Tri-County Steering Committee Minutes January 13, 2021

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TRI-COUNTY STEERING COMMITTEE MEETING

January 13, 2021, 10:05-11:20am

By Zoom Videoconference

M I N U T E S

Members Present:        M. Diaz (Co-chair), A. Straus (Co-chair), D. Ahmed, S. Altaf, V. Alvarez, L. Best, L. Bucknor, D. Dominguez, M. G. Ferone, J. Gago, L. Hakim, G. Harriman, K. Mandel, C. Oldi, J. Palmer, M. Piazza, A. Pizarro, G. Plummer, L. Reid, S. Richmond, A. Ruggiero, S. Sanchez, A. Simmons, S. Thomas

Members Absent:         M. Acevedo, A. Contreras, A. Hardman, P. Laqueur, D. Scholar, K. Scott, T. Seabrook, D. Smith

Staff:                               NYC DOHMH: D. Klotz, E. Jimenez-Levi, J. Acosta, A. Guzman, D. Ferdinand; Public Health Solutions: J. Moy, D. Ortiz

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

Ms. Diaz and Ms. Straus opened the meeting followed by introductions and a moment of silence in memory of Glenn Archer.  The minutes of the November 6, 2020 meeting were approved with no changes.  

Agenda Item #2: Updates

Consumer Update

Mr. Alvarez reported that consumers in Tri-County are doing well in spite of the challenges of physical isolation.  One Living Together member was recently diagnosed with COVID-19, but is doing well.  He thanked the HVCS Thrives program for helping so many people with food insecurity.  Also, he cited challenges that some consumers face with telehealth access.  Ms. Best added that the Consumers Committee’s workshop at the Quality Improvement Conference addressed telehealth and the committee will continue to pursue ways of addressing barriers to accessing telehealth.

Planning Council Update

Mr. Klotz reported that the Planning Council met on December 17th with a presentation on 2019 NYC HIV surveillance report released on World AIDS Day.  The report showed a continued record low number of new infections in the five boroughs.  The 2019 surveillance data for Tri-County will be presented at the March Steering Committee meeting by Wendy Patterson of the NYSDOH AIDS Institute.  

The Consumers Committee had an excellent presentation on HIV and Aging from Jules Levin of NATAP.  This helped kick off a planning project where the Committee will develop recommendations for services that address the needs of older PWH.  There will be a public forum in the spring on the issue and the Tri-County community will be invited.

Mr. Harriman reported that the Council will review the Ending the HIV Epidemic plan, which covers the federal grant for Bronx, Queens, Brooklyn and Manhattan.  The plan will inform the next EMA-wide Integrated HIV Prevention and Care Plan.  Also, Council staff will be activated for vaccine distribution and other COVID-related activities.  It was noted that people with HIV are not considered high priority for vaccines unless they meet other criteria (e.g., over 65, co-morbidities, residents of congregate facilities).

Recipient (Grantee) Report

Ms. Plummer reported that November 19, HRSA/HAB released the 2019 Ryan White HIV/AIDS Program (RWHAP) Annual Client-Level Data Report.  The report shows that 88.1% of RWHAP clients receiving HIV medical care were virally suppressed, an increase from 69.5% in 2010, and exceeding the national viral suppression average of 64.7% among all people with diagnosed HIV.  The report also features RWHAP Services Report (RSR) data on all clients served by the RWHAP during calendar years 2015 through 2019.  The data highlight the key role of the RWHAP in providing high-quality care and treatment to more than half a million people with HIV in the USA.  The US Department of Health and Human Services also announced the first-ever STI National Strategic Plan.

In response to the service directive approved by the Planning Council, Public Health Solutions, on behalf of NYC DOHMH Bureau of HIV (BHIV), released the Ryan White Part A funded services, Psychosocial Support Services for People of Transgender, Intersex, Gender Non-Conforming, and Non-Binary experience. 

On December 8th, over 230 stakeholders, including service providers and consumers, virtually attended BHIV’s 7th Annual, 1st virtual Ryan White Part A (RWPA) Power of Quality Improvement (QI) Conference, with the theme of “Redesigning Systems to Address Social Justice and COVID-19.”  On World AIDS Day, DOHMH Commissioner Chokshi honored the Council’s own Lisa Best for her outstanding commitment to ending the HIV epidemic.

Ms. Acosta reported that she has held meetings with all Tri-County RWPA providers to support them during the pandemic.  Two Tri-County providers held workshops at the QI Conference (Legal Services of the Hudson Valley and St. John’s Riverside Hospital) that were very well received.  BHIV held four trainings for Tri-County providers on trauma-informed care.  More will be held in the future.  BHIV is also continuing its technical assistance to providers to overcome the challenges of delivering services in a pandemic.  Finally, the Emergency Financial Assistance program is successfully providing help throughout the EMA and is open to more referrals. 

Agenda Item #3: Housing Program Update  

Mr. Klotz reported that Congress passed an omnibus appropriations bill that funds Ryan White nationally in FY 2021 at the same level as FY 2020.  This means that, with the continued reduction in the NY EMA’s proportion of cases nationally, we should expect a similar reduction in the Part A formula award for FY 2021 as we have seen in recent years.  The new COVID-related stimulus bill does not include any funding for Ryan White programs, which means that the $1M in CARES funding will not be available in FY 2021. 

The Council’s Priority Setting & Resource Allocation Committee (PSRA) will complete its FY 2021 spending scenario in February.  They have agreed in principle to hold Tri-County programs harmless from cuts in the event of a reduction in the grant award.  In response to the needs for more information on the need for housing, the BHIV Housing Unit has compiled data that will be used to help the Steering Committee assess the funding needs in FY 2021.  In February, PSRA will consider any recommendations on the Housing category that come out of today’s meeting.

Ms. Jimenez-Levi presented on the Ryan White Part A (RWPA) Tri-County Housing program (HOU).  The program’s goals are: decrease homelessness, reduce HIV transmission, and improve health outcomes. The program provides financial assistance in the form of payments directly to landlords and/or utility providers for rent, utilities, telephone service, and moving expenses to secure or maintain stable housing.  Eligible PLWHA must meet RWPA eligibility criteria and priority is given to people who are homeless or unstably housed and/or in danger of becoming homeless.  There is no formal time limit; services are provided on a temporary basis until client is able to secure long term housing arrangements.

In FY 2020, the base Tri-County HOU allocation was $1,047,533.  The category received an additional $45,000 from the CARES Act (coronavirus stimulus), which was a pro-rated amount based on the region’s proportion of the EMA’s award.  A total of 136 households were served.  As of November 30, 2020 (end of the 3rd quarter), 75% of the allocation had been spent, which is right on target.  The one-time CARES funding was instrumental for supporting full rental costs for households impacted by income loss, increased utility costs due to shelter in place orders, and keeping current households stably housed, especially those impacted by COVID-19 infection.  In FY 2021, it would require $90,000 above the original base allocation to support the currently enrolled households with increased rental costs due to impact of COVID-19 and loss of household income, increased consumer utility expenses, costs of PPE/cleaning supplies, and increased costs of program operations (i.e., office rent/utilities, finance, staff salaries/fringe, teleworking, etc.).  For FY 2021, an additional $70,000 would support serving an additional 10 eligible households with housing/short-term assistance needs to prevent homelessness among PLWHA affected by COVID.  This means enhancing the program above its original FY 2020 allocation by $160,000 for a total of $1,207,533.

A summary of the discussion follows:

  • The potential end of the eviction moratorium is causing people who have never requested assistance before to come forward. 
  • Some landlords are taking other steps short of eviction, such as cutting off utilities.  People who face pressure from landlords despite the moratorium should be referred to Legal Services providers, who are helping consumers in this area.
  • People are also facing increased costs for utilities as they are at home more, as well as financial pressure from price gouging for household expenses like cleaning materials. 
  • Local housing providers are seeing an uptick in NYC residents who want to relocate to Tri-County.
  • Section 8 and other non-RWPA/HOPWA programs do not provide the kind of HIV-related supportive services than many consumers need.
  • Stigma can be a barriers to some consumers who may not want to be identified as receiving services form an HIV organization.  This is also true for some landlords.

A motion was made, seconded and approved 18Y-0N (and 4 recusals) to request that PSRA allocate an additional $160,000 to the Tri-County Housing service category in FY 2021 for a total of $1,207,533.

Mr. Klotz added that the AIDS Institute has indicated that they are able to accept a reduction in their RWPA allocation to fund enhancements and absorb a cut to the award.  Also, over-performing programs can be enhanced over the course of the year through the Council’s reprogramming plan.

Agenda Item #4: Policy Update

Mr. Guzman gave an overview of HIV-related federal, state and local policy issues.  He reviewed the results of the elections, which will result in Joe Biden and Kamala Harris being inaugurated next week and the Democrats in control of both houses of Congress. 

The COVID-19 vaccine is now available in New York State.  As of January 12, 2021, eligible groups include: doctors, nurses, and health care workers; people ages 65 and over; first responders, teachers, public transit workers, grocery store workers, and public safety workers; and residents and staff at nursing homes and other long-term care facilities, who will continue to be vaccinated through a federal program for which the state is providing resources to accelerate.

Governor Cuomo is rolling out his 2021 priorities, which include: ending the COVID crisis and vaccinating up to 90% of New Yorkers, economic recovery, and addressing inequities and injustices. 

Agenda Item #5: Other Business

Mr. Palmer urged people to help save 340B funding, which is threatened by the Governor’s Medicaid redesign plan by going to www.savenysafetynet.com  Also, he reported that the need for food assistance has gone up dramatically this past year. 

The next Committee meeting will be held by Zoom on Wed., February 10th, 10am.  The agenda will include a discussion on the Council and committee work plans to address several areas, including continuing to adapt to COVID, addressing racial equity, and incorporating quality management.

There being no further business, the meeting was adjourned.