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Newsletter: Policy

Policy Updates: Hill Happenings and Administration Activities

Julio Contreras

Hill Happenings 

Fiscal Year 2023 Appropriations  

Lawmakers are quickly pivoting to Fiscal Year 2023 (FY2023) spending discussions after President Biden signed the Consolidated Appropriations Act, 2022 (H.R.2471) into law on March 15. On March 28, the White House released the Fiscal Year 2023 (FY2023) Executive Budget Request to Congress, highlighting the Administration’s spending and policy priorities for the upcoming fiscal year. While the document is non-binding, it serves as a starting point for Congressional appropriations and provides Democrats a foundation for upcoming spending negotiations. Additionally, the Office of Management and Budget (OMB) Director Shalanda Young will testify in front of the House Committee on the Budget on March 29 and the Senate Committee on the Budget on March 30 to detail the spending priorities that were included in the budget proposal.

NASTAD will release a memo detailing the Administration’s proposed spending levels for FY2023. NASTAD is monitoring the FY2023 appropriations process and will advocate for the highest possible funding levels on behalf of HIV and hepatitis programs. 

The Partnership to End HIV, Hepatitis and STDs Calls on Congress to Fully Fund Harm Reduction Providers 

On March 22, the Partnership to End HIV, Hepatitis, and STDs sent a letter to Congressional leaders calling on appropriators to robustly fund harm reduction programs in Fiscal Year 2023. The advocates highlight the critical role that community-based harm reduction service providers play in preventing overdose deaths and reducing health risks associated with drug use. The coalition urges appropriators to substantially invest in harm reduction, a key pillar of the Department of Health and Human Services (HHS) Overdose Prevention Strategy, and fully fund the Centers for Disease Control and Prevention (CDC) Opioid and Infectious Disease program and the SAMHSA Harm Reduction grant programs.

The Partnership to End HIV, Hepatitis and STDs Hosts Congressional Briefing 

On March 23, 2022, the Partnership to End HIV, Hepatitis, and STDs held a Congressional Briefing titled Ending the Epidemics through a Syndemic Lens. The event was hosted in conjunction with the offices of Senator Tina Smith (D-MN), Representative Barbara Lee (D-CA-13), and Representative Ritchie Torres (D-NY-15). HIV, hepatitis, and STD experts briefed Congressional offices on the syndemic framework for understanding infectious diseases and highlighted the coordinated approach across federal, state, and local governments that is required to end the epidemics. The experts called on Congress to invest in both the existing public health system and new initiatives to address the syndemic, close the coverage gap, and increase access to HIV Prevention (PrEP) and harm reduction. 

Administration Activities 

HHS Issues Press Release Announcing Gender Affirming Care in the Ryan White HIV/AIDS Program 

On March 25, the Health Resources and Services Administration (HRSA) announced that it would promote access to gender-affirming care and treatment in the Ryan White HIV/AIDS Program (RWHAP). The HRSA Administrator issued a Dear Colleague Letter encouraging RWHAP service providers to leverage their existing infrastructure to provide access to gender-affirming care and treatment services to transgender and gender diverse individuals with HIV.  The letter reaffirms the importance of providing culturally-affirming health care and social services to the transgender community as a key component of improving the lives of transgender people with HIV.  

HHS Announces Nearly $44 Million to Strengthen Mental Health and Substance Use Services for Populations at Risk for or Living with HIV/AIDS 

On March 18, HHS and the Substance Abuse and Mental Health Services Administration (SAMHSA) announced three funding opportunities to strengthen mental health and substance use services for individuals at risk for or living with HIV/AIDS. Totaling $43.7 million dollars, the funding opportunities will target areas of the country with the greatest disparities in HIV-related health outcomes and aligns with the National HIV AIDS Strategy and the HHS Overdose Prevention Strategy. The three grant programs are the Substance Use Disorder Treatment for Racial Ethnic/ Minority Populations at High Risk for HIV/AIDS, Substance Abuse and HIV Prevention Navigator Program for Racial Ethnic Minorities, and the Minority AIDS Initiative – Service Integration. 

CDC Releases Preliminary Epi Data on World Tuberculosis Day 

On March 24, CDC released preliminary data that show a dramatic drop in tuberculosis diagnoses in 2020. Although the decrease in diagnoses may reflect a true reduction in viral incidence and transmission, widespread disruptions to healthcare due to COVID-19 may have resulted in delayed or missed diagnoses. The preliminary numbers also show that tuberculosis diagnoses remained lower in 2021 than pre-pandemic levels. The data was released on World Tuberculosis Day, observed annually on March 24.

Resources 

NASTAD/Reframe Health and Justice Resource: Criminalization and Experiences of Violence: Developing Responsive Harm Reduction Services for Survivors of Violence and Criminalization 

This fact sheet was developed through the National Harm Reduction TA Center and is a companion to the Serving Criminalized Survivors Webinar hosted March 2021. It provides information on developing responsive harm reduction principles and practices for people who experience interpersonal and structural violence due to criminalization. It is essential to consider the effects of criminalization in public health approaches as a systemic barrier to identifying, accessing, and engaging with supportive services. 

Health Affairs Article: Disparities In Uptake Of HIV Pre-Exposure Prophylaxis Among California Medicaid Enrollees 

One of the pillars of efforts in the US to curb HIV incidence is pre-exposure prophylaxis (PrEP). We examined racial/ethnic and sex disparities in PrEP uptake among California Medicaid enrollees…Low PrEP use rates and disparities in uptake threaten efforts to end the HIV epidemic. Policy makers must craft the rollout of innovations such as PrEP in a manner that narrows HIV disparities instead of widening them. 

Fenway Health Toolkit: #TransYouthMatter 

“State lawmakers around the country are filing and voting for bills that seek to limit access to health care for transgender and gender diverse youth and ban these youth from participating in school sports. These bad faith bills have not been created in response to a societal problem. Rather, they are being used to advance the political right’s culture war against LGBTQIA+ people. Whether these bills are enacted into law or not, they are doing immediate and long-term harms to the health of trans youth. If you live in a state where lawmakers are pushing these bills, these #transyouthmatter resources can help raise awareness of the harm these bills can cause.” 

IAPAC HIV Policy Brief: Exploring the Impact of COVID-19 on Urban HIV Policy 

“This brief summarizes the results of a municipal-level survey in Fast-Track Cities from 7 countries. Stakeholders were asked about the current and proposed future impact the COVID-19 pandemic has had on municipal-level HIV funding service provision. The full brief analyzes additional dynamics of funding and, as important, political will in connection with HIV servicing from the perspective of municipal stakeholders. 

In addition, our two previous briefs "Best Practices for Attaining and Surpassing 90-90-90 from Select Fast-Track Cities" and "Innovations and Adaptations to Maintain a Continuity of HIV Services During the COVID-19 Pandemic", are also available online and for PDF download.” 

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. Click here to read a blog post from the Director of the Division of Viral Hepatitis on the new NOFO.

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.

Hepatitis Appropriations Partnership (HAP) Policy and Advocacy Summit 

Please join HAP for the second session in the 2022 Viral Hepatitis Policy & Advocacy Summit, Hepatitis & Maternal/Child Health, on Thursday, March 24 at 1 – 3 pm ET! Fully realizing the country's viral hepatitis elimination goals requires better incorporation of screening, treatment, and prevention efforts into existing maternal and child health practices. Challenges still exist around preventing perinatal and other familial transmissions of viral hepatitis. This session will feature discussions on the current landscapes of perinatal transmission of HBV and HCV, and of the vaccine infrastructure in the U.S. 

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 

NASTAD/NVHR/NACCHO RFP: HepNET Training Consultant 

NASTAD and its partners National Viral Hepatitis Roundtable (NVHR) and National Association of County and City Health Officials (NACCHO) are working with state and local health departments (LHDs), community-based organizations (CBOs), clinical providers, people with lived experience, syringe services programs (SSPs) and harm reduction programs to identify and address the unmet needs of people who inject drugs (PWID) and improve their access to viral hepatitis education, prevention, testing, linkage to care, and treatment. We are seeking a Training Consultant to provide skills and support for people with lived experience to be engaged as part of the Hepatitis Network for Education and Testing (HepNET) training and technical assistance. The project aims to accelerate coordinated strategies in states and communities through expanding a national, state and local network. Applications are due on April 6, 2022. 

NASTAD RFP: Minority Leadership Program – 360 Assessment Consultant 

NASTAD is requesting proposals for consultants to work with NASTAD’s Health Equity team to develop and deliver 360 performance review assessments and feedback for the Minority Leadership Program (MLP). Candidates should send application materials and any questions by e-mail only to Donovan Cousan (dcousan@NASTAD.org). Submissions are due by 11:59 ET on April 8, 2022. 

Patient Care Manager (Operations Manager), HIV/AIDS – Tallahassee, FL 

This is a highly responsible position in the HIV/AIDS Section of the Division of Disease Control and Health Protection, Bureau of Communicable Diseases, Florida Department of Health. This position develops and administers the overall functions of the HIV Patient Care Program funded through state and federal resources. This position reports directly to the Administrator of the HIV/AIDS Section. Applications close April 14.

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 diseases. 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. 

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

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. Applications close April 18. 
  • 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 the 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.  Applications close April 8. 
  • 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 the 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. Applications close April 18. 
  • 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. Applications close May 9. 

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 

Joe Biden’s Never-Ending Campaign to Build on Obamacare 

“In the dwindling time Joe Biden has to revive his domestic agenda, one thing is clear: Even if he succeeds, it will be a far cry from completing one big unfinished task he promised to tackle. That task was delivering on the full promise of Obamacare, the national health care reform law enacted in 2010 while Biden was vice president. His vow to expand and strengthen it was a central theme of his presidential campaign, and part of how he distinguished himself from his challengers in the 2020 primary…In his first year in office Biden had some early successes getting more Americans covered — but his efforts have since stalled out.” 

Supreme Court nominee Ketanji Brown Jackson’s confirmation hearings just ended — here’s what happens next 

“Supreme Court nominee Ketanji Brown Jackson’s confirmation hearings concluded Thursday, bringing her one big step closer to becoming the first Black woman to sit on the nation’s top court. Jackson, a 51-year-old federal judge and President Joe Biden’s first Supreme Court pick, will likely have to wait at least two weeks before the Senate votes on her confirmation. But her performance in the hearings only appeared to make Democrats more confident that her nomination will prevail.” 

To Prevent Future COVID Variants, We Must Protect Those Most At Risk 

“But many of the pleas to protect immunocompromised patients have missed a crucial public health point: Shielding them is not only an important matter of health equity and social justice, it is a critical component in efforts to forestall the rise of new coronavirus variants. Put simply, by protecting people with weakened immune systems, we protect all of us.” 

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