Policy Updates: Hill Happenings and Administration Activities

By Garrett Eberhardt October 21, 2019

Hill Happenings

Congress Continues Negotiations on FY2020 Appropriations

Following its return from recess, Congressional appropriators are continuing to work toward compromises surrounding fiscal year (FY) 2020 appropriations bills.  Senate Appropriations Chair Richard Shelby (R-AL) has proposed passing the appropriations bills for the Departments of Energy, Housing and Urban Development, Transportation, and Agriculture, before moving on to more contentious bills. Negotiations on bills between the House and Senate have stopped, while the Senate focuses on passing these bills. Senate Majority Leader Mitch McConnell (R-KY) opened the door on potentially passing the bills this week when he filed for cloture, a process which limits debate on a bill in order to avoid filibuster, on two House spending packages, one of which includes the contentious Labor-HHS appropriations bill. If the less contentious spending package can win bipartisan support, the Defense and Labor-HHS packages would follow.

Drug Pricing Bill Passed through House Committees

Last week, the House Committees on Education & Labor and Energy & Commerce debated, amended, and passed H.R. 3 (116), Lower Drug Costs Now Act of 2019 . The Education and Labor Committee passed the legislation by a 27-21 party line vote, while the Energy and Commerce Committee saw it pass on a 30-22 vote along party lines. The bill is estimated to save the government $345 billion over a seven-year period, according to analysis from the Congressional Budget Offices. The bill was revised to include a provision on the minimum number of drugs for which the government can negotiate cost, raising it to at least 35 medications. A provision was added to evaluate any medications that come to market at list prices higher than the U.S. median household income, without competition for direct government negotiation. The change to 340B Drug Pricing Program eligibility, which NASTAD had expressed concerns over was rewritten to ensure that eligibility would remain the same. The House Committee on Ways and Means is expected to hold its markup on the bill next week. The Education and Labor Committee passed the legislation by a 27-21 party line vote, while the Energy and Commerce Committee saw it pass on a 30-22 vote along party lines. The bill is estimated to save the government $345 billion over a seven-year period, according to analysis from the Congressional Budget Offices. The bill was revised to include a provision on the minimum number of drugs for which the government can negotiate cost, raising it to at least 35 medications. A provision was added to evaluate any medications that come to market at list prices higher than the U.S. median household income, without competition for direct government negotiation. The change to 340B Drug Pricing Program eligibility, which NASTAD had expressed concerns over, was rewritten to ensure that eligibility would remain the same. The House Committee on Ways and Means is expected to hold its markup on the bill next week.

Ending the Epidemic

HRSA’s Bureau of Primary Health Care to Provide PrEP Funding Opportunity

Last week, the Health Resources and Services Administration’s (HRSA) Bureau of Primary Health Care (BPHC) announced that existing health centers will use fiscal year (FY) 2020 Ending the HIV Epidemic (ETE) - Primary Care HIV Prevention (PCHP) supplemental funding to expand HIV prevention services, focusing on supporting access to and use of pre-exposure prophylaxis (PrEP). The purpose of the opportunity is to decrease the risk of HIV transmission in geographic locations identified by the ETE initiative. PCHP funding is available to 182 health centers who are currently receiving H80 funding in the identified geographic locations. BPHC has also set up a technical assistance page for those interested in applying by the December 16 deadline.

PrEP Donation Program FAQ Available

HIV.gov has provided a Q&A document outlining frequently asked questions regarding the recent donation of pre-exposure prophylaxis (PrEP) medication from Gilead Sciences. The Department of Health and Human Services recently announced its short-term contract to Gilead to accelerate distribution of PrEP by utilizing a pre-existing network of vendors and subcontractors.

Resources

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).

MMWR:  Vaccination Coverage by Age 24 Months Among Children Born in 2015 and 2016

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.

Associate Director, Strategy and Implementation – Georgia

CDC is seeking an Associate Director for Strategy and Implementation for its Division of Viral Hepatitis (DVH) at the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. The position will oversee the Division’s Strategic Implementation Unit within the Office of the Director and be responsible for identifying and developing public health policies, partnerships, and initiatives improving access to viral hepatitis prevention and treatment services across all populations, especially those with disproportionate burden of disease or barriers accessing services.

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.

NASTAD’s HIV Cluster Response Workshop

NASTAD’s HIV Cluster Response Workshop, part of the Southern Capacity Building Workshop Series, will be held November 13-14, 2019 in Atlanta, GA.

News Bulletin

Judge Vacates 2016 Rule That Banned Healthcare Discrimination Against Transgender Patients

“A federal judge in Texas ruled Tuesday that a rule the Obama administration finalized in 2016 to prohibit gender identity discrimination in healthcare violated the Administrative Procedure Act (APA) and the federal Religious Freedom Restoration Act (RFRA).

U.S. District Judge Reed O'Connor's decision came more than two and a half years after he issued a preliminary injunction in the case to prevent the government from implementing the policy, which is based on Section 1557 of the Affordable Care Act.”