[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8025 Introduced in House (IH)]
<DOC>
118th CONGRESS
2d Session
H. R. 8025
To amend title 10, United States Code, to clarify roles and
responsibilities within the Department of Defense relating to
subconcussive and concussive brain injuries and to improve brain health
initiatives of the Department of Defense, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 16, 2024
Mr. Khanna (for himself, Ms. Stefanik, Ms. Houlahan, Mrs. Kiggans of
Virginia, Ms. Lee of Nevada, Mr. Waltz, Mr. Bishop of Georgia, Mr.
Moulton, Ms. Pingree, Mr. Golden of Maine, and Mr. Panetta) introduced
the following bill; which was referred to the Committee on Armed
Services
_______________________________________________________________________
A BILL
To amend title 10, United States Code, to clarify roles and
responsibilities within the Department of Defense relating to
subconcussive and concussive brain injuries and to improve brain health
initiatives of the Department of Defense, 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. SHORT TITLE.
This Act may be cited as the ``Blast Overpressure Safety Act''.
SEC. 2. ROLES AND RESPONSIBILITIES FOR COMPONENTS OF THE OFFICE OF THE
SECRETARY OF DEFENSE RELATING TO BRAIN INJURIES FROM
CONCUSSIVE AND SUBCONCUSSIVE BLASTS.
(a) Findings and Sense of Congress.--
(1) Findings.--Congress finds the following:
(A) Research conducted by the Department of Defense
underscores that concussive and subconcussive brain
injuries can arise not only from combat scenarios but
also from routine training exercises.
(B) Even when adhering to established safety
guidelines, the act of firing or being exposed to the
firing of heavy weapons, grenades, and breaching during
training sessions can potentially lead to cognitive
impairments, particularly affecting aspects such as
delayed verbal memory, visual-spatial memory, and
executive function.
(C) Traumatic brain injuries have become the
signature wound of members of the Armed Forces from the
Global War on Terrorism generation.
(D) Special Warfare Operator 1st Class Ryan Larkin
and Sergeant First Class Michael Froede both suffered
traumatic brain injuries during their rigorous training
and multiple combat deployments and were tragically
lost to suicide as a result of their wounds. Their
stories highlight the critical issues surrounding
traumatic brain injury within the military and the
subsequent risk of suicide among affected individuals.
(E) This Act honors the sacrifices of Special
Warfare Operator 1st Class Ryan Larkin and Sergeant
First Class Michael Froede, as well as the thousands of
affected members of the Armed Forces by expediting the
efforts of the Department of Defense to mitigate,
identify, and treat traumatic brain injuries within the
Armed Forces.
(2) Sense of congress.--It is the sense of Congress that--
(A) Congress commends the Department of Defense for
its efforts to implement measures consistent with
modern science to limit the occurrence of concussive
and subconcussive brain injuries among members of the
Armed Forces and facilitate the rehabilitation of those
recovering from service-related traumatic brain
injuries; and
(B) the Secretary of Defense should sustain those
efforts while also enhancing overall knowledge and
protection against brain injuries.
(b) Establishment of Roles.--The Secretary of Defense shall
establish the roles and responsibilities of components of the Office of
the Secretary of Defense for the mitigation, identification, and
treatment of concussive and subconcussive brain injuries and the
monitoring and documentation of blast overpressure exposure as follows:
(1) The Under Secretary of Defense for Personnel and
Readiness shall be responsible for, not later than one year
after the date of the enactment of this Act--
(A) establishing a baseline neurocognitive
assessment to be conducted during the accession process
of members of the Armed Forces before the beginning of
training;
(B) establishing annual neurocognitive assessments
to monitor the cognitive function of such members to be
conducted--
(i) at least every three years as part of
the periodic health assessment of such members;
(ii) as part of the post-deployment health
assessment of such members; and
(iii) prior to separation from service in
the Armed Forces;
(C) ensuring all neurocognitive assessments of such
members, including those required under subparagraphs
(A) and (B), are maintained in the electronic medical
record of such member;
(D) establishing a process for annual review of
blast overpressure exposure and traumatic brain injury
logs specified in paragraph (2)(A) for each member of
the Armed Forces during the periodic health assessment
of such member for cumulative exposure in order to
refer members with recurrent and prolonged exposure to
specialty care; and
(E) establishing standards for recurrent and
prolonged exposure.
(2) The Assistant Secretary of Defense for Readiness shall
be responsible for, not later than one year after the date of
the enactment of this Act, the following:
(A) Establishing and maintaining blast overpressure
exposure logs and traumatic brain injury logs for every
member of the Armed Forces.
(B) Integrating those logs into the Individual
Longitudinal Exposure Record (as defined in section
1171(b) of title 38, United States Code) for such
member.
(C) Including in those logs at least the following:
(i) The number of previous exposures to
blast overpressure, including the number of
exposures per unit of time, date, blast
overpressure in pounds per square inch, and
number of times the member of the Armed Forces
fires, uses, or is exposed to weapons that
cause blast overpressure.
(ii) Any residual physical, mental, or
emotional effects resulting from such exposure.
(iii) The source of the exposure, activity
when the exposure occurred, whether it occurred
during training or deployment, and any other
relevant context of such exposure.
(iv) The treatment that the member sought
and received in connection with such exposure.
(v) The number of concussive and
subconcussive brain injuries, including
traumatic brain injuries, sustained.
(vi) The severity of concussive and
subconcussive brain injuries, including
traumatic brain injuries, sustained.
(vii) Other head trauma, regardless of
whether it requires the treatment of a medical
provider.
(3) The Inspector General of the Department of Defense
shall be responsible for--
(A) not later than two years after the date of the
enactment of this Act, submitting to Congress a report
(in unclassified form, but with a classified annex as
necessary) evaluating the establishment and maintenance
of the logs required under paragraph (2), including the
cumulative exposure annotated in the blast overpressure
exposure logs and traumatic brain injury logs, as well
as the compliance of the Department of Defense with
Department policies to address the brain health of
members of the Armed Forces;
(B) not later than 10 days after submitting the
report under subparagraph (A), making available to the
public the unclassified portion of the report; and
(C) beginning on the date that is three years after
the date of the enactment of this Act--
(i) evaluating the continued fulfillment by
the Department of the requirements under
paragraph (2), including the cumulative
exposure annotated in the blast overpressure
exposure logs and traumatic brain injury logs,
as well as the compliance of the Department
with Department policies to address the brain
health of members of the Armed Forces;
(ii) not later than December 31 of each
year, submitting to Congress a report (in
unclassified form, but with a classified annex
as necessary) containing the results of such
evaluation; and
(iii) not later than 10 days after
submitting each report under clause (ii),
making available to the public the unclassified
portion of such report.
(4) The Under Secretary of Defense for Acquisition and
Sustainment shall be responsible for, not later than one year
after the date of enactment of this Act, the following:
(A) Establishing the minimization of exposure to
blast overpressure as a performance parameter when
drafting requirements for new weapons systems that
produce blast overpressure for the Department of
Defense.
(B) Establishing a requirement that any entity
under contractual agreement with the Department as part
of the defense weapons acquisition process shall
provide to the Department blast overpressure
measurements and safety data for any weapons system
that produce blast overpressure and exceed the
department set maximum exposure limit procured from
such entity.
(C) Establishing a requirement that any test plan
for a weapons system incorporate testing for blast
overpressure measurements and safety data.
(D) Not later than December 31 of each year,
publishing on a publicly available website, including
govinfo.gov or successor website, a report that
includes--
(i) blast overpressure measurements and
safety data for weapons systems of the
Department, including how those systems have
been tested and in what environments; and
(ii) plans to improve protection for
exposure by members of the Armed Forces to in-
use weapons systems with unsafe levels of blast
overpressure and exposure.
(c) Coordination.--The officials specified in paragraphs (1), (2),
(3), and (4) of subsection (b) shall coordinate and align their plans
and activities to implement such subsection among themselves and with
the Secretaries of the military departments.
(d) Briefings and Reports.--
(1) Implementation briefing.--Not later than 180 days after
the date of the enactment of this Act, and every 180 days
thereafter, the Secretary of Defense shall provide to the
congressional defense committees a briefing on the plans,
associated timelines, and activities conducted to implement
subsection (a).
(2) Report on concussive and subconcussive brain
injuries.--
(A) In general.--Not later than 180 days after the
date of the enactment of this Act, and annually
thereafter, the Secretary of Defense shall submit to
the congressional defense committees a report on--
(i) concussive and subconcussive brain
injuries caused during military operations,
including combat operations, among members of
the Armed Forces, including information on--
(I) the Armed Force of the member;
(II) the name of the operation;
(III) the location within the area
of responsibility;
(IV) the number of concussive and
subconcussive brain injuries caused;
(V) the severity of concussive and
subconcussive brain injuries caused;
(VI) the treatment received for a
concussive or subconcussive brain
injury;
(VII) whether a member of the Armed
Forces was medically retired from
service due to a concussive or
subconcussive brain injury;
(VIII) whether a member of the
Armed Forces died by suicide after
sustaining a concussive or
subconcussive brain injury; and
(IX) the source of the injury,
including the activity conducted when
the injury occurred; and
(ii) concussive and subconcussive brain
injuries caused during training events among
members of the Armed Forces, including
information on--
(I) the Armed Force of the member;
(II) the type of training;
(III) the location of the training;
(IV) the number of concussive and
subconcussive brain injuries caused;
(V) the severity of concussive and
subconcussive brain injuries caused;
(VI) the treatment received for a
concussive or subconcussive brain
injury;
(VII) whether a member of the Armed
Forces was medically retired from
service due to a concussive or
subconcussive brain injury;
(VIII) whether a member of the
Armed Forces died by suicide after
sustaining a concussive or
subconcussive brain injury; and
(IX) the source of the injury,
including the activity conducted when
the injury occurred.
(B) Form.--Each report submitted under subparagraph
(A) shall be submitted in unclassified form, but may
include a classified annex.
(C) Public availability.--Not later than 10 days
after submitting a report under subparagraph (A), the
Secretary of Defense shall make the unclassified
portion of the report available to the public,
including by publishing the report on the govinfo.gov
website, or successor website.
(3) Report on discharges related to concussive and
subconcussive brain injuries.--
(A) In general.--Not later than 180 days after the
date of the enactment of this Act, and annually
thereafter, the officials specified in paragraphs (1)
and (2) of subsection (b) and the Secretary of Defense
shall submit to the congressional defense committees a
report on members of the Armed Forces who were
discharged administratively or punitively and had a
concussive or subconcussive brain injury, including a
traumatic brain injury, including information on--
(i) whether the injury or injuries occurred
during combat operations or training and the
associated combat operations or training
incident;
(ii) the severity of the injury or
injuries;
(iii) if any such injury was combat
related, the name of the operation;
(iv) the treatment sought and received for
the injury or injuries;
(v) the number of discharge upgrade
requests in connection with such an injury or
injuries that have been made; and
(vi) the number of such discharge upgrade
requests that have been approved.
(B) Form.--Each report submitted under subparagraph
(A) shall be submitted in unclassified form, but may
include a classified annex.
(C) Public availability.--Not later than 10 days
after submitting a report under subparagraph (A), the
Secretary of Defense shall make the unclassified
portion of the report available to the public,
including by publishing the report on the govinfo.gov
website, or successor website.
(4) Report on medical providers trained in concussive and
subconcussive brain injuries.--
(A) In general.--Not later than 180 days after the
date of the enactment of this Act, and annually
thereafter, the Secretary of Defense shall submit to
the congressional defense committees a report on
medical providers within the Defense Health Agency who
are trained in traumatic brain injury or concussive and
subconcussive brain injuries as a sub-specialty of
neurology, including information on--
(i) the number of such providers,
disaggregated by location;
(ii) the billets of such personnel;
(iii) the number of medical personnel
currently participating in training or a
fellowship relating to traumatic brain injury
or concussive and subconcussive brain injuries;
and
(iv) the strategy of the Department of
Defense to increase the number of medical
providers trained in traumatic brain injury or
concussive and subconcussive brain injuries as
a sub-specialty of neurology.
(B) Public availability.--Not later than 10 days
after submitting a report under subparagraph (A), the
Secretary of Defense shall make the report available to
the public, including by publishing the report on the
govinfo.gov website, or successor website.
(5) Report on efforts to coordinate with allies and
partners.--
(A) In general.--Not later than 180 days after the
date of the enactment of this Act, and annually
thereafter, the Secretary of Defense shall submit to
the congressional defense committees a report on the
efforts of the Department of Defense to share and
coordinate on blast injury and subconcussive and
concussive brain injury research efforts with allies
and partners of the United States, which shall include
information on--
(i) the activities coordinated with such
allies and partners to better prevent,
mitigate, and treat injuries from blast
exposure; and
(ii) recommendations to improve future
collaboration with such allies and partners,
including administrative and data structures.
(B) Public availability.--Not later than 10 days
after submitting a report under subparagraph (A), the
Secretary of Defense shall make the report available to
the public, including by publishing the report on the
govinfo.gov website, or successor website.
(e) Definitions.--In this section:
(1) Congressional defense committees.--The term
``congressional defense committees'' has the meaning given that
term in section 101(a)(16) of title 10, United States Code.
(2) Contractual agreement.--The term ``contractual
agreement'' includes a contract, grant, cooperative agreement,
and any other similar transaction or relationship.
(3) Neurocognitive assessment.--The term ``neurocognitive
assessment'' means a standardized cognitive and behavioral
evaluation using validated and normed testing performed in a
formal environment that uses specifically designated tasks to
measure cognitive function known to be linked to a particular
brain structure or pathway, which may include a measurement of
intellectual functioning, attention, new learning or memory,
intelligence, processing speed, and executive functioning.
(4) Traumatic brain injury.--The term ``traumatic brain
injury'' means a traumatically induced structural injury or
physiological disruption of brain function as a result of an
external force that is indicated by new onset or worsening of
at least one of the following clinical signs immediately
following the event:
(A) Alteration in mental status, including
confusion, disorientation, or slowed thinking.
(B) Loss of memory for events immediately before or
after the injury.
(C) Any period of loss of or decreased level of
consciousness, observed or self-reported.
SEC. 3. IMPROVEMENTS TO BRAIN HEALTH INITIATIVES OF DEPARTMENT OF
DEFENSE.
(a) Brain Health Initiatives.--
(1) In general.--Part II of subtitle A of title 10, United
States Code, is amended by inserting after chapter 55 the
following new chapter:
``CHAPTER 55A--BRAIN HEALTH INITIATIVES
``Sec. 1110n. Definition of traumatic brain injury
``In this chapter, the term `traumatic brain injury' means a
traumatically induced structural injury or physiological disruption of
brain function as a result of an external force that is indicated by
new onset or worsening of at least one of the following clinical signs
immediately following the event:
``(1) Alteration in mental status, including confusion,
disorientation, or slowed thinking.
``(2) Loss of memory for events immediately before or after
the injury.
``(3) Any period of loss of or decreased level of
consciousness, observed or self-reported.
``Sec. 1110n-1. Warfighter Brain Health Initiative
``(a) In General.--The Secretary of Defense, in consultation with
the Secretaries concerned, shall establish a comprehensive initiative
for brain health to be known as the `Warfighter Brain Health
Initiative' (in this section referred to as the `Initiative') for the
purpose of unifying efforts and programs across the Department of
Defense to improve the cognitive performance and brain health of
members of the armed forces.
``(b) Objectives.--The objectives of the Initiative shall be the
following:
``(1) To enhance, maintain, and restore the cognitive
performance of members of the armed forces through education,
training, prevention, protection, monitoring, detection,
diagnosis, treatment, and rehabilitation, including through the
following activities:
``(A) The establishment of a program to monitor
cognitive brain health across the Department of
Defense, with the goal of detecting any need for
cognitive enhancement or restoration resulting from
potential brain exposures of members of armed forces,
to mitigate possible evolution of injury or disease
progression.
``(B) The identification and dissemination of
thresholds for blast exposure and blast overpressure
safety and associated emerging scientific evidence
that--
``(i) cover brain injury, lung injury, and
impulse noise;
``(ii) measure impact over 24-hour, 72-hour
to 96-hour, monthly, annual, and lifetime
periods;
``(iii) ensure that the thresholds are low
enough that they are not associated with
cognitive deficits after firing;
``(iv) include thresholds that account for
the firing of multiple types of heavy weaponry
and use of grenades in one period of time;
``(v) include minimum safe distances and
levels of exposure for observers and
instructors; and
``(vi) include limits for shoulder-fired
heavy weapons.
``(C) The modification of high-risk training and
operational activities to mitigate the negative effects
of repetitive blast exposure.
``(D) The identification of individuals who perform
high-risk training or occupational activities for
purposes of increased monitoring of the brain health of
such individuals.
``(E) The development and operational fielding of
non-invasive, portable, point-of-care medical devices,
to inform the diagnosis and treatment of traumatic
brain injury.
``(F) The establishment of a standardized
monitoring program that documents and analyzes blast
exposures that may affect the brain health of members
of the armed forces.
``(G) The consideration of the findings and
recommendations of the report of the National Academies
of Science, Engineering, and Medicine published in 2022
and entitled `Traumatic Brain Injury: A Roadmap for
Accelerating Progress' (relating to the acceleration of
progress in traumatic brain injury research and care),
or any successor report, in relation to the activities
of the Department relating to brain health.
``(H) The establishment of policies to encourage
members of the armed forces to seek support for brain
health when needed, prevent retaliation against such
members who seek care, and address other barriers to
seeking help for brain health, including due to the
impact of blast exposure, blast overpressure, traumatic
brain injury, and other health matters.
``(I) The modification of existing weapons systems
to reduce blast exposure of the individual using the
weapon and those within the minimum safe distance.
``(2) To harmonize and prioritize the efforts of the
Department of Defense into a single approach to brain health.
``(c) Thresholds for Blast Exposure and Overpressure Safety.--
``(1) Deadline.--
``(A) In general.--Not later than two years after
the date of the enactment of the Blast Overpressure
Safety Act, the Secretary of Defense shall identify and
disseminate the thresholds for blast exposure and blast
overpressure safety and associated emerging scientific
evidence required under subsection (b)(1)(B).
``(B) Update.--Not less frequently than every five
years, the Secretary of Defense shall update the
thresholds for blast exposure and blast overpressure
safety and associated emerging scientific evidence
required under subsection (b)(1)(B).
``(2) Central repository.--Not later than two years after
the date of the enactment of the Blast Overpressure Safety Act,
the Secretary of Defense shall establish a central repository
of blast-related characteristics, such as pressure profiles and
common blast loads associated with specific systems and the
environments in which they are used, that is available to
members of the armed forces and the public and includes the
information described in subsection (b)(1)(B).
``(3) Waivers.--
``(A) Protocols.--Not later than two years after
the date of the enactment of the Blast Overpressure
Safety Act, the Secretary of Defense shall establish
and implement protocols to require waivers in cases in
which members of the armed forces must exceed the
safety thresholds described in subsection (b)(1)(B),
which shall include a justification for exceeding those
safety thresholds.
``(B) Tracking system.--
``(i) In general.--Not later than two years
after the date of the enactment of the Blast
Overpressure Safety Act, the Secretary of
Defense shall establish a Department of
Defense-wide tracking system for waivers
described in subparagraph (A), which shall
include data contributed by each of the
Secretaries concerned.
``(ii) Report.--
``(I) In general.--Not less
frequently than once each year by
December 31 of that year following the
establishment of the tracking system
required under clause (i), the
Secretary of Defense shall submit to
the Committees on Armed Services of the
Senate and the House of Representatives
a report on waivers described in
subparagraph (A) that includes--
``(aa) the number of
waivers issued, disaggregated
by armed force;
``(bb) the justifications
provided for each waiver;
``(cc) a description of
actions taken by the Secretary
concerned to track the health
effects on members of the armed
forces of exceeding safety
thresholds described in
subsection (b)(1)(B), document
those effects in medical
records, and provide care to
those members; and
``(dd) a description of the
medical care received by those
members in response to
exceeding these safety
thresholds.
``(II) Public availability.--The
Secretary of Defense shall make the
information contained in each report
submitted under subclause (I) available
to the public, including on the
govinfo.gov website, or successor
website, not later than 10 days after
the report is submitted under such
subclause.
``(d) Formal Training Requirement.--
``(1) In general.--The Secretary of Defense shall ensure
that training described in paragraph (2) is required for
members of the armed forces before training, deployment, or
entering other environments determined to be high-risk by the
Secretary concerned.
``(2) Training described.--Training described in this
paragraph is training on the following:
``(A) Thresholds for blast exposure and blast
overpressure safety and associated emerging scientific
evidence required under subsection (b)(1)(B).
``(B) Symptoms of exposure to blasts or blast
overpressure.
``(C) Symptoms of traumatic brain injury.
``(e) Strategies for Mitigation and Prevention of Blast Exposure
and Overpressure Risk for High-Risk Individuals.--In carrying out the
Initiative, not later than one year after the date of the enactment of
the Blast Overpressure Safety Act, the Secretary of Defense shall
establish strategies for mitigating and preventing blast exposure and
blast overpressure risk for individuals most at risk for exposure to
high-risk training or high-risk occupational activities, which shall
include--
``(1) a timeline and process for implementing those
strategies;
``(2) a determination of the frequency with which those
strategies will be updated, at a rate of not less frequently
than every five years; and
``(3) an assessment of how information regarding those
strategies will be disseminated to such individuals, including
after those strategies are updated.
``(f) Annual Budget Justification Documents.--In the budget
justification materials submitted to Congress in support of the budget
of the Department of Defense for each fiscal year (as submitted with
the budget of the President under section 1105(a) of title 31), the
Secretary of Defense shall include a budget justification display that
includes all activities of the Department relating to the Initiative.
``(g) Annual Reports.--
``(1) In general.--Not later than March 31, 2025, and not
less frequently than annually thereafter, the Secretary of
Defense shall submit to the Committees on Armed Services of the
Senate and the House of Representatives a report that includes
the following:
``(A) A description of the activities taken under
the Initiative and resources expended under the
Initiative during the prior fiscal year.
``(B) The number of members of the armed forces
impacted by blast overpressure and blast exposure in
the prior fiscal year, including--
``(i) the number of members who reported
adverse health effects from blast overpressure
or blast exposure;
``(ii) the number of members exposed to
blast overpressure or blast exposure;
``(iii) the number of members who received
treatment for injuries related to blast
overpressure or blast exposure, including at
facilities of the Department of Defense and at
facilities in the private sector;
``(iv) regarding treatment for blast
exposure, blast overpressure, or subconcussive
or concussive brain injuries at the National
Intrepid Center of Excellence, an Intrepid
Spirit Center, or an appropriate military
medical treatment facility--
``(I) the number of members on the
waitlist for such treatment;
``(II) the average period of time
those members are on that waitlist; and
``(III) the average number of days
between when an appointment is
requested and the actual appointment
date; and
``(v) the type of care that members receive
from facilities of the Department of Defense
and the type of care that members receive from
facilities in the private sector.
``(C) A summary of the progress made during the
prior fiscal year with respect to the objectives of the
Initiative under subsection (b).
``(D) A description of the steps the Secretary is
taking to ensure that activities under the Initiative
are being implemented across the Department of Defense
and the military departments.
``(2) Public availability.--The Secretary of Defense shall
make the information contained in each report submitted under
paragraph (1) available to the public, including on the
govinfo.gov website, or successor website, not later than 10
days after the report is submitted under such paragraph.''.
(b) Conforming and Clerical Amendments.--
(1) Clerical amendment.--The table of sections at the
beginning of title 10, United States Code, is amended by
inserting before the item relating to chapter 56 the following
new items:
``CHAPTER 55A--Brain Health Initiatives
``Sec.
``1110n. Definition of traumatic brain injury.
``1110n-1. Warfighter Brain Health Initiative.''.
(2) Conforming repeal.--Section 735 of the James M. Inhofe
National Defense Authorization Act for Fiscal Year 2023 (Public
Law 117-263; 10 U.S.C. 1071 note) is repealed.
(c) Initial Briefing and Report on National Intrepid Center of
Excellence.--
(1) In general.--Not later than 150 days after the date of
the enactment of this Act, the Secretary of Defense shall
provide to the congressional defense committees a briefing and
submit to the congressional defense committees a report on the
parameters of the program of record established under section
1110n-3 of title 10, United States Code, as added by subsection
(a).
(2) Congressional defense committees defined.--In this
subsection, the term ``congressional defense committees'' has
the meaning given that term in section 101(a)(16) of title 10,
United States Code.
SEC. 4. PILOT PROGRAM RELATING TO MONITORING OF BLAST COVERAGE.
(a) Authority.--The Secretary concerned may conduct, as part of the
initiative established under section 1110n-1 of title 10, United States
Code, as added by section 3, a pilot program under which the Secretary
concerned shall monitor blast overpressure exposure through the use of
commercially available, off-the-shelf, remote measurements, and
document and evaluate data collected as a result of such monitoring.
(b) Locations.--Monitoring activities under a pilot program
conducted pursuant to subsection (a) shall be carried out in each
training environment that the Secretary concerned determines poses a
risk for blast overpressure exposure.
(c) Documentation and Sharing of Data.--If the Secretary concerned
conducts a pilot program pursuant to subsection (a), the Secretary
concerned shall--
(1) ensure that any data collected pursuant to such pilot
program that is related to the health effects of the blast
overpressure exposure of a member of the armed forces who
participated in the pilot program is documented and maintained
by the Secretary of Defense in an electronic health record for
the member; and
(2) to the extent practicable, and in accordance with
applicable provisions of law relating to data privacy, make
data collected pursuant to such pilot program available to
other academic and medical researchers for the purpose of
informing future research and treatment options.
(d) Definition of Secretary Concerned.--In this section, the term
``Secretary concerned'' has the meaning given such term in section 101
of title 10, United States Code.
SEC. 5. SPECIAL OPERATIONS BRAIN HEALTH AND TRAUMA PROGRAM.
(a) In General.--Chapter 55A of title 10, United States Code, as
added by section 3, is amended by adding at the end the following new
section:
``Sec. 1110n-2. Special operations brain health and trauma program
``(a) In General.--The Commander of the United States Special
Operations Command (in this section referred to as the `Commander'), in
coordination with the Secretary of Defense, shall conduct an intensive,
comprehensive brain health and trauma program (in this section referred
to as the `Program') to provide coordinated, integrated, multi-
disciplinary specialist evaluations, treatment initiation, and
aftercare coordination in a highly condensed model for special
operations forces.
``(b) Evidence-Based Treatment.--In carrying out the Program, the
Commander shall provide evidence-based physical, mental, and behavioral
health care and counseling for traumatic brain injury, blast
overpressure, blast exposure, and psychological or neurological
conditions that are common among members of the special operations
forces.
``(c) Population Served.--In carrying out the Program, the
Commander shall provide the health care and counseling specified in
subsection (b) to members of the special operations forces and family
members of such members.
``(d) Evaluation, Testing, and Treatment.--The Program shall
include the following:
``(1) Evaluations by health care providers in the areas of
brain injury medicine, neuropsychology, clinical psychology,
psychiatry, neuroendocrinology, sports medicine,
musculoskeletal medicine, vestibular physical therapy,
neuroimaging, and hormonal evaluation.
``(2) Metabolic testing, cardiovascular testing, and
cerebrovascular testing.
``(3) Treatment relating to headaches, sleep interventions
and medication, injection-based therapies for musculoskeletal
pain, cognitive rehab, vestibular physical therapy, and
exercise programming.
``(e) Coordination.--In carrying out the Program, the Commander
shall coordinate with private sector non-profit healthcare
organizations that have the capacity and infrastructure to provide the
care and services required under the Program.
``(f) Medical Records.--In carrying out the Program, the Commander
shall coordinate with the Director of the Defense Health Agency and the
Secretaries of the military departments to ensure that the treatment
received through the Program is documented in the medical records of
members of the armed forces.''.
(b) Clerical.--The table of sections at the beginning of chapter
55A of such title, as amended by section 3, is amended by adding at the
end the following new item:
``1110n-2. Special operations brain health and trauma program.''.
(c) Report and Briefing on Implementation of Special Operations
Traumatic Brain Injury Program.--
(1) Report on program.--
(A) In general.--Not later than December 31, 2025,
the Commander of the United States Special Operations
Command, in coordination with the Secretary of Defense,
shall submit to the Committee on Armed Services of the
Senate and the Committee on Armed Services of the House
of Representatives a report on the special operations
brain health and trauma program required under section
1110n-2 of title 10, United States Code, as added by
subsection (a), which shall include--
(i) the benefits of the program to members
of the Armed Forces and their families;
(ii) the number of members assisted by such
program;
(iii) the type of treatment received under
such program;
(iv) the rate of members of the Armed
Forces returning to duty after receiving
treatment under such program;
(v) how the Commander is coordinating with
the Director of the Defense Health Agency and
the Secretaries of the military departments to
update records of members of the Armed Forces
with treatment received under such program; and
(vi) whether and how the program should be
expanded to include other vulnerable
populations within the Armed Forces;
(B) Public availability.--The Secretary of Defense
shall make the information contained in the report
submitted under subparagraph (A) available to the
public, including on the govinfo.gov website, or
successor website, not later than 10 days after the
report is submitted under such subparagraph.
(2) Comptroller general report and briefing.--Not later
than 180 days after the date of the enactment of this Act, the
Comptroller General of the United States shall brief the
Committee on Armed Services of the Senate and the Committee on
Armed Services of the House of Representatives on the
implementation of section 1110n-2 of title 10, United States
Code, as added by subsection (a), with a report to follow at a
mutually agreed upon date.
SEC. 6. NATIONAL INTREPID CENTER OF EXCELLENCE.
(a) In General.--Chapter 55A of title 10, United States Code, as
added by section 3 and amended by section 5, is further amended by
adding at the end the following new section:
``Sec. 1110n-3. National Intrepid Center of Excellence
``(a) In General.--Not later than 120 days after the date of the
enactment of the Blast Overpressure Safety Act, the Secretary of
Defense shall establish the National Intrepid Center of Excellence (in
this section referred to as the `Center') as a program of record
subject to milestone reviews and compliance with the requirements under
this section.
``(b) Duties.--The duties of the Center are as follows:
``(1) To provide interdisciplinary care to prevent,
diagnose, treat, and rehabilitate members of the armed forces
with traumatic brain injury, post-traumatic stress disorder,
symptoms from blast overpressure or blast exposure, and other
mental health conditions.
``(2) Support and conduct research and education on
traumatic brain injury, post-traumatic stress disorder, blast
overpressure or blast exposure, and other mental health
conditions.
``(c) Childcare.--Childcare services shall be made available for
individuals seeking help through the National Intrepid Center of
Excellence.
``(d) Annual Report.--
``(1) In general.--Not later than one year after the date
of the enactment of the Blast Overpressure Safety Act, and
annually thereafter, the Secretary of Defense shall submit to
the Committees on Armed Services of the Senate and the House of
Representatives a report that shall include, for the year
covered by the report--
``(A) the number of individuals to whom the Center
has provided services;
``(B) the number of individuals who return to
active duty in the armed forces after receiving
services from the Center, and the stage in their career
at which they seek treatment at the Center;
``(C) the number of individuals whose families are
able to participate in programs provided by the Center;
and
``(D) the number of individuals on a waitlist for
treatment at the Center and the average period those
individuals are on the waitlist.
``(2) Public availability.--The Secretary of Defense shall
make the information contained in each report submitted under
paragraph (1) available to the public, including on the
govinfo.gov website, or successor website, not later than 10
days after the report is submitted under such paragraph.''.
(b) Clerical.--The table of sections at the beginning of chapter
55A of such title, as amended by sections 3 and 5, is amended by adding
at the end the following new item:
``1110n-3. National Intrepid Center of Excellence.''.
SEC. 7. MANDATORY TRAINING ON HEALTH EFFECTS OF CERTAIN BRAIN TRAUMA.
(a) In General.--Chapter 55A of title 10, United States Code, as
added by section 3 and amended by sections 5 and 6, is further amended
by adding at the end the following new section:
``Sec. 1110n-4. Mandatory training on health effects of certain brain
trauma
``Not less frequently than once every two years, the Secretary of
Defense shall provide to each medical provider and training manager of
the Department of Defense mandatory training with respect to the
potential health effects of blast overpressure, blast exposure, and
traumatic brain injury.''.
(b) Clerical.--The table of sections at the beginning of chapter
55A of such title, as amended by sections 3, 5, and 6, is amended by
adding at the end the following new item:
``1110n-4. Mandatory training on health effects of certain brain
trauma.''.
SEC. 8. ANNUAL BRIEFING ON INDIVIDUAL LONGITUDINAL EXPOSURE RECORD.
(a) In General.--Chapter 55 of title 10, United States Code, is
amended by adding at the end the following new section:
``Sec. 1110c. Annual briefing on Individual Longitudinal Exposure
Record
``(a) In General.--Not less frequently than annually, the Secretary
of Defense, in consultation with the Secretary of Veterans Affairs,
shall provide the appropriate committees of Congress a briefing on--
``(1) the quality of the databases of the Department of
Defense that provide the information presented in the
Individual Longitudinal Exposure Record; and
``(2) the usefulness of the Individual Longitudinal
Exposure Record in supporting members of the armed forces and
veterans in receiving health care and benefits from the
Department of Defense and the Department of Veterans Affairs.
``(b) Elements.--Each briefing required by subsection (a) shall
include, for the period covered by the report, the following:
``(1) An identification of potential exposures to
occupational or environmental hazards, including blast
overpressure and blast exposure, captured by the current
systems of the Department of Defense for environmental,
occupational, and health monitoring, and recommendations for
how to improve those systems.
``(2) An analysis of the quality and accuracy of the
location data used by the Department of Defense in determining
potential exposures to occupational or environmental hazards by
members of the armed forces and veterans, including blast
overpressure and blast exposure, and recommendations for how to
improve the quality of such data if necessary.
``(c) Definitions.--In this section:
``(1) Appropriate committees of congress.--The term `
appropriate committees of Congress ' means--
``(A) the Committee on Armed Services and the
Committee on Veterans' Affairs of the Senate; and
``(B) the Committee on Armed Services and the
Committee on Veterans' Affairs of the House of
Representatives.
``(2) Individual longitudinal exposure record.--The term
`Individual Longitudinal Exposure Record' has the meaning given
such term in section 1171(b) of title 38.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 55 of title 10, United States Code, is amended by inserting
after the item relating to section 1110b the following new item:
``1110c. Annual briefing on Individual Longitudinal Exposure Record.''.
(c) Conforming Repeal.--Section 802 of the Sergeant First Class
Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act
of 2022 (Public Law 117-168; 10 U.S.C. 1071 note) is repealed.
SEC. 9. REVIEW OF BLAST-RELATED BRAIN INJURY RESEARCH AND OTHER EFFORTS
OF THE DEPARTMENT OF DEFENSE.
(a) Review.--
(1) In general.--The Comptroller General of the United
States shall conduct a review of the research and other efforts
of the Department of Defense on traumatic brain injury,
including injuries related to blast overpressure or blast
exposure.
(2) Matters to be included.--The review required by
paragraph (1) shall include the following:
(A) A description of the research conducted by the
Department of Defense on traumatic brain injury, the
entities involved in that research, and efforts to
coordinate that research internally and externally.
(B) A description of any improvements identified by
that research related to the prevention, diagnosis, and
treatment of blast-related brain injuries and an
assessment of the implementation of those improvements.
(C) An evaluation of the efforts of the Department
to protect members of the Armed Forces from retaliation
for seeking care for the prevention, diagnosis, or
treatment of traumatic brain injury, blast
overpressure, or blast exposure, including any gaps in
or barriers to those efforts.
(D) An evaluation of the list maintained by the
Department of the military occupational specialties
most at-risk for blast overpressure and blast exposure
and whether additional at-risk occupational specialties
should be included.
(E) Any other finding the Comptroller General
considers relevant.
(b) Briefing and Report.--Not later than 180 days after the date of
the enactment of this Act, the Comptroller General shall brief the
Committee on Armed Services of the Senate and the Committee on Armed
Services of the House of Representatives on the review required under
subsection (a), with a report to follow on a mutually agreed upon date.
(c) Definition of Traumatic Brain Injury.--In this section, the
term ``traumatic brain injury'' means a traumatically induced
structural injury or physiological disruption of brain function as a
result of an external force that is indicated by new onset or worsening
of at least one of the following clinical signs immediately following
the event:
(1) Alteration in mental status, including confusion,
disorientation, or slowed thinking.
(2) Loss of memory for events immediately before or after
the injury.
(3) Any period of loss of or decreased level of
consciousness, observed or self-reported.
SEC. 10. IMPLEMENTATION OF INSPECTOR GENERAL RECOMMENDATIONS TO MANAGE
TRAUMATIC BRAIN INJURY CARE.
(a) Implementation.--Not later than December 31, 2025, the
Secretary of Defense shall implement the recommendations contained in
the report of the Inspector General of the Department of Defense
entitled, ``Evaluation of the DoD's Management of Traumatic Brain
Injury'' (DODIG-2023-059).
(b) Briefing.--Not later than April 1, 2025, the Secretary of
Defense shall provide to the Committee on Armed Services of the Senate
and the Committee on Armed Services of the House of Representatives a
briefing on the progress of the Secretary in carrying out the
implementation required under subsection (a).
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