By Zoom
3:00 – 4:30pm
Members Present: David Klotz (Governmental Co-chair), David Martin (Community Co-chair), Billy Fields (Finance Officer), Raffi Babakhanian, Paul Carr, LaShonda Cyrus, Rasheed Ford, Ronnie Fortunato, Marya Gilborn, Freddy Molano, MD, Julian Palmer, Guadalupe Dominguez Plummer (ex-officio), Marcelo Maia Soares, Brook Montes, John Schoepp
Members Absent: Joan Edwards, Steve Hemraj, Emma Kaywin
Staff Present: NYC DOHMH: Michael Navejas, Doienne Saab, Scott Spiegler, Abraham Omeyoma, Kimbirly Mack, Jimmy Jaramillo; Public Health Solutions: Barbara Silver, Gemma Barclay, Arya Shahi, Rosemarie Santos
Agenda Item #1: Welcome/Introductions/Minutes/Public Comment
Mr. Martin and Mr. Klotz opened the meeting followed by introductions, including new Council Community Coordinator Mr. Omeyoma, and a moment of silence. The minutes from the November 21, 2024 meeting were approved with no changes.
Agenda Item #2: GY 2024 3rd Quarter Expenditure Report
Mr. Fields introduced the expenditure report showing data for the first 10 months of the grant year. While most programs are spending at a high rate and are expected to be close to fully spent by the end of the year, there are some service categories with low reported spending rates. The report also shows reprogramming of accruals and allocation of GY 2023 carryover funds. All carryover funds will be fully expended by the end of the grant year (Feb. 28th). Ms. Plummer presentedthe details of the report, which shows that among Base NYC Service categories have spent 69% of the original service category allocations as of December 31, 2024. Categories with less than expected expenditure include: Non-medical Case Management, Mental Health, Rental Assistance, Legal Services, Oral Health and Emergency Financial Assistance. Reasons cited include staff vacancies and retention issues, a lag in submitting invoices, and payor of last resort issues. Ambulatory Outpatient Care (HIV & Aging) shows 0% spent, but programs have been providing services, but administrative issues within DOHMH have prevented approval of invoices from DOHMH administration. In Tri-County, Mental Health, Medical Transportation, Food & Nutrition Services and Legal Services were underspent. Ms. Plummer and Mr. Shahi explained that there is a new reimbursement structure for many services implemented mid-year that will pay down based on deliverables before the end of the grant year.
Agenda Item #3: GY 2025 Spending Scenario Plans
Mr. Klotz opened the presentation of the PSRA Committee’s approved GY 2025 spending scenario plan by noting the great uncertainty around next year’s grant award. The federal government is funded through mid-March and Congressional budget negotiations are just starting. The EMA has received a partial award equal to about 16% of GY 2024 funding, but there is concern in the community about potentially huge cuts to Ryan White appropriations, including the possible elimination of Minority AIDS Initiative (MAI) funding. In order to be prepared for a catastrophic reduction in funding, the PSRA Committee considered scenarios to account for up to a reduction of $10,804,256 (11.7%), which would account for the end of the MAI portion of the award and the customary potential reduction of Base funding up to 3.5%.
Mr. Carr explained that the spending scenario is a methodology that allows the final award amount to be applied immediately upon receipt from HRSA, which avoids a month or more delay in executing contracts. The spending scenario for the Tri-County portion of the award is to hold TC programs harmless up to a 3.5% reduction to the award. Should the award reduction be higher than 3.5%, the TC Steering Committee recommends an across-the-board reduction (weighted by ranking score) for the four lowest ranked categories (Legal, Oral Health, Mental Health, and Early Intervention Services). This plan protects the highest ranked service priorities: Housing, Medical Transportation, Psychosocial Support Services, Medical Case Management, and Food/Nutrition.
In 2024, NYC RWPA Housing programs were re-bid and the PC allocated $931,957 as a one-time enhancement to transition clients. The Health Education category was eliminated (model incorporated into new Behavioral Health category), and the Psychosocial Services for TGNB category was right-sized (savings of $486,495). There is an additional savings in carrying costs of $392,348 due to reduction in Non-Medical Case Management/Rikers as the program no longer needs to pay salaries of corrections officers to accompany inmates to medical and service appointments. This results in a total savings in carrying costs of $1,854,853.
In all scenarios, the PSRA Committee approved a permanent increase to the Housing category of $1,212,656 to maintain current service levels given HRSA guidance allowing the use of RWPA funds to pay for security deposits, NYC laws on brokers fees, and increases in fair market rents. After accounting for the Housing enhancement, there would be $642,197 available to absorb a reduction in the award. PSRA recommends that if the reduction to the award is less than that amount, that any uncommitted funds be allocated to FNS, in accordance with the application spending plan approved in July 2024.
Ms. Gilborn explained that in a scenario where the reduction is more than $642,197, the NYS DOH AIDS Institute has agreed to take an upfront reduction to the ADAP allocation up to $1.5M (to be restored during the year through reprogramming and carryover). Thus, there is a total of $2,142,197 (2.3%) available to absorb a reduction in the grant award with no cuts to other programs. Should the reduction be larger than $2,142,197, PSRA recommends a reduction to the allocation of the lowest ranked category, Early Intervention Services (the lowest ranked category due to the wide availability of testing and the fact that this is a new program beginning GY 2025 with no staff hired yet). The current EIS allocation is $3,729,234, and the new provider has informed the Recipient that the minimum level for a viable program is $1.9M. Thus, an additional $1,829,234 is available to absorb a larger reduction. If there is a reduction of program funds between $3,971,431 and $5,752,399, the EIS category will fall below the viability level and be eliminated and any uncommitted funds will be allocated to FNS and Housing, with the first $642,197 to FNS and any remaining funds to Housing.
In a reduction scenario of program funds over $5,752,399 up to $10,804,256 (11.7%), EIS would be eliminated and any remaining deficit will be covered by reducing the Behavioral Health categories (to be reflected on the spending plan proportionately between Mental Health, Harm Reduction and Supportive Counseling). If the reduction is over 11.7%, PSRA will reconvene to determine additional methods to cover a deficit.
Mr. Carr stated that any reduction to services is difficult to contemplate, but the proposed scenario plan preserves the most essential, life-saving services (e.g., medications, housing, food), and advocacy is needed on all levels to help preserve critical funding for HIV and other public-health programs.
Committee members stressed the impact of large cuts on people’s lives and the importance of advocacy. The PSRA members and chairs were thanked for their thoughtful deliberations.
A motion was made and seconded to approve the GY 2025 spending scenario plans as presented. The motion was adopted 14Y-0N.
Agenda Item #4: Review of February 27th Planning Council Meeting Agenda
Mr. Klotz noted thatthe February 27th full Council meeting will be a hybrid meeting with the in-person component at Cicatelli Associates. The meeting will include today’s agenda items, as well as a presentation from Adrian Guzman on policy issues that affect Ryan White funding and HIV services. In addition, Acting Commissioner of Health, Dr. Michelle Morse, will join the meeting for some remarks.
Agenda Item #5: Other Business
Mr. Maia and Mr. Babakhanian reported that ACT-UP and other advocacy groups are coalescing to fight for continued funding and HIV services and encouraged people to get involved in
There being no further comment, the meeting was adjourned.
