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108th CONGRESS
  2d Session
                                S. 2524

  To amend title 38, United States Code, to improve the provision of 
health care, rehabilitation, and related services to veterans suffering 
    from trauma relating to a blast injury, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 16, 2004

  Mr. Graham of Florida introduced the following bill; which was read 
        twice and referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
  To amend title 38, United States Code, to improve the provision of 
health care, rehabilitation, and related services to veterans suffering 
    from trauma relating to a blast 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. CENTERS FOR RESEARCH, EDUCATION, AND CLINICAL ACTIVITIES ON 
              BLAST INJURIES OF VETERANS.

    (a) In General.--(1) Subchapter II of chapter 73 of title 38, 
United States Code, is amended by adding at the end the following new 
section:
``Sec. 7327. Centers for research, education, and clinical activities 
              on blast injuries
    ``(a) Purpose.--The purpose of this section is to provide for the 
improvement of the provision of health care services and related 
rehabilitation and education services to eligible veterans suffering 
from multiple traumas associated with a blast injury through--
            ``(1) the conduct of research to support the provision of 
        such services in accordance with the most current evidence on 
        blast injuries;
            ``(2) the education and training of health care personnel 
        of the Department; and
            ``(3) the development of improved models and systems for 
        the furnishing of services by the Department for blast 
        injuries.
    ``(b) Establishment.--(1) The Secretary shall establish and operate 
at least one, but not more than three, centers for research, education, 
and clinical activities on blast injuries.
    ``(2) Each center shall function as a center for--
            ``(A) research on blast injury to support the provision of 
        services in accordance with the most current evidence on blast 
        injuries, with such research to specifically address injury 
        epidemiology and cost, functional outcomes, blast injury 
        taxonomy and measurement system, and longitudinal outcomes;
            ``(B) the development of a rehabilitation program for blast 
        injuries, including referral protocol, post-acute assessment, 
        and coordination of comprehensive treatment services;
            ``(C) the development of protocols to optimize linkages 
        between the Department and the Department of Defense on matters 
        relating to research, education, and clinical activities on 
        blast injuries;
            ``(D) the creation of innovative models for education and 
        outreach on health-care and related rehabilitation and 
        education services on blast injuries, with such education and 
        outreach to target those who have sustained a blast injury and 
        health care providers and researchers in the Veterans Health 
        Administration, the Department of Defense, and the Department 
        of Homeland Security;
            ``(E) the development of educational tools and products on 
        blast injuries, and the maintenance of such tools and products 
        in a resource clearinghouse that can serve as resources for the 
        Veterans Health Administration, the Department of Defense, the 
        Department of Homeland Security, and other departments and 
        agencies of the Federal Government;
            ``(F) the development of interdisciplinary training 
        programs on the provision of health care and rehabilitation 
        care services for blast injuries that provide an integrated 
        understanding of the continuum of care for such injuries to the 
        broad range of providers of such services, including first 
        responders, acute-care providers, and rehabilitation service 
        providers; and
            ``(G) the implementation of strategies for improving the 
        medical diagnostic coding of blast injuries in the Department 
        to reliably identify veterans with blast injuries and track 
        outcomes over time.
    ``(3) The Secretary shall designate a designate a center or centers 
under this section upon the recommendation of the Under Secretary for 
Health.
    ``(4) The Secretary may designate a center under this section only 
if--
            ``(A) the proposal submitted for the designation of the 
        center meets the requirements of subsection (c);
            ``(B) the Secretary makes the finding described in 
        subsection (d); and
            ``(C) the peer review panel established under subsection 
        (e) makes the determination specified in subsection (e)(3) with 
        respect to that proposal.
    ``(5) The authority of the Secretary to establish and operate 
centers under this section is subject to the appropriation of funds for 
that purpose.
    ``(c) Proposal Requirements.--A proposal submitted for the 
designation of a center under this section shall--
            ``(1) provide for close collaboration in the establishment 
        and operation of the center, and for the provision of care and 
        the conduct of research and education at the center, by a 
        Department facility or facilities (in this subsection referred 
        to as the `collaborating facilities') in the same geographic 
        area that have a mission centered on the care of individuals 
        with blast injuries and a Department facility in that area 
        which has a mission of providing tertiary medical care;
            ``(2) provide that not less than 50 percent of the funds 
        appropriated for the center for support of clinical care, 
        research, and education will be provided to the collaborating 
        facilities with respect to the center; and
            ``(3) provide for a governance arrangement among the 
        facilities described in paragraph (1) with respect to the 
        center that ensures that the center will be established and 
        operated in a manner aimed at improving the quality of care for 
blast injuries at the collaborating facilities with respect to the 
center.
    ``(d) Findings Relating to Proposals.--The finding referred to in 
subsection (b)(4)(B) with respect to a proposal for the designation of 
a site as a location of a center under this section is a finding by the 
Secretary, upon the recommendation of the Under Secretary for Health, 
that the facilities submitting the proposal have developed (or may 
reasonably be anticipated to develop) each of the following:
            ``(1) An arrangement with an affiliated accredited medical 
        school or university that provides education and training in 
        disaster preparedness, homeland security, and biodefense.
            ``(2) Comprehensive and effective treatment services for 
        head injury, spinal cord injury, audiology, amputation, gait 
        and balance, and mental health.
            ``(3) The ability to attract scientists who have 
        demonstrated achievement in research--
                    ``(A) into the evaluation of innovative approaches 
                to the rehabilitation of blast injuries; or
                    ``(B) into the treatment of blast injuries.
            ``(4) The capability to evaluate effectively the activities 
        of the center, including activities relating to the evaluation 
        of specific efforts to improve the quality and effectiveness of 
        services on blast injuries that are provided by the Department 
        at or through individual facilities.
    ``(e) Departmental Support on Evaluation of Center Proposals.--(1) 
In order to provide advice to assist the Secretary and the Under 
Secretary for Health to carry out their responsibilities under this 
section, the official within the central office of the Veterans Health 
Administration responsible for blast injury matters shall establish a 
peer review panel to assess the scientific and clinical merit of 
proposals that are submitted to the Secretary for the designation of 
centers under this section.
    ``(2) The panel shall consist of experts in the fields of research, 
education and training, and clinical care on blast injuries. Members of 
the panel shall serve as consultants to the Department.
    ``(3) The panel shall review each proposal submitted to the panel 
by the official referred to in paragraph (1) and shall submit to that 
official its views on the relative scientific and clinical merit of 
each such proposal. The panel shall specifically determine with respect 
to each such proposal whether or not that proposal is among those 
proposals which have met the highest competitive standards of 
scientific and clinical merit.
    ``(4) The panel shall not be subject to the Federal Advisory 
Committee Act (5 U.S.C. App.).
    ``(f) Award of Funding.--Clinical and scientific investigation 
activities at each center established under this section--
            ``(1) may compete for the award of funding from amounts 
        appropriated for the Department for medical and prosthetics 
        research; and
            ``(2) shall receive priority in the award of funding from 
        such amounts insofar as funds are awarded from such amounts to 
        projects and activities relating to blast injuries.
    ``(g) Dissemination of Information.--(1) The Under Secretary for 
Health shall ensure that information produced by the centers 
established under this section that may be useful for other activities 
of the Veterans Health Administration is disseminated throughout the 
Administration.
    ``(2) Information shall be disseminated under this subsection 
through publications, through programs of continuing medical and 
related education provided through regional medical education centers 
under subchapter VI of chapter 74 of this title, and through other 
means. Such programs of continuing medical education shall receive 
priority in the award of funding.
    ``(h) Supervision.--The official within the central office of the 
Veterans Health Administration responsible for blast injury matters 
shall be responsible for supervising the operation of the centers 
established under this section and shall provide for ongoing evaluation 
of the centers and their compliance with the requirements of this 
section.
    ``(i) Authorization of Appropriations.--(1) There are authorized to 
be appropriated to the Department of Veterans Affairs for the centers 
established under this section amounts as follows:
            ``(A) $3,125,000 for fiscal year 2005.
            ``(B) $6,250,000 for each of fiscal years 2006 through 
        2008.
    ``(2) In addition to amounts authorized to be appropriated by 
paragraph (1) for a fiscal year, the Under Secretary for Health shall 
allocate to each center established under this section, from other 
funds authorized to be appropriated for such fiscal year for the 
Department generally for medical and for medical and prosthetics 
research, such additional amounts as the Under Secretary for Health 
determines appropriate to carry out the purpose of this section.''.
    (2) The table of sections at the beginning of chapter 73 is amended 
by inserting after the item relating to section 7326, the following new 
item:

                              ``7327. Centers for research, education, 
                                        and clinical activities on 
                                        blast injuries''.
    (b) Designation of Centers.--The Secretary of Veterans Affairs 
shall designate at least one center for research, education, and 
clinical activities on blast injuries as required by section 7327 of 
title 38, United States Code (as added by subsection (a)), not later 
than January 1, 2005.
    (c) Annual Reports.--(1) Not later than February 1 of each of 2006, 
2007, and 2008, the Secretary shall submit to the Committees on 
Veterans' Affairs of the Senate and House of Representatives a report 
on the status and activities during the previous fiscal year of the 
center for research, education, and clinical activities on blast 
injuries established under section 7327 of title 38, United States Code 
(as so added). Each such report shall include the following:
            (A) A description of the activities carried out at each 
        center, and the funding provided for such activities.
            (B) A description of the advances made at each of the 
        participating facilities of the each center in research, 
        education and training, and clinical activities on blast 
        injuries .
            (C) A description of the actions taken by the Under 
        Secretary for Health pursuant to subsection (g) of that section 
        (as so added) to disseminate information derived from such 
        activities throughout the Veterans Health Administration.
            (D) The assessment of the Secretary of the effectiveness of 
        the centers in fulfilling the purposes of the centers.
                                 <all>

Pages: 1

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