HIV Health Services Planning Council
Yerba Buena Center for the Arts, Forum
701 Mission Street (at 3rd Street- see directions below)
San Francisco, CA 94103
July 26, 2004

Lunch at 12:30 PM
Meeting 1:00-8:30 PM

DRAFT MINUTES

I. Call to Order

II. Roll Call

III. Review and Approve Agenda
The Council reviewed and approved the agenda.

IV. Review and Approval of Minutes from June 28th, 2004
The Council reviewed and approved the minutes.

Announcements
CM Hume reviewed the structure of the meeting.
CM Chung will be leaving her position at DPH on August 12, 2004.
CM Sanders encouraged members changing employment status to submit a new application to the Membership Committee.
CM Allgaier announced that the Evaluation Committee had received 26 Council and 52 provider responses to the Grantee Assessment.

V. Public Comment
Patrick Monette Shaw asked Council members to speak loudly because of the acoustics in the room.
Bill Hersch thanked the Council for its advocacy to restore defunded services.

VI. Prioritization Introduction
CM Blum reviewed the agenda and presented guidelines of respectful engagement during the meeting. The Council Co-Chairs will facilitate the meeting using Robert’s Rules of Order; John Golenski will facilitate discussion.

Public Comment
There was no public comment on this item.

VII. Conflict of Interest Disclosure

Council members disclosed all possible or perceived conflicts of interest and signed a conflict of Interest Disclosure Form.
CM Blum works for San Mateo County in client services.
CM Shea is a family nurse practitioner at SFGH Ward 86 representing Title IV primary care for family services.
CM Thomas works for Continuum HIV/AIDS service providers, and was a previous employee of DPH.
CM Booker is a board member of ACRC and an employee of San Mateo County.
CM Hume is a PLWHA with no real or perceived conflict of interest.
CM Sallee works for San Francisco Community Clinic Consortium, which receives Title I funding in primary care, and was the former director of Haight Ashbury Free Medical Clinic.
CM Allgaier is an unaffiliated consumer.
CM Hicks is a nurse practitioner at Ward 86, at the San Francisco AIDS Education Training Center.
CM Chung is working for DPH until August 12, which receives no Title I money, and is on the Board of Directors for the API Wellness Center, which receives Title I funds.
CM Byers works for the State AIDS Office in Sacramento, and has no real or perceived conflict of interest.
CM Soto is the Program Manager of an agency in a Title I funded subcategory.
CM Antonetty works for DPH, which contracts out $6.7 million of CARE money, but where none of the staff is funded by CARE funding.
CM Simmons is the Program Director for Catholic Charities, which receives Title I money.
CM Durio works for AHP in a department which receives no funding from CARE money.
CM McMurray works for Metropolitan Community Church, which receives no CARE funding.
CM Geanuracos works in the Division of Adolescent Medicine at UCSF, which receives no Title I funding, and is a former employee of Larkin Street Youth Center.
CM Sanders is a PLWHA and has no conflict of interest.
CM Siron is a PLWHA and has no conflict of interest.
CM Pugh works for the University of the Pacific Dental School, which receives Title I funding in the area of dental care.
CM Rodriguez works for MNHC, which receives Title II funding.
CM Miller is a PLWHA and has no conflict of interest.
CM Graham works for the SF Sheriff’s Department, and is a former employee of the Immune Enhancement Project.
CM Ortiz is a PLWHA with no conflict of interest.
CM Perez has no conflict of interest, and is a former employee with Positive Resource Center.
CM Conley is employed by the EMA of San Mateo County.
CM Flood works for the State Public Health Medical office.
CM Pearce has no conflict of interest but receives services from CARE-funded agencies.

Public Comment
Richard Johnson commented that the Council as a whole seems to have a conflict of interest by favoring and funding Western medicine over Eastern medicine.
Patrick Monette Shaw recommended placing the hearing enhancement device closer to the microphone for a better audio recording.

VIII. Report from Community Fora

CM Geanuracos and CM Durio from the Community Outreach and Advocacy Committee presented a brief report of the Community fora. See handout.
CM Siron reported on the feedback from the community regarding ISM’s, which emphasized respectful, coordinated and accessible care.
CM Hume asked if there had been mention in the fora of the difficulty of receiving services when one is clean and sober in an environment where people are using substances.
CM Siron responded that many people talked about how being clean and sober had helped their ability to access more services.
CM McMurray stated that the Community Outreach and Advocacy Committee aims to improve the method of reporting on data collected at the fora so that the Council can make best use of the information.

Public Comment

A member of the public advocated for complementary therapy, an integrated service, which helps people with mental health and substance abuse issues.
Patrick Monette Shaw commented that the Council should put more time into collecting quantitative data from the Community Fora.
Richard Johnson commented that the Council does not use the Reggie system to notify people receiving services of Community Forum events.

IX. Input from Providers
Mike Smith presented the HIV/AIDS Providers Network (HAPN) recommendations to the Council.
CM Antonetty stated her appreciation of a unified presentation and voice from HAPN.
CM Chung stated her support for the points made by HAPN. CM Chung requested a commitment to work closer with the Council on the Reggie system regarding severe need.
Mike Smith responded that HAPN would be willing to be on a task force if it included members of the AIDS office and the Planning Council.
CM Geanuracos stated that fields already existed in Reggie that could be used for severe need, as well as data duplication.
CM Sanders suggested that when providers apply for funds would be an opportunity to set up collecting new information.
Cm Pugh cautioned against duplicating data in order to maintain clients’ privacy, and rather than to introduce new fields in Reggie, it was first necessary to get people to be more Reggie-compliant with the data they have.
CM Allgaier mentioned that, since President Bush had emphasized the medicalization of the CARE act in his recent speech, HAPN should register clients to vote.
CM Blum asked about funding scenario recommendations.
Mike Smith explained the recommendation from HAPN. The top tier is not held harmless, deeper cuts to the second and more to the third, but not to the point where it is eliminated.
Cm Hume stated this was the first time hearing a unified voice from providers. CM Hume recommended that more of an interest be taken in Reggie data before adding more fields, for example 20 % of the income fields were “unknown.”
CM Hume appreciated HAPN’s attempt to propose an alternative funding scenario and mentioned as we move more towards an ISM, we don’t want to pull out one service that might be important to the whole network.
Mike Smith noted that agencies who lost staff due to funding cuts would not have the administration to input data into Reggie.

Public Comment
Patrick Monette Shaw suggested introducing a motion that would disallow HAPN from making a presentation, unless it had the support of 100% of providers. HAPN should have addressed the Council before Prioritization.

X. BREAK

XI. Ethical Model for Prioritization Exercise- VOTE
John Golenski facilitated the Council in ranking operational values from the Shared Values and Vision document in order to select a justice paradigm, which will frame the prioritization.
The Council voted to come up with the following shared values (in descending order):
See attachment A, columns 2,3,4.

1. Access
2. Excellence
3. Compassion and Respect

The group voted on which ethical model to use to make decisions in prioritization.

1. Distributive justice (primary)
2. Utilitarianism and Compassion (tied for secondary)

Public Comment:
There was no public comment on this item.

XII. Integrated Service Model Discussion -VOTE

CM Pugh reviewed the history of ISM’s. See handout. CM Allgaier facilitated the discussion and vote on each recommendation.

Public Comment

Patrick Monette Shaw asked the Council to bear in mind conflict of interest.

Recommendation 1:
Integrated Service Models will be called by a new name- Centers of Excellence

CM Perez spoke against the recommendation and commented that even if we move into using an ISM model, there is no assurance that the Centers of Excellence will be excellent until the services being delivered have been evaluated.
CM Geanuracos spoke in favor of the recommendation, but acknowledged the challenges to collecting data on these improved medical outcomes.
CM Pugh spoke in favor of the recommendation and emphasized administration coordination
CM Hume spoke in favor of the motion.
CM Shea called the question.

Public Comment:
Richard Johnson reminded the Council of the importance of Eastern medicine.


? The Council voted. Recommendation 1 was approved.
See Attachment A: Column 5. (24/28 voted in favor).


Recommendation 2
The “ISM Guiding Principles” are to be considered as a base (but not exhaustive) statement for Centers of Excellence.

Cm Durio asked if the recommendations came from the I and P Committee or the ISM Advisory Group.
Cm Allgaier responded that the I and P Committee adopted the rationale and language of the ISM Group, but the guiding principles came from the Planning Council. The motion to adopt the recommendations came from the I and P and Steering Committees.
CM DiCrocco called the question.

? The Council voted. Recommendation 2 was approved.
See Attachment A: Column 6. (27/28 voted in favor)

Recommendation 3
As Centers of Excellence for HIV care in San Francisco are created, the following SFDPH sections should be required to participate in planning as well as provide resources and support to these Centers of Excellence: Community Behavioral Health, HIV Prevention, and Housing and Urban Health.

CM Antonetty spoke against the recommendation. You cannot require community behavioral health and prevention services to comply with the coordination of services.
CM Simmons spoke against the recommendation and expressed concern about who would coordinate services.
CM Shea spoke in favor of the recommendation. DPH is moving towards integrated models, and the different departments need to comply because the movement is going that way.
CM Geanuracos spoke in favor of the recommendation, stating that there are indications from Prevention that this plan will work.
CM Chung suggested that the language could be changed to reflect how the three departments operate under one director.
Cm Hume spoke in favor of the recommendation, with the hope that this plan will work.
Cm Thomas spoke in favor of the recommendation. All three departments have been participating in the planning process through the ISM advisory group. In times of decreasing funds we need to coordinate as much as possible to improve health outcomes for PLWH.
CM Hicks spoke in favor of the recommendation, stating this is advocacy for our patients and clients.

CM Siron called the question.

Public Comment:
Patrick Monette Shaw stated his understanding that it was DPH’s mission to provide access for healthcare for everybody.
A member of the public spoke on behalf of Prevention for Positives and warned against misappropriating funds from the Board of Supervisors.

? The Council voted. Recommendation 3 was approved.
See Attachment A: Column 7. (21/28 voted in favor)

Recommendation 4
The San Francisco Department of Public Health set-aside should be dissolved and all types of organizations (SFDPH, CBO, Universities) be allowed to bid on RFP dollars for ISM and all other services.


CM Conley asked if this recommendation was within the purview of the Planning Council.
CM Hume responded that the Council Co-chairs had met with Jimmy Loyce from the AIDS Office about this matter. They were told that no further discussion or action could be taken on the issue until the Council had made a decision about the set-aside.
CM Geanuracos voiced concern about destabilizing the public health system in the city. The current set aside is a fixed number and it is a percentage of the total award. CM Geanuracos asked to make a requirement for a floor, and take away a ceiling.
CM Allgaier stated that the ISM group did not anticipate that this would affect funding for any particular group. The hope was that it would go to those best able to provide the services.

CM Simmons proposed an amendment to the motion, expressing concern that taking away the set-aside would disrupt services. CM Simmons moved to table this recommendation until it was clear what impact it would have on the DPH budget this year.
CM Conley seconded the motion.

? The Council voted. The amendment to table Recommendation 4 did not carry. See Attachment A, Column 8. (7/28 voted in favor)

CM Byers stated that the Council should provide direction to DPH, whether or not DPH can implement changes is different.
CM Antonetty spoke against the motion, stating there were too many unanswered questions, and that different tables presented were inconsistent.
Michelle Long Dixon stated that DPH could commit to some participation in this model, but could not commit to specific dollar amounts. DPH believes that the providers who contribute to COE’s should be based on the needs of the clients they are serving.
CM Shea spoke in favor of the recommendation. If all the money went out to bid at the same time the monitoring would be public. DPH needs more money to take care of these patients. CM Shea recognized that there are providers who would be competing with the larger DPH who stand to lose money, but the partnerships between CBO’s and DPH were the strongest and most successful ISP’s. If only CBO’s are able to bid on this money, we would lose out on the benefits of the partnerships.
CM Conley spoke against the motion and stated that there would never be enough COE’s to provide for everyone who uses DPH as a place of last resort.
CM Conley would support removing the ceiling while not taking away the floor. Mary Jane Wood in San Mateo County had stated that the history of the set-aside was an agreement about how much CARE money would go to support Union jobs. CM Conley suggested that Council members recuse themselves from voting.
Cm Geanuracos proposed an amendment to the recommendation, that 22% of the set-aside be maintained as a floor for DPH services but that it be removed as a ceiling so that DPH is able to compete with all other service categories, but that total funding would not drop below the current 22%.

CM Geanuracos restated the amendment not using percentages:
Instead of the set aside being dissolved, the current dollar amount received by DPH be a floor not a ceiling for funding overall and that DPH be allowed to compete in other service categories.

CM Blum seconded the amendment.
Cm Geanuracos spoke in favor of the amendment and addressed concerns around care of last resort. CM Geanuracos stated that given the unstable funding in the state, it would be treacherous to take money away from public health.
CM Simmons spoke in favor of the amendment, stating that DPH has done an excellent job, but he fears disruption to the clinics.
CM Allgaier spoke against the amendment, stating that it did not allow a conversation with DPH. The goal on the Council should be to provide the best services to clients, not to secure jobs.
CM Ortiz spoke against the motion.
CM Shea spoke against the motion and stated her conflict of interest. Setting aside 22% will leave only a small amount for COE’s, which is not enough. CM Shea acknowledged that there would be ramifications to eliminating the set-aside, but ultimately they would be for the best.
CM Antonetty spoke against this motion, stating her perceived conflict of interest working for DPH. CM Antonetty commented Council members have asked questions on this issue that still remain unanswered.

Michelle Long Dixon clarified that the AIDS Office monitors programs and determines whether they are good or not. The majority of programs that were funded by CARE dollars were in the commendable category. The rest were in the acceptable category. Most of the services that were funded were good services.
While the AIDS office appreciated the work of the Council and asked for guidance in the direction of allocation, they take recommendations as recommendations. The purview of the Grantee was to implement the direction the Council would like to see things go in.

? CM Siron called the question.
The motion to call the question was approved. See Attachment A, Column 9.

Public comment:

Patrick Monette Shaw stated that there could be consequences for the Grantee taking recommendations and then ignoring them.

? The Council voted on the amendment to the motion.
The amendment was not approved. See Attachment A, Column 10 (13 in favor, 12 opposed).

CM Durio spoke against the original motion, and proposed that the vote to dissolve the set aside be separate from ISM.
The amendment was not seconded.

CM Hume spoke in favor of the original motion, as it supported paradigms of retributive justice and access.
CM Ortiz spoke in favor of the motion, citing the collective support of HAPN.

? CM Pugh called the question.
The motion to call the question was approved. See Attachment A, Column 11.

Public comment:
Patrick Monette Shaw reminded the Council about conflict of interest.

? The Council voted. Recommendation 4 was not approved.
See Attachment A: Column 12. (15 voted in favor, 9 voted against)


CM Conley stated his discomfort with Council members who work for agencies who stand to gain from the recommendation, had it passed.
CM Thomas asked for a chance to respond to this accusation. When all entities are treated the same across the board, there is no potential for a conflict of interest if you are not singling out an agency or putting additional dollars into a service subcategory.
Cm Byers stated that no one needs to recuse themselves when it says “all other services.” CM Byers stated that he was no longer the Council’s parliamentarian, as someone else had provided a training on conflict of interest at the last full Council meeting.

Recommendation 5
Centers of Excellence are to be funded from the ISP sub-category plus a portion of funds from SFDPH, CBO, and University dollars (i.e., from all Title I and Title II dollars within a sub-category) in other service sub-categories as identified in the CoE model. The SFDPH should be allowed to bid to provide services solicited in the CoE solicitation.


CM Byers asked whether COE’s would target severe need but also be available to non-severe need clients.
CM Allgaier stated that COE’s were created for severe need.

Public comment:
Patrick Monette Shaw stated that on matters that are benefiting one’s organization, Council members need to recuse themselves from voting.

? The Council voted. Recommendation 5 was approved.
See Attachment A: Column 13.

Recommendation 6
Because the Planning Council now differentiates between severe need and special populations, Centers of Excellence should serve severe need and special populations as defined by the Planning Council.

CM Antonetty asked if people who were not special populations would be excluded from COE’s.
CM Allgaier responded that targeting special need was not to the exclusion of those people who do not fit those categories.

Public Comment:

Patrick Monette Shaw stated that if the mission of DPH was to serve all of San Francisco, they would need to set up a COE for all the miscellaneous people.
Richard Johnson asked why complementary care was not included as a special population.

? The Council voted. Recommendation 6 was approved.
See Attachment A: Column 14.

Recommendation 7
Program coordination should be funded as an integral part of the new models, including service coordination, organizing case conferences, and ensuring Reggie data entry. A Program Coordinator will be required for each CoE and may be budgeted as a direct expense.


CM Simmons spoke against the motion, as the money requested for network coordination was excessive.
CM Conley spoke against the motion, as it will raise the indirect rate that DPH makes available to CBO’s. This was a cost of doing business that everyone would have to shoulder.
CM Shea stated her perceived conflict of as a member of an ISP and working for UCSF. Network coordination has made a huge difference in organizing the ISP’s. ISM’s will not work without it.
CM Perez spoke in favor of the motion, and has observed a need for coordination.
CM Allgaier spoke in favor of the motion, as there currently were not enough resources for administration and case conferencing.
CM Pugh spoke in favor of the motion. Network coordination was not a luxury; without it, people with severe need would not have care.
CM Geanuracos spoke in favor of the motion.

? CM Blum called the question.
The motion to call the question was approved. See Attachment A, Column 15.

Public comment:
Naomi Prochovnik, Director of TLC, stated that the key distinguisher of ISM’s is the coordination of services rather than parallel services.
A member of the public gave an example at Tom Waddell where case conferencing between providers had ensured that clients got better care.


? The Council voted. Recommendation 7 was approved.
See Attachment A: Column 16.

Recommendation 8
The following services, though not required as part of Centers of Excellence, are essential to taking care of severe need and special populations and should be maintained as well as possible within the community:
– Residential programs: RCFCI’s , supportive housing, transitional housing
– Residential mental health and substance abuse treatment
– Facility Based and Home Based Home Care programs
– Money Management
– Benefits Counseling
– Direct Emergency Financial Assistance

CM Hume spoke in favor of the recommendation, stating that it helped to reinforce the value of all these services.
CM DiCrocco proposed an amendment to include complementary therapies in Recommendation 8.
CM Graham seconded the motion.
CM Byers spoke against the amendment and the original motion, stating that the Council would have to include the whole Prioritization list to the recommendation.

? The Council voted. The amendment did not carry. See Attachment A, column 17.

CM Pugh called the question.

Public comment:
Richard Johnson stated the Council’s behavior showed its Westernization.

? The Council voted. Recommendation 8 was approved.
See Attachment A: Column 18.

Recommendation 9
Funding the new Centers of Excellence subcategory at $6,432,148 or 25.4 % of the San Francisco Direct Services award, whichever is higher using the following budget as a guideline for funding by using the either the dollar amount or the percentage amount- whichever is higher. A part of the money from subcategories primary care, outpatient mental health, and case management will be used to fund $500,000 for network coordination.

CM Pearce stated that 25% of the budget had been pulled to serve severe need from programs that were serving additional populations other than severe need.
CM Allgaier stated that money was left in each subcategory for non-severe need populations.
CM Simmons spoke against the motion, stating the Council did not have enough information and it should have been presented earlier.

? CM Shea called the question.
The motion to call the question was not approved. See Attachment A, Column 19.

CM Thomas spoke in favor of motion. The people who put the budget together put a lot of thought into it and left money for other services. The individuals and money for their services will move from other services into ISM’s.
CM Pugh stated that the information was available to anyone who wanted to attend the meetings for I and P and Steering Committees.
CM Hume stated that the numbers for the budget did not come out of nowhere, but acknowledged that it was a big decision and a shift in the system of care.
CM Hume asked if there was a number of how many people might receive services.
CM Allgaier responded that they did not have that data. They used data from the current ISP’s + 200 (1700) for 50% of what it would cost to serve the same number.
CM Geanuracos spoke in favor of the motion.
CM Antonetty expressed concern about the amount of money in primary care if the set-aside was dissolved.
CM Allgaier responded the Council always makes decisions based on service subcategory. It would be up to DPH to decide how best to work that out considering the set aside.

CM Thomas stated that since primary care is such a focus of ISM, there needed to be additional primary care dollars. The thought was that people were currently accessing care outside of an integrated model, and we wanted to move them into the ISM’s to greatly increase the numbers of PLWH to get their care at ISM’s.

CM Shea stated that there were a lot of functional people using outpatient mental health; therefore, a smaller amount should be taken out of outpatient mental health.
CM Conley stated that even thought the information has been available, the full Council needs more than 2 hours to discuss shifting over $6 million.
CM Shea spoke in favor of the motion, stating that much thought had gone into this recommendation.
CM Pearce stated that he supported COE’s, but that without the empirical numbers for how many people fall into severe need, it was too much of a leap of faith to shift the money into COE’s.
CM Allgaier spoke in favor of the recommendation and of a chronic disease management model, stating that figuring out severe need as a percentage is not the best way because severe need eats up more dollars than other populations.

CM McMurray spoke in favor of the motion, stating that providers who participate in COE’s can also bid for non-severe need dollars.
CM Graham stated she was uncomfortable both discussing allocations before that item came up on the agenda, and that there was a significant increase in the cost per unit but only a small increase in the number of clients served.
CM Graham asked what “more clients” meant.
? CM Allgaier responded that there was only a rough number based on the service subcategory sheets.
CM Graham spoke against the motion.
CM Thomas stated that, based on the information, if we take current cost per client under ISP’s, COE’s could double the 1562 unduplicated clients to 3,046. In addition to existing services, COE’s are adding services:.
CM Sanders stated that there has been an opportunity for participation.

Russ Zellers (AIDS Office) stated that DPH has not yet determined how much money goes toward what category.
CM Antonetty proposed a motion to table voting on Recommendation 9.
The motion was seconded.
The Council agreed to take a dinner break before voting on Recommendation 9.

CM Hume announced that the Council would complete agenda item 13 regarding the Bayview/Southeast Corridor and item 18 regarding Co-Chair nominations. Agenda items 15, 16 and 17 would be postponed to the August full Council meeting at the Mayor’s Conference Room in City Hall, from 4-7:30pm.


Public Comment
Patrick Monette Shaw stated that the ISM discussion had hijacked prioritization, and there was not enough information to base decisions on.
Naomi Prochovnik stated that severe need clients have a higher cost in the system right now.
A member of the public representing the API Wellness center stated that ISM will be a lifesaving model that addressed the acuity of need.

DINNER BREAK

CM Perez called the question.
? The Council voted. Recommendation 9 was approved.
See Attachment A: Column 20 (19 out of 27 voted in favor)


XIII. Southeast Corridor of San Francisco
(Bayview/ Hunter’s Point) Motion & Proposal from
Community Outreach & Advocacy Committee-VOTE

CM Geanuracos presented the following motion from the Outreach & Advocacy Committee:
If the ISM’s Centers of Excellence model and budget are approved by the full Council, a set aside amount of $1.7 million will be dedicated to creating a Center of Excellence in the Bayview Hunter’s Point’s/Southeast Corridor of the City, and the attached proposal will be used as a baseline service model for that area, with the addition of neighborhood level medical evaluation data.
See handout.

CM Geanuracos stated that the model would include more attention to case finding, would be more integrated into primary care, would allot additional money for peer education, and would try to overcome a systemic history of racism in healthcare.
CM Allgaier stated that there was currently no CARE funding in this neighborhood.
CM Geanuracos cautioned against overspecifying and limiting which CBO’s could respond to the solicitation.
CM Byers asked if this COE costing $1.7 million would be different than other COE’s.
CM Durio clarified the general geographic area the COE would serve: outer Mission, Excelsior, Bayview, essentially everything South of Highway280.
CM Shea expressed concern about having $400K of state money in the Bayview, and stated that the AIDS Office would need to help bridge the state money with the federal money that would go into the Bayview.
CM Pearce asked about the numbers the COE would be serving, stating that the report indicated 150 individuals from the report. CM Pearce stated that this was too large a percentage for too few people.

CM Hume stated that the Council needed to do something in the Bayview, but he expressed concern about the proposed.
CM Simmons stated that starting programs was expensive, and that it was critical to support this motion, as the African American community had been disproportionately affected. This proposal would begin as a pilot program and later be evaluated.
CM Sallee asked how much prework would be required for infrastructure development.
Michelle Long Dixon stated they would need to set up Reggie data collection.
CM Sallee spoke against the motion, stating that the capacity building was under-funded in this scenario. CM Sallee recommended putting Title 3 planning process dollars into doing the groundwork.

CM Allgaier proposed an amendment to the motion to set aside $1.7 million for the Southeast Corridor COE, minus the amount, $400K, currently funded by the state for early intervention programs, and the COE be tied into work of early intervention program already in existence in the Bayview.
CM Shea seconded the amendment.

CM Miller spoke against the amendment, stating that it was important that the money needed in that neighborhood stay there to fund programs.
CM Byers spoke against amendment and against the motion, stating that he was against allocating dollar amounts before that item on the agenda. CM Byers suggested directing the AIDS Office to establish a COE in the Bayview, then to let the AIDS office figure out the funding scenario for it.

CM Chung stated that there was a crisis in the Bayview, where whole families infected with the virus do not show up on EPI data, and where homelessness is invisible.
CM Sallee advocated funding support to get the project started, but that it was unreasonable to expect to start a COE within 6 months.
CM Sallee spoke against the amendment that would take out money already in neighborhood.
CM Durio spoke against the amendment, stating that the service area was a lot bigger than just the Southeast Corridor. Many people do not show up on the data who might have a zip code in Oakland but their time was spent in San Francisco, or those who have just come out of prison. CM Durio stated he knew many people in the neighborhood who were infected and not in care.
CM Simmons spoke against the amendment.
CM Ortiz spoke against the amendment and in favor of the motion. This population needed the service and attention from the Council.
CM DiCrocco spoke against the amendment and in favor of the motion.

Michelle Long Dixon explained that there is usually a 3-year start up period, and most programs did not use all their money. The leftover money would come back and be reallocated, then the AIDS Office would make a recommendation.
Michelle Long Dixon stated that it was inappropriate to tie funding to a different provider, as most programs have other providers, and the state may or may not continue to provide funding.
Michelle Long Dixon stated that individual agencies should not leave flyers advertising their organizations at prioritization.
CM Thomas apologized for leaving flyers about the Southeast Health Center that listed existing services provided in the Bayview. CM Thomas stated she was strongly in favor of putting additional services into the Bayview, but to build on existing capacities and strengths and ensure that the services were accessible to the African American community in San Francisco overall. CM Thomas expressed concern that the early intervention program in the Bayview was not at capacity.
CM Geanuracos spoke against the amendment and in favor of the motion, which could forestall an epidemic in African American communities that was occurring all over the east coast, and beginning in Oakland and East Palo Alto. The COE would be an investment in this community.
CM Allgaier withdrew the amendment and stated that the Council did not get complete information about the systems of care already in place.
CM Chung warned the Council about assuming expertise in a culture that was foreign to many.

CM Byers proposed an amendment to the motion that would take away any dollar amounts and reads:
The Planning Council directs the AIDS office to have an RFP that calls for a COE model in the Bayview/Hunter’s Point Southeast Corridor, that will include the attached proposal be used as a baseline service model for that area, with the addition of neighborhood level medical evaluation data.

CM Perez spoke against the amendment.
CM Pearce spoke in favor of the amendment, stating his support for the African American community, but his discomfort with the dollar amount.

CM Siron called the question on the amendment.

Public comment:
Patrick Monette Shaw stated his discomfort with the Council advocating for a dollar amount to one area of the city.
Richard Johnson stated that the African American community is not just in the Southeast.
Marcia Herring stated that no one from the Council had asked for more information regarding the Bayview/Hunter’s Point report and proposal, which she would have provided upon request.
Brett Andrews encouraged the Council to have a clear understanding of what makes up African American culture, and of the necessity to allot CARE funds to this community.

? The Council voted. The amendment did not carry. See Attachment A, column 21.


Public comment: (on the original motion)
John Golenski spoke in favor of the motion, stating that the epidemiology shown only measures perhaps 1/5 of those infected. The community needs resources and is not adequately financed.
Patrick Monette Shaw stated that $1.7 million may be too much, but it followed a retributive justice model.

? The Council voted. The motion was approved.
See Attachment A: Column 22.

XIV. Subcategory Ranking in Order of Priority – VOTE
This item was postponed until the August Full Council meeting.

Public Comment

XV. Allocation to Subcategories-VOTE
This item was postponed until the August Full Council meeting.


Public Comment

XVI. Funding Scenario Discussion - VOTE
This item was postponed until the August Full Council meeting.


Public Comment

XVIII. Open Nominations for Co-chairs
The Co-chairs opened the nominations for Council Co-chairs for the next term commencing in October 2004.
CM Sallee announced that neither herself nor CM Hume would be accepting nominations.
CM Conley nominated CM Booker, who was not present to accept the nomination.
CM Flood nominated CM Allgaier. CM Allgaier accepted the nomination.
CM Sanders nominated CM Siron. CM Siron accepted the nomination.
CM Ortiz nominated CM Sanders. CM Sanders accepted the nomination.
CM Soto nominated CM Blum. CM Blum declined the nomination.
CM Thomas nominated CM Pugh. CM Pugh accepted the nomination.

Public Comment
There was no public comment on this item.

XIX. New Business
CM Durio proposed a discussion about the process of prioritization at the next full Council meeting.

Public Comment
There was no public comment on this item.

XX. The meeting adjourned at 8:40pm.

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

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