FEBRUARY 2013

Is Telemedicine Coming to Your State?

Several state legislatures are considering bills that would provide for or expand access to telemedicine services. These services can help save lives and reduce the impact of stroke, and you can help expand their reach or make them available in your state!

Telemedicine services allow healthcare professionals to care for patients at locations other than where the professional works. For example, it would allow medical staff at a primary stroke center (where the staff is specially trained to care for stroke patients) to help care for patients in other hospitals whose staff don’t have similar training. This is done using various tools, including video conferencing, technology that enables remote patient monitoring and using mobile devices or other technology to allow off-site viewing of health images. Telemedicine gives more people access to these services. Because every minute counts when someone is having a stroke, it can mean more stroke patients will be given the possibility of survival and the impact of stroke can be reduced for those survivors.

Are your state legislators talking about telemedicine? Legislators from the following states are debating bills to provide for or expand access to telemedicine services: Arizona, Connecticut, Florida, Illinois, Indiana, Maryland, Mississippi, Missouri, Montana, Nebraska, New Mexico, New York, Oklahoma, Pennsylvania, South Carolina, Tennessee and Vermont. The District of Columbia Council is also considering a telemedicine measure. If you live in one of these states, you can tell your legislators to support the stroke community by supporting telemedicine services. It only takes a minute to make a difference for stroke patients and survivors across your state!

What Are Your Legislators Doing About Stroke?

Last month, we launched the State Advocacy Action Center, which holds information about stroke-related legislation being debated in state capitals across the nation. Since that time, state legislators have been busy, introducing more than 70 bills related to stroke and major stroke risk factors. What stroke-related issues are your legislators talking about? If you live in any of the states listed below, we’ve provided you with an easy way to send a message to your legislators about the issue being considered in your state. Take action today (by following the link for your state) and help make a difference for stroke patients and survivors.

• In Indiana a bill has been introduced that would create a statewide network of services for people with acquired and other brain injuries. Because stroke is considered an acquired brain injury, these services would be available to stroke survivors. This new office would help survivors recover to their fullest potential, continue rehabilitation for as long as needed and re-establish independence, and provide services to accomplish these goals. Many stroke survivors don’t have access to enough therapy and other services to recover to their fullest potential. Thus, this legislation would close that critical gap in services.
• The state legislatures in Wyoming and Hawaii are debating bills concerning response to and treatment of stroke patients in their state. These bills would establish or improve a statewide stroke system of care, which is designed to decrease the time it takes to diagnose a stroke patient and transport him or her to an appropriate treatment facility. Since every minute counts when someone is having a stroke, these improvements can give stroke patients a better chance at survival and recovery.
• Several states are considering legislation that would provide for or expand access to telemedicine services. These services allow healthcare professionals specially trained in stroke care to help treat patients in other locations where the medical staff don’t have similar training. The following state legislators are considering telemedicine legislation: Arizona, Connecticut, Florida, Illinois, Indiana, Maryland, Mississippi, Missouri, Montana, Nebraska, New Mexico, New York, Oklahoma, Pennsylvania, South Carolina, Tennessee and Vermont. The District of Columbia Council is also considering a telemedicine measure.

The State Advocacy Action Center changes every day. Keep up with what’s happening in your state and how you can help make positive change for the stroke community in your state!

Congressional Budget Battles Could Impact NIH Funding

Between now and the end of March, lawmakers are making important decisions about the future of funding for the National Institutes of Health (NIH), which includes the National Institute of Neurological Disorders and Stroke (NINDS). Why is this important to the stroke community? NINDS is responsible for many important breakthroughs in stroke diagnosis, treatment and recovery. Make sure your lawmakers hear how vital this research is by taking action today.

By taking this action, you can help preserve NIH and NINDS funding for the next two years, not just one. That’s because Congress is considering both this year’s budget (fiscal year 2013) and next year’s (fiscal year 2014) at the same time. How did this happen? Each year, members of the House and Senate must determine how much federal agencies can spend on various programs. They approve these funding levels through a set of 12 “appropriations bills.” The traditional budget process calls for these appropriations bills to be passed through Congress and signed by the president every year by Sept. 30. This is the date when the next fiscal year begins. Last year, Congress failed to complete this process. Thus, they’re still debating this year’s funding levels as they start the normal budget process for next year.

If there’s no federal budget for this year, how is the government still operating? How do agencies and programs know what they can spend? Congress passed a “continuing resolution” to keep the government operating during this period. A continuing resolution simply extends spending authority for a period of time until a budget can be passed. However, the current continuing resolution expires on March 27. This means Congress will either need to complete the appropriations process for this year or extend the continuing resolution to avoid a government shutdown.

The decisions your members of Congress are making now will have a major impact on the amount of research the NIH and NINDS can conduct in the coming years. Tell your legislators not to cut research funding that could save lives and reduce the incidence and impact of stroke and give stroke survivors a chance at a better recovery.

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5 Easy Steps to a Federal Budget

February typically marks the start of the budget season in Congress. By March your legislators are usually into the full swing of appropriations bills, committee hearings to review those bills and, in recent years, debating funding cuts to federal programs. This process can sound intimidating; however, you don’t have to understand all the jargon to understand how our federal budget gets created. Below are some things that will help you better understand the upcoming budget debates in Congress.

The President’s Budget and the Congressional Budget Process

The president offers a budget each February although this year it’s likely to be delayed because of the fiscal cliff debate that occurred last December. This document is just a proposal, or a suggestion, to Congress about how to spend federal dollars. Congress holds the actual “power of the purse strings” and develops their own budget (or budgets if the House and Senate each develop their own). When the person occupying the White House and the leadership of the House and Senate are of the same political persuasion, the budget numbers may be somewhat similar. However, when the president and Congress don’t see eye to eye, the president’s proposal becomes less a document used to find agreement and more one used to identify what items will be most controversial in the budget debates that follow.

Authorization Versus Appropriation

Even Washington, D.C., insiders are often confused by the differences between “authorization” (language allowing a program to exist) and “appropriations” (the actual funding for that program). When the Stroke Advocacy Network asks you to contact your legislators to preserve funding for the National Institutes of Health (NIH), your messages are asking for Congress to provide (or not cut) appropriations—the money scientists have available to spend on research projects—to that program. In contrast, a request to change the policy related to Medicare therapy caps is an authorization matter—it tells staff running the Medicare program what they can and can’t pay for. For a stroke advocate, it’s good to know that such differences exist, but don’t worry too much about the details. That’s what National Stroke Association’s advocacy team is for.

Types of Federal Spending

The largest portion of federal spending is on what are known as “nondiscretionary” programs, such as Medicare, Social Security and interest on the national debt. While Congress can make changes to these programs, the reality is that changes to them have been few and far between. Most funding battles deal with the one-third of the budget that is considered “discretionary.” This includes almost everything else the government funds—defense, transportation, veterans’ programs, grants to states and municipalities, food and drug safety, agricultural programs and many other programs. One of those programs is the National Institutes of Health (NIH), which is the nation’s primary research arm (including conducting research on stroke diagnosis, treatment and rehabilitation). Since 2010, more than $1.5 trillion has been cut from this smaller, discretionary portion of the budget, which means that the pot that funds the NIH has gotten much smaller. This is why it’s so important to make your voice heard on this issue today!

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StrokeSmart™ Is Back

StrokeSmart, our premier magazine for stroke survivors and caregivers, is now better than ever! With your free subscription, you now get:

• More inspirational stories and tips for recovery and lifestyle—now six times a year.
• Exclusive and new daily content online at www.strokesmart.org.
• A new online searchable resource directory with products and services tailored to stroke survivors and caregivers.
• An electronic subscription via the new StrokeSmart e-newsletter.

Subscribe now at www.stroke.org/mag.