Council Members Present: Marvin Innes Council Members Absent: Community Members/Guests/Consultants:

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1 Minnesta Cuncil fr HIV/AIDS Care and Preventin Meeting January 10, am-12 pm Health Services Building, Rm L Prtland Avenue S, Minneaplis Minutes Cuncil Members Present: Alejandr Aguilera Rbert Andrews (phne) Tm Bichanga Lyal Brks (phne) Rger Ernst Terral Ewing (phne) Al Fredericksn Rbert Gillum, Jr. Bielca Guevara Lenny Hayes (phne) Marvin Innes Cuncil Members Absent: Rachel Heule Flrence Nabeta Cmmunity Members/Guests/Cnsultants: Mary McCarthy, RAAN Dennis Andersn, Cmmunity Member Tm Legers, La Clinica Sam Rbertsn, MDH Hennepin Cunty (Part A) Representative: Jnathan Hanft MDH (Preventin) Representative: Krissie Guerard MCHACP Staff: Carissa Weisdrf Qurum Present? Yes Rick Laska Valentine Mm David Neller Lesa Nelsn Tyrie Stanley Matt Tburen (phne) Thuan Tran Gwen Velez Jhn Vener, MD Mnica Yugu Gelli Overtn Val Rubin-Rashaad Nigel Perrte, City f Minneaplis Augustus Wrayee, CANIAR Mariah Wilberg, MDH Anika Kaleewun, Hennepin Cunty DHS (Part B) Representative: Clleen Bjerke Anthny Jacques (minutes) I. Call t rder Lesa called the meeting t rder at 9:17 am and read the guiding principles. Rger will jin us when he can but is still n the rad. Intrductins Apprval f agenda & Nvember 8 meeting minutes Minutes apprved II. III. C-Chair Update Grantee Reprts Part A FY2016 Estimated Unbligated Balances

2 Estimates typically vary between 20-50k per year, s this is a guide We estimate we ll have abut 264k unspent The way carry ver wrks with legislatin is that we can nly carry ver frmula funds t the next year, can nly carry ver 5% withut a penalty Final amunt wn t be determined until July when final financial reprt is submitted Funds have been redistributed t ensure we are spending part a funds first Prpsing t use carry ver funds fr utpatient healthcare services and fdbank hme-delivered meals Cuncil staff hiring update Admin specialist psting clsed n Friday, interviews within the next few weeks Anther mnth t 6 weeks befre we knw Cre Medical Service Expenditure Waiver fr FY2017 Legislatin requires we spend 75% f ur funds n cre medical services Under spending is typically in cre medical than in supprt services Prcess requires a waiver Once the waiver is apprved, it desn t matter what yur expenditures fr cre medical are but; We need a cmmunity meeting t discuss the waiver, prbably extend a cuncil meeting ver lunch next mnth t accmmdate We will cver what ges int waiver request in mre detail at next cuncil meeting CAEAR Calitin Membership Meeting in March We are a member, passed a few years after Ryan White in 1990 Membership meeting is in March Part B Clleen said Rachel is nt here tday, s summing up Part A and B fiscal year is ne mnth different Will be reprting next mnth Open enrllment is very busy Facts and figures will be available next mnth May be mre clients than usual that may be frced t change clinics Quite a bit f hiring in this area New temp psitin will be psted in the next few days t fill in fr smene n leave Temprary jbs mean smene wh wrks less than 6 mnths, can be extended up t a year New RFPs will be released fr case management and nn-medical case management Preventin Ry Nelsn retired in May Mariah Wilberg will be wrking n the technical side f cmmunicatins, website, accuracy, nline training mdules, scial media Sam Rbertsn will be ding wrk in the cmmunity; utreach, events, health educatin materials nline and in paper fr cmmunity distributin Funding update All grant awards came in December C-chair psitin psted n Friday, clses n the 12th Jared update n the cntinuum f care:

3 In the past we have 1-2% we received cd4 but n virals In reviewing lab data there were 4 facilities receiving cd4 but n viral lad In 2015 several facilities switched t new reprting algrithms which changed hw viral lads were reprted Switched frm a number t a letter, s the reprting system was missing thse Wrking n updating 2016 data that was nt reprted because f data cllectin systems at labs The 4 facilities ID d have been addressed Updated care cntinuum will be released in abut a mnth IV. Staff Update Feb is electin perid Electins fr anther 2 year term Sme cuncil members are nt seeking a secnd term s we will hld a celebratin next mnth with cake C-chair electin als in February; let Carissa knw by Jan 19 th if interested Als ging t be hlding cmmittee c-chair electins in March CCG is here, they prvided facilitatin training fr c-chairs in the past, and they are willing t d s again Cmmittee meetings: c-chairs and grantee staff t spend ten minutes after meeting t debrief 3 cuncil members have stepped ff recently: Mike, Karin and Larry and we have cards t sign fr them Cntacted a prfessinal parliamentarian wh is familiar with Rberts s rules f rder and meeting prcedure; she is utside the gvernment agencies and nt a cuncil member but will need t be appinted by the cuncil. Her name is Patricia Reymann and she will start in March It is paid psitin, mre f an appintment than an electin New mileage reimbursement rate: 54.5 cents per mile V. Cmmittee Reprts (als prvided in written frmat) Executive Actin Item: Cllabrative Partner Understanding Vte: passes unppsed Disparities Eliminatin Actin Item: Target Ppulatins fr Preventin Vte: passes unppsed Cmmunity Vices N update, didn t meet The nly current chair is nt seeking re-electin Membership & Training We will interview a cuple candidates a week frm Friday Will g ver peple wh want secnd terms and pass them n t the February meeting New brchure Needs Assessment & Evaluatin

4 Read a letter frm Karin Sabey Planning & Allcatins Didn t meet, n update This cmmittee has penings s please let us knw if yu re interested VI. Open Frum Questin abut enrllment Public health directr is getting invlved, nt sure Karin submitted a letter t Rachel 10k deductible fr abut 200 patients s anyne wh is hspitalized this year, the hspital wn t get paid Medicatin is als a big issue, ptentially culd lse 200 patients, r patients just wn t get meds b/c f incnvenience We are cmmitted t cming up with shrt and lng term plan Ryan White is payer f last resrt, s prviders need t d their best t ensure patients are insured Prpsing sme f the carry ver funds t cver thse ut f pcket csts We d have ver 800k in part a funds fr such csts b/c we anticipate thse csts may g up Cst f medicatin thrugh ADAP cunt twards deductible Overlap between medical assistance and inpatient? Immigratin status? Pharmaceutical cmpanies will prvide meds t yu at n r lw cst if yu dn t have insurance, that des nt apply tward deductible ADAP des If smene is uninsured r underinsured, ADAP can play a rle Unsure hw many f these clients Allina can absrb Spanish speaking clients are nervus Letter written by Rger Ernst Nt even sure if this wuld be apprpriate t cme frm the cuncil As a cuncil, yu cannt d this, hwever, any citizen at any time, yu can always express cncerns t a legislatr, and yu can express that yu are a part f the cuncil and therefre have a level expertise Asked if Matt and Carissa culd gather a list f legislatrs and senatrs t cntact This will be sent ut t everyne n the cuncil Face t face is best Letter is secnd best Phne call is kay still has significance We all knw there are prblems with insurance exchange, changes are needed, but we dn t want t thrw ut the baby with the bath We knw f at least f 1k peple r mre wh lse their insurance if the ACA ges away, and have als calculated pssible new infectins in that scenari BREAK VII. MDH Hepatitis Update Kristin Sweet s presentatin

5 Q&A: Why d baby bmers have higher risk? Bld transfusin prir t 1992, injected drug use, sex with partners wh injected drugs, etc. Mre f an equal distributin between new cases fr men and wmen nw, where it skewed tward male during the baby bmer generatin Transmissin rate fr babies brn t HCV psitive mthers? 4-6% N current prcedures t prevent r treat children at this time Did the # g up significantly because they started autmatically testing fr HCV? Heard that frm flks, but nt frm systems r facilities directly, nly anecdtally Haven t seen a significant increase after that recmmendatin went in place Als think that natinally there is a high prprtin f peple with HCV wh dn t knw their status Rate in MN f HIV cases with HCV as well? Unsure at the mment, will send # s ut n that We d check t see if the numbers remain cnsistent Usually depends n hw it falls int ur pririties, usually every 5 years Reslved cases: are any f them being re-infected? Difficult questin: the data is separated ut Sme are undetectable, but we dn t have gd reprting techniques t establish if these are due t failed treatment r reinfectin was the first year we acknwledged cases can be reslved in the data and tracking Mre inf n needle exchange data relative t HCV Opiid use als relevant t this data Recmmend speaking with Nate since that is part f his fcus Hw many peple need t be infected fr this t be cnsidered an epidemic and get the gvt s attentin? This is an nging questin with many parts Lng term healthcare csts Cst effectiveness f treatment has been prven Mst prgress seems t be cming ut f piid epidemic rather than HCV It s difficult t have all these new tls and resurces and yet nthing seems t change Any idea why the spike in the yunger age grup? Related mainly t piid injected drug use, but als methamphetamines XIII. Annuncements Still accepting cnsumer applicants t quality management advisry cmmittee

6 Lking fr smene t fill cmmunity supervisr f red dr clinic XIV. Adjurn The meeting adjurned at 11:30 a.m. Meeting Summary: The cuncil apprved the Cllabrative Partners Understanding The cuncil apprved the 2017 Preventin RFP Priritized Ppulatins The cuncil received a Hepatitis Update presentatin frm MDH Dcuments Distributed Befre the Meeting: Prpsed Agenda Nvember 8 Meeting Minutes Cmmittee Reprt Summaries Actin Item: Cllabrative Partners Understanding Cllabrative Partners Understanding Actin Item: 2017 Preventin RFP Priritized Ppulatins 2017 Preventin RFP Priritized Ppulatins Dcuments Distributed At the Meeting: Part A Update Ryan White Part A Unbligated Balance Reprt and Carryver Request MDH Update MCHACP Leadership Duties and Respnsibilities AJ/cw