Friday, March 05, 2010

School Children vs. Stem Cell Scientists; A Public Perception Problem

From Humboldt to San Diego, thousands of Californians yesterday protested the budget cuts that are ravaging efforts to teach their children to read, write and calculate.

The picture painted in newspapers and on television stands in dramatic contrast to the situation at the financially comfortable California stem cell agency. Its finances are uniquely isolated from both normal state budgetary controls and the state's budget crisis. Consequently next week, CIRM is expected to move forward on a project involving tens, perhaps hundreds of millions of dollars. No details are available, but it is an effort to aid the biotech industry with the costly clinical trials that are necessary to bring products to market. CIRM directors are also expected to put more money on the table to hire an executive to fill a newly created position that is designed to tie the $3 billion program ever closer to industry. A salary of $332,000 a year, currently top of the current range for the job, is apparently not enough of a lure.

Good arguments exist for these actions. They may in fact be good policy for the stem cell research program. But they do not reflect the travails of the rest of California state and local government. The Golden State is now scraping the bottom nationally in terms of per capita spending for the education of its children -- who certainly represent the future as much as the 300-plus stem cell scientists and institutions that have received $1 billion from CIRM over the last five years. Indeed, California's financial problems are so severe that some say the state is effectively, if not legally bankrupt. One of the causes is ballot-box budgeting, voter approval of spending initiatives that that cannot be controlled by state lawmakers or the governor. Such is the case with CIRM's finances.

Unpleasant comparisons pose a public perception problem for CIRM. Fortunately for the agency, however, it operates in a media shadow. CIRM is all but invisible in the mainstream press. Reporters are focusing on broader issues and higher profile matters, such as the release of prisoners from jails because of a lack of money. The fact is that CIRM's finances have virtually no current impact on the state's financial crisis. Nonetheless, CIRM's spending carries symbolic importance, which CIRM directors should be cognizant of as they vote to spend millions more that the state must borrow. Their largess could bite back as lawmakers wrestle with legislation to ensure more openness and accountability at CIRM.

Next Thursday's meeting of the CIRM board of directors will, in fact, be in the bowels of the beast, so to speak. The 29-directors are scheduled to convene in a large meeting room in the State Capitol. Their agenda is relatively brief. Traditionally, following the meeting, directors fan out to meet with lawmakers privately.

As far as meaningful public participation is concerned, CIRM discourages that by withholding justification and details on what is to be discussed by directors. That includes the proposal to take part in expensive clinical trials, which was deferred from the February meeting. Also not available is size of the proposed salary for CIRM's new vice president for research and development, who will effectively become the No. 2 executive on CIRM staff. CIRM already enjoys some of the highest salaries in state government. President Alan Trounson earns $490,008 a year and was once listed as the second highest paid state employee outside of the UC system.

The lack of information on the specifics of what CIRM directors are considering is pretty much standard practice for the agency, despite calls for more openness and transparency. The reasons are unclear for CIRM's failure to post information in a timely fashion prior to directors' meetings, which are not even noticed on CIRM's home page on the Internet. The sessions, however, are the most important activities at the agency. That's when the direction of research is set, standards established and money handed out. We may see additional information posted next week, but usually it comes too late for the public or interested parties to make plans to attend the meetings or formulate a considered comment.

On Monday, a new subcommitte of CIRM directors will discuss ways to improve communications and sell its story to the California people. One good first step would to be mandate that background information for meetings be posted at least five business days prior to the sessions. A modest but do-able goal.


  1. Francisco Prieto MD1:13 PM

    Dear David:
    Like most if not all members of the ICOC, I try to pay close attention to the criticisms and opinions we hear from the public, and I'm glad to try to respond. When prop. 71 was passed, in better financial times, a promise was made to California voters that we would move very rapidly to drive this medical research forward to try to find and develop actual treatments & cures for chronic diseases. Accordingly, we have consciously chosen to try to pursue a very aggressive timeline in pushing scientific discoveries forward to become treatment for real patients, in marked contrast to the more measured and basic science heavy focus of the NIH for example. Whatever my own (somewhat jaundiced) view might be of big Pharma and some of the Biotech industry, I realize that without them, there is no way that any new medicine or treatment can be produced in the scale needed to make a difference in the lives of people with incurable diseases. I have my own opinions about the amount of regulatuion they should be subject to, and the return they should expect to give back to the people of California, and had the opportunity to voice those in the 2 years of public meetings I participated in as a member of our Intellectual Property task force. In marked contrast to Federal policy for more than a generation, I believe we came up with a very reasonable and progressive policy, one that means that a major success for CIRM will not only mean a cure for a chronic disease, but a direct financial return to California's general fund, as it should.
    When we approved our facilities grants to help fund the establishment of new research labs around the state, I joked to one of my colleagues that "we may be the only people building anything in California right now." Unfortunately, that comment now seems too true to be very amusing. We did nevertheless put a substantial amount of our funds directly into bricks and mortar, putting hundreds of Californians to work, and required that every institution getting a grant raise twice as much privately from other sources, leveraging our own stimulus. As a citizen and parent of two young adults, I worry a great deal about the California they will inherit. Ballot box budgeting is certainly part of the problem, but I think the greater problem is our skewed priorities. Unless we believe (I don't) that Californians are the most evil or criminal people on the planet, I think there is no way to justify incarcerating more of our people per capita than even the most totalitarian regimes. I for one would welcome budgetary and initiative reform, but unless we change our priorities that will only get us so far.
    I agree with you that we need more transparency, but much of what we are criticized for is not for lack of trying. We have had literally hundreds of open public meetings since 2004, and have welcomed and tried to respond to all the public input we receive at them. The members of the Little Hoover Commission, often cited by our critics, actually shared with us that they were very impressed that we scheduled meetings with them and attempted to respond point by point to all of their recommendations - not the usual response they get from other governmental bodies. I haven't asked Bob Klein directly, but I suspect he might now wish that the very stringent limit on CIRM staff and administrative spending had been somewhat looser. We've given our staff an incredible workload, and the Bagley Keene restrictions on public meetings mean that often the members of the board can't discuss these issues among ourselves ahead of time, so we are thrashing these details out among ourselves at the same time as the public is hearing of them - and hopefully weighing in. I would welcome even moe openness and transparency, but I would put our record in this up against that of any other branch of government.

  2. Anonymous11:41 AM

    Who might be the person who gets this $332,000 a year job...any guesses? Think hard, all readers.

  3. A comment to Dr. Prieto's remarks appears on IPBiz:


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