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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.
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