Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras May 25, 2021

Hill Happenings

FY2022 Appropriations

On Wednesday, May 19, the Senate Finance Committee held a hearing entitled “Review of the FY2022 Budget Blueprint for the Centers for Disease Control and Prevention.” Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky and CDC Principal Deputy Director Dr. Anne Schuchat testified before the committee on the CDC’s priorities for the upcoming fiscal year. Director Walensky called for long-term investments in flexible public health infrastructure to improve health equity and better address social determinants of health. Additionally, Director Walensky highlighted the need to address systemic racism in public health and the worsening substance use and opioid epidemic, including the infectious disease consequences related to drug use.

NASTAD joined over 225 national and local organizations and called on Congressional Appropriators to increase funding for the Infectious Diseases and the Opioid Epidemic program at the CDC. The advocates call for increased investments in harm reduction providers like Syringe Service Programs (SSPs) to expand access to preventive services and link drug users to care. The coalition also calls for the removal of the ban on the use of federal funds to purchase syringes, a pivotal cost-prohibitive hurdle that many SSPs struggle to overcome before serving their communities. The advocates highlight the critical need for the funding amid burgeoning rates of substance use and overdose deaths, particularly among communities of color.

Additionally, NASTAD joined a coalition of 64 organizations and urged Congress to increase funding for the Title X family planning program within the Department of Health and Human Services (HHS) Office of Population Affairs (OPA). The coalition of advocates highlight the importance of appropriately funding the nation’s only federally funded family planning program in light of rising rates of STIs and an increase in the number of women who wish to delay or prevent pregnancy due to the COVID-19 pandemic. Additionally, the advocates call for a substantial investment to support the Administration’s efforts to rebuild the program after the Trump Administration’s Title X “Gag Rule” undermined the Title X provider network.

Senate Confirms CMS Administrator Nominee

On May 25, the Senate confirmed the nomination (55-44) of Chiquita Brooks-LaSure as Administrator of the Centers for Medicare and Medicaid Services (CMS). Brooks-LaSure will play a key role in implementing the Biden Administration’s health agenda, including revoking Medicaid work requirements on eligibility and expanding access to coverage. Brooks-LaSure, the first Black woman to serve as CMS Administrator, has extensive healthcare experience, including a former role at CMS during the Obama Administration.

Real Education and Access for Healthy Youth Act

NASTAD joined a coalition of over 100 organizations and supported the introduction of the Real Education and Access for Healthy Youth Act (REAHYA). The legislation was introduced in the House (H.R. 3312) by Reps. Barbara Lee (D-CA-13) and Alma Adams (D-NC-12) and in the Senate (S. 1689) by Sens. Mazie Hirono (D-HI) and Cory Booker (D-NJ). REAHYA would offer the first federal grants for comprehensive sex education programs in the United States and end investments in harmful Title V abstinence-only programs. These grants would fund programs at high schools, colleges, and organizations to support the sexual health and agency of students and young people, including evidence-informed, medically accurate and complete, age and developmentally appropriate, or culturally responsive content. This legislation would also require program grantees to promote gender equity and offer instruction that is inclusive of young people with varying gender identities, gender expressions, and sexual orientations. 

Administrative Activity

Biden Issues Presidential Proclamation in Observance of National Hepatitis Testing Day

On May 18, President Biden issued a Presidential Proclamation in observance of National Hepatitis Testing Day, held annually on May 19. President Biden recommitted the nation to the goal of eliminating viral hepatitis by 2030, called for a syndemic approach in the nation’s public health response to the hepatitis and related epidemics, and pointed to the importance of addressing social inequities to advance health equity in viral hepatitis. Finally, the President called on all Americans who are at risk for hepatitis to get tested, and for all health care providers to educate their patients about viral hepatitis.

CDC Releases 2019 National Viral Hepatitis Surveillance Report

On May 19, National Hepatitis Testing Day, the CDC released the 2019 National Viral Hepatitis Surveillance Report. The annual report serves as a summary of national viral hepatitis surveillance data based on reporting of cases of hepatitis A, B, and C from January 1 through December 31, 2019. The 2019 report details significant increases in rates of hepatitis A and C: from 2015 through 2019, there was a 1300% increase in cases of acute hepatitis A and a 63% increase in cases of acute hepatitis C. The report shows stable rates of acute hepatitis B cases from 2015 through 2019. Additionally, the 2019 report included new data parameters and content, such as demographic characteristics for persons living with chronic hepatitis B and C, the number and rate of viral hepatitis cases by urbanicity status, and outcome data from the CDC’s Perinatal Hepatitis B Prevention Program. The annual National Viral Hepatitis Progress Report is expected to be released later this month.

HHS Orders Drugmakers to Restore 340B Discounted Prices to Contract Pharmacies

On May 17, the Health Resources and Services Administration (HRSA) Acting Administrator sent letters to six pharmaceutical manufacturers mandating that they honor 340B ceiling prices for drugs dispensed at contract pharmacies. The drug manufacturers halted the discounted rates for drugs dispensed at contract pharmacies in July of 2020, contending that contract pharmacies are not 340B covered entities. HRSA determined that their policies that place restrictions on 340B Program pricing to covered entities that dispense medications through pharmacies under contract have resulted in overcharges and are in direct violation of the 340B statute. The Administration gave manufacturers until June 1, 2021, to develop a plan to resume selling covered outpatient drugs at the 340B ceiling price and credit or refund all covered entities for any overcharges.

CDC Seeks Input on Draft Update to PrEP Guidelines

The CDC is conducting two webinars on Monday, May 24 and Tuesday, May 25 from 1 – 2 pm ET to gather public comments on the draft 2021 update to the HIV Preexposure Prophylaxis (PrEP) Clinical Practice Guideline and Providers Supplement. The draft guideline documents were posted online on May 17, 2021 and will remain online for 10 days. The two webinars are an opportunity for all interested parties to ask questions and provide feedback, but are specifically directed toward clinicians, such as medical doctors, nurse practitioners, physician's assistants, and pharmacists. CDC will consider comments made during the webinars prior to finalizing the draft HIV Preexposure Prophylaxis Clinical Practice Guideline and Providers Supplement: 2021 Update for publication. Registration is not required. The webinars can be accessed here.

HHS Announces $3 Billion in ARP Funding for SAMHSA Block Grants

On May 18, HHS announced a $3 billion investment to Substance Abuse and Mental Health Services Administration (SAMHSA) Block Grants to address addiction and the growing mental health crisis. The $3 billion, the largest aggregate amount of funding to date for the mental health and substance use block grant programs, is authorized by the American Rescue Plan. The Community Mental Health Services Block Grant (MHBG) Program and Substance Abuse Prevention and Treatment Block Grant Program (SABG) will disperse $1.5 billion each to states and territories. Additionally, HHS Secretary Becerra established a new Behavioral Health Coordinating Council (BHCC), which will facilitate collaborative, innovative, transparent, equitable, and action-oriented approaches to addressing the HHS' behavioral health agenda.

Resources

NASTAD Webinar: Scaling Up HIV Workforce Capacity for Ending the HIV Epidemic

Date: Wednesday, June 9, from 2:00 to 3:30 PM ET

NASTAD is pleased to announce a three-part webinar series Scaling Up HIV Workforce Capacity for Ending the HIV Epidemic. The series will focus on addressing the needs and challenges faced by health departments and community partners as they work to implement their Ending the HIV Epidemic plans. The series will also highlight the importance of community representation in the HIV workforce. The initial webinar will focus on identifying workforce gaps and needs of health departments and community partners by highlighting important considerations when evaluating and measuring the HIV workforce. NASTAD will review the workforce challenges of health department HIV programs during the COVID-19 pandemic as shared through a 2020 request for information. The Council of State and Territorial Epidemiologists (CSTE) will share tips and tools on evaluation and measurement, and Mecklenburg County, an Ending the HIV Epidemic (EHE) Phase 1 Jurisdiction will share their experience with conducting a workforce capacity assessment as a part of their EHE planning. 

DVH Blog: Hepatitis Awareness Month Puts Focus on Integrating HIV and Viral Hepatitis Services

May is Hepatitis Awareness Month, an annual opportunity to raise awareness of the importance of vaccination for hepatitis A and hepatitis B, testing for hepatitis B and hepatitis C, and the availability of effective care and curative treatment. This year, it is also an opportunity to highlight the value of integrating viral hepatitis services with HIV, sexually transmitted infection (STI), and substance use disorder (SUD) services as the nation seeks to end the viral hepatitis and HIV epidemics.”

HRSA Blog: Hepatitis Awareness Month: Recognizing HIV and Hepatitis C Coinfection

“During the month of May, the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB) recognizes Hepatitis Awareness Month and Hepatitis Testing Day, which is on May 19, 2021. HRSA HAB is raising awareness about the impact of hepatitis C virus (HCV) among people with HIV, and encouraging those with HIV to get tested for HCV. Studies have shown that people with HIV and chronic hepatitis may experience complications with their HIV treatment. Coinfections also puts them at greater risk for liver-related problems including liver cancer and death.”

HRSA HIV/AIDS Bureau Updates Hepatitis Awareness Month Resources

As part of Hepatitis Awareness Month, Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) is raising awareness about the impact of the hepatitis C virus (HCV) among people with HIV, and encouraging those with HIV to get tested for HCV. People with HIV are disproportionately affected by both the hepatitis B virus and HCV, and coinfection with chronic hepatitis may complicate their HIV treatment. Coinfection also puts them at greater risk for liver-related problems including liver cancer and death.

Through the Ryan White HIV/AIDS Program (RWHAP) Part F Special Projects of National Significance (SPNS) Program, HRSA HAB developed several resources available to help health care providers treating people who have or are at risk for HIV/HCV coinfection, including:

Issue Brief: Meeting the Needs of People Aging with HIV on the Path to Ending the HIV Epidemic

“More than half of people living with HIV in the United States are aged 50 or older, and a growing number of people are living and aging with HIV into their 70s and beyond. Concerted action is needed to meet the needs of older people living with HIV. The burdens of HIV, aging, and related health comorbidities, combined with the social and structural challenges that people aging with HIV face, necessitate not only a focus on HIV-related outcomes, but also a comprehensive response aimed at treating comorbidities and improving long-term health and quality of life.”

NVHR/CHLPI Report: Hepatitis C: State of Medicaid Access May 2021 National Progress Report

“The Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) and the National Viral Hepatitis Roundtable (NVHR) today released a new progress report detailing the changes to hepatitis C treatment access in Medicaid programs since first publishing an analysis in 2017. The Hepatitis C: State of Medicaid Access May 2021 National Progress Report (Progress Report) demonstrates that while there is better access to hepatitis C (HCV) treatment today, discriminatory practices persist in some state Medicaid programs. In particular, sobriety restrictions continue to undermine public health efforts to eliminate hepatitis C in the U.S.” 

KFF Report: Key Questions: HIV and COVID-19

Job Postings

Viral Hepatitis Surveillance Coordinator – Des Moines, Iowa

Under the direction of the bureau chief and functional oversight of the Data Program Manager, coordinates and serves as the lead epidemiologist for the Viral Hepatitis Surveillance Program, including providing functional oversight for surveillance activities for hepatitis B and C.

HHS Policy and Research Fellowship – Remote/Washington, DC

Multiple fellowship opportunities are currently available in the Office of Infectious Diseases and HIV/AIDS Policy (OIDP) within the Office of the Assistant Secretary for Health (OASH) at the U.S. Department of Health and Human Services (DHHS) located in Washington, DC. The opportunity will be remote, until otherwise specified by the participant's assigned mentor. The policy and research fellowship within the Office of Infectious Diseases and HIV/AIDS Policy (OIDP) provides participants with an opportunity to learn about the policy development process from a range of different perspectives and program areas. Other activities will include drafting reports, letters, white papers, and other forms of scientific writing. OIDP supports a range of inter-agency activities in public health, and serves as a foundation for federal and non federal stakeholder collaboration.

Director I, HIV/STD Prevention and Care – Austin, Texas

Works under the general direction of the Director of the TB/HIV/STD Section (THSS) of the Department of State Health Services (DSHS). Performs advanced (senior-level) managerial work leading the day-to-day operations of the HIV/STD Prevention and Care Unit. The Director I would lead the day-to-day operations of an array of programmatic services that maintain and facilitate programs of the Unit. These programs include statewide programs for HIV clinical and social services; the provision of medications for the treatment of HIV and other STDs; and HIV, STD and viral hepatitis prevention.

NASTAD Senior Director, Public Health Systems – Remote/Washington, DC

The Senior Director, Public Health Systems, provides leadership and direction to NASTAD’s health care access (HCA) and health systems integration (HSI) efforts. This position leads the HCA and HSI teams providing direct supervision to these teams’ directors and the overarching work of the teams regarding programmatic, technical assistance, and capacity building activities.

Public Health Administrator, HIV Prevention Engagement & Outreach Coordinator – Indianapolis, Indiana

The Public Health Administrator coordinates numerous HIV prevention programs with both high-risk and HIV positive consumers. Programming is targeted to CDC-identified priority populations including but not limited to: Communities of Color, Men who have Sex with Men (MSM), Transgender; People who Inject Drugs (PWID). This position works with prevention team managers and coordinators on the planning, development and implementation programs and projects. This position assures all initiatives are compliant with funders guidance.

Statewide Deputy Medical Director, HIV/STD/Viral 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.

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.

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

At Last, Generic HIV Prevention Drugs Promise Savings And Access—But Also Reveal Precarious Financing

“Pre-exposure prophylaxis or “PrEP,” a once-daily pill that prevents HIV transmission, has been a game changer for HIV and has helped put the United States on a path to end new HIV infections nationwide. However, PrEP has also exposed the instability of HIV public health financing and its outsized reliance on pharmaceutical manufacturers to prop up not only medication access programs but the basic fabric of the HIV workforce.” 

Opioids, LGBT Health, Covid: HHS’s Levine Has Packed Agenda

“Rachel Levine has a full plate of health inequities she wants to tackle as the Biden administration’s assistant secretary for health, including Covid-19 vaccinations, LGBT health care, HIV, opioid use, and environmental impacts on health. Because of her position as the highest ranking openly transgender official in any administration, she is facing pressure to be a voice for her community and make a real impact on health policy in the next few years. The role of assistant secretary for health at the Health and Human Services Department is often shaped by its holder, with the authority to address a multitude of public health issues and a limited amount of time to do so.”

Alarming Hepatitis Increases Highlight Need for Investment in Viral Hepatitis Elimination

“New data released by the Centers for Disease Control and Prevention (CDC) today show shocking increases in the number of viral hepatitis cases, an indication that the United States is losing the battle to eliminate this preventable public health threat. Viral hepatitis is a leading cause of liver disease and liver cancer and it is known to cause or exacerbate other serious and chronic health conditions, costing billions of dollars to treat every year. The United States must increase its commitment to eliminating viral hepatitis by investing in evidence-based prevention and treatment strategies and bolstering our nation’s public health infrastructure.”