- Table View
- List View
The Future of Home Health Care: Workshop Summary
by Victoria WeisfeldIndividuals with disabilities, chronic conditions, and functional impairments need a range of services and supports to keep living independently. However, there often is not a strong link between medical care provided in the home and the necessary social services and supports for independent living. Home health agencies and others are rising to the challenges of meeting the needs and demands of these populations to stay at home by exploring alternative models of care and payment approaches, the best use of their workforces, and technologies that can enhance independent living. All of these challenges and opportunities lead to the consideration of how home health care fits into the future health care system overall. On September 30 and October 1, 2014, the Institute of Medicine and the National Research Council convened a public workshop on the future of home health care. The workshop brought together a spectrum of public and private stakeholders and thought leaders to improve understanding of the current role of Medicare home health care in supporting aging in place and in helping high-risk, chronically ill, and disabled Americans receive health care in their communities. Through presentations and discussion, participants explored the evolving role of Medicare home health care in caring for Americans in the future, including how to integrate Medicare home health care into new models for the delivery of care and the future health care marketplace. The workshop also considered the key policy reforms and investments in workforces, technologies, and research needed to leverage the value of home health care to support older Americans, and research priorities that can help clarify the value of home health care. This summary captures important points raised by the individual speakers and workshop participants.
Review of California's Risk-Assessment Process for Pesticides
by Committee to Review California's Risk-Assessment Process for PesticidesThe California Department of Pesticide Regulation(DPR)conducts human health risk assessments as part of its mission to ensure the protection of workers and public health in the state. The risk assessments identify potential health hazards posed by pesticides, characterize dose-response relationships, and estimate exposure to characterize potential risks to humans. Over the last decade, advances in methods of scientific and technical analysis have led to improvements in the risk-assessment process that have made them more rigorous, transparent, and useful to risk managers. In light of the advances, the California legislature asked DPR to arrange an independent peer review of the agency's risk-assessment practices to ensure that they are scientifically and technically credible.
Potential Risks and Benefits of Gain-of-Function Research: Summary of a Workshop
by Frances SharplesOn October 17, 2014, spurred by incidents at U. S. government laboratories that raised serious biosafety concerns, the United States government launched a one-year deliberative process to address the continuing controversy surrounding so-called "gain-of-function" (GOF) research on respiratory pathogens with pandemic potential. The gain of function controversy began in late 2011 with the question of whether to publish the results of two experiments involving H5N1 avian influenza and continued to focus on certain research with highly pathogenic avian influenza over the next three years. The heart of the U. S. process is an evaluation of the potential risks and benefits of certain types of GOF experiments with influenza, SARS, and MERS viruses that would inform the development and adoption of a new U. S. Government policy governing the funding and conduct of GOF research. "Potential Risks and Benefits of Gain-of-Function Research" is the summary of a two-day public symposia on GOF research. Convened in December 2014 by the Institute of Medicine and the National Research Council, the main focus of this event was to discuss principles important for, and key considerations in, the design of risk and benefit assessments of GOF research. Participants examined the underlying scientific and technical questions that are the source of current discussion and debate over GOF research involving pathogens with pandemic potential. This report is a record of the presentations and discussion of the meeting.
Review of Proposals to the Bureau of Land Management on Wild Horse and Burro Sterilization or Contraception: A Letter Report
by Committee for the Review of Proposals to the Bureau of Land Management on Wild Horse Burro Sterilization or ContraceptionAs a follow-up to the 2013 report Using Science to Improve the Wild Horse and Burro Program: A Way Forward, this letter report reviews research project proposals submitted to the Bureau of Land Management and aimed at developing new or refining existing techniques and establishing protocols for the contraception or permanent sterilization of either male or female wild horses and/or burros in the field. Review of Proposals to the Bureau of Land Management on Wild Horse and Burro Sterilization or Contraception considers factors related to the scientific validity of the proposed technique(s), goals and objectives of the work, research methodology and design of the study, proposed statistical analysis and interpretation of anticipated data obtained, animal welfare implications and Institutional Animal Care and Use Committee approvals, feasibility, as well as the qualifications, expertise, and experience of the investigators. This report ranks the proposals in order of merit and provides a brief report on additional factors for the Bureau of Land Management to consider in selecting proposals to fund.
Space Studies Board: Annual Report 2014
by National Research Council of the National AcademiesUnder the leadership of Jonathan Lunine and Mitch Daniels, the Committee on Human Spaceflight completed one of the most challenging studies undertaken by the Space Studies Board and the Aeronautics and Space Engineering Board. In Pathways to Exploration: Rationales and Approaches for a U.S. Program of Human Exploration, a diverse committee of experts tackled not only the question, How should humans explore space?, but the even more challenging question, Why should humans explore space? <P> The committee identified a pair of enduring questions that motivate human spaceflight: How far from Earth can humans go? and What can humans discover and achieve when we get there? The committee then explored a range of rationales for human spaceflight ranging from the pragmatic (its economic, national security, scientific exploration, international relations, and technology impacts) to the aspirational—the notion that space is humanity’s future. While the committee did not identify a single rationale as the primary justification for space exploration and could not quantify the economic benefit of space exploration, it did conclude that a mix of rationales motivates space exploration. <P><P> Along with an examination of public and stakeholder attitudes about human exploration, the report evaluated three different pathways to illustrate the trade-offs among affordability, schedule, developmental risk, and the frequency of missions for different sequences of intermediate destinations. The pathways, all of which culminate in landing on the surface of Mars, include some combination of missions to asteroids, the Moon, and martian moons.
Opportunities for the Gulf Research Program: A Workshop Summary
by Kim WaddellEnvironmental monitoring in the Gulf of Mexico poses extensive challenges and significant opportunities. Multiple jurisdictions manage this biogeographically and culturally diverse region, whose monitoring programs tend to be project-specific by design and funding. As a result, these programs form more of a monitoring patchwork then a network. At the same time, the Gulf monitoring community faces a unique opportunity to organize and think differently about monitoring - including how best to allocate and manage the resources for this large marine ecosystem and its communities - as a result of the infusion of resources for environmental restoration and related activities after the Deepwater Horizon oil spill. Opportunities for the Gulf Research Program: Monitoring Ecosystem Restoration and Deep Water Environments summarizes a Gulf Research Program workshop held on September 3-4, 2014 in New Orleans, Louisiana. The workshop gathered about 40 participants from the energy industry, state and federal government, academia, and nongovernmental organizations to examine two broad issues that were seen as time-sensitive opportunities in light of significant investments in the Gulf for restoration and accelerating development of energy resources in the deep Gulf: monitoring ecosystem restoration and deep water environments. As participants explored potential opportunities for the Program to consider, they noted the essential role that communication and outreach play in successful monitoring, and the importance of applying an ecosystem service approach to monitoring, forging partnerships among stakeholders, and supporting efforts to organize and manage monitoring data.
Opportunities for the Employment of Simulation in U.S. Air Force Training Environments: A Workshop Report
by Committee on Opportunities for the Employment of Simulation in U.S. Air Force Training Environments: A WorkshopSimulators currently provide an alternative to aircraft when it comes to training requirements, both for the military and for commercial airlines. For the U.S. Air Force, in particular, simulation for training offers a cost-effective way, and in many instances a safer way in comparison with live flying, to replicate real-world missions. Current technical issues related to simulation for training include simulation fidelity and multi-level security, among others, which will need to be addressed in order for the Air Force to take full advantage of this technology. <P><P> The workshop held in November, 2014 examined the current status of simulation training, alternative uses, current and future technologies, and how the combination of simulation and live training can improve aircrew training. The scope of the workshop focused on technologies and practices that could be applicable to high-end aircraft simulations.
2013-2014 Assessment of the Army Research Laboratory
by Army Research Laboratory Technical Assessment BoardThe National Research Council's Army Research Laboratory Technical Assessment Board (ARLTAB) provides biennial assessments of the scientific and technical quality of the research, development, and analysis programs at the Army Research Laboratory, focusing on ballistics sciences, human sciences, information sciences, materials sciences, and mechanical sciences. "2013-2014 Assessment of the Army Research Laboratory" summarizes the findings of the Board for the first biennial assessment. This report discusses the biennial assessment process used by ARLTAB and its five panels; provides detailed assessments of each of the ARL core technical competency areas reviewed during the 2013-2014 period; and presents findings and recommendations common across multiple competency areas.
Opportunities for the Gulf Research Program: Summary of a Workshop
by Leighanne OlsenThere are many connections between human communities and their surrounding environments that influence community resilience and health in the Gulf of Mexico. The impacts of the Deepwater Horizon oil spill on Gulf communities and ecosystems - coupled with the region's preexisting health challenges and environmental stressors - illustrate the need to better understand these connections. In the future, natural and man-made disasters, climate change impacts, and other environmental stressors will present complex challenges to the physical, mental, and social well-being of communities in the Gulf. Understanding the interrelationships among health, ecological, and economic impacts of disasters and other environmental stressors will be crucial to addressing these challenges. Opportunities for the Gulf Research Program: Community Resilience and Health summarizes a Gulf Research Program workshop held on September 22-23, 2014, in New Orleans, Louisiana. The workshop examined opportunities to improve the health, well-being, and resilience of communities in the Gulf region through discussions with about 50 participants with diverse expertise and experience. These discussions identified perceived needs, challenges, and opportunities that align with the Gulf Research Program's mission and goals - particularly its goal to improve understanding of the connections between human health and the environment to support the development of health and resilient Gulf communities. This workshop is expected to lead to the development of additional Program activities and opportunities for the research community.
Policy Issues in the Development and Adoption of Biomarkers for Molecularly Targeted Cancer Therapies: Workshop Summary
by Sharyl J. NassA long-held goal in oncology has been to develop therapies that target the specific abnormalities in each patient's cancer rather than simply treating cancers based on the tissue of origin. In the past decade, advances in technology have enabled researchers to relatively quickly and inexpensively determine, in minute detail, the genetic makeup of tumors. Although relatively few targeted cancer therapies are currently available in the clinic and it is not yet clear whether all cancers are driven by genetic changes that can be targeted, there is widespread optimism in the cancer community that this new ability to assess the genetic abnormalities in tumors will ultimately lead to better cancer treatments and improved patient outcomes. "Policy Issues in the Development and Adoption of Biomarkers for Molecularly Targeted Cancer Therapies" is the summary of a workshop convened in November 2014 by the Institute of Medicine's National Cancer Policy Forum to discuss recent trends in the development and implementation of molecularly targeted cancer therapies and explore potential policy actions to address specific challenges. This report highlights the presentations and discussions at the workshop.
Cognitive Aging: Progress in Understanding and Opportunities for Action
by Dan G. BlazerFor most Americans, staying "mentally sharp" as they age is a very high priority. Declines in memory and decision-making abilities may trigger fears of Alzheimer's disease or other neurodegenerative diseases. However, cognitive aging is a natural process that can have both positive and negative effects on cognitive function in older adults - effects that vary widely among individuals. At this point in time, when the older population is rapidly growing in the United States and across the globe, it is important to examine what is known about cognitive aging and to identify and promote actions that individuals, organizations, communities, and society can take to help older adults maintain and improve their cognitive health. "Cognitive Aging" assesses the public health dimensions of cognitive aging with an emphasis on definitions and terminology, epidemiology and surveillance, prevention and intervention, education of health professionals, and public awareness and education. This report makes specific recommendations for individuals to reduce the risks of cognitive decline with aging. Aging is inevitable, but there are actions that can be taken by individuals, families, communities, and society that may help to prevent or ameliorate the impact of aging on the brain, understand more about its impact, and help older adults live more fully and independent lives. Cognitive aging is not just an individual or a family or a health care system challenge. It is an issue that affects the fabric of society and requires actions by many and varied stakeholders. "Cognitive Aging" offers clear steps that individuals, families, communities, health care providers and systems, financial organizations, community groups, public health agencies, and others can take to promote cognitive health and to help older adults live fuller and more independent lives. Ultimately, this report calls for a societal commitment to cognitive aging as a public health issue that requires prompt action across many sectors.
Communicating to Advance the Public's Health: Workshop Summary
by Ellen BayerThe Institute of Medicine's Roundtable on Population Health Improvement brings together individuals and organizations that represent different sectors in a dialogue about what is needed to improve population health. On September 22, 2014, the roundtable held a workshop to discuss some of the science of health communication, audiences, and messaging, and to explore what it will take to generate widespread awareness, acceptance, and action to improve health, including through the entertainment media, the news media, and social media. This report summarizes the presentations and discussion of the workshop.
Developing a 21st Century Neuroscience Workforce: Workshop Summary
by Sheena M. Posey NorrisFrom its very beginning, neuroscience has been fundamentally interdisciplinary. As a result of rapid technological advances and the advent of large collaborative projects, however, neuroscience is expanding well beyond traditional subdisciplines and intellectual boundaries to rely on expertise from many other fields, such as engineering, computer science, and applied mathematics. This raises important questions about to how to develop and train the next generation of neuroscientists to ensure innovation in research and technology in the neurosciences. In addition, the advent of new types of data and the growing importance of large datasets raise additional questions about how to train students in approaches to data analysis and sharing. These concerns dovetail with the need to teach improved scientific practices ranging from experimental design (e.g., powering of studies and appropriate blinding) to improved sophistication in statistics. Of equal importance is the increasing need not only for basic researchers and teams that will develop the next generation of tools, but also for investigators who are able to bridge the translational gap between basic and clinical neuroscience.
Educate to Innovate: Based on Input from Innovators and Stakeholders
by Arden Bement Jr.Robust innovation in the United States is key to a strong and competitive industry and workforce. Efforts to improve the capacity of individuals and organizations to innovate must be a high national priority to ensure that the United States remains a leader in the global economy. How is the United States preparing its students and workers to innovate and excel? What skills and attributes need to be nurtured? The aim of the Educate to Innovate project is to expand and improve the innovative capacity of individuals and organizations by identifying critical skills, attributes, and best practices - indeed, cultures - for nurturing them. The project findings will enable educators in industry and at all levels of academia to cultivate the next generation of American innovators and thus ensure that the U. S. workforce remains highly competitive in the face of rapid technological changes. Educate to Innovate summarizes the keynote and plenary presentations from a workshop convened in October 2013. The workshop brought together innovators and leaders from various fields to share insights on innovation and its education. This report continues on to describe the specific skills, experiences, and environments that contribute to the success of innovators, and suggests next steps based on discussion from the workshop.
Review of the Edwards Aquifer Habitat Conservation Plan: Report 1
by Committee to Review the Edwards Aquifer Habitat Conservation PlanThe Edwards Aquifer in south-central Texas is the primary source of water for one of the fastest growing cities in the United States, San Antonio, and it also supplies irrigation water to thousands of farmers and livestock operators. It is also is the source water for several springs and rivers, including the two largest freshwater springs in Texas that form the San Marcos and Comal Rivers. The unique habitat afforded by these spring-fed rivers has led to the development of species that are found in no other locations on Earth. Due to the potential for variations in spring flow caused by both human and natural causes, these species are continuously at risk and have been recognized as endangered under the federal Endangered Species Act (ESA). In an effort to manage the river systems and the aquifer that controls them, the Edwards Aquifer Authority and stakeholders have developed a Habitat Conservation Plan (HCP). The HCP seeks to effectively manage the river-aquifer system to ensure the viability of the ESA-listed species in the face of drought, population growth, and other threats to the aquifer. The National Research Council was asked to assist in this process by reviewing the activities around implementing the HCP. "Review of the Edwards Aquifer Habitat Conservation Plan: Report 1" is the first stage of a three-stage study. This report reviews the scientific efforts that are being conducted to help build a better understanding of the river-aquifer system and its relationship to the ESA-listed species. These efforts, which include monitoring and modeling as well as research on key uncertainties in the system, are designed to build a better understanding of how best to manage and protect the system and the endangered species. Thus, the current report is focused specifically on a review of the hydrologic modeling, the ecological modeling, the water quality and biological monitoring, and the Applied Research Program. The fundamental question that "Review of the Edwards Aquifer Habitat Conservation Plan: Report 1" addresses is whether the scientific initiatives appropriately address uncertainties and fill knowledge gaps in the river-aquifer system and the species of concern. It is hoped that the successful completion of these scientific initiatives will ultimately lead the Edwards Aquifer Authority to an improved understanding of how to manage the system and protect these species.
Acute Exposure Guideline Levels for Selected Airborne Chemicals: Volume 17
by Committee on Acute Exposure Guideline LevelsExtremely hazardous substances can be released accidentally as a result of chemical spills, industrial explosions, fires, or accidents involving railroad cars and trucks transporting EHSs. Workers and residents in communities surrounding industrial facilities where these substances are manufactured, used, or stored and in communities along the nation's railways and highways are potentially at risk of being exposed to airborne EHSs during accidental releases or intentional releases by terrorists. Pursuant to the Superfund Amendments and Reauthorization Act of 1986, the U. S. Environmental Protection Agency (EPA) has identified approximately 400 EHSs on the basis of acute lethality data in rodents. "Acute Exposure Guideline Levels for Selected Airborne Chemicals, Volume 17" identifies, reviews, and interprets relevant toxicologic and other scientific data for selected AEGL documents for acrylonitrile, carbon tetrachloride, cyanogen, epichlorohydrin, ethylene chlorohydrin, toluene, trimethylacetyl chloride, hydrogen bromide, and boron tribromide in order to develop acute exposure guideline levels (AEGLs) for these high-priority, acutely toxic chemicals. AEGLs represent threshold exposure limits (exposure levels below which adverse health effects are not likely to occur) for the general public and are applicable to emergency exposures ranging from 10 minutes (min) to 8 h. Three levels - AEGL-1, AEGL-2, and AEGL-3 - are developed for each of five exposure periods (10 min, 30 min, 1 h, 4 h, and 8 h) and are distinguished by varying degrees of severity of toxic effects. This report will inform planning, response, and prevention in the community, the workplace, transportation, the military, and the remediation of Superfund sites.
The Past Half Century of Engineering---And a Look Forward: Summary of a Forum
by Steve OlsonEngineering is poised to make an even greater contribution to society in the next half century than it has made in the past half century. At its annual meeting on September 28-29, 2014, the National Academy of Engineering celebrated the 50th anniversary of its founding. A highlight of the meeting was a forum of distinguished speakers who considered the achievements of the last 50 years and looked toward the potential achievements of the next 50. "The Past Half Century of Engineering - and a Look Forward" summarizes their presentations.
Principles and Obstacles for Sharing Data from Environmental Health Research: Workshop Summary
by Robert Pool Board on Population Health and Public Health Practice Roundtable on Environmental Health Sciences, Research, and Medicine Erin Rusch National Academies of Sciences, Engineering, and Medicine Health and Medicine DivisionOn March 19, 2014, the National Academies of Sciences, Engineering, and Medicine held a workshop on the topic of the sharing of data from environmental health research. Experts in the field of environmental health agree that there are benefits to sharing research data, but questions remain regarding how to effectively make these data available. The sharing of data derived from human subjects--making them both transparent and accessible to others--raises a host of ethical, scientific, and process questions that are not always present in other areas of science, such as physics, geology, or chemistry. The workshop participants explored key concerns, principles, and obstacles to the responsible sharing of data used in support of environmental health research and policy making while focusing on protecting the privacy of human subjects and addressing the concerns of the research community. Principles and Obstacles for Sharing Data from Environmental Health Research summarizes the presentations and discussions from the workshop.
Psychological Testing in the Service of Disability Determination
by Committee on Psychological Testing Including Validity Testing for Social Security Administration Disability DeterminationsThe United States Social Security Administration (SSA) administers two disability programs: Social Security Disability Insurance (SSDI), for disabled individuals, and their dependent family members, who have worked and contributed to the Social Security trust funds, and Supplemental Security Income (SSSI), which is a means-tested program based on income and financial assets for adults aged 65 years or older and disabled adults and children. Both programs require that claimants have a disability and meet specific medical criteria in order to qualify for benefits. SSA establishes the presence of a medically-determined impairment in individuals with mental disorders other than intellectual disability through the use of standard diagnostic criteria, which include symptoms and signs. These impairments are established largely on reports of signs and symptoms of impairment and functional limitation. "Psychological Testing in the Service of Disability Determination" considers the use of psychological tests in evaluating disability claims submitted to the SSA. This report critically reviews selected psychological tests, including symptom validity tests, that could contribute to SSA disability determinations. The report discusses the possible uses of such tests and their contribution to disability determinations. "Psychological Testing in the Service of Disability Determination" discusses testing norms, qualifications for administration of tests, administration of tests, and reporting results. The recommendations of this report will help SSA improve the consistency and accuracy of disability determination in certain cases.
Modeling the Health Risks of Climate Change: Workshop Summary
by Kellyn BettsClimate change poses risks to human health and well-being through shifting weather patterns, increases in frequency and intensity of heat waves and other extreme weather events, rising sea levels, ocean acidification, and other environmental effects. Those risks occur against a backdrop of changing socioeconomic conditions, medical technology, population demographics, environmental conditions, and other factors that are important in determining health. Models of health risks that reflect how health determinants and climate changes vary in time and space are needed so that we can inform adaptation efforts and reduce or prevent adverse health effects. Robust health risk models could also help to inform national and international discussions about climate policies and the economic consequences of action and inaction. Interest in resolving some of the challenges facing health effects modelers and health scientists led the National Research Council's Standing Committee on Emerging Science for Environmental Health Decisions to hold a workshop on November 3-4, 2014, in Washington, DC, to explore new approaches to modeling the human health risks of climate change. Throughout the workshop, the discussions highlighted examples of current application of models, research gaps, lessons learned, and potential next steps to improve modeling of health risks associated with climate change. "Modeling the Health Risks of Climate Change" summarizes the presentation and discussion of the workshop.
Cross-Sector Responses to Obesity: Workshop Summary
by Steve OlsonObesity affects 17 percent of children and adolescents and almost 36 percent of adults in the United States. Conservative estimates suggest that obesity now accounts for almost 20 percent of national health care spending. Until the obesity epidemic is reversed, obesity will continue to drive rates of chronic diseases such as heart disease, stroke, type 2 diabetes, and certain types of cancer. "Cross-Sector Responses to Obesity" is a summary of a workshop convened by the Institute of Medicine Roundtable on Obesity Solutions in September 2014 to explore models of cross-sector work that may reduce the prevalence and consequences of obesity. This report identifies case studies of cross-sector initiatives that engage partners from diverse fields, and lessons learned from and barriers to established cross-sector initiatives.
Genomics-Enabled Learning Health Care Systems: Workshop Summary
by Sarah H. BeachyThe inclusion of genomic data in a knowledge-generating health care system infrastructure is one promising way to harness the full potential of that information to provide better patient care. In such a system, clinical practice and research influence each other with the goal of improving the efficiency and effectiveness of disease prevention, diagnosis, and treatment. To examine pragmatic approaches to incorporating genomics in learning health care systems, the Institute of Medicine Roundtable on Translating Genomic-Based Research for Health hosted a workshop which convened a variety of stakeholder groups, including commercial developers, health information technology professionals, clinical providers, academic researchers, patient groups, and government and health system representatives, to present their perspectives and participate in discussions on maximizing the value that can be obtained from genomic information. The workshop examined how a variety of systems are capturing and making use of genomic data to generate knowledge for advancing health care in the 21st century. It also sought to evaluate the challenges, opportunities, and best practices for capturing or using genomic information in knowledge-generating health care systems. "Genomics-Enabled Learning Health Care Systems" summarizes the presentations and discussion of the workshop.
Genomics-Enabled Learning Health Care Systems: Workshop Summary
by Sarah H. BeachyThe inclusion of genomic data in a knowledge-generating health care system infrastructure is one promising way to harness the full potential of that information to provide better patient care. In such a system, clinical practice and research influence each other with the goal of improving the efficiency and effectiveness of disease prevention, diagnosis, and treatment. To examine pragmatic approaches to incorporating genomics in learning health care systems, the Institute of Medicine Roundtable on Translating Genomic-Based Research for Health hosted a workshop which convened a variety of stakeholder groups, including commercial developers, health information technology professionals, clinical providers, academic researchers, patient groups, and government and health system representatives, to present their perspectives and participate in discussions on maximizing the value that can be obtained from genomic information. The workshop examined how a variety of systems are capturing and making use of genomic data to generate knowledge for advancing health care in the 21st century. It also sought to evaluate the challenges, opportunities, and best practices for capturing or using genomic information in knowledge-generating health care systems. Genomics-Enabled Learning Health Care Systems summarizes the presentations and discussion of the workshop.
Spread, Scale, and Sustainability in Population Health: Workshop Summary
by Theresa Wizemann"Spread, Scale, and Sustainability in Population Health" is the summary of a workshop convened by the Institute of Medicine's Roundtable on Population Health Improvement in December 2014 to discuss the spread, scale, and sustainability of practices, models, and interventions for improving health in a variety of inter-organizational and geographical contexts. This report explores how users measure whether their strategies of spread and scale have been effective and discusses how to increase the focus on spread and scale in population health.
Affordability of National Flood Insurance Program Premiums: Report 1
by Committee on the Affordability of National Flood Insurance Program PremiumsThe National Flood Insurance Program (NFIP) is housed within the Federal Emergency Management Agency (FEMA) and offers insurance policies that are marketed and sold through private insurers, but with the risks borne by the U. S. federal government. NFIP's primary goals are to ensure affordable insurance premiums, secure widespread community participation in the program, and earn premium and fee income that covers claims paid and program expenses over time. In July 2012, the U. S. Congress passed the Biggert-Waters Flood Insurance Reform and Modernization Act (Biggert-Waters 2012), designed to move toward an insurance program with NFIP risk-based premiums that better reflected expected losses from floods at insured properties. This eliminated policies priced at what the NFIP called "pre-FIRM subsidized" and "grandfathered. " As Biggert-Waters 2012 went into effect, constituents from multiple communities expressed concerns about the elimination of lower rate classes, arguing that it created a financial burden on policy holders. In response to these concerns Congress passed The Homeowner Flood Insurance Affordability Act of 2014 (HFIAA 2014). The 2014 legislation changed the process by which pre-FIRM subsidized premiums for primary residences would be removed and reinstated grandfathering. As part of that legislation, FEMA must report back to Congress with a draft affordability framework. "Affordability of National Flood Insurance Program Premiums: Report 1" is the first part of a two-part study to provide input as FEMA prepares their draft affordability framework. This report discusses the underlying definitions and methods for an affordability framework and the affordability concept and applications. "Affordability of National Flood Insurance Program Premiums" gives an overview of the demand for insurance and the history of the NFIP premium setting. The report then describes alternatives for determining when the premium increases resulting from Biggert-Waters 2012 would make flood insurance unaffordable.