Category: Policies

Kellyanne Conway’s ‘opioid cabinet’ sidelines drug czar’s experts

President Donald Trump’s war on opioids is beginning to look more like a war on his drug policy office.

White House counselor Kellyanne Conway has taken control of the opioids agenda, quietly freezing out drug policy professionals and relying instead on political staff to address a lethal crisis claiming about 175 lives a day. The main response so far has been to call for a border wall and to promise a “just say no” campaign.

Trump is expected to propose massive cuts this month to the “drug czar” office, just as he attempted in last year’s budget before backing off. He hasn’t named a permanent director for the office, and the chief of staff was sacked in December. For months, the office’s top political appointee was a 24-year-old Trump campaign staffer with no relevant qualifications. Its senior leadership consists of a skeleton crew of three political appointees, down from nine a year ago.

“It’s fair to say the ONDCP has pretty much been systematically excluded from key decisions about opioids and the strategy moving forward,” said a former Trump administration staffer, using shorthand for the Office of National Drug Control Policy, which has steered federal drug policy since the Reagan years.

The office’s acting director, Rich Baum, who had served in the office for decades before Trump tapped him as the temporary leader, has not been invited to Conway’s opioid cabinet meetings, according to his close associates. His schedule, obtained under a Freedom of Information Act request, included no mention of the meetings. Two political appointees from Baum’s office, neither of whom are drug policy experts, attend on the office’s behalf, alongside officials from across the federal government, from HHS to Defense. A White House spokesperson declined to disclose who attends the meetings, and Baum did not respond to a request for comment, although the White House later forwarded an email in which Baum stressed the office’s central role in developing national drug strategy.

The upheaval in the drug policy office illustrates the Trump administration’s inconsistency in creating a real vision on the opioids crisis. Trump declared a public health emergency at a televised White House event and talked frequently about the devastating human toll of overdoses and addiction. But critics say he hasn’t followed through with a consistent, comprehensive response.

He has endorsed anti-drug messaging and tougher law enforcement. But he ignored many of the recommendations from former New Jersey Gov. Chris Christie’s presidential commission about public health approaches to addiction, access to treatment, and education for doctors who prescribe opioids. And he hasn’t maintained a public focus. In Ohio just this week, it was first lady Melania Trump who attended an opioid event at a children’s hospital. The president toured a manufacturing plant and gave a speech on tax cuts.

Much of the White House messaging bolsters the president’s call for a border wall, depicting the opioid epidemic as an imported crisis, not one that is largely home-grown and complex, fueled by both legal but addictive painkillers and lethal street drugs like heroin and fentanyl.

“I don’t know what the agency is doing. I really don’t,” said Regina LaBelle, who was the drug office’s chief of staff in the Obama administration. “They aren’t at the level of visibility you’d think they’d be at by now.”

Conway touts her opioids effort as policy-driven, telling POLITICO recently that her circle of advisers help “formalize and centralize strategy, coordinate policy, scheduling and public awareness” across government agencies.

That’s exactly what the drug czar has traditionally done.

Conway’s role has also caused confusion on the Hill. For instance, the Senate HELP Committee’s staff has been in touch with both Conway and the White House domestic policy officials, according to chairman Lamar Alexander’s office. But lawmakers who have been leaders on opioid policy and who are accustomed to working with the drug czar office, haven’t seen outreach from Conway or her cabinet.

“I haven’t talked to Kellyanne at all and I’m from the worst state for this,” said Sen. Shelley Moore Capito, a Republican from West Virginia, which has the country’s highest overdose death rate. “I’m uncertain of her role.” The office of Sen. Rob Portman (R-Ohio), another leader on opioid policy, echoed that — although Portman’s wife, Jane, and Conway were both at the event with Melania Trump this week.

Some drug abuse experts and Hill allies find a silver lining, noting that Conway’s high rank brings White House muscle and attention.

“If I want technical advice, I’m going to work with Baum,” said Rep. Tom MacArthur (R-NJ), a co-chair of the Bipartisan Heroin Task Force. “If I want to get a message to the president, Kellyanne is somebody that I know I can talk to.”

“It’s a really good sign that one of the president’s top advisers has been assigned to such an important topic,” said Jessica Hulsey Nickel, president and CEO of the Addiction Policy Forum.

Baum’s email called the drug office the “lead Federal entity in charge of crafting, publishing and overseeing the implementation of President Trump’s National Drug Control Strategy,” which multiple agencies review. He called Conway’s opioids cabinet an “interagency coordinating apparatus for public-facing opioids-related initiatives” and said that it was not overseeing national policy. But several administration officials did say her cabinet was indeed focused on a variety of policies.

Whatever Conway’s ties to the president, her career has been in polling and politics, not public health, substance abuse, or law enforcement.

Some of her “cabinet” participants do have a broad, general health policy background. But they don’t match the experience and expertise of the drug office’s professional staff. In her circle is Lance Leggitt, the deputy director of the White House’s Domestic Policy Council who was also chief of staff to former HHS Secretary Tom Price. Another top Price aide, Nina Schaefer, recently returned to the Heritage Foundation. The conservative think tank then touted her as having managed “the development of the HHS response to the opioid abuse crisis,” but when POLITICO recently tried to contact her, she said through a spokesperson she was not an expert on the topic.

Among the people working on the public education campaign that Trump promised is Andrew Giuliani, Rudy Giuliani’s 32-year-old son, who is a White House public liaison and has no background in drug policy, multiple administration sources told POLITICO. Nor has Conway spent her career in the anti-opioid trenches.

“Kellyanne Conway is not an expert in this field,” said Andrew Kessler, the founder of Slingshot Solutions, a consulting group that’s worked on substance abuse with many federal agencies. “She may be a political operative and a good political operative,” he added. “But look. When you appoint a secretary of Labor, you want someone with a labor background. When you appoint a secretary of Defense, you want someone with a defense background. The opioid epidemic needs leadership that ‘speaks’ the language of drug policy.”

The set-up befuddles other experts who’ve worked on substance abuse for prior administrations. Fresh ideas are fine, they say. But the drug office has a purpose.

“The whole reason we created ONDCP in 1988 was to be a coordinating force with power in the government and to bring together 20 agencies, many reluctant to be involved in drug control,” said Bob Weiner, who served in that office in both the George W. Bush and Clinton White Houses. “This is exactly when the agency should get maximum support from the White House,” he added.

An ONDCP spokesperson told POLITICO the office “works closely with other federal agencies and White House offices, including Kellyanne Conway’s office, to combat the opioid crisis” but declined to say whether the office’s career experts have attended any of her “opioids cabinet” sessions. The drug office is still crafting the annual drug control strategy, outside the Conway group, administration officials said.

A senior White House official confirmed that officials considered kicking off the media campaign with a big splash during the Super Bowl, but that fell through. Beyond that, many experts on drug policy and substance abuse say messaging alone won’t solve the problem anyway. People with addiction need treatment, and many people get addicted in the first place to painkillers their doctors have prescribed. An ad campaign won’t solve that.

One big test for the drug office will come when Trump releases his budget Monday, which is expected to slash the office’s budget, turning much of its work over to HHS and the Department of Justice. Both departments are developing their own opioid approaches; in past administrations, the drug czar would have coordinated. Lawmakers are already sounding the alarms over the budget plan.

A bipartisan group of senators last week wrote a letter to White House budget director Mick Mulvaney, urging him to reconsider and maintain the office’s programs that “prevent and fight against the scourge of drug abuse.”

Pushback to a similar proposal last year led the Trump administration to reverse the decision and maintain the office’s budget. Lawmakers hope that there will be a similar outcome this time — along with a smarter utilization of the drug policy office.

“What we haven’t seen is the kind of coordination of critical programs that ONDCP has traditionally done,” said Sen. Maggie Hassan, a Democrat from New Hampshire, another state with one of the highest overdose death rates in the country.

Trump officials say it was the Obama administration that began undermining the drug policy office, demoting the director from the Cabinet, shrinking the staff and stressing the health aspects more than a law enforcement-focused “war on drugs.” They say the emergency requires a new approach.

Bob Dupont, who served as the second White House drug czar under President Gerald Ford, before the formal drug policy office was created, and still informally advises the Justice Department on drug policy, believes the White House will eventually realize it needs the expertise that ONDCP has to offer.

The West Wing doesn’t “have the staff or capability” to carry out drug policy work like ONDCP does, Dupont told POLITICO. “I don’t think swashbuckling your approach is going to last very long.”

[Politico]

Trump: ‘I’d love to see a shutdown’ over immigration

President Donald Trump said on Tuesday he supports a government shutdown if Democrats won’t agree to tighten immigration laws, undercutting ongoing bipartisan negotiations on Capitol Hill.

The comment, which came during a White House meeting on the violent MS-13 gang, was not well received in the room. Rep. Barbara Comstock, a Virginia Republican who represents a district with thousands of federal workers, confronted Trump about the remark and urged him to avoid another government shutdown.

“If we don’t change it, let’s have a shutdown,” Trump said of the nation’s immigration laws. “We’ll do a shutdown and it’s worth it for our country. I’d love to see a shutdown if we don’t get this stuff taken care of.”

He added: “If we have to shut it down because the Democrats don’t want safety, and unrelated but still related, they don’t want to take care of our military, then shut it down. We’ll go with another shutdown.”

The government will run out of funding Thursday if negotiators can’t strike a deal.
Several Republican aides working on the budget deal have voiced concern to CNN that the President’s comments about a shutdown may cause things to fall apart.
“Holding my breath right now,” texted one senior Republican working on the deal.

The issue is whether House Democrats — who have for months been outright resistant to signing onto a budget agreement without a resolution on the Deferred Action for Childhood Arrivals program — will now back away from the breakthrough deal negotiators are approaching.

The President’s remarks happened at the same time Senate Majority Leader Mitch McConnell and Senate Democratic Leader Chuck Schumer, in separate news conferences, touted the progress on the talks and made clear a deal was close. The talks also separate the issue from immigration altogether — long the GOP goal — making the President’s comments somewhat confusing.

“Things are in a good place, but also fragile,” another GOP aide said, noting all of the moving parts in the talks. “We could do without anything inflammatory for a couple of days.”

Speaking shortly after Trump during the White House meeting, Comstock said she would not back such a move and urged Trump to avoid it.

“We don’t need a government shutdown on this,” she said. “I think both sides have learned that a government shutdown is bad.”

At a later event, Comstock described her comments with Trump as “a very civil discussion” and that she doesn’t “support government shutdowns.

When asked to clarify his remarks at the end of the roundtable, Trump told reporters again that he would shut down the government over immigration.

“I would shut it down over this issue. I can’t speak for everybody at the table but I will tell you, I would shut it down over this issue,” he said, adding that if the US doesn’t straighten out its borders “we don’t have a country. Without borders we don’t have a country.”
Rep. Pete King, R-New York, who attended the White House meeting, told reporters afterward that he doesn’t think the government will shutdown over immigration policy, despite Trump’s comments.

“I don’t see that in the offing,” King said.

Schumer responded to Trump’s shutdown threat, saying it “speaks for itself.”

“We had one Trump shutdown, nobody wants another, maybe except him,” Schumer said.
Trump oversaw a multi-day government shutdown last month over immigration reform.

Though Trump opposed that government shutdown, he has previously said the United States could use a government work stoppage.

“Our country needs a good ‘shutdown’ in September to fix mess,” he tweeted in May.

[CNN]

Trump chief of staff John Kelly suggests some Dreamers ‘too lazy’ and ‘too afraid’ to sign up for DACA

Some immigrants may have been “too afraid” or “too lazy” to sign up for the Obama-era program that offered protection from deportation, White House chief of staff John Kelly said Tuesday as he defended President Donald Trump’s proposal aimed at breaking the impasse on immigration.

In remarks to reporters, Kelly described Trump’s plan, which would provide a path to citizenship for up to 1.8 million people — more than Democrats had sought. He noted extension of the Deferred Action for Childhood Arrivals program was “beyond what anyone could have imagined.”

“There are 690,000 official DACA registrants and the president sent over what amounts to be two and a half times that number, to 1.8 million,” he said.

“The difference between (690,000) and 1.8 million were the people that some would say were too afraid to sign up, others would say were too lazy to get off their asses, but they didn’t sign up,” Kelly said.

Kelly spoke as lawmakers have deadlocked in an effort to reach a bipartisan deal on protecting from deportation recipients of the program, known as “Dreamers.”

Barring a last-minute agreement — which seems unlikely — Senate Majority Leader Mitch McConnell, R-Ky., has said his chamber will begin considering the issue, a debate that GOP leaders expect to start next week.

Kelly said Trump would likely reject an effort to pass a short-term extension for the program, which is set to expire on March 5.

But he also noted the March 5 deadline may not have immediate impact. He said immigrants currently protected won’t be priorities for deportation as long as they do not commit crimes.

Kelly said lawmakers need a deadline to force action.

“What makes them act is pressure,” he said.

Kelly in remarks to reporters later Tuesday seemed to double down on his earlier comments about those eligible for DACA, saying “some of them just should’ve probably gotten off the couch and signed up.”

But Kelly added, “But that doesn’t really matter now because President Trump has given them the status,” referring to Trump’s proposal.

In exchange for making citizenship a possibility, Trump wants $25 billion for border security, including money to build parts of his coveted wall along the U.S.-Mexico boundary. He also wants to curb legal immigration, restricting the relatives that legal immigrants could sponsor for citizenship and ending a lottery that distributes visas to people from diverse places like Africa.

“I can’t imagine men and women of good will who begged this president to solve the problem of DACA” would oppose Trump’s proposal, said Kelly, using the program’s acronym. He added, “Right now, the champion of all people who are DACA is Donald Trump.”

A court ruling earlier this month also has blunted the deadline. A federal judge has indefinitely blocked Trump from terminating DACA’s protections for the so-called Dreamers, who were brought to the U.S. as children and are living here illegally. The program shields them from deportation and gives them the right to hold jobs.

Still, many lawmakers are uneasy about what might happen to the Dreamers after March 5, and Democrats — and Trump himself — are using that uncertainty as leverage to help force a deal. Kelly’s remarks seemed aimed at easing worries that major deportations of Dreamers could begin right away — a scenario that could be damaging to members of both parties.

“They are not a priority for deportation,” Kelly said of Dreamers who’ve not accumulated criminal records.

[NBC News]

Trump pushes for stronger border in wake of Colts’ Edwin Jackson killing

President Donald Trump urged for tougher border security Tuesday after Indianapolis Colts linebacker Edwin Jackson was reportedly killed by an undocumented immigrant in a vehicle collision.

“So disgraceful that a person illegally in our country killed @Colts linebacker Edwin Jackson,” he tweeted. “This is just one of many such preventable tragedies. We must get the Dems to get tough on the Border, and with illegal immigration, FAST!”

Prior to the president’s tweets, however, Chad Bouchez, Jackson’s roommate, said during a CBS interview, that Jackson would not want his death politicized. “He would not want that,” Bouchez said. “I don’t think Edwin would have judged anyone on where they were from or anything else. ”

The man accused of hitting Jackson and his Uber driver with his vehicle in Indianapolis on Sunday had been deported twice, according to Indiana State Police. Manuel Orrego-Savala, 37, might have entered the U.S. on or around July 1, 2004, according to an email Monday from Nicole Alberico, a spokeswoman for Immigration and Customs Enforcement. According to CNN, an ICE statement said the accused also has other “misdemeanor criminal convictions and arrests in California and Indiana.”

News reports say prosecutors have not formally charged Orrego-Savala but authorities said they are working on potential criminal charges.

Rep. Todd Rokita (R-Ind.) shared the president’s sentiments, according to a Washington Times report Monday.

“The loss of life at the hands of illegal immigrant criminals should make all Hoosiers sad and ultimately angry,” Rokita said. “We must do more to get these dangerous illegal immigrant criminals off of our streets, and guarantee this never happens again by building a wall, ending sanctuary cities, and stopping illegal immigration once and for all.”

The second-year linebacker was loved by the Colts organization, according to the team’s statement on Sunday.

“We admired his outgoing personality, competitive spirit and hard-working mentality,” the statement said. “He was well-respected among all with whom he crossed paths, and he will be greatly missed in our locker room and throughout our entire organization.”

After pushing for Democrats to get “tougher” on border control, Trump sent his condolences to Jackson’s family.

“My prayers and best wishes are with the family of Edwin Jackson, a wonderful young man whose life was so senselessly taken. @Colts,” he tweeted.

The president had previously criticized the “disgraceful” verdict in the 2015 case of Kate Steinle, who was shot and killed by an undocumented immigrant in San Francisco. As a result, Trump called for the building of a border wall after the verdict was delivered in the trial in December.

[Politico]

Reality

This was a sad and tragic event by an illegal immigrant, but it is *A* sad and tragic event, meaning this is just one instance. Policy needs to reflect data, which unequivocally shows that immigrants (both legal and illegal) commit crimes at far lower rates than the native population.

Second, Orrego-Savala was driving without a license and intoxicated, so we could make just as strong, if not stronger, of an argument against drunk driving as one could about illegal immigration being the primary factor of death.

Donald Trump thinks not clapping for him is ‘treasonous’

President Donald Trump wasn’t — and, apparently, still isn’t — happy that Democrats in Congress didn’t stand to applaud him in his State of the Union address last week.

Here’s what Trump told a crowd in Cincinnati in a speech on Monday afternoon:

“They were like death and un-American. Un-American. Somebody said, ‘treasonous.’ I mean, Yeah, I guess why not? Can we call that treason? Why not? I mean they certainly didn’t seem to love our country that much.”

So, here we are. Again.

Let’s quickly define “treason,” shall we?

Here’s how Merriam-Webster does it:

“The offense of attempting by overt acts to overthrow the government of the state to which the offender owes allegiance or to kill or personally injure the sovereign or the sovereign’s family.”

Trump loyalists will dismiss all of this as much ado over nothing. He was joking! He didn’t even say that it was treasonous! He was just agreeing with people who said it was treasonous!

Fine. Also, wrong. And missing the point in a major way.

The point? It’s this: Not standing during applause lines for the State of the Union isn’t treasonous or un-American. Not even close.

If it was, all of the Republicans in that chamber are treasonous and un-American as well because when former President Barack Obama would tout his accomplishments in office — as Trump was doing last Tuesday night — lots and lots of Republican legislators would sit on their hands while the Democratic side of the aisle erupted in cheers. And so on and so forth for every president before him (and after).

Then there is the fact that the specific “treasonous” instance Trump was referring to had to do with his touting of historically low African-American unemployment — a bit of a cherry-picked fact based off of a single month’s economic report. By the time the new report for January came out last Friday, black unemployment had ticked up almost a point and was no longer close to a historic low.

Treason is Benedict Arnold. (Side bar: Read Nathaniel Philbrick’s “Valiant Ambition” about Arnold and George Washington.) Treason isn’t refusing to applaud when the President of the United States thinks you should.

Like with many things Trump says or tweets, there’s a natural tendency to just shrug it off. To do that, however, is to miss something very important — and concerning — at work here.

What Trump is saying is that dissent — which is what Democrats are doing when they choose not to clap for a line in his speech — is traitorous and/or un-American. That if these non-clappers really loved the country, they would be applauding when he touted how low black unemployment had dipped under his tenure.

If you think that’s totally OK, flip the script. Put a Democratic president in office. And have him or her chastise Republicans as treasonous because they didn’t applaud for the fact that something close to universal health care has been achieved. Would that be a reasonable charge? Or is it possible that while Republicans agree that more people having health insurance is a good thing, they fundamentally disagree with the way in which it was implemented?

You don’t have to imagine it. Because that’s what happened during several of President Obama’s State of the Union addresses. Except that Obama never suggested those non-clapping Republicans didn’t love America.

Even the suggestion of criminalizing dissent should send a chill down the spine of anyone who counts themselves as a fan of democracy. The right to dissent — without fear of retribution — sits at the heart of what differentiates America from authoritarian countries around the world.

When you have a president float the idea that not clapping at moments when he believes clapping is appropriate sends a very powerful message to the country about how we do (and should) deal with those who disagree with us. And that goes for whether he was “joking” or not.

It’s a very bad message — no matter whether you agree with Trump or not.

[CNN]

Media

Draft Homeland Security report called for long-term surveillance of some Muslim immigrants

The Department of Homeland Security in a draft report from late January recommended authorities surveil Sunni Muslim immigrants in the United States long-term if it were decided that they fit “at-risk” demographic profiles, Foreign Policy reported Monday.

Upon reviewing 25 terrorist attacks that took place on U.S. between October 2001 and December 2017, the draft report concluded it would be of “great value for the United States Government in dedicating resources to continuously evaluate persons of interest,” according to a copy obtained by FP.

When such immigrants reached American soil, the draft report also reportedly recommended the U.S. track them on a “long-term basis.”

The report could raise new questions about the Trump administration’s policies geared toward Muslim immigrants.

The draft identified a broad group of Sunni Muslim residing within the U.S. who were identified as possibly being “vulnerable to terrorist narratives,” because they matched a set of risk indicators, such as being young, male and having national origins in “the Middle East, South Asia or Africa.”

Kevin McAleenan, commissioner of U.S. Customs and Border Protection (CBP), requested the report on Jan. 22, FP reported, citing internal DHS correspondence.

A CBP spokesperson told the news outlet that the report they obtained was a “first draft,” which has already undergone some revisions and continues to be changed.

“[I]t is extremely important to highlight an important aspect — the document that was improperly provided to you is not a final CBP intelligence assessment, and therefore does not reflect CBP’s policy on this matter,” the spokesperson wrote.

“More specifically, the initial draft assessment in your possession not only is still undergoing internal CBP review, but, at the time of its improper disclosure, did not reflect a large number of substantive comments and revisions that have since been made to subsequent versions of the document as a result of CBP’s internal and external review process,” their email continued.

One department official who reviewed the report told FP it is the only risk-analysis product being shared around DHS and the report’s recommendations are derived from reviews of select cases — even if the report markets it as an all-encompassing review.

“First, this report would steer policymakers to implement unfair and discriminatory surveillance of particular ethnic groups,” the DHS official told the magazine.

“Second, the analysis, which is misleadingly packaged as a comprehensive analysis of post-9/11 terrorism, could lead policymakers to overlook significant national security threats,” the official added.

During his presidential campaign, Trump called for a ban on Muslim immigration to the U.S., a policy that critics say has taken the form of his travel-ban on several Muslim-majority countries.

That ban has been challenged in the judicial system, and the Supreme Court announced plans to review it last month.

[The Hill]

Trump’s top health official traded tobacco stock while leading anti-smoking efforts

The Trump administration’s top public health official bought shares in a tobacco company one month into her leadership of the agency charged with reducing tobacco use — the leading cause of preventable disease and death and an issue she had long championed.

The stock was one of about a dozen new investments that Brenda Fitzgerald, director of the Centers for Disease Control and Prevention, made after she took over the agency’s top job, according to documents obtained by POLITICO. Fitzgerald has since come under congressional scrutiny for slow walking divestment from older holdings that government officials said posed potential conflicts of interest.

Buying shares of tobacco companies raises even more flags than Fitzgerald’s trading in drug and food companies because it stands in such stark contrast to the CDC’s mission to persuade smokers to quit and keep children from becoming addicted. Critics say her trading behavior broke with ethical norms for public health officials and was, at best, sloppy. At worst, they say, it was legally problematic if she didn’t recuse herself from government activities that could have affected her investments.

“You don’t buy tobacco stocks when you are the head of the CDC. It’s ridiculous; it gives a terrible appearance,” said Richard Painter, who served as George W. Bush’s chief ethics lawyer from 2005 to 2007. He described the move as “tone deaf,” given the CDC’s role in leading anti-smoking efforts.

Even if Fitzgerald, a medical doctor and former Georgia Department of Public Health commissioner, met all of the legal requirements, “it stinks to high heaven,” Painter said.

A Health and Human Services Department spokesman confirmed “the potentially conflicting” stock purchases, saying they were handled by her financial manager and that she subsequently sold them.

“Like all presidential personnel, Dr. Fitzgerald’s financial holdings were reviewed by the HHS Ethics Office, and she was instructed to divest of certain holdings that may pose a conflict of interest. During the divestiture process, her financial account manager purchased some potentially conflicting stock holdings. These additional purchases did not change the scope of Dr. Fitzgerald’s recusal obligations, and Dr. Fitzgerald has since also divested of these newly acquired potentially conflicting publicly traded stock holdings.”

After assuming the CDC leadership on July 7, Fitzgerald bought tens of thousands of dollars in new stock holdings in at least a dozen companies later that month as well as in August and September, according to records obtained under the Stock Act, which requires disclosures of transactions over $1,000. Purchases included between $1,001 and $15,000 of Japan Tobacco, one of the largest such companies in the world, which sells four tobacco brands in the U.S. through a subsidiary.

The purchases also include between $1,001 and $15,000 each in Merck & Co., Bayer and health insurance company Humana, as well as between $15,001 and $50,000 in US Food Holding Co., according to financial disclosure documents.

On Aug. 9, one day after purchasing stock in global giant Japan Tobacco, she toured the CDC’s Tobacco Laboratory, which researches how the chemicals in tobacco harm human health, according to financial forms obtained from HHS’ Office of Government Ethics and calendars obtained through a Freedom of Information Act request.

The records confirm that Fitzgerald sold the shares of tobacco on Oct. 26 and all of her stock holdings above $1,000 by Nov. 21, more than four months after she became CDC director.

Fitzgerald, who declined to be interviewed for this story, has made tobacco efforts a focus of her public health career, despite owning stock in the industry. She listed tobacco cessation as one of her primary priorities while still serving in the Georgia position in February 2017. Prior to accepting the CDC position, she owned stock in five other tobacco companies: Reynolds American, British American Tobacco, Imperial Brands, Philip Morris International, and Altria Group Inc. — all legal under Georgia’s ethics rules. HHS did not respond to questions about why she invested in tobacco companies while working to reduce tobacco consumption.

“It’s stunning,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids. “It sends two messages, both of which are deeply disturbing. First, it undermines the credibility of a public official when they argue that tobacco is the No. 1 preventable cause of disease. Second, and perhaps even worse, it indicates a public official is willing to put their personal profit above the ethics of investing in a company whose products cause so much harm.”

“It gives you a window, I think, into her value system,” said Kathleen Clark, a professor of law focusing on government ethics at Washington University in St. Louis. “It doesn’t make her a criminal, but it does raise the question of what are her commitments? What are her values, and are they consistent with this government agency that is dedicated to the public health? Frankly, she loses some credibility.”

While holding the newly purchased tobacco, drug company and food stock, along with other financial holdings in various health companies, Fitzgerald participated in meetings related to the opioid crisis, hurricane response efforts, cancer and obesity, stroke prevention, polio, Zika and Ebola, according to a copy of her schedule between Aug. 1 and Oct. 27.

Merck, whose stock Fitzgerald purchased on Aug. 9, has been working on developing an Ebola vaccine and also makes HIV medications. Bayer, whose stock she purchased on Aug. 10, has in the past partnered with the CDC Foundation, which works closely with the CDC, to prevent the spread of the Zika virus.

“If she participated in meetings in which she has financial conflicts of interest, that is not fine in my book,” said Craig Holman, a lobbyist at the liberal watchdog group Public Citizen. Because some of the meetings took place before Fitzgerald had an ethics agreement, Holman said she “could have an easy avenue for excusing herself,” by saying she didn’t understand it was a conflict, or arguing she didn’t make decisions in those meetings. “But that is not how the law should be applied,” he added. “Even if you could claim you didn’t speak up at those meetings, your presence poses a conflict of interest.”

But it could have been possible for Fitzgerald to participate in briefings on topics like tobacco or Ebola without violating government ethics policy, depending on her role, said a former government ethics official. For example, if Fitzgerald was just in listening mode and not making any substantive comments or decisions, she would likely be within the rules, the official said.

Fitzgerald has already been criticized by some lawmakers for her inability to offload two financial holdings, which date to before she became CDC director and left her unable to perform some tasks, such as testifying in front of lawmakers. An HHS spokesperson said she is actively working to address her remaining recusal obligations related to the two companies, adding that both have “complex transfer restrictions.”

HHS officials said Fitzgerald’s lengthy divestment process was due to her complicated stock portfolio. They declined to say whether she had any ethics training. She didn’t enter into a formal ethics agreement with HHS until two months after taking office.

“It’s a little concerning it took two months to get her ethics agreement signed and an additional month for her to dump conflicting stock,” said Scott Amey, general counsel at the Project on Government Oversight, a watchdog group.

The Health and Human Services Department declined to respond to detailed questions about Fitzgerald’s investments, including whether she herself approved the transactions and what activities and decisions she recused herself from due to her holdings.

Normally, senior government officials commence the process of outlining their conflicts of interest before they assume a job, so that they can quickly divest within days of taking office, a former HHS senior legal counsel told POLITICO.

HHS lawyers usually advise employees to avoid purchasing new stock during an interim period, particularly in areas where they would likely need to divest. Fitzgerald’s ethics agreement, dated Sept. 7, identified nearly all the companies in which she bought stocks on the job as conflicts of interest.

But officials are liable for their actions, regardless of whether they have an ethics agreement in place or have been warned by ethics officials that a financial holding is a conflict, multiple former government ethics officials told POLITICO.

One reason Fitzgerald’s divestment may have taken so long is that the Office of Government Ethics has little ability to force government officials to speedily address financial conflicts, unless they are undergoing a Senate confirmation process, said Walter Shaub, who directed the U.S. Office of Government Ethics under Barack Obama from 2013 to 2017. The CDC director is not a Senate-confirmable post.

“There is a lot less transparency around the non-Senate confirmed individuals … and the ethics process lags, even though the rules still apply,” said Max Stier, president of the Partnership for Public Service, a government oversight group. “Those folks put themselves at risk by not getting clearance and understanding the rules.”

[Politico]

CDC to cut by 80 percent efforts to prevent global disease outbreak

Four years after the United States pledged to help the world fight infectious-disease epidemics such as Ebola, the Centers for Disease Control and Prevention is dramatically downsizing its epidemic prevention activities in 39 out of 49 countries because money is running out, U.S. government officials said.

The CDC programs, part of a global health security initiative, train front-line workers in outbreak detection and work to strengthen laboratory and emergency response systems in countries where disease risks are greatest. The goal is to stop future outbreaks at their source.

Most of the funding comes from a one-time, five-year emergency package that Congress approved to respond to the 2014 Ebola epidemic in West Africa. About $600 million was awarded to the CDC to help countries prevent infectious-disease threats from becoming epidemics. That money is slated to run out by September 2019. Despite statements from President Trump and senior administration officials affirming the importance of controlling outbreaks, officials and global infectious-disease experts are not anticipating that the administration will budget additional resources.

Two weeks ago, the CDC began notifying staffers and officials abroad about its plan to downsize these activities, because officials assume there will be “no new resources,” said a senior government official speaking on the condition of anonymity to discuss budget matters. Notice is being given now to CDC country directors “as the very first phase of a transition,” the official said. There is a need for “forward planning,” the official said, to accommodate longer advance notice for staffers and for leases and property agreements. The downsizing decision was first reported by the Wall Street Journal.

The CDC plans to narrow its focus to 10 “priority countries,” starting in October 2019, the official said. They are India, Thailand and Vietnam in Asia; Jordan in the Middle East; Kenya, Uganda, Liberia, Nigeria and Senegal in Africa; and Guatemala in Central America.

Countries where the CDC is planning to scale back include some of the world’s hot spots for emerging infectious disease, such as China, Pakistan, Haiti, Rwanda and Congo. Last year, when Congo experienced a potentially deadly Ebola outbreak in a remote, forested area, CDC-trained disease detectives and rapid responders helped contain it quickly.

In Congo’s capital of Kinshasa, an emergency operations center established last year with CDC funding is operational but still needs staffers to be trained and protocols and systems to be put in place so data can be collected accurately from across the country, said Carolyn Reynolds, a vice president at PATH, a global health technology nonprofit group that helped the Congolese set up the center.

This next phase of work may be at risk if CDC cuts back its support, she said. “It would be akin to building the firehouse without providing the trained firemen and information and tools to fight the fire,” Reynolds said in an email.

If more funding becomes available in the fiscal year that starts Oct. 1, the CDC could resume work in China and Congo, as well as Ethiopia, Indonesia and Sierra Leone, another government official said, also speaking on the condition of anonymity to discuss budget matters.

In the meantime, the CDC will continue its work with dozens of countries on other public health issues, such as HIV, tuberculosis, malaria, polio eradication, vaccine-preventable diseases, influenza and emerging infectious diseases.

Global health organizations said critical momentum will be lost if epidemic prevention funding is reduced, leaving the world unprepared for the next outbreak. The risks of deadly and costly pandemic threats are higher than ever, especially in low- and middle-income countries with the weakest public health systems, experts say. A rapid response by a country can mean the difference between an isolated outbreak and a global catastrophe. In less than 36 hours, infectious disease and pathogens can travel from a remote village to major cities on any continent to become a global crisis.

On Monday, a coalition of global health organizations representing more than 200 groups and companies sent a letter to U.S. Health and Human Services Secretary Alex Azar asking the administration to reconsider the planned reductions to programs they described as essential to health and national security.

“Not only will CDC be forced to narrow its countries of operations, but the U.S. also stands to lose vital information about epidemic threats garnered on the ground through trusted relationships, real-time surveillance, and research,” wrote the coalition, which included the Global Health Security Agenda Consortium and the Global Health Council.

The coalition also warned that complacency after outbreaks have been contained leads to funding cuts, followed by ever more costly outbreaks. The Ebola outbreak cost U.S. taxpayers $5.4 billion in emergency supplemental funding, forced several U.S. cities to spend millions in containment, disrupted global business and required the deployment of the U.S. military to address the threat.

“This is the front line against terrible organisms,” said Tom Frieden, the former CDC director who led the agency during the Ebola and Zika outbreaks. He now heads Resolve to Save Lives, a global initiative to prevent epidemics. Referring to dangerous pathogens, he said: “Like terrorism, you can’t fight it just within our borders. You’ve got to fight epidemic diseases where they emerge.”

Without additional help, low-income countries are not going to be able to maintain laboratory networks to detect dangerous pathogens, Frieden said. “Either we help or hope we get lucky it isn’t an epidemic that travelers will catch or spread to our country,” Frieden said.

The U.S. downsizing could also lead other countries to cut back or drop out from “the most serious multinational effort in many years to stop epidemics at their sources overseas,” said Tom Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health.

CDC spokeswoman Kathy Harben said the agency and federal partners remain committed to “prevent, detect and respond to infectious disease threats.”

The United States helped launch an initiative known as the Global Health Security Agenda in 2014 to help countries reduce their vulnerabilities to public health threats. More than 60 countries now participate in that effort. At a meeting in Uganda in the fall, administration officials led by Tim Ziemer, the White House senior director for global health security, affirmed U.S. support to extend the initiative to 2024.

“The world remains under-prepared to prevent, detect, and respond to infectious disease outbreaks, whether naturally occurring, accidental, or deliberately released,” Ziemer wrote in a blog post before the meeting. “. . . We recognize that the cost of failing to control outbreaks and losing lives is far greater than the cost of prevention.”

The CDC has about $150 million remaining from the one-time Ebola emergency package for these global health security programs, the senior government official said. That money will be used this year and in fiscal 2019, but without substantial new resources, that leaves only the agency’s core annual budget, which has remained flat at about $50 million to $60 million.

Officials at the CDC, the Department of Health and Human Services and the National Security Council pushed for more funding in the president’s fiscal 2019 budget to be released this month. A senior government official said Thursday that the president’s budget “will include details on global health security funding,” but declined to elaborate.

[Washington Post]

Mulvaney closes down consumer bureau office that polices racism in lending

The acting director of the Consumer Financial Protection Bureau (CFPB) has stripped an office devoted to lending discrimination of its enforcement power, according to an email released Thursday.

Acting CFPB chief Mick Mulvaney told bureau staff in a Tuesday email that he would transfer the agency’s Office of Fair Lending and Equal Opportunity to a department under his purview in an effort to streamline the agency.

Mulvaney said the fair lending office will focus on consumer education and advocacy under control of the office of the director. The bureau’s supervision, enforcement and fair lending division, a separate unit outside of the director’s office, will take over policing the lending market for racial discrimination.

“These changes are intended to help make the Bureau more efficient, effective, and accountable, and I plan to seek both internal and external input as I continue to evaluate how we work,” Mulvaney wrote, saying he didn’t expect layoffs from the move but also could not rule them out.

The decision enraged the CFPB’s progressive backers, who supported former Director Richard Cordray and his aggressive actions against lenders suspected of wrongdoing.

Cordray himself panned the “CFPB squatter leadership” for “interfering” with crucial bureau work.

“We took on tough cases about redlining and other violations,” Cordray tweeted. “Some don’t like it but it is the Law of the Land.”

Mulvaney and his staff insisted the restructuring is simply a matter of streamlining the CFPB while still cracking down on racial discrimination.

“It never made sense to have two separate and duplicative supervision and enforcement functions within the same agency — one for all cases except fair lending, and the other only for fair lending cases,” senior Mulvaney adviser John Czwartacki said in a statement. “By announcing our intent to combine these efforts under one roof, we gain efficiency and consistency without sacrificing effectiveness.”

Mulvaney, who as a GOP congressman opposed the CFPB’s existence, has sought to reshape the bureau from within.

The acting director has promised to make the bureau more responsive to the needs of the financial sector, reopened rules on payday loans and prepaid debit accounts, and called for firms subject to CFPB oversight to send complaints about the bureau’s investigative procedures.

Democrats and liberal political groups that fiercely defended the CFPB under Cordray argue that Mulvaney is destroying the agency and leaving vulnerable consumers without a powerful watchdog.

[The Hill]

Officials raised ethics concerns over Ben Carson’s son assisting HUD event

Officials at the Department of Housing and Urban Development (HUD) expressed concerns that Secretary Ben Carson recently risked violating ethics rules by getting family help in organizing a HUD event last year, The Washington Post reported Wednesday.

Linda Cruciani, HUD’s deputy general counsel for operations, and other department officials were reportedly uneasy that Carson’s son and daughter-in-law were involved with last summer’s “listening tour” event in Baltimore.

They worried that Ben Carson Jr., who is a local businessman, was inviting potential business associates to the event, which “gave the appearance that the secretary may be using his position for his son’s private gain,” according to a memo obtained by The Washington Post.

Carson denies any conflict of interest. He said in a statement to the newspaper that his family has “never influenced any decision at HUD.”

The event in question was reportedly aimed at gathering feedback from area business leaders. Carson’s wife, son and daughter-in-law ultimately attended multiple events in Baltimore last summer, according to the Post.

Carson Jr. reportedly promised Cruciani ahead of the event that “nothing we would do would be near a conflict.”

It is not the first time questions have been raised over Carson’s family involvement in his work, but Carson has repeatedly denied that his family overtly influences HUD decisions.

Carson, who briefly ran for the 2016 GOP presidential nomination, was one of President Trump‘s earliest supporters after dropping out of the race. He was confirmed last March to be HUD secretary by a 58-41 vote, despite controversy over his lack of government experience.

Carson, a former pediatric neurosurgeon, has rejected such criticisms, saying successful leaders surround themselves with the right people.

“I liken it to the CEO of a large medical center,” he said at an event last October. “They probably don’t know about infectious disease, or neurosurgery, or anesthesia or pathology. But they have a lot of people who do know a lot about those things.”

[The Hill]

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