Tri-County Steering Committee Minutes May 8, 2024



May 8, 2024, 10:05-11:30am

By Zoom Videoconference

Members Present:          J. Palmer (Co-chair), S. Altaf (Co-chair), V. Alvarez, L. Best,  L, Bucknor, A. Contreras, V. Carlone, L., Cyrus, M. Diaz., J. Gago,  , K. Mandel, L. Reid, K. Scott, A. Milian, S.Thomas, L. Francis

Members Absent:           L M. Acevedo, A. Desir, B. Malloy, J. Gobler, L. Hakim A. Hardman, A. Pizarro,  A. Ruggiero,

Guest Present:                 

Other PC Members

Present:                               B. Fields

Staff Present:                    NYC DOHMH: D. Klotz, D. Saab, G. Plummer, J. Acosta, S., Spiegler., S. Kramer, D. Noble, M. Beyene, G. Hamilton, V. Dinh, M. Pathak, F. Abdelqader,

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

Saqib A. and Julian P. opened the meeting followed by introductions and a moment of silence. The minutes of April 10, 2024 meeting were approved.     

Agenda Item #2: Updates

Consumer Update

  Victor A. reported concern over polypharmacy and long-term side effects associated with taking HIV medications impact on aging adults with HIV. There is an emerging issue of liver and kidney problems occurring among this population. Victor A. highlighted the importance of studies that investigate the long-term impact HIV medications have on PWH and alternative medication options such as, herbal medicines.
He also mentioned that required proof of HV status for RWPA services continues to be a burden on clients. The Recipient said that they are trying to advocate for changes in the legislation, streamline processes and explore staff retention strategies to help address these long-standing complaints from not only consumers but RWPA staff as well. 

Recipient Report

Johanna A. reported news from HRSA and other federal agencies, including commemorating life and legacy of Ryan White, the namesake for the Ryan White HIV/AIDS Program that provides a comprehensive system of HIV medical care and essential support services to more than 560,000 people each year. On April 10th, HRSA recognized National Youth HIV/AIDS Awareness Day and National Transgender HIV Testing Day on April 18th. The federal FY 2024 budget was finalized, with Ryan White appropriations mostly flat funded. Registrations are open for the 2024 Health Grants Workshop as well and the National Ryan White Conference in August. Virtual attendance is unlimited. HRSA is encouraging RWHAP recipients to spread the word about their listserv for the latest updates on opportunities, resources and events.

Public Health Solutions, on behalf of NYC DOHMH, recently released the concept paper for the forthcoming RFPs for Behavioral Health and Non-medical Case Management/ Inmates & Releasees. The NYC Health Department’s RWHAP Part A webpage has been revamped to include a link to their updated RWPA Referral Directory, which will be posted on the Council website and includes newly funded Housing programs. The Quality Management (QM) Committee for the NY EMA continues to meet to discuss updates and feedback on subrecipient quality management trainings. The QM Program is also collaborating with the Consumers Committee to deliver a consumer-led session on client advisory boards (CABs) at the 2024 RWPA Provider Meeting on July 16th. Along with CABs, topics will include using eSHARE data to improve service delivery, resources for immigrants and migrants, and engaging consumers in various methods of collaboration to provide feedback on service delivery and quality improvement.

KFF releases a fact sheet on HIV federal funding trends in FY 2018 to FY 2022. The National Coalition of STD Directors are seeking requests for proposals for self-collect STI/HIV testing kits initiative. The President Advisory Council on HIV/AIDS convenes its 80th full council meeting to discuss various topics addressing the unique needs of Black and Latina cisgender women. The White House appointed Francisco Ruiz as the Director of National AIDS Policy.

Planning Council Update

David K.  announced that the Jeffrey Klein will be joining the Planning Council as a Program Planner this June. The Consumer Committee is presenting their finalized Best Practices Guidelines for Client Advisory Boards, at the annual RWPA Provider meeting on July 16th. The Rules & Membership Committee will begin the process of recruiting new Council members. Council members are encouraged to help spread the word about recruiting potential members. The Integration of Care Committee has revised the service directive for early intervention services, focusing on targeted testing efforts to link undiagnosed persons to care. May’s Planning Council meeting will include a presentation of 4th quarter report for the 2023 grant year to determine the carryover funds for 2025.

Agenda Item #3: Presentation – GY 2025 Spending Plan

Doienne S. presented the spending request grant application for the next grant year, 2025. HRSA allows TCSC to request a 5% increase then the current year amount. The TCSC will be tasked with deciding how to allocate the 5% surplus to a service category(-ies) of choice, this may include an allocation to housing services. David K. confirmed that the surplus decision could be revisited if new program data emerges during the winter scenario planning process. To help with deciding where the surplus of funds should go, the TCSC is receiving a presentation on program data for housing services in the TC region.

Agenda Item #4: Presentation – Housing Opportunities with AIDS and Ryan White Part A Housing Programs

The Recipient provided an overview on the two types of grant-funded programs providing housing services for PWH in NYC and the Tri-County (TC) area – Ryan White Part A (RWPA) and Housing Opportunities for Persons with AIDS (HOPWA). In TC, the RWPA housing program is called HOT, which provides rental assistance payments to eligible payments for short-term and transitional housing services for up to 12 to 24 months. Under TC RWPA housing, all clients receive intake assessments, a service care plan, client assistance with housing, entitlements and benefits, health care and social services; apartment inspection. Additionally, the other grant-funded housing service in TC, is through HOPWA ‘s housing, Tenant-Based Rental Assistance (TBRA) program. TBRA provides financial assistance to HOPWA-eligible households in a unit of their choice in the TC area. The design of TBRA fosters community integration while maximizing household choice, independence, and anonymity. HOPWA TBRA is portable, which means that a client may move into a different unit and continue receiving this subsidy, provided that the new unit is within the provider’s service area and meets the programs and grantee’s criteria.

TC HOPWA housing services are provided through two types of housing: congregate facility housing (also known as single-site) which places tenants in a designated building and provides on-site supportive services; scattered-site housing units, which places tenants in apartment units located throughout the community. In scattered-site apartments, on-site supportive services are limited to home visits. Tenants are encouraged to seek additional supportive services with their housing provider. Supportive services focus on issues related to ongoing access to HIV primary care, behavioral health needs (mental health, substance use), other chronic health conditions, and other needs (childcare/nutrition) to ensure that PWH maintain stable housing and enjoy improved quality of life.

The goals of both housing programs are to reduce the risk of HIV transmission associated with homelessness and unstable housing, increase the number of PWH who enter and stay in HIV medical care and treatment and decrease homelessness and unstable housing among PWH.

The Recipient also provided available demographic and service utilization data for TC’s RWPA housing Program – HOT. Between March 1, 2022 to February 28, 2023, it was reported that most HOT clients resided in Westchester County (86%), followed by Rockland County (12%). The largest racial and ethnic group among HOT clients, were Black (52%) and/or Latino/a (40%).  Almost all clients identified as either cisgender women or men, with slightly more cisgender women represented as HOT clients. Most clients were aged 50 or older.
The most common transmission category was heterosexual contact (63.2%), followed by MSM or men who have sex with men (24%). There were 1,732 service units delivered in Grant Year 2022 to 106 clients. The most common service type utilized was rental assistance payments (865 service units delivered to 92 clients) and the least service type used was intake assessment (26 service units).   The Recipient also shared TC HOPWA TBRA client data for the 2023 calendar year. It was reported that Westchester County accounted for the most clients enrolled. Only two agencies reported waitlists for the HOPWA program. Currently, TC housing program data is not being collected in eCOMPAS, but providers will be set up to start data entry in eCOMPAS later this year. Therefore, recently available provider data was limited to 2024.   In closing, the Recipient stated that HOPWA’s supportive housing programs offer more service types than rental assistance programs in TC. However, TC HOPWA offers fewer service types in comparison to NYC. For both RWPA and HOPWA, most enrolled clients lived in Westchester County with fewer residing in Rockland and Putnam.   Following the presentation, Deborah N. (HOPWA) shared that there are limited housing options for clients in TC but that CBOs in the region are implementing creative solutions to address the shortage. Members expressed an interest in wanting to better understand the housing crisis and affordability issues in TC in comparison to NYC. They are interested in learning more about specific data that can further describe the housing shortage in TC. Members asked if housing vouchers can be transferred between the counties of TC which was confirmed as a possible option.   Doienne S. shared that the June meeting, will describe the HASA program in NYC and state legislation to enhance and provide affordable housing options in TC.    

The next meeting will be the second Wednesday of June.  There being no further business, the meeting was adjourned.