[Congressional Record (Bound Edition), Volume 153 (2007), Part 10]
[House]
[Pages 13710-13718]
[From the U.S. 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

[[Page 13711]]

     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
       ``(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.

[[Page 13712]]

       ``(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--
       ``(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.''.

[[Page 13713]]

       (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 (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

[[Page 13714]]

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 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

[[Page 13715]]

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 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.

[[Page 13716]]

  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 
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.

[[Page 13717]]

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. 
``Gerry'' 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 
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.

[[Page 13718]]

  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. BILBRAY. Mr. Speaker, from the Revolutionary War to the current 
conflicts in Iraq and Afghanistan, our wounded warriors have returned 
from combat with varying degrees of injury. Some of these physical 
injuries, such as bullet wounds or losing a limb have been diagnosed 
and treated since the dawn of our Republic. Others, such as Traumatic 
Brain Injury, TBI, have required the practices of treating veterans to 
evolve and adapt so that we can give our returning service members the 
quality of care and the quality of life they deserve.
  The bill before us today is an example of how our system must adapt 
to these increasingly devastating injuries, specifically TBI. H.R. 2199 
would require that Veterans Affairs, VA, screen every combat veteran 
for TBI and submit a report to Congress on the number of returning 
soldiers that have this debilitating injury, and how we can improve 
upon the care they receive. Additionally, the VA would be required to 
establish transition sites so that those service members who are 
diagnosed have the ability to choose various recovery programs that are 
most comfortable to them.
  What makes TBI such a frightening injury is that the symptoms are not 
instantaneous. A service member might not know if he or she has TBI 
until weeks after the initial jolt or blow to the head. If treatment is 
not readily available, then permanent brain damage and loss of motor 
skills and cognitive thought may be the end result.
  For this reason, I am pleased that the House Veterans' Affairs 
Committee has taken up this legislation and continues to seek ways to 
better the care that our returning men and women will receive. H.R. 
2199 is similar to legislation that was passed during the 108th 
Congress which increased research and outreach activities to service 
members with Post Traumatic Stress Disorder, PTSD.
  I am proud to serve on the House Veterans' Affairs Committee and I 
look forward to supporting further legislation that addresses the 
complex needs of our Nation's veterans. As Memorial Day approaches, I 
urge my colleagues to reflect on the sacrifices our veterans have made 
to preserve freedom and how much work we need to do to properly honor 
that sacrifice. I believe that passing H.R. 2199 is a good first step 
in showing that we in Congress recognize the evolving needs of our 
brave veterans.
  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.

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