April 13, 2001
President's Budget Provides Increases for NIH, AHRQ; Cuts for Health Professions, CDC
The Bush Administration April 9 released details of its $1.96 trillion budget for FY 2002. While holding to a 4 percent overall increase in discretionary spending, the budget provides increases of $2.75 billion (13.4 percent) for the National Institutes of Health and $36 million (13.3 percent) for the Agency for Healthcare Research and Quality. However, other important health programs such as the health professions education programs, Centers for Disease Control and Prevention, Community Access Program and rural health programs were subjected to significant cuts.
Highlights of programs of interest to medical schools and teaching hospitals are listed below.
National Institutes of Health: The budget proposes $23.112 billion for NIH in FY 2002, an increase of $2.751 billion (13.4 percent) over current year funding as the fourth year of a five-year effort to double the agency's budget by FY 2003. NIH estimates that the total number of research project grants (RPGs) will increase to an all-time high of 34,090 (an increase of 1,686 over FY 2001); however, new and competing RPGs will be held at 9,158, the same level as the current year. The budget also assumes a slight rise in the average cost of new grants to $347,915, an increase of $7,455 (2.2 percent) over FY 2001.
Funds for research training are increased by $53.7 million (9.1 percent) to a total of $645.3 million. This figure supports a total of 16,304 individual and institutional full-time training positions, an increase of 140 over FY 2001. Also included is a 10 percent increase in stipends for pre- and post-doctoral students. Under the research contracts line, NIH plans to devote $28 million to two new extramural loan repayment programs for clinical and pediatric researchers.
The budget also proposes to reduce the cap on NIH extramural research salaries back to Executive Level II.
National Center for Research Resources: Within NIH, the NCRR was budgeted $974 million, an increase of $157 million (19.2 percent) over FY 2001 levels. This includes $97 million for extramural construction, an increase of $22 million (29.3 percent).
National Center for Minority Health and Health Disparities (NCMHD) and National Institute for Biomedical Imaging and Bioengineering (NIBIB): The two newest NIH entities were included in the budget proposal, with NCMHD receiving $158 million, an increase of $26 million (19.7 percent) over comparable FY 2001 figures. NIBIB is budgeted at $40 million, an increase of $38 million (1,900 percent) over comparable FY 2001 funding.
Health Professions: The budget slashes these programs by $213 million (60.3 percent) to $140 million. The budget states that these programs were created when a physician shortage existed and recommends refocusing grants on emerging shortage areas, such as nursing. Accordingly, training for primary care medicine and dentistry is eliminated and nursing programs received a slight increase of $5 million (6.5 percent) to $81.5 million. All other programs were severely cut or eliminated: training for diversity cut by $63.4 million (58.1 percent) to $45.8 million; Area Health Education Centers (AHECs) cut by $25.8 million (77.4 percent) to $7.6 million; and geriatric programs eliminated.
Agency for Healthcare Research and Quality (AHRQ): The budget proposes $306 million, an increase of $36 million (13.3 percent). However, these funds are derived solely from transfers of evaluation funds. The funding increase includes $3 million for patient safety research and $16.1 million for investigator-initiated grants for improving the quality and cost-effectiveness of care. The budget also includes is $4 million for development of the National Healthcare Quality Report (NQR), $2 million for the National Healthcare Disparities Report, and $4.7 million for the Medical Expenditure Panel Survey (MEPS).
Center for Disease Control and Prevention (CDC): The administration budget provides for $3.96 billion in budget authority for FY 2002, a decrease of $165 million (3.9 percent) over comparable current year funding.
National Health Service Corps: The budget proposal includes $126 million for the NHSC, an increase of $1 million (0.08 percent) over current year funding. The administration also proposes reforming the Corps to better address the neediest communities and to eliminate taxation on NHSC scholarship awards.
Community Access Program: The budget eliminates this program, which was funded at $125 million last year. This new program provides grants to states and localities that use integrated services to provide care to the uninsured. The budget states that HHS will work to integrate health care services and align delivery through existing channels, such as Medicaid, SCHIP, and Community Health Centers. Community Health Centers received a $124 million proposed increase.
Other HRSA Programs: Ryan White AIDS programs are allotted $1.8 billion, level funding from last year.
Rural health programs received a significant cut of $27.7 million (27.5 percent), down to $73 million, and the telehealth line item is cut by $30.4 million (84.4 percent) to $5.6 million. Funding for poison control centers is cut by $3.6 million (17.9 percent) to $16.4 million; EMS for children is cut by $3.4 million (18 percent) to $15.6 million; and trauma care is reduced by $533,000 (17.7 percent) to $2.5 million.
VA Research: The proposed budget provides for a VA medical and prosthetics appropriation of $360 million, an increase of $10 million (2.9 percent) over current year funding.
Information: Dave Moore (NIH), Jonathan Fishburn (NIH, CDC, NHSC, VA), or Erica Froyd (health professions, AHRQ, HRSA), AAMC Office of Governmental Relations, 202-828-0525.
