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. This update was prepared by: Susan L. Vaughn, Director of Public Policy, publicpolicy@nashia.org
This Week in Congress
Yesterday, the House voted against a bipartisan bill to extend President Obama’s payroll tax cut by two months. The Senate had passed a package that included job payroll tax cut, extending unemployment benefits, and Medicare reimbursement extensions. The House is still in session, however, Senators have returned home for the holidays.
Appropriations:
FY 2012 Appropriations: Late last week, Congress passed a package of nine appropriation bills to fund government programs for the remainder of fiscal year 2012 that ends September 30, 2012. Most federal programs had been operating under a Continuing Resolution (CR), which expired Friday. The President signed a temporary CR which funds government through Dec. 23. After the House passed the conference committee report (House Report 112-331), the Senate passed the budget bill, the Consolidated Appropriations Act, 2012 (H.R. 2055), on Saturday. The bill provides funding to federal agencies, including Health and Human Services, Education, Veterans Affairs and Defense, through the remainder of this fiscal year. The bill has not yet been signed by the President.
Overall, the bill funds the regular (base) discretionary level of $1.043 trillion as agreed to in the Budget Control Act (BCA). When combined with the previous “minibus” appropriations bill enacted in November, total discretionary funding for FY 2012 will equal $1.043 trillion – $7 billion less than last year’s level of $1.050 trillion and $98 billion less than the President’s request. The bill eliminates 23 programs totaling more than $240 million that are ineffective, narrowly targeted to a small constituency, or have fulfilled their federal purpose. One casualty is the termination of the Office of National Drug Control Policy Youth Media Campaign for a savings of $35 million.
Congress passed three bills as a package to continue funding to federal programs: H.R. 2055 that combined nine appropriations bills; H.R. 3672 to provide $8.1 billion in disaster relief funding; and H.Con.Res. 94, which offsets the disaster aid provided in H.R. 3672 with a 1.83% across-the-board cut to Fiscal Year 2012 discretionary spending (excluding the Department of Defense, Military Construction, and Veterans Affairs) – meaning the across-the-board cuts will fund disaster aid. The Labor-HHS-Education section also has a 0.189 percent across-the-board cut to all discretionary programs; except for the Pell Grant program. The figures reported in this issue do not reflect the rescissions.
Department of Health and Human Services (HHS): Congress appropriated a total of $69.7 billion to the Department of Health and Human Services (HHS), nearly $700 million below last year’s level and $3.4 billion below the President’s budget request. (Most programs are also subject to a 0.189 percent rescission.) The bill includes a prohibition on the entire department from activities that advocate or promote gun control – previously this prohibition only applied to CDC. A summary of the appropriations is as follows:
Health Resources and Services Administration (HRSA) – The bill funds HRSA at program level of $6.5 billion, which is $41 million below last year’s level and $848 million below the budget request. Within this total, Community Health Centers are funded at $1.6 billion – the same as last year’s level. The Emergency Medical Services for Children (EMSC) program, which was recommended by the House to be eliminated, was level funded ($21 million) as the result of the support of the Senate.
The Title V Maternal and Child Health Services Block Grant received $646,319,000 — a $10 million decrease from the FY 2011 level of $656 million. The bill specifies that the $10 million reduction will be applied to the Special Projects of Regional and National Significance (SPRANS) portion of the MCH Block Grant. The Senate Appropriations Committee had proposed cutting the program by $50 million.
The HRSA Federal TBI Grant Program is level funded — same as FY 2011 — before recission.
Centers for Disease Control and Prevention (CDC)- The legislation appropriates $6.1 billion for CDC programs — an increase of $38 million above last year’s level and $269 million below the President’s budget request. Within this total, Congress approved $80 million for the Preventive Health and Health Services Block Grant that provides funding to States to address critical public health needs - a program proposed for elimination by the President and the Senate.
Funding for CDC TBI Act programs for FY 2012 is $6.04 million, which is the same as FY 2011. The conference agreement includes $138,480,000 for overall injury prevention and control activities. Funding for youth violence programs was cut by $4.7 million and conferees reduced funding for the Injury Control Research Centers from $10,522,000 to $9,996,000.
The conference agreement includes $138,072,000 for birth defects and developmental diseases. The conferees rejected the consolidation proposed by the Administration in the FY 2012 budget for disability initiatives in the National Center on Birth Defects and Developmental Disabilities (NCBDDD). The conferees direct that any new consolidation put forward by the Administration be accompanied by an assessment of the needs of people with disabilities that includes the categories of disabilities currently served, validates the value of such a consolidation, considers the input of stakeholders, and establishes the basis for any proposed efficiencies and commonalities.
Administration on Aging (A0A): AoA is essentially level-funded for FY 2012, with a few exceptions. The legislation does not include the Administration’s requests for:
· The Caregiver Initiative, which included increases of $40 million for the National Family Caregiver Support Program, $48 million for Supportive Services and Senior Centers, and $7.5 million for Lifespan Respite Care;
· Transfer to AoA of the Senior Community Service Employment Program (SCSEP) and the State Health Insurance Programs (SHIPs); or
· First-time funding for the Elder Justice Act (EJA).
Senate appropriators had proposed that $10 million each in funding for the Chronic Disease Self-Management Program (CDSMP) and falls prevention be allocated from the Prevention and Public Health Fund. The Consolidated Appropriations Act does not contain specific allocation instructions, but there is some belief that appropriators will direct HHS to provide the $10 million in CDSMP funding, but nothing for falls prevention, which will continue to receive $1.96 million in funding from the Centers for Disease Control and Prevention (CDC).
Administration for Children and Families (ACF) - The bill provides $29.2 billion for ACF – a decrease of $855 million below last year’s level and $327 million above the President’s budget request. This funding includes:
· $3.5 billion for the Low Income Home Energy Assistance Program (LIHEAP) block grant -a decrease of $1.2 billion below last year and an increase of $909 million above the President’s budget request, and maintains the funding ratio between “cold weather” and “warm weather” States;
· $2.3 billion – $60 million above last year’s level – for the Child Care and Development Block Grant; and
· $8 billion for Head Start, which is $424 million above, last year’s level and $714 million for the Community Services Block Grant – an increase of $12 million above last year and $349 million above the President’s budget request.
National Institutes of Health (NIH) - The bill provides NIH with $30.7 billion in funding, which is $299 million above last year’s level and $758 million below the President’s request. This bill assumes NIH will support the same number of scientifically meritorious research project grants as last year. The conference agreement includes language to implement the creation of the National Center for Advancing Translational Sciences (NCATS) and eliminates the National Center for Research Resources (NCRR), transferring the various NCRR programs to other institutes and centers. The conferees also provide NCATS with up to $10 million for the Cures Acceleration Network.
Substance Abuse and Mental Health Administration (SAMHSA) – The bill funds SAMHSA at a program level of $3.5 billion – $27 million below last year’s level and $73 million below the President’s budget request. Within this total, the Substance Abuse Block Grant program receives $1.8 billion, an increase of $21 million over last year, and the Mental Health Block Grant receives $461 million, an increase of $41 million over last year. The 20% prevention set aside remains within the Substance Abuse Block Grant.
Centers for Medicare and Medicaid Services (CMS) –The legislation contains $3.9 billion for CMS Program Management, which is $241 million over last year’s level and $517 million below the President’s request. Congress noted that since 2000, the number of CMS beneficiaries (those receiving Medicare, Medicaid and Children’s Health Insurance Program benefits) has increased by 51% – partially due to an aging U.S. population. The bill attempts to keep pace with the increase in beneficiaries to ensure those who rely on these important programs get the benefits they need.
Department of Defense: The bill contains $32.5 billion – $1.1 billion above last year’s level and $283 million above the request – for Defense health programs to provide care for our troops and military families. This includes critical medical research on combat-related illnesses and injuries, including in areas such as brain trauma, cancer, psychological health, hemorrhage control, and prosthetic research. The bill contains $1.227 appropriation for research and treatment to help our soldiers who sustain TBI. This represents a $135.5 million increase in funding over the President’s FY2012 Budget Request.
Department of Education: The Department of Education is funded at $71.3 billion in the legislation, which is $153 million below last year’s level and $9.3 billion below the budget request. Special education programs are funded $11.6 billion in the legislation – an increase of $100 million above last year’s level – to help school districts pay for the extra costs of educating all children with disabilities.
Other Legislation:
CLASS Act: It appears that there is not sufficient support in the House to repeal the CLASS Act before the end of this year. Rep. Charles Boustany (R-LA) introduced legislation to repeal the CLASS Act and has said publicly that he would resume his push for repeal in 2012. The bill was approved by the House Committee on Energy and Commerce. House Republicans told The Hill that the repeal effort would resume in 2012 with a markup by the Ways and Means Committee.
Restraint & Seclusion in Schools: Last Friday, Senator Tom Harkin (D-IA), Chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, introduced the Keeping All Students Safe Act (S. 2020) to limit the use of restraint and seclusion in schools. The bill would prohibit seclusion and mechanical and chemical restraint, restrict the use of physical restraint to emergency situations, require training and certification of school personnel who implement restraint and require parental notification when restraint is used. The bill also authorizes grants to States to carry out the minimum standards and improve school climate through the use of school-wide positive behavioral interventions and supports. It is similar to the House bill by the same name, H.R. 1381, introduced by Representative George Miller (D-CA) in April.
Violence Against Women Act (VAWA): On Nov. 30, Senator Patrick Leahy (D-VT), Chair of the Senate Judiciary Committee, and Senator Mike Crapo (R-ID) introduced S.1925, Violence Against Women Reauthorization Act of 2011. The Violence Against Women Act (VAWA) is a landmark piece of legislation that sought to improve criminal justice and community-based responses to domestic violence, dating violence, sexual assault and stalking in the United States. The passage of VAWA in 1994, and its reauthorization in 2000 and 2005, has changed the landscape for victims of domestic violence, dating violence, sexual assault and stalking.
Workforce Training Reform Bills: On Dec. 8, two members of the House Education and Workforce Committee introduced two workforce training reform bills. Rep. Virginia Foxx (R-NC) introduced H.R. 3610, the Streamlining Workforce Development Programs Act, which consolidates 33 workforce training programs into four funding streams. Rep. Joe Heck (R-NV) introduced H.R. 3611, the Local Job Opportunities and Business Success (JOBS) Act, which addresses workforce investment boards. The bill removes many federal directives regarding board makeup and requires that at least two-thirds of each board is comprised of business representatives. It also strikes provisions that require board representation from community colleges and other educational entities.
Congressional Hearings:
Ways and Means Subcommittee on Social Security Begins Hearing Series on SSDI: On December 2, the House Committee on Ways and Means Subcommittee on Social Security held the first in a series of hearings on the future of the Social Security Disability Insurance (SSDI) program. This program pays benefits to workers who are determined to be unable to work due to a severe medical condition. Enrollment in the program and its costs have grown significantly over the past several decades to the point where the Social Security Trustees project that the Disability Insurance Trust Fund will become exhausted in 2018. In his opening remarks, Subcommittee Chairman Sam Johnson (R-TX) commented that, without Congressional action, the Social Security Administration will be unable to pay full disability insurance benefits beginning in 2018. Chairman Johnson also described the primary purposes of the hearing – to review the history of the program, the importance of its benefits, its growth and drivers of growth, and its financing challenges. For more information and to view the testimony, visit http://waysandmeans.house.gov/Calendar/EventSingle.aspx?EventID=270233.