690 
SEC. 709. INDEPENDENT ANALYSIS OF QUALITY AND PA-
TIENT SAFETY REVIEW PROCESS UNDER DI-
RECT CARE COMPONENT OF TRICARE PRO-
GRAM. 
(a) AGREEMENT.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall seek to enter into an agreement with the Na-
tional Academies of Sciences, Engineering, and Med-
icine (in this section referred to as the ‘‘National 
Academies’’) for the National Academies to carry 
out the activities described in subsections (b) and 
(c). 
(2) TIMING.—The Secretary shall seek to enter 
into the agreement described in paragraph (1) not 
later than 60 days after the date of the enactment 
of this Act. 
(b) ANALYSIS BY THE NATIONAL ACADEMIES.— 
(1) ANALYSIS.—Under an agreement between 
the Secretary and the National Academies entered 
into pursuant to subsection (a), the National Acad-
emies shall conduct an analysis of the quality and 
patient safety review process for health care pro-
vided under the direct care component of the 
TRICARE program and develop recommendations 
for the Secretary based on such analysis.
691 
(2) ELEMENTS.—The analysis conducted and 
recommendations developed under paragraph (1) 
shall include, with respect to the direct care compo-
nent, the following: 
(A) An assessment of the procedures under 
such component regarding credentialing and 
privileging for health care providers (and an as-
sessment of compliance with such procedures). 
(B) An assessment of the processes under 
such component for quality assurance, standard 
of care, and incident review (and an assessment 
of compliance with such processes). 
(C) An assessment of the accountability 
processes under such component for health care 
providers who are found to have not met a re-
quired standard of care. 
(3) INFORMATION ACCESS AND PRIVACY.— 
(A) 
ACCESS
TO
RECORDS.—Notwith-
standing section 1102 of title 10, United States 
Code, the Secretary shall provide the National 
Academies with access to such records of the 
Department of Defense as the Secretary may 
determine necessary for purposes of the Na-
tional Academies conducting the analysis and
692 
developing the recommendations under para-
graph (1). 
(B) PRIVACY OF INFORMATION.—In con-
ducting the analysis and developing the rec-
ommendations under paragraph (1), the Na-
tional Academies— 
(i) shall maintain any personally iden-
tifiable information in records accessed by 
the National Academies pursuant to sub-
paragraph (A) in accordance with applica-
ble laws, protections, and best practices re-
garding the privacy of information; and 
(ii) may not permit access to such in-
formation by any individual or entity not 
engaged in conducting such analysis or de-
veloping such recommendations. 
(c) REPORT.—Under an agreement entered into be-
tween the Secretary and the National Academies under 
subsection (a), the National Academies, not later than one 
year after the date of the execution of the agreement, 
shall— 
(1) submit to the congressional defense commit-
tees and (with respect to any findings concerning the 
Coast Guard when it is not operating as a service 
in the Department of the Navy) the Committee on
693 
Transportation and Infrastructure of the House of 
Representatives and the Committee on Commerce, 
Science, and Transportation of the Senate a report 
on the findings of the National Academies with re-
spect to the analysis conducted and recommenda-
tions developed under subsection (b); and 
(2) make such report available on a public 
website in unclassified form. 
(d) TRICARE PROGRAM DEFINED.—In this section, 
the term ‘‘TRICARE program’’ has the meaning given 
such term in section 1072 of title 10, United States Code. 
Subtitle B—Health Care 
Administration 
SEC. 721. CONGRESSIONAL NOTIFICATION REQUIREMENT 
TO MODIFY SCOPE OF SERVICES PROVIDED 
AT MILITARY MEDICAL TREATMENT FACILI-
TIES. 
Section 1073c(a) of title 10, United States Code, is 
amended by adding at the end the following new para-
graph: 
‘‘(7)(A) The Secretary of Defense may not modify the 
scope of medical care provided at a military medical treat-
ment facility pursuant to paragraph (2)(C) (including by 
modifying the staff, types of services available, or bene-
ficiary population served, at the facility), unless—
694 
‘‘(i) the Secretary submits to the Committees 
on Armed Services of the House of Representatives 
and the Senate a notification of the proposed modi-
fication in scope; 
‘‘(ii) a period of 180 days has elapsed following 
the date on which the Secretary submits such notifi-
cation; and 
‘‘(iii) if the proposed modification in scope in-
volves the termination or reduction of inpatient ca-
pabilities at a military medical treatment facility lo-
cated outside the United States, the Secretary has 
provided to each member of the armed forces or cov-
ered beneficiary receiving services at such facility a 
transition plan for the continuity of health care for 
such member or covered beneficiary and an oppor-
tunity to participate in at least two public forums 
convened by the Secretary, to discuss the transition 
plan and any related concerns. 
‘‘(B) Each notification under subparagraph (A) shall 
contain information demonstrating, with respect to the 
military medical treatment facility for which the modifica-
tion in scope has been proposed, the extent to which the 
commander of the military installation at which the facil-
ity is located has been consulted regarding such modifica-
tion, to ensure that the proposed modification in scope
695 
would have no impact on the operational plan for such 
installation.’’. 
SEC. 722. MODIFICATION OF CERTAIN DEADLINE AND RE-
QUIREMENT TO TRANSFER RESEARCH AND 
DEVELOPMENT 
FUNCTIONS 
TO 
DEFENSE 
HEALTH AGENCY. 
Section 1073c of title 10, United States Code, is 
amended— 
(1) in subsection (e)— 
(A) in the matter preceding paragraph (1), 
by striking ‘‘September 30, 2022’’ and inserting 
‘‘September 30, 2023’’; and 
(B) in paragraph (1)(B), by striking ‘‘the 
Army Medical Research and Materiel Com-
mand’’ and inserting ‘‘such elements and func-
tions of the Army Medical Research and Mate-
riel Command as the Secretary determines ap-
propriate’’; 
(2) by redesignating subsections (g) and (h) as 
subsections (h) and (i); and 
(3) by inserting after subsection (f) the fol-
lowing new subsection: 
‘‘(g) REPORT REQUIREMENT.—The Secretary of De-
fense may not take any action to exclude an element or 
function of the Army Medical Research and Materiel Com-
696 
mand from organization under or transfer to the Defense 
Health Agency Research and Development pursuant to a 
determination referred to in subsection (e)(1)(B) unless— 
‘‘(1) the Secretary submits to the Committees 
on Armed Services of the House of Representatives 
and the Senate a report containing an explanation of 
the determination and a plan for the proposed exclu-
sion; and 
‘‘(2) a period of 90 days has elapsed following 
the date on which the Secretary submits such re-
port.’’. 
SEC. 723. MODIFICATION OF REQUIREMENT TO TRANSFER 
PUBLIC HEALTH FUNCTIONS TO DEFENSE 
HEALTH AGENCY. 
Section 1073c(e)(2) of title 10, United States Code, 
is amended— 
(1) in the matter preceding subparagraph (A), 
by striking ‘‘A subordinate’’ and inserting ‘‘(A) A 
subordinate’’; 
(2) by redesignating subparagraphs (A) and 
(B) as clauses (i) and (ii); 
(3) in clause (ii), as so redesignated— 
(A) by striking ‘‘comprised of’’ and insert-
ing ‘‘except as provided in subparagraph (B), 
comprised of’’; and
698 
mination and a plan for the proposed retention; 
and 
‘‘(ii) a period of 90 days has elapsed fol-
lowing the date on which the Secretary submits 
such report.’’. 
SEC. 724. OTHER TRANSACTION AUTHORITY FOR STUDIES 
AND DEMONSTRATION PROJECTS RELATING 
TO DELIVERY OF HEALTH AND MEDICAL 
CARE. 
Section 1092(b) of title 10, United States Code, is 
amended by inserting ‘‘or transactions (other than con-
tracts, cooperative agreements, and grants)’’ after ‘‘con-
tracts’’. 
SEC. 
725. 
LICENSURE 
REQUIREMENT 
FOR 
CERTAIN 
HEALTH-CARE PROFESSIONALS PROVIDING 
SERVICES AS PART OF MISSION RELATING TO 
EMERGENCY, HUMANITARIAN, OR REFUGEE 
ASSISTANCE. 
Section 1094(d)(2) of title 10, United States Code, 
is amended by inserting ‘‘ contractor not covered under 
section 1091 of this title who is providing medical treat-
ment as part of a mission relating to emergency, humani-
tarian, or refugee assistance,’’ after ‘‘section 1091 of this 
title,’’.
699 
SEC. 726. IMPROVEMENTS RELATING TO MEDICAL OFFICER 
OF THE MARINE CORPS POSITION. 
(a) IN GENERAL.—Chapter 806 of title 10, United 
States Code, is amended by adding at the end the fol-
lowing new section (and conforming the table of sections 
at the beginning of such chapter accordingly): 
‘‘§ 8048. Medical Officer of the Marine Corps 
‘‘(a) There is a Medical Officer of the Marine Corps 
who shall be appointed from among flag officers of the 
Navy. 
‘‘(b) The Medical Officer of the Marine Corps, while 
so serving, shall hold the grade of rear admiral (lower 
half).’’. 
(b) EXCLUSION FROM CERTAIN DISTRIBUTION LIMI-
TATIONS.—Section 525 of such title is amended— 
(1) by redesignating subsection (g) as sub-
section (h); and 
(2) by inserting after subsection (f) the fol-
lowing new subsection: 
‘‘(g) A naval officer while serving as the Medical Offi-
cer of the Marine Corps is in addition to the number that 
would otherwise be permitted for the Navy for officers 
serving on active duty in the grade of rear admiral (lower 
half) under subsection (a).’’.
700 
(c) EXCLUSION FROM ACTIVE DUTY STRENGTH LIM-
ITATIONS PRIOR TO DECEMBER 31, 2022.—Section 526 
of such title is amended— 
(1) by redesignating subsection (k) as sub-
section (l); and 
(2) by inserting after subsection (j) the fol-
lowing new subsection: 
‘‘(k) EXCLUSION OF MEDICAL OFFICER OF MARINE 
CORPS.—The limitations of this section do not apply to 
the flag officer who is serving as the Medical Officer of 
the Marine Corps.’’. 
(d) EXCLUSION FROM ACTIVE DUTY STRENGTH 
LIMITATIONS
AFTER
DECEMBER
31, 2022.—Section 
526a of such title is amended— 
(1) by redesignating subsections (h) through (k) 
as subsections (i) through (l), respectively; and 
(2) by inserting after subsection (g) the fol-
lowing new subsection: 
‘‘(h) EXCLUSION OF MEDICAL OFFICER OF MARINE 
CORPS.—The limitations of this section do not apply to 
the flag officer who is serving as the Medical Officer of 
the Marine Corps.’’.
701 
SEC. 727. AUTHORITY FOR DEPARTMENT OF DEFENSE PRO-
GRAM 
TO 
PROMOTE 
EARLY 
LITERACY 
AMONG CERTAIN YOUNG CHILDREN AS PART 
OF PEDIATRIC PRIMARY CARE. 
(a) PROGRAM.—Chapter 55 of title 10, United States 
Code, is amended by inserting after section 1109 the fol-
lowing new section (and conforming the table of sections 
at the beginning of such chapter accordingly): 
‘‘§ 1109A. Authority for program to promote early lit-
eracy among certain young children as 
part of pediatric primary care 
‘‘(a) AUTHORITY.—The Secretary of Defense may 
carry out a program to promote early literacy among 
young children the caregivers of whom are members of the 
armed forces as part of the pediatric primary care of such 
children. 
‘‘(b) ACTIVITIES.—Activities under the program 
under subsection (a) shall be evidence-informed and in-
clude the following: 
‘‘(1) The provision to pediatric primary care 
providers and other appropriate personnel of the De-
partment of training on early literacy promotion. 
‘‘(2) The purchase and distribution of age-ap-
propriate books to covered caregivers. 
‘‘(3) The modification of waiting rooms in mili-
tary medical treatment facilities, including in spe-
702 
cific clinics within such facilities, to ensure such 
waiting rooms include materials that reinforce lan-
guage-rich interactions between young children and 
their covered caregivers, including a full selection of 
literature for young children. 
‘‘(4) The dissemination to covered caregivers of 
education materials on pediatric early literacy. 
‘‘(5) Such other activities as the Secretary de-
termines appropriate. 
‘‘(c) LOCATIONS.—In carrying out the program 
under subsection (a), the Secretary may conduct the ac-
tivities under subsection (b) at any military medical treat-
ment facility. 
‘‘(d) DEFINITIONS.—In this section: 
‘‘(1) The term ‘covered caregiver’ means a 
member of the armed forces who is a caregiver of a 
young child. 
‘‘(2) The term ‘young child’ means any child 
from birth to the age of five years old, inclusive.’’. 
(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 on the 
extent to which the authority under section 1109A(a) of 
title 10, United States Code, (as added by subsection (a))
703 
is used, including a description of any activities carried 
out under the program so authorized. 
(c) RULE OF CONSTRUCTION.—Nothing in this sec-
tion, or the amendments made by this section, shall be 
construed as requiring that a child have more than one 
caregiver as a condition of receiving services under, or oth-
erwise participating in, the program authorized under 
such section 1109A. 
SEC. 728. ACCOUNTABILITY FOR WOUNDED WARRIORS UN-
DERGOING DISABILITY EVALUATION. 
(a) IN GENERAL.—Not later than April 1, 2023, the 
Secretary of Defense, in consultation with the Secretaries 
concerned, shall establish a policy to ensure accountability 
for actions taken under the authorities of the Defense 
Health Agency and the Armed Forces, respectively, con-
cerning wounded, ill, and injured members of the Armed 
Forces during the integrated disability evaluation system 
process. Such policy shall include the following: 
(1) A requirement that a determination of fit-
ness for duty under chapter 61 of title 10, United 
States Code, of a member of the Armed Forces falls 
under the jurisdiction of the Secretary concerned. 
(2) A description of the role of the Director of 
the Defense Health Organization in supporting the
705 
(b) CLARIFICATION OF RESPONSIBILITIES REGARD-
ING MEDICAL EVALUATION BOARDS.—Section 1073c of 
title 10, United States Code, is amended by redesignating 
subsection (h) as subsection (i); and by inserting after 
subsection (g) the following new subsection (h): 
‘‘(h) AUTHORITIES RESERVED TO THE SECRETARIES 
CONCERNED REGARDING THE DISABILITY EVALUATION 
SYSTEM.—Notwithstanding the responsibilities and au-
thorities of the Defense Health Agency with respect to the 
administration of military medical treatment facilities as 
set forth in this section, including medical evaluations of 
members of the armed forces, the Secretary concerned 
shall maintain personnel authority over and responsibility 
for any member of the armed forces while the member 
is being considered by a medical evaluation board. Such 
responsibility shall include the following: 
‘‘(1) Responsibility for administering the morale 
and welfare of the member. 
‘‘(2) Responsibility for determinations of fitness 
for duty of the member under chapter 61 of this 
title.’’. 
(c) BRIEFING.—Not later than February 1, 2023, the 
Secretary of Defense shall provide to the appropriate con-
gressional committees a briefing on the status of the im-
plementation of subsections (a) and (b).
706 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘appropriate congressional com-
mittees’’ means— 
(A) the Committee on Armed Services and 
the Committee on Transportation and Infra-
structure of the House of Representatives; and 
(B) the Committee on Armed Services and 
the Committee on Commerce, Science, and 
Transportation of the Senate. 
(2) The term ‘‘Secretary concerned’’ has the 
meaning given that term in section 101 of title 10, 
United States Code. 
SEC. 729. INCENTIVE PAYMENTS FOR RETENTION OF CER-
TAIN BEHAVIORAL HEALTH PROVIDERS. 
(a) INCENTIVE PAYMENTS
FOR CERTAIN BEHAV-
IORAL HEALTH PROVIDERS.— 
(1) INCENTIVE PAYMENTS.—The Secretary of 
Defense, using authorities available to the Secretary, 
shall increase the use of incentive payments paid to 
individuals described in paragraph (2) for the pur-
pose of retaining such employees. 
(2) ELIGIBLE
RECIPIENTS.—Individuals de-
scribed in this paragraph are covered civilian behav-
ioral health providers in the following professions: 
(A) Clinical psychologists.
707 
(B) Social workers. 
(C) Counselors. 
(3) PRIORITIZATION.—In increasing the use of 
incentive payments under paragraph (1), the Sec-
retary of Defense shall give priority for such an in-
centive payment to an individual described in para-
graph (2) who is stationed at a remote installation 
or an installation with a higher-than-average turn-
over of covered civilian behavioral health providers, 
as determined by the Secretary. 
(4) REPORTS.—Not later than February 1 of 
each of calendar years 2023, 2024, 2025, and 2026, 
the Secretary of Defense shall submit to the con-
gressional defense committees a report that includes 
the following: 
(A) The number of covered civilian behav-
ioral health providers as of the end of the fiscal 
year preceding the year in which the report is 
submitted, disaggregated by the professions 
specified in paragraph (2) and by whether the 
covered civilian behavioral health provider is 
stationed at a remote installation. 
(B) Of such covered civilian behavioral 
health providers, the number who, during such 
preceding fiscal year, received an incentive pay-
708 
ment 
referred 
to 
in 
paragraph 
(1), 
disaggregated by the professions specified in 
paragraph (2) and by whether the covered civil-
ian behavioral health provider is stationed at a 
remote installation. 
(C) With respect to such covered civilian 
behavioral health providers who so received an 
incentive payment, the median and mean incen-
tive payment amount so received, disaggregated 
by the professions specified in paragraph (2) 
and by whether the covered civilian behavioral 
health provider is stationed at a remote instal-
lations. 
(D) For the five fiscal years preceding the 
year in which the report is submitted, the ag-
gregate amount of incentive payments referred 
to in paragraph (1) paid to covered civilian be-
havioral health providers. 
(E) A summary of the actions taken by the 
Secretary to implement the requirements of this 
section. 
(F) An assessment of the effectiveness of 
increasing the use of incentive payments under 
paragraph (1) for improved retention of covered 
civilian behavioral health providers.
709 
(G) Any recommendations by the Secretary 
for additional authorities, or modifications to 
authorities already available to the Secretary, to 
further improve the retention of covered civilian 
behavioral health providers. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘behavioral health’’ includes clin-
ical psychology, social work, counseling, and related 
fields. 
(2) The term ‘‘civilian behavioral health pro-
vider’’ means a behavioral health provider who is a 
civilian employee of the Department of Defense. 
(3) The term ‘‘counselor’’ means an individual 
who holds— 
(A) a master’s or doctoral degree from an 
accredited graduate program in— 
(i) marriage and family therapy; or 
(ii) clinical mental health counseling; 
and 
(B) a current license or certification from 
a State that grants the individual the authority 
to provide counseling services as an independent 
practitioner in the respective field of the indi-
vidual.
710 
(4) The term ‘‘covered civilian behavioral health 
provider’’ means a civilian behavioral health provider 
whose employment by the Secretary of Defense in-
volves the provision of behavioral health services at 
a military medical treatment facility. 
(5) The term ‘‘military installation’’ has the 
meaning given that term in section 2801 of title 10, 
United States Code. 
(6) The term ‘‘remote installation’’ means a 
military installation that the Secretary determines to 
be in a remote location. 
SEC. 730. CLARIFICATION OF LICENSE PORTABILITY FOR 
HEALTH CARE PROVIDERS PROVIDING SERV-
ICES UNDER RESERVE HEALTH READINESS 
PROGRAM. 
For purposes of license portability under paragraph 
(1) of section 1094(d) of title 10, United States Code, a 
health care provider who provides medical or dental serv-
ices under the Reserve Health Readiness program of the 
Department of Defense (or any successor program) and 
meets the requirements specified in subparagraphs (A) 
and (B) of paragraph (2) of such section shall be consid-
ered a health-care professional described in such para-
graph.
711 
SEC. 731. POLICY OF DEFENSE HEALTH AGENCY ON EX-
PANDED RECOGNITION OF BOARD CERTIFI-
CATIONS FOR PHYSICIANS. 
Not later than 180 days after the date of the enact-
ment of this Act, the Director of the Defense Health 
Agency shall revise the policy of the Defense Health Agen-
cy relating to credentialing and privileging under the mili-
tary health system, to expand the recognition of board cer-
tifications for physicians under such policy to a wide range 
of additional board certifications. 
SEC. 732. SLEEP APNEA SCREENING. 
(a) IN GENERAL.—Not later than 90 days after the 
date of the enactment of this Act, the Assistant Secretary 
of Defense for Health Affairs shall provide a plan to the 
congressional defense committees for a pilot program to 
screen for obstructive sleep apnea among persons going 
through the officer accession program. 
(b) PLAN CONTENTS.—This plan required under sub-
section (a) shall include— 
(1) how many individuals will be tested under 
the pilot program; and 
(2) how much the pilot program would cost.
712 
SEC. 733. DEMONSTRATION PROJECT ON INFANT AND 
EARLY CHILDHOOD MENTAL HEALTH SERV-
ICES FOR CHILDREN OF MEMBERS OF THE 
ARMED FORCES. 
(a) ASSESSMENT OF AVAILABILITY OF SERVICES.— 
The Secretary of Defense shall conduct an assessment of 
the availability at military installations (and in the sur-
rounding communities) of covered services at the Federal, 
State, and local level for covered children, for the purpose 
of ensuring access to such services for covered children 
with infant and early childhood mental health needs. Such 
assessment shall address, at a minimum, the following: 
(1) The availability of covered services that ad-
vance social and emotional development for covered 
children, including any relevant certification or en-
dorsement programs for professionals serving as in-
fant and early childhood mental health consultants 
for military child development centers. 
(2) The availability of adequate diagnostic and 
non-medical intervention covered services for covered 
children. 
(3) The availability of supplemental covered 
services for covered children, such as consultation 
services provided by licensed professionals who are 
appropriately certified or endorsed in infant and
713 
early childhood mental health, as determined by the 
Secretary. 
(4) The ease of access to adequate covered edu-
cational or treatment services for covered children, 
as appropriate, such as the average duration of time 
spent on waiting lists prior to receiving such serv-
ices. 
(b) REVIEW OF BEST PRACTICES.—In developing the 
assessment under subsection (a), the Secretary of Defense 
shall conduct a review of best practices across the United 
States for the provision of covered services to covered chil-
dren. Such review shall include an assessment of any cov-
ered services of the Federal or State government available 
in each State, with an emphasis on the availability in loca-
tions where members of the Armed Forces with children 
reside. 
(c) DEMONSTRATION PROJECTS.— 
(1) PROJECTS AUTHORIZED.—The Secretary of 
Defense may conduct one or more demonstration 
projects under this subsection to test and evaluate 
various approaches to the provision of covered serv-
ices to covered children, for the purposes of deter-
mining the efficacy of such approaches, reducing in-
cidents of behavioral issues among those with infant 
and early childhood mental health needs, ensuring
714 
the early identification of such needs that may re-
quire non-medical intervention, and such other re-
lated purposes as may be determined appropriate by 
the Secretary. 
(2) PARTICIPANTS.—The Secretary may select 
for participation in the study— 
(A) members of the Armed Forces with 
covered children who elect to so participate; and 
(B) military child development centers that 
are located on or near military installations or 
that otherwise provide services to covered chil-
dren. 
(3) PERSONNEL.—In carrying out a demonstra-
tion project under this subsection, the Secretary of 
Defense may assign personnel who hold a covered 
degree that the Secretary determines appropriate for 
the provision of covered services to act as consult-
ants for the provision of such services to covered 
children who are participants in the demonstration 
project. Under such demonstration project, such as-
signed personnel may— 
(A) develop and monitor promotion and 
prevention, and non-medical intervention, plans 
for such participants;
715 
(B) provide appropriate training in the 
provision of covered services to such partici-
pants; 
(C) provide non-medical counseling services 
to such participants, and any members of the 
Armed Forces who are the caregivers of such 
participants, as appropriate; 
(D) coordinate and collaborate with other 
relevant service providers on the military instal-
lation or in the surrounding community regard-
ing covered services; and 
(E) become endorsed, or work towards be-
coming endorsed, by an organization that pro-
vides licensing or professional certifications rec-
ognized by the Federal or State government for 
infant and early childhood mental health profes-
sionals. 
(4) INFANT AND EARLY CHILDHOOD MENTAL 
HEALTH CONSULTATIONS.— 
(A) CURRICULUM.—As an activity under 
the demonstration project, the Secretary of De-
fense may authorize the development of a com-
prehensive professional development curriculum 
for use in training non-medical counselors in in-
fant and early childhood mental health con-
716 
sultation services, so that such counselors may 
serve as infant early childhood mental health 
consultants for covered children who are partici-
pants in the demonstration project. 
(B) COMPETENCY GUIDELINES.—The cur-
riculum under subparagraph (A) shall be based 
on a set of competency guidelines that are— 
(i) designed to enhance culturally sen-
sitive, relationship-focused practice within 
the framework of infant and early child-
hood mental health; and 
(ii) recognized by an organization 
specified in paragraph (3)(E) for the pur-
poses of certification or endorsement as a 
infant and early childhood mental health 
practitioner. 
(5) CONTRACT AUTHORITY.— 
(A) AUTHORITY.—The Secretary of De-
fense may enter into a contract, or multiple 
contracts, for the conduct of any demonstration 
project under this subsection. 
(B) REQUIREMENT
FOR
SUPERVISORY- 
LEVEL PROVIDERS.—As a term of any contract 
that is entered into pursuant to subparagraph 
(A) for the implementation of special edu-
717 
cational and behavioral intervention plans for 
covered children who are participants in the 
demonstration project, the Secretary shall re-
quire that any such plan be developed, reviewed, 
and maintained by supervisory-level providers 
approved by the Secretary. 
(C) CONTRACTOR
REQUIREMENTS.—The 
Secretary shall establish, and ensure the imple-
mentation of, the following: 
(i) Minimum required criteria for the 
education, training, and experience of any 
contractor furnishing covered services pur-
suant to a contract under subparagraph 
(A). 
(ii) Requirements for the supervision 
and oversight of contractors who are infant 
and early childhood mental health consult-
ants, including requirements for relevant 
credentials for such consultants and the 
frequency and intensity of such super-
vision. 
(iii) Such other requirements as the 
Secretary considers appropriate to ensure 
the safety and protection of covered chil-
718 
dren who are participants in the dem-
onstration project. 
(6) DEADLINE
TO
COMMENCE; MINIMUM
PE-
RIOD.—For each demonstration project conducted 
under this subsection— 
(A) the Secretary shall commence the dem-
onstration project not later than 180 days after 
the date of the enactment of this Act; and 
(B) the demonstration project shall be con-
ducted for a period of not less than two years. 
(7) EVALUATION.— 
(A) REQUIREMENT.—The Secretary of De-
fense shall conduct an evaluation of the out-
comes of each demonstration project conducted 
under this subsection, to determine the efficacy 
of covered services provided under the dem-
onstration project. 
(B) MATTERS.— Each evaluation under 
subparagraph (A) shall include, with respect to 
the relevant demonstration project, an assess-
ment of the extent to which activities under the 
demonstration project contributed to the fol-
lowing: 
(i) Positive outcomes for covered chil-
dren.
719 
(ii) Improvements to the services and 
continuity of care for covered children. 
(iii) Improvements to military family 
readiness and enhanced military retention. 
(d) REPORTS ON DEMONSTRATION PROJECTS.—Not 
later than two years and 180 days after the date of the 
commencement of a demonstration project under sub-
section (c), the Secretary of Defense shall submit to the 
Committees on Armed Services of the House of Represent-
atives and the Senate a report on the demonstration 
project. Such report shall include the following: 
(1) A description of the demonstration project. 
(2) The results of the evaluation under sub-
section (c)(7) with respect to the demonstration 
project. 
(3) A description of plans for the future provi-
sion of covered services, in accordance with the 
model or approach evaluated pursuant to the dem-
onstration project. 
(e) RELATIONSHIP TO OTHER BENEFITS.—Nothing 
in this section shall be construed as precluding a member 
of the Armed Forces, or a dependent of such a member, 
from eligibility for benefits under chapter 55 of title 10, 
United States Code, to which such member or dependent 
would otherwise be eligible.
720 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘child’’ has the meaning given 
that term in section 1072 of title 10, United States 
Code. 
(2) The term ‘‘covered child’’ means the infant, 
toddler, or young child (from birth to age five, inclu-
sive) of a member of the Armed Forces. 
(3) The term ‘‘covered degree’’ means a post-
secondary degree that— 
(A) is awarded by an institution of higher 
of education eligible to participate in programs 
under title IV of the Higher Education Act of 
1965 (20 U.S.C. 1070 et seq.); and 
(B) is in the field of mental health, human 
development, social work, or a related field, as 
determined by the Secretary of Defense. 
(4) The term ‘‘covered educational or treatment 
service’’— 
(A) means a service, including a supportive 
service, that provides quality early childhood 
education by promoting healthy social and emo-
tional development and providing support for 
children experiencing mental health challenges; 
and
721 
(B) includes the conduct of assessments, 
coaching for educators and parents, and refer-
rals to health care professionals with specialties 
in infant and early childhood mental health for 
diagnosis, therapeutic treatment, and early 
intervention. 
(5) The term ‘‘covered service’’ means a covered 
educational and treatment service or any other med-
ical or non-medical service, including consultation 
services, relating to the improvement of infant and 
early childhood mental health in the context of fam-
ily, community, and culture. 
(6) The term ‘‘infant and early childhood men-
tal health’’ means the developing capacity of an in-
fant, toddler, or young child (from birth to age five, 
inclusive), to— 
(A) form close and secure adult and peer 
relationships; 
(B) experience, manage, and express a full 
range of emotions; and 
(C) explore the environment and learn.
722 
SEC. 734. IMPROVEMENTS TO PROCESSES TO REDUCE FI-
NANCIAL HARM CAUSED TO CIVILIANS FOR 
CARE 
PROVIDED 
AT 
MILITARY 
MEDICAL 
TREATMENT FACILITIES. 
(a) CLARIFICATION OF FEE WAIVER PROCESS.—Sec-
tion 1079b of title 10, United States Code, is amended— 
(1) by amending subsection (b) to read as fol-
lows: 
‘‘(b) WAIVER OF FEES.—Each commander (or direc-
tor, as applicable) of a military medical treatment facility 
shall issue a waiver for a fee that would otherwise be 
charged under the procedures implemented under sub-
section (a) to a civilian provided medical care at the facil-
ity who is not a covered beneficiary if the provision of such 
care enhances the knowledge, skills, and abilities of health 
care providers, as determined by the respective com-
mander or director.’’; and 
(2) by redesignating subsection (c) as sub-
section (d). 
(b) MODIFIED PAYMENT PLAN FOR CERTAIN CIVIL-
IANS.— 
(1) IN
GENERAL.—Such section is further 
amended— 
(A) by inserting after subsection (b), as 
amended by subsection (a), the following:
723 
‘‘(c) MODIFIED PAYMENT PLAN FOR CERTAIN CIVIL-
IANS.—(1)(A) If a civilian specified in subsection (a) is 
covered by a covered payer at the time care under this 
section is provided, the civilian shall only be responsible 
to pay, for any services not covered by such covered payer, 
copays, coinsurance, deductibles, or nominal fees. 
‘‘(B)(i) The Secretary of Defense may bill only the 
covered payer for care provided to a civilian described in 
subparagraph (A). 
‘‘(ii) Payment received by the Secretary from the cov-
ered payer of a civilian for care provided under this section 
that is provided to the civilian shall be considered payment 
in full for such care. 
‘‘(2) If a civilian specified in subsection (a) does not 
meet the criteria under paragraph (1), is underinsured, 
or has a remaining balance and is at risk of financial 
harm, the Secretary of Defense shall reduce each fee that 
would otherwise be charged to the civilian under this sec-
tion according to a sliding fee discount program. 
‘‘(3) If a civilian specified in subsection (a) does not 
meet the criteria under paragraph (1) or (2), the Sec-
retary of Defense shall implement an additional cata-
strophic waiver to prevent financial harm.
724 
‘‘(4) The modified payment plan under this sub-
section may not be administered by a Federal agency other 
than the Department of Defense.’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) The term ‘covered payer’ means a third- 
party payer or other insurance, medical service, or 
health plan. 
‘‘(2) The terms ‘third-party payer’ and ‘insur-
ance, medical service, or health plan’ have the mean-
ing given those terms in section 1095(h) of this 
title.’’. 
(c) APPLICABILITY.—The amendments made by sub-
sections (a) and (b) shall apply with respect to care pro-
vided on or after the date that is 180 days after the date 
of the enactment of this Act. 
SEC. 735. IMPROVEMENTS TO MILITARY MEDICAL TREAT-
MENT FACILITIES AND OTHER FACILITIES 
UNDER MILITARY HEALTH SYSTEM. 
(a) STUDY.—The Secretary of Defense shall conduct 
a study on any deficiencies of, and necessary improve-
ments to, military medical treatment facilities and other 
covered facilities, to ensure the design, construction, and 
maintenance of such facilities are in compliance with each
725 
covered code, specification, and standard. Such study shall 
include an identification of any necessary updates to the 
Unified Facilities Criteria relating to military construction 
planning and design with respect to such facilities, to en-
sure such compliance. 
(b) REPORTS.— 
(1) FIRST REPORT.—Not later than one year 
after the date of the enactment of this Act, the Sec-
retary of Defense shall submit to the congressional 
defense committees a report on the findings of the 
study under subsection (a). Such report shall in-
clude— 
(A) for each covered facility, a description 
of any deficiencies identified pursuant to such 
study; and 
(B) the plans of the Secretary, including 
costs and timelines, to address such deficiencies 
through the rehabilitation, repair, or retrofit of 
the facility, as applicable. 
(2) ANNUAL
REPORTS.—Not later than one 
year after the date on which the report under para-
graph (1) is submitted, and on an annual basis 
thereafter until the date on which the Secretary de-
termines all covered facilities are in compliance with 
each covered code, specification, and standard, the
726 
Secretary shall submit to the congressional defense 
committees a report on the progress made toward 
addressing any deficiency of a covered facility and 
maintaining covered facilities, to ensure such compli-
ance. 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘covered code, specification, and 
standard’’— 
(A) means the latest published edition of 
any code, specification, or standard that incor-
porates the latest hazard-resistant and energy- 
efficient designs, establishes minimum accept-
able criteria for design, construction, or mainte-
nance, and is at least as stringent as the pre-
viously published edition; and 
(B) includes the following (or the latest 
published edition thereof that is at least as 
stringent as the previously published edition): 
(i) The 2021 International Energy 
Conservation Code. 
(ii) The ASHRAE Standard 90.1. 
(iii) The ASHRAE Standard 170. 
(iv) The ASHRAE Standard 189.3. 
(v) The American Society of Civil En-
gineers Minimum Design Loads for Build-
727 
ings and Other Structures (ASCE Stand-
ard ASCE 7). 
(vi) The International Wildland-Urban 
Interface Code. 
(vii) Executive Order 13690 of Janu-
ary 30, 2015 (80 Fed. Reg. 6425) (relat-
ing to a Federal Flood Risk Management 
Standard for critical facilities). 
(2) The term ‘‘covered facility’’ means any De-
partment of Defense-owned facility used for activi-
ties under the military health system, including mili-
tary medical treatment facilities, military ambula-
tory care and occupational health facilities, and de-
fense health research facilities. 
SEC. 736. ACCESS TO CERTAIN DEPENDENT MEDICAL 
RECORDS BY REMARRIED FORMER SPOUSES. 
(a) ACCESS.—The Secretary of Defense may author-
ize a remarried former spouse who is a custodial parent 
of a dependent child to retain electronic access to the priv-
ileged medical records of such dependent child, notwith-
standing that the former spouse is no longer a dependent 
under section 1072(2) of title 10, United States Code. 
(b) DEFINITIONS.—In this section:
728 
(1) The term ‘‘dependent’’ has the meaning 
given that term in section 1072 of title 10, United 
States Code. 
(2) The term ‘‘dependent child’’ means a de-
pendent child of a remarried former spouse and a 
member or former member of a uniformed service. 
(3) The term ‘‘remarried former spouse’’ means 
a remarried former spouse of a member or former 
member of a uniformed service. 
SEC. 737. AFFILIATES SHARING PILOT PROGRAM. 
Section 5318(g)(8)(B)(iii) of title 31, United States 
Code, is amended by striking ‘‘3 years after the date of 
enactment of this paragraph’’ and inserting ‘‘3 years after 
the date that the Secretary of the Treasury issues rules 
pursuant to subparagraph (A)’’. 
SEC. 738. HOUSING FIRST REPORT. 
(a) IN GENERAL.—The Secretary of Housing and 
Urban Development shall, not later than 180 days after 
the date of the enactment of this section, submit to the 
Financial Services Committee of the House of Representa-
tives and the Banking, Housing and Urban Affairs Com-
mittee of the Senate, a report about the effectiveness and 
success of housing first policies in addressing homeless-
ness by connecting homeless individuals with housing and 
voluntary services.
729 
(b) CONTENTS.—The report required under sub-
section (a) shall include findings made by the Secretary 
of Housing and Urban Development with respect to the 
barriers that people experiencing homelessness face when 
attempting to secure permanent housing. 
(c) HOUSING FIRST POLICY DEFINED.—In this sec-
tion, the term ‘‘housing first policy’’ means a policy that 
prohibits conditioning the provision of housing assistance 
for an individual or family on— 
(1) individual or family participation in sup-
portive services, such as counseling, job training, or 
addiction treatment, for such individual or family; or 
(2) such individuals or family meeting certain 
prerequisites, including employment, sobriety, or 
lack of drug use. 
Subtitle C—Studies and Reports 
SEC. 741. GAO STUDY ON COVERAGE OF MENTAL HEALTH 
DISORDERS UNDER TRICARE PROGRAM AND 
RELATIONSHIP 
TO 
CERTAIN 
MENTAL 
HEALTH PARITY LAWS. 
(a) STUDY AND REPORT REQUIRED.—Not later than 
180 days after the date of the enactment of this Act, the 
Comptroller General of the United States shall— 
(1) conduct a study to identify and assess the 
similarities and differences with respect to coverage
730 
of mental health disorders under the TRICARE pro-
gram and coverage requirements under mental 
health parity laws; and 
(2) submit to the Secretary of Defense, the con-
gressional defense committees, and (with respect to 
any findings concerning the Coast Guard when it is 
not operating as a service in the Department of the 
Navy), the Secretary of Homeland Security, the 
Committee on Transportation and Infrastructure of 
the House of Representatives, and the Committee on 
Commerce, Science, and Transportation of the Sen-
ate a report containing the findings of such study. 
(b) MATTERS.—The report under subsection (a) shall 
include the following: 
(1) A description of any overlaps or gaps be-
tween coverage requirements under the TRICARE 
program and under the mental health parity laws, 
with respect to treatment for the continuum of men-
tal health disorders (including substance use dis-
order). 
(2) An identification of any existing or antici-
pated effects of any such overlaps or gaps on access 
to care by TRICARE beneficiaries. 
(3) An identification of denial rates under the 
TRICARE program for requests by TRICARE bene-
732 
(c) BRIEFING.—Not later than 90 days after the date 
on which the Secretaries receives the report submitted 
under subsection (a), the Secretaries shall provide to the 
congressional defense committees a briefing on any statu-
tory changes the Secretaries determine necessary to close 
gaps in the coverage of mental health disorders under the 
TRICARE program, including any such gaps identified in 
the report, to bring such coverage into conformity with 
requirements under mental health parity laws. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘mental health parity laws’’ 
means— 
(A) section 2726 of the Public Health 
Service Act (42 U.S.C. 300gg–26); 
(B) section 712 of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 
1185a); 
(C) section 9812 of the Internal Revenue 
Code of 1986 (26 U.S.C. 9812); or 
(D) any other Federal law that applies the 
requirements under any of the sections de-
scribed in subparagraph (A), (B), or (C), or re-
quirements that are substantially similar to 
those provided under any such section, as deter-
mined by the Comptroller General.
733 
(2) The term ‘‘TRICARE program’’ has the 
meaning given such term in section 1072 of title 10, 
United States Code. 
SEC. 742. FEASIBILITY STUDY ON ESTABLISHMENT OF NEW 
COMMAND ON DEFENSE HEALTH. 
(a) STUDY.—The Secretary of Defense shall conduct 
a feasibility study regarding the establishment of a new 
defense health command under which the Defense Health 
Agency would be a joint component. In conducting such 
study, the Secretary shall consider for the new command 
each of the following potential structures: 
(1) A unified combatant command. 
(2) A specified combatant command. 
(3) Any other defense health command struc-
ture the Secretary determines appropriate. 
(b) MATTERS.—The study under subsection (a) shall 
include, with respect to the new command specified in 
such subsection, the following: 
(1) An assessment of the organizational struc-
ture required to establish the new command with the 
following responsibilities and duties: 
(A) The conduct of health operations 
among operational units of the Armed Forces. 
(B) The administration of military medical 
treatment facilities.
734 
(C) The administration of the TRICARE 
program. 
(D) Serving as the element of the Armed 
Forces with the primary responsibility for the 
following: 
(i) Medical treatment, advanced trau-
ma management, emergency surgery, and 
resuscitative care. 
(ii) Emergency and specialty surgery, 
intensive care, medical specialty care, and 
related services. 
(iii) Preventive, acute, restorative, cu-
rative, 
rehabilitative, 
and 
convalescent 
care. 
(E) Collaboration with medical facilities 
participating in the National Disaster Medical 
System established pursuant to section 2812 of 
the Public Health Service Act (42 U.S.C. 
300hh–11), the Veterans Health Administra-
tion, and such other Federal departments and 
agencies and nongovermental organizations as 
may be determined appropriate, including with 
respect to the care services specified in subpara-
graph (D)(iii).
735 
(F) The conduct of existing research and 
education activities of the Department of De-
fense in the filed of health sciences. 
(G) The conduct of public health and glob-
al health activities not otherwise assigned to the 
Armed Forces. 
(H) The administration of the Defense 
Health Program Account under section 1100 of 
title 10, United States Code. 
(2) A description of the potential reporting rela-
tionship between the commander of the new com-
mand, the Assistant Secretary of Defense for Health 
Affairs, and the Under Secretary of Defense for Per-
sonnel and Readiness. 
(3) A description of the roles of the Surgeons 
General of the Army, Navy and Air Force, with re-
spect to the commander of the new command. 
(4) A description of the additional legislative 
authorities, if any, necessary to establish the new 
command. 
(c) BRIEFING; REPORT.—Not later than September 
30, 2023, the Secretary of Defense shall— 
(1) provide to the Committees of Armed Serv-
ices of the House of Representatives and the Senate
736 
briefing on the results of the study under subsection 
(a); and 
(2) submit to the Committees of Armed Serv-
ices of the House of Representatives and the Senate 
briefing and report on the results of such study. 
SEC. 743. STUDY AND AWARENESS INITIATIVE REGARDING 
USE OF QUALIFIED ALTERNATIVE THERA-
PIES TO TREAT CERTAIN MEMBERS OF THE 
ARMED FORCES ON TERMINAL LEAVE. 
(a) STUDY.—The Secretary of Defense shall conduct 
a study on the use of qualified alternative therapies as 
alternative therapies to prescription opioids in the treat-
ment of members of the Armed Forces on terminal leave 
preceding separation, retirement, or release from active 
duty. 
(b) PARTICIPANTS.—The Secretary shall select par-
ticipants in the study under subsection (a) from among 
members of the Armed Forces on terminal leave— 
(1) who have been diagnosed with post trau-
matic stress disorder, a traumatic brain injury, or 
any other condition involving severe pain, as deter-
mined by the Secretary for purposes of this section; 
(2) who but for such participation, would be 
prescribed opioid medications in connection with the 
treatment of such condition; and
737 
(3) who elect to participate in the study (includ-
ing in the post-study monitoring under subsection 
(c)). 
(c) POST-STUDY MONITORING.—Following the con-
clusion of the study under subsection (a), the Secretary 
shall monitor the effects of such study on the health of 
former participants by conducting assessments of such 
former participants, and shall submit to the congressional 
defense committees reports on the results of such moni-
toring, at the following intervals: 
(1) One year after the date of such conclusion. 
(2) Three years after the date of such conclu-
sion. 
(d) EFFECT ON OTHER BENEFITS.—The eligibility 
or entitlement of a member of the Armed Forces to any 
other benefit under the laws administered by the Secretary 
shall not be affected by the participation of the member 
in the study under this section (including by participation 
in the post-study monitoring under subsection (c)). 
(e) 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 findings of the study under subsection (a). 
Such report shall include—
738 
(1) a description of any such findings relating 
to the benefits or other effects of using a qualified 
alternative therapy as an alternative to prescription 
opioids under the study; and 
(2) any recommendations of the Secretary 
based on such findings. 
(f) EDUCATION INITIATIVE.—The Secretary shall 
carry out an education initiative regarding the use of a 
qualified alternative therapy for the treatment of the con-
ditions referred to in subsection (b)(1). In carrying out 
such initiative, the Secretary shall take into consider-
ation— 
(1) to the extent practicable, the findings of the 
study under subsection (a); 
(2) the specific vulnerability to opioid abuse and 
substance abuse disorder of individuals transitioning 
from serving on active duty in the Armed Forces; 
and 
(3) best practices for reducing the stigmatiza-
tion of qualified alternative therapies. 
(g) DEFINITIONS.—In this section: 
(1) The terms ‘‘active duty’’ and ‘‘Armed 
Forces’’ have the meaning given those terms in sec-
tion 101 of title 10, United States Code.
739 
(2) The term ‘‘appropriate congressional com-
mittees’’ means— 
(A) the congressional defense committees; 
(B) the Committee on Energy and Com-
merce of the House of Representatives; and 
(C) the Committee on Commerce, Science, 
and Transportation of the Senate. 
(3) The term ‘‘qualified alternative therapy’’ 
means— 
(A) medicinal cannabis; 
(B) 
methylenedioxymethamphetamine 
(commonly referred to as MDMA); and 
(C) psilocybin. 
SEC. 744. REPORT ON COMPOSITION OF MEDICAL PER-
SONNEL OF EACH MILITARY DEPARTMENT 
AND RELATED MATTERS. 
(a) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, and annually thereafter for 
five years, the Secretary of Defense, in coordination with 
the Secretaries of the military departments, shall submit 
to the Committees on Armed Services of the House of 
Representatives and the Senate a report on the composi-
tion of the medical personnel of each military department 
and related matters.
740 
(b) MATTERS.—The report under subsection (a) shall 
include the following: 
(1) With respect to each military department, 
the following: 
(A) An identification of the total number 
of medical personnel of the military depart-
ment. 
(B) An identification of the number of 
such medical personnel who are officers in a 
grade above O–6. 
(C) An identification of the number of 
such medical personnel who are officers in a 
grade below O–7. 
(D) An identification of the number of 
such medical personnel who are enlisted mem-
bers. 
(E) An assessment of potential issues re-
lating to the composition of such medical per-
sonnel. 
(F) A description of any plans of the Sec-
retary to— 
(i) reduce the total number of such 
medical personnel; or 
(ii) eliminate any covered position for 
such medical personnel.
741 
(G) A recommendation by the Secretary 
for the number of covered positions for such 
medical personnel that should be required for 
purposes of maximizing medical readiness 
(without regard to current statutory limitations, 
or potential future statutory limitations, on 
such number), presented as a total number for 
each military department and disaggregated by 
grade. 
(2) An assessment of the advisability of estab-
lishing within the Department of the Air Force, by 
not later than five years after the date of the enact-
ment of this Act, a position of the Medical Officer 
of the Space Force with the responsibilities of advis-
ing the Chief of Space Operations on all matters re-
lating to health care for members of the Space Force 
and serving as the expert on such matters in work-
ing with the heads of other Federal departments and 
agencies on related issues. 
(3) An assessment of the necessity of maintain-
ing the position of the Medical Officer of the Marine 
Corps, including— 
(A) a comparison of the effects of filling 
such position with an officer in the grade of O– 
6 versus an officer in the grade of O–7;
742 
(B) an assessment of potential issues asso-
ciated with the elimination of such position; and 
(C) a description of any potential effects of 
such elimination with respect to medical readi-
ness. 
(c) DISAGGREGATION OF CERTAIN DATA.—The data 
specified in subparagraphs (A) through (D) of subsection 
(b)(1) shall be presented as a total number and 
disaggregated by each medical component of the respective 
military department. 
(d) INCLUSION OF CERTAIN DEMOGRAPHIC DATA.— 
The data specified in subparagraphs (A) through (D) of 
subsection (b)(1) shall include a description and analysis 
of the demographic information of the medical personnel 
covered by each such subparagraph, including with respect 
to the following: 
(1) Race (presented in the aggregate and 
disaggregated by the same major race categories as 
are used in the decennial census of population and 
housing conducted by the Director of the Census 
Bureau). 
(2) Ethnicity. 
(3) Gender identity. 
(e) CONSIDERATIONS IN ASSESSING CERTAIN SPACE 
FORCE MATTER.—In conducting the assessment pursuant
743 
to subsection (b)(2), the Secretary of Defense shall take 
into consideration the tasks, operations, and specific 
health care considerations that accompany the space 
warfighting mission of the Space Force. 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘covered position’’ means a posi-
tion for an officer in a grade above O–6. 
(2) The terms ‘‘enlisted member’’ and ‘‘officer’’ 
have the meanings given those terms in section 
101(b) of title 10, United States Code. 
(3) The term ‘‘medical component’’ means— 
(A) in the case of the Army, the Medical 
Corps, Dental Corps, Nurse Corps, Medical 
Service Corps, Veterinary Corps, and Army 
Medical Specialist Corps; 
(B) in the case of the Air Force, members 
designated as medical officers, dental officers, 
Air Force nurses, medical service officers, and 
biomedical science officers; and 
(C) in the case of the Navy, the Medical 
Corps, Dental Corps, Nurse Corps, and Medical 
Service Corps. 
(4) The term ‘‘medical personnel’’ has the 
meaning given such term in section 115a(e) of title 
10, United States Code.
744 
(5) The term ‘‘military department’’ has the 
meaning given that term in section 101(a) of such 
title. 
SEC. 745. BRIEFING AND REPORT ON REDUCTION OR RE-
ALIGNMENT OF MILITARY MEDICAL MAN-
NING AND MEDICAL BILLETS. 
Section 731(a)(2)(A) of the National Defense Au-
thorization Act for Fiscal Year 2022 (Public Law 117– 
81) is amended to read as follows: 
‘‘(A) BRIEFING; 
REPORT.—The Comp-
troller General shall submit to the Committees 
on Armed Services of the House of Representa-
tives and the Senate— 
‘‘(i) a briefing on preliminary observa-
tions regarding the analyses used to sup-
port any reduction or realignment of mili-
tary medical manning, including any re-
duction or realignment of medical billets of 
the military departments, not later than 
December 27, 2022; and 
‘‘(ii) a report on such analyses not 
later than May 31, 2023.’’.
745 
SEC. 746. REPORT ON FEASABILITY OF CERTAIN LICENS-
ING MODELS FOR DEPARTMENT OF DE-
FENSE-OWNED VACCINES AND OTHER MED-
ICAL INTERVENTIONS RELATING TO COVID– 
19. 
(a) REPORT.—The Secretary of Defense shall submit 
to the congressional defense committees a report on the 
feasibility of a licensing model under which, with respect 
to Department of Defense-owned vaccines or other medical 
interventions relating to COVID–19 that are approved, li-
censed, or otherwise authorized for use in accordance with 
applicable law, the Secretary would grant to Government- 
owned contractor-operated manufacturers nonexclusive li-
censes to manufacture such vaccines or other interven-
tions. 
(b) MATTERS.—The report under subsection (a) shall 
include an evaluation of the estimated differences in the 
pricing of, and equitable access to, the vaccines and other 
interventions specified in such subsection, that may arise 
as a result of— 
(1) the Secretary granting exclusive licenses to 
manufacture such vaccines and other interventions, 
as compared with nonexclusive licenses; and 
(2) the Secretary granting either such license to 
Government-owned contractor-operated manufactur-
ers, as compared with other manufacturers.
746 
SEC. 747. STUDY ON THE IMPACT OF MILITARY TRAUMA 
AND INTIMATE PARTNER VIOLENCE ON MA-
TERNAL HEALTH OUTCOMES. 
(a) STUDY.—The Secretary of Defense shall carry 
out a study on the impact of military trauma and intimate 
partner violence on maternal health outcomes, with a focus 
on racial and ethnic backgrounds. 
(b) REPORT.—The Secretary of Defense shall issue 
a report to the Congress containing all findings and deter-
minations made in carrying out the study required under 
subsection (a). 
SEC. 748. REPORT ON COVERAGE OF BEHAVIORAL AND 
MENTAL HEALTH CRISIS SERVICES UNDER 
TRICARE PROGRAM. 
(a) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Defense 
shall submit to the congressional defense committees a re-
port on the scope of coverage under the TRICARE pro-
gram of inpatient and outpatient behavioral and mental 
health crisis services. 
(b) MATTERS.—The report under subsection (a) shall 
include, with respect to the period beginning on January 
1, 2019, and ending on December 31, 2021, an identifica-
tion of the following: 
(1) The total amount of funds expended under 
the TRICARE program on behavioral and mental
747 
health crisis services, disaggregated by the site at 
which the service was furnished. 
(2) The total amount of funds expended under 
such program for other services furnished to individ-
uals in behavioral or mental health crisis. 
(3) The provider types that billed for the serv-
ices specified in paragraphs (1) and (2). 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘crisis services’’ means the serv-
ices identified as such in the document of the Sub-
stance Abuse and Mental Health Service Adminis-
tration published in 2020, titled ‘‘National Guide-
lines for Behavioral Health Crisis Care: Best Prac-
tice Toolkit’’. 
(2) The term ‘‘TRICARE program’’ has the 
meaning given that term in section 1072 of title 10, 
United States Code. 
SEC. 749. REPORT ON MENTAL HEALTH PROVIDER READI-
NESS DESIGNATIONS. 
Not later than 90 days after the date of the enact-
ment of this Act, the Secretary of Defense shall update 
the registry and provider lists under subsection (b) of sec-
tion 717 of the National Defense Authorization Act for 
Fiscal Year 2016 (Public Law 114–92; 129 Stat. 868; 10
748 
U.S.C. 1073 note) and submit to the congressional defense 
committees a report containing— 
(1) the number of providers that have received 
a mental health provider readiness designation under 
such section 717, disaggregated by geographic re-
gion and provider specialty; and 
(2) recommendations to incentivize, or other-
wise increase the number of, providers with such 
designation. 
SEC. 750. STUDY ON PROVIDER TRAINING GAPS WITH RE-
SPECT TO SCREENING AND TREATMENT OF 
MATERNAL MENTAL HEALTH CONDITIONS. 
(a) STUDY.—The Secretary of Defense, acting 
through the Assistant Secretary of Defense for Health Af-
fairs, shall conduct a study to identify gaps in the training 
of covered providers with respect to the screening and 
treatment of maternal mental health conditions. Such 
study shall include— 
(1) an assessment of the level of experience of 
covered providers with, and the attitudes of such 
providers regarding, the treatment of pregnant and 
postpartum women with mental or substance use 
disorders; and
749 
(2) recommendations for the training of covered 
providers, taking into account any training gaps 
identified pursuant to the study. 
(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 con-
taining the findings of the study under section (a). 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘covered provider’’ means a ma-
ternal health care provider or behavioral health pro-
vider furnishing services under the military health 
system (including under the TRICARE program). 
(2) The term ‘‘TRICARE program’’ has the 
meaning given that term in section 1072 of title 10, 
United States Code. 
SEC. 751. REPORT ON MENTAL HEALTH CONDITIONS AND 
METABOLIC DISEASE AMONG CERTAIN MEM-
BERS OF ARMED FORCES. 
Not later than one year after the date of the enact-
ment of this Act, the Secretary of Defense shall conduct 
a study, and submit to Congress a report, on the rate of 
incidence of the simultaneous presence among members of 
the Armed Forces serving on active duty of a metabolic 
disease and a mental health condition (including post
750 
traumatic stress disorder, depression, and anxiety) or sub-
stance use disorder. 
SEC. 752. STUDY ON ACCESSABILITY OF MENTAL HEALTH 
PROVIDERS 
AND 
SERVICES 
FOR 
ACTIVE 
DUTY MEMBERS OF THE ARMED FORCES. 
(a) STUDY.—The Secretary of Defense shall conduct 
a study on the accessibility of mental health care providers 
and services for members of the Armed Forces serving on 
active duty, including an assessment of— 
(1) the accessibility of mental health care pro-
viders on military installations; 
(2) the accessibility of inpatient services for 
mental health care for such members; and 
(3) steps that may be taken to improve such ac-
cessibility. 
(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 con-
taining the findings of the study under subsection (a). 
SEC. 753. HEALTH-RELATED BEHAVIORS SURVEY AND RE-
PORT. 
(a) SURVEY.—The Director of the Defense Health 
Agency shall conduct a health-related behaviors survey 
among the members of the Armed Forces.
751 
(b) REPORT.—Not later than one year after the date 
of the enactment of this Act, 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 the results of the survey under sub-
section (a). 
SEC. 754. REPORT ON COORDINATION, DATA SHARING, AND 
EVALUATION EFFORTS FOR SUICIDE PRE-
VENTION. 
Not later than 120 days after the date of the enact-
ment of this Act, the Secretary of Defense, in coordination 
with the Secretary of Health and Human Services and the 
Secretary of Veterans Affairs, shall submit to each con-
gressional committee with jurisdiction over the Depart-
ment of Defense, the Department of Veterans Affairs, and 
the Department of Health and Human Services, a report 
on the coordination, data sharing, and evaluation efforts 
on suicide prevention across these departments. The re-
port shall include: 
(1) An overview of the functioning and core 
findings of the Interagency Task Force on Military 
and Veterans Mental Health since its creation in 
2012.
752 
(2) An accounting of the funding each Depart-
ment has obligated towards suicide prevention re-
lated research. 
(3) An outline of methods of comparing pro-
grams and sharing best practices for suicide preven-
tion by each Department. 
(4) An outline of the work to actively develop 
and improve joint suicide prevention practices based 
on information compiled and shared by each Depart-
ment. 
(5) An outline of the plan each Department has 
to achieve greater government efficiency and cross- 
agency coordination, data sharing, and evaluation in 
Federal suicide prevention efforts, in line with Pri-
ority Goal 5 of the plan entitled, ‘‘Reducing Military 
and Veteran Suicide’’, published by the White House 
in November 2021. 
(6) Any other information the Secretary of De-
fense, Secretary of Health and Human Services, or 
the Secretary of Veterans Affairs determines to be 
appropriate. 
SEC. 755. GAO STUDY ON DOD AND VA MAMMOGRAM AND 
BREAST CANCER SCREENING POLICIES. 
(a) STUDY.—The Comptroller General of the United 
States shall conduct a review, beginning not later than 90
753 
days after the date of the enactment of this Act, to exam-
ine and determine whether current Department of Defense 
and Department of Veterans Affairs policies allow individ-
uals with dense breast, regardless of age, with no-cost or 
low-cost access through their health programs to all the 
screening and diagnostic tools needed to confirm breast 
cancer, including when standard mammograms are incon-
clusive or ineffective in doing so. 
(b) CONTENTS.—The study conducted pursuant to 
subsection (a) shall— 
(1) examine the utilization of existing screening 
and diagnosis tools by participants in health pro-
grams administered by the Department of Defense 
and Department of Veterans Affairs, disaggregated 
by demographic characteristics; 
(2) identify and examine barriers to greater ac-
cess to such tools in each such agency, including 
whether cost prevents individuals from receiving ad-
ditional breast cancer diagnostic or screening exams 
that may confirm the presence of breast cancer; 
(3) make recommendations on how each such 
agency can improve policies to best address the 
unique challenges identifying breast cancer in those 
with dense breasts;
754 
(4) analyze how well such agencies’ policies re-
garding breast cancer screening and diagnoses for 
those with dense breast align with coverage under 
other Federal health care programs such as Med-
icaid, Medicare, coverage on the Affordable Care Act 
health care marketplace, and the recommendations 
of the United States Preventive Services Task 
Force; 
(5) identify the most recent time that relevant 
policies were updated by each such agency and how 
often they are currently reviewed or updated; 
(6) analyze how well existing policies reflect or 
include the best available science on helping women 
with dense breast receive accurate diagnosis regard-
ing the presence or absence of cancer; and 
(7) identify any efforts by each such agency to 
educate health care providers who provide cancer 
screening, treatment, or diagnosis services and pa-
tients receiving such services on the limitations of 
mammograms in confirming breast cancer for those 
with dense breasts. 
(c) CONSULTATION.—In conducting the study pursu-
ant to subsection (a), the Comptroller General may consult 
with breast cancer patients or their advocates receiving 
care through the health care systems of the Department
755 
of Defense and Department of Veterans Affairs, health 
care providers supporting breast cancer care or organiza-
tions representing such providers, other Federal agencies, 
and other stakeholders, as appropriate. 
(d) STUDY.—Not later than September 30, 2024, the 
Comptroller General shall submit to the Congress a report 
on the study conducted pursuant to subsection (a) con-
taining a description of the study and any findings and 
conclusions of the study. 
SEC. 756. STUDY AND REPORT ON RATE OF CANCER-RE-
LATED MORBIDITY AND MORTALITY. 
(a) IN GENERAL.—The Secretary of Defense shall 
conduct, or enter into a contract with an appropriate fed-
erally funded research and development center to conduct, 
a study to assess whether individuals (including individ-
uals on active duty or in a reserve component or the Na-
tional Guard) assigned to the Pease Air Force Base and 
Pease Air National Guard Base for a significant period 
of time during the period of 1970 through 2020 experience 
a higher-than-expected rate of cancer-related morbidity 
and mortality as a result of time on base or exposures 
associated with time on base compared to the rate of can-
cer-related morbidity and mortality of the general popu-
lation of the United States, accounting for differences in 
sex, age, and race.
756 
(b) COMPLETION; REPORT.—Not later than 1 year 
after the date of enactment of this Act, the Secretary of 
Defense shall provide for— 
(1) the completion of the study under sub-
section (a); and 
(2) the submission of a report on the results of 
the study to the Committees on Armed Services of 
the Senate and House of Representatives. 
(c) DEFINITION.—In this section, the term ‘‘signifi-
cant period of time’’ shall be defined by the Secretary of 
Defense or by the entity conducting the study under sub-
section (a), as the Secretary determines appropriate. 
SEC. 757. GAO STUDY ON ACCESS TO EXCEPTIONAL FAMILY 
MEMBER PROGRAM AND EXTENDED CARE 
HEALTH OPTION PROGRAM BY MEMBERS OF 
RESERVE COMPONENTS. 
(a) STUDY AND REPORT.—Not later than 180 days 
after the date of the enactment of this Act, the Comp-
troller General of the United States shall— 
(1) conduct a study to determine the barriers to 
members of the reserve components accessing the 
Extended Care Health Option program and the Ex-
ceptional Family Member program of the Depart-
ment of Defense; and
757 
(2) submit to the Secretary of Defense and the 
congressional defense committees a report containing 
the findings of such study. 
(b) ELEMENTS.—The report under subsection (a)(2) 
shall include the following: 
(1) A description of the methodology used by 
the Department of Defense to disseminate informa-
tion regarding the eligibility of members of the re-
serve components for the Extended Care Health Op-
tion program and the Exceptional Family Member 
program upon such members commencing the per-
formance of Active Guard and Reserve duty. 
(2) An identification of the timeline of the en-
rollment process for members of the reserve compo-
nents in such programs and any effects of delayed 
enrollment, such as exclusion from benefits or re-
sources. 
(3) An identification of impediments to enroll-
ment in such programs among such members, in-
cluding an assessment of the following: 
(A) The availability of resources under 
such programs, including specialist providers 
under the Exceptional Family Member pro-
gram, at the time of enrollment in such pro-
grams.
758 
(B) The availability of support under such 
programs at facilities of the reserve compo-
nents. 
(C) Any misinformation provided to service 
members seeking enrollment. 
(4) With respect to the Exceptional Family 
Member program— 
(A) an identification of the number of fam-
ilies with a family member eligible to enroll in 
such program, disaggregated by whether the 
member of the reserve component in such fam-
ily is performing Active Guard and Reserve 
duty; 
(B) an assessment of the effects of navi-
gating the process of enrollment in such pro-
gram on the mission to which the member is as-
signed while performing Active Guard and Re-
serve duty; and 
(C) an identification of the number of spe-
cialist providers and staff who support reserve 
component members through such program. 
(5) Recommendations on improving the dis-
semination of information regarding the eligibility of 
members of the reserve components for the Ex-
759 
tended Care Health Option program and the Excep-
tional Family Member program. 
(6) Recommendations on improvements to such 
programs with respect to the reserve components. 
(c) ACTIVE GUARD AND RESERVE DEFINED.—The 
term ‘‘Active Guard and Reserve’’ has the meaning given 
such term in section 101(b) of title 10, United States 
Code. 
SEC. 758. KYLE MULLEN NAVAL SAFETY ENHANCEMENTS. 
The Secretary of Defense, or his designee to Naval 
Special Warfare Command, shall conduct an appraisal of 
and provide recommended policies for improved medical 
care and oversight of individuals in the Navy engaged in 
high-stress training environments, in an effort to ensure 
sailor safety and prevent related long-term injury, illness, 
and death. The Secretary of the Navy shall ensure that 
such recommended polices are implemented to the full ex-
tent practicable and in a timely manner. 
SEC. 759. REPORT ON OPERATIONAL AND PHYSICAL AND 
MENTAL HEALTH EFFECTS OF LOW RECRUIT-
MENT AND RETENTION TO ARMED FORCES. 
The Secretary of Defense shall submit to the congres-
sional defense committees a report on the current oper-
ational tempo resulting from low recruitment to and reten-
tion in the Armed Forces and the resulting effects on the
760 
physical and mental health of members of the Armed 
Forces. 
SEC. 759A. REPORT ON MATERNAL MORTALITY RATES OF 
FEMALE MEMBERS OF THE ARMED FORCES. 
Not later than one year after the date of the enact-
ment of this Act, the Secretary of Defense shall submit 
to the congressional defense committees a report on how 
maternal mortality rates may disproportionately affect fe-
male members of the Armed Forces (as compared with 
female civilians). Such report shall include an identifica-
tion of any relevant barriers to the access of health care 
for such female members and any recommendations by the 
Secretary to improve such access and reduce such rates. 
SEC. 759B. REPORT ON DEFENSE HEALTH AGENCY CON-
TRACTS. 
Not later than February 1, 2023, 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 that includes, with respect to fiscal 
years 2020, 2021, and 2022— 
(1) the total number of contracts awarded by 
the Defense Health Agency during each such fiscal 
year; and 
(2) the number and percent of such contracts 
for each such fiscal year that were—
761 
(A) protested and the protest was upheld; 
(B) standard professional services con-
tracts; 
(C) issued as a direct award; 
(D) in the case of the contracts described 
in subparagraph (C), exceeded $5 million in 
total value; and 
(E) awarded to the following: 
(i) Businesses eligible to enter into a 
contract under section 8(a) of the Small 
Business Act (15 U.S.C. 637(a)). 
(ii) Qualified HUBZone small busi-
ness concerns. 
(iii) Small business concerns owned 
and controlled by service-disabled veterans. 
(iv) Small business concerns owned 
and controlled by women (as defined in 
section 8(m)(1) of the Small Business Act 
(15 U.S.C. 637(m)(1)).
762 
Subtitle D—Other Matters 
SEC. 761. INCLUSION OF EXPOSURE TO PERFLUOROALKYL 
AND POLYFLUOROALKYL SUBSTANCES AS 
COMPONENT OF PERIODIC HEALTH ASSESS-
MENTS. 
(a) PERIODIC HEALTH ASSESSMENT.—Each Sec-
retary concerned shall ensure that any periodic health as-
sessment provided to a member of the Armed Forces in-
cludes an evaluation of whether the member has been— 
(1) based or stationed at a military installation 
identified by the Secretary concerned as a location 
with a known or suspected release of perfluoroalkyl 
substances or polyfluoroalkyl substances during the 
period in which the member was based or stationed 
at the military installation; or 
(2) exposed to such substances, including by 
evaluating any information in the health record of 
the member. 
(b) SEPARATION HISTORY AND PHYSICAL EXAMINA-
TIONS.—Section 1145(a)(5) of title 10, United States 
Code is amended by adding at the end the following new 
subparagraph: 
‘‘(D) The Secretary concerned shall ensure that each 
physical examination of a member under subparagraph 
(A) includes an assessment of whether the member was—
763 
‘‘(i) based or stationed at a military installation 
identified by the Secretary concerned as a location 
with a known or suspected release of perfluoroalkyl 
substances or polyfluoroalkyl substances during the 
period in which the member was based or stationed 
at the military installation; or 
‘‘(ii) exposed to such substances, including by 
assessing any information in the health record of the 
member.’’. 
(c) 
DEPLOYMENT
ASSESSMENTS.—Section 
1074f(b)(2) of title 10, United States Code, is amended 
by adding at the end the following new subparagraph: 
‘‘(E) An assessment of whether the member 
was— 
‘‘(i) based or stationed at a military instal-
lation identified by the Secretary concerned as 
a location with a known or suspected release of 
perfluoroalkyl substances or polyfluoroalkyl sub-
stances during the period in which the member 
was based or stationed at the military installa-
tion; or 
‘‘(ii) exposed to such substances, including 
by assessing any information in the health 
record of the member.’’
764 
(d) PROVISION OF BLOOD TESTING TO DETERMINE 
EXPOSURE
TO
PERFLUOROALKYL
SUBSTANCES
OR 
POLYFLUOROALKYL SUBSTANCES.— 
(1) PROVISION OF BLOOD TESTING.— 
(A) IN GENERAL.—If a covered evaluation 
of a member of the Armed Forces results in a 
positive determination of potential exposure to 
perfluoroalkyl substances or polyfluoroalkyl sub-
stances, the Secretary concerned shall provide 
to that member, during the covered evaluation, 
blood testing to determine and document poten-
tial exposure to such substances. 
(B) INCLUSION IN HEALTH RECORD.—The 
results of blood testing of a member of the 
Armed Forces conducted under subparagraph 
(A) shall be included in the health record of the 
member. 
(2) ANALYSIS OF BLOOD TESTING RESULTS.— 
(A) PLAN.—Not later than one year after 
the date of the enactment of this Act, the Sec-
retary of Defense shall submit to the Commit-
tees on Armed Services of the House of Rep-
resentatives and the Senate a plan, consistent 
with 
Department 
of 
Defense 
Instruction 
6055.05 (or such successor instruction), to
765 
track and analyze, including through the identi-
fication and analysis of trends, the results of 
blood testing results provided pursuant to the 
paragraph (1) or under section 707 of the Na-
tional Defense Authorization Act for Fiscal 
Year 2020 (Public Law 116–92; 133 Stat. 
1441; 10 U.S.C. 1074m note). 
(B) ANNUAL
REPORTS.—Not later than 
two years after the date of the enactment of 
this Act, and annually thereafter, the Secretary 
shall submit to the Committees on Armed Serv-
ices of the House of Representatives and the 
Senate a report containing a summary of the 
results of blood testing provided pursuant to 
paragraph (1), at a Department of Defense- 
wide level. 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘covered evaluation’’ means— 
(A) a periodic health assessment conducted 
in accordance with subsection (a); 
(B) a separation history and physical ex-
amination conducted under section 1145(a)(5) 
of title 10, United States Code, as amended by 
subsection (b); or
766 
(C) a deployment assessment conducted 
under section 1074f(b)(2) of such title, as 
amended by subsection (c). 
(2) The term ‘‘Secretary concerned’’ has the 
meaning given such term in section 101 of title 10, 
United States Code. 
SEC. 762. MANDATORY TRAINING ON HEALTH EFFECTS OF 
PERFLUOROALKYL OR POLYFLUOROALKYL 
SUBSTANCES. 
The Secretary of Defense shall provide to each med-
ical provider of the Department of Defense mandatory 
training with respect to the potential health effects of 
perfluoroalkyl or polyfluoroalkyl substances. 
SEC. 763. NON-MEDICAL COUNSELING SERVICES FOR MILI-
TARY FAMILIES. 
Section 1781 of title 10, United States Code, is 
amended by adding at the end the following new sub-
sections: 
‘‘(d) NON-MEDICAL COUNSELING SERVICES.—(1) In 
carrying out the duties of the Office under subsection (b), 
the Director of Military Family Readiness Policy may co-
ordinate programs and activities for the provision of non- 
medical counseling services to military families through 
the Military and Family Counseling Program.
767 
‘‘(2) Notwithstanding any law regarding the licensure 
or certification of mental health professionals, a mental 
health professional described in paragraph (3) may pro-
vide non-medical counseling services through the Military 
and Family Counseling Program at any location in a 
State, the District of Columbia, or a Commonwealth, terri-
tory or possession of the United States, without regard 
to where the provider or recipient of such services is lo-
cated or the mode of the delivery of such services, if the 
provision of such services is within the scope of the author-
ized Federal duties of the professional. 
‘‘(3) A mental health professional described in this 
paragraph is an individual who is— 
‘‘(A) a mental health professional who holds a 
current license or certification that is— 
‘‘(i) issued by a State, the District of Co-
lumbia, or a Commonwealth, territory, or pos-
session of the United States; and 
‘‘(ii) recognized by the Secretary of De-
fense; 
‘‘(B) a member of the uniformed services, a ci-
vilian employee of the Department of Defense, or a 
contractor designated by the Secretary of Defense; 
and
768 
‘‘(C) performing authorized duties for the De-
partment of Defense under a program or as part of 
an activity referred to in paragraph (1). 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) The term ‘Military and Family Counseling 
Program’ means the Military and Family Counseling 
Program of the Department of Defense, or any suc-
cessor program. 
‘‘(2) The term ‘non-medical counseling services’ 
means mental health care services that— 
‘‘(A) are non-clinical, short-term, and solu-
tion-focused; and 
‘‘(B) address topics related to personal 
growth, 
development, 
and 
positive 
func-
tioning.’’. 
SEC. 764. CLARIFICATIONS RELATING TO ANALYSIS OF DE-
PARTMENT OF DEFENSE COMPREHENSIVE 
AUTISM DEMONSTRATION PROGRAM BY NA-
TIONAL ACADEMIES. 
(a) CLARIFICATIONS.—Section 737 of the National 
Defense Authorization Act for Fiscal Year 2022 (Public 
Law 117–81; 135 Stat. 1800) is amended— 
(1) in subsection (b)(2)— 
(A) in subparagraph (A), by inserting 
‘‘broadly’’ after ‘‘disorder’’;
769 
(B) in subparagraph (C), by inserting ‘‘pa-
rental involvement in applied behavior analysis 
treatment, and’’ after ‘‘including’’; 
(C) by amending subparagraph (D) to read 
as follows: 
‘‘(D) A review of the health outcomes, in-
cluding mental health outcomes, for individuals 
who have received applied behavioral analysis 
treatments over time.’’; 
(D) in subparagraph (E), by inserting ‘‘, 
since the inception of such program,’’ after 
‘‘demonstration program’’; 
(E) in subparagraph (F), by striking ‘‘ef-
fectiveness’’ and inserting ‘‘cost effectiveness, 
program effectiveness, and clinical effective-
ness’’; 
(F) in subparagraph (G), by inserting 
‘‘than in the general population’’ after ‘‘military 
families’’; 
(G) by redesignating subparagraph (H) as 
subparagraph (I); and 
(H) by inserting after subparagraph (G), 
as amended by subparagraph (F) of this para-
graph, the following new subparagraph:
770 
‘‘(H) An analysis on whether the diagnosis 
and treatment of autism is more prevalent 
among the children of military families than in 
the general population.’’; and 
(2) in subsection (c), by striking ‘‘nine months’’ 
and inserting ‘‘two years and seven months’’. 
(b) TECHNICAL AND CONFORMING AMENDMENT.— 
Such section is further amended by striking ‘‘demonstra-
tion project’’ each place it appears and inserting ‘‘dem-
onstration program’’. 
SEC. 765. CLARIFICATION OF ELIGIBILITY FOR MEMBER-
SHIP TO INDEPENDENT SUICIDE PREVEN-
TION AND RESPONSE REVIEW COMMITTEE. 
Section 738(b)(3) of the National Defense Authoriza-
tion Act for Fiscal Year 2022 (Public Law 117–81; 135 
Stat. 1801) is amended by inserting ‘‘, unless the indi-
vidual is a retired member of the Armed Forces or a 
former civilian employee of the Department, or the indi-
vidual is hired for the purpose of serving on such com-
mittee’’ after ‘‘Department of Defense’’. 
SEC. 766. IMPROVEMENT TO WOUNDED WARRIOR SERVICE 
DOG PROGRAM. 
Section 745 of the William M. (Mac) Thornberry Na-
tional Defense Authorization Act for Fiscal Year 2021
771 
(134 Stat. 3710; Public Law 10 U.S.C. 1071 note) is 
amended— 
(1) by redesignating subsection (b) as sub-
section (c); and 
(2) by inserting after subsection (a) the fol-
lowing new subsection: 
‘‘(b) GRANTS.— 
‘‘(1) IN GENERAL.—In carrying out the Wound-
ed Warrior Service Dog Program, the Secretary of 
Defense may award grants to nonprofit organiza-
tions to provide assistance dogs under such program. 
‘‘(2) APPLICATIONS.—An applicant for a grant 
under paragraph (1) shall submit an application at 
such time, in such manner, and containing such in-
formation as the Secretary determines. 
‘‘(3) SELECTION.—The Secretary shall select 
nonprofit organizations that submit applications for 
the award of grants under the Wounded Warrior 
Service Dog Program using a competitive process. 
‘‘(4) CONSIDERATIONS FOR GRANT AMOUNT.— 
In determining the amount of a grant to award to 
a nonprofit organization selected under paragraph 
(3), the Secretary shall consider the following: 
‘‘(A) The merits of the application sub-
mitted by the nonprofit organization.
772 
‘‘(B) Whether, and to what extent, there is 
demand by covered members or covered vet-
erans for assistance dogs provided by the non-
profit organization. 
‘‘(C) The capacity and capability of the 
nonprofit organization to raise and train assist-
ance dogs to meet such demand. 
‘‘(D) Such other factors as the Secretary 
may determine appropriate. 
‘‘(5) LIMITATION
ON
GRANT
AMOUNTS.—The 
amount of a grant awarded to a nonprofit organiza-
tion selected under paragraph (3) may not exceed 
$2,000,000.’’. 
SEC. 767. IMPROVEMENTS RELATING TO BEHAVIORAL 
HEALTH CARE AVAILABLE UNDER MILITARY 
HEALTH SYSTEM. 
(a) EXPANSION OF CERTAIN BEHAVIORAL HEALTH 
PROGRAMS AT THE UNIFORMED SERVICES UNIVERSITY 
OF THE HEALTH SCIENCES.— 
(1) ESTABLISHMENT
OF
GRADUATE
PRO-
GRAMS.—The Secretary of Defense shall establish 
graduate degree-granting programs in counseling 
and social work at the Uniformed Services Univer-
sity of the Health Sciences.
773 
(2) EXPANSION
OF
CLINICAL
PSYCHOLOGY 
GRADUATE
PROGRAM.—The Secretary of Defense 
shall take such steps as may be necessary to expand 
the clinical psychology graduate program of the Uni-
formed Services University of the Health Sciences. 
(3) POST-AWARD EMPLOYMENT OBLIGATION.— 
(A) AGREEMENT WITH SECRETARY.—Sub-
ject to subparagraph (B), as a condition of en-
rolling in a degree-granting program in clinical 
psychology, social work, or counseling at the 
Uniformed Services University of the Health 
Sciences, a civilian student shall enter into an 
agreement with the Secretary of Defense pursu-
ant to which the student agrees that, if the stu-
dent does not become a member of a uniformed 
service upon graduating such program, the stu-
dent shall work on a full-time basis as a covered 
civilian behavioral health provider for a period 
of a duration that is at least equivalent to the 
period during which the student was enrolled in 
such program. 
(B) OTHER TERMS AND CONDITIONS.—An 
agreement entered into pursuant to subpara-
graph (A) may include such other terms and 
conditions as the Secretary of Defense may de-
774 
termine necessary to protect the interests of the 
United States or otherwise appropriate for pur-
poses of this section, including terms and condi-
tions providing for limited exceptions from the 
employment obligation specified in such sub-
paragraph. 
(C) REPAYMENT.—A civilian graduate who 
does not complete the employment obligation 
required under the agreement entered into pur-
suant to subparagraph (A) shall repay to the 
Secretary of Defense a prorated portion of the 
student’s costs of attendance in the program 
described in such paragraph. The amount of 
such prorated portion shall be determined by 
the Secretary. 
(D) APPLICABILITY.—This subsection shall 
apply to civilian students who enroll in the first 
year of a degree-granting program in clinical 
psychology, social work, or counseling at the 
Uniformed Services University of the Health 
Sciences on or after the date of the enactment 
of this Act. 
(4) IMPLEMENTATION
PLAN.—Not later than 
one year after the date of the enactment of this Act, 
the Secretary shall submit to the congressional de-
775 
fense committees a plan for the implementation of 
this subsection. Such plan shall include— 
(A) a determination as to the resources for 
personnel and facilities required for such imple-
mentation; 
(B) estimated timelines for such implemen-
tation; and 
(C) a projection of the number of grad-
uates from the programs specified in paragraph 
(1) upon the completion of such implementa-
tion. 
(b) SCHOLARSHIP-FOR-SERVICE PROGRAM FOR CI-
VILIAN BEHAVIORAL HEALTH PROVIDERS.— 
(1) IN
GENERAL.—Beginning not later than 
two years after the date of the enactment of this 
Act, the Secretary of Defense shall carry out a pro-
gram under which— 
(A) the Secretary may provide— 
(i) direct grants to cover tuition, fees, 
living expenses, and other costs of attend-
ance at an institution of higher education 
to an individual enrolled in a program of 
study leading to a graduate degree in clin-
ical psychology, social work, counseling, or
776 
a related field (as determined by the Sec-
retary); and 
(ii) student loan repayment assistance 
to a credentialed behavioral health provider 
who has a graduate degree in clinical psy-
chology, social work, counseling, or a re-
lated field (as determined by the Sec-
retary); and 
(B) in exchange for such assistance, the 
recipient shall commit to work as a covered ci-
vilian behavioral health provider in accordance 
with paragraph (2). 
(2) 
POST-AWARD
EMPLOYMENT
OBLIGA-
TIONS.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), as a condition of receiving assistance 
under paragraph (1), the recipient of such as-
sistance shall enter into an agreement with the 
Secretary of Defense pursuant to which the re-
cipient agrees to work on a full-time basis as a 
covered civilian behavioral health provider for a 
period of a duration that is at least equivalent 
to the period during which the recipient re-
ceived assistance under such paragraph.
777 
(B) OTHER TERMS AND CONDITIONS.—An 
agreement entered into pursuant to subpara-
graph (A) may include such other terms and 
conditions as the Secretary of Defense may de-
termine necessary to protect the interests of the 
United States or otherwise appropriate for pur-
poses of this section, including terms and condi-
tions providing for limited exceptions from the 
post-award employment obligation specified in 
such subparagraph. 
(3) REPAYMENT.—An individual who receives 
assistance under paragraph (1) and does not com-
plete the employment obligation required under the 
agreement entered into pursuant to paragraph (2) 
shall repay to the Secretary of Defense a prorated 
portion of the financial assistance received by the in-
dividual under paragraph (1). The amount of such 
prorated portion shall be determined by the Sec-
retary. 
(4) IMPLEMENTATION
PLAN.—Not later than 
one year after the date of the enactment of this Act, 
the Secretary of Defense shall submit to the con-
gressional defense committees a plan for the imple-
mentation of this subsection. Such plan shall in-
clude—
778 
(A) a determination as to the resources re-
quired for such implementation; 
(B) estimated timelines for such implemen-
tation; and 
(C) a projection of the number of recipi-
ents of assistance under paragraph (1) upon 
the completion of such implementation. 
(c) REPORT
ON
BEHAVIORAL
HEALTH
WORK-
FORCE.— 
(1) REPORT.—Not later than 90 days after the 
date of the enactment of this Act, the Secretary of 
Defense shall conduct an analysis of the behavioral 
health workforce under the direct care component of 
the TRICARE program and submit to the congres-
sional defense committees a report containing the re-
sults of such analysis. Such report shall include, 
with respect to such workforce, the following: 
(A) The number of positions authorized for 
military behavioral health providers within such 
workforce, and the number of such positions 
filled, disaggregated by the professions de-
scribed in paragraph (2). 
(B) The number of positions authorized for 
civilian behavioral health providers within such 
workforce, and the number of such positions
779 
filled, disaggregated by the professions de-
scribed in paragraph (2). 
(C) For each military department, the 
ratio of military behavioral health providers as-
signed to military medical treatment facilities 
compared to civilian behavioral health providers 
so assigned, disaggregated by the professions 
described in paragraph (2). 
(D) For each military department, the 
number of military behavioral health providers 
authorized to be embedded within an oper-
ational unit, and the number of such positions 
filled, disaggregated by the professions de-
scribed in paragraph (2). 
(E) Data on the historical demand for be-
havioral health services by members of the 
Armed Forces. 
(F) An estimate of the number of health 
care providers necessary to meet the demand by 
such members for behavioral health care serv-
ices under the direct care component of the 
TRICARE program, disaggregated by provider 
type. 
(G) An identification of any shortfall be-
tween the estimated number under subpara-
780 
graph (F) and the total number of positions for 
behavioral health providers filled within such 
workforce. 
(H) Such other information as the Sec-
retary may determine appropriate. 
(2) PROVIDER
TYPES.—The professions de-
scribed in this paragraph are as follows: 
(A) Clinical psychologists. 
(B) Social workers. 
(C) Counselors. 
(D) Such other professions as the Sec-
retary may determine appropriate. 
(3) BEHAVIORAL WORKFORCE AT REMOTE LO-
CATIONS.—In conducting the analysis of the behav-
ioral health workforce under paragraph (1), the Sec-
retary of Defense shall ensure such behavioral health 
workforce at remote locations (including Guam and 
Hawaii) and any shortfalls thereof, is taken into ac-
count. 
(d) PLAN TO ADDRESS SHORTFALLS IN BEHAVIORAL 
HEALTH WORKFORCE.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary shall sub-
mit to the congressional defense committees a plan to ad-
dress any shortfall of the behavioral health workforce iden-
781 
tified under subsection (c)(1)(G). Such plan shall address 
the following: 
(1) With respect to any such shortfall of mili-
tary behavioral health providers (addressed sepa-
rately with respect to such providers assigned to 
military medical treatment facilities and such pro-
viders assigned to be embedded within operational 
units), the recruitment, accession, retention, special 
pay and other aspects of compensation, workload, 
role of the Uniformed Services University of the 
Health Sciences and the Armed Forces Health Pro-
fessions Scholarship Program under chapter 105 of 
title 10, United States Code, any additional authori-
ties or resources necessary for the Secretary to in-
crease the number of such providers, and such other 
considerations as the Secretary may consider appro-
priate. 
(2) With respect to addressing any such short-
fall of civilian behavioral health providers, the re-
cruitment, hiring, retention, pay and benefits, work-
load, educational scholarship programs, any addi-
tional authorities or resources necessary for the Sec-
retary to increase the number of such providers, and 
such other considerations as the Secretary may con-
sider appropriate.
782 
(3) A recommendation as to whether the num-
ber of military behavioral health providers in each 
military department should be increased, and if so, 
by how many. 
(4) A plan to ensure that remote installations 
are prioritized for the assignment of military behav-
ioral health providers. 
(5) Updated access standards for behavioral 
health care under the military health system, taking 
into account— 
(A) the duration of time between a patient 
receiving a referral for such care and the pa-
tient receiving individualized treatment (fol-
lowing an initial intake assessment) from a be-
havioral health provider; and 
(B) the frequency of regular follow-up ap-
pointments subsequent to the first appointment 
at which a patient receives such individualized 
treatment. 
(6) A plan to expand access to behavioral 
health care under the military health system using 
telehealth. 
(e) DEFINITIONS.—In this section:
783 
(1) The term ‘‘behavioral health’’ includes psy-
chiatry, clinical psychology, social work, counseling, 
and related fields. 
(2) The term ‘‘civilian behavioral health pro-
vider’’ means a behavioral health provider who is a 
civilian employee of the Department of Defense. 
(3) The term ‘‘cost of attendance’’ has the 
meaning given that term in section 472 of the High-
er Education Act of 1965 (20 U.S.C. 1087ll). 
(4) The term ‘‘counselor’’ means an individual 
who holds— 
(A) a master’s or doctoral degree from an 
accredited graduate program in— 
(i) marriage and family therapy; or 
(ii) clinical mental health counseling; 
and 
(B) a current license or certification from 
a State that grants the individual the authority 
to provide counseling services as an independent 
practitioner in the respective field of the indi-
vidual. 
(5) The term ‘‘covered civilian behavioral health 
provider’’ means a civilian behavioral health provider 
whose employment by the Secretary of Defense in-
784 
volves the provision of behavioral health services at 
a military medical treatment facility. 
(6) The term ‘‘institution of higher education’’ 
has the meaning given that term in section 101 of 
the Higher Education Act of 1965 (20 U.S.C. 
1001). 
(7) The term ‘‘military behavioral health pro-
vider’’ means a behavioral health provider who is a 
member of the Armed Forces. 
(8) The term ‘‘military installation’’ has the 
meaning given that term in section 2801 of title 10, 
United States Code. 
(9) The term ‘‘military medical treatment facil-
ity’’ means a facility specified in section 1073d of 
such title. 
(10) The term ‘‘remote installation’’ means a 
military installation that the Secretary determines to 
be in a remote location. 
(11) The term ‘‘State’’ means each of the sev-
eral States, the District of Columbia, and each com-
monwealth, territory or possession of the United 
States. 
(12) The term ‘‘TRICARE program’’ has the 
meaning given that term in section 1072 of title 10, 
United States Code.
785 
SEC. 768. ASSIGNMENT OF BEHAVIORAL HEALTH PRO-
VIDERS AND TECHNICIANS TO AIRCRAFT 
CARRIERS. 
(a) ASSIGNMENT.—Beginning not later than Decem-
ber 31, 2023, the Secretary of the Navy shall ensure there 
is assigned to each aircraft carrier not fewer than two 
military behavioral health providers and not fewer than 
two behavioral health technicians. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘behavioral health’’ includes clin-
ical psychology, social work, counseling, and related 
fields. 
(2) The term ‘‘behavioral health technician’’ 
means an enlisted member of the Armed Forces who 
is trained to perform clinical activities in support of 
a licensed behavioral health provider. 
(3) The term ‘‘military behavioral health pro-
vider’’ means a behavioral health provider who is a 
member of the Armed Forces. 
SEC. 769. DEPARTMENT OF DEFENSE INTERNSHIP PRO-
GRAMS RELATING TO CIVILIAN BEHAVIORAL 
HEALTH PROVIDERS. 
(a) INTERNSHIP PROGRAMS FOR CIVILIAN BEHAV-
IORAL HEALTH.— 
(1) ESTABLISHMENT OF PROGRAMS.—The Sec-
retary of Defense shall establish paid pre-doctoral
786 
and post-doctoral internship programs for the pur-
pose of training clinical psychologists to work as cov-
ered civilian behavioral health providers. 
(2) EMPLOYMENT OBLIGATION.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), as a condition of participating in an 
internship program under paragraph (1), the 
participant shall enter into an agreement with 
the Secretary of Defense pursuant to which the 
participant agrees to work on a full-time basis 
as a covered civilian behavioral health provider 
for a period of a duration that is at least equiv-
alent to the period of participation in such in-
ternship program. 
(B) OTHER TERMS AND CONDITIONS.—An 
agreement entered into pursuant to subpara-
graph (A) may include such other terms and 
conditions as the Secretary of Defense may de-
termine necessary to protect the interests of the 
United States or otherwise appropriate for pur-
poses of this section, including terms and condi-
tions providing for limited exceptions from the 
employment obligation specified in such sub-
paragraph.
787 
(3) REPAYMENT.—An individual who partici-
pates in an internship program under paragraph (1) 
and does not complete the employment obligation re-
quired under the agreement entered into pursuant to 
paragraph (2) shall repay to the Secretary of De-
fense a prorated portion of the cost of administering 
such program with respect to such individual and of 
any payment received by the individual under such 
program. The amount of such prorated portion shall 
be determined by the Secretary. 
(4) IMPLEMENTATION
PLAN.—Not later than 
one year after the date of the enactment of this Act, 
the Secretary of Defense shall submit to the con-
gressional defense committees a plan for the imple-
mentation of this subsection. Such plan shall include 
an explanation of how the Secretary will adjust the 
workload and staffing of behavioral health providers 
in military medical treatment facilities to ensure suf-
ficient capacity to supervise participants in the in-
ternship programs under paragraph (1). 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘behavioral health’’ includes psy-
chiatry, clinical psychology, social work, counseling, 
and related fields.
788 
(2) The term ‘‘behavioral health provider’’ in-
cludes the following: 
(A) A licensed professional counselor. 
(B) A licensed mental health counselor. 
(C) A licensed clinical professional coun-
selor. 
(D) A licensed professional clinical coun-
selor of mental health. 
(E) A licensed clinical mental health coun-
selor. 
(F) A licensed mental health practitioner. 
(3) The term ‘‘covered civilian behavioral health 
provider’’ means a civilian behavioral health provider 
whose employment by the Secretary of Defense in-
volves the provision of behavioral health services at 
a military medical treatment facility. 
(4) The term ‘‘civilian behavioral health pro-
vider’’ means a behavioral health provider who is a 
civilian employee of the Department of Defense. 
(5) The term ‘‘military medical treatment facil-
ity’’ means a facility specified in section 1073d of 
such title.
789 
SEC. 770. BRAIN HEALTH INITIATIVE OF DEPARTMENT OF 
DEFENSE. 
(a) IN GENERAL.—The Secretary of Defense, in con-
sultation with the Secretaries concerned, shall establish a 
comprehensive initiative for brain health to be known as 
the ‘‘Warfighter Brain Health Initiative’’ (in this section 
referred to as the ‘‘Initiative’’) for the purpose of unifying 
efforts and programs across the Department of Defense 
to improve the cognitive performance and brain health of 
members of the Armed Forces. 
(b) OBJECTIVES.—The objectives of the Initiative 
shall be the following: 
(1) To enhance, maintain, and restore the cog-
nitive performance of members of the Armed Forces 
through education, training, prevention, protection, 
monitoring, detection, diagnosis, treatment, and re-
habilitation, including through the following activi-
ties: 
(A) The establishment of a program to 
monitor cognitive brain health across the De-
partment of Defense, beginning upon the acces-
sion of a member to the Armed Forces and re-
peated at regular intervals thereafter, with the 
goal of detecting any need for cognitive en-
hancement or restoration resulting from poten-
tial brain exposures of the member, to mitigate
790 
possible evolution of injury or disease progres-
sion. 
(B) The identification and dissemination of 
thresholds for blast pressure safety and associ-
ated emerging scientific evidence. 
(C) The modification of high-risk training 
and operational activities to mitigate the nega-
tive effects of repetitive blast exposure. 
(D) The identification of individuals who 
perform high-risk training or occupational ac-
tivities, for purposes of increased monitoring of 
the brain health of such individuals. 
(E) The development and operational field-
ing of non-invasive, portable, point-of-care med-
ical devices, to inform the diagnosis and treat-
ment of traumatic brain injury. 
(F) The establishment of a standardized 
monitoring program that documents and ana-
lyzes blast exposures that may affect the brain 
health of members of the Armed Forces. 
(G) The development of a resource that 
would set forth specific criteria used in the 
awarding of potential grants for research 
projects relating to the direct correlation of en-
791 
vironmental exposures and brain injuries to the 
brain health of members of the Armed Forces. 
(H) The incorporation of the findings and 
recommendations of the report of the National 
Academies of Science, Engineering, and Medi-
cine titled ‘‘Traumatic Brain Injury: A Road-
map for Accelerating Progress’’ and published 
in 2022 (relating to the acceleration of progress 
in traumatic brain injury research and care), or 
any successor report, into activities of the De-
partment relating to brain health, as applicable. 
(2) To harmonize and prioritize the efforts of 
the Department of Defense into a single approach to 
brain health, to produce more efficient and effective 
results. 
(c) STRATEGY AND IMPLEMENTATION PLAN.—Not 
later than one year after the date of the enactment of this 
Act, the Secretary of Defense shall submit to the congres-
sional defense committees a report setting forth a strategy 
and implementation plan of the Department of Defense 
to achieve the objectives of the Initiative under subsection 
(b). 
(d) 
ANNUAL
BUDGET
JUSTIFICATION
DOCU-
MENTS.—In the budget justification materials submitted 
to Congress in support of the Department of Defense
792 
budget for each of fiscal years 2025 through 2029 (as sub-
mitted with the budget of the President under section 
1105(a) of title 31, United States Code), the Secretary 
of Defense shall include a budget justification display that 
includes all activities of the Department relating to the 
Initiative. 
(e) ANNUAL REPORTS.—Not later than January 31, 
2024, and annually thereafter until January 31, 2030, the 
Secretary of Defense shall submit to the congressional de-
fense committees a report on the Initiative that includes 
the following: 
(1) A description of the activities taken under 
the Initiative and resources expended under the Ini-
tiative during the prior fiscal year. 
(2) A summary of the progress made during the 
prior fiscal year with respect to the objectives of the 
Initiative under subsection (b). 
(f) SECRETARY CONCERNED DEFINED.—In this sec-
tion, the term ‘‘Secretary concerned’’ has the meaning 
given that term in section 101 of title 10, United States 
Code.
793 
SEC. 771. AUTHORITY TO CONDUCT PILOT PROGRAM RE-
LATING TO MONITORING OF BLAST OVER-
PRESSURE EXPOSURE. 
(a) AUTHORITY.—The Director of the Defense 
Health Agency may conduct, as part of the initiative of 
the Department of Defense known as the ‘‘Warfighter 
Brain Initiative’’ (or any successor initiative), a pilot pro-
gram under which the Director shall monitor blast over-
pressure exposure through the use of commercially avail-
able, off-the-shelf, wearable sensors, and document and 
evaluate data collected as a result of such monitoring. 
(b) LOCATIONS.—Monitoring activities under a pilot 
program conducted pursuant to subsection (a) shall be 
carried out in each training environment that the Director 
determines poses a risk for blast overpressure exposure. 
(c) DOCUMENTATION AND SHARING OF DATA.—If 
the Director conducts a pilot program pursuant to sub-
section (a), the Director shall— 
(1) ensure that any data collected pursuant to 
such pilot program that is related to the health ef-
fects of the blast overpressure exposure of a member 
of the Armed Forces who participated in the pilot 
program is documented and maintained by the Sec-
retary of Defense in an electronic health record for 
the member; and
794 
(2) to the extent practicable, and in accordance 
with applicable provisions of law relating to data pri-
vacy, make data collected pursuant to such pilot pro-
gram available to other academic and medical re-
searchers for the purpose of informing future re-
search and treatment options. 
SEC. 772. STANDARDIZATION ACROSS DEPARTMENT OF DE-
FENSE OF POLICIES RELATING TO SERVICE 
BY INDIVIDUALS DIAGNOSED WITH HBV. 
(a) IN GENERAL.—The Secretary of Defense, in co-
ordination with the Secretaries concerned, shall— 
(1) review regulations, establish policies, and 
issue guidance relating to service by individuals di-
agnosed with HBV, consistent with the health care 
standards and clinical guidelines of the Department 
of Defense; and 
(2) identify areas where regulations, policies, 
and guidance of the Department relating to individ-
uals diagnosed with HBV (including with respect to 
enlistments, assignments, deployments, and reten-
tion standards) may be standardized across the 
Armed Forces. 
(b) AWARENESS, EDUCATION, AND TRAINING.— 
(1) REVIEWS
AND
RECOMMENDATIONS.—The 
Secretary of Defense shall—
795 
(A) conduct a review of the education, 
training, and resources furnished to members of 
the Armed Forces regarding the regulations 
and policies of the Department of Defense that 
govern the screening, documentation, treatment, 
management, and practice standards for indi-
viduals diagnosed with HBV, including a review 
of the awareness and understanding of such 
policies within clinical settings; 
(B) conduct a review of the resources and 
support services furnished to members of the 
Armed Forces diagnosed with HBV, including 
any resources containing information on— 
(i) the health care options of the 
member; or 
(ii) regulations or policies of the De-
partment relating to such diagnosed mem-
bers; and 
(C) identify recommendations, based on 
the findings of the reviews conducted under 
subsections (A) and (B), to improve the aware-
ness and understanding of regulations and poli-
cies of the Department for individuals diag-
nosed with HBV.
796 
(2) PROVISION OF EDUCATION, TRAINING, RE-
SOURCES, AND
SUPPORT.—The Secretary of De-
fense, taking into account the recommendations 
under paragraph (1)(C), shall provide to members of 
the Armed Forces— 
(A) education, training, and resources to 
increase awareness and understanding of the 
regulations and policies of the Department of 
Defense that govern the screening, documenta-
tion, treatment, management, and practice 
standards for individuals diagnosed with HBV, 
including in health care settings; and 
(B) in the case of members of the Armed 
Forces diagnosed with HBV, education, re-
sources, and support services regarding the reg-
ulations and policies of the Department relating 
to such diagnosed members, including with re-
spect to enlistments, assignments, deployments, 
retention standards, and health care services 
available to such members. 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘HBV’’ means the Hepatitis B 
Virus.
797 
(2) The term ‘‘Secretary concerned’’ has the 
meaning given that term in section 101 of title 10, 
United States Code. 
SEC. 773. CERTIFICATION PROGRAM IN PROVISION OF 
MENTAL HEALTH SERVICES TO MEMBERS OF 
THE ARMED FORCES, VETERANS, AND MILI-
TARY FAMILIES. 
(a) IN GENERAL.—The Secretary of Defense, in con-
sultation with the Secretary of Veterans Affairs and the 
President of the Uniformed Services University of the 
Health Sciences, shall develop a curriculum and certifi-
cation program to provide civilian mental health profes-
sionals and students in mental health-related disciplines 
with the specialized knowledge and skills necessary to ad-
dress the unique mental health needs of members of the 
Armed Forces, veterans, and military families. 
(b) IMPLEMENTATION.—Not later than 90 days after 
completing the development of the curriculum and certifi-
cation program under subsection (a), the Secretary of De-
fense shall implement such curriculum and certification 
program in the Uniformed Services University of the 
Health Sciences. 
(c) AUTHORITY
TO
DISSEMINATE
BEST
PRAC-
TICES.—The Secretary of Defense may disseminate best 
practices based on the curriculum and certification pro-
798 
gram developed and implemented under this section to 
other institutions of higher education. 
(d) TERMINATION.—The authority to carry out the 
curriculum and certification program under this section 
shall terminate on the date that is five years after the date 
of the enactment of this Act. 
(e) REPORT.—Not later than 180 days after the ter-
mination date specified in subsection (d), the Secretary 
of Defense shall submit to the appropriate congressional 
committees a report on the results of the curriculum and 
certification program developed and implemented under 
this section. 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘appropriate congressional com-
mittees’’ means— 
(A) the Committee on Armed Services and 
the Committee on Energy and Commerce of the 
House of Representatives; and 
(B) the Committee on Armed Services and 
the Committee on Health, Education, Labor, 
and Pensions of the Senate. 
(2) The term ‘‘institution of higher education’’ 
has the meaning given that term in section 102 of 
the Higher Education Act of 1965 (20 U.S.C. 
1002).
799 
SEC. 774. PILOT PROGRAM ON CRYOPRESERVATION AND 
STORAGE. 
(a) PILOT PROGRAM.—The Secretary of Defense 
shall establish a pilot program to provide not more than 
1,000 members of the Armed Forces serving on active 
duty with the opportunity to cryopreserve and store their 
gametes prior to deployment in support of combat or spe-
cial operations. 
(b) PERIOD.— 
(1) IN GENERAL.—The Secretary shall provide 
for the cryopreservation and storage of gametes of 
a participating member of the Armed Forces under 
subsection (a), at no cost to the member, in a facil-
ity of the Department of Defense or at a private en-
tity pursuant to an agreement under subsection (d) 
until the date that is one year after the retirement, 
separation, or release of the member from the 
Armed Forces. 
(2) 
CONTINUED
CRYOPRESERVATION
AND 
STORAGE.—At the end of the one-year period speci-
fied in paragraph (1), the Secretary shall authorize 
an individual whose gametes were cryopreserved and 
stored in a facility of the Department as described 
in such paragraph to select, including pursuant to 
an advance medical directive or military testa-
800 
mentary instrument completed under subsection (c), 
one of the following options: 
(A) To continue such cryopreservation and 
storage in such facility with the cost of such 
cryopreservation and storage borne by the indi-
vidual. 
(B) To transfer the gametes to a private 
cryopreservation and storage facility selected by 
the individual. 
(C) To authorize the Secretary to dispose 
of the gametes of the individual not earlier than 
the date that is 90 days after the end of the 
one-year period specified in paragraph (1) with 
respect to the individual. 
(c) ADVANCE MEDICAL DIRECTIVE AND MILITARY 
TESTAMENTARY INSTRUMENT.—A member of the Armed 
Forces who elects to cryopreserve and store their gametes 
under this section shall complete an advance medical di-
rective described in section 1044c(b) of title 10, United 
25 States Code, and a military testamentary instrument 
described in section 1044d(b) of such title, that explicitly 
specifies the use of their cryopreserved and stored gametes 
if such member dies or otherwise loses the capacity to con-
sent to the use of their cryopreserved and stored gametes.
801 
(d) AGREEMENTS.—To carry out this section, the 
Secretary— 
(1) may enter into agreements with private en-
tities that provide cryopreservation and storage serv-
ices for gametes; and 
(2) in selecting such private entities with which 
to enter into agreements, shall (to the maximum ex-
tent practicable) select such private entities that 
offer multi-site storage and fertility testing services 
prior to cryopreservation. 
SEC. 775. PILOT PROGRAM FOR PARTICIPATION BY MEM-
BERS OF SELECTED RESERVE IN HEALTH 
PROFESSIONS SCHOLARSHIP AND FINANCIAL 
ASSISTANCE PROGRAMS. 
(a) PILOT PROGRAM.—Notwithstanding section 2123 
of title 10, United States Code, and in accordance with 
such regulations as may be prescribed by the Secretary 
of Defense for the purpose of carrying out this section, 
each Secretary of a military department shall carry out 
a pilot program under which that Secretary may modify 
service obligations for certain individuals under the health 
professions scholarship and financial assistance program 
of that military department, to expand participation in 
such program to such individuals.
802 
(b) ELIGIBILITY.—To be eligible for participation in 
the pilot program under subsection (a), in addition to 
meeting the eligibility requirements under section 2122 of 
title 10, United States Code, an individual may not have 
previously been a member of the health professions schol-
arship and financial assistance program. 
(c) CONDITIONS ON PARTICIPATION.— 
(1) IN GENERAL.—As a condition of partici-
pating in the pilot program under subsection (a), an 
individual eligible under subsection (b) shall enter 
into an agreement with the Secretary of the military 
department concerned pursuant to which the indi-
vidual agrees— 
(A) to participate as a member of the 
health professions scholarship and financial as-
sistance program of that military department; 
(B) to complete courses of study and spe-
cialized training under such program in a 
health profession discipline designated by that 
Secretary as a critically needed wartime dis-
cipline; and 
(C) upon completion of participation in 
such program, to satisfy, in lieu of the active 
duty obligation under section 2123 of title 10, 
United States Code, a service obligation in the
803 
Selected Reserve of the Ready Reserve of that 
military department for the period described in 
paragraph (2). 
(2) LENGTH OF PERIOD OF SERVICE.—The pe-
riod described in this paragraph is a period of time 
of a length determined by the Secretary of the mili-
tary department concerned, except that such period 
may not be shorter than a period equal to— 
(A) each year of participation in the health 
professions scholarship and financial assistance 
program pursuant to paragraph (1)(A) multi-
plied by two and a half; plus 
(B) if such participation was for a period 
of two years or fewer, an additional two and a 
half years. 
(3) DETAILS OF SERVICE OBLIGATION.—Unless 
otherwise specified by the Secretary of the military 
department concerned— 
(A) any period of time spent in intern or 
residency training shall not be creditable in sat-
isfying the service obligation under paragraph 
(1)(C); 
(B) any period of time used to satisfy an-
other military service obligation shall not be
804 
creditable in satisfying the service obligation 
under paragraph (1)(C); and 
(C) the period described in paragraph (2) 
shall be a consecutive period of time. 
(4) FAILURE TO COMPLETE.— 
(A) ALTERNATIVE OBLIGATIONS.—A par-
ticipant in the pilot program under subsection 
(a) who is relieved of the service obligation 
under paragraph (1)(C) before the completion 
of that service obligation may be given, with or 
without the consent of the participant, either of 
the following alternative obligations, as deter-
mined by the Secretary of the military depart-
ment concerned: 
(i) A service obligation in the Selected 
Reserve of the Ready Reserve of another 
military department for a period of time 
not less than the remaining service obliga-
tion of the participant. 
(ii) Repayment to the Secretary of 
Defense of a percentage of the total cost 
incurred by the Secretary under such pilot 
program on behalf of the member pursuant 
to the repayment provisions of section
805 
303a(e) or 373 of title 37, United States 
Code. 
(B) CIVILIAN EMPLOYEE ALTERNATIVE.— 
In addition to the alternative obligations speci-
fied in subparagraph (A), if a participant in the 
pilot program under subsection (a) is relieved of 
the service obligation under paragraph (1)(C) 
by reason of the separation of the participant 
because of a physical disability, the Secretary of 
the military department concerned may give the 
participant a service obligation as a civilian em-
ployee employed as a health care professional in 
a facility of the uniformed services for a period 
of time determined by that Secretary, but not 
to exceed the remaining service obligation of the 
participant. 
(d) METRICS AND EVALUATIONS.—The Secretary of 
Defense shall establish metrics, and carry out evaluations 
using such metrics, to determine the effectiveness of the 
pilot program under subsection (a). 
(e) TERMINATION.—The authority to carry out the 
pilot program under subsection (a) shall terminate on Oc-
tober 1, 2027. 
(f) BRIEFINGS.—Not later than 180 days prior to the 
date on which the pilot program under subsection (a) ter-
806 
minates, each Secretary of a military department shall 
provide to the Committees on Armed Services of the 
House of Representatives and the Senate a briefing on the 
effectiveness of the pilot program. 
(g) DEFINITIONS.—In this section: 
(1) The terms ‘‘course of study’’ and ‘‘special-
ized training’’ have the meaning given those terms 
in section 2120 of title 10, United States Code. 
(2) The term ‘‘health professions scholarship 
and financial assistance program’’ has the meaning 
given the term ‘‘program’’ under such section. 
(3) The term ‘‘member of the health professions 
scholarship and financial assistance program’’ has 
the meaning given the term ‘‘member of the pro-
gram’’ under such section. 
SEC. 
776. 
PILOT 
PROGRAM 
ON 
ENSURING 
PHARMA-
CEUTICAL SUPPLY STABILITY. 
(a) IN GENERAL.—Not later than January 1 2024, 
the Secretary of Defense, acting through the Director of 
the Defense Logistics Agency, shall establish a pilot pro-
gram to acquire, manage, and replenish a 180-day supply 
of at least 30 commonly used generic drugs at risk of 
shortage under the military health system as a result of 
a pharmaceutical supply chain disruption, to ensure the 
stability of such supply.
807 
(b) MILITARY MEDICAL TREATMENT FACILITIES.— 
The Secretary of Defense shall select for participation in 
the pilot program established under subsection (a) not 
fewer than five military medical treatment facilities that 
are— 
(1) located in the continental United States; 
and 
(2) at the greatest risk of pharmaceutical sup-
ply chain disruption, as determined by the Secretary. 
(c) ELEMENTS.—In carrying out the pilot program 
established under subsection (a), the Secretary of Defense 
shall— 
(1) use the systems and processes of the Direct 
Vendor Delivery System established by section 352 
of the National Defense Authorization Act for Fiscal 
Year 1996 (Public Law 104–106; 10 U.S.C. 2458 
note); 
(2) include the establishment of a vendor man-
aged inventory approach to pharmaceutical distribu-
tion, to acquire, manage, and replenish the vendor- 
held supply described in subsection (a) to prevent 
product expiration and shortages; and 
(3) ensure guaranteed Department of Defense 
access to the vendor managed inventory approach 
specified in paragraph (2).
808 
(d) TERMINATION.—The pilot program established 
under this section shall terminate on the date that is three 
years after the date of the enactment of this Act. 
(e) INITIAL REPORT.—Not later than 30 days after 
the date of the establishment of the pilot program under 
subsection (a), the Secretary of Defense shall submit to 
the Committees on Armed Services of the House of Rep-
resentatives and Senate a report on the design of the pilot 
program. Such report shall include— 
(1) a description of the military medical treat-
ment facilities selected under subsection (b) and the 
generic drugs selected for the pilot program pursu-
ant to subsection (a); 
(2) the plan for the implementation and man-
agement of the pilot program; and 
(3) key performance indicators to measure the 
success of the pilot program in ensuring the avail-
ability of generic drugs selected for the pilot pro-
gram pursuant to subsection (a). 
(f) FINAL REPORT.—Not later than 180 days after 
the termination date under subsection (d), the Secretary 
of Defense shall submit to the Committees on Armed Serv-
ices of the House of Representatives and Senate a final 
report on the results of the pilot program. The report shall 
include—
809 
(1) measurements of key performance indica-
tors identified in the initial report required under 
subsection (e); 
(2) an analysis of the success of the pilot pro-
gram in preventing shortages of commonly used ge-
neric drugs within the military medical treatment fa-
cilities selected under subsection (b); and 
(3) recommendations for further expansions of 
the pilot program, including any legislative or regu-
latory proposals the Secretary determines would re-
duce supply chain risk to commonly used generic 
drugs under the military health system. 
(g) DEFINITIONS.—In this section: 
(1) The term ‘‘generic drug’’ means a drug (as 
defined in section 201 of the Federal Food, Drug, 
and Cosmetic Act (21 U.S.C. 231)) that is approved 
pursuant to section 505(j) of such Act (21 U.S.C. 
355(j)). 
(2) The term ‘‘pharmaceutical supply chain dis-
ruption’’ means a disruption described in the report 
of the Inspector General of the Department of De-
fense titled ‘‘Evaluation of the Department of De-
fense’s Mitigation of Foreign Suppliers in the Phar-
maceutical Supply Chain’’ (DODIG-2021-126) and 
published on September 20, 2021.
810 
SEC. 777. ESTABLISHMENT OF PARTNERSHIP PROGRAM BE-
TWEEN UNITED STATES AND UKRAINE FOR 
MILITARY TRAUMA CARE AND RESEARCH. 
Not later than February 24, 2023, the Secretary of 
Defense shall seek to enter into a partnership with the 
appropriate counterpart from the Government of Ukraine 
for the establishment of a joint program on military trau-
ma care and research. Such program shall consist of the 
following: 
(1) The sharing of relevant lessons learned 
from the Russo-Ukraine War. 
(2) The conduct of relevant joint conferences 
and exchanges with military medical professionals 
from Ukraine and the United States. 
(3) Collaboration with the armed forces of 
Ukraine on matters relating to health policy, health 
administration, and medical supplies and equipment, 
including through knowledge exchanges. 
(4) The conduct of joint research and develop-
ment on the health effects of new and emerging 
weapons. 
(5) The entrance into agreements with military 
medical schools of Ukraine for reciprocal education 
programs under which students at the Uniformed 
Services University of the Health Sciences receive 
specialized military medical instruction at the such
811 
military medical schools of Ukraine and military 
medical personnel of Ukraine receive specialized 
military medical instruction at the Uniformed Serv-
ices University of the Health Sciences, pursuant to 
section 2114(f) of title 10, United States Code. 
(6) The provision of support to Ukraine for the 
purpose of facilitating the establishment in Ukraine 
of a program substantially similar to the Wounded 
Warrior Program in the United States. 
(7) The provision of training to the armed 
forces of Ukraine in the following areas: 
(A) Health matters relating to chemical, 
biological, radiological, nuclear and explosive 
weapons. 
(B) Preventive medicine and infectious dis-
ease. 
(C) Post traumatic stress disorder. 
(D) Suicide prevention. 
(8) The maintenance of a list of medical sup-
plies and equipment needed. 
(9) Such other elements as the Secretary of De-
fense may determine appropriate.
812 
SEC. 778. GRANT PROGRAM FOR INCREASED COOPERA-
TION 
ON 
POST-TRAUMATIC 
STRESS 
DIS-
ORDER RESEARCH BETWEEN UNITED STATES 
AND ISRAEL. 
(a) SENSE OF CONGRESS.—It is the sense of Con-
gress that the Secretary of Defense, acting through the 
Psychological Health and Traumatic Brain Injury Re-
search Program, should seek to explore scientific collabo-
ration between American academic institutions and non-
profit research entities, and Israeli institutions with exper-
tise in researching, diagnosing, and treating post-trau-
matic stress disorder. 
(b) GRANT PROGRAM.—The Secretary of Defense, in 
coordination with the Secretary of Veterans Affairs and 
the Secretary of State, shall award grants to eligible enti-
ties to carry out collaborative research between the United 
States and Israel with respect to post-traumatic stress dis-
orders. The Secretary of Defense shall carry out the grant 
program under this section in accordance with the agree-
ment titled ‘‘Agreement Between the Government of the 
United States of America and the Government of Israel 
on the United States-Israel Binational Science Founda-
tion’’, dated September 27, 1972. 
(c) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant under this section, an entity shall be an academic
813 
institution or a nonprofit entity located in the United 
States. 
(d) AWARD.—The Secretary shall award grants 
under this section to eligible entities that— 
(1) carry out a research project that— 
(A) addresses a requirement in the area of 
post-traumatic stress disorders that the Sec-
retary determines appropriate to research using 
such grant; and 
(B) is conducted by the eligible entity and 
an entity in Israel under a joint research agree-
ment; and 
(2) meet such other criteria that the Secretary 
may establish. 
(e) APPLICATION.—To be eligible to receive a grant 
under this section, an eligible entity shall submit an appli-
cation to the Secretary at such time, in such manner, and 
containing such commitments and information as the Sec-
retary may require. 
(f) GIFT AUTHORITY.—The Secretary may accept, 
hold, and administer, any gift of money made on the con-
dition that the gift be used for the purpose of the grant 
program under this section. Such gifts of money accepted 
under this subsection shall be deposited in the Treasury 
in the Department of Defense General Gift Fund and shall
814 
be available, subject to appropriation, without fiscal year 
limitation. 
(g) REPORTS.—Not later than 180 days after the 
date on which an eligible entity completes a research 
project using a grant under this section, the Secretary 
shall submit to Congress a report that contains— 
(1) a description of how the eligible entity used 
the grant; and 
(2) an evaluation of the level of success of the 
research project. 
(h) TERMINATION.—The authority to award grants 
under this section shall terminate on the date that is 7 
years after the date on which the first such grant is 
awarded. 
SEC. 779. SUICIDE CLUSTER: STANDARDIZED DEFINITION 
FOR USE BY DEPARTMENT OF DEFENSE; CON-
GRESSIONAL NOTIFICATION. 
(a) STANDARDIZATION OF DEFINITION.—Not later 
than one year after the date of the enactment of this Act, 
the Secretary of Defense, in consultation with the Secre-
taries concerned, shall develop, for use across the Armed 
Forces, a standardized definition for the term ‘‘suicide 
cluster’’. 
(b) NOTIFICATION REQUIRED.—Beginning not later 
than one year after the date of the enactment of this Act,
815 
whenever the Secretary determines the occurrence of a sui-
cide cluster (as that term is defined pursuant to sub-
section (a)) among members of the Armed Forces, the 
Secretary shall submit to the appropriate congressional 
committees a notification of such determination. 
(c) COORDINATION REQUIRED.—In developing the 
definition under subsection (a) and the process for submit-
ting required notifications under subsection (b), the Sec-
retary of Defense shall coordinate with the Secretaries 
concerned. 
(d) BRIEFING.—Not later than April 1, 2023, the 
Secretary of Defense shall provide to the appropriate con-
gressional committees a briefing on the following: 
(1) The methodology being used in the develop-
ment of the definition under subsection (a). 
(2) The progress made towards the development 
of the process for submitting required notifications 
under subsection (b). 
(3) An estimated timeline for the implementa-
tion of this section. 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘appropriate congressional com-
mittees’’ means the following: 
(A) The Committee on Armed Services of 
the House of Representatives.
816 
(B) The Committee on Armed Services of 
the Senate. 
(C) The Committee on Transportation and 
Infrastructure of the House of Representatives. 
(D) The Committee on Commerce, Science, 
and Transportation of the Senate. 
(2) The term ‘‘Secretary concerned’’ has the 
meaning given that term in section 101 of title 10, 
United States Codes. 
SEC. 780. LIMITATION ON REALIGNMENT OR REDUCTION 
OF 
MILITARY 
MEDICAL 
MANNING 
END 
STRENGTH: CERTIFICATION REQUIREMENT 
AND OTHER REFORMS. 
(a) LIMITATION.— 
(1) IN GENERAL.—In addition to the limitation 
under section 719 of the National Defense Author-
ization Act for Fiscal Year 2020 (Public Law 116– 
92; 133 Stat. 1454), as most recently amended by 
section 731 of the National Defense Authorization 
Act for Fiscal Year 2022 (Public Law 117–81; 135 
Stat. 1795), the Secretary of Defense and the Secre-
taries concerned may not realign or reduce military 
medical end strength authorizations during the pe-
riod described in paragraph (2), and after such pe-
817 
riod, may not realign or reduce such authorizations 
unless— 
(A) the report is submitted under sub-
section (b); and 
(B) the certification is submitted under 
subsection (c). 
(2) COVERED PERIOD.—The period described in 
this paragraph is a period of at least three years 
that begins on the date of the enactment of this Act. 
(b) REPORT ON COMPOSITION OF MILITARY MED-
ICAL WORKFORCE REQUIREMENTS.—The Secretary of 
Defense, in coordination with the Secretaries of the mili-
tary departments, shall conduct an assessment of military 
medical manning requirements and submit to Committees 
on Armed Services of the House of Representatives and 
the Senate a report containing the findings of such assess-
ment. Such assessment shall be informed by the following: 
(1) The National Defense Strategy submitted 
under section 113(g) of title 10, United States Code. 
(2) The National Military Strategy prepared 
under section 153(b) of such title. 
(3) The campaign plans of the combatant com-
mands. 
(4) Theater strategies.
818 
(5) The joint medical estimate under section 
732 of the John S. McCain National Defense Au-
thorization Act for Fiscal Year 2019 (Public Law 
115–232; 132 Stat. 1817). 
(6) The plan of the Department of Defense on 
integrated medical operations, as updated pursuant 
to paragraph (1) of section 724(a) of the National 
Defense Authorization Act for Fiscal Year 2022 
(Public Law 117–81; 135 Stat. 1793; 10 U.S.C. 
1096 note). 
(7) The plan of the Department of Defense on 
global patient movement, as updated pursuant to 
paragraph (2) of such section. 
(8) The biosurveillance program of the Depart-
ment of Defense established pursuant to Depart-
ment of Defense Directive 6420.02 (relating to bio-
surveillance). 
(9) Requirements for graduate medical edu-
cation. 
(10) The report of the COVID–19 Military 
Health System Review Panel under section 731 of 
the William M. (Mac) Thornberry National Defense 
Authorization Act for Fiscal Year 2021 (Public Law 
116–283; 134 Stat. 3698).
819 
(11) The report of the Inspector General of the 
Department of Defense titled ‘‘Evaluation of De-
partment of Defense Military Medical Treatment 
Facility Challenges During the Coronavirus Disease- 
2019 (COVID-19) Pandemic in Fiscal Year 2021 
(DODIG-2022-081)’’ and published on April 5, 
2022. 
(12) Such other reports as may be determined 
appropriate by the Secretary of Defense. 
(c) CERTIFICATION.—The Secretary of Defense shall 
submit to the Committees on Armed Services of the House 
of Representatives and the Senate a certification con-
taining the following: 
(1) A certification of the completion of a com-
prehensive review of military medical manning, in-
cluding with respect to the medical corps (or other 
health- or medical-related component of a military 
department), designator, profession, occupation, and 
rating of medical personnel. 
(2) A justification for any proposed increase, 
realignment, reduction, or other change to the spe-
cialty and occupational composition of military med-
ical end strength authorizations, which may include 
compliance with a requirement or recommendation
820 
set forth in a strategy, plan, or other matter speci-
fied in subsection (b). 
(3) A certification that, in the case that any 
change to such specialty or occupational composition 
is required, a vacancy resulting from such change 
may not be filled with a position other than a 
health- or medical-related position until such time as 
there are no military medical billets remaining to fill 
the vacancy. 
(4) A risk analysis associated with the potential 
realignment or reduction of any military medical end 
strength authorizations. 
(5) An identification of any plans of the De-
partment to backfill military medical personnel posi-
tions with civilian personnel. 
(6) A plan to address persistent vacancies for 
civilian personnel in health- or medical-related posi-
tions, and a risk analysis associated with the hiring, 
onboarding, and retention of such civilian personnel, 
taking into account provider shortfalls across the 
United States. 
(7) A comprehensive plan to mitigate any risk 
identified pursuant to paragraph (4) or (6), includ-
ing with respect to funding necessary for such miti-
gation across fiscal years.
821 
(d) INTERIM BRIEFINGS AND FINAL REPORT.— 
(1) INITIAL BRIEFING.—Not later than April 1, 
2023, the Secretary of Defense shall provide to the 
Committees on Armed Services of the House of Rep-
resentatives and the Senate a briefing on how the 
Secretary plans to meet the report requirement 
under subsection (b) and the certification require-
ment under subsection (c). 
(2) BRIEFING ON PROGRESS.—Not later than 
two years after the date of the enactment of this 
Act, the Secretary of Defense shall provide to the 
Committees on Armed Services of the House of Rep-
resentatives and the Senate a briefing on the 
progress made towards completion of such require-
ments. 
(3) FINAL REPORT.—Not later than three years 
after the date of the enactment of this Act, the Sec-
retary of Defense shall submit to the Committees on 
Armed Services of the House of Representatives and 
the Senate a final report on the completion of such 
requirements. Such final report shall be in addition 
to the report required under subsection (b) and the 
certification required under subsection (c). 
(e) DEFINITIONS.—In this section:
822 
(1) The term ‘‘medical personnel’’ has the 
meaning given such term in section 115a(e) of such 
title. 
(2) The term ‘‘theater strategy’’ means an over-
arching construct outlining the vision of a combatant 
commander for the integration and synchronization 
of military activities and operations with other na-
tional power instruments to achieve the strategic ob-
jectives of the United States. 
SEC. 781. REVIEW AND UPDATE OF POLICY RELATING TO 
COMMAND NOTIFICATION PROCESS AND RE-
DUCTION OF MENTAL HEALTH STIGMA. 
(a) REVIEW AND UPDATE.— 
(1) IN GENERAL.—Not later than October 1, 
2023, the Secretary of Defense, in coordination with 
the Secretaries of the military departments, shall re-
view and update the Department of Defense Instruc-
tion 6490.08, titled ‘‘Command Notification Re-
quirements to Dispel Stigma in Providing Mental 
Health Care to Service Members’’, or any successor 
instruction. 
(2) ELEMENTS.—In carrying out the review 
and update of the instruction under paragraph (1), 
the Secretary shall ensure the updated version—
824 
(b) REPORT.—Not later than April 1, 2023, the Sec-
retary of Defense shall submit to the Committees on 
Armed Services of the House of Representatives and the 
Senate a report on the progress made towards the comple-
tion of the review and update under subsection (a). 
SEC. 782. GRANT PROGRAM TO STUDY TREATMENT OF 
POST-TRAUMATIC STRESS DISORDER USING 
CERTAIN PSYCHEDELIC SUBSTANCES. 
(a) GRANT PROGRAM.—The Secretary of Defense 
shall carry out a program to award grants to eligible enti-
ties to conduct research on the treatment of members of 
the Armed Forces serving on active duty with post-trau-
matic stress disorder using covered psychedelic sub-
stances. 
(b) CRITERION FOR APPROVAL.—The Secretary may 
award a grant under this section to an eligible entity to 
conduct research if the Secretary determines that the re-
search involves a therapy that has the potential to dem-
onstrate significant medical evidence of a therapeutic ad-
vantage. 
(c) ELIGIBLE ENTITIES.—The Secretary may award 
a grant under this section to any of the following: 
(1) A department or agency of the Federal Gov-
ernment or a State government. 
(2) An academic institution.
825 
(3) A nonprofit entity. 
(d) USE OF GRANT FUNDS.—A recipient of a grant 
awarded under this section may use the grant to— 
(1) conduct one or more phase two clinical 
trials for the treatment of post-traumatic stress dis-
order that— 
(A) include members of the Armed Forces 
serving on active duty as participants in the 
clinical trial; and 
(B) use individual or group therapy as-
sisted by covered psychedelic substances; or 
(2) train practitioners to provide treatment to 
members of the Armed Forces serving on active duty 
for post-traumatic stress disorder using covered psy-
chedelic substances. 
(e) PARTICIPATION IN CLINICAL TRIALS.—The Sec-
retary may authorize a member of the Armed Forces to 
participate in a clinical trial that is conducted using a 
grant awarded under this section or funds provided under 
subsection (f) and is authorized pursuant to section 505 
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
355), without regard to— 
(1) whether the clinical trial involves a sub-
stance included in the schedule under section 202 of 
the Controlled Substances Act (21 U.S.C. 812); or
826 
(2) section 912a of title 10, United States Code 
(article 112a of the Uniform Code of Military Jus-
tice). 
(f) ADDITIONAL AUTHORITY.—In addition to award-
ing grants under this section, the Secretary may provide 
funds for a clinical research trial using covered psychedelic 
substances that is authorized pursuant to section 505 of 
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 
355) and includes members of the Armed Forces as par-
ticipants in the trial. 
(g) DEFINITIONS.—In this section: 
(1) The term ‘‘covered psychedelic substances’’ 
means any of the following: 
(A) 3,4-methylenedioxy-methamphetamine 
(commonly known as ‘‘MDMA’’). 
(B) Psilocybin. 
(C) Ibogaine. 
(D) 
5–Methoxy-N,N-dimethyltryptamine 
(commonly known as ‘‘5–MeO–DMT’’). 
(2) The term ‘‘State’’ includes any State, dis-
trict, territory, or possession of the United States. 
SEC. 783. PILOT PROGRAMS OF DEFENSE HEALTH AGENCY 
RELATING TO SEXUAL HEALTH. 
(a) TELEHEALTH PILOT PROGRAM
ON SEXUAL 
HEALTH.—
827 
(1) ESTABLISHMENT.—The Director of the De-
fense Health Agency shall carry out a five-year tele-
health pilot program for sexual health (in this sub-
section referred to as the ‘‘telehealth pilot pro-
gram’’). 
(2) ELIGIBILITY.—An individual is eligible to 
participate in the telehealth pilot program if the in-
dividual is a member of the uniformed services on 
active duty enrolled in TRICARE Prime, without re-
gard to whether a health care professional has re-
ferred the individual for such participation. 
(3) APPLICATIONS.— 
(A) IN
GENERAL.—Eligible individuals 
seeking to participate in the telehealth pilot 
program shall submit to the Director an appli-
cation for participation at such time, in such 
form, and containing such information as the 
Director may prescribe. 
(B) ONLINE ACCESSIBILITY.—Any applica-
tion form under subparagraph (A) shall be ac-
cessible online. 
(4) NUMBER OF PARTICIPANTS.—In selecting 
participants for the telehealth pilot program from 
among eligible individuals who have submitted an 
application in accordance with paragraph (3), the
828 
Director may establish a cap limiting the number of 
such participants only if— 
(A) the Director determines that such lim-
ited participation is necessary as a result of 
limited provider availability; and 
(B) not later than 30 days after making 
such determination, the Director submits to the 
congressional defense committees a report that 
includes— 
(i) a description of the limited pro-
vider availability upon which the Director 
has based such determination; 
(ii) an identification of the total num-
ber of eligible individuals who have sub-
mitted an application in accordance with 
paragraph (3); and 
(iii) an estimated timeline for lifting 
the cap established. 
(5) TELEHEALTH SCREENINGS.— 
(A) IN
GENERAL.—Under the telehealth 
pilot program, the Director shall furnish to any 
eligible individual who elects to participate in 
such program a telehealth screening. During 
such screening, a health care provider shall—
829 
(i) conduct a remote assessment with 
respect to the individual’s sexual health, 
including any medication conditions related 
to the individual’s sexual health 
(ii) provide comprehensive counseling 
on the full range of methods of contracep-
tion available to the individual, in accord-
ance with the clinical practice guidelines 
established under section 718 of the Na-
tional Defense Authorization Act for Fiscal 
Year 2016 (Public Law 114–92; 129 Stat. 
686; 10 U.S.C. 1074d note); 
(iii) as applicable, diagnose the indi-
vidual or, pursuant to subparagraph (B), 
order 
appropriate 
follow-up 
diagnostic 
services as necessary as a result of the as-
sessment under clause (i); and 
(iv) prescribe such prescription medi-
cations, including contraceptives or Pre- 
Exposure Prophylaxis, as may be deter-
mined necessary by the provider as a result 
of such assessment. 
(B) 
LABORATORY
DIAGNOSTIC
SERV-
ICES.—In diagnosing an individual under sub-
paragraph (A)(iii), a health care provider may
830 
furnish to the individual such laboratory diag-
nostic services as may be necessary for the di-
agnosis (including mail-order laboratory diag-
nostic services). 
(C) PRESCRIPTIONS.—The Director shall 
ensure that prescriptions under subparagraph 
(A)(iv) may be filled through either military 
medical treatment facility pharmacies or the na-
tional mail-order pharmacy program under the 
TRICARE program. 
(6) FOLLOW-UP REMOTE APPOINTMENTS.—If a 
health care provider prescribes medications to an in-
dividual pursuant to a screening under the telehelath 
pilot program, that health care provider shall con-
duct such follow-up remote appointments as may be 
necessary to monitor the health of the individual fol-
lowing fulfilment of the prescription. 
(7) COORDINATION WITH FACILITIES.—The Di-
rector shall coordinate with each military com-
mander or director of a military medical treatment 
facility to facilitate the provision through the facility 
of laboratory and other services necessary for the 
furnishment of screenings and the fulfilment of pre-
scriptions under the telehealth pilot program.
831 
(8) CONTRACT
AUTHORITY.—In carrying out 
the telehealth pilot program, the Director may enter 
into contracts under such program with providers of 
mail-order laboratory services and providers of mail- 
order contraceptives or Pre-Exposure Prophylaxis 
for the furnishment of laboratory services or the ful-
filment of prescriptions under paragraph (5). 
(9) REPORTS.—Not later than one year after 
the date of the enactment of this Act, and annually 
thereafter for five years, the Secretary of Defense 
shall submit to the congressional defense committees 
a report on the status and effects of the telehealth 
pilot program. Each such report shall include, with 
respect to the year covered by the report, the fol-
lowing: 
(A) The number of health care providers 
who have furnished services under the tele-
health pilot program, dissagregated by whether 
the provider is a TRICARE network provider. 
(B) The average wait time for screenings 
under the telehealth pilot program. 
(C) Any effect of the telehealth pilot pro-
gram with respect to the Defense Health Agen-
cy.
832 
(D) Such other information relating to the 
status or effect of the telehealth pilot program 
as may be determined relevant by the Sec-
retary. 
(b) PILOT PROGRAM ON REQUIRED SEXUAL HEALTH 
SCREENINGS.— 
(1) IN GENERAL.—The Director of the Defense 
Health Agency shall carry out a five-year pilot pro-
gram to require certain sexual health screenings (in 
this subsection referred to as the ‘‘pilot program’’). 
(2) SEXUAL HEALTH SCREENINGS.— 
(A) IN
GENERAL.—Under the pilot pro-
gram, the Director shall ensure that, during the 
period in which the pilot program is carried out, 
each covered member completes a sexual health 
screening on an annual basis and prior to any 
deployment of the covered member. 
(B) NOTICE REQUIREMENT.—The Director 
shall ensure that, prior to a covered member re-
ceiving a sexual health screening under the pilot 
program, the covered member is provided no-
tice, and submits an acknowledgment, that the 
results of such screening shall be subject to the 
confidentiality provisions under paragraph (3).
833 
(C) OPTION
FOR
FOLLOW-UP
APPOINT-
MENT.—Following the provision of a sexual 
health screening to a covered member under the 
pilot program, the covered member may elect to 
receive a follow-up appointment related to such 
screening. Any such follow-up appointment shall 
be conducted by the provider specified in para-
graph (4) responsible for reviewing the results 
of the screening. 
(3) CONFIDENTIALITY.— 
(A) TRANSMISSION OF RESULTS OUTSIDE 
CHAIN OF COMMAND.—Except as provided in 
subparagraph (B), the results of a sexual health 
screening furnished to a covered member under 
the pilot program shall be transmitted for re-
view to the provider specified in paragraph (4) 
at the military medical treatment facility near-
est to the location at which the screening was 
furnished. Such results may not be transmitted 
to or otherwise accessed by the following: 
(i) Any individual in the chain of com-
mand of the covered member. 
(ii) The primary health care provider 
for the unit of the covered member.
834 
(B) EXCEPTION
AT
ELECTION
OF
MEM-
BER.—The results of a sexual health screening 
furnished to a covered member under the pilot 
program may be transmitted for review to, or 
otherwise accessed by, the primary health care 
provider for the unit of the covered member at 
the election of the covered member. 
(C) SEVERABILITY OF RESULTS.—If a sex-
ual health screening under the pilot program is 
furnished as part of a periodic health assess-
ment (or other similar assessment) provided to 
a covered member, the results of such screening 
shall be separated from the other results of the 
assessment for purposes of separate trans-
mission and review in accordance with subpara-
graph (A). 
(4) SEXUAL HEALTH OR INFECTIOUS DISEASE 
HEALTH CARE PROVIDERS.—The Director shall en-
sure that at each military medical treatment facility 
there is a health care provider with a specialty in 
sexual health or infectious diseases who shall review 
screening results under the pilot program. 
(5) REPORTS.—Not later than one year after 
the date of the enactment of this Act, and annually 
thereafter for five years, the Secretary of Defense
835 
shall submit to the congressional defense committees 
a report on the status and effects of the pilot pro-
gram. 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘covered member’’ means a mem-
ber of a uniformed service described in section 
1074(a)(2) of title 10, United States Code. 
(2) The term ‘‘military medical treatment facil-
ity’’ means a facility specified in section 1073d of 
title 10, United States Code. 
(3) 
The 
terms 
‘‘TRICARE 
Prime’’ 
and 
‘‘TRICARE program’’ have the meaning given those 
terms in section 1072 of such title. 
SEC. 784. DROP BOXES ON MILITARY INSTALLATIONS FOR 
DEPOSIT OF UNUSED PRESCRIPTION DRUGS. 
(a) DROP BOXES.—The Secretary of Defense shall 
ensure there is maintained on each military installation 
a drop box that is accessible to members of the Armed 
Forces and the family members thereof, into which such 
members and family members may deposit unused pre-
scription drugs. 
(b) PRESCRIPTION DRUG DEFINED.—In this section, 
the term ‘‘prescription drug’’ has the meaning given that 
term in section 1074g(i) of title 10, United States Code.
836 
SEC. 785. FUNDING FOR PANCREATIC CANCER RESEARCH. 
(a) INCREASE.—Notwithstanding the amounts set 
forth in the funding tables in division D, the amount au-
thorized to be appropriated in section 1405 for the De-
fense Health Program, as specified in the corresponding 
funding table in section 4501, for Defense Health Pro-
gram, R&D research is hereby increased by $5,000,000 
(with the amount of such increase to be used in support 
of the CRDMP Program for Pancreatic Cancer Research). 
(b) OFFSET.—Notwithstanding the amounts set forth 
in the funding tables in division D, the amount authorized 
to be appropriated in section 301 for operation and main-
tenance, Defense-wide, as specified in the corresponding 
funding table in section 4301, for administration and serv-
ice-wide activities, Defense Human Resources Activity, 
line 240, is hereby reduced by $5,000,000. 
SEC. 786. PSYCHOLOGICAL EVALUATIONS FOR MEMBERS 
OF THE ARMED FORCES RETURNING FROM 
KABUL. 
(a) INITIAL EVALUATION.—Not later than 180 days 
after the date of the enactment of this Act, the Secretary 
of Defense shall provide an initial psychological evaluation 
to each member of the Armed Forces who— 
(1) served at the Hamid Karzai International 
Airport in Kabul, Afghanistan, between August 15 
and August 29, 2021; and
837 
(2) has not already received a psychological 
evaluation with respect to such service. 
(b) ADDITIONAL EVALUATIONS.—The Secretary of 
Defense shall provide to each member of the Armed 
Forces who receives a psychological evaluation under sub-
section (a), or would have received such an evaluation but 
for the application of subsection (a)(2)— 
(1) an additional psychological evaluation not 
later than two years after the date of the enactment 
of this Act; and 
(2) a second additional psychological evaluation 
not later than five years after the date of the enact-
ment of this Act. 
(c) REPORTING REQUIREMENT.—Not later than 220 
days after the date of the enactment of this Act, the Sec-
retary of Defense shall submit to the congressional defense 
committees a report on the number of members of the 
Armed Forces, broken down by component (National 
Guard, Reserve, and Active), that are eligible for, and re-
ceive, an initial psychological evaluation— 
(1) under subsection (a); or 
(2) otherwise resulting from service at the 
Hamid Karzai International Airport in Kabul, Af-
ghanistan, between August 15 and August 29, 2021.
838 
SEC. 787. ANNUAL REVIEW AND UPDATE OF ONLINE INFOR-
MATION RELATING TO SUICIDE PREVENTION. 
Not later than September 30, 2023, and on an an-
nual basis thereafter, each Secretary of a military depart-
ment shall— 
(1) review any information relating to suicide 
prevention or behavioral health, including any con-
tact information for related resources, that is pub-
lished on an Internet website of the military depart-
ment at the installation level; 
(2) make updates to such information as may 
be necessary; and 
(3) submit to the congressional defense commit-
tees a certification that such information is up-to- 
date. 
SEC. 788. FUNDING FOR POST-TRAUMATIC STRESS DIS-
ORDER. 
(a) FUNDING.—Notwithstanding the amounts set 
forth in the funding tables in division D, the amount au-
thorized to be appropriated by section 1405 for the De-
fense Health Program, as specified in the corresponding 
funding table in such division, is hereby increased by 
$2,500,000 for post-traumatic stress disorder. 
(b) OFFSET.—Notwithstanding the amounts set forth 
in the funding tables in division D, the amount authorized 
to be appropriated by section 1405 for the Defense Health
839 
Program, as specified in the corresponding funding tables 
in division D, for Private Sector Care is hereby reduced 
by $2,500,000. 
SEC. 789. INCREASED COLLABORATION WITH NIH TO COM-
BAT TRIPLE NEGATIVE BREAST CANCER. 
(a) IN GENERAL.—The Office of Health of the De-
partment of Defense shall work in collaboration with the 
National Institutes of Health to— 
(1) identify specific genetic and molecular tar-
gets and biomarkers for triple negative breast can-
cer; and 
(2) provide information useful in biomarker se-
lection, drug discovery, and clinical trials design that 
will enable both— 
(A) triple negative breast cancer patients 
to be identified earlier in the progression of 
their disease; and 
(B) the development of multiple targeted 
therapies for the disease. 
(b) FUNDING.—Notwithstanding the amounts set 
forth in the funding tables in division D, the amount au-
thorized to be appropriated by section 1405 for the De-
fense Health Program, as specified in the corresponding 
funding tables in division D, is hereby increased by 
$10,000,000 to carry out subsection (a).
840 
(c) OFFSET.—Notwithstanding the amounts set forth 
in the funding tables in division D, the amount authorized 
to be appropriated by section 1405 for the Defense Health 
Program, as specified in the corresponding funding tables 
in division D, for Private Sector Care is hereby reduced 
by $10,000,000. 
SEC. 790. PILOT PROGRAM TO IMPROVE MILITARY READI-
NESS THROUGH NUTRITION AND WELLNESS 
INITIATIVES. 
(a) PILOT PROGRAM.—The Secretary of Defense, in 
consultation with the Secretaries of the military depart-
ments, shall carry out a pilot program to improve military 
readiness through nutrition and wellness initiatives. 
(b) UNIT SELECTION.—The Secretary of Defense 
shall select for participation in the pilot program under 
subsection (a) a unit at a basic training facility or an early 
instructional facility of a military department. 
(c) ELEMENTS.—The pilot program under subsection 
(a) shall include the following activities: 
(1) The development, and administration to the 
unit selected pursuant to subsection (b), of an edu-
cational curriculum relating to nutrition, physical 
fitness, the proper use of supplements, and any 
other human performance elements determined rel-
841 
evant by the Secretary of the military department 
with jurisdiction over the unit. 
(2) The provision to the unit of health-related 
testing. 
(3) The provision to the unit of dietary supple-
ments. 
(d) IMPLEMENTING PARTNER.— 
(1) SELECTION.—The Secretary of Defense 
shall select as an implementing partner a single con-
tractor to both carry out all of the activities under 
subsection (c) and manufacture at a manufacturing 
facility owned by the contractor the dietary supple-
ments to be provided pursuant to subsection (c)(3). 
In making such selection, the Secretary shall ensure 
that the contractor enforces an appropriate level of 
third-party review with respect to the quality and 
safety of products manufactured, as determined by 
the Secretary. 
(2) CONSIDERATIONS.— In selecting the con-
tractor under paragraph (1), the Secretary shall con-
sider the following: 
(A) Whether the contractor has the ability 
to carry out each activity under subsection (c), 
in addition to the ability to manufacture the di-
842 
etary supplements to be provided pursuant to 
subsection (c)(3). 
(B) Whether the manufacturing facility of 
the contractor is a fully independent, third- 
party certified, manufacturing facility that 
holds the highest ‘‘Good Manufacturing Prac-
tice’’ certification or rating possible, as issued 
by a regulatory agency of the Federal govern-
ment. 
(C) Whether the manufacturing facility of 
the contractor, and all finished products manu-
factured therein, have been verified by a third- 
party as free from banned substances and con-
taminants. 
(D) Whether the contractor is in compli-
ance with the adverse event reporting policy 
and third-party adverse event monitoring policy 
of the Food and Drug Administration. 
(E) Whether the contractor implements a 
stability testing program that supports product 
expiration dating. 
(F) Whether the contractor has a credible 
and robust environment, social, and governance 
policy that articulates responsibilities and an-
nual goals.
843 
(G) Whether the contractor has dem-
onstrated at least five years of operation as a 
business in good standing in the industry. 
(H) Whether the contractor has a dem-
onstrated history of maintaining relationships 
with nationally-recognized medical and health 
organizations. 
(e) COORDINATION.—In carrying out the pilot pro-
gram under subsection (a), the contractor selected under 
subsection (d) shall coordinate with the following: 
(1) Command, training, and medical officers 
and noncommissioned officers. 
(2) Outside experts (including experts with rel-
evant experience from research and testing organiza-
tions, credible medical committees, or hospitals) that 
may lend personalized support, capture data, and fa-
cilitate third-party adverse event reporting. 
(f) DURATION.—The pilot program under subsection 
(a) shall be for a period of six months. 
(g) REPORT.—Upon the termination of the pilot pro-
gram under subsection (a), the Secretary of Defense shall 
submit to the congressional defense committees a report 
on the results of the pilot program, including any findings 
or data from the pilot program, and a recommendation 
by the Secretary of Defense for improvements to the readi-
844 
ness of the Armed Forces based on such findings and 
data. 
SEC. 791. GUIDANCE FOR ADDRESSING HEALTHY RELA-
TIONSHIPS AND INTIMATE PARTNER VIO-
LENCE THROUGH TRICARE PROGRAM. 
The Secretary of Defense shall disseminate guidance 
on— 
(1) the provision through the TRICARE Pro-
gram of universal education on healthy relationships 
and intimate partner violence; and 
(2) implementation of protocols through the 
TRICARE Program for— 
(A) routine assessment of intimate partner 
violence and sexual assault; and 
(B) promotion and strategies for trauma- 
informed care plans.
845 
TITLE VIII—ACQUISITION POL-
ICY, ACQUISITION MANAGE-
MENT, AND RELATED MAT-
TERS 
Subtitle A—Acquisition Policy and 
Management 
SEC. 801. WRITING AWARD TO ENCOURAGE CURIOSITY AND 
PERSISTENCE IN OVERCOMING OBSTACLES 
IN ACQUISITION. 
(a) IN GENERAL.—Chapter 87 of title 10, United 
States Code, is amended by inserting after section 1742 
the following new section: 
‘‘§ 1743. Writing award to encourage curiosity and 
persistence in overcoming obstacles in 
the defense acquisition system 
‘‘(a) ESTABLISHMENT.—The President of the De-
fense Acquisition University shall establish an award to 
recognize members of the acquisition workforce who use 
an iterative writing process to document a first-hand ac-
count of using independent judgment to overcome an ob-
stacle the member faced while working within the defense 
acquisition system (as defined in section 3001 of this 
title).
846 
‘‘(b) SUBMISSION REQUIRED.—A member of the ac-
quisition workforce desiring an award under this section 
shall submit to the President such first-hand account. 
‘‘(c) AMOUNT OF AWARD.—A recipient of an award 
under this section shall receive $10,000. 
‘‘(d) NUMBER OF AWARDS.—The President of the 
Defense Acquisition University may make not more than 
five awards each year. 
‘‘(e) WEBPAGE.—The President of the Defense Ac-
quisition University shall establish and maintain a 
webpage to serve as a repository for submissions made 
under subsection (b). Such webpage shall allow for public 
comments and discussion. 
‘‘(f) CONTENTS OF SUBMISSION.—The recipient of 
an award under this section shall demonstrate in the sub-
mission described under subsection (b)— 
‘‘(1) an original and engaging idea documenting 
the use of independent judgment to overcome an ob-
stacle the recipient faced while working within the 
defense acquisition system; and 
‘‘(2) the use of an iterative writing process, in-
cluding evidence of— 
‘‘(A) critical thinking; 
‘‘(B) incorporation of feedback from di-
verse perspectives; and
847 
‘‘(C) editing to achieve plain writing (as 
defined in section 3 of the Plain Writing Act of 
2010 (5 U.S.C. 301 note)). 
‘‘(g) FUNDING.—The Secretary of Defense shall use 
funds from the Defense Acquisition Workforce Develop-
ment Account to carry out this section.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of such chapter is amended by inserting 
after section 1742 the following new item: 
‘‘1743. Writing award to encourage curiosity and persistence in overcoming ob-
stacles in acquisition.’’. 
SEC. 802. DATA REQUIREMENTS FOR COMMERCIAL ITEM 
PRICING NOT BASED ON ADEQUATE PRICE 
COMPETITION. 
(a) INFORMATION REQUIRED.—Section 3455 of title 
10, United States Code, is amended— 
(1) in subsection (b)— 
(A) by inserting ‘‘(1)’’ before ‘‘A sub-
system’’; 
(B) by redesignating paragraphs (1) and 
(2) as subparagraphs (A) and (B), respectively; 
and 
(C) by adding at the end the following new 
paragraph: 
‘‘(2) With respect to a subsystem for which a con-
tracting officer made a determination under paragraph
848 
(1)(B) and for a subsystem proposed as commercial (as 
defined in section 103(1) of title 41, United States Code) 
and that has not previously been determined commercial 
in accordance with section 3703(d) of this title, the offeror 
shall provide the following information: 
‘‘(A) An identification of a comparable commer-
cial product that is customarily used by the general 
public or nongovernmental entities that serves as the 
basis for assertion that the proposed subsystem is a 
commercial product. 
‘‘(B) A comparison of the essential physical 
characteristics and functionality between the pro-
posed subsystem and the comparable commercial 
product in support of such assertion. 
‘‘(C) The national stock number (as defined in 
section 101-30.101-3 of title 41, Code of Federal 
Regulations (or a successor regulation)), if available, 
for the comparable commercial product and the pro-
posed subsystem.’’; 
(2) in subsection (c), by adding at the end the 
following new paragraph: 
‘‘(3) With respect to components or spare parts pro-
posed as commercial for which a contracting officer made 
a determination under paragraph (1)(B), the offeror shall 
provide the following information for components or spare
849 
parts proposed as commercial (as defined in section 
103(1) of title 41, United States Code) and that have not 
previously been determined commercial in accordance with 
section 3703(d) of this title: 
‘‘(A) An identification of a comparable commer-
cial product that is customarily used by the general 
public or nongovernmental entities that serves as the 
basis for the assertion that the proposed components 
or spare parts are commercial products. 
‘‘(B) A comparison of the essential physical 
characteristics and functionality between the pro-
posed components or spare parts and the com-
parable commercial product in support of such as-
sertion. 
‘‘(C) The national stock number (as defined in 
section 101-30.101-3 of title 41, Code of Federal 
Regulations (or a successor regulation)), if available, 
for the comparable commercial product and the pro-
posed components or spare parts.’’. 
(b) 
MODIFICATIONS
TO
INFORMATION
SUB-
MITTED.—Section 3455(d) is amended— 
(1) in the subsection heading, by inserting 
‘‘FOR
CERTAIN
PROCUREMENTS’’ 
after 
‘‘SUB-
MITTED’’; 
(2) in paragraph (1)—
850 
(A) in the matter preceding subparagraph 
(A), by striking ‘‘section,’’ and all that follows 
through ‘‘to submit’’ and inserting ‘‘section that 
are not subject to the exceptions in section 
3703(a)(1) of this title, the offeror shall be re-
quired to submit to or to provide access to the 
contracting officer, on an unredacted basis’’; 
(B) in subparagraph (A)— 
(i) by inserting ‘‘all’’ before ‘‘prices 
paid’’; and 
(ii) by inserting ‘‘, and the contents of 
such terms and conditions’’ after ‘‘com-
mercial customers’’; 
(C) in subparagraph (B)— 
(i) by striking ‘‘information on’’ and 
all that follows through ‘‘same or similar’’ 
and inserting ‘‘information on prices for 
the same or similar’’; 
(ii) by striking ‘‘conditions;’’ and in-
serting ‘‘conditions, and the contents of 
such terms and conditions; and’’; and 
(iii) by striking clauses (ii), (iii), and 
(iv). 
(D) in subparagraph (C)—
851 
(i) by striking ‘‘reasonableness of 
price,’’ and inserting the following: ‘‘rea-
sonableness of price because the com-
parable products provided by the offeror 
are not a valid basis for a price analysis, 
or the contracting officer determines the 
proposed price is not reasonable after eval-
uating prices paid, the offeror shall be re-
quired to provide’’; and 
(ii) by inserting before the period at 
the end the following: ‘‘, where a request 
for cost data shall be approved at a level 
above the contracting officer’’. 
SEC. 803. PREFERENCE FOR DOMESTIC FOODS FOR MILI-
TARY WORKING DOGS. 
(a) IN GENERAL.—Chapter 287 of title 10, United 
States Code, is amended by adding at the end the fol-
lowing new section: 
‘‘§ 3906. Preference for domestic foods for military 
working dogs 
‘‘With respect to the acquisition of food for military 
working dogs by the Defense Logistics Agency, the Direc-
tor of the Defense Logistic Agency shall give a preference 
for the acquisition of food that is manufactured or pro-
duced—
852 
‘‘(1) in the United States; 
‘‘(2) by an entity that is based in the United 
States; and 
‘‘(3) using only ingredients and materials that 
were grown, mined, manufactured, or produced in 
the United States.’’. 
(b) CLERICAL AMENDMENT.—The table of chapters 
for chapter 287 of title 10, United States Code, is amend-
ed by adding at the end the following new item: 
‘‘3906. Preference for domestic food for military working dogs.’’. 
SEC. 804. LIFE CYCLE MANAGEMENT AND PRODUCT SUP-
PORT. 
Section 4324(b) of title 10, United States Code, is 
amended— 
(1) by designating the matter preceding sub-
paragraph (A), as so redesignated, as paragraph (1); 
(2) by redesignating paragraphs (1), (2), (3), 
(4), (5), (6), (7), and (8) as subparagraphs (A), (B), 
(C), (D), (E), (F), (G), and (I), respectively; 
(3) in paragraph (1), as so designated— 
(A) in the matter preceding subparagraph 
(A), as so redesignated— 
(i) by inserting ‘‘IN GENERAL.—’’ be-
fore ‘‘Before granting’’ ; and 
(ii) by inserting after ‘‘approved life 
cycle sustainment plan’’ the following: ‘‘ap-
853 
proved by all covered individuals for such 
covered system’’; 
(B) by amending subparagraph (G), as so 
redesignated, to read as follows: 
‘‘(G) an intellectual property management 
plan for product support, including access to 
technical data and computer software, as well 
as contract delivery requirements for the data 
rights;’’; 
(C) by inserting after subparagraph (G), 
as so redesignated, the following new subpara-
graph: 
‘‘(H) an estimate of the number of per-
sonnel needed to operate and maintain the cov-
ered system;’’; 
(D) in subparagraph (I), as so redesig-
nated, by striking the period at the end and in-
serting ‘‘; and’’ at the end; and 
(E) by inserting after subparagraph (I), as 
so redesignated, the following new subpara-
graph: 
‘‘(J) a product support business case anal-
ysis that— 
‘‘(i) addresses—
854 
‘‘(I) the costs, benefits, and risks 
to sustainment associated with the 
performance goals; 
‘‘(II) the engineering and design 
considerations; 
‘‘(III) intellectual property, in-
cluding access to technical data and 
computer software; and 
‘‘(IV) the number of personnel 
needed to operate and maintain the 
covered system; and 
‘‘(ii) explicitly addresses— 
‘‘(I) the tradeoffs made between 
the factors described in clause (i); and 
‘‘(II) the associated implications 
of such tradeoffs for— 
‘‘(aa) design, development, 
production, and operating and 
support costs; 
‘‘(bb) operational and mate-
riel availability; 
‘‘(cc) the mix of active and 
reserve components of the mili-
tary, Government civilian em-
ployee, host nation support, and
855 
contractor personnel to operate 
and maintain the covered system; 
and 
‘‘(dd) the ability of the Gov-
ernment to retain core logistics 
capability identified under section 
2464 and comply with the re-
quirements under section 2466.’’; 
and 
(4) by adding at the end the following new 
paragraphs: 
‘‘(2) SUBSEQUENT
PHASES.—Before granting 
approval for entry of the covered system into each 
subsequent phase of the acquisition after the phase 
described in section 4172(e)(7), the milestone deci-
sion authority shall ensure that the life cycle 
sustainment plan described in paragraph (1) for 
such covered system has been updated and again ap-
proved by all covered individuals for such covered 
system. 
‘‘(3) COVERED INDIVIDUALS DEFINED.—In this 
subsection, the term ‘covered individuals’ means— 
‘‘(A) a product support manager described 
in subsection (c);
856 
‘‘(B) a program manager (as defined in 
section 1737(a)); 
‘‘(C) a program executive officer (as de-
fined in section 1737(a)); and 
‘‘(D) an appropriate materiel, logistics, or 
fleet representative.’’. 
SEC. 805. EXTENSION OF REQUIREMENT TO SUBMIT SE-
LECTED ACQUISITION REPORTS. 
(a) REPEAL OF TERMINATION.—Section 4351 of title 
10, United States Code, is amended by striking subsection 
(j). 
(b) REPEAL OF TERMINATION OF CERTAIN ADDI-
TIONAL REPORTS.—Section 1051(x) of the National De-
fense Authorization Act for Fiscal Year 2018 is amended 
by striking paragraph (4). 
SEC. 806. AMENDMENTS TO CONTRACTOR EMPLOYEE PRO-
TECTIONS FROM REPRISAL FOR DISCLOSURE 
OF CERTAIN INFORMATION. 
(a) DEFENSE CONTRACTS.— 
(1) ADDITION
OF
GRANTEES, SUBGRANTEES, 
AND
PERSONAL
SERVICES
CONTRACTORS.—Section 
4701 of title 10, United States Code, is amended— 
(A) in subsection (a), in paragraphs (2)(G) 
and (3)(A), by striking ‘‘or subcontractor’’ and
857 
inserting ‘‘, subcontractor, grantee, subgrantee, 
or personal services contractor’’; 
(B) in subsection (a)(2), by adding at the 
end the following new subparagraphs: 
‘‘(H) The Pandemic Response Account-
ability Committee (established under section 
15010 of title V of division B of the CARES 
Act (Public Law 116–136)). 
‘‘(I) The Integrity Committee of the Coun-
cil of the Inspectors General on Integrity and 
Efficiency.’’. 
(C) in subsection (b)— 
(i) in paragraph (1)— 
(I) by striking ‘‘contractor con-
cerned’’ and inserting ‘‘contractor, 
subcontractor, grantee, subgrantee, or 
personal 
services 
contractor 
con-
cerned’’; 
(II) by inserting before the pe-
riod at the end of the first sentence 
the following: ‘‘, or to the Special In-
spector General for Pandemic Recov-
ery or the Chair of the Pandemic Re-
sponse Accountability Committee’’;
858 
(III) by striking ‘‘Inspector Gen-
eral determines’’ and inserting ‘‘In-
spector General, Special Inspector 
General, or Chair (as applicable) de-
termines’’; and 
(IV) by striking ‘‘Inspector Gen-
eral shall’’ and inserting ‘‘Inspector 
General, Special Inspector General, or 
Chair (as applicable) shall’’; 
(ii) in paragraph (2), by striking ‘‘In-
spector General’’ each place it appears and 
inserting ‘‘Inspector General, Special In-
spector General, or Chair (as applicable)’’; 
and 
(iii) in paragraph (3), by striking ‘‘In-
spector General’’ each place it appears and 
inserting ‘‘Inspector General, Special In-
spector General, or Chair (as applicable)’’; 
(D) in subsection (c)— 
(i) in the matter preceding subpara-
graph (A) of paragraph (1), by striking 
‘‘contractor concerned’’ and inserting ‘‘con-
tractor, 
subcontractor, 
grantee, 
sub-
grantee, or personal services contractor 
concerned’’; and
859 
(ii) in paragraph (1), by inserting 
after ‘‘Order the contractor’’ each place it 
appears the following: ‘‘, subcontractor, 
grantee, subgrantee, or personal services 
contractor’’; 
(iii) in paragraph (2), by inserting 
after ‘‘contractor’’ the following: ‘‘, subcon-
tractor, grantee, subgrantee, or personal 
services contractor’’; 
(E) in subsection (d), by striking ‘‘and 
subcontractors’’ and inserting ‘‘, subcontrac-
tors, grantees, subgrantees, and personal serv-
ices contractors’’; and 
(F) in subsection (e)(2)— 
(i) in the matter preceding subpara-
graph (A), by striking ‘‘or grantee of’’ and 
inserting ‘‘grantee, subgrantee, or personal 
services contractor of’’; and 
(ii) in subparagraph (B), by striking 
‘‘or grantee’’ and inserting ‘‘grantee, or 
subgrantee’’. 
(2) ADDITIONAL AMENDMENTS.—Such section 
is further amended in subsection (c)(1) by adding at 
the end the following new subparagraph:
860 
‘‘(D) Consider disciplinary or corrective action 
against any Department or Administration official, 
if appropriate.’’. 
(b) CIVILIAN AGENCY CONTRACTS.— 
(1) IN
GENERAL.—Section 4712 of title 41, 
United States Code, is amended— 
(A) in subsection (a)(2)(G), by striking ‘‘or 
subgrantee’’ and inserting ‘‘subgrantee, or per-
sonal services contractor’’; 
(B) in subsection (a)(2), by adding at the 
end the following new subparagraphs: 
‘‘(H) The Pandemic Response Account-
ability Committee (established under section 
15010 of title V of division B of the CARES 
Act (Public Law 116–136)). 
‘‘(I) The Integrity Committee of the Coun-
cil of the Inspectors General on Integrity and 
Efficiency.’’; 
(C) in subsection (b)(1), by striking ‘‘or 
subgrantee’’ and inserting ‘‘subgrantee, or per-
sonal services contractor’’; 
(D) in subsection (c)— 
(i) in paragraph (1)— 
(I) by striking ‘‘or subgrantee’’ 
each place it appears and inserting
861 
‘‘subgrantee, or personal services con-
tractor’’; and 
(II) by adding at the end the fol-
lowing new subparagraph: 
‘‘(D) Consider disciplinary or corrective ac-
tion against any executive branch official, if ap-
propriate.’’; and 
(ii) in paragraph (2), by striking ‘‘or 
subgrantee’’ and inserting ‘‘subgrantee, or 
personal services contractor’’; 
(E) in subsection (d), by striking ‘‘and 
subgrantees’’ and inserting ‘‘subgrantees, and 
personal services contractors’’; 
(F) in subsection (f)(2)— 
(i) in the matter preceding subpara-
graph (A), by striking ‘‘or subgrantee’’ and 
inserting ‘‘subgrantee, or personal services 
contractor’’; and 
(ii) in subparagraph (B), by striking 
‘‘or 
subgrantee’’ 
and 
inserting 
‘‘sub-
grantee, or personal services contractor’’; 
and 
(G) by amending subsection (g)(2) to read 
as follows:
862 
‘‘(2) The term ‘Inspector General’ means any 
Inspector General established by Federal law, includ-
ing— 
‘‘(A) an Inspector General appointed under 
the Inspector General Act of 1978 (5 U.S.C. 
App.); 
‘‘(B) the Special Inspector General for 
Pandemic Recovery; 
‘‘(C) the Special Inspector General for Af-
ghanistan Reconstruction; 
‘‘(D) the Special Inspector General for the 
Troubled Asset Relief Program; and 
‘‘(E) any Inspector General that receives 
funding from, or has oversight over contracts 
awarded for or on behalf of, the executive agen-
cy concerned.’’. 
(2) ADDITIONAL AMENDMENTS.— 
(A) IN GENERAL.—Section 4705 of title 
41, United States Code, is repealed. 
(B) CONFORMING AMENDMENTS.— 
(i) TITLE 38.—Subchapter II of chap-
ter 7 of title 38, United States Code, is 
amended— 
(I) in section 731(c)(4)—
863 
(aa) by striking ‘‘section 
4705(b) or’’; and 
(bb) by striking ‘‘, as the 
case may be’’; and 
(II) in section 733(a)(5), by 
striking ‘‘section 4705 or’’. 
(ii) 
TITLE
49.—Section 
40110(d)(2)(C) of title 49, United States 
Code, is amended by inserting ‘‘, as in ef-
fect immediately before the enactment of 
the National Defense Authorization Act for 
Fiscal Year 2022,’’ before ‘‘shall apply’’. 
SEC. 807. ENHANCED DOMESTIC CONTENT REQUIREMENT 
FOR MAJOR DEFENSE ACQUISITION PRO-
GRAMS. 
(a) ASSESSMENT REQUIRED.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, the Sec-
retary of Defense shall submit to the congressional 
defense committees a report assessing the domestic 
source content of procurements carried out in con-
nection with a major defense acquisition program. 
(2) INFORMATION REPOSITORY.—The Secretary 
of Defense shall establish an information repository 
for the collection and analysis of information related
864 
to domestic source content for products the Sec-
retary deems critical, where such information can be 
used for continuous data analysis and program man-
agement activities. 
(b) ENHANCED
DOMESTIC
CONTENT
REQUIRE-
MENT.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), for purposes of chapter 83 of title 41, 
United States Code, manufactured articles, mate-
rials, or supplies procured in connection with a 
major defense acquisition program are manufactured 
substantially all from articles, materials, or supplies 
mined, produced, or manufactured in the United 
States if the cost of such component articles, mate-
rials, or supplies— 
(A) supplied not later than the date of the 
enactment of this Act, exceeds 60 percent of 
cost of the manufactured articles, materials, or 
supplies procured; 
(B) supplied during the period beginning 
January 1, 2024, and ending December 31, 
2028, exceeds 65 percent of the cost of the 
manufactured articles, materials, or supplies; 
and
865 
(C) supplied on or after January 1, 2029, 
exceeds 75 percent of the cost of the manufac-
tured articles, materials, or supplies. 
(2) EXCLUSION FOR CERTAIN MANUFACTURED 
ARTICLES.—Paragraph (1) shall not apply to manu-
factured articles that consist wholly or predomi-
nantly of iron, steel, or a combination of iron and 
steel. 
(3) RULEMAKING
TO
CREATE
A
FALLBACK 
THRESHOLD.— 
(A) IN
GENERAL.—Not later than 180 
days after the date of the enactment of this 
Act, the Secretary of Defense shall issue rules 
to determine the treatment of the lowest price 
offered for a foreign end product for which 55 
percent or more of the component articles, ma-
terials, or supplies of such foreign end product 
are manufactured substantially all from articles, 
materials, or supplies mined, produced, or man-
ufactured in the United States if— 
(i) the application paragraph (1) re-
sults in an unreasonable cost; or 
(ii) no offers are submitted to supply 
manufactured articles, materials, or sup-
plies manufactured substantially all from
866 
articles, materials, or supplies mined, pro-
duced, or manufactured in the United 
States. 
(B) TERMINATION.—Rules issued under 
this paragraph shall cease to have force or ef-
fect on January 1, 2030. 
(4) APPLICABILITY.—The requirements of this 
subsection— 
(A) shall apply to contracts entered into on 
or after the date of the enactment of this Act; 
and 
(B) shall not apply to a country that is a 
member of the national technology and indus-
trial base (as defined by section 4801 of title 
10, United States Code). 
(c) MAJOR DEFENSE ACQUISITION PROGRAM DE-
FINED.—The term ‘‘major defense acquisition program’’ 
has the meaning given in section 4201 of title 10, United 
States Code. 
SEC. 808. MISSION-BASED RAPID ACQUISITION ACCOUNT. 
(a) ESTABLISHMENT.—There is established in the 
Department of Defense an account to be known as the 
‘‘Mission-Based Rapid Acquisition Account’’ (in this sec-
tion referred to as the ‘‘Account’’) to support the pilot 
program.
867 
(b) USE OF FUNDS.—The Deputy Secretary of De-
fense may use the funds in the Account to carry out the 
pilot program. 
(c) SEMIANNUAL BRIEFING.—The Deputy Secretary 
of Defense shall include in each briefing submitted under 
subsection (f)(1)(A) of section 871 of the National De-
fense Authorization Act for Fiscal Year 2022 (Public Law 
117–81; 135 Stat. 1855; 10 U.S.C. 191 note) after the 
date of the enactment of this Act a briefing on the use 
of funds in the Account, including— 
(1) how the Deputy Secretary of Defense has 
used such funds to incent new small businesses to 
enter transactions for prototype projects with the 
Department; 
(2) support the rapid transition of the solutions 
described in subsection (c)(2)(B) of such section 871 
to warfighters; and 
(3) whether additional funding flexibility is 
needed to scale technologies. 
(d) PILOT PROGRAM DEFINED.—In this section, the 
term ‘‘pilot program’’ means the pilot program established 
under section 871 of the National Defense Authorization 
Act for Fiscal Year 2022 (Public Law 117–81; 135 Stat. 
1855; 10 U.S.C. 191 note).
868 
SEC. 809. PREFERENCE FOR OFFERORS THAT MEET CER-
TAIN REQUIREMENTS. 
(a) IN GENERAL.—Chapter 241 of title 10, United 
States Code, is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 3310. PREFERENCE FOR OFFERORS THAT MEET CER-
TAIN REQUIREMENTS. 
‘‘(a) IN GENERAL.—In awarding contracts for the 
procurement of goods or services, the Secretary of Defense 
shall prioritize offerors that meet any of the following 
qualifications: 
‘‘(1) The offeror has entered into an agree-
ment— 
‘‘(A) with a labor organization; 
‘‘(B) that provides the manner in which 
the offeror will— 
‘‘(i) act with respect to lawful efforts 
by such labor organization to organize the 
employees of such offeror, including an 
agreement that the offeror will not assist, 
deter, or promote such efforts; and 
‘‘(ii) engage in collective bargaining 
with such labor organization; and 
‘‘(C) that is effective for the duration of 
the contract to be awarded.
869 
‘‘(2) The offeror has entered into an agreement 
with a majority of the employees of the offeror or a 
labor organization, effective for the duration of the 
contract to be awarded, not to hire individuals to re-
place any employee of the offeror engaged in any 
strike, picketing, or other concerted refusal to work 
or to close a business in response to such a strike, 
picketing, or other refusal to work. 
‘‘(3) The offeror has a collective bargaining 
agreement with a labor organization or a majority of 
the employees of the offeror. 
‘‘(b) PRIORITIZATION ORDER.—The Secretary of De-
fense shall further prioritize an offeror under subsection 
(a) for each qualification described in such subsection that 
such offeror meets. 
‘‘(c) 
APPLICATION.—The 
prioritization 
required 
under this section shall— 
‘‘(1) be applied after any other preference or 
priority applicable to the award of the contract; 
‘‘(2) be accorded weight that is not less than 
such other preference or priority; and 
‘‘(3) not be construed as superseding or replac-
ing any such other preference or priority. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to preempt, displace, or supplant
870 
any provision of the National Labor Relations Act (29 
U.S.C. 151 et seq.). 
‘‘(e) EMPLOYEE; EMPLOYER; LABOR ORGANIZATION 
DEFINED.—In this section, the terms ‘employee’, ‘em-
ployer’, and ‘labor organization’ have the meanings given 
such terms in section 2 of the National Labor Relations 
Act (29 U.S.C. 152).’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
for Chapter 241 of title 10, United States Code, is amend-
ed by adding at the end the following new item: 
‘‘3310. Preference for offerors that meet certain requirements.’’. 
(c) APPLICABILITY.—This section and the amend-
ments made by this section shall apply only with respect 
to contracts entered into on or after the date of the enact-
ment of this Act. 
Subtitle B—Amendments to Gen-
eral 
Contracting 
Authorities, 
Procedures, and Limitations 
SEC. 811. MEMBERSHIP OF COAST GUARD ON STRATEGIC 
MATERIALS PROTECTION BOARD. 
Section 187(a)(2) of title 10, United States Code, is 
amended by adding at the end the following: 
‘‘(F) A senior official of the Coast Guard, as 
designated by the Secretary of the agency or depart-
ment in which the Coast Guard operates, only with
871 
respect to matters of the Board relating to the Coast 
Guard.’’. 
SEC. 812 . COMPTROLLER GENERAL ASSESSMENT OF AC-
QUISITION PROGRAMS AND EFFORTS. 
Section 3072 of title 10, United States Code, is 
amended— 
(1) in the section heading, by striking ‘‘initia-
tives’’ and inserting ‘‘efforts’’; 
(2) in subsection (a)— 
(A) by striking ‘‘initiatives’’ and inserting 
‘‘efforts’’; and 
(B) by striking ‘‘2023’’ and inserting 
‘‘2026’’; 
(3) in subsection (b), by striking ‘‘initiatives’’ 
each place it appears and inserting ‘‘efforts’’; and 
(4) in subsection (c)— 
(A) in the subsection heading, by striking 
‘‘INITIATIVES’’ and inserting ‘‘EFFORTS’’; and 
(B) by striking ‘‘initiatives’’ each place it 
appears and inserting ‘‘efforts’’.
872 
SEC. 813. SUBCONTRACTING REQUIREMENTS FOR CERTAIN 
CONTRACTS AWARDED TO EDUCATIONAL IN-
STITUTIONS. 
(a) IN GENERAL.—Section 3204 of title 10, United 
States Code, is amended by adding at the end the fol-
lowing new subsection: 
‘‘(h) SUBCONTRACTING REQUIREMENTS FOR CON-
TRACTS AWARDED TO EDUCATIONAL INSTITUTIONS.— 
‘‘(1) IN
GENERAL.—The head of an agency 
shall require that a contract awarded to an edu-
cational institution pursuant to subsection (a)(3)(B) 
includes a requirement that the educational institu-
tion subcontract with one or more minority institu-
tions for a total amount of not less than 2 percent 
of the amount awarded in the contract. 
‘‘(2) MINORITY
INSTITUTION.—In this sub-
section, the term ‘minority institution’ means— 
‘‘(A) a part B institution (as that term is 
defined in section 322(2) of the Higher Edu-
cation Act of 1965 (20 U.S.C. 1061(2))); or 
‘‘(B) any other institution of higher edu-
cation (as that term is defined in section 101 
of such Act (20 U.S.C. 1001)) for which not 
less than 50 percent of the total student enroll-
ment consists of students from ethnic groups
873 
that are underrepresented in the fields of 
science and engineering.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall— 
(1) take effect on October 1, 2026; and 
(2) apply with respect to contracts awarded by 
the Secretary of Defense on or after such date. 
SEC. 814. CLARIFICATION TO FIXED-PRICE INCENTIVE CON-
TRACT REFERENCES. 
(a) AUTHORITY TO ACQUIRE INNOVATIVE COMMER-
CIAL PRODUCTS
AND COMMERCIAL SERVICES USING 
GENERAL SOLICITATION COMPETITIVE PROCEDURES.— 
Section 3458(c)(2) of title 10, United States Code, is 
amended by striking ‘‘fixed-price incentive fee contracts’’ 
and inserting ‘‘fixed-price incentive contracts’’. 
(b) CONTRACTOR INCENTIVES TO ACHIEVE SAVINGS 
AND IMPROVE MISSION PERFORMANCE.—Section 832 of 
the National Defense Authorization Act for Fiscal Year 
2017 (Public Law 114–328; 10 U.S.C. 1746 note) is 
amended by striking ‘‘fixed-price incentive fee contracts’’ 
and inserting ‘‘fixed-price incentive contracts’’.
874 
SEC. 815. MODIFICATION TO INDEMNIFICATION AUTHOR-
ITY 
FOR 
RESEARCH 
AND 
DEVELOPMENT 
CONTRACTS. 
(a) IN GENERAL.—Section 3861 of title 10, United 
States Code, is amended— 
(1) in subsection (a), by striking ‘‘Secretary of 
the military department concerned’’ and inserting 
‘‘Secretary of Defense’’; 
(2) in subsection (c), by striking ‘‘Secretary’’ 
and all that follows through ‘‘by him,’’ and inserting 
‘‘Secretary of Defense’’; and 
(3) in subsection (d), by striking ‘‘Secretary 
concerned’’ and inserting ‘‘Secretary of Defense’’. 
(b) CONFORMING AMENDMENT.—Section 1684 of the 
National Defense Authorization Act for Fiscal Year 2022 
(Public Law 117-81; 135 Stat. 2123) is amended by in-
serting ‘‘or the Secretary of Defense, as applicable,’’ after 
‘‘Secretary concerned’’. 
(c) APPLICABILITY.—This section and the amend-
ments made by this section shall apply to contracts en-
tered into on or after the date of the enactment of this 
Act. 
SEC. 816. COMPETITION REQUIREMENTS FOR PURCHASES 
FROM FEDERAL PRISON INDUSTRIES. 
(a) COMPETITION REQUIREMENTS FOR PURCHASES 
FROM FEDERAL PRISON INDUSTRIES.—Section 3905 of
875 
title 10, United States Code, is amended by striking sub-
sections (a) and (b) and inserting the following new sec-
tions: 
‘‘(a) MARKET
RESEARCH.—Before purchasing a 
product listed in the latest edition of the Federal Prison 
Industries catalog published under section 4124(d) of title 
18, the Secretary of Defense shall conduct market re-
search to determine whether such product— 
‘‘(1) is comparable to products available from 
the private sector; and 
‘‘(2) best meets the needs of the Department of 
Defense in terms of price, quality, and time of deliv-
ery. 
‘‘(b) COMPETITION REQUIREMENT.—If the Secretary 
determines that a Federal Prison Industries product is not 
comparable to products available from the private sector 
and does not best meet the needs of the Department of 
Defense in terms of price, quality, or time of delivery, the 
Secretary shall use competitive procedures or make an in-
dividual purchase under a multiple award contract for the 
procurement of the product. In conducting such a competi-
tion or making such a purchase, the Secretary shall con-
sider a timely offer from Federal Prison Industries.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect on February 1, 2023.
876 
SEC. 817. CLARIFICATION OF AUTHORITY OF THE DEPART-
MENT OF DEFENSE TO CARRY OUT CERTAIN 
PROTOTYPE PROJECTS. 
Subsection (f) of section 4022 of title 10, United 
States Code, is amended to read as follows: 
‘‘(f) FOLLOW-ON
PRODUCTION
CONTRACTS
OR 
TRANSACTIONS.—(1) A transaction entered into under 
this section for a prototype project shall provide for the 
award of a follow-on production contract or transaction 
to the participants in the transaction. A transaction in-
cludes all individual prototype subprojects awarded under 
the transaction to a consortium of United States industry 
and academic institutions. 
‘‘(2) A follow-on production contract or transaction 
provided for in a transaction under paragraph (1) may 
be awarded to the participants in the transaction without 
the use of competitive procedures, notwithstanding the re-
quirements of chapter 221 of this title and even if explicit 
notification was not listed within the request for proposal 
for the transaction if— 
‘‘(A) competitive procedures were used for the 
selection of parties for participation in the trans-
action; and 
‘‘(B) the participants in the transaction suc-
cessfully completed the prototype project provided 
for in the transaction.’’.
877 
SEC. 818. REQUIREMENTS FOR THE PROCUREMENT OF 
CERTAIN COMPONENTS FOR CERTAIN NAVAL 
VESSELS AND AUXILIARY SHIPS. 
(a) REQUIREMENTS
FOR
THE PROCUREMENT
OF 
CERTAIN COMPONENTS FOR NAVAL VESSELS.—Section 
4864(a)(2) of title 10, United States Code, is amended 
by adding at the end the following new subparagraph: 
‘‘(G) Ship shafts and propulsion system 
components (including reduction gears and pro-
pellers).’’. 
(b) REQUIREMENT THAT CERTAIN AUXILIARY SHIP 
COMPONENTS BE MANUFACTURED
IN
THE NATIONAL 
TECHNOLOGY AND INDUSTRIAL BASE.— 
(1) TECHNICAL AMENDMENT.—Section 4864 of 
title 10, United States Code, is amended by redesig-
nating subsection (l) (relating to ‘‘Implementation of 
auxiliary ship component limitation’’) as subsection 
(k). 
(2) COMPONENTS
FOR
AUXILIARY
SHIPS.— 
Paragraph (3) of section 4864(a) of title 10, United 
States Code, is amended to read as follows: 
‘‘(3) COMPONENTS
FOR
AUXILIARY
SHIPS.— 
Subject to subsection (k), the following components: 
‘‘(A) Large medium-speed diesel engines. 
‘‘(B) Propulsion system components, in-
cluding reduction gears and propellers.’’.
878 
(3) IMPLEMENTATION.—Subsection (k) of sec-
tion 4864 of title 10, United States Code, as redes-
ignated by paragraph (1), is amended to read as fol-
lows: 
‘‘(k) IMPLEMENTATION OF AUXILIARY SHIP COMPO-
NENT LIMITATION.—Subsection (a)(3) shall apply only 
with respect to contracts awarded by a Secretary of a mili-
tary department for construction of a new class of auxil-
iary ship after the date of the enactment of this Act using 
funds available for National Defense Sealift Fund pro-
grams or Shipbuilding and Conversion, Navy.’’. 
SEC. 819. MODIFICATION TO PROHIBITION ON OPERATION 
OR PROCUREMENT OF FOREIGN-MADE UN-
MANNED AIRCRAFT SYSTEMS. 
Section 848 of the National Defense Authorization 
Act for Fiscal Year 2020 (Public Law 116–92; 10 U.S.C. 
4871 note) is amended— 
(1) by redesignating subsections (b), (c), and 
(d) as subsections (c), (d), and (e), respectively; 
(2) by inserting after subsection (a) the fol-
lowing new subsection: 
‘‘(b) PROHIBITION ON CERTAIN CONTRACTS.—The 
Secretary of Defense may not— 
‘‘(1) procure or obtain, or extend or renew a 
contract to procure or obtain any equipment, sys-
879 
tem, or service that uses any equipment or service 
related to unmanned aircraft systems provided by a 
covered unmanned aircraft system company; or 
‘‘(2) enter into a contract (or extend or renew 
a contract) with an entity that uses any equipment, 
system, or services provided by a covered unmanned 
aircraft system company.’’; 
(3) in subsection (c) (as so redesignated), by 
striking ‘‘the restriction under subsection (a) if the 
operation or procurement’’ and inserting ‘‘any re-
strictions under subsections (a) or (b) if the oper-
ation, procurement, or obtainment’’; 
(4) in subsection (d) (as so redesignated)— 
(A) by striking ‘‘the restriction under sub-
section (a)’’ and inserting ‘‘any restrictions 
under subsections (a) or (b)’’; and 
(B) by striking ‘‘operation or procure-
ment’’ and inserting ‘‘operation, procurement, 
or obtainment’’; and 
(5) in subsection (e) (as so redesignated), by in-
serting the following new paragraph (3): 
‘‘(3) COVERED UNMANNED AIRCRAFT SYSTEM 
COMPANIES.—The term ‘covered unmanned aircraft 
system companies’ means any of the following:
880 
‘‘(A) Da-Jiang Innovations (or any sub-
sidiary or affiliate of Da-Jiang Innovations). 
‘‘(B) Any entity that produces or provides 
unmanned aircraft systems and is included on 
Consolidated Screening List maintained by the 
International Trade Administration of the De-
partment of Commerce. 
‘‘(C) Any entity that produces or provides 
unmanned aircraft systems and— 
‘‘(i) is domiciled in a covered foreign 
country; or 
‘‘(ii) is subject to unmitigated foreign 
ownership, control or influence by a cov-
ered foreign country, as determined by the 
Secretary of Defense unmitigated foreign 
ownership, control or influence in accord-
ance with the National Industrial Security 
Program (or any successor to such pro-
gram).’’. 
SEC. 820. EXTENSION OF PILOT PROGRAM TO ACCELERATE 
CONTRACTING AND PRICING PROCESSES. 
Section 890 of the John S. McCain National Defense 
Authorization Act for Fiscal Year 2019 (Public Law 115– 
232) is amended—
881 
(1) in subsection (a)(2), by striking ‘‘of’’ before 
‘‘chapter 271’’; and 
(2) in subsection (c), by striking ‘‘January 2, 
2023’’ and inserting ‘‘January 2, 2024’’. 
SEC. 821. EXTENSION AND MODIFICATION OF NEVER CON-
TRACT WITH THE ENEMY. 
Subtitle E of title VIII of the Carl Levin and Howard 
P. ‘‘Buck’’ McKeon National Defense Authorization Act 
for Fiscal Year 2015 (Public Law 113–291; 10 U.S.C. 
4871 note prec.) is amended— 
(1) in section 841— 
(A) in subsection (i)(1)— 
(i) in the matter preceding subpara-
graph (A), by striking ‘‘2016, 2017, and 
2018’’ and inserting ‘‘2023, and annually 
thereafter’’; and 
(ii) by adding at the end the following 
new subparagraphs: 
‘‘(C) Specific examples where the authori-
ties under this section can not be used to miti-
gate national security threats posed by vendors 
supporting Department operations because of 
the restriction on using such authorities only 
with respect to contingency operations.