This week, a fiscal year 2011 spending measure was finally cleared by both the House and the Senate and will be sent promptly to the President’s desk. The White House issued a statement of administration policy soon after final passage that confirmed that President Obama would sign the bill.

Programs authorized through the TBI Act and the TBI Model Systems of care program were preserved in the final package. Now that FY11 has been cleared, BIAA will continue its work on FY12 appropriations soon to be debated in both chambers.

On April 8, 2011, BIAA submitted FY12 written testimony to both the Senate and House Appropriations Subcommittees on Labor Health and Human Services and Related Agencies. Both letters proposed the following funding increases for TBI Act programs and the TBI Model Systems of Care Program.

• $10 million (+ $4 million) for the Centers for Disease Control and Prevention TBI Registries and Surveillance, Brain Injury Acute Care Guidelines, Prevention and National Public Education/Awareness
• $8 million (+ $1 million) for the Health Resources and Services Administration (HRSA) Federal TBI State Grant Program
• $4 million (+ $1 million) for the HRSA Federal TBI Protection & Advocacy (P&A) Systems Grant Program
• $11 million (+ $1.5 million) for theTBI Model Systems of Care Program, and line item status within the broader NIDRR budget

Grassroots advocates should look for FY12 appropriations alerts in the coming months.

This week, House Budget Chairman Paul Ryan released a fiscal 2011 budget allocation that would cap spending at $1.055 trillion and slice $32 billion from current government spending levels this year. As many of you know, fiscal year 2011 spending is currently running on FY2010 levels through March 4, 2011.

The allocation by Ryan represents a $58 billion reduction below President Obama’s proposed fiscal 2011 budget request of $478 billion for non-security programs. As defined by Republican leaders, non-security spending includes all discretionary spending not for defense, homeland security, veterans and military construction.

Programs that fall into this category, such as TBI Act programs and the TBI Model Systems are at risk for budget cuts and BIAA is committed to advocating in their favor. As Congress draws near the March 4, 2011 appropriations deadline, the grassroots community should be poised to take action when BIAA alerts are distributed.

On June 15, 2010, BIAA and other TBI stakeholders met with Mary Wakefield, the Administrator of Health and Human Service’s (HHS) Health Resources and Services Administration (HRSA) to discuss the future of the federal TBI program, one of the programs funded through the TBI Act. The federal TBI program provides grants to states to improve access to care for people with brain injury.

The meeting was very positive and both the TBI stakeholders and HRSA are committed to working together to bring the attention needed to the program in order to grow the program and receive more funding for the TBI population in each state. HRSA has committed to working with stakeholders going forward to craft a strategic plan for the program and solicit public comment from appropriate entities such as BIAA state affiliates and state lead agencies in order to ensure that elevation of the program is successful.

BIAA is encouraged by the partnership forged between TBI stakeholders and HRSA and will continue to pass on important information as efforts progress.

On Thursday, April 22, 2010, the Senate cleared an omnibus veterans’ health care measure that provides important assistance to both veterans and caregivers.  S. 1963, as modified by the House, includes nearly $1.6 billion in authorizations for programs designed to aid caregivers of eligible veterans.

The measure, which now goes to the White House for President Obama’s signature, is intended to strengthen the health care support system for veterans and to expand services in rural areas. The measure will also expand caregiver programs, making them eligible for training and education assistance.

The bill also authorizes VA hospitals to contract with non-VA providers, as stated in the bill:

“The Secretary may contract with appropriate entities to provide specialized residential care and rehabilitation services to a veteran of Operation Enduring Freedom or Operation Iraqi Freedom who the Secretary determines suffers from a traumatic brain injury…”

Both BIAA and the Wounded Warrior Project have long advocated for approval of this measure and yesterday’s final passage signified a great victory for service members who suffer from TBI and their families.

Health Care Reform Update

After several weeks of delving into the final text of the health care reform bill, our partners at Powers,  Pyles, Sutter & Verville, PC, sponsored by BIAA’s Business and Professional Council, have prepared an analysis of the major provisions that impact our community.

BIAA will continue to work to identify and advocate for favorable regulations to ensure access to brain injury care as the process moves forward.

Serum S-100B is a type of protein that is related to glial cells (a type of cell that helps regulate and support neurons). Past studies have shown that an increase in S-100B is a sensitive indicator of brain injury in adults.

Evaluating mild traumatic brain injury is difficult in any situation, but it is especially so with children. There are increased complications with obtaining a CT scan, and it is challenging to obtain an accurate history or reliable measures of cognition.

A recent study in Sweden has shown that testing for S-100B is an accurate and reliable tool for determining mild traumatic brain injury in not only adults, but also children. Levels of S-100B can be easily obtained using urine or serum samples. Although the study used a cutoff time of six hours after injury to obtain a sample, the researchers suggested that by testing both urine and serum samples for S-100B, a reliable measurement might be obtained up to 24 hours after the trauma.

Although larger clinical studies would verify cutoff levels and times, it is useful to know that a sensitive marker could predict traumatic brain injury in an otherwise challenging population.

Hallen M, Karlsson M, Carlhed R, et al. S-100B in serum and urine after traumatic head injury in children. The Journal of Trauma: Injury, Infection, and Critical Care. (April 2010).

Health care reform at the federal level is officially on hold. Republican Scott Brown gained the Massachusetts seat vacated by the death of Edward Kennedy, thereby breaking the 60-vote majority in the Senate. Democrats met privately in the days following the Massachusetts special election but were unable to cultivate a strategy for moving forward at this time. A six‐week break is planned, and it is likely policymakers will be forced to accept a substantially scaled‐back package or abandon health care reform altogether.

The Brain Injury Association of America is deeply disappointed. Through our partnership with the Brain Injury Business & Professional Council, we made important gains in the proposed legislation. We cannot forgo this progress; we cannot quit now. We will continue to fight for access to the full continuum of brain injury treatment.

On January 24, 2010, Dateline NBC aired the compelling story of Patrick Gannon, a man who battled a severe anoxic brain injury and was then forced to wage war against his insurance company. The Dateline story accurately portrays how the health care system victimizes patients and families when they are most vulnerable.

I urge brain injury advocates everywhere to watch Patrick’s story and then write to Ann Curry, Dateline correspondent, to thank her for bringing national attention to the extraordinary challenges individuals with brain injury and their families face. I urge advocates to share their own stories with Ms. Curry and ask that she continue to educate the public about the rehabilitation needs of people with brain injury after their lives have been saved. Please address your letters to:

Ms. Ann Curry
Dateline / NBC News
30 Rockefeller Center, Studio 3B
New York, NY 10012

E-mail: Dateline@NBCUNI.com

Once you’ve written your letter (and sent copies to your legislators and BIAA), I ask that you share the Dateline story with friends and neighbors and that you encourage them to spread the story to others. With your help, we can tell the public that a brain injury can happen to anyone at anytime and that having insurance doesn’t mean you’re covered!

Very truly yours,

Susan H. Connors
President/CEO

Please send copies of your letters to your state and federal legislators and to me at BIAA’s address!

Brain Injury Association of America

1608 Spring Hill Road, Suite 110
Vienna, VA 22182

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

The Policy Corner is made possible by the Centre for Neuro Skills, James F. Humphreys and Associates, and Lakeview. Brain Injury Association of America gratefully acknowledges their support for legislative action.b

On March 3, 2010, BIAA made available its 2010 legislative fact sheets. The fact sheets outline the agenda for this year including, access to care for both civilian and military populations, TBI Act and research funding, TBI Act reauthorization, caregiver assistance, and support for the Congressional Brain Injury Task Force is now available on our home page!

Brain Injury Awareness Day 2010

Don’t forget that this year’s Brain Injury Awareness Day on Capitol Hill is set to take place on March, 17, 2010.

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

Hope to see you there!

Health Care Reform Update

House leaders this week prepared a schedule to bring health care reform to a vote before Congress adjourns for its two-week spring recess, which begins on March 26, 2010. BIAA continues to advocate for provisions important to the brain injury community and will alert grassroots advocates if action is necessary.

As most of you already know, March is brain injury awareness month! BIAA will be unveiling its 2010 legislative agenda on Tuesday, March 2, 2010. Fact sheets outlining the agenda for this year including, access to care for both civilian and military populations, TBI Act and research funding, TBI Act re authorization, caregiver assistance, and support for the Congressional Brain Injury Task Force will be available on our website starting Tuesday!

On February 22, 2010, in the wake of the legislative hold put on Congress after the recent Massachusetts election, the White House released an 11-page health care overhaul proposal that would extend coverage to more than 31 million people, at a 10-year cost of $950 billion. The White House says that the cost would be offset by spending reductions and tax increases, resulting in $100 billion of deficit reduction. CQ

Also this week, a bipartisan summit convened to discuss the administration’s health care plan. The White House facilitated the six-hour summit to focus on controlling costs, overhauling insurance regulations, reducing the deficit and expanding health coverage.

The group of 40 representatives and senators agreed on a new set of baseline insurance regulations but were still at odds about things like the cost of insurance premiums, patient choice issues, and deficit calculations.

BIAA is monitoring the situation closely and will continue to advocate for a health care reform plan that will provide people with brain injury access to the full continuum of care that they need and deserve.