HIV Health Services Planning Council
Steering Committee DRAFT MINUTES
Monday, August 15, 2005
25 Van Ness, Room 330 B
5:00-7:00pm

Committee Members Present: Anita Booker, Brad Hume, Walter Miller, Laura Thomas, Wilfredo Ortiz, Ayisha Benham, Ellen Sweetin, Mary Lawrence Hicks
Committee Members Absent: Kim Pickens, Don Soto, Charlene Pugh, Charles Siron, Randy Allgaier, Bill Blum, Catherine Geanuracos
Other Council Members Present: Raymond Banks
Council Support Present: Jack Newby, Leah Crask, Skot Jonz
Others Present: Mike Smith (HAPN), Michelle Long

1. Introductions
CM Booker called the meeting to order.

2. Review/Approve Agenda
Committee members reviewed the agenda. CM Benham asked to have the I&P item on the agenda regarding Unfunds Policy moved up on the agenda. Change was approved by consensus. Agenda was approved by consensus.

3. Review/Approve Minutes
Committee reviewed the minutes from the Steering Committee meeting of July 18, 2005. No changes were noted. Minutes approved by consensus.

4. Announcements
CM Hume announced something for clarity regarding his attendance at the two-day prioritization allocation meeting later in the month. He will not be in attendance on either day.
CM Banks attended the Mayor’s Town Meeting, and wishes to appeal to the business community to help out certain organizations like St. Mary’s who are receiving cuts. He asked if the Planning Council or himself as a Council Member can appeal to the business community to help out.
CM Benham announced that she is a new grandmother.

5. Public Comment
No public comment.

6. Committee Check-in
Community Outreach and Advocacy Committee. CM Ortiz provided an update regarding the community meeting last week targeting the transgender community, and thanked CM Kanios for facilitating the meeting. He expressed concern about no-shows from many of the committee members.

Membership Committee. CM Hume provided an update regarding activities of the committee including a grievance against a Council Member and he reported that the newly approved removal for cause policy proved especially useful under the circumstances, and that the grievance was dismissed for lack of evidence. There was also an in-depth conversation about demographics. There are two candidates to present to the Council in September for membership approval. Another issue that came up regarded a requirement for the number of representatives from the outlying Counties that sit on the Council.

Evaluation Committee. CM Miller provided an update on committee activities, primarily an evaluation of the Three Year Plan. He also discussed that the September meeting needs to be rescheduled due to the regular meeting date falling on the Labor Day Holiday. CM Miller reported that he will be missing Evaluation Committee meetings due to school but will be able to attend Full Council meetings.

Infrastructure & Policy Committee. CM Benham provided an update on committee activities, primarily the efforts to complete the Policy & Procedure manual. Additionally, activities included the discussion regarding the function of the Steering Committee, which is on tonight’s agenda. She provided additional details on the reason why this conversation initially came up.

Planning Committee. CM Thomas pointed to Item 7 on the agenda tonight, and stated that most of Planning Committee activities would be discussed then. She added that a consultant had been selected for working on the Comprehensive Plan and that a working group is being formed to work on this new plan.

Counties Working Group. CM Sweetin discussed activities of Counties WG and mentioned that at the last meeting it was discussed that there was a deadline suggested for wrapping up the work of the group. Some members of the group are very concerned because they have a long list of issues to be addressed, many of which are beyond the scope of the working group. Others are very pleased that the end is in sight. As a co-chair CM Sweetin added that she had agreed to bring this issue to Steering for some direction on how to determine an end date. She believes the basics tasks of the group can probably be done in a month, with maybe a little work follow-up at a Council Meeting. In no way, will everything be resolved according to the needs of everyone in the working group.
Committee offered their opinions on the matter, most of whom believed that the work of the Counties Group should be wrapped up within a month.
CM Sweetin mentioned a lack of resolve, and that there is the desire for some “superstructure” to make everything right, and suggested there will be some sort of ongoing need. She explained that the issues are mostly related to one of the counties’ Advisory Committee and/or Health Department relationship with the consumers, rather than any underlying issue with the SF Health Services Planning Council.
CM Benham mentioned that one discussion in I&P has been that council members are stretched and taking on too much, and that there is a problem with ad hoc committees being more permanent than ad hoc committees should be.
Committee asked for an opinion from Michelle Long regarding the Counties issue.
Michelle stated that she agrees with most of the discussion here at Steering Committee. She believes that an external end-date has been imposed on the working group, and suggested that the working group be asked how much more time they need and let them determine. She explained that with the unresolved issues, they need to figure out a way to wrap it up by September 30, and ask them if they need one more meeting and what would be an appropriate end date.
CM Hume agreed with comments from Michelle, and suggested that the amount of accommodations the Council makes with regard to being flexible and accepting so that everyone feels a part of the work, but that it is sometimes out of balance. He added that a lot of time is spent appeasing people’s concerns rather than actually doing the work, and a small number of people can divert the work that needs to be done. The level of hand-holding is sometimes absurd, but there should be a balance between being accommodating and being manipulated.
CM Ortiz commented that the ad hoc group sounds more like a support group, rather than making effectual decisions regarding structure or function.
CM Sweetin agreed that given the tasks required of the working group, this could be completed by the end of September. She suggested having individuals on the ad hoc group put together a list of particular issues, to determine if there is any assistance available for them to work out the issues within the County. Since many of the issues are outside the initial scope of the ad hoc group.
Jack added that he agrees with Michelle, as the way the end-date message was delivered caused resistance among many of the ad hoc group members. He believes the ad hoc group has completed a document on the relationship between the counties and Planning Council. There is the feeling with some members of the ad hoc group that everything will be magically resolved at once. The only way to resolve some of the issues that seem to be present is to work through them, as part of the normal process. He suggested that with the fiscal year, the new year begin with a clear expectation of all the working groups.
CM Hicks agreed with Michelle Long that the group should be asked how much more time they need beyond September, and get them to decide on an end-date.
Committee agreed that CM Sweetin should take back to the ad hoc group the sense of tonight’s discussion, meet one more time and suggest having everything resolved at the latest by October.

Needs Assessment Working Group. Jack Newby provided an update on the Needs Assessment working group, and indicated that a rough draft of Harder + Co. findings was provided today, circulated to Steering Committee to review. This document will be reviewed again tomorrow at the Needs Assessment Working Group and presented to Council Members some time next week so they have it in time for the August 26 Council meeting. A final presentation will be provided by Harder + Co. on August 26.

Housing Working Group. CM Hume provided an update and reported that the Housing Committee working group will hear a conference call from Harold Phillips regarding the length of stay policy on August 25. There will be no decisions made, but only an informational meeting as part of the regular ad hoc group meeting. He suggested that the Committee hear this and then will be a position to report back to the Full Council.

Prevention for Positives. No report available.

HOPWA Loan Committee. Jack Newby indicated that the procedure has changed, and reported that the new nominees have been appointed. Council Support Leah Crask provided an update on how the procedure has changed and indicated that the names have been forwarded to the Mayor’s Office. CM Hume added that the meeting of the HOPWA Loan Committee has been pushed back, and provided an update on some changes with the committee. He explained that the next meeting is very important for the Council to have a voice.

7. Progress Report on Two-Day Prioritization/Allocation Summit
CM Thomas provided an update on the Two-Day Prioritization/Allocation Summit. She indicated that space, equipment, and agendas are all prepared, the facilitator is being briefed. She added that Harder & Co. staff as well as Health Services Office staff will be present.
CM Hicks asked for clarification regarding proxy voting, so that if it comes up it will be clear.

ACTION: CM Thomas suggested sending out ahead of time to all Council Members the policy regarding proxy voting.
ACTION: CM Thomas suggested confirming attendance for these meetings. Council Support to send email to Council Members to confirm attendance
.

CM Banks asked how the summit meeting will be different than regular council meetings, and inquired about the rules of respectful engagement.
CM Thomas reviewed the breakout groups, and indicated that this would be for Council Members only and there would be no public comment during this time. She added that public comment will be available on other parts of the agenda.
CM Banks asked if an official parliamentarian has reviewed the agendas and asked if it has been approved, and how will it be decided who reports back.
CM Thomas informed Committee that each subgroup will decide on its own who will report back, and they are not decision-making groups, but an opportunity to discuss in more detail specifics regarding prioritization.

Committee discussed other details regarding the prioritization and allocation meeting. CM Thomas provided succinct and informative answers to committee members’ concerns and questions.
Michelle stated that this is a great process for everyone to voice their priorities, but unclear about what will happen next. She added that there is not the luxury of having extra time of being able to go back and say what is feasible. She expressed some concern about this, and suggested building in enough time to do a feasibility test to determine that the Council’s decisions can be accomplished. She added that the entire Council recommendation be given to the AIDS Office at one time.
Committee thanked CM Thomas for a good job. Because of the due date for the application, there is no time to push off decisions and it must be done at the two-day meeting.

8. Unfunds Proposal –VOTE
The Committee will discuss the unfunds proposal forwarded from the Infrastructure & Policy Committee and will vote to approve the Unfunds Proposal.
I&P Unfunds Recommendation:
• $22,000 to Unmet Needs Survey;
• $20,000 to the Comprehensive Plan (a request from HIV Health Services).;
• Regarding the vouchers, find out how much was spent on that (if there are no leftover vouchers) and replenish the vouchers up to $100,000 for food and transportation vouchers;
• The balance (approximately $580,000) to direct financial assistance service category.

Committee discussed the recommendation from I&P Committee regarding the amount of unfunds. The changes to the initial proposal include: changing to $22,000 the amount for Comprehensive Plan, removing bullet number three for the voucher program, and the balance to direct financial assistance service category.
Committee asked why vouchers was removed. Discussion from Michelle Long provided background that the vouchers were removed due to controversy in the past regarding the use of vouchers.
CM Ortiz expressed concern about this much money being left over, especially with so many criticisms that San Francisco is getting too much money to begin with.
Michelle Long indicated that compared to the total amount received by SF EMA this is a relatively small amount, and less than the unspent last year. She added that additional information would be provided to Council Members at the upcoming prioritization and allocation meeting.
CM Hicks suggested that this amount of money could fund a COE, and compounded with the criticisms that this should be explained clearly.
CM Miller reviewed his research on which service categories have and have not spent down their money but are still in the red.
CM Banks commented that he believes the issue should go through as proposed without too much discussion about why it is left over. He added that the majority of the unspent funds are going to a service category with low overhead and most of the money will go directly to clients.
CM Booker indicated that this issue comes up every year, and suggested that the AIDS Office and Health Services look at why certain agencies are not spending the money allocated.
CM Hume called the question.
CM Banks seconded.
All in favor of calling the question.
The vote is for a motion to use the Unfunds amount in the following manner:
$22,000 for unmet needs; $22,000 toward Comprehensive Plan, and the balance of (approximately $680,000) to direct financial assistance.
All in favor. None opposed.

9. Discussion of the Steering Committee Function/ Mission Statement
The Committee will discuss the proposal from I&P to adopt the definition of the Steering Committee(at the bottom of the agenda) as the mission statement but to also include the following ideas:
• The vetting process of proposals forwarded from the Councils committees
• The idea that the Steering committee will not act as the full body of the Council or make decisions for the Council as a whole.
Committee discussed the function of the Steering Committee.
CM Booker stated that every committee is represented at Steering because of the attendance of co-chairs who are responsible for relaying information from Steering to their home committee, and from their committee to Steering. She stated that Executive Committee may not be the right word, but it is the place where decisions get made.
CM Hume asked why there was hesitation about the committee being referred to as Executive Committee. Jack Newby provided his recollection of the discussion at the I&P Committee.
CM Thomas added that Steering Committee should be able to make some decisions, especially when there is a time crunch, and the Full Council has no time to address the issue. She suggested that there be some clarity spelled out about what decisions Steering can make, rather than what they cannot make.
CM Miller discussed his experience that each EMA is different, and explained that in Oakland the Executive Committee is the same as the Steering Committee in SF EMA. If the Full Council cannot make a decision, the Executive Committee is the one that makes the decision.
CM Hume agreed that the current activities and function of the Steering Committee is fine, but believes that it should be put in writing.
CM Benham recalled that some of the concerns were that the Steering Committee could become too powerful.
CM Ortiz explained that having an Executive Committee is disrespectful of the Full Council and this committee should not override the decision (or lack of decision) of the Full Council.
CM made a motion that the Steering Committee draft the parameters of the Steering Committee to I&P Committee for review and approval.
CM Ortiz seconded.
Discussion on motion:
Committee discussed.
CM Hume called the question.
With no quorum, committee was unable to vote.

Committee discussed that Steering Committee should complete the work on this matter and have it ready for I&P Committee by their October meeting.
CM Booker suggested that Steering have two meetings to discuss this, and believes it will take more than one month.
CM Hicks agreed and amended the motion that Steering would work on this matter at their September and October meetings and have something for I&P by their November meeting.
All in favor of the amended motion. None opposed.

10. Discussion to Support AB1677- Bill to Allow Condoms in Prison-VOTE
The Committee will discuss AB1677 and then vote on the Planning Council supporting this bill.
Jack Newby provided background information regarding the AB16777 Bill to allow condoms in Prison. Planning Council’s throughout the State are being asked to support this bill. Information provided to committee members (documents on file at Council Support Offices).
This will help prevent HIV infection in prison, and upon release of incarcerated individuals.
It was agreed to discuss this at Steering Committee since there was not enough time to discuss at a Council Meeting.
This could potentially be added to Saturday August 27 agenda for a brief discussion.

CM Banks suggested this bill does not deal with the entire problem and is merely a temporary bandage, and if they really want to stop the transmission of HIV, handing out condoms will not significantly reduce new infections.
CM Hume asked if other EMAs expressed support.
Jack Newby indicated that Los Angeles has supported, and a few others but did not have specifics.
CM Booker said in general it sounds like a good idea, but she would feel more comfortable hearing the opinions of those against it, specifically the guards who are restricting the use of condoms, and specifically why they are against the use of condoms.
Jack replied that the opposition believes that the use of condoms only condones sex and there is a general denial that sex is happening among inmates.
CM Thomas added that the same argument is used for needle-exchange programs, and change comes slowly to the corrections system. This bill may not be enough, but sometimes it is necessary to make small changes. Prison guards and law enforcement are against it, primarily because they do not have the health of prisoners as a priority. She believes this is a good bill and that the Planning Council should support it. She put a motion on the table that the Planning Council should support Bill AB 1677.
Discussion on the motion:
CM Hume suggested that the motion be that the Steering Committee support the bill and bring before the Full Council for discussion.
CM Banks discussed that as a prisoner there are other, bigger issues besides condoms, such as the restriction on smoking. He suggested this is a slap in the face to inmates, when something as petty as condoms are being presented as a bill (and supported by the Council) when there are much larger issues. He suggested the Council do more rigorous scrutiny of what takes place in prison before making a decision on a matter such as this.
CM Hicks stated that the Council did not come up with this bill, and the committee responsibility is to come up with a response to it. She added that she believes Viagra is often made available to inmates, and condoms are not, which seems to be contradictory. She was unsure if this was factual and would do some research.
CM Ortiz spoke in favor of the motion for Bill AB1677 to go before the Full Council for a vote of support. He added that this is beyond the purview of the function of the Planning Council. If the Planning Council takes a stance that is disapproved by the government, then it only incites those that are intent on disbanding planning councils.
Michelle added that someone on the Council must write the letter, and it cannot come from the AIDS Office.
CM Hume called the question.
CM Ortiz seconded.
All in favor of calling the question.

VOTE: Should Steering Committee take this bill regarding use of condoms in prison to the full Council for a VOTE?
Those in favor: six. Opposed: one.

11. Review Council Meeting Agenda
Committee reviewed the draft agenda for the August 26 and 27 Prioritization and Allocation meetings.
Council Support asked about when the Unfunds Vote should be added to the agenda.
CM Thomas suggested adding ten minutes to the end of day two. Committee discussed that the AIDS Office would be providing a summary regarding why there is unspent funds, which might help people decide on allocations.
CM Hume suggested having this vote and discussion earlier rather than later.
CM Hicks agreed.
CM Booker agreed it should be given at least ten minutes after Michelle’s presentation.
CM Thomas indicated that it is important and needs to be addressed, but doesn’t want to spend an hour on the matter addressing the same questions that came up tonight.
CM Hicks agreed that the item should have fifteen minutes.
Committee agreed to answer many of the questions before the come up.
CM Thomas suggested adding this discussion after the break on Day Two, taking the time out Funding Scenarios. Council Support to adjust the agenda accordingly.

12. Next Meeting Date and Agenda Items
The next Steering Committee meeting is scheduled for September 19, 2005.
AGENDA ITEMS:
Draft Function and Purpose of Steering Committee to present to I&P

Adjourned
CM Booker adjourned the meeting at 6:59 pm.

 

The Steering Committee of the HIV Health Services Planning Council is made up primarily of the co-chairs of the Council's other committees. The primary responsibility of the Steering Committee is to oversee the work of all of the Council's active committees and ad hoc committees, as well as interface with representatives from the Department of Public Health HIV Health Services office; it is also responsible for creating and finalizing the agenda for the upcoming Council meeting.


Meeting Minutes are considered to be in DRAFT form until reviewed and approved by Council attendees.

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