Ryan White Planning Council - Community Health Planning & Strategies (chps) Committee - Regular Meeting

We're going to go ahead and start. We've reached quorum with five out of six.

The meeting begins at 12.01 on May 26, 2026. I invite planning council support to begin the introductions and declarations of conflicts of interest.

Thank you, Eva. So if I call your name, please list any conflicts of interest you have. I will start with committee members and then I'll go to recipient staff and any other guests we have on the call. So I will start with Eva Galindo.

Eva Galindo, present, no conflicts.

Eric Eason. Actually, I think Eric jumped off the call to fix his computer, but he is on the call today.

Randall Furrow.

Present.

Jason Val Cruz.

Jason Val Cruz, conflicts include primary medical, substance use, mental health, IFSCA, and referral for healthcare and support services.

Bradley Reese.

Bradley Reese, present, no conflicts.

Erica Teekamp. Erica Teekamp, present, conflicts with medical and non-medical case management, referral for health care and support services, medical transportation, and HipSTAT. Jeremy Hivarnan.

Jeremy Hivarnan, Maricopa County.

Regan Hoy. Regan Hoy, Maricopa County.

Debra Rudin Maynard.

Debra Rudin Maynard, conflicts with Part B and 8M.

Roel Ayala.

Roel Ayala, conflicts with Part B and 8M.

Thank you everyone. So that is everyone scheduled to speak on today's agenda. Before we move on, I wanted to give anyone a chance if you are not currently on the CHIPS committee, but you are interested in joining, I would like to give you your opportunity now to declare interest in joining.

Oh, Benjamin Pearson, and I would like to join this committee.

Thank you Benjamin anyone else.

Hi, this is Stacy J cavalier. Um, I already. Plan on joining another committee, but I'm a new member to the planning council. So I just wanted to get acquainted with all the. Different subcommittees.

Perfect. That sounds good. And thank you so much, Stacy J. and Benjamin. I will follow up with both of you after the meeting to get you some more information. And with that, I can hand it back to you, Eva, for the agenda.

Eva, you might be muted.

And also, Benjamin. Sorry, I'm struggling today.

That's okay. Thank you, Grant. Thank you. We're going to move on to Agenda item three, reviewing and acceptance of agenda. I cannot change or I cannot add anything to the agenda. We can change the order, but we are not allowed to add anything in compliance with open meeting laws. Does anyone have any comments on the agenda?

Perfect.

We'll move on to- Excuse me.

I'm sorry, Benjamin has his hand up in the meeting, but I'm at home today and my Internet keeps popping in and out. So I had to keep signing back in. So I'm here, but I keep popping out.

Okay, thank you.

Um. We're going to move on to item 4 of the agenda, the reveal review and approval of minutes. and action items. Did everyone have the opportunity to review the minutes for, I think it was in March, March 24th? We'll now review them. If anyone has any changes or revisions, now is the time. And if not, we're looking for a motion to accept the minutes of March 24th.

I'll make that motion. So moved.

Is that Jason?

This is Bradley. I'll second.

Thank you, Bradley. I have a motion from Jason, Phil Cruz, and a second by Bradley. Do we have any discussion before we vote? Seeing none, Gwen, are we doing a roll call, I assume?

Yeah, we'll do a roll call, though. So I'll start with Eva Galindo.

Yes.

Eric Eason?

Yes.

Randall Furrow?

Yes.

Jason Falcruz?

Yes.

Erica Teacamp? Yes. Bradley Reese?

Yes.

Motion carries. Thank you, everyone.

We're going to move on to item five for the chair update. I do not have anything at the time, Eric, if you have anything as an update. Go ahead.

I do not have any update.

Thank you, Eric. We're going to move on to item six. With Ryan White, Part A recipient's office with Jeremy.

Hey, everyone.

Good afternoon. Let me grab my notes. Okay, so we sent out on Thursday, Gwen sent out a notice, but we did receive our Part A final notice of award, which totaled $11,350,085. That's just over $300,000 increase from last year's base award. We are still working on the carryover request. It's ready to go. We're just waiting for something on HRSA's side to be fixed in the system for us to be able to submit it. We have plenty of time, but once we submit that, it will be for a total of $421,983, which is an increase of $44,000, just over $44,000 compared to last year's carryover request. So we will have about $345,000 over what we had last year in funding, once we add in both the full award and the carryover in comparison. We are working on preparing an allocations workgroup and information for that. We anticipate that it will likely be. The latter part of the of the week of June 8th. But more to come on that once we solidify details will hopefully get that up to you within the next day or two so we can get on people's calendars. As a reminder for the work group, we cannot get quorum of the full Council, so we have to. It would be limited to 11 members for the work group too. would then bring those recommendations to the June 23rd Planning Council. Yes, June 23rd Planning Council meeting for review and approval if you are on board with them. We have not received our EHE final notice of award yet, but it is anticipated within the next few weeks, so we'll let you know once we get that in. Also, HRSA did HRSA did release their new interim HIV Resource Hub website. I'm dropping the link in the chat. This replaces the target HIV website while they're working on their finalizing the new Resource Hub. And then we are also looking, we are actively recruiting for new ambassadors for our Positively You campaign, for a campaign refresh project that the EHE team is working on this grant year. So if you know anyone ages 18 to 30 living with HIV, who is a current or former client of Ryan White Services, please have them reach out to Kate Thomas. I'm dropping her email in the chat if you don't have it. with a brief message as to why they want to be an ambassador, and then she will connect with them. And then my other update was about continuum data, but Reagan's going to talk about that on the agenda later.

Any questions for me? I'm complete.

Thank you, Jeremy.

Thank you for everything.

We're going to move on to item seven, the integrated plan update with ADHS.

Hello, everyone. So are we good to share our screen then for the presentation? Yes, please. Awesome.

Hello, everyone. So my name is Raul Yala and I will first of all start by introducing myself. I do know a lot of you all, but I still don't know some of you all. So the ones I don't know, it's nice to meet you. My name is Raul Yala. I've been in this position for about eight months, basically Deborah's old position after her well-deserved promotion. So I've been working on the integrated plan for about eight months, so it's been a pleasure to work in the space and work with all of you guys who I have worked with. And it's nice to meet the ones who I haven't. And so we've been working. So here's our presentation of where we're at. So just real quickly, we received the guidelines from HRSA and CDC 2024, then some reverse versions. And in less than a month, we're going to have this already in the submissions that we're working hard on. and basically our approach to the integrated plan. And I'm sure a lot of you all worked on the 2022 to 2026 plan. And so the approach was like, let's get a more condensed version. Let's get a more condensed and improved version just to build on the hard work that everyone did. And then the structure was ADH leading the coordination with coordination from Ryan White planning body, So thank you all so much. The statewide advisory group, SWAG, Head Free AZ, and Phoenix Fact Check Cities. And then a little shout out also to the Vegas TGA. We started in late summer 2025, and I believe you all have been involved since the very beginning with needs assessment, kickoff meetings. Then it went into surveys and engagement sessions. to talk about how we're going to reduce the number of goals and condense the goals and objective. Then we went into, this is where I joined in the fall 2025. Then winter 25 and 26, we did oversight committee meetings to then talk about the activity surveys. We did work group check-ins as well. And then we also had two community, like open community engagement sessions to talk about the activities and surveys. And then spring 26 into right now, late 26 is we, after all these things, after every time we did like a chunk of stuff, we would get a plan, uh, like this working version of a plan, show it to people, ask them what they thought we would get input feedback. Then we would edit again and keep doing this until now that we have our fourth iteration. And, um, we're right here, uh, finalizing like the wording we did our big community webinar the other day. And then, um, talking to the planning bodies. In total, this is kind of most of the stuff we did. So the needs assessment, we had oversight meetings, we had four work group meetings, we had a lunch and learn, which was basically a community input session, four drafts, meeting with the planning bodies, community engagement webinars, and surveys. And so now we are here in stage four, which concurrence and ladder of support cycle underway. And we are, we got concurrence granted from swag. We presented last week to the executive committee. I have free easy and fast track city. I think we're just waiting for the letter of support. So, I think there's a good place to pause. And is there any questions as of yet or.

Comments. Let me keep it going.

So what is concurrence? Concurrence is the planning body is in support of the plan. There is a concurrence with the reservation, which the planning body is generally in support of the plan, but has reservations and requests change. Not in concurrence, which is major changes would be needed. And the letter of support. For Ryan White, Part A planning body, you all, we're asking for concurrence. Letter support, we gave an option to like HEP3AZ, HEP3AZ, Fast Track Cities, like, hey, do you want to do a letter supported concurrence?

And with, I think probably your group is very familiar with, because this plan does get submitted by both the prevention and Part B program at ADHS, but also Part A program at Maricopa County. We do concurrence is or going through a concurrence process is kind of a mandatory part of what we submit, which is why when we come to Friday, we say, yeah, we have to do concurrence with other groups. We can say, oh, letter of support, but that's why we're a little bit more formal. Yeah.

And here we have so the integrated plan is divided into four pillars. The first pillar is diagnose. And the main goal here is to improve and expand testing for HIV, STI, and Hep C. And we have four objectives. I believe last time we had two goals, seven-ish objectives. So this is just a more concrete plan. Number one focuses on availability. Number two focuses on the access. Three on the awareness. And four on improving partner services.

If anyone has anything.

I believe everyone got copies of the plan itself. Yeah, are there OK? Bradley, go ahead.

Thank you. Could you go back just one slide? For just a second. Thank you. I was just wondering, do you expect to have anyone not in concurrence or have any significant like reservations toward the plan? I know you said that there's kind of a difference between who needs to concur versus have that like letter of support, but.

Sure. Do you want me to jump in on this one, Meryl? Yeah. Okay. We would hope that given the amount of community engagement that we've been doing along the way and all of the input from oversight committee, the work groups, the planning bodies, and the community, that we would have made any meaningful changes that needed to be made before now, so that by the time that we get to the point where we're presenting it and asking for official concurrence, that we would not have reservations. But, you know, things can happen and somebody can, and a group can come back and be like, you know, we've thought about it and we would like things to be different. But in general, we hope that by the time we get here, we kind of know what the process is and what the answer is going to be. But if not, then we know that we do need to go back and do a little bit more work. Does that answer that question?

Thank you. Yeah. So generally speaking, the plan will stay as it is now.

Right. Hopefully.

Okay. Hopefully. Thank you.

Yeah.

Eric? Yes, this is probably, I should know this, but I don't know it. How is hep C passed hepatitis?

Oh, that's a good question. So I think hep B is food, but I'm not sure 100%. But we mainly, we're hep C, which is the main method is through needle sharing and blood. Um, there is a possibility that it is through sex as well if there's, like, carriage. Um, but so, since it's kind of like, in. Like, our world, that's why they all that's why the CDC her regulations are all like, oh, plan, uh, integrate them all together, plumbing together.

Thank you so much.

So we see usually a lot of hep C represent. So when I was at the hep C, the hep free AZ meeting on Friday morning, super early, because the doctors had to go treat people, usually seeing like the hep free space, a lot more representation from like rehabilitation centers, the liver space, those people, like that type of community.

Okay.

Thank you. Yeah, I know.

Jason, you had a question too?

More of a comment. So for y'all that don't know, I'm involved with ADHS SWAG as well, which is the statewide HIV group. And a big part of what SWAG does is to provide input and review this plan, this integrated plan. And as was previously mentioned, we've reviewed this and provided a letter of concurrence for it because we found that it really met the needs of kind of what we were looking at over the next few years in terms of each of these things, HIV, STI, and HCV. So just to kind of throw that out there. I don't know if ADHS staff wants to provide a little bit more input as to what SWAG does so that the planning body here understands kind of the integration between the two.

Sure, if that's of interest, we absolutely can do that. We'll start with the official part first. Much like Planning Council, it's one of the things that is built into the sort of the grant structure for both the HIV prevention grants from CDC and the Ryan White Heart B grants from MRSA. But how we do those is, you know, really up to the state. And in Arizona, we made the decision to make it very community-led, while ADHS provides the support for it. All of the co-chairs are community co-chairs. It is It is a much less, I would say formal than say the planning council is because we do have, we don't have rules that are put out by either CDC or HRSA that say that you have to have a particular kind, set of folks representing or that we have to use particular meeting formats. So it is a very sort of casual, but the main part of it is that they provide advice and council information, all of that to ADHS from the community. So it is folks that are either working with community or living in the community that are sharing with ADHS what's happening and what we need to know. But then also one of the big parts of SWAG is working on the integrated plan and other planning opportunities to make sure that community voice is heard and really centered in the planning and activities that we do at ADHS. We don't do things like allocations, like planning council would do, because all of the heartbeat and prevention activities are more structured from CDC and HRSA, like they tell us more what we will do and how we will spend the funding. So we don't really do the opportunity for allocations, but we do work with the group as far as how things should be implemented. which, you know, what populations are important to look at if there's, you know, some group that maybe we're not addressing. So a little bit different structure than your planning council is. But since, you know, what Jason said, he's part of both. We love it when people are part of both groups. And so if it's something that you're interested in, we'd love to have you come sit in on a meeting and see if it's interesting to you. And Roelle will be taking over the handling of all of that. So you won't get to hear as much from me. Go ahead, Randall.

I just thank you for giving that explanation. I think that's very important on a couple of levels, but I'm also a member of SWAG, and I think the biggest difference to me that I have to keep in mind is SWAG is more of an advisory board. The decisions that they make are non-binding, although most times they're taken into consideration and involvement. With the planning council, the decisions that we make are binding. So I think that kind of helps to add to the conversation.

So that's all I had.

Thank you.

Thank you.

Thank you, Rhonda. Thank you, everyone, on the discussion. Does anyone have any more questions or feedback or any comments before we move on? I think there is a phone.

Well, do you want to kind of scoot forward to the to slide 12? Yes, I think folks have a chance to see what's in the plan, but maybe we can. If we're going to talk about the next steps, got it.

So next step is to complete the concurrent cycle with all the planning bodies. So, so fast track cities, we're done. I think police over waiting on the letter of support, right? Then HEP3-AZ we presented last Friday and going over all the HEP3 specific ones, we got to time. So they're probably going to vote on it in a different time and then get us, I think they're probably going to get us a letter of support. For them, it's optional letter of support or concurrence. We're meeting with Vegas TGA next week.

You can meet with them tomorrow, actually.

Oh, with tomorrow. And then now here we are with you guys. And so we're hoping to get the letter of concurrence from there. We're already been doing this, but we have our amazing epidemiologist here on the call. So everything on the plan, we need to have metrics for. So Elena is working on that part of finalizing the measurable indicators. Then we complete all the submission components, which all of us are working on now, which is like narrative pieces, The situational analysis, the letter of support, putting all of that into a packet, and then we will get it to Jeremy. And then is it your science officer, Jeremy? I forgot the name of who you guys need it for. Yeah.

The ROT science officer will do a review.

So we got Jeremy's eyes, we got Maricopa's chief science officer's eyes, and then submitting it to CDC and HRSA on June 20th.

And that part four, we got done.

That's the number four that was held on the 15th.

Just to clarify a couple of things. The committee here today is just voting to advance it to the full council for concurrence. If they do vote that way, the full planning council will not be meeting until June 23rd to vote on full concurrence there. So As more of this plan, this whole plan will be going out also to the full planning council for them to review in time for that as well. Part A has been actively involved in the oversight committee. Several members of the planning council have been on SWAG or have been attending. I think we had quite a number of planning council members join the last community webinar where the full plan was presented as well. That's something to note. I'm sorry if I missed you all saying this, but this is not comprehensive of all the things we'd like to do. There are things that are not on the list or on the plan because we could not put them on the plan that we're submitting to the federal government. We also say things in ways that are going to be acceptable for submission to the federal government. So not everything is as we would either want to say it or how we would or what we would all want to include. Also, it is more in line with the things that we can fund through our federal programs that require this submission. There are other things that will go on a companion guide later on. after HRSA reviews and approves the plan, that will be things that the community could do that we can't fund as the Ryan White Part A or Part B or prevention organizations, those kinds of things with federal dollars. So hopefully that gives you a little extra context if you're looking at the plan and going, there's some things I'd like to see on here. There might be a reason why they're not there right now.

Yeah, and Jeremy is absolutely correct that we don't try to control anyone else's funding. And so it really is about the funding that comes to the state from CDC and HRSA. And so we really create the plan around what that funding will support. And yeah, we definitely will do that companion guide that you spoke about so that other information will be available as folks wish to implement different activities or maybe want to do something that is outside of what's included in the plan. and want to see what the community had to say, we will have that available for folks as well. And at the time that once we, once it comes back from CDC and HRSA and we have it all approved and anything that they've told us we have to change and all of that, then we will look at doing some of the 508 changes, which is the ruling around like how we present things on websites and such so that they are appropriate for ADA and for folks viewing them. But we will make some changes at that time in the look of it to make sure that when we put it on websites, that it's all appropriate and it's all very accessible to folks. But we don't wanna do all that first and then have CDC come back and say, you gotta change this, or HRSA say, do these big things. So we'll wait.

Thank you.

And thank you for that clarification, Jeremy. Appreciate that. Do we have a motion?

Madam Chair, I'd like to make the motion that we, as this committee, accept the integrated plan as presented so that we may forward it to the Planning Council. So I'll make that motion.

Thank you, Randall. We have a motion by Randall. Do we have a second?

I'll second.

Jason? Yeah, thank you. We have a second by Jason and now we will do, do we have any discussion before we do a roll call vote?

Go ahead, Gwen.

Thank you, Eva. And I'll start with Eva Galindo.

Yes.

Eric Eason.

Yes.

Randall Furrow?

Definite yes.

Jason Valcruz?

Yes.

Erica DeCamp? Yes. Bradley Reese?

Yes.

Motion carries.

Thank you, Grant. Thank you, everyone.

Thank you.

Appreciate it. We're going to move on to item eight, reviewing the EMA continuum with Reagan.

Hello, so this is going to be very quick. I don't actually have a full presentation for you guys. Unfortunately, I'm still finalizing the last pieces of the data, but I did want to share some good news with you guys. So I know last time, oh, I didn't realize my camera wasn't on. Let me, hello everyone. My cat is saying hello as well. But last time with the preliminary data, it was looking like our overall suppression rate was going to be somewhere around like 84%, which is obviously quite a bit lower than we'd like it to be. But I cleaned up the data as we do every time, and now it is at 87%. So it's a lot better. So that was really great to see that it's not quite so low. That is still a little bit of a drop from the last data, the last annual set of data. Last time we ended at, it was 88.5%, which we rounded up to 89%. So just for some perspective, for us to get back to that, there would need to be about 50 more virally suppressed clients, since I know percentages are a little abstract at times. So those are the actual concrete numbers we're looking at in terms of a drop. But again, it's at 87%, which I would say is disaster averted, because 84 would have been much lower than we like. So I'm glad to see that 87%. And I will have the full presentation for you whenever I see you next. We'll probably be sending out this data either early next week or at the end of this week. And we are going to talk to the providers and try to see maybe why there's a drop, if they have any anecdotal evidence or anything like that, just so we can see the explanation for that drop. But again, it's higher than we thought. So I wanted to share that good news with you guys.

Thank you. That's awesome.

Do we have any questions or anything for Regan before she goes or before we move on?

No?

Thank you, Regan.

We appreciate the update.

We're going to move on to item nine, reviewing the PSRA framework with Gwen.

Thank you, Eva. So for today's PSRA discussion, we're going to pick up where we left off from our meeting in March. And at that meeting, we had a really good discussion about ways that we can streamline both days, but particularly day one, and how we can make the partner presentations a bit more accessible and more understandable for planning council members. So to kind of guide this conversation, Jeremy and I have drafted a little chart based on last meeting's conversation to kind of outline the scope of presentation content for each of the presenters, as well as a proposed time limit. So I did share this out with committee members last week, but we wanted to talk about it here in this meeting today too. This is just a draft and we wanted to kind of get your feedback on this and ask if this is too much information, if it's not enough, or if any of these scope descriptions should be updated. And again, these are not listed in any particular order. This is just how we talked through them. Jason, go ahead.

So I think it's important for clarity to have in the scope of the presentation and also potentially even stated during the presentations what traditionally Part A funds versus what's not funded so that folks don't, because folks, everybody that serves on the planning council is really focused on people that are impacted by HIV and they want to do as much for them as possible. And so if they're hearing about stuff like HOPWA, for example, they might be moved by the plight of HOPWA while not realizing that they're, you know, the history of what's funded versus not funded around it. So I think that that is something that is important for the presenters to be tasked with, and also in terms of the description on the agenda so that folks can clearly see in writing what we traditionally funded versus what we haven't.

Thank you. Yeah, that's really good feedback, Jason.

I can integrate that into these kind of outline or the scope here. Bradley, go ahead.

Thank you so much for putting this together. This is super helpful. I was going to suggest that I know we've had some handouts in the past, but maybe asking all of the presenters to send any handouts they have so that planning council members can kind of pre review some of the information and the, I don't know, generalities of the program and whatnot prior to coming into the, I don't know, all day session.

Yeah, absolutely.

What we're going to do this year is ask partner present presenters if they're able to send us those slides at least two to three weeks in advance that way we can get them out to the council for people to review so it's not totally like brand new information but that's a yeah a great thing to do I think awesome thank you so much and Erica your hand is up thank you building on Bradley's great idea I wonder if you could have like a format um so that

It's also consistent across the different providers because sometimes it's hard to compare when people put things in all their different formats, which is great for them, but makes it hard for sometimes people to really compare side by side.

That is really good feedback. Thank you. I agree. It'd be easier if there was a little bit of like a uniform kind of layout there. That way, when we're thinking about it, we can easily compare it. I will write that down.

We were kind of thinking about that for the first kind of like those services, client serves, those kinds of things, like definitely like keeping that pretty consistent and walking through. We've been tossing around some ideas on how to give some good guidance on that just because some of them are so vastly different. But Gwen and I will continue to work and try to find a good template. for them to use.

Go ahead. I'm full of ideas of more things you can do. Also, maybe like a service system graphic visual of like, you know, because again, like people don't always realize HOPWA is of parallel to ryan white it's not underneath ryan white or above ryan white or you know something that kind of overall showed the system in a visual format real easy i do like that i think i'm a visual learner so that would help me personally i think a lot of that would be a great way to help people understand what i think so kind of combining thinking about the things you've just

kind of you all just mentioned. So if we were to do kind of an intro slide to these presentations with that kind of overarching thing that we kind of plug in each time before each one saying, okay, now we're going to HIV surveillance and here's how it fits into the thing. But then also like within that, whoever is, so like if Gwen is the one who's like introducing the next speaker or whoever, we can also then say, uh something about what Ryan White does in relation like Part A does in relation to it so like when we're talking about HOPWA we can say we also just for everyone's awareness EHE funds this you know approximately this much funding for for housing in a you know similar housing systems that are for as HOPWA we can like explain it that like in there and then you have it before walking into what they're about to tell you we're also trying to with this limit some of the things that you're not getting a full breakdown of every of some of the programs. Again, we've had those. We don't necessarily need to know the end, the detailed ins and outs. We really want to know, like, what's the impact and any anticipated changes happening that you that you're seeing? That makes sense.

I think it does, definitely. And thank you, Erica, for that suggestion. We love a map, right? And I'm sure if you give it to Kate, there'll be grass and stick figures and all kinds of people dancing as to where things go. So it'll be lovely and interactive. It's too funny.

Can I just tell you that org charts are not fun. So we may have to reach out to a few folks to be like, what do you think of this before we put this out in public?

But yeah, we'll figure it out.

Thank you for all that.

That was amazing. Do we have any more discussion?

I just had a few quick questions for the committee. So I wanted to share just a brief update to our agenda structure. So we're going to be doing the Part A data session on day one as well, right after the partner presentations. But we will still have Part A data documents printed out and available for review on day two. And then day two will be dedicated to ranking and the PSRA workshop. And then that's when we'll also do all of the certification and conflict of interest forms. That way we can get them done in one place in person. And then I wanted to just ask, because we're doing the workshop on day two, are people comfortable with doing ranking, like maybe from like a smartphone or through an iPad, and we can still use like SurveyMonkey or a similar format for the ranking process. And then the discussion will of course be in person. Would that be okay with people? We do have iPads available for anyone who doesn't have like a smartphone.

Okay, I'm seeing some thumbs up, so.

I like that idea. Okay, cool.

Can I, Gwen, can I throw in the idea that we've been talking a little bit about in terms of like the ranking process where Yes, we'll have the tool and we'll have that up because it'll have helpful information on it. But rather than us trying to play around with the tool in the room, if we can have like, I think we can do this in the space that we're going to have. But if we have like a whiteboard with like the service categories and like big things, magnetic that we could move around and make it visual and easier for us to like shift around and everyone to see in terms of ranking, do you think that would be something that would be helpful rather than just seeing it on the spreadsheet the whole time? The spreadsheet will be up so we can see the additional information that's there, but having something that's a little bit more interactive to move around and easier to visualize.

I think if you're willing to do that, a lot of us would appreciate that, and both versions are great.

Yeah. I've got, I've got team that needs tasks to do. I was like, a little bit of a Vanna White type situation, moving the things around, you know? Yeah.

Yeah. Okay. Oh, that's great.

It makes it easier when we can do some of it, do that day two in person, because we can do a little bit more interactive things with it, so.

Those are all the questions. Sorry, Eva, I'm good.

No, go ahead. Any more discussion or feedback for Gwen or Jeremy around PSRA? Awesome. Thank you, guys. Thank you for the discussion. We're going to go on to line item 10 with Gwen, reviewing policies and procedures.

Thank you, Eva. So this is something that we will do annually. We did not review these last year, I don't think, but we are doing them this year. So each committee will take some time to look at their policies and procedures. I did send these out a few weeks ago in advance of the other meeting information, but I also am going to share it on screen today and we can go through it together. So I think it's a short, much shorter than the team committee, but yeah, so this is just the CHIP's policies and procedures they go through. an overview of the committee and then committee membership requirements. And then also a lot of detail about the committee responsibilities, including integrated planning, analysis and collection of data, and implementation of health strategies. So I will scroll up to the top and we can kind of go through it piece by piece. Before I start this, were there any, if anyone did review it ahead of time, did anything stand out to you or anything that you wanted to highlight? If not, we can just kind of go through it together. I can read it out loud, I guess, and then I'll stop after each section and we can talk about any edits. So starting with the overview, the Greater Phoenix Ryan White HIV Services Planning Council is an entity comprised of individuals appointed by the CEO of the eligible metropolitan area EMA for the purpose of planning for the use of Part A funds to support HIV services in the EMA. The Planning Council has established the Community Health Planning and Strategies Committee to assess and report on changing epidemiological composition of the EMA, survey and report on the needs of those living with HIV AIDS in the EMA, and prepare integrated three-year plans for the EMA that project the needs and emerging trends or responses for the provision of HIV services. Integrated HIV services planning provides a roadmap for developing a system of care over time. This is accomplished by a review of needs assessment data, existing resources to meet those needs and barriers to care. The purpose of integrated HIV services planning is to help planning council members to develop a detailed picture of the current HIV AIDS epidemic in the EMA, potential future picture of the epidemic in the EMA and to guide decisions about HIV related services and resources in the EMA.

So I'll stop there. Are there any, let me turn on track changes.

Are there any changes so far? I'm just going to add a letter, right?

So far so good.

Okay, hearing none, I'll move on to the next paragraph.

Planning is central to local decision-making in developing HIV AIDS care systems. To do so, the planning council will determine the size and demographics of the population of individuals with HIV, establish priorities for the allocation of funds within the EMA, including how to best meet those priorities, determine the needs of this population with particular attention to individuals with HIV who know their HIV status and are not receiving primary care, and to disparities in access and services among affected subpopulations and historically underserved communities. And number three, contribute to and monitor the integrated plan for the organization and delivery of health and support services described in section 2604. And the role of the CHIPS committee is to plan the scope of work, oversee the collection of data and the developmental process of necessary documentation, review reports and recommendations, monitor and make recommendations to the planning council based on these findings.

I'll stop here for anyone who wants to add or make any adjustments. Hearing none, I can go ahead and move on to membership.

So committee membership requirements. All members are strongly encouraged to be a voting member of at least one council committee. Planning Council members may join the CHIPS Committee by declaring their intent to join and by attending two consecutive meetings. The member may vote as a member of the Committee at the third consecutive meeting. Committee Attendance Policy Committee members are expected to attend regular Committee meetings. If a Committee member is unable to attend a meeting, they should notify Planning Council Support and the Committee Chair in advance. If a member misses two consecutive meetings, the member may be determined to have voluntarily resigned from their committee membership. Alternatively, if a member misses two meetings in a rolling 12-month period, the member will be determined to have voluntarily resigned their committee membership. And for members with an alternate, the alternate can cover the attendance but for no more than two consecutive meetings in place of the committee members. And then two exceptions, one, the designee or alternate are exempt from attendance requirements. And if a committee member is absent due to illness or other mitigating circumstances, the member may request that the planning council chair approve a leave of absence. Since the business of the committee must move forward in quorum achieved, a leave of absence may not or shall not exceed 120 days. If the planning council chair declines the request, the member may appeal that decision to the executive committee. This is from our bylaws. by the way, so it's standard language. Moving on, committee chair and vice chair eligibility. For a council member to be either the chair or vice chair of the CHIPS committee, they must meet the following eligibility criteria. The individual must be a voting member of the CHIPS committee, and the individual must have been a member of the council for a minimum of six months immediately prior to appointment.

Any edits so far?

Can I just ask a question? Sure. Can you go back to the absences and the, so if a member misses two consecutive, then they're without letting folks know essentially that something's going on, right? Then they voluntarily resign. What if the something is so significant that they can't let folks know? Is there some way to go back to that? Or can they let them know afterwards? I'm just thinking, you know, worst case scenario, they're out of state, and they have a car accident, and they're unconscious, you know, for an extent. Now, I know that we don't meet monthly. And so the two consecutive meetings would be a long, long way, right? But is there some mitigation? And then I'll kind of going along with that, two meetings in a rolling 12 months, I could see where folks might have two meetings that they would have to miss due to extenuating circumstances. Is there mitigation around that as well? Because it just seems somewhat punitive.

Yeah, I am definitely in favor of making things more flexible and more accessible. And I don't think someone should be like punished for having extenuating circumstances. So I would absolutely recommend Like be in favor of us kind of amending this language so that if something does happen that can we can kind of retroactively like not punish someone for missing meetings. Do we have any or yeah? So how would Jason do you have like a? Recommendation for like how to like change the wording or Randall. I know that you were kind of nodding along too. Do you have any ideas?

I just wanted to add in that. We have. as a practice up until now and i'm not expecting it to change but um we're we're dealing with clients who have situations we have everybody who has life so the general rule of thumb is has been you come to me and you explain to me what's going on. We're not in the practice of excluding people. We're in the practice of including people. So that's why you haven't seen like an exodus of people because we've shown them the door. We've worked with individuals. So I think that any word changes, could just make it real minor that you know speak speak to the chair or you know speak to that speak to the chair and um there there might be an out because as a rule of thumb there there always has been an out we've not shown anybody the door so i'll just leave it with that because i know you've got a lot of people wanting to give some input so

I think it was Erica's hand and then Jason and Jimmy. So Erica, go ahead.

Thank you. Definitely we want to be inclusive and we know life happens. I think we had a lot of discussion about this previously in other meetings. And the issue was that two meetings in a 12-month period is like missing half the meetings. And we're not trying to exclude people, but we also want people to be actively engaged and I think, have, you know, knowledge about what's going on, if they're going to be voting on things. To me, that's kind of the issue about like being a member. I don't think there's anything saying, you know, you can't come back. You know, and definitely, I think the exceptions, I guess, maybe some Some language could be added there, I guess, just about returning, because I think we're definitely talking about mitigating circumstances. And I don't know that that's saying you had to explain that beforehand. Maybe you could explain it afterwards, because like Jason said, there could be a situation where you couldn't request this ahead of time. but i personally wouldn't be in favor i think in general of changing the guideline just because we really did have a lot of discussion about why that was but i definitely want to allow like um randall said the ability to address mitigating circumstances yeah thank you erica um jason go ahead so just taking into account what randall and erica have said

perhaps the fix is to put in, like, if there's mitigating circumstances, the person can become a member again, you know, within maybe an expediated amount of time, if there's extenuating circumstances, versus, you know, just kind of keeping them on. And I would also say, I I appreciate how Randall's leadership has always been and the other leadership that I've seen over the years have always been for the inclusive. I always, however, want to err on the side of writing things out because we don't know who or what is going to be in charge in 15 years, right? Now, goodness knows we want the epidemic ended by then, but if we don't have it ended, then we want to make sure that there's something in writing just so that folks can continue that tradition of being inclusive. So I appreciate the ability to share the feedback.

Yeah, absolutely. Thank you, Jason. Jimmy, go ahead.

I was just going to ask, is there a way to add in language up front that says if you anticipate having to miss two meetings or at the second meeting, miss if you're anticipating having to you know, let me back up. So if you miss the first one, does the planning council reach out and say, hey, that's strike one. And then that way you can be told if you have to miss another one in the next role in 12 months, please notify the chair or Jeremy or whoever's supposed to get notified. Is there a way to kind of do that kind of, I kind of look at it like an HR kind of thing, like, you're doing something wrong at work you kind of get your hand smacked a little and then they're like let's not go down this road again if something is taking you down this road please let us know so that kind of approach is there a way to work that in the language yeah so here in the first paragraph we kind of talk about like if you're unable to attend a meeting they should notify planning council support and the committee chair in advance and then maybe we could

Just like, yeah, I feel like this is kind of like a standing thing that we have or like at any point, like if you're about to miss a meeting or if you think you might miss a meeting, like people usually just reach out to me and I like email them back and I say like, oh, thank you for letting me know, like no worries, that kind of thing. So we sort of already have that language here, but we can also expand that like maybe like in the exceptions with like another bullet point about like being able to reapply for membership or Jeremy, I'm also just now seeing your comment in the chat too.

I remember from the earlier, from a team, when you and Jeremy, or you and Brando were going over this, it said if you get voted off, you have the ability to ask for executive counsel. Kind of like a, you know, like a, I want a hearing kind of thing.

Yeah, that's for the second bullet is talking about leave of absence. And I think we've seen, and Randall's talking about in practice, we've done where people have I don't know that we've ever officially had a leave of absence from the committee, but where they told us usually after the fact. And so when you're talking about illness or mitigating circumstances, often we're hearing about it later anyway. It's not the first thing on your list of things to do when you've got a mitigating circumstance. But is that being a little bit more clear in there that they can request that afterwards and then that kind of holds their position?

I like that, Jeremy.

I think that makes it, gives a lot more flexibility with it. And obviously people can't predict when these things happen.

So I like having this note in there. Oh, Randall, your hand is up.

That's okay. Just also something to keep in mind because I'm sure there, like policies and stuff like this, we're going to be having continuity with the committees that they're all doing the same thing. So then we would need to go back to team and do an adjustment. Other thing to keep in mind is with the policies and procedures, they're living documents. So we can go in and we can make changes like this. And as long as, you know, the committee is fine with it and the star committee is fine with it, and planning council's fine with it, you know, poof, that change is made. My concern is, is any of this language in our bylaws? Because that's not so easy to change. Not saying that the change is not the right thing to do, but just keep in mind that if this is in the bylaws, then it's a much more

cumbersome project because we've always got our representative from the county attorney that reviews it and so just keep all of that in mind thoughts i know that in the bylaws it's a similar um like policy right where if you you can if you miss two consecutive meetings that is determined to be a voluntarily a voluntary resignation so it's a similar process with the full council I can take a look at that too and see how it.

Just make sure that it doesn't state that this is what is done at the subcommittee level, I guess. Yeah.

Okay, so I will take these notes and I'll kind of implement them into the exceptions and I can work on that wording. Oh, thank you, Jeremy. Jeremy added into the chat a note from the bylaws.

Jeremy's my hero. Oh, yeah, with the full planning council, if a member misses, it's three consecutive meetings.

the member will be determined. Okay. So thank you everyone for that feedback. I will now move on to the committee responsibility section. And if at any point you have something to call out or change, please just raise your hand and I can call on you. So we'll start with section one, integrated planning. The CHIPS committee works collaboratively with the Ryan White Part B program and other state agencies to develop and implement a statewide integrated HIV prevention and care plan to be completed approximately every five years or when the HRSA and CDC's guidance is released. The CHIPS committee will designate a planning council member to participate in the oversight committee for the integrated planning process. The integrated plan includes the latest epidemiological data and trends for the EMA, an overview of HIV AIDS service delivery, capacity, needs, and cultural competency, and planning council goals for the future of HIV AIDS service delivery in the EMA. Preparation for the integrated plan includes as much input from the community as possible. Historically, this has been accomplished by conducting a series of public town hall meetings, seeking public input, and brainstorming to develop a common vision for future HIV care of the EMA.

Jason, go ahead.

Just checking these are shared with HRSA, yes? Yes. Okay, so if so, we may need to remove the cultural competency piece in terms of stating it that way and maybe stated a different way. And then also, and this may be a question for Jeremy, do these responsibilities overlap with any of the recipient responsibilities in a way that could be seen as a conflict, because I know that HRSA has a thing about recipient responsibilities and planning council overlapping on what they do. I don't think that these do, but I just want to double check. No, I didn't think so.

No, this is a, because the planning council has to concur with the integrated plan. It is part of their responsibilities to be

part of that whole process okay i thought it might be more with star in terms of quality stuff but we can visit that this afternoon yeah okay oh thank you jason jeremy heavily vets everything don't you jeremy it's a good thing

A progress review of the integrated plan is completed at minimum of twice a year. This review analyzes the performance of the planning council in meeting its goals and objectives. If needed, the CHIPS committee will make recommendations to the planning council regarding how the plan's goals and activities should be adjusted to stay current and meet the needs of an ever-changing epidemic. So that finishes the section one section. Moving on now to section two, collection of data. Each long-term statewide integrated plan developed jointly with the CHIPS Committee includes the following data collection activities, which are presented annually to the CHIPS Committee. Number one, epidemiological profile. This profile describes the current status of the HIV epidemic in the EMA, specifically the prevalence of HIV AIDS overall and among defined populations and trends in the local HIV epidemic. Leads assessments. Needs assessments gather quantitative and qualitative data in order to identify trends and common themes. They identify the service needs of clients and barriers that hinder access to care. They also include an assessment of unmet need and service gaps. The CHIPS Committee typically completes a needs assessment for one affected population each year or in follow-up to data gaps and needs identified through the large-scale statewide needs assessment that is conducted every three to five years. When possible, needs assessments are conducted in partnership with the Arizona Department of Health Services to reduce survey fatigue and client burden. Resource inventory. An analysis of the organizations and individuals providing HIV services available to PWH in the EMA. At a minimum, the resource inventory includes for each service category a description of the providers, the number of clients served, and funding levels and sources. The resource inventory is developed in collaboration with the administrative agency.

And finally, we have secondary data.

Additional data is collected from a variety of sources, including state and federal agencies, the Part A Quality Management Program, Ryan White Parts E, C, and D, and anecdotal information from the community at large. Do we have any changes here?

Hearing none, we'll move on to analysis of data.

Information tabulation and analysis focuses on answering needs assessment questions. The process includes organizing information and analyzing it to identify key needs, trends, and critical issues. The results of the analysis are then compiled into easily understandable fact sheets for use in priority setting, resource allocation, and development of goals and activities for the integrated plan. Fact sheets will include high-level participant information, three to five key data points, along with one or more recommendations from the CHIPS Committee about how to address or improve the noted data points. Identification of issues to be addressed. The careful analysis of data results in the identification of the high priority service needs of specific populations, including individuals who know their HIV status but do not access primary medical care.

I'll pause here for feedback or questions.

And then I'll move on to section three, development of strategies to eliminate identified issues. Based on the results of data collection and analysis, strategies are developed to address high priority issues. These strategies may include the development of directives to the administrative agency to improve service access and quality of care, the implementation of specially developed initiatives or pilot programs, revising guidelines and or initiating additional data collection activities. All strategies include a timeframe for implementation and evaluation. The implementation of all strategies developed by the CHIPS Committee is subject to full planning council approval.

I believe this is, yeah, we're almost done.

Okay. Implementation of strategies Approved strategies are implemented in the EMA. Data is collected on the ability of the strategies to meet identified objectives and reviewed periodically by the CHIPS committee. Our final section is evaluation. Evaluation of the success of each strategy occurs according to identified timeframes. Based on the outcome of the evaluation, a strategy may remain in place, be revised and re-implemented, or be rescinded. Any action developed in response to the evaluation must be approved by the full planning council prior to implementation. So that is it for the CHIP's policies and procedures. Were there any sections we wanted to take a look at again or any questions?

That was great. Thank you, Gwen.

Thanks, Erin.

I'll work on including some of this feedback on cultural competency and maybe having to change that language. And then, of course, we have some changes maybe to make to the way that the exceptions is worded. So I will work on those and I'll have that ready for our next committee meeting.

Just a question, and I don't know how appropriate it is. For cultural competency, are there preferred terms or?

You just may have to be strategic about how you put that in black and white.

Yeah, no, I realize that. I just wonder, do we currently have working terms that we know are better accepted? I don't even know how to word that. There's a few lists circulating out there as to how to

less directly state what the intent is okay um anyone that wants to use my personal email or anything like that to um share that with me i'm open so i would actually say that the integrated plan probably doesn't do that anymore because of the way we have to submit it so um doesn't mean that we're not still evaluating those things in other ways. Um, but I think that you could probably be okay with taking that out as much as I hate saying that. Um, but for that, it's not particularly, I don't think something we would say in the integrated plan anyway, and this is talking about what the integrated plan includes. Um, So we could literally just put an ant with an and before needs and remove that.

But if you're the committee is.

I say take a comfortable comfortable. It's not the right word to use, but. On board with that change for now, it sounds discriminating, so yes.

When I think after needs, it would be a semicolon.

Equal access to health care.

Yeah, I just don't. We say that, but it's not something that does that. Is it? Are we saying that in the integrated plan, Deborah?

we don't say, we aren't saying things this time around, like that we're going to increase our, you know, education for cultural competency or things like that. Like you may have seen in the last plan this time, you know, like we're not saying a whole lot about, you know, decreasing stigma because that's also not super kosher at the moment when turning things into the feds. So really it's just that in our, as we say, You know, we want to increase testing, for example. We would say, you know, including, you know, equal accessibility or improved accessibility, things like that. We're being super neutral in the language right now.

Yeah. All inclusive.

Inclusive is even a word that's a little rough.

Yeah. Erica? You had said, and I'm sorry, I want to, for me personally, I just want to fully understand, when you said it was discriminating, were you saying that taking it out would be discriminating or that when we were talking about it? Okay. Okay. I just wanted to make sure that I understood. Yes. Okay. Thank you, sir.

Thank you.

Were there any final comments or questions on this?

No, I think with everything else that you've had going this meeting, Gwen, thumbs up to you to getting through that and collecting a lot of good things that needed to be done. So just We're going to put you on the amazing list with everyone that's at part A and Jason and Erica. And so we're going to throw you on that list too. And Jimmy, don't forget about Jimmy.

Thank you, Randall. And thank you everyone for all that feedback. It's cool that we got it done in this meeting. So I can, I'll start making those changes. And then if you have any other changes or questions, you can also always email me or Eva or Randall and we can get back to you. but with that, I'll hand it back to you, Eva, and we can go.

So are you, are you making those changes and then bringing it back to this committee in two months from now? Is that what you're saying?

I think that would be the best course of action. That way we can have like finalized language to approve. And so it's like a final product to look at.

Okay. So then keep in mind the corrections that you made on attendance and everything like that, that we're we're backtracking and including that on team and then letting team know that, you know, afterwards we got some information that we are going to need to bring this back to team in two months to do a revote. Does that make sense?

Yeah, I can make sure that all of those look uniform in the edits that we're making.

Okay.

Thank you, Graham. Thank you, Randall and everyone for the discussion. Any more discussion before we move on?

No, but thank you, Eva.

Thanks. We're going to move on to agenda item number 11, review and resolving any parking lot items. We don't have any at this time, so we're going to move on to Agenda item 12, the determined agenda items for the next meeting.

Oh, sorry.

Yes, I can bind that with the PCAT items.

We can take a look at the PCAT and then, yes.

Okay, so we reviewed the result parking lot. I didn't have any PCAT we're doing right now. We did an update on the integrated plan progress.

This will be later on in the year. We're kind of shifting that item.

Okay. I'm sorry. I don't know what alt means.

Oh, so that would just be like if we don't finish it in March, we can also talk about it today. So for PSRA, we continued that discussion.

Review and approval final allocations after receipt that's being moved, yes?

Yeah, so we received it last week, and Jeremy sort of briefly talked about it, but we'll talk about it more again in our June meeting.

Right.

And then the PSRA review of the EMA continuum, we also did that as well. Next we're going to move on to. I don't number 13 current event summaries. This is the time for the planning Council members to share a brief summary of current events members of the planning Council cannot propose discuss deliberate or take legal action any matter voice during this time. We have any current events.

Updates. Events.

Anyone interested in going to Strength for the Journey, going camping, it's available to apply. That's all I got.

Thank you, Eric. Anyone else?

We're going to move on to item 14.

Sorry, Eva. I had one. I apologize. I just want to remind folks about Aunt Rita's bake, sale, and drag show, which is happening This Friday at 3641 North 56th Street. So we'd love to see you come out. There are tickets still available if you look at the Aunt Rita's events website. And it's going to be a fun time. So love to see you.

Thank you, Jason.

Thank you, Jason.

And we're going to move on to item number 14.

Call to the public. This is the time for the public to comment. Members of the planning council cannot propose, discuss, deliberate, or take legal action on any matter of voice during this time.

Do we have anyone from the public for any comments? No?

We're going to adjourn this meeting today on May 26th at 1.20. The next meeting is scheduled for July 28th at 12 o'clock. I hope that you stay cool, stay hydrated, and stay safe. And thank you for all the feedback and conversations today.

Thank you, Ava.

Thank you, everyone.