Minutes of the Meeting of the
Integration of Care Committee
Veronica Fortunato & Steve Hemraj, IOC Co-Chairs
Wednesday, October 8, 2025
10:00am-11:21am
Minutes
DRAFT MINUTES
Members Present: Jeff Natt (Co-chair), Steve Hemraj (Co-chair), Raffi Babakhanian, Victoria Bell, Dorothy Farley, Ronnie Fortunato, Deborah Greene, David Klotz, Jemima Maxine Lewis, Cesar Nuñez, Guadalupe Dominguez Plummer, Brenda Starks-Ross, Leah Richberg, John Schoepp, Gretchen George Ty
Staff Present: NYC DOHMH: Doienne Saab (Cmte. Support Staff), Laura Moya-Adames, Scott Spiegler Adrianna Eppinger-Meiering, Gina Gambone, Johanna Acosta, Frances Silva
Jeff Natt opened the meeting followed by an introduction of new and existing members. Followed by a moment of silence.
The draft minutes from the July 18th meeting were approved with no changes.
None shared.
Adrianna E.M. provided an overview on the three listening sessions conducted in September 2025 to gather feedback from consumers and providers:
• Consumers: September 17 (in-person, bilingual English/Spanish) and September 25 (virtual).
• Providers: September 22 (virtual).
A total of 14 consumers participated across NYC and Tri-County regions with each participant receiving an incentive for their time and input. Discussions aimed to understand the quality, accessibility, and impact of Ryan White FNS programs.
Participants consistently described the food quality as fresh, healthy, and responsive to their medical needs. Many appreciated the portion sizes, diversity of pantry contents, and access to nutrition education through workshops and cooking demonstrations. They emphasized the
value of being able to choose their food—whether through grocery vouchers or pantry selection—and noted how wraparound supports such as translation services, transportation, case management, and emergency financial assistance further strengthened their engagement and overall well-being.
Despite these positive aspects, consumers identified several challenges. Many expressed a desire for larger portions and greater variety in meal options, citing that menus could be repetitive and lacking in seasonal produce or whole-grain items. Some reported encountering waitlists for program enrollment, though a few agencies were commended for offering emergency pantry bags while clients awaited placement. To improve services, participants recommended expanding access to registered dietitians and nutritionists, increasing educational workshops on topics such as diabetes management and safe cooking, and enhancing connections to farmers markets or seasonal produce voucher programs.
Providers echoed the strong value of FNS programs, emphasizing their ability to deliver nutritious meals, home-delivered food, and supportive wraparound services. They noted that flexibility in program design allows agencies to tailor services to meet the specific needs of their communities, and client satisfaction surveys have been useful in refining service delivery. However, providers also reported ongoing challenges, including staffing shortages and retention issues, limited participation in educational workshops, and a growing demand for food assistance that has strained program capacity and led to longer waitlists.
Together, the insights from both consumers and providers underscore the critical role of Food and Nutrition Services in promoting health, stability, and engagement in care for people living with HIV, while highlighting opportunities to strengthen variety, accessibility, and sustainability of these essential programs.
Agenda Item #5: Food and Nutrition Services Draft Service Model David K. provided context for revising service directives as a method to provide guidance to the Recipient on how Ryan White-funded services are implemented. He described how directives inform Requests for Proposals (RFPs) and define: service model and eligibility requirements, service goals and desired outcomes.
The Food and Nutrition Services directive (FNS) is under review in preparation for an RFP release in 2026, with services to begin March 1, 2027. The Council has long planned for one large food & nutrition service category that includes services provided under the HRSA non-core “Food Bank/Home Delivered Meals” service category, and the HRSA core “Medical Nutrition Therapy (MNT)” service category. The Council must now distinguish between two HRSA-defined categories:
• Food & Meals Provision (Non-Core Support Service) – direct food provision addressing food insecurity.
• Medical Nutrition Therapy (MNT) (Core Medical Service) – nutrition counseling and assessment requiring a registered dietitian.
Previously, both were combined under one directive; they will now be reported separately to HRSA while remaining within a unified FNS framework.
David K. explained how PSRA (Priority Setting & Resource Allocation) will determine overall funding allocations for both categories, later disaggregated by the Recipient.
Doienne S. presented the high-level updates applied to the Doienne Saab presented the updated sections of the draft Food and Nutrition Services (FNS) Directive, which incorporated feedback from recent consumer and provider listening sessions, literature reviews, informal interviews and presentations from subject matter experts, as well as updates to ensure compliance with HRSA requirements. The revisions clarified the distinction between the Food and Meals Provision and Medical Nutrition Therapy (MNT) components, aligning the directive with federal definitions.
The updated draft also emphasized the importance of nutrition education, client choice, and linkages to external nutrition resources such as SNAP and NYC Health + Hospitals’ Lifestyle Medicine Program to help clients facing immediate food insecurity and mitigate long waiting lists for food services. Additionally, the revisions highlighted the inclusion of culturally relevant food options, seasonal variety, and public-facing educational materials based on MyPlate dietary guidelines to support healthy eating practices.
Doienne S. also presented a newly added section to the draft Food and Nutrition Services (FNS) Directive that highlights the integration of digital delivery models to enhance access and client engagement. This section introduces innovative approaches such as app-based grocery vouchers, virtual consultations with registered dietitians or nutritionists, and nutrition and diet tracking tools. Programs are encouraged to adopt tele-nutrition, remote health coaching, and culturally inclusive digital education to better meet clients’ diverse needs and preferences. The directive specifies which digital strategies are most suitable for each service category—Food and Meals Provision (F/M) or Medical Nutrition Therapy (MNT)—to ensure consistency and effectiveness. It also establishes clear requirements for HIPAA compliance, data security, and mobile accessibility, ensuring that clients with limited in-person access can still engage meaningfully with services through digital platforms.
Finally, the directive underscored the need for ongoing coordination with other Ryan White Part A services, including Emergency Financial Assistance (EFA) Medical Case Management (MCM) and Psychosocial Support Services (PSS), to promote a holistic and client-centered approach to care.
Raffi B. expressed concerns about lengthy service delays, the absence of standardized emergency food provisions, and the limited availability of referrals for Medical Nutrition Therapy or senior services, noting that a shortage of registered dietitians remains a significant barrier. In response, Ronnie F. explained that while dietetic technician programs exist to help fill such gaps, they are declining due to low pay and recruitment challenges. David K. clarified that the revised directive removes the requirement for registered dietitians in the non-core “food and meals” category to align with HRSA guidelines, and Doienne S. confirmed that the
updated directive incorporates MyPlate and federal dietary standards to guide nutritional quality.
The Cmte. committee reached consensus to adopt the updated directive, with no objections raised.
The next service directive to revise and discuss will be the Legal Services Program.
Adjournment
The Next Steering Committee Meeting will be held on Wednesday, December 17, 2025 10-11:30 AM.
There being no further business, the meeting was adjourned.
