Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
Lawmakers Finalize FY2024 Appropriations
On March 23, lawmakers approved the final minibus of spending bills for fiscal year 2024 (FY2024), closing out a protracted spending cycle marked by partisan disagreements and repeat continuing resolutions. The spending package by and large extended fiscal year 2023 (FY2023) totals for the remainder of FY2024 as a result of non-defense discretionary budget caps set by the bipartisan debt ceiling compromise of 2023. All programs under the Centers for Disease Control and Prevention (CDC) National Center for HIV, Hepatitis, STIs, and Tuberculosis Prevention (NCHHSTP) and the Ryan White HIV/AIDS Programs were level-funded. Ending the HIV Epidemic Initiative programs were also flat funded, despite the House proposal to eliminate the programs.
Although increasing funding for health programs remains urgently necessary, level-funding was the best-case scenario in FY2024 due to the tight fiscal spending environment and right-wing calls to slash spending. With FY2024 appropriations completed, lawmakers are expected to promptly take up fiscal year 2025 (FY2025) spending processes.
FY2025 Appropriations
On March 20, the House Appropriations Committee Subcommittee on Labor, Health and Human Services, Education, and Related Agencies (LHHS) and the House Committee on Ways and Means held hearings on the president’s budget request for FY2025. US Department of Health and Human Services (HHS) Secretary Xavier Becerra appeared before the committees to provide context and answer questions on the budget proposal. The Biden Administration released the Executive Budget Request to Congress, a non-binding proposal that lays out policy and spending priorities for federal agencies and programs in the upcoming fiscal year and typically kicks off spending negotiations, on March 11. The FY2025 budget called for modest increases to some health programs, but most HIV and hepatitis prevention programming were level-funded as a result of the budgetary caps imposed by the bipartisan debt ceiling compromise of 2023. Notably, the budget again included proposals to launch a national PrEP program and a national hepatitis C virus (HCV) elimination program.
House Advances Bill to Improve Fiscal Impact Analysis for Preventive Services
On March 19, the House of Representatives passed the Dr. Michael C. Burgess Preventive Health Savings Act (H.R.766), which would extend the timeframe of fiscal impact analyses conducted by the Congressional Budget Office (CBO) for bills that impact preventive health services. Under current law, CBO fiscal impact analyses are capped at a 10-year window, resulting in underestimates of the true projected cost-savings for legislation that improve preventive health service delivery for chronic conditions. Although the bill does not permit any projected cost-savings that accrue after the 10-year window to offset expenses under PAYGO rules, the description and estimate of the savings must be reported in the CBO projections. The inclusion of this data will help lawmakers to consider the true net benefits and downstream costs of innovative service delivery models, like proposals for a national PrEP program and a national hepatitis C virus (HCV) elimination program.
Administration Activities
NASTAD Submits Comment in Support of the Department of State’s Non-Discrimination Rules for Agencywide Programs
On March 19, NASTAD joined a coalition of civil society organizations and signed onto public comment letters in support of the Department of State (DOS) proposed rule to implement the Department’s “expectation of nondiscrimination against beneficiaries of Department-funded foreign assistance activities.” The proposed rule would create nondiscrimination protections—including on the basis of sexual orientation, gender identity and sex characteristics—across all of its grants and contracts. The coalition urged DOS to ensure that its proposed mechanisms for requesting a waiver from the non-discrimination requirements will operate on a consistent set of principles across varying contracts that are limited to rare and exceptional circumstances.
2022 Overdose Mortality Data
On March 21, CDC National Center for Health Statistics released a data brief detailing drug overdose mortality data collected by the National Vital Statistics System in 2022. The report shows that the overall rate of drug overdose deaths remained at record-high levels, with a slight increase from 2021 to 2022. Age-adjusted rates of drug overdose deaths increased for most racial groups, with American Indian and Alaska Native non-Hispanic facing the highest rates of mortality. Additionally, the report shows increases in rates of polysubstance drug use and overdose deaths related to stimulant use. The report elevates the need to invest in community-based overdose prevention resources and programs that address polysubstance use and serve the communities most at-risk.
CDC Releases 2022 School Health Profiles
On March 20, CDC released the 2022 School Health Profiles survey results, which outlines how states, school districts, territories, and tribes are administering school health policies and practices. The survey includes assessments of programming and services related to HIV, including professional development and training of health education teachers, covering sexual health topics and education for students and families, providing students with referrals for sexual health services, and engaging in practices that foster a safe and supportive school environment for LGBTQ youth. The survey results can help policymakers and community leaders to address gaps in the health and education needs of students.
Resources
GU O’Neill Institute: Medications for Opioid Use Disorder in U.S. Jails and Prisons: Status Update
“This Quick Take outlines the legal and policy efforts that have led to an increase in availability and stresses the importance of continued advocacy efforts to further expand MOUD availability in jails and prisons and in the community.”
Job Opportunites
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
US AIDS relief program gets one-year extension in spending bill
“The flagship U.S. program to combat HIV and AIDS abroad got a one-year reprieve in the spending bill, putting a temporary pause on what was an atypical partisan fight over the initiative. The one-year extension for PEPFAR, the President’s Emergency Plan for AIDS Relief, keeps funding flat through March 2025, but it won’t impose any anti-abortion restrictions sought by conservatives. PEPFAR is credited with saving 25 million lives since it was launched by then-President George W. Bush in 2003, and it typically has enjoyed bipartisan support. It’s been widely regarded as one of the most successful global health programs in U.S. history. This is the first time the program has been reauthorized for fewer than five years.”
Rapid Rise in Syphilis Hits Native Americans Hardest
“Syphilis infections nationwide have climbed rapidly in recent years, reaching a 70-year high in 2022, according to the most recent data from the Centers for Disease Control and Prevention. That rise comes amid a shortage of penicillin, the most effective treatment. Simultaneously, congenital syphilis — syphilis passed from a pregnant person to a baby — has similarly spun out of control… And while infections have risen across the U.S., no demographic has been hit harder than Native Americans. The CDC data released in January shows that the rate of congenital syphilis among American Indians and Alaska Natives was triple the rate for African Americans and nearly 12 times the rate for white babies in 2022.”
Senators introduce bill requiring State Department to track deadly street drug
“A pair of senators introduced a bill Wednesday that would require the State Department to track xylazine in its annual report. Sens. Ted Cruz (R-Texas) and Tim Kaine (D-Va.) introduced the legislation, which would require the State Department to include data on xylazine, nicknamed “tranq,” in its annual International Narcotics Control Strategy (INCSR) Report. The report is meant to record efforts on countering the international drug trade; it already includes data on fentanyl, cocaine and heroin.”