An integrated approach begins with policy input from all the relevant control agencies including such agencies as health departments, executive control agencies, and the correctional agency's staff. Aspects of policy and protocol development are identification and movement; placement and programming; education; testing, condoms, needles, and tattooing; legal and confidentiality issues; centralized AIDS case review; coordination with parole; and budgets. Management's overall purview calls for a balanced approach to security interests, population movement, and bed-space issues as well as a logistical review of medical determinations. The medical recommendations must be considered first, and the policy and protocol must adhere foremost to the medical considerations. For example, the protocol of New York State prisons calls for acute cases of either AIDS or AIDS-related complex to be transferred to the nearest available hospital capable of handling AIDS cases. If the doctors say that the inmate is fit to return to the general inmate population and if the inmate meets security qualifications for that facility, then policy and protocol dictate that the medical advice be followed.