[Congressional Record (Bound Edition), Volume 160 (2014), Part 10]
[House]
[Pages 14819-14820]
[From the U.S. Government Publishing Office, www.gpo.gov]




      VETERANS TRAUMATIC BRAIN INJURY CARE IMPROVEMENT ACT OF 2014

  Mr. LAMBORN. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 4276) to extend and modify a pilot program on assisted 
living services for veterans with traumatic brain injury, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 4276

       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 ``Veterans Traumatic Brain 
     Injury Care Improvement Act of 2014''.

     SEC. 2. EXTENSION AND MODIFICATION OF PILOT PROGRAM ON 
                   ASSISTED LIVING SERVICES FOR VETERANS WITH 
                   TRAUMATIC BRAIN INJURY.

       (a) Modification of Report Requirements.--Subsection (e) of 
     section 1705 of the National Defense Authorization Act for 
     Fiscal Year 2008 (Public Law 110-181; 38 U.S.C. 1710C note) 
     is amended to read as follows:
       ``(e) Reports.--
       ``(1) Quarterly reports.--
       ``(A) In general.--For each calendar quarter occurring 
     during the period beginning January 1, 2015, and ending 
     September 30, 2017, the Secretary shall submit to the 
     Committees on Veterans' Affairs of the Senate and the House 
     of Representatives a report on the pilot program.
       ``(B) Elements.--Each report submitted under subparagraph 
     (A) shall include each of the following for the quarter 
     preceding the quarter during which the report is submitted 
     the following:
       ``(i) The number of individuals that participated in the 
     pilot program.
       ``(ii) The number of individuals that successfully 
     completed the pilot program.
       ``(iii) The degree to which pilot program participants and 
     family members of pilot program participants were satisfied 
     with the pilot program.
       ``(iv) The interim findings and conclusions of the 
     Secretary with respect to the success of the pilot program 
     and recommendations for improvement.
       ``(2) Final report.--
       ``(A) In general.--Not later than 60 days after the 
     completion of the pilot program, the Secretary shall submit 
     to the Committees on Veterans' Affairs of the Senate and the 
     House of Representatives a final report on the pilot program.
       ``(B) Elements.--The final report required by subparagraph 
     (A) shall include the following:
       ``(i) A description of the pilot program.
       ``(ii) The Secretary's assessment of the utility of the 
     activities carried out under the pilot program in enhancing 
     the rehabilitation, quality of life, and community 
     reintegration of veterans with traumatic brain injury.
       ``(iii) An evaluation of the pilot program in light of 
     independent living programs carried out by the Secretary 
     under title 38, United States Code, including--

       ``(I) whether the pilot program duplicates services 
     provided under such independent living programs;
       ``(II) the ways in which the pilot program provides 
     different services that the services provided under such 
     independent living program;
       ``(III) how the pilot program could be better defined or 
     shaped; and
       ``(IV) whether the pilot program should be incorporated 
     into such independent living programs.

       ``(iv) Such recommendations as the Secretary considers 
     appropriate regarding improving the pilot program.''.
       (b) Definition of Community-based Brain Injury Residential 
     Rehabilitative Care Services.--Such section is further 
     amended--
       (1) in the section heading, by striking ``assisted living'' 
     and inserting ``community-based brain injury residential 
     rehabilitative care'';
       (2) in subsection (c), in the subsection heading, by 
     striking ``Assisted Living'' and inserting ``Community-Based 
     Brain Injury Residential Rehabilitative Care'';
       (3) by striking ``assisted living'' each place it appears, 
     and inserting ``community-based brain injury rehabilitative 
     care''; and
       (4) in subsection (f)(1), by striking ``and personal care'' 
     and inserting ``rehabilitation, and personal care''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect on the date of the enactment of this Act.
       (d) Prohibition on New Appropriations.--No additional funds 
     are authorized to be appropriated to carry out this Act and 
     the amendments made by this Act, and this Act and such 
     amendments shall be carried out using amounts otherwise 
     available for such purpose.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Colorado (Mr. Lamborn) and the gentlewoman from Arizona (Mrs. 
Kirkpatrick) each will control 20 minutes.
  The Chair recognizes the gentleman from Colorado.


                             General Leave

  Mr. LAMBORN. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
to H.R. 4276, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Colorado?
  There was no objection.
  Mr. LAMBORN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, H.R. 4276, as amended, would require the Department of 
Veterans Affairs, beginning in January, to provide reports to Congress 
on the pilot program for assisted living services for veterans with 
traumatic brain injury.
  With passage of the Veterans Access, Choice, and Accountability Act 
earlier this year, we were able to extend this important program for 
another 3 years. As of June 1 of this year, 187 veterans from 46 
different facilities in 22 States have been enrolled for services.
  These are severely injured veterans who still want to live within 
their communities. For that reason, this bill also amends the 
definition of ``assisted living'' to encompass community-based brain 
injury residential rehabilitative care.
  Too often, pilot programs are initiated and abandoned by the VA with 
little reporting or data analysis as to the effectiveness or efficiency 
of the program. That is why this bill is important.
  It would require the Secretary to provide quarterly reports to 
Congress on utilization, status, and veteran satisfaction as well as 
interim assessments as to the success of the program and 
recommendations for improvement.
  It would also require a final report as to how the VA would expect to 
continue or integrate this pilot into other services that are vital for 
enhancing the quality of life for those veterans suffering from what 
has been called one of the signature wounds of recent conflicts, 
traumatic brain injury, or TBI.
  I am grateful to Representative Bill Cassidy, my friend and colleague 
from Louisiana, for his leadership in introducing this legislation, and 
I am proud to join him in supporting it.
  Mr. Speaker, I urge all of my colleagues to join me in supporting 
this important piece of legislation, and I reserve the balance of my 
time.
  Mrs. KIRKPATRICK. Mr. Speaker, I yield myself such time as I may 
consume.
  Traumatic brain injury has become a signature wound of the Iraq and 
Afghanistan wars. These conflicts have caused hundreds of thousands of 
servicemembers to sustain TBIs.
  The Veterans Access, Choice, and Accountability Act extended the 
pilot program on assisted living services for veterans with TBI until 
October 2017. This pilot has helped nearly 200 veterans with moderate 
to severe brain injuries, and this program fills a treatment need which 
residential VA facilities currently cannot handle.
  H.R. 4276 will improve the reporting requirements for the TBI 
assisted living pilot program so that we can better gauge its success 
and expand the definition of community-based residential

[[Page 14820]]

rehabilitative services so that veterans with TBI have other 
residential and home-based assisted living options.
  Congress has provided significant resources for this program, 
currently approaching $30 million per year. Reports show that veterans 
believe this is a successful and popular program, but we in Congress 
must provide vital oversight so that innovative pilot programs meet our 
veterans' needs. This is why we need better data on the cost and 
benefits of this program to veterans.
  This bill will require the VA to submit detailed quarterly reports on 
this pilot program. I believe that these increased reporting 
requirements will ensure that the VA is providing the best 
rehabilitative services for our veterans with TBI.
  Earlier this year, I held a field hearing on access to care for 
veterans with TBI at the VA medical center in Tucson, Arizona. The 
Tucson VA's polytrauma care unit is one of several VA centers across 
the country that is at the very forefront of providing care and 
rehabilitative services for veterans with TBI.
  I believe the VA's cutting-edge treatments and its coordinated care 
for veterans with TBI serve as a model for innovative care that could 
be expanded to other medical specialties so that the VA may better 
address the unique health care needs of our veterans.
  In the coming months, we must look to fundamentally reform the VA in 
how it provides benefits and services to veterans. We must look to some 
of the VA health care delivery programs that show promise, such as the 
assisted living pilot program, to implement best practices throughout 
the VA system that will give our veterans the timely, world-class 
health care they deserve. I look forward to engaging my colleagues and 
veterans in this goal.
  I urge my colleagues to support H.R. 4276, and I reserve the balance 
of my time.
  Mr. LAMBORN. Mr. Speaker, I yield 2 minutes to the gentleman from 
Louisiana, Representative Bill Cassidy, my friend and colleague and a 
sponsor of the bill.
  Mr. CASSIDY. Mr. Speaker, over 19 percent of returning veterans 
suffer from some form of traumatic brain injury.
  That is why in March I introduced H.R. 4276 which would extend a VA 
pilot program to care for those suffering from traumatic brain injury, 
or TBI, and was pleased when a portion of this bill was included in the 
Veterans Access to Care Act of 2014.
  In addition to extending the program for a longer length of time, my 
bill also created metrics for determining the success of the program.
  I am pleased the House will now vote on the amended portion of my 
bill which creates more thorough, frequent reporting requirements and 
expands the definition of ``assisted living'' to encompass broader 
definitions of care. The expanded reporting requirements allow for a 
more thorough determination of how successful this program is in 
rehabilitating patients suffering from TBI.
  I am a doc. I know that, unless you measure something, it will not 
change. If we measure and find it doing well, hopefully, we expand; if 
not, we improve it.
  It will also measure the satisfaction that the veteran and their 
family members have with the program. By expanding the definition of 
``assisted living,'' the bill also allows for more partnerships to take 
place with non-VA facilities so that veterans can receive the kind of 
care that serves their unique needs.
  It is our duty as Members of Congress to care for our veterans and 
ensure they receive the best care available. I thank Chairman Miller 
for working with me on this legislation.
  I appreciate the opportunity to have it considered, and I urge all my 
colleagues to support it.
  Mrs. KIRKPATRICK. Mr. Speaker, I yield 3 minutes to the gentlewoman 
from Florida (Ms. Brown).
  Ms. BROWN of Florida. I thank the ranking member. This is certainly a 
bill that I can support.
  H.R. 4276 would improve the reporting requirement for the TBI 
assisted living pilot program so that we can better gauge its success 
and expansion of the definition of the community-based residential 
rehabilitation services so that veterans who have TBI have other 
residential and home-based assisted living options.
  I think it is important for us to go back to what the first President 
of the United States said about any war that we participate in:
  ``The willingness with which our young people are likely to serve in 
any war, no matter how justifiable, shall be directly proportional to 
how they perceive the veterans of earlier wars were treated and 
appreciated by their country.''
  We are not just talking about this on Veterans Day, but about how we 
treat them and how we support them every day. I think this bill goes a 
long way to deal with some of the problems that they are experiencing 
after returning from the last two wars; so this is certainly a bill 
that I can support.
  I want to say may God continue to bless America. I want to thank the 
veterans for their service--and not just thanking them, but this is 
really putting your money where your mouth is.
  Mr. LAMBORN. Mr. Speaker, we have no further speakers, and I am 
prepared to close. I reserve the balance of my time.
  Mrs. KIRKPATRICK. Mr. Speaker, I have no further speakers. I urge my 
colleagues to support H.R. 4276, and I yield back the balance of my 
time.
  Mr. LAMBORN. Mr. Speaker, I too encourage all Members to support H.R. 
4276, as amended, and I yield back the balance of my time.
  Ms. JACKSON LEE. Mr. Speaker, I rise in strong support of H.R. 4276, 
the Veterans Traumatic Brain Injury Improvement Act of 2014.
  Mr. Speaker, the wars in Afghanistan and Iraq, which have demanded 
multiple deployments for many of our nation's courageous soldiers, have 
taken a psychological toll on U.S. service members.
  As our brave military men and women fight to defend our great 
country, they put themselves at risk of combat-related health problems, 
including traumatic brain injury (TBI), post-traumatic stress disorder 
(PTSD) and other brain related maladies.
  More than 280,000 United States service members have been diagnosed 
with a degree of TBI in the past 10 years, and more than 19 percent of 
veterans may have some form of the disorder.
  There is no doubt that these fearless men and women suffering from 
traumatic brain injuries deserve not only our gratitude, but also our 
support throughout recovery and treatment.
  Thanks to the Assisted Living Pilot Program, these veterans 
struggling daily with TBI will be provided with 24-hour assisted living 
help.
  Mr. Speaker, our United States veterans bravely put their life on the 
line to defend our freedoms and to keep our nation safe.
  By passing H.R. 4276, veterans combating TBI and PTSD will receive 
assistance to enhance their rehabilitation, quality of life, and 
community integration.
  The Veterans Traumatic Brain Injury Care Act expands the requirements 
for Veterans Affairs Department reports to affirm the enrollment, 
completion, and effectiveness of the pilot program.
  The community-integrated rehabilitation treatment provided by the 
pilot program will serve as a vital resource to our veterans as they 
overcome burdensome health problems.
  I urge my colleagues to join me in supporting H.R. 4276 to show their 
support and gratitude for the sacrifices made by our service men and 
women, and to ensure that veterans battling traumatic brain injuries 
receive the care and rehabilitation they deserve.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Colorado (Mr. Lamborn) that the House suspend the rules 
and pass the bill, H.R. 4276, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________