Thursday, November 20, 2025, 3:00 – 4:40PM
By Zoom Videoconference
DRAFT MINUTES
Members Present: David Klotz (Governmental Co-chair), David Martin (Community Co-chair), Billy Fields (Finance Officer), Paul Carr, LaShonda Cyrus,Rasheed Ford, Marya Gilborn, Charmaine Graham, Kalvin Laveille (for Joan Edwards), Freddy Molano MD, Brooke Montes, Julian Palmer, Scott Spiegler (for Guadalupe Dominguez Plummer, ex-officio), Marcelo Maia Soares, John Schoepp
Members Absent: Steve Hemraj, Emma Kaywin, Jeff Natt
Staff Present: NYC DOHMH: Michael Navejas, Laura Moya Adames, Abraham Omeyoma, Johanna Acosta, Adrianna Eppinger-Meiering, Renee James, Jimmy Jaramillo; Public Health Solutions: Gemma Barclay, Arya Shahi, Peter Chea
Agenda Item #1: Welcome/Introductions/Minutes/Public Comment
Mr. Martin and Mr. Klotz opened the meeting followed by a roll call and a moment of silence. Mr. Klotz welcomed Mr. Natt and Ms. Graham back to the Executive Committee as newly appointed chair of the Integration of Care Committee and newly elected Consumer-at-Large, respectively. Also, Mr. Laveille has taken over as the alternate for Ms. Edwards. Mr. Babakhanian was thanked for his exemplary two years of service as consumer-at-large. The minutes from the July 17, 2025 meeting were approved with no changes.
Agenda Item #2: Public Comment
Mr. Carr stressed the importance of understanding the impacts of cuts to Medicaid and pending increases in ACA plan premiums on access to care and to the ADAP program.
Mr. Palmer reported that TOUCH had a hugely successful Thanksgiving food giveaway for their clients.
Members announced several World AIDS Day events, including the DOHMH at the LGBT Center, Housing Work’s annual reading of names at the AIDS Memorial, and at Jacobi Medical Center.
Agenda Item #3: GY 2025 Estimated Unobligated Balance Request
Mr. Klotz explained that HRSA-required “estimated unobligated balance” (UOB) request no longer needs to be approved by the Council. The document, which tells HRSA that the EMA will ask to use unspent funds from the current grant year (i.e., 2025 carryover) in the next grant year (2026), is now solely the responsibility of the Recipient. When the actual amount of carryover is known next spring after closeout of the grant year, the PSRA Committee will develop an actual carryover plan for submission to HRSA.
In response to a question from Mr. Schoepp, Mr. Spiegler reported that the Ending the HIV Epidemic grant is still moving forward for a March 1, 2026 start date and includes funds to support client advisory boards.
Agenda Item #4: GY 2025 2nd Quarter Expenditure Report
Mr. Fields explained that spending is on target as of the end of the 2nd quarter (March 1-August 31) at a total of 44% of the grant award, with a few areas of underspending. Mr. Spiegler reviewed the details of the report, noting areas of higher-than-expected underspending. Early Intervention Services (EIS) is unspent due to delays executing a memorandum of understanding with the DOHMH Sexual Health Clinics, but the services are being provided and the money will be drawn down. Tri-County EIS is also underspent due to issues with the sole provider. This will be brought to the Tri-County Steering Committee for consideration. The Quality Management Program is also underspent and any carryover from QM will be used for programs based on the Council’s priorities.
Agenda Item #5: NYC Revised Food & Nutrition Services (FNS) Directive
Mr. Klotz, on behalf of the Integration of Care Committee chairs, introduced the context for a revised FNS directive. The Council has long planned for one large food & nutrition service category that includes services provided under the HRSA non-core “Food Bank/Home Delivered Meals” service category, and the HRSA core “Medical Nutrition Therapy (MNT)” service category. Going forward, the Council must define them separately and they must be reported separately to HRSA.
Mr. Klotz reviewed the HRSA monitoring standards, which have very broad definitions of the two different service categories. The non-core category is the direct provision of food to address food insecurity. MNT is any other form of nutrition services, including counseling, assessment, education and provision of medically tailored meals, all of which requires a registered dietician (RD) or equivalent. The proposed framework for the revised directive’s service model is to delineate the two HRSA categories under one “FNS” umbrella. The non-core service would be called “Food/Meal Services (F/M)” and the core service called MNT. All Ryan White Part A (RWPA) providers would be required to deliver F/M and would be strongly encouraged to provide MNT. This would allow some providers that can address clients’ food insecurity but do not have the resources to hire an RD. The expenditures would be calculated by the Recipient depending on the outcome of the procurement and reviewed by the PSRA Committee for reporting the service category allocations in the Council’s spending plan.
A summary of the changes to the service directive were presented, including updated goals and Integrated Plan objectives. The updates to the service model incorporated feedback from recent consumer and provider listening sessions, literature reviews, informal interviews and presentations from subject matter experts, as well as updates to ensure compliance with HRSA requirements. The revisions clarified the distinction between the Food and Meals Provision and Medical Nutrition Therapy (MNT) components, aligning the directive with federal definitions.
The updated draft emphasizes the importance of nutrition education, client choice, and linkages to external nutrition resources such as SNAP and NYC Health + Hospitals’ Lifestyle Medicine Program to help clients facing immediate food insecurity and mitigate long waiting lists for food services. Additionally, the revisions highlighted the inclusion of culturally relevant food options, seasonal variety, and public-facing educational materials based on MyPlate dietary guidelines to support healthy eating practices.
A newly added section to the revised directive that highlights the integration of digital delivery models to enhance access and client engagement. This section introduces innovative approaches such as app-based grocery vouchers, virtual consultations with registered dietitians or nutritionists, and nutrition and diet tracking tools. Programs are encouraged to adopt tele-nutrition, remote health coaching, and culturally inclusive digital education to better meet clients’ diverse needs and preferences. The directive specifies which digital strategies are most suitable for each service category—Food and Meals Provision (F/M) or Medical Nutrition Therapy (MNT)—to ensure consistency and effectiveness. It also establishes clear requirements for HIPAA compliance, data security, and mobile accessibility, ensuring that clients with limited in-person access can still engage meaningfully with services through digital platforms.
Finally, the directive underscored the need for ongoing coordination with other RPWA services, including Emergency Financial Assistance (EFA), Medical Case Management (MCM) and Psychosocial Support Services (PSS), to promote a holistic and client-centered approach to care.
In response to concerns raised, Recipient staff assured the Committee that there are mechanisms for clients to report issues with service delivery.
A motion was made on behalf of the IOC Committee to accept the Revised FNS Directive as presented. The motion was adopted 13Y-0N.
Agenda Item #6: Tri-County (TC) Revised Service Directives: Medical Case Management, Oral Health, Medical Transportation
Mr. Palmer and Ms. Cyrus introduced the first three TC service directives approved by the Tri-County Steering Committee (TCSC) over the past year. In 2026, virtually the entire TC portfolio of services will be re-RFP’ed for new programs starting March 1, 2027, necessitating the updating of the service directives for the region. This was an opportunity for the TCSC to align service directives with HRSA requirements, provide up-to-date evidence and community-informed guidance and resources, ensure that updates reflect the needs of PWH and address barriers to care, and integrate innovative service delivery strategies and tools to mitigate access barriers to meet the needs of clients. The TCSC reviewed past service directive for updates, conducted literature review and scan of best practices, received presentations and data from the Recipient, assessed service utilization, client outcomes, and emerging needs, and incorporated findings from needs assessments and community feedback.
Mr. Klotz explained that key updates made to all directives included: Apply the NY HIV Planning Council Framing Directive; stronger emphasis on connecting priority populations; reducing stigma, adoption of innovative service models, including telehealth-related strategies; and implementation of a closed loop system to track referrals and verify that clients were indeed linked to supportive services. Highlights of revisions to the service models (which reflect innovations included in recently approved NYC directives) are as follows:
Medical Case Management: Rapid linkage to HIV care and immediate ART (iART) initiation; consistent ART use with motivational interviewing, adherence tools (e.g., pillboxes, apps), and telehealth options like video calls or mHealth technology. Use modified DOT (mDOT) with digital check-ins or incentives across home, field, or virtual settings; and use trained staff to complete a Brief Geriatric Assessment (BGA)to identify aging clients’ needs (e.g., comorbidities, frailty, cognition). Referrals for a Comprehensive Geriatric Assessment (CGA) if needed, and linkage older or isolated clients to Area Agencies on Aging for meals, wellness, and caregiver support.
Oral Health Services: User-friendly services with flexible hours (early mornings, evenings, weekends) and emergency tele-dentistry; monitor alveolar bone status among clients, particularly among older adults over the age of 50 or more and cisgender women; virtual tools for initial and follow-up visits, remote monitoring, and oral health education via mobile apps with real-time feedback; incorporate imaging tools for early detection.
Medical Transportation: The model adds the use of ride-sharing apps (e.g., Uber, Lyft) to the types of transportation that can be used to provide rides to medical and support services.
In response to a concern, it was noted that MCM programs can not provide clinical care, but work to ensure that clients are enrolled in and maintained in clinical care.
A motion was made on behalf of the TCSC Committee to accept the Revised Service Directives as presented. The motion was adopted 12Y-0N.
Mr. Klotz thanked Doienne Saab for her exemplary work on the directives and thanked the IOC and TCSC chairs and members for their outstanding work.
Mr. Klotz noted that the NYC FNS and Tri-County service directives will be presented to the full Council at its next meeting on December 4th (in-person at Cicatelli Associates, or by Zoom). There will also be a presentation of the 2024 HIV Epidemiological and Surveillance Report, to be released by DOHMH on World AIDS Day.
There being no further comment, the meeting was adjourned.
