Advocacy and Policy 101
Advancing public policy requires a combination of transplant expertise and an understanding of the legislative and regulatory process. The AST Government Relations team helps the Society monitor policy developments, educate policymakers, and advance priorities that support transplant professionals, patients, donors, and the broader transplant community.
The AST works with TSG Advocates to advance legislative and regulatory priorities at the federal and, where appropriate, state levels. Clare Chmiel, Chris Rorick, and Shelagh Foster bring extensive experience in government relations, policymaking, and health care advocacy to their work on behalf of the AST.
The team works closely with AST leadership, members, staff, and coalition partners to communicate the clinical, scientific, and practical implications of proposed policies. Their work may include meeting with congressional offices and federal agencies, monitoring legislation and regulations, developing advocacy strategies, and identifying opportunities for the AST and its members to engage.
Clare Chmiel
Clare Chmiel has worked in public policy for more than 16 years and with the AST for more than nine years. Before joining TSG Advocates, Clare served on the Washington, D.C., staff of Congresswoman Doris Matsui, where she gained firsthand experience in congressional operations and policymaking. She also worked on political campaigns and national fundraising efforts for members of Congress, providing her with a strong understanding of the political dynamics that shape policy outcomes.
Clare earned her bachelor’s degree from DePaul University, where she double-majored in political science and women’s studies.
Chris Rorick
Chris Rorick has more than 30 years of experience in federal and state government relations and public service and has worked with the AST for over 15 years.
Earlier in his career, Chris served as a legislative staff member in both the U.S. House of Representatives and the Colorado General Assembly, where he developed a strong foundation in the legislative process and policymaking. His government experience provides him with a practical understanding of how policy is developed, negotiated, and implemented.
Chris earned his bachelor’s degree from the University of Northern Colorado and a Master of Public Administration from the University of Colorado.
Shelagh Foster
Shelagh Foster has more than 25 years of experience in public policy, political strategy, and advocacy at the federal and state levels.
Before joining TSG Advocates, Shelagh spent nearly two decades with the American Society of Clinical Oncology, where she led government relations, policy development, and advocacy efforts. In that role, she directed engagement with Congress, federal agencies, and state legislatures and helped shape policies affecting cancer care nationwide. She has also represented providers across a range of health care sectors, including home health and durable medical equipment.
Shelagh earned her Juris Doctor from Northeastern University School of Law and is a member of the Massachusetts bar.
Congressional Updates
Congress Approves Continuing Resolution to Fund the Federal Government
Congress has returned to Washington following its annual August recess. Upon returning, the House passed the Senate-approved continuing resolution (CR) to maintain federal funding at current levels through December 11, 2026.
Notably, the CR includes language postponing implementation of the Office of Management and Budget’s proposed rewrite of the Uniform Guidance governing federal financial assistance. This provision delays the rule from taking effect while OMB reviews the public feedback it received.
As previously shared, the AST submitted comments outlining the proposed rule’s potential effects on the transplant research community and urging OMB to preserve policies that support scientific innovation and federally funded research.
House Subcommittee Considers Kidney Care Legislation
The House Energy and Commerce Subcommittee on Health held a hearing on September 15 titled “Examining Legislative Proposals to Reform Medicare Provider Payment and Bolster Health Care Cybersecurity.”
The hearing examined potential solutions to challenges within the Medicare physician payment system and policies designed to strengthen cybersecurity across the American health care system. Among the legislative proposals being considered were:
- H.R. 6214, the Kidney Care Access Protection Act, which aims to improve access to innovative treatment options for individuals with end-stage renal disease under Medicare.
- H.R. 8319, the KIDNEY Remote Monitoring Act, which would expand access to certain remote monitoring services furnished by physicians to Medicare beneficiaries with end-stage renal disease.
The AST will continue to monitor these proposals and evaluate their potential implications for transplant patients and professionals.
Global Policy Update
AST Comments on WHO Global Strategy for Donation and Transplantation
The AST submitted a formal comment letter in response to the World Health Organization’s public consultation on its draft global strategy on donation and transplantation.
Through its comments, the AST provided the clinical and scientific perspective of the transplant community as the WHO develops a global framework intended to strengthen donation and transplantation systems worldwide.
CMS Update
AST Supports Clarification of Transplant Coordinator Costs
The AST signed a letter led by the Kidney Transplant Collaborative asking the Centers for Medicare & Medicaid Services (CMS) to clarify that the costs of transplant coordinators who train volunteer living donor facilitators are reimbursable organ acquisition expenses under Medicare.
This clarification would help transplant centers sustain programs that guide and assist prospective living donors.
HRSA and OPTN Update
Public Comment Open on OPTN Board and Committee Applications
The Health Resources and Services Administration (HRSA) is seeking public comment on a proposed information collection covering the applications and related forms used by individuals seeking to serve on the OPTN Board of Directors and its committees.
The proposed collection includes Board and committee applications, along with conflict-of-interest, attestation, code-of-conduct, and confidentiality forms. The public comment period is open through October 5, 2026.
OPTN Board Approves Policy Changes for Donation After Circulatory Death
The OPTN Board of Directors approved policy changes related to donation after circulatory death intended to strengthen protections for potential donors throughout the donation after circulatory death (DCD) process.
The changes establish clearer patient-safety protections, enhance the information provided to potential donor families, and promote greater consistency and accountability in DCD practices.
The AST will continue to monitor OPTN policy development and the broader OPTN modernization effort, and will keep members informed of significant changes affecting the donation and transplantation system.
HHS Update
AST Comments on Federal Vaccine Recommendations
The AST submitted comments to the Department of Health and Human Services (HHS) in response to its request for information, “Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making.” The AST emphasized the importance of clear, evidence-based recommendations and cautioned that broadly applying shared clinical decision-making could increase confusion and vaccine hesitancy, placing transplant candidates and recipients, who depend on both their own vaccination and that of those around them, at greater risk of preventable infections.
Stay Engaged
Advocacy is strongest when it reflects the transplant community’s expertise and experiences. Share your policy concerns, advocacy priorities, or feedback on the AST’s efforts — we want to hear from you.
The AST remains committed to representing the transplant community, advancing policies that support patients and professionals, and keeping members informed.
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