00:00:00 In 1985, we said with reasonable self-assurance, HIV is not transmitted by casual means. As

00:00:15 the years have gone on, we now increasingly know it is not transmitted in the workplace,

00:00:20 on buses, in social settings, in theaters or restaurants. We now can move on to the

00:00:27 much more important issues of how we're going to deal with HIV in the workplace regarding

00:00:33 working disability and all those other employer-employee related aspects. HIV disease is a much more

00:00:48 logical name for this than AIDS. You have to remember that AIDS was named back before

00:00:55 we knew what caused the disease. Now we have a virus. It's called HIV. There are a whole

00:01:02 spectrum of symptoms that that virus causes, so we call it HIV disease. AIDS is Acquired

00:01:12 Immune Deficiency Syndrome. It is actually the name for the very last phases of HIV infection,

00:01:20 when people get very specific severe infections and malignancies. In the 1980s, we learned

00:01:28 that education is the best means to prevent the transmission of HIV disease and to alleviate

00:01:34 fear of contracting it during normal workplace activities. The next step is for business

00:01:39 to include HIV as part of their chronic illness policies and to provide confidentiality, privacy

00:01:45 and reasonable accommodation, as well as ensure appropriate benefit coverage for these

00:01:49 workers. HIV is a chronic disease, and I think it is analogous to a lot of other chronic

00:01:58 diseases in which people can work for long periods of time, even though their lifespan

00:02:04 may be shorter than other people in the population. There have been a number of cases throughout

00:02:09 the states that pretty much resolve the issue that AIDS and AIDS-related diseases are considered

00:02:18 a handicap that is to be protected under both federal and state law. It's important to have

00:02:25 an AIDS policy because people are still afraid. And because people need information, they

00:02:34 need to have that information reinforced. And people need to know up front, ahead of

00:02:40 time, before a crisis occurs. This is how we treat people who have this problem.

00:02:50 Syntex makes prescription medicines with facilities throughout the world. In 1986, senior management

00:02:56 developed a policy that considers AIDS to be like any other life-threatening disease.

00:03:02 Syntex also set out to educate its employees about the disease and its human resources

00:03:07 staff on how to respond when an employee is diagnosed.

00:03:11 The policy we developed was a thoughtful policy based on the best advice that we could get

00:03:17 from national organizations. Therefore, it was a policy that was carefully thought out

00:03:22 and worked through. And we did not experience any kickback from various parts of the country

00:03:28 about the basic policy.

00:03:31 Syntex quickly had the opportunity to put their policy to the test. After a number of

00:03:35 prolonged absences, one of their employees came forward and told health services that

00:03:40 he had HIV disease.

00:03:43 The company had put out a newsletter, I think in March, a big, big, big one that folded

00:03:48 out about HIV. It was to all employees. And it was talking about what it was, how you

00:03:54 got it, how you didn't get it. And it very firmly stated in that newsletter that the

00:03:58 Syntex policy was that anybody who had HIV would be allowed to continue working.

00:04:03 I knew that we had a clear mandate from upper management that this employee was going to

00:04:08 be accommodated. So I could do my job with confidence, and I could communicate policies

00:04:14 to him with confidence that we would make every effort to accommodate him, that his

00:04:19 medical information would be kept confidential, that he didn't have to tell anybody if he

00:04:23 didn't want to.

00:04:25 Katie sought advice from the company's Human Resources Council and discussed the case without

00:04:30 revealing the employee's name. They recognized that Stephen's supervisors had not been educated

00:04:35 about how to implement the policy, so a training session was scheduled.

00:04:40 We had managed to put together a fairly sophisticated training program for all our HR people in

00:04:46 terms of how to train managers to deal with AIDS, in terms of the legal issues, the HR

00:04:52 issues, the sensitivity issues, the confidentiality issues. The training of managers hadn't started.

00:04:57 And then out of the blue, we find out that we've got somebody knocking on our door saying,

00:05:02 I've got a problem.

00:05:04 When we went to the seminar, I learned the difference between HIV positive, between ARC,

00:05:09 between AIDS, very important information to me. I also learned both the legal position

00:05:17 and Syntex's position regarding the confidentiality of information for an employee and the handicap

00:05:27 feature of what we needed to look at in dealing with this employee.

00:05:32 Katie evaluated Stephen's work capability with his physician and shared it with Barbara

00:05:37 so she could develop an accommodation plan, even though she was still unaware of Stephen's

00:05:41 disease.

00:05:42 HIV disease is a very difficult disease to accommodate in many ways. You have frequent

00:05:48 episodic illnesses that are very unpredictable. And it really is, I see it as the highest

00:05:53 standard of accommodation that you can make, or one of the very highest standards that

00:05:57 you can make.

00:05:58 The manager herself came up with the accommodation that we ultimately applied, which was a redistribution

00:06:06 of the workload among the balance of the department, with the sick individual being, in effect,

00:06:13 a floater, who picked up the excess from everybody else when he was there to do it. And it worked

00:06:19 very well.

00:06:21 Stephen eventually told Barbara he had HIV disease, which made it easier for her to understand

00:06:26 his special needs.

00:06:28 I felt like we did the right thing. And I felt like our attitudes were right, our actions

00:06:34 were in good faith. And it's always a learning and growing experience when you go through

00:06:42 that. So I think I probably am better able to deal with any kind of illness than I ever

00:06:52 was before.

00:06:55 Stephen was the test case for Sintex's policy. It works. It's being used with HIV disease

00:07:00 and all other cases of catastrophic illness.

00:07:03 For me, and for other people, having the confidentiality and having the benefits gives

00:07:08 a person more control over their life. And being ill is enough of an out-of-control kind

00:07:13 of issue without having other things in your life be taken over by some other force.

00:07:22 Carla worked for three years as a bookkeeper for a publishing company, where she was an

00:07:26 excellent employee. But she resigned when her attendance became an issue because the

00:07:31 company did not know how to deal with her HIV disease.

00:07:35 If you have an employee that's sick, that cannot do a lot of the work, that has a lot

00:07:40 of sick days, has taken all their vacation days because they were sick, it's not really

00:07:46 looked upon as a moneymaker.

00:07:48 If an employee becomes ill, if an employee has a chronic illness, are we going to scuttle

00:07:55 that employee or are we going to try to retain that person? That's the critical issue. And

00:08:02 I would suggest that just from a business sense, it makes much more sense to retain

00:08:08 a trained employee.

00:08:10 Carla was not only denied reasonable accommodation in her job, but her confidentiality was compromised

00:08:15 by her employer.

00:08:17 I think people need to know that people with AIDS are just like anybody else, that we don't

00:08:24 like our business spread throughout the office, and our personal lives are personal, and who

00:08:32 I choose to tell is who I choose to tell.

00:08:35 An employee, like any other individual, has a basic right under many laws, including the

00:08:45 U.S. Constitution, to have the right to be left alone, essentially, which is your right

00:08:52 to privacy.

00:08:54 Carla has good and bad days, periods where she could work, and others where she is too

00:08:58 sick to think about a job. She's living on disability and is very unhappy about the way

00:09:03 she had to leave her co-workers and her company.

00:09:06 I felt that my employer did not respect my wishes as far as confidentiality, and that

00:09:14 that was a minus, that I did not get any accommodation, that I didn't get a farewell party or a farewell

00:09:22 bonus when I did leave, and something that said, look, you're a valuable person, we're

00:09:31 going to miss you, you did a good job, have a good life.

00:09:40 Wade Smith works for Digital Equipment Corporation, a company of 130,000 employees worldwide.

00:09:46 He has AIDS. When Wade became ill, he was working in a fabrication unit, where attendance

00:09:51 is critical to both the project and continued employment.

00:09:56 Wade did not know about Digital's AIDS policy, and was afraid he'd lose his job. He confided

00:10:01 in a co-worker and in one of his supervisors, who told him, indeed, his job and benefits

00:10:05 were secure. Wade also obtained additional information from the company's AIDS Programs

00:10:10 Office, which is part of Worldwide Corporate Employee Relations.

00:10:15 If I took the chance of telling them, would the policy stand behind me, or would I lose

00:10:20 my job? If I didn't tell them, my absenteeism was going to assuredly make me lose my job.

00:10:29 By listening to some of his fears, and frankly, maybe some doubts and some insecurities, I

00:10:36 was able to talk specifically about our company philosophy, which is that employees who have

00:10:46 HIV infection are entitled to the same benefits and opportunities and treatment as anybody

00:10:52 who has any long-term debilitating illness.

00:10:55 The biggest reason why I came forward as far as HIV positive was because I was informed

00:11:01 that you would not be dismissed from your job because of your condition.

00:11:07 Wade was not Digital's first HIV case. The company developed specific guidelines for

00:11:13 managing HIV. Policies for confidentiality, fitness for duty, and reasonable accommodation

00:11:19 were in place, as well as an education program. Digital also provides seminars for supervisors

00:11:25 on how to manage all forms of chronic illness.

00:11:29 We established an AIDS program office to begin to define the policy, get it clear,

00:11:36 and begin to define a strategy for Digital that would get us very clear about how we

00:11:42 would approach AIDS training in the company.

00:11:45 I know what makes the difference for Wade and other employees living with HIV infection

00:11:51 is the consistency that when they talk to a personnel manager, their own manager, or

00:11:56 their supervisor, or for me, long distance, that they get the same message.

00:12:02 Once Wade understood Digital's HIV policy, he requested an accommodation to the less

00:12:07 stressful job. And he decided to share his HIV status with certain human resources and

00:12:12 health services managers. This was his choice, since Digital's policy on confidentiality

00:12:18 only required that he had a documented medical condition.

00:12:22 I now had a situation that I had never come across before professionally, and I had to

00:12:27 come to grips with how I felt. Then I had to think about how do I act responsive to

00:12:32 my corporation? What kind of plan do I make? Who do I talk to about it? How do I handle

00:12:37 the confidentiality?

00:12:39 From the very beginning, Digital has been 100 percent behind me, in front of me, looking

00:12:47 at aspects of where my health could lead me that I haven't been looked at, and has sat

00:12:55 down and discussed it with me.

00:12:58 The people in Wade's confidence, and others who only knew that a medical condition existed,

00:13:03 worked together to find a more suitable job for him. Once his fitness to work was evaluated,

00:13:08 a reasonable alternative was found.

00:13:11 The most important thing for Wade, in terms of the job selection, was that he would have

00:13:15 some choice. Wade has a lot of pride in what he does, and he wanted to feel as though he

00:13:20 was still making a very active contribution to the success of the program that we were

00:13:24 involved in.

00:13:25 He was very motivated and very concerned. I think he looked at the company and its success

00:13:32 as something that was really part of him.

00:13:34 I think it was a wonderful change for him. Wade, who was a dynamo, had something to strive

00:13:39 for now, had something to think about, something to really put his energies behind.

00:13:45 Wade wanted to make a difference in the time that he had left, and he was working second

00:13:49 shift or off shift, and he wanted to make sure that he wasn't forgotten, and that he

00:13:56 could make a contribution.

00:13:59 Wade's been promoted to a job with flexible hours that takes advantage of his production

00:14:03 skills. He's making a contribution to digital, and is showing that age is having little effect

00:14:08 on his job performance.

00:14:11 It's important for me to do my job well, because there are people that are going to

00:14:16 come up from behind me with AIDS, and I have to set an example not only for myself as a

00:14:24 human being to hold myself up and not give in to self-pity and crying and anger, but

00:14:32 to set an example that we are useful people.

00:14:43 Modine Manufacturing Company is headquartered in Racine, Wisconsin, a city of 80,000. The

00:14:48 company makes heat transfer products primarily for the automotive industry. They have 4,500

00:14:54 employees working at 15 manufacturing sites located in small towns in central and southern

00:14:59 states.

00:15:01 Modine has developed a mandatory education program for all its employees, and policies

00:15:06 to cover HIV like any catastrophic illness. Although they are a conservative company with

00:15:12 no reported HIV cases, Modine realizes that this proactive stance makes good business

00:15:18 sense. The driving force behind their program is the company's personnel director, John

00:15:22 McNulty, with support from senior management.

00:15:26 From the standpoint of the policies, the first thing that we did was to find out as much

00:15:32 as we could about AIDS. We also checked out with our insurance company to find out what

00:15:38 would be covered and how we could best handle those situations. And as a result of that,

00:15:44 we decided that we would cover AIDS just as any other catastrophic illness.

00:15:51 Once we got the policy down, once it said what we were going to do, the rest was very

00:15:55 simple. Then we just went out and told our people, this is what AIDS is, this is how

00:15:58 you get it, this is how you prevent it, and this is what the company will do if you get

00:16:03 in a jam. Very simple after that.

00:16:07 McNulty, along with the company's medical director and labor relations director, went

00:16:11 to the San Francisco AIDS Foundation to learn about the disease and how to set up an education

00:16:16 program. They returned to develop their own program, which includes information on reasonable

00:16:22 accommodation and confidentiality that has been presented to all of their employees.

00:16:27 What we did is that we initially got together with the unions prior to the time we went

00:16:32 in and made a presentation, and sat down with them and explained to them what the program

00:16:36 was and what we intended to do.

00:16:38 The way AIDS is spreading, there's a good chance we will have people working here that

00:16:42 might be infected, and they have to handle them some way, and I think they're just starting

00:16:46 early.

00:16:47 I think they told us that should something like this come up, it would be kept confidential,

00:16:56 that we would have our jobs as long as we were able to work, and that medically, they

00:17:04 would take care of us through the insurance.

00:17:08 The essence of what we're trying to do is that irrespective of the fact that you've

00:17:13 got a problem, we're here to treat you with respect and dignity until such time as you

00:17:19 can no longer be able to work, and then the company continues its support in terms of

00:17:25 payment of bills, payment of salaries, until you no longer need them.

00:17:32 Modine has shared their education program with other companies in the Midwest, and provided

00:17:37 them with a model for policy and procedures for managing HIV cases. John McNulty and Modine's

00:17:42 other trainers have also been invited to speak about HIV disease at a variety of community

00:17:48 organizations.

00:17:50 Most of our plants are in very small communities, rural areas, and while we may not be the most

00:17:57 significant leader in that community, we are one of the leaders from an employment standpoint,

00:18:04 and we feel it's an obligation that the company has to educate those communities where we

00:18:09 can provide a service.

00:18:10 John McNulty and Modine know that it's just a matter of time before HIV disease appears

00:18:17 in one of their facilities, but they have developed an education program that will explain

00:18:22 the disease and set major policy on how to treat any of their employees who become ill.

00:18:31 Modine, Syntex, and Digital have developed quick response teams for handling life-threatening

00:18:35 illnesses. These teams provide counseling and community outreach programs for employees,

00:18:41 their families, and coworkers. They also deal with grief, loss, and bereavement in the workplace.

00:18:49 Wade Smith died while he was employed at Digital. It came as a great shock to his coworkers.

00:18:55 Digital responded by providing grief counseling, first for his immediate circle of coworkers,

00:19:00 and then the plant as a whole.

00:19:02 He was just taken from us too fast, you know, we just weren't prepared for it.

00:19:08 Taking down of the name tag on the office and so on is part of what makes a death real,

00:19:13 and it's the beginning to move on, but those are just as shocking events as the actual

00:19:18 death itself, and it sort of pierces your heart.

00:19:22 I cared a great deal because I thought Digital realizes Wade was a person and that there

00:19:27 were people around him, and it's the first time in my history, you know, of working

00:19:32 that I've seen this happen.

00:19:34 At the beginning, people were saddened and depressed, and that really takes its toll

00:19:41 in terms of working. When you're depressed, your energy is constricted and so on. Over

00:19:46 the period of three or four days, when people were able to facilitate and process through

00:19:50 these feelings, their energy was more released, and I noticed with many of the people, for

00:19:55 instance, they had statements like, well, I got to get back to work now. It was as if

00:19:59 they could now go back to work with the kind of good feeling and good energy that they

00:20:03 would normally put into their work.

00:20:06 Allen also found that he had to talk about how HIV is contracted, and that working around

00:20:11 Wade did not put any of them at risk.

00:20:14 Part of the grieving process is probably to do some reinforcement about the basic, basic

00:20:19 educational facts, you know, geez, I really was working with someone who was ill, he's

00:20:23 now died, am I going to get it? Do I have to really begin worrying about telephones

00:20:28 and desktops? So what part of our work is to do what I would call quick and dirty reinforcement

00:20:34 of the basic facts.

00:20:36 In the 90s, businesses will still need to educate their employees that HIV cannot be

00:20:41 transmitted during normal workplace activities. It is only contracted from unsafe sexual practices,

00:20:47 injected drug use, and prenatal transmission. But the next step for HIV in the 90s will

00:20:52 be much more.

00:20:53 The drug therapies that have developed over the last few years are prolonging life, are

00:21:02 prolonging the interval between infections and problems that take people away from the

00:21:09 workplace. Absenteeism will be less of a problem. Productivity will be greater. Sense of well-being.

00:21:17 Hope, anticipation of living longer, allows people to be more productive human beings

00:21:23 and will make them better at their jobs.

00:21:25 People are a corporation's greatest asset, and people with HIV are working longer. Senior

00:21:31 managers need to provide appropriate benefits, as well as policies for reasonable accommodation

00:21:36 and confidentiality that can be implemented with minimal workplace disruption.

00:21:41 It's important for a company that has developed an AIDS policy not to sit back and think that

00:21:48 their job is finished, because you must go back and look at that policy very, very often

00:21:55 to be sure that new developments have not changed what that policy needs to say and

00:22:01 how it needs to be implemented.

00:22:03 American business needs policies that create an environment which will allow people with

00:22:07 HIV disease to work with dignity, work with job security, and work with a compassion and

00:22:14 understanding of those around them.

00:22:15 I think I will be missed by some of the most fantastic people I have ever met in my life.

00:22:34 My teachers, and that they have allowed me to teach them, and that I will probably, I

00:22:41 know that I will miss them more, because life for them has to go on. But I have learned

00:22:49 a lot from these people.