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 the community. For questions, comments, or content contributions, please contact Mike Weir.
Hill Happenings
Fiscal Year 2023 Appropriations
Lawmakers quickly kicked off the Fiscal Year 2023 (FY2023) appropriations process after the White House released the President’s FY2023 Budget Request to Congress on March 28. The Director of the White House Office of Management and Budget (OMB) appeared before the House Committee on the Budget on March 29 to testify on the President’s FY2023 budget request. On April 5, the Department of Health and Human Services (HHS) Secretary appeared before the Senate Committee on Finance to testify on the health spending and policy priorities included in the FY2023 Health and Human Services budget.
NASTAD is monitoring the FY2023 appropriations process and will advocate for the highest possible funding levels on behalf of HIV and hepatitis programs.
NASTAD Calls on Congress to Provide Strong Funding for HRSA Health Programs
NASTAD joined the Friends of HRSA coalition and called on top Appropriators to provide strong funding for the Health Resources and Services Administration (HRSA) in the FY2023 appropriations bill. The advocates highlight the limitations that HRSA-funded providers face due to years of underfunding, threatening access to quality health services for people living with HIV, pregnant women, mothers and their families, and those otherwise unable to access high-quality health care. The coalition calls for increased resources to critical community-based health programs, such as funding for HRSA-recognized community health centers, the Ryan White HIV/AIDS Program, and the Title X family planning program.
Administration Updates
Biden Administration Released FY2023 Budget Proposal
On March 28, President Biden released his FY2023 Budget Request and the HHS Budget in Brief, which proposes a nearly 15 percent increase to HHS. The budget proposes a $337 million increase in funding for year four of the Ending the HIV Epidemic Initiative (EHE), while also proposing a new national PrEP program.
The HHS Budget in Brief includes language on a proposed National PrEP Program that includes a proposed $237 million in FY2023 mandatory spending.
“The budget also creates a national program that invests $9.8 billion in mandatory funding over 10 years to guarantee pre-exposure prophylaxis (also known as PrEP) at no cost for all uninsured and underinsured individuals; provide essential wraparound services through States, IHS, and tribal entities, and localities; and establish a network of community providers to reach underserved areas and populations. The budget also expands access to PrEP under Medicaid by covering the drug and associated services without cost-sharing, while removing utilization management practices that may limit access.”
It is important to note that this is a budget request and does not have the power of the law. Only Congress has the power to appropriate funds.
CDC Formally Adopts ACIP Recommendation to Vaccinate All Adults Ages 19-59
On March 31, the Centers for Disease Control and Prevention (CDC) published a Morbidity and Mortality Weekly Report (MMWR), Universal Hepatitis B Vaccination in Adults Aged 19-59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices for – United States, 2022, that officially recommends universal hepatitis B virus (HBV) vaccination for all adults ages 19 to 59 in the U.S. CDC Director Dr. Rochelle Walensky adopted the recommendations after the CDC Advisory Committee on Immunization Practices (ACIP) unanimously voted in favor of broadening risk-based HBV immunization guidelines in October of 2021, recommending universal adoption of the HBV vaccine for all adults ages 19 to 59 and for adults 60 and older with known risk factors. NASTAD applauds Director Walensky and the CDC for formally adopting the universal HBV vaccination recommendations, which will help to ensure that we continue to make progress on preventing HBV transmission, improve health equity by removing barriers to vaccine access, and bring the country closer to the goal of viral hepatitis elimination.
Integrated HIV Prevention and Care Plan Guidance, CY 2022-2026 Frequently Asked Questions (FAQs)
On March 14, 2022, HRSA HIV/AIDS Bureau (HAB), and CDC Division of HIV Prevention (DHP) released a frequently asked questions (FAQ) response document to clarify recipient questions about the Integrated HIV Prevention and Care Plan Guidance, including the Statewide Coordinated Statement of Need, CY 2022-2026, which outlines the planning requirements for Ryan White HIV/AIDS Program (RWHAP) Parts A and B recipients and all DHP-funded state and local health departments. In addition to the FAQ response document, recipients of funding can access a number of technical assistance (TA) resources.
HRSA HAB and CDC DHP recipients can visit the Integrated Planning landing page on the Target HIV website to find a number of TA webinar recordings and resources, including:
- The Integrated HIV Prevention and Care Plan Guidance, including the Statewide Coordinated Statement of Need, CY 2022-2026 Overview Webinar presented by HRSA HAB and CDC DHP on October 27, 2021.
- Integrated HIV/AIDS Planning (IHAP) TA Center resources, webinar recordings, and list of upcoming webinars.
Recipients can visit the Capacity Building Assistance Provider Network to view future TA opportunities.
If you have questions and/or need TA to assist your jurisdiction in the integrated planning process, please contact your HRSA and CDC project officers. HRSA and CDC look forward to continued work with all partners and stakeholders involved in HIV prevention and care planning to accomplish the national goals set forth in the National HIV/AIDS Strategy (2022-2025).
President Biden Issues Proclamation on National Public Health Week
On April 1, President Biden issued a Presidential Proclamation recognizing April 4-10 as National Public Health Week. The proclamation celebrates health care workers and public health professionals, and the progress the country has made to revitalize the public health system during the COVID-19 pandemic. Additionally, President Biden calls for an expansion of affordable health coverage, including addressing the high cost of prescription drugs and calls on the nation to recommit itself to improving the public health of the nation.
HHS Awards $256.6 Million to Restore Access to Title X Family Planning Services
On March 30, the Department of Health and Human Services (HHS) announced that it awarded $256.6 million in grant funding to restore access to Title X, the nation’s only federally-funded family planning program. HHS will fund 76 grantees to deliver equitable and affordable family planning services across the country, welcoming back grantees that were formerly ineligible to participate in the program after the Trump Administration leveraged the rulemaking process to disqualify providers who offer abortion services and counseling from participating in the Title X program.
National Youth HIV/AIDS Awareness Day
April 10 is National Youth HIV/AIDS Awareness Day (NYHAAD). Young people aged 13-24 accounted for 21% of estimated new HIV infections in the United States in 2018. NYHAAD is a day to educate the public about the impact of HIV on young people. In the lead-up to NYHAAD, share ready-to-use graphics and social media messages from the updated Let’s Stop HIV Together (Together) NYHAAD toolkit to help spark conversations about HIV and highlight prevention methods to reduce HIV among young people. You can also use Together campaign resources to share information on HIV testing, treatment, prevention, and stigma reduction for young people. For additional shareable social media, check out the Division of Adolescent School and Health’s NYHAAD toolkit.
National Transgender HIV Testing Day
Observed on April 18, National Transgender HIV Testing Day (NTHTD) is a day to address the impact of HIV on transgender and nonbinary people. To support your outreach efforts leading up to and on NTHTD, you can use and share new and ready-to-use social media posts and graphics included in the CDC Division of HIV Prevention toolkit. Use this toolkit to help reduce HIV stigma and promote HIV testing, prevention, and treatment among transgender and nonbinary people.
CDC NOFO: Strengthening Syringe Services Programs
This Notice of Funding Opportunity (NOFO) aims to increase access to harm reduction services for people who currently inject, or have a history of injecting, drugs and reduce incidence of infectious diseases and other complications of injection drug use through two components. Click here to read a blog post from the Director of the Division of Viral Hepatitis on the new NOFO. Applications are due Monday, May 2.
CDC NOFO: Enhanced Surveillance of Persons with Early and Late HIV Diagnosis
This NOFO will support identification and recruitment of adults with recent HIV diagnoses at stage 0 and stage 3 to improve understanding of barriers and gaps associated with new infection and late diagnosis in the era of multiple testing modalities and prevention options such as PrEP. These enhanced surveillance activities will identify actionable missed opportunities for early diagnosis and prevention, thus informing allocation of resources, development, and prioritization of interventions, and evidence-based local and national decisions to improve HIV testing and address prevention gaps. Applications close April 26.
CDC: Proposed Data Collections Submitted for Public Comment and Recommendations
The CDC is seeking comment on a proposed information collection to better understand preferences for Longer-Acting Preexposure Prophylaxis (LA-PrEP) products used to prevent the spread of HIV in populations with the highest need for prevention services, including gay, bisexual, and other men who have sex with men, Black or African American heterosexual persons, transgender women, and people who inject drugs. Comments are due by May 2, 2022.
Resources
Systems Coordination Provider Project
Jared Brumbeloe (he/him) joined the Health Systems Integration team as Senior Manager, Health Systems Integration, and will lead the Medicaid-HIV Systems Coordination Provider’s (SCP) data integration efforts to enable Medicaid programs to improve HIV viral suppression rates among beneficiaries living with HIV. Before joining NASTAD, Jared served as the Ryan White Data Manager at the Georgia Department of Public Health (GDPH). He led the program’s data management team and oversaw the state’s RWHAP data systems. At GDPH, Jared led critical efforts to update and update the program’s data systems and improve data collection and quality management processes, including providing TA and coordinating with laboratories and local health departments. Jared also brings quality improvement (QI) experience, having served as QI Coordinator at the Augusta University Ryan White Program. Jared holds a Master of Public Health in Epidemiology from the University of Georgia and a Bachelor of Science in Community Health and Human Services from Georgia College and State University.
NASTAD SCP staff participated in the final HRSA EHE Programmatic Site Review. 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, and to identify TA requests.
NASTAD’s EHE mentoring program held its second monthly learning session with twenty-three mentees in attendance. Leisha McKinley-Beach, National HIV/AIDS Consultant presented on burnout. Currently, there are 27 mentees from 19 jurisdictions engaged in the program. 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). April’s topic is Community Development. You can look forward to more information about and programming surrounding this being released later this month.
NASTAD Video Series: Conversations from the CommuniTEA: Fostering Health Department Engagement to End the HIV Epidemics
NASTAD is pleased to present this video series as part of the CDC-funded CBA Supplemental project, Community Engagement for Ending the HIV Epidemic (EHE). The video series follows different local influencers within the LGBTQIA community as they discuss what community engagement looks like for their communities and how to strengthen partnership opportunities within EHE. These videos can be used to promote EHE to community members and collaboration throughout the planning and implementation processes.
To explore this resource and other community engagement resources, visit: www.nastad.org/community-engagement
NASTAD Status-Neutral Webinar Series
NASTAD hosted a four-part webinar series, “Employing Status-Neutral Approaches to End the HIV Epidemic”. The series focused 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, 2021. 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, 2022. The recording and slides can be viewed here.
The third webinar in the series, “Addressing Social Determinants of Health through a Status-Neutral Lens” was held on February 8, 2022. The recording and slides can be viewed here.
The final webinar in the series, “Status-Neutral Messaging and Promotion for EHE” was held on March 8, 2022. The recording and slides can be viewed here.
EHE Spotlight Video Series
The EHE video series shines a spotlight on the disruptively innovative work of eight EHE jurisdictions across the U.S. The series comes just after the Biden-Harris administration renewed the U.S. government’s commitment to ending the HIV epidemic on World AIDS Day by requesting $670 million to support the EHE initiative in FY22. With the ambitious goals of reducing new HIV transmissions by 75% and increasing viral suppression of people living with diagnosed HIV by 95% by 2025, EHE jurisdictions are charging ahead to bridge the gap between prevention and care.
With the aim of advancing EHE goals and supporting the 57 EHE jurisdictions in their efforts to diagnose, treat, prevent, and respond to the HIV epidemic, each video offers real stories of action, lessons learned in the field, and tips for replication. Viewers can expect to learn about strategies and activities including:
- Recommendations for implementing harm reduction services from Nevada’s Trac-B Exchange.
- The call for bilingual health care providers and equitable access to PrEP from Arizona’s Chicanos Por La Causa.
- The grassroots, “meet them where they are” approach of Mississippi’s L.I.F.E. Inc.
- The Missouri Department of Health and Senior Services’ tactics for capacity building in rural communities.
- Maryland’s Montgomery County Department of Health and Human Services' strategy for implementing telehealth services.
- The Florida Department of Health in Orange County’s tips for initiating a Test and Treat program.
- The South Carolina Department of Health and Environmental Control’s deep dive into the utility of HIV cluster visualization.
- Texas’ Tarrant County HIV Administration efforts to uplift voices of community members.
Click here for additional information.
NASTAD Webinar Recording: Diversifying PrEP Financing: Strategies to Leverage Funding across the PrEP Care Continuum
On March 9, 2022, NASTAD hosted a webinar as a follow-up to the release of the, “Diversifying PrEP Financing: Strategies to Leverage Funding across the PrEP Care Continuum” resource. Recent changes to the PrEP medication landscape have impacted the way 340B covered entities are able to generate program income from PrEP medications. These changes have led to declining revenues resulting in the potential destabilization of program and client support systems aimed at increasing PrEP access. This tool provides an overview of these landscape changes, discusses the impacts of these changes, and explores opportunities to meet the funding needs of PrEP ancillary services.
Minor Consent and Confidentiality Laws for PrEP and HIV Treatment
NASTAD is pleased to announce the publication of a new resource, Minor Consent and Confidentiality Fact Sheets. This resource was designed specifically for EHE jurisdictions and details statutes related to minor consent and confidentiality for STI and HIV preventive measures, testing, and treatment. It includes separate fact sheets for each of the EHE jurisdictions. The fact sheets interpret and analyze various statutes related to minor consent and confidentiality around a minor’s ability to seek STI and HIV treatment without the consent of a parent or guardian. Additionally, they further interpret statutes’ applicability to a minor’s ability to receive PrEP without parental or guardian consent and detail potential protections or release of information regarding a minor’s treatment through Explanation of Benefits (EOB) from insurance companies. The fact sheets can be found on NASTAD’s website and are linked here. Please contact William Lee if you have questions.
Cross-Jurisdictional Data Sharing: Legal, Practical, and Ethical Considerations for Improved Infectious Disease Cluster Response
NASTAD, in partnership with the ASTHO, released Cross-Jurisdictional Data Sharing: Legal, Practical, and Ethical Considerations for Improved Infectious Disease Cluster Response. The resource seeks to address legal, practical, and ethical considerations to support health department decision-making concerning cross-jurisdictional data-sharing practices relating to HIV and viral hepatitis clusters and outbreaks and offers recommendations for how health departments can improve outbreak preparedness measures through preemptive cross-jurisdictional data-sharing arrangements.
Lancet Article: Estimating naloxone need in the USA across fentanyl, heroin, and prescription opioid epidemics: a modelling study
“Opioid epidemic type and how naloxone is accessed have large effects on the number of naloxone kits that need to be distributed, the probability of naloxone use, and the number of deaths due to overdose averted. The extent of naloxone distribution, especially through community-based programmes and pharmacy-initiated access points, warrants substantial expansion in nearly every US state.”
NACCHO NOFO: Leveraging Pharmacies for STI Services and Care
This funding is to explore the provision of expanded STI patient care via pharmacy settings.
- Two-to-five health department-pharmacy teams will be funded up to $75,000 (per partnership) to develop, design, and implement a collaborative partnership between pharmacies and health departments to expand STI services and care.
- Findings will be shared broadly with STD programs and pharmacies across the country.
- Applications are due on May 27, 2022. For additional information or to access the RFA, visit here.
NACCHO NOFO: Leveraging Retail Health Clinics for STI/HIV Services and Care for Underserved Minorities
This funding is to support integration of sexual health services for underserved and under-diagnosed racial/ethnic and sexual minorities, including young people, across RHCs, health departments, primary care, and other healthcare settings.
- This funding is only available to partnerships in Ending the HIV Epidemic (EHE) priority jurisdictions.
- Up to three health department-retail health clinic teams will be funded up to $300,000 (per partnership) to develop, design, and implement a collaborative partnership to expand STI/HIV services and care.
- Applications are due on May 31, 2022. For additional information or to access the RFA, visit here.
If you are interested in applying for either of these opportunities but have questions, there will be informational webinars in April which are noted in the respective RFAs.
Additionally, if you are interested in applying and need support with developing a partnership with a pharmacy or retail health clinic or have other questions, please contact Rebekah Horowitz.
NACCHO Releases an STD Registry – Guide to Sexually Transmitted Disease Clinics in the United States
NACCHO has developed an STD Registry, a searchable tool for locating STD clinics and services. We encourage any clinic devoted to examining and treating STDS and/or clinics that have staff and service hours dedicated to STDs to register. Please use the following submission form to add your site to the registry.
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.
CSTE Annual Conference Registration is Open
Early bird registration for the 2022 CSTE Annual Conference June 19-23rd in Louisville, KY is now open and will close on May 5th. The Annual Conference is currently hybrid with virtual and in-person sessions. For the most up-to-date information, please visit the conference website.
HIV Resources Inventory Compiler – IHAP TAC’s New Tool for Integrated Planning
The Integrated HIV/AIDS Planning Technical Assistance Center (IHAP TAC) is excited to share its latest tool to support Integrated HIV Prevention and Care Plan development. The HIV Prevention, Care and Treatment Resource Inventory Compiler supports data collection, generates a formatted HIV Resources Inventory table, and includes a dashboard for easy data analysis. The Excel tool can be shared with multiple users to input data for the HIV funding sources they receive, and then combined into one, comprehensive file of all HIV resources in the jurisdiction.
The tool is now available on TargetHIV.org. From this page, you can access the tool, instructions and best practices for use, and a recorded demonstration of how to use the tool. Contact ihaptac@jsi.com with questions or if you need assistance with the tool.
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
Director, HIV and Harm Reduction - NACCHO
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.
News Bulletin
Biden admin plots to fix Obamacare's 'family glitch,' expand coverage
“The Biden administration is planning on Tuesday to propose a long-sought change to the Affordable Care Act aimed at lowering health insurance costs for millions of Americans, four people with knowledge of the matter told POLITICO. The new policy is designed to close a loophole in the ACA known as the “family glitch” that’s prevented an estimated 5 million people from qualifying for subsidized health plans — even when they can’t find affordable coverage elsewhere.”
CDC, under fire for covid response, announces plans to revamp agency
”Centers for Disease Control and Prevention Director Rochelle Walensky announced plans Monday to revamp the agency that has come under blistering criticism for its performance leading the U.S. response to the coronavirus pandemic, saying, “it is time to step back and strategically position CDC to support the future of public health.”
In an agency-wide email sent shortly after 1 p.m., Walensky said she has hired a senior federal health official outside of the Atlanta-based agency to conduct a one-month review to “kick off an evaluation of CDC’s structure, systems, and processes.”