Pediatric Policy Council Update
The APS and SPR are members of the Pediatric Policy Council (PPC) which actively advocates for children and academic pediatrics at the federal level. APS representatives to the PPC are Drs. DeWayne Pursley and Jonathan M. Davis; Drs. Joyce Javier and Shetal Shah represent the SPR.
The PPC also includes representatives from the Academic Pediatric Association (APA) and the Association of Medical School Pediatric Department Chairs (AMSPDC). The PPC is based in the Washington DC office of the American Academy of Pediatrics (AAP), who supplies staff and other support.
The latest advocacy developments are summarized by the PPC below
PPC CAPITOL CONNECTION
October 16, 2020
What Matters Now in Washington:
- Scott Denne will complete his term as PPC chair, having served since September 2018. More…
- The 2020 Census has ended in-person enumeration activities following a Supreme Court ruling allowing the move. Concerns remain about political interference in the decennial count. More…
- The federal government has proposed limiting the length of time that foreign medical trainees can remain in the country legally, raising serious concerns for the pediatric research pipeline and sufficiency of the pediatric workforce, particularly in underserved areas. More…
- After months of inaction, additional COVID-19 relief legislation remains elusive as lawmakers continue to disagree over the cost and scope of a future package. More…
- With the 2020 election just weeks away, the PPC Rx to Vote is here to help pediatric researchers and families get out the vote. More…
- Pfizer will begin enrolling children as young as 12 in its COVID-19 vaccine trials. More…
- Nonpartisan scientific bodies are denouncing political interference in federal public health policymaking. More…
- PPC members authored policy commentaries in Pediatric Research exploring the intersections of child health policy, advocacy, and pediatric research. More…
PPC Leadership Transition Begins following Biennial Chair Election. Dr. Scott Denne, MD, will complete his term as PPC chair, having served since September 2018.
During his term as chair, Dr. Denne led the PPC’s advocacy to support an accurate, complete 2020 Census that addresses the historical undercount of young children, to reduce the impact of gun violence on young people through federally funded public health research, and to ensure the federal government’s response to the opioid epidemic includes an appropriate focus on maternal-child health. He also oversaw the PPC’s response to the COVID-19 pandemic, helping identify advocacy needs to support academic pediatricians during the public health crisis and serving as a leading academic pediatric voice for the importance of science in the public policy response to the pandemic. Dr. Denne also continued years long advocacy to ensure the appropriate inclusion of children in federally funded clinical trials and built sustained relationships between the PPC and key leaders at the National Institutes of Health (NIH). The PPC is grateful to Dr. Denne for his service, which also includes 6 years as a representative to the PPC from the American Pediatric Society prior to serving as chair.
Uncertainty Clouds 2020 Census As Supreme Court Intervenes. The Supreme Court has allowed the Trump administration to end in-person enumeration activities for the 2020 Census early. In a Tuesday ruling, the Court blocked a district court ruling that had required the Census to continue counting Americans through the end of the month. Before the Supreme Court’s ruling, two lower courts had ruled against plans by top Trump administration officials to cut the count short. The Census Bureau announced shortly after the ruling that October 15 would be the last day of data collection.
The controversy stems from plans released by the federal government earlier this year to modify Census operations in light of the COVID-19 pandemic, which forced the agency to delay in-person enumeration activities to reach households that have not yet completed the Census questionnaire on their own. Plans released at the time indicated that Census employees would continue this portion of the count through October 31 and request an extension of the deadlines in law for reporting Census data to Congress. Based on the deadlines set by Congress, initial data used to apportion the 435 seats in the House of Representatives among the states is due by December 31, with other data due early the following year.
Political appointees in the federal government quickly walked back the delayed timeline, indicating that the agency would complete the count on the timeline set out in law despite concerns that doing so would reduce the accuracy of the Census. Delivering the data by December 31 would ensure that the Trump administration has the chance to exclude undocumented immigrants from the final count used to determine political representation in Congress regardless of the outcome of November’s election—a move already struck down by a different federal court.
It is essential that Congress extend the reporting deadlines in law to allow for critical data validation and analysis activities, a move the Pediatric Policy Council has endorsed. The early end to Census counting activities continues to raise serious questions about the accuracy of the 2020 Census, with experts continuing to worry about the quality of the final count. Despite official reporting that more than 99 percent of households have been counted, experts have raised concerns that the Census Bureau has cut corners to get there.
Proposed Limits on J-1 Visas threaten Medical Training, Pediatric Research. In late September, the U.S. Department of Homeland Security (DHS) proposed instituting fixed terms for certain visas, including J-1 visas that are frequently used by individuals from abroad pursuing U.S.-based residency programs. Under current regulations, J-1 visas are issued under a “duration of status” designation, which allows individuals to stay in the country as long as they are complying with the terms of their visa. Trainees are closely monitored by the Educational Commission for Foreign Medical Graduates to ensure they are continuing to comply with the terms of their visa. The proposed rule would end this long-running practice, implementing 2- or 4-year fixed terms for these types of visas. While visa holders would be able to request an extension, the additional administrative burden would render many physicians unable to continue their training. The PPC representatives are working to raise the voice of academic pediatricians on this issue.
As Election Nears, Conflicting Rhetoric and Little Meaningful Legislating on COVID Relief. Lawmakers remain at loggerheads over COVID relief legislation despite months of negotiations between Republicans and Democrats. Hope was high over the summer that the need to aid struggling Americans and small businesses would force bipartisan compromise on another legislative package to address the pandemic. However, despite seemingly daily reports that a deal between congressional Democrats and White House officials is near, an agreement has yet to materialize.
The impasse has grown in part out of a disagreement between key players over just how much aid is needed and what issues the federal government needs to address. Republicans and Democrats remain hundreds of billions of dollars apart, with House Democrats proposing $2.2 trillion in spending—down from an initial proposal of $3.4 trillion—and Senate Republicans proposing spending in the range of $500 billion. Further compounding the problem, White House negotiators and Senate Republicans have been unable to coalesce around a proposal. Indeed, Trump administration officials negotiating with House Democrats have proposed nearly $1.8 trillion in spending, an amount that seems unlikely to garner support from a majority of Senate Republicans.
Whether lawmakers are interested in brokering a deal with the election just weeks away is anyone’s guess. The House of Representatives passed Democratic leadership’s $2.2 trillion package at the beginning of the month on a near party line vote, a sign that negotiations have been unsuccessful despite rosy statements to the contrary. While the package included numerous pediatric priorities, including the, the bill does not appear poised to become law in its current form. Of note, the House legislation includes the PPC-endorsed VACCINES Act to address vaccine hesitancy through public awareness campaigns and piloting innovative approaches to improve vaccination rates in high-risk communities, funding the proposed programs at $1 billion. For his part, President Trump has vacillated in his demands, calling for massive spending packages one moment and announcing at the next that he would be ending negotiations.
—Despite Gridlock, Congress Manages to Keep Government Open with Stopgap Spending Measure. Congress passed a short-term funding bill to avoid a federal government shutdown just hours before the next fiscal year was slated to begin. The bill extends about $1.4 trillion in government funding until December 11, leaving thorny government spending issues for Congress to handle after the election.
Rx to Vote Can Help Academic Pediatricians Get out the Vote. With the election just weeks away, the Rx to Vote is here to help academic pediatricians in their efforts to get out the vote. Pediatric researchers have an important role to play in ensuring children have a voice this election. The Rx to Vote, available in English and Spanish, allows academic pediatricians to share actionable information with patients and families about registering to vote and the importance of completing the 2020 Census. The tool includes a customized QR code and text short code to allow patients and families to quickly and easily access voter registration information online or by text.
Pfizer to Include Children As Young as 12 in COVID-19 Vaccine Trial. Pfizer has announced that it will begin enrolling children as young as 12 in its ongoing vaccine trial, a move that comes as pediatricians advocate that the federal government ensure the inclusion of children in COVID-19 vaccine trials. In a letter to Health and Human Services (HHS) Secretary Alex Azar and Food and Drug Administration (FDA) Commissioner Stephen Hahn, the AAP urged for transparency, scientific rigor, and the inclusion of children in trials for a safe and effective vaccine against the COVID-19 virus. The letter discusses the importance of understanding unique safety and efficacy responses in children so that any vaccines that are eventually licensed include child-specific safety, tolerability, and dosing information for children. Such inclusion considerations must also extend to individuals of diverse racial and ethnic backgrounds, pregnant women, and children with underlying health conditions. It remains essential that all COVID-19 vaccine candidates be studied in children of all ages.
Respected Scientific Authorities Decry Political Interference in Response to Pandemic. The leaders of the National Academy of Medicine and the National Academy of Sciences issued a joint statement in late September raising alarm about political interference in science and public health. The statement emphasizes the importance of transparent, science-based decision-making in ending the pandemic and calls efforts to discredit the best science and scientists threats to the health and welfare of all Americans.
The statement comes as a growing number of reports document political interference in issues of public health. House Democrats are investigating reports that Trump administration officials tampered with content in the Centers for Disease Control and Prevention’s widely respected Morbidity and Mortality Weekly Reports (MMWR). Later reporting indicated that political appointees minimized references to children in one MMWR to better align with the administration’s school reopening narrative. Separately, the White House attempted to block stricter COVID-19 vaccine guidelines developed by the FDA to bolster public confidence in any COVID-19 vaccine approved by the agency. FDA Commissioner Hahn moved ahead with the stricter guidance despite the opposition.
In an unprecedented move, the New England Journal of Medicine condemned the federal government’s response to the pandemic in part over the failure of leaders to listen to scientific expertise. It closed with a call for Americans to remove “dangerously incompetent” political leaders from office.
PPC POLICY COMMENTARIES. Members of the PPC have authored commentaries detailing the policy implications of research published in Pediatric Research. You can read these PPC-authored commentaries online:
- “Challenges and opportunities in academic medicine” APS racism series: at the intersection of equity, science, and social justice by Leslie R. Walker-Harding, MD, Clifford W. Bogue, MD, Karen D. Hendricks-Munoz, MD, MPH, Jean L. Raphael MD, MPH, and Joseph L. Wright, MD, MPH
- “Holistic Promotion of Scholarship and Advancement” APS racism series: at the intersection of equity, science, and social justice by Steven Abman, MD
- “Racism as a public health issue” APS racism series: at the intersection of equity, science, and social justice by Joseph L. Wright, MD, MPH, James N. Jarvis, MD, Lee M. Pachter, DO, and Leslie R. Walker-Harding, MD
- “Organizational solutions: calling the question” APS racism series: at the intersection of equity, science, and social justice by DeWayne M. Pursley MD, MPH, Tamera D. Coyne-Beasley, MD, MPH, Gary L. Freed, MD, MPH, Leslie R. Walker-Harding, MD, and Joseph L. Wright, MD, MPH