TRI-COUNTY STEERING COMMITTEE MEETING
April 9, 2025, 10:00-11:30am
By Zoom Videoconference
Members Present: J. Palmer (Co-chair), L., Cyrus (Co-chair), V. Alvarez, M. Diaz., J. Braithwaite, A. Contreras, L M. Acevedo, R. Agarwal, L. Bucknor, V. Carlone, J. Gago, P. Germinaro, J. Gobler, L. Hakim, K. Palencia-Lua, A. Pizarro, K. Scott, P. Tang, G. Thomas, S.Thomas
Members Absent: D. Anderson, A. Hardman, L. Best, R. Henderson, K. Mandel, B. Malloy, A. Milian, A. Ruggiero,
Guest and other
PC Members Present: J. Goldenbridge, C. Ravida, M. Yomogida, D. Norman
Staff Present: NYC DOHMH: D. Klotz, D. Saab, G. Dominguez-Plummer, J. Acosta, S. Kramer
Agenda Item # 1-2: Introductions/Moment of Silence/Minutes
Julian P. and Lashonda C. opened the meeting followed by a moment of silence.
Agenda Item #3: Meeting Minutes
The minutes for March 12th, 2025 meeting were approved with no changes.
Agenda Item #4: Public Comment
David K. announced that the Consumer’s Committee is hosting a Client Advisory Board (CAB) Townhall at the LGBTQ Center on Monday, April 15th 9:30 am to 2:30 pm. Steering Committee members and community are encouraged to join the event in-person to learn about best practices on implementing and sustaining a successfully operated CAB. Transportation accommodations will be arranged for members traveling from Tri-County. Breakfast, lunch and metro cards will be provided.
Agenda Item #4: Updates
Consumer Update
| Maria D. expressed that Medicaid transportation continues to be an unreliable mode of transport for consumers. Johanna A., and Doienne S. shared that they’ve reached out to the Westchester Department of Social Services (DSS) about the Medicaid transportation issues that have been reported by the group. As a next step, Doienne S. emailed the contractor, Medtrans and submitted a memo detailing the transportation complaints from consumers and requesting a representative speak to the committee at an upcoming meeting. So far, no response was received, the Recipient and Doienne S. will continue to reach out to Med Answering to address consumers’ concerns with Medicaid transportation. Maria D.also mentioned that the frequent occurrences of fall-related incidents and other aging-related medical conditions continue to be an issue for consumers. Victor A. emphasized the importance of addressing social isolation as a contributor to poor health outcomes among consumers. Cindy R. recommended inviting John Hartigan, Project Director of HIV and Aging at the AIDS Institute to come to speak to the committee about aging related concerns. Doienne S. will reach out to John Hartigan and invite him to speak at an upcoming committee meeting. |
Recipient Report
G. Dominguez-Plummer acknowledged that several RWPA sub-recipients shared their concern that their 2025 Ryan White Part A (RWPA) funding has not yet been received. She reassured members that funding has been distributed from the partial award and that there should be no interruption in reimbursement for services delivered. David K. added that a potential delay in receiving funds could be related to the recent workforce terminations at the Department of Health and Human Services (HHS).
Planning Council and Federal Administration Update
David K. shared that the Health Resources and Services Administration (HRSA), is moving forward with funding level plans and announcing funding opportunities. The RW grant award for our EMA will probably stay approximately level with a possible small reduction in our formula funding. If funding is level or only slightly reduced, the Tri-County region’s funding will be held harmless, and we’ll be able to absorb any reduction in the award in the NYC portfolio through savings in the carrying cost of programs. The EMA received a letter from the HRSA administrator affirming the core mission of Ryan White programs to ensure access to primary care and achieve viral load suppression for PWH. The letter also warned against using Ryan White funds for any unallowable purposes.
Agenda Item #5: Oral Health Directive – Draft Revisions to Service Model and Eligibility Criteria
Doienne S. presented on the oral health services directive, Tri-Couty revisions to enhance the delivery of oral healthcare services for people with HIV (PWH), ensuring that these services are accessible and comprehensive. Doienne S. provided background on how oral healthcare is defined under the Ryan White Part A (RWPA) and the Health Resources and Services Administration (HRSA) program. According to HRSA, oral health services include outpatient diagnosis, prevention, and treatment, all of which must be delivered by qualified dental professionals such as general dentists, specialists, hygienists, and licensed dental assistants. The directive outlines several key goals. These include promoting the overall health of PWH by preventing and managing oral health complications, increasing access to timely and appropriate oral healthcare, and avoiding disruptions in HIV care that might arise from untreated oral issues. The directive also emphasizes the role of oral health in supporting nutritional intake, adherence to antiretroviral therapy (ART), and integration into comprehensive HIV primary care. A major focus is also placed on addressing and reducing disparities in access, retention, and health outcomes among underserved populations.
The presentation highlighted the types of services subrecipients are required to provide or coordinate through referral. These services include routine exams and cleanings, the development of individualized treatment plans, restorative care such as root canals, crowns, dentures, and implants, as well as oral health education and medication for HIV-related oral health conditions. Importantly, providers are expected to conduct outreach to engage clients who face additional barriers to care, including those experiencing housing instability, mental illness, or substance use.
A coordinated, client-centered approach remains central to the updated service model. Clients should receive a comprehensive service plan based on an initial intake and periodic reassessments. Oral health providers are expected to collaborate closely with medical case management and primary care providers, ensuring that any changes in a client’s oral health are communicated in a timely and effective manner. Providers are also responsible for keeping clients informed and engaged throughout their care, with clear communication regarding treatment plans, progress, and next steps.
Doienne S. then shared the newest updates to the program’s service model. Included in the updated text of the service model was the importance of serving priority populations, particularly Black and Hispanic/Latino individuals who are disproportionately affected by both HIV and barriers to oral healthcare. Services should align with and complement existing programs such as Medicaid, Medicare, ADAP, and Ryan White Part F to build a more cohesive system of care.
To support long-term engagement in care, the directive calls for the use of high-quality dental materials and emphasizes the importance of routine, recurring dental services. These services include cleanings, extractions, crowns, and dentures, as well as the management of common co-morbidities like diabetes and Hepatitis C. Preventive care should be standard practice, including oral hygiene education, screenings for dental discomfort and anxiety, and referrals for conditions associated with HIV. Clients who smoke should be referred to cessation resources, and providers are encouraged to monitor alveolar bone loss, especially in cisgender women and individuals over the age of 50.
The use of digital technologies is strongly encouraged. The directive suggests expanding digital dentistry tools, such as 3D imaging, intraoral cameras, and digital impressions, to improve the accuracy and comfort of care. Teledentistry is also supported, particularly for follow-up appointments and remote oral health monitoring. Oral health education should be integrated into Ryan White Food and Nutrition Services health modules, and Emergency Financial Assistance (EFA) and hygiene allowances under FNS may be used to cover items like electric toothbrushes.
Another key update involves strengthening referral tracking through a closed-loop referral system. This approach ensures that clients referred for services—whether for oral healthcare, housing, harm reduction, or behavioral health—actually receive those services and that outcomes are documented and communicated back to the referring provider. This system aims to reduce care gaps and improve coordination across providers and support clients unmet needs.
In closing, Doienne S. noted that this revised oral health service directive will guide the procurement process for oral health services in the Tri-County region beginning on March 1, 2027. The presentation concluded with an invitation for questions and discussion from members of the committee.
There was a consensus to approve the revised service directive for oral health services, Tri-County (OHT).
Agenda Item #6: Adjournment
David K. mentioned that the committee will continue revising service directives for the remainder of the planning year into Fall 2025.
The next meeting will occur on May 14th, 2025, from 10 – 11:30 am.
There being no further business, the meeting was adjourned.
