[104th Congress Public Law 166]
[From the U.S. Government Printing Office]


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[DOCID: f:publ166.104]


[[Page 110 STAT. 1445]]

Public Law 104-166
104th Congress

                                 An Act


 
  To amend the Public Health Service Act to provide for the conduct of 
   expanded studies and the establishment of innovative programs with 
respect to traumatic brain injury, and for other purposes. <<NOTE:  July 
                        29, 1996 -  [H.R. 248]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION.

    Part J of title III of the Public Health Service Act (42 U.S.C. 280b 
et seq.) is amended by inserting after section 393 the following 
section:

                 ``prevention of traumatic brain injury

    ``Sec. 393A. <<NOTE: 42 USC 280b-1b.>>  (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 
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
            ``(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.

    ``(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.
    ``(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 near drowning. The Secretary may revise the definition of 
such term as the Secretary determines necessary.''.

SEC. 2. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.

    Section 1261 of the Public Health Service Act (42 U.S.C. 300d-61) is 
amended--

[[Page 110 STAT. 1446]]

            (1) in subsection (d)--
                    (A) in paragraph (2), by striking ``and'' after the 
                semicolon at the end;
                    (B) in paragraph (3), by striking the period and 
                inserting ``; and''; and
                    (C) by adding at the end the following paragraph:
            ``(4) the authority to make awards of grants or contracts to 
        public or nonprofit private entities for the conduct of basic 
        and applied research regarding traumatic brain injury, which 
        research may include--
                    ``(A) the development of new methods and modalities 
                for the more effective diagnosis, measurement of degree 
                of injury, post-injury monitoring and prognostic 
                assessment of head injury for acute, subacute and later 
                phases of care;
                    ``(B) the development, modification and evaluation 
                of therapies that retard, prevent or reverse brain 
                damage after acute head injury, that arrest further 
                deterioration following injury and that provide the 
                restitution of function for individuals with long-term 
                injuries;
                    ``(C) the development of research on a continuum of 
                care from acute care through rehabilitation, designed, 
                to the extent practicable, to integrate rehabilitation 
                and long-term outcome evaluation with acute care 
                research; and
                    ``(D) the development of programs that increase the 
                participation of academic centers of excellence in head 
                injury treatment and rehabilitation research and 
                training.''; and
            (2) in subsection (h), by adding at the end the following 
        paragraph:
            ``(4) 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 near drowning. The Secretary may revise the definition of 
        such term as the Secretary determines necessary.''.

SEC. 3. PROGRAMS OF HEALTH RESOURCES AND SERVICES ADMINISTRATION.

    Part E of title XII of the Public Health Service Act (42 U.S.C. 
300d-51 et seq.) is amended by adding at the end the following section:

``SEC. 1252. <<NOTE: 42 USC 300d-52.>>  STATE GRANTS FOR DEMONSTRATION 
            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 for the purpose of carrying out demonstration projects to improve 
access to health 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 involved agrees to establish an 
        advisory board within the appropriate health department of the 
        State or within another department as designated by the chief 
        executive officer of the State.
            ``(2) Functions.--An advisory board established under 
        paragraph (1) shall advise and make recommendations to the

[[Page 110 STAT. 1447]]

        State 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. In 
        developing recommendations under this paragraph, such boards 
        shall consult with Federal, State, 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 agencies 
                      involved;
                          ``(ii) public and nonprofit private health 
                      related organizations;
                          ``(iii) other disability advisory or planning 
                      groups within the State;
                          ``(iv) members of an organization or 
                      foundation representing traumatic brain injury 
                      survivors in that State; and
                          ``(v) injury control programs at the State or 
                      local level if such programs exist; and
                    ``(B) a substantial number of individuals who are 
                survivors of 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 in carrying out the purpose described in subsection 
        (a), the Secretary may make a grant under such subsection only 
        if the State agrees to make available, in cash, 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.--In determining 
        the amount of non-Federal contributions in cash that a State has 
        provided pursuant to paragraph (1), the Secretary may not 
        include any amounts provided to the State by the Federal 
        Government.

    ``(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) 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.
    ``(f) Report.--Not later than 2 years after the date of the 
enactment of this section, the Secretary shall submit to the Committee 
on Commerce of the House of Representatives, and to the Committee on 
Labor and Human Resources of the Senate, a report describing the 
findings and results of the programs established under this section, 
including measures of outcomes and consumer and surrogate satisfaction.
    ``(g) 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 near drowning. The Secretary

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may revise the definition of such term as the Secretary determines 
necessary.
    ``(h) Authorization of Appropriations.--For the purpose of carrying 
out this section, there is authorized to be appropriated $5,000,000 for 
each of the fiscal years 1997 through 1999.''.

SEC. 4. <<NOTE: 42 USC 300d-61 note.>>  STUDY; CONSENSUS CONFERENCE.

    (a) Study.--
            (1) In general.--The Secretary of Health and Human Services 
        (in this section referred to as the ``Secretary''), acting 
        through the appropriate agencies of the Public Health Service, 
        shall conduct a study for the purpose of carrying out the 
        following with respect to traumatic brain injury:
                    (A) In collaboration with appropriate State and 
                local health-related agencies--
                          (i) determine the incidence and prevalence of 
                      traumatic brain injury; and
                          (ii) develop a uniform reporting system under 
                      which States report incidents of traumatic brain 
                      injury, if the Secretary determines that such a 
                      system is appropriate.
                    (B) Identify common therapeutic interventions which 
                are used for the rehabilitation of individuals with such 
                injuries, and shall, subject to the availability of 
                information, include an analysis of--
                          (i) the effectiveness of each such 
                      intervention in improving the functioning of 
                      individuals with brain injuries;
                          (ii) the comparative effectiveness of 
                      interventions employed in the course of 
                      rehabilitation of individuals with brain injuries 
                      to achieve the same or similar clinical outcome; 
                      and
                          (iii) the adequacy of existing measures of 
                      outcomes and knowledge of factors influencing 
                      differential outcomes.
                    (C) Develop practice guidelines for the 
                rehabilitation of traumatic brain injury at such time as 
                appropriate scientific research becomes available.
            (2) Dates certain for reports.--
                    (A) Not later than 18 months after the date of the 
                enactment of this Act, the Secretary shall submit to the 
                Committee on Commerce of the House of Representatives, 
                and to the Committee on Labor and Human Resources of the 
                Senate, a report describing the findings made as a 
                result of carrying out paragraph (1)(A).
                    (B) Not later than 3 years after the date of the 
                enactment of this Act, the Secretary shall submit to the 
                Committees specified in subparagraph (A) a report 
                describing the findings made as a result of carrying out 
                subparagraphs (B) and (C) of paragraph (1).

[[Page 110 STAT. 1449]]

    (b) Consensus Conference.--The Secretary, acting through the 
Director of the National Center for Medical Rehabilitation Research 
within the National Institute for Child Health and Human Development, 
shall conduct a national consensus conference on managing traumatic 
brain injury and related rehabilitation concerns.
    (c) 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 near drowning. The Secretary may revise the definition of 
such term as the Secretary determines necessary.
    (d) Authorizations of Appropriations.--For the purpose of carrying 
out subsection (a)(1)(A), there is authorized to be appropriated 
$3,000,000 for each of the fiscal years 1997 through 1999. For the 
purpose of carrying out the other provisions of this section, there is 
authorized to be appropriated an aggregate $500,000 for the fiscal years 
1997 through 1999. Amounts appropriated for such other provisions remain 
available until expended.

SEC. 5. TECHNICAL AMENDMENTS.

    Title XXVI of the Public Health Service Act (42 U.S.C. 300ff-11 et 
seq.), as amended by Public Law 104-146 (the Ryan White CARE Act 
Amendments of 1996), is amended--
            (1) <<NOTE: Ante, p. 1369.>>  in section 2626--
                    (A) in subsection (d), in the first sentence, by 
                striking ``(1) through (5)'' and inserting ``(1) through 
                (4)''; and
                    (B) in subsection (f), in the matter preceding 
                paragraph (1), by striking ``(1) through (5)'' and 
                inserting ``(1) through (4)''; and
            (2) <<NOTE: Ante, p. 1363.>>  in section 2692--
                    (A) in subsection (a)(1)(A)--
                          (i) by striking ``title XXVI programs'' and 
                      inserting ``programs under this title''; and
                          (ii) by striking ``infection and''; and
                    (B) by striking subsection (c) and all that follows 
                and inserting the following:

[[Page 110 STAT. 1450]]

    ``(c) Authorization of Appropriations.--
            ``(1) Schools; centers.--For the purpose of grants under 
        subsection (a), there are authorized to be appropriated such 
        sums as may be necessary for each of the fiscal years 1996 
        through 2000.
            ``(2) Dental schools.--For the purpose of grants under 
        subsection (b), there are authorized to be appropriated such 
        sums as may be necessary for each of the fiscal years 1996 
        through 2000.''.

    Approved July 29, 1996.

LEGISLATIVE HISTORY--H.R. 248:
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HOUSE REPORTS: No. 104-652 (Comm. on Commerce).
CONGRESSIONAL RECORD, Vol. 142 (1996):
            July 9, considered and passed House.
            July 12, considered and passed Senate.

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