Policy Updates: Hill Happenings and Administration Activities

By Garrett Eberhardt October 15, 2019

Hill Happenings

House Committee on Appropriations Chair Congresswoman Nita Lowey to Retire

Longtime Representative Nita Lowey (D-NY), who currently serves as Chair of the House Committee on Appropriations, announced that she will not seek reelection to Congress next year. In a statement released to the press, Representative Lowey stated that “After 31 years in the United States Congress, representing the people of Westchester, Rockland, Queens and the Bronx, I have decided not to seek re-election in 2020. It is my deep honor and privilege to serve my community and my country, and I will always be grateful to the people who have entrusted me to represent them. Thank you to the people of my district for the opportunity to serve. I will continue working as hard as ever – with the same optimism and energy – through the end of this term in Congress.”

Congressional Appropriations part of Global Fund Effort to Raise More than $14 Billion

Late last week during its Sixth Replenishment conference, the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) raised $14.02 billion in one day, the largest amount ever for an international health organization. Both the House and Senate Committees on Appropriations approved $1.56 billion in increases for the Global Fund for fiscal year 2020, a 15.6 percent increase overall. Canada, the European Union, France, Germany, Ireland, Italy, Portugal and the United Kingdom all increased their pledges by at least 15 percent and the private sector also contributed, with (RED) increasing its pledge to the organization by 50 percent. With the funding pledges, the Global Fund hopes to lead an international effort to end the AIDS, TB and malaria epidemics and save an estimated 14,600 lives a day over the next three years.

Administration Activities

Federal Judges Block Public Charge Rule

On Friday, federal judges in the states of New York, California, and Washington issued injunctions temporarily blocking the Trump administration’s public charge rule that seeks to impose limits on the legal residencies of immigrants that use, or are deemed likely to use, public programs or benefits such as Medicaid or housing assistance, affecting 1.2 million annual immigration applicants and 500,000 who are already in the United States. Lawsuits have been filed in 21 states arguing that the rule discriminates against low-income immigrants with the judges agreeing and two of the three rulings imposing nationwide injunctions on implementation of the rule. NASTAD has criticized the rule for its effect on access to public health services efforts to end the HIV and hepatitis epidemics.

CDC Releases STI Surveillance Report

Last week, the Centers for Disease Control and Prevention (CDC) released its Sexually Transmitted Infection (STI) Surveillance report. The data in the report show that overall STI rates increased for the fifth consecutive year with rates in 2018 reaching an all-time high. Newborn deaths from syphilis increased 22 percent in 2018, while incidences for Chlamydia, Gonorrhea, Primary and Secondary Syphilis, and Congenital Syphilis all increased as well. As part of a statement released under the Partnership to End the HIV, STD, and Hepatitis Epidemics, NASTAD has called upon Congress to increase funding for CDC’s STI Prevention Services by $70 million in future appropriations bills in order to address the rising rates of STI infection.

CDC Announced Awards from FY2019 Infectious Disease Consequences of the Opioid Crisis Funds

Late last week, the Centers for Disease Control and Prevention (CDC) announced the awards for the $5 million appropriated in fiscal year 2019 under the Infectious Disease and the Opioid Epidemic initiative passed through Congress. Two grantees were awarded funds for the National Harm Reduction Technical Assistance and Syringe Services Program (SSP) Monitoring and Evaluation Funding Opportunity (CDC-RFA-PS19-1909), which also will include two demonstration projects focusing on improving linkages to opioid use disorder and infectious disease care for SSP clients. NASTAD is included as one of the awardees and will be working to develop a national network that provides harm reduction technical assistance responsive to the needs of states and local jurisdictions over a three-year period. In addition, nine jurisdictions were funded for an existing CDC program Improving Hepatitis B and C Care Cascades: Focus on Increased Testing and Diagnosis (PS 17-1702SUPP), which was supplemented by the Infectious Disease and the Opioid Epidemic initiative.

HRSA Releases 2017 Ryan White State Profiles

The Health Resources and Services Administration’s HIV/AIDS Bureau (HRSA HAB) has released 2017 State Profiles for the Ryan White HIV/AIDS Program. The profiles provide a national and state-by-state look at 2017 client-level data within the Ryan White HIV/AIDS Program Services Report (RSR) including a data visualization tool that allows users to make comparisons between states or compare state numbers to national data, or data from previous years.

Ending the Epidemic

HRSA Releases Ending the Epidemic Public Information Request

The Health Resources and Services Administration (HRSA) published a request for public comment on its Ending the HIV Epidemic initiative (ETE) Information Collection Request (ICR) in today’s Federal Register. The ICR asks that service providers who receive ETE funding report aggregate information three times per year on the number of clients receiving specific services and the number of clients who were prescribed antiretroviral medications during the previous four-month period beginning in March 2020. This information would complement the annual information collected through the Ryan White Services Report and other reporting mechanisms. HRSA is seeking public comment on any potential burden for service providers resulting from the ICR data collection. The public comment period is open until December 16.

Resources

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.

HHS will be hosting an informational webinar on October 21, 2019 from 2:00 PM – 3:00 PM ET regarding the 2020 Hepatitis C Medicaid Affinity Group. The Affinity Group encourages collaboration between Medicaid, public health authorities, state corrections agencies, and behavioral health agencies on forming innovative strategies to improve the hepatitis C cure. The upcoming third year will include a new area of focus on individuals with substance use disorder for interested states.

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).

Job Opportunities

NASTAD is pleased to announce the application cycle is open for the 2020 Minority Leadership Program (MLP).  MLP serves as a space rooted in social justice for health department staff of color to engage in critical conversations about job advancement, institutional barriers, managing emotions and burnout, racial and gender-based microaggressions, triggers, staff and project management, communication, and more. Applications for the Minority Leadership Program 2020 Cohort are due on Friday November 15, 2019. To apply, visit: https://www.nastad.org/minority-leadership-program-mlp.

HIV Prevention Specialist – Utah

The Utah Department of Health is seeking an HIV Prevention Specialist to join the Prevention, Treatment, and Care Program to implement HIV prevention activities statewide. This position will provide HIV testing and counseling training to contracted agencies, assist with grant reporting to CDC, ensure targeted HIV testing is being implemented appropriately, oversee contracts, and monitor local jurisdictions and community-based organizations in HIV prevention, testing, investigation, and partner services.

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

HIV-prevention drugs will soon be available without a prescription at California pharmacies

“HIV prevention drugs will be available without a prescription starting next year in California under a bill signed Monday by the state's Democratic governor.

The medications covered by the new legislation are pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), which both help prevent HIV infections.

The state will be the first in the country to allow pharmacists to provide the drugs without a physician's prescription, nonprofit organization Equality California said. The law takes effect January 1.”

These laws were meant to protect people from HIV. They’ve only increased stigma and abuse

“Researchers discovered HIV, the virus that causes AIDS, in 1984. But the death toll kept rising, and the panic along with it. Fear and misunderstanding of the disease were such that when one student at a New York City school was thought to have the virus, 944 of the school’s 1,100 students stayed home, according to a Time magazine report. In one 1985 poll, 50 percent of people supported a quarantine of people with AIDS. Amid this panic, the idea emerged that “there were people who were intentionally spreading HIV,” Scott Schoettes, HIV project director at the LGBTQ civil rights group Lambda Legal, told Vox.

The idea may have been fueled by longstanding social prejudices, including homophobia. As journalist Steven Thrasher writes in a Guardian column on the now-debunked myth of a gay flight attendant as HIV’s ‘Patient Zero,’ ‘we like to blame individuals (especially queer folks, women, immigrants and people of color) for diseases, particularly communicable ones that involve sex. Societally, it is far easier to blame them for disease rather than to deal with the complex medical, political and epidemiological causes.’”