Priority Setting & Resource Allocation Committee Minutes December 14, 2020


Meeting of the Priority Setting & Resource Allocation Committee

Monday, December 14, 2020

By Zoom Videoconference

3:05 – 4:30


Members Present: Jeff Natt (Co-chair), Marya Gilborn (Co-chair), Fulvia Alvelo, Paul Carr, Broni Cockrell, Billy Fields, Graham Harriman, Michael Rifkin, Leo Ruiz, John Schoepp, Carmelo Reyes, Guadalupe Dominguez Plummer

Members Absent: Randall Bruce, Joan Edwards, Claire Simon, Terry Troia, Rob Walker, Barry Zingman, MD

Staff Present: David Klotz, Melanie Lawrence, Scott Spiegler Ashley Azor, Kimbirly Mack, Eleonora Jimenez-Levi, Giovanna Navoa (NYC DOHMH); Bettina Carroll, Gucci Kaloo (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 November 9, 2020 meeting were approved with one change to reflect attendance.

The Committee thanked Mr. Reyes for his service and wished him luck in his move to California. 

Agenda Item #2: FY 2021 Spending Scenario Planning

Ms. Gilborn explained that every year PSRA plans for a possible reduction in the grant award.  A spending scenario is developed that determines how to implement a cut up to a certain percentage of the award.  This allows the Recipient to implement the spending plan immediately upon receipt of the award, rather than waiting a month for the PSRA and Council to approve a final spending plan. 

Mr. Klotz reviewed a spreadsheet for the Committee to build on.  For the EMA totals, the $1M in CARES (Coronavirus Stimulus) Act money that the EMA received in FY2020 is eliminated for FY 2021.  All the CARES program funds went to enhance Housing – $855K in NYC and $45K in Tri-county (a pro-rated amount based on the relative sizes of the two regions’ allocations).  An additional 2.5% reduction in the Base award is put in as a benchmark, for a total of 3.3% less than FY 2020 (the EMA lost about 1.7% of the Base award in FY 2020). 

Other adjustments done to respond to COVID in FY 2020 were detailed (all done by taking down the ADAP allocation): $1M for NYC Housing, $499K for Emergency Financial Assistance (EFA), $50K for Phase One of the Psychosocial Services for TIGNBNC (PSS) for a resource directory and training curriculum.  ADAP was also reduced to cover the reduction in the Base award in FY 2020.  

The spreadsheet postulates that all the COVID adjustments are nullified and we go back to the way baseline allocations.  PSRA will have to decide on whether or not to continue the enhancements that were made to Housing, FNS and EFA.  Part of any reallocation or reduction is already offset by the Council’s elimination of Non-Medical Case Management/General Population (NMG), which had an allocation of $1.2M.  There is also savings from $177K in funds that were unobligated from the Early Intervention Services (EIS) category (which were reallocated to FNS for FY 2020 in response to COVID).

Possible additions for FY 2021 include allocations proposed in the application spending plan for Oral Health and PSS (both of them proposed for half a year’s allocation, as programs won’t start until at least half way through the year). 

The TC Steering Committee approved a spending scenario that seeks to continue the $45K they got as their share of the Housing enhancement from CARES.  This would have to come from savings in other areas of the portfolio (e.g., the elimination of NMG).  Also, the EFA funds for the whole EMA are in the TC plan, as the only provider of this service is located in that region.  The extension of the EFA enhancement is recommended at a slightly reduced amount (equal to half the full-year program allocation for PSS).  A final decision on these numbers can be made after more information is presented.

A summary of the ensuing discussion follows:

  • TC Housing providers are seeing increased demand for utilities assistance, as people are spending more time at home.  Food insecurity in TC has increased, in spite of other additional resources.  Also, there is more demand for food deliveries as people do not want to expose themselves by shopping at stores.
  • In NYC, Housing demand remains high, in spite of the eviction moratorium.  Providers are worried about sustainability, particularly being able to keep new clients enrolled next year. 
  • The Housing program is using HUD guidance for undocumented immigrants.  There is a waiver to use self-attestation where clients can provide what they can to prove eligibility (HIV status, income).
  • Housing providers have not needed to pay for more re-locations than usual due to the moratorium, but if the moratorium is lifted next year, there may be a huge increase in need.
  • Wait lists have started to form, particularly for Housing Placement Assistance.  Better coordination with HASA would mean more placements.
  • There may be a limit to how much ADAP can be reduced.  Besides being the top priority, we do not know the status of ADAP’s other funding streams.  Also, ADAP is the only program that can reliably accept carry-over late in the year and can be used to balance the Base and MAI awards.
  • Oral Health services will not be funded until the beginning of FY 2022, as virtually the entire CTP staff is activated.  The Dental Case Management portion of the service can be funded in FY 2021 using the existing Medical Case Management allocation.
  • There are many unknowns, including the effect of vaccines and the course of the COVID pandemic and the Council must be flexible and nimble in response.  It is unlikely that Ryan White will be expected to support vaccination efforts.

A motion was made, seconded and approved 12Y-0N to move funding for Oral Health services to FY 2022.

Additional data will be presented at the January PSRA meeting on Housing so that the Committee can make a determination on how much to continue enhancing that category in FY 2021.  Also, there will be more information by the February meeting on changes in the carrying costs of program, which should result in some additional savings.  Finally, we will hear from the NYSDOH AIDS Institute on how much of the ADAP allocation can be used to cover enhancements and absorb the cut to the award.

There being no further business, the meeting was adjourned.