Government Relations November Update

BIAA Advocates for PCORI
This week, the Brain Injury Association of America (BIAA) participated in an advocacy day on Capitol Hill to support the Patient Centered Outcomes Research Institute (PCORI) with Partnership to Improve Patient Care (PIPC) and the Friends of PCORI. Congress established PCORI in 2010 to fund research that can help patients and those who care for them to make better-informed decisions about health care choices they make every day, guided by those who will use that information. PCORI has funded more than $1.6 billion in research and related projects, including research in traumatic brain injury. PCORI also provides funding to help more patients and stakeholders to become involved in the research process. Congress will reauthorize PCORI in 2019.

House Releases Details of Tax Bill
The House of Representatives released its "Tax Cuts and Jobs Act" yesterday, calling for changes in business and individual taxes, including changes in tax brackets and deductions. Among the changes to deductions, the bill would delete the long-standing deduction for people with high medical bills, including those with chronic conditions.

It is unknown yet what the cost would be should the bill pass. However, similar to legislation to repeal the Affordable Care Act (ACA), the tax cut bills considered by both the House and the Senate are likely to lead to large budget cuts to Medicaid, Medicare, and discretionary programs that support people with brain injury in order to pay for the lost revenue.

Lawmakers Introduce Health Care Legislation
On Nov. 1, Senate Finance Committee Chairman Orrin Hatch (R-Utah) and House Ways and Means Committee Chairman Kevin Brady (R-Tex.) announced the introduction of their legislation, the "Healthcare Market Certainty and Mandate Relief Act" (S. 2052/H.R.4200). In a press release, the lawmakers explained that "the legislation would pair concrete, structural Obamacare reforms with a temporary funding extension for the health law's cost-sharing reduction (CSR) program." The purpose is to address challenges and issues impacting the current health care system. The proposals are to provide relief from the employer mandates and the Health Savings Account expansion policies.

House Committee Passes VETS Act
The House Veterans Affairs Committee unanimously passed H.R. 2123, the Veterans E-Health and Telemedicine Support Act of 2017 (VETS) Act, yesterday. The bill gives the Department of Veterans Affairs (VA) authority to allow VA providers to practice telemedicine across state lines, regardless of whether the patient or provider is located on federal government property. BIAA is on record supporting the bill.

Einstein Health Networks’ Pride Program: Caring for LGBTQ+ Patients

Einstein Health Networks’ Pride Program: Caring for LGBTQ+ Patients

Libby Parker, MSS LSW

In 2015, Dr. Michele Style, resident physician and cofounder of Einstein Health Network’s Pride Clinic, treated a patient with advanced-stage cervical cancer. Though the patient had health insurance and lived within walking distance of the hospital, she avoided preventative care, including routine Pap smears. During her treatment, the patient disclosed that she identifies as a lesbian and was afraid she would be unfairly judged in a hospital setting because of her sexual orientation. She had avoided pursuing life-saving screenings that could have prevented the progress of her cancer. Unfortunately, her story reflects a much larger trend in healthcare access and outcomes for LGBTQ+ identified individuals.

According to national research, individuals who identify as LGBTQ+ are more likely to experience discrimination in healthcare settings. In a 2010 survey conducted by Lambda Legal, 70% of transgender respondents and almost 56% of lesbian, gay, and bisexual research participants reported experiencing at least one instance of discrimination while trying to access health services.1 In a similar analysis conducted by the National Center for Transgender Equality, in partnership with the National Gay and Lesbian Task Force, 19% of the trans-identified respondents described outright denial to health care because of their gender identity. The same survey found that 28% of respondents reported being harassed, while 2% experienced physical violence, during the course of seeking medical care2.

Avoiding healthcare settings because of concerns regarding safety, comfort, and acceptance has left a large swath of our population without adequate care. Indeed, Philadelphia estimated that 3.9% of its population3, more than 60,000 people, identify as LGBTQ+, yet competent services and resources for LGBTQ+ are limited. As a result, individuals who identify as LGBTQ+ are more likely to experience adverse health outcomes when compared to their cisgender4, straight peers.

When Einstein Healthcare Network launched its LGBTQ+ health initiative and established the Pride Program, its founders recognized that to provide quality care, staff training would be essential. Though most medical providers are well intended, they are seldom required to educate themselves on the unique experiences of their LGBTQ+ patients, leaving providers without adequate tools to offer the highest quality of compassionate care. The Pride Program has sought to ensure individuals working in LGBTQ+ health care have adequate language by which to communicate with their patients.

The Pride Program’s training introduces staff to four essential components of identity: (1) sex assigned at birth, (2) gender identity, (3) gender expression, and (4) sexual orientation.

  1. Sex assigned at birth refers to how an individual is categorized at birth, either as male, female, or intersex. It is important to remember that some people may change this later in life, which is why we say “sex assigned at birthrather than “sex.”
  2. Gender identity refers to one’s individual, internal experience of his or her gender. We must be told how another person identifies before we know what his or her gender is. One’s gender identity may vary over time and is not inherently visible to others, as opposed to gender expression.
  3. Gender expression is an external manifestation of gender communicated in a variety of ways, including by name, pronoun, clothing, haircut/style, voice, or body characteristics. Society often identifies these cues as masculine and feminine, although this may change over time and varies by culture.
  4. Sexual orientation, akin to gender identity, is an internal sense of physical, romantic, and/or emotional attraction to another person. Our sexual orientation is not necessarily visible to others, nor is it inherently static.

Though this language is particularly advantageous in working with LGBTQ+ identified individuals, it is important to recognize that all people were assigned a sex at birth, and we all have an internal gender identity and external gender expression in addition to our sexual orientation.

Understanding these four categories helps us better communicate with all our patients regarding essential components of their identity. While there is a great deal of nuanced language specific to these broader categories (including language that is understood to be offensive and should therefore be avoided5), the Pride Program’s training emphasizes the importance of self-determination. By respecting the self-determination of our patients, we recognize that it is our job to listen and remember the patient is always the expert. As care providers, it is up to us to mirror the language used by our patients and not inset our own assumptions into our interactions. We can take steps toward cultivating a more welcoming environment by using gender-neutral language and avoiding language, policies, and practices that exclude our LGBTQ+ identified patients.

If you are interested in learning more about how to best serve your LGBTQ+ identified patients, there are a plethora of trainings available to you, including those provided through the Pride Program. To learn more please contact our Program Coordinator, Libby Parker, MSS LSW, via e-mail at ParkerLi@Einstein.Edu This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 

Footnotes

1. From When Health Care Isn’t Caring: Lambda Legal’s Survey of Discrimination Against LGBT People and People with HIV (New York: Lambda Legal, 2010). Available at www.lambdalegal.org/health-care-report.

2. Injustice at Every Turn: A Report of the National Transgender Discrimination Survey, J.M. Grant, L.A. Mottet, J. Tanis, J. Harrison, J.L. Herman, and M. Keisling, 2011 (Washington, DC: National Center for Transgender Equality and National Gay and Lesbian Task Force), accessed February 4, 2011.

3. The Metro Areas With the Largest, and Smallest, Gay Populations, David Leonhardt, Claire Cain Miller, March 20, 2015, The New York Times, accessed June 1, 2017.

4. Cisgender describes a gender identity in which a person almost always, if not exclusively, identifies as their sex assigned at birth.

5. If you are interested in learning more about terms to avoid, you utilize a variety of resources available online including GLAAD’s publication, ‘An Ally’s Guide to Language’, Available at: https://www.glaad.org/publications/talkingabout/terminology

Announcement from Jordan Wildermuth

GPC Government Relations/Health Policy Advocacy

On June 27, The Coalition to Preserve Rehabilitation (CPR)/Habilitation and Rehabilitation Coalition (HAB)/Independence Through Enhancement of Medicare and Medicaid Coalition (ITEM) will be holding a joint Hill Day to highlight the importance of rehabilitation and habilitation benefits, services, and devices. The Hill Day will include a Congressional briefing, along with accompanying visits to Senate offices to emphasize the importance of habilitation and rehabilitation, especially in the context of essential health benefits (EHBs) and health reform. The schedule is as follows:

·         Hill Visits TBD (may be scheduled prior to or after the congressional briefing)

·         Congressional Briefing-11:30 AM to 2:00 PM in SD-106, Dirksen Building

Given your proximity to Washington, D.C. we invite you to participate on behalf of ARN.

There will be an informational webinar on Wednesday, May 31, 3 p.m. ET to be sure you know the issues related to health care reform before the Fly-in presented. The presentation will be by Peter W. Thomas, Principal, The Powers Firm. Registration for the webinar is free and available here.

If you are interested in attending the Fly-In or have questions please let me know.

Jordan

 Jordan Wildermuth, MSW Manager, Health Policy & Advocacy

jwildermuth@connect2amc.com

2017 Education Conference: Pictures!

Thanks to all who attended the 2017 Educational Conference: REACH OUT: Caring for Self and Others held at Lankenau Hospital. We hope you found the program engaging inspiring. Thank you to all the speakers who shared their time and expertise with us.

Members participating in the quarterly chapter meeting.

Members participating in the quarterly chapter meeting.

Wendy Wintersgill's Day on the Hill March 16, 2017

Wendy Wintersgill,RN,MSN,CRRN ACNS-BC had a record day on the Hill on March 16.  Representative Smucker (Pa) spent more than 30 minutes with Wendy discussing the Brain Injury Awareness issues and the ARN Health policy agenda. Wendy also had an appointment with Senator Van Hollen's health advisory staffer. Senator Von Hollin is Wendy’s state (Maryland) senator. Great job Wendy.

Overall representative the GPC ARN visited 7 U.S. Congressmen over a 5-day period.

Wendy Wintersgill, RN, MSN, CRRN, ACNS-BC with Rep.Lloyd Smucker ( Pa. D)

Wendy Wintersgill, RN, MSN, CRRN, ACNS-BC with Rep.Lloyd Smucker ( Pa. D)

GPC Goes to Washington for Brain Injury Awareness Day March 22, 2017

Great day in Washington, DC. Kristine Longo, Sharon Murphy Potts, Robin Sheeran, Karyn Kling and myself traveled to Washington, DC. for 2017 Brain Injury Awareness day. While we were on the Hill, we met with the Health policy/Legislative aides (LA) for Reps Meehan, Boyle, Fitzpatrick, Sen. Toomey and Sen Casey. In the meetings we reviewed our (GPC ARN) Legislative agenda. At each meeting we provided and reviewed our Legislative agendas for Brain Injury care and Advocacy. Our resource packets included briefs on; Support for FY 2018 Funding Traumatic Brain Injury Act, Rehabilitation Research and Education at NINR, Preserving Access to Quality Rehabilitation Services, Support Chronic Care Reform, Registered Nurse in the Nursing Home and Appropriate Quality Measures and Outcomes across the Post- Acute Care Continuum. There is a link to the briefs on Government Relations Committee of GPC ARN website.

GPC Members L-R   Elaine Flynn, Kristine Longo, Robin Sheeran, Rep Pascrell, Sharon Murphy- Potts, Karyn Kling

GPC Members L-R   Elaine Flynn, Kristine Longo, Robin Sheeran, Rep Pascrell, Sharon Murphy- Potts, Karyn Kling

We attended the Brain Injury Awareness day. 2017 Brain Injury Awareness day is the work of members of the Congressional Brain Injury Task Force, which is co-chaired by Rep. Bill Pascrell, Jr., D-N.J., and Rep. Tom Rooney, R-Florida. The theme of events and activities this year is Faces of Brain Injury: The Invisible Disability Affecting Children and Adults. The purpose of the Brain Injury Awareness day is to update the public about brain injury prevention, product, services and research for those with brain injuries and their families. An additional goal of the program is as an outreach from the brain injury community to help de-stigmatize the brain injury, empower those who have survived, and promote the support prevention and research.

There was a 75-minute education program “Faces of Brain Injury: The Invisible Disability Affecting Children and Adults,” hosted by Representative Pascrell.  The presentations were brief overviews of brain injury research and stories of survival. There were 4 speakers that included Olivia Long a 18-year-old from New Jersey who discussed her journey of traumatic brain injury survival. She will graduate from high school in June and start college at a local community college in September. She was so brave and had a very powerful story of resilience. The program also included representatives from the CDC/ Active Military, Veteran Affairs and the Department of Defense presented briefs about programs and research that reduce the risk of traumatic brain injury. TBI statistics were reviewed from the 3/17/17 MMWR report shows that 3.5 million adults and children suffer an acquired brain injury every year – this excludes brain injuries that are not hereditary, congenital, degenerative, or induced by birth trauma. TBIs affect at least 2.5 million children and adults annually in this country, with 280,000 TBI hospitalizations and 50,000 TBI deaths recorded annually. This report describes the estimated incidence of TBI-related emergency department (ED) visits, hospitalizations, and deaths during 2013 and makes comparisons to similar estimates from 2007. The highest rates of TBI-related ED visits, hospitalizations, and deaths were observed among persons aged ≥75 years; this suggests an urgent need to enhance fall-prevention efforts in that population.

The CDC representative discussed a pilot Concussion Surveillance project starting in May 2017. This project will look at the burden of TBI and lifetime prevalence. Also discussed was a plan to develop Clinical Practice Guidelines for diagnosis and treatment of TBI in pediatric population based on research.  Also overview of a community Senior’s Falls Prevention program “STEADI’ being used in Oregon. CDC also introduced “Rocket Blades”, the CDC’s Injury Center first-ever mobile game app on concussion safety for children aged 6 to 8. Through a futuristic world of galactic racing adventures children can learn the benefits of playing it safe and smart. Making this a fun way for kids to learn Brain Injury Prevention. We gleaned so much information about how our funds from NINR and CDC research grants are improving the science of brain injury prevention and care.

Flag Flying Above the Capital Building March 22, 2017 Brain Injury Awareness Day

Flag Flying Above the Capital Building March 22, 2017 Brain Injury Awareness Day

After the briefing was a reception hosted by Representative Pascrell to honor the Congressional Brain Injury Task Force and to celebrate brain injury awareness month. The reception was attended by TBI providers, survivors and supporters sha ring their stories of hope.  It was a great day.

Thank you Jordan Wildermuth, ARN Manager Health Policy & Advocacy for helping us prepare for the day.

Written by Elaine Flynn, Chair, Government Relations Committee

Sharon Murphy-Potts Remed, Elaine Flynn MossRehab, Karyn Kling MossRehab and Kristine Longo Bryn Mawr Rehabilation

Sharon Murphy-Potts Remed, Elaine Flynn MossRehab, Karyn Kling MossRehab and Kristine Longo Bryn Mawr Rehabilation

Elaine Flynn Karyn Kling from MossRehab with Christopher Friese Health Policy Fellow for Sen. Robert Casey.

Elaine Flynn Karyn Kling from MossRehab with Christopher Friese Health Policy Fellow for Sen. Robert Casey.

Jordan Wildermuth, ARN Manager Health Policy & Advocacy, Sharon Murphy-Potts ReMed, Karyn Kling MossRehab and Kristine Longo Bryn Mawr Rehabilitation

Jordan Wildermuth, ARN Manager Health Policy & Advocacy, Sharon Murphy-Potts ReMed, Karyn Kling MossRehab and Kristine Longo Bryn Mawr Rehabilitation

Karyn Kling and Elaine Flynn, MossRehab outside Sen Toomey office.

Karyn Kling and Elaine Flynn, MossRehab outside Sen Toomey office.

News from BIPA

News from BIPA

Brain Injury Awareness Resolution
Representatives Thomas Murt and Tim Briggs will be sponsoring a resolution in the Pennsylvania House of Representatives designating March as Brain Injury Awareness Month. Getting support from as many Representatives as possible to co-sponsor the resolution is of great importance. You can help by reaching out to your Representative and asking him or her to support the resolution by signing on as a co-sponsor. You can find your representative and contact information by clicking here for a link to the Pennsylvania House of Representatives webpage. Scroll down the left side of the webpage and lick on "Find My Representative."

2017 Brain Injury Awareness Day

The Government Relation committee of GPC ARN is looking for members of GPC chapter who are interested in participating in the 2017 Brain Injury Awareness Day as part of our advocacy role as rehab nurses.

We are going to Washington DC for Brain Injury Awareness Day on Wednesday, March 22, 2017. The Brain Injury Awareness event is hosted by the Congressional Brain Injury Task Force. While we are in Washington we scheduled meetings with 4 Pennsylvania Congressmen to have discuss key healthcare policy issues and advocacy.

If you are interested, please complete the following actions:

1. Email me your name, email address and cell number to erflynn@einstein.edu by January 16th, 2017 that you are interested in participating in the event.

2. Plan to participate in a 45 minutes Government Relations committee conference call on January 18, 2017 5-5:45pm. The conference call in number and agenda will be emailed to you by January 17th.

President Obama Signs 21st Century Cures Act (H.R. 34)

On Tuesday, President Obama signed the 21st Century Cures Act (H.R. 34). In his remarks, President Obama recognized funding for biomedical research being conducted by the BRAIN Initiative which could lead to better treatment and outcomes for individuals with traumatic brain injury (TBI), Alzheimer's Disease, and other conditions. The Cures Act will provide $1.511 billion over 10 years for the National Institutes of Health's (NIH) role in the BRAIN Initiative. The Cures Act invests in a wide range of health priorities, including $1 billion in funding to address the opioid epidemic.

Brain Injury Awareness Day on Capital Hill 2017

The Congressional Brain Injury Task Force has announced that Brain Injury Awareness Day will be held on Wednesday, March 22, 2017, in Washington, D.C. The fair will be held in the Rayburn House Office Building Foyer and the briefing and reception will be held in the Gold Room (Rayburn 2168).

The Greater Philadelphia chapter ARN Government Relations committee will be planning a trip to the Hill that day. Please look for more details as the GRC plans our trip to Washington.

House Passes 21st Century Cures Bill

This week, the House passed the 21st Century Cures Act, H.R. 34, which provides funding for the National Institutes of Health (NIH) to conduct health research and for the Food and Drug Administration (FDA) to speed up the approval process for drugs used in regenerative medicine. The bill includes $1.6 billion over 10 years for NIH's role in the BRAIN Initiative, which is $53 million less than what was originally included. The intention is that this funding would be in addition to the BRAIN Initiative funding provided by the annual appropriations bill. The bill establishes the Precision Medicine Initiative to help researchers develop medicines tailored to individuals, rather than one-size-fits-all treatments. The bill also authorizes grants for suicide prevention and $1 billion to address the opioid epidemic.

Mental health provisions supported by Rep. Tim Murphy (R-Pa.) were included to reorganize and improve accountability for government mental health programs. The bill establishes a new assistant secretary for mental health in the Department of Health and Human Services (HHS), as well as a chief medical officer. The bill generally requires states to use at least 10 percent of their mental health block grants on early intervention for psychosis, using a model called coordinated specialty care, which provides a team of specialists to provide psychotherapy, medication, education, and support for patients' families, as well as services to help young people stay in school or keep their jobs. Rep. Murphy is a psychologist who treats patients with PTSD and TBI at the Walter Reed National Military Medical Center in Bethesda, Maryland. The Senate is expected to take the bill up before adjourning this session.

Veterans Mobility Safety Act of 2016
On Nov. 17, the Senate unanimously passed the Veterans Mobility Safety Act of 2016, introduced by Sens. Jerry Moran (R-Kans.) and Chuck Schumer (D-N.Y.), to assist veterans with disabilities in purchasing automobiles and adaptive equipment that accommodates their disabilities. The bill also authorizes the Department of Veterans Affairs to hire audiologists, ENTs, hearing aid specialists, and other stakeholder and industry groups to expand resources for veterans with hearing-related disabilities.

Congressional Leadership Changes
On Wednesday, House Democrats re-elected Nancy Pelosi to continue as the House Minority Leader in the upcoming Congress. Also elected this week was Rep. Greg Walden (R-Ore.) to chair the House Energy and Commerce Committee, replacing Rep. Fred Upton (R-Mich.), who has termed out of the position. Health care legislation, including TBI legislation, comes before this committee. California Gov. Jerry Brown announced his appointment of House Democratic Caucus Chairman Xavier Becerra to succeed newly-elected Sen. Kamala Harris as the California's attorney general. Rep. Becerra's position as representative will be open until a successor is named.

 

 

Show the Power of the Nurses' Vote November 8, 2016

Life can be as unpredictable as this election year. But voting can be the easiest thing in the world in you've got a plan.

It's never been more convenient to fit voting into your schedule. Maybe you have time between shifts, or you're planning to take advantage of earlier voting in your state. Election Day is fast approaching. Whatever you need to do, its time to make sure voting is on your calendar.

Please use this resources you need to show the power of nurses this Election Day. If you need help with voting information, please contact us.

Click here for more information!

Thank you for making a plan to get out and vote!

Elaine Flynn and Betsy Schmidt, members of the Government Relations Committee

Up to THREE ARN NIWI Scholarships Available in 2017

Have you ever wanted to learn more about public policy or advocate for rehabilitation nurses on Capitol Hill?

The Nurses in Washington Internship (NIWI) provides nurses with the opportunity to learn how to influence health care through legislative and regulatory processes. The dates for 2017 are March 12-14th.

Participants:

  • learn from health policy and government officials
  • network with other nurses
  • visit members of congress

Applications for ARN NIWI scholarships are now available. To learn more and apply, go to the ARN Website. The deadline for applications is January 9, 2017.

Learn more about NIWI 2017 here.


Interested in getting involved immediately?

Advocate for Rehabilitation Nursing

Take action by asking your member of congress to contact CMS and urge them to require a nurse in the nursing home 24 hours a day, seven days a week. Visit ARN's Legislative Action Center here.

CRRN Review Course 11/3 and 11/4

What: Rehabilitation Nursing Certification Review Course

When:  Thursday and Friday November 3 and 4th, 2016

Where: MossRehab, Einstein Elkins Park Healthcare Network

60 East Township Line Road

Elkins Park, PA 19027

 

THURSDAY, NOVEMBER 3, 2016

7:30 AM Registration/Continental Breakfast

8:00 AM General Rehab Principles

11:00 AM Rehab Team/Community Reentry

12:00 PM Lunch

12:30 PM Economic & Health Policy Issues

1:30 PM Rehab Nursing Principles/Ethics

2:30 PM Break

2:45 PM CVA

4:15 pm Day 1 Evaluations

 

FRIDAY, NOVEMBER 4, 2016

7:30 AM Registration/Continental Breakfast

8:00 AM Traumatic Brain Injury

10:00 AM Break

10:15 AM Pediatric Rehabilitation

11:15 AM Lunch

12:15 PM Spinal Cord Injury

2:15 PM Break

2:30 PM Sexuality

3:45 pm Day 2 Evaluations and CEU Distribution

4:30 Day 2 Evaluations & CEU Distribution

 

REGISTRATION

Name: _______________________________

Phone: (H) ____________ (C) ____________

E-Mail Address: ________________________

Home Address: ________________________

Facility: ______________________________

Tuition fee: Two day course: $300.00

One Day Fee: $150.00

A 10% discount is offered to three or more registrants from the same organization.

Indicate days of attendance:

Thursday ________ Friday ________

Both Days _______

Enclosed is a check or money order in the amount of $_________.

Please make all checks payable to MossRehab

 

Mail to: Denise Bowers

MossRehab

Staff Development Office, Room 200

Einstein Healthcare Network

60 Township Line Rd

Elkins Park, PA 19027

 

Contact: Carol Grossman

E-Mail: grossmanc@einstein.edu

Registration Deadline: November 1, 2016