Executive Committee Meeting Minutes November 16, 2020

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Monday, November 16, 2020, 3:00 – 4:35PM

By Zoom Videoconference and Dial-in

M I N U T E S

Members Present: Graham Harriman (Governmental Co-chair),Dorella Walters (Community Co-chair), Paul Carr (Finance Officer), Danielle Beiling, Lisa Best, Maria Diaz, Joan Edwards, Billy Fields, Marya Gilborn, Amanda Lugg, David Martin, Jeff Natt, Guadalupe Dominguez Plummer, Donald Powell, Claire Simon, Andrea Straus

Members Absent: Randall Bruce, Marcy Thompson
 
Staff Present: NYC DOHMH: David Klotz,Melanie Lawrence, Karen Miller, Kimbirly Mack, May Wong; Public Health Solutions: Christine Nollen, Bettina Carroll, Gucci Kaloo; HRSA: Sera Morgan

Agenda Item #1: Welcome/Introductions/Minutes

Mr. Harriman and Ms. Walters opened the meeting followed by introductions and a moment of silence.  The minutes from the July 23, 2020 meeting were with approved no changes.

Agenda Item #2: Bylaws Amendment

Mr. Fields presented a Bylaws amendment approved by the Rules & Membership Committee to change the timing of the election of the consumer-at-large.  The Bylaws created the post of Consumer-at-large after the PWA Advisory Group was eliminated in order to maintain the level of consumer membership on the Executive Committee.  The consumer-at-large is elected by the Consumers Committee from among the consumers appointed to the Council.  The Rules & Membership Committee is recommending a Bylaws amendment to move the required date of the consumer-at-large election from the end of the planning session (in the spring) to the beginning of the session (in the fall).  Originally, the Bylaws mandated that the election take place in the spring with the term beginning in the fall.  This precluded newly appointed members (most of whom were already active on the Consumers Committee) from being considered.  The amendment puts in place the Consumers Committee’s preference to have the election in the fall with one-year terms beginning immediately upon election and lasting until the subsequent election.

Mr. Fields, on behalf of RMC, made a motion to approve the Bylaws amendment as presented.  The motion was adopted 16Y-0N. 

Agenda Item #3: Estimated Unobligated Balance Request (UOB)

Mr. Natt presented the FY2020 Estimated Unobligated Balance Request, a HRSA mandate due by the end of the year, where we inform HRSA that we might carry-over up to the 5% maximum in unspent funds from the current year (FY 2020 ) into the next FY 2021).  This request will allow us to apply to use the actual carry-over when we know that amount next spring.  Typically, the actual carry-over is less than 1%.  The estimated unobligated balance request must be earmarked for a specific program and we typically say that we will use it to enhance ADAP.  The PSRA is not bound by this.  When the Committee considers the actual carry-over plan next spring, it can be allocated to any service in the portfolio (e.g., the FY 2019 carry-over was allocated to Housing for this year).

Mr. Natt, on behalf of PSRA, made a motion to approve the UOB Request as presented.  The motion was adopted 16Y-0N.

Agenda Item #4: Thoughts and Discussion on Planning Council Work 2020-21

Mr. Harriman and Ms. Walters introduced a discussion on the direction of the Planning Council’s new planning cycle.  Council work will need to accommodate itself to the COVID-19 pandemic and will take time to implement any proposed changes.  Major areas of focus include: 1) Promote an anti-racist and stigma-free care environment to reduce HIV related health inequities; 2) Further incorporate the voices and needs of marginalized populations; 3) Improve data collection and use of data within Ryan White Part A and across bureaus and funders; 4) Implementation science and evidence-based practices; 5) Quality Management; 6) Advocacy; 7) working within the framework of the Status-Neutral Continuum of Care; and 8) Planning Council Administrative Efforts.

COVID-19 will require flexibility on timelines due to staff activation.  The pandemic also will raise issues around mental health and the need to lift up consumers, Council members and staff.  There is a need to build the capacity of staff (Council & Grantee) and Council and committee members to embed anti-racism and anti-stigma practices and policies into planning work, and to strengthen internal and external partnerships across DOHMH, Ryan White providers, and Consumers.  Council membership needs to continue to diversify and models of care become more responsive to special populations (e.g., people of color, youth, TINBNC, older PWH).  The Council needs to review and make recommendations on data collection burden, and advocate for data agreements that allow for the incorporation of data outside of the RWPA system (e.g., Medicaid). 

The Council should build capacity to apply a health equity lens throughout all Council work to better address stigma, racism and social determinants of health, incorporating implementation science to guide the work.  The Council should strengthen its partnership with the Recipient around their quality management work, and increase collaboration across prevention and care to implement a status neutral continuum of care.  The Council can advocate for systemic changes that can benefit, protect and improve the health and health outcomes of PWH, including mental health, HIV testing, Medicaid Managed Care, etc.  This can be done in collaboration with the HPG and BHIV.    

The Council can conduct an assessment to determine the benefits and disadvantages of merging the Needs Assessment and Integration of Care Committees.  The Council can also enhance its assessment of administrative mechanism in partnership with the Recipient. 

A summary of the ensuing discussion follows:

  • When a consumer expresses a need for RWPA services, referrals can be made using the Service Locator (on the Council and PHS websites) and other resources.  Enrollment has to be easier so that paperwork is not a barrier to entry into care. 
  • Providers need to have better coordination to create seamless care with no gaps, particularly when RWPA programs have payer of last resort issues.
  • Reaching priority populations in the time of COVID-19 is particularly challenging.  Tools such as social media need to be prioritized. 
  • Many providers do not understand the Council’s role and how they and their clients can contribute to planning.  CABs are an avenue for reaching consumers who are already engaged.
  • Many people receive support from programs funded by Parts B, C, D, F and through HOPWA and other sources.  There needs to be big picture data so that the Council can see where there is duplication of services.
  • Barriers to receiving virtual care and telehealth (especially technological issues) are keeping many consumers from accessing services, particularly disabled and disadvantaged people.
  • The current climate has exposed a lot of ugliness and disparities, and it is good that the Council will have honest conversations on race and equity, but it will take hard work to address these issues.
  • Faith-based organizations have to be engaged.
  • One options is to assign issues to specific committees, or have small groups sub-committees work on specific issues.  Also, the Council as a whole and all its committees should work on certain issues simultaneously.
  • There is no specific HRSA guidance for planning councils on many of these issues, but there are some trainings that may help council members.

Ms. Walters and Mr. Harriman thanked the Committee for their input.  The conversation will continue at multiple levels.

There being no further comment, the meeting was adjourned.