SCHA-LA

brainstorming session

Posted in hiv by SCHA-LA on November 12, 2009

What are the issues/challenges?

  • Is there a notion that planning isn’t important or that it’s going to go away?
    • Craig: When there is a discussion about streamlining, especially when economic hardship is @ the root of that conversation, Craig’s comment addressed that we don’t streamline it so much that  it’s not substantive any longer. The planning process doesn’t yield anything significant and makes the planning process worthless
  • Re Julie’s presentation on Universal Healthcare / Healthcare Reform (HCR) – there is the medical care coordination component which we are working on currently. That will be able to continue regardless of what happens @ the federal level. What about ADAP and immediate action that needs to take place? Don’t  want to be put on a waiting list
    • at the core is our ability to provide medication
  • Mickie: at the last mtg we tabled until today an item which isn’t on the agenda: a stmt was made by Mario that it is too great a burden to follow all the directives that the COH gives and that all the Standards of Care might not be implemented. Subtext: comprehensive care plan. That was a huge issue. The room exploded but it was put off b/c it was said @ the end of the meeting and it appears to have vanished.
  • Whitney: We strive for constructive tension but we have arrived at destructive tension. Can we call out some of the respective trust issues?
  • Carrie: when I look @ the list of partners that is on the agenda – is this an exhaustive list or are we missing potential partners we could leverage? and
  • Prison parolees – what does that mean in terms of the state of health for LAC?
  • Carol:  partnerships & collaborations. 2 yrs ago, CDC was here to discuss collaborations. This was before the current economic problems. This has not only affected HIV, but also STD, TB, HCV … when do we start to collaborate? We’re reaching out to the same populations.
  • Sharon: post-incarcerated & ADAP. Underserved pops are usually the most incarcerated. To not ensure that they don’t have rx when they go back out into the population is tantamount to criminal. Also
  • Why so long for the HOPWA wait? Criminal background checks and tendency to underserve these communities.
  • Robert: how do we educate & empower the people using out services in addition to people who could potentially be clients or who may never seroconvert
  • Ted: remember walking into an ASO and applying for ADAP 23 years ago. She said that “it’s over. You have to either die or wait for someone else to go to get on the list”. She produced a pamphlet and said “you have to call the governor and you have to get involved”. The people who laid down the groundwork must be turning over in their grave. We think our animals much better than we treat ourselves right now. We can not go on like this. Every day I am … getting someone to listen because we need to take our government back. It is unacceptable that pharma aren’t present for this. They’re sitting pretty. they have tax shelters in the cayman islands. They need to be here to hear these stories time and time again. They need to step up in times of crisis and relieve some of their profits so we can have life.
  • 5% of pop with syphilis are responsible for 50% of new infections.
  • Define “network” and “collaboration” – what are we walking about? What do we mean by that?
  • Medicare reductions
  • How do we keep quality high with reduced resources and less staff? How do we keep a solid infrastructure?
  • Bone-weary of the rancor between COH and OAP and there is plenty of blame on both sides. Stop the needless posturing, wheel-spinning and accusations.
  • Communities are made up of people, not agencies and clients.
  • Alternative economies build community, enable us to care for and about other people in the community because the health of the entire community is keeping everything going. Also, keep people (“clients”) from skills atrophy as everything is being done by a provider
  • Look at countries that have very little but do great work – examples.
  • Carrie:  I don’t think we’re walking away with very much.  … my issue is that our focus – should it be on funding on services on engagement in care. If it is those 3 lenses, then when are we going to have the opportunity to begin to address this and when are we going to think about the issue of civic engagement. We had an entire state that simply sat by and watched budgets be cut and funding be cut and there was no outcry.  Can we start that genuine discussion now or do we wait until December.

 

  1. 1. Is planning going to go away?
  2. 2. What do we do about ADAP?
  3. 3. Is burden of directives too great?
  4. 4. Are Standards of Care being implemented?
  5. 5. Concrete (small) steps toward building confidence and trust
  6. 6. Are we missing potential partners?
  7. 7. Collaborations. When do we start?
  8. 8. Streamlining HOPWA and criminal background checks
  9. 9. Educating and empowering people about how to access services, and which services – what they have available outside of public sphere
  10. 10. keep clients as independent as possible for as long as possible
  11. 11. take government back
  12. 12. pharmaceutical companies need to give back.
  13. Better understanding of planning for services that OAPP implements
  14. Can we plan over a longer period of time than a single year? Look with more long-term
  15. STD and HIV must work together.
  16. Planning that can be realistically implemented
  17. Medicare reductions
  18. Undocumented people paying for medical insurance
  19. Moving people to medi-cal
  20. 20. How do we keep quality high with reduced resources and less staff?
  21. Improvement in tone of dialogue.
  22. Collaboration is not about getting money from other pies
  23. Collaboration is about people
  24. Alternative economies (time banks, bartering etc)
  25. Leveraging policy and political resources
  26. Relationship is critical
  27. Civic engagement (people outside of this room)

 

ESPECIALLY issues between OAPP and the HIV Commission. Can we discuss these through this lens?

 

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