September 5, 2007
Ordered to be printed as passed
HR 1538
3-28-07, Bill Passed House by 426-0
Vote
7-25-07, Senate Passed Bill by Unanimous Consent
Ordered to be printed as Passed (PP), Engrossed Amendment
In the Senate of the United States,
July 25, 2007.
Resolved, That the bill from the House of Representatives (H.R.
1538) entitled `An Act to amend title 10, United States Code, to improve the
management of medical care, personnel actions, and quality of life issues
for members of the Armed Forces who are receiving medical care in an outpatient
status, and for other purposes.', do pass with the following
AMENDMENT:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title- This Act may be cited as the `Dignified Treatment of
Wounded Warriors Act'.
(b) Table of Contents- The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I--WOUNDED WARRIOR MATTERS
Sec. 101. General definitions.
Subtitle A--Policy on Care, Management, and Transition of Servicemembers
With Serious Injuries or Illnesses
Sec. 111. Comprehensive policy on care, management, and transition of
members of the Armed Forces with serious injuries or illnesses.
Sec. 112. Consideration of needs of women members of the Armed Forces
and veterans.
Subtitle B--Health Care
PART I--Enhanced Availability of Care for Servicemembers
Sec. 121. Medical care and other benefits for members and former members
of the Armed Forces with severe injuries or illnesses.
Sec. 122. Reimbursement of certain former members of the uniformed services
with service-connected disabilities for travel for follow-on specialty care
and related services.
PART II--Care and Services for Dependents
Sec. 126. Medical care and services and support services for families
of members of the Armed Forces recovering from serious injuries or illnesses.
Sec. 127. Extended benefits under TRICARE for primary caregivers of
members of the uniformed services who incur a serious injury or illness
on active duty.
PART III--Traumatic Brain Injury and Post-Traumatic Stress Disorder
Sec. 131. Comprehensive plans on prevention, diagnosis, mitigation,
and treatment of traumatic brain injury and post-traumatic stress disorder
in members of the Armed Forces.
Sec. 132. Improvement of medical tracking system for members of the
Armed Forces deployed overseas.
Sec. 133. Centers of excellence in the prevention, diagnosis, mitigation,
treatment, and rehabilitation of traumatic brain injury and post-traumatic
stress disorder.
Sec. 134. Review of mental health services and treatment for female
members of the Armed Forces and veterans.
Sec. 135. Funding for improved diagnosis, treatment, and rehabilitation
of members of the Armed Forces with traumatic brain injury or post-traumatic
stress disorder.
PART IV--Other Matters
Sec. 141. Joint electronic health record for the Department of Defense
and Department of Veterans Affairs.
Sec. 142. Enhanced personnel authorities for the Department of Defense
for health care professionals for care and treatment of wounded and injured
members of the Armed Forces.
Sec. 143. Personnel shortages in the mental health workforce of the
Department of Defense, including personnel in the mental health workforce.
Subtitle C--Disability Matters
PART I--Disability Evaluations
Sec. 151. Utilization of veterans' presumption of sound condition in
establishing eligibility of members of the Armed Forces for retirement for
disability.
Sec. 152. Requirements and limitations on Department of Defense determinations
of disability with respect to members of the Armed Forces.
Sec. 153. Review of separation of members of the Armed Forces separated
from service with a disability rating of 20 percent disabled or less.
Sec. 154. Pilot programs on revised and improved disability evaluation
system for members of the Armed Forces.
Sec. 155. Reports on Army action plan in response to deficiencies in
the Army physical disability evaluation system.
PART II--Other Disability Matters
Sec. 161. Enhancement of disability severance pay for members of the
Armed Forces.
Sec. 162. Traumatic Servicemembers' Group Life Insurance.
Sec. 163. Electronic transfer from the Department of Defense to the
Department of Veterans Affairs of documents supporting eligibility for benefits.
Sec. 164. Assessments of temporary disability retired list.
Subtitle D--Improvement of Facilities Housing Patients
Sec. 171. Standards for military medical treatment facilities, specialty
medical care facilities, and military quarters housing patients.
Sec. 172. Reports on Army action plan in response to deficiencies identified
at Walter Reed Army Medical Center.
Sec. 173. Construction of facilities required for the closure of Walter
Reed Army Medical Center, District of Columbia.
Subtitle E--Outreach and Related Information on Benefits
Sec. 181. Handbook for members of the Armed Forces on compensation and
benefits available for serious injuries and illnesses.
Subtitle F--Other Matters
Sec. 191. Study on physical and mental health and other readjustment
needs of members and former members of the Armed Forces who deployed in
Operation Iraqi Freedom and Operation Enduring Freedom and their families.
TITLE II--VETERANS MATTERS
Sec. 201. Sense of Congress on Department of Veterans Affairs efforts
in the rehabilitation and reintegration of veterans with traumatic brain
injury.
Sec. 202. Individual rehabilitation and community reintegration plans
for veterans and others with traumatic brain injury.
Sec. 203. Use of non-Department of Veterans Affairs facilities for implementation
of rehabilitation and community reintegration plans for traumatic brain
injury.
Sec. 204. Research, education, and clinical care program on severe traumatic
brain injury.
Sec. 205. Pilot program on assisted living services for veterans with
traumatic brain injury.
Sec. 206. Research on traumatic brain injury.
Sec. 207. Age-appropriate nursing home care.
Sec. 208. Extension of period of eligibility for health care for combat
service in the Persian Gulf war or future hostilities.
Sec. 209. Mental health: service-connection status and evaluations for
certain veterans.
Sec. 210. Modification of requirements for furnishing outpatient dental
services to veterans with a service-connected dental condition or disability.
Sec. 211. Demonstration program on preventing veterans at-risk of homelessness
from becoming homeless.
Sec. 212. Clarification of purpose of the outreach services program
of the Department of Veterans Affairs.
TITLE III
Sec. 301. Fiscal year 2008 increase in military basic pay.
TITLE I--WOUNDED WARRIOR MATTERS
SEC. 101. GENERAL DEFINITIONS.
(1) The term `appropriate committees of Congress' means--
(A) the Committees on Armed Services and Veterans' Affairs of the
Senate; and
(B) the Committees on Armed Services and Veterans' Affairs of the
House of Representatives.
(2) The term `covered member of the Armed Forces' means a member of
the Armed Forces, including a member of the National Guard or a Reserve,
who is undergoing medical treatment, recuperation, or therapy, is otherwise
in medical hold or medical holdover status, or is otherwise on the temporary
disability retired list for a serious injury or illness.
(3) The term `family member', with respect to a member of the Armed
Forces or a veteran, has the meaning given that term in section 411h(b)
of title 37, United States Code.
(4) The term `medical hold or medical holdover status' means--
(A) the status of a member of the Armed Forces, including a member
of the National Guard or Reserve, assigned or attached to a military hospital
for medical care; and
(B) the status of a member of a reserve component of the Armed Forces
who is separated, whether pre-deployment or post-deployment, from the
member's unit while in need of health care based on a medical condition
identified while the member is on active duty in the Armed Forces.
(5) The term `serious injury or illness', in the case of a member of
the Armed Forces, means an injury or illness incurred by the member in line
of duty on active duty in the Armed Forces that may render the member medically
unfit to perform the duties of the member's office, grade, rank, or rating.
(6) The term `TRICARE program' has the meaning given that term in section
1072(7) of title 10, United States Code.
Subtitle A--Policy on Care, Management, and Transition of Servicemembers
With Serious Injuries or Illnesses
SEC. 111. COMPREHENSIVE POLICY ON CARE, MANAGEMENT, AND TRANSITION OF
MEMBERS OF THE ARMED FORCES WITH SERIOUS INJURIES OR ILLNESSES.
(a) Comprehensive Policy Required-
(1) IN GENERAL- Not later than January 1, 2008, the Secretary of Defense
and the Secretary of Veterans Affairs shall, to the extent feasible, jointly
develop and implement a comprehensive policy on the care and management
of members of the Armed Forces who are undergoing medical treatment, recuperation,
or therapy, are otherwise in medical hold or medical holdover status, or
are otherwise on the temporary disability retired list for a serious injury
or illness (hereafter in this section referred to as a `covered servicemembers').
(2) SCOPE OF POLICY- The policy shall cover each of the following:
(A) The care and management of covered servicemembers while in medical
hold or medical holdover status or on the temporary disability retired
list.
(B) The medical evaluation and disability evaluation of covered servicemembers.
(C) The return of covered servicemembers to active duty when appropriate.
(D) The transition of covered servicemembers from receipt of care
and services through the Department of Defense to receipt of care and
services through the Department of Veterans Affairs.
(3) CONSULTATION- The Secretary of Defense and the Secretary of Veterans
Affairs shall develop the policy in consultation with the heads of other
appropriate departments and agencies of the Federal Government and with
appropriate non-governmental organizations having an expertise in matters
relating to the policy.
(4) UPDATE- The Secretary of Defense and the Secretary of Veterans
Affairs shall jointly update the policy on a periodic basis, but not less
often than annually, in order to incorporate in the policy, as appropriate,
the results of the reviews under subsections (b) and (c) and the best practices
identified through pilot programs under section 154.
(b) Review of Current Policies and Procedures-
(1) REVIEW REQUIRED- In developing the policy required by this section,
the Secretary of Defense and the Secretary of Veterans Affairs shall, to
the extent necessary, jointly and separately conduct a review of all policies
and procedures of the Department of Defense and the Department of Veterans
Affairs that apply to, or shall be covered by, the policy.
(2) PURPOSE- The purpose of the review shall be to identify the most
effective and patient-oriented approaches to care and management of covered
servicemembers for purposes of--
(A) incorporating such approaches into the policy; and
(B) extending such approaches, where applicable, to care and management
of other injured or ill members of the Armed Forces and veterans.
(3) ELEMENTS- In conducting the review, the Secretary of Defense and
the Secretary of Veterans Affairs shall--
(A) identify among the policies and procedures described in paragraph
(1) best practices in approaches to the care and management described
in that paragraph;
(B) identify among such policies and procedures existing and potential
shortfalls in such care and management (including care and management
of covered servicemembers on the temporary disability retired list), and
determine means of addressing any shortfalls so identified;
(C) determine potential modifications of such policies and procedures
in order to ensure consistency and uniformity among the military departments
and the regions of the Department of Veterans Affairs in their application
and discharge; and
(D) develop recommendations for legislative and administrative action
necessary to implement the results of the review.
(4) DEADLINE FOR COMPLETION- The review shall be completed not later
than 90 days after the date of the enactment of this Act.
(c) Consideration of Findings, Recommendations, and Practices- In developing
the policy required by this section, the Secretary of Defense and the Secretary
of Veterans Affairs shall take into account the following:
(1) The findings and recommendations of applicable studies, reviews,
reports, and evaluations that address matters relating to the policy, including,
but not limited, to the following:
(A) The Independent Review Group on Rehabilitative Care and Administrative
Processes at Walter Reed Army Medical Center and National Naval Medical
Center appointed by the Secretary of Defense.
(B) The Secretary of Veterans Affairs Task Force on Returning Global
War on Terror Heroes appointed by the President.
(C) The President's Commission on Care for America's Returning Wounded
Warriors.
(D) The Veterans' Disability Benefits Commission established by title
XV of the National Defense Authorization Act for Fiscal Year 2004 (Public
Law 108-136; 117 Stat. 1676; 38 U.S.C. 1101 note).
(E) The President's Commission on Veterans' Pensions, of 1956, chaired
by General Omar N. Bradley.
(F) The Report of the Congressional Commission on Servicemembers
and Veterans Transition Assistance, of 1999, chaired by Anthony J. Principi.
(G) The President's Task Force to Improve Health Care Delivery for
Our Nation's Veterans, of March 2003.
(2) The experience and best practices of the Department of Defense
and the military departments on matters relating to the policy.
(3) The experience and best practices of the Department of Veterans
Affairs on matters relating to the policy.
(4) Such other matters as the Secretary of Defense and the Secretary
of Veterans Affairs consider appropriate.
(d) Particular Elements of Policy- The policy required by this section
shall provide, in particular, the following:
(1) RESPONSIBILITY FOR COVERED SERVICEMEMBERS IN MEDICAL HOLD OR MEDICAL
HOLDOVER STATUS OR ON TEMPORARY DISABILITY RETIRED LIST- Mechanisms to ensure
responsibility for covered servicemembers in medical hold or medical holdover
status or on the temporary disability retired list, including the following:
(A) Uniform standards for access of covered servicemembers to non-urgent
health care services from the Department of Defense or other providers
under the TRICARE program, with such access to be--
(i) for follow-up care, within 2 days of request of care;
(ii) for specialty care, within 3 days of request of care;
(iii) for diagnostic referrals and studies, within 5 days of request;
and
(iv) for surgery based on a physician's determination of medical
necessity, within 14 days of request.
(B) Requirements for the assignment of adequate numbers of personnel
for the purpose of responsibility for and administration of covered servicemembers
in medical hold or medical holdover status or on the temporary disability
retired list.
(C) Requirements for the assignment of adequate numbers of medical
personnel and non-medical personnel to roles and responsibilities for
caring for and administering covered servicemembers in medical hold or
medical holdover status or on the temporary disability retired list, and
a description of the roles and responsibilities of personnel so assigned.
(D) Guidelines for the location of care for covered servicemembers
in medical hold or medical holdover status or on the temporary disability
retired list, which guidelines shall address the assignment of such servicemembers
to care and residential facilities closest to their duty station or home
of record or the location of their designated caregiver at the earliest
possible time.
(E) Criteria for work and duty assignments of covered servicemembers
in medical hold or medical holdover status or on the temporary disability
retired list, including a prohibition on the assignment of duty to a servicemember
which is incompatible with the servicemember's medical condition.
(F) Guidelines for the provision of care and counseling for eligible
family members of covered servicemembers in medical hold or medical holdover
status or on the temporary disability retired list.
(G) Requirements for case management of covered servicemembers in
medical hold or medical holdover status or on the temporary disability
retired list, including qualifications for personnel providing such case
management.
(H) Requirements for uniform quality of care and administration for
all covered servicemembers in medical hold or medical holdover status
or on the temporary disability retired list, whether members of the regular
components of the Armed Forces or members of the reserve components of
the Armed Forces.
(I) Standards for the conditions and accessibility of residential
facilities for covered servicemembers in medical hold or medical holdover
status or on the temporary disability retired list who are in outpatient
status, and for their immediate family members.
(J) Requirements on the provision of transportation and subsistence
for covered servicemembers in medical hold or medical holdover status
or on the temporary disability retired list, whether in inpatient status
or outpatient status, to facilitate obtaining needed medical care and
services.
(K) Requirements on the provision of educational and vocational training
and rehabilitation opportunities for covered servicemembers in medical
hold or medical holdover status or on the temporary disability retired
list.
(L) Procedures for tracking and informing covered servicemembers
in medical hold or medical holdover status or on the temporary disability
retired list about medical evaluation board and physical disability evaluation
board processing.
(M) Requirements for integrated case management of covered servicemembers
in medical hold or medical holdover status or on the temporary disability
retired list during their transition from care and treatment through the
Department of Defense to care and treatment through the Department of
Veterans Affairs.
(N) Requirements and standards for advising and training, as appropriate,
family members with respect to care for covered servicemembers in medical
hold or medical holdover status or on the temporary disability retired
list with serious medical conditions, particularly traumatic brain injury
(TBI), burns, and post-traumatic stress disorder (PTSD).
(O) Requirements for periodic reassessments of covered servicemembers,
and limits on the length of time such servicemembers may be retained in
medical hold or medical holdover status or on the temporary disability
retired list.
(P) Requirements to inform covered servicemembers and their family
members of their rights and responsibilities while in medical hold or
medical holdover status or on the temporary disability retired list.
(Q) The requirement to establish a Department of Defense-wide Ombudsman
Office within the Office of the Secretary of Defense to provide oversight
of the ombudsman offices in the military departments and policy guidance
to such offices with respect to providing assistance to, and answering
questions from, covered servicemembers and their families.
(2) MEDICAL EVALUATION AND PHYSICAL DISABILITY EVALUATION FOR COVERED
SERVICEMEMBERS-
(A) MEDICAL EVALUATIONS- Processes, procedures, and standards for
medical evaluations of covered servicemembers, including the following:
(i) Processes for medical evaluations of covered servicemembers
that are--
(I) applicable uniformly throughout the military departments;
and
(II) applicable uniformly with respect to such servicemembers
who are members of the regular components of the Armed Forces and
such servicemembers who are members of the National Guard and Reserve.
(ii) Standard criteria and definitions for determining the achievement
for covered servicemembers of the maximum medical benefit from treatment
and rehabilitation.
(iii) Standard timelines for each of the following:
(I) Determinations of fitness for duty of covered servicemembers.
(II) Specialty consultations for covered servicemembers.
(III) Preparation of medical documents for covered servicemembers.
(IV) Appeals by covered servicemembers of medical evaluation
determinations, including determinations of fitness for duty.
(iv) Uniform standards for qualifications and training of medical
evaluation board personnel, including physicians, case workers, and
physical disability evaluation board liaison officers, in conducting
medical evaluations of covered servicemembers.
(v) Standards for the maximum number of medical evaluation cases
of covered servicemembers that are pending before a medical evaluation
board at any one time, and requirements for the establishment of additional
medical evaluation boards in the event such number is exceeded.
(vi) Uniform standards for information for covered servicemembers,
and their families, on the medical evaluation board process and the
rights and responsibilities of such servicemembers under that process,
including a standard handbook on such information.
(B) PHYSICAL DISABILITY EVALUATIONS- Processes, procedures, and standards
for physical disability evaluations of covered servicemembers, including
the following:
(i) A non-adversarial process of the Department of Defense and
the Department of Veterans Affairs for disability determinations of
covered servicemembers.
(ii) To the extent feasible, procedures to eliminate unacceptable
discrepancies among disability ratings assigned by the military departments
and the Department of Veterans Affairs, particularly in the disability
evaluation of covered servicemembers, which procedures shall be subject
to the following requirements and limitations:
(I) Such procedures shall apply uniformly with respect to covered
servicemembers who are members of the regular components of the Armed
Forces and covered servicemembers who are members of the National
Guard and Reserve.
(II) Under such procedures, each Secretary of a military department
shall, to the extent feasible, utilize the standard schedule for rating
disabilities in use by the Department of Veterans Affairs, including
any applicable interpretation of such schedule by the United States
Court of Appeals for Veterans Claims, in making any determination
of disability of a covered servicemember.
(iii) Standard timelines for appeals of determinations of disability
of covered servicemembers, including timelines for presentation, consideration,
and disposition of appeals.
(iv) Uniform standards for qualifications and training of physical
disability evaluation board personnel in conducting physical disability
evaluations of covered servicemembers.
(v) Standards for the maximum number of physical disability evaluation
cases of covered servicemembers that are pending before a physical disability
evaluation board at any one time, and requirements for the establishment
of additional physical disability evaluation boards in the event such
number is exceeded.
(vi) Procedures for the provision of legal counsel to covered servicemembers
while undergoing evaluation by a physical disability evaluation board.
(vii) Uniform standards on the roles and responsibilities of case
managers, servicemember advocates, and judge advocates assigned to covered
servicemembers undergoing evaluation by a physical disability board,
and uniform standards on the maximum number of cases involving such
servicemembers that are to be assigned to such managers and advocates.
(C) RETURN OF COVERED SERVICEMEMBERS TO ACTIVE DUTY- Standards for
determinations by the military departments on the return of covered servicemembers
to active duty in the Armed Forces.
(D) TRANSITION OF COVERED SERVICEMEMBERS FROM DOD TO VA- Processes,
procedures, and standards for the transition of covered servicemembers
from care and treatment by the Department of Defense to care and treatment
by the Department of Veterans Affairs before, during, and after separation
from the Armed Forces, including the following:
(i) A uniform, patient-focused policy to ensure that the transition
occurs without gaps in medical care and the quality of medical care,
benefits, and services.
(ii) Procedures for the identification and tracking of covered
servicemembers during the transition, and for the coordination of care
and treatment of such servicemembers during the transition, including
a system of cooperative case management of such servicemembers by the
Department of Defense and the Department of Veterans Affairs during
the transition.
(iii) Procedures for the notification of Department of Veterans
Affairs liaison personnel of the commencement by covered servicemembers
of the medical evaluation process and the physical disability evaluation
process.
(iv) Procedures and timelines for the enrollment of covered servicemembers
in applicable enrollment or application systems of the Department of
Veterans with respect to health care, disability, education, vocational
rehabilitation, or other benefits.
(v) Procedures to ensure the access of covered servicemembers during
the transition to vocational, educational, and rehabilitation benefits
available through the Department of Veterans Affairs.
(vi) Standards for the optimal location of Department of Defense
and Department of Veterans Affairs liaison and case management personnel
at military medical treatment facilities, medical centers, and other
medical facilities of the Department of Defense.
(vii) Standards and procedures for integrated medical care and
management for covered servicemembers during the transition, including
procedures for the assignment of medical personnel of the Department
of Veterans Affairs to Department of Defense facilities to participate
in the needs assessments of such servicemembers before, during, and
after their separation from military service.
(viii) Standards for the preparation of detailed plans for the
transition of covered servicemembers from care and treatment by the
Department of Defense to care and treatment by the Department of Veterans
Affairs, which plans shall be based on standardized elements with respect
to care and treatment requirements and other applicable requirements.
(E) OTHER MATTERS- The following additional matters with respect
to covered servicemembers:
(i) Access by the Department of Veterans Affairs to the military
health records of covered servicemembers who are receiving care and
treatment, or are anticipating receipt of care and treatment, in Department
of Veterans Affairs health care facilities.
(ii) Requirements for utilizing, in appropriate cases, a single
physical examination that meets requirements of both the Department
of Defense and the Department of Veterans Affairs for covered servicemembers
who are being retired, separated, or released from military service.
(iii) Surveys and other mechanisms to measure patient and family
satisfaction with the provision by the Department of Defense and the
Department of Veterans Affairs of care and services for covered servicemembers,
and to facilitate appropriate oversight by supervisory personnel of
the provision of such care and services.
(3) REPORT ON REDUCTION IN DISABILITY RATINGS BY THE DEPARTMENT OF
DEFENSE- The Secretary of Defense shall submit a report to the Committees
on Armed Services of the Senate and House of Representatives on the number
of instances in which a disability rating assigned to a member of the Armed
Forces by an informal physical evaluation board of the Department of Defense
was reduced upon appeal, and the reasons for such reduction. Such report
shall cover the period beginning October 7, 2001, and ending September 30,
2006, and shall be submitted to the appropriate committees of Congress by
February 1, 2008.
(1) REPORT ON POLICY- Upon the development of the policy required by
this section but not later than January 1, 2008, the Secretary of Defense
and the Secretary of Veterans Affairs shall jointly submit to the appropriate
committees of Congress a report on the policy, including a comprehensive
and detailed description of the policy and of the manner in which the policy
addresses the findings and recommendations of the reviews under subsections
(b) and (c).
(2) REPORTS ON UPDATE- Upon updating the policy under subsection (a)(4),
the Secretary of Defense and the Secretary of Veterans Affairs shall jointly
submit to the appropriate committees of Congress a report on the update
of the policy, including a comprehensive and detailed description of such
update and of the reasons for such update.
(f) Comptroller General Assessment of Implementation- Not later than
six months after the date of the enactment of this Act and every year thereafter,
the Comptroller General of the United States shall submit to the appropriate
committees of Congress a report setting forth the assessment of the Comptroller
General of the progress of the Secretary of Defense and the Secretary of Veterans
Affairs in developing and implementing the policy required by this section.
SEC. 112. CONSIDERATION OF NEEDS OF WOMEN MEMBERS OF THE ARMED FORCES
AND VETERANS.
(a) In General- In developing and implementing the policy required by
section 111, and in otherwise carrying out any other provision of this title
or any amendment made by this title, the Secretary of Defense and the Secretary
of Veterans Affairs shall take into account and fully address any unique specific
needs of women members of the Armed Forces and women veterans under such policy
or other provision.
(b) Reports- In submitting any report required by this title or an amendment
made by this title, the Secretary of Defense and the Secretary of Veterans
Affairs shall, to the extent applicable, include a description of the manner
in which the matters covered by such report address the unique specific needs
of women members of the Armed Forces and women veterans.
Subtitle B--Health Care
PART I--ENHANCED AVAILABILITY OF CARE FOR SERVICEMEMBERS
SEC. 121. MEDICAL CARE AND OTHER BENEFITS FOR MEMBERS AND FORMER MEMBERS
OF THE ARMED FORCES WITH SEVERE INJURIES OR ILLNESSES.
(a) Medical and Dental Care for Members and Former Members-
(1) IN GENERAL- Effective as of the date of the enactment of this Act
and subject to regulations prescribed by the Secretary of Defense, any covered
member of the Armed Forces, and any former member of the Armed Forces, with
a severe injury or illness is entitled to medical and dental care in any
facility of the uniformed services under section 1074(a) of title 10, United
States Code, or through any civilian health care provider authorized by
the Secretary to provide health and mental health services to members of
the uniformed services, including traumatic brain injury (TBI) and post-traumatic
stress disorder (PTSD), as if such member or former member were a member
of the uniformed services described in paragraph (2) of such section who
is entitled to medical and dental care under such section.
(2) PERIOD OF AUTHORIZED CARE- (A) Except as provided in subparagraph
(B), a member or former member described in paragraph (1) is entitled to
care under that paragraph--
(i) in the case of a member or former member whose severe injury
or illness concerned is incurred or aggravated during the period beginning
on October 7, 2001, and ending on the date of the enactment of this Act,
during the three-year period beginning on the date of the enactment of
this Act, except that no compensation is payable by reason of this subsection
for any period before the date of the enactment of this Act; or
(ii) in the case of a member or former member whose severe injury
or illness concerned is incurred or aggravated on or after the date of
the enactment of this Act, during the three-year period beginning on the
date on which such injury or illness is so incurred or aggravated.
(B) The period of care authorized for a member or former member under
this paragraph may be extended by the Secretary concerned for an additional
period of up to two years if the Secretary concerned determines that such
extension is necessary to assure the maximum feasible recovery and rehabilitation
of the member or former member. Any such determination shall be made on
a case-by-case basis.
(3) INTEGRATED CARE MANAGEMENT- The Secretary of Defense shall provide
for a program of integrated care management in the provision of care and
services under this subsection, which management shall be provided by appropriate
medical and case management personnel of the Department of Defense and the
Department of Veterans Affairs (as approved by the Secretary of Veterans
Affairs) and with appropriate support from the Department of Defense regional
health care support contractors.
(4) WAIVER OF LIMITATIONS TO MAXIMIZE CARE- The Secretary of Defense
may, in providing medical and dental care to a member or former member under
this subsection during the period referred to in paragraph (2), waive any
limitation otherwise applicable under chapter 55 of title 10, United States
Code, to the provision of such care to the member or former member if the
Secretary considers the waiver appropriate to assure the maximum feasible
recovery and rehabilitation of the member or former member.
(5) CONSTRUCTION WITH ELIGIBILITY FOR VETERANS BENEFITS- Nothing in
this subsection shall be construed to reduce, alter, or otherwise affect
the eligibility or entitlement of a member or former member of the Armed
Forces to any health care, disability, or other benefits to which the member
of former member would otherwise be eligible or entitled as a veteran under
the laws administered by the Secretary of Veterans Affairs.
(6) SUNSET- The Secretary of Defense may not provide medical or dental
care to a member or former member of the Armed Forces under this subsection
after December 31, 2012, if the Secretary has not provided medical or dental
care to the member or former member under this subsection before that date.
(b) Rehabilitation and Vocational Benefits-
(1) IN GENERAL- Effective as of the date of the enactment of this Act,
a member of the Armed Forces with a severe injury or illness is entitled
to such benefits (including rehabilitation and vocational benefits, but
not including compensation) from the Secretary of Veterans Affairs to facilitate
the recovery and rehabilitation of such member as the Secretary otherwise
provides to members of the Armed Forces receiving medical care in medical
facilities of the Department of Veterans Affairs facilities in order to
facilitate the recovery and rehabilitation of such members.
(2) LIMITATIONS- The provisions of paragraphs (2) through (6) of subsection
(a) shall apply to the provision of benefits under this subsection as if
the benefits provided under this subsection were provided under subsection
(a).
(3) REIMBURSEMENT- The Secretary of Defense shall reimburse the Secretary
of Veterans Affairs for the cost of any benefits provided under this subsection
in accordance with applicable mechanisms for the reimbursement of the Secretary
of Veterans Affairs for the provision of medical care to members of the
Armed Forces.
(c) Recovery of Certain Expenses of Medical Care and Related Travel-
(1) IN GENERAL- Commencing not later than 60 days after the date of
the enactment of this Act, the Secretary of the military department concerned
may reimburse covered members of the Armed Forces, and former members of
the Armed Forces, with a severe injury or illness for covered expenses incurred
by such members or former members, or their family members, in connection
with the receipt by such members or former members of medical care that
is required for such injury or illness.
(2) COVERED EXPENSES- Expenses for which reimbursement may be made
under paragraph (1) include the following:
(A) Expenses for health care services for which coverage would be
provided under section 1074(c) of title 10, United States Code, for members
of the uniformed services on active duty.
(B) Expenses of travel of a non-medical attendant who accompanies
a member or former member of the Armed Forces for required medical care
that is not available to such member or former member locally, if such
attendant is appointed for that purpose by a competent medical authority
(as determined under regulations prescribed by the Secretary of Defense
for purposes of this subsection).
(C) Such other expenses for medical care as the Secretary may prescribe
for purposes of this subsection.
(3) AMOUNT OF REIMBURSEMENT- The amount of reimbursement under paragraph
(1) for expenses covered by paragraph (2) shall be determined in accordance
with regulations prescribed by the Secretary of Defense for purposes of
this subsection.
(d) Severe Injury or Illness Defined- In this section, the term `severe
injury or illness' means any serious injury or illness that is assigned a
disability rating of 30 percent or higher under the schedule for rating disabilities
in use by the Department of Defense.
SEC. 122. REIMBURSEMENT OF CERTAIN FORMER MEMBERS OF THE UNIFORMED SERVICES
WITH SERVICE-CONNECTED DISABILITIES FOR TRAVEL FOR FOLLOW-ON SPECIALTY CARE
AND RELATED SERVICES.
(a) Travel- Section 1074i of title 10, United States Code, is amended--
(1) by redesignating subsection (b) as subsection (c); and
(2) by inserting after subsection (a) the following new subsection
(b):
`(b) Follow-on Specialty Care and Related Services- In any case in which
a former member of a uniformed service who incurred a disability while on
active duty in a combat zone or during performance of duty in combat related
operations (as designated by the Secretary of Defense), and is entitled to
retired or retainer pay, or equivalent pay, requires follow-on specialty care,
services, or supplies related to such disability at a specific military treatment
facility more than 100 miles from the location in which the former member
resides, the Secretary shall provide reimbursement for reasonable travel expenses
comparable to those provided under subsection (a) for the former member, and
when accompaniment by an adult is determined by competent medical authority
to be necessary, for a spouse, parent, or guardian of the former member, or
another member of the former member's family who is at least 21 years of age.'.
(b) Effective Date- The amendments made by subsection (a) shall take
effect January 1, 2008, and shall apply with respect to travel that occurs
on or after that date.
PART II--CARE AND SERVICES FOR DEPENDENTS
SEC. 126. MEDICAL CARE AND SERVICES AND SUPPORT SERVICES FOR FAMILIES
OF MEMBERS OF THE ARMED FORCES RECOVERING FROM SERIOUS INJURIES OR ILLNESSES.
(1) IN GENERAL- A family member of a covered member of the Armed Forces
who is not otherwise eligible for medical care at a military medical treatment
facility or at medical facilities of the Department of Veterans Affairs
shall be eligible for such care at such facilities, on a space-available
basis, if the family member is--
(A) on invitational orders while caring for the covered member of
the Armed Forces;
(B) a non-medical attendee caring for the covered member of the Armed
Forces; or
(C) receiving per diem payments from the Department of Defense while
caring for the covered member of the Armed Forces.
(2) SPECIFICATION OF FAMILY MEMBERS- Notwithstanding section 101(3),
the Secretary of Defense and the Secretary of Veterans Affairs shall jointly
prescribe in regulations the family members of covered members of the Armed
Forces who shall be considered to be a family member of a covered member
of the Armed Forces for purposes of paragraph (1).
(3) SPECIFICATION OF CARE- (A) The Secretary of Defense shall prescribe
in regulations the medical care and counseling that shall be available to
family members under paragraph (1) at military medical treatment facilities.
(B) The Secretary of Veterans Affairs shall prescribe in regulations
the medical care and counseling that shall be available to family members
under paragraph (1) at medical facilities of the Department of Veterans
Affairs.
(4) RECOVERY OF COSTS- The United States may recover the costs of the
provision of medical care and counseling under paragraph (1) as follows
(as applicable):
(A) From third-party payers, in the same manner as the United States
may collect costs of the charges of health care provided to covered beneficiaries
from third-party payers under section 1095 of title 10, United States
Code.
(B) As if such care and counseling was provided under the authority
of section 1784 of title 38, United States Code.
(b) Job Placement Services- A family member who is on invitational orders
or is a non-medical attendee while caring for a covered member of the Armed
Forces for more than 45 days during a one-year period shall be eligible for
job placement services otherwise offered by the Department of Defense.
(c) Report on Need for Additional Services- Not later than 90 days after
the date of the enactment of this Act, the Secretary of Defense shall submit
to the congressional defense committees a report setting forth the assessment
of the Secretary of the need for additional employment services, and of the
need for employment protection, of family members described in subsection
(b) who are placed on leave from employment or otherwise displaced from employment
while caring for a covered member of the Armed Forces as described in that
subsection.
SEC. 127. EXTENDED BENEFITS UNDER TRICARE FOR PRIMARY CAREGIVERS OF
MEMBERS OF THE UNIFORMED SERVICES WHO INCUR A SERIOUS INJURY OR ILLNESS ON
ACTIVE DUTY.
(a) In General- Section 1079(d) of title 10, United States Code, is amended--
(1) by redesignating paragraphs (2) and (3) as paragraphs (3) and (4),
respectively; and
(2) by inserting after paragraph (1) the following new paragraph (2):
`(2)(A) Subject to such terms, conditions, and exceptions as the Secretary
of Defense considers appropriate, the program of extended benefits for eligible
dependents under this subsection shall include extended benefits for the primary
caregivers of members of the uniformed services who incur a serious injury
or illness on active duty.
`(B) The Secretary of Defense shall prescribe in regulations the individuals
who shall be treated as the primary caregivers of a member of the uniformed
services for purposes of this paragraph.
`(C) For purposes of this section, a serious injury or illness, with
respect to a member of the uniformed services, is an injury or illness that
may render the member medically unfit to perform the duties of the member's
office, grade, rank, or rating and that renders a member of the uniformed
services dependant upon a caregiver.'.
(b) Effective Date- The amendments made by subsection (a) shall take
effect on January 1, 2008.
PART III--TRAUMATIC BRAIN INJURY AND POST-TRAUMATIC STRESS DISORDER
SEC. 131. COMPREHENSIVE PLANS ON PREVENTION, DIAGNOSIS, MITIGATION,
AND TREATMENT OF TRAUMATIC BRAIN INJURY AND POST-TRAUMATIC STRESS DISORDER
IN MEMBERS OF THE ARMED FORCES.
(a) Plans Required- Not later than 180 days after the date of the enactment
of this Act, the Secretary of Defense shall, in consultation with the Secretary
of Veterans Affairs, submit to the congressional defense committees one or
more comprehensive plans for programs and activities of the Department of
Defense to prevent, diagnose, mitigate, treat, and otherwise respond to traumatic
brain injury (TBI) and post-traumatic stress disorder (PTSD) in members of
the Armed Forces.
(b) Elements- Each plan submitted under subsection (a) shall include
comprehensive proposals of the Department on the following:
(1) The designation by the Secretary of Defense of a lead agent or
executive agent for the Department to coordinate development and implementation
of the plan.
(2) The improvement of personnel protective equipment for members of
the Armed Forces in order to prevent traumatic brain injury.
(3) The improvement of methods and mechanisms for the detection and
treatment of traumatic brain injury and post-traumatic stress disorder in
members of the Armed Forces in the field.
(4) The requirements for research on traumatic brain injury and post-traumatic
stress disorder, including (in particular) research on pharmacological approaches
to treatment for traumatic brain injury or post-traumatic stress disorder,
as applicable, and the allocation of priorities among such research.
(5) The development, adoption, and deployment of diagnostic criteria
for the detection and evaluation of the range of traumatic brain injury
and post-traumatic stress disorder in members of the Armed Forces, which
criteria shall be employed uniformly across the military departments in
all applicable circumstances, including provision of clinical care and assessment
of future deployability of members of the Armed Forces.
(6) The development and deployment of effective means of assessing
traumatic brain injury and post-traumatic stress disorder in members of
the Armed Forces, including a system of pre-deployment and post-deployment
screenings of cognitive ability in members for the detection of cognitive
impairment, as required by the amendments made by section 132.
(7) The development and deployment of effective means of managing and
monitoring members of the Armed Forces with traumatic brain injury or post-traumatic
stress disorder in the receipt of care for traumatic brain injury or post-traumatic
stress disorder, as applicable, including the monitoring and assessment
of treatment and outcomes.
(8) The development and deployment of an education and awareness training
initiative designed to reduce the negative stigma associated with traumatic
brain injury, post-traumatic stress disorder, and mental health treatment.
(9) The provision of education and outreach to families of members
of the Armed Forces with traumatic brain injury or post-traumatic stress
disorder on a range of matters relating to traumatic brain injury or post-traumatic
stress disorder, as applicable, including detection, mitigation, and treatment.
(10) The assessment of the current capabilities of the Department for
the prevention, diagnosis, mitigation, treatment, and rehabilitation of
traumatic brain injury and post-traumatic stress disorder in members of
the Armed Forces.
(11) The identification of gaps in current capabilities of the Department
for the prevention, diagnosis, mitigation, treatment, and rehabilitation
of traumatic brain injury and post-traumatic stress disorder in members
of the Armed Forces.
(12) The identification of the resources required for the Department
in fiscal years 2009 thru 2013 to address the gaps in capabilities identified
under paragraph (11).
(13) The development of joint planning among the Department of Defense,
the military departments, and the Department of Veterans Affairs for the
prevention, diagnosis, mitigation, treatment, and rehabilitation of traumatic
brain injury and post-traumatic stress disorder in members of the Armed
Forces, including planning for the seamless transition of such members from
care through the Department of Defense care through the Department of Veterans
Affairs.
(14) A requirement that exposure to a blast or blasts be recorded in
the records of members of the Armed Forces.
(15) The development of clinical practice guidelines for the diagnosis
and treatment of blast injuries in members of the Armed Forces, including,
but not limited to, traumatic brain injury.
(16) A program under which each member of the Armed Forces who incurs
a traumatic brain injury or post-traumatic stress disorder during service
in the Armed Forces--
(A) is enrolled in the program; and
(B) receives, under the program, treatment and rehabilitation meeting
a standard of care such that each individual who is a member of the Armed
Forces who qualifies for care under the program shall--
(i) be provided the highest quality of care possible based on the
medical judgment of qualified medical professionals in facilities that
most appropriately meet the specific needs of the individual; and
(ii) be rehabilitated to the fullest extent possible using the
most up-to-date medical technology, medical rehabilitation practices,
and medical expertise available.
(17) A requirement that if a member of the Armed Forces participating
in a program established in accordance with paragraph (16) believes that
care provided to such participant does not meet the standard of care specified
in subparagraph (B) of such paragraph, the Secretary of Defense shall, upon
request of the participant, provide to such participant a referral to another
Department of Defense or Department of Veterans Affairs provider of medical
or rehabilitative care for a second opinion regarding the care that would
meet the standard of care specified in such subparagraph.
(18) The provision of information by the Secretary of Defense to members
of the Armed Forces with traumatic brain injury or post-traumatic stress
disorder and their families about their rights with respect to the following:
(A) The receipt of medical and mental health care from the Department
of Defense and the Department of Veterans Affairs.
(B) The options available to such members for treatment of traumatic
brain injury and post-traumatic stress disorder.
(C) The options available to such members for rehabilitation.
(D) The options available to such members for a referral to a public
or private provider of medical or rehabilitative care.
(E) The right to administrative review of any decision with respect
to the provision of care by the Department of Defense for such members.
(c) Coordination in Development- Each plan submitted under subsection
(a) shall be developed in coordination with the Secretary of the Army (who
was designated by the Secretary of Defense as executive agent for the prevention,
mitigation, and treatment of blast injuries under section 256 of the National
Defense Authorization Act for Fiscal Year 2006 (Public Law 109-163; 119 Stat.
3181; 10 U.S.C. 1071 note)).
(d) Additional Activities- In carrying out programs and activities for
the prevention, diagnosis, mitigation, and treatment of traumatic brain injury
and post-traumatic stress disorder in members of the Armed Forces, the Secretary
of Defense shall--
(1) examine the results of the recently completed Phase 2 study, funded
by the National Institutes of Health, on the use of progesterone for acute
traumatic brain injury;
(2) determine if Department of Defense funding for a Phase 3 clinical
trial on the use of progesterone for acute traumatic brain injury, or for
further research regarding the use of progesterone or its metabolites for
treatment of traumatic brain injury, is warranted; and
(3) provide for the collaboration of the Department of Defense, as
appropriate, in clinical trials and research on pharmacological approaches
to treatment for traumatic brain injury and post-traumatic stress disorder
that is conducted by other departments and agencies of the Federal Government.
SEC. 132. IMPROVEMENT OF MEDICAL TRACKING SYSTEM FOR MEMBERS OF THE
ARMED FORCES DEPLOYED OVERSEAS.
(a) Protocol for Assessment of Cognitive Functioning-
(1) PROTOCOL REQUIRED- Subsection (b) of section 1074f of title 10,
United States Code, is amended--
(A) in paragraph (2), by adding at the end the following new subparagraph:
`(C) An assessment of post-traumatic stress disorder.'; and
(B) by adding at the end the following new paragraph:
`(3)(A) The Secretary shall establish for purposes of subparagraphs (B)
and (C) of paragraph (2) a protocol for the predeployment assessment and documentation
of the cognitive (including memory) functioning of a member who is deployed
outside the United States in order to facilitate the assessment of the postdeployment
cognitive (including memory) functioning of the member.
`(B) The protocol under subparagraph (A) shall include appropriate mechanisms
to permit the differential diagnosis of traumatic brain injury in members
returning from deployment in a combat zone.'.
(2) PILOT PROJECTS- (A) In developing the protocol required by paragraph
(3) of section 1074f(b) of title 10, United States Code (as amended by paragraph
(1) of this subsection), for purposes of assessments for traumatic brain
injury, the Secretary of Defense shall conduct up to three pilot projects
to evaluate various mechanisms for use in the protocol for such purposes.
One of the mechanisms to be so evaluated shall be a computer-based assessment
tool.
(B) Not later than 60 days after the completion of the pilot projects
conducted under this paragraph, the Secretary shall submit to the appropriate
committees of Congress a report on the pilot projects. The report shall
include--
(i) a description of the pilot projects so conducted;
(ii) an assessment of the results of each such pilot project; and
(iii) a description of any mechanisms evaluated under each such pilot
project that will incorporated into the protocol.
(C) Not later than 180 days after completion of the pilot projects
conducted under this paragraph, the Secretary shall establish a mechanism
for implementing any mechanism evaluated under such a pilot project that
is selected for incorporation in the protocol.
(D) There is hereby authorized to be appropriated to the Department
of Defense, $3,000,000 for the pilot projects authorized by this paragraph.
Of the amount so authorized to be appropriated, not more than $1,000,000
shall be available for any particular pilot project.
(b) Quality Assurance- Subsection (d)(2) of section 1074f of title 10,
United States Code, is amended by adding at the end the following new subparagraph:
`(F) The diagnosis and treatment of traumatic brain injury and post-traumatic
stress disorder.'.
(c) Standards for Deployment- Subsection (f) of such section is amended--
(1) in the subsection heading, by striking `Mental Health'; and
(2) in paragraph (2)(B), by striking `or' and inserting `, traumatic
brain injury, or'.
SEC. 133. CENTERS OF EXCELLENCE IN THE PREVENTION, DIAGNOSIS, MITIGATION,
TREATMENT, AND REHABILITATION OF TRAUMATIC BRAIN INJURY AND POST-TRAUMATIC
STRESS DISORDER.
(a) Center of Excellence on Traumatic Brain Injury- Chapter 55 of title
10, United States Code, is amended by inserting after section 1105 the following
new section:
`Sec. 1105a. Center of Excellence in Prevention, Diagnosis, Mitigation,
Treatment, and Rehabilitation of Traumatic Brain Injury
`(a) In General- The Secretary of Defense shall establish within the
Department of Defense a center of excellence in the prevention, diagnosis,
mitigation, treatment, and rehabilitation of traumatic brain injury (TBI),
including mild, moderate, and severe traumatic brain injury, to carry out
the responsibilities specified in subsection (c). The center shall be known
as a `Center of Excellence in Prevention, Diagnosis, Mitigation, Treatment,
and Rehabilitation of Traumatic Brain Injury'.
`(b) Partnerships- The Secretary shall ensure that the Center collaborates
to the maximum extent practicable with the Department of Veterans Affairs,
institutions of higher education, and other appropriate public and private
entities (including international entities) to carry out the responsibilities
specified in subsection (c).
`(c) Responsibilities- The Center shall have responsibilities as follows:
`(1) To direct and oversee, based on expert research, the development
and implementation of a long-term, comprehensive plan and strategy for the
Department of Defense for the prevention, diagnosis, mitigation, treatment,
and rehabilitation of traumatic brain injury.
`(2) To provide for the development, testing, and dissemination within
the Department of best practices for the treatment of traumatic brain injury.
`(3) To provide guidance for the mental health system of the Department
in determining the mental health and neurological health personnel required
to provide quality mental health care for members of the armed forces with
traumatic brain injury.
`(4) To establish, implement, and oversee a comprehensive program to
train mental health and neurological health professionals of the Department
in the treatment of traumatic brain injury.
`(5) To facilitate advancements in the study of the short-term and
long-term psychological effects of traumatic brain injury.
`(6) To disseminate within the military medical treatment facilities
of the Department best practices for training mental health professionals,
including neurological health professionals, with respect to traumatic brain
injury.
`(7) To conduct basic science and translational research on traumatic
brain injury for the purposes of understanding the etiology of traumatic
brain injury and developing preventive interventions and new treatments.
`(8) To develop outreach strategies and treatments for families of
members of the armed forces with traumatic brain injury in order to mitigate
the negative impacts of traumatic brain injury on such family members and
to support the recovery of such members from traumatic brain injury.
`(9) To conduct research on the unique mental health needs of women
members of the armed forces with traumatic brain injury and develop treatments
to meet any needs identified through such research.
`(10) To conduct research on the unique mental health needs of ethnic
minority members of the armed forces with traumatic brain injury and develop
treatments to meet any needs identified through such research.
`(11) To conduct research on the mental health needs of families of
members of the armed forces with traumatic brain injury and develop treatments
to meet any needs identified through such research.
`(12) To conduct longitudinal studies (using imaging technology and
other proven research methods) on members of the armed forces with traumatic
brain injury to identify early signs of Alzheimer's disease, Parkinson's
disease, or other manifestations of neurodegeneration in such members, which
studies should be conducted in coordination with the studies authorized
by section 721 of the John Warner National Defense Authorization Act for
Fiscal Year 2007 (Public Law 109-364; 120 Stat. 2294) and other studies
of the Department of Defense and the Department of Veterans Affairs that
address the connection between exposure to combat and the development of
Alzheimer's disease, Parkinson's disease, and other neurodegenerative disorders.
`(13) To develop and oversee a long-term plan to increase the number
of mental health and neurological health professionals within the Department
in order to facilitate the meeting by the Department of the needs of members
of the armed forces with traumatic brain injury until their transition to
care and treatment from the Department of Veterans Affairs.
`(14) To develop a program on comprehensive pain management, including
management of acute and chronic pain, to utilize current and develop new
treatments for pain, and to identify and disseminate best practices on pain
management.
`(15) Such other responsibilities as the Secretary shall specify.'.
(b) Center of Excellence on Post-Traumatic Stress Disorder- Chapter 55
of such title is further amended by inserting after section 1105a, as added
by subsection (a), the following new section:
`Sec. 1105b. Center of Excellence in Prevention, Diagnosis, Mitigation,
Treatment, and Rehabilitation of Post-Traumatic Stress Disorder
`(a) In General- The Secretary of Defense shall establish within the
Department of Defense a center of excellence in the prevention, diagnosis,
mitigation, treatment, and rehabilitation of post-traumatic stress disorder
(PTSD), including mild, moderate, and severe post-traumatic stress disorder,
to carry out the responsibilities specified in subsection (c). The center
shall be known as a `Center of Excellence in Prevention, Diagnosis, Mitigation,
Treatment, and Rehabilitation of Post-Traumatic Stress Disorder'.
`(b) Partnerships- The Secretary shall ensure that the Center collaborates
to the maximum extent practicable with the National Center for Post-Traumatic
Stress Disorder of the Department of Veterans Affairs, institutions of higher
education, and other appropriate public and private entities (including international
entities) to carry out the responsibilities specified in subsection (c).
`(c) Responsibilities- The Center shall have responsibilities as follows:
`(1) To direct and oversee, based on expert research, the development
and implementation of a long-term, comprehensive plan and strategy for the
Department of Defense for the prevention, diagnosis, mitigation, treatment,
and rehabilitation of post-traumatic stress disorder.
`(2) To provide for the development, testing, and dissemination within
the Department of best practices for the treatment of post-traumatic stress
disorder.
`(3) To provide guidance for the mental health system of the Department
in determining the mental health and neurological health personnel required
to provide quality mental health care for members of the armed forces with
post-traumatic stress disorder.
`(4) To establish, implement, and oversee a comprehensive program to
train mental health and neurological health professionals of the Department
in the treatment of post-traumatic stress disorder.
`(5) To facilitate advancements in the study of the short-term and
long-term psychological effects of post-traumatic stress disorder.
`(6) To disseminate within the military medical treatment facilities
of the Department best practices for training mental health professionals,
including neurological health professionals, with respect to post-traumatic
stress disorder.
`(7) To conduct basic science and translational research on post-traumatic
stress disorder for the purposes of understanding the etiology of post-traumatic
stress disorder and developing preventive interventions and new treatments.
`(8) To develop outreach strategies and treatments for families of
members of the armed forces with post-traumatic stress disorder in order
to mitigate the negative impacts of traumatic brain injury on such family
members and to support the recovery of such members from post-traumatic
stress disorder.
`(9) To conduct research on the unique mental health needs of women
members of the armed forces, including victims of sexual assault, with post-traumatic
stress disorder and develop treatments to meet any needs identified through
such research.
`(10) To conduct research on the unique mental health needs of ethnic
minority members of the armed forces with post-traumatic stress disorder
and develop treatments to meet any needs identified through such research.
`(11) To conduct research on the mental health needs of families of
members of the armed forces with post-traumatic stress disorder and develop
treatments to meet any needs identified through such research.
`(12) To develop and oversee a long-term plan to increase the number
of mental health and neurological health professionals within the Department
in order to facilitate the meeting by the Department of the needs of members
of the armed forces with post-traumatic stress disorder until their transition
to care and treatment from the Department of Veterans Affairs.
`(13) To develop a program on comprehensive pain management, including
management of acute and chronic pain, to utilize current and develop new
treatments for pain, and to identify and disseminate best practices on pain
management.
`(14) Such other responsibilities as the Secretary shall specify.'.
(c) Clerical Amendment- The table of sections at the beginning of chapter
55 of such title is amended by inserting after the item relating to section
1105 the following new items:
`1105a. Center of Excellence in Prevention, Diagnosis, Mitigation, Treatment,
and Rehabilitation of Traumatic Brain Injury.
`1105b. Center of Excellence in Prevention, Diagnosis, Mitigation, Treatment,
and Rehabilitation of Post-Traumatic Stress Disorder.'.
(d) Report on Establishment- Not later than 180 days after the date of
the enactment of this Act, the Secretary of Defense shall submit to Congress
a report on the establishment of the Center of Excellence in Prevention, Diagnosis,
Mitigation, Treatment, and Rehabilitation of Traumatic Brain Injury required
by section 1105a of title 10, United States Code (as added by subsection (a)),
and the establishment of the Center of Excellence in Prevention, Diagnosis,
Mitigation, Treatment, and Rehabilitation of Post-Traumatic Stress Disorder
required by section 1105b of title 10, United States Code (as added by subsection
(b)). The report shall, for each such Center--
(1) describe in detail the activities and proposed activities of such
Center; and
(2) assess the progress of such Center in discharging the responsibilities
of such Center.
(e) Authorization of Appropriations- There is hereby authorized to be
appropriated for fiscal year 2008 for the Department of Defense for Defense
Health Program, $10,000,000, of which--
(1) $5,000,000 shall be available for the Center of Excellence in Prevention,
Diagnosis, Mitigation, Treatment, and Rehabilitation of Traumatic Brain
Injury required by section 1105a of title 10, United States Code; and
(2) $5,000,000 shall be available for the Center of Excellence in Prevention,
Diagnosis, Mitigation, Treatment, and Rehabilitation of Post-Traumatic Stress
Disorder required by section 1105b of title 10, United States Code.
SEC. 134. REVIEW OF MENTAL HEALTH SERVICES AND TREATMENT FOR FEMALE
MEMBERS OF THE ARMED FORCES AND VETERANS.
(a) Comprehensive Review- The Secretary of Defense and the Secretary
of Veterans Affairs shall jointly conduct a comprehensive review of--
(1) the need for mental health treatment and services for female members
of the Armed Forces and veterans; and
(2) the efficacy and adequacy of existing mental health treatment programs
and services for female members of the Armed Forces and veterans.
(b) Elements- The review required by subsection (a) shall include, but
not be limited to, an assessment of the following:
(1) The need for mental health outreach, prevention, and treatment
services specifically for female members of the Armed Forces and veterans.
(2) The access to and efficacy of existing mental health outreach,
prevention, and treatment services and programs (including substance abuse
programs) for female veterans who served in a combat zone.
(3) The access to and efficacy of services and treatment for female
members of the Armed Forces and veterans who experience post-traumatic stress
disorder (PTSD).
(4) The availability of services and treatment for female members of
the Armed Forces and veterans who experienced sexual assault or abuse.
(5) The access to and need for treatment facilities focusing on the
mental health care needs of female members of the Armed Forces and veterans.
(6) The need for further clinical research on the unique needs of female
veterans who served in a combat zone.
(c) Report- Not later than 90 days after the date of the enactment of
this Act, the Secretary of Defense and the Secretary of Veterans Affairs shall
jointly submit to the appropriate committees of Congress a report on the review
required by subsection (a).
(d) Policy Required- Not later than 120 days after the date of the enactment
of this Act, the Secretary of Defense and the Secretary of Veterans Affairs
shall jointly develop a comprehensive policy to address the treatment and
care needs of female members of the Armed Forces and veterans who experience
mental health problems and conditions, including post-traumatic stress disorder.
The policy shall take into account and reflect the results of the review required
by subsection (a).
SEC. 135. FUNDING FOR IMPROVED DIAGNOSIS, TREATMENT, AND REHABILITATION
OF MEMBERS OF THE ARMED FORCES WITH TRAUMATIC BRAIN INJURY OR POST-TRAUMATIC
STRESS DISORDER.
(a) Authorization of Appropriations-
(1) IN GENERAL- Funds are hereby authorized to be appropriated for
fiscal year 2008 for the Department of Defense for Defense Health Program
in the amount of $50,000,000, with such amount to be available for activities
as follows:
(A) Activities relating to the improved diagnosis, treatment, and
rehabilitation of members of the Armed Forces with traumatic brain injury
(TBI).
(B) Activities relating to the improved diagnosis, treatment, and
rehabilitation of members of the Armed Forces with post-traumatic stress
disorder (PTSD).
(2) AVAILABILITY OF AMOUNT- Of the amount authorized to be appropriated
by paragraph (1), $17,000,000 shall be available for the Defense and Veterans
Brain Injury Center of the Department of Defense.
(b) Supplement Not Supplant- The amount authorized to be appropriated
by subsection (a) for Defense Health Program is in addition to any other amounts
authorized to be appropriated by this Act for Defense Health Program.
SEC. 136. REPORTS.
(a) Reports on Implementation of Certain Requirements- Not later than
90 days after the date of the enactment of this Act, the Secretary of Defense
shall submit to the congressional defense committees a report describing the
progress in implementing the requirements as follows:
(1) The requirements of section 721 of the John Warner National Defense
Authorization Act for Fiscal Year 2007 (Public Law 109-364; 120 Stat. 2294),
relating to a longitudinal study on traumatic brain injury incurred by members
of the Armed Forces in Operation Iraqi Freedom and Operation Enduring Freedom.
(2) The requirements arising from the amendments made by section 738
of the John Warner National Defense Authorization Act for Fiscal Year 2007
(120 Stat. 2303), relating to enhanced mental health screening and services
for members of the Armed Forces.
(3) The requirements of section 741 of the John Warner National Defense
Authorization Act for Fiscal Year 2007 (120 Stat. 2304), relating to pilot
projects on early diagnosis and treatment of post-traumatic stress disorder
and other mental health conditions.
(b) Annual Reports on Expenditures for Activities on Tbi and Ptsd-
(1) REPORTS REQUIRED- Not later than March 1, 2008, and each year thereafter
through 2013, the Secretary of Defense shall submit to the congressional
defense committees a report setting forth the amounts expended by the Department
of Defense during the preceding calendar year on activities described in
paragraph (2), including the amount allocated during such calendar year
to the Defense and Veterans Brain Injury Center of the Department.
(2) COVERED ACTIVITIES- The activities described in this paragraph
are activities as follows:
(A) Activities relating to the improved diagnosis, treatment, and
rehabilitation of members of the Armed Forces with traumatic brain injury
(TBI).
(B) Activities relating to the improved diagnosis, treatment, and
rehabilitation of members of the Armed Forces with post-traumatic stress
disorder (PTSD).
(3) ELEMENTS- Each report under paragraph (1) shall include--
(A) a description of the amounts expended as described in that paragraph,
including a description of the activities for which expended;
(B) a description and assessment of the outcome of such activities;
(C) a statement of priorities of the Department in activities relating
to the prevention, diagnosis, research, treatment, and rehabilitation
of traumatic brain injury in members of the Armed Forces during the year
in which such report is submitted and in future calendar years;
(D) a statement of priorities of the Department in activities relating
to the prevention, diagnosis, research, treatment, and rehabilitation
of post-traumatic stress disorder in members of the Armed Forces during
the year in which such report is submitted and in future calendar years;
and
(E) an assessment of the progress made toward achieving the priorities
stated in subparagraphs (C) and (D) in the report under paragraph (1)
in the previous year, and a description of any actions planned during
the year in which such report is submitted to achieve any unfulfilled
priorities during such year.
PART IV--OTHER MATTERS
SEC. 141. JOINT ELECTRONIC HEALTH RECORD FOR THE DEPARTMENT OF DEFENSE
AND DEPARTMENT OF VETERANS AFFAIRS.
(a) In General- The Secretary of Defense and the Secretary of Veterans
Affairs shall jointly--
(1) develop and implement a joint electronic health record for use
by the Department of Defense and the Department of Veterans Affairs; and
(2) accelerate the exchange of health care information between the
Department of Defense and the Department of Veterans Affairs in order to
support the delivery of health care by both Departments.
(b) Department of Defense-Department of Veterans Affairs Interagency
Program Office for a Joint Electronic Health Record-
(1) IN GENERAL- There is hereby established a joint element of the
Department of Defense and the Department of Veterans Affairs to be known
as the `Department of Defense-Department of Veterans Affairs Interagency
Program Office for a Joint Electronic Health Record' (in this section referred
to as the `Office').
(2) PURPOSES- The purposes of the Office shall be as follows:
(A) To act as a single point of accountability for the Department
of Defense and the Department of Veterans Affairs in the rapid development,
test, and implementation of a joint electronic health record for use by
the Department of Defense and the Department of Veterans Affairs.
(B) To accelerate the exchange of health care information between
Department of Defense and the Department of Veterans Affairs in order
to support the delivery of health care by both Departments.
(1) DIRECTOR- The Director of the Department of Defense-Department
of Veterans Affairs Interagency Program Office for a Joint Electronic Health
Record shall be the head of the Office.
(2) DEPUTY DIRECTOR- The Deputy Director of the Department of Defense-Department
of Veterans Affairs Interagency Program Office for a Joint Electronic Health
Record shall be the deputy head of the office and shall assist the Director
in carrying out the duties of the Director.
(3) APPOINTMENTS- (A) The Director shall be appointed by the Secretary
of Defense, with the concurrence of the Secretary of Veterans Affairs, from
among employees of the Department of Defense and the Department of Veterans
Affairs in the Senior Executive Service who are qualified to direct the
development and acquisition of major information technology capabilities.
(B) The Deputy Director shall be appointed by the Secretary of Veterans
Affairs, with the concurrence of the Secretary of Defense, from among employees
of the Department of Defense and the Department of Veterans Affairs in the
Senior Executive Service who are qualified to direct the development and
acquisition of major information technology capabilities.
(4) ADDITIONAL GUIDANCE- In addition to the direction, supervision,
and control provided by the Secretary of Defense and the Secretary of Veterans
Affairs, the Office shall also receive guidance from the Department of Veterans
Affairs-Department of Defense Joint Executive Committee under section 320
of title 38, United States Code, in the discharge of the functions of the
Office under this section.
(5) TESTIMONY- Upon request by any of the appropriate committees of
Congress, the Director and the Deputy Director shall testify before such
committee regarding the discharge of the functions of the Office under this
section.
(d) Function- The function of the Office shall be to develop and prepare
for deployment, by not later than September 30, 2010, a joint electronic health
record to be utilized by both the Department of Defense and the Department
of Veterans Affairs in the provision of medical care and treatment to members
of the Armed Forces and veterans, which health record shall comply with applicable
interoperability standards, implementation specifications, and certification
criteria (including for the reporting of quality measures) of the Federal
Government.
(e) Schedules and Benchmarks- Not later than 30 days after the date of
the enactment of this Act, the Secretary of Defense and the Secretary of Veterans
Affairs shall jointly establish a schedule and benchmarks for the discharge
by the Office of its function under this section, including each of the following:
(1) A schedule for the establishment of the Office.
(2) A schedule and deadline for the establishment of the requirements
for the joint electronic health record described in subsection (d), including
coordination with the Office of the National Coordinator for Health Information
Technology in the development of a nationwide interoperable health information
technology infrastructure.
(3) A schedule and associated deadlines for any acquisition and testing
required in the development and deployment of the joint electronic health
record.
(4) A schedule and associated deadlines and requirements for the deployment
of the joint electronic health record.
(5) Proposed funding for the Office for each of fiscal years 2009 through
2013 for the discharge of its function.
(1) AUTHORITY- In order to assist the Office in the discharge of its
function under this section, the Secretary of Defense and the Secretary
of Veterans Affairs may, acting jointly, carry out one or more pilot projects
to assess the feasability and advisability of various technological approaches
to the achievement of the joint electronic health record described in subsection
(d).
(2) TREATMENT AS SINGLE HEALTH CARE SYSTEM- For purposes of each pilot
project carried out under this subsection, the health care system of the
Department of Defense and the health care system of the Department of Veterans
Affairs shall be treated as a single health care system for purposes of
the regulations promulgated under section 264(c) of the Health Insurance
Portability and Accountability Act of 1996 (42 U.S.C. 1320d-2 note).
(g) Staff and Other Resources-
(1) IN GENERAL- The Secretary of Defense and the Secretary of Veterans
Affairs shall assign to the Office such personnel and other resources of
the Department of Defense and the Department of Veterans Affairs as are
required for the discharge of its function under this section.
(2) ADDITIONAL SERVICES- Subject to the approval of the Secretary of
Defense and the Secretary of Veterans Affairs, the Director may utilize
the services of private individuals and entities as consultants to the Office
in the discharge of its function under this section. Amounts available to
the Office shall be available for payment for such services.
(1) IN GENERAL- Not later than January 1, 2009, and each year thereafter
through 2014, the Director shall submit to the Secretary of Defense and
the Secretary of Veterans Affairs, and to the appropriate committees of
Congress, a report on the activities of the Office during the preceding
calendar year. Each report shall include, for the year covered by such report,
the following:
(A) A detailed description of the activities of the Office, including
a detailed description of the amounts expended and the purposes for which
expended.
(B) An assessment of the progress made by the Department of Defense
and the Department of Veterans Affairs in the development and implementation
of the joint electronic health record described in subsection (d).
(2) AVAILABILITY TO PUBLIC- The Secretary of Defense and the Secretary
of Veterans Affairs shall make available to the public each report submitted
under paragraph (1), including by posting such report on the Internet website
of the Department of Defense and the Department of Veterans Affairs, respectively,
that is available to the public.
(i) Comptroller General Assessment of Implementation- Not later than
six months after the date of the enactment of this Act and every six months
thereafter until the completion of the implementation of the joint electronic
health record described in subsection (d), the Comptroller General of the
United States shall submit to the appropriate committees of Congress a report
setting forth the assessment of the Comptroller General of the progress of
the Department of Defense and the Department of Veterans Affairs in developing
and implementing the joint electronic health record.
(1) IN GENERAL- The Secretary of Defense and the Secretary of Veterans
Affairs shall each contribute equally to the costs of the Office in fiscal
year 2008 and fiscal years thereafter. The amount so contributed by each
Secretary in fiscal year 2008 shall be up to $10,000,000.
(2) SOURCE OF FUNDS- (A) Amounts contributed by the Secretary of Defense
under paragraph (1) shall be derived from amounts authorized to be appropriated
for the Department of Defense for the Defense Health Program and available
for program management and technology resources.
(B) Amounts contributed by the Secretary of Veterans Affairs under
paragraph (1) shall be derived from amounts authorized to be appropriated
for the Department of Veterans Affairs for Medical Care and available for
program management and technology resources.
(k) Joint Electronic Health Record Defined- In this section, the term
`joint electronic health record' means a single system that includes patient
information across the continuum of medical care, including inpatient care,
outpatient care, pharmacy care, patient safety, and rehabilitative care.
SEC. 142. ENHANCED PERSONNEL AUTHORITIES FOR THE DEPARTMENT OF DEFENSE
FOR HEALTH CARE PROFESSIONALS FOR CARE AND TREATMENT OF WOUNDED AND INJURED
MEMBERS OF THE ARMED FORCES.
(a) In General- Section 1599c of title 10, United States Code, is amended
to read as follows:
`Sec. 1599c. Health care professionals: enhanced appointment and compensation
authority for personnel for care and treatment of wounded and injured members
of the armed forces
`(a) In General- The Secretary of Defense may, in the discretion of the
Secretary, exercise any authority for the appointment and pay of health care
personnel under chapter 74 of title 38 for purposes of the recruitment, employment,
and retention of civilian health care professionals for the Department of
Defense if the Secretary determines that the exercise of such authority is
necessary in order to provide or enhance the capacity of the Department to
provide care and treatment for members of the armed forces who are wounded
or injured on active duty in the armed forces and to support the ongoing patient
care and medical readiness, education, and training requirements of the Department
of Defense.
`(b) Recruitment of Personnel- (1) The Secretaries of the military departments
shall each develop and implement a strategy to disseminate among appropriate
personnel of the military departments authorities and best practices for the
recruitment of medical and health professionals, including the authorities
under subsection (a).
`(2) Each strategy under paragraph (1) shall--
`(A) assess current recruitment policies, procedures, and practices
of the military department concerned to assure that such strategy facilitates
the implementation of efficiencies which reduce the time required to fill
vacant positions for medical and health professionals; and
`(B) clearly identify processes and actions that will be used to inform
and educate military and civilian personnel responsible for the recruitment
of medical and health professionals.'.
(b) Clerical Amendment- The table of sections at the beginning of chapter
81 of such title is amended by striking the item relating to section 1599c
and inserting the following new item:
`1599c. Health care professionals: enhanced appointment and compensation
authority for personnel for care and treatment of wounded and injured members
of the armed forces.'.
(c) Reports on Strategies on Recruitment of Medical and Health Professionals-
Not later than six months after the date of the enactment of this Act, each
Secretary of a military department shall submit to the congressional defense
committees a report setting forth the strategy developed by such Secretary
under section 1599c(b) of title 10, United States Code, as added by subsection
(a).
SEC. 143. PERSONNEL SHORTAGES IN THE MENTAL HEALTH WORKFORCE OF THE
DEPARTMENT OF DEFENSE, INCLUDING PERSONNEL IN THE MENTAL HEALTH WORKFORCE.
(a) Recommendations on Means of Addressing Shortages-
(1) REPORT- Not later than 45 days after the date of the enactment
of this Act, the Secretary of Defense shall submit to the Committees on
Armed Services of the Senate and the House of Representatives a report setting
forth the recommendations of the Secretary for such legislative or administrative
actions as the Secretary considers appropriate to address shortages in health
care professionals within the Department of Defense, including personnel
in the mental health workforce.
(2) ELEMENTS- The report required by paragraph (1) shall address the
following:
(A) Enhancements or improvements of financial incentives for health
