Policy Updates: Hill Happenings and Administration Activities
Fiscal Year 2023 Appropriations
On September 29, one day before the Fiscal Year 2023 (FY2023) funding deadline, lawmakers averted a government shutdown and issued a continuing resolution to extend current funding levels through December 16. Appropriators were forced to issue the CR due to partisan disagreements on topline spending levels for FY2023, and now lawmakers have a few more months to land on a bipartisan spending agreement and pass a bona-fide appropriations package. Although Democrats successfully passed the CR, Republicans blocked the inclusion of additional COVID-19 and monkeypox virus (MPV) response funding.
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 strain health programs, and to pass a bona fide, full-year FY2023 appropriations bill.
NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs.
Mental Health and HIV Caucus Introduces Resolution on Six Protected Classes
On September 22, the Co-Chairs of the Mental Health and HIV/AIDS Caucuses introduced a resolution expressing support for Medicare Part D’s six protected classes policy, which is an essential safeguard that ensures that beneficiaries have access to needed medications. The six-protected class policy, a key component of the Medicare Part D program, requires that part D plans cover all or substantially all medications within those classes, which include: antidepressants, antipsychotics, anticonvulsants, immunosuppressants, antiretrovirals, and antineoplastics. The resolution was introduced to uplift the importance of the protected class safeguards against proposed changes that threatened to alter the affordability of these life-saving medications.
NASTAD Urges Biden Administration to Fund Family Planning Programs
On September 19, NASTAD joined a coalition of 47 organizations and called on the Biden Administration to increase funding for family planning programs and clinical STI services in Fiscal Year 2024 (FY2024). The coalition requests increased funding for the Title X family planning program, which provides safety-net access to contraception, STI screening and treatment, screening for substance use disorder, and PrEP. Additionally, the coalition calls on the Centers for Medicare and Medicaid Services (CMS) to robustly enforce the Medicaid Free Choice of Provider requirement, which allows patients to choose their provider for family planning services and supplies. The additional funds are urgently important in FY2024 due to the limited resources available to health departments and essential health providers to tackle STIs, and to ensure broad access to contraception in light of the Supreme Court’s decision to enable states to restrict access to abortion.
CDC Releases Preliminary STD Data for 2021
In early September, the CDC published preliminary STD surveillance data for calendar year 2021. The data, collected through the National Notifiable Diseases Surveillance System, show 2.5 million reported cases of chlamydia, gonorrhea, and syphilis in 2021, an increase from the record-high levels in 2020. The Director of the CDC Division of STD Prevention highlighted the chronic underfunding of public health programs as a significant contributing factor in the increased rates of STIs, especially as STI staff at health departments continue to be detailed to the COVID-19 and MPV response. In particular, rates of syphilis increased dramatically with a 26% incidence rate increase in 2021.
CDC Observes National Gay Men’s HIV/AIDS Awareness Day
On September 27, the CDC Division of HIV Prevention (DHP) observed National Gay Men’s HIV/AIDS Awareness Day (NGMHAAD), a day to help end HIV stigma and encourage HIV testing, prevention, and treatment among gay, bisexual, and other men who have sex with men. This year, CDC acknowledges the additional health challenges and amplified stigma that gay men face as a result of the MPV outbreak. Additionally, the persistence of racial, ethnic, and regional HIV disparities, and similar patterns of inequity with Hispanic/Latino and Black/African American gay and bisexual men representing the majority of people with monkeypox, reflect the urgent need to scale up treatment and prevention services. Click here to read a Dear Colleague letter on NGMHAAD from DHP leadership uplifting the importance of the annual event.
Biden Administration Announces Record Level Funding for Global Health
On September 21, at the Global Fund to Fight AIDS, Tuberculosis (TB), and Malaria’s (Global Fund) Seventh Replenishment pledging conference, President Biden announced that funders had mobilized $14.25 billion for the Global Fund, marking the largest amount ever amassed to fight the three diseases. The Global Fund was established 20 years ago and invests money in low- and middle-income countries to combat the spread of HIV, TB, and malaria. Government donors and the private sector formally pledged their contributions to enhance global capacity to fight against these existing epidemics and build more resilient health systems in preparation for future health threats and pandemics.
D.C. Medicaid Program Removes Restrictions to HCV Treatment
On September 27, the Washington, D.C. Department of Health Care Finance (DHCF) lifted prior authorization requirements in the D.C. Medicaid program for prescribing hepatitis C virus (HCV) treatment. The prior authorization requirements, which included substance use, prescriber, and retreatment requirements, unnecessarily restricted access to the life-saving direct-acting antiviral treatments that cure HVC. The removal of the prior authorization requirements will help to decrease the mortality and disease burden of HCV by enabling patients to receive prompt treatment and will help to reduce health inequities in access to HCV treatment.
Williams Institute Releases Report and Data Interactive on HIV Criminalization in Louisiana
On September 27, the University of California-Los Angeles Williams Institute released a report and data interactive detailing enforcement of HIV crimes in Louisiana. Using data obtained from the Louisiana Incident-Based Reporting System and from the state’s most populous parishes, researchers found that enforcement of HIV crimes is concentrated in East Baton Rouge Parish, Orleans Parish, and Calcasieu Parish. Furthermore, the number of HIV incidents—or interactions with law enforcement involving allegations of HIV crimes—is not declining over time. Additionally, Black people—and especially Black men—were the majority of people identified as suspects and arrested for HIV-related crimes in Louisiana.
CDC Awards Year-One Funding
On September 20, CDC awarded $8.3 million in year-one funding to Emory University to implement Together TakeMeHome (TTMH), a national HIV self-testing program designed to increase awareness and diagnoses of HIV in the United States. Under this five-year award totaling approximately $41 million, Emory University will provide approximately one million HIV self-tests to populations disproportionately affected by HIV. The program supports the National HIV/AIDS Strategy (NHAS) and Ending the HIV Epidemic in the U.S. (EHE) initiative goal of increasing the proportion of people with HIV who have received a diagnosis.
CDC MPV MMWR:
- Two Cases of Monkeypox-Associated Encephalomyelitis — Colorado and the District of Columbia, July–August 2022
- Health Care Personnel Exposures to Subsequently Laboratory-Confirmed Monkeypox Patients — Colorado, 2022
- Monkeypox in a Young Infant – Florida, 2022
- Incidence of Monkeypox Among Unvaccinated Persons Compared with Persons Receiving ≥1 JYNNEOS Vaccine Dose — 32 U.S. Jurisdictions, July 31–September 3, 2022
- Monkeypox Case Investigation — Cook County Jail, Chicago, Illinois, July–August 2022
O’Neill Institute Issue Brief: MPX Research Gaps: What Remains Unknown
“Although the MPX virus was identified fifty years ago, not enough is known about the latest variant. There are several critical epidemiological, clinical, and behavioral research questions that must be addressed to extinguish the current outbreak and to prevent a future resurgence of MPX community transmission in the U.S.”
Deadline: 11:59 pm EST on October 21, 2022.
We are pleased to announce a new request for proposal for projects that support community-based organizations (CBO) capacity to reduce opioid use disorder (OUD) and overdose mortality. Our goal is to help CBOs enhance their ability to deliver services addressing the opioid crisis, particularly in communities where people are at the greatest risk of developing OUD and dying from overdoses. This funding opportunity is limited to community-based organizations. Applicants may apply for a grant of up to $75,000 a year for up to two years.
Biological Administrator III – Tallahassee, FL
This position is a highly responsible position as the HIV/AIDS Section Administrator for the HIV/AIDS Section reporting directly to the Chief of the Bureau of Communicable Diseases in the Florida Department of Health. This position is responsible for all aspects of the HIV program including providing direction and functional supervision of staff responsible for HIV Prevention, Patient Care, Surveillance and Quality Improvement initiatives for the state of Florida. The position also has the responsibility of coordinating statewide efforts for program planning and culturally competent community engagement efforts. Applications close September 16.
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.
Council of State and Territorial Epidemiologists is seeking a consultant to provide continuous technical assistance (TA) and subject matter expertise on HIV surveillance and epidemiology to improve HIV surveillance capacity and provide support on activities and convenings related to HIV surveillance technical assistance and programmatic planning and execution. If interested in this opportunity, please submit an application to Symone Richardson (email@example.com) by Wednesday, September 7, 2022 according to the process detailed in the RFP.
Surveillance Section Chief – Sacramento, CA
This position supports the California Department of Public Health’s (CDPH) mission and strategic plan by working collaboratively with state and federal agencies, local health jurisdictions (LHJ), universities, and community-based organizations to ensure efforts to combat the HIV/AIDS epidemic are targeted and effective by leveraging data and technology to advance goals, inform action and accountability, strengthen the science base of our services, and expand surveillance systems for evidence-based decision making. The Research Scientist Supervisor II (RSS II) directs and manages all aspects of HIV case and incidence surveillance in California, including managing the activities of the Quality Management Unit (QMU) and the Medical Monitoring Project (MMP)
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.
“The recent surge of monkeypox cases has largely been concentrated among men who have sex with men, with the virus spreading through sexual contact…Many people with monkeypox also have HIV or another recent STI. That means a large brunt of the response has fallen to clinics and organizations that specialize in STI and HIV/AIDS care, a network that for years has complained about a lack of resources even as they faced spiking STI rates. Clinics have rallied for their patients, overcoming red tape and fanning out to bars, clubs, and Pride events to expand access to testing, treatment, and vaccines. But even as monkeypox has been declared a public health emergency both domestically and globally, they haven’t been allocated additional funding. Providers and administrators warn they’re being stretched thin, running at a pace they won’t be able to keep up.”
“This past winter, as Covid cases were beginning to decline, state health officials in New York were expecting a respite after two exhausting years and a chance to refocus on run-of-the-mill public health duties. Almost a year later, they are still waiting. The Omicron variant emerged in December, causing cases to increase ten-fold in one month and forcing the department of health to put its post-Covid strategy plans on hold. In May, monkeypox began to spread, spurring officials to scramble to find and distribute vaccines. And in July, a patient in New York tested positive for polio, triggering frantic attempts to pinpoint how a once-nearly-eradicated virus was spreading.”
“The Centers for Disease Control and Prevention (CDC) says it has “moderate” confidence that the rate of monkeypox cases in the U.S. will continue to decline or hit a plateau in the next two weeks.
In its latest technical report on the monkeypox outbreak, the CDC listed three possible directions in which cases could go. Apart from a decline or plateau, the agency said cases could also begin rising “slowly” or “rapidly” with exponential growth.”