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San Antonio HIV Planning Council Membership Application

Birthday
Month
Day
Year
Q1: What is your gender?
Woman
Man
Q2: What is your race or ethnicity?
American Indian
Asian
Black/African American
Hispanic
Native Hawaiian/Pacific Islander
White/Non-Hispanic
Other (please identify)
Q3: Please select the option that best describes you:
I am a person living with HIV.
I am not a person living with HIV.
Q11: Please select the categories that you are qualified to represent (Check all that apply)
Membership on at least one Standing Committee is required.
Please review the committee descriptions below.

Needs Assessment (NA) / Comprehensive Planning & Continuum of Care (CPCC):

This committee assesses community needs and uses data to guide HIV care planning, service priorities, funding recommendations, and the Integrated HIV Prevention and Care Plan. The committee also develops and monitors the Continuum of Care, Standards of Care, Service Category Definitions, Units of Service, and participates in statewide planning effors.

Fiscal Monitoring & Reallocation (FMRA):

This committee reviews funding priorities, expenditures, and service utilization to ensure Ryan White Part A funds are used effectively. The committee monitors spending, reviews relevant data, and recommends funding reallocations and distribution strategies to support community needs and comply with Ryan White legislation and HRSA requirements.

Membership, Nominations & Elections (MNE):

This committee supports Planning Council membership by recruiting and reviewing prospective members, monitoring member attendance, tracking membership demographics and representation, and recommending changes to ensure the Council reflects the communities affected by HIV.

Q13: Which committee would you be interested in joining in addition to attending the monthly Planning Council meetings? Committees meet once a month. We will consider your interests and preferences when making committee assignments.
Acknowledgment and Commitment
By submitting this application, I understand and agree to the following:

Electronic Signature


By typing my full name below, I acknowledge that it serves as my electronic signature and confirms that the information provided in this application is true and accurate.

San Antonio HIV Planning Council 

Area HIV Health Services Planning Council

Your trusted resource for HIV Planning and Services

HRSA Disclaimer This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87) via grant H89HA00007. PHOTOGRAPH DISCLAIMER The people in the photos on this web site are models and used for illustrative purposes only unless otherwise noted – no representation regarding HIV status is made and should not be inferred.

© 2022 San Antonio Area HIV Health Services Planning Council

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Address 4502 Medical Drive, MS# 45-2 Corporate Square, Suite 200, San Antonio, TX 78229

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