[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 725 Reported in Senate (RS)]

                                                       Calendar No. 397

103d CONGRESS

  2d Session

                                 S. 725

                          [Report No. 103-243]

_______________________________________________________________________

                                 A BILL

 To amend the Public Health Service Act to provide for the conduct of 
  expanded studies and the establishment of innovative programs with 
       respect to traumatic brain injury, and for other purposes.

_______________________________________________________________________

             March 25 (legislative day, February 22), 1994

                       Reported with an amendment
                                                       Calendar No. 397
103d CONGRESS
  2d Session
                                 S. 725

                          [Report No. 103-243]

 To amend the Public Health Service Act to provide for the conduct of 
  expanded studies and the establishment of innovative programs with 
       respect to traumatic brain injury, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                April 1 (legislative day, March 3), 1993

  Mr. Kennedy introduced the following bill; which was read twice and 
         referred to the Committee on Labor and Human Resources

             March 25 (legislative day, February 22), 1994

               Reported by Mr. Kennedy, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to provide for the conduct of 
  expanded studies and the establishment of innovative programs with 
       respect to traumatic brain injury, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

-S-E-C-T-I-O-N -1-. -S-H-O-R-T -T-I-T-L-E-.

    -T-h-i-s -A-c-t -m-a-y -b-e -c-i-t-e-d -a-s -t-h-e 
-`-`-T-r-a-u-m-a-t-i-c -B-r-a-i-n -I-n-j-u-r-y -A-c-t -o-f 
-1-9-9-3-'-'-.

-S-E-C-. -2-. -F-I-N-D-I-N-G-S -A-N-D -P-U-R-P-O-S-E-.

    -(-a-) -F-i-n-d-i-n-g-s-.----C-o-n-g-r-e-s-s -f-i-n-d-s -t-h-a-t---
            -(-1-) -t-h-e -i-n-c-i-d-e-n-c-e -o-f -h-e-a-d -i-n-j-u-r-y 
        -i-n -t-h-e -U-n-i-t-e-d -S-t-a-t-e-s -i-s 
        -i-n-c-r-e-a-s-i-n-g-, -w-i-t-h -o-v-e-r -2-,-0-0-0-,-0-0-0 
        -h-e-a-d -i-n-j-u-r-i-e-s -p-e-r -y-e-a-r -r-e-s-u-l-t-i-n-g 
        -f-r-o-m -a-u-t-o-m-o-b-i-l-e -c-r-a-s-h-e-s-, -s-p-o-r-t-s-, 
        -r-e-c-r-e-a-t-i-o-n-a-l -a-c-t-i-v-i-t-i-e-s-, 
        -a-s-s-a-u-l-t-s-, -v-i-o-l-e-n-c-e -a-n-d -o-t-h-e-r 
        -f-a-l-l-s -a-n-d -i-n-c-i-d-e-n-t-s-;
            -(-2-) -a -m-a-j-o-r-i-t-y -o-f -a-l-l -h-e-a-d 
        -i-n-j-u-r-i-e-s -a-r-e -c-a-u-s-e-d -b-y -m-o-t-o-r 
        -v-e-h-i-c-l-e -a-c-c-i-d-e-n-t-s-;
            -(-3-) -i-n-d-i-v-i-d-u-a-l-s -b-e-t-w-e-e-n -t-h-e 
        -a-g-e-s -o-f -1-5 -a-n-d -2-4 -a-r-e -a-t -g-r-e-a-t-e-s-t 
        -r-i-s-k -f-o-r -s-u-s-t-a-i-n-i-n-g -h-e-a-d 
        -i-n-j-u-r-i-e-s-;
            -(-4-) -o-f -t-h-e -i-n-d-i-v-i-d-u-a-l-s -w-h-o 
        -s-u-s-t-a-i-n -h-e-a-d -i-n-j-u-r-i-e-s -e-a-c-h -y-e-a-r-, 
        -a-p-p-r-o-x-i-m-a-t-e-l-y -5-0-0-,-0-0-0 -r-e-q-u-i-r-e 
        -h-o-s-p-i-t-a-l-i-z-a-t-i-o-n-, -a-n-d -7-5-,-0-0-0 -t-o 
        -1-0-0-,-0-0-0 -o-f -s-u-c-h -i-n-d-i-v-i-d-u-a-l-s -d-i-e 
        -w-i-t-h-i-n -h-o-u-r-s -o-f -t-h-e -i-n-j-u-r-y-;
            -(-5-) -o-f -t-h-e -i-n-d-i-v-i-d-u-a-l-s -w-h-o 
        -s-u-r-v-i-v-e -h-e-a-d -i-n-j-u-r-i-e-s -e-a-c-h -y-e-a-r-, 
        -a-p-p-r-o-x-i-m-a-t-e-l-y -7-0-,-0-0-0 -t-o -9-0-,-0-0-0 
        -w-i-l-l -s-u-f-f-e-r -i-r-r-e-v-e-r-s-i-b-l-e 
        -d-e-b-i-l-i-t-a-t-i-n-g -l-o-s-s -o-f -f-u-n-c-t-i-o-n-, 
        -5-,-0-0-0 -w-i-l-l -d-e-v-e-l-o-p -e-p-i-l-e-p-s-y -a-s -a 
        -r-e-s-u-l-t -o-f -t-h-e -i-n-j-u-r-y-, -a-n-d -2-,-0-0-0 
        -w-i-l-l -e-x-i-s-t -i-n -a -c-o-m-a-;
            -(-6-) -a -s-i-g-n-i-f-i-c-a-n-t -n-u-m-b-e-r -o-f 
        -i-n-d-i-v-i-d-u-a-l-s -w-i-t-h -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
        -i-n-j-u-r-y -a-r-e -n-o-t -e-a-s-i-l-y -r-e-s-t-o-r-e-d -t-o 
        -s-o-c-i-e-t-y -a-n-d -r-e-q-u-i-r-e -y-e-a-r-s -o-f 
        -r-e-h-a-b-i-l-i-t-a-t-i-o-n-, -m-e-d-i-c-a-l -f-o-l-l-o-w--
        -u-p -a-n-d -i-n-t-e-g-r-a-t-e-d -c-o-m-m-u-n-i-t-y 
        -s-e-r-v-i-c-e-s-, -w-h-i-c-h -a-r-e -c-o-s-t-l-y -a-n-d 
        -f-r-e-q-u-e-n-t-l-y -n-o-t -r-e-a-d-i-l-y -a-v-a-i-l-a-b-l-e-;
            -(-7-) -i-n-d-i-v-i-d-u-a-l-s -s-u-s-t-a-i-n-i-n-g 
        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y -r-e-q-u-i-r-e 
        -c-o-o-r-d-i-n-a-t-e-d -a-n-d -s-p-e-c-i-a-l-i-z-e-d 
        -s-e-r-v-i-c-e-s-, -i-n-c-l-u-d-i-n-g -p-o-s-t---i-n-j-u-r-y 
        -s-u-p-e-r-v-i-s-e-d -p-r-o-g-r-a-m-s -f-a-c-i-l-i-t-a-t-i-n-g 
        -r-e-e-n-t-r-y -i-n-t-o -t-h-e -c-o-m-m-u-n-i-t-y-;
            -(-8-) -m-a-n-y -h-e-a-l-t-h -a-n-d -s-o-c-i-a-l 
        -s-e-r-v-i-c-e -a-g-e-n-c-i-e-s-, -b-o-t-h -p-u-b-l-i-c -a-n-d 
        -p-r-i-v-a-t-e-, -o-v-e-r-l-o-o-k-, -e-x-c-l-u-d-e -o-r 
        -i-n-a-d-e-q-u-a-t-e-l-y -s-e-r-v-e -i-n-d-i-v-i-d-u-a-l-s 
        -s-u-r-v-i-v-i-n-g -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-;
            -(-9-) -s-o-c-i-e-t-y -b-e-a-r-s -a-n -e-c-o-n-o-m-i-c 
        -c-o-s-t -o-f -a-p-p-r-o-x-i-m-a-t-e-l-y 
        -$-2-5-,-0-0-0-,-0-0-0-,-0-0-0 -p-e-r -y-e-a-r -f-o-r -t-h-e 
        -d-i-r-e-c-t -a-n-d -i-n-d-i-r-e-c-t -c-o-s-t-s -o-f 
        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-, -w-h-i-c-h 
        -i-n-c-l-u-d-e -m-e-d-i-c-a-l -t-r-e-a-t-m-e-n-t-, 
        -r-e-h-a-b-i-l-i-t-a-t-i-v-e -a-n-d -s-u-p-p-o-r-t 
        -s-e-r-v-i-c-e-s -a-n-d -l-o-s-t -i-n-c-o-m-e-;
            -(-1-0-) -a -p-r-o-g-r-a-m -t-o -d-e-v-e-l-o-p 
        -n-a-t-i-o-n-a-l -s-t-a-n-d-a-r-d-s -f-o-r -h-e-l-m-e-t-s 
        -u-s-e-d -b-y -b-i-c-y-c-l-i-s-t-s -a-n-d -o-t-h-e-r-s -i-s 
        -n-e-e-d-e-d-; -a-n-d
            -(-1-1-) -a -n-a-t-i-o-n-a-l -p-l-a-n -t-o -p-r-o-v-i-d-e 
        -s-e-r-v-i-c-e-s -f-o-r -i-n-d-i-v-i-d-u-a-l-s 
        -s-u-r-v-i-v-i-n-g -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
        -i-n-j-u-r-i-e-s -a-n-d -t-h-e-i-r -f-a-m-i-l-i-e-s -i-s 
        -n-e-e-d-e-d-.
    -(-b-) -P-u-r-p-o-s-e-.----I-t -i-s -t-h-e -p-u-r-p-o-s-e -o-f 
-t-h-i-s -A-c-t -t-o---
            -(-1-) -f-a-c-i-l-i-t-a-t-e -t-h-e -c-o-n-d-u-c-t -o-f 
        -r-e-s-e-a-r-c-h -a-n-d -t-h-e -c-o-l-l-e-c-t-i-o-n -a-n-d 
        -c-o-m-p-i-l-i-n-g -o-f -a-c-c-u-r-a-t-e -s-t-a-t-i-s-t-i-c-a-l 
        -d-a-t-a -o-n -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-;
            -(-2-) -r-a-i-s-e -p-u-b-l-i-c -a-w-a-r-e-n-e-s-s 
        -c-o-n-c-e-r-n-i-n-g -t-h-e -r-i-s-k-s -a-n-d 
        -c-o-n-s-e-q-u-e-n-c-e-s -o-f -s-u-c-h -i-n-j-u-r-i-e-s -a-n-d 
        -t-h-e -d-i-s-t-i-n-c-t -n-e-e-d-s -o-f -i-n-d-i-v-i-d-u-a-l-s 
        -(-a-n-d -t-h-e-i-r -f-a-m-i-l-i-e-s-) -f-o-l-l-o-w-i-n-g 
        -s-u-r-v-i-v-a-l -f-r-o-m -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
        -i-n-j-u-r-y-;
            -(-3-) -p-r-o-m-o-t-e -t-h-e -c-r-e-a-t-i-o-n -o-f 
        -i-n-n-o-v-a-t-i-v-e -p-r-o-g-r-a-m-s -a-n-d -p-o-l-i-c-i-e-s 
        -t-o -p-r-e-v-e-n-t -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y 
        -a-n-d -t-o -r-e-h-a-b-i-l-i-t-a-t-e -t-h-o-s-e 
        -i-n-d-i-v-i-d-u-a-l-s -w-h-o -h-a-v-e -s-u-r-v-i-v-e-d 
        -s-u-c-h -i-n-j-u-r-i-e-s-;
            -(-4-) -d-e-s-i-g-n-a-t-e -a -F-e-d-e-r-a-l -a-g-e-n-c-y 
        -t-o -o-v-e-r-s-e-e -a-n-d -p-r-o-m-o-t-e -p-r-o-j-e-c-t-s 
        -r-e-l-a-t-i-n-g -t-o -t-h-e -p-r-e-v-e-n-t-i-o-n -o-f-, -a-n-d 
        -r-e-h-a-b-i-l-i-t-a-t-i-o-n -f-r-o-m-, -t-r-a-u-m-a-t-i-c 
        -b-r-a-i-n -i-n-j-u-r-y-;
            -(-5-) -c-r-e-a-t-e -S-t-a-t-e -a-d-v-i-s-o-r-y 
        -b-o-a-r-d-s -t-o -c-o-o-r-d-i-n-a-t-e -c-i-t-i-z-e-n 
        -p-a-r-t-i-c-i-p-a-t-i-o-n -i-n -c-o-m-m-u-n-i-t-y 
        -p-r-o-g-r-a-m-s -d-e-a-l-i-n-g -w-i-t-h -t-r-a-u-m-a-t-i-c 
        -b-r-a-i-n -i-n-j-u-r-y-;
            -(-6-) -c-r-e-a-t-e -a -r-e-g-i-s-t-r-y -t-o -a-d-v-a-n-c-e 
        -e-p-i-d-e-m-i-o-l-o-g-i-c -r-e-s-e-a-r-c-h -o-n -s-u-c-h 
        -t-r-a-u-m-a-;
            -(-7-) -e-s-t-a-b-l-i-s-h -s-t-a-n-d-a-r-d-s -f-o-r -t-h-e 
        -m-a-r-k-e-t-i-n-g -o-f -b-r-a-i-n -i-n-j-u-r-y 
        -s-e-r-v-i-c-e-s-;
            -(-8-) -r-e-q-u-i-r-e -t-h-e -S-e-c-r-e-t-a-r-y -t-o 
        -p-u-b-l-i-s-h -v-a-r-i-o-u-s -r-e-p-o-r-t-s 
        -c-o-n-c-e-r-n-i-n-g -t-h-e -a-c-t-i-v-i-t-i-e-s -o-f -t-h-e 
        -D-e-p-a-r-t-m-e-n-t -o-f -H-e-a-l-t-h -a-n-d -H-u-m-a-n 
        -S-e-r-v-i-c-e-s -i-n -t-h-i-s -a-r-e-a-, -i-n-c-l-u-d-i-n-g 
        -a-n -a-n-n-u-a-l -r-e-v-i-e-w -o-f -r-e-l-e-v-a-n-t 
        -a-c-t-i-v-i-t-i-e-s-; -a-n-d
            -(-9-) -p-r-o-v-i-d-e -f-o-r -t-h-e -i-n-i-t-i-a-t-i-o-n 
        -o-f -a -p-r-o-g-r-a-m -t-o -e-s-t-a-b-l-i-s-h -n-a-t-i-o-n-a-l 
        -s-t-a-n-d-a-r-d-s -f-o-r -h-e-l-m-e-t-s -u-s-e-d -b-y 
        -b-i-c-y-c-l-i-s-t-s -a-n-d -o-t-h-e-r-s-.

-S-E-C-. -3-. -A-M-E-N-D-M-E-N-T -T-O -P-U-B-L-I-C -H-E-A-L-T-H 
              -S-E-R-V-I-C-E -A-C-T-.

    -T-i-t-l-e -X-I-I -o-f -t-h-e -P-u-b-l-i-c -H-e-a-l-t-h 
-S-e-r-v-i-c-e -A-c-t -(-4-2 -U-.-S-.-C-. -3-0-0-d -e-t -s-e-q-.-) -i-s 
-a-m-e-n-d-e-d---
            -(-1-) -b-y -r-e-d-e-s-i-g-n-a-t-i-n-g -p-a-r-t -C -a-s 
        -p-a-r-t -D-;
            -(-2-) -i-n -s-e-c-t-i-o-n -1-2-3-2-(-a-) -(-4-2 
        -U-.-S-.-C-. -3-0-0-d---3-2-(-a-)-)-, -b-y -i-n-s-e-r-t-i-n-g 
        -`-`-o-t-h-e-r -t-h-a-n -p-a-r-t -C-,-'-' -a-f-t-e-r 
        -`-`-c-a-r-r-y-i-n-g -o-u-t -t-h-i-s -t-i-t-l-e-,-'-'-; -a-n-d
            -(-3-) -b-y -i-n-s-e-r-t-i-n-g -a-f-t-e-r -p-a-r-t -B-, 
        -t-h-e -f-o-l-l-o-w-i-n-g -n-e-w -p-a-r-t-:

      -`-`-P-a-r-t -C---T-r-a-u-m-a-t-i-c -B-r-a-i-n -I-n-j-u-r-y

-`-`-S-E-C-. -1-2-2-5-. -D-E-F-I-N-I-T-I-O-N-S-.

    -`-`-A-s -u-s-e-d -i-n -t-h-i-s -p-a-r-t-:
            -`-`-(-1-) -A-d-m-i-n-i-s-t-r-a-t-o-r-.----T-h-e -t-e-r-m 
        -`-A-d-m-i-n-i-s-t-r-a-t-o-r-' -m-e-a-n-s -t-h-e 
        -A-d-m-i-n-i-s-t-r-a-t-o-r -o-f -t-h-e -A-g-e-n-c-y -f-o-r 
        -H-e-a-l-t-h -C-a-r-e -P-o-l-i-c-y -a-n-d -R-e-s-e-a-r-c-h-.
            -`-`-(-2-) -D-i-r-e-c-t-o-r-.----T-h-e -t-e-r-m 
        -`-D-i-r-e-c-t-o-r-' -m-e-a-n-s -t-h-e -D-i-r-e-c-t-o-r -o-f 
        -t-h-e -C-e-n-t-e-r-s -f-o-r -D-i-s-e-a-s-e -C-o-n-t-r-o-l 
        -a-n-d -P-r-e-v-e-n-t-i-o-n-.
            -`-`-(-3-) -T-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-.---
        -T-h-e -t-e-r-m -`-t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-' 
        -m-e-a-n-s -a-n -a-c-q-u-i-r-e-d -i-n-j-u-r-y -t-o -t-h-e 
        -b-r-a-i-n -c-a-u-s-e-d -b-y -a-n -e-x-t-e-r-n-a-l 
        -p-h-y-s-i-c-a-l -f-o-r-c-e-. -S-u-c-h -t-e-r-m -d-o-e-s -n-o-t 
        -i-n-c-l-u-d-e -b-r-a-i-n -d-y-s-f-u-n-c-t-i-o-n -c-a-u-s-e-d 
        -b-y -c-o-n-g-e-n-i-t-a-l -o-r -d-e-g-e-n-e-r-a-t-i-v-e 
        -d-i-s-o-r-d-e-r-s-, -n-o-r -d-o-e-s -s-u-c-h -t-e-r-m 
        -i-n-c-l-u-d-e -b-i-r-t-h -t-r-a-u-m-a-. -S-u-c-h -t-e-r-m -i-s 
        -s-y-n-o-n-y-m-o-u-s -w-i-t-h -t-h-e -t-e-r-m -`-h-e-a-d 
        -i-n-j-u-r-y-'-.

-`-`-S-E-C-. -1-2-2-5-A-. -A-G-E-N-C-Y -F-O-R -H-E-A-L-T-H -C-A-R-E 
              -P-O-L-I-C-Y -A-N-D -R-E-S-E-A-R-C-H -S-T-U-D-Y -O-F 
              -E-F-F-E-C-T-I-V-E-N-E-S-S -O-F -T-R-A-U-M-A-T-I-C 
              -B-R-A-I-N -I-N-J-U-R-Y -I-N-T-E-R-V-E-N-T-I-O-N-S-.

    -`-`-(-a-) -I-n -G-e-n-e-r-a-l-.----T-h-e -S-e-c-r-e-t-a-r-y-, 
-a-c-t-i-n-g -t-h-r-o-u-g-h -t-h-e -A-d-m-i-n-i-s-t-r-a-t-o-r-, 
-s-h-a-l-l -c-o-n-d-u-c-t -a -s-t-u-d-y -c-o-n-c-e-r-n-i-n-g 
-t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-.
    -`-`-(-b-) -M-a-j-o-r -F-i-n-d-i-n-g-s-.----T-h-e -s-t-u-d-y 
-c-o-n-d-u-c-t-e-d -u-n-d-e-r -s-u-b-s-e-c-t-i-o-n -(-a-) -s-h-a-l-l 
-s-e-e-k -t-o---
            -`-`-(-1-) -i-d-e-n-t-i-f-y -c-o-m-m-o-n 
        -t-h-e-r-a-p-e-u-t-i-c -i-n-t-e-r-v-e-n-t-i-o-n-s -w-h-i-c-h 
        -a-r-e -u-s-e-d -f-o-r -t-h-e -r-e-h-a-b-i-l-i-t-a-t-i-o-n -o-f 
        -i-n-d-i-v-i-d-u-a-l-s -w-i-t-h -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
        -i-n-j-u-r-i-e-s-, -a-n-d -s-h-a-l-l -i-n-c-l-u-d-e -a-n 
        -a-n-a-l-y-s-i-s -o-f---
                    -`-`-(-A-) -t-h-e -e-f-f-e-c-t-i-v-e-n-e-s-s -o-f 
                -e-a-c-h -s-u-c-h -i-n-t-e-r-v-e-n-t-i-o-n -i-n 
                -i-m-p-r-o-v-i-n-g -t-h-e -f-u-n-c-t-i-o-n-i-n-g -o-f 
                -i-n-d-i-v-i-d-u-a-l-s -w-i-t-h -b-r-a-i-n 
                -i-n-j-u-r-i-e-s-; -a-n-d
                    -`-`-(-B-) -t-h-e -c-o-m-p-a-r-a-t-i-v-e 
                -e-f-f-e-c-t-i-v-e-n-e-s-s -o-f 
                -i-n-t-e-r-v-e-n-t-i-o-n-s -e-m-p-l-o-y-e-d -i-n -t-h-e 
                -c-o-u-r-s-e -o-f -r-e-h-a-b-i-l-i-t-a-t-i-o-n -o-f 
                -i-n-d-i-v-i-d-u-a-l-s -w-i-t-h -b-r-a-i-n 
                -i-n-j-u-r-i-e-s -t-o -a-c-h-i-e-v-e -t-h-e -s-a-m-e 
                -o-r -s-i-m-i-l-a-r -c-l-i-n-i-c-a-l -o-u-t-c-o-m-e-; 
                -a-n-d
            -`-`-(-2-) -d-e-v-e-l-o-p -p-r-a-c-t-i-c-e 
        -g-u-i-d-e-l-i-n-e-s -f-o-r -t-h-e -r-e-h-a-b-i-l-i-t-a-t-i-o-n 
        -o-f -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-.
    -`-`-(-c-) -R-e-p-o-r-t-i-n-g -R-e-q-u-i-r-e-m-e-n-t-s-.----N-o-t 
-l-a-t-e-r -t-h-a-n -4 -y-e-a-r-s -a-f-t-e-r -t-h-e -d-a-t-e -o-f 
-e-n-a-c-t-m-e-n-t -o-f -t-h-i-s -p-a-r-t-, -t-h-e -S-e-c-r-e-t-a-r-y 
-s-h-a-l-l -p-r-e-p-a-r-e -a-n-d -s-u-b-m-i-t -t-o -t-h-e 
-a-p-p-r-o-p-r-i-a-t-e -c-o-m-m-i-t-t-e-e-s -o-f -C-o-n-g-r-e-s-s-, -a 
-r-e-p-o-r-t -c-o-n-t-a-i-n-i-n-g -t-h-e -r-e-s-u-l-t-s -o-f -t-h-e 
-s-t-u-d-i-e-s -c-o-n-d-u-c-t-e-d -u-n-d-e-r -t-h-i-s -s-e-c-t-i-o-n-.
    -`-`-(-d-) -A-u-t-h-o-r-i-z-a-t-i-o-n -o-f 
-A-p-p-r-o-p-r-i-a-t-i-o-n-.----T-h-e-r-e -a-r-e -a-u-t-h-o-r-i-z-e-d 
-t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d -t-o -c-a-r-r-y -o-u-t -t-h-i-s 
-s-e-c-t-i-o-n-, -$-2-,-0-0-0-,-0-0-0 -f-o-r -f-i-s-c-a-l -y-e-a-r 
-1-9-9-4-, -a-n-d -s-u-c-h -s-u-m-s -a-s -m-a-y -b-e -n-e-c-e-s-s-a-r-y 
-f-o-r -e-a-c-h -o-f -t-h-e -f-i-s-c-a-l -y-e-a-r-s -1-9-9-5 
-t-h-r-o-u-g-h -1-9-9-6-.

-`-`-S-E-C-. -1-2-2-5-B-. -C-E-N-T-E-R-S -F-O-R -D-I-S-E-A-S-E 
              -C-O-N-T-R-O-L -A-N-D -P-R-E-V-E-N-T-I-O-N -S-T-U-D-Y 
              -O-F -T-R-A-U-M-A-T-I-C -B-R-A-I-N -I-N-J-U-R-Y 
              -O-C-C-U-R-R-E-N-C-E-.

    -`-`-(-a-) -I-n -G-e-n-e-r-a-l-.----T-h-e -S-e-c-r-e-t-a-r-y-, 
-a-c-t-i-n-g -t-h-r-o-u-g-h -t-h-e -D-i-r-e-c-t-o-r-, -a-n-d -i-n 
-c-o-o-p-e-r-a-t-i-o-n -w-i-t-h -o-t-h-e-r -P-u-b-l-i-c -H-e-a-l-t-h 
-S-e-r-v-i-c-e -a-g-e-n-c-i-e-s -a-s -m-a-y -b-e -n-e-c-e-s-s-a-r-y-, 
-s-h-a-l-l -c-o-n-d-u-c-t -s-t-u-d-i-e-s -c-o-n-c-e-r-n-i-n-g 
-t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-, -a-n-d -s-h-a-l-l 
-e-s-t-a-b-l-i-s-h -a -r-e-p-o-r-t-i-n-g -s-y-s-t-e-m -u-n-d-e-r 
-s-u-b-s-e-c-t-i-o-n -(-b-)-.
    -`-`-(-b-) -R-e-p-o-r-t-i-n-g -S-y-s-t-e-m-.----T-o -a-s-s-i-s-t 
-i-n -d-a-t-a -a-n-d -i-n-f-o-r-m-a-t-i-o-n -g-a-t-h-e-r-i-n-g-, -t-h-e 
-D-i-r-e-c-t-o-r -s-h-a-l-l -e-s-t-a-b-l-i-s-h -a -u-n-i-f-o-r-m 
-r-e-p-o-r-t-i-n-g -s-y-s-t-e-m -u-n-d-e-r -w-h-i-c-h 
-h-o-s-p-i-t-a-l-s-, -S-t-a-t-e -a-n-d -l-o-c-a-l -h-e-a-l-t-h 
-r-e-l-a-t-e-d -a-g-e-n-c-i-e-s -w-i-l-l -r-e-p-o-r-t -t-o -t-h-e 
-D-i-r-e-c-t-o-r -o-n -m-a-t-t-e-r-s -i-n-c-l-u-d-i-n-g---
            -`-`-(-1-) -t-h-e -o-c-c-u-r-r-e-n-c-e -o-f 
        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-i-e-s-; -a-n-d
            -`-`-(-2-) -t-h-e -h-e-a-l-t-h -i-n-s-u-r-a-n-c-e 
        -s-t-a-t-u-s -o-f -i-n-d-i-v-i-d-u-a-l-s -w-i-t-h 
        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-.
-T-h-e -r-e-p-o-r-t-i-n-g -s-y-s-t-e-m -s-h-o-u-l-d -b-e 
-e-s-t-a-b-l-i-s-h-e-d -t-o -p-e-r-m-i-t -t-h-e -D-i-r-e-c-t-o-r -t-o 
-m-a-k-e -a-n -a-c-c-u-r-a-t-e -a-s-s-e-s-s-m-e-n-t -o-f 
-r-e-s-o-u-r-c-e -n-e-e-d-s -a-n-d -l-o-n-g -t-e-r-m -o-u-t-c-o-m-e-s-.
    -`-`-(-c-) -S-u-r-v-e-y -a-n-d -C-o-o-p-e-r-a-t-i-v-e 
-A-g-r-e-e-m-e-n-t-s-.---
            -`-`-(-1-) -S-u-r-v-e-y-.----T-h-e -D-i-r-e-c-t-o-r 
        -s-h-a-l-l -d-e-t-e-r-m-i-n-e -w-h-i-c-h -F-e-d-e-r-a-l-, 
        -S-t-a-t-e-, -l-o-c-a-l -o-r -o-t-h-e-r -e-n-t-i-t-i-e-s 
        -c-o-l-l-e-c-t -d-a-t-a -o-n -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
        -i-n-j-u-r-y -a-n-d -t-h-e -m-e-a-n-s -b-y -w-h-i-c-h -s-u-c-h 
        -e-n-t-i-t-i-e-s -c-o-l-l-e-c-t -s-u-c-h -d-a-t-a-.
            -`-`-(-2-) -C-o-o-p-e-r-a-t-i-v-e -a-g-r-e-e-m-e-n-t-s-.---
        -T-h-e -D-i-r-e-c-t-o-r -m-a-y -e-n-t-e-r -i-n-t-o 
        -c-o-o-p-e-r-a-t-i-v-e -a-g-r-e-e-m-e-n-t-s -w-i-t-h -o-t-h-e-r 
        -a-g-e-n-c-i-e-s-, -a-n-d -p-r-o-v-i-d-e -a-s-s-i-s-t-a-n-c-e 
        -t-o -o-t-h-e-r -e-n-t-i-t-i-e-s -w-i-t-h 
        -r-e-s-p-o-n-s-i-b-i-l-i-t-y -f-o-r -d-a-t-a 
        -c-o-l-l-e-c-t-i-o-n-, -t-o -e-s-t-a-b-l-i-s-h 
        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y -a-s -a 
        -s-p-e-c-i-f-i-c -r-e-p-o-r-t-a-b-l-e -c-o-n-d-i-t-i-o-n -i-n 
        -e-x-i-s-t-i-n-g -a-n-d -f-u-t-u-r-e -r-e-p-o-r-t-i-n-g 
        -s-y-s-t-e-m-s-. -A-n-y -d-a-t-a -s-y-s-t-e-m-s 
        -e-s-t-a-b-l-i-s-h-e-d -i-n -c-o-n-j-u-n-c-t-i-o-n -w-i-t-h 
        -s-u-c-h -a-g-e-n-c-i-e-s -s-h-o-u-l-d -b-e 
        -c-o-m-p-a-t-i-b-l-e -w-i-t-h -o-t-h-e-r -s-u-c-h -d-a-t-a 
        -s-y-s-t-e-m-s-.
    -`-`-(-d-) -M-a-j-o-r -F-i-n-d-i-n-g-s -o-f -S-t-u-d-i-e-s-.---
-T-h-e -s-t-u-d-i-e-s -c-o-n-d-u-c-t-e-d -u-n-d-e-r 
-s-u-b-s-e-c-t-i-o-n -(-a-) -s-h-a-l-l -s-e-e-k -t-o---
            -`-`-(-1-) -d-e-t-e-r-m-i-n-e -t-h-e -m-a-j-o-r 
        -c-a-u-s-e-s -o-f -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-;
            -`-`-(-2-) -d-e-t-e-r-m-i-n-e -t-h-e -p-r-e-v-e-n-t-i-v-e 
        -e-f-f-o-r-t-s -t-h-a-t -a-r-e -b-e-i-n-g -u-s-e-d -b-y 
        -S-t-a-t-e-s -a-n-d -n-o-n---p-r-o-f-i-t -a-g-e-n-c-i-e-s -t-o 
        -r-e-d-u-c-e -t-h-e -o-c-c-u-r-r-e-n-c-e -o-f -s-u-c-h 
        -i-n-j-u-r-i-e-s-;
            -`-`-(-3-) -d-e-t-e-r-m-i-n-e -t-h-e -n-u-m-b-e-r -o-f 
        -i-n-d-i-v-i-d-u-a-l-s -s-u-r-v-i-v-i-n-g -t-r-a-u-m-a-t-i-c 
        -b-r-a-i-n -i-n-j-u-r-i-e-s-, -a-n-d -t-h-e -c-o-s-t -o-f 
        -t-r-e-a-t-m-e-n-t -a-n-d -o-t-h-e-r -r-e-l-a-t-e-d 
        -c-o-s-t-s-;
            -`-`-(-4-) -d-e-v-e-l-o-p -a -u-n-i-f-o-r-m 
        -r-e-p-o-r-t-i-n-g -s-y-s-t-e-m -t-o -f-a-c-i-l-i-t-a-t-e 
        -t-h-e -r-e-p-o-r-t-i-n-g -t-o -t-h-e -C-e-n-t-e-r-s -f-o-r 
        -D-i-s-e-a-s-e -C-o-n-t-r-o-l -a-n-d -P-r-e-v-e-n-t-i-o-n 
        -c-o-n-c-e-r-n-i-n-g -t-h-e -o-c-c-u-r-r-e-n-c-e -o-f 
        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-;
            -`-`-(-5-) -i-d-e-n-t-i-f-y -S-t-a-t-e-s -a-n-d 
        -l-o-c-a-l-i-t-i-e-s -t-h-a-t -h-a-v-e -a-p-p-r-o-v-e-d 
        -m-a-n-d-a-t-e-d -h-e-l-m-e-t -u-s-e -l-a-w-s -f-o-r 
        -b-i-c-y-c-l-i-s-t -a-n-d -o-t-h-e-r-s-;
            -`-`-(-6-) -d-e-t-e-r-m-i-n-e -t-h-e -h-e-a-l-t-h 
        -i-n-s-u-r-a-n-c-e -s-t-a-t-u-s -o-f -i-n-d-i-v-i-d-u-a-l-s 
        -w-i-t-h -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-; -a-n-d
            -`-`-(-7-) -i-n-i-t-i-a-t-e -a -p-r-o-g-r-a-m -o-f 
        -p-r-e-v-e-n-t-i-o-n -r-e-s-e-a-r-c-h -t-o -d-e-v-e-l-o-p 
        -e-f-f-e-c-t-i-v-e -p-r-e-v-e-n-t-i-o-n -o-f -t-r-a-u-m-a-t-i-c 
        -b-r-a-i-n -i-n-j-u-r-y-.
    -`-`-(-e-) -R-e-p-o-r-t-i-n-g -R-e-q-u-i-r-e-m-e-n-t-s-.----N-o-t 
-l-a-t-e-r -t-h-a-n -4 -y-e-a-r-s -a-f-t-e-r -t-h-e -d-a-t-e -o-f 
-e-n-a-c-t-m-e-n-t -o-f -t-h-i-s -p-a-r-t-, -t-h-e -S-e-c-r-e-t-a-r-y 
-s-h-a-l-l -p-r-e-p-a-r-e -a-n-d -s-u-b-m-i-t -t-o -t-h-e 
-a-p-p-r-o-p-r-i-a-t-e -c-o-m-m-i-t-t-e-e-s -o-f -C-o-n-g-r-e-s-s-, -a 
-r-e-p-o-r-t -c-o-n-t-a-i-n-i-n-g -t-h-e -r-e-s-u-l-t-s -o-f -t-h-e 
-s-t-u-d-i-e-s -c-o-n-d-u-c-t-e-d -u-n-d-e-r -t-h-i-s -s-e-c-t-i-o-n-.
    -`-`-(-f-) -B-i-e-n-n-i-a-l -R-e-p-o-r-t-.----T-h-e 
-S-e-c-r-e-t-a-r-y -s-h-a-l-l -b-i-e-n-n-i-a-l-l-y -p-r-e-p-a-r-e -a 
-r-e-p-o-r-t -c-o-n-t-a-i-n-i-n-g -r-e-c-o-m-m-e-n-d-a-t-i-o-n-s -f-o-r 
-t-h-e -p-r-e-v-e-n-t-i-o-n -o-f -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
-i-n-j-u-r-i-e-s-. -T-h-e -r-e-p-o-r-t -s-h-a-l-l -a-l-s-o 
-i-d-e-n-t-i-f-y -S-t-a-t-e-s -t-h-a-t -h-a-v-e -m-a-n-d-a-t-e-d 
-h-e-l-m-e-t -l-a-w-s -f-o-r -b-i-c-y-c-l-i-s-t-s -a-n-d -o-t-h-e-r-s-. 
-S-u-c-h -r-e-p-o-r-t-s -s-h-a-l-l -b-e -d-i-s-s-e-m-i-n-a-t-e-d -t-o 
-S-t-a-t-e -h-e-a-l-t-h -o-f-f-i-c-e-r-s-.
    -`-`-(-g-) -A-u-t-h-o-r-i-z-a-t-i-o-n -o-f 
-A-p-p-r-o-p-r-i-a-t-i-o-n-,----T-h-e-r-e -a-r-e -a-u-t-h-o-r-i-z-e-d 
-t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d -t-o -c-a-r-r-y -o-u-t -t-h-i-s 
-s-e-c-t-i-o-n-, -$-2-,-0-0-0-,-0-0-0 -f-o-r -f-i-s-c-a-l -y-e-a-r 
-1-9-9-4-, -a-n-d -s-u-c-h -s-u-m-s -a-s -m-a-y -b-e -n-e-c-e-s-s-a-r-y 
-f-o-r -e-a-c-h -o-f -t-h-e -f-i-s-c-a-l -y-e-a-r-s -1-9-9-5 
-t-h-r-o-u-g-h -1-9-9-6-.

-`-`-S-E-C-. -1-2-2-5-C-. -S-P-E-C-I-A-L -P-R-E-V-E-N-T-I-O-N 
              -P-R-O-J-E-C-T-S-.

    -`-`-(-a-) -I-n -G-e-n-e-r-a-l-.----T-h-e -S-e-c-r-e-t-a-r-y 
-s-h-a-l-l -c-o-o-p-e-r-a-t-e -w-i-t-h-, -a-n-d -m-a-y -p-r-o-v-i-d-e 
-a-s-s-i-s-t-a-n-c-e -t-o-, -p-u-b-l-i-c -a-n-d -p-r-i-v-a-t-e 
-n-o-n-p-r-o-f-i-t -e-n-t-i-t-i-e-s -t-o -r-e-d-u-c-e -t-h-e 
-i-n-c-i-d-e-n-c-e -o-f -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y 
-t-h-r-o-u-g-h -t-h-e -e-s-t-a-b-l-i-s-h-m-e-n-t -a-n-d 
-e-f-f-e-c-t-u-a-t-i-o-n -o-f -p-r-e-v-e-n-t-i-o-n -p-r-o-j-e-c-t-s-. 
-I-n -c-a-r-r-y-i-n-g -o-u-t -t-h-i-s -s-e-c-t-i-o-n-, -t-h-e 
-S-e-c-r-e-t-a-r-y -m-a-y -a-w-a-r-d -g-r-a-n-t-s -t-o -S-t-a-t-e 
-a-n-d -l-o-c-a-l -e-n-t-i-t-i-e-s-, -a-n-d -t-o -p-u-b-l-i-c -o-r 
-n-o-n---p-r-o-f-i-t -p-r-i-v-a-t-e -e-n-t-i-t-i-e-s-, -t-o 
-s-u-p-p-o-r-t---
            -`-`-(-1-) -s-p-e-c-i-a-l -p-r-e-v-e-n-t-i-o-n -a-n-d 
        -p-u-b-l-i-c -a-w-a-r-e-n-e-s-s -i-n-i-t-i-a-t-i-v-e 
        -p-r-o-j-e-c-t-s-;
            -`-`-(-2-) -m-o-d-e-l -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
        -i-n-j-u-r-y -p-r-e-v-e-n-t-i-o-n-, -r-e-s-e-a-r-c-h -a-n-d 
        -s-u-p-p-o-r-t -p-r-o-g-r-a-m-s-;
            -`-`-(-3-) -p-r-o-j-e-c-t-s -t-h-a-t -s-t-u-d-y -t-h-e 
        -s-e-r-v-i-c-e -n-e-e-d-s -o-f -i-n-d-i-v-i-d-u-a-l-s -w-i-t-h 
        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-; -a-n-d
            -`-`-(-4-) -p-r-o-j-e-c-t-s -i-n-v-o-l-v-i-n-g -g-r-a-n-t-s 
        -f-o-r -s-e-r-v-i-c-e-s -c-o-o-r-d-i-n-a-t-i-o-n-.
    -`-`-(-b-) -R-e-q-u-i-r-e-m-e-n-t-s-.----T-o -b-e -e-l-i-g-i-b-l-e 
-t-o -r-e-c-e-i-v-e -a-s-s-i-s-t-a-n-c-e -u-n-d-e-r 
-s-u-b-s-e-c-t-i-o-n -(-a-)-, -a-n -e-n-t-i-t-y -s-h-a-l-l---
            -`-`-(-1-) -p-r-e-p-a-r-e -a-n-d -s-u-b-m-i-t -t-o -t-h-e 
        -S-e-c-r-e-t-a-r-y -a-n -a-p-p-l-i-c-a-t-i-o-n-, -a-t -s-u-c-h 
        -t-i-m-e-, -i-n -s-u-c-h -m-a-n-n-e-r-, -a-n-d 
        -c-o-n-t-a-i-n-i-n-g -s-u-c-h -i-n-f-o-r-m-a-t-i-o-n -a-s 
        -t-h-e -S-e-c-r-e-t-a-r-y -m-a-y -r-e-q-u-i-r-e-; -a-n-d
            -`-`-(-2-) -p-r-o-v-i-d-e -a-s-s-u-r-a-n-c-e-s -t-o -t-h-e 
        -S-e-c-r-e-t-a-r-y -t-h-a-t -a-n-y -p-r-e-v-e-n-t-i-v-e 
        -m-e-a-s-u-r-e-s -i-m-p-l-e-m-e-n-t-e-d -u-n-d-e-r -a 
        -p-r-e-v-e-n-t-i-o-n -p-r-o-j-e-c-t -f-u-n-d-e-d -u-n-d-e-r 
        -t-h-i-s -s-e-c-t-i-o-n -m-a-y -i-n-c-l-u-d-e---
                    -`-`-(-A-) -b-e-h-a-v-i-o-r-a-l -a-n-d 
                -e-n-v-i-r-o-n-m-e-n-t-a-l -i-n-t-e-r-v-e-n-t-i-o-n-s 
                -(-s-u-c-h -a-s -p-h-y-s-i-c-a-l -r-e-s-t-r-a-i-n-t-s 
                -o-r -h-e-l-m-e-t-s -f-o-r -i-n-d-i-v-i-d-u-a-l-s 
                -u-s-i-n-g -b-i-c-y-c-l-e-s-, -i-n---l-i-n-e 
                -r-o-l-l-e-r -s-k-a-t-e-s-, -a-n-d 
                -s-k-a-t-e-b-o-a-r-d-s-;
                    -`-`-(-B-) -t-h-e -u-s-e -o-f -i-n-n-o-v-a-t-i-v-e 
                -a-n-d -p-r-o-v-e-n -m-o-d-e-l -p-r-e-v-e-n-t-i-o-n 
                -a-p-p-r-o-a-c-h-e-s-;
                    -`-`-(-C-) -t-h-e -p-r-o-m-o-t-i-o-n -o-f 
                -a-c-t-i-v-i-t-i-e-s -t-h-a-t -w-i-l-l -m-i-n-i-m-i-z-e 
                -b-r-a-i-n -i-n-j-u-r-y -r-i-s-k -i-n -a-t-h-l-e-t-e-s 
                -(-s-u-c-h -a-s -t-h-e -u-s-e -o-f -h-e-a-d 
                -p-r-o-t-e-c-t-i-o-n -g-e-a-r-)-; -a-n-d
                    -`-`-(-D-) -t-h-e -i-m-p-r-o-v-e-m-e-n-t -o-f 
                -c-o-m-m-u-n-i-t-y---l-e-v-e-l -a-c-c-e-s-s -t-o 
                -d-a-t-e---b-a-s-e -s-y-s-t-e-m-s -t-o -a-s-s-i-s-t 
                -i-n -d-e-s-i-g-n-i-n-g-, -d-e-v-e-l-o-p-i-n-g-, -a-n-d 
                -i-m-p-l-e-m-e-n-t-i-n-g -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
                -i-n-j-u-r-y -p-r-e-v-e-n-t-i-o-n -p-r-o-g-r-a-m-s-.
    -`-`-(-c-) -A-u-t-h-o-r-i-z-a-t-i-o-n -o-f 
-A-p-p-r-o-p-r-i-a-t-i-o-n-s-.----T-h-e-r-e -a-r-e -a-u-t-h-o-r-i-z-e-d 
-t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d -t-o -c-a-r-r-y -o-u-t -t-h-i-s 
-s-e-c-t-i-o-n-, -$-4-,-0-0-0-,-0-0-0 -f-o-r -f-i-s-c-a-l -y-e-a-r 
-1-9-9-4-, -a-n-d -s-u-c-h -s-u-m-s -a-s -m-a-y -b-e -n-e-c-e-s-s-a-r-y 
-f-o-r -e-a-c-h -o-f -t-h-e -f-i-s-c-a-l -y-e-a-r-s -1-9-9-5 -a-n-d 
-1-9-9-6-.

-`-`-S-E-C-. -1-2-2-5-D-. -B-A-S-I-C -A-N-D -A-P-P-L-I-E-D 
              -R-E-S-E-A-R-C-H-.

    -`-`-(-a-) -I-n -G-e-n-e-r-a-l-.----T-h-e -S-e-c-r-e-t-a-r-y-, 
-a-c-t-i-n-g -t-h-r-o-u-g-h -t-h-e -D-i-r-e-c-t-o-r -o-f -t-h-e 
-N-a-t-i-o-n-a-l -I-n-s-t-i-t-u-t-e-s -o-f -H-e-a-l-t-h-, -m-a-y 
-p-r-o-v-i-d-e -a-s-s-i-s-t-a-n-c-e -t-o -p-u-b-l-i-c -a-n-d 
-p-r-i-v-a-t-e -n-o-n-p-r-o-f-i-t -e-n-t-i-t-i-e-s -t-o -s-u-p-p-o-r-t 
-t-h-e -c-o-n-d-u-c-t -o-f -b-a-s-i-c -a-n-d -a-p-p-l-i-e-d 
-r-e-s-e-a-r-c-h -c-o-n-c-e-r-n-i-n-g -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
-i-n-j-u-r-y-, -e-s-p-e-c-i-a-l-l-y -w-i-t-h -r-e-s-p-e-c-t -t-o -t-h-e 
-b-i-o-m-e-c-h-a-n-i-c-s -o-f -b-r-a-i-n -i-n-j-u-r-y-, -t-h-e 
-m-o-l-e-c-u-l-a-r -a-n-d -c-e-l-l-u-l-a-r 
-c-h-a-r-a-c-t-e-r-i-s-t-i-c-s -o-f -p-r-i-m-a-r-y -a-n-d 
-s-e-c-o-n-d-a-r-y -i-n-j-u-r-y -t-o -t-h-e -b-r-a-i-n -a-n-d -t-h-e 
-d-e-v-e-l-o-p-m-e-n-t -o-f -i-m-p-r-o-v-e-d -e-x-p-e-r-i-m-e-n-t-a-l 
-b-r-a-i-n -i-n-j-u-r-y -m-o-d-e-l-s-.
    -`-`-(-b-) -S-p-e-c-i-f-i-c -R-e-s-e-a-r-c-h-.----R-e-s-e-a-r-c-h 
-t-o -b-e -c-o-n-d-u-c-t-e-d -w-i-t-h -a-s-s-i-s-t-a-n-c-e 
-p-r-o-v-i-d-e-d -u-n-d-e-r -s-u-b-s-e-c-t-i-o-n -(-a-) -s-h-a-l-l -b-e 
-d-e-t-e-r-m-i-n-e-d -b-y -t-h-e -S-e-c-r-e-t-a-r-y-, -p-r-i-o-r -t-o 
-t-h-e -p-r-o-v-i-s-i-o-n -o-f -s-u-c-h -a-s-s-i-s-t-a-n-c-e-, -t-o 
-c-o-n-t-r-i-b-u-t-e -t-o -t-h-e -s-t-r-a-t-e-g-i-e-s -t-h-a-t -w-i-l-l 
-l-i-m-i-t -p-r-i-m-a-r-y -a-n-d -s-e-c-o-n-d-a-r-y 
-m-e-c-h-a-n-i-c-a-l-, -b-i-o-c-h-e-m-i-c-a-l -a-n-d -m-e-t-a-b-o-l-i-c 
-i-n-s-u-l-t-s -t-o -t-h-e -b-r-a-i-n -a-n-d -m-i-n-i-m-i-z-e -t-h-e 
-e-x-t-e-n-t-, -s-e-v-e-r-i-t-y -a-n-d -p-r-o-g-r-e-s-s-i-o-n -o-f 
-r-e-s-u-l-t-i-n-g -d-y-s-f-u-n-c-t-i-o-n-s-. -I-n 
-i-m-p-l-e-m-e-n-t-i-n-g -t-h-i-s -s-e-c-t-i-o-n -t-h-e 
-S-e-c-r-e-t-a-r-y -s-h-a-l-l -e-m-p-h-a-s-i-z-e---
            -`-`-(-1-) -t-h-e -d-e-v-e-l-o-p-m-e-n-t -o-f -n-e-w 
        -m-e-t-h-o-d-s -a-n-d -m-o-d-a-l-i-t-i-e-s -f-o-r -t-h-e 
        -m-o-r-e -e-f-f-e-c-t-i-v-e -d-i-a-g-n-o-s-i-s-, 
        -m-e-a-s-u-r-e-m-e-n-t -o-f -d-e-g-r-e-e -o-f -i-n-j-u-r-y-, 
        -p-o-s-t---i-n-j-u-r-y -m-o-n-i-t-o-r-i-n-g -a-n-d 
        -p-r-o-g-n-o-s-t-i-c -a-s-s-e-s-s-m-e-n-t -o-f -h-e-a-d 
        -i-n-j-u-r-y -f-o-r -a-c-u-t-e-, -s-u-b-a-c-u-t-e -a-n-d 
        -l-a-t-e-r -p-h-a-s-e-s -o-f -c-a-r-e-;
            -`-`-(-2-) -t-h-e -d-e-v-e-l-o-p-m-e-n-t-, 
        -m-o-d-i-f-i-c-a-t-i-o-n -a-n-d -e-v-a-l-u-a-t-i-o-n -o-f 
        -t-h-e-r-a-p-i-e-s -t-h-a-t -r-e-t-a-r-d-, -p-r-e-v-e-n-t -o-r 
        -r-e-v-e-r-s-e -b-r-a-i-n -d-a-m-a-g-e -a-f-t-e-r -a-c-u-t-e 
        -h-e-a-d -i-n-j-u-r-y-, -t-h-a-t -a-r-r-e-s-t -f-u-r-t-h-e-r 
        -d-e-t-e-r-i-o-r-a-t-i-o-n -f-o-l-l-o-w-i-n-g -i-n-j-u-r-y 
        -a-n-d -t-h-a-t -p-r-o-v-i-d-e -t-h-e -r-e-s-t-i-t-u-t-i-o-n 
        -o-f -f-u-n-c-t-i-o-n -f-o-r -i-n-d-i-v-i-d-u-a-l-s -w-i-t-h 
        -l-o-n-g---t-e-r-m -i-n-j-u-r-i-e-s-;
            -`-`-(-3-) -t-h-e -i-n-t-e-g-r-a-t-i-o-n -o-f -b-a-s-i-c 
        -r-e-s-e-a-r-c-h -i-n-t-o -c-l-i-n-i-c-a-l -c-a-r-e 
        -s-e-t-t-i-n-g-s-;
            -`-`-(-4-) -t-h-e -d-e-v-e-l-o-p-m-e-n-t -o-f -a 
        -c-o-n-t-i-n-u-u-m -o-f -c-a-r-e -f-r-o-m -a-c-u-t-e -c-a-r-e 
        -t-h-r-o-u-g-h -r-e-h-a-b-i-l-i-t-a-t-i-o-n-, 
        -d-e-s-i-g-n-e-d-, -t-o -t-h-e -e-x-t-e-n-t 
        -p-r-a-c-t-i-c-a-b-l-e-, -t-o -i-n-t-e-g-r-a-t-e 
        -r-e-h-a-b-i-l-i-t-a-t-i-o-n -a-n-d -l-o-n-g---t-e-r-m 
        -o-u-t-c-o-m-e -e-v-a-l-u-a-t-i-o-n -w-i-t-h -a-c-u-t-e 
        -c-a-r-e -r-e-s-e-a-r-c-h-;
            -`-`-(-5-) -t-h-e -d-e-v-e-l-o-p-m-e-n-t -o-f 
        -p-r-o-g-r-a-m-s -t-h-a-t -i-n-c-r-e-a-s-e -t-h-e 
        -p-a-r-t-i-c-i-p-a-t-i-o-n -o-f -a-c-a-d-e-m-i-c -c-e-n-t-e-r-s 
        -o-f -e-x-c-e-l-l-e-n-c-e -i-n -h-e-a-d -i-n-j-u-r-y 
        -t-r-e-a-t-m-e-n-t -a-n-d -r-e-h-a-b-i-l-i-t-a-t-i-o-n 
        -r-e-s-e-a-r-c-h -a-n-d -t-r-a-i-n-i-n-g-; -a-n-d
            -`-`-(-6-) -t-h-e -c-o-n-d-u-c-t -o-f -n-a-t-i-o-n-a-l 
        -c-o-n-s-e-n-s-u-s -c-o-n-f-e-r-e-n-c-e-s -o-n -m-a-n-a-g-i-n-g 
        -h-e-a-d -i-n-j-u-r-y -a-n-d -r-e-l-a-t-e-d 
        -r-e-h-a-b-i-l-i-t-a-t-i-o-n -c-o-n-c-e-r-n-s-, -t-h-e 
        -f-i-n-d-i-n-g-s -o-f -w-h-i-c-h -s-h-a-l-l -b-e 
        -p-u-b-l-i-s-h-e-d-.
    -`-`-(-c-) -A-u-t-h-o-r-i-z-a-t-i-o-n -o-f 
-A-p-p-r-o-p-r-i-a-t-i-o-n-s-.----T-h-e-r-e -a-r-e -a-u-t-h-o-r-i-z-e-d 
-t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d -t-o -c-a-r-r-y -o-u-t -t-h-i-s 
-s-e-c-t-i-o-n-, -$-5-,-0-0-0-,-0-0-0 -f-o-r -f-i-s-c-a-l -y-e-a-r 
-1-9-9-4-, -a-n-d -s-u-c-h -s-u-m-s -a-s -m-a-y -b-e -n-e-c-e-s-s-a-r-y 
-f-o-r -e-a-c-h -o-f -t-h-e -f-i-s-c-a-l -y-e-a-r-s -1-9-9-5 -a-n-d 
-1-9-9-6-.

-`-`-S-E-C-. -1-2-2-5-E-. -S-T-A-T-E-W-I-D-E -P-R-O-G-R-A-M -F-O-R 
              -T-R-A-U-M-A-T-I-C -B-R-A-I-N -I-N-J-U-R-Y-.

    -`-`-(-a-) -G-r-a-n-t-s-.----T-h-e -S-e-c-r-e-t-a-r-y -s-h-a-l-l 
-a-w-a-r-d -g-r-a-n-t-s -t-o -S-t-a-t-e-s -f-o-r -t-h-e 
-e-s-t-a-b-l-i-s-h-m-e-n-t -o-f -p-r-o-g-r-a-m-s -r-e-l-a-t-e-d -t-o 
-t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-. -S-u-c-h -p-r-o-g-r-a-m-s 
-s-h-a-l-l -i-n-c-l-u-d-e -S-t-a-t-e -a-d-v-i-s-o-r-y -b-o-a-r-d-s-, 
-p-a-t-i-e-n-t -a-d-v-o-c-a-c-y -a-n-d -s-e-r-v-i-c-e 
-c-o-o-r-d-i-n-a-t-i-o-n -s-y-s-t-e-m-s-, -a-n-d -S-t-a-t-e 
-r-e-g-i-s-t-r-i-e-s -c-o-n-c-e-r-n-i-n-g -i-n-d-i-v-i-d-u-a-l-s 
-a-f-f-e-c-t-e-d -b-y -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-i-e-s-. 
-S-e-r-v-i-c-e-s -m-a-y -a-l-s-o -b-e -p-r-o-v-i-d-e-d -u-n-d-e-r 
-t-h-i-s -s-e-c-t-i-o-n-, -w-i-t-h-i-n -t-h-e -l-i-m-i-t-s -o-f 
-s-e-r-v-i-c-e -a-v-a-i-l-a-b-i-l-i-t-y-, -t-o -i-n-d-i-v-i-d-u-a-l-s 
-w-h-o-s-e -d-e-f-i-c-i-t-s -a-r-e -n-o-t -d-u-e -t-o 
-t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-. -T-o -b-e -e-l-i-g-i-b-l-e 
-f-o-r -s-u-c-h -s-e-r-v-i-c-e-s-, -s-u-c-h -i-n-d-i-v-i-d-u-a-l-s 
-s-h-o-u-l-d -b-e -c-o-m-p-a-r-a-b-l-e -t-o -t-r-a-u-m-a-t-i-c 
-b-r-a-i-n -i-n-j-u-r-y -p-a-t-i-e-n-t-s -i-n -r-e-g-a-r-d -t-o -t-h-e 
-r-a-n-g-e -o-f -s-e-r-v-i-c-e-s -n-e-e-d-e-d-, -t-h-e -s-e-v-e-r-i-t-y 
-a-n-d -d-u-r-a-t-i-o-n -o-f -d-e-f-i-c-i-t-s-, -a-n-d -t-h-e 
-e-t-i-o-l-o-g-y -o-f -t-h-e-i-r -d-e-f-i-c-i-t-s -b-e-i-n-g -d-u-e 
-t-o -a -n-o-n-p-r-o-g-r-e-s-s-i-v-e -a-n-d -n-o-n-r-e-c-u-r-r-i-n-g 
-d-i-s-o-r-d-e-r-.
    -`-`-(-b-) -G-e-n-e-r-a-l -E-l-i-g-i-b-i-l-i-t-y 
-R-e-q-u-i-r-e-m-e-n-t-s-.----T-o -b-e -e-l-i-g-i-b-l-e -t-o 
-r-e-c-e-i-v-e -a -g-r-a-n-t -u-n-d-e-r -s-u-b-s-e-c-t-i-o-n -(-a-)-, 
-a -S-t-a-t-e -s-h-a-l-l---
            -`-`-(-1-) -p-r-e-p-a-r-e -a-n-d -s-u-b-m-i-t -t-o -t-h-e 
        -S-e-c-r-e-t-a-r-y -a-n -a-p-p-l-i-c-a-t-i-o-n-, -a-t -s-u-c-h 
        -t-i-m-e-, -i-n -s-u-c-h -m-a-n-n-e-r-, -a-n-d 
        -c-o-n-t-a-i-n-i-n-g -s-u-c-h -i-n-f-o-r-m-a-t-i-o-n -a-s 
        -t-h-e -S-e-c-r-e-t-a-r-y -m-a-y -r-e-q-u-i-r-e-;
            -`-`-(-2-) -p-r-o-v-i-d-e -a-s-s-u-r-a-n-c-e-s -t-h-a-t 
        -i-t -w-i-l-l -p-r-e-p-a-r-e -a-n-d -s-u-b-m-i-t -t-o -t-h-e 
        -S-e-c-r-e-t-a-r-y -r-e-p-o-r-t-s -d-e-s-c-r-i-b-i-n-g -t-h-e 
        -a-c-t-i-v-i-t-i-e-s -u-n-d-e-r-t-a-k-e-n -u-n-d-e-r -t-h-e 
        -S-t-a-t-e -s-y-s-t-e-m -e-s-t-a-b-l-i-s-h-e-d -u-n-d-e-r 
        -t-h-e -g-r-a-n-t-, -a-n-d
            -`-`-(-3-) -p-r-o-v-i-d-e -f-o-r -t-h-e 
        -e-s-t-a-b-l-i-s-h-m-e-n-t -o-f -a -S-t-a-t-e-w-i-d-e 
        -p-r-o-g-r-a-m -t-h-a-t -i-n-c-l-u-d-e-s -a -S-t-a-t-e 
        -r-e-g-i-s-t-r-y -f-o-r -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
        -i-n-j-u-r-y -i-n-f-o-r-m-a-t-i-o-n-, -a -p-r-o-g-r-a-m -o-f 
        -p-a-t-i-e-n-t -a-d-v-o-c-a-c-y -a-n-d -s-e-r-v-i-c-e 
        -c-o-o-r-d-i-n-a-t-i-o-n-, -a-n-d -a -S-t-a-t-e 
        -a-d-v-i-s-o-r-y -b-o-a-r-d -w-i-t-h -r-e-s-p-e-c-t -t-o 
        -a-c-t-i-v-i-t-i-e-s -u-n-d-e-r -t-h-i-s -s-e-c-t-i-o-n-.
    -`-`-(-c-) -S-p-e-c-i-f-i-c -P-r-o-g-r-a-m 
-R-e-q-u-i-r-e-m-e-n-t-s-.---
            -`-`-(-1-) -S-t-a-t-e -r-e-g-i-s-t-r-y-.----T-o -b-e 
        -e-l-i-g-i-b-l-e -t-o -r-e-c-e-i-v-e -a -g-r-a-n-t -u-n-d-e-r 
        -s-u-b-s-e-c-t-i-o-n -(-a-)-, -a -S-t-a-t-e -s-h-a-l-l---
                    -`-`-(-A-)-(-i-) -e-s-t-a-b-l-i-s-h -a-n-d 
                -m-a-i-n-t-a-i-n-, -t-h-r-o-u-g-h -t-h-e 
                -u-t-i-l-i-z-a-t-i-o-n -o-f -p-r-o-c-e-d-u-r-e-s -t-o 
                -e-n-s-u-r-e -p-r-i-v-a-c-y -a-n-d -m-a-i-n-t-a-i-n 
                -t-h-e -c-o-n-f-i-d-e-n-t-i-a-l-i-t-y -o-f 
                -i-n-f-o-r-m-a-t-i-o-n-, -w-h-i-c-h -a-r-e 
                -a-c-c-e-p-t-a-b-l-e -t-o -t-h-e -S-e-c-r-e-t-a-r-y-, 
                -a -c-e-n-t-r-a-l -r-e-g-i-s-t-r-y -o-f -p-e-r-s-o-n-s 
                -w-h-o -s-u-s-t-a-i-n -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
                -i-n-j-u-r-y -i-n -o-r-d-e-r -t-o---
                            -`-`-(-I-) -c-o-l-l-e-c-t 
                        -i-n-f-o-r-m-a-t-i-o-n -t-o 
                        -f-a-c-i-l-i-t-a-t-e -t-h-e 
                        -d-e-v-e-l-o-p-m-e-n-t -o-f -i-n-j-u-r-y 
                        -p-r-e-v-e-n-t-i-o-n-, -t-r-e-a-t-m-e-n-t-, 
                        -a-n-d -r-e-h-a-b-i-l-i-t-a-t-i-o-n 
                        -p-r-o-g-r-a-m-s-; -a-n-d
                            -`-`-(-I-I-) -r-e-p-o-r-t -d-a-t-a -t-o 
                        -t-h-e -D-i-r-e-c-t-o-r -o-n -a-n -a-n-n-u-a-l 
                        -b-a-s-i-s -f-o-r -S-t-a-t-e -r-e-p-o-r-t-i-n-g 
                        -r-e-q-u-i-r-e-m-e-n-t-s-; -a-n-d
                    -`-`-(-i-i-) -a -v-i-o-l-a-t-i-o-n -o-f -s-u-c-h 
                -p-r-i-v-a-c-y -a-n-d -c-o-n-f-i-d-e-n-t-i-a-l-i-t-y 
                -p-r-o-c-e-d-u-r-e-s -o-r -t-h-e 
                -u-n-a-u-t-h-o-r-i-z-e-d -u-s-e -o-f -s-u-c-h 
                -i-n-f-o-r-m-a-t-i-o-n -m-a-y -r-e-s-u-l-t -i-n -a 
                -l-o-s-s -o-f -s-u-p-p-o-r-t -u-n-d-e-r -t-h-i-s 
                -s-e-c-t-i-o-n-; -a-n-d
                    -`-`-(-B-) -p-r-o-v-i-d-e -s-u-m-m-a-r-y 
                -r-e-g-i-s-t-r-y -d-a-t-a -o-r -d-a-t-a -t-h-a-t -i-s 
                -n-o-t -p-e-r-s-o-n-a-l-l-y -i-d-e-n-t-i-f-i-a-b-l-e 
                -t-o -p-u-b-l-i-c -a-n-d -p-r-i-v-a-t-e 
                -e-n-t-i-t-i-e-s -t-o -c-o-n-d-u-c-t -s-t-u-d-i-e-s 
                -u-s-i-n-g -d-a-t-a -c-o-l-l-e-c-t-e-d -b-y -t-h-e 
                -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y 
                -r-e-g-i-s-t-r-y -e-s-t-a-b-l-i-s-h-e-d -u-n-d-e-r 
                -s-u-b-p-a-r-a-g-r-a-p-h -(-A-)-, -f-o-r -w-h-i-c-h 
                -t-h-e -c-o-o-r-d-i-n-a-t-o-r -m-a-y -c-h-a-r-g-e -a 
                -f-e-e -f-o-r -a-l-l -e-x-p-e-n-s-e-s 
                -a-s-s-o-c-i-a-t-e-d -w-i-t-h -t-h-e -p-r-o-v-i-s-i-o-n 
                -o-f -d-a-t-a -o-r -d-a-t-a -a-n-a-l-y-s-i-s-.
            -`-`-(-2-) -A-d-v-o-c-a-c-y -a-n-d -s-e-r-v-i-c-e 
        -c-o-o-r-d-i-n-a-t-i-o-n-.----T-o -b-e -e-l-i-g-i-b-l-e -t-o 
        -r-e-c-e-i-v-e -a -g-r-a-n-t -u-n-d-e-r -s-u-b-s-e-c-t-i-o-n 
        -(-a-)-, -a -S-t-a-t-e -s-h-a-l-l---
                    -`-`-(-A-) -d-e-s-i-g-n-a-t-e -a -S-t-a-t-e 
                -c-o-o-r-d-i-n-a-t-o-r -f-o-r -t-r-a-u-m-a-t-i-c 
                -b-r-a-i-n -i-n-j-u-r-i-e-s -w-h-o---
                            -`-`-(-i-) -s-h-a-l-l -e-s-t-a-b-l-i-s-h 
                        -p-o-l-i-c-i-e-s -a-n-d -s-t-a-n-d-a-r-d-s 
                        -f-o-r -c-o-o-r-d-i-n-a-t-i-n-g 
                        -s-e-r-v-i-c-e-s -w-i-t-h-i-n -t-h-e -S-t-a-t-e 
                        -f-o-r -i-n-d-i-v-i-d-u-a-l-s -w-i-t-h 
                        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-;
                            -`-`-(-i-i-) -m-a-y -c-o-n-t-r-a-c-t 
                        -w-i-t-h -q-u-a-l-i-f-i-e-d -a-g-e-n-c-i-e-s 
                        -o-r -e-m-p-l-o-y -s-t-a-f-f -t-o 
                        -p-r-o-v-i-d-e -s-e-r-v-i-c-e-s -u-n-d-e-r 
                        -t-h-i-s -s-e-c-t-i-o-n -o-n -a 
                        -s-t-a-t-e-w-i-d-e -b-a-s-i-s -t-o 
                        -e-l-i-g-i-b-l-e -i-n-d-i-v-i-d-u-a-l-s-;
                            -`-`-(-i-i-i-) -s-h-a-l-l -b-e 
                        -r-e-s-p-o-n-s-i-b-l-e -f-o-r -a -p-r-o-g-r-a-m 
                        -o-f -a-c-t-i-v-i-t-i-e-s -r-e-l-a-t-e-d -t-o 
                        -p-r-e-v-e-n-t-i-n-g -a-n-d -r-e-d-u-c-i-n-g 
                        -t-h-e -r-a-t-e -o-f -t-r-a-u-m-a-t-i-c 
                        -b-r-a-i-n -i-n-j-u-r-i-e-s -i-n -t-h-e 
                        -S-t-a-t-e -a-c-c-o-r-d-i-n-g -t-o 
                        -s-t-a-n-d-a-r-d-s -e-s-t-a-b-l-i-s-h-e-d -b-y 
                        -t-h-e -C-e-n-t-e-r-s -f-o-r -D-i-s-e-a-s-e 
                        -C-o-n-t-r-o-l -a-n-d -P-r-e-v-e-n-t-i-o-n-; 
                        -a-n-d
                            -`-`-(-i-v-) -s-h-a-l-l-, -a-f-t-e-r 
                        -c-o-n-s-u-l-t-a-t-i-o-n -w-i-t-h -t-h-e 
                        -S-t-a-t-e -a-d-v-i-s-o-r-y -b-o-a-r-d 
                        -e-s-t-a-b-l-i-s-h-e-d -u-n-d-e-r 
                        -p-a-r-a-g-r-a-p-h -(-3-)-, -e-s-t-a-b-l-i-s-h 
                        -s-t-a-n-d-a-r-d-s -r-e-g-a-r-d-i-n-g -t-h-e 
                        -m-a-r-k-e-t-i-n-g -o-f -s-e-r-v-i-c-e-s -(-b-y 
                        -h-o-s-p-i-t-a-l-s -a-n-d -o-t-h-e-r 
                        -p-r-o-v-i-d-e-r-s-) -t-o -t-r-a-u-m-a-t-i-c 
                        -b-r-a-i-n -i-n-j-u-r-y -p-a-t-i-e-n-t-s -o-r 
                        -f-a-m-i-l-y -m-e-m-b-e-r-s-, 
                        -d-i-s-s-e-m-i-n-a-t-e -t-h-e 
                        -s-t-a-n-d-a-r-d-s -t-o -e-a-s-e 
                        -m-a-n-a-g-e-m-e-n-t -p-r-o-g-r-a-m-s-, -a-n-d 
                        -f-u-r-n-i-s-h -i-n-f-o-r-m-a-t-i-o-n -o-n 
                        -s-u-c-h -s-t-a-n-d-a-r-d-s -t-o 
                        -i-n-d-i-v-i-d-u-a-l-s -w-h-o -s-u-s-t-a-i-n 
                        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-i-e-s 
                        -(-a-n-d -t-h-e -f-a-m-i-l-y -m-e-m-b-e-r-s 
                        -o-f -s-u-c-h -i-n-d-i-v-i-d-u-a-l-s-) -a-t 
                        -t-h-e -e-a-r-l-i-e-s-t -a-p-p-r-o-p-r-i-a-t-e 
                        -o-p-p-o-r-t-u-n-i-t-y -a-f-t-e-r -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l -h-a-s -s-u-s-t-a-i-n-e-d 
                        -t-h-e -i-n-j-u-r-y -(-s-u-c-h 
                        -s-t-a-n-d-a-r-d-s -t-o -i-n-c-l-u-d-e -(-a-t 
                        -a -m-i-n-i-m-u-m-) -a -r-u-l-e 
                        -p-r-o-h-i-b-i-t-i-n-g -p-a-y-m-e-n-t-s 
                        -u-n-d-e-r -a -c-a-s-e -m-a-n-a-g-e-m-e-n-t 
                        -p-r-o-g-r-a-m -u-n-d-e-r -t-h-i-s 
                        -s-e-c-t-i-o-n -f-o-r -r-e-f-e-r-r-i-n-g 
                        -p-a-t-i-e-n-t-s-)-;
                    -`-`-(-B-) -p-r-o-v-i-d-e -a-s-s-u-r-a-n-c-e-s 
                -t-h-a-t -a -p-r-o-t-e-c-t-i-o-n -a-n-d 
                -a-d-v-o-c-a-c-y -s-y-s-t-e-m -e-s-t-a-b-l-i-s-h-e-d 
                -u-n-d-e-r -t-h-i-s -s-e-c-t-i-o-n -w-i-l-l---
                            -`-`-(-i-) -p-r-o-v-i-d-e -l-e-g-a-l-, 
                        -a-d-m-i-n-i-s-t-r-a-t-i-v-e -a-n-d -o-t-h-e-r 
                        -a-p-p-r-o-p-r-i-a-t-e -r-e-m-e-d-i-e-s -o-r 
                        -a-p-p-r-o-a-c-h-e-s -t-o -e-n-s-u-r-e -t-h-e 
                        -p-r-o-t-e-c-t-i-o-n -o-f-, -a-n-d 
                        -a-d-v-o-c-a-c-y -f-o-r-, -t-h-e -r-i-g-h-t-s 
                        -o-f -i-n-d-i-v-i-d-u-a-l-s -w-i-t-h 
                        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y 
                        -w-i-t-h-i-n -t-h-e -S-t-a-t-e -w-h-o -a-r-e 
                        -o-r -m-a-y -b-e -e-l-i-g-i-b-l-e -f-o-r 
                        -t-r-e-a-t-m-e-n-t-, -s-e-r-v-i-c-e-s-, -o-r 
                        -r-e-h-a-b-i-l-i-t-a-t-i-o-n-;
                            -`-`-(-i-i-) -p-r-o-v-i-d-e 
                        -i-n-f-o-r-m-a-t-i-o-n -a-n-d -r-e-f-e-r-r-a-l 
                        -t-o -p-r-o-g-r-a-m-s -a-n-d -s-e-r-v-i-c-e-s 
                        -a-d-d-r-e-s-s-i-n-g -t-h-e -n-e-e-d-s -o-f 
                        -i-n-d-i-v-i-d-u-a-l-s -w-i-t-h 
                        -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
                        -i-n-j-u-r-i-e-s-; -a-n-d
                            -`-`-(-i-i-i-) -p-r-o-v-i-d-e -f-o-r -t-h-e 
                        -i-n-v-e-s-t-i-g-a-t-i-o-n -o-f 
                        -i-n-c-i-d-e-n-t-s -o-f -a-b-u-s-e -a-n-d 
                        -n-e-g-l-e-c-t -o-f -i-n-d-i-v-i-d-u-a-l-s 
                        -w-i-t-h -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
                        -i-n-j-u-r-i-e-s -w-h-e-n -i-n-c-i-d-e-n-t-s 
                        -a-r-e -r-e-p-o-r-t-e-d -f-o-r -t-h-e 
                        -p-r-o-v-i-s-i-o-n -o-f -e-x-c-e-s-s-i-v-e -o-r 
                        -u-n-n-e-c-e-s-s-a-r-y -s-e-r-v-i-c-e-s -o-r 
                        -o-t-h-e-r -c-o-m-p-l-a-i-n-t-s 
                        -r-e-l-a-t-i-n-g -t-o -t-h-e -c-a-r-e -o-f 
                        -s-u-c-h -i-n-d-i-v-i-d-u-a-l-s-, -a-n-d 
                        -p-a-y-m-e-n-t -f-o-r -t-h-e -r-e-f-e-r-r-a-l 
                        -o-f -p-a-t-i-e-n-t-s-;
                    -`-`-(-C-) -e-n-s-u-r-e -t-h-e -p-r-o-v-i-s-i-o-n 
                -t-o -p-e-r-s-o-n-s -w-i-t-h -t-r-a-u-m-a-t-i-c 
                -b-r-a-i-n -i-n-j-u-r-y -o-f -i-n-f-o-r-m-a-t-i-o-n 
                -r-e-g-a-r-d-i-n-g -a-p-p-r-o-p-r-i-a-t-e -p-u-b-l-i-c 
                -o-r -p-r-i-v-a-t-e -a-g-e-n-c-i-e-s -t-h-a-t 
                -p-r-o-v-i-d-e -r-e-h-a-b-i-l-i-t-a-t-i-v-e 
                -s-e-r-v-i-c-e-s -s-o -t-h-a-t -i-n-j-u-r-e-d 
                -p-e-r-s-o-n-s -o-r -i-n-d-i-v-i-d-u-a-l-s 
                -r-e-s-p-o-n-s-i-b-l-e -f-o-r -s-u-c-h -p-e-r-s-o-n-s 
                -m-a-y -o-b-t-a-i-n -n-e-e-d-e-d -s-e-r-v-i-c-e -t-o 
                -a-l-l-e-v-i-a-t-e -i-n-j-u-r-i-e-s -a-n-d -a-v-o-i-d 
                -s-e-c-o-n-d-a-r-y -p-r-o-b-l-e-m-s-; -a-n-d
                    -`-`-(-D-) -f-o-r -p-u-r-p-o-s-e-s -o-f 
                -i-d-e-n-t-i-f-y-i-n-g -t-h-e -s-e-r-v-i-c-e-s 
                -r-e-q-u-i-r-e-d -t-o -p-r-e-v-e-n-t -t-h-e 
                -i-n-s-t-i-t-u-t-i-o-n-a-l-i-z-a-t-i-o-n -o-r -t-o 
                -m-i-n-i-m-i-z-e -t-h-e -n-e-e-d -f-o-r 
                -r-e-s-i-d-e-n-t-i-a-l -r-e-h-a-b-i-l-i-t-a-t-i-o-n 
                -i-n -t-h-e -c-a-s-e -o-f -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
                -i-n-j-u-r-i-e-s-; -e-s-t-a-b-l-i-s-h -a 
                -s-e-r-v-i-c-e-s -c-o-o-r-d-i-n-a-t-i-o-n 
                -p-r-o-g-r-a-m -t-h-a-t -s-h-a-l-l---
                            -`-`-(-i-) -p-r-o-v-i-d-e -f-o-r -t-h-e 
                        -i-n-i-t-i-a-l -a-s-s-e-s-s-m-e-n-t -o-f -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l-'-s -n-e-e-d -f-o-r 
                        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y 
                        -s-e-r-v-i-c-e-s-;
                            -`-`-(-i-i-) -p-r-o-v-i-d-e -f-o-r -t-h-e 
                        -r-e-a-s-s-e-s-s-m-e-n-t -o-f -e-a-c-h 
                        -p-a-t-i-e-n-t -a-t -r-e-g-u-l-a-r 
                        -i-n-t-e-r-v-a-l-s -t-o -d-e-t-e-r-m-i-n-e 
                        -t-h-e -e-x-t-e-n-t -o-f -e-a-c-h 
                        -p-a-t-i-e-n-t-'-s -p-r-o-g-r-e-s-s-, -t-o 
                        -a-s-c-e-r-t-a-i-n -w-h-e-t-h-e-r -a 
                        -p-a-t-i-e-n-t -i-s -b-e-i-n-g -k-e-p-t -t-o-o 
                        -l-o-n-g -i-n -a -g-i-v-e-n -s-e-t-t-i-n-g -o-r 
                        -p-r-o-v-i-d-e-d -s-e-r-v-i-c-e-s 
                        -i-n-a-p-p-r-o-p-r-i-a-t-e-l-y-, -o-r -t-o 
                        -d-e-t-e-r-m-i-n-e -w-h-e-t-h-e-r -t-h-e 
                        -p-a-t-i-e-n-t -w-o-u-l-d -b-e -b-e-t-t-e-r 
                        -s-e-r-v-e-d -b-y -o-t-h-e-r -s-e-r-v-i-c-e-s 
                        -o-r -i-n -a-n-o-t-h-e-r -s-e-t-t-i-n-g-;
                            -`-`-(-i-i-i-) -p-r-e-p-a-r-e -a 
                        -t-r-e-a-t-m-e-n-t -p-l-a-n -f-o-r -e-a-c-h 
                        -i-n-d-i-v-i-d-u-a-l -r-e-q-u-i-r-i-n-g 
                        -s-e-r-v-i-c-e-s -c-o-o-r-d-i-n-a-t-i-o-n-, 
                        -w-i-t-h-i-n -a-n -a-p-p-r-o-p-r-i-a-t-e 
                        -p-e-r-i-o-d -a-f-t-e-r -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l -s-u-s-t-a-i-n-s -t-h-e 
                        -i-n-j-u-r-y-, -b-a-s-e-d -o-n -a 
                        -c-o-n-s-u-l-t-a-t-i-o-n -w-i-t-h -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l -(-o-t-h-e-r -t-h-a-n -a-n 
                        -i-n-d-i-v-i-d-u-a-l -w-h-o -i-s 
                        -c-o-m-a-t-o-s-e -i-n -w-h-i-c-h -e-a-s-e 
                        -c-o-n-s-u-l-t-a-t-i-o-n -s-h-a-l-l -b-e 
                        -w-i-t-h -a -p-e-r-s-o-n -w-i-t-h -l-e-g-a-l 
                        -r-e-s-p-o-n-s-i-b-i-l-i-t-y -o-v-e-r -s-u-c-h 
                        -i-n-d-i-v-i-d-u-a-l-) -a-n-d -a-n-y 
                        -p-e-r-s-o-n -n-a-m-e-d -b-y -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l -(-p-r-e-p-a-r-a-t-i-o-n 
                        -o-f -t-h-e -p-l-a-n -m-a-y -b-e -d-e-l-a-y-e-d 
                        -b-a-s-e-d -o-n -a -c-e-r-t-i-f-i-c-a-t-i-o-n 
                        -i-n-c-l-u-d-i-n-g -a -b-r-i-e-f 
                        -e-x-p-l-a-n-a-t-i-o-n -o-f -t-h-e -r-e-a-s-o-n 
                        -f-o-r -t-h-e -d-e-l-a-y-, -b-y -a 
                        -p-h-y-s-i-c-i-a-n -a-t-t-e-s-t-i-n-g -t-h-a-t 
                        -s-u-c-h -a -d-e-l-a-y -i-s -i-n -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l-'-s -b-e-s-t 
                        -i-n-t-e-r-e-s-t-s -w-i-t-h -a -c-o-p-y -o-f 
                        -t-h-e -t-r-e-a-t-m-e-n-t -p-l-a-n -a-n-d 
                        -a-n-y -m-o-d-i-f-i-c-a-t-i-o-n-s -t-o -t-h-e 
                        -p-l-a-n -b-e-i-n-g -p-r-e-s-e-n-t-e-d -t-o 
                        -t-h-e -i-n-d-i-v-i-d-u-a-l -o-r -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l-'-s -l-e-g-a-l 
                        -r-e-p-r-e-s-e-n-t-a-t-i-v-e-)-;
                            -`-`-(-i-v-) -e-n-s-u-r-e -t-h-a-t -e-a-c-h 
                        -i-n-d-i-v-i-d-u-a-l-'-s -t-r-e-a-t-m-e-n-t 
                        -p-l-a-n -i-s -r-e-g-u-l-a-r-l-y -u-p-d-a-t-e-d 
                        -(-b-a-s-e-d -o-n -c-o-n-s-u-l-t-a-t-i-o-n 
                        -w-i-t-h -t-h-e -i-n-d-i-v-i-d-u-a-l -a-n-d 
                        -t-h-e -p-e-r-s-o-n -r-e-s-p-o-n-s-i-b-l-e 
                        -f-o-r -t-h-e -i-n-j-u-r-e-d 
                        -i-n-d-i-v-i-d-u-a-l-) -w-i-t-h -d-a-t-a -a-n-d 
                        -i-n-f-o-r-m-a-t-i-o-n -a-b-o-u-t 
                        -t-r-e-a-t-m-e-n-t-s -a-n-d -s-e-r-v-i-c-e-s 
                        -p-r-o-v-i-d-e-d-, -a-s -w-e-l-l -a-s 
                        -s-p-e-c-i-f-i-c -m-e-a-s-u-r-e-s -o-f -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l-'-s -c-u-r-r-e-n-t 
                        -p-e-r-f-o-r-m-a-n-c-e -o-r -a-c-t-i-v-i-t-y 
                        -r-e-l-a-t-i-v-e -t-o -g-o-a-l-s 
                        -p-r-e-v-i-o-u-s-l-y -e-s-t-a-b-l-i-s-h-e-d-;
                            -`-`-(-v-) -a-s-s-i-s-t -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l -i-n -o-b-t-a-i-n-i-n-g 
                        -s-e-r-v-i-c-e-s -n-e-c-e-s-s-a-r-y -t-o 
                        -a-l-l-o-w -t-h-e -i-n-d-i-v-i-d-u-a-l -t-o 
                        -r-e-m-a-i-n -i-n -t-h-e -c-o-m-m-u-n-i-t-y-;
                            -`-`-(-v-i-) -c-o-o-r-d-i-n-a-t-e -h-o-m-e 
                        -c-a-r-e -s-e-r-v-i-c-e-s -w-i-t-h -o-t-h-e-r 
                        -s-e-r-v-i-c-e-s-;
                            -`-`-(-v-i-i-) -e-n-s-u-r-e 
                        -a-p-p-r-o-p-r-i-a-t-e-, -a-c-c-e-s-s-i-b-l-e-, 
                        -a-n-d -c-o-s-t---e-f-f-e-c-t-i-v-e 
                        -s-e-r-v-i-c-e-s-;
                            -`-`-(-v-i-i-i-) -a-s-s-i-s-t -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l -w-i-t-h -p-r-o-b-l-e-m-s 
                        -r-e-l-a-t-e-d -t-o -t-h-e -p-r-o-v-i-s-i-o-n 
                        -o-f -h-o-m-e -c-a-r-e -s-e-r-v-i-c-e-s-;
                            -`-`-(-i-x-) -e-n-s-u-r-e -t-h-e 
                        -q-u-a-l-i-t-y -o-f -h-o-m-e -c-a-r-e 
                        -s-e-r-v-i-c-e-s-;
                            -`-`-(-x-) -a-s-s-e-s-s -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l-'-s -n-e-e-d -f-o-r -a-n-d 
                        -l-e-v-e-l -o-f -h-o-m-e -c-a-r-e 
                        -s-e-r-v-i-c-e-s -a-t -a-p-p-r-o-p-r-i-a-t-e 
                        -i-n-t-e-r-v-a-l-s -d-u-r-i-n-g -t-h-e 
                        -c-o-u-r-s-e -o-f -t-h-e 
                        -i-n-d-i-v-i-d-u-a-l-'-s -t-r-e-a-t-m-e-n-t 
                        -u-n-d-e-r -t-h-e -p-r-o-g-r-a-m-; -a-n-d
                            -`-`-(-x-i-) -e-x-p-l-o-r-e -e-f-f-o-r-t-s 
                        -t-o -i-n-c-l-u-d-e -s-e-r-v-i-c-e-s 
                        -c-o-o-r-d-i-n-a-t-i-o-n -p-r-o-v-i-s-i-o-n-s 
                        -u-n-d-e-r -t-h-e -S-t-a-t-e-'-s 
                        -m-e-d-i-c-a-i-d -p-r-o-g-r-a-m -u-n-d-e-r 
                        -s-e-c-t-i-o-n -1-9-3-1 -o-f -t-h-e 
                        -S-o-c-i-a-l -S-e-c-u-r-i-t-y -A-c-t-.
            -`-`-(-3-) -S-t-a-t-e -a-d-v-i-s-o-r-y -b-o-a-r-d-.---
                    -`-`-(-A-) -I-n -g-e-n-e-r-a-l-.----T-o -b-e 
                -e-l-i-g-i-b-l-e -t-o -r-e-c-e-i-v-e -a -g-r-a-n-t 
                -u-n-d-e-r -s-u-b-s-e-c-t-i-o-n -(-a-)-, -a -S-t-a-t-e 
                -s-h-a-l-l -e-s-t-a-b-l-i-s-h -a-n -a-d-v-i-s-o-r-y 
                -b-o-a-r-d -w-i-t-h-i-n -t-h-e -a-p-p-r-o-p-r-i-a-t-e 
                -h-e-a-l-t-h -d-e-p-a-r-t-m-e-n-t -o-f -t-h-e 
                -S-t-a-t-e -o-r -w-i-t-h-i-n -a-n-o-t-h-e-r 
                -d-e-p-a-r-t-m-e-n-t -a-s -d-e-s-i-g-n-a-t-e-d -b-y 
                -t-h-e -c-h-i-e-f -e-x-e-c-u-t-i-v-e -o-f-f-i-c-e-r 
                -o-f -t-h-e -S-t-a-t-e-.
                    -`-`-(-B-) -F-u-n-c-t-i-o-n-s-.----A-n 
                -a-d-v-i-s-o-r-y -b-o-a-r-d -e-s-t-a-b-l-i-s-h-e-d 
                -u-n-d-e-r -s-u-b-p-a-r-a-g-r-a-p-h -(-A-) -s-h-a-l-l 
                -b-e -c-o-g-n-i-z-a-n-t -o-f -f-i-n-d-i-n-g-s -a-n-d 
                -c-o-n-c-e-r-n-s -o-f -F-e-d-e-r-a-l-, -S-t-a-t-e 
                -a-n-d -l-o-c-a-l -a-g-e-n-c-i-e-s-, -c-i-t-i-z-e-n-s 
                -g-r-o-u-p-s-, -a-n-d -p-r-i-v-a-t-e -i-n-d-u-s-t-r-y 
                -(-s-u-c-h -a-s -i-n-s-u-r-a-n-c-e-, -h-e-a-l-t-h 
                -c-a-r-e-, -a-u-t-o-m-o-b-i-l-e-, -a-n-d -o-t-h-e-r 
                -i-n-d-u-s-t-r-y -e-n-t-i-t-i-e-s-)-. -S-u-c-h 
                -a-d-v-i-s-o-r-y -b-o-a-r-d-s -s-h-a-l-l 
                -e-n-c-o-u-r-a-g-e -c-i-t-i-z-e-n 
                -p-a-r-t-i-c-i-p-a-t-i-o-n -t-h-r-o-u-g-h -t-h-e 
                -e-s-t-a-b-l-i-s-h-m-e-n-t -o-f -p-u-b-l-i-c 
                -h-e-a-r-i-n-g-s -a-n-d -o-t-h-e-r -t-y-p-e-s -o-f 
                -c-o-m-m-u-n-i-t-y -o-u-t-r-e-a-c-h -p-r-o-g-r-a-m-s-.
                    -`-`-(-C-) -C-o-m-p-o-s-i-t-i-o-n-.----A-n 
                -a-d-v-i-s-o-r-y -b-o-a-r-d -e-s-t-a-b-l-i-s-h-e-d 
                -u-n-d-e-r -s-u-b-p-a-r-a-g-r-a-p-h -(-A-) -s-h-a-l-l 
                -b-e -c-o-m-p-o-s-e-d -o-f---
                            -`-`-(-i-) -r-e-p-r-e-s-e-n-t-a-t-i-v-e-s 
                        -o-f---
                                    -`-`-(-I-) -t-h-e 
                                -c-o-r-r-e-s-p-o-n-d-i-n-g -S-t-a-t-e 
                                -a-g-e-n-c-i-e-s -i-n-v-o-l-v-e-d-;
                                    -`-`-(-I-I-) -p-u-b-l-i-c -a-n-d 
                                -n-o-n-p-r-o-f-i-t -p-r-i-v-a-t-e 
                                -h-e-a-l-t-h -r-e-l-a-t-e-d 
                                -o-r-g-a-n-i-z-a-t-i-o-n-s-;
                                    -`-`-(-I-I-I-) -o-t-h-e-r 
                                -d-i-s-a-b-i-l-i-t-y -a-d-v-i-s-o-r-y 
                                -o-r -p-l-a-n-n-i-n-g -g-r-o-u-p-s 
                                -w-i-t-h-i-n -t-h-e -S-t-a-t-e-;
                                    -`-`-(-I-V-) -m-e-m-b-e-r-s -o-f 
                                -a-n -o-r-g-a-n-i-z-a-t-i-o-n -o-r 
                                -f-o-u-n-d-a-t-i-o-n 
                                -r-e-p-r-e-s-e-n-t-i-n-g 
                                -t-r-a-u-m-a-t-i-c -b-r-a-i-n 
                                -i-n-j-u-r-y -s-u-r-v-i-v-o-r-s -i-n 
                                -t-h-a-t -S-t-a-t-e-; -a-n-d
                                    -`-`-(-V-) -i-n-j-u-r-y 
                                -c-o-n-t-r-o-l -p-r-o-g-r-a-m-s -a-t 
                                -t-h-e -S-t-a-t-e -o-r -l-o-c-a-l 
                                -l-e-v-e-l -i-f -s-u-c-h 
                                -p-r-o-g-r-a-m-s -e-x-i-s-t-; -a-n-d
                            -`-`-(-i-i-) -a -s-u-b-s-t-a-n-t-i-a-l 
                        -n-u-m-b-e-r -o-f -i-n-d-i-v-i-d-u-a-l-s -w-h-o 
                        -a-r-e -s-u-r-v-i-v-o-r-s -o-f 
                        -t-r-a-u-m-a-t-i-c -b-r-a-i-n -i-n-j-u-r-y-, 
                        -o-r -t-h-e -f-a-m-i-l-y -m-e-m-b-e-r-s -o-f 
                        -s-u-c-h -i-n-d-i-v-i-d-u-a-l-s-; -a-n-d
    -`-`-(-d-) -R-e-p-o-r-t-.----N-o-t -l-a-t-e-r -t-h-a-n -2 
-y-e-a-r-s -a-f-t-e-r -t-h-e -d-a-t-e -o-f -e-n-a-c-t-m-e-n-t -o-f 
-t-h-i-s -p-a-r-t-, -t-h-e -S-e-c-r-e-t-a-r-y -s-h-a-l-l -p-r-e-p-a-r-e 
-a-n-d -s-u-b-m-i-t -t-o -t-h-e -a-p-p-r-o-p-r-i-a-t-e 
-c-o-m-m-i-t-t-e-e-s -o-f -C-o-n-g-r-e-s-s -a -r-e-p-o-r-t 
-c-o-n-c-e-r-n-i-n-g -t-h-e -f-i-n-d-i-n-g-s -a-n-d -r-e-s-u-l-t-s -o-f 
-t-h-e -p-r-o-g-r-a-m-s -e-s-t-a-b-l-i-s-h-e-d -u-n-d-e-r -t-h-i-s 
-s-e-c-t-i-o-n-, -i-n-c-l-u-d-i-n-g -m-e-a-s-u-r-e-s -o-f 
-o-u-t-c-o-m-e-s -a-n-d -c-o-n-s-u-m-e-r -a-n-d -s-u-r-r-o-g-a-t-e 
-s-a-t-i-s-f-a-c-t-i-o-n-.
    -`-`-(-e-) -A-u-t-h-o-r-i-z-a-t-i-o-n -o-f 
-A-p-p-r-o-p-r-i-a-t-i-o-n-s-.----T-h-e-r-e -a-r-e -a-u-t-h-o-r-i-z-e-d 
-t-o -b-e -a-p-p-r-o-p-r-i-a-t-e-d -t-o -c-a-r-r-y -o-u-t -t-h-i-s 
-s-e-c-t-i-o-n-, -$-2-7-,-0-0-0-,-0-0-0 -f-o-r -f-i-s-c-a-l -y-e-a-r 
-1-9-9-4-, -a-n-d -s-u-c-h -s-u-m-s -a-s -m-a-y -b-e -n-e-c-e-s-s-a-r-y 
-f-o-r -e-a-c-h -o-f -t-h-e -f-i-s-c-a-l -y-e-a-r-s -1-9-9-5 -a-n-d 
-1-9-9-6-.-'-'-.

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SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Traumatic Brain Injury Act of 
1993''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress finds that--
            (1) each year 2,000,000 individuals suffer serious head 
        injuries resulting from automobile accidents, sports, 
        recreational activities, assaults, violence and other falls and 
        incidents;
            (2) a majority of all head injuries are caused by motor 
        vehicle accidents;
            (3) individuals between the ages of 15 and 24 are at 
        greatest risk for sustaining head injuries;
            (4) of the individuals who sustain head injuries each year, 
        approximately 500,000 require hospitalization, and 75,000 to 
        100,000 of such individuals die within hours of the injury;
            (5) of the individuals who survive head injuries each year, 
        approximately 70,000 to 90,000 will suffer irreversible 
        debilitating loss of function, 5,000 will develop epilepsy as a 
        result of the injury, and 2,000 will exist in a coma;
            (6) a significant number of individuals with traumatic 
        brain injury are not easily restored to society and require 
        years of rehabilitation, medical follow-up and integrated 
        community services, which are costly and frequently not readily 
        available;
            (7) individuals sustaining traumatic brain injury require 
        coordinated and specialized services, including post-injury 
        supervised programs facilitating reentry into the community;
            (8) many health and social service agencies, both public 
        and private, overlook, exclude or inadequately serve 
        individuals surviving traumatic brain injury;
            (9) society bears an economic cost of approximately 
        $25,000,000,000 per year for the direct and indirect costs of 
        traumatic brain injury, which include medical treatment, 
        rehabilitative and support services and lost income; and
            (10) prevention efforts will reduce the mortality, 
        morbidity, disability and costs associated with traumatic brain 
        injury.
    (b) Purpose.--It is the purpose of this Act to--
            (1) facilitate the conduct of research and the collection 
        and compiling of accurate statistical data on traumatic brain 
        injury;
            (2) raise public awareness concerning the risks and 
        consequences of such injuries;
            (3) promote the creation of innovative programs and 
        policies to prevent traumatic brain injury and to rehabilitate 
        those individuals who have survived such injuries;
            (4) designate a Federal agency to oversee and promote 
        projects relating to the prevention of, and rehabilitation 
        from, traumatic brain injury;
            (5) establish State advisory boards to coordinate citizen 
        participation in community programs dealing with traumatic 
        brain injury;
            (6) determine the incidence and prevalence of traumatic 
        brain injury; and
            (7) encourage States to develop or adopt marketing 
        standards for brain injury rehabilitation services.

SEC. 3. AMENDMENT TO PUBLIC HEALTH SERVICE ACT.

    Title XII of the Public Health Service Act (42 U.S.C. 300d et seq.) 
is amended--
            (1) by redesignating part C as part D;
            (2) in section 1232(a) (42 U.S.C. 300d-32(a)), by inserting 
        ``other than part C,'' after ``carrying out this title,''; and
            (3) by inserting after part B, the following new part:

                    ``Part C--Traumatic Brain Injury

``SEC. 1225A. AGENCY FOR HEALTH CARE POLICY AND RESEARCH STUDY OF 
              EFFECTIVENESS OF TRAUMATIC BRAIN INJURY INTERVENTIONS.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Agency for Health Care Policy and Research and subject to the 
availability of appropriations, shall conduct a study concerning 
traumatic brain injury. The Secretary shall ensure that activities 
carried out under this section will be coordinated with activities of 
other agencies of the Public Health Service.
    ``(b) Major Findings.--The study conducted under subsection (a) 
shall seek to--
            ``(1) identify common therapeutic interventions which are 
        used for the rehabilitation of individuals with traumatic brain 
        injuries, and shall, subject to the availability of 
        information, include an analysis of--
                    ``(A) the effectiveness of each such intervention 
                in improving the functioning of individuals with brain 
                injuries;
                    ``(B) the comparative effectiveness of 
                interventions employed in the course of rehabilitation 
                of individuals with brain injuries to achieve the same 
                or similar clinical outcome; and
                    ``(C) the adequacy of existing measures of outcomes 
                and knowledge of factors influencing differential 
                outcomes; and
            ``(2) develop practice guidelines for the rehabilitation of 
        traumatic brain injury at such time as appropriate scientific 
        research becomes available.
    ``(c) Reporting Requirements.--Not later than 4 years after the 
date of enactment of this part, the Secretary shall prepare and submit 
to the Energy and Commerce Committee of the House of Representatives 
and the Labor and Human Resources Committee of the Senate, and a report 
containing the results of the studies conducted under this section.
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $2,000,000 for fiscal year 
1994, and such sums as may be necessary for each of the fiscal years 
1995 through 1996.

``SEC. 1225B. PREVENTION OF TRAUMATIC BRAIN JURY.

    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, may conduct, support 
and provide technical assistance to public and private nonprofit 
entities to reduce the incidence of traumatic brain injury through the 
establishment of prevention projects. The Secretary shall ensure that 
activities carried out under this section will be coordinated with 
activities of the agencies of the Public Health Service.
    ``(b) Grants.--In carrying out this section, the Secretary may 
award grants to State and local entities, and to public or non-profit 
private entities, to support--
            ``(1) the conduct of research into identifying effective 
        strategies to prevent traumatic brain injury; and
            ``(2) the implementation of public information and 
        education programs for the prevention of traumatic brain injury 
        and to broaden the awareness of the public concerning the 
        public health consequences of traumatic brain injury.
    ``(c) Study.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Centers for Disease Control and Prevention, 
        shall collaborate with appropriate State and local health-
        related agencies, to conduct a study on the incidence and 
        prevalence of traumatic brain injury. In conducting such study 
        the Secretary may develop a uniform reporting system under 
        which States report incidences of traumatic brain injury.
            ``(2) Report.--Not later than 3 years after the date of 
        enactment of this part, the Secretary shall prepare and submit 
        to State health departments a report that contains the results 
        of the study conducted under paragraph (1).
    ``(d) Application.--To be eligible to receive assistance under 
subsections (a) and (b), an entity shall prepare and submit to the 
Secretary an application, at such time, in such manner, and containing 
such information as the Secretary may require.
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $6,000,000 for fiscal year 
1994, and such sums as may be necessary for each of the fiscal years 
1995 and 1996. The Secretary shall ensure that activities carried out 
under this section will be coordinated with activities of other 
agencies of the Public Health Service.

``SEC. 1225C. BASIC AND APPLIED RESEARCH.

    ``(a) In General.--The Secretary, acting through the Director of 
the National Institutes of Health, may provide assistance to public and 
private nonprofit entities to conduct basic and applied research 
concerning traumatic brain injury. The Secretary shall ensure that 
activities carried out under this section will be coordinated with 
activities of the agencies of the Public Health Service.
    ``(b) Grants.--In carrying out this section, the Secretary may 
award grants to public or nonprofit entities for--
            ``(1) the development of new methods and modalities for the 
        more effective diagnosis, measurement of degree of injury, 
        post-injury monitoring and prognostic assessment of head injury 
        for acute, subacute and later phases of care;
            ``(2) the development, modification and evaluation of 
        therapies that retard, prevent or reverse brain damage after 
        acute head injury, that arrest further deterioration following 
        injury and that provide the restitution of function for 
        individuals with long-term injuries;
            ``(3) the development of research on a continuum of care 
        from acute care through rehabilitation, designed, to the extent 
        practicable, to integrate rehabilitation and long-term outcome 
        evaluation with acute care research; and
            ``(4) the development of programs that increase the 
        participation of academic centers of excellence in head injury 
        treatment and rehabilitation research and training.
    ``(c) Consensus Conference.--The Secretary, acting through the 
Director of the National Center for Medical Rehabilitation Research 
within the National Institute for Child Health and Human Development, 
shall conduct a national consensus conference on managing head injury 
and related rehabilitation concerns. The findings of such conference 
shall be provided to the Agency for Health Care Policy and Research.
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $5,000,000 for fiscal year 
1994, and such sums as may be necessary for each of the fiscal years 
1995 and 1996.

``SEC. 1225D. STATEWIDE DEMONSTRATION PROJECTS FOR TRAUMATIC BRAIN 
              INJURY.

    ``(a) Grants.--The Secretary, acting through the Director of Health 
Resources and Services Administration, may award grants to States for 
the purpose of assisting grantees in carrying out demonstration 
projects for the--
            ``(1) establishment of policies for coordinating services 
        within the State for individuals with traumatic brain injury;
            ``(2) establishment of standards, or adoption of nationally 
        recognized standards, regarding the marketing of rehabilitation 
        services (by hospitals and other providers) to traumatic brain 
        injury patients or family members, dissemination of the 
        standards to case management programs, and furnishing of 
        information on such standards to individuals who sustain 
        traumatic brain injuries (and the family members of such 
        individuals) at the earliest appropriate opportunity after the 
        individual has sustained the injury (such standards to include 
        (at a minimum) a rule prohibiting payments under a case 
        management program under this section for referring patients);
            ``(3) coordination of legal, administrative and other 
        appropriate remedies or approaches to ensure the protection of, 
        and advocacy for, the rights of individuals with traumatic 
        brain injury within the State who are or may be eligible for 
        treatment, services, or rehabilitation, such treatment, 
        services or rehabilitation to be coordinated with existing 
        protection and advocacy systems through the State;
            ``(4) the provision to persons with traumatic brain injury 
        of information regarding appropriate public or private agencies 
        that provide rehabilitative services so that injured persons or 
        individuals responsible for such persons may obtain needed 
        service to alleviate injuries and avoid secondary problems; and
            ``(5) identification of the services required to prevent 
        the institutionalization or to minimize the need for 
        residential rehabilitation in the case of traumatic brain 
        injury.
    ``(b) General Eligibility Requirements.--To be eligible to receive 
a grant under subsection (a), a State shall prepare and submit to the 
Secretary an application, at such time, in such manner, and containing 
such information as the Secretary may require.
    ``(c) State Advisory Board.--
            ``(1) In general.--To be eligible to receive a grant under 
        subsection (a), a State shall establish an advisory board 
        within the appropriate health department of the State or within 
        another department as designated by the chief executive officer 
        of the State.
            ``(2) Functions.--An advisory board established under 
        paragraph (1) shall assist the State in developing and 
        implementing State programs to carry out activities under this 
        section. The advisory board shall be cognizant of findings and 
        concerns of Federal, State and local agencies, citizens groups, 
        and private industry (such as insurance, health care, 
        automobile, and other industry entities). Such advisory boards 
        shall encourage citizen participation through the establishment 
        of public hearings and other types of community outreach 
        programs.
            ``(3) Competition.--An advisory board established under 
        paragraph (1) shall be composed of--
                    ``(A) representatives of--
                            ``(i) the corresponding States agencies 
                        involved;
                            ``(ii) public and nonprofit private health 
                        related organizations;
                            ``(iii) other disability advisory or 
                        planning groups within the State;
                            ``(iv) members of an organization or 
                        foundation representing traumatic brain injury 
                        survivors in that State; and
                            ``(v) injury control programs at the State 
                        or local level if such programs exist; and
                    ``(B) a substantial number of individuals who are 
                survivors of traumatic brain injury, or the family 
                members of such individuals.
    ``(d) Requirement of Matching Funds.--
            ``(1) In general.--With respect to the costs to be incurred 
        by a State in carrying out the purpose described in subsection 
        (a), the Secretary may not make a grant under such subsection 
        unless the State agrees to provide non-Federal contributions 
        toward such costs, in cash, in an amount that is not less than 
        $1 for each $2 of Federal funds provided under the grant.
            ``(2) Determination of amount contributed.--In determining 
        the amount of non-Federal contributions in cash that a State 
        has provided pursuant to paragraph (1), the Secretary may not 
        include any amounts provided to the State by the Federal 
        Government.
    ``(e) Report.--Not later than 2 years after the date of enactment 
of this part, the Secretary shall prepare and submit to the appropriate 
committees of Congress a report concerning the findings and results of 
the programs established under this section, including measures of 
outcomes and consumer and surrogate satisfaction.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $20,000,000 for fiscal year 
1994, and such sums as may be necessary for each of the fiscal years 
1995 and 1996.

``SEC. 1225E. DEFINITION

    ``As used in this part, the term `traumatic brain injury' means an 
acquired injury to the brain. Such term does not include brain 
dysfunction caused by congenital or degenerative disorders, nor birth 
trauma, but may include brain injuries caused by anoxia due to near 
drowning. Such term is synonymous with the term `traumatic head 
injury'. The Secretary, acting through the Director of the National 
Center for Injury Prevention and Control within the Centers for Disease 
Prevention and Control, may modify the definition of `traumatic brain 
injury'.''.

SEC. 4. NATIONAL HEAD INJURY PREVENTION AND AWARENESS MONTH.

    The month of October, 1994, is hereby designated as ``National Head 
Injury Prevention and Awareness Month'' and the President is requested 
to issue a proclamation calling on the people of the United States to 
observe such month with appropriate ceremonies and activities.

SEC. 5. EFFECTIVE DATE.

    This Act and the amendments made by this Act shall take effect on 
October 1, 1994, or upon the date of enactment of this Act, whichever 
occurs later.
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