Policy Updates: Hill Happenings and Administration Activities

By Mike Weir October 29, 2018

Hill Happenings

Opioid Emergency Declaration

Senate Health, Education, Labor, and Pensions (HELP) Committee ranking member Patty Murray (D-WA) and Senator Elizabeth Warren (D-MA) released a Government Accountability Office (GAO) report on the President’s opioid emergency declarations.

Administration Activities

Opioids

President Trump signed into law H.R. 6, the SUPPORT for Patients and Communities Act. The package authorizes $40 million a year over five years for the Centers for Disease Control and Prevention (CDC) to focus resources to assist states and other partners in expanding surveillance of cases of hepatitis, HIV, and endocarditis stemming from drug use and increase education about infectious diseases and drug use. Additionally, the bill “will expand access to medication-assisted treatment (MAT) by allowing more providers to prescribe buprenorphine and letting states lift Medicaid restrictions on payments for inpatient substance abuse treatment. The bill also encourages doctors to do more to detect patients at risk of prescription opioid misuse and bolsters efforts to prevent illicit drug shipments.”

The White House Office of National Drug Control Policy (ONDCP), in partnership with the Ad Council and Truth Initiative, released the second phase of “The Truth About Opioids” drug prevention ads. The campaign’s website includes “information about opioids, the epidemic, and a treatment locator resource powered by the Substance Abuse and Mental Health Services Administration [SAMHSA].” NASTAD is working to ensure that information about infectious diseases is added to the campaign’s website.

The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) launched a public education campaign on civil rights protections relating to opioids. “The campaign aims to improve access to evidence-based opioid use disorder treatment and recovery services, such as Medication Assisted Treatment, by ensuring that covered entities are aware of their obligations under federal nondiscrimination laws, including laws prohibiting discrimination on the basis of disability or limited English proficiency. In addition, the campaign seeks to educate the public about disability rights protections that may apply to persons in recovery from an opioid addiction.”

The Department of Justice held an opioid summit where Attorney General Jeff Sessions announced $70 million in new grants aimed at curbing drug trafficking and helping children affected by the opioid crisis. Specifically, $35 million in funding will go to “support law enforcement agencies in combating the illegal manufacturing and distribution of methamphetamine, heroin, and prescription opioids, and another $35 million to establish new programs to provide services to children victims of the opioid crisis.” 

Medicare Part B Drug Pricing 

The Trump administration announced a plan to alter how Medicare’s Part B program pays for certain drugs. It includes benchmarking U.S. drug prices to those in similarly developed nations and testing private sector negotiations between vendors and drugmakers. HHS is also considering changes to Medicare's payment system to encourage doctors toward less expensive medications. 

International Family Planning

NASTAD signed onto a letter urging the President to request $1.66 billion for international family planning and reproductive health programs, including $111 million for the United Nations Population Fund, in his FY2020 budget.

2019 Open Enrollment

The Centers for Medicare and Medicaid Services (CMS) announced Healthcare.gov now has 2019 plan data available for window shopping which allows consumers to look at plans without logging in, creating an account, or filling out the official application. Open enrollment starts for most states Thursday, November 1.

Redefining the Term “Sex” 

According to a recent New York Times article, the Trump Administration is preparing to redefine the term “sex” for the purposes of several key government agencies. The CDC director, Robert Redfield, was asked whether any such effort might hamper efforts to treat HIV, especially among transgender women, he replied: “We need to understand that stigmatizing illness, stigmatizing individuals is not in the interest of public health.”

Health Reimbursement Account Rule

The Trump Administration released a proposed rule that would allow employers to pay for health reimbursement arrangements that workers could use to purchase Affordable Care Act marketplace plans. 

Hepatitis C Medicaid Affinity Group

The Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) is inviting states to join the second year of the Hepatitis C Medicaid Affinity Group. Participating states will work collaboratively with colleagues across the country to learn about and share innovative strategies to improve outcomes for hepatitis C virus (HCV) among Medicaid enrollees.

The Expression of Interest form is due on Friday, November 19, 2018 by 5:00 PM EST. More information and to access the Expression of Interest Form and a fact sheet, please visit https://go.usa.gov/xPRX4. Additionally, OHAIDP will be hosting a webinar on October 23, 2018 from 12:00 PM – 1:00 PM EST.

Job Opportunities

Office Director for the Office of Infectious Disease– Washington

The Washington State Department of Health is hiring for an Office Director. The Office Director leads the Office of Infectious Disease (OID), which consists of three programs:  the OID Prevention Section, HIV Client Services, and the OID Assessment Unit.  

Program Specialist V– Texas

The Texas Department of State Health Services is hiring for a Program Specialist V within their HIV/STD Prevention and Care Branch.

Upcoming Conferences

2019 National HIV Prevention Conference

The 2019 National HIV Prevention Conference will be held March 18-21, 2019 in Atlanta, Georgia. Check out the updated website for more information about tracks and to view the tentative conference schedule. 

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. The conference program this year expands beyond HIV testing, and incorporates STI and HCV testing technologies and strategies, with an emphasis on integrating testing programmatically. As with past conferences, there will be a mix of oral presentations, panel discussions, and poster sessions. We strongly encourage health department HIV, HCV, and STI testing program managers and other staff consider submitting an abstract, attending the conference.  Abstract submission for the conference is open.  

Resources

The Kaiser Family Foundation released a report, Medicaid Enrollment & Spending Growth: FY 2018 & 2019, that analyzes Medicaid enrollment and spending trends for FY2018 and FY2019 based on interviews and data provided by state Medicaid directors.

CDC’s Act Against AIDS initiative has launched Prescribe HIV Prevention, a new initiative for healthcare providers that focuses on HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). The target audience includes primary care providers, infectious disease and HIV specialists, nurses, and public health practitioners.

News Bulletin

U.S. 'turning the tide' on the opioid crisis, health secretary says

“The U.S. is "beginning to turn the tide" on the opioid epidemic, HHS Secretary Alex Azar said Tuesday, pointing to new federal data showing a slight dip in overdose deaths last year. Preliminary CDC data released last week shows drug overdose deaths, which spiked in 2017, dropped 2.8 percent toward the end of last year and the beginning of 2018. Azar credited federal, state and local efforts, one day before President Donald Trump will sign overwhelmingly bipartisan legislation to address the opioid crisis.”

Primary Care Doctors ‘Not Doing Enough’ To Curb STDs

“As rates of sexually transmitted infections steadily rise nationwide, public health officials and experts say primary care doctors need to step up screening and treatment.

“We know that doctors are not doing enough screening for STDs,” said David Harvey, executive director at the National Coalition of STD Directors. The failure to screen routinely “is leading to an explosion in STD rates,” he said, adding that cutbacks in funding and a lack of patient awareness about the risks make it worse.”

Older HIV patients struggle with loneliness and depression — and lack of services

“Older people with HIV are frequently lonely and depressed, many of them face serious housing and financial hardships, and they have high rates of physical ailments — such as chronic pain, heart disease, diabetes and fatigue — that can diminish their quality of life.”

HIV cases continue to surge around Northern Kentucky

“HIV cases are continuing to increase in Northern Kentucky and Hamilton County, Ohio, even after health leaders sounded an alert at the beginning of 2018 about surging HIV, especially among injection drug users. As of Oct. 3, Northern Kentucky had tallied 80 new HIV cases since 2017, with more than half, or 44, among injection drug users.”