‘‘(C) OUT-OF-STATE
PLACEMENTS
FOR
RESIDENTIAL
REHABILITATION
SERVICES.—In
accordance with standards established by the
State coordinator, a State case management
program may approve the use of funds provided
under the State plan for medical assistance
under this title to pay for out-of-State place-
ments for residential rehabilitation services.
‘‘(3) SPECIAL RULE FOR PROVIDERS OF LIVING
SERVICES.—No living services described in para-
graph (1) may be provided to or on behalf of any
individual under this section unless the State case-
management program with which the individual is
enrolled has entered into an agreement with the en-
tity providing such services that specifies—
‘‘(A) the living services to be provided,
‘‘(B) the period of time over which such
services will be provided, and
‘‘(C) the charges to the patient for provid-
ing such services.
‘‘(d) ELIGIBILITY
OF INDIVIDUALS TO RECEIVE
SERVICES.—
‘‘(1) IN GENERAL.—An individual is eligible to
receive case-management services under this section
if the individual resides in a State that has imple-
mented a case-management program that meets the
requirements of this section, is eligible to receive
medical assistance under a State plan under this
title, has suffered a traumatic brain injury (as de-
fined in paragraph (2)), and is moderately or se-
verely disabled (as defined in paragraph (3)).
‘‘(2) TRAUMATIC
BRAIN
INJURY
DEFINED.—
For purposes of this section, the term ‘traumatic
brain injury’ means a sudden insult or damage to
the brain or its coverings caused by an external
physical force which may produce a diminished or al-
tered state of consciousness, and which results in a
temporary or permanent impairment of cognitive or
mental abilities or physical functioning, or disturb-
ance of behavioral or emotional functioning. Such
term does not include any injuries of a degenerative
or congenital nature.
‘‘(3) DEFINITIONS RELATING TO MODERATELY
OR SEVERELY DISABLED INDIVIDUALS.—
‘‘(A) IN GENERAL.—For purposes of this
section, the term ‘moderately or severely dis-
abled’ means in the case of an individual 6
years of age or older, an individual who (with-
out regard to income or employment status) is
certified under the case-management program
as—
‘‘(i) needing substantial assistance or
supervision from another individual with at
least 2 activities of daily living (as defined
in subparagraph (C));
‘‘(ii) needing substantial supervision
due to cognitive or other mental impair-
ment and needing substantial assistance or
supervision from another individual with at
least 1 activity of daily living or in comply-
ing with a daily drug regimen; or
‘‘(iii) needing substantial supervision
from another individual due to behaviors
that are dangerous (to the individual or
others), disruptive, or difficult to manage.
‘‘(B) MODERATELY
OR
SEVERELY
DIS-
ABLED CHILD.—
‘‘(i) IN
GENERAL.—For purposes of
this section, the term ‘moderately or se-
verely disabled’ means, in the case of an
individual under 6 years of age, an individ-
ual who is certified under the State case
management program as suffering from
comparable levels of disability which would
entitle such individual to benefits under
this title.
‘‘(ii) COMPARABLE
LEVELS
OF
DIS-
ABILITY.—For purposes of clause (i), the
term ‘comparable levels of disability’
means physical, cognitive, or other mental
impairments that limit the ability of an in-
dividual who is under 6 years of age to
perform activities of daily living appro-
priate for the age of the individual that are
comparable to the physical, cognitive, or
other mental impairments that limit the
ability of an individual 6 years of age or
older such that the individual is described
in clause (i), (ii), or (iii) of subparagraph
(A).
‘‘(C) ACTIVITY
OF
DAILY
LIVING
DE-
FINED.—For purposes of this section, the term
‘activity of daily living’ means any of the follow-
ing activities:
‘‘(i) Bathing.
‘‘(ii) Dressing.
‘‘(iii) Transferring.
‘‘(iv) Toileting.
‘‘(v) Eating.
‘‘(4) COVERAGE OF INDIVIDUALS UNDER DIS-
ABILITY PROTECTIONS.—Individuals receiving serv-
ices through a State case-management program
under this section shall be considered to be individ-
uals with disabilities for purposes of the Americans
with Disabilities Act of 1990.
‘‘(e) ADDITIONAL DUTIES
OF STATE COORDINA-
TOR.—
‘‘(1) PREVENTION
OF
TRAUMATIC
BRAIN
IN-
JURY.—The State coordinator shall establish a pro-
gram of activities related to preventing and reducing
the rate of traumatic brain injuries in the State.
‘‘(2) TRAUMATIC BRAIN INJURY REGISTRY.—
‘‘(A) IN GENERAL.—The State coordinator
shall establish and maintain a central registry
of individuals who sustain traumatic brain in-
jury using standards established by the Sec-
retary under subsection (f) in order to—
‘‘(i) collect information to facilitate
the development of injury prevention,
treatment, and rehabilitation programs;
and
‘‘(ii) ensure the provision to individ-
uals with traumatic brain injury of infor-
mation regarding appropriate public or pri-
vate agencies that provide rehabilitative
services so that injured individuals may ob-
tain needed service to alleviate injuries and
avoid secondary problems, such as mental
illness and chemical dependency.
‘‘(B) 
DISSEMINATION
OF
DATA.—The
State coordinator shall provide summary reg-
istry data to public and private entities to con-
duct studies using data collected by the trau-
matic brain injury registry established under
subparagraph (A). The State coordinator may
charge a fee for all expenses associated with the
provision of data or data analysis.
‘‘(3) NOTIFICATION
OF
INJURIES
TO
JOB
TRAINING PROGRAMS.—Within a reasonable period
of time after receiving a report that an individual
has sustained a traumatic brain injury, the State co-
ordinator shall notify any State agency responsible
for employment services and job training and shall
forward the individual’s name and other identifying
information to such agency.
‘‘(4) STANDARDS
FOR
MARKETING
OF
BRAIN
INJURY
SERVICES.—The State coordinator, after
consultation with the advisory committee established
under paragraph (6), shall—
‘‘(A) monitor standards established by the
Secretary regarding the marketing of services
(by hospitals and other providers) to any indi-
vidual who has sustained traumatic brain injury
or family members of such individual,
‘‘(B) disseminate such standards to State
case-management programs, and
‘‘(C) furnish information about such stand-
ards to such individual and such family mem-
bers at the earliest appropriate opportunity
after such individual has sustained the injury.
Such standards shall include (at a minimum) a rule
prohibiting payments under a State case-manage-
ment program under this section for referring indi-
viduals to rehabilitation facilities.
‘‘(5) STUDIES.—The State coordinator shall
collect injury incidence information (including the
prevalence, prevention, and treatment of traumatic
brain injury), analyze the information, and conduct
special studies regarding traumatic brain injury.
‘‘(6) ESTABLISHMENT
OF
ADVISORY
COMMIT-
TEE.—The State coordinator shall establish an advi-
sory committee (consisting of representatives of pro-
fessionals who provide community-based services
under this section and individuals with traumatic
brain injuries and family members of such individ-
uals) to provide recommendations regarding the
needs of individuals with traumatic brain injuries,
provide advice on activities under paragraph (1), and
assist in the establishment of marketing standards
under paragraph (4).
‘‘(7) PRIVACY.—Any data identifying specific
individuals which is collected by or provided to the
State coordinator may be used only for purposes of
case-management and rehabilitation and studies by
the State coordinator, in accordance with rules
adopted by the State coordinator.
‘‘(8) ADOPTION OF STANDARDS FOR REPORT-
ING
DATA
AND
OPERATION
OF
REGISTRIES.—The
State coordinator shall adopt such standards estab-
lished under subsection (f) as are necessary to carry
out this subsection. At a minimum, the State coordi-
nator shall adopt the standards relating to the mat-
ters identified in subparagraphs (A) through (E) of
subsection (f)(2).
‘‘(9) ESTABLISHMENT
OF
REPORTING
SYS-
TEM.—
‘‘(A) IN GENERAL.—The State coordinator
shall design and establish a reporting system
which requires either the treating hospital, med-
ical facility, or physician to report to the State
coordinator within a reasonable period of time
after the identification of any individual with
ICD diagnostic codes treated for a traumatic
brain injury in the State. The consent of the in-
jured individual is not required.
‘‘(B) REPORT.—A report under subpara-
graph (A) shall include—
‘‘(i) the name, age, and residence of
the injured individual;
‘‘(ii) the date and cause of the injury;
‘‘(iii) the initial diagnosis; and
‘‘(iv) other information required by
the State coordinator.
‘‘(C) LIABILITY
PROTECTION.—The fur-
nishing of information pursuant to the system
established under subparagraph (A) shall not
subject any individual or facility to any action
for damages or other relief, provided that the
individual or facility acted in good faith in fur-
nishing the information.
‘‘(f) STANDARDS FOR REPORTING DATA AND OPER-
ATION OF REGISTRIES.—
‘‘(1) IN GENERAL.—Not later than January 1,
1995, the Secretary of Health and Human Services,
acting through the Director of the Centers for Dis-
ease Control and Prevention, shall establish stand-
ards for the reporting of data on traumatic brain in-
juries and the operation of registries of traumatic
brain injuries for use by State coordinators under
this section.
‘‘(2) SCOPE.—The standards established under
paragraph (1) shall at a minimum provide for—
‘‘(A) the specific International Classifica-
tion of Diseases, Ninth Revision, Clinical Modi-
fication, diagnostic codes (hereafter referred to
in this subsection as ‘ICD diagnostic codes’) in-
cluded in the definitions of traumatic brain in-
jury;
‘‘(B) the type of data to be reported;
‘‘(C) standards for reporting specific types
of data;
‘‘(D) the individuals and facilities required
to report and the time period in which reports
must be submitted; and
‘‘(E) criteria relating to the use of registry
data by public and private entities engaged in
research.’’.
(c) BUDGET NEUTRALITY.—
(1) IN GENERAL.—During the first 12-month
period a State provides case-management services to
which the amendments made by this section apply,
and each 12-month period thereafter, Federal finan-
cial participation for all services under a State plan
approved under title XIX of the Social Security Act
provided to individuals with traumatic brain injuries
shall not exceed the baseline amount determined
under paragraph (2).
(2) BASELINE AMOUNT.—
(A) FIRST
YEAR.—The baseline amount
for the first 12-month period to which para-
graph (1) applies shall be equal to the sum of—
(i) the amount of Federal financial
participation attributable to all services
provided to individuals with traumatic
brain injuries under a State plan in the
12-month period prior to the inclusion of
case-management services in the State
plan, as certified by the Secretary, plus
(ii) such amount multiplied by the es-
timated 
percentage 
increase 
in 
the
Consumer Price Index for All-Urban Con-
sumers for the preceding 12-month period.