Tri-County Steering Committee Minutes January 9, 2019



January 9, 2019, 10:10am-12:00pm
Westchester County Department of Social Services
10 County Center Road, White Plains, NY


Members Present: A. Straus (Co-chair), M. Diaz (Co-chair), D. Ahmed, S. Altaf, V. Alvarez, L. Best (by phone), L. Bucknor, A. Casey (for G. Harriman), B. Catena, A. Contreras, D. Dominguez, J. Gago, J. Gressel, L. Hakim, A. Hardman, J. Palmer, M. Piazza, A. Pizarro, L. Reid, S. Richmond, A. Ruggiero, K. Scott, T. Seabrook, A. Simmons, S. Thomas  

Members Absent: M. Acevedo, D. Bartolini, E. D’Aquino, M. G. Ferone, P. Laqueur, C. Oldi, J. Page, J.C. Park, D. Scholar, C. Watkins

Staff: NYC DOHMH: D. Klotz, D. Wong, J. Colón-Berdecía, S. Spiegler, D. Ferdinand, K. Miller; WCDOH: J. Lehane, PhD

Agenda Item 1: Opening/Moment of Silence/Minutes  

Ms. Straus and Ms. Diaz opened the meeting followed by a moment of silence and introductions. The minutes of the December 5, 2018 meeting were approved with no changes.

Ms. Carney announced that she has been accepted into Empire State College. Also, the NYS AIDS Institute is accepting applications for a review board. Mr. Hardman announced that he and Ms. Carney will be featured in an “HIV Stops With Me” campaign, which will be launched in March.

Ms. Contreras reported that Putman County is holding a health fair that will include HIV testing.

Agenda Item #2: Updates  

Living Together

Mr. Alvarez reported that the smoking cessation program is going well. Also, Living Together will be transitioning to a new provider agency starting March 1st. He stressed the importance of continuing to listen to consumer voices. Peers learning and support has been critical to LT’s success. Finally, education and treatment adherence must also share attention to other non-HIV health issues.

Policy Report

Mr. Wong reported that a national coalition that was formed to respond to the proposed public charge rule reports that over 200,000 comments were submitted during the public comment period.

In response to questions about the partial federal government shutdown, Ms. Casey reported that Ryan White is fully funded through the end of February. The US Dept. of Health and Human Services already had its appropriation bill passed and is not affected by the shutdown, but it is not clear how the shutdown may delay the announcement of the FY 2019 Part A award. Also, the State has filled gaps during past shutdowns when issues arose in the food stamp program.

Grantee Report

Ms. Casey reported the national Ryan White conference in December was successful, with the NY EMA making several presentations, which can be found online at white-conference. Also, the EMA received its core medical services waiver, which allows us to continue funding a higher percentage of support services (housing, food & nutrition, etc.).

Ms. Casey reviewed the results of the Tri-County RFP, which was a competitive bidding process using established criteria to score proposals.  A summary of the awards issued for all eight services categories  and information on the geographic distribution of services in Tri-County was distributed. It should be noted that all Ryan White Part A (RWPA) service providers can provide services to people from throughout the EMA. In a competitive procurement, all proposals deemed responsive are evaluated and all proposals evaluated as fundable are considered for awards. The steps include: Administrative review by Public Health Solutions to determine that applicants meet the eligibility criteria as detailed in this RFP; Eligible proposals undergo a content review by three reviewers; Proposals are evaluated and scored based on responses submitted in the application, not on the reviewers’ knowledge of the contractor. The NYC DOHMH reserves the right to award contracts in such a way as to assure: adequate geographic distribution of services; and/or adequate access to services by populations that are disproportionately affected by the HIV epidemic; and/or adequate access to service by priority populations identified by the Planning Council. A list of awardees was distributed. The current contracts in the Housing Category are being extended for 12 months in order to assess issues that were discussed at the December Steering Committee meeting, in order to assess how technical assistance and other measures helps the programs absorb the additional $300K in funding that was allocated starting in the current year.

In response to questions, Ms. Casey explained that the percentage of services delivered by county is based on the place that services are actually delivered, not the residence of the client. Also, for any existing programs that were not re-funded, agencies may choose to continue providing the services through other funding streams, or there will be a transition plan to ensure that clients do not experience any gaps in services.

Agenda Item #3: Standards of Care  

Dr. Lehane led the Committee through the draft standards of care (SOCs) for 4 service categories. SOCs are used to establish minimum expectations for the delivery of services, help define how services are structured and delivered, and guide quality management and contracting. The EMA develops its own Service/Program Standards, and the Planning Council takes the lead in this effort, through the Integration of Care Committee and TCSC, with extensive Grantee involvement. As the elements of the SOCs are pre- determined by the service directives (already approved by the Committee), and issues that arise about the service models will be put into a parking lot for the next time the Committee revises the directives. The elements of the SOCs reviewed were: definition of services (from the HRSA monitoring standards); purpose of services (i.e., why the service is important); service goals (taken from the directives and RFP); client characteristics and needs; service activities and standards, staff qualifications, case closure, and grievance procedures. Below is a summary of the discussion for each SOC:

Oral Health Care

  • Preventative services need to cover patients’ specific needs.
  • Payer of last resort issues apply to this and all Part A categories, so that Part A funds are used to wrap around Medicaid and other payers.
  • These SOCs only apply to Part A funded services, and so Part F oral health services have different standards, issued by the federal government.

A motion was made, seconded and approved unanimously to accept the Oral Health Care Services Standard of Care as presented.

Emergency Financial Assistance

The funded provider will develop policies and procedures for assessing grants and dealing with time- sensitive situations.

A motion was made, seconded and approved unanimously to accept the Emergency Financial Assistance Standard of Care as presented.

Psychosocial Support Services

  • As discussed earlier, a new agency will provide this services under the RFP results.
  • The program will still use a peer-led model with professional support.
  • This model does not provide clinical services (e.g., prescriptions for DSM diagnoses). Those services are provided through the Mental Health Services category.
  • Trainings are offered to all agencies to provide trauma-informed care, and the hope is that all agencies will successfully develop that capacity, as well as other requirements (e.g., transgender- affirming care).

A motion was made, seconded and approved unanimously to accept the Psychosocial Services Standard of Care as presented.

There being no further business, the meeting was adjourned.