Media Coverage: Political and Research Implications of hESC Ruling

Here are some excerpts and links to interesting coverage of yesterday's federal court ruling on stem cell research.

Text of the judge's ruling from the Washington Post.

Wall Street Journal, reporters Laura Meckler, Gautam Naik and Brent Kendall on election year politics and more.

"It also could inject the divisive issue into election-year politics and spark discussion in Congress whether to try to nullify the decision by writing new legislation.... 

"The government is spending about $137 million on human embryonic stem cell research this year and is projected to spend about $126 million next year. It's unclear whether the judge's decision would affect currently funded projects. Stem-cell advocates were calling on the government to appeal the decision and seek to have the preliminary injunction nullified....

"A significant amount of stem-cell research will go forward thanks to private funding and the state of California's ambitious stem-cell initiative, which isn't affected by Judge Lamberth's ruling. The California group (CIRM) spends $250 million annually on stem-cell research, with some 30%-40% of the money directed to embryonic stem-cell research."

Los Angeles Times, reporters Karen Kaplan and Naom Levy, on legal view of ruling.

"UCLA law professor Russell Korobkin, an expert on stem cell legal issues, said the ruling was "a terrible decision."

“By considering all research part of an unbreakable continuum, the decision implies that the Dickey-Wicker Amendment has no limits, which is an unconvincing interpretation, Korobkin said. 'It suggests that by conducting research on an acorn a scientist would also be conducting research on an oak tree, because acorns come from oak trees,' he said.”

New York Times, reporter Gardiner Harris, on feeding stem cells and politics of the decision.

"'I have had to tell everyone in my lab that when they feed their cells tomorrow morning, they better use media that has not been funded by the federal government,' said Dr. George Q. Daley, director of the stem cell transplantation program at Children’s Hospital Boston, referring to food given cells. 'This ruling means an immediate disruption of dozens of labs doing this work since the Obama Administration made its order.'

“In his ruling, Chief Judge Royce C. Lamberth of the U.S. District Court for the District of Columbia wrote that his temporary injunction returns federal policy to the “status quo,” but few officials, scientists or lawyers in the case were sure Monday night what that meant. Dr. Daley was among those who said they believed that it meant that work funded under the new rules had to stop immediately; others said that it meant that the health institutes had to use Bush Administration rules to fund future grants....

“The ruling could prove politically tricky, since it returns to public attention the politically divisive issue of abortion and research politics. President Obama made support for the research a signature part of his campaign, and he over-turned the Bush Administration’s more restrictive policy in the first two months of his administration.

“Polls show that the public generally supports embryonic stem cell research, and Judge Lamberth’s ruling — while a surprising legal setback for one of the administration’s signature scientific policies — could prove politically beneficial for the administration by reminding votes of a popular decision.”

CIRM still open for business -- Ron Leuty, San Francisco Business Times, The Associated Press(AP story appeared in The Sacramento Bee, San Diego Union-Tribune and other papers)

Washington Post story, reporters Rob Stein and Spencer Hsu

"'This is devastating, absolutely devastating,' said Amy Comstock Rick, immediate past president of the Coalition for the Advancement of Medical Research, a group of patient organizations that has been lobbying for more federal funding.

"'We were really looking forward to research finally moving forward with the full backing of the NIH. We were really looking forward to the next chapter when human embryonic stem cells could really be explored for their full potential. This really sets us back,' Rick said. 'Every day we lose is another day lost for patients waiting for cures.'"

CBS News on ruling and “snowflake adoptions”

CIRM Director Prieto Says hESC Research Ruling 'Almost Beyond Belief'

CIRM Director Francisco Prieto, a Sacramento physician, sent in the following comment on our item on today's ruling temporarily halting federal funding of hESC research.

"I think you're opening hits the nail on the head: this decision 'makes clear the importance of alternative funding sources such as the California stem cell agency.' It is almost beyond belief that the court could find that the plaintiffs really met the high standards for a preliminary injunction to call an immediate halt to Federal runding, i.e. that 'there is a substantial likelihood of success on the merits; (2) that the plaintiff would suffer irreparable injury absent an injunction; (3) that an injunction would not substantially injure other interested parties.' I believe none of these are true. Certainly researchers using adult stem cells have had unfettered access to compete for NIH funding since the Bush decision in 2001, and continue to be able to compete for funding. It seems almost obvious that this decision if upheld would injure substantially other interested parties - all the millions of people with chronic disease who hope that this research may lead someday to a cure."

California Stem Cell Agency Deplores Ruling Nixing Fed hESC Research

A federal judge today put a temporary halt to federal funding of research involving human embryonic stem cells in a move that makes clear the importance of alternative funding sources such as the California stem cell agency.

Some had questioned the relevancy of the state's $3 billion research effort after the Obama administration restored cash for hESC grants. Critics said California was no longer needed because the feds were back in the game. But despite the ruling today, the state can proceed with its research because it is not constrained by the federal law cited in the court action.

Today's ruling is not a final decision in the case and is likely to be appealed. But it could mean that NIH funding in this controversial area will be stymied for some time, depending on the legal skills of its attorneys. Meanwhile, California will remain the largest source of hESC funding in the nation, although it has been moving into other areas as well. In fact, some have criticized the agency for not continuing to focus intensely on hESC research, which was the justification for spending $3 billion that was presented to voters in 2004.

In a statement, CIRM said it “deplored” the ruling, declaring that it was “immoral.” CIRM said its research would continue unabated, but noted that today's ruling will have a major negative impact elsewhere.

CIRM President Alan Trounson said,

“The decision is a deplorable brake on all stem cell research. Many discoveries with other cell types, notably the so-called reprogrammed iPS cells, would not happen without ongoing research in human embryonic stem cells. This decision leaves CIRM as the most significant source of funding for human embryonic stem cells in the U.S.”

CIRM Chairman Robert Klein said,

“It would be immoral to unnecessarily delay the critical medical research that is vital for human embryonic stem cell therapies to reach patients suffering from chronic disease and injury. We must remember that the microscopic cells used for this research would otherwise be thrown away by in vitro fertilization clinics, by couples that had finished their family planning.”

CIRM's statement said,

“Under this decision, even research using on the hESC lines approved by President George W. Bush will be halted.

“However, CIRM will continue to fund research on all hESC lines recognized by the Bush administration as well as newer lines approved by the National Institutes of Health during the past eight months. This points to the importance of CIRM’s California model of sustained funding in this field that promises to create thousands of jobs in California as well as improved therapies for patients in Californian and around the world.

“With federal funding uncertain, CIRM will continue providing a stable source of funding for those researchers who have committed their labs to pursuing new therapies based on work with human embryonic stem cells. Through this ongoing funding, CIRM expects to be able to continue to leverage California’s investment through its Collaborative Funding Partners, grant-making agencies in seven countries and Maryland and New York.”

The statement continued,

“CIRM will also continue to fund research with other types of stem cells, particularly progenitor cells that can create many cell types and other pluripotent cells such as induced Pluripotent Stem cells (iPS cells). However, it is important to note that work in all these cells types requires insights gained through work with hESCs to proceed with maximum efficiency. hESC research informs the entire field.”

The $3 Billion Question: Kids, Scientists and CIRM

Two California newspapers today offered quite different views of the world – one bleak and the other filled with hope. They implicitly captured the framework that will determine the fate of the state's $3 billion stem cell research effort.

In the simplest terms, it could boil down to school kids vs. stem cell researchers. Or it could be framed as school kids vs. the health of millions or in some other way that is more favorable to the California stem cell agency. And there could lie the fate of a measure – perhaps as early as 2012 – asking the people of California to pony up another $4 billion or so to pay for hundreds of more stem cell experiments.

But first, CIRM will have to overcome emotions generated by stories like those in The Sacramento Bee today. Reporters Diana Lambert and Melody Gutierrez wrote,

“Last year, public school districts started the year with fewer teachers, bigger classes and reduced resources.

“This year, it's worse.”

Classes with 30 or more students are common, libraries are closing, buses are being eliminated, counselors are vanishing. Music, art and shop are luxuries at some schools. And the kids are going to school fewer days.

In marked contrast came the Los Angeles Times story. Rachel Bernstein wrote about research funded by the California stem cell agency that could offer a “cure” for HIV. The “cure” is many years – if ever – down the road, but the preliminary work has generated a wave of hope for many thousands of persons.

Central to both stories is California's $19 billion budget crisis, which is not going to vanish any time soon. Given the shortage of cash, the question becomes whether the state should use its dwindling resources to finance stem cell research, which will not have a genuine payoff for many years and is also being funded by the federal government. Or should the state educate its children, improve its hard-pressed undergraduate university system, aid the poor and disabled and provide health care that is urgently needed by those who cannot afford it.

These are not questions for the stem cell agency today. It already has voter approval to borrow $3 billion via state bonds at a total cost of $6-$7 billion. But they are questions for the voters in a few years. In the past five years, the agency has already awarded $1.3 billion and is moving rapidly into ever larger rounds of grants. CIRM Chairman Robert Klein is acutely aware that, in political and scientific terms, the need for more cash is just around the corner. He is pushing hard for CIRM grants that will hopefully generate tangible results that will win endorsements and voter approval of another bond measure. Last week, he gained approval for a $600,000 Institute of Medicine study of CIRM that he expects will be key to the success of a bond measure. It is expected to be completed in time for the general election in the fall of 2012, a presidential year.

Currently, the California stem cell agency is all but invisible to state's beleaguered public. Stem cell research is not on their list of concerns, which deal with holding or finding a job, paying the mortgage and such simple matters as getting the kids to class when the school bus is cancelled.

Building support for another bond measure means generating thousands of stories like the one in the Times. The public must perceive CIRM as a positive force that will improve their lives and the lives of their loved ones. A tall task, but winning an election is like winning a war. It requires an intense, sharply focused drive that overruns all who stand in the way.

The California stem cell agency is not likely to emerge victorious if the election is framed as children vs. stem cell researchers.  If CIRM is to prevail, it must build a squeaky clean image – one that generates real hope but is based on meaningful results that are publicly impressive. That politically salubrious perception is not yet cemented in the minds of the California public.

It is unclear whether the Institute of Medicine study will do just that. Unclear as well is whether the study will address the fundamental question of whether the borrowing billions for research is the best way for the state to spend its money. Probably not is our guess. That would mean assessing the state's overall needs and prioritizing them.

At CIRM, however, discussion of the institute's study is couched often in a political context, which raises other issues. During the next two years at the agency, where will the scientific judgment end and the politics begin? It is natural for any organism, including a state agency, to want to perpetuate itself for good and not-so-good reasons. Politics, as well, is always part of the governmental process, which includes CIRM. However, its directors and the staff must tread carefully.

The campaign to win approval of a $4 billion bond measure is already drawing considerable attention within CIRM. The effort will need more soon. A baseline public opinion poll would be standard at this point to measure initial voter perception of CIRM and to identify ways in which the public could be influenced. That and other electioneering moves, however, are not suitable for a state agency.

Klein has said he will step down from the CIRM chairmanship in December. So far, however, he has given no indication that he will let go of California stem cell issues. He could well remain on the board. He has his own, personal stem cell lobbying organization(Americans for Cures), which grew out of the 2004 campaign for Prop. 71 that he directed. CIRM also could create a nonprofit entity that could take up tasks that are not appropriate for a state agency. Perhaps he might find a home in one or both of those organizations.

Whatever path Klein follows, if he chooses to lead the drive for more CIRM funding, he will face a formidable task. Unless something changes dramatically, winning approval of a $4 billion bond measure in two years seems an unlikely event given the current hardscrabble condition of the Golden State.

Correction

The "$243 Million" item on Aug. 19, 2010, incorrectly said that the "application process" for the latest disease team round would begin next year. The RFAs for the planning grants for that round are scheduled for later this year. In order to apply for a full grant later, an applicant must have already received a planning grant.

Massive, $243 Million Disease Round Gets Okay from Stem Cell Agency

Directors of the California stem cell agency today gave the go ahead to a $243 million disease team grant round aimed at generating a “development candidate” for a clinical trial, doubling the size of the original proposal by the CIRM staff.

The huge round would fund up to 30 planning grants and 12 full grants of up to $20 million. It would come on top of the initial disease team round of $250 million last October. The application process for the latest round would begin this November with planning grants, which are required to be eligible for full grants. Full grants are scheduled to be approved in 2012.


The size of today's round was doubled at the suggestion of CIRM Director Jeff Sheehy. He said most of the disease team efforts are risky and expected to fail. He said it was important to get more in the pipeline.

Sheehy first proposed 45 planning grants and 15 full grants. CIRM President Alan Trounson resisted the increase in the number of grants, declaring it would overtax staff and reviewers. After some discussion, Sheehy agreed to 30 planning grants and 12 full grants.

The board also approved a more than $600,000 study of its operations by the prestigous Institute of Medicine that would be expected to completed by the general election of November 2012. Chairman Robert Klein said the study would be key to winning voter approval of more billions in state bonds to fund stem cell research.

Sheehy supported the proposal, declaring it would be taken “very seriously” by editorial boards and other segments of the media as well as the public.

Duane Roth, co-vice chairman of the stem cell board, dissented. He said the study will require considerable work on the part of staff. He also said the board should not have “blind trust” that the findings would be ones desired by the board.

The study will be funded with part of the $3.5 million that CIRM has in private donor funds. The cost could increase beyond the $600,000 range because CIRM directors indicated they wanted some changes in the scope of the study. CIRM is currently involved in an expensive external review of its strategic plan and will be subject to a performance audit($400,000 or so), which it will also pay for, under the terms of legislation expected to be signed into law.

The board also approved paying its patient advocate members up to $15,000 annually. That action came during a session late yesterday, which CIRM had assured us would be solely an executive session.

In other actions, the board approved procedures for selection of a new chair and vice chairman. Klein has said he will step down as chairman in December. However, if the board does not vote on a replacement, he will continue in office.

Francisco Prieto, a Sacramento physician, was named chairman of the directors' Evaluation Subcommittee, and Ted Love, executive vice president of Onyx Pharmaceuticals, Inc., of Richmond, Ca. , was named vice chairman. The panel evaluates the performance of the chairman, vice chairman and president of the agency.

Here is a link to the CIRM press release on the meeting.

CIRM Board Meeting Underway

The board meeting of the California stem cell agency began about 10 a.m. today. Currently speaking is CIRM President Alan Trounson, who is reviewing recent research involving stem cells.

Today's Board Meeting Coverage Cancelled; Tomorrow's Still On

We are cancelling plans to provide coverage of today's CIRM board meeting. Don Gibbons, CIRM's chief communications officer, says the meeting will be in executive session for personnel matters, presumably the formal evaluation of CIRM President Alan Trounson, his first ever.

However, we will have coverage of tomorrow's board meeting, which begins at 9:30 a.m. PDT.

Coverage of Today's Stem Cell Board Meeting

We will be monitoring via the Internet this afternoon's meeting of the board of the California stem cell agency and filing items as warranted. The session is scheduled to begin at 4 p.m. PDT. We will also file items for tomorrow's session as well. It is scheduled to begin at 9:30 a.m. However, the CIRM board meetings usually start late.

On the agenda are instructions for listening to the Internet audiocast. The meeting itself is at Stanford.

(After this item was posted, Don Gibbons, chief communications officer for CIRM, informed us via email that today's meeting will be devoted to a personnel session, presumably the evaluation of CIRM President Alan Trounson. That will be private, and consequently we will have no coverage of the session this afternoon.)

Belated Info on Election of New CIRM Chair, $120 Million Grant Round and Costly CIRM Study

With only one business day remaining before its meeting this week, the California stem cell agency released details of its plan for an expensive study of its activities along with procedures for election of a new chairman.

The late-coming information disclosed that the proposed Institute of Medicine study of CIRM would cost $615,000. Previously, CIRM discussions indicated that the cost would be in $1 million range. The memo called for the study to be completed in August or September 2012, a few months prior to the presidential election. CIRM Chairman Robert Klein has said the study would be key to winning support for a multi-billion dollar bond measure that would be presented to voters at an unspecified date. CIRM relies state bonds -- borrowed money -- to finance its operations and grants.

The agency today also released an important memo on procedures for replacement of Klein, who said he will step down in December when his six-year term expires. Unclear is whether Klein wants to remain on the board as a regular member. The board cannot simply choose one of its members as the new chairman. Under the terms of Prop. 71, it must pick only from candidates nominated by the governor, treasurer, controller and lieutenant governor. In theory, however, it could reject all of them and ask for new candidates, although the memo does not discuss that possibility.

The procedures proposed by James Harrison of Remcho, Johnansen & Purcell of San Leandro, Ca., the board's outside counsel, envisioned nominations coming from those officials prior to the board's December meeting. Harrison said the board could meet behind closed doors to consider the candidates. Presumably that would be classified as a personnel session, since both the chairman and vice chairman are considered employees.

Another important item was posted late, in this case Friday. It is a proposal for a $120 million grant round, the second in the disease team effort.

As we remarked earlier, this information comes far too late for the public to evaluate it and formulate well-thought out comments for tomorrow's meeting.

CIRM Hiring of Former Geron Exec Raises Conflict of Interest Questions

The California stem cell agency has hired a former executive of Geron Corp. to serve as a consultant on a $50 million clinical trial award round in which Geron is expected to be an applicant.

He is Laurence Elias, who worked for Geron from March 2006 until October 2009 as vice president for oncology clinical development.

In April, Nature Medicine identified Geron as one of the likely applicants in CIRM's first ever involvement in financing a clinical trial. On May 24, CIRM hired Elias as a $50,000 consultant at a rate of $300 an hour. His contract runs until Dec. 31.

In response to a query, CIRM defended the hiring and said no conflicts of interest were involved. The agency said,

“Dr. Elias is an independent consultant and an accomplished clinical development professional. He was consulted for his technical and regulatory input to ensure that the clinical elements of the RFA were technically complete and accurate.  The concept for the clinical RFA had already been approved and as such Dr. Elias was not in any position to influence the overall scope or structure, nor will he have any role in evaluating applications.  Dr. Elias’s integrity and professionalism are beyond question.  CIRM staff and Dr. Elias complied with all conflict of interest requirements.”

The RFA for the clinical trial round was originally expected to be posted in April or May. It is now scheduled for Aug. 31. CIRM has not responded to repeated inquiries concerning the reason for the delay.

We asked CIRM for Elias' statement of economic interests, which some of its consultants are required to file. CIRM said one was not required in Elias' case.

Geron, in announcing Elias' hiring in 2006, said,

His responsibilities will include the planning, design and execution of clinical trial strategies and protocols as well as the monitoring of these multi–center clinical trials.”

The other two companies expected to be competing in the clinicial trial round are Advanced Cell Technology and iPierian, which is backed by venture capitalists who funnelled about $6 million into the election campaign to create the California stem cell agency.

Our take: The Elias hiring has all the appearances of a conflict of interest. We would not expect iPierian or Advanced Cell Technology to be pleased by the situation.

Bad Link Fixed

CIRM had a bad link to the transcript of the Feb. 3 meeting of its governing board, which was mentioned in the item, "economic interests statements." The link has now been fixed.

Economic Interest Statements of CIRM Directors Posted Online by California Stem Cell Report

Eight months ago, the only public body charged with overseeing the financial practices of the California stem cell agency unanimously recommended more openness and transparency on the part of the $3 billion enterprise.

Chaired by California's top fiscal officer, Democrat John Chiang, the Citizens Financial Accountability Oversight Committee said that CIRM should post online the statements of economic interests of its directors and top executives, following the practice of both Republican Gov. Arnold Schwarzenegger and Chiang himself.

Chiang said,

“To ensure that taxpayer dollars are spent lawfully, wisely and successfully, the stem cell program must pursue the highest standards of transparency to be fully accountable to the public.”

CIRM has all but ignored the recommendation. Instead, it has moved to prevent the committee from exercising more financial oversight of the state's unprecedented research operation.

In response to the controller's recommendation, the California Stem Cell Report is publishing online the statements of economic interest of the 29 directors of the stem cell agency along with those of some of the agency's top executives.

When Schwarzenegger announced his efforts at improving openness, he said,

“Transparency is fundamental to promoting efficiency and effectiveness in government and strengthening the democratic process by giving citizens enough information to reach their own conclusions about how their tax dollars are being spent.”

Understanding and assessing the performance of the California stem cell agency is even more critical than with most other state enterprises. CIRM holds a unique and unprecedented place in state government. Created by a $30 million ballot initiative campaign, it is isolated from the normal financial oversight functions of the governor and legislature. Its stream of income – all borrowed money(state bonds) – cannot be touched, despite California's grave financial crisis.

At the same time, CIRM is riddled with built-in conflicts of interest. Its 29-member board is
heavily influenced by directors tied to institutions that are the beneficiaries of its largess. More than $900 million of the $1 billion-plus that directors have handed out has gone to enterprises with members on the board.

None of this is going to change any time in the near future. Which makes it all the more important for the public to understand who has what at stake when it comes to giving away billions of dollars.

You can find the statements of economic interest here. Here is a link to a state document that helps to explain the nature of the information. You can find the statements of economic interest for Chiang's stem cell oversight committee on his Web site. Here is a link to the transcript of the committee's meeting last January during which questions were raised about accountability and openness at CIRM. Here is a link to the transcript of a subsequent CIRM board meeting during which CIRM President Alan Trounson described  (on p. 132) the discussion at Chiang committee meeting as a “strange critique” and “irrational attack.”  Here is a link to a piece by Los Angeles Times columnist Michael Hiltzik, who attended the meeting and wrote that the agency "has self-righteously fought every attempt to improve public oversight over its disbursement of what is, after all, the people's money."

(The statements of economic interest involving CIRM directors were provided via email by the agency at the request of the California Stem Cell Report, which the agency is required to do by law. They are also available via conventional mail from the Fair Political Practices Commission in Sacramento and in person at both agencies.)

Dismal Lead-Up to CIRM Board Meeting Next Week

If CIRM wants to keep the public in the dark about what its directors are up to next week, it is doing excellent so far.

With only two business days before the directors meeting, little noteworthy has been provided via the board's agenda to inform the public about how its money is being spent. Of nine significant matters coming before the directors, only two have some explanation. One of those is appointment of new members to the grant review group, an action that is routine. The other makes changes in contract policies.

On the agenda is a plan to pay one-third of its directors up to $15,000 annually. However, an ordinary reader would never know that. All the agenda says is “consideration of amendments to ICOC bylaws.” Of course, the public would have to also know there is a meeting next week. No notice of that has been posted on CIRM's home page.

A plan to spend $1 million for an external study of CIRM operations merits only eight words: “consideration of proposal commissioning IOM report on CIRM.” We wrote 853 words on the subject on Wednesday, and it is worth more. Good arguments exist for performing the study, but the public is not going to hear them from CIRM in time to comment intelligently.

All of which makes CIRM look as if it is trying to hide something. It goes without saying that this is a sad and dismal situation for an organization that is spending $6 billion (including interest) that comes from California taxpayers.

$1 Million Evaluation of Stem Cell Agency Comes Up Next Week

Directors of the California stem cell agency appear ready to commission a $1 million “gold standard” study of its operations with the hope that it will pave the way for voter approval of billions more for stem cell research, perhaps as early as November 2012.

The proposal is scheduled to be voted on at the CIRM board meeting next Wednesday and Thursday meeting at Stanford. However, few details of the latest version of the plan are currently available on the CIRM Web site.

Nonetheless, some information can be gleaned from the transcripts of the directors' Science Subcommittee meetings in May and July, when the proposed study was discussed.

Here is what we have been able to extract. The study would be performed by the prestigous Institute of Medicine(IOM). The cost would be in the $1 million range. CIRM Chairman Robert Klein is proposing that about half of the amount would come from private donors. In July, Klein referred to a 15-month timetable, which might be quite speedy for the Institute of Medicine, which moves slowly, according to the transcripts. If work begins in January, the study could be completed in time for the presidential election in the fall of 2012. Politically speaking, that is the likely to be the best time to seek approval of another multibillion dollar bond measure, given the larger voter turnout in presidential elections. Klein, however, did not mention a specific election timetable.

During the two subcommittee meetings, no CIRM director raised the possibility that the study would identify serious flaws in the agency's $3 billion operation. Klein predicted that the study “would be a solid milestone.”

Jeff Sheehy, chairman of the Science Subcommittee and a communications manager at UC San Francisco, said the IOM would provide a “gold standard objective evaluation.”

Sheehy continued,

“I certainly don't want to go off the board in two years without this report being finished. I don't think I could go to any member of the public, any editorial board, any member of the legislature, the governor, any elected official without some sort of external review of what's gone on with a billion dollars of the taxpayers money, especially in the middle of this horrible recession.”

Sheehy noted that the IOM is less than a household word. In May, he provided this description,

“The Institute of Medicine is an independent nonprofit organization that works outside government to provide unbiased and authoritative advice to decision makers and the public. established in 1870, theIOM is the health arm of the National Academy of Sciences, which was chartered under President Abraham Lincoln. The IOM asks and answers the nation's most pressing questions about health and healthcare. And the aim is to help those in government and the private sector make informed health decisions by providing evidence upon which they can rely.”

During the Science Subcommittee meetings, CIRM directors often referred to the IOM's vaunted independence, which they implicitly did not think would be affected by a $1 million contract. There also was no discussion of limitations that CIRM might impose on the scope of the study before signing a contract. In the case of a current $300,000 contract to assess the economic impact of the agency, CIRM specified that its economic consultants must “execute a vibrant and aggressive strategy” supporting CIRM, a requirement that fundamentally damages the credibility of whatever the their report says.

At subcommittee meeting in July, CIRM Director Philip Pizzo, dean of the Stanford School of Medicine and a member of the Institute of Medicine, said,

“Of any organization that I'm familiar with on a national level, there isn't any other that carries the weight of independence and critical review (of) the IOM and the National Academy of Sciences.”

Klein, who ran the 2004 Prop. 71 campaign that created the organization he now chairs, repeatedly framed the study in the context of a ballot campaign. He said he wanted it “finished in time that the public can analyze it before we go back and put forth the question about whether we're entitled to more bonds.”

Klein did not publicly identify potential donors to help pay for the study. A question could be raised about whether he or others intend to solicit funds from persons who have financial ties to enterprises that would stand to benefit from CIRM funding.

Directors acknowledged that the $1 million price tag appears steep. However, it is a tiny amount when compared to the $6 billion cost (including interest) of the stem cell research effort.

Klein's support for an IOM study seems to be in some contrast to his previous complaints about the amount of scrutiny (audits and otherwise) that CIRM has received from various sources. This spring, the agency also successfully stripped out of pending legislation a requirement that the state controller, who chairs a Prop. 71-created panel to oversee CIRM finances, commission an independent performance audit. Instead, the now CIRM-backed legislation (SB1064) places that audit squarely in the hands of the stem cell agency.

At the July meeting, Klein mentioned a proposal from the IOM. We have asked CIRM for a copy of that document.

Leadership and Small Things

Author and Harvard business professor Rosabeth Moss Kanter weighed in this week on “big traps in small lapses.”

The case in point was the recent resignation of HP CEO Mark Hurd, a man who made more than $66,000 a day, because he fudged a $20,000 expense report.

Kanter asked,

“How can very smart, accomplished people do such stupid things?”

Kanter, whose 18 books have won her recognition as one of the 50 most influential business thinkers in the world, noted that Hurd has a fair amount of company.

“Hurd is not the first, and probably won't be the last, top leader to fall from grace over seemingly trivial and avoidable lapses of judgment.”

Citing several cases ranging from the US military to politics, she said the underlying causes include embarrassment (fear of disclosure), lack of attention and arrogrance.

Her bottom line:

“As is often said, the devil is in the details — and so is the angel. Signs of character are most visible when they are least visible — that is, demonstrated by what people do when they think no one is watching, such as following the rules or taking the moral high ground with no audience observing them. That's why the signals of a leader's judgment lies in the small things.”

Her comments apply to leadership in any organization.

Cedar-Sinai's Melmed Named to CIRM Board

Shlomo Melmed 

The governing board for the $3 billion California stem cell agency has a new member – Shlomo Melmed, who is senior vice president for academic affairs and dean of the medical faculty at Cedars-Sinai Medical Center in Los Angeles.

Gov. Arnold Schwarzenegger named Melmed to replace Ricardo Azziz, who left California to head the Medical College of Georgia. Azziz was also a top executive at Cedars-Sinai.

The Cedars news release last week on the appointment said,

“Melmed, the Helene A. and Philip E. Hixon Chair in Investigative Medicine at Cedars-Sinai, is an internationally recognized endocrinologist and specialist in pituitary disorders. His research, which is primarily focused on the regulation of growth hormones and causes and treatments of pituitary tumors, has impacted endocrine care worldwide, and has consistently been funded by the National Institutes of Health since 1980.

“He has authored more than 300 articles in prestigious peer-reviewed journals, trained more than 60 physicians, scientists and graduate students, and played a major role in leading the growth of research and educational programs at Cedars-Sinai.”

Melmed is also professor and associate dean at the UCLA School of Medicine.

(Cedars-Sinai photo)

Emotionalism and Potential Favoritism Cited as Need for Changes in CIRM Grant Appeals

Passion and favoritism, democracy and gamesmanship – all are part of the ongoing discussion among directors of the $3 billion California stem cell agency as they try to fix what some of them call a “broken” grant appeal process.

Hundreds of researchers will be directly affected by whatever decisions the governing board might make. The agency still has roughly $2 billion to hand out.

Indirectly affected are patient advocates and others who may think that research that could help them -- and others like them -- is receiving short shrift.

CIRM's directors have been bedeviled for more than 2 ½ years by appeals from researchers whose applications have been rejected by grant reviewers. It wasn't an issue up to that point because most rejected researchers did not avail themselves of the opportunity to make a personal pitch to the board – an action that they are entitled to under state law. Either scientists weren't aware they could speak to the board directly, as any member of the public can, or they weren't brazen enough to do so.

The directors' new Science Subcommittee has taken up the extraordinary petition process in two meetings this year. But nothing has been heard at those meetings from researchers. One likely reason is the agency's failure to make public in a timely fashion a draft of what they are considering. In July, a proposal for “re-scoring” rejected applications, under certain circumstances, was not made available to the public until one business day before the subcommittee meeting.


Jeff Sheehy, a communications manager at UC San Francisco, is chairman of the Science Subcommittee. A patient advocate member of the CIRM board and a member of the grants review committee, he is one of those who describe the petition process as broken. None of the 29 CIRM directors has expressed satisfaction with how petitions are handled.

At the July Science Subcommittee meeting, Sheehy noted that “a lot of applicants” see no disadvantage to filing a petition and consume an “an enormous amount” of CIRM staff time. According to the transcript, he said the petitions have degenerated into “gamesmanship.” Sheehy said, however, the ability of any person to appear before the CIRM governing board is a “positive feature of the California public policy process.”

CIRM director Joan Samuelson, also a patient advocate member of the board, said,

“I don't see it as a broken system exactly. There are concerns about it. But maybe it's like democracy. We're not nuts about it, but it's the best we've got.”

CIRM divides its grant appeal process in two ways. One is formally called an appeal. It is handled behind closed doors, but probably shouldn't be, and involves conflicts of interests. The staff makes decisions on those issues, although they could be raised publicly by a researcher if he or she chose to do so. Over the past few years, more scientists came before directors seeking reconsideration on other grounds. As a result, the board created something called an extraordinary petition, which is just another way of appealing a negative decision by reviewers.

This spring, nine researchers filed petitions, nearly one-third of rejected applications that were rejected. Four petitions were successful. The process, however, tested the patience of the board.

Some scientists have appeared before the board backed by a small cadre of patient advocates for diseases and persons suffering from serious afflictions, which has raised concerns about the role of emotions in making funding decisions. The presentations are powerful. It would take a cold, cold individual not to be swayed.

In July, CIRM Director Philip Pizzo, dean of the Stanford School of Medicine, brought up what he described as the “emotional overtone” of the presentations. He said that board members understandably respond “when someone speaks with deep concern and passion, particularly about a member of their own family.”

Sheehy responded,

"To be perfectly honest, Dr. Pizzo, that was one of the driving forces for this policy because a lot of times I find myself compelled by emotion, and I've lost the science.”

Sheehy said the re-scoring plan could evaluate a petition in “an atmosphere where there is no emotion.”

CIRM Director Oswald Steward, director of the Reeve-Irvine Research Center at UC Irvine, said he did not think that a new policy was needed on re-scoring. He said that directors already have the power to send back a grant for re-evaluation, although that has never happened as far as we know. It would seem to require nothing more than a vote of the board. However, no procedures are in place for staff to deal with such an action.

Steward also discussed how petitions can lead to favoritism. In the normal CIRM grant approval process, the names of applicants are not disclosed when their applications come before the board. However, in some cases it is not too difficult to determine their identities. But under the petition process, the researchers are required to publicly identify themselves, even if they do not appear before the board. The board also does not have copies of the actual applications, only a summary of reviewer comments.

Steward said,

“This is a more fundamental thing, and I've been thinking about this in terms of this whole issue of extraordinary petitions. The thing that we most often run into is an investigator who, first of all, identifies themselves, which is really...one of the fundamental problems with this process, because if this is somebody we all know, we say, 'Oh, well, this person deserves some really extra attention.' And if it's not somebody we know, then maybe we pay less attention to it. It really is a fundamental...unleveling of the playing field.

“The problem that we most often run into is that whoever says...the reviewer missed this, or there's a mistake or whatever, and we have in front of us the letter from the investigator, but we're still unable to look at the grant itself or the comments of the review panel. So my specific proposal that now I'm going to make for all of the extraordinary petitions is that if an investigator wants to make an extraordinary petition, they should volunteer themselves to provide the (directors) with a copy of the original proposal and a copy of the review. In other words, let's get all the issues out on the table for our consideration.”

An odd bit of CIRM management muddle also surfaced during the July session. CIRM President Alan Trounson said he was not aware of the staff proposal for re-scoring grants and expressed reservations. Trounson's comments triggered some irritation on the part of Sheehy, who said he had been working for some time with CIRM staff on the matter.

No decisions were made last month on changes in the petition process. Another Science Subcommittee hearing is likely in the next couple of months.

California stem cell scientists do have something significant at stake in all this. Even if they cannot appear directly before the subcommittee, it is in their best interests to weigh in with constructive suggestions. They can be sent Gil Sambrano, the staff member who deals with grant reviews. His email address is gsambrano@cirm.ca.gov.

Stem Cell Directors Putting Off More Recruitment Grant Decisions

Directors of the California stem cell agency will meet for two days at Stanford University Aug. 18 and 19, and they are not scheduled to give away any money.

The board orginally was scheduled this month to approve some new, multimillion dollar recruitment packages for star researchers from out-of-state. The grant review group met in July to consider applications in the $44 million program. However, the matter is not on next week's agenda.

We are querying the agency concerning the absence of the awards. A number of possibilities exist. One is that no applications were of sufficient quality. Another is that the matter was delayed until a researcher is actually signed. That would avoid the awkward situation that occurred with the first recipient of the awards, Robert Wechsler-Reya of Duke. The board approved $6 million for him in April, although he had not yet made a decision to come to California and the Sanford-Burnham institute. He did not actually make a decision until last month.

Don Gibbons, chief communications officer for CIRM, said the award was postponed because "the candidate being brought forward wanted more time to notify their current

home institution."

(Editor's note: The preceding comment from Gibbons was not contained in an earlier version of this item.)

The board is also considering a proposal for another round of disease team grants, commissioning an expensive, Institute of Medicine study of CIRM and approving a policy that could lead to compensation of up $15,000 annually to patient advocate members of the board.

With only five business days remaining before the meeting, CIRM has listed only cryptic descriptions of the matters to be considered next week. It has failed to post on the agenda any material explaining exactly what the directors are planning to act on.

CIRM Directors Pay Proposal Advances; Another Openness Failure on Grants Management System

The California stem cell agency is set to pay 1/3 of its 29-member board of directors as much as $15,000 a year.

The action, however, is contingent on passage of legislation (SB1064) that is now in the “suspense” file in the Assembly Appropriations committee. Legislation in “suspense” is usually on hold pending action on the state budget, which is not likely to be adopted any time soon.

According to a CIRM spokesman, the agency's directors' Governance Subcommittee on Tuesday approved the new pay policy, which is aimed at compensating the 10 patient advocate members of the board for the extra time that they must put in. The policy will go before the entire board later this month.

A large part of the burden placed on patient advocate members of the board stems from the conflicts of interests built into the board by Prop. 71,  drafted by CIRM Chairman Robert Klein and a handful of others. The ballot initiative requires a super-majority (65 percent) for a CIRM governing board quorum, which is based on the number of board members eligible to vote. Since many of the board members have conflicts of interest that prevent them voting on matters before the board, the presence of patient advocates is necessary to take action – much more so than many other members of the board.

According to Don Gibbons, CIRM's chief communications officer, the subcommittee took no action on staff reports on CIRM's ongoing efforts to build a custom system to deal with its $3 billion in grants. Directors asked for a report after expressing concerns the effort could be an expensive failure. Details on their discussions will have to wait for release of the transcript.

However, once again, CIRM failed in its responsibility to the public by not posting the reports publicly in a timely fashion. The failure effectively bars the public from being able to make informed comments and violates CIRM's promise of highest standards of openness and transparency. Two reports were prepared. One did not appear until one business day before the Governance Subcommittee meeting. The other appears to have been posted on CIRM's Web site only minutes before the meeting was scheduled to begin.

We will have more on the grants management system when the transcript is posted.

Extremely Modest Coverage of Wechsler-Reya Signing; Status of Tannishtha Unclear

The signing of Duke stem cell “star” Robert Wechsler-Reya generated only one news story in California and none in North Carolina, where Duke is located, according to a Google/Yahoo search today on the Internet.

Other search engines, including Dogpile(an aggregator of search engines) and Bing, reported no stories on the successful multimillion dollar recruitment of the researcher to the Sanford-Burnham institute in La Jolla.

The lone article appeared in the San Diego Union-Tribune. Reporter Gary Robbins did not quote any officials from CIRM, which put up nearly $6 million as a signing bonus for Wechsler-Reya. But Robbins did specifically mention the agency and its recruitment program in the second paragraph.

Robbins quoted Josh Baxt, a spokesman for Sanford-Burnham, as saying,

"This is exactly what the award was meant to do: serve as a magnet. Dr. Wechsler-Reya is an ace, a star, who left a tenured post at Duke University to come here. We're very happy to get him."

The story said that Wechsler-Reya will be director of a 20-investigator tumor development program.

Robbins quoted the researcher as saying via email,

"I chose to move to Sanford-Burnham because of the diverse and vibrant research community there, and because of the tremendous resources the Institute offers for doing the kind of science I feel is important.

"The move will allow me to interact and collaborate with world-class cancer biologists and stem cell biologists, not only at SBMRI but in the broader San Diego area. I'm really excited about this opportunity, and look forward to being there."

We queried Sanford-Burnham yesterday concerning Wechsler-Reya's start date and the status of his spouse, Tannishtha Reya, also a Duke stem cell researcher.

A CIRM summary of the Weschler-Reya grant review last spring said,

“Reviewers also noted that the applicant institution has committed to recruiting the candidate's spouse, who is an independent stem cell scientist; this represents a particularly beneficial leveraging of award funds.”

Baxt replied by email,

“Dr. Wechsler-Reya will be starting around November 1. We cannot comment on Tannishtha Reya at this point.”

Neither scientist has responded to our queries regarding Reya's status with Sanford-Burnham.

It's Official: Wechsler-Reya Signs with Sanford-Burnham

The $6 million-plus recruitment of a Duke stem cell researcher to California seems certain to be the topic of considerable discussion this week in research labs around the nation, if not overseas.

The move – first reported by the California Stem Cell Report on Sunday – was officially confirmed today by the Sanford-Burnham Medical Research Institute in La Jolla and the California stem cell agency.

The agency put up $5.9 million in taxpayer funds in the form of a research grant. Sanford-Burnham added an “extremely generous commitment” to bring Robert Wechsler-Reya to the Golden State. He is the first recipient in CIRM's $44 million research leadership award program.

The stem cell agency's program is also likely the first of its kind in the nation. The Wechsler-Reya recruitment starts it off well, given its goal of bringing "franchise players" to California. The agency sent a message to stem cell researchers across the nation that they should be looking ever more closely at California if they want to move forward aggressively with their careers.

The effort also highlights the built-in conflicts of interest at CIRM. Potential beneficiaries of the program include 12 members of the 29-member CIRM governing board whose institutions could use the funds to lure talent.

Others outside of the state may not look kindly on the effort. It could increase the cost of retaining talent, which, of course, could lead to sweeter deals for researchers, even if they stay in place.

In California, some researchers may regard the recruitment as boosting the field generally. Others are likely to think the money may have been better used to fund scientists already in the state. Adding Wechsler-Reya to the pool of potential applicants for CIRM's remaining $2 billion also increases the competition.

Robert Klein, chairman of the California stem cell agency, said in a statement that scientists recruited through the effort will help develop innovative therapies and push CIRM's mission forward. He touted the effort as something of a job creation program for California, which is mired in a serious economic slump and a state budget crisis. Klein said,

“Bringing this caliber of scientist to California also creates high paying positions to staff the labs, providing new jobs and tax revenue to the state.”

The official statement from Sanford-Burnham today said that Wechsler-Reya was appointed professor and director of the Tumor Development Program in the institute’s NCI-designated cancer center.

The announcement quoted Wechsler-Reya as saying,

“The strength of the scientific community there, particularly in cancer biology, stem cell biology and neurobiology, is unparalleled. This move promises to transform the way we do science, and I am grateful to Sanford-Burnham and CIRM for making it possible.”

The news release did not mention Wechsler-Reya's wife, Tannistha, who is also a Duke stem cell researcher. We are querying the couple and Sanford-Burnham about whether she is also joining the institute, as was originally expected.

Oddly, CIRM's news release on the consummation of the deal seemed to downplay the monetary size of its role. It said that the grant to Wechsler-Reya was only $5 million, as opposed to $5.9 million.

California Gains Two Bright Stem Cell Stars from Duke

Robert Wechsler-Reya

Following a lengthy, multimillion dollar courtship, two Duke University stem cell researchers have decided to migrate to the Golden State's Sanford-Burnham Medical Research Institute, the California Stem Cell Report learned today.

Robert Wechsler-Reya is the first scientist to be recruited through a $44 million effort by the California stem cell agency. CIRM's board awarded him $6 million last April, although he was yet to make a final decision. Also believed to be coming to Sanford-Burnham is his spouse, Tannishtha Reya.

In addition to CIRM's signing bonus, Sanford-Burnham is providing “an extremely generous commitment of laboratory space, matching funds for equipment, additional support for relocation and research, and access to excellent core facilities,” according to CIRM documents.

Tannishtha Reya

An anonymous but well-informed source told us that the couple had made a final decision on the move to La Jolla in Southern California. We are querying the Duke researchers, CIRM and Sanford-Burnham for comment.

CIRM directors created the program last year to bring “paradigm-shifting” scientists – “franchise players” – to California. At least 12 members of the 29-member CIRM board are connected to institutions that can benefit from the program.

Look for more of what CIRM calls “research leadership awards” later this month. Reviewers met behind closed doors last month to pick some new, lucky recipients. Their decisions should go to the full CIRM board at its meeting later this month.

(Photos from the Reya and Wechsler-Reya labs)

Geron's Clinical Trial: Risk, Front-loading and Costs

The Vatican doesn't particularly care for the idea. "Unacceptable" was the word it used.

Over at Bioworld Today, it was "the dawn of a new era."

A reader of the New York Times warned of the danger of "front-loaded" arguments that can be detrimental to stem cell research.

What they were talking about is Geron and its re-vitalized clinical trial of an hESC therapy for spinal injuries. The FDA late this week lifted its hold on the effort. Andy Pollack of the New York Times said "cysts were discovered in some mice injected with the cells. Geron had to do another mouse study and develop better ways to check the purity of its cells."

Pollack wrote,

"Years of further testing will be required before the therapy would be proven and ready for widespread use, assuming it works."

Among the readers of Pollack's story was a person from Seattle who said,

"As in the case of most things in science, we just do not know enough to say which scientific modalities will bear fruit first if at all and when and hence multi-pronged approaches are needed. And the field of stem cell biology painfully realized a few years ago, some of these discoveries are fads that cannot be replicated by others ( I am referring to Catherine Verfaillie's assertion that adult stem cells can do most of what embryonic stem cells can do, a claim that has since been refuted/ withdrawn or generally agreed to be highly exaggerated at best). The damage done to stem cell biology from that fiasco is still evident. Hence most scientists would agree that front-loaded arguments for and against particular technologies are dangerous and can be detrimental to general scientific progress."

(Verfaillie is a CIRM grant reviewer.)

Over at UC Davis, stem cell researcher Paul Knoepfler, writing on his blog, called it a “milestone,” but noted that while the potential is high, the risk is very high as well.

Donna Young, Washington editor of Bioworld Today carried a detailed account concerning the trial. Her story began,

"The FDA's blessing Friday of the world's first clinical trial of a human embryonic stem cell (hESC) therapy has not only launched what may be 'the dawn of a new era' for medical treatment, but if successful, the therapies could alleviate much of the burdensome costs plaguing the nation's health care system, insisted Geron Corp. CEO Thomas Okarma."

Most of the news reports did not mention the seminal role of UC Irvine in the research leading to the clinical trial. You can find more details about that here on the Califoria Stem Cell Report.

Geron Go-Ahead Rouses Industry and Researchers

Geron Corp. said today that it hopes to begin within the next two months a clinical trial for an hESC therapy for spinal injuries, triggering a wave of ebullience from scientists, investors and patient advocates.

The company disclosed its plans following the lifting by the FDA of a hold on the effort.

Clive Cookson of the Financial Times of London caught the global significance. He wrote,

“The world’s first treatment based on human embryonic stem cells is set to begin a clinical trial within the next two months, in patients with acute spinal cord injury.”

For patient advocate Don Reed of Fremont, Ca., it was an emotional event. Writing on his blog, Reed said,

“The research behind this ground-breaking event was paid for a California law named after my paralyzed son, the Roman Reed Spinal Cord Injury Research Act of 1999.”
Reed continued,

“Christopher 'Superman' Reeve gave us his blessing, saying, 'One day, Roman and I will stand up from our wheelchairs, and walk away from them forever.' Cure did not come in time for our paralyzed champion, but we still believe in that great dream.”

Shares of Geron, a firm in Menlo Park, Ca., shot up 17 percent or 83 cents to $5.63. Analysts predicted skyrocketing share prices if the clinical trial proves successful.

Rob Waters and Molly Peterson of Bloomberg News interviewed Thomas Okarma, CEO of Geron. Bloomberg said,

"The FDA action strengthens Geron’s ability to start similar trials in the future, Okarma said. It also leaves regulators with a better grasp of how to review a completely new type of therapy.

"'It’s helped both of us to get up the learning curve together,' Okarma said. 'We’ve brought the FDA to a higher level of understanding which has been very positive and mutually beneficial. And phew, it’s about time.'"

Peterson and Bloomberg continued:

"Two other U.S. companies are working with embryonic stem cells. Advanced Cell Technology;of Marlborough, Massachusetts(and Los Angeles), is awaiting FDA approval to start a clinical trial in patients with Stargardt’s macular dystrophy, an eye disorder that causes severe vision loss.

"Viacyte, formerly known as Novocell Inc., a closely held San Diego company, is working on methods of turning embryonic stem cells into insulin-secreting cells for the treatment of diabetes."

Paul Knoepfler, a stem cell researcher at UC Davis, had predicted on his blog on July 1 that the FDA hold on Geron would be lifted “very soon.” Today he said,

"The hold was placed because of a 'higher frequency of cysts.' However many of us were wondering why the serious concern (and seemingly long hold) about non-tumorigenic cysts that were somewhat unremarkable in appearance. That remains unclear except that perhaps it was the "higher frequency" part. Despite being a bit puzzled about the length of the hold, I think in the long run caution makes sense."

CIRM President Alan Trounson said in a statement,

“This is an important milestone for the whole field to have an embryonic stem cell therapeutic in clinical trials. We are looking with hope and expectation that the transplant will be safe and effective.”

Geron is expected to be one of three firms (including Advanced Cell Technology) seeking funding from the California stem cell agency in its upcoming $50 million clinical trial round. The RFA was originally scheduled for May but was rescheduled for this month. CIRM appears likely to miss that target.

Pay Proposal for Patient Advocates on CIRM Board

The California stem cell agency is proposing to pay the 10 patient advocate members on its 29-member board of directors up to $15,000 a year for work performed in connection with their responsibilities for CIRM.

The move would implement some provisions of legislation that also removes the 50 person cap on the size of the CIRM staff. That legislation (SB1064) seems likely to be enacted this year. It is up for consideration in Sacamento next Wednesday by the Assembly Appropriations Committee.

Both the cap and the problem being addressed by the patient advocate proposal stem from Prop. 71, the ballot initiative that created CIRM and also wrote variety of minutia into law. The proposition requires a super-majority (65 percent) for a CIRM governing board quorum, which is based on the number of board members eligible to vote. Since many of the board members have conflicts of interest that prevent them voting on matters before the board, the presence of patient advocates is necessary to take action – much more so than many other members of the board.

A memo by James Harrison, outside counsel to the CIRM board, said,

"As a result of the requirements in Proposition 71, the Patient Advocate members of CIRM’s Governing Board are required to devote a substantial amount of time to the review of applications for research and facilities funding and the development of the standards pursuant to which research must be conducted. The time devoted to service on the Working Groups is above and beyond the time devoted to Board, subcommittee and task force meetings. In the aggregate, this service can seriously affect members’ ability to serve while simultaneously carrying out their other responsibilities, including their current occupations.

“Under the proposed bylaw, the Board would have the authority to set a daily consulting rate to compensate Patient Advocate members of the Grants Working Group and the Vice Chairs of the Facilities and Standards Working Groups for their service on the Working Groups. The Patient Advocates would continue to be limited to a per diem of approximately $116 per day for their service on the Board, Board subcommittees, and task forces. The proposed bylaw also addresses concerns that SB 1064 imposes no cap on the daily consulting rate the Board could set for Patient Advocate members of the Working Groups. Thus, it would impose a $15,000 annual cap and it would limit the daily rate to no more than 75% of the rate paid to scientific members of the Grants Working Group. In addition, the bylaw would require the Board to find that service on the Working Groups requires an extraordinary commitment of time.”

The CIRM directors' Governance Subcommittee will take up the pay plan at its meeting next Tuesday. Also on tap for the session are changes in outside contracting procedures. The agency is heavily reliant on contractors because of the 50 person staff limit.

The panel is additionally slated to discuss CIRM's grants management system, which has been a critical issue for the agency since 2007. A number of directors expressed concern at their June meeting about the staff decision to build a custom system, declaring that such efforts often have unfortunate outcomes. The staff report on the matter is not yet available to the public.

The public can take part in the subcommittee meeting at a number of teleconference locations throughout the state. The specific addresses can be found on the agenda.

Managing More than 300 Grants: CIRM's Thin Ice Question

A key panel of directors of the California stem cell agency on Tuesday will wrestle with ongoing issues involving its critical grants management system and consider changes in its policies concerning the many outside contractors CIRM is forced to rely on.

The agency has already posted some background information for the Governance Subcommittee meeting including a list of current contracts and the proposed changes in contracting. However, still missing is a report on the grants management system, which stirred strong concern from directors at their June meeting.

One director, Michael Friedman, CEO of the City of Hope, warned that CIRM was skating on “thin ice” with its plans to create its own software to monitor and track grants. Friedman said,

“Everybody has seen horrible examples of custom-designed systems that go bad.”

He continued,

“I have to express in the strongest possible terms my discomfort” with the CIRM staff decision to build a custom system.

Friedman's probing led CIRM directors to seek the report on the grants system for next week's meeting. CIRM plans to use the system for the entire grant process from application to termination. CIRM has awarded more than 300 grants involving more than $1 billion. It plans to hand out another $2 billion over the next seven years or so.

The grants management effort has a long history, dating back to 2007 when directors were told it would cost only $757,000. By our count, the agency has spent $1.2 million so far, not including staff time, with much more coming this year. CIRM has not publicly provided its own total nor has it forecast how much more will needed to be spent until the system is fully developed. Also missing are projected annual maintenance and service costs following that point.

For the current fiscal year, the CIRM budget forecasts that spending on information technology will jump by 53 percent, from $817,000 to $1.2 million, an increase of about $433,000. Most of that goes for the grant system.

Also on tap Tuesday are unspecified changes in the bylaws for the CIRM governing board.

Tuesday's meeting will have teleconference locations in San Francisco, Los Angeles, Sacramento, La Jolla, Irvine and Palo Alto. If you would like to attend any of those sessions, you should check the agenda for specific addresses. In some cases, you will need to call CIRM because it has not provided enough information on the agenda to let the public know exactly where the meetings will be held.

Jonny and His Stem Cell Breakdown

We all owe a debt of gratitude to the reader who posted an anonymous comment yesterday concerning the reality of life in stem cell labs.

The commentator poor-mouthed his brief note as “bit light.” But we think it is just what the field needs – a well-seasoned researcher engaged in educating the unwashed – sort of.

The matter involves Jonathan Garlick of Tufts. A light-hearted fellow, he is given to using an unusual method to discuss science. In this case, stem cell science.

Known as Dr. Jonny Cool J, Garlick has put together a six-minute rap on the virtues of the field. It has been viewed nearly 22,000 times.

“This Guy RULEEEES!!!” said one viewer. And now, here's Jonny.

Despite New CEO Job, Alan Lewis to Continue to Consult for CIRM

The California stem cell agency said this morning that Alan Lewis will continue to work as a consultant to the agency although he has what appears to be a full-time job as the new CEO of Ambit Biosciences of San Diego.

In the wake of the announcement of the new job, we queried CIRM earlier today about Lewis' status as the interim vice president for research and development for the $3 billion stem cell agency, an arrangement that began only on June 21.

Don Gibbons, CIRM's chief of communications, replied via a comment filed on our item that reported that Lewis had a new job. Gibbons said,

“CIRM's president was informed of Mr. Lewis' new position Friday. From the outset the $250,000 salary was to be prorated based on days actually worked with the full amount assuming a five-day week. With his new position Mr. Lewis will scale back his time with CIRM from a planned two to three days a week to 2 to 3 days a month, and the salary will be prorated accordingly, while we continue the search for a VP for R&D. “

Gibbons did not mention whether Lewis would continue to hold the title of interim vice president. Ambit and Lewis have not yet responded to our queries concerning his job with CIRM.

CIRM's New Interim VP for Research Takes Job with San Diego Firm

Only a little more than a month into his $250,000, six-month contract with CIRM, Alan Lewis has taken a job as CEO of the Ambit Biosciences of San Diego.

An anonymous reader alerted us this morning to Lewis' new post. (See the reader's comment to the left of this item under the heading “recent comments” or via the comments function on the “$250,000 Contract” item.) The reader makes the reasonable assumption that Lewis, former head of Novocell, will no longer be working part-time with the California stem cell agency. However, the full press release on Lewis' sort-of-new job does not mention the CIRM contract. We are asking both Lewis and the stem cell agency to clarify his status.

Lewis has served as executive chairman of Ambit since March, a fact not mentioned by CIRM when it announced his appointment as interim vice president of research and development. (Lewis told us that his executive chairmanship began in May. Today's Ambit news release says March.)

The anonymous reader also makes a good point concerning the amounts paid to CIRM contractors. The best talent costs money. But failing to effectively manage a $3 billion investment costs a lot more. Also readers should understand that the figures paid to independent contractors should be discounted by 35 to 50 percent if they are to be compared to conventional salaries. Standard pay figures do not include the cost of fringe benefits paid by employers, such as health insurance, retirement contributions, Social Security payments, etc. Depending on the company or government, those fringe benefits can run to 35 to 50 percent. In the case of individual contractors with CIRM, they must pay for those benefits themselves.

But regardless of the justification for spending large sums for outside contractors, California voters can be outraged by the amounts. Their reaction is visceral and emotional, a phenomena we discussed in this item. You can see examples of it on this blog on items dealing with salaries at CIRM and some outside contracts.

We also want to extend our personal thanks to the anonymous reader who brought Lewis' new job to our attention and that of our readers. We encourage comments from all readers, especially those bring fresh information to California stem cell matters.

A Matter for CIRM to Ponder: California's Visceral Reaction to High Salaries for Public Servants

Lavish government or quasi-government salaries are an anathema to California voters.

They reacted predictably with outrage last week when news surfaced about what they considered egregious greed. Jail time was urged. “Nauseating” was another word that was used.

The response is something to be considered by directors of the California stem cell agency, which has its own set of generous executive salaries. What is important here is what the voters perceive as lavish or greedy – not the perceptions of recipients or the perceptions of those who approve the pay.

One non-CIRM instance involved the city of Bell, a tiny, not particularly well-off enclave not too far south of downtown Los Angeles. It was there that the city manager resigned after it was disclosed by the Los Angeles Times that he was earning $800,000 a year. And that left him with a pension estimated at $600,000, going on $700,000. Times columnist Steve Lopez wrote,

“The sad reality, dear Californian, is that depending on where you live, you may be personally contributing to the insultingly fat pension of ousted Bell city administrator Robert "Ratso" Rizzo.”

The other instance involved the executive director of the non-profit California School Boards Association, which is based in Sacramento and supported by tax dollars that are paid to the association by school boards. The executive, who is mostly a lobbyist, retired after Sacramento television station KCRA disclosed that he made more than $540,000 two years ago, the most recent figure available.

“Piggies,” “unconscionable,” “retire him to the county jail” were some of the 129 comments filed on a Sacramento Bee story about the matter.

The salary scale at the $3 billion California stem cell agency tops out at more than $500,000. Amounts paid to its top executives have triggered harsh comments from a handful of observers. CIRM's contracts with outsiders have also been targeted. But the pay and contracts have received no widespread notice.

A good case can be made that the salaries at the highest levels of the stem cell agency are necessary and appropriate. But that makes little difference to citizens struggling with layoffs, cutbacks and wage roll backs. Even before the current dismal economic climate, they would froth and foam reflexively at what they regarded as excessive pay for public servants.

As CIRM aims at another pitch to the voters for billions more for research, its directors and executives should be preparing for a visceral and emotional outburst from citizens concerning its executives' pay.

CIRM Defends Legality of Barring Public From Marriott Meeting

The California stem cell agency says it did not violate state open meeting laws when it barred two members of the public from a meeting in June at a San Francisco hotel.

In an unsolicited note earlier this month to the California Stem Cell Report, Ian Sweedler, deputy legal counsel for CIRM, said,

“The Bagley-Keene Open Meeting Act applies to multimember boards or commissions, like the ICOC (CIRM directors) and its subcommittees, not to agency staff, or to other meetings that staff attend or organize in the operation of the agency, including the SCNT workshop.  We are always mindful of Bagley-Keene, and careful to follow it when it applies.”

We asked him to clarify his response, including whether CIRM's actions in this case violated recent changes in the California Constitution that guarantee the public a broadly construed right to information about the taxpayer's business.

Sweedler said,

“Sorry if I wasn’t clear.  Yes, I am stating, without qualification, that the SCNT workshop did not violate Bagley-Keene or Proposition 59(the change in the state Constitution), or any other law that I am aware of.  You had stated that a specific CIRM activity violated a specific law, and I thought it was important to correct that.  Thanks.”

We understand and respect Sweedler's opinion. However, it would take a court decision to determine whether he is correct. Our research indicates that a strong case can be made that such meetings must be open. Additionally, the state's open meeting laws were written well before CIRM, an agency unlike any other in state history, came into being. They must be reinterpreted not only in the wake of the Prop. 71 but also in the wake of a new, much broader constitutional guarantee of right of public access. The most important point, however, is that CIRM has pledged to go beyond the mere compliance with open meeting laws. As we noted earlier,

“Legalities aside, it is not in CIRM's best interest to bar persons from any of its sessions – not to mention that it is not in the best interests of the people of California. CIRM needs to do more than meet the minimum standards of the state's sunshine laws. To fail to do so will create a record that will surely harm CIRM's public support and hamper its efforts to secure more funding after it runs out of the $2 billion it has left to spend.”

As to whether CIRM adhered to the law, Sweedler confirmed that the meeting in question included the attendance of at least one alternate for a CIRM director, Jeannie Fontana. We also understand that some persons were in attendance who had not been invited directly by CIRM.

Those facts have an impact on whether the ban on the public is strictly legal. The First Amendment Coalition of California watches over the application of sunshine laws in California. The group says,

“California law doesn’t exactly ban deal-making by politicians in smoke-filled rooms, but it comes close to doing that at the local level (under the Brown Act) and among state agencies (under the Bagley-Keene Act). The fundamental idea behind these statutes is that the full process of political deliberating and decision-making—justly likened to the making of sausage—should be conducted in the open, in public meetings for all to see. Although the laws allow for certain matters to be considered in 'executive session,' they are the rare exception (in theory, at any rate).”

The coalition's Web site discusses cases (see here, here and here) that have application concerning the incident at the Marriott Hotel. They deal with the presence of a board member (or alternate in this case) at meetings such as those held by CIRM, as well as the possibility that they could lead to an illegal “serial meeting” of the CIRM board of directors even if only CIRM staffers were involved at the initial meeting.

In one case involving local open meeting laws, the First Amendment Coalition quoted the state attorney general as saying,

“In construing these terms, one should be mindful of the ultimate purposes of the Act — to provide the public with an opportunity to monitor and participate in decision-making processes of boards and commissions.  Conversations which advance or clarify a member’s understanding of an issue, or facilitate an agreement or compromise among members, or advance the ultimate resolution of an issue, are all examples of communications which contribute to the development of a concurrence as to action to be taken by the legislative body.”

In other words, such meetings should be open to the public.

Sweedler's statements go beyond CIRM's earlier comments. The stem cell agency previously contended that the meeting was closed to protect proprietary information, but failed to argue that open meeting laws did not apply. Don Gibbons, CIRM communications chief, said the meeting was designed “to gather information for critical decisions regarding the direction our funding should take.” To us, that sounds like something the public should have access to.

CIRM has virtually nothing to gain by barring the public. It is not as if hoards will descend on the sessions. Even full CIRM board meetings rarely attract more than 10 members of the public. Indeed, the agency is likely to benefit from comments that come from a different angle.

Correction

In two recent items, we misspelled the last name of a Duke University researcher. The correct spelling is Rob Wechsler-Reya. We had it incorrectly as Weschler.

Questions and Commentary on Stem Cell Reprogramming

The California stem cell agency and a UC Davis stem cell researcher are blogging on the implications of research that indicates that reprogrammed adult stem cells may not be the magic bullet that avoids the problems associated with human embryonic stem cells.

You can find a summary of some of the research and discussion from CIRM's Amy Adams here. Paul Knoepfler of UC Davis said,

"So if iPS cells are not that similar to ESC, what does this mean?

"First, it is not the end of the world. Many of us had assumed that iPS cells are similar to ESC in some ways, but distinct in others. These studies simply validate that notion.

"Second, iPS cells are still very useful even if they are not quite so close siblings of ESC. In fact, iPS cells do not need to be extremely similar to ESC to be useful. The pluripotency and self-renewal of iPS cells makes them a powerful tool regardless.

"Third, iPS cells are a distinct type of stem cell from ESC and should be considered as such.

"Fourth, these studies also highlight that every iPS cell line made is distinct from the others made. The heterogeneity amongst iPS cell lines is probably more substantial than the differences between ESC lines, but ESC lines also vary between each other quite a lot as well.

"Finally, the tumorigenicity of iPS cells is a serious concern. A remaining open question is how prone iPS cells are to form malignant tumors (although don't forget that teratoma can be malignant!). We predict that iPS cells are dramatically more prone to produce malignant tumors compared to ESC."

(Editor's note: An earlier version of this item contained typos in the material that was inserted from Knoepfler's original post. He corrected those typos on his blog, and we have altered his quote above to reflect those changes.)