Policy Updates: Hill Happenings and Administration Activities

By Garrett Eberhardt October 7, 2019

Ending the Epidemic

HHS Announces $13.5 Million for State and Local Planning Efforts for Ending the HIV Epidemic Initiative

A $13.5 million award from the Minority HIV/AIDS Fund has been announced to begin state and local planning efforts for the Ending the HIV Epidemic (ETE) initiative. The Office of the Assistant Secretary for Health, through the Centers for Disease Control and Prevention, 32 state and local health departments will receive $12 million of the funds to develop comprehensive ending the HIV Epidemic plans. These health departments represent the 57 geographic areas that have been prioritized for the first year of the initiative. NASTAD has been awarded the remaining $1.5 million for use in enhancing health departments’ capacity to end the HIV epidemic This effort will aid community input in the ETE initiative, as well strengthen the national framework surrounding the program.

Hill Happenings

House Drug Pricing Bill

Speaker of the House of Representatives Nancy Pelosi (D-CA)’s prescription drug legislation is expected to go through the committee process when Congress returns from a two-week recess. The bill is very comprehensive but does contain a provision that concerns NASTAD. The provision would make drugs selected by the HHS Secretary for maximum fair price negotiations ineligible for the 340B Drug Pricing Program discount. NASTAD’s Director of Medication Access and Pricing, Tim Horn, was interviewed by STAT, and stated that “while there is much to appreciate about H.R. 3, the 340B provision is both unnecessary and deeply problematic, and if the provision is passed, it could have “seismic implications” for the Ryan White Program. NASTAD is advocating with Congress to change this provision and it has been reported that it will be rewritten.

Administration Activities

Federal Judge Rules in Favor of Philadelphia Safe Injection Site

A federal judge ruled Wednesday that a nonprofit group’s bid to open a site in Philadelphia where people can inject drugs under medical supervision does not violate federal law. This is an unprecedented decision that could affect the way cities across the country address the opioid crisis. The ruling could affect numerous cities, such as Denver, Seattle, San Francisco, and New York that have considered opening such facilities but have been hesitant due to federal law and the Justice Department’s vow to halt any project like them.  NASTAD has publicly supported these evidence-based, innovative, lifesaving efforts and has urged our members to consider supporting their adoption and implementation where possible. Read our Call to Action and Recommendations for Action here.

CDC Analysis:  Opioid Epidemic Behind Increase in Hepatitis C Among Pregnant Women

The Centers for Disease Control and Prevention (CDC) released an analysis finding that the quintupled rate of hepatitis C (HCV) among pregnant women between 2000 and 2015, was largely driven by the opioid epidemic. HCV infections among women at delivery, both with and without a diagnosed opioid addiction, increased from 0.8 per 1,000 live births to 4.1 during that time frame. An increase in injection drug use was largely responsible for the increase, as the study found that 68 percent of women with HCV have an opioid use disorder.

FDA Approves Descovy for PrEP

Last week, the Food and Drug Administration approved the drug Descovy for HIV-1 pre-exposure prophylaxis (PrEP). The drug was approved in at-risk adults and adolescents weighing at least 77 pounds but excludes those who have receptive vaginal sex. This exception for the population was made due to a lack of evaluated effectiveness of the drug. Gilead Sciences has also made a post marketing commitment to conduct a randomized trial that will include a Truvada arm and evaluate the safety and efficacy of Descovy in cisgender women and adolescent girls weighing at least 77 pounds who are at risk of sexually acquired HIV-1 infection.

CMS to Allow States to Offer Wellness Programs on ACA Exchanges

One week ago, the Centers for Medicare and Medicaid Services (CMS) announced that it will allow ten states to participate in health-contingent wellness demonstrations for their individual markets that would lower premiums by up to 30% for people who meet certain health requirements. Policy experts have expressed concern that the demonstrations will penalize people with health issues or preexisting conditions who cannot meet the set wellness standards, even though CMS says that states must ensure they do not. States can immediately begin applying for the program, and stakeholders won’t have any opportunity to comment on the guidance.

HHS Seeking 2020 Hepatitis C Medicaid Affinity Group Applicants

The Department of Health and Human Services’ Office of Infectious Disease and HIV/AIDS Policy (OIDP) is inviting states to join the 2020 Hepatitis C Medicaid Affinity Group where participating states will work collaboratively across the country to identify, develop, and share innovative strategies to improve hepatitis C cure. Interested parties should visit HHS.gov to apply and submit an Expression of Interest form. The deadline for applications is November 1, 2019 at 5:00 PM ET.

Resources

NASTAD has released Talking Points: The Resource Guide for Facilitating Stigma Conversations, a new tool detailing how health departments can engage in conversations with stakeholders on how best to reduce stigma in the HIV response.

NASTAD’s Hepatitis Testing Partnership is hosting a webinar Thursday, October 17, from 2:00-3:00 PM ET on Expanding Hepatitis Testing and Linkage to Care in Emergency Departments. The webinar will explore different models for hepatitis testing and linkage to care in emergency departments to highlight different approaches to successfully reach individuals living with HCV and link them to care.

NASTAD is hosting a webinar on Insurance Navigation for PrEP, Friday, October 25, at 11:15 PM (EDT) and a webinar on Using PrEPcost.org for 2020 Open Enrollment, Monday, October 28, at 3:00 PM (EDT).

CDC’s Morbidity and Mortality Weekly Report and Medscape are introducing a new continuing education (CE) activity. The activity is free, and its goal is to describe estimated HIV transmission rates along the continuum of care in the United States in 2016, according to an HIV transmission model. It is intended for public health officials and clinicians who treat and manage patients with or at risk for HIV infection including infectious disease physicians, hematologists/oncologists, internists, and other physicians; nurses; and pharmacists.

The Food and Drug Administration has released a two-part series featuring discussion from Commissioner Ned Sharpless, MD on how the agency’s medical product centers are engaged in HIV research and product development, and how it supports both the domestic and global responses to HIV.

CDC has added the following resources to its website:

  • Fact Sheet: HIV and African American Gay and Bisexual Men
  • Fact Sheet: HIV and Gay and Bisexual Men
  • Behavioral and Clinical Characteristics of Persons with Diagnosed HIV Infection Medical Monitoring Project, United States 2017 Cycle (June 2017-May 2018)
  • Racial/Ethnic Disparities in HIV Preexposure Prophylaxis Among Men Who Have Sex with Men - 23 Urban Areas, 2017
  • Fact Sheet: HIV and Men
  • New Communication Tools to Prevent HIV and Help People with HIV Stay Healthy
  • Fact Sheet: HIV and Tuberculosis
  • HIV and Occupational Exposure
  • Fact Sheet: Understanding the HIV Care Continuum

Job Opportunities                   

Coalition Coordinator – Southern US

ACT NOW: END AIDS Coalition is hiring a Coalition Coordinator for a 12-month temporary position with the possibility of a long-term extension. The position will provide planning, operational, administrative, and communications support for a small grants program to foster community leadership for the Ending the Epidemic initiative. The position will be based in the Southern U.S.; Atlanta, GA preferred; candidates based in other southern U.S. cities are eligible to apply.

STI/HIV Branch Chief – Colorado

The Colorado Department of Public Health and Environment is seeking a Chief for its STI/HIV Branch. The Branch Chief directs the work of Program Managers in the Branch by applying the methods of organizational management, strategic planning, project design and implementation, work planning, and public health practice, and working closely with Division leadership; developing, approving, implementing, and evaluating overall Branch and Division goals, objectives, policies, and procedures.

HIV Transitional Specialist – Washington State

The Department of Corrections’ Health Services Division in Washington State is hiring an HIV Transitional Specialist. The position supports the department’s vision of maintaining safe communities by providing support for and developing comprehensive release plans for people living with HIV. The position will also provide technical assistance to correctional health care staff upon initial screening or admission and prior to the release of any patient living with HIV.

Upcoming Conferences

NASTAD National HIV and Hepatitis Technical Assistance Meeting

The NASTAD National HIV and Hepatitis Technical Assistance Meeting “Leveraging Integrated Programs to End the Epidemics” will be held December 3-5, 2019 at the Omni Shoreham Hotel in Washington, DC. Online registration will remain open until November 1 with early bird registration open until September 30.

NASTAD’s HIV Cluster Response Institute

NASTAD’s HIV Cluster Response Institute, part of the Southern Capacity Building Institute Series, will be held November 13-14, 2019 in Atlanta, GA. Registration will be open through October 15.

News Bulletin

The HIV Housing Budget Is Under Threat of Cuts. You Need to Call Your (GOP) Senator Now

“Hey, folks living with and/or working in the field of HIV -- not to mention family, friends, and allies! You need to call your senators now -- especially if they're Republican -- and ask, beg, plead, demand, and implore that they fund the Housing Opportunities for Persons with AIDS (HOPWA) program at HIV/AIDS advocates' requested $410 million for fiscal year 2020.

Why is this so important? The main reason, explains Lauren Banks Killelea, public policy director at the National AIDS Housing Coalition, is that HOPWA is hugely important to keeping some 55,000 low-income households containing a person living with HIV stably housed, funding both direct housing programs and rental assistance.”