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>>>> Help ME Circle <<<<

3 May 2002

Editorship : j.van.roijen@...

Outgoing mail scanned by Norton AV

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Source: <A

HREF= " http://www.cfids.org/advocacy/congress-testimony.asp " >http://www.cfids.org\

/advocacy/congress-testimony.asp</A>

TESTIMONY OF K. KIMBERLY KENNEY

President and Chief Executive Officer of

THE CFIDS ASSOCIATION OF AMERICA

before

THE HOUSE LABOR, HEALTH AND HUMAN SERVICES,

EDUCATION AND RELATED AGENCIES

APPROPRIATIONS SUBCOMMITTEE

Thursday, May 2, 2002

Mr. Chairman, good afternoon and thank you for the opportunity

to appear before the Committee today. My name is K.

Kenney and I am President and Chief Executive

Officer of The CFIDS Association of America. The CFIDS

Association is the leading organization working to conquer

chronic fatigue and immune dysfunction syndrome (CFIDS),

also known as chronic fatigue syndrome (CFS).

Since 1987, the Association has invested over $12 million in

education, public policy and research programs in its efforts to

bring an end to the suffering caused by the illness. There is a

critical need for information about CFIDS -- the Association

receives inquiries from people living in every state and many

countries around the world. The CFIDS Association of America

responds to hundreds of thousands of requests for information

about CFIDS every year.

CFIDS is a serious and complex illness that affects many body

systems. There is no known cause and no diagnostic test.

CFIDS is characterized by incapacitating fatigue (experienced

as profound exhaustion and extremely poor stamina),

neurological problems and numerous other symptoms. It can

be severely debilitating and can last for many years. CFIDS is

often misdiagnosed because symptoms overlap with other

disorders including mononucleosis, multiple sclerosis,

fibromyalgia, Lyme disease, post-polio syndrome and

autoimmune diseases such as lupus.

Only 10% of the nearly 1 million American adults and children

with CFIDS have been diagnosed. It is three times more

common in women than it is in men, and it disproportionately

affects African Americans, Latinos and persons of lower

socioeconomic status. Although few long-term studies of the

illness have been done, CDC estimates the recovery rate to be

less than 12%. These statistics are especially damaging

because CFIDS strikes people during the prime of their most

productive years.

On behalf of those affected by CFIDS, I will make requests of

this Committee for its continued support of activities that are

critical to improving the understanding of CFIDS. The CFIDS

Association’s goal is to advance CFIDS biomedical research

and, ultimately, to eradicate the illness. CFIDS patients are

dependent upon scientific process, and in particular research

funded by the Centers for Disease Control and Prevention, the

National Institutes of Health (NIH) and other federal agencies,

to discover the cause(s), diagnostic tests, effective treatments

and ultimately a cure for this debilitating illness.

Secretary for Health

In 1996, Health and Human Services Secretary Donna Shalala

chartered the Chronic Fatigue Syndrome Coordinating

Committee (CFSCC), providing a forum for advocates,

researchers, clinicians and federal health officials to promote

better understanding and resolve challenging policy issues.

The CFSCC enhanced communication, improved

collaboration, prevented duplication and strengthened CFIDS

programs supported both by the federal government and

private foundations.

In its 1999 report on Public Health Service CFIDS programs,

the General Accounting Office noted that the CFSCC’s

structure was unlike other DHHS advisory committees, in that it

had a federal chairperson and agency representatives had full

voting privileges. In January 2001, the Committee co-chair

announced that DHHS had initiated efforts to convert the

CFSCC to full DHHS advisory committee status and that

nominations would soon be sought for new members and a

non-federal co-chair. More than 15 months have passed since

this announcement and no action has been taken to form this

new committee. The lengthy delay has jeopardized momentum

building in federal efforts to appropriately address this

disease. Trust that was developing between the patient

community and federal health agencies has eroded during this

period of inaction and many are skeptical that the new

committee will ever meet.

The new advisory committee must be formed without further

delay and its new structure must not diminish the full

partnership of involved agencies or the collaborative

relationships among federal agencies, scientists, and CFIDS

advocates that have developed over recent years through the

CFS Coordinating Committee.

Request: The Association asks that the Committee convey its

displeasure that the Department's Chronic Fatigue Syndrome

Advicory Committee, announced in January 2001, has not

been formed, jeopardizing momentum and important

partnerships between the member agencies and the CFIDS

community. We ask that the Committee direct the Department

to immediately approve the CFS Advisory Committee Charter,

publish a call for nominations, install members and hold one

meeting prior to the end of calendar year 2002.

Centers for Disease Control and Prevention

Following a report from the Inspector General that documented

$12.9 million in CFIDS funds had been diverted to other

programs, CDC began restoring this money to the CFIDS

research program in 1999. The “payback†was mandated by

Congress to occur over a four-year period (1999-2003),

mirroring the four-year period over which the misuse of funds

occurred (1995-98).

The CFIDS Association of America considers these funds to

be very precious, and has worked closely with CDC’s top

leadership and the CFS program to ensure that these funds

are used to strengthen the agency’s research program. Largely

as a result of this collaboration, the CDC has built a sturdy

foundation for current and future CFIDS research; however,

only half of the $12.9 million has been expended with only 17

months remaining in the payback period. So that the remaining

funds continue to be effectively used, the Association supports

a one-year extension of the payback period, and strongly

encourages provision of sufficient baseline funding to

accelerate the agency’s CFIDS research programs.

Request: The CFIDS Association asks the Committee to

encourage CDC in its support of new and important areas of

CFIDS research and medical education. We ask the

Committee to instruct CDC to extend the payback period by

one year, through FY'04, and to provice sufficient baseline

funding to accelerate its CFIDS research plan to identify the

causes, risk factors, diagnostic markers, natural history and

economic impact of CFIDS; to create a CFIDS patient registry;

to expand important collaborations with academic rsearchers;

and to educate health care providers about the detection,

diagnosis and management of CFIDS.

National Institutes of Health

Despite the generous budgetary increases Congress has

provided NIH toward doubling its budget, the agency’s CFIDS

research spending has stagnated. CFIDS funding nearly tripled

from 1990-95, but fell by 16% over the following five years. In

fact, FY2000 CFIDS spending was only 84% of 1995

spending. Congress’ intent, that these large overall increases

would benefit all research areas, has failed CFIDS research.

According to newly released surveys, numerous health

organizations report that NIH support has not benefited all

areas of research evenly. As new money continues to pour into

NIH, a new strategy is required to more effectively distribute

these funds beyond the most popular areas of research.

In December 2001 NIH released the first CFIDS program

announcement in five years. The Association hopes that this

initiative will reverse seven years of declining CFIDS funding at

NIH. However, problems with the grant review process persist

and researchers report to our organization that there is little

encouragement from NIH program staff to cultivate promising

research. Additionally, NIAID has informally announced that the

funding of ative Research Centers, a provision of the

NIH Reauthorization bill now in force, will be discontinued.

Research centers offer investigators the opportunity to develop

collaborative research efforts spanning multiple disciplines and

areas of expertise. CFS center grants have formed the core of

NIH’s research effort and have generated important findings.

An NIH state of the science conference held in late 2000

affirmed the need for CFS research to employ a

multi-disciplinary approach. NIAID’s decision to discontinue

funding for these multidisciplinary centers is contrary to

recommendations made by its own advisors.

CFIDS patients rely on medical research not only for

information about the possible causes of their illness and

treatments for it, but also for hope of a healthier future.

Researchers are drawn to new areas of scientific inquiry by

two factors: scientific curiosity and available funding. Efforts

begun in 2001 to build interest in CFIDS among the many NIH

institute program staff must continue and outreach to

researchers working in related fields must be expanded. There

must be an unequivocal statement from NIH that CFIDS

research is a funding priority if we are to reverse the dismal

trend of declining funding and interest.

Request: The Association asks Congress to direct NIH to

allocate an additional $10 million in grants to focus on

promising areas of CFIDS research, such as efforts to

understand the cause and progression of CFIDS, identify

diagnostic markers and focus on pediatric CFIDS, by funding

both multidisciplinary CFIDS research centers and

investigator-initiated studies. The Association requests that

the Committee underscore the need for active outreach to the

research community to attract new investigators to the field and

to continue NIH campus activities that will foster interest among

program officers and intramural researchers.

Department of Education

CFIDS affects people of all ages, including children,

adolescents and teenagers. Having CFIDS can be particularly

difficult for young people because it affects them at a time of

crucial intellectual, social and physical development. Many

students with CFIDS have great difficulty securing appropriate

educational accommodations by their local school districts,

despite federal educational laws such as the Individuals with

Disabilities Education Act and the Rehabilitation Act of 1973

that mandate the free and appropriate education of students

with disabilities and illnesses. The Department of Education’s

Office of Special Education Programs (OSEP) can aid

students with CFIDS to access accommodations from their

local educational authorities by informing educators about

CFIDS and the special educational needs often required by

students with CFIDS.

The CFIDS Association of America is very pleased that the

National Institute on Disability and Rehabilitation Research has

included CFIDS in its list of unmet areas of research and is

funding a CFIDS research study. We encourage NIDRR to

continue its support of CFIDS research.

Request: The CFIDS Association asks the Committee to

share its concern about reports that students with CFIDS are

not receiving appropriate educational accommodations and to

instruct the Office of Special Education Programs to inform

educators about CFIDS and the special educational needs

often required by students with CFIDS.

We ask the Committee to encourage NIDRR to continue its

support of CFIDS as an unmet area of research and to pursue

CFIDS-related research proposals through its

investigator-initiated and other grants programs.

Health Resources and Services Administration

Despite nearly two decades of research on CFIDS, scientific

advances have not translated into improved clinical care for

persons with CFIDS. In fact, CFIDS patients frequently state

their most difficult problem is locating effective, compassionate

medical care. They often go from provider to provider in search

of a practitioner who can provide appropriate symptomatic

care, information and referrals.

HRSA has supported collaborative efforts with The CFIDS

Association of America to develop and implement an

educational curriculum for primary care providers about

CFIDS. To date over 1,800 primary care providers have

learned about the detection, diagnosis and management of

CFIDS. The education of health care providers is just one

element of the effort required to improve medical care of

CFIDS patients.

Over the years, HRSA has supported demonstration grants to

develop new, more effective ways of health care delivery for

emerging illnesses, although not yet for CFIDS. A grant of this

nature would enable the development of centers to explore the

optimum care of CFIDS patients, incorporating various

medical, rehabilitation and adjunctive care services. The cost

savings yielded from a more strategic approach to case

management is ample justification for this investment.

Request: The CFIDS Association asks the Committee to

direct HRSA to provide demonstration grants to develop model

CFIDS clinical centers with the goal of deliverying effective,

multidisciplinary clinical care to persons with CFIDS.

Social Security Administration

Social Security Ruling 99-2p, Evaluating Cases Involving

Chronic Fatigue Syndrome, appears to have greatly improved

the ability of persons disabled by CFIDS to access Social

Security disability benefits. In spite of this ruling that is binding

at all stages of the review process, there remain many

SSA/DDS employees unfamiliar with or misinformed about

CFIDS and the functional limitations it imposes. This lack of

information leads to unnecessary delays in awarding benefits

and increased costs to SSA, as favorable decisions are often

made at later stages of the adjudication process. To quantify

the impact of the Ruling, SSA implemented a tracking program

in 2000, although the agency has not yet reported any data to

the CFIDS community on the program.

Request: We ask the Committee to encourage SSA to

continue CFIDS-related educational efforts, to examine current

obstacles to benefits for persons with CFIDS, to assess and

report the impact of the ruling on CFIDS patients' access to

benefits, and to keep medical information updated throughout

all levels of the application and review process.

We sincerely hope that Congress will help the nearly 1 million

Americans with CFIDS by providing directives to the federal

agencies, particularly NIH and CDC, that there must be a

dedicated and effective federal response to CFS. The CFIDS

Association of America will continue its efforts to hold the

federal agencies accountable for the direction delivered by

Congress through the Appropriations bill and its accompanying

report language. CFIDS advocates will work with Congress to

maximize the federal contribution to the battle against CFIDS.

Mr. Chairman and Members of the Committee, we have all

worked diligently to develop a basic understanding about

CFIDS. The investment we’ve made over the last 15 years will

soon generate dividends in terms of more definitive means of

diagnosing, treating and, perhaps, preventing the illness. Your

commitment to this effort is needed now more than ever. We

must capitalize on the opportunities now before us so that the

men, women and children with CFIDS experience better care

and improved function. Patients wish desperately to return to

productive lives as students, parents, employees and citizens.

Thank you for your efforts on their behalf, for your time and

attention this afternoon, and for your thoughtful consideration of

and action on our requests.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

© 2001, The CFIDS Association of America, Inc.

Tina M. Hendrix

Cure2000@...

Vice-President, California Coalition

Neuro-Immune Dysfunction Syndromes

Autism Spectrum Disorder, ADD/ADHD, Learning Disorders, Hyperactivity, CFS,

etc.

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