II Calendar No. 503 118th CONGRESS 2d Session S. 4755 IN THE SENATE OF THE UNITED STATES July 23, 2024 Mr. Mullin (for himself, Mr. Casey , Mr. Cornyn , Ms. Cortez Masto , and Ms. Ernst ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions September 12, 2024 Reported by Mr. Sanders , with an amendment Strike out all after the enacting clause and insert the part printed in italic A BILL To reauthorize traumatic brain injury programs, and for other purposes.

1. Short title This Act may be cited as the Traumatic Brain Injury Program Reauthorization Act of 2024 . 2. Prevention and control of traumatic brain injury (a) Prevention of traumatic brain injury Section 393B of the Public Health Service Act ( 42 U.S.C. 280b–1c ) is amended— (1) in subsection (a), by inserting and prevalence after incidence ; (2) in subsection (b)— (A) in paragraph (1), by inserting and reduction of associated injuries and fatalities before the semicolon; (B) in paragraph (2), by inserting and related risk factors before the semicolon; and (C) in paragraph (3)— (i) in the matter preceding subparagraph (A), by striking 2020 each place it appears and inserting 2030 ; and (ii) in subparagraph (A)— (I) in clause (i), by striking ; and and inserting a semicolon; (II) by redesignating clause (ii) as clause (iv); and (III) by inserting after clause (i) the following: (ii) populations at higher risk of traumatic brain injury; (iii) causes of, and risk factors for, traumatic brain injury; and ; and (3) in subsection (c), by inserting , and other relevant Federal departments and agencies before the period at the end. (b) National program for traumatic brain injury surveillance and registries Section 393C of the Public Health Service Act ( 42 U.S.C. 280b–1d ) is amended— (1) in subsection (a)— (A) in the matter preceding paragraph (1), by inserting to identify populations that may be at higher risk for traumatic brain injuries, to collect data on the causes of, and risk factors for, traumatic brain injuries, after related disability, ; and (B) in paragraph (4), by inserting short- and long-term before outcomes ; (2) by striking subsection (b); (3) by redesignating subsection (c) as subsection (b); and (4) by adding at the end the following: (c) Availability of information The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall make publicly available aggregated information on traumatic brain injury described in this section, including on the website of the Centers for Disease Control and Prevention. Such website, to the extent feasible, shall include aggregated information on populations that may be at higher risk for traumatic brain injuries and strategies for preventing or reducing risk of traumatic brain injury that are tailored to such populations. . (c) Authorization of appropriations Section 394A of the Public Health Service Act ( 42 U.S.C. 280b–3 ) is amended— (1) in subsection (a), by striking 1994, and and inserting 1994, ; and (2) in subsection (b), by striking 2020 through 2024 and inserting 2025 through 2029 . 3. State grant programs (a) State grants for projects regarding traumatic brain injury Section 1252 of the Public Health Service Act ( 42 U.S.C. 300d–52 ) is amended— (1) in subsection (b)(2)— (A) by inserting , taking into consideration populations that may be at higher risk for traumatic brain injuries after outreach programs ; and (B) by inserting Tribal, after State, ; (2) in subsection (h), by striking paragraphs (1) and (2) and inserting the following: (1) American Indian consortium; State The terms American Indian consortium and State have the meanings given such terms in section 1253. (2) Traumatic brain injury (A) In general Subject to subparagraph (B), the term traumatic brain injury — (i) means an acquired injury to the brain; (ii) may include— (I) brain injuries caused by anoxia due to trauma; and (II) damage to the brain from an internal or external source that results in infection, toxicity, surgery, or vascular disorders not associated with aging; and (iii) does not include brain dysfunction caused by congenital or degenerative disorders, or birth trauma. (B) Revisions to definition The Secretary may revise the definition of the term traumatic brain injury under this paragraph, as the Secretary determines necessary, after consultation with States and other appropriate public or nonprofit private entities. ; and (3) in subsection (i), by striking 2020 through 2024 and inserting 2025 through 2029 . (b) State grants for protection and advocacy services Section 1253(l) of the Public Health Service Act ( 42 U.S.C. 300d–53(l) ) is amended by striking 2020 through 2024 and inserting 2025 through 2029 . 4. Report to Congress Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report that contains— (1) an overview of populations who may be at higher risk for traumatic brain injury, such as individuals affected by domestic violence or sexual assault and public safety officers as defined in section 1204 of the Omnibus Crime Control and Safe Streets Act of 1968 ( 34 U.S.C. 10284 ); (2) an outline of existing surveys and activities of the Centers for Disease Control and Prevention on traumatic brain injuries and any steps the agency has taken to address gaps in data collection related to such higher risk populations; (3) an overview of any outreach or education efforts to reach such higher risk populations; and (4) any challenges associated with reaching such higher risk populations.

1. Short title This Act may be cited as the Traumatic Brain Injury Program Reauthorization Act of 2024 . 2. Prevention and control of traumatic brain injury (a) Prevention of traumatic brain injury Section 393B of the Public Health Service Act ( 42 U.S.C. 280b–1c ) is amended— (1) in subsection (a), by inserting and prevalence after incidence ; (2) in subsection (b)— (A) in paragraph (1), by inserting and reduction of associated injuries and fatalities before the semicolon; (B) in paragraph (2), by inserting and related risk factors before the semicolon; and (C) in paragraph (3)— (i) in the matter preceding subparagraph (A), by striking 2020 each place it appears and inserting 2030 ; and (ii) in subparagraph (A)— (I) in clause (i), by striking ; and and inserting a semicolon; (II) by redesignating clause (ii) as clause (iv); (III) by inserting after clause (i) the following: (ii) populations at higher risk of traumatic brain injury, including populations whose increased risk is due to occupational or circumstantial factors; (iii) causes of, and risk factors for, traumatic brain injury; and ; and (IV) in clause (iv), as so redesignated, by striking arising from traumatic brain injury and inserting , which may include related mental health and other conditions, arising from traumatic brain injury, including ; and (3) in subsection (c), by inserting , and other relevant Federal departments and agencies before the period at the end. (b) National program for traumatic brain injury surveillance and registries Section 393C of the Public Health Service Act ( 42 U.S.C. 280b–1d ) is amended— (1) in subsection (a)— (A) in the matter preceding paragraph (1), by inserting to identify populations that may be at higher risk for traumatic brain injuries, to collect data on the causes of, and risk factors for, traumatic brain injuries, after related disability, ; (B) in paragraph (1), by inserting , including the occupation of the individual, when relevant to the circumstances surrounding the injury before the semicolon; and (C) in paragraph (4), by inserting short- and long-term before outcomes ; (2) by striking subsection (b); (3) by redesignating subsection (c) as subsection (b); (4) in subsection (b), as so redesignated, by inserting and evidence-based practices to identify and address concussion before the period at the end; and (5) by adding at the end the following: (c) Availability of information The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall make publicly available aggregated information on traumatic brain injury and concussion described in this section, including on the website of the Centers for Disease Control and Prevention. Such website, to the extent feasible, shall include aggregated information on populations that may be at higher risk for traumatic brain injuries and strategies for preventing or reducing risk of traumatic brain injury that are tailored to such populations. . (c) Authorization of appropriations Section 394A of the Public Health Service Act ( 42 U.S.C. 280b–3 ) is amended— (1) in subsection (a), by striking 1994, and and inserting 1994, ; and (2) in subsection (b), by striking 2020 through 2024 and inserting 2025 through 2029 . 3. State grant programs (a) State grants for projects regarding traumatic brain injury Section 1252 of the Public Health Service Act ( 42 U.S.C. 300d–52 ) is amended— (1) in subsection (b)(2)— (A) by inserting , taking into consideration populations that may be at higher risk for traumatic brain injuries after outreach programs ; and (B) by inserting Tribal, after State, ; (2) in subsection (e)(3)(B)— (A) by striking (such as third party payers, State agencies, community-based providers, schools, and educators) ; and (B) by inserting (such as third party payers, State agencies, community-based providers, schools, and educators after professionals ; (3) in subsection (h), by striking paragraphs (1) and (2) and inserting the following: (1) American Indian consortium; State The terms American Indian consortium and State have the meanings given such terms in section 1253. (2) Traumatic brain injury (A) In general Subject to subparagraph (B), the term traumatic brain injury — (i) means an acquired injury to the brain; (ii) may include— (I) brain injuries caused by anoxia due to trauma; and (II) damage to the brain from an internal or external source that results in infection, toxicity, surgery, or vascular disorders not associated with aging; and (iii) does not include brain dysfunction caused by congenital or degenerative disorders, or birth trauma. (B) Revisions to definition The Secretary may revise the definition of the term traumatic brain injury under this paragraph, as the Secretary determines necessary, after consultation with States and other appropriate public or nonprofit private entities. ; and (4) in subsection (i), by striking 2020 through 2024 and inserting 2025 through 2029 . (b) State grants for protection and advocacy services Section 1253(l) of the Public Health Service Act ( 42 U.S.C. 300d–53(l) ) is amended by striking 2020 through 2024 and inserting 2025 through 2029 . 4. Report to Congress Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services (referred to in this Act as the Secretary ) shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report that contains— (1) an overview of populations who may be at higher risk for traumatic brain injury, such as individuals affected by domestic violence or sexual assault and public safety officers as defined in section 1204 of the Omnibus Crime Control and Safe Streets Act of 1968 ( 34 U.S.C. 10284 ); (2) an outline of existing surveys and activities of the Centers for Disease Control and Prevention on traumatic brain injuries and any steps the agency has taken to address gaps in data collection related to such higher risk populations, which may include leveraging surveys such as the National Intimate Partner and Sexual Violence Survey to collect data on traumatic brain injuries; (3) an overview of any outreach or education efforts to reach such higher risk populations; and (4) any challenges associated with reaching such higher risk populations. 5. Study on long-term symptoms or conditions related to traumatic brain injury (a) In general The Secretary, in consultation with stakeholders and the heads of other relevant Federal departments and agencies, as appropriate, shall conduct, either directly or through a contract with a nonprofit private entity, a study to— (1) examine the incidence and prevalence of long-term symptoms or conditions in individuals who have experienced a traumatic brain injury; (2) examine any correlations between traumatic brain injury and increased risk of other conditions, such as dementia and mental health conditions; (3) assess existing services available for individuals with such long-term symptoms or conditions; and (4) identify any gaps in research related to such long-term symptoms or conditions of individuals who have experienced a traumatic brain injury. (b) Public report Not later than 2 years after the date of enactment of this Act, the Secretary shall make publicly available a report on the study conducted under subsection (a).

September 12, 2024 Reported with an amendment