Elections Conclude, Budget Battle Begins Anew

The campaign speeches, debates and rallies are over. The results in most states are known at the presidential and congressional levels. However, the November 6th elections did little to settle the debate on how best to reduce the deficit while bolstering the U.S. economy.

A majority of voters opted to give President Barack Obama additional time to right the economy. The president appears on course to secure roughly 51% of the vote and 332 electoral college votes (270 needed for victory). Democrats will gain seats in the United States Senate — retaining their majority — through battleground victories in Connecticut, Florida, Indiana, Massachusetts, Missouri, Montana, New Mexico, North Dakota and Ohio. Republicans will keep their majority in the House of Representatives. However, the net change remains unknown. Overall, after Inauguration Day 2013, the political makeup of the federal government will be much the same as it is today. Continue reading

AADR Encourages Research Objective in Healthy People 2020

The U.S. Department of Health and Human Services (HHS) recently requested public comment on proposed new Healthy People 2020 objectives. The new objectives would be added to the Educational and Community-Based Programs and Seocial Determinants of Health topic areas. According to HHS, “Healthy People 2020 will provide opportunities for public input periodically throughout the decade to ensure that Healthy People 2020 reflects current public health priorities and public input.” AADR applauded HHS for new objectives intended to enhance DDS and DMD programs, but asked that research be more specifically addressed. Continue reading

New Federal Funding Opportunities & Notices (NIH, AHRQ)

HHS components have recently released several funding opportunities and notices of interest. Details follow…

Request for Information (RFI): Identifying Organizations with the Appropriate Expertise to Participate in a Mobile Health (mHealth) Collaborative Public-Private Partnership

Notice Number: NOT-OD-12-151

Key Dates
Release Date: September 14, 2012
Response Date:  October 5, 2012
Issued by:
Office of Behavioral and Social Sciences Research (OBSSR) – NIH

Purpose:
This request for information (RFI) seeks to identify organizations with the appropriate expertise to serve as managing partner and/or participants for the “mHealth Public-Private Partnership” (mHealth PPP) with the Office of Behavioral and Social Sciences Research (OBSSR), a part of the National Institutes of Health (NIH). Continue reading

Vote for… HHS Top Health Innovations

The U.S. Department of Health and Human Services (HHS) has invited the public to vote for one of the finalists of the HHSinnovates program, which recognizes innovating projects led by HHS employees designed to address critical health care challenges facing the nation. The six finalists were selected from over 60 submissions from across the agency. Candidates include:

  • The 100K Pathogen Genome Project
  • National Institute of Allergy and Infectious Diseases (NIAID) Exchange
  • Online Food Handler Training Project
  • Development and Use of Coal Dust Explosibility Meter
  • National Health Service Corps Jobs Center
  • National Institute of Health Research Portfolio Online Reporting Tools

For full project descriptions and to cast your ballot visit: News Release

**Note: Voting is closed**

NCHS Releases Oral Health Disparities Data Brief

The National Center for Health Statistics has released a data brief on oral health disparities, as measured by objectives contained in the Healthy People 2020 initiative (HP2020). HP2020 consists of 42 topics, of which oral health is one, and over 1200 objectives (33 within oral health) selected as indicators of the nation’s health. The NCHS data brief identifies several significant oral health disparities, which will hopefully serve to inform the decisions of government policy makers.

Key Findings:

  • Approximately one in four children aged 3–5 and 6–9 years living in poverty had untreated dental caries.
  • Dental sealants were more prevalent among non-Hispanic white adolescents (56%) compared with non-Hispanic black adolescents (32%) aged 13–15.
  • Among adults aged 45–64, 29% had a full set of permanent teeth (excluding third molars); this includes 19% of Hispanic adults and 11% of non-Hispanic black adults compared with nearly 35% of non-Hispanic white adults.
  • More than one-third of older adults aged 65–74 living below the federal poverty level (34%) were edentulous, whereas approximately one-eighth of older adults living above the poverty level.

Read the full report…

Summer on the Hill #3: What We are Called to Do

Read the speech given by Donald Berwick, MD, MPP, to graduates at Harvard Medical School Class Day where he calls on graduates of medicine and dentistry to reach beyond the research and healing and to tackle broader issues in policy and advocacy. Written in the context of a moving and emotional experience in his life with a young troubled teen, this piece is sure to remind all of that which is bigger than each individual.

http://jama.jamanetwork.com/article.aspx?articleid=1199158

Supreme Court Affirms Affordable Health Care Act

Today, in a 5-4 ruling, the U.S. Supreme Court affirmed the constitutionality of the Patient Protection and Affordable Care Act of 2010 (PPACA). The landmark ruling came as a bit of a surprise to observers of the high court and Capitol Hill, as oral arguments held earlier in the year seemed to indicate Continue reading

Agencies Provide Details on FY13 Budget Proposal

On Monday, President Obama released his Fiscal Year 2013 budget proposal. As the week progressed, federal agency officials began to release details of the proposal, which is drawing criticism from many organizations in the health and research communities. The President’s budget proproses to freeze funding for NIH at the FY12 level of $30.7 billion. In a budget briefing on Wednesday (2/15), NIH Director Frances Collins stated that despite the freeze in funding, the President’s budget proposal would allow for a 7% increase in FY13 (over FY12) in new and competing research grants. Dr. Collins stated that the increase is made possible by increased turnover in grants, largely do to the fact that “science is moving more quickly” than has traditionally been the case. The decrease in the duration of grants coupled with a 1% FY13 reduction to noncompeting grants was mentioned as the primary drivers of the proposed increase in new and competing grants. Dr. Collins acknowledged that, when adjusted for inflation, purchasing power at NIH has been in decline since 2003.

Some items of note from the NIH FY13 Budget Proposal:

  • The NIDCR budget is slated for a $2 million decrease to $408 million.
  • Funds are sought from the Public Health Prevention Fund (part of the Affordable Care Act) to make a significant increase in Alzheimer’s research.
  • The ratio of funding between basic and applied research (54% basic, 46% applied) remains constant -as has been the case for several years.
  • The National Center for Advancing Translational Sciences (NCATS) would receive an 11% increase to $639 million, which includes significant funding ($50 million) for the Cures Acceleration Network.

Other noteworthy budget information:

  • The overall Health and Human Services budget request is 8.5% lower than last year.
  • Oral health funding within CDC, Chronic Disease Prevention and Health Promotion, is essentially the same after a $9,000 increase to $14.653 million.
  • The request for the National Science Foundation is up 5% to $7.373 billion.
  • The request for the Agency for Healthcare Research and Quality is up by roughly 1% to $408.8 million. However, the proposal cuts investigator-initiated researcg grants by more than 31%,  and comparative effectiveness research grants by 41%.

The President’s Budget Request marks the beginning of the budget process on the Hill. It is clear that the FY13 appropriations process is off to a rocky start for health and much of the research community.

FY12 Budget Finalized, NIH Up Slightly and NCATS OK’d

In a demonstration of “better late than never,” the House and Senate joined late last week to approve Fiscal Year 2012 spending for the nine appropriations bills that remained. The end of the FY12 appropriations process came roughly 11 weeks late, as the fiscal year began on October 1st. However, some are commending Congress for passage of all of its spending bills in mid-December, since in recent years the annual appropriations process lasted several months -well into the next calendar year. President Obama is expected to sign the package into law by December 23rd -when temporary spending expires.

Provisions of Note in Final FY12 “Omnibus/Megabus” Spending Bill:

[*Note: The Labor-HHS-Education section of the omnibus FY12 spending bill contains a 0.189% across-the-board (ATB) reduction]

National Institutes of Health– Provided $30.7 billion or $299 million (approximately 1%) above FY11. [$30.6 billion after ATB reduction]

NIH is strongly urged to ensure its policies continue to support a robust extramural community and make certain sufficient research resources are available to the more than 300,000 NIH-supported scientists at over 3,100 institutions across the country. The conferees affirm the critical importance of new and competing research project grants (RPGs) to the mission of NIH and are concerned that in the past few years, NIH has failed to support the number of new, competing RPGs that it estimated would be awarded in its annual congressional budget justifications. The conferees expect NIH to evaluate its new grant-estimating methodology to improve its accuracy and support as many scientifically meritorious new and competing RPGs as possible, at a reasonable award level, with the funding provided in this Act.

In recent years, extramural research has accounted for nearly 90 percent of NIH’s budget. The conferees strongly urge NIH to maintain at least that level in fiscal year 2012. NIH should also establish safeguards to ensure the percentage of funds used to support basic research across NIH is maintained.

National Institute of Dental and Craniofacial Research- $411.5 million or $1.9 million (0.46%) above FY11. [$410.7 million after ATB reduction]

National Center for Advancing Translational Sciences (NCATS)- $576.5 million. [$575.4 million after ATB reduction]

The conference agreement includes language to eliminate the National Center for Research Resources (NCRR) and create the National Center for Advancing Translational Sciences (NCATS).

NCATS will study steps in the therapeutics development and implementation process, consult with experts in academia and the biotechnology and pharmaceutical industries to identify bottlenecks in the processes that are amenable to re-engineering, and develop new technologies and innovative methods for streamlining the processes. In order to evaluate these innovations and new approaches, NCATS will undertake targeted therapeutics development and implementation projects. In all of these efforts, the conferees expect that NCATS will complement, not compete with, the efforts of the private sector.

While the conferees welcome the creation of NCATS, they were disappointed by the way the administration requested it. The President’s proposed budget for fiscal year 2012 included a vague description of NCATS but did not formally request funding for the restructuring or provide any details about which components of NIH would be consolidated into the new Center. The failure to do so caused unnecessary uncertainty about the proposal and contributed to the impression that it was being rushed. The conferees are also aware of concerns that the NIH process for evaluating the merits of the NCATS reorganization did not comply with the NIH Reform Act of 2006 with respect to the role of the Scientific Management Review Board (SMRB).

Lessons learned with NCATS should guide NIH as it considers another proposed restructuring, one that would involve consolidating NIDA, NIAAA and components of other Institutes and Centers (ICs) into a new Institute devoted to research on substance use, abuse and addiction. The conferees understand that NIH plans to adopt a more deliberate approach in evaluating the need for this Institute. The conferees strongly recommend that this approach should include full consideration by the SMRB and that if the administration ultimately decides to seek such a restructuring, it should provide sufficient details in a formal budget request to Congress.

Centers for Disease Control and Prevention, Oral Health- $14.7 million or $276,000 (1.8%) less than FY11. [$14.67 million after ATB reduction]

The conferees are pleased to learn that CDC has decided to retain the Division of Oral Health. This action is supported by a recent Institute of Medicine (IOM) report titled “Advancing Oral Health in America” that recommends oral health be given a high priority within HHS. This decision will allow CDC to focus on the prevention and elimination of oral disease, support state oral health infrastructure programs, and improve the coordination of oral health activities with other chronic disease prevention activities.

Agency for Healthcare Research and Quality- $369 million or $3 million (0.8%) below FY11. [$368 million after ATB reduction]

Human Subjects Protection Report Out

After news reports that the U.S. government supported research from 1946-48 that exposed human subjects in Guatemala to sexually transmitted diseases, President Obama ordered the Presidential Commission for the Study of Bioethics to complete an assessment of research standards. The Commission has completed its work and a report is now available that finds that in general current regulations are sufficient to protect human subjects in research, and notably that the harm to human subjects experienced decades ago in Guatemala could not happen today. However, the Commission also found that many federal agencies that conduct research involving human subjects lack sufficient tracking mechanisms; “In assessing the current regulations that protect human subjects, the Commission learned that there is no central source with information about the overall size, scope, and cost of the government’s research involving human subjects.” Several other findings and recommendations are contained in the report.

Summary and Full Report