Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras March 22, 2021

Hill Happenings

Senate Confirms HHS Secretary Nominee, Advances Key Healthcare Nomination

On March 18, the Senate voted 50-49 to confirm Xavier Becerra as the next Secretary of the Department of Health and Human Services (HHS). Becerra, the former California Attorney General known for his vigorous defense of the Affordable Care Act (ACA) under the Trump Administration, will become the first Latino to head the agency. NASTAD joined a coalition of over 100 public health advocacy organizations and sent a letter to the Senate in support of Becerra’s nomination.

Additionally, the Senate Health, Education, Labor, and Pensions (HELP) Committee advanced the nomination of Dr. Rachel Levine for the HHS Assistant Secretary for Health. The nomination is now headed to the Senate floor, where the entire chamber will vote to confirm the nomination. If Dr. Levine receives a vote majority, she would become the first openly transgender federal official to be confirmed by the U.S. Senate. NASTAD supports the nomination of Dr. Levine.

House Republicans Approve Earmarks Plan

On March 17, House Republicans approved a resolution in support of Democrat’s plan to restore earmarks, or the practice of appropriating funding for specific projects. Congress agreed to an earmark moratorium in 2011 after reports of wasteful and inappropriate spending prompted lawmakers to reconsider the fiscal practice. Senate Appropriations Committee Chair Patrick Leahy (D-VT) and Ranking Member Richard Shelby (R-AL) are reportedly negotiating to restore earmarks in the upper chamber.

NASTAD Condemns Xenophobic & Racist Attacks Against Asian American and Pacific Islander Community

NASTAD condemns the xenophobic, classist, and misogynist violence rooted in white supremacy that resulted in the death of eight people near Atlanta, Georgia. Six of those killed were Asian, and all but one were women. This attack follows months of escalating violence against the Asian American and Pacific Islander (AAPI) community in the United States. Racism is a public health crisis that has fueled xenophobic and racist attacks against the AAPI community since the beginning of the COVID-19 pandemic.

NASTAD is encouraged by President Biden’s statement condemning the vicious hate towards AAPI communities in a speech on March 11, 2021, and the move by the House Judiciary Committee on March 18 to begin to hold hearings on discrimination and violence against the AAPI community. Additionally, we support the COVID-19 Hate Crimes Act, reintroduced on March 11 by Rep. Meng (D-NY-06), which directs the Department of Justice to provide oversight of hate crimes related to COVID-19.These are important first steps, but NASTAD calls on Congress, the Administration, our racial and social justice partners, and allies to continue standing in solidarity with the AAPI community and work to end the hateful violence.

Administrative Activity

Biden Administration Begins to Revoke Medicaid Work Rules

On March 17, the Biden Administration revoked federal permission for Arkansas and New Hampshire to impose work requirements on Medicaid eligibility. The Centers for Medicare and Medicare Services (CMS) sent letters to Medicaid officials at Arkansas and New Hampshire, informing them that the work requirements do not promote the objectives of the Medicaid program. More notices of revocation are expected for the several remaining states that are seeking to implement the controversial work requirements. However, the Biden Administration may have to defend its actions in court before they can take effect due to an agreement that states signed with the former Trump Administration that is designed to make it more difficult for Biden Administration to quickly revoke the requirements.

Biden Administration to Reissue Rulemaking for Title X Family Planning Program

On March 18, the HHS Office of Population Affairs announced that it will reissue rulemaking for the Title X Program, the nation’s only federally funded family planning program. HHS plans to propose revised regulations that would effectively reverse the Trump Administration’s Title X “Gag Rule,” which bars Title X providers from referring patients for abortion or offering abortion counseling. HHS plans to implement the revised rules by fall in an effort to redistribute grants by the FY2022 funding announcement and include abortion providers that were forced out of the program.

Biden Administration Boosts Medicare Payment for COVID-19 Vaccine Delivery

On March 15, CMS announced that it would immediately increase Medicare payments for administering the COVID-19 vaccine. The higher payment rate is intended to increase the number of vaccines that Medicare providers can administer by establishing new or expanding existing vaccination sites, conducting patient outreach and education, and hiring additional staff. Additionally, CMS is updating toolkits for providers, states and insurers to help the health care system swiftly administer the vaccine with these new Medicare payment rates and ensure that no beneficiary pays out-of-pocket for the COVID-19 vaccine.

U.S. District Court Blocks HHS 340B Administrative Dispute Resolution Rule From Taking Effect

On March 16, U.S. District Court Judge Sarah Barker granted drug maker Eli Lilly’s request for a preliminary injunction, halting the Biden Administration from implementing a rule that would establish an Administrative Dispute Resolution (ADR) process for resolving disputes within the 340B program. The ADR rule, published in December of last year, would provide 340B providers with a mechanism to challenge drug companies for failing to honor 340B discounted drug prices for medications that were dispensed at contract pharmacies. It is not yet clear what approach the Biden Administration and recently-confirmed HHS Secretary Xavier Becerra, who supported the ADR process, will take to resolve the contract pharmacy dispute.

CMS Halts Changes to Medicare Part D Protected Class Drug Category

On March 16, the Biden Administration ended a Trump-era rule that would undermine key patient protections in Medicare’s prescription drug program. On January 19, the Center for Medicare and Medicaid Innovation (CMMI) announced a proposal that would allow health plans participating in the Medicare Part D Payment Modernization (PDM) Model to limit the drugs covered in the formulary, including denying patient access to medications used to manage HIV. Congressional Democrats and patient advocacy organizations, including NASTAD, urged the Biden Administration to rescind the rule earlier this month.

NASTAD Signs onto Letter Urging the Biden Administration to Remove Restrictions on Access to Medication Abortion

NASTAD joined a coalition of 55 organizations and signed onto a letter urging the Biden Administration to remove restrictions on remote prescribing of mifepristone. The restrictions, known as Risk Evaluation and Mitigation Strategy (REMS), require that mifepristone be dispensed in a clinical setting, despite permitting patients to self-administer the abortifacient at home. The advocates push for emergency relief from the REMS during the pandemic and call for a comprehensive review of the full REMS on mifepristone.

CDC Announces NOFO to Address COVID-19 Health Disparities

On March 17, the CDC and the Center for State, Tribal, Local, and Territorial Support (CSTLTS) announced a funding opportunity for state and local health departments to address COVID-19-related health disparities and advance health equity by expanding capacity and services to communities disproportionately affected by COVID-19. The COVID-19 relief bill that became law in December of 2020 authorized the funding opportunity, which funds strategies to improve testing capabilities and other COVID-19 response purposes, including those to develop or identify best practices for states and public health officials to use for contact tracing. CDC will award $2.25 billion to state, local, US territorial and freely associated state health departments (or their bona fide agents) to boost capacity for controlling COVID-19 infection (or transmission) among populations that are at higher risk and underserved, including racial and ethnic minority groups and people living in rural communities.

HRSA Data Show Key Role of Health Centers in the EHE Inititative

New data from the Health Resources and Services Administration’s (HRSA) Bureau of Primary Health Care show the significant results in HIV testing, linkage to care, and PrEP starts that health centers achieved in the first several months of their work as partners in the Ending the HIV Epidemic (EHE) initiative. In February 2020, 195 health centers in the 57 EHE jurisdictions received a total of $54 million in supplemental resources under the Primary Care HIV Prevention funding opportunity. This first-of-its-kind funding supports health centers to expand outreach, partnerships, and their workforce to increase HIV testing, increase access to and use of PrEP, and link individuals who test positive for HIV to treatment.

CDC Releases Resources for National Native HIV/AIDS Awareness Day 2021

On March 15, the Centers for Disease Control and Prevention (CDC) released a set of new resources for National Native HIV/AIDS Awareness Day 2021, held on March 20. NNHAAD serves to recognize the impact of HIV among Native populations and highlight the work happening in communities around the country to engage Native people, including American Indians, Alaska Natives, and Native Hawaiians, in fully ending the HIV epidemic. The 2021 theme is “Zero is Possible Together: Innovation + Awareness.

NASTAD Joins Coalition Calling on CMS To Allow Medicaid Funds for Immigrants

NASTAD signed onto a Protecting Immigrant Families coalition letter urging CMS to facilitate the use of Medicaid funds to pay for COVID-19 testing, treatment, and related services for immigrants that are ineligible for full-scope Medicaid due to their immigration status. In particular, the advocates call on CMS to issue guidance clarifying that COVID-19 is an “emergency medical condition.” This designation would effectively lift administrative barriers to Medicaid eligibility for undocumented immigrants who need COVID-19 testing and treatment. The coalition also highlights the disproportionate impact that immigrant communities face during the COVID-19 pandemic due to limitations on healthcare coverage.  

Resources

TakeMeHome Program Expands to Offer STD Test Kits 

NASTAD continues to partner with Building Healthy Online Communities on a free HIV and STD test kit home delivery program, TakeMeHome. The program has already distributed more than 5,000 HIV test kits in eight states around the U.S. and is now expanding to include test kits for syphilis, gonorrhea, and chlamydia. Building Healthy Communities Online and NASTAD worked over two years to create a seamless process to handle payment from health jurisdictions, which will be promoted by Grindr to users who live in city or states included in the program. 

Updated FAQ: COVID-19 Vaccines & People with HIV

The HIV Medicine Association and the Infectious Diseases Society of America developed this document to respond to questions from HIV clinicians, and as a resource for HIV clinicians to respond to patient questions regarding the three COVID-19 vaccines authorized for use in the U.S. by the Food and Drug Administration (FDA). The two mRNA vaccines are referred to by the manufacturer’s names – Moderna and Pfizer/BioNTech, and the adenoviral-vector vaccine is referred to by the manufacturer’s name Janssen (which is a subsidiary of Johnson and Johnson). Unless otherwise specified, the information provided is applicable to all three vaccines.

AAP Pediatric HIV/AIDS Virtual Training Course – May 25-26, 2021

The American Academy of Pediatrics (AAP) Committee on Pediatric AIDS is hosting the Pediatric HIV/AIDS Virtual Training Course on May 25-26, 2021. The comprehensive course will address all aspects of HIV management in infants, children, adolescents and young persons; and to present evidence-based data to optimize clinical practice. The course is intended for individuals that are interested in expanding their knowledge in HIV/AIDS care. Visit https://shop.aap.org/2021-pediatric-hiv-aids-training-course/ to view the agenda, access the course brochure, and register for the course. If you have any questions, please contact Heather Stob at hstob@aap.org.

Job Postings

COVID-19 Project Manager – Richmond, Virginia

The Virginia Department of Health is seeking a COVID-19 Project Manager in the Office of Epidemiology. This position works with various stakeholders to organize resources, communicate on projects, and provide reports to various levels of leadership. The COVID-19 Project Manager is primarily responsible for implementing project management processes, organizing timelines, communicating updates, escalating issues that are identified, and providing various reports that provide updates regarding the project’s status.

Clinic Operations Director—Baltimore, Maryland

The Clinic Operations Director position falls within the Division of Population Health and Disease Prevention at Baltimore City Health Department in the Bureau of Clinical Services and HIV/STI prevention. It reports directly to the Bureau Administrator of the Bureau of Clinical Services and HIV/STI Prevention. The medical direction of the clinics are led by 4 medical directors and 2 clinical chiefs. The clinic operations director will work in tandem with the medical directors and report to the bureau administrator. All 8 leadership positions work in an integrated and collaborative partnership. The Clinic Operations Director will oversee all operational aspects of the two clinics, as well as their integration into other aspects of the health department and coordination with other health department programs.

Assistant Commissioner - Health Department – Baltimore, Maryland

The Baltimore City Health Department (BCHD) is seeking an Assistant Commissioner to lead the Bureau of Communicable Disease and Outbreak Control. This senior management position will lead a talented team responsible for communicable disease investigation, outbreak control and emergency preparedness programming. The incumbent will also be responsible for developing and implementing agency wide policies related to health department readiness to respond to public health emergencies. The incumbent will report directly to the Deputy Commissioner for BCHD’s Division of Population Health & Disease Prevention.   

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

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

Use science, not stigma, to determine the next steps for Nushawn Williams

“In 1999, Nushawn Williams pleaded guilty to two counts of statutory rape and two counts of reckless endangerment for having sex while HIV positive at the age of 19 and 20 years old. He served the full sentence of 12 years, but days before his scheduled release from prison in 2010 he was served with a petition to continue his imprisonment as a “dangerous sex offender” under New York’s civil commitment law.”

People Aging With HIV Expected to Have More Chronic Conditions

“Good health for people aging with HIV will require health care providers to target diabetes, heart disease, anxiety and chronic kidney disease management to this population, especially HIV-positive gay and bisexual men and Latinos. These are the projections of the ProjEcting Age, multimorbidity, and PoLypharmacy (PEARL) simulation model, presented by Parastu Kasaie, PhD, assistant scientist at the Johns Hopkins Bloomberg School of Public Health, at the Conference on Retroviruses and Opportunistic Infections (CROI).”

House passes bill to renew Violence Against Women Act

“The House passed legislation on Wednesday to reauthorize the Violence Against Women Act (VAWA), a law originally authored by President Biden that lapsed in 2019.

Lawmakers voted largely along party lines 244-172 to approve the measure, with only 29 Republicans joining all Democrats in support.”