Priority Setting & Resource Allocation Committee Minutes December 12, 2022

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Meeting of the Priority Setting & Resource Allocation Committee

Monday, December 12, 2022

By Zoom Videoconference

3:05 – 4:30

Members Present: Marya Gilborn (Co-chair), Jeff Natt (Co-chair), Kyron Banks, Joan Edwards, Billy Fields, Graham Harriman, Steve Hemraj, Matthew Lesieur, Guadalupe Dominguez Plummer, John Schoepp, Terry Troia

Members Absent: Fulvia Alvelo, Matt Baney, Henry Nguyen, Claire Simon, Dorella Walters

Staff Present: David Klotz, Scott Spiegler, Johanna Acosta, PhD, Karen Miller, Deb Noble (NYC DOHMH); Arya Shahi (Public Health Solutions)

Agenda Item #1: Welcome/Introductions/Minutes

Ms. Gilborn and Mr. Natt opened the meeting, followed by introductions with conflicts of interest noted, and a moment of silence.  The minutes of the July 11, 2022 meeting were approved with no changes.  

Agenda Item #2: 2022-23 PSRA Work Plan

Mr. Klotz presented the PSRA work plan for the 2022-23 planning year.  Similar to previous years, the committee’s products are an estimated unobligated balance request (December), GY 2023 Spending Scenario Plan (by March), GY 2023 Reprogramming Plan (by April), GY 2022 Carryover Plan (June), GY 2024 Application Spending Plan (by July).

Agenda Item #3: GY 2022 Unobligated Balance (UOB) Request

Mr. Klotz explained that HRSA requires all EMAs to complete and submit by the end of this month an “estimated unobligated balance request”.  The document tells HRSA that the EMA will ask to use unspent funds from the current grant year (i.e., 2022 carryover) in the next grant year (2023).  We will not know the actual amount of carryover until next spring after closeout of the grant year.  The UOB request states that next spring we will ask to carry over as much as 5% (the maximum allowed with no penalty).  The UOB request uses ADAP as a placeholder for the use of the carryover funds, but we are not required to spend the carryover for that purpose.  In June 2023, PSRA will develop an actual carryover plan for submission to HRSA.

A motion was made, seconded and approved 9Y-0N to adopt the GY 2022 UOB as presented.

Agenda Item #3: GY 2023 Spending Scenario Planning

Mr. Klotz explained that every winter the PSRA Committee creates a spending scenario to decide how a possible reduction in the grant award will be implemented.  This allows the Recipient to implement programs as soon as the award is received.  The scenario plan builds on the application spending plan approved the previous summer.

Mr. Klotz reviewed a spreadsheet showing the baseline for discussion of a spending scenario plan for the actual GY 2023 award.  The spreadsheet shows a flat funding scenario (i.e., no increase or decrease to the award).  Two new allocations were approved in the Council’s GY 2023 application spending plan: 1) a full year of Oral Health Services (which started mid-year this year and is currently funded for 6 months), and 2) the new Ambulatory Outpatient Services for Aging PWH (AOS), which will begin on March 1, 2023.  These two new allocations total $1,733,800 in new funding.  

There will be some savings in the carrying costs of programs from GY 2022 into GY 2023 due to contract terminations and other permanent takedowns.  That will offset the amount that PSRA will have to find to cover the deficit from a flat funding or reduction scenario.  In addition, the Tri-County Steering Committee is considering changes to their portfolio which might result in a lower allocation for programs in that region.   PSRA will need to decide how to make up any additional deficit.  

The award is not expected to fluctuate much in GY 2023, as the national RWPA appropriation is expected to remain unchanged, but PSRA still needs to prepare for a possible reduction.  Mr. Lesieur reported that Congressional negotiators and the administration have not asked for either increases or decreases.  The long-time trend of the NY EMA seeing a smaller percentage of PWH across all EMAs due to higher investment in prevention is expected to continue, affecting our formula award, which is two thirds of the total.  The supplemental award should remain stable, as the application score does not change for three years.  

Mr. Harriman noted that the carryover waiver is expected to end this April, and so it is crucial that underspending does not exceed 5%, but it does not mean that the EMA must go back to the days of <1% underspending.  Some carryover can be desirable to fund initiatives.

There was a discussion about what benchmark to use for planning for a reduction.  Any reduction is likely to be minimal, but the Committee should plan for a worst-case scenario.  The previous years’ scenario plans have used a 3-3.5% range.  Strategies used in recent scenario plans first apply targeted reductions where possible.  There will be a discussion with the AIDS Institute on what reduction ADAP can absorb (some will be restored during the year through reprogramming and carryover, and ADAP can take the funds later in the year).  If there is still a deficit after all possible targeted reductions are made, a proportionate reduction can be made across the portfolio based on ranking scores, and the Committee may choose to hold specific categories harmless from those cuts.

A motion was made, seconded and approved 10Y-0N to plan for a reduction scenario of 3.5% in GY 2023 with the obligation to fund a full year of Oral Health and AOS.  Any increase to the award will be applied to the new Oral Health and AOS allocations.

A revised spreadsheet showing the maximum 3.5% reduction and the savings in carrying costs will be presented at the January 9th meeting, where the Committee will develop a plan for the reduction scenario, which is a methodology for applying the actual award numbers so that the Recipient does not need to come back to the Council which would delay the implementation of the programs.

There being no further business, the meeting was adjourned.