M I N U T E S
Members Present: Paul Carr (Co-chair), Marya Gilborn (Co-chair), Raffi Babakhanian, Joan Edwards, Billy Fields, David Klotz, Guadalupe Dominguez Plummer (ex-officio), John Schoepp, Terry Troia
Members Absent: Matt Baney, Steve Hemraj, Marcelo Maia, Stella Safo, MD
Staff Present: Michael Navejas, Doienne Saab, Johanna Acosta, PhD, Scott Spiegler, Adrianna Eppinger-Meiering, Abraham Omeyoma, Renee James (DOHMH); Barbara Silver, Arya Shahi, Gemma Ashby-Barclay, Zachariah Hennessey (Public Health Solutions)
Agenda Item #1: Welcome/Introductions/Minutes
Ms. Gilborn and Mr. Carr opened the meeting, followed by a roll call and a moment of silence. The minutes of the April 14, 2025 meeting were approved with no changes.
Mr. Klotz updated the Committee on the GY 2025 grant award. The second partial award equal to 41% of formula and 27% of MAI GY 2024 awards was expected from HRSA but still has not arrived. When the full award is received, the number will be applied to the spending plan based on the methodology approved by the Council in February. Also, the draft 2026 budget released by the White House shows no changes to Ryan White Parts A, B, C or D, but proposes eliminating Part F. Ms. Plummer assured Committee members that the Recipient is working to ensure continuity of services.
Agenda Item #2: Priority Ranking: Payor of Last Resort
Mr. Klotz reviewed the PSRA priority ranking tool’s payor of last resort (POLR) criterion and scoring method, explaining that the Committee can consider revising the score for any service category based an updated POLR analysis.
Ms. Acosta explained the definition of POLR for RWPA programs and how it’s used to coordinate services with other funded services. A list of reimbursable services under a range of payors was presented, with services noted that overlap with RWPA services and eligibility criteria. Payors include: Medicaid (MA), MA specialized care plans, Medicare, private insurance through the Affordable Care Act, NYS HIV Uninsured Care Programs (incl. ADAP, ADAP+), other NYS AIDS Institute programs, programs under other parts of the Ryan White program (Parts B, C, D, F), and SAMSHA and CDC funded programs.
A major new payor for several services provided by RWPA programs is the Social Care Networks (SCNs) set up under the Medicaid 1115 waiver. This program pays for Housing support, nutrition, transportation and case management. SCNs began in 2024 and are authorized through 2027. The hope is that they will be reauthorized, but that is unknown, given the current administration’s policies. There may be additional changes to other payors, depending on federal actions, particularly around Medicaid and other funding.
Mr. Hennessey clarified that eligibility for SCNs is only for those enrolled in a MA managed care plan and that case management provided by the program should be non-duplicative and unique from other forms of care management. SCNs only serve people who fall into one or more of the populations eligible for enhanced services. An HIV diagnosis alone does not make one eligible. Frequent care users are defined as those who have had one or more hospitalization in 6 months, or 3 or more ED visits in one year. Also, there is a 6-month cap of food and rental assistance provided by SCNs.
Ms. Edwards clarified that ADAP/HUCP income eligibility is now 500% of federal poverty level (i.e., $72K for a single individual). Oral Health coverage under NYS MA plans has greatly expanded, but the effect of demand for RWPA services is unknown. Also, the White House has proposed eliminating RW Part F dental programs in 2026, which would greatly impact POLR for oral health services. There is no indication from spending rates that there is an increased need for or usage of legal services.
Given the evolving nature of federally funded programs and the uncertainty around funding, there was a consensus to leave the current POLR ranking scores unchanged for now and revisit them as developments arise.
CHAIN is preparing a report for the fall on service gaps and needs, which can be used to update the related criterion in the ranking tool.
Agenda Item #3: Public Comment
Ms. Saab invited members to join a presentation from CHAIN on HIV and aging.
Mr. Schoepp discussed the need for people who get their prescriptions at RiteAid to ensure continuity as those pharmacies close.
The next PSRA Committee meeting will be on June 12th to consider a GY 2024 carryover plan. There being no further business, the meeting was adjourned.
