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Indiana State Department of Health

HIV/AIDS in Indiana > Advisory Groups > Community Planning Group (CPG) > CPG Meeting Minutes > CPG Minutes September 2008 CPG Minutes September 2008

IHIV PREVENTION COMMUNITY PLANNING GROUP MEETING
September 16, 2008
10:00 to 4:00 p.m.
Rice Auditorium

ATTENDANCE

Present CPG Members:

  • Archey, Rev. Donald
  • Harris, Larry
  • Pasco, Larry
  • Gilmore, Ramona
  • Woods, Wendy
  • Lozano, Dolly
  • Prado Reyna, Laura
  • French, Paula
  • Morton, Ramon
  • Stanley, Debra
  • Gillespie, Tony
  • Nash, Richard
  • Vesga, Jesus
  • Hail, Anna Urias
  • Hughes, Mark
  • Dooley, Cydrisse

Absent CPG Members:

  • Ajiboye, Shola
  • Nix, Ryan
  • Fisher, Brian
  • Howard, James

Present ISDH/Technical Advisors:

  • Archey-Morgan, Cathy
  • Newton, Susan
  • Jackson, Terry (Afternoon)
  • Burkman, Jerry
  • Bain, Cena
  • Renner, Sarah
  • Johnson, Elloise
  • Ford, Marsha
  • Arnold, Vivian
  • DiOrio Rekas, Dawne
  • Chapman, Erika
  • Burcham, Barbara

Absent ISDH/Technical Advisors:

  • Hillman, Dan
  • Perez, Andrea
  • Pearcy, Cheryl

Guests:

  • Thomson, Kathy, Fort Wayne/Allen Co. Health Dept.
  • Yoder, Beth, Elkhart Co. Health Dept.
  • Grudi, April, MATEC
  • Greene, Latorya, AIDS Ministries/AIDS Assist
  • Wright, Eric, IUPUI
  • Hewitt, Beth, Elkhart Co. Health Dept.
  • Kenney, Anne, ISDH (Intern)

GENERAL INFORMATION

  • Meeting was called to order at 10:10 by Ramon Morton, Community Co-Chair.
  • All Attendees introduced themselves, region, and populations they represent.

Tony Gillespie:  Purpose:  The CPG Represents the federal mandate of partnership between the community and ISDH to address HIV/AIDS, HIV Prevention, and develop a statewide prevention plan.

Larry Harris:  Reads Ground Rules; notes that “Speak Loudly” was added to the Ground Rules at the last CPG Meeting.

Ramon Morton:  Determines that Quorum was met by having 13 members’ present.

Review of Self Assessment Forms:

  No Comments made
- Tony notes that Agenda was sent out timely for this meeting and that last meeting was an unusual occurrence.

Attendance Reviewed:  

 No changes made and no proxy’s determined.

Minutes for 7/15/08 CPG Meeting reviewed: 

No changes to be made –

Tony Gillespie:  Thanks Miss Elloise Johnson for her skills in the meeting minutes.

Executive Committee minutes reviewed:

- Wendy Woods ask about the membership meeting that was scheduled to take place on 8/9/08
- Note this Meeting did not take place.
- Determined that Removal Letter has yet to be sent to Jeff Lane

Tony Gillespie: 

Requests that the discussion about Dr. Pardasani needs to be added to Conference Call Minutes.
Requests that the request for a facilitator made through CBA by Andrea Perez be available to the entire CPG body. 

Ramon Morton: 

Notes that Dolly Lozano is the new Chair for the Membership Committee, taking Debra Stanley’s place.

Ramon Morton: 

Notes that a meeting was held on 9/15/08 regarding a facilitator; whom is a colleague of Dr. Pardasani, his name is Christopher Cotten who asked for policies/procedures, by-laws, roles and responsibilities, etc. – Cena sent all on 9/15/08.  Mr. Cotten plans on attending the CPG meeting in November.  Will keep the CPG body updated on future contacts with Mr. Cotten.

Tony Gillespie: 

Notes that the Facilitator was recommended by the CDC and not a request from the CPG body.

Tony Gillespie: 

Requests that Jerry Burkman speak a little more about Dr. Monroe’s response to the needle exchange letter.  See Executive Conference Call Minutes from 9/2/08.

Jerry Burkman: 

Clarifies that Dr. Monroe’s response is that at this time, she can not support needle exchange in Indiana, legislation will not allow her to do so.

Larry Pasco:  

Appreciates the opinion of Dr. Monroe; however, he believes that it is an incorrect statement.  He states there are no laws that prohibit needle exchange in Indiana; he further reports that neither the Attorney General nor Marion County Prosecutors will prosecute anyone who exchanges needles.
Reports that this is a pharmacy board issue and not a legal issue as exchanging needles for free will disrupt the sales of the pharmacies.
Reports that he is offended that Dr. Monroe does not give time to the IDU’s and that if it was about another group, the whole CPG Body would offended.

Ramon Morton: 

Notes that this IS about the whole group and not just IDU’s;

Tony Gillespie: 

Clarifies that Jerry Burkman never stated that Dr. Monroe had no opinion regarding Needle Exchange, her statement was that at this time she could not support it due to legislative reasons.

Tony Gillespie: 

“We have a response and we have taken the step; we will now take the next step toward needle exchange”
Notes that he wishes to discuss it more at the Advocacy Meeting.

Larry Pasco: 

Requests that Dr. Monroe resign and that he will develop a campaign to achieve this goal; thanks the CPG and Jerry Burkman for their efforts.

Larry Pasco: 

Reports that Dr. Monroe supports Needle Exchange in other Media reports;

Ramon Morton: 

Interrupts to state that Dr. Monroe is not here to defend herself and that “we can not have this going back-and-forth.”

Tony Gillespie: 

Asks if Dr. Monroe is resigning; as he heard it from someone.

Jerry Burkman: 

Reports that she has not heard it and that she doubts it because she [Dr. Monroe] was just nominated as the president of the Association of State and Territorial Health Officials (ASTHO)

Jerry Burkman: 

States that she did what the CPG has asked; and it was done and that she encourages them [CPG] to take the next step and wishes them well in their endeavors [regarding needle exchange]. 

DIVISION UPDATES

Given by Larry Harris

* Asks the body to read division updates on their own; however wishes to discuss HIV Prevention in detail.

- Notes that HIV results should come directly from LIMSNet, Not Luther.
- Reminds Body of the letters of concurrence, non-concurrence, or concurrence with reservations regarding the 12-month cost extension for 2009.

MSM SUPPLEMENTAL FUNDING:

-  The State applied for $55k and actually received $62,605
-  Only a few states applied for the funding
-  Ad Hoc Committee consisted of Tony Gillespie, Paula French, Byron Reynolds,  
   Ramon Morton, Debra Stanley, Erika Chapman, Andrea Perez, and Larry Harris 
    • The Needs Assessment is based on the 2002 data
    • Butler University student Anne Kenney will assist in looking at the data, recognizing any gaps, completing an additional needs assessment, conducting and performing a survey if need be.
    • Focus groups will be looking at the 5 main counties which include Marion, Lake, St. Joseph, Allen, and Vanderburgh counties (5 highest prevalence areas).

Tony Gillespie: 

Asks if the suggested contractor Dr. Marvin Bailey from IU – Bloomington has been contacted, further requests a timeline; when does the project begin?

Barb Burcham: 

States that the funding cycle is 10/08 to 12/09; advises that any left over money will be used to implement the strategic plan.
Further states that additional funds may become available since not many states applied for funds and hopes to requests these funds to assist in the implementation of the strategic plan.

Tony Gillespie: 

Thanks the State of Indiana and the CPG for taking the MSM grant seriously and requesting the money.  States that he is surprised that not all states applied for the funding and is excited to work with Dr. Marvin Bailey for his experience and expertise regarding the MSM population.

Jerry Burkman: 

Clarifies that some states did not apply for the funding because they already have a strategic plan in place for the MSM population.

Tony Gillespie: 

Notes that the last time the CDC made funding available for the MSM population was in 1999, reports that is a plus that these funds have even became available.

Jerry Burkman:   

Introduces Sarah Renner as the new Division Director; notes that she is presently shadowing her [Jerry] around and will take her place in December 2008.

Sarah Renner: 

Introduces herself; has been with ISDH for 3 years. Presently has a Masters in Public Health; working on her MBA; her interest is focusing on Mental Health and the Prison Entry and Re-Entry facilities.  Here to serve them [CPG] and the State of Indiana.

Jerry Burkman: 

SOUTH AFRICA DELEGATION VISIT:
Six nurses and 1 doctor came for training to better understand treatment options for HIV;
Their hopes are to develop a Nurse Practioner skill in South Africa that will eventually become a model for the whole country;
This process is a continual process;
South Africa does not have as many treatment options as the U.S. and hopefully this program will change that.

HIV QUARTERLY MEETING:

Larry Harris:  The meeting was successful and asks that everyone attend; funded and non-funded agencies.

CRCS QUARTERLY MEETING:

Larry Harris:  Is scheduled for 10/23.

COUNSELOR REFRESHER COURSE:

Cathy Archey-Morgan: 

Has been contacted by individuals and they just need to set up a date.
  • Raised as a concern or issue of those who have already been trained and needs to be recertified and given new information; hopefully to have in a one day training; contain the highlights of the 4 day training. 
  • It will just be gentle reminders to make sure everyone is on the same page.

Tony Gillespie:

Adds to the Division Updates regarding CHSPAC and CAB
Tony is a member of CHSPAC/CAB: 
- at this point Indiana has a waiting list for HIV Insurance; up to approx. 49 persons waiting for coverage
- State is waiting on funds from Ryan White Part A; County of Marion to receive funding for individuals to receive treatment for HIV/AIDS
- Waiting on part of that funding to move people up on that list.
- We are now in a state that more people are applying for services faster than individuals are no longer receiving services
- Believes that we will be one of the 13 states that will maintain a constant waiting list.

Paula French: 

Ryan White Part A will again pick up the slack and cover those who are on the waiting list.
*After further clarification from Miss Paula French; Ryan White Part A provided the same funds last year (2007) and has decided to provide the funds again this year.  This decision is made on a year to year basis.

Tony Gillespie: 

CAB made the decision to officially become a committee under CHSPAC instead of being its own separate committee; he believes that this takes the power away from CAB.
Both ISDH staff and the CSHPAC/CAB Liaison have authorized a whole reorganization of both committees;
Mandating the 2 year term that has been set in place; the problem however is that the Care Coordination sites are forced to serve on CHSPAC but consumers are not, with this said CAB will loose 8 of their 9 members.
Notes that a conference call is scheduled for later in the week to address these issues.  

Mark Hughes:  Asks if those on CAB/CSHPAC must be HIV Positive?

Tony Gillespie: 

States that the boards are under services not prevention.
The mandate states that people living with HIV/AIDS must be a part of the process.

MEMBERSHIP APPLICATION PROCESS:

Debra Stanley:  Ask for consensus regarding the membership process:

PROCESS ACCEPTED

* Debra Stanley respectfully turns the membership committee over to Dolly Lozano.

Dolly Lozano:   Reports that there are no limitations on term of years.

Barb Burcham:  States that all members will start in January

Dolly Lozano:   Completed applications need to be sent Cena.

Tony Gillespie: 

Requests that the whole CPG organization needs the CDC Guidance along with CPG Orientation; due to staff changes, etc.
Requests a capacity builder provider to assist in the overview of the guidance.

Jerry Burkman:  Requests that the manuals be delivered to everyone including ISDH Staff.

Tony Gillespie: 

Believes that some of the trust and information has been lost along the way with so many staff changes.  With the whole application/re-application process taking place, it would be a good idea to get the information and trust back.
Requests a Capacity Builder Provider suggests an Asian Pacific Islander that was present at the HPLS Conference.

Debra Stanley: 

Reminds everyone that the CDC guidance and CPG Orientation are two separate things.
CPG Orientation is discussed through the membership committee.
Agrees that the CDC Orientation Guidance needs to be given to everyone.

Dolly Lozano:  Asks if Tony’s request was approved?

Ramon begins to take consensus.

Debra Stanley:  Asks for the issue to be tabled until the Membership committee makes a formal written request.

BUDGET REPORT:

Balance at Present is $16,516.55
Must factor in September and November meetings plus
Approx. $2k for the cost of Rev. Donald Archey’s attending the USCA conference.

Larry Harris:  States that there might be a cost for the Facilitator

CPG members:  State that they thought the Facilitator should be free as the request was made through CBA/BSSV

Ramon Morton:  All remainder funds need to be spent before 12/31/08.

Debra Stanley:  Wishes to have Budget Committee get on this right away; getting precise figures, etc. 

Ramon Morton: 

Asks if the group would allow the Exec. Committee to make the final decisions based on the following options:  Town Hall Meetings, Workshops, or a Celebration Meeting.

Debra Stanley: 

Reports that she does not care if the Executive Committee makes the final decision as long as the rest of the CPG body is kept informed.

* It is noted that Brian Fisher, co-chair of the Budget Committee is at USCA.

PRESENTATION - HIV INCIDENCE REPORT

Given by Richard Passey

Highlights of Richard Passey's presentation:

* Previous incidence estimate was that 40,000 people per year became infected
    with HIV.
* This JAMA study found that an estimated 56,300 people became infected in
    2006.
* HIV incidence peaked in the mid 1980’s at 130,000 infections.
* HIV incidence reached a low point of 49,000 in the early 1990’s at 49,000.
* HIV incidence peaked in the late 1990’s at 58,000.
* HIV incidence has been stable since 2000 at about 55,000.
* Men who have sex with men account for53% of all new HIV infections
* Men accounted for 73% of all new infections.
* Blacks accounted for 45% of new infections; this is 7 times the rate of White   
    individuals becoming infected.
* Hispanics have 3 times the rate as that among White individuals.
* HIV incidence among individuals exposed through IDU has decreased 
   approximately 80% in the United States.

** Overall, new HIV infections in the United States remain concentrated among men 
      who have sex with men and among black individuals.
**  Prevention works.  Testing is of great importance.  Treatment saves lives and may
     decrease the spread of infection.
**  This data should be a wake up call to target prevention and treatment efforts to
      communities of greatest risk of suffering from this Public Health Threat.

Larry Pasco:  Points out that Puerto Rico and California were not included in this study; leaving out a huge number of individuals.

Richard Passey:  Agrees with Larry, showing a huge discrepancy.

Jerry Burkman:  Clarifies between incidence and prevalence

Incidence used in this study means:  people who are expected in a year’s period to be diagnosed with HIV.
Prevalence is the proportion of individuals in a population having a disease

Larry Pasco:  Asks for a breakdown of incidence rates between the counties within Indiana

Jerry Burkman:  States that it is in our [ISDH] database and can be pulled.

Ramon Morton: 

Announces that after today there will be 18 members; announcement that Cydrisse Dooley will be leaving to move to Atlanta, GA.

Lunch 12:00 – 1:00

Committee Time 1:00 – 2:05

Meeting Continued at 2:05:

Committee Reports

Paula reports that the Membership and Evaluation committees merged.

Membership Committee:  See Membership Committee Minutes

Dolly Lozano – Co-Chair

- ask to have a thank you letter sent to members who resign from the committee
- Application/Re-Application deadline is 10/17
- Application Grid report deadline from Cena is 10/24
- Membership Committee to meet on 10/29 at 10 a.m. regarding the members at Debra’s House

Eric Wright was a guest to the Membership Committee:

- Paula French to send Applications to CAG/Statewide
- Tony Gillespie to send Applications to CHSPAC/CAB
- And each CPG member to send word out to all sites

CPG needs to be responsible for recruiting TA’s; not the ISDH – Debra will make an announcement under New Business asking to change this policy

Epi Committee:

Tony Gillespie:  Ask to have a face-to-face meeting with Dan Hillman on 10/21 from 1-4 p.m.

Advocacy Committee:

Tony Gillespie: 

Bulk of discussion was regarding the next step to the needle exchange issue following Dr. Monroe’s response; committee decided that there needs to be some clarification on educating Dr. Monroe that it is a policy issue and not a legal issue; that the Pharmacy laws and NASTAD support the issue of needle exchange.  A second letter will be developed pointing these things out to Dr. Monroe.  Representative Greg Porter supports Needle Exchange; plans to educate legislation on needle exchange “what it is and what it is not.” Focus on working with State Representatives from the 5 counties with the highest rate. 

Tony Gillespie:  Clarity and definition of what the partnerships should look like and what services test sites can and can not provide.

Interventions Committee:

Rico Nash: 

With Erika Chapman’s assistance, the interventions committee will develop a resource/reference guide to interventions that other agencies use presently or have used in the past.  These sources will come from both funded and non-funded sites.

* The purpose is to allow everyone to work together and utilize each other’s sources.

Debra Stanley:  Asks to correlate the information between the needs assessment in order to accomplish the gap analysis

Needs Assessment:

Debra Stanley:  States that the Needs Assessment Committee is in reformation and working on getting recruitment together.

Barb Burcham:   Per Jerry Burkman there is $35,000 allocated for needs assessment usage.

Debra Stanley: 

Is having a preliminary meeting with Professors from the University of Notre Dame; the plan calls to look for cultural competency – do people really understand the culture of HIV?

OLD/NEW BUSINESS

Ramon Morton: 

With suggestions given Ramon and the executive committee, it is asked if the CPG committee will allow the Exec. Committee to make the final decision regarding the remainder of the funds; this decision needs to be done before the November 2008 meeting

Debra Stanley: 

Concurs with Ramon’s request on the condition that everyone is notified; and ask if the committee is open to new suggestions – Miss Stanley has no suggestions at this time.

Larry Pasco:  Asks about alternative conferences other than the ones presented to the body.

* Alternative Conferences have always been allowed.

Debra Stanley: 

Asks about a committee that could go through the Charter and Procedures and ask where this committee was at.  Reports that there are discrepancies between the Charter By Laws and the Policies.

* Membership to investigate the attendance of the TA’s.

Larry Pasco:  States that he has no anger regarding supplies; as he stated that he did not receive the supplies that were promised to him:

Barb Burcham: 

That the kits were given to Ana Hail Urianas as she stated that she would deliver them to him; however Larry states that he did not receive them.

Mark Hughes:  Notes that Miss. Ana has not been present since before lunch although her belongings are still there.

Paula French:  Notes that she had an emergency.

Ramon Morton:  Asks that if there is an emergency let someone know and tell either Larry, Ramon, or Cena.

Ramon Morton:  Notes that Cena and Ramon will revise the Committee Member list and that Shola would probably be receiving a removal letter.

Ramon Morton:  Notes that the CPG body decided to have a Letter of Concurrence with Reservations.

Tony Gillespie: 

States that “from where we were last year to where we are this year, it is different” which allows the change of the letter from non-concurrence to concurrence with reservations.  He notes that the RFP; priorities; revisiting the plan; monetary for TA guidance and expectations; MOA; funding should follow the disease.

** Letter will be offered 9/16 submitted 9/17 at the end of the business day.

PUBLIC COMMENTS

James Morgan: 

introduces himself; whom of which is a HIV Capacity Builder Associate; has been working with National Peace Association; who will be bringing Russian delegates to the States to offer cultural exchange; James Morgan asks for volunteers to assist in this exchange.  To assist in helping with the new drug issues; homelessness; HIV transmission, etc.

Contact 317-726-1892, 9 – 10 p.m.
Jamesmorgan0902@sbcglobal.net

Tony Gillespie: 

Comments on the MSM project noting that it is extremely important and that over the years it has been a constant problem getting people to pay attention to this population; we need those who can bring assistance to this subject and project.

ANNOUNCEMENTS

Larry Pasco: 

Reports that Larry Flint is giving grant money to HIV programs along with Ron Jeremy.  Larry asks if anyone has an extra printer to donate to Larry’s program.

Tony Gillespie: 

Reports that Gloria Manamela received a personal letter from Bill Clinton regarding her story that was printed; he stated that she needs to continue spreading the news and the importance of HIV education.

KEY POINTS:
- Dolly Lozano, New Chair for the Membership Committee
- Exec. Committee to make final decision regarding the allocation of the remainder of the CPG funds; however,
   they must notify the entire CPG body.
- Advisory Committee to further petition for Needle Exchange in Indiana
- Sarah Renner will be the new Division Director beginning in December.
- Application/Re-Application deadline is 10/17
- $35,000 allocated for needs assessment usage
- Notes that HIV results should come directly from LimsNet, Not Luther
- State received $62,605 for MSM funding for the cycle of 10/08 – 12/09
- Christopher Cotten to be CPG Facilitator as requested by the CDC, to attend November Meeting.
Adjourn at 3:45 p.m.

NEXT MEETING ON NOVEMBER 18, 2008 AT 10:00 A.M.