Integration of Care Committee Meeting May 2021

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INTEGRATION OF CARE COMMITTEE

Danielle Beiling & Donald Powell, IOC Co-Chairs

Wednesday, May 19th, 2021, 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, Paul Carr, Ronnie Fortunato, Greg Bruckno, Michael Ealy, Dorothy Farley, Randall Bruce, Micheal Ealy, Charmaine Graham, Joel Zive, Matt Lesieur, Christopher Joseph

Staff/PHS: David Klotz, Guadalupe Dominguez Plummer (Grantee), Graham Harriman (Governmental Chair), Kimbirly Mack, Ashley Azor, Johnell Lawrence, Anisha Gandhi, Jennifer Carmona, Andrea Feduzi

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

Conducted. Minutes were accepted with corrections.

Agenda Item #2: Public Comment

SAGE is starting a virtual support group for people who identify as LGBTQ over 50!

Agenda Item #3: Equity, Pay, Ryan White Part A & the NYC Department of Health (DOHMH) 

Jennifer Carmona, Anisha Gandhi & Johnell Lawrence led the conversation on the Bureau of HIV’s role in ensuring a living wage and pay equity.

Key points of the discussion follow:

  • Purpose of including equity is to ensure that people are paid fairly for their work
  • Diversity is necessary to solve the problems identified within the epidemic.
  • Trying to ensure people are paid fairly across an organization
  • Instead of thinking about why pay equity doesn’t exist – try to imagine something different. Moving away from the lens of white supremacy, to ask agencies to examine what they value and how within their organizations
  • As a program manager for Part A Care Coordination – spent a lot of time debating hiring a peer – because the hours a peer could work are limited, because the amount of pay is limited by the balance with benefits. The hospital required credentials – lived experience did not qualify for eligibility.
  • Revise directive language around pay equity to focus on the goal, because we would then work with agencies to operationalize it. i.e., what is compensation?
    • How does the health department stand up against these goals.
  • Applicants are rated on their responses to the RFP – we could rate organizations on this – wouldn’t disqualify organizations from applying, but would facilitate taking it into consideration regarding who wins funding

Agenda Item #3: Line-by-Line Editing of the Framing Directive

Edits were made with members reading the directive. Edits follow

  • Language around when needs are assessed changed to reflect at a minimum of 6 months.
  • Ryan White inserted before eligibility
  • Statements in Inner Setting need citations
    • Just because it isn’t documented doesn’t mean it isn’t true
  • Many of these descriptions have come up in partner meetings, such as emphasis on credentials versus lived experience
  • The more specific the document is, the more actionable it is – how do we measure improvement if we don’t clearly define the issue.
  • Melanie will find references for the parts that are documented – can also cite provider testimony
  • There is a plethora of data on healthcare systems – widespread disparities are documented in NYC. If our intention is not to address that gap, then we are a part of the problem
  • The healthcare system is historically an oppressive system and that is well documented – doesn’t have to be specific to Ryan White, and has a lot of overlap with the current pandemic in terms of impact and access
  • Human resources dominate the budget – what’s the construct we are looking at for pay equity and the indicator that tells us how we are doing.
  • Has COVID transformed the way data is collected across the city
    • eSHARE has not changed since the beginning of the pandemic, has limitations but that isn’t necessarily a huge barrier to the planning work
  • Programs can’t access data without specifically requesting access to data each time
  • eSHARE is a data collection tool, not a data analysis tool and it should be providing a series of accessible reports regularly.
  • eSHARE is a huge burden to clients who must endure an intake at each agency/service
    • Should be able to give permission to share data so that this doesn’t happen
  • eSHARE should have been equipped to integrate with EMRs
  • eSHARE isn’t all bad – some of the canned reports are really great – does have a wonderful staff who build capacity at organizations to use the system
  • Important to recognize balance between what an employer can ask during an interview and creating a diverse workforce
  • Human resources constrain hiring practices
  • Do unions perpetuate systemic barriers, which are attributable to capitalism? Unions are pathways to the middle class.
    • Unions already get blamed for so much – but the inequities we are examining does not stem from organized labor
  • How do we do this in one fell swoop – how do you dismantle the inequity – very difficult to pull it apart – very challenging work – worry that this will be performative – but there need to be concrete, measurable and actionable changes – really does need to be a revolution
  • Unions were the entrée – but once they are at the table, the rules get changed and the most vulnerable continue to be at the bottom of the pyramid
  • Zoom is oppressive
  • Easy to blame different entities/systems – they are oppressive – easy to say we are powerless – but there are ways to be creative, to push the system, to change the system
  • Have experienced work arounds – and how is this being documented? i.e. an organization that used a subcontractor to hire people with lived experience
  • Per the Council’s work the grantee has de-emphasized credentials- reflected in the last few RFPs – should ensure that that is reflected in the directive.
  • Could Anisha discuss how racial equity work has evolved inside the bureau
  • Outer Setting needs to be more specific and detailed
    • Needs to detail the well documented landscape
  • Priority replaced by disproportionately marginalized and excluded populations
  • Inclusion of anti-oppression sex positivity and harm reduction into “characteristics of individuals”

Agenda Item #3: Public Comment

No public comment.

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