This Week in Washington

1. 2008 Legislative Outlook

2. Senate SAMHSA Reauthorization Hearing Scheduled

HIV/AIDS and the 2008 Elections

1. AIDS Action Board Member and Council Staff Appointed as 2008 DNC Delegates

Announcements

1. HIVMA Accepting Applications for the Minority Clinical Fellowship

2. SAMHSA Accepting Applications for HIV/AIDS Grants

This Week in Washington

1. 2008 Legislative Outlook

The House returned from the Holiday recess on Tuesday, January 15^th, and the Senate will be back for full business on Tuesday, January 22^nd. As the second session of the 110^th Congress begins, numerous reports have forecasted a low volume of legislative activity or accomplishments in the coming year. In the face of a shortened election year calendar, continuing tensions with the White House, and major difficulties delivering on their legislative agenda in 2007, expectations for a full legislative agenda are low for the Democratic controlled Congress in 2008.

Contrary to the start of 2007, the Democratic leadership has given few outward promises and has not explicitly outlined their second session legislative agenda. A more subtle and pragmatic approach to achieving Democratic goals is expected in 2008. A Democratic aide quoted in Roll Call on Thursday, January 17^th said, “We need to lower expectations. We learned that lesson. Overall the tone is going to be, ‘We’re going to fight for change and do what we can, but don’t expect a lot because Bush and the Republicans are putting up roadblocks.’ We need more Democrats in Congress and a Democrat in the White House.”

Democrats have kicked off 2008 urging bipartisan diplomacy in crafting an economic stimulus package to stave off a recession. The attempt is being complicated by presidential politics and ideological differences, but Democratic leaders are hopeful that a short-term stimulus package could be signed into law in just 30 days. Democratic leaders met on Wednesday, January 16^th and announced their plan to clear an economic stimulus package as quickly as possible this year, hoping to act before the economy worsens. On the same day Speaker Nancy Pelosi (D-CA) met with Minority Leader John Boehner (R-OH) to discuss the economic stimulus package and agreed to work together. On Thursday, September 17^th,  Republican and Democratic House and Senate leaders held a conference call with the Administration, which affirmed both parties’ belief that they can work together to craft an economic stimulus package.

Discussions for the economic stimulus package include a temporary increase in federal Medicaid payments by increasing the federal medical assistance percentage (FMAP), (the federal portion of payments) for the federal-state Medicaid program. Many feel that increasing the FMAP moving into a recession would help states maintain Medicaid eligibility levels at a time when more people are likely to become uninsured because of job loss. This proposal may be met with opposition from Republicans, but not necessarily fatal objections.

Apart from the push for an economic stimulus package, the current political climate will have a particular impact on the budget and appropriations process for Fiscal Year (FY) 2009.  Democratic leaders and President Bush battled over FY 2008 appropriations this past year. The debate began when Congress passed a budget resolution in May with discretionary spending levels $22 billion higher than the President’s request. After three continuing resolutions and numerous vetoes and veto threats, the final package met the President’s spending limits and was significantly below Congress’ budgetary proposal, but reflected some Congressional priorities.

Much of the same contention is expected for this year’s appropriations process and the Congressional leadership’s options are few. The President is likely to veto any bill above his budgetary request, making it difficult to rationalize devoting significant floor time to appropriations measures. Options include pushing appropriations work until a lame duck session after the November elections. Another possibility under consideration is to debate a FY 2009 funding resolution that would only cover the period from October 1, 2008 through early 2009, when a new Administration will occupy White House. The pre-election gridlock may also lead to a continuing resolution at FY 2008 levels until early 2009. This is a very possible scenario. The budget and appropriations timeline is uncertain, but it seems unlikely that major shifts or increases in funding amounts for domestic discretionary programs will occur this session. Despite the uncertainty of timing, process, and outcome, AIDS Action will continue to push for increases in discretionary HIV/AIDS prevention, education, treatment, care, and research programs.

Legislation that is expected to move in 2008 includes a reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR). The program is set to expire in September 2008. A reauthorization bill will likely be introduced in the House of Representatives in just a few days, with a hearing tentatively scheduled for February 7^th. The Senate is expected to follow the House’s lead and come forward with their own legislation soon after. Senator Joe Biden (D-DE), Chairman of the Foreign Relations Committee, has ranked PEPFAR reauthorization in his top three priorities for the year. There has been an understood commitment from both the Senate and House Democrats and Republicans to reauthorize the legislation before the bill expires, which in light of the election season, must be before the end of spring 2008.

The House and Senate also seem to be optimistic about crafting a Medicare reform package by this spring, focused on halting 10.6 percent cuts to Medicare’s physician payment rates scheduled to take effect on July 1^st. The Senate Finance Committee is expected to move quickly in the opening weeks of the new session to hold hearings and a markup on Medicare reform. If the package moves forward, AIDS Action will heavily advocate for Medicare improvements that would benefit people living with HIV/AIDS to be incorporated in the bill. These hoped for provision would include allowing funding under the AIDS Drug Assistance Program (ADAP) and Indian Health Services to count towards True Out Of Pocket (TrOOP) costs required under Medicare Part D and codifying the “six protected” drug classifications including HIV anti-retrovirals under Medicare Part D.

2. Senate SAMHSA Reauthorization Hearing Scheduled

The Senate Health, Education, Labor and Pension (HELP) Committee is currently scheduled to mark up the Substance Abuse and Mental Health Services Administration (SAMHSA) reauthorization legislation on Wednesday, January 30th.  A bill has not yet been introduced.  The HELP Committee attempted to introduce and mark up a bill in early December, but the committee could not come to agreement over proposed changes to “charitable choice” provisions which allow religious organizations to provide alcohol and drug treatment services but which also allow them to be exempted from employment discrimination laws on the basis of religion.  It is not clear yet whether this issue has been resolved. 

The most recent draft version of the bill contained three requirements of concern dealing with HIV.  They are:

·         States will continue to be required to set aside 5% of their funding for treatment for people living with HIV if they meet the current standards of 10 AIDS cases per 100,000 population.  However, States that do not meet the criteria will now also be allowed to set aside up to 5% of their funding if they choose to do so. 

·         HIV is listed for purposes of outreach work from SAMHSA Grantees.  Hepatitis B and C are not listed, but are included under the heading of “other communicable disease.”  AIDS Action sent in a comment requesting Hepatitis C (and B) be included within the bill or report language.  We have not heard whether this has been accomplished.

·         The committee removed Section 1921 which requires that intravenous drug users (IDUs) be prioritized for treatment within 14 days, but left intact language regarding outreach to IDUs.  The change was made because cities and other localities are now prioritizing treatment services in different ways and this provides greater flexibility.  AIDS Action has sent the committee report language stating "that the committee recognizes that IDUs are particularly at risk for becoming infected and infecting others with HIV and Hepatitis C and that the committee intends for the SAMHSA Administrator and its grantees to prioritize IDUs and that they should continue to ensure that IDUs (and particularly IDUs who currently share needles) should be prioritized for treatment and for services designed to prevent the spread of HIV." 

The House has not yet decided when to review SAMHSA reauthorization, but is expected to make decisions after reviewing the Senate bill. 

HIV/AIDS and the 2008 Elections

1. AIDS Action Board Member and Council Staff Appointed as 2008 DNC Delegates

On Friday, January 11^th The Democratic National Committee (DNC) Executive Committee approved Governor Howard Dean’s recommendations for 25-at large delegates to serve as standing committee members at the 2008 Democratic National Convention in Denver. Of the named delegates are Diego Sanchez, Director of Public Relations and External Affairs at AIDS Action Committee of Massachusetts, and Dr. Marjorie Hill, Chief Executive Officer of Gay Men’s Health Crisis. Dr. Marjorie Hill is an AIDS Action Council Board Member and Diego Sanchez is AIDS Action Council’s Director of Public Relations.

“This appointment is an incredible opportunity to assist in the formation of our country’s goals and priorities,” said Dr. Hill.  “Our next President has a chance to make a real difference in the lives of people living with AIDS.  We are particularly interested in reinvigorating support for science-based HIV prevention and looking for real solutions to the growing disparities in access to healthcare faced by women and people of color.”

The appointments are historic, as seven LGBT individuals were chosen. At this year’s convention, 16% of the delegates will be LGBT, the largest number of LGBT individuals ever represented. Governor Dean fulfilled a pledge that a member of the transgender community would be among the Platform membership by appointing Diego Sanchez, the first-ever delegate from the transgender community.

The delegates were chosen for service on Platform, Rules and Credentials committees. Both Diego Sanchez and Marjorie Hill will serve on the Platform Committee, of which 4 of the 25 members are from the LGBT community.  The Platform Committee is responsible for drafting and recommending a proposed National Platform for approval at the Convention, after conducting hearings and forums to collect testimony on issues and policies to potentially include in the platform.

“I’m honored, humbled and eager to begin listening and drafting as we shape the Democratic Party’s platform for the coming election,” said Sanchez.  “While each leading Democratic Presidential candidate vows to create a National AIDS Strategy, recognizes LGB and T issues as relevant and expresses clear positions that affect Latinos, the voices we will hear during this process will fortify the candidates, the Party and its platform,” he added.

Rebecca Haag, Executive Director of AIDS Action, said, “I am very proud of Marjorie’s and Diego’s leadership roles within the many communities that we serve. This is well-deserved recognition of their hard work and impact on many very important issues including HIV/AIDS, LGBT equality particularly as it relates to race, ethnicity, gender identity and inclusion.  They both recognize that the root causes of many of the problems are racism, homophobia, transphobia, poverty and violence.  Their voices will be important on the platform.”

A full listing of Standing Committees Chairs and members with biographical information is available at http://www.demconvention.com/a/standingcommittees.pdf

Announcements

1. HIVMA Accepting Applications for the Minority Clinical Fellowship

The HIV Medicine Association (HIVMA) is now accepting applications for the Minority Clinical Fellowship, which is designed to encourage physicians from communities most-affected with HIV/AIDS to enter the field of HIV care. This fellowship targets African American and Latino physicians who are interested in gaining HIV clinical experience and expertise in an HIV clinical setting.

Candidates who have completed their residencies prior to the start of the fellowship, or are in the first five years of medical practice are eligible to apply.  The fellowships will provide each recipient with a stipend plus benefits for one year, as well as financial support for the mentor. Applicants will work with HIVMA mentors at institutions where they will continuously manage HIV-positive inpatients and outpatients. The deadline to apply for the 08-09 fellowship year is February 15, 2008. The training year will begin July 2008. Please pass this announcement on to those in your networks who may be interested.

Interested applicants are encouraged to visit www.hivma.org  for more information, including application instructions. Please contact Jennifer Rainey at jrainey@idsociety.org or (703) 299-5168 with questions or to request brochures.

2. SAMHSA Accepting Applications for HIV/AIDS Grants

The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for grants for their Fiscal Year (FY) 2008 Targeted Capacity Expansion Program for Substance Abuse and HIV/AIDS services. The program is focused on substance abuse treatment programs servicing people with HIV/AIDS in the African American, Latino/Hispanic and Other Minority Communities.

This program aims to enhance and expand substance abuse treatment and/or outreach and prevention services that are provided in conjunction with HIV/AIDS services in the African American, Latino/Hispanic, and other racial and ethnic communities highly affected by the epidemics of substance abuse and HIV/AIDS.

Public and private non profit organizations are encouraged to apply. Grantees must ensure that they will use methods to reach out to high-risk substance abusers in racial and ethnic communities and will launch efforts to address the needs of one or more of the following populations: 

        Women, including mothers and their children,

        Adolescents (ages 12-17) and/or young adults (ages 18-24),

        Injecting and at-risk non-injecting drug (including alcohol) users and their partners, including men who have sex with men, and

        Individuals released from incarceration within the past two years.

It is expected that $19.8 million in grants will be available to fund up to 50 grants. The average annual award amount is expected to be up to $450,000 per year for grantees providing treatment services, and up to $350,000 a year for grantees providing outreach and pretreatment services.  Grants for both types of services could last up to 5 years.

Applications are available by calling SAMHSA’s Information Line at 1-877-SAMHSA7 [TDD: 1 800-487-4889] or by downloading at http://www.samhsa.gov/Grants/2008/ti_08_006.aspx .  Applicants are encouraged to apply online using www.grants.gov.

Applicants with questions about program issues should contact David C. Thompson at 240-276-1623 or david.thompson@samhsa.hhs.gov. For questions on grants management issues, contact Kathleen Sample at 240-276-140 7 or kathleen.sample@samhsa.hhs.gov

Applications are due on March 27, 2008.  

The AIDS Action Weekly Update
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