I 

111TH CONGRESS 

1ST SESSION H. R. 667 

To improve the diagnosis and treatment of traumatic brain injury in members 

and former members of the Armed Forces, to review and expand telehealth and telemental health programs of the Department of Defense 

and the Department of Veterans Affairs, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 23, 2009 

Mr. SALAZAR (for himself, Mr. PASCRELL, Ms. SUTTON, Mr. HALL of New 

York, Mr. HOLT, Mr. SESTAK, Mr. CAPUANO, Mr. MCDERMOTT, Mr. 

FRANK of Massachusetts, Mr. MORAN of Virginia, Mr. HINCHEY, Mr. 

HARE, Ms. MARKEY of Colorado, Mr. PERLMUTTER, and Mr. PLATTS) 

introduced the following bill; which was referred to the Committee on 

Veterans’ Affairs, and in addition to the Committee on Armed Services, 

for a period to be subsequently determined by the Speaker, in each case 

for consideration of such provisions as fall within the jurisdiction of the 

committee concerned 

A BILL 

To improve the diagnosis and treatment of traumatic brain 

injury in members and former members of the Armed 

Forces, to review and expand telehealth and telemental 

health programs of the Department of Defense and the 

Department of Veterans Affairs, and for other purposes. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Heroes at Home Act 

3 of 2009’’. 

4 SEC. 2. TRAINING AND CERTIFICATION PROGRAM FOR 

5 FAMILY CAREGIVER PERSONAL CARE AT6 TENDANTS FOR VETERANS AND MEMBERS OF 

7 THE ARMED FORCES WITH TRAUMATIC 

8 BRAIN INJURY. 

9 (a) PROGRAM ON TRAINING AND CERTIFICATION OF

10 FAMILY CAREGIVER PERSONAL CARE ATTENDANTS.— 

11 The Secretary of Veterans Affairs shall establish a pro12 gram on training and certification of family caregivers of 

13 veterans and members of the Armed Forces with trau14 matic brain injury as personal care attendants of such vet15 erans and members. 

16 (b) LOCATION.—The program required by subsection 

17 (a) shall be located in each of the medical centers of the 

18 Department of Veterans Affairs. 

19 (c) TRAINING CURRICULA.— 

20 (1) IN GENERAL.—The Secretary of Veterans 

21 Affairs shall, in collaboration with the Secretary of 

22 Defense, develop curricula for the training of per23 sonal care attendants described in subsection (a). 

24 Such curricula shall incorporate applicable standards 

25 and protocols utilized by certification programs of 

26 national brain injury care specialist organizations. 


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1 (2) USE OF EXISTING CURRICULA.—In devel2 oping the curricula required by paragraph (1), the 

3 Secretary of Veterans Affairs shall, to the extent 

4 practicable, utilize and expand upon training cur5 ricula developed pursuant to section 744(b) of the 

6 John Warner National Defense Authorization Act 

7 for Fiscal Year 2007 (Public Law 109–364; 120 

8 Stat. 2308). 

9 (d) PROGRAM PARTICIPATION.— 

10 (1) IN GENERAL.—The Secretary of Veterans 

11 Affairs shall determine the eligibility of a family 

12 member of a veteran or member of the Armed 

13 Forces for participation in the program required by 

14 subsection (a). 

15 (2) BASIS FOR DETERMINATION.—A determina16 tion made under paragraph (1) shall be based on the 

17 clinical needs of the veteran or member of the 

18 Armed Forces concerned, as determined by the phy19 sician of such veteran or member. 

20 (e) ELIGIBILITY FOR COMPENSATION.—A family 

21 caregiver of a veteran or member of the Armed Forces 

22 who receives certification as a personal care attendant 

23 under this section shall be eligible for compensation from 

24 the Department of Veterans Affairs for care provided to 

25 such veteran or member. 


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1 (f) COSTS OF TRAINING.— 

2 (1) TRAINING OF FAMILIES OF VETERANS.— 

3 Any costs of training provided under the program 

4 under this section for family members of veterans 

5 shall be borne by the Secretary of Veterans Affairs. 

6 (2) TRAINING OF FAMILIES OF MEMBERS OF

7 THE ARMED FORCES.—The Secretary of Defense 

8 shall reimburse the Secretary of Veterans Affairs for 

9 any costs of training provided under the program 

10 under this section for family members of members of 

11 the Armed Forces. Amounts for such reimbursement 

12 shall be derived from amounts available for Defense 

13 Health Program for the TRICARE program. 

14 (g) CONSTRUCTION.—Nothing in this section shall be 

15 construed to require or permit the Secretary of Veterans 

16 Affairs to deny reimbursement for health care services 

17 provided to a veteran with a brain injury to a personal 

18 care attendant who is not a family member of such vet19 eran. 

20 SEC. 3. OUTREACH AND PUBLIC AWARENESS. 

21 (a) OUTREACH REQUIRED.—The Secretary of Vet22 erans Affairs shall conduct comprehensive outreach to en23 hance the awareness of veterans and the general public 

24 about the symptoms of post-traumatic stress disorder and 

25 traumatic brain injury and the services provided by the 


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1 Department of Veterans Affairs to veterans with such 

2 symptoms. 

3 (b) PROVISION OF BEST PRACTICES.—The Secretary 

4 of Veterans Affairs shall make available to non-Depart5 ment of Veterans Affairs health practitioners the best 

6 practices developed by the Department for the treatment 

7 of traumatic brain injury and post-traumatic stress dis8 order. 

9 SEC. 4. TELEHEALTH AND TELEMENTAL HEALTH SERVICES 

10 OF THE DEPARTMENT OF DEFENSE AND THE 

11 DEPARTMENT OF VETERANS AFFAIRS. 

12 (a) TELEHEALTH AND TELEMENTAL HEALTH DEM13 ONSTRATION PROJECT.— 

14 (1) IN GENERAL.—The Secretary of Defense 

15 and the Secretary of Veterans Affairs shall jointly 

16 establish a demonstration project to assess the feasi17 bility and advisability of using telehealth technology 

18 to assess cognitive (including memory) functioning 

19 of members and former members of the Armed 

20 Forces who have sustained head trauma, in order to 

21 improve the diagnosis and treatment of traumatic 

22 brain injury. 

23 (2) LOCATION.— 

24 (A) IN GENERAL.—The Secretary of De25 fense and the Secretary of Veterans Affairs 


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1 shall carry out the demonstration project re2 quired by paragraph (1) at one or more loca3 tions selected by the Secretaries for purposes of 

4 the demonstration project. 

5 (B) PRIORITY FOR RURAL AREAS.—In se6 lecting locations to carry out the demonstration 

7 project required by paragraph (1), the Sec8 retary of Defense and the Secretary of Veterans 

9 Affairs shall give priority to locations that 

10 would provide service in a rural area. 

11 (3) REQUIREMENTS.—The demonstration 

12 project required by paragraph (1) shall include the 

13 following: 

14 (A) The use of telehealth technology to as15 sess the cognitive (including memory) func16 tioning of a member or former member of the 

17 Armed Forces, including the following: 

18 (i) Obtaining information regarding 

19 the nature of any brain injury incurred by 

20 such member or former member. 

21 (ii) Assessing any symptoms of trau22 matic brain injury in such member or 

23 former member. 

24 (B) The use of telehealth technology to re25 habilitate members or former members of the 


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1 Armed Forces who have traumatic brain injury, 

2 and the use, to the extent practicable, of appli3 cable standards and protocols used by certifi4 cation programs of national brain injury care 

5 specialist organizations in order to assess 

6 progress in such rehabilitation. 

7 (C) The use of telehealth technology to dis8 seminate education material to members and 

9 former members of the Armed Forces and the 

10 family members of such members on tech11 niques, strategies, and skills for caring for and 

12 assisting such members, and to the extend prac13 ticable, such education materials shall incor14 porate training curricula developed pursuant to 

15 section 744(b) of the John Warner National 

16 Defense Authorization Act for Fiscal Year 2007 

17 (Public Law 109–364; 120 Stat. 2308). 

18 (4) USE OF PROVEN TECHNOLOGIES.—Any as19 sessment administered as a part of the demonstra20 tion project required by paragraph (1) shall incor21 porate telemental health technology that has proven 

22 effective in the diagnosis and treatment of mental 

23 health conditions associated with traumatic brain in24 jury. 

25 (5) ADMINISTRATION.— 


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1 (A) IN GENERAL.—The demonstration 

2 project required by paragraph (1) shall be ad3 ministered under the joint incentives program 

4 and carried out pursuant to section 8111(d) of 

5 title 38, United States Code. 

6 (B) FUNDING.—Amounts to carry out the 

7 demonstration project shall be derived from 

8 amounts in the DOD–VA Health Care Sharing 

9 Incentive Fund established under paragraph (2) 

10 of such section. 

11 (6) REPORT.— 

12 (A) IN GENERAL.—The Secretary of De13 fense and the Secretary of Veterans Affairs 

14 shall jointly submit to Congress a report on the 

15 demonstration project required by paragraph 

16 (1). 

17 (B) SUBMISSION WITH ANNUAL JOINT RE18 PORT.—The report required by subparagraph 

19 (A) shall be submitted to Congress at the same 

20 time as the annual joint report required by sec21 tion 8111(f) of title 38, United States Code, for 

22 the fiscal year following the fiscal year of the 

23 date of the enactment of this Act. 

24 (b) ONGOING STUDY ON TELEHEALTH AND TELE25 MENTAL HEALTH SERVICES.— 


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1 (1) IN GENERAL.—The Secretary of Defense 

2 and the Secretary of Veterans Affairs shall, through 

3 the Joint Executive Council (JEC) of the Depart4 ment of Defense and the Department of Veterans 

5 Affairs, conduct an ongoing study of all matters re6 lating to the telehealth and telemental health serv7 ices of the Department of Defense and the Depart8 ment of Veterans Affairs. 

9 (2) MATTERS STUDIED.—The matters studied 

10 under paragraph (1) shall include the following: 

11 (A) The number of members and former 

12 members of the Armed Forces who have used 

13 telehealth or telemental health services of the 

14 Department of Defense or the Department of 

15 Veterans Affairs. 

16 (B) The extent to which members of the 

17 National Guard and the Reserves are utilizing 

18 telehealth or telemental health services of the 

19 Department of Defense or the Department of 

20 Veterans Affairs. 

21 (C) The ways in which the Department of 

22 Defense and the Department of Veterans Af23 fairs can improve the integration of telehealth 

24 and telemental health services with clinical 

25 medicine. 


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1 (D) The extent to which telehealth and 

2 telemental health services of the Department of 

3 Defense and the Department of Veterans Af4 fairs are provided in rural settings and through 

5 community-based outpatient clinics (CBOCs). 

6 (E) Best practices of civilian mental health 

7 providers and facilities with respect to the pro8 vision of telehealth and telemental health serv9 ices, including how such practices can be adopt10 ed to improve telehealth and telemental health 

11 services of the Department of Defense and the 

12 Department of Veterans Affairs. 

13 (F) The feasability and advisability of 

14 partnering with civilian mental health facilities 

15 to provide telehealth and telemental health serv16 ices to members and former members of the 

17 Armed Forces. 

18 (3) ANNUAL REPORTS.—Not later than one 

19 year after the date of the enactment of this Act, and 

20 annually thereafter, the Secretary of Defense and 

21 the Secretary of Veterans Affairs shall jointly sub22 mit to Congress a report on the findings of the Joint 

23 Executive Counsel under this subsection during the 

24 preceding year. 


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1 SEC. 5. DEFINITIONS. 

2 In this Act: 

3 (1) The term ‘‘national brain injury care spe4 cialist organization’’ means a national organization 

5 or association with demonstrated experience in pro6 viding training, education, and technical assistance 

7 in the provision of care for individuals with brain in8 jury. 

9 (2) The term ‘‘neurocognitive’’ means of, relat10 ing to, or involving the central nervous system and 

11 cognitive or information processing abilities (think12 ing, memory, and reasoning), as well as sensory 

13 processing (sight, hearing, touch, taste, and smell), 

14 and communication (expression and understanding). 

15 (3) The term ‘‘traumatic brain injury’’ means 

16 an acquired injury to the brain, including brain inju17 ries caused by anoxia due to trauma and such other 

18 injuries as the Secretary considers appropriate, ex19 cept that such term excludes brain dysfunction 

20 caused by— 

21 (A) congenital or degenerative disorders; or 

22 (B) birth trauma. 

Æ 


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