Old South Church, Guild Room

Planning Council

Thursday, September 12, 2013

4:00-6:00pm

Old South Church, Guild Room

Summary of Attendance

Members Present
Antonia Alves
LaTanya Archie
Stephen Batchelder
Jib Bowers
Jim Campbell
Srin Chakravorty
Tim Comeaux
Donna Daley
Durrell Fox
Ashley Frazier
Deborah Freeman
Linda Goldman
Michael Goldrosen
Elizabeth Harrington
David Hawkesworth
Christopher Ham
Leigh Kalbacker
Alison Kirchgasser
Heather Kough
Jeremy Lapedis
Wendy LeBlanc
Kathy Lituri
Jay Machado
Sarah McPhee
Erika Moreno
Nicholas Paulo
Morrigan Phillips
Carmen Ploszaj
Brian Quigley
Jonathan Reveil
Carmen Rios
Shirley Royster
Carla Rodriguez
Darren Sack*
Gary Sandison
Tali Schiller
Jessica Stewart
Greg-Eugene Sullivan
Meg Sullivan
Kimberly Wilson / Members Excused
Lillian Melendez
Leon Rahaim
Leonard Rise
Donna Rivera
Lawrence Vinson
Members Absent / BPHC Staff
Cheryl Brickey
Dennis Brophy
Alex Moran
Vanessa Sasso
PCS Staff
Gloria Brand
Abiola Lawson
Taiwo Odusanya

6

Welcome and Introductions

Topic A: Welcome, Introductions

Jib Bowers, Chair of the 2012-2013 Planning Council, called the meeting to order, welcomed new and returning members, and asked everyone to introduce themselves for the record.

Jib encouraged members to complete the evaluation forms for each meeting and remember to sign the attendance sheet by the door.

Review and Approve Minutes

Topic C: Review and Approve June 27, 2013 Summary of Meeting

The Council members reviewed the minutes from the June 27, 2013 meeting.

Motion to Approve: Gary Sandison

Second: David Hawkesworth

Results: Minutes were approved; (17) abstentions.

Icebreaker

Topic B: Icebreaker

Gloria Brand, PCS staff, led an icebreaker for Council members to get to know each other.

Elections I: Planning Council Leadership – Chair

Topic D: Planning Council Leadership Elections – Chair

Jib directed members to read the handout on the elections process and pointed out the Leadership Responsibilities sheet. This year, nominations were closed by September 9th and Candidate statements were sent out to Council members before this meeting. Each position would be elected in the order of Chair, 1st Vice-Chair and 2nd Vice-Chair. Two candidates were nominated for chair and vice-chair: Brian Quigley and Kimberly Wilson. Erika Moreno was nominated as 2nd Vice-Chair. Each candidate was requested to give a brief oral statement, and their prepared written statements were also available in the council packet.

The Planning Council members voted and PCS staff collected and counted their votes.

Brian Quigley was elected as the Chair of the 2013-2014 Planning Council.

Motion to accept Brian Quigley as Chair, Kimberly Wilson as 1st Vice Chair and Erika Moreno as 2nd Vice Chair: Wendy LeBlanc

Second: Steve Batchelder

Results: Motion passed, no abstentions

Gloria asked the group if they understood the elections process and to put comments or questions they may have on the evaluation form.

Update from Mayor’s Office

Topic E: Update from Mayor’s Office - Membership

Gary Sandison gave an overview of overall Council membership, reflectivity of members (being reflective of the local epidemic of people living with HIV/AIDS) and membership of consumers (people living with HIV) in terms of percentages of those who are conflicted (work for a Part A-funded agency) and non-conflicted.

Review Roles & Responsibilities of PC Members

Topic F: Review Roles & Responsibilities of PC Members & Workplan Overview – Brian Quigley and Gloria Brand

Michael informed the council to bear with us in terms of new space

Brian briefed the Council on the meeting ground rules. Members should feel comfortable with the council, and be ready to participate. Members should raise their hand and wait to be acknowledged by the chair or presenter. They should turn off cell/smart phones during the meeting (or put on vibrate). If a council member did not have time for his/her question to be asked or answered, he/she could use the anonymous evaluation forms. All questions will be reviewed by PCS and Executive committee and answered during an upcoming council meeting.

Darren explained that the Council uses Robert’s Rules of Order. He emphasized that Planning Council support staff is a valuable resource to contact for information members might need and to report any changes in contact information.

Brian encouraged members to attend Council and respective committee meetings also asked members to let PCS staff know when they cannot attend meetings to be excused. All opinions should be respected when voiced at the Planning Council meetings.

Gloria gave an overview of the workplan and the breakdown of the work done per committee and the Council as a whole. The workplan will be reviewed and revised throughout the Council term.

David asked when members will be notified on committee assignments. Assignments will be sent out next week taking into account member’s choices and needs of the Council.

Review Robert’s Rules

Topic G: Review Robert’s Rules – Jib Bowers

Jib gave an overview of the Robert’s Rules of Order used by the Council for conducting the meetings and voting process.

Conflict of Interest

Topic H: Conflict of Interest – Brian Quigley

Brian Quigley explained the conflict of interest policy. A member is considered to have a conflict of interest if they are an employee of or under fiduciary responsibility as a member of a board of any agency that gets Ryan White Part A funding.

A member may not vote when the Council is voting on one specific service category that their agency gets funded for. However, a member can vote if the council is voting on aggregate service categories (all together). Membership on a Consumer Advisory Board (CAB) does not constitute a conflict of interest. Members were asked to fill out the conflict of interest form and PCS staff collected the forms.

Agency Introductions, Overviews and Reports

Topic I: Agency Introductions, Overviews and Reports

MA Department of Public Health (MDPH) – Linda Goldman

Linda Goldman introduced herself as the director of Client Health Services with the MDPH Office of HIV/AIDS. She also introduced Rose Doherty, a research analyst with the Office of HIV/AIDS, who oversees client level data at the Office. Rose will also be attending Council meetings with her. Linda gave a brief overview of the Office of HIV/AIDS – oversees services for the state of MA ranging from for prevention screening to service provision. The Office receives Part B funding, CDC, HUD and HOPWA money. MDPH works closely with BPHC to share a lot of resources in the community. The office has two main planning bodies – Massachusetts Integrated Prevention and Care Committee (MIPCC) and the State Wide Consumer Advisory Board (SWCAB).

Linda informed the group the State has developed an HIV state plan for MA – a set of recommendations intended to guide activities in MA related to HIV. The process involved a lot of input from the community and the plan has been sent to MIPCC and SWCAB and providers. Another major initiative going on with the OHA is to strengthen coordination between HIV and Hepatitis C prevention, screening and service provision initiatives. The goal is to streamline ways of communication with the office, and help promote education and coordination of services.

Office of Medicaid – Alison Kirchgasser

Alison Kirchgasser introduced herself as the director of Federal Policy Implementation with the Massachusetts Office of Medicaid and has been with the MassHealth program for 9 years

Alison gave a brief presentation on “Subsidized Coverage Options Under the Affordable Care Act for People Living With HIV/AIDS in Massachusetts”. The presentation focused on:

• Medicaid Under the Affordable Care Act:

States have the option to expand Medicaid income eligibility to citizens and qualified aliens with income up to 133% FPL. Massachusetts opted to expand Medicaid to individuals over that limit through MassHealth and Health Connector waiver programs. NH has not yet chosen to expand Medicaid.

Newly eligible to Medicaid individuals will receive benefits through two alternative benefit plans: An equivalent to MassHealth Standard (for 19 and 20 year olds (up to 150% FPL), PLWH, Clients of department of Mental Health, and Medically Frail individuals) and Care plus (similar to Family Assistance for all other “newly eligible” 21 to 64 year olds)

Steve Batchelder asked who makes the decision for individuals considered “medically frail”? Way ACA was written.

• Current MassHealth coverage options for people with HIV/AIDS

If Disabled: MassHealth Standard if income up to 133% FPL or MassHealth CommonHealth if income over 133% FPL

If HIV positive and not disabled: MassHealth Family Assistance if income up to 200% FPL or “HIV waiver” – most states do not include HIV as a Medicaid eligibility factor (they require an AIDS diagnosis and disability)

• MassHealth Coverage for people with HIV/AIDS under the ACA

The ACA does not impact coverage for disabled people under MassHealth. The key message here is coverage is not changing and if the coverage is changing, it’s getting better.

• Transition Process for MassHealth members:

If coverage is not changing, members do not need to do anything. They will automatically be enrolled and current coverage will continue.If coverage is changing members will receive a notice in November explaining coverage will be changing in January.

• Coverage through the Exchange/Marketplace under the ACA

Exchange/Marketplace is the new name for the Health Connector in MA. Those who did not qualify for MassHealth had subsidized coverage through connector. Under ACA, every state will have an exchange for insurance. Wendy informed the group that NH will also have a second provider joining the exchange.

Individuals with Income up to 400% FPL or no access to affordable employer sponsored coverage may be eligible for federal tax credits to help purchase the insurance. Individuals with income up to 300% FPL will also receive state assistance to help keep the coverage affordable.

• Current Connector coverage options for people with HIV/AIDS

Those with income up to 300% FPL have Commonwealth Care (subsidized)and those with income over 300% FPL Commonwealth Choice (unsubsidized)

• Marketplace coverage for people with HIV/AIDS under the ACA

Commonwealth choice and commonwealth care go away but they are replaced by equivalents through the connector.

• Transition Process for Commonwealth Care members:

People that do not automatically qualify for MassHealth have to reapply for coverage through MAHealthConnector.org. Members will receive a notice in September explaining that they need to reapply for coverage.

The health connector is doing extensive outreach for members to get notifications on changes and smaller groups are going out to agencies and providers.

“Dual Eligibles” those on Medicare and MassHealth are not affected by the ACA. Setting up an integrated 0 not people on masshealth and , get a new place .

Wendy informed the Council that since NH hasn’t expanded Medicaid if NH chooses not to those below 133% FPL get nothing (no tax credits or subsidies). The intention of NH CARE program is to pay premiums for those at that level who can’t afford them, as well as paying for subsidies for PLWH.

New Hampshire Department of Health and Human Services (NHDHHS) – Sarah McPhee

Sarah McPhee introduced herself from the New Hampshire Department of Health and Human Services (NH DHHS) with the New Hampshire CARE Program. Sarah gave an overview of the funding sources and the program overall. The primary source of funding is Ryan White Part B but also a contractor of Part A to pay for HIV program and Primary Health Care. Three of their counties are part of the Boston EMA.

Sarah explained her role on council is to keep the group updated on what is going on in NH especially on the policy level and what the NH planning body is doing, Medicaid as they know it and more.

NH still do not know if they are expanding Medicaid, however the governor put together a study commission to investigate the expansion– the report will be given on October 15th. One health insurance carrier, Blue Cross Blue Shield, is working with the state department to find out what plan they would be able to offer, with the concern on making third party payments for clients through the marketplace.

Implementing Pharmacy Benefit Manager, an electronic billing process for the ADAP program, which is a huge improvement for clients as it will give them larger pharmacy network to work with. Also began a new electronic application system through Careware which is the new data management system used by all case management agencies. Starting an HIV needs assessment for the state for unmet needs and barriers, should be a 2 year process. Lastly, the HIV planning group, has gone through a change process this past year – The first business meeting was last week and they have a couple of general meetings coming up open to the public. Three main working groups within the body - consumer, recruitment and education group..

BPHC – Michael Goldrosen

Michael explained that as the Grantee he wears a couple of different hats. He is both a member of the Council and also represents the grantee’s office. The Boston Public Health Commission (BPHC) receives the Part A funds from the CEO of the Boston EMA, the mayor and as such is considered the Part A grantee. Within the BPHC, the grantee sits in the Infectious Disease Bureau as the HIV Client Services Division. The Division’s HIV Quality Management and Client Services staff also attends Council meetings. The BPHC’s HIV Dental Program also sits under the IDB and is overseen by the director of the division.

Michael informed the group his role at every meeting would be to provide updates on the grantee side. Always juggle multiple years when we administer Ryan White dollars. Right now we are in FY 13 and the fiscal year started in March. The grantee continues to monitor how providers do this year but also applying for money for FY 14. BPHC/Grantee staff write the federal grant proposal, and the grant is reflective of the Planning Council’s work. He explained that the grant being written at the present time represents the work of the past Planning Council term. The grantee will also be releasing a community RFP and the Council has already been invited to apply as reviewers.

Federal legislation and federal appropriations impact the council and grantee. Current legislation for Ryan White has expired but no sunset clause so continues as is. In order to get funding, there has to be money in the budget for Ryan White. The federal fiscal year starts in October, and the money is usually not released on time so the Federal Government awards a temporary budget which impacts money given to agencies next March.