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Budget and Policy Update

On February 1st, The President released his $3.8 billion FY 2011 Budget Request.  Below are highlights from the Health and Energy portions of the Administration’s proposal:


Department of Health and Human Services
The President’s FY 2011 Budget totals $81.3 billon for HHS an increase of $2.3 billion over FY 2010.  Highlights include:


Advancing Patient-Centered Health Research (Comparative Effectiveness Research): The Budget includes an additional $261 million, including program support costs, in the Agency for Healthcare Research and Quality (AHRQ) to support new research projects. This funding will support the generation, translation, and dissemination of research that will improve health care quality and efficiency by providing patients and clinicians with evidence-based information to enhance medical decision-making. The Budget also continues to support Patient-Centered Health Research within NIH. HHS continues to invest the $1.1 billion for this research provided in FY 2009 to AHRQ, NIH, and the Office of the Secretary by the Recovery Act.


Enhancing Health Information Technology (Health IT):The Budget includes $78 million, an increase of $17 million, for the Office of the National Coordinator for Health Information Technology (ONC) to advance the President’s health IT initiative by accelerating health IT adoption and electronic health records (EHRs) utilization as essential tools to modernizing the health care system. The increase will enable ONC to lead and coordinate Federal health IT efforts while implementing and evaluating Recovery Act health IT programs.  The Recovery Act also established Medicare and Medicaid health IT incentive programs to provide an estimated $20.6 billion over 10 years for the adoption and meaningful use of EHRs. In FY 2011, these programs begin providing incentive payments to eligible providers. The use of EHRs will improve the reporting of clinical quality measures and will promote health care quality, efficiency, and patient safety.


NIH : The FY 2011 Budget requests $32.2 billion for the National Institutes of Health (NIH), an increase of $1.0 billion, or 3.2 percent, over the FY 2010 enacted level. In FY 2011, NIH will utilize the $32.2 billion Budget to support innovative research across the spectrum from basic to clinical, guided by the NIH Director’s five areas of exceptional research opportunities that includes: 1) supporting genomics and other high-throughput technologies; 2) translating basic science into new and better treatments; 3) reinvigorating the biomedical research community; 4) using science to enable health care reform; and 5) focusing on global health. NIH Director Francis Collins in his budget briefing today talked about NIH research helping to “de-risk” product development.


The FY 2011 budget request also includes $3.2 billion for AIDS research roughly 10% of the total NIH research budget. Controlling and ultimately eliminating HIV/AIDS will require safe, effective vaccines and other preventive measures. Developing such vaccines remains a priority and one of NIH’s greatest challenges. This effort will require significant advances in basic research to both better understand the virus and the disease and to develop new vaccine strategies.  In addition to these funds, the budget for the National Institute of Allergy and Infectious Diseases includes $300 million, the same level as in FY 2010, as part of the United States Government’s $1 billion contribution to the Global Fund to Fight HIV/AIDS, Tuberculosis in FY 2011.


Office of the Secretary-Bioterrorism:  The Budget request for NIH biodefense activities is $1.8 billion, which includes $100 million for radiological/nuclear and chemical countermeasures research. These funds will support basic and applied research on agents with bioterrorism potential which will ultimately lead to the availability of new or improved vaccines and therapies to protect or treat persons exposed to threat agents.


HIV/AIDS Programs at CDC and HRSA: The Budget includes more than $3 billion, an increase of $70 million, for CDC and the Health Resources and Services Administration (HRSA) to enhance HIV/AIDS prevention, care, and treatment. This increase includes $31 million for CDC to integrate surveillance and monitoring systems, address high-risk populations, and support HIV/AIDS coordination and service integration with other infectious diseases. This increase also includes $40 million for HRSA’s Ryan White program to expand access to care for underserved populations, provide life-saving drugs, and improve the quality of life for people living with HIV/AIDS.


CDC: Division of Viral Hepatitis:  CDC requests $21,107,000 for Viral Hepatitis which reflects an increase of $1,848,000 above the FY 2010 Omnibus. FY 2011 funds will sustain and enhance viral hepatitis work in areas such as epidemiology and surveillance; education, training and program collaboration; policy and program development; and laboratory research. CDC’s effort will focus primarily on the most common forms of viral hepatitis in the United States: Hepatitis A (HAV), B (HBV), and C (HCV). CDC aims to decrease morbidity and overall public health burden associated with viral hepatitis with the following portfolio of prevention strategies.


FDA Medical Product Safety Initiative: The Budget includes$1.4 billion, an increase of $101 million, for medical product safety. This increase will enable FDA to invest in tools that will enhance the safety of increasingly complex drugs, medical devices, and biological products. With these additional resources, FDA also will increase inspections to improve the security of the supply chain and reduce the potential for harm.


Investing in FDA’s Scientific Infrastructure: The Budget includes $25 million for advancing regulatory science at FDA. This initiative builds on the President’s commitment to harness the power of science for America’s benefit and includes $15 million for nanotechnology related research, which holds great promise for advances in medical products and cosmetics. The additional resources will also enable FDA to update review standards and provide regulatory pathways for new technologies, such as biosimilars.


Invests in Wellness Initiatives for the Federal Workplace to Improve Health and Lower Costs. The Budget invests $10 million for the Federal employee workplace wellness initiative.  This initiative will implement prototype wellness programs in select locations that will be rigorously evaluated for their ability to produce a healthier workforce and lower healthcare costs.  By encouraging the adoption of these programs, we can improve the productivity of our workforce, delay or avoid many of the complications of chronic disease, and slow medical cost growth.


Prevention: Reducing the burden of chronic disease, collecting and using health data to inform decision-making and research, and building an interdisciplinary public health workforce are critical components to successful prevention efforts. The Budget includes $20 million for a CDC initiative to reduce the rates of morbidity and disability due to chronic disease in up to ten of the largest U.S. cities. These cities will be able to incorporate the lessons learned from implementing evidence-based prevention and wellness strategies of the Recovery Act’s Communities Putting Prevention to Work Initiative.


Improving Health Outcomes of American Indian and Alaska Natives:  The President is committed to improving health outcomes for American Indian and Alaska Native communities and supporting the provision of health care for American Indians and Alaska Natives.  The Budget includes nearly $5.4 billion, an increase of $354 million, that will enable the Indian Health Service (IHS) to focus on reducing health disparities, supporting Tribal efforts to deliver quality care, ensuring that IHS services can be supplemented by care purchased outside the Indian health system where necessary, and funding health facility and medical equipment upgrades.  These investments will ensure continued improvement to support the Administration’s goal of significantly reducing health disparities for American Indians and Alaska Natives.


Expanding Health Centers:  The Administration remains committed to building on Recovery Act investments and ensuring quality access to health centers.  The Budget includes an increase of $290 million for further expansions of health center services, including the creation of 25 new access points in communities without access to a health center, and will facilitate the integration of behavioral health into the existing health centers’ primary care system.  With this increased funding, health centers will be able to serve more than 20 million patients in FY 2011, 1.8 million patients more than FY 2009.


Department of Energy
The Department of Energy (DOE) is requesting $28.4 billion in discretionary budget authority for FY 2011, which includes funding for the department's energy research, science, environmental management, and defense programs. This represents an increase of $1.8 billion, or 6.8 percent, over the FY10 level of 26.6 billion.
The funding request for the DOE Office of Science is $5.1 billion, an increase of $218 million, or 4.4 percent, above the FY10 funding level.

The FY 2011 budget request proposes funding increases for most DOE Office of Science program include:  

• High Energy Physics (HEP) would receive $829 million, an increase of $18.5 million, or 2.3 percent, over the FY10 enacted level;


• Nuclear Physics (NP) would receive $562 million, an increase of $27.0 million, or 5.0 percent, over the FY10 enacted level;


• Fusion Energy Sciences (FES) would be funded at $380 million, a decrease of $46.0 million, or 10.8 percent, below the FY10 enacted level.  This decrease reflects a significant reduction in the U.S. contribution to the ITER project, consistent with the current status of this international project;


• Biological and Environmental Research (BER) would receive $626.9 million, an increase of $22.7 million, or 3.8 percent, over the FY10 enacted level;  


• Basic Energy Sciences would be funded at $1.84 billion, an increase of $198.5 million, or 12.1 percent, over the FY10 enacted level;


• Advanced Scientific and Computing Research (ASCR) would be funded at $420 million, an increase of $32.0 million, or 8.1 percent, over the FY10 enacted level; 


• Science Laboratories Infrastructure would receive $126.0 million, a reduction of $1.6 million, or 1.3 percent, below the FY10 enacted level; and


• Workforce Development for Teachers and Scientists would receive $35.6 million, a $14.9 million, or 72.2 percent, increase over the FY10 enacted amount. Of the total, $16 million is to support 60 new Early Career Research Awards at universities and DOE national laboratories.  Another $10 million is designated for the DOE Office of Science Graduate Fellowship program, an increase for the fellowships program of $5 million over FY10, which would support 170 additional graduate fellowships.


• The Budget Expands the Energy Frontier Research Center (EFRC) Program: The President’s FY 2011 budget for the Office of Science includes $40 million in new funding to expand the Energy Frontier Research Centers (EFRCs) program.  The budget envisions a competition for between three and eight new EFRCs in two specific areas: 1) discovery and development of new materials and, 2) research for energy applications, the latter category to be directed toward applications not currently covered by existing EFRCs.  The budget contains funding to provide ongoing support to the existing EFRCs as well.


• Advanced Research Projects Agency-Energy (ARPA-E) to receive $300 million:  The FY 2011 request for ARPA-E is $300 million, $273.4 million of which is to support ARPA-E supported R&D projects. This funding request builds upon the $400 million in Recovery Act funds provided to ARPA-E. 


• DOE Request Supports Three Existing and One New Energy Innovation Hub:  The budget proposes a total of $107 million to support DOE Energy Innovation Hubs, including $24.3 million for each of the existing three hubs funded by Congress in FY10. These hubs focus on: Production of Fuels from Sunlight (Office of Science); Energy Efficient Building Systems Design (Energy Efficiency and Renewable Energy); and Modeling and Simulation of Advanced Nuclear Reactors (Nuclear Energy).  An additional $34.0 million is designated within the Office of Science for the creation of a new hub to focus on Batteries and Energy Storage. 


• RE-ENERGYSE Energy Education Program Slated to receive $55 million:  The DOE budget includes $55 million for the RE-ENERGYSE (REgaining our ENERGY Science and Engineering Edge) program.  Of this total, $50 million comes from Energy Efficiency and Renewable Energy while $5 million comes out of the Nuclear Energy budget.  Of the $55 million, $40 million is for higher education programs, including undergraduate and graduate scholarships and fellowships, internships, post-doctoral opportunities and development of interdisciplinary masters programs in areas of clean energy.  The remaining $15 million is designated for technical training, mostly at community colleges, and new K-12 education and outreach efforts.

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