Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2025 Appropriations
On June 27, the House Appropriations Labor, Health and Human Services, Education, and Related Agencies (LHHS) Subcommittee marked up and approved the fiscal year 2025 (FY2025) subcommittee spending bill. The committee proposed significant cuts to health programs compared to fiscal year 2024, including a $215 million cut from CDC prevention programs, a $190 million cut from the Ryan White program, and $15 million from the minority HIV/AIDs fund. Programmatic funding levels have not yet been released. The LHHS spending bills has been forwarded to the full House appropriations committee for a markup, which is expected to take place on July 10.
On June 18, Senate Appropriations Chair Patty Murray (D-WA) announced that the upper chamber will start to markup subcommittee bills after the July Fourth recess. The Senate is expected to approve funding levels at or above the statutory spending caps negotiated during the bipartisan debt limit compromise, teeing up party-line disagreements over federal spending totals since the Senate and House appropriations bills must be reconciled in order to become law.
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 Fund MASLD Research at AHRQ
On June 26, NASTAD joined a coalition of 15 organizations and called on Congress to provide strong funding for research advancing the detection, prevention, and research of liver diseases at the Agency for Healthcare Research and Quality (AHRQ). The coalition highlighted metabolic dysfunction-associated liver disease (MASLD), which affects between 80 and 100 million Americans, with most remaining undiagnosed. Left untreated, MASLD can progress to its more dangerous and life-threatening form, metabolic dysfunction-associated steatohepatitis (MASH), which includes fibrosis or scarring of the liver that can lead to liver cancer and liver failure. MASH is expected to become the leading cause of all liver transplantations by 2025.
Administration Activities
FDA Approves First-Ever HCV RNA Point of Care Test
On June 27, the Food and Drug Administration (FDA) approved market authorization for the first point-of-care (POC) hepatitis C virus (HCV) RNA test in the US. The Xpert HCV test and GeneXpert Xpress System, manufactured by Cepheid, may be administered in settings operating under a CLIA (Clinical Laboratory Improvement Amendments) Certificate of Waiver, such as certain substance use disorder treatment facilities, correctional facilities, syringe service programs, doctor’s offices, emergency departments and urgent care clinics. The approval of a POC HCV RNA test is a critical step towards scaling up test-and-treat approaches, which may reduce patient loss to follow up and will boost elimination efforts across the US.
HRSA HAB Releases New Housing Security Deposit Guidance
On June 26, the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) released a new program letter that provides clarifying guidance regarding the use of RWHAP funds to cover housing security deposits for eligible clients. RWHAP funding may be used to pay for a RWHAP client’s security deposit if a RWHAP recipient or subrecipient has policies and procedures in place to ensure that the security deposit is returned to the RWHAP recipient or subrecipient and not to the RWHAP client. Click here to read the press release announcing the housing security deposit program.
Resources
Center for Health Care Strategies Issue Brief and Blog: Medicaid Opportunities to Improve Health Care Access and Quality for LGBTQ+ Communities
“As the primary health insurer for LGBTQ+ communities, Medicaid policies and programs are well positioned to help address the health disparities facing LGBTQ+ communities. This brief highlights key considerations to shape Medicaid policies that enhance health outcomes and quality of care for LGBTQ+ individuals.”
CDC MMWR: Treatment for Opioid Use Disorder: Population Estimates
“Most adults who needed opioid use disorder (OUD) treatment in 2022 either did not perceive that they needed it (43%) or received treatment that did not include medications for OUD (30%).”
SAMHSA NOFOs:
The Substance Abuse and Mental Health Services Administration (SAMHSA) issued two funding opportunities supported by the Minority AIDS Initiative (MAI). In one, SAMHSA is seeking applications for $5.7 million to support substance use prevention and treatment services that adopt a syndemic approach for racial and ethnic minority individuals at risk for or living with HIV. In the other, SAMHSA announced the availability of $2.6 million to expand the number of programs delivering integrated, primary care, behavioral health, infectious disease, and harm reduction services to people experiencing unsheltered homelessness using a portable clinical care approach.
- MAI Substance Use Disorder Prevention and Treatment Pilot Program
- SAMHSA anticipates awarding up to eight programs of up to $700,000 per year for up to five years. At least one award will be made to American Indian/Alaska Native (AI/AN) tribes, or tribal organizations pending sufficient application volume. Applications are due Friday, July 12, 2024.
- MAI: Integrated Behavioral Health and HIV Care for Unsheltered Populations Pilot Project
- A total of $2.6 million is available to support up to four programs with awards of up to $650,000 per year for up to three years. One award will be made to an applicant serving people experiencing unsheltered homelessness in a rural area, pending sufficient application volume. Applications are due July 8, 2024.
Job Opportunities
Director, HIV Prevention – Tennessee Department of Health
This role is responsible for overseeing and administering the entire portfolio of HIV Prevention activities supported by TDH and our community-based organization partners statewide. In addition to leading an internal team of eleven direct and shared staff, this role will also be responsible for maintaining strong relationships with a wide variety of external stakeholders, including our CBO partners, metro Health Department leadership, and the United Way of Middle TN.
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.
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
Supreme Court undercuts regulators’ authority across government
“Federal agencies’ longtime authority to regulate industries was significantly weakened by a Supreme Court decision on Friday. The 6-3 decision, though it stems from cases on fishing regulations, will ripple across government agencies that have broadly interpreted the powers handed to them by Congress since a 1984 decision known as Chevron. The so-called Chevron doctrine laid out that courts should generally defer to federal agencies’ reasonable interpretations of their authority when issuing regulations.”
Divided Supreme Court rules in major homelessness case that outdoor sleeping bans are OK
“The Supreme Court cleared the way for cities to enforce bans on homeless people sleeping outside in public places on Friday, overturning a ruling from a California-based appeals court that found such laws amount to cruel and unusual punishment when shelter space is lacking. The case is the high court’s most significant ruling on the issue in decades and comes as a rising number of people in the U.S. are without a permanent place to live. In a 6-3 decision along ideological lines, the high court found that outdoor sleeping bans don’t violate the Eighth Amendment.”
Supreme Court overturns opioid settlement with Purdue Pharma that shielded Sacklers
“After the Supreme Court struck down a controversial bankruptcy plan from Purdue Pharma, the maker of OxyContin, those who sued the drug company were left uncertain about when promised funds would be available to combat addiction and other damage from the ongoing drug epidemic. The ruling upended a carefully-crafted settlement worth roughly $8 billion, and involving the Sackler family, which owns Purdue, and all the individuals, states and local governments that had sued over harms from the opioid epidemic. In a 5-4 decision, the justices focused on the part of the Purdue bankruptcy plan that shielded members of the Sackler family from future opioid-related lawsuits.”