Policy Updates: Hill Happenings and Administration Activities

By Garrett Eberhardt November 25, 2019

Hill Happenings

Congress Passes Second Continuing Resolution, Continues Work on FY2020 Appropriations

Last week, a second continuing resolution extending funding for the federal government was passed through Congress. This gives appropriators more time to continue negotiations over fiscal year (FY) 2020 appropriations budget allocations. The House passed H.R. 3055 by a vote of 231-192 while the Senate approved the legislation 74-20 before President Trump eventually signed the bill into law ahead of the 11:59pm deadline last Thursday night. On Saturday, Senate and House leaders came to an agreement on budget allocations for the 12 outstanding FY2020 appropriations bills, allowing the two chambers to conference their two versions and come to an agreement on a series of minibus bills for each appropriations subcommittee. NASTAD has continued to advocate for funding for viral hepatitis programs, Ending the Epidemic implementation and funding, a reversal of cuts to Housing Opportunities for Persons with AIDS, and other HIV and viral hepatitis policies as FY2020 appropriations bills are finalized.

Rebate Amendment to be Included in Drug Pricing Bill

Speaker of the House of Representatives Nancy Pelosi (D-CA) announced last week that an amendment requiring the government to examine the possibility of rebates for employer-sponsored health plans when a drug company raises the price of a medicine faster than inflation will remain in the House drug pricing bill. It would also require the Department of Health and Human Services and the Treasury Department to submit a feasibility report to Congress on a system for having drug makers refund the portion of price hikes that exceed the inflation rate by December 31, 2021. The amendment was added to the Lower Drug Costs Now Act of 2019 during a markup in the House Committee on Education and Labor following a concerted push from the amendment’s sponsor Rep. Pramila Jayapal and the Progressive Caucus. The bill is expected to be voted on in December. While House leadership plans to introduce the bill following a final score from the Congressional Budget Office, Senate Majority Leader Mitch McConnell (R-KY) has already stated the Senate will not consider it. NASTAD has been actively advocating before Congress on this legislation, working to change a provision that would have negatively affected the 340B Drug Pricing Program discount and will continue to monitor its progress closely.

Administration Activities

Senate Hearing Held for FDA Commissioner Nominee

Last week, Stephen Hahn, President Donald Trump’s nominee to lead the Food and Drug Administration, went before the Senate Committee on Health, Education, Labor, and Pensions for a confirmation hearing. Hahn fielded questions on e-cigarette regulation, the opioid epidemic, and drug importation in a cordial and non-confrontational hearing. Hahn was non-committal on his plans for dealing with the delayed ban on flavored e-cigarettes and was asked to follow up with specifics in writing. HELP Committee Chair Lamar Alexander (R-TN) said he hoped to confirm Hahn as early as December 3 when Congress returns from recess.

CDC Releases Notice of Funding Opportunity for Viral Hepatitis Surveillance and Prevention

Last week, the Centers for Disease Control and Prevention’s released details for a notice of funding opportunity for integrated viral hepatitis surveillance and prevention funding for health departments. Funding will go toward supporting activities such as surveillance for chronic hepatitis B (HBV) and perinatal hepatitis C (HCV); increased testing and referral to care in high-impact settings, substance abuse treatment centers, correctional facilities, emergency departments and STD clinics; and increased access to services preventing viral hepatitis and other bloodborne infections among persons who inject drugs. Total funding is estimated at more than $91 million with an average award of $315,000 per year for a 5-year award or $394,000 per year for 4 years. The anticipated post date for the announcement is January 6, 2020 with an estimated due date of March 9, 2020 and an estimated start date of June 1, 2020.

HRSA Releases Four Notices of Funding Opportunity

The Health Resources and Services Administration released four new notices of funding opportunity last week in support of the Ryan White HIV/AIDS Program (RWHAP). The first notice, a Dissemination Assistance Provider for Rapid Antiretroviral Therapy (ART), is a three-year Special Projects of National Significance initiative to fund a single organization that will develop a compendium of promising rapid ART interventions. The second notice for the AIDS Education and Training Center National Clinician Consultation Center seeks to provide expert consultation to health care professionals on HIV prevention, care, and treatment. A notice on Data Integration, Systems, and Quality (DISQ) Technical Assistance to provide onsite and virtual technical assistance to RWHAP recipients and subrecipients was also announced as was a notice for TargetHIV seeking to serve RWHAP recipients, subrecipients, and HIV providers by providing readily accessible, up-to-date tools and resources through a web-based platform.

Resources

NASTAD, alongside 270 other organizations, sent a letter urging Congress to restore Medicaid eligibility for people residing in the United States under the Compacts of Free Association (COFA), affecting access to care for persons from Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. By lifting these restrictions, 61,000 individuals and families living in the U.S. and its Pacific

Territories will gain access to essential healthcare. NASTAD will continue to monitor this issue and engage in advocating for its reversal.

NASTAD, in partnership with AIDS United, was awarded a federal CDC cooperative agreement (PS19-1909) to provide technical assistance to Syringe Services Programs (SSPs) and drug user health programs. This three-year cooperative agreement will create a nationwide a technical assistance center to support SSPs and drug user health programs while also facilitating a Patient Navigation demonstration project to improve access to services for people who use drugs. NASTAD will be seeking Harm Reduction TA Providers/Consultants to assist in responding to various requests as they are received. Accepted applicants will join a Technical Assistance Provider ‘pool’ and will be called upon for certain requests based on skillset, region, or expertise as they come in. The project will also provide a funding opportunity to eight SSP’s to create a patient navigation system. Click here for more information on this funding opportunity. For any further questions, email druguserhealthTA@nastad.org

Trust for America’s Health has released a dataset and interactive map that presents state-level statutes and regulations that impact syringe service programs (SSP). Included on the map is the method of authorization for SSPs, requirements for the establishment of SSPs, the types of services provided directly and by referral, drug paraphernalia possession laws, and whether an SSP is operating in the jurisdiction.

Ending the Epidemic

NIH AIDS Division Director Outlines Implementation Research Projects

In a recent conversation, Dr. Carl Dieffenbach, Director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, discussed the National Institutes of Health’s investment in implementation research projects that will take place in 43 of the 57 jurisdictions prioritized in Phase I of the Ending the HIV Epidemic: A Plan for America (EHE) initiative. Researchers at 23 Centers for AIDS Research and AIDS Research Centers will use the implementation research funding to find how best to deliver evidence-based interventions and services for demographics who suffer from disproportionate risk for HIV, including Black and Latino women and men, transgender women, and youth from 13-24 years old. NIH has recently invested $11.3 million to find the most effective ways to diagnose, prevent, and treat HIV using readily available, highly effective methods such as PrEP, PEP, and antiretroviral therapy.

Job Opportunities

Senior Director of Legal and Regulatory Affairs – Baltimore

The Baltimore City Health Department (BCHD) is seeking candidates for a Senior Director of Legal and Regulatory Affairs position. The position will serve as general counsel and principal legal advisor to BCHD's senior leadership team and will provide support throughout the agency on a wide range of legal matters including health law and regulatory compliance, health-related transactional matters, risk assessment, and affirmative litigation efforts with the City's Law Department.

Director of Policy – Illinois

The AIDS Foundation of Chicago (AFC) is seeking a Director of Policy with content expertise to stay abreast of critical healthcare delivery systems including Medicaid, Housing, Ryan White, and the Affordable Care Act (ACA) and influence health policy. The position will serve as the lead for policy development and work on identifying and resolving policy-related issues across the agency with other departments.

Director of Government Relations – Illinois

The AIDS Foundation of Chicago (AFC) is seeking a Director of Government Relations to develop and manage AFC’s federal, state and local government relations activities. The position will be the point person for HIV-related state legislative matters regarding appropriation, health care reform, and policy issues impacting the social determinants of health and health disparities.

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.

Requests for Proposals: Harm Reduction TA Center Patient Navigation Demonstration Project and Technical Assistance Providers - NASTAD

We are pleased to announce that NASTAD, in partnership with AIDS United, was awarded a federal CDC cooperative agreement (PS19-1909) to provide technical assistance to Syringe Services Programs (SSPs) and drug user health programs. This three-year cooperative agreement will create a nationwide a technical assistance center to support SSPs and drug user health programs while also facilitating a Patient Navigation demonstration project to improve access to services for people who use drugs. As you can imagine, we are incredibly excited to begin this project and are currently working to create a platform that will allow us to field requests and develop guidance for programs seeking assistance. More details to come on the technical assistance center and how to request TA soon.

In addition to creation of the TA Center, we are equally as excited to announce two opportunities that this project will provide. First, we will be seeking Harm Reduction TA Providers/Consultants who will assist us in responding to various requests as they are received. Accepted applicants will join a Technical Assistance Provider ‘pool’ and will be called upon for certain requests based on skillset, region, or expertise as they come in. Secondly, this project will provide a funding opportunity to 8 SSP’s to create a patient navigation system. With this funding, it is our hope that your program will have the resources to extend the reach of the work that is being done within your community! Click here for more information on this funding opportunity. For any further questions, be sure to contact us at druguserhealthTA@nastad.org

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. Registration is closed.

News Bulletin

Mailing free home HIV tests helps detect more infections

“Mailing free home HIV tests to high-risk men offers a potentially better strategy for detecting infections than usual care.

That’s according to a U.S. government study that resulted in many more infections found — including among friends with whom recipients shared extra kits.”