Union, NFL split over research funds

On the eve of the 2013 Super Bowl, Harvard Medical School and the NFL Players Association announced one of the most ambitious sports research projects in history: a $100 million grant from the union to "improve the health and well-being of NFL players."

But the NFLPA never intended to give $100 million to Harvard, "Outside the Lines" has learned. The announcement was a public relations gambit by the union to pressure the NFL into putting up half of the money for a study that would address fundamental questions about player health, including the long-term impact of concussions.

The ploy backfired, touching off a behind-the-scenes power struggle between the NFL and the NFLPA over tens of millions of research dollars and leaving Harvard officials struggling to explain how an initiative that involves 10 schools, 16 medical centers, dozens of researchers and 1,000 retired NFL players will be funded.

"The landscape has changed slightly," NFLPA spokesman George Atallah told "Outside the Lines" in a recent interview.

NFLPA officials now say Harvard mischaracterized the initiative as a "grant," because any future money is predicated on performance and availability. And the project isn't necessarily worth $100 million, the officials concede. Harvard might receive far less because of the NFL's refusal to participate and because the union could pull out of the deal at any point -- although the NFLPA says it will continue to fund the project as long as the research is productive.

It's unclear whether Harvard was aware that the blockbuster announcement was part of a campaign to pressure the league.

Harvard officials said their initiative has "commenced" but offered no further details, including how much money, if any, researchers have received. In a six-paragraph "overview" provided to "Outside the Lines," the medical school no longer assigned a dollar figure to the project, noting that "ongoing funding requires Harvard to achieve clear benchmarks for each statement of work."

Harvard declined to make any researcher or administrator involved in the project available for an interview. A link to the NFLPA-funded project on the Harvard Medical School website appears to be broken or has been disabled.

The NFL declined to comment on the union's efforts to persuade the league to fund the Harvard study.

The battle between the NFL and the NFLPA over the research dollars -- initially designated in the collective bargaining agreement as a "joint contribution" to improve player health and safety -- reveals major philosophical differences in the way the two sides are using the league's vast resources to influence the emerging science of football-related brain injuries.

After its own research arm downplayed the significance of concussions for nearly two decades, and with concerns about the health effects of the sport growing, the NFL has donated at least $50 million to science over the past two years. Working with entities such as the National Institutes of Health, the U.S. military and private companies, the money is being used to help researchers better diagnose traumatic brain injury, develop imaging techniques to detect neurodegenerative disease in living patients and examine the effects of concussions in young athletes, among more than two dozen projects.

For years, despite scientific evidence linking the sport to brain damage in dozens of former NFL players, commissioner Roger Goodell has repeatedly stated "we're going to let the medical experts decide" when asked if there is a connection.

But none of the NFL-funded research appears designed to provide definitive answers to the sport's most pressing questions: Does football cause brain damage? How many players will get it? And what is the actual risk of playing America's most popular sport?

League, union spar over research agreement in CBA

The seeds of the dispute between the NFL and the NFLPA were planted in the 2011 collective bargaining agreement. At the time, the league and the union pledged to make a joint $11 million annual contribution to medical research for the duration of the 10-year deal.

But, from the beginning, the two sides were split on how the money should be spent.

The NFL, facing criticism over its handling of the concussion crisis, committed $30 million to the NIH in September 2012. The donation came four months after the shocking suicide of San Diego Chargers great Junior Seau. The NFL muscled aside independent researchers by badmouthing -- within hours of Seau's death -- at least one researcher who had been slated to receive Seau's brain with the permission of Seau's son. Ultimately, the NFL directed Seau's brain to the NIH, where it was later diagnosed with Chronic Traumatic Encephalopathy, the neurodegenerative brain disease found in dozens of deceased football players.

Prior to announcing the $30 million grant, the league had asked the NFLPA to meet with NIH, hopeful of convincing the union to make the pledge come out of the "joint contribution." But Atallah, the NFLPA spokesman, said the union balked because the NIH research wouldn't focus exclusively on players.

Dr. Walter Koroshetz, the deputy director of the National Institute of Neurological Disorders and Stroke, the institute that administers the NFL research, said the NIH, as part of its mandate, can't target a specific group.

"Our job is not to protect NFL players," he said. "Our job is public health."

With the union refusing to budge, the NFL committed the $30 million on its own, telling the Foundation for NIH, which administers the funding, that it would make the donation independent of the CBA, Koroshetz said.

As that deal was playing out, the union was soliciting proposals for a project titled, "Advancing the Frontiers of Research in Professional Football." The NFLPA offered up to $11 million per year through 2021 -- the year after the CBA expires -- to "support scientific exploration of new and innovative ways to protect, treat and improve the health of NFL players," according to a copy provided to "Outside the Lines." The pledge by the NFLPA assumed the NFL would agree to the proposal.

The maximum budget was set at $100 million -- the approximate amount set aside in the CBA as the NFL and the NFLPA's "joint contribution" to medical research.

The research proposal attracted some of the most prestigious research institutions in the country. Although the NFLPA issued the solicitation and vetted the applications, many researchers contacted by "Outside the Lines" said they had been led to believe that funding would come in part from the NFL.

The NFLPA eventually selected Harvard. Atallah and Sean Sansiveri, a lawyer for the NFLPA who was the point person on the project, said the union believed the NFL would cooperate because league officials had been invited to participate in the process throughout.

When the league refused to sign off, the union plotted a major announcement in hopes of pressuring the NFL into contributing its share, a person familiar with the plans told "Outside the Lines."

On the eve of the 2013 Super Bowl in New Orleans, the NFLPA and Harvard trumpeted the initiative. A Harvard news release described a sprawling, decade-long study with unconditional funding ("a $100 million grant") that would identify a group of at least 1,000 retired NFL players and select 200 -- half healthy, half unhealthy -- to use as long-term subjects on a wide range of health issues.

The project was described as a "transformative 10-year initiative" that would "marshal the intellectual, scientific, and medical expertise throughout Harvard University to discover new approaches to diagnosing, treating, and preventing injuries and illnesses in both active and retired players."

Harvard said at least part of the goal was to address the risks of playing football.

"We cannot afford to ignore the health risks associated with this sport," Jeffrey S. Flier, dean of the Faculty of Medicine, was quoted as saying. "This partnership ... represents an extraordinary opportunity to improve the health of NFL players and benefit generations to come."

At the bottom of the electronic press release was a YouTube video of Goodell speaking at the Harvard School of Public Health just two months earlier.

It is unclear whether Harvard was aware at the time of the announcement that part of the funding was subject to the NFL's approval. The $100 million "joint contribution" had been well-publicized within the research community, and the union had no plans to donate beyond its share.

The power play didn't work. Within months of the announcement that Harvard had received the grant, it became apparent the NFL had no intention of participating. The standoff held up the initiative for most of last year.

Finally, about two weeks before the 2014 Super Bowl, the two sides quietly agreed to go their separate ways with their respective $50 million.

The NFL declined comment to "Outside the Lines" except to indicate that the money has been committed. The agreement enables the league to draw on the fund for the $30 million donation to the NIH -- a pledge that the NFL previously said it was making independently -- and a separate initiative with General Electric.

"We are spending the money," Brian McCarthy, an NFL spokesman, wrote in an email. "We have an agreement with the union on how the money will be spent and per that agreement, money is being provided to support the Harvard, [General Electric Head Health Challenge] and NIH initiatives."

But Atallah was clear that no NFL money will be used to fund the Harvard study, which still has many questions surrounding it. Where once the university had a page on its website detailing the project -- "Harvard Integrated Program to Protect and Improve the Health of NFLPA Members" -- the link to that page no longer works.

When pressed by "Outside the Lines" for details about the status of the project, a Harvard Medical School spokeswoman, Gina Vild, declined to make anyone available for comment. Vild requested that OTL email a series of questions; shortly after receiving the list, she refused to answer any of them. Vild referred to the "overview" as the university's full statement on the matter.

The overview lists three areas of focus -- "player studies, pilot grants, and ethics and the law" -- but, in contrast to last year's blockbuster announcement, offers no specifics.

How much money Harvard ultimately will receive from the NFLPA -- and for how long -- is unknown. The union's annual contribution to the joint fund is $5.5 million. Union officials said that money will go toward the Harvard project as long as performance goals are met.

"It really depends on how successful they are," Sansiveri said. "If we're not happy with the work at any point, we can just turn off any funding."

Researchers: NFL seems to want only certain brain studies

Some researchers believe the NFL is purposely steering money away from studies like the Harvard initiative that focus specifically on football.

"The NFL, they're not necessarily in the business of the public good, they're in their business," said Eric Nauman, a professor of biomedical engineering at Purdue University who has studied the effects of football-related head trauma on kids and whose colleagues have received some funding from the league. "So I can understand why they might not be pushing some of the research."

Daniel Perl, a professor of pathology at the Uniformed Services University of the Health Sciences in Bethesda, Md., and a neuropathologist who has studied the brains of former NFL players, said he does not believe current research will address the doubts raised by the league or establish the prevalence of CTE.

That would require the kind of long-term study that is not currently funded by the NFL -- or anyone else.

"You have to be following a large number of people in order to get enough brains," said Perl, who is receiving NFL funding through the NIH in a study that could help determine the prevalence of CTE in the general population. "We're talking about a couple thousand people. That's expensive."

Asked about Goodell's statement that medical people will decide if there is a link between football and brain damage, Perl said, "I think they have decided. At least some of us have." Perl acknowledged there may be contributing factors but added: "CTE is only seen in the setting of repeated head trauma. At the end of the day, this is produced by head trauma. I'm sorry, that's what all the research says."

Koroshetz, of the NIH, agreed that advanced CTE cases are clearly related to head trauma.

"I don't think there's any wiggle room," said Koroshetz, adding that some of the earlier cases may be less certain. "It's pretty clear this is due to head injury. Whether there are other things involved, and when it starts, that's hard to know, but I don't think there's any question that it's related to head injury."

But Koroshetz, a neurologist, said he believes the NIH research will inevitably affect football and other contact sports, even though it focuses on the general population.

"The stuff we're doing, this is life-threatening brain degeneration we're talking about," he said. "This is incredibly important to anybody who engages in activities that involve frequent head trauma, and that includes the NFL. What we're going to find is going to have big implications."

In December, the NIH announced eight projects financed by the NFL -- two $6 million "cooperative" grants involving multiple researchers and six pilot projects totaling $2 million.

One of the lead investigators is Ann McKee, a neuropathologist at the Department of Veterans Affairs and Boston University. McKee has drawn criticism from the NFL for making a direct connection between football and brain damage and warning that the prevalence of CTE among NFL players is likely to be extremely high.

McKee once described NFL researchers as "delusional."

The large NIH grants focus primarily on CTE -- establishing a common set of criteria for diagnosing the disease, examining the role of head trauma in its development and, hopefully, discovering a reliable method to diagnose the disease in living patients.

According to the NIH, the NFL played no role in selecting the projects and has no influence over ongoing work. "They have been very supportive of the research and very hands off in terms of decision-making and who would and would not get funded," said Stephanie James, director of science for the Foundation for NIH, which administers the funding.

But the NFL still has some measure of control, because the league can tell the NIH how it doesn't want its money spent, NIH officials said.

McKee, in an interview, said she viewed the NFL-funded project as a "huge opportunity." One of its objectives is to validate criteria she previously established for diagnosing CTE.

Once multiple neuropathologists have agreed upon the characteristics of the disease, imaging teams at Washington University in St. Louis and Massachusetts General Hospital in Boston will use the information to try to develop scans that identify CTE in living patients.

Despite her history with the league, McKee said she wasn't surprised to receive the grant. But she said she knows that the issue remains controversial.

"Let me just say that I never forget about the politics," she said. "I don't see them, but I know they're there. So I'm always worried about the politics, but don't know what the politics are."