Monday, November 10, 2025
By Zoom Videoconference
3:05 – 4:30pm
DRAFT MINUTES
Members Present: Paul Carr (Co-chair), Marya Gilborn (Co-chair), Raffi Babakhanian, Matt Baney, Joan Edwards, Billy Fields, Camila Gomez, David Klotz, Marcelo Maia, David Martin, Scott Spiegler (for Guadalupe Dominguez Plummer, ex-officio), Stella Safo, MD, John Schoepp, Diane Tider
Members Absent: Steve Hemraj, Marcelo Maia
Staff Present: Michael Navejas, Johanna Acosta, PhD, Adrianna Eppinger-Meiering, Abraham Omeyoma (DOHMH); Arya Shahi (Public Health Solutions); M. Yomogida, A. Furuya (CHAIN Study)
Agenda Item #1: Welcome/Introductions/Minutes
Ms. Gilborn and Mr. Carr opened the meeting, followed by introductions and a moment of silence. The minutes of the July 14, 2025 meeting were approved with no changes.
Agenda Item #2: 2025-26 PSRA Committee Workplan
Mr. Klotz reviewed the Committee’s 2025-26 workplan, which includes the timeline for completing the GY 2026 spending scenario plan, the GY 2026 reprogramming and carryover plans, ADAP update and the GY 2027 application spending plan.
Agenda Item #3: GY 2025 Estimated Unobligated Balance Request
Ms. Gilborn explained that HRSA requires all EMAs to complete and submit by the end of December an “estimated unobligated balance request” (UOB). The document tells HRSA that the EMA will ask to use unspent funds from the current grant year (i.e., 2025 carryover) in the next grant year (2026). The UOB request states that next spring we will ask to carry over as much as 5% (the maximum allowed with no penalty). Mr. Spiegler described the details of the plan, which uses 5% of the Base formula and MAI funds and allocates them to ADAP as a placeholder. The Council is not required to spend the carryover for that purpose. We will know the actual amount of carryover next spring after closeout of the grant year, after which PSRA will develop an actual carryover plan for submission to HRSA. There were questions about the possible need to allocate additional resources to Food & Nutrition Services. That category can receive additional funds during the year through reprogramming and carryover, and the Committee can choose to increase the baseline allocation for the category during the scenario planning process.
A motion was made and seconded to approve the GY 2024 estimated unobligated balance request. The motion was adopted 11Y-0N.
Agenda Item #4: CHAIN Report: NYC Service Needs and Utilization 2018-2024
Mr. Furuya presented the most recent CHAIN report on service needs and gaps. He provided an overview of the CHAIN study and cohort, including the recruitment and data collection processes. This report examines the levels of need, and among those with need, utilization of specific services that fall into Ryan White Part A categories. The report seeks to identify service categories with high need and low utilization, for RWPA planning purposes. The report compares data from interviews in 2025-17, 2018-20 and 2021-24. Some differences in the characteristics of those interviewed were described (e.g., decrease in younger participants, US born and those using hard drugs).
The definition of need and utilization for each service was explained. A summary of the report’s findings include:
- HIV Primary Care: no significant change to need or utilization (100% need by definition, 96% utilization)
- Home Care: No change (low need, 50% utilization)
- Non-Medical Case Management: significant decreases for both need and utilization
- Medical Case Management No change in need, significant increase in utilization
- Professional Mental Health Services: significant decrease in need, no significant change in utilization
- Substance Use Treatment: no significant decrease in need, significant decrease in utilization
- Transportation: no significant change to need or utilization
- Food: no significant decrease in need, significant decrease in utilization
- Nutrition Counseling: significant increase in need, significant decrease in utilization
- Housing Placement: significant decrease in need, significant increase in utilization
- Rental Assistance: significant increase in need, no significant change in utilization
Takeaways from the report include:
- Rental assistance needs increased, while permanent housing needs decreased
- Professional mental health and non-medical case management needs and service utilization decreased
- Nutrition counseling needs increased, while nutrition counseling and food service utilization decreased
- Service utilization for alcohol and drug treatment decreased
Areas with high levels of need but low utilization in 2021-24 were Mental Health, Food and Nutritional Counseling. Transgender individuals, homeless individuals, those experiencing unstable housing, those unemployed and looking for work, and those with substance use issues are more likely to have more service needs. Younger and older adults have a similar number of service needs but have distinctly different sets of service needs. Those with substance use issues, those recently diagnosed (after 2011), and those experiencing poor mental health are more likely to underutilize services.
Committee members raised the question about the reasons for low utilization of services (e.g., lack of access, insufficient provider capacity, substance use barriers). Dr. Yomogida noted that CHAIN collects that information and is able to provide more detailed reports if requested. More detailed population-based data is also available in the full report: https://nyhiv.org/wp-content/uploads/2025/10/NYC-2018-2024-Needs-and-Utilization-Report_Final.pdf
Agenda Item #5: PSRA Priority Ranking Tool: Service Gaps and Emerging Needs Criterion
Mr. Klotz explained that the CHAIN report can be used to update the Service Gaps/Emerging Needs criterion in the PSRA priority ranking tool. He explained the criterion’s definition (To what extent does Part A funded service address a specific service gap or service needed (specific geographic area or demographic/special population?) and scoring scale (0-8). There was a discussion of the CHAIN data and how it may apply to the ranking scores.
Mr. Martin suggested that data supports increasing the Gap/Need criterion score for Mental Health to the maximum of 8. Mr. Klotz explained that the ranking score only affects allocations in the unlikely event of an across-the-board reduction. FNS is already ranked as high as possible. The allocation for the three Behavioral Health Categories (Mental Health, Harm Reduction, Supportive Counseling) are lumped together and would not be affected by a change in ranking, but the categories are reported separately to HRSA in the application.
Starting March 2027, the FNS category is being broken out into two separate categories (Food & Meals Provision, Medical Nutritional Therapy), meaning that those categories will need to be newly ranked.
There was an agreement to table any decisions on new rankings to a future meeting. CHAIN will be approached for additional data on causes of low utilization, which might require some lead time. Also, given the events of 2025, any information from current providers on utilization would be helpful, but that data would only be anecdotal (complete data would have a lag until next year). Any new rankings do not have to be finalized until the end of the planning year in July.
There being no further business, the meeting was adjourned.
