[Congressional Record Volume 159, Number 34 (Monday, March 11, 2013)]
[Senate]
[Pages S1596-S1597]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN (for himself, Mr. Blumenthal, and Mr. Harkin):
  S. 521. A bill to require the Secretary of Defense to award grants to 
fund research on orthotics and prosthetics; to the Committee on Armed 
Services.
  Mr. DURBIN. Mr. President, I want to tell you about a wounded 
warrior.
  He was fitted with a prosthetic leg that fit reasonably well and he 
was able to carry on with his life. But from time to time his leg would 
give out.
  He would fall, but he carried on.
  Then he and his wife were blessed with their first child. He was 
immensely happy to be a father. But he was terrified to hold his baby.
  He was afraid that his leg would give out and he would fall and hurt 
his baby.
  Can you imagine going to war to make the world safe for your children 
and then being afraid to hold your own child?
  One day this young father mentioned his fear to a prosthetics 
practitioner, who began researching other prosthetic legs and was able 
to find a leg that fit him better and was more stable.
  Finally, that new father was able to hold his baby without fear.
  Most Americans will never need for a prosthetic limb. But many do. 
They include people who suffer catastrophic injuries in battle and 
accidents and others who lose limbs to illnesses such as cancer and 
diabetes.
  For these people, proper-fitting, advanced prosthetics and orthotics 
fitted by highly trained, experienced clinicians can mean the 
difference between constant pain and discomfort--and a certain amount 
of anxiety, or living a happier, healthier and more productive life.
  Let me tell you about another veteran who lives in Illinois.
  He lost a leg in Vietnam.
  He was fitted with a prosthetic leg that included a hydraulic knee 
unit. That was the state of the art decades ago.
  Several times a year he would fall. Many of the falls resulted in 
broken bones and other injuries.
  This veteran was also overweight, with high blood pressure.
  About 6 years ago, he was fitted with his first computer-controlled 
knee.
  He had more stability and more range of motion. He moved with more 
confidence.
  With his new, advanced knee, he was able to exercise. He lost weight.
  His health improved and he was able to stop taking multiple 
medications. He is living a happier, healthier life.
  Finding the right prosthetic is more than luck or guess work. It 
requires a great deal of education, training and experience. There are 
many talented prosthetic clinicians working today in Veterans 
Administration Hospitals and other hospitals and rehabilitation 
clinics.
  But we have a problem. Just as the need for these health 
professionals is increasing, many are retiring.
  Wounded warriors deserve the best medical care our grateful Nation 
has to offer.
  Today, with Senators Blumenthal and Harkin, I am introducing two 
bills to help ensure that service members and veterans who need 
prosthetics receive the care and equipment they deserve.
  The first bill, the Wounded Warrior Workforce Enhancement Act, will 
establish a competitive grant program at the Department of Veterans 
Affairs to train more health professionals in the fields of orthotics 
and prosthetics.
  These grants can be used to create new degree programs or expand 
existing programs in these fields.
  Our bill will also require the VA to establish a Center of Excellence 
in Prosthetic and Orthotic Education to research and share information 
about the knowledge, skills, and training clinical professionals in the 
field need the most.
  The work at the Center would add to higher education's clinical 
expertise to train the students going into prosthetics and orthotics.
  The second bill we are introducing today, the Wounded Warrior 
Research Enhancement Act, directs the Secretary of Defense to establish 
an ongoing program of research and best practices in orthotics and 
prosthetics care.
  We ask OD to then make sure clinical professionals serving service 
members and veterans are kept up to date on innovations in technology 
and care.
  In the wars in both Iraq and Afghanistan, tens of thousands of our 
service members have been wounded by roadside bombs, rocket propelled 
grenades and small arms fire.
  As our involvement in these wars winds down, many returning veterans 
are living with complex wounds that require sophisticated prosthetics 
and orthotics.
  We can build on the breakthrough advances made by researchers at the 
Rehabilitation Institute of Chicago and by private providers such as 
Scheck & Siress, founded in Oak Park, IL.
  Northwestern University in Evanston, Illinois, is home to the largest 
and oldest prosthetics and orthotics program in the Western Hemisphere.
  It offers first-rate master's level education and training and 
graduates 50 clinicians every year.
  Northwestern can be a model for other universities around the country 
to meet the needs of veteran amputees.
  New technologies are improving the quality of life for amputees. We 
need to make sure that clinicians in the field have the skills and 
training to help veterans take advantage of these advances.
  Recently the standard for entry-level qualifications for clinicians 
in prosthetics was changed to require a master's degree.
  That makes sense. There is a lot to know. But right now there are not 
enough master's degree programs in our universities to meet the current 
demands for prosthetics and orthotics technicians.
  Many experienced clinicians are nearing retirement age.
  Veterans are not the only people who benefit when we train more 
clinicians in the fields of prosthetics and orthotics.
  As America's population ages and rates of diabetes and cardiovascular 
disease increase, more Americans find themselves in need of prosthetics 
and orthotics. They, too, will benefit from this investment in research 
and training.
  When we ask our service members to risk their lives for us, they 
don't say, ``Ask me later.'' They go.
  If they come home needing a new limb, we shouldn't tell them, ``Ask 
me later.''
  We know that the VA is facing a critical and impending shortage of 
clinicians who are trained in prosthetics and orthotics.
  By working together now, we can prevent that shortage and help 
America's wounded warriors live the fullest lives possible. I hope my 
colleagues will join me in this effort.
  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. 521

       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 ``Wounded Warrior Research 
     Enhancement Act''.

     SEC. 2. ORTHOTIC AND PROSTHETIC RESEARCH.

       (a) Purpose.--The purpose of the grants described in this 
     section is to advance orthotic and prosthetic clinical care 
     for members of the Armed Forces, veterans, and civilians who 
     have undergone amputation, traumatic brain injury, and other 
     serious physical injury as a result of combat or military 
     experience.
       (b) Grants for Research on Patient Outcomes.--The Secretary 
     of Defense shall award grants to persons to carry out 
     research on the following:
       (1) The actions that can be taken to prevent amputation of 
     limbs.

[[Page S1597]]

       (2) The point in the course of patient treatment during 
     which orthotic and prosthetic intervention is most effective.
       (3) The orthotic interventions that are most effective in 
     treating the physical effects of traumatic brain injury.
       (4) The patients that benefit most from particular orthotic 
     and prosthetic technologies.
       (5) The orthotic and prosthetic services that best 
     facilitate the return to active duty of members of the Armed 
     Forces.
       (6) The effect of the aging process on the use of 
     prosthetics, including--
       (A) increased skin breakdown;
       (B) loss of balance;
       (C) falls; and
       (D) other issues that arise during the aging process.
       (c) Grants on Materials Research.--The Secretary shall 
     award grants to persons to carry out research on the 
     following:
       (1) The improvement of existing materials used in orthotics 
     and prosthetics for the purpose of improving quality of life 
     and health outcomes for individuals with limb loss.
       (2) The development of new materials used in orthotics and 
     prosthetics for the purpose of improving quality of life and 
     health outcomes for individuals with limb loss.
       (d) Grants on Technology Research.--The Secretary shall 
     award grants to persons to carry out research on the 
     following:
       (1) The improvement of existing orthotic and prosthetic 
     technology and devices for the purpose of improving quality 
     of life and health outcomes for individuals with limb loss.
       (2) The development of new orthotic and prosthetic 
     technology and devices for the purpose of improving quality 
     of life and health outcomes for individuals with limb loss.
       (e) Request for Proposals.--A person seeking the award of a 
     grant under this section shall submit to the Secretary an 
     application therefore in the form and accompanied by such 
     information as the Secretary shall require.
       (f) Award Requirements.--
       (1) Peer-reviewed proposals.--Grants under this section may 
     be awarded only for research that is peer-reviewed.
       (2) Competitive procedures.--Grants under this section 
     shall be awarded through competitive procedures.
       (g) Grant Use.--A person awarded a grant under subsection 
     (b), (c), or (d) shall use the grant amount to carry out the 
     research described in the applicable subsection.
       (h) Reports.--Not later than 180 days after the date of the 
     enactment of this Act, and annually thereafter, the Secretary 
     of Defense shall, in consultation with the Secretary of 
     Veterans Affairs, veterans, community-based clinicians, and 
     expert researchers in the field of orthotics and prosthetics, 
     submit to Congress a report setting forth the following:
       (1) An agenda for orthotic and prosthetic research that 
     identifies and prioritizes the most significant unanswered 
     orthotic and prosthetic research questions pertinent to the 
     provision of evidence-based clinical care to members of the 
     Armed Forces, veterans, and civilians.
       (2) For each report after the initial report under this 
     subsection--
       (A) a summary of how the grants awarded under subsection 
     (b) are addressing the most significant orthotic and 
     prosthetic needs; and
       (B) the progress made towards resolving orthotic and 
     prosthetic challenges facing members of the Armed Forces and 
     veterans.
       (i) Veteran Defined.--In this section, the term ``veteran'' 
     has the meaning given that term in section 101 of title 38, 
     United States Code.
       (j) Authorization of Appropriations.--There is authorized 
     to be appropriated for fiscal year 2014 for the Department of 
     Defense for the Defense Health Program, $30,000,000 to carry 
     out this section.
                                 ______