Integration of Care Minutes – March 20, 2024

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Minutes of the Meeting of the

Integration of Care Committee

Veronica Fortunato & Steve Hemraj, IOC Co-Chairs

Wednesday, March 20, 2024

10:00am-11:50pm

Minutes

Committee Members Present:

Steve Hemraj (Co-chair), Raffi Babakhanian, Mitchell Caponi, Dorothy Farley, Billy Fields, Charmaine Graham, Deborah Greene, Christopher Joseph, David Klotz, Hondo Martinez, Guadalupe Dominguez Plummer (ex-officio), John Schoepp, Claire Simon

Staff: Adrianna Eppinger-Meiering; Doienne Saab; Scott Spiegler, Johanna Acosta, Monika Pathak

Agenda Item 1: Welcome, Roll Call & Moment of Silence

Steve opened the meeting followed by a roll call and a moment of silence.  The minutes from the February 21st meeting were approved with no changes.

Agenda Item #2: Early Intervention Services (EIS) Directive

Monika presented the revised 2022-26 Integrated Plan goals that align with the service category goals.  The goals are taken from the “test” and “treat” pillars of the Plan and include: increasing the percentage of people tested for HIV, increasing the percentage of people linked to care and virally suppressed, closing disparities in treatment and viral suppression for Black and Latino PWH, and increasing regular testing among priority populations.  There was discussion about the need for additional data on adding people with disabilities to the populations not reflected in current data.  Other points of the discussion included incorporating telehealth options for newly diagnosed.  There was also discussion of the importance of using peers, particularly among target populations with high prevalence rates, such as MSM who use crystal meth.  

David reviewed the current language of the service model section of the directive and reviewed the issues that were raised in the previous two meetings.  

A summary of the discussion follows:

  • Payor of last resort monitoring must abide by HRSA mandates.  No POLR documentation is required for testing, but linkage to care services must be documented within 30 days.  The Recipient is working to make the intake forms less burdensome.
  • A new testing initiative through NASTAD that may have useful models of care that can be incorporated.
  •  There is wide latitude for proof of residency so that new arrivals to the EMA can access RWPA services.
  • EIS programs should follow CDC guidelines for linkage to care, including immediate initiation of ART when possible and a “warm handoff” to medical providers within 14 days.  Medical providers should have experience providing HIV-related medical care.
  • EIS programs should have minimum guidelines for post-test counseling and health education.
  • Site where target populations gather (e.g., sex venues) are the key component of a community-based testing initiative.  Peer workers should be used in those venues.  Programs should develop ongoing relationships with venues and establish sites on location.
  • Post-test counseling for HIV-negatives should include informal basic education about preventing HIV transmission and PrEP (including injectable PrEP and the importance of adherence).  
  • Immigrants/recent arrivals have not been identified as a high priority population and there is no data showing that they have higher rates of undiagnosed HIV.  Given the limited amount of RWPA funds for EIS, programs should be targeted at the populations known to have higher rates of HIV infection, particularly young Black and Latino MSM.

A markup of the directive will be sent to the Committee in advance of the next meeting to continue its process revising the program model section of the directive based on the discussion at this meeting. There being no further business, the meeting was adjourned.