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Newsletter: Policy

Policy Updates: Hill Happenings and Administration Activities

Julio Contreras,
Mike Weir, M.P.H,
Emily McCloskey Schreiber

Hill Happenings

FY2025 Appropriations

On May 16, the House Appropriations Committee released topline spending levels for the 12 fiscal year 2025 (FY2025) federal spending bills. Democrats panned the proposals, which called for lower totals than the statutory spending caps negotiated during the bipartisan debt limit compromise. On May 23, the House Appropriations Committee (HAC) approved the topline levels, allowing subcommittees to begin working on bill text. If approved, the 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 the Public Health Workforce Loan Repayment and Bio-Preparedness Workforce Pilot Programs

On May 14, NASTAD joined a coalition of over 140 organizations and called on Congress to provide strong funding for health workforce programs at the Health Resources and Services Administration (HRSA) in FY2025. The coalition highlighted the Public Health Workforce Loan Repayment Program, which provides financial incentives to bring public health and infectious disease professionals into settings where they are crucially needed, including HIV and hepatitis programs at local, state, and Tribal public health agencies across the country. Additionally, the coalition called for $50 million to launch a new Bio-Preparedness Workforce Pilot Program.

NASTAD Calls on Congress to Fund Global HIV/AIDS Programs

On May 22, NASTAD and the Global AIDS Policy Partnership (GAPP) called on Congress to fund global HIV programs in FY2025. The coalition highlighted the Department of State (DOS) President’s Emergency Plan for AIDS Relief (PEPFAR) program and the Global Fund to Fight AIDS, Tuberculosis and Malaria, HIV programming at the US Agency for International Development (USAID), and the Joint United Nations Programme on HIV/AIDS (UNAIDS). For over two decades, these programs have demonstrated success in addressing the challenges of global HIV and AIDS through prevention, care and treatment programs and policies that are grounded in science and respect for human rights.

NASTAD Calls on Congress to Fund Antimicrobial Resistance Programs

On May 14, NASTAD joined a coalition of over 140 organizations and called on Congress to provide strong funding for domestic and global antimicrobial resistance (AMR) programs in FY2025. The coalition highlights the importance of utilizing the One Health ecological framework approach, which encompasses human, animal, and environmental health with increased funding for surveillance, prevention, stewardship, research, and innovation, to minimize the health system costs and significant morbidity and mortality associated with AMR. The coalition called for increased funding to programs at the Food and Drug Administration and Department of Health and Human Services (HHS), including the Centers for Disease Control and Prevention (CDC) Antibiotic Resistance Solutions Initiative, Advanced Molecular Detection (AMD) Initiative, and programs at the National Institutes of Health.

NASTAD Calls on Congress to Fund CDC Programs Addressing SDOH

On May 14, NASTAD joined a coalition of over 80 organizations and called on Congress to provide strong funding for the CDC National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) Social Determinants of Health Program. The non-medical drivers of health, including the social, economic, and environmental conditions collectively referred as the Social Determinants of Health (SDOH), are estimated to contribute 80-90% to a person’s health outcomes, while traditional healthcare only accounts for 10-20%. Health departments and public health organizations are uniquely situated to address the broader non-medical needs in communities by gathering data from multiple sources, identifying gaps in services, building collaborations across sectors, and with community-based organizations, and identifying and addressing policies that inhibit overall health and well-being.

Senate Finance Committee Holds Hearing on Fentanyl Crisis

On May 23, the Senate Committee on Finance held a hearing titled, Front Lines of the Fentanyl Crisis: Supporting Communities and Combating Addiction through Prevention and Treatment. The hearing, led by Committee Chairman Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID), discussed ways to prevent opioid overdose deaths and remove barriers to treatment for substance use disorder, such as insurance barriers for medications for opioid use disorder (MOUD) and the availability of substance use disorder services for those enrolled in Medicaid and CHIP.

Administration Activities

CDC Publishes New HIV Surveillance Reports

On May 21, the Centers for Disease Control and Prevention (CDC) published three new HIV Surveillance Reports:

The reports cover surveillance data monitored through calendar years 2018-2022 and establish new HIV incidence and prevalence rates. Key findings include:

  • “In 2022, in the United States and 6 territories and freely associated states, there were 38,043 HIV diagnoses, more than half of which (52%) occurred among people living in the South.”
  • “White persons accounted for almost half (47%) of all HIV diagnoses attributed to injection drug use.”
  • “The lowest percentages of viral suppression were among Black persons (61%) and women overall (64%).”
  • “Compared with 2018, in 2022, HIV diagnoses increased among transgender women (25% increase), Hispanic/Latino gay, bisexual, and other MSM (22% increase), Hispanic/Latino persons overall (17% increase), and males who inject drugs (7% increase).”

In order to achieve the national goal of ending new HIV infections in the US, CDC calls for expanded HIV testing, PrEP services, and addressing racism and social and structural determinants of health to scale and equitably reach all people. Click here to read a Dear Colleague Letter from Division leaders that outlines more key findings.

White House Issues Proclamation on National Hepatitis Testing Day

On May 19, the White House issued a Presidential Proclamation in observance of National Hepatitis Testing Day, held annually on May 19. The proclamation encourages public health practitioners and providers to help spread the word on hepatitis B virus (HBV) and hepatitis C virus (HCV) and test more people, especially among disproportionately impacted communities. Additionally, the proclamation highlights President Biden’s proposed HCV viral elimination plan and encourages broader HBV vaccination.

CDC Announces 2024 HIV Testing Day Theme

On May 16, CDC Division of HIV Prevention (DHP) announced the 2024 National HIV Testing Day (NHTD) theme: “Level up your self-love: check your status.” This theme emphasizes valuing yourself, showing yourself compassion and respect, and honoring your health needs with self-love. Knowing your HIV status helps you choose options to stay healthy. NHTD is observed each year on June 27 to highlight the importance of HIV testing. 

HHS Accepting Nominations for CDC/HRSA Advisory Committee

The Department of Health and Human Services (HHS) is currently accepting nominations for the CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment (CHAC) 2025 nomination cycle. CHAC consists of 18 experts in fields associated with public health; epidemiology; laboratory practice; immunology; infectious diseases; substance use disorder; behavioral science; health education; healthcare delivery; state health programs; clinical care; preventive health; medical education; health services and clinical research; health equity; and healthcare financing, who are selected by the Secretary of HHS. Nominations for membership on CHAC must be received no later than October 1, 2024. Please contact the NASTAD Policy & Legislative Affairs team if you would like to nominate yourself or one of your colleagues.

CDC Issues Health Alert Network Advisory for Meningococcal Disease

On March 28, CDC issued a Health Alert Network (HAN) Health Advisory to alert healthcare providers to an increase in invasive meningococcal disease, mainly attributable to Neisseria meningitidis serogroup Y. Cases caused by this strain are disproportionately occurring in people ages 30–60 years (65%), Black or African American people (63%), and people with HIV (15%). CDC encourages health providers to 1) have a heightened suspicion for meningococcal disease, particularly among populations disproportionately affected by the current increase, 2) be aware that patients may present without symptoms typical of meningitis, and 3) ensure that all people recommended for meningococcal vaccination, including people with HIV, are up to date for meningococcal vaccines.

DEA Releases 2024 National Drug Threat Assessment

On May 9, the US Drug Enforcement Administration released the 2024 National Drug Threat Assessment (NDTA), DEA’s comprehensive strategic assessment of illicit drug threats and trafficking trends endangering the United States. The report highlights the growing role of synthetic drugs in the US drug supply, including the severe morbidity and mortality associated with fentanyl and other synthetic opioids like nitazenes, and the growing role of methamphetamine in drug trafficking and overdose. The report also assessed the threat of xylazine, an adulterant increasingly found in the opioid drug supply that is associated with injection-site wounds.

Resources

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.

CDC MMWR: State-Specific Hepatitis C Virus Clearance Cascades

“Analysis of 2013–2022 data from a large national, commercial laboratory found that hepatitis C viral clearance proportions among persons with hepatitis C varied by state from 10% to 51% and fell below established hepatitis C viral clearance goals in all jurisdictions. The assessment of variations in hepatitis C testing and treatment can help identify gaps, prioritize activities to improve linkage to treatment and prevention services, and allocate resources for state hepatitis C elimination programs.”

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.

HIV.gov: Defining the Term “Syndemic”

“OIDP has been working with federal partners to define the term syndemic because many of us work across multiple, inter-related health conditions (e.g., hepatitis, HIV and other sexually transmitted infections, substance use, mental health) and their root causes; a common definition of syndemics can increase awareness of their impact on overall health as well as mobilize and align the public health workforce and others, including community, to implement more holistic approaches and improve health outcomes.”

Hepatology: The obstacle is the way: Finding a path to hepatitis C elimination

“In this Commentary, we consider the obstacles that have hindered progress toward HCV elimination in the United States, discuss potential solutions that have opened a path to elimination, and highlight how the resources proposed by the US HCV Elimination Program and efforts planned by the AASLD/IDSA HCV Guidance Panel will enable achievement of this goal in our country.”

CDC Mpox MMWRs:

HHS/SAMHSA NOFO: Minority AIDS Initiative: Substance Use Disorder (SUD) Prevention and Treatment Pilot Program

“The purpose of this program is to provide substance use prevention, substance use disorder (SUD) treatment, HIV, and viral hepatitis prevention and treatment services for racial and ethnic individuals vulnerable to a SUD and/or mental health condition, HIV, viral hepatitis, and other infectious disease (e.g., sexually transmitted infections, or STIs). Recipients will be expected to take a syndemic approach to SUD, HIV, and viral hepatitis by providing SUD prevention and treatment to racial and ethnic individuals at risk for or living with HIV. With this program, SAMHSA aims to pilot this approach, which combines comprehensive prevention and treatment services, while increasing engagement in care for people at increased risk for SUD, HIV, viral hepatitis, and other infectious diseases.”

KFF Issue Brief: The Biden Administration’s Final Rule on Section 1557 Non-Discrimination Regulations Under the ACA

This brief provides an overview of the Biden Administration 2024 final rule implementing Section 1557 of the ACA, which is home to the law’s major nondiscrimination provisions. While Section 1557’s protections took effect when the ACA was enacted in 2010, much of its reach has been determined by implementation guidance issued across different Presidential administrations, often reflecting conflicting views. The final rule reinstates and expands upon many of the 2016 regulations from the Obama Administration and is a reversal from much of the 2020 Trump Administration rule.

HRSA HAB Webinar: Innovative HIV Care Strategies Using a Comprehensive Approach to Address the Needs of Priority Populations

Date: Thursday, June 7, 2024, 12:00-1:30 pm ET

The HRSA-funded Integrating HIV Innovative Practices (IHIP) project is hosting a webinar featuring two interventions that use a comprehensive approach to address specific challenges faced by people of color with HIV. CE credit is available for individuals who attend the live webinar. The featured interventions include:

  • The Black Women's Project offers tailored interventions that address the barriers to care faced by Black cisgender and transgender women with HIV. Through a holistic approach encompassing enhanced case management, trauma-informed care, peer/patient navigation, self-efficacy gender-affirming support, and intimate/domestic partner violence support, this project is paving the way for improved health outcomes and empowerment of Black women.
  • Curing Hepatitis C Among People of Color with HIV supports a multifaceted approach to help people with HIV prevent hepatitis C virus (HCV) infection or reinfection. This includes expanding capacity for HCV prevention, testing, care, and treatment; improving coordination of care for those with both HIV and HCV; collaborating with SAMHSA-funded substance use disorder treatment providers; and enhancing health department surveillance systems.

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, 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

Walgreens is launching a generic version of over-the-counter Narcan

“Walgreens said Wednesday that it will sell its own generic version of over-the-counter Narcan, the lifesaving opioid overdose reversal drug that first rolled out to drugstore shelves last fall. Its version of the antidote, a drug called naloxone, will cost $34.99 for two doses, $10 cheaper than the brand-name version from Emergent BioSolutions that’s also sold at Walgreens and other major pharmacy chains across the U.S. Walgreens' generic version will be available on store shelves nationwide by the end of the month, the company said. It is already available to buy online.”

Judicial Decisions Constraining Public Health Powers During COVID-19: Implications For Public Health Policy Making

“Analyzing 112 judicial decisions in which the plaintiff prevailed from March 2020 through March 2023, we examined the ways in which courts constrained public health powers during the COVID-19 pandemic. We found that in these 112 decisions, courts shifted how they analyze religious liberty claims and reviewed challenges to the exercise of statutory powers by health officials in novel ways. We discuss implications for public health policy going forward, and we recommend ways in which legislatures and health officials can design policies to maximize their prospects of surviving legal challenges.”

FDA Urged To Relax Decades-Old Tissue Donation Restrictions for Gay and Bisexual Men

“The federal government in 2020 and 2023 changed who it said could safely donate organs and blood, reducing the restrictions on men who have had sex with another man. But the FDA’s restrictions on donated tissue, a catchall term encompassing everything from a person’s eyes to their skin and ligaments, remain in place. Advocates, lawmakers, and groups focused on removing barriers to cornea donations, in particular, said they are frustrated the FDA hasn’t heeded their calls. They want to align the guidelines for tissue donated by gay and bisexual men with those that apply to the rest of the human body.”

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