H. R. 6395—267 
(3) in subsection (b)(1), by striking ‘‘the immediate family 
members of members of the armed forces assigned to special 
operations forces’’ and inserting ‘‘covered individuals’’; 
(4) in subsection (d)(2)— 
(A) in subparagraph (A), by striking ‘‘family members 
of members of the armed forces assigned to special oper-
ations forces’’ and inserting ‘‘covered individuals’’; and 
(B) in subparagraph (B), by striking ‘‘family members 
of members of the armed forces assigned to special oper-
ations forces’’ and inserting ‘‘covered individuals’’; and 
(5) in subsection (e)(4)— 
(A) by inserting ‘‘psychological support, spiritual sup-
port, and’’ before ‘‘costs’’; 
(B) by striking ‘‘immediate family members of members 
of the armed forces assigned to special operations forces’’ 
and inserting ‘‘covered personnel’’; and 
(C) by adding at the end the following: 
‘‘(5) The term ‘covered personnel’ means— 
‘‘(A) members of the Armed Forces (including the 
reserve components) assigned to special operations forces; 
‘‘(B) service personnel assigned to support special oper-
ations forces; and 
‘‘(C) 
immediate 
family 
members 
of 
individuals 
described in subparagraphs (A) and (B).’’. 
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of chapter 88 of title 10, United States Code, is amended 
by striking the item relating to section 1788a and inserting the 
following: 
‘‘1788a. Support programs: special operations forces personnel; immediate family 
members.’’. 
SEC. 584. RESPONSIBILITY FOR ALLOCATION OF CERTAIN FUNDS FOR 
MILITARY CHILD DEVELOPMENT PROGRAMS. 
Section 1791 of title 10, United States Code, is amended— 
(1) by striking ‘‘It is the policy’’ and inserting the following: 
‘‘(a) POLICY.—It is the policy’’; and 
(2) by adding at the end the following new subsection: 
‘‘(b) RESPONSIBILITY FOR ALLOCATIONS OF CERTAIN FUNDS.— 
The Secretary of Defense shall be responsible for the allocation 
of Office of the Secretary of Defense level funds for military child 
development programs for children from birth through 12 years 
of age, and may not delegate such responsibility to the military 
departments.’’. 
SEC. 585. MILITARY CHILD CARE AND CHILD DEVELOPMENT CENTER 
MATTERS. 
(a) CENTER FEES MATTERS.—Section 1793 of title 10, United 
States Code, is amended by adding at the end the following new 
subsection: 
‘‘(c) FAMILY DISCOUNT.—In the case of a family with two or 
more children attending a child development center, the regulations 
prescribed pursuant to subsection (a) may require that installations 
commanders charge a fee for attendance at the center of any child 
of the family after the first child of the family in amount equal 
to 85 percent of the amount of the fee otherwise chargeable for 
the attendance of such child at the center.’’. 
(b) REPORTS
ON INSTALLATIONS WITH EXTREME IMBALANCE 
BETWEEN DEMAND FOR AND AVAILABILITY OF CHILD CARE.—Not
H. R. 6395—268 
later than one year after the date of the enactment of this Act, 
each Secretary of a military department shall submit to Congress 
a report on the military installations under the jurisdiction of 
such Secretary with an extreme imbalance between demand for 
child care and availability of child care. Each report shall include, 
for the military department covered by such report, the following: 
(1) The name of the five installations of the military depart-
ment experiencing the most extreme imbalance between 
demand for child care and availability of child care. 
(2) For each installation named pursuant to subparagraph 
(A), the following: 
(A) An assessment whether civilian employees at child 
development centers at such installation have rates of pay 
and benefits that are competitive with other civilian 
employees on such installation and with the civilian labor 
pool in the vicinity of such installation. 
(B) A description and assessment of various incentives 
to encourage military spouses to become providers under 
the Family Child Care program at such installation. 
(C) Such recommendations at the Secretary of the mili-
tary department concerned considers appropriate to 
address the imbalance between demand for child care and 
availability of child care at such installation, including 
recommendations to enhance the competitiveness of civilian 
child care positions at such installation with other civilian 
positions at such installation and the civilian labor pool 
in the vicinity of such installation. 
SEC. 586. EXPANSION OF FINANCIAL ASSISTANCE UNDER MY CAREER 
ADVANCEMENT ACCOUNT PROGRAM. 
Section 580F of the National Defense Authorization Act for 
Fiscal Year 2020 (Public Law 116–92) is amended— 
(1) by inserting ‘‘(a) PROFESSIONAL LICENSE OR CERTIFI-
CATION; ASSOCIATE’S DEGREE.—’’ before ‘‘The Secretary’’; 
(2) by inserting ‘‘or maintenance (including continuing edu-
cation courses)’’ after ‘‘pursuit’’; and 
(3) by adding at the end the following new subsection: 
‘‘(b) NATIONAL TESTING.—Financial assistance under subsection 
(a) may be applied to the costs of national tests that may earn 
a participating military spouse course credits required for a degree 
approved under the program (including the College Level Examina-
tion Program tests).’’. 
SEC. 587. IMPROVEMENTS TO PARTNER CRITERIA OF THE MILITARY 
SPOUSE EMPLOYMENT PARTNERSHIP PROGRAM. 
(a) EVALUATION; UPDATES.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary of Defense shall 
evaluate the partner criteria set forth in the Military Spouse 
Employment Partnership Program (in this section referred to as 
the ‘‘MSEP Program’’) and implement updates that the Secretary 
determines will improve such criteria without diminishing the need 
for partners to exhibit sound business practices, broad diversity 
efforts, and relative financial stability. Such updates may expand 
the number of the following entities that meet such criteria: 
(1) Institutions of primary, secondary, and higher edu-
cation. 
(2) Software and coding companies. 
(3) Local small businesses.
H. R. 6395—269 
(4) Companies that employ telework. 
(b) NEW PARTNERSHIPS.—Upon completion of the evaluation 
under subsection (a), the Secretary, in consultation with the Depart-
ment of Labor, shall seek to enter into agreements with entities 
described in paragraphs (1) through (4) of subsection (a) that are 
located near military installations (as that term is defined in section 
2687 of title 10, United States Code). 
(c) 
REVIEW; 
REPORT.—Not 
later 
than 
one 
year 
after 
implementation under subsection (a), the Secretary shall review 
updates under subsection (a) and publish a report regarding such 
review on a publicly-accessible website of the Department of 
Defense. Such report shall include the following: 
(1) The results of the evaluation of the MSEP Program, 
including the implementation plan for any change to partner-
ship criteria. 
(2) Data on the new partnerships undertaken as a result 
of the evaluation, including the type, size, and location of the 
partner entities. 
(3) Data on the utility of the MSEP Program, including— 
(A) the number of military spouses who have applied 
through the MSEP Program; 
(B) the average length of time a job is available before 
being filled or removed from the MSEP Program portal; 
and 
(C) the average number of new jobs posted on the 
MSEP Program portal each month. 
SEC. 588. 24-HOUR CHILD CARE. 
(a) 24-HOUR CHILD CARE.—If the Secretary of Defense deter-
mines it feasible, pursuant to the study conducted pursuant to 
subsection (b), the Secretary shall furnish child care to each child 
of a member of the Armed Forces or civilian employee of the 
Department of Defense while that member or employee works on 
rotating shifts at a military installation. 
(b) FEASIBILITY STUDY; REPORT.—Not later than 270 days after 
the date of the enactment of this Act, the Secretary of Defense 
shall submit to the Committees on Armed Services of the Senate 
and the House of Representatives a report setting forth the results 
of a study, conducted by the Secretary for purposes of this section, 
on the feasibility of furnishing child care described in subsection 
(a). 
(c) ELEMENTS.—The report required by subsection (b) shall 
include the following: 
(1) The results of the study described in that subsection. 
(2) If the Secretary determines that furnishing child care 
available as described in subsection (a) is feasible, such matters 
as the Secretary determines appropriate in connection with 
furnishing such child care, including— 
(A) an identification of the installations at which such 
child care would be beneficial to members of the Armed 
Forces, civilian employees of the Department, or both; 
(B) an identification of any barriers to making such 
child care available at the installations identified pursuant 
to subparagraph (A); 
(C) an assessment whether the child care needs of 
members of the Armed Forces and civilian employees of
H. R. 6395—270 
the Department described in subsection (a) would be better 
met by an increase in assistance for child care fees; 
(D) a description and assessment of the actions, if 
any, being taken to furnish such child care at the installa-
tions identified pursuant to subparagraph (A); and 
(E) such recommendations for legislative or administra-
tive action the Secretary determines appropriate to make 
such child care available at the installations identified 
pursuant to subparagraph (A), or at any other military 
installation. 
SEC. 589. PILOT PROGRAM TO PROVIDE FINANCIAL ASSISTANCE TO 
MEMBERS OF THE ARMED FORCES FOR IN-HOME CHILD 
CARE. 
(a) ESTABLISHMENT.—Not later than March 1, 2021, the Sec-
retary of Defense shall establish a pilot program to provide financial 
assistance to members of the Armed Forces who pay for services 
provided by in-home child care providers. In carrying out the pilot 
program, the Secretary shall take the following steps: 
(1) Determine the needs of military families who request 
services provided by in-home child care providers. 
(2) Determine the appropriate amount of financial assist-
ance to provide to military families described in paragraph 
(1). 
(3) Determine the appropriate qualifications for an in-home 
child care provider for whose services the Secretary shall pro-
vide financial assistance to a military family. In carrying out 
this paragraph, the Secretary shall— 
(A) take into consideration qualifications for in-home 
child care providers in the private sector; and 
(B) ensure that the qualifications the Secretary deter-
mines appropriate under this paragraph are comparable 
to the qualifications for a provider of child care services 
in a military child development center or family home 
day care. 
(4) Establish a marketing and communications plan to 
inform members of the Armed Forces who live in the locations 
described in subsection (b) about the pilot program. 
(b) LOCATIONS.—The Secretary shall carry out the pilot program 
in the five locations that the Secretary determines have the greatest 
demand for child care services for children of members of the 
Armed Forces. 
(c) REPORTS.— 
(1) INTERIM REPORTS.—Not later than one year after the 
Secretary establishes the pilot program and thrice annually 
thereafter, the Secretary shall submit to the Committees on 
Armed Services of the Senate and the House of Representatives 
an interim report on the pilot program. Each interim report 
shall include the following elements: 
(A) The number of military families participating in 
the pilot program, disaggregated by location and duration 
of participation. 
(B) The amount of financial assistance provided to 
participating military families in each location. 
(C) Metrics by which the Secretary carries out sub-
section (a)(3)(B); 
(D) The feasibility of expanding the pilot program.
H. R. 6395—271 
(E) Legislation or administrative action that the Sec-
retary determines necessary to make the pilot program 
permanent. 
(F) Any other information the Secretary determines 
appropriate. 
(2) FINAL REPORT.—Not later than 90 days after the termi-
nation of the pilot program, the Secretary shall submit to 
the Committees on Armed Services of the Senate and the 
House of Representatives a final report on the pilot program. 
The final report shall include the following elements: 
(A) The elements specified in paragraph (1). 
(B) The recommendation of the Secretary whether to 
make the pilot program permanent. 
(d) TERMINATION.—The pilot program shall terminate five years 
after the date on which the Secretary establishes the pilot program. 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘in-home child care provider’’ means an indi-
vidual who provides child care services in the home of the 
child. 
(2) The terms ‘‘military child development center’’ and 
‘‘family home day care’’ have the meanings given those terms 
in section 1800 of title 10, United States Code. 
SEC. 589A. CERTAIN ASSISTANCE TO LOCAL EDUCATIONAL AGENCIES 
THAT BENEFIT DEPENDENTS OF MILITARY AND CIVILIAN 
PERSONNEL. 
(a) CONTINUATION
OF
AUTHORITY
TO
ASSIST
LOCAL
EDU-
CATIONAL AGENCIES THAT BENEFIT DEPENDENTS OF MEMBERS OF 
THE
ARMED
FORCES
AND
DEPARTMENT
OF
DEFENSE
CIVILIAN 
EMPLOYEES.— 
(1) ASSISTANCE TO SCHOOLS WITH SIGNIFICANT NUMBERS 
OF MILITARY DEPENDENT STUDENTS.—Of the amount authorized 
to be appropriated for fiscal year 2021 by section 301 and 
available for operation and maintenance for Defense-wide 
activities as specified in the funding table in section 4301, 
$50,000,000 shall be available only for the purpose of providing 
assistance to local educational agencies under subsection (a) 
of section 572 of the National Defense Authorization Act for 
Fiscal Year 2006 (Public Law 109–163; 20 U.S.C. 7703b). 
(2) LOCAL
EDUCATIONAL
AGENCY
DEFINED.—In this sub-
section, the term ‘‘local educational agency’’ has the meaning 
given that term in section 7013(9) of the Elementary and Sec-
ondary Education Act of 1965 (20 U.S.C. 7713(9)). 
(b) IMPACT AID FOR CHILDREN WITH SEVERE DISABILITIES.— 
(1) IN GENERAL.—Of the amount authorized to be appro-
priated for fiscal year 2021 pursuant to section 301 and avail-
able for operation and maintenance for Defense-wide activities 
as specified in the funding table in section 4301, $10,000,000 
shall be available for payments under section 363 of the Floyd 
D. Spence National Defense Authorization Act for Fiscal Year 
2001 (as enacted into law by Public Law 106–398; 114 Stat. 
1654A–77; 20 U.S.C. 7703a). 
(2) ADDITIONAL
AMOUNT.—Of the amount authorized to 
be appropriated for fiscal year 2021 pursuant to section 301 
and available for operation and maintenance for Defense-wide 
activities as specified in the funding table in section 4301, 
$10,000,000 shall be available for use by the Secretary of
H. R. 6395—272 
Defense to make payments to local educational agencies deter-
mined by the Secretary to have higher concentrations of mili-
tary children with severe disabilities. 
(3) REPORT.—Not later than March 1, 2021, the Secretary 
shall brief the Committees on Armed Services of the Senate 
and the House of Representatives on the Department’s evalua-
tion of each local educational agency with higher concentrations 
of military children with severe disabilities and subsequent 
determination of the amounts of impact aid each such agency 
shall receive. 
SEC. 589B. STAFFING OF DEPARTMENT OF DEFENSE EDUCATION 
ACTIVITY SCHOOLS TO MAINTAIN MAXIMUM STUDENT- 
TO-TEACHER RATIOS. 
(a) IN
GENERAL.—The Department of Defense Education 
Activity shall staff elementary and secondary schools operated by 
the Activity so as to maintain, to the extent practicable, student- 
to-teacher ratios that do not exceed the maximum student-to- 
teacher ratios specified in subsection (b). 
(b) MAXIMUM STUDENT-TO-TEACHER RATIOS.—The maximum 
student-to-teacher ratios specified in this subsection are the fol-
lowing: 
(1) For each of grades kindergarten through 3, a ratio 
of 18 students to 1 teacher (18:1). 
(2) For each of grades 4 through 12, a ratio equal to 
the average student-to-teacher ratio for such grade among all 
Department of Defense Education Activity schools during the 
2019–2020 academic year. 
(c) SUNSET.—The requirement to staff schools in accordance 
with subsection (a) shall expire at the end of the 2023–2024 aca-
demic year of the Department of Defense Education Activity. 
SEC. 589C. PILOT PROGRAM TO EXPAND ELIGIBILITY FOR ENROLL-
MENT AT DOMESTIC DEPENDENT ELEMENTARY AND SEC-
ONDARY SCHOOLS. 
(a) PILOT PROGRAM AUTHORIZED.—Beginning not later than 
180 days after the date of the enactment of this Act, the Secretary 
of Defense shall carry out a pilot program under which a dependent 
of a full-time, active-duty member of the Armed Forces may enroll 
in a covered DODEA school at the military installation to which 
the member is assigned, on a space-available basis as described 
in subsection (c), without regard to whether the member resides 
on the installation as described in 2164(a)(1) of title 10, United 
States Code. 
(b) PURPOSES.—The purposes of the pilot program under this 
section are— 
(1) to evaluate the feasibility and advisability of expanding 
enrollment in covered DODEA schools; and 
(2) to determine how increased access to such schools will 
affect military and family readiness. 
(c) ENROLLMENT
ON
SPACE-AVAILABLE
BASIS.—A student 
participating in the pilot program under this section may be enrolled 
in a covered DODEA school only if the school has the capacity 
to accept the student, as determined by the Director of the Depart-
ment of Defense Education Activity. 
(d) LOCATIONS.—The Secretary of Defense shall carry out the 
pilot program under this section at not more than four military 
installations at which covered DODEA schools are located. The
H. R. 6395—273 
Secretary shall select military installations for participation in the 
program based on— 
(1) the readiness needs of the Secretary of a the military 
department concerned; and 
(2) the capacity of the DODEA schools located at the 
installation to accept additional students, as determined by 
the Director of the Department of Defense Education Activity. 
(e) TERMINATION.—The authority to carry out the pilot program 
under this section shall terminate four years after the date of 
the enactment of this Act. 
(f) COVERED DODEA SCHOOL DEFINED.—In this Section, the 
term ‘‘covered DODEA school’’ means a domestic dependent 
elementary or secondary school operated by the Department of 
Defense Education Activity that— 
(1) has been established on or before the date of the enact-
ment of this Act; and 
(2) is located in the continental United States. 
SEC. 589D. PILOT PROGRAM ON EXPANDED ELIGIBILITY FOR DEPART-
MENT OF DEFENSE EDUCATION ACTIVITY VIRTUAL HIGH 
SCHOOL PROGRAM. 
(a) PILOT PROGRAM REQUIRED.— 
(1) IN GENERAL.—The Secretary of Defense shall carry out 
a pilot program on permitting dependents of members of the 
Armed Forces on active duty to enroll in the Department of 
Defense Education Activity Virtual High School program (in 
this section referred to as the ‘‘DVHS program’’). 
(2) PURPOSES.—The purposes of the pilot program shall 
be as follows: 
(A) To evaluate the feasibility and scalability of the 
DVHS program. 
(B) To assess the impact of expanded enrollment in 
the DVHS program under the pilot program on military 
and family readiness. 
(3) DURATION.—The duration of the pilot program shall 
be four academic years. 
(b) PARTICIPANTS.— 
(1) IN GENERAL.—Participants in the pilot program shall 
be selected by the Secretary from among dependents of mem-
bers of the Armed Forces on active duty who— 
(A) are in a grade 9 through 12; 
(B) are currently ineligible to enroll in the DVHS pro-
gram; and 
(C) either— 
(i) require supplementary courses to meet gradua-
tion requirements in the current State of residence; 
or 
(ii) otherwise demonstrate to the Secretary a clear 
need to participate in the DVHS program. 
(2) PREFERENCE IN SELECTION.—In selecting participants 
in the pilot program, the Secretary shall afford a preference 
to the following: 
(A) Dependents who reside in a rural area. 
(B) Dependents who are home-schooled students. 
(3) LIMITATIONS.—The total number of course enrollments 
per academic year authorized under the pilot program may
H. R. 6395—274 
not exceed 400 course enrollments. No single dependent partici-
pating in the pilot program may take more than two courses 
per academic year under the pilot program. 
(c) REPORTS.— 
(1) INTERIM REPORT.—Not later than two years after the 
date of the enactment of this Act, the Secretary shall submit 
to the Committees on Armed Services of the Senate and the 
House of Representatives an interim report on the pilot pro-
gram. 
(2) FINAL
REPORT.—Not later than 180 days after the 
completion of the pilot program, the Secretary shall submit 
to the committees of Congress referred to in paragraph (1) 
a final report on the pilot programs. 
(3) ELEMENTS.—Each report under this subsection shall 
include the following: 
(A) A description of the demographics of the dependents 
participating in the pilot program through the date of 
such report. 
(B) Data on, and an assessment of, student perform-
ance in virtual coursework by dependents participating 
in the pilot program over the duration of the pilot program. 
(C) Such recommendation as the Secretary considers 
appropriate on whether to make the pilot program perma-
nent. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘rural area’’ has the meaning given the term 
in section 520 of the Housing Act of 1949 (42 U.S.C. 1490). 
(2) The term ‘‘home-schooled student’’ means a student 
in a grade equivalent to grade 9 through 12 who receives 
educational instruction at home or by other non-traditional 
means outside of a public or private school system, either 
all or most of the time. 
SEC. 589E. TRAINING PROGRAM REGARDING FOREIGN MALIGN INFLU-
ENCE CAMPAIGNS. 
(a) ESTABLISHMENT.—Not later than September 30, 2021, the 
Secretary of Defense shall establish a program for training members 
of the Armed Forces and civilian employees of the Department 
of Defense regarding the threat of foreign malign influence cam-
paigns targeted at such individuals and the families of such individ-
uals, including such campaigns carried out through social media. 
(b) 
DESIGNATION
OF
OFFICIAL
TO
COORDINATE
AND 
INTEGRATE.—Not later than 30 days after the date of enactment 
of this Act, the Secretary shall designate an official of the Depart-
ment who shall be responsible for coordinating and integrating 
the training program under this section. 
(c) BEST
PRACTICES.—In coordinating and integrating the 
training program under this section, the official designated under 
subsection (b) shall review best practices of existing training pro-
grams across the Department. 
(d) REPORT REQUIRED.—Not later than October 30, 2021, the 
Secretary shall submit a report to the congressional defense commit-
tees detailing the program established under this section. 
(e) FOREIGN MALIGN INFLUENCE DEFINED.—In this section, the 
term ‘‘foreign malign influence’’ has the meaning given that term 
in section 119C of the National Security Act of 1947 (50 U.S.C. 
3059).
H. R. 6395—275 
SEC. 589F. STUDY ON CYBEREXPLOITATION AND ONLINE DECEPTION 
OF MEMBERS OF THE ARMED FORCES AND THEIR FAMI-
LIES. 
(a) STUDY.—Not later than 150 days after the date of the 
enactment of this Act, the Secretary of Defense shall complete 
a study on— 
(1) the cyberexploitation of the personal information and 
accounts of members of the Armed Forces and their families; 
and 
(2) the risks of deceptive online targeting of members and 
their families. 
(b) ELEMENTS.—The study under subsection (a) shall include 
the following: 
(1) An assessment of predatory loans, other financial prod-
ucts, or educational products being targeted to members of 
the Armed Forces and their families. 
(2) An assessment of unproven or unnecessary medical 
treatments or procedures being targeted to members and their 
families. 
(3) An assessment of ethnic or racial violent extremism 
messages targeting members and their families. 
(4) An assessment of the ways in which social media algo-
rithms may amplify the targeting described in paragraphs (1) 
through (3). 
(5) An intelligence assessment of the threat currently posed 
by foreign government and non-state actors carrying out the 
cyberexploitation of members and their families, including 
generalized assessments as to— 
(A) whether such cyberexploitation is a substantial 
threat as compared to other means of information warfare; 
and 
(B) whether such cyberexploitation is an increasing 
threat. 
(6) A case-study analysis of three known occurrences of 
attempted cyberexploitation against members and their fami-
lies, including assessments of the vulnerability and the ultimate 
consequences of the attempted cyberexploitation. 
(7) A description of the actions taken by the Department 
of Defense to educate members and their families, including 
particularly vulnerable subpopulations, about any actions that 
can be taken to reduce cyberexploitation threats. 
(8) An intelligence assessment of the threat posed by for-
eign government and non-state actors creating or using 
machine-manipulated media (commonly referred to as ‘‘deep 
fakes’’) featuring members and their families, including general-
ized assessments of— 
(A) the maturity of the technology used in the creation 
of such media; and 
(B) how such media has been used or might be used 
to conduct information warfare. 
(9) Recommendations for policy changes to reduce the 
vulnerability of members of the Armed Forces and their families 
to cyberexploitation and deception, including recommendations 
for legislative or administrative action. 
(c) REPORT.— 
(1) REQUIREMENT.—The Secretary shall submit to the 
Committees on Armed Services of the House of Representatives
H. R. 6395—276 
and the Senate a report on the findings of the Secretary with 
respect to the study under subsection (a). 
(2) FORM.—The report under paragraph (1) shall be sub-
mitted in unclassified form, but may include a classified annex. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘cyberexploitation’’ means the use of digital 
means and online platforms— 
(A) to knowingly access, or conspire to access, without 
authorization, an individual’s personal information to be 
employed (or to be used) with malicious intent; or 
(B) to deceive an individual with misinformation with 
malicious intent. 
(2) The term ‘‘machine-manipulated media’’ means video, 
image, or audio recordings generated or substantially modified 
using machine learning techniques in order to, with malicious 
intent, falsely depict the speech or conduct of an individual 
without that individual’s permission. 
SEC. 589G. MATTERS RELATING TO EDUCATION FOR MILITARY 
DEPENDENT STUDENTS WITH SPECIAL NEEDS. 
(a) INFORMATION ON SPECIAL EDUCATION DISPUTES.— 
(1) IN GENERAL.—Each Secretary of a military department 
shall collect and maintain information on special education 
disputes filed by members of the Armed Forces under the 
jurisdiction of such Secretary. 
(2) INFORMATION.—The information collected and main-
tained under this subsection shall include the following: 
(A) The number of special education disputes filed. 
(B) The outcome or disposition of the disputes. 
(3) SOURCE OF INFORMATION.—The information collected 
and maintained pursuant to this subsection shall be derived 
from the following: 
(A) Records and reports of case managers and naviga-
tors under the Exceptional Family Member Program of 
the Department of Defense. 
(B) Reports submitted by members of the Armed Forces 
to officials at military installations or other relevant mili-
tary officials. 
(C) Such other sources as the Secretary of the military 
department concerned considers appropriate. 
(4) ANNUAL REPORTS.—On an annual basis, each Secretary 
of a military department shall submit to the Office of Special 
Needs of the Department of Defense a report on the information 
collected by such Secretary under this subsection during the 
preceding year. 
(b) GAO STUDY AND REPORT.— 
(1) IN GENERAL.—The Comptroller General of the United 
States shall conduct a study on the following: 
(A) The manner in which local educational agencies 
with schools that serve military dependent students use 
the following: 
(i) Funds made available for impact aid for children 
with severe disabilities under section 363 of the Floyd 
D. Spence National Defense Authorization Act for 
Fiscal Year 2001 (Public Law 106–398; 20 U.S.C. 
7703a).
H. R. 6395—277 
(ii) Funds made available for assistance to schools 
with a significant number of military dependent stu-
dents under subsection (a) of section 572 of the 
National Defense Authorization Act for Fiscal Year 
2006 (Public Law 109–163; 20 U.S.C. 7703b). 
(C) The efficacy of attorneys and other legal support 
for military families in special education disputes. 
(E) Whether, and to what extent, policies and guidance 
for School Liaison Officers are standardized between the 
Office of Special Needs of the Department of Defense and 
the military departments, and the efficacy of such policies 
and guidance. 
(F) The improvements made to family support pro-
grams of the Office of Special Needs, and of each military 
department, in light of the recommendations of the Comp-
troller General in the report titled ‘‘DOD Should Improve 
Its Oversight of the Exceptional Family Member Program’’ 
(GAO–18–348). 
(2) RECOMMENDATIONS.—As part of the study under para-
graph (1), the Comptroller General shall develop recommenda-
tions on the following: 
(A) Improvements to the ability of the Department 
of Defense to monitor and enforce the compliance of local 
educational agencies with requirements for the provision 
of a free appropriate public education to military dependent 
students with special needs. 
(B) Improvements to the policies of the Office of Special 
Needs, and of each military department, with respect to 
the standardization and efficacy of policies and programs 
for military dependent students with special needs. 
(3) BRIEFING AND REPORT.—Not later than March 31, 2021, 
the Comptroller General of the United States shall provide 
to the Committees on Armed Services of the Senate and the 
House of Representatives a briefing and a report the results 
of the study conducted under paragraph (1). 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘free appropriate public education’’ has the 
meaning given that term in section 602 of the Individuals 
with Disabilities Education Act (20 U.S.C. 1401). 
(2) The term ‘‘local educational agency’’ has the meaning 
given that term in section 8101 of the Elementary and Sec-
ondary Education Act of 1965 (20 U.S.C. 7801). 
(3) The term ‘‘special education dispute’’ means a complaint 
filed regarding the education provided to a child with a dis-
ability (as defined in section 602 of the Individuals with Disabil-
ities Education Act (20 U.S.C. 1401)), including a complaint 
filed in accordance with section 615 or 639 of such Act (20 
U.S.C. 1415, 1439). 
SEC. 589H. STUDIES AND REPORTS ON THE PERFORMANCE OF THE 
DEPARTMENT OF DEFENSE EDUCATION ACTIVITY. 
(a) DOD STUDY AND REPORT.— 
(1) STUDY.—The Secretary of Defense shall conduct a study 
on the performance of the Department of Defense Education 
Activity. 
(2) ELEMENTS.—The study under paragraph (1) shall 
include—
H. R. 6395—278 
(A) a review of the curriculum relating to health, resil-
iency, and nutrition taught in schools operated by the 
Department of Defense Education Activity; and 
(B) a comparison of such curriculum to benchmarks 
established for the curriculum by the Department of 
Defense Education Activity. 
(3) REPORT.—Not later than one year after the date of 
the enactment of this Act, the Secretary of Defense shall submit 
to the Committees on Armed Services of the Senate and the 
House of Representatives a report that includes the results 
of the study conducted under paragraph (1). 
(b) GAO STUDIES AND REPORTS.— 
(1) STUDIES.—The Comptroller General of the United States 
shall conduct two studies on the performance of the Department 
of Defense Education Activity as follows: 
(A) One study shall analyze the educational outcomes 
of students in schools operated by the Department of 
Defense Education Activity compared to the educational 
outcomes of students in public elementary schools and 
public secondary schools (as those terms are defined in 
section 8101 of the Elementary and Secondary Education 
Act of 1965 (20 U.S.C. 7801 et seq.)) outside the Depart-
ment of Defense. 
(B) One study shall assess the effectiveness of the 
School Liaison Officer program of the Department of 
Defense Education Activity in achieving the goals of the 
program with an emphasis on goals relating to special 
education and family outreach. 
(2) REPORTS.—Not later than one year after the date of 
the enactment of this Act, the Comptroller General of the 
United States shall submit to the Committees on Armed Serv-
ices of the Senate and the House of Representatives— 
(A) a report that includes the results of the study 
conducted under subparagraph (A) of paragraph (1); and 
(B) a report that includes the results of the study 
conducted under subparagraph (B) of such paragraph. 
Subtitle J—Other Matters and Reports 
SEC. 591. EXPANSION OF DEPARTMENT OF DEFENSE STARBASE PRO-
GRAM. 
(a) IN GENERAL.—Section 2193b of title 10, United States Code, 
is amended— 
(1) in the section heading, by striking ‘‘science, mathe-
matics, and technology’’ and inserting ‘‘science, tech-
nology, engineering, art and design, and mathematics’’; 
(2) in subsection (a), by striking ‘‘science, mathematics, 
and technology’’ and inserting ‘‘science, technology, engineering, 
art and design, and mathematics’’; and 
(3) in subsection (b), by striking ‘‘mathematics, science, 
and technology’’ and inserting ‘‘science, technology, engineering, 
art and design, and mathematics’’. 
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of chapter 111 of title 10, United States Code, is amended
H. R. 6395—279 
by striking the item relating to section 2193b and inserting the 
following new item: 
‘‘2193b. Improvement of education in technical fields: program for support of ele-
mentary and secondary education in science, technology, engineering, 
art and design, and mathematics.’’. 
SEC. 592. INCLUSION OF CERTAIN OUTLYING AREAS IN THE DEPART-
MENT OF DEFENSE STARBASE PROGRAM. 
Section 2193b(h) of title 10, United States Code, is amended 
by inserting ‘‘the Commonwealth of the Northern Mariana Islands, 
American Samoa,’’ before ‘‘and Guam’’. 
SEC. 593. POSTPONEMENT OF CONDITIONAL DESIGNATION OF EXPLO-
SIVE ORDNANCE DISPOSAL CORPS AS A BASIC BRANCH 
OF THE ARMY. 
Section 582(b) of the National Defense Authorization Act for 
Fiscal Year 2018 (Public Law 115–91; 10 U.S.C. 763 note) is 
amended— 
(1) in paragraph (1), by striking ‘‘October 1, 2020’’ and 
inserting ‘‘October 1, 2025’’; and 
(2) in paragraph (2)— 
(A) in the matter preceding subparagraph (A), by 
striking ‘‘September 30, 2020’’ and inserting ‘‘September 
30, 2025’’; 
(B) in subparagraph (B), by inserting ‘‘, the explosive 
ordnance disposal commandant (chief of explosive ordnance 
disposal),’’ before ‘‘qualified’’; and 
(C) by adding at the end the following new subpara-
graph: 
‘‘(G) The explosive ordnance disposal commandant 
(chief of explosive ordnance disposal) has determined 
whether explosive ordnance disposal soldiers have the 
appropriate skills necessary to support missions of special 
operations forces (as identified in section 167(j) of title 
10, United States Code). Such skills may include airborne, 
air assault, combat diver, fast roping insertion and extrac-
tion, helocasting, military free-fall, and off-road driving.’’. 
SEC. 594. ARMED SERVICES VOCATIONAL APTITUDE BATTERY TEST 
SPECIAL PURPOSE ADJUNCT TO ADDRESS COMPUTA-
TIONAL THINKING. 
Not later than one year after the date of the enactment of 
this Act, the Secretary of Defense shall establish a special purpose 
test adjunct to the Armed Services Vocational Aptitude Battery 
test to address computational thinking skills relevant to military 
applications, including problem decomposition, abstraction, pattern 
recognition, analytical ability, the identification of variables 
involved in data representation, and the ability to create algorithms 
and solution expressions. 
SEC. 595. EXTENSION OF REPORTING DEADLINE FOR THE ANNUAL 
REPORT ON THE ASSESSMENT OF THE EFFECTIVENESS 
OF ACTIVITIES OF THE FEDERAL VOTING ASSISTANCE 
PROGRAM. 
(a) ELIMINATION OF REPORTS FOR NON-ELECTION YEARS.—Sec-
tion 105A(b) of the Uniformed and Overseas Citizens Absentee 
Voting Act (52 U.S.C. 20308(b)) is amended, in the matter preceding 
paragraph (1)—
H. R. 6395—280 
(1) by striking ‘‘March 31 of each year’’ and inserting ‘‘Sep-
tember 30 of each odd-numbered year’’; and 
(2) by striking ‘‘the following information’’ and inserting 
‘‘the following information with respect to the Federal elections 
held during the preceding calendar year’’. 
(b) CONFORMING AMENDMENTS.—Subsection (b) of section 105A 
of such Act (52 U.S.C. 20308(b)) is amended— 
(1) in the subsection heading, by striking ‘‘ANNUAL REPORT’’ 
and inserting ‘‘BIENNIAL REPORT’’; and 
(2) in paragraph (3), by striking ‘‘In the case of’’ and all 
that follows through ‘‘a description’’ and inserting ‘‘A descrip-
tion’’. 
SEC. 596. PLAN ON PERFORMANCE OF FUNERAL HONORS DETAILS 
BY MEMBERS OF OTHER ARMED FORCES WHEN MEMBERS 
OF THE ARMED FORCE OF THE DECEASED ARE UNAVAIL-
ABLE. 
(a) BRIEFING ON PLAN.— 
(1) IN GENERAL.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Defense shall 
provide a briefing to the Committees on Armed Services of 
the Senate and the House of Representatives setting forth 
a plan for the performance of a funeral honors detail at the 
funeral of a deceased member of the Armed Forces by one 
or more members of the Armed Forces from an Armed Force 
other than that of the deceased when— 
(A) members of the Armed Force of the deceased are 
unavailable for the performance of the detail; 
(B) the performance of the detail by members of other 
Armed Forces is requested by the family of the deceased; 
and 
(C) the chief of the Armed Force of the deceased verifies 
the eligibility of the deceased for such funeral honors. 
(2) REPEAL OF REQUIREMENT FOR ONE MEMBER OF ARMED 
FORCE OF DECEASED IN DETAIL.—Section 1491(b)(2) of title 10, 
United States Code, is amended in the first sentence by striking 
‘‘, at least one of whom shall be a member of the armed 
force of which the veteran was a member’’. 
(3) PERFORMANCE.—The plan required by paragraph (1) 
shall authorize the performance of funeral honors details by 
members of the Army National Guard and the Air National 
Guard under section 115 of title 32, United States Code, and 
may authorize the remainder of such details to consist of mem-
bers of veterans organizations or other organizations approved 
for purposes of section 1491 of title 10, United States Code, 
as provided for by subsection (b)(2) of such section 1491. 
(b) ELEMENTS.—The briefing under subsection (a) shall include 
a detailed description of the authorities and requirements for the 
implementation of the plan, including administrative, logistical, 
coordination, and funding authorities and requirements. 
SEC. 597. STUDY ON FINANCIAL IMPACTS OF THE CORONAVIRUS DIS-
EASE 2019 ON MEMBERS OF THE ARMED FORCES AND BEST 
PRACTICES TO PREVENT FUTURE FINANCIAL HARDSHIPS. 
(a) STUDY.—The Secretary of Defense shall conduct a study 
on the financial hardships experienced by members of the Armed 
Forces (including the reserve components) as a result of the 
Coronavirus Disease 2019 (COVID–19) pandemic.
H. R. 6395—281 
(b) ELEMENTS.—The study shall— 
(1) examine the financial hardships members of the Armed 
Forces experience as a result of the COVID–19 pandemic, 
including the effects of stop movement orders, loss of spousal 
income, loss of hazardous duty incentive pay, school closures, 
loss of childcare, loss of educational benefits, loss of drill and 
exercise pay, cancelled deployments, and any additional finan-
cial stressors identified by the Secretary; 
(2) identify best practices to provide assistance for members 
of the Armed Forces experiencing the financial hardships listed 
in paragraph (1); and 
(3) identify actions that can be taken by the Secretary 
to prevent financial hardships listed in paragraph (1) from 
occurring in the future. 
(c) CONSULTATION AND COORDINATION.—For the purposes of 
the study, the Secretary may— 
(1) consult with the Director of the Consumer Financial 
Protection Bureau; and 
(2) with respect to members of the Coast Guard, coordinate 
with the Secretary of Homeland Security. 
(d) SUBMISSION.—Not later than 180 days after the date of 
the enactment of this Act, the Secretary shall submit to the Commit-
tees on Armed Services of the Senate and the House of Representa-
tives a report on the study under subsection (a). 
(e) FINANCIAL HARDSHIP DEFINED.—In this section, the term 
‘‘financial hardship’’ means a loss of income or an unforeseen 
expense as a result of closures and changes in operations in response 
to the COVID–19 pandemic. 
SEC. 598. LIMITATION ON IMPLEMENTATION OF ARMY COMBAT FIT-
NESS TEST. 
The Secretary of the Army may not implement the Army Com-
bat Fitness Test until the Secretary receives results of a study, 
conducted for purposes of this section by an entity independent 
of the Department of Defense, on the following: 
(1) The extent, if any, to which the test would adversely 
impact members of the Army stationed or deployed to climates 
or areas with conditions that make prohibitive the conduct 
of outdoor physical training on a frequent or sustained basis. 
(2) The extent, if any, to which the test would affect recruit-
ment and retention in critical support military occupational 
specialties of the Army, such as medical personnel. 
SEC. 599. SEMIANNUAL REPORTS ON IMPLEMENTATION OF REC-
OMMENDATIONS OF THE COMPREHENSIVE REVIEW OF 
SPECIAL OPERATIONS FORCES CULTURE AND ETHICS. 
(a) SEMIANNUAL REPORTS REQUIRED.—Not later than March 
1, 2021, and every 180 days thereafter through March 1, 2024, 
the Assistant Secretary of Defense for Special Operations and Low 
Intensity Conflict shall, in coordination with the Commander of 
the United States Special Operations Command, submit to the 
congressional defense committees a report on the current status 
of the implementation of the actions recommended as a result 
of the Comprehensive Review of Special Operations Forces Culture 
and Ethics. 
(b) ELEMENTS.—Each report under subsection (a) shall include 
the following:
H. R. 6395—282 
(1) A list of the actions required as of the date of such 
report to complete full implementation of each of the 16 actions 
recommended by the Comprehensive Review referred to in sub-
section (a). 
(2) An identification of the office responsible for completing 
each action listed pursuant to paragraph (1), and an estimated 
timeline for completion of such action. 
(3) If completion of any action listed pursuant to paragraph 
(1) requires resources or actions for which authorization by 
statute is required, a recommendation for legislative action 
for such authorization. 
(4) Any other matters the Assistant Secretary or the Com-
mander considers appropriate. 
SEC. 599A. REPORT ON IMPACT OF CHILDREN OF CERTAIN FILIPINO 
WORLD WAR II VETERANS ON NATIONAL SECURITY, FOR-
EIGN POLICY, AND ECONOMIC AND HUMANITARIAN 
INTERESTS OF THE UNITED STATES. 
(a) IN GENERAL.—Not later than December 31, 2020, the Sec-
retary of Homeland Security, in consultation with the Secretary 
of Defense and the Secretary of State, shall submit to the congres-
sional defense committees a report on the impact of the children 
of certain Filipino World War II veterans on the national security, 
foreign policy, and economic and humanitarian interests of the 
United States. 
(b) ELEMENTS.—The report required by subsection (a) shall 
include the following: 
(1) The number of Filipino World War II veterans who 
fought under the United States flag during World War II to 
protect and defend the United States in the Pacific theater. 
(2) The number of Filipino World War II veterans who 
died fighting under the United States flag during World War 
II to protect and defend the United States in the Pacific theater. 
(3) An assessment of the economic and tax contributions 
that Filipino World War II veterans and their families have 
made to the United States. 
(4) An assessment of the impact on the United States 
of exempting from the numerical limitations on immigrant visas 
the children of the Filipino World War II veterans who were 
naturalized under— 
(A) section 405 of the Immigration Act of 1990 (Public 
Law 101–649; 8 U.S.C. 1440 note); or 
(B) title III of the Nationality Act of 1940 (54 Stat. 
1137; chapter 876), as added by section 1001 of the Second 
War Powers Act, 1942 (56 Stat. 182; chapter 199). 
TITLE VI—MILITARY COMPENSATION 
Subtitle A—Pay and Allowances 
Sec. 601. Increase in basic pay. 
Sec. 602. Compensation and credit for retired pay purposes for maternity leave 
taken by members of the reserve components. 
Sec. 603. Provision of information regarding SCRA to members who receive basic 
allowance for housing. 
Sec. 604. Reorganization of certain allowances other than travel and transportation 
allowances. 
Sec. 605. Expansion of travel and transportation allowances to include fares and 
tolls.
H. R. 6395—283 
Sec. 606. One-time uniform allowance for officers who transfer to the Space Force. 
Subtitle B—Bonuses and Special Incentive Pays 
Sec. 611. One-year extension of certain expiring bonus and special pay authorities. 
Sec. 612. Increase in special and incentive pays for officers in health professions. 
Sec. 613. Increase in certain hazardous duty incentive pay for members of the uni-
formed services. 
Sec. 614. Payment of hazardous duty incentive pay for members of the uniformed 
services. 
Sec. 615. Clarification of 30 days of continuous duty on board a ship required for 
family separation allowance for members of the uniformed services. 
Subtitle C—Disability Pay, Retired Pay, and Family and Survivor Benefits 
Sec. 621. Modernization and clarification of payment of certain Reserves while on 
duty. 
Sec. 622. Restatement and clarification of authority to reimburse members for 
spouse relicensing costs pursuant to a permanent change of station. 
Sec. 623. Expansion of death gratuity for ROTC graduates. 
Sec. 624. Expansion of assistance for Gold Star spouses and other dependents. 
Sec. 625. Gold Star Families Parks Pass. 
Sec. 626. Recalculation of financial assistance for providers of child care services 
and youth program services for dependents. 
Sec. 627. Priority for certain military family housing to a member of the Armed 
Forces whose spouse agrees to provide family home day care services. 
Sec. 628. Study on feasibility and advisability of TSP contributions by military 
spouses. 
Sec. 629. Report on implications of expansion of authority to provide financial as-
sistance to civilian providers of child care services or youth program 
services for survivors of members of the Armed Forces who die in the 
line of duty. 
Sec. 629A. Report on extension of commissary and exchange benefits for surviving 
remarried spouses with dependent children of members of the Armed 
Forces who die while on active duty or certain reserve duty. 
Subtitle D—Defense Resale Matters 
Sec. 631. Base responders essential needs and dining access. 
Sec. 632. First responder access to mobile exchanges. 
Sec. 633. Updated business case analysis for consolidation of the defense resale sys-
tem. 
Subtitle E—Other Personnel Rights and Benefits 
Sec. 641. Approval of certain activities by retired and reserve members of the uni-
formed services. 
Sec. 642. Permanent authority for and enhancement of the Government lodging 
program. 
Sec. 643. Operation of Stars and Stripes. 
Subtitle A—Pay and Allowances 
SEC. 601. INCREASE IN BASIC PAY. 
Effective on January 1, 2021, the rates of monthly basic pay 
for members of the uniformed services are increased by 3.0 percent. 
SEC. 602. COMPENSATION AND CREDIT FOR RETIRED PAY PURPOSES 
FOR MATERNITY LEAVE TAKEN BY MEMBERS OF THE 
RESERVE COMPONENTS. 
(a) COMPENSATION.—Section 206(a) of title 37, United States 
Code, is amended— 
(1) in paragraph (2), by striking ‘‘or’’ at the end; 
(2) in paragraph (3), by striking the period at the end 
and inserting ‘‘; or’’; and 
(3) by adding at the end the following new paragraph: 
‘‘(4) for each of six days for each period during which 
the member is on maternity leave.’’. 
(b) CREDIT FOR RETIRED PAY PURPOSES.—
H. R. 6395—284 
(1) IN GENERAL.—The period of maternity leave taken by 
a member of the reserve components of the Armed Forces 
in connection with the birth of a child shall count toward 
the member’s entitlement to retired pay, and in connection 
with the years of service used in computing retired pay, under 
chapter 1223 of title 10, United States Code, as 12 points. 
(2) SEPARATE CREDIT FOR EACH PERIOD OF LEAVE.—Separate 
crediting of points shall accrue to a member pursuant to this 
subsection for each period of maternity leave taken by the 
member in connection with a childbirth event. 
(3) WHEN CREDITED.—Points credited a member for a period 
of maternity leave pursuant to this subsection shall be credited 
in the year in which the period of maternity leave concerned 
commences. 
(4) CONTRIBUTION
OF
LEAVE
TOWARD
ENTITLEMENT
TO 
RETIRED PAY.—Section 12732(a)(2) of title 10, United States 
Code, as amended by section 516 of this Act, is further 
amended— 
(A) by inserting after subparagraph (F) the following 
new subparagraph: 
‘‘(G) Points at the rate of 12 per period during which 
the member is on maternity leave.’’; and 
(B) in the matter following subparagraph (G), as 
inserted by subparagraph (A), by striking ‘‘and (F)’’ and 
inserting ‘‘(F), and (G)’’. 
(5) COMPUTATION OF YEARS OF SERVICE FOR RETIRED PAY.— 
Section 12733 of such title is amended— 
(A) by redesignating paragraph (5) as paragraph (6); 
and 
(B) by inserting after paragraph (4) the following new 
paragraph (5): 
‘‘(5) One day for each point credited to the person under 
subparagraph (F) of section 12732(a)(2) of this title.’’. 
(c) EFFECTIVE DATE.—This section and the amendments made 
by this section shall take effect on the date of the enactment 
of this Act, and shall apply with respect to periods of maternity 
leave that commence on or after that date. 
SEC. 603. PROVISION OF INFORMATION REGARDING SCRA TO MEM-
BERS WHO RECEIVE BASIC ALLOWANCE FOR HOUSING. 
Section 403 of title 37, United States Code, is amended by 
adding at the end the following: 
‘‘(p) INFORMATION
ON
RIGHTS
AND
PROTECTIONS
UNDER 
SERVICEMEMBERS CIVIL RELIEF ACT.—The Secretary concerned shall 
provide to each member of a uniformed service who receives a 
basic allowance for housing under this section information on the 
rights and protections available to such member under the 
Servicemembers Civil Relief Act (50 U.S.C. 3901 et seq.)— 
‘‘(1) when such member first receives such basic allowance 
for housing; and 
‘‘(2) each time such member receives a permanent change 
of station.’’. 
SEC. 604. REORGANIZATION OF CERTAIN ALLOWANCES OTHER THAN 
TRAVEL AND TRANSPORTATION ALLOWANCES. 
(a) PER DIEM FOR DUTY OUTSIDE THE CONTINENTAL UNITED 
STATES.—
H. R. 6395—285 
(1) TRANSFER TO CHAPTER 7.—Section 475 of title 37, United 
States Code, is transferred to chapter 7 of such title, inserted 
after section 403b, and redesignated as section 405. 
(2) REPEAL
OF
TERMINATION
PROVISION.—Section 405 of 
title 37, United States Code, as added by paragraph (1), is 
amended by striking subsection (f). 
(b) ALLOWANCE FOR FUNERAL HONORS DUTY.— 
(1) TRANSFER TO CHAPTER 7.—Section 495 of title 37, United 
States Code, is transferred to chapter 7 of such title, inserted 
after section 433a, and redesignated as section 435. 
(2) REPEAL
OF
TERMINATION
PROVISION.—Section 435 of 
title 37, United States Code, as added by paragraph (1), is 
amended by striking subsection (c). 
(c) CLERICAL AMENDMENTS.— 
(1) CHAPTER
7.—The table of sections at the beginning 
of chapter 7 of title 37, United States Code, is amended— 
(A) by inserting after the item relating to section 403b 
the following new item: 
‘‘405. Travel and transportation allowances: per diem while on duty outside the con-
tinental United States.’’; and 
(B) by inserting after the item relating to section 433a 
the following new item: 
‘‘435. Funeral honors duty: allowance.’’. 
(2) CHAPTER
8.—The table of sections at the beginning 
of chapter 8 of title 37, United States Code, is amended by 
striking the items relating to sections 475 and 495. 
SEC. 605. EXPANSION OF TRAVEL AND TRANSPORTATION ALLOW-
ANCES TO INCLUDE FARES AND TOLLS. 
Section 452(c)(1) of title 37, United States Code, is amended 
by inserting ‘‘(including fares and tolls, without regard to distance 
travelled)’’ after ‘‘transportation’’. 
SEC. 606. ONE-TIME UNIFORM ALLOWANCE FOR OFFICERS WHO 
TRANSFER TO THE SPACE FORCE. 
(a) IN GENERAL.—The Secretary of the Air Force may provide 
an officer who transfers from the Army, Navy, Air Force, or Marine 
Corps to the Space Force an allowance of not more than $400 
as reimbursement for the purchase of required uniforms and equip-
ment. 
(b) RELATIONSHIP
TO OTHER ALLOWANCES.—The allowance 
under this section is in addition to any allowance available under 
any other provision of law. 
(c) SOURCE OF FUNDS.—Funds for allowances provided under 
subsection (a) in a fiscal year may be derived only from amounts 
authorized to be appropriated for military personnel of the Space 
Force for such fiscal year. 
(d) APPLICABILITY.—The authority for an allowance under this 
section shall apply with respect to any officer described in subsection 
(a) who transfers to the Space Force— 
(1) during the period beginning on December 20, 2019, 
and ending on September 30, 2022; and 
(2) on or after the date the Secretary of the Air Force 
prescribes the official uniform for the Space Force.
H. R. 6395—286 
Subtitle B—Bonuses and Special Incentive 
Pays 
SEC. 611. ONE-YEAR EXTENSION OF CERTAIN EXPIRING BONUS AND 
SPECIAL PAY AUTHORITIES. 
(a) AUTHORITIES RELATING TO RESERVE FORCES.—Section 910(g) 
of title 37, United States Code, relating to income replacement 
payments for reserve component members experiencing extended 
and frequent mobilization for active duty service, is amended by 
striking ‘‘December 31, 2020’’ and inserting ‘‘December 31, 2021’’. 
(b) TITLE 10 AUTHORITIES RELATING TO HEALTH CARE PROFES-
SIONALS.—The following sections of title 10, United States Code, 
are amended by striking ‘‘December 31, 2020’’ and inserting 
‘‘December 31, 2021’’: 
(1) Section 2130a(a)(1), relating to nurse officer candidate 
accession program. 
(2) Section 16302(d), relating to repayment of education 
loans for certain health professionals who serve in the Selected 
Reserve. 
(c) AUTHORITIES RELATING
TO NUCLEAR OFFICERS.—Section 
333(i) of title 37, United States Code, is amended by striking 
‘‘December 31, 2020’’ and inserting ‘‘December 31, 2021’’. 
(d) AUTHORITIES RELATING TO TITLE 37 CONSOLIDATED SPECIAL 
PAY, INCENTIVE PAY, AND BONUS AUTHORITIES.—The following sec-
tions of title 37, United States Code, are amended by striking 
‘‘December 31, 2020’’ and inserting ‘‘December 31, 2021’’: 
(1) Section 331(h), relating to general bonus authority for 
enlisted members. 
(2) Section 332(g), relating to general bonus authority for 
officers. 
(3) Section 334(i), relating to special aviation incentive 
pay and bonus authorities for officers. 
(4) Section 335(k), relating to special bonus and incentive 
pay authorities for officers in health professions. 
(5) Section 336(g), relating to contracting bonus for cadets 
and midshipmen enrolled in the Senior Reserve Officers’ 
Training Corps. 
(6) Section 351(h), relating to hazardous duty pay. 
(7) Section 352(g), relating to assignment pay or special 
duty pay. 
(8) Section 353(i), relating to skill incentive pay or pro-
ficiency bonus. 
(9) Section 355(h), relating to retention incentives for mem-
bers qualified in critical military skills or assigned to high 
priority units. 
(e) AUTHORITY TO PROVIDE TEMPORARY INCREASE
IN RATES 
OF BASIC ALLOWANCE FOR HOUSING.—Section 403(b)(7)(E) of title 
37, United States Code, is amended by striking ‘‘December 31, 
2020’’ and inserting ‘‘December 31, 2021’’. 
SEC. 612. INCREASE IN SPECIAL AND INCENTIVE PAYS FOR OFFICERS 
IN HEALTH PROFESSIONS. 
(a) ACCESSION BONUS GENERALLY.—Subparagraph (A) of sec-
tion 335(e)(1) of title 37, United States Code, is amended by striking 
‘‘$30,000’’ and inserting ‘‘$100,000’’.
H. R. 6395—287 
(b) ACCESSION
BONUS
FOR
CRITICALLY
SHORT
WARTIME 
SPECIALTIES.—Subparagraph (B) of such section is amended by 
striking ‘‘$100,000’’ and inserting ‘‘$200,000’’. 
(c) RETENTION BONUS.—Subparagraph (C) of such section is 
amended by striking ‘‘$75,000’’ and inserting ‘‘$150,000’’. 
(d) INCENTIVE PAY.—Subparagraph (D) of such section is 
amended— 
(1) in clause (i), by striking ‘‘$100,000’’ and inserting 
‘‘$200,000’’; and 
(2) in clause (ii), by striking ‘‘$15,000’’ and inserting 
‘‘$50,000’’. 
(e) BOARD CERTIFICATION PAY.—Subparagraph (E) of such sec-
tion is amended by striking ‘‘$6,000’’ and inserting ‘‘$15,000’’. 
(f) EFFECTIVE DATE.—The amendments made by this section 
shall apply with respect to special bonus and incentive pays payable 
under section 335 of title 37, United States Code, pursuant to 
agreements entered into under that section on or after the date 
of the enactment of this Act. 
SEC. 613. INCREASE IN CERTAIN HAZARDOUS DUTY INCENTIVE PAY 
FOR MEMBERS OF THE UNIFORMED SERVICES. 
Section 351(b) of title 37, United States Code, is amended 
by striking ‘‘$250’’ both places it appears and inserting ‘‘$275’’. 
SEC. 614. PAYMENT OF HAZARDOUS DUTY INCENTIVE PAY FOR MEM-
BERS OF THE UNIFORMED SERVICES. 
Section 351 of title 37, United States Code, is amended— 
(1) in subsection (c)(2)— 
(A) in subparagraph (A)(i), by striking ‘‘shall’’ and 
inserting ‘‘may’’; 
(B) in subparagraph (B)— 
(i) by striking ‘‘paragraph (2) or (3)’’ and inserting 
‘‘paragraph (2)’’; 
(ii) by striking ‘‘the Secretary concerned may pro-
rate’’ and all that follows and inserting ‘‘the Secretary 
concerned—’’; and 
(C) by adding at the end the following: 
‘‘(i) may prorate the payment amount to reflect 
the duration of the member’s actual qualifying service 
during the month; and 
‘‘(ii) in the case of member who performs hazardous 
duty specifically designated by the Secretary con-
cerned, shall pay the member hazardous duty pay in 
an amount not to exceed the maximum amount of 
hazardous duty pay that would be payable to the 
member under subsection (b)(2) for the entire month, 
regardless of the duration of the qualifying service. 
‘‘(C) In the case of hazardous duty pay payable under 
paragraph (3) of subsection (a), the Secretary concerned 
may prorate the payment amount to reflect the duration 
of the member’s actual qualifying service during the 
month.’’; and 
(2) in subsection (h), by striking ‘‘December 31, 2020’’ and 
inserting ‘‘December 31, 2021’’.
H. R. 6395—288 
SEC. 615. CLARIFICATION OF 30 DAYS OF CONTINUOUS DUTY ON 
BOARD A SHIP REQUIRED FOR FAMILY SEPARATION 
ALLOWANCE FOR MEMBERS OF THE UNIFORMED SERV-
ICES. 
Section 427(a)(1)(B) of title 37, United States Code, is amended 
by inserting ‘‘(or under orders to remain on board the ship while 
at the home port)’’ after ‘‘of the ship’’. 
Subtitle C—Disability Pay, Retired Pay, 
and Family and Survivor Benefits 
SEC. 621. MODERNIZATION AND CLARIFICATION OF PAYMENT OF CER-
TAIN RESERVES WHILE ON DUTY. 
(a) CHANGE
IN
PRIORITY
OF
PAYMENTS
FOR
RETIRED
OR 
RETAINER PAY.—Subsection (a) of section 12316 of title 10, United 
States Code, is amended— 
(1) in the matter preceding paragraph (1)— 
(A) by striking ‘‘subsection (b)’’ and inserting ‘‘sub-
section (c)’’; and 
(B) by striking ‘‘his earlier military service’’ and 
inserting ‘‘the Reserve’s earlier military service’’; 
(C) by striking ‘‘a pension, retired or retainer pay, 
or disability compensation’’ and inserting ‘‘retired or 
retainer pay’’; and 
(D) by striking ‘‘he is entitled’’ and inserting ‘‘the 
Reserve is entitled’’; and 
(2) by striking paragraphs (1) and (2) and inserting the 
following new paragraphs: 
‘‘(1) the pay and allowances authorized by law for the 
duty that the Reserve is performing; or 
‘‘(2) if the Reserve specifically waives those payments, the 
retired or retainer pay to which the Reserve is entitled because 
of the Reserve’s earlier military service.’’. 
(b) PAYMENTS FOR PENSION OR DISABILITY COMPENSATION.— 
Such section is further amended— 
(1) by redesignating subsection (b) as subsection (c); and 
(2) by inserting after subsection (a) the following new sub-
section (b): 
‘‘(b) Except as provided by subsection (c), a Reserve of the 
Army, Navy, Air Force, Marine Corps, or Coast Guard who because 
of the Reserve’s earlier military service is entitled to a pension 
or disability compensation, and who performs duty for which the 
Reserve is entitled to compensation, may elect to receive for that 
duty either— 
‘‘(1) the pension or disability compensation to which the 
Reserve is entitled because of the Reserve’s earlier military 
service; or 
‘‘(2) if the Reserve specifically waives those payments, the 
pay and allowances authorized by law for the duty that the 
Reserve is performing.’’. 
(c) ADDITIONAL
CONFORMING
AND
MODERNIZING
AMEND-
MENTS.—Subsection (c) of such section, as redesignated by sub-
section (b)(1) of this section, is amended— 
(1) by striking ‘‘(a)(2)’’ both places it appears and inserting 
‘‘(a)(1) or (b)(2), as applicable,’’;
H. R. 6395—289 
(2) by striking ‘‘his earlier military service’’ the first place 
it appears and inserting ‘‘a Reserve’s earlier military service’’; 
(3) by striking ‘‘his earlier military service’’ each other 
place it appears and inserting ‘‘the Reserve’s earlier military 
service’’; 
(4) by striking ‘‘he is entitled’’ and inserting ‘‘the Reserve 
is entitled’’; and 
(5) by striking ‘‘the member or his dependents’’ and 
inserting ‘‘the Reserve or the Reserve’s dependents’’. 
(d) PROCEDURES.—Such section is further amended by adding 
at the end the following new subsection: 
‘‘(d) The Secretary of Defense shall prescribe regulations under 
which a Reserve of the Army, Navy, Air Force, Marine Corps, 
or Coast Guard may waive the pay and allowances authorized 
by law for the duty the Reserve is performing under subsection 
(a)(2) or (b)(2).’’. 
(e) EFFECTIVE DATE.—The amendments made by this section 
shall take effect 180 days after the date of the enactment of this 
Act. 
SEC. 622. RESTATEMENT AND CLARIFICATION OF AUTHORITY TO 
REIMBURSE MEMBERS FOR SPOUSE RELICENSING COSTS 
PURSUANT TO A PERMANENT CHANGE OF STATION. 
(a) IN GENERAL.—Section 453 of title 37, United States Code, 
is amended by adding at the end the following new subsection: 
‘‘(g) REIMBURSEMENT
OF
QUALIFYING
SPOUSE
RELICENSING 
COSTS INCIDENT TO A MEMBER’S PERMANENT CHANGE OF STATION 
OR ASSIGNMENT.—(1) From amounts otherwise made available for 
a fiscal year to provide travel and transportation allowances under 
this chapter, the Secretary concerned may reimburse a member 
of the uniformed services for qualified relicensing costs of the spouse 
of the member when— 
‘‘(A) the member is reassigned, either as a permanent 
change of station or permanent change of assignment, between 
duty stations located in separate jurisdictions with unique 
licensing or certification requirements and authorities; and 
‘‘(B) the movement of the member’s dependents is author-
ized at the expense of the United States under this section 
as part of the reassignment. 
‘‘(2) Reimbursement provided to a member under this sub-
section may not exceed $1000 in connection with each reassignment 
described in paragraph (1). 
‘‘(3) No reimbursement may be provided under this subsection 
for qualified relicensing costs paid or incurred after December 31, 
2024. 
‘‘(4) In this subsection, the term ‘qualified relicensing costs’ 
means costs, including exam, continuing education courses, and 
registration fees, incurred by the spouse of a member if— 
‘‘(A) the spouse was licensed or certified in a profession 
during the member’s previous duty assignment and requires 
a new license or certification to engage in that profession in 
a new jurisdiction because of movement described in paragraph 
(1)(B) in connection with the member’s change in duty location 
pursuant to reassignment described in paragraph (1)(A); and 
‘‘(B) the costs were incurred or paid to secure or maintain 
the license or certification from the new jurisdiction in connec-
tion with such reassignment.’’.
H. R. 6395—290 
(b) REPEAL OF SUPERSEDED AUTHORITY.—Section 476 of such 
title is amended by striking subsection (p). 
SEC. 623. EXPANSION OF DEATH GRATUITY FOR ROTC GRADUATES. 
Section 623(b) of the National Defense Authorization Act for 
Fiscal Year 2020 (Public Law 116–92) is amended by striking ‘‘the 
date of the enactment of this Act’’ and inserting ‘‘May 1, 2017’’. 
SEC. 624. EXPANSION OF ASSISTANCE FOR GOLD STAR SPOUSES AND 
OTHER DEPENDENTS. 
Section 633(a) of the National Defense Authorization Act for 
Fiscal Year 2014 (10 U.S.C. 1475 note) is amended— 
(1) by redesignating paragraphs (1) through (4) as subpara-
graphs (A) through (D), respectively; 
(2) by inserting ‘‘(1)’’ before ‘‘Each Secretary’’; 
(3) in the matter preceding paragraph (1), by inserting 
‘‘a casualty assistance officer who is’’ after ‘‘jurisdiction of such 
Secretary’’; 
(4) by striking ‘‘spouses and other dependents of members’’ 
and all that follows through ‘‘services:’’ and inserting an em 
dash; and 
(5) by inserting before subparagraph (A), as redesignated, 
the following: 
‘‘(A) a spouse and any other dependent of a member of 
such Armed Force (including the reserve components thereof) 
who dies on active duty; and 
‘‘(B) a dependent described in subparagraph (A) if the 
spouse of the deceased member dies and the dependent (or 
the guardian of such dependent) requests such assistance. 
‘‘(2) Casualty assistance officers described in paragraph (1) 
shall provide to spouses and dependents described in that paragraph 
the following services:’’. 
SEC. 625. GOLD STAR FAMILIES PARKS PASS. 
(a) IN GENERAL.—Section 805(b) of the Federal Lands Recre-
ation Enhancement Act (16 U.S.C. 6804(b)) is amended by adding 
at the end the following: 
‘‘(3) GOLD STAR FAMILIES PARKS PASS.—The Secretary shall 
make the National Parks and Federal Recreational Lands Pass 
available, at no cost, to members of Gold Star Families who 
meet the eligibility requirements of section 3.2 of Department 
of Defense Instruction 1348.36 (or a successor instruction).’’. 
(b) TECHNICAL AND CONFORMING AMENDMENTS.—Section 805 
of the Federal Lands Recreation Enhancement Act (16 U.S.C. 6804) 
is amended— 
(1) in subsection (a)(7), in the first sentence, by striking 
‘‘age and disability’’; and 
(2) in subsection (b)— 
(A) in paragraph (1)(A), in the second sentence, in 
the matter preceding clause (i), by striking ‘‘this subsection’’ 
and inserting ‘‘this paragraph’’; and 
(B) in paragraph (2), in the second sentence, by striking 
‘‘this subsection’’ and inserting ‘‘this paragraph’’.
H. R. 6395—291 
SEC. 626. RECALCULATION OF FINANCIAL ASSISTANCE FOR PRO-
VIDERS OF CHILD CARE SERVICES AND YOUTH PROGRAM 
SERVICES FOR DEPENDENTS. 
(a) IN GENERAL.—Not later than July 1, 2021, the Secretary 
of Defense shall develop a method by which to determine and 
implement appropriate amounts of financial assistance under sec-
tion 1798 of title 10, United States Code. In such development, 
the Secretary shall take into consideration the following: 
(1) Grades of members of the Armed Forces. 
(2) The cost of living in an applicable locale. 
(3) Whether a military installation has a military child 
development center, including any wait list length. 
(4) Whether a military child development center has vacant 
child care employee positions. 
(5) The capacity of licensed civilian child care providers 
in an applicable locale. 
(6) The average cost of licensed civilian child care services 
available in an applicable locale. 
(7) The sufficiency of the stipend furnished by the Secretary 
to members of the Armed Forces for civilian child care. 
(b) REPORT.—Not later than August 1, 2021, the Secretary 
shall submit a report the Committees on Armed Services of the 
Senate and the House of Representatives on the method developed 
under this section. 
(c) DEFINITIONS.—In this section, the terms ‘‘child care 
employee’’ and ‘‘military child development center’’ have the 
meanings given those terms in section 1800 of title 10, United 
States Code. 
SEC. 627. PRIORITY FOR CERTAIN MILITARY FAMILY HOUSING TO A 
MEMBER OF THE ARMED FORCES WHOSE SPOUSE AGREES 
TO PROVIDE FAMILY HOME DAY CARE SERVICES. 
(a) PRIORITY.—If the Secretary of a military department deter-
mines that not enough child care employees are employed at a 
military child development center on a military installation under 
the jurisdiction of that Secretary to adequately care for the children 
of members of the Armed Forces stationed at that military installa-
tion, the Secretary, to the extent practicable, may give priority 
for covered military family housing to a member whose spouse 
is an eligible military spouse. 
(b) NUMBER OF PRIORITY POSITIONS.—A Secretary of a military 
department may grant priority under subsection (a) only to the 
minimum number of eligible military spouses that the Secretary 
determines necessary to provide adequate child care to the children 
of members stationed at a military installation described in sub-
section (a). 
(c) LIMITATION.—Nothing in this section may be construed to 
require the Secretary of a military department to provide covered 
military family housing that has been adapted for disabled individ-
uals to a member under this section instead of to a member with 
one more dependents enrolled in the Exceptional Family Member 
Program. 
(d) RESULT OF FAILURE TO PROVIDE FAMILY HOME DAY CARE 
SERVICES OR LOSS OF ELIGIBILITY.—The Secretary of the military 
department concerned may remove a household provided covered 
military family housing under this section therefrom if the Secretary 
determines the spouse of that member has failed to abide by an
H. R. 6395—292 
agreement described in subsection (e)(3) or has ceased to be an 
eligible military spouse. Such removal may not occur sooner than 
60 days after the date of such determination. 
(e) DEFINITIONS.—In this section: 
(1) The terms ‘‘child care employee’’, ‘‘family home day 
care’’, and ‘‘military child development center’’ have the 
meanings given those terms in section 1800 of title 10, United 
States Code. 
(2) The term ‘‘covered military family housing’’ means mili-
tary family housing— 
(A) located on a military installation described in sub-
section (a); and 
(B) that the Secretary of the military department con-
cerned determines is large enough to provide family home 
day care services to no fewer than six children (not 
including children in the household of the eligible military 
spouse). 
(3) The term ‘‘eligible military spouse’’ means a military 
spouse who— 
(A) is eligible for military family housing; 
(B) is eligible to provide family home day care services; 
(C) has provided family home day care services for 
at least one year; and 
(D) agrees in writing to provide family home day care 
services in covered military family housing for a period 
not shorter than one year. 
SEC. 628. STUDY ON FEASIBILITY AND ADVISABILITY OF TSP CON-
TRIBUTIONS BY MILITARY SPOUSES. 
(a) STUDY REQUIRED.—The Secretary of Defense shall conduct 
a study on the feasibility and advisability of potential enhancements 
to the military Thrift Savings Plan administered by the Federal 
Retirement Thrift Investment Board. 
(b) ELEMENTS.—The study under subsection (a) shall include 
the following: 
(1) An evaluation of the effect of allowing military spouses 
to contribute or make eligible retirement account transfers 
to the military Thrift Savings Plan account of the member 
of the Armed Forces to whom that military spouse in married. 
(2) Legislation the Secretary determines necessary to 
permit contributions and transfers described in paragraph (1). 
(c) REPORTING.— 
(1) INITIAL REPORT.—Not later than February 1, 2021, the 
Secretary of Defense shall submit to the Committee on Home-
land Security & Governmental Affairs of the Senate, the Com-
mittee on Oversight and Reform of the House of Representa-
tives, and the Federal Retirement Thrift Investment Board, 
a report on the results of the study under subsection (a). 
(2) ANALYSIS.—Not later than 60 days after receiving the 
report under paragraph (1), the Federal Thrift Savings Retire-
ment Board shall analyze the report under paragraph (1), gen-
erate recommendations and comments it determines appro-
priate, and submit such analysis, recommendations, and com-
ments to the Secretary. 
(3) FINAL REPORT.—Not later than April 1, 2021, the Sec-
retary shall submit to the Committees on Armed Services of 
the Senate and House of Representatives—
H. R. 6395—293 
(A) the report under paragraph (1); 
(B) the analysis, recommendations, and comments 
under paragraph (2); and 
(C) the recommendations of the Secretary regarding 
elements described in subsection (b). 
SEC. 629. REPORT ON IMPLICATIONS OF EXPANSION OF AUTHORITY 
TO PROVIDE FINANCIAL ASSISTANCE TO CIVILIAN PRO-
VIDERS OF CHILD CARE SERVICES OR YOUTH PROGRAM 
SERVICES FOR SURVIVORS OF MEMBERS OF THE ARMED 
FORCES WHO DIE IN THE LINE OF DUTY. 
(a) REPORT REQUIRED.—Not later than one year after the date 
of the enactment of this Act, the Comptroller General of the United 
States shall submit to the Committees on Armed Services of the 
Senate and House of Representatives a report on the implications 
of expansion of the authority under section 1798 of title 10, United 
States Code, to provide financial assistance to civilian providers 
of child care services or youth program services for survivors of 
members of the Armed Forces who die in the line of duty, without 
regard to whether such deaths occurred in combat-related incidents. 
(b) ELEMENTS.—The report under subsection (a) shall include 
the following: 
(1) An analysis of data during the five years preceding 
the date of the report that regarding the number of— 
(A) members of the Armed Forces who died in the 
line of duty; and 
(B) dependents of such members who would be eligible 
for services described in subsection (a). 
(2) The estimated cost of the expansion described in sub-
section (a). 
(3) An assessment of how such expansion would affect 
the availability of such services for children of members of 
the Armed Forces on active duty, particularly in areas where 
demand for such services by such members is greatest. 
(4) An assessment of existing programs of the Department 
of Defense that provide financial assistance described in sub-
section (a). 
(5) Recommendations for legislative or administrative 
action to expand the provision of services described in sub-
section (a). 
SEC. 629A. REPORT ON EXTENSION OF COMMISSARY AND EXCHANGE 
BENEFITS FOR SURVIVING REMARRIED SPOUSES WITH 
DEPENDENT CHILDREN OF MEMBERS OF THE ARMED 
FORCES WHO DIE WHILE ON ACTIVE DUTY OR CERTAIN 
RESERVE DUTY. 
(a) REPORT REQUIRED.—The Secretary of Defense, in consulta-
tion with the Secretary of Homeland Security, shall submit to 
the Committees on Armed Services of the Senate and the House 
of Representatives a report on procedures of the Department of 
Defense by which an eligible remarried spouse may obtain access, 
as appropriate, to a military installation in order to use a com-
missary store or MWR retail facility. 
(b) ELEMENTS.— The report under this section shall include 
the following: 
(1) Procedures by which an eligible remarried spouse may 
obtain a personal agent designation.
H. R. 6395—294 
(2) Administrative requirements for an eligible remarried 
spouse to obtain access described in subsection (a). 
(3) An assessment of the consistency of procedures 
described in subsection (a) across— 
(A) the Armed Forces; and 
(B) installations of the Department of Defense. 
(4) Security considerations arising from granting access 
described in subsection (a). 
(5) Other matters the Secretary of Defense determines 
appropriate. 
(c) DEADLINE.—The Secretary shall submit the report under 
this section not later than March 1, 2021. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘eligible remarried spouse’’ means an indi-
vidual who is a surviving former spouse of a covered member 
of the Armed Forces, who has remarried after the death of 
the covered member of the Armed Forces and has guardianship 
of dependent children of the deceased member; 
(2) The term ‘‘covered member of the Armed Forces’’ means 
a member of the Armed Forces who dies while serving— 
(A) on active duty; or 
(B) on such reserve duty as the Secretary of Defense 
and the Secretary of Homeland Security may jointly specify 
for purposes of this section. 
(3) The term ‘‘MWR retail facility’’ has the meaning given 
that term in section 1063 of title 10, United States Code. 
Subtitle D—Defense Resale Matters 
SEC. 631. BASE RESPONDERS ESSENTIAL NEEDS AND DINING ACCESS. 
(a) IN GENERAL.—Chapter 54 of title 10, United States Code, 
is amended by adding at the end the following new section: 
‘‘§ 1066. Use of commissary stores and MWR facilities: protec-
tive services civilian employees 
‘‘(a) 
ELIGIBILITY
OF
PROTECTIVE
SERVICES
CIVILIAN 
EMPLOYEES.—An individual employed as a protective services 
civilian employee at a military installation may be permitted to 
purchase food and hygiene items at a commissary store or MWR 
retail facility located on that military installation. 
‘‘(b) USER FEE AUTHORITY.—(1) The Secretary of Defense shall 
prescribe regulations that impose a user fee on individuals who 
are eligible solely under this section to purchase merchandise at 
a commissary store or MWR retail facility. 
‘‘(2) The Secretary shall set the user fee under this subsection 
at a rate that the Secretary determines will offset any increase 
in expenses arising from this section borne by the Department 
of the Treasury on behalf of commissary stores associated with 
the use of credit or debit cards for customer purchases, including 
expenses related to card network use and related transaction proc-
essing fees. 
‘‘(3) The Secretary shall deposit funds collected pursuant to 
a user fee under this subsection in the General Fund of the 
Treasury. 
‘‘(4) Any fee under this subsection is in addition to the uniform 
surcharge under section 2484(d) of this title.
H. R. 6395—295 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) The term ‘MWR retail facility’ has the meaning given 
that term in section 1063 of this title. 
‘‘(2) The term ‘protective services civilian employee’ means 
a position in any of the following series (or successor classifica-
tions) of the General Schedule: 
‘‘(A) Security Administration (GS–0080). 
‘‘(B) Fire Protection and Prevention (GS–0081). 
‘‘(C) Police (GS–0083). 
‘‘(D) Security Guard (GS–0085). 
‘‘(E) Emergency Management (GS–0089).’’. 
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of chapter 54 of title 10, United States Code, is amended 
by adding at the end the following new item: 
‘‘1066. Use of commissary stores and MWR facilities: protective services civilian em-
ployees.’’. 
SEC. 632. FIRST RESPONDER ACCESS TO MOBILE EXCHANGES. 
Section 1146 of title 10, United States Code, is amended by 
adding at the end the following new subsection: 
‘‘(d) EMERGENCY RESPONSE PROVIDERS DURING
A DECLARED 
MAJOR DISASTER OR EMERGENCY.—The Secretary of Defense may 
prescribe regulations to allow an emergency response provider (as 
that term is defined in section 2 of the Homeland Security Act 
of 2002 (Public Law 107–296; 6 U.S.C. 101)) to use a mobile com-
missary or exchange store deployed to an area covered by a declara-
tion of a major disaster or emergency under section 401 of the 
Robert T. Stafford Disaster Relief and Emergency Assistance Act 
(42 U.S.C. 5170).’’. 
SEC. 633. UPDATED BUSINESS CASE ANALYSIS FOR CONSOLIDATION 
OF THE DEFENSE RESALE SYSTEM. 
(a) IN GENERAL.—Not later than March 1, 2021, the Chief 
Management Officer of the Department of Defense, in coordination 
with the Undersecretary of Defense for Personnel and Readiness, 
shall update the study titled ‘‘Study to Determine the Feasibility 
of Consolidation of the Defense Resale Entities’’ and dated December 
4, 2018, to include a new business case analysis that— 
(1) establishes new baselines for— 
(A) savings from the costs of goods sold; 
(B) costs of new information technology required for 
such consolidation; and 
(C) costs of headquarters relocation arising from such 
consolidation; and 
(2) addresses each recommendation for executive action 
in the Government Accountability Office report GAO–20– 
418SU. 
(b) REVIEW AND COMMENT.—Not later than April 1, 2021, the 
Secretary of Defense shall make the updated business case analysis 
(in this section referred to as the ‘‘updated BCA’’) available to 
the Secretaries of the military departments for comment. 
(c) SUBMITTAL TO CONGRESSIONAL COMMITTEES.—Not later than 
June 1, 2021, the Secretary of Defense shall make any comments 
made under subsection (b) and the updated BCA available to the 
Committees on Armed Services of the Senate and the House of 
Representatives.
H. R. 6395—296 
(d) DELAY OF CONSOLIDATION.—The Secretary of Defense may 
not take any action to consolidate military exchanges and com-
missaries until the Committees on Armed Services of the Senate 
and the House of Representatives notify the Secretary in writing 
of receipt and acceptance of the updated BCA. 
Subtitle E—Other Personnel Rights and 
Benefits 
SEC. 641. APPROVAL OF CERTAIN ACTIVITIES BY RETIRED AND 
RESERVE MEMBERS OF THE UNIFORMED SERVICES. 
(a) CLARIFICATION
OF
ACTIVITIES
FOR
WHICH
APPROVAL 
REQUIRED.—Section 908 of title 37, United States Code, is 
amended— 
(1) in subsection (a)— 
(A) in the matter preceding paragraph (1)— 
(i) by striking ‘‘subsection (b)’’ and inserting ‘‘sub-
sections (b) and (c)’’; and 
(ii) by inserting ‘‘, accepting payment for speeches, 
travel, meals, lodging, or registration fees, or accepting 
a non-cash award,’’ after ‘‘that employment)’’; and 
(B) in paragraph (2), by striking ‘‘armed forces’’ and 
inserting ‘‘armed forces, except members serving on active 
duty under a call or order to active duty for a period 
in excess of 30 days’’; 
(2) in the heading of subsection (b), by inserting ‘‘FOR 
EMPLOYMENT AND COMPENSATION’’ after ‘‘APPROVAL REQUIRED’’; 
(3) by redesignating subsections (c) and (d) as subsections 
(d) and (e), respectively; and 
(4) by inserting after subsection (b) the following new sub-
section (c): 
‘‘(c) 
APPROVAL
REQUIRED
FOR
CERTAIN
PAYMENTS
AND 
AWARDS.—A person described in subsection (a) may accept payment 
for speeches, travel, meals, lodging, or registration fees described 
in that subsection, or accept a non-cash award described in that 
subsection, only if the Secretary concerned approves the payment 
or award.’’. 
(b) ANNUAL REPORTS ON APPROVALS.—Subsection (d) of such 
section, as redesignated by subsection (a)(3) of this section, is 
amended— 
(1) by inserting ‘‘(1)’’ before ‘‘Not later than’’; 
(2) in paragraph (1), as designated by paragraph (1) of 
this subsection, by inserting ‘‘, and each approval under sub-
section (c) for a payment or award described in subsection 
(a),’’ after ‘‘in subsection (a)’’; and 
(3) by adding at the end the following new paragraph: 
‘‘(2) The report under paragraph (1) on an approval described 
in that paragraph with respect to an officer shall set forth the 
following: 
‘‘(A) The foreign government providing the employment 
or compensation or payment or award. 
‘‘(B) The duties, if any, to be performed in connection 
with the employment or compensation or payment or award. 
‘‘(C) The total amount of compensation, if any, or payment 
to be provided.’’. 
(c) CONFORMING AMENDMENTS.—
H. R. 6395—297 
(1) SECTION
HEADING.—The heading of such section is 
amended to read as follows: 
‘‘§ 908. Reserves and retired members: acceptance of employ-
ment, payments, and awards from foreign govern-
ments’’. 
(2) TABLE OF SECTIONS.—The table of sections at the begin-
ning of chapter 17 of such title is amended by striking the 
item relating to section 908 and inserting the following new 
item: 
‘‘908. Reserves and retired members: acceptance of employment, payments, and 
awards from foreign governments.’’. 
SEC. 642. PERMANENT AUTHORITY FOR AND ENHANCEMENT OF THE 
GOVERNMENT LODGING PROGRAM. 
(a) PERMANENT AUTHORITY.—Section 914 of the Carl Levin 
and Howard P. ‘‘Buck’’ McKeon National Defense Authorization 
Act for Fiscal Year 2015 (5 U.S.C. 5911 note) is amended— 
(1) in subsection (a), by striking ‘‘, for the period of time 
described in subsection (b),’’; and 
(2) by striking subsection (b). 
(b) TEMPORARY EXCLUSION OF CERTAIN SHIPYARD EMPLOYEES.— 
Such section is further amended by inserting after subsection (a) 
the following new subsection (b): 
‘‘(b) 
TEMPORARY
EXCLUSION
OF
CERTAIN
SHIPYARD 
EMPLOYEES.— 
‘‘(1) IN GENERAL.—In carrying out a Government lodging 
program under subsection (a), the Secretary shall exclude from 
the requirements of the program employees who are traveling 
for the performance of mission functions of a public shipyard 
of the Department if the Secretary determines such require-
ments would adversely affect the purpose or mission of such 
travel. 
‘‘(2) TERMINATION.—This subsection shall terminate on Sep-
tember 30, 2023.’’. 
(c) CONFORMING AMENDMENT.—The heading of such section 
is amended to read as follows: 
‘‘SEC. 914. GOVERNMENT LODGING PROGRAM.’’. 
SEC. 643. OPERATION OF STARS AND STRIPES. 
(a) OPERATION.—Subject to appropriations, the Secretary of 
Defense may not cease operation and maintenance of Stars and 
Stripes until 180 days after the date on which the Secretary submits 
to the Committees on Armed Service of the Senate and the House 
of Representatives notice of the proposed cessation of such operation 
and maintenance. 
(b) REPORT
ON BUSINESS CASE ANALYSIS.—Not later than 
March 1, 2021, the Secretary of Defense, in coordination with the 
editor of Stars and Stripes, shall submit a report to the Committees 
on Armed Services of the Senate and the House of Representatives 
detailing the business case analysis for various options for Stars 
and Stripes. The report shall contain the following elements: 
(1) An analysis of the pros and cons of, and business 
case for, continuing the operation and publication of Stars 
and Stripes at its current levels, including other options for 
the independent reporting currently provided, especially in a 
deployed environment.
H. R. 6395—298 
(2) An analysis of the modes of communication used by 
Stars and Stripes. 
(3) An analysis of potential reduced operations of Stars 
and Stripes. 
(4) An analysis of the operation of Stars and Stripes solely 
as a non-appropriated fund entity. 
(5) An analysis of operating Stars and Stripes as a category 
B morale, welfare, and recreation entity. 
(6) An assessment of the value of the availability of Stars 
and Stripes (in print or an electronic version) to deployed 
or overseas members of the Armed Forces. 
TITLE VII—HEALTH CARE PROVISIONS 
Subtitle A—TRICARE and Other Health Care Benefits 
Sec. 701. Improvement to breast cancer screening. 
Sec. 702. Waiver of fees charged to certain civilians for emergency medical treat-
ment provided at military medical treatment facilities. 
Sec. 703. Authority for Secretary of Defense to manage provider type referral and 
supervision requirements under TRICARE program. 
Sec. 704. Expansion of benefits available under TRICARE Extended Care Health 
Option program. 
Sec. 705. Sale of hearing aids for dependents of certain members of the reserve 
components. 
Sec. 706. Pilot program on receipt of non-generic prescription maintenance medica-
tions under TRICARE pharmacy benefits program. 
Subtitle B—Health Care Administration 
Sec. 711. Repeal of administration of TRICARE dental plans through Federal Em-
ployees Dental and Vision Insurance Program. 
Sec. 712. Protection of the Armed Forces from infectious diseases. 
Sec. 713. Inclusion of drugs, biological products, and critical medical supplies in na-
tional security strategy for national technology and industrial base. 
Sec. 714. Contract authority of the Uniformed Services University of the Health 
Sciences. 
Sec. 715. Membership of Board of Regents of Uniformed Services University of the 
Health Sciences. 
Sec. 716. Temporary exemption for Uniformed Services University of the Health 
Sciences from certain Paperwork Reduction Act requirements. 
Sec. 717. Modification to limitation on the realignment or reduction of military 
medical manning end strength. 
Sec. 718. Modifications to implementation plan for restructure or realignment of 
military medical treatment facilities. 
Sec. 719. Policy to address prescription opioid safety. 
Sec. 720. Addition of burn pit registration and other information to electronic 
health records of members of the Armed Forces. 
Sec. 721. Inclusion of information on exposure to open burn pits in postdeployment 
health reassessments. 
Subtitle C—Matters Relating to COVID–19 
Sec. 731. COVID–19 military health system review panel. 
Sec. 732. Department of Defense pandemic preparedness. 
Sec. 733. Transitional health benefits for certain members of the National Guard 
serving under orders in response to the coronavirus (COVID–19). 
Sec. 734. Registry of certain TRICARE beneficiaries diagnosed with COVID–19. 
Sec. 735. Health assessments of veterans diagnosed with pandemic diseases to de-
termine exposure to open burn pits and toxic airborne chemicals. 
Sec. 736. Comptroller General study on delivery of mental health services to mem-
bers of the Armed Forces during the COVID–19 pandemic. 
Subtitle D—Reports and Other Matters 
Sec. 741. Modifications to pilot program on civilian and military partnerships to en-
hance interoperability and medical surge capability and capacity of Na-
tional Disaster Medical System. 
Sec. 742. Reports on suicide among members of the Armed Forces and suicide pre-
vention programs and activities of the Department of Defense.
H. R. 6395—299 
Sec. 743. Extension of authority for Joint Department of Defense-Department of 
Veterans Affairs Medical Facility Demonstration Fund. 
Sec. 744. Military Health System Clinical Quality Management Program. 
Sec. 745. Wounded Warrior Service Dog Program. 
Sec. 746. Extramedical maternal health providers demonstration project. 
Sec. 747. Briefing on diet and nutrition of members of the Armed Forces. 
Sec. 748. Audit of medical conditions of residents in privatized military housing. 
Sec. 749. Assessment of receipt by civilians of emergency medical treatment at 
military medical treatment facilities. 
Sec. 750. Study on the incidence of cancer diagnosis and mortality among military 
aviators and aviation support personnel. 
Sec. 751. Study on exposure to toxic substances at Karshi-Khanabad Air Base, Uz-
bekistan. 
Sec. 752. Review and report on prevention of suicide among members of the Armed 
Forces stationed at remote installations outside the contiguous United 
States. 
Sec. 753. Study on medevac helicopters and ambulances at certain military instal-
lations. 
Sec. 754. Comptroller General study on prenatal and postpartum mental health 
conditions among members of the Armed Forces and their dependents. 
Sec. 755. Report on lapses in TRICARE coverage for members of the National 
Guard and reserve components. 
Sec. 756. Study and report on increasing telehealth services across Armed Forces. 
Sec. 757. Study on force mix options and service models to enhance readiness of 
medical force of the Armed Forces. 
Sec. 758. Report on billing practices for health care from Department of Defense. 
Subtitle E—Mental Health Services From Department of Veterans Affairs for 
Members of Reserve Components 
Sec. 761. Short title. 
Sec. 762. Expansion of eligibility for readjustment counseling and related out-
patient services from Department of Veterans Affairs to include mem-
bers of reserve components of the Armed Forces. 
Sec. 763. Provision of mental health services from Department of Veterans Affairs 
to members of reserve components of the Armed Forces. 
Sec. 764. Inclusion of members of reserve components in mental health programs 
of Department of Veterans Affairs. 
Sec. 765. Report on mental health and related services provided by Department of 
Veterans Affairs to members of the Armed Forces. 
Subtitle A—TRICARE and Other Health 
Care Benefits 
SEC. 701. IMPROVEMENT TO BREAST CANCER SCREENING. 
Section 1074d(b)(2) of title 10, United States Code, is amended 
by inserting before the period at the end the following: ‘‘, including 
through the use of digital breast tomosynthesis’’. 
SEC. 702. WAIVER OF FEES CHARGED TO CERTAIN CIVILIANS FOR 
EMERGENCY MEDICAL TREATMENT PROVIDED AT MILI-
TARY MEDICAL TREATMENT FACILITIES. 
Section 1079b of title 10, United States Code, is amended— 
(1) by redesignating subsection (b) as subsection (c); and 
(2) by inserting after subsection (a) the following new sub-
section (b): 
‘‘(b) WAIVER OF FEES.—The Secretary may waive a fee that 
would otherwise be charged under the procedures implemented 
under subsection (a) to a civilian who is not a covered beneficiary 
if— 
‘‘(1) the civilian is unable to pay for the costs of the trauma 
or other medical care provided to the civilian (including any 
such costs remaining after the Secretary receives payment from 
an insurer for such care, as applicable); and
H. R. 6395—300 
‘‘(2) the provision of such care enhances the knowledge, 
skills, and abilities of health care providers, as determined 
by the Secretary.’’. 
SEC. 703. AUTHORITY FOR SECRETARY OF DEFENSE TO MANAGE PRO-
VIDER TYPE REFERRAL AND SUPERVISION REQUIRE-
MENTS UNDER TRICARE PROGRAM. 
Section 1079(a)(12) of title 10, United States Code, is amended, 
in the first sentence, by striking ‘‘or certified clinical social worker,’’ 
and inserting ‘‘certified clinical social worker, or other class of 
provider as designated by the Secretary of Defense,’’. 
SEC. 704. EXPANSION OF BENEFITS AVAILABLE UNDER TRICARE 
EXTENDED CARE HEALTH OPTION PROGRAM. 
(a) EXTENDED BENEFITS
FOR ELIGIBLE DEPENDENTS.—Sub-
section (e) of section 1079 of title 10, United States Code, is amended 
to read as follows: 
‘‘(e)(1) Extended benefits for eligible dependents under sub-
section (d) may include comprehensive health care services 
(including services necessary to maintain, or minimize or prevent 
deterioration of, function of the patient) and case management 
services with respect to the qualifying condition of such a dependent, 
and include, to the extent such benefits are not provided under 
provisions of this chapter other than under this section, the fol-
lowing: 
‘‘(A) Diagnosis and screening. 
‘‘(B) Inpatient, outpatient, and comprehensive home health 
care supplies and services which may include cost-effective 
and medically appropriate services other than part-time or 
intermittent services (within the meaning of such terms as 
used in the second sentence of section 1861(m) of the Social 
Security Act (42 U.S.C. 1395x)). 
‘‘(C) Rehabilitation services and devices. 
‘‘(D) In accordance with paragraph (2), respite care for 
the primary caregiver of the eligible dependent. 
‘‘(E) In accordance with paragraph (3), service and modifica-
tion of durable equipment and assistive technology devices. 
‘‘(F) Special education. 
‘‘(G) Vocational training, which may be furnished to an 
eligible dependent in the residence of the eligible dependent 
or at a facility in which such training is provided. 
‘‘(H) Such other services and supplies as determined appro-
priate by the Secretary, notwithstanding the limitations in 
subsection (a)(12). 
‘‘(2) Respite care under paragraph (1)(D) shall be provided 
subject to the following conditions: 
‘‘(A) Pursuant to regulations prescribed by the Secretary 
for purposes of this paragraph, such respite care shall be limited 
to 32 hours per month for a primary caregiver. 
‘‘(B) Unused hours of such respite care may not be carried 
over to another month. 
‘‘(C) Such respite care may be provided to an eligible bene-
ficiary regardless of whether the eligible beneficiary is receiving 
another benefit under this subsection. 
‘‘(3)(A) Service and modification of durable equipment and 
assistive technology devices under paragraph (1)(E) may be provided
H. R. 6395—301 
only upon determination by the Secretary that the service or modi-
fication is necessary for the use of such equipment or device by 
the eligible dependent. 
‘‘(B) Service and modification of durable equipment and 
assistive technology devices under such paragraph may not be 
provided— 
‘‘(i) in the case of misuse, loss, or theft of the equipment 
or device; or 
‘‘(ii) for a deluxe, luxury, or immaterial feature of the 
equipment or device, as determined by the Secretary. 
‘‘(C) Service and modification of durable equipment and 
assistive technology devices under such paragraph may include 
training of the eligible dependent and immediate family members 
of the eligible dependent on the use of the equipment or device.’’. 
(b) CONFORMING AMENDMENT.—Subsection (f) of section 1079 
of title 10, United States Code, is amended by striking ‘‘paragraph 
(3) or (4) of subsection (e)’’ each place it appears and inserting 
‘‘subparagraph (C), (E), (F), or (G) of subsection (e)(1)’’. 
(c) ADDITIONAL REQUIREMENTS IN OFFICE OF SPECIAL NEEDS 
ANNUAL REPORT.—Section 1781c(g)(2) of title 10, United States 
Code, is amended— 
(1) by redesignating subparagraph (C) as subparagraph 
(D); and 
(2) by inserting after subparagraph (B) the following new 
subparagraph (C): 
‘‘(C) With respect to the Extended Care Health Option 
program under section 1079(d) of this title— 
‘‘(i) the utilization rates of services under such program 
by eligible dependents (as such term is defined in such 
section) during the prior year; 
‘‘(ii) a description of gaps in such services, as 
ascertained by the Secretary from information provided 
by families of eligible dependents; 
‘‘(iii) an assessment of factors that prevent knowledge 
of and access to such program, including a discussion of 
actions the Secretary may take to address these factors; 
and 
‘‘(iv) an assessment of the average wait time for an 
eligible dependent enrolled in the program to access alter-
native health coverage for a qualifying condition (as such 
term is defined in such section), including a discussion 
of any adverse health outcomes associated with such wait.’’. 
(d) COMPTROLLER GENERAL REPORT.— 
(1) SUBMISSION.—Not later than April 1, 2022, the Comp-
troller General of the United States shall submit to the Commit-
tees on Armed Services of the House of Representatives and 
the Senate a report on caregiving available to eligible depend-
ents under programs such as home- and community-based serv-
ices provided under State Medicaid plans pursuant to waivers 
under section 1915 of the Social Security Act (42 U.S.C. 1396n) 
or the Program of Comprehensive Assistance for Family Care-
givers of the Department of Veterans Affairs established under 
section 1720G of title 38, United States Code. 
(2) MATTERS.—The report under paragraph (1) shall 
include— 
(A) an analysis of best practices for the administration 
of programs to support caregivers of individuals with
H. R. 6395—302 
intellectual or physical disabilities, based on input from 
payers, administrators, individuals receiving care from 
such caregivers, and advocates; 
(B) a comparison of the provision of respite and related 
care under the Extended Care Health Option program 
under section 1079(d) of title 10, United States Code, and 
similar care provided under programs specified in para-
graph (1), to identify best practices from such program 
and, if necessary, make recommendations for improvement; 
and 
(C) an analysis of the reasons eligible dependents do 
not qualify for State programs under which caregiving is 
available, such as home- and community-based services 
provided under State Medicaid plans as specified in para-
graph (1), with respect to the State in which the eligible 
dependent is located. 
(3) ELIGIBLE
DEPENDENT
DEFINED.—In this subsection, 
‘‘eligible dependent’’ has the meaning given such term in section 
1079(d) of title 10, United States Code. 
SEC. 705. SALE OF HEARING AIDS FOR DEPENDENTS OF CERTAIN MEM-
BERS OF THE RESERVE COMPONENTS. 
Section 1077(g) of title 10, United States Code, is amended— 
(1) by striking ‘‘In addition’’ and inserting ‘‘(1) In addition’’; 
and 
(2) by adding at the end the following new paragraph: 
‘‘(2) For purposes of selling hearing aids at cost to the United 
States under paragraph (1), a dependent of a member of the reserve 
components who is enrolled in the TRICARE program under section 
1076d of this title shall be deemed to be a dependent eligible 
for care under this section.’’. 
SEC. 706. PILOT PROGRAM ON RECEIPT OF NON-GENERIC PRESCRIP-
TION 
MAINTENANCE 
MEDICATIONS 
UNDER 
TRICARE 
PHARMACY BENEFITS PROGRAM. 
(a) PILOT PROGRAM.— 
(1) AUTHORITY.—Subject to paragraph (2), the Secretary 
of Defense may carry out a pilot program under which eligible 
covered beneficiaries may elect to receive non-generic prescrip-
tion maintenance medications selected by the Secretary under 
subsection (c) through military medical treatment facility phar-
macies, retail pharmacies, or the national mail-order pharmacy 
program, notwithstanding section 1074g(a)(9) of title 10, United 
States Code. 
(2) REQUIREMENT.—The Secretary may carry out the pilot 
program under paragraph (1) only if the Secretary determines 
that the total costs to the Department of Defense for eligible 
covered beneficiaries to receive non-generic prescription mainte-
nance medications under the pilot program will not exceed 
the total costs to the Department for such beneficiaries to 
receive such medications under the national mail-order phar-
macy program pursuant to section 1074g(a)(9) of title 10, United 
States Code. In making such determination, the Secretary shall 
consider all manufacturer discounts, refunds and rebates, phar-
macy transaction fees, and all other costs. 
(b) DURATION.—If the Secretary carries out the pilot program 
under subsection (a)(1), the Secretary shall carry out the pilot
H. R. 6395—303 
program for a three-year period beginning not later than March 
1, 2021. 
(c) SELECTION OF MEDICATION.—If the Secretary carries out 
the pilot program under subsection (a)(1), the Secretary shall select 
non-generic prescription maintenance medications described in sec-
tion 1074g(a)(9)(C)(ii) of title 10, United States Code, to be covered 
by the pilot program. 
(d) NOTIFICATION.—If the Secretary carries out the pilot pro-
gram under subsection (a)(1), in providing each eligible covered 
beneficiary with an explanation of benefits, the Secretary shall 
notify the beneficiary of whether the medication that the beneficiary 
is prescribed is covered by the pilot program. 
(e) BRIEFING AND REPORTS.— 
(1) BRIEFING.—If the Secretary determines to carry out 
the pilot program under subsection (a)(1), not later than 90 
days after the date of the enactment of this Act, the Secretary 
shall provide to the Committees on Armed Services of the 
House of Representatives and the Senate a briefing on the 
implementation of the pilot program. 
(2) INTERIM REPORT.—If the Secretary carries out the pilot 
program under subsection (a)(1), not later than 18 months 
after the commencement of the pilot program, the Secretary 
shall submit to the Committees on Armed Services of the House 
of Representatives and the Senate a report on the pilot program. 
(3) COMPTROLLER GENERAL REPORT.— 
(A) IN GENERAL.—If the Secretary carries out the pilot 
program under subsection (a)(1), not later than March 1, 
2024, the Comptroller General of the United States shall 
submit to the Committees on Armed Services of the House 
of Representatives and the Senate a report on the pilot 
program. 
(B) ELEMENTS.—The report under subparagraph (A) 
shall include the following: 
(i) The number of eligible covered beneficiaries 
who participated in the pilot program and an assess-
ment of the satisfaction of such beneficiaries with the 
pilot program. 
(ii) The rate by which eligible covered beneficiaries 
elected to receive non-generic prescription maintenance 
medications at a retail pharmacy pursuant to the pilot 
program, and how such rate affected military medical 
treatment facility pharmacies and the national mail- 
order pharmacy program. 
(iii) The amount of cost savings realized by the 
pilot program, including with respect to— 
(I) dispensing fees incurred at retail phar-
macies compared to the national mail-order phar-
macy program for brand name prescription drugs; 
(II) administrative fees; 
(III) any costs paid by the United States for 
the drugs in addition to the procurement costs; 
(IV) the use of military medical treatment 
facilities; and 
(V) copayments paid by eligible covered bene-
ficiaries. 
(iv) A comparison of supplemental rebates between 
retail pharmacies and other points of sale.
H. R. 6395—304 
(f) RULE OF CONSTRUCTION.—Nothing in this section may be 
construed to affect— 
(1) the ability of the Secretary to carry out section 
1074g(a)(9)(C) of title 10, United States Code, after the date 
on which the pilot program is completed; or 
(2) the prices established for medications under section 
8126 of title 38, United States Code. 
(g) DEFINITIONS.—In this section: 
(1) The term ‘‘eligible covered beneficiary’’ has the meaning 
given that term in section 1074g(i) of title 10, United States 
Code. 
(2) The terms ‘‘military medical treatment facility phar-
macies’’, ‘‘retail pharmacies’’, and ‘‘the national mail-order phar-
macy program’’ mean the methods for receiving prescription 
drugs as described in clauses (i), (ii), and (iii), respectively, 
of section 1074g(a)(2)(E) of title 10, United States Code. 
Subtitle B—Health Care Administration 
SEC. 711. REPEAL OF ADMINISTRATION OF TRICARE DENTAL PLANS 
THROUGH FEDERAL EMPLOYEES DENTAL AND VISION 
INSURANCE PROGRAM. 
(a) TITLE 5.—Section 8951(8) of title 5, United States Code, 
is amended by striking ‘‘1076a or’’. 
(b) TITLE 10.—Section 1076a(b) of title 10, United States Code, 
is amended to read as follow: 
‘‘(b) ADMINISTRATION OF PLANS.—The plans established under 
this section shall be administered under regulations prescribed 
by the Secretary of Defense in consultation with the other admin-
istering Secretaries.’’. 
(c) CONFORMING REPEAL.—Section 713 of the John S. McCain 
National Defense Authorization Act for Fiscal Year 2019 (Public 
Law 115–232; 132 Stat. 1811) is repealed. 
(d) TECHNICAL AMENDMENT.—Section 1076a(a)(1) of title 10, 
United States Code, is amended by striking the second sentence. 
SEC. 712. PROTECTION OF THE ARMED FORCES FROM INFECTIOUS 
DISEASES. 
(a) IN GENERAL.—Chapter 55 of title 10, United States Code, 
is amended by inserting after section 1073d the following new 
section: 
‘‘§ 1073e. Protection of armed forces from infectious diseases 
‘‘(a) PROTECTION.—The Secretary of Defense shall develop and 
implement a plan to ensure that the armed forces have the diag-
nostic equipment, testing capabilities, and personal protective 
equipment necessary to protect members of the armed forces from 
the threat of infectious diseases and to treat members who contract 
infectious diseases. 
‘‘(b) REQUIREMENTS.—In carrying out subsection (a), the Sec-
retary shall ensure the following: 
‘‘(1) Each military medical treatment facility has the testing 
capabilities described in such subsection, as appropriate for 
the mission of the facility. 
‘‘(2) Each deployed naval vessel has access to the testing 
capabilities described in such subsection.
H. R. 6395—305 
‘‘(3) Members of the armed forces deployed in support of 
a contingency operation outside of the United States have access 
to the testing capabilities described in such subsection, 
including at field hospitals, combat support hospitals, field med-
ical stations, and expeditionary medical facilities. 
‘‘(4) The Department of Defense maintains— 
‘‘(A) a 30-day supply of personal protective equipment 
in a quantity sufficient for each member of the armed 
forces, including the reserve components thereof; and 
‘‘(B) the capability to rapidly resupply such equipment. 
‘‘(c) RESEARCH
AND DEVELOPMENT.—(1) The Secretary shall 
include with the defense budget materials (as defined by section 
231(f) of this title) for a fiscal year a plan to research and develop 
vaccines, diagnostics, and therapeutics for infectious diseases. 
‘‘(2) The Secretary shall ensure that the medical laboratories 
of the Department of Defense are equipped with the technology 
needed to facilitate rapid research and development of vaccines, 
diagnostics, and therapeutics in the case of a pandemic.’’. 
(b) CLERICAL AMENDMENT.—The table of contents at the begin-
ning of such chapter is amended by inserting after the item relating 
to section 1073d the following new item: 
‘‘1073e. Protection of armed forces from infectious diseases.’’. 
SEC. 713. INCLUSION OF DRUGS, BIOLOGICAL PRODUCTS, AND CRIT-
ICAL 
MEDICAL 
SUPPLIES 
IN 
NATIONAL 
SECURITY 
STRATEGY FOR NATIONAL TECHNOLOGY AND INDUSTRIAL 
BASE. 
(a) NATIONAL SECURITY STRATEGY FOR NATIONAL TECHNOLOGY 
AND INDUSTRIAL BASE.—Section 2501(a) of title 10, United States 
Code, is amended by adding at the end the following new paragraph: 
‘‘(11) Providing for the provision of drugs, biological prod-
ucts, vaccines, and critical medical supplies required to enable 
combat readiness and protect the health of the armed forces.’’. 
(b) ASSESSMENT.— 
(1) IN GENERAL.—The Secretary of Defense shall include 
with the report required to be submitted in 2022 under section 
2504 of title 10, United States Code, an appendix containing 
an assessment of gaps or vulnerabilities in the national tech-
nology and industrial base (as defined by section 2500(1) of 
such title) with respect to drugs, biological products, vaccines, 
and critical medical supplies described in section 2501(a)(11) 
of such title, as amended by subsection (a) of this section. 
In carrying out such assessment, the Secretary shall consult 
with the Secretary of Health and Human Services, the Commis-
sioner of Food and Drugs, and the heads of other departments 
and agencies of the Federal Government that the Secretary 
of Defense determines appropriate. 
(2) MATTERS INCLUDED.—The assessment under paragraph 
(1) shall include— 
(A) an identification and origin of any finished drugs, 
as identified by the Secretary of Defense, and the essential 
components of such drugs, including raw materials, chem-
ical components, and active pharmaceutical ingredients 
that are necessary for the manufacture of such drugs, 
whose supply is at risk of disruption during a time of 
war or national emergency;
H. R. 6395—306 
(B) an identification of shortages of finished drugs, 
biological products, vaccines, and critical medical supplies 
essential for combat readiness and the protection of the 
health of the Armed Forces (including with respect to any 
challenges or issues with the joint deployment formulary), 
as identified by the Secretary of Defense; 
(C) an identification of the defense and geopolitical 
contingencies that are sufficiently likely to arise that may 
lead to the discontinuance, interruption or meaningful 
disruption in the supply of a drug, biological product, vac-
cine, or critical medical supply, and recommendations 
regarding actions the Secretary of Defense should take 
to reasonably prepare for the occurrence of such contin-
gencies; 
(D) an identification of any barriers that exist to manu-
facture finished drugs, biological products, vaccines, and 
critical medical supplies in the United States, including 
with respect to regulatory barriers by the Federal Govern-
ment and whether the raw materials may be found in 
the United States; 
(E) an identification of potential partners of the United 
States with whom the United States can work with to 
realign the manufacturing capabilities of the United States 
for such finished drugs, biological products, vaccines, and 
critical medical supplies; 
(F) an assessment conducted by the Secretary of 
Defense of the resilience and capacity of the current supply 
chain and industrial base to support national defense upon 
the occurrence of the contingencies identified in subpara-
graph (C), including with respect to— 
(i) the manufacturing capacity of the United 
States; 
(ii) gaps in domestic manufacturing capabilities, 
including nonexistent, extinct, threatened, and single- 
point-of-failure capabilities; 
(iii) supply chains with single points of failure 
and limited resiliency; and 
(iv) economic factors, including global competition, 
that threaten the viability of domestic manufacturers; 
and 
(G) recommendations to enhance and strengthen the 
surge requirements and readiness contracts of the Depart-
ment of Defense to ensure the sufficiency of the stockpile 
of the Department of, and the ready access by the Depart-
ment to, critical medical supplies, pharmaceuticals, vac-
cines, countermeasure prophylaxis, and personal protective 
equipment, including with respect to the effectiveness of 
the theater lead agent for medical materiel program in 
support of the combatant commands. 
(3) SUBMISSION.—In addition to including the assessment 
under paragraph (1) as an appendix to the report required 
to be submitted in 2022 under section 2504 of title 10, United 
States Code, the Secretary of Defense shall submit such 
appendix separately to the appropriate congressional commit-
tees. 
(4) FORM.—The assessment under paragraph (1) shall be 
submitted in classified form.
H. R. 6395—307 
(5) DEFINITIONS.—In this subsection: 
(A) The term ‘‘appropriate congressional committees’’ 
means the following: 
(i) The Committee on Appropriations, the Com-
mittee on Energy and Commerce, and the Committee 
on Homeland Security of the House of Representatives. 
(ii) The Committee on Appropriations, the Com-
mittee on Health, Education, Labor, and Pensions, and 
the Committee on Homeland Security and Govern-
mental Affairs of the Senate. 
(B) The term ‘‘critical medical supplies’’ includes per-
sonal protective equipment, diagnostic tests, testing sup-
plies, and lifesaving breathing apparatuses required to 
treat severe respiratory illnesses and distress. 
SEC. 714. CONTRACT AUTHORITY OF THE UNIFORMED SERVICES 
UNIVERSITY OF THE HEALTH SCIENCES. 
(a) CONTRACT AUTHORITY.—Section 2113(g)(1) of title 10, United 
States Code, is amended— 
(1) in subparagraph (E), by striking ‘‘and’’ at the end; 
(2) in subparagraph (F), by striking the period at the end 
and inserting ‘‘; and’’; and 
(3) by adding at the end the following new subparagraph: 
‘‘(G) notwithstanding sections 2304, 2361, and 2374 
of this title, to enter into contracts and cooperative agree-
ments with, accept grants from, and make grants to, non-
profit entities (on a sole-source basis) for the purpose speci-
fied in subparagraph (A) or for any other purpose the 
Secretary determines to be consistent with the mission 
of the University.’’. 
(b) RULE
OF CONSTRUCTION.—Nothing in section 2113(g) of 
title 10, United States Code, as amended by subsection (a), shall 
be construed to limit the ability of the Secretary of Defense, in 
carrying out such section, to use competitive procedures to award 
contracts, cooperative agreements, or grants. 
SEC. 715. MEMBERSHIP OF BOARD OF REGENTS OF UNIFORMED SERV-
ICES UNIVERSITY OF THE HEALTH SCIENCES. 
(a) IN GENERAL.—Section 2113a(b) of title 10, United States 
Code, is amended— 
(1) by redesignating paragraphs (3) and (4) as paragraphs 
(4) and (5), respectively; and 
(2) by inserting after paragraph (2) the following new para-
graph: 
‘‘(3) the Director of the Defense Health Agency, who shall 
be an ex officio member;’’. 
(b) RULE OF CONSTRUCTION.—The amendments made by this 
section may not be construed to invalidate any action taken by 
the Uniformed Services University of the Health Sciences or its 
Board of Regents prior to the effective date of this section. 
(c) EFFECTIVE DATE.—The amendments made by this section 
shall take effect on January 1, 2021. 
SEC. 716. TEMPORARY EXEMPTION FOR UNIFORMED SERVICES 
UNIVERSITY OF THE HEALTH SCIENCES FROM CERTAIN 
PAPERWORK REDUCTION ACT REQUIREMENTS. 
(a) TEMPORARY EXEMPTION FROM CERTAIN PAPERWORK REDUC-
TION ACT REQUIREMENTS.—
H. R. 6395—308 
(1) IN
GENERAL.—During the two-year period beginning 
on the date that is 30 days after the date of the enactment 
of this Act, the requirements described in paragraph (2) shall 
not apply with respect to the voluntary collection of information 
during the conduct of research and program evaluations— 
(A) conducted or sponsored by the Uniformed Services 
University of the Health Sciences; and 
(B) funded through the Defense Health Program. 
(2) 
REQUIREMENTS
DESCRIBED.—The 
requirements 
described in this paragraph are the requirements under the 
following provisions of law: 
(A) Section 3506(c) of title 44, United States Code. 
(B) Sections 3507 and 3508 of such title. 
(b) REPORTS.— 
(1) INTERIM REPORT.—Not later than one year after the 
date of the enactment of this Act, the Secretary of Defense 
shall submit to the appropriate congressional committees a 
report on the preliminary findings with respect to— 
(A) the estimated time saved by the Uniformed Services 
University of the Health Sciences (if applicable) by reason 
of the exemption under paragraph (1) of subsection (a) 
to requirements described in paragraph (2) of such sub-
section; 
(B) the research within the scope of such exemption 
that has been initiated, is ongoing, or has been completed 
during the period in which the exemption is in effect; 
(C) the estimated cost savings by the University that 
can be attributed to such exemption; and 
(D) the additional burdens upon the research subjects 
of the University that are attributable to such exemption. 
(2) UPDATED REPORT.—Not later than two years after the 
date of the enactment of this Act, the Secretary shall submit 
to the appropriate congressional committees a report con-
taining— 
(A) updated information with respect to the matters 
under paragraph (1); and 
(B) any recommendations with respect to policy or 
legislative actions regarding the exemption under para-
graph (1) of subsection (a) to requirements described in 
paragraph (2) of such subsection. 
(c) APPROPRIATE CONGRESSIONAL COMMITTEES DEFINED.—In 
this section, the term ‘‘appropriate congressional committees’’ 
means— 
(1) the Committee on Armed Services and the Committee 
on Oversight and Reform of the House of Representatives; 
and 
(2) the Committee on Armed Services and the Committee 
on Homeland Security and Governmental Affairs of the Senate. 
SEC. 717. MODIFICATION TO LIMITATION ON THE REALIGNMENT OR 
REDUCTION 
OF 
MILITARY 
MEDICAL 
MANNING 
END 
STRENGTH. 
Section 719 of the National Defense Authorization Act for Fiscal 
Year 2020 (Public Law 116–92; 133 Stat. 1454) is amended— 
(1) in subsection (a), in the matter preceding paragraph 
(1), by striking ‘‘may not realign or reduce military medical 
end strength authorizations until’’ and inserting the following:
H. R. 6395—309 
‘‘may not realign or reduce military medical end strength 
authorizations during the 180 days following the date of the 
enactment of the William M. (Mac) Thornberry National 
Defense Authorization Act for Fiscal Year 2021, and after such 
period, may not realign or reduce such authorizations unless’’; 
and 
(2) in subsection (b)(1), by inserting before the period at 
the end the following: ‘‘, including with respect to both the 
homeland defense mission and pandemic influenza’’. 
SEC. 718. MODIFICATIONS TO IMPLEMENTATION PLAN FOR RESTRUC-
TURE OR REALIGNMENT OF MILITARY MEDICAL TREAT-
MENT FACILITIES. 
Section 703(d) of the National Defense Authorization Act for 
Fiscal Year 2017 (Public Law 114–328; 130 Stat. 2199) is amended— 
(1) in paragraph (2), by striking subparagraph (D) and 
inserting the following new subparagraph: 
‘‘(D) A description of how the Secretary will carry out 
subsection (b), including, with respect to each affected mili-
tary medical treatment facility, a description of— 
‘‘(i) the elements required for health care providers 
to accept and transition covered beneficiaries to the 
purchased care component of the TRICARE program; 
‘‘(ii) a method to monitor and report on quality 
benchmarks for the beneficiary population that will 
be required to transition to such component of the 
TRICARE program; and 
‘‘(iii) a process by which the Director of the Defense 
Health Agency will ensure that such component of 
the TRICARE program has the required capacity.’’; 
and 
(2) by adding at the end the following new paragraph: 
‘‘(4) NOTICE AND WAIT.—The Secretary may not implement 
the plan under paragraph (1) unless— 
‘‘(A) the Secretary has submitted the plan to the 
congressional defense committees; 
‘‘(B) the Secretary has certified to the congressional 
defense committees that, pursuant to subsection (b), if a 
proposed restructure, realignment, or modification will 
eliminate the ability of a covered beneficiary to access 
health care services at a military medical treatment facility, 
the covered beneficiary will be able to access such health 
care services through the purchased care component of 
the TRICARE program; and 
‘‘(C) a 180-day period has elapsed following the later 
of— 
‘‘(i) the date on which the congressional defense 
committees have received both the implementation 
plan under subparagraph (A) and the notice of certifi-
cation under subparagraph (B); or 
‘‘(ii) the date of the enactment of the William M. 
(Mac) Thornberry National Defense Authorization Act 
for Fiscal Year 2021.’’. 
SEC. 719. POLICY TO ADDRESS PRESCRIPTION OPIOID SAFETY. 
(a) REQUIREMENT.—The Secretary of Defense shall develop a 
policy and tracking mechanism to monitor and provide oversight
H. R. 6395—310 
of opioid prescribing to ensure that the provider practices of medica-
tion-prescribing health professionals across the military health 
system conform with— 
(1) the clinical practice guidelines of the Department of 
Defense and the Department of Veterans Affairs; and 
(2) the prescribing guidelines published by the Centers 
for Disease Control and Prevention and the Food and Drug 
Administration. 
(b) ELEMENTS.—The requirements under subsection (a) shall 
include the following: 
(1) Providing oversight and accountability of opioid pre-
scribing practices that are outside of the recommended param-
eters for dosage, supply, and duration as identified in the 
guideline published by the Centers for Disease Control and 
Prevention titled ‘‘CDC Guideline for Prescribing Opioids for 
Chronic Pain—United States, 2016’’, or such successor guide-
line, and the guideline published by the Department of Defense 
and Department of Veterans Affairs titled ‘‘DoD/VA Manage-
ment of Opioid Therapy (OT) for Chronic Pain Clinical Practice 
Guideline, 2017’’ or such successor guideline. 
(2) Implementing oversight and accountability responsibil-
ities for opioid prescribing safety as specified in paragraph 
(1). 
(3) Implementing systems to ensure that the prescriptions 
in the military health system data repository are appropriately 
documented and that the processing date and the metric 
quantity field for opioid prescriptions in liquid form are con-
sistent within the electronic health record system known as 
‘‘MHS GENESIS’’. 
(4) Implementing opioid prescribing controls within the 
electronic health record system known as ‘‘MHS GENESIS’’ 
and document if an overdose reversal drug was co-prescribed. 
(5) Developing metrics that can be used by the Defense 
Health Agency and each military medical treatment facility 
to actively monitor and limit the overprescribing of opioids 
and to monitor the co-prescribing of overdose reversal drugs 
as accessible interventions. 
(6) Developing a report that tracks progression toward 
reduced levels of opioid use and includes an identification of 
prevention best practices established by the Department. 
(7) Developing and implementing a plan to improve commu-
nication and value-based initiatives between pharmacists and 
medication-prescribing health professionals across the military 
health system. 
SEC. 720. ADDITION OF BURN PIT REGISTRATION AND OTHER 
INFORMATION TO ELECTRONIC HEALTH RECORDS OF 
MEMBERS OF THE ARMED FORCES. 
(a) UPDATES TO ELECTRONIC HEALTH RECORDS.—Beginning not 
later than one year after the date of the enactment of this Act, 
the Secretary of Defense shall ensure that— 
(1) the electronic health record maintained by the Secretary 
for a member of the Armed Forces registered with the Airborne 
Hazards and Open Burn Pit Registry is updated with any 
information contained in such registry with respect to the 
member; and
H. R. 6395—311 
(2) any occupational or environmental health exposure 
recorded in the Defense Occupational and Environmental 
Health Readiness System (or any successor system) is linked 
to the electronic health record system of the Department of 
Defense to notify health professionals treating a member speci-
fied in paragraph (1) of any such exposure recorded for the 
member. 
(b) AIRBORNE
HAZARDS
AND
OPEN
BURN
PIT
REGISTRY 
DEFINED.—In this section, the term ‘‘Airborne Hazards and Open 
Burn Pit Registry’’ means the registry established by the Secretary 
of Veterans Affairs under section 201 of the Dignified Burial and 
Other Veterans’ Benefits Improvement Act of 2012 (Public Law 
112–260; 38 U.S.C. 527 note). 
SEC. 721. INCLUSION OF INFORMATION ON EXPOSURE TO OPEN BURN 
PITS IN POSTDEPLOYMENT HEALTH REASSESSMENTS. 
(a) IN GENERAL.—The Secretary of Defense shall include in 
postdeployment health reassessments conducted under section 
1074f of title 10, United States Code, pursuant to a Department 
of Defense Form 2796, or successor form, an explicit question 
regarding exposure of members of the Armed Forces to open burn 
pits. 
(b) INCLUSION IN ASSESSMENTS BY MILITARY DEPARTMENTS.— 
The Secretary of Defense shall ensure that the Secretary of each 
military department includes a question regarding exposure of mem-
bers of the Armed Forces to open burn pits in any electronic 
postdeployment health assessment conducted by that military 
department. 
(c) OPEN BURN PIT DEFINED.—In this section, the term ‘‘open 
burn pit’’ has the meaning given that term in section 201(c) of 
the Dignified Burial and Other Veterans’ Benefits Improvement 
Act of 2012 (Public Law 112–260; 38 U.S.C. 527 note). 
Subtitle C—Matters Relating to COVID–19 
SEC. 731. COVID–19 MILITARY HEALTH SYSTEM REVIEW PANEL. 
(a) ESTABLISHMENT.—The Secretary of Defense shall establish 
a panel to be known as the ‘‘COVID–19 Military Health System 
Review Panel’’ (in this section referred to as the ‘‘panel’’). 
(b) COMPOSITION.— 
(1) MEMBERS.—The panel shall be composed of the fol-
lowing members: 
(A) The President of the Uniformed Services University 
of the Health Sciences. 
(B) The Director of the Defense Health Agency. 
(C) The Surgeon General of the Army. 
(D) The Surgeon General of the Navy. 
(E) The Surgeon General of the Air Force. 
(F) The Joint Staff Surgeon. 
(G) The Deputy Assistant Secretary of Defense for 
Health Readiness Policy and Oversight. 
(H) The Deputy Assistant Secretary of Defense for 
Health Resources Management and Policy. 
(2) CHAIRPERSON.—The chairperson of the panel shall be 
the President of the Uniformed Services University of the 
Health Sciences.
H. R. 6395—312 
(3) TERMS.—Each member shall be appointed for the life 
of the panel. 
(c) DUTIES.— 
(1) IN GENERAL.—The panel shall— 
(A) review the response of the military health system 
to the coronavirus disease 2019 (COVID–19) and the effects 
of COVID–19 on such system, including by analyzing any 
strengths or weaknesses of such system identified as a 
result COVID–19; and 
(B) using information from the review, make such rec-
ommendations as the panel considers appropriate with 
respect to any policy, practice, organization, manning level, 
funding level, or legislative authority relating to the mili-
tary health system. 
(2) ELEMENTS OF REVIEW.—In conducting the review under 
paragraph (1), each member of the panel shall lead a review 
of at least one of the following elements, with respect to the 
military health system: 
(A) Policy, including any policy relating to force health 
protection or medical standards for the appointment, enlist-
ment, or induction of individuals into the Armed Forces. 
(B) Public health activities, including any activity 
relating to risk communication, surveillance, or contact 
tracing. 
(C) Research, diagnostics, and therapeutics. 
(D) Logistics and technology. 
(E) Force structure and manning. 
(F) Governance and organization. 
(G) Operational capabilities and operational support. 
(H) Education and training. 
(I) Health benefits under the TRICARE program. 
(J) Engagement and security activities relating to 
global health. 
(K) The financial impact of COVID–19 on the military 
health system. 
(d) REPORT.—Not later than June 1, 2021, the Secretary of 
Defense shall submit to the congressional defense committees a 
report that includes the findings of the panel as a result of the 
review under subsection (c)(1)(A) and such recommendations as 
the panel considers appropriate under subsection (c)(1)(B). 
(e) TERMINATION.—The panel shall terminate on June 1, 2021. 
SEC. 732. DEPARTMENT OF DEFENSE PANDEMIC PREPAREDNESS. 
(a) STRATEGY.—The Secretary of Defense shall develop a 
strategy for pandemic preparedness and response that includes 
the following: 
(1) Identification of activities necessary to be carried out 
prior to a pandemic to ensure preparedness and effective 
communication of roles and responsibilities within the Depart-
ment of Defense, including— 
(A) reviewing the frequency of each exercise conducted 
by the Department, a military department, or Defense 
Agency that relates to a pandemic or severe influenza 
season or related force health protection scenario; 
(B) ensuring such exercises are appropriately planned, 
resourced, and practiced;
H. R. 6395—313 
(C) including a consideration of the capabilities and 
capacities necessary to carry out the strategy under this 
section, and related operations for force health protection, 
and ensuring that these are included in each cost evalua-
tion, Defense-wide review, or manning assessment of the 
Department of Defense that affects such capabilities and 
capacities; 
(D) reviewing the placement, exploring broader utiliza-
tion of global health engagement liaisons, and increasing 
the scope of global health activities of the Department 
of Defense; 
(E) assessing a potential career track relating to health 
protection research for members of the Armed Forces and 
civilian employees of the Department of Defense; 
(F) providing to members of the Armed Forces guidance 
on force health protection prior to and during a pandemic 
or severe influenza season, including guidance on specific 
behaviors or actions required, such as self-isolating, social 
distancing, and additional protective measures to be carried 
out after contracting a novel virus or influenza; 
(G) reviewing and updating the inventory of medical 
supplies and equipment of the Department of Defense that 
is available for operational support to the combatant com-
mands prior to and during a pandemic (such as vaccines, 
biologics, drugs, preventive medicine, antiviral medicine, 
and equipment relating to trauma support), including a 
review of— 
(i) the sufficiency of prepositioned stocks; and 
(ii) the effectiveness of the Warstopper Program 
of the Defense Logistics Agency, or such successor pro-
gram; 
(H) reviewing and updating distribution plans of the 
Department of Defense for critical medical supplies and 
equipment within the inventory of the Department of 
Defense, including vaccines and antiviral medicines; and 
(I) reviewing and updating research on infectious dis-
eases and preventive medicine conducted by the military 
health system, including research conducted by the Health 
Related Communities of Interest of the Department of 
Defense, the Joint Program Committees, the overseas med-
ical laboratories of the Department of Defense, the Armed 
Forces Health Surveillance Branch, or other elements of 
the Department of Defense that conduct research in support 
of members of the Armed Forces or beneficiaries under 
the TRICARE program. 
(2) Review of Department of Defense systems for health 
surveillance and detection to ensure continuous situational 
awareness and early warning with respect to a pandemic, 
including a review of— 
(A) the levels of funding and investment, and the 
overall value, of the Global Emerging Infections Surveil-
lance and Response System of the Department of Defense, 
including the value demonstrated by the role of such system 
in— 
(i) improving the Department of Defense preven-
tion and surveillance of, and the response to, infectious
H. R. 6395—314 
diseases that may impact members of the Armed 
Forces; 
(ii) informing decisions relating to force health 
protection across the geographic combatant commands; 
(iii) ensuring laboratory readiness to support pan-
demic response efforts and to understand infectious 
disease threats to the Armed Forces; and 
(iv) coordinating and collaborating with partners, 
such as the geographic combatant commands, other 
Federal agencies, and international partners; 
(B) the levels of funding and investment, and the 
overall value, of the overseas medical laboratories of the 
Department of Defense, including the value demonstrated 
by the role of such laboratories in conducting research 
and forming partnerships with other elements of the 
Department of Defense, other Federal agencies, inter-
national partners in the country in which such laboratory 
is located, and, as applicable, the private sector of the 
United States; and 
(C) the levels of funding and investment, and the 
overall value, of the Direct HIV/AIDS Prevention Program 
of the Department of Defense, including the value dem-
onstrated by the role of such program in developing (in 
coordination with other Federal agencies) programs for the 
prevention, care, and treatment of the human immuno-
deficiency virus infection and acquired immune deficiency 
syndrome. 
(3) Identification of activities to limit the spread of an 
infectious disease outbreak among members of the Armed 
Forces and beneficiaries under the TRICARE program, 
including activities to mitigate the health, social, and economic 
impacts of a pandemic on such members and beneficiaries, 
including by— 
(A) reviewing the role of the Department of Defense 
in the National Disaster Medical System under section 
2812 of the Public Health Service Act (42 U.S.C. 300hh– 
11) and implementing plans across the Department that 
leverage 
medical 
facilities, 
personnel, 
and 
response 
capabilities of the Federal Government to support require-
ments under such Act relating to medical surge capacity; 
(B) determining the range of public health capacity, 
medical surge capacity, administrative capacity, and veteri-
nary capacity necessary for the Armed Forces to— 
(i) support operations during a pandemic; and 
(ii) develop mechanisms to reshape force structure 
during such pandemic as necessary (contingent upon 
primary mission requirements); and 
(C) determining the range of activities for operational 
medical support and infrastructure sustainment that the 
Department of Defense and other Federal agencies have 
the capacity to implement during a pandemic (contingent 
upon primary mission requirements), and develop plans 
for the implementation of such activities. 
(b) STUDY ON RESPONSE TO COVID–19.—In addition to the 
review under section 731, the Secretary shall conduct a study 
on the response of the military health system to the coronavirus 
disease 2019 (COVID–19).
H. R. 6395—315 
(c) REPORT.—Not later than June 1, 2021, the Secretary shall 
submit to the congressional defense committees a report con-
taining— 
(1) the strategy under subsection (a); and 
(2) the study under subsection (b), including any findings 
or recommendations from the study that relate to an element 
of the strategy under subsection (a), such as recommended 
changes to policy, funding, practices, manning, organization, 
or legislative authority. 
SEC. 733. TRANSITIONAL HEALTH BENEFITS FOR CERTAIN MEMBERS 
OF THE NATIONAL GUARD SERVING UNDER ORDERS IN 
RESPONSE TO THE CORONAVIRUS (COVID–19). 
(a) IN GENERAL.—The Secretary of Defense shall provide to 
a member of the National Guard separating from active service 
after serving on full-time National Guard duty pursuant to section 
502(f) of title 32, United States Code, the health benefits authorized 
under section 1145 of title 10, United States Code, for a member 
of a reserve component separating from active duty, as referred 
to in subsection (a)(2)(B) of such section 1145, if the active service 
from which the member of the National Guard is separating was 
in support of the whole of government response to the coronavirus 
(COVID–19). 
(b) DEFINITIONS.—In this section, the terms ‘‘active duty’’, 
‘‘active service’’, and ‘‘full-time National Guard duty’’ have the 
meanings given those terms in section 101(d) of title 10, United 
States Code. 
SEC. 734. REGISTRY OF CERTAIN TRICARE BENEFICIARIES DIAGNOSED 
WITH COVID–19. 
(a) ESTABLISHMENT.—Not later than June 1, 2021, and subject 
to subsection (b), the Secretary of Defense shall establish and 
maintain a registry of covered TRICARE beneficiaries who have 
been diagnosed with COVID–19. 
(b) RIGHT OF BENEFICIARY TO OPT OUT.—A covered TRICARE 
beneficiary may elect to opt out of inclusion in the registry under 
subsection (a). 
(c) CONTENTS.—The registry under subsection (a) shall include, 
with respect to each covered TRICARE beneficiary included in 
the registry, the following: 
(1) The demographic information of the beneficiary. 
(2) Information on the industrial or occupational history 
of the beneficiary, to the extent such information is available 
in the records regarding the COVID–19 diagnosis of the bene-
ficiary. 
(3) Administrative information regarding the COVID–19 
diagnosis of the beneficiary, including the date of the diagnosis 
and the location and source of the test used to make the 
diagnosis. 
(4) Any symptoms of COVID–19 manifested in the bene-
ficiary. 
(5) Any treatments for COVID–19 taken by the beneficiary, 
or other medications taken by the beneficiary, when the bene-
ficiary was diagnosed with COVID–19. 
(6) Any pathological data characterizing the incidence of 
COVID–19 and the type of treatment for COVID–19 provided 
to the beneficiary.
H. R. 6395—316 
(7) Information on any respiratory illness of the beneficiary 
recorded prior to the COVID–19 diagnosis of the beneficiary. 
(8) Any information regarding the beneficiary contained 
in the Airborne Hazards and Open Burn Pit Registry estab-
lished under section 201 of the Dignified Burial and Other 
Veterans’ Benefits Improvement Act of 2012 (Public Law 112– 
260; 38 U.S.C. 527 note). 
(9) Any other information determined appropriate by the 
Secretary. 
(d) REPORT.—Not later than 180 days after the date of the 
enactment of this Act, the Secretary shall submit to the Committees 
on Armed Services of the House of Representatives and the Senate 
a report on establishing the registry under subsection (a), 
including— 
(1) a plan to implement the registry; 
(2) the cost of implementing the registry; 
(3) the location of the registry; and 
(4) any recommended legislative changes with respect to 
establishing the registry. 
(e) COVERED TRICARE BENEFICIARY DEFINED.—In this section, 
the term ‘‘covered TRICARE beneficiary’’ means an individual who 
is enrolled in the direct care system under the TRICARE program 
and is treated for or diagnosed with COVID–19 at a military medical 
treatment facility. 
SEC. 735. HEALTH ASSESSMENTS OF VETERANS DIAGNOSED WITH PAN-
DEMIC DISEASES TO DETERMINE EXPOSURE TO OPEN 
BURN PITS AND TOXIC AIRBORNE CHEMICALS. 
(a) EXPOSURE TO OPEN BURN PITS AND TOXIC AIRBORNE CHEMI-
CALS
OR OTHER AIRBORNE CONTAMINANTS
AS PART
OF HEALTH 
ASSESSMENTS FOR VETERANS DURING A PANDEMIC AND INCLUSION 
OF INFORMATION IN REGISTRY.— 
(1) HEALTH ASSESSMENTS AND PHYSICAL EXAMINATIONS.— 
The Secretary of Veterans Affairs shall ensure that the first 
health assessment or physical examination furnished to a vet-
eran under the laws administered by the Secretary after the 
veteran tests positive for a pathogen, such as a virus, with 
respect to which a public health emergency has been declared 
under section 319 of the Public Health Service Act (42 U.S.C. 
247d) includes an evaluation of whether the veteran has been— 
(A) based or stationed at a location where an open 
burn pit was used; or 
(B) exposed to toxic airborne chemicals or other air-
borne contaminants relating to service in the Armed Forces, 
including an evaluation of any information recorded as 
part of the Airborne Hazards and Open Burn Pit Registry. 
(2) INCLUSION OF INDIVIDUALS IN REGISTRY.—If an evalua-
tion conducted under paragraph (1) with respect to a veteran 
establishes that the veteran was based or stationed at a location 
where an open burn pit was used, or that the individual was 
exposed to toxic airborne chemicals or other airborne contami-
nants, the individual shall be enrolled in the Airborne Hazards 
and Open Burn Pit Registry unless the veteran elects to not 
enroll in such registry. 
(3) RULE OF CONSTRUCTION.—Nothing in this subsection 
may be construed to preclude eligibility of a veteran for benefits 
under the laws administered by the Secretary of Veterans
H. R. 6395—317 
Affairs by reason of the history of exposure of the veteran 
to an open burn pit not being recorded in an evaluation con-
ducted under paragraph (1). 
(b) STUDY ON IMPACT OF VIRAL PANDEMICS ON MEMBERS OF 
ARMED FORCES
AND VETERANS WHO HAVE EXPERIENCED TOXIC 
EXPOSURE.— 
(1) IN GENERAL.—The Secretary of Veterans Affairs shall 
conduct a study, through the Airborne Hazards and Burn Pits 
Center of Excellence (in this subsection referred to as the 
‘‘Center’’), on the health impacts of infection with a pathogen, 
such as a virus, with respect to which a public health emergency 
has been declared under section 319 of the Public Health 
Service Act (42 U.S.C. 247d), including a coronavirus, to mem-
bers of the Armed Forces and veterans who have been exposed 
to open burn pits and other toxic exposures for the purposes 
of understanding the health impacts of the pathogen and 
whether individuals infected with the pathogen are at increased 
risk of severe symptoms due to previous conditions linked to 
toxic exposure. 
(2) PREPARATION FOR FUTURE PANDEMIC.—The Secretary, 
through the Center, shall analyze potential lessons learned 
through the study conducted under paragraph (1) to assist 
in preparing the Department of Veterans Affairs for potential 
future pandemics. 
(c) DEFINITIONS.—In this subsection: 
(1) The term ‘‘Airborne Hazards and Open Burn Pit Reg-
istry’’ means the registry established by the Secretary of Vet-
erans Affairs under section 201 of the Dignified Burial and 
Other Veterans’ Benefits Improvement Act of 2012 (Public Law 
112–260; 38 U.S.C. 527 note). 
(2) The term ‘‘coronavirus’’ has the meaning given that 
term in section 506 of the Coronavirus Preparedness and 
Response Supplemental Appropriations Act, 2020 (Public Law 
116–123). 
(3) The term ‘‘open burn pit’’ has the meaning given that 
term in section 201(c) of the Dignified Burial and Other Vet-
erans’ Benefits Improvement Act of 2012 (Public Law 112– 
260; 126 Stat. 2422; 38 U.S.C. 527 note). 
SEC. 736. COMPTROLLER GENERAL STUDY ON DELIVERY OF MENTAL 
HEALTH SERVICES TO MEMBERS OF THE ARMED FORCES 
DURING THE COVID–19 PANDEMIC. 
(a) IN GENERAL.—The Comptroller General of the United States 
shall conduct a study on the delivery of Federal, State, and private 
mental health services to members of the Armed Forces during 
the COVID–19 pandemic. 
(b) ELEMENTS.—The study conducted under subsection (a) 
shall— 
(1) review any strategies used to combat existing stigma 
surrounding mental health conditions that might deter mem-
bers of the Armed Forces from seeking care; 
(2) review guidance to commanding officers at all levels 
on the mental health ramifications of the COVID–19 crisis; 
(3) assess the need for additional training and support 
for mental health care professionals of the Department of
H. R. 6395—318 
Defense with respect to supporting individuals who are con-
cerned for the health of themselves and their family members, 
or grieving the loss of loved ones, because of COVID–19; 
(4) assess the strategy of the Department of Defense to 
leverage telemedicine to ensure safe access to mental health 
services; 
(5) identify all programs associated with services described 
in such subsection; 
(6) specify gaps or barriers to mental health care access 
that could result in delayed or insufficient mental health care 
support to members of the Armed Forces; and 
(7) evaluate the mental health screening requirements for 
members of the Armed Forces immediately before, during, and 
after— 
(A) Federal deployment under title 10, United States 
Code; or 
(B) State deployment under title 32, United States 
Code. 
(c) REPORT.—Not later than one year after the date of the 
enactment of this Act, the Comptroller General shall submit to 
the Committees on Armed Services of the Senate and the House 
of Representatives a report on the study conducted under subsection 
(a). 
Subtitle D—Reports and Other Matters 
SEC. 741. MODIFICATIONS TO PILOT PROGRAM ON CIVILIAN AND MILI-
TARY PARTNERSHIPS TO ENHANCE INTEROPERABILITY 
AND MEDICAL SURGE CAPABILITY AND CAPACITY OF 
NATIONAL DISASTER MEDICAL SYSTEM. 
Section 740 of the National Defense Authorization Act for Fiscal 
Year 2020 (Public Law 116–92; 133 Stat. 1465) is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘The Secretary of Defense may’’ and 
inserting ‘‘Beginning not later than September 30, 2021, 
the Secretary of Defense shall’’; 
(B) by striking ‘‘health care organizations, institutions, 
and entities’’ and inserting ‘‘health care organizations, 
health care institutions, health care entities, academic med-
ical centers of institutions of higher education, and hos-
pitals’’; and 
(C) by striking ‘‘in the vicinity of major aeromedical 
and other transport hubs and logistics centers of the 
Department of Defense’’; 
(2) in subsection (b), by striking ‘‘may’’ and inserting ‘‘shall’’; 
(3) by redesignating subsections (d) through (f) as sub-
sections (e) through (g), respectively; 
(4) by striking subsection (c) and inserting the following 
new subsections: 
‘‘(c) LEAD OFFICIAL FOR DESIGN AND IMPLEMENTATION OF PILOT 
PROGRAM.— 
‘‘(1) IN GENERAL.—The Assistant Secretary of Defense for 
Health Affairs shall be the lead official for the design and 
implementation of the pilot program under subsection (a). 
‘‘(2) RESOURCES.—The Assistant Secretary of Defense for 
Health Affairs shall leverage the resources of the Defense
H. R. 6395—319 
Health Agency for execution of the pilot program under sub-
section (a) and shall coordinate with the Chairman of the 
Joint Chiefs of Staff for the duration of the pilot program, 
including for the duration of any period of design or planning 
for the pilot program. 
‘‘(d) LOCATIONS.— 
‘‘(1) IN GENERAL.—The Secretary of Defense shall carry 
out the pilot program under subsection (a) at not fewer than 
five locations in the United States that are located at or near 
an organization, institution, entity, center, or hospital specified 
in subsection (a) with established expertise in disaster health 
preparedness and response and trauma care that augment and 
enhance the effectiveness of the pilot program. 
‘‘(2) PHASED SELECTION OF LOCATIONS.— 
‘‘(A) INITIAL
SELECTION.—Not later than March 31, 
2021, the Assistant Secretary of Defense for Health Affairs, 
in consultation with the Secretary of Veterans Affairs, the 
Secretary of Health and Human Services, the Secretary 
of Homeland Security, and the Secretary of Transportation, 
shall select not fewer than two locations at which to carry 
out the pilot program. 
‘‘(B) SUBSEQUENT SELECTION.—Not later than the end 
of the one-year period following selection of the locations 
under subparagraph (A), the Assistant Secretary of Defense 
for Health Affairs, in consultation with the Secretaries 
specified in subparagraph (A), shall select not fewer than 
two additional locations at which to carry out the pilot 
program until not fewer than five locations are selected 
in total under this paragraph. 
‘‘(3) CONSIDERATION FOR LOCATIONS.—In selecting locations 
for the pilot program under subsection (a), the Secretary shall 
consider— 
‘‘(A) the proximity of the location to civilian or military 
transportation hubs, including airports, railways, interstate 
highways, or ports; 
‘‘(B) the proximity of the location to an organization, 
institution, entity, center, or hospital specified in subsection 
(a) with the ability to accept a redistribution of casualties 
during times of war; 
‘‘(C) the proximity of the location to an organization, 
institution, entity, center, or hospital specified in subsection 
(a) with the ability to provide trauma care training 
opportunities for medical personnel of the Department of 
Defense; and 
‘‘(D) the proximity of the location to existing academic 
medical centers of institutions of higher education, facilities 
of the Department, or other institutions that have estab-
lished expertise in the areas of— 
‘‘(i) highly infectious disease; 
‘‘(ii) biocontainment; 
‘‘(iii) quarantine; 
‘‘(iv) trauma care; 
‘‘(v) combat casualty care; 
‘‘(vi) the National Disaster Medical System under 
section 2812 of the Public Health Service Act (42 U.S.C. 
300hh–11); 
‘‘(vii) disaster health preparedness and response;
H. R. 6395—320 
‘‘(viii) medical and public health management of 
biological, chemical, radiological, or nuclear hazards; 
or 
‘‘(ix) such other areas of expertise as the Secretary 
considers appropriate. 
‘‘(4) PRIORITY FOR LOCATIONS.—In selecting locations for 
the pilot program under subsection (a), the Secretary shall 
give priority to locations that would facilitate public-private 
partnerships with academic medical centers of institutions of 
higher education, hospitals, and other entities with facilities 
that have an established history of providing clinical care, 
treatment, training, and research in the areas described in 
paragraph (3)(D) or other specializations determined important 
by the Secretary for purposes of the pilot program.’’; 
(5) by striking subsection (g), as redesignated by paragraph 
(2), and inserting the following: 
‘‘(g) REPORTS.— 
‘‘(1) INITIAL REPORT.— 
‘‘(A) IN GENERAL.—Not later than 180 days after the 
commencement of the pilot program under subsection (a), 
the Secretary shall submit to the appropriate congressional 
committees a report on the pilot program. 
‘‘(B) ELEMENTS.—The report under subparagraph (A) 
shall include the following: 
‘‘(i) A description of the pilot program. 
‘‘(ii) The requirements established under sub-
section (e). 
‘‘(iii) The evaluation metrics established under sub-
section (f). 
‘‘(iv) Such other matters relating to the pilot pro-
gram as the Secretary considers appropriate. 
‘‘(2) FINAL
REPORT.—Not later than 180 days after the 
completion of the pilot program under subsection (a), the Sec-
retary shall submit to the appropriate congressional committees 
a report on the pilot program.’’; and 
(6) by adding at the end the following new subsection: 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) The term ‘appropriate congressional committees’ 
means— 
‘‘(A) The Committee on Armed Services, the Committee 
on Transportation and Infrastructure, the Committee on 
Veterans’ Affairs, the Committee on Homeland Security, 
and the Committee on Energy and Commerce of the House 
of Representatives. 
‘‘(B) The Committee on Armed Services, the Committee 
on Commerce, Science, and Transportation, the Committee 
on Veterans’ Affairs, the Committee on Homeland Security 
and Governmental Affairs, and the Committee on Health, 
Education, Labor, and Pensions of the Senate. 
‘‘(2) The term ‘institution of higher education’ means a 
four-year institution of higher education, as defined in section 
101(a) of the Higher Education Act of 1965 (20 U.S.C. 1001(a)).’’.
H. R. 6395—321 
SEC. 742. REPORTS ON SUICIDE AMONG MEMBERS OF THE ARMED 
FORCES AND SUICIDE PREVENTION PROGRAMS AND 
ACTIVITIES OF THE DEPARTMENT OF DEFENSE. 
Section 741(a)(2) of the National Defense Authorization Act 
for Fiscal Year 2020 (Public Law 116–92; 133 Stat. 1467) is 
amended— 
(1) in subparagraph (B), by adding at the end the following 
new clause: 
‘‘(iii) The one-year period following the date on 
which the member returns from such a deployment.’’; 
(2) by redesignating subparagraphs (D) through (H) as 
subparagraphs (E) through (I), respectively; 
(3) by inserting after subparagraph (C) the following new 
subparagraph (D): 
‘‘(D) The number of suicides involving a member who 
was prescribed a medication to treat a mental health or 
behavioral health diagnosis during the one-year period pre-
ceding the death.’’; and 
(4) by adding at the end the following new subparagraph: 
‘‘(J) A description of the programs carried out by the 
military departments to address and reduce the stigma 
associated with seeking assistance for mental health or 
suicidal thoughts.’’. 
SEC. 743. EXTENSION OF AUTHORITY FOR JOINT DEPARTMENT OF 
DEFENSE-DEPARTMENT OF VETERANS AFFAIRS MEDICAL 
FACILITY DEMONSTRATION FUND. 
Section 1704(e) of the National Defense Authorization Act for 
Fiscal Year 2010 (Public Law 111–84; 123 Stat. 2573), as most 
recently amended by section 732(4)(B) of the National Defense 
Authorization Act for Fiscal Year 2020 (Public Law 116–92; 133 
Stat. 1460), is further amended by striking ‘‘September 30, 2021’’ 
and inserting ‘‘September 30, 2022’’. 
SEC. 744. MILITARY HEALTH SYSTEM CLINICAL QUALITY MANAGE-
MENT PROGRAM. 
(a) IN GENERAL.—The Secretary of Defense, acting through 
the Director of the Defense Health Agency, shall implement a 
comprehensive program to be known as the ‘‘Military Health System 
Clinical Quality Management Program’’ (in this section referred 
to as the ‘‘Program’’). 
(b) ELEMENTS OF PROGRAM.—The Program shall include, at 
a minimum, the following: 
(1) The implementation of systematic procedures to elimi-
nate, to the extent feasible, risk of harm to patients at military 
medical treatment facilities, including through identification, 
investigation, and analysis of events indicating a risk of patient 
harm and corrective action plans to mitigate such risks. 
(2) With respect to a potential sentinel event (including 
those involving members of the Armed Forces) at a military 
medical treatment facility— 
(A) an analysis of such event, which shall occur and 
be documented as soon as possible after the event; 
(B) use of such analysis for clinical quality manage-
ment; and 
(C) reporting of such event to the National Practitioner 
Data Bank in accordance with guidelines of the Secretary
H. R. 6395—322 
of Health and Human Services under the Health Care 
Quality Improvement Act of 1986 (42 U.S.C. 11101 et seq.), 
giving special emphasis to the results of external peer 
reviews of the event. 
(3) Validation of provider credentials and granting of clin-
ical privileges by the Director of the Defense Health Agency 
for all health care providers at a military medical treatment 
facility. 
(4) Accreditation of military medical treatment facilities 
by a recognized external accreditation body. 
(5) Systematic measurement of indicators of health care 
quality, emphasizing clinical outcome measures, comparison 
of such indicators with benchmarks from leading health care 
quality improvement organizations, and transparency with the 
public of appropriate clinical measurements for military medical 
treatment facilities. 
(6) Systematic activities emphasized by leadership at all 
organizational levels to use all elements of the Program to 
eliminate unwanted variance throughout the health care system 
of the Department of Defense and make constant improvements 
in clinical quality. 
(7) A full range of procedures for productive communication 
between patients and health care providers regarding actual 
or perceived adverse clinical events at military medical treat-
ment facilities, including procedures— 
(A) for full disclosure of such events (respecting the 
confidentiality of peer review information under a medical 
quality assurance program under section 1102 of title 10, 
United States Code); 
(B) providing an opportunity for the patient to be heard 
in relation to quality reviews; and 
(C) to resolve patient concerns by independent, neutral 
health care resolution specialists. 
(c) ADDITIONAL CLINICAL QUALITY MANAGEMENT ACTIVITIES.— 
(1) IN GENERAL.—In addition to the elements of the Pro-
gram set forth in subsection (b), the Secretary shall establish 
and maintain clinical quality management activities in relation 
to functions of the health care system of the Department sepa-
rate from delivery of health care services in military medical 
treatment facilities. 
(2) HEALTH
CARE
DELIVERY
OUTSIDE
MILITARY
MEDICAL 
TREATMENT FACILITIES.—In carrying out paragraph (1), the Sec-
retary shall maintain policies and procedures to promote clinical 
quality in health care delivery on ships and planes, in deployed 
settings, and in all other circumstances not covered by sub-
section (b), with the objective of implementing standards and 
procedures comparable, to the extent practicable, to those under 
such subsection. 
(3) PURCHASED CARE SYSTEM.—In carrying out paragraph 
(1), the Secretary shall maintain policies and procedures for 
health care services provided outside the Department but paid 
for by the Department, reflecting best practices by public and 
private health care reimbursement and management systems.
H. R. 6395—323 
SEC. 745. WOUNDED WARRIOR SERVICE DOG PROGRAM. 
(a) PROGRAM.—The Secretary of Defense shall establish a pro-
gram, to be known as the ‘‘Wounded Warrior Service Dog Program’’, 
to provide assistance dogs to covered members and covered veterans. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘assistance dog’’ means a dog specifically 
trained to perform physical tasks to mitigate the effects of 
a covered disability, except that the term does not include 
a dog specifically trained for comfort or personal defense. 
(2) The term ‘‘covered disability’’ means any of the fol-
lowing: 
(A) Blindness or visual impairment. 
(B) Loss of use of a limb, paralysis, or other significant 
mobility issues. 
(C) Loss of hearing. 
(D) Traumatic brain injury. 
(E) Post-traumatic stress disorder. 
(F) Any other disability that the Secretary of Defense 
considers appropriate. 
(3) The term ‘‘covered member’’ means a member of the 
Armed Forces who is— 
(A) receiving medical treatment, recuperation, or 
therapy under chapter 55 of title 10, United States Code; 
(B) in medical hold or medical holdover status; or 
(C) covered under section 1202 or 1205 of title 10, 
United States Code. 
(4) The term ‘‘covered veteran’’ means a veteran who is 
enrolled in the health care system established under section 
1705(a) of title 38, United States Code. 
SEC. 746. EXTRAMEDICAL MATERNAL HEALTH PROVIDERS DEM-
ONSTRATION PROJECT. 
(a) DEMONSTRATION PROJECT REQUIRED.—Not later than one 
year after the date of the enactment of this Act, the Secretary 
of Defense shall commence carrying out a demonstration project 
designed to evaluate the cost, quality of care, and impact on 
maternal and fetal outcomes of using extramedical maternal health 
providers under the TRICARE program to determine the appro-
priateness of making coverage of such providers under the 
TRICARE program permanent. 
(b) ELEMENTS OF DEMONSTRATION PROJECT.—The demonstra-
tion project under subsection (a) shall include, for participants 
in the demonstration project, the following: 
(1) Access to doulas. 
(2) Access to lactation consultants or lactation counselors 
who are not otherwise authorized to provide services under 
the TRICARE program. 
(c) PARTICIPANTS.—The Secretary shall establish a process 
under which covered beneficiaries may enroll in the demonstration 
project to receive the services provided under the demonstration 
project. 
(d) DURATION.—The Secretary shall carry out the demonstra-
tion project for a period of five years beginning on the date on 
which notification of the commencement of the demonstration 
project is published in the Federal Register. 
(e) SURVEYS.—
H. R. 6395—324 
(1) IN GENERAL.—Not later than one year after the date 
of the enactment of this Act, and annually thereafter for the 
duration of the demonstration project, the Secretary shall 
administer a survey to determine— 
(A) how many members of the Armed Forces or spouses 
of such members give birth while their spouse or birthing 
partner is unable to be present due to deployment, training, 
or other mission requirements; 
(B) how many single members of the Armed Forces 
give birth alone; and 
(C) how many members of the Armed Forces or spouses 
of such members use doula, lactation consultant, or lacta-
tion counselor support. 
(2) MATTERS COVERED BY SURVEYS.—The surveys adminis-
tered under paragraph (1) shall include an identification of 
the following: 
(A) The race, ethnicity, age, sex, relationship status, 
Armed Force, military occupation, and rank, as applicable, 
of each individual surveyed. 
(B) If individuals surveyed were members of the Armed 
Forces or the spouses of such members, or both. 
(C) The length of advanced notice received by individ-
uals surveyed that the member of the Armed Forces would 
be unable to be present during the birth, if applicable. 
(D) Any resources or support that the individuals sur-
veyed found useful during the pregnancy and birth process, 
including doula, lactation consultant, or lactation counselor 
support. 
(f) REPORTS.— 
(1) IMPLEMENTATION PLAN.—Not later than 180 days after 
the date of the enactment of this Act, the Secretary shall 
submit to the Committees on Armed Services of the House 
of Representatives and the Senate a plan to implement the 
demonstration project. 
(2) ANNUAL REPORT.— 
(A) IN GENERAL.—Not later than one year after the 
date on which the demonstration project commences, and 
annually thereafter for the duration of the demonstration 
project, the Secretary shall submit to the Committees on 
Armed Services of the House of Representatives and the 
Senate a report on the cost of the demonstration project 
and the effectiveness of the demonstration project in 
improving quality of care and the maternal and fetal out-
comes of covered beneficiaries enrolled in the demonstra-
tion project. 
(B) MATTERS COVERED.—Each report submitted under 
subparagraph (A) shall address, at a minimum, the fol-
lowing: 
(i) The number of covered beneficiaries who are 
enrolled in the demonstration project. 
(ii) The number of enrolled covered beneficiaries 
who have participated in the demonstration project. 
(iii) The results of the surveys under subsection 
(e). 
(iv) The cost of the demonstration project. 
(v) An assessment of the quality of care provided 
to participants in the demonstration project.
H. R. 6395—325 
(vi) An assessment of the impact of the demonstra-
tion project on maternal and fetal outcomes. 
(vii) An assessment of the effectiveness of the dem-
onstration project. 
(viii) Recommendations for adjustments to the 
demonstration project. 
(ix) The estimated costs avoided as a result of 
improved maternal and fetal health outcomes due to 
the demonstration project. 
(x) Recommendations for extending the demonstra-
tion project or implementing permanent coverage 
under the TRICARE program of extramedical maternal 
health providers. 
(xi) An identification of legislative or administra-
tive action necessary to make the demonstration 
project permanent. 
(C) FINAL REPORT.—The final report under subpara-
graph (A) shall be submitted not later than 90 days after 
the date on which the demonstration project terminates. 
(g) EXPANSION OF DEMONSTRATION PROJECT.— 
(1) REGULATIONS.—If the Secretary determines that the 
demonstration project is successful, the Secretary may prescribe 
regulations to include extramedical maternal health providers 
as health care providers authorized to provide care under the 
TRICARE program. 
(2) CREDENTIALING AND OTHER REQUIREMENTS.—The Sec-
retary may establish credentialing and other requirements for 
doulas, lactation consultants, and lactation counselors through 
public notice and comment rulemaking for purposes of including 
doulas, lactation consultants, and lactation counselors as health 
care providers authorized to provide care under the TRICARE 
program pursuant to regulations prescribed under paragraph 
(1). 
(h) DEFINITIONS.—In this section: 
(1) The terms ‘‘covered beneficiary’’ and ‘‘TRICARE pro-
gram’’ have the meanings given those terms in section 1072 
of title 10, United States Code. 
(2) The term ‘‘extramedical maternal health provider’’ 
means a doula, lactation consultant, or lactation counselor. 
SEC. 747. BRIEFING ON DIET AND NUTRITION OF MEMBERS OF THE 
ARMED FORCES. 
Not later than 180 days after the date of the enactment of 
this Act, the Secretary of Defense shall provide to the Committees 
on Armed Services of the Senate and the House of Representatives 
a briefing on the diet and nutrition of members of the Armed 
Forces. The briefing shall describe the following: 
(1) The relationship between the diet and nutrition of mem-
bers and the health, performance, and combat effectiveness 
of members. 
(2) The relationship between diets high in omega 3 fatty 
acids, or other diets that may lower inflammation and obesity, 
and improved mental health. 
(3) The extent to which the food and beverages offered 
at the dining halls of the Armed Forces as of the date of 
the briefing are designed to optimize the health, performance,
H. R. 6395—326 
and combat effectiveness of members according to science-based 
approaches. 
(4) The plan of the Secretary to improve the health, 
performance, and combat effectiveness of members by modifying 
the food and beverages offered at such dining halls, including 
in ways that minimize the change for members. 
(5) Expected costs and timeline to implement such plan, 
including any projected costs or savings from reduced medical 
costs if the plan is implemented. 
SEC. 748. AUDIT OF MEDICAL CONDITIONS OF RESIDENTS IN 
PRIVATIZED MILITARY HOUSING. 
(a) AUDIT.—Not later than 90 days after the date of the enact-
ment of this Act, the Inspector General of the Department of 
Defense shall commence the conduct of an audit of— 
(1) the medical conditions of eligible individuals and the 
association between adverse exposures of such individuals in 
unsafe or unhealthy housing units and the health of such 
individuals; and 
(2) the process under section 3053 of the National Defense 
Authorization Act for Fiscal Year 2020 (Public Law 116–92; 
133 Stat. 1943), including whether such process will adequately 
address resolution of environmental health hazards identified 
as a result of the inspections and assessments conducted pursu-
ant to sections 3051(b) and 3052(b) of such Act (Public Law 
116–92; 133 Stat. 1941 and 1942). 
(b) CONTENT OF AUDIT.—In conducting the audit under sub-
section (a), the Inspector General shall— 
(1) determine the percentage of units of privatized military 
housing that are considered by the Inspector General to be 
unsafe or unhealthy housing units and visit at least one mili-
tary installation of the Department of Defense from each of 
the Army, Navy, Air Force, and Marine Corps to verify that 
such units are unsafe or unhealthy housing units; 
(2) study the adverse exposures of eligible individuals that 
relate to residing in an unsafe or unhealthy housing unit and 
the effect of such exposures on the health of such individuals; 
(3) determine, to the extent permitted by available scientific 
data, the association between such adverse exposures and the 
occurrence of a medical condition in eligible individuals residing 
in unsafe or unhealthy housing units and provide quantifiable 
data on such association; 
(4) review the process to identify, record, and resolve 
environmental health hazards developed by the Secretary of 
Defense under section 3053 of the National Defense Authoriza-
tion Act for Fiscal Year 2020 (Public Law 116–92; 133 Stat. 
1943); 
(5) review the inspections and assessments conducted 
pursuant to sections 3051(b) and 3052(b) of the National 
Defense Authorization Act for Fiscal Year 2020 (Public Law 
116–92; 133 Stat. 1941 and 1942); 
(6) study the relationship between the process specified 
in paragraph (4) and any environmental health hazards identi-
fied as a result of the inspections and assessments specified 
in paragraph (5) to determine whether such process will ade-
quately address resolution of such hazards and complaints that
H. R. 6395—327 
relate to such hazards made by eligible individuals residing 
in privatized military housing; and 
(7) make such recommendations as the Inspector General 
may have to improve the process specified in paragraph (4). 
(c) CONDUCT OF AUDIT.—The Inspector General shall conduct 
the audit under subsection (a) using the same privacy preserving 
guidelines used by the Inspector General in conducting other audits 
of health records. 
(d) SOURCE OF DATA.—In conducting the audit under subsection 
(a), the Inspector General shall use— 
(1) de-identified data from electronic health records of the 
Department; 
(2) records of claims under the TRICARE program; and 
(3) such other data as determined necessary by the 
Inspector General. 
(e) SUBMISSION
AND PUBLIC AVAILABILITY
OF REPORT.—Not 
later than one year after the commencement of the audit under 
subsection (a), the Inspector General shall— 
(1) submit to the Secretary of Defense and the Committees 
on Armed Services of the Senate and the House of Representa-
tives a report on the results of the audit conducted under 
subsection (a), including any recommendations made under sub-
section (b)(7); and 
(2) publish such report on a publicly available internet 
website of the Department of Defense. 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘eligible individual’’ means a member of the 
Armed Forces or a family member of a member of the Armed 
Forces who has resided in an unsafe or unhealthy housing 
unit. 
(2) The term ‘‘privatized military housing’’ means military 
housing provided under subchapter IV of chapter 169 of title 
10, United States Code. 
(3) The term ‘‘TRICARE program’’ has the meaning given 
such term section 1072 of title 10, United States Code. 
(4) The term ‘‘unsafe or unhealthy housing unit’’ means 
a unit of privatized military housing in which is present, at 
levels exceeding national standards or guidelines, at least one 
of the following hazards: 
(A) Physiological hazards, including the following: 
(i) Dampness or microbial growth. 
(ii) Lead-based paint. 
(iii) Asbestos or manmade fibers. 
(iv) Ionizing radiation. 
(v) Biocides. 
(vi) Carbon monoxide. 
(vii) Volatile organic compounds. 
(viii) Infectious agents. 
(ix) Fine particulate matter. 
(B) Psychological hazards, including ease of access by 
unlawful intruders or lighting issues. 
(C) Poor ventilation. 
(D) Safety hazards. 
(E) Other similar hazards as determined by the 
Inspector General.
H. R. 6395—328 
SEC. 749. ASSESSMENT OF RECEIPT BY CIVILIANS OF EMERGENCY 
MEDICAL TREATMENT AT MILITARY MEDICAL TREATMENT 
FACILITIES. 
(a) ASSESSMENT.—Not later than one year after the date of 
the enactment of this Act, the Comptroller General of the United 
States shall complete an assessment of the provision by the Sec-
retary of Defense of emergency medical treatment to civilians who 
are not covered beneficiaries at military medical treatment facilities 
during the period beginning on October 1, 2015, and ending on 
September 30, 2020. 
(b) ELEMENTS OF ASSESSMENT.—The assessment under sub-
section (a) shall include, with respect to civilians who received 
emergency medical treatment at a military medical treatment 
facility during the period specified in such paragraph, the following: 
(1) The total fees charged to such civilians for such treat-
ment and the total fees collected. 
(2) The amount of medical debt from such treatment that 
was garnished from such civilians, categorized by garnishment 
from Social Security benefits, tax refunds, wages, or other 
financial assets. 
(3) The number of such civilians from whom medical debt 
from such treatment was garnished. 
(4) The total fees for such treatment that were waived 
for such civilians. 
(5) With respect to medical debt incurred by such civilians 
from such treatment— 
(A) the amount of such debt that was collected by 
the Secretary of Defense; 
(B) the amount of such debt still owed to the Depart-
ment of Defense; and 
(C) the amount of such debt transferred from the 
Department of Defense to the Department of the Treasury 
for collection. 
(6) The number of such civilians from whom such medical 
debt was collected who did not possess medical insurance at 
the time of such treatment. 
(7) The number of such civilians from whom such medical 
debt was collected who collected Social Security benefits at 
the time of such treatment. 
(8) The number of such civilians from whom such medical 
debt was collected who, at the time of such treatment, earned— 
(A) less than the poverty line; 
(B) less than 200 percent of the poverty line; 
(C) less than 300 percent of the poverty line; and 
(D) less than 400 percent of the poverty line. 
(9) An assessment of the process through which military 
medical treatment facilities seek to recover unpaid medical 
debt from such civilians, including whether the Secretary of 
Defense contracts with private debt collectors to recover such 
unpaid medical debt. 
(10) An assessment of the process, if any, through which 
such civilians can apply to have medical debt for such treatment 
waived, forgiven, canceled, or otherwise determined to not be 
a financial obligation of the civilian. 
(11) Such other information as the Comptroller General 
determines appropriate.
H. R. 6395—329 
(c) REPORTS.—The Comptroller General shall submit to the 
Committees on Armed Services of the Senate and the House of 
Representatives— 
(1) not later than December 1, 2021, a report containing 
preliminary observations with respect to the assessment under 
subsection (a); and 
(2) at such time and in such format as is mutually agreed 
upon by the committees and the Comptroller General, a report 
containing the final results of such assessment. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘civilian’’ means an individual who is not— 
(A) a member of the Armed Forces; 
(B) a contractor of the Department of Defense; or 
(C) a civilian employee of the Department. 
(2) The term ‘‘covered beneficiary’’ has the meaning given 
that term in section 1072(5) of title 10, United States Code. 
(3) The term ‘‘poverty line’’ has the meaning given that 
term in section 673 of the Community Services Block Grant 
Act (42 U.S.C. 9902). 
SEC. 750. STUDY ON THE INCIDENCE OF CANCER DIAGNOSIS AND MOR-
TALITY AMONG MILITARY AVIATORS AND AVIATION SUP-
PORT PERSONNEL. 
(a) STUDY.— 
(1) IN GENERAL.—The Secretary of Defense, in conjunction 
with the Directors of the National Institutes of Health and 
the National Cancer Institute, shall conduct a study on cancer 
among covered individuals in two phases as provided in this 
subsection. 
(2) PHASE 1.— 
(A) IN GENERAL.—Under the initial phase of the study 
conducted under paragraph (1), the Secretary of Defense 
shall determine if there is a higher incidence of cancers 
occurring for covered individuals as compared to similar 
age groups in the general population through the use of 
the database of the Surveillance, Epidemiology, and End 
Results program of the National Cancer Institute. 
(B) REPORT.—Not later than one year after the date 
of the enactment of this Act, the Secretary shall submit 
to the appropriate committees of Congress a report on 
the findings of the initial phase of the study under subpara-
graph (A). 
(3) PHASE 2.— 
(A) IN GENERAL.—If, pursuant to the initial phase of 
the study under paragraph (2), the Secretary concludes 
that there is an increased rate of cancers among covered 
individuals, the Secretary shall conduct a second phase 
of the study under which the Secretary shall do the fol-
lowing: 
(i) Identify the carcinogenic toxins or hazardous 
materials associated with military flight operations 
from shipboard or land bases or facilities, such as 
fuels, fumes, and other liquids. 
(ii) Identify the operating environments, including 
frequencies or electromagnetic fields, where exposure 
to ionizing radiation (associated with high altitude
H. R. 6395—330 
flight) and nonionizing radiation (associated with air-
borne, ground, and shipboard radars) occurred in which 
covered individuals could have received increased radi-
ation amounts. 
(iii) Identify, for each covered individual, duty sta-
tions, dates of service, aircraft flown, and additional 
duties (including Landing Safety Officer, Catapult and 
Arresting Gear Officer, Air Liaison Officer, Tactical 
Air Control Party, or personnel associated with aircraft 
maintenance, supply, logistics, fuels, or transportation) 
that could have increased the risk of cancer for such 
covered individual. 
(iv) Determine locations where a covered individual 
served or additional duties of a covered individual that 
are associated with higher incidences of cancers. 
(v) Identify potential exposures due to service in 
the Armed Forces that are not related to aviation, 
such as exposure to burn pits or toxins in contaminated 
water, embedded in the soil, or inside bases or housing. 
(vi) Determine the appropriate age to begin 
screening covered individuals for cancer based on race, 
gender, flying hours, period of service as aviation sup-
port personnel, Armed Force, type of aircraft, and mis-
sion. 
(B) DATA.—The Secretary shall format all data 
included in the study conducted under this paragraph in 
accordance with the Surveillance, Epidemiology, and End 
Results program of the National Cancer Institute, including 
by disaggregating such data by race, gender, and age. 
(C) REPORT.—Not later than one year after the sub-
mittal of the report under paragraph (2)(B), if the Secretary 
conducts the second phase of the study under this para-
graph, the Secretary shall submit to the appropriate 
committees of Congress a report on the findings of the 
study conducted under this paragraph. 
(4) USE OF DATA FROM PREVIOUS STUDIES.—In conducting 
the study under this subsection, the Secretary of Defense shall 
incorporate data from previous studies conducted by the Air 
Force, the Navy, or the Marine Corps that are relevant to 
the study under this subsection, including data from the com-
prehensive study conducted by the Air Force identifying each 
covered individual and documenting the cancers, dates of 
diagnoses, and mortality of each covered individual. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘appropriate committees of Congress’’ means— 
(A) the Committee on Armed Services and the Com-
mittee on Veterans’ Affairs of the Senate; and 
(B) the Committee on Armed Services and the Com-
mittee on Veterans’ Affairs of the House of Representatives. 
(2) The term ‘‘Armed Forces’’— 
(A) has the meaning given the term ‘‘armed forces’’ 
in section 101 of title 10, United States Code; and 
(B) includes the reserve components named in section 
10101 of such title. 
(3) The term ‘‘covered individual’’— 
(A) means an aviator or aviation support personnel 
who—
H. R. 6395—331 
(i) served in the Armed Forces on or after February 
28, 1961; and 
(ii) receives benefits under chapter 55 of title 10, 
United States Code; and 
(B) includes any air crew member of fixed-wing aircraft 
and personnel supporting generation of the aircraft, 
including pilots, navigators, weapons systems operators, 
aircraft system operators, personnel associated with air-
craft maintenance, supply, logistics, fuels, or transpor-
tation, and any other crew member who regularly flies 
in an aircraft or is required to complete the mission of 
the aircraft. 
SEC. 751. STUDY ON EXPOSURE TO TOXIC SUBSTANCES AT KARSHI- 
KHANABAD AIR BASE, UZBEKISTAN. 
(a) STUDY.— 
(1) IN GENERAL.—The Secretary of Defense shall conduct 
a study on exposure to toxic substances by members of the 
Armed Forces deployed to Karshi-Khanabad Air Base, Uzbek-
istan, at any time during the period beginning on October 
1, 2001, and ending on December 31, 2005. 
(2) MATTERS INCLUDED.—The study under paragraph (1) 
shall include the following: 
(A) An assessment regarding the conditions of Karshi- 
Khanabad Air Base, Uzbekistan, during the period begin-
ning on October 1, 2001, and ending on December 31, 
2005, including an identification of any toxic substances 
contaminating the Air Base during such period. 
(B) An epidemiological study of the health con-
sequences of members of the Armed Forces deployed to 
the Air Base at any time during such period. 
(C) An assessment of any association between exposure 
to toxic substances identified under subparagraph (A) and 
the health consequences studied under subparagraph (B). 
(b) REPORT.—Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Defense shall submit to 
the Committees on Armed Services of the House of Representatives 
and the Senate a report on the results of the study under subsection 
(a). 
SEC. 752. REVIEW AND REPORT ON PREVENTION OF SUICIDE AMONG 
MEMBERS OF THE ARMED FORCES STATIONED AT REMOTE 
INSTALLATIONS 
OUTSIDE 
THE 
CONTIGUOUS 
UNITED 
STATES. 
(a) REVIEW REQUIRED.—The Comptroller General of the United 
States shall conduct a review of efforts by the Department of 
Defense to prevent suicide among covered members. 
(b) ELEMENTS OF REVIEW.—The review conducted under sub-
section (a) shall include an assessment of each of the following: 
(1) Current policy guidelines of the Armed Forces on the 
prevention of suicide among covered members. 
(2) Current suicide prevention programs and activities of 
the Armed Forces provided to covered members and their 
dependents, including programs provided by the Defense Health 
Program and the Defense Suicide Prevention Office.
H. R. 6395—332 
(3) The integration of mental health screenings and efforts 
relating to suicide risk and suicide prevention for covered mem-
bers and their dependents into the delivery of primary care 
for such members and dependents. 
(4) The standards for responding to attempted or completed 
suicides among covered members and their dependents, 
including guidance and training to assist commanders in 
addressing incidents of attempted or completed suicide that 
occur within their units. 
(5) The standards regarding data collection for covered 
members and their dependents, including the collection of data 
on factors that relate to suicide, such as domestic violence 
and child abuse. 
(6) The means used to ensure the protection of privacy 
of covered members and their dependents who seek or receive 
treatment relating to suicide prevention. 
(7) The availability of information from indigenous popu-
lations on suicide prevention for covered members who are 
members of such a population. 
(8) The availability of information from graduate research 
programs of institutions of higher education on suicide preven-
tion for members of the Armed Forces. 
(9) Such other matters as the Comptroller General con-
siders appropriate in connection with the prevention of suicide 
among covered members and their dependents. 
(c) BRIEFING AND REPORT.—The Comptroller General shall— 
(1) not later than October 1, 2021, brief the Committees 
on Armed Services of the House of Representatives and the 
Senate on preliminary observations relating to the review under 
subsection (a); and 
(2) not later than March 1, 2022, submit to the Committees 
on Armed Services of the House of Representatives and the 
Senate a report containing the results of such review. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘covered installation’’ means a remote installa-
tion of the Department of Defense located outside the contig-
uous United States. 
(2) The term ‘‘covered member’’ means a member of the 
Armed Forces who is stationed at a covered installation. 
SEC. 753. STUDY ON MEDEVAC HELICOPTERS AND AMBULANCES AT 
CERTAIN MILITARY INSTALLATIONS. 
(a) STUDY.—Not later than one year after the date of the 
enactment of this Act, the Secretary of Defense shall submit to 
the Committees on Armed Services of the House of Representatives 
and the Senate a report containing a feasibility study on the use 
and maintenance of medical evacuation helicopters and ground 
ambulances at covered military installations. 
(b) ELEMENTS.—The study under subsection (a) shall include 
the following: 
(1) The requirements analysis that determines whether 
a medical evacuation helicopter and ground ambulance or 
similar vehicles are required at covered military installations. 
(2) The frequency with which such helicopters and ambu-
lances are inspected for maintenance and restocked with the 
required supplies and equipment.
H. R. 6395—333 
(3) The frequency with which training exercises occur 
involving the use of such helicopters and ambulances. 
(4) The planning factors associated with ensuring that the 
capabilities provided by such helicopters and ambulances are 
readily available and the contingency plans that may involve 
the use of helicopters or ambulances provided by allies of the 
United States or host countries. 
(c) COVERED MILITARY INSTALLATION DEFINED.—In this section, 
the term ‘‘covered military installation’’ means each military 
installation outside the United States at which the Secretary antici-
pates the United States will have an enduring presence. 
SEC. 754. COMPTROLLER GENERAL STUDY ON PRENATAL AND 
POSTPARTUM MENTAL HEALTH CONDITIONS AMONG MEM-
BERS OF THE ARMED FORCES AND THEIR DEPENDENTS. 
(a) STUDY.— 
(1) IN GENERAL.—The Comptroller General of the United 
States shall conduct a study on prenatal and postpartum mental 
health conditions among members of the Armed Forces and 
the dependents of such members. 
(2) ELEMENTS.—The study under paragraph (1) shall 
include the following: 
(A) An assessment of— 
(i) the extent to which beneficiaries under the 
TRICARE program, including members of the Armed 
Forces and the dependents of such members, are 
diagnosed with— 
(I) prenatal or postpartum depression; 
(II) prenatal or postpartum anxiety disorder; 
(III) prenatal or postpartum obsessive compul-
sive disorder; 
(IV) prenatal or postpartum psychosis; and 
(V) other relevant mood disorders; and 
(ii) the extent to which data is collected on the 
prenatal or postpartum mental health conditions speci-
fied under clause (i). 
(B) A demographic assessment of the population 
included in the study with respect to race, ethnicity, sex, 
age, relationship status, military service, military occupa-
tion, and rank, where applicable. 
(C) An assessment of the status of prenatal and 
postpartum mental health care for beneficiaries under the 
TRICARE program, including those who seek care at mili-
tary medical treatment facilities and those who rely on 
civilian providers. 
(D) An assessment of the ease or delay for beneficiaries 
under the TRICARE program in obtaining treatment for 
prenatal 
and 
postpartum 
mental 
health 
conditions, 
including— 
(i) an assessment of wait times for mental health 
treatment at each military medical treatment facility; 
and 
(ii) a description of the reasons such beneficiaries 
may cease seeking such treatment. 
(E) A comparison of the rates of prenatal or postpartum 
mental health conditions within the military community
H. R. 6395—334 
to such rates in the civilian population, as reported by 
the Centers for Disease Control and Prevention. 
(F) An assessment of any effects of implicit or explicit 
bias in prenatal and postpartum mental health care under 
the TRICARE program, or evidence of racial or socio-
economic barriers to such care. 
(G) The extent to which treatment for mental health 
issues specified under subparagraph (A)(i) is available and 
accessible to members of the Armed Forces serving on 
active duty and the spouses of such members. 
(H) The barriers that prevent members of the Armed 
Forces serving on active duty, and the spouses of such 
members, from seeking or obtaining care for such mental 
health issues. 
(I) The ways in which the Department of Defense is 
addressing barriers identified under subparagraph (H). 
(b) REPORT.—Not later than one year after the date of the 
enactment of this Act, the Comptroller General shall submit to 
the Committees on Armed Services of the Senate and the House 
of Representatives a report on the findings of the study conducted 
under subsection (a), including— 
(1) recommendations for actions to be taken by the Sec-
retary of Defense to improve prenatal and postpartum mental 
health among members of the Armed Forces and dependents 
of such members; and 
(2) such other recommendations as the Comptroller General 
determines appropriate. 
(c) DEFINITIONS.—In this section, the terms ‘‘dependent’’ and 
‘‘TRICARE program’’ have the meanings given those terms in sec-
tion 1072 of title 10, United States Code. 
SEC. 755. REPORT ON LAPSES IN TRICARE COVERAGE FOR MEMBERS 
OF THE NATIONAL GUARD AND RESERVE COMPONENTS. 
(a) REPORT.—Not later than one year after the date of the 
enactment of this Act, each Secretary of a military department, 
in consultation with the Director of the Defense Health Agency, 
shall submit to the Committees on Armed Services of the House 
of Representatives and the Senate a report containing an analysis 
of each of the following with respect to the military department 
of the Secretary: 
(1) Any lapses in coverage under the TRICARE program 
for a member of a reserve component that occurred during 
the eight-year period ending on the date of the enactment 
of this Act and were caused by a change in the duty status 
of such member, including an identification of the total number 
of such lapses. 
(2) The factors contributing to any such lapses, including— 
(A) technological factors, including factors relating to 
outdated systems; 
(B) human errors in processing changes in duty status; 
(C) shortages in the level of administrative staffing 
of the reserve component; and 
(D) integration of systems of the reserve component 
with Integrated Pay and Personnel Systems. 
(3) How factors contributing to any such lapses were identi-
fied under paragraph (2) and whether actions have been taken 
to address the factors.
H. R. 6395—335 
(4) The effect of any such lapses on— 
(A) the delivery of health care benefits to members 
of the reserve components and the eligible dependents of 
such members; or 
(B) force readiness and force retention. 
(5) The parties responsible for identifying and commu-
nicating to a member of a reserve component issues relating 
to eligibility under the TRICARE program. 
(6) The methods by which a member of a reserve compo-
nent, an eligible dependent of such member, or the Secretary 
of Defense may verify the status of enrollment in the TRICARE 
program regarding the member before, during, and after a 
deployment of the member. 
(7) The comparative effectiveness, with respect to the 
delivery of health care benefits to a member of a reserve compo-
nent and eligible dependents of such member, of— 
(A) continuing the current process by which a pre-
viously eligible member must transition from coverage 
under TRICARE Reserve Select to coverage under 
TRICARE Prime after a change to active service in the 
duty status of such member; and 
(B) establishing a new process by which a previously 
eligible member may remain covered by TRICARE Reserve 
Select after a change to active service in the duty status 
of such member (whether by allowing a previously eligible 
member to pay a premium for such coverage or by requiring 
the Federal Government to provide for such coverage). 
(8) Whether the current process referred to in paragraph 
(7)(A) negatively affects the delivery of health care benefits 
as a result of transitions between network providers. 
(9) The current status and expected completion of duty 
status reform for personnel of the reserve components. 
(10) The actions necessary to prevent future occurrences 
of such lapses, including legislative actions. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘active service’’ has the meaning given that 
term in section 101(d) of title 10, United States Code. 
(2) The term ‘‘eligible dependent’’ means a dependent of 
a member of a reserve component— 
(A) described in subparagraph (A), (D), or (I) of section 
1072(2) of title 10, United States Code; and 
(B) eligible for coverage under the TRICARE program. 
(3) The term ‘‘previously eligible member’’ means a member 
of a reserve component who was eligible for coverage under 
TRICARE Reserve Select pursuant to section 1076d of title 
10, United States Code, prior to a change to active service 
in the duty status of such member. 
(4) The terms ‘‘TRICARE Prime’’ and ‘‘TRICARE program’’ 
have the meanings given those terms in section 1072 of title 
10, United States Code. 
(5) The term ‘‘TRICARE Reserve Select’’ has the meaning 
given that term in section 1076d(f) of title 10, United States 
Code.
H. R. 6395—336 
SEC. 756. STUDY AND REPORT ON INCREASING TELEHEALTH SERVICES 
ACROSS ARMED FORCES. 
(a) STUDY.—The Secretary of Defense shall conduct a study 
that reviews, identifies, and evaluates the technology approaches, 
policies, and concepts of operations of telehealth and telemedicine 
programs across all military departments. The study shall include 
the following: 
(1) Identification and evaluation of limitations and 
vulnerabilities of health care and medicine capabilities with 
respect to telemedicine. 
(2) Identification and evaluation of essential technologies 
needed to achieve documented goals and capabilities of tele-
health and associated technologies required to support sustain-
ability. 
(3) Development of a technology maturation roadmap, 
including an estimated funding profile over time, needed to 
achieve an effective operational telehealth usage that describes 
both the critical and associated supporting technologies, sys-
tems integration, prototyping and experimentation, and test 
and evaluation. 
(4) An analysis of telehealth programs, such as remote 
diagnostic testing and evaluation tools that contribute to the 
medical readiness of military medical providers. 
(b) REPORT.—Not later than one year after the date of the 
enactment of this Act, the Secretary of Defense shall submit to 
the Committees on Armed Services of the House of Representatives 
and the Senate a report containing the study conducted under 
subsection (a). 
SEC. 757. STUDY ON FORCE MIX OPTIONS AND SERVICE MODELS TO 
ENHANCE READINESS OF MEDICAL FORCE OF THE ARMED 
FORCES. 
(a) STUDY.—Not later than 30 days after the date of the enact-
ment of this Act, the Secretary of Defense shall seek to enter 
into an agreement with a federally funded research and develop-
ment center or other independent entity to conduct a study on 
force mix options and service models (including traditional and 
nontraditional active and reserve models) to enhance the readiness 
of the medical force of the Armed Forces to deliver combat care 
on the battlefield and assist public health responses to pandemics 
or other national public health emergencies. 
(b) ELEMENTS.—The study under subsection (a) shall include, 
at a minimum and conducted separately with respect to members 
of the Armed Forces on active duty and members of the reserve 
components— 
(1) a review of existing models for such members who 
are medical professionals to improve clinical readiness skills 
by serving in civilian trauma centers, Federal agencies, or 
other organizations determined appropriate by the Secretary; 
(2) an assessment of the extent to which such existing 
models can be optimized, standardized, and scaled to address 
readiness shortfalls; and 
(3) an evaluation of the cost and effectiveness of alternative 
models for such members who are medical professionals to 
serve in the centers, agencies, and organizations specified in 
subparagraph (A).