Policy Corner: September 8, 2023
Categories: Policy Corner Archives
U.S. Senate Returns to Session While House is to Return Next Week
On Tuesday, the U.S. Senate returned to Washington, D.C. after a long August recess. The major task facing both the House and Senate is to pass a stop gap measure, referred to as a continuing resolution, to fund federal government past September 30 to avoid a government shut down. The House is expected to return September 12. Both bodies are far apart about funding amounts for federal government. The House is pushing for far less funding than what was agreed to in the debt ceiling bill, while the Senate has stayed within the agreed to limits in the spending bills recommended by the Senate Appropriations Committee. The Senate Appropriations Committee has recommended level funding for the TBI State Partnership Program (SPP) and for the CDC National Concussion Surveillance Program administered by the Centers for Disease Control and Prevention’s (CDC) National Injury Center.
ACL Transmits the TBI Report to Congressional Committees and Present
Last week, the U.S. Department of Health and Human Services’ (HHS) Administration for Community Living (ACL) transmitted the Traumatic Brain Injury (TBI) Act Programs Biennial Report to Congress for Fiscal Years 2019 and 2019 as required by the TBI Program Reauthorization Act of 2018 (Pub. Law 115-377). The report includes a listing of federal programs and resources to meet the requirement of the TBI Act of 2014 (Pub. Law 113-96) directing HHS to develop a TBI Coordination Plan. The report contains information on the ACL TBI State Partnership Program (SPP), the Protection & Advocacy for Individuals with TBI (PATBI) Program, and associated technical assistance and resource centers.
The purpose of the TBI SPP is to coordinate and expand resources across agencies to help people with brain injury and their families navigate multiple systems that provide services and supports to people with brain injury. ACL’s TBI Technical Assistance and Resource Center (TBI TARC) assists TBI SPP grantees to promote access to integrated, coordinated services and supports for people who have sustained a TBI, their families, and their caregivers. The Center also provides a variety of resources to non-grantee states, people living with brain injury, policymakers, and providers.
The PATBI program is to assess state, territory, and tribal Protection and Advocacy Systems’ responsiveness to TBI issues and provide advocacy support to people with TBI and their families. A national support center provides coordinated, comprehensive, and specialized training and technical assistance for P ATBI grantees. The report contains information on the activities, performance outcomes, and special projects of the grantees for fiscal years 2019 and 2020.
The report was sent to President Joe Biden; Senate Health, Education, Labor, and Pensions Committee (HELP) Chair, Bernie Sanders (I-Vt.), and Ranking Member Bill Cassidy, M.D. (R-La.); and House Energy & Commerce Chair Cathy McMorris Rodgers (R-Wash.) and Ranking Member, Frank Pallone (D-N.J.).
Federal Agencies Celebrate the 50th Anniversary of the Rehab Act of 1973
As this year marks the 50th anniversary of the passage of the Rehabilitation (Rehab) Act of 1973, several federal agencies have scheduled webinars and activities to highlight the various sections which relate to employment, housing, and vocational rehabilitation. The Rehab Act prohibits discrimination based on disability in programs conducted by federal agencies, in programs receiving federal financial assistance, in federal employment and in the employment practices of federal contractors. The Rehab Act also authorized the vocational rehabilitation (VR) program and independent living programs.
In commemoration of the anniversary, the Rehabilitation Services Administration (RSA) took part in the VR Workforce Studio podcast: Celebrating the 50th Anniversary of the Rehabilitation Act of 1973, which features VR success stories from across the country and is available throughout the month of September. The U.S. Department of Labor’s (DOL) Office of Disability Employment Policy (ODEP) will be conducting a variety of activities throughout the year, all centered on the theme “Advancing Access and Equity: Then, Now and Next.” The Administration for Community Living has also created a webpage featuring upcoming webinars on housing and the Independent Living movement and programs.
HHS Proposes to Update Section 504 Regulations Pertaining to HHS Program
Yesterday, September 7th, the U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) published a proposed update to the HHS regulations implementing Section 504 of the Rehabilitation Act of 1973, which prohibits disability discrimination by recipients of federal funding. Section 504 covers all health care and human services programs and activities funded by HHS, including hospitals and doctors that accept Medicare, Medicaid, and state child welfare programs. The proposed rule, which is to be published in the Federal Register September 14, clarifies obligations in several areas that are not explicitly addressed in the current rule and improves consistency with legislative developments since the current regulations were issued. These include:
- Discrimination in medical treatment: Ensures that medical treatment decisions are not based on biases or stereotypes about people with disabilities, judgments that an individual will be a burden on others, or beliefs that the life of an individual with a disability has less value than the life of a person without a disability. These include, for example, decisions about life-sustaining treatment, organ transplantation, rationing care in emergencies, and other vital medical decisions.
- Accessibility of medical equipment: Adopts the U.S. Access Board’s accessibility standards for medical equipment to address barriers like exam tables that are inaccessible because they are not height-adjustable, weight scales that cannot accommodate people wheelchairs, and mammogram machines that require an individual to stand to use them. The rule would require most doctor’s offices to have an accessible exam table and weight-scale within two years.
- Web, mobile app, and kiosk accessibility: Adopts the Web Content Accessibility Guidelines (WCAG) 2.1, Level AA accessibility standards for websites and mobile applications. It also requires self-service kiosks to be accessible. These provisions are particularly important given the increased use of websites, apps, telehealth, video platforms, and self-service kiosks to access health care.
- Child welfare programs and activities: Clarifies requirements in HHS-funded child welfare programs and activities to help eliminate discriminatory barriers faced by children, parents, caregivers, foster parents, and prospective parents with disabilities, such using the presence of a disability or an individual’s IQ score alone as a reason for removal of a child, prohibiting disabled parents from serving as foster parents, or failing to place disabled children who need services in the most integrated settings appropriate to their needs.
- Community integration: Clarifies obligations to provide services in the most integrated setting appropriate to a person’s needs, consistent with the Supreme Court’s decision in Olmstead v. L.C.
- Value assessment methods: To establish whether a particular intervention, such as a medicine or treatment, will be provided and under what circumstances, health care organizations often use a variety of methods to evaluate whether the benefits of the intervention outweigh the costs. These “value assessment methods” are an increasingly significant tool for cost containment and quality improvement efforts, but they may discriminate against people with disabilities when they place a lower value on extending the life of a person with disability. The proposed rule prohibits the discriminatory use of such methods to deny or limit access to aids, benefits, or services.