[Congressional Record Volume 153, Number 68 (Thursday, April 26, 2007)]
[Senate]
[Pages S5211-S5214]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. AKAKA (for himself and Mr. Craig):
  S. 1233. A bill to provide and enhance intervention, rehabilitive 
treatment, and services to veterans with traumatic brain injury, and 
for other purposes; to the Committee on Veterans' Affairs.
  Mr. AKAKA. Mr. President, today I, along with my good friend and 
ranking member, Senator Craig, introduce comprehensive legislation to 
improve the capacity of the Department of Veterans Affairs to care for 
veterans with traumatic brain injuries, otherwise referred to as TBI.
  TBI has become the signature wound of the Iraq war. Blast injuries 
account for over 60 percent of all combat wounds suffered by U.S. 
forces in Iraq. The brain can be harmed by the shock of an explosion, 
or by rattling or striking of the head as a consequence of the 
explosion. The high incidence of powerful explosive attacks means that 
potentially thousands of OIF/OEF veterans have incurred some form of 
brain damage or impairment. Many servicemembers who would have perished 
from their wounds in earlier conflicts are now saved by modern body 
armor and rapid medical evacuation. Although these individuals survive, 
many of them suffer brain damage in addition to other injuries. There 
must be new approaches to best meet the health care needs of these 
veterans.
  On March 27, 2007, I chaired a Committee on Veterans' Affairs hearing 
on VA's ability to deal with war injuries, including TBI. The 
provisions of this bill are a direct outgrowth of that hearing and the 
testimony given by those who suffer with TBI.
  This bill addresses the immediate needs of veterans with TBI for 
high-quality rehabilitation in their communities, and provides VA 
clinicians with increased resources to develop the expertise and 
capacity to meet the lifelong needs of these veterans. The bill has 
seven core provisions, and authorizes a total of $63 million over 6 
years to support new TBI-related initiatives. While this amounts to 
significant new funding, every dollar was included in our Committee's 
Views and Estimates Letter to the Budget Committee, and was 
subsequently included in the Senate-passed Budget Resolution.
  I will highlight a few of the provisions of this legislation:
  First, VA health care providers would be required to develop a 
comprehensive rehabilitation and community reintegration plan for each 
veteran with TBI. A diverse team of VA health care providers would be 
required to review and refine the plan to adapt to the needs of the 
veteran. Giving an injured veteran or their caregiver an opportunity to 
request a review of the rehabilitation plan would ensure VA's 
responsiveness to the needs of these individuals. This provision stems 
directly from the hearing testimony of Denise Mettie, whose severely 
injured son Evan went for months without a coherent, well-thought-out 
rehabilitation plan.
  Second, as we heard from the story by ABC news anchor Bob Woodruff, 
who himself suffered a TBI, VA's four lead polytrauma centers have 
developed significant expertise in rehabilitative care, but most other 
VA facilities lack capacity for specialized TBI services. The bill 
would require VA to implement the individualized plan through outside 
providers in cases where VA is unable to provide the required intensity 
of care or the veteran lives too far away to make VA treatment 
feasible. This provision is inspired by the hearing testimony of Dr. 
Bruce Gans, who called for greater private sector involvement in 
veterans' rehabilitation in those cases where VA lacks capacity or 
geographic reach. Our goal is to ensure that VA care is the finest in 
the country. When VA cannot adequately serve veterans with TBI, 
community providers need to be utilized.
  Third, care for veterans with severe TBI often leads to nursing home 
care. This legislation would give VA providers, in collaboration with 
the Defense and Veterans Brain Injury Center, the ability to conduct 
innovative research and treatment to ``re-awaken'' veterans with severe 
TBI, by making $15 million available for research and care over 5 
years.
  Finally, the legislation makes available $48 million over 6 years for 
VA to maximize the independence, quality of life, and community 
reintegration of veterans with TBI who are unable to manage routine 
activities of daily living. These funds would be available for an 
assisted living pilot program for those with TBI, so that veterans who 
might otherwise be forced into institutional long-term care will 
instead have an opportunity to live in group homes or under other 
arrangements. The bill also requires special consideration for rural 
veteran participation in this pilot program.
  I urge all of my colleagues to support this innovative and 
comprehensive legislation, which will bring hope and progress to many 
brain injured veterans and their families.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1233

       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.

[[Page S5212]]

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

[[Page S5213]]

     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).

  Mr. CRAIG. Mr. President, I rise today as the Ranking Member of the 
Senate Committee on Veterans' Affairs to join my distinguished 
colleague, Senator Akaka, who serves as the Chairman of the Committee, 
in introducing this important legislation to assist veterans who suffer 
from a traumatic brain injury.
  Every so often an issue of incredible importance confronts this 
institution and government as whole. And when it does, it is critical 
that we here in Congress cut through the politics of this institution 
and the red tape of government and do what is right and necessary for 
Americans in need. The bill Senator Akaka and I are introducing today 
is one of those times and veterans with traumatic brain injury is one 
of those issues.
  Sadly, hundreds and perhaps even thousands of our dedicated 
servicemen

[[Page S5214]]

and women are returning from Iraq and Afghanistan with mild, moderate, 
and even severe head trauma. Improvised Explosive Devices detonating 
regularly throughout Iraq have exposed our soldiers, sailors, airmen 
and Marines to countless instances in which a TBI can occur. The long-
term consequences of these injuries are, in many ways, unknown to us. 
There's so much modern medicine doesn't know about how the brain 
functions, let alone how little we know about the consequences of small 
changes in its functioning.
  Still, it is incumbent on us to do everything in our power to provide 
the best care and services to those servicemembers and veterans in need 
of TBI care and rehabilitation. To that end, Senator Akaka and I 
believe that quality TBI care must include certain elements, which this 
legislation would impose on VA.
  Most important among these new requirements is the directive for VA 
to provide every veteran who has an inpatient stay for a TBI with an 
individual plan for rehabilitation and reintegration. This may sound to 
many of my colleagues like a very simple, and thus unimportant, 
requirement. But, I believe it is a critical component of recovery.
  It is a requirement that patients, families, doctors, nurses, social 
workers, etc., sit down and develop a detailed plan to maximize the 
chances of recovery and independent living at some point in the future 
for an injured servicemember or veteran. In short, it is the start of 
the road to recovery.
  In addition to the requirement for individual plans, VA must be given 
some flexibility to seek out private care services when the situation 
or the severity of the traumatic brain injury calls for it. This 
legislation would establish the parameters for receipt of that care and 
I believe send an important message to VA and our wounded veterans that 
we want the best care possible regardless of whether it is obtained 
through a door with the letters V-A over them or through a door with a 
different name.
  Also, this bill would establish a research, clinical care, and 
education program for traumatic brain injury. The program would be 
modeled on VA's very successful Mental Illness Research, Education and 
Clinical Care program as well as the special programs for Parkinson's 
disease and geriatric medicine. The nation must invest in learning more 
about the debilitating conditions that accompany a traumatic brain 
injury so that one day we might look forward to better treatment and, 
most importantly, a better quality of life for these heroes.
  Finally, the legislation would create a pilot program for assisted 
living for veterans with severe traumatic brain injury. I recognize 
that generally assisted living is not a program that VA has embraced in 
the past. But, the sheer number of those suffering with TBI and the 
severity of those conditions demand that we once again consider 
assisted living as a viable means of providing some quality of life to 
veterans and their families. And I am proud that assisted living will 
once again be a component of care provided by VA.
  I urge all of my colleagues to cosponsor this legislation. The 
Chairman and I are very proud of the work we've done together in this 
legislation. I see a lot of progress in VA with respect to the care 
they are providing all of our wounded soldiers and veterans. But, more 
can be done.
  I think this bill will move VA further in the direction they are 
heading and provide veterans with traumatic brain injuries an 
opportunity to achieve a full and productive life.
  With that, again, I want to again thank Chairman Akaka for his work.
                                 ______