![](media/image1.jpeg){width="6.302083333333333in" height="1.125in"}

# 

# Legislative Bulletin..............................................March 28, 2007

**Contents:**

> **H.R. 1538** - Wounded Warrior Assistance Act of 2007

H.R. 1538 - Wounded Warrior Assistance Act of 2007 *(Skelton, D-MO)*

**[Order of Business]{.underline}**: H.R. 1538 is expected to be
considered on Wednesday, March 28, 2007, subject to a rule. Details of
the rule are not currently available.

**[Summary]{.underline}**: H.R. 1538 makes a number of changes to
current law regarding the medical care provided to soldiers that have
been hurt during their service in the U.S. Armed Forces. The specific
provisions of the bill are summarized below.

H.R. 1538 would provide individuals in outpatient status at a military
medical treatment facility with a medical care case manager, whose
duties include ensuring that the soldier and his family understand the
patient's medical condition, assisting in the receiving of prescribed
medical care, and conducting a weekly review of the patient's medical
status. The bill would direct DoD to establish a standard training
program for medical care case managers, who would be required to
complete this training before assuming those duties. In addition, the
bill provides that outpatient individuals may also be assigned a service
member advocate, whose duties include communicating with the patient and
their family, assisting with the oversight of the patient's quality of
life, and assisting with resolving financial, administrative, and
personnel matters. DoD is also directed to establish a standard training
program for service member advocates, who must complete this training
before assuming these duties.

H.R. 1538 would direct DoD to establish a toll-free telephone number
("hot line") for individuals to report deficiencies in medical-related
support facilities. Matters reported to the hot line are to be addressed
by the DoD within 96 hours (four days). If DoD determines, based upon a
call to the hot line, that the conditions at a medical facility violate
health and safety standards, the Secretary is directed to relocate the
occupants of the facility, while the violations are corrected.

The legislation would require DoD to notify (with consent of the family)
certain Members of Congress (Senators and Members from that state and
district) of the hospitalization of any member of the armed forces who
is evacuated from a theater of combat.

H.R. 1538 would limit to 20, the number of medical cases that may be
assigned to each physical evaluation board liaison officer. The bill
also directs DoD to establish a standardized training program and
curriculum for physical evaluation board liaison officers.

The bill directs DoD to establish a standardized training program for
those involved in the disability evaluation system, which is the process
for evaluating the nature of and extend of disabilities affecting
members of the armed forces.

H.R. 1538 would establish a [new, one-year pilot program]{.underline} at
an "appropriate active duty base with a major medical facility based on
the Wounded Warrior Regiment program of the Marine Corps, to be known as
the Armey Wounded Warrior Battalion. The program would track and assist
members of the armed forces in an outpatient status that are still in
need of medical treatment through their course of treatment, medical
evaluation boards, their transition back to the parents, and medical
retirement and transition into the Department of Veterans Affairs'(VA)
medical system." In addition, the bill would require the establishment
of a single medical information system to be used by both the VA and the
DoD.

H.R. 1538 would require DoD to ensure that each member of the armed
forces who must retire from the forces because of injuries, has a
written plan in place outlining their transition to the VA medical
system.

The bill would establish at the U.S. Treasury, the Department of Defense
Medical Support Fund, which is to be used to support programs and
activates relating to the medical treatment and care of wounded and
injured soldiers. **The bill authorizes \$50 million for the fund** to
be appropriated from "an emergency supplemental appropriation for fiscal
year 2007 or 2008."

H.R. 1538 would establish the Oversight Board for Wounded Warriors,
which would advise the DoD and House and Senate Committees on Armed
Services on the process for correcting and improving the ratios of case
managers and service member advocates to recovering service members,
among other matters.

H.R. 1538 would require that military housing facilities occupied by
recovering service members are to be inspected on a semi-annual basis
for the first two years after enactment and annually thereafter.

The bill requires a number of evaluative reports, one of which would
require DoD to study what types of additional support services should be
provided to families of recovering service members, **including
provision of medical care at military facilities, provision of job
placement services, and provision of meals without charge at military
medical facilities.**

H.R. 1538 would [prohibit the initiation or announcement of a
competition under Office of Management and Budget Circular
A-76]{.underline} relating to the possible conversion to performance of
functions at a Department of Defense military medical facility by a
private contractor. According to CRS, Circular A-76 is "a policy
statement, a requirement for agencies to submit inventories of their
commercial activities to OMB, and guidance for determining who \--
government agency or private business \-- will perform commercial
activities." **Some conservatives may be concerned that this provision
would prohibit future competition and potential cost savings in DoD
medical facility operations that could be performed by private
contractors.**

**[Earmark Compliance]{.underline}**: According to Committee Report
110-68, the "H.R. 1538 does not contain any congressional earmarks,
limited tax benefits, or limited tariff benefits as defined in clause
9(d), 9(e), or 9(t) of rule XXI."

**[Committee Action]{.underline}**: H.R. 1538 was introduced on March
15, 2007, and referred the House Committees on Armed Services and
Veterans Affairs. The Armed Services Committee considered it, held a
mark-up, and reported the bill as amended, by a vote of 59-0, on March
20, 2007. the Veterans Affairs Committee also considered it and reported
it to the full House on March 23,2007.

[**Cost to Taxpayer**:]{.underline} According to CBO, "The principal
budgetary impact of H.R. 1538 would be discretionary costs for
developing and implementing a single medical information system for DoD
and VA. Such a system **could potentially cost billions of dollars**,
but CBO does not have sufficient information at this time to complete an
estimate of those costs. Ultimately, the cost of such a new system would
depend on how the two departments choose to implement the bill's
requirements and would be subject to appropriation of the necessary
amounts" (emphasis added).

CBO estimates that implementing the remaining provisions of H.R. 1538
would authorize \$100 million in FY 2008, and \$315 million over the FY
2008- FY 2012 period.

**[Does the Bill Expand the Size and Scope of the Federal
Government?:]{.underline}** Yes. The bill requires the creation of a new
medical information system, and would create a new fund in the Treasury
to pay for programs related to medical treatment of wounded soldiers.

[]{.mark}

**[Does the Bill Contain Any New State-Government, Local-Government, or
Private-Sector Mandates?]{.underline}**: No.

[]{.mark}

**[Administration Position]{.underline}:** According to a Statement of
Administration Position (SAP), the Administration "believes that this
legislation is premature." The Administration would prefer that Congress
wait to act on this legislation until the Commission on Care for
America's Returning Wounded Warriors and the Task Force on Returning
Global War on Terror Heroes to release its recommendations. In addition,
the SAP outlines some concerns regarding the Circular A-76 provisions,
stating that "H.R. 1538 raises some concerns, including an objectionable
provision that would impose a broad one-year moratorium on the
initiation of new public-private competitions involving any function at
any military medical facility. ...Numerous Administration reports
provided to Congress on competitive sourcing issued over the past
several years have documented the significant savings and improved
management practices that have been achieved by the responsible use of
public-private competition. For example, competitions completed over the
last four years are expected to generate more than \$6 billion in
savings over the next 10 years."

[]{.mark}

**[Constitutional Authority]{.underline}**: Committee Report 110-68
cites constitutional authority in Article 1, Section 8 of the
Constitution, but fails to cite a specific clause.

House Rule XIII, Section 3(d)(1), requires that all committee reports
contain "a statement citing the specific powers granted to Congress in
the Constitution to enact the law proposed by the bill or joint
resolution" \[emphasis added\].

**[RSC Staff Contact]{.underline}:** Joelle Cannon;
joelle.cannon@mail.house.gov; 202.226.0718

\###