July 31 Legislative Update
The Brain Injury Association of America continues its grassroot effort to move and shake the bills presented in Congress.
Note: The House will recess for the month of August today and the Senate will follow suit next week. There will be no Policy Corner until business resumes in September. However, if any legislative advances do surface during the month of August, BIAA will alert grassroots advocates through alerts and news flashes.
Most Valuable Advocates (MVAs)
In a year that has been bursting at the seams with important policy making and legislation affecting the brain injury community, BIAA would like to take a step back and thank our grassroots for the heavy lifting they have done in the past six months!
We would like to specifically recognize the most active members of our community. The twenty people listed below have sent the most messages to Capitol Hill in response to BIAA action alerts since their subscribership to Policy Corner. Thanks to these individuals and the entire grassroots community for making this year a successful policy year so far for BIAA. Keep up the good work!
Ashley Weiss, Steven Cash, Robert Edwards, Sherry Stock, Cozette Carlisle, Paula Daoutis, Denae Mcelliott, Pat Britz, Freda Arender, Phillip Clarkson, Harold Ellison, Donna Lewis, Denman Jarvis, JoAnne OBoy, Scott Gee, Roberta Jereb, Carrie Lear, Geofrey Lauer, Caroline Feller and Paul Folkert
Appropriations Update
On Thursday, July 30, 2009, the Senate Appropriations Committee approved its fiscal 2010 spending bill for Health, Education and Labor programs.
Currently, further details regarding TBI Act and TBI Model Systems of Care funding have not been released, however, BIAA will continue to monitor the appropriations process closely and will be sure to distribute grassroots action instructions when the bill is scheduled for Senate floor consideration.
Health Care Reform Update
Health Care Reform remains in a holding pattern as Senate Finance Chairman Max Baucus announced this week that his Committee would not formally consider health care legislation until after the August recess.
In tandem, the House has also alluded to the fact that their bill will be postponed until September as moderates and liberals from the Energy and Commerce Committee continue to work towards a compromise.
BIAA will continue to monitor new information throughout the August recess.
FY10 National Defense Authorization Act (S. 1390)
On Thursday, July 23, 2009, the Senate passed its version of the FY10 National Defense Authorization Act. During debate, Senator John McCain for Senator Graham offered an amendment that authorizes the Secretary of Defense to carry out a pilot program for providing cognitive rehabilitation therapy services under TRICARE. Both BIAA and the Wounded Warrior Project have worked tirelessly to advocate for the inclusion of this amendment. To view the amendment, click on the link below:
http://www.biausa.org/elements/policy/2009/ndaa_cognitive%20_rehabilitation_amendment_2009.pdf
The amendment requires the Department of Defense to consult the Department of Veterans Affairs, The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury and relevant national organizations with experience in treating traumatic brain injury. It also requires the Secretary of Defense to submit a report to congress evaluating the effectiveness of the program and making recommendations of the appropriateness of including cognitive rehabilitation as a benefit under the TRICARE program.
In response to the adoption by unanimous consent of this amendment into S. 1390, a representative from the Congressional Budget Office reached out to BIAA to ask advice regarding the cost and duration of cognitive rehabilitation therapy in order to formulate a cost estimate for the pilot program. BIAA authored the following comments in response:
http://www.biausa.org/elements/policy/2009/cbo_request_july_09_cog_rehab.pdf
Currently, the Senate is gearing up for a conference with the House to agree on final language. The informal process began this week even though house conferees have yet to be named. With hope that finalization will happen in early September, be on the lookout for BIAA action alerts to urge congress to retain this important amendment as part of the final package.
In conclusion, BIAA is thrilled to have the opportunity to work on this important inclusion in S. 1390 and believes that this is a much needed step forward in providing access to brain injury care for returning service members.
Veterans Health Care Authorization Act of 2009 (S. 252)
After being favorably reported out of the Senate Veterans Affairs committee last week, the full Senate plans to consider S. 252, the Veterans Health Care Authorization Act of 2009 in the coming days.
Among other things, the legislation authorizes the Department of Veterans Affairs (VA) to provide care to veterans with traumatic brain injury through contracts with non-VA providers when necessary.
BIAA strongly supports this legislation as it is vital to ensuring our returning service members suffering from traumatic brain injury get access to the care that they so desperately need and deserve.
If you have not taken action on this issue and would like to get involved, click on the link below for action alert instructions.
http://capwiz.com/bia/home/
Final NIDRR RRCT Priorities Released
As reported in an earlier edition of Policy Corner, BIAA submitted comments to the National Institute on Disability and Rehabilitation Research (NIDRR) in June specifically regarding the fourth priority included in the proposed plan for the Rehabilitation Research and Training Centers (RRTCs) entitled, "Developing Strategies to Foster Community Integration and Participation for Individuals with Traumatic Brain Injury."
BIAA expressed strong support for the inclusion of a brain injury related research priority. However, BIAA also detailed some concerns related to the strategies used in the priority to foster community integration and participation for affected individuals. As proposed, this priority would develop a classification system based on symptoms experienced by individuals with TBI who are living in the community.
BIAA explained that no two brains are alike and each and every individual presents with different symptoms, and each injury results in different challenges. Therefore, trying to categorize these injuries could be counterproductive to the priority's goal.
In response to BIAA and other stakeholders who also submitted concerns, NIDRR has revised some of its proposed priority to reflect the suggestions that were offered. The discussion and changes made by NIDRR in response to the stakeholder comments are:
Discussion: "NIDRR agrees that there is a great need for community integration and participation (CIP) interventions in TBI. Our reading of the research literature suggests that better characterization of symptom variations within research samples might contribute substantially to improved accumulation of knowledge regarding the effectiveness of interventions. In response to the concerns of commenters that it would be difficult for one RRTC both to develop and test interventions and to develop a TBI classification system, we reordered the priority requirements to emphasize the testing of interventions and we eliminated some of the prescriptive requirements related to the development of a TBI classification system. Although we reduced the number of requirements for the development of a TBI classification system, we expect applicants to propose and justify the steps they will take to accomplish this task. The peer review process will determine the merits of each proposal."
Changes: "We have revised the priority by reordering the priority requirements, eliminating the requirement for expert input into the classification system, and eliminating the requirement for the development of a manual for use of the classification system. Also, in response to this comment and related comments, discussed below in greater detail, we have revised the priority by decoupling the testing of interventions from the classification system, eliminating the
numerous examples of symptoms, eliminating the requirement for a short version of the classification system, and eliminating the requirement for a literature review."
BIAA is thrilled to see these changes implemented and will continue to monitor the process going forward. For further reading click on the link below:
http://edocket.access.gpo.gov/2009/E9-17924.htm
