America Living With AIDS

Working Group on Federal, State and Local Responsibilities
January 1990
1. Efforts in the public sector at all levels of government should be guided by broad policy goals.
The Working Group suggested that the policy goals identified by the National Association of
Counties Task Force on HIV Infection and AIDS could serve as a model for all levels of government. These goals are:
1. to end the HIV epidemic through prevention, education and research;
2. to assure access to treatment, care and support services for all persons with HIV infection;
3. to protect the civil rights of all citizens; and
4. to assure adequate funding for a continuum of HIV prevention, treatment, care and support
services and HIV research through effective public sector-federal, state, and local government and private sector leadership and partnership.
2. Federal, state and local governments should develop comprehensive plans for implementing
identified goals. These plans should be developed in response to the policy recommendations
of the National Commission on AIDS with interagency government representation and private
sector involvement, including community-based organizations and persons with HIV disease.
The Working Group strongly recommended that the federal government should immediately develop a forceful comprehensive national HIV plan addressing prevention, education, treatment, care, support services, civil rights, research, and funding for these activities. The President should designate the Secretary of Health and Human Services to chair a cabinet-level Task
Force to develop the national implementation plan. While the National Commission on AIDS
fully intends to recommend policy goals for a national plan, the Commission believes it is
essential that a Task Force be in place to enhance government-wide implementation of such a
plan. In this way, those who are ultimately responsible for the implementation will have had an
active role in its development, thus enhancing the likelihood of implementation. The Task
Force should include each Department in the federal government and should solicit input from
state and local governments and the private sector, including community-based organizations
and persons with HIV disease.
3. The U.S. House of Representatives should, like the United States Senate, pass the Americans
with Disabilities Act and state and local governments should pass laws forbidding discrimination in areas not covered by the Americans with Disabilities Act or other federal statutes.
4. Immediate action is necessary at the federal level to assist states, counties, and cities disproportionately impacted by the HIV epidemic. "Impact Aid"-disaster relief or direct emergency
relief-is needed to assist states and localities in developing a continuum of HIV prevention,
treatment, care, and support services.
5. The issues of Health Care Financing and Health Care and Social Service Organization and
Delivery require a level of expertise and commitment of time that was not provided for in this
working group session. The Working Group believes these issues would be best addressed by
the full Commission.
6. Incentives at the federal, state and local level need to be created to recruit, retain and train
human services personnel. The Working Group recommends that the federal government
should support a National Health Service Corps approach to involving more primary care
providers in the care of persons with HIV. Medicaid reimbursement rates for outpatient care
should be augmented and all universities (public and private) should include HIV education in
health professional education and training.
7. Federal, state and local government should have in place policies to encourage the development of housing programs that meet emergency, short-term and long-term needs of persons
with HIV. Congress should support legislation to establish housing programs that provide