MN HIV Services Planning Council Meeting

July 11, 2006

9:00 am to 12:00 noon

Hennepin County

525 Portland Avenue, Minneapolis

Minutes

 

Council Members Present:

 

Lee Lewis

Dan Capouch

Jim Lawser

Rae Eden Frank

Sarah Senseman

Andy Ansell (Co-Chair)
Gilbert Achay

Bob Hansen

Francis Mark

Aaron Keith Stewart – (Co-Chair)

Ephraim Olani

Dean Halland

Ron Schut

Eric Meininger

Gary Novotny

Susanne Pfeil

John Cyzon

 

Council Members Absent:

 

LeMonte Graham - excused

Ojuolape Olagbaju - LOA

Antonio Marante - excused

Ama Sabah - LOA

Willie Wesley - unexcused

Gwen Velez - unexcused

Lois Crenshaw - LOA

 

Consultant:

 

Becky Kroll - CLEAR

 

Guests:

 

Karin Sabey

Julia Hidalgo

Randy Bryant

Robert Pioli

G-HAT:

 

Jonathan Hanft - Hennepin County

Sheila Murphy - Hennepin County

Dave Rompa - DHS

Julie Hanson Perez - MDH

John Suhr - Hennepin County

Eduardo Parra - Hennepin County

Summer Martins - MDH

Debra Riley - DHS


Staff:

 

Wendi Kistner

Tim Sullivan

 

I.                    Welcome and Introductions; Lighting of the Candle

The meeting was called to order at 9:07 am.  Introductions were made.  Dan lit the candle for all the transitions people are going through in their lives.  This is Dan’s last meeting with the Planning Council before he moves to Texas.

 

II.                 Review the Minutes of June 13, 2006 Meeting and Proposed Agenda

The minutes, with name corrections, were accepted by unanimous consent.  The agenda was accepted by unanimous consent.

 

III.               Open Forum

Francis told the Planning Council about the struggle he has had with the forced choice prioritization packet.  During the allotted time he met with several members of the Planning Council and Planning Council staff to discuss the decisions he was asked to make.  When he joined the Planning Council he was told he would be asked to make some tough decisions and at the time he thought he would be able to make these decisions.  After several attempts of filling out these forms he was unable to prioritize service areas against each other.  At the Community Voice Committee meeting a few weeks ago he verbally resigned his position as a Planning Council member.  Francis brought a written resignation to hand in today and has asked Planning Council members to decide whether he should remain on the Planning Council or resign.  Andy referred the matter to Operations Committee for review before a decision is made regarding Francis’ resignation.

 

IV.               Co-chair Update

A welcome lunch was held at DHS for Tim Sullivan.  Andy and Aaron Keith were also invited.  Andy felt it was a very nice gesture on their part to make Tim feel welcome. 

 

V.                  Staff Report; Tim Sullivan, Planning Council Coordinator

·         Prioritization Results – Tim presented the final scores of the forced choice sheets.  Tim will send out the service activity forms electronically upon request.  The service activities under the Psychosocial Support Services area were tied.  The Planning & Priorities committee agreed all ties will be broken.  Planning Council members filled out a forced choice sheet to break the tie.  Greater MN and Outreach were also tied.  Planning Council members filled out a forced choice sheet to break the tie.  There were no major changes in the service area ranking from last time other than Transportation moved up slightly. 

 

VI.               Title I Update; Jonathan Hanft, Hennepin County

·         Conditions of Award Submitted in June – HRSA requires WICY be reflective of the epidemic.  A report submitted every year to state reflectiveness is being met.  Sarah made a point that WICY is based on epi data but wanted everyone to be aware that many of the clients accessing services are not eligible for state coverage. 

·         2005 Minority AIDS Initiative Summary – Jonathan presented the graphs and charts that show utilization of MAI service activities.  A clarification was made that the “youth” category is reported as ages 13-24. 

·         Carry Over Request – the carryover plan was approved at the June Planning Council meeting.  The plan will be sent to HRSA soon and implementation will begin shortly thereafter. 

 

VII.             Title II and ADAP Update, Debra Riley & Dave Rompa, DHS

·         Two technical assistance requests from NASTAD have been made.  The first request will be to define the relationships among the Planning Council, Title I, Title II, and other interested parties.  The second request will help DHS work with clients to teach them how to navigate the system.  

·         Trudy Cariveau’s last day is today.  Her position is currently vacant although she is helping out on a very part-time basis until it is filled.   

·         Conditions of Award were submitted July 1st.  A new implementation plan has also been submitted for FY 2006 along with a revised budget.

·         Debra is currently working on the annual report that is due on August 1st.

·         Dave attended the meeting to give a follow-up on the questions the Needs Assessment committee asked regarding cost share. 

o        Rebates – There has never been a surplus of rebate dollars.  Dave described to Planning Council members the DHS accounting system.  DHS needs to prove the balance in rebate money is needed in the next fiscal year so it is not taken away at the end of the current year.  This is the only account that carries money over from year to year.  Sarah stated in her experience any grant program that generates revenue needs to put that money back into the program and asked if this is true for the rebate program.  Dave said HRSA makes recommendations on how this money should be spent, but that they are not required to do this. 

o        AIDSLine – The money to fund this program is currently coming out of rebate funds.  DHS believes the AIDSLine is a valuable program for direct client services and decided to fund the program until they can find other sources of funding.  Gary asked what other expenses the rebate money has been used to cover.  Fifteen for admin costs (about 10% is used), insurance, and drug costs. 

o        Cost Share – The DHS HIV program is the only one that did not have a cost share program.  Currently there is not a cushion of money in the budget and there are some unknowns that could drastically change the budget.  The decision to implement and maintain the cost share program is made by Dave and his team and is backed up by the Commissioner. 

o        Debra presented “Cost Share 101.”    Debra said it is important to know how other services operate so we know when we are asking for too much.  Questions:

§         Sarah expressed concern regarding the tone of the memo.  She feels people have talked thoughtfully about the issue and anecdotal evidence needs to be presented to talk about the issue.  She feels Planning Council members can hear anecdotal information and then look at the data to back it up before making a decision. 

§         Dan thinks one of the dilemmas is to keep practitioners at the table and involved in the decision making process.  Too often analysts are making the decisions based on numbers. 

§         Dave wanted Planning Council members to know one of the biggest admin costs has been pulling data together for Planning Council meetings.  He wants to make sure these reports are for actual Planning Council business and not the result of a personal agenda. 

§         Ron reminded everyone the Planning Council’s mission is getting people into care and keeping them there.  Dave was asked what will happen to clients if they can’t meet their cost share.  He said they will work with the clients that begin to fall though the cracks.  With assistance programs many people should be able to reconnect with the system.  Dave also said there are ethical issues surrounding clients who refuse to contribute even though they make more than another client who makes far less and is contributing. 

§         Jonathan reminded the Planning Council about the cost share discussion from the June meeting.  At the June meeting it was reported 20 people were being closed as a result of their inability to pay their cost share.  There have been studies surrounding cost share that show people are less likely to access care and more likely to use emergency rooms if they don’t have health care coverage.  Jonathan finds it difficult to hear about people who refuse to pay.  He wondered how and who assesses someone’s ability to pay?  Dave clarified that there are other factors that need to be taken into consideration when looking at ethical decisions. 

§         DHS will be cross checking Hennepin County’s closure list because some of the information does not match the list DHS has.  There could be other reasons behind the closures other than cost share.  He is looking forward to looking over these lists and working to get some of the clients back into care.

§         Francis asked if only HCMC is having closure problems.  He was told there are other hospitals and clinics but HCMC is the most likely to find closed clients because they will serve any client that comes though the door.  Tim has requested closure information from three other clinics, La Clinica, Clinic 42 and Regions.

o        Program HH survey – There were 389 surveys collected.  Debra presented the preliminary results of the survey.  Comments:

§         Sarah asked Debra about race and ethnicity and how that relates to respondents answers. 

§         Bob asked if survey participants were given something for filling out the survey.  Dave said it was optional. 

 

VIII.          Committee Reports (Community Participation Committee on hiatus)

Committee report presented in written form.

Planning & Priorities

Needs Assessment and Evaluation

Operations

Community Voice

Executive

·         ACTION ITEM: Outreach definition changes.  This was presented at the June Planning Council meeting but the incorrect language was inadvertently presented for approval.  HRSA requires that outreach activity be conducted in a place where high numbers of HIV+ people are likely to be present.  The new definition is more specific.  A motion was made to accept the definition.  The motion was accepted by unanimous consent.

 

IX.               2006 Consumer Needs Assessment – Final Report, Julia Hidalgo & Allison Rojas, CCG/POI

Julia attended the meeting to give a presentation on the consumer survey data collected in April and May.  Questions/Comments:

·         A clarification was made that the respondents of the survey are those who have been HIV+ up to 20 years.

·         Eric asked if respondents were assisted in filling out these surveys.  Yes, they were interviewed by their case workers.    

 

Allison gave some supplemental information regarding the needs assessment systems analysis. 

 

X.                  Announcements, Evaluation, Next Agenda

·                     This is Sarah Senseman’s last meeting.  She has been the Title IV representative on the Planning Council for five years.  She feels the Planning Council will continue to do great work and thanked members for their contributions.  Sarah hopes to stay involved in the Planning Council as a community member of the Needs Assessment committee. 

·                     Francis and Andy are participating in the Red Ribbon Ride this weekend.  The opening ceremony is at the Mall of America on Thursday at 6:30 am.  The closing ceremony will be at Richfield High School on Sunday at 2:00 pm.

·                     The Director of Community Services position is open at West Side.

·                     The August Planning Council meeting is extended to 1.5 days for allocations.  The first day of allocations is August 8th from 8:30 am-4:30 pm and the second day is August 9th from 8:30 am -12:00 pm.  Breakfast and lunch will be served on both days so please RSVP your attendance.  The meetings will be held at Plymouth Congregational Church.

 

Meeting Adjourned at 12:12 pm

 

Meeting Summary:

·         This was the last Planning Council meeting for Dan Capouch and Sarah Senseman.  Dan is moving to Texas and Sarah has accepted another job. 

·         Francis shared his experience and struggles with the prioritization process.  As a result, the Operations committee will work on the by-laws to more clearly outline member expectations regarding prioritization participation. 

·         Tim presented the preliminary prioritization results.  Planning Council members complete two additional forced choice sheets to break two ties.  A final list of services in ranking order will be sent to Planning Council members once the forms have been tallied.

·         Dave and Debra responded to questions asked in the Needs Assessment committee meeting regarding rebate dollars and cost share.

·         ACTION ITEM: The services definition for outreach was updated to be more specific.

·         Julia Hidalgo and Allison Rojas each gave a presentation on the needs assessment survey results.

 

Documents Distributed Before the Meeting:

·         Agenda

·         Minutes from June 13th, 2006 meeting

 

Documents Distributed At the Meeting:

·         Committee Reports

·         Preliminary Prioritization Results

·         Utilization and Financing of HIV Services Among Minnesotans Living with HIV or AIDS PPT

·         Title I update

·         Historical Overview of Cost Share

·         2006 Program HH Consumer Survey

·         Cost Share 101

·         2005 Minority AIDS Initiative Services Summary

·         Ryan White CARE Act Needs Assessment Analysis: Part I PPT

 

 

WK/tds