Policy Corner: May 30, 2024

Federal Updates

House Committee Advances the TBI Act Reauthorization Bill

On May 22rd, the House Committee on Energy and Commerce reported favorably H.R. 7208, the Dennis John Beningo Traumatic Brain Injury Program Reauthorization Act of 2024, which authorizes funding for U.S. Department of Health and Human Services brain injury programs through FY 2029. These programs are carried out by the Administration for Community Living (ACL) and the Centers for Disease Control and Prevention (CDC). The bill includes a new provision directing CDC to examine the evidence base for designating brain injury as a chronic condition that can impact individuals with brain injury across the lifespan and to issue a report on its findings no later than two years after the date of enactment of this Act. The next step is for the full House to consider the bill.

The bill is sponsored by Rep. Bill Pascrell, Jr. (D-N.J.) and co-sponsored by Reps. Eleanor Holmes Norton (D-D.C.); Michael Lawler (N.Y); Terri A. Sewell (D-Ala.); Raul M. Grijalva (D-Ariz.); Danny K. Davis (D-Ill.); and Dan Crenshaw (R-Tex.) The TBI Act was first passed in 1996 and has been reauthorized each time the programs were set to expire, with the last reauthorization enacted in 2018.

Congress Begins Work on FY 2025 Appropriation Bills

On May 16th, House Committee on Appropriations Chairman, Tom Cole (R-Okla.) released the topline funding allocations for the twelve Fiscal Year (FY) 2025 appropriation bills, which fund federal agencies and programs starting October 1, 2024. Overall, House leadership is proposing an increase of $9 billion for defense spending and a decrease of at least $67 billion for domestic spending programs, which include education, health, disability, research, housing, and other programs benefiting individuals with brain injury and other disabilities.

The Appropriation Subcommittees started marking up spending bills at the end of May and is scheduled to end June 27th, when the Labor-Health and Human Services (HHS)-Education and Related Agencies (LHHS) bill is scheduled for mark-up by the Subcommittee on LHHS, chaired by Rep. Cobert Aderholt (R-Ala.). The full Committee approved the FY 2025 Military Construction, Veterans Affairs, and Related Agencies Appropriations Bill on May 23. The full committee is to mark-up the LHHS bill on July 10th.

Senator Patty Murray (D-Wash.), chair of the Senate Appropriations Committee, has pledged to pair any increase for defense spending above the 1% allowed by the “Fiscal Responsibility Act of 2023” with an equal increase for FY 2025 domestic spending. The Committee/Subcommittees are holding hearings with the Subcommittee on LHHS reviewing the President’s FY 2025 budget request for the National Institutes of Health (NIH) on May 23rd. Monica Bertagnolli, M.D., Director of NIH presented testimony, which included an update on NIH’s research to understand Long COVID. The National Institute of Neurological Disorders and Stroke (NINDS), along with other NIH Institutes, are leading the research.

Senator Chris Van Hollen led efforts to obtain a sign-on letter to support increased funding for HHS programs, including the Administration for Community Living (ACL) Traumatic Brain Injury (TBI) Programs ($25 million) and CDC TBI Programs ($11.75 million), including $5 million for the National Concussion Surveillance System. A similar letter was submitted to the House Appropriations Committee by Reps. Bill Pascrell, Jr. (D-N.J.) and Don Bacon (R-Neb.), Co-chairs of the Congressional Brain Injury Task Force. This is the time to call and educate your Members of Congress on the importance of increased funding for people with brain injury. You can reach your Representative/Senators by calling the Capitol Switchboard at (202) 224-3121.

Lawmakers Introduce Alternatives to Guardianship Education Act

On May 8th, Senator Bob Casey, Jr. (D-Pa.) and Rep. Gay Scanlon (D-Pa.) introduced S. 4283/H.R. 8328, the Alternatives to Guardianship Education Act, to increase awareness of alternatives to guardianships. The bills require states to collect data on guardianships and to create grant programs to implement education programs to increase awareness of guardianship alternatives. The purpose is to offer people options to make decisions without guardianship. Guardianship and/or conservatorship is a legal process that occurs when a court determines that a person is incapable of making or communicating important decisions that affect the safety and welfare of the person. Guardianship may also impact the rights of a person, such as the right to consent to medical treatment, voting, possess a driver’s license, and/or to determine residence, unless the court determines otherwise. Guardianship is governed by state law and, as such, may differ across the country.

On March 30, the Senate Special Committee on Aging, chaired by Senator Casey, held a heading entitled, “Guardianship and Alternatives: Protection and Empowerment.” The hearing examined issues relating to guardianship, including the risk of abuse, neglect, and exploitation by guardians, and alternatives to guardianship, such as supported decision-making. Supported decision-making refers to a less restrictive model that appoints trusted advisors, such as friends, family, or professionals, to serve people who need support making decisions.