110th Congress

Traumatic Brain Injury Act of 2008

P.L. 110-206 (S. 793, H.R. 1418)

Impact of Public Law

On April 28, 2008, the President signed into law the Traumatic Brain Injury Act of 2008 as P.L. 110-206. The purpose of the Act is to direct the Secretary of Health and Human Services to expand and intensify programs with respect to research and related activities concerning traumatic brain injury (TBI). The Act authorizes funding for trauma-related research, treatment, surveillance, and education activities by the Centers for Disease Control and Prevention (CDC), Health Resources and Services Administration (HRSA), and National Institutes of Health’s (NIH) trauma research program and provides authorizations for fiscal years 2009–2012. The Act revises the national program for TBI registries and authorizes CDC, in consultation with NIH, to conduct a study to 1) determine the incidence of TBI and prevalence of TBI-related disability, 2) report national trends in TBI, 3) identify common therapeutic interventions used for the rehabilitation of individuals with these injuries, 4) identify interventions and therapies that can prevent or remediate the development of secondary neurologic conditions related to TBI, and 5) develop practice guidelines for rehabilitation. The law also requires that CDC and NIH report to the relevant congressional committees on activities and procedures that can be implemented by CDC, the U.S. Department of Defense, and the U.S. Department of Veterans Affairs to improve the collection and dissemination of compatible epidemiological studies on the incidence and prevalence of TBI in the military and veterans populations. In addition, the Act directs the Comptroller General of the United States to conduct a study regarding members of the armed forces who have acquired a disability resulting from a TBI received while serving in Operation Enduring Freedom or Operation Iraqi Freedom that examines how these individuals are being reintegrated into their communities.

Legislative History

Each year, of the 1.5 million people in the United States who sustain a TBI, 50,000 die and 235,000 are hospitalized. TBI is defined as brain damage from externally inflicted trauma to the head resulting in significant impairment to an individual’s physical, psychosocial, and/or cognitive functional abilities. According to CDC, brain injuries are among the most likely types of injury to cause death or permanent disability. Motor vehicle accidents, sports accidents, falls, and violence are the major causes of TBI, and people ages 15–24 and those over age 75 are the two age groups at highest risk for TBI. Whereas motor vehicle accidents and violence such as firearm assaults and child abuse account for 70 percent of TBI in the overall U.S. population, falling is the major cause in people age 75 and older. TBI is also caused by explosives, and medical experts have described it as the signature wound of the Iraq war. Up to two-thirds of injuries sustained in the Iraq war may be brain injuries.

TBI can strike anyone—infant, youth, or elderly person—without warning and with devastating results. It is particularly common among young males and people of both sexes age 75 and older. TBI affects the whole family and often results in significant medical and rehabilitation expenses over a lifetime. Estimates indicate that at minimum, brain injuries cost the United States $60 billion annually.

TBI is different from other disabilities because of the severity of cognitive loss. Most rehabilitation programs are designed for people with physical disabilities, not cognitive disabilities that require special accommodation. Finding needed services is typically a logistical, financial, and psychological challenge for family members and other caregivers because few coordinated systems of care exist for individuals with TBI. The Traumatic Brain Injury Act of 1996 improved TBI service systems at the State level and increased the overall visibility of TBI. Sponsors of the Traumatic Brain Injury Act of 2008 believe that more work needs to be done at both the national and State levels to build an effective, durable service system for meeting the needs of individuals with TBI and their families.

S. 793 was introduced by Senator Orrin G. Hatch (R-UT) on March 7, 2007, and H.R. 1418 was introduced by Representative Bill Pascrell, Jr. (D-NJ) on March 8, 2008. S. 793 was reported out of the Senate Committee on Health, Education, Labor and Pensions on August 1 (as S. Rept. 110 140) and was passed by the Senate by unanimous consent on December 11. On April 8, 2008, the House passed S. 793 by a vote of 392 to 1. Also on April 8, the House reported out H.R. 1418, the companion measure to S. 793 (as H. Rept. 110-567). On April 10, the bill was cleared for the White House, and it was presented to the President on April 17. On April 28, President Bush signed S. 793 into law as P.L. 110-206.

May 2008