Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
House Republicans Pass Debt Ceiling, Government Funding Proposal
On April 27, House Appropriations Committee Chair Rep. Kay Granger (R-TX-12) sent a letter to committee members announcing a markup schedule for the lower chamber’s fiscal year 2024 (FY2024) spending bills. The Chairwoman is forging ahead with the House appropriations process, calling for subcommittee markups starting May 17 and full committee markups by June 15 despite the lack of a bipartisan agreement on how to resolve the debt ceiling crisis. The announcement comes on the heels of the House passage of the Limit, Save, Grow Act of 2023 (H.R.2811), Speaker Kevin McCarthy’s (R-CA-20) proposal to temporarily raise the debt limit in exchange for billion-dollar spending cuts in FY2024.
President Biden and Democrats on the Hill have panned the GOP debt limit proposal, which is a nonstarter for Democrats. Democrats will now seek to leverage their majority in the upper chamber to force House Republicans to negotiate in good faith, or recruit House GOP support for an alternative bill that could pass both chambers without Speaker McCarthy’s support. Time is running out, however, with the Department of Treasury announcing that the debt limit “x date” could come as soon as June 1. NASTAD will continue to monitor the debt limit and appropriations process and advocate for strong funding for HIV, hepatitis, and drug user health programs in FY2024.
Administration Activities
CDC Director Rochelle Walensky Departs Agency
On May 5, Director of the Centers for Disease Control and Prevention (CDC) Rochelle Walensky announced that she was resigning from her post after two years, citing the unwinding of the COVID-19 public health emergency as a good moment to transition out of the role. President Biden issued a statement thanking Dr. Walensky for her tenure, especially for her work navigating the agency during the height of the COVID-19 pandemic. During her time as Director, Dr. Walensky also launched a center for forecasting and outbreak analytics and initiated an agency reorganization to improve its ability to respond quickly and communicate effectively during health crises. Director Walensky will formally step down on June 30, and interim director has not yet been named.
HHS Awards $147 Million to Support Ending the HIV Epidemic in the United States
On April 27, the Health Resources and Services Administration (HRSA) awarded more than $147 million to 49 recipients to advance the Ending the HIV Epidemic in the U.S. (EHE) initiative, which aims to reduce the number of new HIV infections in the United States by at least 90 percent by 2030. This funding will help states and metropolitan areas with the highest levels of HIV transmission link people with HIV to essential care, support, and treatment, as well as support training and other resources for these jurisdictions. The awards include $139.1 million to metropolitan areas and states to implement strategies and interventions to provide medical and support services to reduce new HIV infections in the U.S., and $8 million to two non-profit organizations to provide training and other resources to recipients of EHE funds, including NASTAD.
DEA, HHS Pause Controversial Rollback of Telehealth Prescribing Flexibilities
On May 3, the Drug Enforcement Administration (DEA) and HHS announced that it would pause the unwinding of telehealth prescribing flexibilities that were authorized under the COVID-19 public health emergency through May 11 as a result of an outpouring of public comments submitted in opposition to the proposed rule. Advocates panned the proposed rule, calling on the Administration to continue the telehealth prescribing flexibilities that increased access to healthcare. DEA submitted a new final rule for US Office of Management and Budget (OMB) review, Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications, which would extend current flexibilities while the Administration works to build in less burdensome prescribing safeguards.
NCHHSTP Issues Dear Colleague Letter Uplifting National Adolescent Health Month and National Mental Health Awareness Month
On May 2, division leaders of the CDC National Center for HIV, Hepatitis, STIs, and TB Prevention (NCHHSTP) issued a Dear Colleague letter in observance of National Adolescent Health Month and National Mental Health Awareness Month. In February, CDC released the Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021 to highlight key data trends on adolescent health behaviors and experiences, and last week released the full 2021 Youth Risk Behavior Survey (YRBS) dataset and a Morbidity and Mortality Weekly Report Supplement with further analysis of YRBS data. The data brought into clear focus the level of distress many youth, especially girls and LGBQ+ youth, are experiencing: more than 40% of high school students experienced depressive symptoms in the past year, 18% of female students experienced sexual violence, and 22% of LGBQ+ students attempted suicide.
Resources
National Hispanic Hepatitis Awareness Day 2023: Supporting Latinx/Latine communities on the path to viral hepatitis elimination
Date: May 10 at 2 pm ET
To commemorate National Hispanic Hepatitis Awareness Day, NASTAD in coordination with the Latino Commission on AIDS, will host a webinar on May 10, 2023, at 2 pm ET. During the webinar, presenters will discuss the burden of viral hepatitis, updated guidance, and opportunities for increasing screening and vaccination in the Latinx/Latine community. The webinar will also highlight partnerships between health departments and community organizations to increase awareness, testing, and linkage to care. Lastly, NASTAD will discuss available resources for Latinx/Latine communities in English and Spanish. Register here.
CDC DVH Webinars:
- NEW: Federal Implementation of Updated Viral Hepatitis Screening and Vaccination Recommendations
- Date: Tuesday, May 30 from 1 – 2:30 pm ET
- In recognition of Hepatitis Awareness Month, the Office of Infectious Disease and HIV/AIDS Policy (OIDP) is hosting a webinar to raise awareness and to share federal implementation strategies of the updated hepatitis B screening and testing recommendations among all adults aged 18 years and older. The webinar will also provide updates on, and lessons learned from federal implementation of hepatitis C screening recommendations.
- Hepatitis C Virus: Barriers to Treatment and Community-focused Primary Care
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Date: Thursday, May 11 at 3:30 pm ET
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In partnership with the Centers for Disease Control and Prevention (CDC), the American Liver Foundation (ALF) is hosting a webinar for liver specialists and public health providers. During the call, presenters will share recent data indicating that too many Americans remain unaware of their hepatitis C infection and curative treatment continues to be delayed. Presenters will also discuss adult screening recommendations and strategies for addressing gaps in viral hepatitis care.
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- Hepatitis B Screening Recommendations
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Date: Tuesday, May 16 at 1:00 pm ET
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In recognition of Hepatitis Awareness Month, the Bureau of Primary Health Care (BPHC) within the Health Resources and Services Administration (HRSA) is hosting a webinar to brief clinicians and other health care providers about the release of new CDC recommendations for hepatitis B screening and testing. During the call, Dr. Erin Conners will discuss how the updated recommendations differ from the 2008 recommendations, explain the rationale for the changes and why the updated recommendations are beneficial. Dr. Conners will also share key messages. Participants will have an opportunity to ask questions about the science supporting these changes and the expected impact of these recommendations.
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CDC Vital Statistics Report: Estimates of Drug Overdose Deaths Involving Fentanyl, Methamphetamine, Cocaine, Heroin, and Oxycodone: United States, 2021
“The rate of drug overdose deaths increased by 279% for drug overdoses involving fentanyl during the study period, from 5.7 per 100,000 standard population in 2016 to 21.6 in 2021.”
JAMA Viewpoint: Universal Precautions for People at Risk of Opioid Overdose in North America
“North America is experiencing an unprecedented opioid overdose epidemic now driven by illicitly manufactured fentanyl, which has largely displaced prescription opioids and heroin in most drug markets. In the context of high and rising overdose deaths, 4 proven clinical interventions should constitute a set of “universal precautions” that clinicians and health systems could implement to reduce opioid overdose deaths among at-risk patients, including all patients who use opioids or who may be inadvertently exposed to fentanyl.”
KFF Analysis: How Many People Might Lose Medicaid When States Unwind Continuous Enrollment?
“If Medicaid enrollment decreased by 18% in all states between March 2023 and May 2024, as suggested by a recent KFF survey, 17 million would lose Medicaid coverage. Although the midpoint of states’ estimated disenrollment rate was 18%, rates will range considerably across the states. Expected disenrollments during the unwinding could reverse more than half of the Medicaid enrollment gains experienced during the continuous enrollment period.”
NASTAD Webinars: Syphilis and Drug User Health Webinar Series
The NASTAD Drug User Health Team is pleased to announce an upcoming webinar series exploring syphilis among communities of people who use drugs, in partnership with AIDS United, NACCHO, NCSD, and the Northwest Portland Area Indian Health Board. This webinar series consists of five monthly sessions where those working on STIs – specifically syphilis – and those working in harm reduction and drug user health will be brought together to learn from each other, share promising practices, and highlight effective cross-sector partnerships. To join the webinars please register for them here:
- Still Trep-in’: Ongoing Responses to Syphilis in Indian Country – Tuesday, May 30, from 3-4:30pm ET
- State Health Department Innovations at the Intersection of Syphilis & Drug User Health – Tuesday, June 27, from 3-4:30pm ET
- “Solo Makes You Go Slow”: Local Partnerships Addressing Syphilis Among People Who Use Drugs – Tuesday, July 25, from 3-4:30pm ET
Hep B United Webinar: Universal Adult Hepatitis B Recommendations are Here - Best Practices for Implementing Universal Screening and Vaccination
Date: May 1, 2023 at 03:00 PM ET
Adult hepatitis B guidelines from screening and vaccination have shifted from risk-based to universal. What does it look like in practice? Join us for the second part of our webinar series as panelists provide best practices on how they have been able to implement universal screening and vaccination within their communities, challenges they have faced and the findings of a brand new Call-to-Action to eliminate hepatitis B through the new universal recommendations.
NACCHO NOFOs
NACCHO is accepting applications for two related funding opportunities to support the evaluation of STI and harm reduction (HR) services. Applicants must already offer integrated STI and HR services. One application is intended to fund organizations that are primarily STI service providers while the other is intended to fund organizations that are primarily HR service providers. Applicants can request up to $50,000 and applications are due Friday, May 12th. Access additional information here.
NHRC/NHCHC Conference: Harm Reduction and HCH: Supporting People Who Use Drugs Across the Spectrum of Care
Please join NHRC and the National Health Care for the Homeless Council (NHCHC) on May 15 in Baltimore for a full-day session on harm reduction practices to support people experiencing homelessness who use drugs. Taught by expert faculty from both the harm reduction and health care for the homeless communities, the session will cover practical strategies for dismantling stigma, explore language and policies that support people who use drugs, offer in-depth breakout sessions, and highlight where the harm reduction movement is headed. The session is from 8:30 a.m.-4:30 p.m. EDT, with breakfast and lunch included. This learning opportunity is a pre-conference institute (PCI) that is part of NHCHC’s annual conference May 15-18. Attendees can register for just the PCI or for all of the four-day conference.
Job Postings
Viral Hepatitis Database Analyst – San Francisco, CA
Heluna Health invites applications for the full-time position of Viral Hepatitis Data Management Analyst in the ARCHES Branch at the San Francisco Department of Public Health. The Data Analyst will work with the ARCHES Viral Hepatitis Epidemiologist II to improve ongoing hepatitis data reporting and analysis. Responsibilities include higher level data cleaning tasks, data analysis and reporting, coordination with laboratory contacts to improve ELR protocols and procedures, and managing special projects as needed. This is a temporary (2 years), grant-funded, full-time, benefited position. Employment is provided by Heluna Health.
Chicago Department of Public Health
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Chief Racial Equity Officer/Deputy Commissioner - As a member of the CDPH executive team reporting directly to the Commissioner, the Chief Racial Equity Officer/Deputy Commissioner will oversee the Bureau of Inclusion, Diversity, Equity, and Access (the “IDEA Bureau”). Newly created in 2022, the IDEA Bureau is dedicated to leading internal strategy, workforce development, community engagement, communications and other culture and process/system change initiatives rooted in the principles of racial equity. This position will supervise the following offices in the IDEA Bureau: Racial Equity & Belonging, Workforce Development, Community Engagement & Partnership, and Public Information. These offices have grown substantially in the past year, and the Chief Racial Equity Officer/Deputy Commissioner will be tasked with developing plans to nurture and sustain these new teams and functions within the department. This position will also work closely with program staff in core operational and administrative areas such as human resources, finance, and contracts to co-lead process improvement initiatives to ensure that our practices are in line with the department’s anti-racism values. Salary is $133,416 per year.
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Chief Public Health Informatics Officer/Deputy Commissioner - Reporting to the First Deputy Commissioner, this position will serve as the department’s leader for priorities related to data modernization initiatives (DMI) and data process improvement, and in this capacity will establish and guide the department’s strategic public health informatics initiatives and will oversee CDPH’s work to align with national DMI. The position will continue to build and supervise the IT and Informatics teams; and will work closely with the citywide IT team based in the Department of Assets, Information and Services, the Illinois Department of Public Health, healthcare providers and other stakeholders in public health IT and informatics issues. This position will also serve as the primary liaison with the Centers for Disease Control and Prevention for DMI work. Salary is $146,000 per year.
Manager, Meetings and Travel – NASTAD
Under general supervision of the Associate Director, IT and Administration, the Manager, Meetings and Travel will provide management, coordination and hands-on delivery of comprehensive service and support to NASTAD members, staff members, and other stakeholders as appropriate. This position will coordinate and implement several, sometimes simultaneous, live, hybrid, and virtual events, particularly to NASTAD’s Annual and Technical Assistance Meetings. This position will monitor airline travel and purchases, manage travel-related vendors, maintain travel-related processes, reconcile meeting and travel expenses, complete appropriate forms and procedure documents, and work to fulfill NASTAD mission, goals, and objectives within the limitations of agency resources and policies and federal grant requirements.
Director, Health Care Access – NASTAD
NASTAD is recruiting for the Director of our Health Care Access program. The Director, Health Care Access plays a vital leadership role in achieving the organization’s training, technical assistance, and policy support priorities for Ryan White HIV/AIDS Program (RWHAP) Part B and AIDS Drug Assistance Programs (ADAP). The position will work closely with Tim Horn, NASTAD’s Director of Medication Access.
Viral Hepatitis Prevention Manager – Health Federation of Philadelphia
The Prevention Manager will be responsible for coordination of activities related to viral hepatitis prevention, including outreach, training, education and collaboration with appropriate programs to facilitate access to hepatitis services. This position works in close coordination with viral hepatitis surveillance activities. Apply by June 2, 2023.
Drug Trends and Technology-Based Drug Checking Analyst – New York City, NY
NYC DOHMH is looking for an analyst to work on our drug checking initiative. Currently operating in four SSPs across the city, including one of the OPCs, drug checking technicians use Bruker Infrared technology to test samples from SSP participants and provide individualized harm reduction education. This is a great opportunity for someone with strong data skills and an interest in drugs and toxicology. Please send out far and wide and feel free to reach out if you have any questions.
Chief Executive Officer – Western North Carolina AIDS Project (WNCAP)
Western North Carolina AIDS Project’s (WNCAP’s) mission is to provide equitable access to care and reduce harm from HIV, Hepatitis C, and drug use. WNCAP provides case management, prevention education, STD testing, harm reduction, and other support services to people living across 18 counties of western North Carolina. The Chief Executive Officer (CEO) is the principal leadership position at WNCAP and reports to the Board of Directors.
Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC
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NCHHSTP/DVH is recruiting for an exceptional candidate for the position of Prevention Branch Chief, Division of Viral Hepatitis (DVH), National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). The incumbent will serve as Chief in the Prevention Branch, Division of Viral Hepatitis, and will participate in the division’s senior management team responsible for directing the development, administration, implementation, and evaluation of national programs to prevent and control viral hepatitis. The incumbent provides advice to the Division Director on medical and scientific policy and practices associated with program, education, and research activities in support of viral hepatitis prevention and control, including harm reduction.
Boulder County AIDS Project – Boulder, Colorado
- Prevention Coordinator: The primary duties of this position are to provide HIV/HCV/STI testing, syringe access, and street outreach services, as well as outreach education at community partner locations and events. This position provides these services in collaboration with other Prevention Department staff and key community partners, as well as enters data into databases and completes monthly reports. This position reports directly to the Prevention Director, and attends staff, department, and community partner meetings.
Florida Department of Health – Palm Beach County
To apply, please send resumes to Robert Scott, Robert.Scott@flhealth.gov. These are all $20/hr, in-office roles with possible remote flexibility.
- EHE Navigator: This position’s work will be actively guided by the Palm Beach County Ending the Epidemic (EHE) Plan, including the four pillars and their goals, objectives, strategies and activities. Incumbent will assist in the planning, coordination, implementation and monitoring of the goals, objectives, strategies and activities set forth in the Palm Beach County Ending the Epidemic (EHE) Plan, in collaboration with other Area 9 EHE funding recipients, to include, but not limited to: Palm Beach County, FoundCare, and Florida Community Health Centers.
- PrEP Navigator: This position’s work will be actively guided by the Palm Beach County Ending the Epidemic (EHE) Plan, including the four pillars and their goals, objectives, strategies and activities. Incumbent will link high-risk negative persons to available Pre-Exposure Prophylaxis (PrEP) and non-occupational Post Exposure Prophylaxis (nPEP) services with the goal of significantly reducing the number of new HIV infections among high-risk populations. Incumbent will assess and increase the knowledge, desirability, accessibility, and adherence of PrEP among referred high-risk individuals.
- Digital Media Manager: This position is responsible for developing and coordinating the area HIV digital media presence through multiple platforms. Developing digital marketing strategies, creating social media content, collaborating with community partner organizations, and creating new ad campaigns to advance Ending the HIV Epidemic (EHE) in Palm Beach County. Tracking data from digital campaigns to assist with EHE goals.
Executive Director, Hepatitis Education Project (HEP) – Seattle, WA (partially remote)
Reporting to a Board of Directors and in partnership with a staff of 19, the ED will lead the evolution of HEP as the organization reviews its impact to date and plans for the future in the fields of viral hepatitis and drug user health both locally and nationally.
Deputy Medical Director, HIV/STI/Viral Hepatitis/Harm Reduction – Nashville, TN
This position will serve as the Statewide Deputy Medical Director in the HIV/STI/Viral Hepatitis section. The position has cross-cutting responsibility in all program areas with potential for promotion in succession plans. Primary responsibilities include leadership and oversight of cross-cutting programs related to End the Syndemic Tennessee to tackle HIV, sexually transmitted infections, viral hepatitis and substance use disorder in an integrated manner with an outward-facing, community-engaged process.
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.
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.
Viral Hepatitis Epidemiologist - Pennsylvania Department of Health
The Department of Health is seeking a dedicated and hardworking individual to fulfill their Viral Hepatitis Coordinator/Epidemiologist position within the Division of Infectious Disease Epidemiology. If you would like to support an organization that protects the public's health, apply today!
News Bulletin
Gilead, US square off in billion-dollar HIV drug patent trial
“Gilead Sciences Inc (GILD.O) is headed to trial in Delaware federal court this week to fight claims that it owes the U.S. government a share of multibillion-dollar profits from its HIV-prevention drug regimen. The government is seeking more than $1 billion from Gilead for allegedly failing to compensate the Centers for Disease Control and Prevention (CDC) for discovering that Gilead's HIV-treatment drug Truvada could help prevent the disease. Jury selection starts on Tuesday in the case, which marks one of the first times the U.S. government has sued a drug maker to enforce its patent rights.”
For Black Americans, the pandemic spike in fentanyl deaths was decades in the making
“White House officials for years warned that opioids were becoming rampant in Black communities. Then came Covid-19. In 2020, the rate of drug overdose deaths among Black Americans skyrocketed, increasing faster than that of any other racial or ethnic group in the country. Fentanyl, which had become more ubiquitous, drove the rising toll. On Wednesday, the Centers for Disease Control and Prevention released a report showing that more Black Americans died from fentanyl overdoses than from any other drug in 2021 and at far higher rates than whites or Hispanics.”
Gender-Affirming Care Saves Lives and Promotes HIV Prevention
“As anti-trans laws spread like wildfire throughout Republican-controlled legislatures, a study conducted by Johns Hopkins University suggests that when trans women have access to gender-affirming health care, they are less likely to acquire HIV—and less likely to die. The research indicates that trans women, who face high HIV incidence and death rates, need access to more holistic health care―such as programs that go beyond preventing and treating HIV to also address the many structural barriers that block them from living healthy and safe lives.”