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for determining individual chemical exposures to new theories on specific receptors which might link cause and effect from these exposures. Appropriately trained scientists are needed to pursue these leads.

Mr. Early: What about the knowledge of health care providers with respect to environmental health, and air pollution in particular?

Dr. Hoel: On the clinical side, it is important that physicians recognize symptoms of environmentally caused diseases. For example, air pollution can cause a variety of respiratory and other responses in all segments of the population, and it is important that the primary care physician know the causal relationships. With the objective of educating doctors about environmentally and occupationally induced diseases, we have initiated a program to develop this area in medical school curricula.

The program is off to a good start in that applications from almost a third of the United States medical schools were received and reviewed resulting in 8 awards

this year.

Mr. Early: How do the Institute's research training and research career programs address these areas?

Dr. Hoel: The NIEHS training and career programs are comprised of individual and institutional National Research Service Awards and career awards for physicians to engage in basic or clinical research in environmental health. These awards support trainees, fellows and clinicians for Ph.D. or postdoctoral training in determining health effects from environmental exposures. Areas covered are toxicology, pathology, mutagenesis, epidemiology and clinical research. The field is moving rapidly toward a better understanding of how chemicals and other environmental factors affect human health and how to better test and estimate the hazards from such materials, and up-to-date training is critical to advances in these areas.

Mr. Early: What additional steps need to be taken in order to improve this situation?

Dr. Hoel: The NIEHS programs are at a reasonable, steady state to support such efforts in Ph.D. training and we are excited about our new Initiative involving medical school curricula development. A high priority area for the Institute is the growth of this Environmental/Occupational Medicine Academic Award to involve a significant number of the nation's Redical schools, including minority institutions. We are spending approximately $1 million on this area in FY 1992.


Mr. Early: What is the average increase in the size of noncompeting and new and competing research project grants under the budget proposal?

Dr. Hoel: Under the FY 1992 budget proposal the increase for noncompeting continuation awards is 2.4% and for new and competing continuation research projects grants it is 5.8%. Overall the increase is 3.32.


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Dr. Hoel: The Biomedical Research and Development Price Index was 5.2 in
FY 1989 and 5.8 in FY 1990.

Mr. Early: Doesn't this institutionalize the large downward negotiations

the Institute has had to make in competing grants these past few years?


Mr. Early: Will your Institute be able to fund noncompeting grants at
commitment levels and new and competing grants at peer reviewed level?

Dr. Hoel: Based on current projections and programmatic adjustments made
in FY 1990 and FY 1991, sufficient funds would be available to fund the 288
noncompeting grants at their committed levels. Regarding new and competing
grants, we will implement the NIH Financial Management Plan. With increased
scrutiny of budgets by peer review groups, increased emphasis on pre-award
reviews by staff, and out of order funding where appropriate, we anticipate
that we will be able to fund grants at peer reviewed levels.


Mr. Early: What percentage of new and competing grants will the Institute fund under the FY 1992 budget request, and how does this compare to FY 1991 and FY 1990?

Dr. Hoel: It is estimated that the award rate for FY 1992 will be approximately 26%. In FY 1991 this rate was 24.8% and in FY 1990 the award rate was 29.8%.

How does this compare to the award rate of 5 years ago and 10

Mr. Early: years ago?

Dr. Hoel: As compared to the FY 1992 budget proposal, the award rate 5 years prior, in FY 1987, was 32.1% and 10 years ago, in FY 1982, it was 38.0%.


Mr. Early: What is th projected 'success rate" and how does this compare to FY 1991 and FY 1990, 5 years ago, and 10 years ago?

Dr. Hoel: It is estimated that the success rate for FY 1992 will be 25.7%. In FY 1991 the success rate was 24.2% and in FY 1990 the rate was 28.3%. As compared to the FY 1992 budget proposal, the success rate 5 years prior, in FY 1987, was 28.5% and 10 years ago, in FY 1982, it was 25.3%.


Mr. Early: How would you characterize the quality of research applications the Institute is receiving today and what kinds of comparisons would you make to prior years?

Dr. Hoel: The quality is very good. The nature of research on how chemicals and other environmental factors affect health has become increasingly sophisticated over recent years, as we have learned that things are not as simple as we first believed. This is the usual nature of science. However, new tools and techniques have provided the means to test new hypotheses and theories which are moving us toward a better understanding of how and why environmental agents cause diseases. This has reemphasized the need for interdisciplinary efforts in this field and has supported our efforts toward multifaceted approaches as supported by program projects and centers. Although complexity always involves increased costs, we appreciate the need for the use of tools of modern science to learn to predict and thus prevent disease outbreaks from environmental exposures.

Because of this change in the nature of the approach to studying health effects of environmental agents, it is difficult to compare the "quality" of today's applications with those in previous years. However, the applications ve see do reflect an expansion in the scientific disciplines being brought to bear on these problems, and we view that as an important shift.

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PATIE FINNI k. Ezzly: to vis mize gescentii: 21 cze Isseise be adle to fund wder the badget teqesi ed bow does is espezza to ? 1991 od 1990?

Dz. Soel: The perceele valise was sie 31st pesteedtle is I 1990 and the 290 perceactie ia I 1991 it is estimaise the site papiise vill to be the 300 percentile ia I 1992.

RESEARCE CENTRS 2. Early: What is the srerage increase is a cestu get weer the brudget request and bow vas tbe size of csis isezzase determined?

Dz. Foel: Tode: the FI 1952 badget proposal sibe srerage increase of a ceater is 2.51 over 7? 1991. This was seened prepriate iscrease in order to przsue the vazios priorities od eppesteities caised in the FY 1992 badget.

Mr. Early: Dat was the level of seward segotiatives in the cen progras in i 1989 ed II 1990 and what is the estimate for FT 19911

Dr. Hoel: The level of coward segotiatice for ceaters vas 8.51 in FY 1989 and 9.07 in 97 1990. Prograx adjustmesss aproximacing 12are indicated for FY 1991.

Mr. Early: Will SIDES be able to food soncompeting centers at comi chent levels under the budget request and competing centers & the peer revieved levels?

Dr. Hoel: Due to a cap ce ebe size of the centers wich vas instituted a manber of years ago, these gants have sot iacreased in size, but the nuzber of centers has increased in resposse de sex opportunities and initiatives. Since the amount of funds available has not kept pace vith chese energing opportunities,

some adjustzent to the son competing centers vill be required. Through aggressive işlenentation of the financial management plan and preapplication discussions vith applicants and through cost analysis by reviewers ve hope be able to fund competing ceaters at the peer revieved levels.

Mr. Early: How does the NIBHS plan to adainister the Financial
Manageaent Plan with respect to research project grants and how do you plan to
stay within the parameters that have been set?

Dr. Hoel: The Plan for the Containment of the Costs of Biomedical
Research calls for a liait to the increases of che costs of competing research
project grants of not more than the BRDPI. That means that the costs of a
pool of competing grants funded from one year to the next vill increase by no
sore than that index. This vill be accomplished by several means including
the individual deteraination and cost analysis of the proper resources to
support individual projects; the selection of individual grants based on

costs, as well as scientific merit; and funding an array of mechanisms to achieve the overall average.

Noncompeting grants will be computed by providing on average no more than a four percent increase for future years with a limit on indirect costs to the rate in effect at the time of the competing award. In this fashion, we will provide stability and predictability to both NIEHS and the investigator.

Mr. Early: Does the NIEHS plan to make greater use of "out of order" funding to achieve a lower cost per award?

Dr. Hoel: As proposed in the financial management plan, "funding out of order" is not intended expressly as a means of achieving a lower average grant cost but as one of several techniques for containing the overall costs of NIH research awards. Such a funding policy will be applied only to those grant applications near the payline that are still applications of a very high quality. Thus the peer review system will not be compromised in our efforts to manage costs.

Mr. Early: What has been the reaction of your Institute's study sections to the Financial Management Plan, and limiting the overall increase in the cost of a grant?

Dr. Hoel: Our one Institute Study Section has been briefed on the outlines of the draft Financial Management Plan and the importance of close scrutiny of budgets at their level. To date there has been no reaction and limited opportunity for staff to observe any changes in behavior. The extramural community is understandably guarded in its reaction to this proposal. However, once NIH demonstrates that this policy will have no adverse impact, i.e., funding of high quality science will not be compromised, both scientists and administrators will be more reassured.

Mr. Early: What impact will limiting the average increase in the cost per award have for your Institute, particularly with respect to the National Toxicology Program and clinical research?

Dr. Hoel: Limiting the average increase in the cost per award may have peculiar effects on the NIEHS. It may very well have an impact on the nature of science in our portfolio. While we support no clinical trials and little clinical research per se, there are some critical needs in environmental epidemiology. These studies are quite expensive and may be difficult to initiate under the anticipated limitations. Care will have to be taken that the sometimes unique demands for resources in these projects are not unduly effected by the overall management scheme. Since the work of the National Toxicology Program is done primarily through contracts, the limits would have little effect on this.

Mr. Early: In general, Doctor, what do you see as the "down side" of using the BRDPI, out of order funding, and shortening the average length of a grant?

Dr. Hoel: The BRDPI is a relatively accurate measure of the change in costs from one year to the next in biomedical research. To make sure that the

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