Policy Updates: Hill Happenings and Administration Activities

By Julio Contreras October 25, 2021

Hill Happenings

FY2022 Appropriations

On Monday, October 18, the Senate Appropriations Committee released the remaining nine Fiscal Year (FY) 2022 Appropriations Bills, including the FY2022 Labor, Health and Human Services, Educations and Related Agencies Appropriations (LHHS) funding bill. The spending bills were not voted on by the full committee, and are instead the Chairman’s Marks, issued by Appropriations Committee Chair Patrick Leahy (D-VT). Senate Democrats proposed the following funding levels:

  • Health Resources and Services Administration (HRSA)
    • $131 million increase for the RWHAP Program
    • $85 million increase for the Ending the HIV Epidemic Plan HRSA component
  • Centers for Disease Control and Prevention (CDC)
    • $17 million increase for the Opioids and Infectious Diseases Program
    • $5 million increase for STD Prevention
    • $100 million increase for the Ending the HIV Epidemic Plan CDC component
  • Housing and Urban Development (HUD)
    • $20 million increase for the Housing Opportunities for Persons With AIDS (HOPWA) Program

The LHHS spending bill also removes legislative language which prohibited federal funding being used to support sterile injection equipment.

Democrats must now advance the spending package by December 3, when the current continuing resolution (H.R. 5305) expires and the U.S. is projected to default on its debt. NASTAD will continue to monitor the FY2022 appropriations process to advocate for the highest funding levels on behalf of HIV and hepatitis programs.

CBO Releases Cost Estimates for Health Provisions in Democrats’ Reconciliation Package

On October 19, the Congressional Budget Office (CBO) released a cost benefit analysis for certain health care provisions contained in Democrats’ broad-reaching social spending legislation, the Build Back Better Act, which is being advanced through the budget reconciliation process. CBO assessed the cost of health provisions, such as temporarily expanding health insurance premium tax credits to close the Medicaid coverage gap, and found that the provisions would decrease the number of people without coverage by 3.9 million from 2022-2031. However, it is uncertain whether the provisions will remain in the final legislative package due to disagreements on spending priorities within the Democratic party.

NASTAD Calls on Congress to Oppose Permanently Scheduling FRS as Schedule 1 Drugs

On October 22, NASTAD joined a coalition of nearly 100 organizations and issued a joint letter to Congressional leadership opposing the Biden Administration’s proposal to permanently classify fentanyl-related substances (FRS) as Schedule I drugs. The coalition calls on Congress to let the classwide scheduling policy expire and focus on passing public-health solutions, like expanding access to harm reduction and treatment. A permanent classification would worsen racial inequities in the criminal justice system while failing to reduce overdose deaths or promote public safety.

Administrative Activities

HRSA HAB Updates RWHAP Client Eligibility Determination and Recertification Requirements

On October 19, the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB) announced the release of HAB Policy Clarification Notice (PCN) 21-02, Determining Client Eligibility and Payor of Last Resort in the Ryan White HIV/AIDS Program (RWHAP), which is immediately in effect. The updated guidance eliminates the six-month client eligibility recertification requirement for RWHAP programs, instead allowing RWHAP recipients and subrecipients to conduct timely eligibility confirmation in accordance with their policies and procedures. The PCN also states affirmatively that immigration status is irrelevant for the purposes of eligibility for RWHAP services. The PCN was issued in response to RWHAP recipient requests to reduce administrative and client burden while enhancing continuity of care to ensure that clients have access to medical and support services in order to achieve viral suppression.

CDC DHP Expands Guidance on Collection, Use, and Release of HIV Sequence Data

On October 21, the Centers for Disease Control and Prevention (CDC) Division of HIV Prevention (DHP) released expanded guidance on the collection, use, and release of HIV sequence data. State and local HIV surveillance programs funded by CDC should collect HIV sequence data only in the form of Sanger sequences or, when next generation sequencing (NGS) has been conducted, consensus sequences. The guidance clarifies that analyses of HIV sequence data reported to HIV surveillance programs, whether conducted by health departments or academic partners, should not be interpreted as determining transmission direction or proving direct transmission. Additionally, HIV sequence data reported to CDC-funded HIV surveillance programs should not be released to GenBank or other public repositories by health departments or academic partners without individual consent.

HHS Assistant Secretary for Health Sworn in as Four-Star Admiral in Historic Ceremony

On October 19, the Department of Health and Human Services (HHS) announced that Dr. Rachel Levine, HHS Assistant Secretary for Health and head of the U.S. Public Health Service (USPHS) Commissioned Corps, was ceremonially sworn in as a four-star admiral. Admiral Levine now serves as the highest ranking official in the USPHS Commissioned Corps and its first-ever female four-star admiral, as well as the first openly transgender four-star officer across any of the eight uniformed services of the United States.

Resources

CDC MMWR: HIV Infection and HIV-Associated Behaviors Among Persons Who Inject Drugs

“In 2015, the estimated HIV infection prevalence among persons who inject drugs (PWID) in 20 U.S. metropolitan statistical areas was 7%... In 2018, estimated HIV prevalence among PWID remained unchanged, and although overall syringe service program use did not significantly change, a substantial decrease in their use occurred among Black PWID.”

AIDS United NOFO: Syringe Access Fund

The Syringe Access Fund is a collaborative grant-making initiative that seeks to reduce the health, psychosocial and socioeconomic disparities experienced by people who use drugs. The Syringe Access Fund invests in evidence-based and community-driven approaches to prevent the transmission of both HIV and viral hepatitis, reduce injection-related injuries, increase overdose prevention and reversal efforts, and connect people who use drugs to comprehensive prevention, treatment and support services. The application process for begins with the submission of a Letter of Inquiry, due on Nov. 5, 2021, at 5 p.m. EDT. Please find more information, including details on eligibility, process and key dates, in the Request for Letters of Inquiry linked here. 

HRSA NOFO: Ending the HIV Epidemic - Primary Care HIV Prevention

Application Deadline: Tuesday, December 14

TA Webinar: Thursday, October 28 at 2 pm ET

HRSA released the fiscal year (FY) 2022 Ending the HIV Epidemic - Primary Care HIV Prevention (PCHP) Notice of Funding Opportunity (HRSA-22-104). HRSA will invest approximately $50 million in health centers located in the targeted geographic locations where a majority of new HIV infections occur, as identified by the Ending the HIV Epidemic in the U.S. initiative. FY 2022 PCHP will support expanding HIV prevention services that decrease the risk of HIV transmission in underserved communities, focusing on supporting access to and use of pre-exposure prophylaxis (PrEP). Health centers with service delivery sites in the targeted geographic locations that did not receive FY 2020 PCHP or FY 2021 PCHP funding will be eligible to apply. Technical assistance (TA) resources are available on the PCHP TA webpage.

Job Postings

New Hampshire, Department of Health and Human Services, Division of Public Health Services

  • Public Health Program Manager/Ryan White Care Program Manager
    • #43569 (search Job ID 22642)
    • Supervises and monitors the NH Ryan White Human Immunodeficiency Virus (HIV) CARE Program (NH CARE Program) and the NH Tuberculosis Financial Assistance (TBFA) Programs with responsibility for coordinating all aspects of program services and developing goals, objectives and performance improvement measures for a statewide continuum of TB and HIV care.
  • Program Specialist IV/Ryan White Care Program Quality Management Specialist
    • #9T2810 (search Job ID 22333)
    • 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.  

Public Health Policy Analyst, HRSA HAB – Rockville, Maryland

Announcement Link: HRSA-HAB-22-MP-11253755 and HRSA-HAB-22-DE-11253780

This position is a mission critical occupation and is responsible for analyzing public health programs, policies and procedures to ensure that Health Resources and Services Administration meets its mission, goals and objectives. As a Public Health Policy Analyst, you serve as an advisor and resource to HIV/AIDS Bureau (HAB) in developing and formulating policies and regulations that are sensitive to the special needs and concerns of safety net providers and beneficiaries. Applications close October 29, 2021.

HIV Prevention Epidemiologist – Madison, Wisconsin

In collaboration with the UW Population Health Institute, this position will be based in the Communicable Disease Harm Reduction Section, Bureau of Communicable Diseases (BCD), Division of Public Health (DPH), at the Wisconsin Department of Health Services (DHS). Under the general supervision of the HIV Surveillance Unit Supervisor, the HIV Prevention Epidemiologist will serve as a subject matter expert in providing the HIV Program with technical assistance, data management, epidemiology, and evaluation expertise. The HIV Prevention Epidemiologist is responsible for data analysis and interpretation of HIV prevention data used for program planning and development within the Section. This includes responsibility for data management and datasets that are used for public health research, program evaluation, and quality assurance by the US Centers for Disease Control and Prevention (CDC), DPH, medical providers, local health departments, community partners, and the Wisconsin State Laboratory of Hygiene (WSLH).

Wyoming Department of Health, Public Health Division, Communicable Disease Unit

  • 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.  
  • 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.

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.

Hepatitis Surveillance Data Analyst – New Orleans, Louisiana

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.

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.   

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

Covid-19 has killed more people in the US than HIV/Aids did in 40 years

“Covid-19 has now killed about 730,000 people in the US, making it the deadliest pandemic in the nation's history, with more lives claimed than by HIV/Aids.

The tally comes as the US marks four decades since HIV — the virus that can cause Aids — was first detected in the country, and some are now looking at the two vastly different diseases and seeing parallels.”

Health department works to combat naloxone stigma

“Hancock Public Health has worked hard this year to get naloxone — the medication that reverses an opiate overdose — into the hands of community members.

So far in 2021, the health department has distributed 1,542 naloxone kits to the general public, up from 824 in 2020. This is in addition to 125 kits this year and 142 last year distributed to first responders.”

Public Health Data Exchange, Health Equity Require Team Effort

“All sectors, including government, philanthropy, and community-based organizations must work together to achieve health equity through a robust public health data exchange infrastructure, according to the Robert Wood Johnson Foundation’s National Commission to Transform Public Health Data Systems. COVID-19 has highlighted major deficiencies in the national public health data exchange infrastructure, which has underscored health equity concerns. The 16-member commission has released a set of recommendations that aim to boost interoperability in support of health equity.”