Policy Updates: Hill Happenings and Administration Activities

By Mike Weir March 11, 2019

Hill Happenings

FY2020 Funding

The AIDS Budget and Appropriations Coalition (ABAC), which NASTAD co-chairs, sent a letter urging Congress to increase crucial funding for domestic HIV/AIDS and related programs in the Fiscal Year (FY) 2020 Appropriations Bills. NASTAD also signed onto a letter led by the Family Planning Coalition calling for robust funding for the Title X program.

Administration Activities

President’s FY2020 Budget

The President released his skinny FY2020 budget, which provides topline budget priorities for the Administration. The document, entitled “A Budget for a Better America: Promises Kept. Taxpayers First,” proposes severe cuts to safety-net programs. The Budget also proposes eliminating parity between defense and non-defense discretionary spending and increasing defense spending at the expense of non-defense spending. NASTAD will be conducting an analysis of the Budget request and will provide more details as they become available.

HRSA HIV/AIDS Bureau

An informational webinar for Health Resources and Services Administration (HRSA) recipients on “Ending the HIV Epidemic: A Plan for America” will be held on Wednesday, March 13, 2019, from 2:00-3:00 PM EDT. This event will provide HRSA recipients with details about the goals and objectives of the Ending the HIV Epidemic initiative and will discuss HRSA’s critical role in this initiative.

Title X

Planned Parenthood and the American Medical Association announced they would file a lawsuit against the Administration's recently posted rule for the Title X program.

Washington State's Attorney General and the National Family Planning and Reproductive Health Association (NFPRHA) also filed a lawsuit against the Administration's posted rule.

HHS Funding Reallocation

Health and Human Services (HHS) Secretary Azar recently notified Congress that the Administration will transfer funds to pay for child separation activities using, at least in part, $1.173 million from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). This reallocation is from FY2019 funding using the Secretary’s transfer authority. This transfer authority is used almost annually to redirect funds where needed and has been used to fund the AIDS Drug Assistance Program (ADAP) in the past.  The transfer included:

  • $438,000 from CDC Global HIV/AIDS Program
  • $1,173,000 from CDC NCHHSTP
    • $133,000 from Division of Viral Hepatitis
    • $537,000 from Division of STD Prevention
    • $486,000 from Division of Tuberculosis Elimination
    • $17,000 from Infectious Diseases and the Opioid Epidemic

NASTAD is working to obtain detailed information from the Administration about the proposed reallocation from HHS programs and the impact on vital public health programs.

SAMHSA Funding Opportunity

The Substance Abuse and Mental Health Services Administration (SAMHSA) issued a funding opportunity announcement (FOA) through its Center for Substance Abuse Treatment (CSAT) to support substance use treatment service delivery to racial/ethnic minority individuals at risk for or living with HIV. The grant opportunity is supported by Minority AIDS Initiative resources that are appropriated to SAMHSA. Eligible applicants are domestic public and private nonprofit entities. SAMHSA anticipates a total of $12 million to fund up to 24 awards. Project can last up to five years. Applications are due Monday, April 22, 2019.

FY2018 Grant Funding Profiles

The CDC and HRSA have updated the grant funding profiles and fact sheets with FY 2018 data and profiles.

Notice of Benefit and Payment Parameters for 2020

The HIV Health Care Access Working Group (HHCAWG), which NASTAD co-chairs, sent a letter to the Centers for Medicare and Medicaid Services (CMS) on the proposed Notice of Benefit and Payment Parameters for 2020.

National Women and Girls HIV/AIDS Awareness Day

March 10 marked National Women and Girls HIV/AIDS Awareness Day (NWGHAAD), an observance sponsored by the Office on Women’s Health in HHS. The CDC provided free tools in the NWGHAAD Resource Center to help in supporting awareness activities and testing events. 

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

The HHS Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) published a Request for Information (RFI) in the Federal Register to solicit written comments for updating the National HIV/AIDS Strategy (NHAS) and National Viral Hepatitis Action Plan (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.

NASTAD will provide comments.

Resources

National Summit on HIV Stigma

NASTAD is convening a National Summit on HIV Stigma as a pre-meeting to the 2019 National HIV Prevention Conference (NHPC). The summit will take place Monday, March 18, 2019 in Atlanta, GA. The summit will be a unique opportunity for HIV stakeholders to collectively explore innovative ways to address stigma in the context of the shifting HIV prevention landscape. Participants will discuss strategies to address the following six aspects of stigma: implicit bias; resources and messaging; internalized stigma; evaluating stigma reduction; intersectionality and race; and HIV criminalization.

Registration for the National Summit on HIV Stigma is available here. The summit is free to attend, and is open to health department staff, community-led organizations (CBOs), federal partners, CBA providers and HIV stakeholders.

RWHAP Part B and ADAP Coverage of Treatment & Services in SSPs

NASTAD released Ryan White HIV/AIDS Program (RWHAP) Part B and ADAP Coverage of Treatment & Services in Syringe Service Programs (SSPs),a resource identifying strategies for RWHAP Part B Programs and AIDS Drug Assistance Programs (ADAPs) to support the delivery of and access to core medical and support services within and/or in combination with local SSPs. Produced as part of NASTAD’s cooperative agreement with the Health Resources and Services Administration (HRSA), this resource also provides a summary of HRSA HIV/AIDS Bureau (HRSA/HAB) guidance, as well as other federal and local policies related to the provision of services in SSPs.

Substance Abuse Prevention and Treatment (SAPT) Fact Sheet

The National Association of State Alcohol and Drug Abuse Directors released an updated fact sheet on the Substance Abuse Prevention and Treatment (SAPT) Block Grant’s Prevention Set-Aside. The SAPT Block Grant requires that at least 20% must be spent on primary prevention services. The fact sheet reviews the scope of substance use disorders in the U.S. among adults and youth, and highlights the positive impact of prevention efforts for youth, especially with regard to alcohol, prescription opioid, and ecstasy use.

Title X PrEP Resource

The HHS Office of Population Affairs (OPA), with support from the Secretary’s Minority AIDS Initiative Fund, developed the Decision-Making Guide for the Provision of PrEP Services in Title X-Funded Sites to help Title X family planning service sites make evidence-informed decisions about their role in assuring access to PrEP for HIV prevention services in their communities. 

CROI Updates

The annual Conference on Retroviruses and Opportunistic Infections (CROI) brings together top basic, translational, and clinical researchers from around the world to share the latest studies, important developments, and best research methods in the ongoing battle against HIV/AIDS and related infectious diseases. Below are highlights from this year’s conference which was held on March 4-7.

"Test and Treat" Approach Can Reduce New HIV Infections

“Sponsored by NIAID and funded primarily by the President’s Emergency Plan for AIDS Relief (PEPFAR), PopART was conducted in 21 urban and peri-urban communities in Zambia and South Africa. It found that that conducting population-wide, home-based HIV testing and offering treatment to those diagnosed with HIV—a strategy often referred to as “universal test and treat”—resulted in high rates (70%) of viral suppression and a 30% reduction in new HIV infections. The researchers concluded that such a strategy could help control the epidemic in certain settings.”

Upcoming Meetings

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 workshop in 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

Monthly shots control HIV as well as pills in 2 big studies

“Monthly shots of HIV drugs worked as well as daily pills to control the virus that causes AIDS in two large international tests, researchers reported Thursday.

If approved by regulators in the United States and Europe, the shots would be a new option for people with HIV and could help some stay on treatment. Instead of having to remember to take pills, patients instead could get injections from a doctor or nurse each month.”

PrEP use jumps to 35 percent among gay and bi men at risk of HIV

“Thirty-five percent of gay and bisexual men at high risk of HIV infection were using PrEP, or pre-exposure prophylaxis, the daily pill that prevents HIV infection, in 2017, according to data released Thursday by the Centers for Disease Control and Prevention. In 2014, just 6 percent of these men used PrEP. However, despite the nearly 500 percent jump in PrEP use among men who have sex with men, the CDC notes “PrEP use remains too low, especially among gay and bisexual men of color.”

Bit by Bit, Scientists Gain Ground on AIDS

The unnamed “London patient” — the second person apparently cured of H.I.V. — earned all the headlines. But other research released this week at the Conference on Retroviruses and Opportunistic Infections showed that scientists are making slow but steady progress on the tactics and medicines needed to fight the epidemic, especially in Africa.”