In this Edition:

• Negotiations on the FY 2008 Budget Continue in Congress
  
  
• Legislation to Change Names of Drug and Alcohol Research Institutes Introduced in the Senate and House
  
  
• Congresswoman Waters Reintroduces Legislation to Stop the Spread of HIV/AIDS in Federal Prisons
  
  
• Legislation to Provide Comprehensive Health Coverage for Children and Pregnant and Postpartum Women Introduced in the House
  
  

Negotiations on the FY 2008 Budget Continue in Congress

Congress continues its work to resolve the differences between the FY 2008 budget resolutions recently approved by the House and the Senate. Although the budget resolutions approved by the House and the Senate would both call for roughly $2.9 trillion in spending, there are differences between the two resolutions that need to be resolved in order for the budget process to move forward. The budget resolution is the blueprint for Congress that contains the spending cap for discretionary programs, including funding for alcohol and other drug prevention, treatment, education, and research programs, and gives direction to the Appropriations Committees on how much money they can allocate to the programs within their jurisdiction as part of the annual funding process.

The House passed its budget resolution on March 29th and the Senate approved its budget resolution on March 23rd. Both budgets would include more funding for domestic programs than the President proposed in his FY 2008 budget; the Senate budget resolution would increase domestic spending by approximately $18 billion over the President’s request and the House budget resolution calls for spending $25 billion over the President’s budget. It is expected that these funding increases could likely go to education and veterans’ programs.

In addition, both the House- and Senate-approved budget resolutions would hold certain funds in reserve for future spending; for example, both budget resolutions seek to increase funds for the State Children’s Health Insurance Program (SCHIP) by $50 billion over five years. The President’s budget proposal included a $5 billion increase over five years for SCHIP, which is slated to be reauthorized during this 110th Congress.

A key difference between the House and Senate budget resolutions is how each chamber plans to deal with expiring tax cuts. Under new “pay-as-you-go” budget rules adopted by the Congress this session, in order to spend money for new tax cuts or entitlements such as Medicaid or Medicare, Congress must offset the spending increase by cutting other spending or increasing taxes. However, the rules on “pay-as-you-go” differ between the House and the Senate; negotiations to resolve the differences between the House- and Senate-approved budget resolutions will likely include discussion about how to offset proposed tax cuts.

The Appropriations Committees are expected to begin crafting their FY 2008 spending bills in May. Status and text of both budget resolutions, H.Con.Res. 99 and S.Con.Res. 21, can be found at: http://thomas.loc.gov.

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Legislation to Change Names of Drug and Alcohol Research
Institutes Introduced in the Senate and House

On March 28th, Senators Joe Biden (D-DE), Edward Kennedy (D-MA), and Michael Enzi (R-WY) introduced S. 1011, the “Recognizing Addiction as a Disease Act of 2007.” Under the legislation, the names of two agencies in the National Institutes on Health would be changed. The National Institute on Drug Abuse (NIDA) would change to the National Institute on Diseases of Addiction, and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) would change to the National Institute on Alcohol Disorders and Health.

In introductory comments on the legislation, Senator Biden stated that prosecuting the trafficking and possession of illegal drugs is very important, but emphasized that an intense focus on prevention and treatment is equally critical. Senator Biden expressed that to be successful in fighting illegal drugs, there must be an understanding that addiction is a preventable and treatable neurobiological disease. Noting the stigma that people with alcohol and drug addiction histories continue to face, Senator Biden remarked that society must continually work against social stigma. In order to begin to fight stigma and discrimination, Senator Biden asserted that the nature of public discourse about addiction must be changed and that renaming NIDA and NIAAA would help to shift and improve the conversation.

Companion legislation in the House, H.R. 1348, the “NIDA and NIAAA Name Redesignation Act,” was introduced on March 6, 2007. H.R. 1348 was introduced by Representatives Patrick Kennedy (D-RI) and John Sullivan (R-OK).

The text and status of both S. 1011 and H.R. 1348 can be found at: http://thomas.loc.gov.

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Congresswoman Waters Reintroduces Legislation to Stop the Spread of HIV/AIDS in Federal Prisons

On April 19th, Congresswoman Maxine Waters (D-CA) introduced H.R. 1943, the “Stop AIDS in Prison Act of 2007.” H.R. 1943 seeks to curb the spread of HIV/AIDS in federal prisons. The goals of the bill are to: stop the spread of HIV/AIDS among incarcerated people, protect institutional staff from infection, provide comprehensive medical treatment to incarcerated people living with HIV/AIDS, promote HIV/AIDS awareness and prevention, and encourage incarcerated individuals to take personal responsibility for their health as well as reduce the risk that they might transmit HIV/AIDS to persons they have contact with in the community upon their release. Although the legislation contains provisions that would require that incarcerated people be tested for HIV when they enter a federal prison and that incarcerated pregnant women also be tested, the legislation does give individuals a right to refuse testing.

The “Stop AIDS in Prison Act of 2007” would require the Federal Bureau of Prisons (BOP) to develop a comprehensive policy to coordinate testing, treatment and prevention of HIV/AIDS for incarcerated people and individuals returning to the community from the federal prison system. BOP would have one year within enactment of the legislation to implement such a policy, and, in developing this policy, would be required to consult with officials from the Department of Health and Human Services (HHS), the Office of National Drug Control Policy (ONDCP), and the Centers for Disease Control (CDC). H.R. 1943 would authorize that such sums that may be necessary be appropriated for the purposes of the legislation.

The BOP plan must include a mechanism for preventative education and awareness on modes of HIV transmission, prevention methods, and treatment and disease progression. Under the legislation, community-based organizations, local health departments and peer educators could provide these services. In addition, H.R. 1943 includes a requirement that these HIV/AIDS educational programs be culturally sensitive, conducted in a variety of languages and present scientifically accurate information. Educational materials would be required to be made available to all people incarcerated in the federal prisons at orientation, health care clinics, regular educational programs and prior to release.

H.R. 1943 would require that the BOP policy include HIV testing and counseling at intake as well as procedures by which incarcerated people could confidentially request and receive HIV tests. Incarcerated individuals would be allowed to obtain HIV tests upon request once per year or whenever the individual has a reason to believe s/he has been exposed to HIV. Under H.R. 1943, medical personnel would be required to inform incarcerated individuals, throughout their incarceration, both orally and in writing, of this right to obtain HIV tests. Medical personnel would also be required to provide routine HIV testing to women incarcerated in federal prison who become pregnant. In providing testing, medical personnel would be required to provide confidential pre-test and post-test counseling. H.R 1943 also states that individuals who wish to opt-out of testing have the right to refuse and that they must be informed both orally and in writing of this right. Further, the legislation states that if an individual refuses a routine HIV test, medical personnel would be required to make a note of this refusal in the individual’s confidential medical records, but that this refusal would not be considered a violation of prison rules or result in disciplinary action.

The Stop AIDS Act of 2007 would also require that medical personnel provide all individuals who do test positive for HIV with timely comprehensive medical treatment, confidential counseling on managing their medical condition and preventing its transmission to others, and voluntary partner notification services. This medical care would be required to be consistent with current HHS guidelines and standard medical practice. Medical personnel would be required to develop and implement procedures to ensure the confidentiality of HIV tests, diagnoses and treatment, and would, along with correctional personnel, be required to receive regular training on the implementation of those procedures. BOP would be required to specify and strictly enforce penalties for violations of confidentiality by medical personnel or correctional staff.

H.R. 1943 also contains provisions aimed at stopping the spread of HIV/AIDS once people return to the community from the federal prison system. The legislation would require that incarcerated people who previously tested negative be tested before they are released from custody, no more than three months prior to release. The legislation makes clear that individuals who wish to opt-out of the pre-release testing have the right to refuse and that they must be informed both orally and in writing of this right. Further, the legislation states that if an individual refuses a routine HIV test, medical personnel would be required to make a note of this refusal in the individual’s confidential medical records, but that this refusal would not be considered a violation of prison rules or result in disciplinary action.

In addition, when people with HIV/AIDS return to the community from federal incarceration, the legislation requires that medical personnel provide these individuals with confidential pre-release counseling on managing their medical condition in the community, accessing appropriate treatment and services in the community, preventing the spread of HIV in the community, referrals to appropriate health care providers and social service agencies, and a 30-day supply of any medically necessary medications the individual is currently receiving.

The Stop AIDS in Prison Act was introduced by Congresswoman Waters, House Judiciary Committee Chairman John Conyers (D-MI) and Ranking Member Lamar Smith (R-TX), and Representatives Bobby Scott (D-VA), Randy Forbes (R-VA), Barbara Lee (D-CA) and Donna Christensen (D-VI). Following the bill’s introduction, H.R. 1943 was referred to the House Judiciary Committee. Additional information on the “Stop AIDS in Prison Act” can be found at: http://thomas.loc.gov.

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Legislation to Provide Comprehensive Health Coverage for Children and Pregnant and Postpartum Women Introduced in the House

On March 26th, Congressman Bobby Scott (D-VA) introduced H.R. 1688, the “All Healthy Children Act of 2007,” which seeks to expand access to health care to all children in the United States. H.R. 1688 would consolidate the State Children’s Health Insurance Program (SCHIP) and the children’s portion of the Medicaid program to create one streamlined program.

H.R. 1688 states there are approximately nine million children who don’t have health insurance. By consolidating SCHIP and the children’s portion of Medicaid, H.R. 1688 would establish national eligibility criteria so that all children and pregnant women living in families with incomes at or below 300 percent of the federal poverty level would qualify for the new program. Children currently enrolled in Medicaid or SCHIP would automatically qualify for and be enrolled in the new program. Other individuals eligible for this health program would include: pregnant and postpartum women at or below 300 percent of the federal poverty level, and youth up to age twenty who have transitioned from the foster care system and other children with special needs. In addition, children with family incomes over 300 percent could buy into the program. The program would cover all medically necessary health services, including early periodic screening, diagnosis and treatment services now covered under Medicaid.

Recognizing that health care providers are often not adequately reimbursed for services to people with Medicaid or SCHIP coverage, H.R. 1688 has a provision that requires that payment rates for providers not be less than eighty percent of the average payment rates for similar services under private health plans.

Additional co-sponsors of H.R. 1688 include: Representatives G.K. Butterfield (D-NC), Emmanuel Cleaver (D-MO), John Conyers (D-MI), Keith Ellison (D-MN), Jesse Jackson, Jr. (D-IL), Sheila Jackson Lee (D-TX), Barbara Lee (D-CA), and John Sarbanes (D-MD). Following introduction, H.R. 1688 was referred to the House Energy and Commerce, and Rules Committees where the legislation awaits review. Status and text of H.R. 1688 can be found at: http://thomas.loc.gov.

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