Program developed for AIDS-infected inmates.

Florida corrections officials have designed a new program that should cut costs and improve the quality of care for AIDS patients. The prison system could save from $500,000 to $1 million a year by caring for inmates in a special AIDS facility and decreasing the number of times a patient is hospitalized for the disease.

Florida now spends $6.7 million a year for the care of inmates diagnosed with AIDS or HIV, the precursor to AIDS. Prisoner numbers are expected to increase by 60 percent over the next five years, bringing a consequent increase in AIDS cases.

With current and future costs in mind, prison officials went outside the corrections system for ideas on ways to deal with more AIDS cases and how best to care for those dying of the disease.

"We saw that costs declined with increased home, hospice and outpatient care," explains John Burke, chief health services administrator for the Florida Department of Corrections. "We also saw that the patient's quality of life was improved."

Burke and his staff have developed a four-level health care system for HIV-infected inmates. Level 1 and 2 inmates who are HIV-positive but may have only minor symptoms will be cared for through prison infirmaries. Level 3 patients, those with more severe symptoms, will be transferred to prisons close to hospitals that contract with the corrections system to provide treatment. The Level 4 patients, prisoners in the late stages of AIDS, will be moved to the new special care facility near Orlando that will open next year.

An old work release building, renovated as the AIDS center, will hold up to 133 inmates. The patients will be cared for by a group of physicians who routinely handle AIDS cases.

Burke estimated the state would save $500,000 to $1 million a year because people would not end up in the hospital as frequently and could instead be cared for in the new facility. He said he believes this to be the first program of its kind for state corrections systems.

"It's a quality of life issue for them and a cost efficiency issue for us," Burke said. "This will be the best quality care we can provide using resources effectively and efficiently."

When first announced, the project was attacked by the American Civil Liberties Union as a move to segregate HIV-positive prisoners from the general population. Critics likened the program to a leper colony. The criticism was retracted after meetings between the civil liberties group and Florida corrections officials.