Caring for an Aging America Act of 2008

Assistance for Individuals with Functional Impairments. H.R. 3001, S. 1758: provisions pertaining to assistance for individuals with functional impairments and for their families payments for services and supports. Health Insurance Parity. H.R. 1424, S. 558: provisions to provide parity between health insurance coverage of mental health benefits and benefits for medical and surgical services. Nationally-coordinated Elder Justice. H.R. 1783, S. 1070: provisions pertaining to the implementation of a nationally-coordinated elder justice strategy. Commodity Supplemental Food Program. S.1090: provision pertaining to the Commodity Supplemental Food Program for low-income seniors. Health Care Professional Training. S. 2708: provisions relating to the recruitment and retention of trained health care professionals and direct care workers to care for older Americans.

Client expense: $440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Assistance for Individuals with Functional Impairments. H.R. 3001, S. 1758: provisions pertaining to assistance for individuals with functional impairments and for their families payments for services and supports. Health Insurance Parity. H.R. 1367, H.R. 1424, S. 558: provisions to provide parity between health insurance coverage of mental health benefits and benefits for medical and surgical services. Nationally-coordinated Elder Justice. H.R. 1783, S. 1070: provisions pertaining to the implementation of a nationally-coordinated elder justice strategy. Commodity Supplemental Food Program. S.1090: provision pertaining to the Commodity Supplemental Food Program for low-income seniors. Health Care Professional Training. S. 2708: provisions relating to the recruitment and retention of trained health care professionals and direct care workers to care for older Americans.

Client expense: $480,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

S. 588/HR. 1424 "Wellstone Mental Health and Addiction Parity Act," Issue: Mental Health Insurance Coverage; support bills to provide parity between health insurance coverage of mental health benefits and benefits for medical and surgical services; S. 1693 (Kennedy) "Wired for Health Care Quality Act," Issues: Mental Health and Health Privacy; modify a bill to enhance the adoption of a nationwide interoperable health information technology system and to improve the quality and reduce the costs of health care in the United States; HR 5442 (Markey) "TRUST in Health Information Act," Issues: Mental Health and Health Privacy. To modify a bill providing individuals with access to health information, to ensure personal privacy, security, and confidentiality with respect to health related information in promoting the development of a nationwide interoperable health information infrastructure, to impose criminal and civil penalties for unauthorized use of personal health information, to provide for the enforcement of tese rights, to protect States' rights, and for other purposes; HR 6357 (Dingell) "PRO(TECH)T Act," Issues: Mental Health and Health Privacy; Seek modifications in a bill amending the Public Health Service Act to promote the adoption of health information technology, providing limited privacy protections and for other purposes; HR 3800 (Eshoo) "Improving the Interoperability of Health Information Technology," Issues: Mental Health and Health Privacy; seek modifications in a bill amending the Public Health Service Act to promote the adoption of health information technology, and for other purposes; HR 5447 (Towns) "Dorothy I. Height and Whitney m. Young, Jr. Social Work Reinvestment Act," Issue: Health/Social Work Workforce; support a bill to establish the Social Work Reinvestment commission to provide independent counsel to Congress on policy issues associated with the recruitment, retention, research, and reinvestment in the profession of social work; S 2858 (Mikulski) "Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act," Issue: Health/Social Work Workforce, support a bill to establish the social Work Reinvestment Commission to provide independent counsel to Congress on policy issues associated with the recruitment, retention, research, and reinvestment in the profession of social work; Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act S. 2858 and HR 5447 Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act Support establishing a Social Work Reinvestment Commission to address recruitment, retention, research, and reinvestment in the social work profession; HCR: Health Issues, S 3484 and HR 6873, Medicare Hospice Protection Act, support the passage of bill to provide for a delay in the phase out of the hospice budget neurality adjustment factor during fiscal year 2009; S 2708 and HR 6337, Caring for an Aging American Act of 2008, support the need to address the emerging care gap between the increasing numbers of older Americans and the lack of providers who are trained in caring for the medical, health and social needs of the aging population; HR 2165, Teri Zenner Social Worker Safety Act, support establishing a grant program to assist in the provision of safety measures to protect social workers and other professionals who work with at-risk populations; S. 106, National Center for Social Work Research Act, support establishing the National Center for Socail Work Research as an agency of the National Institutes of health (NIH) to conduct, support, and disseminate targeted research on social work methods and outcomes related to problems of significant social concern; HR 5447, S2858, The Dorothy I. Height and Whitney M. Young, Jr., Social Work Reinvestment Act: the initiative attempts to address maters of recruitment/retention as it pertains to the social work profession, in addition to the establishment of a social work commission to study significant problems associated with the profession.

Client expense: $185,826 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S1340/HR2244/HR467, The Geriatric Assessment and Chronic Care Coordination Act of 2007, all provisions relating to Medicare Part B Coverage of geriatric assessment and chrnoic care management services for eligible beneficiaries and process measures and outcomes for Medicare Beneficiaries with multiple chronic illnesses, including dementia. S1758, The Community Living Assistance Services and Supports Act, all provisions relating to establishing a national, voluntary disability insurance program. S2708, Caring for An Aging America Act, all provisions relating to training of health care professionals and direct care workers S264, Nursing Home Transparency and Improvement Act of 2008, all provisions relating to improving the transparency of information about skilled nursing facilities and providing dementia management training. S245 - Retooling for an Aging America, Building the Heatlhcare workforce. All provisions relating to expanding education and training opportunities in geriatric and long-term care for licensed health professionls, direct care workers, and family caregivers.

Client expense: $40,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

S. 2112 - Nurse-Managed Health Clinic Invest. Act of 2007; S. 1604 - Nurse Edu. and Quality of Health Care Act of 2007; S. 1628 - Nurse Faculty and Physical Therapist Edu. Act of 2007; H.R. 2384 - Nurse Faculty Higher Education Act; H.R. 2621 - Teacher and Nurse Support Act of 2007; S. 446/H.R. 772 - Nurse Educ., Expansion, and Development Act of 2007; H.R. 677 - Nursing School Capacity Act of 2007; S. 2708 - Caring for an Aging America Act of 2008; Health Care Reform Initiatives; Title VII Funding.

Client expense: Not reported · Firm income: $20,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

S.901, Health Centers Renewal Act of 2007, include pharmacists as eligible for loan forgiveness programs of the Natinal Health Service Corps. S.2708, Caring for an Aging America Act of 2008, include pharmacists in geriatric training program. Proposed legislation to create an academic counterdetailing program on prescription drugs. Outlined potential role of the pharmacist. S.2932, Poison Center Support, Enhancement and Awareness Act of 2008, support all provisions. Communication to FDA on NDC number.

Client expense: $250,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, SENATE

Improving Education Results for Children with Disabilities/IDEA reauthorization implementation H.R. 3043/S. 1710 - FY08 Labor-HHS-Education Appropriations FY09 Science/Justice/Commerce Appropriations Bills (including NSF) House FY08 Science/State/Justice/Commerce Appropriations Bill (including NSF) Higher Education Act Reauthorization H.R. 2073/S. 1572 - Child Health Care Crisis Relief Act P.L. 108-355 Garrett Lee Smith Memorial Act H.R. 3430/S. 1332 Mental Health in Schools Act P.L. 107-110 No Child Left Behind Act Reauthorization H.R. 3438 The Bullying & Gang Reduction for Improved Education Act H.Res. 762 Supporting the Goals of National Bullying Prevention Awareness Week Threat Assessment S. 2708 Caring for an Aging America Act of 2008 S. 3708/H.R. 7302 Health Professions & Primary Care Reinvestment Act Cyberbullying legislation Sexualization of Girls S. 3364/H.R. 6654 - Increased Student Achievement Through Increased Student Support Act ESEA Title III NPRI Institute of Education Sciences Reauthorization Elementary & Secondary Education Act H.R. 2792 Family & Medical Leave Inclusion Act S. Res. 710 National Teen Dating Violence Awareness & Prevention Week Resolution

Client expense: $186,837 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Motor Carrier Safety Administration, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Indian Health Service, Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Aeronautics & Space Administration (NASA), Natl Institute of Mental Health (NIMH), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

H.R. 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R. 4105 - To impose a moratorium on the use of recovery audit contrators under the Medicare Integrity Program. H.R. 976 - An act to amend title XXI of the Social Sercurity Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R. 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold to determine whether a hospital or unit is an impatient rehabilitation facility. H.R. 562 - To amend title XVIII of teh Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. H.R. 3162 - To amend titles XVII, XIX, and XXI of the Social Security Act to extend and improve the children's health insurance program, to improve beneficiary protections under the Medicare, Medicaid, and the CHIP program, and for other purposes. H.R. 1621 - To amnd title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. H.R. 1536 - To amend part D of title XVII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. H.R. 4541 - To amend title XVIII of the Social Security Act to provide for patient protections under the Medicare prescription drug program for residents of long term care facilities. H.R.3963 - To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.5604 - To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. H.R.5613 - To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009, and for other purposes. H.R.6331 - To amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. H.R.5480 - To respond to a Medicare funding warning. S.2662 - A bill to respond to a medicare funding warning. S.543 - A bill to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. S.1107 - A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S. 2819 - A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn, and for other purposes. S. 3101 - A bill to amend titles XVII and XIX of the Social Security Act to extend expiring provisions under the Medicare program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care sub rural areas, including pharmacy access, and for other purposes. S.1893 - An original bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program, and for other purposes. S.338 - A bill to amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare program. S.2499 - A bill to amend titles XVIII, XIX, and XXI of the Social Security Act to extend provisions under the Medicare, Medicaid, and SCHIP programs, and for other purposes. S.2396 - A bill to amend title XI of the Social Security Act to modernize the quality improvement organization (QIO) program. S. 2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and firect care workers dedicated to providing quality care to the growing population of older Americans. S. 2705 - A bill to authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. S. 2786 - A bill to amend title XVIII of the Social Security Act to improve access to health care under teh Medicare program for beneficiaries residing in rural areas. H.R.5480 - To respond to a Medicare funding warning.

Client expense: $460,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R.7128 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.7110 - Making supplemental appropriations for job creation and preservation, infrastructure investment, and economic and energy assistance for the fiscal year ending September 30, 2009, and for other purposes. H.R. 2807 - To intensify stem cell research showing evidence of substantial clinical benefit to patients, and for other purposes. H.R. 1783 - To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, & for other purposes. H.R. 2521 - To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R.1046 - To amend titles XI and XVIII of the Social Security Act to modernize the quality improvement organization (QIO) program. H.R.1841 - To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for an AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. H.R.4082 - To improve the quality of, and access to, long-term care. H.R.3784 - To amend title XVIII of the Social Security Act to improve the quality of care in skilled nursing facilities under the Medicare Program through requiring the reporting of expenditures for nursing. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.4854 - To amend the provisions of title 31, United States Code, relating to false claims to clarify and make technical amendments to those provisions, and for other purposes. H.R.3453 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive bidding demonstration project for clinical laboratory services. H.R.3180 - To amend title 31, United States Code, to clarify who is an original source for purposes of bringing a qui tam action. H.R. 5480 - To repond to a Medicare funding warning. H.R.6337 - To amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R.5878 - To authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. H.R.2705 - To amend the Compact of Free Association Amendments Act of 2003, and for other purposes. H.R.6252 - To amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. H.R. 5799 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.Res.1203 - Expressing support for designation of the week beginning May 11, 2008, as "National Nursing Home Week". S.Res.543 - A resolutioni designating the week beginning May 11, 2008, as "National Nursing Home Week". S. 2641 - A bill to amend title XVII and XIX of the Social Security Act to improve the transparenct of information on skilled nursing facilities and nursing facilities and to clarift and improce the targeting of the enforcement of requitements with respect to such facilities. S. 1980 - A bill to improve the quality of, and access to, long-term care. S. 2662 - A bill to respond to a Medicare funding warning. S. 2041 - A bill to amend the False Claims Act. S. 1693 - A bill to enhance the adoption of a nationwide interoperable health information technology system and to improce the quality and reduce the costs of health care in the United States. S. 1947 - A bill to amend title XI of the Social Security Act to improve the quality improvement organization (QIO) program. S. 2099 - A bill to amend title XVII of teh Social Security Act to repeal the medicare competitive bidding project for clinical laboratory services. S. 1070 - A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S. 1019 - A bill to provide comprehensive reform of the health care system of the United States, and for other purposes. S. 1814 - A bill to provide individuals with access to health information of which they are a subject, ensure personal privacy with respect to health related information, promote the use of non-identifiabel information for health research, impose criminal and civil penalties for unauthorized use of protected health information, to provide for the strong enforcement of these rights, and to protect States' rights. S. 1615 - A bill to provide loans and grants for fire sprinkler retrofitting in nursing facilities. S. 845 - A bill to direct the Secretary of Health and Human Services to expand and intensify programs with respect to research and related activities concerning elder falls. S. 334 - A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away. S. 325 - A bill to provide for innovation in health care through State initiatives that expand coverage and access and improve quality and efficiency in the health care system. S. 1980 - A bill to improve the quality of, and access to, long-term care. S.2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. S. 3144 - A bill to amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. S.2603 - A bill to amend title XI and XVIII of the Social Security Act to provide increased civil and criminal penalties for acts involving fraud and abuse under the Medicare program and to increase the amount of the surety bond required for suppliers of durable medical equipment. S.2641- A bill to amend title XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.1424 - A bill to provide authority for the Federal Government to purchase and insure certain types of troubled assets for the purposes of providing stability to and preventing disruption in the economy and financial system and protecting taxpayers, to amend the Internal Revenue Code of 1986 to provide incentives for energy production and conservation, to extend certain expiring provisions, to provide individual income tax relief, and for other purposes. H.R. 5268 H.R. 5613 H.R. 6331 S. 2820

Client expense: $460,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Assistance for Individuals with Functional Impairments. H.R. 3001, S. 1758: provisions pertaining to assistance for individuals with functional impairments and for their families payments for services and supports. Health Insurance Parity. H.R. 1424, S. 558: provisions to provide parity between health insurance coverage of mental health benefits and benefits for medical and surgical services. Nationally-coordinated Elder Justice. H.R. 1783, S. 1070: provisions pertaining to the implementation of a nationally-coordinated elder justice strategy. Commodity Supplemental Food Program. S.1090: provision pertaining to the Commodity Supplemental Food Program for low-income seniors. Health Care Professional Training. S. 2708, S. 2708, H.R. 6337: provisions relating to the recruitment and retention of trained health care professionals and direct care workers to care for older Americans; and provisions authorizing funding to help health care practitioners gain geriatric or gerontological specialization.

Client expense: $250,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. H.R. 1669/S. 982, "Positive Aging Act of 2007". Support all provisions. The bill would improve access to mental health services for older adults by integrating mental health services into primary and community settings through demonstration projects that target urban and rural medically underserved areas. Interdisciplinary teams of mental health professionals working in collaboration wiht other providers of health care and social services would provide these evidence-based services. 2. H.R. 1424, the "Paul Wellstone Mental Health and Addiction Equity Act" - Support all provisions. The bill expands the Mental Health Parity Act of 1996 by requiring group health plans that offer benefits for mental health and addiction to do so on the same terms as care for other diseases. 3. H.R. 2502, "Geriatricians Loan Forgiveness Act of 2007". Support all provisions. The bill would extend the National Health Service Corps Loan Repayment Program to geriatric training, forgiving $35,000 of educational debt incurred by medical students for each year of advanced training to obtain a certificate of added qualifications in geriatric medicine or geriatric psychiatry. 4. S. 558, the "Mental Health Parity Act of 2007". Support provisions to prohibit private health insurance plans from imposing treatment limitations or financial requirements on mental health benefits unless comparable limitations or requirements are imposed on medical and surgical benefits. 5. Discussed with House and Senate staff the need to include older adults in clinical trials, following the 2007 release of a GAO report on this issue. 6. S. 1628, a bill to amend the Public Health Service Act to authorize programs to increase the number of nurse faculty and to increase the domestic nursing and physical therapy workforce. Support all provisions. 7. S. 1854, the "Stop Senior Suicide Act". Support provisions to repeal the 50 percent Medicare outpaitent mental health coinsurance rate; improve interagency coordination; provide grants for elderly suicide early intervention and prevention strategies; and enhance the existing Suicide Prevention Resource Center. 8. Support H. R. 3411, the "Juvenile Crime Reduction Act of 2007," to provide strategies to help to decrease the prevalence of young people with mental disorders who come into contact with the juvenile justice system. 9. S. 2708 and H.R. 6337, the "Caring for an Aging America Act of 2008. Support all provisions. The bill would provide for the establishment of a new geriatric and gerontology loan repayment program. 10. Reauthorization of the Substance Abuse and Mental Health Services Administration - discuss inclusion of provisions from S. 982 (the "Positive Aging Act of 2007") and S. 1854 (the "Stop Senior Suicide Act") with Senate staff. 11. Discussed with House and Senate staff the need for additonal health care professionals trained in geriatrics and the need for a study on the mental health care workforce that will be needed to treat older adults with mental disorders over the next three decades. 12. Support S. 2641, the "Nursing Home Transparency and Improvement Act of 2008". Support all provisions. The bill would increase public transparency and accountability of nursing home owners and operators, including nursing home chains, by requiring them to disclose the corporate entities that own nursing homes and their affiliated entities. 13. Support H.R. 6375, "Healthy Transitions Act". Support all provisions. The bill would establish planning and implementation grants to states to assist in the development of a coordinated service delivery system to maximize continuity of care and access to services for young adults who are transitioning to the adult mental health system. 14. Support H.R. 1424, Emergency Economic Stabilization Act of 2008". Support provision to provide mental health parity to require group health plans that offer mental health and substance abuse benefits to do so on the same terms as medical and surgical benefits. 15. S. 3335, the "Jobs, Eneergy, Families and Disaster Relief Act of 2008". Support mental health parity provision. 16. S. 3155, a bill to reauthorize the "Juvenile Justice and Delinquency Prevention Act of 1974". Urge that the bill include provisions to address the plight to young people with mental disorders intersecting with the juvenile justice system. 17. S. 3730, the "Retooling the Health Care Workforce for an Aging America Act of 2008". Support all provisions. This bill addresses the current and future shortage of health care personnel who are trained to care for older adults.

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Alzheimer's Disease Demonstrataion Grants to States Program, Program Implementation S1340/HR2244/HR467, The Geriatric Assessment and Chronic Care Coordination Act of 2007, all provisions relating to Medicare Part B Coverage of geriatric assessment and chrnoic care management services for eligible beneficiaries and process measures and outcomes for Medicare Beneficiaires with multiple chronic illnesses, including dementia. S1758, The Community Living Assistance Services and Supports Act, all provisions relating to establishing a national, voluntary disability insurance program. S897 Alzheimer's Family Assistance Act of 2007, all provisions relating to long term care tax credits, treatment of premiums or qualified long-term care insurance contracts and tax credits for caregivers. S2708, Caring for An Aging America Act, all provisions relating to training of health care professionals and direct care workers S264, Nursing Home Transparency and Improvement Act of 2008, all provisions relating to improving the transparency of information about skilled nursing facilities and providing dementia management training. HR1032, Alzheimer's Treatment and Caregiver Support Act, all provisions relating to grants for the expansion of treatment services to individuals with Alzheimer's and training and support services for families and caregivers

Client expense: $60,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

H.R. 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R. 4105 - To impose a moratorium on the use of recovery audit contrators under the Medicare Integrity Program. H.R. 976 - An act to amend title XXI of the Social Sercurity Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R. 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold to determine whether a hospital or unit is an impatient rehabilitation facility. H.R. 562 - To amend title XVIII of teh Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. H.R. 3162 - To amend titles XVII, XIX, and XXI of the Social Security Act to extend and improve the children's health insurance program, to improve beneficiary protections under the Medicare, Medicaid, and the CHIP program, and for other purposes. H.R. 1621 - To amnd title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. H.R. 1536 - To amend part D of title XVII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. H.R. 4541 - To amend title XVIII of the Social Security Act to provide for patient protections under the Medicare prescription drug program for residents of long term care facilities. H.R.3963 - To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.5604 - To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. H.R.5613 - To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009, and for other purposes. H.R.6331 - To amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. H.R.5480 - To respond to a Medicare funding warning. S.2662 - A bill to respond to a medicare funding warning. S.543 - A bill to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. S.1107 - A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S. 2819 - A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn, and for other purposes. S. 3101 - A bill to amend titles XVII and XIX of the Social Security Act to extend expiring provisions under the Medicare program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care sub rural areas, including pharmacy access, and for other purposes. S.1893 - An original bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program, and for other purposes. S.338 - A bill to amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare program. S.2499 - A bill to amend titles XVIII, XIX, and XXI of the Social Security Act to extend provisions under the Medicare, Medicaid, and SCHIP programs, and for other purposes. S.2396 - A bill to amend title XI of the Social Security Act to modernize the quality improvement organization (QIO) program. S. 2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and firect care workers dedicated to providing quality care to the growing population of older Americans. S. 2705 - A bill to authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. S. 2786 - A bill to amend title XVIII of the Social Security Act to improve access to health care under teh Medicare program for beneficiaries residing in rural areas. H.R.5480 - To respond to a Medicare funding warning.

Client expense: $390,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R.7128 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.7110 - Making supplemental appropriations for job creation and preservation, infrastructure investment, and economic and energy assistance for the fiscal year ending September 30, 2009, and for other purposes. H.R. 2807 - To intensify stem cell research showing evidence of substantial clinical benefit to patients, and for other purposes. H.R. 1783 - To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, & for other purposes. H.R. 2521 - To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R. 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R.1046 - To amend titles XI and XVIII of the Social Security Act to modernize the quality improvement organization (QIO) program. H.R.1841 - To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for an AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. H.R.4082 - To improve the quality of, and access to, long-term care. H.R.3784 - To amend title XVIII of the Social Security Act to improve the quality of care in skilled nursing facilities under the Medicare Program through requiring the reporting of expenditures for nursing. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.4854 - To amend the provisions of title 31, United States Code, relating to false claims to clarify and make technical amendments to those provisions, and for other purposes. H.R.3453 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive bidding demonstration project for clinical laboratory services. H.R.3180 - To amend title 31, United States Code, to clarify who is an original source for purposes of bringing a qui tam action. H.R. 5480 - To repond to a Medicare funding warning. H.R.6337 - To amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R.5878 - To authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. H.R.2705 - To amend the Compact of Free Association Amendments Act of 2003, and for other purposes. H.R.6252 - To amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. H.R. 5799 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.Res.1203 - Expressing support for designation of the week beginning May 11, 2008, as "National Nursing Home Week". S.Res.543 - A resolutioni designating the week beginning May 11, 2008, as "National Nursing Home Week". S. 2641 - A bill to amend title XVII and XIX of the Social Security Act to improve the transparenct of information on skilled nursing facilities and nursing facilities and to clarift and improce the targeting of the enforcement of requitements with respect to such facilities. S. 1980 - A bill to improve the quality of, and access to, long-term care. S. 2662 - A bill to respond to a Medicare funding warning. S. 2041 - A bill to amend the False Claims Act. S. 1693 - A bill to enhance the adoption of a nationwide interoperable health information technology system and to improce the quality and reduce the costs of health care in the United States. S. 1947 - A bill to amend title XI of the Social Security Act to improve the quality improvement organization (QIO) program. S. 2099 - A bill to amend title XVII of teh Social Security Act to repeal the medicare competitive bidding project for clinical laboratory services. S. 1070 - A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S. 1019 - A bill to provide comprehensive reform of the health care system of the United States, and for other purposes. S. 1814 - A bill to provide individuals with access to health information of which they are a subject, ensure personal privacy with respect to health related information, promote the use of non-identifiabel information for health research, impose criminal and civil penalties for unauthorized use of protected health information, to provide for the strong enforcement of these rights, and to protect States' rights. S. 1615 - A bill to provide loans and grants for fire sprinkler retrofitting in nursing facilities. S. 845 - A bill to direct the Secretary of Health and Human Services to expand and intensify programs with respect to research and related activities concerning elder falls. S. 334 - A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away. S. 325 - A bill to provide for innovation in health care through State initiatives that expand coverage and access and improve quality and efficiency in the health care system. S. 1980 - A bill to improve the quality of, and access to, long-term care. S.2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. S. 3144 - A bill to amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. S.2603 - A bill to amend title XI and XVIII of the Social Security Act to provide increased civil and criminal penalties for acts involving fraud and abuse under the Medicare program and to increase the amount of the surety bond required for suppliers of durable medical equipment. S.2641- A bill to amend title XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.1424 - A bill to provide authority for the Federal Government to purchase and insure certain types of troubled assets for the purposes of providing stability to and preventing disruption in the economy and financial system and protecting taxpayers, to amend the Internal Revenue Code of 1986 to provide incentives for energy production and conservation, to extend certain expiring provisions, to provide individual income tax relief, and for other purposes.

Client expense: $390,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S. 2112 - Nurse-Managed Health Clinic Investment Act of 2007; S. 1604 - Nurse Education and Quality of Health Care Act of 2007; S. 1628 - Nurse Faculty and Physical Therapist Education Act of 2007; H.R. 2384 - Nurse Faculty Higher Education Act; H.R. 2621 - Teacher and Nurse Support Act of 2007; S. 446/H.R. 772 - Nurse Education, Expansion, and Development Act of 2007; H.R. 677 - Nursing School Capacity Act of 2007; S. 2708 - Caring for an Aging America Act of 2008

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. H.R. 1669/S. 982, "Positive Aging Act of 2007". Support all provisions. The bill would improve access to mental health services for older adults by integrating mental health services into primary and community settings through demonstration projects that target urban and rural medically underserved areas. Interdisciplinary teams of mental health professionals working in collaboration wiht other providers of health care and social services would provide these evidence-based services. 2. H.R. 1424, the "Paul Wellstone Mental Health and Addiction Equity Act" - Support all provisions. The bill expands the Mental Health Parity Act of 1996 by requiring group health plans that offer benefits for mental health and addiction to do so on the same terms as care for other diseases. 3. H.R. 2502, "Geriatricians Loan Forgiveness Act of 2007". Support all provisions. The bill would extend the National Health Service Corps Loan Repayment Program to geriatric training, forgiving $35,000 of educational debt incurred by medical students for each year of advanced training to obtain a certificate of added qualifications in geriatric medicine or geriatric psychiatry. 4. S. 558, the "Mental Health Parity Act of 2007". Support provisions to prohibit private health insurance plans from imposing treatment limitations or financial requirements on mental health benefits unless comparable limitations or requirements are imposed on medical and surgical benefits. 5. Discussed with House and Senate staff the need to include older adults in clinical trials, following the 2007 release of a GAO report on this issue. 6. S. 1628, a bill to amend the Public Health Service Act to authorize programs to increase the number of nurse faculty and to increase the domestic nursing and physical therapy workforce. Support all provisions. 7. S. 1854, the "Stop Senior Suicide Act". Support provisions to repeal the 50 percent Medicare outpaitent mental health coinsurance rate; improve interagency coordination; provide grants for elderly suicide early intervention and prevention strategies; and enhance the existing Suicide Prevention Resource Center. 8. Support H. R. 3411, the "Juvenile Crime Reduction Act of 2007," to provide strategies to help to decrease the prevalence of young people with mental disorders who come into contact with the juvenile justice system. 9. S. 2708 and H.R. 6337, the "Caring for an Aging America Act of 2008. Support all provisions. The bill would provide for the establishment of a new geriatric and gerontology loan repayment program. 10. Reauthorization of the Substance Abuse and Mental Health Services Administration - discuss inclusion of provisions from S. 982 (the "Positive Aging Act of 2007") and S. 1854 (the "Stop Senior Suicide Act") with Senate staff. 11. Discussed with House and Senate staff the need for additonal health care professionals trained in geriatrics and the need for a study on the mental health care workforce that will be needed to treat older adults with mental disorders over the next three decades. 12. Support S. 2641, the "Nursing Home Transparency and Improvement Act of 2008". Support all provisions. The bill would increase public transparency and accountability of nursing home owners and operators, including nursing home chains, by requiring them to disclose the corporate entities that own nursing homes and their affiliated entities. 13. Support H.R. 6375, "Healthy Transitions Act". Support all provisions. The bill would establish planning and implementation grants to states to assist in the development of a coordinated service delivery system to maximize continuity of care and access to services for young adults who are transitioning to the adult mental health system. 14. Support H.R. 1424, Emergency Economic Stabilization Act of 2008". Support provision to provide mental health parity to require group health plans that offer mental health and substance abuse benefits to do so on the same terms as medical and surgical benefits. 15. S. 3335, the "Jobs, Eneergy, Families and Disaster Relief Act of 2008". Support mental health parity provision. 16. S. 3155, a bill to reauthorize the "Juvenile Justice and Delinquency Prevention Act of 1974". Urge that the bill include provisions to address the plight to young people with mental disorders intersecting with the juvenile justice system.

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 1758/H.R. 3001 - CLASS Act, to establish a national insurance trust for long-term care - for S. 2708/HR 6337 - Caring for an Aging America Act, to recruit and retain health professionals for the field of long-term care - for S 2641/HR 5799, Nursing Home Transparency and Improvement Act - for requirements on reporting nursing home ownership and staffing. Opposed to provisions for increased penalties for survey deficiencies. HR 7128, Nursing Home Transparency and Quality of Care Improvement Act - for requirements on reporting nursing home ownership and staffing. Opposed to provisions for increased penalties for survey deficiencies.

Client expense: $100,140 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Housing & Urban Development, Dept of (HUD), SENATE

Higher Education Act reauthorization legislation pending Labor, HHS, Education Appropriations bill for FY09 (HRSA/Title VII funding, Title VIII funding, AoA appropriations, student financial aid, targeted project funding) H.R. 5715 The Ensuring Continued Access to Student Loans Act of 2008 S. 2708 - Caring for an Aging American Act

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 901, Health Centers Renewal Act of 2007, include pharmacists as eligible for loan forgiveness programs of the National Health Service Corps. S.2708, Caring for an Aging America Act of 2008, include pharmacists in geriatric training program. Proposed legislation to create an academic counterdetailing program on prescription drugs. Outlined potential role of the pahrmacist. S. 2932, Poison Center Support, Enhancement, and Awareness of 2008, support all provisions. H.R. 5491, The Pharmacy Technician Training and Registration Act of 2008; all provisions. FDA: Communicated policy concerning National Drug Code number system and need for improvements. DEA: proposed rule concerning electronic prescriptions for controlled substances. Comments to the Office of the Natinal Coordinator for Health Information Technology re: Draft Medication Gaps and Draft Order Sets.

Client expense: $250,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

S 2337/HR 3363 - Discussion of and support for Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. S 1070/HR 1783 Elder Justice Act/S 1577 Patient Safety and Abuse Prevention Act of 2007 - Support for both pieces of legislation, strategy for how they might both move forward this year, bill markup, background for score on S.1577. S 2708 Caring for an Aging America Act of 2008 - Provisions related to increasing the number of professionals trained in geriatrics or gerontology, etc., providing input on legislation and encouraging offices to cosponsor the bill. Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. S 3230 Empowered at Home Act - Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. HR 7110/S 3604 Job Creation and Unemployment Relief Act - Lobbied for FMAP funding. HR 5613 Protecting the Medicaid Safety Net Act of 2008 - Supported this legislation, particularly provisions related to placing a moratorium on seven harmful Medicaid regulations. HR 6331 Medicare Improvements for Patients and Providers Act - Discussed need to strengthen low-income programs by raising asset limits and streamlining rules, and to keep premiums affordable for all beneficiaries, and promote e-prescriptions in medicare. S 2408/HR 4296 Medicare Electronic Medication and Safety Protection (E-Meds) Act of 2007- Supported provisions related to requiring e-prescribing in Medicare Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. S 2641 Nursing Home Transparency and Improvement Act - Lobbied in support of the bill and to increase co-sponsors; criminal background checks for LTC employees; nursing home quality and proposed five star rating system cms; poor performing nursing homes, family caregiving initiative, nursing home compliance guidelines, Home Health CAHPS, LTC Partnership Program (under Medicaid data reporting requirements), status of Nursing Home Value Based Purchasing Demonstration, Prepare to Care for use in innovative employer caregiving programs satellite broadcast, LTC Quality Alliance. HR 2642 - Lobbied for inclusion of Medicaid Regulation Moratoriam in Military Construction and Veterans Affairs Appropriations Act of 2008, and on supplemental appropriations bill. To build support and obtain sponsors for Medicaid Family Caregiver Assessment Demonstration proposal (no Bill). S 2838/HR 6126 - Lobbied to support the Fairness in Nursing Home Arbitration Act and oppose amendments to weaken the bill. Discussion and input on legislation to improve the health/LTC workforce and support family caregivers (no bill). Advance directives and end-of-life care, education of the public about these issues, portability, and other issues relating to advance directives (no bill). S 1577- Support for Patient Safety and Abuse Prevention Act (S 1577) and marking up the bill; provided feedback and in testimony. HR 7114/S3613 Independence at Home Act/Chronic Care Coordination - Feedback on and support for legislation to provide chronic care coordination services to certain Medicare beneficiaries. S 1102 Part D Equity for Low-Income Seniors Act of 2007- Support for Medicare premium protection and modifications to Medicare Savings Programs/Part D Low-Income Subsidy. S. 3118 Preserving Access to Medicare Act - Lobbied in opposition to Grassley-McConnell bill - All provisions related to beneficiary access and Medicare improvements, including e-prescribing. S 3101- Urged support of the Medicare Improvements for Patients and Providers Act of 2008 to help improve Medicare. Green Houses and culture change in LTC facilities, person centered care and medical homes - testimony and input on draft bill - no bill number. Lobbied for appeal notices for Medicare beneficiaries in Medicare Advantage plans (no bill). S 1102 Part D Equity for Low-Income Services - Lobbied for legislation to increase Medicare Part D LIS. HR 1536 Prescription Coverage Now Act - Lobbied for legislation to increase Medicare Part D LIS asset limits. HR 5702 End-of-Life Care Advance Directive Promotion Act - Discussed ideas for end-of-life care legislation and how to help ensure patient wishes are respected; Advance Directive Promotion Act. Provided feedback on draft legislation regarding physician orders for life sustaining treatment. S.334 - Discussed long-term care broadly and including it in health care reform, including the Healthy Americans Act. Discussed voting in LTC facilities, such as nursing homes, current status and law on the issue (no bill). S 3327 - Provided input and support for the Empowered at Home Act to make improvements in Medicaid HCBS; LTC insurance tax incentives and consumer protection improvements and a caregiver tax credit. Invitations and information about a solutions forum on balancing of state LTC systems. HR 3363/S 2337 - Discussed consumer protections for LTC insurance, premium increases and claims denials, support for family caregivers including assessment, consumer complaints and support for the LTC Affordability and Security Act. HR 6033 - Discussed provisions of Home-Based Health Services Job Training and Caregiving Act. H.Con.Res 133 - Provided input on and support for new LTC Awareness Week resolution. LTC - General discussion of LTC, home and community based services, family caregiving, chronic care, workforce, quality and financing options.(no bill) CMS - Lobbied on the Medicare Medical Home Demo implementation.

Client expense: $7,330,000 · Firm income: Not reported

Government targets: Administration on Aging, Commerce, Dept of (DOC), Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), Federal Reserve System, Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

Improving Education Results for Children with Disabilities/IDEA reauthorization implementation H.R. 3043/S. 1710 - FY08 Labor-HHS-Education Appropriations FY09 Science/Justice/Commerce Appropriations Bills (including NSF) House FY08 Science/State/Justice/Commerce Appropriations Bill (including NSF) Higher Education Act Reauthorization H.R. 2073/S. 1572 - Child Health Care Crisis Relief Act P.L. 108-355 Garrett Lee Smith Memorial Act H.R. 3430/S. 1332 Mental Health in Schools Act P.L. 107-110 No Child Left Behind Act Reauthorization H.R. 3438 The Bullying & Gang Reduction for Improved Education Act H.Res. 762 Supporting the Goals of National Bullying Prevention Awareness Week Threat Assessment H.R. 88 Eating Disorders Awareness, Prevention, and Education Act of 2007 S. 2708 Caring for an Aging America Act of 2008 H.R. 2343 - Education Begins at Home Act Cyberbullying legislation Sexualization of Girls S. 3364/H.R. 6654 - Increased Student Achievement Through Increased Student Support Act ESEA Title III NPRI Institute of Education Sciences Reauthorization Elementary & Secondary Education Act

Client expense: $162,195 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Indian Health Service, Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Aeronautics & Space Administration (NASA), Natl Highway Traffic Safety Administration (NHTSA), Natl Institute of Justice, Natl Institute of Mental Health (NIMH), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

HR 2860 - Health Care Access and Rural Equity (H-CARE) Act of 2007, Title 2, Section 201 which calls for coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program. HR 3162 - Children's Health and Medicare Protection Act of 2007, Subtitle A, Section 607 which relates to coverage for marriage and family therapist services and mental health counselor services. S. 498 - Rural Medicare Equity Act of 2007 - legislation calls for improvement of the Medicare program for beneficiaries residing in rural areas S. 1605 - Craig Thomas Rural Hospital and Provider Equity Act of 2007, Section 16 which would provide coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program. HR 820 - To amend title XVIII of the Social Security Act to provide for the coverage of marriage and family therapist services under Part B of the Medicare Program, and for other purposes. HR 1663 - Title 3, Sec. 302. Coverage of marriage and family therapist services. To amend title XVIII of the Social Security Act to expand and improve coverage of mental health services under the Medicare Program. S. 2708 - Caring for An Aging America Act of 2008, Section 771 - Geriatric and Gerontology Loan Repayment Program

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 6210 Small Business Health Options Program (SHOP) Act S. 2795 Small Business Health Options Program (SHOP) Act H.R 6582 Cooperative for Health Care Options to Improve Coverage for Employers (Small Business CHOICE) Act of 2008 H.R. 6699 Health Security for All Americans Act of 2008 H.R. 2851, Michelles Law S. 334 Healthy Americans Act H.R. 6444 Healthy Americans Act H.R. 6280, Americas Affordable Health Care Act of 2008 S.3402, Consumer Health Education and Transparency Act of 2008 H.R. 2642, Supplemental Appropriations Act of 2008 H.R. 1424 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 S. 558, Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 S. 901Health Care Safety Net Act of 2008 H.R. 1343, Health Care Safety Net Act of 2008 S. 3321, Federal Obesity Prevention Act of 2008 S.1200, Indian Health Care Improvement Amendment Act H.R. 6652, Nurses Higher Education and Loan Repayment Act of 2008 H.R. 6337 Caring for an Aging America Act of 2008 S. 2708, Caring for an Aging America Act of 2008 S. 2672, Conrad 30 State Improvement Act, H.R. 6104 Enhancing Science, Technology, Engineering and Mathematics Education Act of 2008 S. 3047, Enhancing Science, Technology, Engineering and Mathematics Education Act of 2008 S. 3224, Science, Technology, Engineering, and Mathematics Education for the 21st Century Act of 2008 H.R. 6351, 21st Century Rural Health Care Act H.R. 5571, To extend for 5 years the program relating to waiver of the foreign country residence requirement with respect to international medical graduates H.R. 5924, Emergency Nursing Supply Relief Act H.R. 6792, Veterans Physical Therapy Services Improvement Act of 2008 S. 901 Health Care Safety Net Act of 2008 H.R. 1343, Health Care Safety Net Act of 2008 H.R. 2583, Physician Workforce Enhancement Act of 2008 H.R. 4137, College Opportunity and Affordability Act H.R. 2991 Independent Health Record Trust Act H.R. 3800 Promoting Health Information Technology Act H.R. 5442 Technologies for Restoring Users' Security and Trust in Health Information Act H.R. 6357 Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology (PROTECHT) Act H.R. 6898 Health-e Information Technology Act S. 1693Wired for Health Care Quality Act S. 1814 Health Information Privacy and Security Act S. 3408Comparative Effectiveness Research Act

Client expense: $250,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Assistance for Individuals with Functional Impairments. H.R. 3001, S. 1758: provisions pertaining to assistance for individuals with functional impairments and for their families payments for services and supports. Health Insurance Parity. H.R. 1424, S. 558: provisions to provide parity between health insurance coverage of mental health benefits and benefits for medical and surgical services. Nationally-coordinated Elder Justice. H.R. 1783, S. 1070: provisions pertaining to the implementation of a nationally-coordinated elder justice strategy. Commodity Supplemental Food Program. S.1090: provision pertaining to the Commodity Supplemental Food Program for low-income seniors. Health Care Professional Training. S. 2708, S. 2708, H.R. 6337: provisions relating to the recruitment and retention of trained health care professionals and direct care workers to care for older Americans; and provisions authorizing funding to help health care practitioners gain geriatric or gerontological specialization.

Client expense: $280,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

1. H.R. 1669/S. 982, "Positive Aging Act of 2007". Support all provisions. The bill would improve access to mental health services for older adults by integrating mental health services into primary and community settings through demonstration projects that target urban and rural medically underserved areas. Interdisciplinary teams of mental health professionals working in collaboration wiht other providers of health care and social services would provide these evidence-based services. 2. H.R. 1424, the "Paul Wellstone Mental Health and Addiction Equity Act" - Support all provisions. The bill expands the Mental Health Parity Act of 1996 by requiring group health plans that offer benefits for mental health and addiction to do so on the same terms as care fo rother diseases. 3. H.R. 2502, "Geriatricians Loan Forgiveness Act of 2007". Support all provisions. The bill would extend the National Health Service Corps Loan Repayment Program to geriatric training, forgiving $35,000 of educational debt incurred by medical students for each year of advanced training to obtain a certificate of added qualifications in geriatric medicine or geriatric psychiatry. 4. S. 558, the "Mental Health Parity Act of 2007". Support provisions to prohibit private health insurance plans from imposing treatment limitations or financial requirements on mental health benefits unless comparable limitations or requirements are imposed on medical and surgical benefits. 5. Discussed with House and Senate staff the need to include older adults in clinical trials, following the 2007 release of a GAO report on this issue. 6. S. 1628, a abill to amend the Public Health Service Act to authorize programs to increase the number of nurse faculty and to increase the domestic nursing and physical therapy workforce. Support all provisions. 7. S. 1854, the "Stop Senior Suicide Act". Support provisions to repeal the 50 percent Medicare outpaitent mental health coinsurance rate; improve interagency coordination; provide grants for elderly suicide early intervention and prevention strategies; and enhance the existing Suicide Prevention Resource Center. 8. Support H. R. 3411, the "Juvenile Crime Reduction Act of 2007," to provide strategies to help to decrease the prevalence of young people with mental disorders who come into contact with the juvenile justice system. 9. S. 2708 and H.R. 6337, the "Caring for an Aging America Act of 2008. Support all provisions. The bill would provide for the establishment of a new geriatric and gerontology loan repayment program. 10. Reauthorization of the Substance Abuse and Mental Health Services Administration - discuss inclusion of provisions from S. 982 (the "Positive Aging Act of 2007") and S. 1854 (the "Stop Senior Suicide Act") with Senate staff. 11. Discussed with House and Senate staff the need for additonal health care professionals trained in geriatrics and the need for a study on the mental health care workforce that will be needed to treat older adults with mental disorders over the next three decades. 12. Support S. 2641, the "Nursing Home Transparency and Improvement Act of 2008". Support all provisions. The bill would increase public transparency and accountability of nursing home owners and operators, including nursing home chains, by requiring them to disclose the corporate entities that own nursing homes and their affiliated entities. 13. Co-hosted Capitol Hill briefing for House and Senate staff members on mental health needs of older adults, including the need fo rmore geriatric health specialists, the need to integrate mental health care with primary care and the need for parity for Medicare outpatient mental health services.

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3001/ S 1340 - Shared and discusssed actuarial analysis of the CLASS Act regarding creation of a public insurance program for long-term services. S 2337/HR 3363 - Discussion of and support for Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. S 1070 Elder Justice Act/S 1577 Patient Safety and Abuse Prevention Act of 2007 - Support for both pieces of legislation and strategy for how they might both move forward this year. S 1340 Geriatric Assessment and Chronic Care Coordination Act of 2007- Discussed a demonstration version of this Medicare chronic care coordination and geriatric assessment bill. S 2708 Caring for an Aging America Act of 2008 - Provisions related to increasing the number of professionals trained in geriatrics or gerontology, etc., providing input on legislation and encouraging offices to cosponsor the bill. Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. HR 1174 Healthy Hospitals Act of 2007- Discussed with sponsors' staff potential endorsement of this legislation to require hospitals to report infection rates. HR 5613 Protecting the Medicaid Safety Net Act of 2008 - Supported this legislation, particularly provisions related to placing a moratorium on seven harmful Medicaid regulations. Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. Medicaid Personal Assistance Services State Plan option- discussion of comment letter sending and receipt. Discussed need to strengthen low-income programs by raising asset limits and streamlining rules, and to keep premiums affordable for all beneficiaries. S 2480/HR 4296 Medicare Electronic Medication and Safety Protection (E-Meds) Act of 2007- Supported provisions related to requiring e-prescribing in Medicare Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. S 2641/ HR 5799 Nursing Home Quality and Transparency Legislation Act - To protect residents and support for the Nursing Home Transparency and Improvement Act. Discussion of provisions (civil monetary penalties and Special Focus Facilities) in nursing home transparency, accountability, and quality bill. Special Focus Facilities and disclosure of these facilities; criminal background checks for LTC employees; nursing home quality; poor performing nursing homes, family caregiving, nursing home compliance guidelines, Real Choice Systems Change Grants and family caregiver assessments, Home Health CAHPS, LTC Partnership Program (under Medicaid), Aging and Disability Resource Centers (AoA), health care and the uninsured - steps HHS is taking to address this, Medicare Medical Adult Day Care Demonstration. HR 5702 Advance Directive Promotion Act of 2008 - Negotiated provisions on portability of advance directives. HR 2642 - Lobbied for inclusion of Medicaid Regulation Moratoriam in Military Construction and Veterans Affairs Appropriations Act of 2008, and on supplemental appropriations bill. To build support for Medicaid Family Caregiver Assessment Demonstration proposal (no Bill). S 2838/HR 6126 - Input on draft legislation to make arbitration clauses between LTC facilities and their residents or representatives unenforceable; support for this legislation once it was introduced as the Fairness in Nursing Home Arbitration Act, including support letter. Discussion and input on legislation to improve the health/LTC workforce and support family caregivers. Advance directives and end-of-life care, education of the public about these issues, portability, and other issues relating to advance directives. S 1577/HR 3078 - Support for Patient Safety and Abuse Prevention Act (S 1577) and moving the issue forward; provided feedback and in testimony. S 2921 Caring for Wounded Warriors Act of 2008 - Services and supports for family caregivers of certain veterans. Feedback on draft legislation to provide chronic care coordination services to certain Medicare beneficiaries; approaches to improving chronic care for Medicare beneficiaries; discussion of chronic care and Special Needs Plans. S 1102 Part D Equity for Low-Income Seniors Act of 2007- Support for Medicare premium protection and modifications to Medicare Savings Programs/Part D Low-Income Subsidy. S 1758 - Long-term care financing proposals, including the CLASS Act, a public LTC financing program. S. 3164 - Lobbied on Medicare Fraud bill (Martinez and Cornyn) - All provisions related to protecting participants and the Medicare program from fraud and abuse. S. 3118 - Lobbied in opposition to Grassley-McConnell bill - All provisions related to beneficiary access and Medicare improvements, including e-prescribing. S 3101- Urged support of the Medicare Improvements for Patients and Providers Act of 2008 to help improve Medicare. Long Term Care/Reverse Mortgages - To protect consumers when reverse mortgages are used as a LTC financing tool. Green Houses and culture change in LTC facilities. HR 2642 - To keep moratorium on all seven Medicaid regulations in the supplemental appropriations bill. Lobbied on appeal notices for Medicare beneficiaries in Medicare Advantage plans. S 1102 - Lobbied for legislation to increase Medicare Part D LIS. HR 1536 - Lobbied for legislation to increase Medicare Part D LIS asset limits. S 3101/HR 6331 - (Medicare) Lobbied for legislation to protect part B premiums, increase LIS and MSP asset limits, and promote e-prescribing in Medicare. HR 2642 - (Medicaid) Lobbied for inclusion of Medicaid regulation moratorium in Iraq Supplemental.

Client expense: $6,480,000 · Firm income: Not reported

Government targets: Administration on Aging, Commerce, Dept of (DOC), Equal Employment Opportunity Commission (EEOC), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

S. 2112, S. 1604, S. 1628, H.R. 2384, H.R. 2621, S. 446/H.R. 772, H.R. 677, S. 2708

Client expense: Not reported · Firm income: $20,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Higher Education Act reauthorization legislation pending Labor,HHS, Education Appropriations bill for FY09 (HRSA/Title VII funding, Title VIII funding, AoA appropriations, student financial aid, targeted project funding) H.R. 5715 The Ensuring Continued Access to Student Loans Act of 2008 S. 2708 - Caring for an Aging America Act

Client expense: $72,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 901, Health Centers Renewal Act of 2007 and S.2708, Caring for an Aging America Act of 2008. Include pharmacists as eligible for loan forgiveness programs of the National Health Service Corps. S.2932, Poison Center Support, Enhancement, and Awareness Act of 2008 support all provisions. H.R. 5491, The Pharmacy Technician Training and Registration Act of 2008; all provisions. Comments relating to standards and technologies for numerical identifier, validation, track and trace, and authentication for prescription drugs. Comments on Direct-to-Consumer Advertising. Comments on proposed National Institute for Occupational Safety and Health survey of healthcare workers' safety and health. Meetings with HRSA officials on general and common issues on pharmacy technicians, telepharmacy, loan forgiveness.

Client expense: $235,969 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), SENATE

HR 3025 - To amend title XVII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. HR 1459 - To improve Medicare beneficiary access by extending the 60 percent compliance threshold d to determie whether a hospital or unit is an impatient rehabilitation facility. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.562 - To amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare Program. H.R.4105 - To impose a moratorium on the use of recovery audit contractors under the Medicare Integrity Program. H.R.3162 - To amend titles XVIII, XIX, and XXI of the Social Security Act to extend and improve the children's health insurance program, to improve beneficiary protections under the Medicare, Medicaid, and the CHIP program, and for other purposes. H.R.1621 - To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community-based attendant services and supports, and for other purposes. H.R.1536 - To amend part D of title XVIII of the Social Security Act to assist low-income individuals in obtaining subsidized prescription drug coverage under the Medicare prescription drug program by expediting the application and qualification process and by revising the resource standards used to determine eligibility for such subsidies, and for other purposes. H.R.4541 - To amend title XVIII of the Social Security Act to provide for patient protections under the Medicare prescription drug program for residents of long term care facilities. H.R.3963 - To amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.5604 - To amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S.543 - A bill to improve Medicare beneficiary access by extending the 60 percent compliance threshold used to determine whether a hospital or unit of a hospital is an inpatient rehabilitation facility under the Medicare program. S.1107 - A bill to amend title XVIII of the Social Security Act to reduce cost-sharing under part D of such title for certain non-institutionalized full-benefit dual eligible individuals. S.1893 - An original bill to amend title XXI of the Social Security Act to reauthorize the State Children's Health Insurance Program, and for other purposes. S.338 - A bill to amend title XVIII of the Social Security Act to ensure and foster continued patient quality of care by establishing facility and patient criteria for long-term care hospitals and related improvements under the Medicare program. S.2499 - A bill to amend titles XVIII, XIX, and XXI of the Social Security Act to extend provisions under the Medicare, Medicaid, and SCHIP programs, and for other purposes. S.2396 - A bill to amend title XI of the Social Security Act to modernize the quality improvement organization (QIO) program. S.2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. S.2705 - A bill to authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. S.2786 - A bill to amend title XVIII of the Social Security Act to improve access to health care under the Medicare program for beneficiaries residing in rural areas. H.R.5613 - To extend certain moratoria and impose additional moratoria on certain Medicaid regulations through April 1, 2009. S.2819 - A bill to preserve access to Medicaid and the State Children's Health Insurance Program during an economic downturn, and for other purposes. H.R.6331- To amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare Program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes. S.3101 - A bill to amend titles XVIII and XIX of the Social Security Act to extend expiring provisions under the Medicare program, to improve beneficiary access to preventive and mental health services, to enhance low-income benefit programs, and to maintain access to care in rural areas, including pharmacy access, and for other purposes.

Client expense: $380,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR 2807 - To intensify stem cell research showing evidence of substantial clinical benefit to patients, and for other purposes. HR 1783 - To amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, & for other purposes. H.R.2521 - To provide loans and grants for fire sprinkler retrofitting in nursing facilities. H.R.3025 - To amend title XVIII of the Social Security Act to provide comprehensive improvements to the Medicare Prescription Drug Program, and for other purposes. H.R.1046 - To amend titles XI and XVIII of the Social Security Act to modernize the quality improvement organization (QIO) program. H.R.1841 - To amend the Social Security Act and the Internal Revenue Code of 1986 to provide for an AmeriCare that assures the provision of health insurance coverage to all residents, and for other purposes. H.R.4082 - To improve the quality of, and access to, long-term care. H.R.976 - An act to amend title XXI of the Social Security Act to extend and improve the Children's Health Insurance Program, and for other purposes. H.R.3784 - To amend title XVIII of the Social Security Act to improve the quality of care in skilled nursing facilities under the Medicare Program through requiring the reporting of expenditures for nursing. H.R.3453 - To amend title XVIII of the Social Security Act to repeal the Medicare competitive bidding demonstration project for clinical laboratory services. H.R.4854 - To amend the provisions of title 31, United States Code, relating to false claims to clarify and make technical amendments to those provisions, and for other purposes. H.R.3180 - To amend title 31, United States Code, to clarify who is an original source for purposes of bringing a qui tam action. H.R.5480 - To respond to a Medicare funding warning. S.1980 - A bill to improve the quality of, and access to, long-term care. S.2662 - A bill to respond to a medicare funding warning. S.2041 - A bill to amend the False Claims Act. S.1693 - A bill to enhance the adoption of a nationwide interoperable health information technology system and to improve the quality and reduce the costs of health care in the United States. S.2641 - A bill to amend title XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. S.1947 - A bill to amend title XI of the Social Security Act to improve the quality improvement organization (QIO) program. S.2099 - A bill to amend title XVIII of the Social Security Act to repeal the Medicare competitive bidding project for clinical laboratory services. S.1070 - A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes. S.1019 - A bill to provide comprehensive reform of the health care system of the United States, and for other purposes. S.1814 - A bill to provide individuals with access to health information of which they are a subject, ensure personal privacy with respect to health related information, promote the use of non-identifiable information for health research, impose criminal and civil penalties for unauthorized use of protected health information, to provide for the strong enforcement of these rights, and to protect States' rights. S.1615 - A bill to provide loans and grants for fire sprinkler retrofitting in nursing facilities. S.845 - A bill to direct the Secretary of Health and Human Services to expand and intensify programs with respect to research and related activities concerning elder falls. S.334 - A bill to provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away. S.325 - A bill to provide for innovation in health care through State initiatives that expand coverage and access and improve quality and efficiency in the health care system. S.1980 - A bill to improve the quality of, and access to, long-term care. S.2708 - A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R.6337 - To amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans. H.R.5878 - To authorize programs to increase the number of nurses within the Armed Forces through assistance for service as nurse faculty or education as nurses, and for other purposes. H.R.2705 - To amend the Compact of Free Association Amendments Act of 2003, and for other purposes. H.R.6252 - To amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. S.3144 - A bill to amend part B of title XVIII of the Social Security Act to delay and reform the Medicare competitive acquisition program for purchase of durable medical equipment, prosthetics, orthotics, and supplies. S.2603 - A bill to amend title XI and XVIII of the Social Security Act to provide increased civil and criminal penalties for acts involving fraud and abuse under the Medicare program and to increase the amount of the surety bond required for suppliers of durable medical equipment. S.2641 - A bill to amend title XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. H.R.5799 - To amend titles XVIII and XIX of the Social Security Act to improve the transparency of information on skilled nursing facilities and nursing facilities and to clarify and improve the targeting of the enforcement of requirements with respect to such facilities. S.RES.543 - A resolution designating the week beginning May 11, 2008, as "National Nursing Home Week". H.RES.1203 - Expressing support for designation of the week beginning May 11, 2008, as "National Nursing Home Week".

Client expense: $380,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

HR 5447/S 2858: Social Work Reinvestment Act: Working on elements that enhance the capacity of the profession of social work to provide distinguishable social service delivery and also seek to remove systemic barriers such as educational debt which impede professional social workers from adequately engaging their clientele; HR 5447/ S 2858: Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act; support establishing a Social Work Reinvestment Commission to address recruitment, retention, research, and reinvestment in the social work profession; HR 2165: Teri Zenner Social Worker Safety Act, support establishing a grant program to assist in the provision of safety measures to protect social workers and other professionals who work with at risk populations; S 106, National Center for Social Work Research Act, support establishing the National Center for Social Work Research as an agency of the National Institutes of health (NIH) to conduct, support, and disseminate targeted research on social work methods and outcomes related to problems of significant social concern; S 2708/ HR 6337, Caring for an Aging America Act of 2008, support the need to address the emerging care gap between the increasing numbers of older Americans and the lack of providers who are trained in caring for the medical, health and social needs of the aging population; HR 493 and S 358, Genetic Information Nondiscrimination Act 2007: Support the passage of the bill that would prohibit discrimination on the basis of genetic information with respect to health insurance and employment; HR 3333/ S 1576: Minority Health Improvement and Health Disparity Elimination Act Support research, grants and demonstration projects to improve the health of racial and ethnic minority groups; HR 3014: Health Equity and Accountability Act of 2007: Support the bill designed to improve the health of minority individuals. S 588/HR 1424 "Wellstone Mental Health and Addiction Parity Act" Issues: Mental Health Insurance Coverage. Support bills to provide parity between health insurance coverage of mental health benefits and benefits for medical and surgical services; S 1693 (Kennedy) "Wired for Health Care Quality Act" Issues: Mental Health and Health Privacy. Modify a bill to enhance the adoption of a nationwide interoperable health information technology system and to improve the quality and reduce the costs of healthcare in the United States; HR 5442 (Markey) "TRUST in Health Information Act" Issues: Mental Health and Health Privacy. To Modify a bill providing individuals with access to health information, to ensure personal privacy, security, and confidentiality with respect to health related information in promoting the development of a nationwide interoperable health information infrastructure, to impose criminal and civil penalties for unauthorized use of personal health information, to provide for the enforcement of these rights, to protect States' rights, and for other purposes. HR 6357 (Dingell) "PRO(TECH)T Act" Issues: Mental Health and Health Privacy. Seek modifications in a bill amending the Public Health Service Act to promote the adoption of health information technology, providing limited privacy protections and for other purposes. HR 3800 (Eshoo) "Improving the Interoperability of Health Information Technology." Issues: Mental Health and Health Privacy. Seek modifications in a bill amending the Public Health Service Act to promote the adoption of health information technology, and for other purposes. HR 5447 (Towns) "Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act" Issue: Health/Social Work Workforce. Support a bill to establish the Social Work Reinvestment Commission to provide independent counsel to Congress on policy issues associated with the recruitment, retention, research, and reinvestment in the profession of social work. S. 2858 (Mikulski) "Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act: Issue: Health/Social Work Workforce. Support a bill to establish the Social Work Reinvestment Commission to provide independent counsel to Congress on policy issues associated with the recruitment, retention, research, and reinvestment in the profession of social work. S. 3102 (Snowe) "Small Business Information Security Act" Issues: Mental health and health Privacy. Seek modifications in a bill to establish a Small Business Information Security Task Force, to protect health information privacy and for other purposes.

Client expense: $198,284 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Alzheimer's Disease Demonstration Grants to States Program, Program Implementation S1340/HR2244/HR467, The Geriatric Assessment and Chronic Care Coordination Act of 2007, all provisions relating to Medicare Part B Coverage of geriatric assessment and chrnoic care management services for eligible beneficiaries and process measures and outcomes for Medicare Beneficiaires with multiple chronic illnesses, including dementia. S1758, the Community Living Assistance Services and Supports Act, all provisions relating to establishing a national, voluntary disability insurance program. S1628 Nurse Faculty and Physical Therapist Education Act of 2007 all provisions relating to geriatric faculty fellowships H con Res 133 supproting the goals and ideals of Long Term Care Awareness week, all provisions relating to Long Term Care Awareness week. S897 Alzheimer's Family Assistance Act of 2007, all provisions relating to long term care tax credits, treatment of premiums or qualified long-term care insurance contracts and tax credits for caregivers. S2708, caring for An Aging America Act, all provisions relating to training of health care professionals and direct care workers S264, Nursing Home Transparency and Improvement Act of 2008, all provisions relating to improving the transparency of information about skilled nursing facilities and providing dementia management training. HR1032, Alzheimer's Treatment and Caregiver Support Act, all provisions relating to grants for the expansion of treatment services to individuals with Alzheimer's and training and support services for families and caregivers

Client expense: $80,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), SENATE

HR 507, To establish a grant program to provide vision care to children, and for other purposes, sections as it relates to optometry and health care. HR1343 , To amend the Public Health Service Act to provide additional authorizations of appropriations for the health centers program under section 330 of such Act, and for other purposes, sections as it relates to optometry and health care. HR 1931, The Currency for All Act, sections as it relates to optometry and health care. HR 1884 , To amend the Public Health Service Act to provide for the participation of optometrists in the National Health Service Corps scholarship and loan repayment programs, and for other purposes, sections as it relates to optometry and health care. HR 2012, Contact Lens Consumer Health Protection Act, sections as it relates to optometry and health care. HR 2260, The Health Care Truth and Transparency Act of 2007, sections as it relates to optometry and health care. HR 2915, To amend the Public Health Service Act to reauthorize the National Health Service Corps Scholarship and Loan Repayment Programs, sections as it relates to optometry and health care. S 1117, A bill to establish a grant program to provide vision care to children, and for other purposes, sections as it relates to optometry and health care. S 1693, Wired for Health Care Quality Act, sections as it relates to optometry and health care. S 2408/HR 4296, Medicare Electronic Medication and Safety Protection (E-MEDS) Act, sections as it relates to optometry and health care. S 2708, A bill to amend the Public Health Service Act to attract and retain trained health care professionals and direct care workers dedicated to providing quality care to the growing population of older Americans, sections as it relates to optometry and health care. S 2795, Small Business Health Options Program (SHOP) Act, sections as it relates to optometry and health care.

Client expense: $608,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2860 - Health Care Access and Rural Equity (H-CARE) Act of 2007, Title 2, Section 201 which calls for coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program. HR 3162 - Children's Health and Medicare Protection Act of 2007, Subtitle A, Section 607 which relates to coverage for marriage and family therapist services and mental health counselor services. S. 498 - Rural Medicare Equity Act of 2007 - legislation calls for improvement of the Medicare program for beneficiaries residing in rural areas S. 1605 - Craig Thomas Rural Hospital and Provider Equity Act of 2007, Section 16 which would provide coverage of marriage and family therapist services and mental health counselor services under Part B of the Medicare Program. HR 820 - To amend title XVIII of the Social Security Act to provide for the coverage of marriage and family therapist services under Part B of the Medicare Program, and for other purposes. HR 1663 - Title 3, Sec. 302. Coverage of marriage and family therapist services. To amend title XVIII of the Social Security Act to expand and improve coverage of mental health services under the Medicare Program. S. 2708 - Caring for An Aging America Act of 2008, Section 771 - Geriatric and Gerontology Loan Repayment Program

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S 1758/HR 3001: CLASS Act, to establish a national insurance trust to finance long-term care - for HR 6033, to train public housing residents to provide home-based health services for elders living in subsidized housing - for S 2708, to recruit and retain health care professionals to work in the long-term care field - for S 2641/HR 5799 - Nursing Home Transparency and Improvement Act - for provisions on reporting staffing expenditures and ownership transparency. Oppose increases in civil monetary penalties for nursing homes.

Client expense: $52,416 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 2708, Caring for an Aging America Act HR 4082/S 1980, Long Term Care Modernization Act

Client expense: Not reported · Firm income: Not reported

Government targets: SENATE

Improving Education Results for Children with Disabilities/IDEA reauthorization implementation H.R. 3043/S. 1710 - FY08 Labor-HHS-Education Appropriations FY09 Science/Justice/Commerce Appropriations Bills (including NSF) House FY08 Science/State/Justice/Commerce Appropriations Bill (including NSF) Higher Education Act Reauthorization H.R. 2073/S. 1572 - Child Health Care Crisis Relief Act P.L. 108-355 Garrett Lee Smith Memorial Act H.R. 3430/S. 1332 Mental Health in Schools Act P.L. 107-110 No Child Left Behind Act Reauthorization H.R. 3438 The Bullying & Gang Reduction for Improved Education Act H.Res. 762 Supporting the Goals of National Bullying Prevention Awareness Week Threat Assessment H.R. 88 Eating Disorders Awareness, Prevention, and Education Act of 2007 S. 2708 Caring for an Aging America Act of 2008 H.R. 2343 - Education Begins at Home Act Cyberbullying legislation

Client expense: $165,660 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Education, Dept of, Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), Indian Health Service, Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Aeronautics & Space Administration (NASA), Natl Institute on Alcohol Abuse & Alcoholism (NIAA), Natl Institutes of Health (NIH), Natl Science Foundation (NSF), Office of Management & Budget (OMB), SENATE, Social Security Administration (SSA), Substance Abuse & Mental Health Services Administration (SAMHSA), Veterans Affairs, Dept of (VA), White House Office

Assistance for Individuals with Functional Impairments. H.R. 3001, S. 1758: provisions pertaining to assistance for individuals with functional impairments and for their families payments for services and supports. Health Insurance Parity. H.R. 1424, S. 558: provisions to provide parity between health insurance coverage of mental health benefits and benefits for medical and surgical services. Nationally-coordinated Elder Justice. H.R. 1783, S. 1070: provisions pertaining to the implementation of a nationally-coordinated elder justice strategy. Commodity Supplemental Food Program. S.1090: provision pertaining to the Commodity Supplemental Food Program for low-income seniors. Health Care Professional Training. S. 2708: provisions relating to the recruitment and retention of trained health care professionals and direct care workers to care for older Americans.

Client expense: $440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3001/ S 1340 - Shared and discusssed actuarial analysis of the CLASS Act regarding creation of a public insurance program for long-term services. S 2337/HR 3363 - Discussion of and support for Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. S 1070/S 1577 - Support for both pieces of legislation and strategy for how they might both move forward this year. S 1340 - Discussed a demonstration version of this Medicare chronic care coordination and geriatric assessment bill. S 2708 - Provisions related to increasing the number of professionals trained in geriatrics or gerontology, etc., providing input on legislation and encouraging offices to cosponsor the bill. Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. HR 1174/S 1174 - Discussed with sponsors' staff potential endorsement of this legislation to require hospitals to report infection rates. HR 5140- Supported provisions providing rebates to older Americans who do not file income taxes, and potential for adding provisions to temporarily increase federal funding to state Medicaid programs. HR 5613- Supported this legislation, particularly provisions related to placing a moratorium on harmful Medicaid regulations. Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. Filed comment letters with HHS on proposed regulations involving cost sharing and flexibility in benefit packages. Medicaid Personal Assistance Services State Plan option- discussion of comment letter sending and receipt. Advocated for part B premium protection and asset test improvement. Discussed need to strengthen low-income programs by raising asset limits and streamlining rules, and to keep premiums affordable for all beneficiaries. S 2480/HR 4296- Supported provisions related to requiring e-prescribing in Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. S 2641/ HR 5799 Nursing home quality; discussion of provisions (civil monetary penalties and Special Focus Facilities) in nursing home transparency, accountability, and quality bill. Advance directives and end-of-life care: discussed efforts to educate Medicare beneficiaries about advance directives; discussed, negotiated, and provided input on legislation regarding advance directives under Medicare and Medicaid;portability of advance directives, and public education around advance directives. Special Focus Facilities and disclosure of these facilities; criminal background checks for LTC employees; nursing home quality; poor performing nursing homes, family caregiving, nursing home compliance guidelines, Real Choice Systems Change Grants and family caregiver assessments, Home Health CAHPS, LTC Partnership Program (under Medicaid), Aging and Disability Resource Centers (AoA), health care and the uninsured - steps HHS is taking to address this, Medicare Medical Adult Day Care Demonstration.

Client expense: $7,220,000 · Firm income: Not reported

S. 2112, S. 1604, S. 1628, H.R. 2384, H.R. 2621, S. 446/H.R. 772, H.R. 677, S. 2708

Client expense: Not reported · Firm income: $20,000

Nursing home quality; discussion of provisions (civil monetary penalties and Special Focus Facilities) in nursing home transparency, accountability, and quality bill (Senate). Advance directives and end-of-life care: discussed efforts to educate Medicare beneficiaries about advance directives; discussed, negotiated, and provided input on legislation regarding advance directives under Medicare and Medicaid; portability of advance directives, and public education around advance directives. Special Focus Facilities and disclosure of these facilities; criminal background checks for LTC employees; nursing home quality; poor performing nursing homes, family caregiving, nursing home compliance guidelines, Real Choice Systems Change Grants and family caregiver assessments, Home Health CAHPS, LTC Partnership Program (under Medicaid), Aging and Disability Resource Centers (AoA), health care and the uninsured - steps HHS is taking to address this, Medicare Medical Adult Day Care Demonstration. HR 3001 - Shared and discusssed actuarial analysis of the CLASS Act. S 2337/HR 3363 - Discusssed support for Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. S 1070.S 1577 - Support for both pieces of legislation and strategy for how they might both move forward this year. S 1340 - Discussed a demonstration version of this Medicare chronic care coordination and geriatric assessment bill. HR 1758 - Discussions on bill, including actuarial analysis, provisions and strategy on the bill. S 2708 - Increase the number of professionals trained in geriatrics or gerontology, etc., providing input on legislation and encouraging offices to cosponsor the bill. Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. HR 1174/S 1174 - Discussed with sponsors' staff potential endorsement of this legislation to require hospitals to report infection rates.

Client expense: $7,220,000 · Firm income: Not reported

Government targets: Administration on Aging, HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

LONG TERM CARE (SENATE) - Senate, nursing home quality: discussion of provisions (civil monetary penalties and Special Focus Facilities) in nursing home transparency, accountability, and quality bill LONG TERM CARE (HOUSE) - Advance directives and end-of-life care: discussed efforts to educate Medicare beneficiaries about advance directives; discussed, negotiated and provided input on legislation regarding advance directives under Medicare and Medicaid, portability of advance directives, and public education around advance directives LONG TERM CARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Special Focus Facilities and disclosure of these facilities; criminal background checks for LTC employees; nursing home quality, poor performing nursing homes, family caregiving, nursing home compliance guidance, Real Choice Systems Change Grants and family caregiver assessments, Home Health CAHPS, LTC Partnership Program (under Medicaid), Aging and Disability Resource Centers (AoA), health care and the uninsured steps HHS is taking to address this, Medicare Medical Adult Day Care Demonstration LONG TERM CARE (SENATE) - Senate, nursing home quality: discussion of provisions (civil monetary penalties and Special Focus Facilities) in nursing home transparency, accountability, and quality bill LONG TERM CARE (HOUSE) - Advance directives and end-of-life care: discussed efforts to educate Medicare beneficiaries about advance directives; discussed, negotiated and provided input on legislation regarding advance directives under Medicare and Medicaid, portability of advance directives, and public education around advance directives LONG TERM CARE HR 3001 - CLASS Act shared and discussed actuarial analysis of the CLASS Act, a bill to create a public insurance program for long-term services and supports LONG TERM CARE HR 3363 - Discussed support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections; focused consumer protections LONG TERM CARE S 1070/S 1577 - Elder Justice Act (S. 1070) and Patient Safety and Abuse Prevention Act (S. 1577): support for both pieces of legislation and strategy for how they might both move forward this year LONG TERM CARE S 1340 - Geriatric Assessment and Chronic Care Coordination Act, discussed a demonstration version of this Medicare chronic care coordination and geriatric assessment bill LONG TERM CARE S 1758 - CLASS ACT - discussions on Class Act, including actuarial analysis, provisions and strategy on the bill. Bill would create a public long-term care financing program. LONG TERM CARE S 2337 - Discussion of and support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. LONG TERM CARE S 2337/HR 3363 (SENATE) - Discussion of and support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections LONG TERM CARE S 2708 - Caring for an Aging America Act, a health and long-term care workforce bill to increase the number of professionals trained in geriatrics or gerontology, etc., providing input on legislation and encouraging offices to cosponsor the bill LONG TERM CARE (HOUSE) - Advance directives and end-of-life care: discussed efforts to educate Medicare beneficiaries about advance directives; discussed, negotiated and provided input on legislation regarding advance directives under Medicare and Medicaid, portability of advance directives, and public education around advance directives LONG TERM CARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Special Focus Facilities and disclosure of these facilities; criminal background checks for LTC employees; nursing home quality, poor performing nursing homes, family caregiving, nursing home compliance guidance, Real Choice Systems Change Grants and family caregiver assessments, Home Health CAHPS, LTC Partnership Program (under Medicaid), Aging and Disability Resource Centers (AoA), health care and the uninsured steps HHS is taking to address this, Medicare Medical Adult Day Care Demonstration LONG TERM CARE HR 3001 - CLASS Act shared and discussed actuarial analysis of the CLASS Act, a bill to create a public insurance program for long-term services and supports LONG TERM CARE HR 3363 - Discussed support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections; focused consumer protections LONG TERM CARE S 1070/S 1577 - Elder Justice Act (S. 1070) and Patient Safety and Abuse Prevention Act (S. 1577): support for both pieces of legislation and strategy for how they might both move forward this year LONG TERM CARE S 1340 - Geriatric Assessment and Chronic Care Coordination Act, discussed a demonstration version of this Medicare chronic care coordination and geriatric assessment bill LONG TERM CARE S 1758 - CLASS ACT - discussions on Class Act, including actuarial analysis, provisions and strategy on the bill. Bill would create a public long-term care financing program. LONG TERM CARE S 2337 - Discussion of and support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. LONG TERM CARE S 2337/HR 3363 (SENATE) - Discussion of and support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections LONG TERM CARE S 2708 - Caring for an Aging America Act, a health and long-term care workforce bill to increase the number of professionals trained in geriatrics or gerontology, etc., providing input on legislation and encouraging offices to cosponsor the bill LONG TERM CARE (HOUSE) - Advance directives and end-of-life care: discussed efforts to educate Medicare beneficiaries about advance directives; discussed, negotiated and provided input on legislation regarding advance directives under Medicare and Medicaid, portability of advance directives, and public education around advance directives LONG TERM CARE (SENATE) - Senate, nursing home quality: discussion of provisions (civil monetary penalties and Special Focus Facilities) in nursing home transparency, accountability, and quality bill LONG TERM CARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Special Focus Facilities and disclosure of these facilities; criminal background checks for LTC employees; nursing home quality, poor performing nursing homes, family caregiving, nursing home compliance guidance, Real Choice Systems Change Grants and family caregiver assessments, Home Health CAHPS, LTC Partnership Program (under Medicaid), Aging and Disability Resource Centers (AoA), health care and the uninsured steps HHS is taking to address this, Medicare Medical Adult Day Care Demonstration LONG TERM CARE HR 3001 - CLASS Act shared and discussed actuarial analysis of the CLASS Act, a bill to create a public insurance program for long-term services and supports LONG TERM CARE HR 3363 - Discussed support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections; focused consumer protections LONG TERM CARE S 1070/S 1577 - Elder Justice Act (S. 1070) and Patient Safety and Abuse Prevention Act (S. 1577): support for both pieces of legislation and strategy for how they might both move forward this year LONG TERM CARE S 1758 - CLASS ACT - discussions on Class Act, including actuarial analysis, provisions and strategy on the bill. Bill would create a public long-term care financing program. LONG TERM CARE S 2337/HR 3363 (SENATE) - Discussion of and support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections LONG TERM CARE S 1340 - Geriatric Assessment and Chronic Care Coordination Act, discussed a demonstration version of this Medicare chronic care coordination and geriatric assessment bill LONG TERM CARE S 2337 - Discussion of and support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. LONG TERM CARE (HOUSE) - Advance directives and end-of-life care: discussed efforts to educate Medicare beneficiaries about advance directives; discussed, negotiated and provided input on legislation regarding advance directives under Medicare and Medicaid, portability of advance directives, and public education around advance directives LONG TERM CARE (SENATE) - Senate, nursing home quality: discussion of provisions (civil monetary penalties and Special Focus Facilities) in nursing home transparency, accountability, and quality bill LONG TERM CARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Special Focus Facilities and disclosure of these facilities; criminal background checks for LTC employees; nursing home quality, poor performing nursing homes, family caregiving, nursing home compliance guidance, Real Choice Systems Change Grants and family caregiver assessments, Home Health CAHPS, LTC Partnership Program (under Medicaid), Aging and Disability Resource Centers (AoA), health care and the uninsured steps HHS is taking to address this, Medicare Medical Adult Day Care Demonstration LONG TERM CARE HR 3001 - CLASS Act shared and discussed actuarial analysis of the CLASS Act, a bill to create a public insurance program for long-term services and supports LONG TERM CARE HR 3363 - Discussed support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections; focused consumer protections LONG TERM CARE S 1758 - CLASS ACT - discussions on Class Act, including actuarial analysis, provisions and strategy on the bill. Bill would create a public long-term care financing program. LONG TERM CARE S 2337/HR 3363 (SENATE) - Discussion of and support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections LONG TERM CARE S 1340 - Geriatric Assessment and Chronic Care Coordination Act, discussed a demonstration version of this Medicare chronic care coordination and geriatric assessment bill LONG TERM CARE S 2337 - Discussion of and support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. LONG TERM CARE S 2708 - Caring for an Aging America Act, a health and long-term care workforce bill to increase the number of professionals trained in geriatrics or gerontology, etc., providing input on legislation and encouraging offices to cosponsor the bill LONG TERM CARE S 1070/S 1577 - Elder Justice Act (S. 1070) and Patient Safety and Abuse Prevention Act (S. 1577): support for both pieces of legislation and strategy for how they might both move forward this year MEDICAID (HOUSE) - Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. MEDICAID (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Filed comment letters on proposed regulations involving cost sharing and flexibility in benefit packages. MEDICAID (SENATE) - Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. MEDICAID HR 1174 - S1174 Health Hospitals Act discussed with sponsors staff potential endorsement of this legislation to require hospitals to report infection rates. MEDICAID HR 5140 (SENATE) - Recovery Rebates and Economic Stimulus for the American People Act of 2008 supported provisions providing rebates to older Americans who do not file income taxes, and potential for adding provisions to temporarily increase federal funding to state Medicaid programs. MEDICAID HR 5613 - Protecting the Medicaid Safety Net Act support this legislation that places a moratorium on harmful Medicaid regulations. MEDICAID (HOUSE) - Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. MEDICAID (SENATE) - Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. MEDICAID (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Filed comment letters on proposed regulations involving cost sharing and flexibility in benefit packages. MEDICAID HR 1174 - S1174 Health Hospitals Act discussed with sponsors staff potential endorsement of this legislation to require hospitals to report infection rates. MEDICAID HR 5140 (SENATE) - Recovery Rebates and Economic Stimulus for the American People Act of 2008 supported provisions providing rebates to older Americans who do not file income taxes, and potential for adding provisions to temporarily increase federal funding to state Medicaid programs MEDICAID HR 5613 - Protecting the Medicaid Safety Net Act support this legislation that places a moratorium on harmful Medicaid regulations. MEDICAID (HOUSE) - Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. MEDICAID (SENATE) - Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. MEDICAID (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Filed comment letters on proposed regulations involving cost sharing and flexibility in benefit packages. MEDICAID HR 1174 - S1174 Health Hospitals Act discussed with sponsors staff potential endorsement of this legislation to require hospitals to report infection rates. MEDICAID HR 5140 (SENATE) - Recovery Rebates and Economic Stimulus for the American People Act of 2008 supported provisions providing rebates to older Americans who do not file income taxes, and potential for adding provisions to temporarily increase federal funding to state Medicaid programs MEDICAID HR 5613 - Protecting the Medicaid Safety Net Act support this legislation that places a moratorium on harmful Medicaid regulations. MEDICAID (HOUSE) - Lobbied to adjust budget neutrality requirement in waivers to include costs in both Medicare and Medicaid. MEDICAID (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Filed comment letters on proposed regulations involving cost sharing and flexibility in benefit packages MEDICAID HR 1174 - S1174 Health Hospitals Act discussed with sponsors staff potential endorsement of this legislation to require hospitals to report infection rates. MEDICAID HR 5140 (SENATE) - Recovery Rebates and Economic Stimulus for the American People Act of 2008 supported provisions providing rebates to older Americans who do not file income taxes, and potential for adding provisions to temporarily increase federal funding to state Medicaid programs MEDICAID HR 5613 - Protecting the Medicaid Safety Net Act support this legislation that places a moratorium on harmful Medicaid regulations. MEDICAID (SENATE) - Discussed draft legislation to make changes to Medicaid HCBS, including the Medicaid state plan option, spousal impoverishment, Medicaid Transformation Grants, etc. MEDICAID (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Medicaid Personal Assistance Services State Plan option discussion of comment letter sending and receipt MEDICARE (SENATE) - Senate Medicare package--AARP advocated for part B premium protection and asset test improvement. MEDICARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Discussed need to strengthen low-income programs by raising asset limits and streamlining rules, and to keep premiums affordable for all beneficiaries. MEDICARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) HR 3363 - Support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. MEDICARE S.2408 (HOUSE) - S. 2408/HR4296 - Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 support this legislation to require e-prescribing in Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. MEDICARE S.2408 (SENATE) - S. 2408/HR4296 - Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 support this legislation to require e-prescribing in Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. MEDICARE (SENATE) - Senate Medicare package--AARP advocated for part B premium protection and asset test improvement. MEDICARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) HR 3363 - Support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. MEDICARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) HR3363 - Support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. MEDICARE S.2408 (HOUSE) - S. 2408/HR4296 - Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 support this legislation to require e-prescribing in Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. MEDICARE S.2408 (SENATE) - S. 2408/HR4296 - Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 support this legislation to require e-prescribing in Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. MEDICARE (SENATE) - Senate Medicare package--AARP advocated for part B premium protection and asset test improvement. MEDICARE (SENATE) - Senate Medicare package--AARP advocated for part B premium protection and asset test improvement. MEDICARE (SENATE) - Senate Medicare package--AARP advocated for part B premium protection and asset test improvement. MEDICARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Discussed need to strengthen low-income programs by raising asset limits and streamlining rules, and to keep premiums affordable for all beneficiaries. MEDICARE (SENATE) - Senate Medicare package--AARP advocated for part B premium protection and asset test improvement. MEDICARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) HR 3363 - Support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. MEDICARE S.2408 (HOUSE) - S. 2408/HR4296 - Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 support this legislation to require e-prescribing in Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. MEDICARE S.2408 (SENATE) - S. 2408/HR4296 - Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 support this legislation to require e-prescribing in Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. MEDICARE (SENATE) - Senate Medicare package--AARP advocated for part B premium protection and asset test improvement. MEDICARE (SENATE) - Senate Medicare package--AARP advocated for part B premium protection and asset test improvement. MEDICARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) - Discussed need to strengthen low-income programs by raising asset limits and streamlining rules, and to keep premiums affordable for all beneficiaries. MEDICARE S.2408 (HOUSE) - S. 2408/HR4296 - Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 support this legislation to require e-prescribing in Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. MEDICARE S.2408 (SENATE) - S. 2408/HR4296 - Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 support this legislation to require e-prescribing in Part D, at first by providing incentive payments to providers who do and after 2011 lower payments to providers who do not. MEDICARE (DEPARTMENT OF HEALTH & HUMAN SERVICES) HR 3363 - Support for the Long-Term Care Affordability and Security Act that would make private long-term care insurance available through employer-sponsored flexible spending accounts and cafeteria plans and update and add consumer protections. MEDICARE (SENATE) - Senate Medicare package--AARP advocated for part B premium protection and asset test improvement.

Client expense: $7,220,000 · Firm income: Not reported

HR 1038 Access to Life Saving Medicine Act HR 1076 HIPAA Recreational Injury Technical Correction Act; HR 5442, TRUST in Health Information Act of 2008 HR 676 US National Health Insurance Act S 1490 Federal Employees Electronic Personal Health Records Act of 2007 S 1501 Affordable Biologics for Consumers Act S 1544 Medicare Quality Enhancement Act of 2007 S 1814, Health Information Privacy and Security Act S 1899 Universal Health Coverage Act of 2007 S 242 Pharmaceutical Market Access and Drug Safety Act of 2007 S 316 Preserve Access to Affordable Generics Act S 616 HIPAA Recreational Injury Technical Correction Act S 623 Access to Life Saving Medicine Act Antitrust and Health Insurance Reform: HR971 and S2161 "Community Pharmacy Fairness Act of 2007", S618 "Insurance Industry Competition Act of 2007" Health Information Technology Standards; Electronic Health Records; ICD10 Implementation: HR1368 "Personalized Health Information Act of 2007"; S1783; HR3800 "Promoting Health Information Technology Act"; HR2406 "Healthcare Information Technology Enterprise Integration Act" Healthcare Reform; Insurance Market Reform; Employer Based Healthcare System; Uninsured: S1019 "Health Care Choice Act of 2007"; HR3163 "Healthy Americans Act" Genetic Non-discrimination: HR493 and S358 "Genetic Information Nondiscrimination Act of 2007 Mental Health Parity: HR1424 "Paul Wellstone Mental Health and Addiction Equity Act of 2007" and S558 "Mental Health Parity Act of 2007" TAA; HR3801 and S1848 "TAA Health Coverage Improvement Act of 2007" Comparative Effectiveness Reseaarch: HR3162 "Children's Health and Medicare Protection Act of 2007" Section 904 only; HR2184 "Enhanced Health Care Value for All Act" Health Savings Accounts/Medical Savings Accounts; SCHIP, Small Group Market/Small Business Healthcare S2041 "False Claim Act Correction of 2007" as it pertains to the payment of healthcare claims Printed S. 1783: Ten Steps to Transform Health Care in America Act H.R. 853: Wellness and Prevention Act of 2007 H.R. 2147: Healthy Kids Act of 2007 S. 1364: Healthy Kids Act of 2007 S. 334: Healthy Americans Act H.R. 5348: American Health Benefits Program Act of 2008 (AHBP Act) H.R. 1328: The Indian Health Care Improvement Act H.R. 5544: The Patients and Public Health Partnership Act of 2008 H.R. 5545: Ensuring the Future Physician Workforce Act of 2008 S. 2729: Ensuring the Future Physician Workforce Act of 2008 S. 2708: Caring for an Aging America Act of 2008 H.R. 5496: Public Health Preparedness Workforce Development Act of 2008 H.R. 2991: Independent Health Record Trust Act H.R. 5442: TRUST in Health Information Act S. 2672: A bill to provide incentives to physicians to practice in rural and medically underserved communities H.R. 5174: Nursing and Allied Health Education Preservation Act of 2008 HR 380 Pharmaceutical Market Access and Drug Safety Act of 2007 HR 493 Genetic Information Nondiscrimination Act of 2007 HR 1368 Personalized Health Information Act of 2007 HR 1432 Preserve Access to Affordable Generics Act HR 1666 Health Care Price Transparency Promotion Act of 2007 HR 1902 Protecting Consumer Access to Generic Drugs Act of HR 1956 Patient Protection and Innovative Biologic Medicines Act of 2007 HR 3800 Promoting Health Information Technology Act H.R. 5629 Pathway for Biosimilars Act S 28 Generics First Act of 2007 S 251 Pharmaceutical Market Access Act of 2007 S 273 Prescription Drug and Health Improvement Act of 2007 S 316 Preserve Access to Affordable Generics Act S 358 Genetic Information Nondiscrimination Act of 2007 S 596 Safe Internet Pharmacy Act of 2007 S 628 Critical Access to Health Information Technology Act of 2007 S 976 Genomics and Personalized Medicine Act of 2007 S 1408 Health Information Technology Act of 2007 S 1455 National Health Information Technology and Privacy Advancement Act of 2007 S 1505 Affordable Biologics for Consumers Act S 1693 Wired for Health Care Quality Act S 1695 Biologics Price Competition and Innovation Act of 2007 S. 1814 Health Information Privacy and Security Act S 2408 Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007 Health Information Technology Electronic Prescribing Genetic Nondiscrimination Inappropriate use of Human Growth Hormone Confidentiality of Health Information Generic Drugs Generic Biologics S. 1456 Federal Employees Electronic Personal Health Records Act S. 1693 Wired for Health Care Quality Act S 1338/HR 1293 Access to Medicare Imaging Act of 2007 S. 1042/HR 583 Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2007 HR 2708 Mammogram and MRI Availability Act of 2007

Client expense: Not reported · Firm income: $75,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Higher Education Act reauthorization legislation pending Labor,HHS, Education Appropriations bill for FY09 (HRSA/Title VII funding, Title VIII funding, AoA appropriations, student financial aid, targeted project funding) H.R. 5715 The Ensuring Continued Access to Student Loans Act of 2008 S. 2708 - Caring for an Aging America Act

Client expense: $115,500 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE