Policy Corner: February 19, 2024

Federal Updates

2024 Traumatic Brain Injury Program Reauthorization Act Introduced

On Wed., February 14, Rep Bill Pascrell, Jr. (D-N.J.), co-chair of the Congressional Brain Injury Task Force, introduced H.R.7209, the Traumatic Brain Injury (TBI) Program Reauthorization Act of 2024, to extend authorization from 2025 through 2029 for programs administered by the U.S. Department of Health and Human Services’ (HHS) Administration for Community Living (ACL) and the Centers for Disease Control and Prevention (CDC). Initially passed in 1996, the law authorizes funding to the ACL for state grants to improve access to rehabilitation and community services; grants to provide protection and advocacy services; and to CDC for prevention, research, and public education of TBI. Current authorization expires in 2024.

The House Energy & Commerce Committee, chaired by Cathy McMorris Rodgers (R-Wash.), held a hearing Wednesday on 19 bipartisan health and disability related legislation, including the TBI Act and H.R. 6960 to reauthorize the Emergency Medical Services for Children (EMSC) Program. Introduced by Rep. Earl L. “Buddy” Carter (R-Ga.), the bill extends funding for the EMSC program administered by HHS’ Health Resources & Services Administration (HRSA) for purposes of ensuring that children with a brain injury, severe illness, or other injury, have access to high quality, coordinated, and comprehensive emergency, trauma, and critical care services. Funding supports state and local grants and activities to reduce child and youth disability and death due to severe illness and injury. The program was established in 1984.

The committee also discussed H.R. 7300, sponsored by Rep. Mikie Sherrill (D-N.J.), to extend funding for the Family-to Family-to-Family Health Information Centers that are family-led organizations to support families of children and youth with special health care needs. HRSA provides grant funding for this program.

Rep. McMorris Rodgers has announced that she will not be running for reelection in 2024. She is a parent of a child with special health care needs, and, as such, has a special interest in services and resources for Americans with disabilities and other health care needs.

House Votes to Ban Metric Used to Deny Care for People with Disabilities and Chronic Illnesses

On February 7, the House of Representatives passed H.R. 485, the Protecting Care for All Patients Act, to ban federal health programs, such as Medicaid, from using Quality-Adjusted Life Years (QALYs) to value health outcomes. QALYs is the academic standard for measuring how well all different kinds of medical treatments lengthen and/or improve patients’ lives, and therefore the metric has served as a fundamental component of cost-effectiveness analyses in the U.S. and around the world for more than 30 years.

The legislation is led by House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-Wash.), House Ways and Means Committee Chair Jason Smith (R-Mo.), Rep. Michael Burgess, M.D. (R-Tx.), and Rep. Brad Wenstrup, D.P.M. (R-Ohio). Speaking on behalf of the bill, Rep. Rodgers said, “QALYs and other similar discriminatory measures assign a dollar value on the life of a patient to decide if a certain treatment is cost-effective, oftentimes discounting an individual’s worth and need for care solely because of their disability or chronic illness. Measurements like QALYs remove the consideration of unique circumstances and health conditions of a patient and their doctor’s judgment from deciding what’s best for the patient.”

U.S. Census Bureau Halts How It Asks About Disabilities

The Census Bureau has halted its proposed changes about questions relating to disabilities following a backlash from disability stakeholders. Several organizations, including the Brain Injury Association of America (BIAA), expressed concerns with the proposed changes to the American Community Survey (ACS) questions measuring disability and with the lack of involvement of disability stakeholders in the process of changing the ACS questions. Disability stakeholder believed the questions as proposed would undercount important subpopulations, including people with psychiatric conditions and those with chronic illnesses, as well as those who are living with a brain injury. The ACS provides data that is important to federal, state, local, and tribal governments to make informed decisions on the allocation of resources, planning, and responding to natural disasters.

State Updates

Iowa

House Bill 653 was introduced to the Iowa state legislature last week, which aims to organize and improve mental health and behavioral services throughout the state. If passed, this bill would designate the Department of Health and Human Services as the mental health authority for the state and would allocate resources to them to carry out mental health services. In addition, the bill would divide the state into behavioral districts in order to better serve the communities there. This bill designates brain injuries as a disability, which would allow individuals with qualifying brain injury symptoms to be treated under the new behavioral and mental health programs.

Mississippi

Earlier this month, Mississippi legislators introduced House Bill 959 which aims to address waiting periods mandated by Medicaid before receiving medical care. The bill specifically mentions that anyone who has sustained a traumatic brain injury will not have to endure any waiting period before receiving care through Medicaid.

New Mexico

A bill addressing several brain injury services was introduced to the New Mexico state legislature last month that. If passed SB 156 would create a Brain Injury Services Fund that could be used to institute and maintain a statewide brain injury services program designed to increase the independence of people with brain injuries. The healthcare authority department would be responsible for overseeing the fund and would be required to collaborate with the New Mexico Brain Injury Advisory Council to ensure that the program is appropriate for individuals who have sustained brain injuries. In addition to establishing the Brain Injury Services Fund, SB 156 proposes the creation of a Brain Injury Registry. This program would be primarily concerned with conducting brain injury surveillance in order to understand the prevalence and incidence of brain injury within the state of New Mexico. Any person who participates in the registry will receive information about brain injury treatment, services, supports, opportunities to participate in medical research and other appropriate information including access to direct services. The bill also proposes appropriations to be directed to various brain injury services throughout the state.

Oklahoma

A Senate bill concerning limitations on corporal punishment in schools was introduced to the Oklahoma state legislature earlier this month. If passed, the bill would prohibit schools from using certain forms of corporal punishment on students with select disabilities, among which traumatic brain injury was included.

Tennessee

Earlier in February, legislators in Tennessee introduced House Bill 2322 which requires certain health benefit plans to include coverage for treatment services required for and related to treatment of an acquired brain injury. The bill would specifically mandate that health benefit plans must include coverage of certain therapies used to treat acquired brain injuries including cognitive rehabilitation therapy, cognitive communication therapy, neurocognitive therapy and rehabilitation, neurobehavioral, and more. It would also prohibit health benefit plans from imposing certain limitations on the number of days of acute care, post-acute care, and covered inpatient care for acquired brain injuries, and makes additional changes related to such coverage.

Virginia

Virginia legislators introduced House Bill 1064 at the end of January, which if enacted would require the Department of Medical Assistance Services to modify an existing waiver or submit a new waiver to receive federal approval to administer home and community-based services for qualifying individuals with traumatic brain injuries or neurocognitive disorders.