Appropriations Update

Last week, the House passed an omnibus continuing appropriations bill to fund most government programs - including TBI and trauma-related programs – at Fiscal 2008 (last year's) levels until March 6, 2009. Over the weekend, the Senate also passed this omnibus legislative package and forwarded it to President Bush, who signed it into law just hours before the beginning of the new fiscal year on October 1.

This massive year-end spending package includes a Continuing Resolution (CR) which funds programs covered by nine unfinished appropriations bills (including the Fiscal 2009 Labor-HHS-Education Appropriations bill, which contains funding for key federal TBI programs) at Fiscal 2008 levels until enactment of the bills or March 6, 2009 – whichever comes first. This essentially leaves final funding decisions on domestic programs to the next Congress and president.

Within this CR, all civilian health programs, including TBI and trauma-related programs, are funded at Fiscal 2008 levels. These Fiscal 2008 levels, and thus continuing funding levels through the beginning of next year, are as follows:

CDC TBI Programs (HHS): $5.709 million

HRSA TBI Programs (HHS) (HRSA TBI State Grant Program and Protection and Advocacy Systems): $8.754 million

TBI Model Systems of Care (NIDRR/Department of Education): $8.155 million

In addition to the CR to provide continuing appropriations for most federal programs, the omnibus bill also includes three Fiscal 2009 appropriations bills in their entirety. These three appropriations bills are those that fund Defense, Homeland Security and Military Construction-VA for all of FY 2009.

The Defense appropriations measure included in this legislative package contains $300 million in funding for Traumatic Brain Injury and Psychological Health initiatives within the Department of Defense.

The Military Construction-VA appropriations measure includes $41 billion in funding for the Veterans Health Administration (veterans medical care), representing $1.8 billion above the President's budget request earlier this year and $4.1 billion above 2008 levels. This funding bill also provides $510 million in funding for Medical and Prosthetic Research, including cutting edge research into areas such as Post Traumatic Stress Disorder (PTSD), Traumatic Brain Injury, suicide prevention, and polytrauma. This funding level for research represents $30 million above 2008 levels, and rejects a $38 million cut proposed by President Bush.

The Military Construction-VA appropriations bill contained in this omnibus legislative package also included important report language (strongly supported by BIAA) urging the Department of Veterans Affairs to increase returning servicemembers' access to TBI care and expertise in the civilian sector. Specifically, the Explanatory Statement accompanying this bill states:

"The Appropriations Committees strongly urge the Department to establish and expand cooperative agreements with public and private entities with neurobehavioral rehabilitation and recovery experience in the treatment of Traumatic Brain Injury (TBI) as recommended in section 1703 of Public Law 110-181" [FY 2008 National Defense Authorization Act].”

In addition, the bill provides $200 million for fee-based services intended to allow the VA to tap expertise in the public and private sector for health care that may not be readily available within VA medical centers.


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