I 

110TH CONGRESS 

1ST SESSION H. R. 1578 

To establish and monitor medical holdover performance standards. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 20, 2007 

Mr. SHAYS (for himself, Mr. TOM DAVIS of Virginia, Mr. BUCHANAN, and Mr. 

BILIRAKIS) introduced the following bill; which was referred to the Committee on Armed Services 

A BILL 

To establish and monitor medical holdover performance 

standards. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Wounded Warriors 

5 Joint Health Care Performance Metrics and Transparency 

6 Act’’. 

7 SEC. 2. ESTABLISHMENT AND MONITORING OF MEDICAL 

8 HOLDOVER PERFORMANCE STANDARDS. 

9 (a) REQUIREMENT FOR PERFORMANCE STANDARDS

10 FOR MEDICAL HOLDOVER PROCESS.—The Secretary of 

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1 Defense shall assign the Assistant Secretary of Defense 

2 for Health Affairs the responsibility for establishing per3 formance standards for each step of the medical holdover 

4 process, including the following: 

5 (1) Mobilization. 

6 (2) Medical condition. 

7 (3) MNO decision. 

8 (4) Disposition plan. 

9 (5) Execution plan. 

10 (6) Final disposition decision of a medical eval11 uation board or physical evaluation board. 

12 (7) Transition. 

13 (b) QUARTERLY INSPECTIONS.— 

14 (1) REQUIREMENT FOR INSPECTIONS.—The 

15 Secretary of Defense, acting through the Assistant 

16 Secretary of Defense for Health Affairs, shall re17 quire each military medical installation to perform a 

18 quarterly inspection based on the performance 

19 standards established under subsection (a) of the 

20 following: command and control responsibilities, 

21 billeting, staffing, soldier administration, staff train22 ing, in and out processing, transition and separation 

23 processing, dining facilities and other non-medical 

24 patient services, transportation, medical case man25 agement, medical care, access and documentation, 

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1 and medical database and medical records quality. 

2 Inspections teams should include representatives 

3 from all commands with jurisdiction over medical 

4 and administrative services provided to injured and 

5 wounded soldiers, and shall include representatives 

6 from the Department of Defense and the Inspector 

7 General of the Department of Defense. 

8 (2) INSPECTION REPORTS.—The Assistant Sec9 retary shall require a report on each inspection car10 ried out under paragraph (1) to be submitted to the 

11 Secretary of Defense, the Inspector General of the 

12 Department of Defense, each command or agency 

13 with jurisdiction, the Secretary of each military de14 partment, the chief of staff of each Armed Force, 

15 and the inspector general of each military depart16 ment. 

17 (c) ADDITIONAL SPECIFIC STANDARDS.— 

18 (1) SECURITY AND MEDICAL PERSONNEL.—The 

19 Assistant Secretary of Defense for Health Affairs 

20 shall develop and enforce standards for security per21 sonnel and medical personnel to perform daily 

22 rounds of each medical inpatient and outpatient fa23 cility. The standards shall include a requirement for 

24 access to help 24 hours a day for patients with med25 ical emergencies or needs. 

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1 (2) TIMELINESS.—The Assistant Secretary also 

2 shall develop and enforce standards for setting time 

3 standards for responding to patient questions and 

4 scheduling appointments for medical evaluation 

5 board and physical evaluation board evaluations. 

6 (3) PROCESSING.—The Assistant Secretary also 

7 shall develop and enforce in-processing and out-proc8 essing standards, patient counseling standards, and 

9 information standards to address patient and family 

10 members on all aspects of care, including medical 

11 and administrative evaluation procedures and re12 quirements. 

13 (d) MONTHLY REPORTS.— 

14 (1) REQUIREMENT.—The Assistant Secretary 

15 of Defense for Health Affairs shall submit to the 

16 Secretary of Defense and the Inspector General of 

17 the Department of Defense a monthly report on 

18 military service performance in all categories of med19 ical holdover patient care including, at a minimum, 

20 inspections, individual patient information, trends 

21 and problems, statistical information on time of pa22 tients in medical holdover status, performance of 

23 service commands, and other service personnel serv24 ing patients and families in medical holder status. 

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1 (2) ADDITIONAL MATTERS COVERED.—The re2 port also shall contain— 

3 (A) information on all individual patient 

4 complaints and action taken to mediate the pa5 tient concern; 

6 (B) information on all concerns raised by 

7 patient advocates to military service installation 

8 commanders and report on actions taken; and 

9 (C) statistical information on the inci10 dence, treatments, and outcomes of traumatic 

11 brain injury patients among the medical hold12 over patient population. 

13 (e) SEMI-ANNUAL MEETINGS.—The Assistant Sec14 retary of Defense for Health Affairs shall meet semi-annu15 ally with the Secretaries of the military departments to 

16 address medical holdover program execution, including all 

17 medical and administrative issues, force structure, man18 ning, training, and resource requirements. 

19 (f) INSPECTOR GENERAL RESPONSIBILITIES.—The 

20 Inspector General of the Department of Defense shall 

21 audit and review the medical holdover system and the per22 formance standards developed under this section and shall 

23 submit quarterly reports to the Assistant Secretary of De24 fense for Health Affairs, the Secretaries of the military 

25 departments, and the following congressional committees: 

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1 (1) The Committees on Armed Services of the 

2 Senate and the House of Representatives. 

3 (2) The Committee on Homeland Security and 

4 Governmental Affairs of the Senate. 

5 (3) The Committee on Oversight and Govern6 ment Reform of the House of Representatives. 

7 (g) MEDICAL HOLDOVER PATIENT.—In this Act, the 

8 term ‘‘medical holdover patient’’ means a member of the 

9 Armed Forces, including a member of the National Guard 

10 or other reserve component, who is undergoing medical 

11 treatment, recuperation, or therapy, or is otherwise in 

12 medical hold or holdover status, for an injury, illness, or 

13 disease incurred or aggravated while on active duty in the 

14 Armed Forces. 

15 (h) AUTHORIZATION.—There is authorized to be ap16 propriated to carry out— 

17 (1) subsections (a) through (e) of this Act, 

18 $1,000,000 for fiscal year 2007; and 

19 (2) subsection (f) of this Act, $2,000,000 for 

20 fiscal year 2007 and $3,000,000 for fiscal year 

21 2008. 

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