[Congressional Record Volume 153, Number 85 (Wednesday, May 23, 2007)]
[House]
[Pages H5671-H5678]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
TRAUMATIC BRAIN INJURY HEALTH ENHANCEMENT AND LONG-TERM SUPPORT ACT OF
2007
Mr. FILNER. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 2199) to amend title 38, United States Code, to direct the
Secretary of Veterans Affairs to provide certain improvements in the
treatment of individuals with traumatic brain injuries, and for other
purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 2199
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 ``Traumatic Brain Injury
Health Enhancement and Long-Term Support Act of 2007''.
SEC. 2. SCREENING, REHABILITATION, AND TREATMENT FOR
TRAUMATIC BRAIN INJURY.
(a) Screening, Rehabilitation, and Treatment for Traumatic
Brain Injury.--
(1) In general.--Chapter 17 of title 38, United States
Code, is amended by adding at the end the following new
subchapter:
``SUBCHAPTER IX--TRAUMATIC BRAIN INJURY
``Sec. 1791. Screening for traumatic brain injuries
``(a) Screening Program.--The Secretary shall establish a
program to screen veterans who are eligible for hospital
care, medical services, and nursing home care under section
1710(e)(1)(D) of this title for symptoms of traumatic brain
injury.
``(b) Report.--Not later than one year after the date of
the enactment of this section, and annually thereafter, the
Secretary shall submit to the Committees on Veterans' Affairs
of the Senate and the House of Representatives a report
containing the following information:
``(1) The number of veterans screened under the program
during the year preceding such report.
``(2) The prevalence of traumatic brain injury symptoms
among the veterans screened under the program.
``(3) Recommendations for improving care and services to
veterans exhibiting symptoms of traumatic brain injury.
``Sec. 1792. Comprehensive program for long-term traumatic
brain injury rehabilitation
``(a) Comprehensive Program.--The Secretary shall develop
and carry out a comprehensive program of long-term care for
post-acute traumatic brain injury rehabilitation that
includes residential, community, and home-based components
utilizing interdisciplinary treatment teams.
``(b) Location of Program.--The Secretary shall carry out
the program developed under subsection (a) in four
geographically dispersed polytrauma network sites designated
by the Secretary.
``(c) Eligibility.--A veteran is eligible for care under
the program developed under subsection (a) if the veteran is
otherwise eligible for care under this chapter and--
``(1) served on active duty in a theater of combat
operations (as determined by the Secretary in consultation
with the Secretary of Defense) during a period of war after
the Persian Gulf War, or in combat against a hostile force
during a period of hostilities (as defined in section
1712A(a)(2)(B) of this title) after November 11, 1998;
``(2) is diagnosed as suffering from moderate to severe
traumatic brain injury; and
``(3) is unable to manage routine activities of daily
living without supervision or assistance.
``(d) Report.--Not later than one year after the date of
the enactment of this section, and annually thereafter, the
Secretary shall submit to the Committees on Veterans' Affairs
of the Senate and the House of Representatives a report
containing the following information:
``(1) A description of the operation of the program.
``(2) The number of veterans provided care under the
program during the year preceding such report.
``(3) The annual cost of operating the program.
``Sec. 1793. Traumatic brain injury transition offices
``(a) Establishment.--The Secretary shall establish a
traumatic brain injury transition office at each Department
polytrauma network site for the purposes of coordinating the
provision of health-care and services to veterans who suffer
from moderate to severe traumatic brain injuries and are in
need of health-care and services not immediately offered by
the Department.
``(b) Cooperative Agreements.--The Secretary, through each
such office established under subsection (a), shall have the
authority to arrange for the provision of health-care and
services through cooperative agreements with appropriate
public or private entities that have established long-term
neurobehavioral rehabilitation and recovery programs.
``Sec. 1794. Traumatic brain injury registry
``(a) In General.--The Secretary shall establish and
maintain a registry to be known as the `Traumatic Brain
Injury Veterans' Health Registry' (in this section referred
to as the `Registry').
``(b) Description.--The Registry shall include the
following information:
``(1) A list containing the name of each individual who
served as a member of the Armed Forces in Operation Enduring
Freedom or Operation Iraqi Freedom who exhibits symptoms
associated with traumatic brain injury and who--
``(A) applies for care and services from the Department
under this chapter; or
``(B) files a claim for compensation under chapter 11 of
this title on the basis of any disability which may be
associated with such service; and
``(2) any relevant medical data relating to the health
status of an individual described in paragraph (1) and any
other information the Secretary considers relevant and
appropriate with respect to such an individual if the
individual--
``(A) grants permission to the Secretary to include such
information in the Registry; or
``(B) is deceased at the time such individual is listed in
the Registry.
``(c) Notification.--The Secretary shall notify individuals
listed in the Registry of significant developments in
research on the health consequences of military service in
the Operation Enduring Freedom and Operation Iraqi Freedom
theaters of operations.
``Sec. 1795. Centers for traumatic brain injury research,
education, and clinical activities
``(a) Purpose.--The purpose of this section is to provide
for the improvement of the provision of health care to
eligible veterans with traumatic brain injuries through--
``(1) the conduct of research (including research on
improving facilities of the Department concentrating on
traumatic brain injury care and on improving the delivery of
traumatic brain injury care by the Department);
``(2) the education and training of health care personnel
of the Department; and
[[Page H5672]]
``(3) the development of improved models and systems for
the furnishing of traumatic brain injury care by the
Department.
``(b) Establishment of Centers.--(1) The Secretary shall
establish and operate centers for traumatic brain injury
research, education, and clinical activities. Such centers
shall be established and operated by collaborating Department
facilities as provided in subsection (c)(1). Each such center
shall function as a center for--
``(A) research on traumatic brain injury;
``(B) the use by the Department of specific models for
furnishing traumatic brain injury care;
``(C) education and training of health-care professionals
of the Department; and
``(D) the development and implementation of innovative
clinical activities and systems of care with respect to the
delivery of traumatic brain injury care by the Department.
``(2) The Secretary shall, upon the recommendation of the
Under Secretary for Health, designate the centers under this
section. In making such designations, the Secretary shall
ensure that the centers designated are located in various
geographic regions of the United States. The Secretary may
designate a center under this section only if--
``(A) the proposal submitted for the designation of the
center meets the requirements of subsection (c);
``(B) the Secretary makes the finding described in
subsection (d); and
``(C) the peer review panel established under subsection
(e) makes the determination specified in subsection (e)(3)
with respect to that proposal.
``(3) Not more than five centers may be designated under
this section.
``(4) The authority of the Secretary to establish and
operate centers under this section is subject to the
appropriation of funds for that purpose.
``(c) Proposals for Designation of Centers.--A proposal
submitted for the designation of a center under this section
shall--
``(1) provide for close collaboration in the establishment
and operation of the center, and for the provision of care
and the conduct of research and education at the center, by a
Department facility or facilities in the same geographic area
which have a mission centered on traumatic brain injury care
and a Department facility in that area which has a mission of
providing tertiary medical care;
``(2) provide that no less than 50 percent of the funds
appropriated for the center for support of clinical care,
research, and education will be provided to the collaborating
facility or facilities that have a mission centered on
traumatic brain injury care; and
``(3) provide for a governance arrangement between the
collaborating Department facilities which ensures that the
center will be established and operated in a manner aimed at
improving the quality of traumatic brain injury care at the
collaborating facility or facilities which have a mission
centered on traumatic brain injury care.
``(d) Finding of Secretary.--The finding referred to in
subsection (b)(2)(B) with respect to a proposal for
designation of a site as a location of a center under this
section is a finding by the Secretary, upon the
recommendation of the Under Secretary for Health, that the
facilities submitting the proposal have developed (or may
reasonably be anticipated to develop) each of the following:
``(1) An arrangement with an accredited medical school that
provides education and training in traumatic brain injury
care and with which one or more of the participating
Department facilities is affiliated under which medical
residents receive education and training in traumatic brain
injury care through regular rotation through the
participating Department facilities so as to provide such
residents with training in the diagnosis and treatment of
traumatic brain injury.
``(2) An arrangement under which nursing, social work,
counseling, or allied health personnel receive training and
education in traumatic brain injury care through regular
rotation through the participating Department facilities.
``(3) The ability to attract scientists who have
demonstrated achievement in research--
``(A) into the evaluation of innovative approaches to the
design of traumatic brain injury care; or
``(B) into the causes, prevention, and treatment of
traumatic brain injury.
``(4) The capability to evaluate effectively the activities
of the center, including activities relating to the
evaluation of specific efforts to improve the quality and
effectiveness of traumatic brain injury care provided by the
Department at or through individual facilities.
``(e) Peer Review Panel.--(1) In order to provide advice to
assist the Secretary and the Under Secretary for Health to
carry out their responsibilities under this section, the
official within the central office of the Veterans Health
Administration responsible for traumatic brain injury care
shall establish a peer review panel to assess the scientific
and clinical merit of proposals that are submitted to the
Secretary for the designation of centers under this section.
``(2) The panel shall consist of experts in the fields of
traumatic brain injury research, education and training, and
clinical care. Members of the panel shall serve as
consultants to the Department.
``(3) The panel shall review each proposal submitted to the
panel by the official referred to in paragraph (1) and shall
submit to that official its views on the relative scientific
and clinical merit of each such proposal. The panel shall
specifically determine with respect to each such proposal
whether that proposal is among those proposals which have met
the highest competitive standards of scientific and clinical
merit.
``(4) The panel shall not be subject to the Federal
Advisory Committee Act (5 U.S.C. App.).
``(f) Award of Funding.--Clinical and scientific
investigation activities at each center established under
this section--
``(1) may compete for the award of funding from amounts
appropriated for the Department of Veterans Affairs medical
and prosthetics research account; and
``(2) shall receive priority in the award of funding from
such account insofar as funds are awarded to projects and
activities relating to traumatic brain injury.
``(g) Dissemination of Useful Information.--The Under
Secretary for Health shall ensure that information produced
by the research, education and training, and clinical
activities of centers established under this section that may
be useful for other activities of the Veterans Health
Administration is disseminated throughout the Veterans Health
Administration. Such dissemination shall be made through
publications, through programs of continuing medical and
related education provided through regional medical education
centers under subchapter VI of chapter 74 of this title, and
through other means. Such programs of continuing medical
education shall receive priority in the award of funding.
``(h) Supervision of Centers.--The official within the
central office of the Veterans Health Administration
responsible for traumatic brain injury care shall be
responsible for supervising the operation of the centers
established pursuant to this section and shall provide for
ongoing evaluation of the centers and their compliance with
the requirements of this section.
``(i) Authorization of Appropriations.--(1) There are
authorized to be appropriated to the Department of Veterans
Affairs for the basic support of the research and education
and training activities of centers established pursuant to
this section such sums as may be necessary.
``(2) In addition to funds appropriated for a fiscal year
pursuant to the authorization of appropriations in paragraph
(1), the Under Secretary for Health shall allocate to such
centers from other funds appropriated for that fiscal year
generally for the Department of Veterans Affairs medical
services account and the Department of Veterans Affairs
medical and prosthetics research account such amounts as the
Under Secretary for Health determines appropriate to carry
out the purposes of this section.
``(j) Annual Reports.--Not later than February 1 of each of
year, the Secretary of Veterans Affairs shall submit to the
Committees on Veterans' Affairs of the Senate and House of
Representatives a report on the status and activities of the
centers for traumatic brain injury research, education, and
clinical activities during the preceding fiscal year. Each
such report shall include the following:
``(1) A description of the activities carried out at each
center and the funding provided by the Department for such
activities.
``(2) A description of the advances made at each of the
participating facilities of the center in research, education
and training, and clinical activities relating to traumatic
brain injury care and treatment.
``(3) A description of the actions taken by the Under
Secretary for Health pursuant to subsection (g) to
disseminate information derived from such activities
throughout the Veterans Health Administration.
``(4) The evaluation of the Secretary as to the
effectiveness of the centers in fulfilling the purposes of
this section.
``(k) Authorization of Appropriations.--(1) There are
authorized to be appropriated to the Department of Veterans
Affairs for the basic support of the research and education
and training activities of centers established pursuant to
this section amounts as follows:
``(A) $10,000,000 for fiscal year 2008.
``(B) $20,000,000 for each of fiscal years 2009 through
2011.
``(2) In addition to funds appropriated for a fiscal year
pursuant to the authorization of appropriations in paragraph
(1), the Under Secretary for Health shall allocate to such
centers from other funds appropriated for that fiscal year
generally for the Department of Veterans Affairs medical
services account and the Department of Veterans Affairs
medical and prosthetics research account such amounts as the
Under Secretary for Health determines appropriate to carry
out the purposes of this section.
``Sec. 1796. Committee on Care of Veterans with Traumatic
Brain Injury
``(a) Establishment.--The Secretary shall establish in the
Veterans Health Administration a committee to be known as the
`Committee on Care of Veterans with Traumatic Brain Injury'.
The Under Secretary for Health shall appoint employees of the
Department with expertise in the care of veterans with
traumatic brain injury to serve on the committee.
``(b) Responsibilities of Committee.--The committee shall
assess, and carry out a continuing assessment of, the
capability of the Veterans Health Administration to meet
effectively the treatment and rehabilitation needs of
veterans with traumatic brain injury. In carrying out that
responsibility, the committee shall--
[[Page H5673]]
``(1) evaluate the care provided to such veterans through
the Veterans Health Administration;
``(2) identify systemwide problems in caring for such
veterans in facilities of the Veterans Health Administration;
``(3) identify specific facilities within the Veterans
Health Administration at which program enrichment is needed
to improve treatment and rehabilitation of such veterans; and
``(4) identify model programs which the committee considers
to have been successful in the treatment and rehabilitation
of such veterans and which should be implemented more widely
in or through facilities of the Veterans Health
Administration.
``(c) Advice and Recommendations.--The committee shall--
``(1) advise the Under Secretary regarding the development
of policies for the care and rehabilitation of veterans with
traumatic brain injury; and
``(2) make recommendations to the Under Secretary--
``(A) for improving programs of care of such veterans at
specific facilities and throughout the Veterans Health
Administration;
``(B) for establishing special programs of education and
training relevant to the care of such veterans for employees
of the Veterans Health Administration;
``(C) regarding research needs and priorities relevant to
the care of such veterans; and
``(D) regarding the appropriate allocation of resources for
all such activities.
``(d) Annual Report.--Not later than June 1 of 2008, and
each subsequent year, the Secretary shall submit to the
Committees on Veterans' Affairs of the Senate and House of
Representatives a report on the implementation of this
section. Each such report shall include the following for the
calendar year preceding the year in which the report is
submitted:
``(1) A list of the members of the committee.
``(2) The assessment of the Under Secretary for Health,
after review of the initial findings of the committee,
regarding the capability of the Veterans Health
Administration, on a systemwide and facility-by-facility
basis, to meet effectively the treatment and rehabilitation
needs of veterans with traumatic brain injury.
``(3) The plans of the committee for further assessments.
``(4) The findings and recommendations made by the
committee to the Under Secretary for Health and the views of
the Under Secretary on such findings and recommendations.
``(5) A description of the steps taken, plans made (and a
timetable for the execution of such plans), and resources to
be applied toward improving the capability of the Veterans
Health Administration to meet effectively the treatment and
rehabilitation needs of veterans with traumatic brain
injury.''.
(2) Clerical amendment.--The table of contents at the
beginning of such chapter is amended by adding at the end the
following new items:
``subchapter ix--traumatic brain injury
``1791. Screening for traumatic brain injuries.
``1792. Comprehensive program for long-term traumatic brain injury
rehabilitation.
``1793. Traumatic brain injury transition offices.
``1794. Traumatic brain injury registry.
``1795. Centers for traumatic brain injury research, education, and
clinical activities.
``1796. Committee on Care of Veterans with Traumatic Brain Injury.''.
(b) Effective Date.--The Secretary shall implement the
requirements of subchapter IX of title 38, United States
Code, as added by subsection (a), not later than 180 days
after the date of the enactment of this Act.
SEC. 3. PILOT PROGRAM FOR DELIVERY OF CERTAIN SERVICES TO
VETERANS THROUGH MOBILE VET CENTERS.
(a) Pilot Program.--Chapter 17 of title 38, United States
Code, is amended by inserting after section 1712B the
following new section:
``Sec. 1712C. Pilot program for delivery of certain services
through mobile Vet Centers
``(a) Pilot Program.--To improve access to mental health
services in rural areas, the Secretary shall carry out a
pilot program under which the Secretary shall provide
readjustment counseling, related mental health services,
benefits outreach, and, to the extent practicable, assistance
with claims for benefits under this title through the use of
mobile centers (as that term is defined in section
1712A(i)(1)), to be known as `mobile Vet Centers'. In
carrying out the pilot program, the Secretary shall determine
the most effective manner in which to operate the mobile Vet
Centers.
``(b) Scope and Location.--(1) The Secretary shall
establish two mobile Vet Centers in each of the following
five Veterans Integrated Service Networks:
``(A) Veterans Integrated Service Network 1.
``(B) Veterans Integrated Service Network 16.
``(C) Veterans Integrated Service Network 19.
``(D) Veterans Integrated Service Network 20.
``(E) Veterans Integrated Service Network 23.
``(2) Within each Veterans Integrated Service Network under
paragraph (1), the Secretary shall determine the area to be
serviced by each mobile Vet Center. In making that
determination, the Secretary shall give priority to areas in
which limited mental health and outreach services are
available.
``(3) If the Secretary determines that mobile Vet Centers
in addition to such centers required under paragraph (1) are
warranted, the Secretary may establish additional mobile Vet
Centers and may establish such centers in Veterans Integrated
Service Networks other than the Veterans Integrated Service
Networks referred to in that paragraph. Upon such a
determination by the Secretary, the Secretary shall notify
the Committees on Veterans' Affairs of the Senate and House
of Representatives of such determination.
``(c) Termination.--The authority to carry out a pilot
program under this section shall terminate on the date that
is three years after the date of the enactment of this
section.
``(d) Report.--Not later than 90 days after the date on
which the pilot program terminates under subsection (a), the
Secretary shall submit to the Committees on Veterans' Affairs
of the Senate and House of Representatives a report on the
pilot program. Such report shall describe how the Secretary
established and carried out the pilot program and include an
evaluation of the Secretary of the benefits and disadvantages
of providing readjustment counseling, related mental health
services, benefits outreach, and claims assistance through
the use of mobile Vets Centers.
``(e) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section $7,500,000 for
fiscal year 2008 and each subsequent fiscal year.''.
(b) Clerical Amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item related to section 1712B the following new item:
``1712C. Pilot program for delivery of certain services through mobile
Vet Centers.''.
SEC. 4. ADVISORY COMMITTEE ON RURAL VETERANS.
(a) Establishment of Committee.--Subchapter III of chapter
5 of title 38, United States Code, is amended by adding at
the end the following new section:
``Sec. 546. Advisory Committee on Rural Veterans
``(a) Establishment.--(1) The Secretary shall establish an
advisory committee to be known as the `Advisory Committee on
Rural Veterans' (hereinafter in this section referred to as
`the Committee').
``(2)(A) The Committee shall consist of members appointed
by the Secretary from the general public, including--
``(i) representatives of rural veterans;
``(ii) individuals who are recognized authorities in fields
pertinent to the needs of rural veterans, including specific
or unique health-care needs of rural veterans and access
issues of rural veterans;
``(iii) individuals who have expertise in the delivery of
mental health care in rural areas;
``(iv) individuals who have expertise in the delivery of
long-term care in rural areas;
``(v) at least one veterans service organization
representative from a rural State; and
``(vi) representatives of rural veterans with service-
connected disabilities.
``(B) The Committee shall include, as ex officio members--
``(i) the Secretary of Health and Human Services (or a
representative of the Secretary of Health and Human Services
designated by that Secretary);
``(ii) the Director of the Indian Health Service (or a
representative of that Director); and
``(iii) the Under Secretary for Health and the Under
Secretary for Benefits, or their designees.
``(C) The Secretary may invite representatives of other
departments and agencies of the United States to participate
in the meetings and other activities of the Committee.
``(3) The Secretary shall determine the number, terms of
service, and pay and allowances of members of the Committee
appointed by the Secretary, except that a term of service of
any such member may not exceed three years. The Secretary may
reappoint any such member for additional terms of service.
``(b) Responsibilities of Committee.-- The Secretary shall,
on a regular basis, consult with and seek the advice of the
Committee with respect to the administration of benefits by
the Department for rural veterans, reports and studies
pertaining to rural veterans, and the needs of rural veterans
with respect to primary care, mental health care, and long-
term care needs of rural veterans.
``(c) Report.--(1) Not later than September 1 of each odd-
numbered year until 2013, the Committee shall submit to the
Secretary a report on the programs and activities of the
Department that pertain to rural veterans. Each such report
shall include--
``(A) an assessment of the needs of rural veterans with
respect to primary care, mental health care, and long-term
care needs of rural veterans and other benefits and programs
administered by the Department;
``(B) a review of the programs and activities of the
Department designed to meet such needs; and
``(C) such recommendations (including recommendations for
administrative and legislative action) as the Committee
considers appropriate.
``(2) The Secretary shall, within 60 days after receiving
each report under paragraph
[[Page H5674]]
(1), submit to Congress a copy of the report, together with
any comments concerning the report that the Secretary
considers appropriate.
``(3) The Committee may also submit to the Secretary such
other reports and recommendations as the Committee considers
appropriate.
``(4) The Secretary shall submit with each annual report
submitted to Congress pursuant to section 529 of this title a
summary of all reports and recommendations of the Committee
submitted to the Secretary since the previous annual report
of the Secretary submitted pursuant to that section.''.
(b) Clerical Amendment.--The table of sections at the
beginning of such chapter is amended by adding at the end the
following new item:
``546. Advisory Committee on Rural Veterans.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
California (Mr. Filner) and the gentleman from Indiana (Mr. Buyer) each
will control 20 minutes.
The Chair recognizes the gentleman from California.
Mr. FILNER. Mr. Speaker, I yield myself 3 minutes.
Mr. Speaker, I would point out this is one of the most important
bills on the floor today or at any time. It's called the Traumatic
Brain Injury Health Enhancement and Long-Term Support Act of 2007.
The wounded from wars in Afghanistan and Iraq are returning with
multiple injuries due to the use of improvised explosive devices, or
IEDs. This often results in servicemembers and veterans needing
polytrauma care, and has caused an increase in veterans with brain
injury, or TBI.
We are going to have tens of thousands of these young men and women
with these injuries. Among veterans and servicemembers that return from
OEF and OIF and treated at Walter Reed for injuries of any type,
approximately 65 percent have TBI or a comorbid, as they call it,
diagnosis. Survivors of TBI experience physical, cognitive, emotional
and community integration issues. Because of their injury, their
capacity and initiative to seek appropriate care on their own is
diminished.
We are also faced with thousands of veterans returning from Iraq and
Afghanistan with milder cases of brain injury. This milder case often
is missed and goes untreated, and symptoms may often mirror that of
PTSD. Indeed, according to the Defense and Veterans Brain Injury
Center, in prior military conflicts, TBI was present in up to 14 to 20
percent of surviving casualties. The numbers for operations in OEF/OIF
are predicted to go much, much higher.
We must ensure that the health care and services that meet the needs
of returning servicemembers are available and accessible, while never
forgetting the needs of veterans from previous conflicts. This bill
provides for mandatory screening of veterans for traumatic brain
injury. It requires the Secretary to establish a comprehensive program
of long-term care, of postacute traumatic brain injury rehabilitation
at four geographically disbursed polytrauma network sites. It provides
for the establishment of TBI transition offices at each Department
polytrauma network site to coordinate health care and services to
veterans who suffer from moderate to severe traumatic brain injuries.
It requires the Secretary to establish a registry of those who served
in Iraq who exhibit symptoms associated with TBI.
This legislation establishes centers for TBI research, education and
clinical activities, and requires the Secretary to establish a
committee on the care of veterans with TBI. In addition to the
provisions that address health care, research and treatment for
veterans, this legislation also provides for veterans who reside in
rural areas.
Mr. Speaker, it is a very important bill. We will hear soon from Mr.
Michaud, the chairman of our Health Subcommittee, who was the primary
author of this, who has been a leader to make sure that we serve the
veterans who come back with these incredible injuries, that they
receive the proper care that they need.
Mr. Speaker, I reserve the balance of my time.
Mr. BUYER. Mr. Speaker, I yield myself such time as I may consume.
Let me first take this opportunity to thank the chairman of the
Subcommittee on Health, Mr. Michaud, as well as the subcommittee's
ranking member, Mr. Miller, for their leadership in developing this
legislation.
H.R. 2199, as amended, the Traumatic Brain Injury Health Enhancement
and Long-Term Support Act of 2007, seeks to improve the treatment of
veterans suffering with traumatic brain injuries, often referred to as
TBI, and the care for veterans who live in rural communities.
{time} 1715
However, I would comment that several of the provisions included in
this legislation are similar to initiatives that already exist or are
getting underway. For example, section 2 of the bill would require the
VA to screen eligible veterans for symptoms of traumatic brain injury
and create a TBI registry. These are also the recommendations of the
President's task force on returning global war on terror heroes. In
addition, in March 2007, Secretary Nicholson directed a number of
changes to improve the way the VA provides care to our newest combat
veterans.
These veterans initiatives include screening all OEF and OIF combat
patients for TBI and for PTSD; providing each polytrauma patient with
an advocate to assist them and their family; mandatory training for all
VA health care personnel to recognize and care for patients with TBI;
and establishing an outside panel of clinical experts to review the VA
polytrauma system of care.
Additionally, the bill would provide five new centers for TBI
research, education, and clinical activities. During the 108th
Congress, we recognized the frequency and unique nature of the
polytrauma/blast injuries resulting from the global war on terror.
These injuries require an interdisciplinary program to handle the
medical, psychological, rehabilitation, and prosthetic needs of the
injured servicemember.
Public Law 108-422, the Veterans' Health Programs Improvement Act of
2004, directed VA to establish ``an appropriate number of centers for
research, education, and clinical activities to improve and coordinate
rehabilitative services for veterans suffering from complex multitrauma
from combat injuries, and to coordinate these services with the
Department of Defense.''
The centers required in Public Law 108-422 became the Polytrauma
System of Care. There are four centers located in Richmond, VA; Tampa,
FL; Minneapolis, MN; and Palo Alto, CA. The committee strongly
recommends that the new TBI centers be colocated with the VA's
polytrauma rehabilitation centers. In this way, we can capitalize on
the experience and expertise available at the polytrauma centers and
enhance the ability to understand and treat the entire spectrum of the
TBI injury from mild to most severe.
I want to thank Mr. Michaud for recognizing that we can actually get
some benefits by the colocation of these services where TBI is already
located. Because we take and concentrate such expertise, the colocation
can only have benefits. And the gentleman worked with me, and I think
because TBI have a number of comorbidities such as PTSD, depression,
anxiety disorders, and while these issues may appear with TBI, they may
also exhibit themselves separately from TBI, and I think that is
exactly what Mr. Michaud is trying to get to. So I want to thank the
gentleman for his leadership and for bringing this bill to the
committee, along with your staff, for their good work.
Mr. Speaker, I reserve the balance of my time.
Mr. FILNER. Mr. Speaker, I recognize the chairman of our subcommittee
who has taken such a great leadership role on these issues, the
gentleman from Maine (Mr. Michaud) for 4 minutes.
Mr. MICHAUD. Mr. Speaker, I thank the chairman for yielding.
H.R. 2199 is a bipartisan effort to address the challenges presented
by traumatic brain injury and to improve the quality of care for our
rural veterans.
TBI is considered to be the signature wound of this war. TBI is
complex and frequently overlooked or misdiagnosed.
We also have very little understanding of the long-term consequences
of TBI. We must make sure that the VA is doing all they can to provide
for these wounded soldiers. This is only the beginning, we still have
more work to do, but this is a good first step.
H.R. 2199 also includes two provisions to improve the quality of care
provided
[[Page H5675]]
to our rural veterans. With so many veterans from Iraq and Afghanistan
living in rural areas, and an already existing population of older
veterans in these areas, we need to explore innovative ways to improve
VA accessibility and quality of care, especially on mental health
issues. You heard both from the chairman and ranking member as far as
what this legislation does.
I would like to recognize the hard work of a group of Members on both
sides of the aisle who helped craft this legislation. This truly is
bipartisan legislation. I do want to start with my good friend, Mr.
Miller of Florida, who is the ranking member of the Health Care
Subcommittee, who has been extremely helpful in getting this
legislation introduced and moved through the full committee; also, Mr.
Altmire of Pennsylvania, who has taken a real leadership role in
traumatic brain injury, and for his focus on TBI with his legislation,
H.R. 1944, which is included in H.R. 2199; Mr. Walz of Minnesota, for
his legislation to establish centers for TBI research, education, and
clinical activities, which are now also included in H.R. 2199, who also
served on the Veterans' Affairs Committee; and Mr. McNerney of
California, his legislation was included in H.R. 2199 to create the
Committee on Care for Veterans with TBI; Mr. Donnelly, who sits on the
Veterans' Affairs Committee, of Indiana, for his bill which was
included in section 4 of H.R. 2199, to create an advisory committee on
rural veterans; Mr. Welch of Vermont, for his bill and efforts to
establish a pilot program for mobile vet centers, which are extremely
important for rural areas; Mr. Lamborn of Colorado, for his amendment
to include providing benefits outreach and assistance with claims for
benefits as part of the mission of mobile vet centers. He also sits on
the committee and was very helpful in making this bill a better bill.
So this truly has been a real bipartisan piece of legislation that
took a lot of components of other bills that were through, that were
introduced and we had hearings on, to be part of this bill.
I also would like to thank Ranking Member Buyer for his focus on this
issue, and for his understanding of the importance of long-term
research and the pursuit of the best practices for TBI care. He
definitely has been very helpful with this legislation.
And, finally, I would like to thank and congratulate Chairman Filner
for his strong bipartisan leadership on this bill and other veterans
bills on the floor as well, and look forward to tackling other veterans
issues as we move forward in the 110th Congress.
I urge my colleagues to support H.R. 2199.
Mr. BUYER. Mr. Speaker, I would like to thank Mr. Michaud because he
did his committee work. He did his committee work because we brought a
bill to the floor. Yes, under suspension, Mr. Filner, but he did his
committee work. He filed a report which allowed us to work with him.
When you don't file a report, you deny the minority their opportunity
to be heard.
So I want to thank Mr. Michaud for working with us and for his
leadership.
Mr. Speaker, I yield such time as he may consume to the gentleman
from Arkansas (Mr. Boozman).
Mr. BOOZMAN. The only thing I would say is that, again, I am very
much in support of the bill and I appreciate the leadership that was
shown, as Mr. Buyer just said, in getting the bill forward. I think it
is a great example of everybody working together which, again, our
committee very often does demonstrate. So I am very much in support,
and urge a ``yes'' vote.
Mr. FILNER. Mr. Speaker, I yield 1\1/4\ minutes to the chairwoman of
our Economic Opportunity Subcommittee, the gentlelady from South
Dakota, Stephanie Herseth Sandlin.
Ms. HERSETH SANDLIN. Mr. Speaker, I thank the gentleman for yielding.
Mr. Speaker, I rise in strong support of H.R. 2199, the Traumatic
Brain Injury Health Enhancement and Long-Term Support Act. I would like
to thank the chairman of the Veterans' Affairs Health Subcommittee, Mr.
Michaud, for introducing this important bill, and to thank Chairman
Filner and the ranking member for their support of this legislation.
Among other provisions, H.R. 2199 requires screening of veterans for
TBI, establishes a comprehensive program for long-term TBI
rehabilitation to be located at the polytrauma centers, and creates TBI
transition offices at each of the polytrauma network sites. In
addition, the bill creates an advisory committee on rural veterans.
These are important steps toward helping the young men and women who
have suffered traumatic brain injury, and ensuring the needs of our
rural veterans are addressed.
Working closely with a National Guard soldier from South Dakota who
suffered a traumatic brain injury while serving in Iraq, and having
visited him and his family at the Minneapolis polytrauma center, I
witnessed both the good and the bad of the VA's efforts to deal with
these wounded servicemembers. While we have made remarkable strides in
treating veterans with brain injuries, there is much room for
improvement, especially when it comes to the long-term support of these
servicemembers.
I believe the Traumatic Brain Injury Health Enhancement and Long-Term
Support Act will tremendously improve the services available to
veterans suffering from TBI. I look forward to continuing working with
my colleagues on the Veterans' Affairs Committee to address these and
other issues related to treating veterans suffering from traumatic
brain injury.
Again, I thank Representative Michaud for introducing and advancing
this bill, and I ask my colleagues to support H.R. 2199.
Mr. BUYER. Mr. Speaker, I reserve the balance of my time.
Mr. FILNER. Mr. Speaker, we have had many people contribute to this
legislation, as Mr. Michaud said. I would like to recognize a great new
Member from Indiana who has worked hard on this legislation, Mr.
Donnelly, for 2 minutes.
Mr. DONNELLY. Mr. Speaker, I rise today in strong support of H.R.
2199.
Mr. Speaker, this bill will help us better care for America's wounded
warriors suffering from traumatic brain injury, the signature wound of
the Iraq and Afghanistan wars. This important legislation will require
the VA to better screen veterans for symptoms of TBI, devise a long-
term care strategy, and promote better understanding of TBI and how we
can provide the best care possible.
I also want to thank my good friend, Mr. Michaud, for including my
bill, H.R. 2190, establishing an advisory committee on rural veterans,
as a provision of this legislation.
Mr. Speaker, over 40 percent of returning Iraq and Afghanistan
veterans are coming home to rural communities, and countless older
veterans live in rural America, places like Pulaski County and Starke
County, Indiana. The health care needs and services rural veterans
require are very, very unique. These veterans often have increased
barriers to obtaining the same quality of care as their urban and
suburban counterparts. We must do better by them.
It is critical that the VA have direct input from rural veterans at
the highest level of policymaking. The Advisory Committee on Rural
Veterans will work with and advise the VA Secretary on how policies and
programs affect them, and how services can be improved for rural
veterans and their families.
I urge my colleagues in the House to pass this bill to improve care
for our wounded warriors and America's rural veterans.
Mr. BUYER. Mr. Speaker, I would also like to express my support for a
provision in the bill that would require the VA to establish a TBI
transition office at each of the polytrauma network sites. Not only is
this vital for the DOD and the VA to provide for a seamless transition
from active duty to veteran status, but it is also important for VA to
aid in the coordination of veteran care between VA and other health
care providers for services that could possibly not be provided by the
VA. These transition offices would help coordinate veterans care for
services not offered by the VA, and have the authority to arrange care
with public or private entities to establish long-term neurobehavioral
rehabilitation and recovery programs.
The bill also includes two rural health initiative provisions, one of
which would establish a pilot program for vet centers in rural areas.
H.R. 2199, as amended, included an amendment
[[Page H5676]]
offered by Mr. Lamborn of Colorado, the ranking member of the
Subcommittee on Disability Assistance and Memorial Affairs. This
amendment will expand the role of the mobile vet center pilot program
to include helping veterans in need of assistance in the filing of
benefits claims.
Mr. Speaker, I yield such time as he may consume to the gentleman
from Colorado (Mr. Lamborn).
Mr. LAMBORN. Mr. Speaker, I rise in strong support of H.R. 2199, the
Traumatic Brain Injury Health Enhancement and Long-Term Support Act of
2007. I thank Chairman Filner, Ranking Member Buyer, and Health
Subcommittee Chairman Michaud, the sponsor of this legislation, for
their leadership in bringing this excellent legislation to the floor. I
especially want to thank the gentleman from Maine for working with me
on a bipartisan basis to include my amendment in this bill.
One of the provisions of H.R. 2199, as introduced, is a pilot program
of mobile vet centers which would provide veterans with readjustment
counseling and related mental health services. My amendment would
require that these mobile vet centers have trained staff to provide
veterans with benefits outreach and help them with their claims
applications and questions.
Mr. Speaker, much of the trouble associated with the claims
processing system is related to a veteran's difficulties in filing a
correct and complete claim. Veterans may have an incomplete
understanding of the claims system.
{time} 1730
That could easily lead to an imperfectly completed application. My
amendment would help solve this problem by placing qualified VA
employees in the mobile vet centers to educate the veteran and help him
or her to correctly fill out their paperwork the first time.
H.R. 2199 could have significant impact on reducing the growing
backlog of compensation and pension claims. I ask my colleagues to
support this legislation. It will help veterans with traumatic brain
injury get the care they need. At the same time, it will help veterans
seeking to apply for the benefits they have earned in service to their
Nation.
Mr. FILNER. Mr. Speaker, I would like to yield 2 minutes to another
hard-working new member from our committee, the gentleman from
California (Mr. McNerney).
Mr. McNERNEY. Mr. Speaker, traumatic brain injury is the signature
injury of the war in Iraq.
Let me explain a little bit what happens to a veteran soldier with a
traumatic brain injury. They remove part of your skull so that your
brain can expand into that while it's swelling up. They give you blood
thinners so that you don't have blood clots. They give you antibiotics,
and they put on a vest that keeps your body temperature cold, again so
that you don't swell up and cause more injury. So this is the kind of
thing that these veterans, these soldiers are going through.
And we estimate that there's approximately 12,000 servicemembers with
some degree of traumatic brain injury. That's why I was motivated,
along with Mr. Boozman from Arkansas, to introduce the Caring for
Veterans with Traumatic Brain Injury Act of 2007.
H.R. 2199 ensures that the VA will develop the infrastructure
necessary to meet the needs of an increasing number of veterans
diagnosed with TBI. Among other things, the bill requires the VA to
screen all veterans for TBI. It creates a registry for veterans with
TBI so that we don't lose track of them once they're diagnosed, and it
also creates transition offices for patients with TBI who live in areas
where the Veterans Administration isn't able to meet their needs.
I'm thankful for the leadership of Mr. Michaud and Mr. Filner on this
issue, and for the opportunity to speak in favor of 2199.
Mr. BUYER. Mr. Speaker, I reserve my time.
Mr. FILNER. Mr. Speaker, I would like to yield 2 minutes to another
hard-working new member of our committee, the highest-enlisted man ever
to be elected to Congress, Command Sergeant Major Tim Walz from
Minnesota.
Mr. WALZ of Minnesota. Mr. Speaker, I rise today in support of H.R.
2199. I want to thank my colleague from Maine for sponsoring this piece
of legislation; also thank my colleague from Maine (Mr. Michaud), who's
been a leader on this issue and veterans issues in general; grateful
that he introduced this piece of legislation, and grateful that he
allowed a piece of legislation that I had introduced establishing the
five TBI centers around the country.
I'd also like to thank the ranking member, the gentleman from
Indiana, for his thoughtful guidance on the colocation of those
facilities. I think it's absolutely the right thing to do. I think it
concentrates our resources and our expertise. So I thank him for that
addition to it.
The colocation at the polytrauma centers is the right thing to do.
The research that's being done there is world class. And I think an
example of how we can enhance that comes from, and you just heard one
of my colleagues speaking about this injury.
I visit the VA centers every Veterans Day for the last quite some
time. And several years ago there was a young man from Michigan there,
and he had suffered a traumatic brain injury. He had survived a
shrapnel wound, but his brain had literally been turned inside of his
head. And because of the great care he was receiving there, he was
stabilized, and he was starting to rehabilitate. This bill will allow
us to enhance his recovery, starting to reintegrate him back to the
life that he knows and that he should be able to live.
On this floor we're going to continue to debate the wars. We're going
to continue to see the debates divide us on the war in Iraq. This
Congress, and I thank the ranking member, and the chairman for allowing
the care of our veterans to bring us back together. Regardless of how
we feel on this war, this Congress and this committee is proving that
the 110th Congress can and will advance crucial legislation like H.R.
2199. So I thank you both. I thank my colleagues.
Mr. BUYER. Mr. Speaker, I want to thank the gentleman who just spoke.
As a retired sergeant major, we benefit by his expertise not only on
the Veterans' Affairs Committee, but also in Congress. We have a lot of
people here who have been enlisted, and we have had officers and
generals and admirals, but when you get a sergeant major, they speak
softly. And there's a reason the sergeant major speaks softly, because
he doesn't have to speak loudly because they are so well respected. And
so, Sergeant Major, your contributions to the committee are recognized
and appreciated.
Mr. Speaker, I reserve my time.
Mr. FILNER. Mr. Speaker, how much time do we have left?
The SPEAKER pro tempore. The gentleman from California has 6\1/2\
minutes.
Mr. FILNER. I would now recognize another great new Member from
Pennsylvania (Mr. Altmire) for 2 minutes. He has taken the lead on
dealing with traumatic brain injury.
Mr. ALTMIRE. Mr. Speaker, our brave service men and women are
returning from Iraq and Afghanistan with TBI at an alarming rate.
Sixty-five percent of the soldiers at Walter Reed today have been
diagnosed with traumatic injury, and thousands of veterans have mild
TBI, but have not been diagnosed. And I'm concerned that the VA has not
been properly diagnosing and treating those veterans with traumatic
brain injury.
As has been mentioned today, traumatic brain injury is the signature
injury for the wars in Afghanistan and Iraq. This is why I introduced
the Veterans Traumatic Brain Injury Treatment Act, which has been
included in its entirety in this legislation we're debating today. My
bill would improve the diagnosis and treatment of TBI for our Nation's
veterans by requiring the VA to screen veterans for symptoms, develop
and operate a comprehensive program of long-term care for postacute TBI
rehabilitation, establish TBI transition offices at all polytrauma
network sites, and create and maintain a TBI health registry.
In addition to improving the diagnosis and treatment of traumatic
brain injury, this bill will improve the VA's research of TBI and
ensure that the VA provides better care to veterans in rural
communities.
I want to thank the subcommittee chairman, Mr. Michaud, and the full
[[Page H5677]]
committee chair, Mr. Filner, for their leadership on this issue, for
including my legislation in its entirety in this bill, and I want to
urge my colleagues to support this piece of legislation.
Mr. BUYER. Mr. Speaker, I appreciate the gentleman's comments that he
just made. Before you take off, this issue, and I appreciate your
interest in it because this is one of our great challenges. We've got
the best helmet that we put on our soldiers and marines in the field
and even some of the Air Force personnel, Navy personnel. And it
protects them against ballistics, and it's the best in the world. But
when it comes to blasts and crash, what it does to the brain, we're now
on the forefront, and we are pushing the boundary of our knowledge.
And some of the world's experts now are not only at the polytrauma
centers, but in particular, when these soldiers end up at Landstuhl,
Germany, that's where they are. So they can immediately deal with these
neurotraumas.
And when the gentleman said that there could possibly be thousands,
what we do know is that at the polytrauma centers, those who are
actually being treated for traumatic brain injury, there's less than
400 cases.
But the gentleman is right with regard to individuals who may have
had a concussion. Yet, how severe is the concussion?
And if the science is unknown, and we're trying to understand that.
That's the purpose of Mr. Michaud's bill. And I appreciate the
gentleman's interest, would love to continue to work with you in your
interest.
I'd bring to your attention the Veterans Health Administration
Directive 2007-013 released April 13, 2007, establishes the VA policy
and procedure for screening and evaluation of possible TBI in OEF and
OIF veterans. This directive states, ``Not all patients who screen
positive have TBI. It is possible to respond positively to all four
sections due to the presence of other conditions such as PTSD, cervical
cranial injury with headaches and inner ear injury, for example.
Therefore, it's critical that patients not be labeled with a diagnosis
of TBI on the basis of a positive screening test. Patients need to be
referred for further evaluation.''
So we are in an area of science whereby the sand shifts directly
under our feet, and I would look forward to working with the gentleman.
Mr. Speaker, I reserve my time.
Mr. FILNER. Mr. Speaker, I'd like to yield 2 minutes to the fighting
gentleman from New Jersey (Mr. Pascrell), who we like to call an
honorary member of the Veterans' Committee since he fights so hard for
veterans and is cochair of the Traumatic Brain Injury Caucus in the
Congress.
Mr. PASCRELL. Mr. Speaker, I rise in favor of H.R. 2199, the
Traumatic Brain Injury Health Enhancement and Long-Term Support Act.
As cochair of the 8-year-old Congressional Brain Injury Task Force of
over 110 members, I commend the committee under Chairman Filner's
leadership. You've never, ever acted, through the Speaker, to do favors
for veterans. You've always handled it in terms of your own
responsibility. I salute you for that.
For his ongoing endeavors to explore and thoughtfully legislate for
the benefit of our Nation's many veterans suffering from TBI, I want to
thank Jack Murtha, Congressman Murtha, for all his work over the last 5
years on this issue when it wasn't popular to talk about.
The Veterans Administration has shown tremendous effort in addressing
the needs of our returning vets, our returning troops on its own;
however, I believe the large volume of returning TBI victims, the need
for timely treatment and the immediate need for rehab, expertise and
capacity require additional resources. Flexibility for the VA to form
partnerships to ensure top-notch care for our service personnel is
essential. 2199 is an excellent first step to ensuring our Nation's
veterans the care they need and deserve.
The bill establishes five new Veterans Administration research
centers for TBI, which, without a doubt, produce new and exciting
prevention and treatment techniques. A comprehensive TBI treatment
program within the VA is long overdue.
I want to commend the TBI screening program for veterans. We
recommended it. Football teams throughout the United States screen
students before they put on football equipment. I think that's
important that we do that with our vets. I worked to establish it in
the civilian realm. We should have it in the military.
On behalf of the task force, I look forward to working with the
Veterans Committee on this and other TBI issues in the future.
I urge my colleagues to vote in favor of H.R. 2199.
Mr. BUYER. Mr. Speaker, I yield myself such time as I may consume.
At the May 9, 2007, full committee hearing on the results of the
President's Task Force on Returning Global War on Terror Heroes, in
response to my questioning about the actual number of TBI cases treated
in VA as inpatients, Secretary Nicholson responded that VA has treated
369 veterans in its polytrauma centers so far for TBI.
Secretary Nicholson also commented that the VA has the capacity in
their polytrauma centers, and that many of the patients in the
polytrauma centers are active duty military.
Mr. Speaker, I continue to reserve my time.
Mr. FILNER. Mr. Speaker, I'd like to yield 2 minutes to another great
new Member fighting for veterans, Congressman Welch from Vermont.
Mr. WELCH of Vermont. Mr. Speaker, I want to thank the Veterans'
Affairs Committee, the openness of that committee, to let anyone with a
good idea to help veterans to come in and have an opportunity to do
that. Mr. Filner, Mr. Michaud, and, of course, Mr. Buyer and Mr.
Miller, thank you.
Rural Americans have always served the Nation's armed services,
National Guard and Reserves in very great numbers. In fact, though only
19 percent of the Nation lives in rural America, 44 percent of the
current U.S. military recruits come from rural areas, and nearly one-
third of those who died in Iraq are from small towns and communities
across the Nation, Vermont very much among them.
And unfortunately, access to health care for many of our veterans in
rural areas is limited by mileage, distance and just the difficulty of
transportation. Especially true, the provision of mental health care in
rural settings has historically been a challenge for all health care
systems and providers, including the VA. And therefore, what we
recognize in this legislation is that we need to help the VA develop
innovative solutions to address the need for mental health services in
remote areas, TBI being the big injury that's been discussed by my
colleagues.
This legislation takes a significant step towards improving the
mental health services available to geographically isolated veterans.
It creates a pilot program where at least two mobile vet centers will
provide readjustment counseling and mental health services to veterans
in at least five Veterans Integrated Service Networks that have the
highest concentration of rural veterans.
{time} 1745
One of these covers New England and my home State of Vermont. These
mobile vet centers will also provide information and outreach
concerning veterans benefits and, when practicable, assistance with
claims for benefits.
Rural individuals and their families have strong bonds and ties to
their communities. These mobile vet centers will allow veterans to stay
in their communities and prevent endless hours of car rides for the
care they receive.
I urge support and passage of this legislation and thank the
committee for its indulgence.
Mr. BUYER. Mr. Speaker, I believe that it is conceivable that at some
point one of these needed Traumatic Brain Injury Centers of Excellence
could be located in the Department of Veterans Affairs Medical Center
in Albuquerque, New Mexico, which could be named the Raymond G.
``Jerry'' Murphy Department of Veterans Affairs Medical Center, if
Chairman Filner would clear either H.R. 474 or take up Senate bill 229
for consideration on the floor of which that Senate bill, Mr. Speaker,
sits at your desk.
Mr. Speaker, I yield back the balance of my time.
Mr. FILNER. Mr. Speaker, let me just conclude by saying like
everything else about this war, the administration did not prepare
either for the fighting, the aftermath, or the treatment of the
[[Page H5678]]
veterans coming back. We simply left thousands of our veterans without
adequate resources to treat these brain injuries or PTSD or other
issues that arise. No matter what denial that comes from the minority
party, no matter what denial comes from the administration, we have not
prepared for adequate treatment of these veterans. We are passing
legislation today to do that, and we will not deny that there will be
thousands and thousands of brain-injured veterans. We should bring them
home now and we should treat them well when they get back.
Mr. SPACE. Mr. Speaker, I rise again today in support of H.R. 2199,
the Traumatic Brain Injury Health Enhancement and Long-Term Support
Act. This bill offers a comprehensive legislative solution to
confronting our servicemembers' increasing suffering from Traumatic
Brain Injury.
Our brave men and women who serve in Operation Iraqi Freedom and
Operation Enduring Freedom are faced with daunting physical and mental
challenges every day as they carry out their duties. Troops deployed in
Iraq, specifically, encounter the widespread use of IEDs, which can
cause Traumatic Brain Injury. Extended deployments put our troops at
risk for longer periods of time.
H.R. 2199 brings together solutions to begin addressing the needs of
our wounded warriors who have been diagnosed with TBI. The bill
requires the VA to establish five centers for TBI research, education,
and clinical activities. It also instructs the VA to establish a TBI
screening program that would provide critical information to Congress
regarding the number of veterans screened, the prevalence of TBI
symptoms, and recommendations for improving care. H.R. 2199 dictates
that the VA should create a comprehensive program for the long-term
care and rehabilitation for veterans who suffer from TBI. The bill also
requires the VA to create a Traumatic Brain Injury Veterans Health
Registry to generate a list of those who served in Iraq and/or
Afghanistan, who have symptoms of TBI, and who apply for VA medical
care or file a disability claim. The VA can then notify those on the
registry of significant developments in research on health consequences
of serving in Iraq and/or Afghanistan.
Additionally, this bill authorizes funding for a pilot program of
mobile VA centers for rural areas. These mobile VA centers would
improve access to readjustment benefits as well as mental health
services. The mobile centers would also assist veterans in making
disability claims.
I represent a rural district comprised of small towns and villages. I
know that my rural veterans' constituency desperately needs better
access to VA services and care, and these mobile VA centers could be
part of the solution.
I strongly urge my colleagues to support this bill because it makes
great strides in providing comprehensive care for our Nation's wounded
warriors suffering from Traumatic Brain Injury.
Mr. HARE. Mr. Speaker, I rise today in strong support of H.R. 2199,
the Traumatic Brain Injury Health Enhancement and Long-Term Support
Act. As a Member of the Committee on Veterans' Affairs, I had the
privilege of working on this bipartisan bill, which I believe provides
critical resources to our heroes with combat-related brain injuries. I
commend Representative Altmire who initiated this effort and I thank VA
Subcommittee Chairman Michaud, and VA Chairman Filner for quickly
bringing this bill to the floor.
Traumatic brain injury (TBI) is the most common wound suffered by
troops returning from Iraq and Afghanistan; unfortunately it is often
undetected until it is too late. The bill before us today ensures we
preemptively screen all veterans for brain injury and that we have the
facilities and research necessary to provide the best care possible.
Additionally, this bill addresses the needs of the 44 percent of
service members who live in rural areas, like those in my district, by
establishing an Advisory Committee on Rural Veterans. It also creates a
pilot program for mobile counseling and mental health services.
Mr. Speaker, I am proud we took up this bill in the Veterans' Affairs
Committee because it is a strong investment in timely healthcare for
our returning troops. I urge my colleagues to support our military
heroes by voting for the Traumatic Brain Injury Health Enhancement and
Long-Term Support Act.
Mr. REYES. Mr. Speaker, I rise today in support of H.R. 2199, the
Traumatic Brain Injury Health Enhancement and Long Term Support Act of
2007. As a Vietnam combat veteran, I have seen the long term effects
that war-related wounds and illnesses can have on the lives of our
returning soldiers.
As Agent Orange sickness and Post Traumatic Stress Disorder (PTSD)
came to typify the Vietnam War, I believe that Traumatic Brain Injuries
(TBI) have become a signature wound of the current conflicts in Iraq
and Afghanistan. Advances in body armor and battlefield medicine have
allowed our troops to survive head wounds that once would have been
fatal. However, the number of identified traumatic brain injuries is
alarming. Of the 23,000-plus troops who have been wounded in the wars
in Iraq and Afghanistan, two-thirds reportedly have been diagnosed with
traumatic brain injuries. These numbers may even be higher since many
cases are often undiagnosed and go untreated. Some reports suggest that
150,000 veterans of the war in Iraq have suffered a traumatic brain
injury of some kind.
Many of those affected by these devastating injuries are unable to
perform the most basic cognitive functions and have great difficulties
with the tasks of everyday life. These injured soldiers will require
quality care and treatment for the rest of their lives.
While it is our obligation to ensure that our military forces have
all the necessary arms and equipment to safely carry out their
missions, we are also responsible for making sure that our troops know
that we will take care of them when they return home. Today we have an
opportunity to demonstrate to our wounded veterans our appreciation for
their sacrifices and our firm commitment to providing them with the
means for living a full and rewarding life. I urge my colleagues to
join me in supporting this important bill.
Mr. FILNER. Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from California (Mr. Filner) that the House suspend the rules
and pass the bill, H.R. 2199, as amended.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. FILNER. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the
Chair's prior announcement, further proceedings on this question will
be postponed.
____________________