HIV Health Services Planning Council
Needs Assessment Working Group Draft MINUTES
Tuesday April 19th, 2005
1550 Bryant St., 11th Floor
4:30-6:30 p.m.

Committee Members Present: Billie-Jean Kanios (co-chair); Dorothy Kleffner; Ken Pearce; Laura Thomas; Catherine Geanuracos (co-chair)
Committee Members Absent: Joe McMurray; Randy Allgaier; Bill Blum; Anita Booker
Other Council Members Present: Brian DiCrocco
Others Present: Michael Underhill, Allison Weston (Harder & Co.); Michelle Magee (Harder & Co.)
Council Support Present: Leah Crask, Jack Newby, Nicole Matos

1. Introductions

2. Review/Approve Agenda
Agenda reviewed and approved.

3. Review and Approval of Minutes- March 30, 2005
#4-clarified that it hadn’t been decided? Used a confidential ID in 2002 and was intent to continue that process… decision was made with a smaller working group with the needs proposal… in request for proposal stated that we would use a unique identifier. Dorothy would like this issue discussed and revisited; questioning if names are to be used-wants names to be taken out… explained to her that the need for a unique identifier is to disallow duplicates and that the unique identifier would be created by the person filling out the survey and will be up to them. Dorothy clarified that she just wanted it to be as anonymous s as possible.

Minutes reviewed and approved

4. Announcements
There were no announcements.

5. Public Comment
There were no public comments.

6. Update from Harder & Co. Consultants
This is a very short timeline to put together the needs assessment. Contacting providers about the needs assessment to get them to tell their clients and secure space. Interviewers being trained to conduct the surveys. Finalizing the sample groups, who is being surveyed.

Key dates: May 4th 1st survey interview session; May 2nd extra meeting with key members [select group] to approve final survey; April 27 finalize service issues and miscellaneous sections;Today finalize health status and service utilization sections

7. Review and Revise Survey Instrument from 2002
Health status section first sent out proposed changes via e-mail and was color coded; blue could be removed; yellow could be changed; struck out to be removed. Wants to focus on content not format at this time.
Wants to clarify the difference between AIDS and HIV in the questions in the survey. Being asked about having AIDS may make some with HIV not recognize that this question applies to them.
Mike: Take out AIDS in question 20
Jack prefers to call it HIV disease.
Mike wants to take out diagnosis #20 “after testing positive for hiv, when…
#22. that you have progressed from HIV to AIDS
19b.… no objections… where did you test positive… change to the same wording as #20 and 22
21. will stay the same
23a & b. questioning if this question is very relevant… these are “validated questions” and wants to know if there is an objection to adding those questions: Jack feels that injury should be taken out and add a follow up question of whether this is a significant change from initial diagnosis. CM Thomas doesn’t feel that this would bring about much more info. CM Kleffner pointed out that some are diagnosed when they are very sick but are better now. CM Pearce stated that it brings about the severe need aspect of mental illness and substance abuse. CM Thomas believes that this question is not the screen for severe need although it is necessary criteria to pull.
25 & 26 taken out. CM Thomas suggests using 25 but not 26; this is to catch that unmet need population

Regarding question 24. CM Pearce wants to know if viral load would be asked at some other point… to test a level of awareness of your own care. Allison asked how this goes back to the original need for prioritization, which is the point of this survey -- to decide where allocation of services needs to go. Michelle stated that it hasn’t been used in the past or been seen as useful for needs assessment.
CM Thomas suggested that if these questions are added they should be reflected as asked in Reggie.

24. Modified to options instead of month/year.
CM Pearce stated that this would be a place to put in HIV/AIDS.
Jack brought up that people may have sought alternative medicine;
CM Thomas stated Nurse Practitioner.
CM Pearce stated medical provider would be a better choice of wording.
Allison asked if the group wants to capture acupuncture as well as medical professional.
Mike pointed out that when he gets sick he goes to his Chinese doctor but every 3-4 months goes to his medical care provider for check-ups and to see what is going on.
Allison suggested adding a question to ask what medical care they’ve sought out.
28b. Would be changed to year to match #25… to get blood work done will be added
29. Allison suggested not expecting participants to understand where their clinic fits so they should just name it; St. Mary’s has been added.
Jack suggested creating a question that specifically asks about alternative medicine.
Mike pointed out that it is in question 43. SF General/ward 86. Community clinic examples will be added
30. Will use one year to stay with HRSA and to stay consistent within the survey, need to keep all terminology consistent
31-32b Will stay as is
33. Deleted.
34. Removed reference to STDs but left in Hepatitis A, B, or C and not to limit it to the last year.
Jack wants all STDs asked as well, with Hepatitis A, B, or C as one question; STDs within the last year.
Mike asked about adding HPV virus as an option.
Jack feels that genital warts covers for this purpose.
CM Thomas pointed out that this may be worthy in terms of preventative care.
35-37. No changes made but HIV infection can be changed to HIV/AIDS. Many questions regarding the relevance of #36. Michelle suggests looking at the Reggie question and go from there as to how it is worded.
38. Keep Antiretrovirals, antidepressants or other psychiatric medications and herbal. Mike suggests somehow adding a category of medications for secondary infections.
39. New question… to look at other heath indicators. CM Thomas prefers adding the question but questioned heart disease; just make it one question.
Jack stated that he thought the breakdown was more to see about side-effects of long-term HIV medical care. CM Thomas suggested adding asthma as well, and add cholesterol.
CM Kanios brought up joint degeneration as an issue as well that isn’t asked often. Agreed to add neuropathy and remove heart failure/congestive heart failure.
40-44 Have not been modified but #43 would have substance abuse treatment stating treatment within the last year.

Moving on to next section… changes have not been made in order to discuss questions and due to the quick turn around between meetings. This copy does not reflect the current categories have been changed but will. CM Geanuracos asked if we should ask specifically about HIV treatment and how did they find out about the services they received.
Jack likes the way it is now and does not think that it is confusing so breaking it down to being HIV specific or not is just too much.
CM Kleffner stated that there is nothing that states if you got enough instead of how many times. Will change ‘E’ to “Did it meet your needs?”
CM Thomas asked if we should ask about things that no longer exist?
Jack stated that the needs assessment would not be as valid if we just asked about services that exist at this time, and should include all services that were or could be accessed.
CM Pearce asked if housing groups had been asked for input in terms of how housing questions should be asked.
CM Kleffner asked to split out #35 into two categories. #6 would be fleshed out more. Jack suggests #5 be changed to medication adherence support.
CM Pearce suggested fleshing out the definition of adherence.

Housing: CM Pearce suggested that CM Antonetty be consulted for these questions.
CM Kanios stated that HOPWA isn’t stated but would be included into #9, add section 8. Take out #8 change to transitional housing.
Jack stated that these categories are delineated enough.
CM Thomas stated that they aren’t delineated at all, and added that this isn’t asking what kind of housing needs a person had instead of what they got.
Michelle pointed out that since housing is such a great need we need to really look at adding questions to try to capture this information.

Food: No changes recommended.

Mental health: CM Thomas stated that there are other modalities that exist but that we don’t fund them so there are probably quite a few things should be added… individual, group therapy and psychiatric care with a psychiatrist/psychologist monitoring medications.

Substance use: #21 no 24-hour in question; #22 needs to be split out – 4 questions instead of 3.

Client advocacy: #25 needs to be split out and add immigration legal services. CM Thomas prefers keeping it in one category but adding immigration issues; no estate planning.

Case management: leave as is. Some issues with peer advocate. Reference to the person that helps with emotional support needs to be added

Day/respite care: #32 should be adult day health care.

Transportation: will split out #35 into two questions… will put in volunteer transportation assistance.

CM Kleffner suggested adding buddy system support into peer advocate section.
#37 Medi-Cal and Medicare need to be separated; no Medicare, add another option of how is your medication paid for? Add emergency assistance fund, medical reimbursement through ADAP and medications not covered by ADAP or Medi-Cal.
Needle exchange, HIV counseling, partner notification as prevention positives services

8. Discuss Web Updates (If Time Permits)
No time, item was tabled for discussion at a future meeting.

9. Next Meeting Date & Agenda Items
Next Meeting April 27, at same location and time. Meeting adjourned at 6:40pm


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

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