• Background
• Executive Summary
• Report of the Task Force
• Additional Individual Task Force Member Comments and Recommendations
• Appendix 1: Notice of Invitation
• Appendix 2: Task Force Roster
• Appendix 3: NIH Public Forum Planning Committee Roster
• Appendix 4: Invited Speakers
• Appendix 5: Agenda for Public Forum on Tuition Reimbursement

Report of the Task Force on Tuition Reimbursement for National Research Service Awards

June, 1995

Background

There is considerable disparity in tuition policies across the NIH Institutes and Centers (ICs). Although the NIH has made several attempts to develop a uniform tuition policy, none has been endorsed by the academic community, and none has been adopted as formal policy by the NIH.

In an attempt to resolve this issue, a Task Force was assembled to consider the tuition reimbursement policy on NRSA institutional research training awards. The Task Force officiated at a one-day public meeting, to which all interested parties were invited. The Task Force prepared a summation of the testimony from the Public Forum and developed recommendations for a uniform NRSA tuition policy at the National Institutes of Health.

Executive Summary

The members of the Task Force recommend:

1. that NIH establish a uniform tuition policy across all Institutes.
2. that tuition payment policy be a simple marginal rate mechanism which pays 100% of the education cost up to $2,000/trainee/yr and 60% of costs above the $2,000 base.
3. that institutions be allowed to carry over funds from one year to the next.
4. that there be complete fungibility between the three budget categories within an Institutional NRSA Award, stipends, tuition and trainee expenses.
5. that the current prohibition of supplementing NRSA awardees from other federal sources, including NIH R01 awards, be lifted.
6. that institutions be allowed to pay the entire NRSA predoctoral stipend allowance, currently $10,008, over a 9-month academic year appointment.

Report of the Task Force

The members of the Task Force on NIH Tuition Policy on NRSA Awards solicited written comments from interested parties and extended invitations to participate in an open forum convened on June 5, 1995, at the NIH. We received over 80 letters and over 80 guests attended the forum. The views expressed in writing and orally provide the foundation for the Task Force recommendations. The Notice of Invitation, the Task Force Roster, the NIH Public Forum Planning Committee Roster, the List of Invited Speakers and the Forum Agenda are included as appendices.

The members of the Task Force reaffirm that the enormous success of U.S. biomedical science and technology is, in large part, due to the inextricable link between research and training as conducted in a partnership with Federal and State governments and our research universities. A critical component of this research-training partnership has been the support of predoctoral and medical scientist trainees with institutional NRSA awards from the NIH.

In order to insure the long term viability of the NRSA program, the members of the Task Force reaffirm the importance of these NIH institutional awards. Considering the erosion of the number of trainees supported on Institutional NRSA Awards over the past two decades and the uncertainties about future support for graduate training from other sources, we urge that the NIH vigorously renew efforts at the appropriations level for increased support for training the biomedical scientists critical to the nation's future. In addition to vigorous efforts at the appropriations level, we also recommend that research training be ranked among the highest priorities when considering reallocations within the overall mission of the NIH. We are sensitive to the concerns, expressed orally and in writing by the respondents, that if we ignore the real costs of graduate education or continue to expect increased cost-sharing by universities, we will jeopardize the NIH-university partnership responsible for our national research success.

For the short term, however, pragmatic considerations constrain our recommendations. These factors include a fixed NIH training budget, growing inability of universities, and associated medical schools, to share increasing costs of education, and a desire to train as many future scientists as is consistent with demand. Accordingly, the members of the Task Force recommend:

1. that NIH establish a uniform policy across all Institutes.
   
   Note: Tuition, throughout this report, refers to the combined cost of tuition, fees and health insurance.
   
   
2. that tuition payment policy be a simple marginal rate mechanism which pays 100% of the education cost up to $2,000/trainee/yr and 60% of costs above the $2,000 base. This policy largely preserves the current training level, resulting in about a 5% reduction in the number of trainees at NIGMS, our model for projections. This recommendation will provide partial cost of education reimbursement equitably across all institutions recognizing that all institutions have essentially the same real costs of education, but they vary enormously in the mechanism(s) and capacity for meeting the increasing cost sharing component for the cost of education. We believe that this recommendation will largely preserve both the quality and the diversity of the current NIH programs. Further, maintenance of a stable marginal rate will enable the participating educational institutions to carry out reliable long range planning and should guarantee their continuance in the NRSA programs.



The members of the Task Force also strongly recommend that given the severe financial constraints of current circumstances, training institutions be allowed maximal flexibility in the administration of their awards. Specifically we recommend:

3. that institutions be allowed to carry over funds from one year to the next.
4. that there be complete fungibility among the three budget categories within an Institutional NRSA Award ( stipends, tuition and trainee expenses). This flexibility will provide strong incentives for training faculty to recover tuition savings within their institutions and thus support more students. Alternatively institutions may find it advantageous to sacrifice one or more training positions to help cover the cost of education and thereby preserve the program. This flexibility is critical and will be adequately constrained by peer review and the necessity for training programs to operate within the Institute's mission. Most importantly, it allows the institutions to make the decisions, since they are best able to set priorities.
5. that the current prohibition of supplementing NRSA awardee from other federal sources, including NIH R01 awards, be lifted. We note in this regard that apparently NSF predoctoral fellows can now be supplemented from research assistant appointments on NIH R01 grants.
6. that institutions be allowed to pay the entire NRSA stipend allowance, currently $10,008, over a 9-month academic year appointment. Recognizing that the NRSA stipend allowance represents only a fraction of the total yearly stipend, currently between $15-16,000/yr., a 9-month "academic" year NRSA appointment will allow the necessary supplement to be paid during the summer from other sources, including NIH R01 grants, without violating the prohibition of cross supplementation from federal sources. Furthermore, the NRSA cost of education allowance is most logically paid during the academic year when the major costs of education, such as course work, are incurred, and R01 funds most appropriately used for the summer when even 1st year graduate students' work is assigned to a specific sponsored project.

While the members of the Task Force are discouraged that the NRSA program, long a cornerstone of the nation's research and training mission, is under such severe strain, we feel that our short term recommendations of a simple allocation algorithm coupled to substantially increased flexibility in award administration will preserve the overall NRSA mission with minimal risk of irreversible damage. We urge that our recommendations be implemented.

While outside the charge to this Task Force, we want to express our concern, and the concern of participants in the public forum, about the new NIH policy to limit graduate student support on R01 grants to the amount paid to 1st year postdoctoral employees. We feel that the new guidelines have been hastily implemented and are ill defined, given that salaries for post-docs can vary enormously even within one institution. We feel that a process like the public forum on NRSA tuition reimbursement should be initiated, and the new policy held until there is thorough discussion by the biomedical community. Moreover, we not only feel that there should be uniform NRSA tuition policy across all NIH Institutes, as we have recommended, we also feel it would be highly desirable that tuition policy be uniform across all NIH graduate funding mechanisms. In fact, we think it is reasonable that the NRSA tuition policy we have recommended above be used to determine tuition costs on R01 grants as well.

The members of the Task Force, along with the many institutional respondents, appreciate the opportunity to participate in this critical process. We especially appreciate the energetic, excellent support and guidance provided by NIH staff Vince Cairoli, Ernie Márquez, John Norvell, and Wally Schaffer.

Additional Individual Task Force Member Comments and Recommendations

Number One

NRSA training in the biomedical sciences is a key program that should receive strong support. A strong effort should be mounted to convince congress and the executive branch of the federal government of the critical importance of NRSA supported graduate education and that tuition payments are a legitimate and necessary portion of the associated costs.

There should be a uniform tuition reimbursement policy. All NIH institutes should implement a uniform tuition reimbursement policy for their PhD program NRSA awards.

Establishment of base 100% reimbursement followed by 60% reimbursement should be implemented. I recommend that NRSA tuition reimbursement be separated into two components. The first $2,000 of claimed tuition costs per year should be reimbursed in full. The remaining annual reimbursement costs should be reimburses at a rate of approximately 60%.

In devising a schedule for partial reimbursement, an attempt was made to accommodate three considerations. The resources available for trainee stipends should not be reduced dramatically, hopefully substantially less than 10%, in order to ensure that it is possible to continue the support of excellent students in a diverse array of qualified programs. Programs that manifest efficient use of tuition resources should not be penalized. Programs that need high tuition payments in order to finance excellent graduate training, should receive sufficient support under NRSA to allow them to continue participating in the NRSA program.

Institutions should be given maximum flexibility in supplementing NRSA support. Institutions are usually faced with two shortfalls in NRSA support of graduate education; stipend levels and tuition costs. Current practices restrict institutions to using non-federal sources for the needed supplementation. This unnecessarily restrictive and arbitrary. The general recommendation is that institutions be allowed to use other federal funds, specifically funds from NIH sponsored research grants, to supplement NRSA awards. A specific suggested mechanism that would facilitate such a policy is to allow institutions to use the entire yearly stipend (currently $10,008) for a 9-month period. During the remaining 3 months (typically during the summer) the trainees could be appointed 100% on research or program project grants. Other mechanisms that would allow research grant supplementation of NRSA awards should also be studied and implemented if possible.

Currently available flexibility arrangements should be clearly communicated to program directors. An example is the use of unused stipend funds for tuition payments.

Establish fundamental cost matrixes of biology graduate education. Representatives from various institutions should help develop some basic cost categories that currently are paid by tuition payments. For instance faculty salaries related to didactic teaching, research supervision and advisory/examination committee duties. Administrative duties related to recruiting, etc. may also be included. Once these cost categories are developed and accepted as legitimate (not overlapping other types of reimbursement), these will be used in soliciting support for institutional educational allowances. Assuming the development of an adequate funding mechanisms, the future institution allowance for an NRSA award would be the lesser of two amounts; the published tuition costs or the calculated fundamental cost matrixes.

Number Two

Several issues emerged from the public meeting and following discussions which I felt were important regarding the final report of the committee. I agree with the conclusions of the committee as outlined below:

First, it is important that there be a uniform policy for tuition remission across all Institutes. Second, it is equally important that the eventual policy represent stability so that training grant recipients know what to expect in their planning for future years. Third, it seems clear that there needs to be more flexibility given to training grant directors regarding the use of funds. Such flexibility would include the ability to move funds between tuition and stipend categories, the ability to carry over funds from one year to another, and the ability to use other Federal funds to supplement stipends.

With respect to the last point, it is currently possible to move funds from one category to another, but it is probable that PI's don't do this because it would be looked upon negatively by the NIH or review committees. That perception should be changed.

The second point would allow training grants to be put into the same category as research grants and allow for some fluctuation in the system.

The third point is common sense since it is clear that all trainees are supplemented in some way.

Finally, it is important to maintain MST programs since these have been the most successful in providing future leaders in biomedical research. If one had to make a choice between graduate and MST programs, I would choose the latter because the quality of these students, in general, is higher. This is not to say that there are not excellent graduate students, but merely to point out that the pools from which medical students and graduate students are drawn are quite different.

The final formula for tuition remission and the available funds over the next few years will certainly lead to a decrease in trainee positions. In general, the private universities took the position that this was a satisfactory outcome. It was not clear, however, what this actually means. Thus, will marginal schools now receiving funds (or new programs requesting start-up funds) be denied funding, or will the larger program actually cut slots? The latter seems unlikely to me and a consequence of our deliberations will probably be that the larger programs will stay pretty much the same while the smaller ones will disappear. We all recognize that there is some inertia in the system so that schools that have long-standing programs will continue, in general, to be successful in obtaining funds. The consequences of the decrease in available slots therefore will adversely affect emerging and/or smaller programs. This could have serious consequences with respect to life sciences training in this country. Every effort should be made therefore, to not allow funds for graduate training to decrease. Although NIH training grants support only 8% (at any given time) of graduate students, decreases in funding reverberate throughout the educational system. It would seem appropriate, therefore, to have reductions weighted towards the larger programs.

Number Three

The written and verbal material reviewed by the Task Force on Tuition Reimbursement was strongly supportive of a uniform policy on tuition reimbursement. Unfortunately, there was no consensus on what the formula should be. Over time universities have evolved a number of

different methods for calculating the cost of graduate education. While there may not be major differences in the actual cost of graduate education, there are significant differences in the calculation of cost. Thus, it will not be easy to achieve a fair and balanced policy for tuition

reimbursement which does not compromise quality. The proposal on tuition reimbursement set forth by the Task Force was a compromise which does not solve the problem of a gradual loss of training positions that will result from tuition continuing to increase in a flat funding environment. Thus, I would encourage NIH to create a committee empowered to do an in-depth study of training grants and their funding mechanisms. The objective would be to formulate a plan which will insure the longer term survival and viability of training programs.

The community clearly believes that training grants are an important part of the overall method by which high quality scientists are trained for our national biomedical enterprise. Therefore, further work on survival plans for training programs has merit.

Number Four

I am a strong advocate for continuation of the current number of trainees with NRSA awards. However, in the face of reality, I support the uniform tuition policy for the NRSA Awards for predoctoral trainees with institutional NRSA Awards as recommended by the Task Force.

a. The consensus statement developed by the Task Force on NIH Tuition Policy on NRSA Awards focused on the research-training partnership for predoctoral trainees with institutional NRSA awards for NIH. However, some of the same factors that have caused us to recommend a uniform policy for these programs is likely to be applied to other NIH training programs such as postdoctoral training programs and new and yet to be conceived predoctoral programs to assure their long term stability. A uniform tuition policy should not be applied to such programs without a consideration of the critical nature of these programs to the research enterprise for which they have been or will be developed. A carefully articulated waiver statement should be included that will allow for an exemption of new and experimental training programs that represent critical training needs. Such a waiver will be essential to the viability of experimental programs such as the Dentist Scientist training program and other such programs with a small but critical number of trainees.

b. There is an existing unknown which will certainly influence the nation's capacity to sustain the current research training enterprise. That is, we expect institutions to continue to share the cost of research training but we do not know the extent to which this is currently happening or what factors contribute to the existing wide disparity in tuition rates. The published rates, which serve as the basis for calculating training grant support, represent only a portion of the real cost of educating a student (about 30% or less). As we are expecting institutions to bear a greater share of the cost of research training, there is a need to examine the capacity of institutions to sustain this effort. This is especially true for minority and smaller institutions with limited endowments that are tuition driven.

c. NIH is challenged to sustain its efforts to assure the participation of women and minorities in NIH sponsored research training programs. Support for and a careful monitoring of programs such as MARC are necessary to prevent an erosion of trainees and to assure access to research careers for an increasingly diverse population.

d. The extent to which managed care will influence the ability of patient care resources to be transferred to support research and research training is critical to institutional support for research. This mechanism is being rapidly eroded which presents a serious threat to the university's ability to support research training from this income stream.

Lastly, I wish to express strong support for continuance of the research-training partnership that exists with Federal and State governments and our research universities. NIH should continue to play a leadership role in sustaining these partnerships in the future.

Number Five

I endorse the consensus statement of the Task Force, but with significant reservations. The proportion of training funds going to tuition remission at each institution will remain irrational even if all Task Force recommendations should be adopted. However, any consensus statement is clearly useful at this time, even a highly imperfect one.

Flexibility is desirable. Primarily because of the enormous financial crisis that medical schools face (due to the loss of clinical incomes which have been used to subsidize training programs), public testimony indicated that changing tuition policy too radically at the present time would cause unacceptable dislocations. The consensus statement is a political compromise, but NIH's permanent policy should be rational, and if possible, one that relies on the peer-review system as much as it can without putting the onus on NIH administrators to make ad hoc decisions. Obvious inequities need to be analyzed more carefully.

One problem for the Task Force was that the NRSA programs are strikingly diverse, with respect to purpose, as well as institutional setting. Programs which require tuition remissions can be divided into general training programs (Cellular and Molecular Biology, Genetics, etc.) versus specialty programs (many smaller programs from institutes other than the National Institute of General Medical Sciences, the MARC program, etc.). In some settings, training grants support a large fraction of pre-doctoral trainees at the institution. At the other extreme, there are institutions where a training grant is used as a focus, but other mechanisms of support for graduate students predominate. The latter institutions have probably tended to decrease tuition (to make it possible for more research grants to support graduate students) while many of the former institutions have had historically high graduate student tuition. Given this diversity, I fully support the principle that maximum flexibility should be allowed program administrators once an award is made.

Tuition for trainees not taking classes. If the suggestion of the Task Force is adopted to make it possible to have an academic year traineeship, with a summer internship (during which tuition would presumably be minimal), the NIH should make an effort for some uniformity in tuition remission for trainees not taking any classes. Most institutions decrease tuition charges after students have finished their courses, but a few institutions keep a high tuition in later years. In my opinion, there is no justification for a tuition charge of over $20,000 per year for a student spending time doing research in the mentor's laboratory, and taking no courses whatsoever. The vast difference in tuition costs while students are taking classes are bad enough The NIH would be justified in insisting on some consistency in tuition charges for students not taking any classes.

Feasible long term solutions. I endorse the suggestion of Task Force Member 1 that fundamental cost matrices of graduate education should be determined to set institutional educational allowances in training grants. However, if an institution or program feels it necessary to raise this allowance ( and support fewer trainees), it should have the flexibility to do so, but will need to justify the increased allowance through peer review.

Number Six

The scientific eminence of the United States relies on the tradition of providing new scientists with intellectual independence to nurture innovative and productive ideas. In a time when there are fewer job opportunities for young researchers and more constrained research budgets, we may all be quick to reduce the number of trainees. We should guard against this "quick fix". While for the short term this would seem to be the most rational solution, we face the prospect of losing a generation of researchers and their potential productivity if we do not continue to support their training. Unwillingness to invest in their training would have repercussions that could last for decades. This short sightedness could cost this country the position of world leader in science upon which our economic future depends.

The molecular and technological advances over the next decade promise to be the greatest ever. Advances, even if paid for by other countries, cannot be acted upon in this country without trained personnel and an infrastructure through which to respond.

I would strongly encourage the NIH to continue to assess and evaluate mechanisms of training (i.e. training in NRSA programs versus the R01 environment). An important issue is how much money from R01s is currently spent for graduate education during the first year or two when little time is spent in the laboratory? While quality of training is difficult to assess, our changing environment and new career options for individuals trained in the sciences will possibly require different measures of quality of training. Numbers of publications and ability to win grant support can be misleading and false indicators of "quality of education."

While I support the recommendations of the Task Force, I remain concerned that the consequences of their implementation will adversely impact emerging or smaller programs. I remain concerned that individual NIH institutes are not monitoring the needs for training in specific areas. I also remain concerned about the recruitment of not only underrepresented minorities but the fact that we continue to attract fewer and fewer of the brightest U.S. citizens into graduate education in the biomedical sciences.

While I am aware that the NRC has recently conducted an evaluation of the overall NRSA program, I would favor the proposal by one other member of the Task Force who suggested that NIH create a committee empowered to do an in-depth study of NIH training programs to address some of these questions and to formulate a plan which will ensure the longer term survival and viability of training programs.

Number Seven

The NIH program of National Research Service Awards represents one of the fundamental underpinnings of graduate education in the biomedical sciences for the United States. Further, it serves as a paradigm for the partnership between the Federal government, universities and, for public institutions, the State government in advancing our national research and educational goals in the life sciences. Unfortunately, because of unprecedented budget pressures for all participating sectors, this symbiotic partnership has entered a period of severe strain Ideally, the NIH traineeships should cover the real costs of education (supplemented by State support where appropriate) as well as providing a liveable stipend for the trainee. However, because the cost of education over the last decade has risen much faster than the available funds for the trainee programs, the above goal cannot be achieved without a significant diminution in the number of trainees. The latter would clearly have serious consequences for biomedical education and research.

It is therefore, necessary to construct a realistic algorithm for NIH traineeship reimbursements which will enable our leading biomedical academic institutions to continue to participate for the indefinite future in the NRSA programs and at the same time will maximize the number of trainees. I support the compromise which was arrived at by the Task Force. First, for balance and fairness, it is clearly important that there be a uniform tuition policy across all NIH Institutes. Second, there should be a floor in tuition reimbursement so that public universities with exceptional State support would not have to cover very small tuition shortfalls. The proposed number of $2,000 seems to meet this goal. Third, for institutions with high costs of education which are not shared by their respective State governments, it is necessary that a substantial fraction of the real costs be met by NIH. Many of our nation's leading universities are currently operating under severe financial stress due to a number of unfortunate, but inexorable forces. This situation may be ameliorated somewhat by increased efficiencies, but is unlikely that there will be any fundamental change for the better in the near future. Thus, the universities abilities to "cost-share" are quite finite. My own view is that cost sharing at the level of 1/3 is possible for most institutions by using available mechanisms such as teaching assistantships. However, a policy which leads to tuition reimbursement much below 67% will inevitably cause some of our premier academic institutions to withdraw from the NRSA programs. The suggested algorithm of $2,000 + 0.6 times the excess in tuition falls slightly short of my desired 67%, but is sufficiently close that it should be viable. Most importantly, by stabilizing the marginal reimbursement rate at a realistic level, this plan will enable the participating institutions to carry out meaningful long range planning and should enable our leading institutions, including especially our premier private universities, to participate in the NIH traineeship programs for the indefinite future.

Concomitant with the above, it is also important that NIH provide the participating institutions maximum flexibility. This would include the ability to award fewer than the allotted number of trainees, the freedom to bridge funds between fiscal years, the ability to use research funds (NIH or otherwise) to supplement both stipends and tuition and lastly flexibility in the period covered by the stipend.

Finally, the Federal government must be made to understand that for every institution there is an absolute floor in the Federal government's required share in the cost of graduate education in the biomedical sciences. Thus, if the available funds continue to fall behind the real costs of education, then the number of trainees must inevitably decrease. At the same time for the US to compete effectively in the 21st century, we will need more, not fewer, well educated citizens-most especially in the biomedical sciences. Thus, funding for graduate education in this area must be increased.

Number Eight

NRSA training in Ph.D., medical scientist and postdoctoral programs in the past has supported the nations most qualified and creative trainees. A program of this quality should be maintained at current levels of trainees, if not expanded. The trainees should be regarded as a national resource which impacts on improvements in health care and economic leadership in the United States.

A uniform tuition policy should be instituted in the National Institutes of Health. Differences in how the individual institutes view training versus research programs should be reflected in the number of trainees supported and the types of training programs offered rather than different stipend levels provided to trainees.

Diversity in training programs provides strength to the national research enterprise. Public and private institutions have very different sources of support and State support at some public institutions has diminished to the point where distinctions between public and private institutions have blurred. A tuition reimbursement policy should allow both types of institutions to participate in training and those that have formulated the best academic programs are the ones likely to receive support. Certainly, the cost to the taxpayer is one criterion for consideration. A base allocation plus a percentage of total tuition would be the most equitable means of recognizing institutional diversity plus state tax payer contributions to graduate education.

Cost sharing between NIH and the training institution is essential in times of limitations in the federal budget. In recent times, tuition has captured increasing proportions of training budgets forcing the dilemma of decisions between decreases in number of slots versus stipend payments insufficient even for nine month periods. the more intensive and formalized training of graduate students occurs in years 1 and 2. In the remaining thesis years, the student contributes substantially to the institutional research enterprise. Institutions need to evaluate the costs of graduate study in the biomedical sciences over the period of enrollment for a typical student. This should be examined in relation to graduate student contributions to research and the academic milieu of the institution. The paucity of information on costs provided by institutions in the forum and the widely variant numbers from those who attempted to estimate such costs suggest institutions and NIH need more information in this area.

Limited budgets can be most efficiently utilized when program directions have flexibility. Where possible, specific recommendations on fungibility of stipend and tuition categories and carry over of limited funds should be encouraged. Often academic calendars don't interface well with fiscal calendars.

Appendixes - Final Report of the Task Force on NRSA Tuition

Appendix 1

NOTICE OF INVITATION

April 24, 1995

To: All Parties Interested in a Public Forum on NRSA Tuition Reimbursements at the National Institutes of Health

From:Chairman, Task Force on Tuition Reimbursement

Re: Public Forum on Tuition Policy

Under a relatively fixed budget, it has been very difficult for the NIH to continue its policy of paying the full costs of tuition, fees, and health insurance (hereafter called tuition) for predoctoral trainees supported by National Research Service Award (NRSA) institutional research training grants. At the current time, tuition accounts for about half of the cost of supporting a predoctoral trainee, and costs the NIH more than $70 million out of a total NIH NRSA predoctoral training budget of $155 million. At some institutions, graduate tuition costs exceed $25,000 per year.

As a cost saving measure, the NIH froze tuition in 1989 for all ICs (Institutes and Centers). After fiscal year 1989, some Institutes returned to a full reimbursement policy while others kept tuition reimbursements frozen. As a consequence, there is considerable disparity in tuition policies across the NIH ICs. Although the NIH has made several attempts to develop a uniform tuition policy, none has been endorsed by the academic community, and none has been adopted as formal policy by the NIH.

In an attempt to resolve this issue, a Task Force has been assembled to consider the tuition reimbursement policy on NRSA institutional research training awards. The Task Force will officiate at a one-day public meeting, to which all interested parties are invited. Immediately following the Public Forum, the Task Force will prepare a summation of the testimony from the Public Forum, and the members will develop recommendations for a uniform NRSA tuition policy.

PUBLIC FORUM ON TUITION REIMBURSEMENT

The Public Forum will be convened on June 5, 1995, in the Natcher Conference Center, 45 Center Drive, National Institutes of Health campus, Bethesda, Maryland. The one-day meeting will begin at 8:30 am and conclude at approximately 5:30 p.m.

During the Public Forum, individuals will provide brief testimony on tuition reimbursement concerns and issues at the invitation of the Task Force. There will be opportunities for other audience members to offer comments during periods of "Open Discussion" scheduled throughout the day.

We would like to invite all interested parties to submit a two page response, no later than May 25, to the questions below. Individuals interested in responding should mail their responses to the address shown below, or FAX (301-480-8256) their responses to Dr. Ernest Marquez by May 25, 1995. The Task Force will review the responses and select the individuals who will be invited to address the Task Force at its June 5 Public Forum. Be assured that the Task Force will review all responses generated by this solicitation:

1. Should there be a uniform policy for tuition reimbursement on all NRSA institutional training grants made by the NIH?
2. What is the relationship of tuition to the overall cost of training a predoctoral student at your institution, i.e., What specific costs are covered by tuition?

a. Is the tuition charged for graduate students the same as that for undergraduate students?

b. Is the tuition charged the same amount for each year of graduate school, i.e., during course work and full-time research?



3. Assuming an NIH policy to pay less than the full cost of tuition, which of the following reimbursement proposals would you prefer for your institution, and why?
   
   a. The NIH would pay a fixed percentage of published tuition charges for all predoctoral trainees regardless of the actual cost.
   
   b. The NIH would pay a fixed tuition amount for all predoctoral trainees regardless of actual cost (The NSF model).
   
   c. The NIH would pay a fixed amount of tuition for all trainees in public institutions and a higher, but fixed amount of tuition for all trainees in private institutions. The amounts would be based on average tuition costs for public institutions and for private institutions, and in no case would NIH pay more than 100% of tuition costs. This is sometimes called the Capped Two-Tiered Cost of Education Allowance.
   
   d. The NIH would pay 100% of tuition costs below $6,000 and lesser amounts of any costs above this amount in what is sometimes called a Marginal Rate Model. For example, one model proposes the following reimbursement rates:
   
   
   1. If tuition costs are 0-$6000, 100% of this amount is paid
   2. If tuition costs are $6000-10,000, the amount paid would be $6,000 plus 65% of the amount over $6,000
   3. If tuition costs are $10,000-14,000, the amount paid would be $8,600 plus 45% of the amount over $10,000
   4. If tuition costs are $14,000-18,000, the amount paid would be $10,400 plus 30% of the amount over $14,000
   5. If tuition costs are in excess of $18,000, the amount paid would be $11,600 plus 20% of the amount over $18,000
   
   e. None of the above four models necessarily involves a direct relationship between the tuition payment and the quality of training. Can you suggest a workable algorithm which would include quality of education as one of the determining factors in the tuition reimbursement?
   
   
   
4. Assuming constant federal dollars for training, what do you see as a proper balance between number of trainees and tuition reimbursements? Would you favor paying full tuition even at the expense of training positions? What is a rational way to achieve this balance?

If you have further questions about the Public Forum, please telephone Dr. Walter Schaffer at (301) 435-2770 or E-Mail at schaffew@od.nih.gov

We hope that you will take the opportunity to assist in our effort to gather the views of people interested in the tuition reimbursement policies of the NIH by sending us a letter no later than May 25 to:

We know you share our interest in providing an equitable and fair discussion on the issue of tuition reimbursement by the National Institutes of Health.

Sincerely,

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Appendix 2

TASK FORCE ROSTER

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Appendix 3

NIH PUBLIC FORUM PLANNING COMMITTEE

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Appendix 4

LIST OF INVITED SPEAKERS

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Appendix 5

AGENDA

PUBLIC FORUM ON TUITION REIMBURSEMENT ON NATIONAL RESEARCH SERVICE AWARDS

Time	Event	Participant(s)
8:00 a.m.	Registration in Conference Center Lobby
8:30 a.m.	Introductory Remarks Introduction of Task Force NIH Research Training and the NRSA Programs Tuition Background and Alternate Reimbursement Schemes Welcoming Remarks Public Testimony (10 minutes/speaker)	Dr. Ernest Marquez Dr. Paul Anderson Dr. Walter Schaffer Dr. John Norvell Dr. Harold Varmus participants
10:00 a.m.	Break
10:15 a.m.	Public Testimony (10 minutes/speaker)	Participants
11:30 a.m.	Open Mike period	Participants
12:00 p.m.	Lunch
1:00 p.m.	Public Testimony (10 minutes/speaker)	Participants
2:30 p.m.	Open Mike Period	Participants
3:00 p.m.	Break
3:15 p.m.	Public Testimony (10 minutes/speaker)	Participants
4:30 p.m.	Open Mike Period	Participants
5:00 p.m.	Closing Remarks and Adjournment	Dr. Paul Anderson

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