H. R. 7776—1711 
(d) DEFINITION
OF PROTECTED LIVING MARINE RESOURCE.— 
Section 610(e) of the High Seas Driftnet Fishing Moratorium Protec-
tion Act (16 U.S.C. 1826k(e)) is amended by striking paragraph 
(1) and inserting the following: 
‘‘(1) except as provided in paragraph (2), means nontarget 
fish, sea turtles, or marine mammals that are protected under 
United States law or international agreement, including— 
‘‘(A) the Marine Mammal Protection Act of 1972 (16 
U.S.C. 1361 et seq.); 
‘‘(B) the Endangered Species Act of 1973 (16 U.S.C. 
1531 et seq.); 
‘‘(C) the Shark Finning Prohibition Act (16 U.S.C. 1822 
note); and 
‘‘(D) the Convention on International Trade in Endan-
gered Species of Wild Fauna and Flora, done at Washington 
March 3, 1973 (27 UST 1087; TIAS 8249); but’’. 
SEC. 11339. CAPACITY BUILDING IN FOREIGN FISHERIES. 
(a) IN GENERAL.—The Secretary, in consultation with the heads 
of other Federal agencies, as appropriate, shall develop and carry 
out with partner governments and civil society— 
(1) multi-year international environmental cooperation 
agreements and projects; and 
(2) multi-year capacity-building projects for implementing 
measures to address illegal, unreported, or unregulated fishing, 
fraud, forced labor, bycatch, and other conservation measures. 
(b) CAPACITY BUILDING.—Section 3543(d) of the Maritime SAFE 
Act (16 U.S.C. 8013(d)) is amended— 
(1) in the matter preceding paragraph (1) by striking ‘‘as 
appropriate,’’; and 
(2) in paragraph (3) by striking ‘‘as appropriate’’ and 
inserting ‘‘for all priority regions identified by the Working 
Group’’. 
(c) REPORTS.—Section 3553 of the Maritime SAFE Act (16 
U.S.C. 8033) is amended— 
(1) in paragraph (7) by striking ‘‘and’’ after the semicolon; 
(2) in paragraph (8) by striking the period at the end 
and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(9) the status of work with global enforcement partners.’’. 
SEC. 11340. TRAINING OF UNITED STATES OBSERVERS. 
Section 403(b) of the Magnuson-Stevens Fishery Conservation 
and Management Act (16 U.S.C. 1881b(b)) is amended— 
(1) in paragraph (3) by striking ‘‘and’’ after the semicolon; 
(2) by redesignating paragraph (4) as paragraph (5); and 
(3) by inserting after paragraph (3) the following: 
‘‘(4) ensure that each observer has received training to 
identify indicators of forced labor and human trafficking (as 
such terms are defined in section 11329 of the Don Young 
Coast Guard Authorization Act of 2022) and refer this informa-
tion to appropriate authorities; and’’. 
SEC. 11341. REGULATIONS. 
Not later than 1 year after the date of enactment of this 
Act, the Secretary shall promulgate such regulations as may be 
necessary to carry out this subtitle and the amendments made 
by this subtitle.
H. R. 7776—1712 
TITLE CXIV—SUPPORT FOR COAST 
GUARD WORKFORCE 
Subtitle A—Support for Coast Guard 
Members and Families 
SEC. 11401. COAST GUARD CHILD CARE IMPROVEMENTS. 
(a) FAMILY DISCOUNT FOR CHILD DEVELOPMENT SERVICES.— 
Section 2922(b)(2) of title 14, United States Code, is amended 
by adding at the end the following: 
‘‘(D) In the case of an active duty member with two or more 
children attending a Coast Guard child development center, the 
Commandant may modify the fees to be charged for attendance 
for the second and any subsequent child of such member by an 
amount that is 15 percent less than the amount of the fee otherwise 
chargeable for the attendance of the first such child enrolled at 
the center, or another fee as the Commandant determines appro-
priate, consistent with multiple children.’’. 
(b) CHILD DEVELOPMENT CENTER STANDARDS
AND INSPEC-
TIONS.—Section 2923(a) of title 14, United States Code, is amended 
to read as follows: 
‘‘(a) STANDARDS.—The Commandant shall require each Coast 
Guard child development center to meet standards of operation— 
‘‘(1) that the Commandant considers appropriate to ensure 
the health, safety, and welfare of the children and employees 
at the center; and 
‘‘(2) necessary for accreditation by an appropriate national 
early childhood programs accrediting entity.’’. 
(c) CHILD CARE SUBSIDY PROGRAM.— 
(1) AUTHORIZATION.— 
(A) IN GENERAL.—Subchapter II of chapter 29 of title 
14, United States Code, is amended by adding at the end 
the following: 
‘‘§ 2927. Child care subsidy program 
‘‘(a) IN GENERAL.— 
‘‘(1) AUTHORITY.—The Commandant may operate a child 
care subsidy program to provide financial assistance to eligible 
providers that provide child care services or youth program 
services to members of the Coast Guard, members of the Coast 
Guard with dependents who are participating in the child care 
subsidy program, and any other individual the Commandant 
considers appropriate, if— 
‘‘(A) providing such financial assistance— 
‘‘(i) is in the best interests of the Coast Guard; 
and 
‘‘(ii) enables supplementation or expansion of the 
provision of Coast Guard child care services, while 
not supplanting or replacing Coast Guard child care 
services; and 
‘‘(B) the Commandant ensures, to the extent prac-
ticable, that the eligible provider is able to comply, and 
does comply, with the regulations, policies, and standards 
applicable to Coast Guard child care services.
H. R. 7776—1713 
‘‘(2) ELIGIBLE PROVIDERS.—A provider of child care services 
or youth program services is eligible for financial assistance 
under this section if the provider— 
‘‘(A) is licensed to provide such services under 
applicable State and local law or meets all applicable State 
and local health and safety requirements if licensure is 
not required; 
‘‘(B) is either— 
‘‘(i) is a family home daycare; or 
‘‘(ii) is a provider of family child care services 
that— 
‘‘(I) otherwise provides federally funded or fed-
erally sponsored child development services; 
‘‘(II) provides such services in a child develop-
ment center owned and operated by a private, 
not-for-profit organization; 
‘‘(III) provides a before-school or after-school 
child care program in a public school facility; 
‘‘(IV) conducts an otherwise federally funded 
or federally sponsored school-age child care or 
youth services program; or 
‘‘(V) conducts a school-age child care or youth 
services program operated by a not-for-profit 
organization; or 
‘‘(C) is a provider of another category of child care 
services or youth program services the Commandant con-
siders appropriate for meeting the needs of members or 
civilian employees of the Coast Guard. 
‘‘(3) FINANCIAL ASSISTANCE FOR IN-HOME CHILD CARE.— 
‘‘(A) IN
GENERAL.—The Commandant may provide 
financial assistance to members of the Coast Guard who 
pay for services provided by in-home child care providers. 
‘‘(B) REQUIREMENTS.—In carrying out such program, 
the Commandant shall establish a policy and procedures 
to— 
‘‘(i) support the needs of families who request serv-
ices provided by in-home childcare providers; 
‘‘(ii) provide the appropriate amount of financial 
assistance to provide to families described in para-
graph, that is at minimum consistent with the program 
authorized in subsection (a)(1); and 
‘‘(iii) ensure the appropriate qualifications for such 
in-home child care provider, which shall at minimum— 
‘‘(I) take into consideration qualifications for 
available in-home child care providers in the pri-
vate sector; and 
‘‘(II) ensure that the qualifications the Com-
mandant determines appropriate under this para-
graph are comparable to the qualifications for a 
provider of child care services in a Coast Guard 
child development center or family home day care. 
‘‘(b) DIRECT PAYMENT.— 
‘‘(1) IN
GENERAL.—In carrying out a child care subsidy 
program under subsection (a)(1), subject to paragraph (3), the 
Commandant shall provide financial assistance under the pro-
gram to an eligible member or individual the Commandant 
considers appropriate by direct payment to such eligible
H. R. 7776—1714 
member or individual through monthly pay, direct deposit, 
or other direct form of payment. 
‘‘(2) POLICY.—Not later than 180 days after the date of 
the enactment of this section, the Commandant shall establish 
a policy to provide direct payment as described in paragraph 
(1). 
‘‘(3) ELIGIBLE PROVIDER FUNDING CONTINUATION.—With the 
approval of an eligible member or an individual the Com-
mandant considers appropriate, which shall include the written 
consent of such member or individual, the Commandant may 
continue to provide financial assistance under the child care 
subsidy program directly to an eligible provider on behalf of 
such member or individual. 
‘‘(4) RULE OF CONSTRUCTION.—Nothing in this subsection 
may be construed to affect any preexisting reimbursement 
arrangement between the Coast Guard and a qualified pro-
vider.’’. 
(B) CLERICAL AMENDMENT.—The analysis for chapter 
29 of title 14, United States Code, is amended by inserting 
after the item relating to section 2926 the following: 
‘‘2927. Child care subsidy program.’’. 
(2) EXPANSION OF CHILD CARE SUBSIDY PROGRAM.— 
(A) IN GENERAL.—The Commandant shall— 
(i) evaluate potential eligible uses for the child 
care subsidy program established under section 2927 
of title 14, United States Code (referred to in this 
paragraph as the ‘‘program’’); 
(ii) expand the eligible uses of funds for the pro-
gram to accommodate the child care needs of members 
of the Coast Guard (including such members with non-
standard work hours and surge or other deployment 
cycles), including in-home care as described in section 
2927(a)(3) of title 14, United States Code, and including 
by providing funds directly to such members instead 
of care providers; and 
(iii) streamline enrollment policies, practices, 
paperwork, and requirements for eligible child care 
providers to reduce barriers for members to enroll in 
such providers. 
(B) CONSIDERATIONS.—In evaluating potential eligible 
uses under subparagraph (A), the Commandant shall con-
sider in-home child care services, care services such as 
supplemental care for children with disabilities, and any 
other child care delivery method the Commandant con-
siders appropriate. 
(C) REQUIREMENTS.—In establishing expanded eligible 
uses of funds for the program, the Commandant shall 
ensure that such uses— 
(i) are in the best interests of the Coast Guard; 
(ii) provide flexibility for members of the Coast 
Guard, including such members and employees with 
nonstandard work hours; and 
(iii) ensure a safe environment for dependents of 
such members and employees. 
(D) PUBLICATION.—Not later than 18 months after the 
date of the enactment of this Act, the Commandant shall 
publish an updated Commandant Instruction Manual
H. R. 7776—1715 
(referred to in this paragraph as the ‘‘manual’’) that 
describes the expanded eligible uses of the program. 
(E) REPORT.— 
(i) IN GENERAL.—Not later than 18 months after 
the date of the enactment of this Act, the Commandant 
shall submit to the Committee on Commerce, Science, 
and Transportation of the Senate and the Committee 
on Transportation and Infrastructure of the House of 
Representatives a report outlining the expansion of 
the program. 
(ii) ELEMENTS.—The report required by clause (i) 
shall include the following: 
(I) An analysis of the considerations described 
in subparagraph (B). 
(II) A description of the analysis used to iden-
tify eligible uses that were evaluated and incor-
porated into the manual under subparagraph (D). 
(III) A full analysis and justification with 
respect to the forms of care that were ultimately 
not included in the manual. 
(IV) Any recommendation with respect to 
funding 
or 
additional 
authorities 
necessary, 
including proposals for legislative change, to meet 
the current and anticipated future child care sub-
sidy demands of the Coast Guard. 
(V) A description of the steps taken to stream-
line enrollment policies, practices, and require-
ments for eligible child care providers in accord-
ance with paragraph (2)(A)(iii). 
SEC. 11402. ARMED FORCES ACCESS TO COAST GUARD CHILD 
DEVELOPMENT SERVICES. 
Section 2922(a) of title 14, United States Code, is amended 
to read as follows: 
‘‘(a)(1) The Commandant may make child development services 
available, in such priority as the Commandant considers to be 
appropriate and consistent with readiness and resources and in 
the best interests of dependents of members and civilian employees 
of the Coast Guard, for— 
‘‘(A) members and civilian employees of the Coast Guard; 
‘‘(B) surviving dependents of service members who have 
died on active duty, if such dependents were beneficiaries of 
a Coast Guard child development service at the time of the 
death of such members; 
‘‘(C) members of the armed forces (as defined in section 
101(a) of title 10); and 
‘‘(D) Federal civilian employees. 
‘‘(2) Child development service benefits provided under the 
authority of this section shall be in addition to benefits provided 
under other laws.’’. 
SEC. 11403. CADET PREGNANCY POLICY IMPROVEMENTS. 
(a) REGULATIONS REQUIRED.—Not later than 18 months after 
the date of enactment of this Act, the Secretary, in consultation 
with the Secretary of Defense, shall prescribe regulations for the 
Coast Guard Academy consistent with regulations required to be 
promulgated by section 559(a) of the National Defense Authorization 
Act of 2022 (Public Law 117–81).
H. R. 7776—1716 
(b) BRIEFING.—Not later than 180 days after the date of the 
enactment of this Act, the Secretary shall provide to the Committee 
on Commerce, Science, and Transportation of the Senate and the 
Committee on Transportation and Infrastructure of the House of 
Representatives a briefing on the development of the regulations 
required by subsection (a). 
SEC. 11404. COMBAT-RELATED SPECIAL COMPENSATION. 
(a) REPORT AND BRIEFING.—Not later than 90 days after the 
date of enactment of this Act, and every 180 days thereafter until 
the date that is 5 years after the date on which the initial report 
is submitted under this subsection, the Commandant shall submit 
a report and provide an in-person briefing to the Committee on 
Commerce, Science, and Transportation of the Senate and the Com-
mittee on Transportation and Infrastructure of the House of Rep-
resentatives on the implementation of section 221 of the Coast 
Guard Authorization Act of 2016 (Public Law 114–120; 10 U.S.C. 
1413a note). 
(b) ELEMENTS.—Each report and briefing required by subsection 
(a) shall include the following: 
(1) A description of methods to educate members and 
retirees on the combat-related special compensation program. 
(2) Statistics regarding enrollment in such program for 
members of the Coast Guard and Coast Guard retirees. 
(3) A summary of each of the following: 
(A) Activities carried out relating to the education of 
members of the Coast Guard participating in the Transition 
Assistance Program with respect to the combat-related spe-
cial compensation program. 
(B) Activities carried out relating to the education of 
members of the Coast Guard who are engaged in missions 
in which they are susceptible to injuries that may result 
in qualification for combat-related special compensation, 
including flight school, the National Motor Lifeboat School, 
deployable special forces, and other training programs as 
the Commandant considers appropriate. 
(C) Activities carried out relating to training physicians 
and physician assistants employed by the Coast Guard, 
or otherwise stationed in Coast Guard clinics, sickbays, 
or other locations at which medical care is provided to 
members of the Coast Guard, for the purpose of ensuring, 
during medical examinations, appropriate counseling and 
documentation of symptoms, injuries, and the associated 
incident that resulted in such injuries. 
(D) Activities relating to the notification of heath 
service officers with respect to the combat-related special 
compensation program. 
(4) The written guidance provided to members of the Coast 
Guard regarding necessary recordkeeping to ensure eligibility 
for benefits under such program. 
(5) Any other matter relating to combat-related special 
compensation the Commandant considers appropriate. 
(c) DISABILITY DUE
TO CHEMICAL
OR HAZARDOUS MATERIAL 
EXPOSURE.—Section 221(a) of the Coast Guard Authorization Act 
of 2016 (Public Law 114–120; 10 U.S.C. 1413a note) is amended— 
(1) in paragraph (1) by striking ‘‘department is’’ and 
inserting ‘‘department in’’; and
H. R. 7776—1717 
(2) in paragraph (2)— 
(A) in the matter preceding subparagraph (A)— 
(i) by striking ‘‘and hazardous’’ and inserting ‘‘haz-
ardous’’; and 
(ii) by inserting ‘‘, or a duty in which chemical 
or other hazardous material exposure has occurred 
(such as during marine inspections or pollution 
response activities)’’ after ‘‘surfman)’’; and 
(B) in subparagraph (B)— 
(i) by striking‘‘paragraph (1) or paragraph (2) of’’; 
and 
(ii) by striking ‘‘, including—’’ and all that follows 
through ‘‘search and rescue; or’’ and inserting ‘‘; or’’. 
SEC. 11405. STUDY ON FOOD SECURITY. 
(a) STUDY.— 
(1) IN GENERAL.—The Commandant shall conduct a study 
on food insecurity among members of the Coast Guard. 
(2) ELEMENTS.—The study required under paragraph (1) 
shall include the following: 
(A) An analysis of the impact of food deserts on mem-
bers of the Coast Guard and their dependents who live 
in areas with high costs of living, including areas with 
high-density populations and rural areas. 
(B) A comparison of— 
(i) the current method used by the Commandant 
to determine which areas are considered to be high 
cost-of-living areas; 
(ii) local-level indicators used by the Bureau of 
Labor Statistics to determine a cost of living that 
indicates buying power and consumer spending in spe-
cific geographic areas; and 
(iii) indicators of the cost of living used by the 
Department of Agriculture in market basket analyses 
and other measures of the local or regional cost of 
food. 
(C) An assessment of the accuracy of the method and 
indicators described in subparagraph (B) in quantifying 
high cost of living in low-data and remote areas. 
(D) An assessment of the manner in which data 
accuracy and availability affect the accuracy of cost-of- 
living allowance calculations and other benefits, as the 
Commandant considers appropriate. 
(E) Recommendations— 
(i) to improve access to high-quality, affordable 
food within a reasonable distance of Coast Guard units 
located in areas identified as food deserts; 
(ii) to reduce transit costs for members of the 
Coast Guard and their dependents who are required 
to travel to access high-quality, affordable food; and 
(iii) for improving the accuracy of the calculations 
referred to in subparagraph (D). 
(F) The estimated costs of implementing each rec-
ommendation made under subparagraph (E). 
(b) PLAN.—
H. R. 7776—1718 
(1) IN GENERAL.—The Commandant shall develop a detailed 
plan to implement the recommendations of the study conducted 
under subsection (a). 
(2) REPORT.—Not later than 1 year after date of the enact-
ment of this Act, the Commandant shall provide to the Com-
mittee on Commerce, Science, and Transportation of the Senate 
and the Committee on Transportation and Infrastructure of 
the House of Representatives a briefing on the plan required 
under paragraph (1), including the cost of implementation, 
proposals for legislative change, and any other result of the 
study the Commandant considers appropriate. 
(c) FOOD DESERT DEFINED.—In this section, the term ‘‘food 
desert’’ means an area, as determined by the Commandant, in 
which it is difficult, even with a vehicle or an otherwise-available 
mode of transportation, to obtain affordable, high-quality fresh food 
in the immediate area in which members of the Coast Guard 
serve and reside. 
Subtitle B—Healthcare 
SEC. 11406. DEVELOPMENT OF MEDICAL STAFFING STANDARDS FOR 
COAST GUARD. 
(a) IN GENERAL.—Not later than 180 days after the date of 
enactment of this Act, the Commandant, in consultation with the 
Defense Health Agency and any healthcare expert the Commandant 
considers appropriate, shall develop medical staffing standards for 
the Coast Guard that are consistent with the recommendations 
of the Comptroller General of the United States set forth in the 
report titled ‘‘Coast Guard Health Care: Improvements Needed 
for Determining Staffing Needs and Monitoring Access to Care’’ 
and published in February 2022. 
(b) INCLUSIONS.—In developing the standards under subsection 
(a), the Commandant shall address and take into consideration 
the following: 
(1) Current and future operations of healthcare personnel 
in support of Department of Homeland Security missions, 
including surge deployments for incident response. 
(2) Staffing standards for specialized providers, including 
flight surgeons, dentists, behavioral health specialists, and 
physical therapists. 
(3) Staffing levels of medical, dental, and behavioral health 
providers for the Coast Guard who are— 
(A) members of the Coast Guard; 
(B) assigned to the Coast Guard from the Public Health 
Service; 
(C) Federal civilian employees; or 
(D) contractors hired by the Coast Guard to fill vacan-
cies. 
(4) Staffing levels at medical facilities for Coast Guard 
units in remote locations. 
(5) Any discrepancy between medical staffing standards 
of the Department of Defense and medical staffing standards 
of the Coast Guard. 
(c) REVIEW BY COMPTROLLER GENERAL.—Not later than 90 days 
after the Commandant completes the staffing standards required 
by subsection (a), the Commandant shall submit the standards
H. R. 7776—1719 
to the Comptroller General, who shall review the standards and 
provide recommendations to the Commandant. 
(d) REPORT TO CONGRESS.—Not later than 180 days after devel-
oping the standards developed under subsection (a), the Com-
mandant shall submit to the Committee on Commerce, Science, 
and Transportation of the Senate and the Committee on Transpor-
tation and Infrastructure of the House of Representatives a report 
on the standards developed under subsection (a) and the rec-
ommendations provided under subsection (c) that includes a plan 
and a description of the resources and budgetary needs required 
to implement the standards. 
(e) MODIFICATION, IMPLEMENTATION, AND PERIODIC UPDATES.— 
The Commandant shall— 
(1) modify such standards, as necessary, based on the rec-
ommendations under subsection (c); 
(2) implement the standards; and 
(3) review and update the standards not less frequently 
than every 4 years. 
SEC. 11407. HEALTHCARE SYSTEM REVIEW AND STRATEGIC PLAN. 
(a) IN GENERAL.—Not later than 270 days after the completion 
of the studies conducted by the Comptroller General of the United 
States under sections 8259 and 8260 of the William M. (Mac) 
Thornberry National Defense Authorization Act of Fiscal Year 2021 
(Public Law 116–283; 134 Stat. 4679), the Commandant shall— 
(1) conduct a comprehensive review of the Coast Guard 
healthcare system; and 
(2) develop a strategic plan for improvements to, and the 
modernization of, such system to ensure access to high-quality, 
timely healthcare for members of the Coast Guard, their 
dependents, and applicable Coast Guard retirees. 
(b) PLAN.— 
(1) IN GENERAL.—The strategic plan developed under sub-
section (a) shall seek to— 
(A) maximize the medical readiness of members of 
the Coast Guard; 
(B) optimize delivery of healthcare benefits; 
(C) ensure high-quality training of Coast Guard med-
ical personnel; and 
(D) prepare for the future needs of the Coast Guard. 
(2) ELEMENTS.—The plan shall address, at a minimum, 
the following: 
(A) Improving access to healthcare for members of 
the Coast Guard, their dependents, and applicable Coast 
Guard retirees. 
(B) Quality of healthcare. 
(C) The experience and satisfaction of members of the 
Coast Guard and their dependents with the Coast Guard 
healthcare system. 
(D) The readiness of members of the Coast Guard 
and Coast Guard medical personnel. 
(c) REVIEW COMMITTEE.— 
(1) ESTABLISHMENT.—The Commandant shall establish a 
review committee to conduct a comprehensive analysis of the 
Coast Guard healthcare system (referred to in this section 
as the ‘‘Review Committee’’).
H. R. 7776—1720 
(2) MEMBERSHIP.—The Review Committee shall be com-
posed of members selected by the Commandant, including— 
(A) 1 or more members of the uniformed services (as 
defined in section 101 of title 10, United States Code) 
or Federal employees, either of which have expertise in— 
(i) the medical, dental, pharmacy, or behavioral 
health fields; or 
(ii) any other field the Commandant considers 
appropriate; 
(B) 1 representative of the Defense Health Agency; 
and 
(C) 1 medical representative from each Coast Guard 
district. 
(3) CHAIRPERSON.—The chairperson of the Review Com-
mittee shall be the Director of the Health, Safety, and Work 
Life Directorate of the Coast Guard. 
(4) STAFF.—The Review Committee shall be staffed by 
employees of the Coast Guard. 
(5) REPORT TO COMMANDANT.—Not later than 1 year after 
the Review Committee is established, the Review Committee 
shall submit to the Commandant a report that— 
(A) assesses, taking into consideration the medical 
staffing standards developed under section 11406, the rec-
ommended medical staffing standards set forth in the 
Comptroller General study required by section 8260 of 
the William M. (Mac) Thornberry National Defense 
Authorization Act for Fiscal Year 2021 (Public Law 116– 
283; 134 Stat. 4679), and compares such standards to the 
medical staffing standards of the Department of Defense 
and the private sector; 
(B) addresses improvements needed to ensure con-
tinuity of care for members of the Coast Guard, including 
by evaluating the feasibility of having a dedicated primary 
care manager for each such member while the member 
is stationed at a duty station; 
(C) evaluates the effects of increased surge deploy-
ments of medical personnel on staffing needs at Coast 
Guard clinics; 
(D) identifies ways to improve access to care for mem-
bers of the Coast Guard and their dependents who are 
stationed in remote areas, including methods to expand 
access to providers in the available network; 
(E) identifies ways the Coast Guard may better use 
Department of Defense Military Health System resources 
for members of the Coast Guard, their dependents, and 
applicable Coast Guard retirees; 
(F) identifies barriers to participation in the Coast 
Guard healthcare system and ways the Coast Guard may 
better use patient feedback to improve quality of care at 
Coast Guard-owned facilities, military treatment facilities, 
and specialist referrals; 
(G) includes recommendations to improve the Coast 
Guard healthcare system; and 
(H) any other matter the Commandant or the Review 
Committee considers appropriate.
H. R. 7776—1721 
(6) TERMINATION.—The Review Committee shall terminate 
on the date that is 1 year after the date on which the Review 
Committee submits the report required under paragraph (5). 
(7) INAPPLICABILITY
OF
FEDERAL
ADVISORY
COMMITTEE 
ACT.—The Federal Advisory Committee Act (5 U.S.C. App.) 
shall not apply to the Review Committee. 
(d) REPORT TO CONGRESS.—Not later than 2 years after the 
date of enactment of this Act, the Commandant shall submit to 
the Committee on Commerce, Science, and Transportation of the 
Senate and the Committee on Transportation and Infrastructure 
of the House of Representatives— 
(1) the strategic plan for the Coast Guard medical system 
required under subsection (a); 
(2) the report of the Review Committee submitted to the 
Commandant under subsection (c)(5); and 
(3) a description of the manner in which the Commandant 
plans to implement the recommendations of the Review Com-
mittee. 
SEC. 11408. DATA COLLECTION AND ACCESS TO CARE. 
(a) IN GENERAL.—Not later than 180 days after the date of 
enactment of this Act, the Commandant, in consultation with the 
Defense Health Agency and any healthcare expert the Commandant 
considers appropriate, shall develop, and make publicly available, 
a policy to require the collection of data regarding access by mem-
bers of the Coast Guard and their dependents to medical, dental, 
and behavioral healthcare as recommended by the Comptroller 
General of the United States in the report entitled ‘‘Coast Guard 
Health Care: Improvements Needed for Determining Staffing Needs 
and Monitoring Access to Care’’, published in February 2022. 
(b) ELEMENTS.—The policy required by subsection (a) shall 
address the following: 
(1) Methods to collect data on access to care for— 
(A) routine annual physical health assessments; 
(B) flight physicals for aviators or prospective aviators; 
(C) sick call; 
(D) injuries; 
(E) dental health; and 
(F) behavioral health conditions. 
(2) Collection of data on access to care for referrals. 
(3) Collection of data on access to care for members of 
the Coast Guard stationed at remote units, aboard Coast Guard 
cutters, and on deployments. 
(4) Use of the electronic health record system to improve 
data collection on access to care. 
(5) Use of data for addressing the standards of care, 
including time between requests for appointments and actual 
appointments, including appointments made with referral serv-
ices. 
(c) PUBLICATION AND REPORT TO CONGRESS.—Not later than 
90 days after the policy under subsection (a) is completed, or any 
subsequent updates to such policy, the Commandant shall— 
(1) publish the policy on a publicly accessible internet 
website of the Coast Guard; and 
(2) submit to the Committee on Commerce, Science, and 
Transportation of the Senate and the Committee on Transpor-
tation and Infrastructure of the House of Representatives a
H. R. 7776—1722 
report on the policy and the manner in which the Commandant 
plans to address access-to-care deficiencies. 
(d) PERIODIC UPDATES.—Not less frequently than every 5 years, 
the Commandant shall review and update the policy required under 
subsection (a). 
SEC. 11409. BEHAVIORAL HEALTH POLICY. 
(a) INTERIM BEHAVIORAL HEALTH POLICY.— 
(1) IN GENERAL.—Not later than 180 days after the date 
of enactment of this Act, the Commandant shall establish an 
interim behavioral health policy for members of the Coast 
Guard that is in parity with section 5.28 (relating to behavioral 
health) of Department of Defense Instruction 6130.03, volume 
2, ‘‘Medical Standards for Military Service: Retention’’. 
(2) TERMINATION.—The interim policy established under 
paragraph (1) shall remain in effect until the date on which 
the Commandant issues a permanent behavioral health policy 
for members of the Coast Guard. 
(b) PERMANENT POLICY.—In developing a permanent policy with 
respect to retention and behavioral health, the Commandant shall 
ensure that, to the extent practicable, the policy of the Coast Guard 
is in parity with section 5.28 (relating to behavioral health) of 
Department of Defense Instruction 6130.03, volume 2, ‘‘Medical 
Standards for Military Service: Retention’’. 
SEC. 11410. MEMBERS ASSERTING POST-TRAUMATIC STRESS DIS-
ORDER OR TRAUMATIC BRAIN INJURY. 
(a) IN GENERAL.—Subchapter I of chapter 25 of title 14, United 
States Code, is further amended by adding at the end the following: 
‘‘§ 2516. Members asserting post-traumatic stress disorder or 
traumatic brain injury 
‘‘(a) MEDICAL EXAMINATION REQUIRED.— 
‘‘(1) IN
GENERAL.—The Secretary shall ensure that a 
member of the Coast Guard who has performed Coast Guard 
operations or has been sexually assaulted during the preceding 
2-year period, and who is diagnosed by an appropriate licensed 
or certified healthcare professional as experiencing post-trau-
matic stress disorder or traumatic brain injury or who otherwise 
alleges, based on the service of the member or based on such 
sexual assault, the influence of such a condition, receives a 
medical examination to evaluate a diagnosis of post-traumatic 
stress disorder or traumatic brain injury. 
‘‘(2) RESTRICTION
ON
ADMINISTRATIVE
SEPARATION.—A 
member described in paragraph (1) shall not be administra-
tively separated under conditions other than honorable, 
including an administrative separation in lieu of a court-mar-
tial, until the results of the medical examination have been 
reviewed by appropriate authorities responsible for evaluating, 
reviewing, and approving the separation case, as determined 
by the Secretary. 
‘‘(3) POST-TRAUMATIC STRESS DISORDER.—In a case involving 
post-traumatic stress disorder under this subsection, a medical 
examination shall be— 
‘‘(A) performed by— 
‘‘(i) a board-certified or board-eligible psychiatrist; 
or 
‘‘(ii) a licensed doctorate-level psychologist; or
H. R. 7776—1723 
‘‘(B) performed under the close supervision of— 
‘‘(i) a board-certified or board-eligible psychiatrist; 
or 
‘‘(ii) a licensed doctorate-level psychologist, a doc-
torate-level mental health provider, a psychiatry resi-
dent, or a clinical or counseling psychologist who has 
completed a 1-year internship or residency. 
‘‘(4) TRAUMATIC BRAIN INJURY.—In a case involving trau-
matic brain injury under this subsection, a medical examination 
shall be performed by a physiatrist, psychiatrist, neurosurgeon, 
or neurologist. 
‘‘(b) PURPOSE OF MEDICAL EXAMINATION.—The medical exam-
ination required under subsection (a) shall assess whether the 
effects of mental or neurocognitive disorders, including post-trau-
matic stress disorder and traumatic brain injury, constitute matters 
in extenuation that relate to the basis for administrative separation 
under conditions other than honorable or the overall characteriza-
tion of the service of the member as other than honorable. 
‘‘(c) INAPPLICABILITY TO PROCEEDINGS UNDER UNIFORM CODE 
OF MILITARY JUSTICE.—The medical examination and procedures 
required by this section do not apply to courts-martial or other 
proceedings conducted pursuant to the Uniform Code of Military 
Justice. 
‘‘(d) COAST GUARD OPERATIONS DEFINED.—In this section, the 
term ‘Coast Guard operations’ has the meaning given that term 
in section 888(a) of the Homeland Security Act of 2002 (6 U.S.C. 
468(a)).’’. 
(b) CLERICAL AMENDMENT.—The analysis for chapter 25 of title 
14, United States Code, is amended by inserting after the item 
relating to section 2515 (as added by this Act) the following: 
‘‘2516. Members asserting post-traumatic stress disorder or traumatic brain injury.’’. 
SEC. 11411. IMPROVEMENTS TO PHYSICAL DISABILITY EVALUATION 
SYSTEM AND TRANSITION PROGRAM. 
(a) TEMPORARY POLICY.—Not later than 60 days after the date 
of enactment of this Act, the Commandant shall develop a tem-
porary policy that— 
(1) improves timeliness, communication, and outcomes for 
members of the Coast Guard undergoing the Physical Disability 
Evaluation System, or a related formal or informal process; 
(2) affords maximum career transition benefits to members 
of the Coast Guard determined by a Medical Evaluation Board 
to be unfit for retention in the Coast Guard; and 
(3) maximizes the potential separation and career transi-
tion benefits for members of the Coast Guard undergoing the 
Physical Disability Evaluation System, or a related formal or 
informal process. 
(b) ELEMENTS.—The policy required under subsection (a) shall 
include the following: 
(1) A requirement that any member of the Coast Guard 
who is undergoing the Physical Disability Evaluation System, 
or a related formal or informal process, shall be placed in 
a duty status that allows the member the opportunity to attend 
necessary medical appointments and other activities relating 
to the Physical Disability Evaluation System, including comple-
tion of any application of the Department of Veterans Affairs 
and career transition planning.
H. R. 7776—1724 
(2) In the case of a Medical Evaluation Board report that 
is not completed not later than 120 days after the date on 
which an evaluation by the Medical Evaluation Board was 
initiated, the option for such a member to enter permissive 
duty status. 
(3) A requirement that the date of initiation of an evalua-
tion by a Medical Evaluation Board shall include the date 
on which any verbal or written affirmation is made to the 
member, command, or medical staff that the evaluation by 
the Medical Evaluation Board has been initiated. 
(4) An option for such member to seek an internship under 
the SkillBridge program established under section 1143(e) of 
title 10, United States Code, and outside employment aimed 
at improving the transition of the member to civilian life, 
only if such an internship or employment does not interfere 
with necessary medical appointments required for the member’s 
physical disability evaluation. 
(5) A requirement that not less than 21 days notice shall 
be provided to such a member for any such medical appoint-
ment, to the maximum extent practicable, to ensure that the 
appointment timeline is in the best interests of the immediate 
health of the member. 
(6) A requirement that the Coast Guard shall provide such 
a member with a written separation date upon the completion 
of a Medical Evaluation Board report that finds the member 
unfit to continue active duty. 
(7) To provide certainty to such a member with respect 
to a separation date, a policy that ensures— 
(A) that accountability measures are in place with 
respect to Coast Guard delays throughout the Physical 
Disability Evaluation System, including— 
(i) placement of the member in an excess leave 
status after 270 days have elapsed since the date of 
initiation of an evaluation by a Medical Evaluation 
Board by any competent authority; and 
(ii) a calculation of the costs to retain the member 
on active duty, including the pay, allowances, and other 
associated benefits of the member, for the period begin-
ning on the date that is 90 days after the date of 
initiation of an evaluation by a Medical Evaluation 
Board by any competent authority and ending on the 
date on which the member is separated from the Coast 
Guard; and 
(B) the availability of administrative solutions to any 
such delay. 
(8) With respect to a member of the Coast Guard on tem-
porary limited duty status, an option to remain in the member’s 
current billet, to the maximum extent practicable, or to be 
transferred to a different active-duty billet, so as to minimize 
any negative impact on the member’s career trajectory. 
(9) A requirement that each respective command shall 
report to the Coast Guard Personnel Service Center any delay 
of more than 21 days between each stage of the Physical 
Disability Evaluation System for any such member, including 
between stages of the processes, the Medical Evaluation Board, 
the Informal Physical Evaluation Board, and the Formal Phys-
ical Evaluation Board.