Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
FY2024 Appropriations
Lawmakers are working to pass the final minibus of Fiscal Year 2024 (FY2024) appropriations bills, which includes health programs funded through the Labor, Health and Human Services, Education, and Related Agencies (LHHS) bill, by March 22. On March 8, President Biden signed into law the first of the two spending packages, ending a months-long delay due to partisan disagreements on spending levels and policy priorities for certain federal agencies and programs. Despite this progress, there remain lingering disagreements in the final minibus of FY2024 that must be reconciled by the end of the week.
NASTAD will continue to monitor the congressional appropriations process and advocate for the highest possible funding for HIV, hepatitis, and drug user health programs.
Administration Activities
Biden Administration Releases FY2025 Executive Budget Request to Congress
On March 11, the White House released the Administration’s budget request to Congress for fiscal year 2025 (FY2025), a non-binding proposal that typically kicks off spending negotiations on Capitol Hill. The Administration also released the HHS Budget in Brief, which outlines $130.7 billion in discretionary funding for the Department of Health and Human Services (HHS). Notably, the FY2025 budget request includes legislative requests for a new 5-year national hepatitis C virus (HCV) elimination program, as well as a PrEP Delivery Program. In addition, for the first time, the budget request includes $10 million at the Department of Justice for efforts to modernize outdated criminal statues with a discriminatory impact on people living with HIV. It is important to note that this is a budget request and does not have the power of the law. Only Congress has the power to appropriate funds. Click here to read NASTAD’s memo outlining the Administration’s spending and policy priorities for the final year of the term.
NASTAD Submits Comment on HBV Vaccination Quality Measure
On March 13, NASTAD submitted comment in support of the National Committee for Quality Assurance proposal to add preventive hepatitis B virus (HBV) vaccination as a new Adult Immunization Status indicator. Though HBV vaccination is now a routine childhood immunization, only 30% of all adults in the U.S. have been fully vaccinated. The inclusion of HBV vaccination in the Healthcare Effectiveness Data and Information Set (HEDIS) measures will build upon recent policy changes to increase utilization of HBV screening and immunization. Bundling HBV quality measures with the existing indicators will incentivize providers to screen patients and administer HBV vaccines, especially in health systems with value-based payment arrangements.
NASTAD Calls on CMS to Minimize Coverage Losses During the PHE Unwinding Process
On March 12, NASTAD joined a national coalition of organizations and called on the Centers for Medicare and Medicaid Services (CMS) Administrator to ensure that states comply with federal obligations and preserve Medicaid coverage for as many eligible individuals as possible during the COVID-19 public health emergency (PHE) unwinding. Roughly half of Medicaid eligibility renewals are still incomplete, putting millions of people at risk of losing coverage due to administrative hurdles. The coalition highlighted the gains made in expanding affordable health coverage and reducing health disparities through PHE flexibilities in Medicaid enrollment and renewals, and urged CMS to continue to strengthen the Medicaid program as the PHE flexibilities are lifted.
CDC Updates Resource to Observe National Native HIV/AIDS Awareness Day
National Native HIV/AIDS Awareness Day is a day to promote HIV testing, prevention, and treatment in American Indian, Alaska Native, and Native Hawaiian communities.
In 2021, for every 100 American Indian/Alaska Native people with HIV, 80 knew their HIV status. The Centers for Disease Control and Prevention (CDC) are pursuing a high-impact approach to maximize the effectiveness of HIV prevention interventions and strategies. Visit the CDC website for additional resources, including the GetTested Tool, an online tool that helps individuals find free, local, and confidential HIV and sexually transmitted infection testing.
Resources
KFF: Domestic HIV Funding in the White House FY 2025 Budget Request
“President Biden released his FY 2025 budget request on March 11, 2024. The President’s fourth and final budget request of his first term builds on past efforts to address the domestic HIV response…The request also includes discretionary funding levels for key programs aimed at addressing the domestic HIV epidemic.”
GU O’Neill Institute: Leveraging Success to End the HIV Epidemic
“In this Presidential and Congressional election year, we need to reflect on our achievements and what is needed to keep making progress against HIV. Our successes have been built on continued investments from the American people and bipartisan Congresses through Federal discretionary and entitlement programs. Many of our challenges are due to insufficient funding and persistent unmet need. In 2024, we need increased commitments from policymakers for the coming year and beyond and we need to be imaginative and innovative by proposing new ways to strengthen our communities.”
Job Postings
Public Health Physician (40 hour) – Hartford, CT
The State of Connecticut, Department of Public Health (DPH) is seeking two Public Health Physicians to join our teams within our Infectious Diseases Section. These positions will help lead our critical programs: the Healthcare Associate Infections and Antimicrobial Resistance (HAI-AR) program and the HIV/STD/TB & Hepatitis C surveillance program. Apply by March 27.
Viral Hepatitis Prevention Coordinator – Austin, TX
Under direction of the Prevention Unit, provides highly advanced, senior-level consultative services and technical assistance as the DSHS viral hepatitis prevention coordinator. Oversees implementation and maintenance of viral hepatitis prevention efforts by identifying ways to integrate viral hepatitis prevention, vaccination, testing, and linkage to care into existing public health, clinical care, and community settings. Responsible for developing a DSHS viral hepatitis prevention plan as well as legislatively-mandated plans, including working with branch staff to solicit input from the public, including experts on Hepatitis, on the tenets of the plan. Apply by April 23.
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
Treating Kids' HCV Early May Boost Lifetime Health Outcomes and Save Money
“Treating hepatitis C virus (HCV) earlier in kids was associated with better lifetime clinical outcomes and lower healthcare costs compared with deferring treatment, a modeling study showed. Projected life expectancy was longest when treatment started at age 3 (78.36 life years) and decreased with treatment deferral to age 6 (76.10), age 12 (75.99) and age 18 (75.46), reported Megan Rose Curtis, MD, MS, of Brigham and Women's Hospital in Boston, and colleagues. Starting HCV treatment at age 3 was projected to cost $148,162 across a lifetime, which was less expensive than deferring treatment to age 6 ($164,292), 12 ($171,909), or 18 ($195,374), they wrote in JAMA Pediatrics.”
The CDC could shrink under a second Trump administration
“Fueled by a distrust of the CDC’s handling of Covid-19 and the recommendations it made on measures like masking and vaccines, many conservatives want the agency dismantled — and hope a second Trump administration could make it happen. Their proposed approach, outlined in the 2025 Presidential Transition Project offered by the conservative Heritage Foundation think tank, would drastically reduce the CDC’s size by splitting it in two: One agency responsible for public health surveillance work, like data collection on outbreaks, and another responsible for “limited” public health recommendations — with a strict firewall between them.”
Nebraska lawmakers fail to override needle exchange bill veto
“Nebraska state lawmakers failed to override Gov. Jim Pillen’s (R) veto of a needle exchange program on Tuesday, killing a bill that initially passed the unicameral legislature with vast bipartisan support and signaling a trend in how states respond to the opioid epidemic. The needle exchange bill — introduced by state Sen. Megan Hunt (I) — passed the Nebraska Legislature 30-7 earlier this year, but the vote to override Pillen’s veto failed 27-20 on Tuesday, narrowly falling short of the 30 votes needed to overturn it.”
Oregon Measure 110 Wasn't a Failure. Rolling Back Drug Decriminalization Will Be.
“In November 2020, nearly 60% of Oregon voters passed Ballot Measure 110, often referred to as "drug decriminalization," which reclassified schedule I-IV drug possession from a Class A misdemeanor to a Class E civil violation. The change took effect in February 2021. In the 3 years since, Oregon has received much sensationalized attention related to this, culminating most recently in the passage of House Bill 4002 through both houses of the state legislature and an almost certain end to decriminalization, pending governor sign-off.”