Policy Updates: Hill Happenings and Administration Activities
*Editor’s Note: NASTAD will be closed for the holidays from December 26 – 30. There will be no PNL the week of January 2. We will resume the weekly newsletter on January 9.
Hill Happenings
Fiscal Year 2023 (FY2023) Appropriations
Facing an end-of-year deadline, lawmakers are working to resolve spending disputes and pass a fiscal year 2023 (FY2023) appropriations omnibus bill. On December 15, Congress approved a short-term continuing resolution (CR) (H.R.1437) to extend current federal funding through December 23 to provide more time for appropriators to complete negotiations on a FY2023 spending package. 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. NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs.
President Biden Signs Respect for Marriage Act Into Law
On December 13, President Biden signed the Respect for Marriage Act (RMA) (H.R. 8404), a historic act that guarantees the same freedoms and rights to LGBTQ+ and interracial marriages that are afforded to all other marriages, into law. NASTAD applauds the passing of the RMA because it guarantees marriage equality and provides millions of LGBTQ+ and interracial couples with the certainty that their marriages will remain legal. The bipartisan RMA reaffirms the status quo set by the Supreme Court’s landmark decisions in United States v. Windsor (2013) and Obergefell v. Hodges (2015) and protects couples by providing federal benefits to all married couples in every state. Click here to read NASTAD’s statement on the passage of the RMA.
Administration Activities
USPSTF Updates Grade A Recommendation for HIV PrEP
On December 13, the United States Preventive Services Task Force (USPSTF) issued a draft recommendation statement for HIV pre-exposure prophylaxis (PrEP), which will replace the original June 2019 recommendation statement upon being finalized in 2023. USPSTF designated an “A” grade for PrEP, recommending that clinicians prescribe the prophylactic antiretroviral therapy to persons who are at increased risk of HIV acquisition to decrease the risk of acquiring HIV infection. The draft statement is consistent with the 2019 recommendation, but includes additional evidence on new formulations of PrEP, including long-acting injectable PrEP. The opportunity for public comment on USPSTF’s Draft Recommendation Statement expires on January 17, 2023 at 11:59 PM EST. NASTAD will prepare comments and encourages our members and other partners to submit their own comments.
NIAID Announces Acting Director to Replace Retiring Dr. Fauci
On December 9, the National Institutes of Health (NIH) announced that Dr. Hugh Auchincloss will serve as Acting Director of the National Institute of Allergy and Infectious Diseases (NIAID), filling in for the role occupied by Dr. Anthony Fauci for nearly four decades. Auchincloss currently serves as NIAID’s principal deputy director since 2006, overseeing the institute’s strategic plan and heads an internal group to develop its initiatives.
State Department Announces Bureau of Global Health Security and Diplomacy
On December 13, US Department of State (DOS) notified Congress of its intention to establish the Bureau of Global Health Security and Diplomacy (Bureau). The new Bureau will ensure that DOS is well-organized to strengthen global health security and to address the growing national security challenges presented by global health crises, including health threats such as COVID-19, Ebola, HIV/AIDS. Additionally, DOS announced that it would nominate Ambassador Dr. John Nkengasong, the current U.S. Global AIDS Coordinator, to lead the Bureau. The Bureau will integrate the Office of the U.S. Global AIDS Coordinator, which leads and coordinates the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), with other international health offices under the new structure while continuing existing programs.
NIH Launches Harm Reduction Research Network
On December 16, the National Institutes of Health (NIH) announced a new research network that will test harm reduction strategies in different community settings to inform overdose prevention efforts and strategies to address the overdose crisis. The research network, funded through the Helping to End Addiction Long-term (HEAL) Initiative, awarded funding to nine research projects and one coordinating center. Grantees will investigate harm reduction strategies for their effectiveness in preventing drug overdoses and other adverse outcomes, sustainability and level of individual and community engagement, and will include a community advisory board and/or people with lived experience.
Resources
The American Journal of Managed Care: Impact of Direct-Acting Antiviral Use for Chronic Hepatitis C on Health Care Costs in Medicaid: Economic Model Update
“Curative direct-acting antivirals for chronic hepatitis C provide a net economic benefit to Medicaid in less than 1 year. Cumulative savings to date have exceeded $15 billion.”
CDC MMWR: Drug Overdose Deaths Among Persons Aged 10–19 Years — United States, July 2019–December 2021
KFF Analysis: PEPFAR May Improve Key Economic and Educational Outcomes, Not Just Health Outcomes
“A new KFF analysis finds that the President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. global HIV/AIDS response and the largest commitment by any nation to address a single disease in history, is associated with improvements in key economic and educational outcomes in countries that received PEPFAR support. Specifically, the program may have helped to grow per capita GDP and reduce the shares of girls and boys who are out of school.”
NASTAD RFP: Strengthening Syringe Services Programs (SSP) through Direct Program Funding
- 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. Click here to view the RFP TA webinar recording.
HRSA NOFO: Ending the HIV Epidemic - Primary Care HIV Prevention (PCHP)
- 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.
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
- Deadline: February 1, 2023
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.
CDC RFA: Public Health Crisis Response Cooperative Agreement
- 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.
Job Postings
Manager, Legal Research – NASTAD
The Manager, Legal Research provides legal and policy research and analysis as part of NASTAD’s technical assistance and capacity building assistance work. This position will implement key activities under NASTAD’s health systems legal and policy portfolio, including conducting public health legal research, synthesizing complex policy material, and supporting development of webinars, peer learning opportunities, and deliverables to support health department efforts to navigate federal, state, and local laws and policies.
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.
Baltimore City Health Department
- PrEP Navigator: The PrEP Navigator will work with the clinical care team in the Baltimore City Health Department Sexual Health and Wellness Clinics to support patient access to comprehensive HIV pre-exposure prophylaxis (PrEP). The PrEP Navigator provides psychosocial support, linkage to care and nonmedical case management support including health insurance and medication payment assistance navigation. Apply by December 23.
- Disease Reactor Coordinator: The Disease Reactor Coordinator will be part of the HIV/HCV Linkage to Care Team at Baltimore City Health Department, Bureau of Clinical Services and HIV/STI Prevention. This team performs a vital component of HIV and HCV prevention, by assisting individuals in reengaging with HIV and/or Hepatitis C with healthcare providers. The Disease Reactor Coordinator receives notifications of individuals who have fallen out of care for HIV and/or Hepatitis C. They search medical and public health records for contact information and contact medical providers to verify medical history. The Disease Reactor Coordinator assigns cases to additional members of the team. Apply by December 23.
- Care Linkage Specialist: The Care Linkage Specialist (CLS) identifies and provides counseling to people with HIV and/or Hepatitis C (HCV) and links them to qualified infectious disease providers for treatment and case management services. The CLS uses disease intervention specialist techniques to contact people and assist them with transportation and registration to their selected provider. Apply by December 23.
- Community Health Educator II: The Community Health Educator II will work directly with our HIV/STI Prevention: Outreach Program. The Outreach Program provides community testing throughout Baltimore City engaging with over 10,000 individuals yearly. Services are provided via a mobile health unit that conducts HIV, Syphilis, Gonorrhea, and Chlamydia testing. Other community services provided are PrEP navigation, Linkage to Care for people with HIV or Hepatitis C, free condoms, literature and referral resources. The majority of work duties occur in the field, interacting directly with community members. Apply by December 23.
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
Hundreds of incarcerated people are dying of hep C — even though we have a simple cure
“STAT’s investigation found that 1,013 people died of hepatitis C-related complications in states’ custody in the six years after the first cure, a Gilead antiviral drug called Sovaldi, hit the market in late 2013. This tally, based on an analysis of 27,674 highly restricted death records, has never before been reported. Many of those 1,013 people were not serving life sentences; they would likely have had the chance to return home, reapply for jobs, and reconnect with parents, spouses, and children — or, in Ritchie’s case, his one grandchild, Gabe. Many should not have died...Public health experts say it’s possible to cut hepatitis C deaths to virtually zero, and effectively eliminate the virus as we’ve done with smallpox or polio. Francis Collins, the White House science adviser and former longtime director of the National Institutes of Health, called STAT’s findings ‘unacceptable.’”
Suffering Endures on the Other Side of the Mpox Curve
“While the declining epidemic curve is worth celebrating, the virus remains with us, with sometimes deadly consequences for those facing varying intersections of inequity. A recent CDC report showed that the people hospitalized with mpox, with the worst and most severe outcomes, are Black, living with advanced HIV, and experiencing homelessness. This is the profile of who's suffering on the other side of the curve.
I believe that when public health emergencies end, they should come with a community-informed national plan focused on how to prevent the same level of suffering in the future. Our country is willing to tolerate way too much morbidity and mortality with infectious disease outbreaks -- as seen with COVID-19 -- and the way we respond when certain communities like LGBTQIA+ people of color are disproportionately impacted speaks volumes to our values. It is shameful that the U.S. Congress still has not passed one new dollar in funding to address the outbreak.”
“Ever-changing trends in the nation's opioid epidemic have resulted in an increasingly tainted drug supply in the United States. More than ever, drug overdoses are now linked to substances that have been mixed with fentanyl, the powerful synthetic opioid that has largely replaced heroin as the primary driver of drug dependency and death in the U.S. In Philadelphia, the veterinary sedative xylazine, also known as "tranq," has become pervasive in drugs sold on the street. The anesthetic and pain reliever is used by vets to treat horses and cattle, yet the compound also is favored as a cutting agent in fentanyl because it can extend a person's perception of a high.”