Bay Area Reporter - June 1, 2006
Zak Szymanski, z.szymanski@ebar.com

But as the disease has changed, the legal and policy landscape also looks dramatically different, and it has been up to a dedicated corps of AIDS veterans and newer advocates to consistently adapt their focus and strategies to ensure that people are protected at every new stage of the epidemic.

"When I got out of law school in 1986 I was trained by the AIDS Legal Referral Panel to do people's wills. At that point, wills were about 85 percent of what we were doing. You would run to the hospital, go do a will for somebody, and the client would then die in a short period of time," said Bill Hirsh, now executive director of ALRP, the only Bay Area nonprofit organization whose mission is to provide free and low-cost legal services and education to people with HIV/AIDS. "Today, wills are about 10 percent of the work we do. The clients coming to us need assistance with things that are much more about living with HIV."

But just because people are living longer, cautioned Hirsh, doesn't mean there are fewer legal problems, particularly when it comes to accessing insurance.

"As treatments and quality of life for people with HIV/AIDS improve, the legal and insurance needs of those living with the disease are changing," said Hirsh. "Additionally, insurance providers are becoming more aggressive in denying medical and disability claims to avoid the great expense of long-term benefits."

And so this summer ALRP will launch the HIV/AIDS Insurance Protection Project to help ensure that people with HIV/AIDS retain or gain access to medical and disability insurance and prescription drug coverage amidst the continuing evolution of policy and the law. With the help of seed funding from the Wells Fargo Foundation, the Silva Watson Moonwalk Fund, and former Ambassador James C. Hormel, ALRP's staff attorney Nikhil Unadkat will assume the position of HIPP insurance attorney position at the organization beginning on July 1.

Unadkat's new position at ALRP will be the only full-time public interest attorney position in California dedicated solely to insurance-related advocacy on behalf of low-income people with HIV/AIDS, according to Hirsh, and it is anticipated that the HIPP attorney will handle between 25-50 insurance-related legal matters in his first year.

"Clearly, we've made a lot of progress with the medications saving lives, but that doesn't mean everything is hunky dory or that everyone who has HIV is able to work," said Hirsh, explaining the need for the new fulltime insurance attorney at ALRP.

Those without public benefits usually rely on private insurance for their health and related services, and "what we've seen is that increasingly these claims have come under great scrutiny. Whereas before it was much more understood that HIV and AIDS was a disabling condition, now there's this idea that the medication means you should be fine. There's not a lot of understanding how people can be disabled by HIV or even how the side effects of the medication can impact a person's ability to work," said Hirsh, adding that ALRP's role has often been to supply additional documentation to insurance companies. "Part of our role is just to make sure that folks get the services they need and are entitled to."

Through the generosity of about 700 cooperating attorneys, ALRP delivers about $1 million of legal services for its clients annually, on matters such as housing, employment, confidentiality, family law, and immigration. But many of these attorneys have, for a variety of reasons, felt that they could not provide counsel on matters of insurance law.

"Our main way of providing services has been leveraging the resources of the attorneys on our panel who take cases on behalf of clients. But we have struggled at ALRP to find attorneys on our panel to take insurance cases. Many of our attorneys may work for larger firms that represent the insurance companies, so they are conflicted out. It's also a very specialized area of the law, and some attorneys won't want to risk taking on something they don't feel they have the expertise or experience in handling," explained Hirsh, adding that HIPP is aimed at ensuring that people with HIV/AIDS with an insurance-related legal matter have access to an attorney. "We realized we could expand our capacity in-house so that we can take some of these cases and don't have to turn these folks away."

Some ALRP panel attorneys will continue to provide assistance on insurance issues, and each case will receive the attention of the ALRP insurance attorney and a dedicated law clerk. ALRP also will, as always, continue to try to recruit more panel attorneys with expertise and abilities in insurance law. But having a fulltime attorney to lead the HIPP project "will help ALRP clients avert the need for public assistance, avoid a potentially life-threatening deterioration of their health, and find peace of mind."

Unadkat, who previously handled a variety of ALRP cases for clients, said he was attracted to the insurance attorney position as a way to ensure that people with HIV were not denied their rights.

"Doing this work it became clear to me from a legal perspective that there's no greater imbalance of power than that which exists between insurance companies and their policy holders," said Unadkat. "It's a very complicated area of the law, even for many lawyers to navigate, and we want to make sure our clients' rights our preserved. Certainly the insurance companies are not going to be ones to do that. And these are cases that, for many of our clients, are going to impact the rest of their lives."

For more information about HIPP or ALRP, call (415) 701-1200 or visit www.alrp.org.

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