Policy Corner: May 14, 2021

Sen. Van Hollen Circulates “Dear Colleague” Letter to Support TBI Funding

Sen. Chris Van Hollen (D-Md.) is circulating a “Dear Colleague” letter to support additional funding for fiscal year 2022 to the U.S. Department of Health and Human Services for traumatic brain injury (TBI) programs carried out by the Administration for Community Living (ACL) and the Centers for Disease Control and Prevention (CDC). The letter supports an additional $19 million for the ACL State Partnership Program to expand state TBI grant to improve access to rehabilitative and community services and supports, an additional $6 million to increase the number of grant awards to state Protection and Advocacy programs, and an additional $6.6 million for the TBI Model Systems (TBIMS) administered by the ACL’s National Institute on Disability, Independent Living, and Rehabilitative Research (NIDILRR). The proposed increase for NIDILRR is to increase the number of TBIMS; expand collaborative research projects; and increase funding for the National Data and Statistical Center to allow tracking of all participants over their lifetime. In addition, the letter supports $5 million to the CDC to establish the National Concussion Surveillance System as authorized by the TBI Programs Reauthorization of 2018.

The deadline for senators to sign on is May 21. Advocates are encouraged to contact their senators to ask that they sign on to this letter. Lawmakers may email Christina Ramsay in Sen. Van Hollen’s office if they have questions or wish to sign on.

Sens. Announce Legislation to Improve Work Opportunities for Older Adults with Disabilities

Sen. Tim Scott (R-S.C.) issued a news release regarding the “Supporting and Empowering the Nation to Improve Outcomes That Reaffirm Careers, Activities, and Recreation for the Elderly (SENIOR CARE) Act.” This bipartisan legislation would lift the Ticket to Work Program’s Medicaid age restriction, allowing Americans with disabilities over the age of 65 to continue to work and remain eligible for Medicaid. The Ticket To Work and Work Incentives Improvement Act of 1999 created opportunities to increase workforce participation by expanding Medicaid’s income eligibility limits for Americans with disabilities. The expansion allowed citizens with disabilities to accept higher-paying jobs without sacrificing Medicaid coverage. The 1999 law, however, capped the participation age at 65, thus preventing people with disabilities from continuing to work past age 65 and retain their Medicaid coverage. The SENIOR CARE Act, S. 1476, would remove the age limit and ensure every senior with disabilities has the opportunity to work beyond age 65 and remain eligible for Medicaid. Senate Special Committee on Aging Chairman Bob Casey, Jr. (D-Pa.) and Sens. Rob Portman (R-Ohio) and Catherine Cortez Masto (D-Nev.) are also bill sponsors.

Lawmakers Introduce Legislation to Train Direct Care Workers

Reps. Bobby Scott (D-Va.), Susan Wild (D-Pa.), and Susie Lee (D-Nev.) introduced the “Direct Creation, Advancement, and Retention of Employment (CARE) Opportunity Act,” H.R. 2999, to address the shortages of direct care workers who provide daily assistance to millions of people with brain injury, people with disabilities, older Americans, and others with chronic care needs. These workers include personal care aides, home health aides, and nursing assistants. The bill proposes to provide funding to states and entities to invest in strategies to recruit, retain, and advance the direct care workforce pipeline.

CMS Issues Guidelines for Enhanced Federal Match for HCBS

The Centers for Medicare & Medicaid Services (CMS) announced that it is issuing guidance on how states can receive enhanced funding provided through the American Rescue Plan Act of 2021 (ARP) to increase access to home and community-based services (HCBS) for Medicaid beneficiaries. The guidance is a key tool to assist states in leveraging federal resources to increase health equity in Medicaid beneficiaries’ access to HCBS, positive health outcomes, and community integration. In accordance with the ARP, states may use the temporary 10% increase in federal funding for certain HCBS services as outlined in a letter to State Medicaid Directors. About half of the states administer HCBS waiver programs for individuals with brain injury, with a few other states offering HCBS services under their State Plan HCBS benefit or 1115 waiver or managed care arrangement. Click here to read the HHS press release.

BIAA gratefully acknowledges the Centre for Neuro Skills and Avanir Pharmaceuticals for their support for legislative action. Click here to read past issues of Policy Corner.