110th CONGRESS
1st Session
S. 1065
To improve the diagnosis and treatment of traumatic brain injury
in members and former members of the Armed Forces, to review and expand
telehealth and telemental health programs of the Department of Defense and
the Department of Veterans Affairs, and for other purposes.
IN THE SENATE OF THE UNITED STATES
March 29, 2007
Mrs. CLINTON (for herself and Ms. COLLINS) introduced the following bill;
which was read twice and referred to the Committee on Armed Services
A BILL
To improve the diagnosis and treatment of traumatic brain injury
in members and former members of the Armed Forces, to review and expand
telehealth and telemental health programs of the Department of Defense and
the Department of Veterans Affairs, 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. SHORT TITLE.
This Act may be cited as the `Heroes at Home Act of 2007'.
SEC. 2. PROTOCOL FOR ASSESSMENT AND DOCUMENTATION OF COGNITIVE FUNCTIONING
OF EACH DEPLOYED MEMBERS OF THE ARMED FORCES.
(a) Protocol Required- The Secretary of Defense shall establish a protocol
for the assessment and documentation of the cognitive (including memory)
functioning of each member of the Armed Forces before each such member is
deployed in Operation Enduring Freedom or Operation Iraqi Freedom, to facilitate
the assessment of the cognitive (including memory) functioning of each such
member upon returning from such deployment.
(b) Diagnosis of Traumatic Brain Injury and Post Traumatic Stress Disorder-
(1) IN GENERAL- The Secretary shall ensure that the protocol required
by subsection (a) provides appropriate mechanisms to permit the differential
diagnosis of traumatic brain injury (TBI) and post traumatic stress disorder
(PTSD) in members of the Armed Forces who return from deployment in Operation
Enduring Freedom or Operation Iraqi Freedom.
(2) ADDITIONAL PURPOSES- Except as provided in subsection (d), the Secretary
may use the protocol for such other purposes as the Secretary considers
appropriate.
(c) Neurocognitive Assessments-
(1) IN GENERAL- The protocol required by subsection (a) shall include
the administration of computer-based neurocognitive assessments to members
of the Armed Forces.
(2) FREQUENCY- The assessments required by paragraph (1) shall be administered
at least once to each member of the Armed Forces--
(A) before deploying to Operation Enduring Freedom or Operation Iraqi
Freedom; and
(B) upon returning from such deployment.
(3) DEVELOPMENT OF ASSESSMENT- In developing the computer-based assessment
required by paragraph (1), the Secretary may use or adopt a current commercial
product or develop a new computer-based assessment.
(4) FORMAT OF ASSESSMENT- The format of the assessments required by paragraph
(1) shall be the same for each administration described in paragraph (2).
(d) Prohibition on Use of Protocol To Determine Deployment Readiness- The
Secretary may not use the result of any assessment that is part of the protocol
required by subsection (a) to determine the deployment readiness of any
member of the Armed Forces.
(e) Availability of Medical Data- The Secretary shall make available such
medical data on the cognitive (including memory) functioning of members
of the Armed Forces who are deployed in Operation Enduring Freedom or Operation
Iraqi Freedom that is obtained from the protocol required by subsection
(a) as the Secretary considers appropriate to--
(1) combat medics and other Department of Defense personnel who provide
medical services to such members; and
(2) such entities as the Secretary considers appropriate.
(f) Report- Not later than one year after the date of the enactment of this
Act, the Secretary shall submit to Congress a report on the implementation
of this section.
(g) Authorization of Appropriations- There is authorized to be appropriated
to the Department of Defense to carry out this section amounts as follows:
(1) For fiscal year 2008, $3,750,000.
(2) For fiscal years 2009 through 2012, such sums as may be necessary.
SEC. 3. TRAINING AND CERTIFICATION PROGRAM FOR FAMILY CAREGIVER PERSONAL
CARE ATTENDANTS FOR VETERANS AND MEMBERS OF THE ARMED FORCES WITH TRAUMATIC
BRAIN INJURY.
(a) Program on Training and Certification of Family Caregiver Personal Care
Attendants- The Secretary of Veterans Affairs shall establish a program
on training and certification of family caregivers of veterans and members
of the Armed Forces with traumatic brain injury as personal care attendants
of such veterans and members.
(b) Location- The program required by subsection (a) shall be located in
each of the polytrauma centers of the Department of Veterans Affairs designated
as a Tier I polytrauma center.
(1) IN GENERAL- The Secretary of Veterans Affairs shall, in collaboration
with the Secretary of Defense, develop curricula for the training of personal
care attendants described in subsection (a). Such curricula shall incorporate
applicable standards and protocols utilized by certification programs
of national brain injury care specialist organizations.
(2) USE OF EXISTING CURRICULA- In developing the curricula required by
paragraph (1), the Secretary of Veterans Affairs shall, to the extent
practicable, utilize and expand upon training curricula developed pursuant
to section 744(b) of the John Warner National Defense Authorization Act
for Fiscal Year 2007 (Public Law 109-364; 120 Stat. 2308).
(d) Program Participation-
(1) IN GENERAL- The Secretary of Veterans Affairs shall determine the
eligibility of a family member of a veteran or member of the Armed Forces
for participation in the program required by subsection (a).
(2) BASIS FOR DETERMINATION- A determination made under paragraph (1)
shall be based on the clinical needs of the veteran or member of the Armed
Forces concerned, as determined by the physician of such veteran or member.
(e) Eligibility for Compensation- A family caregiver of a veteran or member
of the Armed Forces who receives certification as a personal care attendant
under this section shall be eligible for compensation from the Department
of Veterans Affairs for care provided to such veteran or member.
(1) TRAINING OF FAMILIES OF VETERANS- Any costs of training provided under
the program under this section for family members of veterans shall be
borne by the Secretary of Veterans Affairs.
(2) TRAINING OF FAMILIES OF MEMBERS OF THE ARMED FORCES- The Secretary
of Defense shall reimburse the Secretary of Veterans Affairs for any costs
of training provided under the program under this section for family members
of members of the Armed Forces. Amounts for such reimbursement shall be
derived from amounts available for Defense Health Program for the TRICARE
program.
(g) Construction- Nothing in this section shall be construed to require
or permit the Secretary of Veterans Affairs to deny reimbursement for health
care services provided to a veteran with a brain injury to a personal care
attendant who is not a family member of such veteran.
SEC. 4. TELEHEALTH AND TELEMENTAL HEALTH SERVICES OF THE DEPARTMENT OF
DEFENSE AND THE DEPARTMENT OF VETERANS AFFAIRS.
(a) Telehealth and Telemental Health Demonstration Project-
(1) IN GENERAL- The Secretary of Defense and the Secretary of Veterans
Affairs shall jointly establish a demonstration project to assess the
feasibility and advisability of using telehealth technology to assess
cognitive (including memory) functioning of members and former members
of the Armed Forces who have sustained head trauma, in order to improve
the diagnosis and treatment of traumatic brain injury.
(A) IN GENERAL- The Secretary of Defense and the Secretary of Veterans
Affairs shall carry out the demonstration project required by paragraph
(1) at one or more locations selected by the Secretaries for purposes
of the demonstration project.
(B) PRIORITY FOR RURAL AREAS- In selecting locations to carry out the
demonstration project required by paragraph (1), the Secretary of Defense
and the Secretary of Veterans Affairs shall give priority to locations
that would provide service in a rural area.
(3) REQUIREMENTS- The demonstration project required by paragraph (1)
shall include the following:
(A) The use of telehealth technology to assess the cognitive (including
memory) functioning of a member or former member of the Armed Forces,
including the following:
(i) Obtaining information regarding the nature of any brain injury
incurred by such member or former member.
(ii) Assessing any symptoms of traumatic brain injury in such member
or former member.
(B) The use of telehealth technology to rehabilitate members or former
members of the Armed Forces who have traumatic brain injury, and the
use, to the extent practicable, of applicable standards and protocols
used by certification programs of national brain injury care specialist
organizations in order to assess progress in such rehabilitation.
(C) The use of telehealth technology to disseminate education material
to members and former members of the Armed Forces and the family members
of such members on techniques, strategies, and skills for caring for
and assisting such members, and to the extend practicable, such education
materials shall incorporate training curricula developed pursuant to
section 744(b) of the John Warner National Defense Authorization Act
for Fiscal Year 2007 (Public Law 109-364; 120 Stat. 2308).
(4) USE OF PROVEN TECHNOLOGIES- Any assessment administered as a part
of the demonstration project required by paragraph (1) shall incorporate
telemental health technology that has proven effective in the diagnosis
and treatment of mental health conditions associated with traumatic brain
injury.
(A) IN GENERAL- The demonstration project required by paragraph (1)
shall be administered under the joint incentives program and carried
out pursuant to section 8111(d) of title 38, United States Code.
(B) FUNDING- Amounts to carry out the demonstration project shall be
derived from amounts in the DOD-VA Health Care Sharing Incentive Fund
established under paragraph (2) of such section.
(A) IN GENERAL- The Secretary of Defense and the Secretary of Veterans
Affairs shall jointly submit to Congress a report on the demonstration
project required by paragraph (1).
(B) SUBMISSION WITH ANNUAL JOINT REPORT- The report required by subparagraph
(A) shall be submitted to Congress at the same time as the annual joint
report required by section 8111(f) of title 38, United States Code,
for the fiscal year following the fiscal year of the date of the enactment
of this Act.
(b) Ongoing Study on Telehealth and Telemental Health Services-
(1) IN GENERAL- The Secretary of Defense and the Secretary of Veterans
Affairs shall, through the Joint Executive Council (JEC) of the Department
of Defense and the Department of Veterans Affairs, conduct an ongoing
study of all matters relating to the telehealth and telemental health
services of the Department of Defense and the Department of Veterans Affairs.
(2) MATTERS STUDIED- The matters studied under paragraph (1) shall include
the following:
(A) The number of members and former members of the Armed Forces who
have used telehealth or telemental health services of the Department
of Defense or the Department of Veterans Affairs.
(B) The extent to which members of the National Guard and the Reserves
are utilizing telehealth or telemental health services of the Department
of Defense or the Department of Veterans Affairs.
(C) The ways in which the Department of Defense and the Department of
Veterans Affairs can improve the integration of telehealth and telemental
health services with clinical medicine.
(D) The extent to which telehealth and telemental health services of
the Department of Defense and the Department of Veterans Affairs are
provided in rural settings and through community-based outpatient clinics
(CBOCs).
(E) Best practices of civilian mental health providers and facilities
with respect to the provision of telehealth and telemental health services,
including how such practices can be adopted to improve telehealth and
telemental health services of the Department of Defense and the Department
of Veterans Affairs.
(F) The feasability and advisability of partnering with civilian mental
health facilities to provide telehealth and telemental health services
to members and former members of the Armed Forces.
(3) ANNUAL REPORTS- Not later than one year after the date of the enactment
of this Act, and annually thereafter, the Secretary of Defense and the
Secretary of Veterans Affairs shall jointly submit to Congress a report
on the findings of the Joint Executive Counsel under this subsection during
the preceding year.
SEC. 5. DEFINITIONS.
(1) The term `national brain injury care specialist organization' means
a national organization or association with demonstrated experience in
providing training, education, and technical assistance in the provision
of care for individuals with brain injury.
(2) The term `neurocognitive' means of, relating to, or involving the
central nervous system and cognitive or information processing abilities
(thinking, memory, and reasoning), as well as sensory processing (sight,
hearing, touch, taste, and smell), and communication (expression and understanding).
(3) The term `traumatic brain injury' means an acquired injury to the
brain, including brain injuries caused by anoxia due to trauma and such
other injuries as the Secretary considers appropriate, except that such
term excludes brain dysfunction caused by--
(A) congenital or degenerative disorders; or
END
