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 tele-
health 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Heroes at Home Act 
of 2009’’. 
SEC. 2. TRAINING AND CERTIFICATION PROGRAM FOR 
FAMILY CAREGIVER PERSONAL CARE AT-
TENDANTS FOR VETERANS AND MEMBERS OF 
THE 
ARMED 
FORCES 
WITH 
TRAUMATIC 
BRAIN INJURY. 
(a) PROGRAM ON TRAINING AND CERTIFICATION OF 
FAMILY CAREGIVER PERSONAL CARE ATTENDANTS.— 
The Secretary of Veterans Affairs shall establish a pro-
gram on training and certification of family caregivers of 
veterans and members of the Armed Forces with trau-
matic brain injury as personal care attendants of such vet-
erans and members. 
(b) LOCATION.—The program required by subsection 
(a) shall be located in each of the medical centers of the 
Department of Veterans Affairs. 
(c) TRAINING CURRICULA.— 
(1) IN GENERAL.—The Secretary of Veterans 
Affairs shall, in collaboration with the Secretary of 
Defense, develop curricula for the training of per-
sonal care attendants described in subsection (a). 
Such curricula shall incorporate applicable standards 
and protocols utilized by certification programs of 
national brain injury care specialist organizations. 
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(2) USE OF EXISTING CURRICULA.—In devel-
oping the curricula required by paragraph (1), the 
Secretary of Veterans Affairs shall, to the extent 
practicable, utilize and expand upon training cur-
ricula developed pursuant to section 744(b) of the 
John Warner National Defense Authorization Act 
for Fiscal Year 2007 (Public Law 109–364; 120 
Stat. 2308). 
(d) PROGRAM PARTICIPATION.— 
(1) IN GENERAL.—The Secretary of Veterans 
Affairs shall determine the eligibility of a family 
member of a veteran or member of the Armed 
Forces for participation in the program required by 
subsection (a). 
(2) BASIS FOR DETERMINATION.—A determina-
tion made under paragraph (1) shall be based on the 
clinical needs of the veteran or member of the 
Armed Forces concerned, as determined by the phy-
sician of such veteran or member. 
(e) ELIGIBILITY
FOR COMPENSATION.—A family 
caregiver of a veteran or member of the Armed Forces 
who receives certification as a personal care attendant 
under this section shall be eligible for compensation from 
the Department of Veterans Affairs for care provided to 
such veteran or member. 
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(f) COSTS OF TRAINING.— 
(1) TRAINING OF FAMILIES OF VETERANS.— 
Any costs of training provided under the program 
under this section for family members of veterans 
shall be borne by the Secretary of Veterans Affairs. 
(2) TRAINING OF FAMILIES OF MEMBERS OF 
THE
ARMED
FORCES.—The Secretary of Defense 
shall reimburse the Secretary of Veterans Affairs for 
any costs of training provided under the program 
under this section for family members of members of 
the Armed Forces. Amounts for such reimbursement 
shall be derived from amounts available for Defense 
Health Program for the TRICARE program. 
(g) CONSTRUCTION.—Nothing in this section shall be 
construed to require or permit the Secretary of Veterans 
Affairs to deny reimbursement for health care services 
provided to a veteran with a brain injury to a personal 
care attendant who is not a family member of such vet-
eran. 
SEC. 3. OUTREACH AND PUBLIC AWARENESS. 
(a) OUTREACH REQUIRED.—The Secretary of Vet-
erans Affairs shall conduct comprehensive outreach to en-
hance the awareness of veterans and the general public 
about the symptoms of post-traumatic stress disorder and 
traumatic brain injury and the services provided by the 
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Department of Veterans Affairs to veterans with such 
symptoms. 
(b) PROVISION OF BEST PRACTICES.—The Secretary 
of Veterans Affairs shall make available to non-Depart-
ment of Veterans Affairs health practitioners the best 
practices developed by the Department for the treatment 
of traumatic brain injury and post-traumatic stress dis-
order. 
SEC. 4. TELEHEALTH AND TELEMENTAL HEALTH SERVICES 
OF THE DEPARTMENT OF DEFENSE AND THE 
DEPARTMENT OF VETERANS AFFAIRS. 
(a) TELEHEALTH AND TELEMENTAL HEALTH DEM-
ONSTRATION PROJECT.— 
(1) IN
GENERAL.—The Secretary of Defense 
and the Secretary of Veterans Affairs shall jointly 
establish a demonstration project to assess the feasi-
bility and advisability of using telehealth technology 
to assess cognitive (including memory) functioning 
of members and former members of the Armed 
Forces who have sustained head trauma, in order to 
improve the diagnosis and treatment of traumatic 
brain injury. 
(2) LOCATION.— 
(A) IN GENERAL.—The Secretary of De-
fense and the Secretary of Veterans Affairs 
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shall carry out the demonstration project re-
quired by paragraph (1) at one or more loca-
tions selected by the Secretaries for purposes of 
the demonstration project. 
(B) PRIORITY FOR RURAL AREAS.—In se-
lecting locations to carry out the demonstration 
project required by paragraph (1), the Sec-
retary of Defense and the Secretary of Veterans 
Affairs shall give priority to locations that 
would provide service in a rural area. 
(3) 
REQUIREMENTS.—The 
demonstration 
project required by paragraph (1) shall include the 
following: 
(A) The use of telehealth technology to as-
sess the cognitive (including memory) func-
tioning of a member or former member of the 
Armed Forces, including the following: 
(i) Obtaining information regarding 
the nature of any brain injury incurred by 
such member or former member. 
(ii) Assessing any symptoms of trau-
matic brain injury in such member or 
former member. 
(B) The use of telehealth technology to re-
habilitate members or former members of the 
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Armed Forces who have traumatic brain injury, 
and the use, to the extent practicable, of appli-
cable standards and protocols used by certifi-
cation programs of national brain injury care 
specialist organizations in order to assess 
progress in such rehabilitation. 
(C) The use of telehealth technology to dis-
seminate education material to members and 
former members of the Armed Forces and the 
family members of such members on tech-
niques, strategies, and skills for caring for and 
assisting such members, and to the extend prac-
ticable, such education materials shall incor-
porate training curricula developed pursuant to 
section 744(b) of the John Warner National 
Defense Authorization Act for Fiscal Year 2007 
(Public Law 109–364; 120 Stat. 2308). 
(4) USE OF PROVEN TECHNOLOGIES.—Any as-
sessment administered as a part of the demonstra-
tion project required by paragraph (1) shall incor-
porate telemental health technology that has proven 
effective in the diagnosis and treatment of mental 
health conditions associated with traumatic brain in-
jury. 
(5) ADMINISTRATION.— 
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(A) IN
GENERAL.—The demonstration 
project required by paragraph (1) shall be ad-
ministered under the joint incentives program 
and carried out pursuant to section 8111(d) of 
title 38, United States Code. 
(B) FUNDING.—Amounts to carry out the 
demonstration project shall be derived from 
amounts in the DOD–VA Health Care Sharing 
Incentive Fund established under paragraph (2) 
of such section. 
(6) REPORT.— 
(A) IN GENERAL.—The Secretary of De-
fense and the Secretary of Veterans Affairs 
shall jointly submit to Congress a report on the 
demonstration project required by paragraph 
(1). 
(B) SUBMISSION WITH ANNUAL JOINT RE-
PORT.—The report required by subparagraph 
(A) shall be submitted to Congress at the same 
time as the annual joint report required by sec-
tion 8111(f) of title 38, United States Code, for 
the fiscal year following the fiscal year of the 
date of the enactment of this Act. 
(b) ONGOING STUDY ON TELEHEALTH AND TELE-
MENTAL HEALTH SERVICES.— 
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(1) IN
GENERAL.—The Secretary of Defense 
and the Secretary of Veterans Affairs shall, through 
the Joint Executive Council (JEC) of the Depart-
ment of Defense and the Department of Veterans 
Affairs, conduct an ongoing study of all matters re-
lating to the telehealth and telemental health serv-
ices of the Department of Defense and the Depart-
ment of Veterans Affairs. 
(2) MATTERS STUDIED.—The matters studied 
under paragraph (1) shall include the following: 
(A) The number of members and former 
members of the Armed Forces who have used 
telehealth or telemental health services of the 
Department of Defense or the Department of 
Veterans Affairs. 
(B) The extent to which members of the 
National Guard and the Reserves are utilizing 
telehealth or telemental health services of the 
Department of Defense or the Department of 
Veterans Affairs. 
(C) The ways in which the Department of 
Defense and the Department of Veterans Af-
fairs can improve the integration of telehealth 
and telemental health services with clinical 
medicine. 
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(D) The extent to which telehealth and 
telemental health services of the Department of 
Defense and the Department of Veterans Af-
fairs are provided in rural settings and through 
community-based outpatient clinics (CBOCs). 
(E) Best practices of civilian mental health 
providers and facilities with respect to the pro-
vision of telehealth and telemental health serv-
ices, including how such practices can be adopt-
ed to improve telehealth and telemental health 
services of the Department of Defense and the 
Department of Veterans Affairs. 
(F) The feasability and advisability of 
partnering with civilian mental health facilities 
to provide telehealth and telemental health serv-
ices to members and former members of the 
Armed Forces. 
(3) ANNUAL
REPORTS.—Not later than one 
year after the date of the enactment of this Act, and 
annually thereafter, the Secretary of Defense and 
the Secretary of Veterans Affairs shall jointly sub-
mit to Congress a report on the findings of the Joint 
Executive Counsel under this subsection during the 
preceding year. 
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