Los Angeles County Municipal Code Ch. 3.29 Commission on Hiv

Note— Name of chapter changed by Ords. 95-0010 and Ord. 2002-004.

A.

"Administrative Agency" refers to the Division of HIV and STD Programs (DHSP), Department of Public Health (Public Health) and the County of Los Angeles.

B.

"Administrative Mechanism" refers collectively to the partnership of the Board of Supervisors, the Commission, grantee and administrative agency, and other participants in the Ryan White-funded service delivery system.

C.

"AIDS" refers to Acquired Immune Deficiency Syndrome, and is a diagnosis of late-stage HIV disease.

D.

"Allocations" refers to the funds to be expended for HIV services and related purposes to be determined by the Commission.

E.

"Candidate" refers to a person who has submitted a completed membership application and is seeking appointment to the Commission.

F.

"Centers for Disease Control and Prevention (CDC)" refers to the federal agency that manages HIV and STD prevention programs, surveillance and related communicable disease and co-morbidity activities.

G.

"Committee-only Member" refers to an individual serving on one or more standing committees of the Commission, who is not appointed by the Board of Supervisors, and does not hold a voting seat on the full Commission. Committee-only Members provide technical expertise and lived and/or professional experience and may vote at the committee level, but not on matters before the full Commission.

H.

"Community Health Center (CHC)" or "Federally Qualified Health Center (FQHC)" refers to a public or community-based medical clinic that provides primary care services to low-income populations through Section 330 of the Public Health Service Act.

I.

"Consumer" refers to a person living with HIV and/or AIDS who uses Ryan White Act-funded services or is the caretaker of a minor with HIV/AIDS who receives those services, or an HIV-negative prevention services client.

J.

"Continuum of HIV Services" refers to the local operational strategy for providing high-quality HIV prevention, counseling and testing, linkage, and care and treatment services in response to the needs of those living with HIV and/or at risk of exposure to HIV.

K.

"Division of HIV and STD Programs (DHSP)" refers to the administrative agency within Public Health to whom Public Health delegates authority for the administration of HIV and STD programs and surveillance.

L.

"Eligible Metropolitan Area (EMA)" refers to a jurisdiction eligible to receive Ryan White Part A funds; the County of Los Angeles is the local EMA.

M.

"Executive Director" refers to the executive staff member of the Commission.

N.

"Grantee" refers to the Department of Public Health (Public Health), County of Los Angeles, which receives federal, State, and County funding for HIV services.

O.

"Health Resources and Services Administration (HRSA)" refers to the federal agency that manages and administers the Ryan White program nationally, including the use of Ryan White funds.

P.

"HIV" refers to the Human Immunodeficiency Virus.

Q.

"HIV disease" refers to the disease caused by HIV infection.

R.

"HIV Health Services Planning Council (Planning Council)" refers to the local community planning body for HIV care and treatment services.

S.

"HIV Planning Group (HPG)" refers to the local community planning body for HIV prevention services.

T.

"HIV Planning Guidance" refers to the CDC's planning and prevention service delivery requirements and expectations for HPGs and local health departments.

U.

"Integrated Prevention and Care Guidance" refers to a collaborative, five-year strategy developed by the CDC and HRSA for states and localities to coordinated HIV services, aligning prevention and treatment to end the HIV epidemic by 2030.

V.

"Nominating Body" refers to the Commission in its role of designating candidates as nominees for appointment to the Commission by the Board of Supervisors.

W.

"Open Nominations" refers to the process, requirements and guidelines developed by HRSA, and consistent with the CDC's HIV Planning Guidance, governing how Part A planning councils identify, select, and nominate their members.

X.

"Organization" refers to service agencies and/or groups or coalitions of people affected by HIV.

Y.

"Parity, Inclusion, and Representation (PIR)" refers to the CDC principle to ensure that all HPG members can participate equally (parity), that the planning process actively includes a diversity of views, perspectives, and stakeholders (inclusion), and that HPG members should represent the range of ethnicities, gender, backgrounds, and other characteristics of people affected by HIV (representation).

Z.

"Part A" refers to the Ryan White Act grant funds awarded to EMAs from which the County of Los Angeles directly receives its largest share of Ryan White Act resources.

AA.

"Part B" refers to the Ryan White Act grant funds awarded to states, most of which support the statewide AIDS Drug Assistance Program (ADAP), and a portion of which the State of California disburses to the County of Los Angeles.

BB.

"Priorities" refers to service categories, ranked in order of consumer need and importance that guide the Commission in the allocation of financial resources.

CC.

"Provider" refers to an agency/organization that provides HIV care, treatment and/or prevention services in the EMA, and may or may not be supported by Ryan White, CDC, State, County, or other funding.

DD.

"Recommending Entity" refers to an organization, agency, institution, entity, or person entitled to propose candidates for consideration as nominees for appointment to the Commission pursuant to Section 3.29.030.

EE.

"Representation and Reflectiveness" refers to Ryan White Act requirements for a planning council's membership to include members who represent specific interests identified in the Ryan White Act (representation), and that the planning council membership and its subset of unaffiliated consumer members reflect the ethnic, racial and gender proportions of local HIV prevalence (reflectiveness).

FF.

"Ryan White Program" refers to the program providing the largest non-entitlement source of federal funding for HIV care and treatment services, as authorized by the Ryan White Treatment Extension Act of 2009.

GG.

"Ryan White Act" refers to the federal law beginning at Section 2601 of the Public Health Service Act originally enacted in 1990, and as amended, that authorizes funding, programs, and requirements for the delivery of HIV care, treatment, and support services in the United States, including the Ryan White HIV/AIDS Program.

HH.

"Service Planning Area (SPA)" refers to one (1) of eight (8) subdivided areas of the County intended to facilitate and improve local service and healthcare planning.

II.

"Sexually Transmitted Disease(s) (STD)" refers to an assortment of communicable infections and diseases that are primarily transmitted through sexual relations or contact.

JJ.

"Stakeholder" refers to any party receiving or providing HIV services or affected by HIV.

KK.

"Unaffiliated Consumer" refers to a person living with HIV and/or AIDS who is a user of Ryan White-funded HIV services who does not serve in a decision-making capacity (including but not limited to an employee, consultant and/or board of directors member) at any Part A funded organization or agency.

(Ord. 2026-0008 § 1, 2026; Ord. 2013-0017 § 1, 2013; Ord. 2011-0065 § 1, 2011; Ord. 2006-0076 § 2, 2006; Ord. 2005-0044 § 1, 2005; Ord. 98-0002 § 1, 1998; Ord. 95-0010 § 2, 1995; Ord. 91-0152 § 1, 1991.)

The Commission on HIV is referred to in this chapter as the "Commission."

(Ord. 2011-0065 § 2, 2011; Ord. 2005-0044 § 2, 2005; Ord. 95-0010 § 3, 1995; Ord. 91-0152 § 2, 1991.)

All members of the Commission shall serve at the pleasure of the Board of Supervisors. The Commission shall consist of a total of thirty-two (32) members, including the following three non-voting seats: a representative from the Ryan White Program Part A Recipient/Grantee (Public Health Division of HIV and STD Programs [DHSP]), a representative from the Part B recipient (California Department of Public Health, Office of AIDS), and a representative from the Medicaid/Medi-Cal agency recipient. Members are nominated by the Commission and appointed by the Board of Supervisors. Consistent with the open nominations process, the following recommending entities may forward candidates to the Commission for membership consideration:

A.

Specific Membership Required by the Ryan White Act. Section 2602 of the Ryan White Act lists specific membership categories that must be represented on the Commission. These fifteen (15) membership categories are:

Health care providers, including federally qualified health centers;

Community-based organizations serving affected populations and AIDS service organizations;

Social service providers, including providers of housing and homeless services;

Mental health providers;

Substance use providers;

Local public health agencies (DHSP in Los Angeles County);

Hospital planning agencies or health care planning agencies;

Affected communities, including people with HIV and/or AIDS, members of a federally recognized Indian tribe as represented in the population, individuals co-infected with hepatitis B or C, and historically underserved groups and subpopulations;

Non-elected community leaders;

State government (including the State Medicaid/Medi-Cal agency);

The agency administering the Ryan White program under Part B;

Grantees under subpart II of Part C;

Grantees under Section 2671 of Part D, or if none are operating in the area, representatives of organizations with a history of serving children, youth, women, and families living with HIV and operating in the area;

Recipients of other federal HIV programs, including but not limited to, providers of HIV prevention services; and

Representatives of individuals who formerly were federal, State, or local prisoners released from the custody of the penal system during the preceding three years, and had HIV as of the date of which the individual were so released.

B.

Unaffiliated Consumer Membership. In accordance with Ryan White Program Part A legislative requirements outlined in Section 2602 of the Ryan White Act, the Commission shall ensure that at least thirty-three percent (33%) (at least eleven (11)) of its members are consumers of Ryan White Program Part A services who are not officers, employees, or consultants to any entity that receives funding from the Ryan White Act Part A Program, and do not represent any such entity. Unaffiliated consumers shall reflect the size and demographics of the population of individuals living with HIV and/or AIDS and the size and demographics of the estimated population of individuals living with HIV and/or AIDS within Los Angeles County who are unaware of their status.

C.

HIV Research Representative. One representative from a local academic research institution with subject matter expertise in HIV research and data translation.

D.

Board of Supervisors' Representatives. Five (5) Board of Supervisors' representatives, one (1) recommended by each of the Supervisorial offices.

In all the above membership categories where not specifically required, recommending entities and the nominating body are strongly encouraged to nominate candidates living with HIV or members of populations disproportionately impacted by the HIV epidemic. Members are expected to report to and represent their recommending entities and constituencies. Members may, at times, represent multiple constituencies.

In accordance with Ryan White Act and CDC requirements, the Commission shall ensure that its full membership and its subset of unaffiliated consumer members shall proportionately reflect the ethnic, racial, and gender proportions of HIV disease prevalence in the EMA.

In forwarding nominations for appointment by the Board of Supervisors, the Commission shall ensure that its membership fully conforms to Ryan White Part A planning council requirements on representation, reflectiveness and consumer membership, and the CDC's HPG requirements on Parity, Inclusion, and Representation.

(Ord. 2026-0008 § 2, 2026; Ord. 2013-0017 § 2, 2013; Ord. 2011-0065 § 3, 2011; Ord. 2006-0076 § 3, 2006; Ord. 2005-0044 § 3, 2005; Ord. 2003-0010 § 1, 2003; Ord. 98-0002 § 2, 1998; Ord. 95-0010 § 4, 1995; Ord. 91-0152 § 3, 1991.)

One (1) alternate may be nominated by the Commission for appointment by the Board of Supervisors for each member who has disclosed that they are living with HIV. An alternate shall attend meetings of the Commission and vote in the absence of

the person for whom they are designated as an alternate. Nominations of the alternates shall be made from the pool of candidates recommended for membership. The Commission shall ensure that the composition of alternate members conforms to any Part A planning council requirements which apply to alternates.

(Ord. 2026-0008 § 3, 2026; Ord. 2013-0017 § 3, 2013; Ord. 2011-0065 § 4, 2011; Ord. 2005-0044 § 4, 2005; Ord. 95-0010 § 5, 1995; Ord. 91-0152 § 4, 1991.)

Nominations for membership shall be conducted through an open process and candidates selected based on delineated and publicized criteria which include a conflict-of-interest standard as set out in Section 3.29.046. The Commission shall maintain a standing Membership and Community Engagement committee which shall review the composition of the Commission and conduct broad-based recruitment and initial screening of applicants on an ongoing basis. The Membership and Community Engagement committee is responsible for: processing membership applications; selecting the candidates based on their qualifications to meet general membership and specific seat requirements and to help the Commission meet other membership mandates and requirements; and forwarding its membership recommendations to the Commission for nomination. Upon approval by the Commission, candidate nominations are sent to the Board of Supervisors for its consideration for appointment to the Commission. This process will be conducted prior to expiration of membership terms and during the year in the event of mid-term vacancies.

(Ord. 2026-0008 § 4, 2026; Ord. 2013-0017 § 4, 2013; Ord. 2011-0065 § 5, 2011; Ord. 2005-0044 § 5, 2005; Ord. 98-0002 § 3, 1998.)

A.

The Ryan White Act requires certain constituencies and entities to be represented on the Commission. The Ryan White Act also requires the Commission to establish priorities and allocate funds within the EMA. Therefore, Commission members, regardless of their private affiliations, may participate in the process to determine funding priorities and to allocate Ryan White Act Part A and CDC HIV prevention funds in percentage and/or dollar amounts to various service categories or other types of activities, with the following limitations: as specified in Section 2602 of the Ryan White Act, the Commission shall not be involved directly or in an advisory capacity in the administration of Ryan White Act, CDC, or other funds and shall not designate or otherwise be involved in the selection of particular entities as recipients of those grant funds.

B.

All members and alternates of the Commission and participants in the Commission's community planning process shall act in accordance with the Commission's adopted code of conduct, which includes adherence to conflict-of-interest rules and requirements.

(Ord. 2026-0008 § 5, 2026; Ord. 2013-0017 § 5, 2013; Ord. 2011-0065 § 6, 2011; Ord. 2005-0044 § 6, 2005; Ord. 98-0002 § 4, 1998.)

A.

All members and alternates shall serve at the pleasure of the Board of Supervisors. Any member whose employment, status or other factors no longer fulfill the requirements of the membership seat to which they were appointed shall be removed from the Commission as determined by the Board of Supervisors.

B.

The terms of the current members of the Commission on HIV shall expire as of the date of the first meeting of the HIV Commission in March of 2026. When the revised ordinance becomes effective, the new members appointed by the Board of Supervisors will be seated. The Commission shall classify its members by lot so that sixteen (16) members' terms will expire

after one (1) year and sixteen (16) members' terms will expire after two (2) years. Thereafter, each membership term shall be two (2) years. The new term for members shall begin on March 1, 2026.

C.

No member may serve on the Commission for more than three (3) full consecutive terms, unless such limitation is waived by the Board of Supervisors. All members, Commissioners, Alternate Members, and Committee-only Members may serve a maximum of three (3) consecutive two (2) year terms (six (6) years total). Terms for Commissioners and Alternates are reflected on the Membership Roster; terms for Committee-only Members begin on the date they are approved by the Commission. At the end of each term, members may reapply. After completing six (6) consecutive years, a one (1) year break is required before reapplying, unless waived by the Board of Supervisors.

D.

All members shall complete and submit renewal applications prior to the expiration of their respective terms. However, a member may continue serving in the seat, beyond term expiration, until such time as the member has resigned, is replaced, or the seat is vacated by the Board of Supervisors as recommended by the Commission.

E.

In addition to their Commission service, members are required to serve on at least one (1) of the Commission's standing committees.

F.

During the course of a calendar year, absence from any combination of six (6) regularly scheduled Commission meetings and/or regularly scheduled meetings of the committee to which the member has been assigned may result in the Board of Supervisors removing the member from the Commission. Reinstatement or replacement may occur with subsequent nomination from the Commission and appointment by the Board of Supervisors. An alternate's attendance in a member's place is considered attendance by the member at the meeting.

(Ord. 2026-0008 § 6, 2026; Ord. 2013-0017 § 6, 2013; Ord. 2011-0065 § 7, 2011; Ord. 2005-0044 § 7, 2005; Ord. 95-0010 § 6, 1995; Ord. 91-0152 § 5, 1991.)

A.

The Commission shall meet at least six (6) times per calendar year.

B.

The Commission shall establish an executive committee to set agendas for meetings, and conduct business between Commission meetings. The executive committee shall include the Director of DHSP or their permanent designee as a non- voting member, the co-chairs of the Commission and three (3) at-large members elected by the Commission. For purposes of this Subsection, the authority of the executive committee to conduct business shall include acting on behalf of the Commission in time-sensitive circumstances, which action(s) shall be ratified by the Commission at its next regularly scheduled meeting.

C.

In addition to the executive and Membership and Community Engagement committees, the Commission may establish other standing committees in its bylaws in order to carry out its mission and responsibilities. The Commission may also create other working groups, as allowed by its policies and procedures.

D.

On a quarterly basis, the Board of Supervisors shall be notified of member attendance at Commission meetings and meetings of standing committees.

E.

As needed by committees and appropriate for added professional expertise, as a means of further engaging community participation in the planning process, and/or as necessary to meet the requirements of HRSA and the CDC's Integrated HIV Prevention and Care Plan Guidance, the Commission's standing committees may elect to nominate Committee-only Members for approval by the Commission to serve as voting members on the respective committees to provide professional and/or lived experience expertise, as a means of further engaging community participation in the planning process.

F.

Commission meetings shall be chaired by the Commission's two (2) co-chairs, with the support of the executive director and staff. The co-chairs shall be elected by the Commission and have staggered two (2) year terms.

(Ord. 2026-0008 § 7, 2026; Ord. 2013-0017 § 7, 2013; Ord. 2011-0065 § 8, 2011; Ord. 2005-0044 § 8, 2005; Ord. 95-0010 § 7, 1995; Ord. 91-0152 § 6, 1991.)

The Commission shall adopt bylaws which may include provisions relating to the time and place of holding meetings, election and terms of its co-chairs and other officers, and such other rules and procedures necessary for its operation. A majority of the members who have been appointed shall constitute a quorum of the Commission.

(Ord. 2011-0065 § 9, 2011; Ord. 2005-0044 § 9, 2005; Ord. 95-0010 § 8, 1995; Ord. 91-0152 § 7, 1991.)

When required to travel outside Los Angeles County in performance of Commission duties, members may be reimbursed from Ryan White Act or other funds for necessary travel expenses, including transportation, meals, and lodging. To be reimbursable, such travel must receive prior written approval from the executive director or their designee.

In accordance with the Ryan White Act and HRSA and CDC guidelines, members of the Commission may also be reimbursed for local travel and mileage, meals associated with Commission business, child care during Commission activities, and computer-related expenses if those costs were incurred in the performance of Commission-related duties. The Commission may, in addition to reimbursing those expenses, also provide these services directly to members and/or pay monthly stipends to unaffiliated consumer members of Ryan White Act Part A services or HIV-negative individuals from identified high-risk or special populations who, if positive, would be eligible for Ryan White Program services, provided that the stipends are not paid with Ryan White Program funds. Eligible members must maintain a required level of participation and other performance requirements, as defined in Commission policy.

The Commission will establish, and the executive director will implement, procedures for eligibility and utilization of the foregoing described reimbursements, member services and/or stipends, including stipend amounts up to $500 per month as determined by Commission policy and reported to the Board of Supervisors, and the availability of funding.

(Ord. 2026-0008 § 8, 2026; Ord. 2013-0017 § 8, 2013; Ord. 2011-0065 § 10, 2011; Ord. 2005-0044 § 10, 2005; Ord. 95-0010 § 9, 1995; Ord. 91-0152 § 8, 1991.)

Consistent with Section 2602 of the Ryan White Act, HRSA guidance, and requirements of the CDC's HIV Planning Guidance, the Commission is authorized to:

A.

Develop a comprehensive HIV plan, that is based on assessment of service needs and gaps and that includes a defined continuum of HIV services; monitor the implementation of that plan; assess its effectiveness; and collaborate with DHSP to update the plan on a regular basis;

B.

Develop standards of care for the organization and delivery of HIV care, treatment and prevention services;

C.

Establish priorities and allocations of Ryan White Act Part A and CDC prevention funding in percentage and/or dollar amounts to various services; review the grantee' s allocation and expenditure of these funds by service category or type of activity for consistency with the Commission's established priorities, allocations and comprehensive HIV plan, without the review of individual contracts; provide and monitor directives to the grantee on how to best meet the need and other factors that further instruct service delivery planning and implementation; and provide assurances to the Board of Supervisors and HRSA verifying that service category allocations and expenditures are consistent with the Commission's established priorities, allocations and comprehensive HIV plan;

D.

Evaluate service effectiveness and assess the efficiency of the administrative mechanism with particular attention to outcome evaluation, cost effectiveness, rapid disbursement of funds, compliance with commission priorities and allocations, and other factors relevant to the effective and efficient operation of the local EMA' s delivery of HIV services;

E.

Plan and develop HIV and public health service responses to address the frequency of HIV infection concurrent with STDs and other co-morbidities; deploy those best practices and innovative models in the County's STD clinics and related health centers; and strategize mechanisms for adapting those models to non-HIV-specific platforms for an expanded STD and co- morbidity response;

F.

Study, advise and recommend to the Board of Supervisors, the grantee and other departments' policies and other actions/decisions on matters related to HIV;

G.

Inform, educate, and disseminate information to consumers, specified target populations, providers, the general public, and HIV and health service policy makers to build knowledge and capacity for HIV prevention, care, and treatment; and actively engage individuals and entities concerned about HIV;

H.

Provide a report to the Board of Supervisors annually, describing Los Angeles County's progress in ending HIV, with indicators determined by the Commission in collaboration with DHSP, and make other reports as necessary to the Board of Supervisors, the grantee and other departments on HIV-related matters referred for review by the Board of Supervisors, the grantee, or other departments;

I.

Act as the planning body for all HIV programs in the Department of Public Health or funded by the County; and

J.

Make recommendations to the Board of Supervisors, the grantee and other departments concerning the allocation and expenditure of funding other than Ryan White Part A and B and CDC prevention funds expended by the grantee and the County for the provision of HIV-related services.

(Ord. 2026-0008 § 9, 2026; Ord. 2013-0017 § 9, 2013; Ord. 2011-0065 § 11, 2011; Ord. 2006-0076 § 4, 2006; Ord. 2005- 0044 § 11, 2005; Ord. 95-0010 § 10, 1995; Ord. 91-0152 § 9, 1991.)

The Commission shall have procedures approved by the Board of Supervisors and contained in its by-laws to address grievances with respect to Ryan White and CDC funding. The grievance procedure shall be limited as follows:

A.

Providers eligible to receive Ryan White or CDC funding, consumers, consumer groups and people living with HIV coalitions, and other stakeholders and caucuses may grieve.

B.

Grievances shall be limited to the Commission's, administrative agency's or grantee's failure to follow the Commission's established, written and published procedures for priority-setting, resource allocation or subsequent changes to priorities or allocations, or compliance with comprehensive care plan provisions or implementation strategies. Grievances may not involve funding allocations to individual service providers, procurement of specific services, individual patient interactions with service providers and agencies, or disagreement with the outcome of the priority- and allocation-setting process.

C.

All settlements and rulings resulting from grievances shall not retroactively change priorities or allocations and shall be limited to future actions of the Commission.

D.

The grievance process shall include a procedure to submit grievances that cannot be resolved through mediation to binding arbitration.

(Ord. 2013-0017 § 10, 2013; Ord. 2011-0065 § 12, 2011; Ord. 2005-0044 § 12, 2005; Ord. 98-0002 § 5, 1998.)

The sunset review date for the Commission is indefinite. The Commission shall continue as long as it is federally funded or upon other order of the Board of Supervisors.

(Ord. 2011-0065 § 14, 2011; Ord. 2006-0071 § 1, 2006; Ord. 2004-0070 § 1, 2004; Ord. 2001-0039 § 1, 2001; Ord. 98-0002 § 6, 1998; Ord. 95-0010 § 12, 1995.)