[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 1233 Introduced in Senate (IS)]
110th CONGRESS
1st Session
S. 1233
To provide and enhance intervention, rehabilitative treatment, and
services to veterans with traumatic brain injury, and for other
purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
April 26, 2007
Mr. Akaka (for himself and Mr. Craig) introduced the following bill;
which was read twice and referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To provide and enhance intervention, rehabilitative treatment, and
services to veterans with 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,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Veterans Traumatic
Brain Injury Rehabilitation Act of 2007''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Sense of Congress on Department of Veterans Affairs efforts in
the rehabilitation and reintegration of
veterans with traumatic brain injury.
Sec. 3. Individual rehabilitation and community reintegration plans for
veterans and others with traumatic brain
injury.
Sec. 4. Use of non-Department of Veterans Affairs facilities for
implementation of rehabilitation and
community reintegration plans for traumatic
brain injury.
Sec. 5. Research, education, and clinical care program on severe
traumatic brain injury.
Sec. 6. Pilot program on assisted living services for veterans with
traumatic brain injury.
Sec. 7. Age-appropriate nursing home care.
Sec. 8. Research on traumatic brain injury.
SEC. 2. SENSE OF CONGRESS ON DEPARTMENT OF VETERANS AFFAIRS EFFORTS IN
THE REHABILITATION AND REINTEGRATION OF VETERANS WITH
TRAUMATIC BRAIN INJURY.
It is the sense of Congress that--
(1) the Department of Veterans Affairs should have the
capacity and expertise to provide veterans who have a traumatic
brain injury with patient-centered health care, rehabilitation,
and community integration services that are comparable to or
exceed similar care and services available to persons with such
injuries in the academic and private sector;
(2) rehabilitation for veterans who have a traumatic brain
injury should be individualized, comprehensive, and
multidisciplinary with the goals of optimizing the independence
of such veterans and reintegrating them into their communities;
(3) family support is integral to the rehabilitation and
community reintegration of veterans who have sustained a
traumatic brain injury, and the Department should provide the
families of such veterans with education and support;
(4) the Department of Defense and Department of Veterans
Affairs have made efforts to provide a smooth transition of
medical care and rehabilitative services to individuals as they
transition from the health care system of the Department of
Defense to that of the Department of Veterans Affairs, but more
can be done to assist veterans and their families in the
continuum of the rehabilitation, recovery, and reintegration of
wounded or injured veterans into their communities; and
(5) in planning for rehabilitation and community
reintegration of veterans who have a traumatic brain injury, it
is necessary for the Department of Veterans Affairs to provide
a system for life-long case management for such veterans.
SEC. 3. INDIVIDUAL REHABILITATION AND COMMUNITY REINTEGRATION PLANS FOR
VETERANS AND OTHERS WITH TRAUMATIC BRAIN INJURY.
(a) In General.--Subchapter II of chapter 17 of title 38, United
States Code, is amended by inserting after section 1710B the following
new section:
``Sec. 1710C. Traumatic brain injury: plans for rehabilitation and
reintegration into the community
``(a) Plan Required.--The Secretary shall, for each veteran or
member of the Armed Forces who receives inpatient rehabilitation care
from the Department for a traumatic brain injury--
``(1) develop an individualized plan for the rehabilitation
and reintegration of such individual into the community; and
``(2) provide such plan to such individual before such
individual is discharged from inpatient care.
``(b) Contents of Plan.--Each plan developed under subsection (a)
shall include, for the individual covered by such plan, the following:
``(1) Rehabilitation objectives for improving the physical,
cognitive, vocational, and psychosocial functioning of such
individual with the goal of maximizing the independence and
reintegration of such individual into the community.
``(2) A description of specific interventions,
rehabilitative treatments, and other services to achieve the
objectives described in paragraph (2), which description shall
set forth the type, frequency, duration, and location of such
interventions, treatments, and services.
``(3) The name of the case manager designated in accordance
with subsection (d) to be responsible for the implementation of
such plan.
``(4) Dates on which the effectiveness of the plan will be
reviewed in accordance with subsection (f).
``(c) Comprehensive Assessment.--
``(1) In general.--Each plan developed under subsection (a)
shall be based upon a comprehensive assessment, developed in
accordance with paragraph (2), of--
``(A) the physical, cognitive, vocational, and
psychosocial impairments of such individual; and
``(B) the family education and family support needs
of such individual after discharge from inpatient care.
``(2) Formation.--The comprehensive assessment required
under paragraph (1) with respect to an individual is a
comprehensive assessment of the matters set forth in that
paragraph by a team, composed by the Secretary for purposes of
the assessment, from among individuals with expertise in
traumatic brain injury as follows:
``(A) A neurologist.
``(B) A rehabilitation physician.
``(C) A social worker.
``(D) A neuropsychologist or neuropsychiatrist.
``(E) A physical therapist.
``(F) A vocational rehabilitation specialist.
``(G) An occupational therapist.
``(H) A rehabilitation nurse.
``(I) Such other health care professionals as the
Secretary considers appropriate, including--
``(i) an audiologist;
``(ii) a blind rehabilitation specialist;
``(iii) a recreational therapist;
``(iv) a speech language pathologist; and
``(v) a low vision optometrist.
``(d) Case Manager.--The Secretary shall designate a case manager
for each individual described in subsection (a) to be responsible for
the implementation of the plan required by such subsection for such
individual.
``(e) Participation and Collaboration in Development of Plans.--(1)
The Secretary shall involve each individual described in subsection
(a), and the family of such individual, in the development of the plan
for such individual under that subsection to the maximum extent
practicable.
``(2) The Secretary shall collaborate in the development of a plan
for an individual under subsection (a) with an individual with
expertise in the protection of, and advocacy for, individuals with
traumatic brain injury if--
``(A) the individual covered by such plan requests such
collaboration; or
``(B) if such individual is incapacitated, the family or
guardian of such individual requests such collaboration.
``(3) In the case of a plan required by subsection (a) for a member
of the Armed Forces who is on active duty, the Secretary shall
collaborate with the Secretary of Defense in the development of such
plan.
``(4) In developing vocational rehabilitation objectives required
under subsection (b)(2) and in conducting the assessment required under
subsection (c), the Secretary shall act through the Under Secretary for
Health in coordination with the Vocational Rehabilitation and
Employment Service of the Department of Veterans Affairs.
``(f) Evaluation.--
``(1) Periodic review by secretary.--The Secretary shall
periodically review the effectiveness of each plan developed
under subsection (a). The Secretary shall refine each such plan
as the Secretary considers appropriate in light of such review.
``(2) Request for review by veterans.--In addition to the
periodic review required by paragraph (1), the Secretary shall
conduct a review of the plan of a veteran under paragraph (1)
at the request of such veteran, or in the case that such
veteran is incapacitated, at the request of the guardian or the
designee of such veteran.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 17 of such title is amended by inserting after the item
relating to section 1710B the following new item:
``1710C. Traumatic brain injury: plans for rehabilitation and
reintegration into the community.''.
SEC. 4. USE OF NON-DEPARTMENT OF VETERANS AFFAIRS FACILITIES FOR
IMPLEMENTATION OF REHABILITATION AND COMMUNITY
REINTEGRATION PLANS FOR TRAUMATIC BRAIN INJURY.
(a) In General.--Subchapter II of chapter 17 of title 38, United
States Code, is amended by inserting after section 1710C, as added by
section 3 of this Act, the following new section:
``Sec. 1710D. Traumatic brain injury: use of non-Department facilities
for rehabilitation
``(a) In General.--Subject to section 1710(a)(4) of this title and
subsection (b) of this section, the Secretary shall provide
intervention, rehabilitative treatment, or services to implement a plan
developed under section 1710C of this title at a non-Department
facility with which the Secretary has entered into an agreement for
such purpose, to an individual--
``(1) who is described in subsection (a) of such section;
and
``(2)(A) to whom the Secretary is unable to provide such
intervention, treatment, or services at the frequency or for
the duration prescribed in such plan; or
``(B) who resides at such distance, as determined by the
Secretary, from a Department medical facility as to make the
implementation of such plan through a Department facility
infeasible or impracticable.
``(b) Standards.--The Secretary may not provide intervention,
treatment, or services as described in subsection (a) at a non-
Department facility under such subsection unless such facility
maintains standards for the provision of such intervention, treatment,
or services established by an independent, peer-reviewed organization
that accredits specialized rehabilitation programs for adults with
traumatic brain injury.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 17 of such title is amended by inserting after the item
relating to section 1710C, as added by section 3 of this Act, the
following new item:
``1710D. Traumatic brain injury: use of non-Department facilities for
rehabilitation.''.
SEC. 5. RESEARCH, EDUCATION, AND CLINICAL CARE PROGRAM ON SEVERE
TRAUMATIC BRAIN INJURY.
(a) Program Required.--Subchapter II of chapter 73 of title 38,
United States Code, is amended by inserting after section 7330 the
following new section:
``Sec. 7330A. Severe traumatic brain injury research, education, and
clinical care program
``(a) Program Required.--The Secretary shall establish a program on
research, education, and clinical care to provide intensive neuro-
rehabilitation to veterans with a severe traumatic brain injury,
including veterans in a minimally conscious state who would otherwise
receive nursing home care.
``(b) Collaboration Required.--The Secretary shall establish the
program required by subsection (a) in collaboration with the Defense
and Veterans Brain Injury Center of the Department of Defense and
academic institutions selected by the Secretary from among institutions
having an expertise in research in neuro-rehabilitation.
``(c) Education Required.--As part of the program required by
subsection (a), the Secretary shall conduct educational programs on
recognizing and diagnosing mild and moderate cases of traumatic brain
injury.
``(d) Authorization of Appropriations.--There is authorized to be
appropriated to the Secretary for each of fiscal years 2008 through
2012, $3,000,000 to carry out the program required by subsection
(a).''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 73 of such title is amended by inserting after the item
relating to section 7330 the following new item:
``7330A. Severe traumatic brain injury research, education, and
clinical care program.''.
(c) Report.--Not later than 120 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall submit
to Congress a report on the research to be conducted under the program
required by section 7330A of title 38, United States Code, as added by
subsection (a).
SEC. 6. PILOT PROGRAM ON ASSISTED LIVING SERVICES FOR VETERANS WITH
TRAUMATIC BRAIN INJURY.
(a) Pilot Program.--Not later than 90 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall carry
out a pilot program to assess the effectiveness of providing assisted
living services to eligible veterans to enhance the rehabilitation,
quality of life, and community integration of such veterans.
(b) Duration of Program.--The pilot program shall be carried out
during the five-year period beginning on the date of the commencement
of the pilot program.
(c) Program Locations.--
(1) In general.--The pilot program shall be carried out at
locations selected by the Secretary for purposes of the pilot
program. Of the locations so selected--
(A) at least one shall be in each health care
region of the Veterans Health Administration that
contains a polytrauma center of the Department of
Veterans Affairs; and
(B) any other locations shall be in areas that
contain high concentrations of veterans with traumatic
brain injury, as determined by the Secretary.
(2) Special consideration for veterans in rural areas.--
Special consideration shall be given to provide veterans in
rural areas with an opportunity to participate in the pilot
program.
(d) Provision of Assisted Living Services.--
(1) Agreements.--In carrying out the pilot program, the
Secretary may enter into agreements for the provision of
assisted living services on behalf of eligible veterans with
either of the following:
(A) A provider of services that has entered into a
provider agreement under section 1866(a) of the Social
Security Act (42 U.S.C. 1395cc(a)).
(B) A provider participating under a State plan
under title XIX of such Act (42 U.S.C. 1396 et seq.).
(2) Standards.--The Secretary may not place, transfer, or
admit a veteran to any facility for assisted living services
under this program unless the Secretary determines that the
facility meets such standards as the Secretary may prescribe
for purposes of the pilot program. Such standards shall, to the
extent practicable, be consistent with the standards of
Federal, State, and local agencies charged with the
responsibility of licensing or otherwise regulating or
inspecting such facilities.
(e) Continuation of Case Management and Rehabilitation Services.--
In carrying the pilot program under subsection (a), the Secretary shall
continue to provide each veteran who is receiving assisted living
services under the pilot program with rehabilitative services and shall
designate Department health-care employees to furnish case management
services for veterans participating in the pilot program.
(f) Report.--
(1) In general.--Not later than 60 days after the
completion of the pilot program, the Secretary shall submit to
the congressional veterans affairs committees a report on the
pilot program.
(2) Contents.--The report required by paragraph (1) shall
include the following:
(A) A description of the pilot program.
(B) An assessment of the utility of the activities
under the pilot program in enhancing the
rehabilitation, quality of life, and community
reintegration of veterans with traumatic brain injury.
(C) Such recommendations as the Secretary considers
appropriate regarding the extension or expansion of the
pilot program.
(g) Definitions.--In this section:
(1) The term ``assisted living services'' means services of
a facility in providing room, board, and personal care for and
supervision of residents for their health, safety, and welfare.
(2) The term ``case management services'' includes the
coordination and facilitation of all services furnished to a
veteran by the Department of Veterans Affairs, either directly
or through contract, including assessment of needs, planning,
referral (including referral for services to be furnished by
the Department, either directly or through a contract, or by an
entity other than the Department), monitoring, reassessment,
and followup.
(3) The term ``congressional veterans affairs committees''
means--
(A) the Committee on Veterans' Affairs of the
Senate; and
(B) the Committee on Veterans' Affairs of the House
of Representatives.
(4) The term ``eligible veteran'' means a veteran who--
(A) is enrolled in the Department of Veterans
Affairs health care system;
(B) has received treatment for traumatic brain
injury from the Department of Veterans Affairs;
(C) is unable to manage routine activities of daily
living without supervision and assistance; and
(D) could reasonably be expected to receive ongoing
services after the end of the pilot program under this
section under another government program or through
other means.
(h) Authorization of Appropriations.--There is authorized to be
appropriated to the Secretary of Veterans Affairs to carry out this
section, $8,000,000 for each of fiscal years 2008 through 2013.
SEC. 7. AGE-APPROPRIATE NURSING HOME CARE.
(a) Finding.--Congress finds that young veterans who are injured or
disabled through military service and require long-term care should
have access to age-appropriate nursing home care.
(b) Requirement To Provide Age-Appropriate Nursing Home Care.--
Section 1710A of title 38, United States Code, is amended--
(1) by redesignating subsection (c) as subsection (d); and
(2) by inserting after subsection (b) the following new
subsection (c):
``(c) The Secretary shall ensure that nursing home care provided
under subsection (a) is provided in an age-appropriate manner.''.
SEC. 8. RESEARCH ON TRAUMATIC BRAIN INJURY.
(a) Inclusion of Research on Traumatic Brain Injury Under Ongoing
Research Programs.--The Secretary of Veterans Affairs shall, in
carrying out research programs and activities under the provisions of
law referred to in subsection (b), ensure that such programs and
activities include research on the sequelae of traumatic brain injury,
including--
(1) research on visually-related neurological conditions;
(2) research on seizure disorders; and
(3) research on means of improving the diagnosis,
treatment, and prevention of such sequelae.
(b) Research Authorities.--The provisions of law referred to in
this subsection are the following:
(1) Section 3119 of title 38, United States Code, relating
to rehabilitation research and special projects.
(2) Section 7303 of title 38, United States Code, relating
to research programs of the Veterans Health Administration.
(3) Section 7327 of title 38, United States Code, relating
to research, education, and clinical activities on complex
multi-trauma associated with combat injuries.
(c) Collaboration.--In carrying out the research required by
subsection (a), the Secretary shall collaborate with facilities that--
(1) conduct research on rehabilitation for individuals with
traumatic brain injury; and
(2) receive grants for such research from the National
Institute on Disability and Rehabilitation Research of the
Department of Education.
(d) Report.--Not later than 90 days after the date of the enactment
of this Act, the Secretary shall submit to the Committees on Veterans'
Affairs of the Senate and the House of Representatives a report
describing in comprehensive detail the research to be carried out in
order to fulfill the requirement in subsection (a).
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