MN HIV Services Planning Council
Meeting Minutes for March 8, 2005
Redeemer Missionary Baptist Church

 

 

I.       Welcome and introductions; lighting of the candle

Paul called the meeting to order at 9:00 a.m.  Introductions were made.  Randy lit the candle and talked about how the Planning Council has become another kind of family to him.  We are all unique and everyone brings something different to the table.  As we sit at the table it always amazes him about the passion and love that everyone has for this work.  He hopes that we have the strength to continue and don’t give up the fight.

 

II.     Review the minutes and proposed agenda

The minutes from the February 8^th meeting were passed as written by unanimous consent.

 

III.   Co-chair updates

Paul shared that there are several things happening.  He said that members can see this on the agenda because things continue to change and unfold and the Planning Council co-chairs are responding to them.  The co-chairs have moved discussion of the Comprehensive Plan – that will take place in the in April Planning Council meeting.  Elizabeth Dickenson and Warren Ortland from MAP will be here today to talk about advocacy.

 

Several Planning Council members and staff met with Linda Stein and Lee Greenfield, two Hennepin County employees who deal with intergovernmental relations for the County.  They provided ideas for advocacy strategies that were shared with the ADAP Committee.  Also, this afternoon several of the co-chairs of the Planning Council and ADAP Ad Hoc Committee and staff are meeting with Assistant Commissioner Colman of DHS with the hope of getting more information about the projected ADAP shortfall, etc.

 

New members will be elected and current members reappointed at the end of the meeting.

 

IV.     Title I update - Jonathan Hanft

Jonathan passed out his report outline and a table illustrating this year’s award compared to last year’s and previous year’s awards.  The grantee staff received notice of the Title I award, which is a 2.7(?)% reduction but the good news is that there’s more money than what was allocated for – a reduction of 5%.  There will be more money to allocate at the April meeting.  He then reviewed the award information.  Additional MAI funds were awarded so there will be some additional contracting done for MAI services including culturally appropriate primary care, care advocacy, and outreach.

 

Jonathan then announced that Diane Knust has come on to the staff as the new Quality Management Coordinator.  She’ll be attending Needs Assessment Committee and Quality Management Committee meetings.

 

Jonathan also provided a quick update on the ADAP TA.  It is entering phase two.  The Grantees will be working with a HRSA/BETAH sponsored ethicist named Angela Amondi Wasunna.  She will be here on April 11^th attending the ADAP ad hoc and Formulary committee meetings and April 12^th attending the Planning Council meeting.  It also looks like she will be able to stay after the Planning Council meeting for about an hour if there are additional questions.

 

He then mentioned that he just attended an Unmet Need training in Atlanta.  The goal of the training was to explain the paradigm that HRSA has been using in describing unmet need.  What HRSA has done, along with AIDS Action, is to look at models that nine other cities have used.  Jonathan reported that the EMA is doing about 2/3 of the things discussed.  They were able to divide each activity into community-wide, group, and individual levels.  He shared a diagram that helps illustrate the impact of those who are not in care.  About half know their status and are in care, one quarter know their status but are not in care, and one quarter do not know their status.  For those who are in care it is less likely that they will infect others.  There are probably more transmissions among those who know their status but are not in care.  Those who don’t know their status are most likely to transmit the virus.  As more people learn their status and get into care the assumption is that there will be less transmission of the HIV virus.

 

V.       Title II and ADAP update - Dave Rompa

Dave shared that Amy has had her baby – Daniel Henry was born on February 28^th.  He also let the Planning Council know that Michelle Sims’ grandmother passed away last night so she’ll be out of the office for a few days.

 

Mental health services have been transitioned over to Program HH.  The goal is to increase access to mental health services for all.  Pre-authorization is required and all the necessary forms are on the website.  A mailing was sent to all clients asking them if they want to add the services.  The goal is to fill a gap for services during the time that insurance benefits are kicking in.

 

Assistant Commissioner Colman will be sharing more information about the budget shortfall the meeting today with Planning Council representatives.

 

DHS has secured funding for a grant writer for the integrated health care grant.  The feds have not reopened the grant process yet so they are waiting until it is opened to begin work on the grant.  The alcoholism grant is pending review and the staff hopes to hear about it in late April.

 

The chemical health standards, which were in the process of being changed years ago are almost done and will be rolled out soon.

 

Redwan passed out information about the Title II award, which is a formula award.  There was a slight decrease in the award.  Dave shared that the good news is the reduction was much less than anticipated but the bad news is that funding is still going down. 

 

Jonathan added that there are two mental health trainings coming up (March 25th and April 29^th) and he encouraged all providers to attend one of the sessions.  Dave clarified that the April 29^th training is intended to find out about what is working.  Dave added that there have been individual training with providers.

 

Dave gave an update on Dan Schriener’s Technical Assistance on rebate use – the full report is on the DHS website.  They are also currently submitting an invoice regarding rebates for MCHA expenditures, which has not been included in the ADAP forecasts.  The first check was received yesterday and he was pleased to report that it was more than anticipated.  His hope is that the others will come in in the same range, which will help with the shortfall tremendously.  He thanked Sue Schmitz from GlaxoSmithKline for the hard work she did in advocating for the rebates within her system. 

 

T2CAN just announced that the national $280 million ADAP shortfall has been adjusted to $383 million.

 

The national ADAP Conference is coming up in May.  Dave and Redwan will represent DHS and Aaron Keith will also attend to represent the Planning Council.

 

Formulary Plus will be coming to an end on March 31^st.  The drug company is allocating five slots for individuals in MN who need to continue their benefits while other coverage is kicking in.

 

The will represent the beginning of a new program.  Schering-Plough Pharmaceuticals will host six Hep C treatment slots for the state, but DHS is applying for more slots because there are over 500 Hep C/HIV cases in Minnesota.  They will host a meeting in town with clinicians to let them know about the program.  The downside is that if someone is given that slot and doesn’t do well with the program they will not be able to refill the spot.  Patrick Kinne of the DHS staff will be coordinating the Hep C Program.

On April 11^th there will be a Formulary Committee meeting with the ethicist to discuss ADAP wait list concerns.  An announcement including location will be coming shortly. (It was later announced that the meeting will be at Park House from 6:00 pm to 8:00 pm, MSD)

 

VI.             Review of HH proposed legislation – Warren Ortland, MAP

Members reviewed the bill being proposed by MAP.  Warren handed out a summary page and then gave some background on the development of the bill.  The bill’s purpose is based on recommendations from the Institute of Medicine (IOM) Report.  This bill proposes uninterrupted access to HIV treatment without cost shares for low-income persons living with HIV.  The bill also proposes full funding for the state’s Program HH.  The lead authors are Sen. John Hottinger [DFL St. Peter] and Rep. Paul Thissen [DFL Minneapolis].  Sen. Dibble has agreed to be a co-author.  Warren clarified some typos that will be cleaned up.  The bill is currently in the Reviser’s Office and the hope is that it will be finalized by the end of the week. 

 

Members then asked questions.  Eric asked where the money will be coming from, which is a question legislators will ask.  Troy said there are efforts to restore Minnesota Care and changes in other programs and asked how those changes may influence this bill.  He also suggested that in this climate he thinks it could potentially jeopardize the programs currently in place.  Randy expressed similar concerns and asked if MAP has looked at the idea of “staying off the radar.”  Elizabeth said it’s our job to advocate for the HIV community and the community has to have enough faith in themselves to advocate for what they want.  If you go in with what you want, asking for it positively and forcefully, you’re likely to get at least some of what you want.  She added that we’re at a place where things have been eroded so much that everyone needs to advocate.  Andrea asked what priority this bill has on MAP’s public policy agenda and what other items are on the agenda.  Elizabeth said the first priority on the agenda is comprehensive sex education and refunding of regional training sites.  This bill will be the focus of Lobby Day on April 12^th. 

 

Sarah R. added that this bill seems to be the only horse running on the track because she doesn’t see any other solution, at least not one that anyone has come forward with.  Elizabeth reiterated that it’s not the constituent’s job to figure out where the money is coming from, it’s the legislators’.  Debra asked why they are asking for a specific amount of money – how can the funding request grow with increased demand?  Elizabeth said that they can add language to propose increases based on inflation, etc. and added that legislation can take years to pass – it’s not clear if there will even be a House hearing this session.  Jonathan said that this bill solves administrative problems like the state taking rebate dollars.  He also added that health care for low income people is a basic human right and thinks that anyone with a chronic health care need shouldn’t have financial barriers to getting the care they need.  Troy agreed with that point but doesn’t think this bill accomplishes that.  He argued that the state could be looking at changes to Minnesota CARE and other health care programs.  He used the example of someone who gets $230 in general assistance a month but still has to cover their $5 co-pays.  He thinks supporting other ventures to change health care plans might be more productive.  Gwen shared that she didn’t know we would be voting on a bill today and that she hasn’t had a chance to process the information and that as a group, the Council hasn’t had a chance to discuss the bill enough before making a decision.  Mary Doyle mentioned that MAP had asked that the bill not be sent out in advance of the meeting due to last minute changes.  It came up very suddenly, but the ADAP committee did have time to adequately discuss the bill and decide to recommend supporting it.  Dan asked if there are other health care policy groups on board with this bill.  He also expressed some concern about the timeline but thinks that the work from the AIDS community has provided a source of leadership for other groups in the past.  Megan said if we don’t support this, who will?  She also said that supporting this bill doesn’t stop a legislator from supporting universal health care or some other similar model for health care.  Paul reminded the group that one of the areas identified by this group as an important part of their work is effective advocacy.

 

Discussion moved to the resolutions developed in support of the bill.  The ADAP ad hoc Committee’s recommendation, after meeting yesterday, to the Council is to support the bill.  It sees the bill as significantly moving the ad hoc Committee’s work forward.  Sarah R. shared that resolution language was drafted to present to the Council.

 

MOTION:  Sarah R. moved Eric seconded approval of the resolution without the additional points.  Eric added a point of discussion, which is if the Planning Council doesn’t support the bill that would not be looked upon favorably.  Aaron Keith asked for a process check in having heard reservations about the amount of information.  Sarah S. said she entrusted the ADAP Committee to do this work and supports the work that they’ve done.  Troy said things move quickly during the legislative session and that while it would have been nice to have more time, it is not always possible.  Gwen added that in the future she thinks it would be good to have information in advance.  FRIENDLY AMMENDMENT:  Becky suggested removing the final clause of the resolution (ending with medications).  Friendly amendment accepted by Sarah R. and Eric.  Passed with three abstentions, (Novotny, Lawser, and Mangan).

 

VI.     Open Forum, Legislative advocacy training - Elizabeth Dickinson and Warren Ortland, MAP

What do you think advocacy is? 

Francis – speaking for or against something.

Dan - Influencing policy

Eric – influencing others

Andrea - speaking up for someone or some issue

Sarah S – protecting what we have; speaking on behalf of others who have no voice

Sarah R – to speak (from Latin)

Jonathan - also to educate

Gary – support for advocacy can include info – anecdotal and data

Sarah R – influence other’s knowledge and attitudes, which sometimes matter more than the facts

 

What is Lobbying?

Eric – influence top vote a specific way on an issue

Sarah S – may or may not include sense of morality or “rightness”

Willie – asking for majority support

Andrea – implies some type of remuneration (quid pro quo), transactional

Gary – persuading advocates/non-advocates to prioritize your issue

 

Elizabeth Dickinson (ED) – considers advocacy and lobbying to be very much the same.  Eric makes differentiation based on restrictions on lobbying, but not on advocacy.

 

What are some types of advocacy?

ED – Bob’s baseball analogy: first base (less “risk” or personal contact) = signing petition, post card, voting, forwarding emails/letters, phone calls, endorsing another group’s position; second base = meeting with legislator, talking to neighbors/friends, writing editorial, testifying at hearings, going to demonstration, co-opting media, participating in groups like the Planning Council; third base = introducing bill, picketing/sit-in/civil disobedience, contributing to campaign, meeting with non-elected officials, filing lawsuits, modeling/living your principles, ; home = running for office, staring own advocacy organization, bill passes.

 

Most have done first base activities; about half have done second base activities, about a third have done third base activities.  Today we’re going to concentrate on second base activities.

 

Legislators are people who have been put into office by us.  ED started out as lobbyist for environmental issues and learned that representatives really do want to hear from constituents.  She stressed that constituents have a better chance of influencing representatives than professional lobbyists; reps actually are known to cut short meetings with pro lobbyists to hear from constituents.

 

What happens when you go in a meet with your rep?  Andrea – went to DC and met with Paul Wellstone and some state reps. Andrea’s group had their agenda laid out and found he was extremely interested in the issues and was impressed that they had points laid out on paper and pass out to aids and begin to work on issues.  She said it is helpful to have issues identified and expressed on paper.  On the practical side Andrea pointed out that politicians want to be reelected and said that they will likely consider your ideas more strongly if they believe you will vote for them.

 

Preparation (not absolutely necessary)

– Schedule in advance

- Fact sheets

- Identify who will speak and what will be said

 

ED – an ultimate goal is to have relationship with decision makers; you are their “go to” person (you are a trusted voice) about issues of concern to their communities

 

Sarah R – has been to lobbying meetings where everyone had something to say and tended to get rigid and say their points regardless of where discussion has gone; have to keep track of where meeting is going and be relevant; remember it’s a conversation; try and steer towards your personal expertise;

 

MSD – person she was talking with was very warm and open; others may be not be; have to remember they may not have much time and to get on track early.  ED – did role-playing with children’s lobbying training recently to work this.  Know what you are going in for; perhaps one person introduces issue, another covers background and information; another asks for their support, for instance.  Knowing in advance what you want out of the meeting is important.  MAP public policy website has area where you just put in address and it gives you your legislative district info.

 

Sarah S – if person who represents you is very much on line with your issues, when does it make sense to go to them and discuss?  What are the times to go to others who represent you to advocate?  ED – if you’ve never met with rep start with your rep.  Sarah – if I know they don’t support is it still worth it to go in?  ED – it is still worth the time.  Often reps do not get thanked for their support and need the encouragement. 

 

Eric – don’t just join the choir; stay abreast of issues through other organizations.

 

ED – in closing, it’s easy, it can be fun and it’s very empowering.  Dan agreed it is easy and found staff were every responsive and knew position of the official they work for.

 

 

BREAK

 

VII.        Committee written reports;time for questions, discussion  

Planning and Priorities Committee

Comprehensive Plan input from Planning Council

The P&P Comprehensive Plan Group retreat is this Friday from 9am-4pm at the Harriet Tubman Center

HIV Positive Committee

Retreat update – Francis said that the retreat with Lennie Green is scheduled for March 18^th 9am-5pm and March 19^th from 10am-4pm at the Harriet Tubman Center.

Needs Assessment and Evaluation Committee

Community Participation Committee

Operations Committee

   ACTION ITEM

·        Approval of nominations slate, AK Stewart – two ballots:

o       4 reappointments – all members were reappointed

o       4 new members – all new member recommendations were approved: Andy Ansell, Patrick Kramme, Antonio Marante, and Steven Owens

          ADAP Ad Hoc Committee

 

VIII.    Announcements, evaluation, next agenda

Effective Friday, Sarah Rybicki is resigning her position with the Planning Council and the ADAP ad hoc committee.  Francis wanted to extend the thanks of the ADAP ad hoc committee to Sarah upon her resignation and presented her with a small gift.

 

MSD recognized Debra Riley for her contributions, as this is also her last meeting.  During the group’s applause, Debra gave a big bright smile as she always does.

 

Documents distributed at or before the meeting:

·        Agenda and minutes from February 8^th meeting

·        Written committee reports

·        How to be an Effective Advocate (from MAP’s website)

·        MAP’s HIV Prevention and Health Care Access Program Legislation Summary

·        HH Bill Resolution Draft

·        Planning Council HH Bill Resolution Draft

·        Title I Update outline and award spreadsheet

·        Title II award spreadsheet

 

MOTION: Meeting adjourned by unanimous consent.

 

Adjourned at 11:43 a.m.