II
September 5, 2007
Ordered to be printed as passed
In the Senate of the United States,
July 25, 2007.
Resolved, That the bill from the House of Representa-
tives (H.R. 1538) entitled ‘‘An Act to amend title 10, United
States Code, to improve the management of medical care,
personnel actions, and quality of life issues for members of
the Armed Forces who are receiving medical care in an out-
patient status, and for other purposes.’’, do pass with the fol-
lowing
AMENDMENT:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Dignified Treatment of Wounded Warriors Act’’.
(b) TABLE OF CONTENTS.—The table of contents for
this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—WOUNDED WARRIOR MATTERS
Sec. 101. General definitions.
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Subtitle A—Policy on Care, Management, and Transition of Servicemembers
With Serious Injuries or Illnesses
Sec. 111. Comprehensive policy on care, management, and transition of members
of the Armed Forces with serious injuries or illnesses.
Sec. 112. Consideration of needs of women members of the Armed Forces and vet-
erans.
Subtitle B—Health Care
PART I—ENHANCED AVAILABILITY OF CARE FOR SERVICEMEMBERS
Sec. 121. Medical care and other benefits for members and former members of the
Armed Forces with severe injuries or illnesses.
Sec. 122. Reimbursement of certain former members of the uniformed services
with service-connected disabilities for travel for follow-on spe-
cialty care and related services.
PART II—CARE AND SERVICES FOR DEPENDENTS
Sec. 126. Medical care and services and support services for families of members
of the Armed Forces recovering from serious injuries or illnesses.
Sec. 127. Extended benefits under TRICARE for primary caregivers of members
of the uniformed services who incur a serious injury or illness
on active duty.
PART III—TRAUMATIC BRAIN INJURY AND POST-TRAUMATIC STRESS
DISORDER
Sec. 131. Comprehensive plans on prevention, diagnosis, mitigation, and treat-
ment of traumatic brain injury and post-traumatic stress dis-
order in members of the Armed Forces.
Sec. 132. Improvement of medical tracking system for members of the Armed
Forces deployed overseas.
Sec. 133. Centers of excellence in the prevention, diagnosis, mitigation, treatment,
and rehabilitation of traumatic brain injury and post-traumatic
stress disorder.
Sec. 134. Review of mental health services and treatment for female members of
the Armed Forces and veterans.
Sec. 135. Funding for improved diagnosis, treatment, and rehabilitation of mem-
bers of the Armed Forces with traumatic brain injury or post-
traumatic stress disorder.
Sec. 136. Reports.
PART IV—OTHER MATTERS
Sec. 141. Joint electronic health record for the Department of Defense and De-
partment of Veterans Affairs.
Sec. 142. Enhanced personnel authorities for the Department of Defense for health
care professionals for care and treatment of wounded and in-
jured members of the Armed Forces.
Sec. 143. Personnel shortages in the mental health workforce of the Department
of Defense, including personnel in the mental health workforce.
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Subtitle C—Disability Matters
PART I—DISABILITY EVALUATIONS
Sec. 151. Utilization of veterans’ presumption of sound condition in establishing
eligibility of members of the Armed Forces for retirement for dis-
ability.
Sec. 152. Requirements and limitations on Department of Defense determinations
of disability with respect to members of the Armed Forces.
Sec. 153. Review of separation of members of the Armed Forces separated from
service with a disability rating of 20 percent disabled or less.
Sec. 154. Pilot programs on revised and improved disability evaluation system
for members of the Armed Forces.
Sec. 155. Reports on Army action plan in response to deficiencies in the Army
physical disability evaluation system.
PART II—OTHER DISABILITY MATTERS
Sec. 161. Enhancement of disability severance pay for members of the Armed
Forces.
Sec. 162. Traumatic Servicemembers’ Group Life Insurance.
Sec. 163. Electronic transfer from the Department of Defense to the Department
of Veterans Affairs of documents supporting eligibility for bene-
fits.
Sec. 164. Assessments of temporary disability retired list.
Subtitle D—Improvement of Facilities Housing Patients
Sec. 171. Standards for military medical treatment facilities, specialty medical
care facilities, and military quarters housing patients.
Sec. 172. Reports on Army action plan in response to deficiencies identified at
Walter Reed Army Medical Center.
Sec. 173. Construction of facilities required for the closure of Walter Reed Army
Medical Center, District of Columbia.
Subtitle E—Outreach and Related Information on Benefits
Sec. 181. Handbook for members of the Armed Forces on compensation and bene-
fits available for serious injuries and illnesses.
Subtitle F—Other Matters
Sec. 191. Study on physical and mental health and other readjustment needs of
members and former members of the Armed Forces who deployed
in Operation Iraqi Freedom and Operation Enduring Freedom
and their families.
TITLE II—VETERANS MATTERS
Sec. 201. Sense of Congress on Department of Veterans Affairs efforts in the reha-
bilitation and reintegration of veterans with traumatic brain in-
jury.
Sec. 202. Individual rehabilitation and community reintegration plans for vet-
erans and others with traumatic brain injury.
Sec. 203. Use of non-Department of Veterans Affairs facilities for implementation
of rehabilitation and community reintegration plans for trau-
matic brain injury.
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Sec. 204. Research, education, and clinical care program on severe traumatic
brain injury.
Sec. 205. Pilot program on assisted living services for veterans with traumatic
brain injury.
Sec. 206. Research on traumatic brain injury.
Sec. 207. Age-appropriate nursing home care.
Sec. 208. Extension of period of eligibility for health care for combat service in
the Persian Gulf war or future hostilities.
Sec. 209. Mental health: service-connection status and evaluations for certain vet-
erans.
Sec. 210. Modification of requirements for furnishing outpatient dental services to
veterans with a service-connected dental condition or disability.
Sec. 211. Demonstration program on preventing veterans at-risk of homelessness
from becoming homeless.
Sec. 212. Clarification of purpose of the outreach services program of the Depart-
ment of Veterans Affairs.
TITLE III
Sec. 301. Fiscal year 2008 increase in military basic pay.
TITLE I—WOUNDED WARRIOR
MATTERS
SEC. 101. GENERAL DEFINITIONS.
In this title:
(1) The term ‘‘appropriate committees of Con-
gress’’ means—
(A) the Committees on Armed Services and
Veterans’ Affairs of the Senate; and
(B) the Committees on Armed Services and
Veterans’ Affairs of the House of Representatives.
(2) The term ‘‘covered member of the Armed
Forces’’ means a member of the Armed Forces, includ-
ing a member of the National Guard or a Reserve,
who is undergoing medical treatment, recuperation,
or therapy, is otherwise in medical hold or medical
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holdover status, or is otherwise on the temporary dis-
ability retired list for a serious injury or illness.
(3) The term ‘‘family member’’, with respect to
a member of the Armed Forces or a veteran, has the
meaning given that term in section 411h(b) of title
37, United States Code.
(4) The term ‘‘medical hold or medical holdover
status’’ means—
(A) the status of a member of the Armed
Forces, including a member of the National
Guard or Reserve, assigned or attached to a
military hospital for medical care; and
(B) the status of a member of a reserve com-
ponent of the Armed Forces who is separated,
whether 
pre-deployment 
or 
post-deployment,
from the member’s unit while in need of health
care based on a medical condition identified
while the member is on active duty in the Armed
Forces.
(5) The term ‘‘serious injury or illness’’, in the
case of a member of the Armed Forces, means an in-
jury or illness incurred by the member in line of duty
on active duty in the Armed Forces that may render
the member medically unfit to perform the duties of
the member’s office, grade, rank, or rating.
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(6) The term ‘‘TRICARE program’’ has the
meaning given that term in section 1072(7) of title
10, United States Code.
Subtitle A—Policy on Care, Man-
agement, 
and 
Transition 
of
Servicemembers With Serious In-
juries or Illnesses
SEC. 111. COMPREHENSIVE POLICY ON CARE, MANAGE-
MENT, AND TRANSITION OF MEMBERS OF
THE ARMED FORCES WITH SERIOUS INJU-
RIES OR ILLNESSES.
(a) COMPREHENSIVE POLICY REQUIRED.—
(1) IN GENERAL.—Not later than January 1,
2008, the Secretary of Defense and the Secretary of
Veterans Affairs shall, to the extent feasible, jointly
develop and implement a comprehensive policy on the
care and management of members of the Armed
Forces who are undergoing medical treatment, recu-
peration, or therapy, are otherwise in medical hold or
medical holdover status, or are otherwise on the tem-
porary disability retired list for a serious injury or
illness (hereafter in this section referred to as a ‘‘cov-
ered servicemembers’’).
(2) SCOPE OF POLICY.—The policy shall cover
each of the following:
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(A) The care and management of covered
servicemembers while in medical hold or medical
holdover status or on the temporary disability
retired list.
(B) The medical evaluation and disability
evaluation of covered servicemembers.
(C) The return of covered servicemembers to
active duty when appropriate.
(D) 
The 
transition 
of 
covered
servicemembers from receipt of care and services
through the Department of Defense to receipt of
care and services through the Department of Vet-
erans Affairs.
(3) CONSULTATION.—The Secretary of Defense
and the Secretary of Veterans Affairs shall develop the
policy in consultation with the heads of other appro-
priate departments and agencies of the Federal Gov-
ernment and with appropriate non-governmental or-
ganizations having an expertise in matters relating to
the policy.
(4) UPDATE.—The Secretary of Defense and the
Secretary of Veterans Affairs shall jointly update the
policy on a periodic basis, but not less often than an-
nually, in order to incorporate in the policy, as ap-
propriate, the results of the reviews under subsections
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(b) and (c) and the best practices identified through
pilot programs under section 154.
(b) REVIEW
OF CURRENT POLICIES
AND PROCE-
DURES.—
(1) REVIEW REQUIRED.—In developing the pol-
icy required by this section, the Secretary of Defense
and the Secretary of Veterans Affairs shall, to the ex-
tent necessary, jointly and separately conduct a re-
view of all policies and procedures of the Department
of Defense and the Department of Veterans Affairs
that apply to, or shall be covered by, the policy.
(2) PURPOSE.—The purpose of the review shall
be to identify the most effective and patient-oriented
approaches to care and management of covered
servicemembers for purposes of—
(A) incorporating such approaches into the
policy; and
(B) extending such approaches, where ap-
plicable, to care and management of other in-
jured or ill members of the Armed Forces and
veterans.
(3) ELEMENTS.—In conducting the review, the
Secretary of Defense and the Secretary of Veterans Af-
fairs shall—
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(A) identify among the policies and proce-
dures described in paragraph (1) best practices
in approaches to the care and management de-
scribed in that paragraph;
(B) identify among such policies and proce-
dures existing and potential shortfalls in such
care and management (including care and man-
agement of covered servicemembers on the tem-
porary disability retired list), and determine
means of addressing any shortfalls so identified;
(C) determine potential modifications of
such policies and procedures in order to ensure
consistency and uniformity among the military
departments and the regions of the Department
of Veterans Affairs in their application and dis-
charge; and
(D) develop recommendations for legislative
and administrative action necessary to imple-
ment the results of the review.
(4) DEADLINE
FOR
COMPLETION.—The review
shall be completed not later than 90 days after the
date of the enactment of this Act.
(c) CONSIDERATION
OF
FINDINGS, RECOMMENDA-
TIONS, AND PRACTICES.—In developing the policy required
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by this section, the Secretary of Defense and the Secretary
of Veterans Affairs shall take into account the following:
(1) The findings and recommendations of appli-
cable studies, reviews, reports, and evaluations that
address matters relating to the policy, including, but
not limited, to the following:
(A) The Independent Review Group on Re-
habilitative Care and Administrative Processes
at Walter Reed Army Medical Center and Na-
tional Naval Medical Center appointed by the
Secretary of Defense.
(B) The Secretary of Veterans Affairs Task
Force on Returning Global War on Terror He-
roes appointed by the President.
(C) The President’s Commission on Care for
America’s Returning Wounded Warriors.
(D) The Veterans’ Disability Benefits Com-
mission established by title XV of the National
Defense Authorization Act for Fiscal Year 2004
(Public Law 108–136; 117 Stat. 1676; 38 U.S.C.
1101 note).
(E) The President’s Commission on Vet-
erans’ Pensions, of 1956, chaired by General
Omar N. Bradley.
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(F) The Report of the Congressional Com-
mission on Servicemembers and Veterans Transi-
tion Assistance, of 1999, chaired by Anthony J.
Principi.
(G) The President’s Task Force to Improve
Health Care Delivery for Our Nation’s Veterans,
of March 2003.
(2) The experience and best practices of the De-
partment of Defense and the military departments on
matters relating to the policy.
(3) The experience and best practices of the De-
partment of Veterans Affairs on matters relating to
the policy.
(4) Such other matters as the Secretary of De-
fense and the Secretary of Veterans Affairs consider
appropriate.
(d) PARTICULAR ELEMENTS OF POLICY.—The policy
required by this section shall provide, in particular, the fol-
lowing:
(1) 
RESPONSIBILITY
FOR
COVERED
SERVICEMEMBERS
IN
MEDICAL
HOLD
OR
MEDICAL
HOLDOVER
STATUS
OR
ON
TEMPORARY
DISABILITY
RETIRED LIST.—Mechanisms to ensure responsibility
for covered servicemembers in medical hold or medical
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holdover status or on the temporary disability retired
list, including the following:
(A) Uniform standards for access of covered
servicemembers to non-urgent health care services
from the Department of Defense or other pro-
viders under the TRICARE program, with such
access to be—
(i) for follow-up care, within 2 days of
request of care;
(ii) for specialty care, within 3 days of
request of care;
(iii) for diagnostic referrals and stud-
ies, within 5 days of request; and
(iv) for surgery based on a physician’s
determination of medical necessity, within
14 days of request.
(B) Requirements for the assignment of ade-
quate numbers of personnel for the purpose of re-
sponsibility for and administration of covered
servicemembers in medical hold or medical hold-
over status or on the temporary disability retired
list.
(C) Requirements for the assignment of ade-
quate numbers of medical personnel and non-
medical personnel to roles and responsibilities
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for caring for and administering covered
servicemembers in medical hold or medical hold-
over status or on the temporary disability retired
list, and a description of the roles and respon-
sibilities of personnel so assigned.
(D) Guidelines for the location of care for
covered servicemembers in medical hold or med-
ical holdover status or on the temporary dis-
ability retired list, which guidelines shall address
the assignment of such servicemembers to care
and residential facilities closest to their duty sta-
tion or home of record or the location of their
designated caregiver at the earliest possible time.
(E) Criteria for work and duty assignments
of covered servicemembers in medical hold or
medical holdover status or on the temporary dis-
ability retired list, including a prohibition on
the assignment of duty to a servicemember which
is incompatible with the servicemember’s medical
condition.
(F) Guidelines for the provision of care and
counseling for eligible family members of covered
servicemembers in medical hold or medical hold-
over status or on the temporary disability retired
list.
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(G) Requirements for case management of
covered servicemembers in medical hold or med-
ical holdover status or on the temporary dis-
ability retired list, including qualifications for
personnel providing such case management.
(H) Requirements for uniform quality of
care 
and 
administration 
for 
all 
covered
servicemembers in medical hold or medical hold-
over status or on the temporary disability retired
list, whether members of the regular components
of the Armed Forces or members of the reserve
components of the Armed Forces.
(I) Standards for the conditions and acces-
sibility of residential facilities for covered
servicemembers in medical hold or medical hold-
over status or on the temporary disability retired
list who are in outpatient status, and for their
immediate family members.
(J) Requirements on the provision of trans-
portation 
and 
subsistence 
for 
covered
servicemembers in medical hold or medical hold-
over status or on the temporary disability retired
list, whether in inpatient status or outpatient
status, to facilitate obtaining needed medical
care and services.
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(K) Requirements on the provision of edu-
cational and vocational training and rehabilita-
tion opportunities for covered servicemembers in
medical hold or medical holdover status or on the
temporary disability retired list.
(L) Procedures for tracking and informing
covered servicemembers in medical hold or med-
ical holdover status or on the temporary dis-
ability retired list about medical evaluation
board and physical disability evaluation board
processing.
(M) Requirements for integrated case man-
agement of covered servicemembers in medical
hold or medical holdover status or on the tem-
porary disability retired list during their transi-
tion from care and treatment through the De-
partment of Defense to care and treatment
through the Department of Veterans Affairs.
(N) Requirements and standards for advis-
ing and training, as appropriate, family mem-
bers 
with 
respect 
to 
care 
for 
covered
servicemembers in medical hold or medical hold-
over status or on the temporary disability retired
list with serious medical conditions, particularly
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traumatic brain injury (TBI), burns, and post-
traumatic stress disorder (PTSD).
(O) Requirements for periodic reassessments
of covered servicemembers, and limits on the
length of time such servicemembers may be re-
tained in medical hold or medical holdover sta-
tus or on the temporary disability retired list.
(P) 
Requirements 
to 
inform 
covered
servicemembers and their family members of
their rights and responsibilities while in medical
hold or medical holdover status or on the tem-
porary disability retired list.
(Q) The requirement to establish a Depart-
ment of Defense-wide Ombudsman Office within
the Office of the Secretary of Defense to provide
oversight of the ombudsman offices in the mili-
tary departments and policy guidance to such of-
fices with respect to providing assistance to, and
answering 
questions 
from, 
covered
servicemembers and their families.
(2) MEDICAL EVALUATION AND PHYSICAL DIS-
ABILITY
EVALUATION
FOR
COVERED
SERVICEMEMBERS.—
(A) 
MEDICAL
EVALUATIONS.—Processes,
procedures, and standards for medical evalua-