Policy Updates: Hill Happenings and Administration Activites

By Julio Contreras November 15, 2021

Hill Happenings 

Build Back Better Act and Budget Reconciliation 

House Democrats are forging ahead to pass the lower chamber’s version of the Build Back Better Act (BBB) after successfully advancing the bipartisan infrastructure package on November 5. The broad-reaching social spending package is being advanced through budget reconciliation, requiring consensus within the Democratic caucus to pass the BBB. The current House version includes health spending priorities, such as increasing access to affordable coverage through extended Affordable Care Act (ACA) premium tax credits and subsidized Marketplace plans, funding the Ryan White HIV/AIDS program, and provisions that are intended to reduce the cost of prescription drugs.  

However, it is unclear whether the House version of the BBB will receive enough votes in the Senate to pass. Additionally, competing legislative priorities threaten to delay the BBB from prompt consideration in the Senate, such as the looming debt limit cliff and Fiscal Year 2022 (FY2022) spending negotiations. Despite the uncertainty, House Democrats hope to put forward approved bill text to end the protracted negotiations and pressure the upper chamber to advance the BBB.  

FY2022 Appropriations 

With the bipartisan infrastructure package finalized, Democrats on the Hill are shifting their focus to FY2022 spending discussions. Lawmakers must pass a bipartisan appropriations package by the December 3 funding deadline afforded by the current continuing resolution (CR). After House and Senate Appropriations Committee chairs and ranking members were unable to reach an agreement on topline spending levels after a November 2 “four corners” meeting, Democrats are increasingly anticipating having to pass another CR to avoid a government shutdown while FY2022 spending negotiations continue. NASTAD will continue to monitor the FY2022 appropriations process to advocate for the highest funding levels on behalf of HIV and hepatitis programs.

Administrative Activities 

CDC Data Shows Decline in HCV Treatment 

On November 12, the Centers for Disease Control and Prevention (CDC) released first estimates for hepatitis C (HCV) treatment from 2014-2020. The data show that the number of people who initiated treatment for HCV in the U.S. declined from 2015 to 2020, reaching levels that are insufficient to make progress on the nation’s goal to eliminate HCV in the U.S by 2030. The data corroborates previous research that showed declining rates of HCV testing and treatment in 2020 as a result of the COVID-19 pandemic. The authors note the shifting disease demographic for the HCV epidemic due to injection drug use, citing quadrupled rates of acute hepatitis infections from 2009 to 2019. Additionally, they highlight the key role that Syringe Service Programs (SSPs) play in disease prevention and client linkage to care. The leaders of the CDC National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention (NCHHSTP) issued a dear colleague letter calling for renewed efforts to close HCV testing and treatment gaps in light of the data.  

President Biden Nominates Dr. Robert Califf for FDA Commissioner 

On November 12, President Biden formally announced his intent to nominate Dr. Robert Califf to serve as the Commissioner of Food and Drugs, the leading role within the U.S. Department of Health and Human Services (HHS) Food and Drug Administration (FDA). If confirmed by the Senate, Dr. Califf will play a significant role in coordinating the Biden Administration’s pharmaceutical policy agenda and the country’s COVID-19 response. Dr. Califf previously served as the FDA Commissioner in 2016 under the Obama Administration, but may face increased scrutiny during this Senate confirmation due to increasing opposition over the FDA’s role in facilitating the opioid epidemic. 

Resources

USPSTF Article: Actions to Mitigate Systemic Racism in Clinical Preventive Services 

The U.S. Preventive Services Task Force published an article in the Journal of the American Medical Association (JAMA). Authored by the full Task Force, this article asserts that people who experience racism generally have shorter life expectancies and experience more health problems due to preventable causes. The article details actions the Task Force is taking to promote antiracism and health equity in preventive care by confronting these issues throughout its recommendation development process. These efforts are aimed at reducing the effects of social injustices in healthcare and, ultimately, helping better equip clinicians with the evidence-based guidance they need to prevent disease and keep everyone as healthy as possible. 

CDC Online Course: TB 101 for Health Care Workers 

The CDC Division of Tuberculosis Elimination (DTBE), is pleased to announce the release of the updated TB 101 for Health Care Workers online course. Originally released in 2012, the 2021 edition contains updated information about the treatment of latent TB infection and TB disease, based on the latest available guidance. This interactive, web-based course is designed to educate health care workers about basic concepts related to TB prevention and control in the United States. The target audience for the course includes newly hired TB program staff and health care workers in areas related to TB. It is also a great resource for any health care worker to refresh their knowledge of TB. 

NOFO: Expanding Syringe Services Programs Capacity to Respond to COVID-19 

In 2021, as part of the COVID-19 response under the American Rescue Plan Act and in partnership with the collaborative centers within the CDC, resources to support SSPs and expand their overall capacity to provide COVID-19 vaccination, education testing, and expanded services for additional adult vaccination were awarded to NASTAD and AIDS United. This one-year demonstration project, with expanded authority to extend its impact beyond the first year, aims to strengthen the capacity of SSPs to serve as critically essential access points for COVID-19 vaccination services, general COVID-19 response interventions and expanded adult vaccination services for people who use drugs.  These applications will go live on Nov. 5, 2021, on NASTAD and AIDS United’s websites and a centralized landing page describing the project with links to all three RFPs is available here.  

NASTAD Webinar: Positively Safe: Addressing the Intersection of HIV and Domestic Violence 

Date & Time: Thursday, November 18, 2021, 3:30 PM – 5:00 PM ET 

Please join NASTAD and the National Network to End Domestic Violence (NNEDV) for a webinar presentation exploring the intersections of domestic violence (DV) and HIV, specifically in the context of health department service delivery and Ending the HIV Epidemic (EHE) goals. Ashley Slye (NNEDV) will share an overview on DV, trauma, and how perpetrators of violence may use HIV status to exert power and control. Attendees will also discuss trauma-informed promising practices to implement when working with individuals who disclose DV, as well as and tips and resources to assist in building partnerships with local DV programs.    

NASTAD Webinar: Introducing PrEP Coverage Check—A PrEP Verification Tool 

Date & Time: Thursday, November 18, 3:00-4:00 PM EST 

Please join NASTAD for a webinar introducing and walking through the forthcoming resource, PrEP Coverage Check—A PrEP Verification Tool. As a reminder, The Patient Protection and Affordable Care Act (ACA) requires qualified health plans to cover PrEP as a preventive service without cost-sharing. This tool aims to assist PrEP navigators and enrollment assisters in quickly verifying whether PrEP medications are covered in select health plans throughout the 2022 Open Enrollment Period.    

HRSA NOFO: Ending the HIV Epidemic - Primary Care HIV Prevention 

Application Deadline: Tuesday, December 14 

TA Webinar: Thursday, October 28 at 2 pm ET 

HRSA released the fiscal year (FY) 2022 Ending the HIV Epidemic - Primary Care HIV Prevention (PCHP) Notice of Funding Opportunity (HRSA-22-104). HRSA will invest approximately $50 million in health centers located in the targeted geographic locations where a majority of new HIV infections occur, as identified by the Ending the HIV Epidemic in the U.S. initiative. FY 2022 PCHP will support expanding HIV prevention services that decrease the risk of HIV transmission in underserved communities, focusing on supporting access to and use of pre-exposure prophylaxis (PrEP). Health centers with service delivery sites in the targeted geographic locations that did not receive FY 2020 PCHP or FY 2021 PCHP funding will be eligible to apply. Technical assistance (TA) resources are available on the PCHP TA webpage

Job Postings 

HIV Surveillance Epidemiologist, Washington State Department of Health – Tumwater, WA 

The Washington State Department of Health’s (DOH) mission is to work with others to protect and improve the health of all people in Washington State. The Office of Infectious Disease (OID) Assessment Unit (AU) is responsible for statewide surveillance and investigation of HIV, sexually transmitted infections (STIs; primarily chlamydia, gonorrhea, and syphilis), and hepatitis C (HCV), and data and data system support for the HIV, STD, HCV, and Drug User Health (DUH) programs. In this position you'll contribute to the organization by assuring that the foundational activity of public health assessment is conducted in a timely and accurate way.  You'll contribute specifically to the mission of the Infectious Disease Assessment Unit by providing dataset preparation, document preparation and data analysis. These activities support core HIV Surveillance, the Ryan White Equity Project, and other OID programs. Currently, this position may be located anywhere within the State of Washington. Due to the COVID-19 pandemic, telework (mobile-work) is expected. When approved to return, the incumbent will work with their supervisor to identify an appropriate work schedule and balance, including telework and reporting to the Tumwater duty station for work activities. 

Field Service Consultant, Hepatitis C Disease Intervention Services Team – Washington State Department of Health 

Reporting to the Adult Viral Hepatitis Prevention Coordinator, these consultants will work with multi-county regions statewide and with local governmental and non-governmental stakeholders to make high-quality hepatitis C (HCV) prevention services available and accessible to residents of Washington State. These services include testing and screening, contact investigation and disease intervention services, and linkage to and retention in medical care. These consultants may provide direct service to members of the public who are diagnosed with or exposed to disease. This role also helps local public health and community organization program staff plan, develop, and implement activities to detect, treat, and prevent infectious disease. This announcement will be used to fill three (3) full-time permanent Health Services Consultant 3 positions located within the Division of Disease Control and Health Statistics, in the Office of Infectious Disease. Currently, this position may be located anywhere within the State of Washington. Due to the COVID-19 pandemic, telework (mobile-work) is expected. When approved to return, the incumbent will work with their supervisor to identify an appropriate work schedule and balance, including telework and reporting to the Tumwater duty station for work activities. 

Applications close November 30. 

Program and Administrative Assistant, Building Healthy Online Communities (BHOC) – Springboard HealthLab 

Springboard HealthLab is a brand-new organization, founded in 2021, with a clear goal: to support big ideas that can improve health equity. Springboard is focused on supporting projects to turn promising ideas into new ventures -- and then helping them find a permanent home. Building Healthy Online Communities (BHOC) is a consortium of public health organizations working in partnership with dating apps to improve sexual health outcomes for app users. We’re a small but mighty team that works on home testing and supporting anti-stigma and sexual health features on dating apps. The Program and Administrative Assistant, BHOC, supports the administrative work of BHOC’s programs and strategy. This is a 10 hours per week, part-time position. This is a 3- to- 6-month position dependent on funding availability, with the possibility of extension or expansion of hours. 

Ryan White Part B Program Director, Tennessee Department of Health – Nashville, TN 

The Ryan White Part B Program Director is responsible for developing and administering a budget of over $40 million, with multiple contracts, and comprehensive statewide planning involving persons living with HIV, providers, and other HRSA grantees, including service organizations and case managers. The position also oversees the AIDS Drug Assistance Program (ADAP) which provides Affordable Care Act health insurance to eligible clients or medications and ambulatory HIV care to those not enrolled in the Insurance Assistance Program. Other components include the Minority AIDS Initiative, an oral health program, and Housing Opportunities for Persons with AIDS (HOPWA). 

The position manages a team of 14 people and serves as the Ryan White Part B program spokesperson, liaison, and technical resource to grantees and other partners. The position is situated in, and works closely with, the surveillance and prevention programs for HIV, sexually transmitted infections, and viral hepatitis within the Communicable and Environmental Diseases and Emergency Preparedness Division at the Tennessee Department of Health. 

HIV/STD Director, Texas Department of State Health Services – Austin, Texas 

The Department of State Health Services (DSHS) is seeking an exceptional candidate to serve as the HIV/STD Director in the Texas TB/HIV/STD Section in Austin, TX. The HIV/STD Director works under the general direction of the Director of the TB/HIV/STD Section (THSS) of the DSHS. Performs advanced (senior-level) managerial work leading the day-to-day operations of the HIV/STD Prevention and Care Unit. These programs include statewide programs for HIV clinical and social services; the provision of medications for the treatment of HIV and other STDs; and HIV/STD prevention. To apply, register at Health & Human Services (HHS) Job Opportunities, and search for Job Posting Number #501910.  

Manager, Legal Research (NASTAD) – Remote/Washington, DC 

The Manager, Legal Research provides legal and policy research and analysis as part of NASTAD’s technical assistance and capacity building assistance. This position works closely with the Prevention, Policy & Legislative Affairs, and Health Systems Integration teams to support programmatic activities. This role works with the Director of Policy & Legislative Affairs and Senior Manager of Health Systems Integration, to implement key activities under NASTAD’s health systems legal and policy portfolio, including conducting public health legal research, synthesizing complex policy material, and supporting development of webinars, peer learning opportunities, and deliverables to support health department efforts to navigate federal, state, and local laws and policies 

Program Analyst: HIV, STI, & Viral Hepatitis Program - Harm Reduction (NACCHO)  

The Program Analyst will support projects and activities across NACCHO’s HIV, STI, and Viral Hepatitis program portfolio. In particular, the Program Analyst will support the implementation of projects designed to build local capacity and partnerships for harm reduction and the prevention and elimination of viral hepatitis. The ideal candidate will possess interest and experience in harm reduction and/or the prevention and elimination of viral hepatitis, as well as health department and harm reduction programming, public health policy, the provision of technical and capacity building assistance, monitoring and evaluation, partnership building, and project management. 

Senior Project Manager, HIV, Gender Affirming, and Integrated Care – New York City, New York 

Primary Care Development Corporation (PCDC), a nationally recognized 501(c)(3) community development financial institution (CDFI), catalyzes excellence in primary care through strategic community investment, capacity building, and policy initiatives to achieve health equity. The Senior Project Manager will be a member of the High Impact Prevention (HIP) project team and will work across the broader CQP practice. 

PCDC’s CDC-funded High Impact Prevention (HIP) program provides support to communities greatly impacted by HIV. With CDC and other national partners, the HIP Program enhances the expertise of the HIV prevention workforce – including health care providers and staff in local and state health departments and community-based organizations (CBOs) – to achieve the United States’ goal of substantially reducing the number of new HIV infections. The PCDC HIP Program serves the Northeast region of the US and the territories of Puerto Rico and US Virgin Islands. 

Public Health Specialist 2 – Anchorage, Alaska 

Working as a Public Health Specialist 2 (PHS II) HIV Prevention Coordinator in the HIV/STD Program offers you a rare opportunity to help develop and implement policies, protocols, procedures, and services around HIV prevention activities in the State. You will help assure that services are based on scientific findings and best practices that are adaptable to Alaska’s specific needs. You will provide expertise on HIV Prevention practices, including helping individuals to enter and stay in care, to both improve their health and reduce the likelihood of HIV transmission. Applications close November 22. 

New Hampshire, Department of Health and Human Services, Division of Public Health Services 

  • Public Health Program Manager/Ryan White Care Program Manager 
    • #43569 (search Job ID 22642) 
    • Supervises and monitors the NH Ryan White Human Immunodeficiency Virus (HIV) CARE Program (NH CARE Program) and the NH Tuberculosis Financial Assistance (TBFA) Programs with responsibility for coordinating all aspects of program services and developing goals, objectives and performance improvement measures for a statewide continuum of TB and HIV care. 
  • Infectious Disease Care Coordinator 
    • #9T3153(search Job ID 22634) 
    • Reviews, modifies and implements program policies and procedures related to prevention of transmission of human immunodeficiency virus (HIV) and sexually transmitted diseases (STD), hepatitis C (HCV), COVID-19, and other infectious diseases among high-risk populations. 
  • Infectious Disease Care Coordinator 
    • #9T3152 (search Job ID 22631) 
    • Reviews, modifies and implements program policies and procedures related to prevention of transmission of human immunodeficiency virus (HIV) and sexually transmitted diseases (STD), hepatitis C (HCV), COVID-19, and other infectious diseases among high-risk populations. 

Wyoming Department of Health, Public Health Division, Communicable Disease Unit 

  • Communicable Disease Unit Surveillance Program Manager – Cheyenne, Wyoming 
  • The Wyoming Department of Health, Public Health Division, Communicable Disease Unit is seeking a Communicable Disease Surveillance Program Manager for Cheyenne. This position will serve as the Communicable Disease (CD) Surveillance Program Manager and senior epidemiologist for the Communicable Disease Unit. This position oversees public health surveillance of four disease areas (HIV, STD, TB, and Viral Hepatitis).  This position will monitor disease trends and utilize surveillance data to coordinate public health activities.   
  • 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. 

Hepatitis Surveillance Data Analyst – New Orleans, Louisiana 

This position is responsible for the data analysis activities for the Louisiana Office of Public Health STD/HIV/Hepatitis Program (SHHP), in the Hepatitis Surveillance unit. Data utilized for Hepatitis Surveillance activities include Hepatitis laboratory data, Case Report Forms, Provider Report Forms, Linkage to Cure data, investigation data, Medicaid data, and data from related sources and programs. This position will implement and coordinate data analysis activities to monitor and evaluate progress toward meeting hepatitis elimination within the state. All activities must be completed in accordance with the security and confidentiality guidelines required by the Centers for Disease Control and Prevention (CDC) and SHHP. 

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.  

News Bulletin

Advocates challenge the CDC’s new effort to track HIV spread 

“In 2019, one of America's top public health officials went on the road, promoting an ambitious plan to slash new HIV infections by 90 percent by 2030…Redfield also pushed the plan at the 2019 United States Conference on AIDS in Washington, D.C., an annual meeting that draws several thousand researchers, activists, and people living with HIV. (The conference has since been renamed the U.S. Conference on HIV/AIDS.)… The plan was flawed, according to the activists, because it relied on a new data collection and analysis program that put them in harm's way — something they called "molecular HIV surveillance," and that the CDC now prefers to term ‘molecular analysis.’”

White House Now Supports Harm Reduction Such as Needle Exchanges 

“The Biden administration will directly support harm reduction programs, such as needle exchanges, reports NPR.org. Despite the fact that such programs remain controversial and are even illegal in parts of the country, the federal government is endorsing harm reduction in an effort to combat injection drug overdoses and the spread of HIV and hepatitis B and C.” 

CVS drops SCOTUS appeal in case that challenged prescription policies 

“Less than a month before the Supreme Court was to hear a Bay Area suit against CVS that could have narrowed the scope of the nation’s disability laws, the drugstore chain announced an agreement Wednesday with advocacy groups and HIV patients who had challenged its policies on receiving prescription medication.”