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Legislative Action

AIDS legislation: a Chinese menu


By MICHAEL D. KLEMENS

A divided General Assembly presented a wide range of AIDS legislation to Gov. James R. Thompson. The testers and tracers offered measures to both allow and require tracing of victims' sexual contacts, testing of many hospital admissions and of all state prisoners. The researchers and educators tempted him with morsels that included public school instruction and a pilot program for long-term care for victims of Acquired Immune Deficiency Syndrome.

Both sides held their breaths as Thompson reviewed the package to see which of the 17 bills he would sign, which he would veto and which he would amend. He picked his way through the Chinese menu of offerings choosing some from the testers' and tracers' platter and some from the educators' and researchers'. On September 21 he signed into law a package that totally satisfied no one. But it left no one out, either. Thompson signed 10 bills, including:

• S.B. 651 (P.A. 85-0681), the Illinois Sexually Transmissible Disease Control Act. Thompson calls it the "centerpiece" of the state's policy. It allows the Illinois Department of Public Health to work with victims to trace previous sexual contacts and encourage them to be tested for exposure to the human immunodeficiency virus (HIV). It also allows the department to order testing, to direct persons to seek treatment and allows, with a court order, isolation of those with the disease. The measure includes guarantees of confidentiality.

• S.B. 100 (P.A. 85-0679) and H.B. 100 (P.A. 85-0677) (identical), the Aids Confidentiality Act. It requires written consent before HIV testing, makes results confidential and establishes a 25-member AIDS Advisory Council to develop a statewide plan.

• S.B. 972 (P.A. 85-0683). Requires hospitals to allow blood recipients to designate a donor.

• S.B. 995 (P.A. 85-0684). Allows the Department of Public Aid to offer incentives to nursing homes that care for AIDS victims.

• H.B. 1268 (P.A. 85-0610). Requires testing of all donated blood for HIV antibodies.

• S.B. 771 (P.A. 85-0682). Requires labeling of cadavers suspected of having AIDS or other infectious diseases.

• S.B. 550 (P.A. 85-0680). Requires schools that teach sex education to include AIDS prevention in those classes.

• H.B. 1225 (P.A. 85-0608). Requires schools teaching sex education to teach courses on sexual abstinence until marriage.

• H.B. 1242 (P.A. 85-0135). Requires notification of ambulance personnel that they had handled an AIDS victim.

The governor also amendatorily vetoed three bills on which lawmakers can accept or reject the changes. They are:

H.B. 2044. As amended it would require couples to take an AIDS test before a marriage license can be issued. It would also require that school principals be told of students who test positive for HIV, and it allows for testing of those convicted of sex offenses.

H.B. 736. It would require the state health department to maintain information on cases of AIDS in Illinois.

H.B. 2043. It would require the registry of sperm and tissue banks and HIV testing for donors.

Thompson vetoed four other bills that would have required the state health department to trace sexual contacts, established pilot long-term care programs for AIDS victims and mandated testing of prisoners and most hospital admissions. He cited costs for many of those vetoes. The projected cost of testing prisoners ranged from $33 million to $58 million.

What Thompson did sign will cost money — money the Illinois Department of Public Health says must still be appropriated. It will cost as much as $200,000 per year to oversees the labs that will spring up to do the premarital testing, says department spokesman Thomas J. Schafer. The annual cost of doing the AIDS contact tracing could be as much as $1.5 million. First year costs will be reduced because the laws do not become effective until January 1, Schafer says.

While many legislators felt it was best to take a deep breath and declare victory in crafting a legislative response to the AIDS epidemic, not everyone was willing to do so. Thompson predicted dissent when he signed the measure but called the package reasonable public policy: "The Illinois legislature was the only legislature in the 50 states to act comprehensively across the board. Our legislature acted boldly while other states sat by."

Critics suggested that the legislation was neither bold nor comprehensive. "The package of legislation signed into law by Gov. Thompson creates a contradictory, misleading and dangerous climate," counters Donald H.J. Hermann, director of the Health Law Institute at DePaul University. A board member of the Chicago AIDS Symposium Foundation and the Chicago Area AIDS Task Force, Hermann has researched and written articles on AIDS laws.

Hermann urged Thompson to veto many of the sections, then offered his critique of what became law. He contends that guarantees of confidentiality and authorization to interview victims are contradictory. The package misleads by creating a false sense of security, he says. And he argues that the new laws are dangerous because contact tracing will have a "chilling effect" on those who might voluntarily submit to testing. Civil liberties are endangered by an overbroad authority to quarantine or isolate persons, he adds.

Hermann acknowledges that Thompson's vetoes improved the package: "It's better than what he got." He lauds vetoes of mandatory contact tracing, testing of prisoners, and of hospital patients aged 13 to 55. Hermann sees benefits in the confidentiality requirements, creation of the AIDS Advisory Council, public school education, and measures that protect the blood supply and label infected cadavers. Hermann and others counsel restraint. The laws contain educational features and measures to protect the blood supply that few dispute. Testing and tracing engender controversy. But no one believes the issue is over. As long as AIDS confounds researchers and frightens the public, legislators will be called on to pass laws.

28/November 1987/Illinois Issues



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