Ending the HIV Epidemic Newsletter
NASTAD, with collaboration from 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 community. For questions, comments, or content contributions, please contact Mike Weir.
Hill Happenings
Fiscal Year 2022 Appropriations and the Build Back Better Act
Democrats on the Hill kicked off the new year on January 3, hoping to build momentum after a gridlocked second half of 2021. Democrats punted negotiations on the Build Back Better Act (BBB) (H.R. 5376), President Biden’s broad-reaching social spending package that was being advanced through the budget reconciliation process, due to intransigent opposition from Senator Joe Manchin (D-WV). Without achieving inner-party consensus and receiving no Republican support, Democrats are unable to advance the BBB via a simple majority, and are putting the ambitious legislative package on hold.
With the BBB paused, Democrats are pivoting their focus to voting rights and advancing a Fiscal Year 2022 (FY2022) spending package ahead of the February 18 federal funding deadline afforded by the current continuing resolution (CR). Without an agreement on topline numbers, however, spending negotiations have not gone far in the Senate. Republicans are threatening to oppose any spending package and force a full-year CR to fund the government unless Democrats agree to advance a spending omnibus that is clear of controversial policy riders.
On December 22, NASTAD and the AIDS Budget and Appropriations Coalition (ABAC), a workgroup of the Federal AIDS Policy Partnership (FAPP), issued a letter to Democratic leadership requesting an increase in funding for domestic HIV, hepatitis, STI, TB and related programs in the final FY2022 appropriations package. The coalition urged appropriators to adopt the highest funding level proposed in either the House or Senate’s appropriations bills. Additionally, the coalition called on Congress to pass a bona fide appropriations omnibus in order to avoid issuing a full-year CR amid gridlocked spending negotiations, highlighting the detrimental programmatic interruptions that result from stopgap spending patches.
NASTAD will continue to monitor the FY2022 appropriations and budget reconciliation process to advocate for the highest funding levels on behalf of HIV and hepatitis programs.
Senate HELP Committee Advances FDA Commissioner Nominee
On January 13, the Senate Committee on Health, Education, Labor and Pensions (HELP) advanced the nomination of Robert Califf to serve as FDA commissioner. The HELP committee approved the nomination by a vote of 13-8, advancing the nomination to the full Senate floor for a final confirmation vote. Califf attended a confirmation hearing on December 14, 2021, where he appeared to garner enough bipartisan support to advance his nomination. President Biden announced Califf’s nomination on November 12 after a months-long delay in filling the FDA Commissioner role.
Administration Activities
FDA Approves First Long-Acting Injectable PrEP
On December 20, the U.S. Food and Drug Administration announced that it approved the first long-acting injectable treatment for HIV prevention. Apretude (cabotegravir extended-release injectable suspension) is approved for use in “at-risk adults and adolescents weighing at least 35 kilograms (77 pounds) for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV.” Policymakers anticipate that the availability of a long-acting injectable option will increase PrEP uptake and adherence. Apretude was granted a Priority Review and Breakthrough “Therapy designation. The FDA granted the approval of Apretude to Viiv.
HRSA Announces Carole Johnson to Serve as Administrator
On December 17, the Health Resources and Services Administration (HRSA) announced that Carole Johnson will serve as the agency’s new Administrator, replacing Acting Administrator Diana Espinosa. Johnson is currently the White House COVID-19 Response Team Testing Coordinator. Johnson boasts an extensive public health background, including serving as the Commissioner of the New Jersey Department of Human Services and the public health lead for the White House Domestic Policy Council under the Obama administration, where she oversaw HRSA issues.
HRSA HAB Encourages RWHAP Providers to Provide Gender Affirming Care for Trans and Gender-nonconforming PLWH
On December 16, the HRSA Associate Administrator of the HIV/AIDS Bureau (HAB) issued a letter encouraging Ryan White HIV/AIDS Program (RWHAP) service providers to leverage existing RWHAP infrastructure to support gender-affirming services within allowable RWHAP parameters. The letter reaffirms the importance of providing culturally-affirming health care and social services to the transgender community as a key component to improving the lives of transgender people with HIV and eliminating health disparities. Additionally, the letter provides guidance for RWHAP programs on the allowable use of funds to support gender affirming care across various core medical and support service categories.
HRSA HAB Releases Inaugural EHE Data Report
On December 15, HRSA HAB released the inaugural Ending the HIV Epidemic in the U.S. Initiative (EHE) Data Report, 2020. The report features national-level aggregate data submitted by HAB EHE-funded service providers during the 2020 calendar year, including the number of new and estimated re-engaged clients receiving specific services and those who were prescribed antiretroviral therapy (ART) in 2020. The data collection reporting effort will support HRSA HAB and policymakers to monitor progress toward EHE initiative goals.
CDC Develops Program Guidance for PS18-1802 Grantees to Fund PrEP Ancillary Services
In December 2021, the Centers for Disease Control and Prevention (CDC) developed program guidance for PS18-1802 grantees affording greater flexibility to fund PrEP ancillary services as a payer of last resort. The CDC Division of HIV Prevention (DHP) issued a grantee letter and guidance document encouraging grantees to leverage domestic HIV prevention funding to support PrEP ancillary services. Recipients of PS18-1802 may provide no more than 15 percent of the overall award amount to support PrEP ancillary support services.
USPSTF Posts PrEP Final Research Plan
On January 13, the United States Preventive Services Task Force (USPSTF) posted a final research plan for an updated PrEP for HIV Prevention recommendation. The research plan will guide the USPSTF’s updated analysis of PrEP as a preventive measure for HIV, which received a Grade A recommendation in 2019. The research plan is expected to incorporate the latest biomedical advances in PrEP, such as the availability of new long-acting injectable PrEP. The finalized research plan incorporates public comments that were submitted in response to the draft research plan.
Resources
Systems Coordination Provider Project
NASTAD Systems Coordination Provider (SCP) staff continues to participate in HRSA Ending the HIV Epidemic Programmatic Site Reviews through February 2022. NASTAD SCP staff attended four reviews in December. The site reviews serve as an opportunity for the SCP and CAI, the Technical Assistance Provider (TAP), to provide an overview of the SCP and TAP-in projects and hear directly from jurisdictions about their EHE program and activities.
NASTAD SCP newly launched EHE mentoring program is a three-to-six-month intensive strategy to assist newly hired EHE Managers and Coordinators at health departments in EHE jurisdictions. The program will focus on developing leaders, identify emerging talent, and streamline processes to improve systems operations and ensure data-driven service outcomes. For additional information, please contact Darion Banister.
Social Determinants of Health (SDH) Monthly Highlight
NASTAD is conducting an ongoing monthly series that highlights the intersection of HIV prevention and care with a specific social determinant of health (SDH). January’s topic is Professional Development and Educational Opportunities (outside of college). You can look forward to more information about this being released later this month. In the meantime, please reference these resources on this topic:
Flashback: In October 2021, NASTAD and the National Network to End Domestic Violence (NNEDV) hosted a webinar, Positively Safe: Addressing the Intersection of HIV and Domestic Violence. The recording and slides can be viewed here.
NASTAD Status-Neutral Webinar Series
NASTAD is hosting a four-part webinar series, “Employing Status-Neutral Approaches to End the HIV Epidemic”. The series will focus on status-neutral approaches for CDC and HRSA funded health departments working to end the HIV epidemic.
The first webinar in the series, “Status-Neutral Approaches 101” was held on December 14. The recording and slides can be viewed here.
The second webinar in the series, “Trauma-Informed Approaches to HIV Services” was held on January 14. The recording and slides can be viewed here.
The third webinar in the series, “Addressing Social Determinants of Health through a Status-Neutral Lens” will be held on Tuesday, February 8, 2022, from 2:00 PM – 3:30 PM EST. You can register for the webinar here.
CAI Webinar: Status-Neutral in NYC, Texas, and Detroit: Expanding the Continuum to Improve Patient Experiences
Date and Time: Thursday, January 27, 2022, from 12-1:00 PM ET
TAP-in’s next webinar is Thursday, January 27, 2022, from 12-1 pm EST, titled Status-Neutral in NYC, Texas, and Detroit: Expanding the Continuum to Improve Patient Experiences. This webinar will review the concept of status-neutral and provide examples of real-world applications from jurisdiction peers and leaders. Examples include addressing social determinants of health as part of HIV service delivery; normalizing conversations about sexual health; and addressing stigma by adopting status neutral in communications about services. Please visit CAI Global to register.
CDC MMWR: Trends in and Characteristics of Overdose Deaths Involving Illicitly Manufactured Fentanyls (IMFs)
CA PrEP Guidance for Insurers: Preventive Services Coverage for HIV Preexposure Prophylaxis (PrEP) with Provider-Administered Antiretroviral Drug Therapy
On December 29, the Insurance Commissioner for the state of California issued a bulletin notifying health plans regulated by the by the California Department of Insurance that they are required to cover all PrEP drugs and related clinical services without cost sharing – including injectable PrEP.
CDC Foundation Funding Opportunity
The CDC Foundation recently released two Request for Proposals (RFPs) that will support HIV Self-Testing programs by building the capacity of community based organizations working with populations within 57 priority jurisdictions. The CDC Foundation will contract with a regional or national HIV-prevention partner to provide capacity-building support to 75 community-serving organizations that are starting or enhancing their HIV Self-Testing programs across the U.S.
- Click HERE for the HIV Prevention Technical Assistance Provider Funding Opportunity (proposals due by Monday, Jan. 24, 2022)
- Click HERE for Community-Serving Organizations Funding Opportunity (proposals due by Monday, Feb. 7, 2022)
Funding Opportunity on HIV and Aging
HRSA HAB has released three notices of funding opportunities (NOFOs) related to HIV and aging. Aging with HIV is an important matter within the Ryan White HIV/AIDS Program (RWHAP). Nearly half of people served by the RWHAP were aged 50 years and older in 2019. The health care and psychosocial concerns change as people with HIV grow older and their health care and social services providers need to respond differently. All funded organizations will work collaboratively to achieve the purpose of the NOFOs. Applications for the three NOFOs are due January 25, 2022.
2022 Model and Innovative Practice Award Applications Now Open
NACCHO’s annual award cycle for local health departments is now open, and local HIV programs are encouraged to use this opportunity to share about your ongoing Ending the HIV Epidemic work. In particular, the Innovative Practice Awards recognize adaptations and innovations created in response to the COVID-19 pandemic and related challenges such as changes in staffing structures and outreach practices. These awards are vital to highlighting and sharing promising practices at the local level. Please consider this opportunity to showcase your teams’ hard work and/or share this opportunity with your local health department partners! For questions, contact model-practices@naccho.org and CC ehe@naccho.org.
NACCHO HIV, STI, and Viral Hepatitis Team is Hiring
Director, HIV and Harm Reduction
NACCHO is excited to recruit for a director to oversee HIV and Harm Reduction projects within the HIV, STI, Viral Hepatitis portfolio. The director will lead a fantastic team and projects aimed to strengthen the capacity of local health departments and their partners by providing learning opportunities, developing tools and resources, and providing technical support. An ideal candidate will have familiarity with national HIV programs, funders and partners, experience working with HIV programs or harm reduction programs at the local level, and experience managing a diverse portfolio of projects.
Join NACCHO and NCSD to Discuss 340B Drug Pricing Program
Would your health department benefit from understanding and utilizing the 340B Drug Pricing Program? Join NACCHO and the National Coalition of STD Directors (NCSD) on January 25, 2022 at 2:00 PM ET as we explore the basics and beyond of 340B. Learn how the 340B Drug Pricing Program can support health department operations—saving money, generating revenue, and expanding sexual health services. Interested? Register here.
CSTE: SAS e-Learning Training Opportunity
The application to receive SAS e-Learning training through the CSTE HIV Subcommittee is now open! Please click here to access the 2022 CSTE HIV Subcommittee SAS e-Learning Training application. If you have any questions, please e-mail srichardson@cste.org. Please note that there is limited funding for SAS e-Learning trainings. Applications are due by Monday, January 31 at 11:59 PM ET.
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.
News Bulletin
With Sexually Transmitted Infections Off the Charts, California Pushes At-Home Tests
“California has become the first state to require health insurance plans to cover at-home tests for sexually transmitted infections such as HIV, chlamydia and syphilis — which could help quell the STI epidemic that has raged nearly unchecked as public health departments have focused on covid-19. The rule, part of a broader law addressing the STI epidemic, took effect Jan. 1 for people with state-regulated private insurance plans and will kick in sometime later for the millions of low-income Californians enrolled in the state’s Medicaid program.”
New Policy Proposal Seeks to Improve Access to Medications that Prevent HIV Infection
“Johns Hopkins faculty and colleagues released a proposal for a national program to finance and distribute medications that prevent HIV infection, known as pre-exposure prophylaxis, or PrEP. The goal of the proposal is to scale up access to PrEP substantially in order to help end the HIV epidemic…With funding from Arnold Ventures, authors of the proposal consulted with more than 30 experts in HIV, pharmaceutical, and laboratory policy, federal partners, governmental public health leaders, and PrEP consumers. The proposal recommends a national PrEP program guided by these principles: accessibility, equity, simplicity, affordability, sustainability, and adaptability.”
2021 Was a Year of HIV Progress; Now Let’s Focus on PrEP Access
“As 2021 [came] to a close, it [was] a good time to take a moment to reflect on the year and think about the challenges ahead. [In 2021], we commemorated the 40th anniversary of the first cases of what would become known as AIDS, welcomed a budget proposal from President Biden that more than doubled the funding for the Ending the HIV Epidemic in the U.S. initiative and was fully supported by both the House and Senate. President Biden gave his full commitment to ending HIV during a White House World AIDS Day event and released an updated National HIV/AIDS Strategy for the U.S. 2022–2025. We in the HIV community have many reasons to be hopeful, and yet our work is far from done. We must come together as a community focused on ending the HIV epidemic in new and different ways.”
FQHCs Remain Instrumental in Health Equity, COVID-19 Efforts
“Federally qualified health centers continue to prove pivotal at supporting health equity, with the latest data from the Boston University School of Public Health showing FQHCs were disproportionately responsible for getting populations of color vaccinated against COVID-19.”
ACA Section 1557 As A Tool For Anti-Racist Health Care
“The Affordable Care Act (ACA) has undeniably narrowed racial and ethnic health disparities by reducing the uninsured rate and improving access to care for people of color. Yet, significant gaps persist in access to coverage and high-quality, affordable care. As Congress considers important new programs to help bridge the remaining gaps, the Biden administration can use its existing authority under federal civil rights laws to promote anti-racist health care and insurance.”