II
104TH CONGRESS
2D SESSION
H. R. 248
IN THE SENATE OF THE UNITED STATES
JULY 10, 1996
Received
AN ACT
To amend the Public Health Service Act to provide for
the conduct of expanded studies and the establishment
of innovative programs with respect to traumatic brain
injury, 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. PROGRAMS OF CENTERS FOR DISEASE CON-
TROL AND PREVENTION.
Part J of title III of the Public Health Service Act
(42 U.S.C. 280b et seq.) is amended by inserting after
section 393 the following section:
‘‘PREVENTION OF TRAUMATIC BRAIN INJURY
‘‘SEC. 393A. (a) IN GENERAL.—The Secretary, act-
ing through the Director of the Centers for Disease Con-
trol and Prevention, may carry out projects to reduce the
incidence of traumatic brain injury. Such projects may be
carried out by the Secretary directly or through awards
of grants or contracts to public or nonprofit private enti-
ties. The Secretary may directly or through such awards
provide technical assistance with respect to the planning,
development, and operation of such projects.
‘‘(b) CERTAIN ACTIVITIES.—Activities under sub-
section (a) may include—
‘‘(1) the conduct of research into identifying ef-
fective strategies for the prevention of traumatic
brain injury; and
‘‘(2) the implementation of public information
and education programs for the prevention of such
injury and for broadening the awareness of the pub-
lic concerning the public health consequences of such
injury.
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‘‘(c) COORDINATION OF ACTIVITIES.—The Secretary
shall ensure that activities under this section are coordi-
nated as appropriate with other agencies of the Public
Health Service that carry out activities regarding trau-
matic brain injury.
‘‘(d) DEFINITION.—For purposes of this section, the
term ‘traumatic brain injury’ means an acquired injury
to the brain. Such term does not include brain dysfunction
caused by congenital or degenerative disorders, nor birth
trauma, but may include brain injuries caused by anoxia
due to near drowning. The Secretary may revise the defi-
nition of such term as the Secretary determines
necessary.’’.
SEC. 2. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.
Section 1261 of the Public Health Service Act (42
U.S.C. 300d–61) is amended—
(1) in subsection (d)—
(A) in paragraph (2), by striking ‘‘and’’
after the semicolon at the end;
(B) in paragraph (3), by striking the pe-
riod and inserting ‘‘; and’’; and
(C) by adding at the end the following
paragraph:
‘‘(4) the authority to make awards of grants or
contracts to public or nonprofit private entities for
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the conduct of basic and applied research regarding
traumatic brain injury, which research may in-
clude—
‘‘(A) the development of new methods and
modalities for the more effective diagnosis,
measurement of degree of injury, post-injury
monitoring and prognostic assessment of head
injury for acute, subacute and later phases of
care;
‘‘(B) the development, modification and
evaluation of therapies that retard, prevent or
reverse brain damage after acute head injury,
that arrest further deterioration following in-
jury and that provide the restitution of function
for individuals with long-term injuries;
‘‘(C) the development of research on a con-
tinuum of care from acute care through reha-
bilitation, designed, to the extent practicable, to
integrate rehabilitation and long-term outcome
evaluation with acute care research; and
‘‘(D) the development of programs that in-
crease the participation of academic centers of
excellence in head injury treatment and reha-
bilitation research and training.’’; and
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(2) in subsection (h), by adding at the end the
following paragraph:
‘‘(4) The term ‘traumatic brain injury’ means
an acquired injury to the brain. Such term does not
include brain dysfunction caused by congenital or
degenerative disorders, nor birth trauma, but may
include brain injuries caused by anoxia due to near
drowning. The Secretary may revise the definition of
such term as the Secretary determines necessary.’’.
SEC. 3. PROGRAMS OF HEALTH RESOURCES AND SERVICES
ADMINISTRATION.
Part E of title XII of the Public Health Service Act
(42 U.S.C. 300d–51 et seq.) is amended by adding at the
end the following section:
‘‘SEC. 
1252. 
STATE 
GRANTS 
FOR 
DEMONSTRATION
PROJECTS REGARDING TRAUMATIC BRAIN
INJURY.
‘‘(a) IN GENERAL.—The Secretary, acting through
the Administrator of the Health Resources and Services
Administration, may make grants to States for the pur-
pose of carrying out demonstration projects to improve ac-
cess to health and other services regarding traumatic
brain injury.
‘‘(b) STATE ADVISORY BOARD.—
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‘‘(iii) other disability advisory or plan-
ning groups within the State;
‘‘(iv) members of an organization or
foundation representing traumatic brain
injury survivors in that State; and
‘‘(v) injury control programs at the
State or local level if such programs exist;
and
‘‘(B) a substantial number of individuals
who are survivors of traumatic brain injury, or
the family members of such individuals.
‘‘(c) MATCHING FUNDS.—
‘‘(1) IN GENERAL.—With respect to the costs to
be incurred by a State in carrying out the purpose
described in subsection (a), the Secretary may make
a grant under such subsection only if the State
agrees to make available, in cash, non-Federal con-
tributions toward such costs in an amount that is
not less than $1 for each $2 of Federal funds pro-
vided under the grant.
‘‘(2) DETERMINATION
OF
AMOUNT
CONTRIB-
UTED.—In determining the amount of non-Federal
contributions in cash that a State has provided pur-
suant to paragraph (1), the Secretary may not in-
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clude any amounts provided to the State by the Fed-
eral Government.
‘‘(d) APPLICATION FOR GRANT.—The Secretary may
make a grant under subsection (a) only if an application
for the grant is submitted to the Secretary and the appli-
cation is in such form, is made in such manner, and con-
tains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this sec-
tion.
‘‘(e) COORDINATION OF ACTIVITIES.—The Secretary
shall ensure that activities under this section are coordi-
nated as appropriate with other agencies of the Public
Health Service that carry out activities regarding trau-
matic brain injury.
‘‘(f) REPORT.—Not later than 2 years after the date
of the enactment of this section, the Secretary shall sub-
mit to the Committee on Commerce of the House of Rep-
resentatives, and to the Committee on Labor and Human
Resources of the Senate, a report describing the findings
and results of the programs established under this section,
including measures of outcomes and consumer and surro-
gate satisfaction.
‘‘(g) DEFINITION.—For purposes of this section, the
term ‘traumatic brain injury’ means an acquired injury
to the brain. Such term does not include brain dysfunction
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caused by congenital or degenerative disorders, nor birth
trauma, but may include brain injuries caused by anoxia
due to near drowning. The Secretary may revise the defi-
nition of such term as the Secretary determines necessary.
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there is authorized
to be appropriated $5,000,000 for each of the fiscal years
1997 through 1999.’’.
SEC. 4. STUDY; CONSENSUS CONFERENCE.
(a) STUDY.—
(1) IN GENERAL.—The Secretary of Health and
Human Services (in this section referred to as the
‘‘Secretary’’), acting through the appropriate agen-
cies of the Public Health Service, shall conduct a
study for the purpose of carrying out the following
with respect to traumatic brain injury:
(A) In collaboration with appropriate State
and local health-related agencies—
(i) determine the incidence and preva-
lence of traumatic brain injury; and
(ii) develop a uniform reporting sys-
tem under which States report incidents of
traumatic brain injury, if the Secretary de-
termines that such a system is appropriate.
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(B) Identify common therapeutic interven-
tions which are used for the rehabilitation of in-
dividuals with such injuries, and shall, subject
to the availability of information, include an
analysis of—
(i) the effectiveness of each such
intervention in improving the functioning
of individuals with brain injuries;
(ii) the comparative effectiveness of
interventions employed in the course of re-
habilitation of individuals with brain inju-
ries to achieve the same or similar clinical
outcome; and
(iii) the adequacy of existing measures
of outcomes and knowledge of factors in-
fluencing differential outcomes.
(C) Develop practice guidelines for the re-
habilitation of traumatic brain injury at such
time as appropriate scientific research becomes
available.
(2) DATES CERTAIN FOR REPORTS.—
(A) Not later than 18 months after the
date of the enactment of this Act, the Secretary
shall submit to the Committee on Commerce of
the House of Representatives, and to the Com-
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mittee on Labor and Human Resources of the
Senate, a report describing the findings made
as a result of carrying out paragraph (1)(A).
(B) Not later than 3 years after the date
of the enactment of this Act, the Secretary shall
submit to the Committees specified in subpara-
graph (A) a report describing the findings made
as a result of carrying out subparagraphs (B)
and (C) of paragraph (1).
(b) CONSENSUS CONFERENCE.—The Secretary, act-
ing through the Director of the National Center for Medi-
cal Rehabilitation Research within the National Institute
for Child Health and Human Development, shall conduct
a national consensus conference on managing traumatic
brain injury and related rehabilitation concerns.
(c) DEFINITION.—For purposes of this section, the
term ‘‘traumatic brain injury’’ means an acquired injury
to the brain. Such term does not include brain dysfunction
caused by congenital or degenerative disorders, nor birth
trauma, but may include brain injuries caused by anoxia
due to near drowning. The Secretary may revise the defi-
nition of such term as the Secretary determines necessary.
(d) AUTHORIZATIONS OF APPROPRIATIONS.—For the
purpose of carrying out subsection (a)(1)(A), there is au-
thorized to be appropriated $3,000,000 for each of the fis-
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cal years 1997 through 1999. For the purpose of carrying
out the other provisions of this section, there is authorized
to be appropriated an aggregate $500,000 for the fiscal
years 1997 through 1999. Amounts appropriated for such
other provisions remain available until expended.
SEC. 5. TECHNICAL AMENDMENTS.
Title XXVI of the Public Health Service Act (42
U.S.C. 300ff–11 et seq.), as amended by Public Law 104–
146 (the Ryan White CARE Act Amendments of 1996),
is amended—
(1) in section 2626—
(A) in subsection (d), in the first sentence,
by striking ‘‘(1) through (5)’’ and inserting
‘‘(1) through (4)’’; and
(B) in subsection (f), in the matter preced-
ing paragraph (1), by striking ‘‘(1) through
(5)’’ and inserting ‘‘(1) through (4)’’; and
(2) in section 2692—
(A) in subsection (a)(1)(A)—
(i) by striking ‘‘title XXVI programs’’
and inserting ‘‘programs under this title’’;
and
(ii) by striking ‘‘infection and’’; and
(B) by striking subsection (c) and all that
follows and inserting the following:
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‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) SCHOOLS; CENTERS.—For the purpose of
grants under subsection (a), there are authorized to
be appropriated such sums as may be necessary for
each of the fiscal years 1996 through 2000.
‘‘(2) DENTAL SCHOOLS.—For the purpose of
grants under subsection (b), there are authorized to
be appropriated such sums as may be necessary for
each of the fiscal years 1996 through 2000.’’.
Passed the House of Representatives July 9, 1996.
Attest:
ROBIN H. CARLE,
Clerk.