Minutes of July 22, 2002 HIV Health Services Planning Council meeting

HIV HEALTH SERVICES PLANNING COUNCIL MEETING

Meeting Date: July 22, 2002

Meeting Place: City Hall, Mayor's Conference Room 201

Meeting Time: 4:30pm - 7:30pm

I. Call to Order
4:42pm

II. Roll Call
See Attachment A., a quorum was achieved.

III. Review and Approval of Agenda
The Agenda was approved.

IV. Review and Approval of Minutes 7/08/02
There were several changes made to the minutes. With one abstention, the minutes were approved.
Patrick Monette Shaw, a member of the public, made a few suggestions for changes to the minutes. He claims that the minutes were censored as to Michelle Long Dixon's salary.

V. General Announcements
Cecilia Chung sent an announcement to the Yahoo group about the First National Asian and Pacific Islander Summit on HIV/AIDS Research to be held in Oakland in November. Contact the Council office for more information.
Margot Antonetty announced the Hoarding and Cluttering: Solutions in 2002, presented by the Mental Health Association of San Francisco will be held on 9/30/02 1pm-5pm at 455 Golden Gate.
The Complementary Care Contractors Association distributed a letter for Council members (See Attachment B).

VI. Public Comment
Barry Holler of St. Mary's Medical Center announced that CARE dollars do not nearly cover their costs for their HIV Clinic. The hospital absorbs any amounts not covered by their $580,858 CARE contract, totaling $776,854. He urged the Council not to cut Primary Care.
Amy Cunninghis of SF AIDS Foundation asked the Council to consider primary care and housing as core services. She explained that housing is a main point of entry for those who are out-of-care to connect with primary care services.
Jim Illig, President of the HIV/AIDS Provider Network, explained they are concerned that the CarryForward funding should be applied to supplement those who were cut this year.
Jim Dilly, from the HIV Mental Health Clinic, distributed materials to the Council members via mail. Anyone who did not receive a copy should contact his office.
Tim, Executive Director of Maitri, asked the Council to consider that they receive 75% of the funding from their subcategory. Cutting the subcategory would significantly affect their funding.
Patrick Monette Shaw claimed that the agenda was not posted to the Internet in compliance with the Sunshine Ordinance. He is frustrated last year's cuts were not reconstituted with the CarryForward funds. He believes that Michelle Long Dixon makes $105,000 per year. Mismanagement of money is connected to death.
Naomi, Director of TLC Continuum, spoke for supportive services.
Bill Hirsh, Director of ALRC, asked the Council to consider that legal services are very important to consumers and urged the Council to maintain this category's funding.

VII. Presentation - The REGGIE System & Planning for the Future
Jimmy Loyce, DPH, explained that REGGIE is the only data system available now that is capable of understanding the population served. As HRSA requires this data, accuracy is essential.
Rani Marx, DPH, distributed REGGIE materials via email to the Council at the end of last week for their review (See Attachment C for supplemental materials). Re-inventing the system is not possible until they can report accurate 2002 data. Almost half of the agencies do integrate the REGGIE system into their own data system and are successful in doing so. This year REGGIE has employed part-time staff committed to data entry to try to help get agencies up to date. They are working on creating a method to allow agencies to upload data from their current systems into REGGIE. They have three options to get the data in the best shape:
1. To mandate entering data, updating data, by withholding payment to the agency until the data entry is complete.
2. To allocate money for additional data entry (i.e. update back log data).
3. Provide incentives to agencies to record new data and update records (i.e. $5/client record).
About 10 agencies have moderate problems, with about 6 months of un-entered data.
Rani explained that it costs about $70,000 to update 6 months of backlog data. There are about 5 agencies that have severe problems. Susan Shea explained that upon REGGIE's creation, Mitch Katz assured the Council that DPH would financially support the database system. Susan recommended that REGGIE staff speak with HRSA or the Mayor to ask for funds to rectify the problems. She requested an approximate dollar amount if they intend to ask for money from the Council.
Christopher Scott Gomora commented that there are quite a few technical problems with REGGIE: there is a delay in trainings, he cannot log on, and cannot download.
Rani Marx explained that data entry is not mandated because they have no mechanism to ensure that agencies stay in compliance. The REGGIE discussion will be part of the Retreat prioritization.
Public Comment on Agenda Item VII:
Patrick Monette Shaw expressed his concern that REGGIE does not automatically save data. He stated that the City already gives enough dollars to REGGIE.
Barry Holler would like the Council to ask DPH to create an escape command to automatically save data.
Jim Illig strongly opposed that Providers get payment withheld for not completing data entry.

VIII. Presentation - SFDPH - Healthcare Sub-category Summary Sheets
Laura Thomas distributed Subcategory Sheets, for items to be discussed in this evening's meeting (See Attachment D and E). The sheets include other funding sources, client demographics (from REGGIE), major issues and trends, and the major impact of any cuts. They did not include information on Marin and San Mateo, as those were distributed at previous Council meetings. Planning Council support was not included, as the Council is responsible for their own budget. Brad offered his thanks to the AIDS Office for their hard work in completing the summary sheets.
The Council will use this information for prioritization. Susan Shea asked for information on other EMA's allocation of healthcare funds. Laura explained that SF spends more on Housing and Substance Use than any other EMA.
Mjay Sanders would like more information from providers, from their experience. The DPH Program Managers can provide further information to Council members. Susan Shea explained that the pharmaceutical service might be duplicating services. Susan Shea begged the question of moving funds around from and to primary care providers. Jeff Byers reminded the Council that their role is not to discuss agencies or providers, just services. Susan Shea asked the Council to consider integrating services around primary care in their discussions of prioritization.

IX. Presentation - SFDPH - Report, Housing Sub-category Summary Sheets
Margot Antonetty explained that the City does inspect SROs. The voucher system was created to give leverage to HUH, allowing the agency to choose which SROs receive the money.
Bill Hirsh, ALRP, asked the Council to consider how critical housing is to the overall welfare of people with HIV. Laura explained that New York also has a big problem with housing, and has developed innovative harm reduction housing programs. Both HOPWA and Section 8 are not viable options for solving the housing problem in San Francisco.
Jim Mitulski asked how the Newsom initiative would affect Title I and offered that the group take a position on this. Ken Pearce explained that if services were cut proportionately, then the low number of unduplicated clients listed in the housing summary would require a large cut in housing. Jim Mitulski expressed that if the Council cuts housing (more than healthcare), then the population will lose their quality of health.
Susan Shea would like to look at those services that are not as successful as they used to be so that the Council can move into the future with the epidemic.
Public Comment on Agenda Item IX
Members of the public explained that emergency housing should be increased. John Thulman, a consumer of services, explained that many services do not work together (i.e. housing & substance use programs). He is very frustrated with the housing situation in San Francisco. Charlene explained that housing can prevent funding other services. Supportive services are included in Housing funds, and Brad offered his appreciation for this piece of the housing category.

X. Presentation - SFDPH - Report, Food Sub-category Summary Sheets
Public Comment on Agenda Item X.
Jim Illig of Project Open Hand suggested that food is the primary point of entry for those who are out-of-care to get in care. Oakland's Needs Assessment outlined that food is one of the chief pathways for those to get into care and to encourage people to value their health. If Project Open Hand's funding is cut, then they will be required to put people on a waiting list, which has never happened before. 36% of the meals 68% of the grocery bags and 41% of the unduplicated clients are CARE Funded.

XI. Presentation - SFDPH - Report, Client Advocacy Sub-category Summary Sheets
Positive Resource Center's presentation in early June was valuable for Council members. Eric Whitney explained that consumers must have access to a benefits counselor regardless of their situation, as benefits crosscut all demographics and maximize use of funding sources outside of CARE dollars. Susan Shea asked why women are represented so low in the data represented in the packet, or why any of the services are not utilized by the same demographics of population. Laura Thomas encouraged the group to look at the Epi report when analyzing this data. Jeff Byers would like the group to continue look at demographics when looking at funding cuts.
Ali Riker encouraged the group to look at Benefits Counseling as an integral piece of serving the population most in need. Brad Hume reiterated that this subcategory is a core service.
Public Comment on Agenda Item XI.
Bill Hirsh explained that legal services are critical when they arise.

XII. Presentation - SFDPH - Report, Transportation Sub-category Summary Sheets
Transportation services do not include tokens and vouchers. Drivers are trained to provide psychosocial services to those clients that they are transporting. They need to have this level of knowledge to deal with clients. Susan Shea suggested that this service be either bolstered or cut. While clients are in transition, this is the only service available. MediCal requires that clients be homebound to fund their transportation. Susan spoke in favor of shifting the transportation funding into Benefits Counseling so that clients may access MediCal for transportation.
Laura distributed Carry-Forward funds sheet by service Sub-Category
(See Attachment F). This sheet explains what was left on the table for FY 01-02.

XIII. Committee Reports
Committee Reports were postponed until the next meeting.

XIV. New Business
There was no new business.

XV. Adjourn
7:40pm.

Approved 8/26/02