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Brain Injury Association Legislative Update

The following information comes from the most recent Brain Injury Association of America Legislative Update:

Defense Secretary Gates Responds to Senators’ Letter on Cognitive Rehabilitation:

United States Secretary of Defense Robert Gates has responded to the letter a group of Senators issued on August 4, 2008 calling on him to ensure official TRICARE coverage of cognitive rehabilitation.  As you may recall, BIAA played a crucial role in helping initiate and promote this letter, which was led by Senator Evan Bayh (D-IN).

In his response, Secretary Gates continues to defend TRICARE’s lack of coverage of cognitive rehabilitation, maintaining that there is insufficient evidence from properly structured research protocols to establish the general acceptance of cognitive rehabilitation as a proven medical treatment.
Specifically, Secretary Gates states, “The Assistant Secretary of Defense for Health Affairs reports that while the existing evidence is supportive of cognitive rehabilitation, the rigor of the research by which that evidence was produced has not yet met the required standard.”  At the same time, Secretary Gates’ letter does acknowledge that “many organizations and reviews have supported cognitive rehabilitation.”

BIAA strongly disagrees with the argument put forth by Secretary Gates that there is insufficient evidence to justify official TRICARE coverage of cognitive rehabilitation.  BIAA, along with numerous congressional advocates, will continue to press this issue in the new 111th Congress next year.

VA Signs Interagency Agreement With NIDRR-Funded TBI Model Systems:
In an exciting development, the U.S. Department of Education’s National Institute on Disability and Rehabilitation Research (NIDRR) recently signed an Interagency Agreement (IAA) with the Department of Veterans Affairs (VA) for the NIDRR-funded Traumatic Brain Injury Model Systems National Data and Statistical Center (NDSC) located at Craig Hospital in Englewood, Colorado to provide consultation, training, and technical assistance to the VA and the VA Polytrauma Rehabilitation Centers.
The Agreement calls for Craig and NIDRR to assist the VA to create a new registry of military service personnel and veterans who are returning from Iraq or Afghanistan with traumatic brain injuries (TBI).
BIAA has long been a strong advocate for collaboration between VA and NIDRR’s TBI Model Systems of Care Program, and last year BIAA played a critical role in ensuring the inclusion of legislative language mandating such collaboration in the National Defense Authorization Act for Fiscal Year 2008 (H.R. 4986).  BIAA also played a vital role in obtaining $900,000 in additional funding last year to maintain research capacity within the TBI Model Systems of Care program.

Congressman Pascrell Introduces Bill to Improve Concussion Management in Schools:

In response to the tragic death of Montclair High School’s Ryne Dougherty, U.S. Rep. Bill Pascrell, Jr. (D-NJ), the co-founder and co-chairman of the Congressional Brain Injury Task Force yesterday introduced legislation in the House of Representatives to help schools better protect student athletes from brain injuries. 

The legislation, called the Concussion Treatment and Care Tools (ConTACT) Act, will authorize federal grants to states to be used to help schools invest in concussion screening technology and adopt better concussion management guidelines.

“Providing basic preventative technology and guidelines to mitigate the effects of head injuries can reduce the number of tragic deaths and countless injuries that occur in youth athletics,” stated Pascrell.  “I will push hard with the weight of the entire Congressional Brain Injury Task Force to implement the ConTACT Act.”

Specifically, the ConTACT Act will create a state grant program through the Centers for Disease Control and Prevention (CDC) that will fund computerized pre-season baseline and post-concussion neurological testing for school sponsored sports.  Schools that enroll students from grades 6 through 12 will be eligible for the funding. 

The grant program would be authorized for 5 years and is estimated to cost $5 million in the first year.  It would require a report to Congress within 2 years of enactment regarding the use and results of screening technology. 

Pascrell has long been a strong advocate for expanding concussion management technology to youth athletics.  In August of 2006, Pascrell visited a Nutley High School football practice to announce a new round of grants for New Jersey high schools to implement concussion management technology.

The legislation was developed by Rep. Pascrell, Rep. Todd Platts (R-PA) and the Brain Injury Task Force with consultation from the Brain Injury Association of America, the New Jersey Brain Injury Association, the National Association of State Head Injury Administrators, the Athletic Trainers Society of New Jersey, the International Brain Research Foundation and the New Jersey Office of Disability Services.
A copy of the legislation will be made available on the “Policy & Legislation” section of BIAA’s website

BIAA Testifies at Social Security Administration Compassionate Allowances Hearing:

On November 18, 2008, BIAA Director of Consumer Services, Greg Ayotte, testified in Arlington, Virginia at a Social Security Administration (SSA) Compassionate Allowance outreach hearing on brain injuries.

The purpose of this hearing was to consider views about the advisability and possible methods of identifying and implementing compassionate allowances for children and adults with brain injuries. SSA’s Compassionate Allowance Initiative represents an effort by SSA to consider ways to quickly identify diseases and other serious medical conditions that obviously meet the definition of disability under the Social Security Act (Act) and which can be identified with minimal objective medical information. SSA calls this method “Compassionate Allowances.''

Among other things, BIAA’s testimony focused on illustrating some of the obstacles individuals with brain injuries encounter when trying to access Social Security disability benefits.

BIAA Urges Repeal of Medicare’s Two-Year Wait Period:

On November 12, 2008, BIAA joined the Coalition to End the Two-Year Wait for Medicare - which represents over 75 health advocacy organizations - in launching its campaign to urge the next Congress to end the 24-month wait for Medicare coverage faced by people with disabilities.

At a press conference held on Capitol Hill, people currently caught up in the waiting period described their experiences and Representative Gene Green (D-TX) described legislative efforts to eliminate the waiting period.  In addition, at the press conference Coalition leaders released a letter signed by Coalition members – including BIAA – addressed to Democratic and Republican leaders of the Senate Finance Committee and the House Ways and Means Committee.  The letter calls for health coverage for people with disabilities to be at the forefront of future legislative efforts to cover the uninsured.

The issue this Coalition is working to address is that people who become severely and permanently disabled qualify for Social Security Disability Insurance and Medicare coverage. However, according to federal statute, they must wait two years from their date of eligibility for SSDI before their Medicare coverage begins. About one quarter of people in this waiting period are without insurance for the entire time. Many cannot afford to pay COBRA premiums to maintain coverage from their former employer, and private coverage on the individual market is unavailable or too expensive for this high-cost population, including many individuals with brain injuries.

In a formal statement circulated at the press conference, BIAA noted that, “In causing delay of proper treatment, this unnecessary waiting period promotes increased lifelong disability for individuals with brain injury and significantly decreases cost efficiency in medical and rehabilitative treatment.”
A copy of BIAA’s statement in its entirety, and the Coalition's letter, will be made available on the “Policy & Legislation” section of BIAA’s website  shortly.



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