Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2025 Appropriations
House appropriators are working to advance the 12 fiscal year 2025 (FY2025) subcommittee spending bills after approving topline spending levels on May 23.
Democrats panned the proposals, which called for lower totals than the statutory spending caps negotiated during the bipartisan debt limit compromise. If approved, the House Appropriations Committee (HAC) bills would slash the Labor, Health and Human Services, and Education, and Related Agencies (LHHS) budget by 11%. However, the House version must be approved by the Senate, which is unlikely to approve budget cuts that exceed the statutory spending caps.
Additionally, the HAC is moving forward with an ambitious schedule to pass FY2025 spending bills by the August recess. A House subcommittee markup on the LHHS bill is set for June 27, with a full committee markup scheduled for July 10. The HAC is aiming to finalize the bills by the week of July 29.
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 National PrEP Program
On May 31, NASTAD joined a coalition of over 175 organizations and called on Congress to fund the development of a national PrEP initiative. The coalition calls for $100 million in funding to launch the program, which would be housed under the CDC Ending the HIV Epidemic Initiative in the Division of HIV Prevention (DHP). The advocates urged appropriators to ensure that the program is national in scope and funding will supplement core funding for DHP. Currently, only 36% of individuals in need of PrEP are using it, with significant disparities based on race, ethnicity, geography, age, and other factors.
Administration Activities
NASTAD Submits Comments on Proposed Viral Hepatitis Quality Measures
On June 7, NASTAD submitted comment to the Department of Health and Human Services' (HHS) Office of Infectious Disease and HIV/AIDS Policy (OIDP) in support of proposed viral hepatitis quality measures for implementation at the state and territory level. The comment highlighted the positive impact of implementing quality measures for hepatitis B virus (HBV) screening and hepatitis C virus (HCV) screening and treatment initiation in the Medicaid Adult Core Set. The quality measures would incentivize greater screening and linkage to care and facilitate the building of relationships across Medicaid and other public health programs. Additionally, developing viral hepatitis quality measures will support
HRSA Issues Guidance on Leveraging RWHAP Funding to Provide Expungement Services for People Living With HIV
On June 6, the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) issued a program letter that provides guidance regarding how Ryan White HIV/AIDS Program (RWHAP) funds may be used to provide expungement services for people with HIV who have had legal system involvement. The expungement of criminal records is an effective way to remove barriers to care and services, protect privacy, mitigate stigma, and support successful reentry into the community. Additionally, HRSA HAB will host a June HAB You Heard webinar on Wednesday, June 26, from 3:00-4:00 pm ET that will include additional details.
HRSA Observes HIV Long-Term Survivors Awareness Day (HLTSAD)
On June 5, the HRSA recognized HIV Long-Term Survivors Awareness Day (HLTSAD), an annual observance to celebrate the remarkable resilience of HIV long-term survivors and remember those who have lost their lives to HIV. HRSA highlighted the 34-year history of the Ryan White HIV/AIDS Program (RWHAP) in providing people with HIV the care, treatment, medication, and essential support services needed to reach viral suppression and live longer and healthier lives. Click here to read a Dear Colleague Letter from the Associate Administrator of HRSA that shares more information on HLTSAD and highlights HRSA and RWHAP’s HIV and aging programming.
CDC Issues First Guidelines for DoxyPEP
On June 4, the Centers for Disease Control and Prevention (CDC) issued clinical guidelines for the use of doxycycline postexposure phrophylaxis (doxyPEP), a novel, patient-managed biomedical STI prevention strategy. CDC recommends that men who have sex with men (MSM) and transgender women (TGW) who have had a bacterial STI (specifically syphilis, chlamydia, or gonorrhea) diagnosed in the past 12 months should receive counseling that doxy PEP can be used as postexposure prophylaxis to prevent these infections. Additionally, CDC recommends that providers offer persons in this group a prescription for doxy PEP to be self-administered within 72 hours after having oral, vaginal, or anal sex. The recommended dose of doxy PEP is 200 mg and should not exceed a maximum dose of 200 mg every 24 hours.
Resources
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.
CDC MMWR: Mpox Surveillance Based on Rash Characteristics
“Among 196 emergency department patients who had an mpox-like rash during June–December 2023, three cases were identified. All cases occurred among unvaccinated gay and bisexual men who have sex with men.”
Global Liver Institute: Exploring Viral Hepatitis: Types, Diagnosis, and Treatment
“After decades of innovation in the diagnosis and treatment of viral hepatitis, the 2016 World Health Assembly adopted the resolution that viral hepatitis should be eliminated by 2030. Recently, the World Health Organization (WHO) released its 2024 Global Hepatitis Report, which sheds light on the current state of hepatitis worldwide. Read on to understand the various types of hepatitis, methods of diagnosis, available treatments, and key insights from the WHO report.”
CDC Webinar: National HIV Testing Day (NHTD)
Date: June 13, 2024, at 1pm ET
“Join us for a dynamic discussion on what it means to prioritize knowing your HIV status as an act of self-love. This is a National HIV Testing Day (NHTD) webinar you don’t want to miss. Moderated by the Normal Anomaly Initiative’s Ian Haddock, the webinar on June 13, 2024, at 1pm ET will focus on HIV testing as an act of self-love and a pathway to engaging people in care to keep them healthy, regardless of their test result. Panelists will discuss HIV stigma and other barriers to care, the importance of empowering people to know their status, and status neutral approaches to ending the HIV epidemic.”
HRSA HAB Webinar: Innovative HIV Care Strategies for Individuals Who Are Not In Care or Have a New HIV Diagnosis
Date: Thursday, June 27 from 2:00-3:30 pm ET
Join HRSA HIV/AIDS Bureau for an exciting webinar featuring two groundbreaking interventions that are transforming HIV care: Linkage, Integration, Navigation, and Comprehensive Services (LINCS) and HIV Clinical Pharmacist Services. These initiatives address specific challenges faced by people with HIV and are revolutionizing our strategies for providing comprehensive care and support. The interventions include:
- Linkage, Integration, Navigation, and Comprehensive Services (LINCS) Navigation used three sources of data to identify people not in care: HIV surveillance data, healthcare provider referrals, and electronic health record (EHR) data. LINCS navigators then used disease intervention searching tools and EHR data to locate clients and connect them to an HIV care provider, following up with clients for 90 days to support engagement in care. LINCS participants were more likely to be retained in care and virally suppressed after the intervention.
- HIV Clinical Pharmacist Services shortens the time between referral to and engagement in care by allowing newly referred clients to see pharmacists in addition to other clinical providers for their initial appointment. In addition to significantly decreasing the time between referral and initial visit, clients who saw a pharmacist also experienced shortened time to antiretroviral therapy (ART) initiation and viral suppression compared to those who only saw non-pharmacist providers.
CE credit is available for individuals who attend the live webinar. To learn more about CE credits offered through the IHIP webinar series, visit: https://targethiv.org/page/integrating-hiv-innovative-practices-ihip-continuing-education-credits.
NIH/Coalition for Global Hepatitis Elimination Webinar: Leaving No One Behind: Community Partnerships in Reducing Hepatitis Disparities
Date: Thursday, June 20 from 11-12:30 PM ET
In this webinar, researchers and community leaders will share how to best approach, develop, and maintain trust, value, and collaboration to produce high quality community services and research that have been shown to be effective in reducing the burden of hepatitis. Research-community partnerships addressing Hepatitis B (HBV) and C (HCV) elimination in populations with health disparities will be featured. Panelists will provide commentary and a moderated discussion will include important and timely considerations of innovative community-based care models that are needed to help advance progress to reach HCV elimination targets by 2030 among all populations in the U.S. and its territories.
Job Opportunities
Integrated Care Behavioral Health Clinician – Grand Junction, CO
The Behavioral Health Clinician is responsible for assessing and responding to requests for mental health or substance use/addictions counseling for people living with HIV/AIDS and as well as other underserved individuals. This position helps manage group-counseling services including oversight of volunteer facilitators, scheduling, group admissions, advertising and evaluation.
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.
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
As mpox cases rise, experts urge complete, 2-part vaccinations
“The number of U.S. mpox cases has more than doubled compared with last year, and the federal Centers for Disease Control and Prevention has been urging clinicians across states to encourage vaccinations for those at risk. As of May 25, the nation had seen a roughly 150% increase in cases of the disease formerly known as monkeypox — from 434 at that time last year to 1,089 this year, according to the CDC. About a third of the cases are in New York state, New York City (which the CDC reports separately), New Jersey and Pennsylvania.”
Midwest health departments warn of new deadly animal tranquilizer’s emergence
“Health departments in the Midwest are warning of the emergence of a new deadly animal tranquilizer that’s linked to overdose deaths. The drug, medetomidine, is a powerful sedative used in veterinary medicine to keep dogs sedated and comfortable during exams and medical procedures, the U.S. Food and Drug Administration (FDA) said when it approved the drug in 2022. The Detroit Free Press reported that the drug is most often cut into fentanyl, which is then cut into what passes as heroin. This drug, however, can’t be reversed by naloxone, or Narcan, which has been used to reverse overdoses for other drugs.”
Minority groups’ uninsured rates plummeted under Affordable Care Act: Research
“Uninsured rates among minority groups in the U.S. plunged between 2010 and 2022, according to reports released Friday by the U.S. Department of Health and Human Services (HHS). The increase in the number of insured people points to the impact of the Affordable Care Act, former President Obama’s signature health law.”