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.