Committee Members Present: Charlene Pugh (co-chair), Bill Blum, George Simmons,
Ayisha Benham (co-chair), George Simmons
Committee Members Absent: Charles Siron
Other Council Members Present: Laura Thomas, Dorothy Kleffner
Council Support: Jack Newby, Leah Crask, Skot Jonz
Others Present: Wade Flores, Will Carter, Russ Zellers (HIV Health Services),
Francine Austin
1. Introductions
2. Review/Approve Agenda.
Bill Blum moved to approve the Agenda.
CM Simmons asked about how Item 11 came to be on the agenda. Committee discussed.
Agenda Approved.
3. Review/Approve Minutes
Committee reviewed minutes from September 1 & December 1,2004 & January
5, 2005, Minutes. Nobody present at current meeting attended September 1 meeting,
so it was postponed for approval at a later time. Regarding the December 1
meeting minutes, Committee reviewed, CM Simmons moved to approve, and the minutes
were approved.
Regarding January 5, 2005 minutes, there was not a quorum for that meeting.
CM Simmons moved to approve the minutes. January 5, 2005 minutes approved.
4. Announcements
There were no announcements.
5. Public Comment
There was no public comment.
6. Steering Committee Update
CM Pugh reviewed that the Steering Committee co-chairs agreed to go visit the
Marin County Advisory Council meeting; and other activities and discussions
involved in that meeting. Grantee Assessment, Integrated work plan, and other
issues from meeting were reviewed by committee.
7. Conflict of Interest Policy Discussion
Jack Newby discussed his progress with City Attorney’s Office regarding
conflict of interest policy development. Conflict of Interest Memorandum provided
as an attachment here at this meeting, and is on file at Council Offices. Jack
reviewed issues on memorandum.
Regarding Issue #1. Response was yes.
Regarding Issue #2. Response was yes. Jack discussed conversation with City
Attorney’s Office regarding details of this issue.
Regarding Issue #3. Response was yes in most circumstances.
Regarding Issue #4. Yes, but should be able to vote.
Regarding Issue#5. Jack Newby reviewed his discussion with City Attorney’s
Office regarding perceived conflicts of interest.
Jack Newby reviewed other details in the memo, quoting the bylaws and examples
used from Phoenix and Boston EMA Conflict of Interest Statements.
Committee discussed issues regarding conflict of interest.
CM Pugh indicated that a policy should be in place rather than voting each
time which would unduly lengthen some meetings, as well as avoid any sense
of picking on individual members.
CM Simmons commented that he thinks it is great that the City Attorney approves
the memorandum, and personally would like to adopt the more stringent policy,
specifically citing the Boston example included in the memorandum.
Committee discussed prioritization of higher tier and lower tier items, and
any associated conflict of interest issues that might arise, and most committee
members agreed that people should declare their conflict of interest up front.
CM Pugh suggested that voting by blocks should not be done anymore and instead
voting should be done by individual issues. Committee agreed this is a planning
decision.
CM Thomas discussed potential future conflict issues that agencies may bid
on, and developing a policy that addresses all these scenarios.
CM Pugh indicated that is the goal of Committee.
CM Blum suggested that prioritizing categories one-by-one is cleaner, but logistically
may cause difficulty in getting through it. Committee agreed.
CM Pugh suggested a clearly-worded policy that members should identify and
state conflict of interest up front when entering into a discussion that applies
to one’s service category.
CM Pugh asked how this would be communicated to public and council members.
CM Blum suggested that building trust is important, identifying a rift between
provider and consumer. CM Blum pointed out that conflict of interest and not
voting should be applied to providers as well as the public or anyone else
who may sit on boards and ensure that these disclosures are made.
Committee agreed this is not a legal or ethical conflict of interest.
Jack Newby indicated that with respect to consumers, Council wants input, but
with regard to providers, consumers need to communicate need rather than personal
experience good or bad.
CM Blum state that being up front with individual experiences is important
and that everyone can have a personal conflict of interest. In terms of process,
this should be more above board.
CM Pugh emphasized the importance of consumers avoiding directing their comments
about particular agencies and identifying specific providers. CM Pugh asked
Committee how they would like to go about this policy development.
Jack suggested identifying each issue and subsequently turn it into a policy,
adding that this meeting was announced widely and invitations were offered.
8. Develop Conflict of Interest Policy- VOTE
CM Blum added that he approved of Jack’s suggestion of going one-by-one.
Jack’s conversation with the City Attorney’s Office implied that
the Committee would come up with a draft policy and the City Attorney’s
Office would have someone look at it later to finalize. Because of the multi-county
agency standing of the Council, particular lawsuits pending imply that the
Council will not have to follow the Sunshine Ordinance, according to the Board
of Supervisors. It was noted that this pending lawsuit does not affect the
work of Committee on the current issue.
Committee discussed the individual issues at concern in the Conflict of Interest Memorandum.
CM Simmons stated that he would like to change the culture regarding personal
responsibility that people have around the table. He believes that people should
clearly state any conflicts. He added that the co-chairs have responsibility
as well.
Committee agreed to make a note to add this is a chair responsibility.
CM Thomas suggested identifying the specific time that people should announce
their conflict of interest, whether at the beginning of a meeting, each time
they speak, etc.
CM Simmons indicated that long-standing members are familiar with this conflict
of interest issue; but it should be made known to the newer members.
Committee agreed that each time a comment is made that announcing conflict
is a good idea. It was also suggested that agencies could announce conflicts
(or perceived conflicts) on the name placards.
CM Pugh asked for Committee agreement to develop a policy so that members stating a perceived conflict of interest prior to speaking about a topic on a service category under which you are funded, that it is okay to speak but they must disclose conflict of interest each time they speak, and that this policy will be enforced by chairs.
Committee discussed the appropriateness of adopting something similar to Section
3 from the Phoenix example, which states: “All Council members must sign
a Conflict of Interest Disclosure Form indicating their willingness to disassociate
from any actual or perceived special interests during Council deliberations
and agreeing to act only on behalf of the broadly affected HIV community in
its totality.”
CM Thomas used the example that everyone believes that housing is important
and can agree on that.
CM Benham agreed that is true, but questioned members who may be passionate
about housing or another issue and also receive funding or their agency is
devoted to providing housing services.
CM Blum asked whether people can discuss the issue but not vote.
Committee discussed the difference between voting in blocks or individual
service categories and any issues that may crop up with the process and members
disclosing conflict of interest during prioritization votes.
CM Blum made a motion that the prioritization process group service categories,
and ranking be presented individually. Members should be asked to disclose
their particular conflict of interest with regard to a line item.
CM Simmons seconded the motion.
CM Benham made a motion that the funding sources be identified and that the
name placards be modified to identify any Title I funding. CM Blum seconded.
CM Blum seconded. By vote of hand, the motion was approved.
Will Carter asked for clarification regarding recusal votes.
Committee discussed how all votes are recorded and how a recusal is handled.
Regarding Item #5, Members should fill out a disclosure form, identifying the agency and service category, and information added to name cards regarding Title I funding. Committee emphasized that co-chairs need to monitor and enforce this policy. Committee discussed a way to make this information available to everyone present at meetings so that the conflicts are clear.
Committee discussed mega-agencies that may receive Title I funding for a particular program, but that person may be involved in a totally different agency program. Committee discussed whether people who disclose that they receive Title I funding can vote on that particular category.
CM Simmons indicated that consumers have no perceived conflict of interest (unless they serve on a board), that they are speaking for themselves rather than individual provider comments. If on a board, they no longer have unafilliated consumer status and must disclose this.
Jack Newby stated that he would put the foregoing discussion regarding conflict
of interest issues into policy language and circulate it to Committee Members
and to City Attorney’s Office. From there it will be presented to Steering
and then to the Full Council. Committee discussed that this might come back
to this Committee.
CM Blum suggested that after Steering it be expedited so that Council Support
can distribute to Planning Council ahead of time and ensure that it is reviewed
prior to the next Planning Council meeting.
9. Develop Council Policies & Procedures
(Handout of Policies and Procedures General Outline provided to Committee members
and available on file at Council Offices)
The Committee discussed how to develop a Council Policy and Procedures document.
CM Simmons questioned whether this was even possible.
CM Blum asked for someone to speak to what this might look like.
CM Pugh indicated that such a Policies and Procedures Manual can be cumbersome
and quite lengthy.
CM Blum asked Council Support if anything identified on General Outline (handout)
was already available in draft form.
CM Pugh added that several were already completed or underway.
Committee discussed individual items on the General Outline that need to be
worked on.
Committee discussed questions around “confidentiality policy” and
what that means, and seemed to agree that this meant with regard to HIV status,
since the other information in the meetings is within the public domain.
Jack suggested that grievance issues, membership committee interviews, information
at closed sessions, and so forth need to be confidential and Committee agreed
that a policy developed around these matters would be helpful.
CM Kleffner said it would be helpful to have some policy with regard to the
relationship between the various counties to clarify some of the verbal agreements.
10. Discuss Development of the MOU with Grantee
CM Simmons asked why the last MOU was never signed. CM Thomas said it was signed.
Leah Crask said they were informed that it was lost in the mail and explained
that the approval was finalized in March of last year. She said it was approved
by Council but Council never received a signed copy from the AIDS Office.
Committee reviewed a handout of Memoranda of Understanding: Operationalizing
Roles and Responsibilities between Grantee and Planning Council. (Copy of document
provided to all present, and copy included in Council Support offices).
Jack advised Committee that who reports to who, timelines, communication process,
is what is wanted in the MOU.
CM Pugh suggested that Committee develop a draft and present it to the Grantee.
CM Thomas stated that most of what is currently available can be used, with
some additions, including portions of the grantee assessment, especially with
regard to reporting and deliverables.
CM Simmons asked about the duration of the MOU.
Committee agreed that it will be reviewed and renewed annually.
Council Support reviewed CM Sallee’s notes which emphasize relationship
and communication rather than content of documents.
Jack Newby reviewed specifics of notes.
CM Pugh asked for plan of attack on MOU.
CM Thomas suggested that Jack Newby be involved.
Jack suggested that the first step should be a meeting with Michelle before
revisions are made to determine what works and doesn’t work. The Committee
will do the work on revisions and drafting, but the meeting should be first.
CM Thomas suggested that the AIDS office sign off on the MOU and pointed out
the need to identify missing parts.
Jack Newby stated that with a staff member from the Grantee and staff from
Planning Council Support present at meeting then there doesn’t have to
be any waiting time until the next Steering Committee meeting.
Committee discussed that lack of staff at meetings could have contributed
to the lack of communication and subsequent problems that developed.
Jack Newby agreed to set up a meeting date with Michelle and CM Pugh offered
to participate. CM Blum offered backup. CM Benham offered backup. CM Thomas
offered to help with writing. Jack also said he would obtain examples of MOU’s
from other EMAs.
11. Background/ Discussion of Counties in the EMA
The Committee will discuss background information regarding the presentations
from San Mateo and Marin County. The committee will then forward their ideas
to the Steering Committee.
CM Kleffner posed a question about what issues specifically are being dealt
with and suggested identifying in which direction to go with each issue. CM
Kleffner’s primary issue is whether Marin County is Title I funded and
what framework is involved. CM Kleffner provided a copy of a Marin County Title
I contract to Committee Members. Committee discussed that San Francisco has
chosen to have San Mateo and Marin counties have their own planning bodies,
which go through the San Francisco Planning Council.
Committee discussed differences in the county presentations and issues that
were brought up with regard to contract monitoring.
CM Simmons asked for clarification about the dispute in Marin County between
consumers and the grantee. CM Kleffner said the dispute was with regard to
disbanding the Title I processes and procedures.
Will Carter clarified the issues with regard to consumers in Marin suggesting
that Title I prioritization is out of whack with needs of consumers in Marin
County. He suggested that clients are paying for services that they are not
getting, and do not get services that they believe they do need. He added that
consumers and providers believe this has been going on for at least ten years.
CM Simmons asked if consumers are county-wide or a particular city.
Carter indicated that it is county-wide. Underrepresented populations are the
same in Marin County as in other counties.
CM Simmons suggested that the consumers need to get a lawyer.
Committee discussed assessment of need, development of a plan, allocation and
prioritization. The Planning Council has the responsibility, and it is from
tradition and respect for people of Marin County to make their own decisions
this has been done. The problem is that Marin County is not conducting a process
that meets the needs of consumers, and Marin County has admitted they are not
providing service under Title I. Additionally, Marin County has not communicated
effectively and the Planning Council has not received the appropriate information
and is not incorporating it into the final prioritization. The Planning Council
needs to figure out how to fix the problem if Marin County does not take it
upon itself to do so.
Committee discussed possible approaches to finding a solution.
Will Carter indicated that the point of the problem is not the structure, but
the process. He added that the Marin County Advisory Council is provider-dominated.
Carter identified other specific issues with regard to the process, and what
matters is that the solution incorporates what they need. He indicated that
housing and transportation issues are not prioritized.
CM Pugh stated that the Council and the Grantee both have responsibility in
the issue and suggested that the Grantee needs to ensure that money is being
spent appropriately and monitor the situation, as well as addressing any issues.
She reiterated that the County of Marin needs to have a Title I Council, and
the people of Marin County need a Title I process.
CM Blum emphasized rebuilding communication and accountability of the county.
He stated that the Marin County representative communicated that they are interested
in having involvement from the Planning Council. CM Blum added that the primary
complaint is regarding the fundamental requirements of Title I.
CM Pugh implied that it appears that Marin County is not complying with the
contract, and asked Committee how this should be addressed.
CM Simmons indicated that this has come to the Planning Council because consumers
are unhappy, but that unhappy consumers can be found in every situation. CM
Simmons asked for clarification on getting input from Grantee and contract
monitor, and HIV Consumer advocate as well as receiving input from consumers
present at meetings.
CM Thomas suggested that the Planning Council put in writing the expectations
from other San Mateo and Marin counties that meet criteria for Title I process
to specifically do priorities in a way that arrive to Planning Council in time
for the overall prioritization. CM Thomas indicated that Marin County needs
to get some sort of Title I process somehow. Through the Grantee, the Planning
Council assigned that responsibility to the County of Marin.
CM Pugh reiterated that she is unclear about what Marin County does with their
money.
Will Carter agreed.
Jack Newby reminded Committee that a Needs Assessment is underway, but a big
trust issue is causing problems and emphasized that the past needs to be put
behind and people need to step up to the plate and move forward with open meetings
in such a way that there is a transparency with how numbers get into the contract.
CM Thomas suggested that the Planning Council send a letter to the contractor
in Marin County, Marin Dept. of Health and Human Services with regard to the
concern and spell out the understanding and expectations with regard to Marin
County complying with a Title I process; and that priorities need to be seen
in time to incorporate into the Planning Council process.
CM Blum asked about severe need clients and whether prioritization would be
different.
CM Thomas indicated that information would be used as a feedback mechanism
and offer an opportunity for county residents to make a comment.
Committee discussed details regarding how to approach Marin County regarding
the issue.
Will Carter stated that he believes that Larry Meredith, Director of Marin
County DHHS should be the one who receives the letter.
CM Kleffner suggested that watching the current prioritization process in Marin
County would be educational for Council members.
Wade Flores stated that the meetings are closed and that meetings are only
announced in one particular publication that does not have wide distribution.
CM Pugh indicated that this will be brought at the next Steering Committee
meeting.
CM Simmons reiterated that there are happy consumers and unhappy consumers
in Marin County and cautioned Committee on making decisions based solely on
the voices of a few unhappy ones.
Will Carter reiterated that the issue is with regard to the process of Title
I.
CM Kleffner repeated her earlier comment that she and the Marin County consumers
are not here to complain but simply want a process that follows the CARE Act.
CM Pugh stated that having a copy of the contract is a real eye opener.
CM Thomas made a motion that it will be presented to Steering and that a letter
written to Marin County about Title I process, expectations and understanding,
and that they should provide a report to Planning Council in enough time to
incorporate into Planning Council prioritization. CM Thomas stated that this
should incorporate: Needs Assessment, community input, and other aspects of
Title I process, accountability for responsibilities assigned to them, all
performed with a transparent process.
Committee agreed that their recommendation to Steering should be a letter from co-chairs delineating expectations to the counties with regard to their responsibilities to the prioritization process, and instructing the program manager to report back to the Planning Council on a regular basis.
12. Next meeting date & agenda items
The next meeting for I&P was scheduled for Wed. March 2.
Meeting adjourned at 6:53 pm.
Mission Statement: To ensure that Council activities, policies and procedures
support Council priorities and responsibilities, and monitor and enhance the
relationship between the Council and the grantee.
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