JOSEPH ISAACS

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

HR 4378 - Ensuring Access to Quality Complex Rehabiliation Technology Act of 2012. Throughout the second quarter, 2012, United Spinal has been advocating on this legislation to create a separate benefit category in Medicare for coverage of complex rehabilitation technology such as highly sophisticated, customized power mobility devices. The bill entails a broader baseline of services than those that are currently referred to under the Medicare program as durable medical equipment. HR 4378 ensures access to appropriate prodcuts and technology based on a person's functional needs in addition to their diagnosis and the severity of their injury or disorder; allows individuals to access devices that can be used outside of the home and in the community, allows individuals to work and participate in community life; and, ensuring access to local CRT suppliers equipped to make repairs and maintenance for specialized devices. United Spinal Association wrote a letter in April to Secretary Sebelius applauding the newly created Administration for Community Living (ACL) in support of the focus on community living and urged the agency to lift the outdated rule that ties Medicare coverage of wheelchairs and other mobility assistive equipment to in-the-home use. United Spinal also met with the ACL to discuss complex rehab technology and Medicaid managed care and there will be a continuing dialogue between the Association and the ACL on these and other matters. In April, United Spinal submitted comments to the Centers for Medicare and Medicaid Services in response to the proposed information collection requirements for the Medicare prior authorization demonstration applied to coverage claims for power mobility devices. We insisted that CMS be proactive in providing guidance, in the form of guides or templates, to assist physicians and treating practitioners in filing claims and documenting medical necessity and functional limitations from the outset. In June comments to the Office of Management and Budget, we continue to urge the creation of an electronic template under this demonstration to help accelerate the delivery of necessary equipment that will enhance mobility-related activities of daily living and support the independendce of individuals with disabilities. In April, United Spinal signed onto a letter to the Food and Drug Administration's Center for Devices and Radiological Health on the Medical Device User Fee and Modernization Act (MDUFA) agreement in principle between industry and FDA (Docket No. FDA-2010-N-0389). The letter supports the agency-industry agreements intent to do the following: significantly improve FDA review times to help speed up safe and effective treatments to patients; vastly enhance the consistency and timeliness of the approval process, helping to provide patients more information and certainty about the process; offer greater accountability and improved transparency resulting in more data points on FDAs performance; provide enhanced resources to give FDA the necessary tools for meeting new performance goals. Medicaid Eligibility Rules United Spinal co-signed a Consortium for Citizens with Disabilities letter to HHS Secretary Kathleen Sebelius, spearheaded by the Healthcare for America Now coalition urging the Centers for Medicare & Medicaid Services (CMS) to reconsider the provision of the final Medicaid rule (CMS-2349-F) that permits important eligibility determination functions to be contracted to private entities. Public accountability for Medicaid eligibility determinations is essential. The best way to ensure accountability is if governmental staff carries out these functions in the best interest of the public, free of bias or conflicts of interest. This has been the policy in Medicaid for decades: to change it without a process for notice and comment would be highly unusual and set a bad precedent. Congressional Hearing on Competitive Acquisition United Spinal Association submitted a statement for the record to the United States House Committee on Ways and Means Subcommittee on Health. United Spinal urged the committee to look closely at how the Centers for Medicare and Medicaid Services is gathering data on the impact this program has on all consumers, including people with disabilities. United Spinal Association will continue to monitor how the program is impacting consumers. United Spinal signed onto a Coalition for Disability Health Equity letter to CMS in response to the agencys proposed rules on the agency's electronic health record incentive program. Health information technology and electronic health records have the power to collect aggregated data on people with disabilities to provide information to improve the quality of care of all people with disabilities. The incentive program offers an important opportunity to reduce health disparities and improve equity in the U.S. health care system. Reducing disparities is included in the first of the five pillars of meaningful use health outcomes policy priorities and health disparities among those with disabilities are included in HHS policies to reduce health disparities, including Healthy People 2020 and the Affordable Care Act. Supported reauthorization of the Traumatic Brain Injury Act. This is the only federal legislation that specifically assists states and other entities to develop and expand service delivery systems, and provide needed advocacy to meet the needs and protect the rights of individuals who have sustained a TBI and their families. HR 3613: Part D Beneficairy Appeal Fairness Act which supports implementation of a fair and reasonable exceptions and appeals process under Medicare Part D coverage for seniors and people with disabilities that depend on 'specialty tier' drugs to improve or maintain their health status and function. Support making the Medicaid Buy In program mandatory nationwide. To maintain their capacity for employment that keeps them off the Medicaid rolls, workers with disabilities often need long-term services and supports. In many states, they are able to purchase affordable Medicaid coverage for this purpose but the benefits vary. To promote the productivity and independence of workers with disabilities, Medicaid buy-in coverage should be made consistent in scope, remain affordable and offered for purchase in all states. Request that DOL issue the Rehab Act Section 503 Final Rules governing Federal Contractor compliance with measurable affirmative action goals for recruiting, hiring and advancing workers with disabilities. Federal contractors and subcontractors account for one-fifth of all jobs in the employment marketplace. It is critical that they be held accountable to the law. HR 1546 and S 829, the Medicare Access to Rehabilitation Services Act which eliminates Medicare Part Bs arbitrary and unfair outpatient rehab therapy payment caps. Advance the use of home and community-based services and supports as mandatory long-term care benefits (currently optional to the states) which are far less costly than nursing home and other facility-based care for such purposes and are currently mandatory under Medicaid. Expand managed care where feasible to higher risk, higher cost beneficiaries and those dually eligible for Medicare as well with strict oversight and patient protections to improve care coordination and achieve efficiencies for these patients. Restore Medicaids discount prescription drug pricing to those dually eligible for Medicare. Intensify efforts to reduce fraud and abuse which accounted for $12.9 billion in Medicaid improper payments in FY 2007. Insist that Medicare restore its pre-2008 catheter policy language around individual consideration that enabled physicians to diagnose and prescribe the proper treatment based on their patients specific needs, circumstances and risk factors. Add a new criterion for Medicare eligibility for a closed system catheter that allows automatic qualification for patients with permanent severe bladder impairments, reducing their risk of bacterial contamination which can lead to life-threatening UTIs.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Association has been advocating to protect the civil rights of persons with disabilities and is opposed to various pieces of legislation including H.R. 4200, recently introduced by Rep. David Schweikert (R-5th AZ) which amends the Americans with Disabilities Act of 1990 to prohibit the U.S. Attorney General from administering or enforcing certain ADA accessibility regulations relating to pools at public accommodations or provided by public entities. We also oppose H.R. 4256, the Pool Safety and Accessibility for Everyone (Pool SAFE) Act, introduced by Rep. Rick Mulvaney (R-5th SC), directs the Attorney General to revise certain rules under Titles II and III of the ADA each requirements related to accessible means of entry to public pools. The counterpart bills in the Senate are S. 2191 and S.2186, both introduced by Sen. Jim DeMint (R-SC). United Spinal also submitted comments to the Department of Justice on its delay in implementing the final ADA pool accessibility regulations until May 21, 2012 in response to hotel owner complaints to the White House despite the fact that the intended rules were first announced in 2010. United Spinal expressed that the existing provisions for program accessibility (28 CFR 35.150) and readily achievable barrier removal (28 CFR 36.304) provide sufficient relief for entities that may not be able to immediately comply with the requirements to provide pool or spa access, especially when they more than one such facility as a property. We urged that the requirement be made effective immediately upon the close of the comment period on May 21, 2012. United Spinal opposes the following: H.R. 881, the ADA Notification Act of 2011, denies lawsuit in state or federal court for discrimination in public accommodations and certain private services unless the plaintiff notified defendant prior in writing, notice alleged specific facts, 90 days elapsed after notice, notified they had 90 days, notice states complaint has not been corrected. H.R. 3356 is the ACCESS (ADA Compliance for Customer Entry to Stores and Services) Act of 2011 and denies lawsuits based on inaccessibility in public buildings unless owner/operator is provided notice and they fail to provide description of improvements or plan on how barrier will be removed. H.R. 2032 prohibits any agency that receives funds from the government (such as DOJ) to consult with residents of DD facilities before filing lawsuits (i.e., on Olmstead violations). Residents can remove themselves from a lawsuit to remove the threat of being discharged from that facility. United Spinal helped to craft a Consortium for Citizens with Disabilities statement for the record following the hearing on the pool regulations issue held at the end of April, before the Committee on the Judiciarys Subcommittee on the Constitution entitled, Department of Justices Guidance on Access to Pools and Spas under the ADA. Also, United Spinal submitted our own statement for the record following the hearing stating that United Spinal Association strongly supports the principles of the ADA, enabling equal opportunities for individuals with disabilities in the areas of employment, public services, public transportation, public accommodations and communications. The law reflects hard-fought victories for civil rights and equality. We urge that the Department of Justice be permitted to move forward without further delay to make effective the requirements to provide access to polls, wading pools and spas on May 21, 2012. United Spinal also signed on to an Association of University Centers on Disabilities (AUCD) letter to the United States House of Representatives in opposing an amendment of Representative John Carter (R-31st TX) to the Commerce, Justice, and Science Appropriations Bill that would prevent the Justice Department from using its funds to enforce the ADA regulations to increase access for people with disabilities to swimming pools. Opposed the ADA Compliance for Customer Entry to Stores and Services (ACCESS) Act (H.R. 3356). Opposed legislation that would amend the Americans with Disabilities Act of 1990 to prohibit the Attorney General from administering or enforcing certain accessibility regulations relating to pools at public accommodations or provided by public entities (S. 2191). Opposed legislation that would amend the Americans with Disabilities Act of 1990 to prohibit the Attorney General from administering or enforcing certain accessibility regulations relating to pools at public accommodations or provided by public entities (S. 2186). Support ratification of the Convention on the Rights of Persons with Disabilities to advance the rights of people with disabilities throughout the world.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

Support of the Office of Federal Compliance Contractor/Section 503 of the Rehabilitation Act United Spinal Association expressed its continuing support to the Department of Labors OFCCP to issue final regulations implementing and strengthening the compliance goals of Section 503 of the Rehabilitation Act which speaks to affirmative action in federal contractor and subcontractor hiring of qualified workers with disabilities. These contractors are estimated to be employers to about 20% of the overall U.S. workforce. United Spinal Association signed onto a letter spearheaded by the Consortium for Citizens with Disabilities supporting the Department of Labors thorough review of public comments on its proposed changes to rules implementing Section 503 of the Rehabilitation Act and the Vietnam Era Veterans Adjustment Act (VEVRAA), and urged that the final revised regulations be issued as soon as possible. Participated in discussions regarding the staff discussion draft of the Workforce Investment Act reauthorization. HR 4227: the Workforce Investment Act (WIA) of 2012 which reauthorizes WIA of 1998 to strengthen investment in innovation, alignment and improvement of employment, training and education programs. The bill, introduced by Reps. John Tierney (D-6th MA), Ruben Hinojosa (D-15th TX) and George Miller (D-7th CA), would modernize Rehabilitation Act programs, promote employment in competitive integrated employment and foster post-secondary education for people with disabilities. Reauthorization and funding of the Work Incentives Planning Assistance (WIPA) and Protection and Advocacy for Beneficiaries of Social Security (PABSS), two employment counseling programs that help SSDI beneficiaries return to work. Their funding expires June 30 and September 30, 2012 respectively. H.R. 3086: the Fair Wages for Workers with Disabilities Act, introduced by Reps. Cliff Stearns (R-6th FL) and Tim Bishop (D-1st NY), to phase out outmoded special wage certificates under the Fair Labor Standards Act of 1938 (FLSA). These certificates allow individuals with disabilities to be employed at subminimum wage rates in sheltered settings. Advancements in vocational rehabilitation, technology, and training of workers with disabilities have contributed to dramatic growth of such workers in the national workforce and rendered the FLSA provision obsolete.

United Spinal Association has been advocating to protect the civil rights of persons with disabilities and is opposed to various pieces of legislation including H.R. 4200, recently introduced by Rep. David Schweikert (R-5th AZ) which amends the Americans with Disabilities Act of 1990 to prohibit the U.S. Attorney General from administering or enforcing certain ADA accessibility regulations relating to pools at public accommodations or provided by public entities. We also oppose H.R. 4256, the Pool Safety and Accessibility for Everyone (Pool SAFE) Act, introduced by Rep. Rick Mulvaney (R-5th SC), directs the Attorney General to revise certain rules under Titles II and III of the ADA each requirements related to accessible means of entry to public pools. The counterpart bills in the Senate are S. 2191 and S.2186, both introduced by Sen. Jim DeMint (R-SC). United Spinal also submitted comments to the Department of Justice on its delay in implementing the final ADA pool accessibility regulations until May 21, 2012 in response to hotel owner complaints to the White House despite the fact that the intended rules were first announced in 2010. United Spinal expressed that the existing provisions for program accessibility (28 CFR 35.150) and readily achievable barrier removal (28 CFR 36.304) provide sufficient relief for entities that may not be able to immediately comply with the requirements to provide pool or spa access, especially when they more than one such facility as a property. We urged that the requirement be made effective immediately upon the close of the comment period on May 21, 2012. United Spinal opposes the following: H.R. 881, the ADA Notification Act of 2011, denies lawsuit in state or federal court for discrimination in public accommodations and certain private services unless the plaintiff notified defendant prior in writing, notice alleged specific facts, 90 days elapsed after notice, notified they had 90 days, notice states complaint has not been corrected. H.R. 3356 is the ACCESS (ADA Compliance for Customer Entry to Stores and Services) Act of 2011 and denies lawsuits based on inaccessibility in public buildings unless owner/operator is provided notice and they fail to provide description of improvements or plan on how barrier will be removed. H.R. 2032 prohibits any agency that receives funds from the government (such as DOJ) to consult with residents of DD facilities before filing lawsuits (i.e., on Olmstead violations). Residents can remove themselves from a lawsuit to remove the threat of being discharged from that facility. United Spinal helped to craft a Consortium for Citizens with Disabilities statement for the record following the hearing on the pool regulations issue held at the end of April, before the Committee on the Judiciarys Subcommittee on the Constitution entitled, Department of Justices Guidance on Access to Pools and Spas under the ADA. Also, United Spinal submitted our own statement for the record following the hearing stating that United Spinal Association strongly supports the principles of the ADA, enabling equal opportunities for individuals with disabilities in the areas of employment, public services, public transportation, public accommodations and communications. The law reflects hard-fought victories for civil rights and equality. We urge that the Department of Justice be permitted to move forward without further delay to make effective the requirements to provide access to polls, wading pools and spas on May 21, 2012. United Spinal also signed on to an Association of University Centers on Disabilities (AUCD) letter to the United States House of Representatives in opposing an amendment of Representative John Carter (R-31st TX) to the Commerce, Justice, and Science Appropriations Bill that would prevent the Justice Department from using its funds to enforce the ADA regulations to increase access for people with disabilities to swimming pools. Opposed the ADA Compliance for Customer Entry to Stores and Services (ACCESS) Act (H.R. 3356). Opposed legislation that would amend the Americans with Disabilities Act of 1990 to prohibit the Attorney General from administering or enforcing certain accessibility regulations relating to pools at public accommodations or provided by public entities (S. 2191). Opposed legislation that would amend the Americans with Disabilities Act of 1990 to prohibit the Attorney General from administering or enforcing certain accessibility regulations relating to pools at public accommodations or provided by public entities (S. 2186). Support ratification of the Convention on the Rights of Persons with Disabilities to advance the rights of people with disabilities throughout the world.

HR 4378 - Ensuring Access to Quality Complex Rehabiliation Technology Act of 2012. Throughout the second quarter, 2012, United Spinal has been advocating on this legislation to create a separate benefit category in Medicare for coverage of complex rehabilitation technology such as highly sophisticated, customized power mobility devices. The bill entails a broader baseline of services than those that are currently referred to under the Medicare program as durable medical equipment. HR 4378 ensures access to appropriate prodcuts and technology based on a person's functional needs in addition to their diagnosis and the severity of their injury or disorder; allows individuals to access devices that can be used outside of the home and in the community, allows individuals to work and participate in community life; and, ensuring access to local CRT suppliers equipped to make repairs and maintenance for specialized devices. United Spinal Association wrote a letter in April to Secretary Sebelius applauding the newly created Administration for Community Living (ACL) in support of the focus on community living and urged the agency to lift the outdated rule that ties Medicare coverage of wheelchairs and other mobility assistive equipment to in-the-home use. United Spinal also met with the ACL to discuss complex rehab technology and Medicaid managed care and there will be a continuing dialogue between the Association and the ACL on these and other matters. In April, United Spinal submitted comments to the Centers for Medicare and Medicaid Services in response to the proposed information collection requirements for the Medicare prior authorization demonstration applied to coverage claims for power mobility devices. We insisted that CMS be proactive in providing guidance, in the form of guides or templates, to assist physicians and treating practitioners in filing claims and documenting medical necessity and functional limitations from the outset. In June comments to the Office of Management and Budget, we continue to urge the creation of an electronic template under this demonstration to help accelerate the delivery of necessary equipment that will enhance mobility-related activities of daily living and support the independendce of individuals with disabilities. In April, United Spinal signed onto a letter to the Food and Drug Administration's Center for Devices and Radiological Health on the Medical Device User Fee and Modernization Act (MDUFA) agreement in principle between industry and FDA (Docket No. FDA-2010-N-0389). The letter supports the agency-industry agreements intent to do the following: significantly improve FDA review times to help speed up safe and effective treatments to patients; vastly enhance the consistency and timeliness of the approval process, helping to provide patients more information and certainty about the process; offer greater accountability and improved transparency resulting in more data points on FDAs performance; provide enhanced resources to give FDA the necessary tools for meeting new performance goals. Medicaid Eligibility Rules United Spinal co-signed a Consortium for Citizens with Disabilities letter to HHS Secretary Kathleen Sebelius, spearheaded by the Healthcare for America Now coalition urging the Centers for Medicare & Medicaid Services (CMS) to reconsider the provision of the final Medicaid rule (CMS-2349-F) that permits important eligibility determination functions to be contracted to private entities. Public accountability for Medicaid eligibility determinations is essential. The best way to ensure accountability is if governmental staff carries out these functions in the best interest of the public, free of bias or conflicts of interest. This has been the policy in Medicaid for decades: to change it without a process for notice and comment would be highly unusual and set a bad precedent. Congressional Hearing on Competitive Acquisition United Spinal Association submitted a statement for the record to the United States House Committee on Ways and Means Subcommittee on Health. United Spinal urged the committee to look closely at how the Centers for Medicare and Medicaid Services is gathering data on the impact this program has on all consumers, including people with disabilities. United Spinal Association will continue to monitor how the program is impacting consumers. United Spinal signed onto a Coalition for Disability Health Equity letter to CMS in response to the agencys proposed rules on the agency's electronic health record incentive program. Health information technology and electronic health records have the power to collect aggregated data on people with disabilities to provide information to improve the quality of care of all people with disabilities. The incentive program offers an important opportunity to reduce health disparities and improve equity in the U.S. health care system. Reducing disparities is included in the first of the five pillars of meaningful use health outcomes policy priorities and health disparities among those with disabilities are included in HHS policies to reduce health disparities, including Healthy People 2020 and the Affordable Care Act. Supported reauthorization of the Traumatic Brain Injury Act. This is the only federal legislation that specifically assists states and other entities to develop and expand service delivery systems, and provide needed advocacy to meet the needs and protect the rights of individuals who have sustained a TBI and their families. HR 3613: Part D Beneficairy Appeal Fairness Act which supports implementation of a fair and reasonable exceptions and appeals process under Medicare Part D coverage for seniors and people with disabilities that depend on 'specialty tier' drugs to improve or maintain their health status and function. Support making the Medicaid Buy In program mandatory nationwide. To maintain their capacity for employment that keeps them off the Medicaid rolls, workers with disabilities often need long-term services and supports. In many states, they are able to purchase affordable Medicaid coverage for this purpose but the benefits vary. To promote the productivity and independence of workers with disabilities, Medicaid buy-in coverage should be made consistent in scope, remain affordable and offered for purchase in all states. Request that DOL issue the Rehab Act Section 503 Final Rules governing Federal Contractor compliance with measurable affirmative action goals for recruiting, hiring and advancing workers with disabilities. Federal contractors and subcontractors account for one-fifth of all jobs in the employment marketplace. It is critical that they be held accountable to the law. HR 1546 and S 829, the Medicare Access to Rehabilitation Services Act which eliminates Medicare Part Bs arbitrary and unfair outpatient rehab therapy payment caps. Advance the use of home and community-based services and supports as mandatory long-term care benefits (currently optional to the states) which are far less costly than nursing home and other facility-based care for such purposes and are currently mandatory under Medicaid. Expand managed care where feasible to higher risk, higher cost beneficiaries and those dually eligible for Medicare as well with strict oversight and patient protections to improve care coordination and achieve efficiencies for these patients. Restore Medicaids discount prescription drug pricing to those dually eligible for Medicare. Intensify efforts to reduce fraud and abuse which accounted for $12.9 billion in Medicaid improper payments in FY 2007. Insist that Medicare restore its pre-2008 catheter policy language around individual consideration that enabled physicians to diagnose and prescribe the proper treatment based on their patients specific needs, circumstances and risk factors. Add a new criterion for Medicare eligibility for a closed system catheter that allows automatic qualification for patients with permanent severe bladder impairments, reducing their risk of bacterial contamination which can lead to life-threatening UTIs.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

Support of the Office of Federal Compliance Contractor/Section 503 of the Rehabilitation Act United Spinal Association expressed its continuing support to the Department of Labors OFCCP to issue final regulations implementing and strengthening the compliance goals of Section 503 of the Rehabilitation Act which speaks to affirmative action in federal contractor and subcontractor hiring of qualified workers with disabilities. These contractors are estimated to be employers to about 20% of the overall U.S. workforce. United Spinal Association signed onto a letter spearheaded by the Consortium for Citizens with Disabilities supporting the Department of Labors thorough review of public comments on its proposed changes to rules implementing Section 503 of the Rehabilitation Act and the Vietnam Era Veterans Adjustment Act (VEVRAA), and urged that the final revised regulations be issued as soon as possible. Participated in discussions regarding the staff discussion draft of the Workforce Investment Act reauthorization. HR 4227: the Workforce Investment Act (WIA) of 2012 which reauthorizes WIA of 1998 to strengthen investment in innovation, alignment and improvement of employment, training and education programs. The bill, introduced by Reps. John Tierney (D-6th MA), Ruben Hinojosa (D-15th TX) and George Miller (D-7th CA), would modernize Rehabilitation Act programs, promote employment in competitive integrated employment and foster post-secondary education for people with disabilities. Reauthorization and funding of the Work Incentives Planning Assistance (WIPA) and Protection and Advocacy for Beneficiaries of Social Security (PABSS), two employment counseling programs that help SSDI beneficiaries return to work. Their funding expires June 30 and September 30, 2012 respectively. H.R. 3086: the Fair Wages for Workers with Disabilities Act, introduced by Reps. Cliff Stearns (R-6th FL) and Tim Bishop (D-1st NY), to phase out outmoded special wage certificates under the Fair Labor Standards Act of 1938 (FLSA). These certificates allow individuals with disabilities to be employed at subminimum wage rates in sheltered settings. Advancements in vocational rehabilitation, technology, and training of workers with disabilities have contributed to dramatic growth of such workers in the national workforce and rendered the FLSA provision obsolete.

HR 4378 - Ensuring Access to Quality Complex Rehabiliation Technology Act of 2012. Throughout the second quarter, 2012, United Spinal has been advocating on this legislation to create a separate benefit category in Medicare for coverage of complex rehabilitation technology such as highly sophisticated, customized power mobility devices. The bill entails a broader baseline of services than those that are currently referred to under the Medicare program as durable medical equipment. HR 4378 ensures access to appropriate prodcuts and technology based on a person's functional needs in addition to their diagnosis and the severity of their injury or disorder; allows individuals to access devices that can be used outside of the home and in the community, allows individuals to work and participate in community life; and, ensuring access to local CRT suppliers equipped to make repairs and maintenance for specialized devices. United Spinal Association wrote a letter in April to Secretary Sebelius applauding the newly created Administration for Community Living (ACL) in support of the focus on community living and urged the agency to lift the outdated rule that ties Medicare coverage of wheelchairs and other mobility assistive equipment to in-the-home use. United Spinal also met with the ACL to discuss complex rehab technology and Medicaid managed care and there will be a continuing dialogue between the Association and the ACL on these and other matters. In April, United Spinal submitted comments to the Centers for Medicare and Medicaid Services in response to the proposed information collection requirements for the Medicare prior authorization demonstration applied to coverage claims for power mobility devices. We insisted that CMS be proactive in providing guidance, in the form of guides or templates, to assist physicians and treating practitioners in filing claims and documenting medical necessity and functional limitations from the outset. In June comments to the Office of Management and Budget, we continue to urge the creation of an electronic template under this demonstration to help accelerate the delivery of necessary equipment that will enhance mobility-related activities of daily living and support the independendce of individuals with disabilities. In April, United Spinal signed onto a letter to the Food and Drug Administration's Center for Devices and Radiological Health on the Medical Device User Fee and Modernization Act (MDUFA) agreement in principle between industry and FDA (Docket No. FDA-2010-N-0389). The letter supports the agency-industry agreements intent to do the following: significantly improve FDA review times to help speed up safe and effective treatments to patients; vastly enhance the consistency and timeliness of the approval process, helping to provide patients more information and certainty about the process; offer greater accountability and improved transparency resulting in more data points on FDAs performance; provide enhanced resources to give FDA the necessary tools for meeting new performance goals. Medicaid Eligibility Rules United Spinal co-signed a Consortium for Citizens with Disabilities letter to HHS Secretary Kathleen Sebelius, spearheaded by the Healthcare for America Now coalition urging the Centers for Medicare & Medicaid Services (CMS) to reconsider the provision of the final Medicaid rule (CMS-2349-F) that permits important eligibility determination functions to be contracted to private entities. Public accountability for Medicaid eligibility determinations is essential. The best way to ensure accountability is if governmental staff carries out these functions in the best interest of the public, free of bias or conflicts of interest. This has been the policy in Medicaid for decades: to change it without a process for notice and comment would be highly unusual and set a bad precedent. Congressional Hearing on Competitive Acquisition United Spinal Association submitted a statement for the record to the United States House Committee on Ways and Means Subcommittee on Health. United Spinal urged the committee to look closely at how the Centers for Medicare and Medicaid Services is gathering data on the impact this program has on all consumers, including people with disabilities. United Spinal Association will continue to monitor how the program is impacting consumers. United Spinal signed onto a Coalition for Disability Health Equity letter to CMS in response to the agencys proposed rules on the agency's electronic health record incentive program. Health information technology and electronic health records have the power to collect aggregated data on people with disabilities to provide information to improve the quality of care of all people with disabilities. The incentive program offers an important opportunity to reduce health disparities and improve equity in the U.S. health care system. Reducing disparities is included in the first of the five pillars of meaningful use health outcomes policy priorities and health disparities among those with disabilities are included in HHS policies to reduce health disparities, including Healthy People 2020 and the Affordable Care Act. Supported reauthorization of the Traumatic Brain Injury Act. This is the only federal legislation that specifically assists states and other entities to develop and expand service delivery systems, and provide needed advocacy to meet the needs and protect the rights of individuals who have sustained a TBI and their families. HR 3613: Part D Beneficairy Appeal Fairness Act which supports implementation of a fair and reasonable exceptions and appeals process under Medicare Part D coverage for seniors and people with disabilities that depend on 'specialty tier' drugs to improve or maintain their health status and function. Support making the Medicaid Buy In program mandatory nationwide. To maintain their capacity for employment that keeps them off the Medicaid rolls, workers with disabilities often need long-term services and supports. In many states, they are able to purchase affordable Medicaid coverage for this purpose but the benefits vary. To promote the productivity and independence of workers with disabilities, Medicaid buy-in coverage should be made consistent in scope, remain affordable and offered for purchase in all states. Request that DOL issue the Rehab Act Section 503 Final Rules governing Federal Contractor compliance with measurable affirmative action goals for recruiting, hiring and advancing workers with disabilities. Federal contractors and subcontractors account for one-fifth of all jobs in the employment marketplace. It is critical that they be held accountable to the law. HR 1546 and S 829, the Medicare Access to Rehabilitation Services Act which eliminates Medicare Part Bs arbitrary and unfair outpatient rehab therapy payment caps. Advance the use of home and community-based services and supports as mandatory long-term care benefits (currently optional to the states) which are far less costly than nursing home and other facility-based care for such purposes and are currently mandatory under Medicaid. Expand managed care where feasible to higher risk, higher cost beneficiaries and those dually eligible for Medicare as well with strict oversight and patient protections to improve care coordination and achieve efficiencies for these patients. Restore Medicaids discount prescription drug pricing to those dually eligible for Medicare. Intensify efforts to reduce fraud and abuse which accounted for $12.9 billion in Medicaid improper payments in FY 2007. Insist that Medicare restore its pre-2008 catheter policy language around individual consideration that enabled physicians to diagnose and prescribe the proper treatment based on their patients specific needs, circumstances and risk factors. Add a new criterion for Medicare eligibility for a closed system catheter that allows automatic qualification for patients with permanent severe bladder impairments, reducing their risk of bacterial contamination which can lead to life-threatening UTIs.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Supports H.R. 5428 - The Injured and Amputee Veterans Bill of Rights As part of the Independence through Enhancement of Medicare and Medicaid (ITEM) Coalition, United Spinal Association signed on to a letter to the House Veterans Affairs Committee in support of HR 5428 - the Injured and Amputee Veterans Bill of Rights. This bill would establish a written list of rights that all injured and amputee veterans have access to high quality orthotic and prosthetic (O&P) care. O&P care, consisting of orthopedic braces, artificial limbs, and the clinical services necessary to treat the patient, is vital to veterans who have lost limbs or have sustained injuries or disorders of the arms, legs, back and neck. Supported the GI Bill Consumer Awareness Act of 2012 (S. 2241). Supported the Honoring Americas Veterans and Caring for Camp Lejeune Families Act of 2012 (HR 1627). This omnibus legislation contains many provisions that we have advocated for including access for service dogs to VA facilities. Discussed access to VA mental health services with the Department of Veterans Affairs, Veterans Health Administration. Supported the Veterans I.D. Card Act (H.R. 2985). This legislation directs the Secretary of VA to issue a veteran's identification card to any veteran who requests such card and is neither entitled to military retired pay nor enrolled in the VA system of patient enrollment. Supported the Veterans Data Breach Timely Notification Act (H.R. 3730). Requires the VA Secretary, in the event of a data breach with respect to sensitive personal information that is processed or maintained by the Secretary, to notify Congress and each individual whose sensitive personal information is involved in the data breach. Supported the Veterans Affairs Employee Accountability Act (H.R. 4481). Directs the VA Secretary to ensure that no employee of VA who violates any civil law covered by the Federal Acquisition Regulation receives any retention incentive, payment, or award for or during the year of such violation. Supported the Veterans Fiduciary Reform Act of 2012 (H.R. 5948). Supported the Women Veterans and Other Health Care Improvements Act of 2012 (S. 3313). Supported the Mental Health Access to Continued Care and Enhancement of Support Services Act (S. 3340) Discussed legislation that would amend title 38, United States Code, to require the Secretary of Veterans Affairs to consider the resources of individuals applying for pension that were recently disposed of by the individuals for less than fair market value when determining the eligibility of such individuals for such pension, and for other purposes (S. 3270). Supported legislation that would amend title 38, United States Code, to provide for coverage under the beneficiary travel program of the Department of Veterans Affairs of certain disabled veterans for travel for certain special disabilities rehabilitation, and for other purposes (S. 1755). Discussed the Veteran Voting Support Act of 2011 (S. 1264). Directs the VA Secretary to provide mail voter registration application forms to each veteran who: (1) seeks to enroll in VA health care system at the time of such enrollment; and (2) is already enrolled in such system when there is a change in the veteran's enrollment status or when there is a change in the veteran's address. Discussed with VA the long-term care benefits available to birth children of Korean and Vietnam conflict veterans who have spina bifida. Discussed the Consolidating Veteran Employment Services for Improved Performance Act of 2012 (H.R. 4072). This legislation would consolidate programs currently carried out by DOLs Veterans Employment and Training Service in VA. It would also consolidate the disabled veterans' outreach program specialists and local veterans' employment representatives into a single provision establishing veteran employment specialists, which shall perform both tasks. Supported the Military and Veterans Educational Reform Act (S. 2179). This legislation would make needed reforms to ensure that veterans and servicemembers receive the full benefit of their DOD and VA educational benefits. Supported the VOW to Hire Heroes Act of 2011 (H.R. 674/Pub. Law 112-56). This legislation includes provisions to increase employment opportunities for veterans and represents a blend of proposals that were included in H.R. 2433 and S. 951. Discussed the Veteran Voting Support Act of 2011 (S. 1264). This legislation would require VA to provide voter registration applications and assistance in absentee voting for certain veterans. Urged Congress and the Administration to address the treatment of our nations veterans by some for-profit educational institutions. This includes amending the 90/10 rule. Supported the Veterans Opportunity to Work Act (H.R. 2433). This legislation would help to ensure that veterans receive the training, transition, and placement assistance they need to allow them to gain meaningful employment opportunities. Supported the Helping Our Homeless Heroes Act (H.R. 2559). This legislation would make improvements to Department of Veterans Affairs (VA) programs that assist homeless veterans and their families. Supported the CAL Undiagnosed Diseases Research and Collaboration Network Act of 2011 (H.R. 2671). This legislation would help to track undiagnosed diseases and facilitate collaboration between physicians, researchers, and government agencies by creating a patient registry to be maintained by the National Institutes of Health. Supported the Veterans Dog Training Therapy Act (H.R. 198). This legislation would direct the VA Secretary to carry out a pilot program for assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of service dog training and handling for veterans with disabilities. Also discussed Senate companion bill (S. 1838). Supported H.R. 2074, as amended. The amended legislation includes H.R. 198 and H.R. 1154. Supported S. 914, as amended. The amended legislation includes S. 769, S. 411, and S. 957. Discussed the Hiring Heroes Act of 2011 (S. 951) and the need to ensure that there are platforms for the development of internship opportunities for wounded warriors with private employers. Supported the Helping our Homeless Veterans Act (S. 411/H.R. 1133). This legislation would allow changes to the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs Supported Housing (HUD-VASH) program to ensure that homeless veterans receive more effective case management services. Supported the Veterans Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011 (S. 957). This legislation would help to ensure that veterans with traumatic brain injuries receive the critical rehabilitation services needed to allow them to maximize their independence. Supported the Housing, Employment, and Living Programs (HELP) for Veterans Act of 2011 (H.R. 117). This legislation includes provisions that would not only reform the VAs Special Home Adaptation grant program to allow veterans who meet the nationally accepted standard of legal blindness to receive assistance with critical home modification, but also increase the amount of grant funding available for this program and the Specially Adapted Housing grant program. Supported the Andrew Connolly Veterans Housing Act (H.R. 1671). This legislation would extend until December 31, 2016, the authority of the VA Secretary to provide adaptive housing assistance under the Temporary Residence Adaptation grant program to veterans with disabilities who are temporarily residing with family members. Supported legislation establishing an Injured and Amputee Veterans Bill of Rights (H.R. 805). This legislation directs the VA Secretary to ensure that an Injured and Amputee Veterans Bill of Rights is printed on signage in accessible formats and displayed prominently and conspicuously in each VA prosthetics and orthotics clinic. It also requires VA employees who work at such clinics, as well as patient advocates of veterans who receive care there, to receive training on the Bill of Rights and directs the Secretary to conduct outreach to inform veterans about it. Supported the Veterans Equal Treatment for Service Dogs Act (VETS Dogs Act) (H.R. 1154/S. 769). The VETS Dogs Act states that the VA Secretary may not prohibit the use of service dogs in VA facilities or on VA property. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115/S. 490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged Congress to expand the extended caregivers program authorized by the Caregivers and Veterans Omnibus Health Services Act (P.L. 111-163) to include all veterans who are eligible for VA health care and meet certain needs-based criteria. Urged Congress to expand VA home and community-based services for veterans with disabilities. Urged Congress to increase Dependency and Indemnity Compensation benefits and to eliminate the offset of military Survivor Benefit Plan annuities. Urged Congress to provide appropriate oversight for and resources to address the VAs benefits claims processing backlog. Urged VA to accept the authority granted to them by states through the National Voter Registration Act of 1993 to serve as a voter registration agency.

United Spinal Association has been advocating to protect the civil rights of persons with disabilities and is opposed to various pieces of legislation including H.R. 4200, recently introduced by Rep. David Schweikert (R-5th AZ) which amends the Americans with Disabilities Act of 1990 to prohibit the U.S. Attorney General from administering or enforcing certain ADA accessibility regulations relating to pools at public accommodations or provided by public entities. We also oppose H.R. 4256, the Pool Safety and Accessibility for Everyone (Pool SAFE) Act, introduced by Rep. Rick Mulvaney (R-5th SC), directs the Attorney General to revise certain rules under Titles II and III of the ADA each requirements related to accessible means of entry to public pools. The counterpart bills in the Senate are S. 2191 and S.2186, both introduced by Sen. Jim DeMint (R-SC). United Spinal also submitted comments to the Department of Justice on its delay in implementing the final ADA pool accessibility regulations until May 21, 2012 in response to hotel owner complaints to the White House despite the fact that the intended rules were first announced in 2010. United Spinal expressed that the existing provisions for program accessibility (28 CFR 35.150) and readily achievable barrier removal (28 CFR 36.304) provide sufficient relief for entities that may not be able to immediately comply with the requirements to provide pool or spa access, especially when they more than one such facility as a property. We urged that the requirement be made effective immediately upon the close of the comment period on May 21, 2012. United Spinal opposes the following: H.R. 881, the ADA Notification Act of 2011, denies lawsuit in state or federal court for discrimination in public accommodations and certain private services unless the plaintiff notified defendant prior in writing, notice alleged specific facts, 90 days elapsed after notice, notified they had 90 days, notice states complaint has not been corrected. H.R. 3356 is the ACCESS (ADA Compliance for Customer Entry to Stores and Services) Act of 2011 and denies lawsuits based on inaccessibility in public buildings unless owner/operator is provided notice and they fail to provide description of improvements or plan on how barrier will be removed. H.R. 2032 prohibits any agency that receives funds from the government (such as DOJ) to consult with residents of DD facilities before filing lawsuits (i.e., on Olmstead violations). Residents can remove themselves from a lawsuit to remove the threat of being discharged from that facility. United Spinal helped to craft a Consortium for Citizens with Disabilities statement for the record following the hearing on the pool regulations issue held at the end of April, before the Committee on the Judiciarys Subcommittee on the Constitution entitled, Department of Justices Guidance on Access to Pools and Spas under the ADA. Also, United Spinal submitted our own statement for the record following the hearing stating that United Spinal Association strongly supports the principles of the ADA, enabling equal opportunities for individuals with disabilities in the areas of employment, public services, public transportation, public accommodations and communications. The law reflects hard-fought victories for civil rights and equality. We urge that the Department of Justice be permitted to move forward without further delay to make effective the requirements to provide access to polls, wading pools and spas on May 21, 2012. United Spinal also signed on to an Association of University Centers on Disabilities (AUCD) letter to the United States House of Representatives in opposing an amendment of Representative John Carter (R-31st TX) to the Commerce, Justice, and Science Appropriations Bill that would prevent the Justice Department from using its funds to enforce the ADA regulations to increase access for people with disabilities to swimming pools. Opposed the ADA Compliance for Customer Entry to Stores and Services (ACCESS) Act (H.R. 3356). Opposed legislation that would amend the Americans with Disabilities Act of 1990 to prohibit the Attorney General from administering or enforcing certain accessibility regulations relating to pools at public accommodations or provided by public entities (S. 2191). Opposed legislation that would amend the Americans with Disabilities Act of 1990 to prohibit the Attorney General from administering or enforcing certain accessibility regulations relating to pools at public accommodations or provided by public entities (S. 2186). Support ratification of the Convention on the Rights of Persons with Disabilities to advance the rights of people with disabilities throughout the world.

See next page Met with senior HHS officials, members and staff of the House and Senate to talk about the future of the Community Living Assistance and Supports Act (CLASS Act) insurance program, as well as implementation of other health reform act programs. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Joined with other CCD members to express comments to Institute of Medicine (IOM) task force charged with making recommendations on the "essential benefits" to be included in the standard package of benefits for insurance policies to be offered by the insurance exchanges under the Affordable Care Act. Co-hosted a congressional staff briefing on rehabilitation and habilitation as components of the "essential benefits." Urged members of Congress to support full funding for Social Security Administration to ensure continuing progress at reducing the growing backlog of disability determination hearings around the country. Testified before the House Committee on Veterans Affairs regarding the need to improve employment opportunities for veterans with significant disabilities. The written testimony covered issues relating to the Workforce Investment Act, Social Security, vocational rehabilitation, and attitudinal barriers to the employment of people with disabilities. Endorsed the importance of Social Security for veterans and their families through the booklet, Social Security: Serving Those Who Serve Our Nation. Opposed chained CPI for Social Security COLA formula reform in letters to Members of Congress.

See next page Met with senior HHS officials, members and staff of the House and Senate to talk about the future of the CLASS Act as well as health reform implementation. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged members of Congress to support full funding for Social Security Administration to ensure continuing progress at reducing the growing backlog of disability determination hearings around the country. Continued support of the Community Living Assistance and Supports Act (CLASS Act) to create a national insurance program financed by voluntary payroll deductions to provide services to assist people with activities of daily living in order to stay in their homes and communities if they become disabled. People would not be required to qualify for Medicaid or go into a nursing home or other institution in order to receive benefits. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Testified before the House Committee on Veterans Affairs regarding the need to improve employment opportunities for veterans with significant disabilities. The written testimony covered issues relating to the Workforce Investment Act, Social Security, vocational rehabilitation, and attitudinal barriers to the employment of people with disabilities. Endorsed the importance of Social Security for veterans and their families through the booklet, Social Security: Serving Those Who Serve Our Nation. Opposed chained CPI for Social Security COLA Formula

See next page Met with senior HHS officials to talk about the future of the CLASS Act as well as health reform implementation. Discussed the CHAMPVA Childrens Protection Act of 2011 (H.R. 115). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs [VA]). Urged members of Congress to support full funding for Social Security Administration to ensure continuing progress at reducing the growing backlog of disability determination hearings around the country. Signed on to testimony given before the Senate Committee on Appropriations, Subcommittee on Labor, Health and Human Services, Education, and Related Agencies from the Consortium for Citizens with Disabilities Social Security Task Force regarding the FY2011 and 2012 budgets for the Social Security Administration. Continued support of the Community Living Assistance and Supports Act (CLASS Act) to create a national insurance program financed by voluntary payroll deductions to provide services to assist people with activities of daily living in order to stay in their homes and communities if they become disabled. People would not be required to qualify for Medicaid or go into a nursing home or other institution in order to receive benefits.

Discussed the CHAMPVA Children's Protection Act of 2011 (HR 115/S.490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs (VA). Urged Congress to leave any needed Social Security reforms out of the deliberations of the Joint Select Committee on Deficit Reduction. Includes the submission of a letter and report to Congress and the Administration detailing the detrimental impact that adopting the chained CPI would have on veterans. Endorsed the importance of Social Security for veterans and their families through the booklet, "Social Secruity: Serving Those Who Serve Our Nation." Helped draft and endorse a letter to the Social Security Administration in opposition to interim final rules that would ban claimants from SSA offices for as much as three years for displaying disruptive behavior. Supported co-sponsorship of H.R. 3613 - Part D Beneficiary Appeals Fairness Act. This legislation allows beneficiaries an exceptions process that would allow specialty drugs to be moved to lower, more affordable and accessible categories for beneficiaries with high cost chronic conditions and disabilities. United Spinal signed onto a letter encouraging cosponsorship of H.R. 3613. Opposed H.R. 1173, Fiscal Responsibility and Retirement Security Act of 2011. This legislation repeals the Community Living Assistance Services and Supports (CLASS) program. Endorsed comments in response to proposed rule for Changes to the Medicare Prescription Drug Program (Part D) for Contract Year 2013. Comments expressed support for the rule's efforts to improve Part D beneficairy protections and remove poorly performing plans. Areas addressed in the rule are: coverage gap provisions, beneficiary protections, excluding poor performers, program efficiencies and program requirements. Participated in the development of Consortium for Citizens with Disabilities Principles for reforms in the Social Security disability benefit programs, including Supplemental Security Income (SSI) and disability coverage in the Old Age, Survivors and Disability Insurance (SSDI). Submitted principles to House Ways and Means Social Security Subcommittee hearing on the social security disability programs.

Discussed the CHAMPVA Children's Protection Act of 2011 (HR 115/S.490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs (VA). Urged Congress to leave any needed Social Security reforms out of the deliberations of the Joint Select Committee on Deficit Reduction. Includes the submission of a letter and report to Congress and the Administration detailing the detrimental impact that adopting the chained CPI would have on veterans. Endorsed the importance of Social Security for veterans and their families through the booklet, "Social Secruity: Serving Those Who Serve Our Nation." Helped draft and endorse a letter to the Social Security Administration in opposition to interim final rules that would ban claimants from SSA offices for as much as three years for displaying disruptive behavior. Supported co-sponsorship of H.R. 3613 - Part D Beneficiary Appeals Fairness Act. This legislation allows beneficiaries an exceptions process that would allow specialty drugs to be moved to lower, more affordable and accessible categories for beneficiaries with high cost chronic conditions and disabilities. United Spinal signed onto a letter encouraging cosponsorship of H.R. 3613. Opposed H.R. 1173, Fiscal Responsibility and Retirement Security Act of 2011. This legislation repeals the Community Living Assistance Services and Supports (CLASS) program. Endorsed comments in response to proposed rule for Changes to the Medicare Prescription Drug Program (Part D) for Contract Year 2013. Comments expressed support for the rule's efforts to improve Part D beneficairy protections and remove poorly performing plans. Areas addressed in the rule are: coverage gap provisions, beneficiary protections, excluding poor performers, program efficiencies and program requirements. Participated in the development of Consortium for Citizens with Disabilities Principles for reforms in the Social Security disability benefit programs, including Supplemental Security Income (SSI) and disability coverage in the Old Age, Survivors and Disability Insurance (SSDI). Submitted principles to House Ways and Means Social Security Subcommittee hearing on the social security disability programs.

See next page. Have continued to advocate against the repeal of the 2010 Affordable Care Act. Have met with Congressional staff and signed letters of support for the ACA and full enactment of its various provisions. Participated in discussion with DHHS of data development on health disparities and capturing information on people with disabilities as a disparity population criteria. Continued to reinforce with the DHHS Secretary and the Quality Measures Workgroup of the Health Information Technology Policy Committee better ways to address the health care needs of people with disabilities within the new clinical quality measures to be developed to leverage the evolving health IT infrastructure and decrease disability health disparities. Supported HR 1862 the National Regenerative Medicine Strategy legislation. Supported HR 2376 the Stem Cell Research Advancement Act. Participated in meetings of FDA-sponsored MDUFA III Stakeholders Group. Endorsed group letter to FDA Center for Devices and Radiological Health to comment on the Institute of Medicine (IOM) report on "Medical Devices and the Public Health" and recommend ways to strengthen the 510 (k) new device review process. Joined with 70 other organizations in a letter to the Senate HELP Committee urging reauthorization of the Lifespan Respite Care program. Participated in letters from the NDLA and CCD to the President urging implementation of the CLASS long-term services an supports insurance program. Participated in briefing with Centers for Disease Control and Prevention (CDC) officials on Year One progress the CDC Disability and Health Work Group. See Budget/Appropriation, Medicaid, and Medicare.

See following page. Have continued to advocate against the repeal of the 2010 Affordable Care Act. Have met with Congressional staff and signed letters of support for the ACA and full enactment of provisions included in it. Participated in HHS discussion of data development on health disparities. Recommended to the DHHS Secretary and the Quality Measures Workgroup of the Health Information Technology Policy Committee ways to address the health care needs of people with disabilities within the new clinical quality measures to be developed to leverage the evolving health IT infrastructure and decrease disability health disparities. Supported HR 1862 the National Regenerative Medicine Strategy legislation. Supported HR 2376 the Stem Cell Research Advancement Act.

See next page Participated in meetings with CMS concerning round one and the upcoming round two of the Medicare DME Competitive Bidding program. Worked on draft legislation that would create a separate category for complex rehabilitative technology under Medicare. Supported a House bill sponsored by Representatives Glenn Thompson and Jason Altmire to end the Medicare competitive bidding program for home medical equipment and services (HME) in view of its serious flaws and its impact on patients access to medically required home medical equipment and services. Participated with GAO in discussions on state interests in Medicaid managed care models. Supported Senate bill introduced by Senators Cardin and Collins to amend title XVIII of the Social Security Act to repeal the Medicare outpatient rehabilitation therapy caps. Supported a House bill introduced by Representatives Thornberry and Carnahan to in the House and amend title XVIII of the Social Security Act to permit coverage of certain covered part D drugs for uses that are determined to be for medically accepted indications based upon clinical evidence in peer reviewed medical literature Urged Congress to ensure stable Medicaid and CHIP coverage, per provisions in the Affordable Care Act, by requiring states to hold steady on Medicaid and CHIP eligibility until 2014 for adults and 2019 for children. To date, these stability protections have worked exactly as intended, preventing states from reducing Medicaid and CHIP eligibility and adding red-tape barriers to enrollment just when people need help the most. Discussed possible solutions for improving access to Medicaid for military families who have children with disabilities. Met with the White House staff and House and Senate staff to discuss the Maintenance of Effort (MOE) and proposed blended rate formula under Medicaid. Met with staff of the Joint Select Committee "Super Committee" members to talk about Medicaid and Medicare concerns. Signed on to three letters with other members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition. Two went to CMS concerning respectively the Summary of Benefits and Coverage procedures glossary and Round 2 of Medicare DMEPOS competitive bidding. The third letter went to Members of Congress in support of HR 1958, the Medicare Orthotics and Prosthetics Improvement Act of 2011. Joined on CCD letter to CMS Administrator to express serious concerns about pending payment cuts in California and other states to Medicaid providers serving individuals with disabilities. Wrote to members of the Joint Select Committee on Deficit Reduction on behalf of the National Disability Leadership Alliance (NDLA) to urge rejection of arbitrary, across-the-board cuts to Medicaid and transitioning the program's culture to emphasize lower cost home and community-based services and supports. Joined with others in the CCD in writing to the "Super Committee" emphasizing that changes to Medicaid, Medicare, Social Security, Supplemental Security Income and veterans' disability compensation and pension benefits must not result in service obstacles, benefit cuts or eligibility restrictions, whether directly or indirectly. Joined with others in Families USA coalition on two letters to the "Super Committee." One was focused on protecting the Affordable Care Act from deficit reduction cuts and other discussed the impacts of possible Medicaid cuts on beneficiaries, there families, providers and states. Joined with others in the MapRx coalition in writing to the Super Committee to protect the effective Medicare prescription drug benefit (Part D) from federal spending cuts to reduce the deficit. Served on Steering Committee to organize the "My Medicaid Rally" involving constituents from more than 90 patient/consumer organizations to speak out on Capitol Hill and with policymakers against reducing the deficit on the backs of Medicaid recipients.

See next page. Have continued to advocate against the repeal of the 2010 Affordable Care Act. Have met with Congressional staff and signed letters of support for the ACA and full enactment of its various provisions. Participated in discussion with DHHS of data development on health disparities and capturing information on people with disabilities as a disparity population criteria. Continued to reinforce with the DHHS Secretary and the Quality Measures Workgroup of the Health Information Technology Policy Committee better ways to address the health care needs of people with disabilities within the new clinical quality measures to be developed to leverage the evolving health IT infrastructure and decrease disability health disparities. Supported HR 1862 the National Regenerative Medicine Strategy legislation. Supported HR 2376 the Stem Cell Research Advancement Act. Participated in meetings of FDA-sponsored MDUFA III Stakeholders Group. Endorsed group letter to FDA Center for Devices and Radiological Health to comment on the Institute of Medicine (IOM) report on "Medical Devices and the Public Health" and recommend ways to strengthen the 510 (k) new device review process. Joined with 70 other organizations in a letter to the Senate HELP Committee urging reauthorization of the Lifespan Respite Care program. Participated in letters from the NDLA and CCD to the President urging implementation of the CLASS long-term services an supports insurance program. Participated in briefing with Centers for Disease Control and Prevention (CDC) officials on Year One progress the CDC Disability and Health Work Group. See Budget/Appropriation, Medicaid, and Medicare.

See following page. Have continued to advocate against the repeal of the 2010 Affordable Care Act. Have met with Congressional staff and signed letters of support for the ACA and full enactment of provisions included in it. Participated in HHS discussion of data development on health disparities. Recommended to the DHHS Secretary and the Quality Measures Workgroup of the Health Information Technology Policy Committee ways to address the health care needs of people with disabilities within the new clinical quality measures to be developed to leverage the evolving health IT infrastructure and decrease disability health disparities. Supported HR 1862 the National Regenerative Medicine Strategy legislation. Supported HR 2376 the Stem Cell Research Advancement Act.

Opposed the Regulatory Accountability Act (RAA) (H.R. 3010/S. 1606) and the Regulations from the Executive in Need of Scrutiny (REINS) Act of 2011 ( HR 10/S. 299). RAA adds years to an existing four to eight year rulemaking process with the addition of 60 new analytical requirements. The REINS Act requires Congressional approval of all major rules within 70 days. Both pieces of legislation slows the government's ability to take action on emerging public health threats and opportunities.

Participated in discussions regarding the staff discussion draft of the Workforce Investment Act reauthorization. Supported Fair Wages for Workers with Disabilities Act of 2011, (H.R. 3086). This legislation would phase out over three years the outmoded special wage certificates available under Section 14 c of the Fair Labor Standards Act of 1938 that allows sub-minimum wages to be paid to individuals with disabilities and encourages segregated work settings. Participated in the development of a letter to the U.S. House of Representatives on the issue of Workforce Investment Act (WIA) Reauthorization. Supported reappointment of Stuart Ishimaru to another five-year term at the Equal Employment Opportunity Commission.

Discussed the critical importance of entitlement programs to the United Spinal community and the potential impacts of deficit reduction actions. Discussed disability and health policy. Provided comments to HHS on the essential health benefits bulletin released by Department of Health and Human Services' CMS Center for Consumer Information and Insurance Oversight highlighting concerns with small business product coverage as well as habilitative and rehabilitiative services. Supported Lifespan Respite Care Reauthorization Act (HR 3266). This legislation, enacted in 2006, provides competitive grants to states to establish or enhance statewide Lifespan Respite systems that maximize existing resources and help ensure that quality respite is available and accessible to all family caregivers. Discussed Joint Select Committee on Deficit Reduction potential recommendations, concerns about Medicaid reductions and the potential impact on beneficiaries as well as the issue of unemployment among people with disabilities which is more than double the national average. Endorsed letter expressing concerns that any cuts to Medicare Part D prescription drug program would have significant negative impacts on beneficiary access, treatment affordability and health outcomes. Joined letter in support of greater clarification regarding the development of the Essential Health Benefits (EHB) package under the Affordable Care Act (ACA, P.L. 111-148). The letter stated that EHB must be comprehensive; the EHB package must adopt strong federal standards; the Secretary must define medical necessity; services covered as part of EHB must have a foundation in both evidence-based medicine and best practice standards; the Secretary should carefully balance considerations of affordability and comprehensiveness; the design of EHB must comply with nondiscrimination standards; the Secretary should develop consistent standards for the calculation of actuarial value; the Secretary must define a clear and transparent process for updating the services covered as EHB; and, the Secretary must develop a process for dealing with state mandates. Joined letter requesting that Department of Health and Human Services make publicly available the three largest national Federal Employee Health Benefits Program plan options by enrollment and, for each state, the three largest plans by enrollment in the small-group market, the three largest state employee health benefit plans by enrollment and the largest insured commercial non-Medicaid Health Maintenance Organization (HMO) operating in the state.

Discussed the CHAMPVA Children's Protection Act of 2011 (HR 115/S.490). This legislation increases from 23 to 26 the maximum age of eligibility for certain dependent children of veterans for medical care under CHAMPVA (the Civilian Health and Medical Program of the Department of Veterans Affairs (VA). Urged Congress to leave any needed Social Security reforms out of the deliberations of the Joint Select Committee on Deficit Reduction. Includes the submission of a letter and report to Congress and the Administration detailing the detrimental impact that adopting the chained CPI would have on veterans. Endorsed the importance of Social Security for veterans and their families through the booklet, "Social Secruity: Serving Those Who Serve Our Nation." Helped draft and endorse a letter to the Social Security Administration in opposition to interim final rules that would ban claimants from SSA offices for as much as three years for displaying disruptive behavior. Supported co-sponsorship of H.R. 3613 - Part D Beneficiary Appeals Fairness Act. This legislation allows beneficiaries an exceptions process that would allow specialty drugs to be moved to lower, more affordable and accessible categories for beneficiaries with high cost chronic conditions and disabilities. United Spinal signed onto a letter encouraging cosponsorship of H.R. 3613. Opposed H.R. 1173, Fiscal Responsibility and Retirement Security Act of 2011. This legislation repeals the Community Living Assistance Services and Supports (CLASS) program. Endorsed comments in response to proposed rule for Changes to the Medicare Prescription Drug Program (Part D) for Contract Year 2013. Comments expressed support for the rule's efforts to improve Part D beneficairy protections and remove poorly performing plans. Areas addressed in the rule are: coverage gap provisions, beneficiary protections, excluding poor performers, program efficiencies and program requirements. Participated in the development of Consortium for Citizens with Disabilities Principles for reforms in the Social Security disability benefit programs, including Supplemental Security Income (SSI) and disability coverage in the Old Age, Survivors and Disability Insurance (SSDI). Submitted principles to House Ways and Means Social Security Subcommittee hearing on the social security disability programs.

Participated in drafting and supporting the Achieving a Better Life Experience (ABLE) Act, H.R. 4323/S. 1872. This legislation establishes a new subsection (f), ABLE Account within Section 529 of the Internal Revenue Code and provides a tax-advantaged savings instrument available to individuals with disabilities and their families.

Community Living Assistance and Supports Act (CLASS Act) to create a national insurance program financed by voluntary payroll deductions to provide services to assist people with activities of daily living in order to stay in their homes and communities if they become disabled. People would not be required to qualify for Medicaid or go into a nursing home or other institution in order to receive benefits. In health care reform HR 3590. Advocated for health insurance parity for coverage of prosthetic and orthotics devices, components and benefits for other medical and surgical services: under ERISA and HR 2575 for group health plans and group health insurance Supported HR 1093 regarding fee caps to help make sure that attorneysand others representing Social Security disability claimants are paid in a timely manner and to index the allowed fees to the Cost of Living Adjustment. H.R. 2829, the Recidivism Reduction Act to expedite reinstatement of Social Security, SSI, and Medicaid benefits for eligible individuals after incarceration Supported HR 3325 to reauthorize through fiscal 2010 the Work Incentives Planning and Assistance program and the Protection and Advocacy for Beneficiaries of Social Security program, both of which provide employment-related services for people with disabilities. These provisions would have expired without reauthorization. Met with senior Senior SSA officials, as well as Senate and House staff regarding policies and possible legislation to expedite obtaining and review of medical records of disability claimants while protecting privacy rights of people with disabilities, electronic filing of disabilty applications and electronic authorizations for SSA to obtain medical records in connection with disabilities claims. Submitted comments (in response to an SSA request) on complicated medical evidence issues when Social Security disability applicants have a co-occurring alcohol or substance use diagnosis and a serious mental illness. Supported HR 4532 to renew SSAs demonstration authority and to make permanent a successful demonstration that enables both attorneys and non-attorneys (who meet certain qualifications) representing Social Security disability claimants to be paid reasonable fees out of retroactive benefits. This practice enables many claimants (including those with mental illnesses and conditions such as post-traumatic stress disorder) to have good representation rather than to navigate the esoteric and complex application process on their own (often to be denied for procedural rather than substantive reasons). Supported President's Budget proposal for SSA Limitation on Administrative expenses because the increased funding will help cut the backlog and delays in both the initial and hearing level disability determinations, thus providing disability benefits with less delay to people who meet SSA's strict eligibility requirements. Asked HHS to ensure that lifetime caps are prohibited as of September 2010. Health insurance companies are arguing that they can keep lifetime caps on health insurance for up to another year. Met with senior HHS officials to talk about the future of the CLASS Act as well as health reform implementation. Supported the Prosthetic and Custom Orthotic Parity Act of 2010 (HR 2575/S 3220). The legislation would ensure that there that insurance provide equal coverage for prosthetics and orthotics that it does for other medical treatment. Met with senior House and Senate Hill staff to strategize on obtaining sufficient appropriations for the Social Security Administration to reduce the backlog in disability determinations and otherwise better serve people with disabilities. Met with senior SSA officials regarding SSAs new proposal for work incentives under SSDI and other Title II disability Letter in support of S. 3223

Labor-HHS-Education and Related Agencies appropriations bill-- for additional administrative funding for the Social Security Admininstration in order to reduce the tragic backlogs in Social Security disability applications and for support of many social service programs in appropriations. (continued) As yet to be introduced legislation that may be in Budget/Appropriations or may be in another bill regarding possible terms of extending deadline for Amtrak obligation to make all stations accessible to people with disabilities past original deadline of July 26, 2010. Supported funding for new Vocational Rehabilitation and employment programs for people with disabilities including new competitive grant program to expand supported employment for youth with disabilities as they transition from school to the workforce, Projects with Industry, Supported Employment State Grant Program, Supported Employment Extended Services for Youth Grant Program, Workforce Innovation Fund, Model Transition Program for Students with Intellectual Disabilities into Higher Education, and Agribility. Supported inclusion of appropriate funding levels to support VA research programs in FY 2011 Military Consruction-VA Appropriations (House and Senate). Supported inclusion of funding in the Fiscal 2011 Defense Appropriation legislation (House and Senate) for conducting multiple sclerosis research under the Congressionally Directed Medical Research Programs of the Department of Defense. Supported the inclusion of $22 million for FY 2011 to fund programs authorized by the Traumatic Brain Injury Act Amendments of 2008 under the Department of Health and Human Services and $11 million for the National Institute on Disability and Rehabilitation Research TBI Model Systems administered by the Department of Education. Supported funding for new Agent Orange presumptive VA benefits claims as part of the Supplemental Appropriations Act of 2010 (H.R. 4899). Supported an effort for $10 million to be appropriated for Family to Family Health Information Centers for children with special health care needs. Supported the Able Act H.R. 1205 would provide individuals with disabilities and their families with a savings instrument for specified education, medical and community-based services, including housing, transportation, employment training, and supports for their child without disqualifying that child from receipt of funds from entitlement programs which are vital in ensuring their quality of life. Supported inclusion of funding in the Fiscal 2011 Defense Appropriation legislation (House and Senate) for conducting multiple sclerosis research under the Congressionally Directed Medical Research Programs of the Department of Defense. Supported inclusion of appropriate funding levels to support VA research programs in the Fiscal 2011 Military Construction-VA Appropriations (H.R. 5822). Supported the inclusion of $50 million in the FY 2012 budget to fund the Lifespan Respite Care Program. Supported funding for the Easter Seals Veterans Community Reintegration Project in a sign on letter to VA Secretary Eric Shinseki. Discussed the FY 2011 Military Construction and Veterans Affairs and Related Agencies Appropriations Act (H.R. 5822).

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Community Living Assistance and Supports Act (CLASS Act) to create a national insurance program financed by voluntary payroll deductions to provide services to assist people with activities of daily living in order to stay in their homes and communities if they become disabled. People would not be required to qualify for Medicaid or go into a nursing home or other institution in order to receive benefits. In health care reform HR 3590. Advocated for health insurance parity for coverage of prosthetic and orthotics devices, components and benefits for other medical and surgical services: under ERISA and HR 2575 for group health plans and group health insurance Supported HR 1093 regarding fee caps to help make sure that attorneysand others representing Social Security disability claimants are paid in a timely manner and to index the allowed fees to the Cost of Living Adjustment. H.R. 2829, the Recidivism Reduction Act to expedite reinstatement of Social Security, SSI, and Medicaid benefits for eligible individuals after incarceration Supported HR 3325 to reauthorize through fiscal 2010 the Work Incentives Planning and Assistance program and the Protection and Advocacy for Beneficiaries of Social Security program, both of which provide employment-related services for people with disabilities. These provisions would have expired without reauthorization. Met with senior Senior SSA officials, as well as Senate and House staff regarding policies and possible legislation to expedite obtaining and review of medical records of disability claimants while protecting privacy rights of people with disabilities, electronic filing of disabilty applications and electronic authorizations for SSA to obtain medical records in connection with disabilities claims. Submitted comments (in response to an SSA request) on complicated medical evidence issues when Social Security disability applicants have a co-occurring alcohol or substance use diagnosis and a serious mental illness. Supported HR 4532 to renew SSAs demonstration authority and to make permanent a successful demonstration that enables both attorneys and non-attorneys (who meet certain qualifications) representing Social Security disability claimants to be paid reasonable fees out of retroactive benefits. This practice enables many claimants (including those with mental illnesses and conditions such as post-traumatic stress disorder) to have good representation rather than to navigate the esoteric and complex application process on their own (often to be denied for procedural rather than substantive reasons). Supported President's Budget proposal for SSA Limitation on Administrative expenses because the increased funding will help cut the backlog and delays in both the initial and hearing level disability determinations, thus providing disability benefits with less delay to people who meet SSA's strict eligibility requirements. Asked HHS to ensure that lifetime caps are prohibited as of September 2010. Health insurance companies are arguing that they can keep lifetime caps on health insurance for up to another year. Met with senior HHS officials to talk about the future of the CLASS Act as well as health reform implementation. Supported the Prosthetic and Custom Orthotic Parity Act of 2010 (HR 2575/S 3220). The legislation would ensure that there that insurance provide equal coverage for prosthetics and orthotics that it does for other medical treatment. Met with senior House and Senate Hill staff to strategize on obtaining sufficient appropriations for the Social Security Administration to reduce the backlog in disability determinations and otherwise better serve people with disabilities. Met with senior SSA officials regarding SSAs new proposal for work incentives under SSDI and other Title II disability Letter in support of S. 3223

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Community Living Assistance and Supports Act (CLASS Act) to create a national insurance program financed by voluntary payroll deductions to provide services to assist people with activities of daily living in order to stay in their homes and communities if they become disabled. People would not be required to qualify for Medicaid or go into a nursing home or other institution in order to receive benefits. In health care reform HR 3590. Advocated for health insurance parity for coverage of prosthetic and orthotics devices, components and benefits for other medical and surgical services: under ERISA and HR 2575 for group health plans and group health insurance Supported HR 1093 regarding fee caps to help make sure that attorneysand others representing Social Security disability claimants are paid in a timely manner and to index the allowed fees to the Cost of Living Adjustment. H.R. 2829, the Recidivism Reduction Act to expedite reinstatement of Social Security, SSI, and Medicaid benefits for eligible individuals after incarceration Supported HR 3325 to reauthorize through fiscal 2010 the Work Incentives Planning and Assistance program and the Protection and Advocacy for Beneficiaries of Social Security program, both of which provide employment-related services for people with disabilities. These provisions would have expired without reauthorization. Met with senior Senior SSA officials, as well as Senate and House staff regarding policies and possible legislation to expedite obtaining and review of medical records of disability claimants while protecting privacy rights of people with disabilities, electronic filing of disabilty applications and electronic authorizations for SSA to obtain medical records in connection with disabilities claims. Submitted comments (in response to an SSA request) on complicated medical evidence issues when Social Security disability applicants have a co-occurring alcohol or substance use diagnosis and a serious mental illness. Supported HR 4532 to renew SSAs demonstration authority and to make permanent a successful demonstration that enables both attorneys and non-attorneys (who meet certain qualifications) representing Social Security disability claimants to be paid reasonable fees out of retroactive benefits. This practice enables many claimants (including those with mental illnesses and conditions such as post-traumatic stress disorder) to have good representation rather than to navigate the esoteric and complex application process on their own (often to be denied for procedural rather than substantive reasons). Supported President's Budget proposal for SSA Limitation on Administrative expenses because the increased funding will help cut the backlog and delays in both the initial and hearing level disability determinations, thus providing disability benefits with less delay to people who meet SSA's strict eligibility requirements. Asked HHS to ensure that lifetime caps are prohibited as of September 2010. Health insurance companies are arguing that they can keep lifetime caps on health insurance for up to another year. Met with senior HHS officials to talk about the future of the CLASS Act as well as health reform implementation. Supported the Prosthetic and Custom Orthotic Parity Act of 2010 (HR 2575/S 3220). The legislation would ensure that there that insurance provide equal coverage for prosthetics and orthotics that it does for other medical treatment. Met with senior House and Senate Hill staff to strategize on obtaining sufficient appropriations for the Social Security Administration to reduce the backlog in disability determinations and otherwise better serve people with disabilities. Met with senior SSA officials regarding SSAs new proposal for work incentives under SSDI and other Title II disability Letter in support of S. 3223

Community Living Assistance and Supports Act (CLASS Act) to create a national insurance program financed by voluntary payroll deductions to provide services to assist people with activities of daily living in order to stay in their homes and communities if they become disabled. People would not be required to qualify for Medicaid or go into a nursing home or other institution in order to receive benefits. In health care reform HR 3590. Advocated for health insurance parity for coverage of prosthetic and orthotics devices, components and benefits for other medical and surgical services: under ERISA and HR 2575 for group health plans and group health insurance Supported HR 1093 regarding fee caps to help make sure that attorneysand others representing Social Security disability claimants are paid in a timely manner and to index the allowed fees to the Cost of Living Adjustment. H.R. 2829, the Recidivism Reduction Act to expedite reinstatement of Social Security, SSI, and Medicaid benefits for eligible individuals after incarceration Supported HR 3325 to reauthorize through fiscal 2010 the Work Incentives Planning and Assistance program and the Protection and Advocacy for Beneficiaries of Social Security program, both of which provide employment-related services for people with disabilities. These provisions would have expired without reauthorization. Met with senior Senior SSA officials, as well as Senate and House staff regarding policies and possible legislation to expedite obtaining and review of medical records of disability claimants while protecting privacy rights of people with disabilities, electronic filing of disabilty applications and electronic authorizations for SSA to obtain medical records in connection with disabilities claims. Submitted comments (in response to an SSA request) on complicated medical evidence issues when Social Security disability applicants have a co-occurring alcohol or substance use diagnosis and a serious mental illness. Supported HR 4532 to renew SSAs demonstration authority and to make permanent a successful demonstration that enables both attorneys and non-attorneys (who meet certain qualifications) representing Social Security disability claimants to be paid reasonable fees out of retroactive benefits. This practice enables many claimants (including those with mental illnesses and conditions such as post-traumatic stress disorder) to have good representation rather than to navigate the esoteric and complex application process on their own (often to be denied for procedural rather than substantive reasons). Supported President's Budget proposal for SSA Limitation on Administrative expenses because the increased funding will help cut the backlog and delays in both the initial and hearing level disability determinations, thus providing disability benefits with less delay to people who meet SSA's strict eligibility requirements. Asked HHS to ensure that lifetime caps are prohibited as of September 2010. Health insurance companies are arguing that they can keep lifetime caps on health insurance for up to another year. Met with senior HHS officials to talk about the future of the CLASS Act as well as health reform implementation. Supported the Prosthetic and Custom Orthotic Parity Act of 2010 (HR 2575/S 3220). The legislation would ensure that there that insurance provide equal coverage for prosthetics and orthotics that it does for other medical treatment. Met with senior House and Senate Hill staff to strategize on obtaining sufficient appropriations for the Social Security Administration to reduce the backlog in disability determinations and otherwise better serve people with disabilities. Met with senior SSA officials regarding SSAs new proposal for work incentives under SSDI and other Title II disability Letter in support of S. 3223

Supported HR 4247 and S 2860 the Preventing Harmful Restraint and Seclusion in Schools Act. Testified at DOJ hearing on NPRM on guidlines for Americans with Disabilities Act.

Community Living Assistance and Supports Act (CLASS Act) to create a national insurance program financed by voluntary payroll deductions to provide services to assist people with activities of daily living in order to stay in their homes and communities if they become disabled. People would not be required to qualify for Medicaid or go into a nursing home or other institution in order to receive benefits. In health care reform HR 3590. Advocated for health insurance parity for coverage of prosthetic and orthotics devices, components and benefits for other medical and surgical services: under ERISA and HR 2575 for group health plans and group health insurance Supported HR 1093 regarding fee caps to help make sure that attorneysand others representing Social Security disability claimants are paid in a timely manner and to index the allowed fees to the Cost of Living Adjustment. H.R. 2829, the Recidivism Reduction Act to expedite reinstatement of Social Security, SSI, and Medicaid benefits for eligible individuals after incarceration Supported HR 3325 to reauthorize through fiscal 2010 the Work Incentives Planning and Assistance program and the Protection and Advocacy for Beneficiaries of Social Security program, both of which provide employment-related services for people with disabilities. These provisions would have expired without reauthorization. Met with senior Senior SSA officials, as well as Senate and House staff regarding policies and possible legislation to expedite obtaining and review of medical records of disability claimants while protecting privacy rights of people with disabilities, electronic filing of disabilty applications and electronic authorizations for SSA to obtain medical records in connection with disabilities claims. Submitted comments (in response to an SSA request) on complicated medical evidence issues when Social Security disability applicants have a co-occurring alcohol or substance use diagnosis and a serious mental illness. Supported HR 4532 to renew SSAs demonstration authority and to make permanent a successful demonstration that enables both attorneys and non-attorneys (who meet certain qualifications) representing Social Security disability claimants to be paid reasonable fees out of retroactive benefits. This practice enables many claimants (including those with mental illnesses and conditions such as post-traumatic stress disorder) to have good representation rather than to navigate the esoteric and complex application process on their own (often to be denied for procedural rather than substantive reasons). Supported President's Budget proposal for SSA Limitation on Administrative expenses because the increased funding will help cut the backlog and delays in both the initial and hearing level disability determinations, thus providing disability benefits with less delay to people who meet SSA's strict eligibility requirements. Asked HHS to ensure that lifetime caps are prohibited as of September 2010. Health insurance companies are arguing that they can keep lifetime caps on health insurance for up to another year. Met with senior HHS officials to talk about the future of the CLASS Act as well as health reform implementation. Supported the Prosthetic and Custom Orthotic Parity Act of 2010 (HR 2575/S 3220). The legislation would ensure that there that insurance provide equal coverage for prosthetics and orthotics that it does for other medical treatment. Met with senior House and Senate Hill staff to strategize on obtaining sufficient appropriations for the Social Security Administration to reduce the backlog in disability determinations and otherwise better serve people with disabilities. Met with senior SSA officials regarding SSAs new proposal for work incentives under SSDI and other Title II disability Letter in support of S. 3223

Labor-HHS-Education and Related Agencies appropriations bill-- for additional administrative funding for the Social Security Admininstration in order to reduce the tragic backlogs in Social Security disability applications and for support of many social service programs in appropriations. (continued) As yet to be introduced legislation that may be in Budget/Appropriations or may be in another bill regarding possible terms of extending deadline for Amtrak obligation to make all stations accessible to people with disabilities past original deadline of July 26, 2010. Supported funding for new Vocational Rehabilitation and employment programs for people with disabilities including new competitive grant program to expand supported employment for youth with disabilities as they transition from school to the workforce, Projects with Industry, Supported Employment State Grant Program, Supported Employment Extended Services for Youth Grant Program, Workforce Innovation Fund, Model Transition Program for Students with Intellectual Disabilities into Higher Education, and Agribility. Supported inclusion of appropriate funding levels to support VA research programs in FY 2011 Military Consruction-VA Appropriations (House and Senate). Supported inclusion of funding in the Fiscal 2011 Defense Appropriation legislation (House and Senate) for conducting multiple sclerosis research under the Congressionally Directed Medical Research Programs of the Department of Defense. Supported the inclusion of $22 million for FY 2011 to fund programs authorized by the Traumatic Brain Injury Act Amendments of 2008 under the Department of Health and Human Services and $11 million for the National Institute on Disability and Rehabilitation Research TBI Model Systems administered by the Department of Education. Supported funding for new Agent Orange presumptive VA benefits claims as part of the Supplemental Appropriations Act of 2010 (H.R. 4899). Supported an effort for $10 million to be appropriated for Family to Family Health Information Centers for children with special health care needs. Supported the Able Act H.R. 1205 would provide individuals with disabilities and their families with a savings instrument for specified education, medical and community-based services, including housing, transportation, employment training, and supports for their child without disqualifying that child from receipt of funds from entitlement programs which are vital in ensuring their quality of life. Supported inclusion of funding in the Fiscal 2011 Defense Appropriation legislation (House and Senate) for conducting multiple sclerosis research under the Congressionally Directed Medical Research Programs of the Department of Defense. Supported inclusion of appropriate funding levels to support VA research programs in the Fiscal 2011 Military Construction-VA Appropriations (H.R. 5822). Supported the inclusion of $50 million in the FY 2012 budget to fund the Lifespan Respite Care Program. Supported funding for the Easter Seals Veterans Community Reintegration Project in a sign on letter to VA Secretary Eric Shinseki. Discussed the FY 2011 Military Construction and Veterans Affairs and Related Agencies Appropriations Act (H.R. 5822).

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Supported HR 4247 and S 2860 the Preventing Harmful Restraint and Seclusion in Schools Act. Testified at DOJ hearing on NPRM on guidlines for Americans with Disabilities Act.

Community Living Assistance and Supports Act (CLASS Act) to create a national insurance program financed by voluntary payroll deductions to provide services to assist people with activities of daily living in order to stay in their homes and communities if they become disabled. People would not be required to qualify for Medicaid or go into a nursing home or other institution in order to receive benefits. In health care reform HR 3590. Advocated for health insurance parity for coverage of prosthetic and orthotics devices, components and benefits for other medical and surgical services: under ERISA and HR 2575 for group health plans and group health insurance Supported HR 1093 regarding fee caps to help make sure that attorneysand others representing Social Security disability claimants are paid in a timely manner and to index the allowed fees to the Cost of Living Adjustment. H.R. 2829, the Recidivism Reduction Act to expedite reinstatement of Social Security, SSI, and Medicaid benefits for eligible individuals after incarceration Supported HR 3325 to reauthorize through fiscal 2010 the Work Incentives Planning and Assistance program and the Protection and Advocacy for Beneficiaries of Social Security program, both of which provide employment-related services for people with disabilities. These provisions would have expired without reauthorization. Met with senior Senior SSA officials, as well as Senate and House staff regarding policies and possible legislation to expedite obtaining and review of medical records of disability claimants while protecting privacy rights of people with disabilities, electronic filing of disabilty applications and electronic authorizations for SSA to obtain medical records in connection with disabilities claims. Submitted comments (in response to an SSA request) on complicated medical evidence issues when Social Security disability applicants have a co-occurring alcohol or substance use diagnosis and a serious mental illness. Supported HR 4532 to renew SSAs demonstration authority and to make permanent a successful demonstration that enables both attorneys and non-attorneys (who meet certain qualifications) representing Social Security disability claimants to be paid reasonable fees out of retroactive benefits. This practice enables many claimants (including those with mental illnesses and conditions such as post-traumatic stress disorder) to have good representation rather than to navigate the esoteric and complex application process on their own (often to be denied for procedural rather than substantive reasons). Supported President's Budget proposal for SSA Limitation on Administrative expenses because the increased funding will help cut the backlog and delays in both the initial and hearing level disability determinations, thus providing disability benefits with less delay to people who meet SSA's strict eligibility requirements. Asked HHS to ensure that lifetime caps are prohibited as of September 2010. Health insurance companies are arguing that they can keep lifetime caps on health insurance for up to another year. Met with senior HHS officials to talk about the future of the CLASS Act as well as health reform implementation. Supported the Prosthetic and Custom Orthotic Parity Act of 2010 (HR 2575/S 3220). The legislation would ensure that there that insurance provide equal coverage for prosthetics and orthotics that it does for other medical treatment. Met with senior House and Senate Hill staff to strategize on obtaining sufficient appropriations for the Social Security Administration to reduce the backlog in disability determinations and otherwise better serve people with disabilities. Met with senior SSA officials regarding SSAs new proposal for work incentives under SSDI and other Title II disability Letter in support of S. 3223

Community Living Assistance and Supports Act (CLASS Act) to create a national insurance program financed by voluntary payroll deductions to provide services to assist people with activities of daily living in order to stay in their homes and communities if they become disabled. People would not be required to qualify for Medicaid or go into a nursing home or other institution in order to receive benefits. In health care reform HR 3590. Advocated for health insurance parity for coverage of prosthetic and orthotics devices, components and benefits for other medical and surgical services: under ERISA and HR 2575 for group health plans and group health insurance Supported HR 1093 regarding fee caps to help make sure that attorneysand others representing Social Security disability claimants are paid in a timely manner and to index the allowed fees to the Cost of Living Adjustment. H.R. 2829, the Recidivism Reduction Act to expedite reinstatement of Social Security, SSI, and Medicaid benefits for eligible individuals after incarceration Supported HR 3325 to reauthorize through fiscal 2010 the Work Incentives Planning and Assistance program and the Protection and Advocacy for Beneficiaries of Social Security program, both of which provide employment-related services for people with disabilities. These provisions would have expired without reauthorization. Met with senior Senior SSA officials, as well as Senate and House staff regarding policies and possible legislation to expedite obtaining and review of medical records of disability claimants while protecting privacy rights of people with disabilities, electronic filing of disabilty applications and electronic authorizations for SSA to obtain medical records in connection with disabilities claims. Submitted comments (in response to an SSA request) on complicated medical evidence issues when Social Security disability applicants have a co-occurring alcohol or substance use diagnosis and a serious mental illness. Supported HR 4532 to renew SSAs demonstration authority and to make permanent a successful demonstration that enables both attorneys and non-attorneys (who meet certain qualifications) representing Social Security disability claimants to be paid reasonable fees out of retroactive benefits. This practice enables many claimants (including those with mental illnesses and conditions such as post-traumatic stress disorder) to have good representation rather than to navigate the esoteric and complex application process on their own (often to be denied for procedural rather than substantive reasons). Supported President's Budget proposal for SSA Limitation on Administrative expenses because the increased funding will help cut the backlog and delays in both the initial and hearing level disability determinations, thus providing disability benefits with less delay to people who meet SSA's strict eligibility requirements. Asked HHS to ensure that lifetime caps are prohibited as of September 2010. Health insurance companies are arguing that they can keep lifetime caps on health insurance for up to another year. Met with senior HHS officials to talk about the future of the CLASS Act as well as health reform implementation. Supported the Prosthetic and Custom Orthotic Parity Act of 2010 (HR 2575/S 3220). The legislation would ensure that there that insurance provide equal coverage for prosthetics and orthotics that it does for other medical treatment. Met with senior House and Senate Hill staff to strategize on obtaining sufficient appropriations for the Social Security Administration to reduce the backlog in disability determinations and otherwise better serve people with disabilities. Met with senior SSA officials regarding SSAs new proposal for work incentives under SSDI and other Title II disability Letter in support of S. 3223

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Community Living Assistance and Supports Act (CLASS Act) to create a national insurance program financed by voluntary payroll deductions to provide services to assist people with activities of daily living in order to stay in their homes and communities if they become disabled. People would not be required to qualify for Medicaid or go into a nursing home or other institution in order to receive benefits. In health care reform HR 3590. Advocated for health insurance parity for coverage of prosthetic and orthotics devices, components and benefits for other medical and surgical services: under ERISA and HR 2575 for group health plans and group health insurance Supported HR 1093 regarding fee caps to help make sure that attorneysand others representing Social Security disability claimants are paid in a timely manner and to index the allowed fees to the Cost of Living Adjustment. H.R. 2829, the Recidivism Reduction Act to expedite reinstatement of Social Security, SSI, and Medicaid benefits for eligible individuals after incarceration Supported HR 3325 to reauthorize through fiscal 2010 the Work Incentives Planning and Assistance program and the Protection and Advocacy for Beneficiaries of Social Security program, both of which provide employment-related services for people with disabilities. These provisions would have expired without reauthorization. Met with senior Senior SSA officials, as well as Senate and House staff regarding policies and possible legislation to expedite obtaining and review of medical records of disability claimants while protecting privacy rights of people with disabilities, electronic filing of disabilty applications and electronic authorizations for SSA to obtain medical records in connection with disabilities claims. Submitted comments (in response to an SSA request) on complicated medical evidence issues when Social Security disability applicants have a co-occurring alcohol or substance use diagnosis and a serious mental illness. Supported HR 4532 to renew SSAs demonstration authority and to make permanent a successful demonstration that enables both attorneys and non-attorneys (who meet certain qualifications) representing Social Security disability claimants to be paid reasonable fees out of retroactive benefits. This practice enables many claimants (including those with mental illnesses and conditions such as post-traumatic stress disorder) to have good representation rather than to navigate the esoteric and complex application process on their own (often to be denied for procedural rather than substantive reasons). Supported President's Budget proposal for SSA Limitation on Administrative expenses because the increased funding will help cut the backlog and delays in both the initial and hearing level disability determinations, thus providing disability benefits with less delay to people who meet SSA's strict eligibility requirements. Asked HHS to ensure that lifetime caps are prohibited as of September 2010. Health insurance companies are arguing that they can keep lifetime caps on health insurance for up to another year. Met with senior HHS officials to talk about the future of the CLASS Act as well as health reform implementation. Supported the Prosthetic and Custom Orthotic Parity Act of 2010 (HR 2575/S 3220). The legislation would ensure that there that insurance provide equal coverage for prosthetics and orthotics that it does for other medical treatment. Met with senior House and Senate Hill staff to strategize on obtaining sufficient appropriations for the Social Security Administration to reduce the backlog in disability determinations and otherwise better serve people with disabilities. Met with senior SSA officials regarding SSAs new proposal for work incentives under SSDI and other Title II disability Letter in support of S. 3223

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.

Health care reform and issues in both health care reform and independent legislation. See following page. See also Medicare and Medicaid. Support implementation of comprehensive health care reform legislation (Patient Protection and Affordable Care Act, HR 3590 and Health Care & Education Reconciliation Act of 201, HR 4872) and the related goals of reducing costs, improving quality and expanding health care coverage for Americans with disabilities and chronic conditions and all Americans (including those who lack health insurance). Issues with asterisks * indicate legislation pursued both as part of health care reform and independently. Issues include: Provide for health coverage that adequately meets the needs of people with disabilities and chronic conditions including -- Covering durable medical equipment, prosthetics and orthotics (DMEPOS) including but not limited to power wheelchairs that meet the individual needs of people with disabilities and chronic conditions, enable them to be as independent as possible, to live in their homes and participate in their communities, and enable them to be employed without fear of losing health care/services and supports they need. This includes retaining the first month purchase option for people who have permanent or long-term need for power wheelchairs and including DMEPOS as covered in essential health insurance benefits; delaying CMS competitive bidding program; and having DMEPOS included as essential benefits in health insurance coverage. Providing insurance market reforms, such as those included in House and/or Senate bills, that could greatly improve the lives of people with disabilities and chronic conditions by allowing increased access to health care, such as: --Requiring health insurers to provide the same coverage, charge the same premiums and renew policies to people no matter what their disability or other pre-existing or newly acquired conditions. Currently, unless they have employer-sponsored plans, people with disabilities are often denied coverage altogether, the policies exclude needed services or the premiums are way too costly. --Prohibiting annual and lifetime caps on coverage. People with serious injuries or conditions often quickly exceed these caps due to lengthy hospital stays and/or extensive rehabilitation -- Requiring health insurance to cover rehabilitation and habilitative services. -- Providing for a temporary high risk pool through which people with disabilities and other pre-existing conditions may obtain health insurance pending full implementation of health insurance market reforms. Concerns about the proposed excise tax on medical devices -- that an excise tax on manufacturers would increase their costs which are likely to be passed on to consumers, resulting in increased costs for medical equipment for people with disabilities and chronic conditions who depend on them. Providing for prevention and wellness including --Developing standards for accessible medical equipment; --Authorizing funds to establish a Prevention and Public Health Investment Fund; --Providing for community Transformation Grants that include focus on the needs of people with disabilities; -- Including disability status within data collection on health disparities; -- Proving training programs for primary care providers and dentistry professionals on how to treat individuals with disabilities; Concerns about well-intended wellness provisions that reward people for meeting health standards set by employers and insurance companies with potentially serious unintended onsequences that people with disabilities or other chronic conditions will be unable to meet the health or participation standards because of a limitation, and consequently they would have to pay more for their health coverage, including but not limited to higher deductibles, than people without disabilities or chronic conditions. Providing for comparative effectiveness research and using the resulting information in a way that respects that what works for many people will not work for all; Providing for home and community-based services and supports for people with disabilities and chronic conditions such as Community Living Assistance and Supports (CLASS) provisions* and the Community First ChoiceOption in health care reform. Support increasing Medicaid elibility to a nationwide standard for those whose incomes are up to 133% of the Federal Poverty Level. Since many people with disabilities have low incomes, this would extend Medicaid coverage to many people with disabilities, including childless adults. - Support elimination of Medicare Part D coverage gap (Part D "donut hole") and immediate $250 rebate for beneficiaries who fall into donut hole in 2010. continued next page Note -- Asterisk * indicates issue pursued both independently and as part of health care reform. CLASS Act* -- S. 697/H.R. 1721 included in HR 3590 (Senate health care reform bill) and HR 3962 (House health care reform bill) . Support legislation to establish a voluntary payroll deduction insurance plan so that people with disabilities will be able to pay for assistance with activities of daily living. This would enable them to remain in their homes and off of the Medicaid program. CBO estimates that the CLASS provisions will save Medicaid $2.5 billion in the first 10 years alone. Community Choice Act* (S. 683/H.R. 1670). Support legislation to make services in the home and community the norm under Medicaid - enabling people to stay in their homes and remain part of their communities rather than having to go into nursing homes or other institutions to receive needed services. Became Community First Choice Option in health care reform bills. End Medicares 24-month waiting period* - S 700/HR 1708. Support legislation to end the waiting period for Medicare for people who qualify for Title II Social Security disability benefits and people with life-threatening conditions. Comparative Effectiveness Research HR 2502/S 1213* Support legislation to create non-government independent entities to study the comparative effectiveness of treatments in health care. Mental Illness Chronic Care Improvement (MICCI) Act, S 1136* Support legislation to facilitate access to needed medical services. Amend the Medicare Savings Programs and the Low Income Subsidy* to align, simplify and increase income eligibility, eliminate or substantially increase asset limits, stabilize the programs and make administrative simplifications. First month purchase option* Advocated to maintain the current ability for Medicare beneficiaries to purchase their power wheelchair in the first month of use. Both the House and Senate included language in health reform that would require a beneficiary to rent a power wheelchair for 13 months before purchase. Supported inclusion in HR 3590 and HR 3962 of provisions to exempt Class III and higher power wheel chairs from the rental period and to retain the first-month purchase option under existing law. Community First Choice Option* would allow states to create Medicaid plans that would reverse the institutional bias in Medicaid. The option would provide a 6% increase in FMAP matching funds to states. Supported H.R.2575 to provide parity under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and orthotics devices, components and benefits for other medical and surgical services. Met with senior HHS officials to talk about implementation of health reform. See also Medicare and Medicaid.