Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
Fiscal Year 2024 Appropriations
Lawmakers are finalizing leadership positions and committee assignments for the 118th Congress. On January 16, House Appropriations Committee Chair Kay Granger (R-TX-12) announced leaders of the appropriations subcommittees, and on January 25, House Energy & Commerce Committee (E&C) Chair McMorris Rodgers (R-WA-05) announced committee rosters, including the E&C Health Subcommittee. Additionally, on January 25, House Democrats released chairs and member assignments for key committees, including Appropriations, Energy & Commerce, and Ways and Means.
These leaders will play a key role in resolving major political battles over federal spending in the 118th Congress, including the national debt limit and Fiscal Year 2024 (FY2024) appropriations. On January 19, the Department of Treasury informed lawmakers that it implemented extraordinary measures to avert passing the debit limit, which could have catastrophic consequences for federal programs and the economy if Congress does not take bipartisan action to raise the debt limit and avoid defaulting on the national debt. Although raising the debt limit is typically a bipartisan priority, Republicans in the House of Representatives might leverage the opportunity to extract some budgetary concessions from Democrats during negotiations, despite Senate Republican leaders vowing to avoid a debt default. Additionally, House Republicans’ will complicate spending talks, since the must-pass bipartisan spending bills must be reconciled with the proposal offered by the Democrat-controlled Senate, threatening the possibility of year-long continuing resolutions and government shutdowns.
NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs.
Administration Activities
Medicare Invites Public Comment as it Considers National Coverage Determination for HIV PrEP
On January 12, Centers for Medicare and Medicaid Services (CMS) announced that it initiated a national coverage analysis for Medicare coverage of HIV pre-exposure prophylaxis (PrEP) to inform a National Coverage Determination (NCD) by the agency. A NCD for PrEP would allow Medicare to reimburse providers for prescribing PrEP, increasing patient access to affordable or no-cost PrEP nationwide. CMS is accepting public comment on the proposal through February 11, 2023. CMS is expected to conclude the analysis and issue a proposed decision in the summer of 2023.
FDA Issues Draft Guidance with Comment Period Revising Recommendations for Blood Donor Eligibility
On January 27, the US Food and Drug Administration (FDA) issued draft recommendations for industry revising blood donor eligibility for people that the CDC identifies as being at increased risk for transmitting HIV. The proposed guidance eliminates time-based deferrals for men who have sex with men (MSM) and women who have sex with MSM, replacing it with gender-inclusive, individual risk-based questions to assess blood donor eligibility. Under the proposal, a prospective donor who does not report having new or multiple sexual partners, and anal sex in the past three months, may be eligible to donate, provided all other eligibility criteria are met. The FDA is soliciting public comment on the non-binding draft guidance to inform a final recommendation statement.
Biden-Harris Administration Releases First-Ever Federal Evidence Agenda on LGBTQI+ Equity
On January 24, the White House National Science and Technology Council released the inaugural Federal Evidence Agenda on Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+) Equity, a roadmap that federal agencies will use to ensure they are collecting the data and evidence they need to improve the lives of LGBTQI+ Americans. The agenda builds on work taking place across federal agencies and highlights opportunities to advance LGBTQI+ equity through increased federal data collection and evidence building and provides a roadmap to guide these efforts. Notably, the agenda includes guidelines for collecting sexual orientation, gender identity, and sex characteristics (SOGI) data, including the safeguards agencies might use to enable robust SOGI data collection while protecting individual privacy, security, and civil rights.
CDC Updates Black HIV/AIDS Awareness Day Toolkit
National Black HIV/AIDS Awareness Day (NBHAAD) is observed annually on February 7. On this day, we acknowledge the progress made in HIV prevention and care among Black or African American (hereafter referred to as Black) people while recognizing the work still needed to address the impact of HIV on these communities. To help you prepare for NBHAAD, the Let’s Stop HIV Together (Together) campaign is pleased to share its National Black HIV/AIDS Awareness Day toolkit. This resource includes new, ready-to-use social media posts and graphics in both English and Spanish, as well as an Instagram carousel. These posts can be shared leading up to and on NBHAAD. Use this toolkit to share messages about HIV stigma, testing, prevention, and treatment, along with the hashtags #NBHAAD and #StopHIVTogther. Additionally, join CDC for a NBHAAD webinar on Tuesday, February 7 at 3 pm ET.
CMS Outlines New Medicaid/CHIP Requirements to Unwind from COVID-19 PHE
On January 30, CMS released a State Health Official (SHO) letter outlining new requirements in the Consolidated Appropriations Act, 2023 that impact state activities for the Medicaid and CHIP (Children’s Health Insurance Program) programs to unwind from the COVID-19 public health emergency (PHE). The SHO also addresses changes to the conditions which states must meet to receive increased federal medical assistance percentage (FMAP), reporting requirements, and new enforcement authority for CMS to ensure state compliance with eligibility redetermination and reporting requirements. In addition, CMS released information on a temporary Exceptional Circumstances Special Enrollment Period (SEP) for consumers losing Medicaid or CHIP coverage due to unwinding of the Medicaid continuous enrollment condition. From March 31, 2023 and lasting through July 31, 2024, the Marketplaces using the Federal platform will be providing additional flexibility for Marketplace-eligible consumers losing Medicaid or CHIP to enroll in Marketplace coverage during and immediately following the end of the Medicaid Continuous Enrollment Condition unwinding period. This flexibility will be provided by facilitating access on HealthCare.gov to an SEP, referred to as the “Unwinding SEP.”
Resources
APHL Conference: ID Lab Con
Date: March 13 – 15, 2023
Location: Atlanta, Georgia
Register today for ID Lab Con, a new APHL conference focused on the latest developments in detection and characterization of infectious diseases of public health concern! Join public health laboratory professionals, clinical laboratorians, epidemiologists, leading researchers and diagnostics manufacturers to share the latest findings, technologies and developments and to generate solutions to infectious disease challenges.
CDC Save the Date: Celebration of Life for Janet Cleveland
Date: February 15, 1:00 – 3:00 pm
Janet C. Cleveland was a nationally recognized, influential, and trailblazing HIV prevention and public health leader. A staunch advocate of equity for underserved and underrepresented populations, Janet has left a legacy of high-impact HIV prevention programs that serve the communities she loved. Please join us next month as we honor the life of our beloved colleague and friend. This celebration of life will be a hybrid event. Location and call-in information will follow soon.
CDC Save the Date: Celebration of Life for Dawn Smith
Date: February 8, 2023 from 1:30 – 3:30 pm
Dr. Dawn K. Smith was a nationally and internationally renowned, influential, prolific, and pioneering HIV researcher, epidemiologist, and public health professional. Her distinguished career of over 30 years at CDC resulted in accomplishments that significantly impacted the world’s response to HIV. Please join us next month as we honor the life of our beloved colleague and friend. Dawn was DHP’s own “Mother of PrEP.” Call-in details to come.
HHS NOFO: HIV and Aging Challenges
Applications Due: January 31, 2023
The U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Health (OASH) Office of Infectious Disease and HIV/AIDS Policy (OIDP) and the HHS Administration for Community Living (ACL) are thrilled to announce a partnership on two national prize competitions ($500,000 each) that focus on innovative efforts that help improve health outcomes for people aging with HIV and long-term survivors, particularly among racial and ethnic minority and LGBTQ+ populations, in either rural or urban areas.
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
Public Health Analyst, DHP – CDC
The Prevention Communication Branch, Division of HIV Prevention (DHP) at CDC is searching for a Team Lead, National Partnerships Team. We are seeking diverse and qualified candidates for this dynamic position. The team fosters strategic partnerships that amplify campaign messages and support the implementation of national HIV programs and initiatives that reach priority populations and health care professionals in key geographic areas. NPT oversees the Partnering and Communicating Together cooperative agreement and a range of other partnerships to support our Let’s Stop HIV Together campaign and the Ending the HIV Epidemic initiative. Apply by January 30.
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.
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.
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, 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
History on the Hill: Powerful spending committees now led by women for the first time
“This year, women will hold all four of the top positions on the House and Senate Appropriations committees for the first time in history. The powerful panels control $1.7 trillion in federal spending each year on every aspect of American life, from education and defense to cancer research and roads. It's a remarkable feat for these veteran lawmakers who arrived on Capitol Hill during the 1990s, at a time when there were few women serving in Congress, and even fewer calling the shots on how federal dollars should be spent.”
Why Are We Delaying Coverage Of New HIV Prevention?
“The collective result of the ACA’s implementing rules, USPSTF recommendations, and CMS guidance is suboptimal coverage of PrEP, in all its forms. The USPSTF’s process is lengthy and perhaps incompatible with the speed of innovation in a society that wishes to end the HIV epidemic. Allowing traditional formulary management and utilization review practices only hinders access to appropriate forms of PrEP, risks non-adherence, and risks furthering the spread of HIV… Further clarity from the federal government for payers and providers on the coverage and management, as well as application of patient protections from out-of-pocket liabilities for these products, would ensure better access to HIV preventives, reduce HIV transmission, and increase progress toward ending the HIV epidemic.”
“Alongside fentanyl, fatal overdose cases involving a veterinary drug almost unheard of in the area five years ago have quietly ballooned. Data from the Cook County Medical Examiner’s Office shows 146 opioid-related deaths last year where xylazine was listed as a primary cause, marking a 16.8% increase from 2021. The current numbers are preliminary and will likely increase as there are 564 pending toxicology tests from last year as of Tuesday.”
A record of over 16 million people signed up for insurance through Obamacare
“More than 16.3 million people enrolled in a health plan through the Affordable Care Act (ACA) during the most recent open enrollment period, marking the highest number of enrollees since the program was signed into law 10 years ago. This record amount of enrollments occurred between Nov. 1 and Jan. 15 and represented nearly 2 million more people than the number that enrolled the previous year. According to the White House, 3.6 million people, or 22 percent of those who signed up in this enrollment period, were new to the Marketplace.”