II

September 5, 2007

Ordered to be printed as passed

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:

1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

2 (a) SHORT TITLE.—This Act may be cited as the

3 ‘‘Dignified Treatment of Wounded Warriors Act’’.

4 (b) TABLE OF CONTENTS.—The table of contents for

5 this Act is as follows:

Sec. 1. Short title; table of contents.

TITLE I—WOUNDED WARRIOR MATTERS

Sec. 101. General definitions.
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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 posttraumatic stress disorder.

Sec. 136. Reports.

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.
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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.
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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.

1 TITLE I—WOUNDED WARRIOR

2 MATTERS

3 SEC. 101. GENERAL DEFINITIONS.

4 In this title:

5 (1) The term ‘‘appropriate committees of Con6 gress’’ means—

7 (A) the Committees on Armed Services and

8 Veterans’ Affairs of the Senate; and

9 (B) the Committees on Armed Services and

10 Veterans’ Affairs of the House of Representatives.

11 (2) The term ‘‘covered member of the Armed

12 Forces’’ means a member of the Armed Forces, includ13 ing a member of the National Guard or a Reserve,

14 who is undergoing medical treatment, recuperation,

15 or therapy, is otherwise in medical hold or medical
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1 holdover status, or is otherwise on the temporary dis2 ability retired list for a serious injury or illness.

3 (3) The term ‘‘family member’’, with respect to

4 a member of the Armed Forces or a veteran, has the

5 meaning given that term in section 411h(b) of title

6 37, United States Code.

7 (4) The term ‘‘medical hold or medical holdover

8 status’’ means—

9 (A) the status of a member of the Armed

10 Forces, including a member of the National

11 Guard or Reserve, assigned or attached to a

12 military hospital for medical care; and

13 (B) the status of a member of a reserve com14 ponent of the Armed Forces who is separated,

15 whether pre-deployment or post-deployment,

16 from the member’s unit while in need of health

17 care based on a medical condition identified

18 while the member is on active duty in the Armed

19 Forces.

20 (5) The term ‘‘serious injury or illness’’, in the

21 case of a member of the Armed Forces, means an in22 jury or illness incurred by the member in line of duty

23 on active duty in the Armed Forces that may render

24 the member medically unfit to perform the duties of

25 the member’s office, grade, rank, or rating.
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1 (6) The term ‘‘TRICARE program’’ has the

2 meaning given that term in section 1072(7) of title

3 10, United States Code.

4 Subtitle A—Policy on Care, Man5 agement, and Transition of

6 Servicemembers With Serious In7 juries or Illnesses

8 SEC. 111. COMPREHENSIVE POLICY ON CARE, MANAGE9 MENT, AND TRANSITION OF MEMBERS OF

10 THE ARMED FORCES WITH SERIOUS INJU11 RIES OR ILLNESSES.

12 (a) COMPREHENSIVE POLICY REQUIRED.—

13 (1) IN GENERAL.—Not later than January 1,

14 2008, the Secretary of Defense and the Secretary of

15 Veterans Affairs shall, to the extent feasible, jointly

16 develop and implement a comprehensive policy on the

17 care and management of members of the Armed

18 Forces who are undergoing medical treatment, recu19 peration, or therapy, are otherwise in medical hold or

20 medical holdover status, or are otherwise on the tem21 porary disability retired list for a serious injury or

22 illness (hereafter in this section referred to as a ‘‘cov23 ered servicemembers’’).

24 (2) SCOPE OF POLICY.—The policy shall cover

25 each of the following:
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1 (A) The care and management of covered

2 servicemembers while in medical hold or medical

3 holdover status or on the temporary disability

4 retired list.

5 (B) The medical evaluation and disability

6 evaluation of covered servicemembers.

7 (C) The return of covered servicemembers to

8 active duty when appropriate.

9 (D) The transition of covered

10 servicemembers from receipt of care and services

11 through the Department of Defense to receipt of

12 care and services through the Department of Vet13 erans Affairs.

14 (3) CONSULTATION.—The Secretary of Defense

15 and the Secretary of Veterans Affairs shall develop the

16 policy in consultation with the heads of other appro17 priate departments and agencies of the Federal Gov18 ernment and with appropriate non-governmental or19 ganizations having an expertise in matters relating to

20 the policy.

21 (4) UPDATE.—The Secretary of Defense and the

22 Secretary of Veterans Affairs shall jointly update the

23 policy on a periodic basis, but not less often than an24 nually, in order to incorporate in the policy, as ap25 propriate, the results of the reviews under subsections
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1 (b) and (c) and the best practices identified through

2 pilot programs under section 154.

3 (b) REVIEW OF CURRENT POLICIES AND PROCE4 DURES.—

5 (1) REVIEW REQUIRED.—In developing the pol6 icy required by this section, the Secretary of Defense

7 and the Secretary of Veterans Affairs shall, to the ex8 tent necessary, jointly and separately conduct a re9 view of all policies and procedures of the Department

10 of Defense and the Department of Veterans Affairs

11 that apply to, or shall be covered by, the policy.

12 (2) PURPOSE.—The purpose of the review shall

13 be to identify the most effective and patient-oriented

14 approaches to care and management of covered

15 servicemembers for purposes of—

16 (A) incorporating such approaches into the

17 policy; and

18 (B) extending such approaches, where ap19 plicable, to care and management of other in20 jured or ill members of the Armed Forces and

21 veterans.

22 (3) ELEMENTS.—In conducting the review, the

23 Secretary of Defense and the Secretary of Veterans Af24 fairs shall—
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1 (A) identify among the policies and proce2 dures described in paragraph (1) best practices

3 in approaches to the care and management de4 scribed in that paragraph;

5 (B) identify among such policies and proce6 dures existing and potential shortfalls in such

7 care and management (including care and man8 agement of covered servicemembers on the tem9 porary disability retired list), and determine

10 means of addressing any shortfalls so identified;

11 (C) determine potential modifications of

12 such policies and procedures in order to ensure

13 consistency and uniformity among the military

14 departments and the regions of the Department

15 of Veterans Affairs in their application and dis16 charge; and

17 (D) develop recommendations for legislative

18 and administrative action necessary to imple19 ment the results of the review.

20 (4) DEADLINE FOR COMPLETION.—The review

21 shall be completed not later than 90 days after the

22 date of the enactment of this Act.

23 (c) CONSIDERATION OF FINDINGS, RECOMMENDA24 TIONS, AND PRACTICES.—In developing the policy required
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1 by this section, the Secretary of Defense and the Secretary

2 of Veterans Affairs shall take into account the following:

3 (1) The findings and recommendations of appli4 cable studies, reviews, reports, and evaluations that

5 address matters relating to the policy, including, but

6 not limited, to the following:

7 (A) The Independent Review Group on Re8 habilitative Care and Administrative Processes

9 at Walter Reed Army Medical Center and Na10 tional Naval Medical Center appointed by the

11 Secretary of Defense.

12 (B) The Secretary of Veterans Affairs Task

13 Force on Returning Global War on Terror He14 roes appointed by the President.

15 (C) The President’s Commission on Care for

16 America’s Returning Wounded Warriors.

17 (D) The Veterans’ Disability Benefits Com18 mission established by title XV of the National

19 Defense Authorization Act for Fiscal Year 2004

20 (Public Law 108–136; 117 Stat. 1676; 38 U.S.C.

21 1101 note).

22 (E) The President’s Commission on Vet23 erans’ Pensions, of 1956, chaired by General

24 Omar N. Bradley.
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1 (F) The Report of the Congressional Com2 mission on Servicemembers and Veterans Transi3 tion Assistance, of 1999, chaired by Anthony J.

4 Principi.

5 (G) The President’s Task Force to Improve

6 Health Care Delivery for Our Nation’s Veterans,

7 of March 2003.

8 (2) The experience and best practices of the De9 partment of Defense and the military departments on

10 matters relating to the policy.

11 (3) The experience and best practices of the De12 partment of Veterans Affairs on matters relating to

13 the policy.

14 (4) Such other matters as the Secretary of De15 fense and the Secretary of Veterans Affairs consider

16 appropriate.

17 (d) PARTICULAR ELEMENTS OF POLICY.—The policy

18 required by this section shall provide, in particular, the fol19 lowing:

20 (1) RESPONSIBILITY FOR COVERED

21 SERVICEMEMBERS IN MEDICAL HOLD OR MEDICAL

22 HOLDOVER STATUS OR ON TEMPORARY DISABILITY

23 RETIRED LIST.—Mechanisms to ensure responsibility

24 for covered servicemembers in medical hold or medical
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1 holdover status or on the temporary disability retired

2 list, including the following:

3 (A) Uniform standards for access of covered

4 servicemembers to non-urgent health care services

5 from the Department of Defense or other pro6 viders under the TRICARE program, with such

7 access to be—

8 (i) for follow-up care, within 2 days of

9 request of care;

10 (ii) for specialty care, within 3 days of

11 request of care;

12 (iii) for diagnostic referrals and stud13 ies, within 5 days of request; and

14 (iv) for surgery based on a physician’s

15 determination of medical necessity, within

16 14 days of request.

17 (B) Requirements for the assignment of ade18 quate numbers of personnel for the purpose of re19 sponsibility for and administration of covered

20 servicemembers in medical hold or medical hold21 over status or on the temporary disability retired

22 list.

23 (C) Requirements for the assignment of ade24 quate numbers of medical personnel and non25 medical personnel to roles and responsibilities
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1 for caring for and administering covered

2 servicemembers in medical hold or medical hold3 over status or on the temporary disability retired

4 list, and a description of the roles and respon5 sibilities of personnel so assigned.

6 (D) Guidelines for the location of care for

7 covered servicemembers in medical hold or med8 ical holdover status or on the temporary dis9 ability retired list, which guidelines shall address

10 the assignment of such servicemembers to care

11 and residential facilities closest to their duty sta12 tion or home of record or the location of their

13 designated caregiver at the earliest possible time.

14 (E) Criteria for work and duty assignments

15 of covered servicemembers in medical hold or

16 medical holdover status or on the temporary dis17 ability retired list, including a prohibition on

18 the assignment of duty to a servicemember which

19 is incompatible with the servicemember’s medical

20 condition.

21 (F) Guidelines for the provision of care and

22 counseling for eligible family members of covered

23 servicemembers in medical hold or medical hold24 over status or on the temporary disability retired

25 list.
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1 (G) Requirements for case management of

2 covered servicemembers in medical hold or med3 ical holdover status or on the temporary dis4 ability retired list, including qualifications for

5 personnel providing such case management.

6 (H) Requirements for uniform quality of

7 care and administration for all covered

8 servicemembers in medical hold or medical hold9 over status or on the temporary disability retired

10 list, whether members of the regular components

11 of the Armed Forces or members of the reserve

12 components of the Armed Forces.

13 (I) Standards for the conditions and acces14 sibility of residential facilities for covered

15 servicemembers in medical hold or medical hold16 over status or on the temporary disability retired

17 list who are in outpatient status, and for their

18 immediate family members.

19 (J) Requirements on the provision of trans20 portation and subsistence for covered

21 servicemembers in medical hold or medical hold22 over status or on the temporary disability retired

23 list, whether in inpatient status or outpatient

24 status, to facilitate obtaining needed medical

25 care and services.
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1 (K) Requirements on the provision of edu2 cational and vocational training and rehabilita3 tion opportunities for covered servicemembers in

4 medical hold or medical holdover status or on the

5 temporary disability retired list.

6 (L) Procedures for tracking and informing

7 covered servicemembers in medical hold or med8 ical holdover status or on the temporary dis9 ability retired list about medical evaluation

10 board and physical disability evaluation board

11 processing.

12 (M) Requirements for integrated case man13 agement of covered servicemembers in medical

14 hold or medical holdover status or on the tem15 porary disability retired list during their transi16 tion from care and treatment through the De17 partment of Defense to care and treatment

18 through the Department of Veterans Affairs.

19 (N) Requirements and standards for advis20 ing and training, as appropriate, family mem21 bers with respect to care for covered

22 servicemembers in medical hold or medical hold23 over status or on the temporary disability retired

24 list with serious medical conditions, particularly
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1 traumatic brain injury (TBI), burns, and post2 traumatic stress disorder (PTSD).

3 (O) Requirements for periodic reassessments

4 of covered servicemembers, and limits on the

5 length of time such servicemembers may be re6 tained in medical hold or medical holdover sta7 tus or on the temporary disability retired list.

8 (P) Requirements to inform covered

9 servicemembers and their family members of

10 their rights and responsibilities while in medical

11 hold or medical holdover status or on the tem12 porary disability retired list.

13 (Q) The requirement to establish a Depart14 ment of Defense-wide Ombudsman Office within

15 the Office of the Secretary of Defense to provide

16 oversight of the ombudsman offices in the mili17 tary departments and policy guidance to such of18 fices with respect to providing assistance to, and

19 answering questions from, covered

20 servicemembers and their families.

21 (2) MEDICAL EVALUATION AND PHYSICAL DIS22 ABILITY EVALUATION FOR COVERED

23 SERVICEMEMBERS.—

24 (A) MEDICAL EVALUATIONS.—Processes,

25 procedures, and standards for medical evalua-
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1 tions of covered servicemembers, including the

2 following:

3 (i) Processes for medical evaluations of

4 covered servicemembers that are—

5 (I) applicable uniformly through6 out the military departments; and

7 (II) applicable uniformly with re8 spect to such servicemembers who are

9 members of the regular components of

10 the Armed Forces and such

11 servicemembers who are members of the

12 National Guard and Reserve.

13 (ii) Standard criteria and definitions

14 for determining the achievement for covered

15 servicemembers of the maximum medical

16 benefit from treatment and rehabilitation.

17 (iii) Standard timelines for each of the

18 following:

19 (I) Determinations of fitness for

20 duty of covered servicemembers.

21 (II) Specialty consultations for

22 covered servicemembers.

23 (III) Preparation of medical doc24 uments for covered servicemembers.
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1 (IV) Appeals by covered

2 servicemembers of medical evaluation

3 determinations, including determina4 tions of fitness for duty.

5 (iv) Uniform standards for qualifica6 tions and training of medical evaluation

7 board personnel, including physicians, case

8 workers, and physical disability evaluation

9 board liaison officers, in conducting medical

10 evaluations of covered servicemembers.

11 (v) Standards for the maximum num12 ber of medical evaluation cases of covered

13 servicemembers that are pending before a

14 medical evaluation board at any one time,

15 and requirements for the establishment of

16 additional medical evaluation boards in the

17 event such number is exceeded.

18 (vi) Uniform standards for informa19 tion for covered servicemembers, and their

20 families, on the medical evaluation board

21 process and the rights and responsibilities of

22 such servicemembers under that process, in23 cluding a standard handbook on such infor24 mation.
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1 (B) PHYSICAL DISABILITY EVALUATIONS.—

2 Processes, procedures, and standards for physical

3 disability evaluations of covered servicemembers,

4 including the following:

5 (i) A non-adversarial process of the

6 Department of Defense and the Department

7 of Veterans Affairs for disability determina8 tions of covered servicemembers.

9 (ii) To the extent feasible, procedures to

10 eliminate unacceptable discrepancies among

11 disability ratings assigned by the military

12 departments and the Department of Vet13 erans Affairs, particularly in the disability

14 evaluation of covered servicemembers, which

15 procedures shall be subject to the following

16 requirements and limitations:

17 (I) Such procedures shall apply

18 uniformly with respect to covered

19 servicemembers who are members of the

20 regular components of the Armed

21 Forces and covered servicemembers who

22 are members of the National Guard

23 and Reserve.

24 (II) Under such procedures, each

25 Secretary of a military department
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1 shall, to the extent feasible, utilize the

2 standard schedule for rating disabil3 ities in use by the Department of Vet4 erans Affairs, including any applicable

5 interpretation of such schedule by the

6 United States Court of Appeals for Vet7 erans Claims, in making any deter8 mination of disability of a covered

9 servicemember.

10 (iii) Standard timelines for appeals of

11 determinations of disability of covered

12 servicemembers, including timelines for

13 presentation, consideration, and disposition

14 of appeals.

15 (iv) Uniform standards for qualifica16 tions and training of physical disability

17 evaluation board personnel in conducting

18 physical disability evaluations of covered

19 servicemembers.

20 (v) Standards for the maximum num21 ber of physical disability evaluation cases of

22 covered servicemembers that are pending be23 fore a physical disability evaluation board

24 at any one time, and requirements for the

25 establishment of additional physical dis-
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1 ability evaluation boards in the event such

2 number is exceeded.

3 (vi) Procedures for the provision of

4 legal counsel to covered servicemembers

5 while undergoing evaluation by a physical

6 disability evaluation board.

7 (vii) Uniform standards on the roles

8 and responsibilities of case managers,

9 servicemember advocates, and judge advo10 cates assigned to covered servicemembers

11 undergoing evaluation by a physical dis12 ability board, and uniform standards on the

13 maximum number of cases involving such

14 servicemembers that are to be assigned to

15 such managers and advocates.

16 (C) RETURN OF COVERED

17 SERVICEMEMBERS TO ACTIVE DUTY.—Standards

18 for determinations by the military departments

19 on the return of covered servicemembers to active

20 duty in the Armed Forces.

21 (D) TRANSITION OF COVERED

22 SERVICEMEMBERS FROM DOD TO VA.—Processes,

23 procedures, and standards for the transition of

24 covered servicemembers from care and treatment

25 by the Department of Defense to care and treat-
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1 ment by the Department of Veterans Affairs be2 fore, during, and after separation from the

3 Armed Forces, including the following:

4 (i) A uniform, patient-focused policy to

5 ensure that the transition occurs without

6 gaps in medical care and the quality of

7 medical care, benefits, and services.

8 (ii) Procedures for the identification

9 and tracking of covered servicemembers dur10 ing the transition, and for the coordination

11 of care and treatment of such

12 servicemembers during the transition, in13 cluding a system of cooperative case man14 agement of such servicemembers by the De15 partment of Defense and the Department of

16 Veterans Affairs during the transition.

17 (iii) Procedures for the notification of

18 Department of Veterans Affairs liaison per19 sonnel of the commencement by covered

20 servicemembers of the medical evaluation

21 process and the physical disability evalua22 tion process.

23 (iv) Procedures and timelines for the

24 enrollment of covered servicemembers in ap25 plicable enrollment or application systems
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1 of the Department of Veterans with respect

2 to health care, disability, education, voca3 tional rehabilitation, or other benefits.

4 (v) Procedures to ensure the access of

5 covered servicemembers during the transi6 tion to vocational, educational, and reha7 bilitation benefits available through the De8 partment of Veterans Affairs.

9 (vi) Standards for the optimal location

10 of Department of Defense and Department

11 of Veterans Affairs liaison and case man12 agement personnel at military medical

13 treatment facilities, medical centers, and

14 other medical facilities of the Department of

15 Defense.

16 (vii) Standards and procedures for in17 tegrated medical care and management for

18 covered servicemembers during the transi19 tion, including procedures for the assign20 ment of medical personnel of the Depart21 ment of Veterans Affairs to Department of

22 Defense facilities to participate in the needs

23 assessments of such servicemembers before,

24 during, and after their separation from

25 military service.
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1 (viii) Standards for the preparation of

2 detailed plans for the transition of covered

3 servicemembers from care and treatment by

4 the Department of Defense to care and

5 treatment by the Department of Veterans

6 Affairs, which plans shall be based on

7 standardized elements with respect to care

8 and treatment requirements and other ap9 plicable requirements.

10 (E) OTHER MATTERS.—The following addi11 tional matters with respect to covered

12 servicemembers:

13 (i) Access by the Department of Vet14 erans Affairs to the military health records

15 of covered servicemembers who are receiving

16 care and treatment, or are anticipating re17 ceipt of care and treatment, in Department

18 of Veterans Affairs health care facilities.

19 (ii) Requirements for utilizing, in ap20 propriate cases, a single physical examina21 tion that meets requirements of both the De22 partment of Defense and the Department of

23 Veterans Affairs for covered servicemembers

24 who are being retired, separated, or released

25 from military service.
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1 (iii) Surveys and other mechanisms to

2 measure patient and family satisfaction

3 with the provision by the Department of

4 Defense and the Department of Veterans Af5 fairs of care and services for covered

6 servicemembers, and to facilitate appro7 priate oversight by supervisory personnel of

8 the provision of such care and services.

9 (3) REPORT ON REDUCTION IN DISABILITY RAT10 INGS BY THE DEPARTMENT OF DEFENSE.—The Sec11 retary of Defense shall submit a report to the Com12 mittees on Armed Services of the Senate and House

13 of Representatives on the number of instances in

14 which a disability rating assigned to a member of the

15 Armed Forces by an informal physical evaluation

16 board of the Department of Defense was reduced upon

17 appeal, and the reasons for such reduction. Such re18 port shall cover the period beginning October 7, 2001,

19 and ending September 30, 2006, and shall be sub20 mitted to the appropriate committees of Congress by

21 February 1, 2008.

22 (e) REPORTS.—

23 (1) REPORT ON POLICY.—Upon the development

24 of the policy required by this section but not later

25 than January 1, 2008, the Secretary of Defense and
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1 the Secretary of Veterans Affairs shall jointly submit

2 to the appropriate committees of Congress a report on

3 the policy, including a comprehensive and detailed

4 description of the policy and of the manner in which

5 the policy addresses the findings and recommenda6 tions of the reviews under subsections (b) and (c).

7 (2) REPORTS ON UPDATE.—Upon updating the

8 policy under subsection (a)(4), the Secretary of De9 fense and the Secretary of Veterans Affairs shall joint10 ly submit to the appropriate committees of Congress

11 a report on the update of the policy, including a com12 prehensive and detailed description of such update

13 and of the reasons for such update.

14 (f) COMPTROLLER GENERAL ASSESSMENT OF IMPLE15 MENTATION.—Not later than six months after the date of

16 the enactment of this Act and every year thereafter, the

17 Comptroller General of the United States shall submit to

18 the appropriate committees of Congress a report setting

19 forth the assessment of the Comptroller General of the

20 progress of the Secretary of Defense and the Secretary of

21 Veterans Affairs in developing and implementing the policy

22 required by this section.
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1 SEC. 112. CONSIDERATION OF NEEDS OF WOMEN MEMBERS

2 OF THE ARMED FORCES AND VETERANS.

3 (a) IN GENERAL.—In developing and implementing

4 the policy required by section 111, and in otherwise car5 rying out any other provision of this title or any amend6 ment made by this title, the Secretary of Defense and the

7 Secretary of Veterans Affairs shall take into account and

8 fully address any unique specific needs of women members

9 of the Armed Forces and women veterans under such policy

10 or other provision.

11 (b) REPORTS.—In submitting any report required by

12 this title or an amendment made by this title, the Secretary

13 of Defense and the Secretary of Veterans Affairs shall, to

14 the extent applicable, include a description of the manner

15 in which the matters covered by such report address the

16 unique specific needs of women members of the Armed

17 Forces and women veterans.

18 Subtitle B—Health Care

19 PART I—ENHANCED AVAILABILITY OF CARE FOR

20 SERVICEMEMBERS

21 SEC. 121. MEDICAL CARE AND OTHER BENEFITS FOR MEM22 BERS AND FORMER MEMBERS OF THE ARMED

23 FORCES WITH SEVERE INJURIES OR ILL24 NESSES.

25 (a) MEDICAL AND DENTAL CARE FOR MEMBERS AND

26 FORMER MEMBERS.—
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1 (1) IN GENERAL.—Effective as of the date of the

2 enactment of this Act and subject to regulations pre3 scribed by the Secretary of Defense, any covered mem4 ber of the Armed Forces, and any former member of

5 the Armed Forces, with a severe injury or illness is

6 entitled to medical and dental care in any facility of

7 the uniformed services under section 1074(a) of title

8 10, United States Code, or through any civilian

9 health care provider authorized by the Secretary to

10 provide health and mental health services to members

11 of the uniformed services, including traumatic brain

12 injury (TBI) and post-traumatic stress disorder

13 (PTSD), as if such member or former member were

14 a member of the uniformed services described in para15 graph (2) of such section who is entitled to medical

16 and dental care under such section.

17 (2) PERIOD OF AUTHORIZED CARE.—(A) Except

18 as provided in subparagraph (B), a member or

19 former member described in paragraph (1) is entitled

20 to care under that paragraph—

21 (i) in the case of a member or former mem22 ber whose severe injury or illness concerned is in23 curred or aggravated during the period begin24 ning on October 7, 2001, and ending on the date

25 of the enactment of this Act, during the three-
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1 year period beginning on the date of the enact2 ment of this Act, except that no compensation is

3 payable by reason of this subsection for any pe4 riod before the date of the enactment of this Act;

5 or

6 (ii) in the case of a member or former mem7 ber whose severe injury or illness concerned is in8 curred or aggravated on or after the date of the

9 enactment of this Act, during the three-year pe10 riod beginning on the date on which such injury

11 or illness is so incurred or aggravated.

12 (B) The period of care authorized for a member

13 or former member under this paragraph may be ex14 tended by the Secretary concerned for an additional

15 period of up to two years if the Secretary concerned

16 determines that such extension is necessary to assure

17 the maximum feasible recovery and rehabilitation of

18 the member or former member. Any such determina19 tion shall be made on a case-by-case basis.

20 (3) INTEGRATED CARE MANAGEMENT.—The Sec21 retary of Defense shall provide for a program of inte22 grated care management in the provision of care and

23 services under this subsection, which management

24 shall be provided by appropriate medical and case

25 management personnel of the Department of Defense
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1 and the Department of Veterans Affairs (as approved

2 by the Secretary of Veterans Affairs) and with appro3 priate support from the Department of Defense re4 gional health care support contractors.

5 (4) WAIVER OF LIMITATIONS TO MAXIMIZE

6 CARE.—The Secretary of Defense may, in providing

7 medical and dental care to a member or former mem8 ber under this subsection during the period referred to

9 in paragraph (2), waive any limitation otherwise ap10 plicable under chapter 55 of title 10, United States

11 Code, to the provision of such care to the member or

12 former member if the Secretary considers the waiver

13 appropriate to assure the maximum feasible recovery

14 and rehabilitation of the member or former member.

15 (5) CONSTRUCTION WITH ELIGIBILITY FOR VET16 ERANS BENEFITS.—Nothing in this subsection shall be

17 construed to reduce, alter, or otherwise affect the eligi18 bility or entitlement of a member or former member

19 of the Armed Forces to any health care, disability, or

20 other benefits to which the member of former member

21 would otherwise be eligible or entitled as a veteran

22 under the laws administered by the Secretary of Vet23 erans Affairs.

24 (6) SUNSET.—The Secretary of Defense may not

25 provide medical or dental care to a member or former
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1 member of the Armed Forces under this subsection

2 after December 31, 2012, if the Secretary has not pro3 vided medical or dental care to the member or former

4 member under this subsection before that date.

5 (b) REHABILITATION AND VOCATIONAL BENEFITS.—

6 (1) IN GENERAL.—Effective as of the date of the

7 enactment of this Act, a member of the Armed Forces

8 with a severe injury or illness is entitled to such bene9 fits (including rehabilitation and vocational benefits,

10 but not including compensation) from the Secretary

11 of Veterans Affairs to facilitate the recovery and reha12 bilitation of such member as the Secretary otherwise

13 provides to members of the Armed Forces receiving

14 medical care in medical facilities of the Department

15 of Veterans Affairs facilities in order to facilitate the

16 recovery and rehabilitation of such members.

17 (2) LIMITATIONS.—The provisions of paragraphs

18 (2) through (6) of subsection (a) shall apply to the

19 provision of benefits under this subsection as if the

20 benefits provided under this subsection were provided

21 under subsection (a).

22 (3) REIMBURSEMENT.—The Secretary of Defense

23 shall reimburse the Secretary of Veterans Affairs for

24 the cost of any benefits provided under this subsection

25 in accordance with applicable mechanisms for the re-
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1 imbursement of the Secretary of Veterans Affairs for

2 the provision of medical care to members of the

3 Armed Forces.

4 (c) RECOVERY OF CERTAIN EXPENSES OF MEDICAL

5 CARE AND RELATED TRAVEL.—

6 (1) IN GENERAL.—Commencing not later than

7 60 days after the date of the enactment of this Act,

8 the Secretary of the military department concerned

9 may reimburse covered members of the Armed Forces,

10 and former members of the Armed Forces, with a se11 vere injury or illness for covered expenses incurred by

12 such members or former members, or their family

13 members, in connection with the receipt by such mem14 bers or former members of medical care that is re15 quired for such injury or illness.

16 (2) COVERED EXPENSES.—Expenses for which

17 reimbursement may be made under paragraph (1) in18 clude the following:

19 (A) Expenses for health care services for

20 which coverage would be provided under section

21 1074(c) of title 10, United States Code, for mem22 bers of the uniformed services on active duty.

23 (B) Expenses of travel of a non-medical at24 tendant who accompanies a member or former

25 member of the Armed Forces for required med-
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1 ical care that is not available to such member or

2 former member locally, if such attendant is ap3 pointed for that purpose by a competent medical

4 authority (as determined under regulations pre5 scribed by the Secretary of Defense for purposes

6 of this subsection).

7 (C) Such other expenses for medical care as

8 the Secretary may prescribe for purposes of this

9 subsection.

10 (3) AMOUNT OF REIMBURSEMENT.—The amount

11 of reimbursement under paragraph (1) for expenses

12 covered by paragraph (2) shall be determined in ac13 cordance with regulations prescribed by the Secretary

14 of Defense for purposes of this subsection.

15 (d) SEVERE INJURY OR ILLNESS DEFINED.—In this

16 section, the term ‘‘severe injury or illness’’ means any seri17 ous injury or illness that is assigned a disability rating

18 of 30 percent or higher under the schedule for rating disabil19 ities in use by the Department of Defense.
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1 SEC. 122. REIMBURSEMENT OF CERTAIN FORMER MEMBERS

2 OF THE UNIFORMED SERVICES WITH SERV3 ICE-CONNECTED DISABILITIES FOR TRAVEL

4 FOR FOLLOW-ON SPECIALTY CARE AND RE5 LATED SERVICES.

6 (a) TRAVEL.—Section 1074i of title 10, United States

7 Code, is amended—

8 (1) by redesignating subsection (b) as subsection

9 (c); and

10 (2) by inserting after subsection (a) the following

11 new subsection (b):

12 ‘‘(b) FOLLOW-ON SPECIALTY CARE AND RELATED

13 SERVICES.—In any case in which a former member of a

14 uniformed service who incurred a disability while on active

15 duty in a combat zone or during performance of duty in

16 combat related operations (as designated by the Secretary

17 of Defense), and is entitled to retired or retainer pay, or

18 equivalent pay, requires follow-on specialty care, services,

19 or supplies related to such disability at a specific military

20 treatment facility more than 100 miles from the location

21 in which the former member resides, the Secretary shall pro22 vide reimbursement for reasonable travel expenses com23 parable to those provided under subsection (a) for the

24 former member, and when accompaniment by an adult is

25 determined by competent medical authority to be necessary,

26 for a spouse, parent, or guardian of the former member,
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1 or another member of the former member’s family who is

2 at least 21 years of age.’’.

3 (b) EFFECTIVE DATE.—The amendments made by sub4 section (a) shall take effect January 1, 2008, and shall

5 apply with respect to travel that occurs on or after that

6 date.

7 PART II—CARE AND SERVICES FOR DEPENDENTS

8 SEC. 126. MEDICAL CARE AND SERVICES AND SUPPORT

9 SERVICES FOR FAMILIES OF MEMBERS OF

10 THE ARMED FORCES RECOVERING FROM SE11 RIOUS INJURIES OR ILLNESSES.

12 (a) MEDICAL CARE.—

13 (1) IN GENERAL.—A family member of a covered

14 member of the Armed Forces who is not otherwise eli15 gible for medical care at a military medical treat16 ment facility or at medical facilities of the Depart17 ment of Veterans Affairs shall be eligible for such care

18 at such facilities, on a space-available basis, if the

19 family member is—

20 (A) on invitational orders while caring for

21 the covered member of the Armed Forces;

22 (B) a non-medical attendee caring for the

23 covered member of the Armed Forces; or
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1 (C) receiving per diem payments from the

2 Department of Defense while caring for the cov3 ered member of the Armed Forces.

4 (2) SPECIFICATION OF FAMILY MEMBERS.—Not5 withstanding section 101(3), the Secretary of Defense

6 and the Secretary of Veterans Affairs shall jointly

7 prescribe in regulations the family members of cov8 ered members of the Armed Forces who shall be con9 sidered to be a family member of a covered member

10 of the Armed Forces for purposes of paragraph (1).

11 (3) SPECIFICATION OF CARE.—(A) The Secretary

12 of Defense shall prescribe in regulations the medical

13 care and counseling that shall be available to family

14 members under paragraph (1) at military medical

15 treatment facilities.

16 (B) The Secretary of Veterans Affairs shall pre17 scribe in regulations the medical care and counseling

18 that shall be available to family members under para19 graph (1) at medical facilities of the Department of

20 Veterans Affairs.

21 (4) RECOVERY OF COSTS.—The United States

22 may recover the costs of the provision of medical care

23 and counseling under paragraph (1) as follows (as

24 applicable):
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1 (A) From third-party payers, in the same

2 manner as the United States may collect costs of

3 the charges of health care provided to covered

4 beneficiaries from third-party payers under sec5 tion 1095 of title 10, United States Code.

6 (B) As if such care and counseling was pro7 vided under the authority of section 1784 of title

8 38, United States Code.

9 (b) JOB PLACEMENT SERVICES.—A family member

10 who is on invitational orders or is a non-medical attendee

11 while caring for a covered member of the Armed Forces for

12 more than 45 days during a one-year period shall be eligible

13 for job placement services otherwise offered by the Depart14 ment of Defense.

15 (c) REPORT ON NEED FOR ADDITIONAL SERVICES.—

16 Not later than 90 days after the date of the enactment of

17 this Act, the Secretary of Defense shall submit to the con18 gressional defense committees a report setting forth the as19 sessment of the Secretary of the need for additional employ20 ment services, and of the need for employment protection,

21 of family members described in subsection (b) who are

22 placed on leave from employment or otherwise displaced

23 from employment while caring for a covered member of the

24 Armed Forces as described in that subsection.
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1 SEC. 127. EXTENDED BENEFITS UNDER TRICARE FOR PRI2 MARY CAREGIVERS OF MEMBERS OF THE UNI3 FORMED SERVICES WHO INCUR A SERIOUS

4 INJURY OR ILLNESS ON ACTIVE DUTY.

5 (a) IN GENERAL.—Section 1079(d) of title 10, United

6 States Code, is amended—

7 (1) by redesignating paragraphs (2) and (3) as

8 paragraphs (3) and (4), respectively; and

9 (2) by inserting after paragraph (1) the fol10 lowing new paragraph (2):

11 ‘‘(2)(A) Subject to such terms, conditions, and excep12 tions as the Secretary of Defense considers appropriate, the

13 program of extended benefits for eligible dependents under

14 this subsection shall include extended benefits for the pri15 mary caregivers of members of the uniformed services who

16 incur a serious injury or illness on active duty.

17 ‘‘(B) The Secretary of Defense shall prescribe in regu18 lations the individuals who shall be treated as the primary

19 caregivers of a member of the uniformed services for pur20 poses of this paragraph.

21 ‘‘(C) For purposes of this section, a serious injury or

22 illness, with respect to a member of the uniformed services,

23 is an injury or illness that may render the member medi24 cally unfit to perform the duties of the member’s office,

25 grade, rank, or rating and that renders a member of the

26 uniformed services dependant upon a caregiver.’’.
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1 (b) EFFECTIVE DATE.—The amendments made by sub2 section (a) shall take effect on January 1, 2008.

3 PART III—TRAUMATIC BRAIN INJURY AND POST4 TRAUMATIC STRESS DISORDER

5 SEC. 131. COMPREHENSIVE PLANS ON PREVENTION, DIAG6 NOSIS, MITIGATION, AND TREATMENT OF

7 TRAUMATIC BRAIN INJURY AND POST-TRAU8 MATIC STRESS DISORDER IN MEMBERS OF

9 THE ARMED FORCES.

10 (a) PLANS REQUIRED.—Not later than 180 days after

11 the date of the enactment of this Act, the Secretary of De12 fense shall, in consultation with the Secretary of Veterans

13 Affairs, submit to the congressional defense committees one

14 or more comprehensive plans for programs and activities

15 of the Department of Defense to prevent, diagnose, mitigate,

16 treat, and otherwise respond to traumatic brain injury

17 (TBI) and post-traumatic stress disorder (PTSD) in mem18 bers of the Armed Forces.

19 (b) ELEMENTS.—Each plan submitted under sub20 section (a) shall include comprehensive proposals of the De21 partment on the following:

22 (1) The designation by the Secretary of Defense

23 of a lead agent or executive agent for the Department

24 to coordinate development and implementation of the

25 plan.
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1 (2) The improvement of personnel protective

2 equipment for members of the Armed Forces in order

3 to prevent traumatic brain injury.

4 (3) The improvement of methods and mecha5 nisms for the detection and treatment of traumatic

6 brain injury and post-traumatic stress disorder in

7 members of the Armed Forces in the field.

8 (4) The requirements for research on traumatic

9 brain injury and post-traumatic stress disorder, in10 cluding (in particular) research on pharmacological

11 approaches to treatment for traumatic brain injury

12 or post-traumatic stress disorder, as applicable, and

13 the allocation of priorities among such research.

14 (5) The development, adoption, and deployment

15 of diagnostic criteria for the detection and evaluation

16 of the range of traumatic brain injury and post-trau17 matic stress disorder in members of the Armed Forces,

18 which criteria shall be employed uniformly across the

19 military departments in all applicable circumstances,

20 including provision of clinical care and assessment of

21 future deployability of members of the Armed Forces.

22 (6) The development and deployment of effective

23 means of assessing traumatic brain injury and post24 traumatic stress disorder in members of the Armed

25 Forces, including a system of pre-deployment and
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1 post-deployment screenings of cognitive ability in

2 members for the detection of cognitive impairment, as

3 required by the amendments made by section 132.

4 (7) The development and deployment of effective

5 means of managing and monitoring members of the

6 Armed Forces with traumatic brain injury or post7 traumatic stress disorder in the receipt of care for

8 traumatic brain injury or post-traumatic stress dis9 order, as applicable, including the monitoring and as10 sessment of treatment and outcomes.

11 (8) The development and deployment of an edu12 cation and awareness training initiative designed to

13 reduce the negative stigma associated with traumatic

14 brain injury, post-traumatic stress disorder, and

15 mental health treatment.

16 (9) The provision of education and outreach to

17 families of members of the Armed Forces with trau18 matic brain injury or post-traumatic stress disorder

19 on a range of matters relating to traumatic brain in20 jury or post-traumatic stress disorder, as applicable,

21 including detection, mitigation, and treatment.

22 (10) The assessment of the current capabilities of

23 the Department for the prevention, diagnosis, mitiga24 tion, treatment, and rehabilitation of traumatic brain
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1 injury and post-traumatic stress disorder in members

2 of the Armed Forces.

3 (11) The identification of gaps in current capa4 bilities of the Department for the prevention, diag5 nosis, mitigation, treatment, and rehabilitation of

6 traumatic brain injury and post-traumatic stress dis7 order in members of the Armed Forces.

8 (12) The identification of the resources required

9 for the Department in fiscal years 2009 thru 2013 to

10 address the gaps in capabilities identified under

11 paragraph (11).

12 (13) The development of joint planning among

13 the Department of Defense, the military departments,

14 and the Department of Veterans Affairs for the pre15 vention, diagnosis, mitigation, treatment, and reha16 bilitation of traumatic brain injury and post-trau17 matic stress disorder in members of the Armed Forces,

18 including planning for the seamless transition of such

19 members from care through the Department of Defense

20 care through the Department of Veterans Affairs.

21 (14) A requirement that exposure to a blast or

22 blasts be recorded in the records of members of the

23 Armed Forces.

24 (15) The development of clinical practice guide25 lines for the diagnosis and treatment of blast injuries
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1 in members of the Armed Forces, including, but not

2 limited to, traumatic brain injury.

3 (16) A program under which each member of the

4 Armed Forces who incurs a traumatic brain injury

5 or post-traumatic stress disorder during service in the

6 Armed Forces—

7 (A) is enrolled in the program; and

8 (B) receives, under the program, treatment

9 and rehabilitation meeting a standard of care

10 such that each individual who is a member of the

11 Armed Forces who qualifies for care under the

12 program shall—

13 (i) be provided the highest quality of

14 care possible based on the medical judgment

15 of qualified medical professionals in facili16 ties that most appropriately meet the spe17 cific needs of the individual; and

18 (ii) be rehabilitated to the fullest extent

19 possible using the most up-to-date medical

20 technology, medical rehabilitation practices,

21 and medical expertise available.

22 (17) A requirement that if a member of the

23 Armed Forces participating in a program established

24 in accordance with paragraph (16) believes that care

25 provided to such participant does not meet the stand-
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1 ard of care specified in subparagraph (B) of such

2 paragraph, the Secretary of Defense shall, upon re3 quest of the participant, provide to such participant

4 a referral to another Department of Defense or De5 partment of Veterans Affairs provider of medical or

6 rehabilitative care for a second opinion regarding the

7 care that would meet the standard of care specified in

8 such subparagraph.

9 (18) The provision of information by the Sec10 retary of Defense to members of the Armed Forces

11 with traumatic brain injury or post-traumatic stress

12 disorder and their families about their rights with re13 spect to the following:

14 (A) The receipt of medical and mental

15 health care from the Department of Defense and

16 the Department of Veterans Affairs.

17 (B) The options available to such members

18 for treatment of traumatic brain injury and

19 post-traumatic stress disorder.

20 (C) The options available to such members

21 for rehabilitation.

22 (D) The options available to such members

23 for a referral to a public or private provider of

24 medical or rehabilitative care.
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1 (E) The right to administrative review of

2 any decision with respect to the provision of care

3 by the Department of Defense for such members.

4 (c) COORDINATION IN DEVELOPMENT.—Each plan

5 submitted under subsection (a) shall be developed in coordi6 nation with the Secretary of the Army (who was designated

7 by the Secretary of Defense as executive agent for the pre8 vention, mitigation, and treatment of blast injuries under

9 section 256 of the National Defense Authorization Act for

10 Fiscal Year 2006 (Public Law 109–163; 119 Stat. 3181;

11 10 U.S.C. 1071 note)).

12 (d) ADDITIONAL ACTIVITIES.—In carrying out pro13 grams and activities for the prevention, diagnosis, mitiga14 tion, and treatment of traumatic brain injury and post15 traumatic stress disorder in members of the Armed Forces,

16 the Secretary of Defense shall—

17 (1) examine the results of the recently completed

18 Phase 2 study, funded by the National Institutes of

19 Health, on the use of progesterone for acute traumatic

20 brain injury;

21 (2) determine if Department of Defense funding

22 for a Phase 3 clinical trial on the use of progesterone

23 for acute traumatic brain injury, or for further re24 search regarding the use of progesterone or its metabo-
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1 lites for treatment of traumatic brain injury, is war2 ranted; and

3 (3) provide for the collaboration of the Depart4 ment of Defense, as appropriate, in clinical trials and

5 research on pharmacological approaches to treatment

6 for traumatic brain injury and post-traumatic stress

7 disorder that is conducted by other departments and

8 agencies of the Federal Government.

9 SEC. 132. IMPROVEMENT OF MEDICAL TRACKING SYSTEM

10 FOR MEMBERS OF THE ARMED FORCES DE11 PLOYED OVERSEAS.

12 (a) PROTOCOL FOR ASSESSMENT OF COGNITIVE FUNC13 TIONING.—

14 (1) PROTOCOL REQUIRED.—Subsection (b) of

15 section 1074f of title 10, United States Code, is

16 amended—

17 (A) in paragraph (2), by adding at the end

18 the following new subparagraph:

19 ‘‘(C) An assessment of post-traumatic stress dis20 order.’’; and

21 (B) by adding at the end the following new

22 paragraph:

23 ‘‘(3)(A) The Secretary shall establish for purposes of

24 subparagraphs (B) and (C) of paragraph (2) a protocol for

25 the predeployment assessment and documentation of the
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1 cognitive (including memory) functioning of a member who

2 is deployed outside the United States in order to facilitate

3 the assessment of the postdeployment cognitive (including

4 memory) functioning of the member.

5 ‘‘(B) The protocol under subparagraph (A) shall in6 clude appropriate mechanisms to permit the differential di7 agnosis of traumatic brain injury in members returning

8 from deployment in a combat zone.’’.

9 (2) PILOT PROJECTS.—(A) In developing the

10 protocol required by paragraph (3) of section 1074f(b)

11 of title 10, United States Code (as amended by para12 graph (1) of this subsection), for purposes of assess13 ments for traumatic brain injury, the Secretary of

14 Defense shall conduct up to three pilot projects to

15 evaluate various mechanisms for use in the protocol

16 for such purposes. One of the mechanisms to be so

17 evaluated shall be a computer-based assessment tool.

18 (B) Not later than 60 days after the completion

19 of the pilot projects conducted under this paragraph,

20 the Secretary shall submit to the appropriate commit21 tees of Congress a report on the pilot projects. The re22 port shall include—

23 (i) a description of the pilot projects so con24 ducted;
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1 (ii) an assessment of the results of each such

2 pilot project; and

3 (iii) a description of any mechanisms eval4 uated under each such pilot project that will in5 corporated into the protocol.

6 (C) Not later than 180 days after completion of

7 the pilot projects conducted under this paragraph, the

8 Secretary shall establish a mechanism for imple9 menting any mechanism evaluated under such a pilot

10 project that is selected for incorporation in the pro11 tocol.

12 (D) There is hereby authorized to be appro13 priated to the Department of Defense, $3,000,000 for

14 the pilot projects authorized by this paragraph. Of the

15 amount so authorized to be appropriated, not more

16 than $1,000,000 shall be available for any particular

17 pilot project.

18 (b) QUALITY ASSURANCE.—Subsection (d)(2) of sec19 tion 1074f of title 10, United States Code, is amended by

20 adding at the end the following new subparagraph:

21 ‘‘(F) The diagnosis and treatment of traumatic

22 brain injury and post-traumatic stress disorder.’’.

23 (c) STANDARDS FOR DEPLOYMENT.—Subsection (f) of

24 such section is amended—
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1 (1) in the subsection heading, by striking ‘‘MEN2 TAL HEALTH’’; and

3 (2) in paragraph (2)(B), by striking ‘‘or’’ and

4 inserting ‘‘, traumatic brain injury, or’’.

5 SEC. 133. CENTERS OF EXCELLENCE IN THE PREVENTION,

6 DIAGNOSIS, MITIGATION, TREATMENT, AND

7 REHABILITATION OF TRAUMATIC BRAIN IN8 JURY AND POST-TRAUMATIC STRESS DIS9 ORDER.

10 (a) CENTER OF EXCELLENCE ON TRAUMATIC BRAIN

11 INJURY.—Chapter 55 of title 10, United States Code, is

12 amended by inserting after section 1105 the following new

13 section:

14 ‘‘§ 1105a. Center of Excellence in Prevention, Diag15 nosis, Mitigation, Treatment, and Reha16 bilitation of Traumatic Brain Injury

17 ‘‘(a) IN GENERAL.—The Secretary of Defense shall es18 tablish within the Department of Defense a center of excel19 lence in the prevention, diagnosis, mitigation, treatment,

20 and rehabilitation of traumatic brain injury (TBI), includ21 ing mild, moderate, and severe traumatic brain injury, to

22 carry out the responsibilities specified in subsection (c). The

23 center shall be known as a ‘Center of Excellence in Preven24 tion, Diagnosis, Mitigation, Treatment, and Rehabilitation

25 of Traumatic Brain Injury’.
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1 ‘‘(b) PARTNERSHIPS.—The Secretary shall ensure that

2 the Center collaborates to the maximum extent practicable

3 with the Department of Veterans Affairs, institutions of

4 higher education, and other appropriate public and private

5 entities (including international entities) to carry out the

6 responsibilities specified in subsection (c).

7 ‘‘(c) RESPONSIBILITIES.—The Center shall have re8 sponsibilities as follows:

9 ‘‘(1) To direct and oversee, based on expert re10 search, the development and implementation of a

11 long-term, comprehensive plan and strategy for the

12 Department of Defense for the prevention, diagnosis,

13 mitigation, treatment, and rehabilitation of trau14 matic brain injury.

15 ‘‘(2) To provide for the development, testing, and

16 dissemination within the Department of best practices

17 for the treatment of traumatic brain injury.

18 ‘‘(3) To provide guidance for the mental health

19 system of the Department in determining the mental

20 health and neurological health personnel required to

21 provide quality mental health care for members of the

22 armed forces with traumatic brain injury.

23 ‘‘(4) To establish, implement, and oversee a com24 prehensive program to train mental health and neuro-
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1 logical health professionals of the Department in the

2 treatment of traumatic brain injury.

3 ‘‘(5) To facilitate advancements in the study of

4 the short-term and long-term psychological effects of

5 traumatic brain injury.

6 ‘‘(6) To disseminate within the military medical

7 treatment facilities of the Department best practices

8 for training mental health professionals, including

9 neurological health professionals, with respect to trau10 matic brain injury.

11 ‘‘(7) To conduct basic science and translational

12 research on traumatic brain injury for the purposes

13 of understanding the etiology of traumatic brain in14 jury and developing preventive interventions and new

15 treatments.

16 ‘‘(8) To develop outreach strategies and treat17 ments for families of members of the armed forces

18 with traumatic brain injury in order to mitigate the

19 negative impacts of traumatic brain injury on such

20 family members and to support the recovery of such

21 members from traumatic brain injury.

22 ‘‘(9) To conduct research on the unique mental

23 health needs of women members of the armed forces

24 with traumatic brain injury and develop treatments

25 to meet any needs identified through such research.
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1 ‘‘(10) To conduct research on the unique mental

2 health needs of ethnic minority members of the armed

3 forces with traumatic brain injury and develop treat4 ments to meet any needs identified through such re5 search.

6 ‘‘(11) To conduct research on the mental health

7 needs of families of members of the armed forces with

8 traumatic brain injury and develop treatments to

9 meet any needs identified through such research.

10 ‘‘(12) To conduct longitudinal studies (using im11 aging technology and other proven research methods)

12 on members of the armed forces with traumatic brain

13 injury to identify early signs of Alzheimer’s disease,

14 Parkinson’s disease, or other manifestations of

15 neurodegeneration in such members, which studies

16 should be conducted in coordination with the studies

17 authorized by section 721 of the John Warner Na18 tional Defense Authorization Act for Fiscal Year 2007

19 (Public Law 109–364; 120 Stat. 2294) and other

20 studies of the Department of Defense and the Depart21 ment of Veterans Affairs that address the connection

22 between exposure to combat and the development of

23 Alzheimer’s disease, Parkinson’s disease, and other

24 neurodegenerative disorders.
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1 ‘‘(13) To develop and oversee a long-term plan to

2 increase the number of mental health and neurological

3 health professionals within the Department in order

4 to facilitate the meeting by the Department of the

5 needs of members of the armed forces with traumatic

6 brain injury until their transition to care and treat7 ment from the Department of Veterans Affairs.

8 ‘‘(14) To develop a program on comprehensive

9 pain management, including management of acute

10 and chronic pain, to utilize current and develop new

11 treatments for pain, and to identify and disseminate

12 best practices on pain management.

13 ‘‘(15) Such other responsibilities as the Secretary

14 shall specify.’’.

15 (b) CENTER OF EXCELLENCE ON POST-TRAUMATIC

16 STRESS DISORDER.—Chapter 55 of such title is further

17 amended by inserting after section 1105a, as added by sub18 section (a), the following new section:

19 ‘‘§ 1105b. Center of Excellence in Prevention, Diag20 nosis, Mitigation, Treatment, and Reha21 bilitation of Post-Traumatic Stress Dis22 order

23 ‘‘(a) IN GENERAL.—The Secretary of Defense shall es24 tablish within the Department of Defense a center of excel25 lence in the prevention, diagnosis, mitigation, treatment,
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1 and rehabilitation of post-traumatic stress disorder

2 (PTSD), including mild, moderate, and severe post-trau3 matic stress disorder, to carry out the responsibilities speci4 fied in subsection (c). The center shall be known as a ‘Center

5 of Excellence in Prevention, Diagnosis, Mitigation, Treat6 ment, and Rehabilitation of Post-Traumatic Stress Dis7 order’.

8 ‘‘(b) PARTNERSHIPS.—The Secretary shall ensure that

9 the Center collaborates to the maximum extent practicable

10 with the National Center for Post-Traumatic Stress Dis11 order of the Department of Veterans Affairs, institutions of

12 higher education, and other appropriate public and private

13 entities (including international entities) to carry out the

14 responsibilities specified in subsection (c).

15 ‘‘(c) RESPONSIBILITIES.—The Center shall have re16 sponsibilities as follows:

17 ‘‘(1) To direct and oversee, based on expert re18 search, the development and implementation of a

19 long-term, comprehensive plan and strategy for the

20 Department of Defense for the prevention, diagnosis,

21 mitigation, treatment, and rehabilitation of post22 traumatic stress disorder.

23 ‘‘(2) To provide for the development, testing, and

24 dissemination within the Department of best practices

25 for the treatment of post-traumatic stress disorder.
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1 ‘‘(3) To provide guidance for the mental health

2 system of the Department in determining the mental

3 health and neurological health personnel required to

4 provide quality mental health care for members of the

5 armed forces with post-traumatic stress disorder.

6 ‘‘(4) To establish, implement, and oversee a com7 prehensive program to train mental health and neuro8 logical health professionals of the Department in the

9 treatment of post-traumatic stress disorder.

10 ‘‘(5) To facilitate advancements in the study of

11 the short-term and long-term psychological effects of

12 post-traumatic stress disorder.

13 ‘‘(6) To disseminate within the military medical

14 treatment facilities of the Department best practices

15 for training mental health professionals, including

16 neurological health professionals, with respect to post17 traumatic stress disorder.

18 ‘‘(7) To conduct basic science and translational

19 research on post-traumatic stress disorder for the pur20 poses of understanding the etiology of post-traumatic

21 stress disorder and developing preventive interven22 tions and new treatments.

23 ‘‘(8) To develop outreach strategies and treat24 ments for families of members of the armed forces

25 with post-traumatic stress disorder in order to miti-
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1 gate the negative impacts of traumatic brain injury

2 on such family members and to support the recovery

3 of such members from post-traumatic stress disorder.

4 ‘‘(9) To conduct research on the unique mental

5 health needs of women members of the armed forces,

6 including victims of sexual assault, with post-trau7 matic stress disorder and develop treatments to meet

8 any needs identified through such research.

9 ‘‘(10) To conduct research on the unique mental

10 health needs of ethnic minority members of the armed

11 forces with post-traumatic stress disorder and develop

12 treatments to meet any needs identified through such

13 research.

14 ‘‘(11) To conduct research on the mental health

15 needs of families of members of the armed forces with

16 post-traumatic stress disorder and develop treatments

17 to meet any needs identified through such research.

18 ‘‘(12) To develop and oversee a long-term plan to

19 increase the number of mental health and neurological

20 health professionals within the Department in order

21 to facilitate the meeting by the Department of the

22 needs of members of the armed forces with post-trau23 matic stress disorder until their transition to care

24 and treatment from the Department of Veterans Af25 fairs.
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1 ‘‘(13) To develop a program on comprehensive

2 pain management, including management of acute

3 and chronic pain, to utilize current and develop new

4 treatments for pain, and to identify and disseminate

5 best practices on pain management.

6 ‘‘(14) Such other responsibilities as the Secretary

7 shall specify.’’.

8 (c) CLERICAL AMENDMENT.—The table of sections at

9 the beginning of chapter 55 of such title is amended by in10 serting after the item relating to section 1105 the following

11 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.’’.

12 (d) REPORT ON ESTABLISHMENT.—Not later than 180

13 days after the date of the enactment of this Act, the Sec14 retary of Defense shall submit to Congress a report on the

15 establishment of the Center of Excellence in Prevention, Di16 agnosis, Mitigation, Treatment, and Rehabilitation of

17 Traumatic Brain Injury required by section 1105a of title

18 10, United States Code (as added by subsection (a)), and

19 the establishment of the Center of Excellence in Prevention,

20 Diagnosis, Mitigation, Treatment, and Rehabilitation of

21 Post-Traumatic Stress Disorder required by section 1105b

22 of title 10, United States Code (as added by subsection (b)).

23 The report shall, for each such Center—
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1 (1) describe in detail the activities and proposed

2 activities of such Center; and

3 (2) assess the progress of such Center in dis4 charging the responsibilities of such Center.

5 (e) AUTHORIZATION OF APPROPRIATIONS.—There is

6 hereby authorized to be appropriated for fiscal year 2008

7 for the Department of Defense for Defense Health Program,

8 $10,000,000, of which—

9 (1) $5,000,000 shall be available for the Center

10 of Excellence in Prevention, Diagnosis, Mitigation,

11 Treatment, and Rehabilitation of Traumatic Brain

12 Injury required by section 1105a of title 10, United

13 States Code; and

14 (2) $5,000,000 shall be available for the Center

15 of Excellence in Prevention, Diagnosis, Mitigation,

16 Treatment, and Rehabilitation of Post-Traumatic

17 Stress Disorder required by section 1105b of title 10,

18 United States Code.

19 SEC. 134. REVIEW OF MENTAL HEALTH SERVICES AND

20 TREATMENT FOR FEMALE MEMBERS OF THE

21 ARMED FORCES AND VETERANS.

22 (a) COMPREHENSIVE REVIEW.—The Secretary of De23 fense and the Secretary of Veterans Affairs shall jointly con24 duct a comprehensive review of—
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1 (1) the need for mental health treatment and

2 services for female members of the Armed Forces and

3 veterans; and

4 (2) the efficacy and adequacy of existing mental

5 health treatment programs and services for female

6 members of the Armed Forces and veterans.

7 (b) ELEMENTS.—The review required by subsection (a)

8 shall include, but not be limited to, an assessment of the

9 following:

10 (1) The need for mental health outreach, preven11 tion, and treatment services specifically for female

12 members of the Armed Forces and veterans.

13 (2) The access to and efficacy of existing mental

14 health outreach, prevention, and treatment services

15 and programs (including substance abuse programs)

16 for female veterans who served in a combat zone.

17 (3) The access to and efficacy of services and

18 treatment for female members of the Armed Forces

19 and veterans who experience post-traumatic stress

20 disorder (PTSD).

21 (4) The availability of services and treatment for

22 female members of the Armed Forces and veterans

23 who experienced sexual assault or abuse.
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1 (5) The access to and need for treatment facili2 ties focusing on the mental health care needs of female

3 members of the Armed Forces and veterans.

4 (6) The need for further clinical research on the

5 unique needs of female veterans who served in a com6 bat zone.

7 (c) REPORT.—Not later than 90 days after the date

8 of the enactment of this Act, the Secretary of Defense and

9 the Secretary of Veterans Affairs shall jointly submit to the

10 appropriate committees of Congress a report on the review

11 required by subsection (a).

12 (d) POLICY REQUIRED.—Not later than 120 days after

13 the date of the enactment of this Act, the Secretary of De14 fense and the Secretary of Veterans Affairs shall jointly de15 velop a comprehensive policy to address the treatment and

16 care needs of female members of the Armed Forces and vet17 erans who experience mental health problems and condi18 tions, including post-traumatic stress disorder. The policy

19 shall take into account and reflect the results of the review

20 required by subsection (a).
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1 SEC. 135. FUNDING FOR IMPROVED DIAGNOSIS, TREAT2 MENT, AND REHABILITATION OF MEMBERS

3 OF THE ARMED FORCES WITH TRAUMATIC

4 BRAIN INJURY OR POST-TRAUMATIC STRESS

5 DISORDER.

6 (a) AUTHORIZATION OF APPROPRIATIONS.—

7 (1) IN GENERAL.—Funds are hereby authorized

8 to be appropriated for fiscal year 2008 for the De9 partment of Defense for Defense Health Program in

10 the amount of $50,000,000, with such amount to be

11 available for activities as follows:

12 (A) Activities relating to the improved diag13 nosis, treatment, and rehabilitation of members

14 of the Armed Forces with traumatic brain injury

15 (TBI).

16 (B) Activities relating to the improved diag17 nosis, treatment, and rehabilitation of members

18 of the Armed Forces with post-traumatic stress

19 disorder (PTSD).

20 (2) AVAILABILITY OF AMOUNT.—Of the amount

21 authorized to be appropriated by paragraph (1),

22 $17,000,000 shall be available for the Defense and

23 Veterans Brain Injury Center of the Department of

24 Defense.

25 (b) SUPPLEMENT NOT SUPPLANT.—The amount au26 thorized to be appropriated by subsection (a) for Defense
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1 Health Program is in addition to any other amounts au2 thorized to be appropriated by this Act for Defense Health

3 Program.

4 SEC. 136. REPORTS.

5 (a) REPORTS ON IMPLEMENTATION OF CERTAIN RE6 QUIREMENTS.—Not later than 90 days after the date of the

7 enactment of this Act, the Secretary of Defense shall submit

8 to the congressional defense committees a report describing

9 the progress in implementing the requirements as follows:

10 (1) The requirements of section 721 of the John

11 Warner National Defense Authorization Act for Fiscal

12 Year 2007 (Public Law 109–364; 120 Stat. 2294), re13 lating to a longitudinal study on traumatic brain in14 jury incurred by members of the Armed Forces in Op15 eration Iraqi Freedom and Operation Enduring Free16 dom.

17 (2) The requirements arising from the amend18 ments made by section 738 of the John Warner Na19 tional Defense Authorization Act for Fiscal Year 2007

20 (120 Stat. 2303), relating to enhanced mental health

21 screening and services for members of the Armed

22 Forces.

23 (3) The requirements of section 741 of the John

24 Warner National Defense Authorization Act for Fiscal

25 Year 2007 (120 Stat. 2304), relating to pilot projects
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1 on early diagnosis and treatment of post-traumatic

2 stress disorder and other mental health conditions.

3 (b) ANNUAL REPORTS ON EXPENDITURES FOR ACTIVI4 TIES ON TBI AND PTSD.—

5 (1) REPORTS REQUIRED.—Not later than March

6 1, 2008, and each year thereafter through 2013, the

7 Secretary of Defense shall submit to the congressional

8 defense committees a report setting forth the amounts

9 expended by the Department of Defense during the

10 preceding calendar year on activities described in

11 paragraph (2), including the amount allocated during

12 such calendar year to the Defense and Veterans Brain

13 Injury Center of the Department.

14 (2) COVERED ACTIVITIES.—The activities de15 scribed in this paragraph are activities as follows:

16 (A) Activities relating to the improved diag17 nosis, treatment, and rehabilitation of members

18 of the Armed Forces with traumatic brain injury

19 (TBI).

20 (B) Activities relating to the improved diag21 nosis, treatment, and rehabilitation of members

22 of the Armed Forces with post-traumatic stress

23 disorder (PTSD).

24 (3) ELEMENTS.—Each report under paragraph

25 (1) shall include—
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1 (A) a description of the amounts expended

2 as described in that paragraph, including a de3 scription of the activities for which expended;

4 (B) a description and assessment of the out5 come of such activities;

6 (C) a statement of priorities of the Depart7 ment in activities relating to the prevention, di8 agnosis, research, treatment, and rehabilitation

9 of traumatic brain injury in members of the

10 Armed Forces during the year in which such re11 port is submitted and in future calendar years;

12 (D) a statement of priorities of the Depart13 ment in activities relating to the prevention, di14 agnosis, research, treatment, and rehabilitation

15 of post-traumatic stress disorder in members of

16 the Armed Forces during the year in which such

17 report is submitted and in future calendar years;

18 and

19 (E) an assessment of the progress made to20 ward achieving the priorities stated in subpara21 graphs (C) and (D) in the report under para22 graph (1) in the previous year, and a description

23 of any actions planned during the year in which

24 such report is submitted to achieve any

25 unfulfilled priorities during such year.
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1 PART IV—OTHER MATTERS

2 SEC. 141. JOINT ELECTRONIC HEALTH RECORD FOR THE

3 DEPARTMENT OF DEFENSE AND DEPART4 MENT OF VETERANS AFFAIRS.

5 (a) IN GENERAL.—The Secretary of Defense and the

6 Secretary of Veterans Affairs shall jointly—

7 (1) develop and implement a joint electronic

8 health record for use by the Department of Defense

9 and the Department of Veterans Affairs; and

10 (2) accelerate the exchange of health care infor11 mation between the Department of Defense and the

12 Department of Veterans Affairs in order to support

13 the delivery of health care by both Departments.

14 (b) DEPARTMENT OF DEFENSE-DEPARTMENT OF VET15 ERANS AFFAIRS INTERAGENCY PROGRAM OFFICE FOR A

16 JOINT ELECTRONIC HEALTH RECORD.—

17 (1) IN GENERAL.—There is hereby established a

18 joint element of the Department of Defense and the

19 Department of Veterans Affairs to be known as the

20 ‘‘Department of Defense-Department of Veterans Af21 fairs Interagency Program Office for a Joint Elec22 tronic Health Record’’ (in this section referred to as

23 the ‘‘Office’’).

24 (2) PURPOSES.—The purposes of the Office shall

25 be as follows:
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1 (A) To act as a single point of account2 ability for the Department of Defense and the

3 Department of Veterans Affairs in the rapid de4 velopment, test, and implementation of a joint

5 electronic health record for use by the Depart6 ment of Defense and the Department of Veterans

7 Affairs.

8 (B) To accelerate the exchange of health

9 care information between Department of Defense

10 and the Department of Veterans Affairs in order

11 to support the delivery of health care by both De12 partments.

13 (c) LEADERSHIP.—

14 (1) DIRECTOR.—The Director of the Department

15 of Defense-Department of Veterans Affairs Inter16 agency Program Office for a Joint Electronic Health

17 Record shall be the head of the Office.

18 (2) DEPUTY DIRECTOR.—The Deputy Director of

19 the Department of Defense-Department of Veterans

20 Affairs Interagency Program Office for a Joint Elec21 tronic Health Record shall be the deputy head of the

22 office and shall assist the Director in carrying out the

23 duties of the Director.

24 (3) APPOINTMENTS.—(A) The Director shall be

25 appointed by the Secretary of Defense, with the con-
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1 currence of the Secretary of Veterans Affairs, from

2 among employees of the Department of Defense and

3 the Department of Veterans Affairs in the Senior Ex4 ecutive Service who are qualified to direct the develop5 ment and acquisition of major information technology

6 capabilities.

7 (B) The Deputy Director shall be appointed by

8 the Secretary of Veterans Affairs, with the concur9 rence of the Secretary of Defense, from among employ10 ees of the Department of Defense and the Department

11 of Veterans Affairs in the Senior Executive Service

12 who are qualified to direct the development and ac13 quisition of major information technology capabili14 ties.

15 (4) ADDITIONAL GUIDANCE.—In addition to the

16 direction, supervision, and control provided by the

17 Secretary of Defense and the Secretary of Veterans Af18 fairs, the Office shall also receive guidance from the

19 Department of Veterans Affairs-Department of De20 fense Joint Executive Committee under section 320 of

21 title 38, United States Code, in the discharge of the

22 functions of the Office under this section.

23 (5) TESTIMONY.—Upon request by any of the ap24 propriate committees of Congress, the Director and

25 the Deputy Director shall testify before such com-
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1 mittee regarding the discharge of the functions of the

2 Office under this section.

3 (d) FUNCTION.—The function of the Office shall be to

4 develop and prepare for deployment, by not later than Sep5 tember 30, 2010, a joint electronic health record to be uti6 lized by both the Department of Defense and the Depart7 ment of Veterans Affairs in the provision of medical care

8 and treatment to members of the Armed Forces and vet9 erans, which health record shall comply with applicable

10 interoperability standards, implementation specifications,

11 and certification criteria (including for the reporting of

12 quality measures) of the Federal Government.

13 (e) SCHEDULES AND BENCHMARKS.—Not later than

14 30 days after the date of the enactment of this Act, the Sec15 retary of Defense and the Secretary of Veterans Affairs shall

16 jointly establish a schedule and benchmarks for the dis17 charge by the Office of its function under this section, in18 cluding each of the following:

19 (1) A schedule for the establishment of the Office.

20 (2) A schedule and deadline for the establishment

21 of the requirements for the joint electronic health

22 record described in subsection (d), including coordina23 tion with the Office of the National Coordinator for

24 Health Information Technology in the development of
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1 a nationwide interoperable health information tech2 nology infrastructure.

3 (3) A schedule and associated deadlines for any

4 acquisition and testing required in the development

5 and deployment of the joint electronic health record.

6 (4) A schedule and associated deadlines and re7 quirements for the deployment of the joint electronic

8 health record.

9 (5) Proposed funding for the Office for each of

10 fiscal years 2009 through 2013 for the discharge of its

11 function.

12 (f) PILOT PROJECTS.—

13 (1) AUTHORITY.—In order to assist the Office in

14 the discharge of its function under this section, the

15 Secretary of Defense and the Secretary of Veterans Af16 fairs may, acting jointly, carry out one or more pilot

17 projects to assess the feasability and advisability of

18 various technological approaches to the achievement of

19 the joint electronic health record described in sub20 section (d).

21 (2) TREATMENT AS SINGLE HEALTH CARE SYS22 TEM.—For purposes of each pilot project carried out

23 under this subsection, the health care system of the

24 Department of Defense and the health care system of

25 the Department of Veterans Affairs shall be treated as
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1 a single health care system for purposes of the regula2 tions promulgated under section 264(c) of the Health

3 Insurance Portability and Accountability Act of 1996

4 (42 U.S.C. 1320d–2 note).

5 (g) STAFF AND OTHER RESOURCES.—

6 (1) IN GENERAL.—The Secretary of Defense and

7 the Secretary of Veterans Affairs shall assign to the

8 Office such personnel and other resources of the De9 partment of Defense and the Department of Veterans

10 Affairs as are required for the discharge of its func11 tion under this section.

12 (2) ADDITIONAL SERVICES.—Subject to the ap13 proval of the Secretary of Defense and the Secretary

14 of Veterans Affairs, the Director may utilize the serv15 ices of private individuals and entities as consultants

16 to the Office in the discharge of its function under

17 this section. Amounts available to the Office shall be

18 available for payment for such services.

19 (h) ANNUAL REPORTS.—

20 (1) IN GENERAL.—Not later than January 1,

21 2009, and each year thereafter through 2014, the Di22 rector shall submit to the Secretary of Defense and the

23 Secretary of Veterans Affairs, and to the appropriate

24 committees of Congress, a report on the activities of

25 the Office during the preceding calendar year. Each
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1 report shall include, for the year covered by such re2 port, the following:

3 (A) A detailed description of the activities

4 of the Office, including a detailed description of

5 the amounts expended and the purposes for

6 which expended.

7 (B) An assessment of the progress made by

8 the Department of Defense and the Department

9 of Veterans Affairs in the development and im10 plementation of the joint electronic health record

11 described in subsection (d).

12 (2) AVAILABILITY TO PUBLIC.—The Secretary of

13 Defense and the Secretary of Veterans Affairs shall

14 make available to the public each report submitted

15 under paragraph (1), including by posting such re16 port on the Internet website of the Department of De17 fense and the Department of Veterans Affairs, respec18 tively, that is available to the public.

19 (i) COMPTROLLER GENERAL ASSESSMENT OF IMPLE20 MENTATION.—Not later than six months after the date of

21 the enactment of this Act and every six months thereafter

22 until the completion of the implementation of the joint elec23 tronic health record described in subsection (d), the Comp24 troller General of the United States shall submit to the ap25 propriate committees of Congress a report setting forth the
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1 assessment of the Comptroller General of the progress of the

2 Department of Defense and the Department of Veterans Af3 fairs in developing and implementing the joint electronic

4 health record.

5 (j) FUNDING.—

6 (1) IN GENERAL.—The Secretary of Defense and

7 the Secretary of Veterans Affairs shall each contribute

8 equally to the costs of the Office in fiscal year 2008

9 and fiscal years thereafter. The amount so contributed

10 by each Secretary in fiscal year 2008 shall be up to

11 $10,000,000.

12 (2) SOURCE OF FUNDS.—(A) Amounts contrib13 uted by the Secretary of Defense under paragraph (1)

14 shall be derived from amounts authorized to be appro15 priated for the Department of Defense for the Defense

16 Health Program and available for program manage17 ment and technology resources.

18 (B) Amounts contributed by the Secretary of Vet19 erans Affairs under paragraph (1) shall be derived

20 from amounts authorized to be appropriated for the

21 Department of Veterans Affairs for Medical Care and

22 available for program management and technology re23 sources.

24 (k) JOINT ELECTRONIC HEALTH RECORD DEFINED.—

25 In this section, the term ‘‘joint electronic health record’’
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1 means a single system that includes patient information

2 across the continuum of medical care, including inpatient

3 care, outpatient care, pharmacy care, patient safety, and

4 rehabilitative care.

5 SEC. 142. ENHANCED PERSONNEL AUTHORITIES FOR THE

6 DEPARTMENT OF DEFENSE FOR HEALTH

7 CARE PROFESSIONALS FOR CARE AND TREAT8 MENT OF WOUNDED AND INJURED MEMBERS

9 OF THE ARMED FORCES.

10 (a) IN GENERAL.—Section 1599c of title 10, United

11 States Code, is amended to read as follows:

12 ‘‘§ 1599c. Health care professionals: enhanced ap13 pointment and compensation authority

14 for personnel for care and treatment of

15 wounded and injured members of the

16 armed forces

17 ‘‘(a) IN GENERAL.—The Secretary of Defense may, in

18 the discretion of the Secretary, exercise any authority for

19 the appointment and pay of health care personnel under

20 chapter 74 of title 38 for purposes of the recruitment, em21 ployment, and retention of civilian health care professionals

22 for the Department of Defense if the Secretary determines

23 that the exercise of such authority is necessary in order to

24 provide or enhance the capacity of the Department to pro25 vide care and treatment for members of the armed forces
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1 who are wounded or injured on active duty in the armed

2 forces and to support the ongoing patient care and medical

3 readiness, education, and training requirements of the De4 partment of Defense.

5 ‘‘(b) RECRUITMENT OF PERSONNEL.—(1) The Secre6 taries of the military departments shall each develop and

7 implement a strategy to disseminate among appropriate

8 personnel of the military departments authorities and best

9 practices for the recruitment of medical and health profes10 sionals, including the authorities under subsection (a).

11 ‘‘(2) Each strategy under paragraph (1) shall—

12 ‘‘(A) assess current recruitment policies, proce13 dures, and practices of the military department con14 cerned to assure that such strategy facilitates the im15 plementation of efficiencies which reduce the time re16 quired to fill vacant positions for medical and health

17 professionals; and

18 ‘‘(B) clearly identify processes and actions that

19 will be used to inform and educate military and civil20 ian personnel responsible for the recruitment of med21 ical and health professionals.’’.

22 (b) CLERICAL AMENDMENT.—The table of sections at

23 the beginning of chapter 81 of such title is amended by

24 striking the item relating to section 1599c and inserting

25 the following new item:
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‘‘1599c. Health care professionals: enhanced appointment and compensation authority for personnel for care and treatment of wounded and injured members of the armed forces.’’.

1 (c) REPORTS ON STRATEGIES ON RECRUITMENT OF

2 MEDICAL AND HEALTH PROFESSIONALS.—Not later than

3 six months after the date of the enactment of this Act, each

4 Secretary of a military department shall submit to the con5 gressional defense committees a report setting forth the

6 strategy developed by such Secretary under section 1599c(b)

7 of title 10, United States Code, as added by subsection (a).

8 SEC. 143. PERSONNEL SHORTAGES IN THE MENTAL

9 HEALTH WORKFORCE OF THE DEPARTMENT

10 OF DEFENSE, INCLUDING PERSONNEL IN THE

11 MENTAL HEALTH WORKFORCE.

12 (a) RECOMMENDATIONS ON MEANS OF ADDRESSING

13 SHORTAGES.—

14 (1) REPORT.—Not later than 45 days after the

15 date of the enactment of this Act, the Secretary of De16 fense shall submit to the Committees on Armed Serv17 ices of the Senate and the House of Representatives a

18 report setting forth the recommendations of the Sec19 retary for such legislative or administrative actions

20 as the Secretary considers appropriate to address

21 shortages in health care professionals within the De22 partment of Defense, including personnel in the men23 tal health workforce.
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1 (2) ELEMENTS.—The report required by para2 graph (1) shall address the following:

3 (A) Enhancements or improvements of fi4 nancial incentives for health care professionals,

5 including personnel in the mental health work6 force, of the Department of Defense in order to

7 enhance the recruitment and retention of such

8 personnel, including recruitment, accession, or

9 retention bonuses and scholarship, tuition, and

10 other financial assistance.

11 (B) Modifications of service obligations of

12 health care professionals, including personnel in

13 the mental health workforce.

14 (C) Such other matters as the Secretary

15 considers appropriate.

16 (b) RECRUITMENT.—Commencing not later than 180

17 days after the date of the enactment of this Act, the Sec18 retary of Defense shall implement programs to recruit

19 qualified individuals in health care fields (including mental

20 health) to serve in the Armed Forces as health care and

21 mental health personnel of the Armed Forces.
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1 Subtitle C—Disability Matters

2 PART I—DISABILITY EVALUATIONS

3 SEC. 151. UTILIZATION OF VETERANS’ PRESUMPTION OF

4 SOUND CONDITION IN ESTABLISHING ELIGI5 BILITY OF MEMBERS OF THE ARMED FORCES

6 FOR RETIREMENT FOR DISABILITY.

7 (a) RETIREMENT OF REGULARS AND MEMBERS ON

8 ACTIVE DUTY FOR MORE THAN 30 DAYS.—Clause (i) of

9 section 1201(b)(3)(B) of title 10, United States Code, is

10 amended to read as follows:

11 ‘‘(i) the member has six months or

12 more of active military service and the dis13 ability was not noted at the time of the

14 member’s entrance on active duty (unless

15 compelling evidence or medical judgment is

16 such to warrant a finding that the dis17 ability existed before the member’s entrance

18 on active duty);’’.

19 (b) SEPARATION OF REGULARS AND MEMBERS ON AC20 TIVE DUTY FOR MORE THAN 30 DAYS.—Section

21 1203(b)(4)(B) of such title is amended by striking ‘‘and the

22 member has at least eight years of service computed under

23 section 1208 of this title’’ and inserting ‘‘, the member has

24 six months or more of active military service, and the dis25 ability was not noted at the time of the member’s entrance
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1 on active duty (unless evidence or medical judgment is such

2 to warrant a finding that the disability existed before the

3 member’s entrance on active duty)’’.

4 SEC. 152. REQUIREMENTS AND LIMITATIONS ON DEPART5 MENT OF DEFENSE DETERMINATIONS OF DIS6 ABILITY WITH RESPECT TO MEMBERS OF THE

7 ARMED FORCES.

8 (a) IN GENERAL.—Chapter 61 of title 10, United

9 States Code, is amended by inserting after section 1216 the

10 following new section:

11 ‘‘§ 1216a. Determinations of disability: requirements

12 and limitations on determinations

13 ‘‘(a) UTILIZATION OF VA SCHEDULE FOR RATING DIS14 ABILITIES IN DETERMINATIONS OF DISABILITY.—(1) In

15 making a determination of disability of a member of the

16 armed forces for purposes of this chapter, the Secretary

17 concerned—

18 ‘‘(A) shall, to the extent feasible, utilize the

19 schedule for rating disabilities in use by the Depart20 ment of Veterans Affairs, including any applicable

21 interpretation of the schedule by the United States

22 Court of Appeals for Veterans Claims; and

23 ‘‘(B) except as provided in paragraph (2), may

24 not deviate from the schedule or any such interpreta25 tion of the schedule.
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1 ‘‘(2) In making a determination described in para2 graph (1), the Secretary concerned may utilize in lieu of

3 the schedule described in that paragraph such criteria as

4 the Secretary of Defense and the Secretary of Veterans Af5 fairs may jointly prescribe for purposes of this subsection

6 if the utilization of such criteria will result in a determina7 tion of a greater percentage of disability than would be oth8 erwise determined through the utilization of the schedule.

9 ‘‘(b) CONSIDERATION OF ALL MEDICAL CONDI10 TIONS.—In making a determination of the rating of dis11 ability of a member of the armed forces for purposes of this

12 chapter, the Secretary concerned shall take into account all

13 medical conditions, whether individually or collectively,

14 that render the member unfit to perform the duties of the

15 member’s office, grade, rank, or rating.’’.

16 (b) CLERICAL AMENDMENT.—The table of sections at

17 the beginning of chapter 61 of such title is amended by in18 serting after the item relating to section 1216 the following

19 new item:

‘‘1216a. Determinations of disability: requirements and limitations on determinations.’’.

20 SEC. 153. REVIEW OF SEPARATION OF MEMBERS OF THE

21 ARMED FORCES SEPARATED FROM SERVICE

22 WITH A DISABILITY RATING OF 20 PERCENT

23 DISABLED OR LESS.

24 (a) BOARD REQUIRED.—
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1 (1) IN GENERAL.—Chapter 79 of title 10, United

2 States Code, is amended by inserting after section

3 1554 adding the following new section:

4 ‘‘§ 1554a. Review of separation with disability rating

5 of 20 percent disabled or less

6 ‘‘(a) IN GENERAL.—(1) The Secretary of Defense shall

7 establish within the Office of the Secretary of Defense a

8 board of review to review the disability determinations of

9 covered individuals by Physical Evaluation Boards. The

10 board shall be known as the ‘Physical Disability Board of

11 Review’.

12 ‘‘(2) The Board shall consist of not less than three

13 members appointed by the Secretary.

14 ‘‘(b) COVERED INDIVIDUALS.—For purposes of this

15 section, covered individuals are members and former mem16 bers of the armed forces who, during the period beginning

17 on September 11, 2001, and ending on December 31,

18 2009—

19 ‘‘(1) are separated from the armed forces due to

20 unfitness for duty due to a medical condition with a

21 disability rating of 20 percent disabled or less; and

22 ‘‘(2) are found to be not eligible for retirement.

23 ‘‘(c) REVIEW.—(1) Upon its own motion, or upon the

24 request of a covered individual, or a surviving spouse, next

25 of kin, or legal representative of a covered individual, the
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1 Board shall review the findings and decisions of the Phys2 ical Evaluation Board with respect to such covered indi3 vidual.

4 ‘‘(2) The review by the Board under paragraph (1)

5 shall be based on the records of the armed force concerned

6 and such other evidence as may be presented to the Board.

7 A witness may present evidence to the Board by affidavit

8 or by any other means considered acceptable by the Sec9 retary of Defense.

10 ‘‘(d) AUTHORIZED RECOMMENDATIONS.—The Board

11 may, as a result of its findings under a review under sub12 section (c), recommend to the Secretary concerned the fol13 lowing (as applicable) with respect to a covered individual:

14 ‘‘(1) No recharacterization of the separation of

15 such individual or modification of the disability rat16 ing previously assigned such individual.

17 ‘‘(2) The recharacterization of the separation of

18 such individual to retirement for disability.

19 ‘‘(3) The modification of the disability rating

20 previously assigned such individual by the Physical

21 Evaluation Board concerned, which modified dis22 ability rating may not be a reduction of the disability

23 rating previously assigned such individual by that

24 Physical Evaluation Board.
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1 ‘‘(4) The issuance of a new disability rating for

2 such individual.

3 ‘‘(e) CORRECTION OF MILITARY RECORDS.—(1) The

4 Secretary concerned may correct the military records of a

5 covered individual in accordance with a recommendation

6 made by the Board under subsection (d). Any such correc7 tion may be made effective as of the effective date of the

8 action taken on the report of the Physical Evaluation Board

9 to which such recommendation relates.

10 ‘‘(2) In the case of a member previously separated pur11 suant to the findings and decision of a Physical Evaluation

12 Board together with a lump-sum or other payment of back

13 pay and allowances at separation, the amount of pay or

14 other monetary benefits to which such member would be en15 titled based on the member’s military record as corrected

16 shall be reduced to take into account receipt of such lump17 sum or other payment in such manner as the Secretary of

18 Defense considers appropriate.

19 ‘‘(3) If the Board makes a recommendation not to cor20 rect the military records of a covered individual, the action

21 taken on the report of the Physical Evaluation Board to

22 which such recommendation relates shall be treated as final

23 as of the date of such action.
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1 ‘‘(f) REGULATIONS.—(1) This section shall be carried

2 out in accordance with regulations prescribed by the Sec3 retary of Defense.

4 ‘‘(2) The regulations under paragraph (1) shall specify

5 reasonable deadlines for the performance of reviews required

6 by this section.

7 ‘‘(3) The regulations under paragraph (1) shall specify

8 the effect of a determination or pending determination of

9 a Physical Evaluation Board on considerations by boards

10 for correction of military records under section 1552 of this

11 title.’’.

12 (2) CLERICAL AMENDMENT.—The table of sec13 tions at the beginning of chapter 79 of such title is

14 amended by inserting after the item relating to sec15 tion 1554 the following new item:

‘‘1554a. Review of separation with disability rating of 20 percent disabled or

less.’’.

16 (b) IMPLEMENTATION.—The Secretary of Defense shall

17 establish the board of review required by section 1554a of

18 title 10, United States Code (as added by subsection (a)),

19 and prescribe the regulations required by such section, not

20 later than 90 days after the date of the enactment of this

21 Act.
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1 SEC. 154. PILOT PROGRAMS ON REVISED AND IMPROVED

2 DISABILITY EVALUATION SYSTEM FOR MEM3 BERS OF THE ARMED FORCES.

4 (a) PILOT PROGRAMS.—

5 (1) IN GENERAL.—The Secretary of Defense

6 shall, in consultation with the Secretary of Veterans

7 Affairs, carry out pilot programs with respect to the

8 disability evaluation system of the Department of De9 fense for the purpose set forth in subsection (d).

10 (2) REQUIRED PILOT PROGRAMS.—In carrying

11 out this section, the Secretary of Defense shall carry

12 out the pilot programs described in paragraphs (1)

13 through (3) of subsection (c). Each such pilot program

14 shall be implemented not later than 90 days after the

15 date of the enactment of this Act.

16 (3) AUTHORIZED PILOT PROGRAMS.—In car17 rying out this section, the Secretary of Defense may

18 carry out such other pilot programs as the Secretary

19 of Defense, in consultation with the Secretary of Vet20 erans Affairs, considers appropriate.

21 (b) DISABILITY EVALUATION SYSTEM OF THE DE22 PARTMENT OF DEFENSE.—For purposes of this section, the

23 disability evaluation system of the Department of Defense

24 is the system of the Department for the evaluation of the

25 disabilities of members of the Armed Forces who are being
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1 separated or retired from the Armed Forces for disability

2 under chapter 61 of title 10, United States Code.

3 (c) SCOPE OF PILOT PROGRAMS.—

4 (1) DISABILITY DETERMINATIONS BY DOD UTI5 LIZING VA ASSIGNED DISABILITY RATING.—Under one

6 of the pilot programs under subsection (a), for pur7 poses of making a determination of disability of a

8 member of the Armed Forces under section 1201(b) of

9 title 10, United States Code, for the retirement, sepa10 ration, or placement of the member on the temporary

11 disability retired list under chapter 61 of such title,

12 upon a determination by the Secretary of the mili13 tary department concerned that the member is unfit

14 to perform the duties of the member’s office, grade,

15 rank, or rating because of a physical disability as de16 scribed in section 1201(a) of such title—

17 (A) the Secretary of Veterans Affairs

18 shall—

19 (i) conduct an evaluation of the mem20 ber for physical disability; and

21 (ii) assign the member a rating of dis22 ability in accordance with the schedule for

23 rating disabilities utilized by the Secretary

24 of Veterans Affairs based on all medical

25 conditions (whether individually or collec-
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1 tively) that render the member unfit for

2 duty; and

3 (B) the Secretary of the military depart4 ment concerned shall make the determination of

5 disability regarding the member utilizing the

6 rating of disability assigned under subparagraph

7 (A)(ii).

8 (2) DISABILITY DETERMINATIONS UTILIZING

9 JOINT DOD/VA ASSIGNED DISABILITY RATING.—Under

10 one of the pilot programs under subsection (a), in

11 making a determination of disability of a member of

12 the Armed Forces under section 1201(b) of title 10,

13 United States Code, for the retirement, separation, or

14 placement of the member on the temporary disability

15 retired list under chapter 61 of such title, the Sec16 retary of the military department concerned shall,

17 upon determining that the member is unfit to perform

18 the duties of the member’s office, grade, rank, or rat19 ing because of a physical disability as described in

20 section 1201(a) of such title—

21 (A) provide for the joint evaluation of the

22 member for disability by the Secretary of the

23 military department concerned and the Sec24 retary of Veterans Affairs, including the assign25 ment of a rating of disability for the member in
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1 accordance with the schedule for rating disabil2 ities utilized by the Secretary of Veterans Affairs

3 based on all medical conditions (whether indi4 vidually or collectively) that render the member

5 unfit for duty; and

6 (B) make the determination of disability re7 garding the member utilizing the rating of dis8 ability assigned under subparagraph (A).

9 (3) ELECTRONIC CLEARING HOUSE.—Under one

10 of the pilot programs, the Secretary of Defense shall

11 establish and operate a single Internet website for the

12 disability evaluation system of the Department of De13 fense that enables participating members of the

14 Armed Forces to fully utilize such system through the

15 Internet, with such Internet website to include the fol16 lowing:

17 (A) The availability of any forms required

18 for the utilization of the disability evaluation

19 system by members of the Armed Forces under

20 the system.

21 (B) Secure mechanisms for the submission

22 of such forms by members of the Armed Forces

23 under the system, and for the tracking of the ac24 ceptance and review of any forms so submitted.
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1 (C) Secure mechanisms for advising mem2 bers of the Armed Forces under the system of any

3 additional information, forms, or other items

4 that are required for the acceptance and review

5 of any forms so submitted.

6 (D) The continuous availability of assist7 ance to members of the Armed Forces under the

8 system (including assistance through the case9 workers assigned to such members of the Armed

10 Forces) in submitting and tracking such forms,

11 including assistance in obtaining information,

12 forms, or other items described by subparagraph

13 (C).

14 (E) Secure mechanisms to request and re15 ceive personnel files or other personnel records of

16 members of the Armed Forces under the system

17 that are required for submission under the dis18 ability evaluation system, including the capa19 bility to track requests for such files or records

20 and to determine the status of such requests and

21 of responses to such requests.

22 (4) OTHER PILOT PROGRAMS.—Under any pilot

23 program carried out by the Secretary of Defense

24 under subsection (a)(3), the Secretary shall provide

25 for the development, evaluation, and identification of
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1 such practices and procedures under the disability

2 evaluation system of the Department of Defense as the

3 Secretary considers appropriate for purpose set forth

4 in subsection (d).

5 (d) PURPOSE.—The purpose of each pilot program

6 under subsection (a) shall be—

7 (1) to provide for the development, evaluation,

8 and identification of revised and improved practices

9 and procedures under the disability evaluation system

10 of the Department of Defense in order to—

11 (A) reduce the processing time under the

12 disability evaluation system of members of the

13 Armed Forces who are likely to be retired or sep14 arated for disability, and who have not requested

15 continuation on active duty, including, in par16 ticular, members who are severely wounded;

17 (B) identify and implement or seek the

18 modification of statutory or administrative poli19 cies and requirements applicable to the disability

20 evaluation system that—

21 (i) are unnecessary or contrary to ap22 plicable best practices of civilian employers

23 and civilian healthcare systems; or

24 (ii) otherwise result in hardship, arbi25 trary, or inconsistent outcomes for members
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1 of the Armed Forces, or unwarranted ineffi2 ciencies and delays;

3 (C) eliminate material variations in poli4 cies, interpretations, and overall performance

5 standards among the military departments

6 under the disability evaluation system; and

7 (D) determine whether it enhances the capa8 bility of the Department of Veterans Affairs to

9 receive and determine claims from members of

10 the Armed Forces for compensation, pension,

11 hospitalization, or other veterans benefits; and

12 (2) in conjunction with the findings and rec13 ommendations of applicable Presidential and Depart14 ment of Defense study groups, to provide for the even15 tual development of revised and improved practices

16 and procedures for the disability evaluation system in

17 order to achieve the objectives set forth in paragraph

18 (1).

19 (e) UTILIZATION OF RESULTS IN UPDATES OF COM20 PREHENSIVE POLICY ON CARE, MANAGEMENT, AND TRANSI21 TION OF COVERED SERVICEMEMBERS.—The Secretary of

22 Defense and the Secretary of Veterans Affairs shall jointly

23 incorporate responses to any findings and recommendations

24 arising under the pilot programs required by subsection (a)
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1 in updating the comprehensive policy on the care and man2 agement of covered servicemembers under section 111.

3 (f) CONSTRUCTION WITH OTHER AUTHORITIES.—

4 (1) IN GENERAL.—Subject to paragraph (2), in

5 carrying out a pilot program under subsection (a)—

6 (A) the rules and regulations of the Depart7 ment of Defense and the Department of Veterans

8 Affairs relating to methods of determining fitness

9 or unfitness for duty and disability ratings for

10 members of the Armed Forces shall apply to the

11 pilot program only to the extent provided in the

12 report on the pilot program under subsection

13 (h)(1); and

14 (B) the Secretary of Defense and the Sec15 retary of Veterans Affairs may waive any provi16 sion of title 10, 37, or 38, United States Code,

17 relating to methods of determining fitness or

18 unfitness for duty and disability ratings for

19 members of the Armed Forces if the Secretaries

20 determine in writing that the application of such

21 provision would be inconsistent with the purpose

22 of the pilot program.

23 (2) LIMITATION.—Nothing in paragraph (1)

24 shall be construed to authorize the waiver of any pro-
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1 vision of section 1216a of title 10, United States

2 Code, as added by section 152 of this Act.

3 (g) DURATION.—Each pilot program under subsection

4 (a) shall be completed not later than one year after the date

5 of the commencement of such pilot program under that sub6 section.

7 (h) REPORTS.—

8 (1) INITIAL REPORT.—Not later than 90 days

9 after the date of the enactment of this Act, the Sec10 retary of Defense shall submit to the appropriate com11 mittees of Congress a report on the pilot programs

12 under subsection (a). The report shall include—

13 (A) a description of the scope and objectives

14 of each pilot program;

15 (B) a description of the methodology to be

16 used under such pilot program to ensure rapid

17 identification under such pilot program of re18 vised or improved practices under the disability

19 evaluation system of the Department of Defense

20 in order to achieve the objectives set forth in sub21 section (d)(1); and

22 (C) a statement of any provision described

23 in subsection (f)(1)(B) that shall not apply to

24 the pilot program by reason of a waiver under

25 that subsection.
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1 (2) INTERIM REPORT.—Not later than 150 days

2 after the date of the submittal of the report required

3 by paragraph (1), the Secretary shall submit to the

4 appropriate committees of Congress a report describ5 ing the current status of such pilot program.

6 (3) FINAL REPORT.—Not later than 90 days

7 after the completion of all the pilot programs de8 scribed in paragraphs (1) through (3) of subsection

9 (c), the Secretary shall submit to the appropriate

10 committees of Congress a report setting forth a final

11 evaluation and assessment of such pilot programs.

12 The report shall include such recommendations for

13 legislative or administrative action as the Secretary

14 considers appropriate in light of such pilot programs.

15 SEC. 155. REPORTS ON ARMY ACTION PLAN IN RESPONSE

16 TO DEFICIENCIES IN THE ARMY PHYSICAL

17 DISABILITY EVALUATION SYSTEM.

18 (a) REPORTS REQUIRED.—Not later than 30 days

19 after the date of the enactment of this Act, and every 120

20 days thereafter until March 1, 2009, the Secretary of De21 fense shall submit to the congressional defense committees

22 a report on the implementation of corrective measures by

23 the Department of Defense with respect to the Physical Dis24 ability Evaluation System (PDES) in response to the fol25 lowing:
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1 (1) The report of the Inspector General of the

2 Army on that system of March 6, 2007.

3 (2) The report of the Independent Review Group

4 on Rehabilitation Care and Administrative Processes

5 at Walter Reed Army Medical Center and National

6 Naval Medical Center.

7 (3) The report of the Department of Veterans Af8 fairs Task Force on Returning Global War on Terror

9 Heroes.

10 (b) ELEMENTS OF REPORT.—Each report under sub11 section (a) shall include current information on the fol12 lowing:

13 (1) The total number of cases, and the number

14 of cases involving combat disabled servicemembers,

15 pending resolution before the Medical and Physical

16 Disability Evaluation Boards of the Army, including

17 information on the number of members of the Army

18 who have been in a medical hold or holdover status

19 for more than each of 100, 200, and 300 days.

20 (2) The status of the implementation of modi21 fications to disability evaluation processes of the De22 partment of Defense in response to the following:

23 (A) The report of the Inspector General on

24 such processes dated March 6, 2007.
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1 (B) The report of the Independent Review

2 Group on Rehabilitation Care and Administra3 tive Processes at Walter Reed Army Medical

4 Center and National Naval Medical Center.

5 (C) The report of the Department of Vet6 erans Affairs Task Force on Returning Global

7 War on Terror Heroes.

8 (c) POSTING ON INTERNET.—Not later than 24 hours

9 after submitting a report under subsection (a), the Sec10 retary shall post such report on the Internet website of the

11 Department of Defense that is available to the public.

12 PART II—OTHER DISABILITY MATTERS

13 SEC. 161. ENHANCEMENT OF DISABILITY SEVERANCE PAY

14 FOR MEMBERS OF THE ARMED FORCES.

15 (a) IN GENERAL.—Section 1212 of title 10, United

16 States Code, is amended—

17 (1) in subsection (a)(1), by striking ‘‘his years of

18 service, but not more than 12, computed under section

19 1208 of this title’’ in the matter preceding subpara20 graph (A) and inserting ‘‘the member’s years of serv21 ice computed under section 1208 of this title (subject

22 to the minimum and maximum years of service pro23 vided for in subsection (c))’’;

24 (2) by redesignating subsection (c) as subsection

25 (d); and
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1 (3) by inserting after subsection (b) the following

2 new subsection (c):

3 ‘‘(c)(1) The minimum years of service of a member for

4 purposes of subsection (a)(1) shall be as follows:

5 ‘‘(A) Six years in the case of a member separated

6 from the armed forces for a disability incurred in line

7 of duty in a combat zone (as designated by the Sec8 retary of Defense for purposes of this subsection) or

9 incurred during the performance of duty in combat10 related operations as designated by the Secretary of

11 Defense.

12 ‘‘(B) Three years in the case of any other mem13 ber.

14 ‘‘(2) The maximum years of service of a member for

15 purposes of subsection (a)(1) shall be 19 years.’’.

16 (b) NO DEDUCTION FROM COMPENSATION OF SEVER17 ANCE PAY FOR DISABILITIES INCURRED IN COMBAT

18 ZONES.—Subsection (d) of such section, as redesignated by

19 subsection (a)(2) of this section, is further amended—

20 (1) by inserting ‘‘(1)’’ after ‘‘(d)’’;

21 (2) by striking the second sentence; and

22 (3) by adding at the end the following new para23 graphs:

24 ‘‘(2) No deduction may be made under paragraph (1)

25 in the case of disability severance pay received by a member
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1 for a disability incurred in line of duty in a combat zone

2 or incurred during performance of duty in combat-related

3 operations as designated by the Secretary of Defense.

4 ‘‘(3) No deduction may be made under paragraph (1)

5 from any death compensation to which a member’s depend6 ents become entitled after the member’s death.’’.

7 (c) EFFECTIVE DATE.—The amendments made by this

8 section shall take effect on the date of the enactment of this

9 Act, and shall apply with respect to members of the Armed

10 Forces separated from the Armed Forces under chapter 61

11 of title 10, United States Code, on or after that date.

12 SEC. 162. TRAUMATIC SERVICEMEMBERS’ GROUP LIFE IN13 SURANCE.

14 (a) DESIGNATION OF FIDUCIARY FOR MEMBERS WITH

15 LOST MENTAL CAPACITY OR EXTENDED LOSS OF CON16 SCIOUSNESS.—The Secretary of Defense shall, in consulta17 tion with the Secretary of Veterans Affairs, develop a form

18 for the designation of a recipient for the funds distributed

19 under section 1980A of title 38, United States Code, as the

20 fiduciary of a member of the Armed Forces in cases where

21 the member is medically incapacitated (as determined by

22 the Secretary of Defense in consultation with the Secretary

23 of Veterans Affairs) or experiencing an extended loss of con24 sciousness.
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1 (b) ELEMENTS.—The form under subsection (a) shall

2 require that a member may elect that—

3 (1) an individual designated by the member be

4 the recipient as the fiduciary of the member; or

5 (2) a court of proper jurisdiction determine the

6 recipient as the fiduciary of the member for purposes

7 of this subsection.

8 (c) COMPLETION AND UPDATE.—The form under sub9 section (a) shall be completed by an individual at the time

10 of entry into the Armed Forces and updated periodically

11 thereafter.

12 SEC. 163. ELECTRONIC TRANSFER FROM THE DEPARTMENT

13 OF DEFENSE TO THE DEPARTMENT OF VET14 ERANS AFFAIRS OF DOCUMENTS SUP15 PORTING ELIGIBILITY FOR BENEFITS.

16 The Secretary of Defense and the Secretary of Veterans

17 Affairs shall jointly develop and implement a mechanism

18 to provide for the electronic transfer from the Department

19 of Defense to the Department of Veterans Affairs of any De20 partment of Defense documents (including Department of

21 Defense form DD–214) necessary to establish or support the

22 eligibility of a member of the Armed Forces for benefits

23 under the laws administered by the Secretary of Veterans

24 Affairs at the time of the retirement, separation, or release

25 of the member from the Armed Forces.
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1 SEC. 164. ASSESSMENTS OF TEMPORARY DISABILITY RE2 TIRED LIST.

3 Not later than 180 days after the date of the enactment

4 of this Act, the Secretary of Defense and the Comptroller

5 General of the United States shall each submit to the con6 gressional defense committees a report assessing the con7 tinuing utility of the temporary disability retired list in

8 satisfying the purposes for which the temporary disability

9 retired list was established. Each report shall include such

10 recommendations for the modification or improvement of

11 the temporary disability retired list as the Secretary or the

12 Comptroller General, as applicable, considers appropriate

13 in light of the assessment in such report.

14 Subtitle D—Improvement of

15 Facilities Housing Patients

16 SEC. 171. STANDARDS FOR MILITARY MEDICAL TREATMENT

17 FACILITIES, SPECIALTY MEDICAL CARE FA18 CILITIES, AND MILITARY QUARTERS HOUSING

19 PATIENTS.

20 (a) ESTABLISHMENT OF STANDARDS.—The Secretary

21 of Defense shall establish for the military facilities referred

22 to in subsection (b) standards with respect to the matters

23 set forth in subsection (c). The standards shall, to the max24 imum extent practicable—

25 (1) be uniform and consistent across such facili26 ties; and
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1 (2) be uniform and consistent across the Depart2 ment of Defense and the military departments.

3 (b) COVERED MILITARY FACILITIES.—The military

4 facilities referred to in this subsection are the military fa5 cilities of the Department of Defense and the military de6 partments as follows:

7 (1) Military medical treatment facilities.

8 (2) Specialty medical care facilities.

9 (3) Military quarters or leased housing for pa10 tients.

11 (c) SCOPE OF STANDARDS.—The standards required

12 by subsection (a) shall include the following:

13 (1) Generally accepted standards for the accredi14 tation of medical facilities, or for facilities used to

15 quarter individuals that may require medical super16 vision, as applicable, in the United States.

17 (2) To the extent not inconsistent with the stand18 ards described in paragraph (1), minimally accept19 able conditions for the following:

20 (A) Appearance and maintenance of facili21 ties generally, including the structure and roofs

22 of facilities.

23 (B) Size, appearance, and maintenance of

24 rooms housing or utilized by patients, including

25 furniture and amenities in such rooms.
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1 (C) Operation and maintenance of primary

2 and back-up facility utility systems and other

3 systems required for patient care, including elec4 trical systems, plumbing systems, heating, ven5 tilation, and air conditioning systems, commu6 nications systems, fire protection systems, energy

7 management systems, and other systems required

8 for patient care.

9 (D) Compliance with Federal Government

10 standards for hospital facilities and operations.

11 (E) Compliance of facilities, rooms, and

12 grounds, to the maximum extent practicable,

13 with the Americans with Disabilities Act of 1990

14 (42 U.S.C. 12101 et seq.).

15 (F) Such other matters relating to the ap16 pearance, size, operation, and maintenance of fa17 cilities and rooms as the Secretary considers ap18 propriate.

19 (d) COMPLIANCE WITH STANDARDS.—

20 (1) DEADLINE.—In establishing standards under

21 subsection (a), the Secretary shall specify a deadline

22 for compliance with such standards by each facility

23 referred to in subsection (b). The deadline shall be at

24 the earliest date practicable after the date of the en25 actment of this Act, and shall, to the maximum extent
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1 practicable, be uniform across the facilities referred to

2 in subsection (b).

3 (2) INVESTMENT.—In carrying out this section,

4 the Secretary shall also establish guidelines for invest5 ment to be utilized by the Department of Defense and

6 the military departments in determining the alloca7 tion of financial resources to facilities referred to in

8 subsection (b) in order to meet the deadline specified

9 under paragraph (1).

10 (e) REPORT.—

11 (1) IN GENERAL.—Not later than December 30,

12 2007, the Secretary shall submit to the congressional

13 defense committees a report on the actions taken to

14 carry out this section.

15 (2) ELEMENTS.—The report under paragraph

16 (1) shall include the following:

17 (A) The standards established under sub18 section (a).

19 (B) An assessment of the appearance, condi20 tion, and maintenance of each facility referred to

21 in subsection (a), including—

22 (i) an assessment of the compliance of

23 such facility with the standards established

24 under subsection (a); and
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1 (ii) a description of any deficiency or

2 noncompliance in each facility with the

3 standards.

4 (C) A description of the investment to be al5 located to address each deficiency or noncompli6 ance identified under subparagraph (B)(ii).

7 SEC. 172. REPORTS ON ARMY ACTION PLAN IN RESPONSE

8 TO DEFICIENCIES IDENTIFIED AT WALTER

9 REED ARMY MEDICAL CENTER.

10 (a) REPORTS REQUIRED.—Not later than 30 days

11 after the date of the enactment of this Act, and every 120

12 days thereafter until March 1, 2009, the Secretary of De13 fense shall submit to the congressional defense committees

14 a report on the implementation of the action plan of the

15 Army to correct deficiencies identified in the condition of

16 facilities, and in the administration of outpatients in med17 ical hold or medical holdover status, at Walter Reed Army

18 Medical Center (WRAMC) and at other applicable Army

19 installations at which covered members of the Armed Forces

20 are assigned.

21 (b) ELEMENTS OF REPORT.—Each report under sub22 section (a) shall include current information on the fol23 lowing:

24 (1) The number of inpatients at Walter Reed

25 Army Medical Center, and the number of outpatients
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1 on medical hold or in a medical holdover status at

2 Walter Reed Army Medical Center, as a result of seri3 ous injuries or illnesses.

4 (2) A description of the lodging facilities and

5 other forms of housing at Walter Reed Army Medical

6 Center, and at each other Army facility, to which are

7 assigned personnel in medical hold or medical hold8 over status as a result of serious injuries or illnesses,

9 including—

10 (A) an assessment of the conditions of such

11 facilities and housing; and

12 (B) a description of any plans to correct in13 adequacies in such conditions.

14 (3) The status, estimated completion date, and

15 estimated cost of any proposed or ongoing actions to

16 correct any inadequacies in conditions as described

17 under paragraph (2).

18 (4) The number of case managers, platoon ser19 geants, patient advocates, and physical evaluation

20 board liaison officers stationed at Walter Reed Army

21 Medical Center, and at each other Army facility, to

22 which are assigned personnel in medical hold or med23 ical holdover status as a result of serious injuries or

24 illnesses, and the ratio of case workers and platoon
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1 sergeants to outpatients for whom they are responsible

2 at each such facility.

3 (5) The number of telephone calls received during

4 the preceding 60 days on the Wounded Soldier and

5 Family hotline (as established on March 19, 2007), a

6 summary of the complaints or communications re7 ceived through such calls, and a description of the ac8 tions taken in response to such calls.

9 (6) A summary of the activities, findings, and

10 recommendations of the Army tiger team of medical

11 and installation professionals who visited the major

12 medical treatment facilities and community-based

13 health care organizations of the Army pursuant to

14 March 2007 orders, and a description of the status of

15 corrective actions being taken with to address defi16 ciencies noted by that team.

17 (7) The status of the ombudsman programs at

18 Walter Reed Army Medical Center and at other major

19 Army installations to which are assigned personnel in

20 medical hold or medical holdover status as a result of

21 serious injuries or illnesses.

22 (c) POSTING ON INTERNET.—Not later than 24 hours

23 after submitting a report under subsection (a), the Sec24 retary shall post such report on the Internet website of the

25 Department of Defense that is available to the public.
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1 SEC. 173. CONSTRUCTION OF FACILITIES REQUIRED FOR

2 THE CLOSURE OF WALTER REED ARMY MED3 ICAL CENTER, DISTRICT OF COLUMBIA.

4 (a) ASSESSMENT OF ACCELERATION OF CONSTRUC5 TION OF FACILITIES.—The Secretary of Defense shall carry

6 out an assessment of the feasibility (including the cost-effec7 tiveness) of accelerating the construction and completion of

8 any new facilities required to facilitate the closure of Walter

9 Reed Army Medical Center, District of Columbia, as re10 quired as a result of the 2005 round of defense base closure

11 and realignment under the Defense Base Closure and Re12 alignment Act of 1990 (part A of title XXIX of Public Law

13 101–510; U.S.C. 2687 note).

14 (b) DEVELOPMENT AND IMPLEMENTATION OF PLAN

15 FOR CONSTRUCTION OF FACILITIES.—

16 (1) IN GENERAL.—The Secretary shall develop

17 and carry out a plan for the construction and com18 pletion of any new facilities required to facilitate the

19 closure of Walter Reed Army Medical Center as re20 quired as described in subsection (a). If the Secretary

21 determines as a result of the assessment under sub22 section (a) that accelerating the construction and

23 completion of such facilities is feasible, the plan shall

24 provide for the accelerated construction and comple25 tion of such facilities in a manner consistent with

26 that determination.
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1 (2) SUBMITTAL OF PLAN.—The Secretary shall

2 submit to the congressional defense committees the

3 plan required by paragraph (1) not later than Sep4 tember 30, 2007.

5 (c) CERTIFICATIONS.—Not later than September 30,

6 2007, the Secretary shall submit to the congressional defense

7 committees a certification of each of the following:

8 (1) That a transition plan has been developed,

9 and resources have been committed, to ensure that pa10 tient care services, medical operations, and facilities

11 are sustained at the highest possible level at Walter

12 Reed Army Medical Center until facilities to replace

13 Walter Reed Army Medical Center are staffed and

14 ready to assume at least the same level of care pre15 viously provided at Walter Reed Army Medical Cen16 ter.

17 (2) That the closure of Walter Reed Army Med18 ical Center will not result in a net loss of capacity

19 in the major military medical centers in the National

20 Capitol Region in terms of total bed capacity or

21 staffed bed capacity.

22 (3) That the capacity and types of medical hold

23 and out-patient lodging facilities currently operating

24 at Walter Reed Army Medical Center will be avail25 able at the facilities to replace Walter Reed Army
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1 Medical Center by the date of the closure of Walter

2 Reed Army Medical Center.

3 (4) That adequate funds have been provided to

4 complete fully all facilities identified in the Base Re5 alignment and Closure Business Plan for Walter Reed

6 Army Medical Center submitted to the congressional

7 defense committees as part of the budget justification

8 materials submitted to Congress together with the

9 budget of the President for fiscal year 2008 as con10 templated in that business plan.

11 (d) ENVIRONMENTAL LAWS.—Nothing in this section

12 shall require the Secretary or any designated representative

13 to waive or ignore responsibilities and actions required by

14 the National Environmental Policy Act of 1969 (42 U.S.C.

15 4321 et seq.) or the regulations implementing such Act.

16 Subtitle E—Outreach and Related

17 Information on Benefits

18 SEC. 181. HANDBOOK FOR MEMBERS OF THE ARMED

19 FORCES ON COMPENSATION AND BENEFITS

20 AVAILABLE FOR SERIOUS INJURIES AND ILL21 NESSES.

22 (a) INFORMATION ON AVAILABLE COMPENSATION AND

23 BENEFITS.—The Secretary of Defense shall, in consultation

24 with the Secretary of Veterans Affairs, the Secretary of

25 Health and Human Services, and the Commissioner of So-
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1 cial Security, develop and maintain in handbook and elec2 tronic form a comprehensive description of the compensa3 tion and other benefits to which a member of the Armed

4 Forces, and the family of such member, would be entitled

5 upon the member’s separation or retirement from the Armed

6 Forces as a result of a serious injury or illness. The hand7 book shall set forth the range of such compensation and ben8 efits based on grade, length of service, degree of disability

9 at separation or retirement, and such other factors affecting

10 such compensation and benefits as the Secretary of Defense

11 considers appropriate.

12 (b) UPDATE.—The Secretary of Defense shall update

13 the comprehensive description required by subsection (a),

14 including the handbook and electronic form of the descrip15 tion, on a periodic basis, but not less often than annually.

16 (c) PROVISION TO MEMBERS.—The Secretary of the

17 military department concerned shall provide the descriptive

18 handbook under subsection (a) to each member of the Armed

19 Forces described in that subsection as soon as practicable

20 following the injury or illness qualifying the member for

21 coverage under that subsection.

22 (d) PROVISION TO REPRESENTATIVES.—If a member

23 is incapacitated or otherwise unable to receive the descrip24 tive handbook to be provided under subsection (a), the hand25 book shall be provided to the next of kin or a legal represent-
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1 ative of the member (as determined in accordance with reg2 ulations prescribed by the Secretary of the military depart3 ment concerned for purposes of this section).

4 Subtitle F—Other Matters

5 SEC. 191. STUDY ON PHYSICAL AND MENTAL HEALTH AND

6 OTHER READJUSTMENT NEEDS OF MEMBERS

7 AND FORMER MEMBERS OF THE ARMED

8 FORCES WHO DEPLOYED IN OPERATION

9 IRAQI FREEDOM AND OPERATION ENDURING

10 FREEDOM AND THEIR FAMILIES.

11 (a) STUDY REQUIRED.—The Secretary of Defense

12 shall, in consultation with the Secretary of Veterans Affairs,

13 enter into an agreement with the National Academy of

14 Sciences for a study on the physical and mental health and

15 other readjustment needs of members and former members

16 of the Armed Forces who deployed in Operation Iraqi Free17 dom or Operation Enduring Freedom and their families as

18 a result of such deployment.

19 (b) PHASES.—The study required under subsection (a)

20 shall consist of two phases:

21 (1) A preliminary phase, to be completed not

22 later than 180 days after the date of the enactment

23 of this Act—

24 (A) to identify preliminary findings on the

25 physical and mental health and other readjust-
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1 ment needs described in subsection (a) and on

2 gaps in care for the members, former members,

3 and families described in that subsection; and

4 (B) to determine the parameters of the sec5 ond phase of the study under paragraph (2).

6 (2) A second phase, to be completed not later

7 than three years after the date of the enactment of this

8 Act, to carry out a comprehensive assessment, in ac9 cordance with the parameters identified under the

10 preliminary report required by paragraph (1), of the

11 physical and mental health and other readjustment

12 needs of members and former members of the Armed

13 Forces who deployed in Operation Iraqi Freedom or

14 Operation Enduring Freedom and their families as a

15 result of such deployment, including, at a

16 minimum—

17 (A) an assessment of the psychological, so18 cial, and economic impacts of such deployment

19 on such members and former members and their

20 families;

21 (B) an assessment of the particular impacts

22 of multiple deployments in Operation Iraqi

23 Freedom or Operation Enduring Freedom on

24 such members and former members and their

25 families;
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1 (C) an assessment of the full scope of the

2 neurological, psychiatric, and psychological ef3 fects of traumatic brain injury (TBI) on mem4 bers and former members of the Armed Forces,

5 including the effects of such effects on the family

6 members of such members and former members,

7 and an assessment of the efficacy of current

8 treatment approaches for traumatic brain injury

9 in the United States and the efficacy of

10 screenings and treatment approaches for trau11 matic brain injury within the Department of

12 Defense and the Department of Veterans Affairs;

13 (D) an assessment of the effects of

14 undiagnosed injuries such as post-traumatic

15 stress disorder (PTSD) and traumatic brain in16 jury, an estimate of the long-term costs associ17 ated with such injuries, and an assessment of the

18 efficacy of screenings and treatment approaches

19 for post-traumatic stress disorder and other men20 tal health conditions within the Department of

21 Defense and Department of Veterans Affairs;

22 (E) an assessment of the particular needs

23 and concerns of female members of the Armed

24 Forces and female veterans;
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1 (F) an assessment of the particular needs

2 and concerns of children of members of the

3 Armed Forces, taking into account differing age

4 groups, impacts on development and education,

5 and the mental and emotional well being of chil6 dren;

7 (G) an assessment of the particular needs

8 and concerns of minority members of the Armed

9 Forces and minority veterans;

10 (H) an assessment of the particular edu11 cational and vocational needs of such members

12 and former members and their families, and an

13 assessment of the efficacy of existing educational

14 and vocational programs to address such needs;

15 (I) an assessment of the impacts on commu16 nities with high populations of military families,

17 including military housing communities and

18 townships with deployed members of the Na19 tional Guard and Reserve, of deployments associ20 ated with Operation Iraqi Freedom and Oper21 ation Enduring Freedom, and an assessment of

22 the efficacy of programs that address community

23 outreach and education concerning military de24 ployments of community residents;
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1 (J) an assessment of the impacts of increas2 ing numbers of older and married members of

3 the Armed Forces on readjustment requirements;

4 (K) the development, based on such assess5 ments, of recommendations for programs, treat6 ments, or policy remedies targeted at preventing,

7 minimizing or addressing the impacts, gaps and

8 needs identified; and

9 (L) the development, based on such assess10 ments, of recommendations for additional re11 search on such needs.

12 (c) POPULATIONS TO BE STUDIED.—The study re13 quired under subsection (a) shall consider the readjustment

14 needs of each population of individuals as follows:

15 (1) Members of the regular components of the

16 Armed Forces who are returning, or have returned, to

17 the United States from deployment in Operation

18 Iraqi Freedom or Operation Enduring Freedom.

19 (2) Members of the National Guard and Reserve

20 who are returning, or have returned, to the United

21 States from deployment in Operation Iraqi Freedom

22 or Operation Enduring Freedom.

23 (3) Veterans of Operation Iraqi Freedom or Op24 eration Enduring Freedom.
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1 (4) Family members of the members and vet2 erans described in paragraphs (1) through (3).

3 (d) ACCESS TO INFORMATION.—The National Acad4 emy of Sciences shall have access to such personnel, infor5 mation, records, and systems of the Department of Defense

6 and the Department of Veterans Affairs as the National

7 Academy of Sciences requires in order to carry out the

8 study required under subsection (a).

9 (e) PRIVACY OF INFORMATION.—The National Acad10 emy of Sciences shall maintain any personally identifiable

11 information accessed by the Academy in carrying out the

12 study required under subsection (a) in accordance with all

13 applicable laws, protections, and best practices regarding

14 the privacy of such information, and may not permit access

15 to such information by any persons or entities not engaged

16 in work under the study.

17 (f) REPORTS BY NATIONAL ACADEMY OF SCIENCES.—

18 Upon the completion of each phase of the study required

19 under subsection (a), the National Academy of Sciences

20 shall submit to the Secretary of Defense and the Secretary

21 of Veterans Affairs a report on such phase of the study.

22 (g) DOD AND VA RESPONSE TO NAS REPORTS.—

23 (1) PRELIMINARY RESPONSE.—Not later than 45

24 days after the receipt of a report under subsection (f)

25 on each phase of the study required under subsection
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1 (a), the Secretary of Defense and the Secretary of Vet2 erans Affairs shall jointly develop a preliminary joint

3 Department of Defense-Department of Veterans Af4 fairs plan to address the findings and recommenda5 tions of the National Academy of Sciences contained

6 in such report. The preliminary plan shall provide

7 preliminary proposals on the matters set forth in

8 paragraph (3).

9 (2) FINAL RESPONSE.—Not later than 90 days

10 after the receipt of a report under subsection (f) on

11 each phase of the study required under subsection (a),

12 the Secretary of Defense and the Secretary of Veterans

13 Affairs shall jointly develop a final joint Department

14 of Defense-Department of Veterans Affairs plan to ad15 dress the findings and recommendations of the Na16 tional Academy of Sciences contained in such report.

17 The final plan shall provide final proposals on the

18 matters set forth in paragraph (3).

19 (3) COVERED MATTERS.—The matters set forth

20 in this paragraph with respect to a phase of the study

21 required under subsection (a) are as follows:

22 (A) Modifications of policy or practice

23 within the Department of Defense and the De24 partment of Veterans Affairs that are necessary

25 to address gaps in care or services as identified
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1 by the National Academy of Sciences under such

2 phase of the study.

3 (B) Modifications of policy or practice

4 within the Department of Defense and the De5 partment of Veterans Affairs that are necessary

6 to address recommendations made by the Na7 tional Academy of Sciences under such phase of

8 the study.

9 (C) An estimate of the costs of imple10 menting the modifications set forth under sub11 paragraphs (A) and (B), set forth by fiscal year

12 for at least the first five fiscal years beginning

13 after the date of the plan concerned.

14 (4) REPORTS ON RESPONSES.—The Secretary of

15 Defense and the Secretary of Veterans Affairs shall

16 jointly submit to Congress a report setting forth each

17 joint plan developed under paragraphs (1) and (2).

18 (5) PUBLIC AVAILABILITY OF RESPONSES.—The

19 Secretary of Defense and the Secretary of Veterans Af20 fairs shall each make available to the public each re21 port submitted to Congress under paragraph (4), in22 cluding by posting an electronic copy of such report

23 on the Internet website of the Department of Defense

24 or the Department of Veterans Affairs, as applicable,

25 that is available to the public.
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1 (6) GAO AUDIT.—Not later than 45 days after

2 the submittal to Congress of the report under para3 graph (4) on the final joint Department of Defense4 Department of Veterans Affairs plan under para5 graph (2), the Comptroller General of the United

6 States shall submit to Congress a report assessing the

7 contents of such report under paragraph (4). The re8 port of the Comptroller General under this paragraph

9 shall include—

10 (A) an assessment of the adequacy and suf11 ficiency of the final joint Department of Defense12 Department of Veterans Affairs plan in address13 ing the findings and recommendations of the Na14 tional Academy of Sciences as a result of the

15 study required under subsection (a);

16 (B) an assessment of the feasibility and ad17 visability of the modifications of policy and

18 practice proposed in the final joint Department

19 of Defense-Department of Veterans Affairs plan;

20 (C) an assessment of the sufficiency and ac21 curacy of the cost estimates in the final joint De22 partment of Defense-Department of Veterans Af23 fairs plan; and

24 (D) the comments, if any, of the National

25 Academy of Sciences on the final joint Depart-
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1 ment of Defense-Department of Veterans Affairs

2 plan.

3 (h) AUTHORIZATION OF APPROPRIATIONS.—There is

4 hereby authorized to be appropriated to the Department of

5 Defense such sums as may be necessary to carry out this

6 section.

7 TITLE II—VETERANS MATTERS

8 SEC. 201. SENSE OF CONGRESS ON DEPARTMENT OF VET9 ERANS AFFAIRS EFFORTS IN THE REHABILI10 TATION AND REINTEGRATION OF VETERANS

11 WITH TRAUMATIC BRAIN INJURY.

12 It is the sense of Congress that—

13 (1) the Department of Veterans Affairs is a lead14 er in the field of traumatic brain injury care and co15 ordination of such care;

16 (2) the Department of Veterans Affairs should

17 have the capacity and expertise to provide veterans

18 who have a traumatic brain injury with patient-cen19 tered health care, rehabilitation, and community inte20 gration services that are comparable to or exceed

21 similar care and services available to persons with

22 such injuries in the academic and private sector;

23 (3) rehabilitation for veterans who have a trau24 matic brain injury should be individualized, com25 prehensive, and interdisciplinary with the goals of
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1 optimizing the independence of such veterans and re2 integrating them into their communities;

3 (4) family support is integral to the rehabilita4 tion and community reintegration of veterans who

5 have sustained a traumatic brain injury, and the De6 partment should provide the families of such veterans

7 with education and support;

8 (5) the Department of Defense and Department

9 of Veterans Affairs have made efforts to provide a

10 smooth transition of medical care and rehabilitative

11 services to individuals as they transition from the

12 health care system of the Department of Defense to

13 that of the Department of Veterans Affairs, but more

14 can be done to assist veterans and their families in

15 the continuum of the rehabilitation, recovery, and re16 integration of wounded or injured veterans into their

17 communities;

18 (6) in planning for rehabilitation and commu19 nity reintegration of veterans who have a traumatic

20 brain injury, it is necessary for the Department of

21 Veterans Affairs to provide a system for life-long case

22 management for such veterans; and

23 (7) in such system for life-long case management,

24 it is necessary to conduct outreach and to tailor spe25 cialized traumatic brain injury case management and
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1 outreach for the unique needs of veterans with trau2 matic brain injury who reside in urban and non3 urban settings.

4 SEC. 202. INDIVIDUAL REHABILITATION AND COMMUNITY

5 REINTEGRATION PLANS FOR VETERANS AND

6 OTHERS WITH TRAUMATIC BRAIN INJURY.

7 (a) IN GENERAL.—Subchapter II of chapter 17 of title

8 38, United States Code, is amended by inserting after sec9 tion 1710B the following new section:

10 ‘‘§ 1710C. Traumatic brain injury: plans for rehabili11 tation and reintegration into the commu12 nity

13 ‘‘(a) PLAN REQUIRED.—The Secretary shall, for each

14 veteran or member of the Armed Forces who receives inpa15 tient or outpatient rehabilitation care from the Department

16 for a traumatic brain injury—

17 ‘‘(1) develop an individualized plan for the reha18 bilitation and reintegration of such individual into

19 the community; and

20 ‘‘(2) provide such plan in writing to such indi21 vidual before such individual is discharged from in22 patient care, following transition from active duty to

23 the Department for outpatient care, or as soon as

24 practicable following diagnosis.
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1 ‘‘(b) CONTENTS OF PLAN.—Each plan developed under

2 subsection (a) shall include, for the individual covered by

3 such plan, the following:

4 ‘‘(1) Rehabilitation objectives for improving the

5 physical, cognitive, and vocational functioning of

6 such individual with the goal of maximizing the inde7 pendence and reintegration of such individual into

8 the community.

9 ‘‘(2) Access, as warranted, to all appropriate re10 habilitative components of the traumatic brain injury

11 continuum of care.

12 ‘‘(3) A description of specific rehabilitative treat13 ments and other services to achieve the objectives de14 scribed in paragraph (1), which description shall set

15 forth the type, frequency, duration, and location of

16 such treatments and services.

17 ‘‘(4) The name of the case manager designated in

18 accordance with subsection (d) to be responsible for

19 the implementation of such plan.

20 ‘‘(5) Dates on which the effectiveness of the plan

21 will be reviewed in accordance with subsection (f).

22 ‘‘(c) COMPREHENSIVE ASSESSMENT.—

23 ‘‘(1) IN GENERAL.—Each plan developed under

24 subsection (a) shall be based upon a comprehensive
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1 assessment, developed in accordance with paragraph

2 (2), of—

3 ‘‘(A) the physical, cognitive, vocational, and

4 neuropsychological and social impairments of

5 such individual; and

6 ‘‘(B) the family education and family sup7 port needs of such individual after discharge

8 from inpatient care.

9 ‘‘(2) FORMATION.—The comprehensive assess10 ment required under paragraph (1) with respect to an

11 individual is a comprehensive assessment of the mat12 ters set forth in that paragraph by a team, composed

13 by the Secretary for purposes of the assessment from

14 among, but not limited to, individuals with expertise

15 in traumatic brain injury, including the following:

16 ‘‘(A) A neurologist.

17 ‘‘(B) A rehabilitation physician.

18 ‘‘(C) A social worker.

19 ‘‘(D) A neuropsychologist.

20 ‘‘(E) A physical therapist.

21 ‘‘(F) A vocational rehabilitation specialist.

22 ‘‘(G) An occupational therapist.

23 ‘‘(H) A speech language pathologist.

24 ‘‘(I) A rehabilitation nurse.

25 ‘‘(J) An educational therapist.
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1 ‘‘(K) An audiologist.

2 ‘‘(L) A blind rehabilitation specialist.

3 ‘‘(M) A recreational therapist.

4 ‘‘(N) A low vision optometrist.

5 ‘‘(O) An orthotist or prostetist.

6 ‘‘(P) An assistive technologist or rehabilita7 tion engineer.

8 ‘‘(Q) An otolaryngology physician.

9 ‘‘(R) A dietician.

10 ‘‘(S) An opthamologist.

11 ‘‘(T) A psychiatrist.

12 ‘‘(d) CASE MANAGER.—(1) The Secretary shall des13 ignate a case manager for each individual described in sub14 section (a) to be responsible for the implementation of the

15 plan, and coordination of such care, required by such sub16 section for such individual.

17 ‘‘(2) The Secretary shall ensure that such case manager

18 has specific expertise in the care required by the individual

19 to whom such case manager is designated, regardless of

20 whether such case manager obtains such expertise through

21 experience, education, or training.

22 ‘‘(e) PARTICIPATION AND COLLABORATION IN DEVEL23 OPMENT OF PLANS.—(1) The Secretary shall involve each

24 individual described in subsection (a), and the family or

25 legal guardian of such individual, in the development of
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1 the plan for such individual under that subsection to the

2 maximum extent practicable.

3 ‘‘(2) The Secretary shall collaborate in the development

4 of a plan for an individual under subsection (a) with a

5 State protection and advocacy system if—

6 ‘‘(A) the individual covered by such plan re7 quests such collaboration; or

8 ‘‘(B) in the case such individual is incapaci9 tated, the family or guardian of such individual re10 quests such collaboration.

11 ‘‘(3) In the case of a plan required by subsection (a)

12 for a member of the Armed Forces who is on active duty,

13 the Secretary shall collaborate with the Secretary of Defense

14 in the development of such plan.

15 ‘‘(4) In developing vocational rehabilitation objectives

16 required under subsection (b)(1) and in conducting the as17 sessment required under subsection (c), the Secretary shall

18 act through the Under Secretary for Health in coordination

19 with the Vocational Rehabilitation and Employment Serv20 ice of the Department of Veterans Affairs.

21 ‘‘(f) EVALUATION.—

22 ‘‘(1) PERIODIC REVIEW BY SECRETARY.—The

23 Secretary shall periodically review the effectiveness of

24 each plan developed under subsection (a). The Sec-
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1 retary shall refine each such plan as the Secretary

2 considers appropriate in light of such review.

3 ‘‘(2) REQUEST FOR REVIEW BY VETERANS.—In

4 addition to the periodic review required by paragraph

5 (1), the Secretary shall conduct a review of the plan

6 of a veteran under paragraph (1) at the request of

7 such veteran, or in the case that such veteran is inca8 pacitated, at the request of the guardian or the des9 ignee of such veteran.

10 ‘‘(g) STATE DESIGNATED PROTECTION AND ADVOCACY

11 SYSTEM DEFINED.—In this section, the term ‘State protec12 tion and advocacy system’ means a system established in

13 a State under subtitle C of the Developmental Disabilities

14 Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15041

15 et seq.) to protect and advocate for the rights of persons

16 with development disabilities.’’.

17 (b) CLERICAL AMENDMENT.—The table of sections at

18 the beginning of chapter 17 of such title is amended by in19 serting after the item relating to section 1710B the following

20 new item:

‘‘1710C. Traumatic brain injury: plans for rehabilitation and reintegration into

the community.’’.
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1 SEC. 203. USE OF NON-DEPARTMENT OF VETERANS AF2 FAIRS FACILITIES FOR IMPLEMENTATION OF

3 REHABILITATION AND COMMUNITY RE4 INTEGRATION PLANS FOR TRAUMATIC BRAIN

5 INJURY.

6 (a) IN GENERAL.—Subchapter II of chapter 17 of title

7 38, United States Code, is amended by inserting after sec8 tion 1710C, as added by section 202 of this Act, the fol9 lowing new section:

10 ‘‘§ 1710D. Traumatic brain injury: use of non-Depart11 ment facilities for rehabilitation

12 ‘‘(a) IN GENERAL.—Subject to section 1710(a)(4) of

13 this title and subsection (b) of this section, the Secretary

14 shall provide rehabilitative treatment or services to imple15 ment a plan developed under section 1710C of this title at

16 a non-Department facility with which the Secretary has en17 tered into an agreement for such purpose, to an

18 individual—

19 ‘‘(1) who is described in section 1710C(a) of this

20 title; and

21 ‘‘(2)(A) to whom the Secretary is unable to pro22 vide such treatment or services at the frequency or for

23 the duration prescribed in such plan; or

24 ‘‘(B) for whom the Secretary determines that it

25 is optimal with respect to the recovery and rehabilita26 tion of such individual .
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1 ‘‘(b) STANDARDS.—The Secretary may not provide

2 treatment or services as described in subsection (a) at a

3 non-Department facility under such subsection unless such

4 facility maintains standards for the provision of such treat5 ment or services established by an independent, peer-re6 viewed organization that accredits specialized rehabilita7 tion programs for adults with traumatic brain injury.

8 ‘‘(c) AUTHORITIES OF STATE PROTECTION AND ADVO9 CACY SYSTEMS.—With respect to the provision of rehabili10 tative treatment or services described in subsection (a) in

11 a non-Department facility, a State designated protection

12 and advocacy system established under subtitle C of the De13 velopmental Disabilities Assistance and Bill of Rights Act

14 of 2000 (42 U.S.C. 15041 et seq.) shall have the authorities

15 described under such subtitle.’’.

16 (b) CLERICAL AMENDMENT.—The table of sections at

17 the beginning of chapter 17 of such title is amended by in18 serting after the item relating to section 1710C, as added

19 by section 202 of this Act, the following new item:

‘‘1710D. Traumatic brain injury: use of non-Department facilities for rehabilitation.’’.

20 (c) CONFORMING AMENDMENT.—Section 1710(a)(4) of

21 such title is amended by inserting ‘‘the requirement in sec22 tion 1710D of this title that the Secretary provide certain

23 rehabilitative treatment or services,’’ after ‘‘extended care

24 services,’’.
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1 SEC. 204. RESEARCH, EDUCATION, AND CLINICAL CARE

2 PROGRAM ON SEVERE TRAUMATIC BRAIN IN3 JURY.

4 (a) PROGRAM REQUIRED.—Subchapter II of chapter

5 73 of title 38, United States Code, is amended by inserting

6 after section 7330 the following new section:

7 ‘‘§ 7330A. Severe traumatic brain injury research, edu8 cation, and clinical care program

9 ‘‘(a) PROGRAM REQUIRED.—The Secretary shall estab10 lish a program on research, education, and clinical care

11 to provide intensive neuro-rehabilitation to veterans with

12 a severe traumatic brain injury, including veterans in a

13 minimally conscious state who would otherwise receive only

14 long-term residential care.

15 ‘‘(b) COLLABORATION REQUIRED.—The Secretary

16 shall establish the program required by subsection (a) in

17 collaboration with the Defense and Veterans Brain Injury

18 Center and other relevant programs of the Federal Govern19 ment (including other Centers of Excellence).

20 ‘‘(c) EDUCATION REQUIRED.—As part of the program

21 required by subsection (a), the Secretary shall, in collabora22 tion with the Defense and Veterans Brain Injury Center

23 and any other relevant programs of the Federal Government

24 (including other Centers of Excellence), conduct educational

25 programs on recognizing and diagnosing mild and mod26 erate cases of traumatic brain injury.
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1 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There is

2 authorized to be appropriated to the Secretary for each of

3 fiscal years 2008 through 2012, $10,000,000 to carry out

4 the program required by subsection (a).’’.

5 (b) CLERICAL AMENDMENT.—The table of sections at

6 the beginning of chapter 73 is amended by inserting after

7 the item relating to section 7330 the following new item:

‘‘7330A. Severe traumatic brain injury research, education, and clinical care program.’’.

8 (c) REPORT.—Not later than 18 months after the date

9 of the enactment of this Act, the Secretary of Veterans Af10 fairs shall submit to Congress a report on the research to

11 be conducted under the program required by section 7330A

12 of title 38, United States Code, as added by subsection (a).

13 SEC. 205. PILOT PROGRAM ON ASSISTED LIVING SERVICES

14 FOR VETERANS WITH TRAUMATIC BRAIN IN15 JURY.

16 (a) PILOT PROGRAM.—Not later than 90 days after

17 the date of the enactment of this Act, the Secretary of Vet18 erans Affairs shall, in collaboration with the Defense and

19 Veterans Brain Injury Center, carry out a pilot program

20 to assess the effectiveness of providing assisted living serv21 ices to eligible veterans to enhance the rehabilitation, qual22 ity of life, and community integration of such veterans.
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1 (b) DURATION OF PROGRAM.—The pilot program shall

2 be carried out during the five-year period beginning on the

3 date of the commencement of the pilot program.

4 (c) PROGRAM LOCATIONS.—

5 (1) IN GENERAL.—The pilot program shall be

6 carried out at locations selected by the Secretary for

7 purposes of the pilot program. Of the locations so

8 selected—

9 (A) at least one shall be in each health care

10 region of the Veterans Health Administration

11 that contains a polytrauma center of the Depart12 ment of Veterans Affairs; and

13 (B) any other locations shall be in areas

14 that contain high concentrations of veterans with

15 traumatic brain injury, as determined by the

16 Secretary.

17 (2) SPECIAL CONSIDERATION FOR VETERANS IN

18 RURAL AREAS.—Special consideration shall be given

19 to provide veterans in rural areas with an oppor20 tunity to participate in the pilot program.

21 (d) PROVISION OF ASSISTED LIVING SERVICES.—

22 (1) AGREEMENTS.—In carrying out the pilot

23 program, the Secretary may enter into agreements for

24 the provision of assisted living services on behalf of el25 igible veterans with a provider participating under a
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1 State plan or waiver under title XIX of such Act (42

2 U.S.C. 1396 et seq.).

3 (2) STANDARDS.—The Secretary may not place,

4 transfer, or admit a veteran to any facility for as5 sisted living services under this program unless the

6 Secretary determines that the facility meets such

7 standards as the Secretary may prescribe for purposes

8 of the pilot program. Such standards shall, to the ex9 tent practicable, be consistent with the standards of

10 Federal, State, and local agencies charged with the re11 sponsibility of licensing or otherwise regulating or in12 specting such facilities.

13 (e) CONTINUATION OF CASE MANAGEMENT AND REHA14 BILITATION SERVICES.—In carrying the pilot program

15 under subsection (a), the Secretary shall continue to provide

16 each veteran who is receiving assisted living services under

17 the pilot program with rehabilitative services and shall des18 ignate Department health-care employees to furnish case

19 management services for veterans participating in the pilot

20 program.

21 (f) REPORT.—

22 (1) IN GENERAL.—Not later than 60 days after

23 the completion of the pilot program, the Secretary

24 shall submit to the congressional veterans affairs com25 mittees a report on the pilot program.
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1 (2) CONTENTS.—The report required by para2 graph (1) shall include the following:

3 (A) A description of the pilot program.

4 (B) An assessment of the utility of the ac5 tivities under the pilot program in enhancing

6 the rehabilitation, quality of life, and commu7 nity reintegration of veterans with traumatic

8 brain injury.

9 (C) Such recommendations as the Secretary

10 considers appropriate regarding the extension or

11 expansion of the pilot program.

12 (g) DEFINITIONS.—In this section:

13 (1) The term ‘‘assisted living services’’ means

14 services of a facility in providing room, board, and

15 personal care for and supervision of residents for

16 their health, safety, and welfare.

17 (2) The term ‘‘case management services’’ in18 cludes the coordination and facilitation of all services

19 furnished to a veteran by the Department of Veterans

20 Affairs, either directly or through contract, including

21 assessment of needs, planning, referral (including re22 ferral for services to be furnished by the Department,

23 either directly or through a contract, or by an entity

24 other than the Department), monitoring, reassess25 ment, and followup.
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1 (3) The term ‘‘congressional veterans affairs

2 committees’’ means—

3 (A) the Committee on Veterans’ Affairs of

4 the Senate; and

5 (B) the Committee on Veterans’ Affairs of

6 the House of Representatives.

7 (4) The term ‘‘eligible veteran’’ means a veteran

8 who—

9 (A) is enrolled in the Department of Vet10 erans Affairs health care system;

11 (B) has received treatment for traumatic

12 brain injury from the Department of Veterans

13 Affairs;

14 (C) is unable to manage routine activities

15 of daily living without supervision and assist16 ance; and

17 (D) could reasonably be expected to receive

18 ongoing services after the end of the pilot pro19 gram under this section under another govern20 ment program or through other means.

21 (h) AUTHORIZATION OF APPROPRIATIONS.—There is

22 authorized to be appropriated to the Secretary of Veterans

23 Affairs to carry out this section, $8,000,000 for each of fis24 cal years 2008 through 2013.
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1 SEC. 206. RESEARCH ON TRAUMATIC BRAIN INJURY.

2 (a) INCLUSION OF RESEARCH ON TRAUMATIC BRAIN

3 INJURY UNDER ONGOING RESEARCH PROGRAMS.—The

4 Secretary of Veterans Affairs shall, in carrying out research

5 programs and activities under the provisions of law referred

6 to in subsection (b), ensure that such programs and activi7 ties include research on the sequelae of mild to severe forms

8 of traumatic brain injury, including—

9 (1) research on visually-related neurological con10 ditions;

11 (2) research on seizure disorders;

12 (3) research on means of improving the diag13 nosis, rehabilitative treatment, and prevention of such

14 sequelae;

15 (4) research to determine the most effective cog16 nitive and physical therapies for the sequelae of trau17 matic brain injury; and

18 (5) research on dual diagnosis of post-traumatic

19 stress disorder and traumatic brain injury.

20 (b) RESEARCH AUTHORITIES.—The provisions of law

21 referred to in this subsection are the following:

22 (1) Section 3119 of title 38, United States Code,

23 relating to rehabilitation research and special

24 projects.
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1 (2) Section 7303 of such title, relating to re2 search programs of the Veterans Health Administra3 tion.

4 (3) Section 7327 of such title, relating to re5 search, education, and clinical activities on complex

6 multi-trauma associated with combat injuries.

7 (c) COLLABORATION.—In carrying out the research re8 quired by subsection (a), the Secretary shall collaborate

9 with facilities that—

10 (1) conduct research on rehabilitation for indi11 viduals with traumatic brain injury; and

12 (2) receive grants for such research from the Na13 tional Institute on Disability and Rehabilitation Re14 search of the Department of Education.

15 (d) REPORT.—Not later than 90 days after the date

16 of the enactment of this Act, the Secretary shall submit to

17 the Committee on Veterans’ Affairs of the Senate and the

18 Committee on Veterans’ Affairs of the House of Representa19 tives a report describing in comprehensive detail the re20 search to be carried out pursuant to subsection (a).

21 SEC. 207. AGE-APPROPRIATE NURSING HOME CARE.

22 (a) FINDING.—Congress finds that young veterans who

23 are injured or disabled through military service and require

24 long-term care should have access to age-appropriate nurs25 ing home care.
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1 (b) REQUIREMENT TO PROVIDE AGE-APPROPRIATE

2 NURSING HOME CARE.—Section 1710A of title 38, United

3 States Code, is amended—

4 (1) by redesignating subsection (c) as subsection

5 (d); and

6 (2) by inserting after subsection (b) the following

7 new subsection (c):

8 ‘‘(c) The Secretary shall ensure that nursing home care

9 provided under subsection (a) is provided in an age-appro10 priate manner.’’.

11 SEC. 208. EXTENSION OF PERIOD OF ELIGIBILITY FOR

12 HEALTH CARE FOR COMBAT SERVICE IN THE

13 PERSIAN GULF WAR OR FUTURE HOS14 TILITIES.

15 Section 1710(e)(3)(C) of title 38, United States Code,

16 is amended by striking ‘‘2 years’’ and inserting ‘‘5 years’’.

17 SEC. 209. MENTAL HEALTH: SERVICE-CONNECTION STATUS

18 AND EVALUATIONS FOR CERTAIN VETERANS.

19 (a) PRESUMPTION OF SERVICE-CONNECTION OF MEN20 TAL ILLNESS FOR CERTAIN VETERANS.—Section 1702 of

21 title 38, United States Code, is amended—

22 (1) by striking ‘‘psychosis’’ and inserting ‘‘men23 tal illness’’; and

24 (2) in the heading, by striking ‘‘psychosis’’

25 and inserting ‘‘mental illness’’.
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1 (b) PROVISION OF MENTAL HEALTH EVALUATIONS

2 FOR CERTAIN VETERANS.—Upon the request of a veteran

3 described in section 1710(e)(3)(C) of title 38, United States

4 Code, the Secretary shall provide to such veteran a prelimi5 nary mental health evaluation as soon as practicable, but

6 not later than 30 days after such request.

7 SEC. 210. MODIFICATION OF REQUIREMENTS FOR FUR8 NISHING OUTPATIENT DENTAL SERVICES TO

9 VETERANS WITH A SERVICE-CONNECTED

10 DENTAL CONDITION OR DISABILITY.

11 Section 1712(a)(1)(B)(iv) of title 38, United States

12 Code, is amended by striking ‘‘90-day’’ and inserting ‘‘180-

13 day’’.

14 SEC. 211. DEMONSTRATION PROGRAM ON PREVENTING

15 VETERANS AT-RISK OF HOMELESSNESS FROM

16 BECOMING HOMELESS.

17 (a) DEMONSTRATION PROGRAM.—The Secretary of

18 Veterans Affairs shall carry out a demonstration program

19 for the purpose of—

20 (1) identifying members of the Armed Forces on

21 active duty who are at risk of becoming homeless after

22 they are discharged or released from active duty; and

23 (2) providing referral, counseling, and sup24 portive services, as appropriate, to help prevent such
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1 members, upon becoming veterans, from becoming

2 homeless.

3 (b) PROGRAM LOCATIONS.—The Secretary shall carry

4 out the demonstration program in at least three locations.

5 (c) IDENTIFICATION CRITERIA.—In developing and

6 implementing the criteria to identify members of the Armed

7 Forces, who upon becoming veterans, are at-risk of becom8 ing homeless, the Secretary of Veterans Affairs shall consult

9 with the Secretary of Defense and such other officials and

10 experts as the Secretary considers appropriate.

11 (d) CONTRACTS.—The Secretary of Veterans Affairs

12 may enter into contracts to provide the referral, counseling,

13 and supportive services required under the demonstration

14 program with entities or organizations that meet such re15 quirements as the Secretary may establish.

16 (e) SUNSET.—The authority of the Secretary under

17 subsection (a) shall expire on September 30, 2011.

18 (f) AUTHORIZATION OF APPROPRIATIONS.—There are

19 authorized to be appropriated $2,000,000 for the purpose

20 of carrying out the provisions of this section.

21 SEC. 212. CLARIFICATION OF PURPOSE OF THE OUTREACH

22 SERVICES PROGRAM OF THE DEPARTMENT

23 OF VETERANS AFFAIRS.

24 (a) CLARIFICATION OF INCLUSION OF MEMBERS OF

25 THE NATIONAL GUARD AND RESERVE IN PROGRAM.—Sub-
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1 section (a)(1) of section 6301 of title 38, United States Code,

2 is amended by inserting ‘‘, or from the National Guard or

3 Reserve,’’ after ‘‘active military, naval, or air service’’.

4 (b) DEFINITION OF OUTREACH.—Subsection (b) of

5 such section is amended—

6 (1) by redesignating paragraphs (1) and (2) as

7 paragraphs (2) and (3), respectively; and

8 (2) by inserting before paragraph (2) the fol9 lowing new paragraph (1):

10 ‘‘(1) the term ‘outreach’ means the act or process

11 of reaching out in a systematic manner to proactively

12 provide information, services, and benefits counseling

13 to veterans, and to the spouses, children, and parents

14 of veterans who may be eligible to receive benefits

15 under the laws administered by the Secretary, to en16 sure that such individuals are fully informed about,

17 and assisted in applying for, any benefits and pro18 grams under such laws;’’.

19 TITLE III

20 SEC. 301. FISCAL YEAR 2008 INCREASE IN MILITARY BASIC

21 PAY.

22 (a) WAIVER OF SECTION 1009 ADJUSTMENT.—The ad23 justment to become effective during Fiscal year 2008 re24 quired by section 1009 of title 37, United States Code, in
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1 the rates of monthly basic pay authorized for members of

2 the uniformed services shall not be made.

3 (b) INCREASE IN BASIC PAY.—Effective on January

4 1, 2008, the rates of monthly basic pay for members of the

5 uniformed services are increased by 3.5 percent.

Attest:

Secretary.
110TH CONGRESS

1ST SESSION H. R. 1538

AMENDMENT

September 5, 2007

Ordered to be printed as passed