Reliance on Title 42 appears to be a crucial aspect of Varmus’s overhaul
of NCI.
This isn’t a new Tea-Party-conservative issue. Title 42 has been criticized
by members of Congress for over a decade.
Four days before the BSA-NCAB meeting, at the June 21 hearing of the
Subcommittee on Health of the House Committee on Energy & Commerce, several
House members raised questions about Title 42, suggesting that they may impose
legislative limits on its use.
The issue also came up in May at a hearing of the Energy & Commerce
Subcommittee on Oversight & Investigations. At that hearing, NIH Director Francis
Collins said that 24.8 percent of NIH employees were compensated under Title 42.
Addressing the two advisory boards, Varmus said that Title 42 is an “an
essential tool for including and retaining strong scientists,” adding that efforts to
restrict its use would “put us in too tight a box.”
The threat of enacting new measures to limit the use of Title 42 comes during
a time of deep financial woes at NCI, and suggests that not only will NCI staff
members will have to do more with less, but also that these high expectations may
fall upon the staff members who may not be the best in their field.
Internal rules, in place for the past several years, compound the recruitment
problem. NIH institutes can offer Title 42 positions to officials at levels as low as
division directors. Positions below this level can still qualify for Title 42, but only after
a national search fails to produce an appropriate candidate. This is known as the
“exhaustion clause.” A search of this sort can take six to eight months.
For Varmus, recruitment has been particularly difficult, as his efforts to restructure
the institute threaten to place institute divisions under interim leadership with severely
limited chances of finding new permanent leaders.
Varmus is even changing the way NCI solicits advice.
