CTHPCA Members present: Parker Willson - Chair, Marla Madison, Janet Cates, Sissy Riffin, Sam Guerrero, Cynthia Juniper, Eric Todd

BVCOG staff present: Christopher Hamilton, Crystal Crowell

DSHS staff present: Brenda Howell

The meeting was called to order at 9:20 a.m.

The committee chair raised questions about funding thresholds: (1) how are thresholds calculated for services with $0 allocated and no clients in the utilization data; and (2) should thresholds be created for the subcategories of substance abuse or just to substance abuse as a whole? The answer to the second question is thresholds should be set for the category as a whole since the committee does not allocate to subcategories.

A discussion ensued regarding the first question. A question was raised about whether the AA should go to the providers to find out how many clients are receiving those services. Brenda Howell stated that she wasn't certain it was the AA's job to do that and the committee needs to find out how many clients are referred to those services. The committee discussed whether determining the number of referrals would be an accurate reflection of usage. Some committee members stated that using referrals would give an inflated figure since the number of clients referred does not equal the number of clients that receive the service.

Another question raised was how cost is determined if the service has never been funded out of Ryan White or State Services. Members discussed the possibility of using the Medicaid reimbursement rate as a baseline. Ms. Howell stated that the committee needs to find out how many clients are Ryan White-eligible and said that it is possible to find out how many clients are HIV-positive, since no one will be asking for identifying information. She then stated that the committee should find out the average cost of care per day and the average number of days that clients are in care - the committee needs to look at averages.

The committee then discussed being consistent with all core services. If the committee only looks at Ryan White and State Services funds for some categories, such as ambulatory care, and looks at all services provided to Ryan White-eligible clients for other categories, such as substance abuse, that is not consistent. Ms. Howell stated that this is the first time for setting thresholds and the committee should just do the best they can for this first year.

Ms. Howell stated that the requirement for providing justifications for funding or not funding core services comes from HRSA and the requirement for setting funding thresholds comes from DSHS. It is important for all of the planning areas to know what they would do if a provider (such as Scott and White in Temple) decided to stop seeing HIV-positive clients and how much it would cost to maintain the current level of services. Ms. Howell also reminded the committee that some services, such as transportation and health insurance, can be "sub-funded" under core categories.

The committee then reviewed the thresholds set for each HSDA that were calculated by Christopher Hamilton based on the formula agreed upon by the committee at the previous meeting. A question was brought up about the Bryan HSDA's oral health category. Marla Madison stated that the Bryan provider will be providing transportation to Bering Dental Clinic again, so that may affect some of the information used by the committee. It was stated that the provider in Bryan wasn't told to enter utilization from the Bering Dental Clinic until later in the fiscal year, so the committee will need to look at just those months where the full utilization is recorded in order to get more accurate information.

Mr. Hamilton will e-mail all of the threshold spreadsheets to the committee for their review. The committee members will be responsible for gathering information on the core categories that were previously unfunded through Ryan White and State Services and send the information to Mr. Hamilton no later than August 29th. Allocations for 2006-07 will be held September 15-16 in Bryan. Out of town committee members will drive in on the 14th. BVCOG will send hotel information and directions to the committee.

The meeting was adjourned at 11:25 a.m.