MN HIV Services Planning Coun= cil Meeting

December 9= , 2008

9:00 am – 12:00 noon

Plymouth Congregational Church

1900 Nicollet Avenue= , Minneapolis

Minutes<= /span>

Council Members Present:<= o:p>
Paul Eknes-Tucker (Council Co-Chair)	Mike Behl
Karin Sabey	Hank Jensen
M= akéda Norris	Keith Henry
Dave Rompa	Bob Hansen
Michael Hargrave	David Neller
Darin Rowles	Marty Perry
Loyal Brooks	Rob Piolo
Peggy Darret-Brewer	Ephraim Olani
Luther Christensen	Gerry Tyrrell
Jennifer Houston	Chris Bernard
Ama Sabah	Timona Jarha
Rosetta Hunt
Council Members Absent:<= o:p>
Susanne Pfeil	Jerry Moss
Hazel Erickson	Walter Schwartz
Consultants:<= o:p>
Becky Kroll - CLEAR
Guests:
Marisa Stanley – Hennepin County intern<= /p>
G-HAT:
Jonathan Hanft – Hennepin County	Andy Ansell – DHS
Sheila Murphy – Hennepin County	Thuan Tran – Hennepin County
John Suhr – Hennepin County	Glenis Johnson – MDH
Planning Council Staff:
Wendi Johnson (minut= es)	Tim Sullivan

Quorum Pr= esent? Yes

I.&n= bsp; = ; Welcome and Introductions; Lighting of the Candle

Paul stated he would be pre= siding and called the meeting to order at 9:07 am. Introductions were made. Paul lit the candle for his diagno= sis of 11 years. He is happy to be h= ere.

II.&= nbsp; &nbs= p; Review the November 18, 2008 Meeting Minutes and Proposed Agenda

The minutes were approved by unanimous consent. Open Forum= was added to the agenda and Andy Ansell is now the Part B representative. The agenda, with two corrections, = was approved by unanimous consent.

III.= Open Forum

None

IV.&= nbsp; &nbs= p; Part A, Jonathan Hanft

A. Conditions of Award – There are a series of reports and conditions of award that= are due. The final MAI expenditure report has been submitted. Consolidated list of contacts has also been submitted. MAI annual report is due January 3= 0, 2009.

B. Data Improvement Project Update – The technical assistance request has been approved. A $162,000 grant ha= s been awarded to improve data collection.

C. Access to Care DVD Broadcast Dates on TPT – DVDs available for Council members. Each member can take= one copy and fill out a form for additional copies. Contact Wendi for additional copies.

V.&n= bsp; = ; Part B/ADAP Update, Andy Ansell & Da= ve Rompa

A. Shelly has been working on the Part B application

B. World AIDS Day events sponsored by DHS, AAATF, Planning Council, and Hennepin County. Dr. Fullilove was a very interesti= ng speaker and brought a lot to MN. Andy thought it was a great example of what can be accomplished when everyone works together.

C. Adherence training on January 30^th. MATEC will be conducting a medication adherence training on January = 30^th which is targeted toward case managers but is open to anyone wanting to attend. Wendi will email the = flyer to Council members.

D. Regional adherence conference on April 7^th. This is a day-long conference with several breakout sessions with two keynote speakers.

E. = The nutrition workgroup will meet tomorrow to brainstorm ideas on how to incorporate a nutritionist into the program.

F. = DHS has a prior authorization system for MA clients. This program is very restrictive.<= span style=3D'mso-spacerun:yes'> DHS is working with MA to find a m= iddle ground and find supplements that will fit the clients’ need. Dave hop= es to have the program operational in January.

G. Forecast – the state is a little low on money. By the end of FY 2009 the Governor= has to find $429 million to balance the budget. There is a projected $5 billion shortfall for the following year. Some forecasters are predicting an even larger shortfall.

H. Program forecast – some improvement if everything goes as planned. During the last forecast DHS was concerned about having a shortfall at the end of 2011 and now the forecast expects a shortfall in 2012 but it will be a larger amount. If anyone has an opinion about the= money that was borrowed from the HIV/AIDS Division they should write a letter to = the Commissioner. Please CC to Da= ve Rompa and Alex Bartolic. Questions/Comments:

· Makéda asked for history on this shortfall. Tim said last year= the state borrowed money from the HIV/AIDS Division and promised to pay back th= at money in the following year. =

· Karin asked what happens to the 2012 shortfa= ll forecast if this money is not repaid to the program. Dave said it would move the shortf= all up 8 months.

· Keith asked how some of the surrounding high incidence state’s budgets are looking. Dave suggested going to the NASTAD= website for their ADAP watch. Nebraska has some waiting lists and is currently looking at FPG and formulary changes. Michigan is almost to the point of a wait list.&nbs= p; Wisconsin<= /st1:place> is doing ok.

VI.&= nbsp; &nbs= p; Co-Chairs Update

None

VII.= Staff Update

A. A new member orientation session is scheduled for January 9, 2009 from 8:30-1pm. All Council members= are welcome to attend to get an update on the process. Please let Wendi know if you plan = to attend.

B. A revised Council member roster was distributed. Council members were reminded to k= eep this document within the Council.

C. The 2009 meeting schedule was distributed.&nbs= p; Wendi tried a different format to make it more visual. The Planning Council meetings will= now be at HSB (525 Portland Av= e) in the lower level. Parking w= ill be validated if parked in HCMC parking ramp.&= nbsp; If someone receives reimbursement from their employer they should not ask for a validation sticker. By switching rooms the Council will save $2500/yr. Tim made special note that November & December meeting dates do have some changes.

D. Tim will be sending out an email for volunteers to light the candle for next year.

VIII. Update on Part A 2008 Site Visits and CLRS Data, Sheila Murphy & Marisa Stanley

Sheila distributed a docume= nt entitled 2008 Site Visit Summary Fi= ndings. Site visits are conducted with all contracted providers. Questio= ns/Comments:

· Paul asked if the question about access to c= are status indicates who was actually in care vs. who was assessed for being in care.

· Ama asked if the percentages are statistical= ly significant. Jonathan said th= ey are significant in terms of each provider.

· Loyal asked how providers feel about the site visits. Sheila said providers= seem to be finding the site visits helpful in improving the quality of services. Gerry T. added that= he feels in the past providers haven’t “been there” but that they seem to be more engaged.

· Sheila noted that some providers offer supportive services to significant others of their clients so there is some data on services provided to HIV- clients.

· Chris asked about the 1^st half of= 2008 CLRS data. The number of peop= le receiving services above the FPG seems high. Sheila thinks this is a data error= and will look into the correct information.&nb= sp;

· Tim asked Sheila to talk about who collects = this data. Sheila said every 6 mon= ths Ryan White providers turn in CLRS data.&nb= sp; The focus of the DIP is to streamline the collection process and mak= e it more electronic.

· Karin asked if there were really 80 people u= sing nutrition in the first half of the year.&n= bsp; Dave said everyone enrolled in Program HH has access to the nutrition program.

· Gerry T. asked if those who had not been to a primary care appointment in the last 6 months were using bus card programs = or other support services. Sheil= a said the data collected by each provider shows what services clients are using.<= span style=3D'mso-spacerun:yes'> She said if a provider has primary= care services they should have a higher number of clients in care and those providers who do not provide primary care services should be referring a hi= gher number of clients to a primary care provider.

o = Karin said some of the referral data is incorrect. She noted her agen= cy did not collect this data until recently. Jonathan said collection of this data is improving and quality goals= for providers always change as they meet previous goals.

o = Ama asked if the providers were asked why th= ey did not have data on referrals. Sheila said this is one of the topics of discussion at site visits.<= span style=3D'mso-spacerun:yes'> The look at barriers that may keep= them from giving appropriate referrals and documenting. Because providers have different barriers the outcomes of these discussions vary.

o = Keith thinks it might be a good idea to track appointment/referral data with viral and CD4 counts because they may not ne= ed to see a primary care doctor as often as every 6 months. Sheila said this data will begin b= eing collected by medication adherence and primary care providers.

o = Luther said providers tend to focus more on clients who need the most primary care and collecting this data could help providers be more aware of this.

· The remainder of 2008 data will be presented= in January.

· Gerry T. noted that he thinks the system is working well in monitoring data and the system will continue to improve.

IX.&= nbsp; &nbs= p; Presentation of 2009 Comprehensive Plan

Tim reviewed the Draft 2009 Comprehensive Plan. The Planning & Priorities comm= ittee spent months reviewing the document. The Part A plan is due to HRSA on January 5, 2009 and Part B plan is= due to HRSA on February 5, 2009. = The comp plan is a joint document because of the joint planning and the demographics are similar in both the TGA and the entire state. The comp plan needs to be rewritten/updated every 3 years. This time the directive was to update the plan for 1 year since the = law sunsets in 2009. Planning &am= p; Priorities reviews the monitoring plan every month to ensure the goals and objectives are on track.

Tim asked the Council if an= yone had a guess as to how much money was allocated and spent over the last three years. He said over $36 milli= on!

Tim began review at Section= 3 in the executive summary. There = are two goals in the plan: to get people into care, and to keep them in care. Question/Comments:

· Keith asked that a notation be made where the standards come from. They com= e from the current universal standards. Tim directed members to page 70 to look at the clinical measures. These points were taken from the P= art A application and will be updated once they are received.

· Keith noted the percentages referenced in Objective 1A are an estimate of reported cases.

· Hank asked why injection drug use was includ= ed in Objective 1B. Tim said thi= s was taken from another report and he will add substance use to the plan.

· Karin asked what the definition of “care” is under Goal 2. Tim said it applies to services that PLWH/A need. Karin is confused with the term ca= re used in two different contexts in the same document. Tim will add the word “medical” to differentiate.&nb= sp;

· Karin asked who establishes quality measures. Some are developed = by the medical quality center or locally. Jonathan added that universal standards apply.

· Paul said the “continuum of care” term needs to remain in the document so Tim will do his best to differentiate.

· There will be three letters of concurrence included in the document from the Council Co-Chairs, Hennepin County, and DHS.

· Tim noted that in 2009 Psychosocial Support services were moved under Mental Health service area so the grantees could = meet the 75/25 split.

· MOT= ION: Bob made a motion to approve the 2009-2011 Comprehensive Plan with minor correc= tions. Mike seconded and it was approved = unanimously with a vote of 19-0

X.&n= bsp; = ; Committee Reports

A document entitled Committee Report Summaries was distributed.

· Community Voice – no additional update

· Executive – no additional update<= /u>

· Needs Assessment & Evaluation = 211; no additional update

· Operations – =

o = Election of Planning Council Co-Chair – Council bylaws state a Co-Chair vacancy needs to be filled within 30 days.<= span style=3D'mso-spacerun:yes'> Mike Behl and Bob Hansen have both expressed interest. Rosetta nominated Bob with a second from Jennifer.= Keith nominated Michael B. with a second from Ama. Michael B. and Bob both expressed = why they are interested in serving as Council Co-Chair. Council members were asked to writ= e one name on a piece of paper. Mic= hael B. was elected as Council Co-Chair with a vote of 10-9 with one abstention.=

· Planning & Priorities –

o = Action Item: Reallocation of Funds –

§MOT= ION: Michael B. made a motion to approve the proposal that up to $50,000 in unsp= ent Part A funds can be allocated to ADAP.&nbs= p; Bob seconded and it passed unanimously with <= /span>a vote of 19-0.

XI.&= nbsp; &nbs= p; Unfinished Business

None

XII.= Announcements

· DHS is currently in the process of updating their Statewide Coordinated Statement of Need (SCSN). This is a three year document. A planning group met in October to= offer input on the updated plan. Th= e next meeting is December 10^th at 10am at DHS offices. All final revisions will be made a= t that meeting. All Council members = are welcome to attend.

Meeting Adjourned at 11:16 am

Meeting Su= mmary:

· Sheila presented site visit summary findings= for the first half of 2008. Overa= ll providers are happy with the site visit process and it helps them to improve the quality of their services. The remaining half of 2008 data will be presented in January.

· The Council approved the 2009-2011 Comprehen= sive Plan. This plan is due to HRS= A on January 5, 2009. Planning &am= p; Priorities will monitor the workplan monthly to make sure all objectives are being met.

· Michael Behl was elected as Council Co-Chair= .

· The Council approved a reallocation proposal that would put up to $50,000 of unspent Part A funds into ADAP at the end of the fiscal year.

Documents Distributed Before the Meeting:

· Agenda

· Minutes from October 14, 2008

· Committee Report Summaries

· Draft 2009 Comprehensive Plan

Documents Distributed At the Meeting:

· 2008= Site Visit Summary Findings=

· Action Item: Reallocation of Funds

WJ/tds

December 9= , 2008

9:00 am – 12:00 noon

Minutes<= /span>

Council Members Present:<= o:p>

Paul Eknes-Tucker (Council Co-Chair)

Mike Behl

Karin Sabey

Hank Jensen

Keith Henry

Dave Rompa

Bob Hansen

Michael Hargrave

David Neller

Darin Rowles

Marty Perry

Loyal Brooks

Rob Piolo

Peggy Darret-Brewer

Ephraim Olani

Luther Christensen

Gerry Tyrrell

Jennifer Houston

Chris Bernard

Ama Sabah

Timona Jarha

Rosetta Hunt

Council Members Absent:<= o:p>

Susanne Pfeil

Jerry Moss

Hazel Erickson

Walter Schwartz

Consultants:<= o:p>

Jonathan Hanft – Hennepin County

Andy Ansell – DHS

Sheila Murphy – Hennepin County

Thuan Tran – Hennepin County

John Suhr – Hennepin County

Glenis Johnson – MDH

Planning Council Staff:

Wendi Johnson (minut= es)

Tim Sullivan