Today, the Fiscal Year (FY) 2017 House Labor, Health and Human Services, and Education (LHHS) Appropriation bill was approved by the House Appropriations Committee by a 31-19 vote. This legislation proposes $33.3 billion for the National Institutes of Health (NIH) an increase of $1.25 billion over FY16 and $425.6 million for the National Institute of Dental and Craniofacial Research (NIDCR) which is $12.2 million over the enacted FY16 level of $413.4 million. Some of the increases for NIH were provided for the following initiatives:
- $300 million, an increase of $100 million for Precision Medicine;
- $1.26 billion, an increase of $350 million for Alzheimer’s disease research;
- $195 million, an increase of $45 million, for the BRAIN Initiative to map the human brain;
- And increases to every Institute and Center to continue investments in innovative research that will advance fundamental knowledge and speed the development of new therapies, diagnostics, and preventive measures to improve the health of all Americans.
The House proposed funding level is significantly less than the Senate LHHS bill which proposed $34 billion for NIH and $430.5 million for NIDCR. During the full committee mark-up Rep. Cole (R-OK), Chair of the LHHS Appropriations Subcommittee indicated the committee would like to build upon the $2 billion increase provided for NIH last year. He also stated the House funding level for NIH in this bill to be viewed as the “floor,” and not the ceiling and hoped the funding level for NIH can increase even further in the final appropriations bill.
The House LHHS Committee report also included report language pertinent to NIDCR. Specifically:
- Mission: The mission of NIDCR is to improve the Nation’s oral, dental and craniofacial health through research and research training. NIDCR accomplishes its mission by performing and supporting basic and clinical research; conducting and funding research training and career development programs to ensure that there is an adequate number of talented, well-prepared, and diverse investigators; and coordinating and assisting relevant research and research- related activities. The Committee expects the Institute to systematically coordinate through other HHS agencies to share new scientific information to ensure it reaches the community and providers through various other HHS outreach programs.
- Biomaterials: The Committee understands biomaterials are an important section of biomedical research. The Committee encourages NIDCR to consider efforts to encourage an increased focus on the development and innovation of dental materials.
However, since the overall allocation for this bill is $569 million below the FY16 enacted level, the proposed increased funding came at the expense of other important public health programs. Specific cuts include:
- $110 million for the CDC Office of Smoking and Health
- $54 million for the Agency for Healthcare Research and Quality
Below is additional information about programs of importance to AADR:
- HRSA Title VII Training in Oral Health Care received $35.8 million which is level with FY16. The Committee recommends $35,873,000 for Training in Oral Health Care programs, which is the same as the fiscal year 2016 enacted level and the fiscal year 2017 budget request. Within the funds provided, the Committee includes not less than $10,000,000 for General Dentistry Programs and not less than $10,000,000 for Pediatric Dentistry programs. These programs serve to increase the number of medical graduates from minority and disadvantaged backgrounds and to encourage students and residents to choose primary care fields and practice in underserved urban and rural areas. HRSA is directed to provide continuation funding for predoctoral and postdoctoral training grants initially awarded in fiscal year 2015 and continuation funding for section 748 Dental Faculty Loan Repayment grants initially awarded in fiscal year 2016.
- HRSA Area Health Education Centers. The Committee encourages HRSA to support AHEC oral health projects that establish primary points of service and address the need to help patients find treatment outside of hospital emergency rooms. The Committee is aware that some State dental associations have already initiated programs to refer emergency room patients to dental networks. HRSA is urged to work with these programs.
- HRSA Dental Reimbursement Program. The Ryan White Part F program provides for the Dental Reimbursement Program (DRP), which covers the unreimbursed costs of providing dental care to persons living with HIV/AIDS. Programs qualifying for reimbursement are dental schools, hospitals with postdoctoral dental education programs, and colleges with dental hygiene programs. The Committee is concerned that although the program has provided oral health care to many people living with HIV/AIDS, it has not kept pace with the number of individuals in need. The Committee requests an update in the fiscal year 2018 budget request on the non-reimbursed costs covered by the DRP.
- HRSA Maternal and Child Health Bureau Prenatal Oral Health – Set-aside for Oral Health. The Committee has included$250,000 for demonstration projects to increase the implementationof integrating oral health and primary care practice. The projects should model the core clinical oral health competencies for non-dental providers that HRSA published and initially tested in its 2014 report, ‘‘Integration of Oral Health and Primary Care Practice.’’
- HRSA Rural Health Training in Oral Health Care and Rural Health.—The Committee encourages HRSA to work with States to develop and facilitate public education programs that promote preventive oral health treatments and habits via increased oral health literacy in rural and underserved areas. The Committee believes that prevention centered programs represent a cost effective way to address oral health access. The Committee also encourages the Office of Rural Health Policy to support these programs. Further, the Committee encourages HRSA to include innovative public education programs as eligible for funding as part of the State Oral Health Workforce Improvement Program.
- HRSA Program Management. The Committee is disturbed to learn that despite its directive in House Report (110–231) to establish a Chief Dental Officer (CDO) position, HRSA has not maintained the appointment. The Committee understands that since the beginning of 2012 the position has been downgraded to Senior Dental Advisor and moved several layers below HRSA leadership and decision makers. This has occurred in spite of the Administration’s commitment in 2010 to establish the Oral Health Initiative, which highlighted several HRSA initiatives to improve access to oral health care, especially for needy populations. The Committee directs HRSA to restore the position of HRSA Chief Dental Officer with executive level authority and resources to oversee and lead HRSA dental programs and initiatives. The CDO is also expected to serve as the agency representative on oral health issues to international, national, State, and/or local government agencies, universities, oral health stakeholder organizations, etc.
- CDC Division of Oral Health received $18 million which is level with FY16. The Committee expects the DOH to distribute new waterline safety guidelines to dentist offices and clinics, to coordinate with NIH to conduct follow up research where needed, and for CDC to work with professional organizations to educate dentists and dental students of such guidelines.
What is Next? This is an important step in the legislative process. Given that it is an election year it is very likely that Congress will approve a short term continuing resolution funding the federal government through the November elections. Depending on the outcome of the election Congress will either develop an omnibus appropriation bill funding the federal government through the rest of the year; approve another short term continuing resolution or just approve a year long continuing resolution.
AADR will continue to closely monitor these developments and advocate on behalf of our members to secure the higher level funding for NIH, NIDCR and other oral health programs in the upcoming months.
For More Information:
- Click here to read the House Appropriations Committee Summary of the bill.
- Click here to read the FY17 LHHS Bill Report Language.