The chair, Victor Gonzalez, called the meeting to order at 10:10 a.m. He welcomed everyone and asked for introductions.

Transcription

1 Care and Treatment Committee Meeting United Way Ansin Building 3250 SW 3 rd Avenue, Ryder Conference Room February 8, 2019 Approved March 13, 2019 # Committee Members Present Absent Guests 1 Alcala, Etelvina X Randi Burger Angela Ortiz 2 Boyd, Derek X Brad Mester 3 Brini, Carine X Rudy Hernandez 4 Denord, Luckner X Mary Jo Trepka,MD 5 Gonzalez, Victor X Frances Martinez,MD 6 Grant, Gena X Javier Romero, MD 7 Greene, D. Michael X Khaley Davidson 8 Henriquez, Maria X Karen Hilton 9 Iadarola, Dennis X Carlos Garcia 10 LaGrome, Arthur X Carla Valle-Schwenk 11 Neff, Travis X Jose Camino 12 Puente, Miguel X Shalon Lopez 13 Richardson, Ashley X Staff 14 Siclari, Rick X Brock, Petra 15 Wall, Dan X Ladner, Robert Quorum = 6 Meizoso, Marlen I. Call to Order/Introductions The chair, Victor Gonzalez, called the meeting to order at 10:10 a.m. He welcomed everyone and asked for introductions. II. Resource Persons Miguel Puente indicated Behavioral Science Research (BSR) staff as resource individuals. III. Review/Approve Agenda The committee reviewed the agenda and accepted it as presented. Motion to accept the agenda as presented. Moved: Miguel Puente Seconded: Dennis Iadarola Motion: Passed IV. Floor Open to the Public Mr. Gonzalez read the following: Pursuant to Florida Sunshine Law, I want to provide the public with a reasonable opportunity to be heard on any items on our agenda today. If there is anyone who wishes to be heard, I invite you to speak now. Each person will be given three minutes to speak. Please begin by stating your name and address for the record before you talk about your concerns. Miami-Dade HIV/AIDS Partnership/Care and Treatment Committee page 1

2 No comments were made, so the floor was closed. V. Review/Approve Minutes of January 3, 2019 The committee reviewed the minutes of January 3, 2019 and accepted them as presented. Motion to accept the January 3, 2019 minutes Moved: Dennis Iadarola Seconded: Miguel Puente Motion: Passed VI. Membership Marlen Meizoso February Vacancy Report Marlen Meizoso reviewed the vacancy report for February (copy on file) which included the requirements of membership and next steps for those interested in membership. She indicated there were nine vacancies on the Care and Treatment Committee and one applications pending. New members are required to complete New Member Orientation, Ethics Training, and complete a Source of Income form. Dr. Mary Jo Trepka submitted an application and indicated her interest in the committee. The committee voted to accept her as a member. Motion to accept Dr. Mary Jo Trepka as a member of the Care and Treatment Committee. Moved: Miguel Puente Seconded: D. Michael Greene Motion: Passed Anyone else who is interested in membership may contact staff or invite others to meetings Member Contact Update Mrs. Meizoso requested members complete the 2019 member contact update sheet so current contact information can be on file (copy on file). Annual source of Income Statement Mrs. Meizoso reviewed the annual source of income statement form (copy on file) for members to complete and return. VII. Reports Ryan White Program Update Carla Valle-Schwenk Carla Valle-Schwenk referenced the Part A/MAI FY 28 expenditure report (print date 2/5/2019: copy on file) which indicated the levels of expenditures under the Part A and MAI grants. For the Part A program, 79.52% of direct service dollars have been expended; for the MAI program, 69.38% of direct service dollars have been expended. Client services report is being drafted by the Recipient. Site visits are being completed by the close of February, 2019, and site visit reports will be released. The notice of award for has been received, for a total of $26,596,944, $25,000 more than last year. The grant award scored 98 of 100 and no deficiencies were noted. Miami-Dade HIV/AIDS Partnership/Care and Treatment Committee page 2

3 The County continues to implement the Test & Treat/Rapid Access protocol. There were 391 clients offered the protocol as of the period from July 1, February 2, Of these, 31 declined participation for reasons that include not being ready to start treatment, some requested counseling prior to using medications, other were waiting on labs and others were prescribed non-test and Treatment drugs. Sixty-eight percent (267 clients) were prescribed ARVs. Fifty-seven percent (151 clients) had viral loads less than 200. Part B Program Update Marlen Meizoso Mrs. Meizoso reviewed the Part B reports (copy on file) April-November were provided. Budget revisions have taken place due to projected surplus in November. All contracts report no issues. ADAP Program Update Dr. Javier Romero Dr. Romero reviewed the ADAP-Miami Report, dated January 2019 (copy on file). Dr. Romero indicated August re-enrollments are due. There were 5,702 clients enrolled in the program. In January, $3,097, was spent on 7,806 prescriptions for 3,030 clients. Viral load rates under 200 are 97.34%. New enrollments are 92 and 866 re-enrollments. In January, there were 1,966 Premium-Plus/ACA Insurance clients with $1,830, expended. Of the clients transferred from Ryan White to ADAP ACA premium payments there were 452 approved and 17 denials. There continue to be some problem with the ACA clients. Some had two applications active, which makes payment processing difficult. These clients had prior applications auto-renewed by insurance carriers. Any clients who do not use the CVS cards at Walgreen's to track co-payments can be suspended for non-compliance with the program. The formulary has been expanded again as of 2/15/19. Information on this will be forwarded to staff to share. Torvasy has been added, which is a new family of ARV medications. Thus far, no providers have been found who would provide the medication since it is provided via infusion. Ten slots would be available for the medication. General Revenue Update Marlen Meizoso Mrs. Meizoso reviewed the November Report (copies on file). In November, 1,300 clients were served at a cost of $616,158 with a year to date total of $1,206,311. Partnership Report Miguel Puente Mr. Puente referenced the Partnership report (copy on file) and indicated any questions can be directed to staff. Medical Care Subcommittee Report Marlen Meizoso The Medical Care Subcommittee heard updates from Part A and ADAP; elected Dr. Frances Martinez as chair and Carlos Palacios as vice-chair, and selected Dr. Robert Goubeaux as a new member. Began reviewing changes to the Minimum Primary Medical Care Standards for Chart Review document. Increased the "maximum allowable needle" limit under consumable medical supplies to allow clients to have sufficient supply for those who use insulin flex pens more than three times a day. Miami-Dade HIV/AIDS Partnership/Care and Treatment Committee page 3

4 Motion to increase A215,"needles, sterile, any size" to a maximum of 120 units a month on the consumable medical supplies list. Moved: D. Michael Greene Second: Dennis Iadarola Motion: Passed Added two bacterial conditions, impetigo and MRSA, to the sample medical conditions list since these are HIV complications not currently listed. Motion to add impetigo and MRSA to the sample conditions list. Moved: Miguel Puente Second: Maria Henriquez Motion: Passed The next subcommittee meeting will be February 22, VIII. Standing Business None. IX. New Business Ryan White Report Card Update Petra Brock Petra Brock presented information on cycle 1-4 of the Ryan White Performance Report Card (copy on file). She reviewed the document and explained that the continuum of care, medical case management, outpatient medical care and outreach are addressed by the report card. Details on how the data are defined are located on the reverse of the sheet. The data are presented in aggregate and details by agency are forwarded to agency contacts. In this past year, there were 9,565 clients. Overall, there have been improvements within the last four cycles. There are 12.7% of medically case managed clients who do not have a suppressed viral load. There is a field in SDIS to capture the reasons why clients are not taking medications, but this field may be bypassed. Staff will review to see if this is the case. FIU Grants and the Ryan White Program Robert Ladner Dr. Ladner and Dr. Trepka explained that the Ryan White Program will be working with FIU on some grants funded by the National Institutes on Minority Health and Health Disparities. The results of the studies should improve client outcomes in Part A. Data will be gathered through SDIS and information will be shared with the program and the Partnership. One study will focus on women centered care and examine SDIS data and conduct in depth interviews with clients and providers. These will help identify the practices that help clients return to care. The second study is a patient centered study which will be added onto the client satisfaction survey which will help identify communication issues, cultural competencies and change over time. Community Input Discussion All Aside from the yearly community input prior to the needs assessment meetings, staff requested input on additional ideas to gather opinions and unmet need data from PLWH clients in care. The following suggestions were made: Have a nice catered lunch Try somewhere central e.g. Jackson DTC (above the lunch room) Hold the event mid-day Maybe have an evening session for those who work A flyer should be provided to ACHA to see if they can share it with clients Miami-Dade HIV/AIDS Partnership/Care and Treatment Committee page 4

5 Childcare could be offered to women if attending the input meeting X. Announcements Mrs. Meizoso reviewed new clients in care for November (copy on file). She also reviewed the February and March calendars and reminded the committee the March meetings will be held off cycle. In addition, the Housing Committee meeting has been cancelled. Dr. Robert Ladner added that the February Partnership meeting will be held at HistoryMiami in the Theater-South Building on Tuesday, February 19. In addition, Mrs. Meizoso requested all attendees RSVP to meetings to ensure sufficient materials are available. XI. Next Meeting The next meeting is scheduled for Wednesday, March 13, XII. Adjournment Motion to adjourn. Moved: Dennis Iadarola Second: Miguel Puente Motion: Passed Mr. Gonzalez adjourned the meeting at 11:45 a.m. Miami-Dade HIV/AIDS Partnership/Care and Treatment Committee page 5