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Executive Summary

AHCPR ADMINISTRATOR CLINTON WILL RETAIN POST after a recent request from HHS Assistant Secretary for Health-designate Philip Lee "to stay on." Agency for Health Care Policy and Research chief Jarrett Clinton, MD, told a May 27 meeting of the National Advisory Council for Health Care Policy, Research and Evaluation that his reappointment was a "delightful surprise," and he pledged to "continue to make AHCPR an increasingly solid focal point for health system research." A Bush Administration holdover, Clinton was named acting administrator of AHCPR's predecessor organization, the National Center for Health Services Research and Health Care Technology Assessment, in 1989 and subsequently was appointed AHCPR's first administrator in 1990. Any political opposition to retaining Clinton apparently was overcome by his reputation as an effective administrator. During 1993, AHCPR has issued clinical guidelines on depression ("The Pink Sheet" April 19, p. 8), sickle cell anemia and cataracts, and the agency is scheduled to release six other guidelines -- cancer- related pain, congestive heart failure, early HIV infection, low- back problems, otitis media and post-stroke rehabilitation -- by the end of the year ("The Pink Sheet" April 26, T&G-5). AHCPR is slated to receive the largest percentage budget increase among Public Health Service departments during FY 1994, up 23% to $158 mil. In addition, Clinto said that he has heard "no criticism at all" from other PHS departments about AHCPR's direction and activities. The agency, however, is being asked to pick up new functions without significant new funding. For example, Congress has mandated that AHCPR create a technology prioritization process to allow assessments beyond those formally requested by the Health Care Financing Administration or the Department of Defense, Clinton noted. However, Clinton said he does not foresee future budget appropriations for the project beyond the $1 mil. included in the President's fiscal 1994 budget proposal. Clinton cast the problem in terms of a lack of communication between the congressional committees responsible for authorizing and appropriating funding. "We have no interest whatsoever on the part of either appropriations committees, but a great deal of interest, particularly in the Senate, on the authorization [committees]," he explained. Nevertheless, he stated that he is "confident" that the administration's FY 1995 budget proposal will request "more money for technology assessment." Clinton added that AHCPR has been placed in a "serious bind" in terms of meeting its new responsibilities because of personnel cuts. AHCPR's full-time allottment is down from 282 in FY 1992 to 277 in FY 1993 under an executive order signed by the President implementing an across-the-board cut in federal personnel.

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