Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras January 11, 2021

Hill Happenings 

117th Congress & House Leadership 

On Sunday, January 3, lawmakers convened on Capitol Hill to initiate the 117th Congress and swear in Members of Congress. Additionally, the House of Representatives reelected House Speaker Nancy Pelosi (D-CA-12) to lead the chamber as Speaker of the House. Speaker Pelosi’s successful bid to retain the gavel marks her fourth time in the top role, but she has previously indicated that it may be her last

Democrats Win Key Victories in Georgia Run-Off Race 

The final two remaining Senate seats were filled on Tuesday, January 5, when the Georgia electorate voted in two Democrats, Raphael Warnock and Jon Ossoff, in the state’s special run-off election. The wins ensure that Democrats will hold a 50-50 majority in the Senate, with Vice President-elect Kamala Harris breaking any tie. 

The closely watched race had deep implications for party control in Congress and secures a bicameral party majority. The new Democratic majority in the Senate is expected to facilitate the confirmation of President-elect Biden’s cabinet nominees and the passage of legislation advancing key democratic priorities.  

FY2021 Appropriations & COVID-19 Relief 

After intense weeks of extended negotiations in December, appropriators agreed on a combined FY2021 spending omnibus and COVID relief bill and narrowly avoided a government shutdown before the new year. The $2.3 trillion package completed funding for the 2021 fiscal year and distributed COVID-19 relief aid, including: $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. The stimulus bill did not include requested funding for the Ryan White Program and Housing Opportunities for Persons with AIDS (HOPWA).  President Trump signed the legislation on December 27 after unsuccessfully pressuring Congress to increase the dollar amount of stimulus relief paid out per person from $600 to $2000. 

The final appropriations package included the following funding levels:  

  • National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCHHSTP) 

  • The bill funds NCHHSTP at $1.314 billion, which is an increase of $40.5 million.  

  • The Division of HIV/AIDS Prevention was funded at $755.6 million, which is flat funding.  

  • The CDC Ending the Epidemic (EHE) Plan was funded at $175 million, an increase of $60 million.  

  • The Division of Viral Hepatitis was funded at $39.5 million, an increase of $0.5 million. 

  • Opioid Related Infectious Diseases was funded at $13.0 million, a $3 million increase. 

  • Ryan White Program  

  • The bill allocates $2.424 billion for the Ryan White Program. This is an increase of $35 million.  

  • ADAP is funded at $903million, which is flat funding.  

  • The HRSA’s Ryan White EHE Plan was funded at $105 million, an increase of $35 million.  

  • Community Health Centers 

  • The bill allocates $102.3 million for HRSA’s Community Health Centers. EHE Plan. This is an increase of $52.3 million.  

NASTAD will continue to monitor stimulus negotiations in the 117th Congress and the appropriations process under a Biden Administration to advocate for the highest funding levels on behalf of HIV and hepatitis programs. 

Administrative Activity 

HHS Release the Viral Hepatitis National Strategic Plan 

On Thursday, January 7, 2021 the U.S. Department of Health and Human Services (HHS) released The Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination (2021–2025) (“Strategic Plan”). The 64-page plan outlines a vision, goals, objectives, and strategies to eliminate hepatitis A, B, and C as public health threats in the U.S. NASTAD applauds HHS on the release of a comprehensive domestic plan for elimination of viral hepatitis through strategic coordination with internal and external hepatitis stakeholders. However, we note that a number of key recommendations from NASTAD’s comments were not integrated into the final plan and should be considered at the jurisdictional level in the development and implementation of state and local viral hepatitis elimination plans. Over the next several months, NASTAD staff will work with our members, organizational partners, and federal colleagues to support the release of the corresponding implementation plan by HHS. Additionally, NASTAD will continue to engage in advocacy and policy efforts to increase federal funding for viral hepatitis and implementation of the national hepatitis strategic plan.   

Webinar: EHE Quarterly Stakeholder Webinar Presentation 

The HHS Office of Infectious Disease and HIV/AIDS Policy (OIDP) invites you to join us on January 27, 2021, for a stakeholder webinar on efforts to implement the Ending the HIV Epidemic: A Plan for America (EHE) initiative. The EHE Stakeholder webinar will be held from 2:00 to 3:30 p.m. (ET). 

HIV Criminalization Laws and Ending the HIV Epidemic in the United States 

Recently, The Lancet HIV published a commentary by authors from the CDC titled “HIV Criminalization Laws and Ending the HIV Epidemic in the United States.” The article emphasizes the need to align HIV-specific criminal exposure laws with science and consider reforming, rescinding, and revising the application of relevant laws for the sake of people with HIV and for the public’s health. 

NASTAD Joins Coalition Urging Equitable Inclusion of Immigrants in Vaccine Efforts 

NASTAD is working to ensure that COVID-19 vaccine distribution efforts meaningfully reach immigrants and their communities, regardless of language or immigration status. NASTAD signed onto two coalition letters, addressed to the Director of the Centers for Disease Control and Prevention (CDC) and President-elect Biden’s COVID-19 Advisory Board, urging equitable inclusion of immigrants in vaccination distribution programs, including removing citizenship barriers as a precondition to accessing the vaccine, providing culturally and linguistically appropriate care, and prioritizing immigrant populations in the vaccine distribution queue.  

U.S. District Court Halts Implementation of Trump Executive Order Banning Speech about Systemic Racism, Sexism, and Implicit Bias  

On December 22, U.S. District Court Judge Freeman of the Northern District of California issued a nationwide preliminary injunction barring the Trump administration from implementing an executive order (EO) that prohibits federal contractors and grantees from conducting workplace diversity trainings or engaging in grant-funded work that explicitly acknowledges and confronts the existence of structural racism and sexism in our society. The plaintiffs, a group of non-profit community organizations serving the LGBTQ community and people living with HIV, argued that the EO had a chilling effect on their ability to meaningfully provide care to the communities they serve. NASTAD joined a coalition of over 70 organizations and signed onto a letter calling for President-elect Biden to swiftly repeal the harmful EO.  

HHS Issues Advisory Opinion Challenging Drug Manufacturers’ Actions on 340B Program 

On December 30, HHS General Counsel Robert Charrow issued a legal advisory opinion rejecting drug manufacturers’ legal arguments for terminating or limiting 340B discounted drug prices on covered outpatient drugs that were dispensed at contract pharmacies. The guidance comes after patient advocates sought legal challenges against manufacturers that refused to honor 340B ceiling prices, alleging that the use of contract pharmacies by 340B covered entities led to diversion of funds and issuing of duplicate discounts. The HHS General Counsel concluded that the site of delivery for the covered outpatient drugs was irrelevant as long as the covered entity purchased the pharmaceuticals, and that the manufacturers’ refusal to offer 340B discounted prices to contract pharmacies acting as agents of covered entities was inconsistent with the statute of the 340B program.  

NASTAD Joins Coalition Calling on President-Elect Biden to Lift Fetal Tissue Research Ban 

On January 7, NASTAD joined a coalition of scientific, medical, and patient advocacy organizations and signed onto a letter urging President-elect Biden to swiftly rescind the human fetal tissue (HFT) research restrictions and policy changes that the Department of Health and Human Services made in 2019. These changes have halted all intramural HFT research and obstructed new extramural research involving HFT. Scientists and ethicists have repeatedly reviewed the use of HFT in research and have consistently concluded that HFT is an essential resource for biomedical research. HFT has led to many scientific and medical advances that have saved millions of lives. It remains critical for the development of new treatments for a wide range of serious diseases, including COVID19.  

Resources 

Regional Harm Reduction TA Resources Available through National Harm Reduction Technical Assistance Center Resources  

New information is available online regarding Regional Harm Reduction Technical Assistance available through the CDC-funded National Harm Reduction Technical Assistance Center. The webpage includes information on NASTAD’s network of regional consultants and subject matter experts, ongoing calls to support SSP development and operation, and other opportunities for region- and topic-specific TA and capacity building. These resources are available to state and local health departments, tribal health systems, and community-based organizations operating drug user health programs. Programs are encouraged to contact DrugUserHealthTA@NASTAD.org to connect with regional consultants in order to learn more about regional calls, local programs and trends, or their areas of expertise. Please visit the Regional TA webpage to meet and learn more about our consultants!

NASTAD’s Drug User Health team contracts with a national network of regional harm reduction consultants to encourage local sharing of timely information and best practices. Since June 2020, these consultants have co-facilitated weekly regional calls and have helped identify emergent and priority needs among community partners., After a holiday break, regional calls for drug user health service providers will resume Thursday, January 7, 3-4pm ET with the Southern regional call. The cycle will reset the first week of February. The monthly tribal SSP call is held the second Wednesday of each month and will continue on Wednesday, January 13, 2-3pm ET. More information is available online. NASTAD is currently working with partners to gauge interest and capacity among state health department staff who lead drug user health programming in establishing a regular call or other space for connection and discussion. Please contact Drug User Health with input or recommendations.  

New Episodes of The Southern Steep: Brewing Stronger Community Podcast 

Check out new episodes of NASTAD’s podcast, Southern Steep: Brewing Stronger Community. Southern Steep is a public health and social justice podcast that centers the voices of community leaders in the southern United States. Conversations highlight innovative approaches to unapologetic leadership, meaningful partnerships and thriving communities. Check out new episodes by visiting the CBO Hub’s Southern Steep page

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 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.  

NASTAD Blog: Disproportionate Police Response to U.S. Capitol Attack Another Example of Systemic Racism in United States  

The lack of an effective police response to attacks at the U.S. Capitol reflects a gross double standard when compared with other recent police responses and tactics deployed for mass demonstrations. What we witnessed on the Capitol grounds is merely one example of the detrimental impact prejudiced ideologies have had on communities of color well beyond policing tactics. In public health, we continue to struggle to reach communities most in need because of a lack of prioritization from governmental leadership, discriminatory policies across clinics and health departments, dismal community representation throughout decision-making processes, and a refusal to update epidemiological tools and language to better reflect those we are meant to serve. 

Policy Brief: Building Trust in and Access to a COVID-19 Vaccine Among People of Color and Tribal Nations 

A woeful history of maltreatment of communities of color and tribal nations by government and the healthcare sector is the root of vaccine distrust among those groups, according to a policy brief released by Trust for America’s Health (TFAH) and co-authors the National Medical Association (NMA) and UnidosUS. This historic maltreatment, coupled with current day structural racism, has played out in COVID-19’s disproportionate impact on communities of color and tribal communities. These factors also make ensuring vaccine receptivity and access within those communities challenging and of critical importance to protecting lives and ending the pandemic. 

Report: Local Health Departments as Leaders in the Prevention & Elimination of Viral Hepatitis 

Report: COVID-19 Virtual Think Tank: Ten Action Steps to Enhance the Health and Quality of Life of Communities of Color across the U.S. 

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 

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.” 

Biden picks 3 coordinators for Covid-19 response 

“President-elect Joe Biden is expanding his White House Covid-19 Response team, tapping three senior officials to coordinate vaccine, testing and supply chain strategy in an announcement first shared with POLITICO. The officials are set to play a major role in Biden's response to the worsening pandemic, which the president-elect has made his top priority ahead of taking office. Nearly 20 million Americans have been diagnosed with Covid-19, and more than 336,000 have died with the virus.” 

Many Primary Care Providers Still Don’t Understand PrEP 

“Eight years into the pre-exposure prophylaxis (PrEP) era and two years into the federal government’s plan to end the HIV epidemic in the United States by 2030, about half of the primary care providers in one hard-hit Texas community still lack a basic understanding of PrEP eligibility, side effects and adherence. And that deficiency was associated with a significantly decreased likelihood of prescribing the Truvada (tenofovir disoproxil fumarate/emtricitabine) or Descovy (tenofovir alafenamide/emtricitabine) prevention pills to their patients. The good news is that 35% of those providers had prescribed PrEP in the previous year.” 

A new clash over needle exchange program 

“Officials shut down the Kanawha-Charleston Health Department’s needle exchange program in 2018. A state Department of Health and Human Resources investigation criticized the program for, among other things, ineffective patient tracking, the lack of a detailed plan to prevent needle litter and the failure to offer and provide substance use treatment before dispensing needles. Since then, HIV and hepatitis cases in Charleston have risen. Testing has decreased this year with resources being directed to the coronavirus pandemic, but HIV and hepatitis rates have continued increasing. Overdoses also have increased, according to state Office of Drug Control Policy data.”