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Sunday, December 22, 2013

WHITE HOUSE HIV/AIDS DIRECTOR MEETS WITH BEYOND AIDS DELEGATION, BEFORE LEAVING POSITION


On December 13, 2013, Dr. Grant Colfax, White House Director of National HIV/AIDS Policy (ONAP, a part of the Domestic Planning Council), met with a 7-member Beyond AIDS delegation. The discussion took place at UCLA, immediately after Dr. Colfax delivered a lecture there on "National HIV/AIDS Strategy and the HIV Care Continuum Initiative. Dr. Colfax was the third ONAP Director to have met with Beyond AIDS, over the course of two Presidential Administrations. UCLA Professor Jeffrey Klausner, who was a former colleague of Colfax when they both worked at the San Francisco Department of Public Health, arranged the session.
ONAP Director Colfax lecturing at UCLA

The delegation members provided an introduction to the past accomplishments and future goals of Beyond AIDS, as well as individual introductions. Beyond AIDS expressed support for the President's HIV Care Continuum Initiative, which Dr. Colfax had developed for President Obama and which was issued in July 2013. The delegation also offered to help keep public discussion on national HIV/AIDS strategy focused on the HIV Continuum of Care.
 Hattis presents papers to Colfax

Dr. Colfax reiterated some of the epidemiological points he had expressed in his lecture, including the 9 current goals of the Initiative, noting that the key risk groups continue to be similar to ten years ago: young gay males, blacks, Latinos, and transgender females. The discussion included the recent focus on interrupting transmission, as can be achieved through effective treatment that suppresses the virus. Ron Hattis presented a collection of Beyond AIDS policy drafts and PowerPoint presentation files for Colfax's review.

Jean Davis described the gaps in training of providers and other leaders, left by reduced funding of AIDS Education Training Centers. Gary Richwald brought up linkages of treatment and prevention. 
(Clockwise around table, from front) Jean Davis, Peggy Flanary, 
Grant Colfax, Gary Richwald, Dennis Thompson
Dr. Klausner commented on a proposed recommendation that gay males be tested every 6 rather than 12 months. Klausner suggested that the frequency of testing should depend on their number of partners. Hattis suggested that all infected persons and their immediate partners could be considered as top risk groups deserving focused attention for interruption of transmission.

Grant Colfax, center, makes a point to delegation members (clockwise around table, from 
front) Jeffrey Klausner, Peggy Flanary, Gary Richwald, Dennis Thompson, and Leith States
Ron Hattis explained that Beyond AIDS hoped to contribute ideas during 2014, for the 2015 update of the National HIV/AIDS Strategy, and suggested that it could be organized around the HIV Care Continuum. Leith States, a new Fellow of Beyond AIDS' Foundation, who was part of the delegation, offered to assist with that project. Beyond AIDS was hoping to establish an ongoing communication with ONAP so as to have input during the planning process. However, Dr. Colfax indicated that work had not yet been started on a revision to the strategy.
Delegation with ONAP Director: (left to right) Jeffrey Klausner, Jean Davis, Ron Hattis, 
Grant Colfax, Dennis Thompson, Gary Richwald, Leith States, and Peggy Flanary
Only six days after the meeting, a White House official let it be known that Dr. Colfax would be leaving his position at ONAP on January 13, 2014. Unfortunately, this means that the personal relationships established in the Beyond AIDS meeting will not result in the establishment of an ongoing liaison with White House planning, and further contacts will need to be made with the next Director of ONAP.

Saturday, December 21, 2013

MEDICARE COVERS HIV TESTING...BUT ONLY IF YOU USE THE RIGHT CODE (Z11.4 for ICD10, FORMERLY V73.89 for ICD9)! AND OTHER INSURANCE MAY USE DIFFERENT CODES...

(Updated 10/28/15 for ICD-10; original article 12/21/13))

We thought we had it all solved four years ago. On December 8, 2009, Medicare announced that it would start covering the cost of annual HIV screening for all beneficiaries regardless of age, diagnosis, or risk indication, at no cost to the patient.  (Click here to read the story behind the approval, including the testimony from Beyond AIDS to the Center for Medicare and Medicaid Services, or CMS.) One might assume that if a test is free and does not require a special diagnosis or risk as an indication, coverage should be approved regardless of what codes are entered for billing. But one would be wrong! That's not how government, healthcare, or insurance work.

Beyond AIDS had originally become involved in 2009 when a member on Medicare was billed $77 by a lab because HIV testing was not a covered benefit. Four years after Medicare agreed to cover HIV screening, the same thing happened, only this time the lab bill was $169! Knowing that the test was supposed to be covered, our member appealed and asked for an explanation. It turned out that the doctor had used the "wrong" ICD diagnostic code.

When the physician was told of the correct code (which we're revealing to you here), the billing was revised. However, the lab initially neglected to pass on the corrected code to Medicare, and instead began sending the patient threatening letters from its collection agency. Eventually, the charge for the test was cancelled, but the lack of transparency on the part of CMS, combined with high charges and negligence by the lab, had meanwhile resulted in a lot of avoidable stress.

The good news is that for right now, providers can use the information in this posting and enter ICD-10 code Z11.4, to assure coverage of a routine EIA screening test on a Medicare patient.

ICD-10 code Z11.4 is an encounter for HIV screening, which the provider should enter on the lab requisition, and may also bill if there is no other diagnosis for the visit (this was formerly V73.89 under ICD-9). If there is special high risk, the additional code Z72.89 should be added. Medicare's requirement for codes for patients not complaining of a specific risk factor for HIV is not publicized, and is very difficult for physicians to locate with Web searches. This makes the promise of coverage for screening of all beneficiaries almost meaningless for practical purposes.

There are other codes that providers will generally not need to include in billing. The HCPCS code G0432 (infectious agent antibody detection by EIA technique) identifies an ELISA (EIA) combined HIV-1 and 2. If it is a rapid test, the code is G0435 (infectious agent antibody detection by rapid antibody test). According to CMS publication ICN 006559, October 2015, appropriate HCPCS codes for an HIV screening test depend on technique used.

Since the start of the Affordable Care Act ("Obamacare") at the beginning of 2014, all medical insurance coverages affected by the law (not just Medicare) are required to cover HIV screening at no cost to patients. That requirement is based on a strong (Class A) recommendation for routine and universal HIV screening of all persons ages 15 to 65, by the U.S. Preventive Services Task Force (USPSTF), in April 2013.  In addition to HIV testing, a number of other preventive services, including tests, immunizations, and treatments, will be covered by all qualified insurance plans under the law, especially for women. Hopefully, each insurance plan will agree to use the same codes as Medicare for the free screening. If an insurance plan were to select its own obscure code for the coverage of HIV screening and for each of the other preventive tests, that would present a barrier to preventive screening.

Additional issues are raised by this experience. Our member was required to obtain the HIV test by a healthcare employer. The legality of such a requirement will not be dealt with here, but is problematic. The lab charge for a simple HIV antibody screening when insurance apparently does not apply was already exorbitant in 2009, and increased by 119% in just 4 years. So it's a good thing that the country is moving toward free, routine HIV screening. But the billing code requirements that are currently used in the U.S. are not going to make that a simple matter.

The take-home pearl here is that Medicare providers should use ICD-10 code Z11.4, and Medicare patients who want an HIV test should  pass that information on to providers to avoid getting big bills from labs. But that's just for Medicare, and it might even change in the future. This is only the tip of the iceberg, because different codes may be used by a myriad of insurance plans, and for other newly covered tests and procedures as well as HIV testing. Medical organizations and insurance plans should determine and publicize the ICD-10 codes that must be used for billing each of the newly covered preventive services under the Affordable Care Act. The Beyond AIDS Foundation will continue to follow this issue.

Monday, December 09, 2013

ELEMENTS FOR A NATIONAL STRATEGY ON REDUCING NEW HIV INFECTIONS




(Prepared with input from individual members of HIV Policy Working Group, HIV/AIDS Section, American Public Health Association, but not adopted as an APHA document; carried forward by the Beyond AIDS Foundation)

Non-highlighted text was approved in concept as a basis for further policy development, at the Annual Meeting of Beyond AIDS, 11/9/13. Additions in bold text and deletions in strikethrough have been proposed as update, 12/2/13. This draft is a work in progress, and should not be considered as final policy of Beyond AIDS.

For prevention of HIV infections, Beyond AIDS supports periodic updates to the 2010 National HIV/AIDS Strategy through progress reports, to integrate the concepts described in the President’s 2013 HIV Care Continuum Initiative. The next overall revision of the National AIDS Strategy (expected in 2015) should emphasize a central role for the care continuum, with the goals of achieving treatment as prevention as well as benefiting the health of persons living with HIV. This continuum, with public health enhancements as included in the outline below, should be promoted and supported with adequate public funding, and with a high emphasis on the rights, confidentiality, voluntary cooperation, and dignity of persons with HIV:
  • Universal, routine, opt-out screening should be provided to adolescents and adults, as recommended by the Centers for Disease Control and Prevention (CDC), and by the U.S. Preventive Services Task Force (USPSTF). Screening methods and confirmation algorithms used should be selected from the latest recommended by CDC or by the National Institutes of Health (NIH).
  • Risk assessment and effective prevention messages should be offered to all persons testing negative who can be accessed for such services, with availability of counseling, referrals, and repeat screening based on risk. Nucleic acid or antigen screening at the initial visit should be considered for those with very recent suspected exposure (such as partners of persons with detectable viral loads or persons who have very recently engaged in high risk sex), if these may detect early infections that have not yet produced antibodies.
  •  Prompt and routine initial outreach services, consistently and adequately funded in all local jurisdictions nationwide, should be provided for all individuals confirmed as testing positive:
o   Linkage to care by healthcare providers who are knowledgeable about HIV management and prevention
o   Initial partner services by disease intervention or other public health specialists, or by properly trained healthcare personnel as permitted by law, to identify the most likely source partner and the most recently exposed partners, including confidential notification, counseling, and opt-out testing of possibly exposed individuals

  • Maintenance of continuous HIV care, including integrated prevention measures, should be optimized by competent providers and support resources, including the following services:
o   Prompt offering and initiation of antiretroviral treatment, and assurance of continuous treatment availability, based on current guidelines and best practices
o   Proven strategies for maintaining tight adherence to antiretroviral regimens
o   Active community outreach to patients missing appointments, and closely tracked referrals to new sources of care for those who require a change in provider
o   Referrals to specialists, support groups, ADAP, case management cross-trained in prevention, substance abuse treatment, mental health services, housing, prevention with positives, and other programs (historically funded by the Ryan White CARE Act) as appropriate
o   Prevention messages fully incorporated into ongoing care and treatment, and provided with the best evidence-based approaches including:
o   Routine assessment and brief counseling during clinical visits, regarding sexual and drug-related behavior, with referrals as appropriate
o   Monitoring of treatment adherence, with simplification or adjustment of regimens as needed
o   Monitoring of viral load suppression, with resistance testing and adaptation of treatment when indicated, with the aim of achieving undetectable viral loads or lowest viral levels possible, to prevent transmission as well as the development of viral resistance
o   Use of surveillance data by public health departments to monitor adherence, retention, and viral suppression with follow-up that maintains strict confidentiality
o   Ongoing assessment about new partners, and referral (as above) or performance of follow-up partner services, including confidential notification, counseling, and opt-out testing for contacts
o   Other Prevention with Positives components, including accessible, available, and acceptable condom distribution; screening and treatment of other STDs, hepatitis B and C, and tuberculosis; prevention of mother-to-child transmission; reproductive health care; and referral to other services as needs arise during care

  • Prophylactic use of antiretroviral medications by uninfected persons should gradually become less necessary with implementation of the above strategy.  and should be for clear and limited Its indications should be approved prioritized by CDC.  Pre-exposure prophylaxis should not be advocated as a substitute for condoms.  The efficacy of intra-exposure prophylaxis with various regimens for sero-negative partners of persons known to be infected and on treatment, e.g., if viral load is still detectable on treatment, or when condoms are refused or deferred to attempt pregnancy, should be intensively studied.

Beyond AIDS also supports population-based efforts to reduce risk-prone behaviors within high-risk communities. Such efforts include raising awareness of the issues surrounding HIV/AIDS, reducing stigma related to testing and treatment, mobilizing communities to take preventive actions, making condom distribution a structural intervention, and changing community norms about condom use.  These efforts also should incorporate prevention of other similarly-transmitted STDs and bloodborne pathogens (including hepatitis B and C), especially emphasizing the avoidance of unsafe sexual and drug/needle-related behavior. Education and screening should be utilized as an important means of detecting infected persons to initiate the HIV continuum of care.

For injection drug users, clean needles/syringes should be made available, including through pharmacies and private sector initiatives; but prevention of infections depends on keeping them clean and ultimately unused. Public health and other publicly funded efforts should emphasize disinfection and non-sharing of “works”; screening for HIV, hepatitis C, and hepatitis B; drug abuse prevention and treatment; education and counseling including group support; referrals as needed to health care, nutrition, and housing; and rehabilitation.

In the 2010 National HIV/AIDS Strategy, the three prevention steps were all targeted at populations (intensifying HIV prevention efforts in the communities where HIV is most heavily concentrated; expanding targeted efforts with evidence-based approaches, and educating all Americans about HIV and how to prevent it). While such efforts tend to be less efficient for prevention of HIV than the care continuum, which stops HIV transmission at the source, they remain valuable in preventing infection of persons unaware that they have HIV-infected partners, and in reducing transmission of other sexually transmitted diseases. Funding should be distributed to achieve the most cost-effective combinations and balances among such population-based strategies, and between them and the HIV care continuum.

Population-based programs should be culturally appropriate, and should include sexual health education across the lifespan. They should include efforts to change community norms relating to risk behaviors, which have proven to have high potential effectiveness, such as the A-B-C programs in Uganda and some other locations, and with community-level interventions in the US. All should utilize intensive outreach efforts and the use of social network referral programs and should emphasize screening, in order to initiate the care continuum as outlined above; including combined or coordinated screening for HIV and other similarly transmitted diseases.

Saturday, November 09, 2013

BEYOND AIDS SELECTS LEADERS FOR 2014, 2015

In its biennial election on November 9, 2013, Beyond AIDS has selected the following officers to serve during 2014 and 2015:

President:  Ronald P. Hattis, MD, MPH (California)
Vice-Pres:  Monica M. Sweeney, MD, MPH (New York)
Secretary:  Deanna C. Stover, PhD, FNP (California)
Treasurer:  Dennis Thompson, MD (California)
Past-Pres.: Cary Savitch, MD (California)
Directors:  Adriana Andaluz, MPH (New York)*

                    Franklyn N. Judson, MD (Colorado)
                    Elizabeth Kidder, MD, MPH (Washington, DC)

                    Yvonne W. Pover, RDH (Virginia)   Passed away 4/14,           replaced 9/14 by  Jeffrey D. Klausner, MD, MPH (California)


The Advisory Council will consist of:
Denise Bleak, MSN, PHN (California)
I. Jean Davis, PA, DC (California)
Paul Galatowitsch, PhD* (New York)
Peter Kerndt, MD, MPH (California)
Jeffrey D. Klausner, MD, MPH* (California)  Moved to Board 9/14
Evette Oszyk, BA (Florida)
Gary A. Richwald, MD, MPH (California)                               


The subsidiary Beyond AIDS Foundation, a 501(c)3 charitable corporation, will be governed by the following Board (appointed by the Board of Beyond AIDS):

President:   Deanna C. Stover, PhD, FNP (California)
Vice-Pres.:  Cary Savitch, MD (California)
Secretary:   Ronald P. Hattis, MD, MPH (California)
Treasurer:   Dennis P. Thompson, MD (California)
Directors:    Adriana Andaluz, MPH* (New York)

                    Franklyn N. Judson, MD (Colorado)
                    Elizabeth Kidder, MD, MPH (Washington, DC)

                    Jeffrey Klausner, MD, MPH (California) replacing Yvonne W. Pover, RDH  
                    Monica M. Sweeney, MD, MPH (New York)
              
The Foundation's Scientific Committee is co-chaired by Drs. Franklyn Judson and Monica Sweeney.

*new appointments


BRIEF BIOGRAPHIES OF BOARD MEMBERS OF BEYOND AIDS, 2014/2015

RONALD P. HATTIS, MD, MPH, President


Ron Hattis has served as President of Beyond AIDS for the past six years.  When the organization was founded, he was the first Vice-President, and later served as Secretary, as well as President of our subsidiary tax-deductible Foundation. He has been active in contacts with federal leaders, and in Beyond AIDS' legislative efforts in California, and has represented our organization in consultations with the California Office of AIDS. He developed the original Bylaws for both the membership organization and the foundation, and has mentored many of our past interns. 

He is a physician, certified as a practicing HIV/AIDS specialist (AAHIVMS) and board-certified in Public Health/Preventive Medicine, living in Redlands, California.  He was formerly the chief physician at a large state hospital, where he was in charge of HIV testing and training HIV educators for 20 years, and he treated HIV/AIDS patients at the infectious disease clinic.  Since retiring from that position, he has worked part-time in clinical medicine including HIV care, and is on the clinical faculty of Loma Linda University School of Medicine, where he has lectured on HIV as a representative of our Foundation.  He is also active with a disaster medical assistance team, and helped out at the World Trade Center, Hurricane Katrina, Hurricane Ike, and the Northridge earthquake.
Other past positions in reverse order have included teacher of family medicine, county health officer, country family physician (on Kauai in Hawaii), and Epidemic Intelligence Service Officer for the Centers for Disease Control and Prevention (assigned through field services to the Hawaii Department of Health). 

His goals for Beyond AIDS over the next two years include developing proposals for the 2015 update of the National HIV/AIDS Strategy; and continuing to be involved with legislation in California and important states, as well as at the federal level. In particular, he plans to continue to work to promote the HIV care continuum; to utilize HIV reporting to trigger outreach for referral of patients to treatment, partner services, and other services to prevent transmission; and to enhance HIV prevention science. 


MONICA SWEENEY, MD, MPH, Vice-President

Monica Sweeney recently retired from her position as the Assistant Commissioner of Health for New York City after over 6 years in charge of the Bureau of HIV/AIDS Prevention and Control. Her responsibilities there included oversight of programs and budgets for prevention; care and treatment (Ryan White); Housing Opportunities for People With AIDS (HOPWA); and the epidemiology/Field Services Unit.  She immediately took a position at the Mailman School of Public Health, Columbia University also accepted a position with a Foundation Board. Additionally, she is now the chair of the SUNY Downstate Medical Center's Association of Council Members and College Trustees.

Prior to her present position, she was the medical director and vice president for medical affairs in a Federally Qualified Health Center in Bedford Stuyvesant, Brooklyn NY.  The community served was medically and economically deprived and HIV/AIDS was one of many challenges she addressed daily during her 17 years in Bedford Stuyvesant.  During her tenure there, in addition to direct patient care, she became involved in policy and advocacy and had the opportunity to work with Assemblywoman Nettie Mayersohn to get her historic legislation (the Baby AIDS Bill, and Named-based Reporting) passed -- over almost insurmountable opposition.

Dr. Sweeney is a board-certified internist and geriatrician with a masters degree in public health.  She has always combined individual and public health in her practice, by working with the Medical Society for the State of New York (MSSNY), the National Association of Community Health Centers (NACHC), and the American College of Physicians (ACP) and by serving on the President’s Advisory Council on HIV/AIDS (PACHA).  Prior to election to the position of Vice-President, she was a Director on the Beyond AIDS Board, and before that she served on the Advisory Council. Her goals as Vice-President include working diligently to broaden the reach of the only AIDS organization that has always used sound public health policy to fight the epidemic.


DEANNA STOVER, PHD, RN-BC, FNP-BC, CNS, COHN-S, Secretary

Deanna Stover is the Executive Director, Community Based (Outreach) Programs and Services, at Redlands Community Hospital, with responsibility for the provision of healthcare to the community with a focus on low-income and underserved populations. She began her nursing career in 1979 while serving in the United States Air Force in Europe, and she earned her PhD in Nursing, Health Policy from Loma Linda University in 2011. She holds board-certification as a family practice nurse practitioner, medical-surgical nurse, and occupational health nurse specialist.

Prior positions include Director, Medical Services, City of Los Angeles, and Chief of Clinical Operations, Center for Employee Health and Wellness, County of San Bernardino. She has actively worked in the medical arena for over 30 years with training and expertise in community-based healthcare, health policy, HIV/AIDS health care, occupational medicine, and advance practice nursing as a family nurse practitioner and clinical nurse specialist.

She holds a certificate as an Advanced HIV Nurse Clinician from USC Medical Center, AIDS education training center (1995) and has provided HIV/AIDS training for healthcare providers.

She has served on organizational boards at the state and local level and is a current board member for a local non-profit community service organization, Building A Generation, located in Redlands California, in addition to being the current Secretary, Beyond Aids, Inc, and the President of the organization’s Foundation.


DENNIS P. THOMPSON, MD, Treasurer

Dennis Thompson recently retired as a plastic surgeon in solo practice in Santa Monica, California.  For approximately the last 13 years, he has been an active participant in Beyond AIDS.  He has also been active in Physicians for HIV Control, and was elected its President In  October 2007. He has promoted the positions on HIV/AIDS of both organizations as a frequent delegate to the California Medical Association House of Delegates. 

In the past, he served as President of the Los Angeles Society of Plastic Surgeons, California Society of Plastic Surgeons, UCLA Plastic Surgery Society, and International Society of Clinical Plastic Surgeons.  Other organizational affiliations include membership in the Los Angeles County Medical Association, California Medical Association, American Medical Association (Life Member), American Society for Aesthetic Plastic Surgery, and the American Society of Plastic Surgeons. In addition, Dr. Thompson is a Clinical Professor of Plastic Surgery at UCLA.  His goals in his new role of Treasurer, and as a continued member of the Board of Directors. include lending his organizational experience, and his medical and academic background, to help advance the goals of Beyond AIDS.


ADRIANA ANDALUZ, MPH, Director (New Addition to the Board) 

Adriana Andaluz originally hails from Los Angeles, CA, where she studied Microbiology along with a minor in Spanish Literature at the University of California, Los Angeles. She began her path in public health as an undergrad while working with Dr. Helen Rodriguez-Trias at the Pacific Institute for Women’s Health, an incubator for programs designed to further women’s health in the US, Africa, Latin America, the Middle East, and Asia.
Largely inspired by Dr. Rodriguez-Trias’ dedication to health policy and increasing access to care, Ms. Andaluz’s first post-collegiate job was in the Public Affairs department at Planned Parenthood Los Angeles. During her tenure, she was able to work on many politically charged state and federal campaigns, including California’s historic Reproductive Privacy Act.

Ms. Andaluz later moved to New York to pursue a master in public health and work at the New York City Department of Health, where she has been since 2007. She currently serves as the Director of External Affairs for the Bureau of HIV/AIDS Prevention and Control where she oversees the development of priority policy initiatives, is responsible for the Bureau’s interactions with the Mayor’s Office, other inter- and intra-governmental agencies and key-stakeholders including the agency’s press office, and also oversees the Bureau’s social marketing and social media activities.


FRANKLYN N. JUDSON, MD, MPH, Director 

Frank Judson received his BA from Wesleyan University in 1964, his MD from the University of Pennsylvania in 1968, and his house staff training from the University of Wisconsin Hospitals (internal medicine) and the University of Colorado (infectious diseases).  He was an Epidemic Intelligence Service officer with the Centers for Disease Control assigned to the Colorado Department of Public Health  (1970-72), and Scientific Liaison, Global Program on AIDS, Geneva (1990 -91).  He is board-certified in internal medicine, infectious diseases and preventive medicine. 

For over 41 years, his research interests have concentrated on the epidemiology and control of sexually transmitted infections including hepatitis B and HIV.  His public health policy interests have run the gamut from childhood and adolescent vaccine programs, to urban air pollution, bioterrorism preparedness, and tobacco, tuberculosis, influenza, and HIV prevention and control.  He has authored or co-authored more than 270 scientific publications. 

Dr. Judson has served as President of the American STD Association (ASTDA), President of the International Society for STD Research (ISSTDR), President of the International Union Against the Sexually Transmitted Infections (IUSTI), Chairman of the Board of the American Social Health Association (ASHA), Chief of Infectious Diseases for the Denver Health Medical Center (1983-2002), and Director of the Denver Public Health Department (1986-2004). He has been a member of the Presidential Advisory Council on HIV/AIDS (PACHA), the CDC/HHS Advisory Committee on Immunization Practices (ACIP), the Board of Regents of the American College of Preventive Medicine, and the Colorado State Board of Health. Currently, he is a member of the Colorado Governor’s Expert Emergency Epidemic Response Committee (GEEERC) and Professor, Department of Medicine (Infectious Diseases) and the Colorado School of Public Health, University of Colorado, Denver.


ELIZABETH (BETSY) KIDDER, MD, MPH, Director


Elizabeth (Betsy) Kidder is a medical doctor with a background in public health. Her career focus is on access to quality health care by underserved communities and populations, with a particular interest in innovation in preventive health care services and policy change processes that improve access to such services.

Betsy joined Beyond AIDS in 2001 as an intern, and has served as a Board member since 2003. She received her Master's in Public Health in 2004 and her Medical Degree in 2011, both from the George Washington University. She is currently finishing her doctoral dissertation in health policy, and will begin medical residency in 2014.

As a public health professional, she has worked in Rome, Italy with the United Nations on the development team for the "Initiative to End Child Hunger" - a collaboration between the World Bank, the United Nations Children's Fund, and the World Food Program. Previous to that, she worked with the Global Health Council in Washington, DC on issues related to HIV/AIDS and child health, as a part of a national PBS media and outreach campaign in global health. She has also worked at the Department of Defense's HIV/AIDS Prevention Program as well as the Futures Group, where she assisted with the research and writing of a "What Works" program guide for developing country policymakers on evidence-based practices in HIV/AIDS/STI prevention.

Her interest in issues related to HIV was initially sparked by the case of Nushawn Williams, a young man who knowingly spread HIV in her small hometown community and high school. After that incident, she traveled to South Africa, where she studied the epidemic in the Eastern Cape, taught an HIV/AIDS education class, and volunteered in a pediatric HIV clinic, all of which deepened her commitment to staying involved with HIV advocacy through her career.


JEFFREY D. KLAUSNER, MD, MPH  (appointed 9/14)


Jeffrey D. Klausner is a UCLA Professor of Medicine and Public Health. He served as a CDC Epidemic Intelligence Service Officer 1995-1997, Deputy Health Officer and Director of STD Prevention and Control Services, San Francisco Department of Public Health, 1998-2009, and Branch Chief for HIV and TB, CDC South Africa, 2009-2011. 

Dr. Klausner has been a leader in implementing the public health approach to HIV prevention and control through policy and programmatic activites resulting in the streamlining and evaluation of routine HIV testing, early HIV case detection with HIV RNA screening, linkage-to-care and contact tracing and partner notification services.  In addition Dr. Klausner through his epidemiologic research, identified the role that bacterial STDs, the Internet, sex clubs, methamphetamine and Viagra played in augmenting the risk of HIV tranmission and implemented successful population-based programs to mitigate those risk factors. In collaboration with community leaders and organizations, he inititated sexual health campaigns and peer-led sexual health services for sex workers and gay men in San Francisco which have been replicated globally. 


Dr. Klausner has been conducting research in laboratory-based diagnostics for HIV infection and other STDs since the early 1990s and is considered an expert in infectious disease detection and management.  He is currently board certified in Internal Medicine and Infectious Diseases. He has a busy clinical HIV/AIDS practice in Los Angeles and regularly attends on the infectious diseases consultation service at UCLA Ronald Reagan Hospital.  Dr. Klausner brings nearly two decades of public health, clinical and research experience to the Board, much of it specific to HIV prevention. 



YVONNE POVER, RDH, Director  (until passing 4/14)

Yvonne Pover is one of the original founders of Beyond AIDS, and served as the Treasurer for the organization’s first 15 years. The East Coast headquarters of Beyond AIDS is housed rent-free in her office. She worked with the attorneys to incorporate both Beyond AIDS Inc. and Beyond AIDS Foundation. She designed and formerly produced the organization’s awards and certificates, and previously issued the newsletter and maintained our donor database. She has provided advice and guidance on our web site. As she lives close to the Capitol in suburban Virginia, she has represented Beyond AIDS at Congressional hearings on the Hill.  She has been involved in our strategy, public relations, and fundraising from the beginning.

Before she became a designer and art director, she spent years as a registered dental hygienist, a profession she subsequently continued to practice part-time. In that profession, she became acquainted with HIV/AIDS issues “up close and personal -- at a blood level,” as she says. Since 1981,.she has seen the havoc this disease has wrought, and began wondering early on why we did not deal with the virus in the same way we dealt with some other STD's--with sound public health policy. She is a graduate of Marquette University (dental hygiene), Institut Minerva in Z├╝rich (German languages), and NVCC (Ad Design) in Virginia, and is fluent in German, Swiss-German, and Spanish.


CARY SAVITCH, MD, Immediate Past-President

Cary Savitch was one of the Founding Members of Beyond AIDS, organized its founding meetings, and was elected its first President. He has served on the Board of Directors since the founding of the organization.  He recruited many of the early members of the organization by speaking to friends, colleagues, and patients about the need for HIV reform, writing a book about the subject, and giving talks on HIV, especially in Ventura County and the surrounding area where the founding meetings were held. 

He is an infectious disease physician, and has taken care of AIDS patients for the past 33 years (starting even before the disease had a name). In 1997, he published a book, “The Nutcracker is Already Dancing,” which highlighted the lack of application to HIV of sound public health practices that had been successfully utilized for diseases such as syphilis and tuberculosis. He believes strongly that the mission of Beyond AIDS, to stop the transmission of HIV, is the direction we must take in order to save lives in this epidemic.

He expresses pride in the time he has already spent with Beyond AIDS, which he believes is the only organization willing to stand up and support the necessary public health policies needed to contain HIV. His goals are to continue these efforts in every and any capacity needed, and to encourage others to join our battle for HIV/AIDS prevention.