CAROL TYSON

Discussed US DOT's Safer Streets initiative and increased accessibility including the need for accessibility and disability-related data collection; the importance of human services coordinated transportation in rural America; needed regulation for the non-motorized safety performance measures and the Pedestrian Safety Enhancment Act; ADA enforcment; AMTRAK, air travel, technical assistance; and commercial drivers' licenses for people with disabilities. US Access Board Rail Vehicles Access Advisory Committee (RVAAC) - discussed the development of consensus recommendations regarding vehicles of fixed guideway systems, inlcuding rapid, light, commmuter, intercity and high speed rail. United Spinal suppported an amendment to HR 749 - Passenger Rail Reform and Investment Act of 2015. The amendment requires Amtraks Office of Inspector General to submit a report to the House T&I and Senate Commerce Committees on boarding procedures at the 10 busiest stations for wheelchair users and passengers using or transporting bicycles. Rep. Lipinski mentioned United Spinals support in his floor speech and clarified that the amendment would require the report to include motorized and non-motorized wheelchairs. HR 749 passed with the amendment. United Spinal supports HR 1448 - Transit Accessibility Innovation act of 2015 (HR 1448). The legislation would create a competitive grant program under the Federal Transit Administration (FTA) to encourage transit systems to make public transportation more accessible and user-friendly for individuals with disabilities. United Spinal provided recommendations on multi-modal accessible transporation appplications that would promote independent living and mobility of travelers with disabilities and improve the travel experience of all users. United Spinal discussed strategies for creating successful models for building connected communities and measuring the benefits for its citizens. United Spinal raised questions regarding the accessibility of innovative transportation modes, and the importance of ensuring existing transportation is connecting people with disabilities to their homes, work, schools, and other important destinations. United Spinal engaged in a discussion with senior National Highway Traffic Safety Administration (NHTSA) staff regarding data collection of pedestrians with disabilities injuries and fatalities, as well as the need to report on wheelchair user injuries and fatalities.

United Spinal participated, as an alternate, in the U.S. Access Board's Rail Vehicles Access Advisory Committee (RVAAC) April meeting. The RVAAC is developing consensus recommendations for the Access Boards use in updating sections of the guidelines that cover vehicles of fixed guideway systems, including rapid, light, commuter, intercity, and high speed rail. United Spinal submitted comments concerning U.S.DOT proposed rulemaking on Geographic-Based Hiring Preferences in Administering Federal Awards. United Spinal supported USDOTs efforts to allow city and state departments of transportation to set economic and geographic preferences for projects receiving federal funds. In addition, United Spinal urged USDOT to extend the allowance for targeted hiring provisions, including women and people with disabilities. United Spinal recommended language supporting contractor compliance with the U.S. Department of Labor (DOL) Section 503 rule requiring affirmative action policies leading to the employment of people with disabilities. United Spinal participated in an executive roundtable at the USDOT on Connectivity. The roundtable sought to examine equity measures seeking to ensure all people, including mobility device users, are getting where they need to go. United Spinal participated in a conference call with USDOT staff regarding future webinars to support the USDOTs Mayors Challenge for Safer People, Safer Streets initiative. Mayors offices (and state and other local officials, and planning organizations) who had signed up to participate in the challenge convened for a day at the USDOT headquarters earlier this year. Participants will receive technical assistance throughout the year. United Spinal supports S.705, the Transportation Alternatives Program Improvement Act. S.705 ensures adequate funding for sidewalk and other pedestrian and biking programs. The bill would allocate funds to local communities, and smaller rural communities, to build accessible networks, and to non-profits for safety education. United Spinal signed on to a letter to all members of Congress in support of adequate funding for transportation alternative programs (TAP), which includes funding for sidewalks and curb ramps. United Spinal signed on to a letter to all members of Congress in support of adequate funding for transportation alternative programs (TAP), which includes funding for sidewalks and curb ramps. United Spinal signed on to a letter to Congress regarding the need for reauthorization for a surface transportation bill. The letter highlighted the need for accessible transportation programs, funding for travel training and technical assistance, accessible taxis and public rights-of-way, and quality paratransit and coordinated transportation. United Spinal attended a conversation with USDOT Secretary Foxx, the DC DOT Director, Iowa DOT Director, and a key VA DOT official. The speakers discussed funding challenges and potential solutions. United Spinal attended a talk and interview with House Transportation & Infrastructure Chairman Shuster on transportation funding. Supports HR 2071, the Safe Streets Act of 2015, sponsored by Rep. Matsui (D-CA-6th). The bill encourages communities to consider safety improvements for all users in transportation project planning. United Spinal also calls on Congress to pass a long-term surface transportation bill with adequate funding measures. Any bill should incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system for all in urban, suburban, and rural settings. United Spinal provided guidance to Representative Duckworths staff regarding a bill that would require spaces be provided in airports for mothers to breastfeed. Duckworths staff requested recommended language to ensure the spaces provided would be accessible to all H.R.2530 - the Friendly Airports for Mothers Act of 2015. United Spinal provided a letter of support to Representative Langevins office in support of HR 1448, the Transit Accessibility Innovation Act of 2015. The bill would provide grants to public transit agencies to improve paratransit programs. United Spinal co-signed a letter to the Coast Guard as the Co-Chair of the CCD Transportation Task Force. The letter was addressed to Coast Guard Admiral Zukunft, and ccd key Senate offices on the Coast Guard subcommittee, FEMA, and the White House. The letter raised the concern that the House-passed Coast Guard Reauthorization Act weakens a requirement that survival craft keep a persons entire body out of the water. United spinal co-signed a letter, as Co-Chair of the CCD Transportation Task force, thanking Representative Rick Larsen for adding language to the Federal Aviation Administration (FAA) reauthorization. The language urged the U.S. Department of Transportation (DOT) to swiftly promulgate long-awaited regulations on the Air Carrier Access Act (ACAA) that increase access to accessible air travel for people with disabilities. The letter also raised the hope that rulemaking would increase access to lavatories, for passengers with service animals, and ensure the safety of people with disabilities mobility devices during travel. United Spinal signed on to a Congressional letter organized by Rails-to-Trails in support of funding and maintenance of the Trasnportation Alternatives Program (TAP) under USDOT. TAP provides authorization and funding for bicycle and pedestrian infrastructure and safety programs around the country. United Spinal participated, as an alternate, in the US Access Board Rail Vehicles Access Advisory Committee (RVAAC) June meeting. The RVAAC is developing consensus recommendations for the Access Boards use in updating sections of the guidelines that cover vehicles of fixed guideway systems, including rapid, light, commuter, intercity, and high speed rail.

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

Supports H.R. 1516/S. 1013 - ENsuring Access to Quality Compex Rehabiliation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. United Spinal advocated distributed a Congressional Dear Colleague letter urging that CRT accessories (specialty controls such as head-rests) are not set at competitive bidding pricing the same as standard wheelchairs due to their highly customized nature for a small population living with significant disabilities. United Spinal highlighted our concern with CRT Accessories, described above and with our concerns with access to durable medical equipment for wheelchair users under the competitive acquisition program. United Spinal signed on to a letter to US Health and Human Services Secretary Burwell and CMS officials regarding a pending case, Davis v. Shah, in the U.S. Second Circuit Court of Appeals - a challenge to New York Medicaid's attempt to limit coverage of compression stockings and orthopedic shoes only to Medicaid recipients with specific diagnoses. Supports the Steve Gleason Act which lifts caps on access to speech-generating devices. (HR 1919, H.R. 629, S, 768, S. 984. United Spinal supported Congressional testimony on behalf of the Coalition to Preserve Rehabilitation Steering Committee highlighting the need to eliminate site-neutral payments under Medicare and also advocated for additional signatories to a Dear Colleague letter stating the same issue. United Spinal supports expanded state participation in Medicaid programs that increase funding for HCBS such as the Community First Choice Option, Money Follows the Person, and the Balancing Incentive Program; and oppose restructuring of Medicaid funding through block grants, State Flexibility Funds, or per capita caps. United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services in support of an improved mechanism for the reimbursement of Lemtrada to ensure speedier access to this therapy for individuals with multiple sclerosis. United Spinal signed onto three comment letters to the Centers for Medicare and Medicaid Services in support of improved rehab policy, namely: on in-patient rehabilitative facilities and on skilled nursing facilities to allow for improved quality reporting and on acute care hospitals and payment issues to ensure that bundled payments of services does not hinder coverage of episodes of care for individuals with multiple needs. United Spinal signed onto a MapRx letter to urge the Senate Finance Committee to include, in their discussion of chronic care, robust formularies, coverage of the six-protected classes of drugs, strong oversight, and transparency for consumers are among the design principles essential to meet the needs of Medicare beneficiaries. In addition, a process for notice of non-coverage, appeals and exceptions is critical to providing access to needed drug therapies. United Spinal supports S.1253, the Patient Access to Disposable Medical Technology Act of 2015.The legislation amends title XVIII (Medicare) of the Social Security Act to cover disposable medical technology in addition to equipment traditionally described as durable medical equipment. This legislation was introduced by Senators Burr (R-NC) and Bennet (D-CO) this spring and is identical to its House counterpart, H.R. 1018, which United Spinal has also supported. United Spinal supports the Protect Medical Innovation Act of 2015, HR 160, introduced by Rep. Eric Paulsen of Minnesota, which repeals the medical device tax on medical device manufacturers and importers. United Spinal signed on to a letter to Congress to convey support for the goals of the final Home and Community Based Settings (HCBS) rule issued by the Centers for Medicare & Medicaid Services (CMS) in January 2014. This rule is the first time CMS has defined community for Medicaid-funded HCBS programs. The letter also urges Congress to: protect cuts to funding; support the requested additional $2.8m in CMS funding for HCBS; and defend against policies or changes to the rule that would hinder the goal of providing supports through HCBS so that people with disabilities can live meaningful lives.

Supports H.R. 1516/S. 1013 - ENsuring Access to Quality Compex Rehabiliation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. United Spinal advocated distributed a Congressional Dear Colleague letter urging that CRT accessories (specialty controls such as head-rests) are not set at competitive bidding pricing the same as standard wheelchairs due to their highly customized nature for a small population living with significant disabilities. United Spinal highlighted our concern with CRT Accessories, described above and with our concerns with access to durable medical equipment for wheelchair users under the competitive acquisition program. United Spinal signed on to a letter to US Health and Human Services Secretary Burwell and CMS officials regarding a pending case, Davis v. Shah, in the U.S. Second Circuit Court of Appeals - a challenge to New York Medicaid's attempt to limit coverage of compression stockings and orthopedic shoes only to Medicaid recipients with specific diagnoses. Supports the Steve Gleason Act which lifts caps on access to speech-generating devices. (HR 1919, H.R. 629, S, 768, S. 984. United Spinal supported Congressional testimony on behalf of the Coalition to Preserve Rehabilitation Steering Committee highlighting the need to eliminate site-neutral payments under Medicare and also advocated for additional signatories to a Dear Colleague letter stating the same issue. United Spinal supports expanded state participation in Medicaid programs that increase funding for HCBS such as the Community First Choice Option, Money Follows the Person, and the Balancing Incentive Program; and oppose restructuring of Medicaid funding through block grants, State Flexibility Funds, or per capita caps. United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services in support of an improved mechanism for the reimbursement of Lemtrada to ensure speedier access to this therapy for individuals with multiple sclerosis. United Spinal signed onto three comment letters to the Centers for Medicare and Medicaid Services in support of improved rehab policy, namely: on in-patient rehabilitative facilities and on skilled nursing facilities to allow for improved quality reporting and on acute care hospitals and payment issues to ensure that bundled payments of services does not hinder coverage of episodes of care for individuals with multiple needs. United Spinal signed onto a MapRx letter to urge the Senate Finance Committee to include, in their discussion of chronic care, robust formularies, coverage of the six-protected classes of drugs, strong oversight, and transparency for consumers are among the design principles essential to meet the needs of Medicare beneficiaries. In addition, a process for notice of non-coverage, appeals and exceptions is critical to providing access to needed drug therapies. United Spinal supports S.1253, the Patient Access to Disposable Medical Technology Act of 2015.The legislation amends title XVIII (Medicare) of the Social Security Act to cover disposable medical technology in addition to equipment traditionally described as durable medical equipment. This legislation was introduced by Senators Burr (R-NC) and Bennet (D-CO) this spring and is identical to its House counterpart, H.R. 1018, which United Spinal has also supported. United Spinal supports the Protect Medical Innovation Act of 2015, HR 160, introduced by Rep. Eric Paulsen of Minnesota, which repeals the medical device tax on medical device manufacturers and importers. United Spinal signed on to a letter to Congress to convey support for the goals of the final Home and Community Based Settings (HCBS) rule issued by the Centers for Medicare & Medicaid Services (CMS) in January 2014. This rule is the first time CMS has defined community for Medicaid-funded HCBS programs. The letter also urges Congress to: protect cuts to funding; support the requested additional $2.8m in CMS funding for HCBS; and defend against policies or changes to the rule that would hinder the goal of providing supports through HCBS so that people with disabilities can live meaningful lives.

United Spinal Association calls for FDA Oversight and Congressional Hearings on Biologic Medicines Biologic medicines are made from living organisms and are far more complex and difficult to develop than traditional chemical drugs. United Spinal signed onto a Congressional letter to ask for support for the inclusion of $38 million in the FY 2016 Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs. Funding provided through the AT Act supports programs that assure people with disabilities have access to and acquisition of the assistive technology services they need to live, work, and attend school in their communities. United Spinal wrote a Congressional letter in support of The Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act (companion bills: S. 800 and H.R. 1631) to improve, coordinate, and enhance medical rehabilitation research at the National Institutes of Health (NIH). Support HR 292, Advancing Research for Neurological Diseases Act of 2015, which amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System and requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. United Spinal signed on to a letter organized by the Autistic Self Advocacy Network to be sent to the Federal Drug Administration (FDA). The letter urged the FDA to act on the recommendations of the Neurological Devices Panel of the Medical Devices Advisory Committee that the harms of aversive conditioning devices used for contingent electric shock outweigh any potential benefits. The letter signatories called for the FDA to issue a total ban on any aversive conditioning devices used for contingent electric shock, in order to protect the publics right to safe, evidence-based treatment and the inherent human rights and dignity of people with disabilities. United Spinal Association signed onto an ARCH National Respite Network letter for House and Senate funding requests for FY2016 for the Labor/HHS/Education Appropriations bill for respite and other critical family support programs that provide a safety net for family caregivers across the lifespan and provides savings with proven prevention strategies. The letter requests $5.0 million for the Lifespan Respite Care Program, the amount included in the Presidents FY 2016 budget. We are also seeking support for the National Family Caregiver Support Program ($150 million), the Native American Caregiver Support Program ($6.8 million), and for the new Family Support program ($15 million) proposed by the President. United Spinal commended the United States House of Representatives Committee on Energy & Commerce Committee in support of the $10 billion NIH Innovation Fund which was added to a second discussion draft of the 21st Century Cures Act which makes improvements with access to medical devices, and prescription drugs. United Spinal policy staff requested members of Congress on the House and Senate Appropriations Committees to assist with United Spinal taking a leading role with an Administration for Community Living (ACL) federal $19,589,469 multi-year grant that funds a national Paralysis Resource Center (PRC) to provide access to the most comprehensive, high quality information and supports for people of all ages living with paralysis, their family and caregivers. United Spinal supports efforts by the American Academy of Pain Management and signed onto their letter to the Senate Finance Committee in implementing the development of a comprehensive population-level strategy to advance pain research, education, care and prevention, called the National Pain Strategy (NPS).

Supports H.R. 1516/S. 1013 - ENsuring Access to Quality Compex Rehabiliation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. United Spinal advocated distributed a Congressional Dear Colleague letter urging that CRT accessories (specialty controls such as head-rests) are not set at competitive bidding pricing the same as standard wheelchairs due to their highly customized nature for a small population living with significant disabilities. United Spinal highlighted our concern with CRT Accessories, described above and with our concerns with access to durable medical equipment for wheelchair users under the competitive acquisition program. United Spinal signed on to a letter to US Health and Human Services Secretary Burwell and CMS officials regarding a pending case, Davis v. Shah, in the U.S. Second Circuit Court of Appeals - a challenge to New York Medicaid's attempt to limit coverage of compression stockings and orthopedic shoes only to Medicaid recipients with specific diagnoses. Supports the Steve Gleason Act which lifts caps on access to speech-generating devices. (HR 1919, H.R. 629, S, 768, S. 984. United Spinal supported Congressional testimony on behalf of the Coalition to Preserve Rehabilitation Steering Committee highlighting the need to eliminate site-neutral payments under Medicare and also advocated for additional signatories to a Dear Colleague letter stating the same issue. United Spinal supports expanded state participation in Medicaid programs that increase funding for HCBS such as the Community First Choice Option, Money Follows the Person, and the Balancing Incentive Program; and oppose restructuring of Medicaid funding through block grants, State Flexibility Funds, or per capita caps. United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services in support of an improved mechanism for the reimbursement of Lemtrada to ensure speedier access to this therapy for individuals with multiple sclerosis. United Spinal signed onto three comment letters to the Centers for Medicare and Medicaid Services in support of improved rehab policy, namely: on in-patient rehabilitative facilities and on skilled nursing facilities to allow for improved quality reporting and on acute care hospitals and payment issues to ensure that bundled payments of services does not hinder coverage of episodes of care for individuals with multiple needs. United Spinal signed onto a MapRx letter to urge the Senate Finance Committee to include, in their discussion of chronic care, robust formularies, coverage of the six-protected classes of drugs, strong oversight, and transparency for consumers are among the design principles essential to meet the needs of Medicare beneficiaries. In addition, a process for notice of non-coverage, appeals and exceptions is critical to providing access to needed drug therapies. United Spinal supports S.1253, the Patient Access to Disposable Medical Technology Act of 2015.The legislation amends title XVIII (Medicare) of the Social Security Act to cover disposable medical technology in addition to equipment traditionally described as durable medical equipment. This legislation was introduced by Senators Burr (R-NC) and Bennet (D-CO) this spring and is identical to its House counterpart, H.R. 1018, which United Spinal has also supported. United Spinal supports the Protect Medical Innovation Act of 2015, HR 160, introduced by Rep. Eric Paulsen of Minnesota, which repeals the medical device tax on medical device manufacturers and importers. United Spinal signed on to a letter to Congress to convey support for the goals of the final Home and Community Based Settings (HCBS) rule issued by the Centers for Medicare & Medicaid Services (CMS) in January 2014. This rule is the first time CMS has defined community for Medicaid-funded HCBS programs. The letter also urges Congress to: protect cuts to funding; support the requested additional $2.8m in CMS funding for HCBS; and defend against policies or changes to the rule that would hinder the goal of providing supports through HCBS so that people with disabilities can live meaningful lives.

S.1611 - Coast Guard Authorization Act of 2015. All provisions related to survival craft. (H.R.1987 - Coast Guard Authorization Act of 2015. The House-passed Coast Guard Reauthorization Act weakens a requirement that survival craft keep a persons entire body out of the water.)

S.1611 - Coast Guard Authorization Act of 2015. All provisions related to survival craft. (H.R.1987 - Coast Guard Authorization Act of 2015. The House-passed Coast Guard Reauthorization Act weakens a requirement that survival craft keep a persons entire body out of the water.)

Discussed accessibility and compliance issues with AMTRAK Government Affairs. Discussed and submitted comments to Department of Transportation on equity and accessibility issues. Opposed restrictive provisions in the House 2015 Coast Guard Reauthorization, H.R 1987 rolling back survival craft requirements. Submitted letter to the Senate Committee on Environment and Public Works and the House Transportation and Infrastructure Committee regarding the need for adequate provisions in the final surface transportation bill to ensure the safety of motorized and non-motorized users and support complete streets principles. Discussed with DOT the development of training modules to improve the air travel environment for passengers with disabilities.

S.1611 - Coast Guard Authorization Act of 2015. All provisions related to survival craft. (H.R.1987 - Coast Guard Authorization Act of 2015. The House-passed Coast Guard Reauthorization Act weakens a requirement that survival craft keep a persons entire body out of the water.)

United Spinal participated, as an alternate, in the U.S. Access Board's Rail Vehicles Access Advisory Committee (RVAAC) April meeting. The RVAAC is developing consensus recommendations for the Access Boards use in updating sections of the guidelines that cover vehicles of fixed guideway systems, including rapid, light, commuter, intercity, and high speed rail. United Spinal submitted comments concerning U.S.DOT proposed rulemaking on Geographic-Based Hiring Preferences in Administering Federal Awards. United Spinal supported USDOTs efforts to allow city and state departments of transportation to set economic and geographic preferences for projects receiving federal funds. In addition, United Spinal urged USDOT to extend the allowance for targeted hiring provisions, including women and people with disabilities. United Spinal recommended language supporting contractor compliance with the U.S. Department of Labor (DOL) Section 503 rule requiring affirmative action policies leading to the employment of people with disabilities. United Spinal participated in an executive roundtable at the USDOT on Connectivity. The roundtable sought to examine equity measures seeking to ensure all people, including mobility device users, are getting where they need to go. United Spinal participated in a conference call with USDOT staff regarding future webinars to support the USDOTs Mayors Challenge for Safer People, Safer Streets initiative. Mayors offices (and state and other local officials, and planning organizations) who had signed up to participate in the challenge convened for a day at the USDOT headquarters earlier this year. Participants will receive technical assistance throughout the year. United Spinal supports S.705, the Transportation Alternatives Program Improvement Act. S.705 ensures adequate funding for sidewalk and other pedestrian and biking programs. The bill would allocate funds to local communities, and smaller rural communities, to build accessible networks, and to non-profits for safety education. United Spinal signed on to a letter to all members of Congress in support of adequate funding for transportation alternative programs (TAP), which includes funding for sidewalks and curb ramps. United Spinal signed on to a letter to all members of Congress in support of adequate funding for transportation alternative programs (TAP), which includes funding for sidewalks and curb ramps. United Spinal signed on to a letter to Congress regarding the need for reauthorization for a surface transportation bill. The letter highlighted the need for accessible transportation programs, funding for travel training and technical assistance, accessible taxis and public rights-of-way, and quality paratransit and coordinated transportation. United Spinal attended a conversation with USDOT Secretary Foxx, the DC DOT Director, Iowa DOT Director, and a key VA DOT official. The speakers discussed funding challenges and potential solutions. United Spinal attended a talk and interview with House Transportation & Infrastructure Chairman Shuster on transportation funding. Supports HR 2071, the Safe Streets Act of 2015, sponsored by Rep. Matsui (D-CA-6th). The bill encourages communities to consider safety improvements for all users in transportation project planning. United Spinal also calls on Congress to pass a long-term surface transportation bill with adequate funding measures. Any bill should incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system for all in urban, suburban, and rural settings. United Spinal provided guidance to Representative Duckworths staff regarding a bill that would require spaces be provided in airports for mothers to breastfeed. Duckworths staff requested recommended language to ensure the spaces provided would be accessible to all H.R.2530 - the Friendly Airports for Mothers Act of 2015. United Spinal provided a letter of support to Representative Langevins office in support of HR 1448, the Transit Accessibility Innovation Act of 2015. The bill would provide grants to public transit agencies to improve paratransit programs. United Spinal co-signed a letter to the Coast Guard as the Co-Chair of the CCD Transportation Task Force. The letter was addressed to Coast Guard Admiral Zukunft, and ccd key Senate offices on the Coast Guard subcommittee, FEMA, and the White House. The letter raised the concern that the House-passed Coast Guard Reauthorization Act weakens a requirement that survival craft keep a persons entire body out of the water. United spinal co-signed a letter, as Co-Chair of the CCD Transportation Task force, thanking Representative Rick Larsen for adding language to the Federal Aviation Administration (FAA) reauthorization. The language urged the U.S. Department of Transportation (DOT) to swiftly promulgate long-awaited regulations on the Air Carrier Access Act (ACAA) that increase access to accessible air travel for people with disabilities. The letter also raised the hope that rulemaking would increase access to lavatories, for passengers with service animals, and ensure the safety of people with disabilities mobility devices during travel. United Spinal signed on to a Congressional letter organized by Rails-to-Trails in support of funding and maintenance of the Trasnportation Alternatives Program (TAP) under USDOT. TAP provides authorization and funding for bicycle and pedestrian infrastructure and safety programs around the country. United Spinal participated, as an alternate, in the US Access Board Rail Vehicles Access Advisory Committee (RVAAC) June meeting. The RVAAC is developing consensus recommendations for the Access Boards use in updating sections of the guidelines that cover vehicles of fixed guideway systems, including rapid, light, commuter, intercity, and high speed rail.

United Spinal participated, as an alternate, in the U.S. Access Board's Rail Vehicles Access Advisory Committee (RVAAC) April meeting. The RVAAC is developing consensus recommendations for the Access Boards use in updating sections of the guidelines that cover vehicles of fixed guideway systems, including rapid, light, commuter, intercity, and high speed rail. United Spinal submitted comments concerning U.S.DOT proposed rulemaking on Geographic-Based Hiring Preferences in Administering Federal Awards. United Spinal supported USDOTs efforts to allow city and state departments of transportation to set economic and geographic preferences for projects receiving federal funds. In addition, United Spinal urged USDOT to extend the allowance for targeted hiring provisions, including women and people with disabilities. United Spinal recommended language supporting contractor compliance with the U.S. Department of Labor (DOL) Section 503 rule requiring affirmative action policies leading to the employment of people with disabilities. United Spinal participated in an executive roundtable at the USDOT on Connectivity. The roundtable sought to examine equity measures seeking to ensure all people, including mobility device users, are getting where they need to go. United Spinal participated in a conference call with USDOT staff regarding future webinars to support the USDOTs Mayors Challenge for Safer People, Safer Streets initiative. Mayors offices (and state and other local officials, and planning organizations) who had signed up to participate in the challenge convened for a day at the USDOT headquarters earlier this year. Participants will receive technical assistance throughout the year. United Spinal supports S.705, the Transportation Alternatives Program Improvement Act. S.705 ensures adequate funding for sidewalk and other pedestrian and biking programs. The bill would allocate funds to local communities, and smaller rural communities, to build accessible networks, and to non-profits for safety education. United Spinal signed on to a letter to all members of Congress in support of adequate funding for transportation alternative programs (TAP), which includes funding for sidewalks and curb ramps. United Spinal signed on to a letter to all members of Congress in support of adequate funding for transportation alternative programs (TAP), which includes funding for sidewalks and curb ramps. United Spinal signed on to a letter to Congress regarding the need for reauthorization for a surface transportation bill. The letter highlighted the need for accessible transportation programs, funding for travel training and technical assistance, accessible taxis and public rights-of-way, and quality paratransit and coordinated transportation. United Spinal attended a conversation with USDOT Secretary Foxx, the DC DOT Director, Iowa DOT Director, and a key VA DOT official. The speakers discussed funding challenges and potential solutions. United Spinal attended a talk and interview with House Transportation & Infrastructure Chairman Shuster on transportation funding. Supports HR 2071, the Safe Streets Act of 2015, sponsored by Rep. Matsui (D-CA-6th). The bill encourages communities to consider safety improvements for all users in transportation project planning. United Spinal also calls on Congress to pass a long-term surface transportation bill with adequate funding measures. Any bill should incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system for all in urban, suburban, and rural settings. United Spinal provided guidance to Representative Duckworths staff regarding a bill that would require spaces be provided in airports for mothers to breastfeed. Duckworths staff requested recommended language to ensure the spaces provided would be accessible to all H.R.2530 - the Friendly Airports for Mothers Act of 2015. United Spinal provided a letter of support to Representative Langevins office in support of HR 1448, the Transit Accessibility Innovation Act of 2015. The bill would provide grants to public transit agencies to improve paratransit programs. United Spinal co-signed a letter to the Coast Guard as the Co-Chair of the CCD Transportation Task Force. The letter was addressed to Coast Guard Admiral Zukunft, and ccd key Senate offices on the Coast Guard subcommittee, FEMA, and the White House. The letter raised the concern that the House-passed Coast Guard Reauthorization Act weakens a requirement that survival craft keep a persons entire body out of the water. United spinal co-signed a letter, as Co-Chair of the CCD Transportation Task force, thanking Representative Rick Larsen for adding language to the Federal Aviation Administration (FAA) reauthorization. The language urged the U.S. Department of Transportation (DOT) to swiftly promulgate long-awaited regulations on the Air Carrier Access Act (ACAA) that increase access to accessible air travel for people with disabilities. The letter also raised the hope that rulemaking would increase access to lavatories, for passengers with service animals, and ensure the safety of people with disabilities mobility devices during travel. United Spinal signed on to a Congressional letter organized by Rails-to-Trails in support of funding and maintenance of the Trasnportation Alternatives Program (TAP) under USDOT. TAP provides authorization and funding for bicycle and pedestrian infrastructure and safety programs around the country. United Spinal participated, as an alternate, in the US Access Board Rail Vehicles Access Advisory Committee (RVAAC) June meeting. The RVAAC is developing consensus recommendations for the Access Boards use in updating sections of the guidelines that cover vehicles of fixed guideway systems, including rapid, light, commuter, intercity, and high speed rail.

Protect Fair Housing Senate Letter United Spinal signed on to a letter, also co-signed by the Consortium for Citizens with Disabilities Housing Task Force, urging all Senators to ensure local, private fair housing and housing anti-discrimination laws are protected. In June, the House of Representatives passed its Fiscal Year 2016 the Commerce, Justice, Science (CJS) Appropriations bill, H.R. 2578, and its Transportation, Housing and Urban Development (THUD) appropriations bill, H.R. 2577, with highly concerning anti-fair housing amendments attached that would all but eliminate local private fair housing enforcement, and undermine the federal governments ability to protect Americans from housing discrimination. The letter was organized by the National Fair Housing Alliance.

Protect Fair Housing Senate Letter United Spinal signed on to a letter, also co-signed by the Consortium for Citizens with Disabilities Housing Task Force, urging all Senators to ensure local, private fair housing and housing anti-discrimination laws are protected. In June, the House of Representatives passed its Fiscal Year 2016 the Commerce, Justice, Science (CJS) Appropriations bill, H.R. 2578, and its Transportation, Housing and Urban Development (THUD) appropriations bill, H.R. 2577, with highly concerning anti-fair housing amendments attached that would all but eliminate local private fair housing enforcement, and undermine the federal governments ability to protect Americans from housing discrimination. The letter was organized by the National Fair Housing Alliance.

Protect Fair Housing Senate Letter United Spinal signed on to a letter, also co-signed by the Consortium for Citizens with Disabilities Housing Task Force, urging all Senators to ensure local, private fair housing and housing anti-discrimination laws are protected. In June, the House of Representatives passed its Fiscal Year 2016 the Commerce, Justice, Science (CJS) Appropriations bill, H.R. 2578, and its Transportation, Housing and Urban Development (THUD) appropriations bill, H.R. 2577, with highly concerning anti-fair housing amendments attached that would all but eliminate local private fair housing enforcement, and undermine the federal governments ability to protect Americans from housing discrimination. The letter was organized by the National Fair Housing Alliance.

Protect Fair Housing Senate Letter United Spinal signed on to a letter, also co-signed by the Consortium for Citizens with Disabilities Housing Task Force, urging all Senators to ensure local, private fair housing and housing anti-discrimination laws are protected. In June, the House of Representatives passed its Fiscal Year 2016 the Commerce, Justice, Science (CJS) Appropriations bill, H.R. 2578, and its Transportation, Housing and Urban Development (THUD) appropriations bill, H.R. 2577, with highly concerning anti-fair housing amendments attached that would all but eliminate local private fair housing enforcement, and undermine the federal governments ability to protect Americans from housing discrimination. The letter was organized by the National Fair Housing Alliance.

Protect Fair Housing Senate Letter United Spinal signed on to a letter, also co-signed by the Consortium for Citizens with Disabilities Housing Task Force, urging all Senators to ensure local, private fair housing and housing anti-discrimination laws are protected. In June, the House of Representatives passed its Fiscal Year 2016 the Commerce, Justice, Science (CJS) Appropriations bill, H.R. 2578, and its Transportation, Housing and Urban Development (THUD) appropriations bill, H.R. 2577, with highly concerning anti-fair housing amendments attached that would all but eliminate local private fair housing enforcement, and undermine the federal governments ability to protect Americans from housing discrimination. The letter was organized by the National Fair Housing Alliance.

Protect Fair Housing Senate Letter United Spinal signed on to a letter, also co-signed by the Consortium for Citizens with Disabilities Housing Task Force, urging all Senators to ensure local, private fair housing and housing anti-discrimination laws are protected. In June, the House of Representatives passed its Fiscal Year 2016 the Commerce, Justice, Science (CJS) Appropriations bill, H.R. 2578, and its Transportation, Housing and Urban Development (THUD) appropriations bill, H.R. 2577, with highly concerning anti-fair housing amendments attached that would all but eliminate local private fair housing enforcement, and undermine the federal governments ability to protect Americans from housing discrimination. The letter was organized by the National Fair Housing Alliance.

21st Century Community Policing United Spinal attended an Executive Administration Disability Community briefing on the 21st Century Community Policing Taskforce activities. Other members of the CCD Rights Task Force, as well as representatives from the National Council on Disability and Lead On were present. Representatives from the Domestic Policy Council, the US Department of Justice, and the Task Force presented. Members of the disability community spoke on a range of concerns, including lack of disability issues presented in the Task Force report. Participants discussed the need for the criminal justice system to be aware of the needs and concerns of the disability community, to treat victims, witnesses and those suspected of crime with respect; data collection regarding people with disabilities and police violence; as well as time spent in the prison system, and access to supports and services while in and transitioning out. United Spinal supports a Consortium for Citizens with Disabilities Rights Task Force letter sent to the United States Senate. The letter voiced concerns about the Helping Families in Mental Health Crisis Act (H.R. 2646). The letter pointed out that instead of addressing the dramatic gaps in community services, the bill would remove critical protections for individuals with psychiatric disabilities and promote involuntary treatment. Community Integration Act - United Spinal supports the concepts described in the Community Integration Act, supported by Senator Charles Schumer (D-NY), which ensures that people with disabilities receive home and community-based supports and services in the home setting of their choice. NDLA members are continuing the dialogue with each other to consider additional language tweaks.

21st Century Community Policing United Spinal attended an Executive Administration Disability Community briefing on the 21st Century Community Policing Taskforce activities. Other members of the CCD Rights Task Force, as well as representatives from the National Council on Disability and Lead On were present. Representatives from the Domestic Policy Council, the US Department of Justice, and the Task Force presented. Members of the disability community spoke on a range of concerns, including lack of disability issues presented in the Task Force report. Participants discussed the need for the criminal justice system to be aware of the needs and concerns of the disability community, to treat victims, witnesses and those suspected of crime with respect; data collection regarding people with disabilities and police violence; as well as time spent in the prison system, and access to supports and services while in and transitioning out. United Spinal supports a Consortium for Citizens with Disabilities Rights Task Force letter sent to the United States Senate. The letter voiced concerns about the Helping Families in Mental Health Crisis Act (H.R. 2646). The letter pointed out that instead of addressing the dramatic gaps in community services, the bill would remove critical protections for individuals with psychiatric disabilities and promote involuntary treatment. Community Integration Act - United Spinal supports the concepts described in the Community Integration Act, supported by Senator Charles Schumer (D-NY), which ensures that people with disabilities receive home and community-based supports and services in the home setting of their choice. NDLA members are continuing the dialogue with each other to consider additional language tweaks.

21st Century Community Policing United Spinal attended an Executive Administration Disability Community briefing on the 21st Century Community Policing Taskforce activities. Other members of the CCD Rights Task Force, as well as representatives from the National Council on Disability and Lead On were present. Representatives from the Domestic Policy Council, the US Department of Justice, and the Task Force presented. Members of the disability community spoke on a range of concerns, including lack of disability issues presented in the Task Force report. Participants discussed the need for the criminal justice system to be aware of the needs and concerns of the disability community, to treat victims, witnesses and those suspected of crime with respect; data collection regarding people with disabilities and police violence; as well as time spent in the prison system, and access to supports and services while in and transitioning out. United Spinal supports a Consortium for Citizens with Disabilities Rights Task Force letter sent to the United States Senate. The letter voiced concerns about the Helping Families in Mental Health Crisis Act (H.R. 2646). The letter pointed out that instead of addressing the dramatic gaps in community services, the bill would remove critical protections for individuals with psychiatric disabilities and promote involuntary treatment. Community Integration Act - United Spinal supports the concepts described in the Community Integration Act, supported by Senator Charles Schumer (D-NY), which ensures that people with disabilities receive home and community-based supports and services in the home setting of their choice. NDLA members are continuing the dialogue with each other to consider additional language tweaks.

United Spinal Association calls for FDA Oversight and Congressional Hearings on Biologic Medicines Biologic medicines are made from living organisms and are far more complex and difficult to develop than traditional chemical drugs. United Spinal signed onto a Congressional letter to ask for support for the inclusion of $38 million in the FY 2016 Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs. Funding provided through the AT Act supports programs that assure people with disabilities have access to and acquisition of the assistive technology services they need to live, work, and attend school in their communities. United Spinal wrote a Congressional letter in support of The Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act (companion bills: S. 800 and H.R. 1631) to improve, coordinate, and enhance medical rehabilitation research at the National Institutes of Health (NIH). Support HR 292, Advancing Research for Neurological Diseases Act of 2015, which amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System and requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. United Spinal signed on to a letter organized by the Autistic Self Advocacy Network to be sent to the Federal Drug Administration (FDA). The letter urged the FDA to act on the recommendations of the Neurological Devices Panel of the Medical Devices Advisory Committee that the harms of aversive conditioning devices used for contingent electric shock outweigh any potential benefits. The letter signatories called for the FDA to issue a total ban on any aversive conditioning devices used for contingent electric shock, in order to protect the publics right to safe, evidence-based treatment and the inherent human rights and dignity of people with disabilities. United Spinal Association signed onto an ARCH National Respite Network letter for House and Senate funding requests for FY2016 for the Labor/HHS/Education Appropriations bill for respite and other critical family support programs that provide a safety net for family caregivers across the lifespan and provides savings with proven prevention strategies. The letter requests $5.0 million for the Lifespan Respite Care Program, the amount included in the Presidents FY 2016 budget. We are also seeking support for the National Family Caregiver Support Program ($150 million), the Native American Caregiver Support Program ($6.8 million), and for the new Family Support program ($15 million) proposed by the President. United Spinal commended the United States House of Representatives Committee on Energy & Commerce Committee in support of the $10 billion NIH Innovation Fund which was added to a second discussion draft of the 21st Century Cures Act which makes improvements with access to medical devices, and prescription drugs. United Spinal policy staff requested members of Congress on the House and Senate Appropriations Committees to assist with United Spinal taking a leading role with an Administration for Community Living (ACL) federal $19,589,469 multi-year grant that funds a national Paralysis Resource Center (PRC) to provide access to the most comprehensive, high quality information and supports for people of all ages living with paralysis, their family and caregivers. United Spinal supports efforts by the American Academy of Pain Management and signed onto their letter to the Senate Finance Committee in implementing the development of a comprehensive population-level strategy to advance pain research, education, care and prevention, called the National Pain Strategy (NPS).

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

United Spinal Association signed onto a letter, facilitated by the National Academy of Elder Law Attorneys, to Department of Housing and Urban Development, out of concern that public housing authorities (PHAs) and other rental assistance program administrators are interpreting national HUD policy to be that all distributions from special needs trusts are income for HUD rental assistance programs. The letter stated that HUD rules, in light of special needs trust law and policy, require that distributions from special needs trusts not be counted as income. Support H.R. 3975, the Veterans Homebuyer Accessibility Act - The bill would authorize a veteran first-time homebuyers tax credit equal to 10 percent of the purchase price of the residence and an adaptive housing credit of up to $8,000 for veterans to address structural and other changes to their home to accommodate their disabilities.

Supports H.R. 1516/S. 1013 - ENsuring Access to Quality Compex Rehabiliation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. United Spinal advocated distributed a Congressional Dear Colleague letter urging that CRT accessories (specialty controls such as head-rests) are not set at competitive bidding pricing the same as standard wheelchairs due to their highly customized nature for a small population living with significant disabilities. United Spinal highlighted our concern with CRT Accessories, described above and with our concerns with access to durable medical equipment for wheelchair users under the competitive acquisition program. United Spinal signed on to a letter to US Health and Human Services Secretary Burwell and CMS officials regarding a pending case, Davis v. Shah, in the U.S. Second Circuit Court of Appeals - a challenge to New York Medicaid's attempt to limit coverage of compression stockings and orthopedic shoes only to Medicaid recipients with specific diagnoses. Supports the Steve Gleason Act which lifts caps on access to speech-generating devices. (HR 1919, H.R. 629, S, 768, S. 984. United Spinal supported Congressional testimony on behalf of the Coalition to Preserve Rehabilitation Steering Committee highlighting the need to eliminate site-neutral payments under Medicare and also advocated for additional signatories to a Dear Colleague letter stating the same issue. United Spinal supports expanded state participation in Medicaid programs that increase funding for HCBS such as the Community First Choice Option, Money Follows the Person, and the Balancing Incentive Program; and oppose restructuring of Medicaid funding through block grants, State Flexibility Funds, or per capita caps. United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services in support of an improved mechanism for the reimbursement of Lemtrada to ensure speedier access to this therapy for individuals with multiple sclerosis. United Spinal signed onto three comment letters to the Centers for Medicare and Medicaid Services in support of improved rehab policy, namely: on in-patient rehabilitative facilities and on skilled nursing facilities to allow for improved quality reporting and on acute care hospitals and payment issues to ensure that bundled payments of services does not hinder coverage of episodes of care for individuals with multiple needs. United Spinal signed onto a MapRx letter to urge the Senate Finance Committee to include, in their discussion of chronic care, robust formularies, coverage of the six-protected classes of drugs, strong oversight, and transparency for consumers are among the design principles essential to meet the needs of Medicare beneficiaries. In addition, a process for notice of non-coverage, appeals and exceptions is critical to providing access to needed drug therapies. United Spinal supports S.1253, the Patient Access to Disposable Medical Technology Act of 2015.The legislation amends title XVIII (Medicare) of the Social Security Act to cover disposable medical technology in addition to equipment traditionally described as durable medical equipment. This legislation was introduced by Senators Burr (R-NC) and Bennet (D-CO) this spring and is identical to its House counterpart, H.R. 1018, which United Spinal has also supported. United Spinal supports the Protect Medical Innovation Act of 2015, HR 160, introduced by Rep. Eric Paulsen of Minnesota, which repeals the medical device tax on medical device manufacturers and importers. United Spinal signed on to a letter to Congress to convey support for the goals of the final Home and Community Based Settings (HCBS) rule issued by the Centers for Medicare & Medicaid Services (CMS) in January 2014. This rule is the first time CMS has defined community for Medicaid-funded HCBS programs. The letter also urges Congress to: protect cuts to funding; support the requested additional $2.8m in CMS funding for HCBS; and defend against policies or changes to the rule that would hinder the goal of providing supports through HCBS so that people with disabilities can live meaningful lives.

Discussed US DOT's Safer Streets initiative and increased accessibility including the need for accessibility and disability-related data collection; the importance of human services coordinated transportation in rural America; needed regulation for the non-motorized safety performance measures and the Pedestrian Safety Enhancment Act; ADA enforcment; AMTRAK, air travel, technical assistance; and commercial drivers' licenses for people with disabilities. US Access Board Rail Vehicles Access Advisory Committee (RVAAC) - discussed the development of consensus recommendations regarding vehicles of fixed guideway systems, inlcuding rapid, light, commmuter, intercity and high speed rail. United Spinal suppported an amendment to HR 749 - Passenger Rail Reform and Investment Act of 2015. The amendment requires Amtraks Office of Inspector General to submit a report to the House T&I and Senate Commerce Committees on boarding procedures at the 10 busiest stations for wheelchair users and passengers using or transporting bicycles. Rep. Lipinski mentioned United Spinals support in his floor speech and clarified that the amendment would require the report to include motorized and non-motorized wheelchairs. HR 749 passed with the amendment. United Spinal supports HR 1448 - Transit Accessibility Innovation act of 2015 (HR 1448). The legislation would create a competitive grant program under the Federal Transit Administration (FTA) to encourage transit systems to make public transportation more accessible and user-friendly for individuals with disabilities. United Spinal provided recommendations on multi-modal accessible transporation appplications that would promote independent living and mobility of travelers with disabilities and improve the travel experience of all users. United Spinal discussed strategies for creating successful models for building connected communities and measuring the benefits for its citizens. United Spinal raised questions regarding the accessibility of innovative transportation modes, and the importance of ensuring existing transportation is connecting people with disabilities to their homes, work, schools, and other important destinations. United Spinal engaged in a discussion with senior National Highway Traffic Safety Administration (NHTSA) staff regarding data collection of pedestrians with disabilities injuries and fatalities, as well as the need to report on wheelchair user injuries and fatalities.

Supports H.R. 1516/S. 1013 - ENsuring Access to Quality Compex Rehabiliation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. United Spinal advocated distributed a Congressional Dear Colleague letter urging that CRT accessories (specialty controls such as head-rests) are not set at competitive bidding pricing the same as standard wheelchairs due to their highly customized nature for a small population living with significant disabilities. United Spinal highlighted our concern with CRT Accessories, described above and with our concerns with access to durable medical equipment for wheelchair users under the competitive acquisition program. United Spinal signed on to a letter to US Health and Human Services Secretary Burwell and CMS officials regarding a pending case, Davis v. Shah, in the U.S. Second Circuit Court of Appeals - a challenge to New York Medicaid's attempt to limit coverage of compression stockings and orthopedic shoes only to Medicaid recipients with specific diagnoses. Supports the Steve Gleason Act which lifts caps on access to speech-generating devices. (HR 1919, H.R. 629, S, 768, S. 984. United Spinal supported Congressional testimony on behalf of the Coalition to Preserve Rehabilitation Steering Committee highlighting the need to eliminate site-neutral payments under Medicare and also advocated for additional signatories to a Dear Colleague letter stating the same issue. United Spinal supports expanded state participation in Medicaid programs that increase funding for HCBS such as the Community First Choice Option, Money Follows the Person, and the Balancing Incentive Program; and oppose restructuring of Medicaid funding through block grants, State Flexibility Funds, or per capita caps. United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services in support of an improved mechanism for the reimbursement of Lemtrada to ensure speedier access to this therapy for individuals with multiple sclerosis. United Spinal signed onto three comment letters to the Centers for Medicare and Medicaid Services in support of improved rehab policy, namely: on in-patient rehabilitative facilities and on skilled nursing facilities to allow for improved quality reporting and on acute care hospitals and payment issues to ensure that bundled payments of services does not hinder coverage of episodes of care for individuals with multiple needs. United Spinal signed onto a MapRx letter to urge the Senate Finance Committee to include, in their discussion of chronic care, robust formularies, coverage of the six-protected classes of drugs, strong oversight, and transparency for consumers are among the design principles essential to meet the needs of Medicare beneficiaries. In addition, a process for notice of non-coverage, appeals and exceptions is critical to providing access to needed drug therapies. United Spinal supports S.1253, the Patient Access to Disposable Medical Technology Act of 2015.The legislation amends title XVIII (Medicare) of the Social Security Act to cover disposable medical technology in addition to equipment traditionally described as durable medical equipment. This legislation was introduced by Senators Burr (R-NC) and Bennet (D-CO) this spring and is identical to its House counterpart, H.R. 1018, which United Spinal has also supported. United Spinal supports the Protect Medical Innovation Act of 2015, HR 160, introduced by Rep. Eric Paulsen of Minnesota, which repeals the medical device tax on medical device manufacturers and importers. United Spinal signed on to a letter to Congress to convey support for the goals of the final Home and Community Based Settings (HCBS) rule issued by the Centers for Medicare & Medicaid Services (CMS) in January 2014. This rule is the first time CMS has defined community for Medicaid-funded HCBS programs. The letter also urges Congress to: protect cuts to funding; support the requested additional $2.8m in CMS funding for HCBS; and defend against policies or changes to the rule that would hinder the goal of providing supports through HCBS so that people with disabilities can live meaningful lives.

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

Supports H.R. 1516/S. 1013 - ENsuring Access to Quality Compex Rehabiliation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. United Spinal advocated distributed a Congressional Dear Colleague letter urging that CRT accessories (specialty controls such as head-rests) are not set at competitive bidding pricing the same as standard wheelchairs due to their highly customized nature for a small population living with significant disabilities. United Spinal highlighted our concern with CRT Accessories, described above and with our concerns with access to durable medical equipment for wheelchair users under the competitive acquisition program. United Spinal signed on to a letter to US Health and Human Services Secretary Burwell and CMS officials regarding a pending case, Davis v. Shah, in the U.S. Second Circuit Court of Appeals - a challenge to New York Medicaid's attempt to limit coverage of compression stockings and orthopedic shoes only to Medicaid recipients with specific diagnoses. Supports the Steve Gleason Act which lifts caps on access to speech-generating devices. (HR 1919, H.R. 629, S, 768, S. 984. United Spinal supported Congressional testimony on behalf of the Coalition to Preserve Rehabilitation Steering Committee highlighting the need to eliminate site-neutral payments under Medicare and also advocated for additional signatories to a Dear Colleague letter stating the same issue. United Spinal supports expanded state participation in Medicaid programs that increase funding for HCBS such as the Community First Choice Option, Money Follows the Person, and the Balancing Incentive Program; and oppose restructuring of Medicaid funding through block grants, State Flexibility Funds, or per capita caps. United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services in support of an improved mechanism for the reimbursement of Lemtrada to ensure speedier access to this therapy for individuals with multiple sclerosis. United Spinal signed onto three comment letters to the Centers for Medicare and Medicaid Services in support of improved rehab policy, namely: on in-patient rehabilitative facilities and on skilled nursing facilities to allow for improved quality reporting and on acute care hospitals and payment issues to ensure that bundled payments of services does not hinder coverage of episodes of care for individuals with multiple needs. United Spinal signed onto a MapRx letter to urge the Senate Finance Committee to include, in their discussion of chronic care, robust formularies, coverage of the six-protected classes of drugs, strong oversight, and transparency for consumers are among the design principles essential to meet the needs of Medicare beneficiaries. In addition, a process for notice of non-coverage, appeals and exceptions is critical to providing access to needed drug therapies. United Spinal supports S.1253, the Patient Access to Disposable Medical Technology Act of 2015.The legislation amends title XVIII (Medicare) of the Social Security Act to cover disposable medical technology in addition to equipment traditionally described as durable medical equipment. This legislation was introduced by Senators Burr (R-NC) and Bennet (D-CO) this spring and is identical to its House counterpart, H.R. 1018, which United Spinal has also supported. United Spinal supports the Protect Medical Innovation Act of 2015, HR 160, introduced by Rep. Eric Paulsen of Minnesota, which repeals the medical device tax on medical device manufacturers and importers. United Spinal signed on to a letter to Congress to convey support for the goals of the final Home and Community Based Settings (HCBS) rule issued by the Centers for Medicare & Medicaid Services (CMS) in January 2014. This rule is the first time CMS has defined community for Medicaid-funded HCBS programs. The letter also urges Congress to: protect cuts to funding; support the requested additional $2.8m in CMS funding for HCBS; and defend against policies or changes to the rule that would hinder the goal of providing supports through HCBS so that people with disabilities can live meaningful lives.

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

S.1611 - Coast Guard Authorization Act of 2015. All provisions related to survival craft. (H.R.1987 - Coast Guard Authorization Act of 2015. The House-passed Coast Guard Reauthorization Act weakens a requirement that survival craft keep a persons entire body out of the water.)

S.1611 - Coast Guard Authorization Act of 2015. All provisions related to survival craft. (H.R.1987 - Coast Guard Authorization Act of 2015. The House-passed Coast Guard Reauthorization Act weakens a requirement that survival craft keep a persons entire body out of the water.)

S.1611 - Coast Guard Authorization Act of 2015. All provisions related to survival craft. (H.R.1987 - Coast Guard Authorization Act of 2015. The House-passed Coast Guard Reauthorization Act weakens a requirement that survival craft keep a persons entire body out of the water.)

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

Submitted comments to CMS requiring better clarification of resident rights and person-centered planning needs. United Spinal signed onto a letter of support for the nomination of Henry Claypool to serve as a Commissioner on the Medicaid and CHIP Payment and Access Commission (MACPAC). United Spinal signed onto a letter of support to CMS regarding Section 1557 and nondiscrimination towards people with disabilities in health programs and activities including the ACA regarding the enrollment of people with disabilities and the availability of plans and services for the disability community. Transition to Independence Act (S. 1604) United Spinal Association supports the Transition to Independence Act (S. 1604), introduced by Senator Charles Grassley (R-IA) and signed onto a Consortium for Citizens with Disabilities letter. This bill directs the Secretary of Health and Human Services to establish a demonstration program over five fiscal years, beginning with FY2017, under which a Medicaid Buy-In-State program meeting certain criteria may receive bonus payments for: meeting specific measurable benchmarks in expanding individual integrated employment and reducing subminimum wage work, congregate setting work, or facility-based day habilitation placements for working-age individuals with a disability receiving Medicaid-funded home or community-based services; and taking other actions conducive to expanding employment opportunities for individuals with disabilities within the state. United Spinal signed onto a letter to CMS in support of protecting and improving access to electronic health records - Medicare and Medicaid Programs: Electronic Health Record Incentive Program. Support H.R. 3229/S. 2196 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015 Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs. Support H.R. 1516/S. 1013 - This bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Support S. 2425 - Patient Acsess and Medicare Protection Act - A bill to amend titles XVIII and XIX of the Social Security Act to improve payments for complex rehabilitation technology and certain radiation therapy services, to ensure flexibility in applying the hardship exception for meaningful use for the 2015 EHR reporting period for 2017 payment adjustments, and for other purposes. Discussed with CMS, ACL and GAO concerns as it relates to access to durable medical equipment and accessories under Medicare's competitive acquisition program.

United Spinal participated, as an alternate, in the U.S. Access Board's Rail Vehicles Access Advisory Committee (RVAAC) April meeting. The RVAAC is developing consensus recommendations for the Access Boards use in updating sections of the guidelines that cover vehicles of fixed guideway systems, including rapid, light, commuter, intercity, and high speed rail. United Spinal submitted comments concerning U.S.DOT proposed rulemaking on Geographic-Based Hiring Preferences in Administering Federal Awards. United Spinal supported USDOTs efforts to allow city and state departments of transportation to set economic and geographic preferences for projects receiving federal funds. In addition, United Spinal urged USDOT to extend the allowance for targeted hiring provisions, including women and people with disabilities. United Spinal recommended language supporting contractor compliance with the U.S. Department of Labor (DOL) Section 503 rule requiring affirmative action policies leading to the employment of people with disabilities. United Spinal participated in an executive roundtable at the USDOT on Connectivity. The roundtable sought to examine equity measures seeking to ensure all people, including mobility device users, are getting where they need to go. United Spinal participated in a conference call with USDOT staff regarding future webinars to support the USDOTs Mayors Challenge for Safer People, Safer Streets initiative. Mayors offices (and state and other local officials, and planning organizations) who had signed up to participate in the challenge convened for a day at the USDOT headquarters earlier this year. Participants will receive technical assistance throughout the year. United Spinal supports S.705, the Transportation Alternatives Program Improvement Act. S.705 ensures adequate funding for sidewalk and other pedestrian and biking programs. The bill would allocate funds to local communities, and smaller rural communities, to build accessible networks, and to non-profits for safety education. United Spinal signed on to a letter to all members of Congress in support of adequate funding for transportation alternative programs (TAP), which includes funding for sidewalks and curb ramps. United Spinal signed on to a letter to all members of Congress in support of adequate funding for transportation alternative programs (TAP), which includes funding for sidewalks and curb ramps. United Spinal signed on to a letter to Congress regarding the need for reauthorization for a surface transportation bill. The letter highlighted the need for accessible transportation programs, funding for travel training and technical assistance, accessible taxis and public rights-of-way, and quality paratransit and coordinated transportation. United Spinal attended a conversation with USDOT Secretary Foxx, the DC DOT Director, Iowa DOT Director, and a key VA DOT official. The speakers discussed funding challenges and potential solutions. United Spinal attended a talk and interview with House Transportation & Infrastructure Chairman Shuster on transportation funding. Supports HR 2071, the Safe Streets Act of 2015, sponsored by Rep. Matsui (D-CA-6th). The bill encourages communities to consider safety improvements for all users in transportation project planning. United Spinal also calls on Congress to pass a long-term surface transportation bill with adequate funding measures. Any bill should incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system for all in urban, suburban, and rural settings. United Spinal provided guidance to Representative Duckworths staff regarding a bill that would require spaces be provided in airports for mothers to breastfeed. Duckworths staff requested recommended language to ensure the spaces provided would be accessible to all H.R.2530 - the Friendly Airports for Mothers Act of 2015. United Spinal provided a letter of support to Representative Langevins office in support of HR 1448, the Transit Accessibility Innovation Act of 2015. The bill would provide grants to public transit agencies to improve paratransit programs. United Spinal co-signed a letter to the Coast Guard as the Co-Chair of the CCD Transportation Task Force. The letter was addressed to Coast Guard Admiral Zukunft, and ccd key Senate offices on the Coast Guard subcommittee, FEMA, and the White House. The letter raised the concern that the House-passed Coast Guard Reauthorization Act weakens a requirement that survival craft keep a persons entire body out of the water. United spinal co-signed a letter, as Co-Chair of the CCD Transportation Task force, thanking Representative Rick Larsen for adding language to the Federal Aviation Administration (FAA) reauthorization. The language urged the U.S. Department of Transportation (DOT) to swiftly promulgate long-awaited regulations on the Air Carrier Access Act (ACAA) that increase access to accessible air travel for people with disabilities. The letter also raised the hope that rulemaking would increase access to lavatories, for passengers with service animals, and ensure the safety of people with disabilities mobility devices during travel. United Spinal signed on to a Congressional letter organized by Rails-to-Trails in support of funding and maintenance of the Trasnportation Alternatives Program (TAP) under USDOT. TAP provides authorization and funding for bicycle and pedestrian infrastructure and safety programs around the country. United Spinal participated, as an alternate, in the US Access Board Rail Vehicles Access Advisory Committee (RVAAC) June meeting. The RVAAC is developing consensus recommendations for the Access Boards use in updating sections of the guidelines that cover vehicles of fixed guideway systems, including rapid, light, commuter, intercity, and high speed rail.

United Spinal Association calls for FDA Oversight and Congressional Hearings on Biologic Medicines Biologic medicines are made from living organisms and are far more complex and difficult to develop than traditional chemical drugs. United Spinal signed onto a Congressional letter to ask for support for the inclusion of $38 million in the FY 2016 Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs. Funding provided through the AT Act supports programs that assure people with disabilities have access to and acquisition of the assistive technology services they need to live, work, and attend school in their communities. United Spinal wrote a Congressional letter in support of The Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act (companion bills: S. 800 and H.R. 1631) to improve, coordinate, and enhance medical rehabilitation research at the National Institutes of Health (NIH). Support HR 292, Advancing Research for Neurological Diseases Act of 2015, which amends the Public Health Service Act to require the Centers for Disease Control and Prevention to: (1) enhance and expand infrastructure and activities to track the epidemiology of neurological diseases, including multiple sclerosis and Parkinson's disease; and (2) incorporate information obtained through those activities into a National Neurological Diseases Surveillance System and requires the Department of Health and Human Services (HHS) to ensure that the System facilitates further research on neurological diseases. United Spinal signed on to a letter organized by the Autistic Self Advocacy Network to be sent to the Federal Drug Administration (FDA). The letter urged the FDA to act on the recommendations of the Neurological Devices Panel of the Medical Devices Advisory Committee that the harms of aversive conditioning devices used for contingent electric shock outweigh any potential benefits. The letter signatories called for the FDA to issue a total ban on any aversive conditioning devices used for contingent electric shock, in order to protect the publics right to safe, evidence-based treatment and the inherent human rights and dignity of people with disabilities. United Spinal Association signed onto an ARCH National Respite Network letter for House and Senate funding requests for FY2016 for the Labor/HHS/Education Appropriations bill for respite and other critical family support programs that provide a safety net for family caregivers across the lifespan and provides savings with proven prevention strategies. The letter requests $5.0 million for the Lifespan Respite Care Program, the amount included in the Presidents FY 2016 budget. We are also seeking support for the National Family Caregiver Support Program ($150 million), the Native American Caregiver Support Program ($6.8 million), and for the new Family Support program ($15 million) proposed by the President. United Spinal commended the United States House of Representatives Committee on Energy & Commerce Committee in support of the $10 billion NIH Innovation Fund which was added to a second discussion draft of the 21st Century Cures Act which makes improvements with access to medical devices, and prescription drugs. United Spinal policy staff requested members of Congress on the House and Senate Appropriations Committees to assist with United Spinal taking a leading role with an Administration for Community Living (ACL) federal $19,589,469 multi-year grant that funds a national Paralysis Resource Center (PRC) to provide access to the most comprehensive, high quality information and supports for people of all ages living with paralysis, their family and caregivers. United Spinal supports efforts by the American Academy of Pain Management and signed onto their letter to the Senate Finance Committee in implementing the development of a comprehensive population-level strategy to advance pain research, education, care and prevention, called the National Pain Strategy (NPS).

Supports H.R. 1516/S. 1013 - ENsuring Access to Quality Compex Rehabiliation Technology Act - to ensure Medicare beneficiaries' access to customized wheelchairs. United Spinal advocated distributed a Congressional Dear Colleague letter urging that CRT accessories (specialty controls such as head-rests) are not set at competitive bidding pricing the same as standard wheelchairs due to their highly customized nature for a small population living with significant disabilities. United Spinal highlighted our concern with CRT Accessories, described above and with our concerns with access to durable medical equipment for wheelchair users under the competitive acquisition program. United Spinal signed on to a letter to US Health and Human Services Secretary Burwell and CMS officials regarding a pending case, Davis v. Shah, in the U.S. Second Circuit Court of Appeals - a challenge to New York Medicaid's attempt to limit coverage of compression stockings and orthopedic shoes only to Medicaid recipients with specific diagnoses. Supports the Steve Gleason Act which lifts caps on access to speech-generating devices. (HR 1919, H.R. 629, S, 768, S. 984. United Spinal supported Congressional testimony on behalf of the Coalition to Preserve Rehabilitation Steering Committee highlighting the need to eliminate site-neutral payments under Medicare and also advocated for additional signatories to a Dear Colleague letter stating the same issue. United Spinal supports expanded state participation in Medicaid programs that increase funding for HCBS such as the Community First Choice Option, Money Follows the Person, and the Balancing Incentive Program; and oppose restructuring of Medicaid funding through block grants, State Flexibility Funds, or per capita caps. United Spinal signed on to a letter to the Centers for Medicare and Medicaid Services in support of an improved mechanism for the reimbursement of Lemtrada to ensure speedier access to this therapy for individuals with multiple sclerosis. United Spinal signed onto three comment letters to the Centers for Medicare and Medicaid Services in support of improved rehab policy, namely: on in-patient rehabilitative facilities and on skilled nursing facilities to allow for improved quality reporting and on acute care hospitals and payment issues to ensure that bundled payments of services does not hinder coverage of episodes of care for individuals with multiple needs. United Spinal signed onto a MapRx letter to urge the Senate Finance Committee to include, in their discussion of chronic care, robust formularies, coverage of the six-protected classes of drugs, strong oversight, and transparency for consumers are among the design principles essential to meet the needs of Medicare beneficiaries. In addition, a process for notice of non-coverage, appeals and exceptions is critical to providing access to needed drug therapies. United Spinal supports S.1253, the Patient Access to Disposable Medical Technology Act of 2015.The legislation amends title XVIII (Medicare) of the Social Security Act to cover disposable medical technology in addition to equipment traditionally described as durable medical equipment. This legislation was introduced by Senators Burr (R-NC) and Bennet (D-CO) this spring and is identical to its House counterpart, H.R. 1018, which United Spinal has also supported. United Spinal supports the Protect Medical Innovation Act of 2015, HR 160, introduced by Rep. Eric Paulsen of Minnesota, which repeals the medical device tax on medical device manufacturers and importers. United Spinal signed on to a letter to Congress to convey support for the goals of the final Home and Community Based Settings (HCBS) rule issued by the Centers for Medicare & Medicaid Services (CMS) in January 2014. This rule is the first time CMS has defined community for Medicaid-funded HCBS programs. The letter also urges Congress to: protect cuts to funding; support the requested additional $2.8m in CMS funding for HCBS; and defend against policies or changes to the rule that would hinder the goal of providing supports through HCBS so that people with disabilities can live meaningful lives.

Discussed possible solutions for improving access to Medicaid for military families who have children with disabilities. Discussed passage of House and Senate legislation, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013 -HR 942/S 948. Discussed raising the capped rental rule on some complex rehab technology products and accessories. Discussed possible solutions around improved access to wheelchair repair. Discussed next steps regarding FDA action around biosimilar regulation and the implementation of biosimilar clinical trials. Discussed opposition to restricting Medicare coverage of protected classes of prescription drugs under Medicare Part D. Discussed solutions regarding Medicare physician payment updates known as the 'doc fix' including the repeal of the therapy cap. Discussed solutions regarding Medicare and Medicaid secondary payer regulations. Discussed solutions with state governments and Federal agencies regarding the administration of Medicaid Managed Care programs to ensure protections are in place for people with disabilities. Discussed solutions around CMS guidance on home and commuity based settings. Promote adequate fudning for all Medicaid services that allow people with disabilities to remina in their homes and contribute to the community. Discussed solutions to Medicare's current competitive acquisition program and support - Medicare DMEPOS Market Pricing Program Act of 2013 - HR 1717 Discussed solutions around improved quality measures for home and community based services for the aging and disability communities with HHS. Support advocacy efforts to expand Medicaid.

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362).Support HR 3978, New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA), sponsored by Rep. Albio Sires (D-NJ 8th). The bill includes funding for achieving compliance with the ADA, improving public transit, biking and pedestrian infrastructure. Support HR 3494/S 1708, the Bicycle and Pedestrian Safety Act, sponsored by Rep. Earl Blumenauer (D-OR 3rd) and Rep. Howard Coble (R-NC 6th), and Sen. Jeff Merkley (D-OR) and Sen. Kelly Ayotte (R-NH). The bills would require the DOT to set a non-motorized safety performance measure. Advocated for passage of a long-term surface transportation bill with adequate funding measures. Any bill should incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system in urban, suburban, and rural settings. Support public transit, funding for Section 5310, pilot programs that measure connectivity, including usability of sidewalks, TIGER and FAST grants that can support sidewalk and curb cut maintenance. Suupport biking and pedestrian programs and accessible pathways in MAP-21 reauthorization. Requested funding for progams that support people with disabilities' access to transportation. Discussed improving regulations for out-of-water survival craft included in the Coast Guard reauthorization bill. Discussed dedicated paratransit funding options and the creation of an incentive program to improve paratransit and transit operations for people with disabilities. Discussed establishing a transportation careers workforce development progam at the DOT to create pathways into quality operations, repair, maintenance, and construction jobs for disadvantaged workers including people with disabilities; foster investments in underserved communities in public transportation, bicycle and pedestrian projects (including ADA compliance) through DOT TIGER and TIFIA grants; and leverage DOT and related agency data collection, performance measures, and collaboration to ensure transportation projects benefit all by requiring DOT to prepare a quadrennial report of non-discrimination. United Spinal signed on to a letter to the U.S. Senate Environment and Public Works in support of financing for transit-oriented development (TOD). The EPWs bill included a proposal that would 1) recognize TOD as an eligible category in the TIFIA grant program and (2) lower the project cost threshold from $50million to $10million for TOD-projects. The provision passed and remains in the EPW bill. United Spinal signed on to a letter to Senate and House Transportation Housing and Urban Development and Related Agencies (T-HUD) subcommittee leadership. The letter urges leadership to maintain funding for Department of Transportation programs impacting people with disabilities in the FY 2015 T-HUD appropriations bill. United Spinal has recommended that US DOT ensure that a non-motorized measure would include people who use motorized and non-motorized wheelchairs as part of the Highway Safety Performance Management proposed rules. Supported legislation allowing states and cities to require local residents be hired for highway and public transportation projects. Local residents could include people with disabilities. H. R. 3620 - Local Hire Act.

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362). Discussed mobility and other equipment handling, use of technology to improve the airline passenger experience, and service animals.

Discussed solutions to support transportation equity performance measures.Discussed improved and increased transportation infrastructure, affordable transportation options, increased safety measures, equity performance measures, and expanded access to transportation careers for all Americans, especially disadvantaged communities such as low-income, communities of color, women, and people with disabilities. Support the Bicycle and Pedestrian Safety Act (HR 3494 and S 1708) and New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA) (HR 3978) which would require the Department of Transportation (DOT) to set a non-motorized safety performance measure. NOBPIFA includes funding for projects to achieve compliance with the ADA. Advocate on behalf of people with disabilities to ensure that the requirement that poeple with disabilities are not immersed in water in any survival craft used for people with disabilities on passenger vessels. Request adequate fuding for surface transportation and programs that support access to transportation for people with disabilities. Discussed the Transportation for Heroes Act of 2013 (H.R. 2362).

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362). Discussed mobility and other equipment handling, use of technology to improve the airline passenger experience, and service animals.

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362). Signed on to a letter to the U.S. Department of Transportation and U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. Discussed disability and civil rights with the Department of Transportation FTAs Office of Civil Rights regarding new ADA compliance review processes. United Spinal participated in US Department of Transportation Town Hall discussions regarding drafting language that would bolster the US DOTs proposed surface transportation bill, ensuring that people of color, low income communities and people with disabilities have access to jobs in the transportation industry. United Spinal supports retaining the requirement in section 609 of the Coast Guard Authorization Act of 2010, Pub. L. 111-281 (Section 609), in the Coast Guard and Maritime Transportation Act of 2014. Section 609 provides the common sense requirement that the use of survival craft that do not keep all parts of the body out-of-the-water be phased out by 2015. United Spinal endorsed Representative Langevins Transit Accessibility Innovation Program (TAIF) proposal. The program encourages public transit systems to take actions to address deficiencies in service for individuals with disabilities. United Spinal participated as an alternate in the Access Boards Rail Vehicle Access Advisory Committee (RVAAC) meeting. The Committee reviewed draft reports from subcommittees, including: Boarding and Alighting, Rooms and Spaces, and On-Board Circulation and Seating. The Committee is tasked with presenting recommendations to the Access Board which will draft guidelines. United Spinal discussed Amtrak ADA compliance with Amtrak. Supported HR 3978,New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA). The bill includes funding for achieving compliance with the ADA,improving public transit, biking and pedestrian infrastructure. Supported HR 3494/S1708, the Bicycle and Pedestrian Safety Act. The bills would require the DOT to set a non-motorized safety performance measure. United Spinal supports passage of a long-term surface transportation bill with adequate funding measures which incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system in urban, suburban,and rural settings.

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362). Signed on to a letter to the U.S. Department of Transportation and U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. Discussed disability and civil rights with the Department of Transportation FTAs Office of Civil Rights regarding new ADA compliance review processes. United Spinal participated in US Department of Transportation Town Hall discussions regarding drafting language that would bolster the US DOTs proposed surface transportation bill, ensuring that people of color, low income communities and people with disabilities have access to jobs in the transportation industry. United Spinal supports retaining the requirement in section 609 of the Coast Guard Authorization Act of 2010, Pub. L. 111-281 (Section 609), in the Coast Guard and Maritime Transportation Act of 2014. Section 609 provides the common sense requirement that the use of survival craft that do not keep all parts of the body out-of-the-water be phased out by 2015. United Spinal endorsed Representative Langevins Transit Accessibility Innovation Program (TAIF) proposal. The program encourages public transit systems to take actions to address deficiencies in service for individuals with disabilities. United Spinal participated as an alternate in the Access Boards Rail Vehicle Access Advisory Committee (RVAAC) meeting. The Committee reviewed draft reports from subcommittees, including: Boarding and Alighting, Rooms and Spaces, and On-Board Circulation and Seating. The Committee is tasked with presenting recommendations to the Access Board which will draft guidelines. United Spinal discussed Amtrak ADA compliance with Amtrak. Supported HR 3978,New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA). The bill includes funding for achieving compliance with the ADA,improving public transit, biking and pedestrian infrastructure. Supported HR 3494/S1708, the Bicycle and Pedestrian Safety Act. The bills would require the DOT to set a non-motorized safety performance measure. United Spinal supports passage of a long-term surface transportation bill with adequate funding measures which incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system in urban, suburban,and rural settings.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Supported the Veterans Homebuyer Accessibility Act (H.R. 3422) which would provide tax credits for first time veteran homebuyers and for housing adaptations. Supported Senate efforts to extend and expand the Work Opportunity Tax Credit to incentivize business hiring of people with disabilities and veterans with service-connected disabilities.Advocated for Achieving a Better Life Experience Act of 2013 (ABLE Act) adjusts the Internal Revenue Code to establish tax-exempt ABLE accounts to assist people with disabilities save private funds to pay for education, housing, transportation, employment support and other personal support expenses.

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362). Signed on to a letter to the U.S. Department of Transportation and U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. Discussed disability and civil rights with the Department of Transportation FTAs Office of Civil Rights regarding new ADA compliance review processes. United Spinal participated in US Department of Transportation Town Hall discussions regarding drafting language that would bolster the US DOTs proposed surface transportation bill, ensuring that people of color, low income communities and people with disabilities have access to jobs in the transportation industry. United Spinal supports retaining the requirement in section 609 of the Coast Guard Authorization Act of 2010, Pub. L. 111-281 (Section 609), in the Coast Guard and Maritime Transportation Act of 2014. Section 609 provides the common sense requirement that the use of survival craft that do not keep all parts of the body out-of-the-water be phased out by 2015. United Spinal endorsed Representative Langevins Transit Accessibility Innovation Program (TAIF) proposal. The program encourages public transit systems to take actions to address deficiencies in service for individuals with disabilities. United Spinal participated as an alternate in the Access Boards Rail Vehicle Access Advisory Committee (RVAAC) meeting. The Committee reviewed draft reports from subcommittees, including: Boarding and Alighting, Rooms and Spaces, and On-Board Circulation and Seating. The Committee is tasked with presenting recommendations to the Access Board which will draft guidelines. United Spinal discussed Amtrak ADA compliance with Amtrak. Supported HR 3978,New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA). The bill includes funding for achieving compliance with the ADA,improving public transit, biking and pedestrian infrastructure. Supported HR 3494/S1708, the Bicycle and Pedestrian Safety Act. The bills would require the DOT to set a non-motorized safety performance measure. United Spinal supports passage of a long-term surface transportation bill with adequate funding measures which incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system in urban, suburban,and rural settings.

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362). Signed on to a letter to the U.S. Department of Transportation and U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. Discussed disability and civil rights with the Department of Transportation FTAs Office of Civil Rights regarding new ADA compliance review processes. United Spinal participated in US Department of Transportation Town Hall discussions regarding drafting language that would bolster the US DOTs proposed surface transportation bill, ensuring that people of color, low income communities and people with disabilities have access to jobs in the transportation industry. United Spinal supports retaining the requirement in section 609 of the Coast Guard Authorization Act of 2010, Pub. L. 111-281 (Section 609), in the Coast Guard and Maritime Transportation Act of 2014. Section 609 provides the common sense requirement that the use of survival craft that do not keep all parts of the body out-of-the-water be phased out by 2015. United Spinal endorsed Representative Langevins Transit Accessibility Innovation Program (TAIF) proposal. The program encourages public transit systems to take actions to address deficiencies in service for individuals with disabilities. United Spinal participated as an alternate in the Access Boards Rail Vehicle Access Advisory Committee (RVAAC) meeting. The Committee reviewed draft reports from subcommittees, including: Boarding and Alighting, Rooms and Spaces, and On-Board Circulation and Seating. The Committee is tasked with presenting recommendations to the Access Board which will draft guidelines. United Spinal discussed Amtrak ADA compliance with Amtrak. Supported HR 3978,New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA). The bill includes funding for achieving compliance with the ADA,improving public transit, biking and pedestrian infrastructure. Supported HR 3494/S1708, the Bicycle and Pedestrian Safety Act. The bills would require the DOT to set a non-motorized safety performance measure. United Spinal supports passage of a long-term surface transportation bill with adequate funding measures which incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system in urban, suburban,and rural settings.

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362).Support HR 3978, New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA), sponsored by Rep. Albio Sires (D-NJ 8th). The bill includes funding for achieving compliance with the ADA, improving public transit, biking and pedestrian infrastructure. Support HR 3494/S 1708, the Bicycle and Pedestrian Safety Act, sponsored by Rep. Earl Blumenauer (D-OR 3rd) and Rep. Howard Coble (R-NC 6th), and Sen. Jeff Merkley (D-OR) and Sen. Kelly Ayotte (R-NH). The bills would require the DOT to set a non-motorized safety performance measure. Advocated for passage of a long-term surface transportation bill with adequate funding measures. Any bill should incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system in urban, suburban, and rural settings. Support public transit, funding for Section 5310, pilot programs that measure connectivity, including usability of sidewalks, TIGER and FAST grants that can support sidewalk and curb cut maintenance. Suupport biking and pedestrian programs and accessible pathways in MAP-21 reauthorization. Requested funding for progams that support people with disabilities' access to transportation. Discussed improving regulations for out-of-water survival craft included in the Coast Guard reauthorization bill. Discussed dedicated paratransit funding options and the creation of an incentive program to improve paratransit and transit operations for people with disabilities. Discussed establishing a transportation careers workforce development progam at the DOT to create pathways into quality operations, repair, maintenance, and construction jobs for disadvantaged workers including people with disabilities; foster investments in underserved communities in public transportation, bicycle and pedestrian projects (including ADA compliance) through DOT TIGER and TIFIA grants; and leverage DOT and related agency data collection, performance measures, and collaboration to ensure transportation projects benefit all by requiring DOT to prepare a quadrennial report of non-discrimination. United Spinal signed on to a letter to the U.S. Senate Environment and Public Works in support of financing for transit-oriented development (TOD). The EPWs bill included a proposal that would 1) recognize TOD as an eligible category in the TIFIA grant program and (2) lower the project cost threshold from $50million to $10million for TOD-projects. The provision passed and remains in the EPW bill. United Spinal signed on to a letter to Senate and House Transportation Housing and Urban Development and Related Agencies (T-HUD) subcommittee leadership. The letter urges leadership to maintain funding for Department of Transportation programs impacting people with disabilities in the FY 2015 T-HUD appropriations bill. United Spinal has recommended that US DOT ensure that a non-motorized measure would include people who use motorized and non-motorized wheelchairs as part of the Highway Safety Performance Management proposed rules. Supported legislation allowing states and cities to require local residents be hired for highway and public transportation projects. Local residents could include people with disabilities. H. R. 3620 - Local Hire Act.

Discussed solutions to support transportation equity performance measures.Discussed improved and increased transportation infrastructure, affordable transportation options, increased safety measures, equity performance measures, and expanded access to transportation careers for all Americans, especially disadvantaged communities such as low-income, communities of color, women, and people with disabilities. Support the Bicycle and Pedestrian Safety Act (HR 3494 and S 1708) and New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA) (HR 3978) which would require the Department of Transportation (DOT) to set a non-motorized safety performance measure. NOBPIFA includes funding for projects to achieve compliance with the ADA. Advocate on behalf of people with disabilities to ensure that the requirement that poeple with disabilities are not immersed in water in any survival craft used for people with disabilities on passenger vessels. Request adequate fuding for surface transportation and programs that support access to transportation for people with disabilities. Discussed the Transportation for Heroes Act of 2013 (H.R. 2362).

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362).Support HR 3978, New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA), sponsored by Rep. Albio Sires (D-NJ 8th). The bill includes funding for achieving compliance with the ADA, improving public transit, biking and pedestrian infrastructure. Support HR 3494/S 1708, the Bicycle and Pedestrian Safety Act, sponsored by Rep. Earl Blumenauer (D-OR 3rd) and Rep. Howard Coble (R-NC 6th), and Sen. Jeff Merkley (D-OR) and Sen. Kelly Ayotte (R-NH). The bills would require the DOT to set a non-motorized safety performance measure. Advocated for passage of a long-term surface transportation bill with adequate funding measures. Any bill should incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system in urban, suburban, and rural settings. Support public transit, funding for Section 5310, pilot programs that measure connectivity, including usability of sidewalks, TIGER and FAST grants that can support sidewalk and curb cut maintenance. Suupport biking and pedestrian programs and accessible pathways in MAP-21 reauthorization. Requested funding for progams that support people with disabilities' access to transportation. Discussed improving regulations for out-of-water survival craft included in the Coast Guard reauthorization bill. Discussed dedicated paratransit funding options and the creation of an incentive program to improve paratransit and transit operations for people with disabilities. Discussed establishing a transportation careers workforce development progam at the DOT to create pathways into quality operations, repair, maintenance, and construction jobs for disadvantaged workers including people with disabilities; foster investments in underserved communities in public transportation, bicycle and pedestrian projects (including ADA compliance) through DOT TIGER and TIFIA grants; and leverage DOT and related agency data collection, performance measures, and collaboration to ensure transportation projects benefit all by requiring DOT to prepare a quadrennial report of non-discrimination. United Spinal signed on to a letter to the U.S. Senate Environment and Public Works in support of financing for transit-oriented development (TOD). The EPWs bill included a proposal that would 1) recognize TOD as an eligible category in the TIFIA grant program and (2) lower the project cost threshold from $50million to $10million for TOD-projects. The provision passed and remains in the EPW bill. United Spinal signed on to a letter to Senate and House Transportation Housing and Urban Development and Related Agencies (T-HUD) subcommittee leadership. The letter urges leadership to maintain funding for Department of Transportation programs impacting people with disabilities in the FY 2015 T-HUD appropriations bill. United Spinal has recommended that US DOT ensure that a non-motorized measure would include people who use motorized and non-motorized wheelchairs as part of the Highway Safety Performance Management proposed rules. Supported legislation allowing states and cities to require local residents be hired for highway and public transportation projects. Local residents could include people with disabilities. H. R. 3620 - Local Hire Act.

Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386). Requested adequate funding for the 811 PRA program in HUDs request to OMB. Through the Section 811 Supportive Housing for Persons with Disabilities program, HUD provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities. Discussed the Universal Home Design Act (S. 2889) which would increase the availability of accessible housing for individuals with disabilities.

Advocate for accessible, affording housing for all. Request House and Senate Appropriations to increase the 302(b) allocation to the Subcommittee on Transportation, Housing and Urban Development, and Related Agencies (THUD) to the highest possible level in fiscal year (FY) 2015.Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386).

Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386). Requested adequate funding for the 811 PRA program in HUDs request to OMB. Through the Section 811 Supportive Housing for Persons with Disabilities program, HUD provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities. Discussed the Universal Home Design Act (S. 2889) which would increase the availability of accessible housing for individuals with disabilities.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386). Requested adequate funding for the 811 PRA program in HUDs request to OMB. Through the Section 811 Supportive Housing for Persons with Disabilities program, HUD provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities. Discussed the Universal Home Design Act (S. 2889) which would increase the availability of accessible housing for individuals with disabilities.

Advocate for accessible, affording housing for all. Request House and Senate Appropriations to increase the 302(b) allocation to the Subcommittee on Transportation, Housing and Urban Development, and Related Agencies (THUD) to the highest possible level in fiscal year (FY) 2015.Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386).

Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386). Requested adequate funding for the 811 PRA program in HUDs request to OMB. Through the Section 811 Supportive Housing for Persons with Disabilities program, HUD provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities. Discussed the Universal Home Design Act (S. 2889) which would increase the availability of accessible housing for individuals with disabilities.

Advocate for accessible, affording housing for all. Request House and Senate Appropriations to increase the 302(b) allocation to the Subcommittee on Transportation, Housing and Urban Development, and Related Agencies (THUD) to the highest possible level in fiscal year (FY) 2015.Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386).

Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386). Requested adequate funding for the 811 PRA program in HUDs request to OMB. Through the Section 811 Supportive Housing for Persons with Disabilities program, HUD provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities. Discussed the Universal Home Design Act (S. 2889) which would increase the availability of accessible housing for individuals with disabilities.

Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386). Requested adequate funding for the 811 PRA program in HUDs request to OMB. Through the Section 811 Supportive Housing for Persons with Disabilities program, HUD provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities. Discussed the Universal Home Design Act (S. 2889) which would increase the availability of accessible housing for individuals with disabilities.

Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386). Requested adequate funding for the 811 PRA program in HUDs request to OMB. Through the Section 811 Supportive Housing for Persons with Disabilities program, HUD provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities. Discussed the Universal Home Design Act (S. 2889) which would increase the availability of accessible housing for individuals with disabilities.

Advocate for accessible, affording housing for all. Request House and Senate Appropriations to increase the 302(b) allocation to the Subcommittee on Transportation, Housing and Urban Development, and Related Agencies (THUD) to the highest possible level in fiscal year (FY) 2015.Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386).

Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386). Requested adequate funding for the 811 PRA program in HUDs request to OMB. Through the Section 811 Supportive Housing for Persons with Disabilities program, HUD provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities. Discussed the Universal Home Design Act (S. 2889) which would increase the availability of accessible housing for individuals with disabilities.

Discussed solutions to support transportation equity performance measures.Discussed improved and increased transportation infrastructure, affordable transportation options, increased safety measures, equity performance measures, and expanded access to transportation careers for all Americans, especially disadvantaged communities such as low-income, communities of color, women, and people with disabilities. Support the Bicycle and Pedestrian Safety Act (HR 3494 and S 1708) and New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA) (HR 3978) which would require the Department of Transportation (DOT) to set a non-motorized safety performance measure. NOBPIFA includes funding for projects to achieve compliance with the ADA. Advocate on behalf of people with disabilities to ensure that the requirement that poeple with disabilities are not immersed in water in any survival craft used for people with disabilities on passenger vessels. Request adequate fuding for surface transportation and programs that support access to transportation for people with disabilities. Discussed the Transportation for Heroes Act of 2013 (H.R. 2362).

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362).Support HR 3978, New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA), sponsored by Rep. Albio Sires (D-NJ 8th). The bill includes funding for achieving compliance with the ADA, improving public transit, biking and pedestrian infrastructure. Support HR 3494/S 1708, the Bicycle and Pedestrian Safety Act, sponsored by Rep. Earl Blumenauer (D-OR 3rd) and Rep. Howard Coble (R-NC 6th), and Sen. Jeff Merkley (D-OR) and Sen. Kelly Ayotte (R-NH). The bills would require the DOT to set a non-motorized safety performance measure. Advocated for passage of a long-term surface transportation bill with adequate funding measures. Any bill should incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system in urban, suburban, and rural settings. Support public transit, funding for Section 5310, pilot programs that measure connectivity, including usability of sidewalks, TIGER and FAST grants that can support sidewalk and curb cut maintenance. Suupport biking and pedestrian programs and accessible pathways in MAP-21 reauthorization. Requested funding for progams that support people with disabilities' access to transportation. Discussed improving regulations for out-of-water survival craft included in the Coast Guard reauthorization bill. Discussed dedicated paratransit funding options and the creation of an incentive program to improve paratransit and transit operations for people with disabilities. Discussed establishing a transportation careers workforce development progam at the DOT to create pathways into quality operations, repair, maintenance, and construction jobs for disadvantaged workers including people with disabilities; foster investments in underserved communities in public transportation, bicycle and pedestrian projects (including ADA compliance) through DOT TIGER and TIFIA grants; and leverage DOT and related agency data collection, performance measures, and collaboration to ensure transportation projects benefit all by requiring DOT to prepare a quadrennial report of non-discrimination. United Spinal signed on to a letter to the U.S. Senate Environment and Public Works in support of financing for transit-oriented development (TOD). The EPWs bill included a proposal that would 1) recognize TOD as an eligible category in the TIFIA grant program and (2) lower the project cost threshold from $50million to $10million for TOD-projects. The provision passed and remains in the EPW bill. United Spinal signed on to a letter to Senate and House Transportation Housing and Urban Development and Related Agencies (T-HUD) subcommittee leadership. The letter urges leadership to maintain funding for Department of Transportation programs impacting people with disabilities in the FY 2015 T-HUD appropriations bill. United Spinal has recommended that US DOT ensure that a non-motorized measure would include people who use motorized and non-motorized wheelchairs as part of the Highway Safety Performance Management proposed rules. Supported legislation allowing states and cities to require local residents be hired for highway and public transportation projects. Local residents could include people with disabilities. H. R. 3620 - Local Hire Act.

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362). Signed on to a letter to the U.S. Department of Transportation and U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. Discussed disability and civil rights with the Department of Transportation FTAs Office of Civil Rights regarding new ADA compliance review processes. United Spinal participated in US Department of Transportation Town Hall discussions regarding drafting language that would bolster the US DOTs proposed surface transportation bill, ensuring that people of color, low income communities and people with disabilities have access to jobs in the transportation industry. United Spinal supports retaining the requirement in section 609 of the Coast Guard Authorization Act of 2010, Pub. L. 111-281 (Section 609), in the Coast Guard and Maritime Transportation Act of 2014. Section 609 provides the common sense requirement that the use of survival craft that do not keep all parts of the body out-of-the-water be phased out by 2015. United Spinal endorsed Representative Langevins Transit Accessibility Innovation Program (TAIF) proposal. The program encourages public transit systems to take actions to address deficiencies in service for individuals with disabilities. United Spinal participated as an alternate in the Access Boards Rail Vehicle Access Advisory Committee (RVAAC) meeting. The Committee reviewed draft reports from subcommittees, including: Boarding and Alighting, Rooms and Spaces, and On-Board Circulation and Seating. The Committee is tasked with presenting recommendations to the Access Board which will draft guidelines. United Spinal discussed Amtrak ADA compliance with Amtrak. Supported HR 3978,New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA). The bill includes funding for achieving compliance with the ADA,improving public transit, biking and pedestrian infrastructure. Supported HR 3494/S1708, the Bicycle and Pedestrian Safety Act. The bills would require the DOT to set a non-motorized safety performance measure. United Spinal supports passage of a long-term surface transportation bill with adequate funding measures which incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system in urban, suburban,and rural settings.

Discussed the Transportation for Heroes Act of 2013 (H.R. 2362). Signed on to a letter to the U.S. Department of Transportation and U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. Discussed disability and civil rights with the Department of Transportation FTAs Office of Civil Rights regarding new ADA compliance review processes. United Spinal participated in US Department of Transportation Town Hall discussions regarding drafting language that would bolster the US DOTs proposed surface transportation bill, ensuring that people of color, low income communities and people with disabilities have access to jobs in the transportation industry. United Spinal supports retaining the requirement in section 609 of the Coast Guard Authorization Act of 2010, Pub. L. 111-281 (Section 609), in the Coast Guard and Maritime Transportation Act of 2014. Section 609 provides the common sense requirement that the use of survival craft that do not keep all parts of the body out-of-the-water be phased out by 2015. United Spinal endorsed Representative Langevins Transit Accessibility Innovation Program (TAIF) proposal. The program encourages public transit systems to take actions to address deficiencies in service for individuals with disabilities. United Spinal participated as an alternate in the Access Boards Rail Vehicle Access Advisory Committee (RVAAC) meeting. The Committee reviewed draft reports from subcommittees, including: Boarding and Alighting, Rooms and Spaces, and On-Board Circulation and Seating. The Committee is tasked with presenting recommendations to the Access Board which will draft guidelines. United Spinal discussed Amtrak ADA compliance with Amtrak. Supported HR 3978,New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA). The bill includes funding for achieving compliance with the ADA,improving public transit, biking and pedestrian infrastructure. Supported HR 3494/S1708, the Bicycle and Pedestrian Safety Act. The bills would require the DOT to set a non-motorized safety performance measure. United Spinal supports passage of a long-term surface transportation bill with adequate funding measures which incentivize solutions to ensuring an accessible, affordable, reliable and safe transportation system in urban, suburban,and rural settings.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research INnovaTion Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Supported ensuring network adequacy and protections for pediatric benefits within ACA's essential health benefits. Supports providing improved guidance around notification on Medicare eligibility to individuals not yet collecting Social Security benefits. Supports improving health benefit designs and a guarantee that there is health insurance plan transparency for Affordable Care Act enrollees. Supports protecting the definition of habilitative services and ensuring nondiscrimination as its relates to the provision of health benefits and services. Continues to discuss the 21st Century Cures Initiative with Congress. This initiative attempts to ensure improved access in the discovery, development and delivery of pharmaceutical therapies for the spinal cord injury community. Supports improved access to durable medical equipment and assistive technologies. Supports the Food and Drug Administration (FDA) addressing patient safety issues and the need for more guidance from the FDA on how biologics and biosimilars are being tested and made available to the public. Urges Congress to repeal the cap on therapy services under Medicare. Urges Congress to pursue passage of Ensuring Access To Quality Complex Rehabilitation Technology Act (HR 942/S. 948). Urges Congress to pass HR 4920 - The DMEPOS Medicare Improvement Act - requires state licenses for providers of durable medical equipment (DME) providers and requires that DME companies contracted with the Centers for Medicare and Medicaid must be bound by that contract to provide services and equipment to Medicare and Medicaid beneficiaries. Supports S. 1027 - improved co-ordination of disability and rehabilitation research funding at the National Institutes of Health. Opposes site-neutral payments under Medicare. Supports CMS including a broader range of remote access technologies in the basic health benefit packages offered under CMS.

Discussed the Suicide Prevention Research INnovaTion Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Supported ensuring network adequacy and protections for pediatric benefits within ACA's essential health benefits. Supports providing improved guidance around notification on Medicare eligibility to individuals not yet collecting Social Security benefits. Supports improving health benefit designs and a guarantee that there is health insurance plan transparency for Affordable Care Act enrollees. Supports protecting the definition of habilitative services and ensuring nondiscrimination as its relates to the provision of health benefits and services. Continues to discuss the 21st Century Cures Initiative with Congress. This initiative attempts to ensure improved access in the discovery, development and delivery of pharmaceutical therapies for the spinal cord injury community. Supports improved access to durable medical equipment and assistive technologies. Supports the Food and Drug Administration (FDA) addressing patient safety issues and the need for more guidance from the FDA on how biologics and biosimilars are being tested and made available to the public. Urges Congress to repeal the cap on therapy services under Medicare. Urges Congress to pursue passage of Ensuring Access To Quality Complex Rehabilitation Technology Act (HR 942/S. 948). Urges Congress to pass HR 4920 - The DMEPOS Medicare Improvement Act - requires state licenses for providers of durable medical equipment (DME) providers and requires that DME companies contracted with the Centers for Medicare and Medicaid must be bound by that contract to provide services and equipment to Medicare and Medicaid beneficiaries. Supports S. 1027 - improved co-ordination of disability and rehabilitation research funding at the National Institutes of Health. Opposes site-neutral payments under Medicare. Supports CMS including a broader range of remote access technologies in the basic health benefit packages offered under CMS.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research INnovaTion Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Supported ensuring network adequacy and protections for pediatric benefits within ACA's essential health benefits. Supports providing improved guidance around notification on Medicare eligibility to individuals not yet collecting Social Security benefits. Supports improving health benefit designs and a guarantee that there is health insurance plan transparency for Affordable Care Act enrollees. Supports protecting the definition of habilitative services and ensuring nondiscrimination as its relates to the provision of health benefits and services. Continues to discuss the 21st Century Cures Initiative with Congress. This initiative attempts to ensure improved access in the discovery, development and delivery of pharmaceutical therapies for the spinal cord injury community. Supports improved access to durable medical equipment and assistive technologies. Supports the Food and Drug Administration (FDA) addressing patient safety issues and the need for more guidance from the FDA on how biologics and biosimilars are being tested and made available to the public. Urges Congress to repeal the cap on therapy services under Medicare. Urges Congress to pursue passage of Ensuring Access To Quality Complex Rehabilitation Technology Act (HR 942/S. 948). Urges Congress to pass HR 4920 - The DMEPOS Medicare Improvement Act - requires state licenses for providers of durable medical equipment (DME) providers and requires that DME companies contracted with the Centers for Medicare and Medicaid must be bound by that contract to provide services and equipment to Medicare and Medicaid beneficiaries. Supports S. 1027 - improved co-ordination of disability and rehabilitation research funding at the National Institutes of Health. Opposes site-neutral payments under Medicare. Supports CMS including a broader range of remote access technologies in the basic health benefit packages offered under CMS.

Discussed possible solutions for improving access to Medicaid for military families who have children with disabilities. Discussed passage of House and Senate legislation, Ensuring Access to Quality Complex Rehabilitation Technology Act of 2013 -HR 942/S 948. Discussed raising the capped rental rule on some complex rehab technology products and accessories. Discussed possible solutions around improved access to wheelchair repair. Discussed next steps regarding FDA action around biosimilar regulation and the implementation of biosimilar clinical trials. Discussed opposition to restricting Medicare coverage of protected classes of prescription drugs under Medicare Part D. Discussed solutions regarding Medicare physician payment updates known as the 'doc fix' including the repeal of the therapy cap. Discussed solutions regarding Medicare and Medicaid secondary payer regulations. Discussed solutions with state governments and Federal agencies regarding the administration of Medicaid Managed Care programs to ensure protections are in place for people with disabilities. Discussed solutions around CMS guidance on home and commuity based settings. Promote adequate fudning for all Medicaid services that allow people with disabilities to remina in their homes and contribute to the community. Discussed solutions to Medicare's current competitive acquisition program and support - Medicare DMEPOS Market Pricing Program Act of 2013 - HR 1717 Discussed solutions around improved quality measures for home and community based services for the aging and disability communities with HHS. Support advocacy efforts to expand Medicaid.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research INnovaTion Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Supported ensuring network adequacy and protections for pediatric benefits within ACA's essential health benefits. Supports providing improved guidance around notification on Medicare eligibility to individuals not yet collecting Social Security benefits. Supports improving health benefit designs and a guarantee that there is health insurance plan transparency for Affordable Care Act enrollees. Supports protecting the definition of habilitative services and ensuring nondiscrimination as its relates to the provision of health benefits and services. Continues to discuss the 21st Century Cures Initiative with Congress. This initiative attempts to ensure improved access in the discovery, development and delivery of pharmaceutical therapies for the spinal cord injury community. Supports improved access to durable medical equipment and assistive technologies. Supports the Food and Drug Administration (FDA) addressing patient safety issues and the need for more guidance from the FDA on how biologics and biosimilars are being tested and made available to the public. Urges Congress to repeal the cap on therapy services under Medicare. Urges Congress to pursue passage of Ensuring Access To Quality Complex Rehabilitation Technology Act (HR 942/S. 948). Urges Congress to pass HR 4920 - The DMEPOS Medicare Improvement Act - requires state licenses for providers of durable medical equipment (DME) providers and requires that DME companies contracted with the Centers for Medicare and Medicaid must be bound by that contract to provide services and equipment to Medicare and Medicaid beneficiaries. Supports S. 1027 - improved co-ordination of disability and rehabilitation research funding at the National Institutes of Health. Opposes site-neutral payments under Medicare. Supports CMS including a broader range of remote access technologies in the basic health benefit packages offered under CMS.

Discussed the Suicide Prevention Research INnovaTion Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Supported ensuring network adequacy and protections for pediatric benefits within ACA's essential health benefits. Supports providing improved guidance around notification on Medicare eligibility to individuals not yet collecting Social Security benefits. Supports improving health benefit designs and a guarantee that there is health insurance plan transparency for Affordable Care Act enrollees. Supports protecting the definition of habilitative services and ensuring nondiscrimination as its relates to the provision of health benefits and services. Continues to discuss the 21st Century Cures Initiative with Congress. This initiative attempts to ensure improved access in the discovery, development and delivery of pharmaceutical therapies for the spinal cord injury community. Supports improved access to durable medical equipment and assistive technologies. Supports the Food and Drug Administration (FDA) addressing patient safety issues and the need for more guidance from the FDA on how biologics and biosimilars are being tested and made available to the public. Urges Congress to repeal the cap on therapy services under Medicare. Urges Congress to pursue passage of Ensuring Access To Quality Complex Rehabilitation Technology Act (HR 942/S. 948). Urges Congress to pass HR 4920 - The DMEPOS Medicare Improvement Act - requires state licenses for providers of durable medical equipment (DME) providers and requires that DME companies contracted with the Centers for Medicare and Medicaid must be bound by that contract to provide services and equipment to Medicare and Medicaid beneficiaries. Supports S. 1027 - improved co-ordination of disability and rehabilitation research funding at the National Institutes of Health. Opposes site-neutral payments under Medicare. Supports CMS including a broader range of remote access technologies in the basic health benefit packages offered under CMS.

Discussed the Suicide Prevention Research INnovaTion Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Supported ensuring network adequacy and protections for pediatric benefits within ACA's essential health benefits. Supports providing improved guidance around notification on Medicare eligibility to individuals not yet collecting Social Security benefits. Supports improving health benefit designs and a guarantee that there is health insurance plan transparency for Affordable Care Act enrollees. Supports protecting the definition of habilitative services and ensuring nondiscrimination as its relates to the provision of health benefits and services. Continues to discuss the 21st Century Cures Initiative with Congress. This initiative attempts to ensure improved access in the discovery, development and delivery of pharmaceutical therapies for the spinal cord injury community. Supports improved access to durable medical equipment and assistive technologies. Supports the Food and Drug Administration (FDA) addressing patient safety issues and the need for more guidance from the FDA on how biologics and biosimilars are being tested and made available to the public. Urges Congress to repeal the cap on therapy services under Medicare. Urges Congress to pursue passage of Ensuring Access To Quality Complex Rehabilitation Technology Act (HR 942/S. 948). Urges Congress to pass HR 4920 - The DMEPOS Medicare Improvement Act - requires state licenses for providers of durable medical equipment (DME) providers and requires that DME companies contracted with the Centers for Medicare and Medicaid must be bound by that contract to provide services and equipment to Medicare and Medicaid beneficiaries. Supports S. 1027 - improved co-ordination of disability and rehabilitation research funding at the National Institutes of Health. Opposes site-neutral payments under Medicare. Supports CMS including a broader range of remote access technologies in the basic health benefit packages offered under CMS.

Advocate for accessible, affording housing for all. Request House and Senate Appropriations to increase the 302(b) allocation to the Subcommittee on Transportation, Housing and Urban Development, and Related Agencies (THUD) to the highest possible level in fiscal year (FY) 2015.Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386).

Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386). Requested adequate funding for the 811 PRA program in HUDs request to OMB. Through the Section 811 Supportive Housing for Persons with Disabilities program, HUD provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities. Discussed the Universal Home Design Act (S. 2889) which would increase the availability of accessible housing for individuals with disabilities.

Supported the Housing Assistance for Veterans Act of 2013 (Haven Act) (H.R. 385/H.R. 3743/S. 1387). This legislation will leverage the ability of nonprofits to assist disabled and low-income veterans with needed housing adaptations and home repairs. Discussed the Homes for Heroes Act of 2013 (H.R. 384/H.R. 386). Requested adequate funding for the 811 PRA program in HUDs request to OMB. Through the Section 811 Supportive Housing for Persons with Disabilities program, HUD provides funding to develop and subsidize rental housing with the availability of supportive services for very low- and extremely low-income adults with disabilities. Discussed the Universal Home Design Act (S. 2889) which would increase the availability of accessible housing for individuals with disabilities.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Signed on to a letter to the U.S. Department of Transportation and the U.S. Department of Health and Human Services asking for all modes of public transportation to announce the Suicide Prevention Lifeline for passengers on World Suicide Prevention Day. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care. United Spinal supports Lifespan Respite Care Reauthorization Act (H.R.4683), a free-standing bill that reauthorizes the Lifespan Respite Care Program at $15 million a year for five years. United Spinal discussed the need to provide clarity and certainty for appropriate, risk-based oversight of health information technology.United Spinal supports HR 3077, the TeleMed Act, which allows Medicare providers licensed in one state to provide telemedicine services to certain Medicare beneficiaries across state lines. CMS has proposed a rule to expand prior authorization for DME affecting power wheelchairs, lower limb prostheses and negative pressure wound therapy. United Spinal is in general support of prior authorization is a process that certifies DME suppliers with CMS before they provide equipment and services to Medicare beneficiaries. United Spinal highlighted improved clinical outcomes for rehabilitative care at in-patient rehab facilities over skilled nursing facilities for individuals with spinal cord injuries and other conditions such as brain injury and stroke. United Spinal supports Ensuring Access to Quality Complex Rehabilitation Technology Act/HR 942/ S 948. which creates a separate benefit under Medicare for customized equipment known as complex rehab technology needed by people with significant disabilities. United Spinal discussed the negative impact capped rental agreements for medical equipment and supplies have on access to equipment for individuals with disabilities. United Spinal supports action on improving benefit designs, including cost-sharing options, and guarantee that there is plan transparency for ACA enrollees. United Spinal discussed the 21st Century Cure initiative of Chairman Fred Upton (R-MI-6th) focusing on patient centered care with Congressional staff. United Spinal discussed ACA enrollment and reenrollment matters with HHS. Discussed state of managed care in NYC for dual eligibles and potential improvements in the short term. United Spinal supports greater transparency in Medicare's competitive acquisition program for DMEPOS program as to how providers are evaluated by the Centers for Medicare and Medicaid Services and how the health of beneficiaries are being evaluated. United Spinal supports Medicare Demonstration of Coverage for Low Vision Devices Act of 2013 (H.R. 3749) which would establish a demonstration under the Medicare program for coverage of low vision aids. United Spinal supports HR 713/ S. 367 - Medicare Access to Rehabilitation Services Act of 2013 which eliminates therapy caps for rehabilitative services under Medicare without requiring an exceptions process. United Spinal presented recommendations to the Centers for Medicare and Medicaid Services regarding improvements to the Home and Community Based Services (HCBS) rule which was implemented in January 2014. The rule enhances the quality of HCBS, provides additional protections to HCBS program participants, and ensures that individuals receiving services through HCBS programs have full access to the benefits of community living. The letters recommendations include: ensuring transparency throughout the process; maintaining consistency with Olmstead [The Olmstead Supreme Court decision requires states to provide people with disabilities with the most integrated setting appropriate to their needs]; issuing necessary guidance promptly; clarifying consumer rights and ensuring that states properly identify and categorize settings. United Spinal supports the Community Integration Act/S. 2515. The Act would support the rebalancing of policies to ensure individuals with disabilities can leave institutions and live in the setting of their choosing. United Spinal supports HR 4920, the DMEPOS Medicare Improvement Act of 2014 which requires that providers of durable medical equipment, in areas known as competitive bidding areas, must be licensed in the states that they provide equipment and services and must be bound to the contract that they submitted to CMS if they are awarded a contract to provide equipment and services to Medicare beneficiaries. United Spinal discussed and presented recommendations to the Centers of Medicare and Medicaid Services to proceed with extreme caution when implementing a reimbursement cut in the provision of wound care therapy due to the effects of implementation on beneficiary access to NPWT. Supports making improvements to Medicare trust funds regarding liability settlements.

Discussed the Suicide Prevention Research Innovation Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Discussed with Senate HELP Committee Staff omnibus legislation that includes durable medical equipment, accessible technology, housing, accessible housing and recreation provisions.

Discussed the Suicide Prevention Research INnovaTion Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Supported ensuring network adequacy and protections for pediatric benefits within ACA's essential health benefits. Supports providing improved guidance around notification on Medicare eligibility to individuals not yet collecting Social Security benefits. Supports improving health benefit designs and a guarantee that there is health insurance plan transparency for Affordable Care Act enrollees. Supports protecting the definition of habilitative services and ensuring nondiscrimination as its relates to the provision of health benefits and services. Continues to discuss the 21st Century Cures Initiative with Congress. This initiative attempts to ensure improved access in the discovery, development and delivery of pharmaceutical therapies for the spinal cord injury community. Supports improved access to durable medical equipment and assistive technologies. Supports the Food and Drug Administration (FDA) addressing patient safety issues and the need for more guidance from the FDA on how biologics and biosimilars are being tested and made available to the public. Urges Congress to repeal the cap on therapy services under Medicare. Urges Congress to pursue passage of Ensuring Access To Quality Complex Rehabilitation Technology Act (HR 942/S. 948). Urges Congress to pass HR 4920 - The DMEPOS Medicare Improvement Act - requires state licenses for providers of durable medical equipment (DME) providers and requires that DME companies contracted with the Centers for Medicare and Medicaid must be bound by that contract to provide services and equipment to Medicare and Medicaid beneficiaries. Supports S. 1027 - improved co-ordination of disability and rehabilitation research funding at the National Institutes of Health. Opposes site-neutral payments under Medicare. Supports CMS including a broader range of remote access technologies in the basic health benefit packages offered under CMS.

Discussed the Suicide Prevention Research INnovaTion Act (S. 2035). Supported the Mental Health First Aid Act of 2013 (S. 153). Supported ensuring network adequacy and protections for pediatric benefits within ACA's essential health benefits. Supports providing improved guidance around notification on Medicare eligibility to individuals not yet collecting Social Security benefits. Supports improving health benefit designs and a guarantee that there is health insurance plan transparency for Affordable Care Act enrollees. Supports protecting the definition of habilitative services and ensuring nondiscrimination as its relates to the provision of health benefits and services. Continues to discuss the 21st Century Cures Initiative with Congress. This initiative attempts to ensure improved access in the discovery, development and delivery of pharmaceutical therapies for the spinal cord injury community. Supports improved access to durable medical equipment and assistive technologies. Supports the Food and Drug Administration (FDA) addressing patient safety issues and the need for more guidance from the FDA on how biologics and biosimilars are being tested and made available to the public. Urges Congress to repeal the cap on therapy services under Medicare. Urges Congress to pursue passage of Ensuring Access To Quality Complex Rehabilitation Technology Act (HR 942/S. 948). Urges Congress to pass HR 4920 - The DMEPOS Medicare Improvement Act - requires state licenses for providers of durable medical equipment (DME) providers and requires that DME companies contracted with the Centers for Medicare and Medicaid must be bound by that contract to provide services and equipment to Medicare and Medicaid beneficiaries. Supports S. 1027 - improved co-ordination of disability and rehabilitation research funding at the National Institutes of Health. Opposes site-neutral payments under Medicare. Supports CMS including a broader range of remote access technologies in the basic health benefit packages offered under CMS.

Discussed solutions to support transportation equity performance measures.Discussed improved and increased transportation infrastructure, affordable transportation options, increased safety measures, equity performance measures, and expanded access to transportation careers for all Americans, especially disadvantaged communities such as low-income, communities of color, women, and people with disabilities. Support the Bicycle and Pedestrian Safety Act (HR 3494 and S 1708) and New Opportunities for Bicycle and Pedestrian Infrastructure Financing Act (NOBPIFA) (HR 3978) which would require the Department of Transportation (DOT) to set a non-motorized safety performance measure. NOBPIFA includes funding for projects to achieve compliance with the ADA. Advocate on behalf of people with disabilities to ensure that the requirement that poeple with disabilities are not immersed in water in any survival craft used for people with disabilities on passenger vessels. Request adequate fuding for surface transportation and programs that support access to transportation for people with disabilities. Discussed the Transportation for Heroes Act of 2013 (H.R. 2362).