The Fiscal Year (FY) 2001 budget resolution passed the House of Representatives on March 24 by a vote of 211-207. Six days later, the Senate budget committee approved its version of the resolution on a straight line party vote of 12-10. The full Senate will take up the bill the week of April 3. The budget law requires that a resolution pass the Congress by April 15, although this has not always occurred. A House-Senate conference committee will be necessary to reconcile the two versions. The President does not sign or veto the budget resolution. It sets guidelines for the appropriations committees.
Both the House and the Senate committee version propose overall discretionary spending of $596.5 billion in FY 2001. This amounts to a $10 billion increase over last year's overall funding level, but well below the President's requested level of roughly $622 billion. The budget caps from the 1997 Balanced Budget Agreement would have set spending at $540 billion for FY 2001, but they are now history.
The House added another $400 million to Function 250 General Science, Space, and Technology during House floor consideration. This leaves the function, which includes the National Science Foundation (NSF), NASA, and Energy Science, with a $500 million increase in Budget Authority over FY 2000. The report from the House Budget Committee also includes a sense of the House resolution that NSF is important to the future of the country and should be generously funded. The budget resolution says that National Institutes of Health (NIH) should get a $1 billion increase.
The Senate Budget Committee provided a $445 million increase over FY 2000 for Function 250. Committee Chairman Pete Domenici (R-NM), in the summary, says the resolution assumes that NSF should receive an increase of $152 million, as should NASA.
Domenici also assumes a $1 billion increase for NIH. At the Committee markup Senator Olympia Snowe (R-ME) introduced and the Committee accepted a sense of the Senate resolution that NIH's budget should stay on its current course to doubling and that the increase for NIH for FY 2001 should be $2.7 billion. Senators Arlen Specter (R-PA) and Tom Harkin (D-IA) plan to introduce an amendment when the resolution reaches the Senate floor to increase the appropriation designated for NIH to keep it on the doubling track.
The House of Representatives has passed a FY 2000 Supplemental Appropriations bill that aside from providing money for defense, aid to Colombia, and domestic disaster assistance, also removes the provision preventing NIH from spending its entire budget before the last day of the fiscal year. It also includes a prohibition against spending by the Department of Agriculture for the Initiative for Future Agriculture and Food System program and the Fund for Rural America. It is unclear whether the supplemental will actually become law, since Senate Majority Leader Trent Lott (R-MS) has said he wants to provide this funding in the regular FY 2001 spending bills, but Senate Appropriations Committee Chairman Senator Ted Stevens (R-AK) is ready to move the bill through the Senate.
The Census Bureau recently found itself in the middle of a political firefight that could seriously undermine the chances of an accurate and successful decennial census. The controversy revolves around the long form which contains 52 questions regarding, among other things, personal income, housing costs and characteristics, and mental and physical disabilities. Census Bureau officials have noted that this long form is shorter than the one used in 1990 and that all the questions were subject to congressional-approval. In recent days, however, several Republican leaders have criticized the long form as being intrusive, and even irrelevant. This is occurring despite Congress' opportunity two years ago to make changes to the long form.
Census Bureau Director Kenneth Prewitt noted that Republicans' calls to not fill out the long form is tantamount to breaking the law. Federal law requires that individuals fill out and return their census forms — the penalty for not doing so is a $100 fine. Bureau officials are concerned that the criticism may compromise the data used by Federal and local governments when crafting policies. The initial response rate suggests that the criticism may have already stunted mail response for the long form.
Among those in the fray is the presumptive GOP presidential nominee George W. Bush who questioned whether he would fill out the long form if he received it in the mail. Bush said: "If they're concerned about the government intruding into their personal lives, they ought to think about it. We want as accurate a count as possible, but I can understand why people don't want to give over that information to the government. If I have the long form, I'm not sure I would do it either." Senate Majority Leader Trent Lott (R-MS) also criticized some of the questions in the form and has advised people to only fill out those questions they felt comfortable answering. Senator Chuck Hagel (R-NE) has indicated that he will offer a bill that would make it voluntary to fill out all questions except those used for congressional reapportionment.
Data from both the long form and the short form are used by the Federal government to reapportion the House of Representatives, and to distribute nearly $200 billion in government funds. The long form, which is sent to only one in six households, contains only questions that are either required by law or mandated by Federal court rulings. Long form data are also used by Federal agencies and local governments for many different functions, including to: assess public assistance needs of local communities, develop and fund programs for the disabled and elderly, determine areas subject to ground water contamination or water borne disease, determine areas eligible for urban development programs, and determine eligible recipients for Medicaid and Medicare funds. Additionally, the data captured by the long form are used by Federal statistical agencies to determine several key economic indicators, like the consumer price index and poverty rates.
Democratic leaders and Bureau officials have responded by assuring the public that all answers to census questionnaires are confidential. There is concern among Census Bureau officials, however, that the on-going Republican complaints about the long form have already negatively impacted peoples' willingness to fill out and return their long form. Preliminary numbers show that the response rate for the long form is 10 percent less than the corresponding rate for the short form. The response rate for the long form, however, is historically less than that for the short form. For instance, the response rate for the long form was 4.5 percentage points less than the short form in the 1990 census.
President Clinton echoed the Bureau's calls about the importance of completely filling out and returning census forms. He said: "Those who suggest that filling out your census form isn't essential are plainly wrong. An inaccurate picture distorts our understanding of a community's needs, denies people their fair share of resources and diminishes the quality of life not only for them, but for all of us."
Labor, Health and Human Services, and Education, and Related Agencies Appropriations Subcommittee Chairman Arlen Specter (R-PA) announced at the Subcommittee's annual hearing on the National Institutes of Health (NIH) that he will seek the third consecutive installment toward doubling the agency's budget in five years, despite the spending constraints of the budget.
During floor consideration of the Senate budget resolution this week, Specter and Ranking Member Tom Harkin (D-IA) are expected to offer an amendment to ensure that the budget contains sufficient resources to increase the agency's budget by $2.7 billion in FY 2001. This 15 percent increase for the NIH would continue the effort by Specter, Harkin and Representative John Porter (R-IL) to double the agency's budget by FY 2003. The budget resolution, as passed by the Senate Budget Committee, contains only a $1 billion increase for NIH.
Specter noted during the Subcommittee's hearing that he and Harkin have offered similar amendments for the past three years, with steadily increasing support from the rest of the Senate, but without the "enthusiasm of as many members as we would like to see." Noting that over the last two years Congress has added substantial funding ($4.3 billion) to the NIH's budget, he added that this feat was accomplished because of "NIH's good work and [their] persistence." Specter said he consistently get the question: "Is too much money being thrown at the NIH." He answers by saying the agency is worth it.
Dropping in on the Subcommittee's hearing, Senate Appropriations Committee Senator Chair Ted Stevens (R-AK) stated that he was "ready to do battle" on behalf of the NIH and continue the efforts towards doubling the NIH's budget in five years. Stevens acknowledged that there is "a very tight budget this year." Despite this fact, he said from a "strictly conservative point of view, we ought to increase the investment [in NIH] now" to reduce the impact on government health programs when the baby boomers retire. The budget, he continued, cannot absorb the costs associated with aging of the baby boomers if the rate of disease for that population is comparable to that of his generation. He added, however, that it is imperative that a way be found to ensure that the dollars provided to NIH are going to research. Stevens noted that he is not "too keen on providing funding for bricks and mortar."
Specter was particularly interested with the success rate, or the rate at which NIH funds applications — the ratio of applications funded to total number of applications. The current NIH-wide success rate is 26-28 percent. Specter asked Acting NIH Direct Ruth Kirchstein how much funding it would take for NIH budget to increase its success rate to 40 percent. He then asked each Institute Director to provide him: the Institute's current success rate, the total number of grants funded last year, the desired success rate for the Institute, and the amount of funding required to reach that rate. National Cancer Institute (NCI) Director Richard Klausner noted that NCI's current success rate is 30-31 percent and 4,000 applications were received last year. A meritorious success rate for the NCI would be 35 -37 percent, which would take approximately 20 percent increase in funding for the NCI to reach, he concluded.
At the 10 year anniversary celebration of the formation of the Congressional Biomedical Caucus, Representative John Porter (R-IL), warned NIH advocates against complacency. Speaking on March 27 before a group consisting mainly of House staffers, Porter cautioned advocates for the NIH to not "make the assumption" that the case for a 15 percent increase and doubling the agency's budget in five years is "so compelling that Congress will do it."
Obtaining the 15 percent increase in FY 2001 represents "a particular challenge," Porter continued. He encouraged the advocates to "not sit on the sidelines but to let their voices be heard." He further encouraged them to inform their members of how "much good science" there is and that funding cannot keep up with the opportunities that exist, noting that National Institute of Allergy and Infectious Disease Director Anthony Fauci had indicated that if his Institute's budget was doubled immediately "he would still be funding good science." Porter stressed that he "can think of no better spent dollars anywhere. The lives saved are incalculable," he stated.
The National Institutes of Health's (NIH) support for complementary and alternative medicine (CAM) research is "woefully inadequate," said the Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies Ranking Member Senator Tom Harkin (D-IA) at a March 28 hearing on alternative and complementary, and mind/body medicine. Acknowledging his "deep interest in the field of complementary and alternative medicine," Harkin said that his "basic belief is that we need to take advantage of every possible method of keeping people healthy."
Harkin, an ardent supporter of the National Center for Complementary and Alternative Medicine (NCCAM) and largely responsible for increasing the recognition surrounding complementary and alternative medicine at NIH and in the Congress, stressed that the NCCAM receives about $67 million annually, "less than one half of one percent of the total funding for the entire NIH" (See UPDATE, March 20, 2000, Number 5). He expressed his concern that research in this area remains underfunded given its prevalence. Articulating his skepticism regarding the amount of funding that the various ICs have indicated is for CAM, Harkin said that he has "some real questions about just what they are spending their money on and listing as CAM." He further noted that he intended to address the issue with each of the NIH Institute directors.
Making his first appearance before the Subcommittee, National Center for Complementary and Alternative Medicine Director Stephen E. Straus noted that the hearing reflected the "growing public interest in complementary and alternative medicine." Peter Kauffman, the Acting Director of the Office of Behavioral and Social Sciences Research (OBSSR), accompanied Straus to respond to questions regarding the overall NIH research portfolio on behavioral and mind/body research supported across the NIH Institutes and Centers.
Strauss told the Subcommittee that as NCCAM's first permanent director, he is "excited by the challenge" before him. The Center's strategy, he said, for taking on this challenge is different from that used by other NIH Institutes and Centers (ICs). "While the research conducted by the other ICs is usually driven by basic scientific discoveries, NCCAM has chosen to focus most heavily on definitive clinical trials of widely utilized modalities that, from evidence-based reviews, appear to be most promising," said Strauss.
Strauss pointed out that "mind-body medicine encompasses a spectrum of behavioral, biomedical, social, and spiritual components of our makeup that interact on a continuing basis in health and disease." He further noted that the broad discipline overlaps partially with NCCAM's mission, adding that the CAM community does not consider it a priority for his agency to study mind-body approaches that have well-documented theoretical and evidence bases, such as: patient education, biofeedback, and cognitive-behavioral approaches. These, he said, are all addressed extensively by other ICs working in concert with OBSSR.
This distinction is important because in FY 1999 the Congress provided $10 million in funding to the OBSSR to establish five mind-body research centers. A request for applications to fund the centers was issued in January 1999. In September awards were made to the University of Michigan, the University of Pittsburgh Medical Center/Carnegie Mellon, University of Miami, University of Wisconsin and Ohio State University. The awards are being administered by the National Cancer Institute, the National Heart, Lung and Blood Institute, the National Institute Child Health and Human Development, the National Institute of Mental Health, and National Institute of Dental and Craniofacial Research. The first results are expected in about two years (See UPDATE, October 25, 1999, Number 19).
Herbert Benson of the Mind/Body Medical Institute at Harvard Medical School proposed that "mind/body medicine, with its self-care and belief-related approaches, holds great promise for the nation's health and cost of healthcare." Benson told the Subcommittee that "mind/body medicine is different from what is called alternative and complementary medicine. Mind/body medicine is evidence-based whereas alternative medicine is not." He further stressed that the "full integration of mind/body, spirituality-related, self-care medicine is completely compatible with existing health care approaches."
Benson proposed that the Health Care Financing Administration (HCFA) establish large demonstration projects to definitively test the clinical efficacy of mind-body and belief-related interventions and to assess the cost-savings afforded by such approaches. The projects, he said, should start with medical conditions that are prevalent and expensive, such as: the prevention and treatment of coronary artery disease, the treatment of chronic pain, and the treatment of women's disorders including infertility.
Andrew Weil, from the University of Arizona, said that he is "encouraged by the level of interest Congress has shown in behavioral, alternative, and mind/body medicine." Dean Ornish, of the Preventive Medicine Research Institute at the University of California, San Francisco and a recent appointee to the Presidential White House Commission on Complementary and Alternative Medicine Policy, also applauded "Congress for establishing the Office of Alternative Medicine and elevating its status and funding."
Ornish told the Subcommittee that "although at least 50 percent of the determinants of our health are behaviors such as diet and lifestyle, only 1.4 percent of the national health expenditures and only 7 percent of the NIH budget is devoted to these areas." When we treat these underlying causes of diet and lifestyle, continued Ornish, "we find that the body often has a remarkable capacity to begin healing itself, and much more quickly than once been though possible." He, like Benson, advocated that HCFA cover alternative medicine and mind/body programs that have demonstrated medical effectiveness in randomized controlled trials published in peer-reviewed medical journals.
In his testimony to the Subcommittee, Acting OBSSR Director Peter Kaufmann noted that "currently, NIH supports approximately $1.6 billion in behavioral and social science research across the NIH Institutes and Centers." Kaufmann noted that "one example of the kind of behavioral and social sciences research that OBSSR promotes across all of the Institutes and Centers (ICs) is mind/body research." Funding for mind/body research is significant and broad at NIH, he continued, pointing to the fact that 14 of the NIH ICs will fund an estimated $125.3 million in mind/body research in FY 2001. Approximately 50 percent of the OBSSR's budget is devoted for this type of research.
Kaufmann informed the Subcommittee that mind/body research "encompasses behavioral, social, and biomedical research on the interrelationships among cognition, emotion, biological functioning, and physical health." Examples of the mind/body research being supported by the ICs include the:
* National Institute of Mental Health's support of research that examines the psychological and physiological effects of a group psychotherapy intervention for women with metastatic breast cancer, as well as the Institute's ongoing investigation of the link between social environment, psychological states (positive and negative affect, personal control, self-esteem), and vulnerability to upper respiratory infections;
* National Institute of Dental and Craniofacial Research's examination of how stress affects the ability to heal;
* National Cancer Institute's research assessing the effect of a stress reduction intervention program on the quality of life and immunologic function of women diagnosed with breast cancer; and
* The National Heart, Lung and Blood Institute's examination of pathways through which mental stress influences heart function in health and illness.
Testifying early in the Fiscal Year 2001 appropriations process, Centers for Disease Control and Prevention's (CDC) Director Jeffrey Koplan, received a warm welcome from the Committee despite being under fire for the agency's misreporting to Congress how it spent funds directed to chronic fatigue syndrome research.
With regard to the agency's budget, Porter noted that he is interested in a youth-oriented media campaign. It is his hope to link the CDC with other public health agencies, including the National Institutes of Health. Porter indicated that he had been in discussions with the CDC regarding how to design a campaign that covers a range of health risk factors for adolescents ages 9 -11. He made similar comments to National Institute of Aging Director Richard Hodes during that Institute's appearance before the Subcommittee. His discussion with Hodes likewise focused on lifestyle changes that might lead to healthier aging.
Porter's discussion of the issue of healthy behaviors follows report language in last year's appropriations' bill: One of the major goals of the Department of Health and Human Services is to improve the health of the American population. The Committee believes that, if we are to have a positive impact on the future health of the American Populations, we must change the behaviors of our children and young adult. Therefore, we must reach them at an early age with important health messages, such as tobacco prevention, sexually transmitted diseases, nutrition and exercise, and underage drinking. The Committee also believes that media is an effective way to reach this population with these and other messages, but to be most effective, media ads must run at times when children and young adults are watching and listening. . . In developing this plan, the Committee expects CDC to consult and coordinate with other government agencies that have public education efforts currently underway or have particular expertise in at-risk behaviors. . . The CDC is requested to submit a plan for such a public campaign no later than January 31, 2000. The Committee also expects CDC to take the necessary steps to begin its implementation, on a pilot basis, prior to the full plan's completion."
On June 27-28, the National Institutes of Health (NIH) Office of Behavioral and Social Sciences Research (OBSSR) will sponsor a national conference, Toward Higher Levels of Analysis: Progress and promise in Research on Social and Cultural Dimensions of Health. The conference is designed "to highlight the contributions of social and cultural factors to health and illness in order to achieve a better understanding of the interdependence of social, behavioral, and biological levels of analysis in health research."
The conference will address:
* Sociocultural constructs such as race, ethnicity, socioeconomic status, and gender;
* Sociocultural linkages between demographic factors and health;
* Social/cultural factors in prevention, treatment, and health services;
* Interpersonal, neighborhood, and community influences on health;
* Health justice and ethical issues; and
* Global perspectives on health.
OBSSR is providing a limited number of travel stipends to predoctoral students to attend the conference. Completed applications must be received by April 30, 2000. Recipients will be notified of awards by May 15, 2000. For more information see the OBSSR's web site: www1.od.nih.gov/obssr/events/conference.html. Questions may be directed to Paula Skedsvold, at skedvop@od.nih.gov.
In a "Dear Colleague" letter, the National Science Foundation (NSF) has announced a new special emphasis on research on the Information Technology (IT) workforce. The research should focus on three basic themes: environment and culture, IT Educational continuum, and the IT workplace.
The first theme includes how the environment, culture and other social contexts -- households, neighborhoods, communities -- shape interest in IT. Conversely, how interest in and use of IT shapes the environment, with particular emphasis on our understanding of developmental issues at different ages.
The second focus on the IT Educational Continuum means trying to understand how the overall educational environment influences students' progress from grade school to entry into the workforce. Also, why students who have the potential to succeed in the study of IT disciplines take educational paths that preclude or make it difficult to enter the IT workforce.
Finally, the third theme asks why women and minorities who have the potential to succeed in the IT workforce take alternative career paths. The theme is designed to explore what barriers and obstacles individuals must overcome to achieve success. How the IT workplace can foster increased retention and advancement of women and minorities is another topic under this theme.
NSF encourages multidiscipline collaborations for this research, particularly among social scientists and educators. The research proposed can address issues at the individual, societal and/or institutional level of analysis. NSF also hopes to stimulate explorations using multiple methodologies to explore these topics.
Proposals must be submitted by June 22, 2000. To view the announcement go to: http://www.nsf.gov/pubs/2000/nsf0077/nsf0077.htm. Inquiries may be sent to ITW-prog@nsf.gov.
The Directorate for Social, Behavioral and Economic Sciences (SBE) at NSF has announced its second competition for "Enhancing Infrastructure for the Social and Behavioral Sciences." The deadline is August 4, 2000. SBE expects to make 4-8 awards with about $3 million.
The competition aims to create or extend innovative large-scale infrastructure projects that promise widely spread support to social and behavioral scientists. Proposed projects may fall entirely within one of the following four areas or a combination of them:
-- Collect data from surveys, experiments or administrative records; case or historical records; or objects of investigation (archaeological items for example); that will support broad-based investigations into the most important scientific questions facing social and behavioral science in the next decade.
-- Create web-based data archiving systems that enable world-wide access to linked databases, and that incorporate innovative capabilities for metadata, file searching, and data confidentiality protection.
-- Create web-based collaboratories to enable real-time controlled experimentations, to share the use of expensive experimental equipment, and/or to share widely the process and results of research in progress.
-- Establish centers in research areas where concentrated, sustained and coordinated effort by multiple researchers is required to develop a fledgling field, reinvigorate a stagnant field, or jump start an areas that is ripe for major breakthroughs. Centers may be organized either geographically and/or virtually.
To view the announcement go to: http://www.nsf.gov/pubs/2000/nsf0079/nsf0079.htm. For more information contact: Paul Chapin at 703/306-1760 or pchapin@nsf.gov.