1. AAPM&R Annual Assembly Boston, Massachusetts NIH - Promoting a Robust Pain, Musculoskeletal, and Rehabilitation Research Portfolio Jennifer Zumsteg, M.D. Friday, October 2, 2015

2. Overview Background of AAPM&R Research Advocacy Efforts Disability and Rehabilitation Research Coalition Efforts Status of NIH Developments Status of Legislative Developments Appropriations Update Future Activities 2

3. Background AAPM&R has long been a leader on promoting rehabilitation science Has advocated for rehab research at NIH, NCMRR, NIDRR (now NIDILRR), VA, CDC AAPM&R efforts have focused on NICHD (Child Health and Human Development) and NIAMS (Arthritis and Musculoskeletal Diseases) AAPM&R has worked independently and in coalition with other stakeholders 3

4. DRRC Coalition Founding member of the Disability and Rehabilitation Research Coalition (DRRC) ACRM and AAP co-founded the coalition and APTA and AOTA more recently involved Established in 2007 to help elevate the stature and enhance coordination of rehab science at NIH Over 35 national organizations participate, including clinical, scientific, and consumer- disability groups 4

5. Status of NIH Developments AAPM&R staff recently co-chaired the “Friends of NIAMS” Coalition to promote pain and musculoskeletal research within NIH AAPM&R (through DRRC) has met numerous times since 2007 with senior NIH leadership to promote advances in rehabilitation science Blue Ribbon Panel (BRP) on Medical Rehabilitation Research concluded in late 2012 that rehab science was “not thriving” at NIH Recommendations were made and pursued by NIH officials over the past three years NICHD Director Guttmacher deserves great credit for his leadership in implementing key aspects of the BRP report 5

6. Status of NIH Developments BRP Recommendations NIH Implemented: – New leadership: Alison Cernich, Ph.D., has been permanent NCMRR Director since February 2015 – Dedicated budget (7.5% of NICHD Extramural budget) equates to approx. $75 million annually out of $300 million spent yearly at NIH on rehab science NCMRR has much greater authority now to plan, budget, and proactively fund rehab science with other Institutes and Centers as well as other federal agencies – Reinvigorated NIH’s Rehabilitation Research Coordinating Committee across Institutes/Centers 6

7. Status of Legislative Developments Rehab research legislation is necessary because NIH did not have authority to implement all recommendations of BRP. BRP’s recommendation to elevate NCMRR to a free- standing institute or center requires Congressional approval. Congress capped NIH’s Institutes/Centers at 27 so legislation now focuses on elevating stature and visibility of rehab science at NIH Legislation seeks greater coordination, greater involvement of the NIH Director’s office, better tracking of rehabilitation research projects, and establishing priorities and plans for rehab science. 7

8. Legislative Update Senators Kirk (R-IL) and Bennet (D-CO) introduced S. 800, legislation to enhance the stature of rehab science at NIH House companion: H.R. 1631 introduced by Congressmen Langevin (D-RI) and Harper (R-MS) Both bills need additional cosponsors but have very good support in relevant committees The bills are bipartisan and NIH has offered constructive comments that have been incorporated DRRC’s goal is to move this legislation in the 114 th Congress while continuing to work with NIH to advance rehab science within the agency. 8

9. Rehab Science Legislation The bills would elevate the stature and visibility of rehab science at NIH by including a member of the Director’s Office of Strategic Initiatives in the Rehab Research Coordinating Committee Establish a consensus conference and new research plan every five years Clearly define “rehabilitation research” in order to better track rehab science grants Link rehab grant awards to the research plan’s priorities and the definition of rehab research 9

10. Appropriations Update Continuing Resolution is expected to pass this week funding NIH and the federal government through December 12 th at FY 2015 levels Major appropriations showdown expected in December Big question for NIH: Whether additional funding will be added to the overall budget to provide modest increases to NIH/other programs Current NICHD budget is $1.287 billion and the President’s request for FY 2016 is $1.318 billion NIH and all federal programs are at risk of funding decreases if Congress cannot agree to new spending levels House passed Innovation Act this summer that would add $8.5 billion over 3 years in mandatory funding to NIH’s existing budget of $31 Billion. – The Senate has not yet acted on this bill. 10

11. Future Activities AAPM&R will continue to work with DRRC to promote S. 800/H.R. 1631 AAPM&R will meet with NIH again after draft rehab research priorities are released by NCMRR in October There will be four major opportunities for public comment as NCMRR drafts its research plan Dr. Guttmacher retired on October 1 st and Deputy Director Catherine Spong, M.D., will serve as Acting NIHCD Director while a national search is conducted. AAPM&R will also seek to advance pain and musculoskeletal research through NIAMS and other institutes at NIH Additional advocacy for rehab science will occur at NIDILRR and other government research agencies. 11

12. Questions? Jennifer Zumsteg, M.D.