COVID–19 Recovery for Seniors and People with Disabilities Act of 2020

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act P.L. 116-131 Supporting Older Americans Act of 2020 S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act S.3768 /H.R.6972 Nursing Home COVID-19 Protection and Prevention Act of 2020 H.R.7048 Nursing Home Pandemic Protection Act S.3644/H.R.6698 Quality Care for Nursing Home Residents and Workers During COVID-19 Act H.R.6638 Reducing COVID-19 Disparities by Investing in Public Health H.R.7158 Health Enterprise Zones Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S.3517/H.R.6487 ACCESS Act S.3740/H.R.6951 COVID-19 Recovery for Seniors and People with Disabilities Act H.R.8169 Elder Abuse Protection Act S.4182 Emergency Support for Nursing Homes and Elder Justice Reform Act of 2020 H.R.5958 Senior Health Planning Account Act S.4184/H.R.7463 Assisted Living Facility Coronavirus Reporting Act S.4682/H.R.8511 Care Corp Demonstration Act of 2020 H.R. 2477 Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

Client expense: $360,000 · Firm income: Not reported

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

P.L. 111-375 National Alzheimer's Project Act, All Sections P.L. 115-119 Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act P.L. 115-406 Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer's Act S.591 Guardianship Accountability Act S.299 Geriatrics Workforce Improvement Act S.548/H.R.1342 EMPOWER Care Act H.R.1343 Protecting Married Seniors from Impoverishment Act S.740 Alzheimer's Caregiver Support Act H.R. 1955 Understanding Appropriate Alzheimer's Care Act of 2019 S.880/H.R.1873 Improving HOPE for Alzheimer's Act H.R.1903/S.901 Younger-Onset Alzheimer's Disease Act of 2019 S.2080/H.R.647 Palliative Care and Hospice Education and Training Act S.1250/H.R.2401 American Cures Act S.1017 Supporting America's Caregivers and Families Act S.995/H.R.2035 Lifespan Respite Care Reauthorization Act of 2019 S.1126/H.R.2283 Concentrating on High-Value Alzheimer's Needs to Get to an End (CHANGE) Act of 2019 S.1361/H.R.2584 Preventive Health Savings Act of 2019 S.1628 Paid Family Leave Pilot Extension Act S.1618 Expanding Capacity for Health Outcomes (ECHO) Act of 2019 S.1202 Independence at Home Act of 2019 H.R.3644 Independence at Home Demonstration Act of 2019 H.R.3436 Improving Chronic Care Management Act H.R.3107 Improving Seniors' Timely Access to Care Act H.R.4334 Dignity in Aging Act of 2019 S.2469/H.R.4386 Stop the Wait Act H.R.2781 Educating Medical Professionals and Optimizing Workforce Efficiency and Readiness (EMPOWER) for Health Act of 2019 S.2521/H.R.4397 Direct CARE Opportunity Act S.3057 Modernization of the Older Americans Act Amendments S.2677 Older Americans and Social Isolation and Loneliness Act H.R.4859 Protecting Older Americans from Social Isolation Act of 2019 H.Res.821 to establish a permanent select Committee in Aging in the House of Representatives H.R.6379 Families First Coronavirus Response Act S.3548/H.R.748 Coronavirus Aid, Relief, and Economic Security (CARES) Act; including provisions that would impact individuals living with Alzheimer's and other dementia and their caregivers. H.R.4334 Supporting Older Americans Act of 2020 S.3544/H.R.6305 Coronavirus Relief for Seniors and People with Disabilities Act S.3768 /H.R.6972 Nursing Home COVID-19 Protection and Prevention Act of 2020 H.R.7048 Nursing Home Pandemic Protection Act S.3644/H.R.6698 Quality Care for Nursing Home Residents and Workers During COVID-19 Act H.R.6638 Reducing COVID-19 Disparities by Investing in Public Health H.R.7158 Health Enterprise Zones Act H.R.6800 Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act S.3517/H.R.6487 ACCESS Act S.3740/H.R.6951 COVID-19 Recovery for Seniors and People with Disabilities Act In forthcoming COVID-19 relief packages, the Alzheimer's Association is advocating for inclusion of policies that would impact those in the Alzheimer's and dementia community including: - Improving HOPE for Alzheimer's Act (S.880/H.R.1873) - Extension of the Independence at Home demonstration model - Promoting Alzheimer's Awareness to Prevent Elder Abuse Act, including Elder Justice Initiative training for professionals through the Department of Justice - Emergency Preparedness in long-term and community-based care settings - Expanding Capacity for Health Outcomes (Project ECHO) - Project VITAL: Virtual Inclusive Technology for ALL

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

Government targets: Administration on Aging, Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Indian Health Service, Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), SENATE, Social Security Administration (SSA), Veterans Affairs, Dept of (VA)

COVID-19 Advocacy/CARES Act Support A one-year expansion of federal funding for Medicaid home and community-based services (HCBS), from July 1, 2020 to June 30, 2021. An expansion of the paid leave program to cover family caregiving of adults with disabilities, which would allow all family members, not just parents, to take paid leave for caregiving. Additional pay of up to $10,000 for personal care attendants, home health aides, and direct support professionals for their work during the COVID-19 pandemic. An additional round of Economic Impact Payments, resolving bureaucratic issues for SSI, SSDI, and VA benefits recipients, and fixing an issue that left adult dependents ineligible for these payments. A requirement that that the Department of Health and Human Services (HHS) make specific plans to ensure that COVID-19 testing is accessible to people with disabilities and people with underlying health conditions or compromised immune systems. A requirement that States ensure that absentee or mail-in ballots are accessible for people with disabilities. Support All Dependent Children Count Act introduced by Rep. Craig in the House (H.R. 6420), and Sen. Smiths All Dependents Count Act, S. 3652. Support H.R. 6680 which would disregard unemployment benefits from eligibility consideration for means-tested programs such as SSI and SNAP - Strengthening UI for Coronavirus Impacted Workers and Students Act. Department of Health and Human Services Supported letter to Secretary Azar and Director Severino to express our strong and urgent support for the Departments Office for Civil Rights to issue additional guidance to ensure that schemes to ration scarce health care resources during the coronavirus disease 2019 (COVID-19) pandemic comply with federal nondiscrimination laws. Justice in Aging request HHS Secretary Azar to Remove Barriers for Medicare Enrollment During COVID Pandemic United Spinal joined Justice in Aging and numerous organizations requesting the Department of Health and Human Services take action to remove barriers and to streamline enrollment in health insurance coverage for low-income older adults and people with disabilities who are at highest risk of serious illness and death from COVID-19. United Spinal advocated to exempt non-invasive ventilators from Medicares competitive bidding program which limits choice for consumers and cuts reimbursement to Medicare providers. During the COVID-19 pandemic, it is the wrong time to place additional restrictions on access to life-saving equipment. United Spinal sent in its own letter to Congress along with other stakeholders such as the ALS Association and the company RESMED. As a CCD Rights Task Force co-chair, United Spinal advocacy and policy staff signed a letter to HHS Secretary Alex Azar, CMS Administrator Seema Verma, and CDC Director Robert Redfield urging them to collect and report data on the impact of COVID-19 on people with disabilities, including numbers of tests, testing rates, numbers and rates of positive tests, hospitalizations, deaths and death rates, recoveries, transfers from community living to institutional settings and discharges from institutional settings, and analysis of that data to identify trends and correlational factors. United Spinal advocacy and policy staff provided comments as part of the Disability and Rehabilitation Research Coalition (DRRC) to Senator Warren (D-MA) and Reps. Pressley (D-MA) & Kelly (D-IL) on a bill to require the CDC to collect and report demographic data related to COVID-19; we urged them to include data collection on disability factors. oOn April 14, Reps. Ayanna Pressley, Robin Kelly, and other members of the Congressional Black Caucus, along with Sen. Elizabeth Warren and others introduced the Equitable Data Collection and Disclosure on COVID-19 Act, which would require the Department of Health and Human Services (HHS) to collect and report racial, ethnic, and other demographic data on COVID testing, treatment, and fatality rates. The introduced legislation did mention disability but did not include significant focus on the importance of disability data collection. oMembers of the DRRC, which includes United Spinal, along with other stakeholders, drafted revisions to the legislation. The edits were intended to achieve three purposes: 1) integrate the concerns and interests of the disability community throughout the bill to ensure that disability rights are universally considered civil rights, 2) include on the mandated data collection commission agencies with disability, independent living, and rehabilitation research portfolios, and 3) authorize targeted COVID research funding to NIDILRR comparable to the targeted funding provided to other research agencies. These edits were shared with Sen. Warrens office along with other congressional disability champions, including Sen. Bob Casey (D-PA) and Rep. Jim Langevin (D-RI). Following work in March that resulted in Federal guidance being issued by the Office for Civil Rights (OCR) at the Department of Health and Human Services to remind States and health care providers of their responsibilities under Federal law not to discriminate against people with disabilities in providing health care, United Spinal signed onto a guidance document developed by the disability community outlining principles for states and health care providers to follow in adhering to the Federal guidance. United Spinal also joined over 400 organizations in calling on HHS for additional Federal guidance on nondiscrimination in health care to be issued by OCR. United Spinal, as a member of the ITEM Coalition Steering Committee, endorsed a letter to HHS Secretary Alex Azar urging for improved access to this treatment. We have written to CMS before about the complex and burdensome billing requirements associated with the dNPWT benefit that have resulted in decreased patient access to this important treatment. Proposed Rule and Medicare Advantage (MA), Medicare Part D and Medicaid United Spinal, as a Steering Committee member of CPR endorsed comments to the Centers for Medicare and Medicaid Services highlighting important provisions of benefit to Medicare and Medicaid beneficiaries: Revisions to supplemental benefits for beneficiaries with chronic conditions (SSBCI), Network adequacy requirements for MA plans, Star rating program enhancements, and New tools for beneficiaries under the Medicare prescription drug benefit program (Part D). PCHAlliance Proposed Rule and Medicare Advantage (MA), Medicare Part D and Medicaid United Spinal, as a member of PCHAlliance signed onto this coalitions letter: Interoperable, connected health, requires a broad ecosystem of shared digital health information. It is particularly noteworthy that this proposed rule advances Medicare Advantage coverage of patient centered digital, interoperable, connected healthcare. PCHAlliance members support the advancement of evidence based connected health. CMS work to develop and ensure appropriate use of connected care is particularly noteworthy as one of the key enablers of modernizing Medicare for the use of evidence based connected care is to improve patient outcomes. United Spinal comments on FY 2021-2025 NIH-Wide Strategic Plan Framework United Spinal provided comments on the National Institutes of Healths (NIH) Request for Information on the FY 2021-2025 NIH-Wide Strategic Plan Framework, in support of strengthening and advancing disability and rehabilitation research and included support of the comments submitted by the Disability and Rehabilitation Research Coalition, of which United Spinal Association is a member. United Spinal supports COVID-19 Recovery for Seniors and People with Disabilities Act - S. 3740. United Spinal supports Nursing Home COVID-19 Protection and Prevention Act - S. 3768. United States Postal Services (USPS) - COVID-19 United Spinal signed onto a letter, facilitated by AARP, to House and Senate leadership in support of USPS continued funding in order to provide the vital services that millions of Americans, especially older Americans and those with chronic conditions, depend upon, especially during this pandemic, as it relates to pharmacy and medical supplies needs as well as access to voting. United Spinal sent a letter to the U.S. Senate Aging Committee thanking them for holding a hearing examining the devastating impact COVID-19 has had on nursing homes and urging them to engage the disability community as they seek solutions. Support increased appropriations funding for the SCI Model Systems under the NIDILRR grant. Support continued appropriations funding for CDC's National Neurological Conditions Surveillance System. As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal endorsed these comments: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Value-Based Purchasing Program for Federal Fiscal Year 2021 [CMS-1737-P, RIN: 0938-AU13] - Concerns with the Patient-Driven Payment Model. CPR continues to be concerned with the observed and ongoing impact of the Patient-Driven Payment Model (PDPM) implemented in the SNF PPS effective October 1, 2019. CMS implemented this new case-mix classification model to group patients admitted to SNFs during covered Medicare Part A stays, replacing the Resource Utilization Group, Version IV (RUG-IV) system. As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal endorsed these comments: Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2021 Proposed Rule [CMS-1729-P; RIN 0938-AU05]. Under this proposal, non-physician practitioners would be able to conduct or designate another certified clinician to conduct the preadmission screening (PAS), review and concur with the findings of the preadmission screening, conduct the post-admission physician evaluation (PAPE), which CMS proposes to eliminate, lead the required weekly interdisciplinary team meetings, conduct required face-to-face visits with the patient, and develop and modify the patients plan of care. In sum, CMS proposes to defer to the IRF to determine whether a non-physician practitioner has sufficient specialized training and experience in inpatient rehabilitation to essentially fulfill the role of the rehabilitation physician. CPR views this proposal as a major broadside attack on the integrity and value of care provided by inpatient rehabilitation hospitals and units. We strongly oppose this proposal and believe that, if finalized, it would materially undercut IRF care and decrease the level and quality of care provided in an IRF, potentially causing significant harm to patients with complex conditions who need an intensive, coordinated, interdisciplinary course of inpatient hospital-level rehabilitation treatment.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Federal Communications Commission (FCC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Social Security Administration (SSA), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Veterans Affairs, Dept of (VA)