Meeting of the Priority Setting & Resource Allocation Committee
Monday, January 13, 2025
By Zoom Videoconference
3:05 – 5:00
Members Present: Paul Carr (Co-chair), Marya Gilborn (Co-chair), Raffi Babakhanian, Matt Baney, Joan Edwards, Billy Fields, David Klotz, Guadalupe Dominguez Plummer (ex-officio), Stella Safo, MD, John Schoepp, Terry Troia
Member Absent: Steve Hemraj, Marcelo Maia
Staff Present: Scott Spiegler, Adrianna Eppinger-Meiering, Johanna Acosta, PhD, Gina Gambone, Deborah Noble, Bryan Meisel, Jimmy Jaramillo (DOHMH); Arya Shahi, Gemma Barclay (Public Health Solutions)
Agenda Item #1: Welcome/Introductions/Minutes
Mr. Carr and Ms. Gilborn opened the meeting, followed by a roll call and a moment of silence. The minutes of the December 9, 2024 meeting were approved with no changes.
Agenda Item #2: GY 2025 Spending Scenario Plan
Mr. Klotz reviewed the savings in carrying costs for programs, most of which were explained at the December PSRA meeting: end of the one-time enhancement to Housing to transition clients to new programs, end of the Health Education category, a reduction in PSS TIGNBNC. For Behavioral Health (BH) categories, as presented last month, costs were broken out with $3.3M for Mental Health, $5.3M for Supportive Counseling and $4.6M for Harm Reduction. The initial total added up to the same existing allocation for all three categories in the Council’s GY 2024 spending plan, but there is an additional $44,031 in savings after awards were made, reflected in the Supportive Counseling line. Ms. Plummer added that after final contract negotiations, the savings in BH might be slightly more, which can be applied to the savings in carrying costs. Finally, Ms. Eppinger-Meiering reported that the agency that provides Non-Medical Case Management services on Rikers Island no longer needs to pay for the salaries of corrections officers to accompany inmates, resulting in a savings of $392,348. This is due to a change in Department of Corrections Policy. The total available to offset a reduction (or to reallocate in a flat-funding scenario) is $1,854,853.
Ms. Eppinger-Meiering presented a proposal from the Recipient to permanently enhance the Housing category by $1,212,656 to pay for newly allowable security deposits and adjust for new NYC law on brokers’ fees and adjusted fair market rents. The new allocation would keep capacity at current levels. This increase to Housing would mean that there would be $642,197 to absorb a reduction or reallocate in a flat funding scenario. Mr. Klotz reported that ADAP Director Julie Vara has said that the ADAP allocation could absorb $1.5M to help offset a reduction. The Committee was reminded that in the application spending plan, additional funding was allocated towards Housing and Food & Nutrition. Ms. Noble added that the amount is based on actual numbers of what would be required to keep clients house and make the requisite number of placements.
In response to questions, it was clarified that security deposits are held in escrow and any interest accrued is returned to the person or agency that paid the deposit. The entity that hired the broker is responsible for the broker’s fee (e.g., RWPA sub-recipient, property owner). While NY law requires that shelter be provided to anyone that needs it, that could mean a bed in a large warehouse-style shelter. RWPA provides medically appropriate housing for PWH.
A motion was made and seconded to enhance Housing Services by $1,212,656. The motion was adopted 9Y-0N.
Ms. Saab presented the GY 2025 spending scenario plan for the Tri-County region approved last week by the Tr-County Steering Committee (TCSC). The TCSC is requesting, as in most years, to keep their programs at level funding up to a 3.5 % decrease in the EMA’s awards. PSRA typically allows the TC region to receive a larger percentage of program funds than their proportion of PWH in the EMA due to the lack of local resources compared to NYC (particularly no HASA). Should the EMA get a large decrease of over 3.5%, the TCSC proposes to absorb a proportionate amount along with NYC programs through an across-the-board reduction to the lowest ranked categories (Legal, Oral Health, Mental Health, and Early Intervention Services). This approach will avoid cuts to its top five priority ranked services (Housing, Medical Transportation, Psychosocial Support Services, Medical Case Management, and Food/Nutrition). In response to a question, it was explained that Mental Health services are clinical and require a DSM diagnosis, while PSS can be provided by social workers or counselors and can include non-clinical services such as support groups and pastoral counseling.
A motion was made and seconded to accept the Tri-County Spending Scenario Plan as presented. The motion was adopted 9Y-0N.
Mr. Klotz explained that, given the savings in carrying costs, the enhancement to Housing and the ability of ADAP to absorb up to $1.5M of a reduction, there would be $642,191 available to absorb an additional reduction or reallocated to high priority service categories. It was noted that the PSRA Committee went through a process in the summer for the application spending plan that designated large targeted increases to Housing and Food & Nutrition and a small increase to Legal Services. The Committee discussed various issues to consider when reallocating uncommitted funds. There may be changes in federal policy and/or funding that may cause an uptick in the need for RWPA services (e.g., reductions in SNAP benefits). There may be more demand for Legal Services to address denials of benefits. While Housing just received an increase, it can always absorb more to increase capacity. More information about the number of new clients that would be served would be helpful, but the Recipient may not be able to provide that by the next meeting. It was noted that the amount of uncommitted funding might be much smaller, if anything, and that it would not be helpful to spread it too thin.
The Committee will complete its deliberations on the use of potential uncommitted funds at the February 10th meeting.
Mr. Klotz explained that, in the event of a reduction to the award larger than $2,142,197 (savings in carrying cost and reduction to ADAP), the PSRA Committee needs to decide on how to implement that. Options include across-the-board weighted reductions or targeted decreases to lowest ranked categories. It was noted that the Early Intervention Program will be starting fresh under a new provider as of March 1st. Also, the next lowest ranked category, PSS TIGNBNC is already taking a targeted reduction. The next lowest ranked categories are the new Behavioral Health programs.
The Committee asked to review the new EIS directive (the service model is essentially the same as before, but it puts more emphasis on targeted testing, as well as adding initiation of iART) and for any information about the effect of a potential decrease to the category. It was noted that the EIS allocation was reduced about 7 or 8 years ago due to the few positives that were identified, and because the HIV testing landscape had changed with the implementation of routine testing in NY State.
The Committee will complete its deliberations on a large reduction scenario at the February 10th meeting. There being no further business, the meeting was adjourned.
