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Newsletter: Policy

Policy Updates: Hill Happenings and Administration Activities

Julio Contreras

Hill Happenings 

Fiscal Year 2022 Appropriations  

On March 10, Congress resolved a months-long budget impasse and passed the Consolidated Appropriations Act, 2022 (H.R.2471). The House of Representatives advanced the bill on March 9, and the Senate promptly took up and passed the spending omnibus ahead of the March 11 federal funding deadline afforded by a continuing resolution.  

Although lawmakers approved higher discretionary funding levels for the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), some health programs only received marginal gains. Final Fiscal Year 2022 (FY2022) funding levels included the following:  

  • Centers for Disease Control and Prevention (CDC) 
    • Division of HIV Prevention 
      • HIV Prevention – flat-funded at $755.6 million 
      • EHE Initiative – $20 million increase, totaling $195 million 
      • School Health – $2 million increase, totaling $36.1 million 
    • Division of Viral Hepatitis – $1.5 million increase, totaling $41 million 
    • STD Prevention – $2.5 million increase, totaling $164.3 million 
    • Infectious Diseases and the Opioid Epidemic – $5 million increase, totaling $18 million 
  • Health Resources and Services Administration (HRSA) 
    • Part B: Base -- $29.2 million increase, totaling $443.9 million 
    • Part B: ADAP – flat-funded at $900.3 million 
    • Ryan White Program – $71 million increase, totaling $2,495 billion 
  • National Institutes of Health (NIH) 
    • Office of AIDS Research – $104 million increase, totaling $3.194 billion 
  • Department of Housing and Urban Development (HUD) 
    • Housing Opportunities for People With AIDS (HOPWA) – $20 million increase, totaling $450 million 

Due to Republican opposition, Democrats were unable to remove a provision banning the use of federal funds to purchase sterile needles or syringes. Additionally, the bill extends the schedule I status of fentanyl substances through the end of 2022, despite advocates objecting to the classwide scheduling of fentanyl-related substances. However, language in the spending bill encourages the NIH National Institute of Drug Abuse (NIDA) to support research on the potential public health impacts of Overdose Prevention Centers. 

President Biden signed the spending omnibus into law on March 11. Now that the protracted FY2022 appropriations discussions are finally completed, Congress is expected to quickly pivot to Fiscal Year 2023 discussions. NASTAD is monitoring the FY2023 appropriations process and will advocate for the highest possible funding levels on behalf of HIV and hepatitis programs. 

Administration Activities 

Biden Announces Nominee for Director of Indian Health Service 

On March 9, President Biden announced his intent to nominate Roselyn Tso for Director of the HHS Indian Health Service (IHS). Tso, an enrolled member of the Navajo Nation, has worked with the IHS since 1984, where she currently serves as the Area Director for the Navajo Area IHS and coordinates the delivery of health care for over 244,000 American Indians. As IHS Director, Tso would coordinate the healthcare of more than 2.5 million Native Americans and Alaska Natives. 

National Women and Girls HIV/AIDS Awareness Day 

National Women and Girls HIV/AIDS Awareness Day (NWGHAAD) is observed annually on March 10 and serves as an opportunity to highlight the challenges, barriers, and disparities women continue to face in HIV prevention. In 2019, women accounted for 18% (6,400) of estimated new HIV infections in the United States. The division leaders of the CDC National Center for HIV, Hepatitis, STD, and TB Prevention (NCHHSTP) issued a Dear Colleague Letter highlighting the Center’s progress and challenges in tailoring HIV prevention approaches for women. Additionally, the HHS Office on Women’s Health released a fact sheet and updated materials to help advocates and providers to raise awareness on NWGHAAD. 

Resources 

NASEM Report: Measuring Sex, Gender Identity, and Sexual Orientation  

A new report from the National Academies of Sciences, Engineering, and Medicine (NASEM) recommends that The National Institutes of Health (NIH) adopt new practices for collecting data on sex, gender, and sexual orientation. In particular, the report authors recommend the use of standardized language in survey questions that ask about a respondent’s sex, gender identity, and sexual orientation, including collecting gender data by default, and not conflating gender with sex as a biological variable. 

CDC Update: HIV State Profiles

The HIV prevention profiles highlight the current HIV prevention challenges, opportunities, and investments in select jurisdictions across the nation. 

CDC Issue Brief: The Role of HIV Self-Testing in Ending the HIV Epidemic 

“In 2020, HIV testing decreased noticeably across the country as the COVID-19 pandemic made it more difficult to access traditional, in-person testing services. HIV self-testing programs offer an innovative way to bridge gaps in access to HIV testing and ensure that HIV testing is simple and more accessible for all.” 

The Lancet Webinar: HIV in the USA: One Year Later 

Date: March 17 | 2 pm ET 

“Surveying the ongoing challenges to ending the HIV epidemic in the USA, a six-paper Series published in The Lancet underscores pronounced racial, sexual, and gender disparities; substantial gaps in domestic programme funding; and due to geography and the patchwork health-care system, limited access to HIV treatment and prevention services.” Join the webinar for key findings and recommendations from the authors, followed by implementation updates from the CDC. 

CDC NOFO: Strengthening Syringe Services Programs 

This Notice of Funding Opportunity (NOFO) aims to increase access to harm reduction services for people who currently inject, or have a history of injecting, drugs and reduce incidence of infectious diseases and other complications of injection drug use through two components. Two Pre-Application Technical Assistance webinars will take place on March 16, 2022, and March 30, 2022, from 3-5pm EST to provide potential applicants the opportunity to hear an overview of this NOFO and to ask CDC representatives specific questions related to it. 

CDC NOFO: Enhanced Surveillance of Persons with Early and Late HIV Diagnosis 

This NOFO will support identification and recruitment of adults with recent HIV diagnoses at stage 0 and stage 3 to improve understanding of barriers and gaps associated with new infection and late diagnosis in the era of multiple testing modalities and prevention options such as PrEP. These enhanced surveillance activities will identify actionable missed opportunities for early diagnosis and prevention, thus informing allocation of resources, development and prioritization of interventions, and evidence-based local and national decisions to improve HIV testing and address prevention gaps. Applications close April 26. 

CDC Article in Clinical Infectious Diseases: Characteristics of persons treated for hepatitis C using national pharmacy claims data, United States, 2014–2020 

“Using national pharmacy claims data, during 2014–2020, 843,329 persons were treated for hepatitis C at least once. The proportion treated increased annually among persons aged <40 years, insured by Medicaid, and treated by primary care providers. Monitoring hepatitis C treatment is essential to identify barriers to treatment access.” 

Hepatitis Appropriations Partnership (HAP) Policy and Advocacy Summit 

Please join HAP for the first session in the 2022 Viral Hepatitis Policy & Advocacy Summit on Thursday, March 17th at 3pm ET! Across the U.S., people living with viral hepatitis face challenges to the care they need due to social and systemic barriers. This session will feature a discussion around the intersections of stigma, racism, and access to viral hepatitis services from a community and federal perspective. Please find panelists listed in the registration link here. 

AAHIVM Academy Council for Racial Equity: Minority Student Open 

Date: March 30 from 2:00 – 4:30 pm ET 

The American Academy of HIV Medicine (AAHIVM) Academy Council for Racial Equity is hosting a virtual conference for health-related students and trainees who are people of color and members of minority communities. This free event features a plenary speaker, an interdisciplinary panel discussion and breakout sessions that will inspire and inform minority students and trainees to consider a health professions career in HIV care, policy or research. The event is virtual, free, and open to all.  

Job Postings 

HIV/STI Prevention Program Manager – Portland, OR 

Clark County Public Health’s (CCPH) mission is to work with others to protect and improve the health of all people in Clark County. CCPH’s Communicable Disease program supports statewide surveillance and investigation efforts at the county level for all of Washington State’s notifiable conditions, including planning and response for public health emergencies involving communicable disease. This is an exempt management position and reports directly to the Investigation and Response Program Manager III. Assignments are received with little direction and require initiative and independent judgment. This position will work collaboratively or at times takes direction from the Health Officer who has statutory responsibility for communicable disease control. 

Southeast LA Area Health Education Center – New Orleans, LA 

  • ADAP Forecasting and Billing Coordinator 
    • Southeast LA Area Health Education Center (SELA AHEC), in conjunction with the Louisiana Office of Public Health-STD/HIV Program (OPH-SHHP), is seeking an AIDS Drug Assistance Program (ADAP) Forecasting and Billing Coordinator. The position is integral to the administration and sustainability of a complex statewide program tasked with providing medications for HIV and related opportunistic infections, and assisting with the costs of insurance coverage for eligible individuals living with HIV. The incumbent will support data-related efforts to ensure the provision of essential services, including the use of data to assess medication utilization trends and forecasts. 
  • PBM Contract and Medications Coordinator 
    • Southeast LA Area Health Education Center (SELA AHEC), in conjunction with the Louisiana Office of Public Health-STD/HIV Program (OPH-SHHP), is seeking a Pharmacy Benefit Manager (PBM) Contract and Medications Coordinator. The position is integral to the administration and sustainability of the Louisiana Health Access Program (LA HAP) a complex statewide program tasked with providing medications for HIV and related opportunistic infections, and assisting with the costs of insurance coverage for eligible individuals living with HIV. The incumbent will oversee the provision of essential services to increase access to HIV and other essential medications for eligible low-income Louisiana residents living with HIV infection. The Coordinator will be responsible for the implementation and monitoring of all medication assistance activities and the assurance that the program meets all State and federal regulations.  

STD/HIV/Hepatitis Program, Louisiana Health Hub 

Department of State Health Services – Austin, TX 

  • Research Specialist V 
    • Under the supervision of the Group Manager, the MMP Project Coordinator/Research Specialist V performs advanced research and epidemiological work requiring specialized knowledge of health behaviors related to TB/HIV/STD transmission. Responsible for the coordination of activities involved in the implementation of the Medical Monitoring Project (MMP) in Texas. Coordinates activities related to sampling frame development, healthcare facility, provider, and patient recruitment and data collection. Prepares budget and grant documents, data collection protocols and procedures, annual, interim progress reports, and other reports required by CDC or DSHS.  
  • Program Specialist IV 
    • Under the direction and supervision of the TB/HIV/STD Surveillance Group manager and Electronic Lab Reporting (ELR) Epidemiology Team Lead, conducts activities related to data management and processing of HIV and STD laboratory reports. This position will provide technical expertise in the interpretation of laboratory data and will be responsible for monitoring data quality of incoming laboratory reports. This position, along with the ELR Epidemiology Team Lead, will work directly with laboratories to resolve any reporting issues and improve data quality. This position will assist in the design and implementation of new and/or revised methods for receipt and dissemination of electronic data to more effectively meet HIV/STD surveillance needs.   
  • Public Health & Prevention Specialist II 
    • Public Health and Prevent Specialist II performs a variety of tasks under the direction of the STD/HCV Epidemiology and Surveillance Group Manager related to the management of HIV/STD investigational data, including database maintenance, report tracking, data entry, and quality assurance. This position will aid in development of short-term, mid-term, and long-term goals and objectives, and the development of standards for achieving strategic operational goals. Exercises independent judgment and professional discretion with extensive latitude for the use of initiative and independent judgment to administrate, advise, plan, and coordinate duties. 
  • HIV/STD Director 
    • The HIV/STD Director works under the general direction of the Director of the TB/HIV/STD Section (THSS) of the DSHS. Performs advanced (senior-level) managerial work leading the day-to-day operations of the HIV/STD Prevention and Care Unit. These programs include statewide programs for HIV clinical and social services; the provision of medications for the treatment of HIV and other STDs; and HIV/STD prevention.  

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, 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 

Congress Slashes Proposed Funding for Overdose and HIV Prevention 

“On March 9, Congress released its proposed final appropriations package for fiscal year 2022. If approved, it will drastically reduce money that lawmakers proposed last year for the Centers for Disease Control and Prevention (CDC) to help prevent HIV/AIDS and overdose, as the United States endures the worst overdose crisis in its history.” 

White House warns of 'severe' hit to COVID-19 response after funding dropped 

“The White House on Wednesday warned of “severe consequences” for the country’s COVID-19 response after Congress stripped funding to fight the virus out of a government funding package. The Biden administration warned that without the additional funding, testing capacity will start declining this month, potentially requiring months of ramp up if a new variant causes another surge.” 

Pandemic-Driven Health Policies To Address Social Needs And Health Equity 

“Stark disparities during the COVID-19 pandemic led to new health policy funding and interventions addressing social needs and social determinants of health to improve health equity. Lessons from these interventions and similar prepandemic initiatives can guide policy makers in designing more permanent approaches.” 

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