TESTIMONY OF JOHN SALAMONE

TESTIMONY OF JOHN SALAMONE AT THE SUBCOMMITTEE ON LEGISLATIVE AND POLICY OPTIONS FOR IMPROVING THE VACCINE INJURY COMPENSATION PROGRAM

September 28, 1999

"Compensating Vaccine Injuries: Are Reforms Needed?"

THANK YOU MR. CHAIRMAN AND MEMBERS OF THE SUB- COMMITTEE. I APPRECIATE THE OPPORTUNITY TO TALK WITH YOU TODAY REGARDING LEGISLATIVE AND POLICY OPTIONS

FOR IMPROVING THE VACCINE INJURY COMPENSATION PROGRAM.

BEFORE OFFERING SPECIFIC TESTIMONY CONCERNING THE OUTLINED AREAS FOR IMPROVING THIS PROGRAM, I WOULD LIKE TO STATE FOR THE RECORD THAT I HAVE SERVED AS VICE CHAIR OF THE HHS' ADVISORY COMMISSION ON CHILDHOOD VACCINES AND CURRENTLY SERVE AS A CONSULTANT TO THE SUB-COMMITTEE ON VACCINE SAFETY FOR THE NATIONAL VACCINE ADVISORY COMMITTEE. BUT MORE IMPORTANTLY, I AM THE FATHER OF DAVID, A NINE-YEAR OLD WITH POLIO CONTRACTED FROM THE ORAL POLIO VACCINE. AS DAVID'S DAD AND AS PRESIDENT OF INFORMED PARENTS AGAINST VAPP, ALSO KNOWN AS IPAV, A GROUP OF FAMILIES WHO SUFFER FROM ORAL POLIO VACCINE INJURIES, I WORKED LONG AND HARD WITH IMMUNIZATION ADVOCATES TO MOVE THIS

COUNTRY TO AN ALL-IPV SCHEDULE. I AM A SUPPORTER OF IMMUNIZATIONS. I HAVE SEEN FIRST HAND IN MY LIFE THE DISEASES WE CAN NOW PREVENT AND BELIEVE THAT WE MUST MAINTAIN A STRONG IMMUNIZATION SYSTEM - THE SAFEST ONE POSSIBLE. WITH MY SON AND OTHERS IN IPAV HAVING PAID A HUGE PERSONAL PRICE FOR MASS IMMUNIZATION, I HAVE ALSO BECOME VERY FAMILIAR WITH THE NATIONAL VACCINE INJURY COMPENSATION PROGRAM.

THE FIRST TOPIC I WAS ASKED TO ADDRESS CONCERNS "CHANGING THE ADVERSARIAL NATURE OF COMPENSATION PROGRAM PROCEDURES AND THE HEARING PROCESS." GIVEN THE CHOICE BETWEEN THE PROGRAM AND A PERSONAL INJURY LAWSUIT, THE PROGRAM WINS. HOWEVER, THERE IS ROOM FOR IMPROVEMENT. IN THEIR CURRENT FORM, THE PROCEDURES ARE ADVERSARIAL AND NEED TO BECOME MORE

"USER FRIENDLY." FOR THOSE OF US WHO HAVE SEEN OUR FAMILIES DEVASTATED BY THESE INJURIES, A CHANGE IN THE VICP WOULD MEAN AN AWFUL LOT.

SOME SUGGESTIONS TO IMPROVE THE PROCESS INCLUDE:

* RE-WRITING THE PROCEDURES TO TAKE INTO ACCOUNT

THE LITERACY LEVEL OF MOST APPLICANTS. IN ITS CURRENT FORM, EITHER ON THE WEBSITE OR IN THE

INFORMATION PACKET, THE LANGUAGE OFTEN CITES LEGAL REQUIREMENTS AND CAN PUT OFF THOSE UNFAMILIAR WITH SUCH LEGAL TERMS. IN SHORT, PLEASE PUT IT IN PLAIN ENGLISH AS WELL AS THOSE OTHER LANGUAGES NECESSARY FOR APPLICANTS.

* PROVIDE SIMPLE AND CLEARLY DEFINED STEPS AN APPLICANT MUST GO THROUGH IN ORDER TO BE CONSIDERED FOR AN AWARD. THIS WILL ASSIST APPLICANTS IN WORKING THROUGH THE PROCESS AND LEAD TO A BETTER UNDERSTANDING ON THEIR PART OF WHAT THEIR RESPONSIBILITIES ARE.

* IT WOULD BE IDEAL IF NEW APPLICANTS COULD BE PROVIDED WITH A COUNSELOR WHO CAN PROVIDE SUPPORT THROUGHOUT THE APPLICATION PROCESS. MOST OF THE FAMILIES WHO ARE DEALING WITH VACCINE INJURIES ARE SIMPLY TOO OVERWHELMED, BOTH EMOTIONALLY AND PHYSICALLY, TO EASILY MAKE THEIR WAY THROUGH THE SYSTEM AS IT IS CURRENTLY. A WEBSITE AND INFORMATION PACKET CANNOT PROVIDE THE KIND OF ASSISTANCE THAT COMES FROM A PERSON, WHOSE JOB DESCRIPTION INCLUDES COMPASSION AS A REQUIREMENT.

* YOU MIGHT WANT TO LOOOK AT THE COUNSELLORS AS AN OMBUDSMAN. FOR EXAMPLE, THE COUNSELLOR CAN BE EMPOWERED TO PROVIDE REFERENCES WHERE APPLICANTS CAN GET LEGAL AID. ALL TOO OFTEN, WOULD-BE APPLICANTS DO NOT HAVE ATTORNEYS FAMILIAR WITH THE PROCESS AND ARE BEREFT OF SOUND LEGAL ASSISTANCE THAT IS IN THEIR BEST INTEREST. PERHAPS A BAR ASSOCIATION OR OTHER THIRD PARTY GROUP CAN BE ASKED TO PROVIDE THIS SPECIAL AND MUCH NEEDED SERVICE.

THE SECOND AREA IS REFORMING THE EVIDENTIARY AND ADJUDICATIVE STANDARDS FOR DETERMINING COMPENSATION. FROM MY EXPERIENCE AND THOSE OF OUR FAMILIES, I FEEL THE EVIDENTIARY STAGE IS GENERALLY FAIR AND RUNS SMOOTHLY FOR MOST APPLICANTS. AN OVERALL COMMENT, HOWEVER, IS THAT THE GOVERNMENT TRUST OF

$1.4 BILLION IS GUARDED TOO WELL. THE COFFERS NEED TO BE OPENED TO PROVIDE THE KIND OF HUMANE SERVICE PEOPLE IN VACCINE INJURY SITUATIONS NOT ONLY NEED BUT DESERVE. FOR EXAMPLE, THE "DAMAGES" PHASE, TO USE THE COMMON TERM, CAN BECOME MORE FLEXIBLE IN ALLOWING FOR SPECIAL CIRCUMSTANCES. WE'VE HAD FAMILIES WHO'VE

GONE BANKRUPT TRYING TO MEET THEIR CHILDREN'S MEDICAL AND EMOTIONAL NEEDS WHILE GOING THROUGH THE SYSTEM. WE'RE NOT TALKING ABOUT POKEMON CARDS.

WE'RE TALKING ABOUT THERAPY AND HELP. THEY ALSO CAN PROVIDE GREATER CLARITY WITH REGARD TO FUTURE LOST WAGES. SOME SUGGESTIONS THAT COME TO MIND INCLUDE:

* ADMINISTERING INTERMEDIATE FUNDS TO THOSE IN NEED BASED ON GOOD FAITH AND A REASONABLE BASIS FOR A CLAIM.

* INCLUDING FAMILY COUNSELING EXPENSES AND REASONABLE FEES AND COSTS ASSOCIATED WITH THE ESTABLISHMENT OF A GUARDIANSHIP OR CONSERVATOR-SHIP.

* EXTENDING THE CURRENT STATUTE OF LIMITATIONS FROM 3 YEARS FOR INJURY CLAIMS AND 2 YEARS FOR DEATH TO 6 YEARS.

* AND CREATING A SPECIFIC METHOD OR FORMULA FOR CALCULATING LOST EARNINGS UNDER VICP THAT IS EASILY ADAPTABLE FOR INDIVIDUAL USE.

THE FINAL AREA OF REVIEW IS ENSURING THE LEVEL OF FUNDING TO MEET FUTURE NEEDS. CURRENT FUNDING IS NOT IN JEOPARDY AND SHOULD CERTAINLY BE MAINTAINED. AS FUTURE VACCINES ARE CREATED, THESE NEED TO BE ADDED

AUTOMATICALLY TO THE INJURY TABLE WITH ASSIGNMENT OF AN APPROPRIATE EXCISE TAX. LET ME REPEAT: IT IS NOT ABOUT FUNDING...IT'S ABOUT ACCESS TO FUNDS FOR THOSE WHO NEED IT. IF GREATER FUNDS WOULD EQUATE INTO BETTER SERVICES FOR APPLICANTS, THEN I WOULD SAY, YES, PROVIDE MORE FUNDS EARMARKED FOR THOSE SERVICES I OUTLINED EARLIER. IF THE COMMITTEE TAKES ACTION THAT WILL ENABLE LARGER AWARDS, THEN THE CRITERIA FOR WHAT IS COVERED UNDER AN AWARD WOULD NEED TO BE RE-EVALUATED.

I FIRMLY BELIEVE IN THE VICP. OUR GROUP, IPAV, IS PRO-IMMUNIZATION DESPITE OUR FAMILY MEMBERS CONTRACT-ING POLIO FROM THE VERY VACCINE MEANT TO PROTECT AGAINST IT. THE VICP HAS DONE THE BEST JOB IT CAN, UNDER ITS CURRENT DESIGN, TO FULFILL ITS PURPOSE. I HAVE BEEN IMPRESSED WITH THE DEDICATION OF THOSE I HAVE WORKED WITH IN THE PROGRAM OVER THE PAST SIX YEARS. I BELIEVE THOUGH THAT EVEN THEY WOULD ADMIT THAT IMPROVE-MENTS CAN AND SHOULD BE MADE TO ENSURE THAT THIS PROGRAM, WHICH HAS SERVED US WELL FOR MORE THAN A DECADE, CAN CONTINUE TO MEET THE NEEDS OF THOSE WHO SACRIFICED THEMSELVES FOR A UNIVERSAL VACCINE PROGRAM.

THANK YOU.