Consumers Committee Meeting Minutes March 19, 2019

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CONSUMERS’ COMMITTEE
LGBT Center, 208 West 13th Street, Rm 101, NY, NY 5 Conference Call Info: 1-866-213-1863, Access Code 3587454#
Tuesday, March 19, 2019, 1:00PM – 3:00PM
MINUTES

Planning Council Members Present: Billy Fields (Co-Chair), Saul Reyes (Consumer At

Large), Randall Bruce, Paul Carr, Maria Diaz (Co-Chair, Tri County Steering Committee),

Charmaine Graham, Monique Mackey, John Schoepp 

Planning Council Members Absent: Lisa Best (Co-Chair), Asia Betancourt, Atif Abdul-

Haaq, Justin LiGreci, Jesus Maldonado, Malaya Manacop,

NYCDOHMH:  Jose Colon-Berdecia, Jan Carl Park, Cristina Rodriguez-Hart, Ph.D., Darryl Wong 

Others: Lawrence Francis, Ron Joyner, David Martin, Leonardo Ruiz, Rob Walker 

MEETING MATERIALS DISTRIBUTED

  • Current Meeting Agenda & Minutes of February 19, 2019 meeting
  • Rules of Respectful Engagement
  • Ending the Epidemic: A Plan for America
  • National HIV/AIDS Strategy: Updated to 2020
  • Improving Efficiency, Effectiveness, Coordination and Accountability of HIV & Viral

Hepatitis Prevention, Care & Treatment, DOHMH comments to DHHS, March 11, 2019

  • Statement on the Trump Administration’s FY 2020 Budget, CAEAR Coalition, 3/19
  • Partnership to End HIV, STDs and Hepatitis Statement on President Trump’s FY 2020 Budget Request, AIDS United, 3/15/19
  • Administration Budget Proposal Takes Steps Towards Ending the Epidemic,Undermined by Concurrent Cuts, HIV Medicine Association, 3/13/19
  • President’s Plan to End New HIV Infections Must Leverage Evidence-Based
  • Approaches to End the Epidemic, National Association of State and Territorial AIDS Directors (NASTAD), 2/6/19
  • NYC Department of Health Comments to the US Department of Health & Human
  • Services on the National HIV/AIDS Strategy, presented by Adrian Guzman, 3/19/19
  • NYC Commission of Human Rights Announces Settlement with Lenox Hill Radiology §      Following Investigation Into Failure to Provide Equal Access to Mammograms for Patients with Disabilities, NYC Commission on Human Rights Press Release, 3/14/18
  • NYC Human Rights Law: Disability Discrimination Enforcement Guidance, NYC Commission on Human Rights, 4/19
  • Standards of Care: Ryan White Part A Mental Health Services, Care & Treatment Program, NYCDOHMH, 2/11/19
  • Standards of Care: Supportive Counseling & Family Stabilization, 1/19
  • Standards of Care: Food & Nutrition Services, 1/19
  • Medical Case Management – Transitional Care Coordination (TCC), 3/16
  • HIV/AIDS in Westchester, Rockland & Putnam Counties, 2017, New York State
  • Department of Health, presented by W. Patterson, Bur of HIV/AIDS Epidemiology, AIDS Institute, NYSDOH
  • Patient/Provider Communication – highlights
  • Minutes of February 26, 2019 CHAIN Monthly TRT Meeting
  • Medical Monitoring Project (MMP) – Selected poster sessions & presentations from the 20019 National HIV Prevention Conference, 4/19
  • Consumers Committee Meeting Evaluation, February 2019
  • Consumers Committee Cumulative Meeting Evaluation, 9/18 – 2/19
  • March 2019 Planning Council Meeting Calendar
  • Announcement: TGNB training for PC & Committees, 3/28/19
  • Helping Clients Understand Tax Filing & Health Coverage, ACE TA Center, 3/18/19

WELCOME/INTRODUCTIONS  

Billy Fields, Consumers Committee Co-Chair, opened the meeting with member introductions, noting that Lisa Best, Co-Chair, is unable to attend the meeting.  Ron Joyner, community member, led the group in a moment of silence in honor of those who have passed and those who continue to endure in the struggle.  The minutes from February 19 were approved as presented and meeting materials were presented & reviewed, with typos and one omission noted.  Darryl Wong urged the Committee to review the summary of consumers’ concerns regarding assessment questions in order to better prepare for a follow up meeting with the recipient in April.    

PUBLIC COMMENT

A request was made by a member to add line numbers to the minutes for easier review.  David Martin noted that eSHARE questions focus on quantitative analysis and not on qualitative analysis.

PLANNING COUNCIL UPDATES

  • The consumers of the Consumers Committee made a motion that current/future versions of the Part A client intake/assessment/re-assessment forms should include question(s) on the client’s history & experience with oral health care.  This motion will be brought to the Executive Committee for consideration.   
  • There has been discussion with the CHAIN project on the provision of data relating to the recommendations derived from the Consumer Solar System focus groups. The Principal Investigator expressed interest in meeting with the Committee to further discuss the data currently available, as well as new analyses to be generated. 
  • Several abstracts on stigma, patient provider interactions and co-morbidities from the Medical Monitoring Project (MMP) to be presented at the National HIV Prevention Conference have been included for consumer review. 
  • The Integration of Care committee will be mounting a full day training on Transgender & Non Binary Health on March 28.
  • The Oral Health SubCommittee of the Needs Assessment Committee has been meeting regularly, consulting with national oral health care experts in order to identify the fiscal and clinical barriers to establishing expanded Oral Health services in NYC. 
  • The newly-established Mental Health SubCommittee of the Needs Assessment Committee, under the leadership of Tim Frasca, Ph.D., will be focusing on SPMI and HIV/AIDS. 
  • The Needs Assessment Committee is continuing its review of data and services for PLWH with disabilities. There will be a Town Hall on April 18 where recommendations on serving people with disabilities will be developed,  
  • The Priority Setting/Resource Allocation Committee reviewed, discussed and approved (4) service category fact sheets: Food & Nutrition Services, Medical Case Management/Transitional Care Coordination, Mental Health Services and Supportive Counseling. 
  • At the Tri County Steering Committee the Housing Standards of Care was reviewed and approved and the NYS Dept of Health delivered an epidemiologic update on HIV/AIDS in Westchester, Putnam & Rockland Counties.  It was announced that Living Together, a psychosocial support group, has transitioned to Hudson Valley Community Services as its new provider.

       NYCDOH COMMENT TO US DHHS ON NATIONAL HIV/AIDS STRATEGY 

Adrian Guzman, JD, MPH, Director of the Office of Policy and External Affair in the Bureau of HIV/AIDS Prevention and Control, New York City Department of Health presented a summary of comments submitted to DHHS:

  • In the Feb. 8, 2019 issue of the Federal Register, HHS published a notice soliciting public comments on the next National HIV/AIDS Strategy (NHAS). The notice called for input on ways to improve the efficiency, effectiveness, coordination, and accountability of HIV prevention, care, treatment, and cure policies, services, and programs. The current NHAS: Updated to 2020 (NHAS 2020) is organized around four goals: Reducing new HIV infections; Improving access to care and health outcomes;
  • Reducing HIV-related health disparities; and achieving a more coordinated national response.
  • On Mar. 11, 2019, the New York City Health Department submitted a comment to HHS. A selection from the comment’s introduction is as follows:

“With the NHAS 2020 due to expire in 2020, and following HHS’s announcement of the Ending the HIV Epidemic: A Plan for America, we are at a critical crossroads. The end of the epidemic is within reach, but achievable only through true government/community partnerships in which federal leadership acknowledges localities’ expertise in effectively responding to their local epidemics and invests in their efforts. HHS, local and state health departments, and communities affected by HIV have an opportunity to design a new plan that builds on the successes of [the previous and current editions of the NHAS], and reflects recent scientific advances in HIV. The plan must include reversing course on policies and rhetoric that have stigmatized and isolated the very communities most affected by HIV.”

(1a) What components of the NHAS do you think should be maintained? What changes should be made to the NHAS? This may include changes to the structure, goals, and indicators, key areas of focus and/or populations, and annual reporting processes by federal agencies. This may also include areas of the current strategy

  1. that should be scaled back or areas of the current strategy that should be expanded
  2. or scaled up. 

3            

4                            

5   The comment recommends revising the NHAS Vision as follows:

6          

7  The comment recommends organizing the next NHAS around five goals:

8            

9 Goal 1: Increase the number of people who know their HIV status, and diagnose HIV 10 infection as early as possible. 

11                     Support CDC recommendations for HIV testing in clinical and nonclinical settings, and 12           support state and local jurisdictions’ programs to increase routine testing in all settings. 13                           Eliminate age cap in CDC recommendations for HIV testing so that testing is

14           recommended for all people ages 13 years and older, and improve age-specific testing 15 efforts. 

16                     Improve quality of service delivery and provider capacity in primary care settings and in 17     other clinical and nonclinical settings. 

18           Protect and expand access to primary care services

19                 

20            Goal 2. Prevent new HIV infections by increasing access to proven prevention

21 interventions, including PrEP, PEP, condoms, and harm reduction

  •             Ensure equitable access to PrEP. 
  •             Ensure equitable access to PEP. 
  •             Support condom use as a fundamental HIV and STI prevention strategy. 
  •             Support syringe services programs and other harm reduction tools as a fundamental HIV 26    prevention strategies. 

27                     Ensure equitable access to comprehensive, medically accurate, age-appropriate, and 28 culturally affirming information about sexual and reproductive health, including on HIV 29 and STI prevention and transmission and on healthy decision-making. 

  •       Address the syndemic relationship between HIV and STIs. 
  •       Eliminate viral hepatitis and tuberculosis, and provide coordinated interventions and
  • care.

33                 

34            Goal 3. Improve viral suppression and health outcomes for people with HIV by 35 increasing access to care, treatment, and support services, including immediate 36 initiation of antiretroviral treatment (ART) and partner services. 

  • Establish seamless systems to link people to care that include same-day initiation of ART as the gold standard. 
  • Establish care coordination service delivery models to ensure people with HIV have access to the support services they need to remain engaged in care and adherent to ART. 
  • Support policies that promote access to housing and other supportive services for people with HIV. 
  • Address HIV and aging to improve health outcomes among older people with HIV. 
  • Promote message that HIV treatment can prevent sexual transmission of HIV. 
  • Ensure that people with HIV have affordable, comprehensive health insurance.

Goal 4: Reduce HIV-related disparities and health inequities including through targeted structural interventions. 

  • Acknowledge that poverty, racism, sexism, gender bias, homophobia, transphobia, ableism, and biases associated with HIV status, immigration status, and national origin are drivers of the HIV epidemic, and oppose rhetoric and policies that exacerbate these biases.
  • Acknowledge that stigma is a driver of the HIV epidemic, and invest in anti-stigma interventions addressing the many types of stigma people with HIV and people at risk of acquiring HIV may experience. 
  • Support policies that increase access to affordable health insurance, and oppose policies that reduce coverage.
  • Support 340B programming to ensure continued funding of vital safety net health care facilities. 
  • Acknowledge the structural factors that contribute to HIV-related disparities and health inequities, and invest in targeted interventions to effect structural change in communities disproportionately affected by HIV.

Goal 5: Achieve a more coordinated national response to the HIV epidemic. 

  • Staff, support, and strengthen oversight obligations of the White House’s Office of National AIDS Policy and the Presidential Advisory Council on HIV/AIDS (PACHA).

New York City Health Department Comment: Community Input

(2a) Specific recommendations you think will improve the efficiency, effectiveness, accountability, and impact of the national response to HIV. 

  • Ensure that community input informs the development, implementation, and monitoring of the NHAS and local and state plans to end the epidemic.
  • Support efforts to reduce prescription drug prices, including for HIV ART and PrEP.
  • Invest in biomedical and behavioral and social science HIV research. 
  • Expand the utility of molecular HIV surveillance (MHS) to inform partner services and high-impact HIV prevention interventions more broadly.

3a) What specific actions should the government and others take to improve the coordination of funding and delivery of HIV services? 

  • Allocate funding to directly-funded local jurisdictions
  • Clarify how the Ending the HIV Epidemic: A Plan for America will fit within the new NHAS 
  • Update outcome measures

CONSUMERS COMMITTEE EVALUATIONS

Darryl Wong reviewed the cumulative committee evaluation for the period from September 2018 through February 2019. Apart from logistical issues (starting and ending on time), it was noted that the lowest average scores addressed agenda development and its impact on meeting efficiency.  Efforts will be made to not overburden the agenda so that more complete discussions can take place, including the opportunity to ask questions.  Co-Chair Billy Fields recognized the significant impact of consumers’ voices on the planning process in the NY EMA.  

FOLLOW UP ITEMS

It was suggested that the meeting time be extended to 3:30PM until further notice.  

NEW BUSINESS 

It was announced that the April 25th Planning Council meeting will be taking place at the Bronx Borough President’s Office with the Borough President, Ruben  Diaz, Jr., in attendance.

PUBLIC COMMENT/ ADJOURNMENT

The meeting was extended to 3:30PM.There being no further public comment, the meeting was adjourned.