Needs Assessment Committee Meeting November 12th, 2020

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Meeting of the
Needs Assessment Committee
Amanda Lugg and Marcy Thompson, Chairs
November 12th, 2020, 10:00AM -11:45AM
Zoom Video Call: https://zoom.us/j/4708943670

Members Present: Marcy Thompson (co-chair), Amanda Lugg (co-chair), John Schoepp, David Klotz, Randall Bruce, Lisa Best, Rob Walker, Tim Frasca, Jennifer Irwin, Micah Domingo, Claire Simon, Billy Fields, Fay Barrett, Finn Schubert, Jamie Walkup, Jonathan Reveil, Karen McKinnon, Maiko Yomogido, Mytri Singh, Randall Bruce, Francine Cournos, Micheal Rifkin, Press Canady, Jonathan Reveil, Leo Ruiz, James Satriano, Reginald Thomas Brown, Leo Ruiz, 

DOHMH, PHS, NYS and Other Staff: Cristina Rodriguez-Hart, Claire Simon, Graham Harriman, Kimbirly Mack, Bettina Carroll, Bryan Meisel, Perminder Khosa, Allison Baxter, Rachel Crowley, Guadalupe Dominguez Plummer, Eleonora Jimenez-Levi, Roland Torres, Ashley Azor,

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 July 16th minutes were presented and accepted with corrections toward the end of the meeting. 

SMI: Road Map

Ms.Lawrence presented a review of what information we have gathered since beginning to assess the issue of serious mental illness (SMI).

Mr. Schoepp brought up the issue of COVID and its impact on HIV care. Mr. Ruiz noted that COVID can impact mental health – an aftereffect has been that people who previously had no mental health condition are now experiencing them. 

Ms. Thompson noted that data sharing across entities to better understand the entire client picture is very important and not happening. Issue of SMI highlights all sides of this issue.

Mr. Harriman noted that the Council should be advocating for changes to the larger service system. 

EHE is the new terminology for Ending the HIV Epidemic, vs the state initiative ETE End The Epidemic.

As Ms. Lawrence reviewed the slides, the committee added in additional areas of concern.

  • Inclusion of especially culturally humble and linguistically competent providers
  • Inclusion of peer workers and people with lived experience
  • Data from managed care companies – streamlining how RHIO data is used – developing a strategic plan
  • Incorporate SHI-NY (State Health Info of NY), which attempts to bridge RHIOs and coordinate information
  • ACT (Assertive Community Treatment) team engagement – these teams provide mobile treatment – lots of different providers are contracted to provide this service – all of which are funded by OMH and Division of Mental Health (NYC). Service is billed through Medicaid. Goal would be to build capacity to address HIV care/prevention
  • Coordinate/collaborate with existing behavioral health programs in city and state
  • ACT teams are run by the OMH (NYS Office of Mental Health)
  • Show correlation between mental health psychotic behavior due to crystal meth use
  • OMH may not get money for HIV – AIDS Institute (AI) cdoes – so coordination has to be at the front of this endeavor.
  • Questions about peers – does AI run a track of peer certification that focuses on behavioral health?
  • OASAS does have a peer program, OMH has a peer component. OASAS helped inform development of AI peer certification
    • This is a continuous conversation on the state side – in order to cross train peers
  • OASAS and OMH look like they will merge next year
  • Peers will be integral to preventing clients from falling back into crisis
  • Poorly engaged persons may not trigger the system – since they are not getting their viral load done
  • Providers who are stably on ARVs then experience a break when they are hospitalized for BH.
  • Can we impact the length of hospital stays for people with SMI who are hospitalized – discharge planning?
    • Need to evaluate how length of hospital stay impacts health outcomes
  • Discharge plans should all include continuity of HIV care
  • Need for care status reports
  • HIV providers can use care status reports to get info on patients they haven’t seen in 6 months 
    • Question of provider awareness
    • Question of continuity of provider care for all clients
  • Some of the reports Healthix is able to put together have been very helpful 
    • Work in real time
    • How info is made available is incredibly important to utilization
  • How to bring capacity up among all providers to access this info
  • Need to support testing regimens among partners who serve people with SMI
  • Focus on addressing stigma to ensure access for people with SMI
    • Important to do cross trainings that address stigma among PWH and with SMI
    • Peers can help conduct stigma
  • Trauma informed care cannot be checklisted – both triggering and undermining
    • Emerging concept -often non-evidenced based interventions are implemented
    • Renaming of respectful care
  • High need versus high utilization as underutilization is often an issue.

SMI Forum Draft Invitation Letter

The committee reviewed a draft of the invitation letter for the two part forum the committee proposes to host in 2021. OASAS was not invited so as to focus on serious mental illness without the confounder of substance use.

Still trying to figure out key contacts from the NYS DOH who should be in conversation.

Ms. Lawrence read the committee the most current iteration of the letter. Formatting suggestions were made and incorporated into the letter.

Public Comment

Mr. Fields celebrated the feeling in the room thanks to the 2020 election.