Policy Corner: June 8, 2018

President Signs Veterans Bill

This week, President Trump signed the VA MISSION Act, which combined a number of existing private care programs, including the Veterans Choice Program, administered by the U.S. Department of Veterans Affairs (VA), and expanded private health care options, The VA Mission Act also expands caregivers assistance to families of veterans with disabilities. The Choice Program allowed veterans who lived more than 40 miles from a VA facility, or had to wait more than 30 days for an appointment, to have access to private care, but the program was time-limited and was to run out of funding May 31. VA continued funding until this bill was enacted.

The legislation expands caregivers assistance over two years to veterans of all eras, which previously was limited to post-9/11 veterans. The Congressional Budget Office (CBO) has estimated that more than 41,000 caregivers could be added to the program over the next five years at a cost of nearly $7 billion.

House and Senate Work on FY 2019 Spending Bills

Both the House of Representatives and Senate are working on spending bills to fund federal programs for fiscal year 2019, which starts Oct. 1. This week, the full House passed its first spending bill, which would fund Energy and Water, Military Construction and Veterans Affairs, and the Legislative Branch. Commonly called a “mini-bus,” the bill combined three spending bills. The House Appropriations Committee also marked up the fiscal year 2019 Defense Appropriations bill, drafted by the Subcommittee on Defense. The bill provides $125 million for traumatic brain injury (TBI) and psychological health research and $318 million for sexual assault prevention and response, all above the President’s request.

The Senate Committee on Appropriations also approved the spending bill for Military Construction, Veterans Affairs, and Related Agencies (MilCon-VA) this week and marked up the Transportation, House and Urban Development (HUD) and Related Agencies Appropriations Act 2019. The Committee recommended increasing resources to prevent veteran suicide, improve rural access to healthcare, support critical mental health programs, prevent veteran homelessness, and provide funding for innovative medical research. The bill includes $860.8 million for the VA Caregivers Program.

Appropriators recommended additional funding for HUD rental assistance programs that provide housing to individuals with disabilities or who are elderly as well as funding to improve housing and services for vulnerable populations, including veterans, youth, and survivors of domestic violence.

BIAA Supports Respite Care Funding

The Brain Injury Association of America (BIAA), along with other national organizations, has signed a letter to appropriators in support of funding for fiscal year 2019 respite and family caregiver support programs administered by the U.S. Department of Health and Human Services’ (HHS) Administration for Community Living (ACL). The letter calls for a modest increase to $5 million for the Lifespan Respite Program and continued funding for the National Family Caregiver Support Program. The appropriations bill for Labor-HHS-Education-Related Agencies tends to be one of the most difficult bills to gain consensus and, in past years, has been combined with other spending bills in a larger spending package.

BIAA Joins National Organizations in Supporting IDEA Full Funding Act

BIAA has joined other organizations in calling for full funding for the Individuals with Disabilities Education Act (IDEA). The House IDEA Full Funding Act, H.R. 2902, was introduced June 15, 2017, by Reps. Jared Huffman (D-Calif.), David McKinley (R-W.Va.), Tim Walz (D-Minn.), Dave Reichert (R-Wash.), Kurt Schrader (D-Ore.), and John Katko (R-N.Y.). The Senate IDEA Full Funding Act (S. 2542) was introduced March 13, 2018, by Sen. Chris Van Hollen (D-Md). Both the House and Senate bills were introduced to keep promises made in 1975, when the special education bill was first passed. Although Congress intended to pay 40 percent of the additional cost of educating IDEA-eligible students (based on the average per pupil expenditure), it has never come close to covering that amount.

A “Full Funding Briefing” will be held June 13 in Rayburn 2325 from 12-1 p.m. to call attention to the need for funding for special education and related services. This event is being co-hosted by National Center for Learning Disabilities, The School Superintendents Association (AASA), American Federation of Teachers (AFT), Consortium for Citizens with Disabilities (CCD), National Disability Rights Network (NDRN), National Association of State Directors of Special Education (NASDSE), The ARC, and Autism Society of America.

Advocates Push the ABLE Enhancement Act

Disability advocates are pushing for passage of the ABLE Age Adjustment Act (H.R. 1874/S. 817), which would amend Section 529A(e) of the Internal Revenue Code to increase the eligibility threshold for Achieving a Better Life Experience (ABLE) accounts for onset of disability from age 26 to age 46. ABLE accounts are tax-favored accounts that are designed to enable individuals with disabilities to save for and pay for disability-related expenses. The opportunity provided through the ABLE Act to assist in securing more financial stability for individuals with disabilities and their families is profound; however, it is limited to those individuals whose disability had an onset prior to the age of 26. Many individuals with brain injury who could benefit from ABLE accounts are left out, since brain injury can occur at any age.

TABLE programs that empower individuals with disabilities to achieve and maintain health, independence, and quality of life, have been implemented in 35 states. Millions of individuals with disabilities, including those with brain injury, who sustained their disabilities in their late twenties, thirties, forties, and later in life are unable to take advantage of this important savings tool. Advocacy organizations are working with Congress to pass the bill this year and are reaching out to both House and Senate members to encourage them to sign on to the bill and work for its passage.

ACL Convenes TBI Assessment Study Technical Expert Panel

The ACL is convening a Technical Expert Panel to support the completion of a study funded by the ACL and conducted by New Editions and the Lewin Group to assess the strengths and weaknesses of functional assessment tools used to determine level of care for individuals seeking eligibility for Medicaid Home and Community-based Services (HCBS) waivers and other programs that provide HCBS for individuals with TBI in all 50 states. This study is in response to states moving toward using universal testing tools across populations for brain injury and other HCBS waiver programs, such as waivers for individuals with physical disabilities, intellectual/developmental disabilities, and aging; long-term care waivers, and managed care waiver programs. The BIAA has been invited to serve on the panel.

BIAA gratefully acknowledges the Centre for Neuro Skills and Avanir Pharmaceuticals for their support for legislative action.