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Brain Injury Year End Legislative Update

The following year end legislative update was prepared by the Brain Injury Association of America (BIAA)

Department of Health and Human Services (HHS):

Administration for Community Living (ACL)

The appropriations bill includes a new general provision to support the transfer of the National Institute on Disability and Rehabilitation Research (NIDRR), Independent Living, and Assistive Technology Act programs to the ACL in accordance with the Workforce Innovation and Opportunity Act, which was signed into law in July.

Health Resources and Services Administration (HRSA)

Funding was reduced to $9.3 million (down $23,000) for the Traumatic Brain Injury (TBI) program that funds grants to states to increase access to service delivery and to state Protection & Advocacy (P&A) Systems to provide advocacy assistance to individuals with TBI.

The National Institutes of Health (NIH)

NIH received a little over $30 billion. Several institutes received support in connection with the Brain Research through Application of Innovative Neurotechnologies (BRAIN) initiative.

Congress noted that Comprehensive Rehabilitation Research Centers serve a high volume of Medicare and Medicaid patients with brain injury, strokes, multiple traumas, and wartime injuries. They included language to urge HHS to evaluate the current prospective payment rate with the goal of maintaining these centers of excellence and continuing the high quality of care provided by these centers.

The bill encourages HHS to investigate the development of new and better standards for testing sports equipment to ensure that athletes have state-of-the-art gear that significantly reduces sports-related brain injuries.

The NIH Rehabilitation Coordinating Committee (NIH RCC) was directed to host a trans-NIH State of the Science Conference on Medical Rehabilitation Research to develop and regularly update a trans-NIH plan for medical rehabilitation science and to better coordinate the grants to adhere to the definition of rehabilitation research recommended by the Blue Ribbon Panel on Medical Rehabilitation Research. BIAA has been a longtime supporter of legislative efforts to enhance the stature and visibility of medical rehabilitation research at NIH.

Centers for Disease Control and Prevention (CDC)

The bill includes $170 million for Injury Prevention and Control activities, including $6.6 million for TBI and $28.9 million for injury prevention activities.

Medicare Payment Advisory Board (MedPAC)

Current law requires that MedPAC be comprised of a mix of individuals with expertise in the financing and delivery of health care services and have a broad geographic representation. These include, but are not limited to, people with rural backgrounds and experience. The Government Accountability Office is directed to continue to follow the statute when making appointments to MedPAC.

Department of Education:

Rehabilitation - Client  Assistance Program

The bill includes $1 million in increased funding for Client Assistance State Grants to help people with disabilities obtain competitive, integrated employment through advocacy and the enforcement of their rights under the Rehabilitation Act.

Higher Education

The bill includes $2.5 million for a National Center for Information and Technical Support for Postsecondary Students with Disabilities and $11.8 million for the Model Comprehensive Transition and Postsecondary Programs for Students with Intellectual Disabilities (TPSID).

Social Security Administration (SSA):

The bill includes $35 million for a disability early intervention initiative as part of the research and demonstration budget. This demonstration project will test innovative and evidence-based approaches to help individuals with disabilities who are not yet receiving Social Security disability benefit remain in the workforce. The Social Security Administration (SSA) is directed to work closely with the Departments of Labor, Education, HHS, and other agencies as appropriate to develop and administer the project, including determining the appropriate target population and the types of interventions or services to be tested. SSA is also to ensure that participation in any demonstration is voluntary and that individuals are not required to waive any of their rights under the Social Security Act.

Veterans TBI Care Improvement Act

The Senate also passed H.R. 4276, the Veterans Traumatic Brain Injury Care Improvement Act, which amends the National Defense Authorization Act for Fiscal Year 2008. The act makes changes to the 2008 Assisted-Living for Veterans with Traumatic Brain Injury (AL-TBI) pilot program to place veterans with these severe injuries in residential living programs. Among the provisions, the legislation replaces references to "assisted living" with the term "community-based brain injury residential rehabilitative care."

Provisions were included to alter the reporting requirements under the pilot program to assess the effectiveness of providing assistance to eligible veterans with TBI to enhance their rehabilitation, quality of life, and community integration. In accordance with the legislation, the Secretary of Veterans Affairs is to submit reports to the congressional veterans committees on the pilot program for each quarter occurring between Jan. 1, 2015, and Sept. 30, 2017, with regard to:

•         the number of individuals who participated in the pilot program;

•         the number of individuals who successfully completed the program;

•         the degree to which pilot program participants and their family members were satisfied with the program; and

•         the interim findings and conclusions of the Secretary regarding the success of the program and recommendations for improving it.

Roughly 200 veterans have participated in the program since its inception. In August, Congress extended the AL-TBI program until 2017. BIAA has championed this program from the onset and has worked to continue its funding and viability.

ABLE Act

On Dec. 16, the Senate passed the Achieving a Better Life Experience (ABLE) Act and sent to the president for his signature. The ABLE Act allows for the creations of tax-exempt savings accounts for people born with disabilities or who are diagnosed with a disability by the age of 26. Families may set up accounts and deposit as much as $14,000 per year to pay for services that include transportation, health care, and other long term needs. Accounts can accrue up to $100,000 without impact on eligibility for government benefits, such as Social Security and Medicaid.

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