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tions of covered servicemembers, including the
following:
(i) Processes for medical evaluations of
covered servicemembers that are—
(I) applicable uniformly through-
out the military departments; and
(II) applicable uniformly with re-
spect to such servicemembers who are
members of the regular components of
the 
Armed 
Forces 
and 
such
servicemembers who are members of the
National Guard and Reserve.
(ii) Standard criteria and definitions
for determining the achievement for covered
servicemembers of the maximum medical
benefit from treatment and rehabilitation.
(iii) Standard timelines for each of the
following:
(I) Determinations of fitness for
duty of covered servicemembers.
(II) Specialty consultations for
covered servicemembers.
(III) Preparation of medical doc-
uments for covered servicemembers.
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(IV) 
Appeals 
by 
covered
servicemembers of medical evaluation
determinations, including determina-
tions of fitness for duty.
(iv) Uniform standards for qualifica-
tions and training of medical evaluation
board personnel, including physicians, case
workers, and physical disability evaluation
board liaison officers, in conducting medical
evaluations of covered servicemembers.
(v) Standards for the maximum num-
ber of medical evaluation cases of covered
servicemembers that are pending before a
medical evaluation board at any one time,
and requirements for the establishment of
additional medical evaluation boards in the
event such number is exceeded.
(vi) Uniform standards for informa-
tion for covered servicemembers, and their
families, on the medical evaluation board
process and the rights and responsibilities of
such servicemembers under that process, in-
cluding a standard handbook on such infor-
mation.
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(B) PHYSICAL DISABILITY EVALUATIONS.—
Processes, procedures, and standards for physical
disability evaluations of covered servicemembers,
including the following:
(i) A non-adversarial process of the
Department of Defense and the Department
of Veterans Affairs for disability determina-
tions of covered servicemembers.
(ii) To the extent feasible, procedures to
eliminate unacceptable discrepancies among
disability ratings assigned by the military
departments and the Department of Vet-
erans Affairs, particularly in the disability
evaluation of covered servicemembers, which
procedures shall be subject to the following
requirements and limitations:
(I) Such procedures shall apply
uniformly with respect to covered
servicemembers who are members of the
regular components of the Armed
Forces and covered servicemembers who
are members of the National Guard
and Reserve.
(II) Under such procedures, each
Secretary of a military department
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shall, to the extent feasible, utilize the
standard schedule for rating disabil-
ities in use by the Department of Vet-
erans Affairs, including any applicable
interpretation of such schedule by the
United States Court of Appeals for Vet-
erans Claims, in making any deter-
mination of disability of a covered
servicemember.
(iii) Standard timelines for appeals of
determinations of disability of covered
servicemembers, including timelines for
presentation, consideration, and disposition
of appeals.
(iv) Uniform standards for qualifica-
tions and training of physical disability
evaluation board personnel in conducting
physical disability evaluations of covered
servicemembers.
(v) Standards for the maximum num-
ber of physical disability evaluation cases of
covered servicemembers that are pending be-
fore a physical disability evaluation board
at any one time, and requirements for the
establishment of additional physical dis-
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ability evaluation boards in the event such
number is exceeded.
(vi) Procedures for the provision of
legal counsel to covered servicemembers
while undergoing evaluation by a physical
disability evaluation board.
(vii) Uniform standards on the roles
and responsibilities of case managers,
servicemember advocates, and judge advo-
cates assigned to covered servicemembers
undergoing evaluation by a physical dis-
ability board, and uniform standards on the
maximum number of cases involving such
servicemembers that are to be assigned to
such managers and advocates.
(C) 
RETURN
OF
COVERED
SERVICEMEMBERS TO ACTIVE DUTY.—Standards
for determinations by the military departments
on the return of covered servicemembers to active
duty in the Armed Forces.
(D) 
TRANSITION
OF
COVERED
SERVICEMEMBERS FROM DOD TO VA.—Processes,
procedures, and standards for the transition of
covered servicemembers from care and treatment
by the Department of Defense to care and treat-
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ment by the Department of Veterans Affairs be-
fore, during, and after separation from the
Armed Forces, including the following:
(i) A uniform, patient-focused policy to
ensure that the transition occurs without
gaps in medical care and the quality of
medical care, benefits, and services.
(ii) Procedures for the identification
and tracking of covered servicemembers dur-
ing the transition, and for the coordination
of 
care 
and 
treatment 
of 
such
servicemembers during the transition, in-
cluding a system of cooperative case man-
agement of such servicemembers by the De-
partment of Defense and the Department of
Veterans Affairs during the transition.
(iii) Procedures for the notification of
Department of Veterans Affairs liaison per-
sonnel of the commencement by covered
servicemembers of the medical evaluation
process and the physical disability evalua-
tion process.
(iv) Procedures and timelines for the
enrollment of covered servicemembers in ap-
plicable enrollment or application systems
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of the Department of Veterans with respect
to health care, disability, education, voca-
tional rehabilitation, or other benefits.
(v) Procedures to ensure the access of
covered servicemembers during the transi-
tion to vocational, educational, and reha-
bilitation benefits available through the De-
partment of Veterans Affairs.
(vi) Standards for the optimal location
of Department of Defense and Department
of Veterans Affairs liaison and case man-
agement personnel at military medical
treatment facilities, medical centers, and
other medical facilities of the Department of
Defense.
(vii) Standards and procedures for in-
tegrated medical care and management for
covered servicemembers during the transi-
tion, including procedures for the assign-
ment of medical personnel of the Depart-
ment of Veterans Affairs to Department of
Defense facilities to participate in the needs
assessments of such servicemembers before,
during, and after their separation from
military service.
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(viii) Standards for the preparation of
detailed plans for the transition of covered
servicemembers from care and treatment by
the Department of Defense to care and
treatment by the Department of Veterans
Affairs, which plans shall be based on
standardized elements with respect to care
and treatment requirements and other ap-
plicable requirements.
(E) OTHER MATTERS.—The following addi-
tional 
matters 
with 
respect 
to 
covered
servicemembers:
(i) Access by the Department of Vet-
erans Affairs to the military health records
of covered servicemembers who are receiving
care and treatment, or are anticipating re-
ceipt of care and treatment, in Department
of Veterans Affairs health care facilities.
(ii) Requirements for utilizing, in ap-
propriate cases, a single physical examina-
tion that meets requirements of both the De-
partment of Defense and the Department of
Veterans Affairs for covered servicemembers
who are being retired, separated, or released
from military service.
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(iii) Surveys and other mechanisms to
measure patient and family satisfaction
with the provision by the Department of
Defense and the Department of Veterans Af-
fairs of care and services for covered
servicemembers, and to facilitate appro-
priate oversight by supervisory personnel of
the provision of such care and services.
(3) REPORT ON REDUCTION IN DISABILITY RAT-
INGS BY THE DEPARTMENT OF DEFENSE.—The Sec-
retary of Defense shall submit a report to the Com-
mittees on Armed Services of the Senate and House
of Representatives on the number of instances in
which a disability rating assigned to a member of the
Armed Forces by an informal physical evaluation
board of the Department of Defense was reduced upon
appeal, and the reasons for such reduction. Such re-
port shall cover the period beginning October 7, 2001,
and ending September 30, 2006, and shall be sub-
mitted to the appropriate committees of Congress by
February 1, 2008.
(e) REPORTS.—
(1) REPORT ON POLICY.—Upon the development
of the policy required by this section but not later
than January 1, 2008, the Secretary of Defense and
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the Secretary of Veterans Affairs shall jointly submit
to the appropriate committees of Congress a report on
the policy, including a comprehensive and detailed
description of the policy and of the manner in which
the policy addresses the findings and recommenda-
tions of the reviews under subsections (b) and (c).
(2) REPORTS ON UPDATE.—Upon updating the
policy under subsection (a)(4), the Secretary of De-
fense and the Secretary of Veterans Affairs shall joint-
ly submit to the appropriate committees of Congress
a report on the update of the policy, including a com-
prehensive and detailed description of such update
and of the reasons for such update.
(f) COMPTROLLER GENERAL ASSESSMENT OF IMPLE-
MENTATION.—Not later than six months after the date of
the enactment of this Act and every year thereafter, the
Comptroller General of the United States shall submit to
the appropriate committees of Congress a report setting
forth the assessment of the Comptroller General of the
progress of the Secretary of Defense and the Secretary of
Veterans Affairs in developing and implementing the policy
required by this section.
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SEC. 112. CONSIDERATION OF NEEDS OF WOMEN MEMBERS
OF THE ARMED FORCES AND VETERANS.
(a) IN GENERAL.—In developing and implementing
the policy required by section 111, and in otherwise car-
rying out any other provision of this title or any amend-
ment made by this title, the Secretary of Defense and the
Secretary of Veterans Affairs shall take into account and
fully address any unique specific needs of women members
of the Armed Forces and women veterans under such policy
or other provision.
(b) REPORTS.—In submitting any report required by
this title or an amendment made by this title, the Secretary
of Defense and the Secretary of Veterans Affairs shall, to
the extent applicable, include a description of the manner
in which the matters covered by such report address the
unique specific needs of women members of the Armed
Forces and women veterans.
Subtitle B—Health Care
PART I—ENHANCED AVAILABILITY OF CARE FOR
SERVICEMEMBERS
SEC. 121. MEDICAL CARE AND OTHER BENEFITS FOR MEM-
BERS AND FORMER MEMBERS OF THE ARMED
FORCES WITH SEVERE INJURIES OR ILL-
NESSES.
(a) MEDICAL AND DENTAL CARE FOR MEMBERS AND
FORMER MEMBERS.—
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(1) IN GENERAL.—Effective as of the date of the
enactment of this Act and subject to regulations pre-
scribed by the Secretary of Defense, any covered mem-
ber of the Armed Forces, and any former member of
the Armed Forces, with a severe injury or illness is
entitled to medical and dental care in any facility of
the uniformed services under section 1074(a) of title
10, United States Code, or through any civilian
health care provider authorized by the Secretary to
provide health and mental health services to members
of the uniformed services, including traumatic brain
injury (TBI) and post-traumatic stress disorder
(PTSD), as if such member or former member were
a member of the uniformed services described in para-
graph (2) of such section who is entitled to medical
and dental care under such section.
(2) PERIOD OF AUTHORIZED CARE.—(A) Except
as provided in subparagraph (B), a member or
former member described in paragraph (1) is entitled
to care under that paragraph—
(i) in the case of a member or former mem-
ber whose severe injury or illness concerned is in-
curred or aggravated during the period begin-
ning on October 7, 2001, and ending on the date
of the enactment of this Act, during the three-
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year period beginning on the date of the enact-
ment of this Act, except that no compensation is
payable by reason of this subsection for any pe-
riod before the date of the enactment of this Act;
or
(ii) in the case of a member or former mem-
ber whose severe injury or illness concerned is in-
curred or aggravated on or after the date of the
enactment of this Act, during the three-year pe-
riod beginning on the date on which such injury
or illness is so incurred or aggravated.
(B) The period of care authorized for a member
or former member under this paragraph may be ex-
tended by the Secretary concerned for an additional
period of up to two years if the Secretary concerned
determines that such extension is necessary to assure
the maximum feasible recovery and rehabilitation of
the member or former member. Any such determina-
tion shall be made on a case-by-case basis.
(3) INTEGRATED CARE MANAGEMENT.—The Sec-
retary of Defense shall provide for a program of inte-
grated care management in the provision of care and
services under this subsection, which management
shall be provided by appropriate medical and case
management personnel of the Department of Defense
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and the Department of Veterans Affairs (as approved
by the Secretary of Veterans Affairs) and with appro-
priate support from the Department of Defense re-
gional health care support contractors.
(4) WAIVER
OF
LIMITATIONS
TO
MAXIMIZE
CARE.—The Secretary of Defense may, in providing
medical and dental care to a member or former mem-
ber under this subsection during the period referred to
in paragraph (2), waive any limitation otherwise ap-
plicable under chapter 55 of title 10, United States
Code, to the provision of such care to the member or
former member if the Secretary considers the waiver
appropriate to assure the maximum feasible recovery
and rehabilitation of the member or former member.
(5) CONSTRUCTION WITH ELIGIBILITY FOR VET-
ERANS BENEFITS.—Nothing in this subsection shall be
construed to reduce, alter, or otherwise affect the eligi-
bility or entitlement of a member or former member
of the Armed Forces to any health care, disability, or
other benefits to which the member of former member
would otherwise be eligible or entitled as a veteran
under the laws administered by the Secretary of Vet-
erans Affairs.
(6) SUNSET.—The Secretary of Defense may not
provide medical or dental care to a member or former
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member of the Armed Forces under this subsection
after December 31, 2012, if the Secretary has not pro-
vided medical or dental care to the member or former
member under this subsection before that date.
(b) REHABILITATION AND VOCATIONAL BENEFITS.—
(1) IN GENERAL.—Effective as of the date of the
enactment of this Act, a member of the Armed Forces
with a severe injury or illness is entitled to such bene-
fits (including rehabilitation and vocational benefits,
but not including compensation) from the Secretary
of Veterans Affairs to facilitate the recovery and reha-
bilitation of such member as the Secretary otherwise
provides to members of the Armed Forces receiving
medical care in medical facilities of the Department
of Veterans Affairs facilities in order to facilitate the
recovery and rehabilitation of such members.
(2) LIMITATIONS.—The provisions of paragraphs
(2) through (6) of subsection (a) shall apply to the
provision of benefits under this subsection as if the
benefits provided under this subsection were provided
under subsection (a).
(3) REIMBURSEMENT.—The Secretary of Defense
shall reimburse the Secretary of Veterans Affairs for
the cost of any benefits provided under this subsection
in accordance with applicable mechanisms for the re-
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imbursement of the Secretary of Veterans Affairs for
the provision of medical care to members of the
Armed Forces.
(c) RECOVERY OF CERTAIN EXPENSES OF MEDICAL
CARE AND RELATED TRAVEL.—
(1) IN GENERAL.—Commencing not later than
60 days after the date of the enactment of this Act,
the Secretary of the military department concerned
may reimburse covered members of the Armed Forces,
and former members of the Armed Forces, with a se-
vere injury or illness for covered expenses incurred by
such members or former members, or their family
members, in connection with the receipt by such mem-
bers or former members of medical care that is re-
quired for such injury or illness.
(2) COVERED
EXPENSES.—Expenses for which
reimbursement may be made under paragraph (1) in-
clude the following:
(A) Expenses for health care services for
which coverage would be provided under section
1074(c) of title 10, United States Code, for mem-
bers of the uniformed services on active duty.
(B) Expenses of travel of a non-medical at-
tendant who accompanies a member or former
member of the Armed Forces for required med-
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ical care that is not available to such member or
former member locally, if such attendant is ap-
pointed for that purpose by a competent medical
authority (as determined under regulations pre-
scribed by the Secretary of Defense for purposes
of this subsection).
(C) Such other expenses for medical care as
the Secretary may prescribe for purposes of this
subsection.
(3) AMOUNT OF REIMBURSEMENT.—The amount
of reimbursement under paragraph (1) for expenses
covered by paragraph (2) shall be determined in ac-
cordance with regulations prescribed by the Secretary
of Defense for purposes of this subsection.
(d) SEVERE INJURY OR ILLNESS DEFINED.—In this
section, the term ‘‘severe injury or illness’’ means any seri-
ous injury or illness that is assigned a disability rating
of 30 percent or higher under the schedule for rating disabil-
ities in use by the Department of Defense.
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SEC. 122. REIMBURSEMENT OF CERTAIN FORMER MEMBERS
OF THE UNIFORMED SERVICES WITH SERV-
ICE-CONNECTED DISABILITIES FOR TRAVEL
FOR FOLLOW-ON SPECIALTY CARE AND RE-
LATED SERVICES.
(a) TRAVEL.—Section 1074i 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 subsection (b):
‘‘(b) FOLLOW-ON SPECIALTY CARE
AND RELATED
SERVICES.—In any case in which a former member of a
uniformed service who incurred a disability while on active
duty in a combat zone or during performance of duty in
combat related operations (as designated by the Secretary
of Defense), and is entitled to retired or retainer pay, or
equivalent pay, requires follow-on specialty care, services,
or supplies related to such disability at a specific military
treatment facility more than 100 miles from the location
in which the former member resides, the Secretary shall pro-
vide reimbursement for reasonable travel expenses com-
parable to those provided under subsection (a) for the
former member, and when accompaniment by an adult is
determined by competent medical authority to be necessary,
for a spouse, parent, or guardian of the former member,
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or another member of the former member’s family who is
at least 21 years of age.’’.
(b) EFFECTIVE DATE.—The amendments made by sub-
section (a) shall take effect January 1, 2008, and shall
apply with respect to travel that occurs on or after that
date.
PART II—CARE AND SERVICES FOR DEPENDENTS
SEC. 126. MEDICAL CARE AND SERVICES AND SUPPORT
SERVICES FOR FAMILIES OF MEMBERS OF
THE ARMED FORCES RECOVERING FROM SE-
RIOUS INJURIES OR ILLNESSES.
(a) MEDICAL CARE.—
(1) IN GENERAL.—A family member of a covered
member of the Armed Forces who is not otherwise eli-
gible for medical care at a military medical treat-
ment facility or at medical facilities of the Depart-
ment of Veterans Affairs shall be eligible for such care
at such facilities, on a space-available basis, if the
family member is—
(A) on invitational orders while caring for
the covered member of the Armed Forces;
(B) a non-medical attendee caring for the
covered member of the Armed Forces; or
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(C) receiving per diem payments from the
Department of Defense while caring for the cov-
ered member of the Armed Forces.
(2) SPECIFICATION OF FAMILY MEMBERS.—Not-
withstanding section 101(3), the Secretary of Defense
and the Secretary of Veterans Affairs shall jointly
prescribe in regulations the family members of cov-
ered members of the Armed Forces who shall be con-
sidered to be a family member of a covered member
of the Armed Forces for purposes of paragraph (1).
(3) SPECIFICATION OF CARE.—(A) The Secretary
of Defense shall prescribe in regulations the medical
care and counseling that shall be available to family
members under paragraph (1) at military medical
treatment facilities.
(B) The Secretary of Veterans Affairs shall pre-
scribe in regulations the medical care and counseling
that shall be available to family members under para-
graph (1) at medical facilities of the Department of
Veterans Affairs.
(4) RECOVERY
OF
COSTS.—The United States
may recover the costs of the provision of medical care
and counseling under paragraph (1) as follows (as
applicable):
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(A) From third-party payers, in the same
manner as the United States may collect costs of
the charges of health care provided to covered
beneficiaries from third-party payers under sec-
tion 1095 of title 10, United States Code.
(B) As if such care and counseling was pro-
vided under the authority of section 1784 of title
38, United States Code.
(b) JOB PLACEMENT SERVICES.—A family member
who is on invitational orders or is a non-medical attendee
while caring for a covered member of the Armed Forces for
more than 45 days during a one-year period shall be eligible
for job placement services otherwise offered by the Depart-
ment of Defense.
(c) REPORT ON NEED FOR ADDITIONAL SERVICES.—
Not later than 90 days after the date of the enactment of
this Act, the Secretary of Defense shall submit to the con-
gressional defense committees a report setting forth the as-
sessment of the Secretary of the need for additional employ-
ment services, and of the need for employment protection,
of family members described in subsection (b) who are
placed on leave from employment or otherwise displaced
from employment while caring for a covered member of the
Armed Forces as described in that subsection.
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SEC. 127. EXTENDED BENEFITS UNDER TRICARE FOR PRI-
MARY CAREGIVERS OF MEMBERS OF THE UNI-
FORMED SERVICES WHO INCUR A SERIOUS
INJURY OR ILLNESS ON ACTIVE DUTY.
(a) IN GENERAL.—Section 1079(d) of title 10, United
States Code, is amended—
(1) by redesignating paragraphs (2) and (3) as
paragraphs (3) and (4), respectively; and
(2) by inserting after paragraph (1) the fol-
lowing new paragraph (2):
‘‘(2)(A) Subject to such terms, conditions, and excep-
tions as the Secretary of Defense considers appropriate, the
program of extended benefits for eligible dependents under
this subsection shall include extended benefits for the pri-
mary caregivers of members of the uniformed services who
incur a serious injury or illness on active duty.
‘‘(B) The Secretary of Defense shall prescribe in regu-
lations the individuals who shall be treated as the primary
caregivers of a member of the uniformed services for pur-
poses of this paragraph.
‘‘(C) For purposes of this section, a serious injury or
illness, with respect to a member of the uniformed services,
is an injury or illness that may render the member medi-
cally unfit to perform the duties of the member’s office,
grade, rank, or rating and that renders a member of the
uniformed services dependant upon a caregiver.’’.
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(b) EFFECTIVE DATE.—The amendments made by sub-
section (a) shall take effect on January 1, 2008.
PART III—TRAUMATIC BRAIN INJURY AND POST-
TRAUMATIC STRESS DISORDER
SEC. 131. COMPREHENSIVE PLANS ON PREVENTION, DIAG-
NOSIS, MITIGATION, AND TREATMENT OF
TRAUMATIC BRAIN INJURY AND POST-TRAU-
MATIC STRESS DISORDER IN MEMBERS OF
THE ARMED FORCES.
(a) PLANS REQUIRED.—Not later than 180 days after
the date of the enactment of this Act, the Secretary of De-
fense shall, in consultation with the Secretary of Veterans
Affairs, submit to the congressional defense committees one
or more comprehensive plans for programs and activities
of the Department of Defense to prevent, diagnose, mitigate,
treat, and otherwise respond to traumatic brain injury
(TBI) and post-traumatic stress disorder (PTSD) in mem-
bers of the Armed Forces.
(b) ELEMENTS.—Each plan submitted under sub-
section (a) shall include comprehensive proposals of the De-
partment on the following:
(1) The designation by the Secretary of Defense
of a lead agent or executive agent for the Department
to coordinate development and implementation of the
plan.
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(2) The improvement of personnel protective
equipment for members of the Armed Forces in order
to prevent traumatic brain injury.
(3) The improvement of methods and mecha-
nisms for the detection and treatment of traumatic
brain injury and post-traumatic stress disorder in
members of the Armed Forces in the field.
(4) The requirements for research on traumatic
brain injury and post-traumatic stress disorder, in-
cluding (in particular) research on pharmacological
approaches to treatment for traumatic brain injury
or post-traumatic stress disorder, as applicable, and
the allocation of priorities among such research.
(5) The development, adoption, and deployment
of diagnostic criteria for the detection and evaluation
of the range of traumatic brain injury and post-trau-
matic stress disorder in members of the Armed Forces,
which criteria shall be employed uniformly across the
military departments in all applicable circumstances,
including provision of clinical care and assessment of
future deployability of members of the Armed Forces.
(6) The development and deployment of effective
means of assessing traumatic brain injury and post-
traumatic stress disorder in members of the Armed
Forces, including a system of pre-deployment and
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post-deployment screenings of cognitive ability in
members for the detection of cognitive impairment, as
required by the amendments made by section 132.
(7) The development and deployment of effective
means of managing and monitoring members of the
Armed Forces with traumatic brain injury or post-
traumatic stress disorder in the receipt of care for
traumatic brain injury or post-traumatic stress dis-
order, as applicable, including the monitoring and as-
sessment of treatment and outcomes.
(8) The development and deployment of an edu-
cation and awareness training initiative designed to
reduce the negative stigma associated with traumatic
brain injury, post-traumatic stress disorder, and
mental health treatment.
(9) The provision of education and outreach to
families of members of the Armed Forces with trau-
matic brain injury or post-traumatic stress disorder
on a range of matters relating to traumatic brain in-
jury or post-traumatic stress disorder, as applicable,
including detection, mitigation, and treatment.
(10) The assessment of the current capabilities of
the Department for the prevention, diagnosis, mitiga-
tion, treatment, and rehabilitation of traumatic brain
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injury and post-traumatic stress disorder in members
of the Armed Forces.
(11) The identification of gaps in current capa-
bilities of the Department for the prevention, diag-
nosis, mitigation, treatment, and rehabilitation of
traumatic brain injury and post-traumatic stress dis-
order in members of the Armed Forces.
(12) The identification of the resources required
for the Department in fiscal years 2009 thru 2013 to
address the gaps in capabilities identified under
paragraph (11).
(13) The development of joint planning among
the Department of Defense, the military departments,
and the Department of Veterans Affairs for the pre-
vention, diagnosis, mitigation, treatment, and reha-
bilitation of traumatic brain injury and post-trau-
matic stress disorder in members of the Armed Forces,
including planning for the seamless transition of such
members from care through the Department of Defense
care through the Department of Veterans Affairs.
(14) A requirement that exposure to a blast or
blasts be recorded in the records of members of the
Armed Forces.
(15) The development of clinical practice guide-
lines for the diagnosis and treatment of blast injuries
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in members of the Armed Forces, including, but not
limited to, traumatic brain injury.
(16) A program under which each member of the
Armed Forces who incurs a traumatic brain injury
or post-traumatic stress disorder during service in the
Armed Forces—
(A) is enrolled in the program; and
(B) receives, under the program, treatment
and rehabilitation meeting a standard of care
such that each individual who is a member of the
Armed Forces who qualifies for care under the
program shall—
(i) be provided the highest quality of
care possible based on the medical judgment
of qualified medical professionals in facili-
ties that most appropriately meet the spe-
cific needs of the individual; and
(ii) be rehabilitated to the fullest extent
possible using the most up-to-date medical
technology, medical rehabilitation practices,
and medical expertise available.
(17) A requirement that if a member of the
Armed Forces participating in a program established
in accordance with paragraph (16) believes that care
provided to such participant does not meet the stand-
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ard of care specified in subparagraph (B) of such
paragraph, the Secretary of Defense shall, upon re-
quest of the participant, provide to such participant
a referral to another Department of Defense or De-
partment of Veterans Affairs provider of medical or
rehabilitative care for a second opinion regarding the
care that would meet the standard of care specified in
such subparagraph.
(18) The provision of information by the Sec-
retary of Defense to members of the Armed Forces
with traumatic brain injury or post-traumatic stress
disorder and their families about their rights with re-
spect to the following:
(A) The receipt of medical and mental
health care from the Department of Defense and
the Department of Veterans Affairs.
(B) The options available to such members
for treatment of traumatic brain injury and
post-traumatic stress disorder.
(C) The options available to such members
for rehabilitation.
(D) The options available to such members
for a referral to a public or private provider of
medical or rehabilitative care.
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(E) The right to administrative review of
any decision with respect to the provision of care
by the Department of Defense for such members.
(c) COORDINATION
IN DEVELOPMENT.—Each plan
submitted under subsection (a) shall be developed in coordi-
nation with the Secretary of the Army (who was designated
by the Secretary of Defense as executive agent for the pre-
vention, mitigation, and treatment of blast injuries under
section 256 of the National Defense Authorization Act for
Fiscal Year 2006 (Public Law 109–163; 119 Stat. 3181;
10 U.S.C. 1071 note)).
(d) ADDITIONAL ACTIVITIES.—In carrying out pro-
grams and activities for the prevention, diagnosis, mitiga-
tion, and treatment of traumatic brain injury and post-
traumatic stress disorder in members of the Armed Forces,
the Secretary of Defense shall—
(1) examine the results of the recently completed
Phase 2 study, funded by the National Institutes of
Health, on the use of progesterone for acute traumatic
brain injury;
(2) determine if Department of Defense funding
for a Phase 3 clinical trial on the use of progesterone
for acute traumatic brain injury, or for further re-
search regarding the use of progesterone or its metabo-
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lites for treatment of traumatic brain injury, is war-
ranted; and
(3) provide for the collaboration of the Depart-
ment of Defense, as appropriate, in clinical trials and
research on pharmacological approaches to treatment
for traumatic brain injury and post-traumatic stress
disorder that is conducted by other departments and
agencies of the Federal Government.
SEC. 132. IMPROVEMENT OF MEDICAL TRACKING SYSTEM
FOR MEMBERS OF THE ARMED FORCES DE-
PLOYED OVERSEAS.
(a) PROTOCOL FOR ASSESSMENT OF COGNITIVE FUNC-
TIONING.—
(1) PROTOCOL
REQUIRED.—Subsection (b) of
section 1074f of title 10, United States Code, is
amended—
(A) in paragraph (2), by adding at the end
the following new subparagraph:
‘‘(C) An assessment of post-traumatic stress dis-
order.’’; and
(B) by adding at the end the following new
paragraph:
‘‘(3)(A) The Secretary shall establish for purposes of
subparagraphs (B) and (C) of paragraph (2) a protocol for
the predeployment assessment and documentation of the
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cognitive (including memory) functioning of a member who
is deployed outside the United States in order to facilitate
the assessment of the postdeployment cognitive (including
memory) functioning of the member.
‘‘(B) The protocol under subparagraph (A) shall in-
clude appropriate mechanisms to permit the differential di-
agnosis of traumatic brain injury in members returning
from deployment in a combat zone.’’.
(2) PILOT
PROJECTS.—(A) In developing the
protocol required by paragraph (3) of section 1074f(b)
of title 10, United States Code (as amended by para-
graph (1) of this subsection), for purposes of assess-
ments for traumatic brain injury, the Secretary of
Defense shall conduct up to three pilot projects to
evaluate various mechanisms for use in the protocol
for such purposes. One of the mechanisms to be so
evaluated shall be a computer-based assessment tool.
(B) Not later than 60 days after the completion
of the pilot projects conducted under this paragraph,
the Secretary shall submit to the appropriate commit-
tees of Congress a report on the pilot projects. The re-
port shall include—
(i) a description of the pilot projects so con-
ducted;
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(ii) an assessment of the results of each such
pilot project; and
(iii) a description of any mechanisms eval-
uated under each such pilot project that will in-
corporated into the protocol.
(C) Not later than 180 days after completion of
the pilot projects conducted under this paragraph, the
Secretary shall establish a mechanism for imple-
menting any mechanism evaluated under such a pilot
project that is selected for incorporation in the pro-
tocol.
(D) There is hereby authorized to be appro-
priated to the Department of Defense, $3,000,000 for
the pilot projects authorized by this paragraph. Of the
amount so authorized to be appropriated, not more
than $1,000,000 shall be available for any particular
pilot project.
(b) QUALITY ASSURANCE.—Subsection (d)(2) of sec-
tion 1074f of title 10, United States Code, is amended by
adding at the end the following new subparagraph:
‘‘(F) The diagnosis and treatment of traumatic
brain injury and post-traumatic stress disorder.’’.
(c) STANDARDS FOR DEPLOYMENT.—Subsection (f) of
such section is amended—
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(1) in the subsection heading, by striking ‘‘MEN-
TAL HEALTH’’; and
(2) in paragraph (2)(B), by striking ‘‘or’’ and
inserting ‘‘, traumatic brain injury, or’’.
SEC. 133. CENTERS OF EXCELLENCE IN THE PREVENTION,
DIAGNOSIS, MITIGATION, TREATMENT, AND
REHABILITATION OF TRAUMATIC BRAIN IN-
JURY AND POST-TRAUMATIC STRESS DIS-
ORDER.
(a) CENTER OF EXCELLENCE ON TRAUMATIC BRAIN
INJURY.—Chapter 55 of title 10, United States Code, is
amended by inserting after section 1105 the following new
section:
‘‘§ 1105a. Center of Excellence in Prevention, Diag-
nosis, Mitigation, Treatment, and Reha-
bilitation of Traumatic Brain Injury
‘‘(a) IN GENERAL.—The Secretary of Defense shall es-
tablish within the Department of Defense a center of excel-
lence in the prevention, diagnosis, mitigation, treatment,
and rehabilitation of traumatic brain injury (TBI), includ-
ing mild, moderate, and severe traumatic brain injury, to
carry out the responsibilities specified in subsection (c). The
center shall be known as a ‘Center of Excellence in Preven-
tion, Diagnosis, Mitigation, Treatment, and Rehabilitation
of Traumatic Brain Injury’.
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‘‘(b) PARTNERSHIPS.—The Secretary shall ensure that
the Center collaborates to the maximum extent practicable
with the Department of Veterans Affairs, institutions of
higher education, and other appropriate public and private
entities (including international entities) to carry out the
responsibilities specified in subsection (c).
‘‘(c) RESPONSIBILITIES.—The Center shall have re-
sponsibilities as follows:
‘‘(1) To direct and oversee, based on expert re-
search, the development and implementation of a
long-term, comprehensive plan and strategy for the
Department of Defense for the prevention, diagnosis,
mitigation, treatment, and rehabilitation of trau-
matic brain injury.
‘‘(2) To provide for the development, testing, and
dissemination within the Department of best practices
for the treatment of traumatic brain injury.
‘‘(3) To provide guidance for the mental health
system of the Department in determining the mental
health and neurological health personnel required to
provide quality mental health care for members of the
armed forces with traumatic brain injury.
‘‘(4) To establish, implement, and oversee a com-
prehensive program to train mental health and neuro-
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logical health professionals of the Department in the
treatment of traumatic brain injury.
‘‘(5) To facilitate advancements in the study of
the short-term and long-term psychological effects of
traumatic brain injury.
‘‘(6) To disseminate within the military medical
treatment facilities of the Department best practices
for training mental health professionals, including
neurological health professionals, with respect to trau-
matic brain injury.
‘‘(7) To conduct basic science and translational
research on traumatic brain injury for the purposes
of understanding the etiology of traumatic brain in-
jury and developing preventive interventions and new
treatments.
‘‘(8) To develop outreach strategies and treat-
ments for families of members of the armed forces
with traumatic brain injury in order to mitigate the
negative impacts of traumatic brain injury on such
family members and to support the recovery of such
members from traumatic brain injury.
‘‘(9) To conduct research on the unique mental
health needs of women members of the armed forces
with traumatic brain injury and develop treatments
to meet any needs identified through such research.
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‘‘(10) To conduct research on the unique mental
health needs of ethnic minority members of the armed
forces with traumatic brain injury and develop treat-
ments to meet any needs identified through such re-
search.
‘‘(11) To conduct research on the mental health
needs of families of members of the armed forces with
traumatic brain injury and develop treatments to
meet any needs identified through such research.
‘‘(12) To conduct longitudinal studies (using im-
aging technology and other proven research methods)
on members of the armed forces with traumatic brain
injury to identify early signs of Alzheimer’s disease,
Parkinson’s disease, or other manifestations of
neurodegeneration in such members, which studies
should be conducted in coordination with the studies
authorized by section 721 of the John Warner Na-
tional Defense Authorization Act for Fiscal Year 2007
(Public Law 109–364; 120 Stat. 2294) and other
studies of the Department of Defense and the Depart-
ment of Veterans Affairs that address the connection
between exposure to combat and the development of
Alzheimer’s disease, Parkinson’s disease, and other
neurodegenerative disorders.
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‘‘(13) To develop and oversee a long-term plan to
increase the number of mental health and neurological
health professionals within the Department in order
to facilitate the meeting by the Department of the
needs of members of the armed forces with traumatic
brain injury until their transition to care and treat-
ment from the Department of Veterans Affairs.
‘‘(14) To develop a program on comprehensive
pain management, including management of acute
and chronic pain, to utilize current and develop new
treatments for pain, and to identify and disseminate
best practices on pain management.
‘‘(15) Such other responsibilities as the Secretary
shall specify.’’.
(b) CENTER OF EXCELLENCE ON POST-TRAUMATIC
STRESS DISORDER.—Chapter 55 of such title is further
amended by inserting after section 1105a, as added by sub-
section (a), the following new section:
‘‘§ 1105b. Center of Excellence in Prevention, Diag-
nosis, Mitigation, Treatment, and Reha-
bilitation of Post-Traumatic Stress Dis-
order
‘‘(a) IN GENERAL.—The Secretary of Defense shall es-
tablish within the Department of Defense a center of excel-
lence in the prevention, diagnosis, mitigation, treatment,
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and rehabilitation of post-traumatic stress disorder
(PTSD), including mild, moderate, and severe post-trau-
matic stress disorder, to carry out the responsibilities speci-
fied in subsection (c). The center shall be known as a ‘Center
of Excellence in Prevention, Diagnosis, Mitigation, Treat-
ment, and Rehabilitation of Post-Traumatic Stress Dis-
order’.
‘‘(b) PARTNERSHIPS.—The Secretary shall ensure that
the Center collaborates to the maximum extent practicable
with the National Center for Post-Traumatic Stress Dis-
order of the Department of Veterans Affairs, institutions of
higher education, and other appropriate public and private
entities (including international entities) to carry out the
responsibilities specified in subsection (c).
‘‘(c) RESPONSIBILITIES.—The Center shall have re-
sponsibilities as follows:
‘‘(1) To direct and oversee, based on expert re-
search, the development and implementation of a
long-term, comprehensive plan and strategy for the
Department of Defense for the prevention, diagnosis,
mitigation, treatment, and rehabilitation of post-
traumatic stress disorder.
‘‘(2) To provide for the development, testing, and
dissemination within the Department of best practices
for the treatment of post-traumatic stress disorder.
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‘‘(3) To provide guidance for the mental health
system of the Department in determining the mental
health and neurological health personnel required to
provide quality mental health care for members of the
armed forces with post-traumatic stress disorder.
‘‘(4) To establish, implement, and oversee a com-
prehensive program to train mental health and neuro-
logical health professionals of the Department in the
treatment of post-traumatic stress disorder.
‘‘(5) To facilitate advancements in the study of
the short-term and long-term psychological effects of
post-traumatic stress disorder.
‘‘(6) To disseminate within the military medical
treatment facilities of the Department best practices
for training mental health professionals, including
neurological health professionals, with respect to post-
traumatic stress disorder.
‘‘(7) To conduct basic science and translational
research on post-traumatic stress disorder for the pur-
poses of understanding the etiology of post-traumatic
stress disorder and developing preventive interven-
tions and new treatments.
‘‘(8) To develop outreach strategies and treat-
ments for families of members of the armed forces
with post-traumatic stress disorder in order to miti-