[Congressional Record Volume 140, Number 145 (Friday, October 7, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: October 7, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                   TRAUMATIC BRAIN INJURY ACT OF 1994

                                 ______


                 KENNEDY (AND HATCH) AMENDMENT NO. 2654

  Mr. FEINGOLD (for Mr. Kennedy, for himself and Mr. Hatch) proposed an 
amendment to the bill (S. 725) to amend the Public Health Service Act 
to provide for the conduct of expanded studies and the establishment of 
innovative programs with respect to traumatic brain injury, and for 
other purposes, as follows.

       Strike out all after the enacting clause and insert in lieu 
     thereof the following:

     SECTION 1. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND 
                   PREVENTION.

       (a) In General.--Part B of title III of the Public Health 
     Service Act (42 U.S.C. 243 et seq.), as amended by section 
     209 of the Minority Health Improvement Act of 1994, is 
     amended by inserting after section 317G the following 
     section:


                 ``prevention of traumatic brain injury

       ``Sec. 317H. (a) The Secretary, acting through the Director 
     of the Centers for Disease Control and Prevention, may carry 
     out projects to reduce the incidence of traumatic brain 
     injury. Such projects may be carried out by the Secretary 
     directly or through awards of grants or contracts to public 
     or nonprofit private entities. The Secretary may directly or 
     through such awards provide technical assistance with respect 
     to the planning, development, and operation of such projects.
       ``(b) Certain Activities.--Activities under subsection (a) 
     may include--
       ``(1) the conduct of research into identifying effective 
     strategies for the prevention of traumatic brain injury; and
       ``(2) the implementation of public information and 
     education programs for the prevention of such injury and for 
     broadening the awareness of the public concerning the public 
     health consequences of such injury.
       ``(c) Coordination of Activities.--The Secretary shall 
     ensure that activities under this section are coordinated as 
     appropriate with other agencies of the Public Health Service 
     that carry out activities regarding traumatic brain injury.
       ``(d) Definition.--For purposes of this section, 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 near 
     drowning.''.

     SEC. 2. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.

       Section 1261 of the Public Health Service Act (42 U.S.C. 
     300d-61) is amended--
       (1) in subsection (d)--
       (A) in paragraph (2), by striking ``and'' after the 
     semicolon at the end;
       (B) in paragraph (3), by striking the period and inserting 
     ``; and''; and
       (C) by adding at the end the following paragraph:
       ``(4) the authority to make awards of grants or contracts 
     to public or nonprofit private entities for the conduct of 
     basic and applied research regarding traumatic brain injury, 
     which research may include--
       ``(A) the development of new methods and modalities for the 
     more effective diagnosis, measurement of degree of injury, 
     post-injury monitoring and prognostic assessment of head 
     injury for acute, subacute and later phases of care;
       ``(B) the development, modification and evaluation of 
     therapies that retard, prevent or reverse brain damage after 
     acute head injury, that arrest further deterioration 
     following injury and that provide the restitution of function 
     for individuals with long-term injuries;
       ``(C) the development of research on a continuum of care 
     from acute care through rehabilitation, designed, to the 
     extent practicable, to integrate rehabilitation and long-term 
     outcome evaluation with acute care research; and
       ``(D) the development of programs that increase the 
     participation of academic centers of excellence in head 
     injury treatment and rehabilitation research and training.''; 
     and
       (2) in subsection (h), by adding at the end the following 
     paragraph:
       ``(4) 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 near drowning.''.

     SEC. 3. PROGRAMS OF HEALTH RESOURCES AND SERVICES 
                   ADMINISTRATION.

       Part E of title XII of the Public Health Service Act (42 
     U.S.C. 300d-51 et seq.) is amended by adding at the end the 
     following section:

     ``SEC. 1252. STATE GRANTS FOR DEMONSTRATION PROJECTS 
                   REGARDING TRAUMATIC BRAIN INJURY.

       ``(a) In General.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, may make grants to States for the purpose of 
     carrying out demonstration projects to improve the 
     availability of health services regarding traumatic brain 
     injury.
       ``(b) State Advisory Board.--
       ``(1) In general.--The Secretary may make a grant under 
     subsection (a) only if the State involved agrees to establish 
     an advisory board within the appropriate health department of 
     the State or within another department as designated by the 
     chief executive officer of the State.
       ``(2) Functions.--An advisory board established under 
     paragraph (1) shall be cognizant of findings and concerns of 
     Federal, State and local agencies, citizens groups, and 
     private industry (such as insurance, health care, automobile, 
     and other industry entities). Such advisory boards shall 
     encourage citizen participation through the establishment of 
     public hearings and other types of community outreach 
     programs.
       ``(3) Composition.--An advisory board established under 
     paragraph (1) shall be composed of--
       ``(A) representatives of--
       ``(i) the corresponding State agencies involved;
       ``(ii) public and nonprofit private health related 
     organizations;
       ``(iii) other disability advisory or planning groups within 
     the State;
       ``(iv) members of an organization or foundation 
     representing traumatic brain injury survivors in that State; 
     and
       ``(v) injury control programs at the State or local level 
     if such programs exist; and
       ``(B) a substantial number of individuals who are survivors 
     of traumatic brain injury, or the family members of such 
     individuals.
       ``(c) Matching Funds.--
       ``(1) In general.--With respect to the costs to be incurred 
     by a State in carrying out the purpose described in 
     subsection (a), the Secretary may make a grant under such 
     subsection only if the State agrees to make available, in 
     cash, non-Federal contributions toward such costs in an 
     amount that is not less than $1 for each $2 of Federal funds 
     provided under the grant.
       ``(2) Determination of amount contributed.--In determining 
     the amount of non-Federal contributions in cash that a State 
     has provided pursuant to paragraph (1), the Secretary may not 
     include any amounts provided to the State by the Federal 
     Government.
       ``(d) Application for Grant.--The Secretary may make a 
     grant under subsection (a) only if an application for the 
     grant is submitted to the Secretary and the application is in 
     such form, is made in such manner, and contains such 
     agreements, assurances, and information as the Secretary 
     determines to be necessary to carry out this section.
       ``(e) Coordination of Activities.--The Secretary shall 
     ensure that activities under this section are coordinated as 
     appropriate with other agencies of the Public Health Service 
     that carry out activities regarding traumatic brain injury.
       ``(f) Report.--Not later than 2 years after the effective 
     date under section 901 of the Minority Health Improvement Act 
     of 1994, the Secretary shall submit to the Committee on 
     Energy and Commerce of the House of Representatives, and to 
     the Committee on Labor and Human Resources of the Senate, a 
     report describing the findings and results of the programs 
     established under this section, including measures of 
     outcomes and consumer and surrogate satisfaction.
       ``(g) Definition.--For purposes of this section, 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 near 
     drowning.
       ``(h) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section, 
     $5,000,000 for fiscal year 1995, and such sums as may be 
     necessary for each of the fiscal years 1996 and 1997.''.

     SEC. 4. STUDY; CONSENSUS CONFERENCE.

       (a) Study.--
       (1) In general.--The Secretary of Health and Human Services 
     (in this section referred to as the ``Secretary''), acting 
     through the appropriate agencies of the Public Health 
     Service, shall conduct a study for the purpose of carrying 
     out the following with respect to traumatic brain injury:
       (A) In collaboration with appropriate State and local 
     health-related agencies--
       (i) determine the incidence and prevalence of traumatic 
     brain injury; and
       (ii) develop a uniform reporting system under which States 
     report incidence of traumatic brain injury, if the Secretary 
     determines that such a system is appropriate.
       (B) Identify common therapeutic interventions which are 
     used for the rehabilitation of individuals with such 
     injuries, and shall, subject to the availability of 
     information, include an analysis of--
       (i) the effectiveness of each such intervention in 
     improving the functioning of individuals with brain injuries;
       (ii) the comparative effectiveness of interventions 
     employed in the course of rehabilitation of individuals with 
     brain injuries to achieve the same or similar clinical 
     outcome; and
       (iii) the adequacy of existing measures of outcomes and 
     knowledge of factors influencing differential outcomes.
       (C) Develop practice guidelines for the rehabilitation of 
     traumatic brain injury at such time as appropriate scientific 
     research becomes available.
       (2) Dates certain for reports.--
       (A) Not later than 18 months after the effective date under 
     section 901, the Secretary shall submit to the Committee on 
     Energy and Commerce of the House of Representatives, and to 
     the Committee on Labor and Human Resources of the Senate, a 
     report describing the findings made as a result of carrying 
     out paragraph (1)(A).
       (B) Not later than 3 years after the effective date under 
     section 901, the Secretary shall submit to the Committees 
     specified in subparagraph (A) a report describing the 
     findings made as a result of carrying out subparagraphs (B) 
     and (C) of paragraph (1).
       (b) Consensus Conference.--The Secretary, acting through 
     the Director of the National Center for Medical 
     Rehabilitation Research within the National Institute for 
     Child Health and Human Development, shall conduct a national 
     consensus conference on managing traumatic brain injury and 
     related rehabilitation concerns.
       (c) Definition.--For purposes of this section, 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 near 
     drowning.

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