Planning Council Meeting Minutes April 25, 2024

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Thursday, April 25, 2024

3:00-5:00 PM

By Zoom Videoconference

Members Present: D. Klotz (Governmental Co-chair), D. Martin (Community Co-chair), B. Fields (Finance Officer), S. Altaf, R. Babakhanian, M. Baney, K. Banks, R. Brown, G. Bruckno, P. Carr, V. Decamps, J. Dudley, J. Edwards, J. Goldenbridge, C. Graham, R. Ford, R. Fortunato, M. Gilborn, S. Hemraj, R. Henderson, E. Kaywin, M. Lesieur, M. Maia Soares, L. F. Molano, MD, J. Palmer, M. Rodriguez, L. Sabashvili, J. Schoepp, M. Sedlacek, C. Simon, S. Spiegler (for G. D. Plummer), T. Troia, G. Ty, S. Wilcox

Members Absent: M. Bacon, M. Caponi, J. Gomez, B. Hribar, F. Laraque, W. LaRock, N. Martin, H. Martinez, J. Roman, M. Thompson

Staff Present: DOHMH: D. Saab, G. Gambone, J. Acosta, A. Eppinger-Meiering, S. Kramer, A. Guzman, M. Pathak, M. Dorsheimer; Public Health Solutions: R. Santos; NYSDOH: S. Hajiani

Agenda Item #1: Welcome/Introductions/Minutes/Announcements

Mr. Klotz and Mr. Martin opened the meeting followed by a roll call and a moment of silence.  The minutes from the March 28, 2024 meeting were approved with no changes.  Mr. Klotz announced that his appointment as Planning Council Director will officially take effect on April 29th

Mr. Schoepp announced that the Queens ETE Committee is looking for volunteers for a TGNB event in November.  Mr. Carr announced that he will be participating in a fundraising bike ride for the LGBT Center.

Agenda Item #2: Recipient Report

Ms. Eppinger-Meiering reported news from HRSA and other federal agencies, including commemorating the life of Ryan White, National Youth HIV Awareness Day and National Transgender HIV Testing Day.  Also, the final FY 2024 federal budget was approved with level funding for most HIV programs, including Ryan White.  HOPWA received a modest $6M increase. Updates were also given on the HRSA 2024 Healthy Grants Workshop and the August National Ryan White Conference.

There was an update on the concept paper for the forthcoming RFPs for Behavioral Health and Non-medical Case Management/ Inmates & Releasees.  Comments are due April 29th.  Also, the Ryan White Program webpage on the DOHMH website has gone live and includes a description of the Part A program, a complete list and description of programs available in the NY EMA broken down by borough and/or county with links to each funded organization’s website, a link to the RWPA NY EMA Referral Directory, and additional links to the Council, HOPWA, ADAP, and NYS AIDS Institute.

On April 16, the Quality Management (QM) Committee for the NY EMA met to continue discussions regarding updates and feedback on subrecipient QM trainings and mechanisms for subrecipient and consumer collaboration.  Invitations for the RWPA Provider Meeting on July 16, 2024 have gone out.  The meeting is focused on empowering and engaging consumers. 

Other updates concerned proposals for STI and HIV self-collect testing kits, the new White House Director of National AIDS Policy, and the Presidential Advisory Council on HIV.

Agenda Item #3: GY 2024 Reprogramming Plan

Mr. Carr presentedthe GY 2024 reprogramming plan, which maximizes the expenditure of grant funds that become uncommitted during the course of the year.  The Council gives the Recipient the latitude to shift funds between service categories in order to enhance overperforming contracts.  No service category will be enhanced by more than 20% of its original allocation in the spending plan without Council approval.  ADAP will be included as a category for enhancement after all other service categories have been considered, but will not be subject to the 20% cap. All enhancements are one-time, meaning that they are just for the current grant year and do not change the original service category allocations or contract amounts. 

Mr. Lesieur reminded the Council that there had been discussion last year on whether there should be a floor on takedowns from underspending service categories.  This would impede maximizing spending by not allowing for unspent funds to be reprogrammed before the end of the grant year.  While quarterly expenditure reports to the Council and Executive Committee indicate service categories with lower expenditures, the Recipient can be more proactive reporting significant underspending in the fourth quarter.

Mr. Babakhanian reported that an issue was raised in the Executive Committee about using Council support funds to pay for internet service for consumers to participate in the Council.  This was brought to HRSA project officer Axel Reyes, who relayed the barriers, particularly around tracking use for only RWPA planning purposes.  It was noted that the RWPA Emergency Financial Assistance program can pay for internet access for PWH who need it for general purposes and who could then use it for participating in the Council.

On behalf of the PSRA Committee, Ms. Carr moved to accept the GY 2024 reprogramming plan as presented.  The motion was adopted 29Y-0N.

Agenda Item #4: Quality Management Update

Ms. Gambone presented on the Quality Management Program and an update on implementation of the 2023-26 NY EMA QM Plan.  Recipients in all EMAs are required by the Ryan White legislation to implement a QM program to ensure that services meet current federal guidelines for HIV treatment and conduct activities to improve patient care, health outcomes and satisfaction.  The elements of the QM program and its structure and leadership were described.  Stakeholders include DOHMH, the Council, NYSDOH, PHS, RWPA providers and consumers.  The QM program works directly with subrecipients to provide overall direction and to implement, monitor and exchange any needed data for performance measure data and/or quality improvement activities.  Aspects of the program include: infrastructure, performance measures, action plans and evaluation.

The mission and framework of the 2023-26 QM plan were described.  Activities include: training for providers and consumers, peer learning, resource and curriculum development, capacity building, clinical supervision, dissemination of resources and client experience surveys.  QM Plan priorities include: health equity, capacity building, service engagement and service quality.  A main priority is consumer engagement to increase meaningful consumers involvement.  The QM plan changes over time to respond to new circumstances (e.g., value-based payments are no longer used).  Recent QM Program and Consumers Committee (CC) collaboration on consumer advisory boards (CABs).  The CC presented to the QM program on the importance of CABs and initiated a productive dialogue.  The program also worked with the CC to develop a survey of all providers on the status of CABs, the results of which will be presented to the CC in May.  The CC will also deliver a workshop at the July all provider meeting on CABs best practices and overcoming barriers to having an effective CAB. 

In the ensuing discussion, it was clarified that the QM Committee may form ad hoc sub-committees to work on specific projects, such as developing quality measures for Food & Nutrition Services.  When that happens, the Committee may bring in additional consumers of the service category or get additional feedback through methods such as listening sessions and focus groups.  There were also suggestions that CABs need technical assistance to succeed.  They can also be used to inform CC outreach efforts.

Mr. Klotz thanked Ms. Gambone and the QM staff for their commitment to collaboration and engagement with the Consumers Committee.

Agenda Item #5: Medicaid 1115 Waiver

Ms. Hajiani presented on the recently approved Medicaid 1115 Waiver, which includes about $6 billion in federal funding to advance health equity, reduce health disparities, and support the delivery of social care.”  NYSDOH hopes to achieve this through targeted and interconnected investments that will advance health-related social need (HRSN) services.  NYSDOH will award one Social Care Network (SCN) per region (with up to five awards in New York City), with up to 13 SCNs statewide.  Each SCN will be a designated Medicaid provider and serve as the lead entity in their region for fiscal administration, contracting, data collection, referral management and CBO capacity building.  All Medicaid memberswill be screened for HRSNs and eligible for navigation to existing federal, state, and local social programs.  HRSN services will include housing, nutrition, transportation and case management.  There are also funds to strengthen the workforce with training and student loan repayment for nurses and other clinical professionals.  There is $2.2B in funding for the Medicaid hospital global budget to stabilize financially distressed voluntary hospitals, and $492B for the primary care delivery system to advance primary care.  Finally, there is $125M for Health Equity Regional Organizations and $22M for evidence-based opioid and other substance use treatment.  A timeline of 1115 waiver milestones was provided from January 2024 to early 2025. 

There were questions about value-based payments, how HRSN services will be available to small CBOs that are close to hard-to-reach populations to address social determinants of health, and the criteria for receiving services (clients will have to be enrolled in Medicaid managed care programs and meet other criteria).

Agenda Item #6: Public Comment, Part II

Mr. Maia Soares noted the alarming number of fentanyl-related overdoses, urging that test strips and Narcan be made more widely available. There being no further business, the meeting was adjourned.