Tri-County Steering Committee Minutes April 12, 2023



March 8, 2023, 10:05-11:00am

By Zoom Videoconference

Members Present:       S. Altaf (Co-chair), J. Palmer (Co-chair), V. Alvarez, L. Bucknor, A. Contreras, A. Desir, J. Gago, G. Harriman, B. Malloy, K. Mandel, M. Piazza, L. Reid, S. Richmond, A. Ruggiero, K. Scott, S. Spiegler (for G. Plummer), S. Thomas

Members Absent:        M. Acevedo, L. Beal, L. Best, M. Diaz, L. Hakim, A. Hardman, A. Pizarro

Staff Present:              NYC DOHMH: D. Klotz, J. Acosta, M. Beyene; CHAIN: D. Norman

Agenda Item 1: Opening/Moment of Silence/Minutes/Announcements/Public Comment

Mr. Altaf and Mr. Palmer opened the meeting followed by introductions and a moment of silence.  The minutes of the March 8, 2023 meeting were approved with one change to reflect attendance.

Ms. Contreras announced that Putman County Health Department will be holding upcoming events for STI awareness and smoking cessation, and a migrant clinic.

Agenda Item #2: Updates

Consumer Update

Mr. Alvarez reported that many consumers are reporting the co-morbidities of aging, particularly cancers, and the greater focus on aging is welcome.  Many consumers are also worried about potential budget cuts that may impact HIV services.  The focus must be kept on the human impact of funding cuts.

Planning Council Update

Mr. Harriman reported that at the March 30th Planning Council meeting, the Data Workgroup recommendations were approved, and the Quality Management Plan was presented.  In April there will be a presentation on the Medicaid 1115 waiver and the service standards for NYC programs will be approved.  The Behavioral Health directive is still being developed, which will combine NYC programs in Harm Reduction, Mental Health, Supportive Counseling and Health Education.  The draft Needs Assessment will be submitted to HRSA in advance of their upcoming site visit to the EMA.  The Policy Committee will next host representatives from HASA to address NYC housing issues.  The Consumers Committee is prioritizing a list of issues to focus on, including access to dental care, the effect of staff vacancies on services, benefits navigation and social isolation.

Mr. Klotz reported that the EMA received the final notice of award from HRSA for the 2023-24 grant year.  The GY 2023 award is stable with a slight overall increase of $57,086.  The award numbers were inputted into the spending scenario approved by the Council.  There will be a reduction to ADAP of about $1.5M to cover new commitments for Oral Health and Ambulatory Outpatient Services/Aging.  That reduction will be restored through reprogramming and carryover funds.

Recipient Report

Mr. Spiegler reported on federal updates, including the release of the National Ryan White Part B ADAP Report and National Women and Girls HIV Awareness Day.  HRSA is conducting a site visit to the EMA from May 15-19, which will include fiscal and quality management reviews and a meeting with the Council’s Executive Committee.  On May 15th, there will be a meeting with consumers who accessing RWPA services via Zoom. Consumers who participate will receive a $50 gift card incentive.  A RWPA Housing Services concept paper for NYC services was released in advance of an expected RFP.  The final Quality Management Plan was presented to the Planning Council. 

The eligibility review for Medicaid renewals necessitated by the end of COVID rules was discussed.  Millions of enrollees will have to be recertified or risk losing their coverage.  NY State is spreading the word about the steps that enrollees must take to renew their coverage.  The NYC Commissioner of Health and State legislators are pushing back against the possible end of the 340B program.  The issue is being debated as part of the state budget process.  It was noted that the State has moved forward switching Medicaid prescription benefits to fee-for-service, but there are reports of some pharmacies asking for pre-authorization for some medications.  President Biden has released his 2024 budget proposal, which includes increased for Ryan White as well as CDC and HOPWA HIV programs.  The budget will be negotiated in Congress.

Agenda Item #3: Data Collection Workgroup Recommendations

Mr. Harriman presented the recommendations of the Council’s Data Collection Workgroup, which was formed to address long-standing challenges around Ryan White Part A (RWPA) program data collection (barriers to provider-level data, Inefficient data entry, inability to import or export data, and data collection burden on consumers and providers).  The Workgroup was charged with developing recommendations to share with the Recipient, colleagues in NYC DOHMH, NYSDOH AIDS Institute, and HRSA to improve RWPA data collection through improved database technology.  Current data flow was compared to an equitable data flow that benefits all stakeholders.  A timeline of Workgroup meetings from February 2022 was given, including presentations from HRSA, DOHMH, eSHARE, and RWPA providers and consumers.  The recommendations are summarized below: 

  1. Remove collection for eSHARE of data on: AIDS diagnosis date, hospitalizations and ED visits, sexual history, other assessments.
  2. Eliminate collection of lab test data (except for Ambulatory Outpatient Care programs).
  3. Increased coordination between Recipient and Planning Council to ensure agreement on data collection needs.
  4. Recipient work with eSHARE or a future information system administration to develop routine service category data reports to inform the community planning process.
  5. Recipient inform Council of any additional data collection requirements communicated to Ryan White Part A funded programs
  6. Database changes (accommodate multiple funders, share with NYS AI).
  7. Sharing intake, eligibility, and demographic data between providers to reduce barriers to services for consumers and reduction of data collection burden for providers and consumers.
  8. Ensure organizations have access to their own data for performance measuring, quality assurance, and quality management.
  9. data collection efforts should be aligned with Medicaid data collection to increase interoperability, reduce redundancy, and burden.

After this Committee and the Council ratify the recommendations, they will be shared with NYC DOHMH, NYS AI, HRSA/HAB, the HIV Planning Group and other planning bodies. 

Mr. Harriman, in response to a question from Mr. Altaf, said that the Recipient will be asked to report back on the implementation of the recommendations early next year.  Several committee members commended the Workgroup for the recommendations, noting that changes to RWPA data collection have been discussed for many years and that the current data collection burden takes time away from actual service provision. 

Mr. Alvarez reported that there have been cases of fraud where SNAP benefit account have been drained.  Mr. Piazza noted that the Putnam Department of Social Services recently saw its first case and was able to restore the funds quickly.

There being no further business, the meeting was adjourned.