Tri-County Steering Committee Minutes May 8, 2019


May 8, 2019, 10:10am-12:00pm
Hudson Valley Community Services
40 Saw Mill River Road, Hawthorne, NY


Members Present:   A. Straus (Co-chair), M. Diaz (Co-chair), D. Ahmed, S. Altaf, V. Alvarez, L. Best, L. Bucknor, D. Carney, A. Casey (for G. Harriman), B. Catena, A. Contreras, J. Gago, J. Gressel, L. Hakim, P. Laqueur, J.C. Park, A. Pizarro, L. Reid, S. Richmond, A. Ruggiero, K. Scott, T. Seabrook, A. Simmons, S. Thomas A. Straus (Co-chair), M. Diaz (Co-chair), M. Acevedo, D. Ahmed, S. Altaf, V. Alvarez, L. Best (by phone), L. Bucknor (by phone), A. Casey (for G. Harriman), B. Catena, A. Contreras, D. Dominguez, M. G. Ferone, J. Gago, J. Gressel, L. Hakim, C. Oldi, J. Palmer, A. Pizarro, S. Richmond, A. Ruggiero, K. Scott (by phone), A. Simmons, S. Thomas  
Members Absent:  M. Acevedo, D. Dominguez, M. G. Ferone, A. Hardman, C. Oldi, J. Palmer, M. Piazza, D. Scholar, C. Watkins A. Hardman, P. Laqueur, J. Page, J.C. Park, M. Piazza, L. Reid, D. Scholar, T. Seabrook, C. Watkins
Staff:NYC DOHMH: D. Klotz, J. Colón-Berdecía, A. Guzman (by phone); WCDOH: J. Lehane, PhD NYC DOHMH: D. Klotz, A. Guzman (by phone); WCDOH: J. Lehane, PhD 
Agenda Item 1: Opening/Moment of Silence/Minutes  

Ms. Straus and Ms. Diaz opened the meeting followed by introductions.  The minutes of the April 10, 2019 meeting were approved with no changes.  

A moment of silence of silence was held in honor of Humberto Cruz, former director of the NYS AIDS Institute, who passed away recently.  Humberto worked at the AI for 23 years, including 5 as director.  As a long serving member of the Planning Council, NASTAD and the Presidential Advisory Council, he left a legacy of accomplishments that helped improved the health and lives of PLWH across New York State and nationally.

LaShonda Cyrus and Lisa Dantes from Hudson Valley Community Services (HVCS)distributed flyers with information about two new programs at the agency.  Psycho-social Services, with Mr. Alvarez as peer working with a coordinator, will provide a co-ed support group, a group for women, and art therapy to deal with stigma, coping with HIV and other issues.  Also, Emergency Financial Assistance is now available for one-time or short-term assistance with housing, food, utilities, etc. 

Agenda Item #2: Updates  

Ms. Best asked about the effect of the measles outbreak on PLWH.  Ms. Casey reported that anyone with a CD4 count over 200 can get the vaccine.  People who were immunized as children can get a test to measure the vaccination’s titer, which will determine if a booster shot is necessary.  Ms. Reid and Ms. Scott noted that clinics in the Tri-County region are addressing the outbreak, which is mostly limited so far to the ultra-orthodox community in Rockland. Ms. Contreras announced that Putnam County Health Department is hosting a hepatitis C testing day on May 20th.

Agenda Item #3: Policy Update

Mr. Guzman reported on the 2020 federal appropriations process.  The House has issued their version of the budget, which adds $500M in additional funds for the federal Ending the Epidemic initiative announced earlier this year.  This amount will be negotiated with the Senate and must be signed by the president.  The amount is for prevention, treatment and research.  $170 of the proposed additional funds is for all parts of the Ryan White program.  This means that a relatively small amount would be apportioned to the NY EMA, which may help offset the reductions in formula funds that the EMA has been receiving for several years. 

In response to questions from Mr. Park, Mr. Guzman noted that there has been no movement on State bills to allow for safe injection sites.  Also, NYC DOHMH is gearing up to respond to the changes in adherence programs that will be needed when long-acting injectable anti-retroviral medications become available.  DOHMH also submitted extensive comments on the proposed federal rules to eliminate HIV and other drugs as protected classes under Medicare Part D.

It was also explained that the new Statewide “HASA for All” law requires localities outside of NYC to opt into the program and help fund it.  If counties opt in, there would be a huge benefit for homeless and unstably housed PLWH.  Committee members were urged to educate and advocate with local elected officials to encourage the region’s counties to opt into the program.

Agenda Item #4: FY 2020 Application Spending Request

Mr. Klotz explained that HRSA will likely again cap the amount that an EMA can request in its grant application to a maximum of 5% over its current Base award.  As the majority of the service portfolio in Tri-County is newly re-bid, there is no data on spending that can be used to make adjustments in the service category allocations.  The application spending plan is just a request, and the Committee will have the opportunity over the winter for plan for the actual award, after which there will be some limited data on spending rates.  A 5% increase can be allocated across the portfolio proportionately based on the ranking scores that the Committee approved last year.  Mr. Park noted that the Committee can also request increases targeted to specific categories, but there is no data to make those determinations.  It was reiterated that the Committee will have the opportunity to plan for the actual award over the next planning session.

A A motion was made, seconded and approved unanimously to accept the FY 2020 application spending plan as presented.

There being no further business, the meeting was adjourned.

Agenda Item #5: Updates

Consumer Update

Mr. Alvarez reported the State’s clinical committee is recommending that the focus for long-acting injectable medications be on people with issues around treatment adherence.  Also, issues around side effects (mostly a short-term rash around the injection site) were addressed in the clinical trials.  Consumers are looking forward to the June 5th Long Term Survivors event in Manhattan.  DOHMH is working with HVCS to provide a van to bring Tri-County consumers to the event.   

In response to a question about measuring “performance” of programs, Ms. Casey explained that there are process indicators (e.g., are programs enrolling the kind of clients who are the target of the service, are programs providing the services they are contracted for), quality indicators (e.g., are clients meeting their treatment plans), and outcome indicators (viral load suppression).

Ms. Best reported that the Council’s Consumer Committee met with DOHMH staff about concerns over questions on client intake forms that may be extraneous or inappropriate.  Also, she and Council staff member Darryl Wong held a call with the National Minority AIDS Council on a program to develop leadership among PLWH who are people of color. 

Ending the Epidemic Report

Mr. Laqueur reported that there are discussions going on at this moment to schedule the next meeting to continue the local sub-committee’s work. 

Planning Council Update

Mr. Klotz reported that the April Council meeting was held at Bronx Borough Hall with Borough President Ruben Diaz, Jr. in attendance.  There were Bronx-specific presentations on HIV epidemiology and DOHMH testing programs.  Also, the FY 2019 reprogramming plan was approved, which will allow the Recipient (Grantee) to maximize spending by enhancing over-performing contracts using funds from take-downs of under-performing programs.

At the May Council meeting, the Council will ratify a revised Memorandum of Understanding, which is a document required by HRSA that spells out the roles, responsibilities and relationship between the Council and Recipient.  The Council will also vote on revised Council grievance procedures, which describe the process for resolving disputes around any deviations from the Council’s written policies and procedures.

The Needs Assessment Committee (NAC) is still working on recommendations to enhance access to programs for people with disabilities.  There will be a town hall on the subject on June 27th.  NAC also has sub-committees working on assessing the need for oral health services in NYC and ways to improve access to care for people with serious mental illness.

The Integration of Care Committee (IOC) is working on revising the service directive for a NYC category called Transitional Care Coordination, which provides case management to homeless and unstably housed.  Also, an IOC sub-committee is developing recommendations for ensuring that all Part A programs are culturally competent to serve transgender and non-binary clients.

Applications are being accepted until June 14th for membership on the full Council.  Committee members were encouraged to apply.

Mr. Park added that the Executive Committee will look at new HRSA training tools to complete the mandated assessment of the administrative mechanism, which is the Council’s role in ensuring that the Recipient spend the Part A grant in accordance with Council priorities and gets the funds out to the community in a timely manner.   Also, a new Council website that is accessible to the blind will be rolled out this summer.

Recipient (Grantee) Report

Ms. Casey encouraged consumers to RSVP for the Long-Term Survivors Day event, which will have a number of fun and interactive activities. 

She also reported that DOHMH is fulfilling several conditions of the grant award, including the annual Program Terms and Progress Reports.  Also, HRSA issued a policy clarification notice to allow expedited enrollment so that programs can offer immediate care (esp. HAART).

Finally, there will be a Tri-County providers meeting in the fall.

The Steering Committee having completed its business for the cycle, adjourned for the season.  Meetings will resume in the fall. There being no further business, the meeting was adjourned.