Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
Fiscal Year 2023 (FY2023) Appropriations
Lawmakers are nearing the December 16 funding deadline afforded by the current continuing resolution (CR) without a topline spending agreement in place, complicating the chances of achieving a bipartisan spending package by year’s end. While top appropriators from both parties favor finishing the appropriations bills before 2023, Republicans are emboldened to delay spending discussions until the 118th Congress begins its session in January, after which they will control the majority in the House of Representatives and have more negotiating power. However, the power split between the two chambers in the next Congressional session threatens further entrenchment of partisan budget disagreements and raises the likelihood that appropriators will default to a year-long CR if negotiations drag into the new year.
On December 7, Democrats announced that they would issue their own spending proposals in an effort to advance appropriations negotiations. Congress is expected to issue another temporary CR to buy more time for an end-of-year effort to materialize a bipartisan spending package for FY2023. 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 Fund National Mpox Response
On December 5, NASTAD joined a coalition of public health and LGBTQ organizations and called on Congress to fund the national mpox response. The coalition builds on the White House’s supplemental appropriations request and highlights additional mpox funding needs, including resupplying the national vaccine stockpile for smallpox, building capacity at state and local health departments, and funding community health centers, Ryan White, and STI clinics. The emergency supplemental funding is needed to ensure that providers can continue to address mpox as the national public health emergency winds down.
NASTAD Calls on Congress to Fund Justice Assistance Grant Programs
On December 7, NASTAD joined 70 organizations and called on Congress to provide robust funding for DOJ justice assistance grant programs through the FY2023 Commerce, Justice, Science, and Related Agencies bill. The advocates highlight the critical role of these grant programs in supporting states and community-based organizations to reduce the severity and impact of the overdose and mental health crises.
Administration Activities
ONDCP Launches First-of-its-Kind National Data Dashboard for Non-Fatal Overdoses
On December 8, the White House Office of National Drug Control Policy (ONDCP) launched a first-of-its-kind national data dashboard of non-fatal opioid overdoses across the country. The dashboard was spurred by the Biden Administration’s National Drug Control Strategy, which calls for developing and strengthening the nation’s data systems to reach people at-risk of an overdose, and expand access to treatment for substance use disorder and high-impact harm reduction interventions like naloxone. The ONDCP Nonfatal Opioid Overdose Dashboard is informed by a derivation of clinical and patient characteristics within the National EMS Information System (NEMSIS) maintained by the National Highway Traffic Safety Administration (NHTSA).
Resources
PWID + COVID-19 Data Collaborative
The PWID + COVID-19 Data Collaborative was created to gather existing data on PWID health indicators and to assess change pre- and post-pandemic start. We aim to collect and combine summary data from research studies, surveys, and routinely collected service data. These summary data will be analyzed together and made available to data contributors and the public.
DOJ Press Release: Justice Department Secures Agreement with Alabama Medicaid to Remove Unlawful Sobriety Mandate for Health Care Access
“The Justice Department announced today that it has secured a settlement agreement with the state of Alabama’s Medicaid Agency (Alabama Medicaid) under the Americans with Disabilities Act (ADA) to ensure that Alabama Medicaid recipients with Hepatitis C (HCV) who also have a substance use disorder have equal access to medications to treat their hepatitis.”
PLOS Global Public Health: Correlations between oral Pre-Exposure Prophylaxis (PrEP) initiations and policies that enable the use of PrEP to address HIV globally
“While the adoption of PrEP recommendations into national guidelines exists and is a vital step towards increasing PrEP availability in-country, much more needs to be done to implement effective PrEP services… Results from this analysis imply that enabling policy environments have direct links to PrEP uptake and that policies facilitating access to HIV prevention services will be vital to effectively contain the HIV epidemic.”
CDC Mpox MMWR:
- Reduced Risk for Mpox After Receipt of 1 or 2 Doses of JYNNEOS Vaccine Compared with Risk Among Unvaccinated Persons — 43 U.S. Jurisdictions, July 31–October 1, 2022
- “Among JYNNEOS vaccine-eligible men aged 18–49 years in 43 U.S. jurisdictions, mpox incidence among unvaccinated persons was 9.6 times as high as that among persons who had received 2 vaccine doses and 7.4 times as high as that among persons who had received only the first dose. Preliminary evidence indicates no difference in protection between subcutaneous and intradermal administration routes.”
- Safety Monitoring of JYNNEOS Vaccine During the 2022 Mpox Outbreak — United States, May 22–October 21, 2022
- “Surveillance supports JYNNEOS vaccine safety. CDC and FDA will continue to monitor the safety of JYNNEOS.”
NASTAD RFP: Strengthening Syringe Services Programs (SSP) through Direct Program Funding
- Application Deadline: January 20, 2023, at 11:59 PM EST
NASTAD and project partners, VOCAL-NY and University of Washington (UW), are excited to announce a CDC-supported funding opportunity: Strengthening Syringe Services Programs (SSP) through Direct Program Funding. This five-year project aims to strengthen the capacity of SSPs through direct program funding, provided through NASTAD, to continue serving as critically essential access points for core syringe and safer drug use supplies, overdose prevention information and materials, and a range of services for PWUDs such as adult vaccination services, HIV and viral hepatitis testing and linkage to care services, and referral and navigation efforts.
AIDS United Webinar: Sex Work, Policy, and the Intersection of the Law: A Listening Session
- Date: December 14th, 2022 from 2:00 – 3:30 PM ET
This listening session will provide an opportunity for sex worker activists to discuss their experiences within the sex worker rights movement and the ways in which this work intersects with federal and state policy. In honor of International Day to End Violence Against Sex Workers*, AIDS United’s Harm Reduction and Policy teams will be hosting a listening session of sex work activists and harm reductionists, which will highlight the many ways structural inequality such as gender-based discrimination (i.e., misogyny, homophobia, transphobia), housing inequity, and drug user health stigma, are responsible for reproducing harmful conditions within the sex trade industry.
ASTHOConnects Webinar: Medicaid and Public Health Partnerships in Virginia
- Date: Tuesday, December 13 from 3-4 pm ET
NASTAD is excited to partner with ASTHO on this ASTHOConnects Webinar on Medicaid and Ryan White HIV/AIDs Program alignment in Virginia. Learn how state public health agencies can align with state Medicaid agencies to collaboratively advance the goals of the National Ending the HIV Initiative in this ASTHO webinar. Featured guests include the Virginia Department of Medical Assistance Services, the Virginia Department of Health Ryan White HIV/AIDs Program (RWHAP)/AIDs Drug Assistance Program (ADAP), and the University of Virginia.
CDC RFA: Public Health Crisis Response Cooperative Agreement
- Application Deadline: February 12, 2023
The CDC is activating CDC-RFA-TP22-2201 Public Health Crisis Response Cooperative Agreement to support state and local public health mpox response efforts. CDC will award up to $16 million to select jurisdictions on the approved but unfunded (ABU) list for CDC-RFA-TP22-2201. Funding will be prioritized for jurisdictions reporting the highest numbers of cases during October 2022. Funding is intended to address urgent needs and to implement monkeypox response related activities including efforts to increase vaccine accessibility and uptake, case and cluster investigation, surveillance, testing, communication, education, and outreach. Additional information, including supplemental funding guidance is forthcoming.
HRSA NOFO: Ending the HIV Epidemic - Primary Care HIV Prevention (PCHP)
- Application Deadline: January 17, 2023
HRSA released the fiscal year (FY) 2023 Ending the HIV Epidemic - Primary Care HIV Prevention (PCHP) notice of funding opportunity (NOFO, HRSA-23-025). HRSA will make approximately $50 million available for up to 140 health centers located in the targeted geographic locations where there are a substantial amount of new HIV infections.
FY 2023 PCHP will support expanding HIV prevention services that decrease the risk of HIV transmission in underserved communities. This funding will focus on increasing HIV testing, PrEP prescriptions, and linkage to HIV care and treatment. It is part of HHS’ Ending the HIV Epidemic in the U.S. initiative, which aims to reduce the number of new HIV infections in the U.S. by 90% by 2030. Health centers with service delivery sites in the targeted geographic locations that did not receive FY 2020, FY 2021, or FY 2022 PCHP funding, are eligible to apply. View the FY 2023 PCHP one-pager (PDF) for applicants. Visit the FY 2023 PCHP technical assistance (TA) webpage to access the NOFO, application aids, and other resources.
- Applicant TA Call: December 16, 2022
- Letter of Intent Due: December 19, 2022
- Application Deadline: February 9, 2023
The purpose of the CDC’s National Center for Injury Prevention and Control (NCIPC) Mentored Research Scientist Development Award (K01) is to provide support for an intensive, supervised (mentored) career development experience in substance use and/or overdose prevention research leading to research independence. NCIPC supports K01 grants to help ensure the availability of an adequate number of trained scientists to address critical public health research questions to prevent polydrug use and overdose. Applicants must propose a research project that aims to better understand and identify risk and protective factors related to polydrug initiation, use, escalation, and overdose. This could include, but is not limited to, co-use of opioids, stimulants, and/or cannabis, including co-use with or without the knowledge of the person who is using the drugs. Additionally, research can focus the examination of potential moderators of risk and protective factors for polydrug initiation, use and escalation; and/or can investigate the relationship between polydrug use and overdose.
CDC NCHHSTP NOFO: PS-23-0009: Advancing Policy as a Public Health Intervention to Reduce Morbidity, Mortality, and Disparities in HIV, Viral Hepatitis, STDs, and Tuberculosis
The Center for Disease Control and Prevention’s (CDC) National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) is thrilled to announce a new funding opportunity. This two-component funding opportunity aims to strengthen the ability of leaders who make decisions in public health to identify and implement evidence-based policy interventions. The funding opportunity features two distinct components:
- Leverage legal epidemiology methods to examine laws and policies over time and perform critical analyses to understand the effect of laws and policies on health and economic outcomes.
- Provide robust legal and policy technical assistance (TA) to support leaders who make decisions in public health as they navigate complex issues unique to their jurisdiction and proactively create publicly accessible TA tools and resources.
Application Deadline: February 1, 2023.
Job Postings
NASTAD RFP: NASTAD Media Training
- Deadline: January 9, 2023, at 5:00 pm
NASTAD seeks an experienced strategic communications/public relations partner to develop a comprehensive media training for a group of seven senior staff members. We are currently aiming to hold this training in-person at the NASTAD office on March 9, 2023. The office is located at 444 North Capitol Street, NW, Washington, DC 20001.
While this is a short-term project, our goal is to develop a long-term relationship with a public relations firm or professional. Because of the nature of our work, we would prefer contractors with experience in the public health and social justice fields, and who have worked with non-profit organizations. Total budget for this work is $12,500.
NASTAD RFP: Consultants for HIV Prevention Billing and Coding Guide
- RFP Issue Date: December 5, 2022
- RFP Closing Date: January 15, 2023
- Performance Period: February 1, 2023 – September 29, 2023
NASTAD is soliciting proposals from professionals with demonstrated expertise and experience in medical coding and billing and creation of HIV-related coding guides. The consultant will lead creation of a billing and coding guide for HIV Prevention, with a special emphasis on pre-exposure prophylaxis (PrEP). This work is funded by a cooperative agreement from the Centers for Disease Prevention and Control (CDC) and builds off of and updates a HIV Prevention billing and coding guide NASTAD created in 2018.
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.
- Bilingual Medical and Housing Case Manager: The focus of this position will be to ensure efficient delivery of quality medical case management services to clients who are living with HIV through assessment, planning, service procurement, delivery, coordination, and monitoring, ensuring all services are offered in an inclusive, respectful and professional manner. The Bilingual Medical and Housing Case Manager reports directly to the Care Services Director and is required to attend All Staff meetings, Care Services team meetings, Clinical Consultations, Finance Committee meetings and to keep all client data up to date for reporting purposes. Because this position manages confidential information for clients, the Bilingual Medical and Housing Case Manager must demonstrate the highest degree of professionalism.
Harm Reduction Coordinator, State Opioid Response (SOR) Team – Washington, DC
This position will be responsible for the day-to-day management of one of the country’s largest naloxone (NARCAN®) programs, including working with over 150 community partners and pharmacies, coordinating and providing naloxone trainings, and ramping up fentanyl test strip distribution. An ideal candidate is familiar with social services/drug user health organizations in DC, trained and highly familiar with naloxone administration, able to manage relationships with diverse community stakeholders, and has proficiency with Microsoft Suite, especially Excel. Individuals with lived experience are encouraged to apply. Please note this is *NOT* a fully remote position—this position is expected to be in our NoMa office at minimum three days per week, plus attend occasional events and trainings in the community. Applications will be open until 11/30/2022. Salary range is Salary range is roughly $60-75K.
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, and 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.
News Bulletin
U.S. FDA to review Emergent's OTC opioid overdose drug on priority
“Contract drugmaker Emergent Biosolutions said on Tuesday its over-the-counter nasal spray as a treatment for suspected opioid overdose would be reviewed on a priority basis by the U.S. health regulator.
Emergent is seeking the U.S. Food and Drug Administration's approval for a prescription-free sale of its nasal spray, Narcan, which is already cleared for the treatment of opioid overdose in the country. The agency will make its decision by March 29 and its priority review status puts Narcan on track to become the first naloxone-based drug to be sold over the counter, Benchmark analyst Robert Wasserman said.”
Kevin McCarthy faces debt-limit dilemma as House GOP ratchets up demands amid speaker bid
“House Republicans are plotting tactics for their new majority and weighing how to use their leverage to enact a laundry list of demands, with many zeroing in on an issue with enormous economic implications: Raising the nation’s borrowing limit. It’s an issue confronting House GOP Leader Kevin McCarthy, who is rounding up the votes to win the House speaker race and facing pressure from some of his colleagues to more forcefully detail how he plans to handle the sensitive topic before they decide whether to support him on January 3 for the most powerful position in Congress.”
CMS Proposes Major Changes to Prior Authorization
“Under a new proposed rule, the Centers for Medicare & Medicaid Services (CMS) will require some payers to automate their prior authorization processes, respond more quickly, provide reasons for denials, and publicly report certain metrics, the agency announced on Tuesday. If implemented, the proposed rule would mandate that "impacted payers" share prior authorization decisions within 72 hours for expedited requests and within 7 calendar days for "non-urgent" requests and require payers to include specific reasons for denials.”
The Opioid Epidemic Is Surging among Black People because of Unequal Access to Treatment
“A million people in the U.S. have died of opioid overdoses since the 1990s. But the face—and race—of the opioid epidemic has changed in the past decade. Originally white and middle class, victims are now Black and brown people struggling with long-term addictions and too few resources…The reasons for this dramatic change come down to racial inequities. Research shows that Black people have a harder time getting into treatment programs than white people do, and Black people are less likely to be prescribed the gold standard medications for substance use therapy.”