|
[
Subscribe to SPIN]
Defense Research: Capitol Hill Lobbying Day and Annual
Appropriations
PPO staff joined with colleagues from the Coalition for
National Security Research (CNSR) on July 10th for its annual Department
of Defense (DoD) Lobby Day on Capitol Hill. Heather Kelly and Austin
Weatherford, PPO’s undergraduate intern, visited the offices of Senators
Ernest Hollings (D-SC), Mary Landrieu (D-LA) and Strom Thurmond (R-SC), as
well as staff of the Senate Armed Services Committee and House
Appropriations Defense Subcommittee, to encourage support for behavioral
research in the FY03 DoD funding bill.
The annual appropriations bill for DoD (H.R. 5010) was
passed by the House in June and by the Senate on August 1st. House and
Senate appropriators are likely to meet in conference early in September
(following the August recess) to work out final details on the largely
non-controversial spending bill. There is good news for behavioral
research in both versions of the bill. For the first time, the House met a
science community goal of designating 3% of the overall DoD budget for the
Science & Technology line, which includes all basic research. The
Senate report accompanying the funding bill includes APA-drafted language
urging DoD to fully fund all behavioral research sponsored by the military
laboratories. PPO will seek to keep the larger funding level and the
specific language related to behavioral research in the final bill sent to
the President. To read the APA language included in the Senate DoD
appropriations report, see: http://www.apa.org/ppo/issues/dodrptlang03.html.
Psychologists Nominated for Key Advisory Positions
Science Policy staff regularly look for opportunities to nominate
psychologists to participate in consultative or advisory fora that are
likely to influence agency programs and/or policy decisions. On July 12th,
the Institute of Medicine's Board on Neuroscience and Behavioral Health
announced the roster for a study entitled "Responding to the
Psychological Consequences of Terrorism." We were pleased to see that
one of our nominees, Gerard A. Jacobs, Ph.D. (Director of the National
Disaster Mental Health Institute at the University of South Dakota) will
be serving on the panel. As Dr. Jacobs is the only psychologist
participating in the study to date, we will take advantage of an early
August comment period to reassert our interest in seeing greater
representation of psychological scientists on that panel. For more
information on the study goals and objectives see: http://www.iom.edu/IOM/IOMHome.nsf/Pages/NBH+Psychological+Consequences+of+Terrorism.
In addition, Science Policy staff worked with the Practice
Directorate to nominate a slate of prominent clinicians and prevention
researchers for the Agency for Healthcare Research and Quality's U.S.
Preventive Services Task Force. Tracy Orleans, Ph.D., a Senior Scientist
at the Robert Wood Johnson Foundation is currently the only psychologist
serving on the Task Force. For more information on the Task Force see: http://www.ahrq.gov/clinic/uspstfix.htm.
[back to top]
National Science Foundation Funding for 2003 and
Beyond
Congress has been very active on bills that will set
priorities and establish funding guidelines for the National Science
Foundation in FY03 and perhaps three to five years beyond. The House
Science Committee passed an authorization bill (H.R. 4664, the “Investing
in America's Future Act of 2002”) that encourages substantial increases
for NSF and a significant investment in the behavioral and social
sciences. The Senate version that is now working its way through
committees (S. 2817) is even more ambitious, setting a possible five-year
path to doubling the NSF research budget. PPO’s Heather Kelly invited
representatives of the science community to a July 31st meeting with
Senator George Allen’s (R-VA) staff from the Subcommittee responsible
for NSF oversight. The group urged the Senator and his colleagues to “mark
up” the bill and move it to the Senate for a full vote when Congress
returns in September. Congress will take up the appropriations bill, which
actually allocates specific funding for NSF, in the fall. Visit the
Library of Congress legislative site at http://thomas.loc.gov/ to conduct
online searches of current or past legislation.
Congress Takes Steps to Create Department of Homeland
Security
For much of July Congress worked to craft legislation that
would create a federal Department of Homeland Security. Because the
proposed department would meld or reorganize the functions of 22 other
government departments/agencies just about every Congressional Committee
felt the need to hold oversight hearings on the functions under its
jurisdiction including the administration and funding of research relevant
to the Departments mission. See the full slate of hearings at: http://www.apa.org/ppo/issues/sterrorismhearings.html.
When one provision of the President's plan called for
transferring certain public health preparedness functions to the new
department from the Department of Health and Human Services, APA joined
over two dozen other public health organizations in protesting the
transfer because of the likelihood that it would lead to inefficiencies
and distract from the on-going efforts to prevent and treat chronic health
conditions. The letter can be viewed at: http://www.apa.org/ppo/issues/securitycltnltr.html.
In addition, APA staff worked closely with the Consortium
of Social Science Associations, the office of Rep. Brian Baird (D-WA), and
House Science Committee staff to outline the role of behavioral and social
science research in the new department. However, the House bill did not
include specific language on behavioral research. The House Select
Committee on Homeland Security did include Rep. Baird's mental health
provision in its version that can be viewed at: http://www.house.gov/baird/prhomesec.htm.
On July 23rd, the House completed work on its version of
the bill and the Senate will return from the August recess on September
3rd to continue work on its draft. Science Policy Staff will take
advantage of the relative calm on Capitol Hill between now and then to
continue advocating for behavioral research with Senate staff.
To view the House version, click here: http://hsc.house.gov/legislation/hr5005eh.pdf.
To view the current Senate draft, click here: http://www.senate.gov/~gov_affairs/073002s2452index.htm.
[back to top]
National Human Research Protections Advisory Committee
(NHRPAC) Holds Quarterly Meeting
On July 30th and 31st, NHRPAC convened its quarterly
meeting in Washington to discuss issues related to regulations that seek
to protect human subjects who participate in research. Several NHRPAC
working groups presented progress reports on issues such as decisional
incapacity, informed consent, mental retardation and developmental
disabilities, research with incarcerated persons and research issues with
regards to children.
Of particular interest, the Children’s Workgroup is
drafting a guidance document that can be used by the Office of Human
Research Protections to clarify the section of federal regulations that
governs research with children, (45 CFR 46 subpart D). The workgroup is
focusing its current efforts on the interpretation of “minimal risk”
and “minor increase over minimal risk.” The guidance is meant to
assist Institutional Review Boards (IRBs) and investigators in their
interpretation of these concepts. The guidance will include case studies
to provide examples of what constitutes minimal risk in survey research
and other behavioral research paradigms that have been difficult for IRBs
to integrate with the traditional interpretation of risk. More information
on NHRPAC and its activities can be found at: http://ohrp.osophs.dhhs.gov/nhrpac/nhrpac.htm
Institute of Medicine Now Studying NIH Reorganization
A new Institute of Medicine (IoM) committee charged with
studying the structure of NIH and making recommendations to the U.S.
Senate held its first meeting on July 30th. The study is being conducted
with NIH funds, but began as a result of a congressional request. The
panel includes psychologist Alan Leshner, Ph.D., former director of the
National Institute of Drug Abuse and now head of the American Association
for the Advancement of Science. Other behavioral scientists on the panel
include psychiatrist Ken Wells, M.D. of UCLA and Martha Hill, Ph.D., R.N.,
Dean of Nursing at Johns Hopkins University. The full roster appears at http://www4.nas.edu/webcr.nsf/CommitteeDisplay/BLSX-K-01-05-A?OpenDocument.
The study is expected to last 15 months. The following
questions will be addressed:
- Are there general principles by which NIH should be organized?
- Does the current structure reflect these principles, or should NIH
be restructured?
- If restructuring is recommended, what should the new structure be?
- How will the proposed new structure improve NIH's ability to conduct
biomedical research and training, and accommodate organizational
growth in the future?
- How would the proposed new structure overcome current weaknesses,
and what new problems might it introduce?
APA is closely watching this process, alert to any
proposal that might enhance or dilute the strength of the behavioral and
social sciences at NIH. The discussion of what an ideal NIH organization
would look like is reasonable and overdue. And yet, the behavioral
sciences have been growing and expanding in acceptance at NIH and we want
the progress to continue. Several of the institutes that fund the most
behavioral and social science research –the National Institute of Mental
Health (NIMH) the National Institute of Alcohol Abuse and Alcoholism (NIAAA),
the National Institute on Drug Abuse (NIDA), the National Institute for
Neurological Diseases and Stroke (NINDS)-- are now operating with acting
directors, who carry less political clout than permanent directors.
Consolidating some institutes would not necessarily result in less
behavioral or social science research, and could potentially produce
additional opportunities—but that would depend on many factors.
Certainly not all parties would have the same motivation for suggesting
any particular change.
Several speakers and members of the committee referred to
the notion of merging NIDA and NIAAA to create an Institute of Substance
Abuse or Addiction as an example of reorganization that might reduce
redundancy and allow additional research to be funded.
APA will watch for opportunities to provide comments and
input into the process, and will keep its scientists well informed while
the study continues. A final report will be presented to Congress and
could then be used as a basis for legislation that would authorize a
reorganization of NIH.
A panel of congressional staff members spoke at the
meeting. They explained that Congress does not often know how to respond
to proposals to create new offices or institutes within NIH as a means of
addressing slow progress in a research area. An Institute of Medicine
report could potentially provide cover for members of Congress to say no
to some suggestions, and could guide the creation of new organizational
entities within NIH.
Elias Zerhouni, M.D., the current NIH Director, and
Bernadine Healy and Harold Varmus, former directors, spoke with the
committee. Dr. Zerhouni, who has only been director for two months, used
his time to pose questions to the committee that he hopes the report will
help him answer. Drs. Healy and Varmus had more specific ideas or
proposals.
Dr. Zerhouni acknowledged that NIH is very effective
despite its organizational complexity. He said that it is not easy to
measure whether NIH is optimally configured, because it isn’t easy to
put value on its many ‘outputs’ as one could more easily with a
business product. He had four jobs at Johns Hopkins but there was no
question who the boss was—there was only one boss. In the NIH position
he has one job but many, many bosses (the HHS Secretary, the President,
the Congress, etc.) who each have different expectations. He believes that
the many cultures of NIH have helped it attain success. It has not only a
scientific culture, but an administrative culture of very broad
consultation-- NIH uses 21,000 consultants per year.
He was asked to comment on the relative latitude NIH has
to set its own research priorities. Zerhouni said he feels that Congress
has been very restrained with earmarks. He said there is broad
understanding that NIH is an enterprise engaged in discovery, and that to
a great extent, the peer review process and scientific opportunity must
steer NIH.
Bernadine Healy, M.D., who served as NIH Director from
1990- 93, said the NIH is the greatest humanitarian organization in the
world and it exists for a humanitarian purpose. It has successfully merged
the promise of scientific discovery with easing human suffering. She said
that it isn’t just the number of institutes and disciplines alone that
adds to NIH’s complexity. She said science does grow and change and
scientists aren’t always the first to notice that a promising area is
being neglected. She said that NIH’s attitude has almost always been
that “No new institute is a good institute.” Her point was that if NIH
were ever proactive about new organizing units, it might not be saddled
with them from the outside.
Healy suggested that NIH’s structure could be modified
into clusters in a way that might simplify some types of administration—
- Intramural programs & clinical center
- The health and disease institutes (14 by her count, e.g. the
National Cancer Institute, National Heart, Lung & Blood
Institute).
- Medical and scientific disciplinary institutes e.g. National
Institutes for Nursing Research and General Medical Sciences.
- Capacity-building units, e.g. the Fogarty International Center &
National Center for Research Resources.
[back to top]
She would include a unit for managing large clinical
trials under #4, and emphasized that these clusters would have to be
balanced by a strong headquarters function in the Office of the Director
of NIH. She said that the NIH Director has a hard time ensuring that the
institutes cooperate with each other. That theme was echoed by Dr. Varmus.
Harold Varmus, M.D., director from 1993- 2000, wrote a
piece for Science shortly after he left the NIH outlining his views about
NIH’s sprawling organization. That article is widely credited with
prompting this IoM study.
He said that largely due to the proliferation of
institutes, NIH has become more difficult to manage. The NIH Director’s
job has become harder to fill. Varmus thinks that is due in part to NIH’s
reputation as a bureaucratic nightmare– the human resource challenge
alone of filling all the open positions is discouraging. He proposes a
smaller number of units and greater responsibility and authority for the
director. He said that in many cases the director is underutilized because
he/she has to spend an inordinate amount of time getting agreement to even
modest proposals. In addition, Varmus said there is a significant lack of
flexibility for the smaller institutes—they don’t often have the funds
to do the size of studies or type of work that needs doing.
He acknowledged that reorganization may be difficult to
achieve if advocates perceive it would create fewer opportunities for
their input and less emphasis on research they are interested in. The
fiscal growth of NIH has been fueled by advocacy. The committee must weigh
the political liabilities in the long- and short-term. Clearly he feels
that fewer units would strengthen the NIH research enterprise which is his
chief interest. Speaking of additional authority for the director, Varmus
said that he found the director’s discretionary fund and budgetary
transfer authority not to be useful. What he wanted was incentives for
institutes to collaborate.
He noted that NIH is successful for many reasons that have
little to do with the way it is organized—for example, NIH funds have
trained talented scientists who have trained other talented scientists.
NIH has carefully tended a peer review process by which the best science
is selected for funding. Varmus seemed not to think that the creation of
particular institutes has made as great a difference (though others would
surely disagree). He said that some dramatic and sweeping proposals are
needed, and suggested as an example that NIH could create a huge Mind and
Brain Institute (he wasn’t specific about the name) that would include
multiple institutes: NIMH; NINDS; NIDA; NIAAA; the National Institute on
Deafness and Communicative Disorders (NIDCD); and the National Eye
Institute (NEI).
APA welcomes the comments and questions of SPIN readers on
what works well, and doesn’t work well, within the National Institutes
of Health. More information about the NIH Reorganization study can be
found on the web site of the National Academy of Sciences:
http://www4.nas.edu/cp.nsf/Projects+_by+_PIN/BLSX-K-01-05-A?OpenDocument.
Any questions?
If you have any questions regarding SPIN or specific
science policy issues, please feel free to contact any of APA’s Science
PPO staff.
Geoff
Mumford, Ph.D., Director of Science Policy
Pat
Kobor, Senior Science Policy Analyst
Heather
O'Beirne Kelly, Ph.D., Senior Legislative and Federal Affairs Officer
Karen
Studwell, J.D., Legislative and Federal Affairs Officer
LaTonya Wesley, Legislative Assistant
| 
