Policy Corner: July 13, 2018

House Appropriations Committee Advances FY 2019 Labor-HHS-ED Funding Bill

Yesterday, the House Appropriations Committee approved the fiscal year (FY) Labor, Health and Human Services (HHS), and Education spending bill to fund federal programs under those agencies’ jurisdictions beginning Oct. 1, 2018. In total, the draft bill includes $177.1 billion in discretionary funding, basically the same as the current funding level. With regard to brain injury, the Committee recommended $11,321,000 for the Traumatic Brain Injury (TBI) program, administered by the Administration for Community Living (ACL), which funds both Protection & Advocacy and state grants to improve service delivery. This is the same amount as the current year, which is $2 million more than the previous year and above the President’s budget request. The Senate Appropriations Committee has recommended the same amount. The House Committee recommended $5 million for the ACL Elder Falls program, which is the same as the FY 2018 enacted level and $5 million above the FY 2019 budget request, as the President’s budget calls for elimination of the program.

The House Appropriations Committee recommended level funding for the ACL National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) programs, which administers the TBI Model Systems. The Senate Appropriations Committee has recommended a $4 million increase for NIDILRR. Like the Senate Committee, the House Appropriations Committee has included language opposing moving the program to the National Institutes of Health (NIH), as proposed in the President’s budget.

With regard to the Centers for Disease Control (CDC) National Injury Center, the House Committee included $5 million in funding for the National Neurological Conditions Surveillance System. This new funding has been strongly supported by the Brain Injury Association of America (BIAA) to obtain further information regarding TBI in this country. The House Appropriations Committee recommended level funding for the National Injury Center’s TBI program.

The House Appropriations Committee included language transferring $57,500,000 from the NIH Innovation Account to NIH’s National Institute of Neurological Disorders and Stroke (NINDS) to support the BRAIN Initiative, as authorized in the 21st Century Cures Act (PL 114–255). The Committee also commended NIH for its successful implementation of the BRAIN Initiative and for its five-year partnership with an array of agencies to better understand the brain in order to improve treatment for brain conditions, including brain injury.

The House Committee encourages the Eunice Kennedy Shriver National Institute of Child Health and Human Development’s National Center for Medical Rehabilitation Research to provide greater support for research efforts on assistive health technology, particularly in underserved rural settings. This is in recognition of the significant challenges faced by patients with neurological impairments who live in rural areas, where access to assistive devices, medical advice, and community resources can be limited. The House Committee wrote that proper rehabilitation, with the help of patient ‘‘navigators,’’ is critical to improving quality of life and preventing further, and more costly, health problems.

Judge Blocks Kentucky’s Medicaid Work Requirements

At the end of June, a federal judge blocked work requirements for Medicaid beneficiaries, a requirement proposed by the state of Kentucky. The state submitted a waiver to the federal government in January to allow work requirements for certain Medicaid beneficiaries. The judge noted that the primary purpose of the Medicaid program is to provide health care and medical assistance and that the federal government had not considered how a work requirement would assist with that purpose. The U.S. Department of Health and Human Services (HHS) approved the state’s request to changethe Kentucky Medicaid program to require “able bodied” Medicaid recipients to either find work, engage in job training or volunteer work to be eligible for Medicaid benefits. Kentucky was the first state to receive such approval.

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