HIV Health Services Planning Council
City Hall, Mayor’s Conference Room (Rm. 201)
1 Dr. Carlton B. Goodlett Place
October 25, 2004
4:30 PM - 7:30 PM
DRAFT MINUTES

I. Call to Order

II. Roll Call

III. Review and Approval of Agenda

The agenda was reviewed and approved.

IV. Review and Approval of Minutes- September 27, 2004
The minutes from the September 27, 2004 Council meeting were reviewed and approved.

V. General Announcements
CM Sparkie Spaeth reported that the Marin Planning Council had their second Council meeting. Members will be attending the SF Council meetings to familiarize themselves with the process.
See CM Spaeth for more information on the Marin Planning Council.
CM Allgaier reminded Council members that only 2 committees had reached quorum this month, which is not sufficient attendance for committees to do their work.
CM Durio reminded Council members that there is an open seat on HOPWA Loan Committee that the Council needs to fill. If interested, contact CM Durio or Leah Crask.

VI. Public Comment
Patrick Monette Shaw stated that the announcements regarding meetings did not go out properly. He urged Council members to support the LHH, and to visit the website: www.stoplhhdownsize.com.
Dorothy Klefner stated that in Marin County, she cannot attend a support group, unless she is in full-time case management.
Raymond Banks read the following letter from Oshun Center to the Planning Council:
Unfortunately we at the Oshun Center are unable to be with you today, however we did want our comments to be heard.
As we already know, Black Women with HIV have great difficulty accessing health care. If we make access easier, such as having clinicians that are culturally competent and culturally sensitive available to our women, perhaps we would have more women accessing services and being provided a better standard of living, as well as being able to make informed decisions.
Furthermore, Black Women need to become empowered in regards to health education, not just have certain fragments of information thrown at them. A more comprehensive and cohesive approach is needed using African American mentors, peers, and instructors.

VII. Meeting Introduction
Council Co-chairs
*Planning Committee Prioritization Topic
The Co-chairs reviewed the Council by-laws section regarding voting, as well as basic meeting principles.

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

VIII. Funding Scenarios
Council Co-chairs
*Planning Committee Prioritization Topic
The Council discussed the funding scenario proposals. See handout.
CM Allgaier reviewed some of the principles behind this proposal:
All categories share cuts; refunded categories get the largest cut; categories may be eliminated from the bottom up; COE’s are not held harmless.
The following are not included in the calculations for these funding scenarios: San Mateo and Marin counties, DPH, or MAI.

CM Thomas presented an algorithm for the reduced funding scenarios.
See handout.

The Steering Committee presented motions for discussion.

Motion 1 (please see attached budget):

Decreased funding

In the case of a 5 % cut, Center’s of Excellence (COE’s) would be cut by 2.5%, everything else would be cut by 5%, except for the categories that have been refunded. Those categories would absorb a 10% cut, and category 22 (Outpatient Substance Abuse) would be eliminated.

In the case of a 10% cut, COE’s would be cut by 5%, everything else would be cut by 10%, except for the categories that have been refunded. Those categories would absorb a 15% cut, and categories 22,20,19, would be eliminated.
See handout.

CM Pugh asked for a definition of main service categories.
CM Thomas responded that main service categories were not COE categories and not refunded service categories.
CM Ortiz stated his discomfort with losing categories, after such an arduous prioritization process to preserve categories.
CM DiCrocco agreed with CM Ortiz, as defunding categories creates a disruption for clients and agencies.
CM DiCrocco proposed a motion to amend Motion 1, which would cut numerically from the bottom, rather than go by refunded categories (e.g. 22, 21, 20).
CM Allgaier responded that Category 21 was not a cut and refunded category.
The motion was not seconded.

CM Durio asked why category 22 would be eliminated rather than reduced.
CM Allgaier responded that it would not add up to enough money.
CM Allgaier stated that Motion one did not include the algorithm/principles handout.

Public Comment on this item
Patrick Monette Shaw stated that that the discussion of principles did not include the ethics discussion led by the Council’s consultant during prioritization.

• Roll Call Vote. The motion did not pass. See Attachment A, Column 2. 10/17.


CM Thomas proposed an alternate motion.

Motion 2
Motion to use the algorithm funding scenarios (see handout), but to not eliminate categories, and reduce only by percentages (Cross out 2d, 3g, 4g on handout).

The motion was seconded.
CM Allgaier spoke against the motion, stating that categories would be eliminated because they would be decreased by too much of a percentage. Category elimination is inevitable in the event of a cut.
CM Pugh spoke against the motion, stating that service programs prioritized at a higher level will also be hurt if the Council does not defund some of the less prioritized services.

Russ Zellers (HIV Health Services) stated that the categories had been refunded by taking the average cost of previous programs. If too much is cut, it would not be possible to distribute funds.
CM Booker spoke against the motion because it would hurt COE’s.
CM DiCrocco spoke in favor of the motion, stating it was easier to ask service providers to run a program with less money, rather than to cut it altogether.
CM Sallee spoke against motion, stating that is was easier for providers to plan for if they knew their programs might be cut.
CM Durio stated that if the Council eliminate categories, it should use the priority order.
CM Hicks spoke against the motion, stating that proporitional cuts weakens the whole system. The group should follow its priority order.

Public Comment on this item
Mike Smith observed that the Council was equally split between the first and second motions, and warned against continuing that process.
Patrick Monette Shaw stated that there was not enough discussion about the number of clients who would be affected.

• Roll Call vote. The motion did not pass. 11/17. See Attachment A, Column 3.

CM Sallee proposed a motion.

Motion 3
Motion to continue to maintain same cap on percentage cuts (according to algorithm) which would remain the same in terms of how it would affect all categories (COE’s, main categories, and refunded categories). But in the case of elimination of service categories, 2d, 3g of the algorithm funding scenario (see handout) would start in priority order, from the bottom up.

The motion was seconded.

• Roll Call vote. The motion passed. (17/17 in favor) See Attachment A, Column 4.

Motion 4
INCREASED FUNDING SCENARIO
Any funding increase would give a proportional increase to every service category, except for COE’s, which would receive no proportion of the increase.

• Roll Call vote. The motion passed. See Attachment A, Column 5.


X. Budget for Inclusion with the 2005-2006 Grant
Application- VOTE

Robert Whirry, the grantwriter for HIV Health Services presented the budget to be included in the 2005-2006 HRSA grant application.
A motion was made to approve the budget for the HRSA grant application.

Motion to approve an 18% increase to the Council’s overall budget to be applied to all service subcategories across the board. Any changes would affect all categories proportionally.

The motion was seconded.

Public Comment on this item
Patrick Monette Shaw stated that COE’s needed to be included in any proportional increase.


• Roll Call vote. The motion was approved. See Attachment A, Column 5.

XI. Council Structure Evaluation Report
Randy Allgaier, Evaluation Committee
CM Allgaier presented the results from the Council Structure Evaluation.
CM Hicks stated that the survey does not reflect the hard work of all the volunteers on the Council.
CM Durio objected to an implication he felt came from Section 2, Recommendation 7 regarding commitment and attendance, which stated that those Council members who did not respond to the survey were less committed to the work of the Council. CM Durio stated this implied that since only 1 African American Council member responded, it showed less of a commitment to the work of the Council from African American members, which was inaccurate.
CM Allgaier responded that the statement was made only about those who did respond, not about those who did not respond.

Public Comment on this item
Raymond banks recommended that the Council have a better structure for public input.

XII. Council Strategic Work Plan Development
Council Co-chairs and Jack Newby, Planning Council Director

Jack Newby presented the plan to develop a Council Strategic Work Plan.
CM Allgaier commended Mr. Newby on his hard work.

Public Comment on this item
Raymond Banks observed that he felt the behavior of the Council was inconsistent with its legislative requirements, regarding recruitment and training.

IX. Dinner Break

XIII. Open Nominations for Prevention with Positives
Representatives
Council Co-chairs

The Council Co-chairs opened nominations for official Council representatives on the Prevention with Positives Committee. The members nominated will report to back to the Council at the Community Outreach & Advocacy Committee.

CM Thomas nominated CM Pearce.
CM Booker nominated CM Blum.
CM Sallee nominated CM Siron.
CM Durio nominated CM McMurray.
CM Allgaier stated that the Council will proceed with its responsibilities for nominations and then check with Prevention about further responsibilities on their end, and report back at the next Council meeting.
Nominations are open until the next Council meeting.

XIV. December Council Meeting- VOTE
CM Pugh made a motion that the Planing Council not hold a meeting on December 27th, 2004.
The council voted. The motion was passed.

Public Comment on this item

XV. New Business/ Next Agenda
CM Thomas proposed to update the Council on the CARE Act at the federal level, and the status of the re-authorization of the CARE act.
CM DiCrocco encouraged Council members to write letters to Senators Spector and Tarkin regarding fully funding ADAP.
CM Sallee recommended that Jeff Sheehy, the new HIV/AIDS Policy Advisor for the Mayor, should introduce himself to the Council.
CM McMurray voiced concern about the lack of quorum at committee meetings and the problems with electing co-chairs.
CM Booker requested a date be set for the Steering Committee retreat as soon as possible so that people can plan ahead.
CM Blum stated that Prevention With Positives would present a slide presentation to the Council at the next meeting.
CM Durio requested a discussion to evaluate the prioritization process.

Public Comment on this item
Patrick Monette Shaw stated that Jeff Sheehy should be actively involved in the prioritization process.

XVI. The meeting adjourned at 6:55PM

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

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