CIRM Directors to Hand Out $30 Million and Wrestle with Contracting Policies

Directors of the California stem cell agency meet next Wednesday and Thursday in the Los Angeles area to give away more than $30 million and to make undisclosed changes in its policies for outside contracting, which now run roughly $3 million annually.

CIRM, which is limited by law to only 50 employees, is heavily dependent on outside contractors for everything from public relations to legal advice to federal lobbying. Outside contracts are the second largest item in CIRM's operational budget, behind only its salaries and benefits.

The outside work includes such sensitive matters as computer systems and programs involving proprietary information from grant applicants and recipients and oversight of their performance.

The agenda for next week's meeting contains no information on exactly what contracting changes are being proposed. That is in keeping with CIRM's de facto policy of withholding such details from the public until it is too late for interested parties to comment in a timely fashion. With only three business days remaining before the meeting, CIRM Chairman Robert Klein has released only six words on the proposed changes: “consideration of amendments to contract policy.”

In a related matter, the board will consider the agency's contract with Remcho, Johansen and Purcell of San Leandro, which has served as its primary legal adviser since 2005. Currently it has a two-year, $1 million contract that is scheduled to expire at the end of June. CIRM also withheld information on the Remcho agenda item.

As far as grants go, the board is scheduled to hand out a budgeted $30 million for “basic biology” research and another undisclosed amount for CIRM “research leadership awards.” The latter program is new and is budgeted for $44 million over two years with grants as high as $4.5 million each. The purpose of the program is to assist institutions in luring “paradigm-shifting” scientists to California.

The basic biology round is aimed at both business and nonprofit applicants, including proposals with Japanese collaborators.

Here is a link to scores on all the biology grants to be considered next week along with summaries of reviewer comments, although the directors' agenda does not provide a link to the information. (Review summaries could not be found on the CIRM Web site for the researcher recruitment grants.)

Reviewers approved 14 biology grants, including a $1.4 million application with a score of 66. That grant was slotted for approval despite having a lower score than two other grants that scored ahead of it with 71 and 69.

The directors have final legal authority on approval but almost never overturn a favorable decision by scientific reviewers, who operate behind closed doors and do not have to disclose publicly their economic and professional interests.

Concerning the grant with the 66 score, the CIRM review summary said,

“The reviewers acknowledged that the PI is a strong leader in his/her field with an outstanding publication record in high impact journals. They did note, however, a limited experience with hESC or iPSC. While they appreciated the complementary expertise of the collaborators, the reviewers were puzzled by what they perceived to be a lack of engagement with the local community of stem cell scientists at the applicant's institution. The research environment and facilities were considered excellent.”

Under the “programmatic review” section of the summary, CIRM indicated the rationale for approval. CIRM said,

“A reviewer reasoned that this proposal fills a programmatic need in the area of hematopoiesis for CIRM. Though the application was judged risky, the proposal was felt to represent a scientific direction with great potential. The review panel discerned that the benefits of studying RUNX1 in humans warranted the risks and outweighed the concerns over feasibility.”

One scientific reviewer did not participate in the decision because of a publicly undisclosed conflict of interest. He is Ali Brivanlou of the Rockefeller University. The grant review group includes members of the CIRM board who also may vote during the group's review process.

Significantly not on the agenda is an item dealing with compensation for a new vice president of research and development, whom the agency has been seeking since last summer. The matter has been on the table for several past meetings. The absence this time could mean that no further discussion of the matter is required since a person has been hired. If so, look for an announcement next week.

CIRM directors are also expected to seek to stifle the latest legislative attempts to reform CIRM operations, improve its transparency and ensure affordable access to taxpayer-financed therapies. Their strategy is to have the measure, SB1064, sent to interim study, which would shunt the effort aside for a year or so.

The board meeting will be available via the Internet(audio only). The Wednesday meeting will take place in Monrovia at the Doubletree Hotel and Thursday at the City of Hope in Duarte. Instructions for logging into the audiocast can be found on the agenda. If you want to follow the discussion, you may want to have a copy of the agenda and any background material handy for reference.

CIRM Reform Legislation Advances in Senate

Despite industry opposition, legislation aimed at improving transparency and accountability at the $3 billion California stem cell agency easily cleared its first legislative hurdle this month.

The bill, also aimed at ensuring affordability of taxpayer-financed stem cell therapies, was sent to the state Senate Appropriations Committee on a 6-0 vote in the Senate Health Committee, which is chaired by the bill's author, Sen. Elaine Kontominas Alquist, D-San Jose.

The California Healthcare Institute opposed the bill, SB1064. The biomedical industry group said the measure's requirements for affordability would create a “disincentive” to commercialization of therapies and give CIRM less flexibility.

The board of the stem cell agency is expected next week to formally ask that the bill be sent to interim study, which would effectively kill the measure for the next year or so. However, the legislation contains a rather large carrot for the stem cell agency, which is struggling with a legal cap that limits it to only 50 employees to monitor the $1 billion in grants CIRM now has out – not to mention another $2 billion that it intends to give away. The legislation would remove the staff limit, which CIRM President Alan Trounson has said is endangering the quality of CIRM work. A spending limit on administrative expenses would remain in place.

CIRM Chairman Robert Klein and a handful of his associates in 2004 wrote the staff cap into the 10,000-word ballot measure, Prop. 71, that created the agency. It was an obvious ploy to defuse potential opposition arguments that CIRM would become another large government bureaucracy. Klein led the political campaign on behalf of Prop. 71.

Earlier this year, Alquist said that she was introducing the legislation because CIRM is essentially accountable to no one. Her action followed a call by a sister organization to CIRM that urged greater accountability and transparency on the part of the agency, whose 29-member board is packed with representatives of institutions that have received the bulk of the $1 billion given by CIRM.

The sister organization is the Citizens Financial Accountability Oversight Committee and is chaired by state Controller John Chiang, the state's top fiscal officer. Chiang endorsed Alquist's legislation as did the Little Hoover Commission, a state good government agency that studied the stem cell agency. Much of the Alquist legislation is based on the findings of the Hoover Commission.

Among other things, Alquist's bill would eliminate overlapping responsibilities between the CIRM chairman and president, which have been the source of turmoil in the past. It would change the selection process for the chairman and require performance audits of CIRM and its directors. Currently, CIRM operates with unprecedented autonomy in state government. Its finances and budget cannot be touched by the governor or the legislature. Cash flows from state bonds directly to CIRM in an unfettered stream, regardless of the state's financial crisis and severe cut backs elsewhere.

According to the Health Committee staff analysis by Lisa Chan-Sawin, Alquist states that

“while stem cell research is an important and laudable goal, concerns about transparency, accountability and oversight raised by the public, the independent Citizen's Financial Accountability Oversight Committee, the Little Hoover Commission, and the State Controller detract from CIRM's ability to provide grants and loans in the most efficient way. These concerns divert resources and attention from CIRM's ability to maximize voter's investment in stem cell sciences.”

Exciting(?) California Stem Cell News Upcoming

Look for fresh items beginning tomorrow on the California Stem Cell Report. We have finished our obeisance to King Neptune with a four-night, nonstop, sleep-deprived passage from Mexico to El Salvador. We are now ensconced in a rustic marina at the mouth of the Estero de Jaltepeque after surfing over the bar this morning in our 39-foot home, the sailing vessel Hopalong.

Off to El Salvador

The California Stem Cell Report, which has been quiet for the past week or so, will also be quiet until late next week. We leave tomorrow morning on a passage to El Salvador from Hualtuco in southern Mexico, roughly a four or five night sailing voyage. We will bring you all the California stem cell news that is fit to print after we drop anchor in Bahia del Sol and catch up on our sleep(sailing 24 hours a day also means standing watch night and day with only two persons aboard).

Knoepfler Blog Added to Links

We are in the midst of cleaning up the aging links that we have posted on the California Stem Cell Report. But first we want to call your attention to a new addition – the Knoepfler Lab Stem Cell Blog.

It is a researcher-oriented blog written by UC Davis Assistant Professor Paul Knoepfler and the folks at his lab. Knoepfler is interested in developing an exchange of information and discussion of issues among researchers, focusing on the science of stem cells. Some of the blog's recent headlines include: "Stem Cell Myths -Part 2- Teratoma are Good," "Stem Cell Banking--how far should we go?" and "What will be the next big news/paper on iPS cells?"

If you have a suggestion for a link to an Internet site dealing with stem cell issues, particularly those related to California, please send your suggestions to djensen@californiastemcellreport.com.

Latest on New CIRM VP and Compensation

The California stem cell agency could be eyeing the possibility of beefing up non-salary compensation for a new vice president, who it has been seeking to hire since last summer.

The move appears to be in lieu of boosting the existing VP pay range beyond $332,000 and comes as CIRM President Alan Trounson seems to closing in on a candidate. On two recent occasions, the question of compensation for the new VP for research and development has been on the agenda of CIRM directors. In both cases, however, it was removed with no action. CIRM Chairman Robert Klein explained on one occasion that negotiations were not quite at the appropriate stage.

We have reported that directors were expected to be asked to increase the salary to meet the demands of the new VP. Otherwise there would be no reason to place VP compensation before directors. However, Don Gibbons, chief communications officer for CIRM, said in an email:

“You should know that despite your repeated assertions otherwise, there has never been any discussion of exceeding $332,000.”

We then asked Gibbons whether other types of compensation were being considered or the compensation package restructured in some way. Gibbons replied that “parts of compensation packages other than annual salary can require board review,” but did not elaborate.

The salary is touchy politically because California remains in the throes of a financial crisis that has resulted in major cutbacks around the state. CIRM, on the other hand, has not felt the impact because its budget cannot be touched by the governor or the legislature.

John M. Simpson, stem cell project director for Consumer Watchdog of Santa Monica, Ca., attended the last directors meeting that was scheduled to address the compensation issue. He asked CIRM Chairman Klein about the matter.

According to the meeting transcript, Klein replied:

“We continue to calendar it and will for flexibility in each of our calls until we have gotten to a point that we can make a decision. It provides us the flexibility to consider it. But until we get to the point where we have done all of our due diligence and come to final terms, we're not in a position to take any action if, in fact, action is required. The president has the authority to hire this person. And to the extent that they need any additional approvals from us, we carry that on our agenda. So until we've hired him, we'll continue each time to have it on the agenda because it gives us flexibility.”

Geron and ACT Could Apply in $50 Million Clinical Trial Loan Program

Two more potential applicants for the California stem cell agency's $50 million clinical trial program were identified today by Nature Medicine magazine.

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In a piece by Christian Torres in its April edition, the magazine indicated that Geron of Menlo Park, Ca., and Advanced Cell Technology of Santa Monica, Ca., may well apply.

Torres wrote:

“Trials must take place in the state to qualify, and only companies or researchers with an investigational new drug (IND) application on file with the US Food and Drug Administration (FDA) are eligible for funding. Currently, that leaves only two known projects in the running: a treatment for spinal cord injury by Menlo Park–based Geron and a therapy for Stargardt’s macular dystrophy, a retinal disease, by Santa Monica–based Advanced Cell Technology.”

Earlier, iPierian, Inc., of South San Francisco was identified as another potential applicant.

The Nature magazine article indirectly raises questions about whether iPierian would be eligible for the loan program. The clinical trial proposal approved by directors last month said that applicants would be required to have an “IND filed by application deadline on the novel cell therapy derived from human pluripotent stem cells proposed for CIRM funding.”

However, during the board discussion, CIRM staff said the filing would be required three weeks prior to the grant review, probably in October. An “active” IND would be required at the time of the notice of award, which typically would be within six months of board approval of the application. CIRM President Alan Trounson would also have the ability to extend that another six months.

(The board discussion can be found beginning on page 41 of the meeting transcript.)

We are querying iPierian about its intentions.

Last month, Trounson said he knew of only three companies that would be in a position to apply for the clinical trials loans.

Torres also interviewed the co-chair of iPierian's scientific advisory board concerning the CIRM program. Torres wrote,

“Deepak Srivastava(at right), director of the Gladstone Institute of Cardiovascular Disease in San Francisco(and iPierian's scientific co-chair), says the CIRM announcement is important for academic researchers who 'have faced a major road block with venture capitalists and companies, who find these therapies too risky for their appetite.'

“'With CIRM, we can finally fund this high risk, but necessary, step,' he says.”

The RFA for the clinical trial program is expected to be posted next month, with board approval of one or two applications in December.

Ipierian to Seek Multimillion Clinical Trial Loan from CIRM

One of the handful of companies likely to be eligible for CIRM's ambitious clinical trial loan program has identified itself – iPierian, Inc., of South San Francisco.

According to Ron Leuty of the San Francisco Business Times, the firm will seek funding for possible therapies for Lou Gehrig's disease and spinal muscular atrophy.

Last month, CIRM directors approved the $50 million program, its first venture into clinical trials. The one or two winning applicants could see cash by the end of this year. Directors were told that perhaps only three firms might be eligible to apply. They were not identified at the meeting because that would raise conflict of interest questions. CIRM also does not identify applicants for grants or loans for fear of embarrassing them if they lose their bids for cash.

Leuty wrote about the CIRM clinical trial program on Friday. He quoted John Walker(at left), president of iPierian, as saying that CIRM's assistance fits “very nicely” with the company's plans to generate a therapy candidate within three years.

Ipieran is backed by Kleiner Perkins Caufield and Byers, Highland Capital Partners, FinTech Capital Partners and MPM Capital, which have provided $31.5 million to the firm.

Ipierian came into being last July when iZumiBio and Pierian merged. The company's Web site said it was collaborating with Gladstone Institutes and Kyoto University's Center for iPS Cell Research and Application with Shinya Yamanaka, whose lab first succeeded in creating iPS cells in mice.

High Costs of Stem Cell Therapy: Will Stem Cell Firms Share More Risk?

Stem cell therapies are likely to be quite costly because of high development expenses and potentially high usage, according to a new report from the University of California at Berkeley, which said that new “financial risk-sharing mechanisms” could be needed.

“The cost impact of the therapy is likely to be high, because of a therapy’s high cost per patient, and the potentially large number of individuals who might benefit from the therapy. This expense would put additional stress on the Medicare and Medicaid budgets, cause private insurance health premiums to increase, and create an incentive for private plans to avoid covering individuals eligible for a therapy,” the report said.

Entitled “Coverage, Cost-Control Mechanisms, and Financial Risk-Sharing Alternatives of High-Cost Health Care Technologies,” the October 2009 study was prepared for the California stem cell agency at a cost of $15,000 by Richard Scheffler, director of the Petris Center on Health Care at UC Berkeley, Brent Fulton, also of the center, and three other persons. The agency said it did not endorse the report's conclusions.

California lawmakers are currently considering legislation (SB1064) by Sen. Elaine KoutaminasAlquist, D-San Jose, aimed at ensuring the affordability of state-financed stem cell therapies and requiring more openness and transparency at CIRM.

Concerning coverage by private insurance, the report, said,

“Because private plans experience approximately 20 percent annual enrollee turnover, this gives them an incentive to avoid covering an individual eligible for a therapy, not only because of the high cost of the therapy, but also because future healthcare savings might benefit a different insurer. Risk adjustment and reinsurance programs, which compensate an insurer for covering an individual with above-average risk or high health care expenses, or both, could be used to mitigate this incentive.”

The study said,

“The development of new stem cell-based therapies could significantly improve and extend the lives of people with currently incurable medical conditions, such as diabetes, macular degeneration, osteoarthritis, and spinal cord injuries. However, there is concern that these therapies may not be affordable and accessible because of the high research and development costs, coupled with the uncertainty as to whether health plans will cover these therapies. This may result in these therapies not being developed at a rate that corresponds to their economic benefit.”

The final paragraph of the study said,

“To improve the likelihood that new stem cell-based therapies will be covered by health plans, financial risk-sharing mechanisms may need to be formulated. These may include stem-cell firms bearing some financial risk, particularly regarding the uncertainty as to whether the therapies will result in future health care cost savings because of potential to cure diseases and disabilities. Risk-adjustment and reinsurance programs, which compensate an insurer for covering an individual with above-average risk or high expenses, or both, could be used to reduce private insurers’ incentive to avoid covering individuals who might benefit from an expensive therapy. In turn, this will increase the new therapies’ affordability and access, and will help ensure that investors who fund therapy development will be compensated, resulting in a development rate that more closely corresponds to the therapies’ benefits.”

The California Stem Cell Report asked CIRM for a copy of the document, which is a public record. Don Gibbons, communications chief for the agency, said,

“Please note that CIRM commissioned the attached report to provide a background survey regarding reimbursement for medical therapies.  We are providing the report to you for information purposes only.  The report and its recommendations do not reflect the views of CIRM's management or the Board’s leadership. We had intended to post this report at the same time that we post the full economic impact study that is underway, which will be later this spring.”

Here is the report.

  Stem Cell Therapy Costs by DavidJensen

CIRM Moving to Hire VP at More Than $332,000

The California stem cell agency may well have a new vice president of research and development by the end of this month and at a salary exceeding the $332,000 allotted for the position.

CIRM directors will meet one week from today to consider raising the existing pay range for the position. CIRM President Alan Trounson obviously has a candidate that wants more than $332,000, and the board is not likely to reject Trounson's choice. To do so would indicate a lack of confidence in Trounson.

CIRM has not disclosed exactly what the new salary will be or explained why it is needed. Don't look for that information until the day of the meeting and probably only if you are in attendance at one of the telephonic meeting locations around the state. CIRM generally has not posted such sensitive salary information in advance of meetings.

Trounson was eager to find someone with industry experience. Last July, Trounson told directors that he wanted “someone with the skill base to have more of a focus in their role with biotech/pharma – translation – clinical applications, which is where we are moving with our translational, disease teams and clinical grants and where we are thin in capacity.”

Trounson hired Levin and Company at a cost of $100,000 to help with the search.

The new position was created by Trounson after Marie Csete resigned suddenly last June as CIRM's chief scientific officer. She said her advice was not respected. Her position will not be filled, but her responsibilities are being parcelled out to the new VP and Patricia Olson, executive director of scientific activities, who has been with the agency since its early days. Under a new structure announced last August, Olson reports directly to Trounson as will the new VP. Previously Olson reported to the chief scientific officer.

The compensation for the new post was scheduled to come up at the CIRM board meeting earlier this month in the State Capitol. CIRM chairman Robert Klein took the matter off the table the day of the meeting, saying negotiations were not at the right stage.

The move came on the same day as The Sacramento Bee carried a front page story that said California state workers received 4 percent less pay last year than in 2008 as a result of the state's financial crisis. Approval of a salary beyond $332,000 creates a public relations risk for CIRM, given the severe cutbacks elsewhere around the state. CIRM's salaries are already quite generous compared to other state agencies.

Salaries are easy for the public to criticize and to understand, especially compared to arcane scientific studies that may not seem immediately relevant to many people. Additionally, boosting a $332,000 salary without telling the public in advance why or specifying the size of the increase plays into the hands of those who are critical of CIRM's lack of transparency and openness.

The new VP will have a financial impact on CIRM beyond the salary. He or she is expected to have at least two or more staffers assigned to work for him or her. They will be new hires at CIRM, which is already chafing under the legal limit of 50 employees. In fact, Trounson has warned that the quality of work could slip unless a way is found to circumvent or repeal the cap.

Another matter is on the table as well next Monday. The item says,

"Consideration of guidance and CIRM’s Medical and Ethical Standards regarding use of previously NIH approved lines in CIRM-funded research and additional lines that are comparable to CIRM’s recommendations to the NIH and/or would be grandfathered or approved under those recommendations.”

No further explanation was offered by CIRM.

Interested parties can take part in the board proceedings at teleconference locations throughout the state including San Francisco(4), Los Angeles(2), La Jolla(2), San Diego, Duarte, Berkeley, Sacramento, Pleasanton and Healdsburg. More locations could be added in the next few days. Specific addresses can be found on the agenda.

Trounson's Criteria for New CIRM Chairman

CIRM President Alan Trounson has offered in writing his thoughts on the qualities that should be reflected in a person who may succeed Robert Klein as chairman of the $3 billion stem cell research effort next December.

Trounson's statement was posted Saturday on the agenda for the meeting of the Evaluation Subcommittee of the CIRM directors the day after the meeting was held.

One item on the agenda called for consideration of a succession plan for the replacement of Klein, who has said he will step down in at the end of the year.

Here are the “critical qualities” that Trounson identified for the new chairman.

• “Committed to CIRM’s mission
• “Able to work with persons of disparate viewpoints to move mission forward
• “Scientific training or a good understanding of the financial issues embedded in research and clinical application
• “A deep understanding of the drug development pipeline and the challenges facing cellular therapeutics
• “Knowledge of strategic financing and healthcare economics"

Trounson identified “unquestionable integrity” as a “desired” quality.

More on the succession planning will have to wait until CIRM posts the transcript from the meeting, which will be a couple of weeks, or until it decides to make a public statement about the outcome of last week's meeting.

Accountability and Umbilical Cord Blood Legislation: CIRM's Positions

As expected, directors of the California stem cell agency moved last week to attempt to sidetrack legislation aimed at ensuring affordable access to taxpayer-funded stem cell therapies and to improve accountability and transparency at the $3 billion enterprise.

The real question is what horse will CIRM have to trade in order to send the bill off to interim study, which would, in effect, kill it for the next year or so. A case can be made that CIRM genuinely needs the bill, or least one of its major components. CIRM already has expressed an urgent need for removal of the 50-person cap on its staff, which the legislation (SB1064) by Sen. Elaine Kontominas Alquist, D-San Jose, would provide. CIRM has said that it is examining non-legislative ways to sidestep the legal ban on more than 50 staffers, but nothing has surfaced publicly.

CIRM says its interim study plan is a move that welcomes legislative oversight. However, the tactic has been long used by foes of legislation to kill bills without appearing to be publicly truculent. That said, the tactic is more sophisticated than some of the agency's previous stonewalling.

All this is going on against the backdrop of a California gubernatorial election, not that CIRM will even be a footnote in the campaign. But a new governor next January – whether it is Jerry Brown or a Republican – could be less friendly towards the agency than the current one, who has obliged it with vetoes on bills and a life-saving $150 million loan.

Meanwhile, patient advocate Don Reed once again has weighed in against the Alquist bill or any legislation that would make changes in the California stem cell agency. On his blog, stemcellbattles.com, he recently cited some personal examples of the need for stem cell therapies. Basically, his pitch is that anything that impedes the stem cell agency or what it wants to do is not to be supported. Reed's comments were also carried on the Huffington Post. Reed is vice president of Americans for Cures, the personal lobbying organization of CIRM Chairman Robert Klein.

The first legislative hearing on Alquist's measure is yet to be scheduled. It is expected to be in the Senate Health Committee, which she chairs.

CIRM directors are also doing their own interim study, so to speak, of legislation that would give the agency more cash and broaden its scope. On the table is a proposal that would be embodied in a bill (AB52) by Assemblyman Anthony Portantino, D-Pasadena, to increase fees for copies of birth certificates and send the money to CIRM, which then would run a public umbilical cord blood banking program.

Directors ordered an internal study of the complex matter, including the science, logistics and “liabilities” of such a move. It appears that much of the study will be performed by outside experts, which is entirely appropriate since the agency is short-staffed and has more important priorities, such as the oversight of more than 300 researchers and institutions that have been given more than $1 billion in state cash.

Consultants interested in that contract should watch the RFP section of CIRM Web site closely or call the agency directly to be sure to be notified about any sort of competition for the work.

Capitol Newspaper Explores CIRM Accountability Issues

The California stem cell agency and legislation aimed at improving accountability at the $3 billion enterprise were the subjects of a piece this morning in Capitol Weekly, a newspaper and Web site in Sacramento devoted to government and politics.

Reporter John Howard wrote,

“Lawmakers – again -- are questioning the operations and culture of the state’s stem cell program....(T) the issue isn’t so much the scientific savvy of the California Institute for Regenerative Medicine....Rather, it is the potential for conflicts in the distribution of hundreds of millions of dollars of grants – the current total is over $1 billion  -- and the perceived lack of public disclosure cloaking the agency’s activities....”

Howard continued,

“'Basically, the attitude has been that they just want the Legislature to go away so they can run their own show,' said former state Sen. Sheila Kuehl, D-Santa Monica, a supporter of stem cell research, who authored (unsuccessful) legislation in 2007 to tighten controls over CIRM.”

From CIRM, Howard quoted Vice Chairman Art Torres as saying,

"There is a tremendous adherence to dealing with conflicts of interest, to transparency, to making sure that anyone who has even a scintilla of a conflict is removed from the process.”

Also quoted in the piece were yours truly and John M. Simpson, stem cell project director for Consumer Watchdog of Santa Monica, Ca.

We should note, as we have in the past, that the conflicts at CIRM are part of its DNA and are not going to go away. One key question is how forthright will CIRM be in disclosing them to the public and interested parties.

As we told Howard in an email,

"Prop. 71 created a board of directors with built-in conflicts. The chief beneficiaries of CIRM's largess -- to the tune of around $700 million or so -- have seats on the board. The individuals from those institutions -- multiple campuses of the University of California, USC, Stanford, Burnham, Salk, etc. -- cannot vote on the specific grants to their institutions,  but they decide what type of research to pursue and the rules for conducting the research. The board also has ultimate oversight of the grants,  some of which contain financial benchmarks. The defacto decisions on the grants are made by the grants review group, which includes out-of-state scientists who score the grants on scientific merit.  Those scientists do not have to make public their statements of economic interest, although they are disclosed to some CIRM personnel. That is a major flaw in CIRM's accountability and transparency. The board legally makes the final decision on the grants, but in practice almost never reverses a positive decision by the reviewers. And only in a handful of cases has the board reversed a negative decision by reviewers."

For more on conflicts of interest at CIRM, see the list of articles in the item below.

Reading List on CIRM Conflicts of Interest

For more insight into the conflict-of-interest issues at the California stem cell agency, here are several pieces that examine the problem. More can be found by searching on the label “conflicts” at the end of items.

Conflicts of Interest, CIRM and Transparency(2008)
“Do conflicts of interest exist among the scientists who make the de facto decisions on hundreds of millions of dollars in California grants for research related to embryonic stem cells? The answer? Yes.

CIRM Says No to Auditor's Conflicts Concerns(2007)
“Elaine Howle, the California state auditor, knows a great deal about the mischief that goes on in state government. And make no mistake about it, mischief does occur even when the multibillion dollar battle ground is in public and the economic interests are on full display.  She also knows that the mischief can grow even greater when the doors are closed and the financial interests of the major players are hidden from the public, such as in the case of grants awarded by California's $3 billion stem cell agency.”

Burnham's Reed Warned by State Ethics Agency on Conflict of Interest(2009)
“California's government ethics overseers have issued a "warning letter" to a director of the California stem cell agency for attempting to influence the agency's staff to reverse a denial of a $638,000 grant to his research organization.” 

CIRM Grant Review: Questions About Fairness, Conflicts and Accuracy(2008)
This includes complaints from a researcher from Advanced Cell Technology about how CIRM interprets its financial conflict of interest policy.

“Nature” Assesses CIRM, Warns of Conflicts of Interest(2008)
“Nature magazine took a run at the California stem cell agency today, producing a fine overview and an editorial that warned of "cronyism" on its board of directors.”

Fomer Top Exec at CIRM Hired by San Diego Firm

The former chief scientific officer for the California stem cell agency, Marie Csete, has landed at a San Diego firm, where she has been named executive vice president for research and development.

Csete resigned from her state government post last June, creating a bit of a stir. She told Nature magazine that her advice was not respected at the $3 billion stem cell agency.

Csete has joined Organovo, Inc., a privately held regenerative medicine company that is focused on creating tissue on demand for research and surgical applications.

The company's news release yesterday quoted the company's president, Keith Murphy, as saying,

"She has extensive experience in clinical transplant and is a leader in the understanding of stem cell behavior. In her previous role, Marie was instrumental in fostering translation of early technologies to practical results. Marie is an excellent fit to lead the company's efforts to move our therapeutic pipeline rapidly to the clinic."

Instead of filling Csete's position as chief scientific officer, CIRM President Alan Trounson created the new post of vice president of research and development. That job is not yet filled.

The only media coverage of Csete's appointment that we could find was in the San Diego Business Journal, a brief story by Heather Chambers.

CIRM Directors Take Up Evaluation of Top Management

How should CIRM Chairman Robert Klein be evaluated? How should the performance of Art Torres, co-vice chairman of the $3 billion effort, be assessed? What about President Alan Trounson?

These matters are being considered at the first-ever meeting of the CIRM directors Evaluation Subcommittee, which comes five years after the agency was created and Klein selected for his post. Friday's session could provide an unusual opportunity to peek inside the nitty-gritty of management of a chimeric enterprise that combines big business, big science, big academia and big politics.

Depending on the job, the evaluation process will include solicitation of written comments from the governor, treasurer, state controller, some recipients of CIRM funding, patient advocates, the biotech industry and “other stakeholders.”

Questions to be addressed, in Klein's case, include whether he

• Shows “comfort with and tolerance in managing diverse and conflicting opinions”
• Demonstrates “a record of effectively communicating CIRM’s mission and accomplishments to stakeholders and public”
• Works effectively with lawmakers to ensure on-going support of CIRM

One section on Klein's evaluation form deals with accountability. It asks whether he “effectively manages compliance with CIRM’s public accountability requirements, including (1) the annual public report (2) the independent financial audit; (3) the Citizens’ Financial Accountability Oversight Committee; (4) public meeting and records laws; (5) competitive bidding; (6) conflicts of interest; and (7) intellectual property standards.”

We should note that “compliance with...requirements” is rather minimal, just meeting what is needed by law. That standard does not, for example, reach Klein's oft-repeated assertion that CIRM adheres to the highest standards of openness and transparency. CIRM's accountability or lack of it has surfaced recently in news reports and in a statement by an influential state lawmaker, Sen. Elaine Kontominas Alquist, D-San Jose.

We should also note that state law that requires public sessions of some meetings of the directors Evaluation Subcommittee, including the one this week. However, the specific evaluation of the individuals will be private.

Klein, a Palo Alto real estate investment banker, initially declined a salary for the chairman's job, which has a pay range of $275,000 to $508,750. But in 2008, he said he would like to be paid. Directors approved $150,000 for what they specified was a half-time position.

Torres' job is also considered a part-time position; in his case, four days a week. In December, his salary was boosted from $75,000 for halftime work to the current $225,000. The range for the position fulltime is $180,000 to $332,000. Torres was formerly head of the state Democratic party and was a longtime state legislator.

The other co-chairman, Duane Roth, a San Diego area businessman, has declined a salary.

Trounson began work in January 2008 at a salary of $490,008. His job has the same range as that of the chairman.

Here are links to  the evaluation procedure and the evaluation forms for Klein and Trounson.

Evaluation of the vice chairmen is not specifically on the agenda but is mentioned in the committee's background information. More specifics are likely to surface at a later date and be colored by experience with evaluation of Klein and Trounson. Also to be considered later is the question of just how to evaluate an employee who is not being paid – Roth.

Teleconference locations for the meeting are available for public participation in India and throughout the state, including San Francisco, Los Angeles(2), Elk Grove, La Jolla, Pleasanton, Menlo Park and Emeryville.

All locations, including the one in India, must be open to the public by state law. CIRM has not responded to our question about which CIRM director is in India.

Specific addresses of the teleconference locations can be found on the meeting agenda. To avoid confusion at the time of the meeting, you may want to call CIRM in advance if you plan to attend one of the teleconference locations.

California Stem Cell Matters: What Do You Think?

Evan Snyder of the Sanford-Burnham Institute takes issue with the headline we wrote last Thursday concerning CIRM approval of more cash for his research.

The headline read: “Burnham's Snyder Receives $1.85 Million More Despite Faulty Application.”

The full text of his remarks can be found in the item below. He says the headline uses “pejorative phraseology” and “betrays an absence of journalistic impartiality.”

We responded to Snyder in an email and offered to run his comments verbatim. We gave him and are now passing along to all our readers some thoughts on what we do on this web site and what can be expected by our readers and those we write about.

We appreciate Snyder's point of view and understand where it is coming from. However, the blog has never pretended to be "objective." It offers commentary, news and information on the matters dealing with the California stem cell agency. Because of the dearth of third-party information on the agency, I do considerable basic reporting and information-gathering, far more than is done by most bloggers. I also provide explanation and analysis of the information that is gathered. And, yes, I offer my opinion from time to time.

That said, many legitimate points of view exist on these matters, including Snyder's. I am more than glad to carry his remarks as well as those last week. They provided an important addition to understanding how research comes about.

One of the major weaknesses of the mainstream media is their inability to provide ample room for many points of view. One of the strengths of the Internet is that it provides a venue for many more voices, something we encourage on the California Stem Cell Report.

For some time now, CIRM Chairman Robert Klein and CIRM President Alan Trounson have had a standing offer from us to run verbatim their comments on stem cell topics of their choice. Recently, we notified all the CIRM directors that they have the same opportunity – something that does not occur in the traditional, mainstream media. In addition, we encourage comments directly on items, which can be done by clicking on the word “comments” at the end of each piece. We encourage readers to use their names when they provide commentary, but understand that in some cases important comments can be made only anonymously. That has to do with the tiny size of the California stem cell community and the extremely powerful financial role that CIRM plays in it.

Feel free to comment on this item or simply send me your thoughts via this email address: djensen@californiastemcellreport.com.

Snyder says CSCR Headline Lacks Impartiality

Here is the text of Evan Snyder's remarks concerning the following headline – “Burnham's Snyder Receives $1.85 Million More Despite Faulty Application” – on the item on March 11, 2010.

“I would have to say that the headline you used betrays an absence of journalistic impartiality. I gather from the perjorative phraseology that you have a point-of-view on this issue and are not sitting as a disinterested chronicler. Had you been that -- which I mistakenly assumed you to be -- you would simply have stated the facts -- 'Snyder awarded grant for Parkinson's research'. However, you did not. Rather you injected yourself into the story. I was actually trained in journalism as early as high school, and my instructors would have castigated me for such a headline.

“I, and the scientists who reviewed our proposal, see this proposal as not in the least flawed. Indeed, I (and most who have studied its aims) find it to be among the most scientifically rigorous, predictive, expeditious, parsimonious, and cost-effective study ever proposed in the stem cell field for Parkinson's disease with any hope for answering long-simmering scientific questions and advancing rational and safe treatments to California citizens suffering from this horrible, debilating disease. Every aspect was spelled out in detail from moment #1; no aspects were hidden. California -- as represented by the study section, CIRM, and the ICOC -- recognized the golden unique opportunity to move the field forward for its citizens and appropriately, sagely, and responsibly seized it. Hence, I find 'zero' flaws in this application. My headline would have been very different.”

Nature Blogger Writes About Snyder Grant

One of Nature magazine's blogger wrote briefly this week about the Evan Snyder affair at the California stem cell agency.

Referring to our article on the grant, Elie Dolgin said on the site, Spoonful of Medicine.

"Here’s one creative, albeit seemingly accidental way, to get a 50% boost for your multi-million dollar research grant: Flout the rules, say you’re sorry, and then argue that you can only make up for it with extra cash. "

You can read Dolgin's entire item here.

Burnham's Snyder Receives $1.85 Million More Despite Faulty Application

Directors of the California stem cell agency this morning, on a split vote, approved a $1.85 million increase in a grant to a Southern California scientist after he submitted a proposal that would violate the agency's rules against spending CIRM funds out-of-state.

Nineteen directors of those present voted in favor of the increase, although some expressed concern about the way in which the application was processed. CIRM did not announce the number of negative votes, but they appeared to be only handful, based on what could be heard via the Internet audiocast of the meeting. The board has 29 members but not all were in attendance.

The motion to approve the increase also included a requirement that CIRM staff work with the board to improve the way in which applications are screened prior to approval by the board.

The CIRM staff made the recommendation for the 50 percent boost (for a total of $5.4 million) in the grant to Evan Snyder (see photo) of the Sanford-Burnham Medical Research Institute in La Jolla. Last April CIRM directors approved a $3.6 million award to Snyder without knowing that it would violate the explicit ban on non-California spending. The staff said the additional money was needed because of the increased cost of moving the work to California.

A straight-forward explanation of how the grant came to be approved, despite its out-of-state component, was not available prior to today's board meeting.  Nor was it today. But some details emerged during this morning's discussion. Scientific reviewers, who make the de facto decisions on grant applications, were aware that Snyder's application involved paying for work out-of-state. That information did not reach the staff level until it surfaced during a regular review following approval last April of the grant by the CIRM board.

Based on the board discussion today, the key difficulty appeared to be with a subcontract with Eugene Redmond of Yale University. Snyder mentioned Redmond in his statement to California Stem Cell Report, saying that Redmond is in the process of becoming an adjunct professor at Sanford-Burnham and will spend one week a quarter in La Jolla.

Claire Pomeroy, a CIRM board member and dean of the UC Davis medical school, said that Snyder's revised proposal replaced senior researchers with junior scientists. She said the reviewers' score on the grant might have been different if they had known last year about the use of less experienced researchers. Pomeroy also suggested that Burnham pick up some of the additional costs, but CIRM President Alan Trounson said the institute would not do that.

Other board members worried about fairness issues along with their concerns about how grants are vetted by staff prior to being examined by CIRM's grant review group. Board member Joan Samuelson, a patient advocate with Parkinson's Disease (the subject of Snyder's research), said she supported the grant. But as a condition, she said the staff must “continue the discussion” with the board about how to avoid situations like this in the future.

At the end of the board debate, CIRM director Sherry Lansing, a UC regent and former head of a Hollywood movie studio, said she was still confused about how the Snyder grant was handled and asked to be briefed later about the matter.

No dissent was heard from CIRM board members about the value of the research proposed by Snyder. Director Jeff Sheehy, a patient advocate and communications manager at UC San Francisco, said,

“This is incredibly important science.”

Sheehy warned the board against becoming bogged down “in process.”

You can read more about the Snyder grant, including statements from Snyder and others by searching on the label “snyder grant.”