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 Association supports:
Better Care Better Jobs Act (H.R. 547/S. 100), the HCBS Access Act (H.R. 1493/S. 762), the HCBS Relief Act (H.R. 6296/S. 3118).

United Spinal raised the need to introduce federal legislation to address wheelchair repair reform, and legislation or report language to improve spinal cord injury rehabilitation outcomes.

Follow up contacts with members of Congress on United Spinals Virtual Advocacy Day included recommendations for our members to advocate for the following policy issues with their members of Congress:
Increase funding for SCI Model Systems.

United Spinal policy staff advocated for Senators and Representatives to sign onto respective Dear Colleague letters for funding supporting increased funding for the Model Systems program and the Model Systems Knowledge Translational Center (MSKTC), funded by the National Institute on Disability, Independent Living, Rehabilitation Research (NIDILRR) at the U.S. Department of Health and Human Services and housed under the Administration for Community Living (ACL) in the FY 2025 Labor, Health and Human Services, Education Appropriations. The letter was addressed to the bipartisan leadership of the Senate Labor HHS Education Subcommittee on Appropriations. The letter read in part: The Model Systems program provides the entirety of the rehabilitation process from emergency services at the time of an injury through a persons return to full participation in the community for people with spinal cord injury (SCI), traumatic brain injury (TBI), and burn injury. The Model Systems program has not seen an increase in funding since 2006.

Advocate for support of a House Dear Colleague letter as well for increaed funding for Spinal Cord Injury Model Systems.

Continued raising support for FY2025 report language to direct the Centers for Medicare and Medicaid Services (CMS) to add and/or in the community to CMS policy for mobility assistive equipment and add and/or in the community to Social Security Act 1861 (n) which states that durable medical equipment including wheelchairs be used in the patients home only and support Medicare coverage for standing systems in power wheelchairs to facilitate increased options for independent and community living for all wheelchair users.

As a member of the Disability and Rehabilitation Research Coalition, United Spinal, along with numerous other disability organizations, signed on to a letter of thanks to Anjali Forber-Pratt, Ph.D. director, National Institute on Disability, Independent Living, and Rehabilitation Research for the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) 2024-2028 Long Range Plan.

United Spinal helped draft a United Spinal letter of interest for an Administration for Community Living grant: Disability and Rehabilitation Research Projects (DRRP) Program: Enhancing the Accessibility of Air Travel.

As a member of the Disability & Rehabilitation on Research Coalition (DRRC), United Spinal, along with numerous other disability organizations, signed on to a letter to Chiquita Brooks-LaSure, Administrator, Centers for Medicare and Medicaid Services to provide comments in response to the request for information on Research Data Request and Access Policy Changes.

As a member of the Consortium for Constituents with Disabilities Technology and Telecommunications
Task Force, United Spinal, along with numerous other disability organizations sent a letter to the bipartisan leadership of the Senate and House Labor, Health and Human Services and Education Appropriations Committees in support for the inclusion of $42 million in the Fiscal Year (FY) 2025 Senate Labor, Health and Human Services and Education Appropriations (LHHS) bill for the Assistive Technology (AT) Act Programs.

United Spinal supports H.R 1691 - Ensuring Patient Access to Critical Breakthrough Products Act.

Wrote letters with CMS and met with CMS to talk about the need for Medicare coverage of transanal irrigation. Wrote letter to CMS DME MACS regarding needed reform in ostomy supplies coverage under Medicare.

Health equity issues - Met with CMS, NIH, ACL and the White House at the Danish Embassy discussing the challenges of health equity concerns in the medical supplies sector.

As part of the Coalition to Preserve Rehabilitation, United Spinal signed onto the FY2025 in-patient rehab proposed rule and the RFI on Medicare Advantage data.

As part of the ITEM Coalition, United Spinal also submitted a letter to CMS in support of standing systems (power wheelchairs) and another letter in support of coding reform for catheters.

United Spinal also signed on to a letter to President Biden, with multiple care support groups, in support of the creation of an Office for Caregiver Health.

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

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

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

United Spinal supports:

H.R. 3935, Securing Growth and Robust Leadership in American Aviation Act/

S. 1939, FAA Reauthorization Act of 2023

H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA)
H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act

United Spinal Association supported and participated in a working group, dedicated to implementing one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations, a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights.

United Spinal Association supported and participated in the U.S. Department of Transportations Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS).

United Spinal, along with numerous other disability organizations, signed on to a letter respectfully requesting that the U.S. Department of Transportation deny any requests for an extension of the comment period for the notice of proposed rulemaking (NPRM) titled, Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, DOT-OST-2022-0144.

United Spinal, along with numerous other disability organizations, helped draft and submitted comments in response to the U.S. Department of Transportations Notice of Proposed Rulemaking (NPRM), Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs, (DOT-
OST-2022-0144).

United Spinal submitted comments in response to the Department of Transportations Ensuring Safe Accommodations for Air Travelers with Disabilities Using Wheelchairs (DOT-OST-2022-0144).

United Spinal submitted comments in response to the National Council on Disabilitys (NCD) call for public comment on public facilities and transportation issues. The letter read in part, United Spinal applauds the work of the NCD in raising awareness of issues so vital and critical to our community. NCD serves as an essential bully pulpit to air our communitys legitimate grievances and continues to remind its fellow federal agencies, the White House and members of Congress about the unfinished accessibility work across America. Indeed, as we point out below, the issue of accessibility demands constant vigil in the federal community, lest we regress on this basic fundamental right.

United Spinal had a conversation with the National Council on Disability regarding accessibility activities in autonomous vehicle design and accessible transportation.

United Spinal supports H.R. 7126, the Autonomous Vehicle Accessibility Act, introduced by Representative Greg Stanton (D-AZ-4).

United Spinal, as a member of the SecureRide Coalition, continued to coordinate with Tool, Inc., a company that has successfully submitted an application for a Department of Transportation Small Business Innovation Research (SBIR) Program 24-NH 4 Phase I Pre-Offer, Re: 24-NH4: Lightweight Universal Docking Interface Geometry Manual Wheelchair Attachment.

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

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Transportation - Dept of (DOT), Natl Council on Disability

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

United Spinal signed a comment letter to the FDA in support of a proposed ban on electric shock devices for use on people with disabilities.

H.R. 7351 / S. 3747, Removing Access Barriers to Running for Elected Office for People with Disabilities Act
H.R. 7389 / S. 3748, Accessible Voting Act of 2024
H.R. 7350 / S. 3749, The Accessibility and Inclusion to Diversity Local Government Leadership Act

As a member of the Disability & Rehabilitation Research Coalition (DRRC), United Spinal, along with numerous other disability organizations, signed on to a letter to the Director of the U. S. Census Bureau, Robert L. Santos to express our sincere gratitude for the recent decision by the U.S. Census Bureau to halt the proposed changes to the American Community Survey (ACS) disability
questions for collection year 2025 and reconsider additional questions for future use. This
decision demonstrates a commendable commitment to listening to the concerns of the disability
community and ensuring that our voices are heard in the development of policies that directly
impact us.

As a member of the Disability and Rehabilitation Research Coalition (DRRC), United Spinal, along with numerous other disability organizations, requested a meeting with the Director, National Institutes of Health (NIH), Monica Bertagnolli, M.D. to discuss the implementation of the recommendations of the Working Group on Diversitys Subgroup on Individuals with Disabilities (WGD-SID Recommendations). The letter read in part: These recommendations were unanimously endorsed by the Advisory Committee to the NIH Director (ACD) on December 9, 2022. Several have already been adopted, including the official designation of people with disabilities as an NIH health disparity population on September 26, 2023, but other critical actions, including the creation of a Disability Research Office (DRO), have not yet occurred. We want to help.

As a member of the Consortium for Constituents with Disabilities (CCD) Technology and Telecommunications Task Force, United Spinal support a letter the Task Force sent the bipartisan leadership of the Senate Commerce, Science, and Transportation Committee and the House Energy and Commerce Committee in strong support of S.2494 /H.R.4858, the Communications, Video, and Technology Accessibility Act (CVTA).

Engaged with the White House and ACL on a range of isssues related to medical supplies and durable medical equipment when celebrating the 25th anniversary of Olmstead at the Department of Justice.

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

Food & Drug Administration (FDA), U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Natl Institutes of Health (NIH), Bureau of the Census, Justice - Dept of (DOJ)

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 participated in a quarterly meeting of the Disability Community Advisory Group with DC Homeland Security Emergency Management Agency.

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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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 AVI

16. Specific lobbying issues

United Spinal Association supports:

H.R. 3935/S. 1939 Securing Growth and Robust Leadership in American Aviation Act/FAA Reauthorization Act of 2023

United Spinal Association supports full inclusion of all of the provisions contained in H.R. 1267/ S. 545, the Air Carrier Access Amendments Act (ACAAA) and H.R. 1499 / S. 753, the Good Jobs for Good Airports (GJGA) Act.

As one of the Air Carrier Access Act (ACAA) Advisory Committee recommendations: a U.S. Department of Transportation (DOT) Public Awareness Campaign to Ensure Air Travelers with Disabilities Know Their Rights - United Spinal partcipated and provided recommendations.

United Spinal Association supported is participating in the U.S. Department of Transportation's Office of Aviation Consumer Protection (OACP) ongoing efforts to launch a new database, Aviation Complaint, Enforcement, and Reporting System (ACERS).

In support of Democratic Committee Members of the U.S. House Committee on Transportation and Infrastructure letter sent to Airlines for America (A4A) President and CEO Nicholas Calio expressing concern and dismay regarding the continued trend of mishandled wheelchairs and scooters.

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

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Transportation - Dept of (DOT)

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 TEC

16. Specific lobbying issues

United Spinal responded to the Federal Communications Commissions The Reinstatement of Net Neutrality Rules (Docket No. 23-320) with comments. Which reads in part, Unfortunately, for the millions of people whom United Spinal represents, in too short a timeframe, the FCC has opined and acted on the need for dramatically more and dramatically less regulation with diametrically opposed voices.

United Spinal supports H.R. 6929, The Affordable Connectivity Program Extension Act, introduced by Representative Yvette D. Clarke (D-NY-9). The bill would provide $7 billion to fund the ACP through FY24.

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

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

16. Specific lobbying issues

United Spinal supports:

H.R.7138 - Supplemental Security Income Restoration Act of 2024
H.R. 5408 / S. 2767, the SSI Savings Penalty Elimination Act

As a member of the Consortium for Constituents with Disabilities (CCD) Social Security Task Force, United Spinal, along with numerous other disability organizations, wrote to the bipartisan leadership of the House and Senate Subcommittees on Labor, Health and Human Services Appropriations to urge fully funding the Presidents budget request of $15.4 billion for SSAs FY 2025 administrative budget.

United Spinal, as a member of the Social Security Task Force of the Consortium for Constituents with Disabilities supported a letter the Task Force Co-Chairs sent to The Honorable Martin OMalley,
Commissioner, Social Security Administration in response to a NPRM on the Use of Electronic Payroll Data to Improve Program Administration [Docket No. SSA-2016-0039].

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

U.S. SENATE, U.S. HOUSE OF REPRESENTATIVES, Social Security Administration (SSA)

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

Urge CMS to lift 'in the home' restriction under Medicare and Social Security Act language for wheelchairs. Support Medicare coverage for standing systems wheelchairs.

Seek FY25 Appropriations programmatic report language: Medicare should provide coverage for individuals to obtain wheelchairs that allow them to integrate safely in both their communities and their homes. The Committee directs CMS to update the 2005 National Coverage Determination under Medicare for Mobility Assistive Equipment (MAE) by adding, and/or in the community" after "in the home.

And urge the Centers for Medicare and Medicaid Services to provide Medicare coverage for standing systems in power wheelchairs to facilitate increased options for independent and community living for all wheelchair users.

Centers for Medicare and Medicaid Services
United Spinal, along with numerous other disability and disability related organizations, as members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition and other supporting organizations that endorsed our original request in 2020 for the Centers for Medicare and Medicaid Services (CMS) to conduct a National Coverage Analysis (NCA) for Medicare coverage of seat elevation and standing systems in power wheelchairs, we write to reaffirm our request for CMS to expeditiously open an NCA for standing systems in Group 3 power wheelchairs, which are classified by Medicare as complex rehabilitative technology (CRT) wheelchair.

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

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

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 RRR

16. Specific lobbying issues

United Spinal staff participated in two quarterly calls with Amtrak along with other representatives from disability organizations.

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

AMTRAK - Natl Railroad Passenger Corporation

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

United Spinal supports H.R. 6929 / S. 3565, the Affordable Connectivity Program Extension Act

United Spinal, along with 270 other disability, civil rights, consumer protection, education, environmental and faith groups as well as municipal broadband departments, local, state and Tribal governments organizations, signed onto a letter to members of the U. S. House of Representatives requesting they sign H. Res. 1119, the discharge petition filed by Representative Clarke in support of H.R. 6929, the Affordable Connectivity Program Extension Act of 2024.

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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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