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[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 248 Enrolled Bill (ENR)]

        H.R.248

                       One Hundred Fourth Congress

                                 of the

                        United States of America

                          AT THE SECOND SESSION

         Begun and held at the City of Washington on Wednesday,
   the third day of January, one thousand nine hundred and ninety-six

                                 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.

    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. (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--
        (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. 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 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 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. 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).
    (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) 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) 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:
    ``(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.''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
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