Policy Updates: Hill Happenings and Administration Activities

By Mike Weir January 15, 2019

Hill Happenings

Government Shutdown

Though the 116th Session of the United States Congress has begun, the government shutdown has now entered its 25th day, despite the Democratic controlled House passing a number of funding bills, including the Transportation, Housing and Urban Development, and Related Agencies (T-HUD) bill which funds the Housing Opportunities for Persons With AIDS (HOPWA). Senate Majority Leader Mitch McConnell (R-KY) has continued to decline to take up any of the bills in the Senate, despite Senate Republicans’ earlier support for a stopgap funding bills without border wall funding. 

Committee Assignments

The Senate Appropriations Committee and House Appropriations and Energy & Commerce (E&C) Committees announced new assignments. 

Senate Appropriations:

Richard Shelby (AL) – Committee Chair 

Senate Appropriations Labor-HHS Members:

Republicans: Chairman Roy Blunt (MO), Richard Shelby (AL), Lamar Alexander (TN), Lindsey Graham (SC), Jerry Moran (KS), Shelley Moore Capito (WV), John Kennedy (LA), Cindy Hyde-Smith (MS), Marco Rubio (FL), James Lankford (OK). 

Democrats: Ranking Member Patty Murray (WA), Richard Durbin (IL), Jack Reed (RI), Jeanne Shaheen (NH), Jeff Merkley (OR), Brian Schatz (HI), Tammy Baldwin (WI), Chris Murphy (CT), Joe Manchin (WV)

House Appropriations Full Committee New Democrat Members:

Cheri Bustos (IL-17), Ed Case (HI-1), Charlie Crist (FL-13), Lois Frankel (FL-21), Ann Kirkpatrick (AZ-2), Brenda Lawrence (MI-14), Norma Torres (CA-35), Bonnie Watson Coleman (NJ-12)

House E&C Democrat Members:

Nanette Barragán (CA-44), Lisa Blunt Rochester (DE-At Large), Robin Kelly (IL-2), Ann Kuster (NH-2), Donald McEachin (VA-4), Tom O'Halleran (AZ-1), Darren Soto (FL-9), Marc Veasey (TX-33)

The complete preliminary Senate committee rosters for the Democrats and Republicans are now available. 

Call for Health Equity

NASTAD signed onto a letter urging the 116th Congress to prioritize health equity by taking “immediate action to ensure that each person in the United States has the opportunity to attain their full health potential.”

Administration Activities

National HIV/AIDS Strategy and National Viral Hepatitis Action Plan Update 

The U.S. Department of Health and Human Services (HHS) Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) announced it will host two listening sessions as it begins to update the National HIV/AIDS Strategy (NHAS) and National Viral Hepatitis Action Plan. 

  • Tuesday, January 29, 2019: Virtual Listening Session from 1:00–3:00 PM EST. You must register to participate. 
  • Friday, February 22, 2019: In-person Listening Session at HHS from 11:00 a.m.–1:00 PM EST in Room 800 of the Hubert H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC, 20201. RSVP by Thursday, February 14 by sending your name, title, and organization to HepHIVStrategies@hhs.gov.

Medicare Part D 

In November of 2018, CMS issued a proposed rule to roll back some of the Medicare Part D protections for HIV medications. Antiretrovirals are part of six “protected classes,” meaning Medicare Part D plans have historically had to cover all or substantially all of the drugs in each of these six classes with limited utilization management. The proposal would do three things: 1) allow greater use of step therapy and prior authorization for the six protected classes; 2) allow plans to exclude a protected class drug from a formulary if the drug represents only a new formulation of an existing single-source drug or biological product, regardless of whether the older formulation remains on the market; and 3) allow plans to exclude a drug from a formulary if the price of the drug increased beyond a certain threshold over a certain time period. NASTAD is developing comments to the proposed rule, highlighting potential access issues for people living with and high risk for HIV. For questions, please contact Amy Killelea

The HIV Health Care Access Working Group (HHCAWG) held a webinar on the proposed rules and how it can impact people living with and vulnerable to HIV. A recording of the webinar can be found here.

USPSTF Recommendation

NASTAD signed onto comments drafted by HHCAWG and the HIV Prevention Action Coalition (HPAC) to the U.S. Preventive Services Task Force (USPSTF) on their Draft Recommendation Statement for pre-exposure prophylaxis (PrEP). Under the proposed recommendation, PrEP is assigned an ‘A’ grade for “persons at high risk of HIV acquisition.”

Centers for Disease Control and Prevention 

The Centers for Disease Control and Prevention’s (CDC) Division of HIV/AIDS Prevention (DHAP) released the HIV Testing at CDC-Funded Sites: United States, Puerto Rico, and the U.S. Virgin Islands, 2017 report. This report includes HIV test-level data from 61 CDC-funded state and local health departments and 111 directly funded community-based organizations.

DHAP also recently launched the Transforming Health: Patient-Centered HIV Prevention and Care website. The website provides information and materials for health care providers, whole-care teams, social service providers, and transgender people

National Institutes of Health

In a recent JAMA opinion piece, leaders from the National Institutes of Health’s (NIH) National Institute of Allergy and Infectious Diseases (NIAID) discussed the advancing science around treatment as prevention and asserted that “an overwhelming body of evidence has emerged to provide the firm basis to now accept this concept [U=U] as scientifically sound.”

Resources

Webinar: Health Department and Community-Based Organization Collaborative Strategies for Linkage-to-CareJoin the Latino Commission on AIDS (LCOA) and NASTAD for a webinar featuring experts from the field to explore successful strategies and solutions. Topics covered include:

  • Building relationships between community-based organizations (CBOs) and health departments (HDs);
  • Improving communication between partners within and/or across jurisdictions;
  • Case studies of comprehensive strategies;
  • Resources available to improve outcomes for CBOs; and more!

new report from the Southern HIV/AIDS Strategy Initiative (SASI) and six individual state reports (ALGALAMSNCSC) “break down the percentage of key populations most impacted by the epidemic who live outside the large urban areas in the Deep South States, in particular Black/African American populations, Men who have Sex with Men/Same Gender Loving Men, Women, Youth, and Injection Drug Users.”

Advocates with the Michigan Coalition for HIV Health and Safetyworked with the Michigan Department of Health and Human Services (MDHHS) to update and modernize Michigan’s HIV disclosure law

Job and Project Opportunities

STD Program Manager– Texas

The Texas Department of State Health Services is hiring for a STD Program Manager within their HIV/STD Prevention & Care Branch.

Cook County Health System Executive Director of HIV Services– Cook County

The Cook County Health System (CCH) is hiring an Executive Director of HIV Services.

Disease Intervention Specialist– Alaska

The Alaska Department of Health and Social Services is hiring for a Disease Investigation Specialist I within their Division of Public Health, Section of Epidemiology, HIV/STD Program.

Request for Proposals: Planning for State Viral Hepatitis Elimination Programs

The Association of State and Territorial Health Officials (ASTHO) is seeking state and territorial health agencies to participate in a capacity building project to plan for and work towards hepatitis B and C elimination. Capacity-building support will be tailored to each participating jurisdiction based on its current stage in elimination planning. Applications are due on January 21, 2019 by 5:00PM EST. Selections will be announced January 28, 2019.

Upcoming Meetings

2019 HIV Diagnostics Conference

The 2019 HIV Diagnostics Conference will be held in Atlanta on March 25-28, 2019. The conference will address advances in diagnostic testing, and strategies for using test technologies in public health programs and clinical practice. NASTAD encourages health department HIV, HCV, and STI testing program managers and other staff consider submitting a late breaker abstract.  Particularly encouraged are abstracts that address strategies to integrate HIV and HCV testing and linkage, and best practices to streamline time to test result receipt and linkage to care in clinical and non-clinical settings.

HIV, HCV and Syphilis Diagnostic Testing Workshop

The Association for Public Health Laboratories (APHL) will be hosting an HIV, HCV and Syphilis Diagnostic Testing workshopin conjunction with the 2019 HIV Diagnostics Conference. The workshop will be held Monday March 25, 2019 from 8am-3pm. The conference will kick off at 4pm. The educational workshop will feature short presentations highlighting the current technology and algorithms for each pathogen followed by facilitated and small-group discussions centered around case studies and real-world examples. The objectives of the workshop are two-fold: (1) to educate attendees about the technologies and challenges in diagnostic testing and (2) to encourage peer-to-peer discussions and fostering collaborations beyond the workshop. Program staff are welcome to attend.  If you will be attending the conference and would be interested in participating in the workshop, please contact APHL’s Dr. Anne Gaynor.

News Bulletin

Facing Legal Action, Insurer Now Will Cover People Taking Truvada, an H.I.V.-Prevention Drug

“The insurer also has settled a lawsuit brought by an unidentified gay man in Massachusetts who was turned down for long-term-care insurance after acknowledging that he took an H.I.V.-prevention drug called Truvada.”