Federal Government Shuts Down After Senate Unable to Reach Deal

After weeks of negotiations, the Senate rejected a deal on a measure to keep the government funded after the January 19 deadline.

On January 18, the House had approved legislation to keep the government funded through February 16 and extend funding for the Children’s Health Insurance Program (CHIP) through fiscal year (FY) 2023. Congress will reconvene today, January 20, to discuss a tentative deal on a continuing resolution (CR) that would keep the government funded through February 8, with an agreement to hold a vote prior to that date on the status of individuals enrolled in the Deferred Action for Childhood Arrivals (DACA) program.

According to The Washington Post, Office of Management and Budget Director Mick Mulvaney said the conflict has a “really good chance” of being resolved before the government opens on Monday.

In advance of a shutdown, federal agencies have posted contingency staffing plans for a shutdown. Approximately half of the employees at the U.S. Department of Health and Human Services (HHS) will be furloughed. Included in the operations that will continue, the National Institutes of Health “will continue patient care for current NIH Clinical Center patients, minimal support for ongoing protocols, animal care services to protect the care of NIH animals, and minimal staff to safeguard NIH facilities and infrastructure.” Additionally, the Centers for Disease Control and Prevention “will continue minimal support to protect the health and well-being of US citizens here and abroad through a significantly reduced capacity to respond to outbreak investigations, processing of laboratory samples, and maintaining the agency’s 24/7 emergency operations center.”  For more about how HHS may be affected, read more on the HHS contingency plan or from HealthLeaders Media.

AADR Heads to the Hill: What to Expect for the 2018 Advocacy Day

Next month, the American Association for Dental Research (AADR) and the Friends of NIDCR will host the annual Advocacy Day on Capitol Hill. This event, which will be held on Tuesday, February 27, 2018 from 9:00 a.m. – 5:00 p.m. ET, is intended to bring those who support dental, oral and craniofacial research to Washington, D.C. to educate policymakers about the value of this work.

For some, this event may be second nature, but for others, an advocacy day might be an entirely new concept. Whether you’re new to this type of event or simply need a refresher, we have put together some information about what you can expect for the 2018 Advocacy Day and why you should attend:

Why host an Advocacy Day in the first place?

There are many reasons to host an advocacy day. In particular, advocacy days:

  • Amplify causes by having a diverse, compelling group of individuals make their voices heard;
  • Allow individuals to have face time with those who are creating policy and making decisions about how federal dollars are spent;
  • Bring peers and colleagues together to network and share their experiences with one another; and
  • Provide an opportunity for individuals to hear about the latest developments in Washington, D.C. and how it may affect their home states.

What should I expect on the day of the event?

After breakfast, the day’s agenda will begin with a key issues briefing. Over the course of the morning, attendees will hear a legislative and political overview about what’s happening in Washington, receive a scientific update on the activities and research initiatives at the National Institute of Dental and Craniofacial Research (NIDCR) from NIDCR Director Dr. Martha Somerman, and receive a message training about how to navigate the Hill the conduct meetings with staff.

Once we break from the morning’s briefing and lunch, attendees will head to their visits with congressional offices. AADR is aiming to book at least two meetings for each participant. These visits, scheduled with members’ elected official(s), provide a unique opportunity for attendees to share why they care about dental, oral and craniofacial research and why it is important for the government to fund it.

Why should I attend?

For AADR members, the fields of dental, oral and craniofacial research presumably have a large role to play in your life.

As a researcher, this field may be your livelihood.
As a student, this work may be integral to your future path.
As a patient advocate, this research may hold promise for the disease or condition that you and/or your organization are working to tackle.

Regardless of your connection to this field, your voice is central to elevating oral research on the Hill and ensuring that policymakers know why it should be funded. Members of Congress value and listen to constituents. You are the best stewards of this message. By participating in this event, you can help protect funding for dental research and keep it on the minds of policymakers over the course of the year.

Last year, AADR members conducted over 70 meetings with members of Congress and congressional staff. We’re aiming to conduct even more visits this year!

I’m in. Where do I sign up? 

Register by completing the registration form online. *Please note: your registration represents your professional commitment to attend. Last minute cancellations or failure to attend will harm our relationship with members of Congress and their staff. 

If you have any questions or need any additional information, please contact AADR Assistant Director of Government Affairs Lindsey Horan.

All of Us Research Program Seeks Input on Research Priorities

The All of Us Research Program aims to build one of the largest, most diverse datasets of its kind for health research, with one million or more volunteers nationwide, who will sign up to share their information over time. Researchers will be able to access participants’ de-identified information for a variety of studies to learn more about the biological, behavioral, and environmental factors that influence health and disease. Their findings may lead to more individualized health care approaches in the future.

Using IdeaScale, the All of Us Research Program is collecting ideas through a tool known as a “use case” that outlines and describes research questions that the All of Us Research Program could help answer.

The information provided will be used at the All of Us Research Priorities Workshop on March 21–23, 2018, to identify key research priorities and requirements (such as data types and methods) for future versions of the All of Us protocol.

You can ensure that dental, oral and craniofacial research is included in the All of Us Research Program by:

1. Voting for the following ideas submitted by the National Institute of Dental and Craniofacial Research by Friday, February 9:

2. Clicking here to be directed to IdeaScale, where you can see the ideas submitted by others or add your own idea by Friday, February 9.

3. Sending your idea to sajiboye@iadr.org that may be submitted on behalf of AADR by COB Friday, January 26.

Thank you for your engagement in this research initiative.

AADR submits comments to the Opioid Policy Steering Committee

AADR has submitted comments in response to the Food and Drug Administration’s (FDA) request for public comment on additional steps the FDA can take to reverse the opioid abuse epidemic. AADR’s comments strongly emphasized the need for both prescriber and patient training.

The FDA Opioid Policy Steering Committee (OPSC) was established in May 2017 and tasked with developing strategies for fighting the opioid abuse epidemic. The OPSC’s four focus areas are 1) decreasing exposure to opioids and preventing addiction; 2) supporting opioid use disorder treatment; 3) promoting the development of new, less addictive pain therapies and 4) improving enforcement and revisiting the benefit/risk assessment of opioid therapies.

The request for comment was a follow-up to the National Academy of Medicine (NAM) report, “Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use”. AADR member Dr. Eli Eliav, an orofacial pain researcher at the University of Rochester, was a member of the NAM committee.

In comments to the OPSC, AADR stressed the importance of controlling the opioid abuse epidemic while allowing access to opioids for patients who really need them for pain control. AADR supported the NAM committee recommendations for more research to better understand pain and opioid use disorders, the opioid epidemic and public health considerations to inform the regulatory process. AADR supported the recommendation by the American Dental Association that nonsteroidal anti-inflammatory drugs should be the first-line pain medication for acute dental pain and advocated for the implementation of a national, mandatory prescription drug monitoring program. AADR also recommended mandatory provider training on how to prescribe opioids, recognize possible abuse and treat chemically-dependent patients.

For AADR’s full letter to the OPSC, please click here.

AADR’s 2017 Advocacy Year in Review: Where We’ve Been and Where We Go from Here

In 2017, the American Association for Dental Research (AADR) was presented with myriad opportunities to weigh in on issues with the potential to affect dental, oral and craniofacial research. In each instance – whether a partner coalition’s sign-on letter opportunity, a federal agency’s Request for Information or a federal policy or trend –AADR considered how its members, patients and public health could be affected and sought to provide comments reflective of our field’s values.

Over the year, some of our work mirrored advocacy efforts of years past (e.g., championing the highest possible funding for the National Institute of Dental and Craniofacial Research), but our efforts also expanded into newer territory (e.g., tax reform and the executive order suspending entry of certain foreign nationals into the United States).

Highlights of AADR’s advocacy in 2017 included:

 
 
 
 
For more information about each of these activities, view our one pager.

As we shift our focus to 2018, we don’t want to miss the opportunity to thank our AADR members and community for their partnership in advocacy in 2017. Advocacy makes a difference, and looking ahead, as we advocate for funding for NIH and NIDCR in an environment already wrought with fiscal austerity, we need your voice now more than ever!

In the coming weeks, Congress will work to tackle its already packed legislative agenda, which includes a deal to raise the spending caps, the January 19 deadline to fund the government and the need to find a long-term solution for the Children’s Health Insurance Program.The deadline for the release president’s fiscal year 2019 budget, which signals the administration’s priorities, is also on the horizon.

As in 2017, AADR remains committed to our government affairs and advocacy portfolio, and we will continue to carry the torch for this work and dental, oral and craniofacial research in 2018.

 

In Lead-Up to Holidays, Congress Pushes Tax Reform and a New CR

With one day remaining before the current continuing resolution (CR) – the stopgap spending measure that keeps the government funded in the absence of regular appropriations – expires, Congress has been knee-deep in tax reform, health program funding and fiscal year 2018 spending discussions. Congress has now moved tax reform forward, but other issues still loom large.

Congress on Wednesday passed the sweeping Tax Cuts and Jobs Act to overhaul the U.S. tax code. The $1.5 trillion bill narrowly passed the Senate in a 51-48 vote and passed the House (for the second time to fix technical problems with the legislation) in a 224-201 vote. The bill is now with the president, who may sign the bill into law as early as today but will likely push enacting the bill until early January to postpone the automatic cuts it would trigger. (Read more on the statutory Pay-As-You-Go rule from Politico here.)

AADR remains concerned about how the net $1.5 trillion this bill is expected to add to the federal deficit over 10 years could undermine – and even jeopardize – non-defense discretionary programs, which encompass virtually everything outside of national defense and entitlement programs (education, scientific research, public health programs, infrastructure, etc.). Yet, in a positive move for the research community, the House and Senate during conference committee removed the House bill’s initial provision to treat as taxable income the tuition waivers provided to graduate students by universities in exchange for their teaching courses or conducting research while seeking graduate degrees. In the new bill tuition waivers, which benefit graduate students but are never received by the student as income, will not to be taxed and treated as income – as is current practice.

AADR was troubled about how that provision, among others, could impact higher education and our nation’s scientific advancement by burdening students pursuing or wishing to one day pursue advanced degrees. AADR spoke out against the bill’s potential implications for research, and so did our members. We would like to thank those of you who responded to our call to action and reached out to your elected officials, whether through our action alert or other mechanisms. Through AADR’s action alert portal alone, roughly 80 messages were sent to members of Congress. Your voice matters; the public outcry resulting in the removal of the graduate waiver tax provision in the final bill proves that.

With the tax bill now more or less off its agenda, Congress shifts its attention to reaching an agreement that will keep the government funded beyond tomorrow’s deadline.

Last night House Republicans released the text of a new CR, H.R. 1370, to keep the government funded through January 19, 2018. The bill, which replaces the previously proposed H.J. Res 124, would also extend funding for the Children’s Health Insurance Program (CHIP), the National Health Service Corps and Community Health Centers, and it would waive statutory PAYGO requirements to prevent the automatic spending cuts triggered by the tax legislation’s enactment. However, as a way to pay for the public health program extensions, the CR also contains a provision to cut $750 million from the Prevention and Public Health Fund through fiscal year 2022. As a reminder, the Prevention Fund, which is regularly targeted in spending negotiations, accounts for roughly 12 percent of the Centers for Disease Control and Prevention budget.

At this point, House Democrats say they will vote against the CR unless they get assurances that a final spending bill for fiscal year 2018 will provide parity between defense and non-defense spending and include a solution for Dreamers. Senate Democrats’ standing is unclear.

In sum, there is still much to negotiate in advance of tomorrow’s CR deadline. Continue to check AADR’s blog for updates.

UPDATE: On January 18, Congress voted to approve a CR to fund government operations through January 19 and includes a waiver of the PAYGO spending cuts. The bill provides temporary funding for CHIP and $550 million for community health centers that will is intended to last through March 31. The extension was partly paid for by the previously mentioned $750 million cut to the Prevention Fund, which will begin with a $100 million cut in FY 2019. 

Continuing Resolutions Will Likely Take Spending Talks into 2018

Last week, Congress approved and the president signed H.J. Res 123, a continuing resolution (CR) to fund the government through December 22. The CR, which avoids a shutdown and keeps federal programs operating at current levels, modified the expiration date of the previous CR set to expire on December 8. All of the previous CR provisions carry forward through December 22. After this date, another funding measure – either another CR or a spending bill funding the government for the remainder of fiscal year 2018 – will be needed. Despite the two-week buffer, there is already an expectation that a second CR into January will need to be passed to give lawmakers more time to complete their work.

These funding measures have implications for research and come into play as Republicans and Democrats negotiate longer-term deals over government funding, which include raising the defense and non-defense budget caps and passing an omnibus spending package for fiscal year 2018 appropriations.

By way of background, at the beginning of the fiscal year, October 1, 2017, spending limits on military and domestic programs came into effect as a result of 2011’s Budget Control Act. Consequently, if Congress wants to increase funding for defense and non-defense programs, lawmakers first need to pass a budget deal to lift the caps and then pass a spending bill containing the actual appropriations for fiscal year 2018 (e.g., funding for the Department of Health and Human Services, Education and Related Agencies). Importantly for the dental, oral and craniofacial research community, it is important to note that for the Senate’s proposed increases for the National Institutes of Health (NIH) and the National Institute of Dental and Craniofacial Research (NIDCR) to be realized, Congress will need to make a deal to raise the caps.

Congressional negotiators are currently considering a two-year budget deal to do just that – potentially raising the caps by more than $200 billion. However, Republicans and Democrats are working under different priorities. Republicans are looking to increase the defense budget – initially seeking a deal that would raise defense by $54 billion and non-defense by $37 billion in both fiscal 2018 and 2019 – and Democrats are seeking parity, proposing increasing defense and non-defense equally by $54 billion, a move that would raise the two-year cost above $200 billion.

In addition reaching consensus on top-line numbers and finding a solution for Democrats’ demand for parity, a number of challenges remain for the budget deal as negotiators look to it as a vehicle to pass other legislation, such as the reauthorization of the Children’s Health Insurance Program and a third emergency supplemental for communities affected by this year’s natural disasters.

According to CQ Roll Call, a GOP aide speculates that a budget agreement will be announced December 18, just a few days before the December 22 deadline to pass another funding measure.

AADR will be closely monitoring these developments over the coming weeks given their implications for research funding. Under a CR, NIH will be paying out grants at a lower rate than they would under regular appropriations (see a previous NIH CR notice here). Therefore, it is critical that Congress pass regular appropriations through the end of the year to provide stability for medical research.

If you have questions, please contact AADR’s Assistant Director of Government Affairs Lindsey Horan or continue to check the AADR Government Affairs and Science Policy Blog for updates.

What the Tax Reform Legislation Means for Research

The GOP’s move to overhaul the tax system is moving quickly, with the House and Senate working in parallel on tax reform legislation. Before diving into the respective bills’ potential implications for scientific research, let’s first look at where we stand in the legislative process.

On Thursday, November 16, House Republicans passed their tax bill (H.R. 1) along party lines, 227-205, completing the first step in the budget reconciliation process. The bill, which passed with no Democratic support and 13 Republicans in opposition, will now go to the Senate for its consideration. The budget reconciliation instructions are significant because they will allow the Senate to pass the bill without Democratic support, if needed. (If you want to dive deeper, see this article from The New York Times.)

In the other chamber, the Senate is concurrently working on its own bill, one that greatly differs from that of the House. The Senate’s bill, after four days in markup, passed the Senate Finance Committee on Thursday via a party-line vote of 14-12. The full Senate is expected to take up the bill after Thanksgiving. (Read more from POLITICO.)

While the bills vary in terms of their provisions, which will need to be resolved during conference, both have consequences for research:

At the highest level, the first thing to note about both the House and Senate bills is that they are each expected to add roughly $1.5 trillion to the federal debt over the next 10 years. While the provisions within the bills are likely to shift as negotiations continue among and between the two chambers, this figure is unlikely to change. So, what does this have to do with research specifically? Recent history has shown that when there is an increase in the deficit, the subsequent move from Congress is to take steps to cut discretionary spending. Non-defense discretionary spending, which includes health care and health research, would likely take the bulk of that cut.  Continue reading

AADR Provides Input on Trans-NIH Strategic Plan for Women’s Health Research

In September, the Office of Research on Women’s Health (ORWH) at the National Institutes of Health (NIH) released a Request for Information to solicit input from scientists and advocacy and patient communities on the trans-NIH Strategic Plan for Women’s Health Research. Specifically, ORWH was seeking feedback on three proposed cross-cutting themes and goals under consideration for the next iteration of the plan that is intended to promote allocation of NIH resources for conducting and support women’s health research across NIH Institutes and Centers.

For this reason, AADR wanted to stress to the ORWH that the cross-cutting themes and goals can and should be readily applied to oral and craniofacial health and disease research supported by NIH, and specifically by the National Institute of Dental and Craniofacial Research and submitted a set of comments to this effect:

The American Association for Dental Research (AADR) appreciates the opportunity to provide input on the trans-NIH Strategic Plan for Women’s Health Research. We commend the Office of Research on Women’s Health (ORWH) for putting forth the important cross-cutting themes in the Request for Information and believe they are an imperative step in ensuring that women’s health research is conducted and supported across NIH Institutes and Centers.

As such, we would note that the proposed themes and goals can and should be readily applied to oral and craniofacial health and disease research supported by NIH and specifically, the National Institute of Dental and Craniofacial Research. In addition to the manifestations of sex-based differences in dental, oral and craniofacial diseases and conditions, which may be affected by hormonal changes, genetic variations and more, contextual factors and life experiences also play an important role in oral health – an integral component of overall health.

Additionally, as ORWH deliberates its approach to the science of women’s health, we would encourage ORWH to consider that, while the biologic implications of sex are both justified and important in basic or translational disease models, there is also opportunity for clinical investigators – particularly in the multi-dimensional approach to the science of women’s health – to highlight the socioeconomic and behavioral aspects of gender as well as biological sex. As noted by Ioannidou(1), “economic inequality and hardship for women have resulted in limited access to oral care. As a result, gender emerged as a complex socioeconomic and behavioral factor in influencing oral health and outcomes.” Expanding the strategic plan to encompass gender may lead to a greater understanding of the life-course and psychosocial dimensions sought after by ORWH as well as equip our system for better care by considering health disparities, gender bias and therapeutic interventions.

 

(1) Ioannidou, E.: The sex and gender intersection in chronic periodontitis. Frontiers in Public Health 2017 Aug 4;5:189.

AADR Showcases NIDCR-Funded Research at Second Annual Public Health Fair

For the second year, the American Association for Dental Research (AADR) was a proud co-sponsor and exhibitor at the Coalition for Health Funding’s (CHF) Public Health Fair, an event aimed at educating members of Congress and their staff about the value and importance of public health, including federally-funded public health research and programs. Representative Rob Wittman (R-VA) kicked off the event, stressing the importance of public health research in our society and sharing his belief that prevention efforts are the wisest way to use public health dollars.

  

During this event, held in the Rayburn House Office Building Foyer on November 8, organizations – ranging from professional associations to federal agencies – convened on Capitol Hill to demonstrate how they are collectively working to improve the health and well-being of the American people. Whether through promoting preventive care and community health initiatives, conducting surveillance to prevent and respond to disease, or collaborating with researchers to determine how to make health care safer and more effective for all, each of these groups has a role to play in our nation’s health.

This year, AADR and the Friends of National Institute of Dental and Craniofacial

The finished product of the 3-D printing technology displayed at the Public Health Fair.

Research (FNIDCR) were joined at our booth by Mr. Walter Zimbeck and Mr. Mark Kauf, two researchers from Technology Assessment & Transfer, Inc., a Maryland-based research and development company, who received an NIDCR grant to develop 3-D printing technology for the production of high performance ceramic dental crowns, which has the potential to lower material and processing costs as well as improve restoration aesthetics and performance.

In addition to a display of some ceramic dental crowns they had produced, Mr. Zimbeck and Kauf set up a 3-D printer at the AADR booth so attendees could see the printing technology in action. To learn how the technology works, check out CHF’s Facebook live video.

AADR was proud to be a part of this event and enjoyed learning about other organizations’ public health initiatives. For more insight into the Public Health Fair, view the Facebook live recaps here, and scroll through the day’s Twitter stream by searching the hashtag #PublicHealthFair.

To learn more about the Coalition for Health Funding, visit the CHF website. For more information about AADR’s advocacy and government affairs work, visit our website or contact Lindsey Horan at lhoran@aadr.org.