HIV Prevention Community Planning Group Meeting
USE July 15, 2008 * 10:00 – 3:30pm
Absent: Ajiboye, Shola
Absent w/ Proxy *Jerry Burkman for Larry Harris
The meeting was called to order at 10:15am by the Community Co-Chair, Ramon Morton. All in attendance introduced themselves. The agenda format was changed.
Tony Gillespie: The purpose of CPG, primarily, is to bring the community and the DOH together to look at HIV Prevention and make recommendations, develop strategies and author a statewide plan to reduce HIV.
Ground Rules: The ground rules were read to the CPG body by Jerry Burkman. She included the following change and addition (in italics) to the list:
Ground Rule # 2. Speak clearly and distinctly
2. Change: Speak clearly, distinctly and loudly
Addition: Mrs. Burkman also stated that to “be on time” was also a ground rule. Per Barbara Burcham, this rule was a suggestion from Ted Forbes during his last visit to Indianapolis.
It was also stated that in the past, the CPG body agreed that the ground rules would be blown up and posted appropriately because only a few had a copy. Andrea Perez volunteered to have copies made from heavy card board for posting.
Jerry Burkman asked if the body would like to have the agenda emailed along with the regular documents in order to know what is important in the upcoming meetings.
Barbara Burcham stated that the Prevention program is understaffed. In the Division of HIV/STD Update, July 2008 report, members would see that a CPG liaison has been hired and will be starting the end of this month. She also stated that Prevention did the best they could and agreed that the CPG body did not receive the agenda in a timely fashion this month. However, it hasn’t been in the past nor will it become a regular occurrence. Mr. Morton also agreed and apologized from the community aspect. He stated that he too didn’t see the agenda until the day before the meeting took place.
Debra Stanley stated that if the body would go back to the original format, what was just discussed regarding the ground rules, submission of the meeting agenda and other items to be discussed during the bi-monthly meeting would be found on a template. All these things were once a part of the agenda. The original format even had a place for, “process” kind of questions. She asked that the original agenda template be reviewed and restored so that when the next Executive Committee conference call takes place, the agenda can be prepared as well.
If members have agenda items, please email them to Ramon or Barbara.
The following comments were made to questions 6, 7, and 28.
- Since May 2008, Paula French was no longer on the Executive Committee. On the Executive Committee 2008 Attendance list, extend the color code (pink) into the June 2008 column.
- Diana Bowden resigned for personal reasons
USCA Conference scheduled in Miami Florida, September 18 – 21, 2008 will be attended by CPG member, Rev. Donald Archey. Unfortunately other CPG members were unable to obtain a scholarship. There were 125 offered.
Ramona Gilmore accepted the position as Chair of the Membership Committee but due to personal reasons, she will not be able to fulfill the duties required of her. I will ask for Debra Stanley’s assistance for the next couple of months to prepare assignments of the membership piece.
A lot of committee changes have taken place. Members dropped and new assignments made have resulted in the need for committees to be restructured. These changes, in addition to other committees not having fulfilled their commitments, have affected the board as well causing some members to carry an even heavier load and become “over burdened”. There is therefore now a greater need for more people to step up and assume responsibilities. Yes we do come here representing a certain population and that is all important, but we more importantly come representing the HIV/AIDS virus body as a whole. The whole purpose of this group is to look at the big picture and where we should be responding… where we need to be directing interventions.
During the reapplication process, which has never been done before, the Membership Committee, will review each member’s roles and assignments in an attempt to determine if committee related assignments are being met. By September, all current members will need to have completed the re-application form found at www.in.gov/isdh/17397.htm.
Barbara Burcham: Michael Reese will not be the facilitator based upon his interest in what he wanted to do for CPG versus the actual needs of the CPG body. During our last conference call, Mr. Reese stated that he wanted to do an assessment but an assessment is not what the CPG body needs.
An Ad-Hoc Committee was formed to look at the Technical Assistance plan recommended earlier by both Ted Duncan and Ted Forbes of CDC that would focus on January 2008 thru January 2009. The new members for this Committee are, Dolly Lozano, Ramon Morton, Debra Stanley, Paula French and Tony Gillespie.
Larry Pasco requested 20 copies of the insert, ‘The Faces of HIV and Other Infectious Diseases’ published in the Indianapolis Woman’s Magazine.
Question: How much time should be given to Dr Monroe to respond to the letter sent to her regarding needle exchange and harm reduction?
Answer: Jerry Burkman will be meeting with Dr Monroe at 3:30 p.m. for a 15 minute meeting to discuss questions raised in the letter.
Cathy Archey Morgan received a call from Denver STD/HIV Prevention Training Center stating that those that have someone attending the CRCS training have not registered and they are still holding six slots for the names from Indiana. Those attending will need to contact both Cathy and Denver’s website to register.
Barbara Burcham stated that she wants to bring the training here for those under-trained and who have never been trained. She also stated that this would be an additional tool counselors could use in CTR and as a motivational piece. The training is not mandatory but is highly suggested.
Cathy Archey-Morgan: The counselor refresher course will just be a course to reiterate what the CTR people are already doing and to make sure those trained years ago are up on the CRCS training. One option being considered is to travel and perform training at one site in North, Central, and Southern Indiana.
Barbara Burcham: Lodging and mileage for CPG members will be reimbursed through their agency. That amount will be entered as a contract amendment at a later date from carry over dollars (which have not been approved yet) or from a vacant position we had this year.
(CLIA certifications needed to run laboratory related test) CLIA (Clinical Laboratory Improvement Amendment): Law establishing quality standards for all laboratory testing (except research) to ensure the accuracy, reliability and timeliness of patient test results regardless of where the test is performed. Lab tests are categorized as waived testing, moderately complex, and highly-complex. Laboratories performing these tests must meet certain criteria to perform tests in a particular category.
Rev Donald Archey stated that he had contacted the Allen County Health Department to do rapid testing and they refused. When they refused, he asked if they would come to his site and perform testing there. Again they refused. He also contacted Gary, Elkhart and South Bend, Indiana. During the meeting in Indianapolis, Rev Archey requested to know the exact procedures needed to have someone come to their site and perform testing there. He stated he had not heard of a CLIA Waiver.
Barbara Burcham stated that this is a side issue that would have to be discussed outside of the CPG because it’s not on the agenda and it’s not a CPG issue; however she would be more than willing to talk with him about this, but outside of the meeting.
Rev Donald Archey stated that he was deeply disturbed and concerned when it comes to the minority population particularly in Fort Wayne, particularly in region 3 and when we are attempting to test where the numbers are disproportionate and we're not allowed to do that nor will a funded agency in that area do the test and I did think it was something that needed to be brought to this committee.
Barbara Burcham: “and if you would like to have Ramon included on that call, I'd be more than willing to in the meeting here either way. You can have your presentation”.
Tony Gillespie: “I understand it's not an agenda item, but it certainly is a CPG issue because it’s a difference between funded types and non-funded types sites. This is an issue with a well funded region. Allen County Health Department was one of the health departments that received more funding than any other county health department. The fact that this health department was funded when no other organization was funded in that community speaks to what was the vision of ISDH at the time; that communities move toward those kinds of mutual partnerships and organizations learn to work together. So if there is one funded entity in the area that is suppose to provide that service and yet they won’t do the CLIA and they won’t do the other types of services then, that certainly is an issue that needs to be discussed at community planning”.
Barbara Burcham: “Can we move it down to new business?”
Ramon Morton: Yes
Purpose: Using the state and local health departments to develop a plan to enhance and better address the HIV prevention service for MSMs. The plan will be developed through an assessment of current activities to prevent HIV infections and related risk factors including STDs which are related to HIV. It is to assess our current CPG plan for improvement and enforce the CPG plan immediately thereafter.
There is no additional funding. The award is based on the proportion of MSMs the state had in 2006.
Bring in an outside investigator to work with. (Are we going to contract services out?)
An Ad-Hoc Committee was established for the purpose of working through some of the technicalities of the plan. Tony requested that Dr. Marvin Bailey, Professor from Indiana University to also be a part of this committee. Ad-Hoc Committee members are Dolly Lozano, Tony Gillespie and Paula French.
Tony Gillespie: Duties of the Ad-Hoc Committee: The mission of the Ad-Hoc Committee is to work with the DOH to provide input into the development of a strategic plan as part of the CDC application for the Supplemental Funding.
Lunch: 11:30 – 12:30pm (South Bend Chocolate Factory)
The committee is waiting on a response from Dr Monroe regarding the letter sent to her for a response to needle exchange and harm reduction. The committee would like a written response on ISDH letterhead so it would be official, to let them know where they are to date. Two days after the letter was submitted to Dr Monroe, a sign-on-letter addressed to congressional leadership calling for Congress to lift the federal ban on the funding for syringe exchange programs, a key weapon in the fight against the spread of HIV and Hepatitis C, was released today with 55 signatures. The letter, circulated by Representatives Elijah E. Cummings (D-MD) and Michael Castle (R-DE), gained bipartisan support, with four Republican signers. The letter was forwarded to Dr. Monroe. Jerry was scheduled to meet with Dr. Monroe later that day.
The Advocacy Committee has requested that Andrea Perez and Cathy Archey Morgan serve as staff technical assistant.
Andrea sent out a notice around the state announcing National Testing Day. Seven cities around the state were able to get signed proclamations from their Mayor. The language that went out in the original press release was that if you were able to obtain these proclamations from your Mayor, your city would be able to get up to 500 test kits depending on the size of your city. Indianapolis received 500; Elkhart 200, South Bend 100 and Gary received 100.
Tony is proposing that the Advocacy Committee send, on behalf of the entire body, a resolution, or letter thanking them; recognizing the efforts of both the Mayor and representatives from those cities. The committee would also like to send a letter of acknowledgement to Dr. Manoj Pardasani who will be returning to New York.
Request that Mr. Charles T. Hiltunen, III, Third House Advocacy or someone make a presentation to the CPG body in September, 2008 on advocacy, what CPG members can say to legislators and definition of lobbying.
Richard Passey presented a PowerPoint on the new HIV Incidence report.
Dan Hillman provided packets of his membership matrix requested by the Epi Committee earlier. By September, the Membership Committee will hopefully have a final matrix to present to the full body.
July 28, 2008, is the start date for the new CPG Liaison, Cena Bain. Send all applications to her after July 28th. Before this date, send applications to Barbara.
Question: During the reapplication process, will an appeals process be made a part of the reapplication process? Answer: The Membership Committee will look at adding an appeals process to the Membership Application process. Discussion ensued.
Final: The Membership Committee will not ask for any applications until the application process is done - not from the public or members per Debra Stanley.
All conference attendees will provide a written report on workshops attended.
I would like to thank the CPG members and Co-Chairs for the opportunity to attend HPLS this year. No matter how long any of us have done this work, it is important that we remain current on emerging issues, new funding directions and new prevention/care strategies. HPLS afforded me that opportunity.
The Science of HIV Prevention: Where Are We Now? (CDC)
This session focused on a wide range of issues including microbicides, testing, DEBIs (as well as some of the new interventions that are being rolled out), condom distribution, needle exchange, etc. One of the most interesting aspects of this workshop was the integration of biomedical interventions (such as vaccines, microbicides, HARRT therapy) and behavioral change interventions as well as social changes including needle exchange condom availability in correctional settings, etc. Clearly, we still have a lot to learn and many ways to approach prevention; none of which can be done in a vacuum if we are to prevent the spread of HIV.
Closing the Gap: The CDC’s Response to Women at Risk for HIV/AIDS (Institute 2pm-5pm)
This session focused on how interventions for women have evolved over time, beginning with Public Service Announcements (PSAs) on public transportation, on TV/radio, to projects like SISTA and the adaptation for other women such as Latinas, etc. Several other interventions were discussed. The point was made that the findings show that behavioral intervention do lower risk taking and many are effective. Information was also provided about how interventions have been researched and the fact that some are Evidence-based (EBI) and some are Theory-based interventions (TBI). Information was also provided on some of the efforts to “package” new interventions targeting women. “The CDC will continue to identify and disseminate evidence-based interventions for women to close the gap between the epidemic and the need for a variety of intervention strategies”.
Turning Data into Prevention: Using Core Surveillance and Behavioral Data to inform Local Prevention Planning (CDC HIV Prevention Program Priority)
Information was provided about how data is collect as well as how surveillance works and how it should work. CDC has begun an Epidemiological Capacity Building Program. ISDH has been funded for inclusion in this program. Clearly, it is critical to prevention that good data be collected, effectively analyzed to be used in the development of prevention programs that address current needs and emerging populations.
Offenders, HIV and other STIs: Understanding the Dangerous Combination of Incarceration and STIs (AIDS Partnership MI)
Excellent workshop, but was not as described as title indicated. The session was actually about case management for persons living with HIV coming out of incarceration. Some of the impressive activities included: the staff always eats lunch with the clients. This removes the “us vs. them” mentality. This has been their prison experience and should not be repeated there. The balloon exercise was very interesting. The clients write priorities on balloons…reunite with family, find a job, stay healthy, keep appointments with their parole officer, etc…., then try to keep them up in the air. As ones fall to the floor, the clients talk about how it felt to see your priority fall, which things were most important to keep in the air, etc. This helps clients to put their priorities in prospective and to realize that these things will take time and patience. They also talked about how clients were laughing and having fun, many for the first time in a long time.
Advanced Internet-based Strategies and Safeguards: Updates and Guidance for Internet Service Providers (Public Health Solutions, NY)
This was the best workshop of the conference. There was great interaction and discussion about this emerging intervention opportunity. Many good ideas about being safe, integrity of the intervention (one bad one effects us all), reporting ideas, the importance of policies/procedures, etc.
Shaping the Future of Community Planning: What’s Your Viewpoint? (CDC HIV Prevention Program Priority)
This session began with the CDC representative stating that the CDC is committed to the future of CPG. It seems that we may see some changes associated with CPG, but I’m not sure what those might be. However, they also said that this may be the last HPLS as we know it. They are looking at ways to offer skills building etc without a full-fledged CPG focused conference. There was a lot of discussion about what different CPGs look like and how they operate, etc. One person asked whether or not CDC-funded interventions must be DEBIs. The answer was a swift, to the point, “no”. The CDC rep reiterated that while funded behavioral interventions must be evidence-based, they are not required to be a DEBI. It was mentioned several times that the new CDC initiative is close to being released, but is still undergoing review.
Mostly the state of HIV in Michigan, plus numerous welcomes from local public officials. Interesting speech by a minister whose sister died from HIV and who himself is living with the disease. Mixed reaction to the tone of this presentation.
Overview of the history of CPG and what is now HPLS (CPLS). Very interesting for those of us who have been associated with CPG for so many years; also good look back for newer members.
How HPLS is Changing (this was not a workshop)
- CRCS: Using CRCS for the Re-entry population (those being released back into regular society)
- Rapid HIV Testing: The effort to create a partnership or create partnerships between bath houses and the health departments
- (Inaudible - coughing took place)
- Open discussion about what goes on in other states
- Community Planning: Connecting Your Needs Assessment and Your Epi Profile
HIV Get Tested Day
Indiana juvenile judicial system re-entry rank 6th nationwide.
There were seven cities that actually participated in HIV Get Tested Day.
Andrea will be completing the number of test done on HIV Get Tested Day of sites and data report.
There were traditional and non-traditional activities done on HIV Get Tested Day.
Jerry Burkman was told that she would need to write Dr Monroe’s response to the letter regarding needle exchange and harm reduction. She would be meeting with Dr Monroe today at 3:30pm to discuss why she should support needle exchange and harm reduction. Tentative key points for discussion included the purpose of harm reduction, current regulations and what needs to be changed and supported and supporters of the Harm Reduction Bill.
ISDH Identification: Members, please make sure you are wearing your ISDH identification pass at all times. There will be no access to any floor with out it.
HIV Testing in Fort Wayne revisited
Rev Archey stated that, ‘he was not insinuating that the State Department of Health was prejudice and if any vocabulary or the way he presented it came out that way that was not how he intended it. However he's in Fort Wayne, Indiana and the only funding site in Fort Wayne that provides testing is the Allen County Health Department and the event that his agency has done over the past 5 years is not new but is done annually. So he didn’t know any other way to look at it on a Fort Wayne basis since he is there, other than that race is playing a part in that’. He encouraged everyone around the table that if they are in situations where this is taking place in their community, that it should be brought to this committee. He encouraged everyone not to be intimidated in anyway - to express their feelings of what is taking place in their community. He also stated that the situation in Fort Wayne has been on going.
Barbara Burcham: “(inaudible) and I talked and he found out this last Thursday and didn't have any opportunity to let me know because had I known Friday, I would have possibly been able to have some answers today but it didn't happen that way”.
Sites must be approved test sites. If it (inaudible) distributed (inaudible) to be distributed to funded or indirectly funded sites. Funded meaning, are they getting prevention dollars. Indirectly funded sites are ones that use our lab and enter into the evaluation system. If sites are not approved, then they are encouraged to collaborate. When situations arise such as that, then I would be willing to intercede and facilitate the conversation but if they fall within the guidelines of their contract, if they have certain set policies, depending upon the circumstances, all I can hold them to is the terms of their contract with us. But I'd be willing to enter into the discussion as I offered with Donald Archey. To be an approved site, the things that you need to qualify and there’s a list but the key of confidentiality of records is (inaudible) storages samples etc. The testing date is July 26, which is a very short turn around. I feel I'm willing to at least start a conversation to try and see if we can identify one or two people from Fort Wayne and this is what my attempt will be. I can't guarantee because I'm not in Fort Wayne but I will attempt to see if we can get one or two people from up there in order to provide that testing at that site. Unfortunately you're not an approved test site.
I've visited sites that have expressed an interest of what the things are that are necessary to become an approved site if they don't meet the criteria then I can't approve it. I talk to them about ways that they can attempt to meet whatever that system they have in order to reach the level that they could be approved but until there’s a settlement to that, I refer them to places to talk to them about how certain places are doing it maybe they can work with you and get you up to speed”.
Tony Gillespie: “My concern is the funding process is called into question about the fact that Fort Wayne ranks 3rd or 4th in disease prevalence but number two in funding”.
Barbara Burcham: We've got TA's assistance coming to assist our staff on the 21st of July. It’s a site consultation.
Cathy Archey-Morgan: The Dept of Corrections is beginning to send people to the HIV Prevention Counseling training.
Rev Donald Archey: On July 26, 2008, Union Baptist Church will collaborate with the AIDS Task Force to do a minority AIDS walk.
Larry Pasco: The Harm Reduction Institute also does overdose prevention. They train active drug users on how to use prevention medications.
Next Meeting: September 16, 2008 @ 10:00 A.M. (promptly)
Meeting was adjourned at 3:30 PM