STD APPROPRIATIONS DELIBERATED

The House Appropriations Committee approved the FY 2007 Labor, Health and Human Services, and Education spending bill by voice vote on June 13. The STD program at CDC was funded at $157,383,000. This funding level is $653,000 less that the 2006 funding level, but $454,000 more than the President's budget request. The STD program awards grants to state and local health departments and other nonprofits entities to support a wide variety of public health activities to prevent and treat STDs. CDC uses these funds to directly conduct special investigations, surveillance and epidemiological research.

Of particular concern is report language included in the bill. Report language is not binding, but is usually seriously considered by federal agencies. This language was included in the bill:

"The Committee is pleased that CDC has funded research aimed at assessing the extent to which medical students and physicians are familiar with and practice screening and counseling tailored to individual patients. Despite widespread condom social marketing for the past twenty years, 40,000 new HIV infections are reported every year and other sexually transmitted infections (STIs) are at unprecedented levels. Significant deficits exist in the current sexual health medical education, and many members of the public at risk for STIs are unaware of their need to be screened. To address these problems the Committee urges CDC to (1) promote evidence-based medical school curriculum guidelines for sexual health that will promote risk avoidance and non-condom-related risk reduction; and (2) harness the ever-growing power of the Internet to develop innovative and attractive strategies in a manner that promotes risk avoidance and non-condom-related risk reduction that will efficiently educate the public about their STI risks."

It is difficult to assess the implications of this language. We will keep you posted and try to prevent it from being included in the Senate version, and dropped in conference.

Title X was level-funded at $283 million. Community-based abstinence programs were level funded at $109 million - $28 million less than the President's FY 2007 request. As in prior years, Community Health Centers received a major increase. This year's increase of $206 million is $25 million above the President's request, bringing total funding to $1.988 billion.

MEDICAL ACCURACY BILL INTRODUCED IN HOUSE

On June 12, 2006, Representatives Luis Gutierrez (D-IL) and Jim Moran (D-VA) introduced the Guarantee of Medical Accuracy in Sex Education Act (GMA, H.R. 5598) in the House. The GMA would prohibit the federal government from providing assistance to any entity - including all federally funded health education programs - whose materials on human sexuality contain medically inaccurate information. The bill is intended to address the findings of several studies, including a congressional review by Representative Henry Waxman (D-CA), showing that the most frequently used abstinence-only-until-marriage curricula contain medically inaccurate and misleading information about condom efficacy, transmission of sexually transmitted diseases (STDs), including HIV, and pregnancy prevention.

CMS ISSUES CITIZENSHIP GUIDELINES FOR MEDICAID ELIGIBILITY

HHS has issued guidelines for states, effective July 1, to implement the new proof of citizen requirement under the Deficit Reduction Act. The guidance outlines the types of documents that must be provided in order to be eligible for Medicaid or upon a recipient's first Medicaid predetermination on or after July 1, 2006. The provisions require that a person provide both evidence of citizenship and identity. If an applicant or recipient presents evidence from the listing of primary documentation, no other information is required. When this evidence cannot be obtained, the state will look to the next tier of acceptable forms of identification. In very rare cases, written affidavits are permissible. Federal regulations will be issued soon. Advocates for low-income Americans have strongly criticizing both the requirements themselves and the unrealistic timeframe for implementing these complex changes.