Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras September 27, 2021

Hill Happenings

Reconciliation and FY2022 Appropriations

Democrats on the Hill are working to advance the Fiscal Year 2022 (FY2022) spending package, dubbed the Build Back Better Act, ahead of a September 30th fiscal cliff. Democrats are leveraging the budget reconciliation process to avoid the Senate filibuster and pass policy priorities in the spending package via a party-line majority, but internal disagreements within the party have resulted in protracted negotiations.

As a result, Democratic leadership is preparing a Continuing Resolution (CR) to extend federal funding and avoid a government shutdown while lawmakers continue FY2022 appropriations negotiations. On September 22, the House of Representatives passed H.R. 5305, the stop-gap CR which will extend federal funding through December 3, 2021. The fate of the House-approved CR in the Senate is unclear, however, due to Republican opposition to a provision that would pause the national debt limit through December 2022. If the CR fails to pass in the Senate, Democrats will have to decouple the CR from the debt limit fix and provide an alternative solution before the nation defaults on its debt, which could happen as soon as October.

All the while, House appropriators are moving forward committee text in the Build Back Better Act. Senate appropriators have not advanced committee markups of their spending bills due to disagreements on a top-line spending framework, but the House Budget Committee convened on September 25 to compile each committee's spending bills into a consolidated spending package. However, this House version of the Build Back Better Act will not be brought to a floor vote until there is an agreement in the Senate on spending levels. NASTAD will continue to monitor the FY2022 appropriations process to advocate for the highest funding levels on behalf of HIV and hepatitis programs.

NASTAD Calls on Senate Leadership to Protect LGBTQ+ People in Reconciliation Package

On September 22, NASTAD joined the National LGBTQ Anti-Poverty Action Network and called on Senate leadership to advance provisions in the FY2022 spending package, the Build Back Better Act, that protect the health and economic wellbeing of LGBTQI+ people. The coalition highlighted provisions advanced by House committees that would secure access to inclusive paid leave, expand access to Medicaid and services to support LGBTQI+ older Americans, enact and enforce progressive tax policies, expand housing assistance for low-income renters and aspiring homeowners, and extend ACA tax credits that make healthcare more affordable. LGBTQI+ people disproportionately experienced poverty before the pandemic, which exacerbated economic disparities: according to the Williams Institute, 1 in 5 LGBTQ+ people and nearly 3 in 10 transgender people in the United States lived in poverty before the pandemic.

Congressional HIV/AIDS Caucus Co-chairs Introduce Bipartisan Bill to Support Aging PLWH

On September 17, the co-chairs of the Congressional HIV/AIDS Caucus, Representatives Barbara Lee (D-CA-13) and Jenniffer González Colón (R-PR-At Large), introduced legislation supporting the goals and ideals of National HIV/AIDS and Aging Awareness Day (H.Res.649), which is observed annually on September 18th. The resolution includes ongoing efforts for prevention, care and treatment services, and research programs for communities affected by HIV and especially older people living with HIV in the United States and around the world. The CDC estimates that more than half of the individuals with HIV/AIDS in the United States are people age 50 and older, highlighting the need to support older communities living with HIV/AIDS. NASTAD endorsed the bipartisan resolution.

Administrative Activities

NASTAD Joins Coalition Calling on the White House to Protect the 340B Program

On September 21, NASTAD and a coalition of advocates called on the White House Office of National AIDS Policy (ONAP) to take action to protect the 340B program in light of manufacturer modifications to reimbursement structures that could destabilize community health centers and other safety-net HIV programs. In particular, the coalition urges ONAP to convene a meeting between Gilead Sciences, Inc., nonprofit AIDS service organizations and community-based HIV prevention programs, public health officials, and HIV advocates to prevent devastating harm that will result from the manufacturer’s decision to drastically cut reimbursements to 340B covered entities serving clients enrolled in the Advancing Access Medication Assistance Program (MAP) beginning January 1, 2022. The advocates call on ONAP to build alignment across public, private, and nonprofit sectors in order to negotiate an outcome that reasonably considers the interests of all parties involved.

CDC Advisory Committee on Immunization Practices Considers Universal Adult HBV Vaccination

The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) will convene on September 29th to consider public comment on the proposal to recommend universal adult hepatitis B vaccination. ACIP is currently reviewing evidence and has opened public comment through September 29 to inform their recommendation before the final vote, likely in December. If the committee votes in favor of the proposal, health payers and providers would boost hepatitis B vaccination for all adults, expanding the limited scope of current risk-based inoculation criteria.

NIDA Report Find Dramatic Uptick in Methamphetamine-involved Overdose Deaths

On September 22, the National Institute on Drug Abuse released a report, Methamphetamine Use, Methamphetamine Use Disorder, and Associated Overdose Deaths Among US Adults, which shows that overdose deaths involving methamphetamine nearly tripled from 2015 to 2019 among people ages 18- 64 in the United States. The data show that, although the overall number of people that reported methamphetamine use did not increase as dramatically, methamphetamine users are reporting higher-risk patterns of use that contribute to overdose mortality, such as frequent use and concurrent use of other drugs, particularly synthetic opioids like fentanyl. Additionally, the report shows rising rates of methamphetamine use in marginalized populations, especially American Indians/Alaska Natives, Black people, and homosexual or bisexual men.

Biden Administration to Nominate John Nkengasong to be Global AIDS Coordinator

After a months-long delay in filling the key global health position vacancy, the Biden Administration is expected to announce its intent to nominate Dr. John Nkengasong to serve as the U.S. Department of State Global AIDS Coordinator. Dr. Nkengasong, a virologist by training from Cameroon, currently leads the Africa Centres for Disease Control and Prevention (Africa CDC). As the Global AIDS Coordinator, Dr. Nkengasong would lead the President’s Emergency Plan for AIDS Relief (PEPFAR), the nation’s signature global health initiative that provides funding for AIDS care abroad. The Biden Administration was criticized by HIV and global health advocates for allowing the Global AIDS Coordinator role to remain vacant during the first month of Biden’s tenure in the White House following the departure of the former Coordinator, Deborah Birx, in February of 2020. NASTAD and the Global AIDS Policy Partnership (GAPP) applauded the Biden Administration for the intention to nominate the Dr. Nkengasong.

CMS Extends Coverage for COVID-19 Booster Shots

On September 24, following the Food and Drug Administration’s (FDA) authorization of a booster dose of the Pfizer COVID-19 vaccine for certain high-risk populations and a recommendation from the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS) announced that it will continue to provide coverage for the COVID-19 vaccine, including booster doses, at no cost to the consumer. Beneficiaries with Medicare have no cost-sharing requirements for COVID-19 vaccines or their administration, and there is no applicable copayment, coinsurance or deductible. Additionally, nearly all Medicaid and CHIP beneficiaries must receive coverage of COVID-19 vaccines and their administration without cost-sharing, made possible through funding afforded by the American Rescue Plan Act of 2021.

Resources

CDC NOFO: Comprehensive High-Impact HIV Prevention Programs for Young Men of Color Who Have Sex with Men and Young Transgender Persons of Color

The purpose of this program is to implement comprehensive high-impact HIV prevention programs to address health disparities among Young Men of Color Who Have Sex with Men (YMSM), Young Transgender Persons of Color (YTG), and their partners with the goal of reducing HIV transmission and HIV-associated morbidity and mortality. Letters of Intent are due October 4, 2021 to CBOFOA@cdc.gov. The application deadline is November 19, 2021, 11:59 p.m. Eastern Standard Time.

National Gay Men’s HIV/AIDS Awareness Day

National Gay Men’s HIV/AIDS Awareness Day (NGMHAAD) is observed annually on September 27. NGMHAAD serves as an opportunity to direct attention to the continuing and disproportionate impact of HIV on gay, bisexual, and other men who have sex with men in the United States. Data from 2019 show that 69% of new HIV diagnoses in the United States and dependent areas were among gay and bisexual men; in that same year, an estimated 15% of gay and bisexual men with HIV did not know their status. The disruption of traditional HIV testing services over the last 19 months has made self-testing a great option for some people to take an HIV test, learn their status, and get the benefits of today’s prevention and treatment tools. Click here to read a Dear Colleague letter from the leadership of the CDC National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention on the importance of this year’s NGMHAAD.

CDC MMWR: Increasing Access to HIV Testing Through Direct-to-Consumer HIV Self-Test Distribution — United States, March 31, 2020–March 30, 2021

During March 2020–March 2021, a novel public-private partnership provided free HIV self-test kits directly to MSM. Most participants reported they had never tested (36%) or tested >1 year ago (56%); approximately 10% reported accessing services including sexually transmitted infection testing and preexposure prophylaxis after using the self-test. The data suggest that public funding of HIV self-testing can engage MSM who never previously tested and might increase HIV testing frequency among this population.

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

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.

Job Postings

Public Health Informaticist, California Department of Public Health – Richmond, CA

The Public Health Informaticist position is assigned to the California Department of Public Health (CDPH), Sexually Transmitted Disease (STD) Control Branch, and is located at the CDPH campus in Richmond, CA, with consideration for a telework schedule. Under the general supervision of the STD Control Branch, Surveillance and Data Management Unit Chief, the Informaticist supports the design and implementation of disease prevention and control activities related to HIV, STDs, and viral hepatitis (especially hepatitis C virus (HCV)). 

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

No, Truvada and Descovy PrEP Are Not “AIDS Vaccine Pills”

“Contrary to a New York Post editorial  opposing part of the $3.5 trillion infrastructure bill now before Congress, the two currently approved pills to prevent HIV acquisition are not “AIDS-vaccine pills.” The article, which is packed with bombastic language against the “cure-crushing” “poison pill” of the Lower Drug Costs Now Act plan to pay for itself through costs to pharmaceutical companies, offhandedly contains the misinformation that ‘Descovy and Truvada are, essentially, AIDS-vaccine pills.’”

House passes bill to ensure abortion access in response to Texas law

“The House passed legislation on Friday to ensure nationwide access to abortion after the Supreme Court earlier this month declined to block a Texas law that bans the procedure in nearly all cases. The bill passed along party lines, 218-211, with only one conservative Democrat, Rep. Henry Cuellar (Texas), voting against it. It now heads to the Senate, where it’s likely to stall given a presumptive GOP filibuster if it were to come up for a vote.”

Our global plan to fight HIV has been a strategic weapon against COVID

“When COVID-19 hit, PEPFAR responded immediately to adapt service delivery, accelerate program innovation and drive policy change to better serve our clients. This included dramatically expanding decentralized distribution and multi-month dispensing of life-saving antiretroviral medications to keep clients in care and reduce their exposure to COVID-19. Through these actions, PEPFAR has not only ensured continuity of lifesaving medication for people living with HIV, but also delivered HIV treatment to 1 million more people in the last six months, now reaching over 18.4 million people globally.”