By Zoom
3:00 – 5:00pm
Members Present: David Klotz (Governmental Co-chair), David Martin (Community Co-chair), Billy Fields (Finance Officer), Saqib Altaf, Raffi Babakhanian, Paul Carr, Joan Edwards, Ronnie Fortunato, Marya Gilborn, Charmaine Graham, Steve Hemraj, Matthew Lesieur, Freddy Molano, MD, Julian Palmer, Guadalupe Dominguez Plummer (ex-officio), Marcelo Maia Soares, Marcy Thompson
Members Absent: Emma Kaywin
Staff Present: NYC DOHMH: Jeff Klein, Doienne Saab, Kimbirly Mack, Patrick Chan; Public Health Solutions: Barbara Silver, Arya Shahi, Rosemarie Santos
Agenda Item #1: Welcome/Introductions/Minutes/Public Comment
Following a closed session to approve the Rules & Membership Committee’s slate of nominees for appointment to the Council, Mr. Martin and Mr. Klotz opened the meeting followed by introductions and a moment of silence. The minutes from the June 20, 2024 meeting were approved with no changes.
Agenda Item #2: GY 2025 Application Spending Plan
Mr. Carr presentedthe GY 2025 application spending plan recently approved by the Priority Setting & Resource Allocation (PSRA) Committee, explaining that EMAs may request up to 5% more than we received this year. Even though a request is highly unlikely, the request is a demonstration of the need in the EMA, where the number of people who need services continues to grow, in spite a reduction in the number of new diagnoses.
For GY 2025, the TC Steering Committee is requesting that all the potential increase go to support additional Housing Services(a 19% increase to the category = +$223,491). PSRA recommends that the entire MAI requested increase be allocated to Housing (a 17% increase to that category = +$353,538).
For the NYC Base application spending plan, the 5% increase amount is supplemented by changes in the carrying costs of programs: one-time enhancement to Housing done at the beginning of this year to bridge clients during the transition to newly procured programs ($931,957), and the end of the Health Education category ($292,695). Also, PSRA recommends a 20% Targeted Decrease to Psychosocial Services for TIGNBNC PWH (PSS) (-$193,800). Enrollment and spending have not met targets, despite extensive TA. The reduced allocation helps right-size the program while allowing it to continue to provide services, including allowing for potential increased enrollment.
The 5% increase plus additional available NYC Base funds are allocated as follows:
- Housing Services: $1,731,423 (15% increase)
- Food & Nutrition Services: $1,172,690 (15% increase)
- Legal Services: $361,590 (10% increase)
- Remaining funds allocated in an across-the-board increase (weighted by ranking score) with the exception of ADAP, PSS and Oral Health.
The PSRA Committee will meet in the winter to plan for the actual award, including flat-funding and decrease scenarios. $1,418,452 will be available in a flat funding scenario to allocate to areas of high need (e.g., Housing, Food & Nutrition). The amount can also be used to offset a reduction to the grant award.
In response to a question from Mr. Soares, Mr. Lesieur explained that there has been no progress on legislation to create a HASA-style program for the rest of NY State. Leadership from a non-NYC legislator is needed.
On behalf of the PSRA Committee, Mr. Carr moved to accept the GY 2023 into 2024 carryover plan as presented. The motion was adopted 15Y-0N.
Agenda Item #3: Revised Emergency Financial Assistance (EFA) Service Directive
Mr. Hemraj introduced the revised EFA service directive, approved in June by the Integration of Care (IOC) Committee. The HRSA definition of the service was provided: limited one-time or short-term payments to assist clients with an urgent need for essential items or services necessary to improve health outcomes, including: utilities, housing, food (including groceries and food vouchers), transportation, medication not covered by ADAP, or another HRSA-allowable cost needed to improve health outcomes. A timeline of the service category was described. The category started in the Tri-County region in 2018 with an allocation of $250,000 and has increased to its current $1.6M to serve the entire EMA. The cap on assistance was raised in 2021 from $2000 per client/year to $5000.
Only one organization, located in Westchester, has been the sole service provider since 2018. The Council has long expressed the need to allow for the inclusion of a service provider within NYC to enhance reach and maintain efficiency of service spending.
Mr. Klein reviewed the revisions to the existing directive. Goals were updated to reflect language in NYS Integrated HIV Prevention and Care Plan 2022-2026. The boilerplate statement preceding the service model was removed as it is now part of the framing directive overarching all directives. A new agency eligibility provision was added: “At least one (1) funded agency service site must be geographically located within the five (5) boroughs of New York City and have the capacity and reach to serve clients from New York City and their specific needs.” Also, language of the existing provision regarding Tri-county provider was updated to mirror language of the new provision: “At least one (1) funded agency service site must be geographically located within the Tri-county region with the capacity and reach to serve clients from Tri-county region and their specific needs.”
A summary of the discussion follows:
- Having two programs will mean duplicative administrative costs and less for distribution to clients.
- Subrecipients can use up to 10% of their contract amounts for administration, so the total used for that will be the same across the category no matter how many contracts there are.
- The allocation increased from $250K to $1.6M and added staff is needed to increase capacity.
- Having programs located in each region will allow for more outreach, engagement and enrollment activities. Currently, staff located in Westchester are unable to be physically present in most of the City. If there is only one NYC provider, then there will likely be no outreach in Tri-County.
- There should be a requirement in the directive that programs be able to accept direct enrollment (including through an online portal) and not just through referrals from case managers and other providers, and the application process should be streamlined.
- Programs should be encouraged to use peers to spread the word about the program. That is the most effective strategy for reaching potential new clients.
The directive will be referred back to the IOC Committee to consider the recommendations raised at this meeting.
Agenda Item #4: Other Business
The Committee paid tribute to retiring members Mr. Altaf, Ms. Graham, Mr. Lesieur and Ms. Thompson for their contributions to the Council and community. There being no further comment, the meeting was adjourned.
