Hon. Timothy J. Walz, a Representative in Congress from the State of Minnesota
I want to thank Chairwoman Buerkle, Ranking Member Michaud, and Members of the Subcommittee for giving me the opportunity to appear before you today to discuss my bill, HR 1855, the Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011.
It is a deep privilege to be a member of a Committee devoted to serving those who have served our country. We are truly the stewards of a grateful nation that recognizes our obligation to America’s servicemen and women.
We are also members of a Committee with a great history – not only of developing landmark legislation to meet the needs of many generations of veterans, but of doing this important work on a bipartisan basis. The Committee’s rich legacy continues to the present.
Reflecting on the needs of many of those veterans, I introduced legislation late last year, together with Chairman Miller and Congressman Bilirakis, to help some of our most severely injured, those with traumatic brain injury. That legislation was aimed at improving the rehabilitative services that are so important to these young men and women.
Having re-introduced the bill earlier this year, I’m particularly appreciative that the Subcommittee has included it on the agenda.
Unprecedented numbers of warriors are returning home from Iraq and Afghanistan with severe polytraumatic injuries. This is not only due to the nature of the fighting and the kinds of injuries being sustained, but to advances in military medicine and logistics that have saved countless lives that might have been lost in previous wars.
Traumatic brain injuries are among the most complex injuries our personnel have sustained. Each case is unique and injuries can result in wide-ranging loss of function. Neurological and cognitive loss or impairment in speech, vision, and memory, for example, are not uncommon – as is marked behavioral change, with such manifestations as impaired judgment or diminished capacity for self-regulation.
It is difficult to predict the extent of an individual’s ultimate level of recovery, but the evidence is clear that to be effective in helping an individual recover from a brain injury and return to a life as independent and productive as possible, rehabilitation must be targeted to the specific needs of the individual patient.
H.R. 1855, the Traumatic Brain Injury Rehabilitative Services Improvements Act of 2011, is aimed at closing gaps in current law that have had the effect of denying some veterans with severe TBI from achieving optimal outcomes.
Many VA facilities have dedicated rehabilitation-medicine staff, but the scope of services actually provided to veterans with a severe TBI can be limited, both in duration and in the range of services authorized. Veterans encounter two distinct problems. First, it is all too common for staff to advise families that the VA can no longer provide a particular rehabilitative service because the veteran is no longer making significant progress. But ongoing rehabilitation is often needed to maintain function, and individuals who are denied maintenance therapy can regress and lose cognitive and other gains they’ve made through rehab work.
A second problem veterans encounter is in getting help with community reintegration, and learning to live as independently as possible. VA’s rehabilitation focus relies almost exclusively on a medical model; that assistance is critical, but doesn’t necessarily go far enough for some veterans in providing the range of supports a young person needs to achieve the fullest possible life in the community.
In contrast, other models of rehabilitative care meet TBI patients’ needs through such services as life-skills coaching, supported employment, and community reintegration therapy. These services are seldom made available to veterans. Yet research has shown that with these types of innovative non-medical supports, individuals with severe TBI can flourish in a community setting. Denying wounded warriors such supports compromises their achieving the fullest possible recovery.
H.R. 1855 would close these gaps. Specifically, it would clarify that VA may not prematurely cut off needed rehabilitation services for an individual with traumatic brain injury, and that veterans with TBI can get the supports they need – whether those are health-services or non-medical assistance -- to achieve maximum independence and quality of life.
I’m gratified by the broad support the bill has won from major veterans’ service organizations. And I’m particularly pleased at the strong endorsement from Wounded Warrior Project, whose Executive Director, Steve Nardizzi, described the bill as “powerfully addressing the often agonizing experience of wounded warriors who have been denied important community-reintegration supports and who have experienced premature termination of rehabilitation services.” As Steve said, “This bill offers new hope to these warriors and their families.”
I look forward to responding to all of your questions, and with that, I yield back my time.