Capitol News! June 8, 2021

Volume XVIII, Issue 5, June 8, 2021

                                         Capitol News!
                                                  June 8, 2021

Dear NASHIA Member,

Greetings and welcome to Capitol News!, Vol. 18, Issue 5. This issue is a Special Edition
highlighting the President's Budget for fiscal year (FY) 2022 that impacts individuals with brain
injury and their families. Now that the President has released his full budget requests, House
and Senate Appropriations Committees are working on their recommendations for funding
federal government for FY2022, which begins October 1. NASHIA has submitted testimony to
the House Appropriations Subcommittee on Labor, Health and Human Services (HHS),
Education, and Related Agencies and will submit similar testimony to the Senate
Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies later this
month.

Meanwhile, NASHIA is planning a Public Policy Zoom webinar yet this month to provide an
update on the President's Budget, as well as other legislation that NASHIA is tracking. We are
planning to hold the webinar on Friday, June 18, at noon (ET), so watch for a flier announcing
this opportunity.

As a reminder, NASHIA’s public policy materials are located on its website, both on the public
page and Members Only section (publications). Should you have any questions or comments,
please feel free to send to publicpolicy@nashia.org.

Fiscal Year (FY) 2022 Appropriations
President Releases FY 2022 Budget Proposal
Late Friday afternoon, May 28, the White House released President Biden's proposal for
federal spending for FY 2022. The President’s Budget builds off the American Rescue Plan
Act of 2021, which is the $1.9 trillion package enacted earlier this year to address the
COVID-19 pandemic, including the public health and economic impact. The Budget proposal
includes the two plans the President has already put forward—the American Jobs Plan and the
American Families Plan—and outlines a package of discretionary proposals to help restore
core functions of Government. Budget highlights include investments in public health
infrastructure; expanding access to mental health care; additional funding to support the needs
of those who are involved in the criminal justice system; resources to partner mental health
providers with law enforcement; increasing funding at the Department of Health and Human
Services (HHS) for domestic violence shelters and community-based programs; funding to

addresses racial disparities in healthcare; funding to combat gun violence; funding to end the
opioid epidemic; and funding to increase access to health care and child care, among other
priorities. The following are highlights that may be of interest.

U.S. Department of Health and Human Services HHS
The FY 2022 budget for the U.S. Department of Health (HHS) proposes $131.8 billion in
discretionary budget authority and $1.5 trillion in mandatory funding. The President's Budget
prioritizes access to healthcare by expanding health care coverage across the Centers for
Medicare & Medicaid Services (CMS) programs and expanding provisions of the Affordable
Care Act by extending the premium subsidies and opportunities to apply for enrollment in
Marketplace health care coverage. The Budget also supports reforms to lower the costs of
prescription drugs and efforts to address the co-occurring public health crisis of mental health
and substance use.

Administration for Community Living (ACL)
The President’s Budget for the Administration for Community Living (ACL) recommends $3.124
billion, an increase of $768 million above FY 2021 funding, to increase aging and disability
programs. These proposals are in keeping with ACL’s budget priorities, which are:

   •   Providing direct services, particularly home and community-based support services
   •   Accelerating COVID-19 recovery
   •   Supporting caregivers
   •   Advancing equity

The President’s Budget recommends $12 million for the ACL Traumatic Brain Injury (TBI)
program, which is $1 million more than the FY 2021 enacted level and funds the Protection &
Advocacy and State grant programs. The Budget also proposes a $6 million increase for the
National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR)
program, for a total of $119 million. The proposed increase will allow the program to increase
the number of grants made through its field-initiated grant competitions and to fund three new
Rehabilitation Research and Training Centers focused on equity, one in each of three outcome
domains: community living and participation, employment, and health and function.

Recommendations include:

   •   Nutrition (+390 million)
   •   Preventive Health Services (+$1 million)
   •   Aging Network Support Activities (+3 million)
   •   Independent Living Programs (+$32 million)
   •   Developmental Disabilities Programs (+21 million)
   •   Aging Disability Resource Services (+$15 million)
   •   Assistive Technology (+$7 million)
   •   Lifespan Respite Care ($7million)
   •   Family Caregiver Support Services (+61 million)
   •   Home and Community-Based Supporting Services (+$158 million)

(View the recommendations for disability and caregiver programs compared to the past two
years here.)

Centers for Disease Control and Prevention – Injury Center
The President’s Budget requests $15.4 billion for the Centers for Disease Control and
Prevention (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR). The
President’s Budget includes over $550 million for programs administered through the National
Center for Injury Prevention and Control (NCIPC). These recommendations are to reduce all
forms of violence–including community violence, gun violence, intimate partner violence,

gender-based violence, and sexual violence. The budget includes an additional $5 million for
domestic violence community projects; an additional investments of $12.5 million, for a total of
$25 million, for firearm injury and mortality prevention research and data collection to identify
the most effective ways to prevent firearm related injuries and deaths. View the NCIPC
recommendations compared to the past two years here.

The budget does not include $5 million for a national concussion surveillance system
authorized by the TBI Program Reauthorization Act of 2018 that NASHIA, the Brain Injury
Association of America (BIAA), Congressional Brain Injury Task Force, and other organizations
are recommending. The Injury Center's TBI program is level funded, meaning no increase for
the program.

Health Resources and Services Administration (HRSA)
The President’s Budget includes $12.6 billion for the Health Resources and Services
Administration (HRSA), which is $497 million above FY 2021 enacted. The requests includes a
$6 million increase to the Emergency Medical Services for Children (EMSC) program to
address critical gaps in emergency and trauma care; and $110 million increase for the Maternal
and Child Health Block Grant, which is a key funding source for promoting and improving the
health and well-being of the nation’s mothers and children, including children with special
needs and their families.

The HRSA Budget also supports telehealth services to increase health care quality and
access, expand provider trainings, and improve health outcomes in rural areas. The budget
requests $37 million for Telehealth which is $3 million above FY 2021 enacted, to promote
health services and distance learning with telehealth technologies. In FY 2022, HRSA will
continue the Telehealth Network Grant Program that focuses on Tele-Emergency services to
provide real-time emergency care consultation between a central emergency health care
center and a distant hospital emergency department.

National Institutes of Health (NIH)
The President’s Budget includes $52 billion for the National Institutes of Health (NIH), which is
an increase of $9 billion above FY 2021 enacted. Of the $9 billion increase, $6.5 billion will
support the establishment of the Advanced Research Projects Agency for Health (ARPA-H), a
new entity modeled after the Defense Advanced Research Projects Agency (DARPA) to speed
the development of medical treatments by funding innovative projects focusing initially on
cancer and other diseases such as diabetes and Alzheimer’s Disease. The remaining $2.5
billion will continue NIH’s basic research and translating it into clinical practice to address
issues such as ending the opioids crisis, climate change, and gun violence. The Budget
includes an increase of $272 million for the National Institute of Neurological Disorders and
Stroke, the lead Center in promoting brain injury research.

U.S. Department of Education
The President’s Budget includes $16 billion, a historic increase of $2.7 billion over 2021
enacted, for the Individuals with Disabilities Education Act (IDEA) to support special education
and related services. This is a significant first step toward fully funding IDEA and supports
providing a high-quality education to children with disabilities. The budget also provides $732
million for early intervention services for infants and toddlers with disabilities. The $250 million
increase would be paired with reforms to expand access to these services for underserved
children, including children of color and children from low-income families.

                               This Capitol News was prepared by:

             Susan L. Vaughn, Director of Public Policy, publicpolicy@nashia.org

Becky Corby, NASHIA Governmental Relations, rcorby@ridgepolicygroup.com

              Jennifer Braun, Chair of the NASHIA Public Policy Committee
                            Jennifer.Braun@health.mo.gov

        Rebeccah Wolfkiel, NASHIA Executive Director, execdirector@nashia.org

The National Association of State Head Injury Administrators assists State
                               government
   in promoting partnerships and building systems to meet the needs
           of individuals with brain injuries and their families.

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National Association of State Head Injury Administrators | PO Box 1878, Alabaster, AL 35007