Policy Updates: Hill Happenings and Administration Activities
On January 27, Senate Appropriations Chair Patty Murray (D-WA) and House Appropriations Chair Kay Granger (R-TX-12) reached an agreement on topline spending totals for the 12 Fiscal Year 2024 (FY2024) appropriations subcommittee bills. Appropriators are now working to draft bill text ahead of spending deadlines set by a January 19 continuing resolution (CR) (H.R. 2872). The new CR establishes an updated “laddered” deadline for federal spending bills, with some federal agencies and programs facing a March 1 deadline. Larger agencies, including those funded through the Labor, Health and Human Services, Education, and Related Agencies (LHHS) bill, now face a March 8 deadline, granting lawmakers a few more weeks to finalize FY2024 spending levels.
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 Boost Funding for NIAID
On January 29, NASTAD joined a coalition of organizations and called on Congress to boost funding for the National Institute of Allergy and Infectious Diseases (NIAID) in the FY2024 spending bill. NIAID supports over 1,300 researchers across the country who are building an evidence base to inform public health practice and rulemaking. NIAID-funded research supports efforts to end the HIV and viral hepatitis epidemics, including supporting the development of antiretrovirals to treat HIV and direct-acting antivirals that cure hepatitis C virus (HCV) infection.
DOJ, HHS Push State Medicaid Administrators to Comply with Federal Laws Protecting Access to HCV Treatment for People with SUD
On January 24, the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) issued a joint letter to state Medicaid administrators uplifting their obligation under federal law to ensure that state programs do not impose unlawful barriers to antiviral treatment for people who have HCV and substance use disorder (SUD). The letter reminds states that the Americans with Disabilities Act prohibits non-medically indicated sobriety restrictions for HCV treatment and communicates the DOJ’s willingness to take action against any violations. The letter highlights a 2022 settlement agreement between the DOJ and the Alabama state Medicaid program which removed sobriety restrictions for HCV treatment that violated ADA protections.
CDC STI Surveillance Report Shows Dramatic Increase in National Syphilis Rates in 2022
On January 30, the Centers for Disease Control and Prevention (CDC) released the Sexually Transmitted Infections Surveillance, 2022 report, which reveals a dramatic increase in national syphilis rates during calendar year 2022. While gonorrhea rates decreased by 8.7% between 2021 and 2022, national rates of syphilis increased by 17% in the same time-span, contributing to an overall 78% increase in syphilis rates since 2018. A significant burden of the increased syphilis incidence occurred in the congenital syphilis cohort, which saw a 30.6% increase between 2021 and 2022 and an overall 183.4% increase since 2018. The report authors call for a redoubling of prevention efforts and treatment approaches as the public health system rebounds from the COVID-19 pandemic and mpox outbreak, which strained the STI workforce.
CDC, FDA Work to Address Syphilis Epidemic and Treatment Shortages
On February 8, CDC published an MMWR, CDC Laboratory Recommendations for Syphilis Testing, United States, 2024, which updates laboratory recommendations for syphilis testing. The updates are meant to facilitate greater testing and reporting of syphilis at laboratories as the nation grapples with a growing epidemic. The recommendations highlight the significant health disparities associated with syphilis infections, particularly among sexual and gender minority populations, intersections with the HIV and substance use epidemics, and increased morbidity and mortality attributable to congenital syphilis infections. The STI surveillance report and updated laboratory recommendations follow a January 16 notice that the FDA is temporarily approving importation of Extencilline, an antibiotic approved for use among populations with perinatally acquired syphilis in some countries outside of the US, to fill manufacturing shortages of Bicillin L-A® in the US.
HHS Issues Final Rule to Permanently Extend Remote Prescribing of Buprenorphine
On February 2, HHS and the Substance Abuse and Mental Health Services Administration (SAMHSA) finalized rulemaking that will permanently extend telehealth flexibilities for Opioid Treatment Programs (OTPs) that were first introduced during the COVID-19 public health emergency. The final rule authorizes remote prescribing of buprenorphine without an in-person visit or restrictions against audio-only telehealth appointments. Additionally, the rule updates federal opioid use disorder (OUD) treatment standards to include harm reduction education and services when clinically necessary or otherwise appropriate. The rule will go into effect on April 2, 2024.
HHS Finalizes Regulation Protecting Patient Confidentiality for People Living with SUD
On February 8, HHS finalized rulemaking that will facilitate greater care coordination for patients with living with SUD. The final rule strengthens confidentiality protections and aims to integrate behavioral health information with other medical records to facilitate interoperability between health systems while reducing provider stigma for patients who seek medical care. Notably, the regulation provides HHS with the enforcement authority to address privacy violations. The rule was spurred by the bipartisan Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which required HHS to update existing SUD treatment records privacy regulations into closer alignment with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Breach Notification, and Enforcement Rules.
NASTAD Blog: Remembering Cecilia Gentili
“It is with deep sadness that we write to mourn the passing of Cecilia Gentili, a trailblazing writer, artist, actress, and fierce advocate for the rights of sex workers and incarcerated people, trans liberation, immigrant justice, and drug user health…She will be remembered for her intelligence, her bravery, her art, her witticisms, and the boundless love she showed to her community. Sharing space with Cecilia, her stories, and her fierce sense of humor was an honor and an immense joy. We leave you with a request from Cecilia’s loved ones in honor of her memory: Please be gentle with each other and love one another with ferocity. May she rest in power and peace.”
- CDC Laboratory Recommendations for Syphilis Testing, United States, 2024
- “This report provides new CDC recommendations for tests that can support a diagnosis of syphilis, including serologic testing and methods for the identification of the causative agent Treponema pallidum. These recommendations are intended for use by clinical laboratory directors, laboratory staff, clinicians, and disease control personnel who must choose among the multiple available testing methods, establish standard operating procedures for collecting and processing specimens, interpret test results for laboratory reporting, and counsel and treat patients.”
- Comparison of Administration of 8-Milligram and 4-Milligram Intranasal Naloxone by Law Enforcement During Response to Suspected Opioid Overdose — New York, March 2022–August 2023
- “No benefits to administration of 8-mg intranasal naloxone compared with 4-mg product were found. More data are needed to determine whether higher-dose intranasal naloxone would provide added benefits.”
- Selection of Antibiotics as Prophylaxis for Close Contacts of Patients with Meningococcal Disease in Areas with Ciprofloxacin Resistance
- “CDC’s updated guidance on antibiotic use to prevent meningococcal disease helps health departments determine when other prophylaxis options should be preferred to ciprofloxacin.”
Senior Program Manager, Health Departments & Community Partnerships (KFF) – San Francisco, CA/Hybrid
The KFF Social Impact Media program is looking for a Senior Program Manager for health department and community partnerships. We work with state and local health departments on localized iterations of our campaigns designed to address local priorities and extend the reach of limited public resources. We also have a large-scale ongoing partnership with Walgreens to bring health department and community partners into stores on National HIV Testing Day (June 27) to provide free testing and the latest information about prevention and treatment.
Viral Hepatitis Prevention Coordinator – Austin, TX
Under direction of the Prevention Unit, provides highly advanced, senior-level consultative services and technical assistance as the DSHS viral hepatitis prevention coordinator. Oversees implementation and maintenance of viral hepatitis prevention efforts by identifying ways to integrate viral hepatitis prevention, vaccination, testing, and linkage to care into existing public health, clinical care, and community settings. Responsible for developing a DSHS viral hepatitis prevention plan as well as legislatively-mandated plans, including working with branch staff to solicit input from the public, including experts on Hepatitis, on the tenets of the plan. Apply by April 23.
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.
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.
“The new policy did not allow waivers for opting out of molecular surveillance in places where such data could be used in criminal proceedings, a change that had been recommended by the National Alliance of State and Territorial AIDS Directors, a nonprofit representing public health officers.”
“Vending machines offering tests for sexually transmitted infections hold promise as a way to reach people with sexual health services, according to a study that comes on the heels of recent increases in STIs in both the U.S. and England…Researchers said increased access to testing among men who have sex with men, people from Black communities and younger people 16 to 25 years old “was a priority” in the two regions the machines were placed, “as these groups have high risk of infection and do not regularly engage in HIV and STI testing,” according to the study.”
“Syphilis rates jumped more than 17 percent over last year’s record-setting rate to reach the highest level since the 1950s — a dangerous trend that could worsen if Congress allows scheduled budget cuts to disease trackers to take effect this year. New data from the Centers for Disease Control and Prevention released Tuesday shows a steep escalation of a years-long national increase in syphilis and other sexually transmitted infections as local health departments work to recover from their battle against Covid-19 and Mpox.”
“On the presidential campaign trail, former President Donald Trump is, once again, promising to repeal and replace the Affordable Care Act — a nebulous goal that became one of his administration’s splashiest policy failures…Still, Trump secured some significant policy changes that remain in place today, including efforts to bring more transparency to prices charged by hospitals and paid by health insurers. Trying to predict Trump’s priorities in a second term is even more difficult given that he frequently changes his positions on issues, sometimes multiple times.”
“How is the Centers for Disease Control and Prevention (CDC) functioning in the wake of a sharp, COVID-sparked decline in trust of science and public health messaging? Especially when it comes to playing its role in the federal initiative to end the HIV epidemic by 2030? In January, TheBody put this question to several advocates and public health professionals—and the responses were not encouraging.”