Brain and Spine Injury Lawyer & Attorney : Titolo Law Firm : Las Vegas, Nevada

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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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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BIAA Issues Legislative Action Alert

The Brain Injury Association of America issued a Legislative Action Alert this week asking advocates to contact their Members of Congress on two important timely issues – “Wounded Warrior” Legislation containing important TBI provisions and SCHIP reauthorization legislation containing important Medicaid provisions related to TBI care.

The first part of the alert encouraged brain injury advocates to contact their Representative to urge conferees to retain the Senate’s Dignified Treatment of Wounded Warriors Act. Earlier this week, the Senate passed its version of the defense authorization bill, including the text of the Dignified Treatment of Wounded Warriors Act, which contains critically important provisions to improve TBI care for returning service members. The House of Representatives passed its defense authorization bill, which does not contain these critical TBI provisions, in May. Conferees have now been appointed, as the House and Senate will work in conference to produce a final version of the legislation to send to President Bush. For more information on BIAA’s position on the Dignified Treatment of Wounded Warriors Act, please visit our website at http://www.biausa.org/policyissues.htm.

The second issue addressed in the alert was the immediate need for advocates to contact their Representative to urge them to vote to override President Bush’s veto of the SCHIP reauthorization bill (H.R. 976). On October 3, 2007, President Bush vetoed legislation to reauthorize and expand the State Children’s Health Insurance Program. This bill includes a six-month moratorium on implementing a federal regulation proposed by the Bush Administration, which would restrict the use of Medicaid’s Rehabilitative Services option. Rehabilitation services provided under the Medicaid Rehabilitative Services option are often vital to individuals with traumatic brain injury to improve and maintain their health and independence.

It is expected that a vote to override the president’s veto will occur on October 18 in the House of Representatives. As the Senate already has sufficient votes for the two-thirds majority required for an override of such a likely veto, the question will largely come down to whether the House of Representatives can garner enough votes to override the veto as well. Currently it appears that there is not enough Republican support in the House for an override.

Note: BIAA has been working as part of the Coalition to Preserve Rehabilitation to prevent implementation of this restrictive rule, and will soon be submitting comments to the Centers for Medicare and Medicaid Services (CMS) voicing strong opposition to proposed regulation. These comments will be posted on BIAA's website shortly.

Appropriations Update

Congress moved one step closer this week to a potential showdown with President Bush over Fiscal Year 2008 spending bills. House and Senate Democratic leaders have reportedly reached a tentative agreement on how much each of the 12 separate appropriations bills should provide, which will allow conference negotiations on final bills to go forward.

None of the 12 spending bills have yet reached the President’s desk. Earlier this year, both chambers of Congress agreed to spend $956.1 billion – or $23 billion more than requested in the President’s Fiscal Year 2008 Budget – but as is normally the case each year, the House and Senate differed in their allocations for most of the individual appropriations bills.

In particular, the House allocated $151.1 billion - $1.9 billion more than the Senate allocation - for the Labor-HHS-Education spending bill (H.R. 3043), (although the Senate version of the bill does contain greater funding for TBI, specifically a 14% increase in funding for TBI Act programs). While the Senate version of the Labor-HHS-Education spending bill is not expected to be considered by the full Senate until after Columbus Day recess, in reality conference negotiations between the two chambers have likely already started, now that a tentative agreement has been reached on a total amount for the bill. It is expected that the Labor-HHS-Education spending bill could be one of the first the Democratic leadership sends to President Bush, in order to draw a clear distinction with the president on spending priorities. President Bush has threatened to veto all of the appropriations bills except for the two that are defense-related (Defense (H.R. 3222) and Military Construction-VA (H.R. 2642)).

New Report Calls for Improved Disability Benefits for War Veterans
A report issued on Wednesday by the Veterans’ Disability Benefits Commission recommended revising the disability rating schedule to better take into account neurological disabilities, including TBI. Specifically, the Commission recommended tackling “post-traumatic stress disorder, other mental disorders and traumatic brain injury expeditiously” when revising the disability rating schedule.

The report called for completing a revision of the current disability rating system within the next five years. In addition, the Commission found that, overall, the current disability benefits structure does not take into account the full impact of service-connected disabilities on veterans’ quality of life, and recommended that Congress provide a 25 percent increase in benefits until a new system is put into place.

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Read the latest legislative update from the Brain Injury Association.

BIAA Legislative Action Alert: Please Act on Both Items As Soon As Possible

1-Wounded Warrior Legislation Containing Important TBI Provisions
Earlier this week, the Senate passed its version of the defense authorization bill, including the text of the Dignified Treatment of Wounded Warriors Act, which contains critically important provisions to improve TBI care for returning service members. The House of Representatives passed its defense authorization bill, which does not contain these critical TBI provisions, in May. Conferees have now been appointed, as the House and Senate will work in conference to produce a final version of the legislation to send to President Bush.

Action Requested: Please contact your Representative today and urge them to sign on to the Congressional Brain Injury Task Force letter urging conferees to retain the Senate’s Dignified Treatment of Wounded Warriors Act provisions in the final version of the defense authorization bill.

2-SCHIP Legislation Containing Important Medicaid Provisions Related to TBI Care
Earlier today, (October 3, 2007) President Bush vetoed legislation to reauthorize and expand the State Children’s Health Insurance Program. This bill includes a six-month moratorium on implementing a federal regulation proposed by the Bush Administration which would restrict the use of Medicaid’s Rehabilitative Services option. Rehabilitation services provided under the Medicaid Rehabilitative Services option are often vital to individuals with traumatic brain injury to improve and maintain their health and independence.

It is expected that a vote to override the president’s veto will occur in the House of Representatives next week or shortly thereafter. As the Senate already has sufficient votes for the two-thirds majority required for an override of such a likely veto, the question will largely come down to whether the House of Representatives can garner enough votes to override the veto as well. Currently it appears that there is not enough Republican support in the House for an override.

Action Requested: Please contact your Representative TODAY and urge them to vote to override President Bush’s veto of the SCHIP reauthorization bill.

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This just in from Laura Schiebelhut [grassroots@biausa.org]:

Congress cleared a bill to provide stopgap funding to continue government operations this week, as none of the annual appropriations bills will be completed in time for the new fiscal year which begins on Monday, October 1.

Also this week, both the House and Senate passed a compromise bill to reauthorize and expand the State Children’s Health Insurance Program (SCHIP). Of particular significance to the brain injury community, this bill includes a six-month moratorium on implementation of a proposed federal regulation to restrict the use of the Medicaid Rehabilitative Services option.

Deliberations continued this week in the Senate on the fiscal 2008 defense authorization bill (H.R. 1585), including the passage of an amendment, supported by BIAA, specifically addressing neuro-optometric care for returning service members with TBI.
_______________________________________________________________________________
Appropriations Update

Congress cleared a bill to provide stopgap funding to continue government operations this week, as none of the annual appropriations bills will be completed in time for the new fiscal year which begins on Monday, October 1. The continuing resolution (CR) passed by Congress this week will fund the government through mid-November, although Senate Majority Leader Harry Reid (D-Nev.) expressed yesterday (Thursday, September 27) that he hopes to send President Bush three fiscal 2008 spending bills within the next few weeks. It is unclear which spending measures these will be and what action the president will take on them, as President Bush has threatened to veto any appropriations bill which provides more funding than he requested in his budget earlier this year. Many insiders agree that an omnibus appropriations bill will likely emerge at some point later this fall.

Senator Reid has specifically indicated that he plans to take up the Labor-HHS-Education spending bill within the next few weeks, likely following the Columbus Day recess, which runs from October 8 to October 12.

BIAA has signed on to a letter spearheaded by The Coalition for American Trauma Care urging House and Senate Appropriations Committee leaders to provide the highest possible funding in a final Labor-HHS-Education conference bill for programs that support trauma care, trauma care research, injury prevention, and TBI-specific programs housed within HRSA and CDC. In its letter, the Coalition urges Congress to support the higher Senate number of $10.091 million for the Traumatic Brain Injury HRSA state grant program, instead of the smaller allocation of $8.910 million proposed by the House of Representatives in its version of the spending bill. Likewise, the Coalition expresses its support of the higher Senate increase for Traumatic Brain Injury activities within the CDC’s National Center for Injury Prevention and Control, which is $1 million over fiscal 2007, versus the more modest House increase of $529,000.

Congress Passes SCHIP Reauthorization, Including Important Medicaid Provisions
Congress passed a compromise bill to reauthorize and expand the State Children’s Health Insurance Program (SCHIP) this week. This bill includes a six-month moratorium on implementing a federal regulation proposed by the Bush Administration which would restrict the use of Medicaid’s Rehabilitative Services option. Rehabilitation services provided under the Medicaid Rehabilitative Services option are often vital to individuals with traumatic brain injury to improve and maintain their health and independence. (Note: BIAA has been working as part of the Coalition to Preserve Rehabilitation to prevent implementation of this restrictive rule, and will soon be submitting comments to the Centers for Medicare and Medicaid Services (CMS) voicing strong opposition to proposed regulation. These comments will be posted on BIAA's website shortly).
Unfortunately, President Bush is expected to veto this SCHIP reauthorization bill. As the Senate already has sufficient votes for the two-thirds majority required for an override of such a likely veto, the question will largely come down to whether the House of Representatives can garner enough votes to override the veto as well. Currently it appears that there is not enough Republican support in the House for an override.

The Senate this week adopted by unanimous consent an amendment to the fiscal 2008 defense authorization bill (H.R. 1585) aimed at closing the gap between traditional optometric care and the non-standard optometric care that is required for returning service members with TBI. The amendment, based on S. 1999, a bill introduced by Sen. Kerry (D-MA) earlier this year, would authorize the establishment of a Center of Excellence in prevention, diagnosis, mitigation, treatment and rehabilitation of military eye injuries. The amendment, supported by the Blinded Veterans Association and BIAA, would create a Military Eye Injury Registry and would also authorize a study on Traumatic Brain Injury Post Traumatic Visual Syndrome. Rep. John Boozman (R-AR) has introduced a companion bill, H.R. 3558, in the House of Representatives.

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