HIV Health Services Planning Council
Housing Workgroup Draft MINUTES
Friday, January 20, 2006
101 Grove Street, Room 302
9:30 – 11:00am

Working Group Members Present: Margot Antonetty (co-chair); George Simmons; Sherilyn Adam (Larking Street Youth Services); Molly Stafford (AIDS Legal Referral Panel); Lori Cook (Housing & Urban Health); Elizabeth Colomello (SFRA); Michelle Long (SFDPH); Laura Thomas (Continuum); Brian Basinger (AIDS Housing Alliance)
Council Support Present: Jack Newby, Susan Latham, Skot Jonz

1. Introductions
Co-Chair Antonetty called the meeting to order at 9:35 a.m. and those present introduced themselves.

2. Review/Approve Agenda
The working group reviewed the draft agenda and without objections it was approved by consensus.

3. Announcements
The following announcements were made:
• Brian Basinger announced the second anniversary of AIDS Housing Alliance and a celebration on January 28 at Café Flore. He also announced other progress and successes of AHA.
• Margot introduced Lori Cook, the new Health Program Planner at HUH.

4. Public Comment
No public comment.

5. Presentation of Findings to Work Group
Co-Chair Antonetty reminded the working group of HRSA Consultant, Harold Phillips, and the research conducted during his visit in May of 2005. She explained that due to his unexpected illness, the process was delayed. Since Mr. Phillips was unable to attend, co-chair Antonetty showed a power point presentation of Mr. Phillips’ report to HRSA (On file at Council Support Offices). She provided background information on the length of stay issue and acknowledged the amount of work put into this report.

6. Discussion of Response to the Policy
Comments on the presentation included:

• Sherilyn Adams from Larkin Street Youth Services indicated that the reported number of 2,000 homeless youth living in San Francisco is closer to 4,000.
• The presentation figures for residents per square mile in San Francisco and New York City were transposed, and should reflect the numbers in the actual report (SF-26,400 residents per square mile; NYC 16,600 residents per square mile).
• Group discussed time limits and the need to locate other funding streams for housing needs.
• Group discussed possible next steps, including: HRSA’s response to Mr. Phillips’ recommendations, whether the SFEMA can give an official response; conference call with HRSA regarding implementation, appeals process, time-line and contract modifications.
• Group discussed the official position of the AIDS Office, and the strength of its position in negotiations with HRSA.
• Group discussed the importance of the AIDS Office maintaining a healthy working relationship with HRSA, even while consumers, providers, and the Council are voicing complaints.
• Group discussed the need for an analysis regarding the impact of implementation.
• Regarding a statement in the presentation about the number of rental units converted to condominiums, Brian Basinger indicated that to achieve this, many senior citizens and disabled persons were evicted.
• Regarding the discussion on impact of implementation, it was agreed that clients would need to be notified regarding the time-based programs. Group discussed that when people lose their subsidy they lose their housing, and when they many lose their housing they often drop out of care, and this affects access to care and health status.
• Regarding a response to HRSA, comments included: requesting one year from HRSA to determine the impact, a flat out no, a prolonged appeals/comment period.
• CM Thomas suggested moving on several fronts simultaneously because the Planning Council, AIDS Office, or HRSA are not in the business of making people homeless. She mentioned the sensitive nature of attempting to negotiate this before knowing the results of CARE Act reauthorization. She also mentioned possible political action (contacting Sen. Feinstein, Pelosi, and the Mayor’s Office). She suggested minimizing current length of stays (i.e., work with those clients who have been in deep subsidy and/or CARE funded housing the longest to move them to other funding streams, such as HOPWA.)
• Group agreed with CM Thomas’ suggestions.
• Group agreed that the focus of this meeting was to come up with a strategy to approach HRSA, and how political to make this issue.
• Group discussed what would happen if making a decision on length of stay is a condition of award.
• Discuss with other EMA’s their Length of Stays policy, how they implement it, how they decide on a cap (if any), extensions (if any), etc.
• Brian Basinger suggested a transition process rather than from deep subsidy to nothing at all.
• Co-Chair Antonetty summarized the comments of the working group –

o Department and political response
o Appeals process
o Analysis of consequences/impact
o Implementation period and timeline
o Grandfather clause – if no grandfather clause, the entire recommendation is unacceptable
o Whether OIG will monitor implementation of policy
o Replace CARE dollars with other funds whenever possible
o Gradual transition process to stable housing

• The Housing Workgroup will present their recommendations to the Full Council meeting for the Working Group to continue convening to develop a policy that is acceptable for the EMA. The recommendation to the Full Council will include:

o Continue the ad hoc committee known as the Housing Workgroup; including participation of at least one Council co-chair at each meeting
o Continue to work with HRSA, appeal recommendations, and continue negotiations
o Work with AIDS Office and HUH regarding implementation and analysis of impact

• George Simmons suggested that the client satisfaction survey used by some agencies could be utilized to include questions regarding how the housing subsidy (and its potential loss) could affect the client’s health
• Group discussed that it needs to be clear that HRSA should not be developing a policy specifically for the San Francisco EMA, and that a “national rollout” needs to be considered equally in all EMAS.
• Michelle Long mentioned that this year’s mini needs assessment could also be used to ask similar questions
• Group discussed how funds have moved from housing placement services, and many case managers take the role of being a housing specialist. Brian Basinger commented that is why he started AIDS Housing Alliance because the current system is not working and other agency case managers usually refer clients with housing needs to AHA.
• Group agreed that future discussion topics need to include what keeps people in housing, youth concerns, and other issues. Whether there are HRSA resources available to deal with implementation, including the availability of a consultant to conduct an impact study.
• Group needs to identify persons (or agency representatives) that should be invited to participate in the Working Group on a regular basis.
• Group agreed it is important to coordinate and define rolls and create a clear strategy.

7. Presentation of Consultant Finding and HRSA Modifications by Consultant
Group will discuss the implications of implementation of this policy.
This agenda item included in the discussion above.

8. Implications of Implementation of Policy and Presentation to HIV Health Services Planning Council
This agenda item included in the discussion above.

9. Possible Next Meeting Date & Agenda Items
The next meeting date will be scheduled after a decision from Full Council whether to continue convening the Housing Work Group. Those interested in participating will notify Council Support to be placed on the distribution list.

10. Meeting Adjourned
Co-Chair Antonetty adjourned the meeting at 11:00 a.m.

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