Lobbying Disclosure Act of 1995 (Section 5) - All Filers Are Required to Complete This Page

9. Check if this filing amends a previously filed version of this report

LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code HCR

16. Specific lobbying issues

United Spinal, as a member of the DRRC, supported a DRRC request to meet with HHS Secretary Alex Azar to discuss the implementation of the government-wide strategic plan on disability, independent living, and rehabilitation research.

United Spinal signed onto a letter to House and Senate leadership in support of the permanent repeal of the medical device tax which has a direct impact on access to critical medical devices for individuals with disabilities and chronic illnesses.

National Institutes of Health (NIH) - Request for Information - SCI 2020 Conference
United Spinals response included the following main points:
United Spinal advocates for improved care of SCI patients in the acute trauma setting so that individuals with SCI are transported to the appropriate rehabilitation facilities, ideally, to have access to maximum rehabilitation potential and functional mobility outcomes.
United Spinal advocates for SCI education and SCI expertise throughout the rehab continuum.
The essential role of assistive technology to improve functional recovery.
The importance of adaptive fitness and nutrition and adaptive and accessible technologies.
Regarding the consumer voice in the research space, it is incumbent upon all stakeholders in this space to work collaboratively and it is critical that there is meaningful consumer engagement throughout the research continuum.

United Spinal is in dialogue with Congress on the need to designate Spinal Cord Injury Centers of Excellence

As a member of the Coalition to Preserve Rehabilitation Steering Committee, United Spinal signed onto a letter to HHS in support of nondiscrimination protections:
RIN 0945-AA11; Nondiscrimination in Health and Health Education Programs or Activities; and

in a letter to CMS, Patients over Paperwork raised our concerns in a response to CMS RFI on reducing administrative burden in Medicare and Medicaid. As a Steering Committee member of the ITEM Coalition, United Spinal also signed on to this letter.

United Spinal advocacy and policy staff played a leading role in the passage of S. Res. 329, a resolution designating September 2019 as National Spinal Cord Injury Awareness Month. Senator Marco Rubio (R-FL) and Senator Tammy Baldwin (D-WI) were the co-leads on the resolution.

17. House(s) of Congress and Federal agencies Check if None

Health & Human Services - Dept of (HHS), U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), Centers For Medicare and Medicaid Services (CMS)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code VET

16. Specific lobbying issues

S. 1881, the Veterans Expedited TSA Screening (VETS) Safe Travel Act
Provided letter of support to SEN Youngs office and the SVAC in support of this bill expanding access to TSA Pre✓ to severely disabled veterans at no cost.

H.R 3356, the Veterans Expedited TSA Screening (VETS) Safe Travel Act
Provided letter of support Rep Gosar and Rep Kirkpatrick to the HVAC in support of this bill expanding access to TSA Pre✓ to severely disabled veterans at no cost.

Provided letter of support through Consortium of Citizens with Disabilities to the 2020 Labor, Health and Human Services, Education and Related Agencies appropriations committees in both the House and the Senate requesting funding to establish a Disabled Veteran Program at the U.S. Department of Labor (DOL).

Signed onto letter from The Military Coalition to Reps Pelosi, McCarthy, Lowey, and Granger of the House and the House Committee on Appropriations urging their attention to passing the Fiscal Year (FY) 2020 Military Construction, Veterans Affairs, and Related Agencies Appropriations bills before the current fiscal year ended on September 30, 2019.

H.R. 3867, Violence Against Women Veterans Act
Provided letter of support to Rep. Velasquez for her reintroduction of this act which requires the Secretary of Veterans Affairs to improve the provision of services and benefits from the Department of Veterans Affairs for veterans who experience domestic violence or sexual assault, and for other purposes.

H.R.3504 - Ryan Kules Specially Adaptive Housing Improvement Act of 2019
Provided letter of support to Rep Bilirakis and Rep Levin for the Ryan Kules SAH Improvement Act, which would increase the number of times veterans could tap into the specially adaptive housing (SAH) program and give access to the full amount every 10 years.

S.2022 - Paul Benne Specially Adaptive Housing Improvement Act of 2019
Provided letter of support for the Paul Benne SAH Improvement Act of 2019 to Sens. Moran and Sinema for this act which would increase the number of times and the amount of funding veterans could use in the specially adaptive housing (SAH) program.

Bipartisan Budget Act of 2020.
Signed onto letter from The Military Coalition to the SASC and HASC covering support for specific parts of the Bipartisan Budget Act of 2020:
Elimination of Medical Billets
Survivor Benefits
Basic Needs Allowance (BNA)

Signed onto letter through the Veteran Education Success coalition to Director Kathleen Kraninger of the Consumer Financial Protection Bureau regarding Comment on Debt Collection Practices (Regulation F); Docket No. CFPB-2019-0022 which implements the Fair Debt Collection Practices Act (FDCPA), expressing our views on several pieces of the amendments which may cause undue hardship or loss of clearance for veterans and military members.

United Spinal and VetsFirst signed onto coalition comments to the FCC in response to public notices seeking comment on applications to provide Internet Protocol Captioned Telephone Service (IP CTS) from companies that provide Automatic Speech Recognition (ASR) only services; followed up comments by participating in two in-person meetings with FCC staff.

Discussed emerging technology at the VA with VA staff.

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Consumer Financial Protection Bureau (CFPB), Federal Communications Commission (FCC)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code MMM

16. Specific lobbying issues

United Spinal supports H.R. 2293 introduced by Representatives John Larson and Lee Zeldin - Protecting Access to Wheelchairs Act.
United Spinal supports S. 1223 introduced by Senators Bob Casey and Rob Portman. - Protecting Beneficiary Access to Complex Rehab Technology Act of 2019.
United Spinal supports HR 2408 - Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019.

As a member of the ITEM Coalition Steering Committee, United Spinal, Christopher & Dana Reeve Foundation, Amputee Coalition, PVA and clinicians, SCI physicians and advocates met with Liz Richter, Deputy Director, Center for Medicare at CMS and others to discuss the need for standing feature and seat elevation components to be covered by Medicare.

Medicaid Program; Methods for Assuring Access to Covered Medicaid Services - Rescission, RIN:0938-AT41
Adequate access to services under Medicaid is especially important to people with disabilities. CCD has commented on numerous iterations of this rule, including the original notice of proposed rulemaking in 2011,1 final rule with comment period in 2016,2 request for information in 2016,3 and proposed rulemaking in 2018.4 People with disabilities rely on Medicaid for access to basic health care services and for services that ensure their functioning, independence, and well-being, including: nursing and personal care services, specialized therapies, intensive mental health services, special education services, and other needed services that are unavailable through other insurance. Access to these services is a matter of life, death, and independence for the millions of people with disabilities on Medicaid and the protections provided by the equal access statute are of particular importance to our community.

United Spinal signed onto the Durable Medical Equipment Prosthetics, Orthotics and Supplies CY 2020 Proposed Rule to raise concerns about pricing calculated from the 1980s on new technologies and new codes for medical equipment and prosthetics and orthotics which hinders companies from providing newer equipment or investing in developing new technologies and prevents consumer access to reasonably priced products.

United Spinal signed onto a Congressional House letter in support of H.R. 3107, Improving Seniors Timely Access to Care Act which protects patients from unnecessary delays in care by supporting and seeks to streamline and standardize prior authorization under the Medicare Advantage program.

United Spinal, as a member of the Personal Connected Health Alliance, supports a letter submitted to the Centers for Medicare and Medicaid Services. Medicare and Medicaid Programs; CY 2020 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; Home Health Quality Reporting Requirements; and Home Infusion Therapy Requirements; Proposed Rule.
The letter read in part: Our comments focus on important connected care aspects of the home health prospective payment system and the home infusion therapy benefit, and we offer our comments to ensure efficacious, effective, and non-duplicative coverage for remote patient monitoring.

United Spinal also commented as a member of ITEM Coalition's Steering Committee on (CMS-1711-P) Medicare and Medicaid Programs; CY 2020 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; Home Health Quality Reporting Requirements; and Home Infusion Therapy Requirements

The Proposed Rule updates the home health prospective payment system (HH PPS) payment rates and implements the transition in the unit of payment from a 60-day episode of care to a 30-day episode of care, as required by the Bipartisan Budget Act of 2018. The Proposed Rule also implements the Patient-Driven Groupings Model (PDGM), proposed payment rate changes for home infusion therapy temporary transitional payments, and adjustments to the home infusion therapy benefit, and proposes to phase out the Request for Anticipated Payment (RAP). The Proposed Rule would also change the Home Health Value-Based Purchasing Model (HH VBP) and the Home Health Quality Reporting Program (HH QRP), among other things.

Although some components of CMSs new home health payment reform were finalized last year, we continue to have concerns regarding the implementation of and rationale behind the new payment methodology. Our comments focussed largely on the proposed implementation of the PDGM, the proposed authorization of therapist assistants to provide maintenance therapy, and the impact of these proposals on patients receiving rehabilitative care in the home health setting.

17. House(s) of Congress and Federal agencies Check if None

U.S. HOUSE OF REPRESENTATIVES, Centers For Medicare and Medicaid Services (CMS), U.S. SENATE

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code LBR

16. Specific lobbying issues

United Spinal, along with other members of the Consortium for Citizens with Disabilities, met with Jennifer Sheehy, Deputy Assistant Secretary, ODEP, and her team, to discuss the agencys efforts on its 14(c) online dialogue as well as its efforts on providing resources to states and providers to move towards competitive integrated employment and away from holding certificates to provide subminimum wage [14(c) certificates] to people with disabilities.

United Spinal, along with numerous other disability organizations as members of the Consortium for Citizens with Disabilities (CCD) Long Term Services and Supports (LTSS) Task Force, signed onto a letter to Senator Kamala Harris (D-CA) and Rep. Pramila Jayapal (D-WA-7) supporting the principles that inform the Domestic Workers Bill of Rights Act of 2019 without supporting the bill itself. (S. 2112/H.R. 3760).

United Spinal policy endorsed Secure the Secure Work Coalitions Statement in support of the Disability Employment Incentive Act H.R. 3992, introduced by Representatives Brian Fitzpatrick (D-CA-1st) and Josh Harder (R-PA-10th).

17. House(s) of Congress and Federal agencies Check if None

Labor - Dept of (DOL), U.S. HOUSE OF REPRESENTATIVES

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code TAX

16. Specific lobbying issues

United Spinal supports S. 651/H.R 1814, the ABLE Age Adjustment Act and engaged in Hill meetings.

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code DIS

16. Specific lobbying issues

H.R. 3208/S. 1755: Real Emergency Access for Aging and Disability Inclusion for Disasters Act
Signed onto letter of support as part of the Coalition of Citizens with Disabilities in support of the REAADI Act which aims to ensure that older adults and individuals with disabilities are prepared for disasters, and for other purposes.

United Spinal supports Disaster Relief Medicaid Act - S. 1754/H.R. 3215.

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code TRA

16. Specific lobbying issues

Discussed ADA compliance in AMTRAK railcars with AMTRAK.
Sent comments on accessible autonomous vehicles to House and Senate.
Discussed TNC Accountability with Congressional House staffers.

U.S. Department of Transportation (DOT) Secretary Elaine L. Chao announced the formation of the Air Carrier Access Act Advisory Committee (ACAA Advisory Committee) and the appointment of 19 members, including Nicholas LiBassi, Vice President, Partnership Expansion, United Spinal Association, as representative of national disability organizations and James Sinocchi of JP Morgan Chase. The ACAA Advisory Committee is being established pursuant to the FAA Reauthorization Act of 2018 (FAA Act).

United Spinal staff attended Transportation Security Administration (TSA) Annual Disability & Multicultural Coalition Conference 2019 to discuss agency outreach to the disability community.

U.S. Access Board Released Voluntary Guidelines for Onboard Wheelchairs
United Spinal is advocating for increased accessibility in airline travel in relation to the U.S. Access Board releasing for public comment advisory guidelines for wheelchairs used on commercial passenger aircraft during flight. United Spinal Policy staff monitored a hearing the Board held on September 12 on the guidelines. The Board notice read in part, These onboard wheelchairs are provided by air carriers as a means of facilitating the transfer of passengers with disabilities to aircraft lavatories since personal wheelchairs cannot be used in the cabin. The Department of Transportation (DOT) has expressed its intention to supplement its regulations under the Air Carrier Access Act (ACAA) to include performance standards for onboard wheelchairs on covered aircraft. The Board is developing these non-binding guidelines as technical assistance to air carriers and manufacturers of onboard wheelchairs by providing an example of how to meet DOT's planned performance standards.

United Spinal will be submitting comments to the U.S. Access Board.

17. House(s) of Congress and Federal agencies Check if None

AMTRAK - Natl Railroad Passenger Corporation, U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Transportation - Dept of (DOT), Transportation Security Administration (TSA), Architectural & Transportation Barriers Compliance Board, Labor - Dept of (DOL)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code CIV

16. Specific lobbying issues

On July 25, 2019, United Spinal, and numerous other disability organizations, as members of the Consortium for Citizens with Disabilities (CCD) sent a letter to all members of Congress in recognition of the 29th anniversary of the Americans with Disabilities Act (ADA).

The American Civil Liberties Union, Center for Public Representation, and sixteen other national disability advocacy groups, including United Spinal Association, represented by the global law firm Latham & Watkins filed an amicus brief in support of litigation to stop the U.S. Department of Homeland Security (DHS) from implementing its new public charge rule.

United Spinal signed a letter addressed to Representatives Jamie Raskin (D-MD) and Chip Roy (R-TX), Chairman and Ranking Member of the House Oversight Subcommittee on Civil Rights and Civil Liberties, thanking the Subcommittee for holding a hearing on the revocation of medical deferred action for critically ill children. The letter urges United States Citizenship and Immigration Services (USCIS) to reverse its decision to stop considering visa applications based on medical deferred action for people who have a serious health condition, and for Congress to make the program permanent. The subcommittee hearing was well attended along with representatives from other disability organizations such as Disability Rights Education and Defense Fund. Due to some strong advocacy from the disability community, USCIS did rescind its decision later the same month.

17. House(s) of Congress and Federal agencies Check if None

U.S. HOUSE OF REPRESENTATIVES, U.S. SENATE, Homeland Security - Dept of (DHS)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code COM

16. Specific lobbying issues

As a member of the Personal Connected Health Alliance (PCHAlliance), United Spinal advocacy and policy staff assisted in crafting a letter in response to the FCCs Promoting Telehealth for Low-Income Consumers Notice of Proposed Rulemaking WC Docket No. 18-213.

17. House(s) of Congress and Federal agencies Check if None

Federal Communications Commission (FCC)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code PHA

16. Specific lobbying issues

U.S. Food and Drug Administration (FDA) Scientific Data and Information About Products Containing Cannabis or Cannabis-Derived Compounds; Public Hearing; Request for Comments
United Spinal provided comments on the FDAs Public Hearing for Scientific Data and Information about Products Containing Cannabis or Cannabis-Derived Compounds urging for lifting research restrictions on cannabis.
The letter read in part: As more states move forward with medical and recreational marijuana legalization, it is critical that Congress take action to protect their right to do so. For this reason, United Spinal supports the passage of the Strengthening the Tenth Amendment Through Entrusting States (STATES) Act, which ensures that each state has the right to determine for itself the best approach to marijuana within its borders. This bill extends these protections to Washington, DC, U.S. territories and contains common-sense guidance to ensure states are regulating in a rational and safe manner. We also support H.R. 712/S.179 known as The VA Medicinal Cannabis Research Act of 2019 which directs the Secretary of Veterans Affairs to carry out a clinical trial of the effects of cannabis on certain health outcomes of adults with chronic pain and post-traumatic stress disorder. We also support H.R. 601, The Medical Cannabis Research Act which increases the number of manufacturers registered under the Controlled Substances Act to manufacture cannabis for legitimate research purposes and authorizes health care increases the number of manufacturers registered under providers of the Department of Veterans Affairs to provide recommendations to veterans regarding participation in federally approved cannabis clinical trials.

17. House(s) of Congress and Federal agencies Check if None

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Food & Drug Administration (FDA)

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide information as requested. Add additional page(s) as needed.

15. General issue area code DOC

16. Specific lobbying issues

United Spinal and the DC Center for Independent Living as plaintiffs in litigation against the Government of the District of Columbia attended and presented at the launch of the DC Homeland Security and Emergency Management Agency Disability Integration Initiative at Gallaudet University. The litigation was completed and signed by both parties earlier in the year. Both United Spinal and the DC CIL are co-chairs of the DC Disability Community Advisory Group which include representatives of the disability community representing individuals who are deaf, blind, who have cognitive and intellectual disabilities etc. DC HSEMA is engaging in workgroup activity, as required by the settlement, in the following areas: post-emergency canvassing operations, communications, sheltering, accessible transportation, high-rise evacuation etc.

17. House(s) of Congress and Federal agencies Check if None

18. Name of each individual who acted as a lobbyist in this issue area

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

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Information Update Page - Complete ONLY where registration information has changed.

20. Client new address

21. Client new principal place of business (if different than line 20)

22. New General description of client’s business or activities

LOBBYIST UPDATE

23. Name of each previously reported individual who is no longer expected to act as a lobbyist for the client

ISSUE UPDATE

24. General lobbying issue that no longer pertains

AFFILIATED ORGANIZATIONS

25. Add the following affiliated organization(s)

Internet Address:

26. Name of each previously reported organization that is no longer affiliated with the registrant or client

FOREIGN ENTITIES

27. Add the following foreign entities:

28. Name of each previously reported foreign entity that no longer owns, or controls, or is affiliated with the registrant, client or affiliated organization

CONVICTIONS DISCLOSURE

29. Have any of the lobbyists listed on this report been convicted in a Federal or State Court of an offense involving bribery, extortion, embezzlement, an illegal kickback, tax evasion, fraud, a conflict of interest, making a false statement, perjury, or money laundering?
No Yes