Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras March 1, 2021

Hill Happenings 

COVID-19 Relief Actions 

Congressional Democrats are working in lockstep with the Biden Administration to quickly pass the President’s proposed $1.9 trillion pandemic relief legislative package. After early negotiations failed to offer a clear, bipartisan path forward, Democrats are leveraging the budget reconciliation process to avoid the Senate filibuster and pass the legislative package with a simple majority, which Democrats command using Vice President Harris’ tie-breaking vote. The House passed the package (H.R. 1319) on February 26, setting up a contentious party-line vote in the Senate.  

NASTAD joined a coalition of over 220 organizations to voice our support for the health coverage provisions included in the next COVID-19 relief bill. The coalition of health advocates are aligned in pushing for a COVID-19 relief package that implements coverage gains for America’s families, ensuring the opportunity to receive high-quality health care regardless of race, ethnicity, gender, or geographic location. The health coverage provisions included in the House package--such as affordable premiums, pathways to coverage for people facing unemployment, and increased Medicaid drug rebates--are critical to beating the COVID-19 pandemic, promoting racial justice, and ensuring economic recovery. The coalition calls for these bipartisan measures to pass Congress and swiftly receive President Biden’s signature. 

NASTAD will continue to monitor relief 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 Secretary-Designate, Health Officials Undergo Senate Confirmation Hearings 

President Biden’s Secretary-Designate for the Department of Health and Human Services (HHS), former California Attorney General Xavier Becerra, appeared before the Senate Finance and Health, Education, Labor, and Pensions (HELP) committees for hearings to vet his confirmation. Unlike the rocky confirmation hearings for President Biden’s pick to lead the OMB, Xavier Becerra is likely to secure enough Senate votes to secure the confirmation. A vote is not yet scheduled for his nomination. NASTAD submitted a letter to the Senate Finance Committee in support of his nomination, highlighting Becerra’s extensive qualifications and exemplary track record protecting patients’ rights, equity, and access to health care.  

Additionally, Dr. Rachel Levine, President Biden’s historic nominee for the HHS Assistant Secretary for Health, appeared before the Senate HELP committee for a confirmation hearing on February 25. NASTAD submitted a letter in support of Dr. Levine, highlighting her expertise on LGBTQ+ medicine and notable experience as a physician and public health leader. 

NASTAD Joins Coalition Calling on CMS to Bolster COVID-19 Vaccine Reimbursement for FQHCs 

NASTAD joined a coalition of patient advocacy organizations and signed onto a letter urging the Centers for Medicare and Medicaid Services (CMS) to issue guidance around COVID-19 vaccine administration reimbursement policies for Federally Qualified Health Centers (FQHC) that participate in Medicare and Medicaid programs. Existing federal regulations do not adequately address the administrative and financial burdens FQHCS must overcome to administer the COVID-19 vaccine. In particular, the coalition calls for CMS to alter payment methodologies to ensure that health center reimbursement rates account for the increased costs associated with the COVID-19 vaccine. 

NASTAD Joins Coalition Calling on HHS to Rescind Medicare Part D Payment Modernization Model 

NASTAD and the Federal AIDS Policy Partnership (FAPP) are calling on HHS to rescind the Medicare Part D Payment Modernization (PDM) Model announced under the prior administration. The new Part D demonstration would allow plan sponsors to begin restricting prescription drugs for five protected classes (anticonvulsants, antidepressants, antineoplastics, antipsychotics, and immunospressants) beginning in 2022, and for antiretroviral drugs in 2023. These changes not only undermine long-standing Medicare beneficiary protections, but also pose a direct threat to the health of those living with HIV. 

CDC Releases Updated Integrated HIV Prevention and Care Plan Guidance 

The Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB) and the Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS Prevention (DHAP) announced the release of updated guidance for the Ryan White HIV/AIDS Program (RWHAP) Integrated HIV Prevention and Care Plan. The release of the updated Integrated HIV Prevention and Care Plan guidance and plan submission for the calendar years 2022 – 2027 was postponed due COVID-19 pandemic. HAB and DHAP plan to issue the updated guidance in June of 2021, with submission of the plans targeted for December of 2022.  

Resources 

NASTAD Center for Innovation and Engagement 

NASTAD is thrilled to announce the launch of its Center for Innovation and Engagement (CIE) website. The site is geared towards equipping HIV providers with evidence-informed approaches to better engage and retain people living with HIV (PLWH) in care. CIE is funded by HRSA and serves as a culmination of the collaboration between NASTAD, Northwestern University, Howard Brown Health Center, and Impact Marketing + Communications to identify some of the most effective evidence-based and evidence-informed interventions available and transform them into actionable tools, innovative frameworks, and adaptable resources. Our website showcases a myriad of innovative intervention how-to-guides that are “ready to replicate,” our process for selecting innovative approaches, and much more! Sign up for our listserv to stay in the know about our launch and the rollout of additional how-to-guides, videos, and supplementary resources. 

Infographic: Verifying PrEP is Covered as a Preventive Service 

The Patient Protection and Affordable Care Act (ACA) now requires qualified health plans to cover PrEP as a preventive service at no cost to the patient. The new NASTAD infographic, “Verifying PrEP is Covered as a Preventive Service,” summarizes the steps to verify that a given plan is offering PrEP at no cost to the patient. The brief tool aims to support enrollment assisters and PrEP navigators to maximize the current Special Enrollment Period (SEP).   

HIV Data Protection Landscape for EHE Jurisdiction 

NASTAD released a new resource assessing HIV Data Protection Landscape for EHE Jurisdictions. This interactive map summarizes state-level legal authorities and protections related to health department HIV surveillance data release in response to requests from courts, prosecutors, and law enforcement agencies. The tool helps health department HIV program staff and legal counsel assess data privacy laws in their state and supports health departments in responding appropriately to requests for HIV data in connection with legal and law enforcement matters. NASTAD has also released a Research Protocol explaining the project scope and methodology.  

This map is funded through CDC PS19-1906 Component A, and as such, currently reflects laws in priority jurisdictions included in Phase I of the federal “Ending the HIV Epidemic: Plan for America” (EHE) initiative, which aims to end the HIV epidemic in the United States by 2030.   

The Southern Syringe Services Program (SSP) Institute 

Date & Time: March 3-4 | 12:00 – 4:30 PM ET 

NASTAD invites you to attend a virtual two-day, regional gathering on harm reduction, syringe services programs, and drug user health. The Southern Syringe Services Programs (SSP) and Drug User Health Institute will be held virtually via Zoom and occur on the afternoons of March 3-4, 2021 from 12:00 - 4:30 PM ET.  This convening will bring together health department staff, community-based groups, content experts, national stakeholders, and state and local service providers who work on issues related to the drug use/overdose crisis and reducing associated harms in their respective jurisdictions and communities. Health department staff, SSPs/harm reduction programs, and other community-based organizations and local service providers in southern states are encouraged to attend.   

Registration for AIDSWatch 2021 is Now Open 

Registration is now open for AIDSWatch. AIDSWatch, to be held March 22-24, 2021, will bring together HIV advocates from across the country – virtually – to speak truth to power to members of the 117th Congress and the new Biden-Harris administration. We will gather as a community to sustain our advocacy around ending the HIV epidemic in the United States, even amid more than a year of navigating the COVID-19 pandemic. Presented by AIDS United, the US PLHIV Caucus and the Treatment Access Expansion Project, AIDSWatch is the largest, national, constituent-based HIV advocacy event. While typically held in person in Washington, D.C., AIDSWatch continues to be held virtually due to the COVID-19 pandemic.  

Lancet Journal Series: HIV in the USA 

“Surveying the ongoing challenges to ending the HIV epidemic in the USA, a six-paper Series published in The Lancet underscores pronounced racial, sexual, and gender disparities; substantial gaps in domestic programme funding; and due to geography and the patchwork health-care system, limited access to HIV treatment and prevention services. The Series highlights that the majority of HIV infections are now concentrated in the South and rural areas, where women and minorities are disproportionately affected, and where similar disparities emerged during the COVID-19 pandemic. With recommendations for elevating awareness and better reaching underserved populations as well as funding and outreach reform, the Series presents a path towards eliminating HIV in the USA.” 

MMWREstimated Medicaid Costs Associated with Hepatitis A During an Outbreak — West Virginia, 2018–2019 

Job Postings 

U=U Global Knowledge & Advocacy Assistant – Brooklyn, NY 

This is a challenging and meaningful entrepreneurial position with PAC’s Global U=U Knowledge and Advocacy Collaborative (KAC).  The KAC is in the early stage of growth, so this is a chance to be part of the conversation as global organizations, leaders, and activists join with in-country partners to support community-driven and sustainable U=U movements that change the narrative about HIV. This position will provide support on a variety of PAC's work with partners including conducting needs assessments; providing coalition-building support; curating, developing, and offering "best practices" training and communications materials to engage key audiences including clinicians, community, and policymakers; advising on public health communications; and integrating U=U into advocacy for policies and programs that will increase access to treatment and services. 

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. 

Department of State Health Services, Program Informatics and Evaluation Group – Austin, TX 

  • Program Specialist V - performs advanced (senior-level) consultative services for the Program Informatics and Evaluation Group within the integrated HIV/STD/TB Surveillance and Prevention unit of DSHS 

  • Research Specialist V - conducts highly advanced (senior-level) research and analysis of program evaluation and epidemiologic data associated with HIV, particularly routine testing for HIV in clinical settings 

  • Program Specialist IV - performs highly complex and advanced technical activities related to HIV, STD, and Tuberculosis data management and processing of HIV, STD, and TB laboratory reports 

  • Epidemiologist III - designs and implements statistical analyses appropriate for epidemiologic and programmatic data with a focus on HIV prevention programming. 

Director of Operations, Bureau of Infectious Disease and Laboratory Sciences – Boston, MA 

The Bureau of Infectious Disease and Laboratory Sciences (BIDLS) at the Department of Public Health (DPH) is seeking an experienced leader who is eager to join a mission-driven and fast-paced team in effectively and efficiently supporting the day-to-day operational needs of BIDLS.  The selected candidate will provide direct and indirect supervision to a total of 55 staff, including 4 Managers, and will oversee an annual budget in excess of $500M. To be successful, the incumbent of this position must be detail-oriented and also must understand the complexities of systems change and implementation in government systems, with the ability to ensure alignment with the Bureau’s and Department’s mission, goals, and objectives. 

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 

House passes sweeping protections for LGBTQ people 

“The House on Thursday passed the Equality Act, a sweeping civil rights bill that expands protections in education, housing, employment, and more to LGBTQ people. The bill would also prohibit discrimination based on sexual orientation or gender identity in credit, jury service and public accommodations. Rep. David Cicilline (D-R.I.) reintroduced the legislation, which passed the House in 2019 but never moved in the Senate. The bill, which passed the House on Thursday by a vote of 224-206, faces an uphill battle in the upper chamber, where GOP support is needed to reach the 60-vote threshold.” 

History Repeats Itself: COVID-19 Vaccine Inequities Echo HIV Crisis 

“As a young woman, pregnant and HIV-positive, Maurine Murenga did not have easy access to drugs that could save her life. Today she is an activist for equitable health-care. The global distribution of coronavirus vaccines is an issue of concern.” 

Meet Dr. Demetre Daskalakis, Biden's New Weapon Against HIV 

“Daskalakis, the CDC’s unconventional director of HIV prevention efforts, enters his new role during the most challenging health crisis in decades.” 

Rising Hepatitis Rates Present Opportunities for Biden Administration to Strengthen Federal Public Health Response to All Infectious Diseases 

“As the Biden administration continues to combat the COVID-19 pandemic, there is also an important opportunity to address long-standing gaps in our responses to other public health threats — like viral hepatitis. For many of us working to eliminate viral hepatitis, the struggles our nation has faced to contain and control COVID-19 have been a painful yet predictable reminder of the fragility of our public health and health care system. Recent trends of increasing viral hepatitis rates present valuable lessons learned and clear opportunities for the Biden administration to strengthen our public health response to viral diseases.” 

Supreme Court agrees to hear challenge to Trump administration's public charge rule 

“The Supreme Court agreed on Monday to take up a case brought by various groups and state and local officials challenging a Trump-era rule that makes it more difficult for immigrants to obtain legal status if they use public benefits, such as Medicaid, food stamps and housing vouchers.”