Thursday, April 25th, 2025
2:50-5:05pm
By Zoom Videoconference
Members Present: D. Klotz (Governmental Co-chair), D. Martin (Community Co-chair), B. Fields (Finance Officer), R. Babakhanian, G. Bruckno, P. Carr, L. Cyrus, J. Dudley, L. Francis, J. Goldenbridge, M. Gilborn, S. Hemraj, R. Henderson, M. Maia Soares, L. F. Molano, MD, B. Montes, J, Natt, C. Nuñez, J. Palmer, G. Plummer (ex-officio), L. Richberg, M. Rodriguez, L. Sabashvili, J. Schoepp, M. Sedlacek, S. Stallings, A. Tomlin, T. Troia, G. Ty
Members Absent: M. Bacon, M. Baney, R. Brown, M. Caponi, V. Decamps, J. Edwards, R. Ford, R. Fortunato, E. Kaywin, F. Laraque, W. LaRock, N. Martin, H. Martinez, J. Roman, S. Safo, MD
Staff Present: DOHMH: D. Saab, S. Spiegler, J. Acosta, A. Eppinger-Meiering, G. Gambone, B. Tsoi, MD, R. James, T. Colby, T. Leong-Pelrine, S. Kramer, A. Omeyoma, K. Mack, H. K. Mok, P. Padgen, A. Drab; Public Health Solutions: B. Silver, A. Shahi, G. Ashby-Barclay
Agenda Item #1: Welcome/Introductions/Minutes/Announcements
Mr. Martin and Mr. Klotz opened the meeting followed by a roll call and a moment of silence. The minutes from the March 27, 2024 meeting were approved with no changes.
Agenda Item #2: Public Comment, Part I
Mr. Schoepp reported that the Consumers Committee’s Client Advisory Board Town Hall held on April 15th had about 70 attendees who brought energy and enthusiasm. The ideas developed at the event will be compiled into a written report to be distributed to all stakeholders.
Mr. Omeyoma reported that the Bronx AIDS Task Force will hold a march on May 8th to protest cuts to essential HIV services.
Ms. Colby announced that for sexual health education month, there will be a lunch & learn on May 22nd to promote comprehensive sex ed is schools.
Agenda Item #3: Recipient Report
Ms. Eppinger-Meiering reported that HRSA announced this week that EMAs will receive a 2nd partial award worth 41% of Base and 27% of MAI funding. Final awards will be processed as soon as HRSA receives the full GY 2025 appropriation amount for this program. Ms. Plummer assured subrecipients that the priority for the partial award is to ensure continuous operation of programs. In other news from HRSA, there was a commemoration of the life of Ryan White and observances if National Youth HIV Awareness Day and National Transgender HIV Testing Day.
Updates were provided on the concept paper for NYC Care Coordination, Outpatient Ambulatory (HIV & Aging) and Emergency Financial Services categories, as well as Ending the HIV Epidemic (EHE) funds to support effective and innovative strategies, interventions, approaches, and services to reduce new HIV infections in the Bronx, Brooklyn, Manhattan, and Queens. The EMA’s Quality Management Program is planning for the annual RWPA all-provider meeting on July 29th, which will include a workshop by the Council’s Consumers Committee.
The NYC City Council passed a “HASA for All” bill to expand eligibility to all people with HIV, not just symptomatic PWH. The legislation awaits the Mayor’s signature. BHHS released an updated “Living Sure” marketing campaign to encourage cisgender and transgender women to consider PrEP, and released new posters and postcards on HIV testing, treatment, PrEP, emergency PEP, doxy PEP, and condoms. Finally, BHHS released provider-facing technical assistance resources on long-acting injectables for HIV treatment.
Agenda Item #4: Ending the HIV Epidemic 047 Prevention Grant Workplan
Dr. Tsoi presented an overview of the DOHMH CDC cooperative agreement for grant-funded HIV prevention programs, which includes NY’s federal EHE 047 prevention grant, which covers Manhattan, Brooklyn, Bronx and Queens (as designated by the federal government). The grant will address social and structural factors such as whole-person approaches to HIV prevention, health equity, and syndemic approaches to prevention. Strategies fall under six broad areas: diagnose, treat, prevent, respond, HIV surveillance, community engagement. Proposed activities under each area were described (e.g., Diagnose – fund non-clinical community organizations to conduct outreach and HIV testing in community settings). Reporting requirements were outlines (e.g., monthly surveillance data, annual performance report), and challenges presented (most notably, a loss of $4M from previous CDC HIV prevention grants).
There were questions from the Council on the procurement process for programs subcontracted to community-based organization, community input into planning, the state of condom distribution efforts, HIV testing in non-traditional venues (more difficult now due to the changed nature of those venues), investigation and response to HIV clusters and outbreaks (limited by the availability of lab data from genotype tests and the ability to contact partners), and the impact of layoffs and reorganization at the CDC and the possibility of significant funding cuts in the future.
Agenda Item #5: GY 2025 Reprogramming Plan
Mr. Carr presentedthe GY 2025 reprogramming plan, which maximized the expenditure of grant funds that become uncommitted during 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. Carr made a motion on behalf of the PSRA Committee to approve the GY 2025 reprogramming plan as presented. The motion was adopted 24Y-0N.
Agenda Item #6: Revised Service Standards
Ms. Saab and Ms. Eppinger-Meiering presented an overview of HRSA-required service standards. Service standards outline minimal elements and expectations a RWPA service provider follows when implementing a specific service category, including service models and performance measures. They are a shared responsibility of recipients and planning councils, where recipients draft or revise Service Standards, then reviews and approves them with the council. They should be revised when needed (e.g., after a new service directive is approved and an RFP process completed). Elements included in the standards are: 1) service category definition, 2) service components, 3) staff qualifications, 4) intake and eligibility, 5) transition and discharge, and 6) case closure protocol. Standards are used by recipients to ensure services are provided to clients consistently across funded service providers, and to establish the consistent framework of service provision from which processes and outcomes are measured for quality management. Language for service standards comes from pre-existing sources: 1) Ryan White legislation and HRSA guidance, 2) Planning Council service category directives, 3) DOHMH HIV Care & Treatment Program/PHS requests for proposals (RFPs). There is no new language in the service standards and they are meant to fulfill a HRSA requirement. Revised standards are needed for the following service categories that have had recent revised Council directives and completed RFPs: Behavioral Health (Mental Health, Harm Reduction, Supportive Counseling), Housing and Ambulatory Outpatient Care (HIV & Aging).
Ms. Eppinger-Meiering reviewed the text of the Housing service standard, noting that some is boilerplate language used for all service categories (e.g., case closure, grievance procedures). A sample standard (Harm Reduction) was reviewed in depth showing individualized goals (from the Council’s directives), program enrollment criteria (from the Council’s directives), service types (from the Council’s directives with details from RFPs), and staffing plans (from RFPs). Language regarding discharge/case closure and grievance procedures are taken from HRSA guidance and are the same for all categories.
Mr. Hemraj made a motion on behalf of the IOC Committee to approve the service standards as presented. The motion was adopted 22Y-0N.
Agenda Item #7: 2025 Quality Management (QM) Plan Update
Ms. Gambone presented an overview of the EMA’s Quality Management program, including 2024 accomplishments and challenges. 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. Principle aspects of the 2023026 QM plan: health equity, consumers engagement, collaboration and coordination, capacity building, service engagement, and service quality.
QM program accomplishments in 2024 were described, including: 1) QM Committee met five times throughout the year with high attendance; 2) CTP launched 15 new housing programs and prepared for launch of five new service categories (total of 27 new programs; 3) seven QI trainings delivered to subrecipients and consumers; 4) multiple trainings and webinars on consumer involvement in QI, QI methods and tools – at different levels, throughout the year; 5) two QI project sharing sessions for subrecipients and consumers; 6) 100% of subrecipients with a required QI project or QM plan deliverable submitted; 7) multiple evidence-based intervention (EBI) trainings (Trauma Basics and Seeking Safety, Healthy Conversations); 8) four-day Care Coordination Core Orientation delivered three times during the year; 9) innumerable refreshers and open forums (“office hours”) with providers for various service categories; and 10) quarterly HAB measures presented annually. Sample QI projects were described, such as “Increased Client Participation in Case Conferences” at APICHA. The annual RWPA Provider Meeting in July 2024 had a theme of “Strengthening Collaboration and Consumers Engagement” and included a workshop on CABs conducted by the Consumers Committee.
Accomplishments under the individual QM program priorities and goals were presented (e.g., listening sessions with providers and consumers of Care Coordination and Outpatient Ambulatory Services to inform new RFP under the Equity and Consumer Engagement goals). Extensive work was done on CABs, including the provider survey, the workshop and a webinar with CAB members. There were also trainings for providers specifically on consumer involvement in QI. Other highlighted accomplishments included the new Google Maps and updated Referral Directory, enrollment reports, sharing sessions, evaluations and ongoing support.
Challenges from 2024 include: procurement schedule and number of categories rebid every year; agency hiring delays; uncertainty about the future of Ryan White funding and the rising cost of doing business for subrecipients. Specific project challenges include: new racial equity and stigma training, developing new quality indicators for FNS, and using Salesforce to streamline communications.
Next steps for 2025 are: 1) intensive support to 27 new behavioral health programs; 2) streamlining QM plan guidance and plan template for providers; 3) more focus on hands-on QI support via the series of “Linking Minds – Improving Care” workshops and follow-up calls; 4) seven QI trainings to be offered throughout the year, including a new training (“Enhancing Consumer Engagement & Incorporating Feedback into QI Efforts”); 5) engaging more providers through the QM Committee; and 6) annual RWHAP Part A Provider Meeting on July 29th (including a Consumers Committee-led breakout session).
In response to a questions, Ms. Gambone explained that the program is unable to hold one large meeting like the former Power of QI conference, which included both providers and consumers, but there are more frequent and smaller meetings are being held, such as the sharing sessions. Also, HRSA only allows incentives to clients for engagement in services, and those incentives can not be cash or unrestricted cash cards. Mr. Babakhanian stated that more people with lived experience are needed on the QMPI and Recipient staff. It was noted that there are laws against asking about a potential employee’s HIV status, and candidates would have to self-disclose voluntarily.
The QM Unit was commended for their comprehensive and outstanding work to improve the quality of RWPA services and to center the experiences of clients.
Agenda Item #8: Public Comment, Part I
Mr. Maia noted that this year is the 200th anniversary of the NYC Health Department and that it is vital to defend the programs that support public health.
Mr. Klotz invited Council members to join the Rules & Membership Committee, which will soon undertake the annual appointments process.
There being no further business, the meeting was adjourned.
