Policy Corner: May 21, 2021

House Passes 13 Health Bills

The House of Representatives passed 13 health care bills to improve mental health care, substance use disorder treatment, and suicide prevention impacted in part, by the COVID-19 pandemic. “The COVID-19 pandemic has intensified the pre-existing mental health care crisis in the United States. Now more than ever it is important that we invest in our nation’s mental health care infrastructure to ensure that Americans can readily access quality, culturally competent care in their communities. It’s also vitally important that we equip our first responders and health care providers with the tools and resources they need to properly care for their patients,” said Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ) and Health Subcommittee Chairwoman Anna G. Eshoo (D-CA). For a full list of the bills, click here.

Senator Casey Introduces Policy Reform Measures

Sen. Bob Casey, Jr. (R-Pa.) announced his plans to introduce two police reform bills to address police violence involving people struggling with mental health issues by diverting more 911 calls away from law enforcement and toward social services. The Human Services Emergency Logistic Program (HELP) Act of 2021 would increase access to social services and mental health resources in hopes of reducing police interactions with people with disabilities, those experiencing mental health crises, and more. The proposal would route more calls to 211, a number which refers callers to both private and public health and human service resources, as well as 988, the number for the National Suicide Prevention Lifeline. The Safe Interactions Act would appropriate funds for grants to nonprofit organizations to develop training programs that support safe interactions between law enforcement officers and individuals with disabilities and older individuals.

House Chairs Issue Statement on GAO Report on COVID-19 in Nursing Homes

Reps. Frank Pallone, Jr., (D-NJ), James E. Clyburn (D-S.C.), Richard E. Neal (D-Mass.), and Carolyn B. Maloney (D-N.Y.) issued a statement after the Government Accountability Office (GAO) released a report evaluating the spread of coronavirus in nursing homes across the United States. The press release expressed concerns for the inadequate response to the COVID-19 pandemic by the previous administration with regard to infection control protections, limited supplies of personal protective equipment, and staffing shortages that allowed the coronavirus to spread and cost lives in nursing homes across the country.

The GAO report found that 94% of the nursing homes included in its review experienced more than one coronavirus outbreak between May 2020 and January 2021. Of the nusing homes reviewed, 85% experienced outbreaks lasting five weeks or longer, with the majority of long-duration outbreaks starting between October and December 2020. The GAO also found that most nursing homes that experienced coronavirus outbreaks had received citations for infection prevention and control deficiencies in the years preceding the pandemic, and that shortages of personal protective equipment and staff increased the risk of COVID-19 being introduced and spreading in nursing homes.

Disability Organizations and Lawmakers to Hold Briefing on HCBS Next Week

In collaboration with Chairman Bob Casey, Jr. (D-Pa.), Senate Special Committee on Aging Rep. Debbie Dingell (D-Mich.), and the House Democratic Caucus Task Force on Aging and Families, several disability organizations are sponsoring a virtual briefing to provide information about Medicaid Home- and Community-Based Services (HCBS) and the proposed $400 billion investment in the American Jobs Plan May 26. The briefing panel will discuss how HCBS have been a benefit and explain a proposal to increase access to HCBS to people with disabilities and older Americans. In addition, the American Jobs Plan is to create and improve the quality of direct care jobs, the majority of which are overwhelmingly held by women, women of color, and immigrants. The briefing, “The American Jobs Plan and Medicaid Home and Community-Based Services (HCBS): Addressing the Unmet Needs of Aging Adults, People with Disabilities, and Family Caregivers,” will be held from 2-3:15 p.m. ET and is open to all Congressional staff and advocates. Click here to register.

BIAA Supports Appropriations for Brain Injury Research

As a member of the steering committee of the Disability and Rehabilitation Research Coalition (DRRC), the Brain Injury Association of America (BIAA) signed a  letter to appropriators offering recommendations and requests for program funding in Fiscal Year (FY) 2022. The funding would support federal research impacting people with brain injury, disabilities, illnesses, and chronic conditions, especially those suffering from acute or long-term impacts of COVID-19. DRRC seeks increased funding by $10 million for the National Institute on Disability, Independent Living, and Rehabilitation Research, $2 million in dedicated funding for the Interagency Committee on Disability Research, and $5 million for the Centers for Disease Control and Prevention’s National Concussion Surveillance System authorized by the Traumatic Brain Injury Program Reauthorization Act of 2018 (P. L. 115-377).

Along with funding for the ICDR, organizations support specific report language that addresses and emphasizes the integral role that ICDR should play in advancing equity for people with disabilities. The ICDR was established to promote coordination and collaboration among federal agencies conducting disability, independent living, and rehabilitation research.

BIAA Joins CPR in Supporting the Resetting the IMPACT Act of 2021

BIAA supported the Coalition to Preserve Rehabilitation (CPR) letter to members of Congress expressing support for legislation recently introduced by Reps. Terri Sewell (D-Ala.) and Vern Buchanan (R-Fla.), “The Resetting the IMPACT Act (TRIA) of 2021,” H.R. 2455. The letter urges representatives to support and co-sponsor this bipartisan legislation, which will reset and recalibrate the timeline for implementation of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act. This legislative reset will ensure that the development of a unified post-acute care (PAC) payment system will appropriately respond to the ongoing COVID-19 pandemic and evaluate newly generated data under the individual PAC payment systems.

The IMPACT Act of 2014 focused on the standardization and modernization of data collection in the four PAC settings – home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals. The bill also requires the Medicare Payment Advisory Commission and the Centers for Medicare and Medicaid Services to each develop prototypes for a payment system that would unify all four settings of care into one model.

CPR continues to have significant concerns that a unified PAC prospective payment system may compromise access to rehabilitative care for Medicare beneficiaries in need of these services. Given the recent (and ongoing) experience of Medicare beneficiaries in gaining access to rehabilitation services under the Patient-Driven Groupings Model (PDGM) and the Patient-Driven Payment Model (PDPM) in the Medicare home health and skilled nursing facility payment systems, BIAA continues to have significant concerns that any unified payment system for PAC could have negative implications on therapy access for beneficiaries, especially those with complex conditions and persons with brain injury. To standardize all PAC payments regardless of setting would limit or erase the existing and necessary differences in some of the treatment provided to differing patient populations served in the various PAC settings. Revisions and limitations to home health benefits are especially inappropriate, given the IMPACT Act’s focus on post-acute care; coverage of home health services is not limited to beneficiaries who were first hospitalized and so is not exclusively a PAC benefit.

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.