[Congressional Record Volume 154, Number 57 (Thursday, April 10, 2008)]
[Senate]
[Pages S2952-S2954]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   TRAUMATIC BRAIN INJURY ACT OF 2008

  Mr. SALAZAR. Mr. President, I ask that the Chair lay before the 
Senate a message from the House with respect to S. 793.
  The PRESIDING OFFICER laid before the Senate the following message 
from the House of Representatives:

                                 S. 793

         Resolved, That the bill from the Senate (S. 793) entitled 
     ``An Act to provide for the expansion and improvement of 
     traumatic brain injury programs'', do pass with the following 
     amendment:
       Strike out all after the enacting clause and insert:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Traumatic Brain Injury Act 
     of 2008''.

     SEC. 2. CONFORMING AMENDMENTS RELATING TO RESTRUCTURING.

       Part J of title III of the Public Health Service Act (42 
     U.S.C. 280b et seq.) is amended--
       (1) by redesignating the section 393B (42 U.S.C. 280b-1c) 
     relating to the use of allotments for rape prevention 
     education, as section 393A and moving such section so that it 
     follows section 393;
       (2) by redesignating existing section 393A (42 U.S.C. 280b-
     1b) relating to prevention of traumatic brain injury, as 
     section 393B; and
       (3) by redesignating the section 393B (42 U.S.C. 280b-1d) 
     relating to traumatic brain injury registries, as section 
     393C.

     SEC. 3. TRAUMATIC BRAIN INJURY PROGRAMS OF THE CENTERS FOR 
                   DISEASE CONTROL AND PREVENTION.

       (a) Prevention of Traumatic Brain Injury.--Clause (ii) of 
     section 393B(b)(3)(A) of the Public Health Service Act, as so 
     redesignated, (42 U.S.C. 280b-1b) is amended by striking 
     ``from hospitals and trauma centers'' and inserting ``from 
     hospitals and emergency departments''.
       (b) National Program for Traumatic Brain Injury 
     Surveillance and Registries.--Section 393C of the Public 
     Health Service Act, as so redesignated, (42 U.S.C. 280b et 
     seq.) is amended--
       (1) in the section heading, by inserting ``surveillance 
     and'' after ``national program for traumatic brain injury''; 
     and
       (2) in subsection (a), in the matter preceding paragraph 
     (1), by striking ``may make grants'' and all that follows 
     through ``to collect data concerning--'' and inserting ``may 
     make grants to States or their designees to develop or 
     operate the State's traumatic brain injury surveillance 
     system or registry to determine the incidence and prevalence 
     of traumatic brain injury and related disability, to ensure 
     the uniformity of reporting under such system or registry, to 
     link individuals with traumatic brain injury to services and 
     supports, and to link such individuals with academic 
     institutions to conduct applied research that will support 
     the development of

[[Page S2953]]

     such surveillance systems and registries as may be necessary. 
     A surveillance system or registry under this section shall 
     provide for the collection of data concerning--''.
       (c) Report.--Section 393C of the Public Health Service Act 
     (as so redesignated) is amended by adding at the end the 
     following:
       ``(b) Not later than 18 months after the date of enactment 
     of the Traumatic Brain Injury Act of 2008, the Secretary, 
     acting through the Director of the Centers for Disease 
     Control and Prevention and the Director of the National 
     Institutes of Health and in consultation with the Secretary 
     of Defense and the Secretary of Veterans Affairs, shall 
     submit to the relevant committees of Congress a report that 
     contains the findings derived from an evaluation concerning 
     activities and procedures that can be implemented by the 
     Centers for Disease Control and Prevention to improve the 
     collection and dissemination of compatible epidemiological 
     studies on the incidence and prevalence of traumatic brain 
     injury in individuals who were formerly in the military. The 
     report shall include recommendations on the manner in which 
     such agencies can further collaborate on the development and 
     improvement of traumatic brain injury diagnostic tools and 
     treatments.''.

     SEC. 4. STUDY ON TRAUMATIC BRAIN INJURY.

       Part J of title III of the Public Health Service Act (42 
     U.S.C. 280b et seq.) is amended by inserting after section 
     393C, as so redesignated, the following:

     ``SEC. 393C-1. STUDY ON TRAUMATIC BRAIN INJURY.

       ``(a) Study.--The Secretary, acting through the Director of 
     the Centers for Disease Control and Prevention with respect 
     to paragraph (1) and in consultation with the Director of the 
     National Institutes of Health and other appropriate entities 
     with respect to paragraphs (2), (3), and (4), may conduct a 
     study with respect to traumatic brain injury for the purpose 
     of carrying out the following:
       ``(1) In collaboration with appropriate State and local 
     health-related agencies--
       ``(A) determining the incidence of traumatic brain injury 
     and prevalence of traumatic brain injury related disability 
     and the clinical aspects of the disability in all age groups 
     and racial and ethnic minority groups in the general 
     population of the United States, including institutional 
     settings, such as nursing homes, correctional facilities, 
     psychiatric hospitals, child care facilities, and residential 
     institutes for people with developmental disabilities; and
       ``(B) reporting national trends in traumatic brain injury.
       ``(2) Identifying common therapeutic interventions which 
     are used for the rehabilitation of individuals with such 
     injuries, and, subject to the availability of information, 
     including an analysis of--
       ``(A) the effectiveness of each such intervention in 
     improving the functioning, including return to work or school 
     and community participation, of individuals with brain 
     injuries;
       ``(B) the comparative effectiveness of interventions 
     employed in the course of rehabilitation of individuals with 
     brain injuries to achieve the same or similar clinical 
     outcome; and
       ``(C) the adequacy of existing measures of outcomes and 
     knowledge of factors influencing differential outcomes.
       ``(3) Identifying interventions and therapies that can 
     prevent or remediate the development of secondary neurologic 
     conditions related to traumatic brain injury.
       ``(4) Developing practice guidelines for the rehabilitation 
     of traumatic brain injury at such time as appropriate 
     scientific research becomes available.
       ``(b) Dates Certain for Reports.--If the study is conducted 
     under subsection (a), the Secretary shall, not later than 3 
     years after the date of the enactment of the Traumatic Brain 
     Injury Act of 2008, submit to Congress a report describing 
     findings made as a result of carrying out such subsection 
     (a).
       ``(c) Definition.--For purposes of this section, the term 
     `traumatic brain injury' means an acquired injury to the 
     brain. Such term does not include brain dysfunction caused by 
     congenital or degenerative disorders, nor birth trauma, but 
     may include brain injuries caused by anoxia due to trauma 
     including near drowning. The Secretary may revise the 
     definition of such term as the Secretary determines 
     necessary.''.

     SEC. 5. TRAUMATIC BRAIN INJURY PROGRAMS OF THE NATIONAL 
                   INSTITUTES OF HEALTH.

       Section 1261 of the Public Health Service Act (42 U.S.C. 
     300d-61) is amended--
       (1) in subsection (b)(2), by striking ``Labor and Human 
     Resources'' and inserting ``Health, Education, Labor, and 
     Pensions'';
       (2) in subparagraph (D) of subsection (d)(4), by striking 
     ``head brain injury'' and inserting ``brain injury''; and
       (3) in subsection (i), by inserting ``, and such sums as 
     may be necessary for each of the fiscal years 2009 through 
     2012'' before the period at the end.

     SEC. 6. TRAUMATIC BRAIN INJURY PROGRAMS OF THE HEALTH 
                   RESOURCES AND SERVICES ADMINISTRATION.

       (a) State Grants for Demonstration Projects Regarding 
     Traumatic Brain Injury.--Section 1252 of the Public Health 
     Service Act (42 U.S.C. 300d-52) is amended--
       (1) in subsection (a)--
       (A) by striking ``may make grants to States'' and inserting 
     ``may make grants to States and American Indian consortia''; 
     and
       (B) by striking ``health and other services'' and inserting 
     ``rehabilitation and other services'';
       (2) in subsection (b)--
       (A) in paragraphs (1), (3)(A)(i), (3)(A)(iii), and 
     (3)(A)(iv), by striking the term ``State'' each place such 
     term appears and inserting the term ``State or American 
     Indian consortium''; and
       (B) in paragraph (2), by striking ``recommendations to the 
     State'' and inserting ``recommendations to the State or 
     American Indian consortium'';
       (3) in subsection (c)(1), by striking the term ``State'' 
     each place such term appears and inserting ``State or 
     American Indian consortium'';
       (4) in subsection (e), by striking ``A State that 
     received'' and all that follows through the period and 
     inserting ``A State or American Indian consortium that 
     received a grant under this section prior to the date of the 
     enactment of the Traumatic Brain Injury Act of 2008 may 
     complete the activities funded by the grant.'';
       (5) in subsection (f)--
       (A) in the subsection heading, by inserting ``and American 
     Indian Consortium'' after ``State'';
       (B) in paragraph (1) in the matter preceding subparagraph 
     (A), paragraph (1)(E), paragraph (2)(A), paragraph (2)(B), 
     paragraph (3) in the matter preceding subparagraph (A), 
     paragraph (3)(E), and paragraph (3)(F), by striking the term 
     ``State'' each place such term appears and inserting ``State 
     or American Indian consortium''; and
       (C) in clause (ii) of paragraph (1)(A), by striking 
     ``children and other individuals'' and inserting ``children, 
     youth, and adults'';
       (6) in subsection (h)--
       (A) by striking ``Not later than 2 years after the date of 
     the enactment of this section, the Secretary'' and inserting 
     ``Not less than biennially, the Secretary'';
       (B) by striking ``Commerce of the House of Representatives, 
     and to the Committee on Labor and Human Resources'' and 
     inserting ``Energy and Commerce of the House of 
     Representatives, and to the Committee on Health, Education, 
     Labor, and Pensions''; and
       (C) by inserting ``and section 1253'' after ``programs 
     established under this section,'';
       (7) by amending subsection (i) to read as follows:
       ``(i) Definitions.--For purposes of this section:
       ``(1) The terms `American Indian consortium' and `State' 
     have the meanings given to those terms in section 1253.
       ``(2) 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 may revise the definition 
     of such term as the Secretary determines necessary, after 
     consultation with States and other appropriate public or 
     nonprofit private entities.''; and
       (8) in subsection (j), by inserting ``, and such sums as 
     may be necessary for each of the fiscal years 2009 through 
     2012'' before the period.
       (b) State Grants for Protection and Advocacy Services.--
     Section 1253 of the Public Health Service Act (42 U.S.C. 
     300d-53) is amended--
       (1) in subsections (d) and (e), by striking the term 
     ``subsection (i)'' each place such term appears and inserting 
     ``subsection (l)'';
       (2) in subsection (g), by inserting ``each fiscal year not 
     later than October 1,'' before ``the Administrator shall 
     pay'';
       (3) by redesignating subsections (i) and (j) as subsections 
     (l) and (m), respectively;
       (4) by inserting after subsection (h) the following:
       ``(i) Data Collection.--The Administrator of the Health 
     Resources and Services Administration and the Commissioner of 
     the Administration on Developmental Disabilities shall enter 
     into an agreement to coordinate the collection of data by the 
     Administrator and the Commissioner regarding protection and 
     advocacy services.
       ``(j) Training and Technical Assistance.--
       ``(1) Grants.--For any fiscal year for which the amount 
     appropriated to carry out this section is $6,000,000 or 
     greater, the Administrator shall use 2 percent of such amount 
     to make a grant to an eligible national association for 
     providing for training and technical assistance to protection 
     and advocacy systems.
       ``(2) Definition.--In this subsection, the term `eligible 
     national association' means a national association with 
     demonstrated experience in providing training and technical 
     assistance to protection and advocacy systems.
       ``(k) System Authority.--In providing services under this 
     section, a protection and advocacy system shall have the same 
     authorities, including access to records, as such system 
     would have for purposes of providing services under subtitle 
     C of the Developmental Disabilities Assistance and Bill of 
     Rights Act of 2000.''; and
       (5) in subsection (l) (as redesignated by this subsection) 
     by striking ``2002 through 2005'' and inserting ``2009 
     through 2012''.
  Mr. SALAZAR. Mr. President, I ask unanimous consent that the Senate 
concur in the House amendment, the motion to reconsider be laid upon 
the table, with no intervening action or debate, and any statements 
related to the bill be printed in the Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. KENNEDY. Mr. President, today, Congress took a major step toward 
making a remarkable difference in the lives of some of our Nation's 
most deserving citizens: our soldiers and our children with brain 
injuries.
  I commend our colleagues, Congressmen Pascrell and Platts, as well as 
my friend and cosponsor in the Senate, Senator Hatch, on all they have 
done to achieve passage of this legislation. It is an important and 
timely bill that helps an especially deserving group of people.

[[Page S2954]]

  Traumatic brain injuries have become the signature wound of the war 
in Iraq. Up to two-thirds of our wounded soldiers may have suffered 
such injuries.
  In the civilian population here at home, an unacceptably large number 
of children from birth to age 14 experience traumatic brain injuries 
approximately 475,000 a year and some of the most frequent of these 
injuries are to children under the age of 5. In Massachusetts alone, 
more than 40,000 individuals experience these injuries each year.
  As a result of these injuries, over 5.3 million Americans are now 
living with a permanent disability. Today, we have taken another step 
toward ensuring that these citizens and their families will receive the 
best services we can provide.
  The legislation reauthorizes grants that assist States, territories, 
and the District of Columbia in establishing and expanding coordinated 
systems of community-based services and supports for persons with such 
injuries.
  The legislation also reauthorizes an important provision, the 
Protection and Advocacy for Individuals with Traumatic Brain Injury 
Program. This program, enacted by Congress in 2000, has become 
essential because persons with these injuries have an array of needs 
beyond treatment and health care. Protection and advocacy services 
include assistance in returning to work, finding a place to live, 
obtaining supports and services such as attendant care and assistive 
technology, and obtaining appropriate mental health, substance abuse, 
and rehabilitation services.
  Often these persons especially our returning veterans must remain in 
extremely expensive institutions far longer than necessary, because the 
community-based supports and services they need are not available, even 
though they can lead to reduced government expenditures, increased 
productivity, greater independence and community involvement. Those who 
provide such assistance must have special skills, and their work is 
often time-intensive.
  The legislation also allocates funds for CDC programs that provide 
important information and data on injury prevention of these injuries. 
A recent Institute of Medicine report demonstrated that these programs 
work. Their benefit is obvious, and we must do all we can to expand 
this appropriation in the years ahead to meet the urgent and growing 
need for this assistance.
  A recent report by the Institute of Medicine calls the current TBI 
programs an ``overall success.'' It states that ``there is considerable 
value in providing funding,'' and ``it is worrisome that the modestly 
budgeted TBI Program continues to be vulnerable to budget cuts.''
  Current estimates show that the Federal Government spends less than 
$3 per brain injury survivor on research and services. As the IOM study 
suggests, this program must be able to expand, so that each State will 
have the resources needed to maintain vital services and advocacy for 
the large number of Americans who sustain such injuries each year.
  Enactment of this bipartisan legislation will bring us a giant step 
closer to strengthening these vital programs for these deserving 
individuals and their families.

                          ____________________