This summer, the Shepherd Wellness Community, a 23-year-old AIDS support organization, installed surveillance cameras to deter crime and monitor the building. But now that the cameras are in place, questions about patient confidentiality are coming into focus.
According to the SWC's July/August newsletter, two anonymous donors contributed $10,000 to help buy the system; since then, cameras have been installed both inside and outside the Center's Sciota Street facility, in Bloomfield. City Paper spotted cameras Sept. 25-26 inside an auditorium, where a flea-market fundraiser was held, though Center officials say the cameras haven't been switched on yet.
SWC officials largely declined comment on how the cameras will be used. Executive Director Scott Peterman said it was "premature" to discuss the issue, since a policy will likely not be finalized until the board's Nov. 2 meeting. But according to a draft policy obtained by CP, the cameras are intended to "record images for future identification of individuals in the event of legal or policy violations," and for "monitoring facilities use and staff performance."
Opinions on camera use vary widely: Because of the stigma associated with HIV/AIDS, counselors and medical professionals put a premium on patient confidentiality.
"Depending on what's captured on those tapes, it absolutely raises concerns of confidentiality," says attorney Ronda Goldfein, executive director at the AIDS Law Project of Pennsylvania. State law generally prohibits health-care and social-service providers from disclosing HIV-related information without an individual's permission, she says. And even if camera footage is never shared, she adds, installing cameras is "counterintuitive" for an AIDS service organization.
"I think it sends a very bad message to people that is either 'We don't trust you, the clients,' or 'We don't trust the staff,'" Goldfein adds. "And if you don't trust the staff, I'm not going to [them] with my confidential information."
In its newsletter, the SWC noted security as one the center's "most pressing needs," citing thefts and graffiti. The most recent such act mentioned in the newsletter took place May 27.
A draft of the SWC policy, dated Sept. 15, says camera use will be limited to situations that "do not violate the reasonable expectation of privacy or confidentiality (group meeting areas and office areas)." The policy says footage will not be archived, though it will be recorded on a DVR which will be erased when it reaches capacity. It further states, "Access to the stored images will be provided to law enforcement officials when a possible crime has occurred."
Cameras will not record sound. And only the SWC executive director will have access to footage. The system will be accessible remotely, such as from a home computer.
Peterman emphasized the policy was still being vetted by members and other organizations. He and board chair Rodger Beatty agreed to a meeting with City Paper to discuss the system. But when e-mailed a list of questions asking about the impetus for the camera's installation -- and how the center planned to use the cameras while balancing privacy concerns -- Beatty curtly replied via e-mail: "No meeting."
Of the board's 17 members, most either did not return phone calls or could not be reached. Others declined comment. In an Oct. 14 e-mail to board members obtained by CP, Beatty urged members to "ignore" queries from City Paper. Beatty wrote that CP was "digging deep to create" a story, and "the only story [the reporter] could create is if we respond to her in any manner."
Only one board member, Pittsburgh City Councilor Bruce Kraus, would comment publicly.
The camera system is also news to Buzz Pusateri, who uses SWC services. The former board member and meal coordinator believes Shepherd is likely using the cameras for security, "knowing how strict they are about confidentiality."
Pusateri, who has AIDS, says he'd oppose filming during SWC programs, weekly dinners and meetings of other organizations -- like the Lambda Foundation, where he's a board member. Such surveillance, he says, would "totally undermine everything [SWC] has done since 1987."
And that, Pusateri surmises, is why it won't happen.
"I really can't think that they'd do anything to compromise any of the social events or members. ... I feel that down to my toes," he says. "I can't imagine it's like 'Big Brother.'"
HIV and AIDS have been stigmatized since they gained national attention in the 1980s, at least partly because it often afflicted people who were stigmatized themselves, especially gays and intravenous drug-users.
"People could be thrown out of their house back then. They could lose their jobs," says Father Lynn Edwards, the Episcopal priest who founded SWC with a social worker in 1987.
Edwards says the idea for a community for those with the virus arose in the mid-1980s: "Some people were saying, 'We know we're going to die soon. We want a place where we can get spirituality without getting beat over the head with it.'"
Edwards, now an emeritus board member, says confidentiality is respected at the center. He declined to discuss the security system, saying he didn't know anything about it. But he notes SWC members don't sign confidentiality agreements, and the center's services aren't exclusively for those diagnosed with HIV/AIDS. "We're for the infected and the affected," he says.
In any case, Shepherd would not be the only AIDS-service organization to have cameras in place. The Pittsburgh AIDS Task Force has interior and exterior surveillance at its East Liberty facility, along with signage indicating the cameras' presence. (When City Paper visited SWC at the end of September, no such signs were visible.)
Kathi Boyle, PATF's executive director, says the organization opted for the cameras when it relocated to a building with an all-glass front, which could be susceptible to a break-in.
PATF finalized its policy before installing the cameras, Boyle says, adding that, to her knowledge, the tape was checked only once, when a custodian was suspected of stealing. PATF often directs clients to SWC, and Boyle says cameras wouldn't change that. "In today's world, it's not unusual at all," she says. In fact, "I wish we would have had them at our old place."
Others feel differently.
The Pittsburgh AIDS Center for Treatment clinic, in Oakland, does not have surveillance cameras. Antoine Douaihy, a senior HIV psychiatrist with PACT, says medical information must be kept private, and worries that "[b]y putting cameras up, you are violating that in a sense."
Philadelphia FIGHT, a comprehensive AIDS-service organization, also eschews cameras. FIGHT'S executive director, Jane Shull, says that when the building housing her organization installed cameras, FIGHT asked that its floor not be monitored. "Coming on our floor constitutes as a disclosure of HIV status in many people's minds ... even though obviously there are people who come here who don't have AIDS," she says. "The more we can say, 'We're going to guarantee your privacy,' the better."
At ActionAIDS, in Philadelphia, executive director Kevin Burns says none of his organizations' four offices have cameras inside.
"It's not something we'd want to do because it's opposing to our culture," he says. "We try really hard to build a culture of trust here. It'd be difficult to explain that with cameras."
- Illustration: Steve Cup