Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
2022 Midterm Elections
On November 8, voters across the nation cast their ballot in the 2022 mid-term elections, which will determine the majority party in Congress for the next two years. With large voter turnout and mail-in voting, the results for many elections still have not been announced, and the final party composition of both chambers is not yet clear. Although several races are still uncalled, it is expected that Republicans will pick up enough seats to gain control of the House. On November 12, Democrats secured the majority in the Senate after candidates in Nevada and Arizona won their elections. Georgia’s Senate race will have a runoff on December 6, 2022, which could further expand Democrats’ majority margin in the upper chamber.
NASTAD will be reaching out to the new Members of Congress and providing them with information on our legislative agenda. NASTAD also encourages you to reach out to new congressional members once they are sworn-in in January by introducing your jurisdiction’s programs and offering yourself as a resource.
Fiscal Year 2023 Appropriations
Currently, the government is funded through a continuing resolution (CR) which temporarily extends Fiscal Year 2022 (FY2022) funding levels through December 16. Congress is not expected to resume spending talks until the results of the November mid-term elections are established, which may provide Republicans more leverage during appropriations negotiations if they regain a majority in the House of Representatives. NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs.
Administration Activities
NASTAD Signs onto Comments in Support of Streamlining Medicaid and CHIP Eligibility
On November 7, NASTAD and the Federal AIDS Policy Partnership (FAPP) HIV Health Care Access Working Group (HHCAWG) submitted comments in support of Centers for Medicare and Medicaid Services (CMS) rulemaking that would streamline Medicaid, Children’s Health Insurance Program (CHIP), and Basic Health Program application, eligibility determination, enrollment, and renewal processes. The coalition highlights
The important role that Medicaid enrollment and minimizing coverage gaps plays in improving health outcomes for people with HIV and reducing the risk of HIV transmission. Additionally, the coalition proposed policy solutions to prevent coverage loss and improve health equity among beneficiaries, such as aligning enrollment and renewal requirements for non-MAGI beneficiaries with MAGI policies, establishing actions states must take in response to returned mail, and permitting noninstitutionalized spenddown beneficiaries to estimate medical expenses they are constant and predictable.
NASTAD Calls on the Biden Administration to Support Immigrant Communities Impacted by Marijuana-Related Convictions
On November 4, NASTAD joined a broad coalition and called on the Biden Administration to better support immigrant communities in criminal policy reform efforts. The coalition praised the Administration for pardoning federal convictions for marijuana possession as a much-needed first step toward achieving racial equity and mitigating the harms of the “war on drugs” and “war on crime” policies. However, the explicit exclusion of many immigrants for pardons, clemencies, or sentence reduction prevents meaningful relief from the immigration consequences of drug criminalization. The advocates call on the Biden Administration to extend protections to all immigrants, regardless of immigration status, and to take necessary steps to ensure that immigrants do not suffer negative immigration consequences from marijuana convictions.
FDA Issues Provider Alert on Xylazine
On November 8, the Food and Drug Administration (FDA) issued an alert to health care professionals on the risks to patients exposed to drugs contaminated with xylazine. Xylazine inclusion in fentanyl, heroin, and other drugs can result in serious side effects, including increased risk of overdose death since naloxone does not reverse the effects of xylazine. The FDA urges healthcare professionals to continue to administer naloxone for opioid overdoses and consider xylazine exposure if patients are not responding to naloxone or when there are signs or symptoms of xylazine exposure (e.g., severe, necrotic skin ulcerations). Additionally, the FDA issued a letter to stakeholders providing clinical information about the risks of severe, necrotic skin ulcerations from repeated xylazine exposure, possible withdrawal symptoms, and xylazine’s interference with successful treatment of opioid overdoses.
Resources
NASTAD Resource: Bevel Up Site and Safer Use Education Resource Collection
The NASTAD Drug User Health Team is pleased to announce the release of the Bevel Up website and resource collection. Bevel Up is a comprehensive safer use website for exploring and sharing recommendations on vein care, safer injection, alternative routes of administration, and naloxone and overdose prevention. This resource was developed through the CDC-funded National Harm Reduction Technical Assistance Center in collaboration with project consultant Heather Edney. Bevel Up is created for community-based organizations, grassroots programs, health departments, and other groups running or supporting syringe services programs and other harm reduction service providers. Messages and recommendations come from current and former users with experience navigating the unregulated drug supply, health providers, and program staff who serve people who use drugs. In addition to ready-to-use cards, posters, comprehensive topic-specific guides, and social media posts, there are templates and instructions for customizing materials with program information and creating new versions.
CDC MPV MMWR: Epidemiologic Features of the Monkeypox Outbreak and the Public Health Response — United States, May 17–October 6, 2022
CDC Opportunity: Public Health Policy and Strategy Innovation Hub
Application Deadline: Wednesday, November 30, 2022 at 5:00 pm PST
A new training opportunity for early, mid, and senior career state, tribal, local, and territory public health practitioners is available through Centers for Disease Control and Prevention’s (CDC) Public Health Policy and Strategy Innovation Hub. This strategy-focused training program provides critical and systematic thinking about how governmental agencies can prepare for unforeseen circumstances and uncertainty in the public health landscape. As part of the public health community’s effort to upgrade to Public Health 3.0, the Innovation Hub provides training to support public health practitioners’ multisectoral efforts that can further strategic foresight and thinking, use adaptive leadership to navigate the changing landscape of public health funding, enhance future opportunities for alignment across communities, and leverage workforce decision support tools to utilize and develop complimentary and context specific approaches to address priority public health issues. This program is funded through CDC-RFA-OT18-1802: Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation's Health.
NACCHO Survey: Integrated STI and Harm Reduction Services
This survey is intended to provide more insight into models of integration and facilitators and barriers that affect STI and harm reduction integration. This survey should be completed by health departments, harm reduction organizations, or other clinical and community-based organizations that have experience with the integration of STI and HR services, including those that currently offer or support integrated services, those that have offered integrated services in the past, or those that have attempted or considered integrating these services. The survey will complement an environmental scan and focus groups and will inform a future funding opportunity to support and/or evaluate integration models and strategies. Please contact Kat Kelley (kkelley@naccho.org) with any questions as you complete this survey.
O’Neill Institute Webinar: New Reports: COVID-19 Derails Progress Against HIV
Date: Tuesday, November 15
The O’Neill Institute for National & Global Health Law will host a virtual briefing event to discuss how the COVID-19 pandemic has impacted efforts to end the HIV epidemic in America. Special guests will include representatives from the O’Neill Institute for National & Global Health Law, Milliman, GLAAD, the Southern AIDS Coalition, and Abounding Prosperity! New evidence illustrates that the pandemic has significantly affected critical indicators, such as access to HIV testing, diagnosis, and treatment and delayed progress in ending the epidemic.
O’Neill Institute Quick Take: Illicitly Manufactured Fentanyl As A Weapon of Mass Destruction: Rhetoric And Reality
Recently, members of Congress and eighteen state and territory attorneys general have called for action that would require the federal government to treat illicitly manufactured fentanyl as a “weapon of mass destruction (WMD).” While classifying illicitly manufactured fentanyl as a weapon of mass destruction has some intuitive and emotional appeal, it is ultimately counterproductive in efforts to stem overdose deaths.
AIDS United Resource: Motivational interviewing for addressing vaccine hesitancy among people who use drugs AIDS United’s new guide to vaccine hesitancy and motivational interviewing for people who use drugs explains factors related to this population’s concerns and perspectives surrounding COVID-19 vaccination, including both real and perceived barriers to vaccination. This resource explores motivational interviewing as a successful tactic to address vaccine hesitancy among this population. The resource provides specific guidance and skills for SSP outreach workers to identify concerns surrounding vaccination and engage with participants.
Appalachian Partnership Fund: MPV Outreach to LGBTQIA+ Communities
Community Education Group is proud to announce a new grant opportunity to support rural, Appalachian Community Based Organizations (CBOs) in their Monkeypox outreach to LGBTQIA+ communities. with support from Gilead Sciences and ViiV Healthcare for the “We Are Appalachia: Monkeypox Response” initiative. CEG will be granting award 28 mini-grants funding of $1,000 per organization to eligible programs to be used for any Monkeypox response plans that relates to education, outreach, and more. The focus of this work should involve Appalachian counties but can have a statewide impact. CEG will accept applications on an ongoing basis until funds are spent awarded. The first review of grant applications will begin on November 15, 2022.
CDC NCHHSTP NOFO: PS-23-0009: Advancing Policy as a Public Health Intervention to Reduce Morbidity, Mortality, and Disparities in HIV, Viral Hepatitis, STDs, and Tuberculosis
The Center for Disease Control and Prevention’s (CDC) National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) is thrilled to announce a new funding opportunity. This two-component funding opportunity aims to strengthen the ability of leaders who make decisions in public health to identify and implement evidence-based policy interventions. The funding opportunity features two distinct components:
- Leverage legal epidemiology methods to examine laws and policies over time and perform critical analyses to understand the effect of laws and policies on health and economic outcomes.
- Provide robust legal and policy technical assistance (TA) to support leaders who make decisions in public health as they navigate complex issues unique to their jurisdiction and proactively create publicly accessible TA tools and resources.
Job Postings
HIV Care/Community Planner – Austin, TX
Under the general direction of the Planning Group manager, supports, directs, and monitors administrative agencies and other stakeholders engaged in HIV/STD care and prevention planning in Texas. Identifies technical assistance needs related to planning, monitoring compliance with program policies and directives, coordinates planning activities at the State, region, and local levels. Develops the state plan to address HIV/STD services and prevention needs as required by federal funders. Considerable latitude is required for the exercise of independent initiative, judgement, and action within the program. Experience in program and strategic planning, community engagement, group facilitation, and programmatic research preferred. Applications close December 2.
Harm Reduction Coordinator, State Opioid Response (SOR) Team – Washington, DC
This position will be responsible for the day-to-day management of one of the country’s largest naloxone (NARCAN®) programs, including working with over 150 community partners and pharmacies, coordinating and providing naloxone trainings, and ramping up fentanyl test strip distribution. An ideal candidate is familiar with social services/drug user health organizations in DC, trained and highly familiar with naloxone administration, able to manage relationships with diverse community stakeholders, and has proficiency with Microsoft Suite, especially Excel. Individuals with lived experience are encouraged to apply. Please note this is *NOT* a fully remote position—this position is expected to be in our NoMa office at minimum three days per week, plus attend occasional events and trainings in the community. Applications will be open until 11/30/2022. Salary range is Salary range is roughly $60-75K.
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.
Social Innovations Team Lead – Baltimore, MD
Baltimore City Health Department is seeking to fill the position of the Social Innovations Team Lead for the Bureau of Clinical Services and HIV/STI Prevention. The HIV/STI Social Innovations Team is a unique and visionary program at Baltimore City Health Department that utilizes a human-centered design approach to engage with the Baltimore community on issues related to HIV and Sexually Transmitted Infection (STI) prevention. The team creates innovative, original, and engaging programming to involve the community in the heart of the Health Department’s work.
Project Data Manager, Syringe Service Program – University of Washington
We are hiring for a Project Data Manager (Research Consultant) to work closely with the principal investigator, project coordinator, survey site staff, CDC personnel, and other support staff to enact all data-related components of Project NEXUS. This position will supervise the NEXUS data team, including two research assistants, lead data analysis, and be the main point of contact for the CDC data management team. They will also provide support for the Dave Purchase Memorial Survey and the National Harm Reduction TA Center as needed.
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.
News Bulletin
House GOP presses toward leadership elections despite post-midterm disarray
“As Republicans begin grappling with the reality of a much smaller majority next year than they’d hoped, the GOP leader’s once-clear ascent to the top House gavel is now under threat from the right — an echo of the circumstances that helped derail his 2015 bid for the spot. And a full picture of his problems could emerge as soon as Tuesday, when McCarthy is slated to be nominated as the GOP conference’s pick for speaker.”
R.I.P. Dawn Smith, an HIV Prevention Advocate and CDC Researcher
“The Office of Infectious Disease and HIV/AIDS Policy joins the rest of the HIV community in mourning the passing of Center for Disease Control and Prevention’s Dr. Dawn Smith. Many of us in this office were fortunate to work with Dr. Smith. She was an insightful leader and a friend. Her career as an epidemiologist, medical officer, and researcher in CDC’s Division of HIV Prevention (DHP) spanned decades and her myriad contributions to the field made a real difference in the lives of so many people.”
Fentanyl in High School: A Texas Community Grapples With the Reach of the Deadly Opioid
“The overdose problem facing the district, which is just south of Austin and about an hour northeast of San Antonio, mimics a nationwide trend. More than 107,000 people in the U.S. died of drug overdoses in 2021, according to the Centers for Disease Control and Prevention, a record. Most of those deaths — 71,238 of them — involved fentanyl and other synthetic opioids…The kids are “not intentionally buying fentanyl,” Jennifer Sharpe Potter, a professor of psychiatry and behavioral sciences at UT Health San Antonio, said in testimony during a September hearing before the Texas House of Representatives. They don’t know that it’s in the pills they buy, she added, describing the problem as the ‘third wave of the overdose crisis.’”