Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
2022 Midterm Elections Results
On November 16, Republicans clinched majority control of the House of Representatives, resulting in a divided power split for the 118th Congress and the final two years of President Biden’s term. The change of power in the lower chamber, and a number of retirements in both chambers, will result in new leadership posts for key committees and subcommittees.
Notably, Speaker of the House Nancy Pelosi (D-CA-12) announced that she would step down after serving nearly two decades in leadership. Rep. Kevin McCarthy (R-CA-23) is tentatively expected to become the new Speaker. Senator Patty Murray (D-WA), Chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, is expected to chair the Senate Appropriations Committee after the retirement of current Chair Senator Patrick Leahy (D-VT), and Senator Susan Collins (R-ME) will remain the Ranking Member. Given Senator Murray’s move, Senator Bernie Sanders (D-VT) is expected to chair the Senate HELP Committee alongside Senator Cassidy (R-LA), who is replacing retiring Ranking Member Senator Burr (R-NC). Because the GOP flipped the House, Current House Appropriations Committee Ranking Member Kay Granger (R-TX-12) will become the Chair, and current Chair Rosa DeLauro (D-CT-03) will become Ranking Member. Additionally, Rep. Steny Hoyer (D-MD-05) will step down as House Majority Leader, and resume membership on the House Appropriations committee. These key lawmakers will have considerable influence over the appropriations and health agenda for the 118th Congress.
NASTAD will reach out to the new Members of Congress and provide 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. Click here to read NASTAD’s 2022 Midterm Elections Results memo with more detailed information.
Fiscal Year 2023 Appropriations
The US government is currently funded through a continuing resolution (CR) which temporarily extends Fiscal Year 2022 (FY2022) spending levels through December 16. With the midterm election results established, lawmakers are expected to prioritize passing a Fiscal Year 2023 (FY2023) funding package during the lame duck session, with top appropriators from both parties incentivized to secure a spending deal by year’s end. However, partisan battles over increasing the debt limit and the President’s emergency supplemental request for additional resources to tackle the COVID-19 pandemic and MPV response may derail that timeline.
On November 15, the White House requested that Congress allocate $10 billion in total funding for public health and other pressing issues through an emergency supplemental funding request. Notably, the request includes $750 million to combat hepatitis C virus and monkeypox (MPV). NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs.
NASTAD Calls on Congress to Fund CDC Programs in the FY2023 LHHS Bill
On November 11, NASTAD and the CDC Coalition called on top appropriators to robustly fund Centers for Disease Control and Prevention (CDC) programs in the final FY2023 Labor, Health and Human Services, Education and Related Agencies (LHHS) appropriations bill. The coalition calls on Congress avoid issuing lengthy CRs and issue a full-year package that addresses the underfunding of public health programs, especially amid the ongoing COVID-19 pandemic and MPV outbreak. The advocates request at least $10.45 billion for CDC programs in the FY2023 LHHS bill.
NASTAD Calls on Congress to Modernize HIV Integration into SAMHSA Substance Abuse Block Grant Funding
On November 15, NASTAD and the AIDS Budget and Appropriations Coalition (ABAC), a workgroup of the Federal AIDS Policy Partnership (FAPP), urged appropriators to include language in the final FY2023 LHHS bill that would modernize the way in which states qualify to be eligible for the HIV set-aside of the Substance Abuse Block Grant (SABG). The coalition requests that, instead of basing state eligibility for the 5% HIV set-aside on the number of AIDS cases, Congress modify the language to base eligibility on the number of HIV cases. Currently, only four jurisdictions (Florida, Georgia, Louisiana, and DC) qualify to use 5 percent of their block grant funding on HIV testing, linkage to care and prevention, and other related services, but even less jurisdictions would be eligible in FY2023 without the language change. Changing the criteria to the number of HIV cases would allow 20 jurisdictions to be eligible, greatly increasing integration of HIV activities for SAMHSA grantees without increasing overall funding.
Senate Takes Up Legislation Codifying Right to Same-Sex and Interracial Marriage
On November 15, NASTAD joined a coalition of health, education, and human services organizations to call on the Senate to pass the Respect for Marriage Act (H.R.8404). The Respect for Marriage Act would provide statutory authority for same-sex and interracial marriages, whose legality are threatened following the Supreme Court’s decision on Dobbs vs. Jackson’s Women’s Health Organization, which undermined legal precedent to revoke certain constitutional protections including the right to an abortion, potentially having downstream effects on same-sex and interracial marriages. The House of Representatives passed the bill on July 19, and the bill will be up for a vote on the Senate floor after the Thanksgiving holidays.
Administration Activities
FDA Considers Evidence Base to Approve Over-the-Counter Naloxone
On November 16, the Food and Drug Administration (FDA) announced that it concluded a preliminary assessment that is intended to facilitate the development and approval of nonprescription, or over-the-counter, naloxone products. The FDA determined that certain naloxone drug products–up to 4 milligrams (mg) nasal spray and up to 2 mg autoinjector for intramuscular (IM) or subcutaneous (SC) use–may be approvable as safe and effective for nonprescription use, pending further review. In order to finalize the determination and approve nonprescription use of certain naloxone products, the FDA is requesting comments from the public on whether there is data to support safe and effective nonprescription use of higher dose naloxone products and on potential consequences of a switch from prescription to nonprescription status.
Resources
ASTHOConnects Webinar: Medicaid and Public Health Partnerships in Virginia
- Date: Tuesday, December 13 from 3-4 pm ET
NASTAD is excited to partner with ASTHO on this ASTHOConnects Webinar on Medicaid and Ryan White HIV/AIDs Program alignment in Virginia. Learn how state public health agencies can align with state Medicaid agencies to collaboratively advance the goals of the National Ending the HIV Initiative in this ASTHO webinar. Featured guests include the Virginia Department of Medical Assistance Services, the Virginia Department of Health Ryan White HIV/AIDs Program (RWHAP)/AIDs Drug Assistance Program (ADAP), and the University of Virginia.
CDC Foundation RFP: Reducing Disparities in Monkeypox Vaccination Project
- Deadline: November 30, 2022 by 11:59 pm ET
The CDC Foundation is accepting applications for the Reducing Disparities in Monkeypox Vaccination Project which will provide up to 20 mini-grant awards for up to $25,000 each to community-based organizations, state, territorial, local or tribal health departments or tribal organizations to support activities related to the administration of monkeypox vaccines. Please review the RFA announcement for eligibility and submit completed application materials by November 23, 2022.
CDC RFA: Public Health Crisis Response Cooperative Agreement
The CDC is activating CDC-RFA-TP22-2201 Public Health Crisis Response Cooperative Agreement to support state and local public health monkeypox response efforts. CDC will award up to $16 million to select jurisdictions on the approved but unfunded (ABU) list for CDC-RFA-TP22-2201. Funding will be prioritized for jurisdictions reporting the highest numbers of cases during October 2022. Funding is intended to address urgent needs and to implement monkeypox response related activities including efforts to increase vaccine accessibility and uptake, case and cluster investigation, surveillance, testing, communication, education, and outreach. Additional information, including supplemental funding guidance is forthcoming.
HRSA NOFO: Ending the HIV Epidemic - Primary Care HIV Prevention (PCHP)
- Deadline: January 17, 2023
- Applicant TA Webinar: Thursday, December 1 from 3-4 pm ET
HRSA released the fiscal year (FY) 2023 Ending the HIV Epidemic - Primary Care HIV Prevention (PCHP) notice of funding opportunity (NOFO, HRSA-23-025). HRSA will make approximately $50 million available for up to 140 health centers located in the targeted geographic locations where there are a substantial amount of new HIV infections.
FY 2023 PCHP will support expanding HIV prevention services that decrease the risk of HIV transmission in underserved communities. This funding will focus on increasing HIV testing, PrEP prescriptions, and linkage to HIV care and treatment. It is part of HHS’ Ending the HIV Epidemic in the U.S. initiative, which aims to reduce the number of new HIV infections in the U.S. by 90% by 2030. Health centers with service delivery sites in the targeted geographic locations that did not receive FY 2020, FY 2021, or FY 2022 PCHP funding, are eligible to apply. View the FY 2023 PCHP one-pager (PDF) for applicants. Visit the FY 2023 PCHP technical assistance (TA) webpage to access the NOFO, application aids, and other resource.
- Applicant TA Call: December 16, 2022
- Letter of Intent Due: December 19, 2022
- Application Deadline: February 9, 2023
The purpose of the CDC’s National Center for Injury Prevention and Control (NCIPC) Mentored Research Scientist Development Award (K01) is to provide support for an intensive, supervised (mentored) career development experience in substance use and/or overdose prevention research leading to research independence. NCIPC supports K01 grants to help ensure the availability of an adequate number of trained scientists to address critical public health research questions to prevent polydrug use and overdose. Applicants must propose a research project that aims to better understand and identify risk and protective factors related to polydrug initiation, use, escalation, and overdose. This could include, but is not limited to, co-use of opioids, stimulants, and/or cannabis, including co-use with or without the knowledge of the person who is using the drugs. Additionally, research can focus the examination of potential moderators of risk and protective factors for polydrug initiation, use and escalation; and/or can investigate the relationship between polydrug use and overdose.
CDC HAN Update: Update on Managing Monkeypox in Patients Receiving Therapeutics
“Monkeypox cases have declined since mid-August 2022 in the United States; however, new cases—including clinically severe cases—continue to occur. While there are currently no treatments specifically approved for monkeypox, therapeutics developed for patients with smallpox have been deployed during the current outbreak. This Health Alert Network (HAN) Health Update provides clinicians and public health officials with new information about managing monkeypox in patients requiring therapeutics.”
New England Journal of Medicine: Monkeypox — A Sobering Sentinel for Pandemic Preparedness and Sexual Health System Capacity
“This new pandemic has strained public health and health care systems already battered by Covid-19. It has also highlighted lessons learned — and sometimes ignored — from HIV and Covid-19 and has illustrated the inadequacy of sexual health infrastructure and pandemic preparedness in the United States.”
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.
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
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.
- Bilingual Medical and Housing Case Manager: The focus of this position will be to ensure efficient delivery of quality medical case management services to clients who are living with HIV through assessment, planning, service procurement, delivery, coordination, and monitoring, ensuring all services are offered in an inclusive, respectful and professional manner. The Bilingual Medical and Housing Case Manager reports directly to the Care Services Director and is required to attend All Staff meetings, Care Services team meetings, Clinical Consultations, Finance Committee meetings and to keep all client data up to date for reporting purposes. Because this position manages confidential information for clients, the Bilingual Medical and Housing Case Manager must demonstrate the highest degree of professionalism.
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, and 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
Divided Congress after midterms will allow HHS to execute on policy priorities, Becerra says
“With midterm elections resulting in a narrowly divided Congress, the HHS will be free to focus on longstanding priorities for the health department, such as implementing drug negotiation policy within Medicare, HHS Secretary Xavier Becerra said at the HLTH conference in Las Vegas on Tuesday. “In a way, we’re now going to be able to concentrate on the work we have to still execute on,” Becerra said. Under the Inflation Reduction Act passed earlier this year, Congress granted Medicare the power to negotiate how much it pays for certain prescription drugs starting in 2026, and to receive rebates from pharmaceutical manufacturers that hike drug costs above the rate of inflation starting in 2023.”
U.S. judge rejects Biden administration's LGBT health protections
“A federal judge in Texas ruled on Friday that President Joe Biden's administration had wrongly interpreted an Obamacare provision as barring health care providers from discriminating against gay and transgender people. U.S. District Judge Matthew Kacsmaryk in Amarillo ruled that a landmark U.S. Supreme Court decision in 2020 holding that a law barring workplace discrimination protects gay and transgender employees did not apply to the healthcare law.”
The Barriers to PrEP Uptake Among People Who Inject Drugs
“People who inject drugs may risk HIV transmission through practices like sharing needles—one reason, of course, why access to sterile syringes is vital. This population made up 10 percent of all new HIV transmissions in the United States in 2018. Barry and a team of researchers at the university sought to better understand why people who inject drugs aren’t accessing PrEP more readily. In their recent paper, published in the Harm Reduction Journal, the team identified several significant factors. These “really illustrate the structural and individual issues” at the core of the matter, Barry said.”
Fentanyl isn’t just causing overdoses. It’s making it harder to start addiction treatment
“Doctors are reporting a troubling trend when it comes to fentanyl. The powerful drug, they say, isn’t just causing overdoses — it’s also making it more difficult to begin addiction treatment. In particular, fentanyl appears more likely to cause severe withdrawal symptoms for patients put on buprenorphine, a key medication used to treat opioid use disorder. The development adds yet another layer of crisis to the country’s drug epidemic, which killed nearly 108,000 Americans last year. Even as fentanyl sends overdose deaths soaring, it threatens to make the world’s most-prescribed addiction drug inaccessible to the increasing number of patients who need it.”