On May 22, 2014 the Broward County HIV Health Planning Council (HIVPC) voted to revise their bylaws and changed the structure for planning HIV services in Broward. Before that vote, Ryan White Care (RWC) Part A and B grantees co-chaired the committees that planned local HIV services. RWC Part A funds medical services. RWC Part B funds non-medical services and two important programs: the AIDS Insurance Continuation Program (AICP) and the AIDS Drug Assistance Program (ADAP). RWC Parts A and B grantees appeared to have co-equal status.
Leonard Jones, of the Ryan White Care Part A Program Office, summarized that revision in an e-mail: “The Broward County HIV Health Services Planning Council’s (HIVPC) revised the bylaws definition to remove the word ‘Joint’ inclusive of only South Florida AIDS Network Members, and replace it with ‘Community Stakeholders’ allowing for diverse representation from Ryan White Part B, C, D, or F, Prevention, and representatives of HIV/AIDS care in the community.” According to Leonard Jones, this change had the goal of increasing participation. The Chair of the HIVPC then sent a letter to all the Part B co-chairs encouraging them to continue on the committees, but not as co-chairs. RWC Part B grantees no longer appeared to have co-equal status.
Leonard Jones reported that this change has no policy implications. He referred to letters from the Centers for Disease Control (CDC) and Health Resources and Service Administration (HRSA). Those letters stated their expectations for collaboration and a comprehensive (both treatment and prevention) local plan. According to Leonard Jones, the HIVPC “is developing an integrated response to meet the requirements set by the CDC and HRSA.”
According to Joey Wynn, Chair of South Florida AIDS Network (SFAN), the RWC Part B planning and networking body, “We had a final joint meeting urging them NOT to remove the word ‘joint’ from the by-laws, as it would set off a chain of events that would further fragment our planning and service delivery system.”
Joey explained that co-chairing the committees met the requirements of RWC Part B’s grant. Changes to this arrangement would place RWC Part B grantees in violation of those requirements. The grantees would then have to spend a great deal of time, on relatively short notice, designing and setting up a new structure to bring their programs back into compliance, while running HIV service delivery programs. The resulting time constraints would prevent many, but not all, RWC Part B grantees from continued service on the committees.
All change involves disruption. Fortunately, this disruption occurs at the administrative level rather than the service delivery level, but resources spent at the administrative level are resources not spent at the service delivery level. We will have to watch events to see how this plays out.