Thursday, May 25, 2023
By Zoom Videoconference
Members Present: G. Harriman (Governmental Co-chair), D. Walters (Community Co-chair), B. Fields (Finance Officer), F. Alvelo, R. Babakhanian, K. Banks, R. Brown, M. Caponi, J. Dudley, J. Edwards, R. Fortunato, C. Graham, S. Hemraj, R. Henderson, B. Hribar, M. Lesieur, M. Maia Soares, D. Martin, H. Martinez, L. F. Molano, MD, J. Natt, J. Palmer, L. Sabashvili, J. Schoepp, M. Sedlacek, C. Simon, S. Spiegler (for G. D. Plummer), M. Thompson, T. Troia, S. Wilcox
Members Absent: S. Altaf, M. Bacon, M. Baney, L. Beal, A. Betancourt, G. Bruckno, R. Chestnut, M. Gilborn, J. Gomez, B. Gross, E. Kaywin, W. LaRock, F. Laraque, N. Martin, M. Rifkin
Staff Present: DOHMH: D. Klotz, M. Lawrence, J. Acosta, I. Newman, A. Eppinger-Meiering, K. Mack, R. Torres, R. James, M. Pathak, M. Bayene; Public Health Solutions: G. Ashby-Barclay, A. Shahi; J. Corbisiero (Parliamentarian)
Agenda Item #1: Welcome/Introductions/Minutes/Public Comment
Mr. Harriman and Mr. Fields opened the meeting followed by a roll call and a moment of silence in honor of Long Term Survivors Day. Long term survivors from the Council relayed their experiences living with HIV since the days before effective treatment. The minutes from the April 27, 2023 meeting were approved with no changes.
Agenda Item #2: Public Comment, Part I
Mr. Martin reported that Terry Wilder of SAGE is leading an advocacy effort to have the CDC eliminate the upper age limit (currently 64) for medical providers to automatically offer HIV testing as a part of routine care. Ms. Wilder is seeking adults over 64 who have experienced barriers to testing.
Ms. Walters reported that the NYS Comptroller’s Office has issued guidance that people enrolled in Medicaid can no longer receive means-on-wheels services through the NYC Dept. for the Aging.
Agenda Item #3: EMA Needs Assessment
Ms. Thompson and Mr. Harriman presented the draft EMA Needs Assessment (NA), approved by the Needs Assessment and Executive Committees. Ms. Thompson reviewed the HRSA definition and requirements and noted that the previous NA was done in 2014, and like this one, was a collaboration between the NAC and DOHMH. The 2023 NA has four main sections: 1) Epi Profile, 2) Resource Inventory, 3) Profile of Provider Capacity, and 4) Assessment of Service Needs/gaps. The timeline and process for development of the NA was also presented.
The Epi Profile highlights key HIV epidemiological data from the EMA and examines the HIV-related inequities experienced by PWH and populations disproportionately impacted by HIV. Details of the profile were presented, along with key takeaways, such as that poverty is linked to higher proportions of people being newly diagnosed with HIV and poor HIV-related outcomes. Four recommendations from this section were presented, such as capturing relevant data for all priority populations and explore the social and structural determinants of health.
The Resource Inventory section highlights the RWHAP-funded and other care providers delivering and promoting core medical and support services to address gaps in the HIV care continuum and helps PWH address barriers to viral suppression. The NA found that there is an increasing need for health education, risk reduction, housing services, and medical case management services in the Bronx and Queens. Recommendations include increased support for recipients to offer comprehensive and integrated services, and interventions to support providers in adopting and expanding anti-racism and anti-stigma practices.
Mr. Harriman presented the Provider Capacity section, based on a comprehensive AETC survey, which identifies areas for improvements in workforce capacity, gain knowledge of the workforce (e.g., clinical competency, service efficiency) and defines needed resources. One finding is that respondents who have worked in the HIV field for less than 10 years reported their level of expertise as fair or adequate. Recommendations include that employers should enhance recruitment and retention strategies to increase the representation of communities that are disproportionately impacted by HIV, and that the RWPA program should provide engaging, innovative, and interactive training methodologies to increase provider HIV knowledge and strengthen care delivery.
The Assessment of Service Needs and Gapssection highlights the identified service needs and barriers, provider capacity and capability, and other data such as service utilization, to determine gaps in care by service category and location among specific populations. Recommendations include increased staffing to expand the number of case managers to assist clients in accessing services and streamlined referral services.
The NA identified a number of emerging action items to be addressed in the future, such as HIV outcomes data for special populations (e.g., disabled, unhoused, incarcerated), a list of RW Part B providers, and additional workforce data.
There was discussion on the need for a regularly updated service locator that consumers and providers can use to find services and for referrals. The current PHS locator is out of date and does not include non-PHS managed programs (e.g., Part B or C). DOHMH is working on a Health Map that will cover the range of services. There was also discussion on looking into how staff salaries impact job satisfaction, and more detailed data on sub-populations, particularly people with disabilities.
A motion was made, seconded and approved 25Y-0N to approve the EMA Needs Assessment as presented.
Agenda Item #4: Planning Council Chairs Update
Mr. Harriman reported that the HRSA site visit was conducted last week and they rated the EMA very highly. One finding concerned late payment to subrecipients. Details will be shared with the Council. Yesterday, the DOHMH Division of Disease Control held a full-day Race and Equity Summit, where posters were presented on the Council’s Framing Directive and on the Project ESCALTE anti-stigma project.
Mr. Harriman reported that he is retiring and that his last day as Council director and co-chair will be October 20th. A job posting will be made soon and members were encouraged to spread the word. He expressed his hope that the Council will continue to be led by a person with lived experience. Ms. Walters added that the Executive Committee will be meeting soon to strategize for the transition. Council members expressed their thanks to Mr. Harriman for his dedicated and compassionate leadership.
There being no further business, the meeting was adjourned.