II 

110TH CONGRESS 

1ST SESSION S. 1065 

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 SENATE OF THE UNITED STATES 

MARCH 29, 2007 

Mrs. CLINTON (for herself and Ms. COLLINS) introduced the following bill; 

which was read twice and referred to the Committee on Armed Services 

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, 

3 SECTION 1. SHORT TITLE. 

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

5 of 2007’’. 


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1 SEC. 2. PROTOCOL FOR ASSESSMENT AND DOCUMENTA2 TION OF COGNITIVE FUNCTIONING OF EACH 

3 DEPLOYED MEMBERS OF THE ARMED 

4 FORCES. 

5 (a) PROTOCOL REQUIRED.—The Secretary of De6 fense shall establish a protocol for the assessment and doc7 umentation of the cognitive (including memory) func8 tioning of each member of the Armed Forces before each 

9 such member is deployed in Operation Enduring Freedom 

10 or Operation Iraqi Freedom, to facilitate the assessment 

11 of the cognitive (including memory) functioning of each 

12 such member upon returning from such deployment. 

13 (b) DIAGNOSIS OF TRAUMATIC BRAIN INJURY AND

14 POST TRAUMATIC STRESS DISORDER.— 

15 (1) IN GENERAL.—The Secretary shall ensure 

16 that the protocol required by subsection (a) provides 

17 appropriate mechanisms to permit the differential 

18 diagnosis of traumatic brain injury (TBI) and post 

19 traumatic stress disorder (PTSD) in members of the 

20 Armed Forces who return from deployment in Oper21 ation Enduring Freedom or Operation Iraqi Free22 dom. 

23 (2) ADDITIONAL PURPOSES.—Except as pro24 vided in subsection (d), the Secretary may use the 

25 protocol for such other purposes as the Secretary 

26 considers appropriate. 


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1 (c) NEUROCOGNITIVE ASSESSMENTS.— 

2 (1) IN GENERAL.—The protocol required by 

3 subsection (a) shall include the administration of 

4 computer-based neurocognitive assessments to mem5 bers of the Armed Forces. 

6 (2) FREQUENCY.—The assessments required by 

7 paragraph (1) shall be administered at least once to 

8 each member of the Armed Forces— 

9 (A) before deploying to Operation Endur10 ing Freedom or Operation Iraqi Freedom; and 

11 (B) upon returning from such deployment. 

12 (3) DEVELOPMENT OF ASSESSMENT.—In devel13 oping the computer-based assessment required by 

14 paragraph (1), the Secretary may use or adopt a 

15 current commercial product or develop a new com16 puter-based assessment. 

17 (4) FORMAT OF ASSESSMENT.—The format of 

18 the assessments required by paragraph (1) shall be 

19 the same for each administration described in para20 graph (2). 

21 (d) PROHIBITION ON USE OF PROTOCOL TO DETER22 MINE DEPLOYMENT READINESS.—The Secretary may not 

23 use the result of any assessment that is part of the pro24 tocol required by subsection (a) to determine the deploy25 ment readiness of any member of the Armed Forces. 


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1 (e) AVAILABILITY OF MEDICAL DATA.—The Sec2 retary shall make available such medical data on the cog3 nitive (including memory) functioning of members of the 

4 Armed Forces who are deployed in Operation Enduring 

5 Freedom or Operation Iraqi Freedom that is obtained 

6 from the protocol required by subsection (a) as the Sec7 retary considers appropriate to— 

8 (1) combat medics and other Department of 

9 Defense personnel who provide medical services to 

10 such members; and 

11 (2) such entities as the Secretary considers ap12 propriate. 

13 (f) REPORT.—Not later than one year after the date 

14 of the enactment of this Act, the Secretary shall submit 

15 to Congress a report on the implementation of this section. 

16 (g) AUTHORIZATION OF APPROPRIATIONS.—There is 

17 authorized to be appropriated to the Department of De18 fense to carry out this section amounts as follows: 

19 (1) For fiscal year 2008, $3,750,000. 

20 (2) For fiscal years 2009 through 2012, such 

21 sums as may be necessary. 


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1 SEC. 3. TRAINING AND CERTIFICATION PROGRAM FOR 

2 FAMILY CAREGIVER PERSONAL CARE AT3 TENDANTS FOR VETERANS AND MEMBERS OF 

4 THE ARMED FORCES WITH TRAUMATIC 

5 BRAIN INJURY. 

6 (a) PROGRAM ON TRAINING AND CERTIFICATION OF

7 FAMILY CAREGIVER PERSONAL CARE ATTENDANTS.— 

8 The Secretary of Veterans Affairs shall establish a pro9 gram on training and certification of family caregivers of 

10 veterans and members of the Armed Forces with trau11 matic brain injury as personal care attendants of such vet12 erans and members. 

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

14 (a) shall be located in each of the polytrauma centers of 

15 the Department of Veterans Affairs designated as a Tier 

16 I polytrauma center. 

17 (c) TRAINING CURRICULA.— 

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

19 Affairs shall, in collaboration with the Secretary of 

20 Defense, develop curricula for the training of per21 sonal care attendants described in subsection (a). 

22 Such curricula shall incorporate applicable standards 

23 and protocols utilized by certification programs of 

24 national brain injury care specialist organizations. 

25 (2) USE OF EXISTING CURRICULA.—In devel26 oping the curricula required by paragraph (1), the 


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1 Secretary of Veterans Affairs shall, to the extent 

2 practicable, utilize and expand upon training cur3 ricula developed pursuant to section 744(b) of the 

4 John Warner National Defense Authorization Act 

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

6 Stat. 2308). 

7 (d) PROGRAM PARTICIPATION.— 

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

9 Affairs shall determine the eligibility of a family 

10 member of a veteran or member of the Armed 

11 Forces for participation in the program required by 

12 subsection (a). 

13 (2) BASIS FOR DETERMINATION.—A determina14 tion made under paragraph (1) shall be based on the 

15 clinical needs of the veteran or member of the 

16 Armed Forces concerned, as determined by the phy17 sician of such veteran or member. 

18 (e) ELIGIBILITY FOR COMPENSATION.—A family 

19 caregiver of a veteran or member of the Armed Forces 

20 who receives certification as a personal care attendant 

21 under this section shall be eligible for compensation from 

22 the Department of Veterans Affairs for care provided to 

23 such veteran or member. 

24 (f) COSTS OF TRAINING.— 


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1 (1) TRAINING OF FAMILIES OF VETERANS.— 

2 Any costs of training provided under the program 

3 under this section for family members of veterans 

4 shall be borne by the Secretary of Veterans Affairs. 

5 (2) TRAINING OF FAMILIES OF MEMBERS OF

6 THE ARMED FORCES.—The Secretary of Defense 

7 shall reimburse the Secretary of Veterans Affairs for 

8 any costs of training provided under the program 

9 under this section for family members of members of 

10 the Armed Forces. Amounts for such reimbursement 

11 shall be derived from amounts available for Defense 

12 Health Program for the TRICARE program. 

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

14 construed to require or permit the Secretary of Veterans 

15 Affairs to deny reimbursement for health care services 

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

17 care attendant who is not a family member of such vet18 eran. 

19 SEC. 4. TELEHEALTH AND TELEMENTAL HEALTH SERVICES 

20 OF THE DEPARTMENT OF DEFENSE AND THE 

21 DEPARTMENT OF VETERANS AFFAIRS. 

22 (a) TELEHEALTH AND TELEMENTAL HEALTH DEM23 ONSTRATION PROJECT.— 

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

25 and the Secretary of Veterans Affairs shall jointly 


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1 establish a demonstration project to assess the feasi2 bility and advisability of using telehealth technology 

3 to assess cognitive (including memory) functioning 

4 of members and former members of the Armed 

5 Forces who have sustained head trauma, in order to 

6 improve the diagnosis and treatment of traumatic 

7 brain injury. 

8 (2) LOCATION.— 

9 (A) IN GENERAL.—The Secretary of De10 fense and the Secretary of Veterans Affairs 

11 shall carry out the demonstration project re12 quired by paragraph (1) at one or more loca13 tions selected by the Secretaries for purposes of 

14 the demonstration project. 

15 (B) PRIORITY FOR RURAL AREAS.—In se16 lecting locations to carry out the demonstration 

17 project required by paragraph (1), the Sec18 retary of Defense and the Secretary of Veterans 

19 Affairs shall give priority to locations that 

20 would provide service in a rural area. 

21 (3) REQUIREMENTS.—The demonstration 

22 project required by paragraph (1) shall include the 

23 following: 

24 (A) The use of telehealth technology to as25 sess the cognitive (including memory) funcVerDate Aug 31 2005 00:19 Apr 04, 2007 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1065.IS S1065

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1 tioning of a member or former member of the 

2 Armed Forces, including the following: 

3 (i) Obtaining information regarding 

4 the nature of any brain injury incurred by 

5 such member or former member. 

6 (ii) Assessing any symptoms of trau7 matic brain injury in such member or 

8 former member. 

9 (B) The use of telehealth technology to re10 habilitate members or former members of the 

11 Armed Forces who have traumatic brain injury, 

12 and the use, to the extent practicable, of appli13 cable standards and protocols used by certifi14 cation programs of national brain injury care 

15 specialist organizations in order to assess 

16 progress in such rehabilitation. 

17 (C) The use of telehealth technology to dis18 seminate education material to members and 

19 former members of the Armed Forces and the 

20 family members of such members on tech21 niques, strategies, and skills for caring for and 

22 assisting such members, and to the extend prac23 ticable, such education materials shall incor24 porate training curricula developed pursuant to 

25 section 744(b) of the John Warner National 


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1 Defense Authorization Act for Fiscal Year 2007 

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

3 (4) USE OF PROVEN TECHNOLOGIES.—Any as4 sessment administered as a part of the demonstra5 tion project required by paragraph (1) shall incor6 porate telemental health technology that has proven 

7 effective in the diagnosis and treatment of mental 

8 health conditions associated with traumatic brain in9 jury. 

10 (5) ADMINISTRATION.— 

11 (A) IN GENERAL.—The demonstration 

12 project required by paragraph (1) shall be ad13 ministered under the joint incentives program 

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

15 title 38, United States Code. 

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

17 demonstration project shall be derived from 

18 amounts in the DOD–VA Health Care Sharing 

19 Incentive Fund established under paragraph (2) 

20 of such section. 

21 (6) REPORT.— 

22 (A) IN GENERAL.—The Secretary of De23 fense and the Secretary of Veterans Affairs 

24 shall jointly submit to Congress a report on the 


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1 demonstration project required by paragraph 

2 (1). 

3 (B) SUBMISSION WITH ANNUAL JOINT RE4 PORT.—The report required by subparagraph 

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

6 time as the annual joint report required by sec7 tion 8111(f) of title 38, United States Code, for 

8 the fiscal year following the fiscal year of the 

9 date of the enactment of this Act. 

10 (b) ONGOING STUDY ON TELEHEALTH AND TELE11 MENTAL HEALTH SERVICES.— 

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

13 and the Secretary of Veterans Affairs shall, through 

14 the Joint Executive Council (JEC) of the Depart15 ment of Defense and the Department of Veterans 

16 Affairs, conduct an ongoing study of all matters re17 lating to the telehealth and telemental health serv18 ices of the Department of Defense and the Depart19 ment of Veterans Affairs. 

20 (2) MATTERS STUDIED.—The matters studied 

21 under paragraph (1) shall include the following: 

22 (A) The number of members and former 

23 members of the Armed Forces who have used 

24 telehealth or telemental health services of the 


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1 Department of Defense or the Department of 

2 Veterans Affairs. 

3 (B) The extent to which members of the 

4 National Guard and the Reserves are utilizing 

5 telehealth or telemental health services of the 

6 Department of Defense or the Department of 

7 Veterans Affairs. 

8 (C) The ways in which the Department of 

9 Defense and the Department of Veterans Af10 fairs can improve the integration of telehealth 

11 and telemental health services with clinical 

12 medicine. 

13 (D) The extent to which telehealth and 

14 telemental health services of the Department of 

15 Defense and the Department of Veterans Af16 fairs are provided in rural settings and through 

17 community-based outpatient clinics (CBOCs). 

18 (E) Best practices of civilian mental health 

19 providers and facilities with respect to the pro20 vision of telehealth and telemental health serv21 ices, including how such practices can be adopt22 ed to improve telehealth and telemental health 

23 services of the Department of Defense and the 

24 Department of Veterans Affairs. 


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1 (F) The feasability and advisability of 

2 partnering with civilian mental health facilities 

3 to provide telehealth and telemental health serv4 ices to members and former members of the 

5 Armed Forces. 

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

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

8 annually thereafter, the Secretary of Defense and 

9 the Secretary of Veterans Affairs shall jointly sub10 mit to Congress a report on the findings of the Joint 

11 Executive Counsel under this subsection during the 

12 preceding year. 

13 SEC. 5. DEFINITIONS. 

14 In this Act: 

15 (1) The term ‘‘national brain injury care spe16 cialist organization’’ means a national organization 

17 or association with demonstrated experience in pro18 viding training, education, and technical assistance 

19 in the provision of care for individuals with brain in20 jury. 

21 (2) The term ‘‘neurocognitive’’ means of, relat22 ing to, or involving the central nervous system and 

23 cognitive or information processing abilities (think24 ing, memory, and reasoning), as well as sensory 


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

2 and communication (expression and understanding). 

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

4 an acquired injury to the brain, including brain inju5 ries caused by anoxia due to trauma and such other 

6 injuries as the Secretary considers appropriate, ex7 cept that such term excludes brain dysfunction 

8 caused by— 

9 (A) congenital or degenerative disorders; or 

10 (B) birth trauma. 

Æ 


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