Medical research funding
Ask the Expert
By Victoria Houghton, managing editor, August 1, 2021
DermWorld spoke to Jennifer Mangone, JD, manager of congressional policy for the American Academy of Dermatology Association (AADA), about the Academy’s advocacy efforts to support medical research funding.
DermWorld: Advocating for medical research funding is a top priority for the AADA. Briefly, tell us why supporting this type of funding is so critical for patient care?
Mangone: Dermatologists understand that ongoing scientific research is critical to moving patient care forward. Research helps physicians identify risk factors in patients and root causes of disease, which may lead to prevention or better treatments of serious conditions. The Academy supports medical research that builds on past innovations, fosters momentum in scientific research, and advances medical knowledge.
For example, skin diseases account for 30% of all physician office visits. Yet, access to dermatologic care remains a significant challenge for those in underserved or rural communities. Fiscal year (FY) 2018 funding for the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) contributed to an ongoing study regarding access to dermatologists and solutions to improve patient outcomes related to skin disease. This type of basic scientific research plays a crucial role in the ability of dermatologists to provide valuable, patient-centered care.
Medical research funding
Learn more about the Academy’s medical research funding advocacy activities.
DermWorld: From soup to nuts, can you walk us through the federal appropriations process?
Mangone: Despite the fiscal year beginning on Oct. 1 of each year, the kick-off point for the appropriations and budget process is in late winter to early spring. Typically, the president submits a budget request to Congress in February, although it can sometimes be March or April, or, in this year’s case, May. It is important to note that the president’s budget is not a binding document and should be thought of as more of a “wish list” than an actual budget. The agencies release their budget requests; the individual House and Senate Committees release their views and estimates of what programs within their jurisdictions should be allocated; and, lastly, the House and Senate Budget Committees draft budget resolutions.
The House and Senate pass separate budget bills, which set the top-level spending number for the next fiscal year. During the time that the Budget Committees are beginning their work, the Appropriations Committees, as well as individual member offices, are accepting requests from groups and constituents to be included in the process.
After requests have been submitted, the House drafts its appropriations bills, usually in May or June. There are 12 of these bills that set individual spending levels for individual agencies. They are accompanied by “directives” that include specific instructions to agencies. The individual bills must be passed out of the Appropriations Subcommittee under which it falls, the full Appropriations Committee, and the full House. The bills can see several amendments before they are passed.
Meanwhile, in the Senate, the process is identical. However, under the Constitution, all budget and appropriations measures must originate in the House as all revenue-generating measures must begin there. Once both chambers have each completed their appropriations bills, they must reconcile the differences between the two in what is referred to as Conference.
Often, Congress passes at least one, if not more, continuing resolutions (CR), which extends funding at the levels from the previous fiscal year. Passing a CR prevents the government from shutting down while congressional leaders come to an agreement on the 12 spending bills. Frequently, the bills end up being passed as a package, referred to as an “omnibus,” around the end of the calendar year, sometimes later.
Medical research funding
See how the Academy has moved the needle on medical research funding.
DermWorld: What does the Academy advocate for specifically with regard to medical research funding?
Mangone: Generally speaking, the Academy advocates for increased funding for:
The NIH overall, including the National Cancer Institute (NCI) and the National Institute of Arthritis, Musculoskeletal and Skin Diseases (NIAMS) individually
The National Skin Cancer Prevention Education Program at the CDC
The Agency for Healthcare Research and Quality (AHRQ)
National Hansen’s Clinic at the Health Resources and Services Administration (HRSA)
Dedicated funding for Melanoma Research at the Department of Defense’s Peer Reviewed Cancer Research Program
Maintaining the Congressionally Directed Medical Research Programs (CDMRP) at the Department of Defense through the National Defense Authorization Act
DermWorld: What do the Academy’s advocacy efforts on this issue entail and what role does collaboration/coalition-building play in the work that you do in the Academy’s research funding advocacy activities?
Mangone: In addition to submitting direct requests to the Appropriations Committees, and meeting with key members and staff on the Hill, the AADA also works in tandem with coalitions such as One Voice Against Cancer, the National Council on Skin Cancer Prevention (NCSCP), and the NIAMS Coalition.
Further, we advocate for policy directives to be included in the report language that accompanies the appropriations bills once passed. For example, in the past, the AADA advocated for language to address the need for teledermatology services for Indian Health Centers via the FY2020 Senate Appropriations Subcommittee on the Interior, Environment, and Related Agencies Appropriations bill report. Other examples of report language topics include skin cancer prevention studies and indoor tanning.
DermWorld: Is there a role for Academy members to play in advocating on this issue? What can dermatologists do to get involved?
Mangone: Contact your representative and senators by calling, writing, or tweeting, and ask them to support the AADA’s funding requests.
AADA advocacy priorities
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