INTEGRATION OF CARE COMMITTEE
Danielle Beiling & Donald Powell, IOC Co-Chairs
Wednesday, November 18th, 2020, 10a-11:45a
Zoom Meeting
MINUTES
Attendance: Danielle Beiling (co-chair), Donald Powell (co-chair), Janet Goldberg, Leo Ruiz, John Schoepp, Deborah Green, Bill Gross, Mitchell Caponi, Stephanie Serafino, Paul Carr, Ronnie Fortunato, Rob Walker, Billy Fields, Brenda Starks-Ross, Greg Bruckno, Christopher Joseph, Rose Chestnut, Janet Goldberg, Michael Ealy, Dorothy Farley, Randall Bruce, Matt Lesieur, Joel Zive
Staff/PHS: Jose Colon Berdecia, David Klotz, Guadalupe Dominguez Plummer, Graham Harriman (Governmental Chair), Bettina Carroll, Kimbirly Mack, Ashley Azor, Cristina Rodrigues-Hart, Bettina Carrol, Rachel Crowley, Joan Edwards
Agenda Item #1: Welcome/Introductions/Moment of Silence
Conducted.
Agenda Item #2: Stigma & HIV Care
Dr. Cristina Rodriguez-Hart presented on stigma and HIV care. Highlights from the discussion are below.
- Thinking about stigma as a mark of disgrace is actually stigmatizing.
- Solutions to stigma must be multi-level.
- Providers and consumers surveyed agree that stigma is common in NYC
- Concept of intersectionality not well understood
- Strong need for more staff with lived experience and representative of the community served
- Integrated services are optimal
- A learning culture is needed to transform stigma
- Minimize staff burnout
- Abstinence based programs are associated with enacted stigma – idea of substance use as “dirty” and associated with shame
- Importance on non-violent communication – examining our language within ourselves and with others
- Synergy exists between multiple types of stigma/oppressions – cannot separate them out.`
- Words matter – how we speak to ourselves and others is very important
- Coping is an individual level stigma strategy –
- Not always effective
- Seeking out support as a form of coping is useful
- Educating self is helpful
- Avoidance and vigilance – can create a lot of stress in the long term
- Important to help people with positive coping – but must recognize this is an invidial strategy that doesn’t address the larger structural issues
- Need to assess coping
- Media communications guide during COVID – has been helpful
- A number of resources are mentioned in the slide set – lengthy references are included
- Identify how to support Ryan White providers to do this work
- Hoping the results of the mapping project will provide guidance on best practices:
- Core things that are very effective:
- Integrated services
- Continuous training
- Representative staff
- Core things that are very effective:
- T-Tap has a stigma training and an online accompaniment that looks really good
Mr. Joseph shared a tool that was useful to audit charts and start conversations about the use of stigmatizing language
- Necessary to recognize that many people in the committee have experienced stigma
- People who have good coping strategies fare the best
- Important to have your own way to manage
- Need to evaluate the Council as an organization
- The Health Policy Project developed a stigma survey and a checklist for facilities – could possibly adapt that to the NYC process
- Other organizations have developed organizational assessment tools
- Instead of calling people out – can now educate people – moving beyond being impacted by stigma –
- Ask GMHC about training where providers have to examine use of language
Agenda Item #3: Review Master Directive & Recent Directives
Guidance for the new NYS plan to end the epidemic has not been released.
Committee read through master directive.
Language from Care Coordination not included in master:
- Culturally appropriate
- Accommodations for people with disabilities
Food and Nutrition:
- Leveraging public private partnerships
- Utilizing economies of scale
- CLAS standards
- Age appropriate
- Sensitive to physical and sensory impairments
Should be thinking about who our most vulnerable clients are and how services should be delivered
TIGNBNC:
- Need to use different technology to meet clients where they are
- Gender affirming
- Builds self-management skills
Participant vs client vs consumer vs patient
How are technological inequities to be addressed in the master directive?
No public comment.
