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.

The NCMHD is part of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services (DHHS).

ABOUT NCMHD

Congressional Testimony

DEPARTMENT OF HEALTH AND HUMAN SERVICES NATIONAL INSTITUTES OF HEALTH