From the Brain Injury Association of America:
Attorney Gordon Johnson
http://subtlebraininjury.com
http://tbilaw.com
https://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
Brain Injury Association of America
Policy Corner E-Newsletter – June 27, 2008
A weekly update on federal policy activity related to traumatic brain injury
__________________________________________________________________
Dear Advocates:
Legislative activity related to traumatic brain injury policy ensued on numerous fronts this week, as Congress made progress on several bills before leaving town for a week-long July 4 recess beginning on Monday.
Progress on appropriations occurred this week on the Senate side, as the full Senate Appropriations Committee marked up and approved its Fiscal 2009 Labor, Health and Human Services (HHS), and Education funding bill.
Meanwhile – on the other side of the Capitol – as marked up on the Subcommittee level last week, the House Labor, Health and Human Services (HHS), and Education Appropriations funding measure contains increased funding for some federal TBI programs. Unfortunately, this bill was not approved by the full House Appropriations Committee on Thursday, as a major breakdown in the Committee’s markup process occurred as a result of partisan disputes. The fate of all House appropriations bills are now uncertain.
Progress on several important bills not related to appropriations also took place this week. On Thursday, the Senate Veterans Affairs Committee approved provisions contained in S. 2921, The Caring for Wounded Warriors Act. BIAA has strongly supported and endorsed this legislation, which was recently introduced by Sen. Clinton (D-NY), and would strengthen supports for family caregivers of returning servicemembers with TBI.
On Wednesday, the House of Representatives passed the ADA Amendments Act of 2008 (H.R. 3195) with strong bipartisan backing by a vote of 402-15. Earlier in the week, BIAA formally endorsed this legislation, which is designed to strengthen protections for individuals with disabilities originally enacted through the Americans with Disabilities Act (ADA) in 1990.
Also this week, the Senate approved a compromise version of the war supplemental funding bill, readying the legislation for president’s expected signature. This legislation contained a moratorium – strongly supported by BIAA – on the implementation of several harmful Medicaid regulations.
Finally, the House and Senate were unable to agree on a final Medicare package, which would have prevented deep cuts beginning on July 1 in Medicare payment rates for physicians. Negotiations on such a package are expected to continue when Congress resumes session on Monday, July 7.
Please note that the next issue of Policy Corner will be published on Friday, July 11, as Congress is in recess next week.
*Distributed by Laura Schiebelhut, BIAA Director of Government Affairs, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637; lschiebelhut@biausa.org
BIAA’s Policy Corner and Legislative Action Alerts are made possible by the Centre for Neuro Skills, James F. Humphreys & Associates, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.
To sign up to receive future BIAA Policy Corner E-Newsletters and Legislative Action Alerts, please go to http://capwiz.com/bia/mlm/signup/
__________________________________________________________________
Labor-HHS-Education Appropriations Bill Advances in Senate; Stalls in House
Progress on appropriations occurred this week on the Senate side, as the full Senate Appropriations Committee marked up and approved its Fiscal 2009 Labor, Health and Human Services (HHS), and Education funding bill.
The Senate’s markup provided the same funding amounts for several TBI programs as last year, including $5.7 million for TBI programming within the Centers for Disease Control and Prevention (CDC) and $8.754 million for the HRSA TBI State Grant Program.
Meanwhile, on the other side of the Capitol, as marked up on the Subcommittee level last week, the House Labor, Health and Human Services (HHS), and Education Appropriations funding measure contains increased funding for some federal TBI programs compared to last year. The House Subcommittee markup includes $11 million for the HRSA TBI State Grant Program (+$2.246 million over last year) and $6.6 million for TBI programming within CDC (+$0.9 million over last year).
Unfortunately, though, this bill was not approved by the full House Appropriations Committee on Thursday, as a major breakdown in the Committee’s markup process occurred as a result of partisan disputes. In fact, partisan vitriol reached such a high level during the attempted House markup of the Labor-HHS-Education funding bill that Rep. Obey (D-WI), Chairman of the House Appropriations Committee, threatened not to allow any further progress to occur this year on House appropriations bills. Stay tuned.
Senate Veterans Affairs Committee Approves Caring for Wounded Warrior Act Provisions
On Thursday, the Senate Veterans Affairs Committee approved provisions contained in S. 2921, The Caring for Wounded Warriors Act, S. 2921. BIAA has strongly supported and endorsed this legislation, and several recommendations made by BIAA during the legislative drafting process were incorporated into the bill.
Provisions in the legislation, which was recently introduced by Sen. Clinton (D-NY), would strengthen supports for family caregivers of returning servicemembers with TBI. Specifically, provisions would require two pilot programs to be implemented through the Department of Veterans Affairs, improving the resources available to those caring for returning servicemembers with TBI.
A quote from BIAA President and CEO Susan H. Connors was included in Sen. Clinton’s press release announcing passage of the bill’s provisions:
“Traumatic brain injury not only affects individuals but entire families as well. The Brain Injury Association of America applauds Senator Clinton and Members of the Senate Veterans Affairs Committee for their leadership in passing this legislation, which compassionately and responsibly provides much-needed supports to family caregivers of servicemembers with TBI,” said Susan H. Connors, President and CEO of BIAA.
BIAA will continue to monitor the progress of this important bill, and thanks advocates for urging their Members of Congress to become cosponsors of this legislation.
House Passes ADA Amendments Act of 2008 By Wide Margin
On Wednesday, the House of Representatives passed the ADA Amendments Act of 2008 (H.R. 3195) with strong bipartisan backing by a vote of 402-15. Earlier in the week, BIAA formally endorsed this legislation, which is designed to strengthen protections for individuals with disabilities originally enacted through the Americans with Disabilities Act (ADA) in 1990.
The ADA Amendments Act of 2008 is the product of meaningful negotiations and discussions with experts in the disability community, business and employer groups, Members of Congress, and congressional staff. The measure prohibits consideration of mitigating measures in the determination of whether an individual has a disability, with the exception of ordinary eyeglasses and contact lenses. The bill also affords broad coverage for individuals “regarded as” having a
disability under the ADA.
A copy of BIAA’s endorsement letter, which was circulated to all Members of the House of Representatives prior to the vote this week, is available at http://www.biausa.org/policyissues.htm.
The Search for the Perfect Plaintiff
The technique almost all attorneys hired by insurance companies use to defend brain injury cases, is to blame all of the problems the injured person has after the accident on psychological problems the plaintiff had before the accident. The reason is that post concussional symptoms have much in common with the symptoms someone might have from depression. For that reason, defense attorneys and the doctors they hire will blame it on pre-morbid (pre-injury) factors, even if there is no documentation of such psychological issues beforehand.
Thus, experienced plaintiff attorneys become progressively more gun shy about representing someone who has had documented problems before they got hurt. History of migraine, don’t want the case; history of counseling, don’t want the case; prior accidents, don’t want the case. The list of reasons to not represent someone with a brain injury could go on for two pages, but suffice it to say I have heard lawyers I respect give entire lectures devoted to all the reasons not to represent someone.
To a degree, such caution is a self preservation instinct, because the amount of money and time a plaintiff attorney invests in a case. When a plaintiff attorney chooses the wrong brain injury case, not only do they risk not making any fee for his or her time (almost all of these cases are handled on a contingent fee basis) but the lawyer may lose tens of thousands of dollars in out-of-pocket costs, to get the case ready for trial. I confess to turning down cases that other lawyers are willing to take a chance on. My firm and our colleagues only have so much time and resources. Sometimes, there are just too many negatives to justify going forward.
Yet while I turn down many cases, I am turning down fewer cases because of concerns about a pre-morbid mental health issue. While such issues make a case more difficult, they also make it more significant. Concussion, quite simply, does not disable most people. But it does disable a significant minority, probably in the neighborhood of 15%. Pre-injury psychological problems might make a case more complicated, but to me, they also make it more credible. The “perfect plaintiff”, is considerably less likely to be the person disabled by a seemingly routine concussion. That person would likely have a steady improvement over the first few days after the concussion, and like young jocks, be back in the game a week or two later.
Yes, I suppose there are cases where a remarkable individual – with no clouds on their medical or emotional history – suffers a moderate to severe brain injury and becomes clearly disabled. But if you represent only the “perfect plaintiff” you will turn down far too many people whose cases merit representation. While I choose my challenges carefully, the challenge of connecting pre-morbid vulnerabilities to actual resulting pathology and disability, is one I am shying away from less and less.
Thus, experienced plaintiff attorneys become progressively more gun shy about representing someone who has had documented problems before they got hurt. History of migraine, don’t want the case; history of counseling, don’t want the case; prior accidents, don’t want the case. The list of reasons to not represent someone with a brain injury could go on for two pages, but suffice it to say I have heard lawyers I respect give entire lectures devoted to all the reasons not to represent someone.
To a degree, such caution is a self preservation instinct, because the amount of money and time a plaintiff attorney invests in a case. When a plaintiff attorney chooses the wrong brain injury case, not only do they risk not making any fee for his or her time (almost all of these cases are handled on a contingent fee basis) but the lawyer may lose tens of thousands of dollars in out-of-pocket costs, to get the case ready for trial. I confess to turning down cases that other lawyers are willing to take a chance on. My firm and our colleagues only have so much time and resources. Sometimes, there are just too many negatives to justify going forward.
Yet while I turn down many cases, I am turning down fewer cases because of concerns about a pre-morbid mental health issue. While such issues make a case more difficult, they also make it more significant. Concussion, quite simply, does not disable most people. But it does disable a significant minority, probably in the neighborhood of 15%. Pre-injury psychological problems might make a case more complicated, but to me, they also make it more credible. The “perfect plaintiff”, is considerably less likely to be the person disabled by a seemingly routine concussion. That person would likely have a steady improvement over the first few days after the concussion, and like young jocks, be back in the game a week or two later.
Yes, I suppose there are cases where a remarkable individual – with no clouds on their medical or emotional history – suffers a moderate to severe brain injury and becomes clearly disabled. But if you represent only the “perfect plaintiff” you will turn down far too many people whose cases merit representation. While I choose my challenges carefully, the challenge of connecting pre-morbid vulnerabilities to actual resulting pathology and disability, is one I am shying away from less and less.
Brain Injury and Clubs
Editor’s Note: On http://tbilaw.blogspot.com I am writing a very serious work on the Nightmare of Brain Injury. I thought these pics would be relevant and illustrative, but they disrupted the flow of what I was trying to say there, so I am posting them here.
And thank you Cindy for the images.
And thank you Cindy for the images.
Footnotes to the Nightmare of War Time Brain Injury
Editor’s Note: This week, I am engaged in an intense writing project on my other brain injury blog: http://tbilaw.blogspot.com on the Nightmare of Wartime Brain Injury. There are some footnotes and funnies that don’t really work as a direct part of that project, so I am posting them here. Later in the week, I will comment on Henry VIII’s brain injury here as it is quite pertinent to that topic as well. http://tbilaw.blogspot.com/2008/06/loss-of-smell-was-missed-sign-of-brain.html
Henry the VIII and Brain Injury Behavior Changes
From my co-author of https://waiting.com:
For those who watch the Showtime series, The Tudors, this season brought a lot of changes in the life of King Henry VIII. Although not happy with his new queen’s inability to deliver an heir, Anne’s prospects got a lot worse after the king suffered a fall from a horse in a jousting accident.One very believable theory as to why Henry VIII had such a dramatic change in weight was that he lost his sense of smell, which can dramatically change a person’s eating habits. See a related blog at http://tbilaw.blogspot.com/2008/06/loss-of-smell-was-missed-sign-of-brain.html
Some historians conjecture that Henry was severely affected by a leg injury he suffered at the time, but others further hypothesize that Henry, who is reported to have been unconscious for several hours, may have suffered a brain injury which led to the drastic change of behavior he exhibited towards Anne Boleyn after his fall.
When one considers the sort of activities the king engaged in prior to his fall -jousting tournaments and break neck hunting expeditions – it might be expected that the king most likely had a history of “knocks to the head”. Regardless, his perception of his wife, Anne, certainly became very distorted and in keeping with many of the symptoms of a brain injury.
Very suddenly, he became convinced that the woman he had risked a kingdom for, had seduced him with witchcraft and he became very susceptible to the reports of wrongdoings from her enemies at court. Eventually this led to several trials for infidelity and treason. Five men were accused on unconvincing evidence and sentenced to death, including her own brother, George Boleyn.
The signs are in the change of behavior in the king. When he had divorced Catherine of Aragon, although she was banished from the court, she was treated with some sort of compassion and her daughter Mary was given safe refuge. Not so, with Anne Boleyn. She was granted no mercy and the king was impatient for her execution and announced his betrothal to Jane Seymour 24 hours later, believing that he had a sign during his period of unconsciousness that she was his salvation.
It was a somewhat chilling reminder to me of the type of fill in memory that exists after a major brain injury, in which facts are easily distorted or replaced because the survivor must make sense out of the gaps which occur. I can easily imagine Thomas Cromwell’s whisperings to the king of Anne’s shortcomings suddenly becoming accepted as truth in an attempt by Henry to replace his own confusion.
Many of Henry’s behavioral changes are in keeping with the theory that he suffered a brain injury. Although his leg injury may have complicated his activities, his sudden disinterest in exercise and former activities certainly would help explain many of the medical symptoms he suffered from that point on, foremost being the obesity he suffered until the end of his life.
The reason I found this historical incident so intriguing is because it related to my own experience with a severe brain injury survivor in which confabulation played a key role. The survivor would fill in gaps with whatever information the people he had contact with gave him, true or false, he had no ability to discern reality himself. Thus, in a situation with hostile family members, this led to some very distorted views of his situation, despite proof to the contrary.
Not only did he fill in holes in his memory with random information, whatever information he was given was exaggerated with every telling. Given the facts of his accident, each time he repeated what he believed to have happened, it became more and more fantastic. This point struck me on The Tudors when Henry breaks down and cries that Anne had slept with hundreds of men when proof of her infidelity was sketchy at best.
It is no doubt, chilling, to realize that the 72,000 executions King Henry VIII ordered in his lifetime may have been perpetuated by an undiagnosed brain injury.
Regardless of the actual historical facts surrounding Henry’s injuries, the depiction that the writers for The Tudors chose to encompass was very true to the nature of brain injury. Henry had other injuries that the doctors were more concerned with and his head injury would have gone untreated. He was unable to discern that those around him had their own personal political agendas and became vulnerable to a desperation to fill in missing gaps in his own memory of the facts. He exaggerated fantastic gossip to mammoth proportions. His former grief and compassion for his enemies turned to an unemotional detachment towards those around him. And a former inclination for personal gratification escalated to a point that would make him an infamous character in history.
One can dispute the argument, but the change of person exhibited by Henry following his accident leaves many questions as to what damage actually occurred in his jousting accident.
Rebecca Martin
Bridge Back from Brain Injury Despair
In 1997, Becca Martin and I created https://waiting.com. It is certainly the most important thing I have done in my career. One of the most important contributions of that page was that its Bridge from Despair was the first internet collection of stories from those who had suffered the tragedy of brain injury on the internet. The internet was young then, and people were just beginning to discover the value of the connection it creates.
Yesterday I got this story, and I thought this blog would be a good place to tell this story, a story we will probably add to https://waiting.com/waitingbridge.html
Yesterday I got this story, and I thought this blog would be a good place to tell this story, a story we will probably add to https://waiting.com/waitingbridge.html
Dear Mr. Johnson,Thank you Lisa for allowing me to post your story on this blog.
10 months ago I had a serious car accident and was in coma for 1 week. I had 3 brain-bleedings and 2 brain contusions. While I was in the coma my parents were with me and spoke to me. My father is German and we live in Germany, my mother is English. And I think she spoke a lot in English with me, because since the coma I often think in English. I am very, very grateful to them that they were by my side. This is the most important thing in the world. The love of your parents. You feel it and you know that they are with you, although you are in the coma. To give this deep love is the most comforting and the most beautiful thig you can do to the person you love. And to know that there are people who don`t look at you like doctors look at their disabled patients is comforting. I want to thank you very much for your work. You really help the people. If you come back, sort of return to the world, it isn`t easy at all to talk to people about this time. Mostly they don`t understand, how could they?
I had just one possibility to get to know another person with a near death experience. And this was so different from mine. I don`t remember anything concerning the accident. And I even lost months of memory before the accident, but I can recall my near death experience. I saw multiple universes in higher dimensions. I`m sorry, I don`t know why I am telling you this. Maybe because I don`t know anyone I could talk to about this. Since I am reading books about the quantum-physical possibility of multiverses I feel a bit reliefed, because I know now, that there`s a scientific explanation for what I saw. But I know that every physicist I`d talk to about this topic would bring me to the booby hatch.
I know, that I was very lucky, that I can think again.
The neurologist couldn`t explain my improvement. Although I have problems remembering things, I want to finish the exams on the university in Munich. It might sound queer, but after I have been hating the woman who ran into me far too fast (and sometimes I still hate her and try not to do it) I thought that following Kant`s categorial imperative and wishing a peaceful earth for everyone, I hope that I can release the hate. And I am grateful that I was able to go through this near death experience.
You give the people hope, information and the feeling that one can talk about the accident. Thank you!
Lisa
alchwarizmi@web.de
TBI Support Group – Mint Julip
From one of our favorite former clients:
Thanks Cindy.
I had a good time at our TBI support group meeting today. It was a small group with only about 6 of us. Drake has changed their rules and does not allow us to serve or bring refreshments. We are only allowed to have them if we order them from Drake directly, which our TBI group can’t do since it does not have any funds.And the recipe:
So, I told our local TBI contact person that I would like to share with the group, the therapeutic value of growing mint. I brought several plastic baggies with mint plants along with the directions on How to Grow Mint in a Container Garden. I also shared with them the therapeutic value of making something with the mint….like Non-Alcoholic Mint Juleps. Pulling out all of the necessary items and the directions, I asked the group to help me figure out what we needed to do.We worked on a variety of skills at the beginning of our meeting. Cognitive skills like gathering together necessary materials, figuring out what materials we should distribute to everyone first, reading and following directions, sequencing. Physical skills and coordination involved in scooping ice out of a container with a ladle and placing it into a cup, using tongs to grab the mint sprigs and place in their cups. One member new to the group said the mint sprig should be placed in the top of the straw…so we had the added challenge of using very fine motor skills! Social skills like enjoying each other’s company, “clinking” our plastic cups together and sharing our hopes for this year. Another member came in late, so we re-tested our memory as we worked together to make a Mint Julep for her.
Today’s group was a rewarding experience for me. I was able to do a skill I used to do prior to my TBI on a smaller scale. It was fun and I felt great! And now I have to take a nap and recover.
Cindy
TBI (ALCOHOL-FREE) MINT JULEP
IngredientsDirections
- 1 cup water
- 1 cup white sugar
- _ cup (or more) fresh mint leaves, chopped
- Crushed ice
- Prepared lemonade
- Fresh mint sprigs, for garnish
To Make Mint Syrup:
- 1. Combine water, sugar and chopped mint in a pan. Bring to a boil and stir until sugar has dissolved.
- 2. Turn off burner and set pan aside for about an hour to cool down.
- 3. Strain out mint leaves by placing strainer over the container you are using for your mint syrup. (If the holes in your strainer are large enough to allow some of the leaves to go through, place a paper towel or coffee filter inside your strainer.)
- 4. Refrigerate mint syrup.
To Make Drink:–Cindy Schneider
- 1. Fill cup with ice. (Crushed ice works best)
- 2. Fill cup about _ full with prepared lemonade.
- 3. Pour a small amount of the mint syrup into your cup of lemonade. Taste and adjust according to your preference, adding more lemonade or more mint syrup if desired.
- 4. Garnish with a sprig of mint and a straw. Sip slowly and enjoy. (Especially good on a hot summer’s day.)
- 5. Optional: Make some sun tea and use in place of lemonade.
Thanks Cindy.
EDITORS NOTE: From the Brain Injury Association of America:
Attorney Gordon Johnson
http://subtlebraininjury.com
http://tbilaw.com
https://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
Brain Injury Association of America
Policy Corner E-Newsletter – April 4, 2008
A weekly update on federal policy activity related to traumatic brain injury
__________________________________________________________________
Dear Advocates:
This week BIAA submitted written testimony to the House Appropriations Subcommittee in charge of funding TBI programs within the Department of Health and Human Services and the Department of Education, urging an increase in Fiscal Year 2009 funding for TBI programs.
On Wednesday, April 2, the House Veterans Affairs Subcommittee on Oversight and Investigations held a hearing on TBI Related Vision Issues, which highlighted the high rate of vision disturbances in cases of servicemembers returing from Iraq and Afghanistan with TBI.
Also this week, the House Energy and Commerce Committee held a hearing on H.R. 5613, legislation recently introduced which would place a moratorium until March 2009 on seven Medicaid regulations issued by the Department of Health and Human Services. BIAA has endorsed this legislation, and signed a letter of support spearheaded by the Consortium of Citizens with Disabilities (CCD) in favor of the legislation.
Unfortunately, no activity occurred this week on H.R. 1418, the House version of legislation to reauthorize the TBI Act, which was passed by the House Energy and Commerce Act on March 13, 2008. BIAA will continue to advocate strongly for floor consideration of the bill by the entire House of Representatives and full passage by Congress into law as quickly as possible.
*Distributed by Laura Schiebelhut, BIAA Public Affairs Manager, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637; lschiebelhut@biausa.org
The Policy Corner is made possible by the Adam Williams Initiative, Centre for Neuro Skills, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.
__________________________________________________________________
BIAA Submits Testimony to House Labor-HHS-Education Appropriations Subcommittee
This week BIAA submitted written testimony to the House Appropriations Subcommittee in charge of funding TBI programs within the Department of Health and Human Services and the Department of Education. BIAA’s testimony urges an increase in Fiscal Year 2009 funding for programs authorized through the TBI Act, as well as for TBI research programs conducted within the National Institute on Disability and Rehabilitation Research (NIDRR).
In the testimony, BIAA’s President and CEO Susan H. Connors states, “BIAA was gravely disappointed that last year, even as Congress had the good judgment to add hundreds of millions dollars to the budgets of the Department of Defense and the Department of Veterans Affairs to help address the problem of TBI among returning servicemembers, funding for the HRSA Federal TBI Program was reduced from $8.91 million to $8.754 million.”
Within the testimony, BIAA requests $30 million in funding for programs authorized through the TBI Act, as well as sufficient funding to sustain and increase medical rehabilitation research within NIDRR. The testimony also urges an allocation of at least $8.3 million to allow NIDRR to continue to fund 16 TBI Model Systems research centers.A copy of the testimony can be obtained by visiting BIAA’s website at the following address: http://www.biausa.org/policyissues.htm.
House VA Subcommittee Holds Hearing on TBI And Vision Problems
On Wednesday, April 2, the House Veterans Affairs Subcommittee on Oversight and Investigations held a hearing on TBI Related Vision Issues.
Testimony highlighted the high rate of vision disturbances in cases of servicemembers returing from Iraq and Afghanistan with TBI, and the need for a seamless system of care within the Department of Defense and Department of Veterans Affairs to address these eye injuries, including greater use of specialized vision screening.
In the hearing, the Blinded Veterans Association (BVA) noted research showing that 75 percent of servicemembers with documented TBI injuries also have complaints about vision problems, and that approximately 60 percent of those injured have associated neurological visual disorders. A study conducted by one of the panelists, Gregory L. Goodrich, who is a research psychologist at the VA Palo Alto Health Care System, found that both Polytrauma Level I and Level II patients had high rates of visual impairment and/or visual dysfunction, and that injuries caused by a blast event were associated with more vision related loss and/or deficits than other causes.
In his testimony, Tom Zampieri, Director of Government Relations at BVA, asserted, “At present the current system of screening, treatment, tracking, and follow-up care for TBI vision dysfunction is inadequate. Adding visual dysfunction to this complex mix, especially if undiagnosed, makes attempts at rehabilitation even more daunting and potentially disastrous unless there are significant improvements soon.”
Mr. Zampieri urged the Subcommittee to request that DoD/VA provide for the full implementation of the “Military Eye Trauma Center of Excellence and Eye Trauma Registry,” which was recently authorized as one of the Wounded Warrior provisions in last year’s defense authorization bill (H.R. 4986). BIAA has officially endorsed legislation (S. 1999) to create such a Center.
BIAA Supports Bill to Enact Moratorium on Harmful Medicaid Regulations
Also this week, the House Energy and Commerce Committee held a hearing on H.R. 5613, legislation recently introduced which would place a moratorium until March 2009 on seven Medicaid regulations issued by the Department of Health and Human Services. BIAA has endorsed this legislation, and signed a letter of support spearheaded by the Consortium of Citizens with Disabilities (CCD) in favor of the legislation.
The legislation, which was introduced by Representatives John D. Dingell (D-MI) and Tim Murphy (R-PA) on March 13, 2008, would delay the implementation of seven harmful Medicaid regulations through March 2009, including several rules which would be especially deleterious to individuals with traumatic brain injury.
One of these rules would limit rehabilitation services for Medicaid beneficiaries, severely curtailing the ability of people with disabilities – including TBI – to receive rehabilitation services now covered under Medicaid. Access to these rehabilitative services is essential, as in many cases, these services play a vital role in allowing people with TBI to live independently in the community.
Attorney Gordon Johnson
http://subtlebraininjury.com
http://tbilaw.com
https://waiting.com
http://vestibulardisorder.com
http://youtube.com/profile?user=braininjuryattorney
g@gordonjohnson.com
800-992-9447
Brain Injury Association of America
Policy Corner E-Newsletter – April 4, 2008
A weekly update on federal policy activity related to traumatic brain injury
__________________________________________________________________
Dear Advocates:
This week BIAA submitted written testimony to the House Appropriations Subcommittee in charge of funding TBI programs within the Department of Health and Human Services and the Department of Education, urging an increase in Fiscal Year 2009 funding for TBI programs.
On Wednesday, April 2, the House Veterans Affairs Subcommittee on Oversight and Investigations held a hearing on TBI Related Vision Issues, which highlighted the high rate of vision disturbances in cases of servicemembers returing from Iraq and Afghanistan with TBI.
Also this week, the House Energy and Commerce Committee held a hearing on H.R. 5613, legislation recently introduced which would place a moratorium until March 2009 on seven Medicaid regulations issued by the Department of Health and Human Services. BIAA has endorsed this legislation, and signed a letter of support spearheaded by the Consortium of Citizens with Disabilities (CCD) in favor of the legislation.
Unfortunately, no activity occurred this week on H.R. 1418, the House version of legislation to reauthorize the TBI Act, which was passed by the House Energy and Commerce Act on March 13, 2008. BIAA will continue to advocate strongly for floor consideration of the bill by the entire House of Representatives and full passage by Congress into law as quickly as possible.
*Distributed by Laura Schiebelhut, BIAA Public Affairs Manager, on behalf of the Brain Injury Association of America; 703-761-0750 ext. 637; lschiebelhut@biausa.org
The Policy Corner is made possible by the Adam Williams Initiative, Centre for Neuro Skills, and Lakeview Healthcare Systems, Inc. The Brain Injury Association of America gratefully acknowledges their support for legislative action.
__________________________________________________________________
BIAA Submits Testimony to House Labor-HHS-Education Appropriations Subcommittee
This week BIAA submitted written testimony to the House Appropriations Subcommittee in charge of funding TBI programs within the Department of Health and Human Services and the Department of Education. BIAA’s testimony urges an increase in Fiscal Year 2009 funding for programs authorized through the TBI Act, as well as for TBI research programs conducted within the National Institute on Disability and Rehabilitation Research (NIDRR).
In the testimony, BIAA’s President and CEO Susan H. Connors states, “BIAA was gravely disappointed that last year, even as Congress had the good judgment to add hundreds of millions dollars to the budgets of the Department of Defense and the Department of Veterans Affairs to help address the problem of TBI among returning servicemembers, funding for the HRSA Federal TBI Program was reduced from $8.91 million to $8.754 million.”
Within the testimony, BIAA requests $30 million in funding for programs authorized through the TBI Act, as well as sufficient funding to sustain and increase medical rehabilitation research within NIDRR. The testimony also urges an allocation of at least $8.3 million to allow NIDRR to continue to fund 16 TBI Model Systems research centers.A copy of the testimony can be obtained by visiting BIAA’s website at the following address: http://www.biausa.org/policyissues.htm.
House VA Subcommittee Holds Hearing on TBI And Vision Problems
On Wednesday, April 2, the House Veterans Affairs Subcommittee on Oversight and Investigations held a hearing on TBI Related Vision Issues.
Testimony highlighted the high rate of vision disturbances in cases of servicemembers returing from Iraq and Afghanistan with TBI, and the need for a seamless system of care within the Department of Defense and Department of Veterans Affairs to address these eye injuries, including greater use of specialized vision screening.
In the hearing, the Blinded Veterans Association (BVA) noted research showing that 75 percent of servicemembers with documented TBI injuries also have complaints about vision problems, and that approximately 60 percent of those injured have associated neurological visual disorders. A study conducted by one of the panelists, Gregory L. Goodrich, who is a research psychologist at the VA Palo Alto Health Care System, found that both Polytrauma Level I and Level II patients had high rates of visual impairment and/or visual dysfunction, and that injuries caused by a blast event were associated with more vision related loss and/or deficits than other causes.
In his testimony, Tom Zampieri, Director of Government Relations at BVA, asserted, “At present the current system of screening, treatment, tracking, and follow-up care for TBI vision dysfunction is inadequate. Adding visual dysfunction to this complex mix, especially if undiagnosed, makes attempts at rehabilitation even more daunting and potentially disastrous unless there are significant improvements soon.”
Mr. Zampieri urged the Subcommittee to request that DoD/VA provide for the full implementation of the “Military Eye Trauma Center of Excellence and Eye Trauma Registry,” which was recently authorized as one of the Wounded Warrior provisions in last year’s defense authorization bill (H.R. 4986). BIAA has officially endorsed legislation (S. 1999) to create such a Center.
BIAA Supports Bill to Enact Moratorium on Harmful Medicaid Regulations
Also this week, the House Energy and Commerce Committee held a hearing on H.R. 5613, legislation recently introduced which would place a moratorium until March 2009 on seven Medicaid regulations issued by the Department of Health and Human Services. BIAA has endorsed this legislation, and signed a letter of support spearheaded by the Consortium of Citizens with Disabilities (CCD) in favor of the legislation.
The legislation, which was introduced by Representatives John D. Dingell (D-MI) and Tim Murphy (R-PA) on March 13, 2008, would delay the implementation of seven harmful Medicaid regulations through March 2009, including several rules which would be especially deleterious to individuals with traumatic brain injury.
One of these rules would limit rehabilitation services for Medicaid beneficiaries, severely curtailing the ability of people with disabilities – including TBI – to receive rehabilitation services now covered under Medicaid. Access to these rehabilitative services is essential, as in many cases, these services play a vital role in allowing people with TBI to live independently in the community.