Initiatives in rehabilitation research.

Federal funding of rehabilitation research depends on how much that research is valued, both within the physical therapy profession and among the external groups and individuals who have a stake in the research outcomes. To help advance rehabilitation research, the American Physical Therapy Association (APTA) forges partnerships, coalitions, and collaborations for advocacy, awareness, and legislative action; promotes the appointment of physical therapists to federal panels; and fosters infrastructure and research capacity building. To further cement the physical therapy profession's relationship with policymakers, APTA also is identifying health policy questions.

On Tuesday, September 26, 2006, the US House of Representatives passed the National Institutes of Health Reform Act of 2006 (HR 6164) by a vote of 414-2 . In addition to the obvious broad bipartisan backing, this legislation was widely supported by patient advocacy groups and organizations representing scientists. The American Physical Therapy Association (APTA) was an active supporter and participant in the development of this legislation. APTA worked independently and in collaboration with a coalition of more than 20 organizations interested in advancing rehabilitation research. Over the past year and a haft, APTA has worked with its grassroots membership and Members of Congress and their staff, particularly the House Energy and Commerce Committee, to ensure that rehabilitation research was advanced through this reauthorization.

The bill is an essential step to improve the funding, transparency, coordination, and accountability of the premier research center in the world, the National Institutes of Health (NIH). NIH had not been reauthorized since 1993, and this measure would be only the third reauthorization since its establishment. Chairman Joe Barton (R-TX) has made the long-overdue reauthorization of federal agencies a priority of his chairmanship and provided the fop lowing statement about NIH reauthorization: "This legislation will strengthen the research efforts of the NIH and will provide the foundation for future scientific and medical advancement." Shortly before the House vote, Barton said, "For 13 years, this program has remained unauthorized despite a Republican-led effort to double the NIH budget. Meanwhile, the science has sped past. We can help the NIH catch up by providing it with not just twice the money, but the tools it needs to reorganize and revitalize."

The National Institutes of Health Reform Act of 2006 reauthorizes the NIH under the Public Health Service Act and would accomplish the following objectives:

* Improve funding by authorizing a 5% annual increase in NIH's budget for fiscal years 2007-2009. This measure only authorizes the increase; to realize this funding, Congress will need to appropriate funds at this level for each fiscal year;

* Enhance transparency and accountability by launching a new, agency-wide electronic reporting system to catalog all of the research activities of the NIH in a standard format and creating, a Scientific Management Review Group composed of Institute and Center directors and other experts to evaluate NIH's structural organization at least once every 7 years and propose any restructuring plans it deems necessary;

* Improve efficiency by capping the size of the NIH's organizational structure to the current 27 institutes and centers; and

* Encourage collaboration by investing in particularly promising research or science that cuts across multiple entities within the NIH by establishing a "common fund." The common fund is capped at 5% of the overall NIH budget.

This legislation would benefit rehabilitation scientists by providing additional resources dedicated to research, especially those areas of study that cut across different clinical areas, body systems, and the lifespan. The role of rehabilitation in the continuum of health care has traditionally been under-funded and is well positioned to benefit from the measures outlined in this latest version of NIH reauthorization. With only 1% of current NIH funding being dedicated to rehabilitation research, the establishment of a common fund will provide an additional avenue for funding. Continuing efforts to advocate for rehabilitation researchers within the NIH will be essential once this legislation passes and is implemented at NIH.

In addition to the overall theme and effort to improve NIH through this legislation, rehabilitation was specifically added to a section of the bill that requires the Office of the Director to report on areas of research on a biannual basis. Congressman John Shimkus (R-IL) worked to secure the addition of rehabilitation to this section of the legislation and to offer report language to encourage NIH to recognize rehabilitation as an area of trans-NIH activities. The leadership of Shimkus and his staff was essential to ensure that rehabilitation was advanced through this reauthorization. In his opening statement at the Energy and Commerce Committee vote on the bill, Shimkus spoke of the value and importance of rehabilitation research throughout the life span and across different body systems and diagnoses.

Now that the NIH reauthorization bill has passed the US Hottse of Representatives, it must be considered by the US Senate in order to become law. The legislative calendars are extremely tight with the balance of power in limbo as we enter the mid-term election of 2006. It is unlikely that this measure can complete the legislative process prior to the end of the 109th Congress. Therefore, this effort in the US House is likely to be the starting point as we begin our work in the 110th Congress to make even greater strides in enhancing the awareness of, appropriations for, and activities dedicated to the advancement of rehabilitation science. APTA is implementing its strategy for the Senate and preparation for the reconsideration of this legislation if it is not completed in the 109th Congress.

Justin Moore, PT

Director

Congressional Affairs

Marc Goldstein, EdD

Director

Research Services