Meeting of the
HIV HEALTH AND HUMAN SERVICES PLANNING COUNCIL
OF NEW YORK
Thursday, December 4, 2025
3:05-5:30pm
Cicatelli Associates, 505 Eighth Avenue, New York, NY
and by Zoom Videoconference
MINUTES
Members Present: D. Klotz (Governmental Co-chair), D. Martin (Community Co-chair), B. Fields (Finance Officer), G. Angelopoulos, R. Babakhanian, M. Baney, J. Benitez, A. Betancourt, R. Brown, G. Bruckno, P. Carr, L. Cyrus, V. Decamps, J. Edwards, L. Francis, M. Gilborn, C. Gomez, C. Graham, S. Hemraj, R. Henderson, M. Maia Soares, L. F. Molano, MD, B. Montes, J, Natt, J. Palmer, G. Plummer (ex-officio), J. Robles, M. Rodriguez, L. Sabashvili, S. Safo, MD, J. Sanchez, J. Schoepp, M. Sedlacek, S. Stallings, D. Tider, A. Tomlin, L. Worrell
Members Absent: M. Bacon, V. Bell, M. Caponi, J. Dudley, R. Ford, J. Goldenbridge, E. Kaywin, J. Louis, DDS, K. Laveille, N. Martin, C. Nuñez, G. Ty
Staff Present: DOHMH: D. Saab, M. Navejas, L. Moya Adames, A. Omeyoma, D. Bickram, Z. Edelstein, PhD, D. Bertolino, A. Eppinger-Meiering, S. Kramer, S. Spiegler, J. Acosta, P. Padgen, R. James, H. K. Muk; Public Health Solutions: A. Shahi; CHAIN: A. Aidala, PhD
Agenda Item #1: Welcome/Introductions/Minutes/Announcements
Mr. Martin and Mr. Klotz opened the meeting followed by introductions and a roll call and a moment of silence. The minutes from the October 30, 2025 meeting were approved with no changes.
Agenda Item #2: Recipient Report
Ms. Eppinger-Meiering reported updates from HRSA and other federal partners, including two annual data reports (2023 ADAP and EHE Data Reports). HRSA announced the upcoming dates of the 2026 National Ryan White Conference on HIV Care and Treatment, to be held August 4-7, 2026. The event will include a virtual platform. A recent Kaiser report showed how the ACA premium subsidies and tax credits have made insurance affordable for millions of people. Loss of the subsidies will result in many losing coverage, and will create a strain on RW services. A new interactive online mapping tool has been launched that visualizes the impact of the HIV epidemic on communities across the U.S. This HIV Impact Calculator models how changes in PrEP coverage and viral suppression rates.
In November, PHS on behalf of DOHMH, released the Ending the HIV Epidemic Initiative: Enhanced Data to Care Request for Proposals (RFP). This RFP solicits proposals from hospitals located in the Bronx, Brooklyn, Manhattan and Queens in neighborhoods with the highest HIV prevalence to implement Enhanced Data to Care programs that utilize HIV surveillance and other data sources to facilitate linkage to, access to, and engagement in care for PWH who have or are at risk of falling out of care, or have never been in care.
The EMA Quality Management Committee met on October 28th. New members from subrecipient organizations in the NY EMA (including Tri-County) recently joined the committee and participated in the October meeting. The BHHS Research and Evaluation Unit presented on the status of the NY EMA clinical quality performance measures focused on viral load suppression for care coordination and food/nutrition services. On December 1, the DOHMH released its 2024 HIV Surveillance Annual Report, which be presented later in this meeting. The data were released on December 1st at the DOHMH World AIDS Day 2025 event at the LGBT Center. DOHMH staff spoke at other events around the City.
Other updates included a DOHMH health advisory about clade I Mpox detected in the US (in California), and updates to the DOHMH Condom Availability Program.
Agenda Item #3: Revised NYC Food & Nutrition Services (FNS) Directive
Mr. Natt introduced the context for a revised FNS directive. The Council has long planned for one large food & nutrition service category that includes services provided under the HRSA non-core “Food Bank/Home Delivered Meals” service category, and the HRSA core “Medical Nutrition Therapy (MNT)” service category. Going forward, the Council must define them separately and they must be reported separately to HRSA. The Integration of Care Committee (IOC) reviewed past service directive for updates, conducted literature review and scan of best practices, received presentations and data from the Recipient, assessed service utilization, client outcomes, and emerging needs, and incorporated findings from needs assessments and community feedback.
Ms. Saab reviewed the HRSA monitoring standards, which have very broad definitions of the two different service categories. The non-core category is the direct provision of food to address food insecurity. MNT is any other form of nutrition services, including counseling, assessment, education and provision of medically tailored meals, all of which requires a registered dietician (RD) or equivalent. The proposed framework for the revised directive’s service model is to delineate the two HRSA categories under one “FNS” umbrella. The non-core service would be called “Food/Meal Services (F/M)” and the core service called MNT. All Ryan White Part A (RWPA) providers would be required to deliver F/M and would be strongly encouraged to provide MNT. This would allow some providers that can address clients’ food insecurity but do not have the resources to hire an RD. The expenditures would be calculated by the Recipient depending on the outcome of the procurement and reviewed by the PSRA Committee for reporting the service category allocations in the Council’s spending plan.
A summary of the changes to the service directive were presented, including updated goals and Integrated Plan objectives. The updates to the service model incorporated feedback from recent consumer and provider listening sessions, literature reviews, informal interviews and presentations from subject matter experts, as well as updates to ensure compliance with HRSA requirements. The revisions clarified the distinction between the Food and Meals Provision and Medical Nutrition Therapy (MNT) components, aligning the directive with federal definitions.
The updated draft emphasizes the importance of nutrition education, client choice, and linkages to external nutrition resources such as SNAP and NYC Health + Hospitals’ Lifestyle Medicine Program to help clients facing immediate food insecurity and mitigate long waiting lists for food services. Additionally, the revisions highlighted the inclusion of culturally relevant food options, seasonal variety, and public-facing educational materials based on MyPlate dietary guidelines to support healthy eating practices.
A newly added section to the revised directive that highlights the integration of digital delivery models to enhance access and client engagement. This section introduces innovative approaches such as app-based grocery vouchers, virtual consultations with registered dietitians or nutritionists, and nutrition and diet tracking tools. Programs are encouraged to adopt tele-nutrition, remote health coaching, and culturally inclusive digital education to better meet clients’ diverse needs and preferences. The directive specifies which digital strategies are most suitable for each service category—Food and Meals Provision (F/M) or Medical Nutrition Therapy (MNT)—to ensure consistency and effectiveness. It also establishes clear requirements for HIPAA compliance, data security, and mobile accessibility, ensuring that clients with limited in-person access can still engage meaningfully with services through digital platforms.
Finally, the directive underscored the need for ongoing coordination with other RPWA services, including Emergency Financial Assistance (EFA), Medical Case Management (MCM) and Psychosocial Support Services (PSS), to promote a holistic and client-centered approach to care.
In the ensuing discussion, points were raised around payor of last resort requirements, ensuring that providers follow requirements around healthy food, and how providers will implement client choice when possible. There was discussion about the capacity of services to meet need, particularly if access to SNAP benefits become more limited. It was clarified that the PSRA Committee will discuss the allocation for the service category as one unified allocation. When the procurement is completed, the Recipient will report on the amounts allocated to F/M and MNT.
A motion was made on behalf of the IOC Committee to accept the Revised NYC FNS Directive as presented. The motion was adopted 34Y-0N.
Agenda Item #4: Revised Tri-County Service Directives
Mr. Palmer and Ms. Cyrus introduced the first three TC service directives approved by the Tri-County Steering Committee (TCSC) over the past year. In 2026, virtually the entire TC portfolio of services will be re-RFP’ed for new programs starting March 1, 2027, necessitating the updating of the service directives for the region. This was an opportunity for the TCSC to align service directives with HRSA requirements, provide up-to-date evidence and community-informed guidance and resources, ensure that updates reflect the needs of PWH and address barriers to care, and integrate innovative service delivery strategies and tools to mitigate access barriers to meet the needs of clients. The TCSC used the same process as IOC to revise the directive.
Ms. Saab explained that key updates made to all directives included applying the NY HIV Planning Council Framing Directive; stronger emphasis on connecting priority populations; reducing stigma, adoption of innovative service models, including telehealth-related strategies; and implementation of a closed loop system to track referrals and verify that clients were indeed linked to supportive services. Highlights of revisions to the service models (which reflect innovations included in recently approved NYC directives) are as follows:
Medical Case Management: Rapid linkage to HIV care and immediate ART (iART) initiation; consistent ART use with motivational interviewing, adherence tools (e.g., pillboxes, apps), and telehealth options like video calls or mHealth technology. Use modified DOT (mDOT) with digital check-ins or incentives across home, field, or virtual settings; and use trained staff to complete a Brief Geriatric Assessment (BGA)to identify aging clients’ needs (e.g., comorbidities, frailty, cognition). Referrals for a Comprehensive Geriatric Assessment (CGA) if needed, and linkage older or isolated clients to Area Agencies on Aging for meals, wellness, and caregiver support.
Oral Health Services: User-friendly services with flexible hours (early mornings, evenings, weekends) and emergency tele-dentistry; monitor alveolar bone status among clients, particularly among older adults over the age of 50 or more and cisgender women; virtual tools for initial and follow-up visits, remote monitoring, and oral health education via mobile apps with real-time feedback; incorporate imaging tools for early detection.
Medical Transportation: The model adds the use of ride-sharing apps (e.g., Uber, Lyft) to the types of transportation that can be used to provide rides to medical and support services. In a response to a question from Mr. Fields, it was noted that it is a requirement from the Framing Directive that all RWPA services be accessible to people with disabilities. In particular, a Transportation provider will be responsible for arranging appropriate transportation for a client who uses a wheelchair.
A motion was made on behalf of the TCSC Committee to accept the Revised Service Directives as presented. The motion was adopted 32Y-0N.
Mr. Klotz thanked Ms. Saab for her exemplary work on the directives and thanked the IOC and TCSC chairs and members for their outstanding work and dedication.
Agenda Item #5: 2024 NYC HIV Epidemiological and Surveillance Report
Dr. Edelstein and Mr. Bertolino presented the recently released 2024 NYC HIV surveillance data (Tri-County data will be reported by the NYS AIDS Institute in March to the TC Steering Committee), starting with a graph showing the trend of new HIV and AIDS diagnoses and deaths since the beginning of the epidemic in 1981. In 2024, there were 1791 new HIV diagnoses (333 concurrent with an AIDS diagnosis), 1511 deaths, and 91,300 total PWH. The long decline in the number of new HIV diagnoses stalled after 2020 and in 2024 went up 5% from 2023. The vast majority of new diagnoses was among Black and Hispanic men who have sex with men. These were also the only groups where the number of new diagnoses trended upwards. The proportion of these groups among all PWH is disproportionately larger than their share of the overall population. New cases are also concentrated in neighborhoods with higher poverty levels, particularly in central Brooklyn, the south Bronx and upper Manhattan. New diagnoses were almost event split between US-born and those born outside the US.
The percentage of PWH with timely initiation of care (within 30 days of diagnosis) went up from 77% in 2019 to 80% in 2024, and the overall viral suppression rate went from 83% to 86%, but progress was uneven. Transgender women, Blacks and younger people were less likely to be virally suppressed. Lower VLS rates also correlated with neighborhoods with higher poverty rates. Overall, 81% of all PWH are estimated to be virally suppressed. Of those known to be HIV-positive, NYC is close to meeting 95% UN goals of 88% on ART and of those, 97% virally suppressed. The age-adjusted death rate has fallen from 9.5 to 7.1 since 2019 (with a temporary increase in 2020 due to COVID). The death rates are higher for transgender women, Black people and those in high poverty neighborhoods. 19% of the deaths among PWH in 2023 were HIV-related. Overall, the data shows the need to continue and strengthen efforts to support and increase equitable HIV prevention, testing and care. Dr. Edelstein noted that since the start of the NYS Ending the Epidemic (ETE) initiative in 2015, there have been substantial improvements in the numbers of new diagnoses and health outcomes measures. A summary of the discussion follows:
- The HIV Surveillance Unit sends its ACE Team to interview newly diagnosed to get data that will reduce the number of “unknowns” in the various measures. Some interviewees refuse to answer some questions.
- Data is needed on the amount of time since initial diagnosis when someone enters care or reaches VLS.
- The COVID pandemic caused dips in the number of people diagnosed as well as attaining VLS. This is likely due to reduced access to testing and care during the pandemic.
There being no further business, the meeting was adjourned.
