MAKING THE HEALTH-CARE SYSTEM SAFE FOR PERSONS WITH HIV-INFECTION OR AIDS

If health care reform is implemented in states and nationally, the saf ety of this process needs to be examined for persons with human immuno deficiency virus (HIV) infection or the acquired immunodeficiency synd rome (AIDS). Reform should assure ongoing prevention and transmission control of HIV and continuous coverage of medical costs for persons il l with HIV or AIDS. These persons currently benefit from various state and federal categoric programs designed to assure access to preventiv e and personal care services. Washington State has passed health care reform legislation that envisions integrating these programs to provid e a system of population-based and personal health care. This legislat ion was analyzed using existing epidemiologic and entitlement informat ion about persons with HIV infection or AIDS in the state to assess it s effect. The relationship between public health and personal care ser vices will be a central concern for those with HIV infection or AIDS, and complete coverage of this group may be achieved relatively late in the process of implementing health care reform. Health personnel plan ning under health care reform will affect the delivery of HIV- and AID S-related services. Including treatment of AIDS in the basic benefit p ackage merits particular attention. These issues parallel those being faced by the nation as a whole as it seeks to ensure epidemic disease control and compassionate care for longterm disabling illness if healt h care reform is implemented.