TRI-COUNTY STEERING COMMITTEE MEETING
March 10, 2021, 10:05-11:30am
By Zoom Videoconference
M I N U T E S
Members Present: S. Altaf (Co-chair), M. Diaz (Co-chair), D. Ahmed, V. Alvarez, L. Best, L. Bucknor, D. Dominguez, M. G. Ferone, L. Hakim, G. Harriman, K. Mandel, J. Palmer, M. Piazza, A. Pizarro, G. Plummer, L. Reid, S. Richmond, K. Scott, S. Thomas
Members Absent: M. Acevedo, A. Contreras, J. Gago, A. Hardman, P. Laqueur, C. Oldi, A. Ruggiero, S. Sanchez, D. Scholar, T. Seabrook, A. Simmons, D. Smith
Staff Present: NYC DOHMH: D. Klotz, J. Acosta, J. Colón-Berdecía, D. Ferdinand; Public Health Solutions: A. Feduzi
Guest Present: Wendy Patterson (AIDS Institute)
Agenda Item 1: Opening/Moment of Silence/Minutes/Announcements/Public Comment
Ms. Diaz and Mr. Altaf opened the meeting followed by introductions and a moment of silence. The minutes of the February 13, 2021 meeting were approved with no changes.
Ms. Best announced that she and Council staff Melanie Lawrence are presenting this afternoon at a HRSA TA webinar on lessons learned for Planning Councils after one year of COVID-19.
Agenda Item #2: Updates
Mr. Alvarez, Ms. Diaz and Ms. Best reported that most of the members of Living Together have received their COVID vaccinations, despite initial difficulties obtaining appointments, and they are looking forward to seeing each other face-to-face in small groups of vaccinated individuals, as per CDC guidance. There has been some vaccine hesitancy, which the group is trying to overcome through education.
Outreach efforts have begun to recruit additional consumers for the Committee and for the Planning Council. Mr. Colón-Berdecía has been reaching out to the community and Ms. Acosta has encouraged providers to refer clients.
Mr. Harriman added that the Council’s Rules & Membership Committee will be recommending a change to the Council’s bylaws to allow for full participation (including voting privileges) by people who attend in-person meetings by videoconference. This will help lower barriers to participation for Tri-County residents.
Planning Council Update
Mr. Klotz and Mr. Harriman reported that the Planning Council approved the spending scenario plan for FY 2021 (March 1, 2021-February 28, 2022), including the Tri-County Steering Committee’s recommendation for enhancing Tri-County Housing programs by an additional $160,000, and enhancing the Emergency Financial Assistance at last year’s level to include NYC residents in the program. The full Council also voted to concur with the Ending the HIV Epidemic plan, which covers the federal grant for Bronx, Queens, Brooklyn and Manhattan. The plan will inform the next EMA-wide Integrated HIV Prevention and Care Plan.
The Consumers Committee is continuing its work on HIV and Aging and is planning for a public forum in the spring on the issue. At next week’s meeting, Moisés Agosto-Rosario from NMAC will present on HIV and aging in a national perspective and issues of equity. The timeline calls for a new service directive to address the needs of older PWH to be finalized by July. On Thursday, the Needs Assessment Committee is hosting a follow-up virtual forum on needs of PWH with serious mental illness. The Integration of Care Committee is continuing its work to revise the foundational (i.e., master) service directive, which described elements that must be included in all service category directives (e.g., cultural competence, trauma-informed care, etc.).
At the March 25th full Council meeting, there will be presentations on the Quality Management and Administrative budgets, as well as an overview of the general RWPA budget.
Recipient (Grantee) Report
Ms. Plummer reported that HRSA issued a new program letter and FAQ sheet on the CIVOD-19 vaccines, which will be continuously updated. The RFP for Psychosocial Support Services for TIGNCNB Individuals has been released. The RFP will fund two NYC-based programs with an anticipated start date of September 1, 2021. The BHIV Quality Management and Technical Assistance Unit has developed a Program Navigation Guide to navigating services for PWH with co-occurring mental health conditions. Also, Governor Cuomo has expanded COVID-19 vaccine eligibility to include all people with a list of co-occurring conditions, including HIV. As of today, the age eligibility is lowered to 60 and over. There was some discussion on efforts to address vaccine hesitancy. Committee members reported that they have been conducting Zoom outreach and education, including by doctors, as well as one-on-one counseling. There was an emphasis on consumers working with peers by talking about their own experiences getting vaccinated.
After an internal reorganization, Ms. Feduzi, Deputy Director of Programs at Public Health Solutions, is now the PHS liaison to the Council.
Ms. Acosta reported that she is has met with all Tri-County Part A providers to discuss challenges from the past year and to help them prepare for the new fiscal year, with an emphasis on meeting program goals and overcoming barriers to service provision. She will also be sending quarterly TA memos to address program issues.
Agenda Item #3: Tri-County HIV Epidemiologic and Surveillance Update
Mr. Klotz stated that HRSA requires Planning Councils to get annual updates on the picture of the epidemic in the jurisdiction. He introduced Ms. Patterson, who will present the most recent data collected by the NYSDOH AIDS Institute.
Ms. Patterson described the terms and procedures that the AI uses to collect HIV surveillance data to a secure data registry that gets reports from providers, labs, medical records and DOH partner services. She then provided data (through 2019) on newly diagnosed cases of HIV in Westchester, Rockland and Putnam. The TC region has 109 new HIV diagnoses in 2019 (80 in Westchester, 24 in Rockland, 5 in Putnam). This is the second most after Nassau-Suffolk of any region in NYS outside NYC. But given population size, TC has a higher per capita rate (8.6 cases per 100,000 people). Certain more densely populated areas have larger clusters of cases, particularly Yonkers and Mount Vernon. Seventy-two percent of new diagnoses were male, 26% female (gender categories include male- and female-identified transgender individuals). The overwhelming majority of new diagnoses was among Black and Hispanic people (48% and 34% respectively). Rates by population for those demographic groups were even more disproportionate. A slight majority of new diagnoses are among people who report male-to-male sexual contact as a transmission risk, followed closely by heterosexual contact. Age distribution of the newly diagnosed has remained stable from 2018, but there is a small increase in young people (19 and under). About 30% of new cases were concurrently diagnosed with AIDS, which represents a missed opportunity to test and link to care and treatment. This number is slightly higher in 2019 than 2018, but still lower than 2017. Rates of linkage to care in TC are comparable to the rest of NYS, with the region close to meeting statewide goals of entry to care within 30 or 90 days of diagnosis. Eighty-seven percent of newly diagnosed in TC were in care within 30 days and 60% were virally suppressed within 3 months.
Ms. Patterson then reviewed data on all people in TC living with diagnosed HIV. As of December 31, 2019, there were 3,729 known PWH (the second highest prevalence rate outside NYC after Nassau-Suffolk, and the highest incidence rate). Sixty-six percent of all PWH in TC are male, 34% female, and the vast majority Black or Hispanic. Sixty-one percent are over the age of 50, with people in their 40s and 30s making up the next largest age groups. Eighty-one percent of PWH are in HIV care, which is similar to the rest of the state, but below the ETE target of 90%. Viral suppression is 74%, below the ETE target of 81%. The HIV cascade shows that there is an estimated 4,330 PWH in TC, of which 86% are known, meaning there is room for additional testing and linkage to care. Additional data and updates can be found at etedashboardny.org. A summary of the questions and discussion include:
- NYS counts diagnoses based on the residence of the individual, not where they were tested. NYC counts people who were tested in NYC but live outside the five boroughs in their data.
- The 2020 numbers will be skewed by the effects of the COVID-19 pandemic, as there has been a marked decrease in testing activity.
- In the Tri-County region, particularly in Westchester county, there was an increase in the number of people newly diagnosed with HIV in 2015-2017, with a decrease in 2018 and an increase in 2019. This trend was not seen in NYS as a whole. It occurs in Westchester county which, when combined with Putnam and Rockland county, shows the same trend for the Tri-County region.
The Committee thanked Ms. Patterson for her informative presentation.
The next Committee meeting will be held by Zoom on Wed., April 14th, 10am.
There being no further business, the meeting was adjourned.