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Congressional Justification 2010

DEPARTMENT OF HEALTH AND HUMAN SERVICES
NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine (NCCAM)

This document provides justification for the Fiscal Year 2010. It outlines our plans and priorities, provides details of our budget, and notes our legislative history.

On this page:

Organization Chart

Organization chart showing the organizational relationship and structure of the offices and divisions of the National Center for Complementary and Alternative Medicine. Office of the Director, Director: Josephine P. Briggs, M.D.; Deputy Director, Jack Killen, M.D. Atttached to the Office of the Director is the Senior Advisor for Scientific Coordination and Outreach, Richard Nahin, Ph.D., M.P.H. Also attached to the Office of the Director is the National Advisory Council for Complementary and Alternative Medicine. Under the Office of the Director are the Executive Office/Office of Administrative Operations, Executive Officer: Camille Hoover; Office of Communications and Public Liaison, Director: Chris Thomsen; Office of Policy, Planning, and Evaluation, Acting Director: Chris Thomsen; Division of Extramural Research, Acting Director: Richard Nahin, Ph.D.; Division of Intramural Research, Acting Director: Robert B. Nussenblatt, M.D.; and the Division of Extramural Activities, Director: Martin Goldrosen, Ph.D. Under the Division of Extramural Research are the Office of International Health Research, Director: Jack Killen, M.D.; Officer of Special Populations: Vacant; and the Office of Clinical and Regulatory Affairs, Acting Director: Richard Nahin, Ph.D. Under the Division of Intramural Research are the Endocrine Section, Acting Chief: Robert B. Nussenblatt, M.D.; and the Diabetes Unit, Chief: Michael Quon, M.D., Ph.D. Under the Division of Extramural Activities are the Office of Scientific Review, Chief: Dale Birkle Dreer, Ph.D.; and the Office of Grants Management, Director: George Tucker, M.B.A.

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Appropriation Language

NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine

For carrying out section 301 and title IV of the Public Health Services Act with respect to complementary and alternative medicine [$125,471,000] $127,241,000
(Department of Health and Human Services Appropriation Act, 2009)

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Amounts Available for Obligation 1/
Source of Funding FY 2008 Actual FY 2009 Estimate FY 2010
PB
1/ Excludes the following amounts for reimbursable activities carried out by this account:
FY 2008 -$6,000
FY 2009 -$6,000
FY 2010 -$6,000

Excludes $0 Actual in FY 2008; Estimate $0 in FY 2009 and Estimate $0 in FY 2010 for royalties.

Appropriation $123,739,000 $125,471,000 $127,241,000
Type 1 Diabetes 0 0 0
Rescission -2,162,000 0 0
Supplemental 647,000 0 0
Subtotal, adjusted appropriation 122,224,000 125,471,000 127,241,000
Real transfer under Director's one-percent transfer authority (GEI) -205,000 0 0
Comparative transfer under Director's one-percent transfer authority (GEI) 205,000 0 0
Subtotal, adjusted budget authority 122,224,000 125,471,000 127,241,000
Unobligated balance, start of year 0 0 0
Unobligated balance, end of year 0 0 0
Subtotal, adjusted budget authority 122,224,000 125,471,000 127,241,000
Unobligated balance lapse -6,000 0 0
Total obligations 122,218,000 125,471,000 127,241,000

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Budget Mechanism—Total
(Dollars in Thousands)
MECHANISM FY 2008 Actual FY 2009 Estimate FY 2010 PB Change
Number Amount Number Amount Number Amount Number Amount
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research
Research Grants:                
Research Projects:                
Noncompeting 123 $48,433 121 $47,809 123 $51,482 2 $3,673
Administrative supplements (17) 4,268 (17) 5,543 (17) 1,700 (0) (3,843)
Competing:                
Renewal 3 1,651 0 0 0 0 0 0
New 68 19,951 69 21,633 71 22,700 2 1,067
Supplements 0 0 0 0 0 0 0 0
Subtotal, competing 71 21,602 69 21,633 71 22,700 2 1,067
Subtotal, RPGs 194 74,303 190 74,985 194 75,882 4 897
SBIR/STTR 9 2,738 9 2,765 9 2,803 0 38
Subtotal, RPGs 203 77,041 199 77,750 203 78,685 4 935
Research Centers:                
Specialized/comprehensive 6 2,031 6 2,500 6 2,500 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
Subtotal, Centers 6 2,031 6 2,500 6 2,500 0 0
Other Research:                
Research careers 51 6,116 53 6,409 55 6,684 2 275
Cancer education 0 0 0 0 0 0 0 0
Cooperative clinical research 0 500 0 0 0 0 0 0
Biomedical research support 0 0 0 0 0 0 0 0
Minority biomedical research support 0 0 0 0 0 0 0 0
Other 19 2,683 19 2,782 19 2,824 0 42
Subtotal, Other Research 70 9,299 72 9,191 74 9,508 2 317
Total Research Grants 279 88,371 277 89,441 283 90,693 6 1,252
Research Training:                
Individual awards 24 FTTPs 948 24 FTTPs 956 24 FTTPs 966 0 10
Institutional awards 75 FTTPs 3,136 75 FTTPs 3,162 75 FTTPs 3,194 0 32
Total, Training 99 FTTPs 4,084 99 FTTPs 4,118 99 FTTPs 4,160 0 42
Research & development contracts 14 7,672 14 9,300 14 9,400 0 100
(SBIR/STTR) 0 5 (0) (5) (0) (5) (0) (0)
Intramural research 12 FTEs 7,455 10 FTEs 7,630 10 FTEs 7,744 0 114
Research management and support 55 FTEs 14,642 54 FTEs 14,982 55 FTEs 15,244 1 262
Construction   0   0   0   0
Buildings and Facilities   0   0   0   0
Total, NCCAM 67 FTEs 122,224 64 FTEs 125,471 65 FTEs 127,241 1 1,770

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Budget Authority by Program
(Dollars in Thousands)
  FY 2006 Actual FY 2007 Actual FY 2008 Actual FY 2008 Comparable FY 2009 Estimate FY 2010 PB Change
FTEs Amount FTEs Amount FTEs Amount FTEs Amount FTEs Amount FTEs Amount FTEs Amount
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research

The dollars represent training as a program and not as a disease research category.

Extramural Research                            
Detail:                            
Basic Research   $31,606   $36,955   $39,927   $40,138   $41,233   $41,792   559
Clinical Research   54,698   50,364   49,071   49,071   50,410   51,093   683
Training   13,413   12,182   10,918   10,918   11,216   11,368   152
Subtotal, Extramural   99,717   99,501   99,916   100,127   102,859   104,253   1,394
Intramural research 15 7,448 13 7,443 12 7,452 12 7,455 10 7,630 10 7,744 0 114
Res. management & support 59 14,217 56 14,427 55 14,639 55 14,642 54 14,982 55 15,244 1 262
TOTAL 74 121,382 69 121,371 67 122,007 67 122,224 64 125,471 65 127,241 1 1,770

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Major Changes in the Fiscal Year 2010 Budget Request

Major changes by budget mechanism and/or budget activity detail are briefly described below. Note that there may be overlap between budget mechanism and activity detail and these highlights will not sum to the total change for the FY 2010 budget request for the National Center for Complementary and Alternative Medicine which is +$1.770 million more than the FY 2009 estimate, for a total of $127.241 million.

Research Project Grants (+897 thousand; total $75.882 million). NCCAM will support a total of 194 Research Project Grant (RPG) awards in FY 2009. Noncompeting RPG's will increase by 2 awards and increase $3.673 million, of which $0.993 million will be for conversion of Pathway to Independence awards from Research Careers to noncompeting RPGs. Competing RPG's will increase by 2 awards and increase by $1.067 million. The NIH Budget policy for RPGs in FY 2010 is to provide a 2% inflationary increase in noncompeting awards and a 2% increase in average cost for competing RPGs.

Research Careers (+275 thousand; total $6.684 million). NCCAM will support the Pathway to Independence program, by funding 2 additional awards in FY 2010. Total support for the Pathway program in FY 2010 is 4 awards and $360 thousand.

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Summary of Changes
FY 2009 estimate $125,471,000
FY 2010 estimated budget authority 127,241,000
Net change 1,770,000
NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Summary of Changes (continued)
CHANGES 2009 Current Estimate Base Change from Base
FTEs Budget Authority FTEs Budget Authority
A. Built-in:        
1. Intramural research:        
a. Annualization of January 2009 pay increase   $1,586,000   $19,000
b. January FY 2010 pay increase   1,586,000   24,000
c. Zero less days of pay   1,586,000   0
d. Payment for centrally furnished services   2,064,000   41,000
e. Increased cost of laboratory supplies, materials, and other expenses   3,980,000   64,000
Subtotal       148,000
2. Research management and support:        
a. Annualization of January 2009 pay increase   $7,671,000   $92,000
b. January FY 2010 pay increase   7,671,000   115,000
c. Zero less days of pay   7,671,000   0
d. Payment for centrally furnished services   981,000   20,000
e. Increased cost of laboratory supplies, materials, and other expenses   6,330,000   103,000
Subtotal       330,000
Subtotal, Built-in       478,000
NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Summary of Changes (continued)
CHANGES 2009 Current Estimate Base Change from Base
Number Amount Number Amount
B. Program:        
1. Research project grants:        
a. Noncompeting 121 $53,352,000 2 ($170,000)
b. Competing 69 21,633,000 2 1,067,000
c. SBIR/STTR 9 2,765,000 0 38,000
Total 199 77,750,000 4 935,000
2. Research centers 6 2,500,000 0 0
3. Other research 72 9,191,000 2 317,000
4. Research training 99 4,118,000 0 42,000
5. Research and development contracts 14 9,300,000 0 100,000
Subtotal, extramural       1,394,000
6. Intramural research 10 FTEs 7,630,000 0 FTEs (37,000)
7. Research management and support 54 FTEs 14,982,000 1 FTE (65,000)
8. Construction   0   0
9. Buildings and Facilities   0   0
Subtotal, program   125,471,000   1,292,000
Total changes 64 FTEs   1 FTE 1,770,000

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Fiscal Year 2010 Budget Graphs

Funding Levels by Fiscal Year

Bar chart. See table immediately below for data.

Fiscal Year Dollars in Millions
2006 121.5
2007 121.4
2008 122.2
2009 125.5
2010 127.2

Full-Time Employees by Fiscal Year

Bar chart. See table immediately below for data.

Fiscal Year FTEs
2006 74
2007 69
2008 67
2009 64
2010 65

FY 2010 Budget Mechanism

Pie chart. See table immediately below for data.

Mechanism Budget Percent of Budget
Research Project Grants $79,000 62
RM&S $15,000 12
Other Research $10,000 8
R&D Contracts $9,000 7
Intramural Research $8,000 6
Research Training $4,000 3
Research Centers $3,000 2
Buildings & Facilities 0 0
Construction 0 0

FY 2010 Estimate
Percent Change from FY 2009 Mechanism

Bar chart. See table immediately below for data.

Mechanism Percent Change
Research Project Grants 1.2
Research Centers 0
Other Research 3.4
Research Training 1.0
R&D Contracts 1.1
Intramural Research 1.5
Res. Mgmt. & Support 1.7
B&F 0

FY 2010 Congressional Justification
National Center for Complementary and Alternative Medicine
March 13, 2009

Authorizing Legislation: Section 301 and title IV of the Public Health Service Act, as amended.

  FY 2008 Appropriation FY 2009 Omnibus FY 2009 Recovery Act FY 2010 President's Budget FY 2010 +/- 2009 Omnibus
BA $122,224,000 $125,471,000 $31,728,000 $127,241,000 +$1,770,000
FTE 67 64 0 65 +1

This document provides justification for the Fiscal Year (FY) 2010 activities of the National Center for Complementary and Alternative Medicine (NCCAM), including HIV/AIDS activities. Details of the FY 2010 HIV/AIDS activities are in the "Office of AIDS Research (OAR)" Section of the Overview. Details on the Common Fund are located in the Overview, Volume One. Program funds are allocated as follows: Competitive Grants/Cooperative Agreements; Contracts; Direct Federal/Intramural and Other.

In FY 2009, a total of $31,728,000 American Recovery and Reinvestment Act (ARRA) funds were transferred from the Office of the Director. These funds will be used to to support scientific research opportunities that help support the goals of the ARRA. The ARRA allows NIH to execute these funds via any NIH funding mechanism. Funds are available until September 30, 2010. These funds are not included in the FY 2009 Omnibus amounts reflected in this document.

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Director's Overview

Americans in large numbers use complementary and alternative medicine (CAM) in their pursuit of health and wellness. The mission of the National Center for Complementary and Alternative Medicine (NCCAM) is to develop a rigorous evidence base for CAM and to provide the American public with authoritative information on the benefits and risks of these practices. NCCAM (nccam.nih.gov) achieves its mission through basic and clinical research, research capacity building and training, and education and outreach programs.

The 2007 National Health Interview Survey data showed that nearly 40 percent of adults use CAM. The most common reason for the use of CAM is chronic pain, including back pain, headache, and arthritis pain. The modalities used most frequently for chronic pain include manipulative therapies, meditation, yoga, massage, acupuncture, and various botanical and other dietary supplements. NCCAM-supported research applies state-of-the-art neuroscience to the study of mind-body medicine and acupuncture. Additionally, NCCAM-supported research has provided evidence of significant effects of these practices on the underlying biological mechanisms of pain perception and control. Health care guidelines and systematic reviews on pain management, based in part on NCCAM-supported clinical research, increasingly recommend inclusion of CAM approaches as promising options for the management of pain from osteoarthritis, back pain, and post-operative pain.

Developing reliable and useful evidence on botanical and other dietary supplements presents unique research challenges. These challenges include basic research to elucidate biological effects and rigorous attention to details of product characterization. In FY 2008, NCCAM funded two new institutions as part of its Centers of Excellence for Research on CAM program (nccam.nih.gov/news/2008/102008.htm) that focus on herbal supplement research. NCCAM continues to support the Botanical Research Centers Program, in collaboration with the NIH Office of Dietary Supplements. NCCAM's entire research portfolio for botanical and other dietary supplements has been greatly strengthened by its product integrity review process.

NCCAM remains committed to building CAM research capacity by fostering the development of translational and clinical research skills among CAM practitioners and institutions. In FY 2008, one new award was made under the Developmental Centers for Research on CAM initiative, a program to support collaborations between CAM schools and conventional biomedical research institutions. In addition, NCCAM convened a working group of its Advisory Council in March 2008 to consider new ways to enhance research capacity at CAM institutions. Based on their recommendations, the Advisory Council approved a new partnership initiative, planned for funding in FY 2010.

Basic and translational research remains critically important in the design of optimal clinical studies. NCCAM will continue its efforts to identify and understand the mechanisms underlying key chemical compounds and their protein targets in traditional botanical remedies, ensure the integrity of botanical and dietary supplement research products, and bring modern neuroscience to the study of mind-body and body-based interventions in order to capture fully the potential of these practices. The Center is also investing in better translational tools, metrics, and methodologies to improve conducting, reporting, and comparing clinical investigations of mind-body medicine, acupuncture, and manipulative and body-based therapies. In FY 2010, NCCAM will fund awards designed to address some of these key challenges to build the basic and translational research components of the CAM evidence base under the initiative Program for Translational Tools for CAM Clinical Research.

Another priority of NCCAM is developing an evidence base to better guide the American public on the contribution of CAM approaches to pain management. Chronic back pain, along with its associated morbidity and disability, is a major public health problem (annual U.S. expenditures for back pain are estimated at $50-to-$100 billion annually*), and available treatment approaches are not satisfactory. Though evidence suggests that CAM practices can complement conventional pain management and are widely used by Americans, the evidence base does not yet provide clear guidance for patients or providers about which modalities are best, how they should be used, or which patients are most likely to benefit. To strengthen the evidence for promising CAM interventions for pain management as used in "real world " health care settings, NCCAM will fund awards under its new initiative, Effectiveness Research—CAM Interventions and Chronic Back Pain in FY 2010. This research will provide important insights into the effects of CAM approaches, including mind-body and manipulative and body-based practices, across a range of patient outcomes for chronic pain.

* S. Dagenais, J. Caro, S. Haldeman. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J (2008).

In FY 2010, NCCAM will continue to encourage investigator-initiated research on the use of CAM to treat autism spectrum disorders and will collaborate with other NIH Institutes and Centers on trans-NIH autism research via the Interagency Autism Coordinating Committee. NCCAM will continue to support a broad portfolio of investigator-initiated research on the role of natural products in the prevention of cancer.

Overall 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 (CAM) by stimulating research and increasing research capacity. In FY 2010, NCCAM will continue to fund multidisciplinary investigator-initiated research, support the career development of new investigators, 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.

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FY 2010 Justification by Activity Detail

Activity/Program Budget Policy:

Extramural Basic Research: Basic research clarifies fundamental biological effects that are central to the development of the evidence base in CAM and underpins the design of clinical research. To address these needs, NCCAM will continue investigator-initiated basic research and will increase, through targeted initiatives, its support for translational research on CAM.

NCCAM added two new basic research centers to its cornerstone Centers of Excellence for Research on Complementary and Alternative Medicine (CERC) program during FY 2008 (nccam.nih.gov/research/centers). The University of Chicago's Center for Herbal Research on Colorectal Cancer is studying the biological effects of two forms of ginseng and their potential in preventing cancer. The CERC at Montana State University is exploring the potential for certain biologically based therapies to alter the inflammatory response to infections in the lung and intestines. Several basic research awards were funded under the FY 2007 initiative, Mechanisms of Immune Modulation, studies the ability of various interventions to affect inflammatory processes that underlie many conditions, for which Americans frequently use CAM, such as chronic pain and allergy.

Budget Policy: The FY 2010 budget estimate for extramural basic research is $41.792 million, an increase of $559 thousand or 1.4 percent over the FY 2009 estimate. The FY 2010 basic research plan supports an increase of the evidence base on the physiological mechanisms underlying CAM practices, as well as the development and validation of methods and approaches needed to ensure that clinical research has a solid foundation and facilitate the integration of proven CAM approaches into health care.

In FY 2010 NCCAM will make awards under a new initiative (to be released in FY 2009) entitled Program for Translational Tools for CAM Clinical Research, which will fund research on metrics, standard protocols, and outcome measures aimed at improving the quality, consistency, and comparability of clinical CAM research. The Center will also fund studies under its initiatives Dietary Supplements Research Centers: Botanicals; Exploratory/Developmental Grant for Complementary and Alternative Medicine Studies using Cells, Tissues, and Animal Models of Disease; and Biology of Manual Therapies.

Extramural Clinical Research: The NCCAM extramural research program funds multidisciplinary clinical investigations at leading U.S. biomedical and CAM research institutions on various CAM modalities. Clinical CAM 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 investigator-initiated research.

In FY 2008, NCCAM added two new centers on mind-body research to its CERC program. The University of California, San Francisco center is studying the effects of mindfulness-based stress reduction on obesity and the metabolic syndrome. The University of Wisconsin CERC is examining how different forms of meditation affect the brain's regulation of emotion. NCCAM also funded two new projects on Outcomes and Cost Effectiveness studying use of naturopathic care to treat diabetes and CAM approaches to the treatment of chronic fatigue syndrome. NCCAM continued to work collaboratively with other Institutes to support research on pain management.

Budget Policy: The FY 2010 budget estimate for extramural clinical research is $51.093 million, an increase of $683 thousand or 1.4 percent over the FY 2009 estimate. The NCCAM clinical research plan will target the strategic priorities of support for CAM efficacy and effectiveness research, with the ultimate goal to inform the scientific evidence base on CAM for specific indications.

In FY 2010, NCCAM will continue to fund a portfolio of investigator-initiated clinical research, including new research projects under its initiatives Effectiveness Research—CAM Interventions and Chronic Back Pain; Exploratory/Developmental Grant for Complementary and Alternative Medicine Studies of Humans; Outcomes, Cost-Effectiveness, and the Decision Making Process to Use Complementary and Alternative Medicine; and Omics and Variable Research Responses to CAM: Secondary Analysis for CAM Clinical Trials.

Portrait of a Program: CAM Component of the National Health Interview Survey (NHIS)

FY 2009: $1.750 million
FY 2010: $1.750 million
Change: $0.000 million

To define research needs, priorities, and future directions for CAM research, it is essential to characterize and understand the patterns and trends in use of CAM by Americans. NCCAM leads a trans-NIH initiative to obtain the most comprehensive and reliable information available about CAM use in the United States through the National Health Interview Survey (NHIS). The NHIS, carried out by the CDC, is a national survey that annually monitors the Nation's health through personal interviews of a representative sample of the civilian, non-institutionalized U.S. population. In 2007, CAM-related questions were posed to about 30,000 randomly selected NHIS participants. Data from the survey, which became available late in FY 2008, provide insights into the types of CAM people use, the reasons for which they turn to CAM, and the patterns of use. The 2007 data included information on CAM use among children.

Important observations from the data include the following:

  • Almost 40 percent of adults surveyed reported using some form of CAM during the previous 30 days.
  • Back pain was, by far, the most frequently cited reason for CAM use. Pain and pain-related problems make up half of the top 20 reasons for using CAM.
  • Among specific CAM modalities, the largest increases in use compared to the 2002 NHIS data were reported for meditation, massage, and yoga.
  • CAM use in the previous 30 days was more common among Whites, Asians, and Native Americans (ranging from 40-50%) than among African American and Latino groups (approximately 25%).
  • The largest increases in CAM use were among Americans over 85 years of age.
  • CAM use remains more common among individuals with chronic or serious illness, those with higher educational levels, and those between the ages of 50-59.
  • Preliminary data indicate that CAM use by children was less than and different in type than adult use, and that children were more likely to use CAM approaches if their parents did also.

Portrait of a Program: Product Integrity in CAM Clinical Research

FY 2009: $0.250 million
FY 2010: $0.250 million
Change: $0.000 million

Herbal medicines, dietary supplements, and probiotics are the most frequently used and widely available CAM products in the United States. However, evidence from rigorous preclinical and clinical research and development to support their use is often lacking. Research on the safety, efficacy, and mechanisms of action of these products present many challenges. First, natural products are inherently variable and may consist of complex mixtures containing many individual components. For example, the time and location of plant growth or harvesting may affect significantly the composition of herbal medicines, which in turn may influence the ultimate biological effects of the product. Second, natural products can be contaminated by substances that alter metabolism or cause adverse effects. For these and other reasons, careful attention to documentation of the sources, composition, and integrity of these products are essential in ensuring that they are safe and that research with them yields valid—and importantly—reproducible results.

To address these challenges, NCCAM has established a quality control program for herbal medicines, dietary supplements, probiotics, and similar products used in NCCAM-supported research. Prior to funding of research grant awards, NCCAM requires that investigators submit information documenting the source, composition, and process of production of the product to be studied. These building blocks of information, critical to the integrity of the research, are reviewed by a panel of scientific experts, the NCCAM Product Integrity Working Group (PIWG). The PIWG's mission is to ensure that the particular product to be used in NCCAM-funded research meets specific criteria of analysis and quality before a grant is issued. Investigators are also required to present a plan to reserve samples for future verification or analyses, should it be needed.

From its establishment in 2006 through the end of FY 2008, NCCAM's product integrity initiative has evaluated product information for more than 220 research projects. The program is now widely recognized for its rigor, and for the standard of excellence that it sets for the field of natural product research. Most important, the program ensures that the ensuing research will be optimally designed, rigorously conducted, and maximally authoritative.

Extramural Research Training and Capacity Building. The basic, translational, and clinical research required to develop the evidence base for CAM cannot be developed without the expertise of CAM practitioners working in partnership with conventional researchers. To increase the number, quality, and diversity of investigators who conduct research on CAM, 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. In FY 2008, NCCAM awarded new training and career development awards, and continued the partnership with The Bernard Osher Foundation to support research career development for CAM health professionals. The program's eligibility was expanded to include individuals from a broader range of professional backgrounds.

Budget Policy: The FY 2010 budget estimate for extramural research training and capacity building is $11.368 million, an increase of $152 thousand or 1.4 percent above the FY 2009 estimate. To address the ongoing need to build and sustain CAM research capacity, NCCAM will make awards under its ongoing training initiatives that target CAM and conventional investigators at various stages of their careers, including the Ruth L. Kirschstein National Research Service Awards for Individual Predoctoral Fellowship Training in Complementary and Alternative Medicine, Mentored Patient-Oriented Research Career Development Award, Midcareer Investigator Award in Patient-Oriented Research, and The Bernard Osher Foundation/NCCAM CAM Practitioner Research Career Development Award.

Intramural Research. NCCAM's Division of Intramural Research (DIR) conducts basic, translational, and clinical research on a range of CAM modalities, including dietary supplements and acupuncture, and provides a Complementary and Integrative Medicine Consult Service to provide advice on the appropriate role of CAM interventions for patients who are participating in NIH Clinical Center research protocols (nccam.nih.gov/research/consultservice). In FY 2009, NCCAM will carry out a comprehensive assessment by an independent expert panel of the scientific contributions and future directions for the DIR.

Budget Policy: The FY 2010 budget estimate for intramural research is $7.744 million, an increase of $114 thousand or 1.5 percent above the FY 2009 estimate. The DIR will continue to conduct research investigations on selected CAM therapies and provide services through the Complementary and Integrative Medicine Consult Service.

Research Management and Support (RMS). Through its RMS activities, NCCAM continued to fund meritorious basic, clinical, and translational research and research training efforts, and the Center has also continued its health information dissemination and education/outreach activities, such as the Time To Talk outreach initiative nccam.nih.gov/timetotalk.

Budget Policy: The FY 2010 budget estimate for RMS is $15.244 million, an increase of $262 thousand or 2.0 percent above the FY 2009 enacted level. In FY 2010, NCCAM will continue Time To Talk outreach and establish a portal on the NCCAM website (nccam.nih.gov) to provide health care providers with easy access to CAM information, such as research publications and professional societies' CAM practice guidelines.

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Budget Authority by Object
Total compensable workyears FY 2009 Estimate FY 2010 PB Increase or Decrease Percent Change
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research
Full-time employment 64 65 1 1.6
Full-time equivalent of overtime and holiday hours 0 0 0 0.0
Average ES salary $0 $0 $0 0.0
Average GM/GS grade 12.2 12.2 0.0 0.0
Average GM/GS salary $89,570 $91,361 $1,791 2.0
Average salary, grade established by act of July 1, 1944 (42 U.S.C. 207) $79,392 $80,980 $1,588 2.0
Average salary of ungraded positions 150,332 153,339 3,007 2.0
Budget Authority by Object
(continued)
OBJECT CLASSES FY 2009 Estimate FY 2010 PB Increase or Decrease Percent Change
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research
Personnel Compensation:        
11.1 Full-time permanent $5,046,000 $5,268,000 $222,000 4.4
11.3 Other than full-time permanent 1,688,000 1,757,000 69,000 4.1
11.5 Other personnel compensation 209,000 219,000 10,000 4.8
11.7 Military personnel 142,000 146,000 4,000 2.8
11.8 Special personnel services payments 235,000 242,000 7,000 3.0
Total, Personnel Compensation 7,320,000 7,632,000 312,000 4.3
12.0 Personnel benefits 1,789,000 1,866,000 77,000 4.3
12.2 Military personnel benefits 148,000 154,000 6,000 4.1
13.0 Benefits for former personnel 0 0 0 0.0
Subtotal, Pay Costs 9,257,000 9,652,000 395,000 4.3
21.0 Travel and transportation of persons 271,000 278,000 7,000 2.6
22.0 Transportation of things 29,000 29,000 0 0.0
23.1 Rental payments to GSA 0 0 0 0.0
23.2 Rental payments to others 4,000 4,000 0 0.0
23.3 Communications, utilities and miscellaneous charges 154,000 157,000 3,000 1.9
24.0 Printing and reproduction 69,000 70,000 1,000 1.4
25.1 Consulting services 404,000 408,000 4,000 1.0
25.2 Other services 3,383,000 3,416,000 33,000 1.0
25.3 Purchase of goods and services from government accounts 12,074,000 12,005,000 (69,000) -0.6
25.4 Operation and maintenance of facilities 125,000 127,000 2,000 1.6
25.5 Research and development contracts 5,222,000 5,310,000 88,000 1.7
25.6 Medical care 0 0 0 0.0
25.7 Operation and maintenance of equipment 68,000 67,000 (1,000) -1.5
25.8 Subsistence and support of persons 0 0 0 0.0
25.0 Subtotal, Other Contractual Services 21,276,000 21,333,000 57,000 0.3
26.0 Supplies and materials 516,000 520,000 4,000 0.8
31.0 Equipment 336,000 345,000 9,000 2.7
32.0 Land and structures 0 0 0 0.0
33.0 Investments and loans 0 0 0 0.0
41.0 Grants, subsidies and contributions 93,559,000 94,853,000 1,294,000 1.4
42.0 Insurance claims and indemnities 0 0 0 0.0
43.0 Interest and dividends 0 0 0 0.0
44.0 Refunds 0 0 0 0.0
Subtotal, Non-Pay Costs 116,214,000 117,589,000 1,375,000 1.2
Total Budget Authority by Object 125,471,000 127,241,000 1,770,000 1.4

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Salaries and Expenses
OBJECT CLASSES FY 2009 Estimate FY 2010 PB Increase or Decrease Percent Change
Personnel Compensation:        
Full-time permanent (11.1) $5,046,000 $5,268,000 $222,000 4.4
Other than full-time permanent (11.3) 1,688,000 1,757,000 69,000 4.1
Other personnel compensation (11.5) 209,000 219,000 10,000 4.8
Military personnel (11.7) 142,000 146,000 4,000 2.8
Special personnel services payments (11.8) 235,000 242,000 7,000 3.0
Total Personnel Compensation (11.9) 7,320,000 7,632,000 312,000 4.3
Civilian personnel benefits (12.1) 1,789,000 1,866,000 77,000 4.3
Military personnel benefits (12.2) 148,000 154,000 6,000 4.1
Benefits to former personnel (13.0) 0 0 0 0.0
Subtotal, Pay Costs 9,257,000 9,652,000 395,000 4.3
Travel (21.0) 271,000 278,000 7,000 2.6
Transportation of things (22.0) 29,000 29,000 0 0.0
Rental payments to others (23.2) 4,000 4,000 0 0.0
Communications, utilities and miscellaneous charges (23.3) 154,000 157,000 3,000 1.9
Printing and reproduction (24.0) 69,000 70,000 1,000 1.4
Other Contractual Services:        
Advisory and assistance services (25.1) 404,000 408,000 4,000 1.0
Other services (25.2) 3,383,000 3,416,000 33,000 1.0
Purchases from government accounts (25.3) 7,628,000 7,545,000 (83,000) -1.1
Operation and maintenance of facilities (25.4) 125,000 127,000 2,000 1.6
Operation and maintenance of equipment (25.7 68,000 67,000 (1,000) -1.5
Subsistence and support of persons (25.8) 0 0 0 0.0
Subtotal Other Contractual Services 11,608,000 11,563,000 (45,000) -0.4
Supplies and materials (26.0) 516,000 520,000 4,000 0.8
Subtotal, Non-Pay Costs 12,651,000 12,621,000 (30,000) -0.2
Total, Administrative Costs 21,908,000 22,273,000 365,000 1.7

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Authorizing Legislation
  PHS Act/Other Citation U.S. Code Citation 2009 Amount Authorized FY 2009 Estimate 2010 Amount Authorized FY 2010 PB
Research and Investigation Section 301 42§241 Indefinite Combined $125,471,000 Indefinite Combined $127,241,000
National Center for Complementary and Alternative Medicine Section 402(a) 42§281 Indefinite Indefinite
Total, Budget Authority       125,471,000   127,241,000

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Appropriations History
Fiscal Year Budget Estimate to Congress House Allowance Senate Allowance Appropriation 1/
1/ Reflects enacted supplementals, rescissions, and reappropriations.
2/ Excludes funds for HIV/AIDS research activities consolidated in the NIH Office of AIDS Research.
2001 71,362,000 2/ 78,880,000 100,089,000 89,211,000
Rescission       (54,000)
2002 100,063,000 99,288,000 110,000,000 104,644,000
Rescission       (52,000)
2003 112,547,000 112,547,000 114,149,000 114,149,000
Rescission       (742,000)
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      

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Details of Full-Time Equivalent Employment (FTEs)
OFFICE/DIVISION FY 2008 Actual FY 2009 Estimate FY 2010 PB
Includes FTEs that are reimbursed from the NIH Roadmap for Medical Research
Office of the Director 3 3 3
Office of Administrative Operations 13 13 13
Office of Communication and Public Liaison 7 7 7
Office of Science Policy, Planning and Evaluation 5 5 5
Division of Extramural research and Training 15 14 15
Office of Scientific Review 6 6 6
International Health Research 2 2 2
Special Populations Program 1 1 1
Office Clinical and Regulatory Affairs 3 3 3
Division of Intramural Research 12 10 10
Total 67 64 65
Details of Full-Time Equivalent Employment (FTEs)
(continued)
FISCAL YEAR Average GM/GS Grade
2006 11.8
2007 12.2
2008 12.2
2009 12.2
2010 12.2

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Details of Positions
GRADE FY 2008 Actual FY 2009 Estimate FY 2010 PB
Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research.
Total, ES Positions      
Total, ES Salary      
GM/GS-15 6 6 6
GM/GS-14 15 15 15
GM/GS-13 17 17 18
GS-12 7 6 6
GS-11 4 4 4
GS-10 0 0 0
GS-9 3 2 2
GS-8 0 0 0
GS-7 3 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 56 53 54
Grades established by Act of July 1, 1944 (42 U.S.C. 207):
Assistant Surgeon General 0 0 0
Director Grade 1 1 1
Senior Grade 0 0 0
Full Grade 0 0 0
Senior Assistant Grade 1 1 1
Assistant Grade 0 0 0
Subtotal 2 2 2
Ungraded 24 24 24
Total permanent positions 57 57 57
Total positions, end of year 82 82 82
Total full-time equivalent (FTE) employment, end of year 67 64 65
Average ES salary 0 0 0
Average GM/GS grade 12.2 12.2 12.2
Average GM/GS salary 85,484 89,570 91,361

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New Positions Requested

NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
New Positions Requested for Fiscal Year 2010
Position Grade Number Annual Salary
Health Science Administrator 13 1 $88,022
Total Requested   1  

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