Planning Council Meeting Minutes May 23, 2024

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Thursday, May 23, 2024

3:05-5:00 PM

By Zoom Videoconference

Members Present: D. Klotz (Governmental Co-chair), B. Fields (Finance Officer), R. Babakhanian, M. Baney, K. Banks, G. Bruckno, P. Carr, J. Dudley, J. Edwards, C. Graham, R. Ford, S. Hemraj, R. Henderson, E. Kaywin, W. LaRock, M. Lesieur, N. Martin, M. Maia Soares, L. F. Molano, MD, J. Palmer, M. Rodriguez, J. Roman, L. Sabashvili, J. Schoepp, M. Sedlacek, C. Simon, G. D. Plummer (ex-officio), T. Troia

Members Absent: S. Altaf, M. Bacon, R. Brown, M. Caponi, V. Decamps, R. Fortunato, M. Gilborn, J. Goldenbridge, J. Gomez, F. Laraque, D. Martin H. Martinez, M. Thompson, G. Ty, S. Wilcox

Staff Present: DOHMH: D. Saab, S. Spiegler, J. Acosta, A. Eppinger-Meiering, S. Kramer, A. Guzman, K. Mack, M. Dorsheimer, P. Chan, J. Jaramillo, J. Carmona; Public Health Solutions: R. Santos

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 April 25, 2024 meeting were approved with no changes.  

Mr. Klotz announced that the Council’s new community planner, Jeff Klein, will begin on June 3rd. Mr. Klein will support the Consumers and Integration of Care Committees. Also, the Zoom link for all Council meetings will change effective June 1st. The link has been sent out to the public and is on the Council website. The new website vendor’s contract has been registered and they are working on migrating the site and making updates. Also, the Council’s food purchase order has been approved, which will allow the Consumers Committee to hold an in-person meeting on June 17th. Finally, Council members were asked to save the date for the member recognition event on August 9th in Riverbank State Park in Harlem.

Agenda Item #2: Recipient Report

Mr. Klotz reported that the final notice of GY 2024 grant award was received this morning from HRSA. The total amount of the award was reduced from last year by $1,291,062. The PSRA Committee and Council had planned for such a possibility and approved a spending scenario methodology in January that accounted for an even larger potential cut. With the savings in the carrying costs of programs from GY 2023 into GY 2024, the only cuts that need to be made this year are minor reductions to the ADAP category (even taking into account a one-time enhancement to NYC Housing programs). ADAP will recoup those funds this year through reprogramming and carryover. The bulk of the reductions are in the formula-driven awards, which are driven by the number of people with HIV in our EMA relative to the other 51 EMAs across the country, thus a reduction is ironically a measure of our success in taking steps to end the epidemic.

Ms. Eppinger-Meiering reported news from HRSA and other federal agencies, including observing National Asian/PI HIV Awareness Day, a new CMS fact sheet on Medicare Part B coverage of PrEP, a webinar on innovative HIV care strategies for priority populations, and a funding opportunity for health center support for people leaving incarceration.  

There were announcements on a new HOPWA RFP for supportive permanent housing for single adults with HIV. The Quality Management and Program Implementation Unit (QMPI) Committee launched a new virtual forum for RWPA subrecipients to learn more about program services, resources to assist in service delivery, and evidence-based interventions related to a specific service category. QMPI and the Consumers Committee partnered to develop an informational survey for all subrecipients to complete regarding the status of Consumer Advisory Boards (CABs) and other forms of community engagement activities taking place at subrecipient agencies. The results were presented for discussion at the Consumers Committee Meeting on May 21st.

Agenda Item #3: Revised Service Directive: Early Intervention Services

Mr. Hemraj presentedthe revised service directive for Early Intervention Services (EIS), reviewing the HRSA-defined allowable services and noting that all EMAs must have an “early identification of individuals with HIV” (EIIHA) plan, which is scored in the grant application. EIS is the only category that can serve HIV-negative/unknown people, but for those who test negative, services are limited to basic HIV prevention education and referral to PrEP/PEP. The program goals and objectives were outlined and the service model described. Testing in the community should be done at venues where people from communities with higher incidence rates gather. The revised model also emphasizes immediate initiation of ART for those who test positive, with linkages to long-term treatment adherence support. One major change is no longer differentiating between testing in clinical and non-clinical sites. All EIS providers will be expected to conduct the full range of activities described in the directive. Mr. Klotz reviewed the text of the directive, pointing out the principal areas of revision. The directive will be implemented with the rebid of the program for GY 2025.

On behalf of the IOC Committee, Mr. Hemraj moved to accept the GY 2024 reprogramming plan as presented.  The motion was adopted 23Y-0N.

Agenda Item #4: GY 2023 4th Quarter Closeout Report

Mr. Fields introduced the GY 2023 4th quarter closeout report. The bottom line of the report is the total amount of underspending, which is available for use as carryover in the current grant year. The good news is that the total underspending is $2.3M, less than the previous year, which had $2.9 million underspent. The PSRA Committee will develop a plan for the use of the carryover funds for presentation to the EC in June. Ms. Plummer presented the details of the report, explaining areas of less than 90% spending.

The Non-Medical Case Management category was underspent due to ongoing challenges with staffing. DOHMH and Public Health Solutions (PHS) are working to create better incentives for staff hiring and retention. EIS programs (NYC Base and MAI, Tri-county) were underspent due to challenges in the RWPA/CTL combined PlaySure Network 2.0 program. The problems with the service model were presented to the IOC Committee when they developed the revised service directive for this category. Ambulatory Outpatient Care/Aging PWH was underspent considerably due to a combination of start-up and that one provider did not submit invoices on time. Ms. Plummer stressed that it was a challenge ensuring that this provider submitted for reimbursement on time. She also noted that this category is managed directly by DOHMH and not PHS. Health Education/Risk Reduction, Supportive Counseling and TC Legal Services were all underspent due to contract terminations. Unspent funds were reprogrammed as per the Council’s plan, with significant amounts going to enhance the ADAP program. NYC Oral Health programs were underspent due to payer of last resort issues and most services being paid by Medicaid. Mr. Carr noted that the Oral Health directive included a DOHMH-based dental case management component. More detailed information on Oral Health will be presented at the PSRA Committee in June.

Ms. Plummer noted that the final amount available for carryover will be slightly adjusted with final reconciliation in time for presentation at the Council meeting next week. She also commended PHS for working together to improve the timeliness of reporting and has strengthened contract terms to ensure timely submission for reimbursement. She added that the Recipient is taking steps to reduce data burden and shorten intake forms per the Council’s Data Workgroup recommendations. There will be a report to the Council in the fall. Finally, the Recipient is urging subrecipients to pay living and equitable salaries to entice workers back to social services.

Agenda Item #5: Committee Updates

Brief committee updates were given, including the following highlights:

  • The Consumers Committee is incorporating the CAB survey results, as well as the experience presenting on CAB best practices to a retreat of the ACQC CAB into the presentation to providers at the July RWPA QM meeting. The Committee wants to make a persuasive case that CABs are the optimal avenue for consumer engagement, feedback and program improvement.
  • The Needs Assessment Committee is exploring the challenges faced by people who engage in sex work regarding access to HIV and health services.
  • The Rules & Membership Committee will be reviewing applications for membership in June and July. The Committee is particularly seeking applications from consumers, Black and Hispanic communities, and people who live in Queens.
  • The Integration of Care Committee will next work on revising the directive for Emergency Financial Assistance.
  • The Tri-County Steering Committee, in preparation for the creation of an application spending plan, received presentations on TC housing services and will be getting another on efforts to create a HASA-like program for the entire State. The Committee and/or full Council may want to weigh in with an advocacy letter on pending legislation.

Agenda Item #6: HIV Policy Update

Mr. Guzman presented an update on HIV-related policy issues. The NYS AIDS Institute released “PrEP: Coverage, Compliance and Ending the Epidemic”, a report on how federal and state-based health insurance marketplace plans communicate their coverage of PrEP and related services. The report found that of all plans surveyed, significant numbers do not include PrEP on a preventive service list or include information about the availability of cost-free PrEP. PrEP4All is advocating with Congress to appropriate funds for a national PrEP program. Also, NASTAD updated its US HIV Data Protection Landscape interactive map. Relatedly, NYC DOHMH is working with The Center for HIV Law and Policy to analyze local and state legislation, regulations, and policies governing disclosure of HIV-related data. The White House appointed Fancisco Ruiz, as Director of the White House Office of National AIDS Policy. Mr. Ruiz is a PWH and first Latino in the role.

There were a number of updates on elimination of syphilis, including NY State updated resources on syphilis screening during pregnancy, and a new website for a project on pharmacists’ role in STI prevention and treatment. There were updates on viral hepatitis, including a CDC surveillance report showing a sharp decrease in incidence of hepatitis A and significant racial disparities in incidence of hepatitis B and C. The Governor announced the third annual LGBTQ+ Convening to bring advocates together from across the state to discuss policy issues of concern to those communities. NYS DOH updated its monthly dashboard on program transitions for Medicaid and other health plans.

The Council/HPG Joint Policy Committee issued advocacy letters to the Mayor’s Offices of Immigrant Affairs and Asylum Seeker Operations to improve HIV and sexual health services for new arrivals. They also sent a letter to NYC Council members and borough presidents calling on the City to support emergency wheelchair repairs. NYC and NYS budget updates were provided. The Mayor’s FY 2025 executive budget, while the largest in NYC history, includes a $5.7M reduction to City HIV contracts. This will have an impact on a number of programs, including PlaySureNetwork2.0 and the crystal meth harm reduction services. There being no further business, the meeting was adjourned.