Thursday, October 26, 2023
By Zoom Videoconference
Members Present: D. Klotz (Governmental Co-chair), D. Martin (Community Co-chair), B. Fields (Finance Officer), S. Altaf, R. Babakhanian, M. Baney, R. Brown, M. Caponi, P. Carr, J. Dudley, V. Decamps, J. Edwards, R. Ford, M. Gilborn, J. Goldenbridge, C. Graham, S. Hemraj, R. Henderson, J. Henson, B. Hribar, E. Kaywin, M. Lesieur, M. Maia Soares, H. Martinez, L. F. Molano, MD, J. Palmer, G. D. Plummer, M. Rodriguez, J. Roman, L. Sabashvili, J. Schoepp, M. Sedlacek, C. Simon, M. Thompson, T. Troia, G. Ty, S. Wilcox
Members Absent: F. Alvelo, M. Bacon, K. Banks, G. Bruckno, R. Fortunato, J. Gomez, F. Laraque, W. LaRock, N. Martin
Staff Present: DOHMH: C. Quinn, MD, S. Braunstein, PhD, G. Harriman, M. Lawrence, D. Saab, K. Mack, S. Spiegler, A. Eppinger-Meiering, J. Acosta, J. Carmona, A. Guzman, M. Pathak, R. James, C. Rodriguez-Hart, M. Dorsheimer, M. Navejas; Public Health Solutions: G. Ashby Barclay
Agenda Item #1: Welcome/Introductions/Minutes/Public Comment
Mr. Klotz and Mr. Martin opened the meeting followed by introductions and a moment of silence. The minutes from the July 27, 2023 meeting were approved with no changes.
Dr. Quinn welcomed the Council members and expressed her support for their vital work in partnership with DOHMH to improve health outcomes and address health inequities. She outlined some of the upcoming work of the Council, which the Division of Disease Control will work to advance, such as addressing the needs of immigrants with HIV, developing a new service directive for Non-Medical Case Management/Inmates and Recently Released, and planning for possible reductions to the grant award. Dr. Braunstein also expressed her support for the Council’s work and pledged to work closely to advance the shared goals of the Ryan White Part A (RWPA) program.
Agenda Item #2: Public Comment, Part I
Mr. Schoepp said that the Council needs to make progress on recommendations concerning consumer advisory boards (CABs), a long-standing issue of concern to the Consumers Committee.
Mr. Palmer reported that the new system that NYS DOH has implemented to replace the defunct Medicaid 340b carveout is working well for providers.
Mr. Fields encouraged Council members to participate in committees where financial and expenditure data is discussed in order to have a better understanding of how the RWPA grant is performing.
Mr. Martinez reported that glitches in the Medicaid recertification process after the lifting of the public health emergency has resulted in the disenrollment of thousands of Medicaid beneficiaries, which is something the Council needs to consider.
Mr. Harriman reported that Ms. Lawrence is moving to a position in the DOHMH Public Health Clinics. The Council and staff thanked her for her service to the Council, especially her support of Consumers and their involvement in the planning for services. Ms. Lawrence thanked the Council, saying it had been an honor to support the members in this important work. Mr. Klotz will cover the Consumers Committee and the Division of Disease Control is working to identify someone to cover the IOC Committee.
Agenda Item #3: Recipient Report
Ms. Eppinger-Meiering reported news from HRSA, including observation of the 33rd anniversary of the Ryan White HIV/AIDS Program, as well as National HIV and Aging Awareness Day and Latinx AIDS Awareness Day. Also, the biennial National Ryan White Conference will be held in August 2024 in Washington, DC with the theme of “Innovating to End the HIV Epidemic”.
Proposals have been submitted under the RFP for Ryan White Part A (RWPA) Housing Services. New programs will start on March 1, 2024 with a total of 16 awards anticipated in three service areas (short-term rental assistance, short-term housing, housing placement assistance).
On October 2nd, the Recipient submitted the Grant Year (GY) 2024 Non-Competing Continuation (NCC) Progress Report to HRSA for the New York Eligible Metropolitan Area (NY EMA). The NCC Progress Report solicits a response for the RWPA program, including funding for Base Part A formula, Base Part A supplemental, and Minority AIDS Initiative (MAI). On October 12th, the Recipient received the notice of award from HRSA authorizing the carryover of unobligated balance in the amount of $1,865,823.00. Amendments to contracts are currently in process based on the Carryover plan approved by Planning Council in June (enhancements to Food & Nutrition Programs, Medical Case Management, and Legal Services).
Subrecipients submitted annual quality improvement (QI) project reports in July and August 2023. Staff within CTP’s Quality Management and Program Implementation (QMPI) Unit and Housing Services Unit provided feedback to subrecipients and assisted them in revising their projects as needed. The NY EMA QM Program will be hosting a virtual QI Peer Learning & Sharing Session for subrecipients and consumers in November. Subrecipients will share updates on new QI projects addressing topics like coordinating consumer health care, engaging new participants into services, and improving consumer engagement. The NY EMA QM Program continued its series “QI Tool Training for RWPA Service Providers and PWLE” with a webinar on August 16th. The training focused on process mapping and was facilitated by our partners at the NYS AIDS Institute (AI) Quality Program. The QM Program also held two open forums in September, one for RWPA mental health services subrecipients and one for supportive counseling services subrecipients. The groups discussed quality improvement project reports, the increase in migrants to the city and the role of RWPA services, and barriers to addressing common challenges.
There were questions from Council members concerning guidelines for RSV vaccination for PWH and the local HOPWA grant award (the NY HOPWA award is approximately $42M for the current year).
Agenda Item #4: Planning Council-Recipient Memorandum of Agreement (MoA)
Dr. Molano and Mr. Martin introduced the revised MoA, which is a binding document that guides the
working relationship between the Planning Council and the Recipient. They explained that the Rules & Membership Committee spent almost a year working on revising the document, making numerous changes that will help forestall the kinds of issues that arose in the last Council session. The Committee also reviewed numerous suggestions from the Recipient, working out what they believe is a sold compromise document that reflects the needs of both parties. The revised MoA not only fulfills a HRSA requirement but can lay the groundwork for a more productive and collaborative working relationship between the Council and the Recipient. The MoA provides clear definitions for our respective roles and responsibilities, outlines realistic timelines for products that each party must provide to the other, and provides clear guidelines for how both parties communicate. The hope is that the revised MoA will be a living document that we can refer to when potential disputes arise, and that will help us work more effectively together in order to make the Ryan White Part A program work optimally for the clients that we serve and fulfill our shared mission and values.
Mr. Klotz and Ms. Plummer presented the details of the MoA. The purpose of the MoA was described, defining mutual goals and vision. The MoA is a tool to define roles and responsibilities and avert conflict. The Planning Council and Recipient roles in a wide range of activities were described, including: setting priorities, needs assessment, assessing the administrative mechanism, comprehensive planning, Council operations, grant administration, reporting requirements, quality management and program evaluation.
The MoA sets out guidelines for communications and information sharing, setting out defined procedures and timelines for reports, and information and data requests. The timeline and procedures have already begun to be implemented, for example through formal data request forms that the Council has submitted for the information that the Council and its committees will need over the course of the upcoming year. The MoA also defines who to address disputes that will inevitably arise, given the inherent tension in the way that the Ryan White legislation structures the program. The process for settling disputes will begin with face-to-face internal meetings within five days, with defined steps to take if the issues are not resolved.
A summary of key revisions in the revised document were explained, including: 1) technical changes in response to HRSA and legislative terms, as well as new DOHMH reporting lines); 2) allowing Council staff to review draft RFPs to ensure that they accurately reflect the Council’s service category directives; 3) formalized data request process; 4) new, rational process and timeline for shared reports and such as quarterly expenditure reports, as well as data requests; 5) formalization of long-standing practices, such as monthly Recipient reports to the Council and Council participation on the CHAIN Technical Review Team.
The MoA spells out a timeline for review and revising the document by both parties. The timeline of the development of this version was described (after final approval by the Council, the MoA will be signed by both parties, submitted to HRSA and posted on the Council website).
Highlights of the ensuing discussion follows:
- There is a need for a more efficient administrative mechanism for the Planning Council budget. The inability to quickly procure services to support Council operations is a hindrance to the Council’s mission.
- The MoA is a good foundation but will only be effective if all parties remain vigilant about adhering to and enforcing its requirements.
- A federal government shutdown this fall will not effect the local RWPA program. The entire grant award has already been received. DOHMH and the Council will keep track of potential disruptions in the next grant year.
- The MoA implementation needs to reflect the Denver Principles (“nothing about us without us”).
Mr. Molano moved, on behalf of the Rules & Membership Committee, that the Executive Committee approve the Planning Council-Recipient Memorandum of Agreement as presented. The motion was adopted 34Y-0N.
Agenda Item #5: 2023-2024 Council and Committee Work Plans
Mr. Klotz presented an outline of the agenda items for the full Council meetings for the entire planning year, including timelines for spending plans, the new NMI service directive, spending reports, and presentations on special topics. Staff have developed individual timelines for all subcommittees.
Agenda Item #6: Farewell to Graham Harriman
Council members and staff paid tribute to Mr. Harriman, who is retiring after three years as Council Director, 10 years as Director of the HIV Care & Treatment Program, and a career of serving the community of people living with HIV. A gathering will be held at DOHMH on November 1st to celebrate Graham and his contributions.
There being no further business, the meeting was adjourned.