Tri-County Steering Committee Minutes January 31, 2024

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TRI-COUNTY STEERING COMMITTEE MEETING

January 31, 2024, 10:05-11:35am

By Zoom Videoconference

Members Present:          S. Altaf (Co-chair), J. Palmer (Co-chair), D. Anderson, L. Best, L, Bucknor, A. Contreras, L. Cyrus, A. Desir, M. Diaz, J. Gago, J. Gobler, L. Hakim, B. Malloy,  A. Milian, L. Reid, A. Ruggiero, S. Thomas

Members Absent:           M. Acevedo, , V. Alvarez,  A. Hardman, K. Mandel, A. Pizarro, K. Scott

Guest Present:                  D. Anderson, L. Francis, G. Thomas, J. Williams, M. Yomogida

Other PC Members

Present:

Staff Present:                    NYC DOHMH: D. Klotz, D. Saab, J. Acosta, S. Kramer, A. Prince, S. Spiegler

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

Saqib A. and Julian P. opened the meeting followed by introductions and a moment of silence. The co-chairs introduced the newest Cmte. member, Aldonza Milian of Sun River Health. The moment of silence was led by Maria D. The minutes of the December 13th, 2023 meeting were approved with no changes.

Agenda Item #2: Updates

Consumer Update

Maria D. reported that arranging consumer transportation to medical appointments is still an ongoing issue following the disenrollment of Medicaid beneficiaries. She reported that one consumer missed their scheduled appointment for surgery due to a failed pick up by Medicaid transportation. The Recipient has reached out to their Medicaid contact to address this issue. A reply is still pending. The Recipient reminded the Cmte., that RWPA providers are available for scheduling consumer transportation.

Planning Council Update

David K. reported that the Priority Setting and Resource Allocation (PRSA) Cmte. completed and approved the scenario planning for the actual GY 2024 award. The scenario planning which included the TCSC spending plan was approved by the Executive Cmte. and Planning Council. The Integration of Care (IOC) Cmte. approved a revised service directive for the category of Non-Medical Case Management/Inmates and Recent Releases. The Consumers Cmte. (CC) met with representatives of the Ryan White Part A Quality Improvement Program to begin a dialogue on ensuring effective client input to improve the quality of RWPA programs, particularly through the use of client advisory boards (CABs). The CC is looking forward to working with the QI Program to meet the mutual goal of providing high quality client feedback for the improvement of RWPA programs. The CC will be updating its CAB Best Practices Guide and plans to present them directly to the RWPA sub-recipients at the July annual provider meeting.

Recipient Report

Johanna A. reported news from HRSA and other federal agencies, including new notices of funding opportunities (NOFO) to support HIV training, workforce development and the integration of behavioral health services into primary care settings using telehealth technology.

The Recipient was informed that HRSA is in the process of issuing Notices of Award for FY 2024 RWHAP Part A grants. This award provides partial funding (approximately 45% Formula and 29% MAI) based on the continuation of FY 2023 program requirements and funding levels. Final awards will be processed as soon as HRSA’s HIV/AIDS Bureau receives the full FY 2024 appropriation amount for this program.

The 2024 National Ryan White Conference, “Innovating to End the HIV Epidemic: Empowering communities, Expanding Partnerships, Implementing interventions” will take place between August 20-23, 2024. The Recipient is waiting on the approval of their submitted abstracts for the conference.

Subrecipients have wrapped up their quality improvement (QI) projects for the 2023-2024 contract year focused on various areas such as engaging consumers for feedback on program services, viral load suppression, connections to social support services, and improving documentation of delivered services.

Planning is underway for the 2024 RWHAP Part A All-Provider Meeting for the NY Eligible Metropolitan Area (EMA) slated to take place in mid-July. The Quality Management and Program Implementation Unit (QMPI) and partners have begun to develop the event’s activities, workshops.

Governor Hochul announced that the Centers for Medicare and Medicaid Services (CMS) approved New York State’s 1115 waiver demonstration project, which includes a series of actions to restructure the state’s Medicaid program to promote health equity and improve health care delivery and outcomes for nearly 7.6 million Medicaid enrollees statewide. Overall goals of the waiver include integration of primary care providers and community-based organizations to enhance social service provision, quality and outcome improvements for Medicaid enrollees in geographic areas with a longstanding history of health disparities, integration of care with behavioral health and health-related social needs, and development of new value-based payment programs and other regional reforms. The waiver amendment will remain in effect through March 31, 2027.

On January 9, Governor Hochul delivered her 2024 State of the State: Our New York, Our Future address, during which she highlighted some of the 204 initiatives she has proposed to make New York State more affordable, more livable, and safer. Initiatives are organized around 20 sections, including a section of several proposals related to HIV, STIs, and viral hepatitis.

Agenda Item #3: Women with HIV in the Tri‐ County Region Service Needs, Engagement in Care, and Clinical Outcomes

Maiko Y. of the Community Health Advisory & Information Network (CHAIN) Technical Review Team (TRT) presented on Women with HIV in the Tri‐ County Region Service Needs, Engagement in Care, and Clinical Outcomes. Interviews for this study were conducted with 665 PWH living in the Tri‐County Region between 2008‐2020. The study aimed to examine the social and clinical factors that facilitate or discourage women with HIV to access and remain in appropriate HIV care and adhere to ARV and achieve viral suppression by comparing cisgender women’s needs with that of heterosexual men and men who have sex with men (MSM), and differences among cisgender women by race/ethnicity and age.

Key findings revealed that Tri‐County women with HIV face multiple socioeconomic disadvantages. One‐third of women were living with minor children in the household at their most recent interview. Reported need for childcare services was relatively low; however, none of the women who reported childcare needs at their most recent interview received any childcare services. The largest gaps observed between the need for and receipt of services among women were for gynecological and other women’s health services. More than two‐third reported not receiving care. More than one in four women who needed mental health treatment or services at their most recent interview did not receive it. The reported reasons for not receiving mental health services were related to not being able to get an appointment with a mental health professional, not knowing where to go and/or distrusting that services would help with their problems. Women were more likely than men to report being diagnosed with non‐HIV health conditions. Women reported an average of three comorbidities in addition to HIV at their most recent interview. The study emphasized the importance of support for care coordination to synchronize women’s health care from multiple providers and specialists, including behavioral health providers.

Following the presentation, Lisa B. proposed the formation of a more focused group discussion on women with HIV based upon on the study’s findings. The Committee mentioned the importance of addressing barriers such as poverty, income inequality, mental health resources, co-morbidities, and stigma. Brooke M. emphasized and urged for the use of affirming language for transgender individuals and their inclusion in data collection and research. Julian P. wanted to know if the study had data on the country of origin for foreign-born women, and asked if language was a barrier to accessing services. Maiko Y. said she would follow up on his question.  

Maiko Y. announced that the CHAIN technical review team is recruiting new members, particularly from Tri County to join their monthly meetings. Those interested in joining should contact Doienne S.. CHAIN is also looking to secure a partnership with Westchester Medical Center before proceeding with the next cycle of study recruitment. 

Committee members asked about the availability of a Tri-County region directory of providers delivering supportive services. Scott S. mentioned that he would locate resources and provide an update at the next meeting. He also mentioned providing an update on the resources available via the NYC Health Map.

Lisa B. would like to discuss the outcome of the Cmte.’s November vote to reallocate uncommitted funds to Medical Case Management at the next meeting.  David K. offered to discuss this issue with Lisa one-on-one. Doienne S. mentioned that the next meeting will have a presentation on the annual HIV Surveillance Report from the AIDS Institute.   

The next meeting will be March 13th, 2024.

There being no further business, the meeting was adjourned.

There being no further business, the meeting was adjourned.