Monthly Archives: June 2010
Call Congress and tell them to Pass Health Care Reform Now!
Over the past week, you may have seen news reports suggesting that health care reform is in serious jeopardy. WE MUST INSIST THAT CONGRESS COMPLETE HEALTH CARE REFORM NOW!
Too many Americans with disabilities and chronic conditions are not well served by the current system and will make tremendous gains through enactment of health care reform.
Take action NOW! Starting TODAY and continuing until the final votes on legislation, call your members of Congress and tell them NOT TO GIVE UP ON AMERICANS WITH DISABILITIES AND CHRONIC CONDITIONS! TELL THEM THAT YOU WANT THEM TO CONTINUE FIGHTING FOR HEALTH CARE REFORM!!!
- Health care reform will end discrimination based on health status in the private market – discrimination that currently leaves millions of vulnerable Americans uninsured
- Health care reform will include new, affordable voluntary long term care insurance coverage—the CLASS Act—and expand Medicaid coverage for home and community based services
- Health care reform will expand Medicaid eligibility and provide subsidies in the private market, creating more affordable coverage for people with disabilities
- Health care reform will prohibit annual and lifetime limits on coverage so that individuals with serious conditions will not be forced into medical bankruptcy
CALL THE CAPITOL SWITCHBOARD AT 800-828-0498. (If you can’t get through on the 800 number, call the Capitol switchboard (202-224-3121) or your member’s district office.)
Tell your Senators and Representatives that NOW is the time for Congress to complete meaningful health care reform that prevents discrimination against people with pre-existing conditions, includes the CLASS Act and expands coverage of Medicaid home and community based services.
People with disabilities and their families cannot wait any longer for relief!
BIAA Health Care Reform Update
After the devastating Massachusetts special election, House and Senate leaders are expected to resume negotiations this week to attempt to finish the health care overhaul. Although a clear path is still unknown, BIAA will continue to monitor the situation closely. A big thank you to all of our grassroots advocates who answered the call last week to urge members of Congress to push forward on Health Care Reform!
State Concussion Legislation
Following the extraordinary success of BIA of Washington and BIA of Oregon in the adoption of state level sports concussion legislation, BIAA, in partnership with the Sports Legacy Institute, has become committed to encouraging, and assisting wherever possible, the enactment of sports concussion legislation in all states.
BIAA has developed a sample piece of legislation based on current laws and pending bills that exist throughout the country. This model legislation along with a sample testimony for use in state concussion hearings, distributed on January 25, 2010 to BIAA’s state affiliates, is a step foward in facilitating action in each state.
Due to the increased visibility of sports concussions within the National Football League in recent weeks, BIAA is encouraged that all states will be able to tip the scales in favor of protecting our youth athletes.
Brain Injury Awareness Day 2010
This year’s Brain Injury Awareness Day on Capitol Hill is set to take place on March, 17, 2010. BIAA will be unveiling our 2010 legislative agenda and encouraging the grassroots community along with state affiliates to participate in advocating for increased TBI Act appropriations, increased access to care, federal and state level concussion legislation, increased TBI research, military coverage of cognitive rehabilitation and caregiver assistance.
All issues mentioned will be outlined in fact sheets that advocates will receive that day and can use as reference during congressional visits and may leave behind for review by congressional staff.
Below is the schedule of events for the day:
10:00 AM – 1:00 PM - Brain Injury Awareness Fair, First Floor Foyer of the Rayburn House Office Building
2:30 PM – 4:00 PM - Briefing: “From the Playground to the Pros: A Heads-Up on Concussion”, Capitol Visitors Center – Congressional Meeting Room South
5:30 PM – 7:30 PM - Reception Celebrating Brain Injury Awareness Month, First Floor Foyer of the Rayburn House Office Building
Obama Funds the HRSA State Grant Program
This morning President Obama released his FY 2011 budget. Last week, the State of the Union address warned of spending freezes and tough decisions on what programs to keep and what programs to discontinue in the coming year.
BIAA is pleased to announce that the HRSA state grant program, authorized by the TBI Act, has been level funded in the President’s budget.
Although the appropriations process for 2011 is far from over, we are off to a good start. BIAA would like to make a push for increased appropriations for this program at the 2010 Brain Injury Awareness Day on March 17th on Capitol Hill. Please contact Sarah D’Orsie, Director of Government Affairs, BIAA at sdorsie@biausa.org if you are planning to attend.
BIAA Endorses the Christopher Bryski Student Loan Protection Act
This week, BIAA joined Congressman John Adler in support of a bill that would ensure a method be in place when applying for Federal or Private student loans to designate who will make decisions on your behalf regarding all medical, financial, and legal matters in the event you are catastrophically ill, catastrophically injured, temporarily disabled, permanently disabled or deceased.
On June 17, 2004, 23 year old Christopher Bryski fell forty five feet to the ground in a recreational accident. He sustained a severe Traumatic Brain Injury and was in a coma for approximately 4 weeks. After emerging from the coma Christopher remained in a persistent vegetative state for almost two years before passing away on July 16, 2006.
At the time of Christopher’s accident, he was in his third year of academic study at Rutgers University and needed to supplement his federal student loans with a private alternative education loan through a private lender, in which his father was a co-signer and is still liable after his death for the amount of the loan.
The bill introduced by Congressman Adler would address this important issue for parents and caregivers in the following ways:
Any private educational lender (i.e Citibank, Wells Fargo, Chase, PNC, etc.) shall:
- Discuss with the student and the cosigner of the loan the benefits of creating a power of attorney, in the event of the death of incapacity of the student or cosigner
- Define clearly and concisely the obligations of the cosigner, including the effect of death or incapacity of the student or cosigner
- Discuss with the student and the cosigner the benefit of credit insurance in connection with the loan, however the private educational lender may not require credit insurance or deny a loan on the basis that the borrower or any cosigner has not obtained credit insurance
- Gives power to the Federal Reserve to define death or incapacity in conjunction with the Secretary of Education and institute standards regarding the borrower’s or cosigner’s obligation if the borrower or cosigner were to die or become incapacitated
- Federal PLUS Loans and Federal Consolidation Loans:
- Discuss with the prospective borrower the uses and benefits of creating a durable power of attorney in the event of the death or incapacity of the borrower or the student on whose behalf the loan is borrowed by the parent borrower
- Amends Entrance Counseling requirements for Federal Loans:
- Provide information during entrance counseling that describes the loan discharge rules in the case of death of disability, and the possibility that private loans may not be discharged upon death or disability
- Provide information with respect to creating a durable power of attorney and its benefits and uses
Endurance training after traumatic brain injury
People who lead a sedentary lifestyle are prone to cardiovascular disease, osteoporosis, colon cancer, glucose intolerance, and depression—among other disorders. People with a traumatic brain injury often lead a sedentary lifestyle because of motor impairment and cognitive dysfunction, but have an additional detriment of a decreased aerobic capacity—running on as little as 64% of normal.
Research shows that sedentary people who participate in a formal exercise intervention (rather than a simple increase in activity) will decrease their risk of developing disease. Very few studies have been performed with traumatic brain injury survivors. However, a recent research review has shown that those few studies do support an intervention of endurance training.
The following guidelines were recommended for creating a safe and effective cardiorespiratory and endurance training program for people with traumatic brain injury:
- The exercise should be low-resistance, rhythmic, and dynamic (varied such as walking, jogging, cycling, etc).
- The intensity of training should somewhere between 60-90% of age-predicted maximal heart rate (normally 220 minus age).
- The duration should be no more than 20-40 minutes per session (depending on individual).
- The frequency should be no more than 3-4 times per week.
Mossberg KA, Amonette WE, & Masel BE. Endurance training and cardiorespiratory conditioning after traumatic brain injury. Journal of Head Trauma Rehabilitation. (May 2010).
Hyperglycemia and traumatic brain injury: Challenges to current clinical practices
Traditionally, it has been accepted that hyperglycemia (high blood sugar) at the acute stage of traumatic brain injury is associated with increased mortality and poor outcome. It has also, however, been shown that insulin therapy to reduce this hyperglycemia can induce hypoglycemia (low blood sugar), which is also associated with poor outcome.
Researchers recently completed an animal study in order to get a more precise picture of how hyperglycemia affects the brain in both acute and chronic stages of traumatic brain injury. There were three major outcomes:
- Hyperglycemia at the time of trauma did not increase cortical contusion volume.
- There was no adverse effect of hyperglycemia on motor skills or memory at the acute stage of trauma. Short-term memory was actually improved.
- Sustained hyperglycemia reduced cerebral edema. Insulin treatment was detrimental to this neuroprotective effect.
In conclusion, the authors suggested that neither acute nor sustained hyperglycemia negatively affects outcome in TBI. Furthermore, insulin intervention may increase secondary brain injury (edema).
Hill J, Zhao J, & Dash PK. High blood glucose does not adversely affect outcome in moderately brain injured rodents. Journal of Neurotrauma. (June 2010).
Cognitive deficits in TBI related to impaired driving
Among the multiple skills required to drive safely is the ability to visually scan one’s surroundings in order to adapt and respond to unexpected situations. In a study that compared traumatic brain injury patient to controls, subjects were connected to an eye-tracking device that mapped their visual field while completing a driving simulation.
The study found that people with traumatic brain injuries did not explore as many visual areas as the controls. Additionally, these deficits were associated with reduced scores on neuropsychological tests of attention. The study therefore provided an excellent model of how cognitive impairment translates to practical life. When making a decision to return to driving after a traumatic brain injury, neuropsychological tests of attention may be a useful tool.
Milleville-Pennel I, Pothier J, Hoc J-M, & Mathe J-F. Consequences of cognitive impairments following traumatic brain injury: Pilot study on visual exploration while driving. Brain Injury. (April 2010).
Tell your Senators to Extend Extra Medicaid Funding Through June 2011!
| Description | It is important that all grassroots advocates unite to support the extension of the current elevated Federal Medicaid Assistance Percentage (FMAP) that is currently being debated in the Senate and will be very important to states come the end of this year!Originally, both the House and the Senate acted to extend the extra match through June 2011, the end of the fiscal year for states. However, the offsets that were supposed to pay for this extension went instead to help pay for the health care reform legislation. Without an extension, the money will run out Dec. 31, 2010, and many states will be forced to make drastic cuts to the federal-state program. The 2009 federal stimulus package provided $87 billion to increase the federal share of the program through December (it included a 6.2% increase of the federal medical assistance percentage (FMAP) under Medicaid).
Last week, House Democrats debated HR 4213, the vehicle for this extension and chose to remove the provision extending extra federal Medicaid funding. With states in fiscal peril due to the recession and unemployment, it is vital that the extra federal funding continues in order to keep health care accessible for many brain injury patients and caregivers! |
| Scope | Everybody can Take Action |
| Target Legislators | All Federal Senate elected officials |
| Message To Target Legislators | As a person in your state affected by brain injury, I ask you to reinstate the extension of the current elevated Federal Medicaid Assistance Percentage (FMAP) into HR 4213. States are struggling financially due to the recession and increased unemployment and it is imperative that people with brain injury continue to receive access to care through this federal match. Your constituents deserve timely access to brain injury treatments so that they can become able to function within the community again, and avoid long term care, permanent disability, and as a result, increased financial strain on our public programs such as Medicaid.
I ask you not to ignore this devastating blow to access to affordable health care. While implementation of health care reform continues in the next few years, there are people in your state that need this important care now! |
Cognitive tests strongly associated with demographic variables, not neurological findings
A recent retrospective study of cognitive assessment in traumatic brain injury patients found no clear pattern of cognitive ability associated with neurological impairment.
Cognitive assessment—in the form of tests such as the WAIS (in various versions) or the HRB (Halstead-Reitan Neurological Test Battery)—is often administered early to traumatic brain injury patients in order to determine cognitive functioning, diagnosis, and rehabilitation requirements. However, this study concluded that age and employment status was more strongly associated to cognitive assessment results than neurological findings, such as injury severity.
The researchers looked specifically for clear patterns of cognitive impairment —such as lowered cognitive results associated with lowered neurological results. And there were some sub-groups of cognitive testing did show such as association (such as processing speed). However, their overall finding was that demographics played a stronger role in cognitive assessment results than neurological factors.
Goldstein G, Allen DN, & Caponigro JM. A retrospective study of heterogeneity in neurocognitive profiles associated with traumatic brain injuries. Brain Injury. (April 2010).
Acupuncture to treat brain injury
Electroacupuncture, which delivers electrical stimulation through acupuncture needles, has long been used for pain relief and stroke rehabilitation. A recent animal study has found evidence that electroacupuncture may also stimulate neuroprotective function after cerebral ischemia (lowered blood flow to the brain).
The researchers found that acupuncture administered to the “Bai hui” and “ Da zhui” acupoints activated astrocytes (a critical support cell in the brain), which in turn reduced neurodegeneration. In addition to a physiological benefit, electroacupuncture was associated with improved motor skills and sensory integration.
Electroacupuncture may therefore be a potentially beneficial clinical tool for the prevention of secondary brain injury, as well as a rehabilitation tool for motor and sensory impairments.
Han X, Huang X, Wang Y, & Chen H. A study of astrocyte activation in the periinfarct region after cerebral ischemia with electroacupuncture. Brain Injury. (May 2010).
