The BEACON Act: Partnership, Privatization, or Both?

Seeking to modernize treatment for traumatic brain injury (TBI), Reps. Jack Bergman (R-MI) and Sarah Elfreth (D-MD) introduced the bipartisan BEACON Act to Congress on January 9. The legislation aims to expand access to innovative, evidence-based, nonpharmacological therapies to treat TBI beyond medication-centered approaches that do not always address the long-term and individualized needs of these veterans. These current methods leave “gaps in recovery, wellness, and post-service outcomes,” Bergman and Elfreth argued.

During a March 5 House Committee on Veterans’ Affairs Subcommittee on Health hearing, discussion centered on the proposed BEACON Act, as well as the additional challenges Neurology Centers of Excellence (CoEs) face to address TBI in veterans.

The act proposes awarding $60 million in grants over 3 years to private entities for TBI treatment and research and establishing 2 US Department of Veterans Affairs (VA) grant programs. The TBI Innovation Grant Program would support clinical studies and partnerships between community health care institutions, academic institutions, and the VA. The Independent Research Grant Program would advance third-party research and “implementation of proven alternative treatments,” with oversight by an independent entity modeled after the VA National Center for PTSD.

The proposed legislation has drawn criticism. “I do not disagree that veterans may need support from several different avenues to support their recovery journeys and I don't discount the role that nonprofits and academic affiliates play in facilitating and supporting that care,” said Ranking Member Rep. Julia Brownley (D-CA) said. “However, I need to draw the line at legislation that will take money from existing VA programs and redirect it to outside organizations and providers to do essentially the very same thing VA is already doing.” 

Russell Gore, MD, a neurologist and chief medical officer of Avalon Action Alliance, called VA TBI care fragmented and said the BEACON Act offers an opportunity to enhance it.

“This legislation is designed to evaluate effective treatments and leverage civilian and academic TBI expertise that is aligned with the VA’s mission,” he said. “This is not an attempt to privatize care, but to complement VA research and clinical capacity… With smart, coordinated partnerships and targeted investment, we can reach more veterans earlier, treat them more effectively.”

The VA has 5 polytrauma rehabilitation centers, 23 polytrauma network sites, and numerous clinics supporting > 110 TBI teams. It also has 42 CoEs related to neurology. 

In a prepared statement, Glenn Graham, MD, PhD, retired Executive Director of the VA’s Neurology Clinical Programs representing the Association of VA Neurology Services cited the CoEs’ contribution to standardization of care. “Without systemwide coordination, practice patterns can vary. A veteran in a rural facility should receive the same standard of neurological assessment and management as a veteran treated in one of our flagship medical centers,” he said, before highlighting the capabilities of tele-neurology, electronic consultation, and remote interpretation of diagnostic studies to reduce travel burdens and promote equity in access. 

Graham cautioned, though, that the CoEs face challenges with budgeting and recent VA reductions in force. The proposed legislation, Graham said, would use VA appropriations to fund extramural research and “could drain vital resources from ongoing research, training and clinical programs, diverting funds to institutions with uncertain track records and limited experience working with the veteran population.” 

Several people highlighted the world-renowned research coming out of the VA, efforts that both veterans and the general public endorse.

Russell Lemle, former chief psychologist for the San Francisco VA Healthcare System and a senior policy analyst at the Veterans Healthcare Policy Institute, wrote with Jasper Craven: “The private sector has nothing commensurate with this level of care. And yet this bill would push TBI treatment out to private grantees, part of the accelerating movement to privatize the entire VA—even its signature, best-in-class programs.

“The act aims to divert resources from the VA’s world-class TBI and PTSD programs by creating a parallel treatment framework.”

Gore, however, said the Avalon Action Alliance supports a “fill-the-void” approach of “capacity augmentation, not privatization.”

“The intent is to complement VA by partnering with high-performing programs capable of delivering comprehensive assessment, interdisciplinary treatment, and structured follow-up for veterans who are not effectively reached (or not successfully retained) within traditional pathways,” he said.

Seeking to modernize treatment for traumatic brain injury (TBI), Reps. Jack Bergman (R-MI) and Sarah Elfreth (D-MD) introduced the bipartisan BEACON Act to Congress on January 9. The legislation aims to expand access to innovative, evidence-based, nonpharmacological therapies to treat TBI beyond medication-centered approaches that do not always address the long-term and individualized needs of these veterans. These current methods leave “gaps in recovery, wellness, and post-service outcomes,” Bergman and Elfreth argued.

During a March 5 House Committee on Veterans’ Affairs Subcommittee on Health hearing, discussion centered on the proposed BEACON Act, as well as the additional challenges Neurology Centers of Excellence (CoEs) face to address TBI in veterans.

The act proposes awarding $60 million in grants over 3 years to private entities for TBI treatment and research and establishing 2 US Department of Veterans Affairs (VA) grant programs. The TBI Innovation Grant Program would support clinical studies and partnerships between community health care institutions, academic institutions, and the VA. The Independent Research Grant Program would advance third-party research and “implementation of proven alternative treatments,” with oversight by an independent entity modeled after the VA National Center for PTSD.

The proposed legislation has drawn criticism. “I do not disagree that veterans may need support from several different avenues to support their recovery journeys and I don't discount the role that nonprofits and academic affiliates play in facilitating and supporting that care,” said Ranking Member Rep. Julia Brownley (D-CA) said. “However, I need to draw the line at legislation that will take money from existing VA programs and redirect it to outside organizations and providers to do essentially the very same thing VA is already doing.” 

Russell Gore, MD, a neurologist and chief medical officer of Avalon Action Alliance, called VA TBI care fragmented and said the BEACON Act offers an opportunity to enhance it.

“This legislation is designed to evaluate effective treatments and leverage civilian and academic TBI expertise that is aligned with the VA’s mission,” he said. “This is not an attempt to privatize care, but to complement VA research and clinical capacity… With smart, coordinated partnerships and targeted investment, we can reach more veterans earlier, treat them more effectively.”

The VA has 5 polytrauma rehabilitation centers, 23 polytrauma network sites, and numerous clinics supporting > 110 TBI teams. It also has 42 CoEs related to neurology. 

In a prepared statement, Glenn Graham, MD, PhD, retired Executive Director of the VA’s Neurology Clinical Programs representing the Association of VA Neurology Services cited the CoEs’ contribution to standardization of care. “Without systemwide coordination, practice patterns can vary. A veteran in a rural facility should receive the same standard of neurological assessment and management as a veteran treated in one of our flagship medical centers,” he said, before highlighting the capabilities of tele-neurology, electronic consultation, and remote interpretation of diagnostic studies to reduce travel burdens and promote equity in access. 

Graham cautioned, though, that the CoEs face challenges with budgeting and recent VA reductions in force. The proposed legislation, Graham said, would use VA appropriations to fund extramural research and “could drain vital resources from ongoing research, training and clinical programs, diverting funds to institutions with uncertain track records and limited experience working with the veteran population.” 

Several people highlighted the world-renowned research coming out of the VA, efforts that both veterans and the general public endorse.

Russell Lemle, former chief psychologist for the San Francisco VA Healthcare System and a senior policy analyst at the Veterans Healthcare Policy Institute, wrote with Jasper Craven: “The private sector has nothing commensurate with this level of care. And yet this bill would push TBI treatment out to private grantees, part of the accelerating movement to privatize the entire VA—even its signature, best-in-class programs.

“The act aims to divert resources from the VA’s world-class TBI and PTSD programs by creating a parallel treatment framework.”

Gore, however, said the Avalon Action Alliance supports a “fill-the-void” approach of “capacity augmentation, not privatization.”

“The intent is to complement VA by partnering with high-performing programs capable of delivering comprehensive assessment, interdisciplinary treatment, and structured follow-up for veterans who are not effectively reached (or not successfully retained) within traditional pathways,” he said.

Seeking to modernize treatment for traumatic brain injury (TBI), Reps. Jack Bergman (R-MI) and Sarah Elfreth (D-MD) introduced the bipartisan BEACON Act to Congress on January 9. The legislation aims to expand access to innovative, evidence-based, nonpharmacological therapies to treat TBI beyond medication-centered approaches that do not always address the long-term and individualized needs of these veterans. These current methods leave “gaps in recovery, wellness, and post-service outcomes,” Bergman and Elfreth argued.

During a March 5 House Committee on Veterans’ Affairs Subcommittee on Health hearing, discussion centered on the proposed BEACON Act, as well as the additional challenges Neurology Centers of Excellence (CoEs) face to address TBI in veterans.

The act proposes awarding $60 million in grants over 3 years to private entities for TBI treatment and research and establishing 2 US Department of Veterans Affairs (VA) grant programs. The TBI Innovation Grant Program would support clinical studies and partnerships between community health care institutions, academic institutions, and the VA. The Independent Research Grant Program would advance third-party research and “implementation of proven alternative treatments,” with oversight by an independent entity modeled after the VA National Center for PTSD.

The proposed legislation has drawn criticism. “I do not disagree that veterans may need support from several different avenues to support their recovery journeys and I don't discount the role that nonprofits and academic affiliates play in facilitating and supporting that care,” said Ranking Member Rep. Julia Brownley (D-CA) said. “However, I need to draw the line at legislation that will take money from existing VA programs and redirect it to outside organizations and providers to do essentially the very same thing VA is already doing.” 

Russell Gore, MD, a neurologist and chief medical officer of Avalon Action Alliance, called VA TBI care fragmented and said the BEACON Act offers an opportunity to enhance it.

“This legislation is designed to evaluate effective treatments and leverage civilian and academic TBI expertise that is aligned with the VA’s mission,” he said. “This is not an attempt to privatize care, but to complement VA research and clinical capacity… With smart, coordinated partnerships and targeted investment, we can reach more veterans earlier, treat them more effectively.”

The VA has 5 polytrauma rehabilitation centers, 23 polytrauma network sites, and numerous clinics supporting > 110 TBI teams. It also has 42 CoEs related to neurology. 

In a prepared statement, Glenn Graham, MD, PhD, retired Executive Director of the VA’s Neurology Clinical Programs representing the Association of VA Neurology Services cited the CoEs’ contribution to standardization of care. “Without systemwide coordination, practice patterns can vary. A veteran in a rural facility should receive the same standard of neurological assessment and management as a veteran treated in one of our flagship medical centers,” he said, before highlighting the capabilities of tele-neurology, electronic consultation, and remote interpretation of diagnostic studies to reduce travel burdens and promote equity in access. 

Graham cautioned, though, that the CoEs face challenges with budgeting and recent VA reductions in force. The proposed legislation, Graham said, would use VA appropriations to fund extramural research and “could drain vital resources from ongoing research, training and clinical programs, diverting funds to institutions with uncertain track records and limited experience working with the veteran population.” 

Several people highlighted the world-renowned research coming out of the VA, efforts that both veterans and the general public endorse.

Russell Lemle, former chief psychologist for the San Francisco VA Healthcare System and a senior policy analyst at the Veterans Healthcare Policy Institute, wrote with Jasper Craven: “The private sector has nothing commensurate with this level of care. And yet this bill would push TBI treatment out to private grantees, part of the accelerating movement to privatize the entire VA—even its signature, best-in-class programs.

“The act aims to divert resources from the VA’s world-class TBI and PTSD programs by creating a parallel treatment framework.”

Gore, however, said the Avalon Action Alliance supports a “fill-the-void” approach of “capacity augmentation, not privatization.”

“The intent is to complement VA by partnering with high-performing programs capable of delivering comprehensive assessment, interdisciplinary treatment, and structured follow-up for veterans who are not effectively reached (or not successfully retained) within traditional pathways,” he said.