[Congressional Record Volume 153, Number 76 (Wednesday, May 9, 2007)]
[Senate]
[Pages S5871-S5877]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS
By Mr. KYL (for himself and Mr. McCain):
S. 1341. A bill to provide for the exchange of certain Bureau of Land
Management land in Pima County, Arizona, and for other purposes; to the
Committee on Energy and Natural Resources.
Mr. KYL. Mr. President, today I am pleased to be joined by Senator
McCain to introduce the Las Cienegas Enhancement and Saguaro National
Park Boundary Adjustment Act of 2007. This legislation directs a land
exchange between the Bureau of Land Management, BLM, and the Las
Cienegas Conservation, LLC in southeastern Arizona. A similar bill was
introduced last year, and it passed the House of Representatives.
Unfortunately, the Senate was unable to pass it before the session
ended.
We can turn this disappointment into a success. The bill we introduce
today adds to the exchange a highly sought after private parcel, the
``Bloom Property.'' The Bloom Property would be added to Saguaro
National Park. State and local officials, conservationists, and other
stakeholders have worked together to include the Bloom Property in this
bill and to structure an exchange that is fair and in the public
interest.
Let me explain the details of the exchange. The land to be
transferred out of Federal ownership, approximately 1,280 acres, is
referred to as the ``Sahuarita property.'' This property is BLM-managed
land south of Tucson near Corona de Tucson. The land is low-lying
Sonoran desert and has been identified for disposal by the BLM through
its land-use planning process.
The private land to be brought into Federal ownership consists of two
parcels. The first parcel is approximately 2,392 acres of land referred
to as the ``Empirita-Simonson property.'' This property lies north of
the Las Cienegas National Conservation Area managed by the BLM. The
Empirita-Simonson property lies within the ``Sonoita Valley Acquisition
Planning District'' established by Public Law 106-538, which designated
the Las Cienegas National Conservation Area. The act directed the
Department of the Interior to acquire lands from willing sellers within
the planning district for inclusion within the conservation area. The
idea was to further protect lands with important resource values for
which the national conservation area was designated.
The second parcel, the Bloom Property, is approximately 160 acres of
land that was identified for inclusion in the Saguaro National Park
during a boundary study conducted by the National Park Service in 1993.
In 1994, using the data from the study, Congress enacted legislation
expanding the park and changed Saguaro's designation from monument to
park. At that time, the Bloom Property did not have a willing seller. I
am pleased to say circumstances have changed, and we are able to
include it in this exchange. The Bloom Property, which lies just south
of the Sweetwater Trail in Saguaro Park West, is a prime example of
Sonoran desert important to maintain corridors for wildlife like the
mountain lion.
Although this bill is centered on the land exchange I just described,
it also accomplishes two other important objectives: addressing water
withdrawals at Cienegas Creek and providing road access to a popular
recreation destination, the Whetstone Mountains controlled by the
Forest Service.
Let's talk about water. Arizonans understand that protecting our
water supply is crucial to the State's future. For this reason, we
continually seek ways to promote responsible use of our limited water
supply. This bill promotes responsible use. There is a prior claim to a
well site on the private land that will be exchanged. That prior claim
would allow a developer to withdraw 1,600 acre-feet of water a year.
Pima County and the community at large are concerned about the future
of Cienegas Creek and the entire riparian area if these water
withdrawals occur.
To address this concern, the land exchange is conditioned on Las
Cienegas Conservation, LLC conveying the well site to Pima County and
relinquishing those water rights it controls. The net result is a water
savings of 1,050 acre-feet per year. This is a significant benefit to
this riparian area.
Overall, this bill allows us to accomplish important environmental
and conservation objectives while managing our development. It is a
bill with broad support that includes Pima County, the city of Tucson,
and many others. I urge my colleagues to work with me to approve this
legislation at the earliest possible date.
______
By Mrs. CLINTON (for herself and Ms. Collins)
S. 1343. A bill to amend the Public Health Service Act with respect
to prevention and treatment of diabetes, and for other purposes; to the
Committee on Health, Education, Labor, and Pensions.
Mrs. CLINTON. Mr. President, today, Senator Collins and I will be
introducing the Diabetes Treatment and Prevention Act, legislation to
help our Federal, State and local governments address the growing
epidemic of diabetes across our Nation.
According to the Centers for Disease Control and Prevention, CDC, the
number of Americans with diagnosed diabetes has doubled over the past
15 years.
[[Page S5872]]
Over 20 million Americans are currently living with this disease, but 6
million of them have not yet been diagnosed. Another 54 million are
classified as ``pre-diabetic,'' with a high risk of developing this
condition. Diabetes accounts for over $92 billion in direct medical
costs every year, and these numbers are only likely to increase.
Last year, the New York Times published an insightful series on
diabetes that highlighted the obstacles faced by health care providers
and institutions seeking to prevent complications from diabetes. The
system will pay tens of thousands of dollars for amputations, but not a
low-cost visit to the podiatrist that could have saved the foot.
Hospitals struggle to provide preventive treatment and rehabilitation
in the Byzantine system of reimbursements. The incentives inside our
health care system are backwards, and the payment system is upside-
down: too often paying for costly and debilitating treatment but not
for low-cost prevention.
We know what works. The landmark Diabetes Prevention Program, a
government funded clinical trial, found that moderate diet and exercise
interventions helped to delay and prevent the onset of type 2 diabetes
in persons at high risk for developing the condition. Indeed, the study
was so successful that it was ended a year earlier than planned. Yet
despite the success of this study, we still haven't found a way to
implement these interventions in our communities.
The Diabetes Treatment and Prevention Act would provide additional
support for the Federal, State and local programs that are working to
fight this epidemic. Our legislation would codify the Division of
Diabetes Translation at the Centers for Disease Control and Prevention,
CDC, giving them definitive authority to carry out activities in
diabetes surveillance, translational research, and education efforts.
It would direct the CDC to continue its work in coordinating the
National Diabetes Education Program, in conjunction with the National
Institutes of Health, NIH, and would increase support for its diabetes
control and prevention efforts at the State level.
This bill would also establish several demonstration projects. One
would help to translate the interventions identified as effective by
the Diabetes Prevention Program into clinical interventions that can be
replicated at the State, local and provider level. Another would allow
academic centers, in conjunction with state and local health
departments, to examine ways to improve overall health outcomes in
people living with diabetes and other co-occurring chronic conditions,
such as heart disease, mental illness, or HIV. Finally, the bill would
support efforts to increase surveillance and education at the State and
local level.
The epidemic of diabetes has the potential to place great burdens on
our health care system, but it doesn't have to. We can prevent
diabetes, we can manage diabetes, and we can reduce the health care
costs associated with care and treatment for this condition. The
Diabetes Treatment and Prevention Act will help us take necessary steps
to supporting our public health infrastructure in dealing with this
crisis, and I would urge all of my colleagues to cosponsor this
legislation.
______
By Mrs. MURRAY:
S. 1344. A bill to designate the Department of Veterans Affairs
outpatient clinic in Wenatchee, Washington, as the Elwood ``Bud'' Link
Department of Veterans Affairs Outpatient Clinic; to the Committee on
Veterans' Affairs.
Mrs. MURRAY. Mr. President, I rise today to speak about legislation
that my colleague from Washington, Congressman Doc Hastings, and I are
introducing to name the soon-to-be-opened Community-Based Outpatient
Clinic in Wenatchee, WA, after Elwood ``Bud'' Link. Bud provided both
the inspiration and the energy necessary to make this project a
reality, thereby fulfilling a longstanding and serious need for his
community.
Bud, a World War II veteran and an active member of Veterans of
Foreign Wars Post 10445, recognized the need for better, more
accessible veteran medical services for those veterans living in north
central Washington. Like countless others, Bud suffered from health
problems attributed to his service in the Navy, where he bravely served
aboard the USS Tracy escorting convoys throughout the South Pacific and
protecting medical personnel after the deployment of the atomic bomb.
When Bud returned to the States, he, like so many other veterans,
relied on the VA for health care. In order to receive the necessary
treatment from the VA, however, Bud was forced to make a 3-hour drive
in each direction to the VA medical center nearest to his home.
Realizing that this was the case for veterans all over his community,
Bud, his wife of over 50 years, Helen, and his fellow VFW Post 10445
members, helped by the American Legion and other veteran service
organizations, mobilized the community to work toward the creation of a
new, more accessible outpatient veteran center.
I was proud to contribute to this effort. After several years of hard
work, I stood with Congressman Doc Hastings at the Cashmere VFW hall on
March 20, 2006 to announce the VA's final decision to create the
Community-Based Outpatient Clinic in Wenatchee, WA.
Although Bud sadly passed away before this exciting announcement was
made, the creation of this facility in Wenatchee represents the
culmination of Bud and his fellow veterans' efforts to make veterans'
medical care more accessible and, in turn, to hold the Federal
Government accountable for fulfilling its promises to the veteran
community.
Bud dedicated his time and energy to addressing this and other
veteran needs as an advocate, a leader, and a concerned citizen. Due in
large part to Bud's work, the new CBOC, set to serve six counties in
north central Washington, is likely to make over 25,000 visits by
veterans more accessible next year.
Bud's life of service and activism, coupled with this final victory,
reaffirms a valuable lesson for all Americans: even a single citizen
can see a problem and fix it.
Bud Link dedicated his time and energy to helping other veterans, and
now that the clinic he fought for is going to open, we have a chance to
honor his lifetime of service. My bill will ensure that Bud's efforts
and good example will not be forgotten, but rather, that the new CBOC
will carry on Bud's legacy.
I ask my colleagues to join me in honoring the work that Bud Link and
his fellow veterans have done to make this new CBOC a reality.
______
By Mr. AKAKA (for himself, Mr. Lieberman, Ms. Collins, Mr. Levin,
Mr. Leahy, Mr. Feingold, and Mrs. Clinton):
S. 1345. A bill to affirm that Federal employees are protected from
discrimination on the basis of sexual orientation and to repudiate any
assertion to the contrary; to the Committee on Homeland Security and
Governmental Affairs.
Mr. AKAKA. Mr. President, as we celebrate Public Service Recognition
Week and the dedication and professionalism of Federal employees, I
rise today to introduce legislation to reassert protections for Federal
employees and applicants for Federal employment against discrimination
based on one's sexual orientation. The Clarification of Federal
Employment Protection Act will spell out the protections that Federal
employees currently have but have been denied by the Office of Special
Counsel, OSC. I am pleased that Senators Lieberman, Collins, Levin,
Leahy, Feingold, and Clinton are cosponsoring this important
legislation and that Representative Henry Waxman, Chairman of the House
Oversight and Government Reform Committee, is introducing a companion
bill in the House.
When Congress passed the Civil Service Reform Act of 1978, it
established a list of prohibited personnel practices, personnel actions
that were clearly not in line with the Merit System Principles and were
subject to prosecution by OSC. Examples include personnel actions, such
as hiring, firing, and changes in pay, against employees based on a
whistleblower disclosure, nepotism, or off-duty conduct.
The prohibition on personnel action based on off-duty conduct, found
in section 2302(b)(10) of title 5, United States Code, has been
interpreted for years to prohibit the taking of personnel actions
against employees and applicants
[[Page S5873]]
for employment based on their sexual orientation. In 1980, Mr. Alan
Campbell, Director of the Office of Personnel Management, OPM, at the
time, wrote a memorandum to the heads of all executive branch agencies
advising that, under 5 U.S.C. 2302(b)(10), employees and applicants
were to be protected against inquiries into or actions based upon non
job-related conduct, including religious or community affiliations, or
sexual orientation. The position by OPM has been reaffirmed time and
again, most recently by the current OPM Director, Linda Springer, in
her responses to questions posed by the Homeland Security and
Governmental Affairs Committee in relation to her nomination for the
position. In fact, to this day, OPM's website contains a guide to
Federal employee rights which states that section 2302(b)(10) has been
interpreted by OPM to prohibit discrimination based upon sexual
orientation.
OPM is not alone in this interpretation. The previous Special Counsel
also interpreted 2302(b)(10) to protect against discrimination based on
an individual's sexual orientation. For example, in 2003, OSC secured
corrective and disciplinary action against a Federal supervisor who
discriminated against Federal job applicant because he was gay in
violation of section 2302(b)(10). In 2004, following the debate spurred
by OSC over the interpretation of this provision, White House spokesman
Trent Duffy said the president ``believes that no Federal employee
should be subject to unlawful discrimination, and Federal agencies will
fully enforce the law against discrimination, including discrimination
based on sexual orientation.''
Upon the nomination of Scott Bloch to be the new Special Counsel, I
asked the nominee about his interpretation of the laws protecting
Federal employees and applicants against sexual orientation
discrimination. When asked if he would support the interpretation of
2302(b)(10) by OPM and OSC, he said that he would not fail to enforce a
claim of sexual orientation discrimination before OSC that shows
through the evidence that the statute has been violated.
Nonetheless, after being in office for only a few months, Special
Counsel Bloch conducted a review of the discrimination statute and
claimed that section 2302(b)(10) only provides protection against
discrimination based on conduct, including sexual conduct, but not
one's sexual orientation. Instead, Mr. Bloch claims that for
discrimination based on status, referring to sexual orientation, it
would have to be listed under section 2302(b)(1), which protects
employees from discrimination based on race, gender, religion, or
marital status. This departure from the long-standing interpretation of
(b)(10) by OSC and OPM is illogical. When a supervisor who dislikes
gays or lesbians refuses to hire an applicant who the supervisor
believes is gay or lesbian, it follows that the supervisor is basing
the personnel action on disapproval of the applicant's presumed sexual
conduct. In other words, in the context of sexual orientation
discrimination, status implies conduct.
I believe that Congress must act to guarantee the protections it has
provided to Federal employees and applicants for Federal employment. We
cannot allow one administration official's opinion to undermine the
merit system or the rights and protections Federal workers. The
legislation I am introducing today would affirm that sexual orientation
is protected by section 2302(b)(10) but also make it a clear protected
status under section (b)(1). 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. 1345
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Clarification of Federal
Employment Protections Act''.
SEC. 2. DISCRIMINATION ON THE BASIS OF SEXUAL ORIENTATION
PROHIBITED.
(a) Repudiation.--In order to dispel any public confusion,
Congress repudiates any assertion that Federal employees are
not protected from discrimination on the basis of sexual
orientation.
(b) Affirmation.--It is the sense of Congress that, in the
absence of the amendment made by subsection (c),
discrimination against Federal employees and applicants for
Federal employment on the basis of sexual orientation is
prohibited by section 2302(b)(10) of title 5, United States
Code.
(c) Amendment.--Section 2302(b)(1) of title 5, United
States Code, is amended--
(1) by striking ``or'' at the end of subparagraph (D);
(2) by inserting ``or'' at the end of subparagraph (E); and
(3) by adding at the end the following:
``(F) on the basis of sexual orientation.''.
______
By Mrs. FEINSTEIN:
S. 1347. A bill to amend the Omnibus Indian Advancement Act to modify
the date as of which certain tribal land of the Lytton Rancheria of
California is deemed to be held in trust and to provide for the conduct
of certain activities on the land; to the Committee on Indian Affairs.
Mrs. FEINSTEIN. Mr. President, I rise today to introduce the Lytton
Gaming Oversight Act of 2007, a bill seeking to ensure that Native
American tribes follow the regular process under Federal law prior to
establishing and operating gaming facilities.
I believe this approach provides a good step forward as it has the
support of both the local community and the Lytton tribe.
I am pleased to have worked closely with representatives of the local
community, such as California Assemblymember Loni Hancock, D-Berkeley,
as well as my colleague Senator Specter in crafting this piece of
legislation.
I introduced similar legislation in the 108th and 109th Congresses,
but these bills would have effectively required closure of the casino
operations, until a point when and if the Lytton successfully completed
the two-part determination process.
This legislation, however, stalled. The legislation introduced today
breaks that stalemate and seeks to prevent a massive expansion of
gaming in the Bay Area.
The bill requires that the Lytton Band of Pomo Indians follow
critical oversight guidelines laid out in Section 20 of the Indian
Gaming Regulatory Act, IGRA, before engaging in Class III gaming.
This legislation would amend language inserted into the Omnibus
Indian Advancement Act of 2000.
That language mandated that the Secretary of Interior take a card
club and adjacent parking lot in the San Francisco Bay Area into trust
for the Lytton tribe as their reservation and backdate the acquisition
to October 17, 1988, or pre-IGRA.
This backdating was done expressly with the goal of allowing the
Lytton tribe to circumvent IGRA's ``two-part determination'' process,
an important step that requires both Secretarial and Gubernatorial
approval, in addition to consultation with nearby tribes and the local
community and its representatives.
The legislation that I have introduced would simply return the Lytton
tribe to the same status as all other tribes seeking to pursue Class
III, or Nevada-style gaming, on lands acquired after the passage of
IGRA in 1988.
It would allow the tribe to continue operating its Class II gaming
facility provided it follows all IGRA regulations regarding gaming on
newly acquired lands going forward.
Finally, it would also preclude any expansion of the facility used by
the Lytton for Class II gaming.
I would like to emphasize what the bill would not do. It would not:
Remove the tribe's recognition status; Alter the trust status of the
new reservation; or take away the tribe's ability to conduct gaming
through the normal IGRA process.
This legislation was solely crafted to restore IGRA's rightful
oversight of the gaming process, just as Congress intended.
Section 20 of the Indian Gaming Regulatory Act provides clear
guidelines for addressing the issue of gaming on so-called ``newly-
acquired'' lands, or lands that have been taken into trust since the
enactment of IGRA in 1988.
Most importantly, in my opinion, IGRA's ``two-part determination''
process provides for both Federal and State approval, while protecting
the rights of nearby tribes and local communities.
Circumventing this process creates a variety of serious and critical
multi-jurisdictional issues, issues which can negatively affect the
lives of ordinary citizens and deprive local and tribal governments of
their ability to effectively represent their communities.
[[Page S5874]]
Without passage of this bill, the Lytton could take the former card
club and the adjacent parking lot that is now their reservation and
turn it into a large gambling complex outside the regulations set up by
the Indian Gaming Regulatory Act. In fact, this is exactly what was
proposed in the summer of 2004.
While the tribe announced that it was dropping its pursuit of a
sizable casino, it could reverse these plans at any time and proceed
with Class III gaming without first going through the regular process.
Allowing this to happen would set a dangerous precedent not only for
California, but every State where tribal gaming is permitted.
I do not think it is asking too much to require that the Lytton be
subject to the regulatory and approval processes applicable to all
other tribes by the Indian Gaming Regulatory Act.
This bill would do just that.
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. 1347
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. LYTTON RANCHERIA OF CALIFORNIA.
Section 819 of the Omnibus Indian Advancement Act (Public
Law 106-568; 114 Stat. 2919) is amended--
(1) in the first sentence, by striking ``Notwithstanding''
and inserting the following:
``(a) Acceptance of Land.--Notwithstanding'';
(2) in the second sentence, by striking ``The Secretary''
and inserting the following:
``(b) Declaration.--The Secretary''; and
(3) by striking the third sentence and inserting the
following:
``(c) Treatment of Land for Purposes of Class II Gaming.--
``(1) In general.--Subject to paragraph (2),
notwithstanding any other provision of law, the Lytton
Rancheria of California may conduct activities for class II
gaming (as defined in section 4 of the Indian Gaming
Regulatory Act (25 U.S.C. 2703)) on the land taken into trust
under this section.
``(2) Requirement.--The Lytton Rancheria of California
shall not expand the exterior physical measurements of any
facility on the Lytton Rancheria in use for class II gaming
activities on the date of enactment of this paragraph.
``(d) Treatment of Land for Purposes of Class III Gaming.--
Notwithstanding subsection (a), for purposes of class III
gaming (as defined in section 4 of the Indian Gaming
Regulatory Act (25 U.S.C. 2703)), the land taken into trust
under this section shall be treated, for purposes of section
20 of the Indian Gaming Regulatory Act (25 U.S.C. 2719), as
if the land was acquired on October 9, 2003, the date on
which the Secretary took the land into trust.''.
______
By Mr. DURBIN (for himself, Mr. Warner, Mrs. Murray, Mr. Obama,
Mr. Graham, Mr. Webb, and Ms. Cantwell):
S. 1349. A bill to ensure that the Department of Defense and the
Department of Veterans Affairs provide to members of the Armed Forces
and veterans with traumatic brain injury the services that best meet
their individual needs, and for other purposes; to the Committee on
Armed Services.
Mr. DURBIN. Mr. President, traumatic brain injury is the signature
injury of the Iraq war. The widespread use of Improvised Explosive
Devices, IEDs, has taken a terrible toll. Even those who have walked
off the battlefield without visible scars often find they have suffered
the internal trauma of a traumatic brain injury.
Today, I am introducing legislation, along with Senators Warner,
Murray, Graham, Obama, Webb, and Cantwell, to create a Traumatic Brain
Injury Program, operated jointly by the Department of Defense and the
Department of Veterans Affairs, to ensure that those servicemembers who
suffer a brain injury receive all the services they need. The
legislation establishes a standard of care for each individual found to
have suffered a brain injury, improves the coordination of care,
strengthen the rights of brain injury patients, and expands brain
injury research in the Departments of Defense and Veterans Affairs.
This legislation will reduce the number of our wounded soldiers who
fall through the cracks and are left to fend for themselves as they
struggle to recover from a traumatic brain injury. I am pleased to have
the support of Veterans for America for this legislative effort.
We have made tremendous progress in battlefield medical care. During
Vietnam, one in three servicemembers who were injured died. In Iraq and
Afghanistan, 1 in 16 who are injured die. But with the changes in
warfare and in medical technology, more of our servicemembers are
coming home with serious brain injuries from Iraq and Afghanistan than
from any other recent conflicts we've known.
For some of these wounded warriors, the greatest battle comes at home
when they seek care. Many of these returning troops need long-term
treatment and rehabilitation long after their discharge from active
duty, as they fight to overcome the severe disabilities that a
traumatic brain injury can cause.
For others, there is a different story. Some servicemembers don't
even realize they suffered a traumatic brain injury until long after
their discharge, because we don't do a very good job of identifying and
treating those who may have suffered a brain injury.
Fortunately, many of those who suffer a brain injury are able to
recover fairly quickly. But for some, the experience is life-altering,
even life-shattering. We must not fail them in their time of need.
Consider the case of Sgt. Eric Edmundson. Eric left my home state of
Illinois to serve in Iraq. In October 2005, he suffered a severe head
concussion when a roadside bomb exploded near him. He was cared for at
Walter Reed Hospital, then was transferred to a VA facility where he
and his family felt he was not receiving the kind of treatment that
would allow him to continue to make progress in rehabilitation.
He would have been stuck there if the family had not found a creative
way to obtain the care he needed. The family found a way to ensure that
Eric could receive treatment and rehabilitation at one of the premiere
rehabilitation hospitals in the nation: the Rehabilitation Institute of
Chicago. He is making great progress there and hopes to walk out of the
hospital some day soon.
We need to use private hospitals more. In fact, we should use them
whenever they are the best option for our returning soldiers who are
wounded. In the case of traumatic brain injury, they often have the
special expertise needed, because the leading facilities in this field
deal with brain injuries day in and day out as a result of construction
accidents and car crashes.
Now consider the case of Sgt. Garrett Anderson of Champaign,
Illinois. Garrett went to Iraq with the Illinois National Guard. After
4 months there, an IED exploded next to his armored Humvee in Baghdad.
The blast tore off his right arm below the elbow, shattered his jaw,
severed part of his tongue, damaged his hearing, and punctured his body
with shrapnel.
He spent 7 months at Walter Reed, where he received excellent care in
Ward 57, the famous amputee ward. However, the outpatient care that
followed has been filled with paperwork and red tape. It was months
before the VA recognized that Garrett had suffered a traumatic brain
injury. He has not received the kind of treatment for brain injury that
could make a significant difference in the trajectory of his
rehabilitation.
We need to change the way we handle patients with traumatic brain
injury, so that they receive the care they need at the time they need
it.
The legislation I am introducing takes a comprehensive approach to
dealing with the traumatic brain injuries that plague our troops and
veterans.
First, this legislation would establish a Traumatic Brain Injury
Program, run by DOD and the VA, to provide treatment and rehabilitation
to servicemembers and veterans who have suffered a service-connected
traumatic brain injury.
Second, this bill would establish a standard of care for the
participants in the TBI Program. Specifically, each individual in the
program shall 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 they shall be rehabilitated to the fullest extent
possible using the most up-to-date medical technology, medical
rehabilitation practices, and medical expertise available.''
[[Page S5875]]
That's the standard of care we should provide to these injured troops
who gave so much of themselves for us. They should receive the best we
have to give.
Third, the measure would direct the Defense Department to develop and
administer a standardized cognitive pre-test, which would be
administered to all military personnel prior to deployment and again
upon return from deployment to determine if they have suffered a brain
injury.
It also would require DOD and the VA to refer any servicemember or
veteran for TBI screening if it is found, in the course of later
treatment or contacts, that the servicemember or veteran may have
suffered a service-connected brain injury.
Anyone found to have suffered a traumatic brain injury would be
enrolled in the TBI program and receive the care they need.
One of the things the families of TBI patients complain most about is
the confusion that surrounds their efforts to ensure that their loved
one received all needed care. The fourth thing this measure would do is
to direct DOD and the VA to assign each patient a lead case manager to
ease the stress on the patient and family, facilitate navigation
through the DOD and VA systems, ensure proper care, present options for
care outside of DOD and the VA, and ensure consistent guidance.
Additionally, DOD and the VA would assign to each patient a lead
primary care physician to coordinate and oversee the care provided to
the patient, including all treatment, rehabilitation, and medications.
Another complaint of families and TBI patients is that they are
sometimes blocked from receiving the care they need due to their status
as either a veteran or an active duty member. DOD and the VA have
different health benefit options. In some cases, servicemembers have
found that, because they accepted a discharge, they lost access to
benefits that would help them.
Our bill addresses this problem by establishing, for these TBI
patients, a temporary overlap of benefits. The participants in the TBI
Program will be allowed, for 2 years, to receive any of the benefits
available to veterans and to active duty members, regardless of their
active duty status. This will help ensure they receive the best care
and rehabilitation available, wherever it may be.
Our bill would spell out some other rights that are important for the
rehabilitation of TBI patients. First, DOD and the VA would be required
to provide a referral to a medical professional outside of DOD and the
VA when requested by a TBI patient. This will allow patients to
determine whether there is better care in the private sector that is
not being provided to that patient. They would also have a right to an
appeals process to challenge any failure to provide the standard of
care required in the TBI Program.
In some cases, undiagnosed traumatic brain injuries may contribute to
behavior resulting in other than honorable discharges. Upon the request
of a servicemember who served since 2001 and was discharged under other
than honorable conditions, the DOD would be directed to review the
discharge to determine whether a brain injury might be the root cause
of the actions that precipitated the adverse discharge, with fair
reconsideration of the discharge if such evidence is found.
Similarly, the VA would be required to make available, upon request,
an appeals process to update the disability rating of a veteran who is
found to have suffered a traumatic brain injury.
Finally, this measure authorizes additional funding for research
related to traumatic brain injury both in DOD and in the VA, to improve
screening, diagnosis, treatment, and rehabilitation for traumatic brain
injury.
This is a comprehensive effort to improve the treatment of our
Nation's wounded servicemembers who have suffered a traumatic brain
injury. I can't imagine the anguish that must be associated with such
an injury, but I can imagine the kind of medical system I would like to
have in place if it were my son or daughter struggling to recover from
such an injury. This legislation reflects that vision.
I thank my cosponsors, Senators Warner, Murray, Graham, Obama, Webb,
and Cantwell, and I urge all of my colleagues to support this measure.
Mr. President, 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. 1349
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Military and Veterans
Traumatic Brain Injury Treatment Act''.
SEC. 2. PROGRAM OF SERVICES FOR TRAUMATIC BRAIN INJURY FOR
MEMBERS OF THE ARMED FORCES AND VETERANS.
(a) Traumatic Brain Injury Program Required.--The 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) Standard of Care.--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) Referrals.--
(1) In general.--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) Limitation on referrals.--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) In general.--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) Frequency.--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
functioning.--The 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 examinations.--The
protocol required by subparagraph (C) shall include the
administration of computer-based examinations to members of
the Armed Forces.
(2) Incidental detection.--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) Referrals.--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) Enrollment.--If a member of the Armed Forces or a
veteran is diagnosed under this subsection with a traumatic
brain
[[Page S5876]]
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) Outreach.--
(1) Outreach to members of the armed forces and veterans.--
The 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) Joint manual of benefits.--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 Injury.--The 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) Lead case managers.--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) Primary care physicians.--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) Report.--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) Resources.--
(1) Facilities.--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) Access to equipment.--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 centers.--The 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) Training program.--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) Overlap of benefits.--
(A) In general.--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) Allocation of costs.--Costs associated with the
provision of care under subparagraph (A) shall be borne by
the Department of Defense.
SEC. 3. FACILITATION OF CONTINUITY OF CARE FROM DEPARTMENT OF
DEFENSE TO DEPARTMENT OF VETERANS AFFAIRS.
The 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.
SEC. 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) Review required.--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) Reconsideration.--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 Injury.--Upon 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.
SEC. 5. TRAUMATIC BRAIN INJURY RESEARCH.
(a) Research Required of Department of Defense.--The
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 Affairs.--
Section 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:
[[Page S5877]]
``(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 Agreements.--In 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 Appropriations.--There 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).
SEC. 6. REPORT.
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.
SEC. 7. DEFINITION OF TRAUMATIC BRAIN INJURY.
In 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.
____________________