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.

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.

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:

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.

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:

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.

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:

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).

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.

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.

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).