A Rare, Written Self-Exploration: California's Stem Cell Agency Slices and Dices its Own Spending

It is a rare day that the $3 billion California stem cell agency actually explains in writing its budget and finance choices. Today it did.

Usually the agency relies on Power Point slide presentations at its public meetings that amount to little more than an outline. Today, the California Institute for Regenerative Medicine (CIRM), as the agency is formally known, filed a 652-word item on its blog discussing its spending plans.

Written by Kevin McCormack, the agency's senior director of communications, said the CIRM team had examined CIRM's financial picture during the last few months. He wrote,

"It boiled down to a few options.

• "Keep funding at the current rate and run out of money by 2019

• "Limit funding just to clinical trials, which would mean we could hit our 50 clinical trial goal by 2020 but would not have enough to fund Discovery and Translational level research

• "Place caps on how much we fund each clinical trial, enabling us to fund more clinical trials while having enough left over for Discovery and Translational awards"

McCormack continued,

"The board went for the third option for some good reasons. The plan is consistent with the goals laid out in our strategic plan and it supports Discovery and Translational research, which are important elements in our drive to develop new therapies for patients."

Nearly all of what McCormack wrote is familiar to readers of this web site. But it may be new to many of other followers of the agency.

McCormack noted that budgets are "rarely exciting things." Some might argue that precisely how the agency is spending $6 billion (including interest) of public money is at least as exciting as the arcane world of, let's say,  generating a "mesenchymal stromal cell-seeded small intestinal submucosa  decellularized extracellular matrix,"

CIRM's spending is directly important to hundreds of California scientists and the institutions that benefit financially from CIRM awards. The stem field in general has already benefited from the loads of CIRM research that is laying the groundwork for greater developments -- not only in California but globally.

It can arguably said that CIRM is the largest single source of stem cell research funding in the world. And one of its greatest products is hope -- hope by hundreds of thousands of persons, perhaps millions, that CIRM's research will speed development of therapies that will ease their suffering or the suffering of those who come after them.

Nothing boring about that. And kudos to CIRM for taking a longer look at the nickels and dimes that make it happen.

'Invisible Work' and the California Stem Cell Agency

At one point in its history, the $3 billion California stem cell agency had only about as many employees as a 24-hour Burger King, probably fewer.

Today it is has 46 workers, most of whom labor behind the scenes, rarely visible to the public. They do what I call "invisible work." That means you only see it when it goes away. Then the job that once was performed very well with little notice draws great and sometimes anxious attention because the work -- all of a sudden -- is not getting done.

Last week the California Institute for Regenerative Medicine (CIRM), as the agency is formally known, to its credit moved to recognize some of those workers, which the agency calls team members.

Todd Dubnicoff, CIRM's multimedia editor, posted an item on the agency blog, The Stem Cellar, headlined,

"Meet Team CIRM: The People Behind the Mission to Save Lives."

Dubnicoff wrote,

"I don’t have the word space in this blog to introduce you to them all so, for today, say hello to a few of our 2017 CIRM Game Ball winners. At our quarterly Team meetings, we honor and celebrate members whose efforts reflect our 'All In' culture with this award."

They ranged from Lilia Leal, a finance officer, to Paul Webb, a senior science officer. Webb received his game ball for completing 40 of the important clinical advisory panel sessions in less than six months. Leal won her ball for reducing grant payment time by 30 days. 

We recommend the Dubnicoff item if you want to improve, however slightly, your understanding of CIRM and how it tries to make science happen. And congratulations to all the Game Ball winners. 

New President Coming Up for California Stem Cell Agency: Maria Millan Likely Choice

By this time next week, California's $3 billion stem cell research agency is expected to have a new president to preside over what may be the last act for the nearly 13-year-old effort.

Item Five on the agenda for this Thursday's meeting of the governing board of the agenda says:

"Consideration of appointment of new president, including compensation package."

Preceding that is an executive session of the board to discuss the matter behind closed doors. 

The California Stem Cell Report is predicting that Maria Millan, currently interim president, is likely to get the job. Millan was named as the interim CEO after Randy Mills left the agency at the end of June. Mills publicly recommended Millan to replace him as head of the California Institute for Regenerative Medicine (CIRM), as the agency is formally known. 

A subcommittee of the governing board has met only once -- also behind closed doors -- to consider a replacement for Mills. The board made no public comment about the outcome that July meeting.

Millan was vice president for therapeutics for the agency.  A news release from CIRM said in May that Millan "was instrumental in developing and implementing the current strategic plan."

The news release continued, 

"She received her general surgery training and transplant immunology postdoctoral fellowship at Harvard Medical School and trained in solid organ transplantation at Stanford University School of Medicine, where she went on to serve as associate professor of surgery and ultimately director of the Pediatric Organ Transplant Program. Maria received her bachelor’s degree from Duke University and her M.D. from the University of Medicine and Dentistry of New Jersey."

She joined the agency in 2012 after leaving a position as vice president at StemCells, Inc., which has received $9 million from the agency. 

CIRM has projected that it will run out of cash in mid 2020. Its governing board is currently studying a wide range of options for life after 2020.

California Stem Cell Agency Says Its Top Lawyer Is Departing After More Than 12 years

James Harrison, Remcho photo

The $3 billion California stem cell agency today said it is losing one of its top leaders, James Harrison, one of the authors of the measure that created the agency and who most recently is serving as its “unflappable” general counsel.

The agency announced this afternoon that Harrison would be departing at end of June “to focus full-time on his legal practice.”

Harrison has worked with the agency under contract since its inception in 2004. He was known for his exceptional legal skills and aplomb when matters became muddled or worse at meetings of the agency’s 29-member board.

Randy Mills, president of the agency, said in a press release,

“James is more than wise counsel at CIRM, he has also been a highly effective leader, responsible for designing and implementing many of CIRM 2.0’s more innovative features.

“He is unflappable and maintains a sense of humor and perspective, even in the most challenging of situations. We thank him for his many years of service and wish him the very best.”

Harrison was one of five persons who drafted Proposition 71, the ballot initiative that created the California Institute for Regenerative Medicine or CIRM as the agency is formally known. He is a partner in the Oakland law firm of Remcho, Johansen and Purcell, which also has an office in Sacramento. The firm specializes in political, election, ethics, constitutional and public policy law.

Harrison was known for his work on ballot measures well before he became involved in the Proposition 71 campaign, He also has worked in election law and campaign finance.

Harrison never was formally classified as an employee of the stem cell agency. His services came under a contract with his law firm. For the current fiscal year, that contract amounts to $575,000.

A 2009 memo to the stem cell agency board recounted Harrison’s value to CIRM, ranging from defending its constitutionality to its public records policy. The memo, prepared at the behest of Bob Klein, the agency’s first chairman, said that Harrison had been “has been involved in virtually every aspect of the agency’s operations, including defending the agency in litigation, drafting and reviewing agency policies, advising the agency on conflict of interest issues, and interfacing with constitutional officers and legislators on matters ranging from financing to proposed legislation.”

Mills said that Scott Tocher, deputy general counsel for the agency, will work closely with Harrison to ensure continuity during a transition period. Tocher is also a longtime veteran of CIRM affairs, joining the agency in 2005.

California Stem Cell Audit: Praise for Mills but More Work Needed on IP, Conflicts of Interest

The California stem cell agency this week received good marks for changes made by its new president, but it is also being told that it needs to improve how it tracks potential royalties and how it prevents grant reviewer conflicts of interest.

A "performance audit" by Moss-Adams, a Seattle business consulting firm, made 12 recommendations for the $3 billion research enterprise. One of the 12 was to implement the unfulfilled recommendations made by Moss-Adams three years ago.  Seven of the 24 from that audit still need more action, the firm said.

On Thursday, the agency's governing board is scheduled to discuss the latest audit at a meeting in Berkeley.  The study is required by state law every three years. The agency's scientific performance, however,  is specifically excluded from being examined. Moss-Adams is scheduled to receive $230,000 from the agency for the audit, which was for the 2013-14 year.

On Sunday, the California Stem Cell Report covered the deficiencies involving disclosures of the financial interests of grant reviewers.

Other areas of concern included the need for better tracking of intellectual property that could mean royalties for the state, more timely review of progress reports from grantees, more timely, formal evaluation of employees and keeping up-to-date on technology related to grant management and agency efficiency.

Under the subject of "commendations," Moss-Adams said that CIRM had "many strengths."  The consultant said the agency has made "significant strides" in three areas: the grant management system, grants process improvements and "organizational culture."

The grants process comment referred to CIRM 2.0, the fast-track funding program initiated by Randy Mills since he became president a year ago. The organizational culture commendation also involved Mills' efforts, but touched indirectly and delicately on the resignation of Robert Klein as chairman and the election of Jonathan Thomas to replace him in June of 2011. 

Moss-Adams reported "enhanced seamlessness" between the president's and chairman's offices. Proposition 71, which created the agency, dictated a controversial dual executive situation that has troubled the agency since its inception.

The audit found significant deficiencies involving the treatment of CIRM employees, some of which have been addressed in a positive way already by Mills. One example cited by the audit involved performance evaluations that are tied to pay increases. It said that evaluations that were scheduled to occur in 2013-14 did not actually take place until January of this year.  

Moss-Adams said the agency also needs to do better in monitoring and protecting its intellectual property (IP), which could generate royalties. Without tight tracking of the IP and inventions funded by CIRM research, the state could lose out on revenue. Backers of Proposition 71 told voters in 2004 that the state could receive more than $1 billion in royalties from CIRM research. So far, none has resulted. 

Moss-Adams said that royalties are now more possible because the agency is backing late stage research that is more likely to make it into the market place. 

Moss-Adams said more work was needed on implementing the seven recommendations from three years ago, including those involving IP, the transition plan to deal with the possible demise of the agency and a grants outcome database. 

Chairman of $3 Billion California Stem Cell Effort Up for Evaluation Next Week

One week from today, a select panel of the directors of the $3 billion California stem cell agency will meet for the first time to assess the performance of its chairman, Jonathan Thomas, during his nearly four years in office.

Thomas, a Los Angeles bond financier, was elected as chairman of the agency in June 2011 on a 14-11 vote of the 29-member agency board. (See here and here.) He is paid $400,000 annually for his part-time work (80 percent), according to a Sacramento Bee database. His salary has remained unchanged since he took office.

Left to right, Robert Klein, Art Torres and Jonathan Thomas (2009 photo)

Thomas succeeded Robert Klein as chairman of the agency. Klein was elected in December 2004 after shepherding the ballot campaign that year to pass Proposition 71, which created the agency and funded it with state government borrowing.

The agenda for next week’s meeting gave no clue to the reason for calling this particular evaluation session. But good personnel practices would seem to require regular evaluations, perhaps even more often than every four years.

In 2012, then outside counsel to the board, James Harrison, prepared a memo for the subcommittee discussing evaluation procedures. In the memo, Harrison, now general counsel to the agency but still an independent contractor, summarized procedures that called for Thomas to submit his job goals for 2012-13.

Also to be evaluated, according to the memo,  was Art Torres, vice chairman of the board. Torres was also elected by the board and works part-time (80 percent) at an annual salary of $225,000. The subcommittee has not scheduled a meeting to evaluate Torres’ performance. Torres has been paid $225,000 annually during the last two years. However, his pay ran up to $247,000 in 2012, $239,000 in 2011 and $230,000 in 2010, according to The Bee database, which is drawn from public records.

(In response to a question, the stem cell agency said later today that the money paid to Torres in those three years was for unused vacation time. Earlier versions of this item did not contain that response.)

The Evaluation Subcommittee has six members, including Thomas and Torres. However, Thomas is not likely to be sitting in on his own evaluation next week. Chairman of the panel is Francisco Prieto, a Sacramento physician. The others are Stephen Juelsgaard, former executive vice president of Genentech; Sherry Lansing, former head of a Hollywood studio and a University of California regent, and Jeff Sheehy, a communications manager at UC San Francisco.

The subcommittee has met six times since Thomas was elected. All of those meetings dealt with assessment of Alan Trounson, former president of the stem cell agency, according to agendas.

Next Friday’s meeting will be almost entirely behind closed doors, but the public does have an opportunity to comment.  Two locations for the public exist in San Francisco and one each in Los Angeles, Calistoga and Napa. Specific addresses can be found on the agenda.

Update on the Search for New Execs at the California Stem Cell Agency

California’s $3 billion stem agency no longer lists on the Internet job openings for a director of medical affairs and director of administration but reports that the positions remain vacant.

The new, top level posts were created in a reorganization of the enterprise, which has less than 60 employees, by its president Randy Mills, who took over last May. He made the move as part of his CIRM 2.0 effort.

In the initial postings last month, the agency said the positions would remain open until they were filled. Three other openings for directors in the areas of blood and cancer, neuro/ocular and organ systems continue to remain up on the CIRM Web site.

No explanation was offered for removal of the medical affairs and administration openings. Kevin McCormack, a spokesman for the agency, said the positions have not been filled.

Here are job posting documents as they originally appeared.

   Director of Administration, California Stem Cell Agency

   Director Medical Affairs, California Stem Cell Agency

Former Top Exec at Stem Cell Agency Appointed President of Huntington Medical

The former chief scientific officer of the California stem cell agency, Marie Csete, yesterday was named the president of the $53 million Huntington Medical Research Institutes in Pasadena, Ca.

Marie Csete, Huntington photo

Csete left the stem cell agency in 2009, after serving for a little more than a year. Her departure involved tension between her and former agency President Alan Trounson.  She told the journal Nature,

"When it became clear to me that my considered clinical advice was not respected, I concluded that it made no sense for me to stay at CIRM.”

Csete was the last person to hold the position of chief scientific officer at the agency. Trounson left the agency in July last year.

Huntington reported assets of $53 million in late 2013 and funds a wide variety of research. 

California Stem Cell Agency Seeks Five Executives in $3 Billion Program

California’s $3 billion stem cell agency has embarked on a wave of fresh hiring of well-paid executives to fill top slots in the new structure created by Randy Mills, who has been the chief executive of the program since last May.

Five positions are open with salary ranges that hit $244,204 annually.  All of the announcements are emblazoned with the new CIRM 2.0 logo, emphasizing the “radical” changes underway at the agency. The program is formally known as the California Institute for Regenerative Medicine or CIRM.

The postings amount to the largest number of top level positions opening at the agency in a number of years, perhaps the largest since its inception 10 years ago.  Total employment at research funding program is slightly more than 50 persons and is not expected to increase significantly.

The open positions include “directors” in the following areas:  medical affairs and stem cell centers, blood and cancer therapeutics, neuro/ocular therapeutics, organ systems therapeutics and administration, which includes everything from public relations to information technology.

The agency’s governing board in December approved Mills’ reorganization with little discussion. He said it would flatten the organization, making it speedier and more efficient.

The new structure eliminated a number of positions, including that of Ellen Feigal, who was senior vice president for research and development, then the No. 2 position at the agency. She resigned last October, giving two weeks notice. At the time, she was the fifth person to leave the agency following the hiring of Mills.

Under Mills’ organization, the agency does not have a No. 2 person or a chief scientific officer. The chief scientific officer position was eliminated years ago, although it is common in many biotech companies.

A comparison of the new and old organization can be found here.

Here is a look at some of what the new positions entail:

Director, Medical Affairs and Stem Cell Centers: Oversight of “the Alpha Stem Cell Clinics, the CIRM Stem Cell Genomics Centers of Excellence, and the CIRM hiPSC Initiative with a total budget of over $90 million.”

Director, Blood and Therapeutic Area: Oversight of more than “20 active programs and a budget of over $200 million. Projects in the therapeutic area range from translational research through human clinical trials.”

Director, Neuro/Ocular Therapeutic Area: This area “currently has over 25 active programs and a budget of over $200 million. Projects in the therapeutic area range from translational research through human clinical trials.”

Director, Organ Systems Therapeutic Area: This involves more than “25 active programs and a budget of over $200 million. Projects in the therapeutic area range from translational research through human clinical trials.” 

Director, Administration:  Oversight of Communications, Information Technology (IT), and Human Resource departments; “Importantly, the Director is also responsible for managing all Governing Board activities and communications.”

All of the positions have a salary range of $167,877 to $244,204 and report directly to Mills.

No deadline exists for filing applications. The announcements said applications will remain open until the positions are filled. Mills, however, moves with dispatch. Interested persons should submit applications quickly if they want to be considered.

Nature Reports on Lee Hood Conflict Case

The journal Nature and genomeweb.com today picked up the story from the California Stem Cell Report about the conflict of interest case at the California stem cell agency involving renown scientist Lee Hood of Seattle, Wash.

Science news aggregators on the Internet also relayed various versions of the story. The facts were first reported on this blog yesterday. The matter involved a $24 million application for a genome project involving Irv Weissman of Stanford. Hood was one of the reviewers in the round. Hood and Weissman are longtime friends and own property together in Montana. They have also have a number of professional relationships.

In piece by Ewen Callaway, Nature additionally referred to ongoing conflict of interest issues at the agency, including the findings of an Institute of Medicine study. Harold Shapiro, head of the study, said the agency directors make "proposals to themselves, essentially, regarding what should be funded. They cannot exert independent oversight." 

The genomeweb item was also brief and did not mention the IOM study.

Feigal Interim President at Stem Cell Agency

The $3 billion California stem cell agency has a new CEO – at least until early March – when Alan Trounson is scheduled to resume his fulltime duties.

Ellen Feigal, vice president for research and development, is the interim president at the agency while Trounson is in Australia. Trounson left California Dec. 20.

Trounson told the board last fall that he would be reducing his time at work to 50 percent while he is in Australia. Trounson, who was recruited from Australia to head CIRM, said he wanted to spend more time with his family. Trounson's wife and 11-year-old son live in Australia.   

IOM Recommends Sweeping Changes at California Stem Cell Agency

A blue-ribbon study of the $3 billionCalifornia stem cell agency today said the program has “achieved many notable results,” but recommended sweeping changes to remove conflict of interest problems, clean up a troubling dual-executive arrangement and fundamentally change the nature of the governing board.

The recommendations from the 17-month study by the Institute of Medicine (IOM) would strip the board of its ability to approve individual grants, greatly strengthen the role of the agency's president, significantly alter the role of patient advocates on the governing board and engage the biotech industry more vigorously.

Harold Shapiro, chairman of
IOM-CIRM  panel
Princeton University Photo

Harold Shapiro, former president of Princeton University and chairman of the IOM study panel, said, “Overall, CIRM (the California Institute for Regenerative Medicine) has done a remarkably good job” in giving the state a prominent position in regenerative medicine. But he said the stem cell field has “evolved”and CIRM needs to change with it.

As for turning research into cures, the report said,

 “The challenge of moving its research programs closer to the clinic and California’s large biotechnology sector is certainly on CIRM’s agenda, but substantial achievements in this arena remain to be made.”

Asked for comment, J.T. Thomas, chairman of the CIRM governing board, said it was premature to offer an opinion on the report, which will be presented to directors Dec. 12 at their Los Angeles meeting. (See here for the full text of Thomas' remarks.)

The study was conducted at the behest of CIRM, which paid the IOM $700,000. The IOM is a prestigious non-profit organization that was created in 1970 to provide authoritative advice to policy makers and the public.

In 2010, when directors authorized the study, Robert Klein, then chairman of the CIRM board, and other board members said that they hoped the study would lead to another multibillion dollar state bond issue to support the agency(see here and here). Duane Roth, a San Diego businessman and co-vice chairman of the CIRM governing board, was the lone no vote on the study. He warned directors that that they could not “go in just sort of blind trust that (the IOM is) going to reach the conclusion you want them to reach.”

The agency will run out cash for new grants in four years. Currently California remains in the throes of state budgetary problems, and the agency has put on hold talk of another bond election. It has also broached the possibility of seeking private funding.

The IOM report said the agency should develop a full-blown “sustainability platform” and plans that would spell out its likely financial structure and future rules on grants and their administration, including intellectual property.

The study echoed concerns and complaints about CIRM's operation that were aired even before the agency was officially created by voters in 2004. One of those involves the built-in conflicts of interests on the CIRM governing board. As of September, 92 percent of the $1.7 billion handed out by the agency had gone to institutions linked to persons serving on the 29-member board.

The report said,

“Far too many board mem­bers represent organizations that receive CIRM funding or benefit from that funding. These com­peting personal and professional interests com­promise the perceived independence of the ICOC(the CIRM governing board), introduce potential bias into the board’s decision making, and threaten to undermine confidence in the board.”

The IOM cited an ongoing scandal in Texas dealing with that state's $3 billion cancer agency. The flap has led to mass resignations of the agency's grant reviewers. The IOM said,

“Recent controversy surrounding the Cancer Prevention and Research Institute of Texas grants process illustrates the importance of rigorous scientific review free from inherent or perceived conflict and the consequences when these boundaries appear to be breached.”

However, the IOM press release said,

“Because the committee was not charged with reviewing CIRM's past funding decisions, it did not identify any specific cases of conflict.”

The IOM surveyed members of the board (ICOC) about conflicts of interest. The report said,

 "While a majority of respondents stated that personal interests did not play a role in their work on the ICOC, some responses were more equivocal. One respondent replied that it was 'hard to tell' given that 'so many decisions take place off camera in secret meetings,' while another acknowledged that ICOC members are human, and of course their decisions are influenced by personal beliefs and interests."

To help deal with conflicts of interest, the IOM recommended that the CIRM governing board not be allowed to approve individual grants. Instead, the board would be given a slate of applications that would be approved as a block. All CIRM board members would be removed from the grant review committee and the grant review process would be turned over to the president of the agency, currently Alan Trounson.

The IOM recommended that a majority of the board consist of “independent” members and said that the board should not be increased beyond its current 29 members, although it could be shrunk.

Conflict of interest rules should be revised to deal with personal conflicts, which could have a major impact on the 10 patient advocate members of the board but also other directors and possibly staff who have family members with health issues. The report said,

“California law focuses primarily on financial conflicts of interest, but the committee believes that personal conflicts of interest arising from one’s own or a family member’s affliction with a particular disease or advocacy on behalf of a particular disease also can create bias for board members. Studies in psychology and behavioral economics show that conflict of interest leads to unconscious and unintentional 'self-serving bias' and to a 'bias blind spot' that prevents recognition of one’s own bias. Bias distorts evaluation of evidence and assessment of what is fair.”

The IOM said that the board is much too involved in operational matters, including the chair and the two vice-chairs. The report said,

“The board should transfer management responsibilities to management so it can provide truly independent oversight and evaluation of management, strategic planning, and broad direction for resource allocation.”

The IOM repeatedly and favorably cited a 2009 study by California's Little Hoover Commission, the state's good government agency. It noted that CIRM rejected most of the commission's recommendations. The IOM also cited recommendations by the agency's own “external review” panel in 2010 and suggestions this year from the first performance audit of the agency, which cost CIRM $234,944.

Many of the IOM's recommendations would require either legislative approval or another ballot initiative. However, changes in the Prop. 71, the ballot initiative that created CIRM, require a politically difficult super, supermajority vote (70 percent) of the both houses of the legislature and the signature of the governor. The requirement was written into the 10,000-word initiative and has been used by CIRM to block legislation that it did not favor.

Here is brief rundown on some of the other IOM recommendations:

• Greater engagement with industry to commercialize stem cell research. Noting that industry has received only 6 percent of the agency grants, the report said business representation on CIRM working groups and other committees “should be enhanced to leverage industry’s expertise and resources in product development, manufacturing, and regulatory approval in support of the ultimate goal of bringing therapies to patients.”
• Elimination of the current process in which applicants rejected by reviewers appeal publicly to the governing board. Noting that 32 percent of “extraordinary petitions” have been successful, the report said they “undermine the credibility and independent work” of grant reviewers. Instead appeals would heard only by staff behind closed doors.
• Creation of a new scientific advisory board, appointed by the CIRM president with a majority from outside of California, instead of multiple advisory groups. The report said,“Such an external board would be invaluable in vetting ideas for new RFAs, suggesting RFAs that otherwise would not have been considered, and helping CIRM maintain an appropriate balance in its research portfolio. Input from this board would help CIRM make fundamental decisions about dealing with challenges that cut across particular diseases, decide which discoveries should progress toward the clinic, and determine how best to engage industry partners in developing new therapies.”
• Funding of programs on bioethics and regulatory problems. The report said,“It is difficult for researchers to find appropriate funding for stem cell-specific ethics and policy work, and filling this funding gap is well within CIRM’s budget.”

One final note: As mentioned earlier, Duane Roth, co-vice chairman of the agency, was the only no vote on the board when it authorized the IOM study in 2010. The IOM today said,

“The critical tasks performed by the vice chairs should be reassigned to management. In particular, the important tasks of government relations and corporate relations both should be carried out by staff reporting to the president rather than by the vice chairs of the board.”

For more excerpts from the report, see this item.

,  

Researcher Alert: Stem Cell Agency to Take Up Grant Appeal Restrictions

The move by the $3 billion California stem cell agency to curtail its free-wheeling grant appeal process will undergo its first public hearing next week.

The proposals will mean that scientists whose applications are rejected by reviewers will have fewer avenues to pursue to overturn those decisions. The changes could take effect as early as next year.

The move comes in the wake of a record number of appeals this summer that left the board complaining about “arm-twisting,” lobbying and “emotionally charged presentations.”

Among other things, the new "guidelines" attempt to define criteria for re-review – “additional analysis” – of applications involved in appeals, also called “extraordinary petitions.” The plan states that re-review should occur only in the case of a material dispute of fact or material new information. (See the end of this item for agency's proposed definitions.)

In addition to alterations in the appeal process, the CIRM directors' Application Review Task Force will take up questions involving “ex parte communications.” The agenda for the Oct. 24 meeting did not contain any additional information on the issue but it likely deals with lobbying efforts on grants outside of public meetings of the agency. We understand that such efforts surfaced last summer involving the $$214 million disease team round and Robert Klein, the former chairman of the stem cell agency.

Klein appeared twice publicly before the board on one, $20 million application by StemCells, Inc., the first time a former governing board member has publicly lobbied his former colleagues on an application. The application was rejected twice by reviewers – once on the initial review and again later on a re-review – but it was ultimately approved by directors in September on a 7-5 vote.

The board has long been troubled with its appeal process but last summer's events brought the matter to a new head. The issue is difficult to deal with because state law allows anyone to address the CIRM governing board on any subject when it meets. That includes applicants who can ask the board to approve grants for any reason whatsoever, not withstanding CIRM rules. The board can also approve a grant for virtually any reason although it has generally relied on scientific scores from reviewers.

The proposals to restrict appeals are designed to make it clear to scientists whose applications are rejected by reviewers that the board is not going to look with favor on those who depart from the normal appeals procedure.

While the board almost never has overturned a positive decision by reviewers, in nearly every round it  approves some applications that have been rejected by reviewers. That has occurred as the result of appeals and as the result of motions by board members that did not result from public appeals.

Ten of the 29 board members are classified as patient advocates and often feel they must advance the cause of the diseases that they have been involved with. Sometimes that means seeking approval of applications with low scientific scores.

Here is how agency proposes to define “material dispute of fact:”

“A material dispute of fact should meet five criteria:(1) An applicant disputes the accuracy of a statement in the review summary;(2) the disputed fact was significant in the scoring or recommendation of the GWG(grant review group); (3) the dispute pertains to an objectively verifiable fact, rather than a matter of scientific judgment or opinion;(4) the discrepancy was not addressed through the Supplemental Information Process and cannot be resolved at the meeting at which the application is being considered; and (5) resolution of the dispute could affect the outcome of the board’s funding decision."

Here is how the agency proposes to define “material new information:”

“New information should: (1)be verifiable through external sources; (2) have arisen since the Grants Working Group(grant review group) meeting at which the application was considered; (3) respond directly to a specific criticism or question identified in the Grants Working Group’s review; and (4) be submitted as part of an extraordinary petition filed five business days before the board meeting at which the application is being considered."

Next week's hearing is scheduled for Children's Hospital in Oakland with a teleconference location at UC Irvine. Addresses can be found on the agenda.

Arm-twisting and Emotion: Stem Cell Directors Move to Reform Appeals on Multimillon Dollar Grants

Frustrated with politicking, “arm-twisting,” lobbying and “emotionally charged presentations,” the governing board of the $3 billion California stem cell agency today approved short-term changes in its grant appeal process and ordered up a study to prepare long-term reforms.

The moves followed a prolonged series of appeals on grant applications that began in July and continued through today, setting records for the number of appeals and generating hours of sometimes tearful and emotion-laden presentations from members of the public.

The board adopted changes in the appeal process for its next few meetings that are aimed at curbing its free-wheeling nature and making it more understandable to the public and applicants. The board also directed creation of a panel to make recommendations by the end of the year for more wide-ranging reforms.

Directors of the agency were clearly not happy with the appeal process this summer. However, it has been a problem since 2008 when Bert Lubin, now a director of the stem cell agency and CEO of Childrens Hospital of Oakland, Ca., was the first applicant to make a public pitch before the board to overturn reviewer rejection of his application.

One director, UCLA medical school dean, Gerald Levey, said at the time,

"I don't think we can run a board this way. If we do, it would be chaos." 

Today, CIRM Director Carmen Puliafito, dean of the USC School of Medicine, said that “lots of lobbying” was going over the last couple of months. He predicted there will more lobbying and “more politicking.” Puliafito said,

“On big money grants, people will be calling their friends.”

The name of former board chairman, Robert Klein, was not mentioned during this afternoon's discussion. But Klein vigorously and successfully backed an appeal (see here, here and here) by StemCells, Inc., of Newark, Ca., for a $20 million application that had been rejected twice by reviewers. Last night the board approved the award on a 7-5 vote. It was the first time the board has approved an award that was rejected twice by its reviewers.

Director Jeff Sheehy, co-vice chairman of the review group and a communications manager at UC San Francisco, said the agency is dealing with “big money grants” that are “incredibly complex.” He also referred to “certain arm-twisting by certain individuals.”

Several board members made references to appearances by persons who have diseases or conditions that might be affected by CIRM-financed research. Director Duane Roth, head of CONNECT, a San Diego business development organization, said the board is making decisions in “an emotionally charged setting.”

Other issues cited by directors include the integrity of review process, fairness, consistency, shifting appeals procedures, transparency and board discipline on appeals.

James Harrison, outside counsel to the board, said the board's action today includes "eliminating the reference to unpublished data in the discussion of 'material new information," imposing a 3-page limit on other correspondence, explaining that applicants should have seven business days from the time the (grants review group) recommendation is made available to them to file an (extraordinary petition), and posting all of the information regarding these policies in one place on CIRM’s website."

For a list of articles and CIRM documents dealing with the appeal process, see here.

Business Success Rate at Stem Cell Agency: Zero in Latest Round After 14 Fail

California biotech companies chalked up a zero in the latest funding round by the state's $3 billion stem cell agency, although 14 tried to run a gauntlet that industry has complained about for years.

All $69 million in last month's translational research round went to 21 academic and nonprofit insitutions. No business received an award. One firm, Eclipse Therapeutics of San Diego, appealed to the agency's governing board but was not successful despite having a higher scientific score than at least two winners.

The miniscule amount of funding for commercial enterprises – less than 4 percent of $1.4 billion handed out so far – has been a matter of concern for some time for both industry and some members of the CIRM governing board. Most recently, industry executives complained at an April hearing of the Institute of Medicine panel looking into CIRM's operations. Even a 2010 review commissioned by CIRM said the agency needed to do better by business.

The question of funding goes beyond a simple matter of fairness or "good science," as CIRM describes its funding goal. Without efforts by industry to turn research into cures, CIRM will not be able to fulfill promises to voters in 2004 when they approved creation of the stem cell agency. CIRM last month approved a set of five-year goals that push more aggressively for development of commercial products, but the goals lacked such things as a financing round devoted solely to business applicants.

In last month's translational round, applicants went through a three-step process, which is conducted primarily behind closed doors. First came what CIRM calls pre-applications. Those were reviewed by CIRM staff with the help of outside advisors if necessary. Applicants who cleared that hurdle were allowed to apply for the full, peer-reviewed round. During that process, the CIRM Grants Working Group reviews applications, makes decisions and sends them to the full CIRM board for ratification and possible changes. The board almost never has rejected a grant approved by reviewers. But the board has ultimate authority and sometimes funds applications that reviewers have rejected. The applicants' names are withheld from the board and the public during the process, although some of the board discussion and the final vote is conducted in public. CIRM does not release the names of rejected applicants unless they appeal.

In the translational round, a total of 42 pre-applications out of 167 were approved by staff, according to CIRM. Thirty-eight came from nonprofits and academics out of the 153 such institutions that applied. Four out of 14 business pre-applications advanced to full applications but none made the final cut. All of the winning applications were linked to institutions that have representatives on the CIRM governing board. Those representatives are not allowed to vote on or take part in discussion involving applications to their institutions.

The primary decision tool used by the grant review group is a scientific score. In last month's round, scores of approved grants ranged from 88 to 53. However, eight grants that were ranked above 53 were rejected by the board. One of those higher-ranking applications came from San Diego's Eclipse Therapeutics, which scored 58. The low-ranking grants were approved for what CIRM describes as "programmatic" reasons.

More than three weeks ago, the California Stem Cell Report asked CIRM for figures on the numbers of applications in the translational round, including those for business. CIRM said the figures had not been compiled and would not be available until after the awards were made on May 24. The numbers were finally supplied yesterday.

Our take: The number of applicants, and their breakdown, is basic information that should be part of board's decision-making process. The statistics should be routinely available well in advance of the board's meeting. Indeed, the agency in its earlier days used to routinely publish the figures. It may be now that generating them is more time-consuming than necessary. The recent performance evaluation of the agency said CIRM needs to make major improvements in how it handles critical information needed for its top management and board.

Whatever the reason, given CIRM's poor track record with business, the agency's directors should diligently track industry's success rate on applications. If proposals ranked as low as 53 are approved while higher ranking applications from business are bypassed, it warrants more than cursory examination.

Stem Cell Agency Hires Tech Chief to Solve a Myriad of Problems

In a move that was long overdue, the $3 billion California stem cell agency last week hired a director of information technology to straighten out key problems ranging from its grants management system to how it handles its website.

The new hire comes as the CIRM governing board faces the results of its first-ever performance audit, which is markedly critical of how the agency handles its information. Half of the audit's 20 highest priority recommendations for improvement focus on information deficiencies, including critical information necessary for CIRM executives to determine the agency's performance.

Solving those problems will fall on the shoulders of Bill Gimbel, who is no stranger to CIRM. He has been working with the agency as an information technology advisor since 2010 through a contract with Infonetica, Inc., of Pleasanton, Ca., according to CIRM spokesman Kevin McCormack.  Gimbel is now the first staff person in a chief technology position at CIRM since October 2007, when about 25 percent of CIRM employees left.

Bill Gimbel

A graduate of MIT, Gimbel, who will be paid $180,000 annually, has a broad range of experience in computer technology and software dating back to 1992. According to his Linkedin web site, he was most recently director of IT at Infonetica. He lists himself as owner of aptReader, an app for reference books. He has also worked for LearningExpress and Scholastic, Inc.

The stem cell agency has been wrestling with information technology issues for years. The critical grants management system has been an issue at least since 2007, when directors were told its costs would not exceed $757,000. No figures for the total spent since then have been made public by CIRM, which is attempting to build a custom system, but the amount clearly and easily surpasses the 2007 estimate, based on some of the outside consulting costs. Although the agency hopes to resolve many of the problems by the end of this calendar year, the grant system was the target of considerable attention by Moss Adams, the firm that prepared the performance audit.

Over the years, CIRM directors have received intermittent, sketchy CIRM staff reports about the grants management system, but the Moss Adams discussion is the most comprehensive.

Among other things, the Moss Adams report said in bureaucratically delicate language,

 "Integration of website content management has not been an integral part of the GMS (grants management system) development process, which could result in suboptimal operational efficiency and effectiveness.

"Grants management system development is effectively managed at a tactical level, but it lacks dedicated, strategic governance and oversight, which has resulted in an elongated development process and requirements conflicts."

Moss Adams said,

"The new grants management system intellectual property module, currently under development, does not include provisions to address commercialization activity."

The performance audit additionally said,

"CIRM board members and senior management do not receive regularly updated, enterprise-level performance information. The ability to evaluate performance against strategic goals is critical to effective leadership and program monitoring, evaluation, and reporting. CIRM does not currently have a formal performance reporting program."

Moss Adams continued on other information technology topics:

"Data and document access are inefficient as a result of CIRM operating without a document management system.....In most cases, CIRM staff cannot access information without human interface. Information is stored in multiple locations, which are not linked or indexed."

The audit said that the agency has tried to solve its information problems without a plan. 

 "CIRM’s information system needs have been met by a variety of tools, including in-house developed applications, off-the-shelf applications, databases, and spreadsheets, most of which are not integrated," the audit stated.

One of the effects of all this is much wasted time when CIRM's tiny staff tries to extract information from the hodge-podge of systems. It is time that cannot be spared as the workload increases in the next few years, as it is certain to do. 

CIRM's 29-member board is scheduled to consider the performance audit at its meeting this Thursday. 

IP to Grant Oversight: Study Calls for Host of Improvements at California Stem Cell Agency

The $3 billion California stem cell agency is laboring under a range of problems that include protection of its intellectual property and management of its nearly 500 grants plus an inadequate ability to track its own performance, a seven-month study said yesterday.

The performance audit by the Moss Adams accounting firm of Seattle, Wash., made 27 recommendations for improvements, including more effort to ease strain connected to the agency's controversial dual executive arrangement. The study said that the nearly eight-year-old agency has many "opportunities" to "enhance performance reporting and decision making, strengthen effectiveness and efficiency, retain essential human resources and leverage technology."

In response to the report, the stem cell agency said, "(M)anagement concurs with the findings and recommendations....The recommendations are focused and constructive. CIRM is already implementing many of these recommendations, and we will be investigating the others in the coming months."

The performance audit is the first ever made of the California Institute for Regenerative Medicine. The audit is required by state law and was commissioned by the agency at a cost of $234,944. For years, the agency for years had resisted calls for a performance audit until it sought legislative approval in 2010 for removal of a 50-person cap on its staff. Originally, the performance audit legislation would have put the study in the hands of the only state body charged with oversight of the agency and its board. CIRM, however, was successful in lobbying to have that provision removed.

The 54-page report identified once again a number of issues that have troubled the stem cell agency for some years. Moss made 12 top priority recommendations, many of which dealt with information technology and grants management. Many of the recommendations focused on providing better and faster information on performance outcomes, which the audit said has been slow to come and hard to generate.

The report said,

"Key performance information is not readily available to CIRM leadership and other stakeholders on an ongoing basis. CIRM board members and senior management do not receive regularly updated, enterprise-level performance information. The ability to evaluate performance against strategic goals is critical to effective leadership and program monitoring, evaluation, and reporting."

The audit stated,

"CIRM does not effectively communicate outcome-based performance internally or externally. As such, CIRM does not focus on performance metrics as part of its (staff) meeting process."

The report additionally said,

"CIRM does not have an integrated financial information system....The use of spreadsheets results in labor intensive processes to generate reports and respond to information inquiries, since data must be pulled from multiple spreadsheets, a process that may be prone to error. ...Spreadsheets are not linked to each other or a master report. CIRM does not have a comprehensive list of spreadsheets or instructions for how to maintain the files or generate reports from them."

Moss Adams said that CIRM needed to do a better job in "bond forecasting," a reference to the California state bonds that finance virtually every aspect of the agency's operations. CIRM directors were caught by surprise a few years ago when they suddenly learned the agency was up against a major cash crunch.

Some of the recommendations will require more work from CIRM grantees and their technology transfer offices in an effort to track intellectual property and grant outcomes. The report also recommended a speed-up in CIRM's review of progress reports from grant recipients, which have been lagging completion by several months.

The dual executive arrangement, which was written into law by Prop. 71, has troubled CIRM since nearly day one. CIRM's own external review panel also identified it as problem two years ago. The executive structure is virtually impossible to change because of the political difficulty in making alterations in the ballot initiative.

Moss-Adams said,

"The working relationship between the chairman’s office and the president’s office has vastly improved over the past year, but there are still opportunities for improvement."

The performance audit recommended,

"Make every effort to manage and operate as one cohesive organization, while recognizing the varying roles, responsibilities, and authorities that exist with positions in both the chairman’s office and president’s office."

One of the top 12 recommendations involved CIRM's public relations/communications effort. CIRM Chairman J.T. Thomas told directors last June that the agency was in a "communications war."

Moss-Adams said,

"CIRM does not have a communication plan, and there is lack of clarity on how to address mission-based communication to CIRM’s various target audiences, especially the general public....The best way to facilitate results-based communications is to 1) quantify goals and outcomes in CIRM’s strategic plan and 2) report on achievement of those goals and outcomes by enhancing CIRM’s annual report with additional performance-based information."

Another performance assessment of the stem cell agency is also underway. It is being conducted by the prestigious Institute of Medicine and is costing CIRM $700,000. That report is expected this fall.

CIRM's board of directors is scheduled to consider the Moss Adams report at its meeting May 24.

Our take: While the findings and recommendations of the performance audit were delicately worded in many cases, they brought out issues that need to be addressed, many of which have been around for a great deal of time. At their meeting next week, CIRM directors should act very directly on the recommendations. They can do that by requiring a written report each month from CIRM Chairman J.T. Thomas and CIRM President Alan Trounson on the specific steps that they are taking to implement the performance audit's recommendations. Otherwise, the inevitable drift will set in.

Researcher Alert: CIRM Making Changes in Grant Administration

The California stem cell agency is readying a long list of changes that will affect all of its 453 grant recipients and all future awards.

Many of the changes are minor. Some have been requested by grantees. Others are aimed at dealing with issues posed by larger grants. Some reflect the agency's move to more streamlined reporting.

Amy Lewis, CIRM's grant management officer, has prepared an introductory memo along with the proposed changes for discussion at Thursday's board meeting in Los Angeles. She said the proposal is in its early stages and will not require a vote this week.But it would behoove those affected to carefully check the grant administration policy to see how it might alter their lives.

Former iPierian Exec Joins California Stem Cell Agency as CFO

A former executive at a California stem cell firm has been named as the first chief financial officer of the seven-year-old, $3 billion California stem cell agency, it was announced today.

Matthew Plunkett, CIRM CFO
CIRM Photo

Matthew Plunkett, former vice president and chief financial officer of iPierian Inc., has been at work at CIRM since late last month. The agency said in a news release today that Plunkett is overseeing "budgeting, forecasting, financial compliance and reporting, and implementation of the industry loan award program."

Plunkett will also "play a key role in securing opportunities to leverage CIRM funds with additional outside capital," said CIRM Chairman Jonathan Thomas.

Plunkett worked for iPierian from 2009 until last April. While he was at the firm, it received $7 million in grants from CIRM. The South San Francisco business has a unique connection to CIRM. Major investors in iPierian, including John Doerr of Kleiner Perkins Caulfield Byers of Menlo Park, pumped nearly $6 million into the 2004 ballot campaign that created CIRM. That amounted to 25 percent of the total contributed to the campaign, which was headed by Robert Klein, who later became the first chairman of the stem cell agency.

CIRM has said no connection exists between the contributions and subsequent awards to iPierian.

The agency has needed a chief financial officer for some time. It has sometimes struggled with routine budget matters, although that problem seems to have been largely solved even before Plunkett was hired. Plunkett will report to both the agency's chairman, Jonathan Thomas, and CIRM President Alan Trounson, in a continuation of the troublesome dual executive arrangement at the stem cell agency.

Prior to joining iPierian, Plunkett worked for Oppenheimer/CIBC World Markets from 2000 to 2009. In his last position there, he was managing director/head of West Coast biotechnology. He holds Ph.D. in organic chemistry from UC Berkeley.

Plunkett, who is earning $260,004 annually, began work on Nov. 28. Today's press release on his hiring came after the California Stem Cell Report inquired on Saturday about progress in filling the position.

Here is a link to a brief article in the San Francisco Business Times about the Plunkett announcement.
(An earlier version of this item incorrectly said Plunkett started work on Nov. 11 based on his resume which said "11/11.")

California's $25 Million Loan to Geron: Approval Came Only After Major Departure from Longstanding Procedures

The state of California chalked up a historic first last May when its stem cell research agency approved a $25 million loan to a corporation engaged in another first – a clinical trial for a treatment created from human embryonic stem cells.

It was the first time that the state has funded a clinical trial -- one watched by untold numbers of persons globally who hope that stem cells will ease their pain and cure their suffering. The funding is also critical to Geron Corp. of Menlo Park, Ca., which initiated the safety trial for its spinal injury stem cell therapy.

CIRM President Alan Trounson told agency directors in May,

"It's just possible that this trial might have faltered without our backing."

Approval of the loan, however, came after the $3 billion stem cell agency publicly deviated significantly from its normal funding procedures. The Geron application was not given a public scientific score, standard practice for all the other 433 applications that the agency has approved over the last six years. The usual summary of grant reviewer comments was not provided to the public or the board. The three other applicants in the $50 million round all withdrew prior to presentation to the CIRM board – another first in CIRM's grant program. And no public explanation was provided at the time for the departures from long-established procedures.

In response to questions from the California Stem Cell Report, CIRM defended its actions. James Harrison, the board's outside counsel, said the unusual handling of the Geron application was necessary to protect confidential information. Harrison said,

"CIRM has a significant challenge and responsibility to protect the confidentiality of the companies’ submissions as any violation could have adverse consequences for the companies, including a material disclosure, particularly for those companies that are publicly traded."

Regarding the failure to provide a summary of grant reviewer comments, Harrison said a summary was indeed available, pointing to a document that contained only a 67-word listing of the criteria used by evaluators. By contrast, the top-scoring applicant for a $14.6 million disease team grant in 2009 had a 1,219 word summary review.

Regarding withholding the scientific score of the Geron application by reviewers, Harrison said publishing it would have been "confusing" because all the other applicants had dropped out.

Asked whether the applicants were encouraged by CIRM in any manner to drop their applications. Harrison replied,

"In this case, three applicants, on their own volition, withdrew their applications before the board meeting and therefore the applications were not presented to the board."

Asked whether the other applicants had any sort of assurances that they would have a better chance later, Harrison said,

"CIRM has made no assurances, either directly or indirectly, to any applicants, including the applicants for the Targeted Clinical Development Awards, regarding future funding.  CIRM does try to assist applicants by providing feedback, where appropriate."

As to the lack of an explanation to the public and interested parties for the departure from longstanding procedures, Harrison did not respond directly. He said,

"This was CIRM's first clinical trial review and we expect to strengthen and refine the procedures for the next round, including explaining to the public how and why clinical review summaries differ from other CIRM grant review summaries."

(The full text of Harrison's statement can be found here.)

Geron's application was approved in May by directors on a 16-1 vote. The dissent came from Joan Samuelson, a patient advocate member of the board and a member of the grant review group.

According to the transcript of the directors meeting, she said the trial was not ready and CIRM was not ready.

"There were lots of -- this is based on the peer review and the comments by the scientist members of the grants working group. There were many concerns that many of the scientist members felt should be satisfied before embarking on a clinical trial and they weren't."

Ellen Feigal, CIRM's vice president for research and development, responded following Samuelson's remarks. Feigal said,

"I want to make it clear, making the decision to move towards and into a clinical trial is a very complicated decision. It's not black and white. It's based on judgment, on experience, on science, and the data, and there's not really a right or wrong answer. And I just think that the tenor of the discussions that we've had, the tenor of the discussions of the grant review group had were appropriately deliberative and considered all the different issues."

(Editor's note: Discussion of the Geron application begins on page 142 of the May transcript. It picks up again on page 153. The 16-1 roll call vote on the application by the 29-member board can be found here. Five board members did not vote because of conflicts of interest. The others either were not present or did not answer the roll call. Votes by the grant review group are not disclosed. The names of scientists specifically evaluating applications are not disclosed except for the membership of the grant review group.)