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An Interview with Ann Hilton Fisher of the Aids Legal Council

AnnAnn Hilton Fisher has been at the helm of the Aids Legal Council as its Executive Director since 1997, when she left an amazing run working with the Disability Law Project and beginning the HIV Law project. Among her many accomplishments in the beginning of her career was a 5 year campaign in which she worked to raise income necessary for Medicaid eligibility in Illinois, resulting in 100,0000 people becoming eligible for insurance. When she began at ALCC, Hilton Fisher saw the necessity of her staff to not only keep up with need and become experts in their specific area, but forsee issues that will be affecting their clients with the evolution of both the HIV epidemic and the law. Read on to see what inspires someone with the passion for change and dedication that Hilton Fisher brings to the Aids Legal Council of Chicago.

The L Stop – Lets start from the beginning! Did you know from the start that you would be going into Public Service?

Ann Hilton Fisher – I was always going to go into Public Interest with a particular interest in Civil Rights. In a lot of ways I was a child of the 60’s and the struggles in that time were the ones that really hit me as a teenager and then went on to motivate me as an adult.

TLS – So when you first finished law school, what steps did you take to get onto that path?

AHF– I was very fortunate particularly as a night student from a low tier law school, that I was offered a couple of Federal clerkships, where I had the opportunity to clerk for a year for a Federal District Judge in Detroit, and then for two years on a 7th Circuit Court of Appeal Judge here in Chicago, which is what brought me here! Clerkships are almost the equivalent of a fancy post-graduate fellowship that people do, so they open some tremendous opportunities for you. I knew I wanted to go into Public Interest so through friends I was able to sit down with a woman who was in the regional office of what was then the Legal Services Corporation. I was pointed towards the Legal Assistance Foundation of Chicago, who was said to be doing both the best individual and impact work in the country and began working with them in 1978.

I was there for 17 years, doing both neighborhood work on Madison and Cicero and other Westside neighborhoods working with battered women and car repossessions and evictions, and the other day-to-day public aid work of a legal services lawyer in a neighborhood office. I was also starting to pick up some significant impact work- working on some cases involving things like how welfare benefits are dealt with when there is a disabled child in the household. So eventually the organization had specialized teams downtown in addition to neighborhood offices, and when an opening in the disability law project came up I joined them.

I started representing people with HIV exclusively when I headed the HIV Law Project thought LAF- work I started just as the new antiretroviral came in. So even though I have been doing this for a long time, I was not doing it in the era where people were dying all of the time. I was doing it just as hope came on the horizon. Some of the early clients, I remember I was sure, and they were sure they were not going to be alive another 6 months, but they are alive today. I don’t have PTSD from the early days of the AIDS epidemic- I have been very fortunate.

TLS- Do you think a lot of lawyers shy away from this kind of work? Especially considering loans and other factors?

AHF– There have always been more people wanting to do Public Interest work than there are Public Interest jobs. Many people will look into it and perhaps reconsider when they compare it to their financial situation. But we have many students that come to us during the summer and school year who would be terrific Public Interest lawyers. I used to be on the hiring committee at LAF, and I tell you every year we would have 200-600 applicants for 20 spots. Lawyers have this reputation, but there have always been a group of energetic, idealistic young lawyers who see law as a tool of social change. Thankfully there are some programs though schools and other loan forgiveness opportunities that are helping students who choose to pursue this field.

TLS- So you have been at Aids Legal Council since 1997- how have things changed from when you started until now?

ribbonAHF– It hasn’t changed as much as it has evolved. Public benefits used to be sort of an incidental side of what we did. In 1991 when we opened an office at Cook County Hospital- so long before people saw that HIV was really a disease of poverty, we did. Once you are dealing with poor people, you’ve got to be paying attention to public benefits, Medicaid, Food Stamps, Social Security, the safety net is critical. When I came, this office downtown was working on Wills, Powers of Attorney, discrimination, those kind of issues. In result, Public Benefits was handled by the people out of Cook County Hospital. We then realized that we all had to become experts in these issues- not just something assigned to paralegals in one office or the other. What that means now and what that meant then has changed from basic Public Benefit knowledge, to being experts on things that are now relevant like the Affordable Care Act.

I mentioned that I came into the field right when people were starting to get better… That meant for the first time, people who thought they were going to die, were now feeling better, doing better, and wanted to go back to work. So a whole other set of questions came up- were they going to lose their Medicare? Can they get insurance at work if they already have HIV? So we did a lot to work with those who would return to work and the issues they may face.

Immigration is another issue that we had to come to deal with pretty quickly, as the federal law used to be very hostile to those with HIV, but there was an HIV waiver that was available to some people. With our work at Cook County, many of our clients fell into that category and so again, we became experts. Now that the waiver is no longer necessary, we are able to focus on some more general questions of immigration.

As the epidemic changes and the law evolves, we work to be two steps ahead in preparation, training and resources.

TLS- So with the evolution of the organization and the epidemic itself, where do you see the needs of the Aids Legal Council in the next 5-10 years?

AHF– It is going to be very interesting, there is this wonderful tool now called the cascade. This tool explains that the best way to prevent new infections is to get people with HIV into care. If you can suppress someone’s viral load, they are not going to transmit HIV, so we need to find out who has HIV and get care to them. The Cascade explains the percentage of people who are known to be HIV positive and goes through each step to suppress their viral loads. So the big question now is how can we find these people and get care to them so that these percentages become obsolete?

Since HIV is a reportable disease, this poses legal questions towards the use of that data. What are the privacy issues in doing something like seeking a person to bring them to care? No one is forcing anyone to take medication and get care, but the push is going towards that sentiment that not only are you hurting your health, but you are viewed as somewhat of a danger to the community.

The Affordable Care Act is also a huge deal right now- starting next year, the large percentage of those without Health Insurance, will come into some form of health care. In Illinois, 80% of those who are uninsured and have HIV will be coming into Medicaid. But then what is going to happen to all of the funding that has been supporting some of the programs and organizations that have been doing this work for so long? There will be many changes coming with affordable healthcare… The big question is in this new climate, how do we keep continuity of care, preserve confidentiality and make sure people can access- but are not forced into- care? It will be interesting to see how people with HIV are or are not served in this new healthcare environment.

TLS- It seems that there is a lot that could happen in the next couple years- it will be very interesting to see how everything folds out! So one last question, what is something that you are especially proud of from your time at the Council?

AHF– It is really hard to say…. In terms of programmatically and the organization, I am incredibly proud that we have developed this really expert staff that provides lots of continuity, know how to turn around on a dime…. Our whole approach, which is simply “lets solve a problem”… We aren’t going for the glory, but for actual solutions. We had a case a few years back where one of our partners had done a criminal background check on a perspective employee- knowing full well the candidate had a criminal background history, it didn’t matter for the position he was doing. So they got back the record with nothing surprising to them, except for this little box on page one that was a police record stating “Reason for caution: HIV Positive”. Within the afternoon, the state representative had gotten us on the phone with the legislative liaison for the state police department. By the next morning, the general counsel from the department had contacted us and let us know that overnight, they had removed that same notation from 600 records, and reprogrammed the computer so that it will never happen again. We could have gone and done something fancy and unnecessary, but the fact is we want a solution for everyone, and a solution that protects those in the future.

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About Lauren

Lauren was born and raised in South Minneapolis and like many other innocent midwesterners got sucked into the black hole of Chicago politics 4 years ago. As the LGBT Coordinator for the Gery Chico for Mayor Campaign she attempted to take on the entire city and hasn’t looked back since. Now working for a communications firm, she spends her extra time running around with cases of PBR playing in different sports leagues, hosting couchsurfers from all over the place, and deciding how she is going to change the world. A simple lady at her core, she has decided that the first person to send her an edible arrangement must be the one.

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