Policy Updates: Hill Happenings and Administration Activities

By Mike Weir November 22, 2021

Hill Happenings

Build Back Better Act and Budget Reconciliation 

On November 19, House Democrats passed the $1.75 trillion Build Back Better Act (BBB), the broad-reaching social spending package that is being advanced through the budget reconciliation process. Following the release of the Congressional Budget Office’s (CBO) budget impact analysis which showed that drug price negotiation provisions in the BBB would save the government $160 billion over a decade, House Democrats settled months of negotiations and passed the BBB, advancing the package to the Senate.  

The House-approved version of the BBB includes funding for health programs, such as:  

  • $75 million for the Ryan White HIV/AIDS program, 
  • $7 billion for core public health infrastructure, 
  • And $50 million for mental health and substance use disorder professionals. 

However, it is unclear whether the lower chamber’s BBB will receive enough votes in the Senate to pass. Additionally, competing legislative priorities threaten to delay the BBB from prompt consideration in the Senate, such as the looming debt limit cliff and Fiscal Year 2022 (FY2022) spending negotiations. 

FY2022 Appropriations 

Lawmakers are rushing to advance federal spending packages ahead of a December 3 funding deadline afforded by the current continuing resolution (CR). On November 17, House Democrats issued a statement urging Republicans to end appropriations stonewalling and provide a counteroffer to begin spending negotiations in earnest. Democrats hope to extend another CR through the holidays in order to advance the BBB before finalizing FY2022 spending deals. However, interparty spending disputes threaten to extend BBB and FY2022 spending negotiations beyond the new year, raising the possibility of a months-long CR. NASTAD will continue to monitor the FY2022 appropriations process to advocate for the highest funding levels on behalf of HIV and hepatitis programs. 

Administrative Activity 

CDC Data Show Alarming Increase in Overdose Deaths 

On November 17, the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) released provisional drug overdose death data that show a 28.5 percent increase in overdose deaths from April 2020 to April 2021. For the first time in the nation’s history, 100,000 Americans died from drug overdose in a single year. The data release follows the launch of the Department of Health and Human Services (HHS) Overdose Prevention Strategy on October 27, which focuses on prevention, harm reduction, evidence-based treatment, and recovery support to stem the overdose crisis.  

FDA Reclassifies Hepatitis C Diagnostic Tests to Facilitate Regulatory Approval 

On November 19, the HHS Food and Drug Administration (FDA) issued Final Orders that reclassify hepatitis C (HCV) diagnostic tests from Class III to Class II, easing administrative burdens that complicate the marketing clearance process for the viral assays. In particular, the reclassification will allow diagnostic manufacturers to avoid the stringent FDA premarket approval process and instead seek marketing clearance through the 510(k) pathway. The policy change is intended to increase access to HCV tests, reducing testing disparities and making progress on the viral elimination goals laid out in the Viral Hepatitis National Strategic Plan

Resources

ESCALATE (Ending Stigma through Collaboration and Lifting All To Empowerment) 

ESCALATE is the first-of-its kind training and capacity-building initiative specifically designed to address HIV-related stigma that creates barriers at multiple levels of the HIV care continuum. ESCALATE works across multiple levels of the Ending the HIV Epidemic in the U.S. (EHE) initiative and the HIV National Strategic Plan (HIV Plan) to address internalized and externalized HIV-related stigma. Support is provided to agencies funded by the Health Resources and Services Administration HRSA) HIV/AIDS Bureau's (HAB) Ryan White HIV/AIDS Program (RWHAP). NMAC created ESCALATE to reflect its mission and relationship to the communities of people with HIV. 

NOFO: Expanding Syringe Services Programs Capacity to Respond to COVID-19 

Application Deadline: November 29, 2021 

In 2021, as part of the COVID-19 response under the American Rescue Plan Act and in partnership with the collaborative centers within the CDC, resources to support SSPs and expand their overall capacity to provide COVID-19 vaccination, education testing, and expanded services for additional adult vaccination were awarded to NASTAD and AIDS United. This one-year demonstration project, with expanded authority to extend its impact beyond the first year, aims to strengthen the capacity of SSPs to serve as critically essential access points for COVID-19 vaccination services, general COVID-19 response interventions and expanded adult vaccination services for people who use drugs. A centralized landing page describing the project with links to all three RFPs is available here.  

HRSA NOFO: Ending the HIV Epidemic - Primary Care HIV Prevention 

Application Deadline: Tuesday, December 14 

TA Webinar: Thursday, October 28 at 2 pm ET 

HRSA released the fiscal year (FY) 2022 Ending the HIV Epidemic - Primary Care HIV Prevention (PCHP) Notice of Funding Opportunity (HRSA-22-104). HRSA will invest approximately $50 million in health centers located in the targeted geographic locations where a majority of new HIV infections occur, as identified by the Ending the HIV Epidemic in the U.S. initiative. FY 2022 PCHP will support expanding HIV prevention services that decrease the risk of HIV transmission in underserved communities, focusing on supporting access to and use of pre-exposure prophylaxis (PrEP). Health centers with service delivery sites in the targeted geographic locations that did not receive FY 2020 PCHP or FY 2021 PCHP funding will be eligible to apply. Technical assistance (TA) resources are available on the PCHP TA webpage

Job Postings 

Epidemiologist Manager – Opioids & Emerging Drugs Unit – Lansing, Michigan 

This position is the unit manager for the Opioids and Emerging Drugs Unit and will be responsible for managing and directing staff and activities related to opioid and other drug overdose surveillance and epidemiology, including supporting the Michigan Overdose Data to Action (MODA) program. This unit manager works in cooperation with other unit managers in the Environmental Epidemiology and Analytics Section and in the Division of Environmental Health. 

HIV Surveillance Epidemiologist, Washington State Department of Health – Tumwater, WA 

The Washington State Department of Health’s (DOH) mission is to work with others to protect and improve the health of all people in Washington State. The Office of Infectious Disease (OID) Assessment Unit (AU) is responsible for statewide surveillance and investigation of HIV, sexually transmitted infections (STIs; primarily chlamydia, gonorrhea, and syphilis), and hepatitis C (HCV), and data and data system support for the HIV, STD, HCV, and Drug User Health (DUH) programs. In this position you'll contribute to the organization by assuring that the foundational activity of public health assessment is conducted in a timely and accurate way.  You'll contribute specifically to the mission of the Infectious Disease Assessment Unit by providing dataset preparation, document preparation and data analysis. These activities support core HIV Surveillance, the Ryan White Equity Project, and other OID programs. Currently, this position may be located anywhere within the State of Washington. Due to the COVID-19 pandemic, telework (mobile-work) is expected. When approved to return, the incumbent will work with their supervisor to identify an appropriate work schedule and balance, including telework and reporting to the Tumwater duty station for work activities. 

Field Service Consultant, Hepatitis C Disease Intervention Services Team – Washington State Department of Health 

Reporting to the Adult Viral Hepatitis Prevention Coordinator, these consultants will work with multi-county regions statewide and with local governmental and non-governmental stakeholders to make high-quality hepatitis C (HCV) prevention services available and accessible to residents of Washington State. These services include testing and screening, contact investigation and disease intervention services, and linkage to and retention in medical care. These consultants may provide direct service to members of the public who are diagnosed with or exposed to disease. This role also helps local public health and community organization program staff plan, develop, and implement activities to detect, treat, and prevent infectious disease. This announcement will be used to fill three (3) full-time permanent Health Services Consultant 3 positions located within the Division of Disease Control and Health Statistics, in the Office of Infectious Disease. Currently, this position may be located anywhere within the State of Washington. Due to the COVID-19 pandemic, telework (mobile-work) is expected. When approved to return, the incumbent will work with their supervisor to identify an appropriate work schedule and balance, including telework and reporting to the Tumwater duty station for work activities. 

Applications close November 30. 

Program and Administrative Assistant, Building Healthy Online Communities (BHOC) – Springboard HealthLab 

Springboard HealthLab is a brand-new organization, founded in 2021, with a clear goal: to support big ideas that can improve health equity. Springboard is focused on supporting projects to turn promising ideas into new ventures -- and then helping them find a permanent home. Building Healthy Online Communities (BHOC) is a consortium of public health organizations working in partnership with dating apps to improve sexual health outcomes for app users. We’re a small but mighty team that works on home testing and supporting anti-stigma and sexual health features on dating apps. The Program and Administrative Assistant, BHOC, supports the administrative work of BHOC’s programs and strategy. This is a 10 hours per week, part-time position. This is a 3- to- 6-month position dependent on funding availability, with the possibility of extension or expansion of hours. 

Ryan White Part B Program Director, Tennessee Department of Health – Nashville, TN 

The Ryan White Part B Program Director is responsible for developing and administering a budget of over $40 million, with multiple contracts, and comprehensive statewide planning involving persons living with HIV, providers, and other HRSA grantees, including service organizations and case managers. The position also oversees the AIDS Drug Assistance Program (ADAP) which provides Affordable Care Act health insurance to eligible clients or medications and ambulatory HIV care to those not enrolled in the Insurance Assistance Program. Other components include the Minority AIDS Initiative, an oral health program, and Housing Opportunities for Persons with AIDS (HOPWA). 

The position manages a team of 14 people and serves as the Ryan White Part B program spokesperson, liaison, and technical resource to grantees and other partners. The position is situated in, and works closely with, the surveillance and prevention programs for HIV, sexually transmitted infections, and viral hepatitis within the Communicable and Environmental Diseases and Emergency Preparedness Division at the Tennessee Department of Health. 

HIV/STD Director, Texas Department of State Health Services – Austin, Texas 

The Department of State Health Services (DSHS) is seeking an exceptional candidate to serve as the HIV/STD Director in the Texas TB/HIV/STD Section in Austin, TX. The HIV/STD Director works under the general direction of the Director of the TB/HIV/STD Section (THSS) of the DSHS. Performs advanced (senior-level) managerial work leading the day-to-day operations of the HIV/STD Prevention and Care Unit. These programs include statewide programs for HIV clinical and social services; the provision of medications for the treatment of HIV and other STDs; and HIV/STD prevention. To apply, register at Health & Human Services (HHS) Job Opportunities, and search for Job Posting Number #501910.  

Manager, Legal Research (NASTAD) – Remote/Washington, DC 

The Manager, Legal Research provides legal and policy research and analysis as part of NASTAD’s technical assistance and capacity building assistance. This position works closely with the Prevention, Policy & Legislative Affairs, and Health Systems Integration teams to support programmatic activities. This role works with the Director of Policy & Legislative Affairs and Senior Manager of Health Systems Integration, to implement key activities under NASTAD’s health systems legal and policy portfolio, including conducting public health legal research, synthesizing complex policy material, and supporting development of webinars, peer learning opportunities, and deliverables to support health department efforts to navigate federal, state, and local laws and policies 

Program Analyst: HIV, STI, & Viral Hepatitis Program - Harm Reduction (NACCHO)  

The Program Analyst will support projects and activities across NACCHO’s HIV, STI, and Viral Hepatitis program portfolio. In particular, the Program Analyst will support the implementation of projects designed to build local capacity and partnerships for harm reduction and the prevention and elimination of viral hepatitis. The ideal candidate will possess interest and experience in harm reduction and/or the prevention and elimination of viral hepatitis, as well as health department and harm reduction programming, public health policy, the provision of technical and capacity building assistance, monitoring and evaluation, partnership building, and project management. 

Senior Project Manager, HIV, Gender Affirming, and Integrated Care – New York City, New York 

Primary Care Development Corporation (PCDC), a nationally recognized 501(c)(3) community development financial institution (CDFI), catalyzes excellence in primary care through strategic community investment, capacity building, and policy initiatives to achieve health equity. The Senior Project Manager will be a member of the High Impact Prevention (HIP) project team and will work across the broader CQP practice. 

PCDC’s CDC-funded High Impact Prevention (HIP) program provides support to communities greatly impacted by HIV. With CDC and other national partners, the HIP Program enhances the expertise of the HIV prevention workforce – including health care providers and staff in local and state health departments and community-based organizations (CBOs) – to achieve the United States’ goal of substantially reducing the number of new HIV infections. The PCDC HIP Program serves the Northeast region of the US and the territories of Puerto Rico and US Virgin Islands. 

Public Health Specialist 2 – Anchorage, Alaska 

Working as a Public Health Specialist 2 (PHS II) HIV Prevention Coordinator in the HIV/STD Program offers you a rare opportunity to help develop and implement policies, protocols, procedures, and services around HIV prevention activities in the State. You will help assure that services are based on scientific findings and best practices that are adaptable to Alaska’s specific needs. You will provide expertise on HIV Prevention practices, including helping individuals to enter and stay in care, to both improve their health and reduce the likelihood of HIV transmission. Applications close November 22. 

New Hampshire, Department of Health and Human Services, Division of Public Health Services 

  • Public Health Program Manager/Ryan White Care Program Manager
    • #43569 (search Job ID 22642)
    • Supervises and monitors the NH Ryan White Human Immunodeficiency Virus (HIV) CARE Program (NH CARE Program) and the NH Tuberculosis Financial Assistance (TBFA) Programs with responsibility for coordinating all aspects of program services and developing goals, objectives and performance improvement measures for a statewide continuum of TB and HIV care. 
  • Infectious Disease Care Coordinator
    • #9T3153(search Job ID 22634) 
    • Reviews, modifies and implements program policies and procedures related to prevention of transmission of human immunodeficiency virus (HIV) and sexually transmitted diseases (STD), hepatitis C (HCV), COVID-19, and other infectious diseases among high-risk populations. 
  • Infectious Disease Care Coordinator
    • #9T3152 (search Job ID 22631) 
    • Reviews, modifies and implements program policies and procedures related to prevention of transmission of human immunodeficiency virus (HIV) and sexually transmitted diseases (STD), hepatitis C (HCV), COVID-19, and other infectious diseases among high-risk populations. 

Wyoming Department of Health, Public Health Division, Communicable Disease Unit 

  • Communicable Disease Unit Surveillance Program Manager – Cheyenne, Wyoming 
  • The Wyoming Department of Health, Public Health Division, Communicable Disease Unit is seeking a Communicable Disease Surveillance Program Manager for Cheyenne. This position will serve as the Communicable Disease (CD) Surveillance Program Manager and senior epidemiologist for the Communicable Disease Unit. This position oversees public health surveillance of four disease areas (HIV, STD, TB, and Viral Hepatitis).  This position will monitor disease trends and utilize surveillance data to coordinate public health activities.   
  • Communicable Disease Epidemiologist – Cheyenne, Wyoming 
  • This position will serve as the Communicable Disease AIDS Drug Assistance Program (ADAP) Coordinator, Wyoming TB Controller, and Disease Intervention Specialist (DIS) for the Communicable Disease (CD) Treatment Program.  Assist in outbreak response to ensure the safety of Wyoming residents; by interviewing cases for exposure information, updating news outlets on the progress of outbreak control, analyzing exposure data utilizing epidemiological and statistical methods. 

Hepatitis Surveillance Data Analyst – New Orleans, Louisiana 

This position is responsible for the data analysis activities for the Louisiana Office of Public Health STD/HIV/Hepatitis Program (SHHP), in the Hepatitis Surveillance unit. Data utilized for Hepatitis Surveillance activities include Hepatitis laboratory data, Case Report Forms, Provider Report Forms, Linkage to Cure data, investigation data, Medicaid data, and data from related sources and programs. This position will implement and coordinate data analysis activities to monitor and evaluate progress toward meeting hepatitis elimination within the state. All activities must be completed in accordance with the security and confidentiality guidelines required by the Centers for Disease Control and Prevention (CDC) and SHHP. 

Assistant Commissioner - Health Department – Baltimore, 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.    

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.  

News Bulletin 

These States Are Falling Further Behind in Providing HIV PrEP 

“We know that transgender and gender-nonconforming people — particularly Black and Brown transgender women — are disproportionately affected by HIV. While prevalence for adults in the United States is less than 0.5%, prevalence among TGNC communities is 9.2%. Looking at these numbers, we must also recognize that this is an estimate. For reasons related to safety and access, the information and data that we have on transgender communities is often limited. As the population of openly queer and transgender people increases, we must recognize that these numbers are more drastic than even this current dataset.” 

A Closer Look at the Remaining Uninsured Population Eligible for Medicaid and CHIP 

“Recent policy attention has focused on efforts to reduce the number of uninsured people in the U.S. by expanding eligibility for coverage assistance, including enhanced premium subsidies in the Affordable Care Act (ACA) Marketplace and filling the Medicaid ‘coverage gap.’ A new KFF analysis shows that a majority of the 27.4 million people who remained uninsured in 2020 already are eligible for financial assistance for coverage through Medicaid/the Children’s Health Insurance Program (CHIP) or the Marketplace, suggesting that policies in the Build Back Better Act as well as outreach for the current ACA open enrollment period could help reduce that number.” 

Schumer-McConnell dial down the debt ceiling drama 

“Senate Majority Leader Charles Schumer (D-N.Y.) and Senate Minority Leader Mitch McConnell (R-Ky.) are dialing down the drama as they try to find an escape hatch from another high-stakes fight over the debt ceiling. Congress has until roughly Dec. 15 to raise the nation’s borrowing limit, according to Treasury Secretary Janet Yellen, who has warned that the mid-December date is when the government will no longer be able to fully pay its bills.“