110 HR 2199 : Traumatic Brain Injury Health
U.S. House of Representatives
2007-05-24
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.This Act may be cited as the
Traumatic Brain Injury Health
Enhancement and Long-Term Support Act of 2007
.
2.Screening,
rehabilitation, and treatment for traumatic brain injury
(a)Screening,
rehabilitation, and treatment for traumatic brain injury
(1)Chapter 17 of title 38,
United States Code, is amended by adding at the end the following new
subchapter:
IX
1791.Screening for
traumatic brain injuries
(a)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)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.
1792.Comprehensive
program for long-term traumatic brain injury rehabilitation
(a)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)The Secretary shall carry out the program developed under
subsection (a) in four geographically dispersed polytrauma network sites
designated by the Secretary.
(c)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)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.
1793.Traumatic
brain injury transition offices
(a)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)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.
1794.Traumatic
brain injury registry
(a)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)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)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.
1795.Centers for
traumatic brain injury research, education, and clinical activities
(a)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)(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 centersA 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)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)(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)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 informationThe 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)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)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.
1796.Committee on
Care of Veterans with Traumatic Brain Injury
(a)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 committeeThe 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
recommendationsThe 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)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)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)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.
3.Pilot program for
delivery of certain services to veterans through mobile Vet Centers
(a)Chapter 17 of title 38,
United States Code, is amended by inserting after
section
1712B the following new section:
1712C.Pilot program
for delivery of certain services through mobile Vet Centers
(a)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, related mental health services, benefits
outreach, and, to the extent practicable, assistance with claims for benefits
under this title 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)(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 and
outreach 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)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)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, related mental health services, benefits outreach, and
claims assistance through the use of mobile Vets Centers.
(e)Authorization of
appropriationsThere is authorized to be appropriated to carry
out this section $7,500,000 for fiscal year 2008 and each subsequent fiscal
year.
.
(b)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
certain services through mobile Vet
Centers.
.
4.Advisory
Committee on Rural Veterans
(a)Establishment of
CommitteeSubchapter III of
chapter
5 of title 38, United States Code, is amended by adding at the
end the following new section:
546.Advisory
Committee on Rural Veterans
(a)(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 CommitteeThe 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)(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)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.
.
Passed the House of
Representatives May 23, 2007.
Lorraine C. Miller,
Clerk.