Policy Updates: Hill Happenings and Administration Activities

By Mike Weir May 6, 2019

Hill Happenings

Labor HHS Subcommittee Appropriations Bill

The House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (LHHS) approved their draft FY2020 bill by voice vote. The full House Appropriations Committee will markup the bill on May 8. While final proposed funding figures have not been released, the draft bill includes new funding for the Administration’s Ending the Epidemic (ETE) initiative, which NASTAD supports. NASTAD will continue to provide update on the FY2020 Appropriations process. 

State Opioid Response Grant Authorization Act

A bipartisan group of House members introduced the State Opioid Response Grant Authorization Act that would direct $5 billion over five years to help jurisdictions combat the opioid epidemic. It would reauthorize a pair of existing grant programs for jurisdictions and tribes to increase treatment and prevention services.

Administration Activities

HHS Final Conscience Rule

The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced the issuance of its final conscience rule. In January 2018, following the launch of the Conscience and Religious Freedom Division, HHS announced the proposed conscience rule. OCR received over 242,000 public comments.

NASTAD, in partnership with AIDS United, NMAC, the National Coalition of STD Directors, and The AIDS Institute, previously released this statement on the creation of OCRs Conscience and Religious Freedom Division.

STD Federal Action Plan

The Health and Human Services (HHS) Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) is hosting listening sessions as it begins to develop a Sexually Transmitted Diseases (STD) Federal Action Plan. 

  • Thursday, May 9, 2019: Virtual Listening Session from 3:00 - 5:00 PM (EDT). Click here to register.

OHAIDP published a Request for Information (RFI) in the Federal Register to solicit written comments for the STD Federal Action Plan. Comments are due by 5:00 PM (EDT) on June 3, 2019.

2020 Notice of Benefit and Payment Parameters rule 

In April, the Centers for Medicare and Medicaid Services (CMS) released its final 2020 Notice of Benefit and Payment Parameters rule and an accompanying fact sheet. The final rule – which provides standards and requirements primarily for the individual and small group market – is similar to the proposed rule released earlier this year. However, CMS opted not to adopt many far-reaching changes to prescription drug standards, including its proposal to allow insurers to make certain mid-year formulary changes. Although CMS did finalize its proposal to allow insurers and PBMs to refuse to apply manufacturer coupons to enrollees’ plan deductibles and annual out-of-pocket maximums—referred to as accumulator adjustment programs or copay accumulator programs—this policy is limited to cases where the coupon is used for a brand-name drug with no generic equivalent. This means that manufacturer coupons brand-name drugs with no generic equivalent must count towards an enrollee’s deductible and annual out-of-pocket maximum. Given the lack of generics in the HIV treatment, PrEP, and hepatitis C space, this is an important protection that will reduce the impact of co-pay accumulators on these populations. For a deeper analysis of the 2020 Notice, see this two-part blog post from Health Affairs.

Resource

Evidence Informed Approaches to Improving Health Outcomes for PLWH

NASTAD is leading a collaborative partnership with Northwestern University’s Center for Prevention Implementation Methodology and Howard Brown Health Center  in response to HRSA-18-048, Evidence Informed Approaches to Improving Health Outcomes for People Living with HIV as part of HRSA’s Special Projects of National Significance (SPNS). The project purpose is to identify, catalog, disseminate, and support the replication of evidence-informed approaches and interventions to engage people living with HIV (PLWH) who are not receiving, or who are at risk of not continuing to receive HIV healthcare. We are requesting assistance in completing or disseminating our Request for Information (RFI) which is designed to cast a wide net to identify interventions, models, or best practices being implemented in your jurisdictions. We are interested in reaching clinical or non-clinical providers who are knowledgeable about the implementation and/or evaluation process of interventions that involve: the use of acuity scales to identify people at risk of falling out of care, the use of provider/surveillance data to identify people out of care, innovative clinical/structural system level approaches to re-engage or retain people in care. The RFI will remain open until Friday, May 10. Should you have any questions, please contact Rosy Galvan or Natalie Cramer.

Episode 1 of Defining Equity Podcast Available

The first episode of NASTAD’s Defining Equity podcast is now available for download. Defining Equity is a monthly podcast series that tackles the numerous health equity issues facing underserved communities highlighting public health professionals using strategies to empower and center communities living at the margins. Episode 1 covers the need to address the health inequities and invisibility of queer and bisexual women in public health.

UpdatedGuidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection

NASTAD signed onto a letter calling on the international community to address the ongoing global health and human rights crisis among people who use drugs.

Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study

Upcoming Meetings

2019 National Sexual Health Conference 

The 2019 National Sexual Health Conference will take place July 10-12 in Chicago, IL. The conference aims to create opportunities to share information, efforts, and best practices around sexual health across the lifespan by bridging the varied disciplines of education, advocacy, and clinical care, among others. Registration is currently open.

Job Opportunities 

Director–Maryland

The Maryland Department of Health’s Infectious Disease Prevention and Health Services Bureau is hiring a director within the Prevention and Health Promotion Administration. This position would also serve as the state’s AIDS director. The position is open to both non-physicians and physicians.

Communicable Disease Control Investigator II–Chicago

The Chicago Department of Public Health is hiring a Communicable Disease Control Investigator IIwithin their Public Health Services Division of the HIV/STI Bureau. This posting is open until May 9. 

Epidemiologist II–Chicago

The Chicago Department of Public Health is hiring an Epidemiologist II within their Public Health Services Division of the HIV/STI Bureau. This posting is open until May 13. 

STD/HIV Prevention Data Analyst– Oregon

The Oregon Health Authority is hiring a STD/HIV Prevention Data Analyst within their Public Health Division of the HIV/STD/TB Section. This posting is open until May 12. 

Program Manager– San Francisco

Building Healthy Online Communities is hiring a new program manager that would be housed at the San Francisco AIDS Foundation for a 3-month assignment that may convert to a regular full-time position, dependent on funding. This posting is open until filled.

Surveillance Director– West Virginia 

The West Virginia Department of Health & Human Services is hiring a Surveillance Director for the Division of STD and HIV within the Office of Epidemiology and Prevention Services. This posting is open until July 7. 

Communicable Disease Prevention Program Manager– Wyoming

The Wyoming Department of Health is hiring a Communicable Disease Prevention Program Manager within their Communicable Disease Unit. This posting is open until filled. 

HIV Planner– Texas

The UT-Austin Health Innovation and Evaluation Team and the Texas Department of State Health Services is hiring for an HIV Planner within their HIV Care Services Group and the HIV/STD Prevention and Care Branch Planning team.

News Bulletin

U.N. Issues Urgent Warning on the Growing Peril of Drug-Resistant Infections

“A new report says the overuse of antimicrobial drugs in humans, animals and plants is fueling resistant pathogens that could kill 10 million people annually by 2050.”

PrEP vs. Privacy

“As long as this is the case, going on PrEP is out of the question not just for Salvador, but for thousands of Americans on their parents’ health insurance who are forced to choose between their personal privacy and control of their sexual health. Pioneering research published in the American Journal of Emergency Medicine last year found that while being on parental insurance doesn’t dissuade young adults from taking PrEP, associated concerns around confidentiality—like disclosing prescriptions to their parents—do. According to the study, respondents aged 18 and 26 on parental insurance were 70 percent less likely to take up PrEP if their parents could learn of their prescription.”

HIV treatment eliminates risk of passing on virus, landmark study says

“The risk of passing on the HIV virus is completely eliminated by effective drugs treatment, a landmark study has shown, in a significant boost to the prospects of ending the AIDS pandemic. A study of nearly 1,000 gay male couples with one partner with HIV who took antiretroviral therapy (ART) found no new cases of transmission to the HIV-negative partner during sex without a condom.”