National Center for Complementary and Alternative Medicine (NCCAM)

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Congressional Justification 2012

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

On this page:

NATIONAL INSTITUTES OF HEALTH

National Center for Complementary and Alternative Medicine

  • National Advisory
    Council for
    Complementary and
    Alternative Medicine

  • Office of the Director

    Josephine P. Briggs, M.D.
    Director

    Jack Killen, M.D.
    Deputy Director

    • Office of Clinical and
      Regulatory Affairs

      Catherine Meyers, M.D.
      Director

    • Office of Administrative
      Operations

      Camille Hoover
      Executive Officer

    • Office of Communications
      and Public Liaison

      Chris Thomsen
      Director

    • Office of Policy,
      Planning, and Evaluation

      Karin Lohman, Ph.D.
      Director

    • Division of
      Extramural Research

      Emmeline Edwards, Ph.D.
      Director

      • Manual and Mind-Body
        Medicine Branch

        Emmeline Edwards, Ph.D.
        Acting Chief

      • Natural Products
        Branch

        Emmeline Edwards, Ph.D.
        Acting Chief

    • Division of
      Intramural Research

      Robert B. Nussenblatt, M.D.
      Acting Director

    • Division of
      Extramural Activities

      Martin Goldrosen, Ph.D.
      Director

      • Office of
        Scientific Review

        Dale Birkle Dreer, Ph.D.
        Chief

      • Office of Grants Management

        George Tucker, M.B.A.
        Director



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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 $131,002,000.

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Amounts Available for Obligation 1
(Dollars in Thousands)
Source of Funding FY 2010
Actual
FY 2011
CR
FY 2012
PB
1 Excludes the following amounts for reimbursable activities carried out by this account:
FY 2010—$65         FY 2011—$300         FY 2012—$300
Appropriation 128,844 128,844 131,002
Type 1 Diabetes 0 0 0
Rescission 0 0 0
Supplemental 0 0 0
Subtotal, adjusted appropriation 128,844 128,844 131,002
Real transfer under Director's one-percent transfer authority (GEI) -205 0 0
Real transfer under Secretary's one-percent transfer authority -19 0 0
Comparative Transfers to NLM for NCBI and Public Access -58 -110 0
Comparative transfer under Director's one-percent transfer authority (GEI) 205 0 0
Comparative transfer under Secretary's one-percent transfer authority   0 0
Subtotal, adjusted budget authority 128,767 128,734 131,002
Unobligated balance, start of year 0 0 0
Unobligated balance, end of year 0 0 0
Subtotal, adjusted budget authority 128,767 128,734 131,002
Unobligated balance lapsing -5 0 0
Total obligations 128,762 128,734 131,002

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Budget Mechanism—Total1
(Dollars in Thousands)
MECHANISM FY 2010 Actual FY 2011 CR FY 2012 PB Change vs. FY 2010
Number Amount Number Amount Number Amount Number Amount
1 All items in italics are “non-adds”; items in parenthesis are subtractions
RESEARCH GRANTS                
Research Projects                
Noncompeting 134 $50,336 128 $56,748 124 $55,560 (10) $5,224
Administrative Supplements (15) 1,927 12 1,600 12 1,600 27 (327)
Competing:                
Renewal 1 850 2 900 2 900 1 50
New 57 23,108 52 17,332 58 19,421 1 (3,687)
Supplements 1 122 1 125 1 130 0 8
Subtotal, Competing 59 $24,080 55 $18,357 61 $20,451 2 ($3,629)
Subtotal, RPGs 193 $76,343 183 $76,705 185 $77,611 (8) $1,268
SBIR/STTR 12 $2,914 12 $2,833 12 $2,890 0 ($24)
Research Project Grants 205 $79,257 195 $79,538 197 $80,501 (8) $1,244
Research Centers                
Specialized/Comprehensive 7 $3,800 5 $3,200 5 $3,200 (2) ($600)
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 7 $3,800 5 $3,200 5 $3,200 (2) ($600)
Other Research                
Research Careers 46 $5,681 46 $5,681 46 $5,738 0 $57
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 0 0 0 0 0
Other 10 2,047 10 2,047 10 2,067 0 20
Other Research 56 $7,728 56 $7,728 56 $7,805 0 $77
Total Research Grants 268 $90,785 256 $90,466 258 $91,506 (10) $721
Research Training FTTPs   FTTPs   FTTPs      
Individual Awards 24 $1,033 24 $1,050 24 $1,083 0 $50
Institutional Awards 56 2,922 56 2,968 56 3,063 0 141
Total Research Training 80 $3,955 80 $4,018 80 $4,146 0 $191
Research & Development Contracts 11 $10,483 11 $10,700 11 $11,580 0 $1,097
(SBIR/STTR) 0 ($6) 0 ($6) 0 ($6) 0 $0
  FTEs   FTEs   FTEs   FTEs  
Intramural Research 10 $8,165 10 $8,165 10 $8,245 0 $80
Research Management and Support 57 15,379 57 15,385 57 15,525 0 146
Construction   0   0   0   0
Buildings and Facilities   0   0   0   0
Total, NCCAM 67 $128,767 67 $128,734 67 $131,002 0 $2,235

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Major Changes in the Fiscal Year 2012 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 2012 budget request for the National Center for Complementary and Alternative Medicine which is $2.2 million more than the FY 2010 Enacted Level, for a total of $131.0 million.

Research Project Grants (+$1.244 million; total $80.501 million): NCCAM will support a total of 197 Research Project Grant (RPG) awards in FY 2012. Noncompeting RPG's will decrease by 10 awards and increase $5.2 million. Competing RPG's will increase by 2 awards and decrease by $3.6 million. The decrease in average cost for competing RPGs between FY 2010 and FY 2012 is the result of two large New Innovator awards that were funded in FY 2010 with no outyear noncompeting continuation costs for FY 2011 and beyond. The NIH Director's New Innovator (DP2) Award program was created in 2007 to support a small number of early stage investigators of exceptional creativity who propose bold and highly innovative new research approaches that have the potential to produce a major impact on broad, important problems in biomedical and behavioral research. The NIH Budget policy for RPGs in FY 2012 is to provide a 1% inflationary increase in noncompeting awards and a 1% increase in average cost for competing RPGs.

Research Centers (-$0.600 million; total $3.200 million): In FY 2010, NCCAM contributed a total of $3.8 million in collaboration with the Office of Dietary Supplements towards Botanical Research Centers. Of the total $3.8 million, $3.0 million funded 5 primary awards and $800 thousand was provided as bridge awards to support the projects pending review of their recompleting applications scheduled for October 2010. NCCAM's commitment to these projects for the duration of the program is $3.0 million per year with an additional $200 thousand for possible administrative supplements. The decrease of $600 thousand represents a 16% decrease in this mechanism from FY 2010 to FY 2012.

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Summary of Changes
(Dollars in Thousands)
FY 2010 Actual $128,767
FY 2012 Estimate 131,002
Net change $2,235
NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Summary of Changes (continued)
CHANGES 2012 Estimate Change from FY 2010
FTEs Budget Authority FTEs Budget Authority
A. Built-in:        
1. Intramural Research:        
a. Annualization of January 2010 pay increase   $1,530   $9
b. January FY 2012 pay increase   1,530   0
c. One less day of pay (n/a for 2011)   1,530   -5
d. Payment for centrally furnished services   2,323   23
e. Increased cost of laboratory supplies, materials, and other expenses   4,392   -13
Subtotal       $14
2. Research Management and Support:        
a. Annualization of January 2010 pay increase   $8,521   $51
b. January FY 2012 pay increase   8,521   0
c. One less day of pay (n/a for 2011)   8,521   -33
d. Payment for centrally furnished services   731   7
e. Increased cost of laboratory supplies, materials, and other expenses   6,273   139
Subtotal       $164
Subtotal, Built-in       $178
NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Summary of Changes (continued)
CHANGES 2012 Estimate Change from FY 2010
  Number Amount Number Amount
B. Program:        
1. Research Project Grants:        
a. Noncompeting 124 $57,160 (10) $4,897
b. Competing 61 20,451 2 (3,629)
c. SBIR/STTR 12 2,890 0 (24)
Total 197 $80,501 (8) $1,244
2. Research Centers 5 $3,200 5 ($600)
3. Other Research 56 7,805 0 77
4. Research Training 80 4,146 0 191
5. Research and development contracts 11 11,580 0 1,097
Subtotal, Extramural   $107,232   $2,009
  FTEs   FTEs  
6. Intramural Research 10 $8,245 0 $66
7. Research Management and Support 57 15,525 0 (18)
8. Construction   0   0
9. Buildings and Facilities   0   0
Subtotal, program   $131,002   $2,057
Total changes 67   0 $2,235

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Fiscal Year 2012 Budget Graphs

History of Budget Authority and FTEs

Bar chart of Funding Levels by Fiscal Year. See table immediately below for data.

Funding Levels by Fiscal Year
Fiscal Year Dollars in Millions
2008 122.2
2009 125.4
2010 128.8
2011 128.7
2012 131.0

Bar chart of Full-Time Employees by fiscal year. See table immediately below for data.

Full-Time Employees by Fiscal Year
FY FTEs
2008 67
2009 66
2010 67
2011 67
2012 67

Distribution by Mechanism

A pie chart of distribution of funds by mechanism for fiscal year 2012. See table immediately below for data.
FY 2012 Budget Mechanism
Mechanism Percent
of
Budget
Research Project Grants 62
Research Centers 2
Other Research 6
Research Training 3
R&D Contracts 9
Intramural Research 6
RM&S 12
Buildings & Facilities 0
Construction 0



Change by Selected Mechanism

A bar graph reflecting the change in mechanism as a percent between fiscal years 2010 and 2012.
FY 2012 Estimate Percent Change From FY 2010 Mechanism
Mechanism Percent
Change
Research Project Grants 1.6
Research Centers -15.8
Other Research 1.0
Research Training 4.8
R&D Contracts 10.5
Intramural Research 1.0
Res. Mgmt. & Support 0.9
B&F 0.0

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Budget Authority by Activity
(Dollars in thousands)
  FY 2010 Actual FY 2011 CR FY 2012 PB Change vs. FY 2010
  1. Includes FTEs which are reimbursed from the NIH Common Fund for Medical Research.
  2. Includes Real Transfers and Comparable Adjustments as detailed in the “Amounts Available for Obligation” table.
Extramural Research FTEs Amount FTEs Amount FTEs Amount FTEs Amount
Detail:                
Clinical Research   47,196   47,189   48,159   963
Basic Research   46,722   46,627   47,586   864
Training   11,305   11,368   11,487   182
Subtotal, Extramural   105,223   105,184   107,232   2,009
Intramural Research 10 8,165 10 8,165 10 8,245 0 80
Research Management & Support 57 15,379 57 15,385 57 15,525 0 146
TOTAL 67 128,767 67 128,734 67 131,002 0 2,235

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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 2011 Amount Authorized FY2010 Estimate FY2012 Amount Authorized FY2012 PB
Research and Investigation Section 301 42§241 Indefinite Combined   Indefinite Combined  
        $128,767,000   $131,002,000
National Center for Complementary and Alternative Medicine Section 401(a) 42§281 Indefinite   Indefinite  
Total, Budget Authority         $128,767,000     $131,002,000

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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
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 $123,739,000
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       $19,000
2011 $132,004,000   $131,796,000  
Rescission        
2012 $131,002,000      

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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 2010 Actual FY 2011 Continuing Resolution FY 2012 Budget Request FY 2012 + / - FY 2010
BA $128,767,000 $128,734,000 $131,002,000 $2,235,000
FTE 67 67 67 0

Program funds are allocated as follows: Competitive Grants/Cooperative Agreements; Contracts; Direct Federal/Intramural and Other.

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Director's Overview

The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Government's lead agency for scientific research on complementary and alternative medicine (CAM). NCCAM's mission is to define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their role in improving health and health care. CAM is a group of diverse health-related disciplines, practices, and products that are not generally considered to be part of conventional medicine. Scientific evidence from NCCAM-supported research informs decisionmaking by the public, by health care professionals, and by health policymakers regarding the use of CAM interventions and their integration into strategies for better health care and promoting health.

CAM Use in the United States

CAM is used by many in the United States to treat health problems and promote better health. Data from National Health Interview Surveys1, developed under NCCAM leadership and conducted by the National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC), show that nearly 40 percent of adult Americans and 12 percent of children are using some form of CAM. These data also show that Americans spent $33.9 billion out-of-pocket for CAM in 2007. This amount accounted for approximately 1.5 percent of total health care expenditures, but more than 11 percent of total out-of-pocket health care expenditures. The data also suggest that CAM use is very often for self-care, i.e., not under the advice or supervision of a health professional.

1 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 (375KB PDF). CDC National Health Statistics Report #18. 2009.

Identifying Future CAM Research Priorities

Building on more than 10 years of progress, NCCAM is focusing its research efforts on specific areas of scientific promise. For example, research suggests that acupuncture may provide relief for chronic pain such as low-back pain and osteoarthritis of the knee. Established in 1999, NCCAM is shaping its future through its third strategic plan, developed with input from its diverse stakeholder community. The strategic plan nccam.nih.gov/about/plans/2011/ is built around three long-range goals aimed at improving the state and use of scientific evidence regarding the two major reasons for use of CAM in the United States—treating health problems and supporting or promoting better health and well-being. The 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 CAM use and its integration into health care and health promotion.

(1) Advancing the Science and Practice of Symptom Management

Emerging scientific evidence suggests that some CAM approaches—such as massage, acupuncture, spinal manipulation, and mediation—may be helpful in managing symptoms such as chronic back or neck pain, or pain from arthritis or other musculoskeletal problems. For example, recent research suggests that people with fibromyalgia may benefit from practicing tai chi, which combines meditation, slow movements, deep breathing and relaxation.2 Other studies suggest that these interventions may engage innate biological processes involved in pain and emotion. NCCAM plans to support research that aims to elucidate more clearly how such promising CAM interventions could add value to existing health care approaches. This research will include the study of the safety of CAM interventions and identifying the mechanisms by which they exert biological effects.

(2) Developing Effective and Practical Strategies for Promoting Health and Well-Being

Research has shown that sustaining or improving healthy behaviors (such as good eating habits and regular exercise) and reducing or eliminating unhealthy behaviors (such as smoking) can reduce an individual's risk of chronic disease. Many CAM or integrative medicine practitioners encourage use of meditative and other mind/body approaches to help motivate people to adopt and sustain health-seeking behaviors. These approaches may include physical activities like yoga and healthy eating practices that may be grounded in traditional medical systems or incorporate a healthy food philosophy. Emerging evidence suggests that CAM use may be associated with greater degrees of health-seeking behavior. While causal relationships between CAM use and healthy behavior have not been established, the claims and preliminary data deserve investigation given the formidable public health challenges in motivating behavior change. NCCAM plans to sponsor research exploring whether CAM-inclusive approaches are useful in encouraging improved self-care and greater commitment to a healthy lifestyle.

(3) Enabling Evidence-Based Decisionmaking Regarding Use and Integration of CAM

The public, health professionals, and policymakers need reliable, objective, evidence-based information regarding CAM. Providing such information so that they can make informed decisions about CAM use is of paramount importance to NCCAM, and central to the Center's successful fulfillment of its legislative mandate. Importantly, evidence from several sources suggests that CAM research findings do influence CAM use by the public. NCCAM will continue to use state-of-the-art technologies and approaches to improve access to evidence-based information on CAM for the general public and health professionals.

2 Wang C, Schmid CH, Rones R, et al. A randomized trial of tai chi for fibromyalgia. New England Journal of Medicine. 2010;363(8):743–754.

Conclusion

A decade of investment in research on a broad array of CAM modalities indicates that some approaches may lead to improved strategies for treating bothersome symptoms or promoting better health. Building on this foundation, NCCAM will continue funding rigorous scientific investigations to advance the body of evidence regarding the safety and efficacy of CAM interventions. Such evidence is also essential to efforts to integrate CAM interventions of proven safety and efficacy into health care and disease prevention strategies. Results from NCCAM-supported research will enable evidence-based decisionmaking by the general public, health care professionals, and health policymakers about CAM use.

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 (CAM) by stimulating research and increasing research capacity. In FY 2011, 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 several trans-NIH initiatives, such as the Therapies for Rare and Neglected Diseases program (TRND), the Basic Behavioral and Social Sciences Opportunity Network (OppNet), and support for a new synchrotron at the Brookhaven National Laboratory.

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 medicine (CAM) and underpins the design of clinical research. NCCAM supports investigator-initiated basic research and will increase, through targeted initiatives, its support for translational research on promising CAM 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 2012 NCCAM budget estimate for extramural basic research is $47.6 million, an increase of $864 thousand or 1.8 percent above the FY 2010 enacted level. The FY 2012 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. The program portrait listed below describes the Botanical Research Centers program.

Portrait of a Program—Botanical Research Centers: Enabling Evidence-Based Decisionmaking on Natural Product Use

FY 2010 $3.2 million
FY 2012 $3.2 million

Although the safety and efficacy of many botanical dietary supplements have not been adequately studied, they are still widely used throughout the United States. To advance understanding of how botanicals may affect human health, NIH is funding five interdisciplinary and collaborative dietary supplement centers that are known as the Botanical Research Centers (BRC) Program. The BRCs will conduct studies of the safety, efficacy, and biological action of botanical supplements and conduct research with a high potential of being translated into practical strategies to benefit human health.

This program is intended to advance the science of botanical research, from careful identification of constituents of botanicals to early phase clinical studies of safety and efficacy. Preclinical research that will inform future clinical studies is encouraged as the primary research focus of this program. Many of the BRCs are employing high-throughput technologies to advance understanding of the biological effects of natural products and define their mechanisms of action, or how they work in the human body.

Two of the BRCs are researching botanicals that may show promise for reducing the troublesome menopausal symptoms experienced by nearly two-thirds of perimenopausal women.3 One BRC is focusing on the safety of botanical dietary supplements that are widely available and used by women (e.g., black cohosh, licorice) to determine biological effects and explore possible interactions with prescription drugs. Another BRC is studying botanical products that contain estrogen-like compounds, called phytoestrogens, to determine their safety, efficacy, and mechanism of action.

The BRCs are located at the Pennington Biomedical Research Center, Baton Rouge, Louisiana; University of Illinois at Chicago; University of Illinois at Urbana-Champaign; University of Missouri, Columbia; and Wake Forest University Health Sciences, Winston-Salem, North Carolina. They are jointly funded by NCCAM and the NIH Office of Dietary Supplements. Additionally, the National Cancer Institute is co-supporting two of the five centers.

3Geller, S, Studee L. Botanical and dietary supplements for menopausal symptoms: what works, what does not. Journal of Women's Health. 2005;14(7):634–649.

Extramural Clinical Research: The NCCAM extramural research program funds multidisciplinary clinical investigations into various CAM modalities at leading U.S. biomedical and CAM research institutions. 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 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 CAM 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 CAM use as practiced in the community, and it will provide additional data on the effectiveness of CAM interventions for particular diseases and symptoms.

Budget Policy: The FY 2012 NCCAM budget estimate for extramural clinical research is $48.2 million, an increase of $963 thousand or 2.0 percent above the FY 2010 enacted level. The NCCAM extramural 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. The program portrait listed below provides an overview of NCCAM's meditative practices program.

Portrait of a Program—Understanding the Engagement of Major Pathways of Emotion Regulation by Meditative Practices

FY 2010 $14.3 million
FY 2012 $14.5 million

Meditation may be practiced for many reasons, including possible health benefits such as increased calmness and physical relaxation, improved coping with stress or illness, or enhanced overall health and well-being. Meditative practices include meditation as well as other mind-body practices that incorporate movement with meditation such as yoga and tai chi. Clinical and laboratory studies of mindfulness meditation are yielding a growing body of evidence that meditation affects the mind, the brain, the body, and behavior in ways that have promise for treatment of many health problems, and for promoting healthy behavior.

Research suggests that systematic mindfulness training and other meditation practices influence areas of the brain involved in regulating awareness, attention, and emotion. Brain imaging studies suggest that more mindful people may be better able to regulate emotional reactions or have improved self awareness. Other research suggests that mental training causes structural changes in the brain through the processes of neuroplasticity (the ability of the brain to change as a result of one's experiences). Several studies suggest that meditative practices can positively affect immune function. Many of the beneficial physical effects of mindfulness training could be attributable to learning to cope better with stress.

Investigators are studying the use of mindfulness training in treating specific pain conditions, overeating and obesity, irritable bowel syndrome, insomnia, myocardial ischemia (or angina), and substance abuse. Specifically, NCCAM is supporting studies investigating meditation for: diminishing symptoms of chronic back pain, improving attention-related abilities (focusing and prioritizing), relieving stress in caregivers for elderly patients with dementia, alleviating asthma symptoms, and reducing the frequency and intensity of hot flashes in menopausal women. Mindfulness mediation is also being explored as a means of facilitating and sustaining healthy behavior change, for example smoking cessation or healthier eating habits.

Extramural Research Training and Capacity Building: The basic, translational, and clinical research required to develop the evidence base for CAM is enhanced through 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. 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 CAM interventions; therefore, NCCAM supports programs to attract these researchers to CAM research and partnerships with CAM practitioners.

Budget Policy: The NCCAM FY 2012 budget proposal for extramural research training and capacity building is $11.5 million, an increase of $0.182 million or 1.6 percent above the FY 2010 enacted level. 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 Ruth L. Kirschstein National Research Service Awards, Mentored Patient-Oriented Research Career Development Award (K23), and Midcareer Investigator Award in Patient-Oriented Research (K24). NIH will provide an across-the-board increase in FY 2012 of four percent for stipends levels under the Ruth L. Kirschstein National Research Service Award training program to continue efforts to attain the stipend levels recommended by the National Academy of Sciences. This will build on the two percent increase in stipend levels for FY 2011. Stipend levels have lagged significantly behind inflation, and increases are necessary to sustain the development of a highly qualified biomedical research workforce.

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 CAM modalities (e.g., acupuncture) modulate pain and other symptoms.

Budget Policy: The FY 2012 NCCAM budget proposal for intramural research is $8.2 million, an increase of $80 thousand or 1.0 percent above the FY 2010 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 workshops aimed at defining a research agenda, 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 CAM use and to enable health care providers to better manage their patients' care. For example, the Time To Talk outreach initiative (nccam.nih.gov/timetotalk) encourages patients and their health care providers to discuss CAM use.

Budget Policy: The FY 2012 NCCAM budget proposal for research management and support is $15.5 million, an increase of $146 thousand or 1.0 percent above the FY 2010 enacted level.

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Budget Authority by Object
(Dollars in Thousands)
  FY 2010 Actual FY 2012 PB Increase or Decrease Percent Change
Includes FTEs which are reimbursed from the NIH Common Fund for Medical Research
Total compensable workyears:        
  Full-time employment 67 67 0 0.0%
  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 12.7 12.9 0.2 1.6%
  Average GM/GS salary $106,242 $112,144 $5,902 5.6%
  Average salary, grade established by act of July 1, 1944 (42 U.S.C. 207) $78,640 $82,965 $4,325 5.5%
  Average salary of ungraded positions 164,641 173,696 9,055 5.5%
OBJECT CLASSES FY 2010 Actual FY 2012 Estimate Increase or Decrease Percent Change
  Personnel Compensation:        
11.1 Full-time permanent $5,455 $5,535 $80 1.5%
11.3 Other than full-time permanent 1,695 1,729 34 2.0%
11.5 Other personnel compensation 302 306 4 1.3%
11.7 Military personnel 205 202 (3) -1.5%
11.8 Special personnel services payments 200 218 18 9.0%
  Total, Personnel Compensation $7,857 $7,990 $133 1.7%
12.0 Personnel benefits $1,968 $2,013 $45 2.3%
12.2 Military personnel benefits 93 48 (45) -48.4%
13.0 Benefits for former personnel 0 0 0 0.0%
  Subtotal, Pay Costs $9,918 $10,051 $133 1.3%
21.0 Travel and transportation of persons $248 $266 $18 7.3%
22.0 Transportation of things 33 35 2 6.1%
23.1 Rental payments to GSA 0 0 0 0.0%
23.2 Rental payments to others 14 14 0 0.0%
23.3 Communications, utilities and miscellaneous charges 206 221 15 7.3%
24.0 Printing and reproduction 80 87 7 8.8%
25.1 Consulting services 356 383 27 7.6%
25.2 Other services 6,673 6,833 160 2.4%
25.3 Purchase of goods and services from government accounts 13,178 14,450 1,272 9.7%
25.4 Operation and maintenance of facilities 139 150 11 7.9%
25.5 Research and development contracts 2,320 1,966 (354) -15.3%
25.6 Medical care 39 40 1 2.6%
25.7 Operation and maintenance of equipment 111 112 1 0.9%
25.8 Subsistence and support of persons 0 0 0 0.0%
25.0 Subtotal, Other Contractual Services $22,816 $23,934 $1,118 4.9%
26.0 Supplies and materials $422 $431 $9 2.1%
31.0 Equipment 290 311 21 7.2%
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 94,740 95,652 912 1.0%
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 $118,849 $120,951 $2,102 1.8%
  Total Budget Authority by Object $128,767 $131,002 $2,235 1.7%

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Salaries and Expenses
(Dollars in Thousands)
OBJECT CLASSES FY 2010 Actual FY 2012 PB Increase or Decrease Percent Change
Personnel Compensation:        
Full-time permanent (11.1) $5,455 $5,535 $80 1.5%
Other than full-time permanent (11.3) 1,695 1,729 34 2.0%
Other personnel compensation (11.5) 302 306 4 1.3%
Military personnel (11.7) 205 202 (3) -1.5%
Special personnel services payments (11.8) 200 218 18 9.0%
Total Personnel Compensation (11.9) $7,857 $7,990 $133 1.7%
Civilian personnel benefits (12.1) $1,968 $2,013 $45 2.3%
Military personnel benefits (12.2) 93 48 (45) -48.4%
Benefits to former personnel (13.0) 0 0 0 0.0%
Subtotal, Pay Costs $9,918 $10,051 $133 1.3%
Travel (21.0) $248 $266 $18 7.3%
Transportation of things (22.0) 33 35 2 6.1%
Rental payments to others (23.2) 14 14 0 0.0%
Communications, utilities and miscellaneous charges (23.3) 206 221 15 7.3%
Printing and reproduction (24.0) 80 87 7 8.8%
Other Contractual Services:        
Advisory and assistance services (25.1) 356 383 27 7.6%
Other services (25.2) 6,673 6,832 159 2.4%
Purchases from government accounts (25.3) 7,843 8,006 163 2.1%
Operation and maintenance of facilities (25.4) 139 150 11 7.9%
Operation and maintenance of equipment (25.7) 111 112 1 0.9%
Subsistence and support of persons (25.8) 0 0 0 0.0%
Subtotal Other Contractual Services $15,122 $15,483 $361 2.4%
Supplies and materials (26.0) $422 $431 $9 2.1%
Subtotal, Non-Pay Costs $16,125 $16,537 $412 2.6%
Total, Administrative Costs $26,043 $26,588 $545 2.1%
NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Details of Full-Time Equivalent Employment (FTEs)
OFFICE/DIVISION FY 2010 Actual FY 2011 CR FY 2012 PB
Civilian Military Total Civilian Military Total Civilian Military Total
Office of the Director 3   3 3   3 3   3
Office of Adminstrative Operations 15 1 16 15 1 16 15 1 16
Office of Communication and Public Liaison 8   8 8   8 8   8
Office of Science Policy, Planning, and Evaluation 4   4 4   4 4   4
Division of Extramural Research and Training 19   19 19   19 19   19
Office of Scientific Review 5   5 5   5 5   5
Office of Clinical and Regulatory Affairs 2   2 2   2 2   2
Office of Intramural Research 8 2 10 9 1 10 9 1 10
Total 64 3 67 65 2 67 65 2 67
Includes FTEs which are reimbursed from the NIH Common Fund for Medical Research
Details of Full-Time Equivalent Employment (FTEs) (continued)
Fiscal Year Average GS Grade
2008 12.2
2009 12.4
2010 12.7
2011 12.9
2012 12.9

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NATIONAL INSTITUTES OF HEALTH
National Center for Complementary and Alternative Medicine
Detail of Positions
GRADE FY 2010 Actual FY 2011 CR FY 2012 PB
Total, ES Positions 0 0 0
Total, ES Salary 0 0 0
GM/GS-15 8 8 8
GM/GS-14 17 16 16
GM/GS-13 15 15 15
GS-12 9 9 9
GS-11 3 3 3
GS-10 0 0 0
GS-9 2 2 2
GS-8 0 0 0
GS-7 4 4 4
GS-6 1 1 1
GS-5 0 0 0
GS-4 0 0 0
GS-3 1 1 1
GS-2 1 1 1
GS-1 0 0 0
Subtotal 61 60 60
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 1 1 1
Senior Assistant Grade 1 1 1
Assistant Grade 0 0 0
Subtotal 3 3 3
Ungraded 22 23 23
Total permanent positions 60 63 63
Total positions, end of year 83 87 87
Total full-time equivalent (FTE) employment, end of year 67 67 67
Average ES salary 0 0 0
Average GM/GS grade 12.7 12.9 12.9
Average GM/GS salary 106,242 112,144 112,144

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