INTEGRATION OF CARE COMMITTEE MEETING
December 17 2025, 10:00am-11:46 am
By Zoom Videoconference
MINUTES
Members Present: Jeff Natt (Co-chair), Steve Hemraj (Co-chair), Raffi Babakhanian, Victoria
Bell, Mitchell Caponi, Gretchen George Ty, Dorothy Farley, Ronnie
Fortunato, Charmaine Graham, Chris Joseph, Jemima Maxine Louis,
Marcelo Maia, Cesar Nuñez, Jesus Robles, John Schoepp
Staff Present: NYC DOHMH: David Klotz (Governmental co-chair), Doienne Saab (Cmte.
Support Staff), Laura Moya-Adames, Abraham Omeyoma; Recipient: Guadalupe Domiguez-
Plummer, Johanna Acosta, Jelani Cheek, Adrianna Eppinger-Meiering, Gina Gambone, Sara
Kramer, Frances Silva, Arnelle Vincent
Agenda Item # 1: Roll Call/Moment of Silence/Minutes
Doienne Saab opened the meeting and reviewed the agenda. Members were informed that the
October Integration of Care Committee minutes had been circulated in advance. One minor correction
was noted, which staff agreed to update. With that correction, the minutes were approved.
During announcements, Gretchen George Ty shared information about a community training she
attended, named Hands Off New York City, focused on Know Your Rights education and local
response strategies related to ICE activity. G. George Ty noted that additional trainings are planned
and referenced a volunteer-run hotline that tracks and reports ICE presence. Committee members
engaged in discussion regarding community safety, the role of service providers, and appropriate
ways to share information without exposing clients to legal risk. Planning Council leadership noted that
immigration-related barriers to care are also being explored through other Council bodies, including
the Needs Assessment and Consumers Committees.
Agenda Item #2: Ryan White Part A Legal Services (LSN) Program
Overview
Gina Gambone and Frances Silva presented an overview of the Legal Services service
category, including program goals, HRSA definitions, eligibility requirements, and allowable
services. They reviewed core program components such as intake and reassessment, service
planning, and direct legal advocacy. Allowable legal services discussed included benefits
access (e.g., health insurance), housing-related legal issues, immigration matters directly
related to HIV status (e.g., PRUCOL), family law, and tax preparation. Staffing models, service
delivery approaches, and geographic coverage across the New York EMA were also
reviewed.
Recipient staff shared programmatic data highlighting both successes and challenges. Challenges discussed included court delays, extended length of client enrollment, staffing constraints—particularly for specialized immigration attorneys—and administrative documentation requirements. Successes included strong program performance, flexibility in service delivery models, increased use of hybrid and remote services, enrollment levels exceeding targets, and consistent spend-down of Planning Council-approved and enhancement funds.
Committee members raised questions and shared concerns related to client access to legal services, continuity of legal representation, and the lived experiences of clients navigating legal systems. Members cited challenges related to intake processes, the lack of allowable legal services available to clients, medical-related insurance coverage denials and accountability when providers services are not met with satisfaction. One member asked if LSN providers cover criminal defense in which, Planning Council leadership clarified that criminal defense is not an allowable Ryan White service under HRSA guidance. However, they confirmed that existing complaint processes and warm handoffs to more comprehensive legal service providers exist and are an expectation under LSN to support client satisfaction and continuity of care.
Additional discussion addressed the duration of legal service enrollment and the impact of court delays on open cases. Recipient staff noted that case length varies widely depending on the legal issue and that providers have reported extended timelines anecdotally. Members emphasized the importance of centering client experience, transparency, and equity when revising service directive and future procurement process to truly address the legal service needs of RWPA clients.
Johanna Acosta presented a summary of findings from two virtual listening sessions held in November 2025 with NYC Ryan White Part A Legal Services providers. She explained that the sessions were conducted to gather provider perspectives on program successes, challenges, and opportunities to inform the upcoming Legal Services RFP. Providers highlighted strong client-centered practices, including the use of advisory boards, regular performance monitoring, and collaborative case review processes that support positive client outcomes. At the same time, providers identified significant administrative and fiscal challenges, including burdensome intake and reassessment requirements, difficulties obtaining eligibility documentation, and reimbursement structures that complicate staffing and service planning. J. Acosta also shared provider observations regarding barriers faced by vulnerable clients, particularly older adults aging with HIV, individuals experiencing housing instability, and immigrants navigating complex systems. Providers emphasized the value of integrated service models (e.g., medical-legal partnerships), co-location of legal services with medical case management, and flexible service delivery modalities (e.g., virtual, home-based), while noting gaps in funding for high-demand services such as immigration legal support.
Jelani Cheek provided an overview of demographic, service utilization, and expenditure data related to Legal Services for Grant Years 2022 through 2024. He noted that the data reflected active clients who received at least one service during the reporting period. The majority of clients were aged 50 and older, identified as Black or Hispanic, and resided primarily in the Bronx, followed by Brooklyn, Manhattan, and Queens. Finally, he summarized service utilization trends, including the number of unique clients served across grant years and the volume of services delivered, as well as expenditure patterns, which demonstrated consistent service delivery and spending over time. J. Cheek noted that the data provided important context for understanding who is being served by Legal Services and how the program is functioning.
The committee agreed to discuss the Legal service directive revisions at the next meeting.
The Next Steering Committee Meeting, will be held on Wednesday, January 21, 2026 10-11:30 AM.
There being no further business, the meeting was adjourned.
