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Coalition Seeks Court Order To Protect Confidentiality During Audit

April 3, 1996

BOSTON (AP) _ Two dozen groups that use federal funds to provide services to AIDS patients asked a judge Wednesday to limit government access to their files after auditors compiled a list of client names during an inspection.

The coalition of agencies, which provide services under the Ryan White Comprehensive AIDS Resource Emergency Act, known as CARE, say the auditors jeopardized their mission.

Providers fear that because of the stigma attached to AIDS, people with the virus will not seek treatment if confidentiality is not guaranteed.

``We tell people you can come in and get services confidentially, but now we’re saying it’s confidential but a bunch of federal thugs might come and look at it and drag it around the city,″ said A.G. Breitenstein, lawyer for the Boston-area coalition.

The auditors compiled a list of 78 names after the Haitian Multiservice Center failed to provide documentation that those clients were entitled to services by testing positive for HIV, the virus that causes AIDS, or the disease itself.

The names were then shown to a city official in charge of AIDS services for confirmation of their HIV status, the coalition said.

Coalition members said the auditors could have relied on codes used by service providers, rather than names, for verification.

``We completely understand their need for audits but it’s possible to do an audit without seeing client identifiers,″ said Denise McWilliams, director of the Boston AIDS Consortium.

McWilliams said the coalition did not know when the court might rule. The defendants typically have a month to file a response.

She said that in addition to an injunction to prevent auditors from looking at files with names in the future, the coalition wants a federal judge to rule that the auditors both violated constitutional privacy protections and exceeded their authority. They are not seeking any monetary damages.

McWilliams said a ruling would set a precedent for agencies elsewhere, although it would not be legally binding in other states.

The audit was conducted by the Office of Inspector General of the Health and Human Services Department.

The Boston area’s CARE program was the first to be audited, said HHS spokesman Victor Zonana. Since then, he said, the agency has taken steps to protect patient confidentiality. An audit of New York City’s program created no controversy, he said.

``It is a balancing act between patient confidentiality and program integrity and this administration believes very strongly in both,″ Victor Zonana said. ``We are keenly aware of the need to square that circle and we believe we have.″

He said the audits in Boston and New York City were routine and not a result of any suspicion of wrongdoing.

The 1990 Ryan White act, named for the teen-ager who died in 1990 after contracting AIDS through a blood transfusion, provides funding to cities which have reported 2,000 or more AIDS cases. Recipients are eligible for medical care, drugs, counseling and other services.

More than $500 million was distributed to 42 cities under the act last year. Boston-area agencies have collected more than $23 million in grants since 1991.

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