Meeting of the
Needs Assessment Committee
Amanda Lugg and Marcy Thompson, Chairs
March 11th, 2020, 10:00AM -11:45AM
Zoom Video Call: https://zoom.us/j/4708943670
Members Present: James Satriano, Leonardo Ruiz, James Walkup, Jennifer Irwin, Tim Frasca, John Schoep, Francine Cournos, Reginald Brown, Karen McKinnon. Marcy Thompson, Graham Harriman, Jonathan Reveil, Micah Domingo, Finn Schubert, Billy Fields, Matthew Lesieur, Norine Di Giulio, Charmaine Graham , Randall Bruce, Fay Barrett, Roland Torres
DOHMH, PHS, NYS and Other Staff: Ashley Azor, Kimbirly Mack, Allison Baxter, Jose A. Colon-Berdecia, Guadalupe Dominguez Plummer, Claire Simon, Bryan Meisel
Welcome/Introductions/Moment of Silence/Public Comment/
Review of the Meeting Packet/Review of the Minutes:
Ms. Lawrence opened the meeting with introductions and an icebreaker. Introductions with pronouns were conducted and a moment of silence was held. The Forum Part I findings report (a summary of the previous month’s meeting) was presented and accepted.
SMI & HIV Forum Debrief, with Report Review
The committee reviewed the summary report of Part I of the PWH with SMI Forum. Summary describes why the committee is focused on this work. The summary report reflects the content of the slides verbatim, and then relevant discussion to those slides was summarized under each section, since the content was already broken into themes.
During the forum, stakeholders asked about breakdown of population by zip code – which highlighted the lack of information that we have about this population. Unclear where HIV testing for PWH with SMI is occurring.
Initially hoped to access Medicaid claims data through the Bureau of Mental Health, but the same hurdles to access exist. Really need a champion at OHIP, the Office of Health Insurance Programs.
Lack of harm reduction across mental health programs – real fear among clients in talking about substance use – fear of losing housing or other benefits.
OMH stated that they do not have a policy for HIV testing. Mr. Satriano noted that it was part of his job to ensure the policy was kept up to date with the law. In patient programs have said that consent is the issue. Need to address lack of clarity around what is required to give consent.
Clients in-patient settings often lack advocates.
Vocal staff Arash, who runs Harm Reduction services, discusses Innovative Models – a partnership with Mount Sinai, that sought to bring the clinic to the community. Goal was to integrate care – telemedicine has been a good bridge, but real goal was to build an in house clinic which, while built in coordination with input from the NYS DOH, did not meet regulation. Workarounds are not always possible.
Dr. Cournos noted that OMH mostly provides sevirces to people who may be violent – not people who may die of neglect.
Ms. Thompson noted that state agencies should work with CBOs to support compliance – not to “get them”.
Dr. Cournos asked if it is unethical to provide mental health services without coordination with physical care.
It would make sense for organizations to get starter packs – that facilitate linkages and partnerships to ensure adequate support for clients.
Need to advocate for long acting injectables in Medicaid.
Need better education on how SHIN-NY, RHIOs, Healthix and PSYCKES function, interact and support care.
Mr. Lesieur – RHIOs are pay to access – as long as all providers are paying for that RHIO, they will get notifications about clients. But if a person gets care somewhere that does not have RHIO access, their care will not be represented. Fees can be substantial. SHIN-NY is supposed to amass all the RHIO info.
MyChart is not oriented around sharing info among providers – its for the client.
Dr. Cournos noted that Mychart gives patient a lot more information about themselves and helps put them at the center of their care.
Mr. Frasca is asking if we have developed our recommendations to a point that we can put remedies into action.
Committee will develop and finalize recommendations for the RWPA behavioral health portfolio – these will be folded into the behavioral health directive – and tangible changes will be made to support people with SMI in Ryan White.
The findings – state level of remedies that we are seeking -will take a longer time – and will require us to continue to push agencies to move on these issues – we are proposing a workgroup and asking agencies to commit to collaborating.
We need a better understanding of the regulatory hurdles to integrating care – and where the pressure points are in getting them transformed.
For OMH we want to help to build capacity to provide HIV care, treatment and prevention services. We are also asking for them to better explain PSYCKES.
Will try to find a champion at OHIP. Medicaid data has been less available over the past 3-4 years. Need for mortality data to better understand premature death.
Asking for information on the OASAS OMH integration that is publicly available.
Plans to consolidate peer certification.
Important to understand which regulatory stuck points are on the state vs federal side.
AIDS Institute will provide information on how they will address social determinants of health. How is this specific to PWH with SMI?
Telehealth technology to conduct certification training – using a virtual platform – a lot of current trainings are already online.
Harm reduction was approved, but are many organizations billing for harm reduction.
Someone from OMH’s central office needs to be at the next forum.