POLICY UPDATES: HILL HAPPENINGS AND ADMINISTRATION ACTIVITIES

By Mike Weir July 19, 2021

Hill Happenings 

FY2022 Appropriations 

Congressional Appropriators are working to draft and markup federal spending bills for fiscal year 2022 (FY2022) ahead of a September 30 funding deadline. Appropriators in the House of Representatives are rapidly advancing spending bills, but some lawmakers are anticipating that a protracted appropriations negotiations process in the Senate may necessitate the adoption of a continuing resolution to keep the government open as lawmakers work out an agreement. 

On July 13, the House Appropriations Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies (LHHS) marked up the FY2022 LHHS Funding Bill and advanced the bill to the House Appropriations Committee by voice vote without amendments. On July 14, the committee released the bill reports for the LHHS bill, providing more detailed information on the allocation of federal funds for the Department of Health and Human Services and its operating agencies. Click here to view the breakdown of proposed funding levels by HHS operating division and program area. 

On July 15, the House Appropriations Committee passed the LHHS funding bill out of full committee by a 33-25 vote. Democrats plan to introduce the bill on the House floor next week, packaged in a FY2022 appropriations minibus along seven other spending bills. Senate Appropriators have yet to release any FY2022 funding bills. NASTAD will continue to monitor the FY2022 appropriations process to advocate for the highest funding levels on behalf of HIV and hepatitis programs. 

Senate Appropriators have yet to release any FY2022 funding bills. NASTAD will continue to monitor the FY2022 appropriations process to advocate for the highest funding levels on behalf of HIV and hepatitis programs. 

Senate Democrats Reach Agreement on Budget Resolution Framework 

On July 13, Senate Leader Schumer (D-NY) announced that Budget Committee Democrats in the upper chamber reached an agreement on topline numbers for a FY2022 budget resolution. If approved, the budget resolution would unlock the budget reconciliation process, enabling Democrats to pass the President’s infrastructure package on party lines with a simple majority. Democrats leveraged the budget reconciliation process earlier this year to pass the American Rescue Plan, the President’s landmark COVID-19 relief bill. The Budget Committee Democrats agreed on a $3.5 trillion budget resolution, which will need to be adopted by the full Democratic caucus in order to advance.  

Administrative Activities

Biden Administration Announces Nominee for Director of National Drug Control Policy 

On July 13, the Biden Administration announced that it would nominate Rahul Gupta to serve as the Director of the Office of National Drug Control Policy. Rahul Gupta, MD, MPH, MBA, FACP, is currently a professor and the Chief Medical and Health Officer and Senior Vice President at March of Dimes. Gupta also served as the West Virginia Health Commissioner, where he oversaw the state’s response to the opioid crisis. If confirmed by the Senate, Gupta will succeed current Acting Director Regina LaBelle and become the first physician to lead the Office of National Drug Control Policy.  

Departments of Labor, Health and Human Services Update PrEP Guidance 

On July 19, the Departments of Labor, Health and Human Services, and Treasury issued updated guidance for coverage of PrEP services under the Affordable Care Act. The updated FAQs clarify that, in addition to covering PrEP antiretroviral medication, health plans must cover ancillary PrEP services without cost sharing, including baseline and follow-up testing, medication adherence counseling, and screening for Hepatitis B and C and sexually transmitted infections. The guidance was developed after the United States Preventive Services Task Force (USPSTF) gave an “A” recommendation for PrEP coverage for those who are at risk for contracting HIV in 2019, advising that PrEP is a comprehensive intervention composed of both antiretroviral medication and essential support services. 

HHS Releases Updated Clinical Guidelines for HIV/AIDS 

On July 14, HHS published two updates to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. The updates incorporate the latest available information about the diagnosis and treatment of four infectious diseases—cytomegalovirus, cryptococcosis, coccidioidomycosis, and bartonellosis—in people with HIV. The updated guidelines also include recommendations concerning immunizations for preventable diseases in adults and adolescents with HIV. 

CDC Releases Updated Provisional Drug Overdose Mortality Data 

On July 14, CDC National Center for Health Statistics released updated information that provides a preliminary view of drug overdose mortality during 2020. Data show that opioid-involved drug overdose deaths increased 37.2% in 2020, with 48 states experiencing an increase in overdose deaths. According to the provisional data, the total reported number of drug overdose deaths occurring in the United States increased by 29.6% from 71,130 deaths in 2019 to 92,183 deaths in 2020, although officials predict that the real death toll is closer to 93,331 deaths.  

HRSA Awards American Rescue Plan Funding to Health Center Look-Alikes 

On July 15, the Health Resources and Services Administration (HRSA) announced that it awarded nearly $144 million in American Rescue Plan funding to 102 HRSA Health Center Program look-alikes (LALs) to respond to and mitigate the spread of COVID-19, and enhance health care services and infrastructure in communities across the country. The funds will support community-based healthcare providers that serve underserved communities and populations that are disproportionately impacted by the COVID-19 pandemic. In addition to strengthening the COVID-19 response and vaccination efforts, the funds will enable LALs to build out infrastructure and enhance existing health services. 

Resources 

NASTAD Webinar: Recommendations for Federal Partners and Health Departments Navigating Naloxone Supply 

Date & Time: Monday, July 19 from 3:00 – 4:15 pm ET 

Summary: NASTAD will host a webinar to discuss the Recommendations for Federal Partners and Health Departments Navigating Naloxone Supply resource. During this webinar, we will review the new guidance, hear updates from national, state, and local naloxone access programs, and discuss strategies for management, communication, and working with SSPs. 

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

Date & Time: Wednesday, July 21 from 2:00 – 3:00 pm ET 

Summary: In this final webinar, presenters will emphasize the importance of community representation in the workforce. Black AIDS Institute will offer strategies on how to develop the skills of community members for long term involvement and contribution as illustrated through their pilot HIV Certificate Program. They will also share how their Health Department Initiative provides training and capacity building assistance to support health department efforts to provide culturally appropriate HIV services within Black communities. The Arkansas Department of Health, an Ending the HIV Epidemic (EHE) Phase 1 Jurisdiction, will discuss their approach to navigating challenges related to health department hiring policies and practices through their Community Connector Project and a Community Connector will share their experience of working with the program.   

HCMSG Webinar: Eliminating Hepatitis C: From the Clinic to the Streets 

Date & Time: Wednesday, July 28 at 4:00 – 5:00 PM ET 

Summary: HCMSG is hosting a webinar addressing the impact of Hepatitis C in underserved and overlooked populations. Hear directly from our medical providers at HCMSG about some of the real world challenges we face in order to reach elimination. We invite patients, providers, peers, and community based organizations to join us. 

2021 Midwest LGBTQ Health Symposium 

Date: September 29-30 

As part of the HRSA-funded Special Project of National Significance (SPNS): Evidence-Informed Approaches to Improving Health Outcomes for People Living with HIV, Howard Brown Health will host the virtual 2021 Midwest LGBTQ Health Symposium taking place on September 29-30. This year's theme is Community Informed Care is a Radical Act. The goal of the conference is to provide a space for healthcare professionals, educators, researchers, and advocates from across the country to disseminate evidence-based practices and engage in rigorous discussion around issues relating to the health of the lesbian, gay, bisexual, transgender, and queer communities. 

Job Postings 

Director of the Office of Infectious Disease and HIV/AIDS Policy – Washington, DC 

This position is located in the Office of the Assistant Secretary for Health (OASH). OASH coordinates public health and science activities across HHS components. The incumbent will serve as the senior level advisor to the Assistant Secretary for Health (ASH) on health policies, procedures, and activities relating to infectious disease and related policy and program development. The incumbent provides strategic leadership, oversight, direction and coordination of policies, programs, and activities designed to prevent the occurrence of infectious diseases, such as HIV/AIDS, hepatitis, sexually transmitted infections, and other emerging communicable diseases. 

NASTAD Assistant, Program and Policy – Remote/Washington, DC 

The Assistant, Program and Policy will support NASTAD’s program and policy teams by providing administrative and logistical support for the Senior Directors/Directors. The ideal candidate will be motivated, highly organized, and able to follow through on tasks with minimal prompting. Demonstrated ability to execute projects in a timely manner and precise attention to detail are required. 

NASTAD Senior Associate, Prevention – Remote/Washington, DC 

The Senior Associate, Prevention, as part of NASTAD’s Prevention team, supports the organization’s capacity to support health departments’ (HDs) implementation of Ending the HIV Epidemic plans. The position works primarily on NASTAD’s CDC-funded “Strategic Partnerships and Planning to Support Ending the HIV Epidemic in the United States” (PS19-1906 Component A) project to provide technical assistance to HDs implementing CDC PS20-2010 Component A. 

2021-2022 HepVu Fellowship 

HepVu is focusing on empowering new voices by offering three fellowship opportunities for researchers in viral hepatitis and HIV spaces. Each fellow will be awarded a $10,000 personal stipend to conduct a research project related to HIV, Hepatitis C, or both, using data on AIDSVu and/or HepVu, along with other data sources. Priority will be given to research proposals that address health disparities and/or relevant intersections such as syndemics, the opioid epidemic, social determinants of health, STIs, etc. We believe communities affected by these health disparities should be centered in the work we do and strongly encourage applications from underrepresented groups in the HIV and Hepatitis C space. Fellows’ research will be featured on the Vu platforms and used to further illustrate the impact of HIV and/or viral hepatitis in the U.S. 

New Hampshire Bureau of Infectious Disease Control 

  • ID Care Services Program Manager (Public Health Program Manager #43569, Job ID 20909): This full-time position leads the dynamic NH Ryan White CARE Program and NH TB Financial Assistance Program teams. 

  • HIV Surveillance Coordinator (Program Specialist III #18990, Job ID 21123): This full-time epidemiologist position is responsible for HIV/AIDS case and cluster/outbreak surveillance activities, develops routine and ad hoc reports and data analysis projects, and supports related health equity initiatives.  

  • STD Surveillance Statistical Assistant (Statistical Assistant #19623, Job ID 21093): This full-time position is responsible for supporting STD case surveillance activities, communicating with healthcare providers, and conducting preliminary data analyses. 

  • Viral Hepatitis Coordinator (Health Promotion Advisor #42860 , Job ID 20743): This full-time position is responsible  for coordinating state-wide viral hepatitis activities including prevention, testing, treatment and linkage to care activities.  

  • ID Care Services Quality Management Specialist (Program Specialist IV #9T2810, Job ID: 19231). This full-time position plans and evaluates the quality management areas of the NH Ryan White CARE Program. Provides subject matter expertise with regard to quality improvement methodology and HIV specific performance measures, to demonstrate measured improvements in HIV care across NH.  

  • COVID-19 Public Health Nurse Specialist (Public Health Nurse Specialist #9T2809, Job ID 20592). This full-time registered nurse position will join a multi-disciplinary team responsible for COVID-19 case investigation, contact tracing and outbreak response. 

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. 

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

Another Covid-19 Calamity – More Deaths Due To Hepatitis C Infections 

“From 2014 to 2019, about 1.2 million Americans were treated for hepatitis C leading to a reduction of over 65% of liver-related deaths in 2019 compared to 2014. However, the impact of the pandemic has resulted in fewer diagnoses of hepatitis C (as has happened with other diseases) and fewer people being treated. Momentum for wiping out hepatitis C has slowed. But, the importance of getting back to rigorously testing for and treating hepatitis C is clear. If brought back to pre-pandemic levels, 9,500 – 24,900 cases of hepatocellular carcinoma could be averted over the next eight years.” 

CDC advisers to consider additional coronavirus dose for immunocompromised patients 

“A federal advisory panel is expected next week to consider whether health-care workers should be allowed to give additional coronavirus shots to patients with fragile immune systems, even as top U.S. health officials have said an additional dose of vaccine is not widely needed…The advisory panel next week plans to focus on the 2 to 4 percent of U.S. adults who have suppressed immunity, a population that includes organ transplant recipients, people on cancer treatments and people living with rheumatologic conditions, HIV and leukemia.” 

WHO warns that HIV infection increases risk of severe and critical COVID-19 

“A new WHO report confirms that HIV infection is a significant independent risk factor for both severe/ critical COVID-19 presentation at hospital admission and in-hospital mortality. Overall, nearly a quarter (23.1%) of all people living with HIV who were hospitalized with COVID-19, died. The report is based on clinical surveillance data from 37 countries regarding the risk of poor COVID-19 outcomes in people living with HIV (PLHIV) admitted to hospital for COVID-19. It found that the risk of developing severe or fatal COVID-19 was 30% greater in PLHIV compared to people without HIV infection.”  

Can the Pandemic Usher in a New Age of Harm Reduction Awareness?  

“What is truly powerful about harm reduction is it does not aim to be prescriptive or to force people into boxes. It provides a framework for transformative relationships, and it does not only have to be about drugs. Harm reduction in its bigger form is the fundamental recognition that humanity is broad and inclusive, and that every human being has inherent worth and dignity. That larger purpose entails building connection, bringing people in instead of pushing them out. And it is this—beyond using analogies between face masks and condoms, syringe access and vaccines, to raise public awareness—that might make harm reduction exactly the right vision to help guide recovery from the COVID-19 pandemic. Our communities are looking for ways to rebuild connections, and to help people calculate risks, while treating each other with compassion and empathy.”