Policy Updates: Hill Happenings and Administration Activities
Fiscal Year 2023 Appropriations
On September 29, Congress issued a continuing resolution (CR) to temporarily extend Fiscal Year 2022 (FY2022) funding levels through December 16. Appropriators were forced to issue the CR due to partisan disagreements on topline spending levels for FY2023, and now have a few more weeks to land on a bipartisan spending agreement and pass a full-scale appropriations package or issue another CR.
House and Senate Democrats advanced their set of appropriations bills earlier in July, which proposed funding increases to key health programs, but Democrats will need to secure Republican support to advance the spending package. Advocates are calling on Congress to avoid issuing a repeat CR, which strains health programs, and pass a bona fide, full-year FY2023 appropriations bill. 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 either or both chambers.
NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs.
NASTAD Signs Onto Comments in Support of Updated ACA Nondiscrimination Protections
On October 3, NASTAD and the Federal AIDS Policy Partnership (FAPP) submitted comments in support of the Biden Administration’s proposed rule, Nondiscrimination in Health Programs and Activities. The proposed rule restores and expands Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities, after the Trump Administration narrowed the scope of the rule in 2016. The coalition commended the Biden Administration for providing explicit protections against sex-based discrimination in the proposed rule, and suggested language that would further protect transgender people from discrimination. Additionally, the coalition proposed that the Department of Health and Human Services (HHS) vigorously review any requests for religious exemptions to ensure that people living with or at risk of HIV have protected access to lifesaving reproductive and sexual health care, and to address discriminatory coverage exclusions and adverse tiering for HIV medications in the final rule.
Additionally, NASTAD signed onto comments submitted by the Leadership Conference on Civil and Human Rights in support of the proposed rule. The coalition praised the Administration for bolstering protections against discrimination by race, language, and disability status. Additionally, the coalition called for HHS to address systemic racism in health care and require covered entities to implement disaggregated data collection in order to quantify health disparities.
DHP Releases New 2022-2025 Strategic Plan Supplement
On October 3, the Centers for Disease Control and Prevention (CDC) Division of HIV Prevention (DHP) launched the 2022-2025 Strategic Plan Supplement, which builds on the existing goals, objectives, strategies, and indicators in the 2017-2020 Strategic Plan. The supplement outlines updated priorities and emphasizes six new investment areas where DHP will allocate resources to bolster HIV prevention efforts, including strengthening DHP’s workforce capacity, expanding access to DHP funding, enhancing implementation guidance and technical assistance, data systems integration, advancing collaborative partnerships, and supporting recipient communication efforts.
PACHA Accepting Comments on Recommendations to CDC Regarding Molecular HIV Surveillance
On Monday, October 17, the Presidential Advisory Council on HIV/AIDS (PACHA) unanimously approved a set of recommendations for the CDC regarding molecular HIV surveillance (MHS). The resolution urges CDC to update its guidance to public and state, territorial, and local health departments to collaborate with key stakeholders and PLHIV and assess whether MHS should be implemented locally, as well as how MHS activities might be constituted to ensure PLHIV are not harmed, such as by implementing opt-out options for PLWHIV. HIV advocates and public health organizations, like the Center for HIV Law & Policy, are calling for the implementation of MHS to be put on hold until sufficient safeguards can be put in place that prevent the use of HIV data to criminalize PLWHIV. Additionally, advocates question whether the substantial investments required to build MHS infrastructures could be better spent. The general public can submit comments on PACHA’s recommendations by emailing PACHA@hhs.gov.
USPSTF Recommends Screening for Syphilis Based on Risk
On September 27, the U.S. Preventive Services Task Force (USPSTF) issued an A Grade recommendation to screen for syphilis in all asymptomatic, nonpregnant adolescents and adults who have ever been sexually active and are at increased risk for syphilis. USPSTF identified a higher prevalence of syphilis in men, men who have sex with men, persons with HIV infection, young adults, persons with a history of incarceration, sex work, or military service, people who use drugs, particularly methamphetamine, and previous diagnosis of another STI. Under the ACA preventive services mandate, the A grade recommendation will require cost-free syphilis screening for most patients, which will help to address rising syphilis rates in the US by increasing access to screenings.
CDC Announces Expanded Eligibility for MPX Vaccination
On September 28, CDC announced expanded eligibility for MPX vaccination so that more people may receive the vaccine before they are exposed to the disease. CDC’s Interim Clinical Considerations were also updated to provide additional information on intradermal administration of the monkeypox vaccine. In addition to the forearm, these revisions provide clinicians with additional discreet locations on the body to administer the vaccine, including the skin over the shoulder blade, or at the shoulder muscle, called the deltoid.
HRSA HAB Issues Guidance on RWHAP Recipients Affected by Hurricane Ian
On September 30, the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB) issued guidance to RWHAP recipients impacted by Hurricane Ian. HRSA HAB encourages RWHAP Parts A – D in the surrounding areas to consider streamlined approaches to eligibility and maximizing all available resources to ensure access to medications and services in this emergent situation. HRSA HAB will continue to monitor the long-term impact of Hurricane Ian on service delivery for RWHAP clients or potential displacement of clients.
- RFP Close Date: October 28, 2022
- Performance Period: December 1, 2022 – September 29, 2023
NASTAD is soliciting proposals from professionals with demonstrated expertise and experience in medical coding and billing and creation of HIV-related coding guides. The consultant will lead creation of a billing and coding guide for HIV Prevention, with a special emphasis on pre-exposure prophylaxis (PrEP). This work is funded by a cooperative agreement from the Centers for Disease Prevention and Control (CDC) and builds off of and updates a HIV Prevention billing and coding guide NASTAD created in 2018.
NASTAD Resource: Ending the HIV Epidemic (EHE) Spotlight Video Series
The Ending the HIV Epidemic (EHE) video series shines a spotlight on the disruptively innovative work of EHE jurisdictions across the U.S. 3 new videos were added to the series.
CDC MPV MMWR:
- Receipt of First and Second Doses of JYNNEOS Vaccine for Prevention of Monkeypox — United States, May 22–October 10, 2022
- Characteristics of JYNNEOS Vaccine Recipients Before and During a Large Multiday LGBTQIA+ Festival — Louisiana, August 9–September 5, 2022
- A Health Equity Approach for Implementation of JYNNEOS Vaccination at Large, Community-Based LGBTQIA+ Events — Georgia, August 27–September 5, 2022
- Ocular Monkeypox — United States, July–September 2022
- Monkeypox Virus Infection Resulting from an Occupational Needlestick — Florida, 2022
CDC/NACCHO RFP: Harm Reduction and Academic Detailing (HRAD) Pilot Projects
- Date of release: October 3, 2022
- Applications are due: by 11:59 pm E.T. on November 1, 2022
- Please direct questions to: Audrey Eisemann at AEisemann@naccho.org
With support from the Centers for Disease Control and Prevention (CDC), NACCHO is pleased to offer a funding opportunity for health departments or government, nonprofit, academic, or other organizations to develop key messages on harm reduction that can be delivered through academic detailing. Through this project, selected sites will identify a novel population that has not received academic detailing on harm reduction in their jurisdiction, develop specific key messages for this population, and pilot the key messages. Through this funding opportunity, NACCHO and CDC will award up to six (6) applicants, for up to $60,000 per site.
CDC/NACCHO RFP: Embedding Peers in Emergency Departments (EPED)
This funding opportunity provides an opportunity to embed peer recovery specialists in emergency departments to improve linkages to care for people who use drugs (PWUD). Local Health Departments (LHDs), hospitals, and other community partners will design, implement, maintain, and evaluate a set of protocols to screen patients in the ED for substance use. Eligible patients will be connected with a peer recovery specialist to discuss hospital based MOUD induction, links to ongoing community based MOUD, other treatment options, and/or available harm reduction services. Full details of the project outline and requirements can be found in the Request for Proposals.
Comer Family Foundation NOFO: Syringe Service Program Grant Applicants
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.
“While national efforts to eliminate hepatitis C have faced setbacks because of increased drug use, the impact of COVID-19 and insurance complications, there’s a bright spot: Some states are now making it easier for patients to treat the disease…“As the cost of treatment has come down as a result of things like competition and rebates, state Medicaid programs are more willing to remove these restrictions because they recognize that it's not going to bust their budget,” said Adrienne Simmons, director of programs at the National Viral Hepatitis Roundtable.”
“Washington has run out of funding for its HIV prevention assistance program and its future remains uncertain — despite growing demand. The state Department of Health’s program, known as the pre-exposure prophylaxis drug assistance program (PrEP DAP), covers nearly all out-of-pocket expenses for Washingtonians who take HIV prevention medicine, usually a once-a-day pill, or their related lab or doctor visits. It has existed for eight years, but because of a sudden increase in pharmacy costs and changes to health insurance coverage this summer, program leader Elizabeth Crutsinger-Perry said she’s been forced to close it to new enrollment.”
“President Biden will move to expand the use of medication to treat addiction in pregnant women through a new initiative as part of the administration’s strategy to improve maternal health. The initiative will develop training and technical assistance about medications for opioid addiction treatment, like buprenorphine and methadone, for women who are part of government programs through the Department of Justice and the Department of Health and Human Services. It also will offer opioid addition education to women’s health providers through the Department of Veterans Affairs.”
“The CDC’s new push to get information about health crises out faster to Americans is already running up against its limited authority, congressional inaction and the agency’s own entrenched culture. In August, Director Rochelle Walensky ordered an overhaul of the CDC after its bungled Covid-19 response, including a drive to share research and data sooner and be more open with the public about what agency scientists do — and don’t — know. But the CDC’s inability to compel states to share information about disease outbreaks is getting in the way of the effort, said Walensky, who added that the agency needs more money from Congress to draw in new talent and train the public health workforce to speed up the information flow to the public.”