H.R.248
One Hundred Fourth Congress of the United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Wednesday,
the third day of January, one thousand nine hundred and ninety-six
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
Representatives of the United States of America in Congress
assembled,
SECTION 1. PROGRAMS OF CENTERS FOR DISEASE CONTROL 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, acting through the
Director of the Centers for Disease Control 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 entities. 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 subsection (a) may
include--
(1) the conduct of research into identifying effective
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 public concerning the public health
consequences of such injury.
(c) COORDINATION OF ACTIVITIES- The Secretary shall ensure that
activities under this section are coordinated as appropriate with
other agencies of the Public Health Service that carry out
activities regarding traumatic 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 definition 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 period 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 the conduct of basic
and applied research regarding traumatic brain injury, which
research may include--
(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 injury and that provide the restitution of
function for individuals with long-term injuries;
(C) the development of research on a continuum of care
from acute care through rehabilitation, designed, to the
extent practicable, to integrate rehabilitation and
long-term outcome evaluation with acute care research; and
(D) the development of programs that increase the
participation of academic centers of excellence in head
injury treatment and rehabilitation research and
training.'; and
(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 purpose of carrying out demonstration
projects to improve access to health and other services regarding
traumatic brain injury.
(b) STATE ADVISORY BOARD-
(1) IN GENERAL- The Secretary may make a grant under
subsection (a) only if the State involved agrees to establish
an advisory board within the appropriate health department of
the State or within another department as designated by the
chief executive officer of the State.
(2) FUNCTIONS- An advisory board established under paragraph
(1) shall advise and make recommendations to the State on ways
to improve services coordination regarding traumatic brain
injury. Such advisory boards shall encourage citizen
participation through the establishment of public hearings and
other types of community outreach programs. In developing
recommendations under this paragraph, such boards shall consult
with Federal, State, and local governmental agencies and with
citizens groups and other private entities.
(3) COMPOSITION- An advisory board established under
paragraph (1) shall be composed of--
(A) representatives of--
(i) the corresponding State agencies involved;
(ii) public and nonprofit private health related
organizations;
(iii) other disability advisory or planning 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
contributions toward such costs in an amount that is not less
than $1 for each $2 of Federal funds provided under the grant.
(2) DETERMINATION OF AMOUNT CONTRIBUTED- In determining the
amount of non-Federal contributions in cash that a State has
provided pursuant to paragraph (1), the Secretary may not
include any amounts provided to the State by the Federal
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 application is in such form, is made in such
manner, and contains such agreements, assurances, and information
as the Secretary determines to be necessary to carry out this
section.
(e) COORDINATION OF ACTIVITIES- The Secretary shall ensure that
activities under this section are coordinated as appropriate with
other agencies of the Public Health Service that carry out
activities regarding traumatic brain injury.
(f) REPORT- Not later than 2 years after the date of the
enactment of this section, the Secretary shall submit to the
Committee on Commerce of the House of Representatives, 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
surrogate 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 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.
(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 agencies 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 prevalence of
traumatic brain injury; and
(ii) develop a uniform reporting system under which
States report incidents of traumatic brain injury, if
the Secretary determines that such a system is
appropriate.
(B) Identify common therapeutic interventions which are
used for the rehabilitation of individuals 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 rehabilitation of individuals
with brain injuries to achieve the same or similar
clinical outcome; and
(iii) the adequacy of existing measures of outcomes
and knowledge of factors influencing differential
outcomes.
(C) Develop practice guidelines for the rehabilitation 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 Committee 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 subparagraph (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, acting through the
Director of the National Center for Medical 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
definition of such term as the Secretary determines necessary.
(d) AUTHORIZATIONS OF APPROPRIATIONS- For the purpose of carrying
out subsection (a)(1)(A), there is authorized to be appropriated
$3,000,000 for each of the fiscal 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 preceding 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:
(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.'.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.