AADR Participates in “Raise the Caps Thank You Day”

Last Friday, the House and Senate passed the Bipartisan Budget Act of 2018 (BBA). Among the provisions in the bill, the law raises the austere spending caps for non-defense discretionary programs – which covers virtually everything outside of national defense (e.g., scientific research, education, infrastructure) – by more than $130 billion over two years – the largest single increase to domestic spending since the American Recovery and Reinvestment Act of 2009 (ARRA).

The new spending limits were critical for Congress to provide increased funding for domestic programs, such as research at the National Institutes of Health (NIH) and the National Institute of Dental and Craniofacial Research (NIDCR). While lawmakers will still need to go through the process of allocating funds to the various appropriations subcommittees, including Labor-HHS, the new budget allows for greater certainty through fiscal year 2019 since the top-line levels have now been agreed upon.

In government affairs, equally important to educating members of Congress about our work is thanking them for advancing priorities of importance to our field. Therefore, NDD United, a coalition of which AADR is a member, has coordinated the #BBAValentines campaign to thank members of Congress who voted YES on the Bipartisan Budget Act of 2018 and to let them know their support is appreciated.

On this Valentine’s Day, view the list of lawmakers who voted YES on the BBA, and reach out to your elected officials to thank them for their vote via Twitter or email. Below is a collection of sample Tweets, but feel free to create your own:

  • Thank you [TWITTER HANDLE] for voting to #RaiseTheCaps and protect domestic funding for dental research. Your support is truly appreciated. #BBAValentines
  • On this Valentine’s Day, I extend a heartfelt thanks to [TWITTER HANDLE] for providing a much-needed funding increase for non-defense programs. Thanks for voting to #RaiseTheCaps! #BBAValentines
  • We couldn’t do what we do without you! Thanks [TWITTER HANDLE] for voting to #RaiseTheCaps, which will support important dental research. #BBAValentines

Finally, AADR would be remiss if we didn’t thank you, our members, who participated in the initial #RaiseTheCaps campaign. This campaign played an important role in expressing to members of Congress why raising the caps was important for the public health and health research communities, so thank you!

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

Following Brief Shutdown, Congress Passes Budget Deal and Continuing Resolution

The federal government experienced a roughly five hour shutdown last night, the second in 2018, after Kentucky Senator Rand Paul filibustered the sweeping budget deal and continuing resolution package (on the grounds of how much it would cost taxpayers) and refused to allow action on it before the midnight deadline.

However, passage of the Bipartisan Budget Act of 2018 in the Senate was inevitable, and around 1:30 a.m., the chamber voted 71-28 in favor of the spending package (a summary of the bill can be accessed here). The House, in a 240-186 vote, followed suit and passed the bill around 5:30 a.m., after which time it went to and was signed into law by the president.

The measure includes a deal to raise the spending caps by roughly $300 billion over two years, increasing the caps on non-defense discretionary spending by $63 billion in FY 2018 and $68 billion in FY 2019 and raising the defense caps by $80 billion in FY 2018 and $85 billion in FY 2019. By lifting the federal debt limit until March 2019, lawmakers will push off future confrontations over the spending caps until after the midterm elections.

In addition to identifying the top-line numbers, the package also includes a stopgap spending measure that will keep the government funded at current levels through March 23, 2018, giving appropriators six weeks to finalize final omnibus legislation for fiscal year (FY) 2018. Other significant provisions in the bill include:

  • An additional $2 billion for research at the National Institutes of Health (NIH);
  • A funding extension for the Children’s Health Insurance Program (CHIP) for an additional four years, lengthening the six-year extension that Congress passed last month;
  • $7 billion over two years for community health centers;
  • $6 billion for new grants and prevention programs to combat the mental health and opioid crises; and
  • A $1.35 billion cut to the Prevention and Public Health Fund over 10 years (significantly less than the $2.85 billion proposed in the House’s CR).

With the negotiations on the overall spending caps out of the way, lawmakers will now begin to iron out the final details for FY 2018 funding legislation. While the bill makes a step in the right direction, there is still concern about how Congress will divvy up the 302(b) allocations, the amount of funding given to the respective appropriations subcommittees, such as Labor, Health and Human Services, Education and Related Agencies. The Coalition for Health Funding, of which AADR is a member, recently sent a letter to lawmakers urging them to ensure health-related departments receive a fair share of relief.

As negotiations transpire, the community will encourage lawmakers for proportional relief for the agencies and programs of the Department of Health and Human Services (HHS) and will carefully be monitor for any policy riders in the final FY 2018 omnibus legislation that could undercut public health.

Check back on the blog for updates, and feel free to contact Assistant Director of Government Affairs Lindsey Horan if you have questions.

AADR Provides Dental Research Perspective in Two Strategic Planning Processes

The American Association for Dental Research (AADR) has recently been engaged in the strategic planning process at the National Institutes of Health (NIH) by submitting feedback on two Requests for Information (RFIs): the RFI on the Office of Disease Prevention Strategic Plan for Fiscal Years (FY) 2019-2023 and the RFI Soliciting Input for the Tribal Health Research Office Strategic Plan, FY 2018-2022.

RFIs are one way that AADR elevates the fields of dental, oral and craniofacial research and helps ensure that oral health is represented as being key to overall health. More details on each opportunity and AADR’s response are as follows:

RFI: Office of Disease Prevention Strategic Plan for FY 2019-2023

As part of its charge to improve public health by increasing the scope, quality, dissemination and impact of NIH’s prevention research, the Office of Disease Prevention (ODP) is crafting a new strategic plan on activities related to research in disease prevention and the dissemination of research results. The latest RFI from the ODP sought to gather broad public input on the latest iteration of the Office’s strategic plan, including its five proposed strategic priorities.

AADR responded to the RFI and, throughout its response, stressed oral health research’s role as part of this important conversation. AADR highlighted how much of the progress the United States has made with respect to oral health thus far is a result of effective prevention and treatment efforts, and noted how the  two most common dental diseases – dental caries and periodontal diseases – are thought to be largely preventable.

Read AADR’s full set of comments to the ODP here.

RFI: Soliciting Input for the Tribal Health Research Office Strategic Plan FY 2018-2022

In 2015, the NIH established the Tribal Health Research Office (THRO) “to coordinate tribal health research-related activities across the agency to effectively serve tribal nations and individuals.” The THRO is building upon its charge by working on its first strategic plan, which seeks to “improve, promote and strengthen communication between NIH and American Indian/Alaska Native (AI/AN) communities, as well as communication among its Institutes, Centers and Offices (ICOs), on Indigenous health research and discoveries.”

The THRO’s recent RFI solicited feedback on the five priorities under consideration for the first strategic plan.

AADR’s feedback included commending the THRO for supporting the bidirectional flow of information between NIH ICOs and stakeholders and tribal communities, and made a number of suggestions. Suggestions from AADR included having the NIH pursue direct partnerships with the tribes and tribal Institutional Review Boards, employ incentives for the use of tribal employees and interns in funded research activities or for collaboration with tribal colleagues, and incorporate oral health as a priority area.

Read AADR’s full set of comments to the THRO here.*

*AADR often relies on the subject-matter expertise of our members to help inform responses to Requests for Information/Comment. Given their backgrounds and perspectives, AADR consulted with members Judith Albino, PhD, Colorado School of Public Health, and David Drake, PhD, MS, University of Iowa College of Dentistry and Dental Clinics, on the THRO RFI. AADR would like to thank Drs. Albino and Drake for their comments, which were integral to shaping AADR’s response. 

HHS Delays Implementation of Common Rule Revisions by Six Months

Last week, the U.S. Department of Health and Human Services (HHS) issued an Interim Final Rule that will delay the implementation of revisions to the Federal Policy for the Protection of Human Subjects (more regularly referred to as the Common Rule) from January 19, 2018 to July 19, 2018. The announcement came just two days before most provisions in the rule were set to go into effect.

Changes to the Common Rule have been in motion since September 2015, when HHS and other Common Rule agencies published a Notice of Proposed Rulemaking (NPRM) that solicited more than 2,000 comments and led to an extensive review process. The final rule was released in January 2017 with an “effective” date of January 19, 2018.

Included in the final rule were changes, such as:

  • The requirement for consent forms “to provide potential research subjects with a better understanding of a project’s scope, including its risks and benefits, so they can make a more fully informed decision about whether to participate.”
  • The requirement – in several cases – to use a single institutional review board (IRB) for multi-institutional research studies. The original NPRM proposal was revised “to add substantial increased flexibility in now allowing broad groups of studies (instead of just specific studies) to be removed from this requirement.”
  • New categories and classification of existing categories, including “a new exemption for secondary research involving identifiable private information if the research is regulated by and participants protected under the HIPAA rules.”
  • The new option for researchers conducting studies on stored identifiable data or identifiable data specimens to rely on broad consent obtained for future research as an alternative to seeking IRB approval to waive the consent requirement.

– Changes pulled from HHS press release (changes between proposed and final rule also included in release).

According to the latest notice, the implementation delay “both provides additional time to regulated entities for the preparations necessary to implement the 2018 Requirements, and additional time for the departments and agencies listed…to seek input from interested stakeholders through a notice and comment rulemaking process that allows for public engagement on the proposal for a further implementation delay.”

Those wishing to comment on the delay of revisions – and a potential further delay – may do so at regulations.gov (docket number: HHS– OPHS–2017–0001). The Federal Register notice containing more information can be found here.

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.

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