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MAY 10, 2013
REPEAL Act Reintroduced

With the strong support of AIDS United and many other organizations in the HIV, health, LGBT and criminal justice communities, Representatives Barbara Lee (D-CA) and Ileana Ros-Lehtinen (R-FL) reintroduced the Repeal Existing Policies that Encourage and Allow Legal (REPEAL) HIV Discrimination Act into the 113 th Congress. The bill was given the number House Resolution (HR) 1843. If passed, the bill would register a sense of Congress that federal and state laws, policies, and regulations should not place unique or additional burdens on people solely due to their HIV status and should instead accurately reflect HIV transmission, the health implications of living with HIV and the benefits of treatment and the impact of punitive HIV specific policies. The bill also calls for the Attorney General to conduct a review of state and federal criminal and civil commitment laws related to HIV. Such a review has also been called for in the National HIV/AIDS Strategy. The bill would not prevent prosecution of cases of intentional transmission of HIV.

Representative Ros-Lehtinen is the first Republican to endorse the bill, an important step in the House of Representatives, which has a Republican majority. In a press release, she stated, “I’m pleased to co-sponsor this bipartisan bill that will help end the serious problem of discrimination in criminal and civil cases against those who are HIV positive. Singling out and discriminating against those living with HIV is not in line with our American values and we must do better. The legislation seeks to modernize our current outdated laws and bring them into the 21st century. I urge my Republican and Democrat colleagues to join Barbara and me in helping those persons living with HIV live as healthy and normal a life as possible.”

Reintroduction of the bill is the second effort of Representative Lee to introduce the REPEAL Act, which had attracted 41 co-sponsors, all Democrats. The new version of the bill is slimmed down from the previous version. It contains fewer findings from Congress than the previous version and would not appropriate new funds for activities. It can be found here.

Click here for the two Representatives’ press release.

Budget and Fiscal Year 2014 Update

For the first time in four years both the U.S. House of Representatives and the Senate have passed individual budget resolutions. Under normal circumstances (which Congress refers to as “regular order”) a conference committee would be convened to hash out the differences and agree on a joint budget resolution that each house would pass. Although the two budget committee chairs, Senator Patty Murray (D-WA) and Rep. Paul Ryan (R-WI), have tried to organize a conference committee, it now seems certain that the conference process will not proceed. Without a conference committee agreement, each chamber likely will ask their respective Appropriations Subcommittees to begin marking up their Fiscal Year 2014 (FY14) bills to vastly different numbers. According to Senate appropriations staff, the House budget calls for total discretionary spending of $966 billion; the Senate budget’s total discretionary spending level is $1.058 trillion. The difference between the House and the Senate budgets is $92 billion. The primary difference between the two bills is that the Senate total does not assume a FY 2014 sequester (automatic spending cuts). The House number does assume a FY 14 sequester but largely exempts defense discretionary spending. The House number would place even tighter constraints on non-defense discretionary (NDD) spending, which includes spending on health, public health, and HIV/AIDS programs.

The appropriations battles are going to be harsh since FY 14 will be the second fiscal year that will utilize numbers that were reduced due to the sequester. This year, if the appropriations process is carried out, each subcommittee will get a smaller allocation and would have to make difficult decisions on how to cut spending. From Hill meetings over the last couple of weeks we are hearing that the House will advise each of their subcommittees of their allocation (also known as “302b”) within the next week or two and subcommittee mark-ups will begin the week of May 21st with the Military Construction, Veterans Affairs bill and the Agriculture/Food and Drug Administration bill expected to be the first two bills up for consideration. We expect that the Labor, Health and Human Services, Education bill, which includes funding for most domestic HIV/AIDS programs, will be the last bill considered for mark-up, probably in late July in the House. The Senate is expected to begin mark –up of their bills in late June. AIDS United staff continues to participate in Hill visits with numerous coalitions to advocate for the highest possible level for domestic HIV/AIDS programs.

AIDS United believes the only way out of this fiscal morass is to agree on a grand bargain based on a balanced approach that includes revenues, replaces sequestration, and takes into account the NDD spending cuts enacted since FY ’10. It was hoped that reaching the debt ceiling in May would provide the catalyst for a “grand bargain” discussion. However, since the FY 2013 deficit is now getting smaller faster than anticipated, it looks like the Treasury Department may be able to postpone the hitting of the debt ceiling until October. This delay will create yet another “perfect storm” at the end of FY ‘13, with a possible government shutdown if FY ‘14 appropriations are not complete, and a federal default if the debt ceiling is not increased. AIDS United will work to keep you updated as information becomes available.

Senator Leahy Files Immigration Amendments on Behalf of Same-Sex Couples

On Tuesday, Senator Patrick Leahy (D-VT) filed two amendments to the immigration reform bill that would help ensure that LGBT binational families, including many with one or both partners living with HIV, could remain together. One of the amendments is the Uniting American Families Act, which AIDS United supports. The second amendment would provide equal protection to lawfully married bi-national same sex couples that other spouses receive under existing immigration law. The immigration bill is likely to take several weeks to be marked up in Congress and a decision will then be made about offering these amendments. Immigration Equality, an organization that works on behalf of bi-national same-sex couples has asked for calls to the Senate. AIDS United has long supported ending discrimination against LGBT couples in immigration, particularly as individuals in such couples are often caregivers for their partners with HIV.

A vote could be held on the amendments at any time. Immigration Equality’s action alert and more information can be found here.

The two amendments proposed by the Senator can be found by clicking here and here.

You've Got a Friend...in HRSA

Did you know that the Health Resources and Services Administration (HRSA) has friends? And we aren’t talking Facebook friends, either! We’re talking about 175 organizations representing millions of health professionals, educators and consumers that make up the “Friends of HRSA” coalition, which is convened by the American Public Health Association (APHA). AIDS United is a member of “Friends of HRSA,” and AU’s Director of Political Affairs, Bill McColl, was recently featured in Public Health Newswire, a leading online source of news published by APHA that covers public health events, trends and advocacy. In the interview, McColl talks about what it means to be a Friend of HRSA, and how the coalition works closely with the agency to address health disparities and promote health equity in the country. To read the full interview with McColl on Public Health Newswire, click here.

Finding a Way Forward

By Matthew Rose, HIV advocate

It's never easy to hear that a major scientific endeavor did not produce the results it was hoping to produce. Last week the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, announced it would stop administering injections in its HVTN 505 clinical trial of an investigational HIV vaccine regimen. An independent data and safety monitoring board (DSMB) found during a scheduled interim review that the vaccine being tested did not prevent HIV infection, nor did it reduce the amount of HIV in the blood of those participants who became infected. While the early closure of a trial is always a hard experience, we do go forward from here. This result opens a conversation – a place to discuss where we are in the development of a vaccine and what we understand about the science of HIV prevention. It helps to remind us that in the thirty years we have known HIV, nothing about this virus has been easy. Yet, we are stronger for the struggle. Our experience as gay men throughout the history of HIV/AIDS has proven that we surge forward after setbacks.

To read Matthew's entire blog post, click here.

U.S. Preventive Services Task Force (USPSTF) Gives Grade "A" Recommendation for Routine HIV Screening

AIDS United applauds the U.S Preventive Services Task Force’s (USPSTF) grade “A” recommendation for routine HIV screening. On April 30, 2013, USPSTF released its recommendation that clinicians screen for HIV in all adolescents and adults aged 15-65 years. It also recommends repeat HIV screenings for those who are at increased risk for HIV infection, including men who have sex with men and people who inject drugs. Younger adolescents and older adults who are at increased risk for HIV infection should also be screened. These updated recommendations are in line with the CDC’s 2006 guidelines for HIV testing, which state that testing should be a routine part of medical care for all adults and adolescents in the U.S. Although implementing such screening and testing will take time, this is a necessary step to ensure universal testing and linkage to care, especially when the 20% of those unaware of their HIV infection account for half of all new HIV infections.

You can read the CDC bulletin on the USPSTF recommendation here.

Click here to read the USPSTF recommendation.
Oregon Health Study Finds Increased Use of Health Services Due to Medicaid Expansion

Expanded health insurance coverage from Medicaid expansion may lead to increased health care use and better health outcomes, according to the recently released findings from the Oregon Health Study in the New England Journal of Medicine. The Oregon Health Study was a two-year project initiated in 2008 to determine the possible effects of Medicaid expansion. Oregon used a lottery system to randomly select 30,000 eligible low-income adults (out of 90,000 on the waiting list) and expanded Medicaid to these individuals. The effects of expanded health insurance coverage on health care use and health outcomes are encouraging. Although expanding Medicaid to these individuals did not significantly affect the prevalence or diagnosis of hypertension or high cholesterol, or treatment of these conditions, it did increase the probability that a person would receive a diagnosis of diabetes and be treated. The study also showed that accessing Medicaid coverage reduced the chance of a positive screening for depression by at least 30%, which can be especially important for people living with HIV. Most importantly, however, the study showed that Medicaid expansion increased use of and access to health services while decreasing financial strain due to medical costs. AIDS United continues to advocate for Medicaid expansion across the country, especially in light of the encouraging results of the Oregon Health Study.

To read more about the study, click here.

For a New York Times article on the study, click here.

Announcements

Town Hall for People Living with HIV/AIDS

The Federal AIDS Policy Partnership (FAPP) and the U.S. People Living with HIV Caucus (U.S. PLHIV Caucus) is hosting a forum to review mechanisms for PLHIV to offer input into federal policy decision-making and discuss ongoing engagement of individuals living with HIV or AIDS following the closure of the National Association of People with AIDS (NAPWA) at the end of last year. Leadership from FAPP and the U.S. PLHIV Caucus will be present to hear both your concerns and your recommendations. A FAPP social event will immediately follow the town hall and provide further opportunity to network.

The town hall will take place Tuesday, May 14, 2013, from 5 – 7 p.m. at the Metropolitan Community Church of Washington, D.C., located at 472 Ridge Street NW, Washington, D.C., 20001 (2 blocks from the Mt. Vernon Square Metro on the Green and Yellow Lines). Please contact Kali Lindsey ( klindsey@nmac.org) for more details.


CROI Community-Wide Update Event

The 20th Conference on Retroviruses and Opportunistic Infections (CROI) Community-Wide Update will be held on May 14, 2013, in Washington, D.C. Program highlights include: HIV Prevention, Treatment for HIV/Hepatitis Co-Infection, HIV and Women, Strategies to Address Gaps in HIV Care, Aging and HIV, Cardiac Disease and HIV, HIV “Cure” and the Baby, and “AIDS-Free Generation”: What Does It Mean? The event will take place from 5:30-8:00pm on Tuesday, May 14, at Us Helping Us, located at 3636 Georgia Avenue NW (Georgia Ave-Petworth Metro Stop on the Green/Yellow Line) in Washington, D.C.


2013 Johnson & Johnson /UCLA Health care Executive Program Now Accepting Applications

The UCLA/Johnson & Johnson Health Care Executive Program (HCEP) is a management and leadership development program for executive directors and leaders of Community Health Centers (CHCs) and AIDS Service Organizations (ASOs). The HCEP is especially designed and valuable for ASOs and CHCs that need to prepare for and adapt to the changes in service delivery and health care financing related to the Affordable Care Act (ACA) as well as how the ACA will impact the future of traditional AIDS service funding mechanism like the Ryan White Care Act. The program will take place July 7-17, 2013, and the deadline to submit an application is 5:00pm PT on May 15, 2013.

You can learn more about the program, upcoming informational calls, and application directions by clicking here.


Centers for Disease Control and Prevention (CDC) Launches New National Hepatitis Testing Day Website

The second national Hepatitis Testing Day is May 19, 2013. To support and promote the events and activities surrounding the day, the CDC has launched a new national Hepatitis Testing Day website. The new site allows people to search for Hepatitis Testing Day events near them during the month of May, which is also Hepatitis Awareness Month.

Hepatitis Testing Day is a day for people at risk to be tested, and for health care providers to educate patients about chronic viral hepatitis and testing. Millions of Americans have chronic hepatitis; most of them do not know they are infected.

You can read more about the initiative here.


DC D-CFAR Hosts “Evolution of Infectious Diseases” with Dr. Keith Crandall

The Washington, D.C., Developmental Center for AIDS Research (DC D-CFAR) will host a seminar on May 29, 2013, with Dr. Keith Crandall, who will present on “Evolution of Infectious Diseases.” The seminar will include an overview of the molecular evolution of HIV and HIV diversity. He will demonstrate with examples from his own research computational approaches to pathogen detection, diversity characterization, and diagnosing the evolution of drug and vaccine resistance in HIV. Dr. Crandall is the founding Director of the Computational Biology Institute at George Washington University. He has published over 200 papers and 3 books, including "The Evolution of HIV" published by Johns Hopkins University Press in 1999. The event will take place Wednesday May 29, 2013, from 6:30-8:00pm, at the George Washington University Marvin Center – Room 310 and Amphitheater, located at 800 21st Street NW, Washington, D.C.

You can register for the free event here.

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