Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
House Republicans Release Debt Ceiling, Government Funding Proposal
On April 19, House Speaker Kevin McCarthy (R-CA-20) released the lower chamber’s proposal to address the looming debt ceiling crisis, which ties raising the debt limit with significant spending cuts in the Fiscal Year 2024 (FY2024) spending bills. The Limit, Save, Grow Act would lift the debt limit by $1.5 trillion or until the end of March 2024, whichever comes first. The Act would also cap FY2024 spending to Congressionally approved spending levels for fiscal year 2022, which would amount to a $4.5 trillion spending cut. To achieve these spending cuts, Congress would slash funding for the Internal Revenue Service (IRS), expand work requirements for certain federal assistance programs like the Supplemental Nutrition Assistance Program (SNAP), and unwind President Biden’s student loan forgiveness program, among other provisions.
President Biden quickly panned the proposal, which is a nonstarter for Democrats, and called on Speaker McCarthy to negotiate in good faith to resolve the debt limit crisis ahead of the mid-August “x date.” The debt ceiling discussions also preclude Congress from advancing FY2024 spending bills until a compromise is achieved, delaying progress on FY2024 appropriations until the late summer or fall. Despite this, House Appropriations Chair Rep. Kay Granger (R-TX-12) is moving ahead with the lower chamber’s budget proposal for FY2024 without input from Democrats, anticipating votes in June. Although Republicans can leverage their majority in the House to advance the package, it will ultimately require Senate approval to become law. NASTAD will continue to monitor the appropriations process and advocate for strong funding for HIV, hepatitis, and drug user health programs in FY2024.
NASTAD Calls on Congress to Pass Reentry Act
On April 17, NASTAD joined 125 organizations and called on Congress to support the Reentry Act, legislation that would allow incarcerated individuals to receive medical services supported by Medicaid thirty days prior to the individual’s release. Currently, the Medicaid inmate exclusion policy (MIEP) prohibits the use of federal funds and services for medical care for inmates of a public institution. This policy prevents Medicaid eligible incarcerated individuals from receiving services funded by Medicaid. The policy also prevents incarcerated veterans from receiving hospital and outpatient care in local jails from the Department of Veterans Affairs. If passed, the bill would make permanent the upcoming Biden Administration guidance allowing states to leverage Medicaid programs to pay for drug treatment in prisons.
Administration Activities
President Biden Expected to Nominate Monica Bertagnolli to Lead NIH
President Biden is expected to nominate Monica Bertagnolli, a cancer surgeon and current Director of the US National Cancer Institute, to lead the National Institutes of Health (NIH). If confirmed by the Senate to lead NIH, Bertagnolli would be the second woman to lead the largest public funder of biomedical research in the world. The nomination would come almost two years after Francis Collins stepped down from NIH leadership in December of 2021 after twelve years of service. As NIH Director, Bertagnolli would oversee the nation’s health research initiatives and contend with Republican-led Congressional investigations on the agency’s role in the COVID-19 response.
Hepatitis Awareness Month
Each year, CDC observes Hepatitis Awareness Month in May and National Hepatitis Testing Day on May 19. Both observances serve as a time to raise awareness of hepatitis A, hepatitis B, and hepatitis C as major public health threats, while encouraging vaccination and testing to identify the millions of people living with hepatitis who don’t know it. To support these observances, CDC developed free resources, including a social media toolkit, The ABCs of Viral Hepatitis, hepatitis B materials for Asian and African immigrant audiences, and Hepatitis C Campaign for Healthcare Providers. Additionally, CDC developed a testing locator—fill out this online form to make sure your services are included.
CDC Launches LGBTQ+ Wellness Webpage Ahead of Summer
The CDC National Center for HIV, Viral Hepatitis, STIs, and TB Prevention (NCHHSTP) launched a new web resource, Get Healthy and Ready for Summer 2023. The webpage includes resources that span across the syndemic of infectious disease transmission and drug overdose, including HIV, viral hepatitis, and STIs. The resource will facilitate greater wellness and health outcomes for LGBTQ+ people as they prepare for summer events and Pride month. The webpage includes widgets with resources for COVID-19, Mpox, and a mental health crisis lifeline.
NIH Study Finds Doxycycline Reduces STIs by Two-Thirds
The oral antibiotic doxycycline prevented the acquisition of sexually transmitted infections (STIs) when tested among men who have sex with men (MSM) and transgender women who took the medication within 72 hours of having condomless sex, according to findings published April 12 in the New England Journal of Medicine. Specifically, the post-exposure approach, termed doxy-PEP, resulted in a two-thirds reduction in the incidence of syphilis, gonorrhea, and chlamydia among the study participants, all of whom reported having an STI within the previous year. However, the research also revealed a slight increase in antibacterial resistance that requires further exploration, the authors found. The research was funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
CMS Issues Letter to State Medicaid Directors to Improve Care Transitions for Incarcerated Individuals
On April 17, the Centers for Medicare & Medicaid Services (CMS) issued a letter to State Medicaid Directors announcing a new opportunity for states to help increase care for individuals who are incarcerated in the period immediately prior to their release. The new Medicaid Reentry Section 1115 Demonstration Opportunity will allow state Medicaid programs to cover a package of pre-release services for up to 90 days prior to the individual’s expected release date that address various health concerns, including substance use disorders and other chronic health conditions. CMS is encouraging states to leverage the waiver flexibilities implement an innovative service delivery system to facilitate successful reentry transitions for Medicaid-eligible individuals leaving prisons and jails and returning to the community.
Resources
CDC DVH Webinar: Hepatitis C Virus: Barriers to Treatment and Community-focused Primary Care
- Date: Thursday, May 11 at 3:30 pm ET
In partnership with the Centers for Disease Control and Prevention (CDC), the American Liver Foundation (ALF) is hosting a webinar for liver specialists and public health providers. During the call, presenters will share recent data indicating that too many Americans remain unaware of their hepatitis C infection and curative treatment continues to be delayed. Presenters will also discuss adult screening recommendations and strategies for addressing gaps in viral hepatitis care.
Hepatitis Community Collaborative (HC2)
- Date: April 25, 2023
NASTAD and The AIDS Institute (TAI) are pleased to host the third Hepatitis Community Collaborative (HC2)! Following HC2 events in 2020 and 2021, we are excited to re-convene as a group of hepatitis advocates, infectious disease experts and people with lived experience (PWLE) and provide updates on what communities are doing to combat viral hepatitis. The one-day, virtual and free convening will provide advocates with a platform for cross-jurisdiction learnings and innovative approaches via presentations, peer-to-peer information sharing, dialogue and forums.
NASTAD Webinars: Syphilis and Drug User Health Webinar Series
The NASTAD Drug User Health Team is pleased to announce an upcoming webinar series exploring syphilis among communities of people who use drugs, in partnership with AIDS United, NACCHO, NCSD, and the Northwest Portland Area Indian Health Board. This webinar series consists of five monthly sessions where those working on STIs – specifically syphilis – and those working in harm reduction and drug user health will be brought together to learn from each other, share promising practices, and highlight effective cross-sector partnerships. To join the webinars please register for them here:
- “You Can’t Screen Patients Who Won’t Come in”: Taking a Harm Reduction and Whole Person Approach to Care for Pregnant People Who Use Drugs and Promising Practices – Tuesday, April 25, from 3:00 - 4:30 pm ET
- Still Trep-in’: Ongoing Responses to Syphilis in Indian Country – Tuesday, May 30, from 3:00 - 4:30 pm ET
- State Health Department Innovations at the Intersection of Syphilis & Drug User Health – Tuesday, June 27, from 3:00 - 4:30 pm ET
- “Solo Makes You Go Slow”: Local Partnerships Addressing Syphilis Among People Who Use Drugs – Tuesday, July 25, from 3:00 - 4:30 pm ET
Hep B United Webinar: Universal Adult Hepatitis B Recommendations are Here - Best Practices for Implementing Universal Screening and Vaccination
- Date: May 1, 2023, at 03:00 PM ET
Adult hepatitis B guidelines from screening and vaccination have shifted from risk-based to universal. What does it look like in practice? Join us for the second part of our webinar series as panelists provide best practices on how they have been able to implement universal screening and vaccination within their communities, challenges they have faced and the findings of a brand new Call-to-Action to eliminate hepatitis B through the new universal recommendations.
NACCHO NOFOs
NACCHO is accepting applications for two related funding opportunities to support the evaluation of STI and harm reduction (HR) services. Applicants must already offer integrated STI and HR services. One application is intended to fund organizations that are primarily STI service providers while the other is intended to fund organizations that are primarily HR service providers. Applicants can request up to $50,000 and applications are due Friday, May 12th. Access additional information here.
NHRC/NHCHC Conference: Harm Reduction and HCH: Supporting People Who Use Drugs Across the Spectrum of Care
Please join NHRC and the National Health Care for the Homeless Council (NHCHC) on May 15 in Baltimore for a full-day session on harm reduction practices to support people experiencing homelessness who use drugs. Taught by expert faculty from both the harm reduction and health care for the homeless communities, the session will cover practical strategies for dismantling stigma, explore language and policies that support people who use drugs, offer in-depth breakout sessions, and highlight where the harm reduction movement is headed. The session is from 8:30 a.m.-4:30 p.m. EDT, with breakfast and lunch included. This learning opportunity is a pre-conference institute (PCI) that is part of NHCHC’s annual conference May 15-18. Attendees can register for just the PCI or for all of the four-day conference.
Job Postings
Chicago Department of Public Health
- Chief Racial Equity Officer/Deputy Commissioner - As a member of the CDPH executive team reporting directly to the Commissioner, the Chief Racial Equity Officer/Deputy Commissioner will oversee the Bureau of Inclusion, Diversity, Equity, and Access (the “IDEA Bureau”). Newly created in 2022, the IDEA Bureau is dedicated to leading internal strategy, workforce development, community engagement, communications and other culture and process/system change initiatives rooted in the principles of racial equity. This position will supervise the following offices in the IDEA Bureau: Racial Equity & Belonging, Workforce Development, Community Engagement & Partnership, and Public Information. These offices have grown substantially in the past year, and the Chief Racial Equity Officer/Deputy Commissioner will be tasked with developing plans to nurture and sustain these new teams and functions within the department. This position will also work closely with program staff in core operational and administrative areas such as human resources, finance, and contracts to co-lead process improvement initiatives to ensure that our practices are in line with the department’s anti-racism values. Salary is $133,416 per year.
- Chief Public Health Informatics Officer/Deputy Commissioner - Reporting to the First Deputy Commissioner, this position will serve as the department’s leader for priorities related to data modernization initiatives (DMI) and data process improvement, and in this capacity will establish and guide the department’s strategic public health informatics initiatives and will oversee CDPH’s work to align with national DMI. The position will continue to build and supervise the IT and Informatics teams; and will work closely with the citywide IT team based in the Department of Assets, Information and Services, the Illinois Department of Public Health, healthcare providers and other stakeholders in public health IT and informatics issues. This position will also serve as the primary liaison with the Centers for Disease Control and Prevention for DMI work. Salary is $146,000 per year.
Manager, Meetings and Travel – NASTAD
Under general supervision of the Associate Director, IT and Administration, the Manager, Meetings and Travel will provide management, coordination and hands-on delivery of comprehensive service and support to NASTAD members, staff members, and other stakeholders as appropriate. This position will coordinate and implement several, sometimes simultaneous, live, hybrid, and virtual events, particularly to NASTAD’s Annual and Technical Assistance Meetings. This position will monitor airline travel and purchases, manage travel-related vendors, maintain travel-related processes, reconcile meeting and travel expenses, complete appropriate forms and procedure documents, and work to fulfill NASTAD mission, goals, and objectives within the limitations of agency resources and policies and federal grant requirements.
Director, Health Care Access – NASTAD
NASTAD is recruiting for the Director of our Health Care Access program. The Director, Health Care Access plays a vital leadership role in achieving the organization’s training, technical assistance, and policy support priorities for Ryan White HIV/AIDS Program (RWHAP) Part B and AIDS Drug Assistance Programs (ADAP). The position will work closely with Tim Horn, NASTAD’s Director of Medication Access.
Viral Hepatitis Prevention Manager – Health Federation of Philadelphia
The Prevention Manager will be responsible for coordination of activities related to viral hepatitis prevention, including outreach, training, education and collaboration with appropriate programs to facilitate access to hepatitis services. This position works in close coordination with viral hepatitis surveillance activities. Apply by June 2, 2023.
Drug Trends and Technology-Based Drug Checking Analyst – New York City, NY
NYC DOHMH is looking for an analyst to work on our drug checking initiative. Currently operating in four SSPs across the city, including one of the OPCs, drug checking technicians use Bruker Infrared technology to test samples from SSP participants and provide individualized harm reduction education. This is a great opportunity for someone with strong data skills and an interest in drugs and toxicology. Please send out far and wide and feel free to reach out if you have any questions.
Executive Director, Open Aid Alliance – Missoula, Montana
Open Aid Alliance is searching for an innovative and passionate Executive Director to lead our team as we continue our mission of providing low-barrier, client-centered care.
Reporting to the Board of Directors, the Executive Director (ED) will have overall strategic and operational responsibility for Open Aid Alliance (OAA) staff, programs, expansion, and execution of its mission. The main responsibilities of this position fall within the realms of staff leadership and management, programming and financial management. Priority deadline for first round of interviews is April 10, 2023.
Chief Executive Officer – Western North Carolina AIDS Project (WNCAP)
Western North Carolina AIDS Project’s (WNCAP’s) mission is to provide equitable access to care and reduce harm from HIV, Hepatitis C, and drug use. WNCAP provides case management, prevention education, STD testing, harm reduction, and other support services to people living across 18 counties of western North Carolina. The Chief Executive Officer (CEO) is the principal leadership position at WNCAP and reports to the Board of Directors.
Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC
- Chief, Prevention Branch, DVH
- NCHHSTP/DVH is recruiting for an exceptional candidate for the position of Prevention Branch Chief, Division of Viral Hepatitis (DVH), National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). The incumbent will serve as Chief in the Prevention Branch, Division of Viral Hepatitis, and will participate in the division’s senior management team responsible for directing the development, administration, implementation, and evaluation of national programs to prevent and control viral hepatitis. The incumbent provides advice to the Division Director on medical and scientific policy and practices associated with program, education, and research activities in support of viral hepatitis prevention and control, including harm reduction.
Boulder County AIDS Project – Boulder, Colorado
- Prevention Coordinator: The primary duties of this position are to provide HIV/HCV/STI testing, syringe access, and street outreach services, as well as outreach education at community partner locations and events. This position provides these services in collaboration with other Prevention Department staff and key community partners, as well as enters data into databases and completes monthly reports. This position reports directly to the Prevention Director, and attends staff, department, and community partner meetings.
Florida Department of Health – Palm Beach County
To apply, please send resumes to Robert Scott, Robert.Scott@flhealth.gov. These are all $20/hr, in-office roles with possible remote flexibility.
- EHE Navigator: This position’s work will be actively guided by the Palm Beach County Ending the Epidemic (EHE) Plan, including the four pillars and their goals, objectives, strategies and activities. Incumbent will assist in the planning, coordination, implementation and monitoring of the goals, objectives, strategies and activities set forth in the Palm Beach County Ending the Epidemic (EHE) Plan, in collaboration with other Area 9 EHE funding recipients, to include, but not limited to: Palm Beach County, FoundCare, and Florida Community Health Centers.
- PrEP Navigator: This position’s work will be actively guided by the Palm Beach County Ending the Epidemic (EHE) Plan, including the four pillars and their goals, objectives, strategies and activities. Incumbent will link high-risk negative persons to available Pre-Exposure Prophylaxis (PrEP) and non-occupational Post Exposure Prophylaxis (nPEP) services with the goal of significantly reducing the number of new HIV infections among high-risk populations. Incumbent will assess and increase the knowledge, desirability, accessibility, and adherence of PrEP among referred high-risk individuals.
- Digital Media Manager: This position is responsible for developing and coordinating the area HIV digital media presence through multiple platforms. Developing digital marketing strategies, creating social media content, collaborating with community partner organizations, and creating new ad campaigns to advance Ending the HIV Epidemic (EHE) in Palm Beach County. Tracking data from digital campaigns to assist with EHE goals.
Executive Director, Hepatitis Education Project (HEP) – Seattle, WA (partially remote)
Reporting to a Board of Directors and in partnership with a staff of 19, the ED will lead the evolution of HEP as the organization reviews its impact to date and plans for the future in the fields of viral hepatitis and drug user health both locally and nationally.
Deputy Medical Director, HIV/STI/Viral Hepatitis/Harm Reduction – Nashville, TN
This position will serve as the Statewide Deputy Medical Director in the HIV/STI/Viral Hepatitis section. The position has cross-cutting responsibility in all program areas with potential for promotion in succession plans. Primary responsibilities include leadership and oversight of cross-cutting programs related to End the Syndemic Tennessee to tackle HIV, sexually transmitted infections, viral hepatitis and substance use disorder in an integrated manner with an outward-facing, community-engaged process.
Program Content and Training Specialist, Supporting Harm Reduction Programs (SHaRP) – University of Washington
This position is part of a cooperative agreement award from the Centers for Disease Control and Prevention to provide technical assistance about monitoring and evaluation to syringe services programs (SSPs) as part of the National Harm Reduction Technical Assistance Center. One of the primary projects of this award is to provide technical assistance (TA) to SSPs for monitoring and evaluation activities. The University of Washington is working in collaboration with the CDC, SAMHSA, NASTAD, the National Harm Reduction Coalition, and other TA partners to provide a suite of technical assistance support to individual programs.
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.
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.
Viral Hepatitis Epidemiologist - Pennsylvania Department of Health
The Department of Health is seeking a dedicated and hardworking individual to fulfill their Viral Hepatitis Coordinator/Epidemiologist position within the Division of Infectious Disease Epidemiology. If you would like to support an organization that protects the public's health, apply today!
Viral Hepatitis Database Analyst - Heluna Health position with San Francisco Department of Public Health
Heluna Health is currently looking for a Viral Hepatitis Database Management Analyst to work in the ARCHES Surveillance branch at San Francisco Department of Public Health (SFDPH). The Database Analyst will support SFDPH's Viral Hepatitis Surveillance team in its efforts to improve hepatitis data reporting and analysis. Responsibilities include higher level data cleaning, monitoring and reporting on data trends, coordinating with laboratory contacts to improve ELR protocols and procedures, and managing special projects as needed. This is a full-time, 2-year position based in San Francisco and employed by Heluna Health.
Program Manager (Viral Hepatitis and Harm Reduction Prevention) - Augusta, Maine
We are looking to bring on board a Viral Hepatitis and Harm Reduction Prevention Manager to provide (1) statewide viral hepatitis prevention program coordination; (2) manage education and outreach activities focused on prevention of viral hepatitis disease transmission, (3) develop, coordinate, implement and evaluate statewide viral hepatitis prevention and harm reduction services including education, outreach, testing, linkage to care activities, syringe service programs, and overdose prevention activities; and (4) monitor state and federal viral hepatitis and harm reduction grants and contracts. Work is performed under administrative direction.
Human Services Program Coordinator – Richmond, Virginia
The Virginia Department of Health is hiring a Viral Hepatitis Program Coordinator. The Viral Hepatitis Program Coordinator participates in the design and management of hepatitis B (HBV) and hepatitis C (HCV) program activities, including surveillance, prevention, testing, and linkage-to-care as well as hepatitis data collection tools; assesses hepatitis events of public health significance; leads grant writing efforts around improving HBV/HCV prevention and care cascades; coordinates program planning efforts with respect to surveillance and other viral hepatitis epidemiologic data and evaluation; serves in a supervisory or team lead capacity for staff conducting hepatitis program support activities; uses software tools (i.e. SAS) for data quality activities.
News Bulletin
Supreme Court maintains abortion pill access for now as legal fight continues
“Access to a widely used abortion pill will remain at current levels for the time being, the Supreme Court ruled Friday in a decision staving off sweeping restrictions ordered by lower courts. The high court’s decision keeps the drug, mifepristone, available for now, but the legal battle over the drug, which has become the most common method of abortion nationwide, could drag on for months if not years to come. Justices Samuel Alito and Clarence Thomas dissented from the Supreme Court’s action, which prevents earlier rulings from a Texas-based judge and a federal appeals court from taking effect.”
Why more states are decriminalizing fentanyl test strips
“More red states are moving to decriminalize test strips used to detect fentanyl in illicit or counterfeit drugs as the substance becomes a leading killer of adults under 50. The paper strips can reduce fatal overdoses, especially in instances when people unknowingly consume fentanyl-laced pills that look like prescription drugs…Until recently, many states viewed the strips as drug paraphernalia that could embolden people to use substances shown to be free of fentanyl. That stance is at odds with harm reduction advocates, the American Medical Association and the Biden administration.”
Emergent aims to price over-the-counter Narcan at about $50
“Contract drugmaker Emergent BioSolutions Inc said on Thursday it is aiming to price the over-the-counter (OTC) version of its opioid overdose reversal drug Narcan at around $50 per carton. The OTC version will become available at U.S. stores and online retailers later this summer, while the currently available prescription nasal spray carries a wholesale price tag of $125 per carton. Emergent's statement comes nearly a month after the U.S. Food and Drug Administration allowed Narcan to be sold over-the-counter, allowing for easier availability of the life-saving medication. The approval paved the way for expanded access to the drug in areas that have concentrated overdose problems and a few pharmacies, but uncertainty remains around Narcan's final price and whether insurers will offer coverage. Emergent has not disclosed the final price for OTC Narcan yet.”