,i #aah? ,,congress #b;d ,session ,h4 ,r4 #hjbe ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,april #af1 #bjbd ,mr4 ,khanna 7= himself1 ,ms4 ,/efanik1 ,ms4 ,h\lahan1 ,mrs4 ,kiggans ( ,virg9ia1 ,ms4 ,lee ( ,nevada1 ,mr4 ,waltz1 ,mr4 ,bi%op ( ,georgia1 ,mr4 ,m\lton1 ,ms4 ,p+ree1 ,mr4 ,gold5 ( ,ma9e1 & ,mr4 ,panetta7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,arm$ ,s]vices ,a ,,bill ,to am5d title #aj1 ,unit$ ,/ates ,code1 to cl>ify roles & responsibilities )9 ! ,dep>tm5t ( ,def5se relat+ to subconcussive & concussive bra9 injuries & to improve bra9 heal? initiatives ( ! ,dep>tm5t ( ,def5se1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,bla/ ,ov]pressure ,safety ,act4 #b4 ,roles & responsibilities = compon5ts ( ! (fice ( ! secret>y ( def5se relat+ to bra9 injuries f concussive & subconcussive bla/s 7a7 ,f9d+s & s5se ( congress 7#a7 ,f9d+s ,congress f9ds ! foll[+3 7,a7 ,rese>* conduct$ by ! ,dep>tm5t ( ,def5se und]scores t concussive & subconcussive bra9 injuries c arise n only f combat sc5>ios b also f r\t9e tra9+ ex]cises4 7,b7 ,ev5 :5 adh]+ to e/abli%$ safety guidel9es1 ! act ( fir+ or be+ expos$ to ! fir+ ( heavy weapons1 gr5ades1 & brea*+ dur+ tra9+ sessions c pot5tially lead to cognitive impairm5ts1 p>ticul>ly affect+ aspects su* z delay$ v]bal memory1 visual-spatial memory1 & executive function4 7,c7 ,traumatic bra9 injuries h become ! signature w\nd ( memb]s ( ! ,arm$ ,=ces f ! ,global ,w> on ,t]rorism g5]ation4 7,d7 ,special ,w>f>e ,op]ator #a/ ,class ,ryan ,l>k9 & ,s]geant ,fir/ ,class ,mi*ael ,fro$e bo? suff]$ traumatic bra9 injuries dur+ _! rigor\s tra9+ & multiple combat deploym5ts & 7 tragically lo/ to suicide z a result ( _! w\nds4 ,_! /ories highlight ! critical issues surr\nd+ traumatic bra9 injury )9 ! milit>y & ! subsequ5t risk ( suicide among affect$ individuals4 7,e7 ,?is ,act honors ! sacrifices ( ,special ,w>f>e ,op]ator #a/ ,class ,ryan ,l>k9 & ,s]geant ,fir/ ,class ,mi*ael ,fro$e1 z well z ! ?\s&s ( affect$ memb]s ( ! ,arm$ ,=ces by exp$it+ ! ef=ts ( ! ,dep>tm5t ( ,def5se to mitigate1 id5tify1 & treat traumatic bra9 injuries )9 ! ,arm$ ,=ces4 7#b7 ,s5se ( congress ,x is ! s5se ( ,congress t-- 7,a7 ,congress comm5ds ! ,dep>tm5t ( ,def5se = its ef=ts to implem5t measures consi/5t ) mod]n sci5ce to limit ! occurr5ce ( concussive & subconcussive bra9 injuries among memb]s ( ! ,arm$ ,=ces & facilitate ! rehabilitation ( ^? recov]+ f s]vice-relat$ traumatic bra9 injuries2 & 7,b7 ! ,secret>y ( ,def5se %\ld su/a9 ^? ef=ts :ile also enhanc+ ov]all k & protection aga9/ bra9 injuries4 7b7 ,e/abli%m5t ( roles ,! ,secret>y ( ,def5se %all e/abli% ! roles & responsibilities ( compon5ts ( ! ,(fice ( ! ,secret>y ( ,def5se = ! mitigation1 id5tification1 & treatm5t ( concussive & subconcussive bra9 injuries & ! monitor+ & docum5tation ( bla/ ov]pressure exposure z foll[s3 7#a7 ,! ,"u ,secret>y ( ,def5se = ,p]sonnel & ,read9ess %all be responsible =1 n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act-- 7,a7 e/abli%+ a basel9e neurocognitive assessm5t to be conduct$ dur+ ! accession process ( memb]s ( ! ,arm$ ,=ces be=e ! beg9n+ ( tra9+2 7,b7 e/abli%+ annual neurocognitive assessm5ts to monitor ! cognitive function ( su* memb]s to be conduct$-- 7i7 at lea/ e ?ree ye>s z "p ( ! p]iodic heal? assessm5t ( su* memb]s2 7ii7 z "p ( ! po/-deploym5t heal? assessm5t ( su* memb]s2 & 7iii7 prior to sep>ation f s]vice 9 ! ,arm$ ,=ces2 7,c7 ensur+ all neurocognitive assessm5ts ( su* memb]s1 includ+ ^? requir$ "u subp>agraphs 7,a7 & 7,b71 are ma9ta9$ 9 ! electronic m$ical record ( su* memb]2 7,d7 e/abli%+ a process = annual review ( bla/ ov]pressure exposure & traumatic bra9 injury logs specifi$ 9 p>agraph 7#b77;,a7 = ea* memb] ( ! ,arm$ ,=ces dur+ ! p]iodic heal? assessm5t ( su* memb] = cumulative exposure 9 ord] to ref] memb]s ) recurr5t & prolong$ exposure to specialty c>e2 & 7,e7 e/abli%+ /&>ds = recurr5t & prolong$ exposure4 7#b7 ,! ,assi/ant ,secret>y ( ,def5se = ,read9ess %all be responsible =1 n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! foll[+3 7,a7 ,e/abli%+ & ma9ta9+ bla/ ov]pressure exposure logs & traumatic bra9 injury logs = e memb] ( ! ,arm$ ,=ces4 7,b7 ,integrat+ ^? logs into ! ,individual ,longitud9al ,exposure ,record 7z def9$ 9 section #aaga7;b7 ( title #ch1 ,unit$ ,/ates ,code7 = su* memb]4 7,c7 ,includ+ 9 ^? logs at lea/ ! foll[+3 7i7 ,! numb] ( previ\s exposures to bla/ ov]pressure1 includ+ ! numb] ( exposures p] unit ( "t1 date1 bla/ ov]pressure 9 p\nds p] squ>e in*1 & numb] ( times ! memb] ( ! ,arm$ ,=ces fires1 uses1 or is expos$ to weapons t cause bla/ ov]pressure4 7ii7 ,any residual physical1 m5tal1 or emotional effects result+ f su* exposure4 7iii7 ,! s\rce ( ! exposure1 activity :5 ! exposure occurr$1 :e!r x occurr$ dur+ tra9+ or deploym5t1 & any o!r relevant context ( su* exposure4 7iv7 ,! treatm5t t ! memb] s\ght & receiv$ 9 connection ) su* exposure4 7v7 ,! numb] ( concussive & subconcussive bra9 injuries1 includ+ traumatic bra9 injuries1 su/a9$4 7vi7 ,! sev]ity ( concussive & subconcussive bra9 injuries1 includ+ traumatic bra9 injuries1 su/a9$4 7vii7 ,o!r head trauma1 reg>dless ( :e!r x requires ! treatm5t ( a m$ical provid]4 7#c7 ,! ,inspector ,g5]al ( ! ,dep>tm5t ( ,def5se %all be responsible =-- 7,a7 n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 submitt+ to ,congress a report 79 unclassifi$ =m1 b ) a classifi$ annex z necess>y7 evaluat+ ! e/abli%m5t & ma9t5ance ( ! logs requir$ "u p>agraph 7#b71 includ+ ! cumulative exposure annotat$ 9 ! bla/ ov]pressure exposure logs & traumatic bra9 injury logs1 z well z ! compliance ( ! ,dep>tm5t ( ,def5se ) ,dep>tm5t policies to address ! bra9 heal? ( memb]s ( ! ,arm$ ,=ces2 7,b7 n lat] ?an #aj days aft] submitt+ ! report "u subp>agraph 7,a71 mak+ available to ! public ! unclassifi$ portion ( ! report2 & 7,c7 beg9n+ on ! date t is ?ree ye>s aft] ! date ( ! enactm5t ( ?is ,act-- 7i7 evaluat+ ! cont9u$ fulfillm5t by ! ,dep>tm5t ( ! requirem5ts "u p>agraph 7#b71 includ+ ! cumulative exposure annotat$ 9 ! bla/ ov]pressure exposure logs & traumatic bra9 injury logs1 z well z ! compliance ( ! ,dep>tm5t ) ,dep>tm5t policies to address ! bra9 heal? ( memb]s ( ! ,arm$ ,=ces2 7ii7 n lat] ?an ,decemb] #ca ( ea* ye>1 submitt+ to ,congress a report 79 unclassifi$ =m1 b ) a classifi$ annex z necess>y7 conta9+ ! results ( su* evaluation2 & 7iii7 n lat] ?an #aj days aft] submitt+ ea* report "u clause 7ii71 mak+ available to ! public ! unclassifi$ portion ( su* report4 7#d7 ,! ,"u ,secret>y ( ,def5se = ,acquisition & ,su/a9m5t %all be responsible =1 n lat] ?an "o ye> aft] ! date ( enactm5t ( ?is ,act1 ! foll[+3 7,a7 ,e/abli%+ ! m9imization ( exposure to bla/ ov]pressure z a p]=mance p>amet] :5 draft+ requirem5ts = new weapons sy/ems t produce bla/ ov]pressure = ! ,dep>tm5t ( ,def5se4 7,b7 ,e/abli%+ a requirem5t t any entity "u contractual agreem5t ) ! ,dep>tm5t z "p ( ! def5se weapons acquisition process %all provide to ! ,dep>tm5t bla/ ov]pressure measurem5ts & safety data = any weapons sy/em t produce bla/ ov]pressure & exce$ ! dep>tm5t set maximum exposure limit procur$ f su* entity4 7,c7 ,e/abli%+ a requirem5t t any te/ plan = a weapons sy/em incorporate te/+ = bla/ ov]pressure measurem5ts & safety data4 7,d7 ,n lat] ?an ,decemb] #ca ( ea* ye>1 publi%+ on a publicly available website1 includ+ gov9fo4gov or successor website1 a report t includes-- 7i7 bla/ ov]pressure measurem5ts & safety data = weapons sy/ems ( ! ,dep>tm5t1 includ+ h[ ^? sy/ems h be5 te/$ & 9 :at environm5ts2 & 7ii7 plans to improve protection = exposure by memb]s ( ! ,arm$ ,=ces to 9-use weapons sy/ems ) unsafe levels ( bla/ ov]pressure & exposure4 7c7 ,coord9ation ,! (ficials specifi$ 9 p>agraphs 7#a71 7#b71 7#c71 & 7#d7 ( subsection 7b7 %all coord9ate & align _! plans & activities to implem5t su* subsection among !mselves & ) ! ,secret>ies ( ! milit>y dep>tm5ts4 7d7 ,brief+s & reports 7#a7 ,implem5tation brief+ ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 & e #ahj days !reaft]1 ! ,secret>y ( ,def5se %all provide to ! congressional def5se committees a brief+ on ! plans1 associat$ timel9es1 & activities conduct$ to implem5t subsection 7a74 7#b7 ,report on concussive & subconcussive bra9 injuries 7,a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft]1 ! ,secret>y ( ,def5se %all submit to ! congressional def5se committees a report on-- 7i7 concussive & subconcussive bra9 injuries caus$ dur+ milit>y op]ations1 includ+ combat op]ations1 among memb]s ( ! ,arm$ ,=ces1 includ+ in=mation on-- 7,i7 ! ,arm$ ,=ce ( ! memb]2 7,,ii7 ! "n ( ! op]ation2 7,,iii7 ! location )9 ! area ( responsibility2 7,,iv7 ! numb] ( concussive & subconcussive bra9 injuries caus$2 7,v7 ! sev]ity ( concussive & subconcussive bra9 injuries caus$2 7,,vi7 ! treatm5t receiv$ = a concussive or subconcussive bra9 injury2 7,,vii7 :e!r a memb] ( ! ,arm$ ,=ces 0 m$ically retir$ f s]vice due to a concussive or subconcussive bra9 injury2 7,,viii7 :e!r a memb] ( ! ,arm$ ,=ces di$ by suicide aft] su/a9+ a concussive or subconcussive bra9 injury2 & 7,,ix7 ! s\rce ( ! injury1 includ+ ! activity conduct$ :5 ! injury occurr$2 & 7ii7 concussive & subconcussive bra9 injuries caus$ dur+ tra9+ ev5ts among memb]s ( ! ,arm$ ,=ces1 includ+ in=mation on-- 7,i7 ! ,arm$ ,=ce ( ! memb]2 7,,ii7 ! type ( tra9+2 7,,iii7 ! location ( ! tra9+2 7,,iv7 ! numb] ( concussive & subconcussive bra9 injuries caus$2 7,v7 ! sev]ity ( concussive & subconcussive bra9 injuries caus$2 7,,vi7 ! treatm5t receiv$ = a concussive or subconcussive bra9 injury2 7,,vii7 :e!r a memb] ( ! ,arm$ ,=ces 0 m$ically retir$ f s]vice due to a concussive or subconcussive bra9 injury2 7,,viii7 :e!r a memb] ( ! ,arm$ ,=ces di$ by suicide aft] su/a9+ a concussive or subconcussive bra9 injury2 & 7,,ix7 ! s\rce ( ! injury1 includ+ ! activity conduct$ :5 ! injury occurr$4 7,b7 ,=m ,ea* report submitt$ "u subp>agraph 7,a7 %all be submitt$ 9 unclassifi$ =m1 b may include a classifi$ annex4 7,c7 ,public availability ,n lat] ?an #aj days aft] submitt+ a report "u subp>agraph 7,a71 ! ,secret>y ( ,def5se %all make ! unclassifi$ portion ( ! report available to ! public1 includ+ by publi%+ ! report on ! gov9fo4gov website1 or successor website4 7#c7 ,report on dis*>ges relat$ to concussive & subconcussive bra9 injuries 7,a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft]1 ! (ficials specifi$ 9 p>agraphs 7#a7 & 7#b7 ( subsection 7b7 & ! ,secret>y ( ,def5se %all submit to ! congressional def5se committees a report on memb]s ( ! ,arm$ ,=ces :o 7 dis*>g$ adm9i/ratively or punitively & _h a concussive or subconcussive bra9 injury1 includ+ a traumatic bra9 injury1 includ+ in=mation on-- 7i7 :e!r ! injury or injuries occurr$ dur+ combat op]ations or tra9+ & ! associat$ combat op]ations or tra9+ incid5t2 7ii7 ! sev]ity ( ! injury or injuries2 7iii7 if any su* injury 0 combat relat$1 ! "n ( ! op]ation2 7iv7 ! treatm5t s\ght & receiv$ = ! injury or injuries2 7v7 ! numb] ( dis*>ge upgrade reque/s 9 connection ) su* an injury or injuries t h be5 made2 & 7vi7 ! numb] ( su* dis*>ge upgrade reque/s t h be5 approv$4 7,b7 ,=m ,ea* report submitt$ "u subp>agraph 7,a7 %all be submitt$ 9 unclassifi$ =m1 b may include a classifi$ annex4 7,c7 ,public availability ,n lat] ?an #aj days aft] submitt+ a report "u subp>agraph 7,a71 ! ,secret>y ( ,def5se %all make ! unclassifi$ portion ( ! report available to ! public1 includ+ by publi%+ ! report on ! gov9fo4gov website1 or successor website4 7#d7 ,report on m$ical provid]s tra9$ 9 concussive & subconcussive bra9 injuries 7,a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft]1 ! ,secret>y ( ,def5se %all submit to ! congressional def5se committees a report on m$ical provid]s )9 ! ,def5se ,heal? ,ag5cy :o are tra9$ 9 traumatic bra9 injury or concussive & subconcussive bra9 injuries z a sub-specialty ( neurology1 includ+ in=mation on-- 7i7 ! numb] ( su* provid]s1 disaggregat$ by location2 7ii7 ! billets ( su* p]sonnel2 7iii7 ! numb] ( m$ical p]sonnel curr5tly p>ticipat+ 9 tra9+ or a fell[%ip relat+ to traumatic bra9 injury or concussive & subconcussive bra9 injuries2 & 7iv7 ! /rategy ( ! ,dep>tm5t ( ,def5se to increase ! numb] ( m$ical provid]s tra9$ 9 traumatic bra9 injury or concussive & subconcussive bra9 injuries z a sub-specialty ( neurology4 7,b7 ,public availability ,n lat] ?an #aj days aft] submitt+ a report "u subp>agraph 7,a71 ! ,secret>y ( ,def5se %all make ! report available to ! public1 includ+ by publi%+ ! report on ! gov9fo4gov website1 or successor website4 7#e7 ,report on ef=ts to coord9ate ) allies & p>tn]s 7,a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft]1 ! ,secret>y ( ,def5se %all submit to ! congressional def5se committees a report on ! ef=ts ( ! ,dep>tm5t ( ,def5se to %>e & coord9ate on bla/ injury & subconcussive & concussive bra9 injury rese>* ef=ts ) allies & p>tn]s ( ! ,unit$ ,/ates1 :i* %all include in=mation on-- 7i7 ! activities coord9at$ ) su* allies & p>tn]s to bett] prev5t1 mitigate1 & treat injuries f bla/ exposure2 & 7ii7 recomm5dations to improve future collaboration ) su* allies & p>tn]s1 includ+ adm9i/rative & data /ructures4 7,b7 ,public availability ,n lat] ?an #aj days aft] submitt+ a report "u subp>agraph 7,a71 ! ,secret>y ( ,def5se %all make ! report available to ! public1 includ+ by publi%+ ! report on ! gov9fo4gov website1 or successor website4 7e7 ,def9itions ,9 ?is section3 7#a7 ,congressional def5se committees ,! t]m congressional def5se committees has ! mean+ giv5 t t]m 9 section #aja7;a77#af7 ( title #aj1 ,unit$ ,/ates ,code4 7#b7 ,contractual agreem5t ,! t]m contractual agreem5t includes a contract1 grant1 coop]ative agreem5t1 & any o!r simil> transaction or relation%ip4 7#c7 ,neurocognitive assessm5t ,! t]m neurocognitive assessm5t means a /&>diz$ cognitive & behavioral evaluation us+ validat$ & norm$ te/+ p]=m$ 9 a =mal environm5t t uses specifically designat$ tasks to measure cognitive function kn[n to be l9k$ to a p>ticul> bra9 /ructure or pa?way1 :i* may include a measurem5t ( intellectual function+1 att5tion1 new le>n+ or memory1 intellig5ce1 process+ spe$1 & executive function+4 7#d7 ,traumatic bra9 injury ,! t]m traumatic bra9 injury means a traumatically induc$ /ructural injury or physiological disruption ( bra9 function z a result ( an ext]nal =ce t is indicat$ by new onset or wors5+ ( at lea/ "o ( ! foll[+ cl9ical signs imm$iately foll[+ ! ev5t3 7,a7 ,alt]ation 9 m5tal /atus1 includ+ confusion1 disori5tation1 or sl[$ ?9k+4 7,b7 ,loss ( memory = ev5ts imm$iately be=e or aft] ! injury4 7,c7 ,any p]iod ( loss ( or decreas$ level ( consci\sness1 obs]v$ or self-report$4 #c4 ,improvem5ts to bra9 heal? initiatives ( dep>tm5t ( def5se 7a7 ,bra9 heal? initiatives 7#a7 ,9 g5]al ,"p ,,ii ( subtitle ,a ( title #aj1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] *apt] #ee ! foll[+ new *apt]3 #ee;,a ,,bra9 ,,heal? ,,initiatives #aaajn4 ,def9ition ( traumatic bra9 injury ,9 ?is *apt]1 ! t]m traumatic bra9 injury means a traumatically induc$ /ructural injury or physiological disruption ( bra9 function z a result ( an ext]nal =ce t is indicat$ by new onset or wors5+ ( at lea/ "o ( ! foll[+ cl9ical signs imm$iately foll[+ ! ev5t3 7#a7 ,alt]ation 9 m5tal /atus1 includ+ confusion1 disori5tation1 or sl[$ ?9k+4 7#b7 ,loss ( memory = ev5ts imm$iately be=e or aft] ! injury4 7#c7 ,any p]iod ( loss ( or decreas$ level ( consci\sness1 obs]v$ or self-report$4 #aaajn-#a4 ,w>fight] ,bra9 ,heal? ,initiative 7a7 ,9 g5]al ,! ,secret>y ( ,def5se1 9 consultation ) ! ,secret>ies conc]n$1 %all e/abli% a compreh5sive initiative = bra9 heal? to be kn[n z ! ,w>fight] ,bra9 ,heal? ,initiative 79 ?is section ref]r$ to z ! ,initiative7 = ! purpose ( unify+ ef=ts & programs across ! ,dep>tm5t ( ,def5se to improve ! cognitive p]=mance & bra9 heal? ( memb]s ( ! arm$ =ces4 7b7 ,objectives ,! objectives ( ! ,initiative %all be ! foll[+3 7#a7 ,to enhance1 ma9ta91 & re/ore ! cognitive p]=mance ( memb]s ( ! arm$ =ces ?r\gh education1 tra9+1 prev5tion1 protection1 monitor+1 detection1 diagnosis1 treatm5t1 & rehabilitation1 includ+ ?r\gh ! foll[+ activities3 7,a7 ,! e/abli%m5t ( a program to monitor cognitive bra9 heal? across ! ,dep>tm5t ( ,def5se1 ) ! goal ( detect+ any ne$ = cognitive enhancem5t or re/oration result+ f pot5tial bra9 exposures ( memb]s ( arm$ =ces1 to mitigate possible evolution ( injury or disease progression4 7,b7 ,! id5tification & dissem9ation ( ?re%olds = bla/ exposure & bla/ ov]pressure safety & associat$ em]g+ sci5tific evid5ce t-- 7i7 cov] bra9 injury1 lung injury1 & impulse noise2 7ii7 measure impact ov] #bd-;h\r1 #gb-;h\r to #if-;h\r1 mon?ly1 annual1 & lifetime p]iods2 7iii7 ensure t ! ?re%olds are l[ en\gh t !y are n associat$ ) cognitive deficits aft] fir+2 7iv7 include ?re%olds t acc\nt = ! fir+ ( multiple types ( heavy weaponry & use ( gr5ades 9 "o p]iod ( "t2 7v7 include m9imum safe di/ances & levels ( exposure = obs]v]s & in/ructors2 & 7vi7 include limits = %\ld]-fir$ heavy weapons4 7,c7 ,! modification ( high-risk tra9+ & op]ational activities to mitigate ! negative effects ( repetitive bla/ exposure4 7,d7 ,! id5tification ( individuals :o p]=m high-risk tra9+ or occupational activities = purposes ( increas$ monitor+ ( ! bra9 heal? ( su* individuals4 7,e7 ,! developm5t & op]ational field+ ( non-invasive1 portable1 po9t-(-c>e m$ical devices1 to in=m ! diagnosis & treatm5t ( traumatic bra9 injury4 7,f7 ,! e/abli%m5t ( a /&>diz$ monitor+ program t docum5ts & analyzes bla/ exposures t may affect ! bra9 heal? ( memb]s ( ! arm$ =ces4 7,g7 ,! consid]ation ( ! f9d+s & recomm5dations ( ! report ( ! ,national ,academies ( ,sci5ce1 ,eng9e]+1 & ,m$ic9e publi%$ 9 #bjbb & entitl$ ,traumatic ,bra9 ,injury3 ,a ,roadmap = ,accel]at+ ,progress 7relat+ to ! accel]ation ( progress 9 traumatic bra9 injury rese>* & c>e71 or any successor report1 9 relation to ! activities ( ! ,dep>tm5t relat+ to bra9 heal?4 7,h7 ,! e/abli%m5t ( policies to enc\rage memb]s ( ! arm$ =ces to seek support = bra9 heal? :5 ne$$1 prev5t retaliation aga9/ su* memb]s :o seek c>e1 & address o!r b>ri]s to seek+ help = bra9 heal?1 includ+ due to ! impact ( bla/ exposure1 bla/ ov]pressure1 traumatic bra9 injury1 & o!r heal? matt]s4 7,i7 ,! modification ( exi/+ weapons sy/ems to r$uce bla/ exposure ( ! individual us+ ! weapon & ^? )9 ! m9imum safe di/ance4 7#b7 ,to h>monize & prioritize ! ef=ts ( ! ,dep>tm5t ( ,def5se into a s+le approa* to bra9 heal?4 7c7 ,?re%olds = bla/ exposure & ov]pressure safety 7#a7 ,deadl9e 7,a7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ! ,bla/ ,ov]pressure ,safety ,act1 ! ,secret>y ( ,def5se %all id5tify & dissem9ate ! ?re%olds = bla/ exposure & bla/ ov]pressure safety & associat$ em]g+ sci5tific evid5ce requir$ "u subsection 7b77#a77;,b74 7,b7 ,update ,n less frequ5tly ?an e five ye>s1 ! ,secret>y ( ,def5se %all update ! ?re%olds = bla/ exposure & bla/ ov]pressure safety & associat$ em]g+ sci5tific evid5ce requir$ "u subsection 7b77#a77;,b74 7#b7 ,c5tral repository ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ! ,bla/ ,ov]pressure ,safety ,act1 ! ,secret>y ( ,def5se %all e/abli% a c5tral repository ( bla/-relat$ *>act]i/ics1 su* z pressure pr(iles & common bla/ loads associat$ ) specific sy/ems & ! environm5ts 9 :i* !y are us$1 t is available to memb]s ( ! arm$ =ces & ! public & includes ! in=mation describ$ 9 subsection 7b77#a77;,b74 7#c7 ,waiv]s 7,a7 ,protocols ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ! ,bla/ ,ov]pressure ,safety ,act1 ! ,secret>y ( ,def5se %all e/abli% & implem5t protocols to require waiv]s 9 cases 9 :i* memb]s ( ! arm$ =ces mu/ exce$ ! safety ?re%olds describ$ 9 subsection 7b77#a77;,b71 :i* %all include a ju/ification = exce$+ ^? safety ?re%olds4 7,b7 ,track+ sy/em 7i7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ! ,bla/ ,ov]pressure ,safety ,act1 ! ,secret>y ( ,def5se %all e/abli% a ,dep>tm5t ( ,def5se-wide track+ sy/em = waiv]s describ$ 9 subp>agraph 7,a71 :i* %all include data contribut$ by ea* ( ! ,secret>ies conc]n$4 7ii7 ,report 7,i7 ,9 g5]al ,n less frequ5tly ?an once ea* ye> by ,decemb] #ca ( t ye> foll[+ ! e/abli%m5t ( ! track+ sy/em requir$ "u clause 7i71 ! ,secret>y ( ,def5se %all submit to ! ,committees on ,arm$ ,s]vices ( ! ,s5ate & ! ,h\se ( ,repres5tatives a report on waiv]s describ$ 9 subp>agraph 7,a7 t includes-- 7aa7 ! numb] ( waiv]s issu$1 disaggregat$ by arm$ =ce2 7bb7 ! ju/ifications provid$ = ea* waiv]2 7cc7 a description ( actions tak5 by ! ,secret>y conc]n$ to track ! heal? effects on memb]s ( ! arm$ =ces ( exce$+ safety ?re%olds describ$ 9 subsection 7b77#a77;,b71 docum5t ^? effects 9 m$ical records1 & provide c>e to ^? memb]s2 & 7dd7 a description ( ! m$ical c>e receiv$ by ^? memb]s 9 response to exce$+ ^! safety ?re%olds4 7,,ii7 ,public availability ,! ,secret>y ( ,def5se %all make ! in=mation conta9$ 9 ea* report submitt$ "u subclause 7,i7 available to ! public1 includ+ on ! gov9fo4gov website1 or successor website1 n lat] ?an #aj days aft] ! report is submitt$ "u su* subclause4 7d7 ,=mal tra9+ requirem5t 7#a7 ,9 g5]al ,! ,secret>y ( ,def5se %all ensure t tra9+ describ$ 9 p>agraph 7#b7 is requir$ = memb]s ( ! arm$ =ces be=e tra9+1 deploym5t1 or ent]+ o!r environm5ts det]m9$ to be high-risk by ! ,secret>y conc]n$4 7#b7 ,tra9+ describ$ ,tra9+ describ$ 9 ?is p>agraph is tra9+ on ! foll[+3 7,a7 ,?re%olds = bla/ exposure & bla/ ov]pressure safety & associat$ em]g+ sci5tific evid5ce requir$ "u subsection 7b77#a77;,b74 7,b7 ,symptoms ( exposure to bla/s or bla/ ov]pressure4 7,c7 ,symptoms ( traumatic bra9 injury4 7e7 ,/rategies = mitigation & prev5tion ( bla/ exposure & ov]pressure risk = high-,risk individuals ,9 c>ry+ out ! ,initiative1 n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,bla/ ,ov]pressure ,safety ,act1 ! ,secret>y ( ,def5se %all e/abli% /rategies = mitigat+ & prev5t+ bla/ exposure & bla/ ov]pressure risk = individuals mo/ at risk = exposure to high-risk tra9+ or high-risk occupational activities1 :i* %all include-- 7#a7 a timel9e & process = implem5t+ ^? /rategies2 7#b7 a det]m9ation ( ! frequ5cy ) :i* ^? /rategies w be updat$1 at a rate ( n less frequ5tly ?an e five ye>s2 & 7#c7 an assessm5t ( h[ in=mation reg>d+ ^? /rategies w be dissem9at$ to su* individuals1 includ+ aft] ^? /rategies are updat$4 7f7 ,annual budget ju/ification docum5ts ,9 ! budget ju/ification mat]ials submitt$ to ,congress 9 support ( ! budget ( ! ,dep>tm5t ( ,def5se = ea* fiscal ye> 7z submitt$ ) ! budget ( ! ,presid5t "u section #aaje7;a7 ( title #ca71 ! ,secret>y ( ,def5se %all include a budget ju/ification display t includes all activities ( ! ,dep>tm5t relat+ to ! ,initiative4 7g7 ,annual reports 7#a7 ,9 g5]al ,n lat] ?an ,m>* #ca1 #bjbe1 & n less frequ5tly ?an annually !reaft]1 ! ,secret>y ( ,def5se %all submit to ! ,committees on ,arm$ ,s]vices ( ! ,s5ate & ! ,h\se ( ,repres5tatives a report t includes ! foll[+3 7,a7 ,a description ( ! activities tak5 "u ! ,initiative & res\rces exp5d$ "u ! ,initiative dur+ ! prior fiscal ye>4 7,b7 ,! numb] ( memb]s ( ! arm$ =ces impact$ by bla/ ov]pressure & bla/ exposure 9 ! prior fiscal ye>1 includ+-- 7i7 ! numb] ( memb]s :o report$ adv]se heal? effects f bla/ ov]pressure or bla/ exposure2 7ii7 ! numb] ( memb]s expos$ to bla/ ov]pressure or bla/ exposure2 7iii7 ! numb] ( memb]s :o receiv$ treatm5t = injuries relat$ to bla/ ov]pressure or bla/ exposure1 includ+ at facilities ( ! ,dep>tm5t ( ,def5se & at facilities 9 ! private sector2 7iv7 reg>d+ treatm5t = bla/ exposure1 bla/ ov]pressure1 or subconcussive or concussive bra9 injuries at ! ,national ,intrepid ,c5t] ( ,excell5ce1 an ,intrepid ,_s ,c5t]1 or an appropriate milit>y m$ical treatm5t facility-- 7,i7 ! numb] ( memb]s on ! waitli/ = su* treatm5t2 7,,ii7 ! av]age p]iod ( "t ^? memb]s are on t waitli/2 & 7,,iii7 ! av]age numb] ( days betwe5 :5 an appo9tm5t is reque/$ & ! actual appo9tm5t date2 & 7v7 ! type ( c>e t memb]s receive f facilities ( ! ,dep>tm5t ( ,def5se & ! type ( c>e t memb]s receive f facilities 9 ! private sector4 7,c7 ,a summ>y ( ! progress made dur+ ! prior fiscal ye> ) respect to ! objectives ( ! ,initiative "u subsection 7b74 7,d7 ,a description ( ! /eps ! ,secret>y is tak+ to ensure t activities "u ! ,initiative are be+ implem5t$ across ! ,dep>tm5t ( ,def5se & ! milit>y dep>tm5ts4 7#b7 ,public availability ,! ,secret>y ( ,def5se %all make ! in=mation conta9$ 9 ea* report submitt$ "u p>agraph 7#a7 available to ! public1 includ+ on ! gov9fo4gov website1 or successor website1 n lat] ?an #aj days aft] ! report is submitt$ "u su* p>agraph4 4 7b7 ,con=m+ & cl]ical am5dm5ts 7#a7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( title #aj1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ be=e ! item relat+ to *apt] #ef ! foll[+ new items3 ,,*apt] #ee;,a--,bra9 ,heal? ,initiatives ,sec4 #aaajn4 ,def9ition ( traumatic bra9 injury4 #aaajn-#a4 ,w>fight] ,bra9 ,heal? ,initiative4 4 7#b7 ,con=m+ repeal ,section #gce ( ! ,james ,m4 ,inh(e ,national ,def5se ,au?orization ,act = ,fiscal ,ye> #bjbc 7,public ,law #aag-bfc2 #aj ,u4,s4,c4 #ajga note7 is repeal$4 7c7 ,initial brief+ & report on national intrepid c5t] ( excell5ce 7#a7 ,9 g5]al ,n lat] ?an #aej days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,def5se %all provide to ! congressional def5se committees a brief+ & submit to ! congressional def5se committees a report on ! p>amet]s ( ! program ( record e/abli%$ "u section #aaajn-#c ( title #aj1 ,unit$ ,/ates ,code1 z add$ by subsection 7a74 7#b7 ,congressional def5se committees def9$ ,9 ?is subsection1 ! t]m congressional def5se committees has ! mean+ giv5 t t]m 9 section #aja7;a77#af7 ( title #aj1 ,unit$ ,/ates ,code4 #d4 ,pilot program relat+ to monitor+ ( bla/ cov]age 7a7 ,au?ority ,! ,secret>y conc]n$ may conduct1 z "p ( ! initiative e/abli%$ "u section #aaajn-#a ( title #aj1 ,unit$ ,/ates ,code1 z add$ by section #c1 a pilot program "u :i* ! ,secret>y conc]n$ %all monitor bla/ ov]pressure exposure ?r\gh ! use ( comm]cially available1 (f-!-%elf1 remote measurem5ts1 & docum5t & evaluate data collect$ z a result ( su* monitor+4 7b7 ,locations ,monitor+ activities "u a pilot program conduct$ pursuant to subsection 7a7 %all be c>ri$ out 9 ea* tra9+ environm5t t ! ,secret>y conc]n$ det]m9es poses a risk = bla/ ov]pressure exposure4 7c7 ,docum5tation & %>+ ( data ,if ! ,secret>y conc]n$ conducts a pilot program pursuant to subsection 7a71 ! ,secret>y conc]n$ %all-- 7#a7 ensure t any data collect$ pursuant to su* pilot program t is relat$ to ! heal? effects ( ! bla/ ov]pressure exposure ( a memb] ( ! arm$ =ces :o p>ticipat$ 9 ! pilot program is docum5t$ & ma9ta9$ by ! ,secret>y ( ,def5se 9 an electronic heal? record = ! memb]2 & 7#b7 to ! ext5t practicable1 & 9 accordance ) applicable provisions ( law relat+ to data privacy1 make data collect$ pursuant to su* pilot program available to o!r academic & m$ical rese>*]s = ! purpose ( in=m+ future rese>* & treatm5t options4 7d7 ,def9ition ( secret>y conc]n$ ,9 ?is section1 ! t]m ,secret>y conc]n$ has ! mean+ giv5 su* t]m 9 section #aja ( title #aj1 ,unit$ ,/ates ,code4 #e4 ,special op]ations bra9 heal? & trauma program 7a7 ,9 g5]al ,*apt] #ee;,a ( title #aj1 ,unit$ ,/ates ,code1 z add$ by section #c1 is am5d$ by add+ at ! end ! foll[+ new section3 #aaajn-#b4 ,special op]ations bra9 heal? & trauma program 7a7 ,9 g5]al ,! ,comm&] ( ! ,unit$ ,/ates ,special ,op]ations ,comm& 79 ?is section ref]r$ to z ! ,comm&]71 9 coord9ation ) ! ,secret>y ( ,def5se1 %all conduct an int5sive1 compreh5sive bra9 heal? & trauma program 79 ?is section ref]r$ to z ! ,program7 to provide coord9at$1 integrat$1 multi-discipl9>y speciali/ evaluations1 treatm5t initiation1 & aft]c>e coord9ation 9 a highly cond5s$ model = special op]ations =ces4 7b7 ,evid5ce-,bas$ treatm5t ,9 c>ry+ out ! ,program1 ! ,comm&] %all provide evid5ce-bas$ physical1 m5tal1 & behavioral heal? c>e & c\nsel+ = traumatic bra9 injury1 bla/ ov]pressure1 bla/ exposure1 & psy*ological or neurological conditions t are common among memb]s ( ! special op]ations =ces4 7c7 ,population s]v$ ,9 c>ry+ out ! ,program1 ! ,comm&] %all provide ! heal? c>e & c\nsel+ specifi$ 9 subsection 7b7 to memb]s ( ! special op]ations =ces & family memb]s ( su* memb]s4 7d7 ,evaluation1 te/+1 & treatm5t ,! ,program %all include ! foll[+3 7#a7 ,evaluations by heal? c>e provid]s 9 ! areas ( bra9 injury m$ic9e1 neuropsy*ology1 cl9ical psy*ology1 psy*iatry1 neuro5docr9ology1 sports m$ic9e1 musculoskeletal m$ic9e1 ve/ibul> physical !rapy1 neuroimag+1 & hormonal evaluation4 7#b7 ,metabolic te/+1 c>diovascul> te/+1 & c]ebrovascul> te/+4 7#c7 ,treatm5t relat+ to heada*es1 sleep int]v5tions & m$ication1 injection-bas$ !rapies = musculoskeletal pa91 cognitive rehab1 ve/ibul> physical !rapy1 & ex]cise programm+4 7e7 ,coord9ation ,9 c>ry+ out ! ,program1 ! ,comm&] %all coord9ate ) private sector non-pr(it heal?c>e organizations t h ! capacity & infra/ructure to provide ! c>e & s]vices requir$ "u ! ,program4 7f7 ,m$ical records ,9 c>ry+ out ! ,program1 ! ,comm&] %all coord9ate ) ! ,director ( ! ,def5se ,heal? ,ag5cy & ! ,secret>ies ( ! milit>y dep>tm5ts to ensure t ! treatm5t receiv$ ?r\gh ! ,program is docum5t$ 9 ! m$ical records ( memb]s ( ! arm$ =ces4 4 7b7 ,cl]ical ,! table ( sections at ! beg9n+ ( *apt] #ee;,a ( su* title1 z am5d$ by section #c1 is am5d$ by add+ at ! end ! foll[+ new item3 #aaajn-#b4 ,special op]ations bra9 heal? & trauma program4 4 7c7 ,report & brief+ on implem5tation ( special op]ations traumatic bra9 injury program 7#a7 ,report on program 7,a7 ,9 g5]al ,n lat] ?an ,decemb] #ca1 #bjbe1 ! ,comm&] ( ! ,unit$ ,/ates ,special ,op]ations ,comm&1 9 coord9ation ) ! ,secret>y ( ,def5se1 %all submit to ! ,committee on ,arm$ ,s]vices ( ! ,s5ate & ! ,committee on ,arm$ ,s]vices ( ! ,h\se ( ,repres5tatives a report on ! special op]ations bra9 heal? & trauma program requir$ "u section #aaajn-#b ( title #aj1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 :i* %all include-- 7i7 ! b5efits ( ! program to memb]s ( ! ,arm$ ,=ces & _! families2 7ii7 ! numb] ( memb]s assi/$ by su* program2 7iii7 ! type ( treatm5t receiv$ "u su* program2 7iv7 ! rate ( memb]s ( ! ,arm$ ,=ces return+ to duty aft] receiv+ treatm5t "u su* program2 7v7 h[ ! ,comm&] is coord9at+ ) ! ,director ( ! ,def5se ,heal? ,ag5cy & ! ,secret>ies ( ! milit>y dep>tm5ts to update records ( memb]s ( ! ,arm$ ,=ces ) treatm5t receiv$ "u su* program2 & 7vi7 :e!r & h[ ! program %\ld be exp&$ to include o!r vuln]able populations )9 ! ,arm$ ,=ces2 7,b7 ,public availability ,! ,secret>y ( ,def5se %all make ! in=mation conta9$ 9 ! report submitt$ "u subp>agraph 7,a7 available to ! public1 includ+ on ! gov9fo4gov website1 or successor website1 n lat] ?an #aj days aft] ! report is submitt$ "u su* subp>agraph4 7#b7 ,comptroll] g5]al report & brief+ ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all brief ! ,committee on ,arm$ ,s]vices ( ! ,s5ate & ! ,committee on ,arm$ ,s]vices ( ! ,h\se ( ,repres5tatives on ! implem5tation ( section #aaajn-#b ( title #aj1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 ) a report to foll[ at a mutually agre$ ^u date4 #f4 ,national intrepid c5t] ( excell5ce 7a7 ,9 g5]al ,*apt] #ee;,a ( title #aj1 ,unit$ ,/ates ,code1 z add$ by section #c & am5d$ by section #e1 is fur!r am5d$ by add+ at ! end ! foll[+ new section3 #aaajn-#c4 ,national ,intrepid ,c5t] ( ,excell5ce 7a7 ,9 g5]al ,n lat] ?an #abj days aft] ! date ( ! enactm5t ( ! ,bla/ ,ov]pressure ,safety ,act1 ! ,secret>y ( ,def5se %all e/abli% ! ,national ,intrepid ,c5t] ( ,excell5ce 79 ?is section ref]r$ to z ! ,c5t]7 z a program ( record subject to mile/one reviews & compliance ) ! requirem5ts "u ?is section4 7b7 ,duties ,! duties ( ! ,c5t] are z foll[s3 7#a7 ,to provide int]discipl9>y c>e to prev5t1 diagnose1 treat1 & rehabilitate memb]s ( ! arm$ =ces ) traumatic bra9 injury1 po/-traumatic /ress disord]1 symptoms f bla/ ov]pressure or bla/ exposure1 & o!r m5tal heal? conditions4 7#b7 ,support & conduct rese>* & education on traumatic bra9 injury1 po/-traumatic /ress disord]1 bla/ ov]pressure or bla/ exposure1 & o!r m5tal heal? conditions4 7c7 ,*ildc>e ,*ildc>e s]vices %all be made available = individuals seek+ help ?r\gh ! ,national ,intrepid ,c5t] ( ,excell5ce4 7d7 ,annual report 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ! ,bla/ ,ov]pressure ,safety ,act1 & annually !reaft]1 ! ,secret>y ( ,def5se %all submit to ! ,committees on ,arm$ ,s]vices ( ! ,s5ate & ! ,h\se ( ,repres5tatives a report t %all include1 = ! ye> cov]$ by ! report-- 7,a7 ! numb] ( individuals to :om ! ,c5t] has provid$ s]vices2 7,b7 ! numb] ( individuals :o return to active duty 9 ! arm$ =ces aft] receiv+ s]vices f ! ,c5t]1 & ! /age 9 _! c>e] at :i* !y seek treatm5t at ! ,c5t]2 7,c7 ! numb] ( individuals ^: families are able to p>ticipate 9 programs provid$ by ! ,c5t]2 & 7,d7 ! numb] ( individuals on a waitli/ = treatm5t at ! ,c5t] & ! av]age p]iod ^? individuals are on ! waitli/4 7#b7 ,public availability ,! ,secret>y ( ,def5se %all make ! in=mation conta9$ 9 ea* report submitt$ "u p>agraph 7#a7 available to ! public1 includ+ on ! gov9fo4gov website1 or successor website1 n lat] ?an #aj days aft] ! report is submitt$ "u su* p>agraph4 4 7b7 ,cl]ical ,! table ( sections at ! beg9n+ ( *apt] #ee;,a ( su* title1 z am5d$ by sections #c & #e1 is am5d$ by add+ at ! end ! foll[+ new item3 #aaajn-#c4 ,national ,intrepid ,c5t] ( ,excell5ce4 4 #g4 ,m&atory tra9+ on heal? effects ( c]ta9 bra9 trauma 7a7 ,9 g5]al ,*apt] #ee;,a ( title #aj1 ,unit$ ,/ates ,code1 z add$ by section #c & am5d$ by sections #e & #f1 is fur!r am5d$ by add+ at ! end ! foll[+ new section3 #aaajn-#d4 ,m&atory tra9+ on heal? effects ( c]ta9 bra9 trauma ,n less frequ5tly ?an once e two ye>s1 ! ,secret>y ( ,def5se %all provide to ea* m$ical provid] & tra9+ manag] ( ! ,dep>tm5t ( ,def5se m&atory tra9+ ) respect to ! pot5tial heal? effects ( bla/ ov]pressure1 bla/ exposure1 & traumatic bra9 injury4 4 7b7 ,cl]ical ,! table ( sections at ! beg9n+ ( *apt] #ee;,a ( su* title1 z am5d$ by sections #c1 #e1 & #f1 is am5d$ by add+ at ! end ! foll[+ new item3 #aaajn-#d4 ,m&atory tra9+ on heal? effects ( c]ta9 bra9 trauma4 4 #h4 ,annual brief+ on individual longitud9al exposure record 7a7 ,9 g5]al ,*apt] #ee ( title #aj1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #aaaj;c4 ,annual brief+ on ,individual ,longitud9al ,exposure ,record 7a7 ,9 g5]al ,n less frequ5tly ?an annually1 ! ,secret>y ( ,def5se1 9 consultation ) ! ,secret>y ( ,vet]ans ,affairs1 %all provide ! appropriate committees ( ,congress a brief+ on-- 7#a7 ! quality ( ! databases ( ! ,dep>tm5t ( ,def5se t provide ! in=mation pres5t$ 9 ! ,individual ,longitud9al ,exposure ,record2 & 7#b7 ! usefulness ( ! ,individual ,longitud9al ,exposure ,record 9 support+ memb]s ( ! arm$ =ces & vet]ans 9 receiv+ heal? c>e & b5efits f ! ,dep>tm5t ( ,def5se & ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,elem5ts ,ea* brief+ requir$ by subsection 7a7 %all include1 = ! p]iod cov]$ by ! report1 ! foll[+3 7#a7 ,an id5tification ( pot5tial exposures to occupational or environm5tal haz>ds1 includ+ bla/ ov]pressure & bla/ exposure1 captur$ by ! curr5t sy/ems ( ! ,dep>tm5t ( ,def5se = environm5tal1 occupational1 & heal? monitor+1 & recomm5dations = h[ to improve ^? sy/ems4 7#b7 ,an analysis ( ! quality & accuracy ( ! location data us$ by ! ,dep>tm5t ( ,def5se 9 det]m9+ pot5tial exposures to occupational or environm5tal haz>ds by memb]s ( ! arm$ =ces & vet]ans1 includ+ bla/ ov]pressure & bla/ exposure1 & recomm5dations = h[ to improve ! quality ( su* data if necess>y4 7c7 ,def9itions ,9 ?is section3 7#a7 ,appropriate committees ( congress ,! t]m appropriate committees ( ,congress means-- 7,a7 ! ,committee on ,arm$ ,s]vices & ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate2 & 7,b7 ! ,committee on ,arm$ ,s]vices & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives4 7#b7 ,individual longitud9al exposure record ,! t]m ,individual ,longitud9al ,exposure ,record has ! mean+ giv5 su* t]m 9 section #aaga7;b7 ( title #ch4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #ee ( title #aj1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] ! item relat+ to section #aaaj;b ! foll[+ new item3 #aaaj;c4 ,annual brief+ on ,individual ,longitud9al ,exposure ,record4 4 7c7 ,con=m+ repeal ,section #hjb ( ! ,s]geant ,fir/ ,class ,hea? ,rob9son ,honor+ our ,promise to ,address ,compreh5sive ,toxics ,act ( #bjbb 7,public ,law #aag-afh2 #aj ,u4,s4,c4 #ajga note7 is repeal$4 #i4 ,review ( bla/-relat$ bra9 injury rese>* & o!r ef=ts ( ! dep>tm5t ( def5se 7a7 ,review 7#a7 ,9 g5]al ,! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all conduct a review ( ! rese>* & o!r ef=ts ( ! ,dep>tm5t ( ,def5se on traumatic bra9 injury1 includ+ injuries relat$ to bla/ ov]pressure or bla/ exposure4 7#b7 ,matt]s to be includ$ ,! review requir$ by p>agraph 7#a7 %all include ! foll[+3 7,a7 ,a description ( ! rese>* conduct$ by ! ,dep>tm5t ( ,def5se on traumatic bra9 injury1 ! entities involv$ 9 t rese>*1 & ef=ts to coord9ate t rese>* int]nally & ext]nally4 7,b7 ,a description ( any improvem5ts id5tifi$ by t rese>* relat$ to ! prev5tion1 diagnosis1 & treatm5t ( bla/-relat$ bra9 injuries & an assessm5t ( ! implem5tation ( ^? improvem5ts4 7,c7 ,an evaluation ( ! ef=ts ( ! ,dep>tm5t to protect memb]s ( ! ,arm$ ,=ces f retaliation = seek+ c>e = ! prev5tion1 diagnosis1 or treatm5t ( traumatic bra9 injury1 bla/ ov]pressure1 or bla/ exposure1 includ+ any gaps 9 or b>ri]s to ^? ef=ts4 7,d7 ,an evaluation ( ! li/ ma9ta9$ by ! ,dep>tm5t ( ! milit>y occupational specialties mo/ at-risk = bla/ ov]pressure & bla/ exposure & :e!r additional at-risk occupational specialties %\ld be includ$4 7,e7 ,any o!r f9d+ ! ,comptroll] ,g5]al consid]s relevant4 7b7 ,brief+ & report ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al %all brief ! ,committee on ,arm$ ,s]vices ( ! ,s5ate & ! ,committee on ,arm$ ,s]vices ( ! ,h\se ( ,repres5tatives on ! review requir$ "u subsection 7a71 ) a report to foll[ on a mutually agre$ ^u date4 7c7 ,def9ition ( traumatic bra9 injury ,9 ?is section1 ! t]m traumatic bra9 injury means a traumatically induc$ /ructural injury or physiological disruption ( bra9 function z a result ( an ext]nal =ce t is indicat$ by new onset or wors5+ ( at lea/ "o ( ! foll[+ cl9ical signs imm$iately foll[+ ! ev5t3 7#a7 ,alt]ation 9 m5tal /atus1 includ+ confusion1 disori5tation1 or sl[$ ?9k+4 7#b7 ,loss ( memory = ev5ts imm$iately be=e or aft] ! injury4 7#c7 ,any p]iod ( loss ( or decreas$ level ( consci\sness1 obs]v$ or self-report$4 #aj4 ,implem5tation ( inspector g5]al recomm5dations to manage traumatic bra9 injury c>e 7a7 ,implem5tation ,n lat] ?an ,decemb] #ca1 #bjbe1 ! ,secret>y ( ,def5se %all implem5t ! recomm5dations conta9$ 9 ! report ( ! ,inspector ,g5]al ( ! ,dep>tm5t ( ,def5se entitl$1 ,evaluation ( ! ,do,d's ,managem5t ( ,traumatic ,bra9 ,injury 7,,dodig-#bjbc-jei74 7b7 ,brief+ ,n lat] ?an ,april #a1 #bjbe1 ! ,secret>y ( ,def5se %all provide to ! ,committee on ,arm$ ,s]vices ( ! ,s5ate & ! ,committee on ,arm$ ,s]vices ( ! ,h\se ( ,repres5tatives a brief+ on ! progress ( ! ,secret>y 9 c>ry+ out ! implem5tation requir$ "u subsection 7a74