Thursday, November 19, 2020
By Zoom Videoconference
M I N U T E S
Members Present: G. Harriman (Governmental Co-chair), D. Walters (Community Co-chair), P. Carr (Finance Officer), A. Abdul-Haqq, S. Altaf, F. Alvelo, M. Bacon, M. Baney, D. Beiling, L. Best, A. Betancourt, R. Brown, R. Bruce, M. Caponi, R. Chestnut, E. Casey, B. Cockrell, M. Diaz, M. Domingo, J. Dudley, J. Edwards, B. Fields, R. Fortunato, M. Gilborn, C. Graham, B. Gross, D. Martin, J. Natt, G. Plummer, D. Powell, J. Reveil, M. Rifkin, L. Ruiz, S. Sanchez, J. Schoepp, C. Simon, A. Straus, M. Thompson, R. Walker
Members Absent: P. Canady, B. Fenton, MD, T. Frasca, A. Lugg, M. Mañacop, C. Reyes, A. Roque, F. Schubert, M. Singh, T. Troia, B. Zingman, MD
Staff Present: DOHMH: D. Klotz, M. Lawrence, A. Azor, J. Acosta, A. Guzman, J. Colón-Berdecía, K. Miller, J. Carmona, K. Mack, E. Jimenez-Levi, D. Ferdinand, B. Khan, B. Meisel, A. Thomas-Ferraioli; Public Health Solutions: B. Carroll, G. Kaloo; J. Corbisiero (Parliamentarian)
Agenda Item #1: Welcome/Moment of Silence/Introductions/Minutes
Ms. Walters and Mr. Harriman opened the meeting followed by introductions and a moment of silence. The minutes of the October 29, 2020 meeting were approved with no further corrections.
Mr. Harriman reported that earlier this week the Executive Committee engaged in a discussion on the direction of the Planning Council’s new planning cycle. Council work will need to accommodate itself to the COVID-19 pandemic and will take time to implement any proposed changes. Major areas of focus include: 1) Promote an anti-racist and stigma-free care environment to reduce HIV related health inequities; 2) Further incorporate the voices and needs of marginalized populations; 3) Improve data collection and use of data within Ryan White Part A and across bureaus and funders; 4) Implementation science and evidence-based practices; 5) Quality Management; 6) Advocacy; 7) working within the framework of the Status-Neutral Continuum of Care; and 8) Planning Council Administrative Efforts.
Ms. Best expressed her enthusiasm for this direction and urged Council members to also undertake personal work on implicit bias, which affects everyone.
Agenda Item #2: Recipient (Grantee) Update
Ms. Plummer reported that On November 19, HRSA/HAB’s Data Integration, Systems and Quality Team will host a participant-led discussion for Epic users to share best practices and challenges in data management. HRSA’s World AIDS 2020 Virtual Commemorative Event will take place on December 1st at 11:00am, with the year’s theme is “Ending the HIV Epidemic: Resilience and Impact.”
The Grantee is finalizing the Request for Proposals (RFP) for the Psychosocial Support Services (PSS) service directive for Transgender, Intersex, Gender Non-Conforming, and Non-Binary (TIGNCNB) Individuals, and will release the concept paper on November 30, 2020. A virtual town hall following the release of the concept paper is scheduled on December 9, 2020, from 12:30pm-2:30pm.
BHIV Care and Treatment Program (CTP) and the NYSDOH AIDS Institute are hosting the 7th annual,
first virtual, Ryan White Part A Power of Quality Improvement Conference: “Redesigning Systems to Address Social Justice and COVID-19” on Tuesday, December 8th, from 9:00am – 5:00pm. All
Ryan White Part A-funded providers, consumers and other stakeholders are invited to attend. The purpose of the Conference is to promote improvement activities in RWPA programs, and provide a venue for
peer learning to support continued QI efforts.
The Quality Management and Technical Assistance unit developed a directory for service and health care providers seeking support for people with HIV (PWH) as well as for PWH seeking services for themselves. The directory lists Ryan White Part A programs by service category and provides location, both primary and secondary contacts, and transit information. In response to the COVID-19 pandemic, many of the programs listed can provide services remotely.
DOHMH Deputy Commissioner Dr. Demetre Daskalakis has accepted a position at the Centers for Disease Control and Prevention to serve as the Director of the Division of HIV/AIDS Prevention. Dr. Daskalakis has been at the forefront of many of the Health Department’s greatest successes, particularly in the area of HIV prevention and care.
NYSDOH AIDS Institute is sponsoring a statewide virtual Ending the Epidemic summit on World AIDS Day. There will also be a World AIDS Day event titled “Extraordinary Measures in the Face of Two Pandemics”.
Agenda Item #3: Bylaws Amendment
Mr. Fields presented a Bylaws amendment approved by the Rules & Membership and Executive Committees to change the timing of the election of the consumer-at-large. The Bylaws created the post of Consumer-at-large after the PWA Advisory Group was eliminated in order to maintain the level of consumer membership on the Executive Committee. The consumer-at-large is elected by the Consumers Committee from among the consumers appointed to the Council. The Rules & Membership Committee is recommending a Bylaws amendment to move the required date of the consumer-at-large election from the end of the planning session (in the spring) to the beginning of the session (in the fall). Originally, the Bylaws mandated that the election take place in the spring with the term beginning in the fall. This precluded newly appointed members (most of whom were already active on the Consumers Committee) from being considered. The amendment puts in place the Consumers Committee’s preference to have the election in the fall with one-year terms beginning immediately upon election and lasting until the subsequent election.
In response to a question from Mr. Schoepp, it was explained that the amendment went through the appropriate process. The Consumers Committee made the recommendation to the RMC, which approved it on October 26th. The Executive Committee then approved it earlier this month, and the final ratification is at the full Council.
Mr. Fields, on behalf of RMC, made a motion to approve the Bylaws amendment as presented. The motion was adopted 39Y-0N.
Agenda Item #4: Estimated Unobligated Balance Request (UOB)
Ms. Gilborn presented the FY2020 Estimated Unobligated Balance Request, a HRSA mandate due by the end of the year, where we inform HRSA that we might carry-over up to the 5% maximum in unspent funds from the current year (FY 2020 ) into the next FY 2021). This request will allow us to apply to use the actual carry-over when we know that amount next spring. Typically, the actual carry-over is less than 1%. The estimated unobligated balance request must be earmarked for a specific program and we typically say that we will use it to enhance ADAP. The PSRA is not bound by this. When the Committee considers the actual carry-over plan next spring, it can be allocated to any service in the portfolio (e.g., the FY 2019 carry-over was allocated to Housing for this year).
Ms. Gilborn, on behalf of PSRA, made a motion to approve the UOB Request as presented. The motion was adopted 39Y-0N.
Agenda Item #5: Disability Workgroup Update
Ms. Azor and Ms. Acosta presented on the work of the RWPA Disabilities Workgroup. In 2016, the Council updated the Master Service Directive to address concerns about Ryan White-funded agencies being able to accommodate the needs of persons living with disabilities. One recommendation was that DOHMH assess the needs of people in the EMA with disabilities and to investigate possible funding sources to upgrade facilities to better address those needs. In response, the Grantee developed a survey for RWPA providers. Data was obtained from the data team on disabilities in the NY EMA RWPA program. In 2018, at their most recent visit, 6,156 (45%) out of 13,819 clients reported having at least one disability.
Other Council recommendations were in the areas of: 1) Data Systems; 2) Training; 3) Guidance and Compliance; 4) Resource Guide for Providers; and 5) Access to Assistive Technologies. The Grantee has also developed a resource guide for RWPA providers. This guide is a working document and includes the following, but not limited to: 1) Technical terms and descriptions of each disability; 2) Guidance on effective communication/dialogue with clients with disabilities; and 3) Training and technical assistance resources. In addition, the Grantee developed a timeline of implementation to implement the recommendations, ensuring efforts are made to improve service delivery to clients enrolled in RWPA services.
To support the implementation of the recommendations in 2020-21, the Grantee created a workgroup to review the resource guide, re-design and administer the 2016 disabilities survey, and provide oversight of the implementation plan. Highlights of the plan are: 1) Identify validated screening tools and guidance to improve the identification of disabilities among RWPA clients; 2) Streamline client records to include the accommodations needed and ensure that clients do not have to ask for these accommodations at each visit; 3) Provide RWPA program with training on reasonable accommodations and how to provide such accommodations; 4) Provide tools that guide providers on how to conduct appropriate assessments; 5) Develop a publicly available directory/map of RWPA services that clearly lists disability access available at each service site; 6) Include accessibility in the Part A Quality Management Program to increase access to care for consumers with disabilities (i.e. the referral directory); 7) Recommend agencies to update websites to fully accessible and provide guidance on where to access technical assistance; 8) Work with the Mayor’s Office on Disabilities to continually update literature recommendations and guidelines for working with people with disabilities; 9) the Resource Guide; and 10) Access to assistive technologies.
A summary of the ensuing discussion follows:
- eShare data does not carry over to medical records. There needs to be a centralized system that allows sharing between providers.
- The demands of data collection can take time away from attention to clients.
- The Grantee would like to reduce duplication and is working to address these concerns. COVID-19 has slowed down the process for reviewing it.
- Agencies are required to notify that they are collecting data, but there is no opt-out option. This may be a barrier to some clients enrolling in needed services.
- The grantee can present in more detail on this topic at future meetings.
- There is missing data on the demographics of RWPA clients with disabilities. The vast majority of all RWPA clients are Black and Latinx.
- Having a person with disabilities (PWD) on the workgroup would add a unique, personal perspective. The membership was internal to CTP, but a PWD can be recruited.
Agenda Item #6: Policy Update
Mr. Guzman presented an update on federal HIV-related policy issues, starting with the election of Joe Biden and Kamala Harris as the President- and Vice President-elect, the attempts by the current occupant of the Oval Office to overturn the results, and the timeline for the transition. Democrats will maintain control of the House of Representatives, and Senate control will be decided in a runoff of two Georgia Senate seats. The new administration’s priority is tackling COVID-19 through science-based plans for testing, public health measures and vaccine distribution. Other priorities are economic recovery, racial equity and climate change.
President-elect Biden’s responses to a survey from AIDS United and other HIV advocacy organizations outline his promises to build on the Affordable Care Act (ACA) to bring coverage to more people, strengthen protections for people with pre-existing conditions (including HIV), cover PrEP and PEP, stick to the goal of ending HIV in the USA by 2025, fully fund the Ryan White program, support science-based approaches to prevention, and work to eliminate stigma. The President-elect also pledged to support antiracist and LGBTQ non-discrimination measures and reinstate trainings for federal workers on implicit bias. He will reverse the public charge rule that bars some immigrants who receive governmental services from receiving permanent residency, will protect “Dreamers”, and reverse other current asylum policies. He also expressed support for funding and protecting reproductive health services.
The Supreme Court heard oral arguments in a case on the constitutionality of the ACA without an individual mandate. Also, from November 1 to December 15, 2020, individuals can apply for 2021 health insurance, or renew, change, or update their 2020 health insurance, through the 2021 Health Insurance Marketplace. Finally, based on preliminary 2020 Census data, New York City registered a 61.8% self-response rate, up from 58% for the 2010 Census. The rate surpasses nearly all demographically similar U.S. cities.
In response to a question, Mr. Guzman stated that the plans for distributing a COVID-19 vaccine will be disrupted if the current administration does not coordinate with the incoming one.
Agenda Item #7: Public Comment/New Business
Mr. Harriman thanked Mr. Klotz for his leadership as acting director and governmental co-chair and for the seamless transition during a difficult time.
Mr. Walker proposed that the RMC review how committee chairs are chosen. Mr. Klotz explained that the role, terms of service and selection of committee chairs is on the RMC agenda for their meeting next Monday.
There being no further business the meeting was adjourned.
Minutes approved by the HIV Planning Council on December 17, 2020