Policy Updates: Hill Happenings and Administration Activities

By Mike Weir September 21, 2020

Hill Happenings

COVID-19 Relief and FY2021 Appropriations Updates

With the September 30th fiscal year deadline approaching, Congressional and Appropriations Committee Leaders are continuing negations on a continuing resolution (CR) to avoid a government shutdown. House Majority Leader Hoyer (D-MD-5) expects the CR on the floor this week. The CR is expected to delay the fiscal deadline through December 11th. The Coalition for Health Funding sent a letter to Congressional leaders urging them to pass the fiscal year 2021 funding bills as soon as possible, citing examples of the harmful impact CRs have on public health and research programs. 

Congressional and Administration leaders remain in a deadlock over another round of COVID-19 stimulus. Negotiations are expected to continue through September and possibly until after the November election. 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. 

U.S. Senate Democrats Request Response from PhRMA on Recent 340B Actions

Twenty-two Democratic Senators sent a letter to Pharmaceutical Research and Manufacturers of America (PhRMA) “regarding steps being taken by the industry to end denials of 340B pricing for drugs dispensed through contract pharmacies and demands for contract pharmacy claims data.” “Multiple drug manufacturers’ recent refusals “to provide 340B pricing for use in contract pharmacies are likely a violation of the law,” the lawmakers wrote to PhRMA President and CEO Stephen Ubl. Manufacturers’ related demands for 340B covered entities’ claims data, and threats to deny 340B pricing for drugs dispensed through contract pharmacies if entities fail to provide the data, “are also not tied to 340B compliance obligations,” the senators wrote.”

Administrative Activity

NOFO for Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments

The Centers for Disease Control and Prevention (CDC) released the Notice of Funding Opportunity (NOFO) announcement for PS21-2103: Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments. The purpose of this NOFO is to implement integrated viral hepatitis surveillance and prevention programs in states and large cities. Key strategies include viral hepatitis outbreak planning and response; and surveillance for acute hepatitis A, B, and C, and chronic hepatitis C. PS21-2103 is a five-year cooperative agreement with a total award amount of $341,020,000. The NOFO is composed of three core components: Component 1—Surveillance (Required), Component 2—Prevention (Required), and Component 3—Special Projects (Optional).

It is imperative that all eligible jurisdictions submit an application for the NOFO. NASTAD will continue to provide updates as additional information becomes available. Additional details about the NOFO are available via Grants.gov and on the CDC’s Division of Viral Hepatitis website.

Draft Federal STI Action Plan Open for Public Comment

The Department of Health and Human Services (HHS) Office of Infectious Disease and HIV/AIDS Policy (OIDP) released the draft Sexually Transmitted Infections National Strategic Plan 2021-2025 (STI Plan). All comments must be received by 5:00 PM ET on October 1, 2020. NASTAD previously submitted comments on the proposed STI Plan and will submit comments on the draft STI Plan.

CDC Announces New HIV Treatment Campaign Resources

The CDC has begun rolling out a new suite of HIV Treatment Works (HTW) products and materials as part of its Let’s Stop HIV Together campaign. The new campaign materials focus on reaching and supporting people with HIV and encouraging them to get in care, stay on medication, reduce their risks, and live well with HIV throughout their life.

The suite of new HTW products includes posters, print ads, palm cards, web banner ads, short- and long-form videos, and social media assets. Products have been created in English and Spanish and will be released in phases during the summer and fall of 2020. Materials can be accessed on the English and Spanish Let’s Stop HIV Together websites and YouTube channel , and will be promoted through paid and organic outreach across a variety of digital platforms.

NOFO PS21-2102: Comprehensive High-Impact HIV Prevention Programs for Community-Based Organizations

The CDC released the Notice of Funding Opportunity (NOFO) PS21-2102: Comprehensive High-Impact HIV Prevention Programs for Community-Based Organizations. Letters of Intent are due September 30, 2020 to CBOFOA@cdc.gov. The application deadline is November 20, 2020, 11:59 PM ET. For additional information, please visit the PS21-2102 website.

Dear Colleague: Shortage of STI Diagnostic Kits and Supplies

The CDC Division of STD Prevention issued a Dear Colleague letter offering guidance to prevention programs, including clinics, on approaches to prioritizing chlamydial and gonococcal testing when STI diagnostic test kits are in short supply. “There is a current shortage of STI test kits and laboratory supplies, most notably for chlamydia and gonorrhea nucleic acid amplification tests (CT/GC NAAT). The shortages affect multiple diagnostic companies, public health and commercial laboratories and impact several components of the specimen collection and testing process.”

HRSA/HAB Releases New Program Letter on COVID-19 and RWHAP Recipients 

The Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB) released a new program letter regarding the COVID-19 public health emergency and its impact on clinical and programmatic operations and workflows and, subsequently, on client services, performance measure data, and health outcomes.  This letter is located on the HAB website under Policy Notices and Program Letters

HHS HIV/AIDS Treatment Guidelines' Website Change 

HIV.gov, in collaboration with NIH’s Office of AIDS Research (OAR), launched clinicalinfo.HIV.gov, a website providing access to the latest HHS HIV treatment guidelines, HIV drug database, and HIV glossary. The Spanish language versions of these assets are also available on the site. 

The clinicalinfo.HIV.gov website will ensure that health care providers, public health partners, researchers, people affected by HIV, and the general public continue to have access to the latest, federally-approved HIV clinical treatment and prevention guidelines as well as related tools and information about HIV-related research. 

The new site features: 

  • Guidelines: The federally approved medical practice (clinical) guidelines for HIV/AIDS are developed by panels of experts in HIV care. The guidelines are available in multiple formats. Future updates to the guidelines will be released on this site. 
  • Glossary: The HIV glossary provides definitions of a broad range of HIV-related terms and offers an easily searchable interface. 
  • Drug database: This searchable database helps users find information on FDA-approved HIV/AIDS and opportunistic infection drugs as well as investigational drugs for HIV treatment and prevention.

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.

Resources

National HIV/AIDS and Aging Awareness Day (NHAAAD) was September 18. The CDC has provided resources in the NHAAAD Resource Center to help support awareness activities and testing events. 

Webinar: Hepatitis C Community Navigation Training and Toolkit Launch

Date & Time: September 29 from 1:00 – 3:00 PM ET

Join the launch of to launch the Hepatitis C Community Navigation Toolkit – Improving Care for People Who Use Drugs and Other Impacted Populations. In partnership with the International Network on Hepatitis in Substance Users (INHSU), join NASTAD and our colleagues, Nirah Johnson and Diana Muñoz from the New York City Department of Health and Mental Hygiene, for an interactive, virtual training experience designed to equip jurisdictions and partners with a hepatitis C model and navigation toolkit to explore lessons learned from the field, best practices, and how to make meaningful connections to navigate and get individuals linked to hepatitis C cure. The presenters will share how this toolkit can be practically applied to implement and strengthen hepatitis navigation programs.

Webinar: Determining the Best Monetary Value When Using Digital Technology

Date & Time: NEW DATE Wednesday, September 23, 2020 from 2:00 PM – 3:00 PM EDT

“This webinar, titled “Determining the Best Monetary Value When Using Digital Technology,” will feature the Kaiser Family Foundation as they explore the financial and funding components needed to support digital technology. Topics will include how EHE funding can support digital technology, the costs of certain aspects (e.g., buying an ad versus posting a message, traditional media versus digital media costs, etc.), and how to get the best value out of platforms (cost per share, audience reach, etc.).”

Webinar: Thinking Inside the Box - Implementing Self-Testing Strategies for HIV and STIs

Date and Time: Tuesday, September 22 from 3:00 – 5:00 PM CT

The era of COVID-19 is forcing us to adapt HIV and STI programming to ensure services remain accessible and desirable to the communities we are serving. Business as usual isn't the answer - we need to think inside the box. This two-hour webinar will feature speakers from national and local Chicago contexts talking about programs and research around self and home testing for HIV and STIs. The discussion will include other strategies to improve access to testing that can serve us during COVID-19 and long after.
Speakers from NACCHO (National Association of County and City Health Officials), BHOC (Building Healthy Online Communities), CALOR, Chicago House, Howard Brown Health and Lurie Children's Hospital of Chicago will share information on best practices and challenges. This webinar is hosted by AIDS Foundation Chicago.

Webinar: Systemic Racism, Disparities and Health: The Impact of COVID-19 on Latino Health

Date and Time: Wednesday, September 23, 2020 from 1:00 - 2:00 PM ET

The COVID-19 pandemic has highlighted the synergistic effects of systemic racism, combined with other factors, on the health of Latinos in the United States. Long-standing and ongoing social and economic inequities–including health literacy barriers, disproportionate employment as essential workers and limited access to employment and insurance benefits–leave Latinos at increased risk of contracting COVID-19 and having more severe cases of the disease. Latinos account for a disproportionate number of cases, are over 4 times as likely to be hospitalized than White Americans, and their share of COVID-19 related deaths is increasing. This webinar will highlight effective strategies to address the negative impact that systemic racism, the challenges of immigration, language barriers and other factors have on the health and well-being of Latinos. Experts will share actionable, solutions-based approaches that can make a difference at the state and community level.

Financial, food, and housing insecurity due to COVID-19 among at risk people living with HIV in a non-urban Ryan White HIV/AIDS program clinic 

“COVID-19 negatively impacts social determinants of health that contribute to disparities for people living with HIV. Insecurity of food, housing, and employment increased significantly in April 2020 among patients with lower incomes at a Ryan White HIV/AIDS program clinic in the Southern United States.”

Job Postings

Open Positions – Wisconsin

The Wisconsin Department of Health Services is currently seeking applicants for 3 supervisor positions within the (newly named) communicable disease harm reduction section. The positions are in Harm Reduction, STI, and HIV Prevention. These positions close on September 24, 2020.

Program Director (Public Health) – Washington, DC

NGA is looking to add a bright, resourceful, and organized Program Director to our Center for Best Practices team. This position reports to the Director or Deputy Director. The Program Director’s primary responsibilities will be to manage the public health portfolio, including supporting governors in their efforts to lead the public health response to the COVID-19 pandemic. Key issue areas will include preparing for and responding to public health emergencies, strengthening state public health capacity and partnerships, improving COVID-19 testing and contact tracing, addressing the spread of infectious diseases, advancing chronic disease prevention efforts, and supporting health equity and reducing health disparities for at-risk populations, among other population and public health issues. This position is open until filled.

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.

ManagerWashington, 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

Stigma is keeping LGBTQ+ Hispanic and Latino men from seeking HIV care: report

“Even as women break glass ceilings around them, some men remain trapped by a patriarchal ideal of manhood. "Machismo," in Spanish, is a strong or aggressive masculine pride often associated with a man's role in a traditional, heterosexual family. A new study by ViiV Healthcare and TCC Group finds that for gay and bisexual Latino/Hispanic men with HIV, that machismo can be a threat to their identity and lives.”

Pharmacists Play a Critical Role in Managing Changes to HIV Care During COVID-19

“Overall, cost to the health care system, to insurers, and to society are significant, especially considering the increasing number of people who require lifelong antiretroviral therapy and experience rising drug costs,” Patchett said. “In general, out-of-pocket costs for patients can be a barrier to the initiation and continuation of therapy. Us as pharmacists play such a critical role when it comes to navigating through these potential barriers and cost considerations for patients.”

Researchers explore the acceptability of delivering HIV-positive results by phone

“Stigma, healthcare access issues, and geographic isolation are major barriers to HIV testing and treatment. For a paper published in the journal AIDS and Behavior, a team led by CUNY SPH doctoral student Alexa D'Angelo analyzed interviews from 50 MSM about their experience receiving a positive HIV test result via phone through their participation in a research study that included remote HIV testing.”