Authority: §§ 32.1-11.1, 32.1-11.2, and 32.1-35 through 32.1-73, Code of Virginia; and P.L. 91-464, as amended, Federal Code.

A. Out of this appropriation, $90,000 the first year and $90,000 the second year from the general fund shall be used to purchase medication and supplies for individuals who have drug-susceptible or drug-resistant tuberculosis but who do not qualify for free or reduced prescription drugs and who do not have adequate income or insurance coverage to purchase the required prescription drugs.

B. The requirement for testing of tuberculosis isolates set out in § 32.1-50 E, Code of Virginia, shall be satisfied by the submission of samples to the Division of Consolidated Laboratory Services, or such other laboratory as may be designated by the Board of Health.

C. Out of this appropriation, $2,000,000 the first year and $2,000,000 the second year from nongeneral funds shall be used to purchase the Tdap (tetanus/diphtheria/pertussis) vaccine for children without insurance.

D. Out of this appropriation, $200,000 the first year and $200,000 the second year from the general fund shall be provided to the State Pharmaceutical Assistance Program (SPAP) for insurance premium payments, coinsurance payments, and other out-of-pocket costs for individuals participating in the Virginia Medication Assistance Program (VA MAP) with incomes meeting the VA MAP's current requirements and who are Medicare prescription drug coverage beneficiaries. These funds may also be used for the purchase of medications, co-insurance payments and other out-of-pocket costs for individuals served by the Virginia Department of Health's HIV Pre-Exposure Prophylaxis (PrEP) and non-occupational Post Exposure Prophylaxis (n-PEP) programs to prevent HIV infection.

E. The State Health Commissioner shall monitor patients who have been removed or diverted from the Virginia Medication Assistance Program (VA MAP) due to budget considerations. At a minimum the Commissioner shall monitor patients to determine if they have been successfully enrolled in a private Pharmacy Assistance Program or other program to receive appropriate anti-retroviral medications. The commissioner shall also monitor the program to assess whether a waiting list has developed for services provided through the VA MAP program. The commissioner shall report findings to the Chairmen of the House Appropriations and Senate Finance and Appropriations Committees annually on October 1.

F. The Virginia Department of Health shall report for each month within 30 days after the end of each month, on the number of procedures approved for payment pursuant to § 32.1-92.2, Code of Virginia, and include a description of the nature of the fetal abnormality, to the extent permitted by law, as required for eligibility under § 32.1-92.2, Code of Virginia. The department shall report the information by letter to the Chairmen of the House Appropriations and Senate Finance and Appropriations Committees.

G. Out of this appropriation, $1,600,011 the first year and $1,600,011 the second year shall be provided to the Virginia Department of Health from available federal funding in the Department of Behavioral Health and Developmental Services, including the State Opioid Response Grant, as available, to purchase and provide opioid reversal drugs to support community rescue efforts for those who deal with vulnerable populations.

H. Out of this appropriation, $1,300,000 the first year and $1,300,000 the second year from the general fund shall be used to purchase opioid reversal drugs.

I. The Virginia Department of Health shall review and update their data collection and reporting protocols for COVID-19 or other infectious disease data to report actual deaths not an extrapolated projection of deaths.

J. The State Health Commissioner shall ensure that residents and employees of any nursing home or assisted living facility receive priority for testing indicating the existence of the COVID-19 virus in the Commonwealth. The Commissioner shall make available public health testing, if necessary, in order to ensure that nursing homes or assisted living facilities have access to testing that can provide the most rapid results in order to prevent or contain outbreaks of COVID-19. Such testing shall be provided, as needed, by the Division of Consolidated Laboratory Services or other public health testing agencies of the Commonwealth. Any testing costs through the public health system for employees or residents of nursing homes or assisted living facilities may be billed to responsible third-parties.

K.1. Out of this appropriation, $5,464,145 the first year and $5,464,145 the second year from the Commonwealth Opioid Abatement and Remediation fund shall be provided for the purchase and distribution of opioid reversal agents and test kits and for the development of tracking software.

2. Of the amounts provided in K.1., $1,000,000 the first year and $1,000,000 the second year shall be provided to purchase and distribute eight milligram naloxone nasal spray.

L. Out of this appropriation, $100,000 the first year and $100,000 the second year from the Commonwealth Opioid and Abatement and Remediation fund shall be provided for the purchase and distribution of additional opioid reversal agents for public school divisions by the Virginia Department of Health.

M.1. The Department of Health shall establish a workgroup on childhood immunization schedules and immunizations for public health emergencies. The workgroup shall include representatives from practitioner groups, including pediatricians, family medicine doctors, pharmacists, and other stakeholders to review Virginia's statutes and regulations governing childhood immunizations associated with public health emergencies to ensure evidence-based vaccines are included to protect public health. The Commissioner of the Department of Health shall make recommendations to improve Virginians' access to vaccines approved by the FDA and other organizations that review scientific evidence.

2. The Department of Health shall also collaborate with the Department of Medical Assistance, the Bureau of Insurance, and the Association of Health Plans, and create recommendations to improve the availability and affordability of vaccines with respect to insurance coverage.

3. The Department of Health shall submit a report of recommendations to the Chairs of the House Appropriations Committee, Senate Finance and Appropriations Committee, House Health and Human Services Committee, and Senate Education and Health Committee by November 1, 2026.

N. Out of this appropriation, $105,115 the first year and $105,115 the second year from the Commonwealth Opioid Abatement and Remediation fund shall be provided to fund the fiscal impact of Chapters 667 and 668, 2026 Acts of Assembly which requires the development of a strategic plan for opioid response.

O.1. Out of this appropriation, $5,818,820 the first year and $6,132,814 the second year from the general fund is provided to support core public health services, and maintain epidemiological response capacity and preparedness.

2. Of the amounts in paragraph O.1., $4,642,403 the first year and $4,642,403 the second year from the general fund is provided to support state epidemiology positions, strengthening Virginia's ability to identify, track, and stop HIV/AIDS, measles, and other infectious disease outbreaks.

P.1. Out of this appropriation, $6,600,000 the first year and $6,600,000 the second year from the general fund shall be provided to the Virginia Department of Health for the purposes of funding the Ryan White HIV/AIDS Program Part B for HIV care services to persons living with HIV/AIDS.

2. The department shall submit an annual report to the Chairs of the Senate Finance and Appropriations Committee and the House Appropriations Committee by December 1 detailing the expenditure and use of funds appropriated pursuant to this item.

3. The department shall submit a final report to the Chairs of the Senate Finance and Appropriations Committee and the House Appropriations Committee no later than June 30, 2028, that: (i) identifies the causes of recent revenue shortfalls; (ii) assesses internal controls and compliance with applicable federal grant requirements; (iii) evaluates the administration and financial management of the Ryan White HIV/AIDS Program Part B; and (iv) describes actions taken, or planned, to address financial instability associated with declines in rebate revenue.

Q. Notwithstanding § 54.1-3303.1, a pharmacist may administer an influenza vaccine or COVID-19 vaccine approved by the United States Food and Drug Administration to persons three years of age or older in accordance with the manufacturer's directions. A pharmacist may also delegate the administration of the influenza vaccine or COVID-19 vaccine to a pharmacy technician or intern under the supervision of a pharmacist. This authority shall expire June 30, 2027.