Jim Gibbons, president of Consumers United Insurance Co., remembers the night in January when he visited employe Peter Dooley in the hospital. He listened in shock as the 42-year-old claims adjuster repeated the diagnosis determined that day: AIDS.
Instinctively, Gibbons grabbed Dooley's hand. He assured him that his $22,000-a-year salary would continue. His full medical benefits would be intact. He could go back to work when he felt better. "Don't worry," Gibbons said.
What Gibbons did not tell Dooley was that he had worries of his own. Members of his 160-member staff, including a vice president, had already told him that if anyone there ever contracted AIDS, they would quit.
Within weeks, Gibbons and medical case manager Susan Silver began educating their work force. First, they received approval from Dooley to tell other employes of his illness. Then, they arranged a three-hour session of lectures and discussions, held at a hotel next to their 2100 M St. NW office. Counselors were available to anyone who wanted to continue the discussion there or beyond the seminar.
Today, Consumers United Insurance has what management calls a clear-cut policy on acquired immune deficiency syndrome. Anyone who contracts the disease will receive the same treatment that Dooley does. Any resistance to working with an AIDS patient will not be tolerated. No one has quit.
Consumers United is one of a relatively few companies that have developed a formal policy on AIDS. Yet for every Peter Dooley, according to AIDS experts and lawyers, there are workers who are treated less kindly: Some are fired by panicked employers fearful of fellow workers' reactions, and still other AIDS patients are confronted by confusing and cold responses from employers who have no policies about AIDS.
"The vast majority of businesses are sitting and waiting" to form a policy dealing with AIDS, said Mauro Montoya, legal service coordinator for the Whitman-Walker Center in the District, which treats and counsels AIDS patients. "They're not sure what to do, and they're afraid to do anything because they think it will probably make things worse."
With 40,000 cases already reported and nearly 270,000 expected throughout the general population by 1991, AIDS is a policy concern for every employer. Company officials must weigh the questions of the patient's privacy and welfare against the concerns of coworkers and customers.
"The most important thing I can think of is educating your work force," said Robert Gombar, a Washington attorney who was the legal consultant to the Centers for Disease Control when it recommended AIDS work place guidelines in November 1985. "You really want to try to control the problem in your company by dealing with it throughout the company through education. You have to be able to deal with the facts when it comes up."
In Dooley's case, "I think we got just ahead of the curve," said Silver, who now coordinates Dooley's health care benefits. "The original question was: Do we make this public? And if we were making it public, we didn't want to trample on his rights, even acting in the good interest of everyone else in the company."
When he learned that he had AIDS, Dooley said, "I went into shock. I cried and prayed . . . and thought, 'How is work going to deal with this?' " When Gibbons took his hand at the hospital, Dooley said, "That told me I would have no worries at work." Dooley, when his health allows, still goes to work at Consumers United, where he handles claims by telephone.
According to management consultants now advising companies, legal questions about how to handle infected employes rest largely on what is known medically: that AIDS can be transmitted only by blood or semen and therefore should present no risk to coworkers in conventional office settings. Therefore, the key question in most work places becomes whether an employe with a terminal disease can perform the job.
If the employe is physically able to work, then laws designed to protect the rights of the handicapped appear to require an employer to accommodate reasonably the AIDS-infected worker.
"Whenever I speak to a company that wants to determine whether they should test their employes, I stress the point: What are you going to do if somebody does test positive? If a person doesn't have a productivity problem, what do you do? . . . There aren't any clear lines," said Loretta Denardo, director of Secure Medical Care, a medical facility in Gaithersburg that serves as a consultant to several corporations in Montgomery County.
Because of the medical nature of the problem, the employer is required to safeguard the privacy of the employe. Employes are under no legal obligation to tell employers about the disease, and courts have held that companies have no duty to inform other workers about noncontagious disease.
Some employers fire ill employes because they fear a loss in business from customers who are frightened of the disease. But antidiscrimination laws forbid an employer from using public preference as a basis for discriminating against hiring women and minorities, and that standard would likely hold in the case of an AIDS patient who has no chance of spreading the disease in an office setting, legal experts say.
Corporate managers concede that, more often than not, they have waited until someone at their companies becomes ill with AIDS to determine policy. Then they hurriedly confront the question of who deserves the most protection -- the patient, other employes or the company's business.
Lawyers who deal daily with patients say that the worst cases of management abuse are often hidden from public scrutiny. Most notably in the hotel and restaurant trade, managers at some Washington area businesses have feared public perceptions and have fired dozens of employes with AIDS.
Subsequently, under the threat of employe lawsuits, these employers have agreed to a number of confidential settlements by making cash payments and extending health benefits, according to lawyers involved in such cases. The Whitman-Walker Clinic has handled 35 such settlements in the past two years, and others are handled by private lawyers.
A survey of the nation's largest employers released in June by the National Gay Rights Advocates found that a majority of the 164 responding companies forbid employment discrimination against employes with AIDS or AIDS-related illnesses. But only 23 percent said they had developed or were developing policies on AIDS.
"The proliferation of seminars about AIDS, sponsored by management, is a testament to the fact that employers are realizing AIDS in an issue that won't go away," said Benjamin Schatz, director of the group's AIDS Civil Rights Project. "But just because nondiscriminatory policies have become a part of the mainstream doesn't mean discrimination doesn't exist or that it's not a problem."
Several companies in San Francisco took the first steps, as early as 1983, to develop policies that would quell apprehension and educate their work force. Levi Strauss & Co. representative Joyce Bustinduy said an aggressive campaign of education and care began for its 1,700 employes in San Francisco when several gay employes wanted to sponsor an education workshop but feared the reaction of coworkers. The company took over the task and began developing policy.
"There's always resistance, but we just kept going back and reinforcing the message," she said. "We had to get down to the facts, and then we kept offering counseling . . . . It's not something you can do once and say: 'It's okay now.' You have to continually offer new things and update information as it comes."
Major corporations in the Washington area are undertaking a range of responses to the disease. IBM spokesman Jim Burke said a formal policy was drawn up by his company, which employs 15,000 in the Washington area, in September 1985 and was reviewed this summer. AIDS patients are allowed to work as long as they are physically able and are guaranteed privacy, he said. Health benefits are maintained as they would be for any employe with a terminal illness, he said.
Government Employes Insurance Co. has just begun an AIDS education plan and as yet has no formal policy. Last week, about 30 of Geico's top managers sat around a horseshoe-style table in their Chevy Chase offices to watch "The AIDS Movie," which recounts the plight of three patients. This month, all 2,500 employes in the District, Maryland and Virginia will view the film.
"Everything we see and read tells us that you need intimate contact for the spread of the disease," said Tony Nicely, executive vice president. "But we're not sure most people have been educated to that fact. So far, only one employe that we know of has died of AIDS. And he died without anyone here realizing what he had."
At The Washington Post, which employs more than 5,000 people, three workers have died of of the disease. Personnel Vice President John Kuhns said the company has as yet developed "no formal policy . . . . We're treating AIDS like we treat other fatal illnesses. It's no bigger or less than that."
Health benefits are maintained and AIDS patients are allowed to work as long as they can, he said. Educational seminars have been held for some top managers, Kuhns said, and if coworkers of AIDS patients are concerned about the disease they can ask for educational material. "We urge them to consult our own science and health writers," he said.
Marriott Corp., the hotel and restaurant conglomerate, which employs 17,500 people in the Washington area, declined to discuss whether it had developed a policy for dealing with AIDS patients or educating its work force. Representatives would not discuss whether food service or hotel workers were tested but said managers "look at every case individually" and "follow the best legal and medical advice possible."
Unions too have played a role in educating their membership and in some cases helping management. The American Federation of State, County and Municipal Employees has held workshops and forums, produced videos and tracked legislation that could affect its members. The Service Employees International Union provides booklets to members and employers that translate guidelines recommended by the federal Centers for Disease Control.
This month, the Hotel and Restaurant Employees Union is planning a seminar for its shop stewards. The plan began after some members of Local 25 threatened to walk out of a District hotel that sponsored a conference two months ago for health professionals studying AIDS.
"We had about 30 to 40 calls from different employes -- waiters, waitresses, busboys -- who didn't want to go to work and serve these people," said local union chief Ron Richardson, "It really clicked in my head that we needed to do something quickly. We were able to explain away their worries that day, but we also needed to get there and tell people what they should know about the disease."