Introduction & Mission

Maine HIV Prevention Plan

Spring 2000 Update

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HIV Community Planning Group
Medical Care Development, Inc.
11 Parkwood Drive
Augusta, Maine 04330
Tel: (207) 622-7566, ext. 233
TTY: (207) 622-1209
Fax: (207) 622-3616
Email:

ME HIV CPG  - Community Plan

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Chapter 2: Structure and Function of Maine's CPG

Maine's single statewide group meets on a monthly basis from 9:30 am until 4:00 pm. The CPG's structure and function are best described by it's Bylaws, which were revised during the past year after being adopted in February, 1999.  The following operational overview comes directly from the Bylaws, which are included as Appendix 1 of this document.

  •   The Community Planning Group shall consist of no less than eighteen (18) members and no more than thirty (30) members.  A vacancy shall not prevent the CPG from conducting business.

  • A one year term begins from the date of the first meeting attended.  Members may serve a maximum of five consecutive one year terms.

  •  Members may resign by sending a letter of resignation to the Co-Chairs.  In addition, the CPG may remove a member when he or she misses, except when due to illness, three (3) consecutive unexcused meetings OR four (4) meetings during a membership year.  A termination letter will be sent to the absent member by the Co-Chairs.

  • Membership applications are reviewed by the Membership Committee; references are contacted; population balanced gaps are assessed; and recommendations are presented to the members at the next monthly meeting.  Selection of new members to fill vacancies is made by consensus.

  •  A leave of absence is not available.

  • Meetings shall be held at such times and such places as the Co-Chairs shall from time to time determine.  All meetings shall be called by the Co-Chairs or upon written request of one third of the CPG. Fifty-one percent of members at any time shall constitute a quorum for the transaction of business and action by the majority of these present at any meeting at which a quorum is present shall be the action of the CPG.

Membership Committee:

  • The Membership Committee shall consist of not less than four members of the CPG.  In accordance with current membership policy and practices, the Membership Committee shall prepare a list of proposed officers and members to fill the vacancies for the coming year which list shall be delivered to the Project Coordinator for a mailing to each member with the notice of the Annual Meeting.  The Membership Committee shall submit to the CPG names of individuals to fill vacancies on the CPG or Officers as they occur between annual meetings.

A significant factor in the functional structure of Maine's HIV Prevention Community Planning Process is the employment of a Project Coordinator who answers directly to the two co-chairs and performs multiple functions, a partial list of which follows.  The Project Coordinator shall:

  • be responsible for the administration of the programs in accordance with the policies and regulations of the CPG. 

  • prepare for consideration by the CPG an operating budget, subject to final approval by the CPG. 

  • hold the minutes of all proceedings of the organization and such other books and records as may be required for the proper conduct of it's business and affairs.

  • facilitate the process of community based prevention planning with the Co-Chairs.

  • provide support to the CPG and its Co-Chairs.

  • organize, manage and produce the final annual Comprehensive HIV Prevention Plan based on the conclusions of the CPG.

  • network with members, and the community at large, and maintain contact with the Bureau of Health.

2.1       Procedures for Conducting Business

The procedures for conducting CPG business are clearly outlined in the Bylaws (see Appendix 1).  Some highlights are summarized here.

CPG  meetings are facilitated by the Co-chairs and/or their designee. The agenda is established by the Co-chairs and staff, and is reviewed and amended as necessary by the full membership of the CPG at the beginning of each meeting.  The full membership helps to establish the overall agenda and time line for the year.  Details are added to the agenda to fulfil the overall agenda and time requirements.

There has been one full  CPG meeting each month to date in 1998-1999.  There have also been numerous sub-committee meetings, conducted as necessary in between full CPG meetings.

The ad-hoc Bylaws Committee completed it's work in February with adoption of the Revised Bylaws.  The Membership and Executive committees met outside of usual meeting time as needed to address the issues appropriate to the tasks assigned

Ground rules are posted and reviewed at the beginning of every full CPG meeting.   In addition, travel reimbursement/stipends for participation are available and utilized.

The Modified Consensus Decision Making Process, used during all CPG meetings, can be found in the Bylaws under Article IV: "Meetings of the Organization, Number 9, Decision-making Process," shown below:

a. The group decides the time allotted to the process.        
b. The proposal is presented by a designated member.
c. Questions are asked for clarification or for additional information.
d. Members declare conflicts of interest as they relate to the proposal at hand.
e. Discussion commences and may include but is not limited to thoughts, experiences, ideas, feedback without repetition, suggestions for change, additional information, feelings, etc.
f. End discussion after agreed upon length of time.
g. Assess group's position on proposal; i.e. a unified response is needed.
h. Accept proposal as is.
i. Accept proposal with minor changes previously discussed.
j. Accept proposal with significant changes previously discussed.
k. Reject proposal entirely, even with modifications, with group deciding whether to revisit the issue, how, when for how long.
l. In the event of a split, the following options may be exercised:

i) Decide to take more time.
ii) A small group of people with differing views may meet to generate alternative solutions to take back to the whole group.
iii) Go to fall-back position, return to the status quo.
iv) Make decision by simple majority vote (1/2 plus 1)
v)  In the event of a vote, there shall be one vote only cast by any and all Bureau of Health staff members and that vote shall be made by the Public Health Co-Chair.

m. Not ready to decide by end of time allotted

i) Group may decide whether to take more time and how much more time.
ii) Go to fall-back position, return to status quo.
iii) There shall be written documentation of Minority positions.
iv) Minutes for all meetings shall include discussion of any minority positions taken.

The statement pertaining to conflict of interest, found above in the Decision-Making Process, is expanded in the Bylaws under Article XIII: Conflict of Interest, which reads:

A CPG member shall refrain from voting on matters on which he or she has conflict of interest, but to the extent permitted by law, no contract or other transaction which the  organization may enter shall be affected by the presence of a conflict of interest on the part of a member.

If a decision is to be made which may directly affect a member's personal, financial, or organizational interests, then a potential conflict, or appearance of potential conflict of interest exists or may be perceived to exist.  In such cases:

  1. The individual member must clearly declare early in any discussion that a potential conflict of interest exists or may be perceived to exist.

  2. Other members may raise the question of conflict of interest or perceived conflict of interest of another member for discussion.

  3.  Members may voluntarily recuse themselves from voting/or discussion on issues in which a potential conflict of interest exists or may be perceived to exist.  The decision to abstain, if unresolved by membership discussion, will be determined by a joint decision made by the Co-Chairs in unison.

2.2       Collaboration With Other Organizations

The Community Planning Group continues to become more respected by, and integrated into, the statewide community of HIV/AIDS stakeholders.  Some examples of this integration include the following:

  • A collaboration among AIDS Service Providers; other Community Based Organizations providing prevention efforts, American Red Cross Chapters, Rural Health Providers; the Bureau of Health and the Department of Human Services; the Maine Community AIDS Partnership; and case managers to conduct a state wide, multi-dimensional HIV/AIDS Needs Assessment process initiated by the Community Planning Group (see Chapter 6).

  • The HIV Advisory Committee has voted to invite members of the CPG to be participants of that committee's education and prevention subcommittee.  One CPG member is currently on the Advisory Committee.

  • Additionally, the HIV Advisory Committee has requested that the CPG present all systemic recommendations for their immediate consideration for action.

  • CPG members are invited to attend statewide informational sessions and conferences with other prevention workers.

  • CPG members provide education concerning legislative issues when appropriate, including testimony before state legislative sub-committees.

  • Staff from all AIDS Service Organizations have an increased understanding of the role of the CPG in Maine through a variety of interactions including presentations at conferences and workshops.

Major players in collaborative relationships with the CPG are identified below:

Maine AIDS Alliance (MAA)

The Maine AIDS Alliance is an umbrella organization which represents AIDS Service Organizations (ASOs).  ASO members participate in a variety of ways offering input into the process, and the Alliance provides leadership and a unified voice in return

Maine Community AIDS Partnership (MCAP)

In August of 1993, in response to a growing "grass-roots" interest in addressing the issue of AIDS in Maine, the United Way of Greater Portland spearheaded a successful campaign to secure a grant from the National Community AIDS Partnership establishing MCAP "...with the goal of increasing the statewide capacity to meet demonstrated AIDS/HIV needs."  MCAP is primarily concerned with raising funds and distributing monies through an annual grant process to address HIV/AIDS needs in Maine.

Maine HIV Advisory Committee (HIV AC)

In response to the increasing presence of HIV/AIDS within the State of Maine, the State Legislature, in 1987, established by statute the Committee to Advise the Department of Human Services on AIDS.  The Committee, initially numbering some 30 individuals, was to provide guidance and support to the public health initiatives of the Maine Department of Human Services (DHS) in its efforts to reduce morbidity and mortality associated with HIV in Maine.  For the past two years, a CPG member has sat on the Committee.  Further, this past year the legislature voted to reorganize the structure of the Committee to have more member representation from communities at risk.

Maine HIV/STD Program

The Maine HIV/STD Program is located within the Division of Disease Control, Maine Bureau of Health, and serves as the lead agency for the state's public health response to HIV/AIDS in Maine.  As the lead agency, the HIV/STD Program is charged with the development and implementation of public health strategies consistent with both the National Year 2000 and Healthy Maine 2000 Objectives.  The program also serves as the state liaison with the federal government through a cooperative agreement with the Centers for Disease Control and Prevention.  The CPG Public Health Co-Chair is appointed by the Director of the HIV/STD Program.

Audit, Licensing and Contracting Service Center (Ryan White Monies)

The Audit, Licensing and Contracting Service Center is jointly organized under both the Department of Human Services and the Department of Mental Health, Mental Retardation and Substance Abuse Services in the State of Maine bureaucracy.  This agency collaborated with the CPG in the development of the Statewide CPG Needs Assessment, and works closely with the HIV/STD Program, particularly in relation to the AIDS Drug Assistance Program.

Maine HIV Prevention Community Planning Group (CPG)

 As mandated by the Centers for Disease Control and Prevention, in 1994 Maine established an organization with members which reflects in its composition the characteristics of the current and projected epidemic in its jurisdiction as well as behavioral scientists, HIV Prevention Specialists, and representatives from public health. The CPG, based on data, experience and literature, prioritize both populations in need of prevention efforts and interventions appropriate for Maine and its communities.  Details of the CPG's process and products are evident throughout this document.

Pine Tree and Portland Chapters of the American Red Cross

The above two chapters of the Red Cross are significantly involved in HIV Prevention efforts.  The Portland Chapter employs the Statewide HIV Prevention Network Coordinator for Red Cross efforts who performs several important HIV Prevention functions including education in schools, publication of a statewide prevention events calendar and provision of administrative staffing to the HIV Advisory Committee.

The Pine Tree Chapter has performed prevention outreach to Hispanic and Native North American migrant workers in three counties under a grant from the Maine Community AIDS Partnership.  This program also collaborates with rural health centers, and provides training to other Red Cross Chapters within the State of Maine. 

The following table summarizes the agencies identified above and their current roles in relation to the CPG.

Collaboration/Relationships with other HIV Organizations

AGENCY 

GENERAL MISSION

RELATIONSHIP TO CPG

Maine AIDS Alliance (MAA)

Advocacy for HIV/AIDS issues and AIDS service organizations; includes 16 member organizations.

Provides a link between CPG and Maine AIDS service organizations.

Maine Community AIDS Partnership (MCAP)

Raises and administers private funds.

No direct
relationship.  Funded projects are included in CPG's resource inventory. 

Maine HIV Advisory Committee (HIV AC)

Advises the state government on HIV issues.  Members appointed by the Governor.

CPG supplies priority interventions regarding systemic change to HIV AC.  Some overlap in membership.

One CPG member sits on the HIV AC.

 

Maine HIV/STD Program

Protects public health; reduce HIV morbidity and associated mortality.

Supplies public health Co-Chair, administers funds, supplies epidemiological surveillance and data.

Audit, Contracting and Licensing Service Center

Administers Ryan White Funds, oversee case management and drug reimbursement.

Has entered into a collaborative Needs Assessment Process with the CPG and others.

Maine HIV Prevention Community Planning Group (CPG)

Prioritization of populations and interventions.  Advises HIV/STD Program.

Self.

American Red Cross - Pine Tree and Portland Chapters

Provides HIV Prevention Outreach and Education.

Supplies a member, publishes events, will collaborate in needs assessment, provide data and training.

 

A complete list of Maine organizations engaged in HIV prevention, testing and care can be found at the end of this document in Appendix 2.

2.3       Profile of Maine Community Planning Group

The following sub-sections include an analysis of current CPG membership, profiles the two Co-Chairs, discusses how community input is ensured, and describes the orientation process for new members.  Finally, the CPG's procedures for conducting business are delineated.

2.3.1   Membership Analysis

Bylaws limit CPG membership to a minimum of 18 and a maximum of 30 members.  Currently, there are 21 CPG members.  Over the years, an enormous effort has been made to insure the parity, inclusion and representation of at-risk Maine communities in the HIV prevention community planning process.  Current CPG membership is profiled below.

Analysis of current membership

  • 19 Community Members 

  • 2 Bureau of Health Members

  • 4 Members from Bureau of Health HIV/STD Program funded projects Distribution of Members by Gender:

  • 11 Females

  • 10 Males

Distribution of Members by Geographic Location:

  • 7 Southern Maine (Cumberland and York Counties)

  • 12 Central Maine (Androscoggin, Franklin, Kennebec, Knox, Lincoln, Oxford, Sagadahoc, Somerset and Waldo Counties)

  • 2 Northern Maine (Aroostook, Hancock, Penobscot, Piscataquis and Washington Counties)

Individuals who are members of Prioritized Populations:

(As is indicated on the list below, some individuals represent prioritized populations, but are not themselves members of that population)

  • 7 Males who have Sex with Males

  • 3 Women at Risk (2 non-population representatives)

  • 3 Injecting Drug Users

  • 4 People of Color At Risk (3 African Americans, 1 Hispanic)

  • 2 Youth At Risk (1 non-population representative)

  • 4 Other At Risk Populations with Special Needs (2 non-population representatives)

  • 1 HIV+ self-identified individual (who is also a member of the population Males Who Have Sex with Males)

Other related fields represented:

  • Behavioral science

  • Substance abuse

  • 4 Professionals in the field of HIV Prevention/Treatment (not counting BOH professionals)

Despite Maine's challenging geography and population distribution, efforts to include diverse community representation have been successful.  However, some community representatives are currently being sought.  A continuing challenge is finding and accommodating representation from the extreme northern part of the state; currently, no CPG members reside north of Bangor.  Our overall representation is outlined below:

Well Represented

  • Social science          

  • Epidemiology

  • Public health

  • Representatives from southern Maine

  • Women at increased risk

  • Injection drug users

  • African Americans

  • AIDS service organizations

Additional Representation Being Sought

  • Males who have sex with males from geographically diverse locations

  • Self-identified Gay Male Youth Age 24 or Under

  • Hispanic Americans

  • HIV+ females

  • American Indians

  • Representation from western Maine and rural northern Maine

  • Persons with influence in governmental organizations

2.3.3   Co-Chair Profiles

Each year at it's annual meeting held in October, the full membership of the CPG elects a new Community Co-Chair who shares leadership with the appointed Bureau of Health Co-Chair.

The current Community Co-Chair is Gloria Leach, R.N.C., a veteran health care professional who is liked and respected by all for her "no-nonsense" leadership, warmth and experience.  Gloria is certified in Human Sexuality and Adolescent Health.  She is currently the Community Educator at the AIDS Project, Portland, and has past experience with women who are substance users, incarcerated women and disaffected adolescents.

In 1998 we said good-bye to Sally-Lou Patterson as the Bureau of Health Co-Chair.  It was a loss for the CPG as she had been at the helm for three years.  She was replaced by Mark Griswold, the current HIV/AIDS epidemiologist at the Bureau of Health.  Mark is a former HIV prevention educator who worked with males who have sex with males and was an anonymous HIV antibody test counselor.  He also has a graduate degree in public health.

2.4       Ensuring Community Input

The Maine HIV Prevention Community Planning Group relies heavily upon its members to speak for their particular communities.  Ongoing communication and feedback is encouraged throughout the year between CPG members and the communities they represent.  Additionally, communities or segments of communities not represented through membership provide input in a variety of ways: 

  • All CPG meetings are open to interested persons.

  • Each agenda includes a public comment time, usually at the end of the day's activities.

  • Past CPG focus group participants have requested applications for membership and become members, have developed information exchange systems, and continue relationships with the CPG.

  • The meetings of the multi-purpose, statewide HIV needs assessment process has resulted in input from many locations and has involved a great deal of community input.

2.5       Orientation of New Members

Three orientation sessions were completed this year, each tailored to the specific needs of the newest members; all included the following elements:

  • a review of the history of the CPG

  • overview of the CPG goals and core objectives

  • overview of prioritized populations and interventions

  • overview of current HIV/AIDS epidemiology for Maine and the United States. 

Each member was provided with a CPG member binder which includes: a copy of the most recent prevention plan; basic HIV/AIDS information; HIV/AIDS resources in Maine;  Bylaws, policies and guidelines of the CPG; minutes of previous meetings; a CPG members list; forms for evaluation and expense reimbursement, and HIV Prevention Intervention handouts from a number of sources.  Members are also given an overview of current national and local AIDS epidemiology.

In addition, the CPG uses a 'mentor system'.  An experienced member is paired with a new member in seating arrangements and work sessions during meetings. New persons are encouraged to call either their 'mentor,' a co-chair, or the staff person at other times for additional input or feedback.  The use of a toll-free 800 number makes calling staff more possible. The staff person makes follow up calls to new members following the first few meetings.  An in-person or telephone interview is made within 90 days of each new member's first CPG meeting. The meeting ground rules include asking each member for comments during discussion which also seems to facilitate integration.

Each member participates on a Population Committee which reflects the member's primary representation.  In addition, during the first few meetings, a new member is encouraged to sit in on more than one committee before making a decision of another committee membership.  This smaller group activity assists in folks getting to be more familiar with one another.

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