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Hatch, Kennedy Bill To Help Millions Suffering From Traumatic Brain Injury

Washington – Sens. Orrin G. Hatch (R-Utah) and Edward Kennedy (D-Mass.) today introduced legislation to reauthorize the only federal law specifically addressing issues faced by 5.3 million Americans who live with a long-term disability as a result of traumatic brain injury, or TBI. Hatch and Kennedy were the principal authors of the original TBI law in 1996.

“Those suffering from a traumatic brain injury deserve the best care possible,” Hatch said. “That’s the goal of this bill – to help patients get quality care early, so they can recover from this devastating injury. It’s difficult to describe the heavy physical, emotional, and financial toll caused by TBI. We need to reauthorize the TBI Act to not only improve the care the injured receive but also to help prevent others from suffering brain injuries in the first place.”

“This bill couldn’t be more timely or important -- it will help the thousands of soldiers coming home from Iraq and Afghanistan with traumatic brain injuries,” Kennedy said. “We need to fund programs that have helped individuals with traumatic brain injury with an array of advocacy needs including assistance with returning to work, finding a place to live, accessing needed supports and services such as attendant care and assistive technology, and obtaining appropriate mental health, substance abuse, and rehabilitation services. As a nation we owe it to our injured men and women in uniform to do all we can to provide them with the help they need to recover and live fulfilling lives.”

Brain injuries are the most frequent reasons for visits to physicians and emergency rooms, the most common causes being falls and car crashes. Of the 1.5 million people in the United States who sustain a TBI each year, 50,000 die, 235,000 are hospitalized, and 1.1 million are treated and released from an emergency department. An extremely high incidence of TBI occurs among children between birth and age 14 – approximately 475,000 per year.

The TBI Act would continue essential federal funding for programs within the Centers for Disease Control (CDC), National Institutes of Health (NIH), and Health Resources and Services Administration (HRSA) to conduct research on TBI, provide education and prevention programs and make available protection and advocacy services. The bill would reauthorize these programs through 2011, authorize a new study through CDC and NIH to determine the incidence and prevalence of TBI and instruct HRSA and the Administration on Developmental Disabilities to coordinate data collection regarding protection and advocacy services.

Hatch’s full introductory floor statement follows:

Statement of the Honorable Orrin G. Hatch
on the introduction of the Reauthorization of the Traumatic Brain Injury Act

Mr. President, I rise today to introduce legislation to reauthorize the Traumatic Brain Injury Act. It is my pleasure to be joined in this effort by the Chairman of the Senate Health, Education, Labor and Pension Committee, Senator Ted Kennedy, with whom I worked on the original legislation over ten years ago.

Sustaining a traumatic brain injury - or TBI - can be both catastrophic and devastating. The financial and emotional costs to the individual, family, and community are enormous. Traumatic brain injuries contribute to a substantial number of deaths and cases of permanent disability annually.

Individuals with TBI and their families are often faced with challenges, such as improper diagnosis, inability to access support or rehabilitation services, institutional segregation, unemployment, and being forced to navigate complicated and cumbersome service and support systems.

Of the 1.4 million who sustain a TBI each year in the United States: 50,000 die; 235,000 are hospitalized; and 1.1 million are treated and released from an emergency department. Brain injuries are the most frequent reasons for visits to physicians and emergency rooms.

These statistics are more revealing when one considers that every 16 seconds someone in the U.S. sustains a head injury; and every 12 minutes, one of these people will die and another will become permanently disabled. Of those who survive, each year, an estimated 80,000 to 90,000 people experience the onset of long-term disability associated with a TBI. An additional 2,000 will exist in a persistent vegetative state.

Even more startling is the fact that brain injury kills more Americans under the age of 34 than all other causes combined and has claimed more lives since the turn of the century than all United States wars combined.

Recent publicity about brain injuries Americans have sustained in Iraq points out that TBI is an everyday threat to our servicemen and servicewomen -- 68% of war veterans are returning home with sustained brain injuries. According to the Defense and Veterans Brain Injury Center, which serves active duty military, their dependents and veterans with TBI, traumatic brain injury is one of the leading causes of death and disability on today's battlefield. While not specifically addressed by this bill, the federal TBI program helps to provide resources that supplement the networks which serve our returning soldiers.

The distress of TBI is not limited to diagnosis. A survivor of a severe brain injury typically faces five to 10 years of intensive services and estimated lifetime costs can exceed $4 million. Direct medical costs and indirect costs such as lost productivity of TBI totaled an estimated $60 billion in the United States in 2000.

To recognize the large number of individuals and families struggling to access appropriate and community-based services, Senator Kennedy and I wrote the TBI Act of 1996 (PL 104-166).

The TBI Act of 1996 launched an effort to conduct expanded studies and to establish innovative programs for TBI. It gave the Health Resources and Services Administration (HRSA) authority to establish a grant program for States to assist it in addressing the needs of individuals with TBI and their families. It also delegated responsibilities in the areas of research, prevention, and surveillance to the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), respectively.

Title XIII of the Children's Health Act of 2000 (PL 106-310) reauthorized the programs of the TBI Act of 1996. This reauthorization also added a provision on protection and advocacy (P&A) services for individuals with TBI and their families by authorizing HRSA to make grants to State P&A Systems.

The Traumatic Brain Injury Act is the only federal legislation that specifically addresses issues faced by 5.3 million American children and adults who live with a long-term disability as a result of traumatic brain injury. Reauthorization of the Traumatic Brain Injury Act will provide for the continuation of research, not only for the treatment of TBI, but also for prevention and awareness programs which will help decrease the occurrence of traumatic brain injury and improve the long-term outcome.

This legislation authorizes the Health Resources and Services Administration (HRSA) to make grants for projects of national significance that improve individual and family access to service systems; assist states in developing service capacity; improve monitoring and evaluation of rehabilitation services and supports; and address emerging needs of servicemen and women, veterans, and individuals and families who have experienced brain injury through service delivery demonstration projects.

This bill also authorizes HRSA to include the American Indian Consortium as an eligible recipient of competitive grants awarded to States, Territories, and the District of Columbia to develop comprehensive system of services and supports nationwide.

Furthermore, this bill instructs HRSA and the Administration on Developmental Disabilities to coordinate data collection regarding protection and advocacy services.

Also funded by the TBI program, the CDC supports multiple projects and programs, including those that monitor TBI, link people with TBI to information about services, and prevent TBI-related disabilities. These projects comprise initiatives such as generating national estimates for TBI deaths, hospitalizations, and emergency department visits; planning the future of TBI registries and data systems; and educating health care professionals about TBI. In addition, the CDC funds TBI research in various academic institutions to investigate TBI in children and adolescents.

This year, Congress has an opportunity to strengthen the TBI Act by authorizing the Centers for Disease Control and Prevention (CDC) to determine the incidence and prevalence of traumatic brain injury in the general population of the United States, including all age groups and persons in institutional settings such as nursing homes, correctional facilities, psychiatric hospitals, child care facilities, and residential institutes for people with developmental disabilities.

Brain injury is a complex issue and there is still much unknown. With federal funds provided within the TBI program, researchers at the NIH are studying many issues related to the special cognitive and communication problems experienced by individuals who have traumatic brain injuries. Scientists are designing new evaluation tools to assess the special problems that children who have suffered traumatic brain injuries encounter. Because the brain of a child is vastly different from the brain of an adult, scientists are also examining the effects of various treatment methods that have been developed specifically for children. In addition, research is examining the effects of some medications on the recovery of speech, language, and cognitive abilities following traumatic brain injury. Reauthorization of the TBI program will enable this important research to continue and expand.

As I have mentioned, there is still a lot of unknown surrounding the issue of TBI; however, one aspect is definite, and that is that people are never the same after TBI. Not only are their lives forever changed, but they must face these changes in a compromised state. The TBI program offers balanced and coordinated public policy in brain injury prevention, research, education, and community-based services and supports for individuals living with traumatic brain injury and their families.

Mr. President, reauthorization of the Traumatic Brain Injury Act will further provide mechanisms for the research, prevention, and treatment of TBI and the improvement of the quality of life for those Americans and their families who may sustain such a devastating disability. I ask my colleagues' support in promptly reauthorizing the Traumatic Brain Injury Act.

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