[House Report 113-456]
[From the U.S. Government Publishing Office]


113th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     113-456

======================================================================



 
           TRAUMATIC BRAIN INJURY REAUTHORIZATION ACT OF 2013

                                _______
                                

  May 20, 2014.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

  Mr. Upton, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 1098]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 1098) to amend the Public Health Service Act to 
reauthorize certain programs relating to traumatic brain injury 
and to trauma research, having considered the same, report 
favorably thereon with an amendment and recommend that the bill 
as amended do pass.

                                CONTENTS

                                                                   Page
Amendment........................................................     2
Purpose and Summary..............................................     3
Background and Need for Legislation..............................     3
Hearings.........................................................     4
Committee Consideration..........................................     4
Committee Votes..................................................     4
Committee Oversight Findings.....................................     5
Statement of General Performance Goals and Objectives............     5
New Budget Authority, Entitlement Authority, and Tax Expenditures     5
Earmark, Limited Tax Benefits, and Limited Tariff Benefits.......     5
Committee Cost Estimate..........................................     5
Congressional Budget Office Estimate.............................     5
Federal Mandates Statement.......................................     7
Duplication of Federal Programs..................................     7
Disclosure of Directed Rule Makings..............................     7
Advisory Committee Statement.....................................     7
Applicability to Legislative Branch..............................     7
Section-by-Section Analysis of the Legislation...................     7
Changes in Existing Law Made by the Bill, as Reported............     9

                               Amendment

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Traumatic Brain Injury Reauthorization 
Act of 2013''.

SEC. 2. CDC PROGRAMS FOR PREVENTION AND SURVEILLANCE OF TRAUMATIC BRAIN 
                    INJURY.

  (a) Prevention.--Section 393B(b)(3) of the Public Health Service Act 
(42 U.S.C. 280b-1c(b)(3)) is amended by striking ``health-status goals 
for 2010, commonly referred to as Healthy People 2010'' and inserting 
``health-status goals for 2020, commonly referred to as Healthy People 
2020''.
  (b) Surveillance.--Subsection (b) of section 393C of the Public 
Health Service Act (42 U.S.C. 280b-1d) is amended--
          (1) by striking ``(b) Not later than'' and inserting the 
        following:
  ``(b) Reports.--
          ``(1) Initial report.--Not later than''; and
          (2) by adding at the end the following:
          ``(2) Subsequent report.--Not later than 24 months after the 
        date of enactment of the Traumatic Brain Injury Reauthorization 
        Act of 2013, the Secretary, acting through the Director of the 
        Centers for Disease Control and Prevention and the Director of 
        the National Institutes of Health and in consultation with the 
        Secretary of Defense and the Secretary of Veterans Affairs, 
        shall submit to the relevant committees of Congress a report 
        that--
                  ``(A) identifies which recommendations in the report 
                under paragraph (1) have been adopted and which 
                recommendations in such report have not been adopted; 
                and
                  ``(B) includes a description of planned activities to 
                address each recommendation in such report that has not 
                been adopted.''.
  (c) Funding.--Section 394A of the Public Health Service Act (42 
U.S.C. 280b-3) is amended--
          (1) by striking ``and'' after ``1994,'';
          (2) by striking the second period at the end; and
          (3) by adding at the end the following: ``Of the amounts made 
        available to carry out this part for each of fiscal years 2014 
        through 2018, there is authorized to be appropriated $6,100,000 
        to carry out sections 393B and 393C.''.

SEC. 3. STATE GRANTS FOR PROJECTS REGARDING TRAUMATIC BRAIN INJURY.

  Section 1252 of the Public Health Service Act (42 U.S.C. 300d-52) is 
amended--
          (1) in subsection (a), by striking ``, acting through the 
        Administrator of the Health Resources and Services 
        Administration,'';
          (2) in paragraphs (1)(A)(i) and (3)(E) of subsection (f), by 
        striking ``brain injury'' and inserting ``traumatic brain 
        injury'';
          (3) in subsection (h), by striking the comma after ``under 
        this section'' and inserting a comma before ``including''; and
          (4) by amending subsection (j) to read as follows:
  ``(j) Authorization of Appropriations.--For carrying out this section 
and section 1253, there is authorized to be appropriated $9,760,000 for 
each of fiscal years 2014 through 2018.''.

SEC. 4. STATE GRANTS FOR PROTECTION AND ADVOCACY SERVICES.

  Section 1253 of the Public Health Service Act (42 U.S.C. 300d-53) is 
amended--
          (1) in subsection (a), by striking ``, acting through the 
        Administrator of the Health Resources and Services 
        Administration (referred to in this section as the 
        `Administrator'),'';
          (2) in subsections (c), (d)(1), (e)(1), (e)(4), (g), (h), and 
        (j)(1), by striking ``Administrator'' each place it appears and 
        inserting ``Secretary'';
          (3) in subsection (h)--
                  (A) by striking the subsection heading and inserting 
                ``Reporting'';
                  (B) by striking ``Each protection and advocacy 
                system'' and inserting the following:
          ``(1) Reports by systems.--Each protection and advocacy 
        system''; and
                  (C) by adding at the end the following:
          ``(2) Report by secretary.--Not later than 1 year after the 
        date of enactment of the Traumatic Brain Injury Reauthorization 
        Act of 2013, the Secretary shall prepare and submit to the 
        appropriate committees of Congress a report describing the 
        services and activities carried out under this section during 
        the period for which the report is being prepared.''.
          (4) in subsection (i)--
                  (A) by striking ``Administrator of the Health 
                Resources and Services Administration'' and inserting 
                ``Secretary''; and
                  (B) by striking ``by the Administrator'' and 
                inserting ``by the Secretary'';
          (5) in subsection (k), by striking ``subtitle C'' and 
        inserting ``subtitle C of title I'';
          (6) by striking subsection (l) (relating to authorization of 
        appropriations); and
          (7) by redesignating subsection (m) as subsection (l).

                          Purpose and Summary

    H.R. 1098, Traumatic Brain Injury (TBI) Reauthorization Act 
of 2013, would reauthorize the TBI Act of 2008 and continue 
brain injury prevention and surveillance activities at the 
Centers for Disease Control and Prevention (CDC). The bill also 
would provide for State grants administered by Health Resources 
and Services Administration (HRSA) to help families access 
needed services such as rehabilitation and long-term care. In 
addition, HRSA currently provides grants to States for the 
protection and advocacy of TBI patients. The bill also would 
allow these grant programs to move from HRSA to another agency 
within the Department of Health and Human Services (HHS) in 
order to better coordinate TBI activities with services and 
support available to older Americans and individuals with other 
disabilities.

                  Background and Need for Legislation

    Brain injury is a leading cause of death and disability 
that affects persons of all ages, races, and income levels.\1\ 
TBI is a particularly concerning health issue among current and 
former military personnel and has been described as ``one of 
the signature injuries of troops wounded in Afghanistan and 
Iraq.''\2\ TBI can cause epilepsy and increase the risk for 
Alzheimer's disease, Parkinson's disease, and other brain 
disorders that become more prevalent with age.\3\
---------------------------------------------------------------------------
    \1\http://docs.house.gov/meetings/IF/IF14/20131120/101509/HHRG-113-
IF14-Wstate-NageleD_20131120.pdf.
    \2\http://www.defense.gov/home/features/2012/0312_tbi/.
    \3\http://docs.house.gov/meetings/IF/IF14/20131120/101509/HHRG-113-
IF14-Wstate-NageleD_20131120.pdf.
---------------------------------------------------------------------------
    There were 2.4 million emergency department visits, 
hospitalizations, or deaths associated with TBI in the United 
States in 2009.\4\ According to the CDC, on average, 1.7 
million Americans will sustain a TBI each year.\5\ It is 
estimated that up to 90,000 of these individuals will 
experience long-term, sometimes life-long, impairments as a 
result of their injury.\6\
---------------------------------------------------------------------------
    \4\http://docs.house.gov/meetings/IF/IF14/20131120/101509/HHRG-113-
IF14-Wstate-NageleD_20131120.pdf.
    \5\http://www.cdc.gov/traumaticbraininjury/tbi_ed.html.
    \6\http://www.hrsa.gov/about/budget/budgetjustification2013.pdf.
---------------------------------------------------------------------------
    Timely and comprehensive treatment is vital to save lives 
and improve the quality of life for TBI survivors. Individuals 
with TBI may need a variety of services and support, including 
rehabilitation, counseling, academic and vocational 
accommodations, independent living assistance, transportation 
assistance, and vocational training. The TBI Program was first 
established in 1996 and reauthorized in 2001 and 2008 to 
improve access to these services and supports, among other 
goals.\7\ Through the TBI Program, State and Territorial 
governments receive funding to help individuals with TBI and 
their families receive the comprehensive care and services they 
need to manage ongoing conditions caused by their injuries.
---------------------------------------------------------------------------
    \7\Pub. L. No. 104-166; Pub. L. No. 106-310; Pub. L. No. 110-206.
---------------------------------------------------------------------------
    The TBI Act of 2008 directed the Directors of CDC and the 
National Institutes of Health (NIH)--in consultation with the 
Secretaries of Defense and Veterans Affairs--to submit a report 
to Congress describing how CDC can improve TBI surveillance 
efforts for individuals formerly in the military and 
recommending ways in which these civilian and non-civilian 
departments and agencies can collaborate further on TBI 
diagnostic tools and treatments.\8\ CDC and NIH completed this 
report in June 2013, which included agency-specific 
recommendations as well as five general recommendations: 
strengthen collaboration, utilize standard definitions, enhance 
coding and classification, improve dissemination, and build an 
evidence base.\9\
---------------------------------------------------------------------------
    \8\Pub. L. No. 110-206.
    \9\http://www.nashia.org/pdf/report-to-congress-on-traumatic-brain-
injury-2013-a.pdf.
---------------------------------------------------------------------------

                                Hearings

    The Subcommittee on Health held a hearing on Wednesday, 
November 20, 2013, entitled ``Examining Public Health 
Legislation to Help Local Communities.'' The Subcommittee 
received testimony from: Dr. Marsha Ford of the American 
Association of Poison Control Centers, Dr. Edward R.B. McCabe 
of the March of Dimes Foundation, Ms. Laura Crandall of CJ 
Foundation for SIDS, Mr. Robert Mt. Joy of Cornerstone Care 
Inc., Dr. Drew Nagele from the Brain Injury Association of 
America, Ms. Pat Smith, President of the Lyme Disease 
Association Inc., and Dr. Steven Stack of the American Medical 
Association. H.R. 1098, the ``Traumatic Brain Injury 
Reauthorization Act of 2013,'' was one of the bills discussed 
at the hearing.

                        Committee Consideration

    On December 10, 2013, the Subcommittee on Health met in 
open markup session and favorably forwarded H.R. 1098, as 
amended, to the full Committee by a voice vote.
    On December 10 and 11, 2013, the Committee on Energy and 
Commerce met in open markup session and approved H.R. 1098, as 
amended, by a voice vote.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report legislation and amendments thereto. 
There were no record votes taken in connection with ordering 
reported H.R. 1098. A motion by Mr. Upton to order H.R. 1098 
reported to the House, with amendment, was agreed to by a voice 
vote.

                      Committee Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee has not held an 
oversight hearing on this legislation.

         Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII of the Rules of the 
House of Representatives, the goal of this legislation is to 
reauthorize the TBI Act of 2008, continue brain injury 
prevention and surveillance activities at CDC, and provide for 
State grants administered by HHS to help families access needed 
services such as rehabilitation and long-term care.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee finds that H.R. 
1098 would result in no new or increased budget authority, 
entitlement authority, or tax expenditures or revenues.

       Earmark, Limited Tax Benefits, and Limited Tariff Benefits

    In compliance with clause 9(e), 9(f), and 9(g) of rule XXI 
of the Rules of the House of Representatives, the Committee 
finds that H.R. 1098 contains no earmarks, limited tax 
benefits, or limited tariff benefits.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate prepared 
by the Director of the Congressional Budget Office pursuant to 
section 402 of the Congressional Budget Act of 1974.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
provided by the Congressional Budget Office pursuant to section 
402 of the Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                   Washington, DC, January 8, 2014.
Hon. Fred Upton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 1098, the 
Traumatic Brain Injury Reauthorization Act of 2013.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Lisa Ramirez-
Branum.
            Sincerely,
                                               Douglas W. Elmendorf
    Enclosure.

H.R. 1098--Traumatic Brain Injury Reauthorization Act of 2013

    Summary: H.R. 1098 would amend provisions of the Public 
Health Service Act that authorize the Department of Health and 
Human Services to conduct activities related to traumatic brain 
injury. Those activities, including the study and surveillance 
of traumatic brain injury and the awarding of grants that 
support access to services, are carried out by the Centers for 
Disease Control and Prevention (CDC) and the Health Resources 
and Services Administration (HRSA).
    The bill would authorize the appropriation of about $16 
million annually for fiscal years 2014 through 2018 for 
activities related to traumatic brain injury. CBO estimates 
that implementing the bill would cost about $74 million over 
the 2014-2019 period, assuming appropriation of the authorized 
amounts. Pay-as-you-go procedures do not apply to this 
legislation because it would not affect direct spending or 
revenues.
    The bill contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
    Estimated cost to the Federal Government: The estimated 
budgetary impact of H.R. 1098 is shown in the following table. 
The costs of this legislation fall within budget function 550 
(health).

----------------------------------------------------------------------------------------------------------------
                                                             By fiscal year, in millions of dollars--
                                                ----------------------------------------------------------------
                                                   2014     2015     2016     2017     2018     2019   2014-2019
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATION

CDC:
    Authorization Level........................        6        6        6        6        6        0        31
    Estimated Outlays..........................        2        5        6        6        6        4        29
HRSA:
    Authorization Level........................       10       10       10       10       10        0        49
    Estimated Outlays..........................        2        7        9       10       10        8        45
Total Changes:
    Authorization Level........................       16       16       16       16       16        0        79
    Estimated Outlays..........................        4       12       15       16       16       11       74
----------------------------------------------------------------------------------------------------------------
Note: Numbers may not sum to totals because of rounding.

    Basis of estimate: H.R. 1098 would authorize annual 
appropriations of about $16 million each year for fiscal years 
2014 through 2018 for CDC and HRSA to administer activities 
related to traumatic brain injury. The Congress appropriated 
about $16 million for such activities for fiscal year 2013. 
Sequestration under the Budget Control Act of 2011 reduced the 
2013 funding to about $15 million. That reduced funding level 
has been continued in fiscal year 2014 through January 15, 
2014. For this estimate, CBO assumes that the bill will be 
enacted in early 2014 and that the authorized amounts will be 
appropriated for each year.
    The bill would authorize the appropriation of $6.1 million 
annually for the fiscal year 2014-2018 period for CDC to 
provide grants to states to develop or operate surveillance 
systems that measure the incidence and prevalence of traumatic 
brain injury. The authorized appropriations also would support 
CDC's efforts to study traumatic brain injury. Based on 
historical spending for those activities, CBO estimates that 
implementing those provisions would cost about $29 million over 
the 2014-2019 period, assuming the appropriation of specified 
amounts.
    H.R. 1098 would authorize the appropriation of $9.7 million 
annually for fiscal years 2014 through 2018 for HRSA to provide 
grants to state and tribal governments to expand access to care 
and protection services for individuals with traumatic brain 
injury. Based on historical patterns of spending for those 
activities, CBO estimates that implementing those provisions 
would cost about $45 million over the 2014-2019 period, 
assuming appropriation of the specified amounts.
    Pay-As-You-Go considerations: None.
    Intergovernmental and private-sector impact: H.R. 1098 
contains no intergovernmental or private-sector mandates as 
defined in UMRA. State, local, and tribal governments that 
provide traumatic brain injury services could benefit from 
grant funds authorized by the bill.
    Estimate prepared by: Federal costs: Lisa Ramirez-Branum 
and Santiago Vallinas; Impact on state, local, and tribal 
governments: Lisa Ramirez-Branum; Impact on the private sector: 
Alexia Diorio.
    Estimate approved by: Holly Harvey, Deputy Assistant 
Director for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

                    Duplication of Federal Programs

    No provision of H.R. 1098 establishes or reauthorizes a 
program of the Federal Government known to be duplicative of 
another Federal program, a program that was included in any 
report from the Government Accountability Office to Congress 
pursuant to section 21 of Public Law 111-139, or a program 
related to a program identified in the most recent Catalog of 
Federal Domestic Assistance.

                  Disclosure of Directed Rule Makings

    The Committee estimates that enacting H.R. 1098 would not 
specifically direct to be completed a rulemaking within the 
meaning of 5 U.S.C. 551.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 provides the short title of ``Traumatic Brain 
Injury Reauthorization Act of 2013.''

Section 2. CDC programs for prevention and surveillance of Traumatic 
        Brain Injury

    Section 2 would reauthorize the CDC programs for the 
prevention and surveillance of TBI (sections 393B and 393C of 
the Public Health Service Act (PHSA)) at the currently-
appropriated level of $6.1 million for each of fiscal years 
2014 through 2018.
    Section 2 also would require a report to Congress no later 
than 24 months after the date of enactment by the Secretary, 
acting through the Directors of CDC and NIH, and in 
consultation with the Secretaries of Defense and Veterans 
Affairs, identifying which of the recommendations from the June 
2013 report have been adopted and outlining plans for 
addressing those recommendations that have not been adopted. 
The Committee notes the importance of continued collaboration 
amongst civilian and non-civilian Federal departments and 
agencies in understanding the burden of TBI amongst current and 
former military personnel and preventing and treating of these 
injuries.

Section 3. State grants for projects regarding Traumatic Brain Injury

    Section 3 would reauthorize State grants for projects 
regarding TBI and protection and advocacy services (sections 
1252 and 1253 of the PHSA) at the currently-appropriated level 
of $9.76 million for each of fiscal years 2014 through 2018.
    Section 3, along with provisions in section 4, also would 
remove the requirement that the Secretary of HHS make grants 
for projects regarding TBI and for protection and advocacy 
services through the HRSA Administrator and, instead, gives the 
Secretary discretion to move these authorities to another 
operating division within HHS. Since the last reauthorization 
of the TBI Program, HHS has created a new operating division--
the Administration for Community Living (ACL)--to oversee 
programs of services and supports for older Americans and 
people with disabilities, and maximize the ability of these 
individuals to reside at home and be active participants in 
their communities. The Committee believes the TBI authorities 
in sections 1252 and 1253 of the PHSA are very much consistent 
with ACL's mission and urges the Secretary of HHS to exercise 
her discretion to move these TBI programs to ACL.

Section 4. State grants for protection and advocacy services

    Section 4 would augment the existing reporting requirement 
for protection and advocacy systems. Under current law, 
grantees submit an annual report to the Secretary of HHS 
describing TBI services and activities conducted under section 
1253 of the PHSA. Section 4 requires the Secretary--in turn--to 
submit a one-time report to Congress one year after the date of 
enactment.
    As noted above, protection and advocacy services are 
reauthorized in section 3 of the legislation. Section 3 also 
would give the Secretary of HHS discretion to have protection 
and advocacy services authorized in section 1253 of the PHSA 
administered by another operating division within the 
Department. The Committee's expectation is that the Secretary 
of HHS will exercise her discretion and charge ACL with 
administration of this program, along with State TBI grants 
authorized in section 1252 of the PHSA.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

PUBLIC HEALTH SERVICE ACT

           *       *       *       *       *       *       *



TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



Part J--Prevention and Control of Injuries

           *       *       *       *       *       *       *



                  prevention of traumatic brain injury

  Sec. 393B. (a) * * *
  (b) Certain Activities.--Activities under subsection (a) may 
include--
          (1) * * *

           *       *       *       *       *       *       *

          (3) the implementation of a national education and 
        awareness campaign regarding such injury (in 
        conjunction with the program of the Secretary regarding 
        [health-status goals for 2010, commonly referred to as 
        Healthy People 2010] health-status goals for 2020, 
        commonly referred to as Healthy People 2020), 
        including--
                  (A) * * *

           *       *       *       *       *       *       *


national program for traumatic brain injury surveillance and registries

  Sec. 393C. (a) * * *
  [(b) Not later than] (b) Reports.-- 
          (1) Initial report._Not later than 18 months after 
        the date of enactment of the Traumatic Brain Injury Act 
        of 2008, the Secretary, acting through the Director of 
        the Centers for Disease Control and Prevention and the 
        Director of the National Institutes of Health and in 
        consultation with the Secretary of Defense and the 
        Secretary of Veterans Affairs, shall submit to the 
        relevant committees of Congress a report that contains 
        the findings derived from an evaluation concerning 
        activities and procedures that can be implemented by 
        the Centers for Disease Control and Prevention to 
        improve the collection and dissemination of compatible 
        epidemiological studies on the incidence and prevalence 
        of traumatic brain injury in individuals who were 
        formerly in the military. The report shall include 
        recommendations on the manner in which such agencies 
        can further collaborate on the development and 
        improvement of traumatic brain injury diagnostic tools 
        and treatments.
          (2) Subsequent report.--Not later than 24 months 
        after the date of enactment of the Traumatic Brain 
        Injury Reauthorization Act of 2013, the Secretary, 
        acting through the Director of the Centers for Disease 
        Control and Prevention and the Director of the National 
        Institutes of Health and in consultation with the 
        Secretary of Defense and the Secretary of Veterans 
        Affairs, shall submit to the relevant committees of 
        Congress a report that--
                  (A) identifies which recommendations in the 
                report under paragraph (1) have been adopted 
                and which recommendations in such report have 
                not been adopted; and
                  (B) includes a description of planned 
                activities to address each recommendation in 
                such report that has not been adopted.

           *       *       *       *       *       *       *


                    AUTHORIZATIONS OF APPROPRIATIONS

  Sec. 394A. For the purpose of carrying out this part, there 
are authorized to be appropriated $50,000,000 for fiscal year 
1994, [and] such sums as may be necessary for each of the 
fiscal years 1995 through 1998, and such sums as may be 
necessary for each of the fiscal years 2001 through 2005.[.] Of 
the amounts made available to carry out this part for each of 
fiscal years 2014 through 2018, there is authorized to be 
appropriated $6,100,000 to carry out sections 393B and 393C.

           *       *       *       *       *       *       *


TITLE XII--TRAUMA CARE

           *       *       *       *       *       *       *


Part E--Miscellaneous Programs

           *       *       *       *       *       *       *


SEC. 1252. STATE GRANTS FOR PROJECTS REGARDING TRAUMATIC BRAIN INJURY.

  (a) In General.--The Secretary[, acting through the 
Administrator of the Health Resources and Services 
Administration,] may make grants to States and American Indian 
consortia for the purpose of carrying out projects to improve 
access to rehabilitation and other services regarding traumatic 
brain injury.

           *       *       *       *       *       *       *

  (f) Use of State and American Indian Consortium Grants.--
          (1) Community services and supports.--A State or 
        American Indian consortium shall (directly or through 
        awards of contracts to nonprofit private entities) use 
        amounts received under a grant under this section for 
        the following:
                  (A) To develop, change, or enhance community-
                based service delivery systems that include 
                timely access to comprehensive appropriate 
                services and supports. Such service and 
                supports--
                          (i) shall promote full participation 
                        by individuals with [brain injury] 
                        traumatic brain injury and their 
                        families in decision making regarding 
                        the services and supports; and

           *       *       *       *       *       *       *

          (3) State capacity building.--A State or American 
        Indian consortium may use amounts received under a 
        grant under this section to--
                  (A) * * *

           *       *       *       *       *       *       *

                  (E) tailor existing State or American Indian 
                consortium systems to provide accommodations to 
                the needs of individuals with [brain injury] 
                traumatic brain injury (including systems 
                administered by the State or American Indian 
                consortium departments responsible for health, 
                mental health, labor/employment, education, 
                intellectual disabilities or developmental 
                disorders, transportation, and correctional 
                systems);

           *       *       *       *       *       *       *

  (h) Report.--Not less than biennially, the Secretary shall 
submit to the Committee on Energy and Commerce of the House of 
Representatives, and to the Committee on Health, Education, 
Labor, and Pensions of the Senate, a report describing the 
findings and results of the programs established under this 
section[,] and section 1253, including measures of outcomes and 
consumer and surrogate satisfaction.

           *       *       *       *       *       *       *

  [(j) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be 
appropriated such sums as may be necessary for each of the 
fiscal years 2001 through 2005, and such sums as may be 
necessary for each of the fiscal years 2009 through 2012.]
  (j) Authorization of Appropriations.--For carrying out this 
section and section 1253, there is authorized to be 
appropriated $9,760,000 for each of fiscal years 2014 through 
2018.

SEC. 1253. STATE GRANTS FOR PROTECTION AND ADVOCACY SERVICES.

  (a) In General.--The Secretary[, acting through the 
Administrator of the Health Resources and Services 
Administration (referred to in this section as the 
``Administrator''),] shall make grants to protection and 
advocacy systems for the purpose of enabling such systems to 
provide services to individuals with traumatic brain injury.

           *       *       *       *       *       *       *

  (c) Application.--To be eligible to receive a grant under 
this section, a protection and advocacy system shall submit an 
application to the [Administrator] Secretary at such time, in 
such form and manner, and accompanied by such information and 
assurances as the [Administrator] Secretary may require.
  (d) Appropriations Less Than $2,700,000.--
          (1) In general.--With respect to any fiscal year in 
        which the amount appropriated under subsection (l) to 
        carry out this section is less than $2,700,000, the 
        [Administrator] Secretary shall make grants from such 
        amount to individual protection and advocacy systems 
        within States to enable such systems to plan for, 
        develop outreach strategies for, and carry out services 
        authorized under this section for individuals with 
        traumatic brain injury.

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  (e) Appropriations of $2,700,000 or More.--
          (1) Population basis.--Except as provided in 
        paragraph (2), with respect to each fiscal year in 
        which the amount appropriated under subsection (l) to 
        carry out this section is $2,700,000 or more, the 
        [Administrator] Secretary shall make a grant to a 
        protection and advocacy system within each State.

           *       *       *       *       *       *       *

          (4) Inflation adjustment.--For each fiscal year in 
        which the total amount appropriated under subsection 
        (l) to carry out this section is $5,000,000 or more, 
        and such appropriated amount exceeds the total amount 
        appropriated to carry out this section in the preceding 
        fiscal year, the [Administrator] Secretary shall 
        increase each of the minimum grants amount described in 
        subparagraphs (A) and (B) of paragraph (3) by a 
        percentage equal to the percentage increase in the 
        total amount appropriated under subsection (l) to carry 
        out this section between the preceding fiscal year and 
        the fiscal year involved.

           *       *       *       *       *       *       *

  (g) Direct Payment.--Notwithstanding any other provision of 
law, each fiscal year not later than October 1, the 
[Administrator] Secretary shall pay directly to any protection 
and advocacy system that complies with the provisions of this 
section, the total amount of the grant for such system, unless 
the system provides otherwise for such payment.
  (h) [Annual Report.--] Reporting.-- [Each protection and 
advocacy system]
          (1) Reports by systems._Each protection and advocacy 
        system that receives a payment under this section shall 
        submit an annual report to the [Administrator] 
        Secretary concerning the services provided to 
        individuals with traumatic brain injury by such system.
          (2) Report by secretary.--Not later than 1 year after 
        the date of enactment of the Traumatic Brain Injury 
        Reauthorization Act of 2013, the Secretary shall 
        prepare and submit to the appropriate committees of 
        Congress a report describing the services and 
        activities carried out under this section during the 
        period for which the report is being prepared.
  (i) Data Collection.--The [Administrator of the Health 
Resources and Services Administration] Secretary and the 
Commissioner of the Administration on Developmental 
Disabilities shall enter into an agreement to coordinate the 
collection of data [by the Administrator] by the Secretary and 
the Commissioner regarding protection and advocacy services.
  (j) Training and Technical Assistance.--
          (1) Grants.--For any fiscal year for which the amount 
        appropriated to carry out this section is $6,000,000 or 
        greater, the [Administrator] Secretary shall use 2 
        percent of such amount to make a grant to an eligible 
        national association for providing for training and 
        technical assistance to protection and advocacy 
        systems.

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  (k) System Authority.--In providing services under this 
section, a protection and advocacy system shall have the same 
authorities, including access to records, as such system would 
have for purposes of providing services under [subtitle C] 
subtitle C of title I of the Developmental Disabilities 
Assistance and Bill of Rights Act of 2000.
  [(l) Authorization of Appropriations.--There are authorized 
to be appropriated to carry out this section $5,000,000 for 
fiscal year 2001, and such sums as may be necessary for each 
the fiscal years 2009 through 2012.]
  [(m)] (l) Definitions.--In this section:
          (1) * * *

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