Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
Fiscal Year 2024 Appropriations
Earlier this month, President Biden released the fiscal year 2024 (FY2024) Executive Budget Request to Congress, a non-binding budget proposal that lays out the Administration’s spending and policy priorities for FY2024 and sets the starting point for Congressional negotiations on the appropriations bills. The Biden Administration is proposing significant investments in public health, including a $237 million national PrEP program, a $11.3 billion national hepatitis C virus (HCV) elimination initiative, and a new $50 million Community Harm Reduction and Engagement Initiative.
These major investments are combined with flat funding in other crucial areas of funding allocations for HIV. Ryan White Part A through F remains flat funded despite community requests for much needed increases. The President’s Budget Request also only allocated an additional $6 million to HOPWA, which fails to encompass the large priority to house those impacted by HIV in the US.
The final FY2024 appropriations bills, however, will require bipartisan agreement on spending levels. Republicans in the House of Representatives have pledged to leverage their majority in the lower chamber to impose budget cuts as condition for supporting a bipartisan debt-limit fix and address ongoing concerns of banking stability, which complicates the viability of the landmark national PrEP and HCV elimination programs and will likely result in lower funding allocations than proposed in the President’s budget for health programs. NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs.
Family Planning Coalition Testimony
A collection of 66 organizations, including NASTAD, signed onto testimony to demonstrate support for family planning funding and to urge for more adequate funding for Title X Family Planning Program, the Teen Pregnancy Prevention Program (TPPP), and the Division of STD Prevention. The community requests included the following allocations: Title X Family Planning Program Funding - $512 million, Teen Pregnancy Prevention Program (TPPP) - $150 million, Division of STD Prevention – $312.5 million, and $200 million to support clinical services related to sexually transmitted infections in HRSA.
Friends of HRSA: Appropriations Letter
NASTAD joined another 100 organizations within the Friends of HRSA in a letter to request at least $10.5 billion for discretionary HRSA programs for FY2024. The Friends of HRSA cited this necessary discretionary funding to address the gaps from recipients in their ability to properly conduct programing in the face of many health challenges. Without these funding increases, programs under HRSA face uncertainty in their longevity and thus, long-term impact in the communities they serve.
Administration Activities
CDC observes National Youth HIV and AIDS Awareness Day (NYHAAD) on April 10th
National Youth HIV and AIDS Awareness Day will take place on April 10. CDC released this year’s NYHAAD social media toolkit for health department’s social media activities. National Youth HIV and AIDS Awareness Day aims to raise awareness about the impact of HIV among young people. The CDC encourages promotion of HIV testing, prevention, and treatment opportunities.
CDC Division of HIV Prevention Launches Together TakeMeHome HIV Self-Test Project
On March 21, the Centers for Disease Control and Prevention (CDC) Division of HIV Prevention (DHP) launched Together TakeMeHome (TTHM), a project with the goal of distributing up to 1 million free HIV self-tests over the next 5 years. Check out the official letter announcement from the CDC. By offering free HIV self-tests through mail delivery, TTMH addresses common barriers to HIV testing, such as stigma, privacy concerns, cost, and lack of access to HIV clinics, giving people who otherwise might not have tested an opportunity to know their status. Priority audiences for the program and the Let’s Stop HIV Together (Together) campaign outreach include populations with disproportionately high HIV incidence, including gay, bisexual, and other men who have sex with men, particularly Black/African American and Hispanic/Latino gay and bisexual men, Black/African American cisgender women, and transgender women of all races and ethnicities. Click here to read a Dear Colleague letter from the Director of CDC DHP which outlines the anticipated impact of this new self-testing project for accessible, private HIV testing. NASTAD is proud partner of the TTHM project.
Resources
CDC-DHP Town Hall: HIV Prevention and Care Priorities – Regional Virtual Community Engagement Town Hall
Date: March 30, 2023, from 1:00 PM – 2:30 PM EST
The Division of HIV Prevention (DHP) at the Centers for Disease Control and Prevention will convene its next HIV Prevention and Care Priorities – Regional Virtual Community Engagement Town Hall on March 30, 2023, from 1:00 PM – 2:30 PM EST with HHS Regions 1 and 2. The Town Hall will provide a venue for discussion and collaboration focused on barriers to and opportunities for improving HIV diagnosis, treatment, prevention, and outbreak response. This Town Hall will focus on activities within HHS Regions 1 and 2, but it is open to all to attend.
Hepatitis Community Collaborative (HC2)
Date: April 25, 2023
NASTAD and The AIDS Institute (TAI) are pleased to host the third Hepatitis Community Collaborative (HC2)! Following HC2 events in 2020 and 2021, we are excited to re-convene as a group of hepatitis advocates, infectious disease experts and people with lived experience (PWLE) and provide updates on what communities are doing to combat viral hepatitis. The one-day, virtual and free convening will provide advocates with a platform for cross-jurisdiction learnings and innovative approaches via presentations, peer-to-peer information sharing, dialogue and forums.
Job Postings
Director, Health Care Access – NASTAD
NASTAD is recruiting for the Director of our Health Care Access program. The Director, Health Care Access plays a vital leadership role in achieving the organization’s training, technical assistance, and policy support priorities for Ryan White HIV/AIDS Program (RWHAP) Part B and AIDS Drug Assistance Programs (ADAP). The position will work closely with Tim Horn, NASTAD’s Director of Medication Access.
Viral Hepatitis Prevention Manager – Health Federation of Philadelphia
The Prevention Manager will be responsible for coordination of activities related to viral hepatitis prevention, including outreach, training, education and collaboration with appropriate programs to facilitate access to hepatitis services. This position works in close coordination with viral hepatitis surveillance activities. Apply by June 2, 2023.
Drug Trends and Technology-Based Drug Checking Analyst – New York City, NY
NYC DOHMH is looking for an analyst to work on our drug checking initiative. Currently operating in four SSPs across the city, including one of the OPCs, drug checking technicians use Bruker Infrared technology to test samples from SSP participants and provide individualized harm reduction education. This is a great opportunity for someone with strong data skills and an interest in drugs and toxicology. Please send out far and wide and feel free to reach out if you have any questions.
Executive Director, Open Aid Alliance – Missoula, Montana
Open Aid Alliance is searching for an innovative and passionate Executive Director to lead our team as we continue our mission of providing low-barrier, client-centered care.
Reporting to the Board of Directors, the Executive Director (ED) will have overall strategic and operational responsibility for Open Aid Alliance (OAA) staff, programs, expansion, and execution of its mission. The main responsibilities of this position fall within the realms of staff leadership and management, programming and financial management. Priority deadline for first round of interviews is April 10, 2023.
Chief Executive Officer – Western North Carolina AIDS Project (WNCAP)
Western North Carolina AIDS Project’s (WNCAP’s) mission is to provide equitable access to care and reduce harm from HIV, Hepatitis C, and drug use. WNCAP provides case management, prevention education, STD testing, harm reduction, and other support services to people living across 18 counties of western North Carolina. The Chief Executive Officer (CEO) is the principal leadership position at WNCAP and reports to the Board of Directors.
Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC
- Chief, Prevention Branch, DVH
- NCHHSTP/DVH is recruiting for an exceptional candidate for the position of Prevention Branch Chief, Division of Viral Hepatitis (DVH), National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). The incumbent will serve as Chief in the Prevention Branch, Division of Viral Hepatitis, and will participate in the division’s senior management team responsible for directing the development, administration, implementation, and evaluation of national programs to prevent and control viral hepatitis. The incumbent provides advice to the Division Director on medical and scientific policy and practices associated with program, education, and research activities in support of viral hepatitis prevention and control, including harm reduction.
Boulder County AIDS Project – Boulder, Colorado
- Prevention Coordinator: The primary duties of this position are to provide HIV/HCV/STI testing, syringe access, and street outreach services, as well as outreach education at community partner locations and events. This position provides these services in collaboration with other Prevention Department staff and key community partners, as well as enters data into databases and completes monthly reports. This position reports directly to the Prevention Director, and attends staff, department, and community partner meetings.
Florida Department of Health – Palm Beach County
To apply, please send resumes to Robert Scott, Robert.Scott@flhealth.gov. These are all $20/hr, in-office roles with possible remote flexibility.
- EHE Navigator: This position’s work will be actively guided by the Palm Beach County Ending the Epidemic (EHE) Plan, including the four pillars and their goals, objectives, strategies and activities. Incumbent will assist in the planning, coordination, implementation and monitoring of the goals, objectives, strategies and activities set forth in the Palm Beach County Ending the Epidemic (EHE) Plan, in collaboration with other Area 9 EHE funding recipients, to include, but not limited to: Palm Beach County, FoundCare, and Florida Community Health Centers.
- PrEP Navigator: This position’s work will be actively guided by the Palm Beach County Ending the Epidemic (EHE) Plan, including the four pillars and their goals, objectives, strategies and activities. Incumbent will link high-risk negative persons to available Pre-Exposure Prophylaxis (PrEP) and non-occupational Post Exposure Prophylaxis (nPEP) services with the goal of significantly reducing the number of new HIV infections among high-risk populations. Incumbent will assess and increase the knowledge, desirability, accessibility, and adherence of PrEP among referred high-risk individuals.
- Digital Media Manager: This position is responsible for developing and coordinating the area HIV digital media presence through multiple platforms. Developing digital marketing strategies, creating social media content, collaborating with community partner organizations, and creating new ad campaigns to advance Ending the HIV Epidemic (EHE) in Palm Beach County. Tracking data from digital campaigns to assist with EHE goals.
Executive Director, Hepatitis Education Project (HEP) – Seattle, WA (partially remote)
Reporting to a Board of Directors and in partnership with a staff of 19, the ED will lead the evolution of HEP as the organization reviews its impact to date and plans for the future in the fields of viral hepatitis and drug user health both locally and nationally.
Deputy Medical Director, HIV/STI/Viral Hepatitis/Harm Reduction – Nashville, TN
This position will serve as the Statewide Deputy Medical Director in the HIV/STI/Viral Hepatitis section. The position has cross-cutting responsibility in all program areas with potential for promotion in succession plans. Primary responsibilities include leadership and oversight of cross-cutting programs related to End the Syndemic Tennessee to tackle HIV, sexually transmitted infections, viral hepatitis and substance use disorder in an integrated manner with an outward-facing, community-engaged process.
Program Content and Training Specialist, Supporting Harm Reduction Programs (SHaRP) – University of Washington
This position is part of a cooperative agreement award from the Centers for Disease Control and Prevention to provide technical assistance about monitoring and evaluation to syringe services programs (SSPs) as part of the National Harm Reduction Technical Assistance Center. One of the primary projects of this award is to provide technical assistance (TA) to SSPs for monitoring and evaluation activities. The University of Washington is working in collaboration with the CDC, SAMHSA, NASTAD, the National Harm Reduction Coalition, and other TA partners to provide a suite of technical assistance support to individual programs.
Communicable Disease Epidemiologist – Cheyenne, Wyoming
This position will serve as the Communicable Disease AIDS Drug Assistance Program (ADAP) Coordinator, Wyoming TB Controller, and Disease Intervention Specialist (DIS) for the Communicable Disease (CD) Treatment Program. Assist in outbreak response to ensure the safety of Wyoming residents; by interviewing cases for exposure information, updating news outlets on the progress of outbreak control, analyzing exposure data utilizing epidemiological and statistical methods.
Assistant Commissioner - Health Department – Baltimore, Maryland
The Baltimore City Health Department (BCHD) is seeking an Assistant Commissioner to lead the Bureau of Communicable Disease and Outbreak Control. This senior management position will lead a talented team responsible for communicable disease investigation, outbreak control and emergency preparedness programming. The incumbent will also be responsible for developing and implementing agency wide policies related to health department readiness to respond to public health emergencies. The incumbent will report directly to the Deputy Commissioner for BCHD’s Division of Population Health & Disease Prevention.
Open Positions – New York State
The New York State Department of Health, in partnership with Health Research, Inc, has various job openings, including some within the AIDS Institute. Please visit this link to learn about their current opportunities.
Viral Hepatitis Epidemiologist - Pennsylvania Department of Health
The Department of Health is seeking a dedicated and hardworking individual to fulfill their Viral Hepatitis Coordinator/Epidemiologist position within the Division of Infectious Disease Epidemiology. If you would like to support an organization that protects the public's health, apply today!
Viral Hepatitis Database Analyst - Heluna Health position with San Francisco Department of Public Health
Heluna Health is currently looking for a Viral Hepatitis Database Management Analyst to work in the ARCHES Surveillance branch at San Francisco Department of Public Health (SFDPH). The Database Analyst will support SFDPH's Viral Hepatitis Surveillance team in its efforts to improve hepatitis data reporting and analysis. Responsibilities include higher level data cleaning, monitoring and reporting on data trends, coordinating with laboratory contacts to improve ELR protocols and procedures, and managing special projects as needed. This is a full-time, 2-year position based in San Francisco and employed by Heluna Health.
Program Manager (Viral Hepatitis and Harm Reduction Prevention) - Augusta, Maine
We are looking to bring on board a Viral Hepatitis and Harm Reduction Prevention Manager to provide (1) statewide viral hepatitis prevention program coordination; (2) manage education and outreach activities focused on prevention of viral hepatitis disease transmission, (3) develop, coordinate, implement and evaluate statewide viral hepatitis prevention and harm reduction services including education, outreach, testing, linkage to care activities, syringe service programs, and overdose prevention activities; and (4) monitor state and federal viral hepatitis and harm reduction grants and contracts. Work is performed under administrative direction.
Human Services Program Coordinator – Richmond, Virginia
The Virginia Department of Health is hiring a Viral Hepatitis Program Coordinator. The Viral Hepatitis Program Coordinator participates in the design and management of hepatitis B (HBV) and hepatitis C (HCV) program activities, including surveillance, prevention, testing, and linkage-to-care as well as hepatitis data collection tools; assesses hepatitis events of public health significance; leads grant writing efforts around improving HBV/HCV prevention and care cascades; coordinates program planning efforts with respect to surveillance and other viral hepatitis epidemiologic data and evaluation; serves in a supervisory or team lead capacity for staff conducting hepatitis program support activities; uses software tools (i.e. SAS) for data quality activities.
News Bulletin
Tennessee’s Rejection of $8.8 Million in Federal Funding Alarms H.I.V. Prevention Groups – New York Times
A powerful move by the Tennessee government makes “Tennessee is the only state to have rejected the funding”, referring to H.I.V. prevention and monitoring funding from the CDC. These funds were appropriated for FY2023, which was approved by Congress earlier this year. “The state has not announced which groups will receive the funds, or the rules on how they can be used, the governor’s office has indicated that its priorities include ‘vulnerable populations, such as victims of human trafficking, mothers and children, and first responders’”. “[Friends for life] and other H.I.V. prevention experts across the state have been scrambling to find alternative sources of funding since [Tennessee state health commissioner] told the C.D.C. that the state no longer wanted the grant money”. “Over the past decade, the South has emerged as the epicenter of the nation’s H.I.V. epidemic. People in Southern states account for over half of new H.I.V. cases each year, even though just 38 percent of the U.S. population lives in the region. Shelby County, which includes Memphis, has one of the one of the highest rates of new H.I.V. infections nationwide”.
Methoadone doses haven’t kept up in the age of fentanyl. A new rule aims to help –STAT
The article states that “patients beginning treatment for opioid addiction often face excruciating withdrawal symptoms. But for people struggling to transition from ultra-potent illicit fentanyl to comparatively weaker addiction medications, help may be on the way. A new federal regulation would make it easier for some patients to begin treatment on significantly higher doses of methadone, a key medicine used to treat opioid use disorder. Current regulations recommend that clinicians start patients on just 30 milligrams of methadone, a dose that experts say would almost universally leave people who regularly use fentanyl in significant discomfort. The new proposal would allow for slightly larger doses — and, more significantly, emphasizes that doctors can use their discretion to go substantially higher, if necessary”. These new regulations are another step towards progress in treatment for people impacted by the fentanyl crisis.
Liver Transplant Rule Changes Benefit Some States, But Not Poorer Ones, Kaiser Health News
A mixed outcome has surfaced around new liver transplant rules. “An analysis of the new rules covering donated livers shows that while patients in New York, California, and other states benefit, patients in other, mostly poorer, states do not”. This comes with the “breaking up the monopoly power of the nonprofit organization that has run it for the past 37 years”. However, the stark reality emerges that “while it has succeeded in that goal, it also has borne out the fears of critics who warned the change would reduce the number of surgeries and increase deaths in areas that already lagged behind the nation overall in health-care access”. The fact remains that “nearly 104,000 people are on waiting lists for organs, most of them kidneys; 22 people die each day awaiting transplants, with poor and minority patients generally faring worse than affluent and White people”. Many people impacted by HIV and Hepatitis are included in these populations awaiting and possibly in need of future organ transplants.
Thigh injection could be an option for long-acting cabotegravir and rilpivirine – NAM AIDSMap.
Cabotegravir and rilpivirine in combination are an effective HIV treatment therapy that was the first FDA approved drug combination for long-acting formulation. Recent data suggests thigh injections are possible over conventional gluteal injections. “The analysis included 118 participants. More than 80% were white, 62% were men and the median age was 48 years. They switched to thigh injections for four months on the same schedule they were initially randomized to: 400mg cabotegravir plus 600mg rilpivirine once monthly (54 people) or 600mg cabotegravir plus 900mg rilpivirine every other month (64 people). Most people received cabotegravir jabs in the left thigh and rilpivirine in the right thigh. After four months, they went back to buttocks injections”. The article also included research presented at the CROI conference in February 2023. “These results support rotational or short-term thigh administration of injectable cabotegravir and rilpivirine for people with an established buttocks regimen, the researchers concluded. They added that further analyses will be done to assess the potential for earlier or ongoing thigh injections”. Different injection site options could lead to broader applications of long-acting injectables and create pathways for self-administration.