[House Report 119-720]
[From the U.S. Government Publishing Office]
119th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 119-720
======================================================================
TO REAUTHORIZE AND MAKE IMPROVEMENTS TO FEDERAL PROGRAMS RELATING TO
THE PREVENTION, DETECTION, AND TREATMENT OF TRAUMATIC BRAIN INJURIES,
AND FOR OTHER PURPOSES
_______
July 2, 2026.--Committed to the Committee of the Whole House on the
State of
the Union and ordered to be printed
_______
Mr. Guthrie, from the Committee on Energy and Commerce,
submitted the following
R E P O R T
[To accompany H.R. 1493]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 1493) to reauthorize and make improvements to
Federal programs relating to the prevention, detection, and
treatment of traumatic brain injuries, and for other purposes,
having considered the same, reports favorably thereon without
amendment and recommends that the bill do pass.
CONTENTS
Page
Purpose and Summary.............................................. 1
Background and Need for Legislation.............................. 2
Committee Action................................................. 3
Committee Votes.................................................. 3
Oversight Findings and Recommendations........................... 5
New Budget Authority, Entitlement Authority, and Tax Expenditures 5
Congressional Budget Office Estimate............................. 5
Federal Mandates Statement....................................... 5
Statement of General Performance Goals and Objectives............ 5
Duplication of Federal Programs.................................. 5
Related Committee and Subcommittee Hearings...................... 5
Committee Cost Estimate.......................................... 6
Earmark, Limited Tax Benefits, and Limited Tariff Benefits....... 6
Advisory Committee Statement..................................... 6
Applicability to Legislative Branch.............................. 6
Section-by-Section Analysis of the Legislation................... 6
Changes in Existing Law Made by the Bill, as Reported............ 7
Purpose and Summary
H.R. 1493, introduced on February 21, 2025, by
Representatives Frank Pallone, Jr. (D-NJ) and Don Bacon (R-NE),
reauthorizes traumatic brain injury (TBI) programs at the
Department of Health and Human Services (HHS). The programs
reauthorized in this bill allocate resources for TBI
prevention, improving access to TBI rehabilitation, and TBI
patient advocacy systems. The bill reauthorizes the program for
fiscal years 2026 through 2030.
Background and Need for Legislation
A traumatic brain injury (TBI) is an injury that disrupts
the typical function of the brain and can be acquired from a
range of traumas to the head, including, but not limited to, a
penetrating injury or an external force delivered to the
head.\1\ TBIs usually occur when an outside force causes severe
damage to the brain, this can impact a person's life in many
ways, putting patients at increased risk for depression, falls,
and permanent cognitive decline.\2\ In the United States, TBI
is a significant public health burden and is a major driver of
death and disability; in 2021 alone, there were more than
69,000 TBI-related deaths.\3\
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\1\Ctrs. for Disease Control and Prevention (CDC), Facts About TBI
(Aug. 2025), https://www.cdc.gov/traumatic-brain-injury/data-research/
facts-stats/index.html; see also CDC, Report to Congress: The
Management of Traumatic Brain Injury in Children, National Center for
Injury Prevention and Control; Division of Unintentional Injury
Prevention at 5 (2018), https://stacks.cdc.gov/view/cdc/51852/
cdc_51852_DS1.pdf.
\2\Administration of Community Living, ``Traumatic Brain Injury'',
2024. https://acl.gov/
programs/post-injury-support/traumatic-brain-injury-tbi.
\3\Ctrs. for Disease Control and Prevention (CDC), Facts About TBI
(Aug. 2025), https://www.cdc.gov/traumatic-brain-injury/data-research/
facts-stats/index.html; see also CDC, Report to Congress: The
Management of Traumatic Brain Injury in Children, National Center for
Injury Prevention and Control; Division of Unintentional Injury
Prevention at 5 (2018), https://stacks.cdc.gov/view/cdc/51852/
cdc_51852_DS1.pdf.
---------------------------------------------------------------------------
TBI has the potential to affect all Americans and can occur
at any point during an individual's lifespan. In children, TBI
may negatively affect their brain development, whereas in older
adults, TBI is more likely to have higher morbidity and
mortality, delayed recovery, and more severe outcomes as
compared to younger adults.\4\ TBI may be misdiagnosed or
missed by providers completely given the overlap of TBI
symptoms with other medical conditions that are common in older
populations, such as dementia.\5\
---------------------------------------------------------------------------
\4\CDC, Report to Congress: The Management of Traumatic Brain
Injury in Children, National Center for Injury Prevention and Control;
Division of Unintentional Injury Prevention at 20 (2018), https://
stacks.cdc.gov/view/cdc/51852/cdc_51852_DS1.pdf; see also Dana
Waltzman, et al., Traumatic Brain Injury in Older Adults--A Public
Health Perspective JAMA Neurology at 1-3 (Mar. 14, 2022), https://
jamanetwork.com/journals/jamaneurology/article-abstract/2790075.
\5\CDC, supra note 2.
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Originally enacted in 1996, the TBI Act authorizes federal
programs through the Department of Health and Human Services
(HHS) to promote prevention, data collection, rehabilitation,
and advocacy. The Centers for Disease Control and Prevention
(CDC) is responsible for conducting public information,
education, and prevention activities for determining the
incidence and prevalence of TBI in the United States. The
National Institutes of Health (NIH) is responsible for
conducting research on prevention, diagnosis, and treatment of
TBI. The Administration for Community Living (ACL) is
responsible for two grants programs to states to improve access
to service delivery and support for the Protection and Advocacy
System in each state.
The federal TBI Surveillance and Registries program is
renamed to honor the late Rep. Bill Pascrell, Jr., reflecting
his decades-long advocacy for brain injury awareness, research,
and treatment.
Committee Action
On February 14, 2024, the Subcommittee on Health held a
legislative hearing on H.R. 7208. The title of the hearing was
``Legislative Proposals to Support Patients and Caregivers.''
The Subcommittee received testimony from:
Dr. Andy Shih, PhD, Chief Science Officer,
Autism Speaks
Mr. Corey Feist, JD, MBA, Co-Founder and
CEO, Dr. Lorna Breen Heroes' Foundation
Dr. Joanne Pike, DrPH, President and CEO,
Alzheimer's Association
Dr. Gordon Tomaselli, MD, Former President,
American Heart Association; Marilyn and Stanley M. Katz
Dean, Emeritus and Professor of Medicine, Albert
Einstein College of Medicine; Adjunct Professor of
Medicine, Johns Hopkins University School of Medicine
Ms. Michelle Whitten, President, CEO, and
Co-Founder, Global Down Syndrome Foundation
Mr. Randy Strozyk, President, American
Ambulance Association
Dr. Christina Annunziata, MD, PhD, Senior
Vice President of Extramural Discovery Science,
American Cancer Society
On March 12, 2024, the Subcommittee on Health met in open
markup session and forwarded H.R. 7208, as amended, to the full
Committee by a voice vote.
On March 20, 2024, the full Committee on Energy and
Commerce met in open markup session and ordered H.R. 7208, as
amended, favorably reported to the House by a record vote of 44
yeas and 0 nays.
On May 21, 2026, the full Committee on Energy and Commerce
met in open markup session and ordered H.R. 1493, without
amendment, favorably reported to the House by a record vote of
43 yeas and 0 nays.
Committee Votes
Clause 3(b) of rule XIII requires the Committee to list the
record votes on the motion to report legislation and amendments
thereto. The following reflects the record votes taken during
the Committee consideration:
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Oversight Findings and Recommendations
Pursuant to clause 2(b)(1) of rule X and clause 3(c)(1) of
rule XIII, the Committee held a hearing and made findings that
are reflected in this report.
New Budget Authority, Entitlement Authority,
and Tax Expenditures
Pursuant to clause 3(c)(2) of rule XIII, the Committee
finds that H.R. 1493 would result in no new or increased budget
authority, entitlement authority, or tax expenditures or
revenues.
Congressional Budget Office Estimate
Pursuant to clause 3(c)(3) of rule XIII, at the time this
report was filed, the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974 was not available.
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.
Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to
reauthorize through 2030, Federal programs to reduce the
incidence and prevalence of traumatic brain injuries.
Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 1493 is known to be duplicative of another Federal
program, including any program that was included in a report to
Congress pursuant to section 21 of Public Law 111-139 or the
most recent Catalog of Federal Domestic Assistance.
Related Committee and Subcommittee Hearings
Pursuant to clause 3(c)(6) of rule XIII, the following
related hearing was used to develop or consider H.R. 1493:
On February 14, 2024, the Subcommittee on
Health held a legislative hearing on H.R. 7208. The
title of the hearing was ``Legislative Proposals to
Support Patients and Caregivers.'' The Subcommittee
received testimony from:
Dr. Andy Shih, PhD, Chief
Science Officer, Autism Speaks;
Mr. Corey Feist, JD, MBA, Co-
Founder and CEO, Dr. Lorna Breen Heroes'
Foundation;
Dr. Joanne Pike, DrPH, President
and CEO, Alzheimer's Association;
Dr. Gordon Tomaselli, MD, Former
President, American Heart Association; Marilyn
and Stanley M. Katz Dean, Emeritus and
Professor of Medicine, Albert Einstein College
of Medicine; Adjunct Professor of Medicine,
Johns Hopkins University School of Medicine;
Ms. Michelle Whitten, President,
CEO, and Co-Founder, Global Down Syndrome
Foundation;
Mr. Randy Strozyk, President,
American Ambulance Association; and,
Dr. Christina Annunziata, MD,
PhD, Senior Vice President of Extramural
Discovery Science, American Cancer Society.
Committee Cost Estimate
Pursuant to clause 3(d)(1) of rule XIII, 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. At the time this report was
filed, the estimate was not available.
Earmark, Limited Tax Benefits, and Limited Tariff Benefits
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 1493 contains no earmarks, limited
tax benefits, or limited tariff benefits.
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. Programs to prevent, detect, and treat traumatic brain
injuries
Section 1 clarifies that activities related to the
prevention of traumatic brain injuries, may include activities
to reduce the prevalence of associated injuries and related
risk factors. The bill text repeals the reporting requirements
that were established in 2008.
The legislation makes technical and conforming changes,
including the renaming of the traumatic brain injury
surveillance and registries to ``The Bill Pascrell, Jr.,
national program for traumatic brain injury surveillance and
registries.'' The legislation also reauthorizes activities
related to the prevention and control of TBIs, state grants for
TBI projects, and State grants that provide services to
individuals with TBIs for five fiscal years.
The legislation requires the CDC to report, and make
publicly available, information on TBI and concussions,
including information on high-risk populations, and strategies
for preventing or reducing the risk of TBI.
Further, for ACL-furnished grant programs focused on
increasing access to TBI rehabilitation and other TBI-related
services, this section amends the fund matching requirements to
implement a maintenance of effort standard for States and the
American Indian consortiums. It would also implement a waiver,
if the matching fund would prevent the State or American Indian
consortium from carrying out projects to improve access to
rehabilitation and other services related to TBIs.
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 italics, and 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) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may
carry out projects to reduce the incidence and prevalence of
traumatic brain injury. Such projects may be carried out by the
Secretary directly or through awards of grants or contracts to
public or nonprofit private entities. The Secretary may
directly or through such awards provide technical assistance
with respect to the planning, development, and operation of
such projects.
(b) Certain Activities.--Activities under subsection (a) may
include--
(1) the conduct of research into identifying
effective strategies for the prevention of traumatic
brain injury and reduction of associated injuries and
fatalities;
(2) the implementation of public information and
education programs for the prevention of such injury
and for broadening the awareness of the public
concerning the public health consequences of such
injury and related risk factors; and
(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 [2020] 2030, commonly referred
to as Healthy People [2020] 2030), including--
(A) the national dissemination of information
on--
(i) incidence and prevalence[; and]
of traumatic brain injury;
(ii) populations at higher risk of
traumatic brain injury, including
populations whose increased risk is due
to occupational or circumstantial
factors;
(iii) causes of, and risk factors
for, traumatic brain injury; and
[(ii)] (iv) information relating to
traumatic brain injury and the sequelae
of secondary conditions [arising from
traumatic brain injury], which may
include related mental health and other
conditions, arising from traumatic
brain injury, including upon discharge
from hospitals and emergency
departments; and
(B) the provision of information in primary
care settings, including emergency rooms and
trauma centers, concerning the availability of
State level services and resources.
(c) Coordination of Activities.--The Secretary shall ensure
that activities under this section are coordinated as
appropriate with other agencies of the Public Health Service
that carry out activities regarding traumatic brain injury, and
other relevant Federal departments and agencies.
(d) Definition.--For purposes of this section, the term
``traumatic brain injury'' means an acquired injury to the
brain. Such term does not include brain dysfunction caused by
congenital or degenerative disorders, nor birth trauma, but may
include brain injuries caused by anoxia due to trauma. The
Secretary may revise the definition of such term as the
Secretary determines necessary, after consultation with States
and other appropriate public or nonprofit private entities.
[national program for traumatic brain injury surveillance and
registries] the bill pascrell, jr., national program for traumatic
brain injury surveillance and registries
Sec. 393C. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may
make grants to States or their designees to develop or operate
the State's traumatic brain injury surveillance system or
registry to determine the incidence and prevalence of traumatic
brain injury and related disability, to identify populations
that may be at higher risk for traumatic brain injuries, to
collect data on the causes of, and risk factors for, traumatic
brain injuries, to ensure the uniformity of reporting under
such system or registry, to link individuals with traumatic
brain injury to services and supports, and to link such
individuals with academic institutions to conduct applied
research that will support the development of such surveillance
systems and registries as may be necessary. A surveillance
system or registry under this section shall provide for the
collection of data concerning--
(1) demographic information about each traumatic
brain injury, including the occupation of the
individual, when relevant to the circumstances
surrounding the injury;
(2) information about the circumstances surrounding
the injury event associated with each traumatic brain
injury;
(3) administrative information about the source of
the collected information, dates of hospitalization and
treatment, and the date of injury; and
(4) information characterizing the clinical aspects
of the traumatic brain injury, including the severity
of the injury, short- and long-term outcomes of the
injury, the types of treatments received, and the types
of services utilized.
[(b) Not later than 18 months after the date of enactment of
the Traumatic Brain Injury Act of 2008, the Secretary, acting
through the Director of the Centers for Disease Control and
Prevention and the Director of the National Institutes of
Health and in consultation with the Secretary of Defense and
the Secretary of Veterans Affairs, shall submit to the relevant
committees of Congress a report that contains the findings
derived from an evaluation concerning activities and procedures
that can be implemented by the Centers for Disease Control and
Prevention to improve the collection and dissemination of
compatible epidemiological studies on the incidence and
prevalence of traumatic brain injury in individuals who were
formerly in the military. The report shall include
recommendations on the manner in which such agencies can
further collaborate on the development and improvement of
traumatic brain injury diagnostic tools and treatments.]
[(c)] (b) National Concussion Data Collection and Analysis.--
The Secretary, acting through the Director of the Centers for
Disease Control and Prevention, may implement concussion data
collection and analysis to determine the prevalence and
incidence of concussion and evidence-based practices to
identify and address concussion.
(c) Availability of Information.--The Secretary, acting
through the Director of the Centers for Disease Control and
Prevention, shall make publicly available aggregated
information on traumatic brain injury and concussion described
in this section, including on the website of the Centers for
Disease Control and Prevention. Such website, to the extent
feasible, shall include aggregated information on populations
that may be at higher risk for traumatic brain injuries and
strategies for preventing or reducing risk of traumatic brain
injury that are tailored to such populations.
* * * * * * *
SEC. 394A. AUTHORIZATIONS OF APPROPRIATIONS.
(a) In General.--For the purpose of carrying out this part,
there are authorized to be appropriated $50,000,000 for fiscal
year [1994, and] 1994, 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.
(b) Traumatic Brain Injury.--To carry out sections 393B and
393C, there are authorized to be appropriated $11,750,000 for
each of fiscal years [2020 through 2024] 2026 through 2030.
* * * * * * *
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 for the Administration for Community Living, 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.
(b) State Advisory Board.--
(1) In general.--The Secretary may make a grant under
subsection (a) only if the State or American Indian
consortium involved agrees to establish an advisory
board within the appropriate health department of the
State or American Indian consortium or within another
department as designated by the chief executive officer
of the State or American Indian consortium.
(2) Functions.--An advisory board established under
paragraph (1) shall advise and make recommendations to
the State or American Indian consortium on ways to
improve services coordination regarding traumatic brain
injury. Such advisory boards shall encourage citizen
participation through the establishment of public
hearings and other types of community outreach
programs, taking into consideration populations that
may be at higher risk for traumatic brain injuries. In
developing recommendations under this paragraph, such
boards shall consult with Federal, State, Tribal, and
local governmental agencies and with citizens groups
and other private entities.
(3) Composition.--An advisory board established under
paragraph (1) shall be composed of--
(A) representatives of--
(i) the corresponding State or
American Indian consortium agencies
involved;
(ii) public and nonprofit private
health related organizations;
(iii) other disability advisory or
planning groups within the State or
American Indian consortium;
(iv) members of an organization or
foundation representing individuals
with traumatic brain injury in that
State or American Indian consortium;
and
(v) injury control programs at the
State or local level if such programs
exist; and
(B) a substantial number of individuals with
traumatic brain injury, or the family members
of such individuals.
(c) Matching Funds.--
(1) In general.--With respect to the costs to be
incurred by a State or American Indian consortium in
carrying out the purpose described in subsection (a),
the Secretary may make a grant under such subsection
only if the State or American Indian consortium agrees
to make available non-Federal contributions toward such
costs in an amount that is not less than $1 for each $2
of Federal funds provided under the grant.
(2) Determination of amount contributed.--Non-Federal
contributions under paragraph (1) may be in cash or in
kind, fairly evaluated, including plant, equipment, or
services. Amounts provided by the Federal Government,
or services assisted or subsidized to any significant
extent by the Federal Government, may not be included
in determining the amount of such contributions.
(3) Maintenance of effort.--With respect to
activities for which a grant awarded under subsection
(a) is to be expended, a State or American Indian
consortium shall agree to maintain expenditures of non-
Federal amounts for such activities at a level that is
not less than the level of such expenditures maintained
by the State or American Indian consortium for the
fiscal year preceding the fiscal year for which the
State or American Indian consortium receives such a
grant.
(4) Waiver.--The Secretary may, upon the request of a
State or American Indian consortium, waive not more
than 50 percent of the matching fund amount under
paragraph (1), if the Secretary determines that such
matching fund amount would result in an inability of
the State or American Indian consortium to carry out
the purposes under subsection (a). A waiver provided by
the Secretary under this paragraph shall apply only to
the fiscal year involved.
(d) Application for Grant.--The Secretary may make a grant
under subsection (a) only if an application for the grant is
submitted to the Secretary and the application is in such form,
is made in such manner, and contains such agreements,
assurances, and information as the Secretary determines to be
necessary to carry out this section.
(e) 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 traumatic brain
injury and their families in decision
making regarding the services and
supports; and
(ii) shall be designed for children,
youth, and adults with traumatic brain
injury.
(B) To focus on outreach to underserved and
inappropriately served individuals, such as
individuals in institutional settings,
individuals with low socioeconomic resources,
individuals in rural communities, and
individuals in culturally and linguistically
diverse communities.
(C) To award contracts to nonprofit entities
for consumer or family service access training,
consumer support, peer mentoring, and parent to
parent programs.
(D) To develop individual and family service
coordination or case management systems.
(E) To support other needs identified by the
advisory board under subsection (b) for the
State or American Indian consortium involved.
(2) Best practices.--
(A) In general.--State or American Indian
consortium services and supports provided under
a grant under this section shall reflect the
best practices in the field of traumatic brain
injury, shall be in compliance with title II of
the Americans with Disabilities Act of 1990,
and shall be supported by quality assurance
measures as well as state-of-the-art health
care and integrated community supports,
regardless of the severity of injury.
(B) Demonstration by state agency.--The State
or American Indian consortium agency
responsible for administering amounts received
under a grant under this section shall
demonstrate that it has obtained knowledge and
expertise of traumatic brain injury and the
unique needs associated with traumatic brain
injury.
(3) State capacity building.--A State or American
Indian consortium may use amounts received under a
grant under this section to--
(A) educate consumers and families;
(B) train professionals (such as third party
payers, State agencies, community-based
providers, schools, and educators) in public
and private sector financing [(such as third
party payers, State agencies, community-based
providers, schools, and educators)];
(C) develop or improve case management or
service coordination systems;
(D) develop best practices in areas such as
family or consumer support, return to work,
housing or supportive living personal
assistance services, assistive technology and
devices, behavioral health services, substance
abuse services, and traumatic brain injury
treatment and rehabilitation;
(E) tailor existing State or American Indian
consortium systems to provide accommodations to
the needs of individuals with 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);
(F) improve data sets coordinated across
systems and other needs identified by a State
or American Indian consortium plan supported by
its advisory council; and
(G) develop capacity within targeted
communities.
(f) Coordination of Activities.--The Secretary shall ensure
that activities under this section are coordinated as
appropriate with other Federal agencies that carry out
activities regarding traumatic brain injury.
(g) 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.
(h) Definitions.--For purposes of this section:
[(1) The terms ``American Indian consortium'' and
``State'' have the meanings given to those terms in
section 1253.
[(2) The term ``traumatic brain injury'' means an
acquired injury to the brain. Such term does not
include brain dysfunction caused by congenital or
degenerative disorders, nor birth trauma, but may
include brain injuries caused by anoxia due to trauma.
The Secretary may revise the definition of such term as
the Secretary determines necessary, after consultation
with States and other appropriate public or nonprofit
private entities.]
(1) American indian consortium; state.--The terms
``American Indian consortium'' and ``State'' have the
meanings given such terms in section 1253.
(2) Traumatic brain injury.--
(A) In general.--Subject to subparagraph (B),
the term ``traumatic brain injury''--
(i) means an acquired injury to the
brain;
(ii) may include--
(I) brain injuries caused by
anoxia due to trauma; and
(II) damage to the brain from
an internal or external source
that results in infection,
toxicity, surgery, or vascular
disorders not associated with
aging; and
(iii) does not include brain
dysfunction caused by congenital or
degenerative disorders, or birth
trauma.
(B) Revisions to definition.--The Secretary
may revise the definition of the term
``traumatic brain injury'' under this
paragraph, as the Secretary determines
necessary, after consultation with States and
other appropriate public or nonprofit private
entities.
(i) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated $7,321,000 for each of fiscal years [2020 through
2024] 2026 through 2030.
SEC. 1253. STATE GRANTS FOR PROTECTION AND ADVOCACY SERVICES.
(a) In General.--The Secretary, acting through the
Administrator for the Administration for Community Living,
shall make grants to protection and advocacy systems for the
purpose of enabling such systems to provide services to
individuals with traumatic brain injury.
(b) Services Provided.--Services provided under this section
may include the provision of--
(1) information, referrals, and advice;
(2) individual and family advocacy;
(3) legal representation; and
(4) specific assistance in self-advocacy.
(c) Application.--To be eligible to receive a grant under
this section, a protection and advocacy system shall submit an
application to the Secretary at such time, in such form and
manner, and accompanied by such information and assurances as
the 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
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.
(2) Amount.--The amount of each grant provided under
paragraph (1) shall be determined as set forth in
paragraphs (2) and (3) of subsection (e).
(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
Secretary shall make a grant to a protection and
advocacy system within each State.
(2) Amount.--The amount of a grant provided to a
system under paragraph (1) shall be equal to an amount
bearing the same ratio to the total amount appropriated
for the fiscal year involved under subsection (l) as
the population of the State in which the grantee is
located bears to the population of all States.
(3) Minimums.--Subject to the availability of
appropriations, the amount of a grant a protection and
advocacy system under paragraph (1) for a fiscal year
shall--
(A) in the case of a protection and advocacy
system located in American Samoa, Guam, the
United States Virgin Islands, or the
Commonwealth of the Northern Mariana Islands,
and the protection and advocacy system serving
the American Indian consortium, not be less
than $20,000; and
(B) in the case of a protection and advocacy
system in a State not described in subparagraph
(A), not be less than $50,000.
(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 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.
(f) Carryover.--Any amount paid to a protection and advocacy
system that serves a State or the American Indian consortium
for a fiscal year under this section that remains unobligated
at the end of such fiscal year shall remain available to such
system for obligation during the next fiscal year for the
purposes for which such amount was originally provided.
(g) Direct Payment.--Notwithstanding any other provision of
law, each fiscal year not later than October 1, the 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) Reporting.--
(1) Reports by systems.--Each protection and advocacy
system that receives a payment under this section shall
submit an annual report to the 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 2014, 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 Secretary shall facilitate
agreements to coordinate the collection of data by agencies
within the Department of Health and Human Services 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 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.
(2) Definition.--In this subsection, the term
``eligible national association'' means a national
association with demonstrated experience in providing
training and technical assistance to protection and
advocacy systems.
(k) System Authority.--In providing services under this
section, a protection and advocacy system shall have the same
authorities, including access to records, as such system would
have for purposes of providing services under subtitle C of
title I of the Developmental Disabilities Assistance and Bill
of Rights Act of 2000 (42 U.S.C. 15041 et seq.).
(l) Authorization of Appropriations.--There are authorized to
be appropriated to carry out this section $4,000,000 for each
of fiscal years [2020 through 2024] 2026 through 2030.
(m) Definitions.--In this section:
(1) American indian consortium.--The term ``American
Indian consortium'' means a consortium established
under subtitle C of title I of the Developmental
Disabilities Assistance and Bill of Rights Act of 2000
(42 U.S.C. 15041 et seq.).
(2) Protection and advocacy system.--The term
``protection and advocacy system'' means a protection
and advocacy system established under subtitle C of
title I of the Developmental Disabilities Assistance
and Bill of Rights Act of 2000 (42 U.S.C. 15041 et
seq.).
(3) State.--The term ``State'', unless otherwise
specified, means the several States of the United
States, the District of Columbia, the Commonwealth of
Puerto Rico, the United States Virgin Islands, Guam,
American Samoa, and the Commonwealth of the Northern
Mariana Islands.
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