Policy Updates: Hill Happenings and Administration Activities
*Editor’s note: There will be no weekly newsletter on the week of August 22.
Democrats Advance Social Spending Package via Budget Reconciliation
On August 12, the House of Representatives approved the Inflation Reduction Act (H.R. 5376), finalizing Congressional approval of Democrats’ party-line social spending bill and delivering the legislation to President Biden’s desk for signature. The legislative package was advanced through the budget reconciliation process and marks a years-in-the-making compromise between moderate and liberal Democrats on policy priorities, delivering key health policy wins ahead of the midterm elections.
The Inflation Reduction Act builds upon the Affordable Care Act to improve access to affordable coverage and lower the cost of prescription drugs. Notably, the Inflation Reduction Act includes a provision that empowers the Department of Health and Human Services (HHS) to directly negotiate the price of certain prescription drugs with manufacturers for the Medicare program. The package also includes a three-year extension of ACA Marketplace plan subsidies afforded by the American Rescue Plan Act, saving an average of $800 yearly per enrollee.
However, the Inflation Reduction Act did not include provisions that would fix the Medicaid coverage gap, a key priority for health advocates. The coverage gap fix would have provided more pathways to affordable coverage for people with low incomes in states that did not expand their Medicaid program, a critical step towards reducing health coverage disparities by state and a key tool for ending the HIV and hepatitis epidemics. NASTAD signed onto a coalition letter on July 28 urging Democratic leadership to include the Medicaid coverage gap fix in the budget reconciliation package.
Fiscal Year 2023 Appropriations
Now that the Inflation Reduction Act successfully cleared Congress, Democrats will return to August recess before taking up Fiscal Year 2023 (FY2023) discussions in September. Lawmakers are expected to issue a continuing resolution (CR) to extend federal funding past the October 1 deadline in order to provide more time for appropriators to land on a bipartisan spending framework. House and Senate Democrats advanced their set of appropriations bills earlier this month, providing a starting ground for spending negotiations to begin in earnest after the November elections. The appropriations bills included increases to key health programs, but Democrats will need to secure Republican support to advance the spending package. NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs.
NASTAD Calls on Congress to Protect the Congressional Intent of the Ryan White HIV/AIDS Program
On August 15, NASTAD joined a coalition of Ryan White HIV/AIDS Program (RWHAP) recipient service organizations and patient advocacy organizations and urged Congress to reject the Ryan White PrEP Availability Act (S.4395). S.4395 would expand the intent of the RWHAP program, which was designed to provide dedicated support and services for people living with HIV, authorizing the use of RWHAP funds to provide PrEP to people at risk of acquiring HIV. As a result, S.4395 would divert RWHAP grant funding to PrEP services, potentially reducing the efficacy of the limited resources allocated to the program. The coalition instead highlights the need to provide additional HIV prevention funding to boost PrEP access and supplement, not supplant RWHAP programming.
CDC Releases Vital Signs Report on HCV Treatment Rates
On August 9, the Centers for Disease Control and Prevention (CDC) released a Vital Signs report highlighting the persistent gaps in treatment access for people diagnosed with hepatitis C virus (HCV). The report found that, despite the availability of direct-acting antiviral (DAA) treatment for HCV, less than 1 in 3 people with private health insurance are treated within a year of their diagnosis, with even greater gaps in treatment access for patients with public health coverage. Additionally, the report shows that adults under 40, who show the highest rates of new HCV infection, have the lowest treatment rates by age group. These significant findings usher in a renewed sense of urgency for removing longstanding barriers to timely and affordable DAAs to treat HCV, including removing eligibility restrictions and preauthorization requirements, expanding the number of primary care providers treating HCV, and reducing the cost of antiviral treatment across all payer types.
Biden Administration Ramps Up Nation’s MPV Response
On August 2, President Biden named two key health officials to serve as the National MPV Response Coordinators and manage the nation’s response to the growing outbreak. The White House announced that Robert Fenton, a regional administrator with the Federal Emergency Management Agency (FEMA), will serve as the National MPV Response Coordinator, and Dr. Demetre Daskalakis, Director of the CDC Division of HIV Prevention (DHP), will serve as the National MPV Response Deputy Coordinator. Fenton and Daskalakis will lead the Administration’s strategy and operations to combat the current MPV outbreak, including equitably increasing the availability of tests, vaccinations, and treatments.
Additionally, on August 4, the Biden Administration declared MPV a public health emergency (PHE). The PHE declaration will facilitate greater resource allocation and distribution to combat to combat the growing crisis and provide clear federal coordination and guidance for states and jurisdictions to manage their local MPV response. The PHE declaration was followed by an emergency use authorization for the JYNNEOS vaccine and ongoing efforts to support MPV research.
NASTAD Calls on HHS to Swiftly Strengthen Nation’s MPV Response
On July 22, NASTAD joined a coalition of public health providers, researchers, and advocates and signed-on to a letter calling on HHS leadership to move swiftly to strengthen the nation’s MPV response. The coalition highlighted the challenges impeding the public health response to the spreading outbreak and offered policy recommendations to control the epidemic and improve patient outcomes, including centering equitable, community-based access to vaccinations, streamlining the production of MPV tests and treatments, and engaging with communities to spread awareness and reduce stigma.
NASTAD Calls on CMS to Issue a National Coverage Determination for Long-Acting Injectable PrEP
On August 5, NASTAD joined a coalition of HIV providers and advocates and called on the Centers for Medicare and Medicaid Services (CMS) to expedite its evaluation of a National Coverage Determination (NCD) for long-acting cabotegravir. The coalition applauded CMS for accepting a request to consider a NCD for cabotegravir, which is the only pathway to coverage under Medicare Part B for a provider-administered drug. However, CMS did not identify a timeline for action on the NCD request. The coalition calls on CMS to quickly and efficiently evaluate a NCD for cabotegravir, which would mark an important step required to eliminate cost-sharing for the new form of long-acting injectable PrEP for Medicare Part B beneficiaries.
NASTAD/Balanced Imperfection: Harm Reduction Hacks
Harm Reduction Hacks is a comprehensive microsite and resource to guide organizations developing new and/or with existing syringe services programs (SSPs) in program design, implementation, and organizational sustainability. This resource was developed by NASTAD and Balanced Imperfection through the CDC-funded National Harm Reduction Technical Assistance Center.
“Persons with advanced HIV might be at increased risk for severe monkeypox. Postexposure prophylaxis and antiviral treatments are available for persons with HIV infection. Prompt diagnosis and treatment and enhanced prevention efforts might reduce the risk for severe outcomes.”
“Public health efforts should prioritize gay, bisexual, and other men who have sex with men, who are currently disproportionately affected, for prevention and testing, address equity, and minimize stigma, while maintaining vigilance for transmission in other populations. Clinicians should test persons with rash consistent with monkeypox, regardless of whether the rash is disseminated or was preceded by prodrome.”
O’Neill Institute: Tackling MPX in Black and Latino Communities
“A snapshot of national data released by CDC showed a majority of MPX diagnoses among Black and Latino MSM and 41% of diagnoses among people living with HIV…Concerted action is needed to minimize inequities and effectively serve Black, Latino, and other MSM and transgender people of color in the MPX response.”
Hep ElimiNATION, a collaboration between the O’Neill Institute for National and Global Health Law at Georgetown University Law Center, National Viral Hepatitis Roundtable, and the Center for Health Law and Policy Innovation of Harvard Law School, has released final, revised grades on states’ capacity for viral hepatitis elimination for 2022.
The NIH Research Education Program (R25) supports research education activities in the mission areas of the NIH. The overarching goal of this Office of Research on Women’s Health R25 program is to support educational activities that complement and/or enhance the training of a workforce to meet the nation’s diverse biomedical, behavioral and clinical research needs. As sex and gender influence multiple domains of health, courses, curricula, and methods covering a broad range of topics are appropriate for this FOA, as long as sex, gender, or both is a primary domain of focus, including HIV and women, including HIV cure, prevention, and treatment.
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.
Council of State and Territorial Epidemiologists is seeking a consultant to provide continuous technical assistance (TA) and subject matter expertise on HIV surveillance and epidemiology to improve HIV surveillance capacity and provide support on activities and convenings related to HIV surveillance technical assistance and programmatic planning and execution. If interested in this opportunity, please submit an application to Symone Richardson (email@example.com) by Wednesday, September 7, 2022 according to the process detailed in the RFP.
Surveillance Section Chief – Sacramento, CA
This position supports the California Department of Public Health’s (CDPH) mission and strategic plan by working collaboratively with state and federal agencies, local health jurisdictions (LHJ), universities, and community-based organizations to ensure efforts to combat the HIV/AIDS epidemic are targeted and effective by leveraging data and technology to advance goals, inform action and accountability, strengthen the science base of our services, and expand surveillance systems for evidence-based decision making. The Research Scientist Supervisor II (RSS II) directs and manages all aspects of HIV case and incidence surveillance in California, including managing the activities of the Quality Management Unit (QMU) and the Medical Monitoring Project (MMP)
Viral Hepatitis Epidemiologist (Job ID: 26499) – Concord, NH
The State of New Hampshire, Department of Health and Human Services, Division of Public Health Services has a full-time vacancy for Program Specialist IV. This is a grant-funded position and is subject to renew every two years. The Viral Hepatitis Epidemiologist conducts statewide surveillance activities within the STI/HIV/Viral Hepatitis Surveillance Program. Analyzes and interprets statewide data, policies, and procedures for use in identifying and monitoring trends. Makes recommendations for the planning and development of disease surveillance, prevention, and care program activities. Applications close August 6.
- Intern, Policy and Legislative Affairs
- The Policy and Legislative Affairs (PLA) Intern will assist the PLA team in the implementation of NASTAD’s legislative and policy positions on federal appropriations and authorization legislation related to HIV and hepatitis issues. The PLA Intern supports the day-to-day legislative activity needed to implement federal legislative and regulatory goals. The PLA Intern will assist in tracking, monitoring, researching, and preparing advocacy documents on relevant HIV and hepatitis policy issues and legislation and coordinate and participate in Hill visits.
- Manager, Prevention
- The Manager, Prevention, as part of NASTAD’s prevention team, supports the organization’s capacity to support health departments (HDs) and community-based organizations (CBOs) implementation of high-impact HIV prevention programs. The position works primarily on NASTAD’s CDC-funded Capacity Building Assistance (CBA) project to provide technical assistance to HDs implementing PS18-1802, and to CBOs implementing PS21-2102. The position is responsible for managing NASTAD’s outreach and relationship-building with CBOs in the southern United States.
End Hep C SF Strategic Director – San Francisco Public Health Foundation
The EHCSF Strategic Director will assist all work groups and members by supporting the overall execution of the initiative’s strategic plan while supporting the direction of day-to-day operations. This position will focus on engaging impacted populations through the community navigator program and community meetings, manage initiative grants and budgets, and conceptualize and execute EHCSF community events. Applications close August 19.
Harm Reduction Response Team, University of Wisconsin Madison
The Division of Infectious Diseases at UW-Madison, in collaboration with the Wisconsin Department of Health Services, Communicable Diseases Harm Reduction Section (CDHRS), seeks candidates to join a team that will provide mobile harm reduction outreach services in rural Wisconsin communities. These positions are responsible for providing an array of mobile-based harm reduction services including intakes and ongoing assessments to people living with and at risk for hepatitis C virus infection (HCV), and HIV and other communicable infections (e.g., STI, COVID-19,). Apply by July 27.
Social Innovations Team Lead – Baltimore, MD
Baltimore City Health Department is seeking to fill the position of the Social Innovations Team Lead for the Bureau of Clinical Services and HIV/STI Prevention. The HIV/STI Social Innovations Team is a unique and visionary program at Baltimore City Health Department that utilizes a human-centered design approach to engage with the Baltimore community on issues related to HIV and Sexually Transmitted Infection (STI) prevention. The team creates innovative, original, and engaging programming to involve the community in the heart of the Health Department’s work.
Project Data Manager, Syringe Service Program – University of Washington
We are hiring for a Project Data Manager (Research Consultant) to work closely with the principal investigator, project coordinator, survey site staff, CDC personnel, and other support staff to enact all data-related components of Project NEXUS. This position will supervise the NEXUS data team, including two research assistants, lead data analysis, and be the main point of contact for the CDC data management team. They will also provide support for the Dave Purchase Memorial Survey and the National Harm Reduction TA Center as needed.
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, and analyzing exposure data utilizing epidemiological and statistical methods.
Hepatitis Surveillance Data Analyst – New Orleans, Louisiana
This position is responsible for the data analysis activities for the Louisiana Office of Public Health STD/HIV/Hepatitis Program (SHHP), in the Hepatitis Surveillance unit. Data utilized for Hepatitis Surveillance activities include Hepatitis laboratory data, Case Report Forms, Provider Report Forms, Linkage to Cure data, investigation data, Medicaid data, and data from related sources and programs. This position will implement and coordinate data analysis activities to monitor and evaluate progress toward meeting hepatitis elimination within the state. All activities must be completed in accordance with the security and confidentiality guidelines required by the Centers for Disease Control and Prevention (CDC) and SHHP.
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.
“Democrats are set to achieve their decades-long dream of empowering Medicare to negotiate drug prices. Yet they remain haunted by what could have been and how long they may have to wait before taking another big swing at health care reform…Democrats are widely expected to lose control of one or both chambers in November, and members are aware that today’s vote on the Inflation Reduction Act may be their last chance for some time to enact major reforms to the U.S. health system.”
“U.S. public health officials tracked the early cases around the country that followed. But a series of setbacks in the administration’s response — including clunky early testing protocols, slow vaccine distribution, a lack of federal funding to help state and local governments respond to the outbreak, and patchy communication with communities most affected by the virus — allowed the disease to gain a foothold among men who have sex with men, particularly those who have had multiple partners in a short period of time. Epidemiologists, public health officials and doctors now fear the government cannot eliminate the disease in that community, and they’re warning that they are running out of time to stop the virus from spreading in the U.S. population more broadly.”
“For the first time in nearly 50 years, the U.S. Department of Education plans to explicitly spell out protections for pregnant and parenting students and school employees—an evolution advocates say may be more important than ever in a post-Roe v. Wade world. The Education Department’s proposed Title IX rules made headlines for their historic protections of LGBTQ students when they were released in June. But they also include clarifications on school officials’ obligations to not discriminate against pregnant and parenting students and employees, adding detail to rules which haven’t been updated since 1975.”