Appropriations Action Falters; CR Expected
Congress left for its five-week summer recess on August 1st without having cleared any of the 12 fiscal year 2015 appropriations bills. So far, the House Appropriations Committee has approved 11 of its bills—all but Labor-HHS-Education—with full House approval of seven (Commerce-Justice-Science, Defense, Energy & Water, Financial Services, Legislative Branch, Military Construction-Veterans, and Transportation). The Senate Appropriations Committee has approved eight of its 12 FY 2015 funding bills, but none have been approved by the full Senate. It is expected that none of the bills will clear Congress before the start of the fiscal year on October 1, necessitating a continuing resolution that would allow agencies to operate past the general election on November 4, and perhaps into December.
The bill that funds the CDC, NIH, HRSA, AHRQ and other Public Health Service accounts –the Labor-HHS-Education Appropriations Bill– cleared a Senate Subcommittee on June 10th, but has progressed no further. The bill and report text were released on July 23rd. It showed that all of ASPPH’s specific legislative priorities are funded at their existing (FY 2014) levels. In the current environment, that should be considered a victory. NIH and the CDC were given slight boosts over their FY 2014 levels. ASPPH’s legislative priorities are listed in the chart at the end of this report.
Harkin Legislation Would Alter Caps to Boost NIH
U.S. Senator Tom Harkin (D-IA) introduced legislation on July 24th intended to allow for additional investments in the National Institutes of Health (NIH). Senator Harkin is the chairman of the Senate Appropriations Subcommittee on Labor, Health and Human Services and Education. The Accelerate Biomedical Research Act would institute a budget cap adjustment to prioritize NIH over the remaining fiscal years of the Budget Control Act. According to Senator Harkin, “The budget cap adjustment is sufficient to allow the Appropriations Committees to restore the purchasing power the NIH would have had if funding had kept pace with inflation since 2003, the last year of the doubling. The bill includes language that will require the Appropriations Committee to maintain the current funding of $29.9 billion for NIH, above which appropriations will rise up to $46.2 billion at the end of the seven year period from Fiscal Year 2015 to 2021. The additional funding provides an initial bump of ten percent increases in the first two years to quickly mitigate the lingering effects of sequester, followed by a five percent increase each year thereafter.” ASPPH has endorsed the bill and the Association’s support was mentioned by Senator Harkin in his introductory statement in the Congressional Record.
CDC Lab Safety: Congressional interest in laboratory safety and security issues involving CDC laboratories remains strong. On July 31, leaders of the House Energy and Commerce Committee wrote to the Government Accountability Office requesting “a review the existing policies and procedures that federal agencies use in managing dangerous pathogens and how those agencies evaluate the effectiveness of those policies and procedures.” The panel held a hearing on the matter on July 16th.
Entering the Post-Antibiotic Era?: CDC Director Dr. Thomas Frieden spoke at the National Press Club on July 22nd. His remarks centered on drug-resistant infections. He said, “We talk about the pre-antibiotic era and the antibiotic era, if we are not careful, we will soon be in the post-antibiotic era. In fact, for some patients and for some pathogens, we’re already there.”
Antibiotic Development: The New York Times on July 23rd reported on “A Dearth of Innovation for Key Drugs,” specifically antibiotics. According to the article, “No major new type of antibiotic has been developed since the late 1980s, according to the W.H.O. From 2011 to 2013, the Food and Drug Administration approved only three new molecular entities to combat bacterial diseases — the lowest rate since the 1940s.”
FY 2016 Budget Memos: OMB has distributed to Federal agencies and departments various memoranda related to the development of the fiscal year 2016 budget. The FY 2016 Budget Guidance and FY 2016 Management Agenda memos were distributed on May 5 and July 18. On July 18, OMB distributed three additional memos that may be of particular interest: 1) Science and Technology Priorities for the FY 2016 Budget; 2) FY 2016 Budget Guidance for Combatting Antibiotic Resistant Bacteria Resource Priorities; and 3) FY 2016 Budget Guidance for Countering Biological Threats Resource Priorities.
Tuition for Vets: The recently enacted ‘‘Veterans Access, Choice, and Accountability Act of 2014’’ contains a provision (section 702) that mandates that recent veterans, their spouses, and dependents be charged in-state tuition at public schools, regardless of their actual residence.
ICD-10: The HHS Centers for Medicare and Medicaid Services (CMS) issued a final rule on July 31 setting October 1, 2015 as the date by which health care providers must use ICD-10 billing codes. The deadline has been delayed several times. According to CMS and others, among other benefits the ICD-10 system will strengthen the ability of public health officials to track diseases.
PCORI Funding: The Patient-Centered Outcomes Research Institute (PCORI) Board of Governors on July 27th approved $54.8 million in funding to support 33 new patient-centered comparative clinical effectiveness research (CER) projects “that will study health conditions and concerns that affect millions of Americans.” PCORI now has approved $549 million in support of a total of 313 research projects and initiatives since it began funding research in 2012. PCORI expects to award roughly $1 billion in research support over the two-year period from 2014 through 2015.
Personnel News and Calls for Nominations
Arnold Epstein, MD., has joined the U.S. Department of Health and Human Services (HHS) as the new Deputy Assistant Secretary and head of the Office of Health Policy in the Office of the Assistant Secretary for Planning and Evaluation. Previously, he had been the John H. Foster Professor and Chair of the Department of Health Policy and Management at Harvard University School of Public Health and a practicing internist at Brigham and Women’s Hospital. As a result of his appointment, he has resigned his position on the PCORI Board of Governors.
On July 31, NIH announced that Story Landis, Ph.D., will retire at the end of September from the directorship of the National Institute of Neurological Disorders and Stroke (NINDS). She has served as director since 2003. Walter Koroshetz, M.D., will serve as Acting Director. Formerly a professor of neurology at Harvard Medical School, Dr. Koroshetz joined NINDS as Deputy Director in 2007.
Dr. Joshua M. Sharfstein, a pediatrician and the secretary of the Maryland Department of Health and Mental Hygiene, will join the full-time faculty of the Johns Hopkins Bloomberg School of Public Health as the new associate dean for public health practice and training, effective Jan. 1, 2015. Dr. Sharfstein also will hold a faculty appointment in the Department of Health Policy and Management. Before joining the state of Maryland, he was principal deputy commissioner of the U.S. Food and Drug Administration.
The U.S. Government Accountability Office (GAO) has issued a call for nominations to fill a seat on the Patient-Centered Outcomes Research Institute (PCORI) Board of Governors recently vacated by Arnold Epstein, MD.
The Centers for Disease Control and Prevention has posted a request for nominations of candidates to serve on the CDC’s Advisory Committee to the Director. The submission deadline is August 31st.
Dr. Jesse L. Steinfeld, who served as U.S. Surgeon General during the Nixon Administration’s first term, died on August 5 at the age of 87.
ASPPH Appropriations Priorities FY 2015 (292 KB)