I am pleased to join the ASN as the first full time Director of Public Policy. I especially look forward to working with the ASN’s Council, Policy & Public Affairs Committee and members, as we develop the Society’s activities in the advocacy, policy, and education arenas. I will primarily focus on coordinating the aforementioned activities, by identifying and tracking relevant issues, developing the Society’s positions on these issues, and then vigorously advocating for ASN's position.

In addition, I will build and maintain relationships with federal legislative and regulatory bodies; coordinate relationships with non-governmental regulators and collaborators; build, maintain and participate in coalitions; develop advocacy services and tools for use by ASN members; and pursue entrepreneurial initiatives to expand society activities.

Within the context of these activities, ASN’s Policy & Public Affairs Committee and I are finalizing the ASN Public Policy Agenda for 2003. The beginning of the year presents new opportunities as well as new challenges, and the ASN Policy & Public Affairs Committee will work hard to make advances in the following areas. ASN’s issue priorities for 2003 include supporting adequate National Institutes of Health (NIH) funding increases, improving collaborative efforts with NIH/National Institutes of Diabetes & Digestive & Kidney Diseases (NIDDK), sustaining the NIDDK clinical trials consortium, promoting chronic kidney disease public awareness, identifying and improving workforce-related issues (loan repayment, J-1 Visas), as well as regulatory issues and their impact on workforce issues, and assisting with the Centers for Medicare & Medicaid Services (CMS) dialysis demonstration project.

The ASN will also actively pursue opportunities to collaborate with other organizations and coalitions to promote kidney disease research and improve awareness of kidney disease and other important health-related issues.

To help advance the public policy agenda and keep members informed, the ASN will dedicate one issue a month of its new electronic newsletter, Renal Express, to its Policy & Public Affairs agenda, which will be distributed the third Tuesday of every month. The purpose of the e-newsletter is to educate and engage Society members to become informed advocates. The e-newsletter will provide useful information on advocacy efforts, updates on relevant congressional health committee hearings, debates and activities, and ASN coalition partnerships.

I am excited about working with all of you to advance the policy and public affairs’ issues important to the Society. If we work together and effectively collaborate with NIH, congressional champions, other kidney disease organizations and non-governmental collaborators, I believe we can make great strides.

I encourage you to share your thoughts and views on these and other important issues. Please feel free to contact me if you have questions, comments or suggestions by email or by phone at 202-416-0646.

Sincerely yours,



Paul C. Smedberg

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Senate and House conferees and the Administration have finally reached a compromise on the Fiscal Year (FY) 2003 Omnibus Spending Bill, ending months of gridlock. Congressional leaders and the biomedical research advocacy community are relieved that funds will start flowing for health and biomedical research programs, such as the National Institutes of Health (NIH), Agency for Healthcare Research and Quality, and National Science Foundation.

Congressional conferees agreed to a FY 2003 NIH funding level of $27.159 billion. This figure is $3.7 billion higher than the FY 2002 funding level and in effect completes the five year doubling effort, which had strong bipartisan support. NIDDK received FY 2003 funding of $1.633 billion – an increase of $169.7 million.

Overall, the biomedical research advocacy community is pleased with the final compromise on the proposed NIH figure, given the complexities of the negotiations, pressure by the Administration to hold down FY 2003 domestic spending and influential congressional members pushing for increased funding for education and homeland defense. However, advocates are not so confident NIH will receive appropriate funding increases in FY 2004 and beyond. Should the funding dramatically decrease in FY 2003 as proposed by the Administration, the reduction will likely affect the distribution of current and prospective NIH grants. This may force the NIH to decide between withdrawing long-term grants or awarding fewer new grants.

For more information on the FY 2004 budget, visit the NIH website.

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Centers for Medicare and Medicaid Services (CMS) researchers predict that health care spending will outpace national economic growth between 2002 and 2012, if it remains left unchecked. As reported in the health policy journal "Health Affairs," CMS researchers state that national health expenditures will increase at an average annual rate of 7.3 percent, reaching $3.1 trillion by 2012. The study also states that the health share of the Gross Domestic Product is projected to increase from 14.1 percent to 17.7 percent in 2012. For more information, visit the CMS website.

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Two ASN staff members, Karen Campbell, Executive Director, and Paul Smedberg, Director of Policy & Public Affairs, met with Brady Augustine, Senior Advisor to the Administrator and new End-Stage Renal Disease (ESRD) Policy Director at the Centers for Medicare and Medicaid Services (CMS). Mr. Augustine, who comes to CMS from Gambro, brings a solid working knowledge of CMS renal issues. The meeting provided ASN an excellent opportunity to summarize our Society's mission and activities, emphasize the Society’s four advisory groups, outline our priorities for the coming year and discuss Mr. Augustine’s goals and priorities. The meeting was an important first step in building a close working relationship with Mr. Augustine and the CMS ESRD staff.

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The Renal Coalition comprised of the ASN, National Kidney Foundation (NKF), American Kidney Fund (AKF), American Nephrology Nurses Association (ANNA), American Association of Kidney Patients (AAKP), Renal Physicians Association (RPA), and National Renal Administrators Association (NRAA), recently met with CMS ESRD officials. The Renal Coalition members were briefed by CMS staff on agenda items, including AARP Medigap Insurance, average wholesale price reimbursement for separately billable ESRD drugs, billing for hospital-based dialysis units, ESRD disease management demonstration, and the Benefit Improvement and Protection Act (BIPA) mandated bundling study and disruptive patient issues. Also attending the meeting was Brady Augustine, Senior Advisor to the Administrator, who outlined new initiatives in the ESRD section at CMS. Mr. Augustine encouraged the Renal Coalition to be an even more pro-active participant in the CMS ERSD Open Door Information Forums. The coalition meets with CMS officials on a regular basis.

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Earlier this month, Dr. Josephine Briggs, Director of NIDDK’s Division of Kidney, Urologic, & Hematologic Diseases (DKUH) met with ASN's Council to discuss collaborative efforts between ASN and the NIH. At the meeting, Dr. Briggs and the ASN Council discussed the NIH budget in detail, as well as the recent clinical trials consortium meeting. The ASN looks forward to strengthening its working relationship with the NIH. For more information, visit the NIDDK website.

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Efforts are underway in the House of Representatives to increase the number of physicians practicing in medically underserved areas. Representative Sheila Jackson Lee (D-TX) introduced the “Rural and Urban Health Care Act” that includes a provision to increase the number of waivers each state may grant to J-1 physicians. The proposed legislation would increase the number of waivers from 30 to 40 per state. Under the provision, the current Conrad Program, which was authorized by Congress last year, would expand.

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The House Energy and Commerce Committee recently approved the Organ Donation Improvement Act of 2003 (H.R. 399). This Act would allow the Secretary of Health and Human Services (HHS) to award grants or contracts to states, transplant centers, and other public entities to assist with expenses incurred by organ donors. The grants would cover travel and other basic costs, but only if the donor lives in a different state from the recipient. HHS would also provide grants to states, in order to raise awareness about organ donation, through public education and outreach activities.

The program's success would be determined by an annual progress report HHS would be required to submit to Congress on how public education activities have increased organ donation. For more information on H.R. 399, visit the House website.