HIV Health Services Planning Council
Needs Assessment Working Group Draft MINUTES
Wednesday, March 30th, 2005
730 Polk St., 3rd Floor
Project Open Hand Conference Room
4:30-6:00 p.m.

Committee Members Present: Billie-Jean Kanios (co-chair); Catherine Geanuracos; Ken Pearce; Dorothy Kleffner; Laura Thomas; Bill Blum;
Committee Members Absent: Anita Booker, Joe McMurray
Other Council Members Present:
Council Support Present: Jack Newby; Leah Crask; Skot Jonz
Others Present: Kim Pickens; Jen Sareche, Tracey Packer (SF Dept of Health); Michelle Magee, Erika Takada, David Macias

1. Introductions

2. Review/Approve Agenda
The Committee reviewed the agenda. CM Kleffner asked to discuss the issue with regard to clarifying who decided the use of unique identifiers.
CM Pearce asked for time to discuss the recent Community Forum.
Harder and Company would like to table Item 7 for another time.
With those changes the agenda was approved.

3. Review and Approval of Minutes- March 16, 2005
The Committee reviewed the minutes from the March 16, 2005 Needs Assessment Working Group meeting.
There were no objections to the minutes. Minutes were approved.

4. Announcements
CM Kanios must leave early to participate in a smoking cessation program.
CM Geanuracos April 9-May 8 for an out of town trip.
CM Kleffner asked when it was decided to use a confidential ID instead of names on the survey instrument, and wants clarification on when this was decided. Representatives from Harder & Company clarified.

Discussion of Community Forum: [Added agenda item].

Committee discussed with Harder & Company that the information gathered would be usable.
CM Geanuracos reviewed for Committee and those present the activities that took place during the Community Forum, the large number of people in attendance, people turned away, discussions among the groups.
Jack Newby reviewed the surveys and explained that the dot exercise showed that housing, food, and primary care were the top three priorities which was reflected on the written surveys, and offered suggestions for obtaining usable data.
CM Pearce offered comments about rethinking the issue of incentives, which may have drawn participants for the wrong reason. Regarding no question asked about HIV status, CM Pearce suggested that this be factored into the results. He felt that the results were more representative of the Tenderloin community rather than the targeted community. CM Pearce also indicated that several people left as soon as the meal was served, as well as some people who were turned away who wanted only to participate and offer input and not concerned about the meal.
Committee discussed looking carefully at the group represented and how the next forum in the Tenderloin will offer a representative sample, and suggested asking HIV status on the questionnaire. Committee discussed that the number of HIV-negative people participating in the forum could definitely skew the results.
CM Kanios indicated that he had to shout and the atmosphere was not conducive to a proper conversation.
CM Pearce added that he is not critical of the planners, but nobody could assume that the venue would draw people from the neighboring Tenderloin rather than the community from the Castro.
Jack indicated that the survey did ask how people heard about it. No respondents mentioned the B.A.R. where it was advertised. He would like to see another forum at MCC. Many participants were referred by Tenderloin AIDS Project and TARC (which serves HIV-negative people).
CM Geanuracos suggested that someone convey the information discussed at the next Community Outreach and Advocacy Meeting.

5. Public Comment
There was no public comment.

6. Update from Harder & Co. Consultants
Harder & Company Consultants will give the group a brief progress update.
Representatives from Harder & Company provided a progress update on their activities, and would like to move on to working through two sections of the survey instrument today.

7. Discuss Web Updates
The group will discuss web updates for the Needs Assessment.
[This item tabled for a future date].

8. Review and Revise Survey Instrument from 2002
The group will review the past survey instrument and make changes for the current tool in collaboration with the Harder & Co. consultants beginning with the Demographics and Health Status sections.

Harder & Company mentioned looking at the data and determining if lack of data was due to no response or lack of consistency in administering, or other issues. This will help determine if this question needs to be eliminated or re-worded.
CM Geanuracos discussed that the survey instrument is already too long, and instead of thinking of things to add, perhaps Committee members should consider shortening it anyway possible. If it is overloaded with too much information or repetitive it will not provide any better data. She suggested that discussions resist adding as much as possible and try to think of which items could be eliminated.
CM Thomas also added to be conservative in making changes. The fewer changes made, the better track record will be used to compare data from previous Needs Assessments.
Harder & Company agreed, and pointed to specific questions that produced little or no information that could be eliminated. Harder & Company reviewed the last meeting’s discussion about what is and what is not a Needs Assessment Process:
An update of the current environment of PLWH/A in the SFEMA. It is cross sectional point in time.
Provides demographic information.
Describes use of existing services.
Describes barriers to and gap in existing services. Sheds some light on health status, quality of life of those affected by HIV/AIDS.
IT IS NOT an assessment of satisfaction of services, but an indication of program success.

Harder & Company distributed a sample survey from previous Needs Assessment with highlights and italics and strikethroughs to suggest their recommendations. (Document on file at Council Support Offices).

Harder & Company began with Demographics and Health Status.

1. Committee discussed that this is a screening question, so that they do not complete part of the survey and discover that someone is not qualified to participate. Committee discussed that it should ask HIV+ or HIV negative, and leave out the reference to symptoms.
2. Committee asked why the question referring to date of birth was removed. H&Co. indicated that it was just accidentally eliminated during the transfer into a word document and will be left in.
3. The question referring to gender will remain the same.
4. The question referring to racial background – Committee discussed the inclusion of an “Other” or “Mixed Race” category, and H&Co indicated that it will significantly change the trend data. Indicated that there are special needs with regard to Hispanics or African American. H&Co. suggested offering a separate question that narrows it down. H&Co. added “Select one that you most strongly identify with”. Committee discussed the importance of giving people the opportunity to choose more than one, but there was some concern about using the “other” category. H&Co. suggestions include eliminating Other non-Hispanic Black, South Asian, Southeast Asian, Cape Verdean, and South American because of zero responses or very, very few responses. Vietnamese and Hmong were added to replace Southeast Asian. CM Geanuracos suggested two columns, and H&Co. indicated they would work out the logistics, and if it is necessary to code “Other” they will do so. Committee discussed collapsing Cuban/Puerto Rican, and working with the category Mexican/Mexican American to reflect Chicano. H&Co. indicated that some immigration issues may prevent people from answering this question honestly which could also affect the data and any relevant trends.
5. With regard to question #4 about language most frequently spoken at home, Committee discussed that by asking “If not English, what language do you speak” would speed up the process.
6. With regard to the question about sexual orientation, Committee discussed the issue with MSM who do not identify as gay. Committee discussed that this could be cross-referenced to the mode of infection. CM Blum indicated that the term “homosexual – lesbian” was redundant.
7. With regard to question about education. Committee had no changes or comments.
8. With regard to zip code and city/neighborhood question. Committee discussed that if this is a screening question to eliminate people who were from out of state why not put it first. H&Co. indicated that no out of state people participated in the previous N.A. but there were a few from other counties. H&Co. indicated that this question could be moved to #2. CM Thomas suggested that if people in other counties receive services in the San Francisco EMA, she would want to know this information. H&Co. indicated that there is a level of screening that takes place over the phone before the survey. H&Co. indicated that the out-of-county numbers were very small, but several committee members indicated that even if it was small they would want to know this information. CM Pearce suggested that a random sample of out-of-county people surveyed would not offer a true reflection of those non-residents who access services in SF. Committee discussed that San Mateo and Marin County responders would be left in.
9. With regard to current living situation – H&Co. indicated that there was significant response to all categories so none have been suggested for removal. Committee asked about jail or correctional facility and H&Co. stated that this was missed, and it was not responded to afterall and it could be eliminated. Hospital/Institution also removed as it is not necessarily a residence or place to live. Committee agreed to separate living/crashing with someone and not paying rent into two choices. CM Blum asked where “hotel” would be included and H&Co. discussed that for San Mateo the specific wording could be used to identify this as it is different in San Mateo County than the SRO situation in San Francisco, or use the word “hotel” in parenthesis. Committee also suggested changing the San Mateo and Marin County surveys to delete the “with tenancy” or “without tenancy” wording. CM Blum also suggested adding a “clean and sober living” situation for San Mateo County.
10. With regard to payment for monthly housing. No changes recommended.
11. With regard to living situation. H&Co. indicated that this would be cross-referenced to previous question about where they were living. Committee discussed the purpose of this question was to determine if housing was stable or instable. Committee discussed that this was one question that could be eliminated. COMMITTEE AGREED THIS QUESTION TO BE ELIMINATED.
12. With regard to question (11) If you lived in San Francisco, are you on the housing wait list? Committee discussed the detailed questions on the previous survey instruments could be eliminated. This question to remain the same.
13. Regarding household makeup. No changes.
14. With regard to HIV-positive household members. No changes.
15. With regard to question (13) about total time lived in places below. Committee discussed that perhaps it was not necessary to ask for so much specific information. H&Co. indicated that this information will be collapsed anyway, and it could read “in the last two years” and be a simple yes or no. CM Thomas asked to specify with regard to county jail or detention center and state or federal prison.
16. With regard to current job situation – suggested adding volunteer.
17. With regard to yearly income – adjust to federal poverty and capture the 400% of poverty levels. CM Thomas suggested putting the monthly income first, but Committee agreed to leave it as is.
18. With regard to Health Insurance – H&Co. reworded to eliminate 16a and reworded the question to read “Do you have health insurance yes or no? IF yes, what kind of health insurance do you have? Jack Newby suggested adding a category of “unsure”. Committee discussed adding Veteran’s in this question even though it is included in the next question. CM Blum also suggested adding CARE/HIPP, and County Programs. Committee discussed changing “health insurance” to “health coverage”. H&Co. indicated they would change the language.
19. With regard to Other benefits – H&Co. indicated there would be future opportunities to go through all of these again. CM Thomas suggested asking experts at PRC for a quick assessment of this question. Committee discussed adding HOPWA subsidy to the Subsidized Housing category.
20. With regard to question about different case managers, that it would be consistent with previous survey instrument to change this to “different agencies”. H&Co. indicated that this was merely a typo and would be changed.
H&Co. indicated moving forward in next meetings rather than rehashing items already discussed. H&Co. asked if there would be the possibility of working with a smaller group to move through these faster. Jack Newby indicated that there is a search for meeting location without such time constraints. Jack also encouraged people to send comments and suggestions.
H&Co. identified the next two sections “Health Status” and “Service Utilization” to be reviewed. Committee discussed completely eliminating specific questions and shortening others. H&Co. indicated that there were many of these that received no response. H&Co. will send sections to Committee Members with comments and suggestions for review.

H&Co. indicated that they might have meeting space available and would contact Council Support about arranging to meet there.

12. Next Meeting Date & Agenda Items
There were no other agenda items discussed.

The meeting adjourned at 5:55 pm.

Audio recording for this meeting is saved as DS330193

Meeting minutes are considered to be in DRAFT form until reviewed and approved by Council attendees.

Home | Community Outreach & Advocacy Committee | Policy & Evaluation Committee | Evaluation Committee
Membership Committee | Planning Committee | Steering Committee