By an overwhelming bipartisan vote of 51-0 the House Energy and Commerce Committee approved the latest version of the 21st Century Cures Act (H.R. 6). This bill reauthorizes the National Institutes of Health for three years and establishes a fully paid for mandatory funding stream known as the Innovation Fund. The Innovation Fund provides $2 billion from FY16-FY20 for the Director of NIH to provide funding for basic, translational and clinical research. In order to activate the Innovation Fund Congress must provide a non-specific level of baseline discretionary appropriations for NIH in the annual appropriations bill. However, the funding provided via this mechanism can only be used for very specific activities including a new Accelerating Advancement Program; early stage investigators and promising investigators; high risk high reward programs and intramural research. Funding allocations are determined by the Director and tied to the NIH-wide strategic plan. The resources of the NIH Innovation Fund can contribute to the goals of expanding knowledge to address and find more effective treatments for unmet medical needs including:
- Precision Medicine
- Infectious diseases
AADR continues to closely monitor these developments closely and will provide a more detailed analysis in the upcoming weeks. It is widely epected the House of Representatives will vote on this bill during the first week of June and the Senate will produe its own version of the bill sometime next year.
Yesterday, the Senate Appropriations Committee approved the allocations known as 302(b)s for the fiscal year 2016 appropriations bills. Importantly, these allocations adhere to the $1.01 trillion top line number established by the 2011 Budget Control Act. The Senate Labor Health and Human Services and Education (LHHS) Appropriation bill will receive $153.188 billion, which is an approximate $3.7 billion decrease from fiscal year 2015 and essentially level with the House LHHS allocation. Under these reduced allocations it will be virtually impossible for programs to receive meaningful increases without significantly decreasing other programs under the jurisdiction of this legislation. According to a statement released by the Coalition for Health Funding about the House allocation:
“We understand that the House Appropriations Committee faces significant fiscal constraints under the essentially flat, sequester level nondefense discretionary (NDD) cap. It is nonetheless extremely troubling that the proposed Labor-HHS allocation is 2.4 percent ($3.7 billion) less than the FY 2015 level, particularly when other allocations are increased at the expense of programs that are so vital to the health, education and economic security of this nation. It is time for Congress to acknowledge that the existing austerity framework is unsustainable. Under current law, the funding available to meet basic education, health, social service, and employment and training needs is simply too low, forcing the House Appropriations Committee to set allocations that are unrealistic.”
Unfortunately, the persistent austere budget climate continues to put a strain on discretionary spending. According to media reports there are some indications that Congress may develop a deal to provide some partial relief from sequestration this fall. AADR will continue to urge Congress to undo sequestration and these austerity measures once and for all.
This week, the House Appropriations Committee approved the fiscal year 2016 Commerce, Justice, Science (CJS) bill by a voice vote. The CJS bill proposes funding allocations for the Department of Commerce, the Department of Justice, the National Aeronautics and Space Administration (NASA), the National Science Foundation (NSF), and other related agencies. For NSF specifically, the House allocated approximately $7.4 billion, an increase of $50 million above the fiscal year 2015 enacted level and a $329 million decrease from the President’s request of $7.7 billion.
According to a summary provided by the American Institute of Physics, “While avoiding specific funding levels by directorate, the report states: ‘The Committee directs NSF to ensure that Mathematical and Physical Sciences; Computer and Information Science and Engineering; Engineering; and Biological Sciences comprise no less than 70 percent of the funding within Research and Related Activities. Further, the Committee directs that NSF allocate no less than the fiscal year 2015 levels for the Office of International Science and Engineering; Integrative Activities; and the U.S. Arctic Commission.’ This language results in $1,319.9 million being available in FY 2016 for Geosciences (now receiving $1,304.4 million) and Social, Behavioral and Economic Sciences (now receiving $272.2 million). The combined current budget for these two directorates is $1,576.6 million; the FY 2016 budget in the House bill is $256.7 million or 16.3 percent less.”
The White House Office of Management and Budget sent a letter to the committee expressing their concern with the funding levels provided in this bill. Additionally, on behalf of its members including AADR, the Coalition for National Science Funding sent a letter to the committee also expressing their concerns with the funding levels included in the bill.
AADR will continue to closely monitor these developments and work in partnership with the Coalition for National Science Funding as this bill moves forward.
This week, the House approved the America Creating Opportunities to Meaningfully Promote Excellence in Technology, Education and Science (H.R. 1806) or the COMPETES Act. The Coalition for National Science Funding of which AADR is a member submitted a letter expressing their strong concerns with the bill which include the specific budget authorization levels for each of the individual directorates at NSF. The bill would propose to significantly reduce funding levels for two directorates: Social, Behavioral and Economic Sciences and Geosciences. The White House also issued a Statement of Administrative Policy indicating that, “If the President were presented with H.R. 1806, his senior advisors would recommend that he veto the bill.” It is therefore unlikely the Senate will consider the bill in its current form.
This week, AADR submitted comments in response to a National Institutes of Health Request for Information on the Neuroscience blueprint. Our comments indicated that neuroscience is fundamental to the understanding of other disorders expressed in the face and pain conditions. We encouraged placing an emphasis on proving incentives and opportunities for craniofacial neuroscientists, including inter and multidisciplinary training environments.
This week, AADR submitted comments on the Draft National Pain Strategy. We applauded the efforts of the National Institute of Neurological Disorders and Stroke (NINDS) for their efforts and included some specific recommendations around the inclusion of dental pain, a multidisciplinary research strategy and training of health care professionals.
Last week, AADR submitted comments in response to a National Institutes of Health Request for Information on the Precision Medicine Cohort. Our comments focused on the need for the precision medicine portfolio to include diseases and conditions of the dental, oral and craniofacial regions. We encouraged NIH to consider the immense clinical value of salivary diagnostics. AADR included some potential research questions and encouraged electronic dental records to be included as part of any precision medicine cohort.
Click here for additional information about the precision medicine initiative.
Last month, AADR submitted comments on the Office of the National Coordinator for Health Information Technology (ONC) Nationwide Interoperability Roadmap Draft Version1.0. Our comments focused on the need for electronic dental records to be included as part of any interoperability plan, ensuring the certification criteria include specifications that clearly ensure that disparate products receive certification are indeed interoperable and recommended the inclusion of standardized clinical terminology in common clinical data sets. Finally AADR supported ONC’s vision that the industry converge on the use of the same content and vocabulary standards. AADR strongly encouraged ONC to facilitate the development of a unified clinical dental taxonomy carefully integrated with existing code sets.
Last month, AADR submitted comments on the Advisory Report of the 2015 Dietary Guidelines Advisory Committee. AADR was pleased that the Dietary Guidelines Committee explored the relationship between the intake of added sugars and dental caries or tooth decay. In the comments, AADR endorsed the WHO Guidelines wherein they recommended the reduced intake of free sugars throughout the life course; the intake of sugars not to exceed 10 percent of total energy and a further reduction to below 5 percent or roughly 25 grams of sugar per day would provide additional health benefits. AADR also supported the Advisory Committee recommendations to restrict sugars intake outlined on in Part D. Chapter 6: Cross-Cutting topics of Public Health Importance.