Executive Committee Meeting Minutes January 23, 2020

EXECUTIVE COMMITTEE
NYC DOHMH, Long Island City, NY
Thursday, January 23, 2020, 3:10 – 4:40PM
MINUTES

Members Present: Jan Carl Park (Governmental Co-chair), Matthew Lesieur (Community Co-chair), Lisa Best, Maria Diaz, Billy Fields, Graham Harriman, Amanda Lugg, Claire Simon (by phone), Andrea Straus, Marcy Thompson, Dorella Walters  

Members Present: Matthew Lesieur (Community Co-chair), Steve Hemraj (Finance Officer), Lisa Best, Randall Bruce, Paul Carr, Maria Diaz, Fay Barrett, Danielle Beiling, Graham Harriman, Jeff Natt, Donald Powell (by phone), Claire Simon (for Joan Edwards), Andrea Straus, Marcy Thompson, Dorella Walters

Members Absent: David Klotz, Amanda Lugg
 

Other Planning Council Member Present: Leo Ruiz

Staff Present: NYC DOHMH: Melanie Lawrence, Anisha Gandhi, José Colón-Berdecía, K. Mack, S. Spiegler; Public Health Solutions: Bettina Carroll (by phone), Gucci Kaloo; Joan Corbisiero (Parliamentarian); HRSA Project Officer: Sera Morgan (by phone)

Mr. Lesieur opened the meeting, followed by introductions and a moment of silence.  The minutes from the August 22, 2019 meeting were approved no changes.

Ms. Morgan reported that the full FY 2020 Part A awards are due by February 10th. There will be no partial award this year.  The twelve abstracts submitted by the NY EMA for the 2020 National Ryan White Conference will be reviewed by the end of February.  HRSA plans to reduce the number of presentations at the conference after feedback at the last one that there were too many simultaneous sessions.  While there are officially 7 slots for Part A attendees, HRSA has usually been able to expand that number.  Ms. Morgan congratulated on the launch of the revised website, particularly the accessibility icon.  She expressed how proud she is to be this EMA’s project officer, given the impressive work, particularly around reaching Ending the Epidemic goals.

Mr. Harriman reported that Public Health Solutions (PHS) recently completed its takedown process which included a year-to-date analysis of contract drawdown/spending as part of the Council’s reprogramming plan.  Contracts that were identified for a takedown (contract reduction) demonstrated, through review and analysis of their drawdown/spending trend to date, that they were not likely to spend their full contract amount. The takedowns are one-time reductions for the current year.  Subcontractors whose contract(s) were identified for a takedown had the opportunity to submit a written appeal to PHS including providing a detailed explanation of why they believed PHS should reconsider the takedown. The appeals were reviewed, and final decisions made by PHS and DOHMH.  The takedown process resulted in 23 contract reductions totaling $1.6M. These funds will be reprogrammed as per the Planning Council’s Reprogramming Plan.

On December 31, 2019, the NYC Health Department released a Request for Proposals for the Master Contractor for Disease Control.  The solicitation seeks an appropriately qualified vendor to provide Master Contractor services, including management, administrative coordination services, and oversight of subcontracts with healthcare providers and community-based organizations funded by federal, state and city funds.  The selected contract as a result from this RFP will assist the DOHMH to effectively and efficiently manage the Part A, CDC and City Tax Levy funds for HIV-related care and prevention services. PHS, on behalf of the New York City Department of Health and Mental Hygiene (NYC DOHMH), released a Request for Proposals (RFP) for Ryan White Part A Food and Nutrition Services in New York City on August 9, 2019.  A list of successful awardees along with the information on the geographic distribution of services was distributed.  The RFP includes about $7.46M in Part A allocated by the Planning Council, in addition to about $1M in City Tax Levy (CTL) funds.  Equal proportions of RWPA and CTL funds are allocated, and it is difficult to separate them out in the report.

Mr. Natt presented the FY 2020 Spending Scenario Plan, approved by the Priority Setting & Resource Allocation Committee (PSRA) last week.  The plan is a methodology for implementing a possible reduction to the award.  In June 2019, the PSRA, EC and full Council approved a spending requestthat is a plan for an (unlikely) increase to the award.  The federal budget is final, which means we should receive the entire award on time by the beginning of the new fiscal year (March 1^st).  The national RWPA appropriation is the same as last year’s, and given that our EMA’s number of PLWH relative to other EMAs is declining, we expect about the same reduction as last year (close to 1.5%).  Having an approved spending scenario plan allows the Grantee to renew contracts as soon as we get the Notification of Award from HRSA.  A summary of the plan follows: 

• The plan supposes a possible reduction of up to 3.5% of the Base award (or 3.1% of the total award). 
• There is an enhancement of $175,000 to Tri-County (TC) Housing to cover services to clients in programs that over-enrolled in FY 2019.  There is a reduction of $175K between in ADAP (Base and MAI) to cover the TC Housing enhancement (some funds are shifted between ADAP Base and ADAP MAI to balance the respective portfolio so that the dollar amounts equal the exact Base and MAI awards).
• A total of $1,443,228 is added to Housing (divided between Base and MAI).  That equals the amount taken out of Medical Case Management and reflects the reallocation of an eliminated service category (Transitional Care Coordination) that the Council approved in November 2019.
• There is $298,268 in savings through permanent takedowns or contract terminations in the categories of Non-Medical Case Mgmt./Transitional Support for Inmates ($12,500), Non-Medical Case Mgmt./General Population ($35,000), Harm Reduction ($201,328), Mental Health ($36,940K).  These savings help offset a reduction to the award.
• There is a shift of funds in EIS between Base and MAI.  This is just to balance the portfolio and makes no changes to the allocation for that category.
• There is an addition of $50,000 that the PSRA approved for the Psycho-social Services for TGINBNC category.  This will pay for a resource directory and training curriculum in FY 2020.  Program services will begin in FY 2021 (two programs funded at a total of $847,000).

With a 3.5% reduction to the Base award, the enhancement to TC Housing, the new funds for PSS TGINBNC, minus the savings from the revised carrying costs, there could be a deficit of $2,411,131.  This deficit is made up through a reduction to the ADAP allocation.  Julie Vara, director of the NYSDOH HIV Uninsured Care Program, has assured us that they can absorb a reduction without a negative effect on their services.  While we don’t expect to actually have to reduce ADAP by that much, PSRA generally approves a spending scenario methodology up to that amount just in case the award reduction is higher than anticipated.

Mr. Natt, on behalf of the PSRA, made a motion to approve the spending scenario plan as presented.  The motion was approved 14Y=0N.

Ms. Gandhi presented on the federal Ending the HIV Epidemic (EHE) planning grant (known as 1906) that New York received to align local efforts with the national EHE plan.  The US Department of Health and Human Services will work with funded communities to implement strategies to: 1) Diagnose all PLWH as early as possible; 2) Treat infection rapidly and achieve sustained viral suppression; 3) Prevent new infections; and 4) Respond quickly to potential HIV outbreaks.  The overall goal is a 75% reduction in new infections in 5 years and a 90% reduction in 10 years.

Forty-eight counties (including 4 in NY: Brooklyn, Bronx, Manhattan, Queens) and 7 states with large rural caseloads are funded.  NYC DOHMH received $492,000 in October 2019 with a one-year timeframe to implement the planning activities.  The DOHMH objective is to Improve the Department’s ability to rapidly implement activities to meet identified jurisdictional needs and meet or exceed the national prevention and care goals. Expected 1-year outcomes include: 1) Increased engagement with HIV service partners, including local care and prevention planning bodies, local providers, people with HIV, and other community members affected by HIV; 2) Increased understanding of the epidemiological profile of HIV in NYC; 3) Increased understanding of the HIV care and prevention context/situation for NYC; and 4) Improved ability to rapidly implement activities to meet NYC’s HIV care and prevention needs consistent with the goals of the Ending the HIV Epidemic Initiative.

The grant’s required activities are: 1) Engage with existing local prevention and care planning bodies – the Council and HIV Prevention Planning Group (HPG); 2) Prepare current a epi profile for the jurisdiction; 3) Prepare a brief situational analysis for the jurisdiction; 4) Engage with local community partners; 5) Engage with local HIV service provider partners; 6) Reach concurrence on an EHE plan with local HIV planning bodies; and 7) Prepare a final/revised EHE plan for NYC.

The Council and HPG will be engaged to build on recent years’ integrated planning activities, including: reviewing the jurisdictional epidemiological profile; providing feedback on the brief situational analysis; supporting recruitment efforts for listening sessions; reviewing and providing feedback on the draft EHE Plan during a joint special session; and providing concurrence on the final EHE Plan.  There will also be public listening sessions with community stakeholders in each county with breakout sessions focused on priority populations (e.g., Black MSM, transgender individuals, PLWH over 50).  Local partners will also be engaged (e.g., PlaySure Network, Sexual Health Advisory Group).  The final plan will be disseminated to all stakeholders, posted on appropriate websites and shared with the CDC.

Ms. Gandhi reviewed the 1906 timeline, which started in November 2019 with engaging consultants and preparing the epi profile, culminates in September 2020 with dissemination of the plan to all stakeholders and submission of final deliverables to the CDC.  A summary of the discussion follows:

• The RFP for the implementation grants was released at the same time as the planning grant, but the money has not been received yet.  The planning grant will inform the implementation.
• While many of the EHE activities are similar to the State ETE plan, the federal funds are limited to Bronx, Brooklyn, Manhattan and Queens.
• The federal plan can address populations that require a more concentrated effort beyond what is being done through the State plan.
• 1906 is a requirement of the federal grant so that the City can receive the new EHE money.  It will also allow DOHMH to look at what innovations can be done outside of the State ETE activities.
• The federal EHE funds are limited to the four counties based on a determination made by CDC of areas of the country that are the most highly impacted based on epi data, but NYC DOHMH is coordinating with the State to ensure that work is done in Staten Island, Tri-County and the rest of the State to reach the same goals of ending the epidemic. 
• The list of priority populations does not exclude and group, and there will be emphases on other marginalized groups (e.g., immigrants, people involved in sex work).
• As this is a CDC grant, the concurrence vote will follow the process that the HPG uses (concurrence, non-concurrence or concurrence with conditions).
• While the planning grant seems repetitive for New York, most of the jurisdictions that are receiving federal EHE funds have not done the kind of blueprint that our state has.
• All documents will be distributed in advance and presented with full explanations in advance of a concurrence vote.  It should be made clear how this initiative differs from the State ETE plans.
• There is a need to utilize social media to market this initiative to younger people.
• It would be helpful to have a side-by-side analysis of where areas where State ETE initiatives have been successful and where the federal EHE efforts will be concentrated.
• Ms. Simon stressed that the City and State Health Departments will be coordinating closely to ensure that the entire State is covered.  The Council and all other stakeholders will be kept informed as the process continues. 
• NYC DOHMH hopes that the new funding that focuses on the four counties will allow other resources to be leveraged in Staten Island and Tri-County.

There being no further comment, the meeting was adjourned.