HIV Health Services Planning Council
Needs Assessment Working Group Draft MINUTES
Wednesday, April 27th, 2005
1550 Bryant St., 11th Floor
4:30-6:30 p.m.

Committee Members Present: Billie-Jean Kanios (co-chair); Bill Blum, Ken Pearce
Committee Members Absent: Anita Booker, Catherine Geanuracos, Dorothy Kleffner, Joe McMurray, Laura Thomas
Council Support Present: Jack Newby, Leah Crask, Skot Jonz
Others Present: Allison Westin, Erika Takada

1. Introductions

2. Review/Approve Agenda
The group reviewed the agenda. Without objection the agenda was approved.

3. Review and Approval of Minutes- April 19, 2005
The minutes from the April 19, 2005 meeting were not available and will be approved at the next Needs Assessment Working Group meeting, May 25.

4. Announcements
It was announced that this group will no longer meet at this location due to the building not being ADA accessible. The next meeting will be held at 25 Van Ness Avenue, Room 330B.

5. Public Comment
There were no public comments.

6. Update from Harder & Co. Consultants
Allison Westin provided an update on Harder & Co. progress. They have been contacting providers to do interviews and people to administer the survey. They have already had people call the toll-free phone number to participate in the Needs Assessment. Allison mentioned several agencies that are posting flyers and recruiting clients for participation. She can provide a formal write up regarding the plan if that is wanted.
CM Pearce asked if it was okay for working group members to pass along the phone number.
Council Support agreed to post the phone number on the yahoo group and other appropriate places.
CM Pearce also suggested distributing to HPPC and CARE meetings.
Allison discussed the flyer and recruitment cards, and sites for posting announcements, peer networks, and agencies.
Allison discussed the incentive of a $15 grocery coupon.
Allison discussed that the length of time required for completing the survey would be about an hour and fifteen minutes.
CM Pearce asked about screening people who are participating for the incentive and not actually HIV positive.
Allison mentioned that questions in the demographics highlight invalid surveys and will not be used. The survey may be completed but later screened out.
Jack announced the Community event in the Castro upcoming on May 19 that will not have incentives.
Regarding meeting unmet needs in the community and reaching the “hard-to-reach” populations, CM Kanios suggested that too many flyers might attract people who are only participating for the incentive.
Jack discussed locating places such as Castro County Club as well as sites that do routine testing.
CM Pearce suggested AHP and Magnet as examples.
Allison suggested an intercept design towards the end to locate people at agencies to complete surveys.
CM Kanios mentioned a transgender barbeque occurring at Castro Country Club on the 30th of April, which may be an ideal time and place to get this population to participate.
Allison to put together a formal announcement that the Needs Assessment has begun, and she will distribute this will flyers and recruitment cards. She discussed contacting people who may not always receive regular care at agencies.
CM Pearce suggested AIDS Emergency Fund as an ideal place, as people who are HIV+ may access AEF but not use other services. Allison agreed.
Jack asked about progress with counties.
Allison reported that CM Blum has arranged for space in San Mateo. There is work underway to contact people on the Marin Council who may have space to use for these purposes.
Allison indicated that she is contacting Elyse Graham and Cam Keep, as well as Wade Flores and Will Carter.

7. Update on Small Group to Finalize Survey Instrument
CM Kanios provided an update on the next small group to finalize the survey instrument which will meet on Monday, May 2. Group discussed tentative time of 3-5 at Harder & Company. Billie-Jean, Bill Blum, Laura Thomas and Jack Newby will be in attendance.

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 Service Issues and Satisfaction section.
Allison reviewed the final two sections of the survey instrument, Service Issues and Satisfaction. She mentioned incorporating Prevention with Positives questions. Those were detailed on a handout entitled “Prevention with Positives Items”. Available on file at Council Support Offices.

Two items suggested for adding to question 44 include a reference to question ff -- “My drug or alcohol use” and gg “I was in jail or other correctional facility”. CM Blum asked for defining this a bit, and group agreed to add “current drug or alcohol use”.

CM Blum discussed adding something for the outlying counties regarding the services not available.
Group discussed that this would be covered by the previous question “Other” as well as “did the level of service received meet needs?” Group suggested adding something regarding “the service I want is not available in my area.”

CM Pearce suggested that some of the questions were putting words in people’s mouths and requested removal of item “m” regarding “The organization providing the service made me feel like a number.” Group agreed.

Group discussed adding an item that specifically addresses language barriers, and modify item “p” -- My ability to communicate or interact with the service provider [in my primary language].

CM Blum suggested changing item “o” from “criminal justice manner” to “criminal justice history”.

Group discussed clarifying item “u” regarding confidentiality, and to change the language to reflect a perceived fear, and a sufficient lack of privacy to protect confidentiality.

Group discussed item “s” that states “My ability to find my way through the system” and discussed removing it entirely or changing it to be more specific. Erika Takada mentioned that it was a double-check type of question that is paired with others in the survey. CM Blum suggested adding “lack of professional support” to find my way through the system.

Group discussed item “v” and removing “the” in “the other authorities”.

Group discussed that item “aa” should be changed from service to services.

Group discussed logical groupings of the questions, and Erika Takada mentioned that she is already doing this.

Group discussed a scheduling question to identify services not available at certain time, as well as another regarding distance to location and accessibility.

Group discussed item “w” regarding transportation and suggested adding “no or inadequate” and adding another question nearby that states something along the lines of “services are not available at a time that is convenient for me.”

CM Blum asked about the bias regarding the phrase “barriers” and suggested the wording be more neutral.
Erika Takada mentioned that she also prefers the more neutral approach.
Group agreed changing “problem” to “challenge” and to make this consistent throughout the question to be more neutral.

Group proceeded to Question 45. Allison mentioned that “past six months” had been changed to “past year”.
Allison mentioned adding something regarding anyone who had used the needle exchange program.
CM Kanios suggested a question identifying those who had used injectible hormones.
Allison read feed-back received from other group members:

To make MUNI/BART more universal and applicable to all counties. Group suggested adding “car or own transportation.” Group discussed question 45 to determine mode of transportation rather than who is paying for it, and agreed these are separate questions. Group discussed adding a separate column that might identify how this is being paid for. Group agreed removing references to “token” “pass” and “fare”. Group discussed adding a question regarding “do you receive assistance in paying for this transportation?” Group discussed adding a question regarding whether people receive county or agency transportation through volunteers or other sources, such as a friend or neighbor, caregiver or family member.

Moving on to questions 46 and 46a regarding substance usage -- group discussed adding Ketamine (Special K). Group discussed adding something regarding the class of erectile enhancement drugs and in parenthesis examples such as Viagra. Group discussed separating out more “illegal” drugs from those that are considered less illicit. Allison mentioned that an earlier question asks regarding medications taken and suggested adding the erectile stimulants reference there.

Group discussed asking the Viagra-type question earlier, and adding whether this is used in combination with other drugs linked with the Prevention with Positives questions.
Group discussed changing “Pills not prescribed by my doctor” to “prescription drugs in a recreational use.”
CM Blum discussed the number of people with AIDS who have issues with pain, anxiety, and insomnia and may use drugs for these purposes. Group discussed that the purpose of the survey is to get at the unmet needs. Sleep, anti-depressants, and anti-anxiety will be added in the earlier question linked with the Viagra-type question. Group discussed information wanting to be identified is off-label use.

CM Kanios discussed that accessing proper pain management services is a real issue.
Allison agreed to incorporate this into questions to be reviewed by the small group on Monday.

QUESTION 47: Group discussed narrowing this down to the past year rather than “ever.” Group discussed changing “substances” to “street drugs.” Group discussed adding injecting hormones/steroids in the previous section linked up with the erectile enhancement question.

QUESTION 48: No changes.

Question 49: CM Blum suggested making “territories” singular

QUESTION 49a: other than changing a typo of 49aa to 49a, there were no changes noted for this question.

QUESTION 49b: Group discussed the reluctance of respondents answering this question regarding residency status. Group discussed removing “undocumented” and “other” as these might scare people off and they may not answer, and perhaps adding “Decline to State”. Group agreed to add Resident.


9. Discuss Web Updates (If Time Permits)
Allison provided an update regarding the Prevention with Positives questions. She mentioned that they are a little rough and need some working, and Group will look at them to see the direction. Group discussed changes to the proposed questions. Group discussed the issue with regard to “party and play” and how a question should be structured. Group discussed adding a question with regard to combining recreational drugs during sexual activity and where this question should be integrated. Item “h” under the Prevention with Positives question #37 should refer to Party and Play, and rephrased in #38 to identify the level of riskiness.

10. Next Meeting Date & Agenda Items
The meeting adjourned at 6:33 p.m.

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

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