Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras October 4, 2021

Hill Happenings

Reconciliation and FY2022 Appropriations

Lawmakers successfully avoided a government shut-down hours before the end of Fiscal Year 2021 on September 29. After Senate Republicans blocked a House-approved continuing resolution (CR) on September 27, Senate Democrats reworked the CR bill to secure GOP votes, stripping language that would pause the debt ceiling until the fall of 2022. The House of Representatives advanced the Senate-modified CR (H.R. 5305) on September 29, which was promptly signed into law by President Biden. The CR extends federal funding through December 3, affording Democrats more time to negotiate on the fiscal year 2022 (FY2022) spending bills and advance the Build Back Better Act through budget reconciliation.

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 to Appropriately Fund Domestic HIV, Viral Hepatitis, STI, and TB Programs

On September 27, NASTAD and AIDS Budget and Appropriations Coalition (ABAC), a workgroup of the Federal AIDS Policy Partnership (FAPP), called on Senate appropriators to build on the funding levels proposed by the House of Representatives and increase funding for domestic HIV, viral hepatitis, sexually transmitted infections, and tuberculosis programs. The advocates urged the Senate to build on the Ending the HIV Epidemic initiative and expand funding for the Ryan White HIV/AIDS program. Additionally, the coalition called for increased resources to the Centers for Disease Control and Prevention’s (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, which houses the Division of HIV/AIDS Prevention (DHAP), the Division of Viral Hepatitis (DVH), the Infectious Diseases and Opioid Epidemic program.

NASTAD Urges Lawmakers to Increase Funding for CDC’s STD and DASH Programs

On September 28, NASTAD joined a coalition of 44 organizations and called the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies to increase funding for the CDC Sexually Transmitted Diseases (STD) and Division of Adolescent and School Health (DASH) programs. The advocates highlighted the urgent need for more resources in light of rising rates of chlamydia, gonorrhea, and syphilis and a struggling STD workforce due to the COVID-19 pandemic.

Administrative Activities

NASTAD Urges USPSTF to Evaluate Injectable PrEP

On October 1, NASTAD joined a coalition of HIV advocates and urged the U.S. Preventive Services Task Force (USPSTF) to quickly and efficiently evaluate cabotegravir, a long-acting injectable form of pre-exposure prophylaxis (PrEP), as part of its 2019 Grade A recommendation for PrEP. The coalition urged USPSTF to keep up with advances in biomedical preventive HIV care, citing the CDC’s updated PrEP guidelines that were issued in May of 2021 which included long-acting cabotegravir due to its proven success in preventing HIV infection. The inclusion of long-acting cabotegravir in the USPSTF recommendation for PrEP would facilitate access to cabotegravir without cost-sharing for consumers.

HRSA HAB Waives Ryan White HIV/AIDS Program Core Medical Services Expenditure Requirement

On October 1, the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) released a policy notice that simplifies the process for Ryan White HIV/AIDS Program (RWHAP) Parts A, B, and C recipients to request a waiver of the requirement that a minimum of 75 percent of RWHAP funds be spent on core medical services. The updated guidance, effective October 1, 2021, establishes a one-page HRSA RWHAP Core Medical Services Waiver Request Attestation Form which RWHAP recipients would complete and submit to HRSA attesting to having met the underlying statutory and policy requirements to apply for a waiver of the core medical services expenditure requirement. In order to best effectuate the improvements in this policy, for this year only, Part A recipients are permitted to submit a HRSA RWHAP Core Medical Services Waiver Request Attestation Form and any necessary revised budgets up to four months from the due date of the currently open application period. 

CDC Updates Division of HIV Prevention Organizational Structure

On October 1, the National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) announced the launch of a new organizational structure for the Division of HIV Prevention (DHP), formerly known as the Division of HIV/AIDS Prevention (DHAP). For over two years, NCHHSTP and DHP designed and implemented an updated organizational structure to facilitate enhanced collaboration between scientific and programmatic activities to drive meaningful, lasting change in communities affected by HIV. The new structure will allow DHP to fine tune and optimize support for programs at health departments and community-based organizations, accelerate the Ending the HIV Epidemic (EHE) initiative, and center health equity in all DHP activities.

HHS Announces New Director for the Office of Civil Rights

On September 27, the Department of Health and Human Services (HHS) announced the appointment of Lisa Pino as the Director of the Office for Civil Rights (OCR). In this role, Pino will support the Biden Administration’s efforts to protect federal civil rights in health care, including enforcing HIPAA privacy standards and upholding discrimination protections. Prior to joining OCR, Pino served as the New York State Department of Health's Executive Deputy Commissioner.

Biden Administration Nominates John Nkengasong for Global AIDS Coordinator

On September 27, the Biden Administration nominated 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 months of Biden’s tenure in the White House following the departure of the former Coordinator, Deborah Birx, in February of 2020. AVAC and NASTAD and the Global AIDS Policy Partnership (GAPP) applauded the Biden Administration for the nomination.

Biden Administration Releases Surprise Billing Regulations

On September 30, the Biden Administration released an interim final rule that establishes new protections from surprise billing and excessive cost sharing for consumers receiving health care items/services. The regulation, which spans across the HHS, the Department of Labor, the Department of the Treasury, and the Office of Personnel Management (OPM), implements dispute resolution and external review processes in order to protect patients from costly medical bills that were issued for services that were not covered by their insurance networks. The rule was authorized by No Surprises Act, which was included in the FY2021 Appropriations bill.

Resources

TAG Issue Brief: Realizing Returns on U.S. Government Investments in GeneXpert Diagnostic Technologies

GeneXpert, a program owned by U.S.-based company Cepheid, produces diagnostic tests that are essential tools in the struggle against COVID-19, tuberculosis, HIV, viral hepatitis, and other diseases. Despite substantial public investments in GeneXpert research and development, Cepheid refuses to publicly disclose its cost of production and sells GeneXpert tests at unaffordable prices that limit access in the U.S. This brief outlines actionable steps the U.S. government can take to hold Cepheid accountable for transparent, fair, and equitable pricing of GeneXpert tests and ensure public return on public investment for health technologies developed using U.S. government funding.

Chicago Department of Health Survey: Experiences of COVID-19 Survivors

The Chicago Department of Public Health is conducting a study of Chicagoans who have survived COVID, building in part on the CDC’s MMWR Report of 9/10/21. In planning this study, we are interested in a mutual sharing of ideas with other public health jurisdictions that are following up with survivors. If you are part of a public health jurisdiction conducting survivor follow-up and would like to be part of this discussion, please contact CDPH Project Manager Jenifer Buckley (jenifer.buckley@cityofchicago.org). She is interested in jurisdictions’ overall goals in these efforts, methods they use, partners they engage, and other considerations.

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.

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

Communicable Disease Unit Surveillance Program Manager – Cheyenne, Wyoming

The Wyoming Department of Health, Public Health Division, Communicable Disease Unit is seeking a Communicable Disease Surveillance Program Manager for Cheyenne. This position will serve as the Communicable Disease (CD) Surveillance Program Manager and senior epidemiologist for the Communicable Disease Unit. This position oversees public health surveillance of four disease areas (HIV, STD, TB, and Viral Hepatitis).  This position will monitor disease trends and utilize surveillance data to coordinate public health activities.  

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-19through 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-19through 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-19through 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

One in Six HIV PrEP Descovy Switches Contraindicated

“A recent study in the journal Open Forum Infectious Diseases suggests that only between 1 in 10 and 1 in 3 switches to the new formulation of HIV pre-exposure prophylaxis (PrEP) are indicated by lab work — and that nearly half of people receiving a prescription for the new version had lab results actually contraindicating the switch. This, combined with the lower cost of generic Truvada and the steep cost of Descovy, led study co-author and HIV PrEP prescriber Douglas Krakower, MD, and colleagues to suggest that the generic version should be standard of care for all people on PrEP unless otherwise indicated.”

POLITICO-Harvard poll: Drug price negotiation is Americans' top priority

“Americans support letting the government negotiate drug prices above all the other major priorities in the infrastructure and social spending packages now before Congress, according to a new POLITICO-Harvard poll that suggests health care is at the top of most respondents' minds.”

FDA grants Priority Review to ViiV Healthcare’s New Drug Application for cabotegravir long-acting for prevention of HIV

“ViiV Healthcare, the global specialist HIV company majority owned by GlaxoSmithKline plc (GSK), with Pfizer Inc. and Shionogi as shareholders, today announced that the U.S. Food and Drug Administration (FDA) has accepted and granted Priority Review for a New Drug Application (NDA) for investigational, injectable cabotegravir long-acting for pre-exposure prophylaxis, or PrEP. The Priority Review designation of cabotegravir long-acting for PrEP builds upon its prior identification as a Breakthrough Therapy by the FDA.”