Planning Council Meeting Minutes June 27, 2024

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Thursday, May 23, 2024

3:05-4:30 PM

By Zoom Videoconference

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

Members Absent: M. Bacon, M. Baney, G. Bruckno, M. Caponi, J. Edwards, J. Gomez, F. Laraque, W. LaRock, H. Martinez, J. Roman, C. Simon, M. Thompson, G. Ty, S. Wilcox

Staff Present: DOHMH: D. Saab, J. Klein, S. Spiegler, J. Acosta, A. Eppinger-Meiering, K. Mack, M. Dorsheimer, P. Padgen; Public Health Solutions: 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 May 23, 2024 meeting were approved with one minor change.  

Mr. Klotz introduced the Council’s new community planner, Jeff Klein, who begin on June 3rd and is supporting the Consumers and Integration of Care Committees.

In honor of Pride Month, Ms. Saab presented on lesser known LGBTQ+ trailblazers in the fight against HIV. The presentation was created by the Council’s summer intern, Roya Barakzai.

Ms. Saab thanked Mr. Schoepp for helping with outreach on behalf of the Council at a community event held by the DOHMH HIV Prevention Program in Jackson Heights.

Agenda Item #2: Call for Nominations for Finance Officer

Mr. Klotz announced that at its July 25th meeting, the Council will hold an election for Finance Officer for a two-year term beginning September 1, 2024 and ending on September 1, 2026. Any full voting member who is not a representative of a governmental agency is eligible to run for election to the position. Please submit nominations to me e-mail. You may nominate yourself. A description of the position from the Council’s bylaws was given.

Agenda Item #3: Recipient Report

Ms. Eppinger-Meiering reported news from HRSA and other federal agencies, including observing HIV Long-Term Survivors Awareness Day and National HIV Testing Day, as well as Pride Month. HRSA also released a letter providing guidance on how Ryan White funds may be used to provide expungement services for PWH who have had legal system involvement. The expungement of criminal records is an effective way to remove barriers to care and services, protect privacy, mitigate stigma, and support successful reentry into the community.  

Mr. Klotz added that HRSA announced yesterday that Ryan White funds can now be used to pay security deposits, which was long sought by the communities. This will help overcome a major barrier to securing stable housing for clients.

Ms. Eppinger-Meiring continued that on June 25th, Public Health Solutions (PHS), on behalf of DOHMH Bureau of Hepatitis, HIV, and STIs (BHHS) released the Ryan White Part A (RWPA) Behavioral Health Services for PWH in NYC and Non-Medical Case Management Services for Currently and Recently Incarcerated PWH in New York City Request for Proposals (RFP). This funding opportunity intends to fund 27 behavioral health subawards under three RWPA behavioral health service categories (i.e., Mental Health Services, Supportive Counseling Services, and Harm Reduction Services) at a total of $13,203,171 annually and one RWPA Non-Medical Case Management Services for Currently and Recently Incarcerated PWH subaward at a total of $1,436,644 annually.

Last month, the Recipient submitted the GY 2023 Annual Progress Report to HRSA, which provides a summary of the EMA’s progress in meeting program goals and other RWPA requirements, including updates on service categories and the HIV Care Continuum; Planning Council activities; Early Identification of Individuals Living with HIV/AIDS (EIIHA); the Minority AIDS Initiative Annual Report; certification of aggregate administrative expenditures; and Women, Infants, Children, and Youth (WICY) expenditures reports.

On May 14, the NYC Health Department released the Housing Opportunities for Persons with AIDS (HOPWA) Single Adults RFP. The RFP intends to fund up to 20 qualified not-for-profit organizations to provide supportive permanent housing in New York City to very low-income PWH for a period of nine years (July 1, 2025, to June 30, 2034), with no options for renewal.

On May 30, the Quality Management and Program Implementation (QMPI) Unit of the HIV Care and Treatment Program (CTP) facilitated the first ever Category Showcase, focusing on housing services. The Showcase, a new virtual event, offers subrecipients the opportunity to build knowledge, awareness, and understanding about the array of services offered in the New York EMA. The 2024 Ryan White Part A All-Provider Meeting is around the corner, taking place on July 16 in Manhattan at Baruch College. Important updates and helpful information for subrecipients will be shared throughout the day.

On July 22nd, members of both BHHS HIV-related stigma groups (EHE and ESCALATE) are joining forces to host an event at DOHMH for Zero HIV Stigma Day, a new observance centered around raising awareness on how HIV-related stigma affects allcommunities. There were also brief updates on various policy issues, such as NY State legislation on HIV testing and insurance discrimination, and federal HIV appropriations.

Agenda Item #4: GY 2023 into 2024 Carryover Plan

Ms. Gilborn and Ms. Plummer presentedthe carryover plan for the unexpended funds from the previous year (GY 2023) for use in the current year. Ms. Plummer explained that HRSA usually does not approve the plan until the fall, leaving a short time frame for providers to spend the funds. Any unspent carryover is deducted from the following year’s award as a penalty. All carryover must be used for program services benefiting PWH (i.e., no grant administration or quality management activities). As presented at the last Council meeting, there is $2,294,4212 available for carryover (about $600,000 less than the previous year).

Ms. Gilborn explained that, based on the Recipient’s analysis of need and the ability of programs to spend the money, the recommendation is to use the funds for Housing and Food & Nutrition Services (both NYC and Tri-County). The proposed breakdown is:

  • Short-term rental assistance (NYC) = $798,216
  • Short-term housing (NYC) = $816,264
  • Short-term rental assistance (Tri-Co) = $205,896
  • Food and Nutrition Services (NYC) = $401,115
  • Food and Nutrition Services (Tri-Co) = $72,930

Any funds that cannot be spent in those categories would be allocated to the ADAP Program. The PSRA Committee approved the plan unanimously last week.

Ms. Plummer noted that the Council will need to address the issue of rising costs for housing and food services when considering new baseline allocations in future years.

On behalf of the PSRA Committee, Ms. Gilborn moved to accept the GY 2023 into 2024 carryover plan as presented.  The motion was adopted 26Y-0N.

Agenda Item #5: GY 2023 Assessment of the Administrative Mechanism

Mr. Fields introduced the GY 2023 assessment of the administrative mechanism, explaining that the assessment is a legislative requirement that planning councils assess whether Ryan White Part A grant funds are being expended according to the Council’s priorities and allocations, and whether funds are being rapidly disbursed to the community. The assessment is for the 2023-24 grant year and contains findings related to four areas: 1) Executed Contracts/Renewals, 2) Procurement, 3) Subcontractor Payments, and 4) Spending.  The draft assessment is based on information presented to the EC and PC through quarterly spending reports and monthly Recipient reports, as well as fiscal information provided from the Recipient. Overall, the findings are positive, particularly in the areas of spending and procurement. Mr. Klotz reviewed the text of the draft assessment’s findings.

The Recipient and PHS have taken concrete steps to address the findings of the GY 2022 assessment of the administrative mechanism. Through TA sessions with HRSA, effectively addressed issues affecting timely contract executions and subcontractor payments. the Recipient provided results of the procurement process for Housing Services, including new contract lists to the Council in the Recipient Report. Public Health Solutions has made the results publicly available online and they have been incorporated into the Recipient’s revised RWPA Referral Directory. The Recipient has also kept the Council informed of the ongoing procurement process for Non-Medical Case Management and Behavioral Health services. Commitments are consistent with the Council’s approved spending plan.

The Recipient reported spending for the 2023-2024 Ryan White Part A grant year for the 2nd and 3rd quarters, and through a final closeout report on 5/16/2024 to the Executive Committee and on 5/23/2024 at the full Council meeting. The final expenditure report results showed that most program funds had been expended. Explanations for underspending in categories were provided, as well as a report on reprogramming amount by service category. Unspent program and administrative funds will be carried over into GY 2024 and used for program services. In GY 2023-24, spending improved over the previous year, when underspending was still greatly impacted by the COVID-19 pandemic. While underspending was still higher than historical levels, the trend is in the right direction, with underspending about $600K less than the previous year.

Mr. Lesieur, Mr. Babakhanian and Mr. Fields commended Ms. Plummer and the Recipient team for the significant improvement in the management of the grant and the collaboration with the Council. Ms. Plummer thanked the Council and noted the large effort by many people at DOHMH and PHS who worked to improve the administration of the grant.

Mr. Fields made a motion, which was seconded, to accept the GY 2023 assessment of the administrative mechanism as presented.  The motion was adopted 26Y-0N.

Agenda Item #6: Committee Updates

Consumers Committee

Ms. Graham and Mr. Maia reported that the Consumers Committee developed a plan to facilitate a 90-minute breakout session during the July Quality Improvement provider workshop on Consumer Advisory Boards (CABs). The plan includes small group discussion to allow shared knowledge and community building among participants. The session will also incorporate the recipient’s recent survey results with data regarding the current state of CABs among RWPA programs and provide resources for best practices to uptake and implement CABs.

Needs Assessment Committee

Mx. Kaywin reported that the Needs Assessment Committee concluded its review of data on the topic of improving access to HIV services for people involved in sex work, a population that was identified in the 2022 full Needs Assessment. The Committee is now in the process of developing recommendations for RWPA providers on serving this population.

 Integration of Care Committee

Mr. Hemraj reported that the IOC Committee reviewed and discussed a revised Emergency Financial Assistance (EFA) services directive which incorporates updated language from the current NY State Integrated HIV Care and Treatment Plan as well as mandating spending through at least one service site located within the five boroughs of NYC (currently only 1 provider located in the Tri-county region serves the entire EMA).

Priority Setting and Resource Allocation

Ms. Gilborn reported that the PSRA Committee is developing the spending request for the GY2025 grant application. The EMA is allowed to request up to 5% more than the current grant year’s award. The Committee has been reviewing data on service categories with a history of underspending and/or lower than expected enrollment and will receive data on categories with unmet need that can absorb additional funds to increase capacity.

Tri-County Steering Committee

Mr. Altaf and Mr. Palmer reported that the TCSC is also developing the GY 2025 application spending plan for their portion of the EMA. The Committee has had several presentations on unmet need for housing services in the region. Stable housing for PWH remains a critical and underfunded need in the region, particularly as there is no equivalent of HASA in any of the three counties. It was noted that the fair market rents in Tri-County are higher than in NYC and that there is no equivalent of HASA in the region.

Joint HPG/Council Policy Committee

Mr. Lesieur reported that the JPC approved advocacy letters regarding emergency wheelchair repair and the City’s asylum seeker response efforts. The June meeting was cancelled in order to allow members to participate in National HIV Testing Day activities. Also, a subcommittee of the US House Appropriations Committee is proposing drastic cuts to many programs, including Ryan White and Ending the HIV Epidemic. These cuts are not likely to survive negotiations with the Senate and White House.

Rules & Membership Committee

Dr. Molano reported that the RMC met on Monday to review applications for Council membership for the term that begins in the fall. There were 17 applications, representing a diverse range of backgrounds and experience. Candidate interviews will be conducted in early July and a slate of candidates presented to the Executive Committee on July 18th.

Agenda Item #7: Co-chairs Update

Mr. Klotz reviewed the work to be completed in the final Planning Council meetings of the session. In July, in addition to the election for Finance Officer, there will be a review and approval of the GY 2025 application spending request, approval of a revised Emergency Financial Assistance service directive, and recognition of retiring members. Also, the Council was reminded that the annual member recognition event will take place on Friday, August 9th, 1-4pm at Riverbank State Park. Family members, significant others and pets are welcome.

Agenda Item #8: Public Comment

Mr. Babakhanian expressed the need to address the “clientization” and infantilization in service delivery where users of services are not seen in their full humanity, often unintentionally.

Mr. Klein added that there are studies about the medicalization of services, where the focus is only on clinical outcomes, rather than the holistic care. He expressed his intention to address this specifically when the service directive for Medical Case Management/Care Coordination is revised.

Mr. Maia encouraged people to stop by ACT-UP’s booth at Harlem and NYC Pride this weekend, where they will provide MPox vaccines, fentanyl test strips and other health resources. There being no further business, the meeting was adjourned.