Minnesota Department of Health
STD and HIV Section
HIV/STD Community Prevention Planning
COMMISSIONER’S TASK FORCE ON HIV/STD PREVENTION PLANNING
Snelling Office Park
12:00 p.m. - 4:00 p.m.
Friday, January 16, 2004
Present
TASK FORCE MEMBERS
Gerry Anderson
Roxanne Anderson
Kip Beardsley
Kathy Brothen
Donna Clark
Kirk Fiereck
Rhys Fulenwider
Kelly Hansen - Parliamentarian
Doris Johnson
Nick Metcalf
Amy Moser
Anita Moss for Jerry Moss
Rosemary Thomas
COMMUNITY MEMBERS
Fred McCormick
Traci Capesius
Cherrene Horazuk
Elizabeth Burgos
Neri Díaz
José Luis García
Don Anderson
Jessie Saavedra
Becky Kroll - consultant
MDH STAFF
Ruth Dauffenbach-Kotrba
Janell Brown
Julie Hanson Pérez
Lucy Slater
Absent:
Dennis Anderson
Linda Atlas - notified
Cliff Noltee
INTRODUCTION
Introductions were made. Doris Johnson lit the candle. Rhys Fulenwider read the three goals
of community planning; Anita Moss read the ground rules. The November minutes were
reviewed and approved. The November meeting evaluation compilation was reviewed. The
announcement sheet was passed around.
CO-CHAIR ELECTION
The co-chair election is being held according to the current bylaws, under which the election
occurs in January and the two-year co-chair term begins in July and ends in June two years
later. The six months between election and the beginning of the co-chair term is a learning
period for the co-chair elect. Julie Hanson Pérez explained that under the proposed new
bylaws, future co-chair elections will be held in September, and the two-year co-chair term will
run from October to September.
Consensus: The Task Force agreed to extend the term of the co-chair to be elected today by
two months so that the term will run from July 2004 through September 2006.
Task Force Minutes, 01/16/04, page 1
Julie reviewed the eligibility criteria and responsibilities of the community co-chair. Each co-chair
nominee was asked to speak for a few minutes about why s/he wanted to be co-chair and what
s/he could bring to the Task Force as a co-chair. Nominees were Doris Johnson, Roxanne
Anderson, Cliff Noltee, and Gerry Anderson. Cliff Noltee wasn’t present. Task Force members
voted by secret ballot, and the results were tabulated by MDH staff. Congratulations to Gerry
Anderson as the new co-chair.
REPORTS
Executive Committee
Nick Metcalf reported that over the last few months, the Executive Committee reviewed what
was occurring in the Restructuring Committee, and spent most of its last meeting preparing for
this Task Force meeting. Recruitment of new members will continue.
Consensus: Because the full Task Force does not meet again until April, the Task Force
agreed that nominations for new Task Force members will be approved by the Executive
Committee during the next two months so that new members are brought on in time for the
orientation to be given in March.
Community Access Committee
“All That and a Bag of Chips” awards were handed out by Don Anderson. The Celebration of
Change will be held on February 17, 2004 from 5-7 p.m. at “Wake up Were Affected” (WUWA).
All Task Force members are invited, as well as interested community members. Please plan on
bringing a dish to pass. A sign up sheet was passed around. Please RSVP to Don Anderson at
612-521-4885.
MDH Report
Julie received a call from Walter Washington of African American Men United Against AIDS
(AAMUAA). In 2002, he came and spoke to the Task Force about the services AAMUAA could
provide to build capacity among African American MSM to participate in the community planning
process. The Task Force asked for their assistance, but soon after the agency lost the funding.
AAMUAA is currently in the process of reapplying to CDC for capacity building assistance (CBA)
funding and has asked for a memorandum of understanding from the Task Force. Under this
memorandum, AAMUAA would be responsible for an assessment of the Task Force’ s needs
and the development and delivery of an action plan for providing capacity building assistance.
The expectation is that the Task Force would work with AAMUAA in planning and developing
CBA activities that would occur in Minnesota, and would use any newly acquired skills and
information in the community planning process. The contract would be from January 2004
through March 2005.
Consensus: The Task Force agreed to sign the memorandum of understanding.
Kip Beardsley announced that Lucy Slater is leaving the Task Force as the MDH co-chair,
although she will still be working with the Task Force to some extent. Kip will be taking her
place as the co-chair. He said it is a distinct honor and privilege to work with Lucy on a day-today basis. The Task Force gave Lucy a card and plant as a thank-you gift.
EMERGING POPULATIONS
In the HIV prevention application submitted to the CDC for 2004, there was a budget line item
called “other.” Funds were allocated to this line item in keeping with Minnesota’s HIV
Task Force Minutes, 01/16/04, page 2
prevention budget management philosophy, which is that funds should be used to sustain core
activities while allowing some flexibility to respond to emerging trends and unmet needs. Thus,
annually, Minnesota divides its available funds into two categories – core activities and
response activities. The “other” line item in the FY 2004 budget request represents funding set
aside to support response activities. Specifically, the $150,247 in response funds for 2004 were
designated to develop HIV prevention interventions for the African immigrant and
Hispanic/Latino communities, which are currently experiencing emerging HIV epidemics. MDH
worked with advisory groups from the African immigrant and Latino communities to review the
results of needs assessment activities and to identify priority HIV prevention interventions.
At the previous Task Force meeting held in November, MDH staff shared the findings from
needs assessment projects in the Latino and African communities, as well as recommendations
gathered from the communities for prevention interventions. At this meeting, the Task Force is
being asked to review the spending plan developed by MDH and determine whether the
activities being proposed address the needs that were identified by the communities.
African Immigrant Communities
The STD and HIV Section of MDH will make up to $100,000 available to up to 15 African
community-based organizations to implement short-term HIV prevention community awareness
activities during 2004. Types of activities that may be implemented include health fairs, dramas,
speaker events, culturally and linguistically appropriate brochures, etc. Each agency that is
funded will be required to train staff in basic HIV information using a culturally competent AIDS
101 course currently being developed by the St. Paul Red Cross.
Latino Community
The STD and HIV Section will use the balance of the funds to make a Community Outreach
Coordinator available to the Latino community, either through contract, or through a temporary
position within the STD and HIV Section. The coordinator will be responsible for implementing
an early HIV testing campaign targeting providers serving the Latino community, and Latino
men.
The coordinator will identify health and social service professionals currently providing services
to Latino communities in the metro area and Greater Minnesota. The coordinator will develop
culturally and linguistically appropriate HIV test information packets as resources for these
providers. The coordinator will also provide training to identified providers in order to increase
their capacity to serve men who have sex with men and other high risk individuals, and to
promote HIV testing. HIV tests may also be made available to specific providers on a case by
case basis.
The coordinator will also develop simple informational brochures and posters in Spanish to
provide basic HIV information, promote HIV testing, and list local resources. The coordinator
will work with Latino community leaders to distribute these materials, and to promote HIV testing
through various outreach mechanisms, including working with existing HIV prevention
programs, holding health fairs, and making information available at points of access to the
community (churches, laundry mats, grocery stores, dance clubs, bars, libraries, etc.).
Discussion
Jessie Saavedra, an MDH employee attending the meeting as a community member during
time off, asked how the amount of funding for each community is determined. Lucy said the
final amounts are not yet determined. The amount of funding to the African communities will
depend on the number of agencies that apply and are successfully funded. MDH is committed
to funding a 1.0 full time equivalent (FTE) position for the outreach coordinator in the Latino
Task Force Minutes, 01/16/04, page 3
community, but the exact amount is not yet known. Jessie voiced his concern that the Latino
community is only receiving the leftover funding. Many others agreed. Rhys Fulenwider
suggested that the funding be divided equally between the two populations.
When asked what the surveillance data show regarding these two populations, MDH staff
responded that new infections among the Latino population have remained steady over the last
few years while they have increased significantly in the African community. It was noted that
the surveillance data do not include members of either population who may be infected but have
not been tested. The prevalence (number of living HIV/AIDS cases) is higher among Africans.
Lucy noted that the funding referred to in this spending plan is specifically for use in 2004. MDH
would like to continue the activities in 2005, but it will depend on the availability of funding and
what the Task Force prioritizes as unmet needs for next year.
Rhys voiced concern about the capacity of the Red Cross to develop a culturally competent
AIDS 101 curriculum for the African community. Lucy stated that the Red Cross is working with
an advisory group of African individuals to develop the curriculum. Rhys responded that a
similar process was used by the Red Cross to develop an AIDS curriculum for the Native
American community, but the resulting curriculum did not account for differing traditions among
numerous Indian nations. He noted that the African community in Minnesota represents many
different countries, cultures and languages. Lucy suggested changing the language to say,
“each agency will be required to train staff in basic HIV information using a culturally competent
AIDS 101 curriculum” without specifying that it be developed by the Red Cross. The Task Force
agreed.
Lucy asked for specific suggestions for changes to the spending plan. Jessie stated that people
don’t get tested in Greater Minnesota because there are no [publicly funded] testing facilities in
Greater Minnesota. Amy Moser suggested including testing as a specific activity in this
proposal. Lucy responded that there is language stating that tests may be provided to agencies
based on their capacity to do testing. Kip said that MDH would soon hire a counseling and
testing coordinator who will be responsible for looking at testing throughout Minnesota and
developing a system to provide technical support and/or funding to address the greatest need
and highest priorities. It is MDH’s hope that this effort will build the capacity of agencies serving
the Latino community to a point where they can be an ongoing part of the testing system.
Kirk Fiereck had heard that CDC is making free OraQuick tests available to agencies and asked
whether MDH would be able to assist in obtaining them. Kip thought it was a possibility, but
noted that MDH would need to identify agencies that have the capacity to implement OraQuick
testing in order to request the tests. OraQuick tests are more complicated to administer than
OraSure and require a fair amount of training. In addition, a confirmatory test is required for
positive results, which would need to be processed by a lab. Kip noted that an OraSure test can
be used as the confirmatory test, and that MDH would be willing to pay for the cost of
processing the confirmatory tests for identified agencies.
Rosemary Thomas asked whether the group was ready to arrive at consensus on the spending
plan. Roxanne Anderson wanted to make sure that people had heard Jessie’s point about the
leftover money being allocated to the Latino community. Rhys said he would like to have had
the surveillance data as background information to assist in making a decision. Julie replied that
some of the information had been provided at the last Task Force meeting, and that it would be
integrated into the spending plan to provide context. A community member commented that the
issue about the way the money is being allocated has been raised but not heard. Kip
respectfully challenged the comment, and said that MDH is committed to funding a 1.0 FTE for
this work, even if it means that MDH has to look for extra funding to ensure that it happens. Don
Task Force Minutes, 01/16/04, page 4
asked why the total available funding couldn’t be divided evenly between the two populations.
Lucy replied that although that may seem to be a fair distribution of funds, it may not actually be
equitable based on rates of HIV incidence and prevalence in the communities. MDH staff
agreed to review the surveillance data in order to determine if any changes in the allocations
should be made.
Consensus: The Task Force agreed that MDH would make the appropriate revisions to the
spending plan and bring it to the Executive Committee meeting for final review and approval
before it is submitted to CDC.
The Executive Committee Meeting will be on February 5, 2004 from 1:00 – 3:00 p.m. at the
Minnesota AIDS Project (MAP). Julie will e-mail the agenda and the revised version of the
spending plan to all Task Force members and any community members who indicate interest.
AD HOC RESTRUCTURING COMMITTEE REPORT
In June 2003, MDH had discussion with the Executive Committee and the full Task Force about
how to change the structure of the planning process. The Task Force agreed on a model and
an ad hoc Restructuring Committee was convened to work out details of the new structure. Kip
thanked everyone who participated in those meetings. He noted that MDH and the Task Force
are moving forward with this new model with the best of intentions, and will evaluate the process
as we move along.
Nick Metcalf gave an overview of the work of the Restructuring Committee, which included the
names of everyone who participated and awards for perfect attendance, the number of hours
spent on the work, and an approximate cost in dollars for the time dedicated to the committee’s
work. He also summarized the main topics of discussion. Finally, he provided his viewpoint of
the restructured planning process, including his concerns that it is exclusionary of community,
does not realize the power of community, has a professional focus, and relegates the
community to an advisory role.
Donna Clark stated that although the work of the Restructuring Committee was difficult, she was
able to develop greater trust of MDH staff and other Task Force and community members
through the process. Other Restructuring Committee members were invited to share their
perspectives. Don noted that Task Force members need to adjust and work with what we have,
and that we want to be part of the solution, not the problem. Amy stated that she appreciated
that MDH staff were honest about what could and could not be negotiated during the process.
Kip presented a diagram that describes three spheres of community input – political,
implementation of programs, and community planning. Part of the restructuring process was to
clarify that the purpose of the Task Force is specifically related to the community planning
sphere of community input. One of Kip’s top priorities with this new structure is to take the Task
Force table out to the community instead of waiting for the community to come to the table in
order to gather the information needed for the Task Force to do its work of prioritizing target
populations, identifying interventions, and developing the comprehensive plan.
Lucy reviewed a document that describes various opportunities for members of the public to
provide input to the STD and HIV Section about its HIV/STD programs. The purpose of the
document is to inform the public of opportunities that exist to provide input into community
planning, as well as the political and implementation spheres. Settings for community input
include: Community Building Community Healing, Ad Hoc Community Forums, Ad Hoc
Task Force Minutes, 01/16/04, page 5
Advisory Committees, Commissioner’s Task Force on HIV Prevention Planning, Committees of
the Task Force, RFP Community Review Committee, Established Community Groups, Materials
Review Committee, and the STD and HIV Section.
Julie presented a continuum of collaboration, developed by the Wilder Foundation. The
continuum describes three stages of intensity in collaborative relationships, growing in intensity
from cooperation to coordination to collaboration. The Restructuring Committee reviewed this
continuum and agreed that part of the struggle and tension experienced by the committee in
their discussions was due to a shift in the type of relationship that exists between the Task
Force and MDH. In the past it felt like there was more of a collaborative relationship between
the Task Force and MDH. Most committee members felt that the current relationship is closer
to coordination.
Julie then presented an overview of the restructured prevention planning cycle, which will be a
three year cycle. The first year of a planning cycle will be the major prioritization year when the
Task Force prioritizes the populations that are most at risk for HIV infection or transmission and
identifies a set of effective prevention interventions/activities for each of the target populations.
Major prioritization next occurs in 2005. The following two years in the planning cycle are gap
analysis years, when the Task Force will identify and prioritize what the unmet prevention needs
are. Every meeting in the planning cycle is structured around specific decision points. In 2004,
which would normally be the second gap analysis year, the Task Force will instead use the
meetings in April and May for developing processes, such as prioritization and gap analysis,
that will be used in future planning cycles.
Another component of the prevention planning cycle is that each year Task Force members will
be expected to either go to existing community groups or to convene ad hoc community forums
in order to gather information from the community that will feed into the planning process. This
will be done in groups of three, with the expectation that one of the members will be from the
target population that information is being gathered from and will serve as liaison to that
community. The other two members should be from another community, The purpose of doing
it this way is that it gives Task Force members the opportunity to hear first hand the needs of
other communities and builds their capacity to serve as advocates of communities other than
their own.
Under this new process, the full Task Force will meet four times a year for two full days. MDH is
hoping that as the process becomes more familiar, and according to the purpose of a particular
meeting, this can be reduced to one-day or 1.5 day meetings. Julie originally proposed that
meetings run from 8:00 a.m. to 4:00 p.m., but noted that another option would be 9:00 a.m. to
5:00 p.m. if it were more convenient. By majority vote, the Task Force decided to hold the
meetings from 9:00 a.m. – 5:00 p.m.
The full Task Force meeting dates in 2004 are:
Thursday and Friday, April 15th and16th
Thursday and Friday, May 20th and 21st
Thursday and Friday, August 5th and 6th
Thursday and Friday, September 9th and 10th
The meetings in August and September have been moved to earlier in the month to allow
sufficient time for the Task Force to review and provide feedback on the plan and application,
and to conduct the concurrence process prior to the due date of the application to CDC.
Task Force Minutes, 01/16/04, page 6
There will also be an orientation with more in-depth information about the restructured planning
process for all Task Force members and interested members of the community on Thursday,
March 18, 2004 from 12:00 – 4:00 p.m. (location to be determined). The date has been
changed from March 19th because the Empowering Heroes Conference may be scheduled for
that day. Because we’d like any potential new Task Force members to attend the orientation,
people who are interested in membership should have their applications to MDH before the end
of February. This will allow Community Access members time to set up interviews and forward
nominations to the Executive Committee for approval at their March 4th meeting.
Discussion
Julie asked for comments or questions about the restructured process. Rhys noted that the
Task Force appears to be moving in a different direction, and feels that it has stepped back
instead of moving forward. He knows that this process is based on trust and acknowledged that
he is not sure if he can trust. Others voiced similar concerns about how the new process feels.
Lucy added that MDH is in the process of developing a process to evaluate the restructured
process and is open to hearing suggestions for evaluation questions from the Task Force.
Three suggestions were given:
- To what extent are people impacted by HIV included (or excluded) from the planning
process?
- Is there a change in the way that the community views the Task Force?
- To what extent do the other avenues for community input into MDH’s HIV/STD programs get
utilized?
For a copy of any of the handouts presented during this discussion, contact Janell Brown at
612.676.5572 or by e-mail at [email protected]
PROPOSED BYLAW CHANGES
Task Force and community members received a copy of the proposed bylaw changes. Julie
explained that the changes are being distributed and briefly discussed at this meeting. There
will be more discussion at the April meeting, at which time the Task Force will be asked to
approve the revised bylaws. There was a multi-step process for developing the proposed
changes to the bylaws. Lucy, Julie and Nick originally met and developed some suggestions for
the bylaw changes based on the restructured process. Those suggestions were then taken to
an ad hoc Bylaws Committee, which consisted of the co-chairs, past and present
parliamentarians (Kelly Hansen, Amy Moser, and Kevin Sitter), and Julie. The Bylaws
Committee had discussion and made additional changes, which were then taken to the
Restructuring Committee for further discussion and changes.
Julie briefly highlighted some of the major changes:
Roles and responsibilities of the Task Force, MDH, and joint responsibilities have been
updated to reflect the new CDC community planning guidance.
Task Force members will be able to serve up to 3 consecutive two-year terms. Current
members can choose to serve a third term.
New Task Force members will be brought on once a year in November. Current
members’ terms will be adjusted so that they end in a November.
Task Force members will be required to serve on a committee only one year of each
two-year term.
Task Force Minutes, 01/16/04, page 7
There will be an Executive Team, made up of community co-chairs, the MDH co-chair,
and MDH staff, that will meet on an as needed basis to strategize the overall planning
process.
The Community Access Committee will now be called the Membership and Training
Committee. Its focus will be on membership recruitment, retention, and orientation and
training.
The Executive Committee will now be called the Process and Procedures Committee.
Its focus will be to review and refine processes and materials used by the Task Force in
its decision making, and assign roles and responsibilities for each Task Force meeting.
Task Force members are required to attend 75% of Task Force meetings, and 75% of
their committee meetings in the year they’re on a committee. Because of the decision
making structure of each Task Force meeting, members are asked to either attend an
entire meeting or not attend at all.
The process that had been agreed upon was that if the Bylaws and Restructuring Committees
were able to come to consensus regarding changes, the Task Force would be encouraged to
accept them. Any changes that did not achieve consensus within the committees would be
taken to the full Task Force for further discussion. The only item that did not achieve consensus
was related to the role of the Task Force in sexually transmitted disease (STD) prevention
planning.
This was an issue that was presented to the Task Force by MDH about nine months ago, but
there was no agreement at the time and it was tabled. However, it has come to the forefront
again because of the bylaw changes. MDH is asking that the Task Force formally acknowledge
that its work is focused on planning for HIV prevention. Realistically, the Task Force does not
have the time or resources to engage in a separate planning process to identify STD risk
populations and STD interventions. However, the name of the planning body and the wording in
the bylaws implies that the Task Force does conduct STD prevention planning. MDH is
proposing that “STD” be deleted from the name of the group and the wording of the bylaws in
order to accurately reflect the work of the body.
Kip noted that MDH’s HIV and STD programs are fundamentally different. The federal funding
received for STD prevention is used to fund clinics that reach adolescents and young adults to
provide chlamydia and gonrrhea testing and treatment.
Lucy stated that the last STD prevention planning activities occurred several years ago, and
were conducted through an ad hoc STD Committee of the Task Force. Other community
experts were also invited to participate. Any future STD planning activities would occur in a
similar fashion. An ad hoc committee would be established by MDH, and community members,
including Task Force members, would be invited to participate. Lucy added that MDH would
continue to provide information about STDs to the Task Force to assist them in planning for HIV
prevention activities.
Discussion
Rhys noted that although the Task Force doesn’t actually do STD planning, STDs are very
closely related to HIV; and in fact, HIV is an STD. He thought that the name of the group and
the bylaws should remain the same. Doris and Don agreed. Kirk asked whether it would be
more appropriate to use the term sexually transmitted infections (STIs) instead of STDs. Nick
thought the Task Force should serve in an advisory role as opposed to a planning role in
relation to STDs. Gerry suggested establishing a separate STD Task Force. Julie replied that
Minnesota receives very little funding for STD prevention. MDH wouldn’t be able to support an
ongoing task force for STD planning.
Task Force Minutes, 01/16/04, page 8
Consensus: The Task Force agreed with the following proposal made by Amy Moser: 1) STD
will remain in the name of the group; 2) In the Bylaws under Roles and Responsibilities of the
Task Force, there will be a specific section added to describe its role in relationship to STD
planning; 3) In the Charge there will be a statement saying the primary focus of the Task Force
is HIV prevention planning, but that the Task Force has specific responsibilities related to STD
prevention which are outlined further in the document; and 4) Throughout the document,
references to “HIV/STD” will be changed to read “HIV.”
Julie addressed one further change that was a result of the restructuring process and will be
noted in the bylaws. The Youth Council will now be focused on providing technical assistance to
youth-serving agencies. They will no longer be involved in community planning and will not
have two seats on the Task Force. However, the Restructuring Committee felt very strongly
that there needs to be an emphasis on recruiting youth to be members of the Task Force and
providing mentorship as needed. The Restructuring Committee also recommended expanding
the definition of youth to include young adults up to the age of 24 who may be able to attend
more meetings. There was some concern voiced about eliminating the Youth Council seats.
Julie pointed out that the Task Force has never done a good job of accommodating youth into
the process, and that the new process will be even less accommodating. Kip added that the
two Youth Council seats were revolving so there was no consistent attendance. He felt it would
be more effective to have one young person who is a member and is really able to become
involved and learn the process.
Julie asked that any comments, concerns, or suggestions for changes to the bylaws be
forwarded to her by February 1st. If suggested changes are minor, she will go ahead and make
them. If there are any major changes suggested, she will bring the Bylaws Committee together
to discuss them. Task Force members will receive another copy of the proposed bylaw
changes in advance of the April meeting when they’ll be asked to approve them.
ANNOUCEMENTS
Nick Metcalf – There is a weekend seminar for HIV positive gay and bisexual men at the
Program in Human Sexuality, 1300 S. 2nd St., Suite 180, Minneapolis on Saturday, February
21 and Sunday, February 22, 2004. Call 612-625-9551 or 612-625-9547 with questions and
to register.
Don Anderson – A community forum called "Celebrating Your Spirit: HIV, Dating, and
Relationships" will be held on February 12, 2004 from 6:00 – 8:30 p.m. at Park House. Call
651-634-2280 to register.
Amy Moser – Empowering Heroes Conference will be held in March. Stay tuned for dates or
call Redwan Hamza for information at 651-582-1974. The Hennepin County Community
Health Department is hosting a cultural competency training series; participants must
commit to all five sessions. Task Force members are welcome to attend. E-mail Amy for a
registration form at [email protected].
Task Force Minutes, 01/16/04, page 9