Policy Updates: Hill Happenings and Administration Activities

By Mike Weir February 19, 2019

Administration Activities

Federal Ending the Epidemic Plan

The Department of Health and Human Services (HHS) released documents detailing the Administration’s Ending the Epidemic plan, Ending the HIV Epidemic: A Plan for Americawhich aims to reduce new HIV infections by 75% in the next five years and by 90% in the next ten years. NASTAD will continue to engage with administration officials on the implementation of this plan. NASTAD will ensure a role for health departments and that the plan focuses on populations most impacted by HIV.

While no dollar figures have been released, we have been told that a “significant” amount of “new” resources will be included in the President’s budget proposal for FY2020. The President’s budget request will be released in mid-March. 

To achieve this goal, HHS will:

  • Focus on four key strategies: Diagnose, Treat, Protect, and Respond.
    • “Diagnose all individuals with HIV as early as possible after infection.”
    • “Treat the infection rapidly and effectively after diagnosis, achieving sustained viral suppression.”
    • “Protect individuals at risk for HIV using proven prevention approaches.” 
    • “Respond rapidly to detect and respond to growing HIV clusters and prevent new HIV infections.” 
  • Provide new targeted resources to 48 counties, Washington, D.C., and San Juan, Puerto Rico. These areas accounted for more than 50% of new HIV diagnoses in 2016 and 2017.
  • Provide new targeted resources to seven states (Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma, South Carolina) that have a substantial rural HIV burden.
  • Lead Federal Agencies: HHS, Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and Indian Health Service (IHS).

As outlined by HHS, the plan will fund three major areas:

  • “Increasing investments in geographic hotspots through our existing, effective programs, such as the Ryan White HIV/AIDS Program, as well as a new program through community health centers that will provide medicine to protect persons at highest risk from getting HIV.”
  • “Using data to identify where HIV is spreading most rapidly and guide decision-making to address prevention, care and treatment needs at the local level.”
  • “Providing funds for the creation of a local HIV HealthForce in these targeted areas to expand HIV prevention and treatment.”

In a JAMAarticle, HHS officials Dr. Anthony FauciDr. Robert RedfieldDr. George SigounasRADM Michael Weahkee, and ADM Brett Giroir discuss the plan and say, “The President’s budget will ask Republicans and Democrats to make the needed commitment to support a concrete plan to achieve this goal.”

NASTAD released this statement and is working with the HIV community on a further response. NASTAD will continue to provide updates as additional plan details are released. 

Medicare Payment Cut Proposal

The HIV Health Care Access Working Group (HHCAWG), which NASTAD co-chairs, sent a letter to the Centers for Medicare and Medicaid Services (CMS) urging them to reject Tennessee’s TennCare II Demonstration Amendment Section 1115 waiver application.

National HIV/AIDS Strategy and National Viral Hepatitis Action Plan Update

The Health and Human Services (HHS) Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) is hosting listening sessions as it begins to update the National HIV/AIDS Strategy (NHAS) and National Viral Hepatitis Action Plan (NVHAP). NASTAD will provide comments.

  • Friday, February 22, 2019: In-person Listening Session at HHS from 11:00 a.m.–1:00 PM EST in Room 800 of the Hubert H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC, 20201. RSVP by Thursday, February 14 by sending your name, title, and organization to HepHIVStrategies@hhs.gov.

OHAIDP previously held listening sessions during the 2018 National Ryan White Conference on HIV Care and Treatment, 2018 National HIV and Hepatitis Technical Assistance Meeting convened by NASTAD, and at the 2018 U.S. Conference on AIDS (USCA).

OHAIDP has published a Request for Information (RFI) in the Federal Register to solicit written comments for updating NHAS and NVHAP. Electronic responses are strongly preferred and should be sent to HepHIVStrategies@hhs.gov. Hard copy responses can be sent to:

U.S. Department of Health and Human Services
330 C Street, SW, Room L001
Washington, DC 20024
Attention: HIV/Viral Hepatitis RFI

Comments are due no later than 5:00 PM (EDT) on March 11, 2019.

Substance Abuse and Mental Health Services Administration 

In a Dear Colleague letter sent to Substance Abuse and Mental Health Services Administration (SAMHSA) grantees, Elinore McCance-Katz, MD, PhD, the Assistant Secretary for Mental Health and Substance Use, urged “the public health and substance use treatment communities to focus on the synergistic epidemic of substance use disorder, [HIV], and viral hepatitis.”

Hill Happenings

Fiscal Year 2019

Congressional negotiators reached a deal to fund all seven of the remaining FY2019 spending bills. The Senate approved the conference report by a vote of 83-16, and the measure cleared the House by a 300-128 vote. The President signed the bill into law. 

The deal funds the Housing Opportunities for Persons With AIDS (HOPWA) program at $393 million, an increase of $18 million over FY2018. The Presidents Emergency Plan for AIDS Relief (PEPFAR) also received a $50 million increase to be funded at $5.7 billion. 

Congressional Hearings

The House Ways and Means Committee held a hearing on prescription drug prices. 

Committee Chairman Richard Neal (D-MA-1) and Ranking Member Kevin Brady (R-TX-8) issued a joint statement at the start of the hearing saying calling for a bipartisan commitment to lower drug prices. 

The House Energy and Commerce Health Subcommittee held a hearing “Strengthening our Health Care System: Legislation to Reverse ACA Sabotage and Ensure Pre-Existing Conditions Protections.” Topics discussed included decreased ACA outreach, advertisement, and enrollment activities and the promotion of short-term limited duration and association health plans.

Resources

Public Health Reports: Implementing a Data to Care Strategy to Improve Health Outcomes for People With HIV: A Report From the Care and Prevention in the United States Demonstration Project

MMWR: Increased Methamphetamine, Injection Drug, and Heroin Use Among Women and Heterosexual Men with Primary and Secondary Syphilis — United States, 2013–2017

MMWR: Recommendations of the Advisory Committee on Immunization Practices (ACIP) for Use of Hepatitis A Vaccine for Persons Experiencing Homelessness

The updated Common Patient Assistance Program Application (CPAPA) was released along with an instructive companion document

Job and Project Opportunities

Assistant Director, Bureau of HIV/STD Field Services– New York

The New York AIDS Institute is hiring for an Assistant Director in their Bureau of HIV/STD Field Services. This posting closes on February 19.

Deputy Medical Director– Tennessee

The Tennessee Department of Health is hiring for a Ryan White Part B Director.

HIV/STD Prevention Program Manager– Maine 

The Maine Department of Health and Human Services is hiring for the HIV/STD Prevention Program Manager position within their Center for Disease Control and Prevention. This posting closes on February 15. 

Director, Ryan White Part B Program– Tennessee 

The Tennessee Department of Health is hiring for a Ryan White Part B Director.

Cook County Health System Executive Director of HIV Services– Cook County

The Cook County Health System (CCH) is hiring an Executive Director of HIV Services.

Upcoming Meetings

2019 National HIV Prevention Conference

The 2019 National HIV Prevention Conference (NHPC) will be held March 18-21, 2019 in Atlanta, Georgia. Registration is open.

2019 HIV Diagnostics Conference

The 2019 HIV Diagnostics Conference will be held in Atlanta on March 25-28, 2019. The conference will address advances in diagnostic testing, and strategies for using test technologies in public health programs and clinical practice. NASTAD encourages health department HIV, HCV, and STI testing program managers and other staff consider submitting a late breaker abstract.  Particularly encouraged are abstracts that address strategies to integrate HIV and HCV testing and linkage, and best practices to streamline time to test result receipt and linkage to care in clinical and non-clinical settings.

HIV, HCV and Syphilis Diagnostic Testing Workshop

The Association for Public Health Laboratories (APHL) will be hosting an HIV, HCV and Syphilis Diagnostic Testing workshopin conjunction with the 2019 HIV Diagnostics Conference. The workshop will be held Monday March 25, 2019 from 8am-3pm. The conference will kick off at 4pm. The educational workshop will feature short presentations highlighting the current technology and algorithms for each pathogen followed by facilitated and small-group discussions centered around case studies and real-world examples. The objectives of the workshop are two-fold: (1) to educate attendees about the technologies and challenges in diagnostic testing and (2) to encourage peer-to-peer discussions and fostering collaborations beyond the workshop. Program staff are welcome to attend.  If you will be attending the conference and would be interested in participating in the workshop, please contact APHL’s Dr. Anne Gaynor.

AIDSWatch 2019

AIDSWatch will take place April 1-2, 2019 in Washington, DC. AIDSWatch is the nation's largest annual constituent-based national HIV advocacy event, bringing together hundreds of people living with HIV and their allies to meet with Members of Congress and to educate them about the important issues at stake for people living with and affected by HIV in the United States. Please forward this information to your networks and encourage their participation in AIDSWatch 2019. 

News Bulletin

Trump Pledged to End H.I.V. But His Policies Veer the Other Way.

“In his State of the Union address, President Trump announced a bold plan to end the scourge of H.I.V. by 2030, a promise that seemed to fly in the face of two years of policies and proposals that go in the opposite direction and could undermine progress against the virus that causes AIDS.”