110th CONGRESS
1st Session
S. 1044
To improve the medical care of members of the Armed Forces and
veterans, and for other purposes.
IN THE SENATE OF THE UNITED STATES
March 29, 2007
Mr. BIDEN introduced the following bill; which was read twice and referred
to the Committee on Armed Services
A BILL
To improve the medical care of members of the Armed Forces and
veterans, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Effective Care for the Armed Forces and Veterans
Act of 2007'.
SEC. 2. PROHIBITION ON COMPETITIVE SOURCING OF CERTAIN ACTIVITIES AT MEDICAL
FACILITIES OF THE DEPARTMENT OF DEFENSE.
(a) Findings- Congress finds the following:
(1) The health and recovery of wounded members of the Armed Forces may
be risked by competitive sourcing of services at military medical facilities.
(2) The provision of medical services to members and former members of
the Armed Forces who were injured while serving in Operation Iraqi Freedom
or Operation Enduring Freedom is a basic service that is the responsibility
of the Government and any disruption is unacceptable when it risks the
health of veterans and members of the Armed Forces.
(3) The Department of Defense has attempted to implement competitive sourcing
of services at military medical facilities despite the fact that doing
so provides no improvement in the efficiency or effectiveness of such
services.
(b) Prohibition on Initiation of Competitive Sourcing Activities at Medical
Facilities of Department of Defense During Period of Major Military Conflict-
(1) IN GENERAL- Except as provided in paragraph (2), during a period in
which the Armed Forces are involved in a major military conflict, the
Secretary of Defense shall not take any action under the Office of Management
and Budget Circular A-76 or any other similar administrative regulation,
directive, or policy--
(A) to subject work performed by an employee of a medical facility of
the Department of Defense or employee of a private contractor of such
a medical facility to public-private competition; or
(B) to convert such employee or the work performed by such employee
to private contractor performance.
(2) EXCEPTION TO PREVENT NEGATIVE IMPACT ON PROVISION OF SERVICES- Paragraph
(1) shall not apply to any action at a medical facility of the Department
of Defense if the Secretary of Defense certifies to Congress that not
initiating such action during such period would have a negative impact
on the provision of services at such military medical facility.
(c) Study on Competitive Sourcing Activities at Medical Facilities of Department
of Defense- The Comptroller General of the United States shall assess the
efficiency and advisability of subjecting work performed by an employee
of a medical facility of the Department of Defense or a private contractor
of such a medical facility to public-private competition, or converting
such employee or the work performed by such employee to private contractor
performance, under the Office of Management and Budget Circular A-76 or
any other similar administrative regulation, directive, or policy.
SEC. 3. MINIMUM BUDGET FOR MEDICAL SERVICES OF THE ARMED FORCES DURING
PERIOD OF MAJOR MILITARY CONFLICT.
(a) Findings- Congress finds the following:
(1) Pressure to reduce the budget for the medical services of the Department
of Defense has contributed to many of the current problems at Walter Reed
Army Medical Center.
(2) It is inappropriate to reduce the budget for medical services of the
Department of Defense or the Department of Veterans Affairs while such
services are needed to treat members of the Armed Forces or veterans who
were wounded in Iraq and Afghanistan.
(b) Minimum Budget for Medical Services-
(1) IN GENERAL- Except as provided in paragraph (2), if the Armed Forces
are involved in a major military conflict at the time the President submits
the budget for a fiscal year to Congress, the President shall not include
in that budget a total aggregate amount allocated for medical services
for the Department of Defense and the Department of Veterans Affairs that
is less than the total aggregate amount allocated for such purposes in
the budget submitted by the President to Congress for the previous fiscal
year.
(2) EXCEPTION- Paragraph (1) shall not apply if the President--
(A) certifies to Congress that submitting a total aggregate amount allocated
for medical services for the Department of Defense and the Department
of Veterans Affairs that is less than that required under paragraph
(1) is in the national interest; and
(B) submits to Congress a report on the reasons for the reduction described
by subparagraph (A).
SEC. 4. LIMITATION ON IMPLEMENTATION OF RECOMMENDATION TO CLOSE WALTER
REED ARMY MEDICAL CENTER.
(a) Findings- Congress finds the following:
(1) The final recommendations of the Defense Base Closure and Realignment
Commission under the 2005 round of defense base closure and realignment
include recommendations to close Walter Reed Army Medical Center and to
build new, modern facilities at the National Naval Medical Center at Bethesda
and at Fort Belvoir to improve the overall quality of and access to health
care for members of the Armed Forces.
(2) These recommendations include the transfer of medical services from
the Walter Reed Army Medical Center to the National Naval Medical Center
at Bethesda and at Fort Belvoir, but they do not adequately provide for
housing for the families of wounded members of the Armed Forces who will
receive treatment at such new facilities.
(3) The recommended closure of the Walter Reed Army Medical Center has
impaired the ability of the Secretary of Defense to attract the personnel
required to provide proper medical services at such medical center.
(b) Limitation on Implementation of Recommendations- The Secretary of Defense
shall not take any action to implement the recommendations of the Defense
Base Closure and Realignment Commission under the 2005 round of defense
base closure and realignment relating to the transfer of medical services
from Walter Reed Army Medical Center to the National Naval Medical Center
at Bethesda and at Fort Belvoir during the period beginning on the date
of the enactment of this Act and ending on the date that is 60 days after
the date on which Congress receives the plan required under subsection (c).
(c) Plan Required- Not later than one year after the date of the enactment
of this Act, the Secretary of Defense shall submit to Congress a plan that
includes an assessment of the following:
(1) The feasibility and advisability of providing current or prospective
employees at Walter Reed Army Medical Center a guarantee that their employment
will continue in the Washington, DC, metropolitan area for more than two
years after the date on which Walter Reed Army Medical Center is closed.
(2) Detailed construction plans for new medical facilities and family
housing at the National Naval Medical Center at Bethesda and at Fort Belvoir
to accommodate the transfer of medical services from Walter Reed Army
Medical Center to the National Naval Medical Center at Bethesda and at
Fort Belvoir.
(3) The costs, feasibility, and advisability of completing all of the
construction planned for the transfer of medical services from Walter
Reed Army Medical Center to the National Naval Medical Center at Bethesda
and at Fort Belvoir before any patients are transferred to such new facilities
from Walter Reed Army Medical Center as a result of the recommendations
of the Defense Base Closure and Realignment Commission under the 2005
round of defense base closure and realignment.
SEC. 5. IMPROVING CASE MANAGEMENT SERVICES FOR MEMBERS OF THE ARMED FORCES.
(a) Findings- Congress makes the following findings:
(1) Case managers are important for scheduling appointments and making
sure recovering servicemembers get the care they need.
(2) Many case managers are overwhelmed by the large number of wounded
members of the Armed Forces returning from deployment in Iraq and Afghanistan.
(3) Regular contact between health care providers and members of the Armed
Forces returning from deployment is important for the diagnosis of post
traumatic stress disorder in such members.
(4) It is inappropriate to require a wounded member of the Armed Forces
or a family member of such member to provide a photo or a medal from deployment
in Iraq or Afghanistan to prove that such member served in and was injured
from such deployment.
(5) Case managers are well qualified to assist recovering servicemembers
and their families with the disability evaluation system and discharge
procedures of the Department of Defense.
(1) IN GENERAL- The Secretary of Defense shall assign at least one case
manager for every 20 recovering servicemembers to assist in the recovery
of such recovering servicemember.
(2) MINIMUM CONTACT- The Secretary of Defense shall ensure that case managers
contact each of their assigned recovering servicemembers not less than
once per week.
(3) TRAINING- The Secretary of Defense shall ensure that case managers
of the Department of Defense are familiar with the disability and discharge
system of the Department of Defense and that such case managers are able
to assist recovering servicemembers complete necessary and related forms.
(c) Recovering Servicemember- In this section, the term `recovering servicemember'
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,
or is otherwise in medical hold or holdover status, for an injury, illness,
or disease incurred or aggravated while on active duty in the Armed Forces.
SEC. 6. SCREENING FOR TRAUMATIC BRAIN INJURY.
(a) Findings- Congress finds the following:
(1) Many of the members of the Armed Forces deployed in Iraq and Afghanistan
have brain injuries.
(2) In many cases, such injuries are not diagnosed because there is no
external indication of such injury.
(3) The Secretary of Veterans Affairs carries out programs to screen all
recent combat veterans for traumatic brain injury; the Secretary of Defense
does not do so.
(b) Screening Required- The Secretary of Defense shall screen every member
of the Armed Forces returning from deployment in Operation Iraqi Freedom
or Operation Enduring Freedom for traumatic brain injury upon the return
of each such member.
(c) Studies on Treating Traumatic Brain Injury as Presumptive Condition
for Disability Compensation-
(1) STUDY BY SECRETARY OF DEFENSE-
(A) IN GENERAL- The Secretary of Defense shall conduct a study on the
feasability and advisability of treating traumatic brain injury as a
presumptive condition for members of the Armed Forces who served in
Operation Iraqi Freedom or Operation Enduring Freedom for the qualification
for disability compensation under laws administered by the Secretary
of Defense.
(B) REPORT- 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 results of the study required by subparagraph (A).
(2) STUDY BY SECRETARY OF VETERANS AFFAIRS-
(A) IN GENERAL- The Secretary of Veterans Affairs shall conduct a study
on the feasability and advisability of treating traumatic brain injury
as a presumptive condition for veterans who served as members of the
Armed Forces in Operation Iraqi Freedom or Operation Enduring Freedom
for the qualification for disability compensation under laws administered
by the Secretary of Veterans Affairs.
(B) REPORT- Not later than 180 days after the date of the enactment
of this Act, the Secretary of Veterans Affairs shall submit to Congress
a report on the results of the study required by subparagraph (A).
(3) STUDY BY DIRECTOR OF NATIONAL INSTITUTES OF HEALTH-
(A) IN GENERAL- The Director of the National Institutes of Health shall
conduct a study on traumatic brain injury, including the detection of
traumatic brain injury and the measurement and classification of the
severity of traumatic brain injury.
(B) REPORT- Not later than 180 days after the date of the enactment
of this Act, the Director of the National Institutes of Health shall
submit to Congress a report on the results of the study required by
subparagraph (A).
SEC. 7. REQUIRING MEDICAL RECORDS MANAGEMENT SYSTEMS OF DEPARTMENT OF
DEFENSE TO COMMUNICATE WITH MEDICAL RECORDS MANAGEMENT SYSTEMS OF DEPARTMENT
OF VETERANS AFFAIRS.
(a) Findings- Congress makes the following findings:
(1) The electronic transfer of medical records of members of the Armed
Forces from the medical records management systems of the Department of
Defense to the medical records management systems of the Department of
Veterans Affairs would be prudent.
(2) The Department of Veterans Affairs has been a leader in the implementation
of electronic medical records management systems.
(b) Electronic Communication Between Medical Records Management Systems
Required-
(1) IN GENERAL- Not later than two years after the date of the enactment
of this Act, the Secretary of Defense shall ensure that the medical records
management systems of the Department of Defense are capable of transmitting
medical records to and receiving medical records from the medical records
management systems of the Department of Veterans Affairs electronically.
(2) INITIATION OF ACTIVITIES- Not later than one year after the date of
the enactment of this Act, the Secretary of Defense shall begin any activities
required to meet the requirements of paragraph (1).
SEC. 8. DEPARTMENT OF VETERANS AFFAIRS ASSESSMENT OF LONG-TERM CARE NEEDS
OF VETERANS.
(a) Findings- Congress makes the following findings:
(1) Multiple studies show that, in the next five years, the Department
of Veterans Affairs will add hundreds of thousands of new veterans to
the medical records management systems of the Department of Veterans Affairs.
(2) During such period, many veterans will have multiple medical care
needs caused by complex medical conditions.
(b) Assessment of Long-Term Care Needs- The Secretary of Veterans Affairs
shall assess the current ability of the Department of Veterans Affairs to
meet long-term care needs of veterans during the 50-year period that begins
on the date of the enactment of this Act.
(c) Determination of Actions Required To Meet Long-Term Care Needs- The
Secretary of Veterans Affairs shall determine what actions are required
to ensure that the needs described in subsection (b) are satisfied.
(d) Report Required- Not later than one year after the date of the enactment
of this Act, the Secretary of Veterans Affairs shall submit to Congress
a report on the assessment required in subsection (b) and the determination
required in subsection (c).
END
