Tri-County Steering Committee Minutes March 13, 2024



March 13, 2024, 10:05-11:50am

By Zoom Videoconference

Members Present:          J. Palmer (Co-chair), V. Alvarez, L. Best, L. Cyrus, L. Hakim, B. Malloy, K. Mandel, L. Reid, K. Scott, S.Thomas, A. Milian, L. Francis

Members Absent:           S. Altaf (Co-chair), M. Acevedo, A. Desir, J. Gago, A. Hardman, A. Pizarro, A. Ruggiero, M. Diaz, J. Gobler, , L, Bucknor, A. Contreras

Guest Present:                  E.Pradhan, D.Norman

Other PC Members

Present:                               N/A

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

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

Julian P. opened the meeting followed by introductions and a moment of silence.  The minutes of the January 31, 2024 meeting were approved with no changes.

Agenda Item #2: Updates

Consumer Update

Victor R. reported that arranging consumer transportation for medical appointments is still an long-standing concern following the disenrollment of Medicaid beneficiaries. The Recipient and PC support staff continue their efforts in getting in touch with a Medicaid representative for a comprehensive discussion for this concern. In the meantime, Johanna A. suggested that the consumer use the Cornerstone transportation program. Victor R. also shared that many consumers are struggling with co-morbidities and dying from conditions such as, including heart disease and cancer.

Planning Council Update

David K. reported that the Consumer’s Committee will review and discuss changes for a set of revised Best Practices Guidelines for Client Advisory Boards, developed by the Consumers Committee in 2015.  David K. announced the retirement of the Planning Council’s Community Coordinator, Jose Colon-Berdecia. The PC is in the process of looking for a replacement for Jose’s former position.

Recipient Report

Johanna A. reported on HRSA and other federal partner updates, including the commemoration of National Black HIV/AIDS Awareness Day, a new infographic highlighting 2022 RW Program data, tool for Medicare-Medicaid dual eligibility, the 2024 National Ryan White Conference and the 2022 State Profiles on Sexual Health Policy and Data Landscapes.

She also shared updates for the upcoming Request for Proposals (RFP) for Behavioral Health and Non-Medical Case Management services for currently and recently incarcerated PWH in NYC. The Quality Management (QM) Committee recently reviewed the impact and utilization of learned skills of providers on internal quality management activities. The Committee also discussed potential activities for subrecipient and consumer collaboration to gather important feedback on delivery of services and implementation of quality improvement in RWHAP Part A programs. The NY EMA QM Program is collaborating with the Consumer Committee to address concerns about Consumer Advisory Boards (CABs), the dialogue included identifying three key projects to address.

In January, the Partnership to End the HIV, STD, and Hepatitis Epidemics wrote a letter to U.S. House and Senate Appropriations Committee leadership expressing concern over proposed cuts to fiscal year 2024 (FY24) funding for critical public health programs.

The U.S. Department of Justice and U.S. Department of Health and Human Services (HHS) issued a letter to state ate Medicaid administrators encouraging them to ensure that their Medicaid programs allow people with hepatitis C and substance use disorder to access direct-acting antiviral medicines for hepatitis C.

3rd Quarter Expenditure Report

Scott S.  reported the third quarter expenditure for the TC region and mentioned that half of the contracts were deliverable based. He reported that housing services have had some issues with staff retention which has impacted the ability of programs to provide services. For medical transportation, he reported that it has been utilized less during COVID-19 but has increased in usage since then. Legal services spending was low due to a contract being rescinded, which was previously discussed when the Committee reviewed the GY 24 scenario spending plan earlier in the planning year. Oral health care spending was low due to Medicare paying for more services in this area. Overall spending is on par for what is expected during this time of year. The final expenditure report is expected to change as the Recipient reprograms funded where needed and any service categories that need approval will be presented to Committee.

Agenda Item #3: Tri-County HIV Epidemiology and Surveillance Report

Eva P. provided the annual HIV surveillance update for Tri-County (TC), with data as of December 31, 2022.  She noted that many definitions are standardized, but to remember that all the numbers represent real people. She explained that HIV data collection procedures (through lab and provider reporting, medical record reviews, partner services, etc.). TC had 82 new HIV diagnoses in 2022, the vast majority in lower Westchester. Overall, from 2018-2022, the number of those newly diagnosed with HIV infections has dropped by almost 20.4%.  All racial groups have seen decreases, but Hispanic and Non-Hispanic Black, MSM and people aged 20-29 were reported as the populations with largest number of new HIV diagnoses. The number of concurrent HIV/AIDS diagnoses (a sign of people who were not tested early or received treatment) has dropped by half since 2018. Westchester has the highest total number of people with HIV in TC, concentrated in the parts of the county close to NYC. There are currently 3,574 PWH TC. Of the regions in the State outside of NYC, TC has the second highest number of PWH (after Nassau-Suffolk), but the highest rate. There are 35 transgender PWH in TC.

The Ending the Epidemic metrics were described. In comparison to other regions in the TC, entry to care within 30 days of a diagnosis could use an improvement (76% entry to care, lower than the 90% ETE target). However, entry to care within 90 days is slightly on par with the rest of the State other regions, (93%)). Viral suppression rates in TC are on par with the rest of the State (82% of those diagnosed, slightly lower than the 85% ETE target). The treatment cascade for TC was described. Additional data is available on the NYS ETE dashboard. 

Members expressed concern about some NYS ETE targets not being met, and wondered what could be done to improve the ETE metrics. A member suggested the need to understand the best practices of regions with higher success rates than TC for linking newly diagnose people into care.

Additional comments included having additional HIV outcomes data on transgender and cisgender women by race and ethnicity in TC. 

The next meeting will be the second Wednesday of April.   

There being no further business, the meeting was adjourned.