Needs Assessment Committee Meeting December 9th, 2021

Needs Assessment Committee

Finn Schubert and Marcy Thompson, Chairs

December 9^th, 2021, 1:00PM -3:00PM

Zoom Video Call: https://zoom.us/j/4708943670

Members Present: Fay Barrett, Billy Fields, Graham Harriman (Gov’t Co-chair), Amanda Lugg, Finn Schubert (Co-chair), John Schoepp, Marcy Thompson (Co-chair), Angela Aidala, Erin Harned, Karen McKinnon, Norine Di Giulio, Reginald Brown, Jennifer Irwin, Claire Simon, David Martin  

DOHMH, PHS, NYS and Other Staff: Cristina Rodriguez-Hart, Johnell Lawrence, Kimbirly Mack, Noelisa Montero, Jose Colon-Berdecia, Roland Torres, Nadine Alexander, Scott Spiegler, Dave Ferdinand, Arly Pelaez

Welcome/Introductions/Moment of Silence/Public Comment/

Review of the Meeting Packet/Review of the Minutes:

John Schoepp led the committee in a moment of silence. There was no public comment. No corrections to the November minutes. Cristina briefly covered the agenda and the new workplan template format. Billy asked for a document that explains the workplan and so Cristina said she would send it back out with explanations of the different parts and a link to a website explaining gantt charts.

Review of workplan format

Cristina briefly covered the agenda and the new workplan template format. Billy asked for a document that explains the workplan and so Cristina said she would send it back out with explanations of the different parts and a link to a website explaining gantt charts.

Needs assessment (NA) workgroups

NAC split up into 4 simultaneous breakout rooms, each discussing a different component of the HRSA-required NA. Noelisa and Nadine facilitated the epi profile workgroup, Graham the resource inventory workgroup, Johnell and Scott the provider capacity workgroup, and CHAIN staff (Angela, Maiko, and Erin) the service needs and gaps workgroup. Below is a summary for each workgroup in terms of their progress.

Epi Profile Workgroup

Summary of what was discussed:

• Data sources available 
• Proposed timeline
• Epi profile document
• Discussion questions

Next steps:

• Review data on five priority populations (OPWH, Black or Latino cisgender MSM, cisgender YMSM, transgender women, and Black and Latina cisgender women):
• HIV Care Continuum 
• Unmet need in terms of viral load suppression, defined as: 
  • (1) the number and/or percentage of people with diagnosed HIV who are not receiving medical care for their HIV infection: diagnosed but no CD4/VL in 2020
  • (2) the number and/or percentage of people with diagnosed HIV who are receiving medical care for their HIV infection but whose most recent test included an amount of HIV in the blood that was at or greater than 200 copies/mL: diagnosed, had CD4/VL in 2020, but VL>=200
• Data request to NYS DOH on most recent data for the care continuum for priority populations available (to be developed) This allows them to get Tri-County data for PPs- from the RW grant app and new data request to NYSDOHAI.
• Unmet needs with Mental Health: Explore results on Prevalence and Correlates of Mental Health Diagnoses among People with HIV Receiving RWPA Services in NYC using the SMI report made to NAC in a prior year

Resource Inventory Workgroup

They did an initial review of materials and gave input on the format and process for the development of the resource inventory. The Resource Inventory Tracking Document will be their tool for consolidating their work. For the next meeting please review:

• Resource Inventory Presentation 12.9.21 (this is just included for reference) 
• Attachment 7 – GY 22 Coordination of Services and Funding NY EMA H89HA00015
• POLR Presentation for PRSA_2-11-19rev11.30.21

In the January meeting please bring your own ideas for key takeaways, and information gaps to the meeting (email them to me if you can) and we will work on the recommendations together. Graham will prepopulate the description of each document before each meeting so that we can have that handy as we review each set of documents in our meetings.

Graham submitted a data request on geographic distribution of RW services that has been sent to PHS by CTP leadership.

Provider Capacity Workgroup

1. Next Steps: 

Individual review of AETC workforce capacity survey draft and Discussion questions (below) 

Take time for review

Come to next meeting ready to finalize questions 

• Data request: Scott to reach out to agencies re. training assessments (Cicatelli, NYS AI, DOHMH, etc.)
• Review/Discuss AETC Survey

Adding table of contents/intro to sections

Separate health and racial equity questions (page 10/19)

Q44- separate health and racial equity (different topics) 

Q44- These trainings aren’t necessarily optional. We may want to assess what topics would be most useful for their work? Assess what topics/trainings are needed to make work better/easier/more fluid.  

1. What topics have been most useful to your work? 

Q45- What other training topics (including those mentioned above) would make your work easier/better? 

Q14- Add- Intersex, Gender Non-Conforming/Non-Binary 

1. Discussion Questions:

1. What do you think about the current survey? Are the questions, in their current state, addressing provider capacity in health + racial equity and stigma adequately? Why/Why not? 
2. What are some missing topics/questions you would like to see included relating to provider capacity in addressing stigma and racial equity?
3. Can the current questions be edited to better address provider capacity in stigma reduction, health and racial equity? Cristina referred them to a recently published paper on how NYC HIV organizations are addressing stigma that can be found here: https://link.springer.com/content/pdf/10.1007/s10461-021-03498-0.pdf. The workgroup will review it as a data source once they have finalized questions for the AETC survey.

d.         Should any questions be removed and/or replaced in the current survey? If yes, which questions? How should they be re-tooled? 

2. Possible Additions to survey based on Previous workgroup discussions

Service Needs & Gaps Workgroup

1. Determine service area vs. population-driven approach.

After a discussion, the workgroup decided to assess CHAIN data by service category and then special populations within those categories.

Erin explained the possible service area categories in Table 2: Column 1, “RW Part-A Fundable Service categories” are all RW fundable services and are not necessarily offered in the NYC EMA; Column 2, labeled “NYC DOHMH categories” are service areas of interest to the TRT/ NYC DOH RW application planning needs, featured in the CHAIN Needs and Utilization reports, not necessarily all NYC EMA service areas; and Column 3, CHAIN Service Categories are the service categories that CHAIN collects data on and broadly include all RW service categories. Cristina recommends not limiting the needs assessment to just RW funded areas because the findings may uncover a recommendation to fund a service area not currently covered by RW. CHAIN team will need help from Cristina to verify covered RW services in the NY EMA. Workgroup selected the 3^rd column, CHAIN service categories, as the starting service areas for analyses, with data addressing behavioral health and housing needs to be presented at January NAC workgroup. 

• Select service need and gap definition(s).

Table 1 presented different ways of defining need using need food assistance as an example. The first indicator, based on self-reported need for a service only, tends to underrepresent service need. For example, based on self-report only relatively few people indicate they need assistance with food or nutrition services because they may already be receiving some assistance (e.g., receiving food stamps) even though that may not adequately address their needs; or they are not aware of available services for which they would be eligible; or may not perceive themselves to need “food or nutrition services” but do experience running out of money to buy healthy food by end of the month, etc.. The second indicator is based on respondent reports that would indicate need for the service but also includes people receiving the service (rationale being that if they did not have need, they would not be receiving the service). The third indicator is the approach CHAIN uses in most analyses based on standardized indicators of service need as well as self-report of a problem, issue, or need for assistance in the service area, whether or not they may currently be receiving some form of assistance or have had some service contact. The workgroup selected the second and third measures for the January results presentation. 

• Review and confirm CHAIN report summary template and sample results presentations for workgroup.

For graphs and tables, the suggestion was made to provide sufficient information to make them stand alone in that the key takeaway messages and definitions are all there with the table/figure and the reader doesn’t have to search for them elsewhere in the document. There was a suggestion to put % or Ns into the graphs at least for first and last years.

4.         Set action items for next NAC (January 13, 2022).
In January NAC workgroup, we will review data on service need for behavioral health and housing services or assistance, along with different ways that needs are measured/operationalized. From there we can decide how to proceed with other service areas.