In September 2017, NASHIA membership voted on public policy priorities for the 116th Congress. To make the best use of our limited resources to cover the array of issues and the number of federal agencies and House/Senate committees involved, NASHIA lists its priorities under two categories: Primary Support and Secondary Support. Primary support issues relate to federal initiatives that directly impact public service delivery systems for individuals with brain injury and their families. NASHIA policy staff may initiate, research or draft legislative language or funding proposals; respond to federal rules and regulations; educate Members of Congress and other policy makers; and actively seek coalitions to partner with and to support brain injury initiatives.
NASHIA also supports (or opposes) and monitors other federal legislation, funding, and Administrative policies that affect injury prevention, research, health care, rehabilitation, and public assistance programs (i.e., TANF, SSI, Medicaid, housing assistance). These issues are noted under Secondary Support and advocacy is primarily conducted through collaboration with organizations and coalitions that promote these broader issues as their primary focus.
Increase funding for the Administration for Community Living (ACL) TBI State Partnership Grant Program.
Expand data capacity for determining national and state incidence and prevalence:
- Funding for National Injury Surveillance Pilot Project.
- Funding to support state surveillance initiatives (CDC)
- Expand data capacity for identifying individuals with TBI in institutional and nursing facility settings (CDC, CMS).
Promote opportunities for home and community long-term services and supports:
Money Follows the Person Program Legislation.
Disability Integration Act.
Lifespan Respite Care Reauthorization.
Funding for VR supported employment program.
Expand capacity of ACL programs to better address TBI (e.g., ADRCs, Assistive Technology, ILCs, I/D
Appropriate and adequate education for students with TBI.
Full funding for IDEA and reauthorization.
Return to Learn legislation.
Improved reporting of TBI in Child Fund.
Training for educators.
Violence Against Women Reauthorization (include TBI screening, training, accommodations/strategies, resource collaboration).
Juvenile justice and corrections legislation/funding (TBI screening, training, accommodations/strategies, resources to support community re-entry).
Individuals with TBI and co-occurring conditions (e.g., screening, best practice, professional training).
Individuals with TBI and neurobehavioral issues (e.g., best practice models, professional training, payment such as Medicaid/insurance).
Older adults with TBI (e.g., screening, education and training).
Support funding and policies for addressing homelessness among individuals with brain injury, including veterans.
3. Maintain and expand access to health care, trauma care and rehabilitation
Increase access to health care insurance plans that provide necessary rehabilitation and therapies.
Support Medicare/Medicaid reimbursement methods that support comprehensive post-acute rehabilitation, cognitive and behavioral therapies.
Support initiatives to support treatment for pain, but avoid dependence or overuse of opioids.
Oppose measures to block grant, cut and transfer the Medicaid program to the states.
Support legislation to improve EMS and trauma systems.
4. Expand research to promote best practices with regard to TBI treatment, care, rehabilitation and vocational rehabilitation:
Support funding to continue and expand Project BRAIN research.
Increase funding for TBI Model Systems (TBIMS) to expand the number of TBIMS and research projects.
Support research to improve understanding of concussion treatment, diagnosis and lingering effects.
Support funding for research and dissemination of best practices and models for VR services for youth and adults with TBI and for sustaining employments.
5. Support public assistance and safety net programs
Oppose work requirements which may present a hardship for individuals with brain injury or their caregivers with regard to such programs as housing assistance, Medicaid, SNAP (food stamps).
Support continued funding for SSI/Social Security, SNAP, housing assistance, TANF and other benefits necessary for individuals to survive and reside in the community.
Support the Medicaid Buy-In program, an optional State Medicaid benefit group for workers with disabilities who have earnings in excess of traditional Medicaid rules.
Support the ABLE Age Adjustment Act to extend eligibility to participate in the savings program from age of onset of disability from age 26 to age 46, in order to set aside money for future needs and still be eligible for public assistance.
6. Expand primary and secondary prevention related initiatives to reduce the number of TBI-related injuries and to minimize affects:
Increase funding for the CDC’s National Injury Center’s TBI program and integrate TBI among injury center prevention programs (e.g. injury and violence prevention, motor vehicle injuries, older adult falls, child abuse and neglect).
Support legislation to prevent and minimize sports-related concussions
Support elder-falls prevention initiatives and funding within ACL’s Administration on Aging (AoA) and CDC.
Proposed Federal Agency Rules and Regulations and Federal Plans
- Coalition to Preserve Rehabilitation sign on letter on Benefit and Payment Parameters for 2019 Related to Essential Health Benefits and other policies implementing Affordable Care Act, Nov. 27, 2017
- CDC Comments on Department of Education’s Website on IDEA, April 24, 2017
- NASHIA Comments on the NIDILRR Draft Long-Range Plan, 2018-2023, March 17, 2017
- Coalition to Preserve Rehabilitation Comments on Medicare Proposed Rule for Intermediate Rehabilitation Facility Prospective Payment, June 20, 2016
- Coalition to Preserve Rehabilitation Comments on Medicare Proposed Rule for SNF Prospective Payment and Consolidated Bill and SNF Value-Based Purchasing Program, June 20, 2016
- Coalition to Preserve Rehabilitation (CPR) Sign on Letter to CMS on Medicare Prior Authorization of Home Health Services Demonstration, April 5, 2016
- Coalition to Preserve Rehabilitation (CPR) Sign on Letter to CMS on Proposed Updates to the Medicare Advantage (MA) and Part D Programs, March 6, 2016
- DRRC Comments on the Proposed Rule on NIDILRR and Implementation of the WIOA, Feb. 19, 2016
- NASHIA Comments to ACL on Proposed ILC Rules, Jan. 15, 2016
- NASHIA Position Paper on Characteristics of HCBS Waivers, Submitted to CMS