Congressional Justification 2013
DEPARTMENT OF HEALTH AND HUMAN SERVICES
NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine (NCCAM)
On this page:
- Organization Chart
- Appropriation Language
- Amounts Available for Obligation
- Budget Mechanism Table
- Major Changes in Budget Request
- Summary of Changes
- Budget Graphs
- Budget Authority by Activity
- Authorizing Legislation
- Appropriations History
- Justification of Budget Request
- Director’s Overview
- Budget Authority by Object
- Salaries and Expenses
- Details of Full-Time Equivalent Employment (FTE)
- Detail of Positions
NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
National Advisory
Council for
Complementary and
Alternative MedicineOffice of the Director
Josephine P. Briggs, M.D.
DirectorJack Killen, M.D.
Deputy DirectorOffice of Clinical and
Regulatory AffairsCatherine Meyers, M.D.
DirectorOffice of Administrative
OperationsRobin Klevins
Acting Executive OfficerOffice of Communications
and Public LiaisonAlyssa Cotler, M.P.H.
DirectorOffice of Policy,
Planning, and EvaluationKarin Lohman, Ph.D.
Director
Division of
Extramural ResearchEmmeline Edwards, Ph.D.
DirectorManual and Mind-Body
Medicine BranchEmmeline Edwards, Ph.D.
Acting ChiefNatural Products
BranchEmmeline Edwards, Ph.D.
Acting Chief
Division of
Intramural ResearchRobert B. Nussenblatt, M.D.
Acting DirectorDivision of
Extramural ActivitiesMartin Goldrosen, Ph.D.
DirectorOffice of
Scientific ReviewDale Birkle Dreer, Ph.D.
ChiefOffice of Grants Management
George Tucker, M.B.A.
Director
NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
For carrying out section 301 and title IV of the PHS Act with respect to complementary and alternative medicine [$128,299,000] $127,930,000. (Department of Health and Human Services Appropriations Act, 2012.)
Source of Funding | FY 2011 Actual |
FY 2012 Enacted |
FY 2013 PB |
---|---|---|---|
1 Excludes the following amounts for reimbursable activities carried out by this account: FY 2011—$290 FY 2012—$316 FY 2013—$416 |
|||
Appropriation | 128,844 | 128,299 | 127,930 |
Type 1 Diabetes | 0 | 0 | 0 |
Rescission | -1,131 | -242 | 0 |
Supplemental | 0 | 0 | 0 |
Subtotal, adjusted appropriation | 127,713 | 128,057 | 127,930 |
Real transfer under Secretary’s transfer authority | 0 | -36 | 0 |
Comparative Transfers for NCATS reorganization | 0 | 0 | 0 |
Comparative Transfers to NCATS for Therapeutics and Rare and Neglected Diseases (TRND) | -105 | 0 | 0 |
Comparative Transfers to NLM for NCBI and Public Access | -110 | -117 | 0 |
Subtotal, adjusted budget authority | 127,498 | 127,904 | 127,930 |
Unobligated balance, start of year | 0 | 0 | 0 |
Unobligated balance, end of year | 0 | 0 | 0 |
Subtotal, adjusted budget authority | 127,498 | 127,904 | 127,930 |
Unobligated balance lapsing | -7 | 0 | 0 |
Total obligations | 127,491 | 127,904 | 127,930 |
MECHANISM | FY 2011 Actual | FY 2012 Enacted | FY 2013 PB | Change vs. FY 2012 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Number | Amount | Number | Amount | Number | Amount | Number | Amount | |||||
1All items in italics are “non-adds”; items in parenthesis are subtractions. | ||||||||||||
RESEARCH GRANTS | ||||||||||||
Research Projects | ||||||||||||
Noncompeting | 127 | $51,443 | 150 | $61,328 | 123 | $50,520 | (27) | ($10,808) | ||||
Administrative Supplements | 16 | 2,638 | 10 | 1,600 | 10 | 1,600 | 0 | 0 | ||||
Competing: | ||||||||||||
Renewal | 1 | 697 | 1 | 700 | 1 | 700 | 0 | 0 | ||||
New | 50 | 21,437 | 29 | 12,174 | 53 | 21,944 | 24 | 9,770 | ||||
Supplements | 1 | 484 | 1 | 500 | 1 | 500 | 0 | 0 | ||||
Subtotal, Competing | 52 | $22,618 | 31 | $13,374 | 55 | $23,144 | 24 | $9,770 | ||||
Subtotal, RPGs | 179 | $76,699 | 181 | $76,302 | 178 | $75,264 | (3) | ($1,038) | ||||
SBIR/STTR | 7 | $2,774 | 8 | $3,078 | 8 | $3,173 | 0 | $95 | ||||
Research Project Grants | 186 | $79,473 | 189 | $79,380 | 186 | $78,437 | (3) | ($943) | ||||
Research Centers | ||||||||||||
Specialized/Comprehensive | 5 | $3,113 | 5 | $3,113 | 5 | $3,113 | 0 | $0 | ||||
Clinical Research | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
Biotechnology | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
Comparative Medicine | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
Research Centers in Minority Institutions | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
Research Centers | 5 | $3,113 | 5 | $3,113 | 5 | $3,113 | 0 | $0 | ||||
Other Research | ||||||||||||
Research Careers | 44 | $5,651 | 44 | $5,651 | 44 | $5,651 | 0 | $0 | ||||
Cancer Education | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
Cooperative Clinical Research | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
Biomedical Research Support | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
Minority Biomedical Research Support | 0 | 0 | 0 | 438 | 0 | 438 | 0 | 0 | ||||
Other | 10 | 1,821 | 10 | 1,821 | 10 | 1,821 | 0 | 0 | ||||
Other Research | 54 | $7,472 | 54 | $7,910 | 54 | $7,910 | 0 | $0 | ||||
Total Research Grants | 245 | $90,058 | 248 | $90,403 | 245 | $89,460 | (3) | ($943) | ||||
Research Training | FTTPs | FTTPs | FTTPs | |||||||||
Individual Awards | 23 | $1,034 | 23 | $1,050 | 22 | $1,067 | (1) | $17 | ||||
Institutional Awards | 47 | 1,595 | 65 | 2,210 | 64 | 2,245 | (1) | 35 | ||||
Total Research Training | 70 | $2,629 | 88 | $3,260 | 86 | $3,312 | (2) | $52 | ||||
Research & Development Contracts | 14 | $11,063 | 14 | $10,500 | 14 | $11,300 | 0 | $800 | ||||
SBIR/STTR | 0 | $245 | 0 | $6 | 0 | $6 | 0 | $0 | ||||
FTEs | FTEs | FTEs | FTEs | |||||||||
Intramural Research | 10 | $8,256 | 10 | $8,256 | 10 | $8,256 | 0 | $0 | ||||
Research Management and Support | 59 | 15,492 | 59 | 15,485 | 59 | 15,602 | 0 | 117 | ||||
Construction | 0 | 0 | 0 | 0 | ||||||||
Buildings and Facilities | 0 | 0 | 0 | 0 | ||||||||
Total, NCCAM | 69 | $127,498 | 69 | $127,904 | 69 | $127,930 | 0 | $26 |
Major Changes in the Fiscal Year 2013 President’s Budget Request
Major changes by budget mechanism and/or budget activity detail are briefly described below. The FY 2013 President’s Budget request for the National Center for Complementary and Alternative Medicine is $127.930 million, an increase of $0.026 million over the FY 2012 Enacted level.
Research Project Grants (-$0.943 million; total $78.437 million): NCCAM will support a total of 186 Research Project Grant (RPG) awards in FY 2013. Noncompeting RPGs will decrease by 27 awards and decrease $10.808 million. Competing RPGs will increase by 24 awards and increase by $9.770 million. NIH budget policy for RPGs in FY 2013 discontinues inflationary allowances and reduces the average cost of noncompeting and competing RPGs by one percent below the FY 2012 level.
FY 2012 Enacted | $127,904 |
---|---|
FY 2013 President’s Budget | $127,930 |
Net change | $26 |
CHANGES | 2013 President’s Budget | Change from FY 2012 | ||
---|---|---|---|---|
FTEs | Budget Authority | FTEs | Budget Authority | |
A. Built-in: | ||||
1. Intramural Research: | ||||
a. Annualization of January 2012 pay increase & benefits | $1,465 | $0 | ||
b. January FY 2013 pay increase & benefits | 1,465 | 6 | ||
c. One more day of pay | 1,465 | 6 | ||
d. Annualization of PY net hires | 1,465 | 0 | ||
e. Payment for centrally furnished services | 2,154 | 0 | ||
f. Increased cost of laboratory supplies, materials, other expenses, and non-recurring costs | 4,637 | 0 | ||
Subtotal | $12 | |||
2. Research Management and Support: | ||||
a. Annualization of January 2012 pay increase & benefits | $8,892 | $0 | ||
b. January FY 2013 pay increase & benefits | 8,892 | 26 | ||
c. One more day of pay | 8,892 | 34 | ||
d. Annualization of PY net hires | 8,892 | 0 | ||
e. Payment for centrally furnished services | 932 | 0 | ||
f. Increased cost of laboratory supplies, materials, other expenses, and non-recurring costs | 5,778 | 0 | ||
Subtotal | $61 | |||
Subtotal, Built-in | $73 | |||
B. Program: | ||||
1. Research Project Grants: | ||||
a. Noncompeting | 123 | $52,120 | (27) | ($10,808) |
b. Competing | 55 | 23,144 | 24 | 9,770 |
c. SBIR/STTR | 8 | 3,173 | 0 | 95 |
Total | 186 | $78,437 | (3) | ($943) |
2. Research Centers | 5 | $3,113 | 0 | $0 |
3. Other Research | 54 | 7,910 | 0 | 0 |
4. Research Training | 86 | 3,312 | (2) | 52 |
5. Research and development contracts | 14 | 0 | 800 | |
Subtotal, Extramural | $104,072 | ($91) | ||
FTEs | FTEs | |||
6. Intramural Research | 10 | $8,256 | 0 | ($12) |
7. Research Management and Support | 59 | 15,602 | 0 | 56 |
8. Construction | 0 | 0 | ||
9. Buildings and Facilities | 0 | 0 | ||
Subtotal, program | 69 | $127,930 | 0 | ($47) |
Total changes | $26 |
Fiscal Year 2012 Budget Graphs
History of Budget Authority and FTEs
Fiscal Year | Dollars in Millions | 2009 | 125.4 |
---|---|
2010 | 128.8 |
2011 | 127.5 |
2012 | 127.9 |
2013 | 127.9 |
FY | FTEs |
---|---|
2009 | 66 |
2010 | 67 |
2011 | 69 |
2012 | 69 |
2013 | 69 |
Distribution by Mechanism
Mechanism | Dollars in Thousands | Percent of Budget |
---|---|---|
Research Project Grants | $78,437 | 61% |
Research Centers | $3,113 | 2% |
Other Research | $7,910 | 6% |
Research Training | $3,312 | 3% |
R&D Contracts | $11,300 | 9% |
Intramural Research | $8,256 | 7% |
RMS | $15,602 | 12% |
Change by Selected Mechanism
Mechanism | Percent Change |
---|---|
Research Project Grants | -1.2% |
Research Centers | 0.0% |
Other Research | 0.0% |
Research Training | 1.6% |
R&D Contracts | 7.6% |
Intramural Research | 0.0% |
Res. Mgmt. & Support | 0.8% |
FY 2011 Actual | FY 2012 Enacted | FY 2013 PB | Change vs. FY 2012 Enacted | |||||
---|---|---|---|---|---|---|---|---|
|
||||||||
Extramural Research | FTEs | Amount | FTEs | Amount | FTEs | Amount | FTEs | Amount |
Detail: | ||||||||
Clinical Research | $48,614 | $48,803 | $48,771 | (32) | ||||
Basic Research | 45,318 | 45,500 | 45,470 | (30) | ||||
Training | 9,818 | 9,860 | 9,831 | (29) | ||||
Subtotal, Extramural | $103,750 | $104,163 | $104,072 | ($91) | ||||
Intramural Research | 10 | $8,256 | 10 | $8,256 | 10 | $8,256 | 0 | $0 |
Research Management & Support | 59 | $15,492 | 59 | $15,485 | 59 | $15,602 | 0 | $117 |
TOTAL | 69 | $127,498 | 69 | $127,904 | 69 | $127,930 | 0 | $26 |
PHS Act/Other Citation | U.S. Code Citation | 2012 Amount Authorized | FY 2012 Enacted | 2013 Amount Authorized | FY 2013 PB | |||
---|---|---|---|---|---|---|---|---|
Research and Investigation | Section 301 | 42§241 | Indefinite | Indefinite | ||||
$127,904,000 | $127,930,000 | |||||||
National Center for Complementary and Alternative Medicine | Section 401(a) | 42§281 | Indefinite | Indefinite | ||||
Total, Budget Authority | $127,904,000 | $127,930,000 |
Fiscal Year | Budget Estimate to Congress | House Allowance | Senate Allowance | Appropriation |
---|---|---|---|---|
2004 | $116,202,000 | $116,202,000 | $117,092,000 | $117,752,000 |
Rescission | ($774,000) | |||
2005 | $121,116,000 | $121,116,000 | $121,900,000 | $123,116,000 |
Rescission | ($1,011,000) | |||
2006 | $122,692,000 | $122,692,000 | $126,978,000 | $122,692,000 |
Rescission | ($1,227,000) | |||
2007 | $120,554,000 | $120,554,000 | $121,982,000 | $121,576,000 |
Rescission | $0 | |||
2008 | $121,699,000 | $123,380,000 | $124,213,000 | $121,577,000 |
Rescission | ($2,162,000) | |||
Supplemental | $647,000 | |||
2009 | $121,695,000 | $125,878,000 | $125,082,000 | $125,471,000 |
Rescission | $0 | |||
2010 | $127,241,000 | $129,953,000 | $127,591,000 | $128,844,000 |
Rescission | $0 | |||
2011 | $132,004,000 | $131,796,000 | $128,844,000 | |
Rescission | ($1,131,327) | |||
2012 | $131,002,000 | $131,002,000 | $126,275,000 | $128,299,000 |
Rescission | ($242,485) | |||
2013 | $127,930,000 |
Justification of Budget Request
National Center for Complementary and Alternative Medicine
Authorizing Legislation: Section 301 and title IV of the Public Health Service Act, as amended.
Budget Authority (BA):
FY 2011 Actual | FY 2012 Enacted | FY 2013 President’s Budget | FY 2013 +/- FY 2012 | |
---|---|---|---|---|
BA | $127,498,000 | $127,904,000 | $127,930,000 | + $26,000 |
FTE | 69 | 69 | 69 | 0 |
Program funds are allocated as follows: Competitive Grants/Cooperative Agreements; Contracts; Direct Federal/Intramural and Other.
Director’s Overview
The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Government’s lead agency for scientific research on the health interventions, practices, products, and disciplines that originate from outside the mainstream of conventional medicine. NCCAM’s mission is to define, through rigorous scientific investigation, the usefulness and safety of these complementary and alternative approaches and their potential role in improving health and health care. Scientific evidence from NCCAM-supported research informs decisionmaking by the public, by health care professionals, and by health policymakers regarding the use and integration of these approaches into strategies for better health care and health promotion.
While there is vast diversity in the nature of complementary and alternative approaches, there is an emerging base of scientific evidence regarding the potential usefulness of some approaches in addressing several health care and health promotion needs. Furthermore, interest in the integration of some of these interventions with conventional health care and health promotion practices is growing. For example, both the Department of Defense and the Department of Veterans Affairs1 have begun integrating a number of complementary modalities into conventional care of patients to address problems of stress and sleep disorders, and to improve treatment of pain. In addition, data from national studies conducted by the Centers for Disease Control and Prevention (CDC) indicate widespread availability of complementary approaches in hospice settings2.
1 Department of Defense Pain Management Task Force (2010). Final Report on Providing a Standardized DoD and VHA Vision and Approach to Pain Management to Optimize Care for Warriors and Their Families.
2 Bercovitz A, Sengupta M, et al. Complementary and Alternative Therapies in Hospice: The National Home and Hospice Care Survey: United States, 2007. [327KB PDF] CDC National Health Statistics Report #33. 2011.
Use of Complementary and Alternative Approaches in the United States
Data from the 2007 National Health Interview Survey3 (NHIS), developed under NCCAM leadership in collaboration with the National Center for Health Statistics at the CDC, show that nearly 40 percent of American adults and 12 percent of children are using some form of complementary and alternative medicine (CAM). The data also show that in 2007 out-of-pocket expenditures for CAM totaled $33.9 billion. While this amount accounted for only 1.5 percent of total health care expenditures, it was more than 11 percent of out-of-pocket expenditures. NHIS data also indicate that a large portion of CAM use is best described as “self-care” in that it occurs outside of the framework of a relationship with a health care professional. The scope, associated costs, and self-care nature of CAM use in the United States reinforce the need to develop reliable, objective scientific evidence concerning the usefulness and safety—or lack thereof—of CAM interventions, and to ensure that the public has access to accurate and timely evidence-based information.
Expanding the Evidence Base
NCCAM’s efforts over the past decade have helped produce a growing body of science that points toward specific, promising opportunities to improve health care and health promotion using complementary and integrative strategies. These opportunities are reflected directly in the priorities and directions defined by NCCAM’s third strategic plan, Exploring the Science of Complementary and Alternative Medicine (available at www.nccam.nih.gov). The plan’s three goals are to: (1) advance the science and practice of symptom management; (2) develop effective, practical, personalized strategies for promoting health and well-being; and (3) enable better evidence-based decisionmaking regarding use of complementary approaches and their integration into improved strategies for health care and health promotion. To achieve these goals, NCCAM is studying complementary interventions, approaches, and disciplines across the continuum of basic, translational, efficacy, and effectiveness research.
Continued scientific exploration of the underlying biological effects and mechanisms of action of complementary therapies is one important area of emphasis for NCCAM. Grants funded under the “Mechanistic Research on CAM Natural Products” Funding Opportunity Announcement will drive understanding of the molecular and cellular targets of natural products and provide biological markers of potential beneficial or harmful effects that are critical for human studies. Researchers supported under this FOA may employ advanced technologies and systems biology approaches. In addition, modern methods of neuroscience are providing extraordinary insights into the fundamental biological effects on the brain of mind and body interventions such as meditation and acupuncture. For example, recent NCCAM-funded studies have shown that mindfulness meditation is associated with structural and functional changes in the brain in regions involved in memory, learning, and pain processing.
NCCAM is equally committed to strengthening research required to design and implement definitive clinical research and “real world” outcomes and effectiveness research that capitalizes on the reality that many complementary and alternative approaches are in widespread public use. At the “real world” end of the research continuum, NCCAM is implementing the third complementary and alternative approaches module in the 2012 National Health Interview Survey to provide accurate and up-to-date data on the patterns of use of complementary and alternative health practices in the United States. NCCAM also has a leadership role in an NIH Common Fund initiative, the Health Care Systems Research Collaboratory, a program that is developing innovative methods for research partnerships with health care delivery organizations. Results from this initiative will provide insights into the integration of complementary approaches in real world settings, a research priority of NCCAM.
3 Nahin RL, Barnes PM, Stussman BA, et al. Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. CDC National Health Statistics Report #18. 2009.
Translating Evidence into Improved Care
The growing evidence base for complementary therapies is influencing professional practice guidelines—particularly for pain management. For example, one area of great public health need is better symptom management, especially related to pain. Increasingly, complementary approaches are being integrated into the care of individuals suffering from back or neck pain, arthritic or other musculoskeletal pain, and headaches. NCCAM recently funded two Centers of Excellence for Research on CAM that use advanced functional and structural neuro-imaging technologies to study pain. Additional information on NCCAM’s research portfolio on nonpharmacological management of chronic pain is provided in the Program Portrait.
As part of NCCAM’s commitment to enable better decisionmaking regarding CAM use and its integration into health care and health promotion, NCCAM continues to use innovative technologies and approaches to improve access to evidence-based information for the general public as well as health professionals. For example, NCCAM has a portal on its Web site tailored to fit the needs of health care providers and to encourage the important dialogue with patients on the use of complementary approaches to health.
Overall IC Budget Policy: Guided by its strategic plan, the advice of the National Advisory Council for Complementary and Alternative Medicine, and input from a diverse community of stakeholders, NCCAM builds the scientific evidence base for complementary and alternative medicine by stimulating research and increasing research capacity. In FY 2013, NCCAM will continue to fund multidisciplinary investigator-initiated research, will support new investigators on R01 equivalent awards at success rates equivalent to those of established investigators submitting new R01 equivalent applications, and encourage capacity building across the field of CAM research. Areas of special emphasis include studies examining the effectiveness of CAM approaches to alleviate chronic pain and translational research to improve the quality, reproducibility, and comparability of clinical CAM research. The Division of Intramural Research and Research Management and Support will receive modest increases to maintain staffing levels and ensure responsible oversight of research activities.
Funds are included in R&D contracts to support trans-NIH initiatives, such as the Basic Behavioral and Social Sciences Opportunity Network (OppNet).
Program Descriptions and Accomplishments
Extramural Basic Research: Basic research clarifies fundamental biological effects that are central to the development of the evidence base in complementary and alternative therapies and underpins the design of clinical research. NCCAM supports investigator-initiated basic research and will continue, through targeted initiatives, its support for translational research on promisingcomplementary interventions. NCCAM funds basic research initiatives such as Mechanistic Research on CAM Natural Products, which will support development of advanced technologies and methodologies to study natural products. Knowledge of the active components as well as the biological effects of natural products is critical for designing clinical studies to determine the efficacy of these products.
Budget Policy: The FY 2013 President’s Budget request for extramural basic research is $45.470 million, a decrease of $0.030 million or 0.07 percent below the FY 2012 Enacted level.
Extramural Clinical Research: The NCCAM extramural research program funds multidisciplinary clinical investigations into various complementary modalities at leading U.S. biomedical and CAM research institutions. Clinical complementary intervention research ranges from small pilot studies to large-scale clinical trials and epidemiological studies supported through solicited research initiatives, collaboration between NIH Institutes and Centers and the CDC, and investigator-initiated research. As part of this effort, NCCAM will explore the use of outcomes and effectiveness research in developing practice-based evidence on how complementary and alternative approaches could aid in better symptom management and thereby help to reduce the public health burden of chronic diseases and troublesome conditions. The benefits of this research are two-fold: it will help to inform our understanding of complementary and alternative therapies as practiced in the community, and it will provide additional data on the effectiveness of complementary interventions for particular diseases and symptoms.
Budget Policy: The FY 2013 President’s Budget request for extramural clinical research is $48.774 million, a decrease $0.032 million or 0.07 percent below the FY 2012 Enacted level. The program portrait listed below provides an overview of NCCAM’s nonpharmacologic management of chronic pain program.
Program Portrait: Investigating Nonpharmacological Management of Chronic Pain
FY 2012: $29.0 million
FY 2013: $29.0 million
Difference: $0.0 million
Chronic pain affects an estimated 116 million Americans. Each year, approximately $635 billion is spent on the medical treatment of pain and lost productivity due to pain. In fact, pain is the number one reason for worker absenteeism, costing U.S. businesses more than $61 billion annually in lost worker productivity.1
While there has been substantial progress in the medical management of chronic pain, improved strategies are needed. For many individuals suffering from chronic pain, conventional medical approaches provide incomplete relief. Furthermore, pharmacological treatment with opioids or anti-inflammatory drugs often increases the risk of adverse effects.
Chronic pain is, by far, the most frequently cited reason for which Americans use complementary interventions.2 While there is evidence that some nonpharmacological interventions, such as massage, spinal manipulation, yoga, and acupuncture, may be helpful for the treatment of chronic pain, additional scientific evidence is needed to better understand how these interventions work. This need to develop better evidence on the efficacy and safety of promising complementary modalities for symptom management such as chronic pain was identified as a primary goal in NCCAM’s third strategic plan. To this end, NCCAM is supporting studies on the use of nonpharmacological interventions for the management of chronic pain, including back and neck pain and pain associated with osteoarthritis, fibromyalgia, and headaches. Additionally, NCCAM is investigating whether and how complementary interventions can be effectively integrated into better conventional approaches to treating pain.
NCCAM is also supporting research to close gaps in our basic understanding of the biological mechanisms of chronic pain. For example, two recently funded Centers of Excellence for Research on Complementary and Alternative Medicine are focused on pain. Researchers at these centers are using neuroimaging technology to understand alterations in brain functions involved in processing chronic low-back pain, and to elucidate how mind-and-body interventions affect these processes. Specifically, one center is using real-time functional magnetic resonance imaging (fMRI) neurofeedback as an innovative technique to study ways to manipulate key brain systems related to pain. Once researchers better understand how this learned control of specific neural processes leads to reductions in chronic pain, they will investigate strategies for translating their mechanistic findings into improved clinical therapies. The other center is using fMRI to measure changes in pain processing brain regions to identify the mechanisms underlying acupuncture analgesia in chronic low-back pain. The results from these studies will help to understand ways that pain can be modulated and may lead to better treatments to address this critical public health need.
1Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, Institute of Medicine, June 2011.
2 Nahin, RL, Barnes PM, Stussman BA, et. al. Costs of complementary and alternative medicine (CAM) and frequency of visits to CAM practitioners: United States, 2007. CDC National Health Statistics Report #18. 2009.
Extramural Research Training and Capacity Building: The basic, translational, and clinical research required to develop the evidence base for the use of complementary and alternative modalities is enhanced through the expertise of CAM practitioners working in partnership with conventional medical researchers. To increase the number, quality, and diversity of investigators who conduct research on complementary and alternative interventions, NCCAM supports a variety of training and career development activities for pre-doctoral and post-doctoral students, CAM practitioners, and conventional medical researchers and practitioners. For example, NCCAM supports programs aimed at enhancing CAM practitioners’ abilities to evaluate biomedical literature, participate in clinical research, and seek advanced training and career development opportunities. Researchers from many different biomedical and behavioral disciplines have the expertise required for in-depth investigation of the basic biological, physiological, and clinical effects and safety of complementary and alternative interventions; therefore, NCCAM supports programs to attract these researchers and to encourage them to establish partnerships with CAM practitioners.
Budget Policy: The FY 2013 President’s Budget request for extramural research training and capacity building is $9.831 million, a decrease of $0.029 million or 0.29 percent below the FY 2012 Enacted level
Intramural Research: NCCAM is partnering with other NIH Institutes and Centers to develop innovative investigations that will expand intramural interdisciplinary research collaborations in areas such as neuroscience and neuroimaging. Research supported under this program will focus on ways that different complementary and alternative approaches (e.g., acupuncture) modulate pain and other symptoms.
Budget Policy: The FY 2013 President’s Budget request for intramural research is $8.256 million, the same as the FY 2012 Enacted level.
Research Management and Support (RMS): Through its RMS activities, including grants review and management, NCCAM continues to fund meritorious basic, clinical, and translational research and research training efforts. NCCAM is also providing important trans-NIH leadership on the significant public health problem of back pain, for example through efforts aimed at defining the research priorities, or on scientific issues regarding control/comparison groups for trials of non-pharmacologic interventions. Additionally, the Center continues to provide reliable, objective, and evidence-based information to help the public make informed decisions about the use of complementary and alternative therapies and to enable health care providers to better manage their patients’ care. For example, NCCAM launched an online resource (nccam.nih.gov/health/providers) designed to give health care providers easy access to evidence-based information on complementary and alternative therapies, so that they would be better able to discuss the safety and effectiveness of these therapies with their patients.
Budget Policy: The FY 2013 President’s Budget request for research management and support is $15.602 million, an increase of $0.117 million or 0.76 percent above the FY 2012 Enacted level.
FY 2012 Enacted | FY 2013 PB | Increase or Decrease | ||
---|---|---|---|---|
Includes FTEs which are reimbursed from the NIH Common Fund. | ||||
Total compensable workyears: | ||||
Full-time employment | 69 | 69 | 0 | |
Full-time equivalent of overtime and holiday hours | 0 | 0 | 0 | |
Average ES salary (in dollars) | $0 | $0 | $0 | |
Average GM/GS grade | 12.6 | 12.6 | 0.0 | |
Average GM/GS salary (in dollars) | $106,011 | $106,541 | $530 | |
Average salary, grade established by act ofJuly 1, 1944 (42 U.S.C. 207) (in dollars) | $0 | $0 | $0 | |
Average salary of ungraded positions (in dollars) | 0 | 0 | 0 | |
OBJECT CLASSES | FY 2012 Enacted | FY 2013 PB | Increase or Decrease | |
Personnel Compensation: | ||||
11.1 | Full-time permanent | $5,683 | $5,713 | $30 |
11.3 | Other than full-time permanent | 1,913 | 1,934 | 21 |
11.5 | Other personnel compensation | 206 | 208 | 2 |
11.7 | Military personnel | 176 | 180 | 4 |
11.8 | Special personnel services payments | 63 | 64 | 1 |
Total, Personnel Compensation | $8,041 | $8,099 | $58 | |
12.0 | Personnel benefits | $2,161 | $2,176 | $15 |
12.2 | Military personnel benefits | 82 | 82 | 0 |
13.0 | Benefits for former personnel | 0 | 0 | 0 |
Subtotal, Pay Costs | $10,284 | $10,357 | $73 | |
21.0 | Travel and transportation of persons | $194 | $194 | $0 |
22.0 | Transportation of things5252023.1Rental payments to GSA | 0 | 0 | 0 |
23.2 | Rental payments to others | 25 | 25 | 0 |
23.3 | Communications, utilities and miscellaneous charges | 201 | 201 | 0 |
24.0 | Printing and reproduction | 27 | 27 | 0 |
25.1 | Consulting services | 789 | 791 | 2 |
25.2 | Other services | 4,912 | 5,063 | 151 |
25.3 | Purchase of goods and services from government accounts | 16,217 | 16,848 | 631 |
25.4 | Operation and maintenance of facilities | 53 | 53 | 0 |
25.5 | Research and development contracts | 1,089 | 1,149 | 60 |
25.6 | Medical care | 0 | 0 | 0 |
25.7 | Operation and maintenance of equipment | 95 | 95 | 0 |
25.8 | Subsistence and support of persons | 0 | 0 | 0 |
25.0 | Subtotal, Other Contractual Services | $23,155 | $23,999 | $844 |
26.0 | Supplies and materials | $175 | $175 | $0 |
31.0 | Equipment | 128 | 128 | 0 |
32.0 | Land and structures | 0 | 0 | 0 |
33.0 | Investments and loans | 0 | 0 | 0 |
41.0 | Grants, subsidies and contributions | 93,663 | 92,772 | (891) |
42.0 | Insurance claims and indemnities | 0 | 0 | 0 |
43.0 | Interest and dividends | 0 | 0 | 0 |
44.0 | Refunds | 0 | 0 | 0 |
Subtotal, Non-Pay Costs | $117,620 | $117,573 | ($47) | |
Total Budget Authority by Object | $127,904 | $127,930 | $26 |
OBJECT CLASSES | FY 2012 Enacted | FY 2013 PB | Increase or Decrease |
---|---|---|---|
Personnel Compensation: | |||
Full-time permanent (11.1) | $5,683 | $5,713 | $30 |
Other than full-time permanent (11.3) | 1,913 | 1,934 | 21 |
Other personnel compensation (11.5) | 206 | 208 | 2 |
Military personnel (11.7) | 176 | 180 | 4 |
Special personnel services payments (11.8) | 63 | 64 | 1 |
Total Personnel Compensation (11.9) | $8,041 | $8,099 | $58 |
Civilian personnel benefits (12.1) | $2,161 | $2,176 | $15 |
Military personnel benefits (12.2) | 82 | 82 | 0 |
Benefits to former personnel (13.0) | 0 | 0 | 0 |
Subtotal, Pay Costs | $10,284 | $10,357 | $73 |
Travel (21.0) | $194 | $194 | $0 |
Transportation of things (22.0) | 52 | 52 | 0 |
Rental payments to others (23.2) | 25 | 25 | 0 |
Communications, utilities and miscellaneous charges (23.3) | 201 | 201 | 0 |
Printing and reproduction (24.0) | 27 | 27 | 0 |
Other Contractual Services: | |||
Advisory and assistance services (25.1) | 789 | 791 | 2 |
Other services (25.2) | 4,912 | 5,063 | 151 |
Purchases from government accounts (25.3) | 12,320 | 11,860 | (460) |
Operation and maintenance of facilities (25.4) | 53 | 53 | 0 |
Operation and maintenance of equipment (25.7) | 95 | 95 | 0 |
Subsistence and support of persons (25.8) | 0 | 0 | 0 |
Subtotal Other Contractual Services | $18,169 | $17,862 | ($307) |
Supplies and materials (26.0) | $175 | $175 | $0 |
Subtotal, Non-Pay Costs | $18,843 | $18,536 | ($307) |
Total, Administrative Costs | $29,127 | $28,893 | ($234) |
OFFICE/DIVISION | FY 2011 Actual | FY 2012 Enacted | FY 2013 PB | ||||||
---|---|---|---|---|---|---|---|---|---|
Civilian | Military | Total | Civilian | Military | Total | Civilian | Military | Total | |
Office of the Director | |||||||||
Direct: | 30 | 3 | 3 | 0 | 3 | 3 | 0 | 3 | |
Reimbursable: | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 3 | 0 | 3 | 3 | 0 | 3 | 3 | 0 | 3 |
Office of Administrative Operations | |||||||||
Direct: | 14 | 1 | 15 | 15 | 0 | 15 | 15 | 0 | 15 |
Reimbursable: | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 14 | 1 | 15 | 15 | 0 | 15 | 15 | 0 | 15 |
Office of Policy, Planning, and Evaluation | |||||||||
Direct: | 6 | 0 | 6 | 6 | 0 | 6 | 6 | 0 | 6 |
Reimbursable: | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 6 | 0 | 6 | 6 | 0 | 6 | 6 | 0 | 6 |
Office of Communication and Public Liaison | |||||||||
Direct: | 8 | 0 | 8 | 8 | 0 | 8 | 8 | 0 | 8 |
Reimbursable: | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 8 | 0 | 8 | 8 | 0 | 8 | 8 | 0 | 8 |
Office of Clinical and Regulatory Affairs | |||||||||
Direct: | 4 | 0 | 4 | 4 | 0 | 4 | 4 | 0 | 4 |
Reimbursable: | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 4 | 0 | 4 | 4 | 0 | 4 | 4 | 0 | 4 |
Division of Extramural Research | |||||||||
Direct: | 8 | 0 | 8 | 8 | 0 | 8 | 8 | 0 | 8 |
Reimbursable: | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 8 | 0 | 8 | 8 | 0 | 8 | 8 | 0 | 8 |
Division of Intramural Research | |||||||||
Direct: | 9 | 0 | 9 | 10 | 0 | 10 | 10 | 0 | 10 |
Reimbursable: | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 10 | 0 | 10 | 10 | 0 | 10 | 10 | 0 | 10 |
Division of Extramural Activities | |||||||||
Direct: | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 |
Reimbursable: | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 |
Manual and Mind Body Medicine Branch | |||||||||
Direct: | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 |
Reimbursable: | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 |
Office of Scientific Review | |||||||||
Direct: | 5 | 0 | 5 | 5 | 0 | 5 | 5 | 0 | 5 |
Reimbursable: | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 5 | 0 | 5 | 5 | 0 | 5 | 5 | 0 | 5 |
Natural Products Branch | |||||||||
Direct: | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 |
Reimbursable: | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 2 | 0 | 2 | 2 | 0 | 2 | 2 | 0 | 2 |
Office of Grants Management | |||||||||
Direct: | 4 | 0 | 4 | 4 | 0 | 4 | 4 | 0 | 4 |
Reimbursable: | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Total: | 4 | 0 | 4 | 4 | 0 | 4 | 4 | 0 | 4 |
Total | 68 | 1 | 69 | 69 | 0 | 69 | 69 | 0 | 69 |
Includes FTEs which are reimbursed from the NIH Common Fund. | |||||||||
FTEs supported by funds from Cooperative Research and Development Agreements | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Fiscal Year | Average GS Grade |
---|---|
2009 | 12.4 |
2010 | 12.7 |
2011 | 12.6 |
2012 | 12.6 |
2013 | 12.6 |
GRADE | FY 2011 Actual | FY 2012 Enacted | FY 2013 PB |
---|---|---|---|
Includes FTEs which are reimbursed from the NIH Common Fund. | |||
Total, ES Positions | 0 | 0 | 0 |
Total, ES Salary | 0 | 0 | 0 |
GM/GS-15 | 8 | 8 | 8 |
GM/GS-14 | 19 | 19 | 19 |
GM/GS-13 | 16 | 16 | 16 |
GS-12 | 9 | 9 | 9 |
GS-11 | 3 | 3 | 3 |
GS-10 | 0 | 0 | 0 |
GS-9 | 2 | 2 | 2 |
GS-8 | 2 | 2 | 2 |
GS-7 | 2 | 2 | 2 |
GS-6 | 0 | 0 | 0 |
GS-5 | 0 | 0 | 0 |
GS-4 | 1 | 1 | 1 |
GS-3 | 0 | 0 | 0 |
GS-2 | 0 | 0 | 0 |
GS-1 | 0 | 0 | 0 |
Subtotal | 62 | 62 | 62 |
Grades established by Act of July 1, 1944 (42 U.S.C. 207): | |||
Assistant Surgeon General | 0 | 0 | 0 |
Director Grade | 0 | 0 | 0 |
Senior Grade | 0 | 0 | 0 |
Full Grade | 1 | 1 | 1 |
Senior Assistant Grade | 0 | 0 | 0 |
Assistant Grade | 0 | 0 | 0 |
Subtotal | 1 | 1 | 1 |
Ungraded | 9 | 9 | 9 |
Total permanent positions | 62 | 62 | 62 |
Total positions, end of year | 72 | 72 | 72 |
Total full-time equivalent (FTE) employment, end of year | 69 | 69 | 69 |
Average ES salary | 0 | 0 | 0 |
Average GM/GS grade | 12.6 | 12.6 | 12.6 |
Average GM/GS salary | 106,011 | 106,011 | 106,541 |
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The NCCAM Clearinghouse provides information on NCCAM and complementary health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.
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