Minutes, August 26, 2002 HIV Health Services Planning Council meeting

Approved 10/28/02

HIV HEALTH SERVICES PLANNING COUNCIL MEETING

Meeting Date: August 26, 2002

Meeting Place: Walden House, 1885 Mission Street, 3rd Floor

Meeting Time: 1:00pm - 8:00pm

I. Call to Order
1:00pm

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

III. Review and Approval of Agenda
There were no changes to the agenda.

IV. Review and Approval of Minutes 7/22/02 & 8/12/02
There were a few changes made to the July 22 minutes. With no further discussion, the July 22 minutes were approved. With one abstention, the August 12 minutes were approved.

V. General Announcements
George Simmons announced that the federal government has started auditing about 23 organizations, at the request of a number of conservative politicians. He asked that concerned people should contact respective parties in Washington to express their thoughts.
Catherine Geanuracos and Laura Thomas met with Nancy Pelosi to discuss the status of HIV funding in San Francisco. She was supportive of their position, and was sympathetic about the financial challenges that the San Francisco EMA faces.

VI. Public Comment
Brian, consumer, explained that consumer satisfaction is extremely important. He asked for the Council to look at trends and consumer satisfaction, not just units of service. Brian asked that the Council look for funds that may not be utilized by the Care Not Cash proposal, assuming it passes.
Patrick Monette-Shaw provided written Public Comment as follows:

During July 2002, the San Francisco Department of Public Health
distributed to this Council 66 pages of summary sheets itemizing by
subcategory, service utilization data for last year and the current
fiscal year’s allocation of CARE Act funds for each category. Notably
absent from DPH’s 66-page handouts was a one-page summary showing the
total allocations across all categories for the current FY. This
Council is to vote tonight setting next year’s priorities based on DPH’s
misinformation, but this Council has not recognized for yourself that $5
million remains either unallocated, or unaccounted for. I prepared a
one-page summary myself, which I distribute now, showing the
sub-categories which DPH has not informed you of how much will be
allocated to each. How will this missing $5 million be allocated, and
why hasn’t this Council asked before voting commences today that DPH
account for these missing funds? Show me the money!

Jim Illig, of Project Open Hand, would like the Council to think about people with HIV/AIDS, the staff of these agencies, when thinking about making these difficult decisions.
Tanya Reids, staff of ALRP, asked for Carry Forward funds to be allocated to Legal Services. Further, she asked for a formal application process for service providers to apply for Carry Forward funds in the future.
BJ Styles, Interim ED of AEF, explained that they are experiencing a 10% increase in clients this year. They will soon have over 3,000 unduplicated clients. They are an all volunteer-run organization. They only have one staff member, so they cannot decrease any overhead.

VII. Prioritization Introduction
Laura Thomas and Catherine Geanuracos introduced the process the Council will undergo this afternoon. The I & E Committee discussed the proposal at depth and has made a sound recommendation for the Council's approval. The 3-Year Goals and Objectives were developed to guide the prioritization process, and have captured the discussions of the 3-Year Plan Working Group. Following the approval of the Goals, the Council will determine the priority of Sub-Categories.
For the Title I application, Laura needs an ordered list of sub-categories, the +5% funding scenario, and approved goals & objectives. Sam Kaplan asked for the AIDS Office to assess the outcomes of this decision making process.
Patrick Monette-Shaw provided written Public Comment as follows:

On August 13 I asked DPH to supply me with a one-page document showing
“Allocations” for the current FY in the same format it presented you
showing unspent money from last fiscal year. As you know, the Bay Area
Reporter reported in March 2002 that this Council had recommended a six
percent across-the-board cut to all programs for the current fiscal year
to cope with the $2.2 million cut from CARE funds awarded by the federal
government. On the back of the handout I just distributed, you can see
that anything *but* an across-the board cut occurred evenly. My handout
shows some sub-categories received up to 28% more, while the primary
healthcare category was cut by 17 percent. If this advisory body had
directed DPH to cut all categories evenly by six percent, why aren’t you
concerned that DPH did not follow your recommendations to cut programs
evenly and equitably?

VIII. 3-Year Plan Goals & Objectives
The 3-Year Plan Working Group forwarded this motion for full Council's approval (See Attachment B). Laura Thomas introduced the Goals & Objectives, as realistic goals, with reduced funding in mind. The objectives include System wide goals, service category goals, and Planning Council goals. Catherine Geanuracos explained that a few items have been changed from past year's goals, reflecting the Council's current funding prioritization tone. She encouraged the Council to review the goals, while keeping the reality of future decreased funding in mind.
Jeff Byers spoke in favor of the motion and offered his thanks to the work of the 3-Year Plan Working Group: Laura Thomas, Charles Siron, Catherine Geanuracos, Brad Hume, John Conley. Larry Cruz made a friendly amendment to include language regarding collaboration of Mental Health service and Substance Abuse services as a goal (See I.J). Anthony Huynh suggested including API language accessibility as a goal.
Randy Allgaier explained that the document includes language advocating for ISPs, but does not include an evaluative piece to assess those ISP systems already in place. Before moving more money into the ISP system, the Council should know more about them. George Simmons spoke for a more qualitative assessment, not just quantitative.
Bill Blum asked to include ongoing Mental Health Services to the System Goal referring specifically to Mental Health (See II. H). He asked for an addition to include people coming out of incarceration to the Coordinating Resources item (I.J.7). Donald explained that using the term "people of color" does not specifically notice the disproportionate positive population in the African American and Latino communities. He proposed that the language be changed to specifically target African American and Latino populations. The group discussed the matter, and resolved to include "people of color, specifically African American and Latino communities".
Patrick Monette-Shaw provided written Public Comment as follows:

This Council approved funding a $175,000 needs assessment by LaFrance
Associates, which the Health Commission approved. Another needs
assessment was conducted by Compass Point funded with CARE Act money to
evaluate integrated service providers, at an as-yet-unknown cost. How
many needs assessments does San Francisco need annually? Why is it that
qualitative and quantitative data went unanswered in these two flawed
assessments, and why is Mr. Simmons now asking for yet another
assessment to obtain data which should have been acquired during the
first two assessments? Why was this information not included in the
study design before the contracts to either organization were issued? I
object to diverting $40,000 in unspent CARE Act funds from last year to
conduct yet another needs assessment, in addition to the $175,000 plus
the amount paid to Compass Point. Can’t carry-forward funds be more
wisely spent meeting real needs of people with HIV/AIDS?

Elyse Graham made a friendly amendment to include a goal asking for collaboration under the complementary therapy item. Catherine called the question.
Outcome: Including the aforementioned amendments, the Council unanimously voted to approve the 3-Year Plan Goals and Objectives.

IX. Norm Nickens -SF DPH -- Conflict of Interest Presentation
Norm Nickens, DPH, explained that an economic conflict of interest would require Council members to own stock sold by the Council, which obviously is not possible. The Council should mainly focus on perceived conflict of interest. Public Officials are required to submit a Statement of Economic Issues, to disclose economic interests on an annual basis. Norm explained that Conflict is not necessarily a bad thing, because many Council members were appointed to use their expertise.
When a Council member's decision would benefit them personally, a Conflict would occur. Virtually everything the Council does is public information. When the Council is determining service categories, Conflict issues can surface because they are so specific, and some sub-categories only have one provider/contractor. Because the Council decides on a service category, not agency, these issues can be avoided. Norm encouraged the Council to raise conflict issues at the time they arise. Disclosure and reviewing this issue is important and should be part of the Council's ongoing process.
If the Council perceives a Conflict, they should take a vote to excuse a person from the vote. If someone (or their partner/family) is receiving services or working for services, they should disclose, but this would not be a real economic conflict. He urged the Council to err on the side of full disclosure.
Norm explained that the Council Bylaws appropriately capture Conflict of Interest issues, but may need some work on a clearer disclosure explanation. If there is a conflict, the issue is not raised, and a vote passes, the vote could be voided.
The group went around the room and disclosed their perceived conflicts.

Donald Frazier, employee of Walden House, a Title I recipient
Catherine Geanuracos, employee of Larkin Street Youth Center, a Title IV recipient
Jim Mitulski, consumer of Title I funded Primary Care services
Charlene Pugh, employee of UOP Dental, a Title V recipient
Randy Allgaier, consumer of ADAP; Long term disability beneficiary from working at SF AIDS Foundation, a Title I recipient
George Simmons, employee of Catholic Charities, a Title I recipient
Margot Antonetty, employee of DPH, Housing and Urban Health
Larry Cruz, retired employee of DPH
Curtis Baker, consumer of Title I funded services, volunteer for ABC, Black Coalition on AIDS
Lindy Hill, employee of Center on Juvenile and Criminal Justice and St. Vincent DePaul
Ali Riker, employee of Center on Juvenile and Criminal Justice
Mary Lawrence Hicks, employee of AETC and SFGH, a Title I recipient
Lara Sallee, employee of SF CCC, a Title III recipient that partners with several Title I recipients
Susan Shea, employee of UCSF AIDS program, a Title I recipient
Anthony Huynh, employee of API Wellness Center, a Title I recipient
Charles Siron, no conflict
Mjay Sanders, consumer of Title I funded services
Ken Pearce, consumer of Title I funded services, volunteer for Title I funded agencies
Trevor Bougouneau, consumer of Title I funded services
Kevin Johnson, employee of Catholic Charities, a Title I recipient, and eligible for Title I funded services
Elyse Graham, employee of Immune Enhancement Project, a Title I recipient
Sam Kaplan, employee of SF MediCal Field office
Mark Dunlop, former recipient of Title I funded services, currently employee of San Francisco Redevelopment Agency
Karen Wuopio, employee of Marin Dept. of Health and Human Service, a Title I recipient
Jeff Byers, employee of State of California MediCal office
Brad Hume, consumer of Title I funded services

X. Carry Forward Proposal
Charlene Pugh distributed a proposal for use of Carry Forward funds (See Attachment C). After backfilling current contracts cut this fiscal year, the I & E Committee made the following proposal to apply the remaining funds:

Marin County Carry-Forward= $7,500
Planning Council Support= $47,500
Muni Tokens= $30,000
Direct Emergency Financial Assistance= $125,508

George Simmons spoke in favor of the motion. Sam Kaplan would like the Council to discuss the REGGIE system at the September I & E Committee. Brad Hume mentioned that the committee should also explore the possibility that contractors may not have the time to use the funding. Further, the I & E Committee asked the AIDS Office for an analysis of why so much money was left on the table.
Patrick Monette-Shaw provided written Public Comment as follows:

The proposal just handed out by your I&E subcommittee recommends
spending $47,500 of last year’s unspent funds on additional support to
this CARE Council. $3,000 of the $47,000 is budgeted for “Outreach and
Promotion,” including developing a new web site. Unfortunately, the
requirement to advertise meeting notices in the print media will gobble
up $2,604.40 of the $3,000, leaving a whopping total of $395.60 to pay
for developing yet another web site. San Francisco may be home to the
dot-com industry, but no dot-com’er is going to be willing to develop a
web site for you to earn an astronomical $396.60. Between DPH and the
Positive Resource Center, you already have two web sites to post
documents to. You don’t need another web site. What you need is for
someone to pick up the phone and insist that DPH’s webmaster post
meeting notices and agendas onto its existing web site.

Brad Hume called the question; Charles Siron seconded the motion.
Outcome: The motion carried.
Jim Illig asked the AIDS Office when the request will be submitted to HRSA, and how contractors will be notified. Michelle Long Dixon explained that the AIDS Office is planning to get the request out to HRSA, who has agreed to entertain the request upon the time they receive it. Donald Frazier asked the Council to think about why San Francisco received a 2.2 million dollar cut. He offered that the Council should have thought about what HRSA was asking for when making this decision.
Jeff Byers clarified that the motion has carried, and discussion is over.

XI. Decision Matrix Discussion - Summary Of Results
Charlene Pugh walked the group through the Decision Matrix (See Attachment D). Sam Kaplan explained that looking at the median is better because the average (mean) could be skewed by someone who votes way off the norm. The median is the number in the middle of a distribution. Based on the average, the sub-categories were listed in order of priority. This exercise was assigned to assist with the prioritization process.
Discussion
Bill Blum asked the Council to look at the fact that service providers will rank differently than severe need populations. The Matrix is a summary of the information provided from the Needs Assessment, Summary Sheets, Community Forum, and Council members, and should assist with decision-making. Ken Pearce mentioned that the pharmaceuticals ranking is an example of how different people have a range of understanding about the sub-categories. Further clarification is needed on these issues for the Council to make a sound decision. Kevin Johnson added that some mental health consumers might not know that they need mental health services. Sam Kaplan asked the Council to consider using a different methodology than has been used in the past to determine the priority of sub-categories. He added that the perceived needs as outlined in the Needs Assessment is a valuable tool. Catherine Geanuracos explained that there is not enough data to identify who is most in need. Mjay Sanders stated that in addition to the Decision Matrix, the AIDS Office has provided valuable information to assist with the prioritization process.
Patrick Monette-Shaw, member of the public, stated that using some sort of formula or equation would be beneficial for the Council's decision-making process.
Susan Shea explained that the job of the Council is to allocate these funds to the most severe need clients. There are differences between what clients and providers would prioritize. Unmet need versus the Importance should be thought about - one might not think a service is important if the need has been met; and if a need has been met, it might not be perceived as important.
Sam Kaplan suggested the group put together an algorithm. George Simmons asked the Council to consider that though providers may think differently than consumers, the Needs Assessment clearly outlines consumers' priorities. He emphasized that the Council be client-centered, as outlined in the Shared Values. Naomi Prochovnick explained that many sub-categories are interconnected in their delivery, and should not be seen as isolated issues. Cutting one sub-category would essentially cut another service indirectly.
Brad Hume emphasized that it is impossible to take emotions out of this process through using an algorithm. Charlene Pugh explained that creating a system would be too difficult to do now. Clarification was made regarding integrated services. Donald Frazier asked the Council to use common sense. Jeff Byers explained that another planning group he participates in uses an algorithm, and is not successful in separating their opinions, emotions, or expertise from discussions. Susan Shea made a motion to vote on sub-categories in thirds, by identifying the top ten and bottom ten. The motion was seconded; the question was called; discussion ensued.
Outcome: With one opposition, the motion passed.

XII. Sub-Category Prioritization - VOTE
1-11 Sub-Categories
Jim Mitulski made a motion for the first ten priorities; the motion was seconded. Charlene Pugh spoke against the motion because Outpatient Mental Health was left out of the motion. Ken Pearce spoke against the motion to maintain Outpatient Mental Health. Mark Dunlop made a friendly amendment to swap Outpatient Mental Health with Centralized Dental Care. Jim Mitulski did not accept the friendly amendment. Mark Dunlop then made a friendly amendment to replace Transitional Housing with Outpatient Mental Health. Jim Mitulski accepted the friendly amendment. George Simmons made a friendly amendment to switch the order of ISPs and Food Bank. Ali Riker suggested not making friendly amendments in this process, as it makes the discussion very confusing. She spoke for Jim Mitulski's original motion, and clarified that Transitional Housing should be maintained, and looking at Housing Unduplicated Clients (UDC) should not be interpreted comparable to other sub-categories. She made a friendly amendment to keep Transitional Housing in the top ten, and Jim Mitulski did not accept.
Ali Riker made an alternate motion, incorporating Money Management and Transitional Housing in the top ten (Outpatient Mental Health would be in the second tier). Margot Antonetty spoke for Ali's motion, as Transitional Housing often serves those most in need, especially African Americans and people of color. Sam Kaplan spoke against the motion, sighting the Needs Assessment's low priority of Transitional Housing. Bill Blum spoke against the motion. Charlene Pugh spoke against the motion and reiterated that Mental Health services are under funded and rarely reimbursed by MediCal. Ken Pearce spoke against the motion, and added that UDCs for Mental Health Crisis services are almost as high as Primary Care. Curtis Baker spoke for Ali Riker's motion, as a consumer. Randy Allgaier spoke against the motion, to maintain Mental Health services. There are no Substance Abuse services listed in the top ten. Larry Cruz spoke against the motion, as CARE dollars should go to the greatest number of people possible. George Simmons spoke against Ali Riker's motion, as Mental Health should be in the top ten. Mary Lawrence Hicks spoke against the motion, to maintain Mental Health in the top ten. Donald Frazier spoke against the motion, to maintain Mental Health in the top ten. Mark Dunlop spoke against the motion to maintain Mental Health services. Charles Siron called the question to vote on Ali Riker's alternate motion.
Outcome: The alternate motion failed.
Discussion returned to the motion made by Jim Mitulski. Margot Antonetty made a friendly amendment to switch Money Management with Outpatient Mental Health. Jim Mitulski did not accept the amendment. Ken Pearce made a friendly amendment to replace Outpatient Mental Health with Crisis Mental Health. Jim did not accept the friendly amendment. Lara Sallee made a friendly amendment to move Integrated Case Management and replace it with Money Management. He did not accept the amendment. The Council decided to vote for the motion, on condition that number 11 is Transitional Houising. The question was called, seconded, and a vote was taken.
Outcome: The motion carried, with the following results:
1. Primary Care
2. Emergency Housing
3. Food Bank/Home Delivered Meals
4. ISPs
5. Residential Programs and Subsidies
6. Benefits Counseling
7. Outpatient Mental Health
8. Direct Emergency Financial Assistance
9. Centralized Dental Care
10. Money Management

11. Transitional Housing

22-31 Sub-Categories
Brad Hume made a motion for the bottom ten sub-categories, Charlene Pugh seconded the motion. He included Case Management in the bottom ten, because the 3-Year Plan had incorporated this idea of Integrated Service Programs (which include Case Management) as a priority. Many of the listed categories are funded specifically as CBC (Congressional Black Caucus, now referred to as the Minority AIDS Initiative, or MAI) funded services. Donald Frazier made a friendly amendment to allow for Detox and Case Management to be taken out of the bottom group, and to be replaced with Facility Based Home Care and Home Based Home Care. Brad Hume did not accept the amendment. Donald Frazier changed his friendly amendment to keep Detox in the bottom tier, and identified Facility Based Home Care as the one to leave in the bottom tier. Brad accepted the amendment, as did Charlene Pugh. Susan Shea explained that Facility Based Home Care is so important because this allows people, many of which are homeless, to die with dignity. Susan Shea made a friendly amendment to maintain Facility Based Home Care in the middle tier, and replace it with Complementary Care. With discussion, Brad Hume and Charlene Pugh accepted the amendment.
Mjay Sanders spoke against the motion because Complementary Care does not belong in the bottom third. He asked the Council to consider his position as a consumer. George Simmons spoke in favor of the motion. Ken Pearce spoke against the motion, as Psychiatric Consultation should be maintained in the second tier. Mary Lawrence Hicks spoke in favor of the motion. Catherine Geanuracos spoke in favor of the motion. Elyse Graham spoke against the motion to maintain Complementary Care, as it is considered Primary Care in the State of California. She made a friendly amendment to replace Complementary Care with the Residential Mental Health. Brad Hume did not accept the friendly amendment. Charles Siron called the question; with opposition, the question was not called.
Mark Dunlop made a friendly amendment; Charlene Pugh (the second) did not accept it. Jim Mitulski made a friendly amendment to keep Complementary Care in the second tier to protect it, and replace it in the third care with Case Management. The friendly amendment was accepted. Anthony Huynh spoke against the motion, to maintain Case Management in the second tier, as monolingual and multiply diagnosed consumers really need those services. Randy Allgaier spoke against the motion, as Case Management is so connected to Primary Care, and should be protected. Brad Hume reiterated that according to the 3-Year plan, Case Management will be integrated. Margot Antonetty called the question.
Outcome: The motion failed.
Catherine Geanuracos explained that Case Management should not be in the bottom ten. She suggested substituting Integrated Case Management with Case Management. Donald Frazier concurred. Mark Dunlop explained that Adult Day Health Care should not be compromised. Ken Pearce explained that Substance Abuse services might have alternate funding sources. Susan Shea spoke for Case Management, as it is actually more integrated into Primary Care than Integrated Case Management.
Catherine Geanuracos made a new motion that moved Integrated Case Management. Substance Abuse programs are utilized by homeless people, and could provide a short-term respite for those who need housing. Ken Pearce made a friendly amendment, Catherine Geanuracos did not accept. Susan Shea made a friendly amendment. Bill Blum called the question.
Outcome: The motion carried, with the following results:

22. Integrated Case Management
23. Adult Day Health Care
24. Treatment Adherence
25. Child Care
26. Psychiatric Consultation
27. Methadone Maintenance
28. De-Centralized Dental Care
29. Transportation
30. Congregate Meals
31. Pharmaceuticals

12-21 Sub-Categories
Donald Frazier made a motion to order 12-21. George Simmons seconded the motion. He spoke for the motion because Crisis Mental Health and Residential Mental Health Services are critical to the continuum of services provided. Anthony Huynh made a friendly amendment to switch Case Management with Crisis Mental Health. Donald Frazier accepted the friendly amendment. Brad Hume made another friendly amendment to switch Legal/Immigration Assistance with Detox. Donald Frazier did not accept Brad Hume's friendly amendment and explained that Detox is an access point, and would serve those most in need. Detox offers a specialized service for people with HIV, and is a major access point. Ali Riker would like the Council to understand that the folks utilizing Detox services are the most in need. Mjay Sanders would like to move Complementary Care up in order, as it often allows people to die with dignity. Bill Blum made a friendly amendment to switch Detox and Outpatient Substance Abuse Services. Donald Frazier did not accept the amendment. Michael, former co-chair of the Treatment on Demand Council, explained that the City is not going to supplement any cuts in Substance Abuse. Speed use among gay men with HIV is a critical issue in San Francisco, and moving Outpatient Substance Abuse could compromise their permanent housing. Mark Dunlop made a friendly amendment to switch Detox with Legal/Immigration Services. Donald Frazier did not accept the friendly amendment. Charles Siron called the question; there was an opposition to calling the question. A vote was taken and the question was not called.
Brad Hume presented a substitute motion to switch legal services with Detox. Mark Dunlop seconded the motion. Donald Frazier reiterated that the folks that use Detox are the people who are most in need. Margot called the question; it was seconded.
Outcome: The motion failed.
The group reverted to discussion on Donald Frazier's original motion. Randy Allgaier made a friendly amendment to switch Outpatient Substance Abuse with Legal/Immigration. The friendly amendment was not accepted. Susan Shea made a friendly amendment to move Facility Based Home Care and Home Based Home Care above Detox. Donald Frazier accepted on condition that Detox is above those sub-categories. George Simmons concurred and the friendly amendment was accepted. Brad Hume spoke against the motion, with the changes made, as Legal/Immigration is still too low, and does not reflect the Needs Assessment findings.
Brad Hume made a substitute motion to move Legal Services under Crisis Mental Health. Sam Kaplan seconded the motion. Elyse Graham spoke in favor of the motion to support Legal Services, and offered a friendly amendment to move Complementary Care up and move Home-based Home Care down. Lara Sallee made a friendly amendment to move Complementary Care under Legal/Immigration. Susan Shea spoke against the motion and spoke for Home-based Health Care, as these services are extremely linked to Primary Care. Catherine Geanuracos spoke against the motion, and stated that Detox should be higher up in the list. The question was called.
Outcome: The motion failed.

The group reverted back to the discussion on Donald Frazier's original motion. Catherine Geanuracos called the question, there was no opposition, and the question was called.
Outcome: The motion carried with the following results:

12. Case Management
13. Crisis Mental Health
14. Residential Substance Abuse Treatment
15. Residential Mental Heath Services
16. Detox
17. Facility-Based Home Care
18. Home-Based Home Care
19. Outpatient Substance Abuse
20. Legal/Immigration Assistance
21. Complementary Care

Trevor Bougouneau explained that the Needs Assessment should be used when making these decisions.

Patrick Monette-Shaw provided written Public Comment as follows:

I appreciate the remarks Trevor just made . I have heard several times
during the priority voting that some council members are concerned that
the needs expressed by clients in the needs assessment conducted by
LaFrance Associates are being ignored by this council and that you are
placing a higher priority on some subcategories of services than the
clients have expressed. I support Trevor’s statement that if you are
going to ignore the findings of the needs assessment, that you might as
not well conduct them. To that extent, Dr. Katz has presented testimony
to the Health Commission that all contracts issued by DPH are subject to
cancellation with a 30-day notice. If the LaFrance contract is a
multi-year contract, there is no need to keep spending $175,000 annually
on it just to ignore the findings. I urge you to consider cancel that
contract if you find the results useless.

XIII. Multiple Cut Funding Scenarios
Catherine Geanuracos explained that the only funding scenarios that need to be applied in order to write the grant are the increased and the flat fund scenarios (See Attachment E). The funding decrease decisions will be made at a later date. Susan Shea suggested the Council look at augmenting ISP's funding. Five of the Eight Primary Care providers are NOT involved in ISPs. Jim Mitulski asked the group to look at focusing on bolstering the top third, holding the second tiered to be held harmless, and the final to be eliminated.
Jeff Byers made a motion for any increase, up to 5%, to be applied to the top 11 categories as outlined tonight. The remainder of the sub-categories would receive flat funding. George Simmons seconded the motion.
Patrick Monette-Shaw explained that the Health Commissioner asked non-profits to fundraise for COLAs.
George Simmons spoke for the motion. Charlene Pugh offered a friendly amendment to cut the last three completely, and apply those dollars to bolster ISPs. The friendly amendment was not accepted. Ali Riker spoke in favor of the motion. Randy Allgaier spoke in favor of the motion. Brad Hume offered a friendly amendment to bolster ISPs: whatever the increase is, 25% would be applied to ISPs. Jeff Byers did not accept the amendment because the increase amount is not determined. Catherine Geanuracos spoke in support of the motion. Elyse Graham made a friendly amendment to include Case Management and Crisis Mental Health to the increase group. The friendly amendment was not accepted. Jim Mitulski called the question, Randy Allgaier seconded.
Outcome: The motion carried.

Patrick Monette-Shaw asked when the Council would get an accurate budget from the AIDS Office.

XIV. Open Nominations for Co-Chairs
The requirements for the Co-chair position are that the person(s) be a woman, HIV +, and/or a person of color. Nominations were opened for Council Co-Chair: Susan Shea nominated Brad Hume. Mark Dunlop seconded. Brad Hume nominated Charlene Pugh, the nomination as seconded. Ken Pearce nominated Jim Mitulski for another term. Kevin Johnson nominated Donald Frazier for another term. Margot Antonetty nominated Catherine Geanuracos.

XV. New Business
There was no new business.

XV. Adjourn
7:22pm.

DRAFT