Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2025 Appropriations
Congress has adjourned for the August recess through September 9, pausing a flurry of activity on the fiscal year 2025 (FY2025) spending bills in July. On August 1, the Senate Appropriations Committee marked up and approved the Labor, Health and Human Services, Education, and Related Agencies (LHHS) Subcommittee spending bill for FY2025, which starts on October 1, 2024. The Senate’s LHHS bill avoids deep spending cuts proposed by the House of Representatives, maintaining investments in core health programs, but many health programs at the Centers for Disease Control and Prevention (CDC) National Center for HIV, Viral Hepatitis, STIs, and TB Prevention were flat-funded, including the HIV and viral hepatitis prevention programs and the infectious disease and opioids program. The Senate’s overall LHHS package includes a higher total than the House bill, teeing up a fall showdown on budget negotiations ahead of the November election.
On July 10, the House Appropriations Committee (HAC) approved the lower chamber’s LHHS spending bill and released an accompanying report for FY2025. The House bill proposes major cuts to health programs across the Department of Health and Human Services (HHS), totaling a decrease of 7% compared to fiscal year 2024 enacted levels. The cuts include the elimination of the CDCcomponent of the Ending the HIV Epidemic Initiative (EHE) and a $190 million cut to the Health Resources and Services (HRSA) Ryan White HIV/AIDS Program (RWHAP). Notably, the subcommittee proposed a $10 million increase for the CDC hepatitis program and a $6.1 million increase for the infectious disease and opioids program.
NASTAD will continue to monitor the congressional appropriations process and advocate for the highest possible funding for HIV, hepatitis, and drug user health programs.
NASTAD Calls on Congress to Support Continuous Eligibility for Adults Enrolled in Medicaid and CHIP
On August 13, NASTAD joined a coalition of 187 organizations and called on Congress to support 12-month continuous eligibility for adults in Medicaid and the Children’s Health Insurance Program (CHIP) by passing the Stabilize Medicaid and CHIP Coverage Act (H.R. 5434 and S. 3138). Complex redetermination requirements, including inefficient paperwork, overly burdensome reporting requirements, or temporary income fluctuation, result in eligibility churn for many beneficiaries, causing millions to lose coverage within a year of enrollment. A nationwide policy of 12-month continuous eligibility for all adults in Medicaid and CHIP will allow for continuous and stable enrollment and for these programs to operate more like private coverage and Medicare.
Administration Activities
HRSA HAB Releases RWHAP EHE Initiative Data Report for 2022
On August 14, the HRSA HIV/AIDS Bureau (HAB) released the Ryan White HIV/AIDS Program (RWHAP) Ending the HIV Epidemic in the U.S. (EHE) Initiative Data Report, 2022, which presents national data on services delivered by 60 RWHAP programs who receive EHE funding to reach people with HIV who are unaware of their status and people with HIV who are not receiving regular care. In 2022, HAB EHE-funded providers served 22,001 clients new to care and 19,204 clients estimated to be re-engaged in care, nearly double the number of new and re-engaged clients served in 2020. From July 2021 through June 2022, RWHAP Part F AIDS Education and Training Center (AETC) Program recipients conducted 483 EHE-funded trainings, a seven-fold increase from July 2019 through June 2020.
HHS Releases 2023 Viral Hepatitis Progress Report
On August 14, the Department of Health and Human Services (HHS) Office of Infectious Disease and HIV/AIDS Policy released the 2023 Progress Report on the Viral Hepatitis National Strategic Plan 2021-2025. This is the second progress report on the 5-year National Strategic Plan, which aims to eliminate the public health threat of viral hepatitis by 2030. The strategic plan sets five goals and has eight core and eight disparities indicators with annual, 2025, and 2030 quantitative targets to measure progress toward the goals. The 2023 progress report highlights actions taken by federal agencies housed within HHS to prevent new infections, improve hepatitis-related health outcomes, reduce disparities and inequities, improve surveillance and data usage, and integrate work planning across all stakeholders.
NASTAD Calls on Biden-Harris Administration to Support Investments in Global HIV Programming
On August 16, NASTAD joined a coalition of 101 organizations and called on the White House Office of Management and Budget (OMB) to support increased funding for global LGBTQI+ rights programs in the President’s Budget Request for Fiscal Year 2026. The coalition highlighted the need for increased investments to continue the work of the Department of State Global Equality Fund and the US Agency for International Development (USAID) Inclusive Development Hub’s Protection of LGBTQI+ Persons programs. These programs protect the rights and wellbeing of LGBTQI+ persons across the world, many of whom live in countries experiencing increased criminalization and persecution of consensual same-sex sexual acts.
FDA Issues Marketing Authorization for First At-Home, Over-the-Counter Syphilis Antibody Test
On August 16, the US Food and Drug Administration granted marketing authorization for the first at-home, over-the-counter test to detect Treponema pallidum (syphilis) antibodies in human blood. The First To Know Syphilis Test, manufactured by NOWDiagnostics, provides an at-home result without a prescription in approximately 15 minutes. Positive test results from this test alone are not sufficient to diagnose syphilis infection and should be followed by additional laboratory testing through a health care provider to confirm a diagnosis of syphilis.
HHS Announces Savings from First Drug Price Negotiations for 10 Costly Drugs
On August 15, HHS announced the projected savings on prescription drug costs from the Medicare drug price negotiation program. The 2022 Inflation Reduction Act authorized HHS and CMS to negotiate prescription drug prices for the Medicare program, starting with 10 of the costliest drugs. The new prices for the 10 selected drugs will go into effect for people with Medicare Part D prescription drug coverage in 2026. When the negotiated prices go into effect in 2026, people enrolled in Medicare Part D are estimated to save $1.5 billion in out-of-pocket costs.
Resources
CHLP Legal Primer: Aging & HIV: An introduction to legal issues facing people living and aging with HIV
“This legal primer written by CHLP Staff Attorney Kae Greenberg explores the unique issues facing the rapidly expanding population of older Americans living with HIV. The focus of the primer is to help PLAHIV identify and overcome the legal barriers to aging with dignity. It explains existing support systems and serves as a guide for advocates to identify priority areas for policy work. This publication explores three areas of the law that impact PLAHIV:”
HRSA HAB Webinar: An Innovative Approach for Improving STI Screening and Treatment Among Those with or Vulnerable to HIV Acquisition
Date: Thursday, September 18, 2024, 2:00-3:00 pm ET
“Join us for an exciting webinar featuring a groundbreaking intervention, Addressing STIs: Ask. Test. Treat. Repeat., designed to improve routine screening, testing, and treatment of common STIs. This initiative integrates evidence-based interventions into routine, primary HIV care without adding extensive burden to the clients and clinical team. CE credit is available for individuals who attend the live webinar. Click here to learn more about CE credits offered through the IHIP webinar series.”
“The Vaccines For Children (VFC) program plays a vital role in increasing and sustaining vaccination coverage. Increased efforts must promote awareness of, confidence in, and receipt of all recommended vaccines among those eligible for the VFC program.”
CDC MMWR: QuickStats: Age-Adjusted Drug Overdose Death* Rates,† by State — United States, 2022
“In 2022, 21 states and the District of Columbia had drug overdose death rates that were higher than the national age-adjusted rate of 32.6 deaths per 100,000 standard population. Rates were generally higher among eastern jurisdictions, including the two jurisdictions with the highest rates, West Virginia (80.9) and the District of Columbia (64.3), although rates were also higher than the U.S. average in Arizona, Louisiana, Missouri and New Mexico.”
NVHR/CHLPI: Hepatitis C State of Medicaid Access - 2024 National Snapshot Report
“The Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) and the National Viral Hepatitis Roundtable (NVHR) recently published updates to their state report cards reflecting changes to hepatitis C treatment access in Medicaid programs since the organizations’ February 2024 National Snapshot Report. Notably, Arkansas’ removal of substance use restrictions means there are no longer any jurisdictions that require sobriety as a pre-requisite to hepatitis C treatment.”
OIDP NOFO: Supporting Vaccine Confidence
Deadline: August 21, 2024 at 6:00 PM ET
This initiative seeks to expand, plan, implement, and evaluate promising practices and develop novel approaches to increase vaccine confidence in local communities, particularly partnerships with organizations that work with populations with low vaccination rates (e.g., African Americans and residents in rural communities). Practical solutions at local levels are needed to help support vaccination efforts in communities by healthcare providers, immunization program managers, immunization advocates, vaccine manufacturers, and other stakeholders. OIDP anticipates the availability of approximately $1,000,000 for this funding opportunity to support four awards ranging from $250,000 to $115,000 per year for up to three years. OIDP and ORHO will support activities by public health departments, community organizations, academic institutions, professional or trade organizations, and immunization coalitions, among others, that work with populations with low vaccination rates.
NIH NOFO: High Priority HIV and Substance Use Research
“The purpose of this notice of funding opportunity (NOFO) is to support high priority research at the intersection of HIV and substance use. This NOFO invites research projects with the potential to open new areas of HIV/AIDS research and/or lead to new avenues for prevention, treatment and cure of HIV among people who use addictive substances.”
Job Opportunities
Public Health Program Director – Harrisburg, PA
The Department of Health is seeking a Public Health Program Director to oversee the Division of HIV Health within the Bureau of Communicable Diseases. In this role, you will oversee the planning, organizing, coordinating, directing, reporting, and executing of a comprehensive HIV program across Pennsylvania, including creation of protocols, policies, goals, and objectives for HIV programs and aligning these with federal requirements and the Department of Health’s mission. Your responsibilities include preparing, reviewing, and finalizing reports required for federal funding, such as annual and semi-annual progress reports on HIV-related services and activities. Apply by August 21.
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.
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.
News Bulletin
CDC Finally Puts $7 Million Toward Pilots for Free, Easy PrEP Access
“For these reasons, advocates from PrEP4All and other groups like PrEP in Black America, the HIV Medicine Association, and AVAC (formerly AIDS Vaccine Advocacy Coalition) were delighted in early August to learn that the CDC has finally decided to put $7 million toward funding for four U.S. jurisdictions that have been hard hit by HIV. This funding will be used by each jurisdiction to design their own pilot programs to offer PrEP totally for free—and presumably with extremely easy access. There is hope that people who have had no other way to access the drug, except perhaps via sometimes hard-to-navigate drugmaker patient assistance (charity) programs, will now be able to do so.”
Schumer says he will work to block any effort in the Senate to significantly cut the CDC’s budget
“The Senate’s top Democrat said Sunday he will work to block a plan that would significantly cut the proposed budget of the Centers for Disease Control and Prevention, warning that such a spending reduction could endanger the public.
Majority Leader Chuck Schumer of New York told The Associated Press he would block legislation from passing the Senate if it were to include the proposed cut.”
WHO declares mpox outbreak a global health emergency
“The World Health Organization on Wednesday declared the spread of mpox in multiple African countries a public health emergency of international concern, the second such declaration in the past two years called in response to transmission of the virus. The latest decision came on the recommendation of a panel of experts convened to advise WHO Director-General Tedros Adhanom Ghebreyesus on the issue. It also follows a similar declaration Tuesday by the Africa Centres for Disease Control and Prevention.”