[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2199 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 2199

   To amend title 38, United States Code, to direct the Secretary of 
 Veterans Affairs to provide certain improvements in the treatment of 
   individuals with traumatic brain injuries, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 8, 2007

 Mr. Michaud introduced the following bill; which was referred to the 
                     Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To amend title 38, United States Code, to direct the Secretary of 
 Veterans Affairs to provide certain improvements in the treatment of 
   individuals with traumatic brain injuries, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Traumatic Brain Injury Health 
Enhancement and Long-Term Support Act of 2007''.

SEC. 2. SCREENING, REHABILITATION, AND TREATMENT FOR TRAUMATIC BRAIN 
              INJURY.

    (a) Screening, Rehabilitation, and Treatment for Traumatic Brain 
Injury.--
            (1) In general.--Chapter 17 of title 38, United States 
        Code, is amended by adding at the end the following new 
        subchapter:

                ``SUBCHAPTER IX--TRAUMATIC BRAIN INJURY

``Sec. 1791. Screening for traumatic brain injuries
    ``(a) Screening Program.--The Secretary shall establish a program 
to screen veterans who are eligible for hospital care, medical 
services, and nursing home care under section 1710(e)(1)(D) of this 
title for symptoms of traumatic brain injury.
    ``(b) Report.--Not later than one year after the date of the 
enactment of this section, and annually thereafter, the Secretary shall 
submit to the Committees on Veterans' Affairs of the Senate and the 
House of Representatives a report containing the following information:
            ``(1) The number of veterans screened under the program 
        during the year preceding such report.
            ``(2) The prevalence of traumatic brain injury symptoms 
        among the veterans screened under the program.
            ``(3) Recommendations for improving care and services to 
        veterans exhibiting symptoms of traumatic brain injury.
``Sec. 1792. Comprehensive program for long-term traumatic brain injury 
              rehabilitation
    ``(a) Comprehensive Program.--The Secretary shall develop and carry 
out a comprehensive program of long-term care for post-acute traumatic 
brain injury rehabilitation that includes residential, community, and 
home-based components utilizing interdisciplinary treatment teams.
    ``(b) Location of Program.--The Secretary shall carry out the 
program developed under subsection (a) in four geographically dispersed 
polytrauma network sites designated by the Secretary.
    ``(c) Eligibility.--A veteran is eligible for care under the 
program developed under subsection (a) if the veteran is otherwise 
eligible for care under this chapter and--
            ``(1) served on active duty in a theater of combat 
        operations (as determined by the Secretary in consultation with 
        the Secretary of Defense) during a period of war after the 
        Persian Gulf War, or in combat against a hostile force during a 
        period of hostilities (as defined in section 1712A(a)(2)(B) of 
        this title) after November 11, 1998;
            ``(2) is diagnosed as suffering from moderate to severe 
        traumatic brain injury; and
            ``(3) is unable to manage routine activities of daily 
        living without supervision or assistance.
    ``(d) Report.--Not later than one year after the date of the 
enactment of this section, and annually thereafter, the Secretary shall 
submit to the Committees on Veterans' Affairs of the Senate and the 
House of Representatives a report containing the following information:
            ``(1) A description of the operation of the program.
            ``(2) The number of veterans provided care under the 
        program during the year preceding such report.
            ``(3) The annual cost of operating the program.
``Sec. 1793. Traumatic brain injury transition offices
    ``(a) Establishment.--The Secretary shall establish a traumatic 
brain injury transition office at each Department polytrauma network 
site for the purposes of coordinating the provision of health-care and 
services to veterans who suffer from moderate to severe traumatic brain 
injuries and are in need of health-care and services not immediately 
offered by the Department.
    ``(b) Cooperative Agreements.--The Secretary, through each such 
office established under subsection (a), shall have the authority to 
arrange for the provision of health-care and services through 
cooperative agreements with appropriate public or private entities that 
have established long-term neurobehavioral rehabilitation and recovery 
programs.
``Sec. 1794. Traumatic brain injury registry
    ``(a) In General.--The Secretary shall establish and maintain a 
registry to be known as the `Traumatic Brain Injury Veterans' Health 
Registry' (in this section referred to as the `Registry').
    ``(b) Description.--The Registry shall include the following 
information:
            ``(1) A list containing the name of each individual who 
        served as a member of the Armed Forces in Operation Enduring 
        Freedom or Operation Iraqi Freedom who exhibits symptoms 
        associated with traumatic brain injury and who--
                    ``(A) applies for care and services from the 
                Department under this chapter; or
                    ``(B) files a claim for compensation under chapter 
                11 of this title on the basis of any disability which 
                may be associated with such service; and
            ``(2) any relevant medical data relating to the health 
        status of an individual described in paragraph (1) and any 
        other information the Secretary considers relevant and 
        appropriate with respect to such an individual if the 
        individual--
                    ``(A) grants permission to the Secretary to include 
                such information in the Registry; or
                    ``(B) is deceased at the time such individual is 
                listed in the Registry.
    ``(c) Notification.--The Secretary shall notify individuals listed 
in the Registry of significant developments in research on the health 
consequences of military service in the Operation Enduring Freedom and 
Operation Iraqi Freedom theaters of operations.
``Sec. 1795. Centers for traumatic brain injury research, education, 
              and clinical activities
    ``(a) Purpose.--The purpose of this section is to provide for the 
improvement of the provision of health care to eligible veterans with 
traumatic brain injuries through--
            ``(1) the conduct of research (including research on 
        improving facilities of the Department concentrating on 
        traumatic brain injury care and on improving the delivery of 
        traumatic brain injury care by the Department);
            ``(2) the education and training of health care personnel 
        of the Department; and
            ``(3) the development of improved models and systems for 
        the furnishing of traumatic brain injury care by the 
        Department.
    ``(b) Establishment of Centers.--(1) The Secretary shall establish 
and operate centers for traumatic brain injury research, education, and 
clinical activities. Such centers shall be established and operated by 
collaborating Department facilities as provided in subsection (c)(1). 
Each such center shall function as a center for--
            ``(A) research on traumatic brain injury;
            ``(B) the use by the Department of specific models for 
        furnishing traumatic brain injury care;
            ``(C) education and training of health-care professionals 
        of the Department; and
            ``(D) the development and implementation of innovative 
        clinical activities and systems of care with respect to the 
        delivery of traumatic brain injury care by the Department.
    ``(2) The Secretary shall, upon the recommendation of the Under 
Secretary for Health, designate the centers under this section. In 
making such designations, the Secretary shall ensure that the centers 
designated are located in various geographic regions of the United 
States. The Secretary may designate a center under this section only 
if--
            ``(A) the proposal submitted for the designation of the 
        center meets the requirements of subsection (c);
            ``(B) the Secretary makes the finding described in 
        subsection (d); and
            ``(C) the peer review panel established under subsection 
        (e) makes the determination specified in subsection (e)(3) with 
        respect to that proposal.
    ``(3) Not more than five centers may be designated under this 
section.
    ``(4) The authority of the Secretary to establish and operate 
centers under this section is subject to the appropriation of funds for 
that purpose.
    ``(c) Proposals for Designation of Centers.--A proposal submitted 
for the designation of a center under this section shall--
            ``(1) provide for close collaboration in the establishment 
        and operation of the center, and for the provision of care and 
        the conduct of research and education at the center, by a 
        Department facility or facilities in the same geographic area 
        which have a mission centered on traumatic brain injury care 
        and a Department facility in that area which has a mission of 
        providing tertiary medical care;
            ``(2) provide that no less than 50 percent of the funds 
        appropriated for the center for support of clinical care, 
        research, and education will be provided to the collaborating 
        facility or facilities that have a mission centered on 
        traumatic brain injury care; and
            ``(3) provide for a governance arrangement between the 
        collaborating Department facilities which ensures that the 
        center will be established and operated in a manner aimed at 
        improving the quality of traumatic brain injury care at the 
        collaborating facility or facilities which have a mission 
        centered on traumatic brain injury care.
    ``(d) Finding of Secretary.--The finding referred to in subsection 
(b)(2)(B) with respect to a proposal for designation of a site as a 
location of a center under this section is a finding by the Secretary, 
upon the recommendation of the Under Secretary for Health, that the 
facilities submitting the proposal have developed (or may reasonably be 
anticipated to develop) each of the following:
            ``(1) An arrangement with an accredited medical school that 
        provides education and training in traumatic brain injury care 
        and with which one or more of the participating Department 
        facilities is affiliated under which medical residents receive 
        education and training in traumatic brain injury care through 
        regular rotation through the participating Department 
        facilities so as to provide such residents with training in the 
        diagnosis and treatment of traumatic brain injury.
            ``(2) An arrangement under which nursing, social work, 
        counseling, or allied health personnel receive training and 
        education in traumatic brain injury care through regular 
        rotation through the participating Department facilities.
            ``(3) The ability to attract scientists who have 
        demonstrated achievement in research--
                    ``(A) into the evaluation of innovative approaches 
                to the design of traumatic brain injury care; or
                    ``(B) into the causes, prevention, and treatment of 
                traumatic brain injury.
            ``(4) The capability to evaluate effectively the activities 
        of the center, including activities relating to the evaluation 
        of specific efforts to improve the quality and effectiveness of 
        traumatic brain injury care provided by the Department at or 
        through individual facilities.
    ``(e) Peer Review Panel.--(1) In order to provide advice to assist 
the Secretary and the Under Secretary for Health to carry out their 
responsibilities under this section, the official within the central 
office of the Veterans Health Administration responsible for traumatic 
brain injury care shall establish a peer review panel to assess the 
scientific and clinical merit of proposals that are submitted to the 
Secretary for the designation of centers under this section.
    ``(2) The panel shall consist of experts in the fields of traumatic 
brain injury research, education and training, and clinical care. 
Members of the panel shall serve as consultants to the Department.
    ``(3) The panel shall review each proposal submitted to the panel 
by the official referred to in paragraph (1) and shall submit to that 
official its views on the relative scientific and clinical merit of 
each such proposal. The panel shall specifically determine with respect 
to each such proposal whether that proposal is among those proposals 
which have met the highest competitive standards of scientific and 
clinical merit.
    ``(4) The panel shall not be subject to the Federal Advisory 
Committee Act (5 U.S.C. App.).
    ``(f) Award of Funding.--Clinical and scientific investigation 
activities at each center established under this section--
            ``(1) may compete for the award of funding from amounts 
        appropriated for the Department of Veterans Affairs medical and 
        prosthetics research account; and
            ``(2) shall receive priority in the award of funding from 
        such account insofar as funds are awarded to projects and 
        activities relating to traumatic brain injury.
    ``(g) Dissemination of Useful Information.--The Under Secretary for 
Health shall ensure that information produced by the research, 
education and training, and clinical activities of centers established 
under this section that may be useful for other activities of the 
Veterans Health Administration is disseminated throughout the Veterans 
Health Administration. Such dissemination shall be made through 
publications, through programs of continuing medical and related 
education provided through regional medical education centers under 
subchapter VI of chapter 74 of this title, and through other means. 
Such programs of continuing medical education shall receive priority in 
the award of funding.
    ``(h) Supervision of Centers.--The official within the central 
office of the Veterans Health Administration responsible for traumatic 
brain injury care shall be responsible for supervising the operation of 
the centers established pursuant to this section and shall provide for 
ongoing evaluation of the centers and their compliance with the 
requirements of this section.
    ``(i) Authorization of Appropriations.--(1) There are authorized to 
be appropriated to the Department of Veterans Affairs for the basic 
support of the research and education and training activities of 
centers established pursuant to this section such sums as may be 
necessary.
    ``(2) In addition to funds appropriated for a fiscal year pursuant 
to the authorization of appropriations in paragraph (1), the Under 
Secretary for Health shall allocate to such centers from other funds 
appropriated for that fiscal year generally for the Department of 
Veterans Affairs medical services account and the Department of 
Veterans Affairs medical and prosthetics research account such amounts 
as the Under Secretary for Health determines appropriate to carry out 
the purposes of this section.
    ``(j) Annual Reports.--Not later than February 1 of each of year, 
the Secretary of Veterans Affairs shall submit to the Committees on 
Veterans' Affairs of the Senate and House of Representatives a report 
on the status and activities of the centers for traumatic brain injury 
research, education, and clinical activities during the preceding 
fiscal year. Each such report shall include the following:
            ``(1) A description of the activities carried out at each 
        center and the funding provided by the Department for such 
        activities.
            ``(2) A description of the advances made at each of the 
        participating facilities of the center in research, education 
        and training, and clinical activities relating to traumatic 
        brain injury care and treatment.
            ``(3) A description of the actions taken by the Under 
        Secretary for Health pursuant to subsection (g) to disseminate 
        information derived from such activities throughout the 
        Veterans Health Administration.
            ``(4) The evaluation of the Secretary as to the 
        effectiveness of the centers in fulfilling the purposes of this 
        section.
    ``(k) Authorization of Appropriations.--(1) There are authorized to 
be appropriated to the Department of Veterans Affairs for the basic 
support of the research and education and training activities of 
centers established pursuant to this section amounts as follows:
            ``(A) $10,000,000 for fiscal year 2008.
            ``(B) $20,000,000 for each of fiscal years 2009 through 
        2011.
    ``(2) In addition to funds appropriated for a fiscal year pursuant 
to the authorization of appropriations in paragraph (1), the Under 
Secretary for Health shall allocate to such centers from other funds 
appropriated for that fiscal year generally for the Department of 
Veterans Affairs medical services account and the Department of 
Veterans Affairs medical and prosthetics research account such amounts 
as the Under Secretary for Health determines appropriate to carry out 
the purposes of this section.
``Sec. 1796. Committee on Care of Veterans with Traumatic Brain Injury
    ``(a) Establishment.--The Secretary shall establish in the Veterans 
Health Administration a committee to be known as the `Committee on Care 
of Veterans with Traumatic Brain Injury'. The Under Secretary for 
Health shall appoint employees of the Department with expertise in the 
care of veterans with traumatic brain injury to serve on the committee.
    ``(b) Responsibilities of Committee.--The committee shall assess, 
and carry out a continuing assessment of, the capability of the 
Veterans Health Administration to meet effectively the treatment and 
rehabilitation needs of veterans with traumatic brain injury. In 
carrying out that responsibility, the committee shall--
            ``(1) evaluate the care provided to such veterans through 
        the Veterans Health Administration;
            ``(2) identify systemwide problems in caring for such 
        veterans in facilities of the Veterans Health Administration;
            ``(3) identify specific facilities within the Veterans 
        Health Administration at which program enrichment is needed to 
        improve treatment and rehabilitation of such veterans; and
            ``(4) identify model programs which the committee considers 
        to have been successful in the treatment and rehabilitation of 
        such veterans and which should be implemented more widely in or 
        through facilities of the Veterans Health Administration.
    ``(c) Advice and Recommendations.--The committee shall--
            ``(1) advise the Under Secretary regarding the development 
        of policies for the care and rehabilitation of veterans with 
        traumatic brain injury; and
            ``(2) make recommendations to the Under Secretary--
                    ``(A) for improving programs of care of such 
                veterans at specific facilities and throughout the 
                Veterans Health Administration;
                    ``(B) for establishing special programs of 
                education and training relevant to the care of such 
                veterans for employees of the Veterans Health 
                Administration;
                    ``(C) regarding research needs and priorities 
                relevant to the care of such veterans; and
                    ``(D) regarding the appropriate allocation of 
                resources for all such activities.
    ``(d) Annual Report.--Not later than June 1 of 2008, and each 
subsequent year, the Secretary shall submit to the Committees on 
Veterans' Affairs of the Senate and House of Representatives a report 
on the implementation of this section. Each such report shall include 
the following for the calendar year preceding the year in which the 
report is submitted:
            ``(1) A list of the members of the committee.
            ``(2) The assessment of the Under Secretary for Health, 
        after review of the initial findings of the committee, 
        regarding the capability of the Veterans Health Administration, 
        on a systemwide and facility-by-facility basis, to meet 
        effectively the treatment and rehabilitation needs of veterans 
        with traumatic brain injury.
            ``(3) The plans of the committee for further assessments.
            ``(4) The findings and recommendations made by the 
        committee to the Under Secretary for Health and the views of 
        the Under Secretary on such findings and recommendations.
            ``(5) A description of the steps taken, plans made (and a 
        timetable for the execution of such plans), and resources to be 
        applied toward improving the capability of the Veterans Health 
        Administration to meet effectively the treatment and 
        rehabilitation needs of veterans with traumatic brain 
        injury.''.
            (2) Clerical amendment.--The table of contents at the 
        beginning of such chapter is amended by adding at the end the 
        following new items:

                 ``subchapter ix--traumatic brain injury

``1791. Screening for traumatic brain injuries.
``1792. Comprehensive program for long-term traumatic brain injury 
                            rehabilitation.
``1793. Traumatic brain injury transition offices.
``1794. Traumatic brain injury registry.
``1795. Centers for traumatic brain injury research, education, and 
                            clinical activities.
``1796. Committee on Care of Veterans with Traumatic Brain Injury.''.
    (b) Effective Date.--The Secretary shall implement the requirements 
of subchapter IX of title 38, United States Code, as added by 
subsection (a), not later than 180 days after the date of the enactment 
of this Act.

SEC. 3. PILOT PROGRAM FOR DELIVERY OF READJUSTMENT COUNSELING AND 
              MENTAL HEALTH SERVICES TO VETERANS THROUGH MOBILE VET 
              CENTERS.

    (a) Pilot Program.--Chapter 17 of title 38, United States Code, is 
amended by inserting after section 1712B the following new section:
``Sec. 1712C. Pilot program for delivery of readjustment counseling and 
              mental health services through mobile Vet Centers
    ``(a) Pilot Program.--To improve access to mental health services 
in rural areas, the Secretary shall carry out a pilot program under 
which the Secretary shall provide readjustment counseling and related 
mental health services through the use of mobile centers (as that term 
is defined in section 1712A(i)(1)), to be known as `mobile Vet 
Centers'. In carrying out the pilot program, the Secretary shall 
determine the most effective manner in which to operate the mobile Vet 
Centers.
    ``(b) Scope and Location.--(1) The Secretary shall establish two 
mobile Vet Centers in each of the following five Veterans Integrated 
Service Networks:
                    ``(A) Veterans Integrated Service Network 1.
                    ``(B) Veterans Integrated Service Network 16.
                    ``(C) Veterans Integrated Service Network 19.
                    ``(D) Veterans Integrated Service Network 20.
                    ``(E) Veterans Integrated Service Network 23.
    ``(2) Within each Veterans Integrated Service Network under 
paragraph (1), the Secretary shall determine the area to be serviced by 
each mobile Vet Center. In making that determination, the Secretary 
shall give priority to areas in which limited mental health services 
are available.
    ``(3) If the Secretary determines that mobile Vet Centers in 
addition to such centers required under paragraph (1) are warranted, 
the Secretary may establish additional mobile Vet Centers and may 
establish such centers in Veterans Integrated Service Networks other 
than the Veterans Integrated Service Networks referred to in that 
paragraph. Upon such a determination by the Secretary, the Secretary 
shall notify the Committees on Veterans' Affairs of the Senate and 
House of Representatives of such determination.
    ``(c) Termination.--The authority to carry out a pilot program 
under this section shall terminate on the date that is three years 
after the date of the enactment of this section.
    ``(d) Report.--Not later than 90 days after the date on which the 
pilot program terminates under subsection (a), the Secretary shall 
submit to the Committees on Veterans' Affairs of the Senate and House 
of Representatives a report on the pilot program. Such report shall 
describe how the Secretary established and carried out the pilot 
program and include an evaluation of the Secretary of the benefits and 
disadvantages of providing readjustment counseling and related mental 
health services through the use of mobile Vets Centers.
    ``(e) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $7,500,000 for fiscal year 2008 
and each subsequent fiscal year.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item related to section 
1712B the following new item:

``1712C. Pilot program for delivery of readjustment counseling and 
                            mental health services through mobile Vet 
                            Centers.''.

SEC. 4. ADVISORY COMMITTEE ON RURAL VETERANS.

    (a) Establishment of Committee.--Subchapter III of chapter 5 of 
title 38, United States Code, is amended by adding at the end the 
following new section:
``Sec. 546. Advisory Committee on Rural Veterans
    ``(a) Establishment.--(1) The Secretary shall establish an advisory 
committee to be known as the `Advisory Committee on Rural Veterans' 
(hereinafter in this section referred to as `the Committee').
    ``(2)(A) The Committee shall consist of members appointed by the 
Secretary from the general public, including--
            ``(i) representatives of rural veterans;
            ``(ii) individuals who are recognized authorities in fields 
        pertinent to the needs of rural veterans, including specific or 
        unique health-care needs of rural veterans and access issues of 
        rural veterans;
            ``(iii) individuals who have expertise in the delivery of 
        mental health care in rural areas;
            ``(iv) individuals who have expertise in the delivery of 
        long-term care in rural areas;
            ``(v) at least one veterans service organization 
        representative from a rural State; and
            ``(vi) representatives of rural veterans with service-
        connected disabilities.
    ``(B) The Committee shall include, as ex officio members--
            ``(i) the Secretary of Health and Human Services (or a 
        representative of the Secretary of Health and Human Services 
        designated by that Secretary);
            ``(ii) the Director of the Indian Health Service (or a 
        representative of that Director); and
            ``(iii) the Under Secretary for Health and the Under 
        Secretary for Benefits, or their designees.
    ``(C) The Secretary may invite representatives of other departments 
and agencies of the United States to participate in the meetings and 
other activities of the Committee.
    ``(3) The Secretary shall determine the number, terms of service, 
and pay and allowances of members of the Committee appointed by the 
Secretary, except that a term of service of any such member may not 
exceed three years. The Secretary may reappoint any such member for 
additional terms of service.
    ``(b) Responsibilities of Committee.--The Secretary shall, on a 
regular basis, consult with and seek the advice of the Committee with 
respect to the administration of benefits by the Department for rural 
veterans, reports and studies pertaining to rural veterans, and the 
needs of rural veterans with respect to primary care, mental health 
care, and long-term care needs of rural veterans.
    ``(c) Report.--(1) Not later than September 1 of each odd-numbered 
year until 2013, the Committee shall submit to the Secretary a report 
on the programs and activities of the Department that pertain to rural 
veterans. Each such report shall include--
            ``(A) an assessment of the needs of rural veterans with 
        respect to primary care, mental health care, and long-term care 
        needs of rural veterans and other benefits and programs 
        administered by the Department;
            ``(B) a review of the programs and activities of the 
        Department designed to meet such needs; and
            ``(C) such recommendations (including recommendations for 
        administrative and legislative action) as the Committee 
        considers appropriate.
    ``(2) The Secretary shall, within 60 days after receiving each 
report under paragraph (1), submit to Congress a copy of the report, 
together with any comments concerning the report that the Secretary 
considers appropriate.
    ``(3) The Committee may also submit to the Secretary such other 
reports and recommendations as the Committee considers appropriate.
    ``(4) The Secretary shall submit with each annual report submitted 
to Congress pursuant to section 529 of this title a summary of all 
reports and recommendations of the Committee submitted to the Secretary 
since the previous annual report of the Secretary submitted pursuant to 
that section.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding at the end the following new item:

``546. Advisory Committee on Rural Veterans.''.
                                 <all>