Southwest Florida Regional HIV/AIDS Council (RHAC)

Southwest Florida Regional HIV/AIDS Council (RHAC)

Date: January 19, 2011

Time: 9:30AM – 11:00PM

Place: Charlotte County Health Department

Attendees: attached list

I.  Order

The meeting was called to order by Bill Little. Introductions were made by all in attendance. The Minutes from November 17th, 2010 were reviewed. A correction of clarification was requested by Dr. Hartner within the Prevention Committee Update which was stated by J. Acevedo in regards to individual counties working together collectively to submit EPI data instead of doing individually in order to compete with larger areas such as Miami-Dade.

The Program Report was pulled for review. Dr. Hartner also requested if the submission of the Ryan White Part B Budget for 2011 -2012 is finalized? S. Barrows stated due to the bureau requesting specific documentation HPC had to follow the timeline which was sent the bureau a proposed budget allocation in December. E. Houck explained that the contract manager receives notification for the preliminary budget, and narrative. HPC only had a few weeks to send to the bureau. This proposed allocated budget is for the next contract year which begins April 1st 2011, although RHAC had not reviewed the proposed budgets. B. Little addressed that if the budget allocation had to be done prior to RHAC being notified then what is RHAC’s purpose, structure? How is this driven, and what is the impact?

S. Barrows explained that Case Management had been divided into two line items (supportive/comprehensive) for 2011-2012 which are the new guidelines set by HRSA. Case Management has been increased from 24% to 35%. The previous case management was funded at $441,311.00 and next year will be funded at $543,745.29. S. Barrows also clarified although Transportation and Food have been funded at zero the line item is still available to be funded with a shift if needed. It was explained that a revision can be done as long as the line item has been submitted , but it the line item is not listed on the budget allocation then an amendment must be submitted to the bureau which it could take several months to receive a response of approval or denial. The big contract has to be done by April 1st 2011 and the second is the subcontract. The only agency not receiving medical funding is ICAN. Ambulatory and Case management contract has not been scheduled for negotiation with each individual agency at this time. R. Bobo stated that there is a concern the HMS dump doesn’t match the RDR and this needs to be coordinated with Careware. S. Barrows stated that she has a conference call with Rich Powers, and Alex Bello tomorrow and will inform Rich that Area 8 DOH providers would like to have an upload/download done weekly so that accurate information can be collected. C. Kirby recommended that although the budget allocation was given after the fact a detailed analysis being given to RHAC at the end of the next contract year for March 31st would give a good indication of what services are being utilized an propose the direction of which RHAC should address the budget allocation for the following year. Dr. Hartner motioned, and M. Burns seconded. R. Bobo acknowledged a letter from T. Libert. C. Kirby stated that PCPG received a letter about Closing the GAP not facing termination and that funding would not be going to ADAP. This was a very extremely positive outcome and no reduction has been made. Dr. Hartner approved the remaining agenda, and seconded by M Burns.

II. HOPWA Update

S. Barrows stated that HOWPA has been on spending on a fast track. A subcommittee met and thought there would be funding for supportive services. If the clients counts continue to increase then HPC will need to meet with RHAC in March and speak of possibly doing reduction in services. It may be possible that this current HOPWA funds may break even if there are no new clients that accessing HOPWA services. The possible reduction could include not doing concurrent services w/ Mortgages (Rent). B. Little wanted to know why in previous years was Area 8 not faced with this situation. L. Archipov explained that more clients have been accessing HOPWA services now due to loss of income, unemployment benefits. It could be possible that due to Sarasota in HOPWA instead of HUD the margin is now gone. Although Sarasota came into HOPWA last October there is no need for HPC to isolate and view the impact of acquiring Sarasota. Within a month HPC will now the spending pattern and will advise RHAC of possible recommendations. This may include cutting HOPWA services to (1) service per month, and no concurrency, but not limited to Security Deposits. S. Craig stated that there should be a possible methodology in place to be reviewed prior to a HOPWA crisis occurring. K. Hustad suggesting looking at the guidance of overspending, and under spending and then look at a shift. J. Trout inquired was it possible to do a restriction? S. Barrows stated that there is no restriction that has been put in place for HOPWA clients receive 147 days of service. B. Little recommended that HPC also review the drive for HOPWA (loss of employment).

III.  Proposed RHAC Meeting Dates 2011-2012

S. Barrows submitted the proposed RHAC dates. After review of the previous calendar with an exception to Thanksgiving it was suggested that either an RHAC meeting could be on November 16th, 2011 or on November 30th, 2011. November 16th was selected as the meeting date, and Charlotte CHD as the location. S. Barrows will send A. Kendall the RHAC schedule for the year and she will confirm that the meeting room is available for those proposed dates.

IV.  Comprehensive Plan

P. Brown requested that RHAC assist in catorizing a handout and returning it back at the end of the RHAC meeting. P. Brown stated that there was a survey last year which needed feedback. The results of the survey is about 40 pages. Information is broken out by county. 2 weeks ago a workgroup met. There was a lot of ranking that was approved (Local Needs Assessment Analysis). At the previous RHAC meeting the ranking was approved, but the workgroup of 16 decided on ranking Patient Care. PCPG was challenged with local input. The 5 ranks are out of 10 which were not selected. There is concern for addressing the underserved instead of harder to serve. Often is is about an individual not ready to address issues or access to services. An example of which is Ex-Offenders. How many ex-offenders are coming out of DOC and going into care? L. Archipov stated that many ex-offenders will not access services due to ex-offender status, and will not be able to access HOPWA due to the criteria. If the ex-offenders aren’t stabilized many go back to jail or relocate to larger metropolitan areas where it is easier to blend into the community. P. Brown requested that all input be emailed so that it can be added to the Narrative. M. Kehoe asked if it would be feasible to submit the rankings individually as everyone is going to have a separate idea of what a priority should. Also, Dr. Hartner’s concern was if RHAC submits a priority ranking will this impact Area 8 in a negative/ or positive way. P. Brown indicated that this ranking is necessary to the comprehensive plan and is mandated to submit. RHAC ranked the following Support Services:

1. Medical

2. Pharmacy

3. Medical Case Management

4. Oral Health

5. Early Intervention

6. Non Medical Case Management

7. Housing

8. Food

9. Health Education

10. Transportation

11. Treatment Adherence

12. Mental Health

13. Substance Abuse (Outpatient)

14. Medical Nutrition Therapy

RHAC recommended that P. Brown find out the consequences of the ranking, and also the definitions.

P. Brown requested if there is any input on Providing Service Gaps, and Justification, Epidemiological Data Analysis to send her an email.

P. Brown asked if RHAC could provide the annual case load capacity information for the Resource Inventory. P. Brown was asked to clarify if this is facility or staff capacity? Also is this a limitation on the physical space which is used to build capacity, get clarification if this is under optimum circumstances? P. Brown requested approval of the ranking to be submitted as reviewed with RHAC. B. Little approved.

Due to this being a local needs assessment there is no way to go ahead and have submission of the comprehensive plan to be more organized.

R. Bobo stated that Florida has a waitlist with an emergency conference this afternoon due to the governor placing a freeze on all regulations which include changing the current federal poverty level from the current 400% to 300%.

The ADAP program placed client level data into the system of when clients receive medications. S. Murphy inquired if there is any way to get current information about ADAP as soon as possible? L. Archipov stated that Care at the bureau is not being communicated with and leaves Area 8 CBO’s out of the loop. Although HPC receives the notification and disseminates immediately. S. Craig stated that ADAP was audited and owes funds, and if unable to recoup those lost funds the local area will need to payback the funds.

R. Bobo stated that if you were included in the HRSA audit the central office was to report back to HRSA with the finding and someone would contact you. B. Little suggested that a letter to T. Liberti be drafted to address and clarify the ADAP issues. S. Barrows will do the letter and sent to B. Little.

V.  PCPG

R. Bobo clarified that at this time there is nothing to report at this time but should have some updated information for the next RHAC meeting.

VI.  Prevention Plan

C. Kirby recognized P. Brown, B. Little and his staff for assistance in gathering the prevention plan data. The local plan was created due to the state plan not fitting into Area 8.The color version of the plan is available on the HPC website. B. Little recommends a copy of the Prevention plan be sent to the Bureau from RHAC. C. Kirby will also include that the collection of the Area8 Prevention plan was unfunded. J. Acevedo stated that we need to look beyond the county lines and compete. Area 8 is not included due to our low numbers, but if you join with others 2-3 counties their EPI data then you are then able to compete.

VII.  Public Comment

M. Burns announced that B. Little’s last meeting was today. B. Little stated that he is going to take on more of a county role vs. state role, and that he is resigning from his position in RHAC. A new chair will need to be elected for RHAC, everyone was informed to submit nominations to HPC and a vote will be done at the next RHAC meeting.

Anne McDaniel now the Executive Director for the Bob Rauschenberg Center for the Living. She is now currently looking to move forward and take assistance where needed in order to provide assistance to people within the community. A. McDaniel has spoken with Dr. Hartner, and S. Barrows and will be attending future meetings.

The next RHAC Meeting will be March 16th, 2011 at The Charlotte County Health Dept

RHAC Members and Guests
Attendance List 2010-2011 / 9/15/2010 / 11/17/2010 / 1/19/11 /
RHAC County Health Department Members
Mary Kay Burns / Interim Charlotte CHD / ü / ü / ü
Donna Olsen / Charlotte CHD Alternate / ü
Joan Colfer / Collier CHD / A
Susan Craig / Collier CHD Alternate / ü / ü
Mary Kay Burns / DeSoto CHD / ü / ü / ü
Penny Kurtz / DeSoto CHD Alternate / ü / ü / ü
Pat Dobbins / Glades CHD / ü
Robert Bobo / Hendry CHD / ü / ü / ü
Judith Hartner, MD / Lee CHD / ü / ü
Bill Little / Sarasota HD / ü / ü
Barbara Laidlaw / Sarasota HD
RHAC Community Representative Members
Open / Charlotte County
Ellen Cordoba / Marion E. Feather Collier / ü / ü / ü
Cheryl Adams / DeSoto County / ü / ü
Jennifer Hood / Glades County / ü / ü / ü
Art Gallagher / Hendry County / ü / ü
Open / Lee County / ü
Mike Kehoe / Sarasota County / ü / ü
RHAC At-Large Members
John Acevedo / Prevention Representative / ü / ü / ü
Sean McIntosh / Patient Care Representative
Area 8 DOH Representatives
Gail Counts / Area 8 HAPC / ü / ü
Jesse Flores / Area 8 Contract Manager / ü / ü / ü
Clarke Kirby-Retired / Area 8 Early Intervention / ü / ü / ü
Lead Agency Staff
Ed Houck / HPC / ü / ü / ü
Susan Barrows / HPC / ü / ü / ü
Mike Waite / HPC / ü
Kim White / HPC / ü / ü / ü
Alma Johnston / HPC / ü
Peggy Brown / HPC / ü / ü / ü
Lauren Boyar / HPC / ü
RHAC Guests
Suzanne Stevens / DOH / ü
Dr. Jeff Beal / DOH HIV/AIDS Medical Dir. / ü
Amy Pinter / Positive Healthcare / ü
Jan Leather / Positive Healthcare / ü / ü
Amy Zamot / Minority AIDS Coordinator / ü / ü
Anne Solmo / McGregor Clinic
Sylvia Garcia / DeSoto CHD / ü
Bill McBurnie / Charlotte CHD / ü / ü / ü
Brenda Lastinger / Hendry/Glades CHD
Chris Ada / Aids Manasota
Jim Yearns / Lee CHD
Eric Stockley / Charlotte CHD / ü / ü
James Ogedegbe / Charlotte CHD / ü / ü
Joan Surso / Sarasota CHD
Kim Hustad / Lee CHS / ü / ü
Lyzza Archipov / McGregor Clinic / ü / ü / ü
Marie Boisol / McGregor Clinic
Sharon Murphy / McGregor Clinic / ü / ü / ü
Jeff Trout / ü
Nilda Porenza / Collier CHD
Mike Cuffage / Comprehensive Care Clinic / ü
Richard Sapp
Diane Sabatino / Tibotrco & Boward Part B / ü
Antonia Rafalsky / Hendry CHD
Christine Griffith / Sarasota CHD / ü / ü
Sonya Paige
April Glasco / ü
Stephen MacGregor / Mental Health / ü
Amber Beckwith / ü
Carolyn Moore / ICAN
Lynn McElroy / Tibotrco Therapeutics
Anne McDaniel / The Rauschenberg Center / ü
Lynn Mackavoy
Lynthia Oratokhai / Sarasota CHD / ü / ü
James McCloud / ü

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