HIV Health Services Planning Council
Steering Committee Minutes
Monday, April 17th, 2006
SFDPH 25 Van Ness Avenue, Room 330B
5:00 -7:00pm

Committee Members Present: Randy Allgaier (Council Co-chair); Billie-Jean Kanios (Council Co-chair); Donald Soto (Council Co-chair); Margot Antonetty (Housing Work Group Co-Chair); Bill Blum (PWP Co-Chair); Mary Lawrence Hicks (Evaluation Committee); Dorothy Kleffner (Membership Committee); Mark Molnar (Membership Committee); George Simmons (Planning Committee); Laura Thomas (Planning Committee)
Committee Members Absent: Devin Anderson (COA Committee); Ayisha Benham (I&P Committee); Charles Siron (I&P Committee); Sparkie Spaeth (Evaluation Committee)
Other Council Members Present: Darnell Durio
Others Present: Michelle Long
Council Support Present: Jack Newby; Enrique Asis; Susan Latham; Joe Lynn

1. Introductions

Co-Chair Allgaier called the meeting to order at 5:06 pm and asked all to introduce themselves.

2. Review/Approve Agenda

Mr. Jack Newby asked that the third bullet point under Policies and Procedures be struck from the agenda. There was no objection and the point was struck by consensus.

3. Review/Approve March 20th, 2006 Minutes

Without objection, there was a consensus to approve the minutes.

4. Announcements

Mr. Newby introduced Joe Lynn, new Council support staff.

• Update on meetings with San Francisco Board of Supervisors

Mr. Allgaier said that he and representatives of the Council had met with various Supervisors and their aides. A resolution was being prepared for Sup. Ammiano to introduce. There are plans to meet with more Supervisors as well as the Mayor.

There was an announcement of an opening of new facilities at Berry Street.

An appeal was made for Council presence at Project Homeless Connect.

5. Public Comment

There was no public comment.

6. Committee Check-in

• I&P(Infrastructure and Policy) Committee
Ms. Antonetty said that no further action had been taken.
• Planning Committee
CM Laura Thomas said that some matters were on the agenda and that further consultation with the Housing committee would be made.
• Community Outreach and Advocacy (COA)
CM Darnell Durio said that CM Aimee Barnes and CM Devin Anderson had been elected Co-Chairs. He also announced an event at the Mission Reform Health Center.
• Housing Work Group –
Ms. Antonetty said that items to be discussed on the agenda reflected their work.
Membership Committee: announce April applicants for recommendation to Full Council; announce May renewal; committee reassignments

CM Dorothy Kleffner said that a meeting of the I&P and Membership Committees was being set up. The Committee was recommending for approval two new members, Mr. Stephen Herman and Ms. Catherine Newell, as well as the renewal of CM William Blum. Mr. Anderson was being given a two month leave of absence.

Evaluation Committee – Update

CM Mary Hicks said that they were calendaring times to meet with I&P although there was no sense of urgency with setting the meeting up.

There was some discussion on a survey done in 2004 that evaluated members’ satisfaction with the council structure. Many members then were not aware of the responsibilities of other committees. Attendance problems seemed statistically the same from one year to another. It may make more sense to look at a redistribution of duties among the committees. What recommendations the survey made have been accomplished.

A suggestion was made that I&P should meet with COA. There was also a question as to whether attendance problems had seasonality. Perhaps, explaining the importance of the issues would help. Other issues in the lives of Persons Living With AIDS may also explain in part attendance problems. Some noted that this matter had been discussed often in the past with suggestions made of increased training and support for members. Paring agendas to a minimum may give additional time for greater discussion and understanding of the importance of problems faced by the Council.

• POI(Points of Integration)

Mr. Blum said the meetings had been well attended and had good participation. A presentation on late testers had been given, and another on nontesters was planned. They study Prevention with Positives each month and plan to meet with the Centers of Excellence. A Memorandum of Understanding is being prepared by the Prevention Council to define the role of the committee. It will be presented for review by CARE.

7. Discussion of Policies and Procedures - VOTE

• Advocacy Project Reporting Policies
Mr. Newby said the issue of listing names of agencies in the Consumer Advocate’s Monthly Report had been raised before COA which had strongly reaffirmed its original position in support of the practice. Mr. Richard Bargetto said that COA wanted the name of the agency for consumer reporting reasons.

Other Council Members expressed concern that the accusation of wrongdoing contained in the report could be misconstrued as a finding of wrongdoing. Others thought that the public could distinguish an accusation from a finding. Some thought a preamble could be added to the report explicitly stating the assumptions made concerning the accusation. In addition, there was a concern that too much detail in the report could lead to outing the accuser. There was a suggestion of a joint meeting of I&P and COA to discuss the problem together.

• Supervision of Director of HIV Health Services Planning Council
Co-Chair Allgaier said that the Steering Committee has supervision over the director and not the co-chairs. The Evaluation Committee presents Steering with a report that it takes to Kevin Burns.

Motion (Molnar/Hicks) to adopt the present policy for supervision (passed unanimously).

8. Update on Recommendation from the Department of Public Health HIV Health Services Regarding the HRSA (Health Resources and Services Administration) Award: Implementation of the Reduction ($332,913.00) – VOTE

Ms. Michelle Long (SFDPH, HIV Health Services) said she had no update to give. The Members said that the direction of the recommendations would be supported given its size. A larger problem might draw a different reaction. Some urged that this latter sentiment be made explicit.

Motion (Thomas/Simmons) to support DPH’s approach to the issue (passed unanimously with CM Durio abstaining).

A discussion ensued as to the history of the decision not to take a vote on the matter in March.

9.Review and Discussion of HRSA Letter (received 3/29/06: HAB Policy Notice-99-02, AMENDMENT #1, Document Title: The Use of Ryan White CARE Act Funds for Housing Referral Services and Short-term or Emergency Housing Needs)

Ms. Long said a letter was now being approved. HRSA’s most recent letter arrived just as DPH’s letter was being sent. CM Antonetty said the Housing Committee would review the letter that appears to be more restrictive than the consultant’s suggestion of 24 months plus three six-month extensions. The letter does not include the extensions. DPH’s response, due 60 days after HRSA’s policy is posted, will necessarily be conservative because of its need to maintain a working relationship with the federal agency. They thought that their response would be supplemented by separate letters from the public and providers.
Ms. Thomas said that the Planning Council should draft a response as well, suggesting that Housing present the Steering Council with a draft response. Ms. Antonetty shared this view and noted that the Health Commission would consider its own resolution on May 15.

DPH would advocate for a grandfather clause. No one could tell whether the period of 24 months applied to each time or was a lifetime amount. However, that distinction may be academic.

10. Discussion of Eligibility Criteria, Severe Need, and Special Populations Definition

Ms. Thomas said that Planning wanted to get Steering’s feedback on whether to maintain the present county residency requirement. No one seemed to know what the impact of a change would be.
Some argued that chopping the EMA into three districts provided separate but not equal facilities for residents of the different counties.

Others minimized the impact saying that folks would not travel out of their way to go to another county.

Co-Chair Allgaier suggested that a pilot project might be the best way to adopt the policy.

Others opposed the change without knowing more about its impact. Changing the three EMA’s into one could also lead to prioritizing the money in one geographical unit.

Caution was needed to prevent destabilizing services. Some members supported a pilot program with certain services that could first be tested.

There was a consensus to bring this to the full council for discussion.

11. Discussion Regarding REGGIE Updates and How They May Impact CARE Clients

Co-Chair Allgaier described the proposal to require the sharing of all REGGIE client data with appropriate agencies. Presently, 86% of users agree to share their information. DPH estimates that as many as 92% would agree to the sharing with proper explanation of its purposes and risks. No case notes are shared, just demographics and basic information. However, there had been a strong outcry against the proposal by COA.

Some agreed that sharing the information had strong administrative advantages. However, they contrasted HIPPA’s move towards confidentiality with the proposal’s move in an opposite direction. These members predicted that there would be problems dealing with client complaints. To them there was a question whether the administrative advantages could trump the ethical concerns raised.

Others in opposition criticized the process by which it is being done as heavy-handed without any input from the clients. However, Mr. Allgaier said that Celinda had thought the client input would come through the Council.
Many of the concerns held by others had been answered by a training session. They thought that a large reason for clients’ not opting for shared status was a failure to explain the system properly.

In response to Co-Chair Allgaier’s questions, Mr. Newby said that individual information could not be retrieved by surfing the site.
Mr. Durio said he had been involved with REGGIE since its beta test, and he opposed the proposal. He wanted to know where to direct client dissatisfaction with the proposal.

There was the view that clients should not protest the proposal until the draft proposal had been made more specific. The facts had not yet been fully gathered to allow for proper discussion. The rollout of the plan was planned occur July 1. DPH wanted to develop a fact sheet so clients can understand what there is to gain and what will be lost. Consideration needs to be given of what populations will be affected. Much of the provider anxiety was about irate clients. While clients will need to consent to the sharing of the information, those who do not can be funded by non-CARE funds.

Co-Chair Allgaier said the matter would be placed before the Council for discussion only.

12. Review Council Meeting April Agenda

Review and finalize next Full Council meeting agenda for Monday, April 24th, 2006. The meeting will be located at the Milton Marks Convention Center, 455 Golden Gate Avenue, Lower Level San Diego A & B.

Time amounts were allotted to the various agenda items.

13. Next Meeting Date and Agenda Items

The next Steering Committee meeting will be on Monday, May 15th, 2006. Determine June agenda items.

Adjournment

Co-Chair Allgaier adjourned the meeting at 7:21pm

*All documents reviewed at meeting are on file at Council Support Offices.



Home | Community Outreach & Advocacy Committee | Policy & Evaluation Committee | Evaluation Committee
Membership Committee | Planning Committee | Steering Committee