Mr. Milan informed CHAC that Dr. McGuire would no longer serve as the CHAC co-Chair after the current meeting because her term would expire on November 30, 2006. Dr. Temoshok raised the possibility of CHAC making a formal recommendation to extend Dr. McGuire’s term for an additional year due to her ongoing involvement in the Strategic Plan Workgroup and other CHAC activities.

Dr. Fenton clarified that this request would most likely not be honored because Dr. McGuire has served for two consecutive terms as a member and co-Chair. However, he explained that Dr. McGuire could still be involved in CHAC’s activities as a workgroup member or external consultant. The participants applauded Dr. McGuire’s diligent efforts, dedication and commitment during her outstanding service as the CHAC co-chair.

Mr. Milan entertained a motion to approve the previous minutes. A motion was properly placed on the floor and seconded by Drs. Leoutsakas and Garcia, respectively. CHAC unanimously approved the May 17-18, 2006 Meeting Minutes with no changes or further discussion.

Mr. Milan reviewed issues that the members raised during the meeting or suggested to him and Dr. McGuire off-line as CHAC’s potential formal motions or letters of advice to the CDC Director, HRSA Administrator or HHS Secretary.

• FY’07, FY’08 and FY’09 budgets for HIV, STD and hepatitis prevention, treatment and care.
• Strategic Plan issues: (1) creation of a coordinated National HIV Strategic Plan with cross-sector and cross-agency resources; (2) a related or separate Strategic Plan for AAs; (3) an additional two-year extension for a five-year Strategic Plan, including annual targets, resource requirements and strategies for AAs; and (4) development of models for resources needed for each year of the Strategic Plan.
• Issues related to CDC’s revised HIV testing recommendations: (1) projections of newly-diagnosed HIV cases identified through the new HIV testing initiatives; (2) implementation in both public and private sectors; (3) standardized language or best practices for HIV testing consent forms; and (4) development of HIV testing algorithms for private laboratories.
• Refined projections by HRSA on the current number of PLWH affected by the Medicare Part D donut hole and strategies to ensure continued HIV care for these clients.
• Completion of the HHS clearance process for HECAT.
• STD issues: (1) consistent messages to implement CDC’s STD Treatment Guidelines; and (2) future activities and resources by DASH and DSTDP to reduce the number of STD infections in the United States.
• Inadequate funding of the CDC Division of Viral Hepatitis and the need for more resources for hepatitis prevention, C&T and vaccine distribution.
• Response by HRSA, CMS and NIH on treatment and care for newly-diagnosed HIV-positive persons.
• Development of medical protocols by HRSA and CMS for HIV and STD testing and treatment.
• CDC’s approaches to resolve problems with PEMS data elements.
• Specific language in the reauthorized CARE Act to allow for a transition period for states that have not converted to name-based reporting systems.
• Recognition of HRSA’s outstanding efforts during a time with no reauthorization of the CARE Act.

CHAC extensively discussed the issues Mr. Milan proposed as potential formal motions or letters of advice to the agencies. The deliberations resulted in CHAC making ten formal motions to the CDC Director, HRSA Administrator or HHS Secretary. All ten of the formal motions were properly placed on the floor and seconded by voting members and unanimously approved by CHAC.

1. CHAC recommends that the HHS Secretary seek supplemental funding in the FY’07 budget to meet current program needs for domestic HIV, STD and hepatitis prevention, treatment and care.
2. CHAC recommends that the HHS Secretary request FY’08 and FY’09 budget levels for domestic HIV, STD and hepatitis prevention, treatment and care which move beyond historic flat funding levels and provide significant new resources to meet program and domestic needs.
3. CHAC recommends that CDC revise the draft HIV Prevention Strategic Plan with the following changes. The first two bullets under the “summary of recommendations” on page 5 should be deleted. The third bullet should be modified with the following language: “Prioritize racial, ethnic and sexual minority populations as well as demographic groups with disproportionate burden of disease/incidence where funding prioritization is linked to the degree of burden/incidence. On the basis of current epidemiology, highest priority in implementation of the Strategic Plan should be given to high-risk AAs and MSM within the goals as appropriate.”
4. CHAC recommends that CDC extend the Strategic Plan to 2010 and include annual indicators of progress.
5. CHAC recommends that the HHS Secretary take the following actions: (1) The HHS Secretary should initiate the development of a multi-sectoral National Plan for HIV Prevention, Treatment and Care that addresses activities of all sectors and includes all relevant federal agencies. (2) The HHS Secretary should provide CHAC with a status report on progress in developing the National Plan by the next CHAC meeting. (3) The HHS Secretary should request that the President support and impanel a committee to develop the National Plan. (4) The HHS Secretary should meet with CHAC or its co-Chairs on the development of the National Plan.
6. CHAC recommends that CDC develop projections for the number of newly identified HIV-positive persons who might be identified through its new HIV testing initiatives. CHAC further recommends that CDC develop models for financial resources needed to successfully implement the updated HIV Prevention Strategic Plan.
7. CHAC recommends that HRSA continue to refine its estimates of the number of HIV-positive persons who would be impacted by the Medicare Part D donut hole. CHAC further recommends that HRSA develop strategies to support and maintain health coverage for these individuals.
8. CHAC recommends that the HHS Secretary expedite final clearance of the HECAT curriculum for STDs among youth because this evidence-based guidance is a critical need in the field.
9. CHAC recommends that CDC develop projections and models of needed resources for promoting national control of HPV, genital herpes, chlamydia, gonorrhea and syphilis.
10. CHAC recommends that the co-Chairs draft a letter to the HHS Secretary with the formal motions approved during the meeting and a delineation of percent increases for the funding requests.

In addition to approving the ten formal motions, CHAC also took actions to address other issues. CHAC agreed that CDC would complete the development of the goals, objectives and targets in the Strategic Plan. CDC would finalize and distribute the Strategic Plan to each CHAC member no later than March 31, 2007 in preparation of a discussion of the document during the May 2007 meeting.

CHAC identified several items to be placed on the next meeting agenda:

• Progress report by DSTDP on CHAC’s formal motion to promote national control of HPV, genital herpes, chlamydia, gonorrhea and syphilis.
• Presentation by CDC and HRSA on prevention strategies with the Internet, text messaging and other technologies that could be used to reach young MSM of color and other high-risk populations.
• Presentation by CDC and HRSA on HIV prevention, care and treatment targeted to Native Americans, Alaska Natives and Native Hawaiians.
• Update by HRSA on the CARE Act.
• Presentation by an HHS representative on the HHS department-wide strategic plan and its relationship to HIV and STDs.
• Overview by CDC on its approaches to generate, collect and utilize surveillance data, particularly information gathered on MSM.
• Progress report by CDC on the ongoing development of laboratory algorithms for HIV testing and confirmation in the context of rapid HIV tests.