Newsletter: Policy

Policy Updates: Hill Happenings and Administration Activities

Hill Happenings

NASTAD Calls on Congress to Provide Strong Funding for CDC in FY2024 

On March 22, NASTAD joined the CDC Coalition and called on appropriators to provide strong funding for the Centers for Disease Control and Prevention (CDC) in FY2024. The coalition highlights Congress’ record of underfunding CDC despite its leading role in developing and coordinating a broad range of federal strategies to prepare, respond, and recover from health crises, including HIV, STI, and hepatitis prevention. Additionally, the advocates highlight the key role CDC programs play in reducing health disparities and improving health equity.

NASTAD Calls on Congress to Allocate Strong Funding for HRSA in FY2024 

On March 23, NASTAD and the Friends of the Health Resources and Services Administration (HRSA) Coalition called on appropriators to provide strong funding for HRSA programs in the FY2024 appropriations package. The coalition highlighted the historic underfunding of HRSA programs and the additional funding needed to fill preventive and primary health care gaps, support urgent and long-term public health workforce needs and build upon the achievements of HRSA’s more than 90 programs and more than 3,000 grantees, including community health centers, Ryan White HIV/AIDS programs, and the Title X Family Planning program. 

NASTAD Urges Congress to Fund the CDC Data Modernization Initiative and Center for Forecasting and Outbreak Analytics 

On March 24, NASTAD joined a group of 90 organizations and called on appropriators to increase funding for the Data Modernization Initiative (DMI) at the Centers for Disease Control and Prevention (CDC) in FY2024. The coalition requests the funding to shore up underinvested data infrastructures at state, territorial, local, and tribal (STLT) health departments, including ensuring interoperability across data systems and implementing electronic case and laboratory reporting. Additionally, the increased funding will support the newly established CDC Center for Forecasting Outbreak Analytics (CFA).

NASTAD Calls on Congress to Fund Public Health Workforce and Education Programs 

On March 24, NASTAD joined 120 organizations and called on appropriators to fully fund the Public Health Workforce Repayment Program and invest funding to launch the new Health Resources and Services Administration (HRSA) Bio-Preparedness Workforce Pilot Program. The coalition highlights the nation’s eroding public health and infectious disease workforce that is accelerated by low paying jobs and few financial incentives for health departments to retain staff. By fully funding these programs, the coalition anticipates that health departments could recruit and retain as many as 2,000 public health professionals at STLT health agencies across the country, and as many as 1,000 ID and HIV health care professionals in rural and urban health professional shortage areas, medically underserved communities, or federal facilities by offering loan repayment in exchange for three-year service commitments. 

NASTAD Calls on Congress to Fund Maternal and Child Health Programs 

On March 23, NASTAD joined the Friends of the Title V Maternal and Child Health Services Program coalition and called on Congress to provide strong funding for the HRSA Title V Maternal and Child Health (MCH) Services Block Grant in the FY2024 appropriations package. The coalition highlights the MCH Block Grant’s wide reach, providing access to health care and public health services for an estimated 60 million people in fiscal year 2021, including 98% of infants, 92% of all pregnant people, and 58% of children nationwide. Additionally, NASTAD joined a coalition of over 80 health organizations and called on Congress to support robust funding for the CDC Surveillance for Emerging Threats to Mothers and Babies (SET-NET) program. This funding would enable SET-NET to reach additional jurisdictions, track more threats, and lead the nationwide preparedness and response needed to protect pregnant individuals and infants in the United States from emerging and re-emerging public health threats. With additional funding, SET-NET could provide support for 64 total STLT health departments to respond to Zika, syphilis, hepatitis C, COVID-19, and congenital cytomegalovirus. 

NASTAD Urges Congress to Fund Global Health and Rights Programs for LGBTQI+ People 

On March 24, NASTAD joined 110 organizations and called on Congress to support the rights of LGBTQI+ people around the world by increasing funding for the Department of State Global Equity Fund (GEF) and USAID. The coalition highlights the need for more funding to address the significant challenges facing LGBTQI+ communities impacted by COVID-19, rising authoritarianism, and humanitarian crises. 

Administration Activities 

FDA Approves Nonprescription Narcan  

On March 29, the US Food and Drug Administration (FDA) approved the first naloxone product for use without a prescription. FDA granted Emergent BioSolutions over-the-counter (OTC) approval for Narcan, its 4 milligram (mg) naloxone hydrochloride opioid overdose reversal nasal spray. The new OTC designation permits the dispensing of Narcan in retail settings, facilitating greater access to Narcan by authorizing its sale in locations like gas stations, convenience and grocery stores, and retail pharmacies. Advocates cheered the decision, but continue to urge the Biden administration to ensure that OTC naloxone is sold at an affordable price and that the OTC designation is not limited to intranasal formulations. Emergent anticipates that OTC Narcan will become available during the summer. Additionally, FDA is currently reviewing OTC approval for RiVive, Harm Reduction Therapeutics’ 3 mg naloxone hydrochloride nasal spray. Other formulations and dosages of naloxone will remain available by prescription only, including intramuscular (injectable) naloxone, which is the most widely used naloxone formulation.

End of Mandatory Coverage of PrEP by Insurers Puts Lives at Risk 

On March 30, U.S. District Judge Reed O’Connor ruled against the US Department of Health and Human Services on a high-stakes trial that could undermine the legality of the Affordable Care Act’s (ACA) preventive care mandate. The ruling places a nationwide injunction on preventive services recommended by the U.S. Preventive Services Task Force (USPSTF), halting the provision of no-cost USPSTF-recommended preventive services, which includes pre-exposure prophylaxis for HIV (PrEP) and HIV, STI, and hepatitis screening. If upheld, the ruling could have significant impacts on public and private coverage for preventive care, including PrEP access and STI testing. The Biden Administration is appealing the decision, which will likely be decided by the Supreme Court of the United States. Click here to read NASTAD’s press statement on Judge O’Connor’s ruling.

Department of Justice Releases Report on People with HIV in Prisons 

On March 29, the Department of Justice (DOJ) published a report that provides data on persons in the custody of state and federal correctional authorities who were known to be living with HIV in 2021. The report presents national- and jurisdiction-level estimates of the number and rate of prisoners living with HIV while in the custody of state and federal correctional authorities. The data show a slight decrease in the estimated persons with HIV in the custody of state and federal correctional authorities, totaling 11,810 persons at year-end 2021.

CDC Releases Updated National Transgender HIV Testing Day Toolkit 

On March 28, CDC released the National Transgender HIV Testing Day (NTHTD) toolkit. Observed annually on April 18, NTHTD is a day to recognize the importance of routine HIV testing, status awareness, and continued focus on HIV prevention and treatment for transgender and nonbinary people. The toolkit includes ready-to-use social media posts and graphics to share leading up to and on NTHTD. 

SAMHSA Issues Dear Colleague Alerting Providers of Xylazine in the Drug Supply  

On March 27, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a Dear Colleague letter to providers and grantees alerting them of the impact of xylazine in the drug supply. The letter educates providers on the adverse health outcomes associated with xylazine use, including severe wounds. SAMHSA encourages health care professionals and patients to report adverse events resulting from possible xylazine exposure to their local health department. The letter accompanies similar alerts from the US Drug Enforcement Administration and the Food and Drug Administration (FDA). 


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: 

  1. “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 - 4:30 pm ET 
  2. Still Trep-in’: Ongoing Responses to Syphilis in Indian Country – Tuesday, May 30, from 3 - 4:30 pm ET 
  3. State Health Department Innovations at the Intersection of Syphilis & Drug User Health – Tuesday, June 27, from 3-4:30 pm ET 
  4. “Solo Makes You Go Slow”: Local Partnerships Addressing Syphilis Among People Who Use Drugs – Tuesday, July 25, from 3-4:30 pm ET 

CDC MMWR: JYNNEOS Vaccination Coverage Among Persons at Risk for Mpox — United States, May 22, 2022–January 31, 2023 

“Despite administration of >1 million vaccine doses, only 23% of the at-risk population has been fully vaccinated. Targeted outreach and continued access to and availability of mpox vaccines to persons at risk is important to help prevent and minimize the impact of a resurgence of mpox.” 

KFF Issue Briefs 

These new Kaiser Family Foundation resources examine the roles that Medicare and Medicaid programs play in the lives of people with and at risk for HIV. They include significant new data updates and reflect the current policy environment. 

CDC MMWR: Vital Signs: Progress Toward Eliminating HIV as a Global Public Health Threat Through Scale-Up of Antiretroviral Therapy and Health System Strengthening Supported by the U.S. President’s Emergency Plan for AIDS Relief — Worldwide, 2004–2022 

“The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) began providing HIV antiretroviral therapy (ART) worldwide in 2004. Through viral load suppression, effective ART improves health outcomes and prevents transmission. By 2022, approximately 20 million persons with HIV infection in 54 countries received PEPFAR-supported ART (62% CDC-supported); this number represents an increase of 300-fold from 66,550 in 2004. During 2015–2022, viral load suppression rates increased from 80% to 95% among those who received testing.” 

JAMA: Association of Receipt of Opioid Use Disorder–Related Telehealth Services and Medications for Opioid Use Disorder With Fatal Drug Overdoses Among Medicare Beneficiaries Before and During the COVID-19 Pandemic 

“This study found that emergency authorized telehealth expansion and MOUD provision during the COVID-19 pandemic were associated with lower odds of fatal drug overdose, demonstrating the potential benefits of continuing these services.” 

JAMA: Twenty-Year Trends in Drug Overdose Fatalities Among Older Adults in the US 

“US opioid overdose deaths have been concentrated in the working-age population, but older adults may be at increasing risk as the baby boom generation ages. Approximately 2.0% of Medicare enrollees 65 years or older meet diagnostic criteria for a substance use disorder (SUD), and half of enrollees take 4 or more prescription drugs daily. Both factors may raise risk of intentional and unintentional overdose in individuals with and without SUD.”  

JAMA: Incidence of Precipitated Withdrawal During a Multisite Emergency Department–Initiated Buprenorphine Clinical Trial in the Era of Fentanyl 

“In this geographically diverse observational cohort, buprenorphine induction in the ED remained safe and effective, even with fentanyl present. Continued access to buprenorphine for opioid use disorder treatment is essential given the ongoing overdose crisis.” 

International Journal for Equity In Health: Shifting the narrative: equity, evidence, effectiveness, and innovation in the era of Ending the HIV Epidemic 

“It is crucial for entities supporting public health interventions to prioritize equity and inclusion in all stages of funding, design, and implementation. This is particularly true for conditions, such as HIV, that disproportionally impact the most marginalized. This will require approaching evidence-based/evidence-informed research with a critical lens towards power and a willingness to dismantle historical dynamics that perpetuate inequities as a way of encouraging truly innovative solutions to support those who need it most.” 

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. 

Job Postings 

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, 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

Texas judge strikes down free HIV drugs, cancer screenings under Obamacare 

“A federal judge on Thursday struck down a key provision of the Affordable Care Act, jeopardizing free coverage of a wide range of preventive services including mammograms, colonoscopies and mental health screenings for nearly 168 million people on employer health insurance and on Obamacare’s individual market. 

District Court Judge Reed O’Connor, the author of several previous rulings against Obamacare, sided with conservative employers and individuals in Texas who argued that the U.S. Preventive Services Task Force that set those requirements has been acting unconstitutionally since 2010. The decision blocks enforcement of the rules nationwide.” 

As states start to get opioid settlement cash, few are sharing how they spend it 

“Since last spring, drugmakers and distributors have sent out about $3 billion in opioid settlement funds to thousands of state and local governments. It's a start on paying what the companies agreed to after they were accused of flooding communities around the country with opioid painkillers that have left millions addicted or dead… But how state and local governments choose to deploy that massive windfall seems to be shrouded in mystery. Reporting requirements are scant, and documents filed so far are often so vague as to be useless.” 

Ten Key Recommendations to Expand Hepatitis C Care in Prisons 

“Safe oral medications, taken for two or three months, cure over 95 percent of people treated. Unfortunately, people in prison often face the greatest obstacles to accessing this lifesaving treatment. Barriers include lack of policies for testing and treatment, lack of financing for HCV care in prisons, low awareness of effective HCV testing and treatment strategies in these settings, and biases against incarcerated people in general and people who inject drugs in particular.”

N. Carolina governor signs Medicaid expansion bill into law

“North Carolina Gov. Roy Cooper on Monday signed a Medicaid expansion law that was a decade in the making and gives the Democrat a legacy-setting victory, although one significant hurdle remains before coverage can be implemented, thanks to a Republican-backed provision…Republicans in charge of the legislature had for years knocked down the expansion idea that originated from the 2010 Affordable Care Act. That led to litigation against Cooper and budget impasses between them. But GOP leaders reversed themselves in recent times, convinced that the state’s Medicaid program was fiscally sound with a switch to managed care, and that Congress would neither repeal the 2010 law nor raise the state’s 10% required share of expenses.”