The reorganization calls for NIOSH to be placed inside a new entity called the "Coordinating Center for Environmental Health, Injury Prevention, and Occupational Health." In addition to NIOSH, the other previously separate CDC agencies included in this new cluster are: the National Center for Environmental Health/Agency for Toxic Substances and Disease Registry and the National Center for Injury Prevention and Control. Dr. Henry Falk will lead this coordinating center, and he will report through a new layer of management, called "executive leadership" to the CDC director.
The possible "downgrading" of NIOSH from a center reporting directly to CDC Director Julie Gerberding, to a unit that is now separated from CDC leadership by a new layer of management, is one of the concerns raised in a May 25 letter to Gerberding by Franklin Mirer, director of health and safety at the United Auto Workers. (See related article "The Impact of the CDC Reorganization on NIOSH.")
"Our dialogue should start with a statement of what problem regarding NIOSH the reorganization is intended to solve," wrote Mirer.
In an interview, NIOSH Director John Howard addressed this question. Before the reorganization, Howard explained, NIOSH along with a dozen other centers, offices and institutes maintained a semi-autonomous status within CDC and reported directly to the CDC's director. That was precisely the problem, according to Howard.
"All these different offices, centers and institutes had administrative structures and missions, and some of these are duplicative," asserted Howard. He added that in the current budget climate, CDC's funding is expected to rise by only two or three percent next year. "We're hoping that by avoiding duplication we can put that money into programs and enhance our impact."
Howard also asserted the organization chart showing NIOSH's separation from CDC leadership is "inaccurate," because the extra layer will be devoted solely to the coordination of the programs within this cluster.
"My job will remain the same, to manage programs, and I will still report to the director of the CDC," said Howard.
Mirer also expressed concern that NIOSH has been placed in a cluster with an environmental focus. "Historically, this combination has lead to neglect of the occupational environment," he wrote.
But while Mirer worries about neglect, Howard anticipates "synergy."
Howard cites birth defects as an example, a topic that was addressed by NIOSH as well as elsewhere inside CDC. "The question is how well are we working with them?" asked Howard. "Now the reorganization allows us to ask, 'what do we have in common, and why don't we attack this as one problem?"
Mirer called for the organizational structure to be rescinded, but Howard said the process is already under way and should be completed within six months, perhaps not coincidentally, just about the time of the November elections. While the UAW complained that it, and other members of the occupational health community, had little input into the decision, Howard countered that the move is one that lies within the authority of the administration.
It appears, therefore, that if a new administration were voted into office in November and wanted to restore NIOSH's relative autonomy, it would be free to do so.