Priority Setting & Resource Allocation Committee Minutes April 13, 2024

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Meeting of the Priority Setting & Resource Allocation Committee

Monday, April 13, 2024

By Zoom Videoconference

3:05 – 4:20

Members Present: Paul Carr (Co-chair), Matt Baney, Billy Fields, David Klotz, Steve Hemraj, Matthew Lesieur, Guadalupe Dominguez Plummer (ex-officio), John Schoepp, Claire Simon, Terry Troia  

Members Absent: Raffi Babakhanian, Kyron Banks, Joan Edwards, Marya Gilborn

Staff Present: Doienne Saab, Scott Spiegler, Bryan Meisel, Isidra Grant, Kobe Familara, Johanna Acosta, PhD, Adrianna Eppinger-Meiring, Kimbirly Mack, Patrick Chan (DOHMH); Arya Shahi

Agenda Item #1: Welcome/Introductions/Minutes

Mr. Carr and Ms. Gilborn opened the meeting, followed by introductions and a moment of silence. The minutes of the March 18, 2024 meeting were approved with no changes.  

Agenda Item #2: GY 2025 Application Spending Plan

Mr. Klotz explained that the PSRA Committee must complete a spending request for the GY 2025 grant application. The amount and the accompanying narrative must demonstrate data-driven need. The Committee will develop a spending scenario in the winter for the actual award, but the application plan can be a blueprint for that. The EMA can request up to 5% above the current year’s award. While the full award has not been announced yet, based on the GY 2023 amount, a 5% increase would mean an additional $4.27M. Also, there will be an additional $932K to allocate from the one-time enhancement to Housing programs, and an additional $293K freed up from the end of the Health Education/Risk Reduction category. The Recipient has identified service categories that have had challenges and will present data on them to the Committee to help assess whether any allocations should be revised.

Ms. Grant and Mr. Meisel presented on Psychosocial Support for TIGNBNC PWH (SCX), which provides an array of counseling and support services to the target population, which were listed. The program goals, objectives and client eligibility were described. Service types and activities were explained, along with the recommended staffing model. Programs started September 1, 2021 with two programs (one targeting Bronx residents, one located in Manhattan but targeting the entire city). Quality Management Specialists in the DOHMH HIV CTP’s Quality Management and Program Implementation Unit provided monthly quality management calls and program implementation consultation in addition to quarterly open forums. Subrecipients report increasing numbers of client enrollment despite staffing challenges and are hopeful to increase their program census. Challenges have included finding program staff to hire with TIGNCNB lived experience, recruit clients for a TIGNCNB specific program, and enrolling those client (many of whom report other urgent needs such as housing).

Mr. Familara presented on client enrollment and service units delivered. In GY 2022, there were 49 clients enrolled at both programs. This increased to 125 in GY 2023. A report from April 2024 shows the client census at 132. The number of service units increased from 856 in 2022 to 5951 in 2023, with the most common service types client assistance outreach for re-engagement and supportive counseling. Client assistance is any action taken to help a client get services, such as helping with documentation for enrollment in benefits and making appointments. Each service unit can take anywhere from a few minutes to half a day.

Sixty percent of clients were aged 30-49, 93% were Black or Hispanic, and 78% were TGNCNB (although the cisgender clients may consider themselves to be part of the target population). One hundred percent of the service category allocation was spent, with the caveat that these are cost-based programs and are paid no matter what the level of service is. Programs were expected, per the RFP and based on the cost analysis provided to the PSRA Committee, to serve 120 client each, about double what they are currently serving.

A summary of the discussion follows:

  • While the program started in the wake of the COVID pandemic, program data is from the period that started two years after the shutdown. It is unclear how much the lingering effect of the pandemic is still affecting enrollment.
  • It is unrealistic to expect that the programs will reach full expected enrollment any time soon.
  • While programs have target catchment areas, all RWPA programs are expected to allow eligible clients from anywhere in the EMA to enroll.  
  • Selection of programs by geographic area was not in the purview of CTP for this procurement, but was limited based on the proposals received and their scores. It is unclear if there is a mismatch between program sites and concentrations of the target population.

Ms. Plummer noted that the Recipient is working to identify categories of concern and bring those to the attention of the Committee with data that they can use to assess and make decisions around prioritization and allocation. The Recipient provided extensive technical assistance to these programs and want them to succeed, but it may be a better strategy to reduce the allocation to match the levels of service.

Mr. Klotz stressed that if the Council changes the service category allocation, it will be up to the Recipient to implement that based on their analysis. The Committee will need to assess the allocation for this and other categories based on the conflicting needs in a restricted resource environment. An option is to defer a final decision on SCX until the winter when there will be additional months of enrollment data.

At the June meeting, the Committee will develop a carryover plan for unspent GY 2023 funds, and will continue the discussion of the GY 2025 application spending plan.  The June and July meetings will be scheduled for 2 hours. There being no further business, the meeting was adjourned.