Policy Updates: Hill Happenings and Administration Activities
Fiscal Year 2023 Appropriations
Lawmakers returned from August recess and must now approve a spending deal before the October 1 Fiscal Year 2023 (FY2023) deadline. Lawmakers are expected to issue a continuing resolution (CR) to extend current funding levels for a few months to give appropriators more time to land on a bipartisan spending agreement. 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.
On September 2, the White House called on Congress to include supplemental funding through the upcoming CR for the national monkeypox virus (MPV) response. President Biden requested a total of $3.9 billion to ensure the continued availability of vaccinations, testing, treatment, and operational support, especially for disproportionally impacted communities. In addition to the MPV funding, the White House called for additional COVID-19 funds, financial support for Ukraine, and natural disaster aid. However, Republicans demonstrated early resistance to the additional funding.
Appropriators must overcome persistent partisan divides in order to avoid issuing repeated CRs, which strain health programs, and pass a bona fide FY2023 appropriations bill. In addition to the Republican opposition to the MPV funding, over 70 House Democrats are threating to oppose the CR if it includes an already agreed-upon energy provision, complicating Democrats’ spending negotiations strategy.
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 Pass MAT Act
On August 31, NASTAD joined a coalition of over 165 organizations and called on Senate leaders to pass the Mainstreaming Addiction Treatment Act (H.R. 1384 / S. 445) (MAT Act) via the anticipated September CR. The MAT Act would educate providers on best practices to treat substance use disorder (SUD) and help to integrate substance use treatment into primary care settings by eliminating the X-waiver requirement, which prohibits providers from prescribing buprenorphine until they fulfill a separate training and registration requirement for dispensing narcotic drugs in schedule III, IV, or V. The coalition highlights the broad bipartisan support for the MAT Act, including the legislation’s passage in the House of Representatives via the Restoring Hope for Mental Health and Well-Being Act of 2022 (H.R. 7666). By including the MAT Act in the must-pass spending CR, Congress could expedite the availability of increased provider capacity to treat SUD at a time when record-high overdose rates continue to rise.
Senate HELP Committee Urges Biden Administration Address Health Inequities in National Monkeypox Virus (MPV) Response
On August 25, a group of 12 Senators urged the Biden Administration to increase efforts to monitor and address racial disparities in the national response to the MPV public health emergency. The Senators highlighted recent data that show significant disparities in infections and access to treatment and vaccination by race. In order to avoid exacerbating existing health disparities and reducing mortality and disease burden in vulnerable communities, the Senators call on the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) to learn from the lessons of the COVID-19 pandemic and support health departments’ ability to collect racially and ethnically disaggregated data on both diagnosis and treatment of MPV.
Lawmakers Urge Biden Administration to End HBV Discrimination in the Military
On September 8, a bicameral group of lawmakers called on President Biden to direct the armed services to update outdated policies and personnel management instructions that discriminate against people living with hepatitis B virus (HBV) and HIV. Rep. Mike Quigley (D-IL-05), Vice-Chair of the Congressional LGBTQ+ Equality Caucus, along with Reps. Sara Jacobs (D-CA-53) and Barbara Lee (D-CA-13), sent a letter to President Biden urging a revision of Department of Defense policies that prohibit people living with HBV and/or HIV from enlisting and deploying. The lawmakers highlight the medical advances that enable people living with HBV and HIV to live full lives with minimal risk of battlefield transmission, rendering the stigma-based policies obsolete. Members of the Senate also sent an identical letter, led by Senators Chris Coons (D-DE) and Kirsten Gillibrand (D-NY).
Hepatitis Congressional Caucus Calls on HHS to Recognize NAIRHHA Day
On September 9, the Hepatitis Caucus Co-Chairs Congressman Hank Johnson (D-GA-04), Congresswoman Grace Meng (D-NY-06), along with HIV/AIDS Caucus Chair Congresswoman Barbara Lee (D-CA-13), sent a letter with 11 House colleagues to HHS leadership requesting support for the designation of September 9th as “National African Immigrant and Refugee HIV/AIDS and Hepatitis Awareness (NAIRHHA) Day.” The lawmakers call on HHS to provide federal recognition of NAIRHHA Day in order to bring increased awareness and attention to the health issues of HIV/AIDS and viral hepatitis in African immigrant and refugee populations in the U.S., who suffer HIV infection rates six times higher than the national average, and face the highest average chronic hepatitis B rates in the country with approximately 10 percent of people in these communities living with hepatitis B.
Federal District Judge Rules Against ACA Coverage Mandate for PrEP
On September 7, a federal District Judge in Texas ruled that the mandatory cost-free coverage of PrEP under the Affordable Care Act’s (ACA) preventive services requirement is unconstitutional, enabling insurers and health plans to collect copayment, coinsurance, or deductibles for the critical medication at their discretion. The ruling could lead to the denial of access to affordable PrEP for thousands of people nationwide, threatening to halt or reverse the progress made towards ending the HIV epidemic in the US. The judge also ruled that the U.S. Preventive Services Task Force (USPSTF) lacks the legal authority to issue its recommendations, undermining the preventive services framework established by the ACA and threatening access to cost-free preventive care for over 150 million people. Click here to read NASTAD’s statement condemning the harmful ruling. NASTAD does expect this ruling to be appealed and will continue to provide updates.
CDC Releases Updated MPV Data
On September 8, the Centers for Disease Control and Prevention (CDC) released a Morbidity and Mortality Weekly Report (MMWR), “HIV and Sexually Transmitted Infections Among Persons with Monkeypox—Eight U.S. Jurisdictions, May 17 – July 22, 2022”, demonstrating that people with HIV and other sexually transmitted infections (STIs) are disproportionately affected by monkeypox. Among the almost 2,000 people in eight jurisdictions diagnosed with MPV in this report, 38% had received an HIV diagnosis, and 41% had been diagnosed with one or more other STIs in the preceding year. These findings highlight a critical opportunity to use established HIV and STI care and prevention delivery systems for MPV prevention efforts, including prioritizing people with HIV and STIs for MPV vaccination and offering concurrent HIV and STI testing for persons evaluated for MPV.
CMS Proposes to Streamline Medicaid Eligibility and Enrollment Processes
On August 7, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would simplify the processes for eligible individuals to enroll and retain eligibility in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program. The proposed rule would remove barriers to enrollment for new applicants and eases administrative processes related to reenrollment. The new enrollment protections will help to retain the coverage of beneficiaries as the flexibilities afforded by the COVID-19 pandemic wind down.
White House Releases LGBTQI+ Equity RFI
On August 24, the White House Office of Science and Technology Policy (OSTP) published a request for information soliciting input on the development of the Federal Evidence Agenda on LGBTQI+ Equity (Evidence Agenda). The White House Interagency Working Group on Equitable Data subcommittee on sexual orientation, gender identity, and variations in sex characteristics (SOGI) data, established by President Biden’s executive order on Advancing Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Individuals, will develop the Evidence Agenda to improve the federal government's ability to make data-informed policy decisions that advance equity for the LGBTQI+ community. Comments are due by October 3. If you would like to provide input, please send over recommendations or comment language to PLA@NASTAD.org by September 21.
OIDP Webinar: NHAS Federal Implementation Plan
Date & Time: Wednesday, September 14 from 3:00–4:00pm ET
Summary: Register now for the Office of Infectious Disease and HIV/AIDS Policy (OIDP)-hosted webinar on the recently released Federal Implementation Plan (FIP) which details over 380 action items that 10 federal departments and agencies will take to implement the National HIV/AIDS Strategy (NHAS).
Date of first webinar: September 22 at 6 pm EST
With the fall of Roe v. Wade and the persistence of War on Drugs-era policies, pregnancy and substance use will be increasingly criminalized. Please join the Washington AIDS Partnership and the Academy of Perinatal Harm Reduction for a three-part, virtual series on the necessity of integrating harm reduction services and reproductive justice. We invite all health care providers, social service providers, and community organizers who are looking to better serve pregnant people in our communities to attend!
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.
AIDS United: Harm Reduction Futures Fund
All pre-application surveys should be submitted through AIDS United’s online grantee community portal by 5 p.m. EDT on Sept. 21, 2022. A webinar will be held on Sept. 8 from 3-4 p.m. EDT to provide clarification about the grant announcement and key application submission tips. Click here to register for the webinar: bit.ly/hrff-ta
“The expansion of telehealth services during the COVID-19 pandemic was associated with individuals staying in treatment longer and reducing their risk of medically treated overdose, according to a new study.”
“A status neutral approach to HIV-related service delivery aims to deliver high-quality, culturally affirming health care and services at every engagement, supporting optimal health for people with and without HIV. This approach is especially important now to reduce the unacceptably high number of annual HIV infections and help close the persistent gaps along the HIV prevention and care continuum, which indicate that not enough people are being engaged or retained in HIV prevention and treatment.”
CDC Monkeypox MMWR:
- HIV and Sexually Transmitted Infections Among Persons with Monkeypox — Eight U.S. Jurisdictions, May 17–July 22, 2022
- Strategies Adopted by Gay, Bisexual, and Other Men Who Have Sex with Men to Prevent Monkeypox virus Transmission — United States, August 2022
- Modeling the Impact of Sexual Networks in the Transmission of Monkeypox virus Among Gay, Bisexual, and Other Men Who Have Sex with Men — United States, 2022
- Orthopoxvirus Testing Challenges for Persons in Populations at Low Risk or Without Known Epidemiologic Link to Monkeypox — United States, 2022
- Clinical Use of Tecovirimat (Tpoxx) for Treatment of Monkeypox Under an Investigational New Drug Protocol — United States, May–August 2022
The NIH Research Education Program (R25) supports research education activities in the mission areas of the NIH. The overarching goal of this Office of Research on Women’s Health R25 program is to support educational activities that complement and/or enhance the training of a workforce to meet the nation’s diverse biomedical, behavioral and clinical research needs. As sex and gender influence multiple domains of health, courses, curricula, and methods covering a broad range of topics are appropriate for this FOA, as long as sex, gender, or both is a primary domain of focus, including HIV and women, including HIV cure, prevention, and treatment.
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.
“Congress and the Biden administration need to do more to keep people alive by increasing access to effective, lifesaving interventions, such as harm reduction services.
Traditionally, federal support has focused on access to drug prevention and treatment services. To expand support for harm reduction and related interventions, Congress and the administration should provide resources for syringe services programs and related harm reduction programs nationwide to help prevent drug overdose and provide access to critical health and support services.”
“US lawmakers will look to press Biden administration health officials on their response to the growing monkeypox outbreak in a Senate hearing planned for next month, according to people familiar with the matter. The Health, Education, Labor and Pensions Committee is planning the hearing on monkeypox for mid-September, according to the people, who asked not to be identified because the information isn’t public.”
“Today, the HIV+Hepatitis Policy Institute, the Diabetes Leadership Council (DLC), and the Diabetes Patient Advocacy Coalition (DPAC), representing 42 million people, filed suit in the U.S. District Court for the District of Columbia challenging a federal rule that allows health insurers to avoid counting the value of drug manufacturer copay assistance toward patients' out-of-pocket cost obligations.”