Southwest Florida Regional HIV/AIDS Council (RHAC)

Date: December 4, 2013

Time: 9:30AM – 12:00 PM

Place:Charlotte County Health Department

Attendees:Attached list

  1. Dr. Hartner started with introductions around the room, and called the meeting to order.
  2. The Consent Agenda motion for approval P. Dobbins, and seconded by M. Burns.
  1. Program Report- P. Brown stated that the 2014-2015 Ryan White contracts will be a one page renewal; everything will be exactly the same as the current contract. HPC has submitted our contract into DOH; hopefully we will have our contracts back in advance. The AICP subcontract has been extended for our area through March 31st, 2014. The extension is intended to allow for an RFP at the state-level. If that RFP is not out in the next week or two we may receive another extension. We discussed at the last RHAC meeting about Craig Reynolds visiting and discussing HOPWA, Dr. Hartner sent a letter up to the state and we did receive a response to that letter and Craig Reynolds will be coming down to visit us. He will be coming to the January RHAC meeting and the Case Managers meeting and will be visiting a couple of agencies to look at charts and look at how HOPWA works in our area. If you have any questions for Craig, it would be great if you can send those questions to Peggy or Jesse ahead of time so they can be complied.

ADAP/AICP- P. Brown reported that we have been seeing a drop in the number of clients in the AICP program that is in combination with some people not wanting to transition in the ADAP program, some clients not able to because there plans were deemed inadequate, plus some clients losing their policies and not getting new policies through the Affordable care Act. We are still waiting for the policy for the Affordable Care Act marketplace plans and whether we are going to be able to wrap around that. We are hoping for that policy in mid-January. In the meantime, Case Managers should still be encouraging clients to hold off on signing up for Affordable Care Act plans until the policy is available. If clients are losing their policies it has been suggested that Ryan White can pay for medical visit, it is not the most cost effective, and however we want to be cautious when doing that. Of our active AICP clients 58% have transitioned, 5% were given a waiver because their insurance plans won’t allow them to use CVS, 2% Transition Pending, %17 still need to transition, and 18% is leaving AICP because of some of the requirements. Once we received the policy from the state we expect those numbers to increase.

  1. Financial- M. Waite reported that Ryan White year to date, April-November $1,208,000, we have spent $1,188,000 which is right on track. Dental we had budgeted for higher at the beginning and lower at the end and it was following that pattern the first few months. Then it went up in August and September, so we were able to move $25,000 in to Dental. Drug is slightly over budget, however it is not a large amount, and if we need to we can move money in to drug as well. J. Hartner stated the money we are moving into Dental and drug where is that coming from. M. Waite stated that the money is coming from Supportive Case management, medical and administrative/clinical quality management which has all been under budget.

HOPWA the report goes from July to November 30th; as far as budget movement goes we moved $20,000 from rent to transitional housing. The year to date budget is $404,000, we so far has spent $212,000, which is down from last year at $250,000. We did have more HOPWA clients in November than in the previous November, which hasn’t happened in a while.

AICP the report goes from July-November; we spent $248,000 for premiums, copays, and deductible for 92 people.

  1. Prevention-J. Acevedo stated that the Sequestration led to budget cuts in 2013 and will do the same for 2014. The cut was almost 3 million dollars and this cut will continue through 2016. Prevention is being driven by the Treatment Cascade. J.Acevedo also discussed that the HIV 500 is now available online through the TRAIN system, it is self-paced and 4 hours. They are still looking to put the 501 online, but as of now it is still handled in person. There has also been a change in the oral Rapid testing guidelines, which is clients, must wait 15 minutes after eating, drinking or chewing gum or it can skew the test results.

At the statewide Prevention Planning Group Meeting, April Hogan discussed the bureau’s vision for the structure of the new body. The body approved the new structure and new workgroups were formed. All members and alternates are required to sit in at least one workgroup. The workgroups will have teleconferences and webinars in between the two annual meetings with specific tasks and assignments that must be completed for each meeting.

Area 8 did present the AREA 8 HIP project; they were surprised how we were able to bring together seven health departments and providers throughout 7 counties with such little funding. They were stunned how we were leveraging other funds to complete the task at hand. Many did have questions about the Peer Navigator Program, such as how are the Peer Navigators addressing the youth; however we as an area have not talked that issue just yet. J. Hartner inquired how many Peer Navigator we have. J. Acevedo stated we currently have a total of 7 Peer Navigators, in Sarasota, Collier, and Lee counties. The Sarasota Peer Navigators spread out to Charlotte and Desoto, there are 3 in Lee County at McGregor Clinic, there is a Patient Navigator, and there are two in Hendry Glades.

J. Acevedo stated that at the last RHAC prevention committee meeting we wanted to take a look at our inventory of all the prevention services in Area 8, whether they are funded or unfunded by other entities. We wanted to put together a gap analysis so we can see where we are at and where we are not at. One of the goals of HIP is look at the target, which is the high risk zip codes, and with that we are seeing a lot of activities are being funneled to those areas. By looking at the gap analysis we wanted to look at high risk areas within certain communities that were not specifically targeted. There are currently lots of providers that are providing services in all counties. The gap analysis will be looking in the gaps in linkage, retention, and adherence in those certain communities. P. Dobbins inquired if J. Acevedo is going to be presenting your data to this group. J. Acevedo stated that he hasn’t really thought about it but he can. He can show all the providers and what they are doing. M. Burns stated that she thinks that it will be very valuable to this group. P. Brown we can possibly present the data in our March meeting, which is focusing on prevention, because we will have the data for a full year of the HIP project and we will be further along. The inventory gap analysis is going to be ongoing process; it is a warming process to get some of our new partners easing into being partners.

P. Dobbins stated that she is concerned about the increase in the youth population, and believes that we shouldn’t be sitting on this problem. R. Bobo stated that this seems to be a state wide problem for under the age of 23. P. Dobbins stated that we could possibly start committing ourselves and create a work group and see what we can pull together. S. Murphy stated that it is a national phenomenon; the trouble is getting the youth to come forward. The work group will be people that are not youth, so coming up with those ideas will be harder. It is a broad spectrum with just risk factors plus the immortality of the young mind. It is starting to get the spotlight that it deserves but they are still looking for more information. I think getting information from people in our practice and getting their information and what they are seeing and expiring and bring that to table and start from there. R. Bobo suggested that possible getting into the schools and seeing if they are getting funded.If so, what are they doing with it and possibly we can assist them with presentations and health fairs. P. Dobbins stated that it may be a good idea to present a set of questions that we can ask the youth. D. Sabatini stated that there is group part of the Children’s Diagnostic and Treatment Center call P.R.O.M.I.S.E., and one thing that is unique about them is that they find team or youth mentors that are leaders in their group, whether they are positive or not, for example a band person, athlete, or student government person. Then you will find them and then informed and educated about HIV and how it is transmitted and they carry that message. They are already natural leaders within their groups and pass it on to their peers. A. Zamot stated that there are things already happening around our area, like in Collier called Popular Opinion Leader that is working with FGCU and Edison College as well as a couple of high schools. I don’t believe there should be a different group because work is being done without funding. We can definitely expand what’s already out there.

F. Rivera stated that there are a couple of training that will be held at Charlotte County Health Department on December 12th, Outreach, Recoupment an RetentionTraining the presenter is the National Community Partners from 9:00 a.m.-5:00 p.m. also on Friday December 13th, A Faith Based Leadership Training from 9:00 a.m.-5:00 p.m.

  1. PCPG Update- S. McIntosh stated that the PCPG meeting in Tampa started out with the Section Administrator, Sherry Riley. She expressed her concerns to make sure that, she declared that everything that they do was guided by 2 basic principles: 1) No clients go without 2) As much community inclusion as possible. She did share that we are in a same place as other states. There is new leadership for the bureau which is R. Sterling Whisenhunt. She also stated that there are 2 bills coming up in session, one was making the testing routine to deal with conform consent as well as the needle exchange.

S. McIntosh stated that Sherri Riley had received data that there has been an increase in Hispanic males that is contracting HIV.

S. McIntosh stated that Lorraine Wells was at the PCPG and presented and answered questions. M. Cuffage statedthat she received an email stating that clients are not required to go to CVS. P. Brown wanted to clarify that ADAP cannot require people to use CVS; they can require people to go and sign up at ADAP if they want to continue their AICP. They are saying that it is just for data purposes. Clients can get waivers. K. Medina inquired on how that works do they tell their ADAP leader “I am signing up but I want to still use my pharmacy”. P. Brown stated that’s where things become tricky because they do not have a mechanism for a waiver because you don’t choose to use CVS. That is where the rules and the policies that they put in place don’t match what their limitations under the law are right now. People can get waivers if there are financial reasons, or if their insurance companies are requiring it. As of right now there is not a policy.

P. Brown stated she was at the PCPG it was stated that if there are HIPAA violations involving anything to the CAREWare folks, for example, if someone sends an MIP number, a name, or a birthday, in a request the people who send that are going to be locked out and would have to go through a training session and a review panel to get back into CAREWare. So please double and triple check every email that is sent to make sure it doesn’t include anything that it shouldn’t include.

P. Brown stated that HRSA put out a treatment cascade for the state of Florida; we are going to be working on our own local treatment cascade, for those that are doing the medical monitoring that is now looking at how many have a suppressed viral load, and how many are on certain drugs, this is why we are tracking some of these things. This puts us in line in how everything is being framed by Tallahassee. They don’t think what was put together for them was accurate, that’s why are going to try and build state and local versions.

P Brown stated that we are going to be doing the annual surveys, the long survey. They used to be every three years they are now doing them annually. We expect the next round to be coming out in May or June. We were the state leaders in our participation in the last round we just need to prepare that will be happening again. It is probably going to be the same survey because they want to be able to track from year to year.

S. McIntosh stated that the Medicaid Managed Care is targeted for June. Individuals will received a 30, 60, 90 day enrollment reminders. If someone is automatically put in a plan because they miss the enrollment they have 90 days to change. P. Brown stated that there are 4 plans that people can choose from in our area, one of which is a HIV specific plan, the Clear House Alliance plan, and then there are 3 other plans that people can choose from, there are additional HIV specific benefits for clients if they choose the Clear House Alliance Plan.

  1. Selection of 2014-2015 Chair & Co-Chair

We have two nominees for chair is Pat Dobbins and Mary Kay Burns or write in. K. Medina nominated Mike Cuffage.

Motion to close nominations for chair E. Cordoba, and seconded by R. Bobo.

After the election the new chair for 2014-2015 Chair is Pat Dobbins.

The floor was open to nominate for Co-Chair, Sean McIntosh. Motion to close nominations for Co-Chair P. Dobbins. The Co-Chair for 2014-2015 is Sean McIntosh.

  1. Public Comment-

D. Sabatini brought brochures for Mobile Health Manager for smartphones, not only for HIV specific group.

P. Dobbin inquired what is the status for county groups do we have them anymore. P. Brown stated that Collier has them and Sarasota. R. Bobo the smaller counties don’t.

P. Dobbins stated that we need to be looking into leveraging other dollars, we are seeing a trend. I am not sure where those dollars are, we should do some research on it and see if we can bring it to the table.

P. Dobbins stated that we should have a small group to take a look at the old by laws, S. McIntosh, M. Cuffage and P. Kurtz volunteered.

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