TRI-COUNTY STEERING COMMITTEE MEETING
January 14 2026, 10:00 am-11:53 am By Zoom Videoconference
DRAFT MINUTES
Members Present: J. Palmer (Co-chair), L. Cyrus (Co-chair), M. Acevedo, V. Alvarez, L. Best,
J. Braithwaite, L. Bucknor, V. Carlone, A. Contreras, M. Diaz, J. Gago, L. Hakim, B. Malloy, A.
Milian, K. Palencia-Lua, K. Scott, P. Tang, S. Thomas
Members Absent: R. Agarwal, P. Germinaro, J. Gobler, A. Hardman, A. Pizarro, A. Ruggiero,
S.Servadio
Other PC Members Present: B. Fields, J. Schoepp
Staff Present: NYC DOHMH: D. Klotz (Governmental Co-Chair), D. Saab, L. Moya-Adames, A. Omeyoma,
G. Dominguez-Plummer (ex-officio), J. Acosta, S. Kramer, J. Cheek
Agenda Item # 1: Roll Call/Moment of Silence/Announcements
LaShonda and Julian opened the meeting with a roll call of members followed by a moment of silence.
The minutes for the December 10th 2025 meeting were approved with no changes.
John S. invited Tri-County (TC) consumers to attend the Council’s Consumers Committee to work
collaboratively across the EMA. David K. encouraged providers and consumers to share and complete
the Consumer’s Committee survey on Immigration Health to better understand the safety and health
needs of RWPA immigrant clients.
Agenda Item #2: Updates
Recipient Report
No Report this Month
Planning Council and Federal Administration Update
David Klotz provided a Planning Council and federal budget update. David highlighted ongoing work
by the Consumers Committee and Needs Assessment Committee related to safe access to services for
immigrants. He also noted that the Integration of Care Committee has begun revisions to the Legal
Services directive, the next category scheduled for re-
procurement in 2026.
In November, the Planning Council approved three Tri-County service directives—Medical Case
Management, Oral Health, and Medical Transportation.
He noted that the Priority Settings and Resource Allocation (PSRA) Committee started the
development of the GY 2026 spending scenario plan, which assumes potential funding reductions.
D. Klotz summarized current federal budget negotiations, outlining proposed funding scenarios from
the White House, House, and Senate.
Key federal updates included:
- The federal fiscal year began October 1 without a finalized budget
- A continuing resolution is currently funding the government and expires in January
- Three federal budget proposals preserve base Ryan White funding
- A proposed HRSA formula change (counting clients by current residence rather than diagnosis
location) is expected to result in a modest funding increase for the New York EMA over time
He noted that uncertainty remains regarding the Minority AIDS Initiative (MAI) portion of the
grant. If MAI funding is preserved, minimal or no reductions are anticipated; if eliminated, the
EMA could face an approximate 8.5% cut.
D. Klotz concluded by noting that PSRA is planning conservatively and preparing for multiple
funding scenarios.
Advocacy resources were discussed and will be shared with committee members.
Agenda Item #3: GY 2026 Tri-County Spending Scenario Plan – Overview
D. Saab introduced the GY 2026 Tri-County Spending Scenario Plan, explaining that this annual
process involves reviewing funding changes, discussing options, and voting on a recommended
spending scenario.
Conflict of Interest Review
D. Saab reviewed the Conflict-of-Interest guidelines prior to discussion and voting for the
spending scenario plan. Members were reminded that individuals with a financial interest in a
service category must abstain from voting on funding decisions affecting that category.
Clarifications were provided that:
- Disclosure is required for paid staff or board members of funded agencies
- Consumers and advisory board members are not subject to abstention requirements
and Medical Nutrition Therapy delivered by registered dietitians. Challenges such as rising food
costs, COVID-related staffing impacts, and service utilization trends were discussed, along with
successes related to program spend-down and use of enhancement and carryover funds.
Overview of Proposed Spending Changes
2
Adrianna Eppinger-Meiring shared feedback drawn from recent listening sessions, highlighting client
and provider experiences and perspectives related to food access, service delivery, and nutritional
needs within the Tri-County region under FBT. The feedback emphasized the importance of healthy and
culturally responsive food options, food quantity provided, service flexibility, and addressing
practical barriers clients face in accessing nutrition services. These insights were shared to help
inform the ongoing development of the Food and Nutrition Services service directive and upcoming
directive revisions.
Grace Mackson presented the Food and Nutrition Services (FBT) factsheet summarizing program goals,
utilization, and client demographics across the Tri-County region. G. Mackson highlighted that the
program serves 303 active clients (GY2024), primarily people aged 50 and older, Black or Latino
individuals, cisgender MSM, cisgender women of color, people with disabilities, and transgender
women—populations disproportionately impacted by HIV and food insecurity. Data demonstrated
consistent utilization of multiple service modalities, including food vouchers, pantry bags,
home-delivered meals, and nutrition counseling, with strong spend-down of Planning Council-approved
allocations over recent grant years. Food insufficiency data showed that the majority of clients
experience moderate to severe food insufficiency, underscoring the continued need for nutrition
services. G. Mackson also noted systems-level considerations, including potential federal funding
uncertainty for SNAP and WIC, which may further increase reliance on Ryan White–funded Food and
Nutrition Services in the Tri-County region.
Draft Service Directive Revisions
Doienne Saab. presented a revised draft of the directive, incorporating revisions made to the most
recent Tri-County Food and Nutrition Service directive and adding innovations based on data and
research collected by the Community Planner to ensure the language and service model are reflective
of the needs of PWH, update aims to align the service model with current best practices, integrate
equity and stigma-reduction goals, and reflect new tools available to providers. Details of the
proposed revisions included aligning the directive with HRSA requirements, updating nutritional
standards, and introducing accessible and innovative food and nutrition delivery models to better
address food insecurity and dietary needs among Ryan White Part A clients.
D. Saab highlighted a structural clarification within the directive separating Food and Meals
(non-core) from Medical Nutrition Therapy (core), in accordance with HRSA monitoring standards,
while encouraging providers to offer or partner for both service components. Key updates included
expanded and modernized food and meal services, emphasizing healthy, whole and nutritionally
balanced, and culturally relevant food options, client choice, and
flexibility to reflect clients’ cultural, religious, and dietary preferences. The directive allows
for emergency pantry bags and food vouchers, prepared meals for clients unable to cook or shop, and
guidance to ensure meals meet nutritional standards.
She also reviewed newly added and strengthened service delivery options, including mobile food
pantries, grocery and meal delivery using provider or contracted services, and coordination of
transportation supports (e.g., discounted/free rideshare programs or taxi vouchers). D. Saab
described updates that removed overly clinical language for Food and Meal providers only, in favor
of client-centered, public-facing nutrition guidance, and strengthened expectations around
nutrition education using evidence-based tools and community resource directories.
3
D. Saab reviewed key elements of the proposed GY 2026 spending scenario, including:
- Emergency Financial Assistance (EFA) returning to the Tri-County portfolio with a proposed
allocation of $250,000, reflecting a structural change rather than a service expansion - $226,628 in uncommitted funds resulting from contract cancellations in Early Intervention
Services and Legal Services - Confirmation that the former Legal Services provider will continue offering services using
non–Ryan White Part A funding - Guidance from PSRA recommending:
o Full reallocation of Tri-County uncommitted funds if the overall EMA reduction is below $652,294
o Use of 50% of Tri-County uncommitted funds if reductions exceed that amount
She also noted that while the Tri-County region represents approximately 4.3% of the EMA’s
population of people with HIV, it receives 5.8% of Part A funding and has historically been held
harmless from cuts.
Legal Services – Program Overview and Data
S. Kramer and J. Cheek presented an overview and data review for Early Intervention and Legal
Services in Tri-County inform the discussion regarding the reallocation of uncommitted funds
resulting from contract cancellations in both service categories.
Key highlights:
- The one prior contact for Early Intervention Services (HIV testing and linkage) was rescinded on
October 31, 2024, due to challenges identifying and enrolling eligible clients - In FY 2024, the provider tested 102 clients, with one positive HIV test result
- In FY 2025 (partial year), the provider tested 35 clients, with two positive test
results - Overall testing volume averaged approximately 100 clients per year
- The Legal Services contract currently exists and will end February 28, 2026 after the provider
rescinded the contract - Low enrollment and high staff turnover contributed to underperformance
- In FY 2024, only 7 active clients received services, all in Rockland County
- Expenditures consistently underperformed allocated funding
- Multiple alternative legal service providers exist in the region using non–Ryan White
funding
Jelani reviewed Legal services demographic and utilization data, showing declining client counts
and service units over the past three grant years.
Clarifications were provided that: - Units of Direct Legal Advocacy represent billable legal activity (e.g., meetings, calls, case
work) - Ryan White Legal Services cannot be used for criminal defense or immigration services, except
limited assistance related to PRUCOL status
4
Discussion
Both S. Kramer and D. Saab shared that there are multiple alternative HIV testing and linkage
resources and Legal services available throughout the Tri-County region, supported by other funding
streams. These include community-based organizations, healthcare providers, hospitals, and
home-based HIV self-testing and tele-legal programs offered by New York State and nationally.
An Excel directory and a searchable Google map of organizations providing HIV testing services were
shared for the region. D.Saab will share the Google map directory once it is completed.
Committee members reflected on the reduced need for Ryan White–funded Early Intervention Services
given widespread availability of routine HIV testing, changes in New York State law, and immediate
linkage to care following diagnosis. David Klotz added historical context, noting that Early
Intervention Services have been reduced over time and are currently ranked among the
lowest-priority service categories.
In terms of Legal services, committee members asked clarifying questions regarding:
- The meaning of a contract being “rescinded” versus terminated
- Allowable scope of Ryan White Legal Services
- Implications of low utilization for future funding decisions
Staff clarified that rescinding indicates the provider voluntarily relinquished the contract and
confirmed that legal services remain accessible through other funding sources
Formal motion and Vote
Following presentation of the GY 2026 Tri-County Spending Scenario Plan, including data on Early
Intervention Services and Legal Services, and subsequent Committee discussion, the Steering
Committee proceeded to consider a motion.
A motion was made to approve the GY 2026 Tri-County Spending Scenario Plan to include the
allocation of uncommitted funds to the Food and Nutrition Services category.
The motion was approved by the Steering Committee (14 – Yes; 2 – Abstentions; 0 – No)
Agenda Item #4: Consumer Update Committee members emphasized the importance of addressing the following concerns:
- Fall injuries and neurological conditions among aging PWH and the importance of
screenings - Social isolation challenges for people aging and the importance of support groups (Living
Together) and art activities - Medicaid transportation delays and program miscommunications – case managers are one solution to
mitigating transportation scheduling
5
6
The Next Steering Committee Meeting will be held on Wednesday, March 11th 10-11:30 AM.
There being no further business, the meeting was adjourned.
