MN HIV Services Planning Council Meeting

June 13, 2006

9:00 am to 1:30 noon

Plymouth Congregational Church

1900 Nicollet Avenue, Minneapolis

Minutes

 

Council Members Present:

 

Ron Schut

LeMonte Graham

Eric Meininger

Rae Frank

Francis Mark

Dean Halland

Jim Lawser

Bob Hansen

Gary Novotny

Sarah Senseman

Andy Ansell

Ephraim Olani

Antonio Marante

Aaron Keith Stewart

Dan Capouch

Susanne Pfeil

Gilbert Achay

 

Council Members Absent:

 

Lois Crenshaw - LOA

Lee Lewis - excused

John Cyzon - excused

Ojuolape Olagbaju - LOA

Gwendolyn Velez – unexcused

Willie Wesley - unexcused

Ama Sabah - LOA

 

Consultant:

 

Allison Rojas – CCG

Becky Kroll - CLEAR

Guests:

 

Kathleen Anderson

Ron Kemmet

Rob Pioli

Allain Hankey - Hennepin County

Stephen Poljack

Roger Henley

Karin Sabey

Jerry Moss

Reverend G. Allen Foster

Jody Smeby

Ben Ostrom

Trudy Cariveau

David Jewison

Joan Othieno - CSAD

S. Marie Graham

 

G-HAT:

 

John Suhr - Hennepin County

Julie Hanson Pérez – MDH

Eduardo Parra - Hennepin County

Dave Rompa - DHS

Jonathan Hanft - Hennepin County

Redwan Hamza – DHS

Sheila Murphy - Hennepin County

 



Staff:

 

Wendi Kistner

Lori Lippert

Tim Sullivan

 

 

I.                    Welcome and Introductions; Lighting of the Candle

The meeting was called to order at 9:05.  Introductions were made.  Andy lit the candle in honor of all the people who are participating in the Red Ribbon Ride.  Andy was hit by a car on Saturday while training for the Red Ribbon Ride. 

 

II.                 Review the Minutes of May 9, 2006 Meeting and Proposed Agenda

The meeting minutes were approved by unanimous consent.  The agenda was approved by unanimous consent.

 

III.               Open Forum

·         Joan Othieno, CSAD Project Wrap-up – Joan attended the meeting to present two articles she wrote about the CSAD report.  The full, national report will be released in February.  Joan directed the Planning Council to several pages in the articles and discussed its content.  Joan is trying to get the site report finished by the end of June.  Joan thanked everyone on the Planning Council and those who she interviewed for their help and support.

o        Jody Smeby, Impact of Cost Share Closures on HCMC Patients – Jody is the Ryan White benefits counselor at Hennepin County Medical Center.  She came to the meeting to talk about how the HH cost share closures have affected some of her clients.  There were several questions from the members and a brief discussion.  Dave Rompa from Program HH at DHS referred people to the Title II update portion of the agenda where he would be discussing the Cost Share program.

 

IV.               Co-chair Report

·         ADAP Forecast Meeting with Assistant Commissioner Coleman – Aaron Keith, Andy, Dave, Debra, and Jonathan met with Shirley York, DHS Division Director and DHS Assistant Commissioner Loren Coleman to talk about the ADAP forecast.  As long as there are no major bumps in the road, the ADAP program will be solvent through June, 2009. 

·         Meeting with Title II Grantee Re: MOU and Roles & Responsibilities in Title II Planning – The Title I and II grantees, Council co-chair Andy Ansell and Council interim staff coordinator Lori Lippert met recently to discuss creating a more formal mechanism for defining the roles and responsibilities of the Council and the Title II grantee.  The meeting went well in terms of laying the ground work for creating a process to do this work.  The Co-chairs will keep the Council informed as to the development of this work.

 

V.                  Staff Report

·         Staffing Update

o        Welcome Tim - Tim Sullivan is the new Planning Council Coordinator.  His first day was June 12, 2006.  Most Planning Council members had a chance to meet him during his interview. Tim is looking forward to working with the Planning Council and getting to know everyone better.

o        Coordinator Transition – Lori is planning to give transitional support to Tim and the Council through the allocations process.  Lori will also be working with the Council in the future to develop and deliver Council trainings and orientations.

 

VI.               Title I Update, Jonathan Hanft, Hennepin County

·         Staffing Update – Welcome Sheila.  Sheila Murphy is the new Quality Management Coordinator.  Her first day was May 30, 2006.  She worked for MHP before joining the Ryan White team. 

·         Title I Grant Conditions of Award Submitted –On June 1, 2006 the final reporting on fiscal year 2005 was submitted to HRSA, along with other requirements of the grantee.

·         2005 Final Expenditure Report – Jonathan walked the Planning Council through the final expenditure report for 2005.  Title I FY 2005 ended February 28, 2006 and Title II FY 2005 ended March 31, 2006.  He also pointed out where carry-over money came from.  Ninety-three percent of all funds were spent last year which is pretty common.    He said vacant positions and underutilization of services can be some reasons why money is unspent.  Jonathan said it is important to look at spending from the past year during the allocation process.

 

VII.             Title II and ADAP Update, Dave Rompa, DHS

·         Formulary committee update and waitlist decisions – The formulary committee met last week to look at the recommendations made to DHS for having a waitlist.  Although the committee did not support the waitlist concept they put forth a model of how they would like the waitlist system to work should it need to be implemented.  DHS agrees with the committee recommendations and will get a final report to the Planning Council.  The thing to remember is this will only be implemented if needed and it is a working document that can change based on information as it becomes available. 

·         Program HH staff changes – Steven Pojack has joined the team.  Insurance Specialist Duane Bandel reduced his hours and Eligibilty Specialist Mary Halvorsen resigned.  Steven will be helping with Mary’s responsibilities until her position is replaced.  Then he will take on the responsibilities of an Insurance Specialist. 

·         AIDSline Planning –AIDSline funding from the Dept. of Health was cut in Feb/March by 47%.  DHS sees the AIDSline as being a useful means of directing people to the DHS programs, particularly people in Greater MN and were concerned about this cut.  DHS met with MDH and pulled resources together to find funding so MAP can continue operating this program for another year.  DHS will be contributing rebate funds for this purpose until March 1, 2007.  In the meantime, DHS is working on a possibly strategy within DHS to provide funding for this service on a more permanent basis.

·         Cost share questions – In the last 18 months there have been a variety of closures.  The 29 clients mentioned in the HCMC report do not come close to the numbers DHS has (DHS has a much lower count of cases that have been closed due to failure to pay cost-share.)  These clients could have closed for reasons other than cost share. Cost share program is a permanent policy for all MN Healthcare Programs and will not go away when budget crises go away.  DHS is planning to present the Planning Council with a cost share report each August.  Lori asked if cost share report could come at a time that would be more in sync with Planning Council planning cycle—every other August the Council will be busy with allocations.  Dave stated that this is not possible as a report cannot be generated before the state’s fiscal year ends on June 30th.  The Council referred the matter of working with DHS to develop a helpful reporting format for this annual report to the Needs Assessment and Evaluation Committee.  One suggestion is to get accurate projections of the hardship the cost share is causing. 

·         Redwan gave a cost share program update.  In phase III, 107 clients were identified as being in arrears but only four cases were closed.  DHS will extend people’s coverage if there are circumstances that prevent them from getting their forms filled out in time.  A member asked, if there are sufficient rebate funds available to support the AIDSLine, can’t these funds be used to increase the support for cost share?  Dave said no—rebate money is not a reliable source of on-going funding and is better used for “one-time” needs.  He suggests the Council reallocate unspent Title I and II funds that are being unspent throughout the year towards cost-share assistance, if it is needed.  Redwan said that as of May, 2006 over $14,000 has been refunded to clients when the program identified over-payments. 

·         Program HH forecast – The forecast looks good through June, 2009.  DHS HIV/AIDS Programs staff are working to get an allocation from the legislature to partially support the Drug Program.  They will have a better read of their chances for success by January/February.  Program changes due to Medicare Part D and MCHA are things that could cost more money. 

 

VIII.          Committee Reports (Community Participation Committee on hiatus)

Planning & Priorities

·         ACTION ITEM – approval of carry-over budget.  The carry-over amount from FY 2005 is $316,767.  Planning & Priorities and Executive committees have approved of this proposal.  A motion was made to approve the carry-over proposal.  A member asked, in light of the cost-share discussion, if there was a way to give some of the money for health care.  There is already an allocation for primary care and these funds can be used for co-pays.  Jonathan said that it is hard to allocate carry-over for cost-share without having a clear idea of what is going to be needed.  The concern was raised that doing mid-year re-allocations next year doesn’t cover people who are being closed right now.  An amendment was made to use some of the 2005 carry-over for cost share assistance in order to increase the cap and lift the rule that people can only use cost share assistance 8 out of 12 months every year.  Lori asked if we know there is not enough money or if there is money there but people are maxing out their limits.  Yes – they are maxing out their limits.  Jonathan asked if the motion could be written to allow the grantee flexibility to put the funds towards either primary medical care or cost-share assistance, depending on the grantee’s analysis of need.  Ron made an amendment that the top two items be lumped together so funds can be administered to these based on need.  The motion was approved by unanimous consent.

·         ACTION ITEM – care advocacy definition changes – The committee wanted to add clarity where there was confusion.  Information regarding Quick Connect is being removed from care advocacy.  (motion and approval of item includes all definition changes and appears below)

·         ACTION ITEM – primary care definition changes – Language will be added so that funds can be used to pay for co-pays and co-insurance costs.  Sarah made an amendment to add deductibles to this list.  (motion and approval of item includes all definition changes and appears below)

·         ACTION ITEM – outreach definition changes – Examples were added because people were confused what inreach and outreach are.  (motion and approval of item includes all definition changes and appears below) [PLEASE NOTE:  Following the Council meeting, staff realized that we inadvertently used a form of this definition that had come out of the P&P committee, not the definition as it was later amended and approved by the Executive Committee.  The definition that was supposed to be presented to the Council did not list “tables at festivals” as an example of allowable outreach activities since this is expressly NOT allowed by HRSA.  The correct definition will be presented to the Council for another vote at the July meeting.]

·         ACTION ITEM – referral definition changes – The information removed from care advocacy regarding Quick Connect will be added in this definition.  The name “Quick Connect” will not be used.  A motion was made to accept all the definition changes with amendment.  The motion was approved by unanimous consent. 

·         ACTION ITEM – changes to allocation process – During this Prioritization & Allocation process some suggestions were made on how the allocations process will be run and facilitated.  Francis made a clarification that although the meeting will be open and there will be an open forum time anyone who is not a Planning Council member will not be able to speak unless specifically asked.  A motion was made to accept the allocation process.  Sarah asked if there has always been an open forum time.  In the past there has not been an open forum but since there is open forum scheduled at each Planning Council meeting it made sense to give that time.  The Council and guests had a brief discussion about how to handle the open forum time, both at the August meeting and all PC meetings.  The Operations Committee will work on this issue—specifically, procedures for open forum and making those procedures publicly known (suggestions:  posting on the website and including in the memo that is mailed out with meeting notices).  A motion was made to accept the proposal, with amendment about the process for getting on the open forum.  The motion was accepted by unanimous consent. 

o        A motion was made to divide open forum time for the allocations day meeting among the number of people who come to the meeting.  There was one opposition and one abstention.  The motion passed by majority. 

Needs Assessment and Evaluation

·         ACTION ITEM – approve process for 2006 assessment of administrative mechanism – Every year an assessment of the grantees is done.  The NA&E committee has developed a plan to improve this process but there isn’t time to implement those changes this year.  More information on the new process will be presented at a later date.  A motion was made to accept the current proposal.  The motion was accepted by unanimous consent.

Operations

·         Recruitment Reminder – The Planning Council is still recruiting.  Interviews are being held June 29th and 30th.

Community Voice

·         Recruitment Luncheon Report – The luncheon went well.  Community Voice committee members did an outstanding job.  There were eight invited guests who came to learn about the Planning Council. 

 

IX.               Prioritization Instructions 

Prioritization packets were distributed to Planning Council members.  Lori explained the information included in the packet.  A member asked if all Council members would be given a master list showing how each Planning Council member voted.  Overall members felt it was not a good idea to have names attached to the master list but breaking the total votes out by individuals (indicated by a number, not by name) voted is okay. 

 

X.                  Learning Stations

Planning Council members rotated in groups through learning stations, receiving service area/activity data at each stop.

·         Substance Abuse & Mental Health Services

·         Health Education / Risk Reduction & Psychosocial Support Services

·         Treatment Adherence & Legal Services

·         Other Support Services

 

XI.               2006 Consumer Needs Assessment – Preliminary Report, Allison Rojas, CCG/POI

Allison, from CCG, attended the meeting to provide some preliminary data to the Planning Council on the Needs Assessment survey.  Allison presented the data to the Planning Council and asked for feedback on how to better present the final data.  390 surveys were completed and 379 surveys were analyzed.  Allision asked for suggestions on how to best present the data in the final report.

Suggestions:

·         State clearly if someone went to get services and wasn’t able to vs. someone who needed services but didn’t try to get them.

·         Becky asked to add non-metro EMA data to the report

·         There was a brief discussion about how to identify/classify people who were not born in the US.  It was recommended that all foreign born people not be grouped together. 

·         Keep age groupings consistent with the HRSA categories.

·         It would be helpful to see how dental information compares to the general population. 

 

XII.             2005 HIV/AIDS Epidemiology Update, Luisa Pessoa-Brandao, MN Dept. of Health

Luisa Pessoa-Brandao, from MDH, attended the meeting to give current 2005 epi data.  The full data is available on the MDH website for review.  There are 7824 HIV infections in MN as of December 31, 2005. 

 

XIII.          Announcements, Evaluation, Next Agenda

·         The July Planning Council meeting will be held at the Hennepin County Health Services Building, room 112. 

·         Dan Capouch will be resigning his Council position because he is moving to Texas to be the Quality Manager for Child Protection.  His last meeting will be in July.

 

Meeting Adjourned at 1:27 pm

 

Meeting Summary:

·         Joan Othieno gave a final report during the open forum on the CSAD project.  Once the Minnesota report is finished it will be sent out to Planning Council members.  Jody Smeby from HCMC also spoke during the open forum about how her clients have been affected by the cost share program at DHS.

·         Tim Sullivan, the Planning Council Coordinator, and Sheila Murphy, the Quality Management Coordinator, were both hired since the last Planning Council meeting.

·         Jonathan walked Council members through the Year 10 final expenditure report.

·         Dave gave an update on the formulary committee’s decision regarding a waitlist, the changes to Program HH staff, a cost share update, and the AIDSLine funding.

·         ACTION ITEMS:  (Action item #1) The carryover proposal, in the amount of $316,767 was approved as proposed by the Planning & Priorities and Executive committees.  (Action items #2-5) Minor changes were made to some of the service area/activity definitions.  (Action item #6)  The allocations process was approved, with an amendment regarding how one signs up to be on the open forum.  (Action item #7) Open forum time at the allocations meeting will be divided among the number of people who request to speak during the open forum.  The motion was passed by majority with one abstention and one opposition.  (Action item #8)  The process for evaluating the Title I grantee will remain the same as last year.

·         The prioritization sheets were handed out to Planning Council members.  Forced choice sheets are due back to the Planning Council office by noon on June 27th.

·         Planning Council members attended learning stations.

·         Allison Rojas reported preliminary data on the needs assessment surveys.  There were 390 surveys collected and 379 of them will be used.

·         Luisa Pessoa-Brandao reported on the current 2005 epi data.  In 2005 there were 7824 HIV infections.

 

Documents Distributed Before the Meeting:

·         Agenda

·         Meeting minutes from May 9th, 2006

·         Meeting summaries

·         Action items for: FY 2005 carry-over spending plan and supporting documentation, care advocacy definition change and supporting documentation, primary care definition change and supporting documentation, outreach definition change and supporting documentation, referral definition change and supporting documentation, 2006 allocations process and supporting documentation, evaluation of the administrative mechanism and supporting documentation.

·         Evaluation of the grantee form

·         Final spending report

 

Documents Distributed At the Meeting:

·         HIV/AIDS MDH 2005 Epi Update

·         CSAD Findings and Recommendations for The Journal of Health Care for the Poor and Underserved

·         CSAD Context for the Project in the Twin Cities for The Journal of Health Care for the Poor and Underserved

·         Funding and Cost Projections for MN Program HH and Insurance Programs

·         DHS HIV/AIDS Division Final Cost Share Closure Update – Phases I-III

 

 

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