Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras December 21, 2020

Editor’s Note: In observance of the winter holidays and new year, NASTAD’s Policy and Legislative affairs team will not be issuing a weekly newsletter until January 11, 2020. Happy Holidays!  

Hill Happenings 

FY2021 Appropriations  

Negotiations are ongoing between House and Senate Appropriations leaders on a bicameral omnibus bill to complete FY2021 funding. Lawmakers passed a third, day-long continuing resolution (CR) to buy appropriators more time to strike a deal after a weekend of intense negotiations. Despite some progress in negotiations, Congress is expected to pass another CR as party leaders iron out the final details of the combined spending bill and COVID-19 relief package ahead of the holidays.  

COVID-19 Relief  

Party leaders are still negotiating on the final details of the combined spending and COVID-19 relief bill, but there is some agreement on key provisions of the legislation. Although negotiators have not released legislative text, it is expected that the $900 billion relief bill will include money for direct stimulus payments, unemployment benefits, and key health funding: $9 billion for vaccine distribution; $22 billion to states for testing and contact tracing; $4.5 billion for mental health programs; $1 billion to the National Institutes of Health (NIH); and $1 billion for the Indian Health Service. 

NASTAD will continue to monitor the appropriations process and stimulus negotiations and advocate for the highest funding levels on behalf of HIV and hepatitis programs. 

Speaker Pelosi Announces House Committee Assignments for 117th Congress  

On December 16, the House Democratic Steering Committee submitted nominations for key appointments on powerful House committees, including the House Appropriations Committee (HAC). Six House Democrats were appointed to the HAC: Congressman Adriano Espaillat (NY-13), Congressman Josh Harder (CA-10), Congresswoman Susie Lee (NV-03), Congressman David Trone (MD-06), Congresswoman Lauren Underwood (IL-14), and Congresswoman Jennifer Wexton (VA-10). The nominations must be approved by the full Democratic Caucus. 

Administrative Activity 

NASTAD Advocates for the Equitable Inclusion of Marginalized Populations in COVID-19 Vaccination Distribution Strategies 

Following the Food and Drug Administration’s (FDA) emergency use approval for the first COVID-19 vaccine, the country is embarking on the largest nationwide public health initiative in its history. As federal agencies and public health officials develop COVID-19 vaccine distribution strategies and establish priority populations, NASTAD is working to ensure that those efforts reach individuals and communities who are disproportionately impacted by HIV, hepatitis, and now COVID-19. Not only must this vaccination effort overcome logistical challenges because of its unprecedented scale, but it must also address the systemic racism, medical mistrust, and structural inequalities that drive COVID-19 disparities. To be successful, vaccination plans at the state and local levels must include the community networks and trusted providers that are best able to reach communities disproportionately impacted by the COVID-19 pandemic, including HIV and hepatitis health department programs, community-based organizations, and harm reduction service providers who have demonstrated an impact in reducing health inequities among communities of color. Click here to read NASTAD’s statement

NASTAD Signs Onto Letter to ACIP Urging Prioritization of COVID-19 Vaccines for People Living with HIV 

A coalition of 66 organizations, including NASTAD, submitted an open public comment letter to the Centers for Disease Control Prevention Advisory Committee on Immunization Practices (ACIP) urging prioritization of COVID-19 vaccines for people living with HIV (PLWH). The letter points to mounting evidence that PLWH are at increased risk of hospitalization and mortality from COVID-19.  

U.S. Preventive Services Task Force Issues Final Recommendation on Screening for Hepatitis B Virus Infection in Adolescents and Adults 

The U.S. Preventive Services Task Force (USPSTF) released a final recommendation in support of screening for hepatitis B virus (HBV) infection in adolescents and adults. USPSTF issued a “B” grade for the diagnostic procedure, recommending screening for HBV infection in adolescents and adults at increased risk for infection, including: HIV-positive persons, persons who inject drugs, men who have sex with men, and persons born in countries and regions with a high prevalence of HBV infection. The “B” grade designation is consistent with the USPSTF’s previous recommendation for HBV screening in 2014. Click here to read comments NASTAD signed onto for the draft recommendation.  

Bipartisan Coalition of Attorneys General Pen Letter To Azar in Defense of 340B 

A group of 29 attorneys general (AGs), including President-elect Biden’s nominee for Secretary of Health and Human Services (HHS) Xavier Becerra, sent a letter to current HHS Secretary Alex Azar defending the 340B program. In particular, the AGs call on HHS to hold accountable drug manufacturers that are unlawfully refusing to provide discounts to federally qualified health centers, hospitals, and other providers that serve vulnerable patient populations through the 340B Drug Pricing Program. 340B covered entities and health advocates praised the letter, but it drew ire from pharmaceutical manufacturers who argue that they are not legally bound to continue providing discounted drug prices in the 340B program. 

HHS Releases First-Ever Sexually Transmitted Infections National Strategic Plan 

Through the Office of the Assistant Secretary for Health (OASH) and its Office of Infectious Disease and HIV/AIDS Policy (OIDP), HHS released the nation’s first STI National Strategic Plan (STI Plan). The STI Plan provides a roadmap for all types of stakeholders – including federal, state, tribal, and local public health officials and policymakers – to strengthen the nation’s response to and reduce the STI epidemic.  

CDC Issues Health Alert Network Advisory Following Increase in Fatal Drug Overdoses Across the US  

On December 17, the Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) Advisory alerting public health departments, healthcare professionals, first responders, harm reduction organizations, laboratories, and medical examiners and coroners to the rapid increase in drug overdose deaths. The CDC National Center for Health Statistics (NCHS) released new provisional data showing that 81,230 drug overdose deaths occurred in the United States in the 12-months ending in May 2020, marking the highest number of overdose deaths ever recorded in a 12-month period. 

Resources 

NASTAD and CDC Release: Syringe Services Programs: A Technical Package of Effective Strategies an Approaches for Planning, Design, and Implementation 

We are excited to announce that CDC released the publication Syringe Services Programs: A Technical Package of Effective Strategies and Approaches for Planning, Design and Implementation – a collaborative effort between CDC and NASTAD. This technical package provides evidence of the effectiveness of strategies and approaches to support successful planning, design, implementation, and sustainability of syringe services programs (SSPs).  

This timely and impactful resource provides a broad framework of evidence-based programmatic practices that will improve SSP service delivery and access to care for people who use drugs. New and existing SSPs can use the technical package to help guide effective planning and implementation and to identify opportunities for program enhancement. Please find the Dear Colleague Letter announcing the publication here and a link to the resource here. Please share widely with your networks and contact Laura Pegram or NASTAD’s Drug User Health team with questions or to request TA on SSP implementation.  

NASTAD Webinar: Overdose Prevention and Response During the COVID-19 Pandemic 

Date & Time: January 12, 2021 from 1.00 – 4.00 pm ET 

Please join NASTAD for a webinar focused on overdose prevention and response in Syringe Services Programs (SSPs) during the COVID-19 pandemic. This webinar is co-hosted by NASTAD and our partners at the CDC. We will share provisional data on increased overdose rates since COVID-19, the experiences of SSP frontline staff, and reflections on trends and emerging needs. Please feel free to share this announcement with others who might be interested. Attendees are welcome to submit questions in advance to: druguserhealthTA@nastad.org  (Subject Line: Webinar: COVID-19 and Overdose Prevention and Response). 

NASTAD Webinar: Self-Testing Strategies for HIV Testing and PrEP Access 

Date & Time: January 13, 2021 from 2:00 PM – 3:30 PM ET 

Join NASTAD for the third presentation in the Self-Testing Strategies for HIV Testing and PrEP Access webinar series, called Integrating Self-Testing for PrEP with Providers and Partners. This webinar focuses on various models currently in place within organizations by highlighting the overall model, outreach efforts, order fulfillment and resources available to promote within communities. Please click here to register for this webinar.  

The second webinar in the series, Implementing Self-Testing for HIV and PrEP Monitoring, focused on approaches for clinical decisions regarding self-testing for PrEP and lessons learned when implementing self-testing with various populations. Please click here to access slides, questions posed, and the recording of this webinar that took place on December 3. The final webinar topic, Innovative Strategies to Improve Access to PrEP Monitoring Labs and Testing for HIV, Viral Hepatitis, and STIs, will be announced in January 2021.  

NASTAD Workshop: Addressing Implicit Bias for Enhancing HIV Prevention Programs 

Dates: January 25 – 26, 2021 

Join NASTAD for our upcoming workshop, “Addressing Implicit Bias for Enhancing HIV Prevention Programs,” being held through our Capacity Building Assistance (CBA) program. The workshop will be hosted through two interactive virtual sessions on January 25-26, 2021. Due to the early influx of registrants, the new deadline for registration is December 23. Participants will receive further information and Zoom links closer to the workshop date.  

This workshop is designed for health department HIV prevention program staff and CBO staff. This video provides a brief introduction to implicit bias and its impact on HIV prevention efforts and can provide insight into topics that will be discussed in the workshop. Two staff members from each organization can attend, so please review the agenda topics to help determine which staff will register. Space is limited. The workshop is open ONLY to participants from CDC directly-funded health departments and CBOs in the Southern CBA region of the U.S. (including AL, AR, Baltimore, DC, DE, FL, GA, Houston, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, and WV). 

NASTAD Webinar: Virtual Condom Distribution as a Structural Intervention 

Dates: February 8 – 9, 2021 

Registration is now open for the NASTAD workshop, “Condom Distribution as a Structural Intervention,” being held through our Capacity Building Assistance (CBA) program. The workshop will be hosted through two interactive virtual sessions on February 8-9, 2021. This workshop is designed for HD HIV prevention program staff and CBO staff. Moreover, the workshop is open ONLY to participants from CDC directly-funded HDs and CBOs in the Southern CBA region of the U.S. Registration will be open through February 1, 2021. 

Condom distribution programs remain a crucial component of the HIV response. Effective programs can increase condom use, while preventing transmission of HIV and other STIs. Given the focus of Ending the HIV Epidemic by 2030, Health Departments (HDs) and Community Based Organizations (CBOs) are in a unique position to promote innovative strategies and address persisting gaps in condom distribution programs.  

Report: How COVID Changed HIV Care and Prevention: A Survey of Ryan White Providers 

Job Postings 

HIV/STD Epidemiologist – Augusta, ME 

The University of Southern Maine seeks applicants for a full-time, soft-money funded scientific professional position for statewide epidemiological support, program coordination, and leadership focusing on for HIV and sexually transmitted diseases (STD). Responsibilities include statewide surveillance for HIV and other STDs, education and outreach activities focused on prevention of HIV and STD transmission, and participation in routine and outbreak infectious disease monitoring and response activities. Candidates must develop and maintain technical expertise in the subject area, and coordinate, design, develop, evaluate, implement, and oversee programmatic interventions. Strong written and oral communication skills are needed along with knowledge of epidemiology, statistics, outbreak response, and data management. Work is performed under administrative direction. Work location will be Augusta, Maine Center for Disease Control and Prevention with travel to remote work sites around the state. 

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. 

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.comrajeshwarj@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.  

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 

FDA Authorizes Moderna Vaccine for Emergency Use 

“The Food and Drug Administration authorized emergency use of Moderna’s coronavirus vaccine Friday, launching a second option to inoculate against the virus and adding millions of doses to the national supply. The agency’s green light was widely expected after an expert advisory committee nearly unanimously endorsed the vaccine on Thursday and FDA Commissioner Stephen Hahn said it would “rapidly work” to finalize the authorization. Federal health officials also already promised that they would begin shipping out millions of doses this weekend.” 

Trusted Messengers May Help Disenfranchised Communities Overcome Vaccine Hesitancy 

“This month, the Food and Drug Administration gave emergency use authorization for one vaccine and is weighing approval of another. So, public health officials around the country are gearing up for what might be as challenging as figuring out how to store a vaccine at 70 degrees below zero Celsius. They need to persuade people who are part of communities that have been hit hard by the virus — those in low-income families and some minority populations, especially Black and Latino residents — to take a vaccine developed in less than a year and approved under emergency use authorization.” 

To Correct Population Health Disparities, Reinvigorate Public Health Systems: The Continuing Lessons Of COVID-19 

“Our current health care landscape of hospitals, clinics, and stand-alone medical practices can and does play an important role in providing services that support the public’s health. But without developing and sustaining additional systems that are specifically keyed to improving population-level health outcomes, our society will continue to perpetuate preventable health disparities. Reflecting on how our country has responded to the COVID-19 pandemic offers insights into why a health care system that has been designed and financed to address individual, often acute, medical needs cannot, by itself, ensure improvements in health at a population level.” 

COVID-19 Expected to Reshape Health-Care Sector, HHS Says 

“The coronavirus pandemic will reshape health-care spending, even though its full impact on the sector isn’t yet known, the Department of Health and Human Services said in a report that found health-care spending increased at a relatively slow pace in 2019 due to greater hospital care and drug expenditures. The report released Wednesday showed U.S. health-care spending in 2019 rose 4.6% to $3.8 trillion, in line with the relatively slow 4.7% increase the prior year and in keeping with a largely stable pace since 2016. Federal officials warned that the findings don’t include any of the effects of the coronavirus pandemic on health-care spending.” 

In Global Efforts To End HIV And Advance Reproductive Health, President-Elect Joe Biden Should Seize The Opportunity For Bold Leadership 

“For the past four years, the US government’s engagement in global health has been on an unchecked backslide. From reinstatement and expansion of the global gag rule to the planned withdrawal from the World Health Organization, the Trump administration has made an unprecedented pivot toward destructive, unilateral action that shows total disregard for human rights and evidence-based public health practices. It is going to take more than a return to pre-Trumpian policies to undo the damage that has been done. To regain the trust of health and human rights advocates worldwide, the incoming administration must take immediate action and champion respect for science in public health.” 

The First COVID-19 Vaccine Is Here. Is It Safe for People With HIV? 

“Many people living with HIV are wondering whether the vaccines are appropriate for them and where they will end up in the queue. Reassuringly, current evidence indicates that vaccination is safe for this population, and advocates are asking that HIV-positive people be considered a priority group.” 

‘A Shining Moment’: Congress agrees to restore Medicaid for Pacific Islanders 

“The wait may be over for tens of thousands of Marshall Islanders after nearly 25 years of seeking to correct an oversight that denied them federal health benefits. Congressional negotiators on Sunday agreed to allow Marshallese living in the United States to sign up for Medicaid, revising a drafting mistake in the 1996 welfare reform bill that barred the islanders from the program, according to three people with knowledge of the deal.”