approved this language for FY 1991. We believe that it would be helpful if the Subcommittee would adopt identical or similar language to provide guidance and direction for AoA.

We further urge the Subcommittee to approve the following language adopted by the House Appropriations Committee for the FY 1991 Labor-HHS-Education Appropriations Act:

"The Committee finds the pool of trained personnel to provide services to a dramatically increasing number of dependent elders has failed to keep pace. Major initiatives are required to train individuals for effective, skilled service to the nation's elders. The Committee believes the Administration should emphasize education and training programs both at universities and at community colleges. The Committee intends the training and education funds should strengthen the capacity of higher education and associate degree programs to provide gerontological training, thereby assuring long-term commitments to personnel development in the aging fields."

National Institute on Aging

The Research on Aging Act created the National Institute on Aging (NIA) in 1974. NIA is responsible for conducting and supporting biomedical, social, and behavioral research and training concerning the aging process, as well as diseases and other special problems and needs of older Americans.

NIA is now funded at $323.752 million for FY 1991. The Administration's budget request calls for $348.558 million. We support a $358.558 million funding level, $10 million above the Administration's request.

There is a great need for increased support for social/behavioral research and training, since NIA is the major federal agency concerned with basic (not applied) agingrelated research and training in the social and behavioral behavioral disciplines. NIA has historically not had the funds to support these programs more than at a minimal level.

This appropriation could expand research concerning new treatments focusing on the causes and earlier diagnosis of Alzheimer's disease, which costs our nation about $90 billion a year in a variety of ways. Some experts believe that a realistic possibility exists for our nation to develop treatment for this disease within five to ten years. This development could yield a $45 billion dividend to our nation in terms of increased productivity, reduced institutionalization costs, and other savings.

Our proposal could also lead to additional research concerning problems associated with frailty and independence. Frailty costs our nation an estimated $54 billion a year.

Thank you for this opportunity to testify. We look forward to working with you to secure equitable and realistic funding for gerontological education, training, and research.

STATEMENT OF THE LEGAL ACTION CENTER

Thank you for the opportunity to submit testimony on appropriations for programs within the Department of Health and Human Services. The following testimony is submitted by the Legal Action Center, a not-for-profit law and public policy office that focuses on issues surrounding alcohol and other drug treatment and prevention and AIDS, and fourteen state treatment and prevention associations from across the country. (See attached list). These associations represent the individuals on the front lines of treatment and prevention activities who, on a daily basis, confront the dramatic need to expand drug and alcohol services. We urge you to adopt the following funding requests.

1. Alcohol. Drug Abuse and Mental Health Services (ADMS) Block Grant

A. Increase Funding for the ADMS Block Grant

The ADMS block grant provides the foundation for community-based alcohol and drug treatment and prevention services and community mental health services. We urge the Subcommittee to increase the block grant to $2 billion as a way to move the nation closer to providing appropriate treatment to all who request it and to placing an equal emphasis on demand reduction (treatment and prevention) and supply reduction (law enforcement and interdiction) activities.

The President's budget, which would fund the ADMS block grant at the FY 1991 level of $1.268 billion and below current services of $1.319 billion, is inadequate to (1) meet the treatment needs of underserved populations, such as women and children, adolescents, homeless individuals and persons with HIV infection, and (2) attract and retain qualified staff.

B. Limit Administrative Expense Set-Aside

We also urge the Subcommittee to explicitly limit the block grant statutory set-aside for data collection, services research and technical assistance to 5% and to direct the Administrator to use a greater portion of the funds for technical assistance, particularly targeted to providers as well as the States.

II. National Institute on Drug Abuse (NIDA)

A. Expand Treatment Services Research

The proposed FY 1992 budget makes medications development a top research priority, requesting $55 million, an increase of $15.5 million (39%) over FY 1991. While medications development is important, the treatment and prevention field has a far greater need for treatment and prevention services research. The congressionally mandated Institute of Medicine study, Treating Drug Problems, noted "the prospects for maintaining and improving treatment quality as well as continuing to develop more effective treatment methods depend to a great extent on treatment services research." (Treating Drug Problems at 193).

We urge you to appropriate $25 million of the research funds requested for medications development for services-related research so that we can better determine how to get people into treatment and keep them there, make treatment even more effective and prevent relapse.

B. Maintain AIDS Outreach Projects

The NIDA AIDS Outreach Demonstration Program has demonstrated its effectiveness in getting injection drug users and their sexual partners to seek and enter treatment and modify risky injection and sexual practices. This critical program is being phased out with little prospect of states or other entities continuing this work which will save lives and millions of dollars in long-term health care costs. We urge you to provide $10 million above the President's request to maintain the current funding for these programs.

III. National Institute on Alcoholism and Alcohol Abuse (NIAAA)

Maintain Homeless Demonstration Project

The NIAAA Homeless Demonstration Project, which has developed innovative programs for homeless alcohol and drug dependent individuals, is slated to be replaced by a new "Consolidated Research Program" that will combine the NIAAA and NIMH homeless demonstration projects. The consolidated program would reduce total funding for the two programs and would impose new requirements that will disqualify many of the alcohol and drug dependent individuals who are currently receiving services. Eliminating funding for current projects before the third and final year of their work will waste much of the $30 million already invested in these programs.

We urge you to provide funding for the NIAAA demonstration project at the current services funding level of $17.1 million.

IV. Office for Substance Abuse Prevention (OSAP)

Expand OSAP's Demonstration and Communications Projects

We urge the Subcommittee to add $100 million to OSAP for the High Risk Youth, Pregnant Women and Infants and Communications programs. At a minimum, $20 million, above the President's request, should be added to both the Pregnant Women and Infant demonstration program to support residential services for pregnant addicted women and their children and $20 million to the High Risk Youth program. In addition, the Community Youth Activity Program should not be eliminated but rather retained at the current services level. OSAP does not have sufficient resources to fund qualified High Risk Youth applications and should not be forced to spread those funds to support projects that reach this important population.

V. Office for Treatment Improvement (OTI)

Capacity Expansion Program

While we support the proposal to increase treatment funding for alcohol and drug problems by $99 million, we strongly urge that that funding be added to the ADMS block grant, which provides a foundation for comprehensive services, rather than diverted to another one-time categorical program, as proposed with the Capacity Expansion Program. If the ADMS block grant is increased, we would suggest that the Capacity Expansion Program be funded on a multi-year basis and provide funding for both alcohol and drug treatment.

Alabama Alcohol and Drug Abuse Association

Arizona Association of Behavioral Health Programs

California Association of County Drug Program Administrators

Florida Alcohol & Drug Abuse Association

Illinois Alcoholism & Drug Dependence Association

lowa Substance Abuse Program Directors' Association

Massachusetts Alcoholism & Drug Abuse Association

New Jersey Association for the Prevention and Treatment of Substance Abuse

New York State Association of Substance Abuse Programs

Association of Ohio Substance Abuse Programs

Drug and Alcohol Service Providers Organization of Pennsylvania

Drug and Alcohol Treatment Association of Rhode Island

Tennessee Alcohol & Drug Association

Wisconsin Association on Alcohol & Other Drug Abuse

Legal Action Center

STATEMENT OF THE DORIS DAY ANIMAL LEAGUE

The Doris Day Animal League, with 400,000 members nationwide, is an organization dedicated to increasing protections for animals through the legislative process.

We have recently been made aware of biomedical research experiments conducted by Dr. Charles Larson of Northwestern University involving macaques. The National Institutes of Health (NIH) provided funding for this research, Grant #2 RO1 NS 19290-04, on the basis of obtaining substantial human health benefits. Several biomedical professionals have reviewed Dr. Larson's research protocol and have questioned the probability of deriving human health knowledge from his research.

Dr. Larson's protocol states that he intends to provide insight into Huntington's disease, Parkinsonism, and spastic dysphonia through his vocalization experiments with animals. Dr. Roger Fouts, an expert in primate communication, asserts that human speech and primate vocalization are not comparable. Ironically, Dr. Larson himself, in a 1985 paper, admits that human speech may be fundamentally different from animal vocalization and that the extent to which the midbrain matter (periaqueductal gray) is involved in human speech is yet to be determined. If Dr. Fouts and, indeed, Dr. Larson are in agreement regarding the inability to extrapolate monkey vocalizations to human speech, then Dr. Larson's statement of significance is not relevant to his research.

The scientific community is experiencing great difficulty in procuring funding for important research. This research has been funded with approximately $472,370 taxpayer dollars. This money should be appropriated to other projects.

It is the review of the protocol demonstrating an apparent lack of applicability to human health advances and the gross amounts of taxpayer funds appropriated for this research which concern the members of the Doris Day Animal League. Although the committee does not generally address specific protocols, we urge the committee to request that the NIH refuse to renew funds for Dr. Larson's research.

STATEMENT OF BARRY SLEIGHT AND ROY SNOEYENBOS

Mr. Chairman, we provide this testimony as individual patients with Chronic Fatigue Syndrome, or CFS, and also in cooperation with nearly 400 patient support groups and national organizations involved in matters related to this illness. This disease has also been known by other names, including Chronic Epstein-Barr Virus Syndrome, or CEBV, and Chronic Fatigue Immune Dysfunction Syndrome, or CFIDS.

The 1990 Labor-HHS-Education Appropriations Bill was accompanied by a report, number 101-516, which contained related language. The National Institutes of Health, the Centers for Disease Control, and the Social Security Administration were again urged or requested, as in previous years, to improve activities related to CFS. Our continuing thanks to this Committee, and its able staff, for leadership in the Federal public health response to this disease.

A small CDC surveillance program continues, and has recently been augmented by related research studying the blood and immune systems of some patients with this illness. A CDC document has called CFS an "emerging epidemic."

The case definition used by the CDC in its research includes many of the major symptoms that our patient population suffers with: fever, sore throat, swollen and painful lymph nodes, muscle weakness and aches, fatigue, headaches, joint pain, sleep disturbances, fatigability upon exercise, and neurological problems. This definition has intentionally been kept narrow for research purposes; there are over twenty other symptoms listed in the medical literature for this disease.

The most severely disabled patients are bedridden for an indeterminate period. Other patients experience a varying pattern of disability, which may fluctuate over time. Total recovery is very rare; people get ill with CFS and stay that way. America continues to pay increasing social and economic