Executive Committee Meeting Minutes May 16, 2024


By Zoom

3:00 – 4:10pm

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, Emma Kaywin, Freddy Molano, MD, Julian Palmer, Guadalupe Dominguez Plummer (ex-officio), Marcelo Maia Soares

Members Absent: Matthew Lesieur, Marcy Thompson

Staff Present: NYC DOHMH: Doienne Saab, Scott Spiegler, Johanna Acosta, Adrianna Eppinger-Meiering, Patrick Chan, Jimmy Jaramillo; Public Health Solutions: Barbara Silver, Arya Shahi, Rosemarie Santos

Agenda Item #1: Welcome/Introductions/Minutes/Public Comment

Mr. Klotz and Mr. Martin opened the meeting followed by introductions and a moment of silence. The minutes from the April 18, 2024 meeting were approved with no changes.  

Mr. Klotz reported that the Council’s new Community Planner, Jeffrey Klein, will start on June 3rd. Mr. Klein will staff the Consumers and Integration of Care Committees. Also, the contract for a new website vendor was registered on Monday and updates should be made shortly.  

Agenda Item #2: Revised Service Directive: Early Intervention Services

Ms. Fortunato presentedthe revised service directive for Early Intervention Services (EIS), reviewing the HRSA-defined allowable services and noting that all EMAs must have an “early identification of individuals with HIV” (EIIHA) plan, which is scored in the grant application. EIS is the only category that can serve HIV-negative/unknown people, but for those who test negative, services are limited to basic HIV prevention education and referral to PrEP/PEP. The program goals and objectives were outlined and the service model described. Testing in the community should be done at venues where people from communities with higher incidence rates gather. The revised model also emphasizes immediate initiation of ART for those who test positive, with linkages to long-term treatment adherence support. One major change is no longer differentiating between testing in clinical and non-clinical sites. All EIS providers will be expected to conduct the full range of activities described in the directive. Mr. Klotz reviewed the text of the directive, pointing out the principal areas of revision. The directive will be implemented with the rebid of the program for GY 2025.

Dr. Molano noted that the revised directive fits into the status-neutral approach, albeit within the parameters of allowable use of RWPA funds. Mr. Maia added that PWH with serious mental illness are often not addressed.

On behalf of the IOC Committee, Ms. Fortunato moved to accept the revised EIS directive as presented.  The motion was adopted 14Y-0N.

Agenda Item #3: GY 2023 4th Quarter Closeout Report

Mr. Fields introduced the GY 2023 4th quarter closeout report. The bottom line of the report is the total amount of underspending, which is available for use as carryover in the current grant year. The good news is that the total underspending is $2.3M, less than the previous year, which had $2.9 million underspent. The PSRA Committee will develop a plan for the use of the carryover funds for presentation to the EC in June. Ms. Plummer presented the details of the report, explaining areas of less than 90% spending.

The Non-Medical Case Management category was underspent due to ongoing challenges with staffing. DOHMH and Public Health Solutions (PHS) are working to create better incentives for staff hiring and retention. EIS programs (NYC Base and MAI, Tri-county) were underspent due to challenges in the RWPA/CTL combined PlaySure Network 2.0 program. The problems with the service model were presented to the IOC Committee when they developed the revised service directive for this category. Ambulatory Outpatient Care/Aging PWH was underspent considerably due to a combination of start-up and that one provider did not submit invoices on time. Ms. Plummer stressed that it was a challenge ensuring that this provider submitted for reimbursement on time. She also noted that this category is managed directly by DOHMH and not PHS. Health Education/Risk Reduction, Supportive Counseling and TC Legal Services were all underspent due to contract terminations. Unspent funds were reprogrammed as per the Council’s plan, with significant amounts going to enhance the ADAP program. NYC Oral Health programs were underspent due to payer of last resort issues and most services being paid by Medicaid. Mr. Carr noted that the Oral Health directive included a DOHMH-based dental case management component. More detailed information on Oral Health will be presented at the PSRA Committee in June.

Ms. Plummer added that the final amount available for carryover will be slightly adjusted with final reconciliation in time for presentation at the Council meeting next week. She also commended PHS for working together to improve the timeliness of reporting and has strengthened contract terms to ensure timely submission for reimbursement. There being no further comment, the meeting was adjourned.