# Duncan Hunter National Defense Authorization Act for Fiscal Year 2009/Division A/Title VII
## TITLE VII — HEALTH CARE AND WOUNDED WARRIOR PROVISIONS
### Subtitle A—Improvements to Health Benefits
#### SEC. 701. ONE-YEAR EXTENSION OF PROHIBITION ON INCREASES IN CERTAIN HEALTH CARE COSTS FOR MEMBERS OF THE UNIFORMED SERVICES.

    (a) Charges Under Contracts for Medical Care—
       Section 1097(e) of title 10, United States Code, is amended by striking `September 30, 2008' and inserting `September 30, 2009'.
    (b) Charges for Inpatient Care—
       Section 1086(b)(3) of such title is amended by striking `September 30, 2008' and inserting `September 30, 2009'.

#### SEC. 702. TEMPORARY PROHIBITION ON INCREASE IN COPAYMENTS UNDER RETAIL PHARMACY SYSTEM OF PHARMACY BENEFITS PROGRAM.

    During the period beginning on October 1, 2008, and ending on September 30, 2009, the cost sharing requirements established under paragraph (6) of section 1074g(a) of title 10, United States Code, for pharmaceutical agents available through retail pharmacies covered by paragraph (2)(E)(ii) of such section may not exceed amounts as follows:
       (1) In the case of generic agents, $3.
       (2) In the case of formulary agents, $9.
       (3) In the case of nonformulary agents, $22.

#### SEC. 703. CHIROPRACTIC HEALTH CARE FOR MEMBERS ON ACTIVE DUTY.

    Not later than September 30, 2009, the Secretary of Defense shall provide chiropractic services to active duty military personnel at 11 additional military treatment facilities that do not currently provide chiropractic services.

#### SEC. 704. CALCULATION OF MONTHLY PREMIUMS FOR COVERAGE UNDER TRICARE RESERVE SELECT AFTER 2008.

    (a) Calculation of Monthly Premiums for Years After 2009—
       Section 1076d(d)(3) of title 10, United States Code, is amended—
       (1) by inserting `(A)' after `(3)';
       (2) in subparagraph (A), as so designated—
          (A) by striking `that the Secretary determines' and inserting `determined'; and
          (B) by striking the second sentence; and
       (3) by adding at the end the following new subparagraph:
                   `(B) The appropriate actuarial basis for purposes of subparagraph (A) shall be determined, for each calendar year after calendar year 2009, by utilizing the actual cost of providing benefits under this section to members and their dependents during the calendar years preceding such calendar year.'.
    (b) Calculation of Monthly Premiums for 2009—
       For purposes of section 1076d(d)(3) of title 10, United States Code, the appropriate actuarial basis for purposes of subparagraph (A) of that section shall be determined for calendar year 2009 by utilizing the reported cost of providing benefits under that section to members and their dependents during calendar years 2006 and 2007, except that the monthly amount of the premium determined pursuant to this subsection may not exceed the amount in effect for the month of March 2007.
    (c) Effective Date—
       The amendments made by this section shall take effect as of October 1, 2008.

#### SEC. 705. PROGRAM FOR HEALTH CARE DELIVERY AT MILITARY INSTALLATIONS PROJECTED TO GROW.

    (a) Program—
       The Secretary of Defense is authorized to develop a plan to establish a program to build cooperative health care arrangements and agreements between military installations projected to grow and local and regional non-military health care systems.
    (b) Requirements of Plan—
       In developing the plan, the Secretary of Defense shall—
       (1) identify and analyze health care delivery options involving the private sector and health care services in military facilities located on military installations;
       (2) develop methods for determining the cost avoidance or savings resulting from innovative partnerships between the Department of Defense and the private sector;
       (3) develop requirements for Department of Defense health care providers to deliver health care in civilian community hospitals; and
       (4) collaborate with State and local authorities to create an arrangement to share and exchange, between the Department of Defense and nonmilitary health care systems, personal health information, and data of military personnel and their families.
    (c) Coordination With Other Entities—
       The plan shall include requirements for coordination with Federal, State, and local entities, TRICARE managed care support contractors, and other contracted assets around installations selected for participation in the program.
    (d) Consultation Requirements—
       The Secretary of Defense shall develop the plan in consultation with the Secretaries of the military departments.
    (e) Selection of Military Installations—
       Each selected military installation shall meet the following criteria:
       (1) The military installation has members of the Armed Forces on active duty and members of reserve components of the Armed Forces that use the installation as a training and operational base, with members routinely deploying in support of the global war on terrorism.
       (2) The military population of an installation will significantly increase by 2013 due to actions related to either Grow the Force initiatives or recommendations of the Defense Base Realignment and Closure Commission.
       (3) There is a military treatment facility on the installation that has—
          (A) no inpatient or trauma center care capabilities; and
          (B) no current or planned capacity that would satisfy the proposed increase in military personnel at the installation.
       (4) There is a civilian community hospital near the military installation, and the military treatment facility has—
          (A) no inpatient services or limited capability to expand inpatient care beds, intensive care, and specialty services; and
          (B) limited or no capability to provide trauma care.
    (f) Reports—
       Not later than one year after the date of the enactment of this Act, and every year thereafter, the Secretary of Defense shall submit to the Committees on Armed Services of the Senate and House of Representatives an annual report on any plan developed under subsection (a).

#### SEC. 706. GUIDELINES FOR COMBINED MEDICAL FACILITIES OF THE DEPARTMENT OF DEFENSE AND THE DEPARTMENT OF VETERANS AFFAIRS.

    Before a facility may be designated a combined Federal medical facility of the Department of Defense and the Department of Veterans Affairs, the Secretary of Defense and the Secretary of Veterans Affairs shall execute a signed agreement that specifies, at a minimum, a binding operational agreement on the following areas:
       (1) Governance.
       (2) Patient priority categories.
       (3) Budgeting.
       (4) Staffing and training.
       (5) Construction.
       (6) Physical plant management.
       (7) Contingency planning.
       (8) Quality assurance.
       (9) Information technology.

### Subtitle B—Preventive Care
#### SEC. 711. WAIVER OF COPAYMENTS FOR PREVENTIVE SERVICES FOR CERTAIN TRICARE BENEFICIARIES.

    (a) Waiver of Certain Copayments—
       Subject to subsection (b) and under regulations prescribed by the Secretary of Defense, the Secretary shall—
       (1) waive all copayments under sections 1079(b) and 1086(b) of title 10, United States Code, for preventive services for all beneficiaries who would otherwise pay copayments; and
       (2) ensure that a beneficiary pays nothing for preventive services during a year even if the beneficiary has not paid the amount necessary to cover the beneficiary's deductible for the year.
    (b) Exclusion for Medicare-Eligible Beneficiaries—
       Subsection (a) shall not apply to a medicare-eligible beneficiary.
    (c) Refund of Copayments—
       (1) AUTHORITY—
          Under regulations prescribed by the Secretary of Defense, the Secretary may pay a refund to a medicare-eligible beneficiary excluded by subsection (b), subject to the availability of appropriations specifically for such refunds, consisting of an amount up to the difference between—
          (A) the amount the beneficiary pays for copayments for preventive services during fiscal year 2009; and
          (B) the amount the beneficiary would have paid during such fiscal year if the copayments for preventive services had been waived pursuant to subsection (a) during that year.
       (2) COPAYMENTS COVERED—
          The refunds under paragraph (1) are available only for copayments paid by medicare-eligible beneficiaries during fiscal year 2009.
    (d) Definitions—
       In this section:
       (1) PREVENTIVE SERVICES—
          The term `preventive services' includes, taking into consideration the age and gender of the beneficiary:
          (A) Colorectal screening.
          (B) Breast screening.
          (C) Cervical screening.
          (D) Prostate screening.
          (E) Annual physical exam.
          (F) Vaccinations.
          (G) Other services as determined by the Secretary of Defense.
       (2) MEDICARE-ELIGIBLE—
          The term `medicare-eligible' has the meaning provided by section 1111((b) of title 10, United States Code.

#### SEC. 712. MILITARY HEALTH RISK MANAGEMENT DEMONSTRATION PROJECT.

    (a) Demonstration Project Required—
       The Secretary of Defense shall conduct a demonstration project designed to evaluate the efficacy of providing incentives to encourage healthy behaviors on the part of eligible military health system beneficiaries.
    (b) Elements of Demonstration Project—
       (1) WELLNESS ASSESSMENT—
          The Secretary shall develop a wellness assessment to be offered to beneficiaries enrolled in the demonstration project. The wellness assessment shall incorporate nationally recognized standards for health and healthy behaviors and shall be offered to determine a baseline and at appropriate intervals determined by the Secretary. The wellness assessment shall include the following:
          (A) A self-reported health risk assessment.
          (B) Physiological and biometric measures, including at least—
             (i) blood pressure;
             (ii) glucose level;
             (iii) lipids;
             (iv) nicotine use; and
             (v) weight.
       (2) POPULATION ENROLLED—
          Non-medicare eligible retired beneficiaries of the military health system and their dependents who are enrolled in TRICARE Prime and who reside in the demonstration project service area shall be offered the opportunity to enroll in the demonstration project.
       (3) GEOGRAPHIC COVERAGE OF DEMONSTRATION PROJECT—
          The demonstration project shall be conducted in at least three geographic areas within the United States where TRICARE Prime is offered, as determined by the Secretary. The area covered by the project shall be referred to as the demonstration project service area.
       (4) PROGRAMS—
          The Secretary shall develop programs to assist enrollees to improve healthy behaviors, as identified by the wellness assessment.
       (5) INCLUSION OF INCENTIVES REQUIRED—
          For the purpose of conducting the demonstration project, the Secretary may offer monetary and non-monetary incentives to enrollees to encourage participation in the demonstration project.
    (c) Evaluation of Demonstration Project—
       The Secretary shall annually evaluate the demonstration project for the following:
       (1) The extent to which the health risk assessment and the physiological and biometric measures of beneficiaries are improved from the baseline (as determined in the wellness assessment).
       (2) In the case of baseline health risk assessments and physiological and biometric measures that reflect healthy behaviors, the extent to which the measures are maintained.
    (d) Implementation Plan—
       The Secretary of Defense shall submit a plan to implement the health risk management demonstration project required by this section not later than 90 days after the date of the enactment of this Act.
    (e) Duration of Project—
       The health risk management demonstration project shall be implemented for a period of three years, beginning not later than March 1, 2009, and ending three years after that date.
    (f) Report—
       (1) IN GENERAL—
          The Secretary of Defense shall submit to the Committees on Armed Services of the Senate and the House of Representatives an annual report on the effectiveness of the health risk management demonstration project in improving the health risk measures of military health system beneficiaries enrolled in the demonstration project. The first report shall be submitted not later than one year after the date of the enactment of this Act, and subsequent reports shall be submitted for each year of the demonstration project with the final report being submitted not later than 90 days after the termination of the demonstration project.
       (2) MATTERS COVERED—
          Each report shall address, at a minimum, the following:
          (A) The number of beneficiaries who were enrolled in the project.
          (B) The number of enrolled beneficiaries who participate in the project.
          (C) The incentives to encourage healthy behaviors that were provided to the beneficiaries in each beneficiary category, and the extent to which the incentives encouraged healthy behaviors.
          (D) An assessment of the effectiveness of the demonstration project.
          (E) Recommendations for adjustments to the demonstration project.
          (F) The estimated costs avoided as a result of decreased health risk conditions on the part of each of the beneficiary categories.
          (G) Recommendations for extending the demonstration project or implementing a permanent wellness assessment program.
          (H) Identification of legislative authorities required to implement a permanent program.

#### SEC. 713. SMOKING CESSATION PROGRAM UNDER TRICARE.

    (a) TRICARE Smoking Cessation Program—
       Not later than 180 days after the date of the enactment of this Act, the Secretary of Defense shall establish a smoking cessation program under the TRICARE program, to be made available to all beneficiaries under the TRICARE program, subject to subsection (b). The Secretary may prescribe such regulations as may be necessary to implement the program.
    (b) Exclusion for Medicare-Eligible Beneficiaries—
       The smoking cessation program shall not be made available to medicare-eligible beneficiaries.
    (c) Elements—
       The program shall include, at a minimum, the following elements:
       (1) The availability, at no cost to the beneficiary, of pharmaceuticals used for smoking cessation, with a limitation on the availability of such pharmaceuticals to the national mail-order pharmacy program under the TRICARE program if appropriate.
       (2) Counseling.
       (3) Access to a toll-free quit line that is available 24 hours a day, 7 days a week.
       (4) Access to printed and Internet web-based tobacco cessation material.
    (d) Chain of Command Involvement—
       In establishing the program, the Secretary of Defense shall provide for involvement by officers in the chain of command of participants in the program who are on active duty.
    (e) Plan—
       Not later than 90 days after the date of the enactment of this Act, the Secretary shall submit to the congressional defense committees a plan to implement the program.
    (f) Refund of Copayments—
       (1) AUTHORITY—
          Under regulations prescribed by the Secretary of Defense, the Secretary may pay a refund to a medicare-eligible beneficiary otherwise excluded by this section, subject to the availability of appropriations specifically for such refunds, consisting of an amount up to the difference between—
          (A) the amount the beneficiary pays for copayments for smoking cessation services described in subsection (c) during fiscal year 2009; and
          (B) the amount the beneficiary would have paid during such fiscal year if the beneficiary had not been excluded under subsection (b) from the smoking cessation program under subsection (a).
       (2) COPAYMENTS COVERED—
          The refunds under paragraph (1) are available only for copayments paid by medicare-eligible beneficiaries during fiscal year 2009.
    (g) Report—
       Not later than one year after the date of the enactment of this Act, the Secretary shall submit to the congressional defense committees a report covering the following:
       (1) The status of the program.
       (2) The number of participants in the program.
       (3) The cost of the program.
       (4) The costs avoided that are attributed to the program.
       (5) The success rates of the program compared to other nationally recognized smoking cessation programs.
       (6) Findings regarding the success rate of participants in the program.
       (7) Recommendations to modify the policies and procedures of the program.
       (8) Recommendations concerning the future utility of the program.
    (h) Definitions—
       In this section:
       (1) TRICARE PROGRAM—
          The term `TRICARE program' has the meaning provided by section 1072(7) of title 10, United States Code.
       (2) MEDICARE-ELIGIBLE—
          The term `medicare-eligible' has the meaning provided by section 1111(b) of title 10, United States Code.

#### SEC. 714. PREVENTIVE HEALTH ALLOWANCE.

    (a) Allowance—
       Chapter 7 of title 37, United States Code, is amended by adding at the end the following new section:
          `Sec. 438. Preventive health services allowance
             `(a) Demonstration Project— During the period beginning on January 1, 2009, and ending on December 31, 2011, the Secretary of Defense shall conduct a demonstration project designed to evaluate the efficacy of providing an annual allowance (to be known as a `preventive health services allowance') to members of the armed forces described in subsection (b) to increase the use of preventive health services by such members and their dependents.
             `(b) Eligible Members— (1) Subject to the numerical limitations specified in paragraph (2), a member of the armed forces who is serving on active duty for a period of more than 30 days and meets the medical and dental readiness requirements for the armed force of the member may receive a preventive health services allowance.
                `(2) Not more than 1,500 members of each of the Army, Navy, Air Force, and Marine Corps may receive a preventive health services allowance during any year, of which half in each armed force shall be members without dependents and half shall be members with dependents.
             `(c) Amount of Allowance— The Secretary of the military department concerned shall pay a preventive health services allowance to a member selected to receive the allowance in an amount equal to—
                `(1) $500 per year, in the case of a member without dependents; and
                `(2) $1,000 per year, in the case of a member with dependents.
             `(d) Authorized Preventive Health Services— (1) The Secretary of Defense shall specify the types of preventive health services that may be procured using a preventive health services allowance and the frequency at which such services may be procured.
                `(2) At a minimum, authorized preventive health services shall include, taking into consideration the age and gender of the member and dependents of the member:
                   `(A) Colorectal screening.
                   `(B) Breast screening.
                   `(C) Cervical screening.
                   `(D) Prostate screening.
                   `(E) Annual physical exam.
                   `(F) Annual dental exam.
                   `(G) Weight and body mass screening.
                   `(H) Vaccinations.
                `(3) The Secretary of Defense shall ensure that members selected to receive the preventive health services allowance and their dependents are provided a reasonable opportunity to receive the services authorized under this subsection in their local area.
             `(e) Data Collection— At a minimum, the Secretary of Defense shall monitor and record the health of members receiving a preventive health services allowance and their dependents and the results of the testing required to qualify for payment of the allowance, if conducted. The Secretary shall assess the medical utility of the testing required to qualify for payment of a preventive health allowance.
             `(f) Reporting Requirement— Not later than March 31, 2010, and March 31, 2012, the Secretary of Defense shall submit to Congress a report on the status of the demonstration project, including findings regarding the medical status of participants, recommendations to modify the policies and procedures of the program, and recommendations concerning the future utility of the project.
             `(g) Regulations— The Secretary of Defense shall prescribe regulations to carry out this section.'.
    (b) Clerical Amendment—
       The table of sections at the beginning of such chapter is amended by adding at the end the following new item:
          `438. Preventive health care allowance.'.

#### SEC. 715. ADDITIONAL AUTHORITY FOR STUDIES AND DEMONSTRATION PROJECTS RELATING TO DELIVERY OF HEALTH AND MEDICAL CARE.

    Section 1092(a) of title 10, United States Code, is amended by adding at the end the following new paragraphs:
                `(3) The Secretary of Defense may include in the studies and demonstration projects conducted under paragraph (1) studies and demonstration projects to provide awards and incentives to members of the armed forces and covered beneficiaries who obtain health promotion and disease prevention health care services under the TRICARE program in accordance with terms and schedules prescribed by the Secretary. Such awards and incentives may include cash awards and, in the case of members of the armed forces, personnel incentives.
                `(4)(A) The Secretary of Defense may, in consultation with the other administering Secretaries, include in the studies and demonstration projects conducted under paragraph (1) studies and demonstration projects to provide awards or incentives to individual health care professionals under the authority of such Secretaries, including members of the uniformed services, Federal civilian employees, and contractor personnel, to encourage and reward effective implementation of innovative health care programs designed to improve quality, cost-effectiveness, health promotion, medical readiness, and other priority objectives. Such awards and incentives may include cash awards and, in the case of members of the armed forces and Federal civilian employees, personnel incentives.
                   `(B) Amounts available for the pay of members of the uniformed services shall be available for awards and incentives under this paragraph with respect to members of the uniformed services.
                `(5) The Secretary of Defense may include in the studies and demonstration projects conducted under paragraph (1) studies and demonstration projects to improve the medical and dental readiness of members of reserve components of the armed forces, including the provision of health care services to such members for which they are not otherwise entitled or eligible under this chapter.
                `(6) The Secretary of Defense may include in the studies and demonstration projects conducted under paragraph (1) studies and demonstration projects to improve the continuity of health care services for family members of mobilized members of the reserve components of the armed forces who are eligible for such services under this chapter, including payment of a stipend for continuation of employer-provided health coverage during extended periods of active duty.'.

### Subtitle C—Wounded Warrior Matters
#### SEC. 721. CENTER OF EXCELLENCE IN PREVENTION, DIAGNOSIS, MITIGATION, TREATMENT, AND REHABILITATION OF HEARING LOSS AND AUDITORY SYSTEM INJURIES.

    (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 hearing loss and auditory system injury to carry out the responsibilities specified in subsection (c).
    (b) Partnerships—
       The Secretary shall ensure that the center collaborates to the maximum extent practicable with the Secretary 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—
       (1) IN GENERAL—
          The center shall—
          (A) implement a comprehensive plan and strategy for the Department of Defense, as developed by the Secretary of Defense, for a registry of information for the tracking of the diagnosis, surgical intervention or other operative procedure, other treatment, and follow up for each case of hearing loss and auditory system injury incurred by a member of the Armed Forces while serving on active duty;
          (B) ensure the electronic exchange with the Secretary of Veterans Affairs of information obtained through tracking under subparagraph (A); and
          (C) enable the Secretary of Veterans Affairs to access the registry and add information pertaining to additional treatments or surgical procedures and eventual hearing outcomes for veterans who were entered into the registry and subsequently received treatment through the Veterans Health Administration.
       (2) DESIGNATION OF REGISTRY—
          The registry under this subsection shall be known as the `Hearing Loss and Auditory System Injury Registry' (hereinafter referred to as the `Registry').
       (3) CONSULTATION IN DEVELOPMENT—
          The center shall develop the Registry in consultation with audiologists, speech and language pathologists, otolaryngologists, and other specialist personnel of the Department of Defense and the audiologists, speech and language pathologists, otolaryngologists, and other specialist personnel of the Department of Veterans Affairs. The mechanisms and procedures of the Registry shall reflect applicable expert research on military and other hearing loss.
       (4) MECHANISMS—
          The mechanisms of the Registry for tracking under paragraph (1)(A) shall ensure that each military medical treatment facility or other medical facility shall submit to the center for inclusion in the Registry information on the diagnosis, surgical intervention or other operative procedure, other treatment, and follow up for each case of hearing loss and auditory system injury described in that paragraph as follows (to the extent applicable):
          (A) Not later than 30 days after surgery or other operative intervention, including a surgery or other operative intervention carried out as a result of a follow-up examination.
          (B) Not later than 180 days after the hearing loss and auditory system injury is reported or recorded in the medical record.
       (5) COORDINATION OF CARE AND BENEFITS—
          (A) The center shall provide notice to the National Center for Rehabilitative Auditory Research (NCRAR) of the Department of Veterans Affairs and to the auditory system impairment services of the Veterans Health Administration on each member of the Armed Forces described in subparagraph (B) for purposes of ensuring the coordination of the provision of ongoing auditory system rehabilitation benefits and services by the Department of Veterans Affairs after the separation or release of such member from the Armed Forces.
          (B) A member of the Armed Forces described in this subparagraph is a member of the Armed Forces with significant hearing loss or auditory system injury incurred while serving on active duty, including a member with auditory dysfunction related to traumatic brain injury.
    (d) Utilization of Registry Information—
       The Secretary of Defense and the Secretary of Veterans Affairs shall jointly ensure that information in the Registry is available to appropriate audiologists, speech and language pathologists, otolaryngologists, and other specialist personnel of the Department of Defense and the Department of Veterans Affairs for purposes of encouraging and facilitating the conduct of research, and the development of best practices and clinical education, on hearing loss or auditory system injury incurred by members of the Armed Forces.
    (e) Inclusion of Records of OIF/OEF Veterans—
       The Secretary of Defense shall take appropriate actions to include in the Registry such records of members of the Armed Forces who incurred a hearing loss or auditory system injury while serving on active duty on or after September 11, 2001, but before the establishment of the Registry, as the Secretary considers appropriate for purposes of the Registry.

#### SEC. 722. CLARIFICATION TO CENTER OF EXCELLENCE RELATING TO MILITARY EYE INJURIES.

    Section 1623(d) of Public Law 110-181 is amended by striking `in combat' at the end.

#### SEC. 723. CENTER OF EXCELLENCE IN THE MITIGATION, TREATMENT, AND REHABILITATION OF TRAUMATIC EXTREMITY INJURIES AND AMPUTATIONS.

    (a) In General—
       The Secretary of Defense and the Secretary of Veterans Affairs shall jointly establish a center of excellence in the mitigation, treatment, and rehabilitation of traumatic extremity injuries and amputations.
    (b) Partnerships—
       The Secretary of Defense and the Secretary of Veterans Affairs shall jointly ensure that the center collaborates with the Department of Defense, 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 the responsibilities as follows:
       (1) To implement a comprehensive plan and strategy for the Department of Defense and the Department of Veterans Affairs for the mitigation, treatment, and rehabilitation of traumatic extremity injuries and amputations.
       (2) To conduct research to develop scientific information aimed at saving injured extremities, avoiding amputations, and preserving and restoring the function of injured extremities. Such research shall address military medical needs and include the full range of scientific inquiry encompassing basic, translational, and clinical research.
       (3) To carry out such other activities to improve and enhance the efforts of the Department of Defense and the Department of Veterans Affairs for the mitigation, treatment, and rehabilitation of traumatic extremity injuries and amputations as the Secretary of Defense and the Secretary of Veterans Affairs consider appropriate.
    (d) Reports—
       (1) IN GENERAL—
          Not later than one year after the date of the enactment of this Act, and annually thereafter, the Secretary of Defense and the Secretary of Veterans Affairs shall jointly submit to Congress a report on the activities of the center.
       (2) ELEMENTS—
          Each report under this subsection shall include the following:
          (A) In the case of the first report under this subsection, a description of the implementation of the requirements of this Act.
          (B) A description and assessment of the activities of the center during the one-year period ending on the date of such report, including an assessment of the role of such activities in improving and enhancing the efforts of the Department of Defense and the Department of Veterans Affairs for the mitigation, treatment, and rehabilitation of traumatic extremity injuries and amputations.

#### SEC. 724. ADDITIONAL RESPONSIBILITIES FOR THE WOUNDED WARRIOR RESOURCE CENTER.

    Section 1616(a) of the Wounded Warrior Act (title XVI of Public Law 110-181; 122 Stat. 447; 10 U.S.C. 1071 note) is amended in the first sentence by inserting `receiving legal assistance referral information (where appropriate), receiving other appropriate referral information,' after `receiving benefits information,'.

#### SEC. 725. SENSE OF CONGRESS ON RESEARCH ON TRAUMATIC BRAIN INJURY.

    It is the sense of Congress that the requirement under section 1621(c)(7) of the National Defense Authorization Act for Fiscal Year 2008 (Public Law 110-181; 122 Stat. 453; 10 U.S.C. 1071 note) to conduct basic science and translational research on traumatic brain injury includes pilot programs designed to test the efficacy of clinical approaches, including the use of pharmacological agents. Congress urges continued studies of the efficacy of pharmacological agents for treatment of traumatic brain injury and supports continued joint research with the National Institutes of Health in this area.

#### SEC. 726. EXTENSION OF SENIOR OVERSIGHT COMMITTEE WITH RESPECT TO WOUNDED WARRIOR MATTERS.

    (a) In General—
       The Secretary of Defense and the Secretary of Veterans Affairs shall jointly take such actions as are appropriate, including the allocation of appropriate personnel, funding, and other resources, to continue the operations of the Senior Oversight Committee until December 31, 2009.
    (b) Report on Further Extension of Committee—
       Not later than August 31, 2009, the Secretary of Defense and the Secretary of Veterans Affairs shall jointly submit to Congress a report setting forth the joint recommendation of the Secretaries as to the advisability of continuing the operations of the Senior Oversight Committee after December 31, 2009. If the Secretaries recommend that continuing the operations of the Senior Oversight Committee after December 31, 2009, is advisable, the report may include such recommendations for the modification of the responsibilities, composition, or support of the Senior Oversight Committee as the Secretaries jointly consider appropriate.
    (c) Senior Oversight Committee Defined—
       In this section, the term `Senior Oversight Committee' means the Senior Oversight Committee jointly established by the Secretary of Defense and the Secretary of Veterans Affairs in May 2007. The Senior Oversight Committee was established to address concerns related to the treatment of wounded, ill, and injured members of the Armed Forces and veterans and serves as the single point of contact for oversight, strategy, and integration of proposed strategies for the efforts of the Department of Defense and the Department of Veterans Affairs to improve support throughout the recovery, rehabilitation, and reintegration of wounded, ill, or injured members of the Armed Forces.

#### SEC. 727. MODIFICATION OF UTILIZATION OF VETERANS' PRESUMPTION OF SOUND CONDITION IN ESTABLISHING ELIGIBILITY OF MEMBERS OF THE ARMED FORCES FOR RETIREMENT FOR DISABILITY.

    (a) Retirement of Regulars and Members on Active Duty for More Than 30 Days—
       Section 1201(b)(3)(B)(i) of title 10, United States Code, is amended—
       (1) by striking `the member has six months or more of active military service and'; and
       (2) by striking `(unless compelling evidence' and all that follows through `active duty)' and inserting `(unless clear and unmistakable evidence demonstrates that the disability existed before the member's entrance on active duty and was not aggravated by active military service)'.
    (b) Separation of Regulars and Members on Active Duty for More Than 30 Days—
       Section 1203(b)(4)(B) of such title is amended—
       (1) by striking `the member has six months or more of active military service, and'; and
       (2) by striking `(unless compelling evidence' and all that follows through `active duty)' and inserting `(unless clear and unmistakable evidence demonstrates that the disability existed before the member's entrance on active duty and was not aggravated by active military service)'.

### Subtitle D—Other Matters
#### SEC. 731. REPORT ON PROVIDING THE EXTENDED CARE HEALTH OPTION PROGRAM TO DEPENDENTS OF MILITARY RETIREES.

    (a) Report Required—
       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 on including dependents of military retirees in the ECHO program for a limited transitional period following retirement.
    (b) Contents of Report—
       The report required under subsection (a) shall include the following:
       (1) The most current data on the number of military retirees with dependents who are eligible to receive extended benefits under the ECHO program and an estimate of the number of future military retirees with dependents who are eligible to receive such benefits.
       (2) The cost estimates of providing extended benefits under the ECHO program to dependents of all current and future military retirees.
       (3) The feasibility of including dependents of military retirees in any ongoing demonstration or pilot programs within the ECHO program.
       (4) The statutory and regulatory impediments to including dependents of military retirees in the ECHO program.
    (c) ECHO Program—
       In this section, the term `ECHO program' means the Extended Care Health Option program provided pursuant to subsections (d), (e), and (f) of section 1079 of title 10, United States Code.

#### SEC. 732. INCREASE IN CAP ON EXTENDED BENEFITS UNDER EXTENDED HEALTH CARE OPTION (ECHO).

    Section 1079(f) of title 10, United States Code is amended—
       (1) in paragraph (2)(A), by striking `month shall not exceed $2,500,' and inserting `year shall not exceed $36,000, prorated as determined by the Secretary of Defense,'; and
       (2) in paragraph (2)(B), by striking `month' and inserting `year.'.

#### SEC. 733. DEPARTMENT OF DEFENSE TASK FORCE ON THE PREVENTION OF SUICIDE BY MEMBERS OF THE ARMED FORCES.

    (a) Requirement to Establish—
       The Secretary of Defense shall establish within the Department of Defense a task force to examine matters relating to prevention of suicide by members of the Armed Forces.
    (b) Composition—
       (1) MEMBERS—
          The task force shall consist of not more than 14 members appointed by the Secretary of Defense from among individuals described in paragraph (2) who have demonstrated expertise in the area of suicide prevention and response.
       (2) RANGE OF MEMBERS—
          The individuals appointed to the task force shall include—
          (A) at least one member of each of the Army, Navy, Air Force, and Marine Corps;
          (B) a number of persons from outside the Department of Defense equal to the total number of personnel from within the Department of Defense (whether members of the Armed Forces or civilian personnel) who are appointed to the task force;
          (C) persons who have experience in—
             (i) national suicide prevention policy;
             (ii) military personnel policy;
             (iii) research in the field of suicide prevention;
             (iv) clinical care in mental health; or
             (v) military chaplaincy or pastoral care; and
          (D) at least one family member of a member of the Armed Forces who has experience working with military families.
       (3) INDIVIDUALS APPOINTED OUTSIDE DEPARTMENT OF DEFENSE—
          Individuals appointed to the task force from outside the Department of Defense may include officers or employees of other departments or agencies of the Federal Government, officers or employees of State and local governments, or individuals from the private sector.
       (4) DEADLINE FOR APPOINTMENT—
          All appointments of individuals to the task force shall be made not later than 180 days after the date of the enactment of this Act.
       (5) CO-CHAIRS OF TASK FORCE—
          There shall be two co-chairs of the task force. One of the co-chairs shall be designated by the Secretary of the Defense at the time of appointment from among the Department of Defense personnel appointed to the task force. The other co-chair shall be selected from among the members appointed from outside the Department of Defense by members so appointed.
    (c) Assessment and Recommendations on Suicide Prevention Policy—
       (1) IN GENERAL—
          Not later than 12 months after the date on which all members of the task force have been appointed, the task force shall submit to the Secretary a report containing recommendations regarding a comprehensive policy designed to prevent suicide by members of the Armed Forces.
       (2) UTILIZATION OF OTHER EFFORTS—
          In preparing the report, the task force shall take into consideration completed and ongoing efforts by the military departments to improve the efficacy of suicide prevention programs.
       (3) ELEMENTS—
          The recommendations (including recommendations for legislative or administrative action) shall include measures to address the following:
          (A) Methods to identify trends and common causal factors in suicides by members of the Armed Forces.
          (B) Methods to establish or update suicide education and prevention programs conducted by each military department based on identified trends and causal factors.
          (C) An assessment of current suicide education and prevention programs of each military department.
          (D) An assessment of suicide incidence by military occupation to include identification of military occupations with a high incidence of suicide.
          (E) The appropriate type and method of investigation to determine the causes and factors surrounding each suicide by a member of the Armed Forces.
          (F) The qualifications of the individual appointed to conduct an investigation of a suicide by a member of the Armed Forces.
          (G) The required information to be determined by an investigation in order to determine the causes and factors surrounding suicides by members of the Armed Forces.
          (H) The appropriate reporting requirements following an investigation conducted on a suicide by a member of the Armed Forces.
          (I) The appropriate official or executive agent within the military department and Department of Defense to receive and analyze reports on investigations of suicides by members of the Armed Forces.
          (J) The appropriate use of the information gathered during investigations of suicides by members of the Armed Forces.
          (K) Methods for protecting confidentiality of information contained in reports of investigations of suicides by members of the Armed Forces.
    (d) Administrative Matters—
       (1) COMPENSATION—
          Each member of the task force who is a member of the Armed Forces or a civilian officer or employee of the United States shall serve without compensation (other than compensation to which entitled as a member of the Armed Forces or an officer or employee of the United States, as the case may be). Other members of the task force shall be treated for purposes of section 3161 of title 5, United States Code, as having been appointed under subsection (b) of such section.
       (2) OVERSIGHT—
          The Under Secretary of Defense for Personnel and Readiness shall oversee the activities of the task force.
       (3) ADMINISTRATIVE SUPPORT—
          The Washington Headquarters Services of the Department of Defense shall provide the task force with personnel, facilities, and other administrative support as necessary for the performance of the duties of the task force.
       (4) ACCESS TO FACILITIES—
          The Under Secretary of Defense for Personnel and Readiness shall, in coordination with the Secretaries of the military departments, ensure appropriate access by the task force to military installations and facilities for purposes of the discharge of the duties of the task force.
    (e) Report—
       (1) IN GENERAL—
          The task force shall submit to the Secretary of Defense a report on its activities under this section. The report shall include—
          (A) a description of the activities of the task force;
          (B) the assessment and recommendations required by subsection (c); and
          (C) such other matters relating to the activities of the task force that the task force considers appropriate.
       (2) TRANSMITTAL TO CONGRESS—
          Not later than 90 days after receipt of the report under paragraph (1), the Secretary shall transmit the report to the Committees on Armed Services of the Senate and the House of Representatives. The Secretary may include in the transmittal such comments on the report as the Secretary considers appropriate.
    (f) Plan Required—
       Not later than March 1, 2010, the Secretary of Defense shall develop a plan based on the recommendations of the task force and submit the plan to the congressional defense committees.
    (g) Termination—
       The task force shall terminate 90 days after the date on which the report of the task force is submitted to Congress under subsection (e)(2).

#### SEC. 734. TRANSITIONAL HEALTH CARE FOR CERTAIN MEMBERS OF THE ARMED FORCES WHO AGREE TO SERVE IN THE SELECTED RESERVE OF THE READY RESERVE.

    (a) Provision of Transitional Health Care—
       Section 1145(a)(2) of title 10, United States Code, is amended by adding at the end the following new subparagraph:
                   `(F) A member who is separated from active duty who agrees to become a member of the Selected Reserve of the Ready Reserve of a reserve component.'.
    (b) Effective Date—
       Subparagraph (F) of section 1145(a)(2) of title 10, United States Code, as added by subsection (a), shall apply with respect to members of the Armed Forces separated from active duty after the date of the enactment of this Act.

#### SEC. 735. ENHANCEMENT OF MEDICAL AND DENTAL READINESS OF MEMBERS OF THE ARMED FORCES.

    (a) Expansion of Availability of Medical and Dental Services for Reserves—
       (1) EXPANSION OF AVAILABILITY FOR RESERVES ASSIGNED TO UNITS SCHEDULED FOR DEPLOYMENT WITHIN 75 DAYS OF MOBILIZATION—
          Subsection (d)(1) of section 1074a of title 10, United States Code, is amended by striking `The Secretary of the Army shall provide to members of the Selected Reserve of the Army' and inserting `The Secretary concerned shall provide to members of the Selected Reserve'.
       (2) AVAILABILITY FOR CERTAIN OTHER RESERVES—
          Such section is further amended by adding at the end the following new subsection:
             `(g)(1) The Secretary concerned may provide to any member of the Selected Reserve not described in subsection (d)(1) or (f), and to any member of the Individual Ready Reserve described in section 10144(b) of this title the medical and dental services specified in subsection (d)(1) if the Secretary determines that the receipt of such services by such member is necessary to ensure that the member meets applicable standards of medical and dental readiness.
                `(2) Services may not be provided to a member under this subsection for a condition that is the result of the member's own misconduct.
                `(3) The services provided under this subsection shall be provided at no cost to the member.'.
       (3) FUNDING—
          Such section is further amended by adding at the end the following new subsection:
             `(h) Amounts available for operation and maintenance of a reserve component of the armed forces may be available for purposes of this section to ensure the medical and dental readiness of members of such reserve component.'.
    (b) Waiver of Certain Copayments for Dental Care for Reserves for Readiness Purposes—
       Section 1076a(e) of such title is amended—
                (1) by redesignating paragraphs (1), (2), and (3) as subparagraphs (A), (B), and (C), respectively;
                (2) by striking `A member or dependent' and inserting `(1) Except as provided pursuant to paragraph (2), a member or dependent'; and
                (3) by adding at the end the following new paragraph:
                `(2)(A) During a national emergency declared by the President or Congress and subject to regulations prescribed by the Secretary of Defense, the Secretary may waive, in whole or in part, the charges otherwise payable by a member of the Selected Reserve of the Ready Reserve or a member of the Individual Ready Reserve under paragraph (1) for the coverage of the member alone under the dental insurance plan established under subsection (a)(1) if the Secretary determines that such waiver of the charges would facilitate or ensure the readiness of a unit or individual for deployment.
                   `(B) The waiver under subparagraph (A) may apply only with respect to charges for coverage of dental care required for readiness.'.
    (c) Report on Policies and Procedures in Support of Medical and Dental Readiness—
       (1) IN GENERAL—
          Not later than March 1, 2009, the Secretary of Defense shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report on the policies and procedures of the Department of Defense to ensure the medical and dental readiness of members of the Armed Forces.
       (2) ELEMENTS—
          The report required by paragraph (1) shall include the following:
          (A) A description of the current standards of each military department with respect to the medical and dental readiness of individual members of the Armed Forces (including members of the regular components and members of the reserve components), and with respect to the medical and dental readiness of units of the Armed Forces (including units of the regular components and units of the reserve components), under the jurisdiction of such military department.
          (B) A description of the manner in which each military department applies the standards described under subparagraph (A) with respect to each of the following:
             (i) Performance evaluation.
             (ii) Promotion.
             (iii) In the case of the members of the reserve components, eligibility to attend annual training.
             (iv) Continued retention in the Armed Forces.
             (v) Such other matters as the Secretary considers appropriate.
          (C) A statement of the number of members of the Armed Forces (including members of the regular components and members of the reserve components) who were determined to be not ready for deployment at any time during the period beginning on October 1, 2001, and ending on September 30, 2008, due to failure to meet applicable medical or dental standards, and an assessment of whether the unreadiness of such members for deployment could reasonably have been mitigated by actions of the members concerned to maintain individual medical or dental readiness.
          (D) A description of any actual or perceived barriers to the achievement of full medical and dental readiness in the Armed Forces (including among the regular components and the reserve components), including barriers associated with the following:
             (i) Quality or cost of, or access to, medical and dental care.
             (ii) Availability of programs and incentives intended to prevent medical or dental problems.
          (E) Such recommendations for legislative or administrative action as the Secretary considers appropriate to ensure the medical and dental readiness of individual members of the Armed Forces and units of the Armed Forces, including recommendations regarding the following:
             (i) The advisability of requiring that fitness reports of members of the Armed Forces include—
                (I) a statement of whether or not a member meets medical and dental readiness standards for deployment; and
                (II) in cases in which a member does not meet such standard, a statement of actions being taken to ensure that the member meets such standards and the anticipated schedule for meeting such standards.
             (ii) The advisability of establishing a mandatory promotion standard relating to individual medical and dental readiness and, in the case of a unit commander, unit medical and dental readiness.