Tri-County Steering Committee Minutes May 10, 2023



May 10, 2023, 10:05-11:05am

By Zoom Videoconference

Members Present:       S. Altaf (Co-chair), J. Palmer (Co-chair), V. Alvarez, L. Cyrus, A. Desir, M. Diaz, G. Harriman, K. Mandel, S. Richmond, A. Ruggiero, K. Scott, S. Spiegler (for G. Plummer), S. Thomas

Members Absent:        M. Acevedo, L. Best, L. Bucknor, A. Contreras, J. Gago, L. Hakim, B. Malloy, M. Piazza, A. Pizarro, L. Reid

Staff Present:              NYC DOHMH: D. Klotz, D. Saab

Mr. Altaf and Mr. Palmer opened the meeting followed by introductions and a moment of silence.  The minutes of the April 12, 2023 meeting were approved with no changes.

Agenda Item #2: Updates

Consumer Update

Mr. Alvarez and Ms. Diaz reported that many consumers are coping with the co-morbidities of aging, including heart disease and cancers.  Many consumers are also worried about potential budget cuts that may impact HIV services, particularly for aging PWH. 

Planning Council Update

Mr. Harriman reported that members of the Consumers Committee presented on the HIV and Aging Directive at the recent NY Links conference.  They also submitted a letter to the Recipient with concerns about consumer engagement and client advisory board to help improve quality of services.  The Integration of Care Committee continues to make progress on the Behavioral Health directive.  They hope to include wellness activities such as exercise and are seeking clarification from HRSA if this is an allowable service.  The draft Needs Assessment will be voted on at the May Council meeting and then submitted to HRSA.  It will be presented to the Steering Committee next month.  The Priority Setting & Resource Allocation Committee is working on the GY 2024 application spending request for the NYC portion of the grant.  The Policy Committee hosted representatives from HASA to address NYC housing issues.  They are also keeping abreast of issues arising from the Medicaid carveout and the end of the 340B program.  Mr. Palmer added that the final State budget did not save the 340B program, but $30M has been allocated to Ryan White Part A (RWPA) programs in NYS to apply for offset funding.  Advocacy to ensure that this offset funding is implemented quickly would be welcome.

Mr. Klotz reported that a court ruled that NYS must provide all Medicaid recipients with full dental coverage, including root canals, crowns, bridges and implants.  This may mean a reduction in the amount that RWPA oral health programs need.  Also, the application period for membership on the Planning Council is open.  Consumers are especially encouraged to apply.  

Recipient Report

Mr. Spiegler reported on federal updates, including the release of a report on a National Aging with HIV Survey and a RW Part B planning guide.  HRSA’s triennial site visit to the EMA is next week (virtual this time).  They will be conducting meetings with the Council’s Executive Committee, consumers of RWPA programs in NYC and Tri-County, and conducting administrative, fiscal and program reviews.  

A concept paper for the upcoming RWPA RFP for Housing services in NYC has been released.  The EMA’s Quality Management Plan was submitted to HRSA.  The QM program is developing new trainings and other activities for subrecipients (providers).  Other updates were provided on Medicaid recertification, 340B, approval of an over-the-counter form of Naloxone and other policy issues.

Agenda Item #3: GY 2024 Application Spending Request

Mr. Palmer explained that the EMA submits a request for the following year’s grant application and is allowed to request up to 5% more than the current year’s award.

Mr. Klotz added that a 5% increase to the GY 2023 allocation for Tri-County programs would be an additional $222,490 for a total of $4,672,294.  The amount is a wish list that demonstrates in the application the need for increased resources to address expanding need, particularly for aging PWH.  The chances of actually getting an increase are very slim, and in the winter the Committee will develop a spending scenario plan for an actual award, which is likely to be flat or a decrease.  Any increase request needs to be justifiable, and a logical approach would be to do an across-the-board increase (weighted by service category ranking score) to reflect the increase cost of providing services due to inflation. 

It was noted that a 5% increase is almost identical to what was reduced in the current year.  The targeted reduction to Medical Case Management in GY 2023 was in response to specific data on that category (e.g., payor of last resort).  Data on actual expenditures and service levels can be used during the scenario planning process to make adjustments to the allocations by specific service categories.

A motion was made and seconded to approve a spending request with a 5% across-the-board proportional increase based on ranking scores.  The motion was adopted 10Y-0N.

The next meeting will be on Wednesday, June 14th @10am. 

There being no further business, the meeting was adjourned.