Mr. Speaker, I yield myself such time as I may consume. Let me first take this opportunity to thank the chairman of the Subcommittee on Health, Mr. Michaud, as well as the subcommittee's ranking…
Mr. Speaker, I yield myself such time as I may consume.
Let me first take this opportunity to thank the chairman of the Subcommittee on Health, Mr. Michaud, as well as the subcommittee's ranking member, Mr. Miller, for their leadership in developing this legislation.
H.R. 2199, as amended, the Traumatic Brain Injury Health Enhancement and Long-Term Support Act of 2007, seeks to improve the treatment of veterans suffering with traumatic brain injuries, often referred to as TBI, and the care for veterans who live in rural communities.
However, I would comment that several of the provisions included in this legislation are similar to initiatives that already exist or are getting underway. For example, section 2 of the bill would require the VA to screen eligible veterans for symptoms of traumatic brain injury and create a TBI registry. These are also the recommendations of the President's task force on returning global war on terror heroes. In addition, in March 2007, Secretary Nicholson directed a number of changes to improve the way the VA provides care to our newest combat veterans.
These veterans initiatives include screening all OEF and OIF combat patients for TBI and for PTSD; providing each polytrauma patient with an advocate to assist them and their family; mandatory training for all VA health care personnel to recognize and care for patients with TBI; and establishing an outside panel of clinical experts to review the VA polytrauma system of care.
Additionally, the bill would provide five new centers for TBI research, education, and clinical activities. During the 108th Congress, we recognized the frequency and unique nature of the polytrauma/blast injuries resulting from the global war on terror. These injuries require an interdisciplinary program to handle the medical, psychological, rehabilitation, and prosthetic needs of the injured servicemember.
Public Law 108-422, the Veterans' Health Programs Improvement Act of 2004, directed VA to establish ``an appropriate number of centers for research, education, and clinical activities to improve and coordinate rehabilitative services for veterans suffering from complex multitrauma from combat injuries, and to coordinate these services with the Department of Defense.''
The centers required in Public Law 108-422 became the Polytrauma System of Care. There are four centers located in Richmond, VA; Tampa, FL; Minneapolis, MN; and Palo Alto, CA. The committee strongly recommends that the new TBI centers be colocated with the VA's polytrauma rehabilitation centers. In this way, we can capitalize on the experience and expertise available at the polytrauma centers and enhance the ability to understand and treat the entire spectrum of the TBI injury from mild to most severe.
I want to thank Mr. Michaud for recognizing that we can actually get some benefits by the colocation of these services where TBI is already located. Because we take and concentrate such expertise, the colocation can only have benefits. And the gentleman worked with me, and I think because TBI have a number of comorbidities such as PTSD, depression, anxiety disorders, and while these issues may appear with TBI, they may also exhibit themselves separately from TBI, and I think that is exactly what Mr. Michaud is trying to get to. So I want to thank the gentleman for his leadership and for bringing this bill to the committee, along with your staff, for their good work.
Mr. Speaker, I reserve the balance of my time.
Mr. Speaker, I would like to thank Mr. Michaud because he did his committee work. He did his committee work because we brought a bill to the floor. Yes, under suspension, Mr. Filner, but he did his committee work. He filed a report which allowed us to work with him. When you don't file a report, you deny the minority their opportunity to be heard.
So I want to thank Mr. Michaud for working with us and for his leadership.
Mr. Speaker, I yield such time as he may consume to the gentleman from Arkansas (Mr. Boozman).
Mr. Speaker, I would also like to express my support for a provision in the bill that would require the VA to establish a TBI transition office at each of the polytrauma network sites. Not only is this vital for the DOD and the VA to provide for a seamless transition from active duty to veteran status, but it is also important for VA to aid in the coordination of veteran care between VA and other health care providers for services that could possibly not be provided by the VA. These transition offices would help coordinate veterans care for services not offered by the VA, and have the authority to arrange care with public or private entities to establish long-term neurobehavioral rehabilitation and recovery programs.
The bill also includes two rural health initiative provisions, one of which would establish a pilot program for vet centers in rural areas. H.R. 2199, as amended, included an amendment
offered by Mr. Lamborn of Colorado, the ranking member of the Subcommittee on Disability Assistance and Memorial Affairs. This amendment will expand the role of the mobile vet center pilot program to include helping veterans in need of assistance in the filing of benefits claims.
Mr. Speaker, I yield such time as he may consume to the gentleman from Colorado (Mr. Lamborn).
Mr. Speaker, I reserve my time.
Mr. Speaker, I want to thank the gentleman who just spoke. As a retired sergeant major, we benefit by his expertise not only on the Veterans' Affairs Committee, but also in Congress. We have a lot of people here who have been enlisted, and we have had officers and generals and admirals, but when you get a sergeant major, they speak softly. And there's a reason the sergeant major speaks softly, because he doesn't have to speak loudly because they are so well respected. And so, Sergeant Major, your contributions to the committee are recognized and appreciated.
Mr. Speaker, I reserve my time.
Mr. Speaker, I appreciate the gentleman's comments that he just made. Before you take off, this issue, and I appreciate your interest in it because this is one of our great challenges. We've got the best helmet that we put on our soldiers and marines in the field and even some of the Air Force personnel, Navy personnel. And it protects them against ballistics, and it's the best in the world. But when it comes to blasts and crash, what it does to the brain, we're now on the forefront, and we are pushing the boundary of our knowledge.
And some of the world's experts now are not only at the polytrauma centers, but in particular, when these soldiers end up at Landstuhl, Germany, that's where they are. So they can immediately deal with these neurotraumas.
And when the gentleman said that there could possibly be thousands, what we do know is that at the polytrauma centers, those who are actually being treated for traumatic brain injury, there's less than 400 cases.
But the gentleman is right with regard to individuals who may have had a concussion. Yet, how severe is the concussion?
And if the science is unknown, and we're trying to understand that. That's the purpose of Mr. Michaud's bill. And I appreciate the gentleman's interest, would love to continue to work with you in your interest.
I'd bring to your attention the Veterans Health Administration Directive 2007-013 released April 13, 2007, establishes the VA policy and procedure for screening and evaluation of possible TBI in OEF and OIF veterans. This directive states, ``Not all patients who screen positive have TBI. It is possible to respond positively to all four sections due to the presence of other conditions such as PTSD, cervical cranial injury with headaches and inner ear injury, for example. Therefore, it's critical that patients not be labeled with a diagnosis of TBI on the basis of a positive screening test. Patients need to be referred for further evaluation.''
So we are in an area of science whereby the sand shifts directly under our feet, and I would look forward to working with the gentleman.
Mr. Speaker, I reserve my time.
Mr. Speaker, I yield myself such time as I may consume.
At the May 9, 2007, full committee hearing on the results of the President's Task Force on Returning Global War on Terror Heroes, in response to my questioning about the actual number of TBI cases treated in VA as inpatients, Secretary Nicholson responded that VA has treated 369 veterans in its polytrauma centers so far for TBI.
Secretary Nicholson also commented that the VA has the capacity in their polytrauma centers, and that many of the patients in the polytrauma centers are active duty military.
Mr. Speaker, I continue to reserve my time.
Mr. Speaker, I believe that it is conceivable that at some point one of these needed Traumatic Brain Injury Centers of Excellence could be located in the Department of Veterans Affairs Medical Center in Albuquerque, New Mexico, which could be named the Raymond G. ``Jerry'' Murphy Department of Veterans Affairs Medical Center, if Chairman Filner would clear either H.R. 474 or take up Senate bill 229 for consideration on the floor of which that Senate bill, Mr. Speaker, sits at your desk.
Mr. Speaker, I yield back the balance of my time.