The Membership Committee met on September 19, 2005 at 1:00 p.m. to review candidate applications and recommend applicants to council, review a draft recruitment brochure, and review a draft of the policies and procedures.

Members Present: Dennis Nelson, Marla Madison, Jerry Oliver, Sam Guerrero

BVCOG Staff: Christopher Hamilton

The meeting came to order at 1 p.m.

Sam informed the committee that Juan, the most recent addition to the Planning Council, is resigning due to health reasons.

The committee then began to discuss the three candidates. Ms. Harris and Mr. Benfer expressed their views regarding the candidates prior to the meeting. For candidate one, both Ms. Harris and Mr. Benfer stated they felt there is enough provider representation from the Concho HSDA and voted no. All other committee members voted yes, citing the 15 years of HIV/AIDS experience and the candidate's clinical expertise as an R.N. Mr. Oliver stated that he personally did not distinguish between providers or consumers in this matter, that input in needed regardless. Since the majority of the committee votes yes for candidate one, he will be recommended to the Planning Council for membership.

The committee then reviewed candidate two. All committee members, including previous input from Mr. Benfer and Ms. Harris vote yes for candidate two. The committee reviewed candidate three, and as with candidate two, all approved.

It was noted that at the next Planning Council meeting on October 11, the candidates will be voted on with the recommendation of the Membership Committee that all be voted in.

Next, the committee discussed the recruitment brochure. Mr. Oliver made a suggestion that mention be made of the incentive given to consumer participants on the council. Mr. Guerrero agreed with the suggestion. All approved of the brochure. Mr. Hamilton will incorporate the incentive suggestion and proceed with distributing the brochure. He and Ms. Harris are composing a letter to send to providers asking them to place the brochure in their clinics, offices, etc... Mr. Nelson offered to place the brochure in his clinic.

Lastly, the committee reviewed the policies and procedures draft. Mr. Nelson made a change in the document to 'soften' the wording regarding termination of members due to excessive absences. The re-wording will be incorporated in the draft. The policies and procedures draft will be presented to the Planning Council at the October 11 meeting for a vote to approve.

The meeting adjourned at 1:20 p.m.

Posted by BVCOG-HIV at 08:15 PM | Permalink

The Allocation Committee (AC) met in Bryan on September 16, 2005, at 9:10 a.m. to continue allocating funds for the Central Texas HIV/AIDS Planning Area, Waco and Concho Plateau HSDAs.

CTHPCA Members present: Parker Willson - Chair, Sissy Riffin, Cynthia Juniper

BVCOG staff present: Christopher Hamilton, Crystal Crowell

DSHS staff present: Brenda Howell, Laura Moch

The meeting was called to order at 9:10 a.m.

Brenda Howell checked with Michelle Porter regarding the health insurance category and confirmed that ambulatory copays are funded from the health insurance category. Ms. Howell will talk to Frances Hodges to get a ruling from HRSA. A question was raised that if an Austin agency came to the Planning Council with a reallocation request to move money from ambulatory to health insurance to correct this, would that agency be at risk of having the money given to another agency? Ms. Howell stated that it will have to go back to the table, but the agency could make a compelling argument that it's still going to ambulatory care for clients.

The committee continued allocating funds for the remaining HSDAs:

WACO HSDA - $375,411

Ambulatory/Outpatient Medical Care (AOMC)
*2005-06 funding: $7,114 in RW, $23,514 in SS

Discussion:
- Provider Survey: under #5 the agency addresses AOMC and expects to spend less next year because of the Scott & White HIV clinic, but will spend more in transportation to get clients to the clinic
- The committee reviewed past years' expenditures
- It was suggested that if this category remains level, it should be adequate based on the data
- The committee had consensus to stay level for AOMC from 05-06 allocations
- Mr. Hamilton stated that the Council does not have to split the funding between Ryan White (RW) and State Services (SS) and it could be allocated to one or the other. Ms. Howell stated that it's better to split categories that can't be spent down easily at the end of the year. For example, funding for food and drugs can be easily spent down, but AOMC can't.
- It was suggested that the committee should consider the different funding years when taking money out of a funding source and putting it all in another, so the providers are not without that money for several months.

Decision and Justification:
- The committee decided to leave AOMC just like it was in 2005-06 in both RW and SS.
- Justification for not meeting the threshold: the provider survey shows that it's sufficient and the Scott & White Clinic will result in lower costs.

Drug Reimbursement
*2005-06 funding: $85,245 in RW, $562 in SS

Discussion:
- Provider Survey: the agency states they are using more programs than before to assist clients
- The agency spent 96% last year in RW. With 1 month left in SS they are at 3%, and there's 10% left in RW currently.
- A point was brought up that Waco's costs went down because of more frivolous spending in the past and because of not getting people on the Texas HIV Medication Program (THMP) more quickly.
- The data show that the provider does not need as much as last year
- A suggestion was made to take the $562 out of SS and drop RW funding to $80,000.
- The committee discussed splitting the funds so the provider would not be without drug funding for the time between fiscal years.

Decision and Justification:
- The committee decided to fund $80,000 in drugs total ($51,631 out of RW and $28,369 out of SS)
- Justification for not meeting the threshold: because the data, especially patterns in expenditures and the fact that the provider is utilizing other sources, show that additional funding is not necessary to meet the needs of the clients.

Oral Health
*2005-06 funding: $9,000 funded entirely out of RW

Discussion:
- Provider Survey: there is no alternate funding for oral health and no waiting list identified.
- Expenditures are at 17% now; final was 95% in 04-05.
- This category was under spent in both 03-04 and 04-05, as well as the current year.
- The committee decided that the data do not support increasing the oral health category much, but that they could increase it slightly because of the increase in expenditures from 03-04 to 04-05.
- Expenditures increased 12% from 03-04 to 04-05, so another 12% increase would be $10,640.

Decision and Justification:
- The committee reached consensus that $10,640 will be the allocation for this category in RW.
- Justification for not meeting the threshold: the allocation was increased slightly because of patterns in expenditures; however, the data show that additional funding is not necessary to meet the needs of the clients.

Mental Health
*2005-06 funding: not funded out of RW or SS

Discussion:
- Provider Survey: MHMR is adequate to take care of the needs of clients
- A question was raised about whether or not family practice has a mental health component. Participants were unsure.
- Representatives from this HSDA stated that other efforts have been made in the Waco area to get clients together for a support group, but they were not interested - there doesn't seem to be a high need.

Decision and Justification:
- The committee decided not to fund this service.
- Justification for not meeting the threshold: none of the data, including the needs assessment, indicate a need from the clients for this service; the small need is taken care of by other resources

Substance Abuse
*2005-06 funding: not funded out of RW or SS

Discussion:
- Provider Survey: The Freeman Center meets the needs of all clients according to the provider
- data indicate there is not a need to fund this category
- no utilization in previous history; no indication of need

Decision and Justification:
- The committee decided not to fund this service.
- Justification for not meeting the threshold: none of the data indicate a need from the clients for this service; the small need is taken care of by other resources

Case Management
*2005-06 funding: $117,946 in RW, $53,848 in SS

Discussion:
- 04-05 final was spent at 100%; right now in RW the provider is slightly overspent. The provider spent 100% in 03-04 and current SS is 88% with 1 month remaining
- The committee discussed a 3% increase, which would be $176,948

Decision and Justification:
- The committee reached consensus to fund this category at $176,948
- Justification for not meeting the threshold: this category consists of salaries; it's a marginal cost and the committee provided a 3% increase

Health Insurance
*2005-06 funding: $12,257 funded entirely from RW

Discussion:
- Provider Survey: use has exceeded expectations; the provider is spending more than allocated - the provider was paying for 2 clients with cobra that are about to reach their maximum; expenditures should stabilize after that
- The committee discussed level funding health insurance - it seems from the data that the provider could make it on that amount next year

Decision and Justification:
- The committee reached consensus to fund this category at $12,257 out of RW
- Justification for funding this category over core services: this funding will be used to pay health insurance costs for clients to access medical care at a greatly reduced cost; the core services were met with the allocation given.

Transportation
*2005-06 funding: $4,800 funded entirely from RW

Discussion:
- Provider survey: more funding is needed in transportation for clients to seek services at the Scott & White HIV clinic.

Decision and Justification:
- The committee reached consensus to fund this category at $4,800 out of RW
- Justification for funding this category over core services: this is an access service and without this category, clients would not be able to access needed medical services; the core services were met with the allocations given; not as much funding was needed in ambulatory because of decrease cost from the Scott & White clinic, but more is needed in transportation to access that clinic.

Food Bank/Nutritional Supplements
*2005-06 funding: $50,000 funded entirely from RW

Discussion:
- The need seems to be continually increasing.
- There is very little in the area regarding other sources of funding for food and nutritional supplements.
- The majority of the utilization from Emergency Financial Assistance was food - the committee decided to not fund EFA and increase the food bank category to make up for the difference.

Decision and Justification:
- The committee reached consensus to fund this category at $56,737 - $28,369 in RW and $28,368 in SS due to the difference in grant years.
- Justification for funding this category over core services: the core services were met with the allocations given and utilization and past expenditures indicate a high need for funding in this category.

Emergency Financial Assistance
*2005-06 funding: $6,000 in RW, $2,327 in SS

Discussion:
- The majority of the utilization from Emergency Financial Assistance was food - the committee decided to not fund EFA and increase the food bank category to make up for the difference.

Decision and Justification:
- The committee reached consensus to not fund this category.

Plan for 5% decrease
- A 5% decrease for the Waco HSDA would be $18,770.55
- The entire decrease would come out of the food bank category
- If the core services need more funding, then the funding will first come out of the food bank category, then transportation, then health insurance

Ambulatory/Outpatient Medical Care (AOMC)
*2005-06 funding: $25,531 completely funded out of RW

Discussion:
- Provider Survey: the provider has an EACPS grant (early access) from DSHS that pays for a lot of AOMC expenses; provider states that they do not foresee an increase or decrease in any core services; the provider enrolled 4 new clients with no insurance
- With 8 mo remaining, the provider is 67% spent; with 1 month left in SS, they are 100% spent.
- 1st quarter expenditures are high because of 4 new clients
- A proposal was made by a member to increase AOMC to cover some additional clients
- In 04-05, the provider spent around $33,000; In 05-06, they are at 67% with 8 months left
- The utilization data show that labs were done for 50 clients

Decision and Justification:
- The committee decided to allocate $40,000 to the AOMC category in RW
- Justification for not meeting the threshold: the allocation was significantly increased to cover new clients and the rise in utilization and expenditures; the remaining amount of the threshold is covered by other resources through a grant ending in 2007.

Drug Reimbursement
*2005-06 funding: $35,500 completely funded out of RW

Discussion:
- Provider Survey: EACPS grant also covers drugs
- In 04-05, the agency spent close to $30,000 with 1 month remaining in State Services

Decision and Justification:
- The committee decided to leave this category at level funding
- Justification for not meeting the threshold: because the data, especially patterns in expenditures and the fact that the provider is utilizing other sources, show that additional funding is not necessary to meet the needs of the clients.

Oral Health
*2005-06 funding: $2,663 completely funded out of SS

Discussion:
- Provider Survey: the provider has a waiting list with 9 clients. A question was raised about whether that is because of funding or because the clinic is backed up - what is their definition of a waiting list?
- The Provider survey says it's because of differences in funding streams

Decision and Justification:
- The committee decided to fund oral health at $3,100 to cover the threshold and increased need.

Mental Health
*2005-06 funding: $2,500 completely funded out of SS

Discussion:
- RW 04-05 allocation was $531, but increased for 05-06 SS to $2,500. Increase appears to be based on historical utilization and expenditures.

Decision and Justification:
- The committee decided to leave this category at level funding - there was some confusion with past numbers, 03-04 had close to $8,000 in expenditures, then 04-05 dropped to $531.

Substance Abuse
*2005-06 funding: not funded out of either RW or SS

Discussion:
- It has never been funded by RW or SS - no demonstrated need.
- Another provider receives TCADA funding to cover this need.

Decision and Justification:
- The committee decided to not fund this category
- Justification for not meeting the threshold: no demonstrated need; other resources available.

Case Management
*2005-06 funding: $81,900 completely funded out of RW

Discussion:
- The committee will provide a 3% cost of living increase.

Decision and Justification:
- The committee decided to fund this category at $84,357 out of RW, then after discussing the Related Housing Services category, decided to move an additional $12,748 into SS for case management and not fund housing related services.

Related Housing Services
*2005-06 funding: $15,000 completely funded out of RW

Discussion:
- There was some discussion regarding what this category actually pays for- some believe it is for a case manager to find housing services. The AA checked on that for the committee and found that it does actually pay for case managers' salaries.

Decision and Justification:
- The committee decided not to fund this category and put the money into case management.

Buddy Companion Services

Discussion/Decision and Justification:

- The committee decided not to refund this category. They decided that they really need to fund Transportation, Health Insurance, and Food Bank and there is not enough money to fund all support services.

Health Education/Risk Reduction

Discussion/Decision and Justification:

- The committee decided not to refund this category. They decided that they really need to fund Transportation, Health Insurance, and Food Bank and there is not enough money to fund all support services.

Transportation
*2005-06 funding: $5,573 funded completely out of RW

Discussion/Decision and Justification:
- The committee decided to allocate $3,647 to transportation in RW and $3,000 in SS
- Justification for funding this category over core services: this is an access service and is needed for clients to access medical services

Health Insurance
*2005-06 funding: $22,555 funded completely out of SS

Discussion/Decision and Justification:
- The committee decided to allocate $23,000 in health insurance in RW
- Justification for funding this category over core services: this funding will be used to pay health insurance costs for clients to access medical care at a greatly reduced cost; the core services were met with the allocation given.

Food Bank/Nutritional Supplements
*2005-06 funding: $10,489 funded completely out of SS

Discussion/Decision and Justification:
- The committee decided to allocate $10,000 in food bank in SS
- Justification for funding this category over core services: funding was allocated to this category based on past utilization and expenditures demonstrating a need for this service.

Plan for 5% decrease
- A 5% decrease for the Concho Plateau HSDA would be $10,892.60
- The committee decided to take 70% out of food bank, 20% out of transportation, 10% out of health insurance.

AUSTIN HSDA
The committee revisited the Austin HSDA allocations - the total didn't add up because the committee was looking at the allocation minus administrative costs instead of the full allocation. The committee decided to make the following adjustments:
- increase case management by $1,470
- add a justification to the mental health category that local funds (a donor account) can cover the difference
- $171,147 is the new total for case management in RW

Public Hearings will take place in October and November and the Planning Council will vote at the December meeting. Input received from community members and subcontractors will be taken into account before the final vote of the Council.

Since Marla Madison was present for the first day of allocations and is needed for a quorum of votes, she will be informed of the allocation decisions from today and will be asked to vote.

The meeting was adjourned at 12:55 p.m.

Posted by BVCOG-HIV at 10:32 PM | Permalink

The Allocation Committee (AC) met in Bryan on September 15, 2005, at 9:30 a.m. to allocate funds for the Central Texas HIV/AIDS Planning Area, Austin, Bryan-College Station, and Temple-Killeen HSDAs

CTHPCA Members present: Parker Wilson - Chair, Sissy Riffin, Cynthia Juniper, Marla Madison

BVCOG staff present: Christopher Hamilton, Kristi Hanle

DSHS staff present: Brenda Howell, Laura Moch

The meeting was called to order at 9:34 a.m.

Mr. Wilson wanted to first go over the rules for the Allocations Committee.

1. Conflict of interest - individuals cannot vote for their own HSDA. They may speak for the HSDA to give more information than the data shows, but they may not vote.

2. The committee will vote on consensus.

3. A quorum of members is defined for this process as a majority of those present that are able to vote on an HSDA.

4. The allocation process is data driven. The committee must look at utilization, expenditures and all other relevant data in order to make decisions.

Mr. Wilson asked if BVCOG had conducted Provider Surveys and Mr. Hamilton directed everyone to the information in the back of each section of the binder. He let the committee know that the information was based on surveys, quarterly reports, etc.

Mr. Wilson asked if we should assume level funding and the committee agreed that allocations should be based on level funding and that most categories should be left at level funding. The Core Services must be funded first and the committee should look at the threshold to assist with the funding level. If the threshold cannot be met, the committee must justify why this is the case. Once the core services are funded, then the committee can look at funding the non-core services. The committee also needs to look at the instance of an HSDA receiving less than level funding and decide how that will affect the allocations.

AUSTIN HSDA - $1,114,343

Ambulatory/Outpatient Medical Care (AOMC)
*2005-06 funding: $455,000 in RW, $254,324 in SS

Discussion:
- The previous allocation was 791,251 and the projected threshold is 897,727. The committee decided that the threshold has gone up because of a growth in the number of clients in the HSDA.
- The committee discussed that they can arbitrarily decide that there will not be that much growth in the number of clients.
- Looking at the expenditures - there was 79% left at the end of the year at the end of the year. In RW, Parker doesn't see why they should be funded at the same level. Cynthia stated that there was some trouble with the clinic due to staff turnover, but they do need every penny of the allocation. Also look at state services.
- Mr. Wilson reminded everyone that the process must be data-driven.
- Brenda felt that looking at utilization over the last 2 years, an increase was not necessary, but level funding would be appropriate.
- Based on the data that we have seen - they should not be level funded, especially since the committee does not know how much is allocated to each agency within the HSDA.
- Austin got an increase in Title I (for the EMA). Only 2 or 3% of the clients are in the counties that are not covered in the EMA.
- Parker said that based on the expenditures and utilization, he does't see any reason to go any lower than the current allocation, but also does not see any reason to allocate more this category.
- The Austin HSDA is under spent at this point.

Decision and Justification:
- Go with $709,324 and not raise it any more because they are not spending at the current level that they should be. They have not spent to the limit of their allocation, so $709,324 is ok, especially since the title I allocation was increased.
- The committee decided to keep the allocation the same, with $455,000 coming from Ryan White and $354,324 coming from State Services for a total of $709,324.
- The justification for this is that previous expenditures were not fully expended.

Drug Reimbursement
*2005-06 funding: $101,000 in RW, $67,305 in SS

Discussion:
- Looking at the threshold, if we reduce the current allocation by $60,000 we would still be able to meet the threshold.
- HSDA is 7% in drugs now in Ryan White, but they were 127% spent in 04/05 and in State Services they are 13% spent at this time.
- We need to keep in mind that one of the Austin providers does have income and that explains the HSDA being 127% spent. They were not really overspent.
- This will probably be taken care of at the end because one of the agencies has a pharmacy and can spend funds at the end of the grant year. Also, many agencies spend down one funding stream at a time, so the expenditure may look odd.

Decision and Justification:
- The committee decided to fund $105,842 in this category, $63,505 from Ryan White and $42,337 in State Services.
- The justification for this amount is that it is at the threshold.

Oral Health
*2005-06 funding: $8,000 funded entirely out of RW

Discussion:
- The threshold is up.
- There has been an increase in the number of clients who have not had dental care and tend to have more expensive dental needs. So, the need has risen.
- We will meet the threshold since the need seems to be on the rise.

Decision and Justification:
- The committee decided to fund $9,517 in this category, all from Ryan White
- No justification is necessary since this category is funded at the threshold.

Mental Health
*2005-06 funding: not funded out of RW or SS

Discussion:
- This category was not funded at all last year.
- Since it is a core service, it must be funded this year.

Decision and Justification:
- The committee decided to fund this category at $5000, all from Ryan White.
- The justification for not meeting the threshold is because there is Title I funding for this service category. If a need is determined in the future, funds will be reallocated from non-core services.

Substance Abuse
*2005-06 funding: not funded out of RW or SS

Discussion:
- This was not funded the last 2 years.
- The Title I allocation was increased over $100,000.
- Based on the funds available, there is a waiting list, but with the increase, this should be able to be met, especially with other funds from TCADA, SAMSHA, and other sources.

Decision and Justification:
- The committee decided not to fund this service.
- Justification for not meeting the threshold: none of the data indicate a need from the clients for this service; the AA has not had requests for this category; the small need is taken care of by other resources.
- If a need is found, funds will be moved from non-core services.

Case Management
*2005-06 funding: $165,651 in RW, $40,267in SS

Discussion:
- The threshold has jumped $30,000.
- The question was raised wondering if the case management category was salaries. It was decided that it included salaries and fringe.
- The funds are being expended in case management.
- Not funding at the threshold because of marginal costs- an increase in the number of clients does not increase the cost of case management.
- Should increase allocation from last year to include funds to increase case manager salaries and fringe.

Decision and Justification:
- The committee reached consensus to fund this category at $212,096, with $169,677 coming from Ryan White and $42,419 coming from State Services.
- Justification for not meeting the threshold: this category consists of salaries; it's a marginal cost and the committee provided a 3% increase

Health Insurance
*2005-06 funding: not funded from RW or SS

Discussion:
- There are funds in Title I to pay for this service.

Decision and Justification:
- The committee reached consensus to fund this category at $13,482 out of RW
- Justification for funding this category over core services: this funding will be used to pay health insurance costs for clients to access medical care at a greatly reduced cost; the core services were met with the allocation given.

Transportation
*2005-06 funding: $15,000 from RW and $4,266 from SS

Discussion:
- More funding is needed, as there is an increase in clients and an increase in gas prices.

Decision and Justification:
- The committee reached consensus to fund this category at $36,000, with $27,000 coming out of RW and $9,000 coming out of State Services.
- Justification for funding this category over core services: this is an access service and without this category, clients would not be able to access needed medical services; the core services were met with the allocations given.

Food Bank/Nutritional Supplements
*2005-06 funding: $5,000 funded entirely from SS, this category was reallocated at the end of the year.

Discussion:
- The need seems to be continually increasing.
- The client need for food seems to be getting greater in the rural areas.
- The food bank in the EMA is getting stricter on their eligibility requirements.

Decision and Justification:
- The committee reached consensus to fund this category at $10,000. Justification for funding this category over core services: the core services were met with the allocations given and utilization and past expenditures indicate a high need for funding in this category.

Emergency Financial Assistance
*2005-06 funding: not funded

Discussion:
- The committee decided that food would be taken care out of the food bank category and decided to fund only medication and utilities.

Decision and Justification:
- The committee reached consensus to fund this category entirely from State Services at a total of $13,082. This will be divided between Medication ($6541) and Utilities ($6541).

Plan for 5% decrease
- A 5% decrease for the Austin HSDA would be $55,732.30.
- The entire decrease would come out Emergency Financial Assistance, then Health Insurance, then Food Bank and lastly Transportation.
- If the core services need more funding, then the funding will first come out of Emergency Financial Assistance, then Health Insurance, then Food Bank and lastly Transportation.

Called to order at 12:43

BRYAN/COLLEGE STATION HSDA - $295,375

Ambulatory/Outpatient Medical Care (AOMC)
*2005-06 funding: $25,000 in RW; $0 in SS

Decision and Justification:
- The committee decided to fund this category at $25,000, all from Ryan White.
- The justification for not funding at the threshold is that historic utilization does not show that it is necessary.

Drug Reimbursement
*2005-06 funding: 0 in RW; $15,081 in SS

Discussion:
- This is a category that is needed and funds are expended.

Decision and Justification:
- The committee decided to fund $23,545.28 to this category, all from State Services.
- The justification for this amount is that it is at the threshold.

Oral Health
*2005-06 funding: $2,031 funded entirely out of SS

Discussion:
- Clients can be seen at the Bering Dental Clinic in Houston. The agency has a ¼ time transportation person.
- There has been an increase in the need for local dental funds than in the past, but since transportation is available to Houston for free dental care, the committee does not see the need to fund to the threshold.

Decision and Justification:
- The committee decided to fund $8,000 to this category all from State Services.
- The justification for not funding to the threshold is that there are other options available for this category such as the Bering Dental Clinic and the local FQHC Dental Clinic.

Mental Health
*2005-06 funding: not funded out of RW or SS

Discussion:
- This category was not funded at all last year.
- MHMR doesn't assist many clients because of funding cuts. The TAMU clinic is no longer an option for clients. Clients have requested this service, but the provider has not been able to locate a clinician who will sign a contract with the agency.
- Since it is a core service, it must be funded this year.

Decision and Justification:
- The committee decided to fund this category at $3870, all from State Services.
- No justification was necessary since this category was funded at the threshold.

Substance Abuse
*2005-06 funding: not funded out of RW or SS

Discussion:
- This was not funded the last 2 years.
- The Administrative Agency has not had requests for this category.

Decision and Justification:
- The committee decided not to fund this service.
- Justification for not meeting the threshold: none of the data indicate a need from the clients for this service; the AA has not had requests for this category; the small need is taken care of by other resources.
- If a need is found, funds will be moved from non-core services.

Case Management
*2005-06 funding: $198,134 in RW.

Discussion:
- The threshold has jumped more than $60,000 since the last allocation. .
- The funds are being expended in case management.
- Not funding at the threshold because of marginal costs- an increase in the number of clients does not increase the cost of case management.
- Should increase allocation from last year to include funds to increase case manager salaries and fringe.

Decision and Justification:
- The committee reached consensus to fund this category at $204,078, with all of the funds coming from Ryan White.
- Justification for not meeting the threshold: this category consists of salaries; it's a marginal cost and the committee provided a 3% increase

Health Insurance
*2005-06 funding: not funded from RW, $5,540 in SS

Discussion:
- These funds are for Health insurance premiums, COBRA, and co-pays.

Decision and Justification:
- The committee reached consensus to fund this category at $5,000 out of SS.
- Justification for funding this category over core services: this funding will be used to pay health insurance costs for clients to access medical care at a greatly reduced cost; the core services were met with the allocation given.

Transportation
*2005-06 funding: $10,687 from RW and $23,760 from SS

Discussion:
- This is a category that is necessary so that clients can get to appointments. The Medicaid transportation system is not always a good option for clients because they are not reliable in the time that they arrive to pick up clients.

Decision and Justification:
- The committee reached consensus to fund this category at $23,380, with $4,743 coming out of RW and $18,637 coming out of State Services.
- Justification for funding this category over core services: this is an access service and without this category, clients would not be able to access needed medical services; the core services were met with the allocations given.

Food Bank/Nutritional Supplements
*2005-06 funding: $5,048 funded entirely from SS

Discussion:
- Fundraisers can be held to raise funds to purchase food from the food bank.
- The funds allocated to this category will be used for nutritional supplements.

Decision and Justification:
- The committee reached consensus to fund this category at $2,500. Justification for funding this category over core services: the core services were met with the allocations given and utilization and past expenditures indicate a high need for funding in this category.

Emergency Financial Assistance
*2005-06 funding: not funded

Discussion:
- There has not been a need for this category.

Decision and Justification:
- The committee reached consensus to not fund this category.

Plan for 5% decrease
- A 5% decrease for the Bryan/College Station HSDA would be $14,768.75.
- The entire decrease would come out Food Bank, then Health Insurance and lastly Transportation.
- If the core services need more funding, then the funding will first come out of Food Bank, then Health Insurance and lastly Transportation.

TEMPLE/KILLEEN HSDA - $328,502

Ambulatory/Outpatient Medical Care (AOMC)
*2005-06 funding: $8,000 in RW, $0 in SS

Discussion:
- Clients in this HSDA get their medical care free from Scott & White.

Decision and Justification:
- The committee decided to fund this category at $8,000, all from Ryan White.
The justification for not funding at the threshold is that historic utilization, along with other resources available to clients in this HSDA. The committee does not feel that it is necessary.

Drug Reimbursement
*2005-06 funding: $62,235 in RW, $20,138 in SS

Discussion:
- This is a category that is needed and funds are expended.

Decision and Justification:
- The committee decided to fund $82,373 to this category, with $56,442 coming from Ryan White and $25,931 coming from State Services.
- The justification for not funding at the threshold is that the current allocation appears to be meeting the needs.

Oral Health
*2005-06 funding: $10,036 funded entirely out of SS

Discussion:
- This is a category that clients are using.

Decision and Justification:
- The committee decided to fund $10,036 to this category all from State Services.
- The justification for not funding to the threshold is that based on utilization and expenditure data, the current funds are able to meet client needs.

Mental Health
*2005-06 funding: not funded out of RW or SS

Discussion:
- This category was not funded at all last year.
- Scott & White covers the needs that clients have in this category.

Decision and Justification:
- The committee decided to not fund this category.
- The justification for not funding this category is that it is covered by Scott & White.

Substance Abuse
*2005-06 funding: not funded out of RW or SS

Discussion:
- This was not funded the last 2 years.
- The Administrative Agency has not had requests for this category.

Decision and Justification:
- The committee decided not to fund this service.
- Justification for not meeting the threshold: none of the data indicate a need from the clients for this service; the AA has not had requests for this category; the small need is taken care of by other resources.
- If a need is found, funds will be moved from non-core services.

Case Management
*2005-06 funding: $193,097 in RW.

Discussion:
- The funds are being expended in case management.
- Not funding at the threshold because of marginal costs - an increase in the number of clients does not increase the cost of case management.
- Should increase allocation from last year to include funds to increase case manager salaries and fringe.

Decision and Justification:
- The committee reached consensus to fund this category at $198,890, with all of the funds coming from Ryan White.
- Justification not needed, funded above threshold. Funding level include a 3% increase over 05-06 levels.

Health Insurance
*2005-06 funding: not funded from RW , $16,097 in SS

Discussion:
- These funds are for Health insurance premiums, COBRA, and co-pays.

Decision and Justification:
- The committee reached consensus to fund this category at $10,304 out of SS.
- Justification for funding this category over core services: this funding will be used to pay health insurance costs for clients to access medical care at a greatly reduced cost; the core services were met with the allocation given.

Transportation
*2005-06 funding: $0 from RW and $10,818 from SS

Discussion:
- This is a category that is necessary so that clients can get to appointments.

Decision and Justification:
- The committee reached consensus to fund this category at $10,818, the entire amount coming from State Services.
- Justification for funding this category over core services: this is an access service and without this category, clients would not be able to access needed medical services; the core services were met with the allocations given.

Food Bank/Nutritional Supplements
*2005-06 funding: $8,081 funded entirely from SS

Discussion:
None

Decision and Justification:
- The committee reached consensus to fund this category at $8,081, coming entirely from State Services
- Justification for funding this category over core services: the core services were met with the allocations given and utilization and past expenditures indicate a high need for funding in this category.

Plan for 5% decrease
- A 5% decrease for the Temple/Killeen HSDA would be $16,425.10.
- The entire decrease would come out of Food Bank (81.3%), then Transportation (60.7%) and then Health Insurance (31.9%).
- If the core services need more funding, then the funding will first come out of Food Bank (81.3%), then Transportation (60.7%) and then Health Insurance (31.9%).

Meeting Adjourned at 3:30.

Posted by BVCOG-HIV at 09:27 PM | Permalink

The Comprehensive Planning Committee met on September 8, 2005 at 9:00 a.m. to review and discuss implementation of the Comprehensive HIV Care Services Plan.

Members Present: Sam Guerrero*, Cynthia Juniper, Robert Luckey, and Chris Benfer

BVCOG Staff Present: Christopher Hamilton

The committee discussed each of the goals and objectives, noting those that have been met, those that should be changed, and those that are not appropriate to the Planning Council. Mr. Hamilton will make the agreed upon revisions to the goals and objectives section of the plan.

The committee discussed the upcoming reauthorization of the Ryan White CARE Act (RWCA) and came to the conclusion that the plan should not be rewritten before the reauthorization occurs because of potential changes to the legislation. The committee has agreed to wait and evaluate the reauthorization prior to developing new goals and objectives for the comprehensive plan.

The committee will report to the Planning Council that it has reviewed the plan and continues to do so, agreeing upon some changes to be made thus far, but primarily, feeling it is best to wait until the RWCA is reauthorized before undertaking any major revisions.

The next meeting is October 20. The committee will decide a week before it will still meet on this date, depending on guidance from HRSA/DSHS about RWCA reauthorization.

The meeting was adjourned at 9:45 a.m.

Posted by BVCOG-HIV at 11:22 PM | Permalink

Texas Department of State Health Services (DSHS) HIV/STD: http://www.dshs.state.tx.us/hivstd/default.shtm

Department of Health and Human Services - Health Resources and Services Administration HIV/AIDS Bureau
http://hab.hrsa.gov/

AIDSinfo at National Institutes of Health
http://www.aidsinfo.nih.gov/

The Kaiser Family Foundation Global HIV/AIDS Timeline

Brazos Valley Council on Alcohol and Substance Abuse
http://www.bvcasa.org

Posted by BVCOG-HIV at 11:10 PM | Permalink

HIV Administrative Services is a program of the Brazos Valley Council of Governments. We serve as the Ryan White Title II Administrative Agency for the Central Texas HIV/AIDS Planning Area. Our role as the Administrative Agency is to plan for service delivery, disseminate funds for those services, and monitor the use of those funds to ensure client needs are met. We are also responsible for the collection and management of HIV services data for the 43 counties in our planning area.

This website provides information regarding services planning, BVCOG's HIV subcontractors, and others interested in taking part in the planning process or HIV service delivery.

Posted by BVCOG-HIV at 04:45 PM | Permalink

The following is the 2003 Continuum of Care.
Download file PDF - 14.6 MB

Posted by BVCOG-HIV at 02:11 PM | Permalink

Included in this section is a list of frequently asked questions regarding the Housing Opportunities with AIDS program. The following is a fact sheet compiled by the Brazos Valley Council of Governments (BVCOG) based on the Texas Department of State Health Services (DSHS) HOPWA Manual, as well as training received by HUD and clarification from DSHS. This fact sheet is merely meant to provide some general clarification and guidance and is not a comprehensive source for information on HOPWA in Texas. For more information, please refer to the most recent DSHS HOPWA Manual at http://www.dshs.state.tx.us/hivstd/fieldops/hopwa.shtm

HOPWA Fact Sheet

Short-term Rent, Mortgage, and/or Utility Assistance (STRMU)
STRMU is a term used by HUD, but it is also known as "Emergency" or "Short-term" Assistance. Below is a description of the requirements for eligibility for Short-term Assistance, as well as the documentation required before payments can be made:

Following is information about the eligible period for short-term HOPWA assistance:

Methods for calculating the eligible period:
The 21-week eligibility period may be calculated by using one of two acceptable methods. However, the provider must elect to use one method consistently for all of its clients.
1. The 1st method is to use a set period for all clients. This can be either the calendar year or the grantee's contract year.
2. The 2nd method is for providers to establish a separate period of eligibility for each client, based on the date the client began to receive assistance. The client's eligibility period would end 52 weeks after the payments were supposed to be received by the payee from the client (e.g., June 1st from the example above, which establishes the beginning of the period covered by the assistance). This is the preferred method of determining eligibility.

* The push for HOPWA is housing stability. If someone is on the Emergency (short-term) Assistance program, they are not in stable housing. Short-term assistance is not intended to provide continuous or perpetual assistance and the statute requires that good faith efforts be undertaken to relocate clients to permanent housing.

Tenant-Based Rental Assistance (TBRA)
TBRA is another term used by HUD, but is also known as long-term rental assistance. Following is some important information regarding long-term assistance:

Other important HOPWA information

HOPWA assistance should not be denied simply because a client uses or is alleged to use or abuse illegal drugs in their place of residence, or because he or she refuses to enter drug treatment services. Client eligibility must be based on the criteria specified in the eligibility sections of the manual. The owner of the rental property certainly has the right to prohibit illegal acts on his or her property, and has the right to notify law enforcement officials when needed or to initiate eviction proceedings when a client has violated lease provisions.

If a client is evicted, they can reapply for the program.

A client can be terminated for non-compliance with program requirements, but you MUST HAVE the following in place:

The client can self-identify whether the person they live with is a partner or roommate. That relationship can change, but it should really only be done at recertification (the client can't change their mind every week or month). However, the client should make an informed decision and the Case Manager should explain both options very clearly.

There is a manual called "Section 8 Made Simple: Using the Housing Choice Voucher Program to Assist People with Disabilities" that is recommended for all providers to access: http://www.tacinc.org/cms/admin/cms/_uploads/docs/Sect8.2ndEd.pdf

Please ensure that all program staff are aware of and are operating under these requirements. You can contact Crystal Crowell at ccrowell@bvcog.org or (979) 595-2800 with any questions or concerns regarding
the above information.

Link to the HOPWA Appendix Y
http://www.dshs.state.tx.us/hivstd/fieldops/hopwa/appendix_y.pdf

HOPWA Training Session Q&A
The following file is a summary of discussion questions and answers at a HOPWA training provided by BVCOG in January 2006.
Download file (MS Word)

Posted by BVCOG-HIV at 01:55 PM | Permalink

The following PDF is the Comprehensive Plan for the central Texas HIV planning area. It was completed in 2003.
Download file PDF - 1.68 MB

Posted by BVCOG-HIV at 10:06 AM | Permalink

The following PDF document is the needs assessment for the central Texas HIV planning area. It was conducted in 2003.
Download file PDF - 989KB

Posted by BVCOG-HIV at 10:03 AM | Permalink

Call toll free: 866-841-7288

Mailing address:
PO Drawer 4128
Bryan, TX 77805-4128
Fax: 979.595.2815

Shipping Address:
3991 East 29th Street
Bryan, TX 77802

Posted by BVCOG-HIV at 10:00 AM | Permalink