April 28, 2006

This Week in Washington
1. UCHAPS Holds Annual Spring Meeting in D.C.

CARE Act in Brief
1. Two Hearings and a New GAO Report

Announcements
1. Changes to Weekly Update News Coverage
2. AIDS Action Government Affairs Job Listing
3. NAPWA to Hold AIDSWatch 2006 from May 8 - 10

This Week in Washington
1. UCHAPS Holds Annual Spring Meeting in D.C.
The Urban Coalition of HIV/AIDS Prevention Services (UCHAPS) held their annual spring meeting in Washington, April 23rd – April 25th. This was the first time for the newest UCHAPS member, Washington, DC, to host the meeting. In addition to Washington, UCHAPS consists of the six jurisdictions that are directly funded by the Centers for Disease Control and Prevention (CDC), Chicago, Houston, Los Angeles, New York, Philadelphia, and San Francisco. At each meeting, representatives from both government health offices and community providers from each UCHAPS member jurisdiction provide peer technical assistance (TA) to each other on the work that they are doing on HIV prevention issues. At this meeting the peer TA topic was transition to names reporting in UCHAPS jurisdictions.

The meeting also provided an opportunity for AIDS Action’s new executive director, Rebecca Haag, to meet with members. AIDS Action government affairs director, Donna Crews, political director, William McColl, associate executive director, Jenifer Johnson, and associate program coordinator, Dea Varsovczky, also attended the meeting during the three days. On Monday, April 24th, UCHAPS met with U.S. Department of Health and Human Services (HHS) staff to discuss coordination of federal programs. In attendance were Christopher Bates and Tim Harrison from the Office of HIV/AIDS Prevention at HHS; Doug Morgan from the HIV/AIDS Bureau at Health Resources Services Administration; Raul Romaguera from the Divisions of HIV/AIDS Prevention at CDC Division of Prevention in Care; and Kirk James, Medical Officer from the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration (SAMHSA). Christine Beato from the office of the Assistant Secretary for Health came in to welcome the UCHAPS delegation to HHS and thank them for all of their hard work over the past year in HIV prevention.

At this meeting UCHAPS was able to clearly articulate the unique nature of UCHAPS with their seven governmental entities and seven community-planning partners that is the epicenter of the HIV epidemic encompassing 35% of the AIDS cases in the United States. The UCHAPS members urged the federal government to call on their expertise in advance of new initiatives such as SAMHSA’s HIV rapid test roll-out, which did not go smoothly in all cities, and a UCHAPS consultation might have been able to suggest a smoother unveiling all across the country.

UCHAPS members also discussed the importance of working together with the treatment and care side of HIV, since those who test positive during prevention testing programs must secure care and treatment to learn to live with HIV. Many Ryan White CARE Act planning councils are combined with the community-planning group in jurisdictions, and many others work very closely together to ensure the total HIV prevention, care, and treatment spectrum is covered for the jurisdiction. At the end of day two, UCHAPS members received training in “Connecting to CARE” by AIDS Action Foundation and the D.C. HIV Administration.

On the last day of their meeting, UCHAPS members met with their House and Senate congressional delegations to advocate for increased funding for HIV prevention programs, especially supporting the President’s $93 million proposed increase in his FY 2007 budget request. They let Members of Congress know that prevention efforts are a specific and important part of the national effort working toward the elimination of HIV and that Members should not forget prevention efforts as they continue to work on the CARE Act reauthorization and other issues. UCHAPS members also explained the importance of the use of science-based HIV prevention interventions, as well as their support for voluntary HIV testing as a part of routine medical care.

CARE Act in Brief
1. Two Hearings and a New GAO Report
The week of the 23rd of April saw an unusual amount of activity on the Ryan White CARE Act reauthorization on Capitol Hill. On Wednesday, April 26th, the Senate Homeland and Government Affairs Committee’s Subcommittee on Federal Financial Management, Government Information, and International Security conducted a hearing focusing on the operations of the Ryan White CARE Act reauthorization and highlighting the release of a new report by the Government Accountability Office (GAO) earlier in the day.

The GAO report, Improved Oversight Needed to Ensure AIDS Drug Assistance Programs Obtain Best Price for Drugs, is available at http://www.gao.gov/new.items/d06646.pdf. The new report compared prices of 10 drugs in state AIDS Drug Assistance Programs (ADAPs) with pricing of drugs available through the federal 340B program. The GAO found that of 52 ADAPs all but three received prices higher than the lowest price available through the 340B program. However results may have been skewed by the use of rebates or other reporting issues. The GAO recommended that HRSA require ADAPs to report final prices they paid for drugs including discounts or rebates and that HRSA routinely determine whether the prices were at or lower than the 340B prices. The GAO report additionally reports on, “Prenatal HIV Testing and Perinatal HIV Transmission Rates Within the States” and “State Approaches to Identifying and Notifying Partners of HIV-Infected Individuals of Possible HIV Exposure.”

This report differs from a GAO report issued on March 1st of this year which examined distribution of funds under the CARE Act. That report is available at http://www.gao.gov/cgi-bin/getrpt?GAO-06-332. (See also Weekly Update http://www.aidsaction.org/communications/weekly_updates/2006/030306.htm).

The witnesses who testified included:

• Dr. Marcia Crosse, Director of Office of Public Health and Military Health Care Issues, U.S. Government Accountability Office
• Dr. Deborah Hopson, Associate Administrator of the Health Resources and Services Administration’s HIV/AIDS bureau
• Dr. Kevin Fenton, Director, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention
• Beth Scalco, Director of HIV/AIDS Program, Louisiana Office of Public Health
• Michael Weinstein, President, AIDS Healthcare Foundation (AHF), the nation’s largest provider of HIV/AIDS medical care

Senator Tom Coburn (R-OK) who chairs the subcommittee acknowledged that stigma and discrimination have helped shape the U.S. response to the HIV epidemic but said that it was now time to remove barriers to testing. Senator Tom Carper (D-DE), the Ranking Member of the Subcommittee, who was the only other member of the Subcommittee to participate in the hearing, said that the Ryan White CARE Act on the whole is working and noted that the Senate Health, Education, Labor and Pensions (HELP) Committee and the House Energy and Commerce committee are working in a bipartisan way to produce a bill. Senator Coburn’s subcommittee is not affiliated with the Senate HELP committee, which has jurisdiction over the reauthorization and hosted a reauthorization hearing earlier on March 1st. (See Weekly Update http://www.aidsaction.org/communications/weekly_updates/2006/030306.htm).

The House Energy and Commerce Committee Subcommittee on Health hosted the first House hearing regarding the CARE Act reauthorization on April 27, 2006. The hearing was conducted by Representative Nathan Deal (R-GA), the chair of the Subcommittee on Health. Ranking Member Sherrod Brown (D-OH) also attended.

In total, 19 Members of the House attended all or part of the hearing. In addition to Chairman Deal and Ranking Member Brown, the Members of the health subcommittee who attended were Tammy Baldwin (D-WI), Michael Burgess (R-TX), Mary Bono (R-CA), Lois Capps (D-CA), Anna G. Eshoo (D-CA), Charlie Norwood (R-GA), Frank Pallone, Jr. (D-NJ), Joseph R. Pitts (R-PA), Bobby L. Rush (D-IL), John Shimkus (R-IL), Ted Strickland (D-OH), Edolphus Towns (D-NY), Fred Upton (R-MI), and Henry A. Waxman (D-CA). Representatives Edward Markey (D-MA) and Eliot Engel (D-NY), who are members of the full committee but not of the subcommittee, also attended although Representative Engel did not speak. Representative Joe Barton (R-TX), the Chair of the full committee and an ex officio member of the subcommittee, also attended.

Two of the three witnesses at this hearing had testified just the day before in Senator Coburn’s hearing. The witnesses were:

• Dr. Marcia Crosse, director of Office of Public Health and Military Health Care Issues, U.S. Government Accountability Office
• Elizabeth M. Duke, administrator, Health Resources and Services Administration, Department of Health and Human Services
• Dr. Kevin Fenton, director, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention

In general the hearing covered a lot of ground that ranged from basic issues such as what programs are covered by each Title of the CARE Act to consideration of the issues of particular jurisdictions. For example Representative Markey asked Dr. Fenton and Dr. Duke specifically about what would happen to states like Massachusetts that had made the decision (“under duress”) to switch to name based HIV reporting from a code based system if the reauthorization is not accomplished by October 1, 2006 (the beginning of FY 2007). Dr. Fenton stated that the CDC would work with the state to become certified as soon as possible but that the CDC would not be able to go outside of the law. Dr. Duke said that the question was under consideration at HRSA and that she would get back to Rep. Markey. Rep. Deal later asked how long states had to get ready for the change to names based reporting and was told that the CDC had first made the recommendation in 1999.

Although very civil, the tone of the hearing occasionally became testy, particularly when Representatives debated the question of whether or not there was too much funding going to states containing Title I Eligible Metropolitan Areas (EMAs) and not enough funding to states that do not have Title I EMAs. Dr. Duke was repeatedly asked about the administration’s proposal to end “double counting.” Representative Waxman noted that the administration’s proposal would mean that all states would loose their Title II funding aimed at EMAs and that funding would be redistributed. “The loss of funding to the District of Columbia would be 100% of Title II funds,” he said, “and California would lose 62% of Title II funds.” Dr. Duke said that the administration’s proposal specifically contemplated having a Severity of Need Index in place which would ensure that funds would go to the areas of the country that were experiencing high need indicators such as prevalence, incidence and high levels of poverty. However, she stated that she was unable to provide specific figures and would get back to the subcommittee about that. This did not mollify Representative Waxman (D-CA) who expressed frustration that the administration had proposed principles but had only offered vague definitions and had not provided specifics on the effect of any proposed changes.

Ms. Crosse was asked a number of times why the February GAO report only included information about Titles I and II in their report (and did not include Titles III and IV and Part F). She responded by stating that the GAO had answered the questions that they were asked and noted that, unlike Titles I and II, the other parts of the CARE Act were not linked to formula based funding allocations, but rather were grant driven.
Other issues that received attention included the issue of Core Medical Services and the creation of a “Severity of Need Index” as proposed by the administration.

Representative Mary Bono specifically aligned her comments with Representative Capps and others in the CA delegation pointing out that the issues were not necessarily being discussed on partisan lines. Rep. Deal later stated that many of the issues were “geographical” rather than partisan issues. Representative Shimkus focused heavily on ensuring that ADAP continued to reach people in need. The hearing was particularly interesting as it is the first opportunity for Members of the House of Representatives to weigh in on the reauthorization. There were several calls to continue the bipartisanship, and Rep. Towns was at particular pains to stress that the reauthorization could be accomplished within a bipartisan structure.

Two developments may be of particular interest. Representative Deal stated that he was planning to hold a “roundtable” style hearing at the subcommittee level so that members of community groups and others not associated with the administration had the opportunity to testify. Second, although Representative Joe Barton (R-TX), who is the Chairman of the Full Committee, was not present during the opening statements he did show up in time for questions. At that time, he prefaced his statement by saying that there had been rumors that the reauthorization would not happen this year. He said that he did not know how rumors like that got started, but that he expected that the reauthorization would take place this year.

Announcements
1. Changes to Weekly Update News Coverage
In an effort to better focus on current HIV policy issues at the federal and state level, AIDS Action’s Weekly Update will no longer include an “In the News Section.” The Weekly Update will continue to highlight important policy news that affects HIV and AIDS. To maintain HIV news coverage, please consider signing up for the news service provided by the Kaiser Family Foundation. On a daily basis this service offers daily news on issues related to HIV and AIDS in the United States and around the world, and it’s emailed directly to you. The link is below.

According to the website, “the Henry J. Kaiser Family Foundation is a non-profit, private operating foundation focusing on the major health care issues facing the nation. The Foundation is an independent voice and source of facts and analysis for policymakers, the media, the health care community, and the general public.” HIV has been one of the top priority issues for the Foundation. Of its twelve main topics, HIV is the focus of two: “HIV/AIDS” and “Youth & HIV/STDs.”

The Foundation develops and runs its own research and communications programs, often in partnership with outside organizations. The Foundation contracts with a wide range of outside individuals and organizations through its programs. The Foundation is not associated with Kaiser Permanente or Kaiser Industries.

The following link has been provided for your convenience to sign up for the Kaiser Daily HIV/AIDS News Report: http://www.kaisernetwork.org/dailyreports/hiv.

2. AIDS Action Government Affairs Job Listing
AIDS Action recently announced that it is seeking a new government affairs associate. Here is the listing. We encourage all qualified applicants to consider applying.

POSITION ANNOUNCEMENT Government Affairs Associate

Job Description
The Government Affairs Associate, under supervision of the Director of Government Affairs, the Government Affairs Associate researches and analyzes HIV related policy and legislative issues to inform federal advocacy efforts. The GA Associate Provides logistical and technical support to the Government Affairs team, helps to write and carry out campaigns for signature letters, drafts and activates the AIDS Action “Action Alerts” targeting broad membership, prepares advocacy talking points, presents legislative strategy and updates. The GA Associate conducts research on specific issues impacting individuals living with HIV/AIDS, the organizations that serve them and the communities in which they live. She or he participates in the development of policy fact sheets, background memos, The Weekly Update (an online member newsletter), action alerts and other public policy documents. The GA Associate will report to the Director of Government Affairs and will work closely with the Political Director.

Job Duties

• Researches and collects data to inform federal HIV/AIDS policy
• Identifies data sources and resources
• Monitors and evaluates HIV-related legislation and regulations impacting HIV care, treatment, and prevention
• Prepares advocacy materials and talking points for Congress and Administration visits.
• Organizes lobbying and advocacy days for organization members and schedules meetings with staff members of elected officials
• Manages online “legislative action center” to provide constituents with up-to-date advocacy information
• Develops and disseminates Action Alerts, State Fact Sheets, Legislative Updates, sign on letters and articles for The Weekly Update
• Maintains appropriations and budget chart information
• Prepares briefing materials for Executive Board and Public Policy Committee meetings
• Assists in the research and preparation of HIV/AIDS related publications
• Proofreads materials for public dissemination
• Coordinates Hill briefings on HIV and other related health systems issues
• Represents AIDS Action at conferences, meetings and workshops
• Attends congressional briefings, congressional hearings and other policy related meetings
• Other duties as assigned

Required Knowledge and Skills

• Excellent written and oral communication skills
• Basic knowledge of research concepts and principles
• Strong organizational and work management skills including ability to work independently, handle multiple projects simultaneously, work under pressure and handle tight deadlines
• Minimum of three years of work experience; Experience in lobbying, advocacy or Capitol Hill experience a plus
• Bachelors degree in a relevant profession; Masters degree a plus
• Knowledge of HIV and its impact on communities throughout the nation
• HIV, viral hepatitis or related health job experience a plus
• Ability to work with diverse populations and as a member of a government relations team
• Proficiency in Microsoft applications and strong computer skills, including Excel; Ability to learn legislative action center management software (Capwiz) required
• Interest in working with a national HIV/AIDS public health organization
• Interested in working within a diverse work environment
• Strong cultural competence
• Willing to travel as needed
• AIDS Action is an equal opportunity employer and encourages all qualified applicants to apply

Salary Range:

• $35,000-43,000 depending on experience

Closing Date:

• May 8, 2006 (close of business)

Send cover letter, resume, and salary requirements to:

Donna Crews
Director of Government Affairs
Email: dcrews@aidsaction.org

NO CALLS PLEASE

3. NAPWA To Hold AIDSWatch 2006 from May 8 - 10
The National Association of People With AIDS (NAPWA) will hold AIDSWatch, its annual DC-based advocacy event, from Monday, May 8 to Wednesday, May 10. Each year, NAPWA invites people living with HIV to Washington, DC, where they first participate in advocacy training sessions and then take their stories, new skills, and updated materials to Capitol Hill. While on Capitol Hill, participants meet with Members of Congress and their staffs to urge them to strengthen essential health care programs—like the Ryan White CARE Act, Housing Opportunities for Persons with AIDS, and Medicaid/Medicare—through increases in funding and improvements in legislation.

This year, AIDSWatch will also assist individuals unable to travel to Washington, DC with the scheduling of meetings closer to home, in the district offices of their Members of Congress.

Interested parties may learn more about this year’s AIDSWatch by linking to http://www.napwa.org/aidswatch.html and may register for AIDSWatch at http://www.napwa.org/register_online.html.

Individuals who have questions, cannot register online, or wish to talk their plans over may contact High Noon Communications, toll-free, at 1-866-243-7282 or by sending an email to becky@highnooncommunications.com.

The AIDS Action Weekly Update
The Weekly Update is written with a mind toward the interests of our members. If you are interested in membership with AIDS Action, we invite you to contact members@aidsaction.org.

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