Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras September 20, 2021

Hill Happenings

Reconciliation and FY2022 Appropriations

Democrats on the Hill are working across the House of Representatives and the Senate to prepare the Fiscal Year 2022 (FY2022) spending package, dubbed the Build Back Better Act. Democrats are leveraging the budget reconciliation process to avoid the Senate filibuster and pass Democratic policy priorities in the spending package without Republican support, while advancing the Senate-negotiated bipartisan infrastructure package (H.R.3684) and the House-approved voting rights bill (H.R.4) in tandem.

On September 13, the House Energy and Commerce Committee kicked off a three-day markup of the Committee’s spending bill, where lawmakers considered health spending priorities. The bill was passed out of Committee on September 15, advancing language that would expand Affordable Care Act (ACA) tax credits to close the Medicaid coverage gap through 2025, when the Department of Health and Human Services (HHS) would launch a federal Medicaid program to permanently close the coverage gap by covering people with low incomes who live in states that did not expand their Medicaid programs. Due to Democratic opposition, the committee was unable to advance language that would empower the Secretary of HHS to directly negotiate with pharmaceutical companies to lower the price of certain prescription drugs. However, House Democrats were able to advance identical language in the Ways and Means Committee’s spending bill, so the price negotiation provision will be considered in the final reconciliation package.

Although Congress is working to quickly advance the FY2022 spending bills, lawmakers are increasingly anticipating that a continuing resolution will be needed to extend federal funding ahead of a September 30 fiscal deadline. On September 20, the House Rules Committee will convene to prepare the bill text for a continuing resolution that extends current funding levels until December 2021. NASTAD will continue to monitor the FY2022 appropriations process to advocate for the highest funding levels on behalf of HIV and hepatitis programs.

Administrative Activities

HHS Awards Over $48 Million to Health Centers for Ending the HIV Epidemic Initiative

On September 16, the Department of Health and Human Services (HHS) awarded over $48 million to 271 health centers located in in Ending the HIV Epidemic (EHE) priority jurisdictions to expand HIV prevention and treatment. The funding will allow health centers supported by the Health Resources and Services Administration (HRSA) to conduct more HIV testing and expand workforce capacity to improve PrEP services and care coordination. Additionally, the awardees are encouraged to partner with community organizations and health departments to facilitate increased linkage to care.

USPSTF Released Final Recommendation for Chlamydia and Gonorrhea Screening

On September 14, the United States Preventive Services Task Force (USPSTF) issued a B Grade Final Recommendation in support of screening sexually active women for Chlamydia and Gonorrhea. In particular, the USPSTF recommends that providers screen all sexually active women below the age of 25, and sexually active women 25 years or older if they are at increased risk for infection. Under the Affordable Care Act (ACA), the USPSTF B Grade recommendation supports coverage of chlamydia and gonorrhea screening without cost sharing for most health plans.

NASTAD Calls on Biden Administration To Properly Fund Sexual Health and Education Programs in Fiscal Year 2023 Budget

On September 14, NASTAD joined a coalition of 42 organizations and called on the Office of Management and Budget (OMB) to properly fund sexual health and education programs in the fiscal year 2023 (FY2023) budget. The group of advocates are calling for increased resources to the Office of Population Affair’s Teen Pregnancy Prevention Program and the Centers for Disease Control and Prevention’s (CDC) Division of Adolescent and School Health. Additionally, the coalition calls on the Biden Administration to eliminate the Sexual Risk Avoidance Program, created under the Trump Administration, which exclusively funds programs promoting abstinence-only approaches to sex and are not based on clinical evidence or sexual health best practices.

HHS Releases Final 2021 Special Enrollment Period Report and Medicaid Enrollment Snapshot

On September 15, HHS released the final enrollment report for the 2021 COVID-19 Special Enrollment Period (SEP), which shows historic enrollment levels and lower costs for health plans sold on HealthCare.gov and state-based Marketplaces. Over 2.8 million people newly gained access to coverage, and 90% of those enrollees received reduced premiums due tax credits afforded by the American Rescue Plan. Existing consumers saved an average of $67 per month in premium savings. Additionally, the Medicaid Snapshot showed record high enrollment for Medicaid and the Children’s Health Insurance Program (CHIP), with over 82.3 million people enrolled as of April 2021.

Resources

NASTAD Information Brief & Webinar: What about Post-Exposure Prophylaxis (PEP)? PEP Implementation in the South.”  

Published in both English and Spanish, this brief provides an overview of HIV Post-exposure Prophylaxis (PEP) in the southern United States (“the South”). The goal is to provide an overview of prevention with PEP to drive collective action between: jurisdictional and local public health departments, community-based organizations (CBOs), and community health clinics, to increase and improve prevention with PEP. Increasing PEP utilization as an effective prevention method is necessary for ending the HIV epidemic (EHE) and reaching EHE goals and objectives, particularly within the context of the South.  

Additionally, NASTAD, the Latino Commission on AIDS, and My Brother’s Keeper, Inc. will host a panel discussion and webinar on Thursday, September 23 from 3-4 pm ET to continue the conversation around PEP implementation in the South.

NASTAD Webinar: US Drug Supply and Impacts on Health

Date & Time: Wednesday, September 22 at 4:30 – 6:00 PM ET

Please join NASTAD and partners for a webinar to discuss how changes to the U.S. drug supply during the COVID-19 pandemic are affecting the health and safety of users, and the programmatic responses by harm reduction and public health organizations. The webinar will be moderated by Maya Doe-Simkins and will feature speakers from around the United States, including North Carolina Urban Survivors Union and the City of Philadelphia Department of Public Health, discussing impacts of drug supply and contamination in their communities. The moderated conversation and participatory Q&A will address U.S. drug supply, drug quality and contamination, innovative surveillance methods, drug checking services, and street-based medicine and wound care for people who use drugs.   

NACCHO/CDC Funding Opportunity: Comprehensive Community Approaches Preventing Substance Misuse (CCAPS)

Informational Webinar: Wednesday, September 15 from 4-5 pm EST

Application Deadline: Wednesday, October 13, 2021

With support from the Centers for Disease Control and Prevention (CDC), NACCHO is pleased to announce a funding opportunity to support the implementation of evidence-based approaches to prevent overdose, substance use disorders (SUD), adverse childhood experiences (ACEs), and other potentially traumatic events in the homes and families of those most at risk of overdose. Through this funding opportunity, NACCHO and CDC will award up to seven applicants to implement or expand programs that prevent SUD or overdose and that also have the potential to simultaneously prevent ACEs within the selected communities and populations of focus. Applicants may request up to $450,000.

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

HIV Section Administrator, Bureau of Communicable Diseases -  Tallahassee, Florida

This position in the Florida Department of Health is a highly responsible position as the HIV/AIDS Section Administrator for the HIV/AIDS Section reporting directly to the Chief of the Bureau of Communicable Diseases. This position is responsible for all aspects of the HIV program including providing direction and functional supervision of staff responsible for HIV Prevention, Patient Care, Surveillance and Quality Improvement initiatives for the state of Florida. The position also has the responsibility of coordinating statewide efforts for program planning and culturally competent community engagement efforts.

NASTAD Drug User Health Team

NASTAD, in partnership with AIDS United, has been selected by the CDC to manage a grant that will support SSPs in expanding their COVID and adult vaccination programming. We are recruiting for a Manager, a Senior Manager, and Associate Director/Project Coordinator. More information can be found below:

  • The Manager, Drug User Health plays a vital role in expanding the organization’s capacity to address the impacts of the intersecting crises of drug use, HIV/AIDS, and viral hepatitis in community and public health settings, particularly within state and local health departments and Syringe Services Programs (SSPs). Core activities will be to support NASTAD’s role in the launch and management of the Centers for Disease Control’s Supplemental Project for Expanding SSP Capacity to Respond to COVID-19 through the Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health (CDC-RFA-OT18-1802). 
  • The Senior Manager, Drug User Health plays a vital role in expanding the organization’s capacity to address the impacts of the intersecting crises of drug use, HIV/AIDS, and viral hepatitis in community and public health settings, particularly within state and local health departments and Syringe Services Programs (SSPs). Core activities will be to support NASTAD’s role in the launch, advancement, and management of the Centers for Disease Control’s Supplemental Project for Expanding SSP Capacity to Respond to COVID-19 through the Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health (CDC-RFA-OT18-1802).
  • The Associate Director, Drug User Health plays a vital role in expanding the organization’s capacity to address the impacts of the intersecting crises of drug use, HIV/AIDS, and viral hepatitis in community and public health settings, particularly within state and local health departments and Syringe Services Programs (SSPs). Core activities will be to serve as the Project Coordinator and direct activities related to NASTAD’s role in the launch and management of the Centers for Disease Control’s Supplemental Project for Expanding SSP Capacity to Respond to COVID-19 through the Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health (CDC-RFA-OT18-1802).

Hepatitis Surveillance Data Analyst – New Orleans, Lousiana

This position is responsible for the data analysis activities for the Louisiana Office of Public Health STD/HIV/Hepatitis Program (SHHP), in the Hepatitis Surveillance unit. Data utilized for Hepatitis Surveillance activities include Hepatitis laboratory data, Case Report Forms, Provider Report Forms, Linkage to Cure data, investigation data, Medicaid data, and data from related sources and programs. This position will implement and coordinate data analysis activities to monitor and evaluate progress toward meeting hepatitis elimination within the state. All activities must be completed in accordance with the security and confidentiality guidelines required by the Centers for Disease Control and Prevention (CDC) and SHHP.

Program Specialist IV, Division of Public Health Services – Concord, New Hampshire

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.

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.

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

Financing Comprehensive PrEP Access to End the HIV Epidemic

“We are in a moment of urgent and necessary innovation for HIV prevention. Our present approaches to scale up biomedical prevention options such as pre-exposure prophylaxis (PrEP) have largely failed…To end the HIV epidemic and address the unequal and insufficient use of PrEP in the United States, we must make PrEP access simple. Make. It. Simple.”

Is the Affordable Care Act’s Preventive Services Mandate Constitutional?

“Prevention is at the heart of the Affordable Care Act (ACA). The word prevention appears 233 times in the law; the word preventive 108 times. Section 2713, a key insurance reform provision, requires that all nongrandfathered health insurance and group health plans cover certain preventive services (such as flu shots and diabetes screening) without cost sharing. Studies have shown an increase in the use of preventive services since the law was enacted and a reduction in racial and ethnic disparities in the use of preventive care. Section 2713 is now being challenged by lawsuits, claiming it is unconstitutional.”

Key Issues and Questions for PEPFAR’s Future

“The Biden administration has inherited the President’s Emergency Plan for AIDS Relief (PEPFAR) at a critical time for the program and the fight against HIV, as it faces important strategic decisions and new challenges, not the least of which being the continuing impact of COVID-19. PEPFAR, the U.S. government’s signature global health effort,… is at a turning point.