Washington Highlights: December
3, 2004
Congress Nears Finish Line For FY 2005 Spending Bills
Contents
Prior Issues
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Although Congress has approved a $388.4 billion omnibus spending
package that incorporates the nine regular FY 2005 appropriations
bills not yet enacted into law, a controversial proposal to give
the chairs of the Appropriations Committees access to individuals'
tax returns continues to delay final approval of the omnibus spending
bill.
The House passed the conference agreement Nov. 20 by a vote of 344
to 51. The Senate passed the package 65 to 30 later the same day
only after adding a provision to strike the tax proposal to a resolution
(H.
Con. Res. 528) containing technical corrections to the omnibus
bill. H. Con. Res. 528 also reduces the across-the-board cut to
non-defense, non-homeland security discretionary funding from 0.83
percent to 0.80 percent. The House was expected to approve the amended
resolution Nov. 24 under unanimous consent, clearing the omnibus
bill for the President for his signature. However, House Minority
Leader Nancy Pelosi (D-Calif.) objected, saying Democrats would
agree to a vote Dec. 6 "after the rest of the spending bill
can be examined." The House is expected to return Dec. 6 to
approve the technical corrections resolution, releasing the omnibus
bill to the President. In the meantime, Congress passed another
continuing resolution (CR) to continue funding for federal programs
through Dec. 8. The current CR expires Dec. 3.
The final spending package, which was incorporated into H.R.
4818, the foreign operations appropriations bill, complies with
the overall spending target for FY 2005 agreed to by the Congress
and the Administration. This represents a freeze in non-defense
discretionary spending. Additional spending added to the conference
agreement was offset in part by the across-the-board cut in all
non-defense and non-homeland security spending. The following provisions
cover programs of interest to medical schools and teaching hospitals.
All funding totals presented in this summary include
the 0.80 percent across-the-board cut.
National Institutes of Health: The conference agreement appropriates
$28.371 billion for NIH, an increase of $571 million (2.1 percent)
over the FY 2004 level. The bill provides $30 million through the
National Center for Research Resources (NCRR) for extramural research
facilities construction and renovation. The House bill proposed
no funding for this program; the Senate bill included $119.2 million,
the same as in FY 2004. The conference agreement also provides $150
million through the National Institute for Allergy and Infectious
Diseases (NIAID) for constructing BSL-3 laboratories.
The conference agreement retains the cap on extramural salaries
for NIH, as well as the Substance Abuse and Mental Health Services
Administration and the Agency for Healthcare Research and Quality,
at Executive Level I ($175,700 in 2004).
On the issue of public access, the conference report states, "The
conferees are aware of the draft NIH policy on increasing public
access to NIH-funded research. Under this policy, NIH would request
investigators to voluntarily submit electronically the final, peer
reviewed author's copy of their scientific manuscripts; six months
after the publisher's date of publication, NIH would make this copy
publicly available through PubMed Central. The policy is intended
to help ensure the permanent preservation of NIH-funded research
and make it more readily accessible to scientists, physicians, and
the public. The conferees note that the comment period for the draft
policy ended November 16th; NIH is directed to give full and fair
consideration to all comments before publishing its final policy.
The conferees request NIH to provide the estimated costs of implementing
this policy each year in its annual Justification of Estimates to
the House and Senate Appropriations Committees. In addition, the
conferees direct NIH to continue to work with the publishers of
scientific journals to maintain the integrity of the peer review
system."
The conference report notes, "The conferees concur with the
concerns expressed in the Senate report about the disappointing
precedent contained in the Administration request that would have
used average cost assumptions inconsistent with NIH's own Cost Management
Plan. To the extent that resources allow, the conferees believe
that NIH should follow its Cost Management Plan principles, which
will help NIH continue to maintain the purchasing power of the research
in which it invests."
The conference agreement does not include a provision in the House
bill to stop funding for two grants supported by the National Institute
on Mental Health. The Senate bill did not contain a similar provision.
The conferees "reiterate their support of the two-tiered peer
review process used by NIH to judge research grant applications
and continue to expect NIH to ensure that its funds are allocated
to research that is both scientifically meritorious and has high
potential public health impact."
Health Professions: The final bill provides $299.6 million
for the Title VII health professions education programs for FY 2005,
an increase of 1.8 percent over last year. The only programs to
receive an increase are the primary care medicine and dentistry
programs, which receive $88.8 million, an 8.6 percent increase.
All other programs, including Scholarships for Disadvantaged Students,
AHECs, geriatric training programs, and workforce information and
analysis received level funding. The Title VIII nursing programs
received $150.7 million for FY 2005, a 6.2 percent increase.
Children's Hospital's Graduate Medical Education: The children's
hospitals GME program is funded at $300.8 million, a 0.8 percent
decrease from FY 2004.
Council on Graduate Medical Education: The conference report
includes language to permit the Health Resources and Services Administration
to continue funding for COGME through FY 2005.
National Health Service Corps: The omnibus agreement provides
$131.5 million for the National Health Service Corps, a reduction
of $38.4 million (22.6 percent) from the previous year. The accompanying
report language indicates that the reduction is not expected to
result in fewer awards because HRSA will no longer provide additional
payments to cover the tax burden associated with loan repayment
awards. The corporate tax relief bill enacted earlier this year
exempted such awards from federal income taxes.
Agency for Healthcare Research and Quality: AHRQ is funded
at $318.7 million for a $15 million increase (5 percent) over last
year. Report language dictates that the additional funds are to
be used for clinical effectiveness research, as authorized in the
Medicare Modernization Act. As all funds for AHRQ are derived from
transfers from other Public Health Service agencies, this funding
is not subject to the 0.80 across-the-board cut.
Centers for Disease Control and Prevention: The omnibus
agreement appropriates $4.498 billion for the Centers for Disease
Control and Prevention (CDC), an increase of $130 million (3.0 percent)
over FY 2004.
Bioterrorism Preparedness: The final bill provides $1.164
billion for the CDC ($58 million over FY 2004), which includes $396.8
million for the Strategic National Stockpile, $926.9 million for
state and local preparedness, $141.1 million for upgrading CDC capacity,
$79.4 million for biosurveillance activities, and $16.7 million
for anthrax vaccine research. The HRSA Hospital Bioterrorism Preparedness
program receives $491.4 million, a $26.6 million (5.2 percent) decrease
below FY 2004. The curriculum development program receives $27.5
million, level with last year. Another $47 million is directed to
the NIH for research on countermeasures.
Health Information Technology: The final conference agreement
does not include funds for Health Information Technology within
the Secretary's office. The Administration had requested $50 million,
while the House bill provided $25 million for this purpose.
Veterans Medical Care: The FY 2005 omnibus agreement includes
an appropriation of $27.7 billion for veterans medical care, an
increase of $1.26 billion (4.7 percent) over FY 2004. The conference
agreement assumes an additional $2 billion in third-party collections.
Veterans Medical Research: The omnibus agreement provides
$402.3 million for the VA Medical and Prosthetics Research program,
a decrease of $3.24 million (0.8 percent).
National Science Foundation: The omnibus agreement includes
$5.47 billion for the National Science Foundation (NSF), a reduction
of $105 million (1.9 percent) from FY 2004. This total includes
$4.22 billion for NSF Research, a cut of $30.8 million (0.7 percent).
75 Percent Rule: Section 219 of the Labor-HHS portion of
the bill delays implementation of the April 30, 2004, Final Rule
that revises the criteria Medicare uses to classify hospitals as
inpatient rehabilitation facilities (the so-called "75 Percent
Rule"). The revisions would reduce Medicare payments for some
rehabilitation facilities. The AAMC and 29 other provider and patient
advocacy organizations had supported adoption of the delay, which
would apply to IRFs certified on or before June 30, 2004. Under
Sec. 219, the Secretary of Health and Human Services may not expend
funds to implement the Final Rule until the Government Accountability
Office (GAO) issues a study and recommendations regarding "clinically
appropriate standards for defining inpatient rehabilitation services."
Once the study is released, the Secretary has 60 days to determine
whether the Final Rule is consistent with the GAO recommendations
and to revise the IRF classification criteria accordingly.
Foreign conferences: The conference agreement does not include
a general provision proposed by the House limiting the attendance
of HHS employees at foreign conferences. The Senate bill did not
contain a similar provision. The conferees state they "are
pleased that in the current constrained fiscal environment, the
Secretary of HHS has taken steps to monitor and limit travel by
HHS agency employees to international conferences. The Secretary
should, however, ensure that all necessary U.S. scientists are permitted
to attend important international scientific meetings to present
their research findings and to learn about research being conducted
in other countries."
H-1B Visas: The omnibus bill also contains several provisions
related to H-1B visas. Individuals that have earned masters or higher
degree from a U.S. institution of higher education will not be counted
against the annual cap on H-1B visas; however, this exemption is
limited to the first 20,000 eligible applicants. Additionally, all
sponsoring employers will now be required to pay a new $500 fee
for fraud prevention and detection at the time of the initial application
and if the individual changes employers.
Information:
Dave Moore, Senior Associate Vice President
AAMC Government Relations
dbmoore@aamc.org
(202) 828-0525 (overall bill, NIH, CDC)
Jonathan Fishburn, Director, Research, Education and Veterans' Legislative Affairs
AAMC Office of Governmental Relations
jfishburn@aamc.org
(202) 828-0525
(NIH, NHSC, VA, NSF, H-1B)
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Office of Governmental Relations
efroyd@aamc.org
(202) 828-0525
(health professions, AHRQ, preparedness)
Christiane Mitchell, Senior Legislative Affairs Manager
AAMC Government Relations
cmitchell@aamc.org
(202) 828-0526
(75 percent rule)
NAS Report Focuses on Facilitating Interdisciplinary
Research
The National Academies Committee on Facilitating Interdisciplinary
Research Nov. 19 issued a report
urging academic institutions to explore new models that foster and
reward interdisciplinary interactions. The study panel was co-chaired
by Nancy Andreasen, M.D., Ph.D., Chair of Psychiatry, University
of Iowa, and Theodore L Brown, Ph.D., Beckman Institute for Advanced
Science and Technology, University of Illinois. The panel's report
provides recommendations for students, post-doctoral students, researchers
and faculty members, educators, team leaders, academic institutions,
professional societies, funding organizations, and journal editors.
Policy recommendations for academic institutions include:
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Academic institutions should develop new and strengthen existing
policies and practices that lower or remove barriers to interdisciplinary
research and scholarship, including developing joint programs
with industry and government and non-government organizations;
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Beyond the measures suggested above, institutions should experiment
with more innovative policies and structures to facilitate interdisciplinary
research (IDR), making appropriate use of lessons learned from
the performance of IDR in industrial and national laboratories;
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Institutions should support interdisciplinary education and
training for students, postdoctoral scholars, researchers, and
faculty by providing such mechanisms as undergraduate research
opportunities, faculty team-teaching credit, and IDR management
training; and
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Institutions should develop equitable and flexible budgetary
and cost-sharing policies that support IDR.
The report also makes a number of academic institutional structure
recommendations, including:
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Institutions should explore alternative administrative structures
and business models that facilitate IDR across traditional organizational
structures;
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Allocations of resources from high-level administration to
interdisciplinary units, to further their formation and continued
operation, should be considered in addition to resource allocations
of discipline driven departments and colleges. Such allocations
should be driven by the inherent intellectual values of the
research and by the promise of IDR in addressing urgent societal
problems;
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Recruitment practices, from recruitment of graduate students
to hiring of faculty members, should be revised to include recruitment
across department and college lines; and
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Traditional practices and norms in hiring of faculty members
and making tenure decisions should be revised to take into account
more fully the values inherent in IDR activities.
Information:
Tony Mazzaschi, Senior Associate Vice President
AAMC Biomedical Health Sciences Research
tmazzaschi@aamc.org
(202) 828-0059
Congress Passes CREATE Act
The House of Representatives Nov. 20 approved legislation (S.
2192) revising federal patent statutes to better protect inventions
arising from collaborative research among universities and other
organizations. The Senate approved the bill on June 25 and it was
presented to the President on Nov. 29. The "Cooperative Research
and Technology Enhancement Act of 2004," known as the CREATE
Act, remedies a 1997 federal circuit court decision (OddzOn Products
Inc. v. Just Toys Inc), which appeared to make it possible that
certain information shared among research collaborators at different
institutions could be cited as "prior art" and used to
invalidate subsequent applications for joint patents. The legislation
excludes such information from prior art if a joint research agreement
is in place at the time the invention is made and if other provisions
are met.
Information:
Stephen Heinig, Senior Research Fellow
AAMC Biomedical Health Sciences Research
sheinig@aamc.org
(202) 828-0488
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