Policy Updates: Hill Happenings and Administration Activities

By Meredith McCarthy July 27, 2020

Hill Happenings

Appropriations Updates 

The House has passed a four-bill minibus containing the Agriculture-FDA, Interior-Environment, Military Construction-VA and State and Foreign Operations appropriations. The bill requires President Trump to send funds to the WHO, blocks transferred funding for the border wall, includes $250 billion in emergency spending beyond the 2019 budget agreement. 

The House Appropriations Committee released the details of the second minibus, which will be considered this week and will contain 7 of the remaining FY2021 spending bills, including Commerce-Justice-Science, Defense, Energy and Water Development, Financial Service and General Government, Homeland Security, Labor-HHS, and Transportation-Housing and Urban Development. Votes should be completed by the end of this week.  

Upcoming COVID-19 Relief Package 

The Senate was set to release a new COVID-19 relief package last week but was unsuccessful. The White House has suggested a partial relief package could be coming to address the expiration of unemployment benefits at the end of this week. It is unclear what the path forward is going to be as Democrats and Republicans are still in negotiations over the next COVID-19 relief package. 

Administration Activity

Trump Administration Renews Public Health Emergency After Urging from States 

The Trump Administration has renewed the public health emergency for the coronavirus, ensuring that critical resources to fight the pandemic can continue while much of the country battles rising caseloads. The previous emergency declaration expired on July 25.  

HHS Issues a Statement on Civil Rights Protections Prohibiting Race, Color and National Origin Discrimination During COVID‐19 

The Department of Health and Human Services’ (HHS) Office of Civil Rights (OCR) has issued a statement focused on recipients’ compliance with the prohibitions against race, color, and national origin discrimination contained in Title VI of the Civil Rights Act of 1964 (Title VI). The statement lists a variety of recommendations for recipients of federal financial assistance to ensure Title VI compliance during the COVID-19 pandemic.  

HUD Proposed Rule on Admission/Placement Determinations Based on Sex in Facilities Under Community Planning and Development Housing Programs 

The Department of Housing and Urban Development (HUD) has proposed a rule that would provide that grant recipients, subrecipients, owners, operators, managers, and providers under HUD programs that permit single-sex or sex-specific facilities (such as temporary, emergency shelters or other facilities with physical limitations or configurations that require and are permitted to have shared sleeping quarters or bathrooms) may establish a policy, consistent with federal, state, and local law, to accommodate persons based on sex. The HUD proposal would reverse a 2016 measure implemented under the Obama administration that built on provisions enacted four years earlier. The 2012 Equal Access Rule mandated that shelters are "open to all eligible individuals and families regardless of sexual orientation, gender identity, or marital status," and the administration issued further guidance clarifying that the rule barred shelters from denying access to trans people in accordance with their gender identity. 


National African American Hepatitis C Action Day 

National African American Hepatitis C Action Day (NAAHCAD) was observed on July 25th. NAAHCAD is a community mobilization initiative started by the National Black Leadership Commission on Health (NBLCH). The day aims to draw attention to the significant burden of hepatitis C in Black communities and promote hepatitis C education, testing, and treatment. Additionally, on Wednesday, July 29 from 1:00 – 2:00 PM EDT, NBLCH will host a discussion titled “National African American Hepatitis C Action Day: Addressing Screening, Treatment and Care in the Time of COVID-19” with Ada D. Stewart, MD, FAAFP, President-Elect of the American Academy of Family Physicians and Tatyana Kushner, MD, MSCE, Assistant Professor of Medicine at Icahn School of Medicine at Mount Sinai. Registration can be found here

Kaiser Family Foundation Releases Analysis on Medicaid and CHIP Enrollment 

In a new analysis, the Kaiser Family Foundation found that after two years of declining enrollment, the number of people covered by Medicaid and the Children's Health Insurance Program (CHIP) rose by 1.2 million between December 2019 and April 2020, including an increase in enrollment of 800,000 people since March. The analysis of newly released data from the Centers for Medicare and Medicaid Services suggests a reversal in previous trends of flat or negative enrollment growth as more people experience income and job loss and become eligible and enroll in Medicaid coverage. From March to April, Medicaid and CHIP enrollment increased in all but five states, reaching at total of 72.3 million people nationally. Adults accounted for most of the increase. The most recent rise in enrollment coincides with the dramatic increase in novel coronavirus cases this spring as the pandemic gained a foothold in the U.S., which had the collateral effect of disrupting the economy and triggering large job losses. The enrollment increases also reflect provisions in the Families First Coronavirus Response Act under which states cannot tighten Medicaid eligibility standards beyond policies in place as of January 1 or disenroll existing beneficiaries through the public emergency period. 

Center for Budget and Policy Priorities Publishes Report on States’ Needs for More Federal Aid 

The Center for Budget and Policy Priorities has published a new report on states’ need for more federal aid amidst a deepening budget crisis. As states revisit their spending plans for the 2021 budget year, which began July 1 in most states, they are making deep budget cuts to offset huge revenue shortfalls triggered by COVID-19 and the worst economic downturn since the Great Depression. The initial state and local cuts enacted in spring and early summer caused sizable harm through layoffs, furloughs, and cuts to vital public services. Unless federal policymakers provide a new round of flexible fiscal aid, the harm will only worsen. Federal aid in the Families First Act and CARES Act, both enacted in March, helped, but only about $100 billion of it is flexible enough for states to use to offset revenue shortfalls and limit cuts in services. Even after accounting for states’ “rainy day” reserves, which were a historically high $75 billion when the crisis started, about $380 billion in potential shortfalls remains through 2022. 

The National Office of AIDS Research Launches New Website 

The National Office of AIDS Research (OAR) has redesigned its website. The website has changed its navigation and added new content including frequently asked questions, information on OAR leadership, a timeline of progress against HIV/AIDS, and new research highlights. There is also a new online subscription form to receive email updates.  

HIV Self-Testing Analysis 

NASTAD is excited to announce a comprehensive, landscape analysis of HIV self-testing programs across the United States through our new state-by-state maps detailing HIV self-testing and TelePrEP services in honor of National HIV Testing Day on June 27. As programs began to experience disruption in HIV testing and PrEP clinical services as a result of COVID-19, the CDC released guidelines to use self-testing via home specimen self-collection kit or an oral swab-based test whenever lab visits are unfeasible. In early June 2020, NASTAD surveyed its members to learn more about how health departments are providing access to at-home HIV, HCV, STI, and PrEP self-testing services. In all, our review demonstrated that twenty-one jurisdictions currently offer HIV self-testing services. This represents 55% of the jurisdictions that responded to NASTAD’s RFI. Most of these self-testing programs are recent additions to expand the availability of HIV testing services, with more than 70% of programs starting in 2019 or 2020. The complete analysis can be viewed here.  

The Asian & Pacific Islander American Health Forum Issues Letter to Congress 

The Asian & Pacific Islander American Health Forum has issued a letter to Congress requesting that they act against barriers for COVID-19 testing and treatment due to communications and language access issues. The letter was signed by over 125 organizations. NASTAD has also signed on to the letter.  

Upcoming Conferences

2020 National Ryan White Conference on HIV Care & Treatment  

The 2020 National Ryan White Conference on HIV Care and Treatment (NRWC) is officially going virtual. The conference will be held August 11-14, 2020, but the times will be adjusted to accommodate different time zones. Registered participants are still encouraged to attend the full length of the conference; however, the virtual platform would allow for more flexibility. The NRWC theme this year is “30 Years of Innovating Care, Optimizing Public Health, Ending the HIV Epidemic,” which is timely as HRSA celebrates 30 years since the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act was first enacted. This year’s theme also aligns with the Administration’s Ending the HIV Epidemic: A Plan for America, the 10-year initiative with the important goal of reducing new HIV infections to less than 3,000 per year by 2030. 

USCHA 2020  

Due to the ongoing COVID-19 pandemic, the 2020 United States Conference on HIV/AIDS (USCHA) will take place online October 21-23. Registration is free for the first 4,000 community/non-profit registrants. All content will be available online for free after the conference. The 2020 meeting will have five plenaries, 60 workshops, 14 institutes, and a Virtual Exhibit Hall. 

Job Postings

Senior Associate — Washington, DC  

NASTAD is seeking a Senior Associate for the Health Systems Integration team. The Senior Associate, Health Systems Integration provides administrative and substantive support for NASTAD’s technical assistance and capacity building assistance for Ryan White HIV/AIDS Programs (RWHAP), with a focus on Ending the HIV Epidemic (EHE) initiative activities. This position works closely with entire Health Systems Integration and Health Care Access teams to support programmatic activities.  

Strategic Planning/Visioning Consultant—Washington, DC 

NASTAD is seeking an experienced professional or company to work with NASTAD’s strategic visioning committee of Board, members, and staff, in the creation of a 3-5-year strategic vision. NASTAD is seeking a consultant who has demonstrated experience in successfully developing participatory/consensus-building strategic plans, has strong facilitation skills, has proven experience with non-profit strategic planning/visioning, and a strong understanding of building an anti-racism/anti-stigma multicultural framework as the foundation for an organization’s strategic vision. 

Manager — Washington, DC  

NASTAD is seeking a Manager for the Health Care Access team. The Manager, Health Care Access plays a vital role in expanding the organization’s capacity and priority of addressing the impact of HIV/AIDS and viral hepatitis programs within health departments. Under direction from the Associate Director, Health Care Access, the Manager will play a key role the Health Care Access programs technical assistance efforts, having a strong voice in the development of NASTAD’s cooperative agreement with the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB) and Ending the HIV Epidemic (EHE) initiative activities. The Manager will provide quantitative analytics and qualitative analyses regarding the impact of health system changes on health department programs and people living with HIV (PLWH).     

Health Services Consultant  — Washington  

The Washington State Department of Health, Division of Disease Control and Health Statistics (DHCS), Office of Infectious Diseases, HIV Client Services is recruiting for three full-time permanent Health Services Consultant positions (a Health Disparities Consultant (Bi-lingual), a Peer Navigation Consultant, and a Stigma Reduction Consultant). The closing date for these positions is July 29 at 11:59 PM PT. 

Deputy Director—Maryland  

This position serves as the Deputy Director of Infectious Disease Prevention and Health Services Bureau within Prevention and Health Promotion Administration. The Deputy Director collaborates with the Director in planning, implementing and evaluating the internal operations of the Bureau in support of efforts to develop healthcare delivery systems responding to the needs to all Marylanders. Key functions include administrative oversight, regulatory and programmatic compliance, operational planning and evaluation, and staff development. The Deputy Director provides administrative supervision to the Bureau leadership team, which includes the Chiefs of the Centers of HIV Prevention and Health Services, the Maryland AIDS Drug Assistance Program (MADAP), HIV/STI Integration and Capacity, Harm Reduction Services, Viral Hepatitis, HIV Surveillance, Epidemiology and Evaluation, and STI Prevention. The position may act for the Director at his/her direction.  

Assistant Commissioner — Maryland   

The Baltimore City Health Department (BCHD) is seeking an Assistant Commissioner to lead the Bureau of Communicable Disease and Outbreak Control. This senior management position will lead a talented team responsible for communicable disease investigation, outbreak control and emergency preparedness programming. The incumbent will also be responsible for developing and implementing agency wide policies related to health department readiness to respond to public health emergencies. The incumbent will report directly to the Deputy Commissioner for BCHD's Division of Population Health & Disease Prevention.  

Chief of Global Communications – Flexible    

Prevention Action Campaign (PAC) is seeking applicants for the Chief of Global Communications (CGC). The CGC is a critical senior global leadership position responsible for building a new communications function and team to oversee PAC's communications work with domestic and international partners. Working closely with the PAC senior leadership team and ambassadors, and in collaboration with U=U partners, the CGC will develop and implement PAC's new communications strategy. The communications team will create, curate, and share outstanding U=U resources to support and expand U=U's growing network and build upon the movement's success disseminating the U=U science worldwide.  

Community Health Worker/Contact Tracer—Maryland 

The Baltimore Health Corps is looking for a Community Health Worker/Contact Tracer to assist in addressing the economic and public health crises caused by COVID-19. The Community Health Worker (CHW) will be a part of the COVID-19 response team at the Baltimore City Health Department (BCHD). Under general supervision by a direct supervisor, the Community Health Worker will be working as a public health representative. The person will be working on activities such as contact tracing (approximately 70%), public health messaging (approximately 20%), and any other public health activities as directed (10%). As the needs to the response will change over time, the role of the CHW will also adapt to public health needs. 

Viral Hepatitis Policy Fellow—Washington, D.C./Remote 

The National Viral Hepatitis Roundtable seeks a Viral Hepatitis Policy Fellow to coordinate its policy work. The Viral Hepatitis Fellowship is a year-long remote position, with the possibility of renewal. Due to the need for meetings with federal lawmakers, the employee shall be based in commuting distance to Washington, D.C. The Fellowship will be awarded to a medical, public health, or policy professional interested in health equity; specifically, in strengthening the collaboration between key stakeholders and government, highlighting key gaps in policy and service delivery, and working with partners to address the disparate impact of viral hepatitis among underserved populations. 

Public Health and Prevention Specialist III—Texas  

The Texas Department of State Health Services is seeking a Public Health and Prevention Specialist to perform highly complex and advanced technical activities related to HIV, STD, and Tuberculosis data management and processing, under the direction of the Program Informatics and Evaluations Group Manager. Oversee, monitor and maintain high volume workflows and conduct activities related to data management and processing in the TB, HIV, STD Integrated System (THISIS). Create written procedures for the monitoring and maintenance of high-volume workflows and best practices in maintaining workflows. Collaborate with program subject-matter experts to enhance work processes and best practices. Develop and provide training on deduplication and facility management. Act as the subject-matter expert for facility management and deduplication. 

Epidemiology Specialist II—Alaska 

The Alaska Division of Public Health is seeking an Epidemiology Specialist to serve as the HIV epidemiological professional for disease surveillance, data analysis, public health investigation, and quality assurance for Alaska. The closing date for this position is July 30 at 5:00 PM Alaska Time. 

Program Specialist IV—Texas 

The Texas Department of State Health Services is seeking a Program Specialist for the Epidemiology & Surveillance Department. Under the limited supervision of the STD/Hepatitis C Epidemiology and Surveillance Group Manager, uses knowledge to independently perform highly complex disease database management. Provides complex and advanced oversight of sexually transmitted disease (STD) data in the TB/HIV/STD Integrated System (THISIS). This includes effective, secure, and efficient storage, retrieval, and archiving of information from multiple program sites into the THISIS system, which includes local and regional health departments across the State. Provides programmatic consultative services and technical assistance to the THISIS users located at each of the remote sites statewide. Develops and implements procedures, standards and policies relating to the operations and design of THISIS and its STD components. Performs site reviews statewide of STD surveillance sites, this includes local and regional Health Departments. Assists in establishing goals and objectives for the statewide STD surveillance program and THISIS and monitors progress toward those goals and objectives. Works under limited supervision, with moderate latitude for the use of initiative and independent judgement. 

News Bulletin 

Our Ending the Epidemic Plan Needs to Invest in PrEP—but Not Just the Cost of the Pill 

“Ending the HIV Epidemic: A Plan for America (EHE) aims to end the HIV epidemic in the United States by 2030. Doing so requires a massive investment in HIV prevention efforts, largely focused on pre-exposure prophylaxis (PrEP), but this public health investment must support removing all the financial barriers to a patient being on PrEP, not just access to the medication.”  

COVID-19 affects HIV and tuberculosis care 

“Shortly after instituting coronavirus disease 2019 (COVID-19) mitigation measures, such as banning air travel and closing schools, the South African government implemented a national lockdown on 27 March 2020 when there were 402 cases and the number of cases was doubling every 2 days (1). This drastic step, which set out to curb viral transmission by restricting the movement of people and their interactions, has had several unintended consequences for the provision of health care services for other prevalent conditions, in particular the prevention and treatment of tuberculosis (TB) and HIV. Key resources that had been extensively built up over decades for the control of HIV and TB are now being redirected to control COVID-19 in various countries in Africa, particularly South Africa. These include diagnostic platforms, community outreach programs, medical care access, and research infrastructure. However, the COVID-19 response also provides potential opportunities to enhance HIV and TB control.” 

What Happens When A Pandemic And An Epidemic Collide 

“Anton Basenko is worried. He fears all the hard-won progress made in fighting the AIDS epidemic is on a collision course with the urgent needs of the coronavirus pandemic. ‘For people with HIV, it's double, triple the crisis since the start of the lockdown,’" says the Ukrainian AIDS advocate. ‘I have a bad feeling that organizations and governments are so concentrated on COVID that they are completely forgetting about HIV. For marginalized people, it's a question of life and death.’” 

Dr. Fauci on How AIDS May Be the Key to Defeating COVID-19 

“The nonprofit Retro Report's new film asks Dr. Anthony Fauci, Harvard professor Dr. Allan Brandt, and GMHC cofounder Dr. Larry Mass what lessons from the fight against AIDS that our country should be putting to use now.” 

Addressing HIV Stigma in MSM 

New data from the International AIDS Society (IAS) AIDS 2020 Virtual Sessions last week showed men who have sex with men (MSM) are far more likely to avoid or not seek out information nor access to HIV pre-exposure prophylaxis (PrEP). Unfortunately, this is a long-known issue in HIV care, as the at-risk population often perceives greater hurdles of stigma in their reason for seeking out preventive care. In an interview with Contagion, Hugh Klein, PhD, study co-author of the PrEP Obstacles Scale, discussed solutions, both clinical and otherwise, in getting MSM adherence to PrEP. 

New GLAAD survey on HIV stigma and lack of knowledge about transmission shows 'how much work is left to do' 

“‘Only half of Americans feel knowledgeable about HIV, and nearly 90 percent believe that stigma still exists around it, according to new findings just released by GLAAD’s “State of HIV Stigma Study,”’ revealed exclusively to Yahoo Life. The release of the findings on Monday come paired with another GLAAD announcement — that it will work even harder to fight the persistent HIV stigma by kicking off two programs, around accurate HIV media coverage and HIV outreach education, with a focus on the U.S. South and communities of color, through a $9 million multi-year grant from Gilead Sciences as part of its COMPASS Initiative.”