Blast Overpressure Safety Act
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.
Sec. 2 Roles and responsibilities for components of the Office of the Secretary of Defense relating to brain injuries from concussive and subconcussive blasts
Sec. 3 Improvements to brain health initiatives of Department of Defense
“55A Brain health initiatives
“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.
“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 Forces;
“(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.”
Sec. 4 Pilot program relating to monitoring of blast coverage
Sec. 5 Special operations brain health and trauma program
“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.”
Sec. 6 National Intrepid Center of Excellence
“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.”
Sec. 7 Mandatory training on health effects of certain brain trauma
“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.”
Sec. 8 Annual briefing on Individual Longitudinal Exposure Record
“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.”