 All right, next up Joy Boyer is going to take us to the second concept which is the renewal of the LC Centers of Excellence in LC Research for CERC. If Terry doesn't steal the microphone. I was willing to let Terry talk through my presentation. So this is a concept here. It's for a limited competition reissue of our Centers of Excellence in LC research or CERC program, RFA. Just some information on the CERC program. I know most of you are familiar with it. The first grants were funded in 2004, so we're entering our 15th year of the CERC program. The goals of the program have not changed over that time. There are three. The first is to support the development of transdisciplinary research teams that can integrate a wide spectrum of social science humanities, clinical science, behavioral science methodologies with genomic research. The second goal is to facilitate the use of the findings of this research so that they can be used to inform health research and public policies and practices. And the third goal is to support the development of the next generation of LC researchers. In the past, we used the P50 full center mechanism and the P20, which is an exploratory or planning grant mechanism. In 2015, we switched to the RM1 activity code, which is a complex project for complex things. And we reissued the RFA last in 2017, and we are still using the RM1 activity code. So, some background. Since 2004, we've supported 11 full centers and eight of our planning centers. We're currently supporting five RM1 centers. And I would mention that we provide four years of funding for these centers with the opportunity for one competitive four-year renewal. We find that it's important to have that renewal period in order to help develop some real sustainability for these transdisciplinary teams. In 2018, this year budget was about 5.2 million, and that's approximately 24% of the LC budget. So, this map was... I had a lot of help with this from our wonderful program analysts, Alex Raphael and Natalie Pino. But the green stars represent the RM1 centers that we're currently supporting. You can see the University of Utah, Jeff Botkin is a PI, University of Oklahoma, Vanderbilt University, Johns Hopkins University. And we just recently renewed Columbia University for their final four years of funding. The purple stars and the purple ovals represent our graduated seers. These are seers that are no longer receiving support from us. I won't go through the entire list. The ovals obviously are the centers that receive planning grants in the past. I've added on to this... we've recently funded two T32 or NRSA institutional fellowships. And we funded one at the University of Michigan, one at University of Pennsylvania, which was a former seer site, and one at Stanford University, also another former site of the seer. And the explosions are our new diversity action plan programs. We've just funded those this year for the first time. We have a new diversity action plan at the University of Utah, which is focused on disabled students. We have a diversity action plan at University of Oklahoma, which focuses on American Indian and Native Alaska students, and a center at Johns Hopkins, which is teaming up with some local minority serving institutions. To develop a training program and research experiences. So, just a few words on the accomplishments of this year program. We really view this as an extremely successful program. They've successfully established these very productive transdisciplinary research teams that have integrated both LC and genomics research. And a sign of this is that a lot of our PIs have served as investigators and some of them as PIs of some of these large genomic medicine programs, like the CSER grants and the Emerge projects and the newborn sequencing or end site projects. They've developed a lot of resources that have been used by policy makers. They've done white papers and policy briefs that have been used to inform federal and state legislation. They've testified before Congress and state legislatures and also a number of advisory committees. And they've also served as both members and chairs of some of these national federal advisory committees. They've also generated support at their institutions for transdisciplinary LC research, and in some ways they've really put LC on the radar screen of their home institutions, where I think it wasn't recognized before as a real discipline. And most importantly, they've really nurtured the next generation of LC researchers. And we've seen more than 150 undergraduate, graduate, postdoctoral and junior faculty fellows come through the series over time. Many of these have gone on to tenure track positions in academia. A number have gotten career development awards through the LC program and through other institutes. And we're now seeing... I think a dozen of these trainees have now successfully competed for individual research grants. So, we're very proud and pleased of the role the centers have played in that. So, now as we're moving forward, since the program was funded in 2004, we're seeing a real evolution in both the genomics and the LC landscapes. I think everyone's aware of the increasing use of genetics and genomics in healthcare settings and with diverse populations and in diverse communities. We're seeing some very rapid advances in genome technologies, and these are now more accessible and have the potential to be used in a way that we haven't seen in the past. But on the other side, I think in part due to the efforts of programs like this year's, we're seeing some very strong genomic LC partnerships to look at some of these issues as they emerge. We're also seeing a very deep and diverse pool of young LC investigators, many of whom are now submitting their own competitive research grants. We see multiple institutions with LC research capacity, and all of this is happening within our ongoing strategic planning process. So, we find ourselves kind of at a moment where we're contemplating the future of LC research. We're looking at the changes in the research landscape, and we're undergoing a strategic planning process. So, we really feel it's a good time to examine all of our ongoing LC initiatives. And in this process, we've decided to limit the growth of the CIRA program through 2023. And what this will mean is that we will allow the existing centers who are eligible for their final four-year renewal, there are four of them, will allow them to compete for funding for that final four-year renewal. This will allow them hopefully to develop full sustainability as a center. It will also create the flexibility for us to develop new initiatives based on the strategic planning process and really addressing some of the new needs that are coming up in genomics research. And most importantly, it will ensure that we can continue to support our investigator-initiated research and career development activity portfolios, which have always been a really important part of the LC program. So, in summary, we're proposing to issue this RFA as a limited competition, which will be restricted to the CIRAs that are currently eligible to compete for renewal. The budget, as it has been in the past couple of RFAs, will be limited to 650,000 direct costs a year for four years. We're hoping to make up to $4 million available to fund up to four CIRA renewals. And this is our proposed timeline. We hope to issue the RFA at the end of March. The application receipt date should be mid-July of 2019. Peer review will be in the fall of 2019. And these applications will come back to council next February, February 2020, for second-level review. And we hope to fund in April or May of 2020. I'm happy to take questions. I did ask Gail Henderson and Wendy Chung to lead off the discussion. So, if there aren't any immediate questions, I will turn it over to Gail. Okay. Thanks. Well, I have a pretty strong conflict of interest about this program since I got a planning grant in 2004, a P50 in 2007, and another in a renewal in 2013. And now I'm in a no-cost extension. So it's just about over. So, I have a little bit of a benefit that we could experience in my career. But there's a couple of things I wanted to say. First of all, during this time that the Sears, by me, I think Joy did a way better job than I was thinking I might do in terms of highlighting the just extraordinary change that genomics has undergone and that ELSI has been, in many ways, responding to and anticipating and being either at the center of or on the margins of this, just the sea change in genomics. And the way that genomic medicine has arisen, et cetera, et cetera. So it's been a whirlwind of trying to keep up and learn and grow and develop. But the one thing I wanted to point out to everybody was that one thing the Sears were required to do was offer a theme. And so you may think a sear was a sear was a sear, but no, not really not at all. That's really not true. You could think of them as big R01s in one sense. And so I wanted to just run through the list of themes because I think it's really important and each sear has been required to create a training pool of diverse investigators to publish as much translationally oriented work as they could as well as focusing on the home disciplines of people outside of the basic and medical sciences. And yet within that, we've got IP, patents commercialization, which was Bob Cook dig in a duke. We had the genomics of behavior. Meldred show at Stanford, which in some ways is taken up by the not really entirely by the Columbia sear, which looks at psychiatric neurologic and behavioral genetic information and its impact on stigma and self-image. Wiley Burke's fantastic sear at the University of Washington, Seattle, which focused in its entirety on health equity issues. Now there's the University of Oklahoma, which is carrying that mantle to Native American and Alaskan populations. I think it's a very exciting place, Oklahoma, I've heard. Never been there. And there's our work has been has morphed into public health preventive genomics. Utah is looking at how family members communicate about prenatal and newborn screening and how test results get communicated decisions get made. Vanderbilt's looking at privacy risks. Mainly Vanderbilt's also looking at the ways that community can be engaged. Many of us have had a big community engagement focus. Penn, when it had a sear looked at uncertainty and genetic information specifically. And then Hopkins is looking at genomic information to help manage the prevention control and treatment of infectious diseases. And I think that's all of them. But you can just see this wealth of topic areas. And then we bring the LC, you know, the LC really big range of disciplinary backgrounds. And then one more thing about this is that over time, I think partly because of the changes in genomics, small studies that would be conducted by anthropologists to look at the meaning of genetic information for patients in really basically a small scale kind of way, trying to develop some policy orientations has and these were very important mainly ethnographic studies has morphed into a focus on health psychology, health economics, the ideas of behavioral economics and incorporating other kinds of disciplines, also incorporating the ways that the arts can be brought in. So the LC disciplines themselves over time have changed. Now, is this all because of the sears? Probably not. And yet the sears have really I think been instrumental in creating both a diversity of topics in communities and also enough of a core in terms of yearly meetings, in terms of trainees getting to know each other across institutions, that that kind of a program could never have been accomplished with an equal number of R01s focused on an equal number of diverse topics. And Joy obviously also mentioned that a lot of LC investigators were mandated in the beginning to be brought into genomic medicine or the early clinical sequencing studies and now of course many are without being made to be. And maybe I think I probably took up my five minutes already but I really wanted to express how important a program this is and what it's been. That said, I do think it's time for a new look. And so at first I thought, gee whiz, wait a minute. And then I immediately thought, oh my gosh, what an opportunity to rethink where we are and think creatively about new ways that the LC program can use its dollars and again create new ways to have a community and also respond to changes in genomics. I think it's really positive about this. I guess let's just say that. I haven't got any criticisms. I think it's just, I wanted to say something about the program itself. I think it's just been so important. Okay, that's it. Wendy. So I agree with what Gail had said. I mean I think what the CERS have done is really this transdisciplinary bringing the communities together and it's communities that otherwise would not have come together and they're a bit of oddball in some cases. As you were saying Gail, sociologist, economist, philosopher. Lawyers, but they're people that were there not some real glue to keep them together, they would not come together. And so if you were to for instance just have training programs, T32s or training programs or things like that, you would fulfill the training mission, but I don't think you'd get that community to come together and actually start functioning cohesively. And I just want to second what Joanne Gail had also said. The impact I think is not necessarily what we always traditionally see in terms of publications, but it's really been a lot of the policy implications and a lot of the other things and kind of non-traditional, at least from a scientific point of view, the impact. And so I don't underestimate that I guess is part of what I would say. So whatever this is in terms of a transition, I guess my point would be to not lose some of that in whatever that is. Really having R01 funded studies or training programs, I think those will do pieces of it and I don't know what you have in mind in terms of doing that, but keeping the communities together I think really has been successful in terms of the community, the seers sort of across the country being able to learn from each other and really truly having now produced a new generation of researchers. So hopefully there's a creative way to think of making this even better but not lose what's been successful. Great. Thank you, Wendy. Are there any other questions or comments? Yes. I'll make a comment from the non-expert side on this, that I think that this is an area of great uncertainty and difficulty for researchers who are actually not in the field but they have to grapple with it. And having an investment in this area should keep that in mind, meaning identifying kind of the almost a help desk version of this, not about the specific protocol, that's an institutional responsibility to approve and so on. But there are so many questions that people raise and that they have a hard time actually getting anyone to answer. And they float about with their question, trying to get someone to tell them what is it that they're supposed to do or to mostly plan for, right? It's not about your IRB giving you some sealant, some approval. And I think that's going to be an increasing need and something that these centers maybe should have under their realm beyond the broad policy statement. Great. Thank you. I think some of the centers, at least the one at Stanford, actually provided kind of this consultation service for researchers in the field. That was part of what they did. I think most researchers in the field have no idea, meaning they don't know anything about the field because it's not actually their field, so they don't know who to go to when they have a question. We encounter that a lot. I'm not saying that hypothetically. We need an advertising budget. Possibly. Well, what is called outreach, right? It's not in genomics all the time, but that's an area where I think there's been less of that. Yeah. Thank you. That's a very good point. I'd agree with that. So in teaching genomic medicine to undergrads and grad students, there are ethical questions that come up all the time in class around the papers that we read. And I think that this sort of service is really valuable, not service, but this body of research. Great. Thank you. If I can add, I think there's going to be otherwise a growing sense of discomfort and also things like almost memes can get attached to certain questions that are not the right way of thinking about them possibly, but they can be very damaging and problematic over time. So we have to be careful about this kind of educational outreach thing within our own genomics community because then those people become kind of the next step of ambassadors and have the same experience from teaching undergrad genetics. Students ask those questions and you don't know the answer to them because it's actually not your area. So I think that's a great question. I'm not sure what the right thing is, but you're not sure what the right thing is. So, yeah. Sharon. Just kind of a timing issue. This announcement, well, the announcement about this limited competition is likely to come out before there's any new program, right? Correct. So I do think that it will be important somehow to talk about the fact that there is going to be additional funding because there certainly, you have funded many sites, but there are many sites that may have still been thinking about, in fact, we had a discussion on the way on, I think, the last council or the strategic planning meeting about bail or applying or not applying or whatever. So, I mean, I do think there are sites that are still thinking about applying. They're going to be surprised to see this and if there's some language around as part of the strategic plan, we're looking at new mechanisms and we're looking at new programs. So, I would say, I would say, I would say, we don't see this as an ending more as an opening to replace it with something. Well, but it's an opening that hasn't opened yet, right? So, that's what I'm trying to say. So, I would say, I would say, I would say, I would say, I would say, so you don't have the next RFA ready to go out. So, to those people, it's just going to be a closing. So, you may just want it a little bit like what was presented, I think in the director's report, point out in the RFA, since it is a limited one, what are the open LC funding programs right now? Sure. Right, because the money for those new opportunities is four years away. So, there are other LC grant mechanisms. Sure. And I would just make a point of that. Yeah, in every RFA, we do try to highlight our standing program announcements. So, we will make sure we do that. It's just, I think there's a number of places that are disappointed to read that it's only going to be available to those who already have Sears. Seems that's one message that the SEAR program has tried hard not to give that it's an inside club and blah, blah, you know, but people would really, would have applied. There's a number of places that would have applied for Sears. But they're just, they don't have that chance now. But there'll be another thing to apply for. That's what we're planning. Any other questions? Thank you very much for these helpful comments. Okay, so can I have a motion and a second? All in favor? Any opposed? Any abstentions? No, he's just being a gentleman here. We appreciate that. Thank you, Jeff.