In somewhat of a surprise move, the House Appropriations Committee released a draft FY12 spending plan for the Labor-HHS-Education agencies that included a $1 billion or 3.3% increase (over FY11) for the National Institutes of Health. The legislation would fund the National Institute of Dental and Craniofacial Research at $420.4 million, an increase of 2.7% over FY11. The increase is in line with a request from President Obama earlier this year. According to the President’s Budget request, the 3.3% increase to NIH would fund and increase of roughly 450 grants. In contrast, the Senate recommended a $190 million or 0.6% reduction to NIH (below FY11). The relatively positive outcome for NIH is certainly counterbalanced by other components of the draft bill. The legislation would cut $52 million or 1% from the CDC and also includes a rescission of $1 billion from the Prevention and Public Health Fund included in the Affordable Care Act. Many steps remain in the process. Additionally, the bill goes counter to a NIH plan to create a National Center for Advancing Translational Sciences (NCATS) by instead funding the continuation of the National Center for Research Resources (NCRR). NIH is currently planning to dissolve NCRR in order to stand-up NCATS. The Senate supports the NIH plan to create NCATS. The bill does include $488 million for Clinical and Translational Sciences Awards (CTSAs), and $331 million for Institutional Development Awards (IDeA) programs. If the House draft does pass the chamber, it will have to be reconciled with the Senate.
Contacts from the AADR community to Capitol Hill will remain extremely important over the next several week, so that the House NIH figure is protected while the importance of other research budget lines is made clear.
Draft FY12 Labor-HHS-Education Bill
Detailed Agency/Program Appropriations Table
The current fiscal year ends on Friday and Congress remains several weeks — if not months — away from having final FY12 spending bills in place. With the government set to run out of the ability to spend money on October 1st, Congress is scrambling to pass temporary spending measures — continuing resolutions (CRs) — that would last into November. Two CRs will likely be required. The first will fund government operations through October 4th, as the House is in recess this week. Government agencies would be funded at the FY11 level minus 1.409% -the ceiling agreed to in the August deficit reduction deal between the White House and Congress. The House is likely to meet briefly on Thursday to take-up the first CR, which has already been passed in the Senate. Passage of a second CR will likely be more tricky, as leaders in the House have pushed to have the cost of disaster assistance deducted from the spending levels agreed to in the August deal with the White House. Such a move could further decrease agency allocations. The Senate has opposed the House effort.
Prospects for a permanent spending plan for the cluster of agencies that includes NIH remains uncertain, given a House push to decrease spending levels below the August agreement with the president.
AADR was successful in advocating for an oral health component within health disparities legislation in the House of Representative. The Health Equity and Accountability Act was introduced by Congresswoman Barbara Lee (D-CA) and 68 original co-sponsors on September 16th. The legislation is the product of a tri-caucus effort (Asian Pacific American Caucus, Congressional Black Caucus, Congressional Hispanic Caucus) to eliminate racial and ethnic health disparities. According to a press release from Rep. Lee, “…this legislation improves and guides federal efforts in the following vital areas: data collection and reporting; culturally and linguistically appropriate health care; health workforce diversity; improvement of health outcomes for women, children and families; mental health; high impact minority diseases (hepatitis B, HIV/AIDS, diabetes, cancer); health information technology; emboldened accountability and evaluation; creation of a new Office of Minority Health at the Department of Veterans Affairs; and, addressing social determinants of health.
The legislation contains the following provision on oral health:
SEC. 736. CLINICAL RESEARCH FUNDING FOR ORAL HEALTH.
(a) IN GENERAL.—The Secretary of Health and Human Services shall expand and intensify the conduct and support of the research activities of the National Institutes of Health and the National Institute of Dental and Craniofacial Research to improve the oral health of the population through the prevention and management of oral diseases and conditions.
(b) INCLUDED RESEARCH ACTIVITIES.—Research activities under subsection (a) shall include— (1) comparative effectiveness research and clinical disease management research addressing early childhood caries and oral cancer; and (2) awarding of grants and contracts to support the training and development of health services researchers, comparative effectiveness researchers, and clinical researchers whose research improves the oral health of the population.
Press Release, Office of Congresswoman Lee
Health Equity and Accountability Act
The Senate Appropriations Committee has come out with their FY12 figure for NIH, $30.5 billion. The figure represents a $190 million or 0.6% reduction from the FY11 level. The Senate plan would fund NIDCR at $404.9 million, which is $4.7 million or 1.2% less than FY11. The numbers are considerably better than what is expected to emerge from the House. However, when inflation is taken into account, the Senate figures continue the decline in support for NIH seen over the past 8 years.
In an interesting move, Senator Jerry Moran (R-KS) proposed an amendment to remove the $190 million cut to NIH by providing an even reduction to all other agencies funded under the Labor-HHS-Education bill. The amendment was defeated along party lines, with all Democrats opposing and all Republicans voting in support.
Despite early resistance, the Senate Appropriations Committee did recommend funding for the creation of the National Center for Advancing Translational Sciences (NCATS), part of a NIH reorganization that will include the elimination of the National Center for Research Resources and contributions from most ICs to support NCATS. $20 million is also provided for the Cures Acceleration Network (CAN). Some other policy items of note to the oral health community include:
- Systemic Bone Active Therapeutics.—The Committee urges continued research on the effects of systemic bone active therapeutics on the craniofacial skeleton, including factors predisposing individuals to osteonecrosis of the jaw, as well as new approaches to facilitate bone regeneration.
- Temporomandibular Joint [TMJ] Disorders.—The Committee encourages NIDCR to collaborate with other ICs regarding the etiology and pathogenesis of TMJ disorders as well as the co-morbid chronic pain conditions and disorders that solely or predominantly affect women. In particular, NIDCR should work with NIAMS and NIBIB to develop research opportunities in the area of joint pain. Examples of topics that need more exploration include: a basic understanding of the kinematics and biomechanics of TMJ disorders as they relate to normal jaw function and in disease; the develop ment of biomarkers in bone, muscle and cartilage that are predictive of temporomandibular disease progression; the interactions of the TMJ musculoskeletal system with the nervous system; and the development of non-invasive measures of TMJ bone structure, growth, degradation and repair. The recent scientific meeting of the TMJ Association, co-sponsored by NIDCR and other ICs, concluded that there needs to be a shift in research toward a systematic exploration of common underlying root causes. The Committee strongly urges NIH to heed the recommendations from this meeting, which have the potential to accelerate scientific progress not just in TMJ disorders but in the other coexisting conditions.
- Oral Health Research.—The Committee notes that the recent IOM report ‘‘Advancing Oral Health in America’’ highlights the important role that the Department can play in improving oral health and oral healthcare in the United States. The Committee encourages the Secretary to place a high priority on efforts to advance oral health research, as recommended by IOM.
- Oral Health.—The Committee is deeply concerned by CDC’s plan to convert the Division of Oral Health to a branch. This action appears to counter the recent IOM report ‘‘Advancing Oral Health in America,’’ which recommended that oral health be given a high priority within HHS. The Committee is concerned that this reorganization has instead lowered the visibility and priority of the Division of Oral Health. The Committee urges CDC to reestablish the Division. Absent such a move, the Committee directs CDC to report to the Committee by January 1, 2012, on how the oral health branch will be more effective in improving oral health in America, what steps CDC is taking to recruit and retain the high caliber staff that the Division employed, and how CDC intends to ensure that oral health is appropriately represented in leadership meetings at CDC. The Committee recognizes that reducing disparities in oral disease will require investments in proven prevention strategies at the State and local levels. The Committee strongly supports broadbased community programs that can result in significant cost savings. The Committee recommendation assumes that CDC will support grants to States at no less than last year’s level to strengthen oral health infrastructure and community prevention programs. The Committee remains concerned about the high incidence of tooth decay among American Indian/Alaska Native [AI/AN] children and is pleased by the work CDC has done to support effective oral health messages in these communities. CDC is encouraged to continue pursuing collaborative efforts with the Indian Health Service and through the National Oral Health Surveillance System to assess early childhood caries [ECC] epidemiology in AI/AN children. The Committee encourages CDC to work with key external stakeholders to identify and fill strategic information gaps about age of onset, prevalence, severity and microbiology to improve and accelerate existing and novel approaches to prevent ECC.
At this time, it is unclear when the House Appropriations Committee will take up the spending bill that funds NIH. Yesterday, in an oral health briefing, a Member of the House declared the bill the hardest to pass among the 12 appropriations bills that fund the government.
Senate FY12 Labor-HHS-Education Appropriations Summary
Full Senate FY12 Labor-HHS-Education Appropriations Bill
The Department of Health and Human Services (HHS) is in the process of determining how to implement the essential pediatric benefit, which includes dental coverage, contained in the Patient Protection and Affordable Care Act. AADR joined with over 50 state and national organizations to urge HHS Secretary Kathleen Sebelius to create a pediatric dental benefit that is based in current science, best practice, and professional recommendations for children’s dental care.
Read the letter here.
The Joint Select Committee on Deficit Reduction (also known as the Super Committee) has a new website. The group is seeking your input on the best path forward to reduce the deficit and grow the economy. The group only has a few weeks to develop a plan, so make your thoughts known today. You can send the committee a note in under 5 minutes on their website.
Joint Select Committee on Deficit Reduction – Write to us Today
Fiscal Year 2012 starts in two weeks and Congress is scrambling to put a new spending plan in place in time. The initial plan will be a temporary measure, known as a Continuing Resolution (CR), that provides additional time for the development of a permanent FY12 budget. In this case, the CR would likely last until mid-November. A CR typically funds government operations on a temporary basis at the level provided during the previous fiscal year. However, the CR moving forward in the House would fund FY12 discretionary programs at a rate of 1.409% below the FY11 level. The reduction reflects a FY12 allocation contained in the Budget Control Act (BCA). The BCA was signed into law in early August and sets a spending framework for the next 10 years (FY12-21). Additional spending cuts are likely, due to a second round of deficit reduction contained in the BCA. The Senate CR is expected to be similar to that seen in the House. So, for the initial days of FY12, expect agencies to operate slightly below their FY11 strength.
Agreement between the House and Senate on FY12 stops with the CR. At present, the two chambers have dramatically different ideas on the level of funding necessary in a permanent FY12 budget. For the Labor-HHS-Education Appropriations bill, which funds NIH and many other federal agencies, the House is leaning towards a FY12 reduction of $18 billion -from FY11. The level provided by the House would be below the BCA agreement reached in early August. Fiscal conservatives assert that the BCA establishes ceilings and not spending levels. In stark contrast, the Senate reduction for the FY12 bill is currently slated at $300 million. An $18 billion reduction spread evenly across the agencies in the bill would mean a cut of roughly 11.5% for NIH.
Now would be an ideal time for members of the AADR community to reach out to their House members.
Continuing Resolution Overview
The Naval Postgraduate School and American Society for Engineering Education have asked AADR to share the following student funding opportunity:
The SMART (Science, Mathematics, and Research for Transformation) Program pays for all educational expenses for a B.S., M.S. or Ph.D. program, and then provides scholars unique opportunities to work as research scientists or engineers on cutting edge technology in world class Department of Defense facilities. A comprehensive list of facilities can be found on the SMART website.
This is a highly competitive, national program, open to U.S. citizens only. The SMART program will pay all educational costs and a stipend while the individual in school from as little as one (1) term up to 5 years.
Specifically the program pays for:
- Full Tuition – to any accredited U.S. University
- A very generous stipend while in school ranging from $25,000 – $41,000 per year
- Book allowance – $1,000
- Health insurance contribution
- Paid Summer internships
- Travel fees for internships
- All required student fees
For more information, visit the webpage.
The application deadline is December 1, 2011.
AADR joined with 531 other organizations in a letter to the Chairs and Ranking Members of the House and Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies. The letter calls on Congress to preserve federal support for health and education in the FY12 budget process, which begins again this week as Members of Congress return to DC from the August recess.
Read the full letter…
The National Institutes of Health has released a Request for Information (RFI) that seeks input to inform deliberations of its Advisory Committee to the NIH Director Working Group on the Future Biomedical Research Workforce. Members of the AADR community are encouraged to respond directly to the RFI. Additionally, AADR invites comments for consideration as part of its response on behalf of the organization to the NIH RFI. Individuals interested in providing input for the AADR response are asked to e-mail Jonathan Nurse (firstname.lastname@example.org) by September 23rd. It is critical that the unique needs of the dental and craniofacial community are included in the NIH assessment, so please take a few minutes to review the RFI guidelines and provide a response.
Full NIH RFI (NOT-OD-11-106)