TRI-COUNTY STEERING COMMITTEE MEETING
September 8 2025, 10:00am-11:57 am By Zoom Videoconference
DRAFT MINUTES
Members Present: J. Palmer (Co-chair), L., Cyrus (Co-chair), V. Alvarez, L. Bucknor, M. Diaz,
V. Carlone, J. Gago, P. Germinaro, B. Malloy, K. Palencia-Lua, K. Scott, S. Thomas
Members Absent: L M. Acevedo, R. Agarwal, D. Anderson, L. Best, J. Braithwaite, A. Contreras, J. Gobler, L. Hakim, A. Hardman, K. Mandel, A. Milian, A. Pizarro, L. Reid, A. Ruggiero, P. Tang, G. Thomas
Guest and other
PC Members Present: None
Staff Present: NYC DOHMH: D. Klotz, D. Saab, M. Navejas, L. Moya-Adames, A. Omeyoma, G. Dominguez-Plummer, J. Acosta, S. Kramer, Cassidy Burt
Julian P. and LaShonda C. opened the meeting with a roll call of members followed by a moment of silence.
The minutes for the June 11th 2025 meeting were approved with no changes.
Doienne S. announced that National HIV/AIDS and Aging Awareness Day will be held on September 18th, 2025.
Consumer Update
Maria D. and Victor A. informed the Committee that the Living Together support group can no longer provide lunch to participants due to funding restrictions within the program. In response, Doienne S. shared that supports groups and agencies should identify corporate food donation partnerships to fill the gap for these incentives for the time being.
Maria D. highlighted emerging issues like social isolation and the value of support groups for mitigating this barrier for PWH in the region. She also mentioned that many aging consumers have been falling and the need for resources to support them.
Recipient Report
None reported for this month.
Planning Council and Federal Administration Update
David K. reported that the Council is welcoming 11 new members. The Council new member orientation will be held Friday, Oct. 17th from 8-530p.
David K. shared that the Senate Fiscal Year 26 appropriations bill keeps HIV program funding largely level. However, the House Labor – HHS bill, proposes the largest cuts to federal HIV programs in over two decades. The proposed cuts include significant reductions to federal HIV/AIDS funding by over $500 million:
- Defunds the entire Ending the HIV Epidemic Initiative
- Cuts to Ryan White HIV/AIDS Program, including all of Parts C, D, and F
- Slashes funding for the Minority HIV/AIDS Initiative funding by over $65 million to $20 million
- Cuts $24 million funding for viral Hepatitis, STI and TB prevention at the CDC while also reconstituting funding for these programs as a block grant to states
- Reductions to CDC HIV Prevention funding
Sara K. presented an overview on RWHAP Part A Medical Case Management Program. She informed the Cmte. that a new service directive for the Medical Transportation Program is required from the Tri-County Steering Committee. The goals of the Medical Transportation Program are to provide:
- Client-centered medical case management services to help improve health outcomes for people with HIV;
Services include:
client assistance, case conferencing, care planning, coordination with service providers, linkage to services, health education (individual and group), accompaniment, immediate initiation of ART (iART), and modified directly observed therapy (mDOT).
The program seeks to:
- Increase the proportion of newly diagnosed individuals who enter into primary care within three months of HIV diagnosis
- Increase retention in HIV care and treatment
- Increase the proportion of clients who have an optimal level of ART adherence
- Increase the proportion of clients with and undetectable viral load and improve immunological health
- Reduce mortality
- Reduce and then maintain below significance socio-demographic difference in prompt linkage to HIV/AIDS care following diagnosis, retention in primary medical care, undetectable viral load and HIV related mortality
The objectives of the Medical Case Management program are to: - Provide coordinated access to medically appropriate levels of health and support services and continuity of care
- Provide referrals and linkages to medical or supportive services that improve clients’
physical and behavioral health - Provide comprehensive treatment adherence services, promoting access to, and the consistent utilization of antiretroviral (ART) therapies
To be eligible, clients must meet at least one of following: newly diagnosed, out of care, previously diagnosed but out of care, inconsistently engaged in care, diagnosed and engaged in care but not on ART, virally unsuppressed, currently co-infected with Hep C, at risk of falling out of care, new to HIV treatment of change in regiment, pregnant women with HIV.
The recommended staffing for the program includes a program director, data entry specialist, care coordinator, patient navigator, medical provider and clinical supervisor.
Sara K. shared some challenges and successes for the 5 funded programs since implementation in March 2016. Some identified challenges included:
- Regular attendance at group education sessions
o Fluctuates depending on clients’ health statuses and other factors
o Those who do attend, however, share the value of them - Data reporting – sometimes confusing to report services in eSHARE
o Especially for agencies with multiple contracts asking for similar but distinct services
o High turnover contributes to staff who are unfamiliar eSHARE - Documentation burden
o Services require a lot of documentation - High turnover for staffing, especially during the COVID pandemic
o All levels of staffing were impacted However, program successes include: - Many modes of communication (e.g. virtual, in-person, phone) depending on client’s
preference - CCR/MCT-specific training provided to strengthen program model and collaboration between sites
o included one in-person at Tri-County last year - Client engagement and program utilization is high
o Programs regularly fully spend down funded allocations
Cassidy B. (Evaluation Specialist) presented the latest factsheet on the RWHAP Medical Case Management program, sharing key data points for informing the Cmte.
Priority Populations & Demographics (Grant Year 2024)
Cassidy B. reported that were a total of 486 active clients enrolled in the Medical Case Management, Tri-County (MCT) program during Grant Year 2024. Clients were considered “active” if they received at least one service during the grant year.
It was noted that the majority of clients (47%) were identified as people aging with HIV. Other priority populations included cisgender women of color, individuals with disabilities, Black or Latino cisgender men who have sex with men (MSM) (35%), cisgender women of color (31%), and people with a disability (16%).
Cassidy B. then reviewed the demographic profile of active clients. Most clients were between the ages of 30 to 49, followed by those aged 50 to 64. Regarding race and ethnicity, 54% of clients identified as Hispanic, and 38% of clients identified as Black. Sixty-six percent of clients were Man or Boy, followed by Woman or girl at 33%. The majority of clients (61%) resided in Westchester County, followed by smaller numbers in Rockland (24%) and Putnam Counties (2%). Heterosexual transmission was the most commonly reported mode at 55%, followed by MSM (40%).
Service Utilization Trends (2022–2024)
All service types excluding Linkage to Services and Outreach for Client Engagement increased over the three-year period. Increase in services and units delivered over this time period may be linked to the increase in telehealth use which provided additional accessibility delivery options for clients.
Financial Overview
Jelani C. reviewed Planning Council allocation amounts and actual expenditures from 2022 through 2024. In 2024, actual expenditures were slightly higher than the original allocated amount.
Overall, it was mentioned that the service program is demonstrating to be a success with an increase in the total number of clients served and service activities delivered.
It was noted that it would be interesting to examine data on demographic information by the different service types under this program. The Recipient said that their team is experiencing a staff shortage and hiring freeze which may limit the capacity to provide additional data
requests at the moment. Doienne S. will identify outside data sources to share with the Cmte. in the meantime.
Agenda Item #7: Medical Transportation (TRN) Service Directive Doienne S. presented the updated Medical Transportation Service Directive for Cmte. review. She explained that the directive is being revised to ensure the language and service model.
Framing Directive Inclusion
The directive now includes a link to the New York HIV Planning Council’s Framing Directive, which outlines guidance for delivering client-centered, nonjudgmental, and culturally responsive services. This update replaces previous boilerplate language on client-centered care.
Allowable Services
Doienne S. reviewed the types of transportation services permitted under Ryan White Part A (RWPA):
• Rides to RWPA-eligible medical services, pharmacies, in-person support groups, and other essential services that support HIV care.
• Rides are only allowable when no other viable transportation options are available.
• Services must occur within the NY EMA region.
• Approved transportation modes include Metro-North train tickets, bus vouchers, taxi rides, and—newly added—ride-share services (Uber, Lyft).
• Ride-share services were added based on a successful California RWPA model.
Program Model Updates
Doienne S. outlined that the model includes:
• To ensure that clients who are newly diagnosed are connected to HIV care and can achieve an undetectable viral load. Coordinate the immediate initiation of antiretroviral treatment (immediate ART or iART) on the day of diagnosis, at the first clinic visit, or on the day a client returns to care.
• The adoption of innovative telehealth-related strategies for treatment adherence including modified directly observed therapy (mDOT), and other contingency management tools (e.g., digital devices, applications) for adherence support
• The use of validated screeners such as the Brief Geriatric Assessment (BGA) to identify and then link adults over the age of 50 to health care and supportive services to ensure wholistic needs are being met – the BGA is a tool that non-clinical staff can use to identify and address specific needs of clients aging with HIV to manage co-morbidities, social isolation, cognitive impairments, frailty, polypharmacy, and other age-related concerns.
• Encouraging the implementation of closed loop referral system to track and ensure that clients are connected to the supportive services that they need and/or request
• To link clients to programs that address social isolation and/or to identify additional funding to create such programming
Client and Agency Eligibility
• All individuals with HIV in the NY EMA are eligible, regardless of criminal or substance use history
• Agencies must provide assessment and engagement into health insurance programs and assist eligible clients in accessing existing and future insurance exchanges, e.g., Medicaid, Medicare, and NYS Health Insurance Exchange Systems
• Agencies must have the capacity to bill 3rd party payers for billable services
• Agencies must either be co-located or have established linkages with programs providing early intervention services, medical care, mental health, alcohol and substance use services, housing programs, food and nutrition services, legal services, supportive counseling services, employment related services, medical transportation, and other unmet social and make closed-loop referrals as appropriate
• Non-profit licensed community-based clinics/hospitals, governmental health organization, and non-profit community-based HIV/AIDS service organization (CBO) and social service providers with established MOU with a clinical provider that allows for same day appointments and access to medical records
Doienne S. emphasized that the development of the service directive included testimony from providers and clients in the MCT program and a review of literature conducted by both Council and Recipient staff.
The Cmte. committee reached consensus to adopt the updated directive, with no objections raised.
The next service directive to revise and discuss will be the Psychosocial Support program.
Adjournment
The Next Steering Committee Meeting will be held on Tuesday, October 8, 2025 10-11:30 AM.
There being no further business, the meeting was adjourned.
