TRI-COUNTY STEERING COMMITTEE MEETING
June 12, 2024, 10:05-11:30am
By Zoom Videoconference
Members Present: S. Altaf (Co-chair), V. Alvarez, L, Bucknor, A. Contreras, V. Carlone, L., Cyrus, M. Diaz., J. Gago, B. Malloy, A. Pizarro, L. Reid, K. Scott, L. Hakim
Members Absent: J. Palmer (Co-chair), L M. Acevedo, L. Best, A. Desir, J. Gobler, A. Hardman, K. Mandel A. Ruggiero, A. Milian, S.Thomas, L. Francis
Guest Present: M. Yomogida, J. Braithwaite, K. Palencia-Lua, Julie Lehane, G. Shubert, D. Norman, C. Ravida
Other PC Members
Present:
Staff Present: NYC DOHMH: D. Klotz, D. Saab, J. Klein, J. Acosta, S. Kramer, A. Eppinger-meiering, M. Pathak
Agenda Item # 1-3: Opening/Moment of Silence/Minutes/Public Comment
Saqib A. opened the meeting followed by introductions and a moment of silence. The minutes of May 8th, 2024 meeting were approved.
Agenda Item #4: Updates
Consumer Update
| Victor A. reported concern over polypharmacy and long-term side effects associated with taking HIV medications impact on aging adults with HIV. Maria D. mentioned that Medicaid transportation issues reported during past steering committee meetings have been improving for consumers utilizing these services. |
Recipient Report
Johanna A. reported news from HRSA and other federal agencies, including the recognition of National Asian & Pacific Islander HIV/AIDS Awareness Day and a recently published fact sheet on Medicare Part coverage of HIV PrEP for Medicare beneficiaries. On June 7th, HRSA hosted a webinar on innovative strategies to address the needs of priority populations, specifically faced by people of color with HIV. HRSA announced a new competitive funding opportunity, Transitions in Care for Justice-Involved Populations, HRSA anticipates making awards to 51 health centers of up to $1 million each for innovative work to support transitions in care prior to release from incarceration. HHS is currently accepting nominations for the CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment (CHAC) 2025 nomination cycle; the CHAC will consist of 18 experts in fields associated with public health. CDC developed “The Pride in a Box Toolkit” to plan and optimize participation in local Pride festivals and post-event activities. There is also a social media toolkit, as well as additional materials.
Registration is open for the 2024 National Ryan White Conference in August. Virtual attendance is unlimited. HRSA is encouraging RWHAP recipients to spread the word about their listserv for the latest updates on opportunities, resources and events. On May 1, HRSA shared that it is in the process of issuing Notices of Award to grant recipients providing the balance of fiscal year 2024 (FY 24) funding. Funding is based on HRSA’s FY 24 appropriations and budget allocations for the RWHAP Part A grant. On May 14, the NYC Health Department released the Housing Opportunities for Persons with AIDS (HOPWA) Families RFP. In accordance with HOPWA federal funding guidelines, the RFP intends to fund up to 20 qualified not-for-profit organizations to provide supportive permanent housing in New York City to very low-income PWH for a period of nine years (July 1, 2025, to June 30, 2034), with no options for renewal.
This month the Quality Management and Program Implementation Unit (QMPI) is launching a new virtual forum for RWHAP Part A subrecipients to learn more about program services, resources to assist in service delivery, and evidence-based interventions related to a specific service category. The NY EMA QM Program and the Consumers Committee partnered to develop an informational survey for all subrecipients to complete regarding the status of Consumer Advisory Boards (CABs) and other forms of community engagement activities taking place at subrecipient agencies. Subrecipients completed the survey in late April. The QMPI team will present the results for discussion at the May Consumers Committee Meeting. In January 2024, HRSA HAB-supported Center for Quality Improvement and Innovation (CQII) released two new resources on how to effectively involve people with lived experience in quality improvement activities.
On April 24, Mayor Eric Adams released his FY 2025 Executive Budget. The $111.6 billion budget proposal is the largest in the City’s history. The FY 2025 Executive Budget includes a program to relieve over $2 billion in medical debt for income-eligible and severely debt burdened New Yorkers. On May 13, the New York City Council’s Health Committee, Finance Committee, Hospitals Committee, and Mental Health, Disabilities, and Addiction Committee, held a hearing on the FY 2025 Executive Budget’s health-related components. Health Commissioner Dr. Ashwin Vasan testified on behalf of the New York City Department of Health and Mental Hygiene, fielding questions from Council Members on the City’s Program to Eliminate the Gap (PEG) cuts for FY 2025, including those resulting in a $5.7 million reduction in City tax levy funding for HIV contracts. The goal of these hearings is to review the FY 2025 Executive Budget and adopt a final budget prior to the July 1, 2024, deadline. On April 22, Governor Hochul announced New York State’s $237 billion FY 2025 Enacted Budget, which the state legislature passed on April 20, 2024. Notably, several HIV-, STI-, and viral hepatitis-related items that appeared in the Governor and/or Senate’s proposed FY 2025 budgets were omitted from enacted FY 2025 budget, including items requiring labs to report negative HIV, syphilis, and hepatitis B and C test results; allowing pharmacists to dispense PrEP and administer the mpox vaccine; allowing registered nurses to screen for hepatitis B; and repealing a statute that makes it a misdemeanor for a person who knows they have an STI to have sexual intercourse with another person.
On May 3, KFF launched its Medicaid Enrollment and Unwinding Tracker, which features state-reported data on Medicaid disenrollments, renewals, overall enrollment, and other key indicators.
Planning Council Update
David K. announced that Jeffrey Klein joined the Planning Council as a Program Planner this month. The Consumer Committee developed a plan to facilitate a breakout session during the July Quality Improvement provider workshop on Consumer Advisory Boards. The Needs Assessment Committee concluded its review of data on the topic improving access to HIV services for people involved in sex work, a population identified in the 2022 full Needs Assessment. The Committee is in the process of developing recommendations for RWPA providers on serving this population. The Integration of Care Committee reviewed and discussed a revised Emergency Financial Assistance (EFA) services directive which incorporates updated language from current NY State Integrated HIV Care and Treatment plan as well as mandating spending through as least one service site located within the five boroughs of NYC. The Priority Setting and Resource Allocation Committee is developing the spending request for the GY 2025 grant application. The EMA is allowed to request up to 5% more than the current grant year’s award. The Committee has been reviewing data on service categories with a history of underspending and/or lower than expected enrollment and will receive data on categories with unmet need that can absorb additional funds to increase capacity.
Agenda Item #5: Presentation – 4th Quarter Expenditure Report
Adrianna E.M. introduced the GY 2023 4th quarter closeout report for Tri-County. The bottom line of the report is the total amount of underspending, which is available for use as carryover in the current grant year. The good news is that the total underspending is $2.3M, less than the previous year, which had $2.9 million underspent.
Agenda Item #4: Presentation – Overview of A2428/S183: State Legislation to Expand HASA to Rest of State
To plan for the GY 2025 application spending plan the TCSC continued its series of presentations on housing services in the region. Every year, HRSA allows TCSC to request a 5% increase then the current year amount. The TCSC will be tasked with deciding how to allocate the 5% surplus to a service category(-ies) of choice, this may include an allocation to housing services.
Monika P., delivered an overview of New York City’s HIV/AIDS Services Administration (HASA) program and advocacy efforts to expand a similar program and services to rest of State (ROS). HASA has existed since 1985, as a program only for people with HIV who exhibited an HIV-related illness. In 2014, New York City and New York State established the 30% rent cap for HASA clients, and in 2016, expanded HASA eligibility to include all income-eligible New York City residents diagnosed with HIV. Since August 29, 2016, New Yorkers no longer need an HIV-related illness to receive HASA services. All New York City residents with HIV who meet financial need requirements are eligible. In the five boroughs, eligible people with HIV enrolled in HASA receive support with a 30% rent cap, intensive case management and assistance in applying for public benefits and services, such as Medicaid, SNAP, emergency transitional housing, rental assistance, transportation, etc. Currently, New York State counties outside New York City can opt in to such a program, but none have done so. There is proposed state legislation that if passed, would create HASA for the rest of New York State, or rest-of-state (ROS). State legislation, A2418/S183, would require local social services districts (i.e., counties) and the New York State Office of Temporary and Disability Assistance to provide access to housing and case management to income-eligible New Yorkers with HIV, and to establish a 30% rent cap to ensure they pay no more than 30% of their monthly income toward rent.
Agenda Item #4: Presentation –
Tri-County Housing Landscape and Need
Doienne S. provided an overview of the benefits, availability and resources for rental housing assistance programs in Tri-County. She also described the landscape and growing need for affordable housing and related services to support unhoused PWH. She described that housing assistance improves health care outcomes and supports equitable access to HIV care for PWH. HIV housing assistance works to improve retention in effective HIV care, viral suppression, and overall health, generating Medicaid savings from avoided emergency and inpatient care sufficient to offset public investments in housing. Since 2015, the State’s historic Blueprint for Ending the Epidemic has recommended specific actions to increase access to housing supports as an HIV health care intervention. She shared that according to a 2019 CHAIN report on economic hardship among PWH living in Tri-County, nearly 20% of respondents reported that they were severely rent burdened.
Ginny S. also presented on the need for HASA-like rental assistance for PWH living in the Tri-County region based upon a Housing Works analysis of the estimated poverty rate among PWH, estimated need for rental assistance, and fair market rental rate for a one-bedroom apartment. Findings from the analysis reported that 260 PWH in Westchester, 99 PWH in Rockland and 9 PWH in Putnam County would be eligible for public assistance benefits through HASA assuming if such a program were expanded to Rest of State.
Doienne S. and Cindy R. continued the presentation, with an overview of additional housing programs that Tri-County PWH may be eligible for. Currently, NYS operates several housing assistance initiatives including the Housing Retention Services & Financial Assistance (HRFA), Medicaid Redesign Team (MRT) Housing Retention Services & Financial Assistance for High Need Medicaid Beneficiaries (MRT HRFA), and Empire State Supportive Housing Initiative (ESSHI). HRFA assistance is intended to provide short-term direct financial support to individuals to help them find stable housing and engage in medical treatment. MRT HRFA provides long-term rental assistance to individuals who are on Medicaid and who are living with HIV or other chronic morbidities. ESSHI assistance is intended to be a means to provide affordable and long-term stable permanent housing as well as supportive services to families, individuals, and youth who are homeless and have at least one or more disabling conditions or other life challenges.
here being no further business, the meeting was adjourned.
