Planning Council Thursday, January 12, :00-6:00pm Old South Church, Guild Room

Transcription

1 H-1-5 Planning Council Thursday, January 12, :00-6:00pm Old South Church, Guild Room Summary of Attendance Members Present Adelina Alves Jazzz Bennett Barry Callis Stephen Corbett Larry Day Dan Drolet Les Grant Leigh Kalbacker Alison Kirchgasser Kathy Lituri Jowanna Malone Sarah McPhee Erika Moreno Robert Quinn Jonathan Reveil Edward Rewolinski Carla Rodriguez Darren Sack Lexi Schneider Sandra Silva-Guzman Jessica Stewart Michael Swaney Richard Swanson Bryan Thomas Lawrence Vinson Arthur Weeks Timothy Young Keith Nolen Hilani Morales Brian Holliday Dennis Brophy Members Excused Stephen Batchelder Wendy LeBlanc George Diaz Shirley Royster Lorraine Anyango Members Absent Lisa Holden BPHC Staff Anissa Ray Shannon Shields Mahara Pinheiro Claudiane Phillippe Eric Thai Marcos Palmarin PCS Staff Ben Penningroth Masill Miranda Prakrity Silwal Karki Guests Amir Dixon Elizabeth Sanchez Topic A: Welcome and Introductions Darren Sack, Chair of the Planning Council, called the meeting to order, asked everyone to introduce themselves for the record, and asked for a moment of silence. The ground rules were mentioned again. Darren informed the Planning Council committee that Ben Penningroth has accepted the position of Program Manager, Planning Council Support Services. Topic B: Review and Approve Minutes Planning Council members reviewed the minutes from the December 08, 2016 meeting. Motion to Approve: Brian 1

2 Second: Stephen Results: Minutes were approved; (3) abstentions. Topic C: Committee Reports SPEC: Carla reported on behalf of SPEC. The committee met on January 05, SPEC reviewed the Boston EMA service categories. The Emergency Financial Assistance (EFA) category was discussed, and it was voted as an additional category to be proposed to the Planning Council for FY18. Last, reviewed the results of the Assessment of Administrative Mechanism (AAM), and proposed recommendations for FY18. NRAC: Kathy and Brian reported on behalf of NRAC. The committee met on December 15, The first half of the meeting consisted of an update on the Assessment of Needs Project by Alex De Groot (BU Consultant). During this update, members of the committee learned about the survey distribution, recruitment efforts of BPHC funded agencies, providers, and focus groups. The second half of the meeting consisted of reviewing the FY17 Funding Principles, as well as revising FY18 Funding Principles. Last, Pharmaceutical Activities was introduced as a potential funding principle for FY18. Its vote is still pending as NRAC has initiated an Adhoc committee who is expected to draft the language. Consumer: Stephen reported on behalf of the Consumer committee. The committee met on January 12, During the meeting, last month s minutes were reviewed. Adelina Alves was the spotlight person, and members of the council were able to learn something new about Adelina. Last, Dr. Cahill from Fenway Health presented on HIV & Aging, with a focus on Long-term Survivors. It was a well informed presentation. All members in attendance were delighted by his presentation and information provided. Exec: Darren reported back on behalf of the Executive committee. The committee met on December 19, During the meeting, members met to review December s meeting attendance, evaluations, and meeting reports per committee. In addition, Emergency Financial Assistance (EFA) was discussed. There will be a lot of work behind the scenes to be done. Topic D: Training Program Update Anissa Ray introduced herself as the Training Program Manager at the Boston Public Health Commission (BPHC). The training program was created a year ago, in efforts to conduct outreach, and facilitate trainings specifically for medical case managers (MCM). The objective is to educate medical case managers via trainings, modules, and webinars with the goal of client viral suppression. Last, Anissa introduced Shannon Shields, Program Coordinator for the Training Program. They work collectively in assuring all medical case managers are being trained. The presentation aims to provide the Planning Council an overview of the training program, discuss the training program s progress in 2016, and learn what the training program has planned moving forward. Below are the Modules and Webinars medical case managers are expected to attend Current Modules: (In order to attend the next Module, the medical case manager has had to attend the previous one) Module 1: Science of HIV (Webinar) Module 2: Building an Effective Client and MCM Partnership (all day in-person session) Module 3: Comprehensive Service Planning (all day in-person session) Module 4: Self-Care and Boundary Setting (3 hour in-person session) The science of HIV-Webinar Topics: What is HIV and AIDS? HIV Transmission HIV Life Cycle Stages and Symptoms of Untreated HIV Antiretroviral (ARV) Treatment The Training Program conducted a Managers Session, which included: 2 HIV Resistance Why PLWH Don t Engage in Care HIV Case Numbers HIV Prevention

3 Two sessions: 11/7/16 & 11/29/16 Held at BPHC Training goals: Identify gaps and weaknesses- MCM Identify gaps & weaknesses Managers/Supervisors Identify ways to support your staff Medical case managers (MCM) requested trainings in the following topics: Housing Substance use Writing concise notes ISP Mental illness/behavioral issues How to talk about sex Home visits Discharging/dismissing clients Moving forward: Make-up sessions of in-person core modules scheduled for: Building an Effective Client and MCM Partnership (BECMP) January 11 th Comprehensive Service Planning (CSP) January 18 th Additional modules: Housing- complete - with a pilot session done HIV and Wellness (webinar)- complete HIV Lab Reports (webinar) complete Working with Black & Latino MSM (collaboration with MAC) Working with Youth Working with LGBTQ individuals Working with transgender individuals Questions? Is a medical case manager outside of BPHC welcomed to attend? Yes, if their funder approves it. The modules are meant to be open to the public. Are they free? Yes, free and mobile. Who do we contact if interested? Contact Anissa Ray. Is there a schedule posted? Not yet, once it is finalized it will be promoted. What does MAC stand for? It stands for Multicultural AIDS Coalition. In regards to social media, do online applications or dating application come into the equation? In regards to clients, yes. There are boundaries established between client and medical case manager. However, many have expressed having to use a social media application in order to contact a client that has been hard to reach. Yet, many agencies do block that type of activity to take place. Has there been an increase of MCM s electronically communicating with clients, with the means to connect with them? Yes, there has been discussion regarding this topic. Many medical case managers have spoken about texting clients but unable to document it. There is a need for different communication methods made acceptable for medical case managers to use. Do you speak about disclosure? For example, when is the right time to disclose ones status, and if so how are you, consumers, and medical case managers approaching this topic? Disclosure shows up in Module 1, but not necessarily talks about engaging in sex. The state does not mandate one to disclose, but we work on how to build a clients confidence to disclose. The Culturally Competent module answers better your question. JRI has been doing it for many years, as they have a great training and tool. Topic E: Service Category Panel Discussion: Psychosocial Support-Peer Support Moderator: Stephen Corbett Panelist: Larry Day, Elizabeth Sanchez, and Amir Sanchez Ben introduced Stephen as the moderator, and Stephen introduced the panelists. Planning Council members were able to refer back to the introductory biography handout for more details about each panelist. The panel discussed six predetermined questions, followed by a question and answer session. 3

4 Q1. What has been your experience with providing or obtaining psychosocial support services? What makes peer support a strong service category is that it doesn t take a Masters level worker/provider/clinician to do the work, experiential knowledge is all you need. People of color have better health outcomes when connected to these services (based on a study conducted in previous years). Elizabeth stated that peer support services changed her life. She had nothing after being released from jail. Due to case managers being overworked, peer support services were crucial to her sobriety and obtaining the services that she needed. Being a bilingual Latina, it was easy to obtain services, but for other Latinos it is not the same due to the language barrier, as it is difficult to find interpreters. There are no Latino agencies that offer peer support services. Q2. What is the standard waiting time for clients/consumers to obtain psychosocial support services? And if too long, what are the consequences of that? Amir stated that in order to provide quality peer support services, it requires empathy rather than a college degree. When we are thinking about wait time, it s about how can we center our role as advocates for our clients. Elizabeth stated that when there is long waiting time, there is a window period. If clients are not connected to the services, they will fall through the cracks. Case managers are overworked, so the agency staff needs to help support the client the best they can. It is critical one does not lose a client, especially if they have a dual diagnosis. Larry stated that in places he s worked, they have been adamant that a client is initially connected with peer support services. If there is a wait time for clients, then that speaks on the agency s lack of staff or support. One needs to assure that the people have the adequate training to do the job. Many times agencies do not have enough peer support staff available; one needs to think about investing money in it. Stephen stated that is crucial to deliver services quickly at Dimock Health Center in order to not to lose a client. It is important to collaborate with case managers to get clients services. Comment: Case managers need to begin working collectively with the peer support staff. If peers were more utilized, then the case managers work load would be alleviated, as we both have a common goal. Ultimately, allowing for clients to have better services, and needs are being met. Question: What will be your advice for agencies that are not serving a particular cultural population but want to serve? What is the advice so they do not get overwhelmed? Clients should be connected to people of similar interest, there may be a language gap but someone that is willing to accept that, and still work with the client, that is the most important piece. Also, more money to hire more staff. Q3. What are the barriers and gaps to providing these services? Lack of staff and programs communicating, and not using each other as resources. Lack of language capacity. There needs to be more staff/providers out in the community that speak the language. Things can get lost in translations. Therefore, having more people that speak various languages would be ideal. Q4. Do you find that access to psychosocial support services are harder to obtain for clients/consumers living in suburban or rural areas? Yes. There is no doubt about it. Rural areas have more difficulty accessing services. Maybe look into providing materials and information online, via and connect with folks through different avenues, the method of connection needs to be rethought and possibly innovated. There are clients in Mattapan that cannot access services as well. How is it that we can create ambassadors and train members of the community to offer these services? Question: How can the Planning Council support consumers learn how to talk to other consumers, and then talk to people within one s own network about resources? That helps case managers, and everyone else. This is something to think about. Q5. From your perspective, what are the strengths you see when working with clients for psychosocial support? Elizabeth stated that she gets self gratification. She enjoys working with clients from the morning, until the evening. It allows her to remain connected, and be a better peer supporter. Q6. What advice would you give to somebody who is seeking psychosocial support? 4

5 Self determination: You can fire your doctor/provider There are people like us that are willing to advocate for you to get the services you need. Peer support works I am living proof, get the services! It doesn t matter where I work, come talk to me I can probably steer you in the right direction. Stephen shared his experience seeking peer support, and Larry being a great advocate and peer. Questions/Answers (Q&A): Do you believe that the funders of HIV services support peer support? If not, why do you feel that is? No, we do not feel that funders sufficiently value the role of peer support as a service. If not, what should happen to articulate its value? (in reference to the question above). There is no value in peer support. Ideally, everyone needs to come together as one and start using the peers more. Peers play a major role in each agency. A client will disclose to a peer before a case manager or provider. It varies. The agencies that are funded may not value a peer support staff, which trickles down between other staff. The respect is lacking, and it translates. Agencies value more a MSW or JD than a person living with HIV. Funders should conduct not only one site visit or read a report. They should take the time to speak to a peer support staff and legitimize their role. Comment: We have increased 30% in funding for next year. This includes funding in shelters, Latino agencies, and expanded services for MSM s. A total of 75K thus far. Peer Support services for PLWH, and of color have also received funding and an increase. BPHC invests funding where the need is within the Boston EMA. People in this room were adamant about adding the money, and without the Planning Council this would not have happened Is there any data that a consumer that had peer support services had better outcomes than a consumer who did not have peer support services? Most studies do prove and say it. BPHC has data per service category, but has not looked at the casual relationship between peers and PLWH. Is there space for more specific data collection on peer support short term and long term? The health of consumers? Also, can we reference it? Once someone receives Part A services, they are responsible reporting back viral suppression. It can be tied back to the question whether they receive or offer peer support. But it takes a while. Comment: We also need to talk about long term survivors needing peer support because this is a population that is growing. Therefore, we can be inclusive not exclusive. Comment: A clinician or provider with a MSW has structure. Peer support lacks structure. There is no curriculum or guidelines to follow. If one wants to measure peer support and add metrics, then leadership at agencies need to set these metrics or standards in order to obtain the data. Now you are seeing a new generation of peers and clinicians/providers attending the same training, the evenness are going to eventually level out. The training expectations for peers have increased. Topic F: Quality Management Update Carla introduced Ben as the follow up presenter. In addition, she thanked PCS staff for taking on the roles and doing a good job. Ben introduced himself, and provided an overview of the presentation, which included: The legislative requirements for Quality Management (QM). The Quality Management Plan. The process to update the Boston EMA plan. Ryan White legislation requires the establishment of a clinical quality management program to: Assess the extent to which HIV Health Services provided to patients under the grant are consistent with the most recent Public Health Service guidelines (otherwise known as the HHS guidelines) for the treatment of HIV disease and related opportunistic infections; and 5

6 Develop strategies for ensuring that such services are consistent with the guidelines for improvement in the access to, and quality of HIV services. The QM Plan revision process has four steps: BPHC updates QM plan BPHC senior management approves QM plan Planning Council approves QM plan BPHC submits QM plan to HRSA Annual process: Reviewing past performance Reviewing national HIV goals Consider new best practices Adapt to emerging needs/trends Questions: Is this related to AAM? No, this is a separate piece. This is BPHC s ability to see the qualities of work funded agencies are doing. The AAM is more of a stand alone. Is there any consumer representation in step 1? No, HRSA mandates that there be a quality committee, and possibly SPEC will take the lead. There has been discussion on how to move forward in the next cycle, the time crunch is the reason why things are not in place. Comment: If there was representation from each agency it would allow cutting the middleman. Agency involvement may be helpful moving forward. Topic G: Agency Report Mayor s Office- Hilani Morales No reports. Massachusetts Department of Public Health - Barry Callis Early spring MDPH will host a memorial service for two individuals who passed away of HIV/AIDS in the fall. MDPH representative will adjust the preliminary numbers stated in last month s meeting of the proposed budget reductions. See below: Overall reduction is 1million on top of the 9C reductions; therefore, there is a total 2 million in cuts. All the organizations that will be impacted have been notified. MDPH is initiating a new advisory group for transgender population. New Hampshire Department of Health and Human Services Sarah McPhee On the website new service has been posted. Partners report in the upcoming meeting. Office of Medicaid (MassHealth) Alison Kirchgasser o Congress sent a letter to all governors about the ACA. Governor Baker released his letter. It is a positive letter, states supports for the ACA, and health coverage for citizens. Last, asks for no repeal. Boston Public Health Commission Refer to Dennis Brophy s Memo FY is closing in February. Final invoices are due on March 15, Currently, most agencies have submitted at least 9 invoices. Eight proposals were submitted to BPHC on December 9, Funding decisions are expected to be made in January 2017 and new contracts for these housing services will begin March 1, BPHC will begin the contract extensions process in February 2017.There is currently no word on FY17 funding from HRSA. Last year, BPHC and all other Part A recipients were given partial awards to start the New Year. Based on the uncertainty of next year s award, BPHC will utilize the $500K and $1M reduction scenarios based on the Council s FY17 Plan. The goal is to issue contracts, even at reduced amounts, to prevent any disruptions in service for clients. The Housing category currently has spent 60% of its FY16 funding. Currently, the Rental Assistance Program is at 55% and the Housing Search & Advocacy program is at 74%. 6

7 Topic H: Announcements, Evaluation & Adjourn Announcements: Eric Thai is moving on to new adventures, and will attend his last meeting in February. Dennis Brophy will be taking his position, welcome! Darren reminded the council to sign in and fill out evaluations. HDAP is moving its office, closed from 1/19-1/23. Moving to Charlestown. Thank you to Eric for all you have done for the BPHC and Planning Council. On the 21 st lifetime network will premiere the remake of Beaches, please support it. Community Servings is hiring! Please check it out. Feb 15 th MCM networking event at the Federal Reserve will take place, please attend Anissa is inviting agencies that may not be funded to attend. There will be many tables and resources provided at the event. AIDS project Worcester hosting an event for National Black AIDS Awareness Day on Feb 3 rd, please attend. Happy New Year Motion to adjourn: Sandra Second: Keith Results: meeting adjourned. 7