38 U.S.C. § 1710C — Traumatic brain injury: plans for reha-

Page 366 TITLE 38—VETERANS’ BENEFITS § 1710C ‘‘(A) A description of the implementation and oper- ation of the program. ‘‘(B) An analysis comparing use of institutional care among participants in the program with the ex- perience of comparable patients who are not enrolled in the program. ‘‘(C) A comparison of assisted living services pro- vided by the Department through the pilot program with domiciliary care provided by the Department. ‘‘(D) The Secretary’s recommendations, if any, re- garding an extension of the program. ‘‘(f) DURATION.—The authority of the Secretary to provide services under the pilot program shall cease on the date that is three years after the date of the com- mencement of the pilot program. ‘‘(g) DEFINITION.—For purposes of this section, the term ‘assisted living services’ means services in a facil- ity that provides room and board and personal care for and supervision of residents as necessary for the health, safety, and welfare of residents. ‘‘(h) STANDARDS.—The Secretary may not enter into a contract with a facility under this section unless the facility meets the standards established in regulations prescribed under section 1730 of title 38, United States Code.’’ § 1710C. Traumatic brain injury: plans for reha- bilitation and reintegration into the commu- nity (a) PLAN REQUIRED.—The Secretary shall, for each individual who is a veteran or member of the Armed Forces who receives inpatient or out- patient rehabilitative hospital care or medical services provided by the Department for a trau- matic brain injury— (1) develop an individualized plan for the re- habilitation and reintegration of the indi- vidual into the community with the goal of maximizing the individual’s independence; and (2) provide such plan in writing to the indi- vidual— (A) in the case of an individual receiving inpatient care, before the individual is dis- charged from inpatient care or after the in- dividual’s transition from serving on active duty as a member of the Armed Forces to re- ceiving outpatient care provided by the De- partment; or (B) as soon as practicable following a diag- nosis of traumatic brain injury by a Depart- ment health care provider. (b) CONTENTS OF PLAN.—Each plan developed under subsection (a) shall include, for the indi- vidual covered by such plan, the following: (1) Rehabilitation objectives for improving (and sustaining improvement in) the physical, cognitive, behavioral, and vocational func- tioning of the individual with the goal of maximizing the independence and reintegra- tion of such individual into the community. (2) Access, as warranted, to all appropriate rehabilitative services and rehabilitative com- ponents of the traumatic brain injury con- tinuum of care, and where appropriate, to long-term care services. (3) A description of specific rehabilitative services and other services to achieve the ob- jectives described in paragraph (1), which shall set forth the type, frequency, duration, and lo- cation of such services. (4) The name of the case manager designated in accordance with subsection (d) to be respon- sible for the implementation of such plan. (5) Dates on which the effectiveness of such plan will be reviewed in accordance with sub- section (f). (c) COMPREHENSIVE ASSESSMENT.—(1) Each plan developed under subsection (a) shall be based on a comprehensive assessment, developed in accordance with paragraph (2), of— (A) the physical, cognitive, vocational, and neuropsychological and social impairments of the individual; and (B) the family education and family support needs of the individual after the individual is discharged from inpatient care or at the com- mencement of and during the receipt of out- patient care and services. (2) The comprehensive assessment required under paragraph (1) with respect to an indi- vidual is a comprehensive assessment of the matters set forth in that paragraph by a team, composed by the Secretary for purposes of the assessment, of individuals with expertise in traumatic brain injury, including any of the fol- lowing: (A) A neurologist. (B) A rehabilitation physician. (C) A social worker. (D) A neuropsychologist. (E) A physical therapist. (F) A vocational rehabilitation specialist. (G) An occupational therapist. (H) A speech language pathologist. (I) A rehabilitation nurse. (J) An educational therapist. (K) An audiologist. (L) A blind rehabilitation specialist. (M) A recreational therapist. (N) A low vision optometrist. (O) An orthotist or prosthetist. (P) An assistive technologist or rehabilita- tion engineer. (Q) An otolaryngology physician. (R) A dietician. (S) An ophthalmologist. (T) A psychiatrist. (d) CASE MANAGER.—(1) The Secretary shall designate a case manager for each individual de- scribed in subsection (a) to be responsible for the implementation of the plan developed for that individual under that subsection and the coordination of the individual’s medical care. (2) The Secretary shall ensure that each case manager has specific expertise in the care re- quired by the individual for whom the case man- ager is designated, regardless of whether the case manager obtains such expertise through ex- perience, education, or training. (e) PARTICIPATION AND COLLABORATION IN DE- VELOPMENT OF PLANS.—(1) The Secretary shall involve each individual described in subsection (a), and the family or legal guardian of such in- dividual, in the development of the plan for such individual under that subsection to the max- imum extent practicable. (2) The Secretary shall collaborate in the de- velopment of a plan for an individual under sub- section (a) with a State protection and advocacy system if— (A) the individual covered by the plan re- quests such collaboration; or (B) in the case of such an individual who is incapacitated, the family or guardian of the individual requests such collaboration. Page 367 TITLE 38—VETERANS’ BENEFITS § 1710C (3) In the case of a plan required by subsection (a) for a member of the Armed Forces who is serving on active duty, the Secretary shall col- laborate with the Secretary of Defense in the de- velopment of such plan. (4) In developing vocational rehabilitation ob- jectives required under subsection (b)(1) and in conducting the assessment required under sub- section (c), the Secretary shall act through the Under Secretary for Health in coordination with the Vocational Rehabilitation and Employment Service of the Department of Veterans Affairs. (f) EVALUATION.— (1) PERIODIC REVIEW BY SECRETARY.—The Secretary shall periodically review the effec- tiveness of each plan developed under sub- section (a). The Secretary shall refine each such plan as the Secretary considers appro- priate in light of such review. (2) REQUEST FOR REVIEW BY VETERANS.—In addition to the periodic review required by paragraph (1), the Secretary shall conduct a review of the plan for an individual under paragraph (1) at the request of the individual, or in the case of an individual who is incapaci- tated, at the request of the guardian or des- ignee of the individual. (g) STATE DESIGNATED PROTECTION AND ADVO- CACY SYSTEM DEFINED.—In this section, the term ‘‘State protection and advocacy system’’ means a system established in a State under subtitle C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15041 et seq.) to protect and advocate for the rights of persons with development disabilities. (h) REHABILITATIVE SERVICES DEFINED.—For purposes of this section, and sections 1710D and 1710E of this title, the term ‘‘rehabilitative serv- ices’’ includes— (1) rehabilitative services, as defined in sec- tion 1701 of this title; (2) treatment and services (which may be of ongoing duration) to sustain, and prevent loss of, functional gains that have been achieved; and (3) any other rehabilitative services or sup- ports that may contribute to maximizing an individual’s independence. (Added Pub. L. 110–181, div. A, title XVII, § 1702(a), Jan. 28, 2008, 122 Stat. 486; amended Pub. L. 112–154, title I, § 107(a), (d), Aug. 6, 2012, 126 Stat. 1173.) Editorial Notes REFERENCES IN TEXT The Developmental Disabilities Assistance and Bill of Rights Act of 2000, referred to in subsec. (g), is Pub. L. 106–402, Oct. 30, 2000, 114 Stat. 1677. Subtitle C of the Act probably means subtitle C of title I of the Act, which is classified generally to part C (§ 15041 et seq.) of sub- chapter I of chapter 144 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 15001 of Title 42 and Tables. AMENDMENTS 2012—Subsec. (a)(1). Pub. L. 112–154, § 107(a)(1), in- serted ‘‘with the goal of maximizing the individual’s independence’’ before semicolon. Subsec. (b)(1). Pub. L. 112–154, § 107(a)(2)(A), inserted ‘‘(and sustaining improvement in)’’ after ‘‘improving’’ and ‘‘behavioral,’’ after ‘‘cognitive,’’. Subsec. (b)(2). Pub. L. 112–154, § 107(a)(2)(B), inserted ‘‘rehabilitative services and’’ before ‘‘rehabilitative components’’. Subsec. (b)(3). Pub. L. 112–154, § 107(a)(2)(C), sub- stituted ‘‘rehabilitative services’’ for ‘‘rehabilitative treatments’’ and struck out ‘‘treatments and’’ after ‘‘location of such’’. Subsec. (c)(2)(S). Pub. L. 112–154, § 107(d), substituted ‘‘ophthalmologist’’ for ‘‘opthamologist’’. Subsec. (h). Pub. L. 112–154, § 107(a)(3), added subsec. (h). Statutory Notes and Related Subsidiaries RESEARCH, EDUCATION, AND CLINICAL CARE PROGRAM ON TRAUMATIC BRAIN INJURY Pub. L. 110–181, div. A, title XVII, § 1704, Jan. 28, 2008, 122 Stat. 490, provided that: ‘‘(a) IN GENERAL.—To improve the provision of health care by the Department of Veterans Affairs to veterans with traumatic brain injuries, the Secretary of Vet- erans Affairs shall— ‘‘(1) conduct research, including— ‘‘(A) research on the sequelae of mild to severe forms of traumatic brain injury; ‘‘(B) research on visually-related neurological conditions; ‘‘(C) research on seizure disorders; ‘‘(D) research on means of improving the diag- nosis, rehabilitative treatment, and prevention of such sequelae; ‘‘(E) research to determine the most effective cognitive and physical therapies for such sequelae; ‘‘(F) research on dual diagnosis of post-traumatic stress disorder and traumatic brain injury; ‘‘(G) research on improving facilities of the De- partment concentrating on traumatic brain injury care; and ‘‘(H) research on improving the delivery of trau- matic brain injury care by the Department; ‘‘(2) educate and train health care personnel of the Department in recognizing and treating traumatic brain injury; and ‘‘(3) develop improved models and systems for the furnishing of traumatic brain injury care by the De- partment. ‘‘(b) COLLABORATION.—In carrying out research under subsection (a), the Secretary of Veterans Affairs shall collaborate with— ‘‘(1) facilities that conduct research on rehabilita- tion for individuals with traumatic brain injury; ‘‘(2) facilities that receive grants for such research from the National Institute on Disability and Reha- bilitation Research of the Department of Education; and ‘‘(3) the Defense and Veterans Brain Injury Center of the Department of Defense and other relevant pro- grams of the Federal Government (including Centers of Excellence). ‘‘(c) DISSEMINATION OF USEFUL INFORMATION.—The Under Secretary of Veterans Affairs for Health shall ensure that information produced by the research, edu- cation and training, and clinical activities conducted under this section that may be useful for other activi- ties of the Veterans Health Administration is dissemi- nated throughout the Veterans Health Administration. ‘‘(d) TRAUMATIC BRAIN INJURY REGISTRY.— ‘‘(1) IN GENERAL.—The Secretary of Veterans Affairs shall establish and maintain a registry to be known as the ‘Traumatic Brain Injury Veterans Health Reg- istry’ (in this section referred to as the ‘Registry’). ‘‘(2) DESCRIPTION.—The Registry shall include the following information: ‘‘(A) A list containing the name of each indi- vidual who served as a member of the Armed Forces in Operation Enduring Freedom or Operation Iraqi Freedom who exhibits symptoms associated with traumatic brain injury, as determined by the Sec- retary of Veterans Affairs, and who— Page 368 TITLE 38—VETERANS’ BENEFITS § 1710C ‘‘(i) applies for care and services furnished by the Department of Veterans Affairs under chapter 17 of title 38, United States Code; or ‘‘(ii) files a claim for compensation under chap- ter 11 of such title on the basis of any disability which may be associated with such service. ‘‘(B) Any relevant medical data relating to the health status of an individual described in subpara- graph (A) and any other information the Secretary considers relevant and appropriate with respect to such an individual if the individual— ‘‘(i) grants permission to the Secretary to in- clude such information in the Registry; or ‘‘(ii) is deceased at the time such individual is listed in the Registry. ‘‘(3) NOTIFICATION.—When possible, the Secretary shall notify each individual listed in the Registry of significant developments in research on the health consequences of military service in the Operation En- during Freedom and Operation Iraqi Freedom thea- ters of operations.’’ [Functions which the Director of the National Insti- tute on Disability and Rehabilitation Research exer- cised before July 22, 2014 (including all related func- tions of any officer or employee of the National Insti- tute on Disability and Rehabilitation Research), trans- ferred to the National Institute on Disability, Inde- pendent Living, and Rehabilitation Research, see sub- section (n) of section 3515e of Title 42, The Public Health and Welfare.] PILOT PROGRAM ON COMMUNITY-BASED BRAIN INJURY RESIDENTIAL REHABILITATIVE CARE SERVICES FOR VETERANS WITH TRAUMATIC BRAIN INJURY Pub. L. 110–181, div. A, title XVII, § 1705, Jan. 28, 2008, 122 Stat. 491, as amended by Pub. L. 113–146, title V, § 501, Aug. 7, 2014, 128 Stat. 1792; Pub. L. 113–257, § 2(a), (b), Dec. 18, 2014, 128 Stat. 2924, 2925; Pub. L. 115–62, title I, § 107(a), (b), Sept. 29, 2017, 131 Stat. 1161, provided that: ‘‘(a) PILOT PROGRAM.—Beginning not later than 90 days after the date of the enactment of this Act [Jan. 28, 2008], the Secretary of Veterans Affairs, in collabo- ration with the Defense and Veterans Brain Injury Cen- ter of the Department of Defense, shall carry out a pilot program to assess the effectiveness of providing community-based brain injury rehabilitative care serv- ices to eligible veterans to enhance the rehabilitation, quality of life, and community integration of such vet- erans. ‘‘(b) PROGRAM LOCATIONS.— ‘‘(1) IN GENERAL.—The pilot program shall be car- ried out at locations selected by the Secretary for purposes of the pilot program. Of the locations so se- lected— ‘‘(A) at least one location shall be in each health care region of the Veterans Health Administration of the Department of Veterans Affairs that con- tains a polytrauma center of the Department of Veterans Affairs; and ‘‘(B) any location other than a location described in subparagraph (A) shall be in an area that con- tains a high concentration of veterans with trau- matic brain injuries, as determined by the Sec- retary. ‘‘(2) SPECIAL CONSIDERATION FOR VETERANS IN RURAL AREAS.—The Secretary shall give special consider- ation to providing veterans in rural areas with an op- portunity to participate in the pilot program. ‘‘(c) PROVISION OF COMMUNITY-BASED BRAIN INJURY RESIDENTIAL REHABILITATIVE CARE SERVICES.— ‘‘(1) AGREEMENTS.—In carrying out the pilot pro- gram, the Secretary may enter into agreements for the provision of community-based brain injury reha- bilitative care services on behalf of eligible veterans with a provider participating under a State plan or waiver under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.). ‘‘(2) STANDARDS.—The Secretary may not place, transfer, or admit a veteran to any facility for com- munity-based brain injury rehabilitative care serv- ices under the pilot program unless the Secretary de- termines that the facility meets such standards as the Secretary may prescribe for purposes of the pilot program. Such standards shall, to the extent prac- ticable, be consistent with the standards of Federal, State, and local agencies charged with the responsi- bility of licensing or otherwise regulating or inspect- ing such facilities. ‘‘(d) CONTINUATION OF CASE MANAGEMENT AND REHA- BILITATION SERVICES.—In carrying out the pilot pro- gram, the Secretary shall— ‘‘(1) continue to provide each veteran who is receiv- ing community-based brain injury rehabilitative care services under the pilot program with rehabilitative services; and ‘‘(2) designate employees of the Veterans Health Administration of the Department of Veterans Af- fairs to furnish case management services for vet- erans participating in the pilot program. ‘‘(e) REPORTS.— ‘‘(1) QUARTERLY REPORTS.— ‘‘(A) IN GENERAL.—For each calendar quarter oc- curring during the period beginning January 1, 2015, and ending September 30, 2017, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a re- port on the pilot program. ‘‘(B) ELEMENTS.—Each report submitted under subparagraph (A) shall include each of the following for the quarter preceding the quarter during which the report is submitted the following: ‘‘(i) The number of individuals that participated in the pilot program. ‘‘(ii) The number of individuals that success- fully completed the pilot program. ‘‘(iii) The degree to which pilot program par- ticipants and family members of pilot program participants were satisfied with the pilot pro- gram. ‘‘(iv) The interim findings and conclusions of the Secretary with respect to the success of the pilot program and recommendations for improve- ment. ‘‘(2) FINAL REPORT.— ‘‘(A) IN GENERAL.—Not later than December 6, 2017, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a final report on the pilot program. ‘‘(B) ELEMENTS.—The final report required by sub- paragraph (A) shall include the following: ‘‘(i) A description of the pilot program. ‘‘(ii) The Secretary’s assessment of the utility of the activities carried out under the pilot pro- gram in enhancing the rehabilitation, quality of life, and community reintegration of veterans with traumatic brain injury. ‘‘(iii) An evaluation of the pilot program in light of independent living programs carried out by the Secretary under title 38, United States Code, including— ‘‘(I) whether the pilot program duplicates services provided under such independent living programs; ‘‘(II) the ways in which the pilot program pro- vides different services that the services pro- vided under such independent living program; ‘‘(III) how the pilot program could be better defined or shaped; and ‘‘(IV) whether the pilot program should be in- corporated into such independent living pro- grams. ‘‘(iv) Such recommendations as the Secretary considers appropriate regarding improving the pilot program. ‘‘(f) DEFINITIONS.—In this section: ‘‘(1) The term ‘community-based brain injury reha- bilitative care services’ means services of a facility in providing room, board, rehabilitation, and personal care for and supervision of residents for their health, safety, and welfare. Page 369 TITLE 38—VETERANS’ BENEFITS § 1710E ‘‘(2) The term ‘case management services’ includes the coordination and facilitation of all services fur- nished to a veteran by the Department of Veterans Affairs, either directly or through a contract, includ- ing assessment of needs, planning, referral (including referral for services to be furnished by the Depart- ment, either directly or through a contract, or by an entity other than the Department), monitoring, reas- sessment, and followup. ‘‘(3) The term ‘eligible veteran’ means a veteran who— ‘‘(A) is enrolled in the patient enrollment system of the Department of Veterans Affairs under sec- tion 1705 of title 38, United States Code; ‘‘(B) has received hospital care or medical serv- ices provided by the Department of Veterans Af- fairs for a traumatic brain injury; ‘‘(C) is unable to manage routine activities of daily living without supervision and assistance, as determined by the Secretary; and ‘‘(D) could reasonably be expected to receive on- going services after the end of the pilot program under this section under another program of the Federal Government or through other means, as de- termined by the Secretary.’’ ‘‘(g) TERMINATION.—The pilot program shall termi- nate on January 6, 2018.’’ [Pub. L. 115–62, title I, § 107(c), Sept. 29, 2017, 131 Stat. 1161, provided that: ‘‘Not later than December 6, 2017, the Secretary of Veterans Affairs shall notify veterans participating in the pilot program under such section [section 1705 of Pub. L. 110–181, set out above] regarding a plan for transition of care for such veterans.’’] [Pub. L. 113–257, § 2(c), Dec. 18, 2014, 128 Stat. 2925, pro- vided that: ‘‘The amendments made by this section [amending section 1705 of Pub. L. 110–181, set out above] shall take effect on the date of the enactment of this Act [Dec. 18, 2014].’’] § 1710D. Traumatic brain injury: comprehensive program for long-term rehabilitation (a) COMPREHENSIVE PROGRAM.—In developing plans for the rehabilitation and reintegration of individuals with traumatic brain injury under section 1710C of this title, the Secretary shall develop and carry out a comprehensive program of long-term care and rehabilitative services (as defined in section 1710C of this title) for post- acute traumatic brain injury rehabilitation that includes residential, community, and home- based components utilizing interdisciplinary teams. (b) LOCATION OF PROGRAM.—The Secretary shall carry out the program developed under subsection (a) in each Department polytrauma rehabilitation center designated by the Sec- retary. (c) ELIGIBILITY.—A veteran is eligible for care under the program developed under subsection (a) if the veteran is otherwise eligible to receive hospital care and medical services under section 1710 of this title and— (1) served on active duty in a theater of com- bat operations (as determined by the Sec- retary in consultation with the Secretary of Defense) during a period of war after the Per- sian Gulf War, or in combat against a hostile force during a period of hostilities after No- vember 11, 1998; (2) is diagnosed as suffering from moderate to severe traumatic brain injury; and (3) is unable to manage routine activities of daily living without supervision or assistance, as determined by the Secretary. (d) REPORT.—Not later than one year after the date of the enactment of this section, and annu- ally thereafter, the Secretary shall submit to the Committees on Veterans’ Affairs of the Sen- ate and the House of Representatives a report containing the following information: (1) A description of the operation of the pro- gram. (2) The number of veterans provided care under the program during the year preceding such report. (3) The cost of operating the program during the year preceding such report. (Added Pub. L. 110–181, div. A, title XVII, § 1702(a), Jan. 28, 2008, 122 Stat. 488; amended Pub. L. 112–154, title I, § 107(b), Aug. 6, 2012, 126 Stat. 1173; Pub. L. 114–58, title VI, § 601(5), Sept. 30, 2015, 129 Stat. 538.) Editorial Notes REFERENCES IN TEXT The date of the enactment of this section, referred to in subsec. (d), is the date of enactment of Pub. L. 110–181, which was approved Jan. 28, 2008. AMENDMENTS 2015—Subsec. (c)(1). Pub. L. 114–58 struck out ‘‘(as de- fined in section 1712A(a)(2)(B) of this title)’’ after ‘‘hos- tilities’’. 2012—Subsec. (a). Pub. L. 112–154 inserted ‘‘and reha- bilitative services (as defined in section 1710C of this title)’’ after ‘‘long-term care’’ and struck out ‘‘treat- ment’’ before ‘‘teams’’. § 1710E. Traumatic brain injury: use of non-De- partment facilities for rehabilitation (a) COOPERATIVE AGREEMENTS.—The Secretary, in implementing and carrying out a plan devel- oped under section 1710C of this title, may pro- vide hospital care and medical services, includ- ing rehabilitative services (as defined in section 1710C of this title), through cooperative agree- ments with appropriate public or private enti- ties that have established long-term neurobehavioral rehabilitation and recovery programs. (b) COVERED INDIVIDUALS.—The care and serv- ices provided under subsection (a) shall be made available to an individual— (1) who is described in section 1710C(a) of this title; and (2)(A) to whom the Secretary is unable to provide such treatment or services at the fre- quency or for the duration prescribed in such plan; or (B) for whom the Secretary determines that it is optimal with respect to the recovery and rehabilitation for such individual. (c) AUTHORITIES OF STATE PROTECTION AND AD- VOCACY SYSTEMS.—Nothing in subtitle C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 shall be construed as pre- venting a State protection and advocacy system (as defined in section 1710C(g) of this title) from exercising the authorities described in such sub- title with respect to individuals provided reha- bilitative treatment or services under section 1710C of this title in a non-Department facility. (d) STANDARDS.—The Secretary may not pro- vide treatment or services as described in sub- section (a) at a non-Department facility under such subsection unless such facility maintains