II

106TH CONGRESS

2D SESSION S. 3081

To amend the Public Health Service Act to provide for the conduct of

studies and the establishment of innovative programs with respect to

traumatic brain injury, and other purposes.

IN THE SENATE OF THE UNITED STATES

SEPTEMBER 20, 2000

Mr. HATCH introduced the following bill; which was read twice and referred

to the Committee on Health, Education, Labor, and Pensions

A BILL

To amend the Public Health Service Act to provide for

the conduct of studies and the establishment of innovative programs with respect to traumatic brain injury,

and other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Traumatic Brain In5 jury Act Amendments of 2000’’.

6 SEC. 2. FINDINGS AND PURPOSES.

7 (a) FINDINGS.—Congress makes the following find8 ings:
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1 (1) Traumatic brain injury is among the na2 tion’s most significant public health concerns. It is

3 the leading cause of death and disability in young

4 Americans.

5 (2) 1,500,000 traumatic brain injuries occur

6 each year. 1,000,000 of those injuries are serious

7 enough to require treatment in hospital emergency

8 departments. An estimated 5,300,000 Americans live

9 with a disability as a result of brain injury. The an10 nual cost to society is estimated conservatively at

11 $38,700,000,000.

12 (3) Traumatic brain injury often results in sig13 nificant impairment of an individual’s physical, cog14 nitive, and psychosocial functioning requiring access

15 to an array of health care, education, social services

16 and long-term supports from acute care to rehabili17 tation to community re-entry and participation.

18 (b) PURPOSES.—In is the purpose of this Act to—

19 (1) require the Secretary of Health and Human

20 Services, working in cooperation with other Federal

21 agencies, to study and monitor the incidence and

22 prevalence of traumatic brain injury and conduct na23 tional education activities to increase awareness of

24 the causes and consequences of traumatic brain in25 jury;
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1 (2) require the Secretary of Health and Human

2 Services to cause to be identified best practices in

3 diagnosis, emergent care, special education, and re4 habilitation with the ultimate goal of independent

5 functioning within the community;

6 (3) require the Secretary of Health and Human

7 Services to encourage States to build capacity and

8 enhance community based service delivery systems to

9 provide adequate, appropriate, and accessible serv10 ices to individuals with traumatic brain injury and

11 their families; and

12 (4) require the Secretary of Health and Human

13 Services to conduct basic and applied research re14 garding traumatic brain injury, including diagnosis,

15 treatment, and rehabilitation.

16 SEC. 3. PROGRAMS OF CENTERS FOR DISEASE CONTROL

17 AND PREVENTION.

18 Section 393A(b) of the Public Health Service Act (42

19 U.S.C. 280b–1b(b)) is amended—

20 (1) in paragraph (1), by striking ‘‘and’’ at the

21 end;

22 (2) in paragraph (2), by striking the period and

23 inserting ‘‘; and’’; and

24 (3) by adding at the end the following:
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1 ‘‘(3) the implementation of a national education

2 and awareness campaign in conjunction with

3 Healthy People 2010, including—

4 ‘‘(A) national dissemination and distribu5 tion of incidence and prevalence findings;

6 ‘‘(B) national dissemination of information

7 relating to traumatic brain injury and the

8 sequelae of secondary conditions arising from

9 traumatic brain injury upon discharge from

10 hospitals and trauma centers; and

11 ‘‘(C) the provision of information in pri12 mary care settings, including emergency rooms

13 and trauma centers, concerning the availability

14 of State level services and resources.’’.

15 SEC. 4. STUDY AND MONITOR INCIDENCE AND PREVA16 LENCE.

17 Section 4 of Public Law 104–166 (42 U.S.C. 300d–

18 61 note) is amended—

19 (1) in subsection (a)(1)(A)—

20 (A) by striking clause (i) and inserting the

21 following:

22 ‘‘(i) determine—

23 ‘‘(I) the incidence and prevalence

24 of traumatic brain injury in all age

25 groups in the general population of
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1 the United States, including institu2 tional setting; and

3 ‘‘(II) appropriate methodological

4 strategies to obtain data on the inci5 dence and prevalence of mild trau6 matic brain injury and report to Con7 gress on such strategies within 18

8 months of the date of enactment of

9 the Traumatic Brain Injury Act

10 Amendments of 2000; and’’; and

11 (B) in clause (ii), by striking ‘‘, if the Sec12 retary determines that such a system is appro13 priate’’;

14 (2) in subsection (a)(1)(B)(i), by inserting ‘‘,

15 including return to work or school and optimal com16 munity participation,’’ after ‘‘functioning’’; and

17 (3) in subsection (d), to read as follows:

18 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There

19 is authorized to be appropriated to carry out this section,

20 such sums as may be necessary for each of the fiscal years

21 2001 through 2005.’’.
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1 SEC. 5. PROGRAMS OF THE NATIONAL INSTITUTES OF

2 HEALTH.

3 (a) INTERAGENCY PROGRAM.—Section 1261(d)(4) of

4 the Public Health Service Act (42 U.S.C. 300d–61(d)(4))

5 is amended—

6 (1) in subparagraph (A), by striking ‘‘degree of

7 injury’’ and inserting ‘‘degree of brain injury’’;

8 (2) in subparagraph (B), by striking ‘‘acute in9 jury’’ and inserting ‘‘acute brain injury’’; and

10 (3) in subparagraph (D), by striking ‘‘injury

11 treatment’’ and inserting ‘‘brain injury treatment’’.

12 (b) RESEARCH ON COGNITIVE DISORDERS ARISING

13 FROM TRAUMATIC BRAIN INJURY.—Section 1261(d)(4)

14 of the Public Health Service Act (42 U.S.C. 300d–

15 61(d)(4)) is amended—

16 (1) in subparagraph (C), by striking ‘‘and’’

17 after the semicolon at the end;

18 (2) in subparagraph (D), by striking the period

19 at the end and inserting ‘‘; and’’; and

20 (3) by adding at the end the following:

21 ‘‘(E) carrying out subparagraphs (A)

22 through (D) with respect to cognitive disorders

23 and the neurobehavioral consequences arising

24 from traumatic brain injury, including the de25 velopment, modification, and evaluation of

26 therapies and programs of rehabilitation toward
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1 restoring normal capabilities to read, com2 prehend, speak, reason, and deduce.’’.

3 (c) AUTHORIZATION OF APPROPRIATIONS.—Section

4 1261 of the Public Health Service Act (42 U.S.C. 300d–

5 61) is amended by adding at the end the following:

6 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is

7 authorized to be appropriated to carry out this section,

8 such sums as may be necessary for each of the fiscal years

9 2001 through 2005.’’.

10 SEC. 6. PROGRAMS OF HEALTH RESOURCES AND SERVICES

11 ADMINISTRATION.

12 Section 1252 of the Public Health Service Act (42

13 U.S.C. 300d–52) is amended—

14 (1) in the section heading by striking ‘‘DEM15 ONSTRATION’’;

16 (2) in subsection (a), by striking ‘‘demonstra17 tion’’;

18 (3) in subsection (b)(3)—

19 (A) in subparagraph (A)(iv), by striking

20 ‘‘representing traumatic brain injury survivors’’

21 and inserting ‘‘representing individuals with

22 traumatic brain injury’’; and

23 (B) in subparagraph (B), by striking ‘‘who

24 are survivors of’’ and inserting ‘‘with’’;

25 (4) in subsection (c)—
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1 (A) in paragraph (1), by striking ‘‘in cash’’

2 and inserting ‘‘in cash (or with respect to the

3 second and each subsequent year for which

4 matching funds are required, in-kind)’’; and

5 (B) by adding at the end the following:

6 ‘‘(3) EFFECTIVE DATE.—The requirements of

7 this subsection shall apply with respect to a State

8 for grant years beginning after the first year in

9 which the State receives a grant under this sec10 tion.’’;

11 (5) by redesignating subsections (e) through (h)

12 as subsections (g) through (j), respectively;

13 (6) by inserting after subsection (d), the fol14 lowing:

15 ‘‘(e) CONTINUATION OF PREVIOUSLY AWARDED

16 DEMONSTRATION PROJECTS.—A State that received a

17 grant under this section prior to the date of enactment

18 of the Traumatic Brain Injury Act Amendments of 2000

19 may compete for new project grants under this section

20 after such date of enactment.

21 ‘‘(f) USE OF STATE GRANTS.—

22 ‘‘(1) COMMUNITY SERVICES AND SUPPORTS.—A

23 State shall use amounts received under a grant

24 under this section to, directly or through grants or

25 contracts with nonprofit entities—
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1 ‘‘(A) develop, change, or enhance commu2 nity based service delivery systems that include

3 timely access to an array of comprehensive serv4 ices and supports that promote full community

5 participation by individuals with brain injury

6 and their families;

7 ‘‘(B) reflect local consumer or family driv8 en values;

9 ‘‘(C) address the needs of individuals of all

10 ages;

11 ‘‘(D) provide outreach and services to un12 derserved and inappropriately served individ13 uals, such as individuals in institutional set14 tings, individuals with low socioeconomic re15 sources, individuals in rural communities, and

16 individuals in culturally and linguistically di17 verse communities;

18 ‘‘(E) provide grants to nonprofit entities

19 for consumer or family service access training,

20 consumer support, peer mentoring, and parent

21 to parent programs;

22 ‘‘(F) provide individual and family service

23 coordination or case management systems; and

24 ‘‘(G) support other needs identified by a

25 State plan that is supported by its advisory
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1 council and that reflects local consumer or fam2 ily driven values.

3 ‘‘(2) BEST PRACTICES.—

4 ‘‘(A) IN GENERAL.—State services and

5 supports provided under a grant under this sec6 tion shall reflect the best practices in the field

7 of traumatic brain injury, and shall be sup8 ported by quality assurance measures as well as

9 the appropriate standard of health care and in10 tegrated community supports.

11 ‘‘(B) DEMONSTRATION BY STATE AGEN12 CY.—The State agency responsible for admin13 istering amounts receive under a grant under

14 this section shall demonstrate or obtain exper15 tise and knowledge of traumatic brain injury

16 and the unique needs associated with traumatic

17 brain injury.

18 ‘‘(3) STATE CAPACITY BUILDING.—A State may

19 use amounts received under a grant under this sec20 tion to leverage State resources to—

21 ‘‘(A) educate consumers and families;

22 ‘‘(B) train professionals in public and pri23 vate sector financing (such as third party pay24 ers, State agencies, community-based providers,

25 schools, and educators);
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1 ‘‘(C) develop or improve case management

2 or service coordination systems;

3 ‘‘(D) develop best practices in areas such

4 as family or consumer support, return to work,

5 housing or supportive living, personal assistance

6 services, assistive technology, substance abuse,

7 behavioral health services, and traumatic brain

8 injury treatment and rehabilitation;

9 ‘‘(E) tailor existing State systems to pro10 vide accommodation to the needs of individuals

11 with brain injury (including systems adminis12 tered by the State departments responsible for

13 health, mental health, labor, education, mental

14 retardation or developmental disabilities, trans15 portation, housing, and correctional systems);

16 and

17 ‘‘(F) improve data sets coordinated across

18 systems and other needs identified by a State

19 plan supported by its advisory council.’’;

20 (7) in subsection (g) (as so redesignated), by

21 striking ‘‘agencies of the Public Health Service’’ and

22 inserting ‘‘Federal agencies’’;

23 (8) in subsection (j) (as so redesignated), to

24 read as follows:
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1 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—For the

2 purpose of carrying out this section, there is authorized

3 to be appropriated—

4 ‘‘(1) $7,000,000 for fiscal year 2001;

5 ‘‘(2) $9,000,000 for fiscal year 2002;

6 ‘‘(3) $7,500,000 for fiscal year 2003;

7 ‘‘(4) $6,500,000 for fiscal year 2004; and

8 ‘‘(5) $6,000,000 for fiscal year 2005.’’; and

9 (9) by adding at the end the following:

10 ‘‘(k) STATE.—In this section, the term ‘State’ in11 cludes territories of the United States.’’.

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