Policy Updates: Hill Happenings and Administration Activities

By Mike Weir November 23, 2020

Hill Happenings

FY2021 Appropriations

Negations are ongoing between House and Senate Appropriations leaders on a bicameral omnibus deal to complete FY2021 funding. The current continuing resolution (CR) extending government funding through December 11th. Speaker Nancy Pelosi (D-CA-13) said she still wants both chambers to fund the government with a full spending deal, “not a CR,” and Senate Majority Leader Mitch McConnell (R-KY) has agreed.

Congressional Results

Several House races are still undecided, but Democrats have kept control of the chamber. Republicans picked up several House districts but did not net the 17 seats they needed to gain the majority. Control of the Senate is still unknown with two runoffs in Georgia set for January 5, 2021. While it remains likely that Republicans will remain in control of the Senate, if Democrats win both run off races, they will gain control of the Senate with Vice-President-elect Harris serving as tiebreaker. NASTAD provided this outline of the election results.

COVID-19 Relief Updates

Congressional and Administration leaders remain in a deadlock over another round of COVID-19 stimulus, with a deal during the lame duck session still unknown. NASTAD will continue to monitor the appropriations process and stimulus negations and advocate for the highest funding levels on behalf of HIV and hepatitis programs. 

Administrative Activity

NOFO for Initiative to Improve Reporting Viral Suppression Data to Centers for Medicare and Medicaid Services

The Health Resources and Services Administration (HRSA) released a “Notice of Funding Opportunity (NOFO) for a new 4-year SPNS initiative entitled "Building Capacity to Improve Collecting and Reporting Viral Suppression Data to the Medicaid Adult Core Set." HRSA will establish one Cooperative Agreement with a System Coordination Provider (SCP) that will select, fund, and work with up to 10 Ryan White HIV/AIDS Program (RWHAP) Part B recipients, and HIV surveillance and Medicaid programs to build capacity to report high-quality HIV viral suppression data to the Centers for Medicare & Medicaid Services (CMS), as part of the annual state Medicaid Adult Core Set reporting. The anticipated period of performance is August 1, 2021 through July 31, 2025. Up to $4,000,000 will be available per year.

An informational pre-application webinar will be held 1:30-3:00 PM ET on Thursday, December 10. Applications are due February 16, 2021. Information on the NOFO is available at www.grants.gov. After the pre-application webinar, questions on the NOFO may be directed to spns@hrsa.gov.

Q&A about RWHAP Use of CARES Act Funding to Purchase Mobile Technology

“HRSA’s HIV/AIDS Bureau added a new question and answer to their COVID-19 Frequently Asked Questions (FAQs) to provide updated clarification about recipients’ use of RWHAP and/or CARES Act funds to pay for mobile devices and connectivity costs. Mobile devices (e.g., telephones, tablets, laptops) and connectivity costs (e.g., data plans, phone cards), collectively referred to as “mobile technology,” are allowable uses of federal funds in instances where the RWHAP recipient or subrecipient can ensure that costs are reasonable, allocable, and needed in order to achieve the statutory purpose of the program. RWHAP recipients and subrecipients can fund mobile technology costs to support access to HIV care, treatment, and support via telehealth across various core medical and support services, as outlined in PCN #16-02 Ryan White HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds. For additional clarifications around the use of CARES Act funding, visit the COVID-19 FAQ webpage.”

Vital Signs: Deaths Among Persons with Diagnosed HIV Infection, U.S., 2010–2018

“The Centers for Disease Control and Prevention (CDC) published a study in the Morbidity and Mortality Weekly Report (MMWR) that found that the age-adjusted rate of HIV-related deaths among people with HIV in the U.S. fell by nearly half from 2010 to 2017. The age-adjusted HIV-related death rate (the number of HIV-related deaths per 1,000 people with HIV) fell from 9.1 to 4.7.”

New FAQs for PS22-2103 Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments

The CDC Division of Viral Hepatitis (DVH) completed an additional update to the Frequently Asked Questions (FAQ) section of the webpage for funding opportunity PS21-2103 Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments. This new content can be found below and via the PS21-2103 FAQ webpage.

PACHA Virtual Meeting

The Presidential Advisory Council on HIV/AIDS (PACHA) will hold its 69th full Council meeting virtually on Wednesday, December 2 and Thursday, December 3, 2020 from 1:00 - 5:00 PM (ET). The meeting agenda will be posted on the PACHA page on HIV.gov prior to the meeting. Instructions on attending this meeting virtually will be posted one week prior to the meeting here.

World AIDS Day

World AIDS Day (WAD) will be held on December 1. The CDC has provided free tools in the WAD Resource Center to help support awareness activities and testing events. 

The Health and Human Services’ (HHS) Office of Infectious Disease and HIV/AIDS Policy (OIDP) will host a special Live with Leadership - World AIDS Day Edition conversation to learn directly from key HHS and community leaders about new and ongoing work further the Ending the HIV Epidemic: A Plan for America (EHE) initiative. The Live with Leadership session will take place on Tuesday, December 1st from 2:00 – 3:00 pm ET. 

USPSTF Recommendation

The U.S. Preventive Services Task Force (USPSTF) issued a Draft Research Plan on Screening for Syphilis in Nonpregnant Persons. The opportunity for public comment on USPSTF’s Draft Research Plan expires on December 23, 2020, at 11:59 PM EST.

Resources

Webinar: Implementing Self-Testing for HIV and PrEP Monitoring

The second webinar in the series Self-Testing Strategies for PrEP and HIV will be held on December 3, from 3:00 – 4:30 PM ET. The webinar, Implementing Self-Testing for HIV and PrEP Monitoring, focuses on approaches for clinical decisions regarding self-testing for PrEP and lessons learned when implementing self-testing with various populations. Please click here to register for this webinar.

The initial webinar in the series, Providing At-Home Testing Through the BHOC Partnership, was held on October 15, 2020, provided an overview of self-testing initiatives and highlighted Building Healthy Online Communities’ Take Me Home program, which included details about expanding self-testing options to STI and PrEP panels. The recording, presentation slides, and questions posed during the first webinar can be accessed on NASTAD’s website by following this link.

NASTAD Resources for Open Enrollment

The 2021 Open Enrollment Period began on November 1 in every state, and ends on December 15 in most states. This Open Enrollment Period poses unique challenges due to the ongoing COVID-19 pandemic, and NASTAD is available to support members’ important work helping clients enroll in and maintain coverage for the upcoming plan year.

The following NASTAD resources are now available on our website:

  • NASTAD’s September 8 webinar, “RWHAP ADAP Considerations for the 2021 Plan Year
  • Pre-recorded education session on Unemployment Benefits During COVID-19 (available via NASTAD’s Online Technical Assistance Platform, OnTAP)
  • NASTAD’s 2021 ADAP Cost-Effectiveness Toll and User Guide (attached)
  • NEW Pre-recorded training on NASTAD’s 2021 Cost-Effectiveness Tool (available via OnTAP)

Additionally, NASTAD has developed the following resources related to enrollment and coverage considerations during the COVID-19 pandemic:

And finally, here are some resources from NASTAD’s partners that may be helpful to you during Open Enrollment:

  • TargetHIV resources for Open Enrollment and more (ACE TA Center)
  • Health Reform Beyond the Basics comprehensive webinars and other materials related to all things enrollment (Center on Budget and Policy Priorities)
  • Find Your State tool, an easy-to-use web hub with information about health coverage options in each state, including enrollment dates, eligibility, Marketplace and Medicaid websites, and more (Greater Than AIDS)

New Ending the HIV Epidemic Jurisdictional Directory

NASTAD released a new Ending the HIV Epidemic (EHE) Jurisdictional Directory. The directory provides a list of local and state points of contact for EHE-related community engagement activities. Aiming to increase community participation, the directory also includes EHE websites, EHE jurisdictional plans, and social media accounts if available. NASTAD maintains the directory as the HRSA-20-089 Systems Coordination Provider and CDC PS19-1906 National Partner. The directory is available through NASTAD’s EHE website and it is used to populate additional national contact lists. 

Issue Brief: Trump Administration Reverses Course on Medicaid Maintenance of Effort Provisions, Clearing the Way for Devastating Cuts in The Midst Of The Covid-19 Pandemic

Job Postings

Health Programs, Bureau Administrator – Baltimore, MD

Baltimore City Health Department is hiring for the Bureau Administrator for the Bureau of Clinical Services and HIV/STI Prevention. The Bureau Administrator is a critical member of the bureau leadership team, and helps with the overall management, operations, direction, and strategic vision of the bureau. Organization, initiative, teamwork, flexibility, patience, empathy, and creativity are all important for the role. This posting closes on November 27, 2020. 

Senior Associate, Health Equity – Washington, DC

NASTAD is seeking a Senior Associate for the Health Equity team. The Senior Associate, Health Equity plays an essential role in supporting the implementation and dissemination of evidence-based interventions identified by NASTAD's Center for Innovation and Engagement (CIE). CIE is leading a collaborative partnership with Northwestern University's Center for Prevention Implementation Methodology and Howard Brown Health Center to identify, catalog, disseminate, and support the replication of evidence-informed approaches and interventions to engage people living with HIV (PLWH) who are not receiving HIV care or who are at risk of not continuing to receive HIV care. The project's end goal is to support the replication of identified interventions into real-world implementation by Ryan White HIV/AIDS Program (RWHAP) and HIV care providers.

DC Ending the HIV Epidemic Coordinator

The incumbent serves as the Ending the HIV Coordinator and is responsible for serving as team lead and coordinating all program components for implementation of the District’s Ending the HIV Epidemic plan. The incumbent will develop strategic, operational, budget, project, and evaluation plans and coordinate data collection to assess progress on implementation of the Ending the HIV Epidemic plan, program effectiveness, and impact of policies and programs. They will serve as the lead on the development and updating of an Ending the HIV Epidemic Dashboard and develop program materials, position papers, policy documents, and presentations for a range of internal and external audiences. and providing technical assistance to internal teams and staff related to performance measures, program evaluation designs, and data collection protocols. This position closes on 11/29/2020.

Clinical Quality Management Health Planner – Fort Lauderdale/Broward County EMA

The Clinical Quality Management Health Planner is a professional health planning position. Incumbents in this classification carry out work assignments with considerable degree of independence and are free to develop their own work sequence within the broad guidelines of policies and procedures. Key Skill sets include the ability to: conduct data analysis; write proficiently; provide clear, accurate, and engaging presentations; facilitate Clinical Quality meetings; and conduct technical research. This role will participate in communications with the Ryan White Part A Grant Recipient, provides insight into relevant data activities and will have access to confidential information. The Health Planner requires a broad knowledge of assigned program areas and expertise in program planning techniques.

Interested applicants should submit a resume and a cover letter indicating how your past experience relates to this position to quality@brhpc.org .

Virginia Medication Assistance Technicians Levels II and I – Virginia

The VA Medication Assistance Program (VA MAP) provides access to critical HIV-related treatment for low-income individuals who have no other resources to pay for their medications. The Medication Assistance Technician (MAT) Level I manage telephone, fax, and written communications with consumers, providers, vendors, insurance companies, HCS team members, and others. The MAT I conducts individual client’s VA MAP eligibility and recertification in accordance with the most current Health Resources and Services Administration (HRSA) guidance and program policies and supports all daily operational activities of the VA MAP including staffing the program’s telephone hotline. The MAT I also supports daily VA MAP operations including responding to and managing client inquiries that come through the Eligibility Hotline and provider communications through other channels, referring clients to resources, resolving medication access issues, assisting with insurance enrollment and contacting clients to obtain additional application information. Candidates must have very good customer service skills, strong computer skills, the ability to follow instruction, problem-solve medication access issues, and accurately collect, organize, analyze, manage, and report data. Minimum requirements are a high school diploma or equivalent training and experience. Knowledge of HIV/AIDS health care services delivery and call center experience preferred. These are contractual positions working a minimum of 40 hours per week, but do not offer benefits (annual leave, sick pay, or health insurance). For Level I, the pay ranges from $18-$22 per hour based on experience. The Medication Assistance Technician Level II demonstrates a mastery of all duties and skills for the Level I position, in addition to providing training for new Level Is and assists with tasks and projects as assigned by their supervisor. Level II pay ranges from $23-$26 per hour based on experience.

These positions are open until filled. To apply for either of these positions, please send your resume and cover letter by email to myras@tscti.com, rajeshwarj@tscti.com, and dgsjobs@tscti.com, and in the subject line put “VA Medication Assistance Technician Level I or VA Medication Assistance Technician Level II”. Applicants must successfully pass a background investigation.

STD Epidemiology and Surveillance Team Lead – Texas

The Texas Department of Health Services is seeking a STD Epidemiology and Surveillance Team Lead in the STD/Hepatitis C Epidemiology and Surveillance Group of the HIV/STD/HCV Epidemiology and Disease Surveillance Branch. Under the supervision of the group manager the Epidemiologist III performs highly advanced senior-level research and epidemiological work requiring specialized knowledge of STD surveillance. Designs and conducts advanced epidemiological research, evaluating populations and their risk factors for STDs using data from the STD reporting systems and other large data sets in the Epidemiology and Surveillance Branch. Prepares and presents research findings on STD issues in reports, professional journals, national conferences, and state meetings. Plan, assign, and/or supervise the work of others. Works under minimum supervision with extensive latitude for the use of initiative and independent judgment.  

Ending the HIV Epidemic Treatment Coordinator – Tarrant County, TX

The Ending the HIV Epidemic Treatment Coordinator oversees implementation of the Ending the HIV Epidemic grant activities for the Tarrant County HIV Administrative Agency. This position focuses on operational functions while working with community partners and sub-recipients to drive changes impacting the lives of more than 6,000 clients living with HIV. The Coordinator will assist with preparing the grant application, developing the workplan, overseeing grant-related reporting, monitoring the budget, and supervising Ending the HIV Epidemic staff. The posting may close at any time.

HIV Planner - HIV/STD DSHS Grant – UT Austin

The HIV Planner, in coordination with the UT-Austin Health Innovation and Evaluation Team and the Texas Department of State Health Services (DSHS) HIV Care Services Group and the HIV/STD Prevention and Care Branch Planning team, will perform comprehensive, advisory duties in developing, planning, and monitoring the development and implementation of HIV strategic, operational, program, and technical assistance plans.

HIV Prevention Manager — Ohio

The Ohio Department of Health’s Bureau of Infectious Diseases is seeking one candidate to fill their Health Planning Administrator 2 role for the HIV Prevention program. The Manager would be responsible for coordinating all components of the HIV Prevention Program (e.g., managing the statewide HIV testing program, implementing high-impact prevention strategies including pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and blood-borne pathogen prevention programs, managing the statewide PrEP assistance program known as PAPI (Prevention Assistance Program Interventions), collaborating with the STI Prevention program to achieve partner services and linkage to care performance measures, implementing innovative HIV testing initiatives, managing the deliverables of contractors, reducing health disparities among disproportionately impacted populations, providing leadership in the statewide community planning group and community-level interventions, demonstrating the application of feedback from stakeholders in community planning documents and activities consistent with federal guidance, provide programmatic leadership in cluster investigation and outbreak response related to HIV transmission).

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

Will the Biden-Harris Administration Breathe Life Back Into Vital HIV and Hepatitis Programs?

“Federally funded HIV and hepatitis programs vital to the health care of millions of Americans have endured deep funding cuts under the Trump Administration. With just a couple of months before President-elect Joseph R. Biden and Vice President-elect Kamala Harris take office, public health advocates like Amy Killelea have set expectations high for a renewed commitment to health equity and the expansion of programs that continue momentum towards fighting HIV and hepatitis in the U.S.

Killelea serves as the senior director of Health Systems and Policy at NASTAD, a leading nonpartisan nonprofit organization that represents public health officials who administer HIV and hepatitis programs in the U.S. Last week, NASTAD issued a statement urging the incoming Biden Administration to “immediately end several current policies that harm communities vulnerable to HIV and hepatitis.” Killelea leads NASTAD’s activities regarding policy, public and private insurance, and healthcare financing, which includes developing recommendations to inform state and federal policy.”

How Might Telehealth Benefit Persons Living With HIV?

“In light of the coronavirus disease 2019 (COVID-19) pandemic, care for persons living with HIV (PWH) has become even more critical—especially considering that consistent retention in care can improve health outcomes and help to prevent transmission of the virus, according to a poster and abstract presented at the recent ID Week that looked at the use of telehealth among PWH. “Several definitions exist for retention in care, but they are centered around outpatient clinic visits,” the authors note. “It is now more important than ever to understand PWH’s attitudes about using telemedicine for HIV care instead of face-to-face clinic visits.””