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Brain Injury Association Fall Legislative Outlook

The following fall legislative outlook has been supplied by the Brain Injury Association of America:

Dear Advocates:

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.
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.

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."

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.

As 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.

As further brain injury legislative updates are issues, I will post them on this brain injury news and information blog.



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Ellen Weber

I look forward to hearing more about the future of this new resoltion and thanks for this fascinating post, Michael.

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