Thursday, April 21, 2022, 3:05-3:40pm
By Zoom Videoconference
Members Present: Dorella Walters (Community Co-chair), Paul Carr (Finance Officer), Saqib Altaf, Joan Edwards, Billy Fields, Ronnie Fortunato, Marya Gilborn, Charmaine Graham, Matthew Lesieur, David Martin, Jeff Natt, Julian Palmer, Guadalupe Dominguez Plummer, Donald Powell, Leo Ruiz, Claire Simon, Marcy Thompson
Members Absent: Graham Harriman, Finn Schubert
Staff Present: NYC DOHMH: David Klotz, Melanie Lawrence, Scott Spiegler, Scarlet Macias, Renee James, Giovanna Navoa; Public Health Solutions: Barbara Silver, Gemma Barclay, Arya Shahi, Rosemarie Santos; Joan Corbisiero (Parliamentarian)
Agenda Item #1: Welcome/Introductions/Minutes/Public Comment
Mr. Carr opened the meeting followed by introductions and a moment of silence. The minutes from the March 17, 2022 meeting were approved with one typo corrected.
In response to a question from Mr. Martin, Mr. Klotz clarified that the Ryan White legislation caps funding for the quality management program at either 5% of the total award or $3M, whichever is less.
Agenda Item #2: GY 2022 Reprogramming Plan
Mr. Natt introduced the GY 2022 Reprogramming Plan approved last week by the Priority Setting & Resource Allocation (PSRA) Committee. The Council develops a reprogramming plan each year to spend funds that become uncommitted during the course of the year. We traditionally give the Recipient the latitude to shift funds between service categories in order to enhance overperforming contracts. No service category will be enhanced by more than 20% of its original allocation in the spending plan without Council approval. ADAP will be included as a category for enhancement after all other service categories have been considered, but will not be subject to the 20% cap. With programs reverting to fee-for-service reimbursement, the plan will allow the EMA to maximize spending during the year and reduce the levels of carryover seen during the two pandemic years.
Mr. Natt, on behalf of PSRA, moved to approve the Reprogramming Plan as presented. The motion was adopted 14Y-0N.
Agenda Item #3: Committee Reports
Consumers Committee (CC)
Ms. Graham reported that the CC had a lively meeting this month focused on respectful engagement and conflict resolution as well as feedback for the Integrated Plan. Compiling feedback and ensuring that everyone’s concerns are heard will continue to be the focus of CC meetings, in addition to planning an end of year picnic for the Council hosted by the Consumers, tentatively slated for the date of the July CC meeting. The CC also continues working on designing a lapel pin for consumers on the committee and is re-configuring our approach to hosting a youth forum by partnering with agencies that serve youth.
Needs Assessment Committee (NAC)
Ms. Thompson reported that the NAC is continuing its work on the full HRSA-mandated Needs Assessment. Recent NAC meetings have been mostly used for breakout sessions of four workgroups (Epi Profile, Service Needs and Gaps, Resource Inventory, Provider Capacity) that are compiling data and discussion points, identifying key gaps in data and developing recommendations. A consultant will be hired over the summer to draft the document, which will be reviewed by the NAC and Council for submission to HRSA in December.
Integration of Care Committee (IOC)
Ms. Fortunato reported that IOC is working on the integrated Behavioral Health directive that will combine Mental Health, Harm Reduction and Supportive Counseling Services. The Committee had a presentation from CHAIN on behavioral health service needs and utilization and impact of HIV outcomes, and held a panel discussion with two Article 28/31/32 providers. IOC also has a sub-committee working concurrently on a revised Housing directive.
Mr. Natt reported that after a year of in-depth data review In preparation for a revised set of allocations for GY 2023, PSRA is looking at several specific areas. We will be getting a cost analysis from the Recipient for the two new service categories to be funding under the Aging & HIV directive (Outpatient Medical Care, Referrals to Health and Support Services). We will also review a proposed methodology for reducing Medical Case Management, which is by far the largest category in the portfolio, and which we have identified as having substantial payer of last resort issues. A reduction in MCM is the most likely avenue for paying for the Aging services and absorbing future cuts to the award.
A decision about the allocation for the other category with payer of last resort issues, Harm Reduction, will need to be put off until GY 2024 when new programs start under the IOC’s Behavioral Health service directive. Also, by then will be clearer what POLR issues there will be with Medicaid and harm reduction services. PSRA will also develop a spending plan for the grant application that asks for the maximum increase allowed (5% over the current award).
Tri-County Steering Committee
Mr. Palmer reported that at last week’s Tri-County Steering Committee meeting, there was an interesting and thorough presentation from the Recipient on how COVID affected Ryan White Part A services in the Tri-County region. Service providers faced challenges in enrolling new clients and delivering services during the pandemic. Overall, new enrollments dropped except for Food & Nutrition and Emergency Financial Assistance. Even with the decline in new enrollments, however, provision of service units increased in most services (with the exception of those that require in-person services like Oral Health).
At the meeting, the Committee also got a preview of the service category fact sheets that the Recipient will provide during the next planning session. The fact sheets contain three years of data on client enrollment, service utilization, expenditures, etc. that the Committee will use to review the Tri-County service portfolio for the 2023 grant year.
Rules & Membership Committee
Mr. Fields reported that the Rules & Membership Committee is about to undertake its annual membership recruitment drive. We anticipate that there will be about 8 vacant seats to fill. Please encourage your contacts to apply. As always, we are particularly looking to increase representation from consumers. We also strongly encourage people from under-represented communities to apply. Applications are available 24/7 through the PC website. The deadline for this year’s applications process is June 17th. Applications will be reviewed by the Rules & Membership Committee in late June. Candidates will be interviewed in early July, and a slate of nominees will be brought to the July Executive Committee meeting.
Mr. Lesieur reported that the Committee meets next week to hear a presentation from the City’s first overdose prevention center. They are also developing a tracking system for policy issues, with the most likely next topic HIV housing in the rest of NY State (outside of NYC). The last meeting had a presentation on this subject from Ginny Shubert.
Data Collection Workgroup
Mr. Carr reported that next week’s meeting is cancelled, but that the work will pick up in May as the committee works towards a set of recommendations on data collection for RWPA programs.
Seriously Mentally Ill Workgroup
Ms. Lawrence reported that the SMI Workgroup meets quarterly to continue the work done by NAC last session. They are looking at an analysis of mental health flags among PWH in NYS and the factors that impact MH functioning among PWH.
Agenda Item #4: Council Chairs Report
Ms. Walters reported that the Council’s contributions to the Integrated Plan discussion from the last meeting have been shared with the State. The Consumers Committee will continue to provide feedback on the Integrated Plan, which will also be shared with the State. A draft plan is expected in the fall.
The Assessment of the Administrative Mechanism survey will be sent out to providers in the next several days. Results of the survey will be shared at the June Executive Committee meeting and by the Full Council the following week. The chairs are also working with the Consumers Committee on a date for the Annual Council Picnic in July or August.
Mr. Carr announced a new clinical trial for an HPV treatment that is recruiting PWH. He also thanked everyone who contributed to his participation in the AIDS LifeCycle fundraiser.
In response to a question from Mr. Natt, Mr. Lesieur said that there is no information yet about HIV funding in the Mayor’s proposed City budget.
There being no further comment, the meeting was adjourned.