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QUESTIONS SUBMITTED BY THE SUBCOMMITTEE

DIRECTOR'S DISCRETIONARY FUND

Question. Last year for the first time the Committee provided the NIH Director with a $20 million discretionary fund. Dr. Raub, I understand that you have made the first allocation out of this fund for the Office of Women's Health, the Office of Minority Affairs, and for a new math-science education program.

Please tell us the amounts of each of these allocations and the criteria you have established for use of the discretionary fund.

Answer. The FY 1991 Director's discretionary fund will provide $1.5 million to the Office of Research on Women's Health, $1.5 million to the Office of Minority Programs, and $2.0 million for science education. We have solicited from the institutes, centers and divisions their ideas as to what aspects of their programs might be extended or amplified by an allocation from the fund. We will begin to review those soon and develop a set of recommendations for Dr. Healy as to how she may wish to proceed with allocation of the remaining discretionary funds.

COST CONTAINMENT

Question. Last year both the House and Senate report asked the NIH to develop a cost containment plan to help bring some stability to NIH programs. I understand the plan has the following major elements:

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Set four year as the average length of research grants. This would help provide funding continuity to investigators while insuring that a sufficient number of competing grants can be made each year.

Hold the average cost of increases for research grants to the same rate as the Biomedical Research and Development Price Index.

Scrap the practice of "approving" grant applications in favor of the "success rate" method.

Fund the maximum number of training grants without
jeopardizing ability to increase trainee stipends.

Control center costs instead of establishing a limit on the number of centers.

Increase funding for other mechanisms to allow for inflation.

Tell the Committee a little more about the proposal to scrap the practice of "approving" grant applications. What is the new system that you now propose?

Answer. The House and Senate Appropriations Reports both encouraged NIH to modify the peer review system in an effort to address the situation where 95% of applications are approved but only half are really considered as deserving support. To remove

he semantic confusion, NIH proposes to abolish the practice of 'approving" grant applications. This action would eliminate the category of approved but unfunded applications, i.e., those pplications that contribute to the high "approval" rate.

In its place, the NIH proposes to adopt the "success" rate. his rate is derived by dividing the number of awards by the total umber of applications reviewed, to report funding ratios. This ractice is in effect in all other federal agencies.

In addition, NIH proposes that Initial Review Groups, as well s Councils and/or Boards not recommend for further consideration ny application that does not merit funding under any ircumstances. The remaining applications will receive a score as ell as a percentile ranking. When the Councils and Boards meet,

hey will not review the bottom third of these applications. owever, any Council or Board may recommend singling out specific pplications to be funded from the bottom third on an exceptional asis as a result of scientific and/or programmatic onsiderations.

DELAYED OBLIGATIONS

Question. Dr. Raub, $400 million of the $498.1 million ncrease you have requested is for delayed obligation and will not e available until September 19 with less than two weeks of the iscal year remaining.

I understand that this is a budget gimmick to hold down utlays. We have also had to resort to things like that from time o time up here.

Will this proposal cause NIH any operational difficulties?

Answer. The FY 1992 Presiden't Budget proposes that $400 illion of new budget authority be made available for obligation on eptember 19, 1992, as part of the effort to insure that overnment-wide outlay limits are not exceeded.

Some minor operational difficulties will be created if the roposal is enacted; awards that normally would be made in late ummer 1992 may have to be delayed a month or so. onsequences, however, should be inconsequential.

RESEARCH ON WOMEN'S HEALTH

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Question. I understand that Dr. Ruth Kirschstein was ppointed Acting Associate Director for Research on Women's Health n September. I am glad to see that the office is up and running nd the recruitment of a permanent Associate Director is underway. am also pleased that you used the discretionary fund to provide he office with $1.5 million of research funds.

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I am a little concerned, however, that the operating budget or the office is only $400,000 and 3 positions. oordinating office had 33 people.

Are three positions really adequate for the Office on Women's Health to make a difference?

Answer. The Office of Research on Women's Health is a new and evolving office within the Office of the Director, NIH. A national search is ongoing for a permanent Associate Director which is an SES position. In addition, a second senior staff level position will be filled in the very near future. The office has also hired another senior level expert and a secretary. I expect that the ambitious goals and planned activities of the office will make it an enterprise whose needs will have to be reassessed as we progress. In this initial stage, we will make effective use of the resources provided in the President's Budget in carrying out the important mission of this new office.

CLINICAL CENTER RENOVATION

Question. Doctor, your FY 1992 budget includes a request for $13.4 million to begin Phase I of a major renovation of the Clinical Center expected to cost over $800 million. Since 1979, and through your 1992 request, $69 million has been either funded or requested for Clinical Center modernization.

Why do we need this major renovation now? I thought we were keeping up with the Center's modernization needs.

Answer. This major renovation must proceed to avoid failures of major infrastructure systems that serve large areas of the Clinical Center Complex.

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The Clinical Center Modernization program, when conceived, was intended to modernize the architectural and functional characteristics of patient care and patient support areas. requirement of maintaining normal operations in areas not being renovated precluded taking infrastructure systems out of service. Therefore, the modernization program has not accomplished the major improvements to the utilities infrastructure that are necessary to maintain reliable service and to keep pace with added utility loads necessary for modern research.

A comprehensive utility assessment of the Clinical Center Complex was initiated in 1988 after preliminary surveys indicated serious problems within the building's utility systems. The final assessment, completed by an independent architectural/engineering firm in 1989, indicated that significant and widespread deficiencies existed in the facility's infrastructure and that major construction was required to correct those deficiencies. a result of this assessment, the Clinical Center Complex Infrastructure Modernization and Improvement Program was initiated.

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Because of the very broad scale renovations that will be done under the infrastructure modernization, the current program has been redirected to address the most pressing safety and utility system problems until the new program can accomplish the needed major improvements.

MOUSE PRODUCTION FACILITY

Question. Earlier this year, I wrote you to request that you narrow the competition for the mouse production facility funds just to animal production facilities and laboratory facilities to make this competition more consistent with our original request to you in the FY 1991 Senate report.

What is the status of this competition?

Answer. On March 15, NIH issued a single solicitation for competitive applications for construction of a large-scale mouse production and mutant characterization facility. There will be full peer review as required by statute; applicants may request up to 75 percent of the allowable costs of a requested project, not to exceed $10 million. We anticipate making an award prior to the end of September.

OFFICE OF MINORITY PROGRAMS

Question. I am pleased to hear that your new Associate Director for Minority Programs, Dr. John Ruffin, recently assembled a team of experts to do some fact-finding on minority recruitment in the biomedical field and to hear firsthand some of the minority community's health concerns.

What is the status of the Office of Minority Program's 4-year Comprehensive Plan?

Answer. The Office of Minority Programs will soon submit to the Congressional Appropriations Committees a preliminary report outlining its strategy for developing a 4-year comprehensive plan to strengthen NIH's minority health research and training activities. This report describes the current activities in this area supported by the Institutes, Centers and Divisions, as well as several activities now being undertaken or planned by the Office of Minority Programs.

One major activity now being undertaken by the office is to convene a fact-finding team that will review NIH's current activities in the area of minority research and training and make recommendations as to how these activities can be strengthened. The recommendations of the fact-finding team will form the basis for the 4-year plan. The fact-finding team is expected to complete its work by the end of fiscal year 1991.

Question. Last year, the Committee urged NIH to develop a comprehensive plan to increase the number of Native Americans in the behavioral and biomedical fields. Will the Office of Minority Programs be taking the lead in this area?

Answer. The Office of Minority Programs serves as the focal point for coordinating the development of NIH policies, goals and objectives related to minority research and research training programs. Its mission includes developing strategies to strengthen NIH's efforts to increase the number of minorities, including Native Americans, working in the biomedical research fields.

The office is in the process of developing a four-year plan to increase research and training activities directed toward all minority groups. A fact-finding team will soon be convened to assist in drafting this plan. This team will be ethnically diverse and include representatives from academia, industry, and national and community based organizations interested in minority health.

Because of the comprehensive nature of this approach, we do not believe a separate Task Force for Native Americans is necessary. However, because of the extent of underrepresentation of Native Americans in the sciences, NIH plans to develop unique strategies specifically designed for this population. We plan to constitute a working group within the fact-finding team that will focus specifically on Native American health and training issues. Several Native Americans are expected to serve on the fact-finding

team.

This approach would maintain the inclusiveness of the factfinding effort, but still enable the targeting of a particular group or problem for special attention. The fact-finding team is expected to complete its work by the end of fiscal year 1991.

DIAGNOSTIC RADIOLOGY RESEARCH PROGRAM

Question. In FY 1990, the Committee provided $2 million to enable the Office of the Director to establish a free-standing intramural research program on diagnostic radiologic imaging. Last year, we were pleased to learn during our hearings that laboratory staff were being selected and some equipment were assembled. is the current status of the intramural program?

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Answer. We have made significant progress during the past year in our efforts to establish a Diagnostic Radiology Research Program. The Radiology Research Training program has been organized, and included the participation of radiology research labs from a variety of different intramural Institute programs. In response to advertisement of the Training Program, a large number of applications were received and evaluated. As a result, in July 1991, the first class of radiology fellows will arrive for research training in the program. In support of the program, an image analysis system is being acquired that will provide a centralized basis for the storage and analysis of radiological imaging data. This will also function as a powerful research tool for novel approaches to the interpretation of imaging data derived by different techniques, such as the superimposition of MRI and PET data. Finally, following an active advertising and recruitment effort, a large number of candidates have been screened for the position of Director of the Diagnostic Radiology Research Program. The final selection process is underway. It is anticipated a Director will be selected within the next few months.

Question. How has the Institute capitalized on the most promising areas of research?

Answer. A large variety of new techniques and new ideas has arisen just in the last few years, and a large number of scientists at NIH are utilizing these techniques and developing these ideas.

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