What’s at stake: Explaining the President’s proposed 2018 budget

Posted by Reeve Foundation Staff in Daily Dose on June 12, 2017 # Advocacy and Policy

As new policies and recommendations are released by the White House, it is clear there is a lot of confusion as it relates to the impact on Americans living with paralysis. Just last week, the Trump Administration’s proposed 2018 budget eliminates funding for the Paralysis Resource Center (PRC), which could mean the end of this vital program and the removal of services that thousands living with paralysis depend on. In this post, we’ll break down the specific budget request language to explain why this proposed cut poses a serious risk to the needs of the paralysis community.

“The FY 2018 Budget request achieves $63 million in savings by discontinuing discretionary funding for the Limb Loss Resource Center, the Paralysis Resource Center, and the State Health Insurance Assistance Program.”

Two things: First, in the 2017 federal budget, the State Health Insurance Program was funded at $47 million, the Limb Loss Resource Center at $2.5 million, and the PRC at $6.7 million (following a $1 million cut to the program this year). Thus, the elimination of these programs represents a savings of $56.2 million, not $63 million. Beyond the math, the elimination of these programs could result in an increase in the budget.

Second, it’s worth noting that funding for the Paralysis Resource Center – the ONLY federally funded program specifically tailored to paralysis community – represents just .012 percent of the entire budget for the Department of Health & Human Services (HHS), and .00016 percent of Trump’s total proposed budget. Cutting .00016 percent of your budget by eliminating life-saving resources and services for individuals living with mobility impairments seems like questionable math.

“The activities carried out by these programs are duplicative of other Federal efforts.”

This might be the most misleading sentence in the budget, as it’s simply untrue. No other federal program provides services like the PRC such as Information Specialists that offer personalized support and information to families impacted by paralysis; a peer-to-peer network that helps individuals navigate the challenges of paralysis; a Military and Veterans Program with specialized expertise for veterans living with mobility impairment; and a Quality of Life Grants Program that has awarded over $22 million in financial support to fellow nonprofits to fund assistive technology, accessible transportation, and other quality of life initiatives. These programs exist only within the Reeve Foundation Paralysis Resource Center.

“Activities carried out by the…Paralysis Resource Center will be merged into the National Institute on Disability, Independent Living and Rehabilitation Research.”

A quick overview on the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), which, I know, is a mouthful. NIDILRR is the primary research arm of the Administration for Community Living (the Federal agency that oversees most aging and disability programs). They conduct important studies to determine the best ways to improve quality of life for people with disabilities and, while their efforts are exemplary, they have never been tasked with applying their studies to directly help the disability community; it’s simply not what they do. Perhaps an easier way to think of it is that the last “R” in NIDILRR stands for “research” and the “R” in PRC stands for “resource” – one studies, the other provides direct help and a lifeline to those in need.

It’s also worth noting that NIDILRR serves “individuals across the age continuum and including all disability subpopulations,” whereas the PRC focuses solely on Americans living with paralysis. There are over 56 million individuals living in the U.S. with disabilities. Moving the PRC to NIDILRR would dilute the ability to provide personalized, specific information to people with mobility impairments.

While we understand the Administration’s intention to save funds, it cannot be at the expense of those who rely on vital services to support their health, independence and quality of life. Shoehorning a program, like the PRC, into an entity like NIDILRR would, in fact, represent a cost INCREASE, as NIDILRR would then be tasked with building new programs, training new staff, and creating new materials. And, instead of providing a funding increase to NIDILRR to cover these costs, the proposed budget actually cuts NIDILRR by $9 million, thereby asking them to do more work with less money.

The success of the PRC is unparalleled – just ask the hundreds of thousands of people who have benefitted from it. Cutting its funding or moving its programs is shortsighted, irrational, and dangerous. Write your Members of Congress today and tell them not to cut funding for the PRC. It will take just a few minutes, but can make a life-changing difference for the 5.4 million Americans living with paralysis.