Integration of Care Committee Meeting April 2021

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INTEGRATION OF CARE COMMITTEE

Danielle Beiling & Donald Powell, IOC Co-Chairs

Wednesday, April 19th, 2020, 10a-12p

Zoom Meeting

https://zoom.us/j/4708943670

MINUTES

Attendance: Danielle Beiling (co-chair), Janet Goldberg, Leo Ruiz, John Schoepp, Deborah Greene, Bill Gross, Mitchell Caponi, Stephanie Serafino, Paul Carr, Ronnie Fortunato, Billy Fields, Brenda Starks-Ross, Greg Bruckno, Michael Ealy, Dorothy Farley, Rose Chestnut, Annette Roque-Lewis, Randall Bruce, Micheal Ealy, Charmaine Graham, Joel Zive

Staff/PHS: Jose Colon Berdecia, David Klotz, Guadalupe Dominguez Plummer (Grantee), Graham Harriman (Governmental Chair), Kimbirly Mack, Ashley Azor, Cristina Rodriguez-Hart, Rachel Crowley, Claire Simon, Johnell Lawrence

Agenda Item #1: Welcome/Introductions w. Pronouns/Moment of Silence/Review of Minutes

Conducted. Minutes were accepted with corrections.

Agenda Item #2: Public Comment

No public comment

Agenda Item #3: Line-by-Line Editing of the Framing (Name TBD) Directive

The directive was placed into an implementation science framework for a second run of line-by-line editing. The committee word-smithed the document through multiple sections.

Edits are reflected in the current document. Key points of the discussion involved:

  • How are we evaluating the accessibility of service sites?
  • Ms. Goldberg posited that organizations are responsive to barriers to care and quickly stand-up trainings for issues around equity and disparities, or identify barriers
  • Burnout, understaffing, COVID stress has deeply impacted service delivery
  • ETE plan is forthcoming
  • Need for a racial equity audit/analysis to be included
  • Unions impede ability to determine pay structures. How do we address pay structures?
  • Relationship between pay and turnover isn’t necessarily direct
  • Question of whether we want to contract with organizations that already examine pay equity
    • How will contractors get in line?
    • What is pay equity? Unequal pay for the same work, with consideration for experience
    • Is an analysis a huge burden on agencies?
    • Are we only concerned about the equity in RW programs, or are we demanding the entire institution, i.e., a hospital do this work?
    • We want to support agencies doing these analysis and developing responsive plans. – idea to incentivize this work
    • How challenging would a race and pay equity audit be for smaller organizations?
    • How do we do this work – in a way that fosters engagement
    • Shouldn’t be a black and white
    • to challenge people about addressing pay equity at a time of lay offs and limited funds is not something that is achievable/moniterablle given current economic concerns (Ms. Farley)
    • From Janet Goldberg : this is a lot of administrative overhead, added to many of the other additions we are recommending. It may make it not doable for many agencies. I agree with Matt that this is a bit off mission.
    • addressing pay equity would be part of the application and part of the support for implementation going forward. (Dir. Harriman)
    • need to address the floor in terms of how much front line workers are paid and the ceiling– the inequity between the leadership and front line worker.
    • this is an important advocacy issue that we (the Council) needs to support.   Having an organization do a plan won’t likely change their HR policies when for many organizations RW Part A funding is but a 1/10 of their budget. 
    • Sounds like a lot of relevant determinants are coming up in this discussion that could be put into the determinants section. Many providers are expressing their anxieties about this strategy because of the contexts of where they work. Their context is part of determinants.
    • Would this be unrealistic for some agencies to conduct
    • Base idea is to conduct an analysis to inform a plan
    • Having to account for salary decisions would help encourage responsiveness/accountability
    • Is an analysis a burden?
    • Will contracts be lost because agencies cannot make this happen? Organizations are rarely penalized – first response is to work with the organization.
    • Fee for service creates a different perspective on operational costs
    • Need to think about how this requirement will impact all types of organizations?
      • Not a one size fits all model – can require fund raising for some orgs
    • Question of whether we are “punishing” agencies
    • RWPA has right to look at Ryan White, but should they be able to examine the larger institution, ie a hospital’s CEO
    • Will this compel agencies to not apply for funds?
      • Grantwriters disagree
    • What’s an agreeable method for implementation. The issue is larger then part A.
    • Do we need to start over?
  • Do we believe orgs don’t know what crisis plans are?
    • Survey of part A orgs indicate that almost none have crisis plans
    • Hard to believe mental health organizations 
    • Agencies will develop their own workable crisis plans
  • Clear need for infrastructure support among smaller orgs i.e., bathroom modernization

Agenda Item #3: Public Comment

No public comment.

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