Brain Injury Association Information, Brain Injury Legislative News
Brain Injury Association of America-Legislative Update Nov 2013
The following legislative update has been prepared by the Brain Injury Association of America (BIAA):
TBI Act Reauthorization 2013
The Brain Injury Association of America testified before the House Subcommittee on Health hearing "Examining Public Health Legislation to Help Local Communities" on November 20, 2013. The Subcommittee on Health is chaired by Rep. Pitts (R-PA) and Rep. Pallone (D-NJ) is the ranking member.
The TBI Act, H.R. 1098 was included with six other public health bills in the hearing. Dr. Drew Nagele, member of BIAA's board of directors testified on behalf of the TBI Act. BIAA is pleased to see the progress of the TBI Act in the House of Representatives. We ask you to contact your Senator's and urge him or her to introduce a companion bill in the Senate for H.R. 1098, the TBI Act.
Safe Kids Capitol Day
BIAA was invited to participate in the second annual Safe Kids Capitol Day hosted by the Congressional Kids Safety Caucus and Safe Kids Worldwide. The event promoted prevention of brain injury including wearing helmets and included concussion education. The Centers for Disease Control and Prevention (CDC) also participated in the Safe Kids Capitol Day.
The TBI Act, which BIAA advocates for provides funding to the CDC to conduct surveillance, prevention and public education programs on TBI. CDC provides free resources through the Heads Up Concussion Campaign for youth sports, schools, high school sports and practitionersBIAA is proud to partner with the CDC and to be a part of Safe Kids Capitol Day.
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Legislative Update from the Brain Injury Association of America
The following is the November 2013 legislative and policy update from the Brain Injury Assocation of America (BIAA):
TBI Act Reauthorization 2013
The Brain Injury Association of America along with the TBI Act stakeholders, National Association of State Head Injury Administrators (NASHIA) and National Disability Rights Network (NDRN), continue to work with Senate staff on reauthorization. The TBI Act should be introduced in the Senate this fall. National Conference on Youth Sports Safety BIAA was invited to participate in the first National Conference on Youth Sports Safety in Washington DC. The conference was led by Dr. David Satcher, the 16th U.S. Surgeon General. Dr Satcher is currently the Director of the Satcher Health Leadership Institute. The Protecting Athletes and Sports Safety (PASS) initiative seeks to initiate a sustained national conversation on changing the culture of sport so we can better protect our young athletes. PASS will continue to bring together the nation's thought leaders to take the discussion to the next level. Over the next two years, the conversation will lead to the development of a set of national guidelines that identify best practices proven to help 1) significantly reduce youth sports injuries including concussion and 2) provide parents with information they need to make good decisions about involving their children in youth sports. BIAA looks forward to working with PASS to make all sports safer for student athletes.
This week BIAA attended the Nondefense Discretionary (NDD) United Congressional Briefing. NDD United is a campaign of 3,200 national, state, and local organizations working to protect nondefense discretionary investments. As we enter into the next critical phase of budget negotiations, we are urging Congress to replace sequestration with a balanced approach to deficit reduction.
Future Care Coalition
BIAA continues to lead the Future Care Coalition with United Spinal Association meeting with the Office of Financial Management at the Centers for Medicare and Medicaid Services (CMS) to inform them of our concerns related to the Advanced Notice of Proposed Rule Making (ANPRM) for Medicare Secondary Payer Future Medicals. In the ANPRM, CMS proposed 7 options for a beneficiary to reimburse CMS for future medical costs. The Future Care Coalition believes there needs to be strong protections in place for the beneficiary in terms of access to care if CMS were to move forward with collecting future medical costs. The rule is currently at the Office of Management and Budget (OMB) where it is reviewed by OMB staff. BIAA and other members of the Future Care Coalition met with OMB staff to share our concerns about the ANPRM as they move through the review process. The coalition continues to meet with Congressional offices to build Champions on the hill related to this important issue. BIAA and members of the coalition met with staff in Reps. Jenkins (R-KS) and Kind (D-WI) and Sens. Kirk (R-IL) and Portman (R-OH) during the past week.
Centers for Medicare and Medicaid DMEPOS Bidding Program
BIAA was invited to participate in a meeting with the Centers for Medicare and Medicaid (CMS) that was led by United Spinal Association and the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition which BIAA is a member of to educate CMS regarding the DMEPOS bidding program that provides wheelchairs to Medicare beneficiaries. Wheelchair suppliers also attended the meeting. Even though CMS has opened up the rules to allow non-contract suppliers to repair wheelchairs in addition to contract suppliers, there is no enforcement of non-contract suppliers making repairs for those that need them. The implementation of the bidding program is an added obstacle in ensuring affordable, quality coverage and access to critical medical equipment, supplies and related services to an already vulnerable population; seniors and people with disabilities that must rely on a smaller number of providers for their medical equipment.
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Brain injury and the affordable health care act--free webinair
The Brain Injury Association of America has announced a new webinair to explore the new Obama, health care legislation and its implications for those with traumatic brain injury entitled, “One Month Into Health Care Reform: An Update on Health Insurance Exchanges”
Participants will learn:
1. The status of how the new health insurance marketplace is operating
2. How individuals with brain injury fit into overall health care reform
3. What the changes mean for providers and consumers of brain injury benefits
Date and Time Fri, Oct 25, 2013 3:00 PM - 4:00 PM EDT
Panelists Peter Thomas, Principle The Powers Firm Theresa Morgan, Legislative Director The Powers Firm
Registration Register at this link
Webinar ID: 147-022-147
Audio Participants can use their computer's microphone and speakers (VoIP) or telephone. United States Toll: +1 (909) 259-0012 Access Code: 205-103-885 Audio PIN: Shown after joining the webinar
Brain Injury Association Information, Brain Injury Legislative News
Brain Injury Legislative Update
The following legislative update on developments on traumatic brain injury in Washington has been prepared by the Brain Injury Association of America (BIAA):
Appropriations Bill Approved
The Senate Defense Appropriations Subcommittee approved a $594 billion fiscal 2014 Defense spending bill this week. In the bill there is a $60 million increase in Pentagon medical research efforts for traumatic brain injury and psychological health.
Committee Passes Reauthorization of the Workforce Investment Act, S. 1356
This week, the Health Education Labor and Pensions (HELP) Committee passed the reauthorization of the Workforce Investment Act (WIA). The WIA Reauthorization has been over due since 2003. The bill passed through committee by an 18-3 vote, and will now be considered by the full Senate.
In the bill, the National Institute on Disability and Rehabilitation Research (NIDRR) will be moved to the Administration on Community Living (ACL) in the Department of Health and Human Services (HHS). NIDRR is renamed the National Institute on Disability and Independent Living Research (NIDILR). NIDILR is where the TBI
Model Systems are located. There are 16 TBI Model Systems throughout the United States that provide care and collect information on individuals with traumatic brain injury during the acute hospital stay and in the community after discharge.
Title V of WIA reauthorize the Rehabilitation Act, including vocational rehabilitation (VR) programs. According to the committee press release the updates to the Title V are aimed at making sure that young people with disabilities have increased preparation and opportunities for competitive, integrated employment. The bill requires state VR agencies, in conjunction with local educational agencies, to make "pre-employment transition services" available to students with disabilities. Updates to the bill also focus on creating better alignment of government programs at the national level that are focused on employment and independent living for people with disabilities.
Congressional Hearing on Human Brain Research
This week the House Committee on Science, Subcommittee on Research and Technology held a
hearing entitled the Frontiers of Human Brain Research. Witness included Dr. Story Landis, Director of National Institute of Neurological Disorders and Stroke at the National Institutes of Health, Michael McLoughlin, Deputy
Business Area Executive, Research and Exploratory Development at Applied Physics Laboratory at John Hopkins University, U.S. Air Force Master Sergeant Joseph Deslauriers Jr., Dr. Marcus Raichle, Professor of Radiology, Neurology, Neurobiology and Biomedical Engineering at Washington University, and Dr. Gene Robinson, Director at the Institute for Genomic Biology, Swanlund Chair, Center for Advanced Study Professor in Entomology and Neuroscience at the University of Illinois.
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Set the right example-wear a helmet while bicycle riding
Next time you ride a bicycle, wear a helmet!
New statistics from the American Association of Neurological Surgeons show bike accidents were the cause of 86,000 sports-related head injuries in 2009. Football accounted for 47,000 head injuries, and baseball accounted for 38,394 head injuries.
Bicycle riding was the leading cause of head injuries among kids under age fourteen.
Part of the reason for the greater number of individuals suffering brain trauma while riding a bicycle is that there are more persons who riding a bike then playing football or baseball. Bicycle riders also face great dangers of being struck by a motor vehicle and many fail to wear a helmet. Studies show 90 percent of bicyclists killed in the United States in 2009 were not wearing helmets
According to Safe Kids USA, helmet use can reduce the risk of head injury by 85 percent and severe brain injury by 88 percent.
Helmets are not just for children. While eight states, including New York State and the District of Columbia mandate helmet use for children, adults also need to wear helmets.Protect your brain and set the right example-- wear a helmet while bicycle riding.
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Brain Injury Association of America Testimony to House Subcommittee on Labor Health and Human Services
Here is the testimony submitted by the Brain Injury Association of America (BIAA) to the Senate Appropriations Subcommittee on Labor Health and Human Services and Related Agencies concerning proposed funding increases for TBI Act programs and the TBI Model Systems of Care Program.
Testimony of the Brain Injury Association of America on CDC, HRSA – Department of Health and Human Services, NIDRR – Department of Education: Prepared for the Subcommittee on Labor, Health and Human Services, Education and Related Agencies May 6, 2013
Testimony of the Brain Injury Association of America on CDC, HRSA – Department of Health and Human Services, NIDRR – Department of Education:
Prepared for the Subcommittee on Labor, Health and Human Services,
Education and Related Agencies
May 6, 2013
Chairman Harkin and ranking member Moran, thank you for the opportunity to submit this written testimony with regard to the FY 2014 Labor-HHS-Education appropriations bill. This testimony is on behalf of the Brain Injury Association of America (BIAA), our national network of state affiliates, and hundreds of local chapters and support groups from across the country.
In the civilian population alone every year, more than 1.7 million people sustain brain injuries from falls, car crashes, assaults and contact sports. Males are more likely than females to sustain brain injuries. Children, teens and seniors are at greatest risk.
Recently, we are seeing an increasing number of service members returning from the conflicts in Iraq and Afghanistan with TBI, which has been termed one of the signature injuries of the War. Many of these returning service members are undiagnosed or misdiagnosed and subsequently they and their families will look to community and local resources for information to better understand TBI and to obtain vital support services to facilitate successful reintegration into the community.
For the past 14 years Congress has provided minimal funding through the HRSA Federal TBI Program to assist States in developing services and systems to help individuals with a range of service and family support needs following their loved one’s brain injury. Similarly, the grants to state Protection and Advocacy Systems to assist individuals with traumatic brain injuries in accessing services through education, legal and advocacy remedies are woefully underfunded. Rehabilitation, community support and long-term care systems are still developing in many States, while stretched to capacity in others. Additional numbers of individuals with TBI as the result of war-related injuries only adds more stress to these inadequately funded systems.
BIAA respectfully urges you to provide States with the resources they need to address both the civilian and military populations who look to them for much needed support in order to live and work in their communities.
With broader regard to all of the programs authorized through the TBI Act, BIAA specifically requests:
$10 million (+ $4 million) for the Centers for Disease Control and Prevention TBI Registries and Surveillance, Brain Injury Acute Care Guidelines, Prevention and National Public Education/Awareness
$8 million (+ $1 million) for the Health Resources and Services Administration (HRSA) Federal TBI State Grant Program
$4 million (+ $1 million) for the HRSA Federal TBI Protection & Advocacy (P&A) Systems Grant Program
CDC – National Injury Center - The Centers for Disease Control and Prevention’s National Injury Center is responsible for assessing the incidence and prevalence of TBI in the United States. The CDC estimates that 1.7 million TBIs occur each year and 3.4 million Americans live with a life-long disability as a result of TBI. In addition, the TBI Act as amended in 2008 requires the CDC to coordinate with the Departments of Defense and Veterans Affairs to include the number of TBIs occurring in the military. This coordination will likely increase CDC’s estimate of the number of Americans sustaining TBI and living with the consequences.
CDC also funds states for TBI registries, creates and disseminates public and professional educational materials, for families, caregivers and medical personnel, and has recently collaborated with the National Football League and National Hockey League to improve awareness of the incidence of concussion in sports. CDC plays a leading role in helping standardize evidence based guidelines for the management of TBI and $1 million of this request would go to fund CDC’s work in this area.
HRSA TBI State Grant Program - The TBI Act authorizes the HHS, Health Resources and Service Administration (HRSA) to award grants to (1) states, American Indian Consortia and territories to improve access to service delivery and to (2) state Protection and Advocacy (P&A) Systems to expand advocacy services to include individuals with traumatic brain injury. For the past thirteen years the HRSA Federal TBI State Grant Program has supported state efforts to address the needs of persons with brain injury and their families and to expand and improve services to underserved and unserved populations including children and youth; veterans and returning troops; and individuals with co-occurring conditions
In FY 2009, HRSA reduced the number of state grant awards to 15, in order to increase each monetary award from $118,000 to $250,000. This means that many states that had participated in the program in past years have now been forced to close down their operations, leaving many unable to access brain injury care.
Increasing the program to $8 million will provide funding necessary to sustain the grants for the 21 states currently receiving funding along with the three additional states added this year and to ensure funding for four additional states. Steady increases over five years for this program will provide for each state including the District of Columbia and the American Indian Consortium and territories to sustain and expand state service delivery; and to expand the use of the grant funds to pay for such services as Information & Referral (I&R), systems coordination and other necessary services and supports identified by the state.
HRSA TBI P&A Program - Similarly, the HRSA TBI P&A Program currently provides funding to all state P&A systems for purposes of protecting the legal and human rights of individuals with TBI. State P&As provide a wide range of activities including training in self-advocacy, outreach, information & referral and legal assistance to people residing in nursing homes, to returning military seeking veterans benefits, and students who need educational services.
Effective Protection and Advocacy services for people with traumatic brain injury is needed to help reduce government expenditures and increase productivity, independence and community integration. However, advocates must possess specialized skills, and their work is often time-intensive. A $4 million appropriation would ensure that each P&A can move towards providing a significant PATBI program with appropriate staff time and expertise.
NIDRR TBI Model Systems of Care - Funding for the TBI Model Systems in the Department of Education is urgently needed to ensure that the nation’s valuable TBI research capacity is not diminished, and to maintain and build upon the 16 TBI Model Systems research centers around the country.
The TBI Model Systems of Care program represents an already existing vital national network of expertise and research in the field of TBI, and weakening this program would have resounding effects on both military and civilian populations. The TBI Model Systems are the only source of non-proprietary longitudinal data on what happens to people with brain injury. They are a key source of evidence-based medicine, and serve as a “proving ground” for future researchers.
In order to make this program more comprehensive, Congress should provide $11 million (+ $1.5 million) in FY 2014 for NIDRR’s TBI Model Systems of Care program, in order to add one new Collaborative Research Project. In addition, given the national importance of this research program, the TBI Model Systems of Care should receive “line-item” status within the broader NIDRR budget.
We ask that you consider favorably these requests for the CDC, the HRSA Federal TBI Program, and the NIDRR TBI Model Systems Program to further data collection, increase public awareness, improve medical care, assist states in coordinating services, protect the rights of persons with TBI, and bolster vital research.
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Brain Injury Association of America: Legislative News
Here is the latest legislative news report from the Brain Injury Association of America (BIAA):
Traumatic Brain Injury (TBI) Act Reauthorization 2013
On Wednesday, March 13, 2013, the TBI Act, H.R. 1098, was introduced by Reps. Pascrell and Rooney, co-chairs of the Congressional Brain Injury Task Force. This bill will reauthorize the current programs relating to TBI and also will move the state grant and protection and advocacy grant programs from the Maternal and Child Health Bureau to another agency with the U.S. Department of Health and Human Services. The move acknowledges the impact of TBI across the age span, including older adults and returning service members/veterans. The Congressional Brain Injury Task Force recommends relocating the program to better coordinate with federal agencies regarding long-term services and supports available to individuals with other disabilities, particularly the long-term services and supports provision of the Affordable Care Act. BIAA thanks Reps. Pascrell and Rooney for introducing this important legislation. Please call your Member of Congress and ask them to co-sponsor H.R. 1098 today!
President's Budget FY 2014
This week, President Obama released his proposed fiscal year (FY) 2014 budget. In the budget, the President proposed to cancel sequestration and replace it with an additional $1.8 trillion in deficit reduction through new revenue, $400 billion in health savings, Social Security changes, and $200 billion in discretionary cuts split evenly between defense and nondefense programs. It is unlikely Congress will pass the president's budget.
Also in the President's proposed FY2014 budget, BIAA is 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 FY12 final and FY13 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 21 states to improve systems coordination access to care for people with brain injury.
The budget recommends $110 million in funds for the National Institute on Disability and Rehabilitation Research (NIDRR) of the U.S. Department of Education. NIDRR administers grants to the TBI Model Systems which is a collection of research centers located across the United States that conduct disability and rehabilitation research. The TBI Model Systems 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.
BIAA will continue to work to ensure that legislators understand the importance of these programs and how they affect the 3.5 million people across the United States with brain injury.
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Mapping the Human Brain
The New York Times reports this morning that the Obama admiration will announce a plan latter today for the investment of $100 million starting in 2014 focused on research to understand how the human brain functions. “Obama to Unveil Initiative to Map the Human Brain”
The plan is to develop new technology that will enable scientists to map and understand the complex circuits that comprise the human brain. According to the Times story, “The effort will require the development of new tools not yet available to neuroscientists and, eventually, perhaps lead to progress in treating diseases
like Alzheimer’s and epilepsy and traumatic brain injury. It will involve both government agencies and private institutions”.
The plan has been named the Brain Research Through Advancing Innovative Neurotechnologies, or Brain for short. Government agencies to be involved in the project are: the National Institutes of Health, the Defense Advanced
Research Projects Agency and the National Science Foundation.
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Seeking Comments on the Pediatric Mild TBI Guideline Protocol
Between March 7 and April 7, the Pediatric Mild Traumatic Brain Injury (TBI) Guideline Workgroup is seeking public comment on a guideline protocol on diagnosing and treating pediatric mild TBI (among patients age 18 and under).
Comprised of leading experts in the field of TBI, CDC Injury Center’s Board of Scientific Counselors established the Pediatric Mild TBI Guideline Workgroup to create a clinical guideline for health care professionals working in the acute care and primary care setting.
The Workgroup is using the American Academy of Neurology’s (AAN) guideline development process to develop a multidisciplinary, evidence-based guideline. You can access the guideline protocol for review and comment by clicking here
Public comment on the guideline protocol is one of the first steps in the evidence-based clinical guideline development process. To learn more about the Pediatric Mild TBI Guideline Workgroup and next steps for the project, click here
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National Brain Injury Survey from Sarah Jane Brain Foundation
The Sarah Jane Brain Foundation (SJBF) and CE Outcomes have announced a national survey to identify gaps in services and research dealing with brain injury.
This is a joint effort during Brain Injury Awareness Month to understand the current state of brain injury across the country and across two different clinical populations (youth/developing brain and adult/developed brain).
The survey will investigate the differences in services between “Mild” TBI/concussions and moderate to severe brain injury. In addition, the assessment will analyze across the continuum of care from prevention to acute care/rehabilitation services to reintegration/long-term care. The online survey is being hosted by CE Outcomes and can be accessed by clicking here.
“This survey will include physicians, psychologists, educators, allied health professionals, and most importantly families and brain injury survivors across this country,” said Dr. Ron Savage, President of SJBF and author of the survey. “We will have data from thousands of voices to better understand the gaps in services that impact the lives of millions of people. Those voices will be heard.”