Rep. Kind Discusses Research Funding with UW Administration

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MADISON – Rep. Ron Kind (D-WI, 3rd District) paid a visit to the University of Wisconsin School of Medicine and Public Health (SMPH) Wednesday to discuss health care and education funding with UW Health and SMPH administration.

SMPH Dean Robert Golden also thanked Rep. Kind for his strong hand in helping resolve an administrative error that threatened the funding for a residency program in the Department of Family Medicine (DFM), a University of Wisconsin physician training program.
Dean Robert Golden with Rep. Ron Kind

Dean Golden presents a plaque to Rep. Kind in gratitude for his work with the DFM residency program.

The Centers for Medicare and Medicaid Services (CMS) erroneously removed residency slots from the Fox Valley Family Medicine Resident Training Program and placed them into a reallocation pool. When the error was discovered, CMS said it could not reinstitute these slots because the law did not provide for the ability to correct this or other errors.
With the help of Rep. Kind, who sits on the Ways and Means Committee, DFM proved its paperwork was in order, and its funding was restored.
"Your leadership and support means a lot to us," Golden said to Rep. Kind. "But more importantly, it means a lot to the people who are going to benefit from this program."
While grateful for his work on the DFM snafu, the leaders on hand also took the opportunity to express their concerns about recent National Institutes of Health (NIH) decisions that could affect local research programs.
In 2007 the University of Wisconsin became one of 24 institutions nationwide to receive an NIH clinical and translational science award (CTSA). CTSAs provide federal dollars to encourage the development of new methods and approaches to clinical and translational research, which expedite the process by which critical medical and health discoveries are delivered from a laboratory setting to the communities that need them.
Because of their emphasis on translational research, NIH director Elias A. Zerhouni wants CTSAs to replace current research programs, called general clinical research centers (GCRCs), by 2010.
CTSAs fit in nicely with the goals of SMPH, the first academic medical center in the country to combine its School of Medicine with public health studies. In fact, the University of Wisconsin has established the Institute for Clinical and Translational Research (ICTR) to accommodate its CTSA.
The ICTR unites a wide variety of research-oriented organizations, including the Schools of Nursing, Medicine and Public Health, Pharmacy, Veterinary Medicine and Engineering, as well as University of Wisconsin Hospital and Clinics and American Family Children's Hospital. Under the ICTR umbrella, these disparate organizations will work together toward a common goal of translating biomedical discoveries into practices that improve health.
But the NIH has underestimated the costs associated with CTSAs, and UW programs will suffer if it continues with its current plan for funding.
"What has happened, which is very upsetting, is that the NIH has figured out after the fact that it has miscalculated the cost of the program," Golden said. "What they are on track to do now makes no sense. They are going to fund 60 CTSAs but underfund them in such a horrible way. It's setting us up for failure."
Backed by ICTR principal investigator Marc Drezner, UW Hospital and Clinics President and CEO Donna Katen-Bahensky, UW Medical Foundation President and CEO Jeffrey Grossman and Department of Family Medicine chair Valerie Gilchrist, Golden outlined a more strategic funding plan.
Rather than underfund 60 programs nationally, Golden suggested funding fewer CTSA institutions – perhaps 25 or 30 – with money enough to complete their work.
Drezner said that not all current GCRCs are equipped to upgrade to CTSA status, and the decision to compel them to do so while at the same time underfunding CTSAs could prove fatal to research efforts nationwide.
"It takes a substantial institution to mount the kind of program a CTSA calls for," he said. "There are some that are just better off having GCRCs if they can't do it. Why make everybody have a CTSA when the GCRCs have done so well? The GCRC can continue to contribute in remarkable ways."
"The individual investigators should not be penalized while trying to roll out this grand scheme of 60 CTSAs," Golden added. "We'd rather see 30 adequately funded (CTSAs) and have the GCRCs continue to do their work."
Rep. Kind was sympathetic to the group's concerns but skeptical about what can be done in the short-term, given the contentious political climate in Washington and a federal budget already stretched thin.
"It's going to be a tough budget year," he said. "There's not going to be any stomach for wholesale reform, or major appropriation funding. When we get a new administration in place, hopefully they'll have a different agenda."
Rep. Kind did mention his positive working relationships with Wisconsin Senators Russ Feingold and Herb Kohl, and said he would make sure they are aware of the funding shortages. He also said that Rep. Pete Stark (D-CA, 13th District), who chairs the Ways and Means Subcommittee on Health, is a "sympathetic ear."
"You're all doing great work, and we're going to do what we can to support you," Kind said.

Date Published: 02/21/2008

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