IB 
Union Calendar No. 100 
110TH CONGRESS 
1ST SESSION H. R. 2199 
[Report No. 110–166] 
To amend title 38, United States Code, to direct the Secretary of Veterans 
Affairs to provide certain improvements in the treatment of individuals 
with traumatic brain injuries, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 8, 2007 
Mr. MICHAUD introduced the following bill; which was referred to the 
Committee on Veterans’ Affairs 
MAY 23, 2007 
Additional sponsors: Mr. MILLER of Florida, Mr. HARE, Ms. CORRINE BROWN 
of Florida, Ms. BERKLEY, Mr. ALTMIRE, Mr. WALSH of New York, Mr. 
HINCHEY, Mr. PATRICK MURPHY of Pennsylvania, Mr. WELCH of 
Vermont, Ms. SHEA-PORTER, Mr. MCGOVERN, Ms. EDDIE BERNICE 
JOHNSON of Texas, Mr. HOLT, Mr. HODES, Mr. MATHESON, Mr. 
PERLMUTTER, Mr. BRALEY of Iowa, Mr. WALZ of Minnesota, Mr. 
ELLISON, Mr. TAYLOR, Mr. MELANCON, Mr. BOREN, Mr. POMEROY, Mr. 
BOSWELL, Mr. DONNELLY, Mr. BILIRAKIS, Mr. MCDERMOTT, Mr. 
ENGEL, Mr. ALLEN, Mr. SOUDER, Mrs. BOYDA of Kansas, Mr. OBER-
STAR, Mr. BLUMENAUER, Mr. CUMMINGS, Mr. TIM MURPHY of Pennsyl-
vania, and Mr. SPRATT 
MAY 23, 2007 
Reported with amendments, committed to the Committee of the Whole House 
on the State of the Union, and ordered to be printed 
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[Omit the part struck through and insert the part printed in italic] 
A BILL 
To amend title 38, United States Code, to direct the Sec-
retary of Veterans Affairs to provide certain improve-
ments in the treatment of individuals with traumatic 
brain injuries, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Traumatic Brain In-
jury Health Enhancement and Long-Term Support Act of 
2007’’. 
SEC. 2. SCREENING, REHABILITATION, AND TREATMENT 
FOR TRAUMATIC BRAIN INJURY. 
(a) SCREENING, REHABILITATION, AND TREATMENT 
FOR TRAUMATIC BRAIN INJURY.— 
(1) IN
GENERAL.—Chapter 17 of title 38, 
United States Code, is amended by adding at the 
end the following new subchapter: 
‘‘SUBCHAPTER IX—TRAUMATIC BRAIN INJURY 
‘‘§ 1791. Screening for traumatic brain injuries 
‘‘(a) SCREENING PROGRAM.—The Secretary shall es-
tablish a program to screen veterans who are eligible for 
hospital care, medical services, and nursing home care 
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under section 1710(e)(1)(D) of this title for symptoms of 
traumatic brain injury. 
‘‘(b) REPORT.—Not later than one year after the 
date of the enactment of this section, and annually there-
after, the Secretary shall submit to the Committees on 
Veterans’ Affairs of the Senate and the House of Rep-
resentatives a report containing the following information: 
‘‘(1) The number of veterans screened under 
the program during the year preceding such report. 
‘‘(2) The prevalence of traumatic brain injury 
symptoms among the veterans screened under the 
program. 
‘‘(3) Recommendations for improving care and 
services to veterans exhibiting symptoms of trau-
matic brain injury. 
‘‘§ 1792. Comprehensive program for long-term trau-
matic brain injury rehabilitation 
‘‘(a) COMPREHENSIVE PROGRAM.—The Secretary 
shall develop and carry out a comprehensive program of 
long-term care for post-acute traumatic brain injury reha-
bilitation that includes residential, community, and home- 
based components utilizing interdisciplinary treatment 
teams. 
‘‘(b) LOCATION OF PROGRAM.—The Secretary shall 
carry out the program developed under subsection (a) in 
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four geographically dispersed polytrauma network sites 
designated by the Secretary. 
‘‘(c) ELIGIBILITY.—A veteran is eligible for care 
under the program developed under subsection (a) if the 
veteran is otherwise eligible for care under this chapter 
and— 
‘‘(1) served on active duty in a theater of com-
bat operations (as determined by the Secretary in 
consultation with the Secretary of Defense) during a 
period of war after the Persian Gulf War, or in com-
bat against a hostile force during a period of hos-
tilities (as defined in section 1712A(a)(2)(B) of this 
title) after November 11, 1998; 
‘‘(2) is diagnosed as suffering from moderate to 
severe traumatic brain injury; and 
‘‘(3) is unable to manage routine activities of 
daily living without supervision or assistance. 
‘‘(d) REPORT.—Not later than one year after the 
date of the enactment of this section, and annually there-
after, the Secretary shall submit to the Committees on 
Veterans’ Affairs of the Senate and the House of Rep-
resentatives a report containing the following information: 
‘‘(1) A description of the operation of the pro-
gram. 
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‘‘(2) The number of veterans provided care 
under the program during the year preceding such 
report. 
‘‘(3) The annual cost of operating the program. 
‘‘§ 1793. Traumatic brain injury transition offices 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish a traumatic brain injury transition office at each De-
partment polytrauma network site for the purposes of co-
ordinating the provision of health-care and services to vet-
erans who suffer from moderate to severe traumatic brain 
injuries and are in need of health-care and services not 
immediately offered by the Department. 
‘‘(b) COOPERATIVE AGREEMENTS.—The Secretary, 
through each such office established under subsection (a), 
shall have the authority to arrange for the provision of 
health-care and services through cooperative agreements 
with appropriate public or private entities that have estab-
lished long-term neurobehavioral rehabilitation and recov-
ery programs. 
‘‘§ 1794. Traumatic brain injury registry 
‘‘(a) IN GENERAL.—The Secretary shall establish 
and maintain a registry to be known as the ‘Traumatic 
Brain Injury Veterans’ Health Registry’ (in this section 
referred to as the ‘Registry’). 
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‘‘(b) DESCRIPTION.—The Registry shall include the 
following information: 
‘‘(1) A list containing the name of each indi-
vidual who served as a member of the Armed Forces 
in Operation Enduring Freedom or Operation Iraqi 
Freedom who exhibits symptoms associated with 
traumatic brain injury and who— 
‘‘(A) applies for care and services from the 
Department under this chapter; or 
‘‘(B) files a claim for compensation under 
chapter 11 of this title on the basis of any dis-
ability which may be associated with such serv-
ice; and 
‘‘(2) any relevant medical data relating to the 
health status of an individual described in paragraph 
(1) and any other information the Secretary con-
siders relevant and appropriate with respect to such 
an individual if the individual— 
‘‘(A) grants permission to the Secretary to 
include such information in the Registry; or 
‘‘(B) is deceased at the time such indi-
vidual is listed in the Registry. 
‘‘(c) NOTIFICATION.—The Secretary shall notify indi-
viduals listed in the Registry of significant developments 
in research on the health consequences of military service 
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in the Operation Enduring Freedom and Operation Iraqi 
Freedom theaters of operations. 
‘‘§ 1795. Centers for traumatic brain injury research, 
education, and clinical activities 
‘‘(a) PURPOSE.—The purpose of this section is to 
provide for the improvement of the provision of health care 
to eligible veterans with traumatic brain injuries 
through— 
‘‘(1) the conduct of research (including research 
on improving facilities of the Department concen-
trating on traumatic brain injury care and on im-
proving the delivery of traumatic brain injury care 
by the Department); 
‘‘(2) the education and training of health care 
personnel of the Department; and 
‘‘(3) the development of improved models and 
systems for the furnishing of traumatic brain injury 
care by the Department. 
‘‘(b) ESTABLISHMENT OF CENTERS.—(1) The Sec-
retary shall establish and operate centers for traumatic 
brain injury research, education, and clinical activities. 
Such centers shall be established and operated by collabo-
rating Department facilities as provided in subsection 
(c)(1). Each such center shall function as a center for— 
‘‘(A) research on traumatic brain injury; 
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‘‘(B) the use by the Department of specific 
models for furnishing traumatic brain injury care; 
‘‘(C) education and training of health-care pro-
fessionals of the Department; and 
‘‘(D) the development and implementation of 
innovative clinical activities and systems of care with 
respect to the delivery of traumatic brain injury care 
by the Department. 
‘‘(2) The Secretary shall, upon the recommendation 
of the Under Secretary for Health, designate the centers 
under this section. In making such designations, the Sec-
retary shall ensure that the centers designated are located 
in various geographic regions of the United States. The 
Secretary may designate a center under this section only 
if— 
‘‘(A) the proposal submitted for the designation 
of the center meets the requirements of subsection 
(c); 
‘‘(B) the Secretary makes the finding described 
in subsection (d); and 
‘‘(C) the peer review panel established under 
subsection (e) makes the determination specified in 
subsection (e)(3) with respect to that proposal. 
‘‘(3) Not more than five centers may be designated 
under this section. 
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‘‘(4) The authority of the Secretary to establish and 
operate centers under this section is subject to the appro-
priation of funds for that purpose. 
‘‘(c) PROPOSALS FOR DESIGNATION OF CENTERS.— 
A proposal submitted for the designation of a center under 
this section shall— 
‘‘(1) provide for close collaboration in the estab-
lishment and operation of the center, and for the 
provision of care and the conduct of research and 
education at the center, by a Department facility or 
facilities in the same geographic area which have a 
mission centered on traumatic brain injury care and 
a Department facility in that area which has a mis-
sion of providing tertiary medical care; 
‘‘(2) provide that no less than 50 percent of the 
funds appropriated for the center for support of clin-
ical care, research, and education will be provided to 
the collaborating facility or facilities that have a 
mission centered on traumatic brain injury care; and 
‘‘(3) provide for a governance arrangement be-
tween the collaborating Department facilities which 
ensures that the center will be established and oper-
ated in a manner aimed at improving the quality of 
traumatic brain injury care at the collaborating fa-
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cility or facilities which have a mission centered on 
traumatic brain injury care. 
‘‘(d) FINDING OF SECRETARY.—The finding referred 
to in subsection (b)(2)(B) with respect to a proposal for 
designation of a site as a location of a center under this 
section is a finding by the Secretary, upon the rec-
ommendation of the Under Secretary for Health, that the 
facilities submitting the proposal have developed (or may 
reasonably be anticipated to develop) each of the following: 
‘‘(1) An arrangement with an accredited med-
ical school that provides education and training in 
traumatic brain injury care and with which one or 
more of the participating Department facilities is af-
filiated under which medical residents receive edu-
cation and training in traumatic brain injury care 
through regular rotation through the participating 
Department facilities so as to provide such residents 
with training in the diagnosis and treatment of trau-
matic brain injury. 
‘‘(2) An arrangement under which nursing, so-
cial work, counseling, or allied health personnel re-
ceive training and education in traumatic brain in-
jury care through regular rotation through the par-
ticipating Department facilities. 
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‘‘(3) The ability to attract scientists who have 
demonstrated achievement in research— 
‘‘(A) into the evaluation of innovative ap-
proaches to the design of traumatic brain injury 
care; or 
‘‘(B) into the causes, prevention, and 
treatment of traumatic brain injury. 
‘‘(4) The capability to evaluate effectively the 
activities of the center, including activities relating 
to the evaluation of specific efforts to improve the 
quality and effectiveness of traumatic brain injury 
care provided by the Department at or through indi-
vidual facilities. 
‘‘(e) PEER REVIEW PANEL.—(1) In order to provide 
advice to assist the Secretary and the Under Secretary for 
Health to carry out their responsibilities under this sec-
tion, the official within the central office of the Veterans 
Health Administration responsible for traumatic brain in-
jury care shall establish a peer review panel to assess the 
scientific and clinical merit of proposals that are sub-
mitted to the Secretary for the designation of centers 
under this section. 
‘‘(2) The panel shall consist of experts in the fields 
of traumatic brain injury research, education and training, 
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and clinical care. Members of the panel shall serve as con-
sultants to the Department. 
‘‘(3) The panel shall review each proposal submitted 
to the panel by the official referred to in paragraph (1) 
and shall submit to that official its views on the relative 
scientific and clinical merit of each such proposal. The 
panel shall specifically determine with respect to each such 
proposal whether that proposal is among those proposals 
which have met the highest competitive standards of sci-
entific and clinical merit. 
‘‘(4) The panel shall not be subject to the Federal 
Advisory Committee Act (5 U.S.C. App.). 
‘‘(f) AWARD OF FUNDING.—Clinical and scientific in-
vestigation activities at each center established under this 
section— 
‘‘(1) may compete for the award of funding 
from amounts appropriated for the Department of 
Veterans Affairs medical and prosthetics research 
account; and 
‘‘(2) shall receive priority in the award of fund-
ing from such account insofar as funds are awarded 
to projects and activities relating to traumatic brain 
injury. 
‘‘(g) DISSEMINATION OF USEFUL INFORMATION.— 
The Under Secretary for Health shall ensure that infor-
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mation produced by the research, education and training, 
and clinical activities of centers established under this sec-
tion that may be useful for other activities of the Veterans 
Health Administration is disseminated throughout the 
Veterans Health Administration. Such dissemination shall 
be made through publications, through programs of con-
tinuing medical and related education provided through 
regional medical education centers under subchapter VI 
of chapter 74 of this title, and through other means. Such 
programs of continuing medical education shall receive 
priority in the award of funding. 
‘‘(h) SUPERVISION OF CENTERS.—The official within 
the central office of the Veterans Health Administration 
responsible for traumatic brain injury care shall be re-
sponsible for supervising the operation of the centers es-
tablished pursuant to this section and shall provide for 
ongoing evaluation of the centers and their compliance 
with the requirements of this section. 
‘‘(i) AUTHORIZATION
OF
APPROPRIATIONS.—(1) 
There are authorized to be appropriated to the Depart-
ment of Veterans Affairs for the basic support of the re-
search and education and training activities of centers es-
tablished pursuant to this section such sums as may be 
necessary. 
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‘‘(2) In addition to funds appropriated for a fiscal 
year pursuant to the authorization of appropriations in 
paragraph (1), the Under Secretary for Health shall allo-
cate to such centers from other funds appropriated for 
that fiscal year generally for the Department of Veterans 
Affairs medical services account and the Department of 
Veterans Affairs medical and prosthetics research account 
such amounts as the Under Secretary for Health deter-
mines appropriate to carry out the purposes of this sec-
tion. 
‘‘(j) ANNUAL REPORTS.—Not later than February 1 
of each of year, the Secretary of Veterans Affairs shall 
submit to the Committees on Veterans’ Affairs of the Sen-
ate and House of Representatives a report on the status 
and activities of the centers for traumatic brain injury re-
search, education, and clinical activities during the pre-
ceding fiscal year. Each such report shall include the fol-
lowing: 
‘‘(1) A description of the activities carried out 
at each center and the funding provided by the De-
partment for such activities. 
‘‘(2) A description of the advances made at 
each of the participating facilities of the center in 
research, education and training, and clinical activi-
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ties relating to traumatic brain injury care and 
treatment. 
‘‘(3) A description of the actions taken by the 
Under Secretary for Health pursuant to subsection 
(g) to disseminate information derived from such ac-
tivities throughout the Veterans Health Administra-
tion. 
‘‘(4) The evaluation of the Secretary as to the 
effectiveness of the centers in fulfilling the purposes 
of this section. 
‘‘(k) AUTHORIZATION
OF
APPROPRIATIONS.—(1) 
There are authorized to be appropriated to the Depart-
ment of Veterans Affairs for the basic support of the re-
search and education and training activities of centers es-
tablished pursuant to this section amounts as follows: 
‘‘(A) $10,000,000 for fiscal year 2008. 
‘‘(B) $20,000,000 for each of fiscal years 2009 
through 2011. 
‘‘(2) In addition to funds appropriated for a fiscal 
year pursuant to the authorization of appropriations in 
paragraph (1), the Under Secretary for Health shall allo-
cate to such centers from other funds appropriated for 
that fiscal year generally for the Department of Veterans 
Affairs medical services account and the Department of 
Veterans Affairs medical and prosthetics research account 
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such amounts as the Under Secretary for Health deter-
mines appropriate to carry out the purposes of this sec-
tion. 
‘‘§ 1796. Committee on Care of Veterans with Trau-
matic Brain Injury 
‘‘(a) ESTABLISHMENT.—The Secretary shall estab-
lish in the Veterans Health Administration a committee 
to be known as the ‘Committee on Care of Veterans with 
Traumatic Brain Injury’. The Under Secretary for Health 
shall appoint employees of the Department with expertise 
in the care of veterans with traumatic brain injury to serve 
on the committee. 
‘‘(b) RESPONSIBILITIES OF COMMITTEE.—The com-
mittee shall assess, and carry out a continuing assessment 
of, the capability of the Veterans Health Administration 
to meet effectively the treatment and rehabilitation needs 
of veterans with traumatic brain injury. In carrying out 
that responsibility, the committee shall— 
‘‘(1) evaluate the care provided to such veterans 
through the Veterans Health Administration; 
‘‘(2) identify systemwide problems in caring for 
such veterans in facilities of the Veterans Health 
Administration; 
‘‘(3) identify specific facilities within the Vet-
erans Health Administration at which program en-
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richment is needed to improve treatment and reha-
bilitation of such veterans; and 
‘‘(4) identify model programs which the com-
mittee considers to have been successful in the treat-
ment and rehabilitation of such veterans and which 
should be implemented more widely in or through fa-
cilities of the Veterans Health Administration. 
‘‘(c) ADVICE AND RECOMMENDATIONS.—The com-
mittee shall— 
‘‘(1) advise the Under Secretary regarding the 
development of policies for the care and rehabilita-
tion of veterans with traumatic brain injury; and 
‘‘(2) make recommendations to the Under Sec-
retary— 
‘‘(A) for improving programs of care of 
such veterans at specific facilities and through-
out the Veterans Health Administration; 
‘‘(B) for establishing special programs of 
education and training relevant to the care of 
such veterans for employees of the Veterans 
Health Administration; 
‘‘(C) regarding research needs and prior-
ities relevant to the care of such veterans; and 
‘‘(D) regarding the appropriate allocation 
of resources for all such activities. 
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‘‘(d) ANNUAL REPORT.—Not later than June 1 of 
2008, and each subsequent year, the Secretary shall sub-
mit to the Committees on Veterans’ Affairs of the Senate 
and House of Representatives a report on the implementa-
tion of this section. Each such report shall include the fol-
lowing for the calendar year preceding the year in which 
the report is submitted: 
‘‘(1) A list of the members of the committee. 
‘‘(2) The assessment of the Under Secretary for 
Health, after review of the initial findings of the 
committee, regarding the capability of the Veterans 
Health Administration, on a systemwide and facility- 
by-facility basis, to meet effectively the treatment 
and rehabilitation needs of veterans with traumatic 
brain injury. 
‘‘(3) The plans of the committee for further as-
sessments. 
‘‘(4) The findings and recommendations made 
by the committee to the Under Secretary for Health 
and the views of the Under Secretary on such find-
ings and recommendations. 
‘‘(5) A description of the steps taken, plans 
made (and a timetable for the execution of such 
plans), and resources to be applied toward improving 
the capability of the Veterans Health Administration 
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to meet effectively the treatment and rehabilitation 
needs of veterans with traumatic brain injury.’’. 
(2) CLERICAL AMENDMENT.—The table of con-
tents at the beginning of such chapter is amended 
by adding at the end the following new items: 
‘‘SUBCHAPTER IX—TRAUMATIC BRAIN INJURY 
‘‘1791. Screening for traumatic brain injuries. 
‘‘1792. Comprehensive program for long-term traumatic brain injury rehabilita-
tion. 
‘‘1793. Traumatic brain injury transition offices. 
‘‘1794. Traumatic brain injury registry. 
‘‘1795. Centers for traumatic brain injury research, education, and clinical ac-
tivities. 
‘‘1796. Committee on Care of Veterans with Traumatic Brain Injury.’’. 
(b) EFFECTIVE DATE.—The Secretary shall imple-
ment the requirements of subchapter IX of title 38, 
United States Code, as added by subsection (a), not later 
than 180 days after the date of the enactment of this Act. 
SEC. 3. PILOT PROGRAM FOR DELIVERY OF READJUST-
MENT
COUNSELING
AND
MENTAL
HEALTH 
SERVICES CERTAIN SERVICES TO VETERANS 
THROUGH MOBILE VET CENTERS. 
(a) PILOT PROGRAM.—Chapter 17 of title 38, United 
States Code, is amended by inserting after section 1712B 
the following new section: 
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