Policy Updates: Hill Happenings and Administration Activities

By Mike Weir September 8, 2020

Hill Happenings 

COVID-19 Relief and FY2021 Appropriations Updates 

Last week, Senate Republicans released a "skinny" version of their HEALS Act COVID-19 relief bill, the Delivering Immediate Relief to America's Families, Schools and Small Businesses Act. While the Senate is expected to vote on the bill this week,  it does not appear they will have the votes to pass the bill. The bill's major provisions include: 

  • $16 billion for testing, contact tracing, surveillance, containment, and mitigation to monitor COVID-19 

  • An extension of small business loans under the PPP 

  • Expanded unemployment benefits of $300 extra a week until December 27, 2020 

The deadlock over another round of COVID-19 stimulus remains and will likely lead to negotiations continuing through September. With the September 30th fiscal year deadline approaching, it is possible that the stimulus legislation will be tied to the FY2021 appropriations process. Congressional leaders are seemingly preparing for a short-term spending extension known as a continuing resolution (CR) to keep the federal government funded and running. NASTAD will continue to monitor the appropriations process and stimulus negations and advocate for the highest funding levels on behalf of HIV and hepatitis programs.  

House Committee Chairs Letter on 340B 

In a letter to HHS Secretary Azar, Energy & Commerce Chair Frank Pallone (D-NJ-06), Health Subcommittee Chair Anna G. Eshoo (D-CA-18), and Oversight and Investigations Chair Diana DeGette (D-CO-01) expressed “concerns about several drug manufacturers’ actions that threaten to undermine the 340B Drug Pricing Program.” They continued, “we are concerned that in recent weeks, several drug manufacturers have taken or threatened to take varying measures to limit the reach of the 340B Program. This has included placing arbitrary limits on the number of contract pharmacies they will serve, or, in some instances, cutting off delivery of drugs at discounted 340B prices to contract pharmacies altogether. Other drug manufacturers have instituted new reporting requirements on covered entities, suggesting that should covered entities fail to comply, manufacturers may take additional steps that would be “substantially more burdensome.” NASTAD is monitoring this situation.  

Administrative Activity 

COVID-19 Testing and Vaccine Recommendations 

The Centers for Disease Control and Prevention (CDC) modified its coronavirus testing guidelines to exclude people who do not have symptoms of COVID-19, even if they have been recently exposed to the virus. NASTAD signed onto a letter with 235 other organizations urging the White House Coronavirus Task Force to reverse the revisions to CDC’s testing guidelines for asymptomatic individuals. IDSA and HIVMA released a statement calling on the Administration to reverse “the abrupt revision of the CDC COVID-19 testing guidelines which diminish the importance of testing asymptomatic individuals who were exposed to COVID-19.” NACCHO and Big Cities Health Coalition also released a statement calling on the CDC to reverse the changes made to the testing guidance.  

In a recent letter from CDC Director Robert Redfield, state governors are encouraged to prepare for a COVID-19 vaccine to be ready by November 1st. The CDC and HHS “are rapidly making preparations to implement large-scale distribution of the Covid-19 vaccines in the fall of 2020,” Redfield wrote. The CDC contracted with McKesson Corp. to distribute COVID-19 vaccines to jurisdictional health departments and other facilities. ASTHO issued a statement in response to comments from federal leadership implying a COVID-19 vaccine could be distributed to the public prior to the completion of phase 3 clinical trials. 

Fetal Tissue Research 

NASTAD signed onto a letter calling on Health and Human Services’ (HHS) Secretary Azar “to reject the Ethics Advisory Board’s recommendations to block specific research projects. Additionally, we ask that you immediately revoke the HHS policy restricting federal funding for biomedical research involving fetal tissue.”” 

PEPFAR 2020 Annual Report to Congress 

The President's Emergency Plan for AIDS Relief (PEPFAR) recently released its 2020 Annual Report to Congress. “These reports are prepared by the Office of the United States Global AIDS Coordinator in collaboration with the United States Departments of State (including the United States Agency for International Development), Defense, Commerce, Labor, Health and Human Services (including the Centers for Disease Control and Prevention, the Food and Drug Administration, the Health Resources and Services Administration, the National Institutes of Health, and the Office of Global Health Affairs), and the Peace Corps.” 

HHS HIV/AIDS Treatment Guidelines' Website Change 

The Office of AIDS Research (OAR) announced the transition of the public AIDSinfo.nih.gov and infoSIDA.nih.gov websites and associated HIV/AIDS activities from the National Library of Medicine (NLM) to OAR and the HHS Office of Infectious Diseases and HIV/AIDS Policy (OIDP). The current AIDSinfo.nih.gov and infoSIDA.nih.gov sites will be renamed HIVinfo.nih.gov on the NIH OAR website. OAR will maintain and update the content once the new HIVinfo.nih.gov site goes live on September 14, 2020. 

Conferences 

Hepatitis Virtual Collaborative 

Join NASTAD and The AIDS Institute on October 22nd for the first ever Hepatitis Virtual Collaborative! It is a partial-day opportunity for hepatitis and infectious disease advocates and patients from across the country to come together virtually to connect with each other and learn about what jurisdictions are doing to combat viral hepatitis in their communities through presentations and conversations. Best of all, it’s FREE! 

Presentations will include hepatitis elimination strategies and how a syndemic approach must be taken that incorporates responses to the viral hepatitis epidemics, overdose prevention, and other public health efforts. Additional barriers to advancing hepatitis elimination will also be examined, including criminalization of hepatitis and drug use, discrimination and stigma concerns, treatment access issues in correctional settings, vaccination barriers, and health inequities. Registration information will be sent around at a later date. Please reach out to Frank Hood (fhood@taimail.org) or Jasmine West (jwest@nastad.org) with any questions. 

340B 2021 Winter Conference Call for Speakers 

The 340B Coalition is currently interested in receiving proposals on a broad range of 340B-related topics, including operations, C-suite topics, policy, compliance, and patient care for the upcoming 2021 340B Coalition Winter Conference at the end of January. The call for speakers is open until Friday, September 11, 2020.  Please use the button below to learn more and to submit a speaker proposal. If you have not yet submitted your application, please visit our submission page to view the required information and application form to learn how to submit your application. We welcome early submissions. Encourage your colleagues to participate—share this announcement. We hope to continue increasing the number of new speakers participating as more than 70 new speakers have been added to this year’s conferences. If you have any questions, please contact Eddie Van Aken at eddie.vanaken@340bhealth.org or (202) 536-2296. 

Resources 

Webinar: Hepatitis A and Hepatitis B Vaccination Efforts in People Who Inject Drugs 

Date & Time: Thursday, September 10, 2020 from 2:00 - 3:00 PM EDT 

“Despite recommendations for vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV) for all adults at increased risk of infection, there have been several US states that have reported outbreaks and/or increases in HAV and HBV infections among PWID in recent years. When not treated, these infections can be highly contagious and can be transmitted through unsafe injecting practices. As part of the overall goal to eliminate viral hepatitis by 2030, it is necessary to increase vaccine uptake through targeted interventions among PWID. During this webinar, CDC’s NCHHSTP and DVH will provide an overview of their viral hepatitis vaccination recommendations and the recent release of new communications materials encouraging hepatitis A and B vaccination in PWID. Additionally, you will hear from jurisdictions who will speak to their community outreach initiatives to implement hepatitis A and B vaccinations for PWID.” 

Webinar: Accessing Federal Government Employment Opportunities 

Date & Time: Thursday, September 24, 2020 1:00 - 2:30 PM EDT 

“We need People Living with HIV to get jobs in the HIV Workforce. That's why the HRSA HIV/AIDS Bureau and NMAC are partnering to present a webinar focused on helping people living with HIV, especially those without the same amount of opportunities to access gainful employment, learn the best way to apply for a job. The webinar will feature Accessing Employment Opportunities for people living with HIV at federal, state, and community levels.”  

Job Postings 

Government Operations Consultant III—Florida  

The Florida Department of Health is seeking a Government Operations Consultant for the Bureau of Communicable Disease – HIV/AIDS Section. This is a highly responsible professional position that serves as the Statewide Minority HIV/AIDS Coordinator, established in Section 381.0046, Florida Statutes. This position is responsible for facilitating statewide efforts focused on HIV prevention and care initiatives and programs which reduce racial/ethnic disparities. This position is assigned to and stationed at the Department of Health in Tallahassee. The closing date for this posting is 8/28/2020. 

Open Positions – New York State 

The New York State Department of Health, in partnership with Health Research, Inc, has various job openings, including some within the AIDS Institute. Please visit this link to learn about their current opportunities.  

Manager—Washington, DC 

NASTAD is seeking a Manager for the Policy & Legislative Affairs Team. The Manager, Policy & Legislative Affairs plays a vital role in managing the development and implementation of hepatitis-related federal appropriations strategies, including for the NASTAD convened Hepatitis Appropriations Partnership, and legislation related to hepatitis prevention, care and treatment issues.  This position manages the day-to-day activities necessary to implement hepatitis-related federal legislative and regulatory goals.  The Manager also interfaces with governmental agencies, national organizations, coalitions and other non-governmental organizations to promote NASTAD’s legislative and policy agenda.  In addition, this position interfaces with NASTAD members to develop their understanding of the federal policy process and respond to their inquiries.  Demonstrated ability to execute projects in a timely manner is also required.   

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.  

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. 

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 

Contact tracing foiled by conspiracy theories, lack of federal messaging 

“POLITICO requested tracing data from all of the states showing the percentage of confirmed cases tracers reached and interviews that ended with information on contacts. A total of 14 states and New York City supplied results showing widespread public reluctance to participate in disease tracking as officials were tracking new hot spots and trying to prevent uncontrolled spread. Only a few, including Massachusetts and Vermont, have persuaded the majority of their Covid-positive residents to reveal who they may have infected.” 

11th Circuit Reduces Florida Inmate Access to Hepatitis C Treatment 

“Tossing out a court order forcing Florida prisons to treat inmates suffering from the early effects of hepatitis C, an 11th Circuit panel Monday ruled that state prison officials are not constitutionally required to treat all inmates who suffer from the disease with expensive antiviral drugs. In a 2-1 decision, a three-judge panel of the Atlanta-based federal appeals court ruled that a treatment plan providing direct-acting antiviral drugs for only those hepatitis-C-infected prisoners who have developed significant liver damage from the disease is constitutional.” 

California bill bans insurers from discriminating against people living with HIV 

“Lawmakers in California have approved a bill that would prohibit life and disability income insurance providers from denying coverage to HIV-positive individuals.  

The Equal Insurance HIV Act, sponsored by Sen. Lena Gonzalez (D-Long Beach), passed the Senate 39-0 after being unanimously by the State Assembly as part of a larger omnibus bill. Under the bill, insurers must require informed consent before testing for HIV, and must treat HIV-positive individuals according to the same standards they would use in underwriting insurance for individuals without HIV. The bill also requires insurers to maintain “strict confidentiality” for personal information obtained through testing.” 

Transitions: In Appreciation of Retired Rear Adm. Sylvia Trent-Adams’ Service to HHS 

“Yesterday, Rear Adm. Sylvia Trent-Adams retired, bringing to a close a long and distinguished career in federal service and a tremendous commitment to ending the HIV epidemic globally and in the United States. While she is concluding this chapter of her life, she leaves behind a legacy in her work to advance our nation’s public health and improve access to care for poor and underserved communities, including those at risk for and with HIV.” 

How to Visually Track Data From the Plan to End the U.S. HIV Epidemic 

“You’ve probably read about “Ending the HIV Epidemic: A Plan for America,” the national initiative President Trump launched last year with the goal of reducing new HIV diagnoses in the country by 75% by 2025 and by 90% by 2030. Now you can actually track the plan’s progress using America’s HIV Epidemic Analysis Dashboard (AHEAD).” 

How Were HIV Care Services in South Carolina Interrupted By the COVID-19 Pandemic? 

“Results from a recent study out of South Carolina, which examined how its HIV service care continuum was affected by the coronavirus disease 2019 pandemic (COVID-19), show that more than a quarter (26%) of HIV clinics had to shut their doors completely and over half (56%) experienced partial service interruptions, reports the study in AIDS and Behavior.” 

Watch Federal Leaders Discuss National Ryan White Conference 

“During the 2020 Virtual National Ryan White Conference on HIV Care & Treatment, HIV.gov hosted conversations about current and planned activities  to further the Ending the HIV Epidemic: A Plan for America (EHE) initiative. The sessions featured conversations between Harold Phillips, Chief Operating Officer for EHE, and Senior HIV Advisor for the HHS Office of Infectious Disease and HIV/AIDS Policy, and HRSA and community leaders.”