I 
108TH CONGRESS 
1ST SESSION H. R. 1998
To enhance and further research into paralysis and to improve rehabilitation 
and the quality of life for persons living with paralysis and other physical 
disabilities, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 7, 2003
Mr. BILIRAKIS (for himself, Mr. BROWN of Ohio, Mr. YOUNG of Florida, Mr. 
LANGEVIN, Mr. HOUGHTON, Mr. HOYER, Mr. GREENWOOD, Mr. WAX-
MAN, Mr. FOSSELLA, Mr. TOWNS, Mr. ENGEL, Mr. STRICKLAND, Mr. 
RUSH, Mr. EVANS, and Mr. FILNER) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committee on Veterans’ Affairs, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To enhance and further research into paralysis and to im-
prove rehabilitation and the quality of life for persons 
living with paralysis and other physical disabilities, 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 ‘‘Christopher Reeve Pa-
ralysis Act’’.
SEC. 2. TABLE OF CONTENTS.
Sec. 1. Short title. 
Sec. 2. Table of contents. 
TITLE I—PARALYSIS RESEARCH 
Sec. 101. Expansion and coordination of activities of the National Institutes of 
Health with respect to research on paralysis. 
TITLE II—PARALYSIS REHABILITATION RESEARCH AND CARE 
Sec. 201. Expansion and coordination of activities of the National Institutes of 
Health with respect to research with implications for enhancing 
daily function for persons with paralysis. 
TITLE III—IMPROVING QUALITY OF LIFE FOR PERSONS WITH 
PARALYSIS AND OTHER PHYSICAL DISABILITIES 
Sec. 301. Programs to improve quality of life for persons with paralysis and 
other physical disabilities. 
TITLE IV—ACTIVITIES OF THE DEPARTMENT OF VETERANS 
AFFAIRS 
Sec. 401. Expansion and coordination of activities of the Veterans Health Ad-
ministration.
TITLE I—PARALYSIS RESEARCH 
SEC. 101. EXPANSION AND COORDINATION OF ACTIVITIES 
OF THE NATIONAL INSTITUTES OF HEALTH 
WITH RESPECT TO RESEARCH ON PARALYSIS. 
(a) IN GENERAL.—
(1) ENHANCED
COORDINATION
OF
ACTIVI-
TIES.—The Director of the National Institutes of 
Health (in this section referred to as the ‘‘Director’’) 
may expand and coordinate the activities of such In-
stitutes with respect to research on paralysis. 
(2) ADMINISTRATION OF PROGRAM; COLLABO-
RATION AMONG AGENCIES.—The Director shall carry 
out this section acting through the Director of the
National Institute of Neurological Disorders and 
Stroke (in this section referred to as the ‘‘Institute’’) 
and in collaboration with any other agencies that the 
Director determines appropriate. 
(b) COORDINATION.—
(1) IN GENERAL.—The Director may develop 
mechanisms to coordinate the paralysis research and 
rehabilitation activities of the agencies of the Na-
tional Institutes of Health in order to further ad-
vance such activities and avoid duplication of activi-
ties. 
(2) REPORT.—Not later than December 1, 
2003, the Director shall prepare a report to Con-
gress that provides a description of the paralysis ac-
tivities of the Institute and strategies for future ac-
tivities. 
(c) CHRISTOPHER REEVE PARALYSIS RESEARCH 
CONSORTIA.—
(1) IN
GENERAL.—The Director may under 
subsection (a)(1) make awards of grants to public or 
nonprofit private entities to pay all or part of the 
cost of planning, establishing, improving, and pro-
viding basic operating support for consortia in paral-
ysis research. The Director shall designate each con-
sortium funded under grants as a Christopher Reeve 
Paralysis Research Consortium. 
(2) RESEARCH.—Each consortium under para-
graph (1)—
(A) may conduct basic and clinical paral-
ysis research; 
(B) may focus on advancing treatments 
and developing therapies in paralysis research; 
(C) may focus on one or more forms of pa-
ralysis that result from central nervous system 
trauma or stroke; 
(D) may facilitate and enhance the dis-
semination of clinical and scientific findings; 
and 
(E ) may replicate the findings of consortia 
members for scientific and translational pur-
poses. 
(3) COORDINATION OF CONSORTIA; REPORTS.—
The Director may, as appropriate, provide for the 
coordination of information among consortia under 
paragraph (1) and ensure regular communication 
between members of the consortia, and may require 
the periodic preparation of reports on the activities 
of the consortia and the submission of the reports to 
the Director.
(4) ORGANIZATION OF CONSORTIA.—Each con-
sortium under paragraph (1) may use the facilities 
of a single lead institution, or be formed from sev-
eral cooperating institutions, meeting such require-
ments as may be prescribed by the Director. 
(d) PUBLIC INPUT.—The Director may under sub-
section (a)(1) provide for a mechanism to educate and dis-
seminate information on the existing and planned pro-
grams and research activities of the National Institutes 
of Health with respect to paralysis and through which the 
Director can receive comments from the public regarding 
such programs and activities. 
(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2004 through 2007. Amounts ap-
propriated under this subsection are in addition to any 
other amounts appropriated for such purpose.
TITLE II—PARALYSIS REHABILI-
TATION RESEARCH AND CARE 
SEC. 201. EXPANSION AND COORDINATION OF ACTIVITIES 
OF THE NATIONAL INSTITUTES OF HEALTH 
WITH RESPECT TO RESEARCH WITH IMPLICA-
TIONS FOR ENHANCING DAILY FUNCTION 
FOR PERSONS WITH PARALYSIS. 
(a) IN GENERAL.—
(1) EXPANSION OF ACTIVITIES.—The Director 
of the National Institutes of Health (in this section 
referred to as the ‘‘Director’’) may expand and co-
ordinate the activities of such Institutes with respect 
to research with implications for enhancing daily 
function for people with paralysis. 
(2) ADMINISTRATION OF PROGRAM; COLLABO-
RATION AMONG AGENCIES.—The Director shall carry 
out this section acting through the Director of the 
National Institute on Child Health and Human De-
velopment and the National Center for Medical Re-
habilitation Research and in collaboration with the 
National Institute on Neurological Disorders and 
Stroke, the Centers for Disease Control and Preven-
tion, and any other agencies that the Director deter-
mines appropriate. 
(b) PARALYSIS CLINICAL TRIALS NETWORKS.—
(1) IN
GENERAL.—The Director may make 
awards of grants to public or nonprofit private enti-
ties to pay all or part of the costs of planning, estab-
lishing, improving, and providing basic operating 
support to multicenter networks of clinical sites that 
will collaborate to design clinical rehabilitation inter-
vention protocols and measures of outcomes on one 
or more forms of paralysis that result from central 
nervous system trauma, disorders, or stroke, or any 
combination of such conditions. 
(2) RESEARCH.—Each multicenter clinical trial 
network may—
(A) focus on areas of key scientific con-
cern, including—
(i) improving functional mobility; 
(ii) promoting behavioral adaptation 
to functional losses, especially to prevent 
secondary complications; 
(iii) assessing the efficacy and out-
comes of medical rehabilitation therapies 
and practices and assistive technologies; 
(iv) 
developing 
improved 
assistive 
technology to improve function and inde-
pendence; and
(v) understanding whole body system 
responses to physical impairments, disabil-
ities, and societal and functional limita-
tions; and 
(B) replicate the findings of network mem-
bers for scientific and translation purposes. 
(3) COORDINATION OF CLINICAL TRIALS NET-
WORKS.—The Director may, as appropriate, provide 
for the coordination of information among networks 
and ensure regular communication between members 
of the networks and may require the periodic prepa-
ration of reports on the activities of the networks 
and submission of reports to the Director. 
(c) REPORT.—Not later than December 1, 2003, the 
Director shall submit to the Congress a report that pro-
vides a description of research activities with implications 
for enhancing daily function for persons with paralysis. 
(d) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2004 through 2007. Amounts ap-
propriated under this subsection are in addition to any 
other amounts appropriated for such purpose.
TITLE III—IMPROVING QUALITY 
OF LIFE FOR PERSONS WITH 
PARALYSIS AND OTHER PHYS-
ICAL DISABILITIES 
SEC. 301. PROGRAMS TO IMPROVE QUALITY OF LIFE FOR 
PERSONS 
WITH 
PARALYSIS 
AND 
OTHER 
PHYSICAL DISABILITIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this Act referred to as the ‘‘Sec-
retary’’), acting through the Director of the Centers for 
Disease Control and Prevention, may study the unique 
health challenges associated with paralysis and other phys-
ical disabilities and carry out projects and interventions 
to improve the quality of life and long-term health status 
of persons with paralysis and other physical disabilities. 
The Secretary may carry out such projects directly and 
through awards of grants or contracts. 
(b) CERTAIN
ACTIVITIES.—Activities under sub-
section (a) include—
(1) the development of a national paralysis and 
physical disability quality of life action plan, to pro-
mote health and wellness in order to enhance full 
participation, independent living, self-sufficiency and 
equality of opportunity in partnership with voluntary 
health agencies focused on paralysis and other phys-
ical disabilities, to be carried out in coordination 
with the State-based Comprehensive Paralysis and 
Other Physical Disability Quality of Life Program of 
the Centers for Disease Control and Prevention; 
(2) support for programs to disseminate infor-
mation involving care and rehabilitation options and 
quality of life grant programs supportive of commu-
nity based programs and support systems for per-
sons with paralysis and other physical disabilities; 
(3) in collaboration with other centers and na-
tional voluntary health agencies, establish a hospital-
based paralysis registry and conduct relevant popu-
lation-based research; and 
(4) the development of comprehensive, unique 
and innovative programs, services, and demonstra-
tions within existing State-based disability and 
health programs of the Centers for Disease Control 
and Prevention which are designed to support and 
advance quality of life programs for persons living 
with paralysis and other physical disabilities focus-
ing on—
(A) caregiver education; 
(B) physical activity; 
(C) education and awareness programs for 
health care providers;
(D) prevention of secondary complications; 
(E) home and community-based interven-
tions; 
(F) coordinating services and removing 
barriers that prevent full participation and inte-
gration into the community; and 
(G) recognizing the unique needs of under-
served populations. 
(c) GRANTS.—The Secretary may award grants in ac-
cordance with the following: 
(1) To State and local health and disability 
agencies for the purpose of—
(A) establishing paralysis registries for the 
support of relevant population-based research; 
(B) developing comprehensive paralysis 
and other physical disability action plans and 
activities focused on the items listed in sub-
section (b)(4); 
(C) assisting State-based programs in es-
tablishing and implementing partnerships and 
collaborations that maximize the input and sup-
port of people with paralysis and other physical 
disabilities and their constituent organizations;
(D) coordinating paralysis and physical 
disability activities with existing state-based dis-
ability and health programs; 
(E) providing education and training op-
portunities and programs for health profes-
sionals and allied caregivers; and 
(F) developing, testing, evaluating, and 
replicating effective intervention programs to 
maintain or improve health and quality of life. 
(2) To nonprofit private health and disability 
organizations for the purpose of—
(A) disseminating information to the pub-
lic; 
(B) improving access to services for per-
sons living with paralysis and other physical 
disabilities and their caregivers; 
(C) testing model intervention programs to 
improve health and quality of life; and 
(D) coordinating existing services with 
state-based disability and health programs. 
(d) COORDINATION OF ACTIVITIES.—The Secretary 
shall assure that activities under this section are coordi-
nated as appropriate with other agencies of the Public 
Health Service.
(e) REPORT TO CONGRESS.—Not later than Decem-
ber 1, 2003, the Secretary shall submit to the Congress 
a report describing the results of the evaluation under sub-
section (a), and as applicable, the strategies developed 
under such subsection. 
(f) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2004 through 2007.
TITLE IV—ACTIVITIES OF THE 
DEPARTMENT OF VETERANS 
AFFAIRS 
SEC. 401. EXPANSION AND COORDINATION OF ACTIVITIES 
OF THE VETERANS HEALTH ADMINISTRA-
TION. 
(a) IN GENERAL.—
(1) ENHANCED
COORDINATION
OF
ACTIVI-
TIES.—The Secretary of Veterans Affairs may ex-
pand and coordinate activities of the Veterans 
Health Administration of the Department of Vet-
erans Affairs with respect to research on paralysis. 
(2) ADMINISTRATION OF PROGRAM.—The Sec-
retary shall carry out this section through the Direc-
tor of the Office of Research and Development of 
the Veterans Health Administration and in collabo-
ration with the National Institutes of Health and 
other agencies the Secretary determines appropriate. 
(b) ESTABLISHMENT
OF
PARALYSIS
RESEARCH, 
EDUCATION, AND CLINICAL CARE CENTER.—
(1) IN GENERAL.—The Secretary may establish 
within the Department of Veterans Affairs centers 
for paralysis research, education and clinical activi-
ties. Such centers shall be established at Depart-
ment medical centers through the award of grants to 
Department medical centers that are affiliated with 
medical schools or other organizations the Secretary 
considers appropriate. Such grants may be used to 
pay all or part of the cost of planning, establishing, 
improving, and providing basic operating support for 
such centers. 
(2) RESEARCH.—Each center under paragraph 
(1)—
(A) may focus on basic biomedical research 
on paralysis; 
(B) may focus on rehabilitation research 
on paralysis; 
(C) may focus on health services and clin-
ical trials for paralysis that result from central 
nervous system trauma or stroke;
(D) may facilitate and enhance the dis-
semination of clinical and scientific findings; 
and 
(E) may replicate the findings of centers 
for scientific and translational purposes. 
(3) COORDINATION
OF
CENTERS
INTO
CON-
SORTIA.—The Secretary may, as appropriate, pro-
vide for the linkage and coordination of information 
among centers under paragraph (1) in order to cre-
ate national consortia of centers and ensure regular 
communications between members of the centers. 
Each such consortium—
(A) may conduct large-scale clinical trials 
for greater statistical significance; 
(B) may operate in an interdisciplinary re-
habilitation team; 
(C) may focus on determining current 
standards of care and best practices; and 
(D) may identify research gaps for specific 
populations and identify future research needs. 
(4) ORGANIZATION OF CONSORTIA.—Each con-
sortium under paragraph (3) may use the facilities 
of a single lead institution, or be formed from sev-
eral cooperating institutions, meeting such require-
ment as prescribed by the Secretary.
(5) REPORTS.—The Secretary may require the 
periodic preparation of reports on the activities of 
the centers and consortia and submission of such re-
ports to the Secretary. 
(c) ESTABLISHMENT
OF QUALITY ENHANCEMENT 
RESEARCH INITIATIVES FOR PARALYSIS.—
(1) IN GENERAL.—The Secretary may carry out 
initiatives for quality enhancement of research on 
paralysis to translate clinical findings and rec-
ommendations into practices within the Veterans 
Health Administration. The Secretary shall carry 
out those initiatives through the award of grants to 
Department of Veterans Affairs medical centers that 
are affiliated with medical schools or other partners 
the Secretary considers appropriate. Such grants 
may be used to pay all or part of the cost of plan-
ning, establishing, improving and providing basic op-
erating support for the initiatives. 
(2) ACTIVITIES.—Each medical center for 
which funds are provided under paragraph (1)—
(A) may identify high-risk/high volume dis-
eases or problems; 
(B) may formulate evidence-based clinical 
research;
(C) may define existing practice patterns 
and outcomes across the Veterans Health Ad-
ministration and current variation from best 
practices; 
(D) may identify and implement interven-
tions (including performance criteria) to pro-
mote best practices; 
(E) may document that best practices im-
prove outcomes; 
(F) may document that improved patient 
outcomes are associated with improved health-
related quality of life; 
(G) may develop, test, and refine, and fa-
cilitate active distribution of, tools and products 
designed to promote clinical quality improve-
ments; 
(H) may plan and prepare to launch at 
least one project to implement and evaluate a 
quality enhancement intervention program for 
the translation of clinical research findings into 
routine clinical practice within the Administra-
tion; and 
(I) may compete for other Veterans Health 
Administration and non-Veterans Health Ad-
ministration research projects to leverage core 
support. 
(d) MAINTENANCE OF EFFORT.—The Secretary may 
make an award under this section only if, with respect 
to activities for which the award is authorized to be ex-
pended, the applicant for the award agrees to maintain 
expenditures of non-Federal amounts for such activities 
at a level that is not less than the level of such expendi-
tures maintained by the applicant for the fiscal year pre-
ceding the first fiscal year for which the entity receives 
such an award. 
(e) PUBLIC INPUT.—The Secretary may under sub-
sections (a)(1) and (c)(1) provide for a mechanism—
(1) to educate the public on, and disseminate 
information to the public on, the existing and 
planned programs and research activities of the Vet-
erans Health Administration with respect to paral-
ysis; and 
(2) through which the Secretary can receive 
comments from the public regarding those programs 
and activities. 
(f) AUTHORIZATION OF APPROPRIATIONS.—For the 
purposes of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of fiscal years 2004 through 2007. Amounts appro-
priated under this section are in addition to any other 
amounts appropriated for such purpose.
Æ
SEC. 2. TABLE OF CONTENTS.
Sec. 1. Short title. 
Sec. 2. Table of contents. 
TITLE I—PARALYSIS RESEARCH 
Sec. 101. Expansion and coordination of activities of the National Institutes of 
Health with respect to research on paralysis. 
TITLE II—PARALYSIS REHABILITATION RESEARCH AND CARE 
Sec. 201. Expansion and coordination of activities of the National Institutes of 
Health with respect to research with implications for enhancing 
daily function for persons with paralysis. 
TITLE III—IMPROVING QUALITY OF LIFE FOR PERSONS WITH 
PARALYSIS AND OTHER PHYSICAL DISABILITIES 
Sec. 301. Programs to improve quality of life for persons with paralysis and 
other physical disabilities. 
TITLE IV—ACTIVITIES OF THE DEPARTMENT OF VETERANS 
AFFAIRS 
Sec. 401. Expansion and coordination of activities of the Veterans Health Ad-
ministration.
TITLE I—PARALYSIS RESEARCH 
SEC. 101. EXPANSION AND COORDINATION OF ACTIVITIES 
OF THE NATIONAL INSTITUTES OF HEALTH 
WITH RESPECT TO RESEARCH ON PARALYSIS. 
(a) IN GENERAL.—
(1) ENHANCED
COORDINATION
OF
ACTIVI-
TIES.—The Director of the National Institutes of 
Health (in this section referred to as the ‘‘Director’’) 
may expand and coordinate the activities of such In-
stitutes with respect to research on paralysis. 
(2) ADMINISTRATION OF PROGRAM; COLLABO-
RATION AMONG AGENCIES.—The Director shall carry 
out this section acting through the Director of the
National Institute of Neurological Disorders and 
Stroke (in this section referred to as the ‘‘Institute’’) 
and in collaboration with any other agencies that the 
Director determines appropriate. 
(b) COORDINATION.—
(1) IN GENERAL.—The Director may develop 
mechanisms to coordinate the paralysis research and 
rehabilitation activities of the agencies of the Na-
tional Institutes of Health in order to further ad-
vance such activities and avoid duplication of activi-
ties. 
(2) REPORT.—Not later than December 1, 
2003, the Director shall prepare a report to Con-
gress that provides a description of the paralysis ac-
tivities of the Institute and strategies for future ac-
tivities. 
(c) CHRISTOPHER REEVE PARALYSIS RESEARCH 
CONSORTIA.—
(1) IN
GENERAL.—The Director may under 
subsection (a)(1) make awards of grants to public or 
nonprofit private entities to pay all or part of the 
cost of planning, establishing, improving, and pro-
viding basic operating support for consortia in paral-
ysis research. The Director shall designate each con-
sortium funded under grants as a Christopher Reeve 
Paralysis Research Consortium. 
(2) RESEARCH.—Each consortium under para-
graph (1)—
(A) may conduct basic and clinical paral-
ysis research; 
(B) may focus on advancing treatments 
and developing therapies in paralysis research; 
(C) may focus on one or more forms of pa-
ralysis that result from central nervous system 
trauma or stroke; 
(D) may facilitate and enhance the dis-
semination of clinical and scientific findings; 
and 
(E ) may replicate the findings of consortia 
members for scientific and translational pur-
poses. 
(3) COORDINATION OF CONSORTIA; REPORTS.—
The Director may, as appropriate, provide for the 
coordination of information among consortia under 
paragraph (1) and ensure regular communication 
between members of the consortia, and may require 
the periodic preparation of reports on the activities 
of the consortia and the submission of the reports to 
the Director.
(4) ORGANIZATION OF CONSORTIA.—Each con-
sortium under paragraph (1) may use the facilities 
of a single lead institution, or be formed from sev-
eral cooperating institutions, meeting such require-
ments as may be prescribed by the Director. 
(d) PUBLIC INPUT.—The Director may under sub-
section (a)(1) provide for a mechanism to educate and dis-
seminate information on the existing and planned pro-
grams and research activities of the National Institutes 
of Health with respect to paralysis and through which the 
Director can receive comments from the public regarding 
such programs and activities. 
(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2004 through 2007. Amounts ap-
propriated under this subsection are in addition to any 
other amounts appropriated for such purpose.
TITLE II—PARALYSIS REHABILI-
TATION RESEARCH AND CARE 
SEC. 201. EXPANSION AND COORDINATION OF ACTIVITIES 
OF THE NATIONAL INSTITUTES OF HEALTH 
WITH RESPECT TO RESEARCH WITH IMPLICA-
TIONS FOR ENHANCING DAILY FUNCTION 
FOR PERSONS WITH PARALYSIS. 
(a) IN GENERAL.—
(1) EXPANSION OF ACTIVITIES.—The Director 
of the National Institutes of Health (in this section 
referred to as the ‘‘Director’’) may expand and co-
ordinate the activities of such Institutes with respect 
to research with implications for enhancing daily 
function for people with paralysis. 
(2) ADMINISTRATION OF PROGRAM; COLLABO-
RATION AMONG AGENCIES.—The Director shall carry 
out this section acting through the Director of the 
National Institute on Child Health and Human De-
velopment and the National Center for Medical Re-
habilitation Research and in collaboration with the 
National Institute on Neurological Disorders and 
Stroke, the Centers for Disease Control and Preven-
tion, and any other agencies that the Director deter-
mines appropriate. 
(b) PARALYSIS CLINICAL TRIALS NETWORKS.—
(1) IN
GENERAL.—The Director may make 
awards of grants to public or nonprofit private enti-
ties to pay all or part of the costs of planning, estab-
lishing, improving, and providing basic operating 
support to multicenter networks of clinical sites that 
will collaborate to design clinical rehabilitation inter-
vention protocols and measures of outcomes on one 
or more forms of paralysis that result from central 
nervous system trauma, disorders, or stroke, or any 
combination of such conditions. 
(2) RESEARCH.—Each multicenter clinical trial 
network may—
(A) focus on areas of key scientific con-
cern, including—
(i) improving functional mobility; 
(ii) promoting behavioral adaptation 
to functional losses, especially to prevent 
secondary complications; 
(iii) assessing the efficacy and out-
comes of medical rehabilitation therapies 
and practices and assistive technologies; 
(iv) 
developing 
improved 
assistive 
technology to improve function and inde-
pendence; and
(v) understanding whole body system 
responses to physical impairments, disabil-
ities, and societal and functional limita-
tions; and 
(B) replicate the findings of network mem-
bers for scientific and translation purposes. 
(3) COORDINATION OF CLINICAL TRIALS NET-
WORKS.—The Director may, as appropriate, provide 
for the coordination of information among networks 
and ensure regular communication between members 
of the networks and may require the periodic prepa-
ration of reports on the activities of the networks 
and submission of reports to the Director. 
(c) REPORT.—Not later than December 1, 2003, the 
Director shall submit to the Congress a report that pro-
vides a description of research activities with implications 
for enhancing daily function for persons with paralysis. 
(d) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2004 through 2007. Amounts ap-
propriated under this subsection are in addition to any 
other amounts appropriated for such purpose.
TITLE III—IMPROVING QUALITY 
OF LIFE FOR PERSONS WITH 
PARALYSIS AND OTHER PHYS-
ICAL DISABILITIES 
SEC. 301. PROGRAMS TO IMPROVE QUALITY OF LIFE FOR 
PERSONS 
WITH 
PARALYSIS 
AND 
OTHER 
PHYSICAL DISABILITIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this Act referred to as the ‘‘Sec-
retary’’), acting through the Director of the Centers for 
Disease Control and Prevention, may study the unique 
health challenges associated with paralysis and other phys-
ical disabilities and carry out projects and interventions 
to improve the quality of life and long-term health status 
of persons with paralysis and other physical disabilities. 
The Secretary may carry out such projects directly and 
through awards of grants or contracts. 
(b) CERTAIN
ACTIVITIES.—Activities under sub-
section (a) include—
(1) the development of a national paralysis and 
physical disability quality of life action plan, to pro-
mote health and wellness in order to enhance full 
participation, independent living, self-sufficiency and 
equality of opportunity in partnership with voluntary 
health agencies focused on paralysis and other phys-
ical disabilities, to be carried out in coordination 
with the State-based Comprehensive Paralysis and 
Other Physical Disability Quality of Life Program of 
the Centers for Disease Control and Prevention; 
(2) support for programs to disseminate infor-
mation involving care and rehabilitation options and 
quality of life grant programs supportive of commu-
nity based programs and support systems for per-
sons with paralysis and other physical disabilities; 
(3) in collaboration with other centers and na-
tional voluntary health agencies, establish a hospital-
based paralysis registry and conduct relevant popu-
lation-based research; and 
(4) the development of comprehensive, unique 
and innovative programs, services, and demonstra-
tions within existing State-based disability and 
health programs of the Centers for Disease Control 
and Prevention which are designed to support and 
advance quality of life programs for persons living 
with paralysis and other physical disabilities focus-
ing on—
(A) caregiver education; 
(B) physical activity; 
(C) education and awareness programs for 
health care providers;
(D) prevention of secondary complications; 
(E) home and community-based interven-
tions; 
(F) coordinating services and removing 
barriers that prevent full participation and inte-
gration into the community; and 
(G) recognizing the unique needs of under-
served populations. 
(c) GRANTS.—The Secretary may award grants in ac-
cordance with the following: 
(1) To State and local health and disability 
agencies for the purpose of—
(A) establishing paralysis registries for the 
support of relevant population-based research; 
(B) developing comprehensive paralysis 
and other physical disability action plans and 
activities focused on the items listed in sub-
section (b)(4); 
(C) assisting State-based programs in es-
tablishing and implementing partnerships and 
collaborations that maximize the input and sup-
port of people with paralysis and other physical 
disabilities and their constituent organizations;
(D) coordinating paralysis and physical 
disability activities with existing state-based dis-
ability and health programs; 
(E) providing education and training op-
portunities and programs for health profes-
sionals and allied caregivers; and 
(F) developing, testing, evaluating, and 
replicating effective intervention programs to 
maintain or improve health and quality of life. 
(2) To nonprofit private health and disability 
organizations for the purpose of—
(A) disseminating information to the pub-
lic; 
(B) improving access to services for per-
sons living with paralysis and other physical 
disabilities and their caregivers; 
(C) testing model intervention programs to 
improve health and quality of life; and 
(D) coordinating existing services with 
state-based disability and health programs. 
(d) COORDINATION OF ACTIVITIES.—The Secretary 
shall assure that activities under this section are coordi-
nated as appropriate with other agencies of the Public 
Health Service.
(e) REPORT TO CONGRESS.— Not later than Decem-
ber 1, 2003, the Secretary shall submit to the Congress 
a report describing the results of the evaluation under sub-
section (a), and as applicable, the strategies developed 
under such subsection. 
(f) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2004 through 2007.
TITLE IV—ACTIVITIES OF THE 
DEPARTMENT OF VETERANS 
AFFAIRS 
SEC. 401. EXPANSION AND COORDINATION OF ACTIVITIES 
OF THE VETERANS HEALTH ADMINISTRA-
TION. 
(a) IN GENERAL.—
(1) ENHANCED
COORDINATION
OF
ACTIVI-
TIES.—The Secretary of Veterans Affairs may ex-
pand and coordinate activities of the Veterans 
Health Administration of the Department of Vet-
erans Affairs with respect to research on paralysis. 
(2) ADMINISTRATION OF PROGRAM.—The Sec-
retary shall carry out this section through the Direc-
tor of the Office of Research and Development of 
the Veterans Health Administration and in collabo-
ration with the National Institutes of Health and 
other agencies the Secretary determines appropriate. 
(b) ESTABLISHMENT
OF
PARALYSIS
RESEARCH, 
EDUCATION, AND CLINICAL CARE CENTER.—
(1) IN GENERAL.—The Secretary may establish 
within the Department of Veterans Affairs centers 
for paralysis research, education and clinical activi-
ties. Such centers shall be established at Depart-
ment medical centers through the award of grants to 
Department medical centers that are affiliated with 
medical schools or other organizations the Secretary 
considers appropriate. Such grants may be used to 
pay all or part of the cost of planning, establishing, 
improving, and providing basic operating support for 
such centers. 
(2) RESEARCH.—Each center under paragraph 
(1)—
(A) may focus on basic biomedical research 
on paralysis; 
(B) may focus on rehabilitation research 
on paralysis; 
(C) may focus on health services and clin-
ical trials for paralysis that result from central 
nervous system trauma or stroke;
(D) may facilitate and enhance the dis-
semination of clinical and scientific findings; 
and 
(E) may replicate the findings of centers 
for scientific and translational purposes. 
(3) COORDINATION
OF
CENTERS
INTO
CON-
SORTIA.—The Secretary may, as appropriate, pro-
vide for the linkage and coordination of information 
among centers under paragraph (1) in order to cre-
ate national consortia of centers and ensure regular 
communications between members of the centers. 
Each such consortium—
(A) may conduct large-scale clinical trials 
for greater statistical significance; 
(B) may operate in an interdisciplinary re-
habilitation team; 
(C) may focus on determining current 
standards of care and best practices; and 
(D) may identify research gaps for specific 
populations and identify future research needs. 
(4) ORGANIZATION OF CONSORTIA.—Each con-
sortium under paragraph (3) may use the facilities 
of a single lead institution, or be formed from sev-
eral cooperating institutions, meeting such require-
ment as prescribed by the Secretary.
(5) REPORTS.—The Secretary may require the 
periodic preparation of reports on the activities of 
the centers and consortia and submission of such re-
ports to the Secretary. 
(c) ESTABLISHMENT
OF QUALITY ENHANCEMENT 
RESEARCH INITIATIVES FOR PARALYSIS.—
(1) IN GENERAL.—The Secretary may carry out 
initiatives for quality enhancement of research on 
paralysis to translate clinical findings and rec-
ommendations into practices within the Veterans 
Health Administration. The Secretary shall carry 
out those initiatives through the award of grants to 
Department of Veterans Affairs medical centers that 
are affiliated with medical schools or other partners 
the Secretary considers appropriate. Such grants 
may be used to pay all or part of the cost of plan-
ning, establishing, improving and providing basic op-
erating support for the initiatives. 
(2) ACTIVITIES.—Each medical center for 
which funds are provided under paragraph (1)—
(A) may identify high-risk/high volume dis-
eases or problems; 
(B) may formulate evidence-based clinical 
research;
(C) may define existing practice patterns 
and outcomes across the Veterans Health Ad-
ministration and current variation from best 
practices; 
(D) may identify and implement interven-
tions (including performance criteria) to pro-
mote best practices; 
(E) may document that best practices im-
prove outcomes; 
(F) may document that improved patient 
outcomes are associated with improved health-
related quality of life; 
(G) may develop, test, and refine, and fa-
cilitate active distribution of, tools and products 
designed to promote clinical quality improve-
ments; 
(H) may plan and prepare to launch at 
least one project to implement and evaluate a 
quality enhancement intervention program for 
the translation of clinical research findings into 
routine clinical practice within the Administra-
tion; and 
(I) may compete for other Veterans Health 
Administration and non-Veterans Health Ad-
ministration research projects to leverage core 
support. 
(d) MAINTENANCE OF EFFORT.—The Secretary may 
make an award under this section only if, with respect 
to activities for which the award is authorized to be ex-
pended, the applicant for the award agrees to maintain 
expenditures of non-Federal amounts for such activities 
at a level that is not less than the level of such expendi-
tures maintained by the applicant for the fiscal year pre-
ceding the first fiscal year for which the entity receives 
such an award. 
(e) PUBLIC INPUT.—The Secretary may under sub-
sections (a)(1) and (c)(1) provide for a mechanism—
(1) to educate the public on, and disseminate 
information to the public on, the existing and 
planned programs and research activities of the Vet-
erans Health Administration with respect to paral-
ysis; and 
(2) through which the Secretary can receive 
comments from the public regarding those programs 
and activities. 
(f) AUTHORIZATION OF APPROPRIATIONS.—For the 
purposes of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of fiscal years 2004 through 2007. Amounts appro-
priated under this section are in addition to any other 
amounts appropriated for such purpose.
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