Frequently Asked Questions
- What is the HIV Health Services Planning Council?
The San Francisco HIV Health Services Planning Council is a community planning group that oversees the prioritization and allocation of Ryan White CARE Act Title I and II funds. It is also called the CARE Council or Ryan White Council.
- What does the Council do?
The Council has several major duties, including:
- determining the needs of people living with HIV/AIDS, especially those not in care;
- setting priorities for the allocation of funds;
- developing a comprehensive plan for the organization and delivery of health services; and
- assessing the efficiency of the grant administration and the effectiveness of services.
The Council is also responsible for ensuring that services are coordinated with prevention and substance abuse treatment. The Council has a mandate to focus on people who are not in care (i.e. not receiving medical care) by assessing their needs and developing programs to bring them into care. The Council takes on additional projects as needed or required.
- When and where does it meet?
The full Council meets on the fourth Monday of every month in Milton Marks Conference Center, The State Building, 455 Golden Gate Avenue, Lower Level, San Diego Rooms B&C, from 4:30 to 7:30pm. It may schedule additional meetings as needed. Each committee usually meets once a month. The standing committees are Community Outreach & Advocacy Committee, Policy and Evaluation Committee, Membership Committee, Planning Committee, and Steering Committee. The Council creates ad hoc work groups to address short-term projects. Meeting dates and times are subject to change. For current meeting information, please visit our calendar.
- How does one find out about Council meeting times and agendas?
The Planning Council has a website, www.sfcarecouncil.org, which includes upcoming Council meeting times and agendas, committee meeting times, agendas, and locations, and minutes from full Council and committee meetings. It links to documents such as the Three Year Comprehensive Plan and other useful Council information. Planning Council meeting times and agendas are also posted to the Council’s Yahoo Group email list.
- How does one contact Council members or staff?
The Planning Council's Administrative Office can be reached by phone at 415.674.4768 or by mail to 730 Polk Street, 3rd Floor, San Francisco, CA 94109. The fax number is 415.674.0371. Council members and co-chairs can be reached through the Administrative Office.
- Who is on the Council?
There are forty seats on the Council. The federal legislation prescribes a number of areas of representation such as people living with HIV, community-based organizations, housing providers, and medical providers. It also specifies that organizations funded under other parts of the CARE Act, such as Title III and Title IV, and other federal programs, such as HOPWA, be represented. The membership must reflect the demographics of the epidemic in the EMA. The members of the Council represent the broad range of people involved in the fight against AIDS in San Francisco, San Mateo, and Marin counties.
- Are people with HIV/AIDS on the Council?
The legislation mandates that at least 33% of Council members be unaffiliated consumers of CARE services and that they reflect the demographics of the epidemic. The Council has also decided that a majority of Council members should be people living with HIV/AIDS. In addition, at least one Council co-chair must be a person living with HIV.
- How does one join the Council?
Membership application forms are available from Council staff and on the Council web site. The Membership Committee reviews applications and interviews potential applicants on an on-going basis. The Membership Committee selects nominees and forwards names to the full Council. The Council votes on the applicants, and the names are forwarded to the Mayor for appointment. The Membership Committee strongly recommends that persons thinking about applying to the Council attend several Council or committee meetings first. Attendance at a full Planning Council meeting is required to be considered for an interview.
- Who appoints the members?
All members are appointed by the Chief Elected Official (CEO) of the EMA, in accordance with the legislation. The CEO is the Mayor of San Francisco.
- What is the term of office?
Council members are appointed for a two-year term. Members can re-apply for additional two-year terms, as long as they are members in good standing with the Council. Council members must meet the meeting attendance requirements to stay in good standing.
- Can one participate without becoming a member?
As per the Brown Act and the Sunshine Ordinance, all Council meetings and committee meetings are open to the public. Public comment is taken at the beginning of each full Council meeting and during the meeting on each agenda item. Members of the public are often able to participate in the discussions at committee and work group meetings. The Council also holds community forums throughout the year to gather input from specific communities or neighborhoods.
- How long has the Council been meeting?
The Council was first created in 1990 and continues to meet on a regular basis.
- What area does it cover?
The Council covers the San Francisco Eligible Metropolitan Area or EMA, which includes San Francisco, San Mateo, and Marin Counties. The money is allocated between the three counties based on the proportion of living AIDS cases in each county. San Mateo and Marin have local planning groups that help set priorities and determine allocations within each county.
- What is the Ryan White CARE Act?
The Ryan White CARE Act is federal legislation originally passed in 1990 and reauthorized in 1995, 2000 and 2006. It authorizes spending federal dollars for HIV health services through five different titles or parts. It was envisioned as a disaster relief bill to help cities and states overwhelmed by the costs of caring for people with HIV/AIDS. It helps support a comprehensive continuum of HIV health services for low-income people living with HIV. The current CARE Act will expire in FY 2010. Congress and Community Organizations are already working on the new version of the CARE Act.
- What is Title I?
Title I funds go directly to the urban areas hardest hit by HIV/AIDS. There are now 55 cities receiving Title I funds. San Francisco, Oakland, San Jose, Santa Rosa, and Sacramento are the Bay Area Title I cities. The funds are for emergency HIV health services as described in the legislation. Title I requires a community planning process to prioritize and allocate the funds.
- What is Title II?
Title II funds go to the states. Title II covers the AIDS Drug Assistance Program, which provides medications to low income people with HIV/AIDS. A small amount of Title II funds are also distributed to each county in California by the State Office of AIDS.
- What are the other titles?
The other titles fund other types of programs and the money goes directly to community-based organizations and medical facilities. Title III funds early intervention services and community health clinics. Title IV is for services for women, families, children, and youth. Title V or Part F covers dental services at dental schools, the AIDS Education and Training Centers, and Special Projects of National Significance. San Francisco has programs funded through each of these titles.
- Who administers the programs?
The Health Resources and Services Administration (HRSA) administers the programs on the federal level. They are a part of Health and Human Services (HHS). On the local level the HIV Health Services section of the Department of Public Health (DPH) administers the funds. DPH is the grantee for Title I and II funds.
- How much money does San Francisco get?
For fiscal year (FY) 2005-2006, the San Francisco EMA was awarded $28,297,777 in Title I and $1,384,088 in Title II. Since 1991 San Francisco has received over $460 million for services for people living with HIV/AIDS.
- What determines how much money San Francisco gets?
Congress appropriates the funding for the Ryan White CARE Act services each year. Two-thirds of the money for Title I is distributed through a formula developed by the CDC to estimate the number of people living with HIV/AIDS. The one-third is allocated through a competitive grant proposal process, often called the supplemental process. The legislation was changed in 2000 to reduce San Francisco's share of the formula. It will decrease by 3% every year until FY 2004, when it will decrease by either 2% or 4%, depending on the status of HIV reporting. There are further formula reductions in the reauthorized Ryan White CARE Act that passed Congress in 2006.
- What is it used for?
CARE funds pay for primary medical care, dental care, home health care, complementary care, housing, food, substance abuse treatment, mental health care, case management, peer advocacy, treatment advocacy, legal assistance, benefits counseling, money management, transportation, respite child care, adult day health care, outreach, and adherence support. It also pays for Planning Council staff and activities such as needs assessment, evaluation, and comprehensive planning. The funds are distributed to community-based organizations, public health programs, community health clinics, and hospitals.
Overall, 33% of funds go to health care services, 9% to mental health, 13% to substance abuse services, 19% to housing, four percent to food, four percent to case management, and the rest to the other services. Under the new legislation, the Planning Council must allocate at least 75% of the funds to “Core” Medical Services. Eleven percent of funds are directed to San Mateo and Marin Counties for services for their residents. Up to ten-percent of the funding goes to the Department of Public Health to administer the grant, including contract development and monitoring, Planning Council Support and a small portion of the funding is set aside for quality management programs.
- Are there things that the funds can't be used for?
Yes. The Federal government has a number of restrictions on funding. The money cannot be spent on capital improvements or construction. It cannot pay for permanent housing services. It must be used as the payor of last resort, meaning that if a service can be paid for somewhere else, such as billed to Medi-Cal, it cannot be paid for by CARE. Money also cannot be given directly to consumers. The ability to use funds for counseling and testing or prevention services is limited. As with all federal funds, CARE cannot be used for needle exchange.
- Who can get services?
CARE services are for people living with HIV/AIDS who are low income and uninsured or underinsured. Some services are also available to the family members of people living with HIV/AIDS. Programs or agencies may have additional eligibility criteria, such as disability. Clients also must be a resident of the county where the service is located to receive CARE-funded services. CARE services are prioritized for those with the most severe needs, such as those who are homeless or who have multiple diagnoses.
- Where are CARE services available?
CARE services are available at several locations throughout the city and county of San Francisco and in Marin and San Mateo Counties. For a full inventory of CARE services in the EMA, visit our Supporting Documents page on our website and click on: Inventory of HIV Service Agencies and Resources.
- Who does CARE serve?
Over 10,000 people received CARE-funded services in the EMA in 2005. Compared to the demographics of all people living with HIV/AIDS, CARE clients are disproportionately poor, people of color, and women. Most clients are enrolled in the Reggie system, providing additional demographic information. Of those for whom we have demographic information:
- The majority of CARE clients are people of color, including 22% African American, 15% Latino, 8% multi-ethnic, 4% API, and 1.4% Native American. Most are men, with 12% women and 3% transgender.
- Nearly 70% of all Reggie clients are within 0 to 150% of the 2004 Federal Poverty Level. Further, 66.5% of those meeting the Federal Poverty Level Criteria have a disabling AIDS or Disabling HIV+ status.
- One third are homeless or in unstable housing such as a shelter, a treatment program, or staying with friends.
- 27% have no health insurance and half are on public insurance such as Medi-Cal.
- Nearly 60% are men having sex with men (MSM), 27% report injection drug use (IDU) as their HIV exposure risk, 12% report both MSM and IDU, and 2% identified other sexual contact as their exposure risk.
- What else do we know about CARE clients?
- More clients access CARE-funded medical care than any other service.
- Very few PLWH in the system of care do not have access to medical care, with only 2% reporting no source of care.
- About 13% of current clients entered the system of care last year.
- Nearly 50% of Reggie clients meet at least two of the criteria for “Severe Need.”
- What is Reggie?
Reggie is the centralized client intake and registration system. It helps clients register for services throughout the system of care. Once a client is registered, they can access services at any of the other agencies in the system without repeating the intake process. Reggie is also a client-level data system, providing information about client demographics, health status, service use, and needs. Client level data is required by HRSA as a condition of funding with several different reports. Reggie incorporates extensive client confidentiality protections. Reggie data is also useful for planning and needs assessment activities.
