[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 725 Engrossed in Senate (ES)]
103d CONGRESS
2d Session
S. 725
_______________________________________________________________________
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.
103d CONGRESS
2d Session
S. 725
_______________________________________________________________________
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 B of title III of the Public Health Service Act (42 U.S.C. 241
et seq.), as amended by section 703 of Public Law 103-183 (107 Stat.
2240), is amended by inserting after section 317F the following
section:
``prevention of traumatic brain injury
``Sec. 317G. 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.
``(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 Energy and 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.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of the fiscal years 1995 through 1997.''.
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:
(1) In collaboration with appropriate State and local
health-related agencies--
(A) determine the incidence and prevalence of
traumatic brain injury; and
(B) develop a uniform reporting system under which
States report incidences of traumatic brain injury, if
the Secretary determines that such a system is
appropriate.
(2) 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--
(A) the effectiveness of each such intervention in
improving the functioning of individuals with brain
injuries;
(B) 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
(C) the adequacy of existing measures of outcomes
and knowledge of factors influencing differential
outcomes.
(3) 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 Energy and 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) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of the fiscal years 1995 through 1997.
SEC. 5. MAPLE SYRUP.
(a) Preemption.--Section 403A(a) of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 343-1(a)) is amended--
(1) in paragraph (1), by inserting at the end the
following: ``except that this paragraph does not apply to a
standard of identity of a State or political subdivision of a
State for maple syrup which is of the type required by sections
401 and 403(g),'',
(2) in paragraph (2), by inserting at the end the
following: ``except that this paragraph does not apply to a
requirement of a State or political subdivision of a State
which is of the type required by section 403(c) and which is
applicable to maple syrup,'', and
(3) in paragraph (3), by inserting at the end the
following: ``except that this paragraph does not apply to a
requirement of a State or political subdivision of a State
which is of the type required by section 403(h)(1) and which is
applicable to maple syrup,''.
(b) Procedure.--Section 701(e)(1) (21 U.S.C. 371(e)(1)) is amended
by striking ``or maple syrup (regulated under section 168.140 of title
21, Code of Federal Regulations).''.
Passed the Senate April 21 (legislative day, April 11),
1994.
Attest:
Secretary.
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