The Washington Letter

Senate Committee Calls for More Lung Disease Research

The ATS has achieved a victory towards increasing research support for lung disease in its Year of the Lung campaign! The Senate FY2011 health research and services spending, known as the Labor-HHS-ED Appropriations bill, includes language that the ATS recommended concerning lung disease at the NIH. The language, which is a directive to the NIH director, states, "The Committee encourages the Director to work with the NHLBI, NIEHS, NIAID and FIC to develop cross-Institute initiatives on the causes, identification, treatment and prevention of lung disease."

The following are the additional directives/policy guidance that the ATS was successful in securing for 2011:
• COPD
COPD is the fourth leading cause of death in the U.S. and the only one of the leading five causes of death that is on the rise. The Committee encourages the CDC to develop, in consultation with appropriate stakeholders, a federal plan to respond to this disease.

• NIAID
The Committee applauds the NIAID for its increased attention to the development of new TB diagnostics, drugs and vaccines, and it urges the Institute to continue to expand these efforts to halt the spread of TB, including drug resistant TB.

Senate Panel Approves 2011 Health Research and Services Funding

The FY2011 appropriations bills have been moving through House and Senate subcommittees and full appropriations committee's over the past few weeks. On July 29, the Senate Appropriations committee, chaired by Sen. Inouye (D-HI), approved the FY2011 Labor-HHS-ED Appropriations bill, following subcommittee action earlier in the week. The Senate bill proposes $577.8 billion for the Department of Health and Human Services, a decrease of $32.456 billion over FY2010.

The Senate Labor-HHS bill includes a $1 billion funding increase (+3.2%) for the NIH in 2011. However, this increase is based on NIH's appropriation for 2010, and does not factor in the 2010 NIH American Recovery and Reinvestment Act (ARRA) funding of $6.5 billion. The House Labor-HHS subcommittee, which met earlier this month, provided the same $1 billion increase for NIH in its FY2011 Labor-HHS bill.

The Senate bill provides $6.905 billion for the CDC, a 1.8% increase over the FY2010 funding level and $123 million over the House bill's proposed funding for CDC. Within CDC's budget, the Senate bill did not adopt the $1.2 million cut to the domestic tuberculosis control program proposed by the President's budget as the House did, and instead kept the program at the FY2010 funding level of $144.2 million.

Other highlights from Senate Labor-HHS bill include:
• $50 million for new Cures Acceleration Network within the Office of the NIH director;
• An increase of almost 80% for the CDC's Office of Smoking and Health. This funding is targeted to the CDC's efforts to analyze tobacco products and smoke following passage of the FDA regulation of tobacco bill and funding for media campaign to prevent youth smoking;
• A 21% increase for the National Institute of Occupational Health Research (NIOSH), much of it targeted for World Trade Center-related illness research;
• $251 million for a new state block grant on chronic disease prevention at CDC; and
• $40 million for CMS to support the creation of community-based patient-centered medical homes.

The Senate also approved the FY2011 Military Construction and VA Appropriations bill, which includes a 1.5% funding increase for the VA Research program, proposing a total of $590 million for the program in FY2011, and the Foreign-Operations bill, which includes flat funding at the FY2010 level of $225 million for USAID's tuberculosis program. The Senate has not yet acted on the 2011 Interior-Environment Appropriations bill, which includes the EPA budget. The House subcommittee has proposed a 2.6% cut to the EPA budget following the almost 40% funding increase for the agency in 2010.

The next step for the FY2011 Labor-HHS Appropriations bill is a vote by the full House Appropriations Committee. As the Congress is scheduled to adjourn within the next few days, this action appears unlikely to occur until September when Congress returns from its break. It is expected that due to the upcoming election, ultimately the final FY2011 appropriations bills will be delayed until after the election.

Proposed funding levels for specific programs and agencies that the ATS monitors at the NIH, CDC, VA and USAID are listed in several charts below. The House subcommittee has not released all of the program funding levels. We will share the proposed House and Senate funding for all programs once we have it.

Below are several charts of funding levels for NIH and CDC programs, the EPA, USAID's TB program and the VA Research program. Please let me know if you have any questions.

HHS Secretary Solicits Public Comment on Strategic Plan

Health and Human Services Secretary Kathleen Sebelius is inviting public comments on the Department's draft strategic plan for 2010 - 2015. The plan includes 5 overarching goals to implement the recently enacted healthcare reform law, each with a set of objectives. The goals of the plan are to:

• Advance scientific knowledge and innovation.
• Advance the health, safety, and well-being of the American people.
• Increase efficiency, transparency, and accountability of HHS programs.
• Strengthen the nation's health and human service infrastructure and workforce

Each goal includes a set of objectives followed by strategies for implementation. Included under the goal to transform health care are objectives to:

• Make coverage more secure for those who have insurance, extend affordable coverage to the uninsured
• Improve health care quality and patient safety

Some of the strategies of most interest to the ATS include those aimed at implementing payment reforms that reward quality care, supporting promising biomedical research to save lives, reduce the burden of chronic diseases, and identify new and more effective prevention strategies, reduce the number of healthcare acquired infections, reduce the occurrence of infectious diseases, and address persisting problems of workforce shortages.

The deadline for submission of public comments on the plan is August 14. The ATS will be submitting comments on the HHS draft strategic plan. The plan can be viewed at the following link and public comments may also be submitted here:
http://www.hhs.gov/open/strategicplan/index.html

The Washington Letter is written by the American Thoracic Society government relations office and emailed to all ATS members living in the United States. The letter keeps clinicians, scientists, and patients abreast of legislative, judicial, and regulatory issues in pulmonary, critical care, and sleep medicine. Each week's edition is archived on the ATS Web site, www.thoracic.org. If you have any questions or one more information about becoming involved in advocacy, please contact the ATS Washington office at 202-296-9770.