I 
110TH CONGRESS 
1ST SESSION H. R. 1578 
To establish and monitor medical holdover performance standards. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 20, 2007 
Mr. SHAYS (for himself, Mr. TOM DAVIS of Virginia, Mr. BUCHANAN, and Mr. 
BILIRAKIS) introduced the following bill; which was referred to the Com-
mittee on Armed Services 
A BILL 
To establish and monitor medical holdover performance 
standards. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Wounded Warriors 
Joint Health Care Performance Metrics and Transparency 
Act’’. 
SEC. 2. ESTABLISHMENT AND MONITORING OF MEDICAL 
HOLDOVER PERFORMANCE STANDARDS. 
(a) REQUIREMENT FOR PERFORMANCE STANDARDS 
FOR MEDICAL HOLDOVER PROCESS.—The Secretary of 
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Defense shall assign the Assistant Secretary of Defense 
for Health Affairs the responsibility for establishing per-
formance standards for each step of the medical holdover 
process, including the following: 
(1) Mobilization. 
(2) Medical condition. 
(3) MNO decision. 
(4) Disposition plan. 
(5) Execution plan. 
(6) Final disposition decision of a medical eval-
uation board or physical evaluation board. 
(7) Transition. 
(b) QUARTERLY INSPECTIONS.— 
(1) REQUIREMENT
FOR
INSPECTIONS.—The 
Secretary of Defense, acting through the Assistant 
Secretary of Defense for Health Affairs, shall re-
quire each military medical installation to perform a 
quarterly inspection based on the performance 
standards established under subsection (a) of the 
following: command and control responsibilities, 
billeting, staffing, soldier administration, staff train-
ing, in and out processing, transition and separation 
processing, dining facilities and other non-medical 
patient services, transportation, medical case man-
agement, medical care, access and documentation, 
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and medical database and medical records quality. 
Inspections teams should include representatives 
from all commands with jurisdiction over medical 
and administrative services provided to injured and 
wounded soldiers, and shall include representatives 
from the Department of Defense and the Inspector 
General of the Department of Defense. 
(2) INSPECTION REPORTS.—The Assistant Sec-
retary shall require a report on each inspection car-
ried out under paragraph (1) to be submitted to the 
Secretary of Defense, the Inspector General of the 
Department of Defense, each command or agency 
with jurisdiction, the Secretary of each military de-
partment, the chief of staff of each Armed Force, 
and the inspector general of each military depart-
ment. 
(c) ADDITIONAL SPECIFIC STANDARDS.— 
(1) SECURITY AND MEDICAL PERSONNEL.—The 
Assistant Secretary of Defense for Health Affairs 
shall develop and enforce standards for security per-
sonnel and medical personnel to perform daily 
rounds of each medical inpatient and outpatient fa-
cility. The standards shall include a requirement for 
access to help 24 hours a day for patients with med-
ical emergencies or needs. 
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(2) TIMELINESS.—The Assistant Secretary also 
shall develop and enforce standards for setting time 
standards for responding to patient questions and 
scheduling appointments for medical evaluation 
board and physical evaluation board evaluations. 
(3) PROCESSING.—The Assistant Secretary also 
shall develop and enforce in-processing and out-proc-
essing standards, patient counseling standards, and 
information standards to address patient and family 
members on all aspects of care, including medical 
and administrative evaluation procedures and re-
quirements. 
(d) MONTHLY REPORTS.— 
(1) REQUIREMENT.—The Assistant Secretary 
of Defense for Health Affairs shall submit to the 
Secretary of Defense and the Inspector General of 
the Department of Defense a monthly report on 
military service performance in all categories of med-
ical holdover patient care including, at a minimum, 
inspections, individual patient information, trends 
and problems, statistical information on time of pa-
tients in medical holdover status, performance of 
service commands, and other service personnel serv-
ing patients and families in medical holder status. 
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(2) ADDITIONAL MATTERS COVERED.—The re-
port also shall contain— 
(A) information on all individual patient 
complaints and action taken to mediate the pa-
tient concern; 
(B) information on all concerns raised by 
patient advocates to military service installation 
commanders and report on actions taken; and 
(C) statistical information on the inci-
dence, treatments, and outcomes of traumatic 
brain injury patients among the medical hold-
over patient population. 
(e) SEMI-ANNUAL MEETINGS.—The Assistant Sec-
retary of Defense for Health Affairs shall meet semi-annu-
ally with the Secretaries of the military departments to 
address medical holdover program execution, including all 
medical and administrative issues, force structure, man-
ning, training, and resource requirements. 
(f) INSPECTOR GENERAL RESPONSIBILITIES.—The 
Inspector General of the Department of Defense shall 
audit and review the medical holdover system and the per-
formance standards developed under this section and shall 
submit quarterly reports to the Assistant Secretary of De-
fense for Health Affairs, the Secretaries of the military 
departments, and the following congressional committees: 
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(1) The Committees on Armed Services of the 
Senate and the House of Representatives. 
(2) The Committee on Homeland Security and 
Governmental Affairs of the Senate. 
(3) The Committee on Oversight and Govern-
ment Reform of the House of Representatives. 
(g) MEDICAL HOLDOVER PATIENT.—In this Act, the 
term ‘‘medical holdover patient’’ means a member of the 
Armed Forces, including a member of the National Guard 
or other reserve component, who is undergoing medical 
treatment, recuperation, or therapy, or is otherwise in 
medical hold or holdover status, for an injury, illness, or 
disease incurred or aggravated while on active duty in the 
Armed Forces. 
(h) AUTHORIZATION.—There is authorized to be ap-
propriated to carry out— 
(1) subsections (a) through (e) of this Act, 
$1,000,000 for fiscal year 2007; and 
(2) subsection (f) of this Act, $2,000,000 for 
fiscal year 2007 and $3,000,000 for fiscal year 
2008. 
Æ 
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