In these decisions the Board serves as an evaluator 

 for the R&D Committee of the local facility and 

 for the Medical Research Service, the latter during 

 determination of the funding allocated to the local 

 facility. 



The R&D Committee and the ACOS exercise 

 considerable discretion in the use of the funds 

 provided them. They are also responsible for the 

 continuing evaluation of research in the facility 

 and can implement needed modifications or can 

 terminate an unsatisfactory project. 



Peer review of the progress of smaller programs 

 of the individual investigators is arranged by the 

 Medical Research Service to provide scientific 

 evaluation and funding guidance. The health care 

 facility, on the other hand, solicits supplemental 

 funds for unrepeated expenditures by submitting 

 through the Service a comparatively brief request 

 to a Regional Advisory Group. Such funds charac- 

 teristically support a new investigator until he can 

 submit a formal proposal for peer review but may 

 replace damaged equipment or provide for unex- 

 pectedly rapid expansion of a promising project. 



The senior staff of the Medical Research Service 

 formally reviews the scientific evaluations by the 

 Regional Advisory Groups and by the Merit Re- 



view Boards. It then determines the relevance of 

 each project and its investigator to the VA's mis- 

 sion and research programs in order to arrive at 

 the level of funding allowed for the research. 



Direction and Protection of Basic Research 

 Projects 



The VA establishes a few areas of medicine for 

 special research emphasis and publicizes these 

 areas among the staffs of health care facilities. In a 

 few instances, centers are created within one or a 

 few facilities to combine patient care with research 

 in a special clinical field, e.g., spinal cord injury. 

 These measures elicit basic research projects as 

 well as more applied ones. 



Some R&D committees have diverted funds 

 from basic to applied projects which are more di- 

 rectly in line with the VA's mission. Scientists 

 usually appeal such decisions to the Central Office 

 which can continue support for the basic research 

 projects if they are considered important and pro- 

 ductive. The Medical Research Service conducts 

 cooperative clinical studies of a developmental 

 character as the sole major program which could 

 threaten directly the funding of basic research. So 

 far it has not been allowed to do so. 



232 



VETERANS ADMINISTRATION 



