DEPARTMENT OF HEALTH AND HUMAN SERVICES
NATIONAL INSTITUTES OF HEALTH
Fiscal Year 2003 Budget Request
Witness appearing before the
Senate Subcommittee on Labor-HHS-Education Appropriations
John Ruffin, Ph.D.
Director
National Center on Minority Health and Health Disparities
April 11, 2002
Kerry N. Weems, Acting Deputy Assistant Secretary for Budget
Mr. Chairman and Members of the Committee:
I am honored to appear before you as the Director of the National
Center on Minority Health and Health Disparities (NCMHD) to
present the President's budget request for FY 2003, a sum of
$187.159 million, which reflects an increase of $29.294 million
over the comparable FY 2002 appropriation. The NIH budget request includes the performance information
required by the Government Performance and Results Act (GPRA) of
1993. Prominent in
the performance data is NIH’s second annual performance report
which compares our FY 2001 results to the goals in our FY 2001
performance plan. As performance trends on research outcomes
emerge, the GPRA data will help NIH to identify strategies and
objectives to continuously improve its programs.
Thanks to the support of the Congress, the National Center on Minority
Health and Health Disparities was created in January 2001, as
mandated by Public Law 106-525. NCMHD’s mission is to lead, coordinate, support, and
assess the NIH effort to reduce and ultimately eliminate health
disparities. The
Center will achieve its mission by conducting and supporting
basic, clinical, social, and behavioral research, promoting
research infrastructure and training, fostering emerging programs,
disseminating information, and reaching out to minority and other
health disparity communities. NCMHD
envisions an America in which all populations will have an equal
opportunity to live long, healthy and productive lives.
Over
the past year, NCMHD has worked diligently with its partners, the
other Institutes and Centers (ICs) and Offices at NIH, to
implement its statutory requirements. I am grateful for the extensive support and cooperation
that the Center has received from Dr. Ruth Kirschstein, Acting
Director of NIH, and all of the other IC Directors. The help of the other ICs is demonstrated in the Center’s
achievements that I will discuss today. Last year, I informed you of what we were planning to attain.
Now, one year later, I am proud to share with you
highlights of what we have accomplished. The Center has successfully developed its organizational
structure and continues to hire new staff to carry out its
programs and initiatives.
NIH COMPREHENSIVE STRATEGIC PLAN AND BUDGET
For the first time in the history of the National Institutes of
Health, it will have a comprehensive Strategic Plan and Budget
that will be a guiding mechanism for the conduct and support of
all NIH minority health disparities research and other health
disparities research activities. NCMHD was honored to be charged with the development of
this plan in collaboration with the Director of NIH and the
Directors of the other NIH ICs. The Center has submitted the Strategic Plan and Budget to
the Office of the Director, NIH, for review.
The Plan was developed with substantial input from various
stakeholders including the public, academia and health
professionals representing those who disproportionately experience
disparities in health. It
describes current activities and future plans of the NIH to
address the health disparities crisis, to build a culturally
competent cadre of biomedical and behavioral investigators and to
increase the number of minority clinical and basic medical
scientists who are essential to the success of our efforts. There
are three main goals of the plan–research, research
infrastructure and community outreach which encompasses
information dissemination and public health education. Within each goal there are areas of emphasis
and objectives to accomplish the priorities identified or
mandated. Each
objective outlines an action plan, time-line, performance measures to monitor and report progress and
outcome measures to demonstrate accomplishment and ultimate
impact. The Plan will
continue to be an evolving document over the next five years.
Once finalized, it will be posted on the NCMHD website at www.ncmhd.nih.gov
on a continuing basis, and comments from the public will be
welcomed at any time. We
will update and revise the Strategic Plan and Budget annually with
the continued collaborative input of the other NIH ICs, and we
will provide annual reports on our progress.
NCMHD CONGRESSIONALLY MANDATED PROGRAMS
NCMHD also has
made rapid progress in implementing its three major
congressionally mandated programs --the Loan Repayment Program,
the Endowment Program for Section 736 (PHS Act) institutions, and
the Centers of Excellence Program. Currently, we are in the preliminary phase of implementing
the Centers of Excellence Program, which we have named Project
EXPORT, “Centers of EXcellence in Partnerships for
Community Outreach, Research on Health Disparities,
and Training.” We
are grateful to the NIH ICs for providing us with the necessary
mechanisms and support which made it possible for the NCMHD to
launch in fiscal year 2001 our two new loan repayment programs and
the Endowment Program for Section 736 institutions.
THE LOAN REPAYMENT PROGRAMS
In FY 2001,
the Center established the Loan Repayment Program for Health
Disparities Research, mandated in law, and the Extramural Clinical
Research Loan Repayment Program for individuals from disadvantaged
backgrounds, the authority for which was delegated to the Center
by the Acting Director of NIH. The Loan Repayment Program for
Health Disparities Research is aimed at increasing the number of
highly qualified health professionals in health disparity research
careers, and focuses on basic, clinical, and behavioral research with priority given to
biomedical research. The
Extramural Clinical Research Program seeks to increase the number
of highly qualified health professionals from disadvantaged
backgrounds who pursue clinical research careers. Applicants to the loan repayment programs, must have a
health professions degree, such as a M.D., Ph.D., D.O., D.D.S., or
equivalent doctorate degree. Individuals completing their residencies, post-doctoral
training, and internships may also apply.
We are pleased
to report that the first round of loan repayment awards were made
to 45 health professionals in FY 2001, eight months after the
Center’s creation. Twenty
eight awards went to the Health Disparities Research Loan
Repayment Program, and seventeen awards to the Extramural Clinical
Research Loan Repayment Program. A total of 125 applications were received.
Based on the tremendous interest in the program, during the
current fiscal year we anticipate receiving about 350
applications. We plan
to announce the FY 2002 awards in September.
THE ENDOWMENT PROGRAM
The Center is fortunate to have had similar success in implementing
the Endowment Program for Section 736 Institutions, as required by
Public Law 106-525. These
institutions are Centers of Excellence already established by the
Health Resources and Services Administration (HRSA) under Section
736 of the Public Health Service Act. The purpose of this program is to facilitate capacity
building for minority health disparities research and other health
disparities research at institutions that have a demonstrated
commitment to educating and training researchers from minority and
health disparity populations. In FY 2001, the NCMHD made the first round of endowment
awards to five institutions. The Center will continue its commitment to the Endowment Program
this year. The
preliminary phase of the
application process will begin with the release of
the next RFA in April to culminate with the issuing of FY 2002
awards in September.
CENTERS OF EXCELLENCE PROGRAM
Our efforts to
implement our Project EXPORT Centers of Excellence Program are
well underway. The
purpose of the Project EXPORT program is to develop and implement a network of centers of
excellence at academic institutions with a significant number of
students from racial and ethnic minority and other health
disparity populations. This
program aims to promote the conduct of minority health and/or
health disparity research aimed at reducing disparities in health
status; promote the participation of members of health disparity
groups in biomedical and behavioral research, prevention and
intervention activities through education and training; and build
research capacity in minority serving institutions. The RFAs for the program have been released, and the Center
is currently accepting applications through May 24. We have just successfully completed a series of four
technical assistance workshops across the country, which provided
the community with guidance on all aspects of completing and
submitting applications for the program. The attendance and level of participation at the workshops
was outstanding, and we look forward to receiving a number of
highly competitive applications. We expect to announce the FY 2002 awards in September.
NEW INITIATIVES
NCMHD is excited about the opportunity to undertake new approaches
to the health disparities crisis. The Center is presently exploring the development of the
following additional programs for FY 2003:
1) The Virtual University Program: to improve training
outcomes for students from minority and other health disparity
groups, improve the transition from undergraduate to graduate
programs and to independent investigators, and serve as a resource
for continuing education and/or retooling for faculty at minority
serving institutions.
2) The Rural Poor and other Health Disparity Groups: NCMHD will
collaborate with the
National Institute on Dental and Craniofacial Research (NIDCR) to
support 1) planning grants for research to prevent or reduce oral
health disparities, 2) pilot grants for research to prevent or
reduce oral health disparities, and 3) research infrastructure and
capacity building for minority institutions to reduce oral health
disparities.
3) Community Outreach: the NCMHD is committed to creating
communication
channels
that lend themselves to the bi-directional, interactive nature of
effective outreach. Accordingly,
the NCMHD will divide its outreach efforts into three major
objectives: 1) Outreach to Communities and their Community Based
Organizations 2) Outreach to Health and Social Service Professionals
3) Outreach to Health, Research and Social Service Institutions,
Professional Organizations, and the Business Sector.
4) Mississippi
Delta Project: with a
medical research agenda for the Mississippi Delta Region, the NCMHD
will concentrate on (1) solidifying the organizational and
technological network within the community to conduct research on
health disparities; (2) increasing the level of involvement of
community residents in the health research; (3) facilitating the
availability of culturally-appropriate health education material;
and (4) establishing a base for involvement of small businesses with
these entities.
CONCLUSION
The NCMHD is grateful
to the Congress, the Administration and the NIH Institutes and
Centers for the overwhelming support that each has provided the
Center in transitioning from the Office of Research on Minority
Health, to the National Center on Minority Health and Health
Disparities. I am proud
of the progress that the Center has made over the past year in
establishing its organizational structure and programs. The American people can now learn about the Center’s
activities and programs by accessing our new website at www.ncmhd.nih.gov
which is now averaging about 50,000 hits a month. Through continued and increasing collaborative ventures,
NCMHD will work diligently to define the health disparity issue for
every American, and garner their support to someday ensure an America in which all populations will have an
equal opportunity to live long, healthy and productive lives.