HD56 - Acquired Immunodeficiency Syndrome (AIDS)

  • Published: 1991
  • Author: Joint Subcommittee
  • Enabling Authority: House Joint Resolution 129 (Regular Session, 1990)

Executive Summary:
In response to the growing concerns of the citizens of the Commonwealth, a number of resolutions were introduced during the 1988 Session of the General Assembly calling for studies of acquired immunodeficiency syndrome (AIDS) and the impact of the AIDS epidemic on Virginia. House Joint Resolution 31 and Senate Joint Resolution 28 of 1988 were approved, thereby establishing this study.

House Joint Resolution 31 and Senate Joint Resolution 28 noted that, because of the complexity of the issues related to AIDS and the lack of a cure for this disease, public officials are confronted with many difficult issues in determining the most appropriate policies for prevention and treatment. These resolutions also recognized the potentially crippling effect that an increase in the incidence of AIDS could have on Virginia's health care industry and noted that, until an appropriate medical means of preventing the spread of the disease can be developed, methods of containing the epidemic might include testing, education, and behavior modification. The Joint Subcommittee was directed to assess prevention efforts to abate the spread of the disease; determine the appropriate role of state and local agencies for establishing public policy; determine whether state policies exist concerning the containment of the virus, the care and treatment of infected individuals, and Medicaid coverage; determine the need for and advisability of criminal statutes to prohibit the knowing and willful exposure to HIV infection; evaluate policies related to testing and contact tracing; analyze issues related to privacy, confidentiality, disclosure, insurance, employment, and school attendance; and identify any other related issues deemed appropriate.

Due to the subtlety of the issues posed by the AIDS epidemic, including concerns for the containment of ever-escalating health care costs, the Joint Subcommittee recommended to the General Assembly that the study be continued. This action was authorized pursuant to HJR 431 of 1989. During the second year of its study, the Joint Subcommittee was charged with determining the feasibility of placement and isolation policies as an alternative to criminalization of knowing and willful transmission of HIV infection; determining the procedures to be prescribed by any such statutes; the circumstances, if any, under which criminal sanctions should be imposed, and any appropriate penalties for such actions; determining the feasibility of health insurance risk pools and any other cost containment mechanisms that may serve to control the spiraling costs of health care services for persons infected with HIV; assessing the costs of recommended services and the appropriate revenue streams for such funds; determining whether and under what circumstances or conditions, the test results of an unemancipated minor who tests positive for HIV infection should be reported to the minor's parent or legal custodian; and any other related issues deemed appropriate.

In 1990, the Joint Subcommittee recommended continuation again. House Joint Resolution 129 of 1990 reflected the members' consensus that the AIDS epidemic remained a crisis which required legislative monitoring and, possibly, intervention. The Joint Subcommittee was directed to maintain and update, as necessary, data on the effectiveness of state policies designed to address the impact of human immunodeficiency viruses, and programs and policies for assisting persons infected with such viruses; conduct a careful and judicious evaluation of the Commonwealth's response to the epidemic; monitor the effectiveness of the programs established as a result of its recommendations and determine whether any revisions to such programs were necessary to meet the evolving needs of the health care system in a addressing the AIDS crisis; determine new initiatives as necessary to ameliorate the effects of the AIDS epidemic in Virginia; and address any other related issues deemed appropriate.

The Joint Subcommittee consisted of 15 members appointed as follows: two members of the House Committee on Health, Welfare and Institutions and one member each of the House Committees for Courts of Justice, Corporations, Insurance and Banking, Education, and Appropriations; one member each of the Senate Committees on Education and Health, Courts of Justice, Commerce and Labor, Rehabilitation and Social Services, and Finance; one attorney for the Commonwealth; and three citizen members with expertise in research regarding infectious diseases, in care and treatment of AIDS patients, and in medical ethics. Various ex officio members were also required.

Those appointed to serve were Delegates J. Samuel Glasscock of Suffolk, Edward R. Harris, Jr., of Lynchburg, Joan H. Munford of Blacksburg, Warren G. Stambaugh of Arlington, Marian Van Landingham of Alexandria, and S. Vance Wilkins, Jr., of Amherst; Senators John H. Chichester of Fredericksburg, Clive L. Duval 2d of Arlington, Mark L. Earley of Chesapeake, Yvonne B. Miller of Norfolk, and Frank W. Nolen of New Hope; and four citizen members, Dr. Lisa G. Kaplowitz of Richmond, Dr. Richard P. Keeling of Charlottesville, Mr. John E. Kloch of Alexandria, and Dr. James L. Levenson of Richmond. Ex officio members were Dr. C.M.G. Buttery, Commissioner of Health; Mr. Howard M. Cullum, Commissioner of Mental Health, Mental Retardation and Substance Abuse Services (1988 and 1989); Dr. King E. Davis, Commissioner of Mental Health, Mental Retardation and Substance Abuse Services (1990); Dr. S. John Davis, Superintendent of Public Instruction (1988 and 1989); Dr. Joseph A. Spagnolo, Superintendent of Public Instruction (1990); Mr. Steven T. Foster, Commissioner of Insurance; Mr. Larry D. Jackson, Commissioner of Social Services; Mr. Bruce U. Kozlowski, Director of the Department of Medical Assistance Services; Mr. Edward W. Murray, Director of the Department of Corrections; and Dr. Albert W. Tiedemann, Jr., Director of the Division of Consolidated Laboratories. Delegate J. Samuel Glasscock served as the chairman and Senator Clive L. DuVal 2d served as the vice chairman.