I. Call to Order
Co-chair Allgaier called the meeting to order and asked Council Support to
call roll.
II. Roll Call
Council Support called roll. [See Attachment A, Column 1]
III. Review and Approval of Agenda
Council reviewed the agenda for today. There were no objections and it was
approved by consensus.
IV. General Announcements
No general announcements.
V. Public Comment
Tracy of Maitri Hospice – reminded Council that they are the only agency
providing psychosocial services for people who need hospice care. She implored
the Council to leave this service at the current priority level and to protect
this service and program.
No other public comments.
VI. Introduction and Review of Previous Day
Facilitator will provide an overview of the previous day meeting, review rules
and logistics. Council Members will introduce themselves.
Co-Chair Allgaier turned the meeting over to the facilitator, Susan Strong.
She began the meeting with general comments about the previous day’s
experience.
CM Byers clarified some of his findings.
CM Hicks indicated that the experience was very helpful.
CM Allgaier found that the small groups was very useful, and heard some things
he hadn’t heard before. He thanked Planning Committee and Council Support
for putting together the day’s work.
CM Antonetty wondered if everyone got rebellions and revolt out of their system
last year, and pleased with the way everything went yesterday, the way people
listened to each other. No longer feeling bad about spending a Saturday here.
Susan directed Council Members to the evaluation of yesterday’s meeting. Overall it was a very positive evaluation in all aspects. She indicated that another evaluation is provided for today to get feedback so the Planning Committee can plan next year’s process.
Susan had everyone pull out their drawings from yesterday, what they hoped to feel like at the end of today’s meeting. She went around the room and asked Council Members to state what they hope to feel like at the end of the day.
CM Ortiz – happy
CM Soto – hope to feel done
CM Thomas – hope to feel relieved
CM Hicks – hope to be done
CM Callandrillo – process complete
CM Simmons – want to be calm
CM Hicks – smiling and content
CM Smelcer – content
CM Graham – content
Kanios – done
Anderson – complete
Booker – I feel good!
Allgaier - happy and at peace
Pugh –happy and at peace
Blum – part of a well working team
Sweetin – resolve
Byers - satisfaction
Benham - resolve
Miller -We did it!
DiCrocco - Big muscles and a crown
Kelffner – satisfied
Flood – a heart
Spaeth – relieved and released
Banks – victory over defeat
From here, Susan energized the Council in an exercise and gave direction in the goals and process planned for the day. She asked anyone had questions. There were none.
Public Comment on this item
No public comment.
VII. Conflict of Interest Disclosure by Council Members
Council Members declared their conflicts or perceived conflicts of interest.
Public Comment on this item
Patrick Monette Shaw, stated he has no conflicts of interest. But as he testified
in previous years, he stated that the conflicts of interest policy is in need
of change, to expressly prohibit voting on item when there is a conflict of
interest. He concluded by saying indicating the quicker that change is made,
the quicker he will quit harping on the subject.
VIII. Break [break was delayed since the meeting was ahead of schedule].
IX. Review of Initial Prioritization Determinations
CM Thomas reviewed the analysis of the tallies from yesterday’s priority
rankings.
She indicated that after the meeting, the rankings were averaged and the results
are provided for Council Members to review (document on file at Council Support
Offices).
CM Thomas asked if there were any questions.
Public Comment
Patrick Monette Shaw commented that it was not clear that individual votes
were noticed on the priorities. That way it would be easier to compare to
last year and see how things are being changed around. He added that the
Council needs to be more aware of how they are conducting the meeting.
X. Prioritization Recommendations, Review & Discussion VOTE
Planning Co-Chairs, Laura Thomas and Don Soto will present recommendations
from the Planning Committee regarding prioritization. Council Members will
discuss.
CM Thomas indicated that there was a written proposal coming from Planning
Committee and does not need a second:
The Planning Council should accept the group average priority order for service
category prioritization for FY 2006/2007.
CM Banks stated that one category should be down and one should be up.
CM Thomas indicated that there can be discussion on proposal number one. If
anyone believes that the order is inappropriate, someone can speak against
the proposal or make amendments. As a reminder, Robert’s Rules of orders,
once an amendment is on the table, a new speaker list is made, then a vote
on the amendment. If the amendment passes then it goes on as amendment. If
it doesn’t pass then back to the initial proposal.
Open for discussion on the motion as presented.
CM Simmons spoke against the motion as presented. Disagree with ranking of
number 5 – OHC, and feels outpatient substance abuse and Client Advocacy
should be higher.
CM Hicks spoke against – feeling substance abuse needs to be higher
Pearce – disagrees with ranking as well, but if the group starts on road
of changing one, it will be a long road of changing them all to appease everyone’s
needs. This is long thought out process, and needs to be given consideration.
CM Siron called the question to vote on the stated proposal.
CM Kanios seconded.
Show of hands, not in favor of calling the question.
CM Ortiz agrees with CM Pearce about quibbling about the specifics of each category ranking. If we do this, will be here all day. It can be a simple process.
CM Pugh added her support of the motion. This is why everyone listed their priorities and this is how it came out. It’s not exactly what individuals wanted, but reflects the group. Can nitpick all night and then meet again tomorrow, and never get to funding. Allocations do not have to be done in priority order. They are totally separate processes.
CM DiCrocco spoke in favor of the motion. He added that they are not his personal priorities, and certain priorities do not need to be funded. Last year this process took several months.
CM Hicks commented on the importance in recognizing the difference between
prioritization and allocation. It can feel different to separate. She stated
that she is nervous about the situation, but has been through several years
of struggles and should respect different services need to get more attention
than is reflected on the list. She withdrew her disagreement with the motion.
She agrees with democracy.
CM Simmons withdrew his objection to the motion, and echoed CM Hicks’ comments.
Did not vote to call the question, because there needs to be a reasonable amount
of time to discuss the issues.
CM Allgaier spoke in favor of the motion, and surprised that substance abuse
on the list as high as it is. Not everything is how he personally wants it,
but we are not here to satisfy personal desires.
CM Callandrillo in favor of the current ranking, but concerned about some of
the placements, such as outreach which is low on the list and will be difficult
to find an argument to move it from 18 to 3. He suggested others provide a
sufficient explanation to convince him to change if they want something higher
on the ranking.
CM Banks indicated that he has used practically every service on the list,
he’s not thinking about getting his teeth done, he is more concerned
about mental health or substance abuse services.
CM Ortiz added that everyone could comment and then get more comfortable with
the decision. Don’t want to rush through the process, suggested open
mic and deal with it to go on to the vote.
CM Banks suggested that if someone is trying to get their life together and
get off the streets, the priorities need to be looked at closer.
CM Siron pointed everyone to the priorities from last year in the binder. He
indicated that if there is no more questions or comments, he is calling the
question to vote on accepting the group average priority order.
CM called the question.
CM DiCrocco seconded.
Anyone opposed to calling the question; NONE
Public Comment
Patrick Monette Shaw indicated that he compared the pink sheet of this order,
compared to last year’s and wants to know what happened to COE category.
He thinks it is sad the Council is moving to group averages, and has gone
from ethical decision making to averages.
Naomi from Continuum and HAPN, commented regarding the distinction between prioritization and allocation. This is voting on the order of the most important categories. HAPN made a recommendation that when making allocations that consideration be given to other funding streams, and others are limited in scope. Potentially a category low on the list could get CARE funds, but one much higher has access to other funding, since CARE is the fundor of last resort may not fund as much. This is a list of priorities valuable to clients. She suggested the list is accurate.
ROLL CALL VOTE on motion: The Planning Council should accept the group average
priority order for service category prioritization for FY 2006/2007. Unaminous.
The motion carried.
[See Attachment A, Column 2]
CM Thomas suggested taking the break now and returning from break move to
Item XIII.
Council Members were in agreement.
BREAK MOVED TO HERE.
After returning from break: three quick items:
Co-chair Allgaier clarified the PROXY issue. First, only people living with HIV are allowed to give a proxy. HRSA does require it. Proxy are allowed in two ways, one specific for votes to tell someone how to vote for you, or tell that person to vote their conscience for you.
CM Hicks reminded about Rules of Engagement, and that no repetition of the same idea. With several people telling the group about the difference between prioritization and allocation takes up too much time from discussion and condescending to repeat explaining things that everyone knows.
Co-Chair Siron reminded people about recycling in the room.
Susan reminded everyone that we are here to get the work done. If by 6:00 the
work is not done, the Council will decide at that point how to proceed. She
suggested everyone relax and try to have a good time.
XII. Continued Prioritization Determination and Vote
Council Members will continue their prioritization discussions and vote on
service category priorities.
[This item not needed as the prioritization determination was decided in previous
agenda item].
XI. Lunch
[group moved on to the next agenda item since they were ahead of schedule]
XIII. Beginning Funding Allocations Discussion - Vote
The Council will begin to discuss funding allocations, including distinguishing
a top tier and bottom tier of service categories.
CM Thomas indicated that the Planning Committee has forwarded a proposal and they are putting it forward as a motion:
The Planning Council should use service tiers for resource allocation, identifying top tier and bottom tier services for essential and non-essential service categories. This will be done on the local subcategory level. Top tier means the most essential, most important to fund with CARE dollars. Bottom tier means important, but not essential or less necessary to fund with CARE dollars.
CM Thomas mentioned that there had been the new subcategory voted on yesterday
that had been added.
CM Pearce asked if there is a list regarding the local subcategories in the
priority order that has been decided.
CM Thomas indicated that Dean Goodwin of the AIDS Office has this information.
It is in the priority order that has been decided on.
CM Banks asked where the cut off is between the tiers, and asked whether it
is influenced by money.
CM Thomas advised that it works the other way around. If tiers are agreed on,
then tiers can be used in resource allocation, Tier 1 can be cut less than
tier 2, or vice versa. It is designed as a tool in the funding decisions.
CM Hicks suggested that this may be a way to bridge the concern between prioritization
and allocation. Even if funding is not provided in a descending order, funding
is being protected for service categories that are prioritized. She speaks
in favor of the proposal.
CM Callandrillo not opposed to tiers, but wants more dialogue to understand
why prioritization doesn’t become allocation. If there is a cutoff on
what is prioritized, there needs to be some explanation.
CM Pugh spoke against the motion, saying she would feel more comfortable being
able to fund things and consider outside funding sources. If not tiered, funding
levels can be chosen and funding scenarios in the event of cuts. If tiered,
it feels as if prioritization and allocation has been done at once.
CM Molnar agreed with CM Pugh, and expressed having problems with something
being held harmless and spoke against the motion.
CM Thomas explained that there are certain service categories that may be important to clients, but that it may not need to be funded as much with CARE dollars, since there are other funding streams, and other items more important. Some are expensive per person and the Council may want to put more money into something lower on list, and less money into something higher on the list. It is important to disconnect the priority setting from the allocation process. The Council has used priority order in the past to fund categories (or defund from the bottom up). She explained how there had been resistance to this in the past and agreement to avoid do this in the future.
CM Allgaier expressed mixed feelings on the issue of tiers. Looking at different
categories within the COE services, how to reconcile things higher on the tiers
that are mixed into the COEs and questions how that will work.
CM Ortiz referred Council to the notes from the HAPN presentation that suggested
no category be held harmless. In the situation of tiers, one may be held harmless
and others subject to higher percentage of cuts. If cuts happen, HAPN prefers
cuts across the board.
CM DiCrocco opposed to the motion, because he prefers to have freedom to decide
how much funding goes into each
CM DiCrocco called the question.
Seconded.
Opposition to calling the question.
VOTE TO CALL QUESTION: 14 in favor/13 opposed. Motion to call the question
does not pass because of the 2/3 rule.
CM Blum suggested a structure to chunk the categories to help move forward,
not to move things in or out of the prioritization list.
CM Byers stated uncertainty about the Planning Committee’s rationale
for bringing this motion forward. He asked for clarification.
CM Thomas indicated that the intent was to provide a tool as the Council proceeds
through funding scenarios to treat categories differently. What needs to be
done the remainder of the day, is to develop a level funding scenario, and
a decreased funding scenario to respond to different percentages of cuts. This
could be easier if service categories are identified into different tiers.
This had been originally defined as core and non-core services as defined by
HRSA. This is a way to get there. If people feel the tool will not make the
decisions easier, then it does not have to be used.
CM Booker spoke in favor of the proposal for tiers. We will get nowhere if
we don’t start somewhere. Otherwise we will get stuck.
CM Simmons indicated that he participated in the conversation at Planning Committee,
and suggested the committee wanted a base to begin with for essential services
funded by Title I money, and will help direct how to do the funding scenarios
later.
CM Byers stated that in general he is favor of the motion. He suggested that
the ability to respond in the application and comprehensive plan regarding
core and non core services.
CM Pearce indicated that he also participated in the Planning Committee discussions
that went round and round. He echoed CM Byers concerns about making tiers,
it is deciding essential services. Not saying that “non-essential” is
not needed, but what has to be retained in the worst-case scenario in the event
of severe cuts.
CM Anderson called the question.
CM Siron seconded.
No opposition to calling the question.
Public Comment on this item
Patrick Monette Shaw commented on the tiers and holding harmless. He stated
that the Council is here to represent the consumers’ needs and unmet
needs, rather than the wishes and whims of providers.
Bill Hirsh with ALRP and HAPN. He reminded that HAPN suggested not eliminating any service categories, and not to repeat what happened last year which eliminated service categories. Higher ranked services should not get hit as hard as lower ranked categories, and HAPN could not agree on what that should be.
Motion restated:
The Planning Council should use service tiers for resource allocation, identifying
top tier and bottom tier services for essential and non-essential service
categories. This will be done on the local subcategory level. Top tier means
the most essential, most important to fund with CARE dollars. Bottom tier
means important, but not essential or less necessary to fund with CARE dollars.
ROLL CALL VOTE on tier proposal: 24 in favor/5 against. The motion carried.
[See Attachment A, Column 3]
CM Thomas explained that now there will be discussion on how to decide where the cut-off will be for tier one and tier two.
CM Callandrillo suggested looking at the things they want to fund it looks
more manageable. Not tiering on essential services – but rather what
is essential for CARE to fund as there may be other funding sources and it
is important to keep this in mind.
CM Banks indicated that he feels some categories overlap and it is difficult
to determine where to draw the line.
CM Byers agreed. He asked for clarification about the exercise to determine
the tier cut off line.
CM DiCrocco indicated that there were three essentials: medical, housing and
food. He suggested these categories in the top tier and everything else in
the second tier.
CM Allgaier added that tiering is not ranking within the tiers.
CM Durio asked for clarification about how many tiers can be used.
It was agreed that the motion specifies only two tiers (top and bottom).
CM Antonetty – expressed a concern that many different terms are being
used to express the same thing. When deciding on the tiers, the category ranking
stays the same. She also added that side conversation is distracting from the
group discussion.
CM Molnar added that his ranking of service categories will be guided by HRSA’s
core services and essential components of the COEs.
CM Simmons asked for a process item regarding how to put the tiers on the paper.
Susan clarified that after individuals set their tier cut off, a break will
be taken, the results will be compiled and the group will return.
CM Graham – Are we ranking tiers of what is an essential service? Or
what is essential for CARE to fund? What is the amount column supposed to do?
CM Thomas indicated that the amount column is for a later exercise. If people
want to move dollars around that can be done later. The proposal indicates
that the top tier is for the service categories most essential to fund with
CARE dollars.
Russ Zellers explained the difference between case management and integrated
case management.
CM Kleffner expressed continued confusion and wanted clarification about how
to do the ranking.
CM Thomas explained that it can be with a simple line or the subcategories
can be ranked individually, as they are being ranked on the local subcategory
level.
CM Banks asked if considering payor of last resort influences the ranking and
tiers.
Council agreed that it does.
Russ asked for clarification on the subcategories, and stated that some of
them are not local subcategories. He identified professional and paraprofessional
home health as HRSA categories.
Michelle suggested that there are too many lists and people are getting confused.
CM Soto asked if anyone had a copy of last year’s list regarding essential
services to COEs.
CM Thomas clarified the concern. The service subcategories used in past regarding
home health care (residential and home-based home care). HRSA doesn’t
recognize these and uses professional and paraprofessional. Could create four
different categories, but the AIDS Office recommends using home based and facility
based instead of professional and para professional so the AIDS Office can
make the connection between what the Council is allocation to the HRSA categories.
These are the same categories used last time and works better with the AIDS
Office. Council Members were instructed to cross out professional care and
write in facility based, cross out paraprofessional and write in home-based.
LUNCH BREAK 12:30 PM – Group to return at 1:00.
Susan indicated that the tiering count was completed.
CM Thomas explained. Due to one Council Member proxy vote unavailable, 19 votes
is a two-thirds majority approved
Informal written votes tallied for separating service categories into Tier
I and Tier II
Tier I:
Ambulatory outpatient Care
Emergency Housing
Transitional Housing
Residential Programs and Subsidies
Crisis M|H
Outpatient MH
Residential MH
Oral Health Care
Case Management
Substance Abuse Residential
TIER II:
Home Health: Home-based
Complementary Care
Legal Services
Day Respite Care
Child Care
Transportation
Outreach
Buddy/Companion
Planning Council Support (required)
Quality Management (required)
This left a set in the middle where there was a split without a clear majority, with these service categories.
Food
Benefits Counseling
Money Management
Emergency Financial
Home Health: Facility
Integrated CM
SA Detox
SA Outpatient
Treatment Adherence
Residential CM
CM Antonetty expressed a concern about Residential CM being a new category that some may not have written it in or because it was at the bottom of the list that many decided not to rank it. The vote for Residential CM was 17 in Tier 1, 8 in Tier II indicating 25 voted for the category.
CM Allgaier made a motion to accept Tier I and Tier II as chunks notwithstanding
the others undecided.
CM Kanios seconded.
Discussion:
CM Durio expressed no support for the motion and would rather wait to vote
until each category has been decided.
CM Antonetty spoke in favor of the motion since they seem like clear cuts.
She doesn’t want to get sidetracked.
CM Pugh spoke in favor of the motion.
CM Banks spoke as a consumer and disagrees with the entire list and would like
more discussion, and spoke against the motion.
CM DiCrocco spoke against the motion, and disappointed that Residential Substance
Abuse is so high and indicated that if CARE completely de-funded this service
it would still survive as a service due to other funding streams.
CM Kanios expressed a conflict of interest, because she works with substance
abuse services. She explained that it would be helpful to have this service
better funded, because it allows quicker access to the service and prevents
relapse and homelessness.
CM Hicks spoke in favor of the motion. The two tiers have been decided on by
the group. If other funding is available for Tier I items it should be taken
into consideration.
CM Anderson spoke in favor of the motion for the same reason as CM Hicks. He
called the question.
CM Booker seconded.
No opposition to calling the question.
Public comment
Patrick Monette Shaw described the waiting list at Laguna Honda, and the closing
of ADHC at Continuum, the Council has a responsibility of moving ADHC into
Tier I. He said it would be a huge mistake to keep in Tier II.
Hersch of ALRP suggested three tiers. In the past there were three tiers for ranking. It is important for the later funding scenarios discussion.
ROLL CALL ON MOTION – to accept Tier I and Tier II as written and agreed to by the list compiled. 24 in favor/5 against. The motion carried. [See Attachment A, Column 4].
CM Blum made a motion that items on the undecided list, any with 17 or 18
in Tier I is put into Tier I, and anything with 17 or 18 put into Tier II.
CM Sweetin seconded.
CM Byers spoke against the motion and proposed an alternate motion. He suggested
giving the majority of each category undecided – be put into the tier
with the most votes.
CM Ortiz seconded CM Byers motion.
Discussion on CM Byers motion.
CM Pearce spoke against the motion. With this getting so close to the middle
it causes distress.
CM Simmons spoke against the motion. He prefers the first motion proposed by
CM Blum.
CM Allgaier spoke against the motion. The decision is made on 2/3rd vote, if
decision is based on majority, it is not in keeping with the way the Council
makes decisions.
CM Hicks was originally in favor of the motion, and now is against the motion.
CM Banks agrees with CM Pearce, using Emergency Financial as an example that
would be in Tier II.
CM Byers, hearing no support for his motion, withdrew his motion.
Returning to CM Blum’s motion:
If an item on the mixed list receives a 17 or 18 on Tier I or Tier II, it will
be placed on that respective Tier.
CM Simmons spoke in favor of the motion.
CM Pugh asked what happened with the others without a 17 or 18. It was agreed
that those would be discussed later.
CM Pearce spoke in favor of the motion.
CM Blum repeated his motion: Anything with a score of 17 or 18 in Tier I would
be ranked in Tier I, anything with a score of 17 or 18 in Tier II would placed
on that respective tier.
CM Pearce called the question.
CM Anderson seconded.
Hand vote in favor of calling the question: 26
Against calling the question: 2 against.
Public Comment.
A staff person from Maitri Hospice indicated that the severe need population and providing housing it is virtually impossible without money management. If this category risks losing funding, housing will suffer as well.
Tim Patriarca from Maitri, reminded Council that the Residential Health Care is an essential service and gave some examples of why he believes this. He indicated that the majority of their funding is Ryan White CARE funds, and if decreased or eliminated, it would significantly impair their ability to deliver service.
ROLL CALL: 24 in favor/5 against. The motion carried. [See Attachment A, Column 5].
Benefits Counseling – Tier I
Money Management – Tier II
Home Health Facility Tier II
SA Detox Tier I
SA Outpaitent – Tier I
Residential CM –Tier I
CM Ortiz made a motion that the remaining categories be re-polled for a decision
by the Council.
CM DiCrocco seconded.
CM Pearce spoke against the motion.
CM Hicks asked for clarification
CM Simmons asked for clarification:
CM Callandrillo asked if the straw poll will have an opportunity for discussion.
Council agreed yes.
CM Durio asked for clarity on the motion, which is actually to decide whether
there will be a straw poll on the remaining categories.
Discussion on the motion to have a straw poll continued.
CM Anderson called the question.
CM DiCrocco seconded.
No opposition.
Public Comment about the motion to take a straw poll.
None
VOTE ON TAKING A STRAW POLL BY HAND:
In favor: 26; Against or abstaining: 3. Motion carried.
Remaining Categories for decision:
STRAW POLL ON EACH CATEGORY
Food – TIER I: 14 TIER II: 15
Emergency Financial- TIER I: 21 TIER II: 8
Integrated CM – TIER I: 18 TIER II: 8
Treatment Adherence – TIER I: 3 TIER II: 26
Straw Poll decided that
Food to Tier II
Emergency Financial Tier I
Integrated Case Management Tier I
Treatment Adherence Tier II
CM Pearce made a motion that Treatment Adherence be assigned to Tier II.
CM Antonetty Seconded and called the question.
No opposition to calling the question.
No public comment.
Roll Call on placing Treatment Adherence in TIER II: 27 in favor, 2 against. The motion carried. [See Attachment A, Column 6].
CM Pugh made a motion that Emergency Financial Assistance and Integrated Case
Management be moved into Tier I.
CM Anderson called the question.
CM Siron called the question.
No opposition to calling the question.
Public comment
Patrick Monette Shaw suggested moving Case Management into a lower category.
ROLL CALL – for the motion to place Emergency Financial Assistance and Integrated CM into Tier I: 16 in favor, 13 against. The motion did not carry. [See Attachment A, Column 7].
CM DiCrocco made a motion that Em. Financial Assistance be placed in Tier
I.
Motion seconded.
No discussion on the motion.
No public comment on the motion.
ROLL CALL on motion to place Emergency Financial Assistance in Tier I: 23 in favor, 6 against. The motion carried. [See Attachment A, Column 8].
CM Pugh made a motion to place Food in TIER II.
CM Byers seconded.
Discussion on the motion.
CM Pearce indicated that other sources of funding exist for food and Ryan White
is not the payor of last resort and supports the motion to place the service
category of Food in Tier II.
CM Allgaier echoed and spoke in favor of the motion.
CM Callandrillo asked what those alternative funding sources are for food.
CM Ortiz expressed concern that food is being minimalized and not considered
as a priority. It is clearly a priority for someone living with HIV. He said
that the Council should consider the dignity of people who do not want to go
to a soup kitchen.
CM Molnar echoed CM Ortiz’ comments, and stunned that something considered
a top priority by consumers is considered second tier by the Council. He also
expressed frustration by people calling the question so quickly.
CM Simmons spoke against the motion, and explained how he doesn’t how
some people can survive on some of the food subsidies available. He echoed
that he is also stunned as this does not reflect the concerns of the public.
CM Anderson indicated that this is more than a matter of dignity and with people
with neuropathy it is difficult to stand in line at a food bank. He spoke against
the motion and feels that it should be Tier I.
CM Byers reminded Council that the decision is not about whether this is considered
a priority for clients (which it clearly is), but rather if this service is
essential to fund with CARE dollars. The decision is not so hard to put it
into Tier II, but later how much to allocate. The discussion about the importance
of food has already been had. He speaks in favor of the motion.
CM Pearce clarified his comment and wishes to say that he feels food is definitely
essential for everyone, by putting it in Tier II it is still important and
the funding should be appropriate.
CM Thomas expressed support of placing Food in Tier II. She added that food
is necessary for survival, but her concern is using CARE Title I funds for
food, and less important to put significant funding into food than other categories
in Tier I. Food should be in Tier II, not as a reflection of the continuum
of care, but the concern to use CARE funds to support it.
CM Benham supports Food in Tier I, and spoke against the motion. She feels
food is more important than other Tier I categories such as Oral Health Care.
CM Banks supports Food in Tier I, and stated that food is important with treatment
adherence and spoke against the motion.
CM Antonetty believes that food is a high need for everyone, but a lot of the
services include that people will be given food, or have advocates to give
them food. Making the hard decisions she believes there is other funding to
help people get food. She is in favor of the motion.
CM Booker suggested that listening respectfully is important, people are repeating
the same thing. We need to move on to allocation, and wasting time on this
decision is not productive. She said state position and let it go.
CM Banks stated that people sell their food in the Tenderloin and this may
make it appear as a low priority, but he doesn’t feel the actions of
a few should influence the decision of the Council.
CM Siron called the question.
CM Anderson seconded.
No opposition to calling the question.
Public comment.
Patrick Monette Shaw said it is sending the wrong message to the community
if Food is placed into Tier II. He said CARE funds are needed to clear up
wait lists. He said the message sent to the participants of the community
forums will contradict what they identified as a priority. He thinks this
motion should be withdrawn.
THE MOTION IS TO PLACE FOOD IN TIER II:
ROLL CALL VOTE on motion to place the service category of Food in Tier II.
See Attachment A, Column 9 – 18 in favor; 11 against. The motion did
not carry.
CM Siron made a motion to place Integrated Case Management (ICM) in Tier II.
CM Ortiz seconded.
Discussion:
CM Molnar said he has a conflict, but spoke against this motion and believes
it should be in Tier I.
CM DiCrocco believes ICM should be in Tier I.
CM Allgaier spoke against the motion and believes ICM should be in Tier I and
gave an example that this decision will affect COEs.
CM Pearce spoke against the motion. He believes ICM should be in Tier I since
COE will cover case management for severe need population. To cut this off
from everyone except for COE clients will be a disservice.
Public Comment
Patrick Monette Shaw said that this decision will ignore the needs of consumers
as expressed in community forums. He stated that these decisions are more
related
to conflict
of interest and provider issues.
ROLL CALL on the motion to place Integrated Case Management in Tier II: 13
in favor, 15 against, 1 abstention. The motion did not carry.
[See Attachment A, Column 10]
CM Pearce made a motion that the two items of Food and ICM be in a middle
Tier, which would put the items now in Tier II to Tier III.
CM Anderson seconded.
Discussion:
CM Antonetty indicated that this is difficult, but the early vote was for two
tiers.
CM Molnar spoke in favor of the motion, mostly in the interest of moving on.
CM DiCrocco indicated this would put Tier II into a Tier III
CM Siron said the vote was for two tiers, not three, and asked why it is so
difficult to make a decision.
CM Byers said it would not solve the issue to add another tier. He said there
are additional sources of funding to provide for food. He emphasized that the
service is important, but the question is about funding, which will be done
later.
CM Booker said it appears that the group is putting off the inevitable. She
encouraged the Council to make the difficult decisions and move on with these
two minor decisions and save the hard decisions for later.
CM Allgaier spoke against the motion. Since it was already decided on two tiers,
it would open up problem with making decisions on what to put into that tier.
CM Pearce withdrew his motion and replaced it with a different motion. He made
a motion to put Food in Tier II.
CM Pugh seconded.
Discussion:
CM Callandrillo asked for some hard data that will help him change his mind.
He admitted being unaware of other funding available.
CM Ortiz indicated that public feedback at community forums indicated that
food was a high priority and symbolically it is sending a wrong message to
put food in Tier II.
CM DiCrocco indicated that other resources for food in San Francisco. The pantry
for people with HIV makes it more convenient as they provide protein and vegetables.
As a consumer he agrees with Food in Tier II as he is dissatisfied with the
quality and some of the salaries at a particular provider.
CM Antonetty added that nobody is to speak on a service provider level, only
on a service category.
CM Byers said the message to the community is around the allocations. The priorities
will help with the application to HRSA and help to move on.
CM Pugh indicated that it was ranked 8 on the group priority list, and will
still be considered a top priority. She added that there are other funding
sources, food stamps, and private donations. The funding of last resort is
for CARE services.
CM Booker stated that she remains in favor of Food in Tier I.
CM Benham stated that ICM provides direction to get food, but doesn’t
provide the food and doesn’t make sense to put ICM in Tier I and Food
in Tier II.
CM Simmons called the question.
Seconded.
No opposition to calling the question.
Public comment.
Patrick Monette Shaw indicated that the summary sheets show that there are
alternative funding sources for Integrated Case Management than for Food.
He believes this is a useless discussion, because if people can’t get
to the foodbank, they will die of malnutrition before they get to their case
manager.
Naomi Prochovnick from Continuum stated that food is an emotional issue. She echoed CM Byers’ comments that this is more than a message to the community, but a message to HRSA. She suggested being aware of other funding streams. Nobody is talking about eliminating food. How else can these services be paid for? Or must it come out of CARE dollars because there is no other way to pay for it.
ROLL CALL on motion to put Food in Tier II: 26 in favor; 6 against. The motion
carried.
See Attachment A, Column 11:
CM Molnar made a motion to move ICM – Integrated Case Management- into
Tier I.
Motion seconded.
Discussion.
CM Molnar brought up several points regarding ICMs providing services to those
severe need populations not covered by COEs.
CM Anderson spoke in favor of the motion, and called the question.
CM Pugh seconded calling the question.
Opposition to calling the question: None.
Public Comment
Patrick Monette Shaw stated that case management is being allocated too much
money and the Council has their decisions backwards. He said that if case
management is prioritized higher and there are significant cuts coming, it
doesn’t make sense.
ROLL CALL on motion to put ICM in Tier I: 21 in favor; 8 against. The motion
carried.
[See Attachment A, Column 12].
XIV. Break
After the break Co-Chair Allgaier reminded members of the public that they should addressed an issue and not focus on personal attacks against individual members of the Council or be disrespectful. He suggested being engaged on issues, not personalities. Additionally, to ensure an appropriate meeting atmosphere, he suggested not having the public walk around Council Members as it could appear to be lobbying.
XV. Unfunds - Vote
The unfunds amount will be presented in context with an analysis. The Council
will then vote on the motion from Steering.
Motion from Steering:
Unfunds Recommendation:
•
22,000 on Unmet Needs Survey
•
22,000 on Comprehensive Plan Consultant
•
The remainder (approximately 680,000) to the direct financial assistance service
category
CM Siron discussed his motion brought from Steering Committee and discussed
the Unfunds Policy. It was voted on at Steering that the $724,796 (unspent
dollars) should be spent in the following manner:
Unfunds Recommendation:
•
$22,000 on Unmet Needs Survey
•
$22,000 on Comprehensive Plan Consultant
•
$The remainder (approximately 680,000) to the direct emergency financial assistance
service category
This was approved by Steering Committee and bringing it to the full Council
for approval.
Open for discussion.
CM Pugh asked if Direct Emergency Financial Assistance is currently out of
funds.
Michelle Long indicated that they increase the maximum a person can get during
fiscal year, or add more people eligible to receive an allocation. Her understanding
is that they will increase the limit.
CM Pugh spoke against the motion.
CM Simmons spoke in favor of the motion, but with reservation. He stated that
the amount to Direct Emergency Financial Assistance is fine, and concerned
about the process used to access these funds. He added that clients don’t
often present a compelling need or emergency to receive money.
CM Allgaier spoke in favor of the motion because the service category has historically
relied on unfunds, and it is a way to spend the money well, and client-centered.
CM Banks called the question.
CM Anderson seconded.
Opposition to calling the question.
CM Durio opposed to calling the question.
Those in favor of calling the question: 19. Calling the question carries.
Public Comment on this item
Patrick Monette Shaw commented that with the Bush Administration proposals
coming the Council needs to clean up their act. If unfunds are left laying
around, these funds will eventually be put into ADAP. He suggested asking
for quarterly or monthly accountings of funds spent to date by the service
providers, and suggested having an additional committee or appointing someone
from Council Support to monitor this.
Tim Patriarca commented that directing these funds is worthy decision, and suggested that there are other agencies that need more money and stated that there has not been enough transparency in making this decision. He expressed concern about having this amount of unfunds, and how the unfunds are later redirected.
No other public comment.
Unfunds Recommendation:
•
$22,000 on Unmet Needs Survey
•
$22,000 on Comprehensive Plan Consultant
•
$The remainder (approximately 680,000) to the direct emergency financial assistance
service category
Roll Call on Motion regarding Unfunds Policy: 7 in favor, 11 against. The
motion did not carry.
[See Attachment A, Column 13].
Michelle Long added additional background regarding unspent dollars from prior fiscal year. Agencies were asked to do a reconciliation along with their invoices. In 2003-04 there was a smaller amount unspent around $400,000. The dollars increased this year. It is difficult to determine the base out of total CARE funds, there is a reasonable amount expected to be left on the table at the end of the year. This is higher than last year. The objective is to have the amount smaller. Now providers are doing a reconciliation. She drew attention to the categories with the largest amounts left over. Some categories were having problems, but will not continue to be funded in the next fiscal year. Because of the COEs this will change the spending patterns. This may not be a good predictor of categories that are over funded. When reviewing the categories that traditionally leave money on the table, it does tend to be in these larger categories, and it may be helpful for Council to determine if these categories are over funded. Each provider is given an opportunity to make changes to their budget that will avoid accidentally leaving extra money. Some programs missed the deadline, and they were not allowed to reallocate and were forced to leave the money on the table.
CM Pearce asked Michelle regarding the deadline from the AO to make a decision.
Michelle Long indicated that the submission deadline is October 1. Something needs to be provided to the AO before this time so they can get it to HRSA or the funds will be taken away. She stated that there have been questions on some submissions (especially vouchers) in the past and recommends that it not be spent on vouchers this year.
CM Hicks asked if it would be reasonable to put this out to bid to other agencies.
Michelle stated that this is following the protocol and putting it out to bid
would cause to many delays and not be acceptable.
CM Antonetty stated that it is normal for several types of grants.
CM Pearce asked again if these funds could be used across the board for capital
improvements or bonuses.
Michelle stated that would depend on how much money is left at the end of the
year. She said there are two unfunds processes. One is money left from last
year. The other is from current year predicting how much will be unspent. Requests
have been sent to providers to determine their budgets and amount of left over
money.
CM Callandrillo stated that the Council voted earlier in the year about moving
funds within service categories and that the AO is doing this when needed.
This isn’t about the AO not watching what is going on and making adjustments.
This is actually about the AO doing their job well. There isn’t another
place to put it and there isn’t another area in the service category
to put it. The chunk left over is less than 3% of total award, and 97% was
spent as planned, representing a very small amount of total award.
CM Booker added that nobody is happy to see money left at end of year, but
we have to decide what to do about it. She suggested that the proposal offers
one solution. How to get rid of this money in 30 days, without returning it
to HRSA and making San Francisco look bad. She asked if there were other options
than to put it into a category other than Emergency Financial Assistance (EFA).
Michelle unsure why motion did not pass, or what the objections are by Council
Members. She added that the two smaller items are required to send to Unmet
Needs Survey and Comprehensive Plan Consultant. She referred Council to Unfunds
Policy to determine if spending this money on Direct Emergency Financial Assistance
is appropriate.
CM Pugh stated that her problem is with $680,000 going to that service category.
She asked if other adjustments to the contract can be made, and asked if providers
who spent all their funds in the current contract year would qualify for receipt
of these funds.
Michelle indicated that money has been allocated in the past to providers who
have met their units of service and continue to provide the service, and funds
have been provided for development and equipment. She added that HHS staff
has done a great job in developing the contracts. Should HRSA approve additional
changes to contracts, they will have to be reopened. She suggested that it
gets dicey when a lot of contracts have to get opened and expect providers
to spend the money, but it can be done.
CM Pugh stated that the agencies have already provided the service. If the
contract is in place it seems that the money could be given to them.
CM Siron made a motion to use the first two items as described and decide
later on the $680,000 by sending this back to I&P for a decision.
Motion seconded.
Discussion:
CM DiCrocco spoke against the motion as the lack of time will cause too many
problems. He stated that Direct Emergency Financial Assistance has low overhead
and is a direct consumer service.
CM Simmons spoke against the motion and suggested going back and adopt the
original proposal as described.
Seconded.
Discussion:
CM Pearce against motion, and suggests addressing the issues now.
CM Hicks asked for clarification on the matter about the deadline.
CM Byers spoke against motion on table and in favor of former motion. These
decisions could affect the grant in light of the reauthorization matter. He
is concerned more about that amount going to that particular service. Given
there is a month to make the decision, he suggests being more thoughtful. That
amount of money to that service category is problematic to him.
CM Simmons withdrew his motion.
Back to motion: Two items of $22,000 each to be kept the same. The remainder back to I&P for decision.
CM Banks commented that this is a service he has used before. He stated that
the agency is client-centered and most of the money goes to the clients. He
speaks against this motion, and is in favor of the original motion.
CM Benham spoke against the motion, and mentioned that I&P Committee has
struggled with a quorum for several months and given the time constraints it
would be sad if there was not enough committee participation to make this big
decision.
CM Allgaier spoke against the motion, adding that the AIDS Office needs time
to implement this decision.
CM DiCrocco added to CM Benham’s comments and mentioned that September
is a time when many CMs will stand down and certain committees will likely
not have quorum.
CM Molnar spoke in favor of the motion, and feels it should be discussed more
and the money could be spread out more. He asked for guidance from the AIDS
Office for where they feel it should go.
CM Antonetty spoke against the motion, and believes nothing much different
will be arrived at in the coming weeks. She stated that if agencies are continuing
to provide service without CARE funds then they have other sources of funding
and additional CARE dollars should not be given to them.
CM Pugh indicated that the student dental program at the CARE clinic faces
closure and favors the funds going to Dental Care. She added that the current
budget for this service category is high enough and allocating these additional
funds to the same category would be difficult for her.
CM Booker spoke in favor of the motion, and called the question.
Seconded.
No opposition to calling the question.
MOTION: $22,000 each on Unmet Needs and Comprehensive Plan, remainder to I&P for a decision.
Public Comment
Patrick Monette Shaw commented on the amount of unfunds.
Marhsia Herring spoke against the motion.
ROLL CALL ON MOTION: $22,000 each on Unmet Needs and Comprehensive Plan, remainder
to I&P for a decision --19 in favor, 10 against. The motion did not carry.
See [Attachment A, Column 14].
CM Simmons would like to reintroduce the original motion.
Motion seconded.
Discussion on original motion.
CM Siron called the question.
Seconded.
No opposition to calling the question.
Public Comment
Patrick Monette Shaw suggested giving the AIDS Office sufficient time to implement
this decision and not putting it off.
Motion on Unfunds Amounts to be distributed with $22,000 to Unmet Needs Survey
and $22,000 Comprehensive Plan Consultant. The remainder of approximately $680,000
will go to the direct emergency financial assistance service category.
ROLL CALL on motion: 24 in favor, 5 against. The motion carried.
[See Attachment A, Column 15].
XVI. Review and Discussion of Funding Allocations - VOTE
Laura Thomas and Don Soto, Planning Committee Co-Chairs will present Planning
Committee recommendations on this item. Council will review, discuss and
vote.
At 3:40 pm. CM Thomas suggested a check-in and reminded the Council that they
have little more than two hours to get one of the most difficult tasks accomplished.
What needs to be done between now and the end of the meeting. First the allocations
need to be decided on, then funding scenarios need to be discussed. She was
blunt in stating that there will indeed be cuts, despite that both the number
of HIV cases and the cost of services have increased. It is only a question
of how much of a cut. She suggested moving through the budget decisions as
expeditiously as possible, so that time can be spent on the funding scenarios
to create appropriate, feasible alternatives for the AIDS Office regarding
funding scenarios and cuts.
CM Pugh asked what needs to be done and asked if funding scenarios were required
for the grant.
CM Thomas: Yes. Grant writer wants to know how reductions are being handled.
CM Simmons made a motion regarding allocations. He would like to adopt the
allocations as shown by the budget provided by the AIDS Office as their base
budget, including Tier I and Tier II.
CM Thomas seconded.
Discussion:
CM Graham asked why the budget in the binder was different than the one provided.
This is because the subcategory of Residential Case Management has been figured
in.
CM Simmons repeated his motion: for the purposes of 06-07 allocation, use the rankings projected as the base budget.
CM Durio asked if some of the money based from last year is for Needs Assessment
and does not be needed for the 06-07 year, and doesn’t feel those funds
need to be in Council Support.
CM Byers still needs clarification about the intent of the motion. The current
year’s budget should be rolled into the flat-funding scenario of this
year. There is no need to move money around.
CM Simmons agreed. The correction would be to residential case management.
CM DiCrocco spoke against the motion, because he was expecting a thoughtful
process.
CM Simmons and CM Byers reiterated that the intent of the motion is to honor
the allocations of the service categories of last year (except the question
with Council Support and Needs Assessment). This decision will allow the Council
to move forward with how to deal with funding cuts.
Honor or approve allocations of last year to service categories (not including PC Support) for 06-07 base funding.
CM Pugh stated that she has questions about COEs and Planning Council Support.
Council agreed that would be discussed later.
CM Callandrillo discussed that everything funded this year will be funded next
year. The question is whether any new services are to be funded. If not, approving
this budget would be fine. The next question would be how much to cut from
one service category to make the differences pan out. Nothing is going to be
added to any category, but taken from others to make up the difference.
CM Simmons answered CM Pugh’s question regarding COEs and indicated that
COEs are funded by these categories.
CM Hicks spoke in favor of the motion.
Michelle Long of HHS indicated a budget was prepared with original service
categories before the work to prioritize. The proposed categories for funding
COEs because they are ballpark figures because money is being moved around
by COEs. Planning Committee has requested for approximate figures. The budget
is Title I and Title II.
CM Pearce asked that any excess dollars be put into COEs.
CM Simmons asked if allocations could be discussed after this motion. He thanked
Michelle Long for providing these figures from COEs as the information is
very helpful.
CM Thomas stated she doesn’t care where the extra money (from Council
Support) goes in a flat funding scenario. She suggested saving this for discussion
when there is to be decisions made on where to take cuts.
CM Molnar indicated that there are some service categories with no budget line
item and they should be discussed first.
CM Callandrillo asked for point of clarification on the discrepancy in Title
I and Title II amounts for COEs. Point clarified.
CM Siron called the question on CM Simmons proposal.
Seconded.
No opposition to calling the question.
Public Comment
Patrick Monette Shaw stated that in the interest of getting to allocation discussion
this decision should be made soon.
No other public comment.
ROLL CALL ON MOTION TO ACCEPT BASE BUDGET FOR FLAT FUNDING SCENARIO: Unanimous
in favor. [See Attachment A, Column 16].
CM Durio asked for clarification on the process for voting and taking motions
off the table.
CM Simmons and CM Byers clarified CM Durio’s concern about how the
motion had become changed. He stated that CM Durio is technically correct,
but the group agreed that CM Byers’ clarification on the original motion
was simply clarification and there could be an additional vote if necessary.
Susan asked if there was any other concern about the process.
None expressed.
XVII. Development of Funding Scenarios - Vote
Laura Thomas and Don Soto, Planning Committee Co-Chairs will present Planning
Committee recommendations on this item. Council will review, discuss and
vote.
CM Thomas added that the motion excluded Planning Council Support (PCS). She made a motion that PCS should be added to the base budget at the same amount.
This reduces the PCS budget by the amount used for Needs Assessment costs this year, and brings it down to the budget requested by the Planning Council Director. This means that the first $140,000 of any funding cut will be absorbed by that money and not any other services.
THE MOTION:
For the base budget FY06-07 the funding amount for PCS will be $381,641.
Seconded.
Discussion:
CM Durio stated that was not the verbiage of CM Thomas’ original motion.
CM Thomas had originally explained the intent of the motion: which automatically
puts $140,000 as the amount that is first cut, to avoid cutting any other service
categories first. The base budget is lower. The budget in the grant application
will be higher.
CM DiCrocco asked a question about the PCS budget change.
CM Thomas suggested that it could be left in the budget with the larger amount.
Or it can be done this way, and start out with the lower base amount. Either
way it is the same, and whichever is the quickest for the Council.
CM Antonetty added to CM Thomas’ explanation. If a 5% cut for example
of $1.5 million, the $140,000 will be taken from that, and less will need to
be cut from other categories.
Public Comment on this item
No public comment.
CM Anderson called the question.
Seconded.
Opposition to calling the question: CM Callandrillo
Those in favor of calling the question: 22. Question has been called.
Public Comment
No public comment.
MOTION: FY06-07 base budget for the service category of Planning Council Support
(PCS) will be $381,641.
ROLL CALL: Unanimous in favor. [See Attachment A, Column 17].
CM Simmons made a motion regarding funding scenarios. If a 0-5% reduction
in funding all categories will share a proportional cut. If there is a 5-10%
cut, Tier II would take a full 10% cut, and Tier I will take the remaining
percent cut proportionally.
CM Ortiz seconded.
Discussion:
CM Pugh asked for clarifications.
CM Callandrillo asked for clarifications from the AIDS Office.
Michelle Long indicated that the funding scenarios presented to the AIDS Office
last year was very difficult. She suggested the 5% proportional. The next larger
cut should build on that. She suggested it needs to be clear to all Council
members as well as the general public.
CM Pearce clarified his understanding of the motion.
CM Antonetty provided an alternate motion: and identified the first part of
the motion only. If a 0-5% cut it will be taken to all categories. Making a
motion to split the motion.
Seconded.
Discussion on splitting the motion.
Public comment on splitting the motion to allow separate voting on the separate
parts of the funding scenarios.
No public comment.
By hand vote. 25 in favor of splitting the motion into two separate votes.
MOTION: If a 0-5% cut, all categories share proportionately.
CM Ortiz seconded.
Discussion:
CM DiCrocco suggested an alternate motion: Any reduction will be shared proportionatly
among all categories.
CM Anderson called the question.
Seconded.
Hand vote in favor of calling the question: 21
Hand vote opposed to calling the question: 7
Calling the question passed.
Public Comment
Patrick Monette Shaw clarified that everything will be cut the same across
the board, but suggested that when this was done in the past that it was
anything but. He suggested clear directions to the AIDS Office.
Bill Hirsh supports the motion and feels it is reasonable. Especially with concern about not de-funding service categories, and ensures all will be able to continue.
Naomi Prochavnick spoke against the motion, and suggested that equal cuts across the board seems to be in contradiction to the prioritization process.
ROLL CALL ON MOTION that any funding reduction will be shared proportionately
among all categories in both Tier I and Tier II: 4 in favor, 25 against. The
motion did not carry.
[See Attachment A, Column 18].
In terms of process, back to the original motion: IF 0-5% reductions, all
categories will receive cuts proportionately.
CM Simmons spoke in favor of the motion.
CM Thomas supports sharing a small cut like this across the board, and a good
way to manage such a reduction.
CM Graham supports the motion and called the question.
Seconded.
Hand vote in favor of calling the question: 23. No opposition to calling the question. Calling the question passed.
Public Comment
Patrick Monette Shaw stated that with Food moved into Tier II, he reminded Council they will be cutting food for home delivered meals.
POINT OF ORDER. People giving their proxy to others and leaving the room. Last hand vote recounted. Same results.
CM Banks expressed concern about calling the question too quickly before everyone
has a chance to discuss appropriately. He asked if COEs will be hit, and if
so even a small cut will be troublesome for the COEs.
Clarification is that COEs are included in this motion.
ROLL CALL ON MOTION that states in the event of 0-5% funding reductions, all service categories in both Tier I and Tier II will receive cuts proportionately: 25 in favor, 3 against, 1 abstention. The motion carried. [See Attachment A, Column 19].
CM Byers agreed that people seem to be calling the question too quickly. He suggested that more people need to talk to the matter before calling the question.
Susan agreed to read the list of people waiting to speak if the question is
called.
CM Ortiz commented that if someone does not want the question called, then
it should not be called and asked for clarification.
If a question called, the group is to be asked if there is opposition. If not,
to public comment and vote. If there is opposition, then the group is polled
and goes by the 2/3 hand poll.
CM Antonetty asked if names of the speaker list could be displayed on the wall, and mentioned that calling the question is not done to upset people.
The second part of the split motion:
In the event of 5-10% funding reduction to the EMA, 10% would be applied to
Tier II, and Tier I would share proportionately any remaining cut.
CM Booker indicated that it is confusing for the AO with complicated funding
scenarios.
Michelle Long clarified that a progressive funding scenario would make more
sense. Make sure we all understand it, because last year it was not clear,
everyone had a different impression.
CM Thomas proposed a sub motion for any cut greater than 5% that Tier I cut
be capped at 5 % and the remainder of the reduction be shared proportionally
across Tier II.
CM Simmons seconded.
Discussion:
CM Simmons spoke in favor of the motion.
CM Banks suggested the scenario with $20 million, how much would be taken from
each tier.
CM Thomas explained that under such a budget, a $500,000 cut from Tier I, leaving
$9.5 million. $1.5 million would come out of Tier II, leaving $8.5 million.
Russ Zellers from HHS asked if there was a cap on this percentage cut.
CM Thomas stated that it is any amount of cut.
Russ explained that some are not at the discretion of the Council, such as
Quality Management. CM Thomas: If the grantee chooses to include it in the
scenario, if not that is fine.
Russ: How envisioning the cut to the Counties?
CM Thomas: She indicated that the Counties would automatically be taking a
cut.
CM Pugh: asked if it was 5% off gross number or 5% off grant. She provided
an example.
CM Pearce pointed to the figures on the budget between Tier I and Tier II,
and said this scenario could potentially devastate some programs because most
of the money is in Tier I.
CM Graham spoke against the motion for same reasons.
CM Durio spoke against the motion for same reasons.
CM Anderson called the question.
Seconded.
No opposition to calling the question.
Public Comment
Bill Hirsh suggested that putting the burden of cuts on Tier II would completely eliminate some programs. If the service is to remain viable, the pain needs to be shared more equally.
Patrick Monette Shaw stated that in the event of a 15% cut, food could be cut by $177,000. He suggested that this cannot be done to this program. He suggested inverting the motion, by putting the larger cut in Tier I in order to preserve services in Tier II.
Naomi Prochavnick spoke in favor of the motion, which has the potential for drastic repercussions. One proposal from HAPN was to look at intended service model and shape funding recommendations accordingly. They would like all service categories to be funded, but it is not realistic. If reauthorization does not go through, need to look at priorities, and prioritized client population, and the services needed by that population. She urged the Council to bite this hard bullet.
Tim Patriarca agrees both with CM Pearce and Naomi. He suggested that lumping with Tier I and Tier II, that the Council needs to look at summary sheets. The proportional cut could end the service of hospice care. He suggested looking at multi-year planning. If this decision doesn’t completely kill an agency, it will be devastated beyond recognition.
MOTION: For any cut greater than 5% the Tier I cut will be capped at 5 % and
the remainder of the reduction will be shared proportionally across Tier II.
ROLL CALL: 8 yes, 21 no. The motion did not carry. [Attachment A, Column 20].
Back to the original motion:
CM Pearce asked for a point of clarification.
CM Thomas suggested that this is to be clear direction, whatever the cut then
something will be easily understood by the AIDS Office.
Discussion:
CM Pugh offered a way for smaller organizations to be hurt less. She gave an
example.
CM Soto offered an alternative motion:
Any cut greater than 5% - all service categories receive a cut of 5%, and the
remainder of the reduction be absorbed from the bottom up.
No second.
Discussion on the proposal:
CM Sweetin questioned the primary principles, not to allow any services fall
off the map. Also a lot of discussion went into Tier I and Tier II. If tiers
matter, then the formula must reflect that Tier II services are set up to
take a larger cut, because Tier I services have a priority. She suggested
the motion could put us in the opposite position.
CM Byers – expressed concern about the previous motion. He suggested
some middle ground to capture 5-10 and then something else for greater than
10.
CM Pearce spoke in favor of the motion, and clarified. This motion is for a 5-10% cut, no category in Tier II will take more than a 10% cut, and Tier I will take varying amounts (less of a hit than Tier II). He suggested this is a good middle ground.
CM Banks asked why each category could not be looked at individually about
how much to reduce.
CM Simmons spoke to CM Sweetin’s comments. The decision on creating tiers
was to identify essential and non-essential services. He spoke in favor of
the motion.
CM Blum reminded people about the alternative funding streams and spoke against
the motion. He suggested looking at other funding sources for each category.
CM DiCrocco agreed with CM Blum
CM Pugh provided a visual explanation on the budget chart of the funding cuts.
CM Booker spoke in favor of the motion, and encouraged the Council to make
some decisions. She indicated that cuts are going to happen and the decisions
need to be made. If necessary to look at each separately the group needs to
do this. The bottom line is that categories are going to get cut, she suggested
cutting evenly across the board. She added that her health and that of others
is not up to staying here for 3-4 more hours.
CM Thomas suggested that there is no way to make cuts without reducing some
categories service. There is no way to deal with a 10% cut without having to
cut something. She suggested moving forward with a vote and decide how to manage
a greater than 10% cut.
CM Siron echoed CM Booker’s comments and reminded Council that he and
other CMs are on medications.
CM Siron called the question.
CM Graham seconded.
Objection to calling the question: none.
Public Comment
Mr. Hirsch in support of the motion.
Mr. Monette Shaw not in support of the motion because he feels that the Tier
I categories can absorb the cuts easier due to alternate funding sources
and suggested reversing this formula.
Mr. Patriarca in support of the motion.
Naomi Prochavnick in support of the motion. She encouraged Council to make
the decision and echoed CM Thomas that cuts must be made.
MOTION: If the EMA faces a 5-10% reduction, Tier II takes a 10% reduction,
and Tier I shares the remainder of the reduction proportionately.
ROLL CALL :– 23 in favor, 6 against. The motion carried. [See Attachment
A, Column 21].
CM DiCrocco asked about cuts greater than 10%. He proposed a motion:
With cuts greater than 10% start from the bottom of Tier II, but start with
largest amount.
CM Anderson proposed a second motion for cuts greater than 10%.
Seconded.
CM Pearce spoke against the second motion.
CM DiCrocco withdrew his motion.
Back to CM Anderson’s MOTION: With a reduction greater than 10%, the
cuts would be shared proportionately across the board.
Discussion:
CM Simmons spoke against the motion.
CM Molnar spoke against the motion.
CM Pugh spoke against the motion.
CM Allgaier spoke against the motion as the decisions made earlier were around
severe need population, if across the board cuts are done then the disservice
is to those who need the service the most.
CM Flood spoke against the motion. She suggested having an emergency meeting
if the situation arises.
CM Callandrillo asked if the spreadsheet could represent what is left in the
event of a greater than 10% cut.
CM Pearce added that he is very tired, and angry at a system that is forcing
the Council to make these types of decision. He feels that it is not acceptable
to be forced into coming up with a plan to deal with greater than 10% reduction.
He suggested that a decision does not need to be made regarding more than a
10% cut, and feels that such a cut is unacceptable. If it does happen then
the Council can deal with it at that point. He proposed a motion to stop doing
funding scenarios at this point, and deal with greater than 10% reductions,
if it occurs, at the time it happens.
CM Graham seconded.
CM Anderson withdrew his motion.
THE MOTION: STOP DOING FUNDING SCENARIOS at this point, deal with greater than 10% reductions if it occurs at the time it happens.
Discussion:
CM Thomas supports the motion. It is not the worst thing in the world that
no greater than 10% cuts have been discussed. She suggested not waiting until
the award, and addressing this before March.
CM Allgaier spoke in favor of CM Pearce motion. If taking more than a 10% hit,
there needs to be very thoughtful discussions and it is not going to happen
today. We don’t want to be accepting of that, but it needs to be looked
at.
CM Siron spoke in favor of CM Pearce’s motion.
CM Banks suggested that if there was a 10% cut, that each category could be
gone through individually and that sort of cut could be worked out, rather
than doing across the board cut.
CM Graham spoke in favor of the motion, and agrees with the comment about refusing
to accept such a reduction.
CM Simmons called the question.
Seconded.
No opposition to calling the question.
Public Comment
Mr. Monette Shaw cautioned against doing anything with the grant application that could reduce the funding any more. He suggested the next Council Meeting be devoted to discussing this matter.
Naomi Prochovnick supports the motion, and to make these types of crucial decisions at this late hour is not realistic. She supports making this decision at a later time.
THE MOTION: STOP DOING FUNDING SCENARIOS at this point, deal with greater
than 10% reductions if it occurs at the time it happens.
ROLL CALL: 28 in favor, 1 against. The motion carried.
[See Attachment A, Column 22].
For purposes of the grant application, CM Thomas proposed an increased funding
scenario. If any increased funding received those funds be distributed proportionately
to Tier I. For purposes of the grant application, direct grantee staff and
grant writer to increase service categories Tier I by 20% and Tier II by 10%.
CM Allgaier seconded.
Discussion:
Robert Whirry (grant writer) provided some clarification.
CM Thomas changed that if there is increased funding that will be distributed proportionately to Tier I. For purposes of the grant application all services categories will be increased 21%.
One is a funding scenario for a greater than base budget. Part two of the motion, there needs to be a budget approved by the Council, so the budget is requesting a 21% across the board funding increase in all categories.
Discussion:
CM Molnar suggested two separate motions.
In the unlikely event of a funding increase, the amount will be distributed
proportionately to Tier I.
Seconded.
Discussion: None.
Public Comment
No pubic comment.
ROLL CALL ON MOTION: Any funding increase will be distributed proportionately to Tier I service categories: 25 in favor, 3 against. The motion carried. [See Attachment A, Column 23].
CM Thomas proposed the next motion:
For purposes of the grant application all services categories will be increased
21%.
Seconded.
Discussion:
CM Byers explained that for purposes of grant writing, you always want to ask
for more money.
No further discussion.
Public Comment
Mr. Monette Shaw stated that with the decreased number of AIDS cases there needs to be more justification in asking for a 21% increase in the budget.
ROLL CALL on motion that states for the purposes of the grant application all service categories will be increased 21%: Vote unanimous in favor. [See Attachment A, Column 24]. –
XVIII. Nominations for Planning Council Co-Chairs
CM Banks nominated CM Molnar.
CM Molnar declined.
CM Antonetty nominated CM Thomas
CM Thomas said she cannot accept at the moment but will think about it.
CM Flood nominated CM Allgaier
CM Allgaier accepted.
CM Pugh nominated CM Siron
CM Siron accepted.
CM Allgaier nominated CM Kanios
CM Kanios accepted.
CM [_________] nominated CM Callandrillo.
CM Callandrillo accepted.
CM Benham nominated CM Booker.
CM Booker respectfully declined.
CM Simmons moved for nominations to be closed.
Nominations not closed.
CM Booker nominated CM Antonetty
CM Antonetty respectfully declined.
CM Kleffner nominated CM Soto.
CM Soto accepted.
No other nominations.
CM Simmons thanked Susan and Planning Committee team for making this process
work well.
Public Comment on this item
Mr. Monette Shaw asked for someone to nominate CM DiCrocco. He added that the Council should move up on the calendar the item for completing the grant application and it is inexcusable to not review the grant application prior to sending to DC.
No other public comments.
XIX. Adjournment
The meeting adjourned at 5:55 p.m. – FIVE MINUTES AHEAD OF SCHEDULE!!
Note: Agenda items are subject to change, postponement, or removal. Meeting agendas are considered to be in DRAFT form until reviewed and approved by Committee attendees.
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