Policy Updates: Hill Happenings and Administration Activities
Hill Happenings
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. Democrats are expected to issue a continuing resolution (CR) to temporarily extend current funding levels amid a budget impasse and give appropriators more time to land on a bipartisan spending agreement in the fall. 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 and additional COVID-19 funds. However, Republicans demonstrated early resistance to the additional funding and Democrats may have to compromise on spending priorities in order to pass a CR by September 30 and avert a government shutdown. Advocates are calling on Congress to avoid issuing repeat CRs, which strain health programs, and 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.
Senate HELP Committee Holds Hearing on Federal MPV Response
On September 14, the Senate Committee on Health, Education, Labor, & Pensions (HELP) held a full committee hearing on the nation’s federal response to the MPV public health emergency. Key public health officials, including Centers for Disease Control (CDC) Director Rochelle Walensky, appeared before the committee to testify on the Biden Administration’s actions to-date to stop the spread of MPV. Senators expressed their frustration at the slow rollout of the MPV response, including delays in vaccine production and dissemination and confusing guidance messaging to states. Although national MPV rates are decreasing from a peak incidence rate in July, lawmakers urged the health officials to continue pushing strong measures in order to contain the spread of MPV.
NASTAD Calls on Congress to Provide Supplemental Funding for MPV Response
On September 12, NASTAD joined a coalition of 28 organizations and called on top appropriators to approve President Biden’s supplemental funding request to support the federal MPV response. On September 2, the White House called on Congress to dedicate $4.5 billion in supplemental funding through the upcoming CR to bolster MPV programs nationwide. The advocates highlight the burden that MPV has placed on the chronically underfunded public health infrastructure, especially in the wake of the COVID-19 pandemic. The coalition requests the funding to support testing, vaccine administration, treatment, clinical support, community outreach and education, coordinated surveillance, wrap-around services, financial assistance for patients in isolation, and research.
NASTAD Calls on the Biden Administration to Fund Sexual Health Programs
On September 12, NASTAD joined a coalition of 24 public health organizations and called on the Office of Management and Budget (OMB) to increase funding for sexual health and pregnancy prevention programs in the Fiscal Year 2024 (FY2024) Executive Budget Request to Congress. The coalition requests additional funding for the Teen Pregnancy Prevention Program (TPP) and CDC’s Division of Adolescent and School Health (DASH), which contribute to reductions in unintended pregnancies, HIV, and other STIs among youth. Additionally, the coalition urges the Administration to maintain its proposed zero-funding of the Sexual Risk Avoidance Program (SRAP), an ideologically driven program that exclusively funds abstinence-only until marriage programs despite the lack of an evidence base. The Biden Administration proposed eliminating funding for SRAP programs in the Fiscal Year 2022 Executive Budget Request to Congress.
Administration Activities
CDC Publishes 2020 Viral Hepatitis Surveillance and Progress Reports
On September 15, the CDC Division of Viral Hepatitis (DVH) published the viral hepatitis surveillance and progress reports for 2020. Due to the significant disruptions to health care systems and service delivery during the COVID-19 pandemic, the results of the 2020 surveillance report should be interpreted with caution. This year, the reports were published exclusively in digital format to improve accessibility. The 2020 surveillance report shows a decrease in the overall reported number of viral hepatitis cases, but the decrease may be related to a reduction in the available hepatitis workforce and fewer people seeking healthcare and being tested during the COVID-19 pandemic. Click here to read a NASTAD memo highlighting key findings published in the report.
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.
Transgender Rights Coalition Sues Florida Over State Rule Barring Medicaid Coverage of Gender-Affirming Health Care
On September 7, a coalition of legal rights groups sued the Florida Agency for Health Care Administration after it implemented a rule barring Medicaid coverage of gender-affirming care. Additionally, on September 12, the coalition filed a motion seeking a temporary injunction to pause the rule which went into effect on August 21. The plaintiffs, which include Lambda Legal, Southern Legal Counsel, Florida Health Justice Project, and National Health Law Program, argue that the rule violates the 14th Amendment’s equal protection clause and the healthcare discrimination protections afforded by Section 1557 of the Affordable Care Act. Florida’s ban on Medicaid coverage of gender-affirming care will prevent around 9,000 transgender Medicaid enrollees in the state of Florida from receiving medically necessary health care services.
Resources
HRSA HAB Webinar: HAB You Heard
Date & Time: Tuesday, September 27 from 3-4 PM ET
Summary: During the September monthly update from the HIV/AIDS Bureau, we will be joined by the CDC who will provide the latest updates on monkeypox (MPx) specific to Ryan White HIV/AIDS Program (RWHAP) recipients and subrecipients, and HAB leadership will share additional MPx updates. In addition, the webinar will feature a 2022 National Ryan White Conference wrap up, highlight new updates to the RWHAP Best Practices Compilation, and share new RWHAP resources and data tools. We strongly encourage all RWHAP recipients, subrecipients, stakeholders, and federal staff to participate. Registration is required.
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
KFF Analysis: Assessing Monkeypox (MPX) Vaccine Eligibility Across the United States
“Overall, we find that almost all jurisdictions have adopted PEP and PEP++ vaccination strategies, with a much smaller number employing PrEP as currently defined by CDC. However, there is substantial variation in how eligibility is defined within, and in some cases beyond, these categories. Additionally, several jurisdictions lack clear criteria or information about who is eligible or where to get vaccinated. Such variation has implications for access and may affect how equitable roll-out of vaccination is across the country, particularly as new MPX cases are increasingly concentrated among MSM of color.”
Webinar: Fundamentals of Perinatal Harm Reduction Webinar Series
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!
FORE RFP: Community-Driven Responses to Opioid Use Disorder and Overdose Mortality
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
Job Postings
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.
CSTE RFP: Continuous HIV Surveillance and Epidemiology TA and SME
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 (srichardson@cste.org) 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.
News Bulletin
“For nearly a decade, many experts assumed the biggest obstacle to eliminating hepatitis C was the sky-high cost of the new cures. So when Washington state and Louisiana signed flashy, unprecedented deals with the pharmaceutical companies that make the medicines back in 2019, and dedicated personnel and money toward the lofty goal, many celebrated. Just last week, the White House held the states up as a potential model for a forthcoming multibillion-dollar national effort with the same aim. But those states are nowhere near achieving the overarching goals they set, a new STAT investigation reveals…It raises questions, too, about the shape of the new White House initiative, which has not yet been announced. President Biden’s science adviser, Francis Collins, told hepatitis C advocates last week he hoped Congress would allocate $8 billion to $10 billion to help eliminate the virus nationally.”
Southern States’ Lackluster Monkeypox Efforts Leave LGBTQ+ Groups Going It Alone
“The perception that the response to the monkeypox virus in the South has lacked coordination has rekindled familiar concerns about recent state policies that leave members of the region’s LGBTQ+ communities feeling marginalized and discriminated against. More urgently, it raises questions about whether state and local health departments are doing enough to protect the people principally affected by the virus: men who have sex with men.”
The meth crisis is worse than ever, but new treatments might be around the corner
“Despite the skyrocketing use of meth, a stimulant particularly common in the western U.S., there’s no medication currently approved to treat meth overdose or aid in long-term recovery…Recently, though, Robey has added a new weapon to his limited meth-treatment arsenal: A monoclonal antibody that binds to methamphetamine molecules and helps prevent them from entering the brain.”
Graham's abortion ban stuns Senate GOP
“Lindsey Graham’s anti-abortion legislation once unified the Republican Party. The 15-week abortion ban he pitched Tuesday had the exact opposite effect. The South Carolina senator chose a uniquely tense moment to unveil his party’s first bill limiting abortion access since this summer’s watershed reversal of Roe v. Wade. It was designed as a nod to anti-abortion activists who have never felt more emboldened. Yet Graham’s bill also attempted to skate past a Republican Party that’s divided over whether Congress should even be legislating on abortion after the Supreme Court struck down a nationwide right to terminate pregnancies.”