1.This Act may be cited as
the Military and Veterans Traumatic
Brain Injury Treatment Act
.
2.Program of
services for traumatic brain injury for members of the Armed Forces and
veterans
(a)Traumatic brain
injury program requiredThe Secretary of Defense and the
Secretary of Veterans Affairs shall jointly establish a program meeting the
requirements of subsections (c) through (f) under which each member of the
Armed Forces or veteran who incurs a traumatic brain injury during service in
the Armed Forces—
(1)is enrolled in
the program; and
(2)receives, under
the program, treatment and rehabilitation meeting the standard of care
specified in subsection (b).
(b)The standard of care for treatment and rehabilitation
specified in this subsection is that each individual who is a member of the
Armed Forces or veteran who qualifies for care under the program established
under subsection (a) shall—
(1)be provided the
highest quality of care possible based on the medical judgment of qualified
medical professionals in facilities that most appropriately meet the specific
needs of the individual; and
(2)be rehabilitated
to the fullest extent possible using the most up-to-date medical technology,
medical rehabilitation practices, and medical expertise available.
(c)
(1)If a member of the Armed Forces or a veteran
participating in the program established under subsection (a) determines that
care provided to such participant by the Department of Defense or the
Department of Veterans Affairs, as the case may be, does not meet the standard
of care specified in subsection (b), the Secretary of Defense or the Secretary
of Veterans Affairs, as the case may be, shall, upon request of the
participant, provide to such participant a referral to a public or private
provider of medical or rehabilitative care for consultation regarding the care
that would meet the standard of care specified in subsection (b).
(2)The Department of Defense shall bear the cost of
referrals under paragraph (1), except that the Secretary of Defense shall not
be required to pay for more than one referral for each participant in any
consecutive three month period.
(d)Screening for
traumatic brain injury
(1)Protocols for
detection and diagnosis of traumatic brain injury
(A)The Secretary of Defense shall, in cooperation with the
Secretary of Veterans Affairs, establish protocols for the detection and
diagnosis of traumatic brain injury, including the use of various types of
screening tools as appropriate.
(B)The
protocol required by subparagraph (A) shall provide that examinations shall be
administered at least once to each member of the Armed Forces—
(i)before deployment
to a combat theater; and
(ii)during the
period beginning on the 30th day after the member returns from such deployment
and ending on the 90th day after the date on which such member returns to the
member's permanent duty station after such deployment.
(C)Protocol for
determination of baseline cognitive functioningThe protocols
required by subparagraph (A) shall include a protocol—
(i)for
the assessment and documentation of the cognitive functioning of each member of
the Armed Forces before each such member is deployed in a combat theater, in
order to facilitate the detection and diagnosis of traumatic brain injury of
such member upon return from such deployment; and
(ii)for the
comparison of the cognitive functioning determined under clause (i) with the
cognitive functioning of the member upon return from deployment.
(D)Administration
of computer-based examinationsThe protocol required by
subparagraph (C) shall include the administration of computer-based
examinations to members of the Armed Forces.
(2)If, while delivering health care services to a member
of the Armed Forces or a veteran who is not a participant in the program
established under subsection (a), the Secretary of Defense or the Secretary of
Veterans Affairs, as the case may be, discovers that such member or veteran may
have incurred a service-connected traumatic brain injury, the Secretary
concerned shall test such member or veteran for traumatic brain injury.
(3)If
the Secretary of Defense or the Secretary of Veterans Affairs receives a
referral for the testing of a member of the Armed Forces or a veteran for
traumatic brain injury, the Secretary concerned shall test such member or
veteran for traumatic brain injury expeditiously.
(4)If
a member of the Armed Forces or a veteran is diagnosed under this subsection
with a traumatic brain injury that was incurred during service in the Armed
Forces, such member or veteran shall be enrolled in the program required by
subsection (a).
(e)
(1)Outreach to
members of the Armed Forces and veteransThe Secretary of Defense
and the Secretary of Veterans Affairs shall conduct a program of outreach to
members of the Armed Forces and veterans to inform such members and veterans
of—
(A)the program
required by subsection (a);
(B)the availability
of screening for the diagnosis of traumatic brain injury under subsection
(d);
(C)the consequences,
with regard to the treatment and care of traumatic brain injury, of separation,
discharge, and retirement from the Armed Forces; and
(D)the rights of
such members or veterans described in subsection (f).
(2)As part of the program of outreach under paragraph (1),
the Secretary of Defense and the Secretary of Veterans Affairs shall annually
and jointly publish and distribute a manual explaining the benefits available
to participants in the program required by subsection (a) and their
families.
(f)Rights of
members of the Armed Forces and veterans with traumatic brain
injuryThe Secretary of
Defense and the Secretary of Veterans Affairs shall inform members of the Armed
Forces and veterans with traumatic brain injury and their families of their
rights with respect to the following:
(1)The receipt of
medical care from the Department of Defense and the Department of Veterans
Affairs.
(2)The options
available to such members and veterans for treatment of traumatic brain
injury.
(3)The options
available to such members and veterans for rehabilitation.
(4)Referrals under
subsection (c)(1).
(5)The right to any
administrative or judicial appeal of any agency decision with respect to the
program established under subsection (a).
(6)Reviews of
decisions under section 4.
(g)Coordination of
case management and health care services for program participants
(1)The Secretary of Defense and the Secretary of Veterans
Affairs shall assign a qualified lead case manager to each member of the Armed
Forces or veteran, as the case may be, that participates in the program
required by subsection (a). Each lead case manager shall, with respect to a
participant in the program under subsection (a) to whom the lead case manager
has been assigned—
(A)coordinate the
work of any other case managers associated with such participant;
(B)help the
participant and the family of such participant manage the stress associated
with receiving treatment and rehabilitative services for traumatic brain
injury;
(C)present the
participant with options for the receipt of medical and rehabilitative care,
including options for such care outside the Department of Defense and the
Department of Veterans Affairs, that meet the standard of care specified in
subsection (b);
(D)help the
participant find and receive the care, including care from outside the
Department of Defense and the Department of Veterans Affairs, to which the
participant is entitled under subsection (a); and
(E)ensure that
providers of care to participants in the program required by subsection (a)
provide consistent guidance to such participants.
(2)The Secretary of Defense and the Secretary of Veterans
Affairs shall assign a lead primary care physician to each member of the Armed
Forces or veteran, as the case may be, who participates in the program required
by subsection (a). Such lead primary care physician shall coordinate and
oversee the care provided to the participant, including all treatment,
rehabilitation, and medications.
(3)Not
later than 6 months after the date of the enactment of this Act, the Secretary
of Defense and the Secretary of Veterans Affairs shall report to Congress on
the steps taken to coordinate care, as required by this subsection, along with
recommendations, if any, for legislation to improve such coordination.
(h)
(1)The
Secretary of Defense and the Secretary of Veterans Affairs may provide
treatment and rehabilitation in accordance with subsection (a) in any of the
facilities as follows:
(A)Facilities of the
Department of Defense.
(B)Facilities of the
Department of Veterans Affairs.
(C)Public or private
medical facilities accredited or otherwise qualified to provide treatment and
rehabilitation.
(2)The Secretary of Defense and the Secretary of Veterans
Affairs shall ensure, by procurement, contract, or agreement, that the program
established under subsection (a) has access to all specialized programs,
services, equipment, and medical expertise required to ensure that each
participant receives the standard of care specified in subsection (b).
(3)Cooperative
agreements, contracts, or partnerships with private and public medical
centersThe Secretary of Defense and the Secretary of Veterans
Affairs shall, separately or jointly, enter into cooperative agreements,
contracts, or partnerships with private or public medical centers with
expertise in the treatment or rehabilitation of individuals with traumatic
brain injury to provide consultation, treatment, or rehabilitation to members
of the Armed Forces or veterans as required by subsection (a).
(4)The Secretary of Defense and the Secretary of Veterans
Affairs shall, separately or jointly, provide grants to, or enter into
contracts or agreements with, private or public medical centers with expertise
in the treatment or rehabilitation of individuals with traumatic brain injury
to provide training, education, or other assistance to personnel of the
Department of Defense and the Department of Veterans Affairs to ensure that
such personnel are consistently using the most up-to-date and best practices
and procedures for the screening, treatment, and rehabilitation of members of
the Armed Forces and veterans with traumatic brain injury.
(5)
(A)During the 24-month period beginning on the date that a
member of the Armed Forces or a veteran is enrolled in the program required by
subsection (a), the member or veteran shall be entitled to all of the benefits
otherwise available to a veteran (in the case of a member) or member (in the
case of a veteran), including participation in the TRICARE program under
chapter 55 of title 10, United States Code, and care provided in a facility of
the Department of Defense, the Department of Veterans Affairs, or other public
or private facility, regardless of the active duty status of such member or
veteran.
(B)Costs associated with the provision of care under
subparagraph (A) shall be borne by the Department of Defense.
3.Facilitation of
continuity of care from Department of Defense to Department of Veterans
AffairsThe Secretary of
Defense and the Secretary of Veterans Affairs shall establish protocols to
ensure that members of the Armed Forces receive, with regard to health care
benefits and services from the Department of Veterans Affairs and otherwise, a
continuity of care and assistance during and after the transition from military
service to civilian life, including protocols for the following:
(1)The expeditious
transfer of medical records from the Department of Defense to the Department of
Veterans Affairs.
(2)Continuity of
health care services, treatment, and coverage for members of the Armed Forces
who are transitioning to civilian life, with particular emphasis on providing
continued health care to participants in the program required by section
2.
(3)The development
of a specific, individualized transition plan for each member, prior to
discharge or release from the Armed Forces, outlining the member's seamless
continuity of care.
4.Review of
certain decisions of the Department of Defense and the Department of Veterans
Affairs
(a)Review of other
than honorable discharge status for former members of the Armed Forces with
traumatic brain injury
(1)The Secretary of Defense shall, upon the request of any
former member of the Armed Forces who served in the Armed Forces after October
6, 2001, and has been discharged from the Armed Forces under other than
honorable conditions, conduct a review (including a medical evaluation) to
determine whether a traumatic brain injury was a cause of the actions of the
member that precipitated the discharge under other than honorable conditions.
Such request may also be made by an authorized representative of the
member.
(2)If
the Secretary of Defense determines under this subsection that the traumatic
brain injury of a member was a cause of the actions of the member that
precipitated the discharge under other than honorable conditions, the Secretary
shall reconsider the discharge and redesignate the status of such discharge if
such action is warranted.
(b)Review of
decisions of Secretary of Veterans Affairs affecting veterans with traumatic
brain injuryUpon the request of any veteran diagnosed with a
traumatic brain injury, the Secretary of Veterans Affairs shall review and
adjust as the Secretary considers appropriate, the disability rating of such
veteran.
5.Traumatic brain
injury research
(a)Research
required of Department of DefenseThe Secretary of Defense shall
conduct research—
(1)to improve the
screening, diagnosis, and treatment of traumatic brain injury;
(2)to improve
rehabilitation of members of the Armed Forces with traumatic brain
injury;
(3)to improve best
practices for the activities described in paragraphs (1) and (2); and
(4)to identify the
mechanisms of brain injury and ways to prevent or ameliorate secondary effects
of brain injuries.
(b)Research
required of Department of Veterans AffairsSection 7303 of title
38, United States Code, is amended—
(1)in subsection
(a)(2), by inserting traumatic brain injury research,
after
mental illness research,
; and
(2)by adding at the
end the following new subsection:
(e)Traumatic brain
injury research shall include research—
(1)to improve the
screening, diagnosis, and treatment of traumatic brain injury;
(2)to improve
rehabilitation of veterans with traumatic brain injury;
(3)to improve best
practices for the activities described in paragraphs (1) and (2); and
(4)to identify the
mechanisms of brain injury and ways to prevent or ameliorate secondary effects
of brain
injuries.
.
(c)Grants or
cooperative agreementsIn conducting the research required by
subsection (a) or in accordance with section 7303(e) of title 38, United States
Code, the Secretary of Defense and the Secretary of Veterans Affairs may
provide grants to, or enter into cooperative agreements with, private or public
medical centers with expertise in research on traumatic brain injury, including
the treatment or rehabilitation of individuals with traumatic brain
injury.
(d)Authorization
of appropriationsThere are authorized to be appropriated—
(1)to the Secretary
of Defense, $20,000,000 to carry out the provisions of subsection (a);
and
(2)to the Secretary
of Veterans Affairs, $20,000,00 to carry out the amendments made by subsection
(b).
6.Not later than December 15 of each year, the
Secretary of Defense shall, in conjunction with the Secretary of Veterans
Affairs, submit to Congress a report that contains, with respect to the fiscal
year ending in the year such report is submitted, the following:
(1)Descriptions of
the activities, accomplishments, and limitations of the program on traumatic
brain injury established under section 2.
(2)Recommendations
of the Secretary of Defense and the Secretary of Veterans Affairs, if any, for
improving the program established under section 2.
(3)Information on
the following:
(A)The number of
members of the Armed Forces and veterans tested for traumatic brain injury by
the Department of Defense and the Department of Veterans Affairs under section
2(d).
(B)The number of
members of the Armed Forces and veterans diagnosed with a traumatic brain
injury.
(C)The number of
members of the Armed Forces and veterans enrolled in the program on traumatic
brain injury established under section 2.
(D)The types of
treatment and rehabilitation provided as part of the program established under
section 2.
(E)The types of
facilities in which services were provided under section 2 and how such
facilities were chosen to meet the individual needs of individual
patients.
(F)The mechanisms
used by the Department of Defense and the Department of Veterans Affairs to
ensure continuity of care for members of the Armed Forces as they transition
from receipt of health care services from the Department of Defense to the
receipt of such services from the Department of Veterans Affairs.
(G)The number and
nature of any cooperative agreements engaged in under section 2(h).
(H)The outreach
activities carried out under subsections (e) and (f) of section 2.
(4)A description of
the expenditures associated with the outreach, screening, diagnosis, treatment,
rehabilitation, and other services provided to members of the Armed Forces and
veterans under sections 2 and 3.
7.Definition of
traumatic brain injuryIn this
Act, the term traumatic brain injury means an acquired injury to
the brain. Such term does not include brain dysfunction caused by congenital or
degenerative disorders, nor birth trauma, but may include brain injuries caused
by anoxia due to trauma. The Secretary of Defense and the Secretary of Veterans
Affairs may jointly revise the definition of such term as the Secretaries
determine necessary, after consultation with the following:
(1)The Secretary of Health and Human
Services.
(2)Representatives of any organization
recognized by the Secretary of Veterans Affairs for the representation of
veterans under section 5902 of title 38, United States Code.
(3)Such public or nonprofit private entities
that the Secretary of Defense or the Secretary of Veterans Affairs considers
appropriate.