Tri-County Steering Committee Minutes October 23, 2019


October 23, 2019, 10:10am-12:15pm
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, B. Catena, D. Dominguez, J. Gago, J. Gressel, P. Laqueur, K. Mandel, C. Oldi, J. Palmer, J.C. Park, A. Pizarro, S. Richmond, T. Seabrook, A. Simmons, S. Spiegler (for G. Harriman)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. Carney, A. Contreras, M. G. Ferone, L. Hakim, A. Hardman, M. Piazza, L. Reid, A. Ruggiero, D. Scholar, K. Scott, S. Thomas, C. Watkins
Staff:NYC DOHMH: D. Klotz, J. Colón-Berdecía, M. Lawrence, 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 May 8, 2019 meeting were approved with no changes.  

A moment of silence of silence was held in honor of Joe Page, who was a long-time Steering Committee and Living Together member. 

Agenda Item #2: Public Comment  

Patricia B. expressed concern that the recent clinical focus of the Living Together (LT) meetings was changing the nature of the group, which had always been peer led.  Also, Mt. Vernon Hospital is closing, to be replaced by an urgent care center, which would not meet the full needs of HIV patients. 

Ms. Best  encouraged everyone to register for the Nov. 25th Power of Quality Improvement Conference, where the Council’s Consumers Committee will host an exciting session on Meeting Client Needs for Oral Health Services. 

Kahlil M. from the Loft LGBT Center announced a new initiative to increase awareness around HIV and the transgender community.  More details will be shared as the program is implemented.  There was a discussion about the nature of the LT program.  Mr. Park noted that it is funded under Ryan White Part A as a psychosocial support service, which has certain federal and local requirements, and he suggested the possibility of consumers creating a sub-committee of the Steering Committee to meet informally, or creating another support group to continue the old LT format.  Some LT members noted that the group has many long standing members who have been free to share intimate personal information, as well as get support for treatment adherence (which is almost 100%), and that the presence of a clinician puts  damper on what people share.  LT has also helped bring people into the Steering Committee and Council.

Agenda Item #3: Policy Update

Mr. Guzman reported that a federal judge issued a preliminary injunction prohibiting the Trump Administration from enforcing the public charge rule nationwide, which would have prohibited immigrants from accessing many kinds of benefits.  There was a discussion on whether or not the three County Executives in the region were supportive, as the Mayor of New York City is.  It was noted that Committee members could, as citizens of the region, advocate for more progressive treatment of immigrants.  Advocates, service providers and consumers can arrange to meet with local leaders to educate them and develop a relationship with them.  Also, the Committee can draft letters about specific policy issues (although as a federally funded body, they are prohibited from lobbying for specific legislation).  Mr. Palmer noted that TOUCH is meeting with the Rockland Commissioner of Social Services tomorrow to discuss issues around immigrants and access to services. 

Mr. Guzman reported that the FDA has approved a new drug, Descovy, for PrEP to greatly reduce the risk of sexually acquired HIV in adults and adolescents, but not including individuals at risk from receptive vaginal sex “because the effectiveness in this population has not been evaluated.”  This is based on the fact that the drug maker, Gilead, did not conduct clinical trials among cis women and trans men.  Gilead stated it will conduct a new study to evaluate Descovy for PrEP in cisgender women, and will incorporate community voices in the study’s design and implemented, however, the study will not be completed for several years. The Committee thanked Mr. Guzman for his update and extended an invitation to present in person, requesting that he incorporate more details related to policy decisions in the three counties in the region.

Agenda Item #4: Updates

Consumer Update

Mr. Alvarez discussed the issues around aging that many PLWH are facing, particularly the effects of being on HIV medications for many years.  He stressed the need to keep the focus of all decisions on the health and quality of life of PLWH .

Ending the Epidemic Report

Mr. Laqueur and Ms. Mandel reported that the local sub-committee is being reconstituted.  They will be conducting meetings with non-traditional partners (e.g., juvenile justice) to present about ETE initiatives. 

Recipient (Grantee) Report

Mr. Speigler reported that the FY 2020 Ryan White Part A grant application has been successfully submitted to HRSA.  The application was a huge undertaking involving the Recipient and Planning Council.  Also, NYC DOHMH has submitted an application under a new notification of funding opportunity for up to $9M under the federal Ending the HIV Epidemic initiative, which is limited to four counties in New York (Bronx, Brooklyn, Manhattan, Queens). 

Mr. Speigler reported that there was a successful training in August for the Part A Medical Case Management providers in Tri-County to prepare them for the new service model.  Also, last week there was a meeting for all Tri-County Part A providers, with 51 providers in attendance for program updates, including a tutorial on using the eShare data system.  Finally, the Bureeau is interviewing for a new program planner for Tri-County to take Julie’s place, and for a replacement for Amber Casey.  Until those positions are filled, Mr. Spiegler will provide support for the Tri-County providers and Steering Committee.

Planning Council Update

Mr. Klotz reported that the new Council cycle has begun, with the first full Council meeting to be held next week.  At that meeting, the Council will approve recommendations to improve access to Part A services for people with disabilities.  This was an initiative championed by Mr. Park.  The recommendations will apply to services is the entire EMA and will help people with mobility or sensory disabilities overcome barriers to accessing services.  The recommendations will be presented to the Steering Committee.

In the upcoming planning cycle, the Needs Assessment Committee (NAC) will work on recommendations to improve access to care for people with serious mental illness.  The Integration of Care Committee (IOC) will work on a new service directive for a NYC-based Oral Health Services category.  The Priority Setting & Resource Allocation Committee will begin working on scenario planning for the FY 2020 grant award.

Agenda Item #5: FY 2020 Spending Scenario Planning

Mr. Klotz introduced the work of planning for a possible cut to the grant award in FY 2020, which begins March 1, 2020.  Public Health Solutions has reported that the carrying costs of programs will remain stable as programs are in their start-up year.  In future years, with the advent of performance-based contracting (where agencies are paid for the services delivered based on rates, rather than fixed costs), there will be adjustments as programs find their maximum reimbursement levels.  For FY 2020, the one exception is Housing Services, which will require some ongoing additional funding.  The PSRA and Council allocated $200,000 in carry-over funds (unspent dollars from FY 2018, which must be spent by the end of FY 2019, which ends 2/29/20) to cover over-enrollment in those programs.  (Those funds should be approved by HRSA within the next month or so).  At the November meeting, Pam Farquhar, Director of HIV Housing, will present data on the ongoing needs for additional Housing Services in Tri-County.  Also, traditionally, the Steering Committee has asked PSRA to hold TC programs harmless from cuts to the award, which (along with any additional funds for Housing) can be reallocated from the funds now allocated for ADAP (NYS DOH has informed the Council that they have sufficient funding to help the EMA absorb cuts to the award).

Agenda Item #6: Public Comment

Eleanor of Legal Services of the Hudson Valley reported on a recently completed Ryan White needs assessment.  Also, a tenant “Know Your Rights” seminar is planned for November 26th.

Ms. Lawrence reported that a new Planning Council website is nearing completion.  It will be more user-friendly, easier to read and accessible to the visually impaired.  It will also include a community calendar for non-Council events.

Ms. Best encouraged Committee members and consumers to think about applying for Council membership, as the terms of the current TC members will end in 2021. 

Mr. Simmons asked about the affect of the new PrEP drug on heterosexual men.

Agenda Item #7: Farewell to Julie and Jan

Committee members celebrated the retirement of Dr. Lehane and Mr. Park, who are retiring after many years of dedicated service.  Plaques were presented honoring their contributions to the fight against HIV in Tri-County and beyond.  Members spoke movingly about their commitment and outstanding efforts in the region, and Jan and Julie spoke of how meaningful it has been to work with the community in Tri-County. 

There being no further business, the meeting was adjourned.