1 00:00:08,909 --> 00:00:12,012 THIS IS A PUBLIC MEETING BEING 2 00:00:12,012 --> 00:00:12,880 VIDEOCAST AND RECORDED. 3 00:00:12,880 --> 00:00:15,015 MEMBERS OF THE PUBLIC WHO MAY 4 00:00:15,015 --> 00:00:16,650 EXPRESS VIEWS OF ANY ITEMS 5 00:00:16,650 --> 00:00:19,219 DISCUSSED MAY DO SO BY WRITING 6 00:00:19,219 --> 00:00:20,621 TO DR. GRAY, EXECUTIVE 7 00:00:20,621 --> 00:00:22,623 SECRETARY OF THE NCAB WITHIN 8 00:00:22,623 --> 00:00:24,591 TEN DAYS OF THE MEETING. 9 00:00:24,591 --> 00:00:25,759 ANY WRITTEN STATEMENTS OR 10 00:00:25,759 --> 00:00:27,194 QUESTIONS SUBMITTED BY MEMBERS 11 00:00:27,194 --> 00:00:28,729 OF THE PUBLIC WILL RECEIVE 12 00:00:28,729 --> 00:00:30,197 CAREFUL CONSIDERATION. 13 00:00:30,197 --> 00:00:31,832 THE FOLLOWING SUBCOMMITTEE 14 00:00:31,832 --> 00:00:33,433 MEMBERS ARE PARTICIPATING IN 15 00:00:33,433 --> 00:00:35,702 TODAY'S MEETING, THE CHAIR 16 00:00:35,702 --> 00:00:39,239 VADAPARAMPIL, DR. BOXER, DR. 17 00:00:39,239 --> 00:00:42,576 HEIMBERGER, AND DR. KHATIBI. 18 00:00:42,576 --> 00:00:45,379 THERE IS A QUORUM. 19 00:00:45,379 --> 00:00:47,314 ANY QUESTIONS REGARDING PROCESS? 20 00:00:47,314 --> 00:00:48,248 DR. VADAPARAMPIL, CAN YOU 21 00:00:48,248 --> 00:00:48,749 BEGIN, THANK YOU. 22 00:00:48,749 --> 00:00:50,617 >> THANK YOU SO MUCH, JOY, I 23 00:00:50,617 --> 00:00:52,920 WOULD LIKE TO WELCOME EVERYBODY 24 00:00:52,920 --> 00:00:54,454 TO OUR CANCER CENTER 25 00:00:54,454 --> 00:00:55,055 SUBCOMMITTEE MEETING. 26 00:00:55,055 --> 00:00:56,890 I KNOW IT'S BEEN A WHILE SINCE 27 00:00:56,890 --> 00:00:59,159 WE MET AND AT OUR LAST MEETING 28 00:00:59,159 --> 00:01:00,327 WE DISCUSSED WANTING TO GET 29 00:01:00,327 --> 00:01:02,663 TOGETHER AS A GROUP, SO I 30 00:01:02,663 --> 00:01:03,864 APPRECIATE EVERYONE COMING 31 00:01:03,864 --> 00:01:06,166 TOGETHER. 32 00:01:06,166 --> 00:01:08,235 SINCE WE HAVEN'T REALLY BEEN ON 33 00:01:08,235 --> 00:01:10,771 TOGETHER FOR A WHILE, I KNOW IT 34 00:01:10,771 --> 00:01:13,140 WILL JUST TAKE A FEW MINUTES 35 00:01:13,140 --> 00:01:14,808 AND I'M COGNIZANT OF THE TIME 36 00:01:14,808 --> 00:01:16,009 WE ONLY HAVE AN HOUR. 37 00:01:16,009 --> 00:01:17,411 BUT I DO THINK IT WILL BE 38 00:01:17,411 --> 00:01:19,046 HELPFUL FOR THE SUBCOMMITTEE 39 00:01:19,046 --> 00:01:21,315 MEMBERS TO INTRODUCE THEMSELVES. 40 00:01:21,315 --> 00:01:26,586 JUST HELLO AND YOUR NAME, YOUR 41 00:01:26,586 --> 00:01:26,920 ORGANIZATION. 42 00:01:26,920 --> 00:01:29,122 AND WE CAN GO FROM THERE. 43 00:01:29,122 --> 00:01:31,425 IN THE INTEREST OF TRYING TO 44 00:01:31,425 --> 00:01:33,260 MOVE THINGS, I'M JUST GOING TO 45 00:01:33,260 --> 00:01:35,829 TRY TO CALL ON YOU AND IF I 46 00:01:35,829 --> 00:01:37,898 LEFT ANYBODY WHO IS ON THE 47 00:01:37,898 --> 00:01:38,732 COMMITTEE OFF, PLEASE JUMP IN 48 00:01:38,732 --> 00:01:39,766 AFTER THAT. 49 00:01:39,766 --> 00:01:44,972 AND I THINK DR. CIOLINO WILL DO 50 00:01:44,972 --> 00:01:48,175 A BRIEF INTRODUCTION OF THE NCI 51 00:01:48,175 --> 00:01:49,643 TEAM HERE PART OF THE CANCER 52 00:01:49,643 --> 00:01:50,677 CENTER'S OFFICE. 53 00:01:50,677 --> 00:01:53,313 WITH THAT, MAYBE START WITH DR. 54 00:01:53,313 --> 00:01:54,214 BOXER? 55 00:01:54,214 --> 00:02:00,620 >> DR. BOXER: HI, I'M DR. 56 00:02:00,620 --> 00:02:02,622 BOXER, CLINICAL -- UCLA 57 00:02:02,622 --> 00:02:05,058 MEDICAL CENTER. 58 00:02:05,058 --> 00:02:07,461 >> DR. FRIESE. 59 00:02:07,461 --> 00:02:10,230 >> NURSING POLICY ROGO CANCER 60 00:02:10,230 --> 00:02:12,566 CENTER UNIVERSITY OF MICHIGAN. 61 00:02:12,566 --> 00:02:14,167 >> DR. HEIMBERGER? 62 00:02:14,167 --> 00:02:16,570 >> PROFESSOR OF NEUROSURGERY, 63 00:02:16,570 --> 00:02:19,573 NORTHWESTERN UNIVERSITY. 64 00:02:19,573 --> 00:02:24,277 >> DR. KHATIBI, ARE YOU ON? 65 00:02:24,277 --> 00:02:27,047 >> YES, HI, THIS IS DR. KHATIBI 66 00:02:27,047 --> 00:02:28,415 FROM SOUTHERN CALIFORNIA. 67 00:02:28,415 --> 00:02:32,419 I'M A PHYSICIAN, CEO OF 68 00:02:32,419 --> 00:02:34,221 HEALTHCARE IN THE PRIVATE 69 00:02:34,221 --> 00:02:34,721 INDUSTRY. 70 00:02:34,721 --> 00:02:40,694 >> I DON'T SEE DR. T -- 71 00:02:40,694 --> 00:02:41,228 DR. W -- 72 00:02:41,228 --> 00:02:42,362 >> HERE. 73 00:02:42,362 --> 00:02:44,698 NO PROBLEM. 74 00:02:44,698 --> 00:02:47,501 ASSISTANT PROFESSOR OHIO STATE 75 00:02:47,501 --> 00:02:48,201 UNIVERSITY, COMPREHENSIVE 76 00:02:48,201 --> 00:02:48,668 CANCER CENTER. 77 00:02:48,668 --> 00:02:57,177 >> NICE TO SEE YOU. 78 00:02:57,177 --> 00:03:00,280 DR. WEERARATNA AND DR. 79 00:03:00,280 --> 00:03:02,315 WINKFIELD. 80 00:03:02,315 --> 00:03:06,053 >> I'M DR. WINKFIELD AT 81 00:03:06,053 --> 00:03:08,789 VANDERBILT UNIVERSITY AND 82 00:03:08,789 --> 00:03:11,124 PROFESSOR OF MEDICINE AT 83 00:03:11,124 --> 00:03:12,025 HARRIET MEDICAL COLLEGE. 84 00:03:12,025 --> 00:03:14,628 >> A COUPLE OTHER NCAB MEMBERS 85 00:03:14,628 --> 00:03:18,665 I SEE ON, DR. BARKER? 86 00:03:18,665 --> 00:03:23,870 >> HI, ANN BARKER, ARIZONA 87 00:03:23,870 --> 00:03:25,038 STATE UNIVERSITY, 88 00:03:25,038 --> 00:03:26,640 TRANSFORMATIVE MEDICINE, USC. 89 00:03:26,640 --> 00:03:31,211 >> AND DOES AZAD. 90 00:03:31,211 --> 00:03:36,616 >> I'M PROFESSOR AT JOHNS 91 00:03:36,616 --> 00:03:37,684 HOPKINS CANCER CENTER. 92 00:03:37,684 --> 00:03:40,387 >> GREAT TO SEE ALL OF YOU, I 93 00:03:40,387 --> 00:03:43,256 THINK THAT'S EVERYONE ON THE 94 00:03:43,256 --> 00:03:45,125 SUBCOMMITTEE, WE WELCOME OUR 95 00:03:45,125 --> 00:03:46,993 BSA COLLEAGUES AS WELL. 96 00:03:46,993 --> 00:03:50,764 SO I WILL JUST WELCOME 97 00:03:50,764 --> 00:03:52,032 EVERYONE, THANK YOU FOR ALL 98 00:03:52,032 --> 00:03:54,067 YOUR INPUT ON THE AGENDA. 99 00:03:54,067 --> 00:03:56,169 AND THE WAY WE HAVE STRUCTURED 100 00:03:56,169 --> 00:03:58,038 TODAY'S MEETING IS THAT HENRY 101 00:03:58,038 --> 00:04:01,708 IS GOING TO BE PRESENTING, DR. 102 00:04:01,708 --> 00:04:03,410 CIOLINO WILL BE PRESENTING ON A 103 00:04:03,410 --> 00:04:06,646 COUPLE OF THE TOPICS YOU ALL 104 00:04:06,646 --> 00:04:07,514 HAD SUGGESTED. 105 00:04:07,514 --> 00:04:09,483 I THINK YOU WANTED TO HEAR MORE 106 00:04:09,483 --> 00:04:09,683 ABOUT. 107 00:04:09,683 --> 00:04:11,751 AND THEN WE LEFT PLENTY OF TIME 108 00:04:11,751 --> 00:04:12,719 FOR DISCUSSION AND THEN A 109 00:04:12,719 --> 00:04:14,821 LITTLE BIT OF TIME TO WRAP UP 110 00:04:14,821 --> 00:04:16,456 IN FUTURE DIRECTIONS. 111 00:04:16,456 --> 00:04:21,895 AND BEFORE I GET STARTED, I SEE 112 00:04:21,895 --> 00:04:24,798 DR. HAYES JOINED US. 113 00:04:24,798 --> 00:04:27,834 HELLO. 114 00:04:27,834 --> 00:04:32,873 >> ANDREA HAYES DICK ON, HOWARD 115 00:04:32,873 --> 00:04:35,775 COLLEGE AZZEDINE. 116 00:04:35,775 --> 00:04:37,277 -- AS DEAN. 117 00:04:37,277 --> 00:04:41,348 I STUDY SARCOMA IN THE 118 00:04:41,348 --> 00:04:44,351 MOLECULAR BIOLOGY LABORATORY. 119 00:04:44,351 --> 00:04:47,854 >> DR. CARPTEN? 120 00:04:47,854 --> 00:04:50,423 >> JOHN CARPTEN, CHAIR FOR 121 00:04:50,423 --> 00:04:51,825 NCAB, I'M DIRECTOR FOR THE CITY 122 00:04:51,825 --> 00:04:53,627 OF HOPE COMPREHENSIVE CANCER 123 00:04:53,627 --> 00:04:53,960 CENTER. 124 00:04:53,960 --> 00:04:55,128 >> ALL RIGHT. 125 00:04:55,128 --> 00:04:57,731 THANK YOU, EVERYBODY. 126 00:04:57,731 --> 00:04:59,399 SO WITH THAT, HENRY, I WILL 127 00:04:59,399 --> 00:05:01,968 TURN IT OVER TO YOU FOR THE 128 00:05:01,968 --> 00:05:03,370 NEXT COUPLE OF PRESENTATIONS 129 00:05:03,370 --> 00:05:04,771 AND WE WILL GO FROM THERE. 130 00:05:04,771 --> 00:05:06,606 >> THANK YOU, SUSAN. 131 00:05:06,606 --> 00:05:07,474 THANK YOU EVERYONE WHO CAME 132 00:05:07,474 --> 00:05:08,275 HERE. 133 00:05:08,275 --> 00:05:10,110 THIS IS QUITE A TURN-OUT. 134 00:05:10,110 --> 00:05:12,345 I WOULD LIKE THE PRINCIPLE 135 00:05:12,345 --> 00:05:14,147 LEADERS OF NCI TO INTRODUCE 136 00:05:14,147 --> 00:05:15,315 THEMSELVES. 137 00:05:15,315 --> 00:05:16,716 STARTING WITH THE DEPUTIES. 138 00:05:16,716 --> 00:05:19,519 DOUG? 139 00:05:19,519 --> 00:05:21,421 >> DOUG LOWY, ACTING DIRECTOR 140 00:05:21,421 --> 00:05:22,556 NCI. 141 00:05:22,556 --> 00:05:25,592 >> JIM, JIM DOROSHOW OF CANCER 142 00:05:25,592 --> 00:05:27,027 TREATMENT AND DIAGNOSIS. 143 00:05:27,027 --> 00:05:28,762 >> DINA? 144 00:05:28,762 --> 00:05:34,034 >> DEPUTY DIRECTOR OF NCI. 145 00:05:34,034 --> 00:05:35,669 >> UNEXPECTEDLY DR. RATHWELL, 146 00:05:35,669 --> 00:05:37,003 MY NEXT BOSS. 147 00:05:37,003 --> 00:05:41,141 >> JUST A BSA -- TODAY. 148 00:05:41,141 --> 00:05:42,209 GLAD TO BE HERE. 149 00:05:42,209 --> 00:05:44,277 >> O'ER ALL RIGHT, FOLKS SINCE 150 00:05:44,277 --> 00:05:46,379 IT'S BEEN SO LONG SINCE WE HAVE 151 00:05:46,379 --> 00:05:47,581 MET, I THOUGHT I WOULD 152 00:05:47,581 --> 00:05:48,949 INTRODUCE YOU TO THE STAFF OF 153 00:05:48,949 --> 00:05:52,485 THE OFFICE OF CANCER CENTERS. 154 00:05:52,485 --> 00:05:56,223 I'VE BEEN DIRECTOR SINCE 2015, 155 00:05:56,223 --> 00:05:57,390 I SUCCEEDED LINDA WEISS WHO HAD 156 00:05:57,390 --> 00:06:01,595 BEEN IN THE JOB SINCE 2001. 157 00:06:01,595 --> 00:06:02,963 DR. CHRISTOFF. 158 00:06:02,963 --> 00:06:08,335 WE HAVE FOUR PROGRAM DIRECTORS, 159 00:06:08,335 --> 00:06:08,535 MAFIQ. 160 00:06:08,535 --> 00:06:09,803 IN ADDITION TO HANDLING THE 161 00:06:09,803 --> 00:06:12,372 NORMAL PORTFOLIO FOR PROGRAM 162 00:06:12,372 --> 00:06:15,108 DIRECTOR OF ABOUT 15 CANCER 163 00:06:15,108 --> 00:06:18,712 CENTERS ALSO RUNS AIDS 164 00:06:18,712 --> 00:06:21,481 MALIGNANCIES P 30 SUPPLEMENT, 165 00:06:21,481 --> 00:06:23,483 SHE SECURES FUNDING FROM OFFICE 166 00:06:23,483 --> 00:06:29,756 HUMAN AIDS MALIGNANCIS. 167 00:06:29,756 --> 00:06:31,992 DR. SONJA ROBERSON IS VERY 168 00:06:31,992 --> 00:06:33,126 EXPERIENCED IN THE REVIEW SIDE 169 00:06:33,126 --> 00:06:35,562 AND NOW THE PROGRAM SIDE OF THE 170 00:06:35,562 --> 00:06:37,964 CCSG. 171 00:06:37,964 --> 00:06:40,400 PRISCILLA CAME TO US FROM -- 172 00:06:40,400 --> 00:06:43,069 SHE WORKED ON THE P 30 173 00:06:43,069 --> 00:06:45,205 SUPPLEMENT CURE PROGRAM. 174 00:06:45,205 --> 00:06:48,708 AND ALSO HAS A REAL INTEREST IN 175 00:06:48,708 --> 00:06:51,044 SURVIVEORSHIP ISSUES X DR. MINH 176 00:06:51,044 --> 00:06:52,912 CAME FROM DIVISION OF CANCER 177 00:06:52,912 --> 00:06:55,015 TREATMENT AND CONTROL WHERE SHE 178 00:06:55,015 --> 00:06:56,182 DEVELOPED NEW MECHANISMS 179 00:06:56,182 --> 00:06:57,117 PARTICULARLY AROUND DRUG 180 00:06:57,117 --> 00:07:01,688 DEVELOPMENT AND TRAINING. 181 00:07:01,688 --> 00:07:04,224 CHI DIN I.T. SPERKIST. 182 00:07:04,224 --> 00:07:05,859 MARTINEZ IS PROGRAM SPECIALIST 183 00:07:05,859 --> 00:07:08,194 AND MOLLIE MAYOR IS OUR NEWEST 184 00:07:08,194 --> 00:07:10,797 RECRUIT ONBOARD A FEW MONTHS 185 00:07:10,797 --> 00:07:12,465 AGO HANDLES ALL OUR BUDGET AND 186 00:07:12,465 --> 00:07:14,301 SORT OF OUR PROGRAM DIRECTOR IN 187 00:07:14,301 --> 00:07:15,535 TRAINING. 188 00:07:15,535 --> 00:07:18,538 WE HAVE PROBABLY THE SMALLEST 189 00:07:18,538 --> 00:07:20,173 DIVISION OFFICE OR CENTER IN 190 00:07:20,173 --> 00:07:22,075 ALL OF NCI AND WE HAVE ONE OF 191 00:07:22,075 --> 00:07:22,776 THE LARGEST BUDGETS. 192 00:07:22,776 --> 00:07:25,111 I WOULD LIKE TO THINK WE ARE 193 00:07:25,111 --> 00:07:27,047 VERY EFFICIENT MOVING NCI 194 00:07:27,047 --> 00:07:28,181 DOLLARS OUT THE DOOR. 195 00:07:28,181 --> 00:07:30,583 YOU CAN GIVE ME THE NEXT SLIDE, 196 00:07:30,583 --> 00:07:36,956 PLEASE. 197 00:07:36,956 --> 00:07:39,092 SO DR. RATHWELL WILL GET THESE 198 00:07:39,092 --> 00:07:40,694 SLIDES TWICE, I ASKED THE 199 00:07:40,694 --> 00:07:43,029 FORMAT WE WERE ASKED TO PREPARE 200 00:07:43,029 --> 00:07:44,664 FOR HER BRIEFING AS THE FIRST 201 00:07:44,664 --> 00:07:45,632 PART OF MY TALK. 202 00:07:45,632 --> 00:07:48,902 SO WE HAVE A TOTAL BUDGET OF 203 00:07:48,902 --> 00:07:51,438 $322.1 MILLION IN TOTAL COSTS 204 00:07:51,438 --> 00:07:53,406 FOR THE CCSG, THAT DOES NOT 205 00:07:53,406 --> 00:07:54,708 INCLUDE SUPPLEMENTS. 206 00:07:54,708 --> 00:07:56,843 AND OUR MAIN MISSION IS TO 207 00:07:56,843 --> 00:07:58,912 OVERSEE THAT PROGRAM. 208 00:07:58,912 --> 00:08:00,113 WE PROVIDE PRE-APPLICATION 209 00:08:00,113 --> 00:08:02,082 ADVICE TO NEW AND RENEWING 210 00:08:02,082 --> 00:08:04,184 CANCER CENTERS. 211 00:08:04,184 --> 00:08:06,753 THIS IS PARTICULARLY IMPORTANT 212 00:08:06,753 --> 00:08:08,655 FOR THE EMERGING CANCER CENTERS. 213 00:08:08,655 --> 00:08:11,658 WE OFTEN MEET WITH THEM ON A 214 00:08:11,658 --> 00:08:13,893 YEARLY BASIS RUN-UP TO THEIR 215 00:08:13,893 --> 00:08:15,929 INITIAL APPLICATION. 216 00:08:15,929 --> 00:08:18,465 AND FOR RENEWING CANCER CENTERS 217 00:08:18,465 --> 00:08:21,701 IT ALL DEPENDS HOW EXPERIENCED 218 00:08:21,701 --> 00:08:23,536 THE DIRECTOR IS, WE CHANGED 219 00:08:23,536 --> 00:08:26,806 SINCE THE LAST TIME HE OR SHE 220 00:08:26,806 --> 00:08:29,376 WROTE THE APPLICATION AS TO HOW 221 00:08:29,376 --> 00:08:30,810 EXTENSIVE THAT MEETING GOES. 222 00:08:30,810 --> 00:08:32,746 WE PARTNER WITH OTHER NCI 223 00:08:32,746 --> 00:08:34,681 DIVISION OFFICES AND CENTERS 224 00:08:34,681 --> 00:08:36,483 FOR NEW INITIATIVES. 225 00:08:36,483 --> 00:08:38,585 THE D43 WE DEVELOP WITH CENTER 226 00:08:38,585 --> 00:08:40,420 FOR GLOBAL HEALTH. 227 00:08:40,420 --> 00:08:42,589 THE CLINICAL SCIENTIST FOR 228 00:08:42,589 --> 00:08:44,124 CLINICAL TRIALS. 229 00:08:44,124 --> 00:08:46,926 P 30 SUPPLEMENT THAT TRAINS 230 00:08:46,926 --> 00:08:47,894 EARLY SURGEON SCIENTISTS WE 231 00:08:47,894 --> 00:08:51,197 DEVELOP WITH CENTER FOR CANCER 232 00:08:51,197 --> 00:08:53,266 TRAINING AND INTRAMURAL 233 00:08:53,266 --> 00:08:53,767 ONCOLOGY BRANCH. 234 00:08:53,767 --> 00:08:56,669 AND WE ALSO HELP OTHER DOCS 235 00:08:56,669 --> 00:08:58,204 DEVELOPING P 30 SUPPLEMENT 236 00:08:58,204 --> 00:08:59,139 IDEAS. 237 00:08:59,139 --> 00:09:01,274 THIS HAS LED TO QUITE A LARGE 238 00:09:01,274 --> 00:09:03,543 AMOUNT OF FUNDING DIRECTED 239 00:09:03,543 --> 00:09:07,113 TOWARD THE P 30 DESIGNATED 240 00:09:07,113 --> 00:09:08,782 CANCER CENTERS FROM 20-30 241 00:09:08,782 --> 00:09:11,584 MILLION A YEAR IN FUNDING. 242 00:09:11,584 --> 00:09:13,686 IS DEVOTE TODAY P 30 243 00:09:13,686 --> 00:09:15,355 SUPPLEMENTS RIGHT NOW. 244 00:09:15,355 --> 00:09:16,856 THESE PROGRAM PRIORITIES. 245 00:09:16,856 --> 00:09:18,391 I WILL GO THROUGH EACH ONE OF 246 00:09:18,391 --> 00:09:19,793 THESE IN MORE DETAIL. 247 00:09:19,793 --> 00:09:22,162 LET'S START WITH OUR MANDATE TO 248 00:09:22,162 --> 00:09:24,597 REVISE AND IMPROVE THE CCSG 249 00:09:24,597 --> 00:09:24,931 REQUIREMENTS. 250 00:09:24,931 --> 00:09:26,966 NEXT SLIDE. 251 00:09:26,966 --> 00:09:28,334 THIS IS THE MOST IMPORTANT 252 00:09:28,334 --> 00:09:29,035 THING WE DO. 253 00:09:29,035 --> 00:09:31,137 WHAT THE OFFICE OF CANCER 254 00:09:31,137 --> 00:09:33,473 CENTERS LAYS OUT IS ESSENTIALLY 255 00:09:33,473 --> 00:09:34,407 WHAT CANCER CENTERS ARE 256 00:09:34,407 --> 00:09:36,042 REQUIRED TO DO AND WHAT THEY 257 00:09:36,042 --> 00:09:37,777 ARE REQUIRED TO DISCUSS WITHIN 258 00:09:37,777 --> 00:09:39,412 THEIR APPLICATION. 259 00:09:39,412 --> 00:09:41,114 THIS HAS TO OCCUR EVERY THREE 260 00:09:41,114 --> 00:09:44,417 YEARS UNDER THE NIH RULES. 261 00:09:44,417 --> 00:09:46,619 AND WE THEORETICALLY COULD 262 00:09:46,619 --> 00:09:49,189 PUBLISH THE EXACT SAME THING 263 00:09:49,189 --> 00:09:54,828 THAT THE PREVIOUS CYCLE HAD. 264 00:09:54,828 --> 00:09:59,332 WE LOOK AS AN OPPORTUNITY TO 265 00:09:59,332 --> 00:10:05,905 IMPROVE THE CCSG AND ALIGN ARE 266 00:10:05,905 --> 00:10:09,042 ALIGN WITH NIH PRIORITIES. 267 00:10:09,042 --> 00:10:14,180 WE LOOKED AT REVIEW CRITERIA AND 268 00:10:14,180 --> 00:10:19,986 ADDED CANCER RESEARCH TRAINING 269 00:10:19,986 --> 00:10:22,188 AND COORDINATION, ADDED SHARED 270 00:10:22,188 --> 00:10:23,056 RESOURCE MANAGEMENT AND RECENTLY 271 00:10:23,056 --> 00:10:25,458 PUBLISHED AT THE END OF 21 AND 272 00:10:25,458 --> 00:10:27,660 CAME ONLINE FOR 22, WE ADDED THE 273 00:10:27,660 --> 00:10:28,728 PLAN TO ENHANCE DIVERSITY WHICH 274 00:10:28,728 --> 00:10:30,497 WE'RE GOING TO TALK ABOUT IN THE 275 00:10:30,497 --> 00:10:33,132 SECOND PART OF MY TALK. 276 00:10:33,132 --> 00:10:36,169 WE'RE GOING TO PUBLISH AGAIN AT 277 00:10:36,169 --> 00:10:38,271 THE END OF 24, SOMETIME AFTER 278 00:10:38,271 --> 00:10:40,540 SEPTEMBER 25 THE LAST RECEIPT 279 00:10:40,540 --> 00:10:42,308 DATE FOR THE CCSG DATE OF THAT 280 00:10:42,308 --> 00:10:45,912 WE'RE COMING OUT WITH A NEW 281 00:10:45,912 --> 00:10:49,082 REVISION, AND WE HAVE CLOSELY 282 00:10:49,082 --> 00:10:49,649 MONITORED REVIEWERS' 283 00:10:49,649 --> 00:11:00,193 EXPECTATIONS AND WE'RE GOING TO 284 00:11:03,396 --> 00:11:09,369 BE REVISING DIVERSITY. 285 00:11:09,369 --> 00:11:10,470 NEXT SLIDE. 286 00:11:10,470 --> 00:11:15,074 ONE OF THE MAJOR EFFORTS IS 287 00:11:15,074 --> 00:11:16,276 DEVICE STRATEGY FOR RENEWING 288 00:11:16,276 --> 00:11:17,710 CANCER CENTERS. 289 00:11:17,710 --> 00:11:19,579 NCI NEVER HAD THIS BEFORE. 290 00:11:19,579 --> 00:11:24,050 AND LET ME GIVE -- SINCE THE 291 00:11:24,050 --> 00:11:33,192 COMMITTEE HASN'T MET, IN 2010 292 00:11:33,192 --> 00:11:35,395 WE WERE LIMITED TO 10% OVER THE 293 00:11:35,395 --> 00:11:37,063 PREVIOUS CYCLE. 294 00:11:37,063 --> 00:11:38,898 THAT LED TO A PROTEST ON THE 295 00:11:38,898 --> 00:11:44,604 PART OF CENTERS WITH SMALLER 296 00:11:44,604 --> 00:11:47,440 CCSGs, AND DR. VARMUS FORMED A 297 00:11:47,440 --> 00:11:50,743 WORKING GROUP WHICH CONSISTEDDED 298 00:11:50,743 --> 00:11:52,078 OF TEN NCI DESIGNATED DIRECTORS 299 00:11:52,078 --> 00:11:52,612 AND CHAIR. 300 00:11:52,612 --> 00:11:54,380 THEY MET OVER A PERIOD OF 18 301 00:11:54,380 --> 00:11:56,349 MONTHS AND THEY ISSUED A REPORT 302 00:11:56,349 --> 00:11:59,185 THAT WAS ACCEPTED BY THE NCAB 303 00:11:59,185 --> 00:12:03,056 WITH RECOMMENDATIONS ON HOW TO 304 00:12:03,056 --> 00:12:04,057 REALIGN CANCER CENTER FUNDING. 305 00:12:04,057 --> 00:12:05,892 STAFF IN THE OFFICE OF CANCER 306 00:12:05,892 --> 00:12:08,061 CENTERS AS WELL AS DR. VARMUS' 307 00:12:08,061 --> 00:12:12,432 OFFICE BEGAN TO WORK ON THOSE 308 00:12:12,432 --> 00:12:14,634 RECOMMENDATIONS AND AFTER 309 00:12:14,634 --> 00:12:17,370 SEVERAL YEARS DEVELOPED A 310 00:12:17,370 --> 00:12:19,672 THREE-PHASE FUNDING STRATEGY FOR 311 00:12:19,672 --> 00:12:20,573 CANCER CENTERS. 312 00:12:20,573 --> 00:12:24,077 PHASE 1 WAS IN 2016, WE CREATED 313 00:12:24,077 --> 00:12:27,680 MINIMUM AWARDS FOR EACH TYPE OF 314 00:12:27,680 --> 00:12:28,982 CANCER CENTER AND RAISED 21 315 00:12:28,982 --> 00:12:33,820 CANCER CENTERS UP TO NEW LEVELS, 316 00:12:33,820 --> 00:12:35,455 SPENDING HAVE A $10.1 MILLION IN 317 00:12:35,455 --> 00:12:36,089 TOTAL COSTS. 318 00:12:36,089 --> 00:12:38,091 PHASE 2 WAS TWO YEARS LATER. 319 00:12:38,091 --> 00:12:40,259 WE DETERMINED THE MAXIMAL BUDGET 320 00:12:40,259 --> 00:12:41,260 ELIGIBILITY OF CANCER CENTER 321 00:12:41,260 --> 00:12:44,197 BASED ON ITS NIH CANCER RELEVANT 322 00:12:44,197 --> 00:12:46,599 PORTFOLIO, AND THEN MADE A FINAL 323 00:12:46,599 --> 00:12:48,067 FUNDING AWARD BASED ON THE 324 00:12:48,067 --> 00:12:49,702 OVERALL IMPACT SCORE THAT THE 325 00:12:49,702 --> 00:12:56,643 CENTER ACHIEVED IN ITS NEXT 326 00:12:56,643 --> 00:12:59,579 REVIEW. 327 00:12:59,579 --> 00:13:01,648 THAT COST EXTRA $33 MILLION, WE 328 00:13:01,648 --> 00:13:03,082 HAVE ONE REMAINING CANCER CENTER 329 00:13:03,082 --> 00:13:06,219 TO GO THROUGH PHASE 2, 330 00:13:06,219 --> 00:13:07,987 UNIVERSITY OF MIAMI. 331 00:13:07,987 --> 00:13:09,756 AND MY RECOMMENDATION TO NCI 332 00:13:09,756 --> 00:13:12,125 LEADERSHIP IS EVERY NEW CANCER 333 00:13:12,125 --> 00:13:14,127 CENTER IN ITS INITIAL RENEWAL 334 00:13:14,127 --> 00:13:16,663 APPLICATION WILL HAVE A CHANCE 335 00:13:16,663 --> 00:13:18,965 TO RAISE ITS FUNDING IN A MANNER 336 00:13:18,965 --> 00:13:20,600 SIMILAR TO WHAT THE PHASE 2 HAS 337 00:13:20,600 --> 00:13:20,900 DONE. 338 00:13:20,900 --> 00:13:25,104 THAT'S WHAT WE'RE DOING WITH 339 00:13:25,104 --> 00:13:26,506 MIAMI. 340 00:13:26,506 --> 00:13:31,144 WE'RE IN THE MIDST OF PHASE 3 341 00:13:31,144 --> 00:13:33,312 APPROVED BY DR. SHARPLESS WITH A 342 00:13:33,312 --> 00:13:33,980 MORE TARGETED APPROACH. 343 00:13:33,980 --> 00:13:36,849 WE LOOKED AT THE VARIOUS 344 00:13:36,849 --> 00:13:39,218 COMPONENTS OF THE CCSG AND CAME 345 00:13:39,218 --> 00:13:41,754 TO THE REALIZATION THAT THE MOST 346 00:13:41,754 --> 00:13:42,822 UNDERFUNDED IS COMMUNITY 347 00:13:42,822 --> 00:13:44,257 OUTREACH ENGAGEMENT. 348 00:13:44,257 --> 00:13:45,692 THE CLINICAL PROTOCOL AND DATA 349 00:13:45,692 --> 00:13:48,461 MANAGEMENT, WE'VE HAD THE NEW 350 00:13:48,461 --> 00:13:49,095 COMPONENT, PLAN TO ENHANCE 351 00:13:49,095 --> 00:13:52,331 DIVERSITY, SO WE'RE INSTRUCTING 352 00:13:52,331 --> 00:13:55,568 CANCER CENTERS TO APPLY FOR 353 00:13:55,568 --> 00:13:58,271 PREVIOUS AWARD PLUS $650,000 354 00:13:58,271 --> 00:14:01,708 DIRECT COSTS IN THEIR NEXT 355 00:14:01,708 --> 00:14:06,212 RENEWAL DIVIDED AMONGST THOSE 356 00:14:06,212 --> 00:14:07,513 THREE COMPONENTS AND WE'LL MAKE 357 00:14:07,513 --> 00:14:10,850 A FUNDING DECISION BASED ON 358 00:14:10,850 --> 00:14:13,853 MERIT DESCRIPTOR EACH OF THE 359 00:14:13,853 --> 00:14:16,255 COMPONENTS ACHIEVES IN REVIEW. 360 00:14:16,255 --> 00:14:19,292 THIS MORE DIRECTED APPROACH WE 361 00:14:19,292 --> 00:14:21,828 FELT LIKE WOULD SPREAD PHASE 3 362 00:14:21,828 --> 00:14:22,995 FUNDING ACROSS MORE CANCER 363 00:14:22,995 --> 00:14:24,697 CENTERS IN A MORE EQUITABLE 364 00:14:24,697 --> 00:14:27,734 MANNER THAN PHASE 2 WHICH TENDED 365 00:14:27,734 --> 00:14:29,469 TO BE FOCUSED ON LARGER CANCER 366 00:14:29,469 --> 00:14:31,104 CENTERS AND CENTERS THAT MADE A 367 00:14:31,104 --> 00:14:39,746 BIG MOVE IN OVERALL IMPACT 368 00:14:39,746 --> 00:14:42,782 SCORE, MAYBE SHORT ON REWARDING 369 00:14:42,782 --> 00:14:46,953 SMALLER CANCER CENTERS WHICH DID 370 00:14:46,953 --> 00:14:53,593 BENEFIT GREATLY FROM PHASE 1. 371 00:14:53,593 --> 00:14:54,727 AS FOR PHASE 2 372 00:14:54,727 --> 00:14:57,597 IT COMMITS NCI TO A BUDGET 373 00:14:57,597 --> 00:14:58,197 INCREASE IN THIS PROGRAM OVER 374 00:14:58,197 --> 00:14:59,699 PERIOD OF YEARS WHEN WE DON'T 375 00:14:59,699 --> 00:15:01,501 KNOW WHAT THE NCI BUDGET IS 376 00:15:01,501 --> 00:15:02,101 GOING TO BE. 377 00:15:02,101 --> 00:15:04,904 WE'RE GOING TO RUN INTO THAT 378 00:15:04,904 --> 00:15:08,074 PROBLEM THIS YEAR IN 24 AND 379 00:15:08,074 --> 00:15:09,275 PROBABLY 25 WHERE NCI IS 380 00:15:09,275 --> 00:15:14,881 ANTICIPATED TO HAVE FLAT BUDGET 381 00:15:14,881 --> 00:15:15,948 WHICH MEANS A NEGATIVE BUDGET 382 00:15:15,948 --> 00:15:18,918 FOR US DUE TO RISING COSTS AND 383 00:15:18,918 --> 00:15:20,553 RISING COSTS OF GRANTS, AND THIS 384 00:15:20,553 --> 00:15:23,489 IS COMMITTING US TO INCREASING 385 00:15:23,489 --> 00:15:33,800 THE CCSG FUNDING REQUIRING 386 00:15:33,800 --> 00:15:35,001 REALIGNMENT OF FUNDING. 387 00:15:35,001 --> 00:15:38,971 ARE WE GOING TO AWARD PHASE 3 388 00:15:38,971 --> 00:15:41,073 FUNDING IN 24 AND 25? 389 00:15:41,073 --> 00:15:42,341 WE'RE ADVISINGS THEM TO REQUEST 390 00:15:42,341 --> 00:15:43,776 AND I PRESUME A DECISION IS 391 00:15:43,776 --> 00:15:46,479 GOING TO BE MADE WHEN I GO 392 00:15:46,479 --> 00:15:48,581 BEFORE THE SENIOR PROGRAMMATIC 393 00:15:48,581 --> 00:15:50,783 LEADERSHIP, LEADER OF THE DOCS 394 00:15:50,783 --> 00:15:51,751 AND PRESENT THE RENEWING 395 00:15:51,751 --> 00:15:53,920 APPLICATIONS WHICH I DO THREE 396 00:15:53,920 --> 00:15:58,057 TIMES A YEAR, AND DISCUSS THE 397 00:15:58,057 --> 00:15:59,559 BUDGET INCREASES THAT WE'RE 398 00:15:59,559 --> 00:16:02,395 PROPOSING FOR EACH CANCER 399 00:16:02,395 --> 00:16:07,767 CENTER. 400 00:16:07,767 --> 00:16:09,101 NEXT SLIDE PLEASE. 401 00:16:09,101 --> 00:16:12,538 THE PROGRAM IS NOW 52 YEARS OLD. 402 00:16:12,538 --> 00:16:15,107 WE'VE CREATED SIX NO CANCER 403 00:16:15,107 --> 00:16:17,410 CENTERS OVER THE LAST 11 YEARS, 404 00:16:17,410 --> 00:16:17,910 MOST RECENTLY THIS YEAR 405 00:16:17,910 --> 00:16:18,611 UNIVERSITY OF FLORIDA. 406 00:16:18,611 --> 00:16:22,114 WE HAVE A NUMBER OF EMERGING 407 00:16:22,114 --> 00:16:23,115 CANCER CENTERS, CEDARS-SINAI 408 00:16:23,115 --> 00:16:26,185 APPLICATION IS IN, UNIVERSITY OF 409 00:16:26,185 --> 00:16:28,888 ROCHESTER PROBABLY COMING IN 410 00:16:28,888 --> 00:16:30,623 JANUARY, UNIVERSITY OF ILLINOIS 411 00:16:30,623 --> 00:16:31,524 URBANA HAS POSSIBLE SUBMISSION 412 00:16:31,524 --> 00:16:33,826 IN 24 AS DOES THE MEDICAL 413 00:16:33,826 --> 00:16:35,962 COLLEGE OF WISCONSIN UNIVERSITY 414 00:16:35,962 --> 00:16:37,363 OF ILLINOIS AT CHICAGO. 415 00:16:37,363 --> 00:16:39,432 WE EXPECT ALL OF THESE WITHIN 416 00:16:39,432 --> 00:16:42,902 THE NEXT COUPLE OF YEARS AND 417 00:16:42,902 --> 00:16:44,303 THERE'S ANOTHER SLATE INCLUDING 418 00:16:44,303 --> 00:16:46,906 PENN STATE, SUNY STONY BROOK, 419 00:16:46,906 --> 00:16:49,508 LSU, THREE TO FIVE TO SEVEN 420 00:16:49,508 --> 00:16:51,711 YEARS OUT DEPENDING HOW WELL 421 00:16:51,711 --> 00:16:58,484 THEY GET THEMSELVES ORGANIZED. 422 00:16:58,484 --> 00:17:04,624 OUR CRITERIA COMES DOWN TO 423 00:17:04,624 --> 00:17:10,630 IMPACT SCORE AND WHETHER THE 424 00:17:10,630 --> 00:17:13,799 CATCHMENT AREA IS NOT COVERED OR 425 00:17:13,799 --> 00:17:14,133 UNDERCOVERED. 426 00:17:14,133 --> 00:17:16,736 A NEW CANCER CENTER COSTS 427 00:17:16,736 --> 00:17:17,770 $2.2 MILLION IN TOTAL COSTS 428 00:17:17,770 --> 00:17:19,305 BECAUSE NEW CENTERS COME IN AT 429 00:17:19,305 --> 00:17:21,240 THAT MINIMUM AWARD THAT WE 430 00:17:21,240 --> 00:17:23,876 ESTABLISHED THAT I DISCUSSED 431 00:17:23,876 --> 00:17:24,443 EARLIER. 432 00:17:24,443 --> 00:17:27,146 VARIES WITH INDIRECT COSTS AT 433 00:17:27,146 --> 00:17:28,381 THE INSTITUTION. 434 00:17:28,381 --> 00:17:30,449 WE'VE NEVER REDUCED THE EXISTING 435 00:17:30,449 --> 00:17:32,018 CANCER CENTERS AWARDS IN ORDER 436 00:17:32,018 --> 00:17:37,590 TO FUND A NEW CANCER CENTER. 437 00:17:37,590 --> 00:17:39,292 IT'S ALWAYS BEEN NEW MONEY TO 438 00:17:39,292 --> 00:17:41,260 FUND NEW CANCER CENTERS. 439 00:17:41,260 --> 00:17:42,995 AGAIN, WITH THESE NEW CANCER 440 00:17:42,995 --> 00:17:47,900 CENTERS COMING IN IN 24 AND 441 00:17:47,900 --> 00:17:50,436 PERHAPS 25 IN THE FACE OF A FLAT 442 00:17:50,436 --> 00:17:53,806 BUDGET REQUEST NCI ACCORD TO ADD 443 00:17:53,806 --> 00:17:58,177 TOED THIS PROGRAM BY ADDING NEW 444 00:17:58,177 --> 00:17:58,744 MONEY? 445 00:17:58,744 --> 00:18:02,548 SHOULD WE CONSIDER SUBTRACTING A 446 00:18:02,548 --> 00:18:06,752 SMALL PERCENTAGE AND IT COULD 447 00:18:06,752 --> 00:18:10,690 COST .5% OF THE CCSG AWARDS TO 448 00:18:10,690 --> 00:18:13,092 FUND A NEW CANCER CENTER. 449 00:18:13,092 --> 00:18:14,760 THAT'S GOING TO DEPEND HOW 450 00:18:14,760 --> 00:18:16,095 MERITORIOUS IT IS. 451 00:18:16,095 --> 00:18:17,697 WHETHER THE CATCHMENT AREA IS 452 00:18:17,697 --> 00:18:19,999 COMPELLING OR WHETHER WE FEEL 453 00:18:19,999 --> 00:18:21,334 LIKE IT'S ALREADY COVERED 454 00:18:21,334 --> 00:18:23,302 SOMEWHAT BY THE EXISTING CANCER 455 00:18:23,302 --> 00:18:23,803 CENTERS. 456 00:18:23,803 --> 00:18:25,605 AND ALSO GOING TO DEPEND ON 457 00:18:25,605 --> 00:18:26,906 SENIOR LEADERSHIP AT NCI AND 458 00:18:26,906 --> 00:18:28,774 WHETHER THEY WANT TO DEVOTE NEW 459 00:18:28,774 --> 00:18:30,643 MONEY OR WHETHER THEY WANT TO 460 00:18:30,643 --> 00:18:32,645 CONSIDER CUTTING EXISTING AWARDS 461 00:18:32,645 --> 00:18:41,754 IN ORDER TO FUND THIS. 462 00:18:41,754 --> 00:18:43,923 WE HAVE ROBUST SUPPLEMENT 463 00:18:43,923 --> 00:18:45,358 PROGRAM, AND WE GENERALLY 464 00:18:45,358 --> 00:18:46,425 COLLABORATE WITH OTHER DOCS. 465 00:18:46,425 --> 00:18:48,728 IT'S THEY WHO HAVE THE SOURCES 466 00:18:48,728 --> 00:18:50,162 OF MONEY, COMING PRIMARILY OUT 467 00:18:50,162 --> 00:18:51,030 OF DIVISIONAL FUNDS. 468 00:18:51,030 --> 00:18:53,899 WE WORK WITH THEM TO DEVELOP THE 469 00:18:53,899 --> 00:18:54,734 CONCEPT AND THE PROGRAM 470 00:18:54,734 --> 00:18:57,803 DIRECTORS IN THE OFFICE OF 471 00:18:57,803 --> 00:19:02,975 CANCER CENTERS SERVE AS 472 00:19:02,975 --> 00:19:03,242 REVIEWERS. 473 00:19:03,242 --> 00:19:04,844 WE WOULD LOVE TO HAVE OUR OWN 474 00:19:04,844 --> 00:19:11,217 SOURCE OF FUNDING FOB FOR 475 00:19:11,217 --> 00:19:11,517 SUPPLEMENTS. 476 00:19:11,517 --> 00:19:13,119 PROGRAM DIRECTORS IN OTHER 477 00:19:13,119 --> 00:19:14,520 DIVISIONS, OFFICES, AND CENTERS 478 00:19:14,520 --> 00:19:16,188 COME TO US WITH REALLY EXCITING 479 00:19:16,188 --> 00:19:18,124 IDEAS AND I HAVE TO LET THEM 480 00:19:18,124 --> 00:19:19,558 DOWN GENTLY AND TELL THEM WE 481 00:19:19,558 --> 00:19:22,728 HAVE NEW SOURCE OF FUNDING TO DO 482 00:19:22,728 --> 00:19:23,162 THIS. 483 00:19:23,162 --> 00:19:27,033 IT'S INTERESTING THAT THE NCAB 484 00:19:27,033 --> 00:19:28,334 WORKING GROUP RECOMMENDED IN 485 00:19:28,334 --> 00:19:31,937 THEIR REPORT THAT WE WITHHOLD 486 00:19:31,937 --> 00:19:34,040 10% OF THE CCSG BUDGET FOR 487 00:19:34,040 --> 00:19:36,142 SUPPLEMENTS SO WE CAN REWARD 488 00:19:36,142 --> 00:19:37,343 CANCER CENTERS BASED ON 489 00:19:37,343 --> 00:19:38,577 ALIGNMENT WITH NCI PRIORITIES. 490 00:19:38,577 --> 00:19:40,079 THAT WAS A RECOMMENDATION THAT 491 00:19:40,079 --> 00:19:41,380 WE REJECTED. 492 00:19:41,380 --> 00:19:43,349 WE DIDN'T FEEL LIKE WE WANTED TO 493 00:19:43,349 --> 00:19:44,884 RESERVE THAT BUT IT'S BEEN A 494 00:19:44,884 --> 00:19:48,621 DREAM OF OURS TO HAVE A 495 00:19:48,621 --> 00:19:49,055 SUPPLEMENT PROGRAM. 496 00:19:49,055 --> 00:19:50,523 OBVIOUSLY THIS IS GOING TO HAVE 497 00:19:50,523 --> 00:19:55,361 TO WAIT UNTIL THE NCI BUDGET 498 00:19:55,361 --> 00:19:59,565 IMPROVES, HOPEFULLY IN 26. 499 00:19:59,565 --> 00:20:01,567 NEXT SLIDE. 500 00:20:01,567 --> 00:20:05,037 SO, THAT'S THE UPDATE, WHAT THE 501 00:20:05,037 --> 00:20:06,472 OFFICE OF CANCER CENTER DOES AND 502 00:20:06,472 --> 00:20:10,810 I'LL STOP BEFORE WE GO TO THE 503 00:20:10,810 --> 00:20:12,678 CCSG AND ANSWER ANY QUESTIONS 504 00:20:12,678 --> 00:20:22,922 YOU MAY HAVE. 505 00:20:23,856 --> 00:20:27,359 506 00:20:27,359 --> 00:20:29,729 507 00:20:29,729 --> 00:20:31,297 >> AS FAR AS THE DIVERSITY 508 00:20:31,297 --> 00:20:32,431 PORTION EXPECTATIONS THAT ARE 509 00:20:32,431 --> 00:20:33,966 CHANGING, HOW IS THAT GOING TO 510 00:20:33,966 --> 00:20:37,703 BE MONITORED AND HOW FREQUENTLY? 511 00:20:37,703 --> 00:20:41,674 >> WE WILL DISCUSS THAT IN THE 512 00:20:41,674 --> 00:20:46,145 NEXT COMPONENT. 513 00:20:46,145 --> 00:20:46,645 >> OKAY. 514 00:20:46,645 --> 00:20:47,379 >> THANK YOU. 515 00:20:47,379 --> 00:20:48,981 QUICK QUESTION. 516 00:20:48,981 --> 00:20:51,784 IS THERE ANY DIFFERENCE IF A NEW 517 00:20:51,784 --> 00:20:55,554 APPLICATION COMES FROM AN 518 00:20:55,554 --> 00:20:58,791 ACADEMIC CENTER OR COMMUNITY 519 00:20:58,791 --> 00:20:59,024 CENTER? 520 00:20:59,024 --> 00:21:01,293 >> THERE'S NO DIFFERENCE IN 521 00:21:01,293 --> 00:21:02,128 GENERAL, ONLY AN ACADEMIC CENTER 522 00:21:02,128 --> 00:21:04,964 WOULD HAVE THE BASE OF RESEARCH 523 00:21:04,964 --> 00:21:15,107 THAT WOULD MAKE THEM ELIGIBLE 524 00:21:15,107 --> 00:21:17,710 FOR A CCSG AWARD. 525 00:21:17,710 --> 00:21:20,412 >> CAN YOU TALK ABOUT NEW 526 00:21:20,412 --> 00:21:23,149 INCOMING CANCER CENTERS AND THE 527 00:21:23,149 --> 00:21:26,952 BUDGETING IN TERMS OF PHASE 3? 528 00:21:26,952 --> 00:21:28,187 >> SO ALL NEW CANCER CENTERS 529 00:21:28,187 --> 00:21:30,856 START AT BASE AWARDS. 530 00:21:30,856 --> 00:21:34,293 IT WOULD BE $1.2 MILLION FOR 531 00:21:34,293 --> 00:21:35,394 BASIC CENTER, $1.4 MILLION FOR 532 00:21:35,394 --> 00:21:36,929 CLINICAL CENTER. 533 00:21:36,929 --> 00:21:43,169 YOU'RE NOT ALLOWED TO REQUEST 534 00:21:43,169 --> 00:21:44,203 COMPREHENSIVENESS NOTICE FIRST 535 00:21:44,203 --> 00:21:44,537 CYCLE. 536 00:21:44,537 --> 00:21:47,706 THEY I HOPE TO CONVINCE TO GET A 537 00:21:47,706 --> 00:21:49,208 CRACK IN RENEWAL FIVE YEARS 538 00:21:49,208 --> 00:21:51,944 LATER UNDER PHASE 3 AND FIVE 539 00:21:51,944 --> 00:21:54,413 YEARS AFTER THAT WE'LL SEE WHERE 540 00:21:54,413 --> 00:21:56,415 CENTER FUNDING IS AT THAT POINT. 541 00:21:56,415 --> 00:22:01,187 >> SO NEW CENTERS WOULD BE 542 00:22:01,187 --> 00:22:04,823 EXPECTED TO FUND THEIR COE, POD 543 00:22:04,823 --> 00:22:08,627 AND SHARED RESOURCE PART OUT OF 544 00:22:08,627 --> 00:22:08,961 $1.4 MILLION? 545 00:22:08,961 --> 00:22:11,163 >> THAT'S CORRECT. 546 00:22:11,163 --> 00:22:19,371 >> DR. ULRICH . 547 00:22:19,371 --> 00:22:20,272 >> ARE THERE SPECIFIC DOMAINS 548 00:22:20,272 --> 00:22:22,341 THAT YOU HAVE AN INTEREST IN 549 00:22:22,341 --> 00:22:24,543 BECAUSE -- WOULD IT BE HELP 550 00:22:24,543 --> 00:22:26,111 FOLLOW HAVE THIS LIKE MECHANISM 551 00:22:26,111 --> 00:22:32,218 TO BE ABLE TO REACT MORE QUICKLY 552 00:22:32,218 --> 00:22:34,987 TO OPPORTUNITIESES? 553 00:22:34,987 --> 00:22:36,222 AND SECOND QUESTION, A LOT OF 554 00:22:36,222 --> 00:22:38,791 DISCUSSION ABOUT DIFFERENT 555 00:22:38,791 --> 00:22:40,359 CRITERIA FOR DIFFERENT CANCERS 556 00:22:40,359 --> 00:22:49,201 TO KEEP IN MIND THE 557 00:22:49,201 --> 00:22:50,269 INSTITUTIONAL FUND GZ AND 558 00:22:50,269 --> 00:22:51,804 SUPPORT IS TIED TO THE FACT THIS 559 00:22:51,804 --> 00:22:54,840 IS A SPECIAL DESIGNATION AND 560 00:22:54,840 --> 00:22:56,442 COMES, AND IF THERE IS INFLATION 561 00:22:56,442 --> 00:22:58,711 AND A LOT OF PEOPLE CAN HAVE IT 562 00:22:58,711 --> 00:23:00,312 WITH DIFFERENT REQUIREMENTS IT 563 00:23:00,312 --> 00:23:01,647 MAY ACTUALLY CAUSE SOME 564 00:23:01,647 --> 00:23:02,681 CHALLENGES FOR THE EXISTING 565 00:23:02,681 --> 00:23:04,750 CANCER CENTERS TO HAVE THAT 566 00:23:04,750 --> 00:23:05,718 SUPPORT FROM INSTITUTIONS. 567 00:23:05,718 --> 00:23:08,921 >> I UNDERSTAND EXACTLY WHAT 568 00:23:08,921 --> 00:23:11,323 YOU'RE TALKING ABOUT, AND DON'T 569 00:23:11,323 --> 00:23:13,158 WORRY ABOUT THAT. 570 00:23:13,158 --> 00:23:18,664 WE'RE NOT GOING TO DILUTE THE 571 00:23:18,664 --> 00:23:19,765 CCSG RIGOR OR IMPORTANCE. 572 00:23:19,765 --> 00:23:21,500 IT'S ONE OF OUR MAIN FUNCTIONS 573 00:23:21,500 --> 00:23:24,370 IN THAT SLIDE SET I HAD, I 574 00:23:24,370 --> 00:23:30,376 DELETED FOR THIS PRESENTATION, 575 00:23:30,376 --> 00:23:33,913 PROTECTING THE SANCTITY, SO 576 00:23:33,913 --> 00:23:36,415 WE'VE DEVELOPED FOR EXAMPLE WE 577 00:23:36,415 --> 00:23:43,589 DEVELOPED A SUPPLEMENT ON THE -- 578 00:23:43,589 --> 00:23:46,225 TO ENHANCE PO1 SUBMISSIONS, AN 579 00:23:46,225 --> 00:23:48,093 IDEA FOR AIDS MALIGNANCY EVERY 580 00:23:48,093 --> 00:23:49,828 YEAR, SOMETIMES TWO, VERY 581 00:23:49,828 --> 00:23:54,433 EXCITING IN THEMSELVES BUT HELPS 582 00:23:54,433 --> 00:24:00,372 NCI SPEND MAN DATED PORTION OF 583 00:24:00,372 --> 00:24:01,573 FUNCTION. 584 00:24:01,573 --> 00:24:03,942 A SUPPLEMENT PROPOSAL ENHANCES 585 00:24:03,942 --> 00:24:04,777 MINORITY PARTICIPATION IN 586 00:24:04,777 --> 00:24:06,512 CLINICAL TRIALS WHICH WE'RE NOT 587 00:24:06,512 --> 00:24:07,813 BRINGING FORWARD NOW BECAUSE 588 00:24:07,813 --> 00:24:10,549 OBVIOUSLY THERE'S NOT MONEY 589 00:24:10,549 --> 00:24:11,884 UNDER THAT. 590 00:24:11,884 --> 00:24:18,023 BUT I WOULD SAY THE MAIN FOCUS 591 00:24:18,023 --> 00:24:27,933 IS GREAT IDEAS FOR P32s. 592 00:24:27,933 --> 00:24:31,236 THE HPV VACCINE LED TO THE FIRST 593 00:24:31,236 --> 00:24:33,872 PUBLIC SERVICE ANNOUNCEMENT ON 594 00:24:33,872 --> 00:24:35,307 HPV VACCINATION THAT EVERY 595 00:24:35,307 --> 00:24:36,475 CANCER CENTER SIGNED ON TO 596 00:24:36,475 --> 00:24:39,778 LEADING TO A GENERATION OF 597 00:24:39,778 --> 00:24:40,879 NETWORKS OF ANNUAL MEETINGS 598 00:24:40,879 --> 00:24:44,616 HAPPENING EVERY YEAR, ALL AROUND 599 00:24:44,616 --> 00:24:46,218 THE SUPPLEMENT PROGRAM WHICH 600 00:24:46,218 --> 00:24:47,619 COSTS $3 MILLION TOTAL BECAUSE 601 00:24:47,619 --> 00:24:49,488 WE DON'T GIVE A LOT OF MONEY. 602 00:24:49,488 --> 00:24:52,558 IT'S SEED MONEY TO START THESE 603 00:24:52,558 --> 00:24:56,862 THINGS. 604 00:24:56,862 --> 00:24:58,697 IT'S FOLKS DCCPS, I WOULD LIKE 605 00:24:58,697 --> 00:25:01,000 TO RESPOND WITH FUNDING TO 606 00:25:01,000 --> 00:25:04,002 SUPPORT THIS SORT OF THING. 607 00:25:04,002 --> 00:25:05,604 YES, WE'D LIKE TO DEVELOP OUR 608 00:25:05,604 --> 00:25:06,905 OWN AND PARTNER WITH COLLEAGUES 609 00:25:06,905 --> 00:25:09,942 A LITTLE MORE OFTEN TOO. 610 00:25:09,942 --> 00:25:13,545 >> THANK YOU. 611 00:25:13,545 --> 00:25:14,046 DR. HINEBERGER. 612 00:25:14,046 --> 00:25:16,782 >> I'VE BEEN INVOLVED IN A 613 00:25:16,782 --> 00:25:17,750 NUMBER OF THESE RENEWALS AT A 614 00:25:17,750 --> 00:25:19,385 VARIETY OF CENTERS. 615 00:25:19,385 --> 00:25:21,587 IT'S USUALLY A VERY SIGNIFICANT 616 00:25:21,587 --> 00:25:23,422 EFFORT, USUALLY STARTS ALMOST 617 00:25:23,422 --> 00:25:25,424 TWO YEARS BEFORE THE ACTUAL 618 00:25:25,424 --> 00:25:28,360 SUBMISSION, AND INVOLVES A LOT 619 00:25:28,360 --> 00:25:29,661 OF RESOURCES, SOMETIMES 620 00:25:29,661 --> 00:25:31,630 SHUFFLING OF THE DECK, SO TO 621 00:25:31,630 --> 00:25:32,965 SPEAK, VARIOUS INDIVIDUALS, HOW 622 00:25:32,965 --> 00:25:35,033 YOU FRAME IT, HOW YOU DO ALL OF 623 00:25:35,033 --> 00:25:35,267 THAT. 624 00:25:35,267 --> 00:25:38,504 HAS THERE BEEN ANY THOUGHT WITH 625 00:25:38,504 --> 00:25:40,606 REGARDS TO WAYS TO STREAMLINE 626 00:25:40,606 --> 00:25:42,474 ASSESSMENT OF MERIT COMPONENT SO 627 00:25:42,474 --> 00:25:45,377 THAT IT'S NOT A MASSIVE DOCUMENT 628 00:25:45,377 --> 00:25:47,880 THAT INVOLVES SUCH A FOCUSED 629 00:25:47,880 --> 00:25:49,415 EFFORT BY THE CANCER CENTER 630 00:25:49,415 --> 00:25:51,083 DIRECTOR AS WELL AS ASSOCIATED 631 00:25:51,083 --> 00:25:53,519 DEPUTY DIRECTORS AS WELL AS 632 00:25:53,519 --> 00:25:55,187 SENIOR FACULTY IN ASSEMBLING 633 00:25:55,187 --> 00:25:56,622 THIS DOCUMENT TO GET IT MORE 634 00:25:56,622 --> 00:25:59,191 STREAMLINED SO YOU CAN MAKE 635 00:25:59,191 --> 00:26:00,359 THOSE CRITICAL ASSESSMENTS 636 00:26:00,359 --> 00:26:02,094 WITHOUT DISTRACTING THEM FROM 637 00:26:02,094 --> 00:26:02,928 THE IMPORTANT WORK THEY ARE 638 00:26:02,928 --> 00:26:05,898 DOING ON CLINICAL TRIALS AND 639 00:26:05,898 --> 00:26:06,498 RESEARCH? 640 00:26:06,498 --> 00:26:08,300 >> YOU'RE SPEAKING LIKE A CANCER 641 00:26:08,300 --> 00:26:09,701 CENTER DIRECTOR. 642 00:26:09,701 --> 00:26:12,004 THIS IS WHAT I HEAR FROM THEM 643 00:26:12,004 --> 00:26:13,839 ALL THE TIME. 644 00:26:13,839 --> 00:26:16,341 YES, AND NO. 645 00:26:16,341 --> 00:26:18,143 SO, SEVERAL YEARS AGO WE 646 00:26:18,143 --> 00:26:20,979 RESPONDED TO THAT NCAB WORKING 647 00:26:20,979 --> 00:26:21,280 GROUP. 648 00:26:21,280 --> 00:26:23,182 ONE OF THEIR RECOMMENDATIONS 649 00:26:23,182 --> 00:26:25,217 WHICH WAS NOT ADOPTED, BY THE 650 00:26:25,217 --> 00:26:28,454 WAY, BY THE NCAB, WAS THAT WE 651 00:26:28,454 --> 00:26:30,155 WOULD ELIMINATE SITE VISITS AND 652 00:26:30,155 --> 00:26:32,591 RELY ONLY ON THE APPLICATION. 653 00:26:32,591 --> 00:26:34,660 THIS WAS ROUNDLY REJECTED BY THE 654 00:26:34,660 --> 00:26:36,528 NCAB BASED ON FEEDBACK THAT WAS 655 00:26:36,528 --> 00:26:42,134 GIVEN BOTH BY NCAB MEMBERS AND 656 00:26:42,134 --> 00:26:43,101 CENTER DIRECTORS WHO SPOKE TO 657 00:26:43,101 --> 00:26:46,405 THE IMPORTANCE OF THE PROCESS IN 658 00:26:46,405 --> 00:26:47,005 GENERATING BOTH CENTEREDNESS 659 00:26:47,005 --> 00:26:48,907 THAT SENSE OF BRINK THE MEMBERS 660 00:26:48,907 --> 00:26:50,342 OUT OF THEIR LABORATORIES AND 661 00:26:50,342 --> 00:26:51,543 GETTING THEM TO FOCUS ON THE 662 00:26:51,543 --> 00:26:54,713 CENTER AS A WHOLE BUT ALSO 663 00:26:54,713 --> 00:26:58,884 INSTITUTIONAL COMMITMENT, AS WAS 664 00:26:58,884 --> 00:27:01,086 SAID, THE FACT THAT NCI BOTHERS 665 00:27:01,086 --> 00:27:03,622 TO SEND FOLKS TO DESCEND ON YOUR 666 00:27:03,622 --> 00:27:07,626 CANCER CENTER FOR WHAT IS A 667 00:27:07,626 --> 00:27:09,461 THREE-DAY ORDEAL OF REVIEWING 668 00:27:09,461 --> 00:27:10,462 YOUR CANCER CENTER CONCENTRATES 669 00:27:10,462 --> 00:27:13,765 THE MIND OF INSTITUTIONAL 670 00:27:13,765 --> 00:27:14,032 OFFICIALS. 671 00:27:14,032 --> 00:27:18,270 I UNDERSTAND THE BURDEN OF THE 672 00:27:18,270 --> 00:27:19,471 APPLICATION IS A CONSIDERATION, 673 00:27:19,471 --> 00:27:24,943 YOU KNOW, I'VE LOOKED AT VARIOUS 674 00:27:24,943 --> 00:27:25,210 CCSG. 675 00:27:25,210 --> 00:27:29,414 IT'S AROUND 300 PAGES. 676 00:27:29,414 --> 00:27:36,788 THE -- WE STARTED CUTTING BACK 677 00:27:36,788 --> 00:27:40,959 ON THE SHARED RESOURCE WRITEUPS, 678 00:27:40,959 --> 00:27:42,261 HAD VISIONS OF SHARING TO TRY TO 679 00:27:42,261 --> 00:27:47,933 BALANCE WHAT WE WERE ADDING WITH 680 00:27:47,933 --> 00:27:48,233 SUBTRACTING. 681 00:27:48,233 --> 00:27:51,970 SO IT'S ALWAYS A CONSIDERATION. 682 00:27:51,970 --> 00:27:53,305 THAT'S WHY SERTAC, AND ISLAND 683 00:27:53,305 --> 00:27:57,476 TALK IN A FEW MINUTES, IS SIX 684 00:27:57,476 --> 00:27:57,910 PAGES. 685 00:27:57,910 --> 00:27:59,444 IT'S WHY ENHANCED DIVERSITY IS 686 00:27:59,444 --> 00:28:02,981 SIX PAGES AND NOT TWELVE. 687 00:28:02,981 --> 00:28:04,716 NIH HAS VERY SPECIFIC PAGE -- 688 00:28:04,716 --> 00:28:07,986 YOU DON'T JUST PICK OUT A PAGE 689 00:28:07,986 --> 00:28:12,591 LIMIT, IT'S SIX OR TWELVE. 690 00:28:12,591 --> 00:28:15,427 SO, YEAH, I'D LOVE TO REDUCE 691 00:28:15,427 --> 00:28:18,830 FROM 300 DOWN TO 100 IF I COULD 692 00:28:18,830 --> 00:28:20,699 BE GUARANTEED THAT THE REVIEWERS 693 00:28:20,699 --> 00:28:21,800 WOULD HAVE EVERYTHING THEY NEED 694 00:28:21,800 --> 00:28:25,170 TO EVALUATE A CANCER CENTER 695 00:28:25,170 --> 00:28:26,705 RIGOROUSLY AND IT DIDN'T AFFECT 696 00:28:26,705 --> 00:28:28,607 THE QUALITY OF THE CANCER CENTER 697 00:28:28,607 --> 00:28:28,840 ITSELF. 698 00:28:28,840 --> 00:28:32,945 WE'VE BEEN DOING THIS FOR 52 699 00:28:32,945 --> 00:28:33,145 YEARS. 700 00:28:33,145 --> 00:28:35,647 THE CENTERS ARE IN THE STRONGEST 701 00:28:35,647 --> 00:28:38,116 POSITION THEY HAD EVER BEEN IN 702 00:28:38,116 --> 00:28:39,952 TERMS OF SCIENTIFIC RESEARCH AND 703 00:28:39,952 --> 00:28:41,186 ALIGNMENT WITH THE COMMUNITIES. 704 00:28:41,186 --> 00:28:43,722 I DON'T WANT TO MESS WITH THAT. 705 00:28:43,722 --> 00:28:46,892 SO, I UNDERSTAND IT'S ALWAYS ON 706 00:28:46,892 --> 00:28:49,294 THE RADAR SCREEN, TO TRY TO 707 00:28:49,294 --> 00:28:59,638 REDUCE THE BURDEN OF 708 00:29:04,710 --> 00:29:05,243 APPLICATION. 709 00:29:05,243 --> 00:29:06,111 >> LOOKING FORWARD TO TIME WITH 710 00:29:06,111 --> 00:29:07,946 YOU AT THE CITY OF HOPE. 711 00:29:07,946 --> 00:29:09,982 IT'S TIGHT ALL AROUND. 712 00:29:09,982 --> 00:29:17,322 WE'LL HEAR MORE TOMORROW, FROM 713 00:29:17,322 --> 00:29:18,423 M.K. AND OTHER -- 714 00:29:18,423 --> 00:29:19,157 [AUDIO DISTORTION] 715 00:29:19,157 --> 00:29:22,327 FDA WHEN WE THINK ABOUT 716 00:29:22,327 --> 00:29:23,895 INCREASING REPRESENTATION IN 717 00:29:23,895 --> 00:29:25,397 CLINICAL TRIALS, ARE THERE 718 00:29:25,397 --> 00:29:27,299 OPPORTUNITIES FOR PARTNERSHIPS 719 00:29:27,299 --> 00:29:28,900 WITH OTHER AGENCIES CONSIDERING 720 00:29:28,900 --> 00:29:31,003 THE CANCER CABINET AROUND THE 721 00:29:31,003 --> 00:29:33,572 MOONSHOT, ARE THERE DISCUSSIONS 722 00:29:33,572 --> 00:29:36,475 FLOATING AROUND NCI GIVEN THE 723 00:29:36,475 --> 00:29:41,647 CRITICAL NATURE OF THE CANCER 724 00:29:41,647 --> 00:29:42,080 CENTER PROGRAM. 725 00:29:42,080 --> 00:29:43,348 >> WE NEED TO GET AGENCIES 726 00:29:43,348 --> 00:29:44,449 WORKING TOGETHER ON THINGS. 727 00:29:44,449 --> 00:29:47,085 THE OFFICE OF CANCER CENTERS HAD 728 00:29:47,085 --> 00:29:47,753 EXTENSIVE DISCUSSIONS WITH HRSA 729 00:29:47,753 --> 00:29:50,289 WHEN IT WAS DOING THE ACCESS 730 00:29:50,289 --> 00:29:51,690 PROGRAM. 731 00:29:51,690 --> 00:29:55,761 AND WE WERE PROPOSING TO FUND A 732 00:29:55,761 --> 00:29:57,029 DATA COORDINATING CENTER FOR 733 00:29:57,029 --> 00:29:59,464 THAT IF HRSA WOULD PUT UP THE 734 00:29:59,464 --> 00:30:01,333 MONEY, WE WOULD PUT UP THE MONEY 735 00:30:01,333 --> 00:30:02,134 FOR COORDINATING CENTER. 736 00:30:02,134 --> 00:30:04,836 IN THE END THAT DIDN'T FLY 737 00:30:04,836 --> 00:30:06,638 BECAUSE THE ACCESS PROGRAM WAS 738 00:30:06,638 --> 00:30:09,074 CUT FROM $50 MILLION DOWN TO $5 739 00:30:09,074 --> 00:30:11,176 MILLION AND WE DIDN'T FEEL LIKE 740 00:30:11,176 --> 00:30:12,544 IT WAS WORTH OUR INVESTMENT. 741 00:30:12,544 --> 00:30:15,047 BUT YES WE WOULD LOVE TO DISCUSS 742 00:30:15,047 --> 00:30:16,648 THAT SORT OF THING. 743 00:30:16,648 --> 00:30:18,150 AGAIN, UNDER A FLAT BUDGET. 744 00:30:18,150 --> 00:30:20,819 ANYTIME WE HAVE AN IDEA, I GO TO 745 00:30:20,819 --> 00:30:23,121 THE NCI DIRECTOR AND SAY, HEY, 746 00:30:23,121 --> 00:30:25,824 TAKE A LOOK, WE'D LIKE TO DO 747 00:30:25,824 --> 00:30:26,692 THAT. 748 00:30:26,692 --> 00:30:29,327 THAT'S BEEN SUCCESSFUL WITH THE 749 00:30:29,327 --> 00:30:30,962 PO1, BUT THAT IS A STEP THAT'S 750 00:30:30,962 --> 00:30:33,298 GOING TO BE DIFFICULT FOR THE 751 00:30:33,298 --> 00:30:34,332 NEXT COUPLE YEARS. 752 00:30:34,332 --> 00:30:35,567 >> GREAT TO EXPLORE THOSE TYPES 753 00:30:35,567 --> 00:30:45,877 OF OPPORTUNITIES. 754 00:30:48,113 --> 00:30:48,914 THANK YOU. 755 00:30:48,914 --> 00:30:50,682 >> PART 2. 756 00:30:50,682 --> 00:30:55,153 >> WE'RE FACING A REVISION AFTER 757 00:30:55,153 --> 00:30:56,788 SEPTEMBER 25 OF 24 WITH JANUARY 758 00:30:56,788 --> 00:30:57,689 APPLICANTS. 759 00:30:57,689 --> 00:30:58,724 THERE'S NO WAY AROUND THE SHORT 760 00:30:58,724 --> 00:30:59,091 TIME LINE. 761 00:30:59,091 --> 00:31:01,893 WE'RE NOT ALLOWED TO HAVE TWO 762 00:31:01,893 --> 00:31:03,028 VERSIONS OF ANY MECHANISM ON THE 763 00:31:03,028 --> 00:31:05,797 STREETS SO IT'S NOT LIKE WE CAN 764 00:31:05,797 --> 00:31:08,433 GET THE JANUARY APPLICANTS A 765 00:31:08,433 --> 00:31:10,502 HEADS-UP FORMALLY. 766 00:31:10,502 --> 00:31:11,903 WE GENERALLY DO INFORMALLY EVEN 767 00:31:11,903 --> 00:31:14,339 THOUGH WE'RE NOT SUPPOSED TO DO 768 00:31:14,339 --> 00:31:15,073 THAT. 769 00:31:15,073 --> 00:31:22,447 AND WHEN THE COE AND SIRTEC CAME 770 00:31:22,447 --> 00:31:25,083 OUT WE GAVE EXTENSIONS THE FIRST 771 00:31:25,083 --> 00:31:34,926 CYCLE TO GIVE MORE TIME TO 772 00:31:34,926 --> 00:31:35,160 PREPARE. 773 00:31:35,160 --> 00:31:36,561 WE'RE GOING TO SPEND TIME ON 774 00:31:36,561 --> 00:31:42,734 PLAN TONE -- TO ENHANCE 775 00:31:42,734 --> 00:31:46,404 DIVERSITY AND 2.0 VERSION. 776 00:31:46,404 --> 00:31:47,305 YOU'RE PROBABLY FAMILIAR WITH 777 00:31:47,305 --> 00:31:50,408 THIS BUT THIS IS THE PHILOSOPHY 778 00:31:50,408 --> 00:31:50,675 STATEMENT. 779 00:31:50,675 --> 00:31:54,613 I WANTED TO LEAD WITH THIS. 780 00:31:54,613 --> 00:31:56,014 DIVERSIFYING MEMBERSHIP AND 781 00:31:56,014 --> 00:31:56,848 LEADERSHIP AND EXTERNAL ADVISORY 782 00:31:56,848 --> 00:31:58,917 BOARDS IS GOING TO RESULT IN 783 00:31:58,917 --> 00:32:00,886 BETTER CANCER SCIENCE AND RESULT 784 00:32:00,886 --> 00:32:02,687 IN ADDRESSING CANCER HEALTH 785 00:32:02,687 --> 00:32:03,889 DISPARITIES IN UNIQUE WAYS. 786 00:32:03,889 --> 00:32:04,823 THAT IS OUR VIEW. 787 00:32:04,823 --> 00:32:07,926 THAT'S WHY WE PUT THE PLAN TO 788 00:32:07,926 --> 00:32:09,227 ENHANCE DIVERSITY INTO THIS. 789 00:32:09,227 --> 00:32:11,630 YOU PROBABLY HAVE NEVER HEARD ME 790 00:32:11,630 --> 00:32:13,832 TELL THIS STORY, BUT THIS REALLY 791 00:32:13,832 --> 00:32:16,301 AROSE OUT OF THE CENTER 792 00:32:16,301 --> 00:32:18,370 DIRECTORS MEETING, WHICH IS 793 00:32:18,370 --> 00:32:21,173 YEARLY THAT WE HOST AT NCI FOR 794 00:32:21,173 --> 00:32:22,974 THE CENTER DIRECTORS. 795 00:32:22,974 --> 00:32:27,045 WE HAD ROB WYNN PRESENT IN 2018, 796 00:32:27,045 --> 00:32:29,247 ON HIS EXPERIENCES AS AFRICAN 797 00:32:29,247 --> 00:32:34,286 AMERICAN AND AS A NEW -- THEN 798 00:32:34,286 --> 00:32:37,255 NEW DIRECTOR. 799 00:32:37,255 --> 00:32:39,558 I CONTACTED DR. SHARPLESS, WE 800 00:32:39,558 --> 00:32:40,325 SHOULD DO SOMETHING ABOUT 801 00:32:40,325 --> 00:32:41,526 DIVERSITY, HIS RESPONSE WAS YOU 802 00:32:41,526 --> 00:32:42,694 MEAN YOU'RE NOT? 803 00:32:42,694 --> 00:32:43,795 HE WAS SURPRISED. 804 00:32:43,795 --> 00:32:45,263 I WAS UNDER THE IMPRESSION WE 805 00:32:45,263 --> 00:32:46,731 WERE NOT ALLOWED BY NIH TO 806 00:32:46,731 --> 00:32:48,200 ADDRESS THIS. 807 00:32:48,200 --> 00:32:49,835 THAT WAS MY MISCONCEPTION 808 00:32:49,835 --> 00:32:51,203 BECAUSE EVERY TIME DIVERSITY OF 809 00:32:51,203 --> 00:32:54,105 LEADERSHIP CAME UP AT A REVIEW 810 00:32:54,105 --> 00:32:55,874 IT WAS SQUELCHED BY THE REVIEW 811 00:32:55,874 --> 00:32:56,541 OFFICIAL. 812 00:32:56,541 --> 00:32:57,843 BECAUSE IT'S NOT A REVIEW 813 00:32:57,843 --> 00:32:59,044 CRITERIA. 814 00:32:59,044 --> 00:33:03,081 I THOUGHT IT WAS BECAUSE IT WAS 815 00:33:03,081 --> 00:33:04,149 AN NIH RULE. 816 00:33:04,149 --> 00:33:05,417 IT TOOK A FEW YEARS TO DEVELOP 817 00:33:05,417 --> 00:33:06,084 THIS PLAN. 818 00:33:06,084 --> 00:33:08,253 WE KNOW HOW IMPORTANT IT IS AND 819 00:33:08,253 --> 00:33:10,522 HOW SENSITIVE AN ISSUE IT CAN 820 00:33:10,522 --> 00:33:10,989 BE. 821 00:33:10,989 --> 00:33:12,991 EVERY CANCER CENTER WE DECIDED 822 00:33:12,991 --> 00:33:14,860 THE METRIC WAS NATIONAL 823 00:33:14,860 --> 00:33:15,927 DIVERSITY, AFTER ALL EVERY 824 00:33:15,927 --> 00:33:17,362 CANCER CENTER REGARDLESS OF 825 00:33:17,362 --> 00:33:20,232 WHERE THEY WERE LOCATED RECRUIT 826 00:33:20,232 --> 00:33:20,532 NATIONALLY. 827 00:33:20,532 --> 00:33:22,167 BUT WE RECOGNIZE ALSO SOME 828 00:33:22,167 --> 00:33:23,501 CANCER CENTERS WILL BE 829 00:33:23,501 --> 00:33:25,804 CHALLENGED TO ADDRESS THE 830 00:33:25,804 --> 00:33:28,340 DIVERSITY OF THE NATION WITHIN 831 00:33:28,340 --> 00:33:30,709 THEIR AREA SEE WE WANTED TO MAKE 832 00:33:30,709 --> 00:33:34,779 SURE THEY ARE ABLE TO EMPHASIZE 833 00:33:34,779 --> 00:33:36,047 THE SPECIAL OPPORTUNITIES WITHIN 834 00:33:36,047 --> 00:33:41,119 THEIR CATCHMENT AREA. 835 00:33:41,119 --> 00:33:44,756 AS WITH THE COMMUNITY OUTREACH 836 00:33:44,756 --> 00:33:45,757 AND ENGAGEMENT COMPONENT WE KNOW 837 00:33:45,757 --> 00:33:47,893 THIS IS A LONG-TERM COMMITMENT 838 00:33:47,893 --> 00:33:48,860 AND CAN'T EXPECT CANCER CENTERS 839 00:33:48,860 --> 00:33:55,500 TO SATURN ON A -- TO TURN ON A 840 00:33:55,500 --> 00:33:55,834 DIME. 841 00:33:55,834 --> 00:34:02,908 WE HAVE TO NUDGE AND WATCH. 842 00:34:02,908 --> 00:34:04,476 USUALLY REVIEWERS NUDGE HARDER. 843 00:34:04,476 --> 00:34:06,044 WE WANT THEM BASED NOT ON WHAT 844 00:34:06,044 --> 00:34:07,112 DIVERSITY IS NOW. 845 00:34:07,112 --> 00:34:13,919 WE WANT THEM JUDGED ON WHAT 846 00:34:13,919 --> 00:34:14,419 INFRASTRUCTURE THEY ARE 847 00:34:14,419 --> 00:34:17,088 ESTABLISHING TO DIVERSIFY IN THE 848 00:34:17,088 --> 00:34:17,322 FUTURE. 849 00:34:17,322 --> 00:34:19,724 WE NOW ARE HAVING PROBLEMS OVER 850 00:34:19,724 --> 00:34:20,525 THE WORD "DIVERSITY." 851 00:34:20,525 --> 00:34:23,662 I'LL TALK ABOUT THAT. 852 00:34:23,662 --> 00:34:25,096 NEXT SLIDE. 853 00:34:25,096 --> 00:34:26,932 SO, WE'VE HAD 20 CANCER CENTERS 854 00:34:26,932 --> 00:34:28,567 BE EVALUATED FOR THE PLAN TO 855 00:34:28,567 --> 00:34:29,234 ENHANCE DIVERSITY. 856 00:34:29,234 --> 00:34:33,972 IT GOT OFF TO A ROCKY START. 857 00:34:33,972 --> 00:34:44,516 BY GOT OUR EXCEPTIONAL THOUGHTS 858 00:34:49,921 --> 00:34:53,258 THE HIGHEST SCORE. 859 00:34:53,258 --> 00:34:54,259 RECENTLY SCORES HAVE BEEN 860 00:34:54,259 --> 00:34:54,926 PEAKING UP. 861 00:34:54,926 --> 00:34:58,430 WE HAVE A BARE MAJORITY OF 862 00:34:58,430 --> 00:34:59,965 CENTERS SCORING EXCELLENT OR 863 00:34:59,965 --> 00:35:00,398 BETTER. 864 00:35:00,398 --> 00:35:01,166 WE THINK REVIEWERS ARE STARTING 865 00:35:01,166 --> 00:35:03,501 TO REALIZE THIS IS NOT SOMETHING 866 00:35:03,501 --> 00:35:07,973 THAT CAN HAPPEN OVERNIGHT. 867 00:35:07,973 --> 00:35:09,474 THAT'S NOT SOMETHING THAT WE'RE 868 00:35:09,474 --> 00:35:10,141 ASKING FOR. 869 00:35:10,141 --> 00:35:12,544 THIS IS A PLAN AND I THINK THEY 870 00:35:12,544 --> 00:35:15,847 ARE STARTING TO ALIGN BETTER 871 00:35:15,847 --> 00:35:26,358 WITH THE NOW CALLED NOTICE OF 872 00:35:33,465 --> 00:35:35,667 FUNDING OPPORTUNITY. 873 00:35:35,667 --> 00:35:38,770 I THOUGHT LEADERSHIP WAS 874 00:35:38,770 --> 00:35:40,071 SOMETHING LEADERS COULD 875 00:35:40,071 --> 00:35:40,338 EVALUATE. 876 00:35:40,338 --> 00:35:42,240 DR. SHARPLESS SAID YOU HAVE TO 877 00:35:42,240 --> 00:35:43,108 INCLUDE MEMBERSHIP BECAUSE 878 00:35:43,108 --> 00:35:45,110 THAT'S WHERE THE SENIOR LEADERS 879 00:35:45,110 --> 00:35:47,979 COME FROM, AND THEN WE HAD TO 880 00:35:47,979 --> 00:35:50,048 MAKE SURE EABs WERE INCLUDED 881 00:35:50,048 --> 00:35:54,519 BECAUSE WE NEED DIVERSIFIED 882 00:35:54,519 --> 00:35:56,921 EABs TO MOVE THE NEEDLE. 883 00:35:56,921 --> 00:36:02,293 THOSE ARE TARGET AUDIENCES FOR 884 00:36:02,293 --> 00:36:02,761 THIS. 885 00:36:02,761 --> 00:36:09,234 PATIENTS ARE COVERED UNDER CPDM 886 00:36:09,234 --> 00:36:10,835 SECTION AND INCLUSIONS POLICY. 887 00:36:10,835 --> 00:36:12,470 WE WANTED CANCER CENTERS TO 888 00:36:12,470 --> 00:36:14,139 ESTABLISH AND WE WANTED TO FUND 889 00:36:14,139 --> 00:36:15,540 INFRASTRUCTURE AND CALLED THESE 890 00:36:15,540 --> 00:36:17,876 THINGS OUT IN THE CCSG WITH THE 891 00:36:17,876 --> 00:36:18,743 THOUGHT THIS INFRASTRUCTURE 892 00:36:18,743 --> 00:36:20,712 WOULD LEAD TO NEW APPROACHES AND 893 00:36:20,712 --> 00:36:23,481 WE'VE BEEN SEEING NEW APPROACHES 894 00:36:23,481 --> 00:36:23,748 PRESENTED. 895 00:36:23,748 --> 00:36:25,417 WE REALIZE CENTERS HAVE BEEN 896 00:36:25,417 --> 00:36:26,751 WORKING ON THIS, SOME CENTERS 897 00:36:26,751 --> 00:36:28,720 WORKING ON THIS LONG BEFORE WE 898 00:36:28,720 --> 00:36:31,022 INTRODUCED THIS IN THE CCSG, 899 00:36:31,022 --> 00:36:33,858 INSTITUTIONS IN GENERAL HAD BEEN 900 00:36:33,858 --> 00:36:34,759 WORKING LONG BEFORE WE 901 00:36:34,759 --> 00:36:35,860 INTRODUCED THIS. 902 00:36:35,860 --> 00:36:39,864 BUT IT IS A NEW COMPONENT TO THE 903 00:36:39,864 --> 00:36:42,000 CSGG SO WE NEED TO BE JUDICIOUS 904 00:36:42,000 --> 00:36:47,038 IN WHAT WE ASK FOR. 905 00:36:47,038 --> 00:36:49,941 SOME WILL LEAD TO GOLD STANDARD 906 00:36:49,941 --> 00:36:51,710 FOR DIVERSITY WHERE A CENTER IS 907 00:36:51,710 --> 00:36:53,945 ABLE TO PRESENT HERE'S HOW WE 908 00:36:53,945 --> 00:36:54,846 DIVERSIFIED OUR MEMBERSHIP AND 909 00:36:54,846 --> 00:36:56,247 LEADERSHIP AND THIS IS THE NEW 910 00:36:56,247 --> 00:36:57,749 SCIENCE THAT IT LED TO AND THIS 911 00:36:57,749 --> 00:36:59,217 WAS THE NEW IMPACT ON PATIENTS 912 00:36:59,217 --> 00:37:00,285 THAT IT LED TO. 913 00:37:00,285 --> 00:37:02,153 THAT'S GOING TO BE EXAMPLES I 914 00:37:02,153 --> 00:37:03,388 WILL BE VERY EXCITED TO SEE 915 00:37:03,388 --> 00:37:06,591 SOMETIME IN THE FUTURE. 916 00:37:06,591 --> 00:37:08,059 WE'RE NOT THERE YET. 917 00:37:08,059 --> 00:37:10,261 BUT I EXPECT OVER THE NEXT 918 00:37:10,261 --> 00:37:12,130 COUPLE CYCLES WE'LL START SEEING 919 00:37:12,130 --> 00:37:13,565 CANCER CENTERS WITH EXAMPLES OF 920 00:37:13,565 --> 00:37:17,135 THIS SORT OF THING. 921 00:37:17,135 --> 00:37:18,136 NEXT SLIDE. 922 00:37:18,136 --> 00:37:20,004 THIS IS ALL SWIMMING UPSTREAM AT 923 00:37:20,004 --> 00:37:22,207 A LARGE NUMBER OF STATES. 924 00:37:22,207 --> 00:37:26,611 SUSAN IS AWARE OF THIS. 925 00:37:26,611 --> 00:37:29,013 WE'VE BEEN MONITORING THIS 926 00:37:29,013 --> 00:37:29,347 CLOSELY. 927 00:37:29,347 --> 00:37:31,750 I KNOW MONICA IN HER TIME TALKED 928 00:37:31,750 --> 00:37:34,819 TO A NUMBER OF CANCER CENTERS 929 00:37:34,819 --> 00:37:35,720 AND POLITICAL TYPES. 930 00:37:35,720 --> 00:37:37,655 BUT IN SOME STATES THIS IS GOING 931 00:37:37,655 --> 00:37:44,562 TO BE MUCH HARDER THAN OTHERS. 932 00:37:44,562 --> 00:37:46,798 I FACETIOUSLY SAID THAT IN THE 933 00:37:46,798 --> 00:37:48,500 EXAMPLE MAYBE WE SHOULD CHANGE 934 00:37:48,500 --> 00:37:50,368 TO THE PLAN TO ELIMINATE 935 00:37:50,368 --> 00:37:52,270 DIVERSITY, IT WOULD GO OVER MUCH 936 00:37:52,270 --> 00:37:53,438 BETTER IN THAT STATE. 937 00:37:53,438 --> 00:37:56,207 AND IN A PLACE LIKE TEXAS THEY 938 00:37:56,207 --> 00:37:59,477 ARE NOT ALLOWED TO HIRE AN A.D. 939 00:37:59,477 --> 00:38:01,112 FOR DIVERSITY. 940 00:38:01,112 --> 00:38:04,048 THAT SO MANY CANCER CENTERS HAVE 941 00:38:04,048 --> 00:38:06,718 ALREADY NOT ONLY HIRED BUT 942 00:38:06,718 --> 00:38:08,019 INCLUDED IN SENIOR LEADERSHIP. 943 00:38:08,019 --> 00:38:09,821 I DON'T KNOW THE ANSWER. 944 00:38:09,821 --> 00:38:11,656 I'M GOING TO PROPOSE SOMETHING 945 00:38:11,656 --> 00:38:13,324 THAT SEEMS TRIVIAL BUT MAYBE YOU 946 00:38:13,324 --> 00:38:16,394 THINK IT'S A GOOD IDEA IN A 947 00:38:16,394 --> 00:38:17,896 SUBSEQUENT SLIDE BUT I WANT YOU 948 00:38:17,896 --> 00:38:19,864 TO BE AWARE WE KNOW THIS IS 949 00:38:19,864 --> 00:38:21,966 PROBLEMATIC AT A LARGE NUMBER OF 950 00:38:21,966 --> 00:38:22,934 OUR CANCER CENTERS. 951 00:38:22,934 --> 00:38:25,803 I WAS ON THE PHONE WITH THE NEW 952 00:38:25,803 --> 00:38:26,771 DIRECTOR OF NEBRASKA TODAY, 953 00:38:26,771 --> 00:38:29,841 THAT'S ONE OF HER CONCERNS ALSO. 954 00:38:29,841 --> 00:38:31,709 BECAUSE SHE KNOWS THEY NEED TO 955 00:38:31,709 --> 00:38:34,012 DO CATCH-UP BUT THE WORD 956 00:38:34,012 --> 00:38:36,080 "DIVERSITY" GETS PEOPLE BACK ON 957 00:38:36,080 --> 00:38:38,850 THEIR HEELS WHEN SHE'S TALKING 958 00:38:38,850 --> 00:38:39,951 TO STATE LEGISLATORS AND THAT 959 00:38:39,951 --> 00:38:41,586 SORT OF THING. 960 00:38:41,586 --> 00:38:42,353 NEXT SLIDE. 961 00:38:42,353 --> 00:38:45,423 SO I JUST WANTED TO BRING THIS 962 00:38:45,423 --> 00:38:49,127 UP TO DISCUSS HOW REVIEW 963 00:38:49,127 --> 00:38:51,095 CRITERIA MIGHT BE ADJUSTED FOR 964 00:38:51,095 --> 00:38:51,329 PED. 965 00:38:51,329 --> 00:38:55,700 THIS APPLIED TO EVERY COMPONENT. 966 00:38:55,700 --> 00:38:58,870 DO WE WANT TO FOCUS ON IMPACT AT 967 00:38:58,870 --> 00:39:03,608 CANCER CENTERS OR FOCUS ON 968 00:39:03,608 --> 00:39:03,841 PROCESS? 969 00:39:03,841 --> 00:39:06,744 I HAVE GOTTEN THE COMPLAINT THAT 970 00:39:06,744 --> 00:39:10,515 PROCESS IS OVEREMPHASIZED IN THE 971 00:39:10,515 --> 00:39:10,815 CCSG. 972 00:39:10,815 --> 00:39:11,883 IT'S AN INFRASTRUCTURE GRANT WE 973 00:39:11,883 --> 00:39:13,818 NEED TO EVALUATE BOTH. 974 00:39:13,818 --> 00:39:15,587 JUST BECAUSE A CANCER CENTER CAN 975 00:39:15,587 --> 00:39:18,523 LIST A NUMBER OF ACCOMPLISHMENTS 976 00:39:18,523 --> 00:39:20,325 OR IMPACT, DOESN'T MEAN THAT 977 00:39:20,325 --> 00:39:21,359 THEIR PROCESS IS OPTIMIZED. 978 00:39:21,359 --> 00:39:24,462 THEY MIGHT HAVE BEEN ABLE TO DO 979 00:39:24,462 --> 00:39:24,696 BETTER. 980 00:39:24,696 --> 00:39:26,531 AND THIS IS TRUE FOR COE. 981 00:39:26,531 --> 00:39:29,400 WE NEED TO KNOW WHAT THE PROCESS 982 00:39:29,400 --> 00:39:31,302 IS IN COE, NOT JUST EVALUATE 983 00:39:31,302 --> 00:39:33,805 PEOPLE SCREENED OR NUMBER OF 984 00:39:33,805 --> 00:39:35,006 COMMUNITIES THAT HAVE BEEN 985 00:39:35,006 --> 00:39:35,340 DISCUSSED. 986 00:39:35,340 --> 00:39:39,844 WE NEED TO KNOW THE PROCESS. 987 00:39:39,844 --> 00:39:41,512 SO, MY MINDSET WE WANT TO 988 00:39:41,512 --> 00:39:44,449 EVALUATE BOTH IN THE CCSG, IT'S 989 00:39:44,449 --> 00:39:47,318 A BALANCE BETWEEN THE TWO. 990 00:39:47,318 --> 00:39:49,087 NEXT SLIDE. 991 00:39:49,087 --> 00:39:50,822 SO THIS IS THE CURRENT PLAN. 992 00:39:50,822 --> 00:39:52,190 I'M NOT GOING THROUGH THIS. 993 00:39:52,190 --> 00:39:53,625 WE DON'T HAVE TIME. 994 00:39:53,625 --> 00:39:55,093 LET ME DISCUSS WITH YOU SOME 995 00:39:55,093 --> 00:39:58,062 THOUGHTS ABOUT WHERE WE MAY BE 996 00:39:58,062 --> 00:39:58,396 GOING. 997 00:39:58,396 --> 00:40:00,231 MY UNDERSTANDING OF THIS 998 00:40:00,231 --> 00:40:02,000 PROCESS, I'M GOING TO CLARIFY 999 00:40:02,000 --> 00:40:05,136 WITH PAULETTE GRAY, I CAN'T ASK 1000 00:40:05,136 --> 00:40:06,671 YOU FOR RECOMMENDATIONS USING 1001 00:40:06,671 --> 00:40:08,006 SPECIFIC LANGUAGE FOR REVIEW 1002 00:40:08,006 --> 00:40:10,341 CRITERIA, THAT WOULD BE GIVING 1003 00:40:10,341 --> 00:40:11,876 YOU AN UNFAIR ADVANTAGE IN 1004 00:40:11,876 --> 00:40:13,978 APPLICATIONS IN THE FUTURE TO 1005 00:40:13,978 --> 00:40:14,712 LET YOU TAILOR. 1006 00:40:14,712 --> 00:40:16,681 BUT I CAN TALK IN GENERAL TERMS 1007 00:40:16,681 --> 00:40:17,615 ABOUT THIS. 1008 00:40:17,615 --> 00:40:21,552 I'LL CLARIFY WITH HER. 1009 00:40:21,552 --> 00:40:22,220 NEXT SLIDE. 1010 00:40:22,220 --> 00:40:25,490 SO, HOW ARE WE GOING TO CHANGE 1011 00:40:25,490 --> 00:40:25,657 IT? 1012 00:40:25,657 --> 00:40:27,358 HOW ARE WE NOT GOING TO CHANGE 1013 00:40:27,358 --> 00:40:27,659 ITS? 1014 00:40:27,659 --> 00:40:29,861 SHOULD WE REQUIRE CENTERS TO 1015 00:40:29,861 --> 00:40:32,397 PRESENT BASELINE DATA TO 1016 00:40:32,397 --> 00:40:32,664 REVIEWERS? 1017 00:40:32,664 --> 00:40:35,466 REVIEWERS HAVE BEEN ASKING FOR 1018 00:40:35,466 --> 00:40:37,735 THAT, FOR THE NOW OBVIOUS REASON 1019 00:40:37,735 --> 00:40:42,340 THEY NEED TO KNOW TO DECIDE WHAT 1020 00:40:42,340 --> 00:40:43,675 PROGRESS IS MADE IN THE FUTURE. 1021 00:40:43,675 --> 00:40:45,109 WE THINK YES WE'RE GOING TO CALL 1022 00:40:45,109 --> 00:40:46,311 THIS OUT. 1023 00:40:46,311 --> 00:40:51,382 SHOULD WE SPELL OUT IT MUST 1024 00:40:51,382 --> 00:40:53,818 INTERACT WITH THE CRTEC AND 1025 00:40:53,818 --> 00:40:57,722 COROE AND MAYBE THE PRNS DISEASE 1026 00:40:57,722 --> 00:40:58,122 GROUPS? 1027 00:40:58,122 --> 00:41:01,225 REVIEWERS ARE EXPECTING THIS. 1028 00:41:01,225 --> 00:41:05,330 THEY HAVE ASKED THIS QUESTION AS 1029 00:41:05,330 --> 00:41:06,597 IT'S IN THE CCSG. 1030 00:41:06,597 --> 00:41:08,900 WE'RE GOING TO UPDATE THE REVIEW 1031 00:41:08,900 --> 00:41:09,233 CRITERIA. 1032 00:41:09,233 --> 00:41:11,069 SHOULD WE ADD STAFF TO THE 1033 00:41:11,069 --> 00:41:13,371 TARGET LIST OF MEMBERSHIP 1034 00:41:13,371 --> 00:41:14,572 LEADERSHIP IN EAB? 1035 00:41:14,572 --> 00:41:19,744 A NUMBER OF CENTERS MADE 1036 00:41:19,744 --> 00:41:21,012 PROGRESS DIVERSIFYING STAFF. 1037 00:41:21,012 --> 00:41:22,580 YES, LET'S GIVE THEM CREDIT THEY 1038 00:41:22,580 --> 00:41:24,115 DESERVE FOR THAT. 1039 00:41:24,115 --> 00:41:34,625 NAME CHANGE, RATHER THAN SAY 1040 00:41:36,894 --> 00:41:38,363 CRITERIA FOR EVALUATING 1041 00:41:38,363 --> 00:41:42,533 PROGRESS, I I RATHER LIKE THOSE 1042 00:41:42,533 --> 00:41:43,301 TERMS. 1043 00:41:43,301 --> 00:41:45,403 IT'S THE PLAN TO ENHANCE 1044 00:41:45,403 --> 00:41:49,006 DIVERSITY, WE DIDN'T TALK ABOUT 1045 00:41:49,006 --> 00:41:50,375 EQUITY, INCLUSION, ACCESS. 1046 00:41:50,375 --> 00:41:51,542 THESE ARE VERY DIFFERENT. 1047 00:41:51,542 --> 00:41:52,944 THEY ARE DIFFERENT. 1048 00:41:52,944 --> 00:41:54,512 ALTHOUGH IN MY MIND NOT BEING AN 1049 00:41:54,512 --> 00:41:57,448 EXPERT IN THIS AREA THEY ALL FIT 1050 00:41:57,448 --> 00:41:58,916 UNDER DIVERSITY. 1051 00:41:58,916 --> 00:42:01,619 IT'S A SIX-PAGE WRITE-UP. 1052 00:42:01,619 --> 00:42:03,221 WE DIDN'T WANT A FRACTURED 1053 00:42:03,221 --> 00:42:04,455 NARRATIVE ON EACH COMPONENT. 1054 00:42:04,455 --> 00:42:05,456 WE AGAIN WANTED TO NUDGE THE 1055 00:42:05,456 --> 00:42:07,325 SHIP A LITTLE BIT OF THE TIME SO 1056 00:42:07,325 --> 00:42:08,459 WE STARTED WITH THIS. 1057 00:42:08,459 --> 00:42:10,261 BUT THERE'S A QUESTION AS TO 1058 00:42:10,261 --> 00:42:12,230 WHETHER WE SHOULD CHANGE THE 1059 00:42:12,230 --> 00:42:13,765 NAME OF THE COMPONENT OR AT 1060 00:42:13,765 --> 00:42:15,733 LEAST IN THE NARRATIVE 1061 00:42:15,733 --> 00:42:17,602 REQUIREMENTS TO COVER THESE 1062 00:42:17,602 --> 00:42:18,035 OTHER THINGS. 1063 00:42:18,035 --> 00:42:21,439 SO LET ME DISCUSS WITH YOU THE 1064 00:42:21,439 --> 00:42:22,874 TITLE. 1065 00:42:22,874 --> 00:42:24,709 PLAN TO ENHANCE DIVERSITY. 1066 00:42:24,709 --> 00:42:27,879 CAN WE HELP CANCER CENTERS IN 1067 00:42:27,879 --> 00:42:29,480 RED STATES MANAGE THIS BETTER BY 1068 00:42:29,480 --> 00:42:31,582 CHANGING THE NAME OF THE 1069 00:42:31,582 --> 00:42:33,684 COMPONENT AND ADJUSTING THE 1070 00:42:33,684 --> 00:42:34,018 LANGUAGE? 1071 00:42:34,018 --> 00:42:39,857 WOULD IT HELP THEM IN THEIR 1072 00:42:39,857 --> 00:42:40,691 DISCUSSIONS? 1073 00:42:40,691 --> 00:42:42,560 PLAN TO ENHANCE INCLUSIVE 1074 00:42:42,560 --> 00:42:46,297 EXCELLENCE, PLAN TO ASSURE EQUAL 1075 00:42:46,297 --> 00:42:46,831 ACCESS. 1076 00:42:46,831 --> 00:42:47,832 DOES THAT DILUTE WHAT WE'RE 1077 00:42:47,832 --> 00:42:49,901 TRYING TO DO AT ALL THE OTHER 1078 00:42:49,901 --> 00:42:51,335 CANCER CENTERS? 1079 00:42:51,335 --> 00:42:54,105 DOES IT REALLY HELP THE CENTERS 1080 00:42:54,105 --> 00:42:55,406 WHO ARE CHALLENGED BY STATE LAWS 1081 00:42:55,406 --> 00:42:57,775 AROUND DIVERSITY? 1082 00:42:57,775 --> 00:42:59,444 I'D LOVE TO HEAR FEEDBACK. 1083 00:42:59,444 --> 00:43:00,978 THIS IS SOMETHING I DON'T 1084 00:43:00,978 --> 00:43:04,916 UNDERSTAND SINCE I'M NOT ON THE 1085 00:43:04,916 --> 00:43:06,117 GROUND TALKING TO STATE 1086 00:43:06,117 --> 00:43:06,484 REPRESENTATIVES. 1087 00:43:06,484 --> 00:43:09,821 HOPEFULLY WE'LL HAVE TIME TO 1088 00:43:09,821 --> 00:43:11,456 DISCUSS THIS. 1089 00:43:11,456 --> 00:43:12,990 SHOULD WE REQUIRE DEIA IN 1090 00:43:12,990 --> 00:43:16,060 GENERAL BE PART OF THE STRATEGIC 1091 00:43:16,060 --> 00:43:16,394 PLAN? 1092 00:43:16,394 --> 00:43:20,565 THAT'S GOT TO MOVE OUT OF MAYBE 1093 00:43:20,565 --> 00:43:21,766 INTO YES. 1094 00:43:21,766 --> 00:43:22,433 IT'S ABSOLUTELY REQUIRED, SHOULD 1095 00:43:22,433 --> 00:43:26,437 BE PART OF THE CENTERS, NOT JUST 1096 00:43:26,437 --> 00:43:27,038 INSTITUTIONS' STRATEGIC PLAN, 1097 00:43:27,038 --> 00:43:28,873 THEY NEED TO THINK ABOUT THIS IN 1098 00:43:28,873 --> 00:43:30,842 THE FUTURE. 1099 00:43:30,842 --> 00:43:37,081 TWO NOs SHOULD WE EXPAND TO 12 1100 00:43:37,081 --> 00:43:39,050 PAGES, EVENTUALLY, IT'S THAT 1101 00:43:39,050 --> 00:43:39,317 IMPORTANT. 1102 00:43:39,317 --> 00:43:40,485 ONLY 20 OF 72 CANCER CENTERS 1103 00:43:40,485 --> 00:43:41,452 EVALUATED FOR THIS. 1104 00:43:41,452 --> 00:43:43,087 WE'RE STILL IN THE EARLY STAGES 1105 00:43:43,087 --> 00:43:44,889 SO WE THINK WE WANT TO KEEP IT 1106 00:43:44,889 --> 00:43:47,024 AT SIX FOR NOW. 1107 00:43:47,024 --> 00:43:48,693 SHOULD WE START EMPHASIZING 1108 00:43:48,693 --> 00:43:50,228 IMPACT OVER PROCESS? 1109 00:43:50,228 --> 00:43:52,263 AGAIN, I DON'T THINK SO. 1110 00:43:52,263 --> 00:43:55,333 WE DON'T WANT REVIEWERS GETTING 1111 00:43:55,333 --> 00:43:56,868 CONFUSED SAYING WAIT A MINUTE 1112 00:43:56,868 --> 00:43:58,469 YOU'RE ONLY 10% X. 1113 00:43:58,469 --> 00:44:00,638 WE WANT TO KNOW THAT THERE'S 1114 00:44:00,638 --> 00:44:01,572 INFRASTRUCTURE THAT'S GOING TO 1115 00:44:01,572 --> 00:44:03,274 IMPROVE THAT SOMETIME IN THE 1116 00:44:03,274 --> 00:44:03,708 FUTURE. 1117 00:44:03,708 --> 00:44:06,677 SO I THINK PRIMARILY IT'S A 1118 00:44:06,677 --> 00:44:08,946 PROCESS DRIVEN COMPONENT RIGHT 1119 00:44:08,946 --> 00:44:09,180 NOW. 1120 00:44:09,180 --> 00:44:10,915 BUT I THINK IT NEEDS TO STAY 1121 00:44:10,915 --> 00:44:14,752 THAT WAY FOR THE TIME BEING. 1122 00:44:14,752 --> 00:44:15,319 NEXT SLIDE. 1123 00:44:15,319 --> 00:44:17,255 I CONFESS I DON'T SEE A CLOCK. 1124 00:44:17,255 --> 00:44:19,357 I'M NOT SURE HOW WE'RE DOING ON 1125 00:44:19,357 --> 00:44:19,690 TIME. 1126 00:44:19,690 --> 00:44:21,926 IF I NEED TO MOVE UP -- 1127 00:44:21,926 --> 00:44:24,695 >> WE'RE A LITTLE BIT OVER TIME 1128 00:44:24,695 --> 00:44:26,664 BECAUSE WE HAD SOME DISCUSSION 1129 00:44:26,664 --> 00:44:30,501 ALREADY SO WE WERE -- WE'RE AT 1130 00:44:30,501 --> 00:44:30,701 1:45. 1131 00:44:30,701 --> 00:44:33,337 IF YOU WANT TO WRAP UP IN FIVE 1132 00:44:33,337 --> 00:44:33,704 MINUTES. 1133 00:44:33,704 --> 00:44:35,540 >> I'M NOT GOING THE REST OF MY 1134 00:44:35,540 --> 00:44:37,308 SLIDES, I'LL TALK YOU THROUGH 1135 00:44:37,308 --> 00:44:37,942 IT. 1136 00:44:37,942 --> 00:44:38,943 MOST IMPORTANT THING OCC THINKS 1137 00:44:38,943 --> 00:44:43,080 ABOUT IS HOW WE CAN HELP COE. 1138 00:44:43,080 --> 00:44:45,616 IT'S BECOME INCREDIBLY IMPORTANT 1139 00:44:45,616 --> 00:44:47,351 PART OF CANCER CENTERS, AND IT'S 1140 00:44:47,351 --> 00:44:50,521 FAR MORE EXPANSIVE THAN A 1141 00:44:50,521 --> 00:44:51,822 RESEARCH PROGRAM. 1142 00:44:51,822 --> 00:44:53,057 AND IT'S UNDERFUNDED. 1143 00:44:53,057 --> 00:44:54,358 WE KNOW THAT. 1144 00:44:54,358 --> 00:44:56,460 WE DIRECTED PHASE 3 FUNDING 1145 00:44:56,460 --> 00:44:57,662 ORIGINALLY GOING TO OVERALL 1146 00:44:57,662 --> 00:44:59,730 IMPACT AT CANCER CENTERS AND DR. 1147 00:44:59,730 --> 00:45:01,032 LOWY GAVE PERMISSION TO CHANGE 1148 00:45:01,032 --> 00:45:07,271 THAT AFTER WE CAME BACK FROM A 1149 00:45:07,271 --> 00:45:08,039 CCCIF MEETING IN PHILADELPHIA, 1150 00:45:08,039 --> 00:45:11,108 THESE FOLKS HAVE TO GET HELP. 1151 00:45:11,108 --> 00:45:12,810 THERE WAS A SUGGESTION MOVING 1152 00:45:12,810 --> 00:45:14,145 GLOBAL HEALTH OUT. 1153 00:45:14,145 --> 00:45:18,549 WE HAVE TO FIT IT IN ELSEWHERE. 1154 00:45:18,549 --> 00:45:20,952 I LOVE THE IDEA, OUTREACH AND 1155 00:45:20,952 --> 00:45:22,920 ENGAGEMENT IS A BIT REPETITIVE. 1156 00:45:22,920 --> 00:45:23,487 WHAT ABOUT PARTNERSHIP? 1157 00:45:23,487 --> 00:45:27,491 IF YOU WERE TO TELL ME INCLUDING 1158 00:45:27,491 --> 00:45:28,960 PARTNERSHIP WOULD REALLY HELP 1159 00:45:28,960 --> 00:45:31,662 YOU TALK WITH YOUR COMMUNITIES, 1160 00:45:31,662 --> 00:45:32,897 WHETHER IT'S COMMUNITY 1161 00:45:32,897 --> 00:45:33,965 PARTNERSHIP OR COMMUNITY 1162 00:45:33,965 --> 00:45:35,733 OUTREACH AND PARTNERSHIP, WE'LL 1163 00:45:35,733 --> 00:45:36,834 CONSIDER THAT NAME CHANGE 1164 00:45:36,834 --> 00:45:38,035 BECAUSE I ACTUALLY REALLY LIKE 1165 00:45:38,035 --> 00:45:38,369 THAT. 1166 00:45:38,369 --> 00:45:40,338 I THINK THAT'S HOW COE HAS 1167 00:45:40,338 --> 00:45:40,538 GROWN. 1168 00:45:40,538 --> 00:45:45,009 IT'S BECOME A PARTNERSHIP WITH 1169 00:45:45,009 --> 00:45:45,676 THE COMMUNITY. 1170 00:45:45,676 --> 00:45:51,382 DATA TABLE 3 IS A PROBLEM AT THE 1171 00:45:51,382 --> 00:45:56,354 EAB LEVEL, A LIST OF NEW 1172 00:45:56,354 --> 00:45:57,989 ANALYTIC CASES, WE ELIMINATED 1173 00:45:57,989 --> 00:45:58,889 THE DENOMINATOR SEVERAL YEARS 1174 00:45:58,889 --> 00:46:01,959 AGO BECAUSE WE DON'T WANT THAT 1175 00:46:01,959 --> 00:46:03,261 RATIO BEING A REVIEW 1176 00:46:03,261 --> 00:46:04,895 CONSIDERATION ANYMORE AND IT'S 1177 00:46:04,895 --> 00:46:05,062 NOT. 1178 00:46:05,062 --> 00:46:06,664 REVIEWERS DON'T BRING IT UP. 1179 00:46:06,664 --> 00:46:09,400 IF THEY DO, THAT DISCUSSION IS 1180 00:46:09,400 --> 00:46:11,702 ELIMINATED BY THE SRO 1181 00:46:11,702 --> 00:46:12,036 IMMEDIATELY. 1182 00:46:12,036 --> 00:46:13,671 BUT EOBs STILL WORRY ABOUT. 1183 00:46:13,671 --> 00:46:15,873 SO CAN WE HELP CENTERS BY 1184 00:46:15,873 --> 00:46:16,841 ELIMINATING THAT? 1185 00:46:16,841 --> 00:46:19,310 WE WOULD STILL REQUEST THE 1186 00:46:19,310 --> 00:46:21,212 INFORMATION AS PART OF THE 1187 00:46:21,212 --> 00:46:23,281 NON-COMPETITIVE SO NCI HAS AN 1188 00:46:23,281 --> 00:46:25,383 IDEA OF HOW MANY PATIENTS BY 1189 00:46:25,383 --> 00:46:27,385 ANATOMIC SITE ARE SEEN AT OUR 1190 00:46:27,385 --> 00:46:28,986 CANCER CENTERS, THAT'S 1191 00:46:28,986 --> 00:46:29,253 IMPORTANT. 1192 00:46:29,253 --> 00:46:31,956 IN A TYPE 1 APPLICATION NEW 1193 00:46:31,956 --> 00:46:32,923 CANCER CENTER WOULD STILL 1194 00:46:32,923 --> 00:46:34,225 REQUIRE THAT INFORMATION. 1195 00:46:34,225 --> 00:46:38,529 IS IT TIME TO EXPAND CRTEC TO 12 1196 00:46:38,529 --> 00:46:41,599 PAGES IN THEY THINK SO. 1197 00:46:41,599 --> 00:46:44,635 I'M LEERY OF EXPANDING IN THAT 1198 00:46:44,635 --> 00:46:44,869 WAY. 1199 00:46:44,869 --> 00:46:48,706 BUT THAT'S SOMETHING I'D LOVE TO 1200 00:46:48,706 --> 00:46:51,542 HAIR BACK FROM YOU THERE'S 1201 00:46:51,542 --> 00:46:54,178 DISCUSSION AT NCAB A COUPLE 1202 00:46:54,178 --> 00:46:58,015 SESSIONS AGO ABOUT HOW CENTERS 1203 00:46:58,015 --> 00:46:58,983 INCLUDE INDIGENT AND MEDICAID 1204 00:46:58,983 --> 00:46:59,817 PATIENTS TO HAVE ACCESS TO 1205 00:46:59,817 --> 00:47:00,885 CLINICAL TRIALS. 1206 00:47:00,885 --> 00:47:03,154 THIS IS SOPPING THAT MY 1207 00:47:03,154 --> 00:47:04,555 IMPRESSION IS EVERY CANCER 1208 00:47:04,555 --> 00:47:06,757 CENTER DOES BUT I DON'T KNOW THE 1209 00:47:06,757 --> 00:47:07,525 DETAILS. 1210 00:47:07,525 --> 00:47:09,827 SHOULD WE ADD THIS TO THE CCSG 1211 00:47:09,827 --> 00:47:11,796 TO ALLOW THEM TO GET CREDIT FOR 1212 00:47:11,796 --> 00:47:14,098 WHAT THEY DO BUT ALSO TO 1213 00:47:14,098 --> 00:47:15,900 GENERATE LEVERAGE TO GET FURTHER 1214 00:47:15,900 --> 00:47:17,268 INSTITUTIONAL COMMITMENT BECAUSE 1215 00:47:17,268 --> 00:47:20,337 THIS IS AN EXPENSIVE PROPOSITION 1216 00:47:20,337 --> 00:47:23,741 AND MAYBE WOULD FIT UNDER 1217 00:47:23,741 --> 00:47:27,244 INSTITUTIONAL COMMITMENT. 1218 00:47:27,244 --> 00:47:28,312 AND WE HAVEN'T SINCE 2016 1219 00:47:28,312 --> 00:47:30,514 REVISION REALLY LOOKED AT EVERY 1220 00:47:30,514 --> 00:47:30,781 COMPONENT. 1221 00:47:30,781 --> 00:47:33,884 WE FOCUSED ON FOUR AND ON THE 1222 00:47:33,884 --> 00:47:35,653 PRMS SYSTEM HAVE BEEN THE MAJOR 1223 00:47:35,653 --> 00:47:35,886 CHANGES. 1224 00:47:35,886 --> 00:47:38,723 IT'S TIME FOR US TO GO BACK WORD 1225 00:47:38,723 --> 00:47:41,125 BY WORD THROUGH EVERYTHING RIGHT 1226 00:47:41,125 --> 00:47:42,460 FROM THE RESEARCH PROGRAMS, 1227 00:47:42,460 --> 00:47:43,527 THROUGH THE SHARED RESOURCES. 1228 00:47:43,527 --> 00:47:45,496 AND WE'RE GOING TO BE EVALUATING 1229 00:47:45,496 --> 00:47:50,234 THAT ON THIS IMPACT VERSUS 1230 00:47:50,234 --> 00:47:51,035 PROCESS SPECTRUM. 1231 00:47:51,035 --> 00:47:52,436 THE PROGRAM DIRECTORS ARE GOING 1232 00:47:52,436 --> 00:47:54,271 TO START DOING THAT. 1233 00:47:54,271 --> 00:47:55,473 WE'VE ALREADY STARTED ALTHOUGH I 1234 00:47:55,473 --> 00:47:57,875 PLANNED TO DO IT IN JANUARY. 1235 00:47:57,875 --> 00:47:59,410 WE'VE ALREADY STARTED ON THAT. 1236 00:47:59,410 --> 00:48:02,913 SO I THINK WE CAN END MY SLIDES 1237 00:48:02,913 --> 00:48:03,247 NOW. 1238 00:48:03,247 --> 00:48:05,015 ALL THE SLIDES WILL BE AVAILABLE 1239 00:48:05,015 --> 00:48:05,649 TO YOU. 1240 00:48:05,649 --> 00:48:07,184 THERE ARE SEVERAL OTHERS THAT 1241 00:48:07,184 --> 00:48:09,687 I'M NOT GOING TO SHARE SO WE 1242 00:48:09,687 --> 00:48:13,758 HAVE MORE TIME FOR DISCUSSION. 1243 00:48:13,758 --> 00:48:16,160 >> THANK YOU SO MUCH. 1244 00:48:16,160 --> 00:48:20,731 JEB CON -- GENERAL CONSENSUS IN 1245 00:48:20,731 --> 00:48:23,501 THE CHAT IS NO MORE PAGES, ASKED 1246 00:48:23,501 --> 00:48:25,236 AND ANSWERED, AND APPLAUSE FROM 1247 00:48:25,236 --> 00:48:26,670 SOME PEOPLE. 1248 00:48:26,670 --> 00:48:35,312 WITH THAT, I'LL OPEN IT UP AND 1249 00:48:35,312 --> 00:48:36,180 GET STARTED. 1250 00:48:36,180 --> 00:48:37,148 >> HENRY, WE APPRECIATE YOU 1251 00:48:37,148 --> 00:48:39,450 SPEAKING WITH US AND HOPE WE CAN 1252 00:48:39,450 --> 00:48:42,419 BE HELPFUL TO YOU AND YOUR TEAM. 1253 00:48:42,419 --> 00:48:47,024 THIS IS A GENERAL THING. 1254 00:48:47,024 --> 00:48:49,326 YOU'RE PROPOSING -- YOU'RE 1255 00:48:49,326 --> 00:48:50,628 RESPONSIVE, YOU'VE LISTENED, AND 1256 00:48:50,628 --> 00:48:52,163 THERE'S A LOT OF POTENTIAL 1257 00:48:52,163 --> 00:48:52,396 CHANGES. 1258 00:48:52,396 --> 00:48:56,000 I WONDERED IF YOU AND YOUR TEAM 1259 00:48:56,000 --> 00:48:57,635 THOUGHT ABOUT POSTING AN RFI 1260 00:48:57,635 --> 00:48:59,270 BEFORE YOU REVISE NEXT TIME. 1261 00:48:59,270 --> 00:49:03,541 THERE'S ALWAYS THE CHALLENGE OF 1262 00:49:03,541 --> 00:49:05,176 SHOWING DRAFTS TO US, THAT 1263 00:49:05,176 --> 00:49:06,510 CREATES SOME ISSUES. 1264 00:49:06,510 --> 00:49:10,381 BUT IF THERE WAS A PUBLIC RFI 1265 00:49:10,381 --> 00:49:11,849 THEN THE CANCER CENTERS AND 1266 00:49:11,849 --> 00:49:12,983 PARTICULARLY OUR STAFFS WHO DO 1267 00:49:12,983 --> 00:49:14,618 THIS WORK CAN GIVE US THE 1268 00:49:14,618 --> 00:49:16,053 FEEDBACK YOU NEED AND BRING THAT 1269 00:49:16,053 --> 00:49:17,888 TO YOUR TEAM IN A THOUGHTFUL WAY 1270 00:49:17,888 --> 00:49:19,557 AND YOU CAN WORK THROUGH THAT. 1271 00:49:19,557 --> 00:49:21,659 THAT'S JUST A SUGGESTION FOR YOU 1272 00:49:21,659 --> 00:49:23,194 AS YOU THINK ABOUT THESE 1273 00:49:23,194 --> 00:49:23,761 IMPORTANT CHANGES. 1274 00:49:23,761 --> 00:49:24,829 THANK YOU SO MUCH. 1275 00:49:24,829 --> 00:49:25,596 >> THANK YOU. 1276 00:49:25,596 --> 00:49:27,665 THAT'S NOT SOMETHING WE HAD 1277 00:49:27,665 --> 00:49:27,998 CONSIDERED. 1278 00:49:27,998 --> 00:49:31,168 I USUALLY TALK TO TWO GROUPS OF 1279 00:49:31,168 --> 00:49:34,104 PEOPLE, THE DIRECTORS AND 1280 00:49:34,104 --> 00:49:34,538 ADMINISTRATORS. 1281 00:49:34,538 --> 00:49:39,476 ONE OF THINGS ON AGENDA HOW THE 1282 00:49:39,476 --> 00:49:41,445 SUBCOMMITTEE CAN HELP. 1283 00:49:41,445 --> 00:49:42,546 YOU'RE SENIOR LEADERS. 1284 00:49:42,546 --> 00:49:43,848 I LOVE THE FACT THERE'S ANOTHER 1285 00:49:43,848 --> 00:49:45,716 GROUP I CAN TALK TO ABOUT THESE 1286 00:49:45,716 --> 00:49:45,950 CHANGES. 1287 00:49:45,950 --> 00:49:47,785 I'LL HAVE TO LOOK INTO THE RFI 1288 00:49:47,785 --> 00:49:50,621 AND SEE HOW IT WOULD NEED TO BE 1289 00:49:50,621 --> 00:49:53,390 TAILORED BECAUSE IT'S SUCH A 1290 00:49:53,390 --> 00:49:55,226 COMPLEX COMPONENT, I WONDER IF 1291 00:49:55,226 --> 00:50:05,703 WE COULD GET INUNDATED WITH 1292 00:50:11,008 --> 00:50:13,878 RANDOM SUGGESTIONS. 1293 00:50:13,878 --> 00:50:17,948 >> DR. HAYES-DIXON? 1294 00:50:17,948 --> 00:50:24,488 >> A COMMENT ABOUT MEDICARE AND 1295 00:50:24,488 --> 00:50:25,456 INDIGENT PATIENT INCLUSION, 1296 00:50:25,456 --> 00:50:28,425 CRITICAL IN NOT JUST HAVING 1297 00:50:28,425 --> 00:50:31,295 ACCOUNT OF CLINICAL TRIALS BUT 1298 00:50:31,295 --> 00:50:34,565 DAY-TO-DAY TREATMENT IN CANCER 1299 00:50:34,565 --> 00:50:35,266 CENTERS. 1300 00:50:35,266 --> 00:50:37,434 THERE ARE SOME CANCER CENTERS 1301 00:50:37,434 --> 00:50:40,004 THAT ARE TURNING AWAY PATIENTS 1302 00:50:40,004 --> 00:50:45,943 BASED ON INDIGENT OR MEDICARE OR 1303 00:50:45,943 --> 00:50:47,378 OTHER REASONS, WE WANT TO 1304 00:50:47,378 --> 00:50:48,846 INCLUDE THEM IN CLINICAL TRIALS 1305 00:50:48,846 --> 00:50:50,381 AND ALSO IN THEIR DAY-TO-DAY 1306 00:50:50,381 --> 00:50:54,318 PATIENT CARE AND HOW SOME WAY OF 1307 00:50:54,318 --> 00:50:58,923 THEM RECORDING IT SO IT CAN BE 1308 00:50:58,923 --> 00:51:01,425 REVIEWED BY YOUR COMMITTEE. 1309 00:51:01,425 --> 00:51:03,160 >> SO, I UNDERSTAND, I'M A 1310 00:51:03,160 --> 00:51:08,332 LITTLE LEERY OF MY ABILITY TO 1311 00:51:08,332 --> 00:51:09,967 MANDATE ACCEPTANCE OF UNINSURED 1312 00:51:09,967 --> 00:51:12,236 PATIENTS BY CANCER CENTERS INTO 1313 00:51:12,236 --> 00:51:13,671 BASIC CLINICAL CARE. 1314 00:51:13,671 --> 00:51:15,873 THIS IS A RESEARCH MECHANISM. 1315 00:51:15,873 --> 00:51:18,075 WE DON'T EVALUATE CARE IN THAT 1316 00:51:18,075 --> 00:51:18,242 WAY. 1317 00:51:18,242 --> 00:51:22,046 I CERTAINLY THINK WE CAN 1318 00:51:22,046 --> 00:51:25,316 CONSIDER FOR CLINICAL TRIALS HOW 1319 00:51:25,316 --> 00:51:26,417 THE CENTER SUPPORTS INCLUSION ON 1320 00:51:26,417 --> 00:51:27,084 CLINICAL TRIALS. 1321 00:51:27,084 --> 00:51:29,053 >> YES, AND HAVE A WAY TO ASK 1322 00:51:29,053 --> 00:51:30,821 FOR THAT DOCUMENTATION OF HOW 1323 00:51:30,821 --> 00:51:32,323 THAT'S DONE BECAUSE THE OTHER 1324 00:51:32,323 --> 00:51:35,292 THING I'M FINDING ON MY END AT 1325 00:51:35,292 --> 00:51:38,595 HOWARD, THERE ARE OTHER CENTERS 1326 00:51:38,595 --> 00:51:39,897 REACHING OUT TO INCLUDE THE 1327 00:51:39,897 --> 00:51:42,633 UNDERREPRESENTED MINORITY 1328 00:51:42,633 --> 00:51:46,804 PATIENTS WE TAKE CARE OF BUT ARE 1329 00:51:46,804 --> 00:51:50,174 NOT INCLUDING THEM -- BUT ARE 1330 00:51:50,174 --> 00:51:51,442 NOT -- NOT APPLYING RESOURCE TO 1331 00:51:51,442 --> 00:51:52,609 INCLUDE THEM IN CLINICAL TRIALS 1332 00:51:52,609 --> 00:51:53,978 EITHER SO THEY ARE ASKING FOR 1333 00:51:53,978 --> 00:51:56,413 ALL OF MY PATIENTS WITHOUT ANY 1334 00:51:56,413 --> 00:51:59,149 REAL PARTNERSHIP, SO IF THAT 1335 00:51:59,149 --> 00:52:00,150 COULD ALSO BE PART OF THE 1336 00:52:00,150 --> 00:52:03,420 EVALUATION THAT WOULD BE 1337 00:52:03,420 --> 00:52:05,189 HELPFUL. 1338 00:52:05,189 --> 00:52:05,522 >> OKAY. 1339 00:52:05,522 --> 00:52:09,460 >> THANK YOU. 1340 00:52:09,460 --> 00:52:09,994 DR. ULRICH? 1341 00:52:09,994 --> 00:52:11,528 >> WONDERFUL TO HEAR FROM YOU, 1342 00:52:11,528 --> 00:52:13,197 HAPPY TO GET MORE FEEDBACK. 1343 00:52:13,197 --> 00:52:14,598 THE BIG ONE HERE IS WHERE YOU 1344 00:52:14,598 --> 00:52:18,002 ASKED ABOUT WOULD IT HELP THE 1345 00:52:18,002 --> 00:52:20,404 RED STATES TO HAVE ACCESS IN THE 1346 00:52:20,404 --> 00:52:22,272 TITLE, I WOULD SAY ABSOLUTELY. 1347 00:52:22,272 --> 00:52:24,008 I THINK, YOU KNOW, WE DON'T KNOW 1348 00:52:24,008 --> 00:52:25,442 WHAT'S GOING TO COME DOWN THE 1349 00:52:25,442 --> 00:52:27,411 PIKE IN UTAH THIS YEAR. 1350 00:52:27,411 --> 00:52:31,448 WE WERE ABLE TO FEND OFF LAWS 1351 00:52:31,448 --> 00:52:34,385 LAST YEAR IN PART BY USING CCSG 1352 00:52:34,385 --> 00:52:36,920 REQUIREMENT BUT I THINK HAVING A 1353 00:52:36,920 --> 00:52:39,356 COMBINATION OF SAYING PLANS TO 1354 00:52:39,356 --> 00:52:40,958 ENHANCE DIVERSITY AND BROADEN 1355 00:52:40,958 --> 00:52:44,762 ACCESS OR SOMETHING LIKE THAT 1356 00:52:44,762 --> 00:52:46,563 WOULD ILLUSTRATE TO OUR 1357 00:52:46,563 --> 00:52:48,966 COMMUNITIES THAT THE NCI CARES 1358 00:52:48,966 --> 00:52:50,367 ALSO ABOUT THE RURAL POPULATIONS 1359 00:52:50,367 --> 00:52:55,005 AND THAT IS WHERE WE HAVE A LOT 1360 00:52:55,005 --> 00:52:56,440 OF FOCUS ON PROVIDING ACCESS. 1361 00:52:56,440 --> 00:53:00,577 AS LONG AS YOU HAVE AIMS OF 1362 00:53:00,577 --> 00:53:01,345 DIVERSITY, MINDFULNESS ABOUT 1363 00:53:01,345 --> 00:53:06,016 WOMEN AND UNDERREPRESENTED 1364 00:53:06,016 --> 00:53:07,251 MINORITIES IN LEADERSHIP, WE 1365 00:53:07,251 --> 00:53:09,153 TALKED ABOUT THAT, IT WOULDN'T 1366 00:53:09,153 --> 00:53:10,654 DETRACT BUT WOULD BROADEN AND 1367 00:53:10,654 --> 00:53:12,956 MAY HELP PROTECT IT SO I'M 1368 00:53:12,956 --> 00:53:14,391 LOOKING FORWARD TO HEARING FROM 1369 00:53:14,391 --> 00:53:14,758 OTHERS. 1370 00:53:14,758 --> 00:53:17,661 I DO WANT TO GIVE ONE SMALL 1371 00:53:17,661 --> 00:53:19,763 CONSIDERATION ABOUT THE MEDICAID 1372 00:53:19,763 --> 00:53:20,030 PATIENTS. 1373 00:53:20,030 --> 00:53:21,398 SO WE ABSOLUTELY WANT TO MAKE 1374 00:53:21,398 --> 00:53:23,267 SURE THOSE PATIENTS ARE SEEN, WE 1375 00:53:23,267 --> 00:53:25,769 HAVE A LOT OF CHARITY CARE WE DO 1376 00:53:25,769 --> 00:53:27,971 WHAT WE CAN DO INCLUDE THEM IN 1377 00:53:27,971 --> 00:53:28,272 TRIALS. 1378 00:53:28,272 --> 00:53:30,908 IT'S MAYBE A LITTLE BIT TRICKY 1379 00:53:30,908 --> 00:53:32,676 TO THEN MAKE SURE PEOPLE, 1380 00:53:32,676 --> 00:53:34,211 REVIEWERS DON'T SEE THIS AS 1381 00:53:34,211 --> 00:53:35,179 QUANTITATIVE BECAUSE WE HAVE 1382 00:53:35,179 --> 00:53:39,883 STATES THAT DON'T HAVE MEDICAID 1383 00:53:39,883 --> 00:53:44,088 EXPANSION IN OUR FIVE STATES 1384 00:53:44,088 --> 00:53:45,889 AREA WE SERVE, WE CALL IT AREA 1385 00:53:45,889 --> 00:53:46,790 WE SERVE. 1386 00:53:46,790 --> 00:53:48,125 IN ADDITION PARTNERSHIP WITH 1387 00:53:48,125 --> 00:53:50,060 FEDERALLY QUALIFIED HEALTH 1388 00:53:50,060 --> 00:53:51,261 CENTERS IT'S BECOME CLEAR THAT 1389 00:53:51,261 --> 00:53:53,697 FOR THEM THIS IS A MAJOR SOURCE 1390 00:53:53,697 --> 00:53:56,300 OF INCOME AND NOT GOOD IF WE 1391 00:53:56,300 --> 00:53:57,835 SOMETIMES DRAW THOSE PATIENTS IN 1392 00:53:57,835 --> 00:54:00,671 ESPECIALLY IF THEY DON'T HAVE 1393 00:54:00,671 --> 00:54:02,539 COMPLEX CASES OR DON'T END UP IN 1394 00:54:02,539 --> 00:54:02,906 CLINICAL TRIALS. 1395 00:54:02,906 --> 00:54:04,842 THERE'S A LOT OF CONSIDERATIONS 1396 00:54:04,842 --> 00:54:07,244 THAT MAY BE DIFFERENT ACROSS THE 1397 00:54:07,244 --> 00:54:11,181 COUNTRY, OF COURSE EVERYBODY 1398 00:54:11,181 --> 00:54:13,684 SHOULD SERVE AND WE DO. 1399 00:54:13,684 --> 00:54:15,486 >> IT FITS UNDER INSTITUTIONAL 1400 00:54:15,486 --> 00:54:17,421 COMMITMENT, NOT AS EVALUATION 1401 00:54:17,421 --> 00:54:21,258 FOR, SAY, THE CPDM COMPONENT OR 1402 00:54:21,258 --> 00:54:22,159 SOMETHING LIKE THAT BECAUSE 1403 00:54:22,159 --> 00:54:23,794 THERE ARE A LOT OF BUSINESS 1404 00:54:23,794 --> 00:54:26,530 CONSIDERATIONS HERE THAT I DON'T 1405 00:54:26,530 --> 00:54:28,699 UNDERSTAND HOW IT MIGHT BE 1406 00:54:28,699 --> 00:54:33,237 AFFECTED IF WE WERE TO EMPHASIZE 1407 00:54:33,237 --> 00:54:35,506 IT IN OTHER COMPONENTS. 1408 00:54:35,506 --> 00:54:42,980 >> AND JUST TO PIGGYBACK, THE 1409 00:54:42,980 --> 00:54:45,783 WORD ACCESS, IT SEEMED LIKE P.E. 1410 00:54:45,783 --> 00:54:49,086 D WAS FOCUSED ON TRAINING, 1411 00:54:49,086 --> 00:54:50,320 DIVERSITY, WORKFORCE, AND ACCESS 1412 00:54:50,320 --> 00:54:51,755 ISSUES ARE MORE PATIENT 1413 00:54:51,755 --> 00:54:52,923 CENTERED, I'M NOT SAYING IT 1414 00:54:52,923 --> 00:54:54,458 DOESN'T NEED TO GO SOMEWHERE BUT 1415 00:54:54,458 --> 00:54:56,660 THEN I FEEL LIKE THE 1416 00:54:56,660 --> 00:54:58,295 BEHIND-THE-SCENES OF NOW WHERE 1417 00:54:58,295 --> 00:55:02,232 DOES COE FIT IN AND CPDM BUT 1418 00:55:02,232 --> 00:55:04,768 YOUR POINT ABOUT ACCESS IS HUGE 1419 00:55:04,768 --> 00:55:06,069 AND WELL TAKEN. 1420 00:55:06,069 --> 00:55:09,873 WAS THERE ANOTHER HAND UP? 1421 00:55:09,873 --> 00:55:12,910 >> I HAD A QUESTION THAT WAS 1422 00:55:12,910 --> 00:55:17,447 ADDRESSED. 1423 00:55:17,447 --> 00:55:17,848 THANKS. 1424 00:55:17,848 --> 00:55:18,415 >> OKAY. 1425 00:55:18,415 --> 00:55:20,884 >> I THANK YOU FOR PRESENTING. 1426 00:55:20,884 --> 00:55:26,723 I WANT TO GIVE A LITTLE BIT OF 1427 00:55:26,723 --> 00:55:29,226 CONTRASTING OPINION ABOUT THE 1428 00:55:29,226 --> 00:55:31,195 CHANGE IN NAME. 1429 00:55:31,195 --> 00:55:33,597 PLAN TO ENHANCE DIVERSITY. 1430 00:55:33,597 --> 00:55:35,799 IN TEXAS THE LAW SPECIFICALLY 1431 00:55:35,799 --> 00:55:37,267 STATES THAT WE CAN'T CALL IT 1432 00:55:37,267 --> 00:55:39,036 SOMETHING ELSE WHILE WE'RE DOING 1433 00:55:39,036 --> 00:55:40,704 DIVERSITY, SO IT'S NOT -- 1434 00:55:40,704 --> 00:55:42,239 >> OH REALLY? 1435 00:55:42,239 --> 00:55:42,506 >> YEAH. 1436 00:55:42,506 --> 00:55:44,608 >> TEXAS WAS ONE OF THE STATES I 1437 00:55:44,608 --> 00:55:45,475 WAS THINKING I COULD HELP. 1438 00:55:45,475 --> 00:55:47,110 >> I DON'T KNOW THAT IT HELPS. 1439 00:55:47,110 --> 00:55:49,580 BE HAPPY TO HAVE A CHAT WITH OUR 1440 00:55:49,580 --> 00:55:51,415 GOVERNMENTAL RELATIONS PERSON 1441 00:55:51,415 --> 00:55:53,283 AND SIGH IF HE THINKS THERE'S 1442 00:55:53,283 --> 00:55:54,918 WIGGLE ROOM BUT MY UNDERSTANDING 1443 00:55:54,918 --> 00:55:56,353 IS IT'S SPECIFIC LI WRITTEN INTO 1444 00:55:56,353 --> 00:55:59,223 THE LAW THAT YOU CAN'T CALL IT 1445 00:55:59,223 --> 00:56:03,760 SOMETHING ELSE AND STILL DO 1446 00:56:03,760 --> 00:56:04,127 DIVERSITY. 1447 00:56:04,127 --> 00:56:06,964 >> WE WOULD STILL HAVE THE WORD 1448 00:56:06,964 --> 00:56:08,165 "DIVERSITY" WITHIN THE 1449 00:56:08,165 --> 00:56:08,765 COMPONENT. 1450 00:56:08,765 --> 00:56:09,399 >> SURE. 1451 00:56:09,399 --> 00:56:13,437 >> IF WE COULD GET THE TITLE TO 1452 00:56:13,437 --> 00:56:16,740 BE UNOFFENSIVE TO ALL WITHOUT 1453 00:56:16,740 --> 00:56:18,909 DILUTING IT, THAT WAS MORE MY 1454 00:56:18,909 --> 00:56:19,476 THINKING. 1455 00:56:19,476 --> 00:56:20,110 >> YEAH, YEAH. 1456 00:56:20,110 --> 00:56:21,712 I DON'T KNOW THAT THAT WOULD 1457 00:56:21,712 --> 00:56:25,249 HELP US A LOT IN TEXAS. 1458 00:56:25,249 --> 00:56:25,515 >> OKAY. 1459 00:56:25,515 --> 00:56:29,453 >> WE ARE A STRANGE STATE 1460 00:56:29,453 --> 00:56:29,820 SOMETIMES. 1461 00:56:29,820 --> 00:56:37,394 >> FLORIDA STANDS WITH YOU IN 1462 00:56:37,394 --> 00:56:37,794 THAT. 1463 00:56:37,794 --> 00:56:40,130 >> I DON'T THINK CHANGING THE 1464 00:56:40,130 --> 00:56:43,767 NAME ITSELF IS A PROBLEM. 1465 00:56:43,767 --> 00:56:45,235 BROADENING THE TITLE WOULD BE 1466 00:56:45,235 --> 00:56:45,469 HELPFUL. 1467 00:56:45,469 --> 00:56:50,173 IF WE MAKE IT BROADER IN SUCH A 1468 00:56:50,173 --> 00:56:52,042 WAY IT COMPENSATES, NOT JUST A 1469 00:56:52,042 --> 00:56:58,915 RACE ISSUE, IT WILL HELP. 1470 00:56:58,915 --> 00:57:01,285 BUT I HAD A CHANCE TO LOOK AT 1471 00:57:01,285 --> 00:57:04,955 MANY OF THESE LAWS IN TEXAS FOR 1472 00:57:04,955 --> 00:57:05,422 SURE. 1473 00:57:05,422 --> 00:57:07,724 AND EVEN HERE, IF THE BILLS 1474 00:57:07,724 --> 00:57:09,660 PASS, JUST CHANGING THE NAME IS 1475 00:57:09,660 --> 00:57:10,894 NOT GOING TO MAKE A DIFFERENCE. 1476 00:57:10,894 --> 00:57:13,730 AS A MATTER OF FACT, IT WOULD 1477 00:57:13,730 --> 00:57:14,798 JUST CHANGE DISCOURSE TO 1478 00:57:14,798 --> 00:57:15,499 SOMETHING ELSE. 1479 00:57:15,499 --> 00:57:17,134 I THINK HAVING IT IN THE 1480 00:57:17,134 --> 00:57:19,036 COMPONENTS IS HELPFUL BECAUSE IT 1481 00:57:19,036 --> 00:57:20,570 DOES PROVIDE AVENUE TO WORK ON 1482 00:57:20,570 --> 00:57:23,974 THESE ISSUES SO I WOULD SAY JUST 1483 00:57:23,974 --> 00:57:26,777 TWEAK IT TO MAKE IT BROADER SO 1484 00:57:26,777 --> 00:57:30,047 IT CAN ENGAGE PEOPLE IN THE 1485 00:57:30,047 --> 00:57:32,015 PROCESS, BUT YOU WOULDN'T CHANGE 1486 00:57:32,015 --> 00:57:42,526 THE NAME OR DROP "DIVERSITY." 1487 00:57:46,697 --> 00:57:47,097 >> OKAY. 1488 00:57:47,097 --> 00:57:51,635 >> I THINK YOU MIGHT BE MUTED. 1489 00:57:51,635 --> 00:57:56,807 >> SO, I WANTED TO MENTION THAT 1490 00:57:56,807 --> 00:58:00,043 ALTHOUGH I SEE SOME POINT IN 1491 00:58:00,043 --> 00:58:01,812 ADDING THE WORD "DIVERSITY" I 1492 00:58:01,812 --> 00:58:03,347 MEAN ACCESS AROUND DIVERSITY 1493 00:58:03,347 --> 00:58:07,384 WITH THE TITLE, I DO HAVE REAL 1494 00:58:07,384 --> 00:58:08,251 CONCERNS ABOUT MUDDYING THE 1495 00:58:08,251 --> 00:58:09,986 WATER OVER EXACTLY WHAT THAT 1496 00:58:09,986 --> 00:58:11,221 ACCESS MEANS. 1497 00:58:11,221 --> 00:58:12,489 IT'S ALREADY COMPLICATED ENOUGH 1498 00:58:12,489 --> 00:58:13,757 WHEN WE'RE TRYING TO PUT THESE 1499 00:58:13,757 --> 00:58:14,825 THINGS TOGETHER AND MAKE SENSE 1500 00:58:14,825 --> 00:58:17,127 TO PEOPLE IN THE COMMUNITY. 1501 00:58:17,127 --> 00:58:19,996 WE TALK ABOUT ONE, WE TALK ABOUT 1502 00:58:19,996 --> 00:58:21,832 DIVERSITY, AND EQUITY AND 1503 00:58:21,832 --> 00:58:23,900 INCLUSION, AND PED, AND THEN WE 1504 00:58:23,900 --> 00:58:26,670 TALK ABOUT COE AND PATIENT 1505 00:58:26,670 --> 00:58:27,137 ACCRUALS. 1506 00:58:27,137 --> 00:58:32,175 AND SO THE WAY IT IS NOW IT 1507 00:58:32,175 --> 00:58:33,143 NICELY SEPARATES THAT, RIGHT? 1508 00:58:33,143 --> 00:58:38,281 AND THEY HAVE TWO VERY DIFFERENT 1509 00:58:38,281 --> 00:58:39,149 MISSIONS AND FOCI, AND, YOU 1510 00:58:39,149 --> 00:58:41,017 KNOW, TO ME I FEEL LIKE IF 1511 00:58:41,017 --> 00:58:42,486 YOU'RE GOING TO USE ACCESS MAYBE 1512 00:58:42,486 --> 00:58:44,621 WE NEED TO THINK OF A DIFFERENT 1513 00:58:44,621 --> 00:58:45,622 WORD, NOT ACCESS, BECAUSE I 1514 00:58:45,622 --> 00:58:47,457 THINK WE THINK OF PATIENT ACCESS 1515 00:58:47,457 --> 00:58:49,760 TO CARE, WE THINK OF PATIENT 1516 00:58:49,760 --> 00:58:51,395 ACCESS TO CLINICAL TRIALS, LIKE 1517 00:58:51,395 --> 00:58:52,963 PEOPLE ACROSS THE COUNTRY KNOW 1518 00:58:52,963 --> 00:58:55,365 THAT AND RECOGNIZE THAT. 1519 00:58:55,365 --> 00:58:57,434 IF YOU WANT TO DO SOMETHING 1520 00:58:57,434 --> 00:58:58,869 DIFFERENT WITH A TERM WE NEED TO 1521 00:58:58,869 --> 00:59:01,705 THINK OF SOMETHING ELSE. 1522 00:59:01,705 --> 00:59:02,339 1523 00:59:02,339 --> 00:59:05,208 >> I UNDERSTAND. 1524 00:59:05,208 --> 00:59:07,444 THE WHITE HOUSE USES DEIA BUT 1525 00:59:07,444 --> 00:59:09,146 THE ACCESS PART, THAT'S NOW 1526 00:59:09,146 --> 00:59:12,883 OFFICIAL AT NIH, WE'RE REFERRING 1527 00:59:12,883 --> 00:59:14,451 TO THE DISABLED, NOT PATIENTS, 1528 00:59:14,451 --> 00:59:16,953 TO ACCESS TO TRIALS AND THAT 1529 00:59:16,953 --> 00:59:18,355 SORT OF THING. 1530 00:59:18,355 --> 00:59:20,323 I AGREE, WE WON'T DO THAT. 1531 00:59:20,323 --> 00:59:22,192 >> IT'S CONFUSING TO PEOPLE OUT 1532 00:59:22,192 --> 00:59:22,392 THERE. 1533 00:59:22,392 --> 00:59:25,328 >> IT'S COMPLICATED ENOUGH. 1534 00:59:25,328 --> 00:59:28,098 1535 00:59:28,098 --> 00:59:29,065 >> TAKE US HOME. 1536 00:59:29,065 --> 00:59:30,801 >> I WANT TO ECHO BECAUSE I 1537 00:59:30,801 --> 00:59:32,569 THINK IT'S IMPORTANT NOT TO MAKE 1538 00:59:32,569 --> 00:59:33,670 THINGS MORE CONFUSING THANK WHAT 1539 00:59:33,670 --> 00:59:34,871 THEY ARE. 1540 00:59:34,871 --> 00:59:42,279 PEOPLE STRUGGLING WITH WHAT IS 1541 00:59:42,279 --> 00:59:43,513 CRTEC'S CONTROL VERSUS COE. 1542 00:59:43,513 --> 00:59:45,282 I WOULD LEAVE IT THAT WAY. 1543 00:59:45,282 --> 00:59:55,792 I WOULDN'T CHANGE IT AT ALL. 1544 01:00:16,446 --> 01:00:18,248 CAN I WOULD MAKE SURE THE WORK 1545 01:00:18,248 --> 01:00:18,782 WE'RE DOING IS BROADLY 1546 01:00:18,782 --> 01:00:20,750 APPLICABLE TO THE PEOPLE THAT 1547 01:00:20,750 --> 01:00:23,186 WE'RE SERVING, SO KEEPING THAT 1548 01:00:23,186 --> 01:00:24,821 FOCUS NEEDS TO RESONATE WITH 1549 01:00:24,821 --> 01:00:29,860 FOLKS VERSUS THE OUTREACH PIECE. 1550 01:00:29,860 --> 01:00:33,163 IT'S ALL ABOUT ENGAGEMENT. 1551 01:00:33,163 --> 01:00:39,169 1552 01:00:39,169 --> 01:00:49,212 1553 01:00:51,882 --> 01:00:53,283 >> IT SOUNDS LIKE YOU'RE GROUP 1554 01:00:53,283 --> 01:00:55,151 IS MOVING IN THE RIGHT 1555 01:00:55,151 --> 01:00:55,452 DIRECTION. 1556 01:00:55,452 --> 01:00:58,788 >> WE'RE A MINUTE OVER. 1557 01:00:58,788 --> 01:01:00,590 I JUST WANTED TO THANK THE TEAM 1558 01:01:00,590 --> 01:01:03,393 AND ALL OF YOU FOR SUCH AN 1559 01:01:03,393 --> 01:01:03,860 ENGAGED DISCUSSION. 1560 01:01:03,860 --> 01:01:05,228 WE'LL DO A SUMMARY AND READOUT 1561 01:01:05,228 --> 01:01:06,763 AND HOPEFULLY THAT'S AN 1562 01:01:06,763 --> 01:01:07,664 OPPORTUNITY FOR US TO THINK 1563 01:01:07,664 --> 01:01:13,236 ABOUT HOW WE CAN BE OF SERVICE 1564 01:01:13,236 --> 01:01:23,236 TO YOU, HENRY.