Ending the HIV Epidemic Newsletter
NASTAD, in collaboration with the National Association of County and City Health Officials (NACCHO), the Council of State and Territorial Epidemiologists (CSTE), and the National Coalition of STD Directors (NCSD), distributes a monthly newsletter to Phase 1 Ending the HIV Epidemic: A Plan for America (EHE) jurisdictions. The newsletter informs recipients of EHE-related policy updates, communications from federal partners, success stories, and other related EHE information. As the CDC PS19-1906 National Partner and HRSA-20-089 Systems Coordinator Provider recipients, NASTAD also launched an EHE website to house programmatic updates, share strategies and outcomes from Phase 1 jurisdictions, and connect health departments with the community. For questions, comments, or content contributions, please contact Mike Weir.
Hill Happenings
Fiscal Year 2023 (FY2023) Appropriations
Facing an end-of-year deadline, lawmakers are working to resolve spending disputes and pass a fiscal year 2023 (FY2023) appropriations omnibus bill. On December 15, Congress approved a short-term continuing resolution (CR) (H.R.1437) to extend current federal funding through December 23 to provide more time for appropriators to complete negotiations on a FY2023 spending package. While top appropriators from both parties favor finishing the appropriations bills before 2023, Republicans are emboldened to delay spending discussions until the 118th Congress begins its session in January, after which they will control the majority in the House of Representatives and have more negotiating power. However, the power split between the two chambers in the next Congressional session threatens further entrenchment of partisan budget disagreements and raises the likelihood that appropriators will default to a year-long CR if negotiations drag into the new year. NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs.
NASTAD Calls on Congress to Fund National mpox Response
On December 5, NASTAD joined a coalition of public health and LGBTQ organizations and called on Congress to fund the national mpox response. The coalition builds on the White House’s supplemental appropriations request and highlights additional mpox funding needs, including resupplying the national vaccine stockpile for smallpox, building capacity at state and local health departments, and funding community health centers, Ryan White, and STI clinics. The emergency supplemental funding is needed to ensure that providers can continue to address mpox as the national public health emergency winds down.
Administration Updates
President Biden Signs Respect for Marriage Act Into Law
On December 13, President Biden signed the Respect for Marriage Act (RMA) (H.R. 8404), a historic act that guarantees the same freedoms and rights to LGBTQ+ and interracial marriages that are afforded to all other marriages, into law. NASTAD applauds the passing of the RMA because it guarantees marriage equality and provides millions of LGBTQ+ and interracial couples with the certainty that their marriages will remain legal. The bipartisan RMA reaffirms the status quo set by the Supreme Court’s landmark decisions in United States v. Windsor (2013) and Obergefell v. Hodges (2015) and protects couples by providing federal benefits to all married couples in every state. Click here to read NASTAD’s statement on the passage of the RMA.
ONDCP Launches First-of-its-Kind National Data Dashboard for Non-Fatal Overdoses
On December 8, the White House Office of National Drug Control Policy (ONDCP) launched a first-of-its-kind national data dashboard of non-fatal opioid overdoses across the country. The dashboard was spurred by the Biden Administration’s National Drug Control Strategy, which calls for developing and strengthening the nation’s data systems to reach people at-risk of an overdose, and expand access to treatment for substance use disorder and high-impact harm reduction interventions like naloxone. The ONDCP Nonfatal Opioid Overdose Dashboard is informed by a derivation of clinical and patient characteristics within the National EMS Information System (NEMSIS) maintained by the National Highway Traffic Safety Administration (NHTSA).
USPSTF Updates Grade A Recommendation for HIV PrEP
On December 13, the United States Preventive Services Task Force (USPSTF) issued a draft recommendation statement for HIV pre-exposure prophylaxis (PrEP), which will replace the original June 2019 recommendation statement upon being finalized in 2023. USPSTF designated an “A” grade for PrEP, recommending that clinicians prescribe the prophylactic antiretroviral therapy to persons who are at increased risk of HIV acquisition to decrease the risk of acquiring HIV infection. The draft statement is consistent with the 2019 recommendation, but includes additional evidence on new formulations of PrEP, including long-acting injectable PrEP. The opportunity for public comment on USPSTF’s Draft Recommendation Statement expires on January 17, 2023 at 11:59 PM ET. NASTAD will prepare comments and encourages our members and other partners to submit their own comments.
NIAID Announces Acting Director to Replace Retiring Dr. Fauci
On December 9, the National Institutes of Health (NIH) announced that Dr. Hugh Auchincloss will serve as Acting Director of the National Institute of Allergy and Infectious Diseases (NIAID), filling in for the role occupied by Dr. Anthony Fauci for nearly four decades. Auchincloss currently serves as NIAID’s principal deputy director since 2006, overseeing the institute’s strategic plan and heads an internal group to develop its initiatives.
HRSA NOFO: Ending the HIV Epidemic - Primary Care HIV Prevention (PCHP)
- Deadline: January 17, 2023
HRSA released the FY2023 Ending the HIV Epidemic - Primary Care HIV Prevention (PCHP) notice of funding opportunity (NOFO, HRSA-23-025). HRSA will make approximately $50 million available for up to 140 health centers located in the targeted geographic locations where there are a substantial amount of new HIV infections.
FY 2023 PCHP will support expanding HIV prevention services that decrease the risk of HIV transmission in underserved communities. This funding will focus on increasing HIV testing, PrEP prescriptions, and linkage to HIV care and treatment. It is part of HHS’ Ending the HIV Epidemic in the U.S. initiative, which aims to reduce the number of new HIV infections in the U.S. by 90% by 2030. Health centers with service delivery sites in the targeted geographic locations that did not receive FY 2020, FY 2021, or FY 2022 PCHP funding, are eligible to apply. View the FY 2023 PCHP one-pager (PDF) for applicants. Visit the FY 2023 PCHP technical assistance (TA) webpage to access the NOFO, application aids, and other resource.
CDC NCHHSTP NOFO: PS-23-0009: Advancing Policy as a Public Health Intervention to Reduce Morbidity, Mortality, and Disparities in HIV, Viral Hepatitis, STDs, and Tuberculosis
- Deadline: February 1, 2023
The Center for Disease Control and Prevention’s (CDC) National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) is thrilled to announce a new funding opportunity. This two-component funding opportunity aims to strengthen the ability of leaders who make decisions in public health to identify and implement evidence-based policy interventions. The funding opportunity features two distinct components:
- Leverage legal epidemiology methods to examine laws and policies over time and perform critical analyses to understand the effect of laws and policies on health and economic outcomes.
- Provide robust legal and policy technical assistance (TA) to support leaders who make decisions in public health as they navigate complex issues unique to their jurisdiction and proactively create publicly accessible TA tools and resources.
CDC RFA: Public Health Crisis Response Cooperative Agreement
- Deadline: February 12, 2023
The CDC is activating CDC-RFA-TP22-2201 Public Health Crisis Response Cooperative Agreement to support state and local public health mpox response efforts. CDC will award up to $16 million to select jurisdictions on the approved but unfunded (ABU) list for CDC-RFA-TP22-2201. Funding will be prioritized for jurisdictions reporting the highest numbers of cases during October 2022. Funding is intended to address urgent needs and to implement monkeypox response related activities including efforts to increase vaccine accessibility and uptake, case and cluster investigation, surveillance, testing, communication, education, and outreach. Additional information, including supplemental funding guidance is forthcoming.
Resources
NASTAD RFP: Strengthening Syringe Services Programs (SSP) through Direct Program Funding
- Deadline: January 20, 2023, at 11:59 PM EST
NASTAD and project partners, VOCAL-NY and University of Washington (UW), are excited to announce a CDC-supported funding opportunity: Strengthening Syringe Services Programs (SSP) through Direct Program Funding. This five-year project aims to strengthen the capacity of SSPs through direct program funding, provided through NASTAD, to continue serving as critically essential access points for core syringe and safer drug use supplies, overdose prevention information and materials, and a range of services for PWUDs such as adult vaccination services, HIV and viral hepatitis testing and linkage to care services, and referral and navigation efforts. Click here to view the RFP TA webinar recording.
DOJ Press Release: Justice Department Secures Agreement with Alabama Medicaid to Remove Unlawful Sobriety Mandate for Health Care Access
“The Justice Department announced today that it has secured a settlement agreement with the state of Alabama’s Medicaid Agency (Alabama Medicaid) under the Americans with Disabilities Act (ADA) to ensure that Alabama Medicaid recipients with Hepatitis C (HCV) who also have a substance use disorder have equal access to medications to treat their hepatitis.”
MPV Resources
The CDC continues to respond to an outbreak of MPV. NASTAD has created a monkeypox microsite that will be updated as current information and resources are released. If your jurisdiction has resources that can be shared on the microsite, please send them to communications@NASTAD.org.
NASTAD: HIV Criminalization, Data Privacy, and the Role of Health Departments Consultation
NASTAD is hosting a consultation on HIV Criminalization, Data Privacy and the Role of Health Departments in Seattle, WA on February 28, 2023. The consultation will provide peer-to-peer information sharing on how health departments have engaged in HIV criminalization modernization reforms in their jurisdictions, identify engagement opportunities with law enforcement partners, including prosecutors and identify opportunities to safeguard public health data. Participation in this consultation is open to CDC PS20-2010 Component A Phase One health department staff. NASTAD can provide some travel support to one person per jurisdiction. To register for this meeting, please click here. Please email eschreiber@nastad.org with questions.
NACCHO: Invitation to Local Health Official EHE Convening
NACCHO is convening local health officials/directors and local health department EHE leadership to provide updates on progress from the EHE initiative and to highlight the role of health leaders in addressing challenges to implementing equitable, effective EHE strategies.We are particularly encouraging attendance by local health officials / health directors for this invitation-only event. Invitations have been distributed to local health officials and EHE staff in the Phase I jurisdictions, but the support of EHE staff in facilitating our outreach to local health department from your jurisdictions is greatly appreciated. Please email HIV@naccho.org for more information or to RSVP for this event.
This event is an opportunity to learn how jurisdictions can leverage EHE to advance health equity and whole-of-society approaches to the syndemics of HIV, COVID-19, mpox, and more. By the end of the convening, local health official participants will have a fresh understanding of the importance of the EHE initiative in their counties and leave with a plan for next steps to convene colleagues from within and beyond the HIV field to promote administrative processes and collaborations supportive of EHE implementation.
NCSD: Introducing the STI/HIV Interview Series
The National Network of Disease Intervention Training Centers (NNDITC) is now offering learning collaboratives on successful interviewing techniques for the collection of critical information from people diagnosed with STI/HIV. Learn more & register for the STI/HIV Interview Series here: https://nationalditc.org/training/learning-collaboratives/.
NCSD Resource
The National Network of Disease Intervention Training Centers is now offering new Learning Collaboratives! Join us for a series of interactive learning collaboratives to build skills and learn from your colleagues. Information is available for current and upcoming courses at nationalditc.org.
CSTE: 2023 Annual Conference – Call for Abstracts
The Call for Abstracts for the 2023 Council of State and Territorial Epidemiologists (CSTE) Annual Conference in Salt Lake City, Utah is now open. The deadline for abstract submission is Thursday, January 5, 2023 at 11:59 pm EST. Submit an abstract today!
HIV Cluster Detection and Response Learning Collaborative: Apply Now
CAI’s Technical Assistance Provider – innovation network (TAP-in), together with the New York State AIDS Institute’s Center for Quality Improvement and Innovation (CQII), is launching an HIV Cluster Detection and Response Learning Collaborative. This Collaborative aims to improve HIV cluster detection and response efforts to reduce the number of new HIV diagnoses and better link people newly diagnosed with HIV to care. Join other EHE jurisdictions funded by HRSA to participate in a 15-month learning collaborative that will build community partnerships, share lessons learned from other jurisdictions, discover the latest evidence-based practices, and provide strategies for updating HIV cluster and detection plans. For more information and to apply.
EHE Community of Practice (CoP) on NASTAD’s Online Technical Assistance Platform (OnTAP)
NASTAD and NACCHO manage a virtual Community of Practice (CoP) to support peer-to-peer learning and mentorship for EHE jurisdictions. The EHE CoP is housed on NASTAD’s online technical assistance platform (OnTAP) for those leading their jurisdictions' EHE efforts at local and state health departments to share resources and news, discuss challenges and successes, access notes from monthly EHE Office Hours calls, and request technical assistance (TA). If you need access to OnTAP, please contact Krupa Mehta.
Ending the HIV Epidemic Jurisdictional Directory
NASTAD maintains an Ending the HIV Epidemic (EHE) Jurisdictional Directory. Health department staff members are encouraged to update their jurisdiction’s information using this brief form.
Jurisdictional Map of Phase 1 EHE Final Plans
NASTAD released a resource that provides access to Phase 1 EHE websites and plans. Please email Krupa Mehta additional Phase 1 EHE plans for inclusion in this resource, as well as any changes to existing plans.
Job Postings
EHE Project Coordinator – Jacksonville, FL
The EHE Project Coordinator will be responsible for coordination, monitoring and oversight of Ending the HIV Epidemic efforts in the Jacksonville Ryan White Part A Transitional Grant Area (TGA) servicing Duval, Clay, Nassau and St. Johns County. The Coordinator, reporting to the Ryan White Program Manager, will be responsible for coordination of project activities, support of project-specific meetings, and development and implementation of community engagement strategies. The EHE Coordinator, in collaboration with key stakeholders, will be responsible for the implementation of the required strategies that align with the four pillars of the national Ending the HIV Epidemic plan as well as activities and outcomes associated with the plan. The EHE Coordinator will work closely with STD/HIV/Hepatitis Program (SHHP) staff involved in coordinating Ending the HIV Epidemic activities, key constituents in the Jacksonville TGA, HIV prevention and care providers as well as other partners.
Manager, Surveillance and Prevention Integration – NASTAD
The Manager, as part of NASTAD’s prevention team, supports the organization’s capacity to provide technical assistance (TA) to health departments (HDs) and community-based organizations (CBOs) to implement high-impact HIV prevention programs. The position works primarily on NASTAD’s CDC-funded Capacity Building Assistance (CBA) program to provide TA to HDs implementing CDC PS18-1802, and to CBOs implementing CDC PS21-2102 in the South region, and to support the implementation of the National HIV Cluster and Outbreak Detection and Response Implementation Learning Collaborative (CDR ILC).
Manager, Legal Research – NASTAD
The Manager, Legal Research provides legal and policy research and analysis as part of NASTAD’s technical assistance and capacity building assistance work. This position will 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.
News Bulletin
Hundreds of incarcerated people are dying of hep C — even though we have a simple cure
“STAT’s investigation found that 1,013 people died of hepatitis C-related complications in states’ custody in the six years after the first cure, a Gilead antiviral drug called Sovaldi, hit the market in late 2013. This tally, based on an analysis of 27,674 highly restricted death records, has never before been reported. Many of those 1,013 people were not serving life sentences; they would likely have had the chance to return home, reapply for jobs, and reconnect with parents, spouses, and children — or, in Ritchie’s case, his one grandchild, Gabe. Many should not have died...Public health experts say it’s possible to cut hepatitis C deaths to virtually zero, and effectively eliminate the virus as we’ve done with smallpox or polio. Francis Collins, the White House science adviser and former longtime director of the National Institutes of Health, called STAT’s findings ‘unacceptable.’”
Suffering Endures on the Other Side of the Mpox Curve
“While the declining epidemic curve is worth celebrating, the virus remains with us, with sometimes deadly consequences for those facing varying intersections of inequity. A recent CDC report showed that the people hospitalized with mpox, with the worst and most severe outcomes, are Black, living with advanced HIV, and experiencing homelessness. This is the profile of who's suffering on the other side of the curve.
I believe that when public health emergencies end, they should come with a community-informed national plan focused on how to prevent the same level of suffering in the future. Our country is willing to tolerate way too much morbidity and mortality with infectious disease outbreaks -- as seen with COVID-19 -- and the way we respond when certain communities like LGBTQIA+ people of color are disproportionately impacted speaks volumes to our values. It is shameful that the U.S. Congress still has not passed one new dollar in funding to address the outbreak.”
CMS Proposes Major Changes to Prior Authorization
“Under a new proposed rule, the Centers for Medicare & Medicaid Services (CMS) will require some payers to automate their prior authorization processes, respond more quickly, provide reasons for denials, and publicly report certain metrics, the agency announced on Tuesday. If implemented, the proposed rule would mandate that "impacted payers" share prior authorization decisions within 72 hours for expedited requests and within 7 calendar days for "non-urgent" requests and require payers to include specific reasons for denials.”
U.S. FDA to review Emergent's OTC opioid overdose drug on priority
“Contract drugmaker Emergent Biosolutions said on Tuesday its over-the-counter nasal spray as a treatment for suspected opioid overdose would be reviewed on a priority basis by the U.S. health regulator. Emergent is seeking the U.S. Food and Drug Administration's approval for a prescription-free sale of its nasal spray, Narcan, which is already cleared for the treatment of opioid overdose in the country. The agency will make its decision by March 29 and its priority review status puts Narcan on track to become the first naloxone-based drug to be sold over the counter, Benchmark analyst Robert Wasserman said.”