Greater Baltimore HIV Health Services Planning Council Minutes of the Meeting of July 21, 2009

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Minutes of the Meeting of July 21, 2009 Vol. VI, No. 5 Final August 18, 2009 Meeting Attendance Present 1 Absent BCHD Staff Visitors R. Bradley C. Brown V. Burrell-Gibson R. Disharoon* C. Edmonds C. Gibson R. Haden P. Hall T. Hawkins M. Hitch M. Becketts K. Bellesky V. Clark R. Gore-Simmons M. Graves R. Green C. Harvey Sr. D. Henson D. Hunter A. Foyles T. James A. Ferrari J. Ungard D. Munro E. Saber D. Brewer S. Bosley M. Carroll S. Cherry T. Davis J. Fleming L. Haskins P. Henry D. Jackson W. Telp D. Kelson C. Massey* R. Matens A. Middleton G. Nelson M. Reese W. Samuels D. Shamer J. Winslow Ra. Johnson R. Johnson J. Keller J. Keruly A. Leverrette W. Miller N. Robinson R. Rubino L. Smith B. Thomas-El D. Wilson N. Slaughter R. Vaishnav Rhyne C. Wilhite S. Jenkins V. Moone R. Parrish L. Servance P. Snead H. Smith J. Smith H. Tabler M. Taylor Handouts Meeting agenda (July 21, 2009). Planning council packet (July 2009). Grantee report (July 2009). PSRA Allocation Spreadsheet (July 2009). Comprehensive Plan Progress Review (June 2009). Update meeting calendar (July 2009). Final action items and updates (July 2009). FY 2010 PSRA meeting minutes (June 22 and 23, 2009) POZ magazine (July 2009). 1 Attendance is based on sign-in sheet. * Present but did not sign in.

Executive summary The meeting convened without quorum at 6:45 p.m. with introductions and roll call. 2 A. Middleton announced that the chair and vice-chair, W. Miller and A. Foyles, respectively, had resigned from their roles due to health reasons; W. Miller will remain as a planning council member. A. Middleton then announced that she would chair the meeting and have C. Massey serve as vice-chair for the meeting. The chair announced nominations for chair and vice-chair were open from now until the August planning council meeting and elections would be held at the September planning council meeting. Nominations can be submitted to the Nominating Committee via the planning council support office, PCSO, during the next 30 days; eligibility for these positions is stated in the planning council bylaws. The chair congratulated the planning council members and Counties Committee members for their successful planning efforts for FY 2010 and thanked their partners for assisting in the FY 2010 PSRA. 3 The chair announced that the council is moving forward with its submission of the FY 2010 Part A application, including completing related deliverables. The chair also made announcements regarding membership. The FY 2010 PSRA allocations and related meeting minutes were presented to the council. The Part A grantee announced: For Part A services: the transition of Part A services from Bon Secours Imani Center is progressing on schedule; the grantee s office is working with providers to prepare for the first submission of client-level data; the final submission date for the Ryan White Data Report; and notices of award for FY 2009 MAI program will be released no later than July 25 th. 4 For CQM: work continues on the client-level data efforts, and four contracts were awarded among primary medical care programs to address needs and improvements. 5 For the Baltimore City Health Department: the deputy commissioner and chief medical officer will depart in August; a discount card program was launched to help consumers with the cost of prescription drugs; the start of a new program for men caught soliciting prostitution. 2 Quorum is defined as attendance of at least 51 percent of membership. 3 PSRA stands for Priority Setting and Resource Allocation. It is an annual event at which the planning council identifies service categories with the highest need and the funding-level increase or decrease for each respective service category dependent on the Part A award. 4 MAI stands for Minority AIDS Initiative. It is a funding stream authorized under the Ryan White Treatment Modernization Act to provide additional funding, beyond Part A, to minority areas affected by HIV/AIDS. 5 CQM stands for clinical quality management. It is the quality assurance program that assesses Part A- funded agencies to ensure compliance with the standards of care as established by the planning council. InterGroup Services, Inc., for the Greater Baltimore HIV Health Services Planning Council 2

For program support services: L.E.A.P. 13 s graduating class included 29 people, the largest graduating class in its history. 6 For technical assistance and capacity building: site visits were being conducted at housing services programs to ensure safe and sanitary conditions; the next Ryan White provider s meeting is scheduled for August 3rd. The Part B representative announced the start of the AIDS Administration s fiscal year, the schedule for upcoming community meetings and information about the MADAP formulary. 7 The representative also announced that it was awaiting the MAI award decision from HRSA. 8 The Part D representative announced that the AIDS Administration was awaiting its FY 2009 Part D and Part D-Youth Initiative award decision from HRSA. The representative also announced that members of the Youth Community Advisory Board would be attending the Transitioning HIV Positive Youth from Adolescent to Adult Services training and that this topic was relevant for the coming fiscal year. Committee co-chairs reported on their respective committee s activities: The Comprehensive Planning Committee (CPC) will review recommended FY 2010 directives, determine a date for the PSRA Review Group and begin looking at the comprehensive plan s November deadlines at its July meeting. The Continuum of Care Committee held two workgroups. One workgroup developed recommendations to the committee on the Baltimore EMA s service definitions and key services as stated in the standards of care to ensure compliance with federal requirements. The second work group received presentations on best practices for outreach. The Evaluation Committee completed part one and two of its assessment, agreed to extend the deadline for providers to complete the second provider questionnaire to July 24, 2009 and reviewed the comprehensive plan and its impact on the committee s work plan. 9 The Nominating Committee reviewed current member terms and identified new appointments. The committee made recommendations to move members onto the pool list and planning council. Pool list members would be contacted and encouraged to participate in committees while awaiting full membership on the council. 6 L.E.A.P (leadership, empowerment, advocacy and participation) is a program with a comprehensive curriculum that helps prepare consumers to serve on the planning council. 7 MADAP stands for Maryland AIDS Drug Assistance Program. It is a statewide program, funded primarily through the HIV/AIDS Treatment Modernization Act of 2006, that helps low to moderate income Maryland residents who are HIV infected receive assistance purchasing the medications they need to treat HIV. 8 HRSA stands for the Health Resources and Services Administration. HRSA is an agency of the U.S. Department of Health and Human Services that works to improve access to health care services for people who are uninsured, isolated or medically vulnerable. HRSA is the federal grantee of the Baltimore EMA s part A award. 9 The assessment of the administrative mechanism is an evaluation of the efficiency of the administrative mechanism in allocating funds and the effectiveness of services offered in meeting the identified need. InterGroup Services, Inc., for the Greater Baltimore HIV Health Services Planning Council 3

The Counties Committee met for PSRA FY 2010 and made recommendations on initial allocations for the counties Part A set-aside. The PLWH/A Committee will meet to review the potential topics it identified in January to select the topic on which to develop its position paper. The planning council support office (PCSO) reported that it prepared and distributed notices, agendas and minutes and arranged logistics for three committee meetings, two work groups, one planning council meeting and PSRA 2010 EMA and PSRA 2010 Counties, implemented the online scorecards web site and electronic voting system, attended two community events, and provided individual co-chair training. An updated meeting calendar was distributed by the PCSO. The meeting adjourned at 7:05 p.m. Proceedings Introductions/Review of Minutes The meeting convened without quorum at 6:45 p.m. with introductions and roll call. A. Middleton announced that the chair and vice-chair, W. Miller and A. Foyles, respectively, have resigned from their roles due to health reasons; W. Miller will remain as a planning council member. A. Middleton then announced that, per the planning council bylaws, as Nominating Committee chair she would be acting chair for tonight s meeting and had asked C. Massey to serve as vice-chair for that night s meeting. The chair announced nominations for chair and vice-chair were open from now until the August planning council meeting and elections would be held at the September planning council meeting. Nominations can be submitted to the Nominating Committee via the planning council support office, IGS, during the next 30 days; eligibility for these positions is stated in the planning council bylaws, section 4.2. Chair s Report The chair congratulated the planning council and members of the counties committee for a job well done with FY 2010 planning. The chair thanked the council s partners, the Ryan White team of the Baltimore City Health Department and the planning council support office for assistance in PSRA FY 2010; in addition the chair thanked the data presenters. The chair announced the council would continue preparing for the submission of the Ryan White Part A application for FY 2010. The council is moving forward with completing its assessment of the administrative mechanism, developing new outreach standards of care and identifying new members to replace those whose terms end this year. Grantee s Report The Part A grantee reported the following: Part A Administration o The transition of Part A client services from Bon Secours Imani InterGroup Services, Inc., for the Greater Baltimore HIV Health Services Planning Council 4

Center to Bon Secours Family Care Center located at 1940 West Baltimore Street is progressing on schedule and without incident. The closure of the Imani Center was effective July 13th. Door-to-door transportation services are being provided to patients who are unable to travel to the new location; through in-kind support, would fund the staffing of a case manager and outreach worker there. o The grantee s office is working with providers to prepare for the first submission of client-level data required of all primary medical care and case management programs. The final submission date for the Ryan White Data Report is September 15th and covers the period of January through June 2009. o HRSA HIV/AIDS Bureau has not released any update on the status of the Ryan White reauthorization. o Notices of Award associated with the FY 2009 Minority AIDS Initiative program that starts August 1st will be released no later than July 25th; this includes the results of the RFP process for the categories of medical case management, mental health, substance abuse outpatient and child care services. Clinical Quality Management Program (CQM) o Efforts continue on the development and implementation of the Client-level Data System. Providers independently reviewed the system several times over the past month, and for the most part the system is being well received as a beneficial administrative tool. o The grantee s office awarded four contracts among primary medical care programs to address clinical quality management needs and improvements through Plan-Do-Study-Act (PDSA) activities that enhance clinical quality management practices and improve the quality and delivery of HIV services. 10 Baltimore City Health Department o Dr. Charlene Brown, the Deputy Commissioner and Chief Medical Officer for the health department, will be departing in early August and taking a position with the United States Aid for International Development (USAID) to work on HIV and tuberculosis initiatives. 11 o Baltimore City officials launched a discount card program to help consumers cope with the high price of prescription drugs. The city is making free prescription drug discount cards available under a program sponsored by the National Association of Counties that offers average savings of 20 percent off the retail price of commonly prescribed drugs. The cards may be used by all city residents, 10 Plan-Do-Study-Act is a methodology to implement when making changes to improve. It is based on breaking down change into manageable chunks by testing change on a micro level and analyzing the results to validate improvement before implementing across the organization. From the American Heart Association web site (http://www.americanheart.org/presenter.jhtml?identifier=3039771). 11 The U.S. Agency for International Development (USAID) is an independent agency that provides economic, development and humanitarian assistance around the world in support of the foreign policy goals of the United States. InterGroup Services, Inc., for the Greater Baltimore HIV Health Services Planning Council 5

regardless of age, income, or existing health coverage. Residents do not have to be Medicare beneficiaries to be eligible for this program. A national network of more than 59,000 participating retail pharmacies will honor the prescription discount cards. Information is available from the planning council support office. o BCHD announced the debut of a Johns school, formally called RESPECT, a once-a-month Saturday program that men who are caught soliciting prostitution can take in return for a probation before judgment disposition of their cases. The classes, which could begin this fall, will include five components, taught by lawyers, officers, community members and advocates. The components of the planned eight-hour classes will cover prostitution law, sexually transmitted diseases including HIV, how prostitution affects the prostitute, how prostitution affects the community at large and sexual/drug addiction. Program Support Services o The L.E.A.P. 13 class graduated this month with 29 members; the largest graduating class in the program s history. Grantee/HRSA-sponsored Technical Assistance and Capacity Building o The grantee is conducting site visits at selected Housing Services programs, specifically those that provide transitional housing. Based on consumer concerns, the objective of these reviews is to ensure that facilities housing Ryan White funded clients are safe and that the facilities are sanitary and adequately maintained. o The next Ryan White Provider s Meeting is scheduled for August 3, 2009, from 9:00 a.m. to 3:00 p.m. at the Sheppard Pratt Conference Center. Part B Report The Part B representative reported the following: The AIDS Administration State Fiscal Year 2010 started July 1, 2009. The next MADAP Advisory Board meeting is scheduled for July 23, 4:00 p.m. to 6:00 p.m., at the AIDS Administration. The MADAP formulary is being reviewed and new medications should be added in January 2010. The next Central Regional Advisory Committee (RAC) meeting is scheduled for September 14, 4:30 p.m. to 7:00 p.m., at Nebo Christian Ministries (240 N. Franklintown Road). The focus of the meeting will be community dialogue on HIV/AIDS prevention and care services and co-chair nominations. Please contact Dionna Robinson for more information at drobinson1@dhmh.state.md.us or 410-767-0605. The AIDS Administration is still awaiting an award decision from HRSA for its Part B Minority AIDS Initiative (MAI) application, submitted on March 6, 2009. Part D Report The Part D representative reported the following: InterGroup Services, Inc., for the Greater Baltimore HIV Health Services Planning Council 6

The AIDS Administration is still awaiting an award decision for its Part D and Part D-Youth Services Initiative grant applications. The AIDS Administration anticipates it will hear something soon since Part D ends July 31, 2009, and Part D Youth ends August 31, 2009. Six youth from the Youth Community Advisory Board (CAB) have been identified to attend Transitioning HIV Positive Youth from Adolescent to Adult Services training in New York in early fall. It is projected that 200 to 300 youth will transition to adult care within the next year. Committee Reports Comprehensive Planning Committee (CPC): The committee co-chair reported: The committee had not met since the last planning council meeting. The co-chairs will present information about the comprehensive plan progress review report at an upcoming planning council meeting. The committee will review recommendations for directives for FY 2010; a copy of the recommendations will be provided to the grantee for comment prior to the July committee meeting. The committee will debrief from the FY 2010 PSRA and determine a date to hold the review group. The review group is open to all members. The co-chair encouraged participation in the review group. The committee will begin to look at November deadlines within the comprehensive plan. Continuum of Care Committee: The committee co-chair reported: The continuum of care committee held two work groups. o The standards of care work group reviewed current standards of care to ensure compliance with federal requirements. The work group made recommendations to the Continuum of Care Committee on the Baltimore EMA s service definitions and key services as listed in the standards for services funded in FY 2009 and planned for FY 2010. o The outreach work group received presentations on best practices. The work group agreed to reconvene to discuss EMA best practices and recommendations for the standards of care on August 5, 2009. Evaluation Committee: The committee co-chair reported: Regarding the assessment of the administrative mechanism, there were 20 respondents to the second provider questionnaire so far. The questionnaire was scheduled to close on July 21, 2009, but the Executive Committee approved extending the deadline to July 24, 2009, in order to get more responses; there were 42 respondents to provider questionnaire one, the highest response rate yet received for the assessment. The independent contractor will present findings to the committee on the second grantee and provider questionnaires on August 3, 2009. InterGroup Services, Inc., for the Greater Baltimore HIV Health Services Planning Council 7

The committee received a presentation regarding the findings from the first provider and grantee questionnaires. The committee reviewed chapters seven and eight of the comprehensive plan and the plan s impact on the committee s work plan. Nominating Committee: The committee chair reported: The committee reviewed current member terms and has identified new appointments. The committee continued to review planning council member attendance and recruit new members. Pool list members will be contacted and encouraged to participate in committees while awaiting full membership on the council. People Living with HIV/AIDS Committee: The committee member-at-large reported: The committee did not meet in June. The committee will meet in July to begin development of a position paper. Counties Committee: The committee co-chair reported the following: The committee met for priority setting and resource allocation and made recommendations on initial allocations for the counties Part A set-aside for FY 2010. Planning Council Support Office Report IGS reported the following: The support team prepared and distributed notices, agendas and minutes and arranged logistics for three committee meetings, two work groups, one planning council meeting and PSRA FY 2010 EMA and PSRA FY 2010 Counties; implemented the online scorecards web site; and implemented the electronic voting system for PSRA 2010. The support team provided individual co-chair training and preparation for committee meetings, arranged for a facilitator for PSRA 2010 EMA and Counties, and arranged for presenters for the outreach services work group. The support team researched best practices for outreach and developed a related presentation for the outreach work group. The support team developed the online scorecard web site and the PSRA FY 2010 EMA and Counties allocation spreadsheets. The support team attended L.E.A.P. 13 graduation on July 9, 2009. The PCSO is in the process of contacting the graduates to educate them about how to get involved in the planning council. The support team attended the AIDS Administrations focus group on outreach to incarcerated and recently incarcerated persons. An updated meeting calendar for August was distributed. InterGroup Services, Inc., for the Greater Baltimore HIV Health Services Planning Council 8

New Business The council reviewed the meetings minutes from PSRA FY 2010. D. Munro of the planning council support office presented the draft FY 2010 percent allocations set by the council and Counties Committee during PSRA. D. Munro explained in order to submit accurate allocation figures to HRSA with the Part A application, that adjustments to allocated funds needed to be made to resolve a rounding concern; the recommended changes were presented to the council and will require a vote at next month s planning council meeting, pending quorum, to be included in the Part A application. The meeting ended at 7:45 p.m. I certify these minutes to be accurate and inclusive record of the planning council meeting as amended and approved by the Greater Baltimore HIV Health Services Planning Council. Alice Middleton, JD August 18, 2009 Alice Middleton, JD August 18, 2009 InterGroup Services, Inc., for the Greater Baltimore HIV Health Services Planning Council 9