Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras April 19, 2021

Hill Happenings 

FY2022 Appropriations 

On April 15, Department of Health and Human Services (HHS) Secretary Xavier Becerra testified before the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies on the Administration’s FY 2022 Budget Request for HHS. Becerra defended the increased funding proposed for HHS and the Centers for Disease Control and Prevention (CDC) in the President’s Budget request, pointing to the need for improved public health systems, increased medical research funding, and greater focus on mental and maternal health.  

Biden Health Nominees Undergo Senate Hearings 

On April 15, the Senate Finance Committee held a hearing on the nominations of Andrea Joan Palm to be HHS Deputy Secretary and Chiquita Brooks-LaSure to be Administrator of the Centers for Medicare and Medicaid Services (CMS). The nominees spoke to the Administration’s plans to boost Marketplace coverage and affordability, unwind Medicaid work requirements, and the government’s COVID-19 response. A date for the full floor confirmation vote has not been announced. 

Administrative Activity 

CDC Report Shows STDs Reach All-Time High for 6th Consecutive Year 

On April 14, the CDC National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) released the 2019 STD Surveillance Report, an annual report that documents the incidence of chlamydia, gonorrhea, and syphilis in the US. CDC found that reported cases of chlamydia, gonorrhea, and syphilis increased for the sixth consecutive year—reaching a new, all-time high. CDC calls for targeted efforts to reduce STI health disparities for populations facing social inequities, particularly racial and ethnic minority populations, and adolescent and young adults, have limited access to these services.  

NASTAD Signs Onto Comments in Support of Equitable Health IT 

NASTAD joined a coalition of 64 organizations and called on the Office of the National Coordinator for Health Information Technology (ONC) leadership to develop United States Core Data for Interoperability (USCDI) that facilitates an interoperable, value-based, and person-centered health system. In particular, the advocates call on ONC to implement national sexual orientation and gender identity (SOGI) health IT standards in order to improve public health research, address population-level health disparities, and improve clinical outcomes for LGBTQIA+ individuals. 

FDA Lifts In-Person Dispensing Requirements for Mifepristone during PHE 

On April 12, the US Food and Drug Administration (FDA) announced that it would remove the risk evaluation and mitigation strategy (REMS) drug safety protocols that required in-person dispensing of mifepristone during the COVID-19 pandemic Public Health Emergency (PHE). Advocates called for the removal of the in-person dispensing requirements, pointing to the risk of COVID-19 transmission as a result of having to break social distancing to receive the abortifacient. In the statement, Acting FDA Commissioner Janet Woodcock announced that FDA would exercise enforcement discretion through the duration of the PHE, allowing the dispensing of mifepristone through mail. NASTAD supported removing the in-person dispensing requirement during the COVID-19 pandemic. 

National Transgender HIV Testing Day 

National Transgender HIV Testing Day (NTHTD) is observed each year on April 18. NTHTD is a day to recognize the importance of routine HIV testing, status awareness, and continued focus on HIV prevention and treatment efforts among transgender and gender non-binary people. In preparation for the day, CDC's Let's Stop HIV Together campaign is providing you with new materials and resources to use in your outreach efforts. Click here to read a Dear Colleague letter from the Acting Directors of the CDC Division of HIV/AIDS Prevention and NCHHSTP on the importance of NTHTD. 

Resources 

Gilead Announces Payment Model Changes for HIV and HBV Medications in Patient Assistance Programs 

On April 8, Gilead Sciences announced changes to payment models used in the Advancing Access® Patient Assistance/Medication Assistance Program (PAP/MAP), which would result in significant reductions in reimbursement rates for AIDS Drug Assistance Programs (ADAP) and community-based providers that are 340B covered entities. Advocates warn that the changes to the retail pharmacy model will drastically reduce 340B revenue for HIV prevention and care programs serving low-income and uninsured people living with and vulnerable to HIV, threatening the sustainability of the programs, especially in the South. The effective date for the change was delayed from October 1, 2021 to January 1, 2022, after advocates urged Gilead to reconsider the payment model changes.  

NASTAD ResourceCOVID-19’s Impact on PrEP/PEP and Sexual Health Services 

NASTAD, in collaboration with the National Coalition of STD Directors (NCSD), is pleased to announce the release of a resource that further explores the impact COVID-19 has had on the provision of sexual health and HIV prevention services over the last year. 

This reflection piece details the many challenges, and opportunities, COVID-19 has brought to the HIV/STD prevention field, particularly in the southern United States, and showcases the innovative approaches sexual health providers implemented to further prevent service disruption. 

NASTAD Factsheet: COVID-19 Vaccine Guidance for Syringe Service Programs, Health Departments, and People Who Use Drugs 

Health departments across the country are working to make COVID-19 vaccines available to populations at higher risk of experiencing serious complications or illness. Partnering with syringe services programs (SSPs) for vaccine distribution is one way to increase access to COVID-19 vaccines among people who use drugs and others underserved by traditional healthcare systems. This fact sheet contains recommendations that are based on experiences from SSPs in the United States and includes strategies for involving SSPs and health departments in vaccine distribution, increasing vaccine access among SSP staff and participants, and supporting people who use drugs throughout the vaccination process. 

NASTAD Toolkit: Self-Testing: A Strategy to Improve Access to HIV, Viral Hepatitis, and STI Testing 

NASTAD, in partnership with the Association of Public Health Laboratories (APHL), developed this toolkit to help health departments, public health laboratories, and their community partners decide whether and how to incorporate self-testing for HIV, viral hepatitis, and STIs. The toolkit is designed to support health departments in their efforts to strengthen HIV, viral hepatitis, and STI testing and linkage programs.  

CDC HIV Surveillance ReportHIV Infection, Risk, Prevention, and Testing Behaviors Among Transgender Women 

“This report summarizes findings from the first NHBS-Trans data collection cycle, which was conducted in 2019–2020. Transgender women, especially transgender women of color, are disproportionately affected by HIV. This report provides descriptive, unweighted data that can be used to describe HIV infection among transgender women and the percentages of transgender women reporting specific behaviors, HIV testing, access to care, participation in prevention programs, gender-affirming medical treatment, experiences of abuse and harassment, and suicidality.” 

CDC COVID-19 Vaccine Equity Resources 

HRSA FactsheetCOVID-19 Care for Uninsured Individuals 

HRSA developed fact sheets to help both patients and providers better understand their rights and responsibilities regarding access to COVID-19 vaccines. The COVID-19 vaccines are free to all individuals living in the United States and these resources will help to empower patients and educate providers on this fact. 

National Nurse-Led Care Consortium Learning Collaborative: Enhancing the HCV Care Model - Best Practices for Universal Testing & Linkage to Care 

“Join the National Nurse-Led Care Consortium for a 4-session learning collaborative focused on improving screening and treatment of HCV. Faculty for this learning collaborative include an infectious disease physician, a provider in community health, an HCV/HIV Patient Navigator, and policy advocates who will share their expertise and examples demonstrating best practices in screening.” 

CDC MMWR: State-Level Economic Costs of Opioid Use Disorder and Fatal Opioid Overdose — United States, 2017 

“In the 39 jurisdictions studied, combined costs of opioid use disorder and fatal opioid overdose varied from $985 million in Wyoming to $72,583 million in Ohio. Per capita combined costs varied from $1,204 in Hawaii to $7,247 in West Virginia. States with high per capita combined costs were located mainly in the Ohio Valley and New England. Federal and state public health agencies can use these data to help guide decisions regarding research, prevention and response activities, and resource allocation.” 

Job Postings 

NASTAD Drug User Health Team – Remote/Washington, DC 

  • The Associate, Drug User Health will play a vital role in project coordination to streamline and enhance the team’s expanding drug user health portfolio. Core activities will entail administrative and logistical support to NASTAD’s Drug User Health team in the delivery of technical assistance (TA) and training to health department and community-based officials. This position works closely with the team to facilitate effective coordination and communication across multifaceted project activities and deliverables. 

  • The Manager, Drug User Health will support the advancement of NASTAD’s efforts to assist health departments and community-based drug user health programs by providing technical assistance (TA) and training on effective drug user health strategies and connecting people who use drugs to HIV and hepatitis prevention and treatment programs. Core activities will include: leading collaborations and organizational partnerships to expand access to clinical care for people who use drugs; supporting the creation and release of training curricula and guidance documents; and providing tailored TA to support health department drug user health and harm reduction programs, community SSPs, and HIV and hepatitis care and treatment programs. 

NASTAD Request for Proposal (RFP): TIA Tools & Assessments Consultant 

RFP Issue Date: April 12, 2021 
RFP Closing Date: April 26, 2021 
Anticipated Performance Period: May 1, 2021 – June 30, 2021 

Role Summary: NASTAD is seeking a Trauma-Informed Approaches (TIA) Tools & Assessments Consultant to create trauma-informed, healing-centered tools and assessments for RWHAP Part B recipients and ADAPs to guide and assist them in becoming healing-centered care and treatment programs. 

Statewide Deputy Medical Director, HIV/STD/Vi ral Hepatitis -- Nashville, Tennessee 

Primary responsibilities include leadership and oversight of programs related to HIV prevention and treatment in Tennessee. This position will supervise and provide mentorship to the directors of HIV Prevention and Surveillance and the Ryan White Part B program. Utilize data to guide program and policy development and will provide clinical and programmatic oversight for the implementation of all related prevention and treatment activities. Requires management and leadership skills. 

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.    

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 

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

  • 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 

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 

Biden is asking Congress for $670M to end the HIV/AIDS pandemic 

“Even before the coronavirus pandemic has ended, President Biden is gearing up to tackle another public health crisis — this time for good. In his request for discretionary funding from Congress, Biden requested $670 million with the goal of ending the HIV/AIDS pandemic. With the money, the Biden administration is committing to ‘help accelerate and strengthen efforts to end the HIV/AIDS epidemic in the United States.’” 

Overdose Deaths Have Surged During the Pandemic, C.D.C. Data Shows 

“More than 87,000 Americans died of drug overdoses over the 12-month period that ended in September, according to preliminary federal data, eclipsing the toll from any year since the opioid epidemic began in the 1990s. The surge represents an increasingly urgent public health crisis, one that has drawn less attention and fewer resources while the nation has battled the coronavirus pandemic.” 

Biden Administration Moves To Undo Trump Abortion Rules For Title X 

“The Biden administration is moving to reverse a Trump-era family planning policy that critics describe as a domestic "gag rule" for reproductive healthcare providers. 

The proposal published on Wednesday would largely return the federal Title X family planning program to its status before Trump took office. The current rules, implemented in March 2019 under Trump, forbid any provider who provides or refers patients for abortions from receiving federal funding through Title X to cover services such as contraception and STD screenings for low-income people.”