All those interested in the issues surrounding disability and services for those with disabilities, including traumatic brain damage should sign up for the webcast of the National Forum on Disability Issues, which will be held tomorrow (July 26, 2008) from 12:30 to 4:00 p.m. in Columbus, Ohio. The Forum is a non-partisan presidential forum organized by the Ohio Disability Vote Coalition (ODVC) and the American Association of People with Disabilities (AAPD). Sen. John McCain (R-AZ), the Republican presidential candidate, has agreed to participate in the forum via satellite, while Sen. Tom Harkin (D-Iowa) is expected to serve as a surrogate for the Democratic presidential candidate, Sen. Barack Obama (D-Ill.) To register for tomorrow’s webcast, please click here.
The Brain Injury Association of America has issued the following important legislative alert this evening:
Tell Your Senators to Vote YES on Advancing America's Priorities Act
Call Your Senators TODAY. Click here to take action.
Earlier this week, Senator Majority Leader Harry Reid (D-Nev.) introduced the Advancing America's Priorities Act (S. 3297), an omnibus bill that combines nearly three dozen non-controversial, bipartisan measures which have been blocked from full Senate consideration due to objections from Oklahoma Republican Senator Tom Coburn.
Among the measures included in this omnibus legislative package are two bills which are important to brain injury prevention and care in this country. These two bills are 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.
Call your Senators TODAY and urge them to vote YES on S. 3297 when it is considered the week of July 27, 2008. Click here to request your legislator vote YES.
Thanks to the Brain Stimulant blog for information on a new brain mapping project. A team of researchers has modeled in high-resolution the underlying architecture of the human cerebral cortex, showing how different brain regions interact with one another. This is basically an outline of the wiring connections between neurons in the brain's outer layer. This is the most complete mapping of the interconnected brain nodes to date. Apparently this is one of the first maps of the human brain at this level of detail. The researchers used a state-of-the-art diffusion MRI technology to image neural fibers. This new map may allow a better interpretation of brain scans as scientists will now know the underlying mechanisms of brain activation/deactivation. This diagram will give scientists a keener insight into how the brain works.
More information can be obtained by reading the full brain mapping article.
I am pleased to have been invited to speak again at the 21st annual North American Brain Injury Legal Conference to be held in New Orleans, Louisiana, on October 2-4, 2008. The conference is sponsored by the North American Brain Injury Society (NABIS) and will offer detailed, practical information on every aspect of litigating a traumatic brain injury case. Over 50 of the leading attorneys and medical experts from North America will provide information to attorneys on how to successfully handle the legal representation of victims of brain brain damage.
This year, I have been asked to present on how to successfully use medical literature to cross examine defense experts during the trial of a brain injury case.
You can obtain more information by reviewing the NABIS Legal Conference web site.
Unsafe truck drivers and the vehicle crashes they cause are a continued source of traumatic brain injuries.
A 30-page General Accounting Office study, released by the Associated Press today in advance of a governmental hearing on truckers and unsafe tractor trailer operations scheduled for later this week found that 563,000 commercial drivers were determined by the Veterans Affairs Department, Labor Department or Social Security Administration to also be eligible for full disability benefits over health issues. In many of these cases, the drivers were found to have vision, hearing or seizures disorders which would prohibit them from operating big rigs or other commercial trucks.
According to AP: The problems threatening highway travelers persist despite years of government warnings and hundreds of deaths and injuries blamed on commercial truck and bus drivers who blacked out, collapsed or suffered major health problems behind the wheels of vehicles that can weigh 40 tons or more.
Amazingly, the U.S. agency responsible for cracking down on unfit truckers, the Federal Motor Carrier Safety Administration, acknowledges it hasn't completed any of eight recommendations that U.S. safety regulators have proposed since 2001. One would set minimum standards for officials who determine whether truckers are medically safe to drive. Another would prevent truckers from "doctor shopping" to find a physician who might overlook a risky health condition. It's unclear whether any of the eight recommendations will be done before President Bush leaves office.
According to information supplied by the The Transportation Department over 126,000 individuals were received serious injuries in the last year studied as a result of crashes with trucks or buses and an additional 5,300 people died in crashes involving large commercial trucks or buses in 2006.
In hearings to be conduced on Thursday by the The House Transportation and Infrastructure Committee, the committee must demand that immediate steps be taken by the Federal Motor Carrier Safety Administration to remove unsafe truck drivers from our roads and highways.
The follow is this week's legislative alert distributed by the Brain Injury Assocation of America:
Numerous developments related to brain injury policy and advocacy efforts occurred this week in the nation’s capital.
In a welcome development on Tuesday, Congress successfully overrode the president’s veto of key Medicare legislation (H.R. 6331). The bill, which will now become law, prevents deep cuts in Medicare payment rates to physicians. It also contains important delays in the implementation of Medicare’s competitive bidding program for Durable Medical Equipment (DME), and a critically important extension of the Medicare outpatient therapy cap exceptions process.
Thank you to all of the advocates who responded to BIAA’s Legislative Action Alert last week urging Senators to override a veto by President Bush!!!
Also this week, although appropriations activity remains stalled in the House, the Senate Appropriations Committee approved its version of the fiscal 2009 Military Construction and Veterans Affairs spending bill, containing funding for TBI research as well as valuable report language related to TBI care for veterans.
In addition this week, on Thursday BIAA issued a Legislative Action Alert to urge both presidential candidates to attend the 2008 Fort Hood Presidential Town Hall and engage in an in-depth discussion of the increasingly complex issues facing America’s military and veterans community, including the rate of traumatic brain injury among returning service members. BIAA is a member of the 2008 Forth Hood Presidential Town Hall Consortium, and the event is tentatively scheduled to be televised by CBS on August 11, 2008. If you have not already, please take action TODAY
In other news, on Wednesday, a BIAA representative attended a Capitol Hill briefing, organized by Rep. Bill Pascrell, the founder and co-Chairman of the Congressional Brain Injury Task Force, on exciting new developments in TBI research. At the briefing, experts from the Cleveland Clinic discussed revolutionary new research efforts in the field of regenerative medicine to develop new treatments and therapies for TBI.
In addition, this week the Army issued new guidelines for TBI care, including a new requirement for all soldiers who experience dizziness or loss of consciousness from a blast, fall, collision or other direct impact incident to receive immediate medical assistance. View these new brain injury guidelines.
Legislation is presently pending before New York Governor, Patterson (A.7277 (Destito) S.7337 (Griffo)) which would amend state law to require state agencies to ensure that services for New Yorkers with disabilities are provided in the most integrated community setting, rather than in state or other institutional or segregated settings, by requiring state agencies to prioritize that in their state plans and to file annual reports demonstrating that priority.
According to the bill:
“tens of thousands of New Yorkers with disabilities are unnecessarily institutionalized/segregated from the non-disabled community and tens of thousands more are at risk of institutionalization, because of a long-standing financial and policy bias in state funded and/or state-administered programs for institutions rather than community-based/integrated services. New York continues to spend millions of dollars more for unnecessary segregated services for individuals that perpetuates dependence and inhibits workforce development and growth.”
This bill remedies that bias by requiring state-funded and/or state-administered programs to
• provide services in the most integrated setting to an individual`s needs
• requires the programs to identify all barriers to community-based services to ensure that an individual is only in an institutionalized, segregated setting if that individual was unable to benefit from a community-based setting.
The bill is on Governor Paterson’s desk so please ACT TODAY:
Call Governor Paterson at (518) 474-8390 and leave the following message:
“I’m a registered voter from (your locality and zip code) urging the Governor to sign A.7277 to make sure state agencies file annual reports demonstrating how they are helping people with disabilities to live in the most integrated community setting.”
Congratulations to my partner, SHANA DE CARO for being elected an officer of the American Association of Justice (AAJ) Traumatic Brain Injury Litigation Group. Shana has served as a member of the executive board for the past four years and was unanimously elected an officer at our annual meeting just held as part of the American Association of Justice annual convention held in Philadelphia Pennsylvania. Shana also focuses her practice along with me in representing victims of brain trauma throughout the country.
The AAJ Traumatic Brain Injury Litigation Group was formed approximately twenty years ago by attorneys with a special interest in representing individuals who have sustained traumatic brain damage. We meet several times a year to discuss the medical and legal issues surrounding traumatic brain injury litigation and host programs to teach personal injury lawyers how to effectively represent individuals and their families in traumatic brain injury cases.
I am a past chair of the traumatic brain injury litigation group and one of its founding members. I continue to be an active member of the group and continue my lecturing to attorneys throughout the country.
In addition to Shana's accomplishments in the field of traumatic brain injury litigation, she also serves as a member of the Board of Trustees of the Civil Justice Foundation, a prestigious group of attorneys that provides resources to grass root non for profit groups throughout the country who provide services for victims of accidents and injury and also work to prevent future injuries from occurring. She is also an active member of the Brain Injury Association of New York State.
If Shana or I can assist your family and yourself with your brain injury legal case, please do not hesitate to contact us. We can be reached toll free at 1 866 BRAIN LAW or by email.
We handle cases of individuals who have sustained traumatic brain damage as a result of all types of accidents, including car accidents, truck accidents and other motor vehicle accidents. We also represent individuals who have sustained brain damage as a result of medical malpractice such as hypoxia and anoxia caused at birth, at surgery including anesthesia and as a result of misdiagnosis including stroke or other neurological conditions. You can also visit our brainlaw web site for more information about our brain injury legal practice.
The first edition of the Congressional Brain Injury Task Force Newsletter has been published. This document is not yet available on line so I have published the entire newsletter for our readers:
Congressional Brain Injury Task Force
July 9, 2008
In an effort to educate and promote the awareness of brain injury, one of the driving missions of the Task Force, we would like to introduce the first edition of the quarterly Congressional Brain Injury Task Force Newsletter. Below you will find recent legislative activity, studies and reports, media coverage, and upcoming events related to traumatic brain injury (TBI). We believe that knowledge and information can inspire the change needed to improve the lives of individuals suffering from TBI.
Approximately 1.4 million Americans experience traumatic brain injury (TBI) each year, and an estimated 5.3 million Americans are living with long-term, severe disabilities as a result of brain injury. TBI is the leading cause of death and disability among young Americans in the United States and has been named the signature wound of the War in Iraq and Afghanistan.
We hope that you and your staff find this newsletter informative. Please contact Mandy Spears in Rep. Pascrell’s office or Becky Wolfkiel in Rep. Platts’ office if you have questions about any of the information included in the newsletter, would like more information about the Task Force, or would like to join.
Bill Pascrell, Jr. Todd Russell Platts
Recent Legislative Activity
Recent Studies and Reports
Recent Media Coverage
RECENT LEGISLATIVE ACTIVITY
The Traumatic Brain Injury Act (H.R. 1418)
On April 28, 2008, the President signed into law the Traumatic Brain Injury Act, which reauthorized TBI programs within the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration (HRSA), and the National Institutes of Health (NIH), all within the Department of Health and Human Services (HHS), through 2011.
FY 2008 Supplemental Appropriations
The FY 2008 Supplemental Appropriations Act, which has been signed into law, provides a total of $375 million to the Department of Defense (DOD) to stimulate research, educate health care providers, and increase treatment for traumatic brain injury.
FY 2009 Appropriations
On March 19, 2008, members of the Congressional Brain Injury Task Force called on the Appropriations Subcommittee on Defense to provide $28 million to support the work of the Defense and Veterans Brain Injury Center within the Defense Center of Excellence in Psychological Health and Traumatic Brain Injury.
On March 19, 2008, members of the Congressional Brain Injury Task Force called on the Appropriations Subcommittee on Labor, Health and Human Services, and Education to provide $30 million for programs authorized under the Traumatic Brain Injury Act, including $9 million for CDC TBI Registries, Surveillance, and Education; $15 million for HRSA TBI State Grants; and $6 million for HRSA TBI Protection and Advocacy Grants. Status: The Senate Appropriations Committee mark-up level funds these programs at $14.7 million. While the full House Appropriations Committee has not yet approved the Labor-HHS-Education bill, the Subcommittee’s mark-up includes a $3 million increase over FY 2008, including $11 for the HRSA TBI Grants and $6.6 million for CDC TBI programs.
TBI Awareness (H.Con.Res. 91)
This resolution expresses the need for enhanced public awareness of TBI and support for the designation of a National Brain Injury Awareness Month. It currently has 59 co-sponsors
RECENT STUDIES AND REPORTS
In 2005, there were nearly 8,000 fall-related TBI deaths and over 56,000 hospitalizations for nonfatal fall-related TBI among adults 65 and older in the United States. –CDC, “Fall-Related TBI Deaths”
New England Journal of Medicine: Mild Traumatic Brain Injury in U.S. Solders Returning from Iraq; January 31, 2008
Findings: Of the 2,500 Iraq soldiers surveyed, nearly 15 percent reported injuries associated with mild TBI. Compared to soldiers with other injuries, these individuals reported significantly higher rates of physical and mental health problems. These cases of mild TBI were also significantly associated with symptoms of post-traumatic stress disorder.
Government Accountability Office: VA Health Care: Mild Traumatic Brain Injury Screening and Evaluation Implemented for OEF/OIF Veterans, but Challenges Remain; February 2008
Findings: In April 2007, VA facilities implemented a national protocol for the evaluation and treatment of Operation Enduring Freedom (OEF) / Operation Iraqi Freedom (OIF) veterans who may have a mild TBI, including adoption of a computer-based screening tool. Some facilities had difficulty in following the protocols, and the largest challenge faced by the screening program is the lack of evidence to the validity and reliability of the screening tool.
RAND: Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery; April 2008
Findings: An estimated 320,000 individuals deployed for OEF/OIF experienced a TBI, 57 percent of which were not evaluated by a physician for brain injury. The annual cost of care for the 2,700 individuals who were diagnosed with TBI is estimated at $591 million to $910 million. The major gaps in TBI-related care for EOF/OIF-deployed individuals include a failure to identify cases of TBI and a lack of care coordination. RAND recommends the use of evidence-based care practices, an increase in the number of specially-trained providers, and research investments to close information gaps.
Veteran’s Health Administration: Understanding the Effects of Blasts on the Brain; April 2008
Findings: The VA and the Office of Naval Research are funding research to understand the biological effects of blasts on the brain. Findings from the research will be used to design therapies that can be administered in the combat zone to troops as a preventive measure or after a blast has occurred to stem damage to the brain. The research also contains a genetic component that aims to identify genes that may get activated in brain injury. Figuring out a way to turn off those genes with a drug could be a breakthrough for the treatment of brain injury on the battlefield and in field hospitals.
Government Accountability Office: DOD Health Care: Mental Health and Traumatic Brain Injury Screening Efforts Implemented, but Consistent Pre-Deployment Medical Record Review Policies Needed;
Findings: Pursuant to the FY 2007 John Warner National Defense Authorization Act, DOD added TBI screening questions to the pre-deployment health assessment in January 2008. Beginning in July 2008, DOD plans to require screening of all service members for mild TBI prior to deployment in order to provide a baseline against which individuals can be assessed post-deployment.
Veteran’s Administration Inspector General: VA’s Role in Ensuring Services for OEF/OIF Veterans after Traumatic Brain Injury Rehabilitation; May 1, 2008
Findings: Of VA patients who initially received inpatient rehabilitation for TBI in 2005, many continue to have significant disabilities. For these patients, significant needs remain unmet, including primarily long-term case management.
Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury: May/June 2008 Newsletter
The Centers for Disease Control and Prevention: Fall-related traumatic brain injury deaths and hospitalizations among older adults — United States, 2005; June 23, 2008
Findings: In 2005, nearly 56,000 seniors 65 and over were hospitalized as the result of traumatic brain injuries. Of these, 8,000 died. In fact, TBIs accounted for 50 percent of unintentional fall deaths and 8 percent of nonfatal fall-related hospitalizations among older adults.
RECENT MEDIA COVERAGE
“Post-traumatic stress disorder, traumatic brain injuries, major depression and suicide are exacting a fearful price from combat soldiers and marines. These matters are not even being talked about enough, much less dealt with adequately.” –Robert Herbert, “Wounds You Can’t See”
House Expands Aid for Brain Injuries, USA Today, April 8, 2008
Pentagon Seeks Battlefield Device to Diagnose Brain Injury, The Wall Street Journal, April 17, 2008
Audit: Brain Injured Vets Not Getting Proper Care, USA Today, May 1, 2008
Report: Improve Care of Vets with Brain Injury, USA Today, May 2, 2008
‘Samantha Who?’ Forgets to Check the Facts on Brain Injuries, The Los Angeles Times, May 5, 2008
Op-Ed: War Wounds We Don’t See, The Los Angeles Times, May 13, 2008
Better Brain-Injury Tests Planned for Troops, USA Today, May 22, 2008
The Sergeant Lost Within, The New York Times, May 25, 2008
Op-Ed: Wounds You Can’t See, The New York Times, June 24, 2008
High-Tech Testing for War Vets with Post-Traumatic Stress Disorder, The Chicago Tribune, June 26, 2006
Op-Ed: Baseline Maneuvers, The New York Times, July 6, 2008
Briefing with Dr. Ali Rezai of the Cleveland Clinic on Advances in Deep Brain Stimulation to Treat TBI
July 16, 2008
Session with Michael Paul Mason, Author of “Head Cases: Stories of Brain Injury and Its Aftermath”
September – TBD
NY Times Book Reviews: Empathy for the Brain, After Insult and Injury; Damage Control
International Conference on Behavioral Health and Traumatic Brain Injury
Experts on Brain Injuries to Gather, The Herald News, June 10, 2008
Roughly 2.7 million Americans have epilepsy, according to government estimates and many forms of epilepsy are caused by a traumatic brain injury.
The Food and Drug Administration is recommending a "black box" warning about the risk of suicidal thoughts and behavior with epilepsy drugs, just days ahead of an advisory panel meeting.
The FDA in a memo said that the warning would apply to all epilepsy drugs.
A black box warning is the strongest type of warning that the FDA can compel a drug manufacturer to insert on a product.
Some of the tops selling epilepsy medication that can be affected by the warning are GlaxoSmithKline Plc's Lamictal, Pfizer Inc's Lyrica, Johnson & Johnson's Topamax and Abbott Laboratories Inc's Depakote.
Read the full FDA epilepsy briefing document.