SPENDING BILLS CONTINUE TO MOVE FORWARD

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The House of Representatives left Washington for its summer recess on July 29.  The Senate, meanwhile, remained in session for an additional week.  One of the goals set by Senate Appropriations Committee Chairman Robert C. Byrd (D-WV) was to have all 13 Fiscal Year 2003 spending bills through the committee by the recess.  That goal has been met, but the House leads the Senate in getting these bills through the full body five to three.  The House, however, has moved only one other bill through committee, leaving it with seven appropriations that are still taking shape at the staff level.   Three bills are set for a conference committee (Defense, Legislative Branch, and Military Construction).  In addition, on July 24th the Congress finally sent the FY2002 Supplemental Appropriations bill to the President, which he signed on August 2. 

        As usual, Congress should not complete the appropriations process on time for the start of FY2003 on October 1, 2002.  It appears, as in many recent years, that a Continuing Resolution will be necessary to keep the government running and there is still talk of a lame-duck session following the election to complete the spending bills.  What follows are more details on the spending bills that have made it through the committee process, based on reports written by the panels to accompany the legislation.  Keep in mind that report language does not have the force of law, but agencies generally do not like to make the appropriators angry by ignoring their advice. 

Senate Provides Step Toward Doubling NSF Research Budget

        The Senate VA, HUD, Independent Agencies Appropriations Subcommittee, whose Chair Barbara Mikulski (D-MD) and Ranking Republican Kit Bond (R-MO) are committed to doubling the National Science Foundation (NSF) budget, took a major first step toward that goal during the markup of the FY2003 bill on July 23.  The full appropriations panel ratified their actions on July 25. 

        The Committee allocated $5.353 billion for NSF in FY2003, an increase of $564 million or 11.8 percent over the FY2002 appropriation and $325 million above the President’s request.  The Committee rejected the Administration’s proposal to transfer three programs from the Department of Commerce and the Environmental Protection Agency to NSF. 

         For Research and Related Activities (R&RA), the panel appropriated $4.132 billion, an increase of $533 million or 14.8 percent over the FY2002 level and $348.4 million above the President’s request.  The Committee provided the Social, Behavioral, and Economic Science Directorate (SBE) with its requested $195.6 million, $26.8 million or 16 percent above FY2002.  Within that amount, the Committee decided that the Children’s Research Initiative should be a priority and doubled its funding to $10 million.  The report calls for NSF to use the R&RA increase to help raise grant size and duration.  

        The Education and Human Resources Directorate (EHR) received $947.7 million, a $72.7 million boost over last year.  The Committee provided sufficient funding so that Graduate Student Stipends could be increased to $30,000 from the current $21,500.  Since there is a $30 million carryover from FY2002 in the Math Science Partnership Program, the panel only appropriated $120 million for this Administration initiative in FY2003, significantly reducing the President’s $200 million request.  The Committee also continued to hike support for programs to aid minorities and those institutions of higher education that serve them and to raise funding for the Experimental Program to Stimulate Competitive Research (ESPCOR) so that research capacity can be built to help universities in several states compete for NSF grants. 

        In addition, the FY2002 Supplemental Appropriations bill provided NSF $19.3 million for a scholarship program intended to increase the number of Federal cyber-security personnel.   

        In the same bill, the Committee provided $47 million for the Department of Housing and Urban Development’s Office of Policy Development and Research.  This is the same as the President’s request and $3.2 million below last year.   Once again, the Senators rejected the Administration’s request to eliminate the Partnership for Advanced Housing Technologies (PATH) program, providing it with $8.5 million.  This means that other programs will get less.

 Labor-HHS-Education

        The largest of the non-defense appropriations bills, the FY2003 Labor, Health and Human Services and Education bill, consisting of more than 300 programs spanning three departments, contains a significant amount of report language related to the social and behavioral sciences.   

The Bureau of Labor Statistics received $498.2 million from the Senate Committee for FY2003.  This is the same as the budget request, and $22.7 million above the FY2002 level.   Of this amount, $72 million comes from the unemployment trust fund and $426.1 million is Federal appropriations.  On July 26th, the Senate confirmed Kathleen Utgoff as the new Commissioner of Labor Statistics. 

The report language for the Department of Health and Human Services reflects Committee recognition of the alarming increase in the rate of premature death from obesity, the continuing racial/ethnic disparities in health, the need to prevent, treat, and control cardiovascular disease, the need to address lifestyle contributions to the leading causes of death, and the need to translate basic research into disease prevention. 

The $3.7 billion increase allocated to the National Institutes of Health completes the “historic five-year effort to double the funding for the agency, providing it with a $27.2 billion budget,” as noted by the report. 

The Agency is encouraged to contract with the Institute of Medicine (IOM) to study the distribution of research resources across its Institutes and Centers following the IOM’s study of the organization of the NIH.  (See related story, page 7).   

The Office of Behavioral and Social Science Research (OBSSR) is encouraged to foster the NIH’s behavioral research portfolio by planning and sponsoring interdisciplinary initiatives that further the public health missions of multiple Institutes and Centers.  “In particular, the OBSSR’s efforts to encourage research on new methodologies in the behavioral and social sciences are appreciated.”   

OBSSR is also urged to follow up on its conferences on sociocultural research and health disparities by developing initiatives with the National Center for Minority Health and Health Disparities and the NIH Institutes and Centers.  (See Update, July 10 and July 24, 2000 and January 14, 2002).  Similarly, the Office is urged to “push forward” on planned initiatives to increase scientific understanding of “the elements of education and the workplace that most affect health, and to follow up on its successful program of grants on behavior change by focusing on the challenge of maintaining behavior change.” 

As the result of a May 16 hearing by the Appropriations Subcommittee on Labor, Health and Human Services and Education held to examine the factors contributing to cardiovascular disease and explore possible approaches to prevent, control, and reverse it effects, the Committee included $419.3 million for this purpose in addition to the amounts provided as part of the physical activity and nutrition initiative.  (See Update, May 24, 2002).  The Committee encouraged the Departments of Health and Human Services and Education to coordinate programs and activities to address both initiatives. 

The National Cancer Institute (NCI) is encouraged to continue its recent emphasis on the interactions of genetic, environmental, and lifestyle factors that affect cancer risk and the prevention, diction, and treatment of cancer.  The Committee is particularly supportive of NCI’s work on risk determination and better communication of that risk. 

The Committee expressed its support for research that reveals the pathways through which positive experiences and emotions may enhance health or protect against illness.   The National Heart, Lung, and Blood Institute (NHLBI) is urged to continue its work in this area and to expand where possible any initiatives to increase basic behavioral research on the etiology of disease resistance.  

The National Institute of Diabetes and Digestive and Kidney Diseases is encouraged to continue “a research emphasis on the links between depression and diabetes.”  NIDDK is also strongly encouraged to build on its investments in behavioral research, particularly in areas that would add to the science base on the maintenance of positive behavior change. 

The Committee noted its pleasure with the development of a long-range plan for demographic research supported by the National Institute of Child Health and Human Development (NICHD).  The Institute is encouraged to continue focusing attention on family and community factors in examining the health and development of poor children.

NICHD is also applauded for its efforts to work collaboratively with the Environmental Protection Agency and the Centers for Disease Control and Prevention (CDC) to develop the Longitudinal Cohort Study on Environmental Effects on Child Health and Development, which is now called the National Children’s Study.  The study is being designed to “quantify the effects of environmental exposures plus the biological and social factors” on child health and development. 

The Committee provided $810.8 million to the Centers for Disease Control and Prevention to combat chronic disease and promote health, an increase of $63.6 million over the 2002 enacted level and $120.6 million above the President’s request.   

Recognizing that obesity has become the Nation’s “fastest rising public health threat,” the Committee noted its commitment to improving physical activity and nutrition in order to reduce chronic disease, premature deaths, and related health care costs.  Accordingly, the Committee provided $998.3 million for programs designed to increase “physical activity, healthy lifestyles and nutrition,” an increase of $49.7 million over last year’s level.   

The Agency is also provided $10 million to increase its cardiovascular program as part of the Committee’s effort to prevent and reverse heart disease.  The CDC is urged to initiate research “to examine strategies to prevent and reverse heart disease, including mind/body approaches to stress management, yoga, diet modification and exercise programs.” 

The report noted that “three factors – tobacco use, poor nutrition, and lack of physical activity are major contributors to our Nation’s leading causes of death.”  Accordingly, the Committee stated that it “believes the Federal investment in chronic disease prevention remains inadequate.”  In addition, “recognizing the need to establish chronic disease prevention as a national priority,” the appropriators provided a $55 million increase over the FY2002 level to begin to more appropriately address this “national crisis.” 

For the Behavioral Risk Factor Surveillance System, the appropriators provided $8 million, noting that “gathering, analyzing, and distribution data on behavioral risk factors is key to addressing a host of health problems, especially chronic diseases.” 

The report expressed concern for the health status of the residents of rural communities and commended the CDC for its efforts last year to conduct an assessment of rural health problems.  The Committee, therefore, provided “sufficient funds” to continue the effort. 

For the National Center for Health Statistics, the Committee recommends $125.9 million, $780,000 below the FY2002 funding level and the same as the Administration’s request. 

The Committee provided $308.6 million for the Agency for Healthcare Research and Quality (AHRQ), $58 million more than requested and $9.9 million more than FY2002.  Included in this amount is $106 million in Public Health Service transfers. 

The report expressed its disappointment that the President’s request for AHRQ reflected a 16 percent cut in funding, precluding the Agency from issuing any new grants or contracts.  In addition, the President’s request would require current, non-patient safety grants to be cut in half.  

The Committee continues to be very concerned about the enormous personal and economic cost of medical errors.  For FY2003, AHRQ is directed to devote $60 million to determine ways to reduce medical errors, a $5 million increase. 

The Committee recommended $6.9 billion for the Head Start program, an increase of $332.4 million above the FY2002 funding level.  This recommendation includes $1.4 billion in advance funding that will become available on October 1, 2003.  The findings of the Administration for Children and Families’ (ACF) recently released seven year national evaluation of the Federal Early Head Start program (EHS) justify the Committee’s efforts to substantially increase funding for EHS.  (See Update, July 8, 2002).  The Committee, however, expressed its concern that the congressionally-mandated National Impact Study of Head Start has not been completed and encouraged the ACF to finish the task. 

Expressing concern that “little progress has been made in reducing maternal mortality or morbidity over the past 20 years,” the Committee provided $3 million in funding to the Office on Women’s Health to establish an “Interagency Coordinating Committee on Safe Motherhood.”  The Coordinating Committee is directed to develop a five-year Federal research and strategic action plan, including professional funding proposals. 

The Department of Education funds several programs that support social and behavioral science research and provide financial aid to those in need seeking advanced degrees in these disciplines. 

The Committee appropriated $140 million for research and dissemination activities within the Office of Educational Research and Improvement (OERI), $18.2 million above FY2002 but $35 million below the President’s request.  The report notes that “the budget request presumed that Congress would succeed in passing legislation to reorganize education research in the Department of Education.  Until such legislation is approved, the Committee believes it would be premature to increase funding in this account to the level requested…”  OERI reauthorization is still a possibility this year as both houses of Congress have considered the issue.   

Also within the OERI account, the Regional Education Laboratories were appropriated $67.5 million, the National Center for Education Statistics received $90 million, and the National Assessment of Educational Progress and its leadership panel the National Assessment Governing Board were allocated $95.4 million.  Last year’s figures for these programs were $67.5 million, $85 million, and $111.6 million respectively. 

The Committee provided $102.5 million for International Education and Foreign Language Studies.  This is the same as the Administration’s request and 4 percent above last year, and breaks down as follows:  $88 million for Domestic Programs, $13 million for Overseas Programs, and $1.5 million for the Institute for Public Policy. 

The Fund for the Improvement of Postsecondary Education was appropriated $75.9 million.  This is an increase of $36.8 million over the Administration’s request, and while it is $105 million less than the FY2002 level, this can be explained by the removal of earmarked projects.   

The Javits Fellowships were funded to the tune of $12 million.  This is $2 million more than both last year’s appropriation and the budget request.  The Graduate Assistance in Areas of National Need program was allocated $31 million.  This is the same as both last year and the Administration’s figure.          

Commerce-Justice-State

      The Committee appropriated $56.6 million to the Department of Commerce’s Bureau of Economic Analysis (BEA).  The amount is the same as the FY2002 funding and rejects the Administration’s request for a $13.2 million increase.  The Bureau of the Census was allocated $496.8 million, slightly more than last year but $208.5 million below the requested level.  Period Censuses and Programs was appropriated $323.6 million.  The President had submitted a $500.3 million budget for this program.  The $176.7 million drop would likely make it impossible for the Bureau to fully implement the American Community Survey, as had been planned.  Funding levels for the BEA and the Census Bureau were hurt by the need to fund Federal Homeland Security programs. 

The National Institute of Justice received an appropriation of $64.9 million for FY2003.  This is $10.4 million above last year, but $13.4 million below the President’s request.  NIJ gets an additional $20 million from the local law enforcement block grant and $5.2 million from the violence against women allocation.   Much of the increase will go to boost the NIJ Office of Science and Technology, which the report commends for its many activities in assisting local law enforcement.  The Committee provided $32.3 million in FY2003 for the Bureau of Justice Statistics.  This is the same as the FY2002 funding.  On July 29, the Senate confirmed Lawrence Greenfeld as the Director of BJS.  He had been Acting Director for quite some time.   

The appropriation also provides $5 million for evaluations of the Office of Domestic Preparedness’ national programs.  For Juvenile Justice Programs, the Committee recommended $298.4 million in FY2003, slightly less than FY2002, but $40.6 million above the President’s request.  Of these funds, the Office of Juvenile Justice and Delinquency Prevention can set aside 2 percent for training and technical assistance and 10 percent for research, evaluation, and statistics activities. 

Agriculture

On July 25 the Senate Appropriations Committee approved its version of the FY2003 agriculture appropriations bill (S. 2801).  House appropriators passed H.R. 5263 on July 11. (See Update, July 22, 2002).  The following figures come from the Senate report.  

The Committee provided a total of $611.7 million for the Cooperative State Research, Education, and Extension Service (CSREES), $59.2 million more than the budget request and $69.6 million above last year’s funding.  Within the CSREES account, the Hatch Act formula funds program was allocated $185.6 million, $5.5 million more than FY2002.  As they did last year, the House Appropriations Committee prohibited funding for the Initiative for Future Agriculture and Food Systems (IFAFS).  The Senate bill attempts to get around the IFAFS’ “all or nothing” spending mechanism by appropriating $60 million to a discretionary account that is directed to fund the Initiative.  It’s unclear whether House appropriators will agree with this tactic when the bills go to conference.   

Also within the CSREES, the National Research Initiative Competitive Grants program received $164 million, a significant boost of $44 million over last year’s appropriation.  The Special Grants category received $119.5 million, $7.3 more than the FY2002 level.  Turning to the Department’s other research agencies, the Economic Research Service was allocated $65.7 million by the Committee.  This is $13.5 million below the President’s request, due in part to $5.9 million in rental payment increases that the appropriators rejected.  The National Agricultural Statistics Service was funded at $141.7 million.  Last year’s appropriation was $113.8 million; the President’s requested $143.7 million for the Agency.   

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HOMELAND SECURITY DEPARTMENT PASSES HOUSE; SENATE BILL FACES DELAY

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      On July 26, the House of Representatives approved legislation (H.R. 5005) to establish a Department of Homeland Security (DHS).  The previous day, the Senate Governmental Affairs Committee reported out its version (S. 2452) of the proposed department.  Some had hoped that the full Senate would give its assent before the summer recess.  This will not happen, as Senator Robert Byrd (D-WV) has raised objections to moving the bill too swiftly.  Another roadblock to the Department’s creation is the Bush Administration’s opposition to Senate provisions protecting civil service status for certain employees of the new DHS.

With regard to research, the House bill includes the undersecretary for science and technology placed in the legislation at the insistence of the Science Committee.  (See Update, July 22, 2002).  The full House also accepted an amendment sponsored by Rep. Lynn Woolsey (D-CA) to establish the NAS-report recommended Homeland Security Institute that would be operated “as a separate entity” by the DHS Secretary.  The Select Committee had rejected this idea during the mark-up.  (See Update, July 22, 2002).  Among the duties of the HSI are “economic and policy analysis to assess the distributed costs and benefits of alternative approaches to enhancing security.”  The House also accepted an amendment from Rep. Steve Israel (D-NY) to create a Homeland Security Science and Technology Advisory Committee consisting of 20 members appointed by the S&T undersecretary.

The Governmental Affairs Committee, chaired by Senator Joseph Lieberman (D-CT), marked up the new version of S. 2452 over two days.  The bill that emerged establishes six directorates including one for science and technology headed by an undersecretary.  Homeland Security Research and Development is defined as R&D “applicable to the detection of, prevention of, protection against, response to, and recovery from homeland security threats, particularly acts of terrorism.”  This is an expanded definition from the earlier version of the bill that the committee reported out in May, which focused almost exclusively on technology.

       The S&T directorate will contain an Office of Risk Analysis and Assessment to conduct or commission studies that include:  scenario based threat assessment exercises and simulations; predicting and discerning the potential methods, means, and targets of terrorists; and economic and policy analyses of alternative counterterrorism policies.

Like its House counterpart, the Senate bill also includes provisions for the contracting with already established or creating a new Federally funded research and development center(s) to provide the Department with independent analysis and support.  This would be somewhat similar to the House provisions for the HSI.  The Senate legislation also creates an “acceleration fund” to support R&D of technologies related to homeland security.  The fund would provide money for projects selected by a Security Advanced Research Projects Agency, a new entity modeled on the Defense Advanced Research Projects Agency (DARPA).

In addition, the bill creates an Inter-agency Science and Technology Council to provide the undersecretary with recommendations on priorities and strategies.  The undersecretary may also establish an Advisory Panel of people from industry, academia, and other non-Federal entities to advise and support the Council and Working Groups in specific homeland security areas to support the Council.

Although the full Senate will consider the bill when it returns in early September, the goal of creating the Department by September 11 is now in doubt.  In addition, the issue of employee rights remains, despite Senator Lieberman’s comment that it was “peripheral,” a fundamental difference between the Administration and the Democrats in Congress.

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IOM COMMITTEE BEGINS EXAMINATION OF THE ORGANIZATION OF NIH

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      On July 30, the Institute of Medicine’s (IOM) Board on Life Sciences held the first meeting of a year-long project to consider the organizational structure of the National Institutes of Health (NIH) and whether that structure needs reorganizing to allow the Agency to work more effectively and efficiently.

The NIH-sponsored study, conducted at the request of Congress, is chaired by former Princeton University President Harold Shapiro.  Shapiro is also the former Chair of both the Clinton Administration’s National Bioethics Advisory Commission and the IOM’s 1988 study, A Healthy NIH Intramural Program:  Structural Change or Administrative Remedies?  

The current project will attempt to discern: 

• If there are general principles by which the 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?

Optimal Performance

       Newly appointed NIH director Elias Zerhouni expressed his appreciation for the efforts the committee is about to undertake.  He questioned whether the Congress found NIH to be opaque and confusing.  Acknowledging that he is conscious of the need to examine the structure of the NIH, Zerhouni emphasized that “no organization should go too long without the exercise” the IOM Committee is performing.   

The funding change in science leads us to guess if NIH is optimally structured, stated Zerhouni.  He observed that concerns have been noted repeatedly regarding whether or not NIH is manageable, if the job is doable, and if the number of Institutes and Centers were unduly proliferating.  There are currently 27. 

For NIH, the optimal structure is complex and the output is difficult to measure, he said.  He explained optimal performance to the scientific community “may not be perceived as optimal by the disease advocacy groups or the Congress or the Administration.” 

Zerhouni questioned whether organizational change alone would significantly modify the input and output demands of the NIH stakeholders.  Any change will have to come against existing forces.  He cautioned the Committee that an exercise on the optimal number of institutes may not accomplish all that is needed and that the effectiveness of the process needs examining. 

Zerhouni noted other factors he thought the Committee should consider:  1) the effectiveness of the governance mechanism now in place; 2) the effectiveness of the decision-making process within and across the operational structure; and 3) the proper balance between centralization and decentralization. 

Clusters of Institutes?

 Former NIH Director Harold Varmus, now at Memorial Sloan-Kettering Cancer Center, echoed some of the concerns that he voiced in a March 2001 editorial in Science regarding the “Proliferation of National Institutes of Health.”  The proliferation of institutes and centers has caused the NIH to become more difficult to manage, he explained.   

The director is underused and spends too much time trying to get agreement.  The more institutes and centers that are created, the more difficult it is to coordinate across the NIH, he explained.  Moreover, the drive to create more institutes and centers is great and expansion is hard to stop.  Accordingly, the NIH director job is less attractive, said Varmus. 

Both Varmus and Bernadine Healy (NIH Director under Bush I) urged the Committee to consider creating “clusters of institutes” to allow for more efficient and effective management of the NIH. 

      Varmus cautioned the Committee against saying there should not be any new institutes and centers. There is an opportunity for the IOM Committee to do a dramatic experiment, he noted.  Consolidating the Institute of Drug Abuse and the Institute on Alcoholism and Alcohol Abuse, a suggestion made several times, is too obvious according to Varmus.