Newsletter: Policy

Policy Updates: Hill Happenings and Administration Activities

Hill Happenings 

Fiscal Year 2023 Appropriations  

On June 23, the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (LHHS) marked up legislative text for its Fiscal Year 2023 (FY2023) spending bill, operating under a $1.6 trillion topline spending cap approved by a deeming resolution (H.R. 1151). Although appropriators may not stick to the budgetary total established in the deeming resolution, the bill allows House committee staff to move the appropriations process forward in the absence of a bipartisan budget resolution.  

The LHHS Subcommittee approved the package, advancing a bill that would increase LHHS spending by 13% above Fiscal Year 2022. The increase would fund key health policy priorities, such as bolstering public health infrastructure and providing more resources to the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration (HRSA), and state and local health departments. The key funding proposals include:  

  • CDC 
    • $750 million for public health infrastructure and capacity 
    • $250 million to modernize public health data surveillance and analytics 
    • $245 million – Ending the HIV Initiative 
  • HRSA 
    • $1.9 billion (+$198 m) – Health Centers program 
    • $2.7 billion (+$200 m) – Ryan White HIV/AIDS Program 
  • Department of Health and Human Services (HHS) 
    • $60 million (+$3 m) – Minority HIV/AIDS Initiative 

Although the committee is moving forward with the spending bills, appropriators have not issued detailed allocations for programmatic funding levels. Notably, House Democrats included provisions that would remove controversial policy riders, such as lifting the prohibition on purchasing sterile injection equipment with federal dollars. House Appropriations Chair Rosa DeLauro (D-CT-03) announced that the full committee will promptly take up the LHHS bill on June 30. Full details on the spending bill will be available at that time and NASTAD will provide a detailed update in the next newsletter.  

Administration Activities 

SCOTUS Overturns Roe v Wade 

On June 24, the Supreme Court of the United States (SCOTUS) revoked the federal constitutional protection of abortion rights that was established by the landmark Roe v. Wade decision in 1973. The justices ruled in a 5-4 decision that abortion is not a constitutionally protected right, providing states the legal discretion to permit or restrict abortion services at any point in pregnancy. Advocates disparaged the decision, highlighting the court’s dangerous willingness to overturn decades of legal precedent to erode privacy rights, personal autonomy, and healthcare access. NASTAD issued a press release after the ruling was announced, highlighting the critical role of legal privacy protections for health care access, especially for stigmatized conditions such as HIV and hepatitis. The court’s ruling presents a new threat to reproductive and sexual healthcare and well-being for stigmatized communities and providers who treat them.  

HRSA Releases RWHAP ADAP Annual Client-Level Data Report 

On June 23, HRSA HIV/AIDS Bureau (HAB) released the Ryan White HIV/AIDS Program (RWHAP) AIDS Drug Assistance Program (ADAP) Annual Client-Level Data Report, 2019. The report is a crucial component of data-driven program decision-making and improved health equity at HRSA HAB, including using report data to assess the numbers and demographics of clients receiving RWHAP services, understand client HIV-related outcomes, and identify and address HIV-related disparities. Among the key findings, the 2019 report found that nearly 90% of RWHAP patients reached viral suppression but identified that more work is needed to support patients with temporary or unstable housing.  

HHS Approves Colorado 1332 Waiver to Expand Coverage through State-Based Marketplace Plans 

On June 23, HHS announced that it approved Colorado’s Section 1332 State Innovation Waiver amendment request to create a state-specific health coverage plan that increases access to affordable coverage. The “Colorado Option,” which launches in 2023 and expands upon Colorado’s existing 1332 state-based reinsurance program, will lower premiums and healthcare costs for all Coloradans who enroll in health insurance plans on the individual market by an average of approximately $132 per person per month. CMS anticipates that 32,000 Coloradans will gain health insurance under the amended waiver by 2027. Colorado is the first state to leverage the 1332 waiver process to expand access to affordable coverage after the Trump Administration issued guidance in 2018 that allows states more flexibility to alter state-based insurance coverage via the innovation waivers.  


CHLPI/NVHR Report: Hepatitis C: State of Medicaid Access 

“The Center for Health Law and Policy Innovation (CHLPI) at Harvard Law School and the National Viral Hepatitis Roundtable (NVHR) launched the next phase of Hepatitis C: State of Medicaid Access, a project that evaluates hepatitis C virus (HCV) treatment policies across state Medicaid programs and advocates for policy change to connect more people living with HCV with the cure. Since its inception in 2017, Hepatitis C: State of Medicaid Access has evaluated treatment access based on three criteria: fibrosis, substance use, and prescriber limitations. The project now considers an expanded range of barriers to HCV treatment access for Medicaid beneficiaries, as advocacy and litigation have transformed the treatment access landscape over the past several years.”  

CDC MMWR: HIV Testing Before and During the COVID-19 Pandemic — United States, 2019–2020 

“The COVID-19 pandemic disrupted health care delivery and might have affected HIV testing, which is critical to ending the HIV epidemic in the United States…Partnering among federal organizations, state, and local health departments, community-based organizations, and health care systems to increase access to services, including HIV self-testing and routine opt-out screening in health care settings, can compensate for testing and diagnoses missed during the COVID-19 pandemic and accelerate the Ending the HIV Epidemic initiative.” 

CDC MMWR: Interim Analysis of Acute Hepatitis of Unknown Etiology in Children Aged <10 Years — United States, October 2021–June 2022 

“The investigation is ongoing; further clinical data are needed to understand the cause of these cases and to assess the potential association with adenovirus.” 

CDC MMWR: Trends in Acute Hepatitis of Unspecified Etiology and Adenovirus Stool Testing Results in Children — United States, 2017–2022 

“Current data do not suggest an increase in pediatric hepatitis or adenovirus types 40/41 above pre–COVID-19 pandemic baseline levels; continued surveillance is important to monitor changes over time.” 

CDC Naloxone Resources 

“CDC released a new suite of trainings and resources to promote the importance of naloxone to mitigate risks associated with opioid-involved overdose, increase naloxone dispensing in communities, and reduce the stigma surrounding naloxone in clinical settings through effective communication. Dispensing naloxone to those who need it is a critical component of the public health response to the opioid overdose epidemic.” 

O’Neill Institute Issue Brief: Addressing Trauma Will Bolster the HIV Response 

“This brief and accompanying summary recognizes that the COVID-19 pandemic has been traumatic for many people and continues to have ramifications for public health, individual health, and social cohesion. In order to bolster our response to HIV we must broaden our understanding of trauma, expand access to mental health and wellness services for people living with HIV and the HIV workforce, and embrace trauma-informed practices that alleviate the burden placed on communities impacted by HIV/AIDS as well as the organizations and providers that serve them.” 

CDC Immunization Schedule 

CDC updated the 2022 immunization schedule to include the recently updated hepatitis B universal vaccination recommendation. 

CDC/Quest Diagnostics Report: Hepatitis C Virus Testing During Pregnancy After Universal Screening Recommendations  

“In 2020, the Centers for Disease Control and Prevention and the US Preventive Services Task Force published guidelines recommending universal screening of all pregnant persons for hepatitis C virus (HCV) infection during each pregnancy. This study determined change in HCV testing among pregnant persons performed by Quest Diagnostics from January 2011 through June 2021. Analyses showed that testing among pregnant persons increased 145% over the study period, from 16.6% to 40.6%, demonstrating that current testing falls far short of universal screening.” 

SAMHSA NOFO: State Opioid Response Grant Program 

SAMHSA is announcing a State Opioid Response (SOR) grant funding opportunity that will provide nearly $1.5 billion to states and territories to help address the Nation’s opioid addiction and overdose epidemic. The SOR grant program provides formula funding to states and territories for increasing access to FDA-approved medications for the treatment of Opioid Use Disorder (OUD), and for supporting prevention, harm reduction, treatment, and recovery support services for OUD and other concurrent substance use disorders (SUD). Applications are due July 18. 

Job Postings 

Program Associate, Harm Reduction – AIDS United 

AIDS United is seeking a Program Associate to provide administrative support and coordination to the organization’s Expanding Syringe Services Programs Capacity to Respond to COVID-19 initiative. This project supports syringe services programs to effectively respond to COVID-19 among people who use drugs with services including vaccination education, and referral and linkage, navigation services. 

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.  

Social Innovations Team Lead – Baltimore, MD 

Baltimore City Health Department is seeking to fill the position of the Social Innovations Team Lead for the Bureau of Clinical Services and HIV/STI Prevention. The HIV/STI Social Innovations Team is a unique and visionary program at Baltimore City Health Department that utilizes a human-centered design approach to engage with the Baltimore community on issues related to HIV and Sexually Transmitted Infection (STI) prevention.  The team creates innovative, original, and engaging programming to involve the community in the heart of the Health Department’s work.  

Director of Operations – Boston, MA 

The Bureau of Infectious Disease and Laboratory Sciences (BIDLS) at the Department of Public Health (DPH) is seeking an experienced leader who is eager to join a mission-driven and fast-paced team in effectively and efficiently supporting the day-to-day operational needs of BIDLS.  The selected candidate will provide direct and indirect supervision to a total of 55 staff, including 5 Managers, and will oversee an annual budget in excess of $500M. To be successful, the incumbent of this position must be detail-oriented and also must understand the complexities of systems change and implementation in government systems, with the ability to ensure alignment with the Bureau’s and Department’s mission, goals, and objectives. 

Project Data Manager, Syringe Service Program – University of Washington 

We are hiring for a Project Data Manager (Research Consultant) to work closely with the principal investigator, project coordinator, survey site staff, CDC personnel, and other support staff to enact all data-related components of Project NEXUS. This position will supervise the NEXUS data team, including two research assistants, lead data analysis, and be the main point of contact for the CDC data management team. They will also provide support for the Dave Purchase Memorial Survey and the National Harm Reduction TA Center as needed. 

STD/HIV/Hepatitis Program, Louisiana Department of Health Office of Public Health 

Wyoming Department of Health, Public Health Division, Communicable Disease Unit 

  • Communicable Disease Unit Surveillance Program Manager – Cheyenne, Wyoming
    • The Wyoming Department of Health, Public Health Division, Communicable Disease Unit is seeking a Communicable Disease Surveillance Program Manager for Cheyenne. This position will serve as the Communicable Disease (CD) Surveillance Program Manager and senior epidemiologist for the Communicable Disease Unit. This position oversees public health surveillance of four disease areas (HIV, STD, TB, and Viral Hepatitis).  This position will monitor disease trends and utilize surveillance data to coordinate public health activities.   
  • 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. 

Hepatitis Surveillance Data Analyst – New Orleans, Louisiana 

This position is responsible for the data analysis activities for the Louisiana Office of Public Health STD/HIV/Hepatitis Program (SHHP), in the Hepatitis Surveillance unit. Data utilized for Hepatitis Surveillance activities include Hepatitis laboratory data, Case Report Forms, Provider Report Forms, Linkage to Cure data, investigation data, Medicaid data, and data from related sources and programs. This position will implement and coordinate data analysis activities to monitor and evaluate progress toward meeting hepatitis elimination within the state. All activities must be completed in accordance with the security and confidentiality guidelines required by the Centers for Disease Control and Prevention (CDC) and SHHP. 

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 

Meeting America’s Public Health Challenge 

“The United States should build a national public health system to promote and protect the health of every person, regardless of who they are and where they live; implement effective strategies with others in the public and private sectors; respond to both day-to-day health priorities and crises with vigor and competence; and, in the process, earn high levels of trust. In this report, the Commission provides a detailed set of recommendations to achieve this vision…” 

Fighting stigmas and regulations, the VA is giving clean needles to veterans who use illegal drugs 

“The VA is expanding its syringe services programs, but there are barriers. In about a dozen states, needle exchanges are illegal. Hospitals have also had to navigate federal restrictions on using government funds to buy items that could be considered drug paraphernalia. The team in Orlando is helping other VA’s work through those challenges, according to Byrd. She wants more programs to open because she said they help reach vets who might otherwise avoid the VA.” 

Biden launches plan to protect transgender youths’ health care 

“President Joe Biden on Wednesday will order his health agency to begin efforts to ban conversion therapy and expand access to gender-affirming treatment after a slew of state attempts to limit transgender health care, particularly for children. The president’s executive order will call on the Department of Health and Human Services to clarify that federally funded programs cannot offer conversion therapy, a widely discredited practice that attempts to change a person’s sexual orientation or gender identity, and work on a public information campaign about the practice.”