The Weekly Update

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March 14, 2008

This Week in Washington

1. Senate HELP Committee Holds Hearing on Flat Funding of NIH

2. Drug Policy Alliance holds Congressional Briefing on Methamphetamine

3. HRSA Awards Title I Grants

4. Senate Foreign Relations Committee Passes PEPFAR Reauthorization

5. FY 09 Budget Update

                

Announcements

1. San Francisco AIDS Foundation Job Opportunity

2. HRSA Provides 2008 Ryan White HIV/AIDS Program Meeting Information

3. Upcoming Connecting to Care Trainings

4. SAMHSA Accepting Applications for HIV/AIDS Grants

5. Registration Open for AIDSWatch 2008

                                                                                                                       

This Week in Washington

1. Senate HELP Committee Holds Hearing on Flat Funding of NIH

On Tuesday, March 11th the Senate Committee on Health, Education, Labor, and Pensions (HELP) held a hearing entitled, “The Broken Pipeline: Losing Opportunities in the Life Sciences.” The National Institutes of Health (NIH) has suffered from a lack of new funding since Fiscal Year (FY) 2003. The hearing focused on the effects of level funding on medical innovation in the United States.

 

Witnesses included leading science academics who warned Congress that flat funding for NIH is pushing young scientists away from a career in research and endangering the future of America’s search for medical innovations and cures. The panel of witnesses included Dr. Drew Faust, President of Harvard University; Dr. Jill Rafael-Fortney, Professor at the Ohio State University; Dr. Edward Miller, Dean of the John Hopkins University of Medicine. Ms. Dana Lewis, Student Diabetes Advocate, and Dr. Samuel Rankin, Associate Executive Director of the American Mathematical Society. Their testimonies can be found at http://help.senate.gov/Hearings/2008_03_11/2008_03_11.html.

 

During the hearing Chairman Ted Kennedy (D-MA) and Senator Barbara Mikulski (D-MD) gave opening statements calling for greater federal investment in the National Institutes of Health. Chairman Kennedy’s statement can be found at http://kennedy.senate.gov/newsroom/press_release.cfm?id=42bddedb-a276-431a-bcf3-ab0be14ceaad, Senator Miluski’s press release can be found at http://mikulski.senate.gov/record.cfm?id=294543.

 

The expert witnesses outlined the results of a study released Tuesday in the New England Journal of Medicine co-authored by seven science research institutions. The study was titled “A Broken Pipeline: Flat Funding of the NIH Puts a Generation of Science at Risk.” The study shows that while Congress doubled the budget for NIH research from 1998 to 2003, funding has remained flat for the last five years and the real-money purchasing power of the agency to award grants has declined. As a result, fewer researchers are receiving grants and younger scientists are being overlooked. The study found that in 1999, 32 percent of proposals presented to the NIH for funding were awarded grants. Eight years later, the NIH turned down three out of every four grant proposals. Now, only 25% or proposals are awarded. The witnesses stressed the most affected in this NIH budget crisis are the emerging new scientists. They called on Congress to steadily increase funding for the NIH to keep pace with inflation. They proposed this as the best way to achieve sustainability, not too boost funding sporadically and then watch as funding levels deteriorate.

 

2. Drug Policy Alliance holds Congressional Briefing on Methamphetamine

On March 11, the Drug Policy Alliance held a Congressional forum on a “Four Pillars’ Approach to Methamphetamine: Effective Prevention, Treatment, Policing and Harm Reduction.”  The forum focused on the need to shift from more traditional tactics for treating and preventing methamphetamine addiction towards approaches that are tailored for specific populations and communities.

 

The forum featured Carl L. Hart, Ph.D., Associate Professor of Psychology at Columbia University and Director of the Residential Studies and Methamphetamine Research Laboratories at the New York State Psychiatric Institute.  Mr. Hart discussed areas of needed research and outreach. He highlighted the need for research on methamphetamines taken inter-nasally and intravenously, rather than the historically studied of oral dosage of the drug.  The future of methamphetamine research, he said, should include better information on multiple doses and binges, a methadone type treatment for methamphetamine addiction. He also expressed the dire need for increased dissemination of accurate information to the public. 

 

The second panelist was Reena Szczepanski, Director of Drug Policy Alliance- New Mexico and co-chair of Governor Richardson’s Methamphetamine Working Group.  She presented the “four pillars” approach to methamphetamine treatment in New Mexico.  The first pillar is prevention, which is accomplished through after school programs and family strengthening, employment, and education initiatives.  The second pillar is harm reduction, accomplished through reducing the health consequences of methamphetamine use, including curbing HIV infections through syringe exchanges, and reducing the environmental hazards of  methamphetamine manufacturing.  Third, Ms. Szczepanski discussed increasing effective drug treatment by introducing alternatives to incarceration, Medicaid coverage for substance abuse treatment, increased funding for family treatment, and incentives for parents to seek treatment.  The final pillar of the approach is public safety and enforcement. To learn more about New Mexico’s methamphetamine program, please visit: http://www.drugpolicy.org/about/stateoffices/newmexico/.

 

The final panelist was Malika Saada Saar, Founder and Executive Director of the Rebecca Project for Human Rights.  Ms. Saada discussed the effect of methamphetamine use on women and mothers, and the lack of treatment resources for women.  Methamphetamine use, she said, is largely related to a history of sexual violence.  A 2000 survey conducted by the Department of Health and Human Services found that 97% of mothers addicted to methamphetamines were trying to anesthetize themselves from a history of sexual violence.  She discussed family based programs for mothers living with methamphetamine addiction in which the family can be counseled and rehabilitated together.  These programs have a 60% success rate, according to the Department of Health and Human Services, as compared with a 30% success rate for these women in traditional isolated treatment facilities. To learn more about the Rebecca Project, please visit: http://www.rebeccaproject.org/.

 

3. HRSA Awards Title I Grants

On Tuesday, March 11, 2008, the Health Resources and Services Administration (HRSA) issued a press release announcing Ryan White CARE Act Part A (Title I) formula and supplemental grant awards for FY (2008). HRSA awarded $550 million in Part A (Title I) grants. 

 

The Part A (Title I) awards are divided into two categories, formula and supplemental. Grants will go to 22 cities that qualify as Eligible Metropolitan Areas (EMAs) and to 34 Transitional Grant Areas (TGAs). To be eligible as an EMA, metropolitan areas must have a cumulative total of more than 2,000 AIDS cases over the most recent five-year period and a population of 50,000 or more. Cities are considered TGAs if they have at least 1,000, but not more than 1,999, cumulative AIDS cases during the most recent five years, and a population of 50,000 or more.

 

The 2006 reauthorized CARE Act calls for formula awards to be based on 2/3 of the total Title I funds.  The FY 08 formula grants accounted for $394,269,007 of the Title I funding and supplemental awards totaled $155,636,173. Of the total funds awarded, $423.2 million (77%) was distributed to the 22 EMAs and $126.7 million (23%) was distributed to the 34 TGAs.

 

Among the 22 EMAs, 17 received an increase in their total funding (Formula + Supplemental) over FY 07.  Increases over FY 07 ranged from 0.5% to 7.8%.  The EMAs receiving the largest % increases are Phoenix, San Diego and Fort Lauderdale. Two EMAs, Detroit and Orlando, received a decrease in their total funding from FY 07. Three EMAs were virtually flat funded: Dallas, Miami, and San Francisco.

 

Among the 34 TGAs, 22 received an increase in their total funding over FY 07.  Increases ranged from 1.2% to 13.4%.  Indianapolis and Ponce, PR received the largest % increases in total funding. Nine TGAs received decreased total funding compared to FY ’07.  Decreases ranged from 0.5% to 8.3%.  Vineland-Millville-Bridgeton (NJ) received the largest % decrease in total funding compared to FY 07. Three TGAs, Hartford, Middlesex-Somerset-Hunterdon (NJ) and Oakland were flat funded in their total grant award compared to FY 07.

 

To read HRSA’s full press release containing award amounts for each EMA and TGA please visit: http://newsroom.hrsa.gov/releases/2008/RWPartAMarch.htm.

In the press release HRSA Administrator Elizabeth Duke said, “Historically, Part A grants target care and services to major urban areas with the highest concentration of HIV/AIDS cases. But these funds also enable us to direct essential services such as counseling and testing to emerging areas to help reduce the spread of HIV/AIDS.”

Below is the list of grant awards.

Ryan White HIV/AIDS Program
FY 2008 Part A Grant Awards

EMAs

Formula

Supplemental

Total

Atlanta, GA

$12,223,780

$4,545,448

$16,769,228

Baltimore, MD

13,744,674

4,638,004

18,382,678

Boston, MA

9,242,683

3,941,557

13,184,240

Chicago, IL

17,301,275

7,441,199

24,742,474

Dallas, TX

9,528,533

3,193,601

12,722,134

Detroit, MI

5,648,743

1,740,345

7,389,088

Ft. Lauderdale, FL

9,444,098

4,606,203

14,050,301

Houston, TX

12,780,890

5,647,525

18,428,415

Los Angeles, CA

23,182,654

10,241,932

33,424,586

Miami, FL

16,014,327

6,427,201

22,441,528

New Orleans, LA

4,944,055

2,179,492

7,123,547

New York, NY

74,867,223

27,562,982

102,430,205

Newark, NJ

9,089,812

3,665,111

12,754,923

Orlando, FL

5,503,524

1,858,800

7,362,324

Philadelphia, PA

14,920,594

5,981,001

20,901,595

Phoenix, AZ

5,188,717

2,124,235

7,312,952

San Diego, CA

7,107,693

3,285,804

10,393,497

San Francisco, CA

14,672,553

4,105,604

18,778,157

San Juan, PR

9,415,282

2,653,442

12,068,724

Tampa-St. Petersburg, FL

6,330,047

2,657,601

8,987,648

Washington, DC

18,759,719

7,027,957

25,787,676

West Palm Beach, FL

5,769,416

2,017,579

7,786,995

SUBTOTAL

$305,680,292

$117,542,623

$423,222,915

 

TGAs

Formula

Supplemental

Total

Austin, TX

$2,397,874

$1,140,316

$3,538,190

Baton Rouge, LA

2,248,682

724,999

2,973,681

Bergen-Passaic, NJ

2,469,614

1,011,874

3,481,488

Caguas, PR

718,029

216,982

935,011

Charlotte-Gastonia, NC-SC

2,952,743

1,333,776

4,286,519

Cleveland, OH

2,578,175

1,014,140

3,592,315

Denver, CO

4,857,964

2,155,747

7,013,711

Dutchess County, NY

756,120

287,144

1,043,264

Ft. Worth, TX

2,343,911

1,030,444

3,374,355

Hartford, CT

2,105,203

813,727

2,918,930

Indianapolis, IN

2,297,565

1,095,049

3,392,614

Jacksonville, FL

3,044,799

1,386,392

4,431,191

Jersey City, NJ

2,838,469

1,328,024

4,166,493

Kansas City, MO

2,606,743

1,204,976

3,811,719

Las Vegas, NV

3,433,334

872,368

4,305,702

Memphis, TN

3,608,554

1,677,816

5,286,370

Middlesex-Somerset-Hunterdon, NJ

1,591,599

703,471

2,295,070

Minneapolis-St. Paul, MN

3,073,368

1,316,149

4,389,517

Nashville, TN

2,528,655

1,003,423

3,532,078

Nassau-Suffolk, NY

3,254,303

1,212,286

4,466,589

New Haven, CT

3,528,564

1,326,973

4,855,537

Norfolk, VA

3,427,620

1,542,094

4,969,714

Oakland, CA

3,792,137

1,676,005

5,468,142

Orange County, CA

3,386,154

1,639,547

5,025,701

Ponce, PR

1,217,031

537,327

1,754,358

Portland, OR

2,226,011

996,599

3,222,610

Riverside-San Bernardino, CA

4,468,353

2,215,876

6,684,229

Sacramento, CA

1,535,758

685,328

2,221,086

San Antonio, TX

2,539,448

1,146,703

3,686,151

San Jose, CA

1,656,285

774,962

2,431,247

Santa Rosa, CA

731,404

290,695

1,022,099

Seattle, WA

4,194,949

1,869,595

6,064,544

St. Louis, MO

3,677,121

1,708,641

5,385,762

Vineland-Millville-Bridgeton, NJ

502,176

154,102

656,278

SUBTOTAL

$88,588,715

$38,093,550

$126,682,265

TOTAL (EMAs and TGAs)

 

 

$549,905,180

 

4. Senate Foreign Relations Committee Passes PEPFAR Reauthorization

On Thursday, March 13th, the Senate Foreign Relations Committee passed the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008, S. 2731. The bill passed by a vote of 18-3 with no amendments. Chairman Joseph Biden (D-DE) and Ranking Member Richard Lugar (R-IN) introduced the bill on March 7th with lead co-sponsors Ted Kennedy (D-MA) and John Sununu (R-NH). The Senate Bill largely resembles the House committee passed bill with several thoughtful changes to the original legislation, as well as some bipartisan compromises.

 

Both the House and Senate versions of the bill would reauthorize the President’s Emergency Plan for AIDS Relief (PEPFAR) at $50 billion over five years for global programs for the prevention, care, and treatment of HIV/AIDS, tuberculosis, and malaria. Both the House and Senate bills also remove the 33% abstinence-until-marriage directive for the expenditure of HIV prevention funds, but contain a reporting requirement for countries with a generalized epidemic that do not spend 50% of sexual prevention money on behavior change programs such as abstinence and fidelity. The bills share goals to support treatment of 3 million individuals, prevent 12 million new infections, and train at least 140,000 health care professionals. Both bills increase support for HIV prevention and treatment services for men who have sex with men and injection drug users. To the dismay of many advocates, both bills retain the “prostitution pledge” requirement.

 

There are also significant differences between the House and Senate bills. Both bills would authorize $50 billion dollars over five years, but differ in yearly funding amounts. The House bill calls for $10 billion per year, while the Senate bill lays out a more gradual scale up. The Senate bill removes all funding earmarks contained in the original bill except a requirement that 10% of funding go towards programs for orphans and vulnerable children. The House bill retains several funding earmarks from the original legislation including 20% for prevention, 15% for palliative care, and 10% for orphans and vulnerable children.

 

The Senate bill would remove the United States’ entry ban for HIV positive people. The House bill does not include language to reverse this discriminatory policy. The bills also differ in regards to family planning services.  The House bill authorizes family planning organizations to use PEPFAR funding for HIV testing and education, but there is concern that the wording could be interpreted to apply the Mexico City policy to PEPFAR. PEPFAR is currently exempt from the policy. The Senate bill makes no reference to or recognition of the importance of linkages between HIV/AIDS services to family planning and contraceptive services for women.

 

No amendments were offered during the mark up. Senator Boxer (D-CA) originally planned to offer an amendment to expand the ability of family planning groups to provide HIV/AIDS services. During the mark up she asked Senator Biden if the bill would prevent linkages between services or overturn the program’s exemption from the Mexico City policy. He assured the committee that it would not, and Senator Boxer did not offer the amendment. AIDS Action was also closely following an amendment expected to be offered by Senator DeMint (R-SC) that would have prohibited PEPFAR support for syringe exchange programs. Senator DeMint did not offer this amendment or an expected amendment to reduce overall funding levels or reinstate the abstinence-until-marriage funding requirement. While no amendments were offered, Chairman Biden did incorporate 13 changes into his manager’s amendment which was approved by the committee. Many of the amendments were technical. Language offered by Senator Kerry (D-MA) to promote vaccine development and an amendment by Senator Obama (D-IL) to promote microbicide development were both accepted. The bill also included an amendment from Senator Nelson (D-FL) to highlight Caribbean countries as new PEPFAR focus countries.

 

To view the Senate bill, please visit: http://www.thomas.gov/cgi-bin/bdquery/z?d110:s.02731:.

 

The bill is expected to go to the House floor during the first week of April. The Senate schedule remains uncertain.

 

5. FY 09 Budget Update

Both the House and the Senate passed their respective budget resolutions late Thursday, March 13th. Next week’s Update will include a detailed analysis of the funding and policy aspects of the budget resolutions.

 

Announcements

1. San Francisco AIDS Foundation Job Opportunity

The San Francisco AIDS Foundation is seeking a Deputy Legislative Affairs Director to execute the legislative and advocacy agenda and priorities of the Foundation at the local, state, and federal levels, and to ensure coordination among them.  This includes overseeing the activities of the Director of Federal Affairs, Policy Analyst, Interns, and/or other Science and Public Policy staff engaged in legislative and advocacy activities. To view the complete job posting visit: http://www.sfaf.org/aboutus/jobs/legislativedirector. If you are interested, please send resume and cover letter to jobs@sfaf.org, Attn: DLAD.

 

2. HRSA Provides 2008 Ryan White HIV/AIDS Program Meeting Information

On March 6, 2008, the Health Resources Services Administration HRSA announced that the 2008 Ryan White HIV/AIDS Program Meeting website was now live.  The website will allow participants to register, submit workshop and poster abstracts, and reserve hotel rooms.

 

HRSA states that the meeting will be held August 25-28, 2008 in Washington, DC and is being co-sponsored by HRSA/HAB and the American Academy of HIV Medicine (AAHIVM).  Once again, two meetings will occur simultaneously: 1) the Grantee Meeting; and 2) the 11th Annual Clinical Update.  The Clinical Update is sponsored by the International AIDS Society-USA (IAS-USA).  The meeting theme, "New Era, New Act," reflects a focus on implementing the 2006 Ryan White legislation as well as ongoing efforts to seek ever better ways to deliver HIV care to the underserved.  We make a difference for over half a million people each year and owe much of our success to our creativity and adaptability to change.

 

The conference website provides all the information you need to get ready for the meeting, such as: key deadline dates; instructions for registering and submitting abstracts for workshops and poster sessions; and reserving hotel rooms.

 

Access the site at:
http://www.ryanwhite2008.com/

 

3. Upcoming Connecting to Care Training

AIDS Action is accepting registration for an upcoming Connecting to Care training. Participants in the two-day session have an opportunity to review agency programs with the specific objective of evaluating how successful these activities are in addressing “unmet need.”  Additionally, hands-on group exercises are provided in a stimulating and creative environment that will help the participants build the skills necessary to strengthen existing activities and create new ones that connect HIV+ people to care. Limited financial support is available to participants needing to travel to attend the session. Dates: Dallas, TX March 26-27. For registration information, please email Dea Varsovczky, dvarsovczky@aidsaction.org.

 

4. 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.  

5. Registration Open for AIDSWatch 2008

Registration is now open for AIDSWatch 2008, taking place in Washington DC from April 28-30, 2008. AIDSWatch is a grassroots advocacy program, organized by the National Association of People With AIDS (NAPWA), which brings HIV positive people and their supporters to Washington DC to meet their elected Members of Congress. AIDSWatch participants are given the opportunity to educate their legislators on the need for an improved governmental response to the domestic HIV epidemic. This year’s AIDSWatch will focus on the need for improved treatment accessibility, science and evidence based prevention, and increased appropriations for HIV/AIDS programs.

NAPWA says, "We invite all persons infected and affected by HIV in America to join us in 2008 to allow your voice to be heard in our nation's capital. Please revisit the website frequently for updates about the 2008 program and registration."

To learn more and to register, please visit: http://napwa.org/index.php?option=com_content&task=view&id=19.

 

The AIDS Action Weekly Update

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