Tri-County Steering Committee Minutes June 9, 2021

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TRI-COUNTY STEERING COMMITTEE MEETING

June 9, 2021, 10:05-11:30am

By Zoom Videoconference

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

Members Absent:         M. Acevedo, A. Contreras, M. G. Ferone, A. Hardman, C. Oldi, M. Piazza, A. Pizarro, D. Scholar, T. Seabrook, D. Smith  

Staff Present:                 NYC DOHMH: D. Klotz, J. Acosta, J. Colón-Berdecía, D. Ferdinand; Public Health Solutions: A. Feduzi, R. Santos; CHAIN: D. Norman

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

Mr. Altaf and Ms. Diaz opened the meeting followed by introductions and a moment of silence.  The minutes of the May 12, 2021 meeting were approved with no changes.  

Mr. Altaf announced that Hudson Valley Community Services will be resuming full-time in-person office hours on July 6th

Ms. Reid announced that Suffolk County is conducting a health needs assessment of their LGBTQ+ population.  As another suburban region, the results may be pertinent to Tri-County.

Ms. Best reported that the federal FCC has a program to pay for Internet services, as well as money towards a tablet, for qualifying people to access telehealth.  The program will last until the current health emergency is declared over.  Also, Medicaid forms are expiring without consumers being notified, which is resulting in inability to access care.  This is something that Westchester County must address.

Agenda Item #2: Updates

Consumer Update

Mr. Alvarez reported that Living Together is planning to resume face-to-face meetings in July.  He thanked everyone who helped consumers get through a difficult year.  While almost everyone is vaccinated, other issues related to HIV and aging and long-term survivors continue to present themselves, including cancer diagnoses and bone loss.  This shows why the work that the Consumers Committee and Council are doing around aging is so important.  Also, virtual care continues to be important for people who are unable to travel to appointments, especially as Medicaid issues prevent some people from accessing transportation services.  Ms. Reid noted that case managers can assist people with their Medicaid applications. 

Planning Council Update

Mr. Harriman discussed how great it was to have consumers, subject matter experts and the community work together to address the needs of PWH over 50.  The June 4th Forum was excellent and gave many people the opportunity to provide feedback on the draft service directive addressing older PWH.  The Consumers Committee hopes to complete the directive at its June 15th meeting.  The directive, which is being cited as a potential national model, will be presented at the July Tri-County Steering Committee meeting.  

At the May 27th full Council meeting, there was a presentation on the effects of the COVID-19 pandemic on non-profits by Eli Dvorkin of the Center for an Urban Future.   The presentation was followed up a rich discussion on how RWPA providers have been impacted by the pandemic.  The July Executive Committee and full Council meetings will be extended (up to 4 hours) in order to complete work coming through the committees, including application spending plans, close-out reports, the Older PWH and Framing Directives, and more.  The Integration of Care Committee’s work on the Framing Directive (an overarching service directive that applies to all service categories)is proceeding, and it will have a focus on incorporating anti-racist and anti-stigma practices.  The Needs Assessment Committee is close to finalizing its recommendations for addressing the needs of the seriously mentally ill. 

Mr. Klotz reported that the deadline for applications for membership on the Council and Steering Committee is June 18th.  Barriers to membership have been eased as the Council approved a change to its Bylaws to allow for full participation (including voting) by phone or videoconference at all meetings, including in-person meetings, which the Council expects to resume in the fall.

The Priority Setting & Resource Allocation Committee (PSRA) meets Monday to develop a carryover plan for the use of unspent funds from last year (FY 2020) in the current year.  As per HRSA rules, carryover must be used for programs and must be spent by the end of the next fiscal year (Feb. 28, 2022 in this case).  HRSA usually does not approve the carryover plan until late fall.  As the money is one-time, it precludes programs from using it for on-going expenses, such as enrolling new clients or hiring staff.  This year, the carryover is about $4.9M (compared to about $250K last year).  All EMAs have experienced larger than usual underspending due to the impact of COVID and HRSA has waived penalties for underspending.  The draft plan for using the carryover includes about half a million more for Emergency Financial Assistance (EFA).  In order to maximize spending and meet needs, the annual cap on assistance would be lifted from $2000 to $5000 per client.  The PSRA will also look at how to extend this into FY 2022.  Carryover would also be used for Food & Nutrition Services (FNS) to buy supplies and pay for more meals.  Some funds would be used for programs to obtain their own capacity building services.  The bulk of the carryover will be used for ADAP, which is the one program guaranteed to be able to absorb the funds and spend it all by the deadline.  Also, ADAP is the top ranked priority and all the funds will be used directly for medications.

Committee members raised the possibility of using carryover funds to support Internet access for clients, as well as pay for air conditioning when medically necessary.  The Grantee will look into if this can be added to the allowable expenditures in the EFA program.  In response to a question from Mr. Palmer, it was noted that carryover can not be used to reimburse programs for expenditures over their contract amounts from last year.  However, there can be a bigger commitment of funds to FNS and the Grantee would work with programs to assess what they can absorb.

Grantee Update (Highlights)

Ms. Acosta reported that FY2022 Ryan White HIV/AIDS Program (RWHAP) Part C Early Intervention Services Program: Existing Geographic Services Areas NOFO was released on April 2nd. The purpose of the program is to provide comprehensive primary health care and support services in an outpatient setting for low income, uninsured, and underserved people with HIV.  The U.S. Department of Housing and Urban Development’s (HUD) released a NOFO through the Housing Opportunities for Persons with AIDS (HOPWA) program for housing assistance and supportive services for low-income people with HIV and their families.  On May 19, HRSA commemorated National Asian/Pacific Islander HIV/AIDS Awareness Day.

On April 30th, the DOHMH BHIV Care and Treatment Program (CTP) submitted the Coronavirus Aid, Relief, and Economic Security (CARES) Act Progress Report to HRSA.  In 2020, CTP received $1M in CARES Act funding providing critical support to Ryan White Part A (RWPA) Short-term Rental Assistance programs in NYC and Short-term Rental and Utility Assistance programs in the Tri-County region.  The $1M CARES Act funds received from HRSA was fully spent in the grant year.  CTP also will soon submit to HRSA the FY 2020 Part A Annual Progress Report and Expenditures Report, Federal Financial Report (FFR), and Unobligated Funds (Carryover) report. 

The Care and Treatment Program’s Quality Management and Technical Assistance program will hold its annual RWPA Provider Meeting (virtually) for all RWPA-funded programs in July 2021.  On April 29th, DOHMH’s HIV Care and Treatment Program and CUNY’s Institute for Implementation Science in Population Health (ISPH) received a notice of award for the collaborative “APPLI” project aimed at optimizing the rollout of long-acting injectable (LAI) antiretroviral therapy (ART) in the Ryan White population. 

Agenda Item #3: Tri-County FY 2022 Application Spending Plan

Mr. Klotz explained that Committee must approve a spending request for the FY 2022 grant application.  The spending request is not binding and is an expression of the Committee’s needs for the following year.  In the winter, the Committee plans for the actual award, which for many years has seen reductions in the formula portion of the award due to the relatively slower increase in HIV cases in the NY EMA compared to other parts of the country.

A draft application spending plan was presented for discussion that asks for the maximum increase allowed by HRSA (5%).  As a placeholder, the increase ($267,621) is spread it out across the entire portfolio, weighted based on ranking scores (higher ranked categories are increased at a proportionally higher rate).  PSRA may make a targeted increase to the EFA category, as it serves the entire EMA.  President Biden has proposed a $10M increase nationally for RWPA.  If Congress approves the appropriation, the NY EMA might get around $1.2M.  The reductions in the award over the last few years have been in the $2-3M range, which means that any additional appropriations would only mitigate a cut. 

A motion was made, seconded and adopted 17Y-0N to approve the FY 2022 application spending plan as presented.

Agenda Item #4: Public Comment, Part II

Mr. Alvarez noted that air conditioners are also necessary to keep non-refrigerated meds at an appropriate room temperature.  The HEAP heating program might also help pay for cooling. 

Ms. Reid announced that Hudson River Health Care is having a Pride event in Peekskill on June 26th

Mr. Alvarez and Ms. Gago stated that requiring intakes for anyone who accesses group support is a barrier.  Living Together encourages consumers to come to a group session to assess whether or not they want to make a commitment to it.  There needs to be low-threshold access so that people can see what the group is like before making a commitment and going through an intake.  Ms. Acosta will speak to Mr. Alvarez about how to resolve the issue.

The next Committee meeting will be held by Zoom on July 14th, 10am.

There being no further business, the meeting was adjourned.