Priority Setting & Resource Allocation Committee Minutes April 11, 2022

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Meeting of the Priority Setting & Resource Allocation Committee

Monday, April 11, 2022

By Zoom Videoconference

3:05 – 3:35

Members Present: Marya Gilborn (Co-chair), Jeff Natt (Co-chair), Fulvia Alvelo, Matt Baney, Paul Carr, Broni Cockrell, Billy Fields, Graham Harriman, Guadalupe Dominguez Plummer, Michael Rifkin, Leo Ruiz, Victor Velazquez

Members Absent: Eunice Casey, Joan Edwards, Matthew Lesieur, Henry Nguyen, Claire Simon, Terry Troia, Dorella Walters

Staff Present: David Klotz, Scott Spiegler, Scarlett Macias, Kimbirly Mack, Johanna Acosta, Giovanna Navoa, Dave Ferdinand (NYC DOHMH); Gemma Barclay, Arya Shahi (Public Health Solutions)

Agenda Item #1: Welcome/Introductions/Minutes

Mr. Natt and Ms. Gilborn opened the meeting, followed by introductions and a moment of silence.  The minutes of the March 14, 2022 meeting were approved with no changes.  

Agenda Item #2: GY 2022 Reprogramming Plan

Mr. Klotz presented the draft GY 2022 Reprogramming Plan, explaining that the Council traditionally allows the Recipient the latitude to shift funds between service categories in order to enhance overperforming contracts.  No service category will be enhanced by more than 20% of its original allocation in the spending plan, unless the Council approves an increase above 20%.  ADAP will be included as a category for enhancement after all other service categories have been considered for enhancement.  ADAP will not be subject to the 20% cap on enhancements.  With programs reverting to fee-for-service reimbursement, the plan allows the EMA to maximize spending during the year.  

A motion was made and seconded to adopt the reprogramming plan as presented.  The motion was adopted 11Y-0N.

Agenda Item #3: Planning for GY 2023

Mr. Klotz and Mr. Harriman explained that the Council staff is working with the Recipient on a methodology for reducing Medical Case Management/Care Coordination, the largest allocation in the portfolio.  Given payer of last resort (POLR) issues, particularly around overlap with health homes, there is clearly opportunity for reductions, which can be used for new initiatives, particularly the Aging & HIV categories. The Recipient is planning to conduct POLR site visits with providers, but results will not be available in time for PSRA’s planning purposes.  

Changes to the Harm Reduction allocation will also need to be put off until GY 2024 when new programs start under the IOC’s Behavioral Health service directive.  Also, by then will be clearer what POLR issues there will be with Medicaid and harm reduction services.  Syringe exchanges can now bill Medicaid, but reimbursement rates are very low.  Medicaid and Health Homes are reimbursing similar services at syringe exchanges at different rates, and this will be considered by IOC when they develop new directive.

Also, the Recipient will present a cost analysis for two new Aging & HIV service categories (Outpatient Medical Care, Referrals to Health and Support Services).  These programs will begin in GY 2023 and funding will have to come from other sources within the RWPA portfolio, as no additional funding is expected.

For the GY 2023 application spending plan, it is a best practice to ask for the maximum increase (5% above current year’s award), and PSRA can use ADAP as placeholder for an increase request.  The Committee will simultaneously plan for an actual spending plan with reductions to pay for new initiatives (Aging and fully funding Oral Health).

The Housing Services category is being rebid for GY 2023, and an additional temporary allocation might be needed.  If new providers are chosen, the program will need to pay for a transition period to ensure that clients have continuous housing.  At next month’s meeting, the Housing Unit will provide an estimate.  Members were encouraged to send questions for the discussion (e.g., does the contractor hold the leases of units, or do clients).  While the total allocation for the category is up to PSRA/PC, the amount has been increased in recent years.    

There being no further business, the meeting was adjourned.