and 2009.

So how does one prove to Social Security that Anthony didn't earn the money that's tied to his Social Security number? Cases like this aren't uncommon, and usually we can show that the person couldn't possibly have done the work credited to their number, perhaps because the work was done in another state, or because it was done during a time when the client was hospitalized. But in Anthony's case, the work was reported as self-employment, tied to a Chicago address.

We were a bit daunted by the facts, but Ian volunteered to take on the case. Mind you, many of us at the Council have been doing Social Security overpayment cases for years, and we were quaking in our boots at the thought of trying to get Social Security to back off from collecting the money they believed Anthony owed them. Ian had done exactly one overpayment case before this, helping someone negotiate a reasonable payment plan with Social Security. We gave him all the Social Security rules and regulations we could find that we thought were relevant, and assumed he'd be battling Social Security for the next decade or so.

Well clearly he's got some serious advocacy skills, because all he had to do was have a nice little chat with the supervisor at the local Social Security office, explain what was going on, and poof! Social Security agreed to suspend any collection of the overpayment until the IRS had made its determination on Anthony's claims. And since, in the meantime, the IRS has approved Anthony's appeal of his 2006 tax bill, it seems quite likely they'll rule in his favor for his current appeal. And then the world will be full of rainbows and unicorns, all thanks to Ian Ackerman!

OK, maybe we're getting a bit carried away. But those of you who have ever tried to talk sense into a Social Security worker know how exhausting, extensive and futile the effort can often be. Ian got it done with a single phone call. So we're singing his praises around the office. And we encourage you to send him flowers and candy.

Will the Mainstream Media EVER Learn?!

2010-09-30T11:13:00.009-05:00

This week the venerable Chicago Tribune ran an article about the efforts Southlawn United Methodist Church is making to increase HIV awareness among its congregation. "That's really where the power of the church comes in is to say, 'Hey, you belong. You're part of us," says Reverend Robert Biekman, the church's senior pastor. Given our society's long history of imagining that people at risk for HIV are only shady, shifty, deviant "others," the good reverend's message is a vital one (despite its slight syntactical muddle). It's a shame that in reporting the story, the Tribune persuasively counters his message, assuming that only certain types of people could be at risk for HIV.

Southlawn United Methodist has begun offering free HIV testing (along with diabetes and blood pressure screenings) after Sunday services. That's a fine idea. But the Trib needed to interview only one person awaiting his HIV test to reinforce one of the most outdated, inaccurate assumption about HIV risk. "Though Jermaine Bell said he uses condoms and isn't promiscuous, he patiently waited for his screening at Southlawn," the paper reports. Ah, so promiscuous people are at risk for HIV. People who have too much sex with too many people are assumed to be at risk for HIV, not those who can "control" their sexuality and confine it within "normal" limits. Never mind finding out what actual sexual behaviors this marauding band of "promiscuous" people actually engage in, and whether such behaviors present any actual risk of HIV infection. Never mind that a person can have perfectly safe sex with a different person every week and be at no risk for HIV, while another person in a "committed, monogamous" relationship can have unprotected intercourse once and get infected. No, promiscuity is the problem.

Since Mr. Bell isn't "promiscuous," and even uses condoms, why is he getting an HIV test? "He had just gotten out of a relationship," the newspaper explains, unhelpfully. Um, wouldn't it make a whole lot more sense to get an HIV test at the start of a relationship, so that you might know whether you present a risk to your partner?

As the coup de grace, the Trib tells us that Mr. Bell calls on "anyone who might be at risk for having the disease, such as drug users and prostitutes, to get tested." Check. It's those shady, shifty, deviant others who are at risk. And God help them if they're also promiscuous.

The article informs us that the idea for Sunday morning HIV screening came out of the First Ladies Luncheon, when about "100 wives of pastors from mainly black churches in the Chicago area, as well as a few female pastors, attended and decided to champion HIV testing." Sounds noble. But apparently this benevolent group doesn't champion HIV testing for themselves. Nor does Reverend Biekman. Nor does Reverend James Meeks, a prominent Chicago minister quoted in the article. Nor does Tracey Alston, quoted in the article as the "spokeswoman for the Sunday event." Ministers, their luncheoning wives, and their spokespeople clearly aren't the type of people who could possibly have HIV. No, it's the great unwashed laity that needs to be screened. The Trib would have us believe, as we've been asked to believe since the epidemic began, that your risk for HIV stems from the type of person you are, rather than the specific behaviors you engage in.

Is it too much to ask that a newspaper as allegedly well-informed as the Chicago Tribune stop making assumptions about HIV that were outdated in 1983?

You can read the entire article here.

Health Care Reform Takes Effect Today ... Sort Of

2010-09-23T11:57:00.003-05:00

So you've probably heard lots of news stories telling you that many of the most important aspects of the Affordable Care Act going into effect today. For example, insurers can no longer deny insurance for children with pre-exisiting conditions. And insurers can't put life-time caps on the benefits in their plans.

That's not quite the whole story. In fact, for any particular insurance plan these changes will go into effect on the date of the new plan year, on or after September 23, 2010. That means that the changes happen the next time your insurance plan renews.

So for example, if your current insurance plan has a million dollar lifetime cap, that cap doesn't disappear today. It disappears when your plan is up for renewal. The cap stays in place until that time.

There, hope that clears things up.

We Hope You Didn't Miss the Fun

2010-09-16T13:26:00.010-05:00

We can't imagine what you were thinking if you missed the swanky, sexy party we threw last night. It was a splendiferous Argentine bash we called Club Tango. Now that we're done nursing our hangovers, we'll show you some of the fun we all had.

Fun guests!

Fun food!

Fun silent auction!

And professional tango dancers!

See? We told you it was fun. We're confident we'll see you at next year's fete.

Pooped Paralegals

2010-09-09T13:57:00.005-05:00

Don't be surprised if you hear snoring coming from the offices of two of the Council's hardest working paralegals, Kate Miller and Dale Green. They've each had two Social Security hearings in the past week -- and Kate has another one scheduled for next week. If you've ever had to represent someone at a Social Security hearing, you know the gargantuan amount of work that goes into preparing to face the judge.

But here's the truly goofy thing: in three of the four hearings, the judges already had everything they needed to make a decision in the case. They didn't need to drag Kate, Dale and their clients to their offices in the first place. Oy gevult.

To wit:

1) Last week Dale went to a hearing with a 28-year-old client who suffered from mental retardation. A few weeks before the hearing Dale had submitted a brief to the judge, outlining the reasons that his client's disability claim should be approved based upon the available medical evidence. "When we sat down in front of the judge, the first thing she said to me was, 'Oh, this is such a great brief.' And I'm thinking, 'OK, then why do any of us need to be here?'" The judge asked Dale a few procedural questions and then approved the client's disability claim.

2) Yesterday the same thing happened again -- except this time Dale's client hadn't even shown up. "The hearing was scheduled for 10am," Dale says, "and I had been calling my client from the hearing office every few minutes since 9:30. She never answered. Finally at 10 she called and said that the person who was supposed to drive her to the hearing never showed up, and she was on the bus about 20 minutes away." At 10:25 the client still hadn't arrived, and the judge's assistant told Dale that the judge wanted to speak to him. So Dale went into the hearing room, to find that the judge was staring at him from a huge video screen. "It was a video hearing," he says. "And he's in California, watching me from inside this big television." The judge asked Dale a few questions, then said that all the records Dale had submitted were enough for him to approve the case right then and there. "So I called my client, told her to get off the bus and get on the next bus going back to her home."

3) Last week Kate was putting the finishing touches on the argument she'd make at the Social Security hearing she had scheduled for the next day. Weeks before she'd submitted a brief to the judge asking that the case be approved based on the medical records she'd submitted. But with no response from the judge's office, she kept working to be ready for the hearing. Then the phone rang. "The judge called, said she'd read my brief, and she was going to approve the case and cancel the hearing," Kate explains. Great news for the client, of course. Bad news that Kate had done tons of work getting ready for the hearing.

And finally...

4) Yesterday Kate had a Social Security hearing, representing a client with organic brain disorder brought on by years of heavy crystal meth use. This time, the hearing actually went forward. "We had a big problem, that there were a lot of inconsistencies in the medical records," Kate says. "You see, the client has such a low level of comprehension that he often doesn't understand what medical providers are really asking him. So he gives answers that he thinks will please them. They'll ask him, 'Do you have trouble concentrating?' And he'll say no. He'll say no to everything because he thinks that's what the doctors want him to say." Fortunately Kate was able to convince the judge, as well as the medical expert at the hearing, that her client's inconsistent answers were not evidence of "malingering" but concrete examples of the very cognitive impairments that would prevent him from being able to work. She won the hearing.

So feel free to send Kate and Dale flowers and candy. Oh, and maybe gift certificates for full-body massages.

South Carolina Prisons and Basic HIV Science: Never the Twain Shall Meet

2010-09-01T10:43:00.004-05:00

Perhaps you've heard that the U.S. Department of Justice is threatening to bring suit against the South Carolina Department of Corrections for its treatment of prisoners with HIV. While the rest of the country (almost) has figured out that HIV-positive prisoners don't need to to segregated from the general prison population, South Carolina persists (along with that other bastion of progressive thought, Alabama). And mind you, South Carolina keeps HIV-positive prisoners in maximum security units.

If that's not bad enough, the South Carolina Department of Corrections also bars HIV-positive prisoners from certain types of prison jobs, including kitchen work. Has anyone in South Carolina bothered to note that the CDC has never included HIV on its list of conditions that preclude people from food handling? Are these people still living in 1981?

HIV-positive inmates are also ineligible for work release. Even Alabama isn't that stupid.

In a smug, blustery, facts-be-damned op-ed piece in The State, Jon Ozmint, director of the South Carolina Department of Corrections, called the threatened lawsuit "an attack on public health and safety" (rather than, say, an attempt to enforce the Americans With Disabilities Act). How does Ozmint justify his assertion? First he points out that his prison system tests every incoming inmate for HIV. Then he adds that "unlike most prison systems, we know which inmates can impose a death sentence by biting, stabbing, or merely inflicting a flesh wound with a contaminated weapon." A death sentence from a bite? And South Carolina actually leaves this pinhead in a position of authority?

If you'd like to read Ozmint's nonsense, you'll find it here. If you'd like to read a reasoned response, go to the Center for HIV Law & Policy's blog here.

New Insurance Option in Illinois

2010-08-26T11:06:00.012-05:00

One big piece of health insurance reform is now in place in Illinois: a new high-risk insurance pool for Illinoisans who are otherwise uninsurable. The new plan goes by the sub-euphonious moniker, Illinois Pre-Existing Condition Insurance Plan, or IPXP. We can't fathom why the program's acronym isn't IPCIP, or even IPXCP, but who are we to question the wisdom of government bureaucrats? EIEIO.

Anyway, to qualify for IPXP a person has to have been uninsured for at least six months, have a pre-existing condition, be a U.S. citizen or legal resident, and be unable to obtain health insurance from any other source. The premiums are considerably lower than Illinois's other high-risk insurance pool, ICHIP. But unfortunately folks currently enrolled in ICHIP are not eligible for IPXP -- which is a bit like being barred from buying a cheaper toaster oven just because you already have an old one that works adequately. But who are we to question the wisdom of government bureaucrats?

Our state's portion of the $5 billion dollars the feds allotted to national risk-pool insurance plans means that Illinois can afford to enroll 4,000 to 6,000 people in the plan --at best about 4 percent of the 1.7 million uninsured people in the state. But who are we to question the wisdom of government bureaucrats?

We're the first ones to acknowledge that IPXP will be a godsend to those 4,000 to 6,000 people. One wishes they didn't have to go uninsured for six months before becoming eligible (that's enough time to rack up $8,000 in HIV medications), but who are we to question the wisdom of government bureaucrats? EIEIO.

The bottom line is this: if you are eligible and can afford the coverage, sign up quick before the program is full. You can get all the information, including an online application, here. And you can read a brief interview with Michael McRaith, director of the Illinois Department of Insurance, discussing IPXP here.

The Messiness of HIV Criminal Transmission Laws

2010-08-05T13:56:00.004-05:00

Ever since the release of last month's redundantly titled National HIV/AIDS Strategy for the United States (as opposed to the international strategy for the United States?), we've been thinking a lot about one of the report's recommendations: that states consider repealing their HIV criminal transmission statutes. At least 32 states, including Illinois, have laws which specifically criminalize all sort of "intimate behaviors" if a person with HIV does not first disclose his or her status.

It's an incredibly volatile topic. And a recent New York Times article about a former Olympic medalist facing such charges in Florida does a fine job of teasing out the sort of warring facts, opinions and hostilities that routinely arise in such cases. You can read the full article here.

Hail Mary!

2010-07-28T10:40:00.003-05:00

There's a groovy new gal in the Council's corner office -- Mary Hankey, our new Community Outreach Coordinator.

Mary grew up in Chicago's north suburbs, then attended University of Illinois at Urbana-Champaign where she received a degree in journalism and women's studies. While there she discovered her passion for advocacy, focusing on women's rights and sexual assault education.

"The school was the only Big Ten university without a women's crisis center," she says. "There was a center in Champaign, but it was a good 20 minutes from the university. So I worked with other students to bring a women's center to campus." Eventually their efforts were successful.

Mary graduated last spring and then spent a year working in development for the Taproot Foundation which provides business talent to nonprofits. Last week she joined the Council's team, and we're sure she'll love working with us. I mean, who wouldn't?

A New National Strategy?

2010-07-15T12:39:00.006-05:00

You've probably heard that the White House Office of National AIDS Policy just issued the National HIV/AIDS Strategy for the United States. Like many similar documents, it's full of lofty language about all the marvelous things the federal government might consider doing to address the HIV epidemic. Those of you with a cynical side might be tempted to roll your eyes and throw the document out the window after reading no further than the "Vision for the National HIV/AIDS Strategy" which functions as the plan's preamble: "The United States will become a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination." Heck, all people with seasonal allergies will never have "unfettered access" to health care in America.

(And yes, we know the feds should have included a comma after "rare" and deleted the comma after "circumstance," but apparently the budget crisis is so severe they couldn't afford a copy of Elements of Style. But we digress.)

As idealistic (and admittedly laudable) as this "vision" is, it also sends a critical message to those working to end the HIV epidemic: stigma and discrimination must be defeated before we can claim to have conquered this disease. In a nutshell, that's why AIDS Legal Council exists.

The document is also somewhat remarkable in its tone. It's one of the few government-generated reports about HIV that bends over backwards to remind readers that people with HIV are "us," not "them," and furthermore that HIV is a national emergency whether or not you happen to know someone with HIV. The executive summary eloquently makes the case:

"Our national commitment to ending the HIV epidemic ... cannot be tied only to our own perception of how closely HIV affects us personally. Just as we mobilize the country to support cancer prevention and research whether or not we believe that we are at high risk for cancer, or just as we support investments in public education whether or not we have children, success at fighting HIV calls on all Americans to help us sustain a long-term effort against HIV."

We couldn't have said it better ourselves. And we talk real good.

Perhaps the most surprising aspect of the document is the way it links ongoing stigma to the existence and enforcement of criminal HIV transmission laws. It begins by pointing out that public health policies depend upon the cooperation of affected populations, and that "people at high risk for HIV cannot be expected to, nor will they seek testing or treatment if they fear that it would result in adverse consequences of discrimination." It goes on to say (and pardon us if we quote at length):

"At least 32 states have HIV-specific laws that criminalize behavior by people living with HIV. Some criminalize behavior like spitting and biting by people with HIV, and were initially enacted at a time when there was less knowledge about HIV's transmissibility. Since it is now clear that spitting and biting do not pose significant risks for HIV transmission, many believe that it is unfair to single out people with HIV for engaging in these behaviors and should be dealt with in a consistent manner without consideration of HIV status. Some laws criminalize consensual sexual activity between adults on the basis that one of the individuals is a person with HIV who failed to disclose their status to their partner. CDC data and other studies, however, tell us that intentional HIV transmission is atypical and uncommon. A recent research study also found that HIV-specific laws do not influence the behavior of people living with HIV in those states where these laws exist. While we understand the intent behind such laws, they may not have the desired effect and they may make people less willing to disclose their status by making people feel at even greater risk of discrimination. In some cases, it may be appropriate for legislators to reconsider whether existing laws continue to further the public interest and public health."

Talk about food for thought. And food for advocacy.

If you want to read the whole document, it's here.

Let Us Pat Ourselves on the Back

2010-07-08T15:42:00.007-05:00

A note from our executive director, Ann Fisher:

There are lots of ways to measure how effective we are. We get lovely responses on our client satisfaction surveys. We see how many cases we open. We review our training evaluations. We see the results of our advocacy in the Governor's budget. But one thing I'm always looking for is whether we do better for our clients than we do for ourselves. In other words, are our clients better off because funders give us support, rather than giving money directly to our clients?

You'll be glad to know the answer is "yes." I just looked at our case outcomes for fiscal year 2010. Even if we disregard all the wills and powers of attorneys we prepared, all the debt we got discharged or forgiven, all the Medicaid, Medicare or Illinois Cares Rx insurance coverage we got for people, all the clients for whom we secured Lawful Permanent Resident status, or indeed everything except our work for clients seeking Social Security or long-term disability benefits, our clients still came out ahead. Last year, as a result of our representation, disabled ALCC clients began receiving regular annual income totaling $657,168. In addition, our clients received retroactive benefits totaling $461,253 -- for a total amount of $1,118,421 to our clients. That's a heck of a lot more than we received from our funders.

Rah, rah, rah, team ALCC!

Bad ADAP News

2010-05-26T11:16:00.003-05:00

Throughout its long history, the Illinois AIDS Drug Assistance Program has gone through many changes -- funding ups and downs, formulary caps, eligibility expansions. But the program has never had a waiting list. That may be about to change.

Last week the Medical Issues Advisory Board, comprised of medical professionals, legal experts and people with HIV, voted unanimously to urge the immediate closure of the program to new applicants and institute a waiting list. The problem? Illinois's massive budget deficit.

David Ernesto Munar, vice president of the AIDS Foundation of Chicago, lamented that unless a waiting list is established, the entire program is in jeopardy. "Because the program is deeply underfunded, Illinois must take immediate steps to preserve services for those who rely on ADAP for their life-saving care," he said.

The Board's recommendation is now under review by state officials. We'll keep you posted.

You can read more about it here.

Another Crack in the Great Wall

2010-05-06T15:03:00.002-05:00

The list of countries banning HIV-positive visitors continues to shrink. On April 19, the China State Council (analogous to the White House Cabinet) announced that it had approved the repeal of China's 21-year-old HIV travel ban. Five days later Premier Wen Jiabao signed a decree making the policy change official -- just in time for Shanghai world exposition.

Earlier this year the United States lifted its own 23-year-old policy of barring HIV-positive people from entering the country. In response to China's decision, Senator John Kerry, chair of the Foreign Relations Committee, said, "This is evidence that when the United States leads with our ideals, the world takes the power of our example very seriously." Umm ... except most every other western nation never bothered to implement an irrational, discriminatory HIV travel ban in the first place. Call us cynics, but the U.S. has hardly "led with its ideals" in this issue.

Wrapping Our Brains Around Health Care Reform

2010-04-15T10:15:00.003-05:00

Quick! According to the new, massive health care reform law, when must employers begin to report the value of employees' health insurance benefits on their W-2s? When will Health and Human Services establish a process to review unreasonable insurance premium increases? When must insurance companies start selling individual insurance policies to anyone, regardless of pres-existing condition?

If you know the answers to any of these questions, you are a bigger wonk than us. But if you'd like a concise timeline for the implementation of the various aspects of health care reform, click on this lovely link and read to your wonky heart's content.

2010 Advocates of the Year Announced

2010-03-26T10:45:00.010-05:00

I know you've all been sitting beside your computers with bated breath for months, wondering who would be named 2010 Advocates of the Year. Well, wait no longer. Here is the esteemed list:

Alan Amberg

Alan Amberg’s advocacy for people with HIV stretches back more than 20 years. He’s created informational programs for LesBiGay Radio (the station he founded), written cutting-edge medical articles for many top hospitals, developed innumerable trainings for AIDS service agencies, co-chaired Cook County’s HIV Regional Implementation Group – all while helping thousands of HIV+ clients navigate complex medical and insurance networks as a neighborhood pharmacist.

Patrice Dean
A tireless community advocate for more than 10 years, Patrice Dean has devoted her time and energy to organizations serving the needs of people with HIV. She has been a member of the Mayor’s Council on AIDS, a co-chair of the Chicago Area HIV Planning Council and a champion for people with HIV through her involvement with North Side Coalition, Chicago Women’s AIDS Project and the HIV Prevention Planning Group.

Dr. Joseph Pulvirenti
Dr. Joseph Pulvirenti has been treating people with HIV since 1985, when he moved to Chicago to begin his medical practice at Cook County Hospital. He has since served as head of retrovirology and director of inpatient HIV services at Cook, as well as chairman of infectious diseases at Provident Hospital. To his patients and colleagues, he is a caring and devoted provider who goes the extra mile to ensure access to care to those who need it.

John Coburn
John Coburn of Health and Disability Advocates has worked to maximize Medicare benefits for people with HIV in order to save scarce Illinois AIDS Drug Assistance Program dollars and ensure access to life-saving medications to as many people as possible. He has worked similar magic in other states around the country, saving tens of millions of dollars for vital ADAP programs nationwide.

CORE Center Bilingual Clinic
A model for bilingual service delivery around the nation, the Bilingual Clinic at the CORE Center provides a wide range of critical services in Spanish to people living with HIV. The Clinic’s hands-on and comprehensive approach has enabled clients to access life-saving medical care, case management, mental health counseling and other vital services for more than a decade.

Sidley Austin LLP
Friend of the Council Award
ALCC is honored to give its 2010 Friend of the Council Award to the firm of Sidley Austin LLP. Sidley has been one of the Council’s most steadfast supporters since the beginning, providing countless hours of pro bono counseling to our clients, generous financial assistance and years of outstanding board service.

And there you have it. If you want to come to the official, swanky awards ceremony, mark your calendars. It'll be Thursday April 29 at Playboy Enterprises, 680 N. Lakeshore Drive, beginning at 6 pm. Heck, we'll make it even easier for you. Just click here to order your tickets today!

More Health Insurance Reform Specifics

2010-03-25T11:59:00.006-05:00

Yesterday's Chicago Tribune featured an interesting interview with Michael McRaith, director of the Illinois Department of Insurance, about the effects of the new health insurance laws on Illinoisans. Here's something McRaith said that jumped out out at us:

"Effective immediately, the secretary of (the U.S. Department of) Health and Human Services, in conjunction with the states, has authority to review and challenge unreasonable health insurance rate increases.

Right now, insurance companies report premium increases in the individual market, but we (in Illinois) do not have the authority to approve or deny rate changes. In the small-employer market, we don't even get informed of rate increases or premiums charged.

We will establish a protocol (for reporting data) as soon as possible. … It is absolutely certain that if there is an unreasonable rate increase, we will examine that and we will challenge that."

All we can say is hip-hooray. You can read the entire article here

2010-03-23T11:11:00.004-05:00

President Obama signed health insurance reform into law just a few minutes ago. Here are some important highlights from the new law.

Effective in 2010:

Employment-based and individual insurance policies will have to end pre-exisiting condition exclusions for children.

Individual and group plans will not be able to rescind coverage except in cases of fraud or intentional misrepresentation.

Policies can have annual caps on benefits only if allowed by the secretary of Health and Human Services.

Children up to age 26 can stay on their parents insurance (yeah, yeah, we know that 26-year-olds aren't children, but you get the point).

Small employers (under 25 employees, average salary under $50,000) who offer insurance get a tax credit.

A new national high-risk insurance pool will be available to people with pre-existing medical conditions who have been uninsured for at least six months. Maximum cost-sharing will be limited to $5,950 for an individual in the new pool.

Effective down the road:

Expand Medicaid eligibility to include everyone with income up to 133% of the federal poverty level without regard to whether they are disabled or living in a family with children.

Increase Medicaid payment rates for primary care to the Medicare levels.

End pre-existing condition exclusions and lifetime caps in all employer and individual insurance policies.

Provide subsidies that allow people with income up to 400% of the federal poverty level to buy insurance.

Require large employers (over 50 employees) to offer health insurance.

Create insurance exchanges which allow more choices and less cost in the individual and small group markets.

OK, discuss.

A Happy Ending

2010-03-17T10:59:00.003-05:00

You may recall our client's debacle last month, when he contacted a large child welfare agency to begin the process of becoming a foster parent -- and was told that his HIV status would make that impossible. (If you don't recall, you can read it here). The child welfare agency had sent him a letter explaining that the Department of Children and Family Services (DCFS) prohibits anyone with a "communicable disease" from being a foster parent.

Well, we contacted the attorney for the child welfare agency. To his credit, his immediate response was, "That doesn't sound right." After some investigation, the attorney assured us that it is not his agency's policy to turn potential foster parents away simply because they have HIV. In fact, the agency had worked with many HIV-positive foster parents in the past. What might have happened, he suggested, was a misunderstanding between his agency and DCFS concerning the definition of a "communicable disease." In Illinois, HIV is considered a sexually transmitted disease, not a communicable disease.

In any event, the attorney assured us that his agency would not eliminate our client from consideration as a foster parent merely because he has HIV. Currently our client is considering his options.

Stupidity Never Pays

2010-03-02T15:54:00.007-06:00

Wrap your brain around this one. A pharmaceutical home delivery company dropped off our client Maria's medications at a neighbor's house -- and right there visible on the packaging were the dreaded letters "HIV."

Maria wasn't home when the medications were delivered. She is very protective of her confidentiality, and she had asked the delivery company not to leave the medications with neighbors. Nonetheless, the delivery company did just that. The medications were in a clear plastic bag, and visible inside the bag was a sheet printed "RN Copy of Physician's Orders." That sheet listed "HIV" and "severe neutropenia."

Worse still, Maria had contacted the delivery company several weeks earlier, because she did not like the fact that the paperwork included with her medications revealed her HIV status in a way that anyone could see. She explained her concern to at least three different people at the company, all of whom reassured her it wouldn't happen again.

We contacted the attorney for the pharmaceutical delivery company, and after some firm talk we reached a settlement which made Maria quite happy.

Are They Kidding?!?

2010-02-25T11:34:00.004-06:00

It makes us all a bit weary to hear yet another story of blatant discrimination against a person with HIV, but this one just about knocked the floor out from under us.

Bob is an award-winning schoolteacher in a northern suburb of Chicago. He recently decided to become a foster parent. So he called one of the largest child welfare agencies in his community -- we'll call it Agency X -- to begin the process. As part of the intake process, Bob had to complete a health questionnaire. Before filling it out, he called the agency and told them that he wanted to be upfront about having HIV. Would that make him ineligible for a foster child placement? The staff person on the phone didn't know but promised to get back to him.

A week or so later Bob received a letter from Agency X. The letter informed him that Agency X had consulted with the Department of Children and Family Services (DCFS) and that DCFS had informed them that anyone with a "communicable disease," even one not easily transmitted, is barred from being a foster parent.

Well, we consulted with DCFS -- in fact, with the attorney who oversees all the HIV cases there. She made it very clear that DCFS has no such policy, and that people with HIV can and do become foster parents. Which makes us wonder: do the pinhead at Agency X think they can just make stuff up to scare people with HIV away? And how can they be so stupid as to put their discriminatory policy in writing?

We can't wait to have a little tete-a-tete with Agency X's attorney. We'll keep you posted.

Ideology Trumps Science

2010-01-19T14:46:00.003-06:00

In 2003 President George W. Bush signed legislation that created the President's Emergency Plan for AIDS Relief (PEPFAR), a program that has funneled $25 billion to combat the AIDS epidemic primarily in Africa. The cynics among us might lament that calling AIDS an "emergency" more than two decades after its appearance shows just how long our government willfully neglected the global pandemic. Still, more than 2 million people have received anti-retroviral medications through PEPFAR.

But PEPFAR's politics, with its insistence on abstinence-heavy HIV prevention messages, have always been troubling to the majority of AIDS activists. A report just released by the Council for Global Equality shows in saddening, infuriating detail just how PEPFAR's moralistic presumptuousness hinders, complicates and confuses HIV prevention efforts. For example, PEPFAR requires any organization receiving funds to adopt a policy explicitly stating their opposition to sex work, thus making it all but impossible for any group trying to prevent infections among sex workers -- one of the world's most vulnerable populations -- to receive any PEPFAR support. PEPFAR funds also routinely go to organizations that, at best, do no outreach to men who have sex with men, or, at worst, to governments like Uganda's that make homosexuality (or "carnal knowledge of any person against the order of nature," as the Ugandan penal code describes it) a criminal act.

The report is a fascinating, if dispiriting document. As tempting as it is to place blame on the Christian right wing for its pervasive influence on PEPFAR's particulars, those of us who work as AIDS advocates should be asking ourselves how we have allowed this travesty to go on for so many years.

You can read the entire report here.

A Bit of Video Wisdom

2010-01-14T15:52:00.001-06:00

Here are 18 seconds of wisdom from YouTube.

Fighting HIV Stigma Protects Public Health

2010-01-08T10:28:00.010-06:00

Too often we've heard that legal services for people with HIV are "secondary" to health care services. What people with HIV need more than anything, the argument goes, is medicine, as though pharmaceuticals alone will render HIV "chronic and manageable" no matter what non-medical crises a person with HIV might face. The insistence on viewing AIDS as primarily a medical issue (as opposed to, say, a civil rights issue or a social justice issue) has even resulted in major funders requiring legal agencies like ours to evaluate the effectiveness of our services by demonstrating improved health outcomes in our clients. And "health" is always defined as personal health, rather than social health. Imagine trying to justify fighting a discriminatory job termination by showing how much a lawsuit increases your client's CD4 count.

Now comes a study that shows what we in legal services have known all along: social health and personal health are inextricably linked for people with HIV. The study, published in the August, 2009 issue of the Journal of General Internal Medicine, examined the relationship between social stigma and access to health care. In essence, the study showed that the more people with HIV experience stigma, the less likely they are to access health care regularly or take their medications as prescribed. Here's one of the study's more sobering conclusions: "We found that respondents experiencing high levels of stigma had over four times the odds of reporting poor access to care."

Perhaps even more sobering, the report showed that one third of the participants reported experiencing "high levels of internalized HIV stigma."

Clearly, then, fighting against HIV stigma -- something we, like our colleagues at other legal agencies around the city and country, do every day -- is fighting for better health care, for the health of individuals, communities, and the nation as a whole.

Why You're Glad You're Not a Teenager Anymore

2009-12-30T11:26:00.004-06:00

We got a call this morning that really got us thinking about the difficulties of facing HIV as an adolescent.

Theresa called with concerns about her godson, Gerard. Gerard is 16 and has been HIV-positive since birth. Theresa has known about his status for his entire life, and when Gerard's mother died she took him in for several years. Theresa knew that Gerard has had a steady boyfriend for the past year, and yesterday while she and Gerard were hanging out in her kitchen she asked him if he had told his boyfriend about his HIV status. Gerard said he had not, and added that they always had protected sex. Theresa asked Gerard if he was afraid to tell his boyfriend about his HIV status, and he said he wasn't; he just hadn't gotten around to it.

So Theresa called us, wanting to know how her godson's actions squared with Illinois law. We told her that the law requires a person with HIV to disclose that information before engaging in "intimate contact" with another person, and that the law defines "intimate contact" as anything which might transmit HIV, whether it does or not. So under a strict reading of the law, Gerard had committed a felony every time he and his boyfriend had sex.

Next came the really difficult question. What would we advise her to do?

One thing was clear: under the Illinois AIDS Confidentiality Act, Theresa could not legally inform Gerard's boyfriend (or anyone else, for that matter) of Gerard's HIV status without Gerard's written permission. She said she had no intention of betraying Gerard's trust that way. But what could she advise Gerard to do? Here are the suggestions we made:

He could tell his boyfriend that the two of them should go get tested for all STDs, including HIV. After all, public health departments routinely put out the message that sexually active gay men should get STD tests done every six months (yes, that's a ridiculous message to put out, as it suggests that gay men can do nothing short of celibacy to eliminate their risk of contracting STDs, unlike straight people). Hopefully the boyfriend's tests would all come back negative. Then Gerard could disclose his HIV status to his boyfriend, emphasizing that safe sex works. Perhaps Gerard would want to include his boyfriend's parents in that discussion.

He could self-report to the local department of health, and have them inform his boyfriend that he may have been exposed to HIV. They would do so without disclosing Gerard's name. Of course, if the boyfriend hasn't been with anyone but Gerard in the last year, he would know who the department of health was talking about. And getting the information from health authorities, rather than from Gerard personally, might create a lot of bad feelings.

He could end the relationship and keep quiet. But as Theresa pointed out, this option prevents Gerard's boyfriend from learning important information for his own sexual health. Theresa felt strongly that the boyfriend should get an HIV test.

Lastly, Theresa asked what repercussions Gerard might face. Would he be arrested? Put in jail? We told her that the likelihood of a criminal prosecution in a case like this is very low, at least here in Cook County, Illinois. A bigger concern might be the boyfriend's parents threatening some sort of civil legal action against Gerard for putting their son in jeopardy without informing him first. But it seemed to us that the real risk Gerard faces is that his HIV status becomes widely known at his school; it's hard to imagine that any 16-year-old boy who learns he's been dating someone with HIV for a year will tell none of his friends at school. And if Gerard's status became common knowledge at school, it's hard to know how difficult his life there might become.

We sure hope things work out for Gerard and his boyfriend.

More CORBA Help

2009-12-22T09:53:00.007-06:00

Perhaps you recall that last spring President Obama signed the American Recovery and Reinvestment Act, which among other things provides a 65% subsidy for COBRA premiums for those who become COBRA eligible between September 1, 2008 and December 31, 2009. If you don't recall this momentous event, then clearly you have not been reading our blog regularly, like all good people should, since we blogged about it back then. We even included a link to the IRS regulations that govern the program. Gosh, we are marvelous, not to mention thorough.

Well, now there's news that the program will be extended to February 28, 2010. The extension is included as part of the Department of Defense Appropriations Act, which the President signed into law on December 19.

Here's an important thing to know about this extension: your COBRA coverage doesn't have to begin by February 28, 2010. Rather, your COBRA eligibility has to begin by February 28, 2010. For example, if you lose your job on February 28, you would be eligible for the extension, even though you probably won't have your COBRA coverage in place until a month or two later.

If you really want to make your brain overheat, read through the Act here. You'll have to wade through 63 pages of blah-blah-blah until you get to the COBRA stuff in Section 1010. Here's our favorite tidbit:

(c) RULES RELATED TO 2009 EXTENSION.—Subsection (a) of such section is further amended by adding at the end the following: ‘‘(16) RULES RELATED TO 2009 EXTENSION.—
(A) ELECTION TO PAY PREMIUMS RETROACTIVELY AND MAINTAIN COBRA COVERAGE.—In the case of any premium for a period of coverage during an assistance eligible
individual’s transition period, such individual shall be treated for purposes of any COBRA continuation provision as having timely paid the amount of such premium if—
(i) such individual was covered under the COBRA continuation coverage to which such premium relates for the period of coverage immediately preceding such transition period, and
(ii) such individual pays, not later than 60 days after the date of the enactment of this paragraph (or,if later, 30 days after the date of provision of the notification required under subparagraph (D)(ii)), the amount of such premium, after the application of paragraph
(1)(A).

That sure clears things up.

Flee Fornication!

2009-12-17T16:28:00.001-06:00

And here we have our nominee for the most useless, moralizing, irresponsible and poorly sung HIV prevention message ("Limit yourself to one faithful spouse / And flee fornication!") to disgrace the Internet.

And what a shame the poor dear can't pronounce 'trichomonas.'

Discuss.

ALCC in the News

2009-12-01T10:45:00.003-06:00

The venerable Chicago Tribune ran a feature today about the looming repeal of the HIV travel ban -- and quoted our paralegal Kate Miller. Check out the article here.

And if you want to be truly flabbergasted, read through the comments people left after reading the article. Perhaps it's not terribly surprising, in light of all the deliberate misinformation that has been promulgated in an effort to scuttle health care reform, that so many people think immigrants are granted free health care in America. But it's astonishing that in 2009 so many people appear willfully and proudly ignorant of the basics of HIV infection. One pinhead even calls HIV an "easily communicable, incurable, and deadly disease." Oy gevult. Some people shouldn't be allowed access to computers.

Now People with HIV are Potential Terrorists ... At Least in Michigan

2009-11-12T11:18:00.004-06:00

We thought we'd heard it all when it comes to fear of and contempt for people with HIV. But now comes word of a Michigan prosecutor who has charged an HIV-positive man under anti-terrorism laws -- because he allegedly bit someone!

Yes, we can all agree that biting other people in a fit of anger is juvenile, idiotic and icky. And if the charges are to be believed (allegedly the HIV-positive guy bit his neighbor's lip clean through because he was infuriated when a kid's football landed in his yard) this particular incident is about as absurd and inexplicable as an assault can get. Originally the alleged biting fiend was charged with aggravated assault and assault with attempt to maim. However, after the guy admitted on a local Fox news interview that he is HIV-positive (why did the interviewer ask? because the guy looks kinda maybe a little gay?), the prosecutor tacked on a new charge, "possession or use of a harmful device." The prosecutor was relying upon a 2004 Michigan law designed to fight terrorism; the law defines a "harmful device" as either biological, chemical, electronic or radioactive.

And yes, the prosecutor maintained a straight face while defending his belief that HIV is a harmful device "designed or intended to release a harmful biological substance." (Who knew that HIV was "designed?"). Worse still, Judge Linda Davis agreed. “[He] knew he was HIV positive, and he bit the guy,” Davis said. “That on its own shows intent.” Well, it shows intent to bite, anyway.

And since when does a bite present anything more than a vanishingly tiny, theoretical risk of HIV transmission? The CDC puts the risk at 0.000000001 percent. In fact, nearly 30 years after HIV was discovered, the CDC has identified exactly one case in which biting may have been the source of infection: a South Carolina man alleged that his only risk of infection came when an angry sex worker bit him after he refused to pay her. (So...he hired a sex worker, and he can't think of any other risk factor for his HIV infection?).

Already Michigan lawmakers, including the head of the House Judiciary Committee, have spoken out against this prosecutorial folly.

You can read a well-researched article about this mess in the Michigan Messenger here.

Things That Make You Go "Hmmmm"

2009-11-11T15:10:00.004-06:00

No one ever accused the Social Security Administration of literary genius. But really, if you received this notice, as our client did, would you have any idea what you were supposed to do:

If you earn more than $14,160.00 in the year when your benefits are stopped, you need to let us know how much you earn. This is because earnings can affect the amount of benefits you were due before we stopped paying you. Please report about money you earned both before and after we stopped paying you.

Please translate the above paragraph into English and submit it to us. We'll pass it along to our client.

It's Official ... But Wait a Couple Months

2009-11-10T10:00:00.007-06:00

It all started in October of 2008, when President Bush signed legislation that changed the Immigration and Nationality Act, removing HIV from the list of conditions that make people inadmissible to the United States. Since that time, we've all been waiting for the CDC to change the underlying federal regulations to reflect the change in the law. Well, the final rule is -- finally -- out. As of January 4, 2010, HIV will no longer be a "communicable disease of public health significance," meaning HIV will be no more relevant to immigration than a runny nose.

If you enjoy reading boring regulations as much as we do, you can read the final rule here.

Link Card Follies

2009-11-05T15:52:00.005-06:00

The best thing about the Illinois Department of Human Services is its highly developed sense of farce. Consider Jeff's story.

Recently Jeff went to his local IDHS office and applied for Food Stamps (also known as a Link Card ... also known as SNAP ... and no, that's not really the farcical part of our tale). Not long thereafter, he received two letters from IDHS. Both letters were dated September 18. Both were sent from the same local IDHS office. The first said his application for food stamps was approved. The second said his application for food stamps was denied.

The farce gets a tiny bit better. The next day Jeff received a third IDHS letter, from the same wacky local office, saying he would receive a Link Card with $93 on it. The card never showed up; clearly the cut-ups at IDHS appreciate that it's funnier that way.

Understandably befuddled, Jeff called us and talked to our paralegal Lindsee Redmond. She filed an appeal (imagine how much fun it was to explain exactly which IDHS action she was appealing). This morning she accompanied Jeff to his hearing at the comedy-rich IDHS office that had sent all the bewildering letters.

Lindsee didn't just fix the problem, she fixed it immediately. She got the hearing officer to approve Jeff's food stamp application right then and there, and she made sure Jeff had a $93 Link Card in his hand before she left.

Our Eloquent President

2009-10-30T12:27:00.006-05:00

Before President Obama reauthorized the Ryan White Care Act today, he made these remarks. They speak for themselves:

THE PRESIDENT: We often speak about AIDS as if it's going on somewhere else. And for good reason -- this is a virus that has touched lives and decimated communities around the world, particularly in Africa. But often overlooked is the fact that we face a serious HIV/AIDS epidemic of our own -- right here in Washington, D.C., and right here in the United States of America. And today, we are taking two important steps forward in the fight that we face here at home.

It has been nearly three decades since this virus first became known. But for years, we refused to recognize it for what it was. It was coined a "gay disease." Those who had it were viewed with suspicion. There was a sense among some that people afflicted by AIDS somehow deserved their fate and that it was acceptable for our nation to look the other way.

A number of events and advances over the years have broadened our understanding of this cruel illness. One of them came in 1984, when a 13-year-old boy from central Indiana contracted HIV/AIDS from a transfusion. Doctors assured people that Ryan White posed no risk to his classmates or his community. But ignorance was still widespread. People didn't yet understand or believe that the virus couldn't be spread by casual contact. Parents protested Ryan's attendance in class. Some even pulled their kids out of school. Things got so bad that the White family had to ultimately move to another town.

It would have been easy for Ryan and his family to stay quiet and to fight the illness in private. But what Ryan showed was the same courage and strength that so many HIV-positive activists have shown over the years and shown around -- show around the world today. And because he did, we didn't just become more informed about HIV/AIDS, we began to take action to fight it.

In 1990, the year Ryan passed away, two great friends and unlikely political allies, Ted Kennedy and Orrin Hatch, came together and introduced the Comprehensive AIDS Resources Emergency Act -- the CARE Act -- which was later named after Ryan.

In a few minutes, I'm going to sign the fourth reauthorization of the Ryan White CARE Act. Now, in the past, policy differences have made reauthorizations of this program divisive and controversial. But that didn't happen this year. And for that, the members of Congress that are here today deserve extraordinary credit for passing this bill in the bipartisan manner that it deserves: Tom Harkin and Mike Enzi in the Senate, we are grateful to you for your extraordinary work; Speaker Pelosi, who's always leading the charge on so many issues; Frank Pallone, Jr., Joe Barton, Barbara Lee and Donna Christensen in the House, thank you for your extraordinary work -- oh don't worry, I'm getting to Henry. (Laughter.) Nancy is always looking out for members, but we've got a special section for Henry.

And Chairman Henry Waxman, who began holding hearings on AIDS in 1982, before there was even a name for AIDS, was leading here in Washington to make sure that this got the informed attention that it deserved and who led the House in passing the original Ryan White legislation in 1990.

I also want to acknowledge the HIV community for crafting a consensus document that did so much to help move this process forward. Some of the advocates so important to this legislation are with us here today: Ernest Hopkins from Cities Advocating for Emergency AIDS Relief; Frank Oldham, Jr., President and CEO of the National Association of People with AIDS; and Julie Scofield, Executive Director of the National Alliance of State and Territorial AIDS Directors.

And I'm especially honored that Ryan's mother, Jeanne White-Ginder, is here today. For 25 years, Jeanne had an immeasurable impact in helping ramp up America's response to this epidemic. While we lost Ryan at too young an age, Jeanne's efforts have extended the lives and saved the lives of so many others. We are so appreciative to you. Thank you. (Applause.)

You know, over the past 19 years this legislation has evolved from an emergency response into a comprehensive national program for the care and support of Americans living with HIV/AIDS. It helps communities that are most severely affected by this epidemic and often least served by our health care system, including minority communities, the LGBT community, rural communities, and the homeless. It's often the only option for the uninsured and the underinsured. And it provides life-saving medical services to more than half a million Americans every year, in every corner of the country.

It's helped us to open a critical front on the ongoing battle against HIV/AIDS. But let me be clear: This is a battle that's far from over, and it's a battle that all of us need to do our part to join. AIDS may no longer be the leading killer of Americans ages 25 to 44, as it once was. But there are still 1.1 million people living with HIV/AIDS in the United States, and more than 56,000 new infections occur every single year.

Some communities still experience unacceptably high rates of infection. Gay men make up 2 or 3 percent of the population, but more than half of all new cases. African Americans make up roughly half of all new cases. Nearly half of all new cases now occur in the South. And a staggering 7 percent of Washington, D.C.'s residents between the ages of 40 and 49 live with HIV/AIDS -- and the epidemic here isn't as severe as it is in several other U.S. cities.

So tackling this epidemic will take far more aggressive approaches than we've seen in the past -- not only from our federal government, but also state and local governments, from local community organizations, and from places of worship.

But it will also take an effort to end the stigma that has stopped people from getting tested; that has stopped people from facing their own illness; and that has sped the spread of this disease for far too long. A couple of years ago Michelle and I were in Africa and we tried to combat the stigma when we were in Kenya by taking a public HIV/AIDS test. And I'm proud to announce today we're about to take another step towards ending that stigma.

Twenty-two years ago, in a decision rooted in fear rather than fact, the United States instituted a travel ban on entry into the country for people living with HIV/AIDS. Now, we talk about reducing the stigma of this disease -- yet we've treated a visitor living with it as a threat. We lead the world when it comes to helping stem the AIDS pandemic -- yet we are one of only a dozen countries that still bar people from HIV from entering our own country.

If we want to be the global leader in combating HIV/AIDS, we need to act like it. And that's why, on Monday my administration will publish a final rule that eliminates the travel ban effective just after the New Year. Congress and President Bush began this process last year, and they ought to be commended for it. We are finishing the job. It's a step that will encourage people to get tested and get treatment, it's a step that will keep families together, and it's a step that will save lives. (Applause.)

We are continuing the work of crafting a coordinated, measurable national HIV/AIDS strategy to stem and suppress this epidemic. I'm pleased to report that the Office of National AIDS Policy, led by Jeffrey Crowley, has already held eight in a series of 14 community discussions in cities across the country. They've brought together faith-based organizations and businesses, schools and research institutions, people living with HIV and concerned citizens, gathering ideas on how to target a national response that effectively reduces HIV infections, improves access to treatment, and eliminates health disparities. And we are encouraged by the energy, the enthusiasm, and great ideas that we've collected so far.

We can't give Ryan White back to Jeanne, back to his mom. But what we can do -- what the legislation that I'm about to sign has done for nearly 20 years -- is honor the courage that he and his family showed. What we can do is to take more action and educate more people. What we can do is keep fighting each and every day until we eliminate this disease from the face of the Earth.

So with that, let me sign this bill. (Applause.)

One Step Closer to End of HIV Immigration Ban

2009-10-27T11:05:00.002-05:00

Yippy skippy! The Centers for Disease Control and Prevention (CDC) has finally approved the federal regulation that will make people with HIV admissible to the United States. As you probably know, for about the last 20 years people with HIV have been barred from immigrating to the United States -- or even visiting as tourists -- unless the could qualify for a narrow, onerous waiver. With this new federal regulation, a person's HIV status will be irrelevant for immigration purposes.

One final step remains before the change goes into effect: the White House Office of Management and Budget must approve the regulation within the next 60 days. So keep your fingers crossed.

Social Security Payments Flat for 2010

2009-10-15T14:30:00.004-05:00

Perhaps you've already heard the news that Social Security payments won't be going up in 2010. Whether you're receiving SSDI or SSI, you'll get exactly the same amount next year as you got last year.

Well, what's going on here? Don't Social Security payments go up every year? Not exactly. In fact, it wasn't until 1973 that Congress passed a law that subjected Social Security payments to an annual Cost of Living Adjustment (COLA) -- but only if the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) goes up. Specifically, Social Security compares the averaged CPI-W for the third quarter of this year to the averaged CPI-W for the third quarter of last year. And whaddya know, that number actually went down, from 215.459 in 2008 to 211.001 in 2009.

Don't we sound smart, throwing lots of numbers around?

The bottom line is that according to the feds, the consumer price index did not increase from 2008 to 2009, and therefore Social Security checks won't increase for 2010.

But here's an interesting twist on the story: just yesterday President Obama proposed giving a one-time payment of $250 next year to everyone on Social Security. "Even as we seek to bring about recovery, we must act on behalf of those hardest hit by this recession," Obama said. Of course, that's just his proposal; it needs Congressional approval. We'll keep you posted.

Here is a CNN story on this issue.

Health Care Reform? How About Health INSURANCE Reform?

2009-09-17T15:17:00.005-05:00

A recent case out of South Carolina's Supreme Court gives a glimpse of just how unfair, unreasonable and downright cold-hearted at least one insurance company can be when dealing with a person with HIV.

Here's what happened, according the court's ruling.

On May 15, 2001, Jerome Mitchell, Jr. of Florence, South Carolina, applied for health insurance through Fortis Insurance Company. Jerome was 17 years old at the time and no longer covered under his mother's health insurance policy. The application for the insurance included a health questionnaire. Among other things the application asked if he had been diagnosed or treated "for any immune deficiency disorder by a member of the medical profession." Jerome answered "no."

A little over a year later Jerome donated blood, and on May 13, 2002 he received a letter from the Red Cross informing him that his blood has tested positive for HIV. Jerome contacted his doctor, got an HIV test, and the very next day -- May 14, 2002 -- his doctor confirmed that he was HIV-positive. However, the hand-written medical note in his doctor's file confirming his diagnosis was incorrectly dated May 14, 2001.

When Fortis received Jerome's claim for the HIV test, Fortis initiated an investigation to see if Jerome had failed to disclose any pre-existing condition on his insurance application. It was Fortis's policy to investigate such claims for anyone with a long-term disease. In June Fortis received Jerome's medical records, including the misdated progress note. In September Fortis's "rescission committee" convened and spent two hours reviewing 46 cases, including Jerome's, for possible rescission. And you guessed it, they determined that Jerome had lied on his application and cancelled his policy.

When Jerome received notice from Fortis about the termination of his insurance, he called Fortis's customer service department, and was told that nothing could be done. Then his case manager called, and offered to fax in Jerome's medical records, including the properly dated HIV test result. The customer service representative spurned the offer and provided no information about Jerome's right to appeal Fortis's decision.

Jerome then hired an attorney, who sent Fortis the properly dated HIV test result along with a letter explaining that Jerome had first tested HIV-positive in May 2002, a full year after he had applied for insurance. When the rescission committee met to consider Jerome's appeal, they didn't receive a copy of the actual HIV test result that his attorney submitted; rather, they were given a single piece of paper which read: "letter from attorney stating that the insured did not misrep[resent] coverage since the first diagnosis of AIDS was 5/14/2002." Jerome's appeal was denied.

So Jerome sued. According to the court's ruling:

"At trial, Mitchell’s insurance expert testified that it was Fortis’s practice to shut down an investigation once a single piece of evidence was discovered that would support rescission. Further, Mitchell introduced testimony from Fortis’s manager of underwriting and correspondence – Stephens’s direct supervisor – who testified that she was “not able to answer” whether she or any of her employees “had a responsibility to find out the truth” about a policyholder’s medical conditions. On cross-examination, Fortis’s insurance expert conceded that an insurance company has a duty to investigate and find information that may lead to payment of a claim."

When all was said and done, Jerome won his case. Fortis had to pay $150,000 in compensatory damages and -- get this -- $10 million in punitive damages. Chief Justice Jean Hoefer wrote in her decision that Fortis "demonstrated an indifference to Mitchell’s life and a reckless disregard to his health and safety."

It's particularly astonishing that this unanimous decision came out conservative, pro-business South Carolina.

If you want to read the court's decision, it's here.

If you want to read a nice summary of the case, it's here.

Our New Hero

2009-09-08T15:37:00.006-05:00

So we're all swooning over our new legal idol, attorney Seth M. Lloyd, with the law firm Dykema Gossett PLLC. He took on one heck of a confused, complicated, messy insurance case for a client with end-stage cancer and fixed everything -- in about a week. And he did all the work for free!

Back in April, our client Luis received his regular payment coupon from his health insurance company. It was a rather confusing document, listing "total due" and a "past due" amount, with no indication whether the past due amount was included in the total due amount. The statement also showed a "due date" of May 1 and a "grace date" of June 1, with no indication of which amounts were due when. Did the grace period apply only to the amount currently due? Did it also apply to the past due amount? Luis assumed that all of the payments listed on the statement were subject to the grace period: a reasonable assumption. He was wrong. So even though Luis got the entire amount in to the insurance company by June 1, the part that was not subject to the grace period (whatever part that might have been) was considered late, and his insurance was cancelled.

Mind you, Luis is in the final stages of cancer. He needs insurance coverage primarily to pay for his hospice care, so that his final few months might be tolerable.

Seth Lloyd agreed to appeal the termination of Luis's coverage. Just a few days after getting the case from us, he sent off an exquisitely clear, concise, passionate three-page appeal letter to Luis's insurance company, complete with numerous exhibits. It's rather astonishing that he managed to make compelling sense out of such confusing facts. More importantly, his appeal worked. Poof. Just like that, the insurance company was picking up the bills for Luis's hospice care again. Wow.

Oh, and did I mention that Mr. Lloyd worked exactly the same kind of magic for Luis last year, when his insurance was cancelled the first time?

So everyone at ALCC has joined the official Seth M. Lloyd fan club. We even put posters of him all over the office. We encourage you to start a chapter of the fan club in your town.

Creative HIV Prevention or Socialized Marriages?

2009-08-19T10:24:00.005-05:00

Here's something that caught our eye: in an effort to stem the spread of HIV in one Nigerian state, the government has set up a program to encourage HIV-positive people to marry each other.

According to a report on CNN, the Bauchi State Agency for the Control of AIDS, Tuberculosis and Malaria (BACATMA) offers to pay the dowry for HIV-positive couples who get married. It will also provide counseling and a job within the department.

Rilwanu Mohammed, the BACATMA chairman, told CCN, "If someone having HIV marries another HIV-AIDS person, that means there will be no HIV transmission to another negative person." Of course, he overlooks an obvious truth: a marriage license does not prevent sex outside of marriage.

Warren Naamara, the UNAIDS Nigeria coordinator, expressed reservations about the program. "There are better methods to address the prevention of HIV and AIDS rather than encouraging that kind of union," he said. "We have made it very clear from UNAIDS that the best way to address HIV infection is universal access to prevention, treatment and care."

Still, if state-sponsored marriages do little to spread HIV infection, they may help combat the stigma against HIV-positive people in Nigeria.

What do you think? We'd love to hear your thoughts.

You can read the CNN article here.

More Idiot Chronicles

2009-08-13T11:21:00.008-05:00

We had a little flashback to 1983 this week, when a client called with a story that seemed to come straight from those days of ignorance and intolerance.

Sheila works transporting passengers who need assistance, typically the elderly and disabled. When she started the job about six months ago, she hired a good family friend, Angela, to babysit her young children. But last week Sheila began to suspect that Angela might be mistreating her kids, so she fired her. Angela didn't take kindly to losing her job, so she decided to make life difficult for Sheila.

Angela didn't know that Sheila had HIV, but she did know that Sheila was getting housing assistance from a certain social service agency in Chicago. So she called that agency, pretending to need help, and asked how she could become eligible for services. The agency worker told her that she would have to be HIV-positive to qualify.

Angela then called Sheila's supervisor Tom and told him that Sheila has AIDS.

Now, you would think that in 2009 Tom would have been properly trained to know that someone with HIV pushing people around an in wheelchairs poses no threat to anyone, and he would have told Angela to take a long walk off a short pier. Instead, he pulled Sheila aside that evening as she was clocking out from her shift. "Someone called today and told me you have AIDS," he said. "Is this true?" Sheila said she didn't know what he was talking about, so Tom went on. "If you have AIDS, it's going to be a problem because you work with the disabled." He told her that she would have to get an HIV test to prove she was not infected before she could return to work. He even confiscated her ID badge so that she could not get back into her office.

Sheila called us the next morning and talked to our whip-smart paralegal Steve Barrera. After listening to her story, he took a moment to pick his jaw up off the floor and then rolled up his sleeves. "What your supervisor did is completely illegal under the Americans with Disabilities Act," he told her. Steve knew that mounting a formal legal challenge against her employer is typically a lengthy process; even contacting her employer's attorney can take several days. So Steve decided that perhaps he could give Sheila the tools she needed to resolve this problem herself. "Tell Tom that you've talked to us," he told her, "and that in our opinion his actions are illegal. Ask him to put his decision in writing, and ask him which company policy he was relying upon in barring you from work." (We told you Steve was smart).

Sheila hung up, then called back 15 minutes later. She had followed Steve's advice and confronted Tom. Tom called his boss, then told Sheila that she was correct, he had no right to bar her from work, and that she could return to her regular shift. Whammo, problem solved.

Party People in da House

2009-08-07T12:10:00.006-05:00

We know you've been waiting all year for AIDS Legal Council's next bash. Well, now you need wait only another month for Bollywood Nights, ALCC's 2009 blow-out. It'll be on Wednesday, September 9 at Sidetrack, 3349 N. Halsted in Chicago's lakeview neighborhood. The fun starts at 6pm. There will be Indian cuisine, a couple raffles, a performance of Bollywood-style dancing, and the exciting thrill of meeting the ALCC staff and board. You can get tickets right here. Come on, you've got nothing else to do that night, and we're a fun crew.

For a taste of last year's blow-out, click here

Ann Fisher Gets Yet Another Award

2009-07-01T09:57:00.003-05:00

It seems that our executive director Ann Fisher's all-around fabulousness is getting more attention these days. To wit: she's just been awarded the 2009 Community Leadership Award from the Illinois State Bar Association. Given by the ISBA’s Committee on Sexual Orientation and Gender Identity (SOGI), the honor recognizes individuals for efforts to foster understanding of lesbian, gay, bisexual and transgender (LGBT) people and their issues of concern.

Ann received her honor last week at the ISBA's 133rd Annual Meeting in beautiful downtown Fontana, Wisconsin.

More Social Security Follies

2009-05-22T10:54:00.005-05:00

Here's some more evidence to prove what most of us intuit to be true: lots of Social Security workers believe their main job is to send people away so that they don't have to do any work.

Case in point: yesterday I went to a Social Security office on the near west side to try to sort out my client Rhonda's overpayment issue. All I wanted to do was meet with a Social Security representative in order to explain that Social Security had calculated her overpayment amount incorrectly. I had all of Rhonda's bank statements which clearly showed that Social Security's overpayment amount was about $3,000 too high.

So I walked into the office, took a number and waited for my name to be called. After about half an hour I was called up to the front window. I explained the issue briefly, handed the Woman Behind the Glass a brief memo outlining the problem, and also handed her the Appointment of Representative form which Rhonda had signed authorizing me to represent her before Social Security. The WBTG asked me to return to my seat while she talked to her supervisor.

Twenty minutes later she called me back. The scowl on her face did not bode well. "The overpayment notice came from the southside Social Security office on Sacramento," she said. "So you have to go there." Now, I've been doing this work for almost 20 years, and I know a thing or two about Social Security rules. "Actually, that's not true," I said, trying to remain pleasant. "I can do Social Security business at any Social Security office." The WBTG picked up her magic phone, asked her invisible supervisor if I was correct. And whaddya know, I was.

Still, she scowled. "The other problem is that you haven't submitted an Appointment of Representative form, so I can't release any information on your client's overpayment." Keep in mind that she said this while holding the Appointment of Representative form in her hand.

I stood in stupefied silence for a moment, then said, "You have the form right there."

"Right," she said, "but you didn't submit it earlier, so it's not in the file."

"That form is all you need to discuss this case with me."

"But the form shows that she appointed you as her representative just last week," she said, "and this overpayment is from a year ago."

At this point, I knew I had three choices. I could yell, laugh or ask her to pick up her magic phone yet again. I chose the third option. It worked. After talking to the invisible supervisor, the WBTG informed me that I could, indeed, meet with a Social Security representative who could, indeed, accept the documentation I wanted to submit. I would just have to wait until someone was available. And that would be in, oh, an hour. Luckily I brought a book.

After a few chapters of Death in Venice, I was called back to meet with a worker who listened to my explanation, accepted my client's financial documentation, and told me that really, you were supposed to go to the Sacramento office. I decided to move in for the kill. "Oh, but everyone in this office is so friendly and knowledgeable," I said. "That's why I came here."

Meet the Nasty Iowa Judge

2009-05-15T14:08:00.008-05:00

Figure this one out: earlier this month Judge Bradley Harris sentenced an HIV-positive Iowa man to a 25-year prison term for not infecting someone with HIV.

Here's what happened. According to published news reports, an Iowa man named Nick Rhoades met another man in an internet chat room back in June of 2008. The two agreed to get together for sex. Rhoades did not disclose his HIV status.

A week or so later Rhoades's sex partner learned through friends that Rhoades was HIV-positive. He went to the police and had Rhoades arrested. When the case finally got before Judge Harris earlier this month (nearly a year since the two men had sex) Rhoades admitted his wrongdoing, pled guilty and expressed remorse. "I always wanted to be part of the solution and not part of the problem," he told the judge. "Clearly I've fallen short in this case."

The man with whom Rhoades had sex one time, 11 months ago, has repeatedly tested negative for HIV.

I'm sure we can all agree that Rhoades should have disclosed his HIV status before engaging in sex. We might also agree that Rhoades's sex partner could have insisted on using a condom no matter what Rhoades said; after all, trusting the word of a complete stranger is hardly a wise HIV prevention strategy.

In any event, Rhoades did not infect the other man. He pled guilty to the charge, which only required that he had put the other man at risk. And for this single act of consensual sex which caused no harm to anyone, Judge Harris sentenced Rhoades to 25 years in prison.

Consider the sentences handed down in similar cases. Last year an Arkansas man was given 12 years in prison after not disclosing his HIV status to two long-term girlfriends (Rhoades, by contrast, put his sex partner at risk only once). Also last year, a Swedish court handed down a 14-year sentence to an HIV-positive man who had sex with over a dozen women without disclosing his status. Two of them became infected. Six of them were under the age of 15.

As part of his ruling, Judge Harris decreed that he could amend Rhoades's sentence anytime in the next 12 months. So if you'd like to advise the judge, you can reach him at the State of Iowa District Court, 315 E. 5th Street, Waterloo, IA 50703.

2009 Advocates of the Year Awards

2009-05-06T10:19:00.013-05:00

I sure hope you didn't miss the elegance and sophistication last night at AIDS Legal Council of Chicago's 15th annual Advocates of the Year Awards. If you did, you'll have to wait another year. Many thanks to the swell folks at the Playboy Foundation for letting us use their swanky headquarters. We blogged about this year's winning advocates here.

So while you're counting the days until next year's event, you can relive last night's shindig with this lovely selection of pictures.

Ann Fisher To Claim Italy for ALCC

2009-04-30T14:27:00.005-05:00

The AIDS Legal Council of Chicago is now one step closer to its ultimate goal of world domination: next week executive director Ann Fisher will be invading Italy.

Actually, Ann is off to Rome for the International Expert Meeting on HIV Legal Services, sponsored by the International Development Law Organization. The purpose of the conference is to bring together practitioners in HIV law from across the globe to strategize about ways to strengthen and expand legal services to people with HIV in developing countries. And check this out: of all the AIDS law attorneys in the country, the American Bar Association selected Ann to attend the meeting. They're even paying her way.

"I'm thrilled to have the opportunity to work with other advocates trying to provides legal services in developing country," she says. "Plus, a trip to Rome in May sounds wonderful after a long Chicago winter."

Of course, here at ALCC we're a little worried that the Italians won't let Ann return. If they like her as much as we do they're likely to elect her Queen of the Realm.

Think Before You Blurt

2009-04-16T11:48:00.006-05:00

And you thought doctors were supposed to be smart...

Brian was hospitalized for a week last August. One day his friend Cheryl was visiting him when a doctor walked into his room. She introduced herself as the allergy specialist, and she'd come to check for any allergic response to the medications he'd been given. Then she said, 'The HIV specialist will be in tomorrow to monitor you as well.' Cheryl didn't know Brian had HIV until the doctor unthinkingly blurted it out.

As you might imagine, Brian was quite upset at the doctor's disregard for his privacy. He filed a grievance with the hospital. The hospital acknowledged the doctor's mistake and apologized. That wasn't enough to convince Brian that this wouldn't happen again to someone else. So he contact us. We interviewed Cheryl, confirmed the story, and determined that the doctor's disclosure was a violation of the Illinois AIDS Confidentiality Act which says in part, "No person to whom the results of [an HIV] test have been disclosed may disclose the test results to another person" without written authorization. The AIDS Confidentiality Act also says that someone who negligently discloses a person's HIV status faces a statutory fine of $2,000 per disclosure.

So we contacted the attorneys for the hospital, and after a few telephone conversations the hospital agreed to settle with Brian for $2,000. And you better believe that stupid doctor got a strong talking-to.

Only for the COBRA Wonks

2009-04-10T14:15:00.004-05:00

You may have heard that under Obama's economic stimulus package, officially known as the American Recovery and Reinvestment Act (ARRA), the federal government will pay 65% of COBRA premiums for people who were involuntarily terminated from their jobs between September 1, 2008 and December 31, 2009. As you might imagine, there are a whole lot of technical specifics used to determine who is eligible. If you aren't scared of ten-dollar words and bureaucratic verbosity, you can read the official IRS explanation of the plan here.

Or you could just call us at 312-427-8990 if you have questions. Operators are standing by.

And the Winners Are...

2009-04-10T11:28:00.011-05:00

AIDS Legal Council of Chicago's 2009 Advocates of the Year have been announced. And what a lovely crew they are! If you want to help us honor the work they've done on behalf of people with HIV, come to our Advocates of the Year party on Tuesday, May 5. It'll be at the fancy schmancy offices of Playboy Enterprises, 680 N. Lakeshore Drive. The party starts at 6pm, and general admission is only $80. Come on, call us at 312-427-8990 and reserve your spot today.

Here are this year's winning advocates:

Swarup Mehta -- Outstanding Healthcare Advocate.

As pharmacy manager for Walgreens at Northstar Medical Center, Swarup Mehta has gained the trust, respect and admiration of patients and colleagues alike. His attention to patients' needs, in-depth knowledge of HIV treatment and willingness to navigate the bureaucracies of the insurance industry ensure that thousands of people with HIV get the information and medicines they depend on to survive.

Ann Dunmore -- Outstanding Advocate in Client Services. For years, Ann Dunmore has been a tireless champion for people with HIV in the south suburbs. Her determination to bring better health services to her community led her to play an instrumental role in starting the South Suburban HIV/AIDS Regional Coalition. She has continued to grow as a leader and administrator over the years, becoming one of the most respected advocates for the health needs of people in the south suburbs.

Rev. Stan Sloan -- Outstanding Community Advocate.

As CEO of Chicago House, Reverend Stan Sloan has shaped a vision for his agency that guides people with HIV away from homelessness and toward independence and self-sufficiency. His remarkable efforts to bring housing, stability and employment opportunities to people with HIV have earned national attention, most recently with the opening of Sweet Miss Giving's, a bakery that trains and employs individuals with HIV and other disabilities.

Peter McLoyd -- Outstanding Community Advocate. From his first years as a volunteer at the CORE Center, Peter McLoyd has been going to extraordinary lengths to ensure that his clients with HIV receive the care they need. He developed a peer training program to integrate consumers to care, helped start a program to promote HIV awareness and prevention, and has addressed audiences nationwide with his wife to discuss issues that discordant couples face.

Linda Arnade -- Outstanding Emerging Leader. Before graduating from college, Linda Arnade had already travelled the globe and written extensively about the impact of HIV on women worldwide. Now, through her work at Chicago Women's AIDS Project and her passionate advocacy for the health of women and girls, Linda is busy empowering women, training future leaders and promoting improved access and funding for sexual health services at home and around the world.

Northwestern University Dance Marathon -- Outstanding Philanthropic Advocate. For 35 years, Northwestern University Dance Marathon has been one of the largest student-run philanthropies in the country. It has raised more than $1.4 million for local AIDS charities, including the Pediatric AIDS Ward of Children's Memorial Hospital and the Pediatric AIDS Prevention Initiative. This yes, NUDM will be dancing for Project Kindle, which provides free summer camping programs, recreational activities and educational services to children and families impacted by HIV.

The Ethicist is a Pinhead

2009-04-08T11:03:00.011-05:00

So have you read the idiotic column in the New York Times by the self-appointed "Ethicist," Randy Cohen? This chowderhead seems to be operating on pre-1983 knowledge of HIV.

In his March 25, 2009 column, he addresses this antediluvian question: does a person with HIV have an ethical duty to disclose his HIV status to his roommates? Of course, anyone with half a brain, as well as basic knowledge of HIV transmission, knows that the answer is obvious: if he plans to have sex with his roommates, or share needles with them, then he's got an ethical (and legal) duty to disclose first. Otherwise, his roommates have no more need to know his HIV status than his cholesterol level.

But rather than base his column on the obvious fact that never in the nearly 30-year history of the epidemic has there ever been a single documented case of HIV transmission without the intimate exchange of bodily fluids -- and that doesn't happen through vacuuming the living room, reheating a pot pie or watching television on the couch -- he turns to an epidemiologist whom he describes as "not an expert on HIV" (because, you know, it would be impossible for a New York Times columnist to find an HIV expert in Manhattan...). This non-expert declares that "the risk of transmission of household contact is very low." Thus the Pinhead -- sorry, the Ethicist -- magnanimously pronounces that he sees "no obligation to disclose HIV status to housemates."

But he goes on to undermine his own conclusion, imagining all sorts of unique risks that the person with HIV poses. He says that the person with HIV has to make sure he doesn't leave his toothbrush or razor lying around. And he should put Band-Aids on his cuts (in other words, a person with HIV should have the same hygienic consciousness as anyone else). Furthermore, "he should consult his physician about how to generally protect the people he lives with." In short, Cohen reinforces the erroneous notion that without doctor-sanctioned precautions, casual contact with roommates will transmit HIV. And really, isn't the ethical duty on the roommate not to use someone else's razor without asking first?

Cohen brings his point home in his concluding paragraph: "While disclosing his HIV status is not required, to do so would be admirable. The danger such a person presents to housemates is slight, but it would be good if they could act with knowledge of their circumstances." In other words, the "slight" risk (a risk which, in truth, is non-existent) is too much risk to accept without paternalistic warnings. With this sort of reasoning, Cohen should advise people with HIV to do the "admirable" thing and disclose their status to anyone who comes over for a visit. And Cohen never deigns to consider the risk to the person with HIV: who knows if the roommates while kick him out and leave him homeless? Just last week I got a call from someone who told his roommates he has HIV, and they gave him 30 days to move out.

But Cohen saves his greatest moment of hypocrisy for last. After spending his entire column reinforcing the notion that roommates have to be incredibly careful when HIV is in the mix, he concludes with this: "[B]y being forthcoming, your roommate helps combat the stereotype that casual contact with someone who has HIV presents a health risk." Apparently Cohen misses the point that his column supports that very stereotype.

I coulda sworn the Times had editors and fact checkers.

If you want to read Cohen's stupid column in it's entirety, it's here.

Welcome to America, Gilles!

2009-04-02T15:23:00.008-05:00

We do love reporting stories with happy endings. So here we go.

Gilles is from Cameroon, and was granted asylum by the United States Citizenship and Immigration Services (USCIS) in August of 2005. Gilles wanted to get a green card so that he would be an official 'lawful permanent resident,' the first step toward becoming a citizen. So he filled out all the proper forms, and then went to get the required medical exam. The civil surgeon who did the exam told Gilles he had HIV. Convinced that he could never get a green card because of his diagnosis, Gilles threw his completed immigration forms away.

A couple months later, he called us and spoke to Ruth Edwards, our super-whiz-bang immigration attorney. She explained that having HIV did not automatically disqualify him from getting a green card: he would have to get a special HIV Waiver from USCIS.

One of the most important pieces of evidence Gilles needed so support his waiver request was evidence that he understood HIV, took it seriously, was receiving proper care, and understood how to avoid transmitting HIV to others. But unfortunately, Gilles was so stunned by his diagnosis that he retreated into denial. He wasn't getting any medical care. He believed that his undetectable viral load meant the disease had left his body. And he was suffering from great anxiety and depression.

So Ruth decided to submit Gilles's application for a green card right away, knowing that USCIS would take several months to review it before requesting his HIV waiver. In that time, Ruth hooked Gilles up with Lawndale Christian Health Center for both primary HIV care and mental health counseling. By the time USCIS sent an official request for his HIV waiver, Gilles had developed enough rapport with his medical providers to get statements of support from them. And after jumping over the hundred other bureaucratic hurdles required of anyone submitting a request for an HIV waiver, Ruth sent in all the required evidence. And lo and behold, last week Gilles got his green card! Yippy skippy!

Steven Barrera, Superduper Hero

2009-03-26T16:27:00.002-05:00

In truth, it's nothing special. We here at AIDS Legal Council often have to rush out of the office to help clients in tight spots. But here's a story that reminds us why it's important for the Council to be ready at a moment's notice to leap tall buildings in a single bound (metaphorically, of course).

Our lovely and talented paralegal Steven Barrera has a client who called last week, wanting to do powers of attorney. We'll call her Crystal. She fled from Cuba a couple decades ago. Back then she was Juan. These days she lives as a woman. Crystal only speaks Spanish, and she cannot read or write. Crystal called because she was having some sort of heart trouble and was in the hospital for observation. The doctors assured her it was minor, but since she has no family here, she realized that without a power of attorney there was no one legally authorized to make medical decisions for her. In addition, she receives SSI, and without a power of attorney for property, no one could cash her SSI check and pay her bills if she were incapacitated.

So Steve got all the information he needed to complete powers of attorney. Crystal said that when she got out of the hospital, she'd call him to make an appointment so he could go to her apartment and execute the powers of attorney with her.

That was on a Thursday. The following Monday afternoon, Crystal's case manager called Steve. It turned out that Crystal's doctors realized her heart trouble was serious: she would be be going into open heart surgery in a few hours! So Steve drew up Crystal's documents lickety-split, waved goodbye to our director Ann Fisher as he flew out the door, jumped on the el, transferred to a bus, and made it to Crystal's hospital room in half an hour. He even remembered to bring his notary stamp (in Illinois, powers of attorney for property have to be notarized). Fifteen minutes later, Crystal's documents were complete. Steve told Crystal's nurse to put a copy in her medical files, so her doctor would know who to contact in an emergency.

Here's the take-home point (besides the obvious one about Steve Barrera's superhuman legal skills): if, like most people, you don't have powers of attorney, don't put it off. They're simple to do. And if you're lucky, Steve will even let you see his fancy red notary stamp when you visit us.

Know Your Rights!

2009-03-24T16:32:00.004-05:00

Doesn't it seem that every time you read some "helpful publication" that explains your legal rights, you spend half your time looking up all the big words that only attorneys could possibly understand? Well, once again, AIDS Legal Council comes to your rescue.

We hate convoluted legal mumbo-jumbo just as much as you do. That's why we wrote 10 legal guides in plain, simple language. And just look at the super-excellent topics they cover:

HIV in the Workplace
HIV and Public Benefits
HIV and Insurance
HIV and Confidentiality
HIV: Wills and Powers of Attorney
HIV and Discrimination
HIV and Undocumented Immigrants
HIV: Issues for Families with Children
HIV: Issues for Youth and Young Adults
HIV: Returning to Work

Impressive, no? Did I mention that each and every legal guide is available in English and Spanish? And the best part is, they're free and available right here on our website.

So, get reading!

I'm Just a Bill...Part 2

2009-03-19T10:27:00.007-05:00

Did you know that if a school-aged child in Illinois tests HIV-positive, the Department of Health is required to notify that child's school principal? And if the child is enrolled in a public school, the principal must identify that child to the superintendent? And the principal may also tell the child's classroom teachers?

This law, part of the Communicable Disease Prevention Act, has been on the books since 1987. In the 22 years since its passage, no one has ever come up with a rational justification to support it -- that is, a justification based on sound public health principles rather than fear, hysteria or ignorance.

The typical defense of the school-notification law is this: we have to make sure our schools are as safe as possible. Indeed, when then governor Thompson signed the law, he wrote that his aim was "to be sure the greatest number of healthy people are protected from infection." Apparently the supporters of this law imagine that writing algebra problems on the chalkboard or singing in show choir presents a serious risk of HIV infection.

How does the identification of school children with HIV make a school safer? Here's the line we're all supposed to swallow: if a school knows which child has HIV, the staff can take precautions in case that child has some sort of accident that spills blood. But guess what? Schools are already required to use universal precautions whenever any child has a blood spill. Furthermore, the Occupational Safety and Health Act and state law require annual training for school personnel in universal precautions. The blood of an HIV-positive child needs no "special precautions."

When it comes to infection control, identifying school children with HIV tends to make a school less, rather than more safe. It would be impossible to identify every potentially infectious blood-borne pathogen in every student in a school. When staff are led to believe that infection risk lies primarily -- or even exclusively -- with HIV-positive children, they lose incentive to handle every potentially infectious bodily fluid in accordance with accepted universal precautions.

Here's the bottom line: if parents want their child's school to know that their son or daughter is HIV-positive, they can tell the principal. But requiring that schools be notified is bad law and bad public health.

Two months ago House Bill 90 was introduced in Springfield (the chief sponsor is Representative LaShawn Ford) that would eliminate the school-notification provision from the Communicable Disease Prevention Act. Sounds like a no-brainer, yes? Well, many legislators are having a heck of a time understanding this issue (our favorite comment from a state representative: "I was an EMT, and if I'm called to a school I have to know everything about that child so I don't kill him!"). So now is the time for you to call your state representatives and tell them to support HB90. You can find your state reps by searching here.

The VA Wises Up

2009-03-18T09:17:00.006-05:00

File this one under "You've Got To Be Kidding Me, It's Not 1983 Anymore."

Our client Mark is a disabled veteran. A few years ago he was a raging alcoholic and drug addict. Then he started going to NA and AA meetings every day -- yes, every day -- for 18 months (hell, I can't even make my bed every morning). Cleaned up at last, he decided to pursue his life-long dream of becoming a chef. So he signed up for vocational rehabilitation through the Veterans Administration. He began his first semester of culinary school and received all A's.

But a couple weeks ago, one of Mark's vocational counselors was ready to pull the plug on his employment plan, convinced that a person with HIV shouldn't work around food. "Would you want someone with HIV cooking your food?" he reportedly lamented to one of his co-workers. Apparently this counselor was unaware of the fact that the CDC has never put HIV on the list of conditions that bar a person from working as a food handler (conditions like salmonella and shigella).

So the Council's director, Ann Fisher, shot off a letter to the regional counsel for the VA, explaining the problem and asking for a quick investigation. Before we got any response, Mark called and said that a different vocational counselor wanted to meet with him the very next day to discuss his vocational plan. Mark was convinced that the point of the meeting was to talk him out of his plan to become a chef. So we decided to accompany Mark to see what was up.

The vocational counselor was a genial, down-to-earth guy who was truly impressed with all that Mark was doing to improve his life. He emphasized to Mark that he understood that a person with HIV had as much right to a food-handler job as anyone else. "But we live in the real world," he continued, "and, you know, if an employer found out he had an HIV-positive person in the kitchen, that might cause some problems." Of course, the counselor is correct: there are employers out there who willfully discriminate against people with HIV. But it made no sense to scuttle someone's dream to become a chef because an employer might discriminate if he found out that Mark had HIV (and Mark has no duty to tell his employer). After all, an employer could just as easily have a problem with Mark's race or his religion. "You can't base an employment plan on the possibility of future discrimination," we pointed out to the counselor.

He listened. He understood. He thanked us for helping him understand the issue better. He told Mark that the VA would have no problem supporting his plan to become a chef. Now that's the kind of guy we all want helping our veterans.

The Council Loses a Colleague and Friend

2009-03-17T09:48:00.005-05:00

About 10 years ago, a guy called me with a messy insurance problem. For reasons neither of us could figure out, his insurer wasn't paying several bills for routine care. The caller was mouthy, cranky, a little demanding -- and he understood the ins and outs of the American health insurance system better than anyone I'd ever spoken to. He had already written numerous appeals, spoken with executives at his insurance company, contacted several other AIDS service agencies, and negotiated with his doctor's billing office. I thought to myself, "This guy is gonna wear me out, but I could learn a thing or two from him about fighting the good fight."

That caller was Carey Nachtigall. By the time I had rounded up all the paperwork I needed to address his insurance problem, he'd resolved it himself. Basically, I was no help to him. But he said something that stunned me: of all the groups he'd contacted for assistance, AIDS Legal Council was the only group that made him feel like his problem was taken seriously.

I went to our director, Ann Fisher, and said that we had to do something to bring Carey into the fold. We needed his knowledge of insurance issues and his skill in advocacy. Ann was impressed with his story, so we asked if he'd like to become a volunteer-advocate specializing in insurance cases. Carey had been disabled and on Social Security for several years, and he gladly accepted the offer to help out. Not long after, the Council hired him full time.

That was in June of 2000. Since then we all made a habit of giving him our impossible Medicare cases, our brain-addling HMO fiascoes. Now we're stuck having to handle them ourselves. Carey passed away yesterday after a long, arduous fight with cancer. He was 53. You can see Carey in the video the Council produced last year. The video is on our web page here.

The 411 on HIV and Pregnancy

2009-03-12T11:24:00.003-05:00

If you are HIV-positive and pregnant, or considering becoming pregnant, you probably have 18 million questions about prenatal care. Well, you're in luck. The groovy folks at Pediatric AIDS Chicago Prevention Initiative (PACPI) have teamed up with the Illinois Department of Public Health to create the Illinois Perinatal HIV Hotline. You can call 1-800-439-4079 day or night to get information about:

current treatment guidelines
links to specialty care
case management
rapid HIV testing for women in labor
lots and lots of other stuff (no, really!)

Not only have they set up the hotline, but they've created a website so full of excellent information it'll make your head spin (in a good way). If you don't believe me, check it out here.

Another COBRA Success Story

2009-03-10T11:25:00.006-05:00

A lot of people think that the only legal cases that matter are the big, headline-garnering lawsuits. But often, a little bit of simple legal assistance can make a huge difference in someone's life. And it doesn't come with thousands of dollars in attorneys fees attached.

Case in point: a few weeks ago Bill called the Council because he was facing a big problem with his insurance continuation under COBRA. As you probably know, COBRA is a federal law that allows you to continue your employment-based health insurance for at least 18 months after you lose your job, so long as you pay the full premiums yourself. Well, Bill was almost at the end of his 18 months. He had started receiving Social Security when he left his job, but his Medicare wouldn't start for another 11 months. He was facing the possibility of being uninsured.

Bill knew that he could get an 11-month extension of his COBRA coverage if he informed his employer that he was found disabled by Social Security. The law says if Social Security finds you disabled within 60 days of the date that you originally took COBRA, then you can get the 11-month extension (that way you have COBRA coverage until your Medicare starts). All you have to do is notify the people in charge of your COBRA coverage within 60 days of receiving your disability award letter from Social Security.

Well, Bill did notify the benefits office right after he received his Social Security disability notice. He was told not to worry about it; he should just remind them toward the end of his initial 18 months of COBRA. In the ensuing months, he was told the same thing several other times by other people in the benefits office. Then, with only a month left in his COBRA coverage, the benefits office told him that it was too late for him to ask for the 11-month extension!

The problem in Bill's case was that the benefits people had told him everything over the phone; he had no written proof of what he'd been told. Nonetheless, we helped him write an appeal letter, explaining that he had relied to his detriment on information he was given from the people who are supposed to know better. And two weeks later, his 11-month extension was approved.

Cases like this remind us why it's so important for the AIDS Legal Council to respond quickly to client's concerns. Bill didn't have to wait several weeks for an appointment to see us. We didn't have to send his case through any supervisory committee for approval. Bill called and talked to a Council paralegal immediately. The paralegal advised him to write up an appeal letter and email it to the Council. The next day Bill's email showed up, the paralegal made a few small changes, and advised Bill to submit his appeal. That's all it took for Bill to maintain his insurance coverage.

I'm Just a Bill....Part 1

2009-03-06T14:11:00.007-06:00

We know that you're just dying to know what bills we're following in the Illinois legislature. We understand. We're used to people hanging on our every word, thought and deed. We're legal darlings, after all. So we're going to start making regular blog posts to keep you informed about important bills working their way through the hallowed hall of the Springfield capitol.

First up, a Medicaid expansion bill we love, introduced by state senator Jeffrey M. Schoenberg (woot woot!). All the cool kids call the bill SB1855 (that's 'SB' for 'senate bill,' doncha know). It would expand Medicaid eligibility to any uninsured person aged 50 to 64 with an income at or below the federal poverty level (that's $10,830 a year for 2009) (we're using too many parenthetical expressions in this blog post). Those folks won't have to be disabled or otherwise 'categorically eligible' for regular Medicaid; anyone in that age rage with low income and no insurance would qualify for Medicaid. In other words, Illinois will finally say, 'You're poor, you're uninsured, you're getting up in years, we want to give you health insurance so that you can get routine medical care and not end up in the emergency room with a catastrophic problem that will require massive, expensive intervention that the public health system will have to pay for.' It's downright logical.

SB1855 would also expand Medicaid eligibility to people between the ages of 19 and 49 who: 1) have income below the federal poverty level; 2) have applied for SSI, and; 3) have been determined by the Department of Healthcare and Family Services to be "probably eligible for SSI on the basis of disability." Now, all you policy wonks out there are thinking, 'Wait a minute. There is already a Medicaid program for people who have applied for SSI and are 'probably' disabled. It's the Medicaid P3 program.' Sure, that program exists, but have you ever tried to get a P3 approval out of the Department of Human Services? You've got a better chance of seeing the blessed virgin in your cat's litter box. SB1855 will (hopefully) provide a good end-run around the P3 program and actually get Medicaid to people who need it.

Don't you want to call or write your legislators to voice your support for SB1855? Of course you do. So do it, already. If you don't know who your legislators are (and don't feel bad, most of us here don't know the name of that cute vampire guy in 'Twilight'), just do a search here at the State Board of Elections. Easy peasy!

Who Knew the Swedes Were So Mean?

2009-03-05T10:21:00.005-06:00

You may have heard about the first-of-its-kind-in-the-world ruling from the Geneva Court of Justice last month. The court was considering the appeal of a 34-year-old immigrant from the Democratic Republic of Congo who had been convicted of having unprotected sex without first disclosing his HIV status. In considering his appeal, the court relied upon the paradigm-shifting opinion of the Swiss Federal Commission for HIV/AIDS, which issued a consensus statement early last year. In that statement, authored by four of Sweden's leading HIV experts, the Commission asserted that, based on available evidence, HIV-positive individuals on successful antiretrovial therapy (in other words, people with undetectable viral loads for at least six months) are essentially non-infectious: their research showed that the risk of HIV transmission through unprotected sex was roughly 1 in 100,000.

In the case before the court, the man had been on successful therapy, and he had not infected his sexual partner with HIV. The court ruled in his favor, and his 18-month prison sentence was quashed.

Sure, the court's decision is newsworthy. But what really struck us was a telling detail about Swedish law that hasn't gotten much attention. Under Article 231 of the Swedish penal code, a person with HIV who has unprotected sex can be prosecuted for criminal transmission whether or not he discloses his HIV first -- and whether or not his partner consents. In essence, the Swedes have criminalized just about all sexual activity for HIV-positive people.

Imagine: you've been in a committed relationship with Mr. Right for several years. He told you he had HIV on your first date. You've always used protection. But his viral load has been undetectable for three years. You love him more than you've ever loved anyone, and you believe, based on the opinion of leading HIV experts, that your chance of getting HIV from him is theoretical. Nonetheless if you leave the condoms in the drawer for one night, you've just made him a felon.

So remind me to cancel my Swedish vacation plans.

Getting Your HIV Meds: A Primer

2009-02-27T14:57:00.021-06:00

Good morning, class....class!...Class! Sit turn, turn off your Gameboys and pay attention for five minutes! It's time for a quick lesson we like to call, "How to Get Your HIV Medications.

Since there are myriad government programs designed to help people of modest incomes get their medications (Medicaid, Medicare, Illinois Cares Rx, ADAP, Extra Help) we won't make fun of you if you're a little confused. So let's outline the basics.

Medicaid, also called a "medical card," is health insurance for people who are disabled and have very low incomes -- less than $927 a month. Most everyone who receives SSI can get Medicaid. People who receive SSDI checks less than $927 can also get Medicaid (if your SSDI is more than $927, you will have a Medicaid 'spend-down,' which is a monthly deductible). Medicaid will pay for your HIV medications at no cost to you.

You apply for Medicaid at your local Public Aid office.

Medicare Part D is optional prescription drug coverage for people who have been receiving SSDI for two years. There are many Part D plans with various premiums. Also, many Part D plans have very high co-pay and co-insurance costs. However, people with relatively low SSDI checks can qualify for a Social Security program called Extra Help, which will pay those Part D co-pay and co-insurance costs. If your SSDI is less than $1217 (that's 135% of federal poverty in 2009), you can get full Extra Help. You apply for it at your Social Security office, or online here

There is another way to get rid of the Part D co-pay and co-insurance costs. If you qualify for both Medicare and Medicaid, you can get Extra Help, no matter how high your income.

However, , if you can't get Medicaid, and your SSDI check is too high to qualify for Extra Help you might be able to qualify for:

Illinois Cares Rx. This is part of the Circuit Breaker program. Illinois Cares Rx coordinates with your Medicare Part D plan to eliminate the huge co-pays for your HIV medications (it doesn't eliminate those costs for any non-HIV meds you need). If your income for last year was less than $25,532, Illinois Cares Rx may be a good option for you. You may also have to swith your Part D to plan to one of the plans that coordinates with Illinois Cares Rx. You can find out more at their website.

If your income is too high for Illinois Cares Rx, you may qualify for:

Illinois AIDS Drug Assistance Program (ADAP). This is a program run by the Illinois Department of Health, and it provides free HIV medications for people who can't get Medicaid, Extra Help or Illinois Cares Rx. The annual income cap for ADAP in 2009 is $43,320 (that's 400% of federal poverty). ADAP is an excellent option for people with HIV who are not disabled (and thus not eligible for Medicaid, Medicare or Extra Help) but have modest incomes. It's also good for folks with relatively high SSDI checks -- say $2000 a month -- who also do some part-time work. ADAP can even help people with big drug co-pays on their private insurance. ADAP's information, including an application you can download it here.

All right, class, I hope that makes things a little clearer. If you want some private tutoring on any of these topics, feel free to call AIDS Legal Council of Chicago at 312-427-8990.

Class dismissed.

The Stimulus Package, Social Security and You

2009-02-20T12:12:00.006-06:00

Here's more good stuff in the stimulus package: everybody on Social Security is going to get a one-time payment of $250.

If you're on Social Security -- SSI or SSDI -- you should get your $250 by the end of May, 2009. It will be a separate payment, not added on to your regular monthly check. And it will be delivered in the same way that your regular check is delivered. So if you have direct deposit, for example, the stimulus payment will also come as direct deposit.

If you are receiving both SSI and SSDI, you don't get two stimulus payments. The rule is: one payment per individual. But people receiving Veterans' Benefits and Railroad Retirement Benefits should also get one-time payments.

In total, some 55 millions people will be getting extra money. Jinkies!

The Stimulus Package, COBRA and You

2009-02-20T10:46:00.018-06:00

Yes, yes, we know that COBRA is not a deadly snake. But hey, we had to do something to get your attention (especially since we couldn't do better than the lame headline for this post).

COBRA is, in fact, a federal law that lets people continue their work-based health insurance for at least 18 months after they have lost eligibility for that insurance (typically because they have lost the job). The catch is that employees have to pay the entire premium themselves. In Illinois, we have a program called CHIC which can pay COBRA premiums for people with HIV with relatively low incomes (the program is almost as cool as the 70s funk band of the same name..."Le Freak," anyone?). Now a provision in the stimulus package -- officially known as the American Recovery and Reinvestment Act of 2009 (ARRA) -- helps even more people with their COBRA premiums.

In a nutshell, ARRA will pay 65% of your COBRA premium for nine months. To be eligible for the COBRA subsidy, you must have been involuntarily terminated from your job on or after September 1, 2008 (so if you lost your insurance because you quit your job, or because you were moved to a part-time position that didn't entitle you to insurance, you're not eligible). Also, if you were terminated for gross misconduct, you're not eligible.

Here's another great part of the subsidy plan: if you didn't elect COBRA after you lost the job (maybe because you couldn't afford to pay the insurance premium) you get a second chance to elect COBRA. Your former employer must send you a notice advising of your right to elect COBRA within 60 days. Cool, huh?

COBRA applies only to employers with 20 or more employees. Illinois has a similar law that covers employers with fewer than 20 but more than 10 employees: it lets people working for those companies continue their health insurance for 9 months. The new ARRA subsidy will be available to those folks as well.

Perhaps best of all, you don't have to be dirt poor to get the subsidy. In fact, individuals with annual incomes up to $145,000 -- or married couples with incomes up to $290,000 -- are eligible.

Ain't it grand?

I Got Yer Stimulus Package Right Here...

2009-02-13T09:55:00.007-06:00

If you can't figure out what the heck is contained in the gazillion-dollar stimulus package galumphing its way toward President Obama's desk, you're not alone. So we've come to your rescue. Here are a few of the key elements of the bill that will directly affect many people with HIV:

A one-time payment of $250 to people on SSI, SSDI and Veterans' Benefits.

Twenty additional weeks of Unemployment Compensation.

A 65% COBRA subsidy for up to nine months for people on Unemployment and people who were laid off since September 1, 2008.

And 3.5 billion dollars for AIDS Legal Council of Chicago. OK, we made that up.

Ah, the Heartlessness of the 'Public Servant'

2009-02-11T13:08:00.009-06:00

Just when you thought you'd heard all there is to hear about unfeeling government workers...

Our client Doug (not his real name) recently learned he has a Social Security overpayment of about $25,000. He did some part-time work for several years, and Social Security shouldn't have been paying him benefits for about 24 months, so he has to pay $25,000 back. Social Security, in its infinite wisdom, decided to withhold his entire monthly check for two years to recoup their money, leaving him with no income at all. And believe it or not, Social Security regulations allow this!

So Doug went into his local office to ask if there were any other alternative. The Social Security worker said that the best she could do was to give him 36 months to pay back the money. So she divided $25,000 by 36 -- which is $694 -- and said that Social Security would now "only" withhold $694 from his monthly check. Well, Doug's check is $1012; under this new arrangement, he'd get $318 a month. True, that's better than $0, but Doug can't live on $318 a month.

"My rent is $600 a month," he told her. "What am I supposed to do?"

The correct answer should have been: "Doug, we'll work out a payment plan you can afford." Social Security does not have a rule that says it must collect an overpayment in 36 months. Rather, Social Security guidelines state that they should try to collect it in 36 months if possible. But leaving someone destitute is contrary to the spirit of the Social Security Act.

So, did the Social Security worker offer a lower payment plan? Nope. What did she do? She handed him a list of homeless shelters! Why such people have jobs in "public service" is a mystery.

Doug called us and was meeting with a paralegal in our office within an hour. He explained what happened, and said that the heartless Social Security worker had given him another appointment in a week. Oh, and Doug now had a five-day notice from his landlord. After silently swearing a blue streak, our paralegal told Doug to put his coat on, took him to the Social Security office, and after a five minute conversation with a Social Security representative arranged for Doug's check to be reduced by only $100 a month, which Doug said he could afford.

The take-home point: Never trust anything a government worker tells you.

Where To Go, What To Do?

2009-02-05T14:26:00.004-06:00

Trying to figure out what to do for National Black HIV/AIDS Awareness day? Well, who isn't? But you better hurry up and decide, but it's tomorrow. Don't say we didn't warn you.

If you are looking for ideas, the AIDS.Gov blog has lots of good suggestions. Check it out here: http://blog.aids.gov/2009/02/national-black-hivaids-awareness-day-is-around-the-corner.html

Don't forget to send us photos.

Ann Fisher, Queen of the Advocates

2009-02-05T09:10:00.010-06:00

I know what you think. You think that executive directors sit around all day in their corner offices eating bon-bons, getting pedicures and telling everyone else what to do. Clearly you haven't spent much time with Ann Fisher, AIDS Legal Council's executive director. Consider this story:

Four and a half years ago Ann got a call from Sherry (not her real name) whose Social Security check had been cut off. Social Security had received a report of income earned on Sherry's Social Security number, and since that income was so high she was no longer entitled to her check. The trouble was, Sherry hadn't done any work. Somehow or other someone stole her Social Security number and was using her name and number to work and file taxes.

Such cases aren't unusual. Often we can contact employers, show them photos of our clients, and have them write affidavits that our clients did not work for them. But in Sherry's case, the work was all self-employment. Making things worse, the thief filed tax returns electronically, so there was no signature to compare to Sherry's.

So, over the last four and a half years Ann Fisher filed 17 appeals, submitted three requests for waivers, had two in-person interviews with Social Security, and enlisted the assistance of the IRS, Children's Place, Northwestern Memorial Hospital, Lutheran Social Services, Family Options, Chicago House and AIDSCare. Along the way she also had to address Sherry's issues with DCFS, special education evaluations, child support, permanency planning, confidentiality and debt collection.

Finally, after all that work, Social Security has agreed that Sherry didn't earn the income credited to her, and she can have her disability benefits back again. So just for today, Ann Fisher is allowed to put up her feet and eat all the bon-bons she wants.

People with HIV are Sex Offenders? Oh Fercryinoutloud

2009-01-23T09:56:00.014-06:00

First the government insisted on getting the names of everyone with HIV. Now they're about to turn every person with HIV into a potential sex offender.

Illinois House Bill 230, introduced by downstate representative Chapin Rose, amends the Sex Offender Registration Act. If the bill passes -- and Springfield insiders assure us it will -- then anyone who commits "criminal transmission of HIV" will have to register as a sex offender.

Now, perhaps your initial response is, "What's the problem? If you knowingly infect someone with HIV, you are a danger to the public!" The problem is that in Illinois, the definition of "criminal transmission of HIV" is so broad that you don't have to infect someone to become a felon. All sorts of harmless behaviors -- like kissing, believe it or not -- could be considered illegal. Our law says that a person with HIV cannot have "intimate contact" with someone without first disclosing his or her HIV status. And "intimate contact" is defined as "the exposure of the body of one person to a bodily fluid of another person in a manner that could result in the transmission of HIV." This means that anything which might conceivably expose someone to HIV, no matter how minuscule or theoretical the risk, is criminal.

And you'll note that nothing in this law requires that HIV actually be transmitted to the other person. In other words, if you have HIV, and you make out with someone withouth first disclosing your HIV status -- and that person (of course) does not get HIV from you -- you are still a potential felon.

Consider an HIV-positive woman who lives in an abusive marriage. She can't ask her husband to use a condom, and she knows that if she tells him she's HIV-positive she'll get her head kicked in. She will be sex offender.

Or consider the gay man who is assaulted by three thugs in Boystown. As they beat him up, blood gushes from his nose and mouth. He doesn't disclose to the thugs that he has HIV. He will be a sex offender.

What's the big deal about being a sex offender? Not only do you have to register with the state, so that you're name and address are public for everyone to see, but you can't go within 500 feet of a school. So the mother who didn't tell her rapist that she has HIV won't be able to pick up her five-year-old from kindergarten.

Thanks to the genius of Representative Rose, people with HIV who have the audacity to live sexual lives risk ending up on a registry alongside those who commit rape, sexual assault, keeping a place of juvenile prostitution, sexual exploitation of a child, juvenile pimping, and of course ritualized abuse of a child.

People with HIV, Illinois loves you!

We're (Semi) Famous!

2009-01-22T11:25:00.007-06:00

We here at AIDS Legal Council are well aware of the excess of brilliance among our staff. Now you can read some of it yourself, as we popped up twice in the news this month. Our executive director and fearless leader Ann Fisher was interviewed by POZ Magazine in an article discussing the ways the troubled economy is affecting people with HIV. Here's our favorite quote from the article:

“Together we’ve gotten through a lot before—and people with HIV have faced up to a lot, and dealt with a lot—and I think people are going to get through this,” she says, adding, “The challenges we have now are significant, but for people with HIV who’ve already faced the challenges of living day to day with this disease…you know, it’s a pretty resilient group.”

Here's a link to the article: http://www.poz.com/articles/hiv_economy_benefits_401_15943.shtml

Not to be outdone, our dedicated and glamorous paralegal Justin Hayford was interviewed in the Chicago Go Guide, talking about the importance of legal services for people with HIV. Our favorite quote:

"I think AIDS is really a human-rights problem and everything else is secondary. Why else is it that AIDS disproportionately affects the poor, the dark-skinned, the disenfranchised, the socially marginalized? Are those bodies more susceptible to HIV? No. But they’ve been systematically excluded from the social resources that prevent you from getting infected or from taking care of yourself. That’s what will ultimately cure AIDS: political will, not medical will."

You can read the full interview here: http://www.goguidechicago.com/node/56

Criminey, They're Idiots Again

2009-01-22T11:12:00.007-06:00

Remember Linda, our client who's trying to get her Social Security started again? When last we checked in, the (seemingly) helpful supervisor at the local Social Security office informed us that she had spoken to the Payment Center, and Linda would be getting a check in 3 business days. Well, you probably know where this is headed. A week later, Linda had not received a check. So she went into the Social Security office and was told that she must be mistaken. "No one here told your representative that you'd get a check in three days," they told her. "It will be more like 30 days."

As you might imagine, we got a little hot under the collar when Linda told us what happened. Since then, we've left several messages for the once helpful supervisor, none of which she has answered. Will we have to get in touch with the office of Linda's Congressman next? Stay tuned.

They're Still Not All Idiots

2009-01-13T12:23:00.012-06:00

Here's an update on Linda, our client trying to get back on Social Security.

You will recall that a few weeks back, we went to a local Social Security office with Linda to try to straighten out the mess they made of her case at a different Social Security office. (Did you know that Social Security allows you to do your business at any local office? Remember that the next time some government flunky tells you that you have to go to the office nearest your home). Linda is trying to get back on benefits through a process called Expedited Reinstatement, which is available to people who lost their benefits due to excessive income but then stop working. Well, the lovely, friendly, patient Social Security representative who met with us straightened everything out, and then sent the file to...(ominous chord)...the Payment Center.

The Payment Center is the black hole of Social Security, where many a file goes and disappears to eons. The Payment Center is supposed to issue Linda a "provisional benefit," so that she will get a monthly check while her adjudicator in Springfield is deciding her case. Linda was told that it should take about two weeks for the Payment Center to issue her first check. From experience, I knew that was the most wishful of wishful thinking.

Exactly two weeks later Linda called me, saying that she had not received a check. I told her I wasn't surprised, since in my experience cases can moulder at the Payment Center for months. Worse still, the Payment Center doesn't accept phone calls from public, so there's no way to talk to someone there and plead for speed. All one can typically do is lay one's head on one's desk and wait. And wait. And wait...

Well, since I've got back troubles that make laying my head on my desk quite painful, I decided to call the supervisor at the local Social Security office. I explained that Linda had gone two months without income, and now she and her 15-year-old son were in danger of eviction. The supervisor said she would call the Payment Center and ask them to expedite the case. I figured she was giving me the brush off. Then she called me back a few hours later, telling me she'd spoken to the person handling Linda's case at the Payment Center, and that person agreed to cut Linda a check within three business days!

When I called and told Linda the good news, she thanked God, Jesus, Jehovah and quite a few of the saints.

Give Someone Their Props

2008-12-23T15:24:00.005-06:00

Drop everything. It's time to nominate someone for AIDS Legal Council's prestigious (and totally groovy) Advocates of the Year Award.

Every year we at ALCC honor folks in the community who have made a difference in the lives of people with HIV, whether through case management, volunteer activities, medical care, advocacy or philanthropy (sorry, there's no category for fashion sense). You can nominate someone by completing the nomination form, found here: http://www.aidslegal.com/Documents/Nominating_Form_2009.pdf.

We'll be handing out the awards at the fancy-shmancy Playboy Foundation on Tuesday, May 5. The deadline for nominations is January 30, 2009. So come on. Do it. Stop reading this post right now and nominate someone. Seriously.

If you have questions, contact Ricardo Cifuentes at the Council, 312.427.8990 or ricardo@aidslegal.com.

Yet Another Way to Not Get Your HIV Meds

2008-12-18T15:14:00.008-06:00

File this one under "Can't Stand Up For Falling Down" (to quote the 60s soul duo Sam & Dave). You've probably heard of the AIDS Drug Assistance Program, or ADAP, run by the Illinois Department of Public Health. It provides free HIV medications to financially eligible people in Illinois through a pharmacy service called PharmaCare. It's a great program, run by friendly, responsible, hard-working people who genuinely care about serving people with HIV. The program even helps people who have private insurance with big copays; if you have 80/20 prescription drug coverage through your work-based health insurance, for example, your 20% drug copays could be a few hundred dollars a month. ADAP can pick up these costs.

But in recent months, we at AIDS Legal Council have been contacted by working people caught in an impossible predicament. They have health insurance through work with big copays, and ADAP is eager and willing to help them meet those costs -- but their insurance plans will not coordinate with PharmaCare. Their plans have exclusive contracts with other pharmacy services, direct competitors of PharmaCare. And since ADAP contracts exclusively with PharmaCare, ADAP can't help. So although these folks are "the lucky ones" with private health insurance, the unmanageable copays keep their life-saving drugs out of reach.

Lots of brainpower is being applied to this problem here at AIDS Legal Council (as well as at AIDS Foundation and Health and Disability Advocates). If you've got ideas, throw them our way.

Wonk Wonk Wonky Wonk

2008-12-17T14:24:00.007-06:00

OK, I know all you policy-wonk types are just dying to know what the Social Security dollar amounts will be for 2009. If you have no idea what I'm talking about then you're not a wonk, you should be proud, and you needn't read another word of this post.

Here are a few important Social Security amounts for 2009. For people on SSI, the monthly benefit will be $674. For people on SSDI, the amount of money you can earn in a month before triggering a Trial Work Period month is $700. The amount of money you can earn each month and still keep your check after your Trial Work Period is $980 (that amount is known as 'substantial gainful activity,' or SGA). For those of you who want to know all of SSA's numbers for 2009, go here: http://www.ilr.cornell.edu/EDI/publications/colafacts2009.pdf

For those of you who'd like to understand what on earth all this is about, read our lovely legal guide "HIV and Public Benefits" here: http://www.aidslegal.com/Publications/Benefits_English.pdf

This has been our most boring blog post yet. Yet we make no apologies.

They're Not All Idiots After All

2008-12-16T16:27:00.011-06:00

If you read our recent blog posting, "Idiots Still Run the Show," you're up-to-date on the travails of Linda, our client whose Social Security benefits were cut off -- and who got the Royal Runaround when she went to her local office (twice!) to try to fix the problem. Well, never let it be said that we at AIDS Legal Council of Chicago do nothing but gripe on this blog. This morning we went to the squeaky-clean Social Security office near Racine and Adams where they saw us ahead of our appointment time. We met with a friendly, patient, knowledgeable worker who fixed everything for us. Of course, the mountain of required paperwork took a solid 90 minutes to fill out. But we thought your cockles would be warmed to learn that sometimes a government worker is on the ball.

Stigma and Hysteria are Alive and Well in the Heartland

2008-12-11T14:56:00.006-06:00

Surely you've read in numerous mainstream media reports that AIDS is now a "chronic, manageable" illness like diabetes or high cholesterol, thanks to advances in antiretroviral medications. Right. Consider the panic that hit Normandy High School in St. Louis last month when news spread that maybe -- maybe -- as many as 50 kids in the school might -- might -- have been exposed to HIV. Prom dates were cancelled. Parents from a different school worried that their football team shouldn't play against Normandy. Yeah, that's just how people would have responded if there had been an outbreak of diabetes at Normandy.

Astonishingly, the superintendent thought it necessary to send letters to 1,300 parents informing them the school was a possible cesspool of infection -- despite the fact that the Department of Health had confirmed exactly one infection. "We weren't trying to create mass hysteria and panic," the superintendent protested to the New York Times -- although short of setting Normandy on fire, it would be difficult to think of a more efficient way to create mass hysteria and panic. This chowderhead is in charge of a school?

And you wonder why the AIDS Legal Council wants to get rid of Illinois's stupid requirement that schools be informed when their students test HIV-positive. You wonder why the AIDS Legal Council opposes the CDC's recommendation that HIV testing be done "routinely," without specific, written consent from patients.

If you want to read a good story about the incident, click here: http://www.nytimes.com/2008/11/09/us/09hiv.html?_r=1&partner=rssnyt&emc=rss

Idiots Still Run the Show

2008-12-11T14:19:00.009-06:00

Ever get the feeling that government bureaucrats make it up as they go along? Here's a recent case that will confirm those feelings.

Our client Linda (not her real name) has been receiving Social Security disability benefits for several years. In 2004 Linda started doing some part-time work. Then in 2007 her health got worse, and she had to quit. She didn't report any of the income to Social Security like she was supposed to, so it wasn't until last month that Social Security figured out that she had been working while receiving benefits (probably the Social Security computer cross-checked with the IRS computer). So Linda got a notice that her benefits were being cut off because her income was too high. Social Security couldn't know that Linda had already stopped working, and therefore her check shouldn't stop, so their mistake is understandable.

Their subsequent screw-ups, however, are not. When Linda got the notice that her check was cut off, she immediately went to the local office to see what she could do. What should have happened? Well, Social Security has a program for people in Linda's situation, called Expedited Reinstatement (EXR). Under EXR, if your check stops because of earned income and you inform Social Security within five years that you are no longer working, your check is supposed to start up again while Social Security determines if you are still entitled to disability benefits. Moreover, Social Security regulations say that when people like Linda go into the office, they "must be informed of all their filing options, including the option to request EXR." Sounds simple, no?

Well, no one at the local office bothered to tell Linda about EXR. And of course, Linda didn't know to ask about it (would you?). Instead they told her that she had to file a new application for benefits -- in essence, to start over from scratch.

She contacted me the next day, and I told her I was pretty darn sure that she had a right to file for EXR. To double check, I called a Social Security worker I know (one who is completely on the ball) and he told me I was right. In addition, he sent an email to the office Linda had visited instructing them to change her application to EXR.

Problem solved? Are you kidding?

I told Linda that if she wanted to go to the office and make sure they had done everything right, it wouldn't be a bad idea (Linda is one of those amazing clients who has no hesitancy to knock on any door to get what she needs). Well, she went back to the local office, and she was told that she was no longer eligible for EXR because she had already filed a new application for benefits -- despite a specific Social Security regulation that says you can file for both at the same time.

To add to the mess, the worker also told Linda that she could have filed for EXR if she had come into the office within ten days of losing her benefits. This is pure nonsense for two reasons: 1) Linda did come into the office within ten days, and 2) Linda has five years to ask for EXR.

I know what you're thinking. Everyone confuses ten days with five years.

Anyway, our plan now is to walk hand-in hand with Linda to a different Social Security office, preferably one not staffed by pinheads. We'll bring along a stack of Social Security regulations and hopefully fix this problem lickety-split. Pray for us.

Why We Work Hard, part 2

2008-10-17T16:03:00.006-05:00

We work hard because, once in a while, Social Security doesn't. As you'll recall from our last post, Ann Fisher headed off to a Social Security hearing this afternoon with Steve, a 29-year-old man with a host of medical problems but scant medical records to document them -- a tough case if there ever was one. Well, it turns out that the Social Security judge wasn't prepared to hold a hearing, even though it had been scheduled for several weeks. Steve didn't have representation when the hearing was scheduled, so the point of the hearing, apparently, was to advise Steve that he would do better with a lawyer. Ann did her best to explain her theory of the case to the judge, but he was unwilling to conduct a full hearing. Oy gevult.

So Mr. Judge plans to send a questionnaire to Steve's doctor, which will perhaps provide enough information to allow the judge to rule on the case. If not, Ann will have to go back for hearing number two. Stay tuned.

Why We Work Hard

2008-10-17T10:55:00.008-05:00

If you'd like a snapshot of the realities our clients face every day -- the sort of realities that can make providing legal services a real challenge -- consider this story.

Steve (not his real name) grew up being shuttled between various foster homes. By the age of 19 he was HIV-positive. He spent the next ten years moving around, from Chicago to St. Louis to Tennessee to Milwaukee, never able to settle down, never able to maintain regular medical care. At his best a few years ago, he was working a steady job in a call center in Milwaukee. Then his health fell apart. He came back to the Chicago area and moved in with a man he calls his brother, but who is in fact a friend he met in foster care.

Steve's got persistent diarrhea and vomiting. He's lost 20 pounds. He feels weak. His immune system is nearly depleted; his CD4 count is only 38, and his viral load is a massive 267,000. Essentially, the guy is a wreck. Steve lives in the far south suburb of Burnham. It takes Steve two hours on public transportation to get to his doctor at the CORE Center in Chicago (the return trip is two hours as well). He has to take three buses and then a train. And in his part of the world, the bus comes only once an hour. So as you might imagine, he misses as many of his doctor's appointments as he makes.

Steve called us a couple months ago, asking us to represent him at his Social Security hearing. He spoke with the Council's executive director Ann Fisher. "In a lot of ways, Steve really represents today's 'face of AIDS,'" she says. "He grew up poor. He was infected as an teenager. He's had to rely on the public health system for most of his adult life. He's gotten nothing but a raw deal from the get-go."

After speaking with Steve on the phone, Ann agreed to represent him at his hearing. However, Steve didn't show up for his appointment a few days later because he was too sick. Ann didn't hear from Steve again until last week, a few days before his hearing!

So Ann scrambled to get copies of his medical records. And when she received them, she saw how spotty his medical care had been -- meaning that there isn't a lot of medical evidence to document the persistence and severity of his symptoms. Even with thorough, consistent medical records, it can be very difficult to convince Social Security that a client is disabled and therefore eligible for benefits. Trying to persuade Social Security that Steve is disabled with such thin evidence is daunting, to say the least.

As this blog entry is being written, Steve is sitting in Ann's office. They're preparing for the hearing, which is scheduled for this afternoon. We'll keep you posted on what happens. Keep your fingers crossed for Steve.

Give Me Your Tired, Your Poor... But Not Your HIV Positive

2008-10-08T10:41:00.009-05:00

You may have read in the news recently that President Bush signed legislation lifting the ban that prevented HIV-positive people from emigrating (or even visiting) the United States. As a result, you may think that now the U.S. Citizenship and Immigration Services treats people with HIV just like anyone else who wants to come to our country. Well, not quite. Here's the deal.

The Immigration and Nationality Act (INA) states that a person with a "communicable disease of public health significance" is barred from entry into the United States. That law was passed in 1952, and for years it did not name specific diseases; instead the Department of Health and Human Services (HHS) was given the authority to decide which diseases should be included on the list. People with such diseases -- things like gonorrhea, syphilis, infectious leprosy and active tuberculosis -- could only enter the United States if granted a waiver. Getting a waiver has always been a difficult, cumbersome project.

When AIDS came along, a notoriously anti-gay senator named Jesse Helms decided that people with HIV should be kept out of the United States, and bolstered by the fervor of the religious right, he was able to amend the INA to name HIV as a communicable disease of public health significance. It was, in fact, the only illness ever specifically named in the law. In short, the Helms Amendment took authority away from HHS; no matter what HHS believed, HIV was automatically a communicable disease of public health significance.

When the President authorized the recent change in the INA, he essentially undid the Helms Amendment. HIV is no longer specifically named in the INA as a condition that bars people from coming to the U.S. But HIV is still on HHS's list of communicable diseases of public health significance. That means that HIV-positive people who want to adjust their legal status and get a green card still need to be granted a waiver -- which a great number of people do not qualify for.

So if you've got nothing to do today, why don't you give your Congressperson and Senator a call and ask them to tell HHS to take HIV off the list. Then you'll have done your good deed for the day.

HIV May Be Older Than We Think

2008-10-02T10:35:00.007-05:00

Well whaddya know, it wasn't a sex-crazed, vampiric Canadian flight attendant after all. New research from the University of Arizona suggests that HIV may have begun circulating among humans as early as 1908. Here's a link to an article describing the study: http://africa.reuters.com/top/news/usnJOE491050.html ters.com/top/news/usnJOE491050.html s.com/top/news/usnJOE491050.html (you'll have to excuse the author for using the inaccurate term "AIDS virus," but then again, half the journalistic world makes the same mistake).

Of course, the new research doesn't appear to answer a rather important question: if HIV has been infecting people since the turn of the century, why did it take 70 years for the virus to become deadly? Anyone?

Hooray for President Bush (No, Really)

2008-09-25T15:42:00.005-05:00

Yippy skippy! If you have been keeping up with our lovely little blog, you read last week that Congress passed important amendments to the Americans With Disabilities Act, expanding the protections this law gives to people with disabilities (you can read that post here: http://alcc-legalpad.blogspot.com/2008/09/hooray-for-110th-congress.html). Well, we're happy to report that President Dubya himself signed these amendments into law today. So call the Prez and give him a big thank-you.

Cool Thing #87 About AIDS Legal Council

2008-09-19T11:37:00.009-05:00

Imagine you have a question about cancer. You pick up the phone, call the nearest cancer center and say, "I've got a couple questions about cancer. Can I talk to an expert in the field?" There would be two chances of having your request granted: slim and none.

Now imagine you have a question about your legal rights as a person with HIV. You call ALCC and say, "Can I talk to an expert in HIV law?" The receptionist answers, "Sure." And in 12 seconds you're talking to an expert. No need for an appointment. No waiting list. Just start talking. And it won't matter to us if you're rich or poor, young or old, citizen or undocumented immigrant, living in Chicago or in Nome. If we can answer your question about HIV law -- and perhaps arm you with the information you need to avert a problem -- we've done our good deed for the day. We're at 312-427-8990.

Lindsee to the Rescue!

2008-09-18T09:47:00.003-05:00

The AIDS Legal Council's newest paralegal and superhero-in-training is Lindsee Redmond, who came on board September 3. Lindsee grew up in the Bronzeville neighborhood in Chicago, and she graduated from Pomona College last year with a degree in psychology and women's studies.

Why did the Council catch her eye when she was job hunting this summer? "I was really impressed at the commitment that ALCC shows to its clients," she explains. "And I was particularly impressed that the information on the Council's website makes the law understandable to people who don't have law degrees.

"I'm very committed to serving populations that are underserved," she continues. "And HIV is still a very relevant and sensitive issue that is too often overlooked as an epidemic of the past."

In her third week on the job, Lindsee has hit the ground running. "I'm doing real work, even though I'm brand new," she says with a laugh. "I've already interviewed clients. I've talked to doctors. And I've been quite impressed by the fine array of breads and cheeses that have shown up in the Council's kitchen."

Hooray for the 110th Congress

2008-09-18T09:47:00.002-05:00

Everyone loves to complain that our elected officials don't care a petootie about the real struggles of everyday people. Well whaddya know, it seems the current Congress cares a whole lot about everyday people with disabilities -- including people with HIV. To prove it, they've just passed powerful amendments to the Americans With Disabilities Act (ADA). If President Bush signs the bill -- and he says he will -- legal advocates will have stronger weapons to fight discrimination against people with disabilities.

The ADA was created in 1990 and signed into law by Bush, Sr. Its intent was to provide sweeping protection for people with disabilities who for decades had been systematically denied full access to and participation in American society, particularly in the area of employment. The ADA said that employers could no longer discriminate against employees simply because they had a disability. The ADA defined a disability as "a physical or mental impairment that substantially limits one or more major life activities."

But since that law was enacted, many courts have interpreted the ADA quite narrowly, often ruling that people with serious medical problems did not have "disabilities" under the law and therefore were not protected under the ADA. The new amendments address this problem head-on, stating, "The definition of disability in this Act shall be construed in favor of broad coverage of individuals under this Act, to the maximum extent permitted by the terms of this Act." In the immortal words of Home Simpson, woo hoo!

Equally important, it has often been difficult for many people with HIV to prove they have a disability under the ADA because HIV infection didn't cause a substantial limitation in a major life activity. In other words, it was not always possible to convince a judge that a very healthy person with HIV had a disability under the ADA. But the new amendments provide helpful language on this point: "A major life activity includes the operation of a major bodily system, including...functions of the immune system."

We're excited about these sounds changes in the ADA, and we hope the President signs them into law. We'll keep you posted.

Going the Extra Mile ... Or 1000

2008-09-17T10:33:00.001-05:00

We can forgive Council paralegal Steve Barrera if he's looking a little pooped today. He's spent the last week or so talking with various officials in the criminal court in Pinellas County, Florida trying to make sure his client's Social Security won't be cut off.

Why would a criminal court in Florida have anything to do with someone's Social Security benefits in Illinois? Well, according to Social Security rules, anyone who is a "fleeing felon" is not entitled to receive benefits. As a matter of course, Social Security deems anyone with an outstanding warrant to be a fleeing felon. It turns out that one of Steve's clients, whom we'll call Tom, had an outstanding warrant issued in Florida in 1995. When Social Security discovered the warrant two months ago, they wrote to Tom explaining that they were planning to stop his benefits.

Tom, like many others who have contacted the Council in similar situations, had no idea that a warrant was outstanding against him (it was for a probation violation). Yet Social Security still believes he is fleeing prosecution. Recently the Second Circuit Court of Appeals ruled that the existence of an outstanding warrant alone is not sufficient evidence to prove that someone is "fleeing to avoid prosecution, custody of confinement." But that ruling is binding only in the states that make up the Second Circuit, namely New York, Vermont and Connecticut. To fix Tom's problem, Steve had two options. He could appeal Social Security's decision and plead Tom's case in a hearing, but the average wait for a hearing is roughly a year. Or he could try to convince the Florida court that Tom's warrant should be quashed.

Since the Council does not handle any criminal cases, we usually counsel clients in Tom's situation to advocate for themselves, advising them to contact the court where their warrant was issued and ask how to get it quashed. But it seemed to Steve that Tom's severe bipolar disorder left him so impaired that he wouldn't be capable of advocating for himself with the Pinellas County court. So Steve got on the phone to Florida, explained the situation, and provided medical evidence to show that Tom couldn't travel to Florida to deal with the warrant. He also had Tom write a letter directly to the judge. "I thought it was important to humanize the issue," Steve says, "so I wanted the judge to hear directly from the client." After much back-and-forth, the court decided that all Tom needed to do was pay a $250 fine, and the warrant would go away. Then Tom won't lose his Social Security benefits.

From now on, we're going to call Steve the Super Warrant Quasher Man. Kinda catchy, no?

Don't Tell Me You Missed Our Party!

2008-09-12T16:45:00.000-05:00

What?! You MISSED the ALCC's fundraising fete Tropicalia, the most EXTRAVAGANT party of the YEAR?! Hang your head in shame! Our Brazilian-themed bash was a grand old time. We'll have another shindig next summer, and we'll expect you to show up this time!

While you're counting the days until our next party, look at the fun you missed:

Making Noise in New York

2008-09-12T15:33:00.005-05:00

Council paralegal Kate Miller is just back from an important Social Security conference that took place at the LaGuardia Airport Marriott on Wednesday (yes, Kate went all the way to New York and spent the whole day at the airport...). The meeting, convened by the Social Security Administration, gave legal advocates and health care providers a chance to voice their concerns about the way Social Security determines whether people with HIV are "disabled" and therefore eligible for benefits.

One of the most important tools Social Security uses in making this determination is known as "The Listings." Essentially, Social Security publishes a huge, detailed list of various medical conditions which they consider automatically disabling. In other words, if your medical records show that you've got something in the Listings, then you are entitled to Social Security benefits. (If you're a policy wonk like most of us here at the Council, you can see the entire Listings here: http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm) The Social Security Administration has spent the last couple years working on updates to the section of the Listings that describes HIV (it hadn't been updated since 1993!). The final changes were published in June.

"Social Security made a lot of good changes," Kate explains. "For example, it used to be the case that if you got PCP, it had to be diagnosed with a bronchoscopy in order for you to meet the Listing. Well, not everyone with PCP gets a bronchoscopy. So now the Listings allows PCP to be diagnosed differentially and still count." But as good as many of the changes were, more pressure needed to be put on Social Security. "Many advocates across the country felt that the new changes to the Listings didn't capture the complexity of living with HIV disease as well as they could," Kate says.

So Kate flew off to New York to join other legal advocates and health care providers, all hoping to convince Social Security to make even more changes to the Listings. "I was really impressed with the doctors who testified," Kate says. "Many of them have been HIV specialists for the entire duration of the epidemic. Their ability to explain the intricacies of living with HIV was astonishing."

We won't know whether Social Security will adopt the further changes that Kate and her colleagues advocated for, but Kate is hopeful. "It felt like a very good meeting. It seemed to me that Social Security heard what we said, understood what we said, and responded favorably."

By the way, if you want to know everything there is to know about Social Security benefits (well, maybe not everything, but darn close) read our legal guide, HIV and Public Benefits. You'll find it here: http://www.aidslegal.com/Publications/Benefits_English.pdf

Oh, and don't feel too bad for Kate. She may have spent the whole day at LaGuardia, but she spent the night in Manhattan with friends.

Welcome to the Blog!

2008-09-12T14:31:00.001-05:00

In 20 years providing free legal services to people with HIV, we at the AIDS Legal Council of Chicago have long prided ourselves on keeping up-to-date on the changing demographics of the epidemic, as well as the newly emerging legal issues that challenge people with HIV. And we've been so busy fighting for social justice -- trying to secure fair and equitable treatment for our clients in all walks of life -- that we haven't had time to keep up with the "latest thing" in the blogosphere. So pardon us if we glow with pride at having finally figured out how to make our own blog. Ain't it pretty?

We hope to keep you current on the daily work we do here at the Council -- our frustrations, our inspirations, and our victories -- as well as advising you of important legal developments at home and across the country. If you're looking for in-depth information about ALCC, visit our swanky website: http://www.aidslegal.org/. And make sure you watch our groovy 20th anniversary video, AIDS Legal Council of Chicago: Providing Access to Justice. I'm sure you'll agree that we're the best looking do-gooders in Chicago.

The Legal Pad

A Movement to Reform State Laws

Poetry for the Council

2011 Advocates of the Year Awards

Obama Who?

ADAP to the Rescue!

Second Annual Disney Concert for ALCC!

Illinois Civil Unions are Almost here.

Hot Off the Presses

Our New Hero

Will the Mainstream Media EVER Learn?!

Health Care Reform Takes Effect Today ... Sort Of

We Hope You Didn't Miss the Fun

Pooped Paralegals

South Carolina Prisons and Basic HIV Science: Never the Twain Shall Meet

New Insurance Option in Illinois

The Messiness of HIV Criminal Transmission Laws

Hail Mary!

A New National Strategy?

Let Us Pat Ourselves on the Back

Bad ADAP News

Another Crack in the Great Wall

Wrapping Our Brains Around Health Care Reform

2010 Advocates of the Year Announced

More Health Insurance Reform Specifics

A Happy Ending

More Video Wisdom

Stupidity Never Pays

Are They Kidding?!?

Ideology Trumps Science

A Bit of Video Wisdom

Fighting HIV Stigma Protects Public Health

Why You're Glad You're Not a Teenager Anymore

More CORBA Help

Flee Fornication!

ALCC in the News

Now People with HIV are Potential Terrorists ... At Least in Michigan

Things That Make You Go "Hmmmm"

It's Official ... But Wait a Couple Months

Link Card Follies

Our Eloquent President

One Step Closer to End of HIV Immigration Ban

Social Security Payments Flat for 2010

Health Care Reform? How About Health INSURANCE Reform?

Our New Hero

Creative HIV Prevention or Socialized Marriages?

More Idiot Chronicles

Party People in da House

Ann Fisher Gets Yet Another Award

More Social Security Follies

Meet the Nasty Iowa Judge

2009 Advocates of the Year Awards

Ann Fisher To Claim Italy for ALCC

Think Before You Blurt

Only for the COBRA Wonks

And the Winners Are...

The Ethicist is a Pinhead

Welcome to America, Gilles!

Steven Barrera, Superduper Hero

Know Your Rights!

I'm Just a Bill...Part 2

The VA Wises Up

The Council Loses a Colleague and Friend

The 411 on HIV and Pregnancy

Another COBRA Success Story

I'm Just a Bill....Part 1

Who Knew the Swedes Were So Mean?

Getting Your HIV Meds: A Primer

The Stimulus Package, Social Security and You

The Stimulus Package, COBRA and You

I Got Yer Stimulus Package Right Here...

Ah, the Heartlessness of the 'Public Servant'

Where To Go, What To Do?

Ann Fisher, Queen of the Advocates

People with HIV are Sex Offenders? Oh Fercryinoutloud

We're (Semi) Famous!

Criminey, They're Idiots Again

They're Still Not All Idiots

Give Someone Their Props

Yet Another Way to Not Get Your HIV Meds