39–006 

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 


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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 


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1http://docs.house.gov/meetings/IF/IF14/20131120/101509/HHRG-113-IF14-WstateNageleD_20131120.pdf. 2http://www.defense.gov/home/features/2012/0312_tbi/. 3http://docs.house.gov/meetings/IF/IF14/20131120/101509/HHRG-113-IF14-WstateNageleD_20131120.pdf. 4http://docs.house.gov/meetings/IF/IF14/20131120/101509/HHRG-113-IF14-WstateNageleD_20131120.pdf. 5http://www.cdc.gov/traumaticbraininjury/tbi_ed.html. 6http://www.hrsa.gov/about/budget/budgetjustification2013.pdf. 

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

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

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 


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7Pub. L. No. 104–166; Pub. L. No. 106–310; Pub. L. No. 110–206. 

8Pub. L. No. 110–206. 

9http://www.nashia.org/pdf/report-to-congress-on-traumatic-brain-injury-2013-a.pdf. 

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. 

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

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. 


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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. 


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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. 


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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.’’ 


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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. 


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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 øhealth-status goals for 

2010, commonly referred to as Healthy People 2010¿ healthstatus goals for 2020, commonly referred to as Healthy People 

2020), including— 

(A) * * * 

* * * * * * * 

NATIONAL PROGRAM FOR TRAUMATIC BRAIN INJURY SURVEILLANCE

AND REGISTRIES

SEC. 393C. (a) * * * 

ø(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. 


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(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, 

øand¿ 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.ø.¿ 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 Secretaryø, 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 øbrain injury¿ traumatic brain injury and their 


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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 øbrain 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 sectionø,¿ and section 

1253, including measures of outcomes and consumer and surrogate 

satisfaction. 

* * * * * * * 

ø(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 Secretaryø, 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 øAdministrator¿ Secretary at such time, in such form and 

manner, and accompanied by such information and assurances as 

the øAdministrator¿ 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 øAdministrator¿ Secretary 

shall make grants from such amount to individual protection 


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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. 

* * * * * * * 

(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 øAdministrator¿ 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 øAdministrator¿ 

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 øAdministrator¿ 

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) øANNUAL REPORT.—¿ REPORTING.— øEach 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 øAdministrator¿ 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 øAdministrator 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 øby 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 øAdministrator¿ Secretary shall use 2 percent of such 


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13 

amount to make a grant to an eligible national association for 

providing for 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 øsubtitle C¿ subtitle C of title I 

of the Developmental Disabilities Assistance and Bill of Rights Act 

of 2000. 

ø(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.¿ 

ø(m)¿ (l) DEFINITIONS.—In this section: 

(1) * * * 

* * * * * * * 

Æ 


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