Planning Council Meeting Minutes October 27, 2022

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Thursday, October 27, 2022

3:05-4:50 PM

By Zoom Videoconference

Members Present: G. Harriman (Governmental Co-chair), D. Walters (Community Co-chair), B. Fields (Finance Officer), F. Alvelo, M. Baney, A. Betancourt, R. Brown, G. Bruckno, M. Caponi, J. Dudley, J. Edwards, R. Fortunato, M. Gilborn, C. Graham, B. Gross, R. Henderson, E. Kaywin, M. Lesieur, D. Martin, L. F. Molano, MD, J. Natt, J. Palmer, C. Simon, S. Spiegler (for G. Dominguez Plummer), M. Thompson, T. Troia, S. Wilcox

Members Absent: S. Altaf, M. Bacon, L. Beal, E. Casey, R. Chestnut, J. Gomez, H. Nguyen, M. Rifkin, V. Velazquez

Staff Present: DOHMH: D. Klotz, M. Lawrence, J. Acosta, D. Noble, J. Colón-Berdecía, K. Mack, I. Newman, A. Eppinger-Meiering, R. James, K. Miller, Monika Pathak; Public Health Solutions: G. Ashby-Barclay, R. Santos, A. Shahi

Guests Present: A. Vasan, MD, PhD (NYC Commissioner of Health); K. Hagos, J. Fuller (NYSDOH AIDS Institute)

Agenda Item #1: Welcome/Introductions/Minutes/Public Comment

Mr. Harriman and Ms. Walters opened the meeting followed by a moment of silence.  Mr. Harriman introduced the following people who are awaiting their final appointment letters from the Mayor and will soon formally join the Council as voting members: Raffi Babakhanian, Kyron Banks, Steve Hemraj, Beth Hribar, Bill LaRock, PhD, Natasha Martin, Hondo Martinez, John Schoepp, Marcy Sedlacek, Marcelo Maia Soares.  Continuing members then introduced themselves.

The minutes from the June 23, 2022 meeting were approved with no changes.  

Agenda Item #2: Public Comment, Part I

P. Carr: Since DOHMH renegotiated the new master contract with Public Health Solutions, the Council has faced great obstacles procuring resources for essential Council activities through the DOHMH bureaucracy, which is impeding Council’s functioning.

Agenda Item #3: Commissioner of Health

Mr. Harriman introduced NYC Commissioner of Health Ashwin Vasan, MD, PhD.  Dr. Vasan is a primary care physician, epidemiologist and public health expert with nearly 20 years of experience working to improve physical and mental health, social welfare and public policy for marginalized populations here in New York City, nationally and globally. Dr. Vasan began his career in global health and most recently served as the President and CEO of Fountain House, a national mental health nonprofit. He was the founding Executive Director of the DOHMH Health Access Equity Unit, which focused on the intersection of clinical and social services for the care of people involved in the justice system and other vulnerable populations. He serves as faculty at the Columbia University Schools of Public Health and Medicine.

Dr. Vasan expressed his admiration and support for the work of the Council, explaining that he started his public health work in the field of ARV access in the global south, noting that the landscape has shifted to a place where we can imagine ending the epidemic.  He described the recent challenges to public health from COVID, MPV, polio and political attacks on public health workers, and how public health is central to the mayor’s agenda.  He explained that DOHMH’s strategic priorities align with the work of the Council, citing the Framing Directive as an example of how to address stigma and equity.  He also cited the work of the Data Workgroup to modernize and humanize data collection.  He commended the Council for addressing behavioral health in a holistic way in the development of a new service directive. 

In response to a question, Dr. Vasan noted that one-time funding can build needed public health infrastructure, and DOHMH is looking at how to get sustained long-term funding, including form the private sector.  He also said that NYC continues to study long COVID and has opened three long COVID clinics.  Dr. Molano stated that NYC needs to ensure that newly arrived migrants receive comprehensive HIV prevention and care services.

Agenda Item #4: New York State Integrated HIV Prevention and Care Plan

Ms. Hagos introduced the proposed edits to the draft NYS Integrated HIV Prevention and Care Plan (IP), based on the Council’s feedback at last week’s informational session.  Topics included: data collection in communities of color, analysis of low testing numbers during COVID-19, addressing 340b drug pricing, including language on opportunities for co-location of HIV and other services, clarifying goals for addressing disparities, address routinization of testing for high risk populations in specific settings, include transmasculine individuals in epi and surveillance data, improving patient experience, and specific strategies for addressing aging and HIV.

There was a discussion on the 340b program, which allows savings in drugs costs in the Medicaid program to be allocated to HIV service providers.  The program expires in April and advocates are working to extend it.  The Planning Council/HPG Joint Policy Committee is addressing this issue and Council members were encouraged to join to learn more about it.  Other comments included that quality improvement metrics should capture telehealth visits, and that DOHMH is working to better understand the impact of COVID-19 on ETE/EHE plans.

Ms. Hagos stated that once all planning bodies vote to concur with the IP, it will be submitted to HRSA and CDC and the State and all parties will work to implement it, with regular check ins.    

A motion was made and seconded to concur with the revised Integrated Plan.  The motion was adopted by a roll call vote 21Y-0N.

Agenda Item #5: Recipient Update

Dr. Acosta reported that HRSA recently observed National HIV and Aging Awareness Day.  The CDC issued a health advisory on possible sever manifestations of MOV (monkeypox) in immune compromised people.  The NY EMA’s presentations from the National Ryan White Conference held in August are available, including two from the Planning Council (on the HIV & Aging Directive, and the Framing Directive).

The NY EMA submitted its Non-competing Progress Report to HRSA.  This acts in place of a full application for the 2nd year of the three-year award.  The EMA’s Quality Management Committee reviewed the latest draft of the QM plan.  Also, the WM Program held RWPA service category-specific open forums/provider meetings from June to August.  These meetings create a space for providers to share their experiences, strategies, and coping mechanisms. Providers were very actively engaged and expressed an interest in continuing the open forum format.

Awards under the RWPA RFP for NYC Oral Health Services will be announced on June 15th with funded programs set to start on September 1st.

Agenda Item #6: Council Chairs Update

Mr. Harriman gave an update on the work of the Council’s committees.  Needs Assessment will begin work next month on the final comprehensive needs assessment.  A consultant has been engaged to write the draft document.  Integration of Care has begun work on the new Behavioral Health service directive.  The Consumers Committee is working on the EMA’s quality management plan.  PSRA will work over the fall and winter on scenario planning for a possible reduced grant award.  The Tri-County Steering Committee has begun review of the entire service portfolio in the region as part of a possible adjustment to service category allocations.  The Rules & Membership Committee will begin working on a revision of the Council/Recipient memorandum of understanding.  The Data and SMI workgroups continue to meet.

Mr. Lesieur reported that the Planning Council/HPG Joint Policy Committee is working on three key issues: 1) overdose prevention centers, comprehensive sex education, the 340b program.  The Committee hopes to contribute to educating policy makers on these issues.

Agenda Item #7: Public Comment, Part II

Ms. Edwards reported on reorganization at the AIDS Institute.  Former director Joanne Morne is now a deputy commissioner and Joe Kerwin is acting director.  Also, a new Aging & Long-Term Care Office has been created.

There being no further business, the meeting was adjourned.

Delayed Contract Executions: PHS began working with the subrecipients to collect scopes of work, service target grids, budgets, etc. for FY 2022, beginning 03/01/2022. The majority of the subrecipients will receive amendments to their existing agreements for FY 2022. Amendments now require less paperwork and should not necessitate the same type of legal review on the part of the subrecipients.

Monitoring of Spending: Quarterly meetings with Recipient and BHHS Admin at NYC DOHMH will be scheduled starting in August.  Most service categories are returning to fixed rate reimbursement.   PHS will work with the Recipient to engage in in-depth spend down reviews and budget modifications to avoid large carryover amounts.  The Recipient, BHHS Admin, and PHS meet monthly to coordinate the programmatic, contractual, and fiscal management of the Ryan White Part A program. PHS will be more proactive with cash flow, streamlining contract executions and amendments, and have done cash advances to ensure that providers have cash flow. 

Mr. Harriman thanked the Recipient for taking the assessment’s finding seriously and developing a corrective action plan.  The assessment was made in a spirit of cooperation and collaboration to improve spending, particularly as the waiver of penalties for underspending will not be in place for this year.

Mr. Carr made a motion, which was seconded, to accept the GY 2021 Assessment of the Administrative Mechanism as presented.  The motion was adopted a roll call vote of 22Y-0N. 

Agenda Item #7: Planning Council Chairs Update

Mr. Harriman and Ms. Walters acknowledged the retiring members of the Council: Mr. Abul-Haqq, Mr. Canady, Mr. Carr, Ms. Cockrell, Mr. Powell, Mr. Ruiz, Mr. Schubert, and Mr. Walker.  They were thanked for their contributions to the Council. 

Mr. Harriman thanked everyone who attended the annual member recognition event is scheduled to take place on July 19th in Riverbank State Park.  He noted that the Data, Policy and SMI Committees will continue to meet during the recess.

Ms. Simon announced that there will be a special session in October for Council members to provide input into the draft Statewide Integrated HIV Prevention and Care Plan, which is the next step in the process of moving toward a Council vote on concurrence with the Plan.

Agenda Item #8: Public Comment

Mr. Fields gave a report on the recent Abilities Expo, an annual event that brings together people of diverse abilities to address issues and network on advocacy for the disabled.  He highlighted some issues raised at the Expo, including accessibility, dating and relationships, technology and disability products, and the need for wheelchair assistance at all hours.  He encouraged RWPA providers to attend next year’s Expo.

There being no further business, the meeting was adjourned.