Brain Injury Law Blog : Head Injury : Coma : Personal Injury : Las Vegas Nevada Lawyer & Attorney Tim Titolo

The Brain Injury Association of America has asked me to send this update along to my readers.

Appropriations Update

 On Thursday, March 17, 2011, the Senate cleared a sixth stopgap measure set to expire on April 8, 2011. Going forward, House and Senate leaders will engage in talks to negotiate government funding for the rest of the fiscal year. BIAA is monitoring the situation closely and will alert grassroots advocates if any action becomes necessary.

This week, BIAA met with Senate Appropriations staff to advocate for increased funding for programs authorized through the TBI Act in 2012. BIAA will continue to follow up on this request as well as meet with the House Appropriations staff in the near future.

Sports and Concussion

On March 16, 2011, U.S. Representatives Bill Pascrell, Jr. and Todd Russell Platts, as well as U.S. Senator Tom Udall introduced bipartisan legislation aimed at protecting youth athletes from the dangers of sports-related traumatic brain injuries. BIAA endorsed the legislation and provided technical assistance during the writing of the bill.

The Children’s Sports Athletic Equipment Safety Act would ensure that new and reconditioned football helmets for high school and younger players meet safety standards that address concussion risk and the needs of youth athletes. The bill also increases potential penalties for using false injury prevention claims to sell helmets and other sports equipment.

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The Brain Injury Association of America and the Center for Neuro Skills and Lakeview Neurorehabilitation Centers & Specialty Hospital, request I forward this update. 

Appropriations Update

On Friday, March 11, 2011, the House Appropriations Committee will unveil a three-week continuing resolution (CR) that will extend FY10 funding through April 8, 2011. The current CR is set to expire on March 18, 2011. The bill would make some relatively non-controversial spending cuts, totaling about $6 billion dollars in savings.

BIAA is monitoring the situation closely and working with the Congressional Brain Injury Task Force to make sure that FY2011 appropriations will look favorably on brain injury programs. BIAA is also engaging with both Senate and House Appropriations Committees in preparation for FY2012 appropriations work.

Brain Injury Awareness Day 2011

This year, brain injury awareness day on Capitol Hill will be held on Wednesday, March 16, 2011. As in years past, there will be an awareness fair, briefing and reception. The full schedule for the day is as follows:

10:00 am – 1:00 pm Brain Injury Awareness Fair,
First Floor Foyer of the Rayburn House Office Building

1:30 pm – 3:30 pm Briefing: Brain Injury Rehabilitation and Re-Entry: Lessons Learned and the Road Ahead
Rayburn Gold Room
5:00 pm – 7:00 pm Reception Celebrating Brain Injury Awareness Month
First Floor Foyer of the Rayburn House Office Building

For those who are attending, please stop by BIAA’s exhibit in the Rayburn foyer to pick up leave-behind materials for your Congressional visits!

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This is the latest from the Brain Injury Association of America: 

BIAA Unveils 2011 Legislative Fact Sheets

This week, BIAA released it 2011 legislative fact sheets highlighting critical public policy issues for people with brain injury including access to care, research, TBI Act appropriations and reauthorization, military, and membership in the Congressional Brain Injury Task Force. BIAA is excited to move forward these priorities in the 112^th Congress!

Appropriations Update

On Wednesday, March 2, 2011, President Obama avoided a government shutdown by signing into law a two week extension of the current continuing resolution that was set to expire today. The measure keeps the government running through March 18, 2011.

Today, March 4, 2011, Senate Democrats released a proposal for a $6.5 billion cut from current spending levels, a modest reduction compared with the before released Republican proposal. The Senate is expected to hold a series of test votes next week on both Democratic and Republican spending plans.

BIAA will continue to monitor the situation closely and alert grassroots advocates if action becomes necessary.

Brain Injury Awareness Day 2011

This year, brain injury awareness day on Capitol Hill will be held on Wednesday, March 16, 2011. As in years past, there will be an awareness fair, briefing and reception. The full schedule for the day is as follows:

10:00 am – 1:00 pm   Brain Injury Awareness Fair,

                                       First Floor Foyer of the Rayburn House Office Building

1:30 pm – 3:30 pm     Briefing: Brain Injury Rehabilitation and Re-Entry: Lessons Learned  and the Road Ahead

Location to be Determined

5:00 pm – 7:00 pm     Reception Celebrating Brain Injury Awareness Month

                                       First Floor Foyer of the Rayburn House Office Building

BIAA is committed to helping the Congressional Brain Injury Task Force plan a successful event around the importance of rehabilitation in recovery. Look for a special edition of Policy Corner early next week detailing the speaker list for the briefing. 

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 The Brain Injury Association requested that I send this to my readers:

After analyzing the President’s proposed FY2012 budget, we are pleased to report that programs authorized by the TBI Act, including the HRSA Federal TBI Program and the CDC’s important TBI work have both been recommended to receive at least the same funding found in FY10 final and FY11 CR appropriations bills, $10 million for HRSA and just under $7 million for CDC.

The CDC collects data, links both military and civilian populations with TBI services, increases public awareness, and conducts public health research. The HRSA Federal TBI Program funds 18 states to improve systems coordination access to care for people with brain injury.

On another note, the budget recommends reducing the TBI Model Systems of Care Program from 16 centers to 14 centers. BIAA will address the issue with both the House and Senate Appropriations Committees to ensure that Congress is aware of the importance of each center and encourage full funding for all 16 centers.

The TBI Model Systems is a collection of research centers located across the United States that conduct disability and rehabilitation research under grants administered by the National Institute on Disability and Rehabilitation Research of the U.S. Department of Education. They are the only source of non-proprietary longitudinal data on what happens to people with brain injury. The TBI Model Systems are a key source of evidence-based medicine, and serve as a “proving ground” for future researchers.

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 This is the latest from the Traumatic Brain Injury Association Legislative Update:

This week House Republicans previewed a spending measure that would cut $74 billion in non-security spending from President Obama’s 2011 budget request. In addition, appropriators are trying to find billions more in spending cuts, as leaders work to put together a bill that will meet conservative demands.

Programmatic funding information is not yet available, but BIAA will analyze the data when it is released next week. Currently, the summary information available does not point to any cuts for TBI programs and in order to avoild calling attention to the line item, we ask that grassroots take action next week only if it becomes necessary. BIAA will alert grassroots advocates if mobilization is needed.   

In the Senate, Democratic leaders called the proposed House cuts “extreme” and warned that a series of stopgap funding measures may be needed in the weeks ahead to avert a government shutdown. As many of you know, the current continuing resolution (CR) is set to expire on March 4, 2011.

Look for a special edition of Policy Corner early next week that will include an analysis of the House programmatic FY11 funding and an analysis of the President’s 2012 budget that is expected to be released early in the week.

Cognitive Rehabilitation Update

On Monday, February 7, 2011, BIAA participated in a day-long public workshop involving the Institutes of Medicine (IOM) Committee on Cognitive Rehabilitation Therapy for Traumatic Brain Injury. The meeting included several speakers including the charge to the Committee by TRICARE Management Activities.

BIAA is optimistic that IOM will reinforce in this new study that cognitive rehabilitation is an effective and medically necessary intervention for service members with traumatic brain injury and therefore should be a covered benefit under the TRICARE program.

Brain Injury Awareness Day 2011

This year, brain injury awareness day on Capitol Hill will be held on Wednesday, March 16, 2011. As in years past, there will be an awareness fair, briefing and reception. The full schedule for the day is as follows:

10:00 am – 1:30 pm   Brain Injury Awareness Fair,

                                       First Floor Foyer of the Rayburn House Office Building

1:30 pm – 3:30 pm     Briefing: Brain Injury Rehabilitation and Re-Entry: Lessons Learned and the Road Ahead

                                       Location to be Determined

5:00 pm – 7:00 pm     Reception Celebrating Brain Injury Awareness Month

                                       First Floor Foyer of the Rayburn House Office Building

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 The Brain Injury Association of America asked me to post this update on this blog:

At the request of the Secretary of the Health and Human Services Department (HHS), the Institute of Medicine (IOM) is spearheading a study that will make recommendations on the criteria and methods for determining and updating the essential health benefits package, which was passed as part of the Affordable Care Act. This week, as part of the Consortium for Citizens with Disabilities (CCD), BIAA contributed to oral testimony delivered to IOM’s Committee of the Determination of Essential Health Benefits suggesting criteria and models for the design of the rehabilitative and habilitative benefits package.

In addition, BIAA submitted written testimony specific to brain injury that emphasized a continuum of care, including rehabilitation treatment provided in a variety of settings, as medically necessary to reach optimal recovery.

BIAA will continue to assist IOM, as they move through this process, to ensure appropriate access to care for people with brain injury is achieved as health care reform regulations take shape.

Research Appropriations Update

On January 13, 2011, The Congressional Brain Injury Task Force, with help from BIAA, Ohio State University and JFK-Johnson Rehabilitation Institute, issued a letter to the Office of Management and Budget (OMB) encouraging line-item status and increased funding for the TBI Model Systems of Care program within the soon-to-be released President’s budget.

As of now, the budget is set to be released during the week of February 14, 2011. At that time, BIAA will analyze funding levels and alert grassroots advocates when appropriations action becomes necessary.

Brain Injury Awareness Day 2011

This year, brain injury awareness day on Capitol Hill will be held on Wednesday, March 16, 2011. BIAA and other stakeholders are working with the Congressional Brain Injury Task Force to develop a schedule for the day and a theme for this year’s briefing.
 

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This is the latest as reported by the Brain Injury Association of America:

Federal TBI Program Update

On June 15, 2010, BIAA and other TBI stakeholders met with Mary Wakefield, the Administrator of Health and Human Service’s (HHS) Health Resources and Services Administration (HRSA) to discuss the future of the federal TBI program, one of the programs funded through the TBI Act. The federal TBI program provides grants to states to improve access to care for people with brain injury. 

The meeting was very positive and both the TBI stakeholders and HRSA are committed to working together to bring the attention needed to the program in order to grow the program and receive more funding for the TBI population in each state. HRSA has committed to working with stakeholders going forward to craft a strategic plan for the program and solicit public comment from appropriate entities such as BIAA state affiliates and state lead agencies in order to ensure that elevation of the program is successful.

BIAA is encouraged by the partnership forged between TBI stakeholders and HRSA and will continue to pass on important information as efforts progress.

FMAP Update

Last week, Senate Democrats came four votes short of invoking cloture on the tax extenders bill that includes the extension of increased federal Medicaid monies through June, 2011. After passing a Medicare physicians’ payment bill on its own instead of as a part of the larger extender package, Senator Max Baucus is encouraged that the larger bill still has the support and momentum needed for approval. The bill is expected to be considered in the Senate this week. 

BIAA will continue to monitor the situation closely. If you haven’t taken action on this alert, it’s not too late!

Health Care Reform Update

Last week, the Health and Human Services (HHS) department asked for public comments regarding their draft strategic framework on multiple chronic conditions (MCC). The framework addresses approaches to improving the health of individuals with concurrent MCC by providing options for HHS to strengthen coordination of its efforts internally and collaboration with stakeholders externally.

BIAA submitted a document detailing the concern that the draft framework does not include TBI in the list of conditions that constitute concurrent multiple chronic conditions. BIAA argued that because brain injury has been linked to epilepsy, Parkinson’s and Alzheimer’s disease and that individuals with brain injury manifest neurologic, neuroendocrine and psychiatric disorders as well as cardiovascular, musculoskeletal, gastrointestinal, urologic and sexual dysfunction it absolutely should be addressed in the framework.

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The Brain Injury Association of America posts the following update:

Tell your Senators to Extend Extra Medicaid Funding Through June 2011!

It is important that all grassroots advocates unite to support the extension of the current elevated Federal Medicaid Assistance Percentage (FMAP) that is currently being debated in the Senate and will be very important to states come the end of this year!

Originally, both the House and the Senate acted to extend the extra match through June 2011, the end of the fiscal year for states. However, the offsets that were supposed to pay for this extension went instead to help pay for the health care reform legislation. Without an extension, the money will run out Dec. 31, 2010, and many states will be forced to make drastic cuts to the federal-state program. The 2009 federal stimulus package provided $87 billion to increase the federal share of the program through December (it included a 6.2% increase of the federal medical assistance percentage (FMAP) under Medicaid).

Last week, House Democrats debated HR 4213, the vehicle for this extension and chose to remove the provision extending extra federal Medicaid funding. With states in fiscal peril due to the recession and unemployment, it is vital that the extra federal funding continues in order to keep health care accessible for many brain injury patients and caregivers!
 

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BIAA continues providing updates at the legislative level.

CDC Forms Disability and Health Work Group

Largely due to the advocacy of the Disability and Rehabilitation Research Coalition (DRRC), the Centers for Disease Control and Prevention (CDC) has announced that they will form the first Disability and Health Work Group to advance the health of people with disabilities.  With cross-agency representation, the work group will focus on incorporating disability status into CDC surveys, showcasing best practices, and ensuring relevant issues for people with disabilities are reflected in CDC programs and policies.

BIAA is pleased that these issues will be elevated within the CDC and will offer any assistance needed to further the group’s efforts.

 House Education and Labor Committee Holds Sports and Concussion Hearing

On May 20, 2010, The House Education and Labor Committee held a hearing to investigate the impact of concussions on student athletes and their academic performance. BIAA was contacted by the Committee early in the planning stages for general guidance of the issue including expertise regarding appropriate witnesses.

In conjunction with the hearing, a Government Accountability Office (GAO) report was released finding that concussions in high school athletes are widely unreported and under-diagnosed suggesting a gross underestimate of the overall national occurrence of concussion in high school sports.

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BIAA reports the following"

BIAA Endorses the Christopher Bryski Student Loan Protection Act

This week, BIAA joined Congressman John Adler in support of a bill that would ensure a method be in place when applying for Federal or Private student loans to designate who will make decisions on your behalf regarding all medical, financial, and legal matters in the event you are catastrophically ill, catastrophically injured, temporarily disabled, permanently disabled or deceased. 

On June 17, 2004, 23 year old Christopher Bryski fell forty five feet to the ground in a recreational accident. He sustained a severe Traumatic Brain Injury and was in a coma for approximately 4 weeks. After emerging from the coma Christopher remained in a persistent vegetative state for almost two years before passing away on July 16, 2006.

At the time of Christopher’s accident, he was in his third year of academic study at Rutgers University and needed to supplement his federal student loans with a private alternative education loan through a private lender, in which his father was a co-signer and is still liable after his death for the amount of the loan.

The bill introduced by Congressman Adler would address this important issue for parents and caregivers in the following ways:

Any private educational lender (i.e Citibank, Wells Fargo, Chase, PNC, etc.) shall:

·         Discuss with the student and the cosigner of the loan the benefits of creating a power of attorney, in the event of the death of incapacity of the student or cosigner

·         Define clearly and concisely the obligations of the cosigner, including the effect of death or incapacity of the student or cosigner

·         Discuss with the student and the cosigner the benefit of credit insurance in connection with the loan, however the private educational lender may not require credit insurance or deny a loan on the basis that the borrower or any cosigner has not obtained credit insurance

·         Gives power to the Federal Reserve to define death or incapacity in conjunction with the Secretary of Education and institute standards regarding the borrower’s or cosigner’s obligation if the borrower or cosigner were to die or become incapacitated

·         Federal PLUS Loans and Federal Consolidation Loans:

·         Discuss with the prospective borrower the uses and benefits of creating a durable power of attorney in the event of the death or incapacity of the borrower or the student on whose behalf the loan is borrowed by the parent borrower

·         Amends Entrance Counseling requirements for Federal Loans:

·         Provide information during entrance counseling that describes the loan discharge rules in the case of death of disability, and the possibility that private loans may not be discharged upon death or disability

·         Provide information with respect to creating a durable power of attorney and its benefits and uses

BIAA applauds Representative Adler for his commitment to this important issue and will continue to monitor the status of the bill and advocate on its behalf.

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The Brain Injury Association of America continues to update us:

On Thursday, April 22, 2010, the Senate cleared an omnibus veterans’ health care measure that provides important assistance to both veterans and caregivers. S. 1963, as modified by the House, includes nearly $1.6 billion in authorizations for programs designed to aid caregivers of eligible veterans.

The measure, which now goes to the White House for President Obama’s signature, is intended to strengthen the health care support system for veterans and to expand services in rural areas. The measure will also expand caregiver programs, making them eligible for training and education assistance.

The bill also authorizes VA hospitals to contract with non-VA providers, as stated in the bill:

“The Secretary may contract with appropriate entities to provide specialized residential care and rehabilitation services to a veteran of Operation Enduring Freedom or Operation Iraqi Freedom who the Secretary determines suffers from a traumatic brain injury…”

Both BIAA and the Wounded Warrior Project have long advocated for approval of this measure and yesterday’s final passage signified a great victory for service members who suffer from TBI and their families.

Health Care Reform Update

After several weeks of delving into the final text of the health care reform bill, our partners at Powers, Pyles, Sutter & Verville, PC, sponsored by BIAA’s Business and Professional Council, have prepared an analysis of the major provisions that impact our community.

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BIAA Unveils 2010 Legislative Fact Sheets

On March 3, 2010, BIAA made available its 2010 legislative fact sheets. The fact sheets outline the agenda for this year including, access to care for both civilian and military populations, TBI Act and research funding, TBI Act reauthorization, caregiver assistance, and support for the Congressional Brain Injury Task Force is now available on our home page!

Brain Injury Awareness Day 2010

Don’t forget that this year’s Brain Injury Awareness Day on Capitol Hill is set to take place on March, 17, 2010. 

Below is the schedule of events for the day:

10:00 AM – 1:00 PM - Brain Injury Awareness Fair, First Floor Foyer of the Rayburn House Office Building

2:30 PM – 4:00 PM - Briefing: “From the Playground to the Pros: A Heads-Up on

Concussion”, Capitol Visitors Center – Congressional Meeting Room South

5:30 PM – 7:30 PM - Reception Celebrating Brain Injury Awareness Month, First Floor Foyer of the Rayburn House Office Building

Hope to see you there!

Health Care Reform Update

House leaders this week prepared a schedule to bring health care reform to a vote before Congress adjourns for its two-week spring recess, which begins on March 26, 2010. BIAA continues to advocate for provisions important to the brain injury community and will alert grassroots advocates if action is necessary.

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Sarah D'Orsie of the BIAA advises as follows:

Health Care Reform Update


This week  the Senate worked towards combining two health care reform drafts, one from the Health, Education, Labor and Pensions (HELP) committee and the other from the Finance Committee, into one final version.  BIAA, as a part of the Consortium for Citizens with Disabilities (CCD) coalition, submitted a letter to Senate leadership asking to ensure that several provisions important to the brain injury community are included in this final version of the bill.

The letter outlines several priorities such as the need for private insurance reform, improvements to Medicaid and long terms services and supports, and clarifications to the Medicare program.  For further reading, the full text of the letter can be found on our web site:  http://www.biausa.org/elements/policy/2009/ccd_hcreform_letter.pdf

As the Senate works to combine its measures into one bill, BIAA will monitor the progress and alert grassroots advocates if action becomes necessary. 

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Sarah D'Orsie of the Brain Injury Association of America has asked me to post this latest legislative update:

On Wednesday, October 7, 2009, the House and Senate Armed Services Committees announced that they had reached an agreement on a conference report to H.R. 2647, the Fiscal Year 2010 National Defense Authorization Act. 

In a major victory for the brain injury community, the report included an amendment that authorizes the Secretary of Defense to carry out a pilot program for providing cognitive rehabilitation therapy services under TRICARE.  BIAA worked with the Congressional Brain Injury Task Force to preserve its status as part of the final conference report.  We are thrilled to have contributed to this important step towards providing better access to care for returning service members.

A link to the full text of the amendment can be found below:

http://www.biausa.org/elements/policy/cognitive_rehabilitation_ndaa_letter.pdf  

Health Care Reform Update

This week the Congressional Budget Office (CBO) delivered their estimate of the Senate Finance Committee health care reform package.  The bill scored under the $900 billion goal and would reduce the deficit by more than expected while covering millions more of the uninsured. (CQ)

With this news providing momentum, the Senate Finance Committee is expected to vote on October 13, 2009 to clear the bill.  A final vote in the Finance Committee will open the door for negotiations to begin on melding that draft with the one previously approved by the Senate Health, Education, Labor and Pensions (HELP) Committee.  Once that process has been completed, the final bill may be considered by the full Senate as early as the week of October 19, 2009. 

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Here are the latest updates from the Brain Injury Association of America.

Health Care Reform Update

This week the Senate finance committee wrapped up debate on its version of a health care reform package.  The committee now has finished debating the more than one hundred amendments offered to the bill.  A final vote is possible next week, although the finance committee cautiously waits to hear the cost estimate of the measure from the congressional budget office.

BIAA will continue to monitor the situation as the legislation progresses.

Appropriations Update

Last week, Congress considered a measure, known as a continuing resolution (CR), that would keep the government funded into the 2010 fiscal year, which began on October 1, 2009.  TBI related programs will be funded at FY2009 levels until the spending bills for next year have been approved.

The full Senate has yet to consider the Fiscal Year 2010 Labor, Health and Human Services and Education spending bill that will provide the funding allocation for programs authorized through the TBI Act and for NIDRR's TBI-related research programs, including TBI Model Systems of Care.

BIAA will alert grassroots advocates when action is needed.

National Defense Authorization Update

As reported in a previous edition of Policy Corner, the Senate version of this year's National Defense Authorization bill includes an amendment that authorizes the Secretary of Defense to carry out a pilot program for providing cognitive rehabilitation therapy services under TRICARE. 

As the House and Senate meet to debate the differences in the two versions in order to craft a final bill, BIAA has increased awareness among House members serving on the Armed Services Committee of the amendment and its importance to returning service members sufferring from TBI.

This week, Congressman Bill Pascrell, Jr. and Congressman Todd Platts, co-chairs of the Congressional Brain Injury Task Force, sent a letter to members of both the House and Senate Armed Services Committee members urging their support in preserving this amendment in the final bill.  A copy of the letter can be viewed on our web site, or by clicking the link below:

http://www.biausa.org/elements/policy/cognitive_rehabilitation_ndaa_letter.pdf

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The Brain Injury Association of America asks me to pass this update on.

*BIAA would like to take a moment to remember Senator Ted Kennedy and the profound influence he had on the brain injury community, by acting as the sponsor and champion of the TBI Act for many years. He will be missed.

Health Care Reform Update

President Obama made it clear Wednesday evening in a joint session speech that he is demanding health care reform action this year. With the spark given by the President's address, Democrats are enthusiastically working to find a way past their differences over such issues as inclusion of a public insurance option.

This week, the Senate Finance Committee released an outline of their proposal that is set to be made public next week. BIAA has some concerns about the proposal and is contacting members of the committee to ensure comprehensive coverage in the full proposal. The Committee plans to mark up a bill the week of Sept. 21, 2009.

The House may vote on its bill in the coming weeks, though debate continues over what kind of public option it will contain.

Stay tuned for action alerts as legislation progresses!

Brain Injury Survivor Advocacy Program

In August, BIAA launched a pilot program dedicated to encouraging area brain injury survivors to become more effective self-advocates. The program included identifying likely targets, making appointments, participating in a day of meetings in Capitol Hill, and following up and maintaining relationships with Congressional staffters.

Due to the success of the program, BIAA will continue to offer the opportunity on a quarterly basis to survivors who would like to learn more about advocacy. Space is limited, so if you would like to participate and you live in the Washington, DC area, please send me an email so that I can begin assembling the next advocacy group.

Appropriations Update

With energy legislation delayed and the future of a health care overhaul uncertain, Senate appropriators will try to take advantage of a window of opportunity to pass and clear as many spending bills as possible in September. (CQ)

If Congress is unable complete all 12 fiscal 2010 bills before the next fiscal year begins Oct. 1, 2009, lawmakers will have to pass a continuing resolution later this month to keep money flowing to the government.
 

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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

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The Brain Injury Association continues to keep us apprised of legislative matters.

Appropriations Update

TBI Act

On Friday, July 24, 2009 the House of Representatives passed a $730.5 billion bill to fund health, education and labor programs in fiscal 2010.  The bill (HR 3293) allocates $10 million to the HRSA state grant and protection and advocacy programs.  The accompanying committee report states:

"The Committee provides $10 million for the Traumatic Brain Injury (TBI) program. This is $123,000 above the fiscal year 2009 funding level and the budget request. The TBI program funds the development and implementation of statewide systems to ensure access to care, including pre-hospital care, emergency department care, hospital care, rehabilitation, transitional services, education and employment, and long-term community supports. Grants also go to State protection and advocacy systems. In fiscal year 2009, 16 States will receive TBI awards, and 57 State and territorial protection and advocacy systems will be funded.  The Committee intends that HRSA allocates the TBI funding increase to States and protection and advocacy systems in the same proportion as they received with fiscal year 2009 funding."

The National Institute on Disability and Rehabilitation Research

Also, considered as part of the bill, funding for the National Institute on Disability and Rehabilitation Research as stated in the Committee Report is as follows:

"The Committee recommends $110,741,000 for the National Institute on Disability and Rehabilitation Research, which is $3,000,000 above the fiscal year 2009 funding level and the same as the budget request. The Institute supports research, demonstration, and training activities that are designed to maximize the employment and integration into society of individuals with disabilities of all ages. The Committee encourages the Administration to establish an Interagency Committee on Disability Research to develop a comprehensive government-wide strategic plan for disability and rehabilitation research, including capacity building and knowledge translation."

Social Security Administration

The Social Security Administration's program that supports seniors and the disabled received $11.4 billion in the bill, $993 million above 2009, for a limitation on administrative expenses for SSA. The Committee expressed dedication to helping the Social Security Administration (SSA) address several challenges, including processing a rising number of retirement and disability claims, reducing the backlog of disability claims, and improving service to the public.

BIAA will continue to monitor the bill as the Senate Appropriations Committee is scheduled to begin marking up its version of the bill July 28.  Look for more details and action alerts in the coming weeks.  In the meantime, BIAA thanks grassroots advocates for their assistance!


Health Care Reform Update

House

After more contentious private and public negotiations on a health overhaul between House leaders and moderate Democrats, prospects are uncertain for a vote on the bill before lawmakers leave for a long August recess.

The Energy and Commerce Committee Chairman, Henry Waxman, is aiming to come to an agreement by Monday or Tuesday of this week in order to report the bill to the full house.

 
House Democratic leaders will attempt to convince their caucus of the merits of the legislation Monday evening, in the hope of holding a vote at the end of this week or early next week.

Majority Leader Steny Hoyer, had earlier dismissed the idea that Energy and Commerce might have to discharge the bill without voting on it --- something Waxman said, in the heat of his dispute with moderate democrats, that he was considering himself. "I'm not interested in that, and I don't think the Speaker is either," Hoyer said. (CQ)

He said chances are "very small" they will take the bill to the floor before the House's scheduled July 31 break for the August recess. However, he said it was possible the leadership would hold the chamber in session beyond that date.

Senate

Senate leaders last week abandoned plans to pass their own bill before August, but work continues among a bipartisan group of six Finance Committee members - backed by their leadership - to reach agreement on an overhaul.

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Sarah D'Orsie, on behalf of the Brain Injury Association of America, requests we call our Senators regarding this bill.

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The Brain Injury Association has requested I post this latest update:

In This Issue:
Appropriations Update
Health Care Reform Update
____________________________________________________________________
The Policy Corner is made possible by the Centre for Neuro Skills, James F. Humphreys and Associates, and Lakeview Healthcare Systems, Inc. Brain Injury Association of America gratefully acknowledges their support for legislative action.
__________________________________________________________________
Appropriations Update

Today, July 17, 2009, the House Appropriations Full Committee acted on legislation that would fund labor, health and education programs for Fiscal Year 2010. The overall numbers for this year's reported bill are as follows:

Bill Total
2009 Comparable: $155.049 billion
President's Request: $160.706 billion
Committee Mark: $160.654 billion

Currently, further details regarding TBI Act and TBI Model Systems of Care funding have not been released, however, look for a special edition of Policy Corner on Monday, July 27, 2009 for a special appropriations report. BIAA will continue to monitor the appropriations process closely and will be sure send out grassroots action instructions when the bill is scheduled for floor action.

Health Care Reform Update

This week the Senate, Health, Education, Labor and Pensions (HELP) Committee approved its draft Health Care Reform measure, and the Finance Committee is expected to begin consideration next week.

In the House, the Education and Labor Committee approved its section of the bill (HR 3200) after a very long session lasting through the night on Thursday. The Ways and Means Committee also finished action on its portion of the legislation early Friday, while the Energy and Commerce Committee is expected to continue its proceedings on Monday.

BIAA will continue to monitor the situation closely as the House is hoping to send their bill to the floor before the August recess.
 

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This in from the Brain Injury Assocation:

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The Brain Injury Association of America updates us on the legislative activities.

Health Care Reform Update

This week the Senate Finance Committee engaged in three daylong sessions to discuss various policy options that may be included in a Health Care Reform bill later this year.

As reported by Congressional Quarterly, Senator Baucus, the Chairman of the Senate Finance Committee, was not very enthusiastic when asked whether committee members had reached consensus on any issues. However, he did say that he sensed some common ground on broader issues and believes his committee is moving towards a "convergence" on these issues that are expected to be debated next month.

As always, BIAA will continue to monitor any health care reform related progress. If you have not yet taken action and emailed your Senators and Representatives regarding the brain injury guiding principles, you may still do so by clicking the following link:

http://capwiz.com/bia/home

Senate Finance Committee Health Care Delivery System Comments

On Friday, May 15, 2009, BIAA submitted comments to the Senate Finance Committee in response to their proposed set of recommendations regarding health care delivery system reform.

BIAA expressed support for several recommendations with respect to the coordination of chronic conditions but also made clear within the submission that the organization is strongly opposed to the bundling of post-acute care as it applies to persons with brain injury.

To view the full document, click on the link below:

http://www.biausa.org/elements/policy/2009/biaa_finance_committee_response.pdf

DCoE Launches Real Warriors Anti-Stigma Campaign

On Thursday May 21, 2009, The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) launched a public awareness campaign focused on combating the stigma associated with seeking care and treatment for psychological health and Traumatic Brain Injury (TBI).

For more information, visit http://www.realwarriors.net/ . The Real Warriors Web site features articles and resources as well as video interviews with service members, their families and others dealing with psychological health and/or TBI.

BIAA has been an active partner in this campaign and will continue to work towards its success with the DCoE.
 

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The Las Vegas Review Journal reports on the state of legislative activity on un-capping medical malpractice lawsuits.  The caps limit injured individuals from recovering compensation from negligent doctors for their injuries.

An Assembly-approved bill to let some patients seek unlimited damages in medical malpractice lawsuits was being held up in the Senate in apparent retaliation for an Assembly committee chairman's decision to sit on two Senate-passed construction defect bills.

Though no one had told him directly, Assembly Judiciary Chairman Bernie Anderson, D-Sparks, said he had heard that the Senate Judiciary Committee won't act on Assembly Bill 495 unless his committee passes Senate bills 337 and 349.

The Senate committee on Wednesday cancelled a scheduled hearing on the medical malpractice bill. Under legislative rules, the bills must be approved by their respective committees by the end of business Friday or they cannot be passed during this Legislature.

The chairman of the Senate Judiciary Committee, Sen. Terry Care, D-Las Vegas, said only that he spoke with Anderson earlier Wednesday about the medical malpractice bill, which passed the Democrat-controlled Assembly in April on a 26-15 party-line vote.

The proposal would lift the $350,000 cap on pain and suffering damages in lawsuits where doctors are found guilty of gross negligence.

The bill was drawn up in part by colonoscopy patients in Las Vegas who believe they were hurt by the deliberate negligence of doctors and now are being hurt by a system that limits their damages.

More than 50,000 patients at two now-closed outpatient clinics in Las Vegas were notified last year that they might have been exposed to blood-borne diseases because of shoddy injection practices by clinic staffers. Nine people contracted hepatitis C, and another 105 cases might be linked to the clinics.

Anderson said the bill is straightforward and will help these patients. He also acknowledged the testimony of some doctors who said the bill would lead to higher malpractice insurance rates and drive them out of Nevada.

"Keeping doctors in Nevada is one of our priorities, but what happened in my mind in the South was gross negligence," he said.

http://www.lvrj.com/news/44970727.html 

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The BIAA keeps us apprised of the latest legislation:

Health Care Reform Update

Lawmakers are now developing policy options that could become part of the national health care reform, but currently no legislation has been introduced and there are no specific bills to support or oppose. In anticipation of both proposed and final legislation, BIAA has adopted five guiding principles (below) designed to aid Congress in drafting language that would increase access to treatment for individuals with brain injury.

Guiding Principles:

1. Recognize brain injury is a disease.
2. Focus on medical necessity.
3. Provide access to the full treatment continuum.
4. Use accredited programs, interdisciplinary team of qualified/specialized clinicians, and appropriate treatment settings based on patient and family choices and aspirations.
5. Hold private insurers accountable for the premiums they collect; avoid Medicare/Medicaid as first option for coverage.

These principles are explained in a Brain Injury Health Care Pledge that can be signed and supported by members of congress who want to make sure that the unique needs of those with brain injury are addressed in the final health care plan. Our goal is to encourage all Representatives and Senators to sign this pledge to raise awareness and understanding of how proposed policies could impact people with brain injury, family members, researchers and clinicians.

On May 6, 2009, BIAA circulated an action alert that included the pledge in the body of the message advocates send to their Representatives and Senators. If you haven't taken action by asking your members of congress to support the pledge, you may still do so by clicking on the following link:

http://capwiz.com/bia/home/

BIAA's full position paper explaining each guiding principle, an executive summary, and a detailed article from The Challenge! regarding our positions on health care reform can also be found on our website by clicking on the link below.

http://www.biausa.org/policyissues.htm#library

In support of BIAA's health care reform campaign, BIAA leaders and staff participated in several high level meetings in the House, Senate, and the White House to encourage support for these principles.

BIAA gained the support of the Co-Chairmen of the Congressional Brain Injury Task Force (Rep. Pascrell, Rep. Platts), who circulated a letter to their House of Representatives colleagues encouraging them to sign the Brain Injury pledge. BIAA will continue to reach out to members of both the House and the Senate to secure brain injury treatment in health care reform proposals.

Appropriations Update

President's FY10 Budget Proposal Released

TBI Act, Department of Health and Human Services

The White House proposes to sustain funding for the Health Resources and Services Administration (HRSA) Federal TBI Program, which provides grants to state agencies and protection and advocacy organizations to improve access to health and other services for individuals with traumatic brain injury (TBI) and their families. The President's plan proposes $10 million be allocated to HRSA, the same amount designated in FY09.

For the past three years, President Bush had proposed to eliminate the HRSA TBI Program funding in his budgets. BIAA applauds President Obama's decision to preserve this program, although still underfunded, so that we can continue to address the huge public health problem of traumatic brain injury

NIDRR, Department of Education

The President's budget proposal slates a $3 million increase for the National Institute on Disability and Rehabilitation Research (NIDDR), going from $108 million in FY09 to $111 million in FY10. Although BIAA is thrilled about this increase, we will continue to advocate for increased funding for the TBI Model Systems of Care as the appropriations process advances this summer.

BIAA submits FY10 testimony to both the House and Senate Appropriations Committees

This week, BIAA submitted testimony to the House and Senate Appropriations Committees, Subcommittees on Labor, Health and Human Services, Education and Related Agencies.

http://www.biausa.org/policyissues.htm#testimony

The testimony detailed the importance of appropriating $37 million to preserve and advance TBI Act Programs, as well as the need to designate $13.3 to sustain and bolster health and function research -- including the TBI Model Systems of Care, Rehabilitation, Research & Training Centers; and field-initiated investigations---within the National Institute on Disability and Rehabilitation Research (NIDRR).

NIDDR Releases notice of proposed priorities for RRTCs and RERCs

This week the Assistant Secretary for Special Education and Rehabilitative Services under the Department of Education proposed funding priorities for the Disability and Rehabilitation Research Projects and Centers Program administered by NIDRR. Specifically, this notice proposes four priorities for the Rehabilitation Research and Training Centers (RRTCs) and three priorities for the Rehabilitation Engineering Research Centers (RERCs).

Notably, the proposed priorities for RRTCs include "Developing Strategies to Foster Community Integration and Participation (CIP) for Individuals with Traumatic Brain Injury." The goal of this priority is to develop a classification system based on symptoms experienced by individuals with TBI who are living in the community.

This classification system can be used to link the post-rehabilitation consequences of TBI with CIP-oriented interventions. Such a classification will allow practitioners and researchers to better match individuals with TBI with specific interventions, and to better characterize their study samples.

BIAA applauds the Assistant Secretary for proposing this priority and will continue to advocate in its favor.

BIAA endorses the Heroes at Home Act of 2009

This week, BIAA submitted a letter to the House Veteran's Affairs Committee, Subcommittee on Health urging consideration of the Heroes at Home Act of 2009 (HR 667). The bill would significantly improve support for family caregivers of returning service members with TBI and acknowledge the critical role played by family caregivers in facilitating recovery from brain injury and the pressing need for training, certification and financial compensation of caregivers.

BIAA will continue to advocate for the swift passage of this bill as the 111th Congress progresses. The legislation currently has 36 cosponsors.

BIAA submits letter of endorsement for the Concussion Treatment and Care Tools Act of 2009 (conTACT)

BIAA submitted a letter to the House Energy and Commerce Committee encouraging swift passage of the conTACT Act of 2009 (HR 1347), applauding the bill's proposal to provide grants to states to ensure that elementary and secondary schools implement concussion management guidelines by funding computerized pre-season baseline and post-injury neuropsychological testing for student athletes.

BIAA will continue to track the progress of this measure and will advocate on its behalf.

BIAA Urges Cosponsorship of the National Neurotechnology Initiative Act

On April 22, 2009, BIAA circulated an action alert targeting House Members to cosponsor the National Neurotechnology Initiative Act of 2009 (HR 1483). The bill would promote discoveries and accelerate the development of new and safer treatments for brain-related illness, injury and disease.

The action alert message also details the need to initiate much-needed coordination among federal agencies with respect to research, while adding efficiency in the regulatory approval processes that would shorten development times and lead to more and better treatments for TBI and other neurological conditions.

You can still access this alert and take action by clicking on the link below!

http://capwiz.com/bia/issues/alert/?alertid=13209766
 

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BIAA staying on top of the legislature reports the following:

Appropriations Update

On Wednesday, marking President Obama's first 100 days in office, Congress adopted a fiscal year 2010 budget resolution, setting the stage for action on many of his top legislative priorities. Being a non-binding framework used by Congress to make legislative decisions on taxes, appropriations and entitlement programs later in the year, it is important to note that the $3.56 trillion budget resolution includes reconciliation instructions that would allow the President's proposed healthcare overhaul to move through Congress immune from a Senate filibuster. (CQ)

BIAA will continue to monitor the appropriations process with a special edition of Policy Corner next Wednesday. The President's budget, in its entirety, is expected to be released early next week.
 

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Laura Schiebelhut, BIAA Director of Government Affairs, asked me forward this on:

Dear Advocates:

As a month-long summer recess dominated by party politics and convention drama draws to a close, Congress plans to reconvene for its fall legislative session on Monday, September 8, 2008.
You may recall that unfortunately, due to technical difficulties the Brain Injury Association of America was unable to distribute the August 1, 2008 edition of BIAA Policy Corner. We apologize for this inconvenience, and thank you again for your patience.

This special Fall Outlook Special Edition of BIAA’s Policy Corner E-Newsletter contains numerous legislative updates on congressional activity which took place in the days right before the beginning of the summer recess period.

In addition, this Fall Outlook Special Edition includes a preview of the political climate expected to impact legislative proceedings over the next few weeks and months leading up to the November election.

*Distributed by Laura Schiebelhut, BIAA Director of Government Affairs, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637; lschiebelhut@biausa.org
BIAA’s Policy Corner and Legislative Action Alerts are made possible by the Centre for Neuro Skills, James F. Humphreys & Associates, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.
To sign up to receive future BIAA Policy Corner E-Newsletters and Legislative Action Alerts, please go to http://capwiz.com/bia/mlm/signup/
__________________________________________________________________
BIAA Spearheads Senate Letter Urging TRICARE to Cover Cognitive Rehabilitation
Reflecting one of BIAA's biggest public policy accomplishments this year, a group of Senators issued a letter on August 4, 2008 to Defense Secretary Robert M. Gates urging official TRICARE coverage of cognitive rehabilitation.

The group of 10 United States Senators, led by Evan Bayh (D-IN) and Barack Obama (D-IL), sent a letter to Defense Secretary Robert M. Gates calling on him to enact official coverage of cognitive rehabilitation within the military's TRICARE health insurance program. Several major media outlets covered this story, and the press release announcing this letter included a quote from Democratic Presidential Candidate Barack Obama in which he described cognitive rehabilitation therapy as “one of the most accepted treatments for TBI.”

Throughout the summer, BIAA worked closely with Senator Bayh's office to support the development of this letter and to urge the support of 10 highly esteemed Senators who signed on in support of this important effort to increase access to timely, state-of-the-art care for returning servicemembers with traumatic brain injury.

A copy of the letter, along with talking points in support of TRICARE coverage of cognitive rehabilitation, and a summary of evidence attesting the efficacy of cognitive rehabilitation, is available on BIAA's website at http://www.biausa.org/policyissues.htm.
In another promising development, the Congressional Brain Injury Task Force is currently working on a similar effort on the House side.

House Approves Military Construction-VA Spending Bill Without TBI Amendments
Despite little progress on appropriations so far this year, the House of Representatives was able to pass its version of the Fiscal 2009 Military Construction-VA spending bill (H.R. 6599) by a vote of 409-4 on August 1, 2008.

This appropriations measure represents the only regular Fiscal 2009 appropriations bill to receive House floor consideration so far this session, and could also be one of the last. (See “Fall Outlook” section below).

The $118.7 billion Military Construction-VA appropriations bill includes $500 million for medical and prosthetic research, rejecting the President’s $38 million cut and representing $20 million over last year’s funding allocation for such research. In addition, the bill allocates $200 million for fee-based services to improve access to care where Veterans Health Administration services are not available; it is possible that such services could potentially include TBI care and rehabilitation services.

Two amendments filed by House Veterans Affairs Chairman Bob Filner (D-CA) related to veterans’ TBI care were subsequently withdrawn after bill manager Rep. Chet Edwards (D-TX) promised to work with Rep. Filner on his suggestions over the next several months.
One of the amendments filed by Rep. Filner would have allocated $250 million to establish a community grant program to provide rehabilitative services to veterans diagnosed with post-traumatic stress disorder (PTSD) or TBI.

Rep. Filner’s other TBI-related amendment would have designated $10 million to establish a “heroes’ homecoming pilot program” intended to evaluate the effectiveness of offering compulsory screening, evaluation and treatment for TBI (as well as mental health conditions, including PTSD), for active-duty servicemembers and veterans.

Meanwhile, the Senate Appropriations Committee approved its version of the fiscal 2009 Military Construction-VA spending bill (S. 3301), on July 17, 2008. The Senate version of this funding bill contains increased funding for medical research, including TBI research. The bill also includes valuable report language directing the Department of Veterans Affairs (VA) to establish and expand cooperative agreements with public and private groups to treat traumatic brain injury patients from the wars in Iraq and Afghanistan, and to report on expanding the pool for expertise available to treat the injuries.

BIAA applauds this report language, as one of BIAA’s main federal policy goals continues to be increasing access to non-VA (civilian) TBI care providers when in the optimal interest of the service member, and BIAA remains very active on this issue on Capitol Hill.
House Defense Appropriations Subcommittee Approves TBI Funding
On a related note, the House Defense Appropriations Subcommittee passed its version of the Fiscal 2009 Defense Appropriations bill on July 30, 2008, including hundreds of millions of dollars allocated for TBI.

The funding bill approved by the Subcommittee includes $617 million for Traumatic Brain Injury and Psychological Health.
Senate Republicans Block The Advancing America’s Priorities Act
Unfortunately, on July 28, 2008, Senate Republicans rejected an effort to invoke cloture on The Advancing America’s Priorities Act (S. 3297), an omnibus measure containing several non-controversial bills, including important public health measures related to brain injury.
With the exception of three Republican Senators -- Norm Coleman of Minnesota, Gordon H. Smith of Oregon and John W. Warner of Virginia – all other Senate Republicans followed the lead of conservative Senator Tom Coburn of Oklahoma in blocking consideration of the legislation.
As you may recall, in July BIAA issued a Legislative Action Alert requesting that advocates call their Senators and urge them to vote for passage of this important legislation.

Among the nearly three dozen bipartisan, non-controversial measures included in this omnibus legislation were two bills which would help address the public health epidemic of brain injury in United States: The STOP Stroke Act (S. 999/ H.R. 477) and The Christopher and Dana Reeve Paralysis Act (S. 1183/H.R. 1727).

The STOP Stroke Act is bipartisan legislation by Senators Thad Cochran (R-Miss.) and Edward Kennedy (D-Mass.) that would help ensure that all stroke patients are treated as quickly and effectively as possible. Among other things, the STOP Stroke Act would authorize a grant program to help provide states with resources to ensure that patients have access to quality stroke education, prevention, treatment and rehabilitation services by establishing coordinated stroke care systems.

The Christopher and Dana Reeve Paralysis Act is a non-controversial, bipartisan bill which is primarily about two things: 1 - Advancing collaborative research in paralysis and 2 - Improving the quality of life today for people living with paralysis and mobility impairments from any cause -- stroke, traumatic brain injury, ALS, spinal cord injuries, and others.
It remains unclear whether there will be another opportunity this year in the Senate to pass the bills contained in this legislative package.

BIAA Again Urges Senators to Swiftly Pass the ADA Amendments Act
Once again, BIAA signed a coalition letter urging passage of the ADA Amendments Act of 2008 (H.R. 3195/S.3406). On August 8, 2008, BIAA joined a number of other groups in signing a letter which was distributed to Senators over the summer recess urging swift Senate enactment of the ADA Amendments Act of 2008 (S. 3406).

The Senate version of the bill (S. 3406) was recently introduced in that chamber on July 31, 2008. Earlier this summer, the House of Representatives passed its version of the bill (H.R. 3195) by an overwhelming margin of 402-17.

Department of Labor Announces Initiative to Help Veterans with TBI
On August 20, 2008, the United States Department of Labor announced a new initiative to help employers of veterans and others with traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD).

As part of this initiative, the Department of Labor unveiled the America's Heroes at Work website, which will "provide information about TBI and PTSD, as well as tools and guidance on how to implement workplace accommodations and other services that benefit affected individuals."
The America’s Heroes at Work website address is http://www.americasheroesatwork.gov/.
Fall Outlook

Although Congress is reconvening to begin its fall legislative session on Monday, this session is not expected to last long, given the universal need to campaign in the weeks leading up to the November election. The target adjournment date for the House of Representatives is September 26, leaving roughly three weeks for legislative activity to occur.
 

s soon as Congress returns on Monday, both chambers are expected to begin developing a Continuing Resolution (CR) to ensure continued funding for the government once Fiscal Year 2008 ends on September 30.

A CR is expected to take the place of the many regular Fiscal Year 2009 annual appropriations bills, because most of these appropriations bills will likely remain stalled this year. Note: The fiscal 2009 Military Construction-VA appropriations bill, as well as the Fiscal 2009 Defense Appropriations bill, are the only two regular Fiscal 2009 appropriations measures expected to possibly progress.

A CR would provide stopgap funding for the federal government as Fiscal Year 2009 begins on October 1, 2008.

Since a CR is expected to include funding for the federal agencies which house important TBI programs, there is an urgent need for advocates to call on elected officials to ensure sufficient funding is provided for these programs in the stopgap funding resolution.
 

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Susan Connors, president  of the BIAA, asked me to post this message.

On behalf of the Brain Injury Association of America, I am thrilled to announce that yesterday a group of United States Senators, led by Evan Bayh (D-IN) and Barack Obama (D-IL), sent a letter to Defense Secretary Robert M. Gates calling on him to enact official coverage of cognitive rehabilitation within the military's TRICARE health insurance program.

BIAA worked closely with Senator Bayh's office to initiate the development of this letter and to urge the support of ten highly esteemed Senators who signed on in support of this important effort to increase access to timely, state-of-the-art care for returning servicemembers with traumatic brain injury. A copy of the letter is available from BIAA's website, along with talking points in support of TRICARE coverage of cognitive rehabilitation and a summary of the efficacy evidence. Additionally, on our website you will find BIAA's position statement, Cognitive Rehabilitation: The Evidence, Funding and Case for Advocacy, published in November 2006.

BIAA thanks Senators Bayh and Obama for their leadership on this issue and looks forward to continuing to work with Congress and the Department of Defense to make TRICARE coverage of cognitive rehabilitation a reality. We gratefully acknowledge the members of BIAA's Federal Legislative Advisory Committee who dedicated their time and expertise on behalf of this effort: Drs. Mark Ashley, Wayne Gordon, Debbie McMorrow, Greg O'Shanick, Jim Schraa, and Tina Trudel.

In addition, BIAA expresses special appreciation to Drs. Keith Cicerone and Wayne Gordon for assistance in identifying the evidence supporting cognitive rehabilitation and to the Cognitive Rehabilitation Task Force of the American Congress of Rehabilitation Medicine's Brain Injury Interdisciplinary Special Interest Group. Last, but certainly not least, I wish to recognize Laura Schiebelhut, BIAA's Director of Government Affairs, for her hard work and perseverance on this issue. She has my heartfelt gratitude and deepest respect.

BIAA is dedicated to educating the nation's policymakers about the value of cognitive and other brain injury rehabilitation therapies and the dire need to increase access to these therapies across both civilian and military populations. We will keep you informed of our progress.

Thank you for your support.

Susan H. Connors, President/CEO

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Laura Shiebelhut asked me to forward this Legislative Update. Brain Injury Association of America
Policy Corner E-Newsletter – June 27, 2008
A weekly update on federal policy activity related to traumatic brain injury
__________________________________________________________________
Dear Advocates:

Legislative activity related to traumatic brain injury policy ensued on numerous fronts this week, as Congress made progress on several bills before leaving town for a week-long July 4 recess beginning on Monday.

Progress on appropriations occurred this week on the Senate side, as the full Senate Appropriations Committee marked up and approved its Fiscal 2009 Labor, Health and Human Services (HHS), and Education funding bill.

Meanwhile – on the other side of the Capitol - as marked up on the Subcommittee level last week, the House Labor, Health and Human Services (HHS), and Education Appropriations funding measure contains increased funding for some federal TBI programs. Unfortunately, this bill was not approved by the full House Appropriations Committee on Thursday, as a major breakdown in the Committee’s markup process occurred as a result of partisan disputes. The fate of all House appropriations bills are now uncertain.

Progress on several important bills not related to appropriations also took place this week. On Thursday, the Senate Veterans Affairs Committee approved provisions contained in S. 2921, The Caring for Wounded Warriors Act. BIAA has strongly supported and endorsed this legislation, which was recently introduced by Sen. Clinton (D-NY), and would strengthen supports for family caregivers of returning servicemembers with TBI.

On Wednesday, the House of Representatives passed the ADA Amendments Act of 2008 (H.R. 3195) with strong bipartisan backing by a vote of 402-15. Earlier in the week, BIAA formally endorsed this legislation, which is designed to strengthen protections for individuals with disabilities originally enacted through the Americans with Disabilities Act (ADA) in 1990.
Also this week, the Senate approved a compromise version of the war supplemental funding bill, readying the legislation for president’s expected signature. This legislation contained a moratorium – strongly supported by BIAA - on the implementation of several harmful Medicaid regulations.

Finally, the House and Senate were unable to agree on a final Medicare package, which would have prevented deep cuts beginning on July 1 in Medicare payment rates for physicians. Negotiations on such a package are expected to continue when Congress resumes session on Monday, July 7.

__________________________________________________________________
Labor-HHS-Education Appropriations Bill Advances in Senate; Stalls in House
Progress on appropriations occurred this week on the Senate side, as the full Senate Appropriations Committee marked up and approved its Fiscal 2009 Labor, Health and Human Services (HHS), and Education funding bill.

The Senate’s markup provided the same funding amounts for several TBI programs as last year, including $5.7 million for TBI programming within the Centers for Disease Control and Prevention (CDC) and $8.754 million for the HRSA TBI State Grant Program.

Meanwhile, on the other side of the Capitol, as marked up on the Subcommittee level last week, the House Labor, Health and Human Services (HHS), and Education Appropriations funding measure contains increased funding for some federal TBI programs compared to last year. The House Subcommittee markup includes $11 million for the HRSA TBI State Grant Program (+$2.246 million over last year) and $6.6 million for TBI programming within CDC (+$0.9 million over last year).

Unfortunately, though, this bill was not approved by the full House Appropriations Committee on Thursday, as a major breakdown in the Committee’s markup process occurred as a result of partisan disputes. In fact, partisan vitriol reached such a high level during the attempted House markup of the Labor-HHS-Education funding bill that Rep. Obey (D-WI), Chairman of the House Appropriations Committee, threatened not to allow any further progress to occur this year on House appropriations bills. Stay tuned.

Senate Veterans Affairs Committee Approves Caring for Wounded Warrior Act Provisions
On Thursday, the Senate Veterans Affairs Committee approved provisions contained in S. 2921, The Caring for Wounded Warriors Act, S. 2921. BIAA has strongly supported and endorsed this legislation, and several recommendations made by BIAA during the legislative drafting process were incorporated into the bill.

Provisions in the legislation, which was recently introduced by Sen. Clinton (D-NY), would strengthen supports for family caregivers of returning servicemembers with TBI. Specifically, provisions would require two pilot programs to be implemented through the Department of Veterans Affairs, improving the resources available to those caring for returning servicemembers with TBI.

A quote from BIAA President and CEO Susan H. Connors was included in Sen. Clinton’s press release announcing passage of the bill’s provisions:
“Traumatic brain injury not only affects individuals but entire families as well. The Brain Injury Association of America applauds Senator Clinton and Members of the Senate Veterans Affairs Committee for their leadership in passing this legislation, which compassionately and responsibly provides much-needed supports to family caregivers of servicemembers with TBI,” said Susan H. Connors, President and CEO of BIAA.

BIAA will continue to monitor the progress of this important bill, and thanks advocates for urging their Members of Congress to become cosponsors of this legislation.
House Passes ADA Amendments Act of 2008 By Wide Margin

On Wednesday, the House of Representatives passed the ADA Amendments Act of 2008 (H.R. 3195) with strong bipartisan backing by a vote of 402-15. Earlier in the week, BIAA formally endorsed this legislation, which is designed to strengthen protections for individuals with disabilities originally enacted through the Americans with Disabilities Act (ADA) in 1990.

The ADA Amendments Act of 2008 is the product of meaningful negotiations and discussions with experts in the disability community, business and employer groups, Members of Congress, and congressional staff. The measure prohibits consideration of mitigating measures in the determination of whether an individual has a disability, with the exception of ordinary eyeglasses and contact lenses. The bill also affords broad coverage for individuals “regarded as” having a disability under the ADA.

A copy of BIAA’s endorsement letter, which was circulated to all Members of the House of Representatives prior to the vote this week, is available at http://www.biausa.org/policyissues.htm.

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The Brain Injury Association of America appreciates me passing this latest legislative news on to my readers.

Brain Injury Association of America

Policy Corner E-Newsletter – June 6, 2008
A weekly update on federal policy activity related to traumatic brain injury
__________________________________________________________________
Dear Advocates:

Congress returned from a week-long Memorial Day recess this week, and proceeded to successfully pass a fiscal 2009 budget resolution (S. Con Res 70).

Also this week, BIAA joined coalition efforts focused on several important policy issues impacting the disability community, including efforts to protect Medicaid, strengthen the Americans with Disabilities Act, and formally comment on recently proposed rules concerning the Developmental Disabilities Act.

In other developments, the Senate passed by voice vote on Tuesday a package of veterans’ mental health bills. This package included legislation endorsed by BIAA which authorizes the establishment of six VA Epilepsy Centers of Excellence (Epilepsy CoEs) across the country to lead the way in epilepsy diagnosis, research, treatment and surgery. The House Veterans Affairs Health Subcommittee passed an amended version of the bill’s companion in the House, H.R. 2818, on Thursday.

SPECIAL LEGISLATIVE ACTION ALERT: BIAA issued a Legislative Action Alert on Fiscal Year 2009 TBI appropriations two weeks ago. Now that Congress has successfully passed a final budget resolution, BIAA continues to urge advocates to make contact with their representatives in Congress and urge them to increase appropriations for federal TBI programs this year. If you have not already done so, please visit BIAA’s website TODAY to take action:

http://www.biausa.org/policyissues.htm

*Distributed by Laura Schiebelhut, BIAA Director of Government Affairs, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637;  lschiebelhut@biausa.org

BIAA’s Policy Corner and Legislative Action Alerts are made possible by the Centre for Neuro Skills, James F. Humphreys & Associates, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.
To sign up to receive future BIAA Policy Corner E-Newsletters and Legislative Action Alerts, please go to http://capwiz.com/bia/mlm/signup/
__________________________________________________________________
Congress Passes Fiscal 2009 Budget Resolution

The House of Representatives passed the final fiscal 2009 budget resolution conference report (S. Con Res 70) on Thursday, by a narrow vote of 214-210. The Senate adopted the same resolution on June 4 by a vote of 48-45.

This marks the first year since 2000 that Congress has been able to successfully agree upon a final budget resolution. Congressional budget resolutions do not become law but rather serve as a blueprint, setting the parameters for spending and tax bills throughout the year.

Final passage of this year’s budget resolution facilitates the establishment of official funding (“302b”) allocations for the fiscal 2009 Labor-HHS-Education Appropriations bill, which funds multiple TBI-related programs, including programs authorized through the TBI Act. Once 302b Subcommittee allocations have been determined, the fiscal 2009 appropriations process can officially go forward with committee markups and other official action.

BIAA recently signed on to a coalition letter urging Appropriations Committee Chairs in both chambers to allocate an additional $15 billion over last year’s funding levels for the Labor-HHS-Education Subcommittees.

According to CQ Today, “The Democrats’ budget resolution calls for $24.5 billion more in discretionary spending than the $991.6 billion President Bush requested. Bush has threatened to veto bills that exceed his target, but Democrats may wait for him to leave office before completing work on these bills. The Appropriations committees will begin work this month, with the first House subcommittee markups next week” (David Clarke, CQ Today, 6/5/2008).

SPECIAL LEGISLATIVE ACTION ALERT: BIAA issued a Legislative Action Alert on Fiscal Year 2009 TBI appropriations two weeks ago. Now that Congress has successfully passed a final budget resolution, BIAA continues to urge advocates to make contact with their representatives in Congress and urge them to increase appropriations for federal TBI programs this year. If you have not already done so, please visit BIAA’s website TODAY to take action:

http://capwiz.com/bia/issues/alert/?alertid=11411806.

Also this week, BIAA joined coalition efforts focused on several important policy issues impacting the disability community, including efforts to protect Medicaid, strengthen the Americans with Disabilities Act (ADA), and formally comment on recently proposed rules concerning the Developmental Disabilities Act.

BIAA joined other advocacy organizations in signing on to one more letter urging Senate and House Democratic leadership to ensure that a comprehensive moratorium on seven harmful proposed Medicaid rules remains part of any supplemental war spending bill that is sent to the President. BIAA continues to strongly support the moratorium, as implementation of these proposed Medicaid rules would, among other harmful effects, restrict important access to rehabilitation services for many individuals with brain injury.

BIAA also signed on this week in support of a proposed deal on the ADA Restoration Act (ADARA) which has emerged in recent days. The drafted legislative language of this proposed deal on ADARA is aimed at restoring the intent and protections of the Americans with Disabilities Act of 1990, and is supported by numerous other disability advocacy organizations, including the American Association of People with Disabilities and the National Disability Rights Network. BIAA will continue to monitor developments as this legislation progresses.

In addition, BIAA signed on to joint comments of the Consortium for Citizens with Disabilities in response to proposed rules related to the Developmental Disabilities Act. The Comment Letter expresses several concerns regarding the proposed rules, including concern that these regulations were only recently published on April 10, 2008 – almost seven years after the 2000 Developmental Disabilities reauthorization bill mandated publication of these rules, and right in the middle of ongoing efforts to work on the 2008-2009 reauthorization.

Bill to Create VA Epilepsy Centers Progresses in Both Chambers

In other developments, the Senate passed by voice vote on Tuesday a package of veterans’ mental health bills. This package included legislation endorsed by BIAA which authorizes the establishment of six VA Epilepsy Centers of Excellence (Epilepsy CoEs) across the country to lead the way in epilepsy diagnosis, research, treatment and surgery. The House Veterans Affairs Health Subcommittee passed an amended version of the bill’s companion in the House, H.R. 2818, on Thursday.

The full House Veterans Affairs Committee is expected to approve the bill and report it to the floor of the House of Representatives before the end of the month.
In April, BIAA formally endorsed the legislation in a letter stating, “BIAA continues to advocate for the use of all available resources (including civilian sector resources when appropriate), as well as the development of new resources and system capacity within the VA, in order to ensure that all veterans with TBI receive the right care, right now.”

A copy of BIAA’s letter endorsing H.R. 2818 can be obtained by visiting BIAA’s website at the following address:  http://www.biausa.org/policyissues.htm.

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Brain Injury Association of America
Policy Corner E-Newsletter – May 23, 2008
A weekly update on federal policy activity related to traumatic brain injury
__________________________________________________________________
Dear Advocates:
After a busy week focused on a variety of legislation, including unsuccessful efforts to achieve final passage of the war supplemental appropriations bill and a budget resolution conference agreement, Congress is now in recess until Monday, June 2, in observance of the Memorial Day holiday.

BIAA issued a Legislative Action Alert on Fiscal Year 2009 TBI appropriations this week, despite the fact that Congress failed to successfully pass a final budget resolution. BIAA urges advocates to make contact with their representatives in Congress - and if possible, schedule a face-to-face meeting while they are in their home districts this next week – and urge them to increase appropriations for federal TBI programs.

On Wednesday, May 21, the Senate Veterans Affairs Committee held a hearing on pending health care legislation, including S. 2921, The Caring for Wounded Warriors Act, which BIAA has strongly endorsed. BIAA submitted a Statement for the Record for the hearing urging the Committee to swiftly approve the bill, which would strengthen supports for family caregivers of returning servicemembers with TBI.

Also this week, BIAA distributed an issue brief to Capitol Hill staff highlighting the need for TRICARE to officially cover cognitive rehabilitation. The information paper was accompanied by a summary of the research supporting the efficacy of cognitive rehabilitation in treating brain injury.
In addition this week, on May 22, 2008, BIAA submitted official comments to the Department of Education on the National Institute on Disability and Rehabilitation Research’s (NIDRR) Proposed Long-Range Plan for Fiscal Years 2010-2014. BIAA’s comments were based on a coalition letter which BIAA signed on to as well, but also included BIAA’s individual recommendations for future research priorities.

Note: Policy Corner will not be published next week, as Congress will be out of session. The next issue of Policy Corner will be published on Friday, June 6.

*Distributed by Laura Schiebelhut, BIAA Director of Government Affairs, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637; lschiebelhut@biausa.org

BIAA’s Policy Corner and Legislative Action Alerts are made possible by the Centre for Neuro Skills, James F. Humphreys & Associates, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.

To sign up to receive future BIAA Policy Corner E-Newsletters and Legislative Action Alerts, please go to http://capwiz.com/bia/mlm/signup/
__________________________________________________________________
Appropriations Update
BIAA issued a Legislative Action Alert on Fiscal Year 2009 TBI appropriations this week, despite the fact that Congress failed to successfully pass a final budget resolution.
Although conferees came to an agreement on a final budget plan on Tuesday, a glitch with a major farm bill (H.R. 2419) threw the congressional schedule in to chaos Wednesday night. This scheduling problem eventually resulted in the postponement of a vote on the adoption of the fiscal 2009 budget resolution conference agreement until June.

The budget resolution is a nonbinding document which determines annual aggregate revenue and spending targets for Congress. This year, Democrats have proposed to spend $24.5 billion more than the $991.6 billion in discretionary funding proposed by President Bush.
Final passage of a budget resolution would facilitate the establishment of official funding allocations for the fiscal 2009 Labor-HHS-Education Appropriations bill, which funds multiple TBI-related programs, including programs authorized through the TBI Act.

However, according to CQ Today, “Because of the likelihood of a protracted dispute between Congress and the White House, few, if any, of the appropriations bills are likely to be cleared before the Nov. 4 elections. Indeed, Democrats may try to enact a long-term continuing resolution that would last until after the Jan. 20 inauguration of the next president” (David Clark, CQ Today, 5/22/08).

Regardless of how the appropriations process is expected to play out this year, BIAA urges advocates to make contact with their representatives in Congress - and if possible, schedule a face-to-face meeting while they are in their home districts this next week – and urge them to substantially increase appropriations for federal TBI programs.

BIAA Submits Statement for the Record to Senate Veterans Affairs Committee
On Wednesday, May 21, the Senate Veterans Affairs Committee held a hearing on pending health care legislation, including S. 2921, The Caring for Wounded Warriors Act, which BIAA has strongly endorsed. BIAA submitted a Statement for the Record for the hearing urging the Committee to swiftly approve the bill, which was introduced by Senator Hillary Rodham Clinton and would increase support for family caregivers of servicemembers with TBI. Several recommendations made by BIAA during the legislative drafting process were incorporated into the bill.

The bill would require two pilot programs to be implemented through the Department of Veterans Affairs, improving the resources available to those caring for returning servicemembers with TBI.
In the Statement for the Record, BIAA President and CEO Susan H. Connors noted, “Family care is the most important source of assistance for people with chronic or disabling conditions, including people with brain injury. Yet, research has found that all too often, the traumatic brain injury of a spouse or close relative places extreme stress on family caregivers, frequently resulting in negative physical and emotional outcomes for the caregivers themselves.”
To view a copy of BIAA’s Statement for the Record on S. 2921, please visit our website at http://www.biausa.org/policyissues.htm.

BIAA Publishes Issue Brief Calling for Official TRICARE Coverage of Cognitive Rehabilitation
Also this week, BIAA distributed an issue brief to Capitol Hill staff highlighting the need for TRICARE to officially cover cognitive rehabilitation. The information paper was accompanied by a summary of the research supporting the efficacy of cognitive rehabilitation in treating brain injury.
BIAA’s issue brief makes a compelling argument for making cognitive rehabilitation an official benefit within TRICARE, arguing that “A clear clinical consensus has developed recognizing the importance of providing cognitive rehabilitation to patients with TBI, and servicemembers suffering from TBI resulting from deployment deserve nothing less than the appropriate level of care based on currently accepted and widely used treatment modalities.”

To view a copy of BIAA’s Issue Brief on Cognitive Rehabilitation & TRICARE, please visit our website at http://www.biausa.org/policyissues.htm.

BIAA Submits Comments on NIDRR’s Long-Range Plan for Fiscal Years 2010-2014
On May 22, 2008, BIAA submitted official comments to the Department of Education on the National Institute on Disability and Rehabilitation Research’s (NIDRR) Proposed Long-Range Plan for Fiscal Years 2010-2014. BIAA’s comments were based on a coalition letter which BIAA signed on to as well, but also included BIAA’s individual recommendations for future research priorities.

To view a copy of BIAA’s Comment Letter on NIDRR’s Long-Range Plan, please visit our website at http://www.biausa.org/policyissues.htm.

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BIAA legislative update as follows: 

Defense issues are expected to be the focus of legislative activity next week, as the Senate plans to debate the war supplemental bill, while the House plans to consider the fiscal 2009 defense authorization bill (H.R. 5658).

Earlier this week, the House passed an amendment related to the war supplemental bill containing a provision, strongly supported by the Brain Injury Association of America, which would

delay implementation of seven harmful Medicaid regulations proposed by the Bush Administration. BIAA will continue to advocate in favor of maintaining this provision in the war supplemental bill as it is considered by the Senate next week.

Also next week, floor consideration of a possible final version of the fiscal 2009 budget resolution (S. Con. Res. 70) could also take place, as Congress works to accomplish legislative goals before leaving town for a week-long Memorial Day Recess beginning on Monday, May 26.
Final passage of a budget resolution would include the establishment of official funding allocations for the fiscal 2009 Labor-HHS-Education Appropriations bill, which funds multiple TBI-related programs, including programs authorized through the TBI Act.

Please watch for a BIAA Legislative Action Alert on fiscal 2009 TBI Appropriations to be sent out early next week.
__________________________________________________________________
Debate over War Supplemental Bill Continues

An amendment related to the war supplemental bill passed by the House earlier this week contained a provision, strongly supported by the Brain Injury Association of America, which would delay implementation of seven Bush administration Medicaid regulations.

This provision includes the content of legislation (H.R. 5613) endorsed by BIAA, which would place a moratorium through March 2009 on several harmful Medicaid regulations, including regulations which would negatively impact individuals with traumatic brain injury.

According to an article last week in CQ Today, by attaching H.R. 5613 to the war spending bill, Democrats hope to avoid an extra set of cloture votes in the Senate, where the Medicaid moratorium bill on its own had been facing a GOP filibuster (Alex Wayne, CQ Today, 5/6/2008).
The House of Representatives passed H.R. 5613 by a veto-proof margin, 349-62, on April 23. Without a moratorium, all seven of the regulations would go into effect by June 30 of this year, including regulations which would limit access to essential services for individuals with brain injury.

BIAA continues to strongly endorse H.R. 5613 and supports efforts to keep the bill’s content in the war supplemental legislation as it is considered by the Senate next week.
Fiscal 2009 Appropriations Update

Floor consideration of a possible final version of the fiscal 2009 budget resolution (S. Con. Res. 70) could take place next week, as Congress works to accomplish legislative goals before leaving town for a week-long Memorial Day Recess beginning on Monday, May 26.
Final passage of a budget resolution would include the establishment of official funding (“302b”) allocations for the fiscal 2009 Labor-HHS-Education Appropriations bill, which funds multiple TBI-related programs, including programs authorized through the TBI Act.

Last week, BIAA signed on to a coalition letter urging Appropriations Committee Chairs in both chambers to allocate an additional $15 billion over last year’s funding levels for the Labor-HHS-Education Subcommittees.

The letter states that this additional funding is necessary, as it would “(1) restore cuts to core program funding over the last four years, (2) more appropriately account for four years of inflation and population growth to maintain service levels and purchasing power; and (3) return these programs to the FY 2005 level, a high water mark for many.”

Once 302b Subcommittee allocations have been determined, the fiscal 2009 appropriations process can officially go forward with bill markups and other official action.

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BIAA has strongly endorsed The Caring for Wounded Warriors Act of 2008 (S. 2921), legislation introduced on Monday, April 28 by Senator Hillary Rodham Clinton which would increase support for family caregivers of servicemembers with TBI. Several recommendations made by BIAA during the legislative drafting process were incorporated into the bill.

BIAA encourages you to urge your Senator to sign on as a cosponsor of this important legislation.
The bill would require two pilot programs to be implemented through the Department of Veterans Affairs, improving the resources available to those caring for returning servicemembers with TBI.
The first pilot program, which would provide for training, certification and compensation for family caregiver personal attendants for veterans and members of the Armed Forces with TBI, is very similar to a provision in last year’s Heroes At Home Act of 2007, which BIAA also strongly endorsed.

The second pilot program would leverage existing partnerships between Veterans Affairs facilities and the nation’s premier universities, training graduate students to provide respite care for families caring for wounded warriors suffering from TBI.

To urge your Senator to become a cosponsor of S. 2921, click here.

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This week marked a major legislative victory for the brain injury community, as President Bush officially signed into law legislation reauthorizing the TBI Act (S. 793) on Monday, April 28! Congratulations to all BIAA state affiliates, advocates, and national stakeholders who helped make TBI Act reauthorization a reality. To view a copy of BIAA’s official press release applauding this major accomplishment, please visit our website at http://www.biausa.org/policyissues.htm.

In other exciting news, BIAA proudly endorsed The Caring for Wounded Warriors Act of 2008 (S. 2921), legislation introduced on Monday, April 28 by Senator Hillary Rodham Clinton which would increase support for family caregivers of servicemembers with TBI. Several recommendations made by BIAA during the legislative drafting process were incorporated into the bill. A copy of BIAA’s Letter of Endorsement for S. 2921 will be available shortly on our website at http://www.biausa.org/policyissues.htm.

Also this week, a report was released by the Department of Veterans Affairs Inspector General which found that the VA is not providing the necessary standard of support and long-term follow-up assistance needed by veterans with TBI and their families.

In addition, after the House of Representatives passed by a veto-proof margin last week important legislation which would place a moratorium until March 2009 on several harmful Medicaid regulations (H.R. 5613), the fate of the bill was left up to the Senate. Earlier this week, Senate Majority Leader Harry Reid (D-NV) attempted to bring the bill up on the Unanimous Consent Calendar, but this attempt was blocked by Senator Coburn (R-OK). Now there is an effort to get the bill included in the FY 2008 Supplemental Appropriations bill. BIAA continues to strongly endorse H.R. 5613 and supports efforts to include the bill in the FY 2008 Supplemental Appropriations bill.
As a final note, BIAA is waiting to see if Congress will be able to establish a budget this year before sending out its Legislative Action Alert on FY 2009 TBI Appropriations. There is speculation that Congress may indeed be able to achieve a budget agreement in the upcoming next few weeks, and BIAA’s Appropriations Action Alert will be sent out shortly thereafter.

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President Bush signed legislation to reauthorize the TBI Act this afternoon: http://www.whitehouse.gov/news/releases/2008/04/20080428-5.html..

President Bush Signs S. 793 into Law

On Monday, April 28, 2008, the President signed into law:

S. 793, the "Traumatic Brain Injury Act of 2008," which authorizes appropriations and makes changes to the Department of Health and Human Services programs that provide grants for State programs for: tracking and reporting of brain injuries; and brain injury rehabilitation.

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House Overwhelmingly Passes Bill to Delay Harmful Medicaid Regulations
This week the House of Representatives passed by a veto-proof margin H.R. 5613, important legislation which would place a moratorium until March 2009 on seven harmful Medicaid regulations issued by the Department of Health and Human Services. BIAA issued a Legislative Action Alert earlier this week before the vote encouraging advocates to urge their Representative to vote YES on the bill. The fate of the bill is now up to the Senate.

The legislation, which was originally introduced on March 13, 2008, would delay the implementation of seven harmful Medicaid regulations through March 2009, including several rules which would be especially deleterious to individuals with brain injury.

One of these rules would limit rehabilitation services for Medicaid beneficiaries, severely curtailing the ability of people with disabilities – including TBI – to receive rehabilitation services now covered under Medicaid. Access to these rehabilitative services is essential, as in many cases, these services play a vital role in allowing people with TBI to live independently in the community.
As the House considered and passed H.R. 5613 by a vote of 349-62 on Wednesday, Senate Republican leadership began circulating a letter defending the Medicaid regulations and urging colleagues to reject such legislation in the Senate. According to news sources, this letter forms part of a Republican strategy to demonstrate to supporters of H.R. 5613, through the gathering of a sufficient number of signatures, that they will not be able to override a veto in the Senate.
If enough Senators sign on to the Republican leadership letter, effectively backing up the president’s veto threat, there is speculation that the White House could then offer a limited moratorium on only two of the harmful regulations. Unfortunately, these two regulations are not the ones addressing targeted case management and rehabilitative services, which stand to directly impact individuals with brain injury. (CQ Healthbeat News, April 24, 2008, John Reichard).
Without a moratorium, all seven of the regulations would go into effect by June 30 of this year.
BIAA thanks advocates for contacting their Representatives this week, and will shortly issue another Legislative Alert anticipating Senate action on the bill.

A copy of BIAA’s letter endorsing H.R. 5613 can be obtained by visiting BIAA’s website at the following address: http://www.biausa.org/policyissues.htm.
BIAA Submits Testimony to Senate Appropriations Subcommittee

Also this week, BIAA submitted written testimony to the Senate Appropriations Subcommittee in charge of funding TBI programs within the Department of Health and Human Services and the Department of Education. BIAA’s testimony urges an increase in funding in Fiscal Year 2009 for programs authorized through the TBI Act, as well as TBI research programs conducted within the National Institute on Disability and Rehabilitation Research (NIDRR).

Within the testimony, BIAA requests $30 million in funding for programs authorized through the TBI Act, as well as sufficient funding to sustain and increase medical rehabilitation research within NIDRR. The testimony also urges an allocation of at least $8.3 million to allow NIDRR to continue to fund 16 TBI Model Systems research centers.

 
In addition, BIAA played a leading role, along with other national organizations, in recent weeks in drafting and circulating an organizational sign-on letter in support of FY09 TBI appropriations. The letter, which was signed by over 25 organizations - including several veterans organizations - was recently delivered to both the House and Senate Appropriations Subcommittees on Labor, Health and Human Services, and Education.

Copies of both BIAA’s written testimony and the Organizational Sign-On Letter in support of appropriations for TBI programs can be obtained by visiting BIAA’s website at the following address: http://www.biausa.org/policyissues.htm.

BIAA Roots On Servicemembers at Wounded Warrior Soldier Ride White House Kickoff
A representative of BIAA was invited to attend an event hosted by President George W. Bush on Thursday at the White House. BIAA Government Affairs Director Laura Schiebelhut was proud to be part of the inspiring event, which honored a group of wounded warriors as they kicked off the Wounded Warrior Project’s second annual “Soldier Ride: White House to Light House Challenge.”
Soldier Ride, sponsored by the Wounded Warrior Project, is a rehabilitative cycling program for wounded warriors, including individuals with brain injury. For many of these combat-wounded veterans, Soldier Ride provides the first steps in the return to an active lifestyle.
BIAA Signs On In Support of National Shaken Baby Syndrome Awareness Week Resolution
BIAA was proud to sign on as a supporter of the National Shaken Baby Syndrome Awareness Week Resolution (S. Res. 518), which passed the Senate on Monday. The Resolution, introduced by Senator Dodd (D-CT), dedicates this week (the week of April 21st through 25th) to raise awareness of Shaken Baby Syndrome and to ultimately eliminate its occurrence.
BIAA was included as a supporter of the resolution in Senator Dodd’s floor statement that was submitted to the Congressional Record when it was introduced on Thursday, April 16, 2008.

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This week was an another extremely eventful one on Capitol Hill, including passage of legislation to reauthorize the TBI Act by the full House Energy and Commerce Committee!
On Tuesday, the House Energy and Commerce Committee's Subcommittee on Health approved the Traumatic Brain Injury Act of 2008 (H.R. 1418) and forwarded it on for consideration by the full Committee.

Yesterday afternoon, the full Energy and Commerce Committee passed the bill, and the legislation is expected to be brought up on suspension for consideration on the House floor when Congress reconvenes after a two-week recess set to begin on Monday, March 17.

Also this week, the Brain Injury Association of America (BIAA) joined the Congressional Brain Injury Task Force, and a variety of other advocacy groups, in successfully conducting Brain Injury Awareness Day on Capitol Hill. The day’s events drew the participation of several Members of Congress and their staff.

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Earlier this evening, the House Energy and Commerce Subcommittee on Health approved the Traumatic Brain Injury Act of 2008 and forwarded it on for consideration by the full Committee. The bill which was passed by the Subcommittee tonight was a slightly amended version of H.R. 1418.
The bill is now ready to be taken up by the full House Energy and Commerce Committee. This is a very positive development towards the goal of getting the TBI Act reauthorized before the end of this year, and a very exciting development for Brain Injury Awareness Month!

The Brain Injury Association of America is a strong lobby in Washington, DC for the rights of the Brain Injured.  The BIAAs efforts are to applauded and supported.

The BIAA is sponsoring an educational conference in Las Vegas next month.  To learn more click here.

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Please note the updated logistical information (below) for Brain Injury Awareness Day on Capitol Hill, taking place this Wednesday, March 12, 2008 in Washington, D.C.

In addition, please click on the "Take Action" tab in the upper right hand corner of this email to call your representatives in Congress and urge them to attend at least one of the day's events!

Congressional Brain Injury Awareness Day
Wednesday, March 12, 2008
Capitol Hill – Washington, D.C.

To celebrate March as Brain Injury Awareness Month, the Congressional Brain Injury Task Force is hosting a "2008 Brain Injury Awareness Day," on Wednesday, March 12, 2008, on Capitol Hill.
SCHEDULE OF EVENTS:

Brain Injury Awareness Fair
10:00 a.m. – 2:00 p.m.

First Floor Foyer of the Rayburn House Office Building

Advocacy Training Session
11:00 a.m. – 12:00 p.m. 1116 Longworth House Office Building

Congressional Briefing on “Traumatic Brain Injury and Community Needs”
3:00 p.m. – 4:00 p.m.
H-137 United States Capitol Building

Congressional Reception Celebrating Brain Injury Awareness Day
5:00 p.m. – 7:00 p.m.
1100 Longworth House Office Building

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Laura Schiebelhut [grassroots@biausa.org] asked me to post this update for all those interested in keeping up on the latest congressional activity.

Brain Injury Awareness Month Fair On Capitol Hill
More Info
The Congressional Brain Injury Task Force is hosting a "2008 Brain Injury Awareness Day," on Capitol Hill, March 12, 2008.

To celebrate March as Brain Injury Awareness Month, the Congressional Brain Injury Task Force is hosting a "2008 Brain Injury Awareness Day," on Wednesday, March 12, 2008, on Capitol Hill.

Multiple events are planned, which are designed to educate Members of Congress and their staff about brain injury. These events include an Awareness Day Fair, which will feature exhibits and informational materials from individuals and organizations working in the field of brain injury. The day will also include a Congressional Briefing focused on the topic of "Traumatic Brain Injury and Community Needs." The end of the day will feature an early-evening Congressional Reception sponsored by various national advocacy organizations, including the National Brain Injury Treatment and Training Foundation (NBIRTT), the Brain Injury Association of America (BIAA), the National Disability Rights Network (NDRN) and the National Association of State Head Injury Administrators (NASHIA).

 BIAA invites all advocates to attend "2008 Brain Injury Awareness Day" events, and help educate Members of Congress and their staff. The Day also represents an important opportunity to network with others interested in helping increase brain injury awareness.

2008 Brain Injury Awareness Day Schedule of Events

Brain Injury Awareness Fair
10:00 a.m. – 2:00 p.m.

First Floor Foyer of the Rayburn House Office Building
Congressional Briefing on “Traumatic Brain Injury and Community Needs”
3:00 p.m. – 4:00 p.m.

1116 Longworth House Office Building
Congressional Reception Celebrating Brain Injury Awareness Day
5:00 p.m. – 6:30 p.m.

2105 Rayburn House Office Building

Please RSVP by Monday, March 3, 2008, to Hope Mandel in Congressman Bill Pascrell's office if you wish to attend and/or exhibit materials during the Awareness Fair. You may also contact Hope at (202) 225-5751 or Becky Wolfkiel in Congressman Platts' office at (202) 225-5836 with questions or for more information. In addition, as always, you may contact Laura Schiebelhut, BIAA's Director of Government Affairs, at lschiebelhut@biausa.org, or 703-761-0750 ext. 637, for further clarification.

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Laura Schiebelhut, BIAA Public Affairs Manager asked me to distribute this update:

President Bush signed the National Defense Authorization Act for Fiscal Year 2008 (H.R. 4986), containing important wounded warrior provisions related to TBI care which BIAA actively lobbied for last year, into law on Monday.

At the same time, negotiations continued over the development of an economic stimulus package, as the House passed its version of the bill, which represents a compromise with the Bush Administration. This House version does not include increases in federal Medicaid payments to states, which BIAA strongly supports. BIAA will continue advocating for the inclusion of provisions to raise Medicaid reimbursement rates to states as Senate negotiations on the package go forward next week.

Looking ahead, President Bush’s Proposed Budget for Fiscal Year 2009 will be delivered to Congress on Monday, February 4. Unfortunately, early reports are that funding for government health programs will be dramatically decreased by more than $2 billion.

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Congress passed the Fiscal Year 2008 Labor-HHS-Education appropriations bill this week, including some important funding increases for TBI programs, including the HRSA Federal TBI program and the TBI Model Systems of Care program.

The Labor-HHS-Education spending measure will now be sent to President Bush, who has pledged to veto it, because it contains $9.8 billion more than he requested in his budget earlier this year.

BIAA has also been busy on Capitol Hill working on several other issues this past week, including pushing for the inclusion of important TBI provisions in the final defense authorization bill.

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Unfortunately, the House of Representatives failed this week, by a vote of 156-273, to override President Bush's veto of the SCHIP reauthorization bill (H.R. 976). A BIAA Action Alert had been issued in recent weeks asking brain injury advocates to contact their Representatives to urge them to vote to override the president's veto of the SCHIP legislation. This SCHIP reauthorization bill included a six-month moratorium on implementing the proposed Centers for Medicare and Medicaid Services (CMS) rule to restrict use of the Medicaid Rehabilitative Services Option; this rule would have a harmful impact on many individuals with TBI.

BIAA has formally submitted comments to CMS opposing implementation of the rule. These comments are available in the "Policy & Legislation" section of BIAA's website, located at http://www.biausa.org/policyissues.htm.

Democratic leadership in the House of Representatives is now expected to push forward with a new version of the SCHIP reauthorization bill, containing minor changes which are not expected to be substantive, but may give some Republicans added political coverage.

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Laura Schiebelhut provides this update and annouBIAA Plays Key Role in Passing TBI Model Systems Funding Amendment.

This week, BIAA worked closely with Sen. Ken Salazar's (D-CO) office to pass an amendment to the FY08 Senate Labor-HHS-Education Appropriations bill which would increase funding for the TBI Model Systems of Care program by $900,000. The amendment to the Senate Labor-HHS-Education spending bill (H.R. 3043), sponsored by Sen. Salazar, passed by unanimous consent on Thursday evening, October 18, 2007. The amendment was co-sponsored by Senators Carl Levin (D-MI), Debbie Stabenow (D-MI), Bob Casey (D-PA), Joe Lieberman (I-CT), and Evan Bayh (D-IN).

The additional funding is intended to counteract the recent reduction, announced in August, in the number of TBI Model Systems of Care Centers from 16 research center sites to 14 sites. The language of the amendment specifies that the funding "shall be used to carry out the Traumatic Brain Injury (TBI) Model Systems of Care Program and to sustain at least 16 TBI Model Systems Centers."

BIAA has been working with the American Congress of Rehabilitation Medicine (ACRM) over the past few months on various legislative strategies to try and obtain this stopgap funding in order to ensure that the service capacity of the important TBI Model Systems of Care program is not diminished. New Department of Defense (DoD) and Department of Veterans Affairs (VA) TBI research efforts authorized by legislation recently passed by the Senate are directed to collaborate closely with key TBI research efforts in the civilian sector, specifically including the TBI Model Systems of Care program.

 
Reduction in the number of research centers in the TBI Model Systems of Care program would have negative impacts both regionally and nationally, undermining established networks of expertise and research in the field of TBI. Certainly, such a reduction would make no sense considering the increased recognition of TBI as the signature injury of the War in Iraq, and Congress' clear legislative intent to link new DoD and VA TBI research efforts with civilian TBI research programs, specifically those - such as the TBI Model Systems of Care - administered through the National Institute on Disability Research and Rehabilitation (NIDRR).
The Senate is expected to pass its Labor-HHS-Education funding bill early next week. BIAA will then work with Sen. Salazar's office going forward to ensure this amendment is included in the eventual Labor-HHS-Education Appropriations conference report. Ultimately, the fate of this amendment will also depend on whether Bush vetoes the overall Labor-HHS-Education spending bill, which he has threatened to do, and how Congress chooses to proceed after that.
BIAA has also issued an Action Alert urging Congress to adopt the Senate version of the Labor-HHS-Education bill, which contains greater funding than the House bill for TBI programs.

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Laura Schiebelhut of the BIAA encourages all of us to take action by urging Adoption of Higher Funding Allocation for TBI Programs in Senate Version of FY08 Labor-HHS-Education Spending Bill.

The Senate is expected to consider its version of the Fiscal Year 2008 Labor-HHS-Education appropriations bill later this week (Week of October 15, 2007). Consideration on the Senate floor is then to be followed by a formal conference between the House and Senate to determine final funding allocations in the bill, although informal conference negotiations have already likely begun. Please urge your representatives in Congress to support the highest possible funding in a final Labor-HHS-Education conference bill for TBI-specific programs housed within HRSA and CDC.

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