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(6) Separated from the Armed Forces as a re-
sult of a covered medical condition. 
(b) DEFINITIONS.—In this section: 
(1) EXEMPT AND NONEXEMPT INDIVIDUALS.— 
The terms ‘‘exempt individuals’’ and ‘‘nonexempt in-
dividuals’’ have the meanings given those terms in 
attachment 3 of the memorandum— 
(A) issued by the Office of the Deputy Sec-
retary of Defense; 
(B) dated March 12, 2019; and 
(C) with the subject heading ‘‘Directive- 
type 
Memorandum 
(DTM)–19–004–Military 
Service by Transgender Persons and Persons 
with Gender Dysphoria’’. 
(2) COVERED MEDICAL CONDITION.—The term 
‘‘covered medical condition’’ means— 
(A) gender dysphoria; 
(B) gender transition treatment; or 
(C) any other condition related to gender 
dysphoria or gender transition treatment. 
(3) REPORTING PERIOD.—The term ‘‘reporting 
period’’ means, with respect to a report submitted 
under subsection (a), the calendar year most re-
cently completed before the date on which such re-
port is to be submitted. 
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(4) SERVICE WAIVER.—The term ‘‘service waiv-
er’’ includes a waiver— 
(A) for accession into the Armed Forces; 
(B) to continue service in the Armed 
Forces; or 
(C) to otherwise permit service in the 
Armed Forces. 
SEC. 598. STUDY ON BEST PRACTICES FOR PROVIDING FI-
NANCIAL LITERACY EDUCATION FOR VET-
ERANS. 
(a) STUDY REQUIRED.—The Secretary of Defense 
and the Secretary of Veterans Affairs, and with respect 
to members of the Coast Guard, in coordination with the 
Secretary of the Department in which the Coast Guard 
is operating when it is not operating as a service in the 
Navy, shall conduct a study on the best practices to pro-
vide financial literacy education for separating members 
of the Armed Forces and veterans. 
(b) ELEMENTS.—The study required by subsection 
(a) shall include— 
(1) an examination, recommendations, and re-
porting on best practices for providing financial lit-
eracy education to veterans and separating members 
of the Armed Forces; 
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(2) detailed current financial literacy programs 
for separating members of the Armed Forces, and 
an examination of linkages between these programs 
and those for veterans provided by the Department 
of Veterans Affairs; and 
(3) steps to improve coordination between the 
Department of Defense and Department of Veterans 
Affairs for the provision of these services. 
(c) CONSULTATION.—In conducting the study re-
quired by subsection (a), the Secretaries shall consult with 
the Financial Literacy and Education Commission of the 
Department of the Treasury. 
(d) REPORT.—Not later than 120 days after the date 
of the enactment of this Act, the Secretary of Defense 
shall submit to the appropriate congressional committees 
a report on the study under subsection (a). 
(e) DEFINITION.— In this section: 
(1) The term ‘‘financial literacy’’ means edu-
cation of personal finance including the insurance, 
credit, loan, banking, career training and education 
benefits available to veterans. 
(2) The term ‘‘appropriate congressional com-
mittees’’ means the Committees on Armed Services 
of the Senate and House of Representatives, and the 
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Committees on Veterans’ Affairs of the Senate and 
House of Representatives. 
SEC. 599. HONORARY PROMOTION OF COLONEL CHARLES 
E. MCGEE TO BRIGADIER GENERAL IN THE 
AIR FORCE. 
The President is authorized to issue an honorary 
commission promoting, to brigadier general in the Air 
Force, Colonel Charles E. McGee, United States Air Force 
(retired), a distinguished Tuskegee Airman whose hon-
orary promotion has the recommendation of the Secretary 
of the Air Force under section 1563 of title 10, United 
States Code. 
SEC. 599A. RECOMMENDING THAT THE PRESIDENT GRANT 
LIEUTENANT 
COLONEL 
RICHARD 
COLE, 
UNITED STATES AIR FORCE (RET.), AN HON-
ORARY AND POSTHUMOUS PROMOTION TO 
THE GRADE OF COLONEL. 
(a) FINDINGS.—Congress finds the following: 
(1) Richard E. Cole (in this section referred to 
as ‘‘Cole’’) graduated from Steele High School in 
Dayton, Ohio, and completed two years at Ohio Uni-
versity before enlisting in the Army Air Corps in No-
vember, 1940. 
(2) Cole completed pilot training and was com-
missioned as a Second Lieutenant in July, 1941. 
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(3) On April 18, 1942, the United States con-
ducted air raids on Tokyo led by Lieutenant Colonel 
James ‘‘Jimmy’’ Doolittle, which later became 
known as ‘‘the Doolittle Raid’’. 
(4) Cole flew in the Doolittle Raid as Lieuten-
ant Colonel Doolittle’s co-pilot in aircraft number 1. 
(5) For their outstanding heroism, valor, skill, 
and service to the United States, the Doolittle Raid-
ers, including Cole, were awarded the Congressional 
Gold Medal in 2014. 
(b) RECOMMENDATION OF HONORARY PROMOTION 
FOR RICHARD E. COLE.—Pursuant to section 1563 of 
title 10, United States Code, Congress recommends that 
the President grant Lieutenant Colonel Richard E. Cole, 
United States Air Force (retired), an honorary and post-
humous promotion to the grade of colonel. 
(c) ADDITIONAL BENEFITS NOT TO ACCRUE.—The 
advancement of Richard E. Cole on the retired list of the 
Air Force under subsection (b) shall not affect the retired 
pay or other benefits from the United States to which 
Richard E. Cole would have been entitled based upon his 
military service, or affect any benefits to which any other 
person may become entitled based on such military service. 
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SEC. 599B. INCLUSION OF CERTAIN VETERANS ON TEM-
PORARY DISABILITY OR PERMANENT DIS-
ABLED 
RETIREMENT 
LISTS 
IN 
MILITARY 
ADAPTIVE SPORTS PROGRAMS. 
(a) INCLUSION OF CERTAIN VETERANS.—Subsection 
(a)(1) of section 2564a of title 10, United States Code, 
is amended by striking ‘‘for members of the armed forces 
who’’ and all that follows through the period at the end 
and inserting the following: ‘‘for— 
‘‘(A) any member of the armed forces who 
is eligible to participate in adaptive sports be-
cause of an injury, illness, or wound incurred in 
the line of duty in the armed forces; and 
‘‘(B) any veteran (as defined in section 
101 of title 38), during the one-year period fol-
lowing the veteran’s date of separation, who— 
‘‘(i) is on the Temporary Disability 
Retirement List or Permanently Disabled 
Retirement List; 
‘‘(ii) is eligible to participate in adapt-
ive sports because of an injury, illness, or 
wound incurred in the line of duty in the 
armed forces; and 
‘‘(iii) was enrolled in the program au-
thorized under this section prior to the vet-
eran’s date of separation.’’. 
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(b) CONFORMING AMENDMENT.—Subsection (b) of 
such section is amended by inserting ‘‘and veterans’’ after 
‘‘members’’. 
(c) CLERICAL AMENDMENTS.— 
(1) HEADING
AMENDMENT.—The heading of 
such section is amended to read as follows: 
‘‘§ 2564a. Provision of assistance for adaptive sports 
programs: members of the armed forces; 
certain veterans’’. 
(2) TABLE OF SECTIONS.—The table of sections 
at the beginning of chapter 152 of such title is 
amended by striking the item relating to section 
2564a and inserting the following new item: 
‘‘2564a. Provision of assistance for adaptive sports programs: members of the 
armed forces; certain veterans.’’. 
SEC. 599C. SENSE OF CONGRESS REGARDING THE HIGH-AL-
TITUDE ARMY NATIONAL GUARD AVIATION 
TRAINING SITE. 
(a) FINDING.—Congress finds that the High-Altitude 
Army National Guard Aviation Training Site is the lone 
school of the Department of Defense where rotary-wing 
aviators in the Armed Forces and the militaries of foreign 
allies learn how to safely fly rotary-wing aircraft in moun-
tainous, high-altitude environments. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that military aviation training in Colorado, including 
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the training conducted at the High-Altitude Army Na-
tional Guard Aviation Training Site, is critical to the na-
tional security of the United States and the readiness of 
the Armed Forces. 
TITLE VI—COMPENSATION AND 
OTHER PERSONNEL BENEFITS 
Subtitle A—Pay and Allowances 
SEC. 601. CLARIFICATION OF CONTINUATION OF PAYS DUR-
ING HOSPITALIZATION AND REHABILITATION 
RESULTING FROM WOUNDS, INJURY, OR ILL-
NESS INCURRED WHILE ON DUTY IN A HOS-
TILE FIRE AREA OR EXPOSED TO AN EVENT 
OF HOSTILE FIRE OR OTHER HOSTILE AC-
TION. 
Section 372(b)(1) of title 37, United States Code, is 
amended to read as follows: 
‘‘(1) The date on which the member is returned 
for assignment to other than a medical or patient 
unit for duty; however, in the case of a member 
under the jurisdiction of a Secretary of a military 
department, the date on which the member is deter-
mined fit for duty.’’. 
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SEC. 602. BASIC NEEDS ALLOWANCE FOR LOW-INCOME 
REGULAR MEMBERS. 
(a) IN GENERAL.—Chapter 7 of title 37, United 
States Code, is amended by inserting after section 402a 
the following new section: 
‘‘§ 402b. Basic needs allowance for low-income reg-
ular members 
‘‘(a) ALLOWANCE REQUIRED.—(1) Subject to para-
graph (2), the Secretary of Defense shall pay to each cov-
ered member a basic needs allowance in the amount deter-
mined for such member under subsection (b). 
‘‘(2) In the event a household contains two or more 
covered members entitled to receive the allowance under 
this section in a given year, only one allowance may be 
paid for that year to a covered member among such cov-
ered members whom such covered members shall jointly 
elect. 
‘‘(b) AMOUNT
OF ALLOWANCE
FOR
A COVERED 
MEMBER.—(1) The amount of the monthly allowance pay-
able to a covered member under subsection (a) for a year 
shall be the aggregate amount equal to— 
‘‘(A) the aggregate amount equal to— 
‘‘(i) 130 percent of the Federal poverty guide-
lines of the Department of Health and Human Serv-
ices for the location and number of persons in the 
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household of the covered member for such year; 
minus 
‘‘(ii) the gross household income of the covered 
member during the preceding year; and 
‘‘(B) divided by 12. 
‘‘(2) The monthly allowance payable to a covered 
member for a year shall be payable for each of the 12 
months following March of such year. 
‘‘(c) NOTICE OF ELIGIBILITY.—(1)(A) Not later than 
December 31 each year, the Director of the Defense Fi-
nance and Accounting Service shall notify, in writing, each 
individual whom the Director estimates will be a covered 
member during the following year of the potential entitle-
ment of that individual to the allowance described in sub-
section (a) for that following year. 
‘‘(B) The preliminary notice under subparagraph (A) 
shall include information regarding financial management 
and assistance programs administered by the Secretary of 
Defense for which a covered member is eligible. 
‘‘(2) Not later than January 31 each year, each indi-
vidual who seeks to receive the allowance for such year 
(whether or not subject to a notice for such year under 
paragraph (1)) shall submit to the Director such informa-
tion as the Director shall require for purposes of this sec-
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tion in order to determine whether or not such individual 
is a covered member for such year. 
‘‘(3) Not later than February 28 each year, the Di-
rector shall notify, in writing, each individual the Director 
determines to be a covered member for such year. 
‘‘(d) ELECTION NOT TO RECEIVE ALLOWANCE.—(1) 
A covered member otherwise entitled to receive the allow-
ance under subsection (a) for a year may elect, in writing, 
not to receive the allowance for such year. Any election 
under this subsection shall be effective only for the year 
for which made. Any election for a year under this sub-
section is irrevocable. 
‘‘(2) A covered member who does not submit informa-
tion described in subsection (d)(2) for a year as otherwise 
required by that subsection shall be deemed to have elect-
ed not to receive the allowance for such year. 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) The term ‘covered member’ means a reg-
ular member of the Army, Navy, Marine Corps, or 
Air Force— 
‘‘(A) who has completed initial entry train-
ing; 
‘‘(B) whose gross household income during 
the most recent year did not exceed an amount 
equal to 130 percent of the Federal poverty 
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guidelines of the Department of Health and 
Human Services for the location and number of 
persons in the household of the covered member 
for such year; and 
‘‘(C) who does not elect under subsection 
(d) not to receive the allowance for such year. 
‘‘(2) The term ‘gross household income’ of a 
covered member for a year for purposes of para-
graph (1)(B) does not include any basic allowance 
for housing received by the covered member (and 
any dependents of the covered member in the house-
hold of the covered member) during such year under 
section 403 of this title. 
‘‘(f) REGULATIONS.—The Secretary of Defense shall 
prescribe regulations for the administration of this section. 
Subject to subsection (e)(2), such regulations shall specify 
the income to be included in, and excluded from, the gross 
household income of individuals for purposes of this sec-
tion.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 7 of such title is amended by 
inserting after the item relating to section 402a the fol-
lowing new item: 
‘‘402b. Basic needs allowance for low-income regular members.’’. 
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SEC. 603. TEMPORARY INCREASE OF RATES OF BASIC AL-
LOWANCE FOR HOUSING FOLLOWING DETER-
MINATION THAT LOCAL CIVILIAN HOUSING 
COSTS SIGNIFICANTLY EXCEED SUCH RATES. 
Section 403(b) of title 37, United States Code, is 
amended by adding at the end the following new para-
graph: 
‘‘(8)(A) The Secretary of Defense may prescribe a 
temporary increase in the current rates of basic allowance 
for housing for a military housing area or a portion there-
of (in this paragraph, ‘BAH rates’) if the Secretary deter-
mines that the actual costs of adequate housing for civil-
ians in that military housing area or portion thereof ex-
ceed the current BAH rates by more than 20 percent. 
‘‘(B) Any temporary increase in BAH rates under 
this paragraph shall remain in effect only until the effec-
tive date of the first adjustment of BAH rates for the af-
fected military housing area that occurs after the date of 
the increase under this paragraph. 
‘‘(C) This paragraph shall cease to be effective on 
September 30, 2022.’’. 
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SEC. 604. BASIC ALLOWANCE FOR HOUSING FOR A MEMBER 
WITHOUT DEPENDENTS WHEN RELOCATION 
WOULD FINANCIALLY DISADVANTAGE THE 
MEMBER. 
Section 403(o) of title 37, United States Code, is 
amended— 
(1) by inserting ‘‘(1)’’ before ‘‘In’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(2)(A) In the case of a member described in sub-
paragraph (B), the member may be treated for the pur-
poses of this section as if the unit to which the member 
is assigned did not undergo a change of home port or a 
change of permanent duty station if the Secretary con-
cerned determines that it would be inequitable to base the 
member’s entitlement to, and amount of, a basic allowance 
for housing on the new home port or permanent duty sta-
tion. 
‘‘(B) A member described in this subparagraph— 
‘‘(i) has no dependents; 
‘‘(ii) is assigned to a unit that undergoes a 
change of home port or a change of permanent duty 
station; and 
‘‘(iii) is in receipt of orders to return to the pre-
vious home port or duty station.’’. 
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SEC. 605. PARTIAL DISLOCATION ALLOWANCE. 
(a) CURRENT AUTHORITY.—Section 477(f)(1) of title 
37, United States Code, is amended by striking ‘‘family’’. 
(b) FUTURE AUTHORITY.—Section 452(c) of title 37, 
United States Code, is amended— 
(1) by redesignating paragraph (3) as para-
graph (4); and 
(2) by inserting after paragraph (2) the fol-
lowing new paragraph (3): 
‘‘(3)(A) A partial dislocation allowance paid to 
a member ordered to occupy or vacate housing pro-
vided by the United States. 
‘‘(B) Beginning on January 1, 2022, the partial 
dislocation allowance under subparagraph (A) shall, 
subject to subparagraph (C), be equal in value to the 
allowance under section 477(f) of this title on De-
cember 31, 2021, as adjusted in regulations pre-
scribed by the Secretary concerned under the au-
thority established by that section. 
‘‘(C) Effective on the same date in 2022 and 
any subsequent year that the monthly rates of basic 
pay for all members are increased under section 
1009 of this title or another provision of law, the 
Secretary of Defense shall adjust the rate of the 
partial dislocation allowance under this paragraph 
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by the percentage equal to the average percentage 
increase in the rates of basic pay.’’. 
SEC. 606. INCREASE IN BASIC PAY. 
Effective on January 1, 2020, the rates of monthly 
basic pay for members of the uniformed services are in-
creased by 3.1 percent. 
SEC. 607. ANNUAL ADJUSTMENT OF BASIC PAY. 
The adjustment in the rates of monthly basic pay re-
quired by subsection (a) of section 1009 of title 37, United 
States Code, to be made on January 1, 2020, shall take 
effect, notwithstanding any determination made by the 
President under subsection (e) of such section with respect 
to an alternative pay adjustment to be made on such date. 
SEC. 608. STUDY REGARDING RECOUPMENT OF SEPARA-
TION PAY, SPECIAL SEPARATION BENEFITS, 
AND VOLUNTARY SEPARATION INCENTIVE 
PAYMENTS FROM MEMBERS OF THE ARMED 
FORCES AND VETERANS WHO RECEIVE DIS-
ABILITY COMPENSATION UNDER LAWS AD-
MINISTERED BY THE SECRETARY OF VET-
ERANS AFFAIRS. 
(a) STUDY.—The Secretaries of Defense and Vet-
erans Affairs shall conduct a joint study to determine, 
with regards to members of the Armed Forces and vet-
erans whose separation pay, special separation benefits, 
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and voluntary separation incentive payments either Sec-
retary recoups because such members and veterans subse-
quently receive disability compensation under laws admin-
istered by the Secretary of Veterans Affairs— 
(1) how many such members and veterans are 
affected by such recoupment; and 
(2) the aggregated amount of additional money 
such members and veterans would receive but for 
such recoupment. 
(b) REPORT REQUIRED.—Not later than September 
30, 2020, the Secretaries shall submit to the Committees 
on Armed Services and Veterans’ Affairs of the Senate 
and House of Representatives a report regarding the re-
sults of the study under subsection (a). 
SEC. 609. ANNUAL REPORTS ON APPROVAL OF EMPLOY-
MENT OR COMPENSATION OF RETIRED GEN-
ERAL OR FLAG OFFICERS BY FOREIGN GOV-
ERNMENTS FOR EMOLUMENTS CLAUSE PUR-
POSES. 
(a) ANNUAL REPORTS.—Section 908 of title 37, 
United States Code is amended— 
(1) by redesignating subsection (c) as sub-
section (d); and 
(2) by inserting after subsection (b) the fol-
lowing new subsection (c): 
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‘‘(c) ANNUAL REPORTS
ON APPROVALS
FOR RE-
TIRED GENERAL AND FLAG OFFICERS.—(1) Not later 
than January 31each year, the Secretaries of the military 
departments shall jointly submit to the appropriate com-
mittees and Members of Congress a report on each ap-
proval under subsection (b) for employment or compensa-
tion described in subsection (a) for a retired member of 
the armed forces in general or flag officer grade that was 
issued during the preceding year. The report shall be post-
ed on a publicly available Internet website of the Depart-
ment of Defense no later than 30 days after it has been 
submitted to Congress. 
‘‘(2) In this subsection, the appropriate committees 
and Members of Congress are— 
‘‘(A) the Committee on Armed Services, the 
Committee on Foreign Relations, and the Committee 
on Appropriations of the Senate; 
‘‘(B) the Committee on Armed Services, the 
Committee on Foreign Relations, and the Committee 
on Appropriations of the House of Representatives; 
‘‘(C) the Majority Leader and the Minority 
Leader of the Senate; and 
‘‘(D) the Speaker of the House of Representa-
tives and the Minority Leader of the House of Rep-
resentatives.’’. 
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(b) SCOPE OF FIRST REPORT.—The first report sub-
mitted pursuant to subsection (c) of section 908 of title 
37, United States Code (as amended by subsection (a) of 
this section), after the date of the enactment of this Act 
shall cover the five-year period ending with the year before 
the year in which such report is submitted. 
SEC. 610. CONTINUED ENTITLEMENTS WHILE A MEMBER 
OF THE ARMED FORCES PARTICIPATES IN A 
CAREER INTERMISSION PROGRAM. 
Section 710(h) of title 10, United States Code, is 
amended— 
(1) in paragraph (1), by striking ‘‘; and’’ and 
inserting a semicolon; 
(2) in paragraph (2), by striking the period and 
inserting a semicolon; and 
(3) by adding at the end the following new 
paragraphs: 
‘‘(3) the entitlement of the member and of the 
survivors of the member to all death benefits under 
the provisions of chapter 75 of this title; 
‘‘(4) the provision of all travel and transpor-
tation allowances for the survivors of deceased mem-
bers to attend burial ceremonies under section 481f 
of title 37; and 
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‘‘(5) the eligibility of the member for general 
benefits as provided in part II of title 38.’’. 
SEC. 610A. REPORT REGARDING TRANSITION FROM OVER-
SEAS HOUSING ALLOWANCE TO BASIC AL-
LOWANCE 
FOR 
HOUSING 
FOR 
SERVICEMEMBERS IN THE TERRITORIES. 
Not later than February 1, 2020, the Secretary of 
Defense shall submit a report to the congressional defense 
committees regarding the recommendation of the Sec-
retary whether members of the uniformed services located 
in the territories of the United States and who receive the 
overseas housing allowance should instead receive the 
basic allowance for housing to ensure the most appropriate 
housing compensation for such members and their fami-
lies. 
SEC. 610B. EXEMPTION FROM REPAYMENT OF VOLUNTARY 
SEPARATION PAY. 
Section 1175a(j) of title 10, United States Code, is 
amended— 
(1) in paragraph (1), by striking ‘‘paragraphs 
(2) and (3)’’ and inserting ‘‘paragraphs (2), (3), and 
(4)’’; 
(2) by redesignating paragraph (4) as para-
graph (5); and 
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(3) by inserting after paragraph (3) the fol-
lowing new paragraph: 
‘‘(4) This subsection shall not apply to a member 
who— 
‘‘(A) is involuntarily recalled to active duty or 
full-time National Guard duty; and 
‘‘(B) in the course of such duty, incurs a serv-
ice-connected disability rated as total under section 
1155 of title 38.’’. 
Subtitle B—Bonuses and Special 
Incentive Pays 
SEC. 611. ONE-YEAR EXTENSION OF CERTAIN EXPIRING 
BONUS AND SPECIAL PAY AUTHORITIES. 
(a) 
AUTHORITIES
RELATING
TO
RESERVE 
FORCES.—Section 910(g) of title 37, United States Code, 
relating to income replacement payments for reserve com-
ponent members experiencing extended and frequent mo-
bilization for active duty service, is amended by striking 
‘‘December 31, 2019’’ and inserting ‘‘December 31, 
2020’’. 
(b) TITLE 10 AUTHORITIES RELATING TO HEALTH 
CARE PROFESSIONALS.—The following sections of title 
10, United States Code, are amended by striking ‘‘Decem-
ber 31, 2019’’ and inserting ‘‘December 31, 2020’’: 
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(1) Section 2130a(a)(1), relating to nurse offi-
cer candidate accession program. 
(2) Section 16302(d), relating to repayment of 
education loans for certain health professionals who 
serve in the Selected Reserve. 
(c) AUTHORITIES RELATING
TO NUCLEAR OFFI-
CERS.—Section 333(i) of title 37, United States Code, is 
amended by striking ‘‘December 31, 2019’’ and inserting 
‘‘December 31, 2020’’. 
(d) AUTHORITIES RELATING TO TITLE 37 CONSOLI-
DATED SPECIAL PAY, INCENTIVE PAY, AND BONUS AU-
THORITIES.—The following sections of title 37, United 
States Code, are amended by striking ‘‘December 31, 
2019’’ and inserting ‘‘December 31, 2020’’: 
(1) Section 331(h), relating to general bonus 
authority for enlisted members. 
(2) Section 332(g), relating to general bonus 
authority for officers. 
(3) Section 334(i), relating to special aviation 
incentive pay and bonus authorities for officers. 
(4) Section 335(k), relating to special bonus 
and incentive pay authorities for officers in health 
professions. 
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(5) Section 336(g), relating to contracting 
bonus for cadets and midshipmen enrolled in the 
Senior Reserve Officers’ Training Corps. 
(6) Section 351(h), relating to hazardous duty 
pay. 
(7) Section 352(g), relating to assignment pay 
or special duty pay. 
(8) Section 353(i), relating to skill incentive 
pay or proficiency bonus. 
(9) Section 355(h), relating to retention incen-
tives for members qualified in critical military skills 
or assigned to high priority units. 
(e) AUTHORITY TO PROVIDE TEMPORARY INCREASE 
IN RATES OF BASIC ALLOWANCE FOR HOUSING.—Section 
403(b)(7)(E) of title 37, United States Code, is amended 
by striking ‘‘December 31, 2019’’ and inserting ‘‘Decem-
ber 31, 2020’’. 
Subtitle C—Family and Survivor 
Benefits 
SEC. 621. PAYMENT OF TRANSITIONAL COMPENSATION 
FOR CERTAIN DEPENDENTS. 
Section 1059(m) of title 10, United States Code, is 
amended— 
(1) in the subsection heading, by inserting 
‘‘MEMBERS OR’’ after ‘‘DEPENDENTS OF’’; 
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(2) by inserting ‘‘member or’’ before ‘‘former 
member’’ each place it appears; and 
(3) by amending paragraph (3) to read as fol-
lows: 
‘‘(3) For the purposes of this subsection, a member 
is considered separated from active duty upon the earliest 
of— 
‘‘(A) the date an administrative separation is 
initiated by a commander of the member; 
‘‘(B) the date the court-martial sentence is ad-
judged if the sentence, as adjudged, includes a dis-
missal, dishonorable discharge, bad conduct dis-
charge, or forfeiture of all pay and allowances; or 
‘‘(C) the date the member’s term of service ex-
pires.’’. 
SEC. 622. DEATH GRATUITY FOR ROTC GRADUATES. 
(a) IN GENERAL.—Section 1475(a)(4) of title 10, 
United States Code, is amended by adding ‘‘; or a grad-
uate of a reserve officers’ training corps who has yet to 
receive a first duty assignment; or’’ at the end. 
(b) EFFECTIVE DATE.—The amendment under sub-
section (a) applies to deaths that occur on or after the 
date of the enactment of this Act. 
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SEC. 623. CONTINUED ELIGIBILITY FOR EDUCATION AND 
TRAINING OPPORTUNITIES FOR SPOUSES OF 
PROMOTED MEMBERS. 
Section 1784a(b) of title 10, United States Code, is 
amended— 
(1) by inserting ‘‘(1)’’ before ‘‘Assistance’’; and 
(2) by adding at the end the following new 
paragraph: 
‘‘(2) A spouse who is eligible for a program under 
this section and begins a course of education or training 
for a degree, license, or credential described in subsection 
(a) may not become ineligible to complete such course of 
education or training solely because the member to whom 
the spouse is married is promoted to a higher grade.’’. 
SEC. 624. OCCUPATIONAL IMPROVEMENTS FOR RELO-
CATED SPOUSES OF MEMBERS OF THE UNI-
FORMED SERVICES. 
(a) IMPROVEMENT
OF
OCCUPATIONAL
LICENSE 
PORTABILITY FOR MILITARY SPOUSES THROUGH INTER-
STATE COMPACTS.—Section 1784 of title 10, United 
States Code, is amended by adding at the end the fol-
lowing new subsection: 
‘‘(h) IMPROVEMENT
OF OCCUPATIONAL LICENSE 
PORTABILITY THROUGH INTERSTATE COMPACTS.— 
‘‘(1) IN GENERAL.—The Secretary of Defense 
may enter into a cooperative agreement with the 
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Council of State Governments to assist with funding 
of the development of interstate compacts on li-
censed occupations in order to alleviate the burden 
associated with relicensing in such an occupation by 
spouse of a members of the armed forces in connec-
tion with a permanent change of duty station of 
members to another State. 
‘‘(2) LIMITATION.—The amount provided under 
paragraph (1) as assistance for the development of 
any particular interstate compact may not exceed 
$1,000,000. 
‘‘(3) ANNUAL REPORT.—Not later than Feb-
ruary 28 each year, the Secretary shall submit to 
the Committees on Armed Services of the Senate 
and the House of Representatives a report on inter-
state compacts described in paragraph (1) developed 
through assistance provided under that paragraph. 
Each report shall set forth the following: 
‘‘(A) Any interstate compact developed 
during the preceding calendar year, including 
the occupational licenses covered by such com-
pact and the States agreeing to enter into such 
compact. 
‘‘(B) Any interstate compact developed 
during a prior calendar year into which one or 
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more additional States agreed to enter during 
the preceding calendar year. 
‘‘(4) EXPIRATION.—The authority to enter into 
a cooperative agreement under paragraph (1), and 
to provide assistance described in that paragraph 
pursuant to such cooperative agreement, shall expire 
on September 30, 2024.’’. 
(b) GUARANTEE OF RESIDENCY FOR REGISTRATION 
OF BUSINESSES
OF SPOUSES
OF MEMBERS
OF UNI-
FORMED SERVICES.— 
(1) 
IN
GENERAL.—Title 
VI 
of 
the 
Servicemembers Civil Relief Act (50 U.S.C. 4021 et 
seq.) is amended by adding at the end the following 
new section: 
‘‘SEC. 707. GUARANTEE OF RESIDENCY FOR BUSINESSES OF 
SPOUSES OF SERVICEMEMBERS. 
‘‘For the purposes of registering a business— 
‘‘(1) a person who is absent from a State be-
cause the person is accompanying the person’s 
spouse who is absent from that same State in com-
pliance with military or naval orders shall not, solely 
by reason of that absence— 
‘‘(A) be deemed to have lost a residence or 
domicile in that State, without regard to wheth-
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er or not the person intends to return to that 
State; 
‘‘(B) be deemed to have acquired a resi-
dence or domicile in any other State; or 
‘‘(C) be deemed to have become a resident 
in or a resident of any other State; and 
‘‘(2) the spouse of a servicemember may elect 
to use the same residence as the servicemember re-
gardless of the date on which the marriage of the 
spouse and the servicemember occurred.’’. 
(2) CLERICAL AMENDMENT.—The table of con-
tents in section 1(b) of such Act is amended by in-
serting after the item relating to section 706 the fol-
lowing new item: 
‘‘Sec. 707. Guarantee 
of 
residency 
for 
businesses 
of 
spouses 
of 
servicemembers.’’. 
SEC. 625. EXPANSION OF AUTHORITY TO PROVIDE FINAN-
CIAL ASSISTANCE TO CIVILIAN PROVIDERS 
OF CHILD CARE SERVICES OR YOUTH PRO-
GRAM SERVICES WHO PROVIDE SUCH SERV-
ICES TO SURVIVORS OF MEMBERS OF THE 
ARMED FORCES WHO DIE IN LINE OF DUTY. 
Section 1798(a) of title 10, United States Code, is 
amended by inserting ‘‘, survivors of members of the 
armed forces who die in line of duty while on active duty, 
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active duty for training, or inactive duty for training,’’ 
after ‘‘armed forces’’. 
SEC. 626. SPACE-AVAILABLE TRAVEL ON MILITARY AIR-
CRAFT 
FOR 
CHILDREN 
AND 
SURVIVING 
SPOUSES OF MEMBERS WHO DIE OF HOSTILE 
ACTION OR TRAINING DUTY. 
Section 2641b(c) of title 10, United States Code, is 
amended— 
(1) by redesignating paragraph (6) as para-
graph (7); and 
(2) by inserting after paragraph (5) the fol-
lowing new paragraph (6): 
‘‘(6) 
Children 
(as 
described 
by 
section 
1072(2)(D) or section 1110b(b) of this title, as the 
case may be) and surviving spouses of members of 
the armed forces who die as a result of hostile action 
or training duty.’’. 
SEC. 627. CONSIDERATION OF SERVICE ON ACTIVE DUTY 
TO REDUCE AGE OF ELIGIBILITY FOR RE-
TIRED PAY FOR NON-REGULAR SERVICE. 
Section 12731(f)(2)(B)(i) of title 10, United States 
Code, is amended by striking ‘‘under a provision of law 
referred to in section 101(a)(13)(B) or under section 
12301(d)’’ and inserting ‘‘under section 12301(d) or 
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12304b of this title, or under a provision of law referred 
to in section 101(a)(13)(B)’’. 
SEC. 628. MODIFICATION TO AUTHORITY TO REIMBURSE 
FOR STATE LICENSURE AND CERTIFICATION 
COSTS OF A SPOUSE OF A MEMBER ARISING 
FROM RELOCATION. 
Section 476(p) of title 37, United States Code, is 
amended— 
(1) in paragraph (1), by striking ‘‘armed 
forces’’ and inserting ‘‘uniformed services’’; 
(2) in paragraph (2), by striking ‘‘$500’’ and 
inserting ‘‘$1,000’’; 
(3) in paragraph (3)— 
(A) in subparagraph (A), by striking 
‘‘and’’; 
(B) in subparagraph (B), by striking the 
period and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(C) an analysis of whether the maximum reim-
bursement amount under paragraph (2) is sufficient 
to cover the average costs of relicensing described in 
paragraph (1).’’; and 
(4) in paragraph (4), by striking ‘‘December 
31, 2022’’ and inserting ‘‘December 31, 2024’’. 
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SEC. 629. IMPROVEMENTS TO CHILD CARE FOR MEMBERS 
OF THE ARMED FORCES. 
(a) EXPANSION OF AUTHORITY TO PROVIDE FINAN-
CIAL ASSISTANCE TO CIVILIAN PROVIDERS OF CHILD 
CARE SERVICES OR YOUTH PROGRAM SERVICES WHO 
PROVIDE SUCH SERVICES TO SURVIVORS OF MEMBERS 
OF THE ARMED FORCES WHO DIE IN THE LINE OF 
DUTY.—Section 1798(a) of title 10, United States Code, 
is amended by inserting ‘‘, survivors of members of the 
armed forces who die in the line of duty while on active 
military, naval, or air service (as that term is defined in 
section 101 of title 38),’’ after ‘‘armed forces’’. 
(b) EXPANSION OF DIRECT HIRING AUTHORITY FOR 
CHILD CARE SERVICE PROVIDERS.—Section 559 of the 
National Defense Authorization Act for Fiscal Year 2018 
(Public Law 115–91; 10 U.S.C. 1792 note) is amended— 
(1) in the section heading, by striking ‘‘FOR 
DEPARTMENT
CHILD
DEVELOPMENT
CEN-
TERS’’; 
(2) in subsection (a)(1), by striking for ‘‘De-
partment of Defense child development centers’’ and 
inserting ‘‘for the Department of Defense’’; and 
(3) in subsection (e), by striking ‘‘in child de-
velopment centers’’. 
(c) ASSESSMENT OF FINANCIAL ASSISTANCE PRO-
VIDED TO CIVILIAN CHILD CARE PROVIDERS.— 
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(1) ASSESSMENT.—The Secretary of Defense 
shall assess the maximum amount of financial as-
sistance provided to eligible civilian providers of 
child care services or youth program services that 
furnish such service for members of the armed 
forces and employees of the United States under sec-
tion 1798 of title 10, United States Code, as amend-
ed by subsection (a). Such assessment shall include 
the following: 
(A) The determination of the Secretary 
whether the maximum allowable financial as-
sistance should be standardized across the 
Armed Forces. 
(B) Whether the maximum allowable 
amount adequately accounts for high-cost duty 
stations. 
(2) REPORT.—No later than June 1, 2020, the 
Secretary of Defense shall submit a report to the 
Committees on Armed Services of the Senate and 
the House of Representatives regarding the results 
of the assessment under paragraph (1) and any ac-
tions taken by the Secretary to remedy identified 
shortfalls in assistance described in that paragraph. 
(d) ASSESSMENT
OF CHILD CARE CAPACITY
ON 
MILITARY INSTALLATIONS.— 
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(1) ASSESSMENT.—The Secretary of Defense 
shall assess the capacity for child care at all military 
installations to ensure that members of the Armed 
Forces have meaningful access to child care during 
tours of duty. 
(2) REMEDIAL ACTION.—The Secretary of De-
fense shall take steps the Secretary determines nec-
essary to alleviate the waiting lists for child care de-
scribed in paragraph (1). 
(3) REPORT.—Not later than June 1, 2020, the 
Secretary of Defense shall provide a report to the 
Committees on Armed Forces of the Senate and the 
House of Representative regarding— 
(A) the assessment under paragraph (1); 
(B) action taken under paragraph (2); and 
(C) any additional resources (including ad-
ditional funding for and child care facilities and 
workers) the Secretary determines necessary to 
increase access described in paragraph (1). 
(e) ASSESSMENT OF ACCESSIBILITY OF WEBSITES 
OF THE DEPARTMENT OF DEFENSE RELATED TO CHILD 
CARE AND SPOUSAL EMPLOYMENT.— 
(1) ASSESSMENT.—The Secretary of Defense 
shall review the functions and accessibility of 
websites of the Department of Defense designed for 
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members of the Armed Forces and the families of 
such members to access information and services of-
fered by the Department regarding child care, 
spousal employment, and other family matters. 
(2) REPORT.—Not later than March 1, 2020, 
the Secretary of Defense shall provide a briefing to 
the Committees on Armed Services of the Senate 
and the House of Representatives regarding the re-
sults of the assessment under paragraph (1) and ac-
tions taken to enhance accessibility of the websites. 
(f) PORTABILITY OF BACKGROUND INVESTIGATIONS 
FOR CHILD CARE PROVIDERS.—Not later than 180 days 
after the date of the enactment of this Act, the Secretary 
of Defense shall ensure that the background investigation 
and training certification for a child care provider em-
ployed by the Department of Defense in a facility of the 
Department may be transferred to another facility of the 
Department, without regard to which Secretary of a mili-
tary department has jurisdiction over either such facility. 
SEC. 630. CASUALTY ASSISTANCE FOR SURVIVORS OF DE-
CEASED ROTC GRADUATES. 
Section 633 of the National Defense Authorization 
Act for Fiscal Year 2014 (10 U.S.C. 1475 note) is amend-
ed by adding at the end the following new subsection: 
‘‘(c) ROTC GRADUATES.— 
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‘‘(1) TREATED AS MEMBERS.—For purposes of 
this section, a graduate of a reserve officers’ train-
ing corps who dies before receiving a first duty as-
signment shall be treated as a member of the Armed 
Forces who dies while on active duty. 
‘‘(2) EFFECTIVE
DATE.—This subsection ap-
plies to deaths on or after the date of the enactment 
of the National Defense Authorization Act for Fiscal 
Year 2020.’’. 
SEC. 630A. REPEAL OF REQUIREMENT OF REDUCTION OF 
SURVIVOR BENEFIT PLAN SURVIVOR ANNU-
ITIES BY AMOUNT OF DEPENDENCY AND IN-
DEMNITY COMPENSATION. 
(a) REPEAL.— 
(1) REPEAL.—Subchapter II of chapter 73 of 
title 10, United States Code, is amended as follows: 
(A) In section 1450, by striking subsection 
(c). 
(B) In section 1451(c)— 
(i) by striking paragraph (2); and 
(ii) by redesignating paragraphs (3) 
and (4) as paragraphs (2) and (3), respec-
tively. 
(2) CONFORMING
AMENDMENTS.—Such sub-
chapter is further amended as follows: 
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(A) In section 1450— 
(i) by striking subsection (e); and 
(ii) by striking subsection (k). 
(B) In section 1451(g)(1), by striking sub-
paragraph (C). 
(C) In section 1452— 
(i) in subsection (f)(2), by striking 
‘‘does not apply—’’ and all that follows 
and inserting ‘‘does not apply in the case 
of a deduction made through administra-
tive error.’’; and 
(ii) by striking subsection (g). 
(D) In section 1455(c), by striking ‘‘, 
1450(k)(2),’’. 
(b) PROHIBITION ON RETROACTIVE BENEFITS.—No 
benefits may be paid to any person for any period before 
the effective date provided under subsection (f) by reason 
of the amendments made by subsection (a). 
(c) PROHIBITION
ON RECOUPMENT
OF CERTAIN 
AMOUNTS PREVIOUSLY REFUNDED
TO SBP RECIPI-
ENTS.—A surviving spouse who is or has been in receipt 
of an annuity under the Survivor Benefit Plan under sub-
chapter II of chapter 73 of title 10, United States Code, 
that is in effect before the effective date provided under 
subsection (f) and that is adjusted by reason of the 
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amendments made by subsection (a) and who has received 
a refund of retired pay under section 1450(e) of title 10, 
United States Code, shall not be required to repay such 
refund to the United States. 
(d) REPEAL OF AUTHORITY FOR OPTIONAL ANNUITY 
FOR DEPENDENT CHILDREN.—Section 1448(d)(2) of 
such title is amended— 
(1) by striking ‘‘DEPENDENT
CHILDREN.—’’ 
and all that follows through ‘‘In the case of a mem-
ber described in paragraph (1),’’ and inserting ‘‘DE-
PENDENT CHILDREN.—In the case of a member de-
scribed in paragraph (1),’’; and 
(2) by striking subparagraph (B). 
(e) RESTORATION OF ELIGIBILITY FOR PREVIOUSLY 
ELIGIBLE SPOUSES.—The Secretary of the military de-
partment concerned shall restore annuity eligibility to any 
eligible surviving spouse who, in consultation with the Sec-
retary, previously elected to transfer payment of such an-
nuity to a surviving child or children under the provisions 
of section 1448(d)(2)(B) of title 10, United States Code, 
as in effect on the day before the effective date provided 
under subsection (f). Such eligibility shall be restored 
whether or not payment to such child or children subse-
quently was terminated due to loss of dependent status 
or death. For the purposes of this subsection, an eligible 
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spouse includes a spouse who was previously eligible for 
payment of such annuity and is not remarried, or remar-
ried after having attained age 55, or whose second or sub-
sequent marriage has been terminated by death, divorce 
or annulment. 
(f) EFFECTIVE DATE.—This section and the amend-
ments made by this section shall take effect on the later 
of— 
(1) October 1, 2019; and 
(2) the first day of the first month that begins 
after the date of the enactment of this Act. 
Subtitle D—Defense Resale Matters 
SEC. 631. GAO REVIEW OF DEFENSE RESALE OPTIMIZATION 
STUDY. 
(a) REVIEW.—The Comptroller General of the United 
States shall conduct a review of the business case analysis 
performed as part of the defense resale optimization study 
conducted by the Reform Management Group, titled 
‘‘Study to Determine the Feasibility of Consolidation of 
the Defense Resale Entities’’ and dated December 4, 
2018. 
(b) REPORT REQUIRED; ELEMENTS.—Not later than 
April 1, 2020, the Comptroller General shall submit to the 
Committees on Armed Services of the Senate and the 
House of Representatives a report regarding the review 
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performed under this section. The report shall include 
evaluations of the following: 
(1) The descriptions and justifications for the 
assumptions, analytical choices and data used by the 
Reform Management Group to calculate: 
(A) Pricing. 
(B) Sales assumptions. 
(C) Accuracy of methods employed to 
measure patron savings levels. 
(2) The timetable for consolidation of military 
exchanges and commissaries. 
(3) The recommendations for consolidation de-
veloped as part of the business case analysis, includ-
ing the overall cost of consolidation. 
(4) The budget and oversight implications of 
merging non-appropriated funds and appropriated 
funds to implement the recommended reforms. 
(5) The extent to which the Reform Manage-
ment Group coordinated with the Secretaries of the 
military departments and the chiefs of the Armed 
Forces in preparing the study. 
(6) The extent to which the Reform Manage-
ment Group addressed concerns of the Secretaries of 
the military departments and the chiefs of the 
Armed Forces in the study. 
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(7) If the recommendations in the business case 
analysis were implemented— 
(A) the ability of military exchanges and 
commissaries to provide earnings to support on- 
base morale, welfare, and recreation programs; 
and 
(B) the financial viability of the military 
exchanges and commissaries. 
(c) DELAY ON CONSOLIDATION.—The Secretary of 
Defense may not take any action to consolidate military 
exchanges and commissaries until the Committees on 
Armed Services of the Senate and the House of Represent-
atives notify the Secretary in writing of receipt and accept-
ance of the findings of the Comptroller General in the re-
port required under this section. 
SEC. 632. REPORT REGARDING MANAGEMENT OF MILITARY 
COMMISSARIES AND EXCHANGES. 
(a) REPORT REQUIRED.—Not later than 180 days 
after the enactment of this Act, the Secretary of Defense 
shall submit to the congressional defense committees a re-
port regarding management practices of military com-
missaries and exchanges. 
(b) ELEMENTS.—The report required under this sec-
tion shall include a cost-benefit analysis with the goals 
of— 
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(1) reducing the costs of operating military 
commissaries and exchanges by $2,000,000,000 dur-
ing fiscal years 2020 through 2024; and 
(2) not raising costs for patrons of military 
commissaries and exchanges. 
SEC. 633. REDUCTIONS ON ACCOUNT OF EARNINGS FROM 
WORK PERFORMED WHILE ENTITLED TO AN 
ANNUITY SUPPLEMENT. 
Section 8421a of title 5, United States Code, is 
amended in subsection (c)— 
(1) by striking ‘‘full-time as an air traffic con-
trol instructor’’ and inserting ‘‘as an air traffic con-
trol instructor, or supervisor thereof,’’; and 
(2) by inserting ‘‘or supervisor’’ after ‘‘an in-
structor’’. 
SEC. 634. EXTENSION OF CERTAIN MORALE, WELFARE, AND 
RECREATION PRIVILEGES TO FOREIGN SERV-
ICE OFFICERS ON MANDATORY HOME LEAVE. 
(a) IN GENERAL.—Section 1065 of title 10, United 
States Code, as added by section 621 of the John S. 
McCain National Defense Authorization Act for Fiscal 
Year 2019 (Public Law 115–232), is amended— 
(1) in the heading, by striking ‘‘veterans 
and caregivers for veterans’’ and inserting 
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‘‘veterans, caregivers for veterans, and 
Foreign Service officers’’; 
(2) by redesignating subsections (f) and (g) as 
subsections (g) and (h), respectively; 
(3) by inserting after subsection (e) the fol-
lowing new subsection (f): 
‘‘(f) ELIGIBILITY OF FOREIGN SERVICE OFFICERS 
ON MANDATORY HOME LEAVE.—A Foreign Service offi-
cer on mandatory home leave may be permitted to use 
military lodging referred to in subsection (h).’’; and 
(4) in subsection (h), as redesignated by para-
graph (2), by adding at the end the following new 
paragraphs: 
‘‘(5) The term ‘Foreign Service officer’ has the 
meaning given that term in section 103 of the For-
eign Service Act of 1980 (22 U.S.C. 3903). 
‘‘(6) The term ‘mandatory home leave’ means 
leave under section 903 of the Foreign Service Act 
of 1980 (22 U.S.C. 4083).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on January 1, 2020, as if 
originally incorporated in section 621 of Public Law 115– 
232. 
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TITLE VII—HEALTH CARE 
PROVISIONS 
Subtitle A—TRICARE and Other 
Health Care Benefits 
SEC. 701. CONTRACEPTION COVERAGE PARITY UNDER THE 
TRICARE PROGRAM. 
(a) IN GENERAL.—Section 1074d of title 10, United 
States Code, is amended— 
(1) in subsection (a), by inserting ‘‘FOR MEM-
BERS
AND FORMER MEMBERS’’ after ‘‘SERVICES 
AVAILABLE’’; 
(2) by redesignating subsection (b) as sub-
section (d); and 
(3) by inserting after subsection (a) the fol-
lowing new subsections: 
‘‘(b) CARE RELATED
TO PREVENTION
OF PREG-
NANCY.—Female covered beneficiaries shall be entitled to 
care related to the prevention of pregnancy described by 
subsection (d)(3). 
‘‘(c) PROHIBITION ON COST SHARING FOR CERTAIN 
SERVICES.—Notwithstanding section 1074g(a)(6), section 
1075, or section 1075a of this title, or any other provision 
of law, cost sharing may not be imposed or collected for 
care related to the prevention of pregnancy provided pur-
suant to subsection (a) or (b), including for any method 
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of contraception provided, whether provided through a fa-
cility of the uniformed services, the TRICARE retail phar-
macy program, or the national mail-order pharmacy pro-
gram.’’. 
(b) 
CONFORMING
AMENDMENT.—Section 
1077(a)(13) of such title is amended by striking ‘‘section 
1074d(b)’’ and inserting ‘‘section 1074d(d)’’. 
(c) CARE RELATED
TO PREVENTION
OF PREG-
NANCY.—Subsection (d)(3) of such section 1074d, as re-
designated by subsection (a)(2) of this section, is further 
amended by inserting before the period at the end the fol-
lowing: ‘‘(including all methods of contraception approved 
by the Food and Drug Administration, contraceptive care 
(including with respect to insertion, removal, and follow 
up), sterilization procedures, and patient education and 
counseling in connection therewith)’’. 
SEC. 702. PREGNANCY PREVENTION ASSISTANCE AT MILI-
TARY MEDICAL TREATMENT FACILITIES FOR 
SEXUAL ASSAULT SURVIVORS. 
(a) IN GENERAL.—Chapter 55 of title 10, United 
States Code, is amended by inserting after section 1074o 
the following new section: 
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‘‘§ 1074p. Provision of pregnancy prevention assist-
ance at military medical treatment facili-
ties 
‘‘(a) INFORMATION
AND ASSISTANCE.—The Sec-
retary of Defense shall promptly furnish to sexual assault 
survivors at each military medical treatment facility the 
following: 
‘‘(1) Comprehensive, medically and factually ac-
curate, and unbiased written and oral information 
about all methods of emergency contraception ap-
proved by the Food and Drug Administration. 
‘‘(2) Notification of the right of the sexual as-
sault survivor to confidentiality with respect to the 
information and care and services furnished under 
this section. 
‘‘(3) Upon request by the sexual assault sur-
vivor, emergency contraception or, if applicable, a 
prescription for emergency contraception. 
‘‘(b) INFORMATION.—The Secretary shall ensure that 
information provided pursuant to subsection (a) is pro-
vided in language that— 
‘‘(1) is clear and concise; 
‘‘(2) is readily comprehensible; and 
‘‘(3) meets such conditions (including condi-
tions regarding the provision of information in lan-
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guages other than English) as the Secretary may 
prescribe in regulations to carry out this section. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) The term ‘sexual assault survivor’ means 
any individual who presents at a military medical 
treatment facility and— 
‘‘(A) states to personnel of the facility that 
the individual experienced a sexual assault; 
‘‘(B) is accompanied by another person 
who states that the individual experienced a 
sexual assault; or 
‘‘(C) whom the personnel of the facility 
reasonably believes to be a survivor of sexual 
assault. 
‘‘(2) The term ‘sexual assault’ means the con-
duct described in section 1565b(c) of this title that 
may result in pregnancy.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of such chapter is amended by inserting 
after the item relating to section 1074o the following new 
item: 
‘‘1074p. Provision of pregnancy prevention assistance at military medical treat-
ment facilities.’’. 
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SEC. 703. MODIFICATION OF ELIGIBILITY FOR TRICARE RE-
SERVE SELECT FOR CERTAIN MEMBERS OF 
THE SELECTED RESERVE. 
Section 1076d(a)(2) of title 10, United States Code, 
is amended by striking ‘‘Paragraph (1) does not apply’’ 
and inserting ‘‘During the period preceding January 1, 
2030, paragraph (1) does not apply’’. 
SEC. 704. LEAD LEVEL SCREENINGS AND TESTINGS FOR 
CHILDREN. 
(a) TRICARE.— 
(1) WELL-BABY CARE.—Section 1077 of title 
10, United States Code, is amended by adding at 
the end the following new subsection: 
‘‘(i)(1) Beginning January 1, 2020, in furnishing 
well-baby care under subsection (a)(8), the Secretary shall 
ensure that the following care is made available: 
‘‘(A) With respect to a child who lives in hous-
ing built before 1978 at any time during the first 24 
months of the life of the child— 
‘‘(i) the first testing of the child for the 
level of lead in the blood of the child at approxi-
mately the age of 12 months; and 
‘‘(ii) the second such test at approximately 
the age of 24 months. 
‘‘(B) With respect to a child not covered by 
subparagraph (A) whose parent or guardian, at any 
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time during the first 24 months of the life of the 
child, has a military occupational specialty that the 
Secretary determines poses an elevated risk of lead 
exposure— 
‘‘(i) the first testing of the child for the 
level of lead in the blood of the child at approxi-
mately the age of 12 months; and 
‘‘(ii) the second such test at approximately 
the age of 24 months. 
‘‘(C) With respect to a child not covered by 
subparagraph (A) or (B)— 
‘‘(i) the first screening of the child for an 
elevated risk of lead exposure at approximately 
the age of 12 months; and 
‘‘(ii) the second such screening at approxi-
mately the age of 24 months. 
‘‘(D) With respect to a child covered by sub-
paragraph (C) whose screening indicates an elevated 
risk of lead exposure, testing of the child for the 
level of lead in the blood of the child. 
‘‘(2) The Secretary shall ensure that any care pro-
vided to a child pursuant to this chapter for lead poi-
soning, including the care under paragraph (1), is carried 
out in accordance with applicable advice from the Centers 
for Disease Control and Prevention. 
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‘‘(3)(A) With respect to a child who receives a test 
under paragraph (1), the Secretary shall provide the re-
sults of the test to the parent or guardian of the child. 
‘‘(B) With respect to a child who receives a test under 
paragraph (1), the Secretary shall provide the results of 
the test and the address at which the child resides to— 
‘‘(i) the relevant health department of the State 
in which the child resides if the child resides in the 
United States; or 
‘‘(ii) the Centers for Disease Control and Pre-
vention if the child resides outside the United 
States. 
‘‘(C) In providing information regarding a child to 
a State or the Centers for Disease Control and Prevention 
under subparagraph (B), the Secretary may not provide 
any identifying information or health information of the 
child that is not specifically authorized in such subpara-
graph. 
‘‘(D) In this paragraph, the term ‘State’ means each 
of the several States, the District of Columbia, the Com-
monwealth of Puerto Rico, and any territory or possession 
of the United States.’’. 
(2) 
CONFORMING
AMENDMENT.—Subsection 
(a)(8) of such section is amended by striking ‘‘in-
cluding well-baby care that includes one screening of 
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an infant for the level of lead in the blood of the in-
fant’’ and inserting ‘‘including, in accordance with 
subsection 
(i), 
well-baby 
care 
that 
includes 
screenings and testings for lead exposure and lead 
poisoning’’. 
(3) STUDY.—Not later than January 1, 2021, 
the Secretary of Defense shall submit to the con-
gressional defense committees a report detailing the 
following: 
(A) The number of children who were test-
ed for the level of lead in the blood of the child 
pursuant to subparagraph (A) of subsection 
(i)(1) of section 1077 of title 10, United States 
Code, as added by paragraph (1), and of such 
number, the number who were found to have 
elevated blood lead levels. 
(B) The number of children who were test-
ed for the level of lead in the blood of the child 
pursuant to subparagraph (B) of such sub-
section (i)(1), and of such number, the number 
who were found to have lead poisoning. 
(C) The number of children who were 
screened for an elevated risk of lead exposure 
pursuant to subparagraph (C) of such sub-
section (i)(1). 
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(D) The number of children who were test-
ed for the level of lead in the blood of the child 
pursuant to subparagraph (D) of such sub-
section, and of such number, the number who 
were found to have elevated blood lead levels. 
(E) The treatment provided to children 
pursuant to chapter 55 of title 10, United 
States Code, for lead poisoning. 
(4) GAO REPORT.—Not later than January 1, 
2022, the Comptroller General of the United States 
shall submit to the congressional defense committees 
a report on the effectiveness of screening, testing, 
and treating children for lead exposure and lead poi-
soning pursuant to chapter 55 of title 10, United 
States Code. 
(b) NOTIFICATION
OF HOUSING.—Section 403 of 
title 37, United States Code, is amended by adding at the 
end the following new subsection: 
‘‘(p) RECORDS REGARDING HOUSING
AND LEAD- 
BASED PAINT.—(1) The Secretary concerned shall keep 
a record of whether the following housing was built before, 
during, or after 1978: 
‘‘(A) Quarters of the United States under the 
jurisdiction of that Secretary concerned. 
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‘‘(B) A housing facility under the jurisdiction of 
that Secretary concerned. 
‘‘(C) Other housing in which a member of the 
uniformed service of that Secretary concerned re-
sides. 
‘‘(2) As a condition of receipt of a basic allowance 
for housing under this section, a member of the uniformed 
services shall notify the Secretary concerned whether the 
housing in which that member resides was built before, 
during, or after 1978.’’. 
SEC. 705. EXPOSURE TO OPEN BURN PITS AND TOXIC AIR-
BORNE CHEMICALS OR OTHER AIRBORNE 
CONTAMINANTS 
AS 
PART 
OF 
PERIODIC 
HEALTH ASSESSMENTS AND OTHER PHYS-
ICAL EXAMINATIONS. 
(a) PERIODIC HEALTH ASSESSMENT.—The Sec-
retary of Defense shall ensure that any periodic health as-
sessment provided to members of the Armed Forces in-
cludes an evaluation of whether the member has been— 
(1) based or stationed at a location where an 
open burn pit was used; or 
(2) exposed to toxic airborne chemicals or other 
airborne contaminants, including any information re-
corded as part of the Airborne Hazards and Open 
Burn Pit Registry. 
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(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: 
‘‘(C) The Secretary concerned shall ensure that each 
physical examination of a member under subparagraph 
(A) includes an assessment of whether the member was— 
‘‘(i) based or stationed at a location where an 
open burn pit, as defined in subsection (c) of section 
201 of the Dignified Burial and Other Veterans’ 
Benefits Improvement Act of 2012 (Public Law 
112–260; 38 U.S.C. 527 note), was used; or 
‘‘(ii) exposed to toxic airborne chemicals or 
other airborne contaminants, including any informa-
tion recorded as part of the registry established by 
the Secretary of Veterans Affairs under such section 
201.’’. 
(c) 
DEPLOYMENT
ASSESSMENTS.—Section 
1074f(b)(2) of title 10, United States Code, is amended 
by adding at the end the following new subparagraph: 
‘‘(D) An assessment of whether the member 
was— 
‘‘(i) based or stationed at a location where 
an open burn pit, as defined in subsection (c) 
of section 201 of the Dignified Burial and 
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Other Veterans’ Benefits Improvement Act of 
2012 (Public Law 112–260; 38 U.S.C. 527 
note), was used; or 
‘‘(ii) exposed to toxic airborne chemicals or 
other airborne contaminants, including any in-
formation recorded as part of the registry es-
tablished by the Secretary of Veterans Affairs 
under such section 201.’’. 
(d) SHARING OF INFORMATION.— 
(1) DOD–VA.—The Secretary of Defense and 
the Secretary of Veterans Affairs shall jointly enter 
into a memorandum of understanding providing for 
the sharing by the Department of Defense with the 
Department of Veterans Affairs of the results of 
covered evaluations regarding the exposure by a 
member of the Armed Forces to toxic airborne 
chemicals or other airborne contaminants. 
(2) REGISTRY.—If a covered evaluation of a 
member of the Armed Forces establishes that the 
member was based or stationed at a location where 
an open burn pit was used or that the member was 
exposed to toxic airborne chemicals or other airborne 
contaminants, the member shall be enrolled in the 
Airborne Hazards and Open Burn Pit Registry un-
less the member elects to not so enroll. 
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(e) RULE OF CONSTRUCTION.—Nothing in this sec-
tion may be construed to preclude eligibility for benefits 
under the laws administered by the Secretary of Veterans 
Affairs by reason of the open burn pit exposure history 
of a veteran not being recorded in a covered evaluation. 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘Airborne Hazards and Open 
Burn Pit Registry’’ means the registry established 
by the Secretary of Veterans Affairs under section 
201 of the Dignified Burial and Other Veterans’ 
Benefits Improvement Act of 2012 (Public Law 
112–260; 38 U.S.C. 527 note). 
(2) 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 
this section; and 
(C) a deployment assessment conducted 
under section 1074f(b)(2) of such title, as 
amended by this section. 
(3) The term ‘‘open burn pit’’ has the meaning 
given that term in section 201(c) of the Dignified 
Burial and Other Veterans’ Benefits Improvement 
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Act of 2012 (Public Law 112–260; 38 U.S.C. 527 
note). 
SEC. 
706. 
ENHANCEMENT 
OF 
RECORDKEEPING 
AND 
POSTDEPLOYMENT 
MEDICAL 
ASSESSMENT 
REQUIREMENTS 
RELATED 
TO 
OCCUPA-
TIONAL AND ENVIRONMENTAL HAZARD EX-
POSURE DURING DEPLOYMENT. 
(a) RECORDING OF OCCUPATIONAL AND ENVIRON-
MENTAL HEALTH RISKS IN DEPLOYMENT AREA.— 
(1) ELEMENTS
OF
MEDICAL
TRACKING
SYS-
TEM.—Subsection (b)(1)(A) of section 1074f of title 
10, United States Code, is amended— 
(A) in clause (ii), by striking ‘‘and’’ at the 
end; 
(B) in clause (iii), by striking the period at 
the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
clause: 
‘‘(iv) accurately record any 
exposure to occupational and en-
vironmental health risks during 
the course of their deployment.’’. 
(2) RECORDKEEPING.—Subsection (c) of such 
section is amended by inserting after ‘‘deployment 
area’’ the following: ‘‘(including the results of any 
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assessment performed by the Secretary of occupa-
tional and environmental health risks for such 
area)’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall take effect on the date of the 
enactment of this Act. 
(b) INTEGRATION OF BURN PIT REGISTRY INFORMA-
TION INTO ELECTRONIC HEALTH RECORDS.— 
(1) 
UPDATES
TO
ELECTRONIC
HEALTH 
RECORDS.—Beginning not later than one year after 
the date of the enactment of this Act— 
(A) the Secretary of Defense shall ensure 
that the electronic health record maintained by 
such Secretary of a member of the Armed 
Forces registered with the burn pit registry is 
updated with any information contained in such 
registry; and 
(B) the Secretary of Veterans Affairs shall 
ensure that the electronic health record main-
tained by such Secretary of a veteran registered 
with the burn pit registry is updated with any 
information contained in such registry. 
(2) BURN
PIT
REGISTRY
DEFINED.—In this 
subsection, the term ‘‘burn pit registry’’ means the 
registry established under section 201 of the Dig-
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nified Burial and Other Veterans’ Improvements Act 
of 2012 (Public Law 112–260; 38 U.S.C. 527 note). 
(c) POSTDEPLOYMENT MEDICAL EXAMINATION AND 
REASSESSMENTS.— 
(1) 
ADDITIONAL
REQUIREMENTS.—Section 
1074f of title 10, United States Code is further 
amended by adding at the end the following new 
subsection: 
‘‘(g) 
ADDITIONAL
REQUIREMENTS
FOR 
POSTDEPLOYMENT
MEDICAL
EXAMINATIONS
AND 
HEALTH REASSESSMENTS.—(1) The Secretary of Defense 
shall— 
‘‘(A) standardize and make available to a pro-
vider that conducts a postdeployment medical exam-
ination or reassessment under the system described 
in subsection (a) questions relating to occupational 
and environmental health exposure; and 
‘‘(B) prior to an examination or reassessment 
of a member of the armed forces, require such pro-
vider to review information applicable to such mem-
ber— 
‘‘(i) in a Periodic Occupational and Envi-
ronmental Monitoring Summary (or any suc-
cessor document); and 
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‘‘(ii) on the Defense Occupational and En-
vironmental Health Readiness System (or any 
successor system). 
‘‘(2) The Secretary shall ensure that the medical 
record of a member includes information on the external 
cause relating to a diagnosis of the member, including by 
associating an external cause code (as issued under the 
International Statistical Classification of Diseases, 10th 
Revision (or any successor revision)).’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection shall take effect 180 days after 
the date of the enactment of this Act. 
(d) REPORT BY COMPTROLLER GENERAL OF THE 
UNITED STATES.—Not later than two years after the date 
of the enactment of this Act, the Comptroller General of 
the United States shall submit to the congressional de-
fense committees and the Committees on Veterans’ Affairs 
of the House of Representatives and the Senate a report 
containing an evaluation of the implementation of this sec-
tion (and the amendments made by this section), including 
an assessment of the extent to which the Secretary of De-
fense and Secretary of Veterans Affairs are in compliance 
with the applicable requirements of this section (and the 
amendments made by this section). 
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SEC. 707. MODIFICATIONS TO POST-DEPLOYMENT MENTAL 
HEALTH ASSESSMENTS FOR MEMBERS OF 
THE ARMED FORCES DEPLOYED IN SUPPORT 
OF A CONTINGENCY OPERATION. 
(a) REQUIRED ASSESSMENTS.—Section 1074m(a)(1) 
of title 10, United States Code, is amended by striking 
subparagraphs (C) and (D) and inserting the following 
new subparagraphs: 
‘‘(C) Subject to paragraph (3) and sub-
section (d), once during the period beginning on 
the date of redeployment from the contingency 
operation and ending 14 days after such rede-
ployment date. 
‘‘(D) Subject to subsection (d), not less 
than once annually— 
‘‘(i) beginning 14 days after the date 
of redeployment from the contingency op-
eration; or 
‘‘(ii) if the assessment required by 
subparagraph (C) is performed during the 
period specified in paragraph (3), begin-
ning 180 days after the date of redeploy-
ment from the contingency operation.’’. 
(b) EXCEPTIONS.—Section 1074m(a) of such title, as 
amended by subsection (a), is further amended by striking 
paragraph (2) and inserting the following new paragraphs: 
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‘‘(2) A mental health assessment is not required for 
a member of the armed forces under subparagraphs (C) 
and (D) of paragraph (1) (including an assessment per-
formed pursuant to paragraph (3)) if the Secretary deter-
mines that providing such assessment to the member dur-
ing the time periods under such subparagraphs would re-
move the member from forward deployment or put mem-
bers or operational objectives at risk. 
‘‘(3) A mental health assessment required under sub-
paragraph (C) of paragraph (1) may be provided during 
the period beginning 90 days after the date of redeploy-
ment from the contingency operation and ending 180 days 
after such redeployment date if the Secretary determines 
that— 
‘‘(A) an insufficient number of personnel are 
available to perform the assessment during the time 
period under such subparagraph; or 
‘‘(B) an administrative processing issue exists 
upon the return of the member to the home unit or 
duty station that would prohibit the effective per-
formance of the assessment during such time pe-
riod.’’. 
(c) ELIMINATION
OF SUNSET
FOR ASSESSMENTS 
DURING DEPLOYMENT.—Section 1074m(a)(1)(B) of such 
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title is amended by striking ‘‘Until January 1, 2019, 
once’’ and inserting ‘‘Once’’. 
(d) EFFECTIVE DATE.—The amendments made by 
subsections (a) and (b) shall apply with respect to a date 
of redeployment that is on or after January 1, 2020. 
SEC. 708. PROVISION OF BLOOD TESTING FOR FIRE-
FIGHTERS OF DEPARTMENT OF DEFENSE TO 
DETERMINE 
EXPOSURE 
TO 
PERFLUOROALKYL AND POLYFLUOROALKYL 
SUBSTANCES. 
The Secretary of Defense shall include, as part of the 
annual physical examination provided by the Secretary to 
each firefighter of the Department of Defense, blood test-
ing to determine and document the potential exposure of 
such firefighters to perfluoroalkyl and polyfluoroalkyl sub-
stances (commonly known as ‘‘PFAS’’). 
SEC. 709. INCLUSION OF INFERTILITY TREATMENTS FOR 
MEMBERS OF THE UNIFORMED SERVICES. 
(a) INCLUSION.—The Secretary of Defense may pro-
vide to members of uniformed services under section 
1074(a) of title 10, United States Code, and spouses of 
such members, treatment for infertility, including non-
experimental assisted reproductive services, including, at 
a minimum, the following: 
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(1) Services, medications, and supplies for non- 
coital reproductive technologies. 
(2) Counseling on such services. 
(3) Reversal of tubal ligation or vasectomy in 
conjunction with services furnished under this sec-
tion. 
(4) Cryopreservation, including associated serv-
ices, supplies, and storage. 
(b) PROHIBITION ON COST SHARING.—The Secretary 
may not require any fees or other cost-sharing require-
ments under subsection (a). 
(c) INFERTILITY DEFINED.—In this section, the 
term ‘‘infertility’’ means a disease, characterized by the 
failure to establish a clinical pregnancy— 
(1) after 12 months of regular, unprotected sex-
ual intercourse; or 
(2) due to a person’s incapacity for reproduc-
tion either as an individual or with his or her part-
ner, which may be determined after a period of less 
than 12 months of regular, unprotected sexual inter-
course, or based on medical, sexual and reproductive 
history, age, physical findings, or diagnostic testing. 
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SEC. 
710. 
AUTHORIZATION 
OF 
APPROPRIATIONS 
FOR 
TRICARE LEAD SCREENING AND TESTING 
FOR CHILDREN. 
(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 Undistributed, 
TRICARE lead level screening and testing for children, 
is hereby increased by $5,000,000. 
(b) OFFSET.—Notwithstanding the amounts set forth 
in the funding tables in division D, the amount authorized 
to be appropriated in section 101 for Procurement of 
Wheeled and Tracked Combat Vehicles, Army, as specified 
in the corresponding funding table in section 4101, for 
Bradley Program (Mod) is hereby reduced by $5,000,000. 
Subtitle B—Health Care 
Administration 
SEC. 711. REQUIREMENTS FOR CERTAIN PRESCRIPTION 
DRUG LABELS. 
(a) REQUIREMENT.—Section 1074g of title 10, 
United States Code, is amended— 
(1) by redesignating subsections (h) and (i) as 
subsections (i) and (j), respectively; and 
(2) by inserting after subsection (g) the fol-
lowing new subsection (h): 
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‘‘(h) LABELING.—The Secretary of Defense shall en-
sure that drugs made available through the facilities of 
the armed forces under the jurisdiction of the Secretary 
include labels that— 
‘‘(1) are printed and physically located on or 
within the package from which the drug is to be dis-
pensed; and 
‘‘(2) provide adequate directions for the pur-
poses for which the drug is intended.’’. 
(b) CONFORMING AMENDMENT.—Subsection (b)(1) 
of such section is amended by striking ‘‘under subsection 
(h)’’ and inserting ‘‘under subsection (j)’’. 
(c) IMPLEMENTATION.—Beginning not later than 90 
days after the date of the enactment of this Act, the Sec-
retary of Defense shall implement subsection (h) of section 
1074g of title 10, United States Code, as added by sub-
section (a). 
SEC. 712. OFFICERS AUTHORIZED TO COMMAND ARMY 
DENTAL UNITS. 
Section 7081(d) of title 10, United States Code, is 
amended by striking ‘‘Dental Corps Officer’’ and inserting 
‘‘commissioned officer of the Army Medical Department’’. 
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SEC. 713. IMPROVEMENTS TO INTERAGENCY PROGRAM OF-
FICE OF THE DEPARTMENT OF DEFENSE AND 
THE DEPARTMENT OF VETERANS AFFAIRS. 
(a) LEADERSHIP.—Subsection (c) of section 1635 of 
the Wounded Warrior Act (title XVI of Public Law 110– 
181; 10 U.S.C. 1071 note) is amended to read as follows: 
‘‘(c) LEADERSHIP.— 
‘‘(1) DIRECTOR.—The Director of the Office 
shall be the head of the Office. 
‘‘(2) DEPUTY DIRECTOR.—The Deputy Director 
of the Office shall be the deputy head of the Office 
and shall assist the Director in carrying out the du-
ties of the Director. 
‘‘(3) REPORTING.—The Director shall report to 
the Department of Veterans Affairs-Department of 
Defense Joint Executive Committee established by 
section 320 of title 38, United States Code. 
‘‘(4) APPOINTMENTS.— 
‘‘(A) DIRECTOR.—The Director shall be 
jointly appointed by the Secretary of Veterans 
Affairs and the Secretary of Defense for a five- 
year term. The Director may be reappointed for 
one or more additional terms. 
‘‘(B) DEPUTY
DIRECTOR.—The Deputy 
Director shall be jointly appointed by the Sec-
retary of Veterans Affairs and the Secretary of 
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Defense for a five-year term. The Deputy Di-
rector may be reappointed for one or more ad-
ditional terms. 
‘‘(C) ADVICE.—The Department of Vet-
erans Affairs-Department of Defense Joint Ex-
ecutive Committee shall provide the Secretary 
of Veterans Affairs and the Secretary of De-
fense with advice regarding potential individuals 
to be appointed Director and Deputy Director 
under subparagraphs (A) and (B), respectively. 
‘‘(D) 
MINIMUM
QUALIFICATIONS.—The 
Department of Veterans Affairs-Department of 
Defense Joint Executive Committee shall de-
velop qualification requirements for the office of 
the Director and the Deputy Director. Such re-
quirements shall ensure that, at a minimum, 
the Director and Deputy Director, individually 
or together, meet the following qualifications: 
‘‘(i) Significant experience as a clini-
cian, at the level of chief medical officer or 
equivalent. 
‘‘(ii) Significant experience in health 
informatics, at the level of chief health 
informatics officer or equivalent. 
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‘‘(iii) Significant experience leading 
implementation of enterprise-wide tech-
nology in a health care setting in the pub-
lic or private sector. 
‘‘(5) ADDITIONAL
GUIDANCE.—In addition to 
providing direction, supervision, and control of the 
Office pursuant to paragraph (3), the Department of 
Veterans Affairs-Department of Defense Joint Exec-
utive Committee shall— 
‘‘(A) provide guidance in the discharge of 
the functions of the Office under this section; 
and 
‘‘(B) facilitate the establishment of a char-
ter and mission statement for the Office. 
‘‘(6) INFORMATION TO CONGRESS.—Upon re-
quest by any of the appropriate committees of Con-
gress, the Director and the Deputy Director shall 
testify before such committee, or provide a briefing 
or otherwise provide requested information to such 
committee, regarding the discharge of the functions 
of the Office under this section.’’. 
(b) AUTHORITY.—Paragraph (1) of subsection (b) of 
such section is amended by adding at the end the following 
new sentence: ‘‘The Office shall carry out decision making 
authority delegated to the office by the Secretary of De-
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fense and the Secretary of Veterans Affairs with respect 
to the definition, coordination, and management of func-
tional, technical, and programmatic activities that are 
jointly used, carried out, and shared by the Depart-
ments.’’. 
(c) PURPOSES.—Paragraph (2) of subsection (b) of 
such section is by adding at the end the following new 
subparagraphs: 
‘‘(C) To develop and implement a com-
prehensive interoperability strategy, including 
pursuant to the National Defense Authorization 
Act for Fiscal Year 2020 or other provision of 
law requiring such strategy. 
‘‘(D) To pursue the highest level of inter-
operability (as defined in section 713 of the Na-
tional Defense Authorization Act for Fiscal 
Year 2020) for the delivery of health care by 
the Department of Defense and the Department 
of Veterans Affairs. 
‘‘(E) To accelerate the exchange of health 
care information between the Departments in 
order to support the delivery of health care by 
both Departments. 
‘‘(F) To collect the operational and stra-
tegic requirements of the Departments relating 
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to the strategy under subsection (a) and com-
municate such requirements and activities to 
the Office of the National Coordinator for 
Health Information Technology of the Depart-
ment of Health and Human Services for the 
purpose of implementing title IV of the 21st 
Century Cures Act (division A of Public Law 
114–255), and the amendments made by that 
title, and other objectives of the Office of the 
National Coordinator for Health Information 
Technology. 
‘‘(G) To plan for and effectuate the broad-
est possible implementation of standards, spe-
cifically with respect to the Fast Healthcare 
Interoperability Resources standard or suc-
cessor standard, the evolution of such stand-
ards, and the obsolescence of such standards. 
‘‘(H) To actively engage with national and 
international health standards setting organiza-
tions, including by taking membership in such 
organizations, to ensure that standards estab-
lished by such organizations meet the needs of 
the Department of Defense and the Department 
of Veterans Affairs pursuant to the strategy 
under subsection (a), and oversee and approve 
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adoption of and mapping to such standards by 
the Departments. 
‘‘(I) To express the content and format of 
health data of the Departments using a com-
mon language to improve the exchange of data 
between the Departments and with the private 
sector, and to ensure that clinicians of both De-
partments have access to integrated, comput-
able, comprehensive health records of patients. 
‘‘(J) To inform each Chief Information Of-
ficer of the Department of Defense and the 
Chief Information Officer of the Department of 
Veterans Affairs of any activities of the Office 
affecting or relevant to cybersecurity.’’. 
(d) RESOURCES AND STAFFING.—Subsection (g) of 
such section is amended— 
(1) in paragraph (1), by inserting before the pe-
riod at the end the following: ‘‘, including the as-
signment of clinical or technical personnel of the De-
partment of Defense or the Department of Veterans 
Affairs to the Office’’; and 
(2) by adding at the end the following new 
paragraphs: 
‘‘(3) COST
SHARING.—The Secretary of De-
fense and the Secretary of Veterans Affairs, acting 
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through the Department of Veterans Affairs-Depart-
ment of Defense Joint Executive Committee, shall 
enter into an agreement on cost sharing and pro-
viding resources for the operations and staffing of 
the Office. 
‘‘(4) HIRING
AUTHORITY.—The Secretary of 
Defense and the Secretary of Veterans Affairs shall 
delegate to the Director the authority under title 5, 
United States Code, regarding appointments in the 
competitive service to hire personnel of the Office.’’. 
(e) BUDGET MATTERS.—Such section is amended by 
adding at the end the following new subsection: 
‘‘(k) BUDGET AND CONTRACTING MATTERS.— 
‘‘(1) BUDGET.—The Director may obligate and 
expend funds allocated to the operations of the Of-
fice. 
‘‘(2) CONTRACT
AUTHORITY.—The Director 
may enter into contracts to carry out this section.’’. 
(f) REPORTS.—Subsection (h) of such section is 
amended to read as follows: 
‘‘(h) REPORTS.— 
‘‘(1) ANNUAL REPORTS.—Not later than Sep-
tember 30, 2020, and each year thereafter through 
2024, the Director shall submit to the Secretary of 
Defense and the Secretary of Veterans Affairs, and 
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to the appropriate committees of Congress, a report 
on the activities of the Office during the preceding 
calendar year. Each report shall include the fol-
lowing: 
‘‘(A) A detailed description of the activities 
of the Office during the year covered by such 
report, including a detailed description of the 
amounts expended and the purposes for which 
expended. 
‘‘(B) With respect to the objectives of the 
strategy under paragraph (2)(C) of subsection 
(b), and the purposes of the Office under such 
subsection— 
‘‘(i) a discussion, description, and as-
sessment of the progress made by the De-
partment of Defense and the Department 
of Veterans Affairs during the preceding 
calendar year; and 
‘‘(ii) a discussion and description of 
the goals of the Department of Defense 
and the Department of Veterans Affairs 
for the following calendar year. 
‘‘(2) QUARTERLY
REPORTS.—On a quarterly 
basis, the Director shall submit to the appropriate 
committees of Congress a detailed financial sum-
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mary of the activities of the Office, including the 
funds allocated to the Office by each Department, 
the expenditures made, and an assessment as to 
whether the current funding is sufficient to carry 
out the activities of the Office. 
‘‘(3) AVAILABILITY.—Each report under this 
subsection shall be made publicly available.’’. 
(g) CONFORMING REPEAL.—Section 713 of the Na-
tional Defense Authorization Act for Fiscal Year 2014 
(Public Law 113–66; 10 U.S.C. 1071 note) is repealed. 
SEC. 
714. 
COMPREHENSIVE 
ENTERPRISE 
INTEROPER-
ABILITY STRATEGY FOR THE ARMED FORCES 
AND THE DEPARTMENT OF VETERANS AF-
FAIRS. 
(a) IN GENERAL.—The Secretary of Defense and the 
Secretary of Veterans Affairs, acting through the office 
established by section 1635(b) of the Wounded Warrior 
Act (title XVI of Public Law 110–181; 10 U.S.C. 1071 
note), shall jointly develop and implement a comprehensive 
interoperability strategy to— 
(1) improve the delivery of health care by the 
Armed Forces and the Department of Veterans Af-
fairs by taking advantage of advances in the health 
information technology marketplace; 
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(2) achieve interoperability capabilities that are 
more adaptable and farther reaching than those 
achievable through bidirectional information ex-
change between electronic health records or the ex-
change of read-only data alone; 
(3) establish an environment that will enable 
and encourage the adoption of innovative tech-
nologies for health care delivery; 
(4) leverage data integration to advance health 
research and develop an evidence base for the health 
care programs of both Departments; 
(5) prioritize open systems architecture; 
(6) ensure ownership and control by patients of 
their health data; 
(7) protect patient privacy and enhance oppor-
tunities for innovation by preventing contractors of 
the Departments or other non-Department entities 
from owning or exclusively controlling patient health 
data; 
(8) make maximum use of open-application pro-
gram interfaces and the Fast Healthcare Interoper-
ability Resources standard, or successor standard; 
and 
(9) achieve— 
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(A) a single lifetime longitudinal personal 
health record between the Armed Forces and 
the Department of Veterans Affairs; and 
(B) interoperability capabilities sufficient 
to enable the provision of seamless health care 
relating to— 
(i) the Armed Forces and private-sec-
tor health care providers under the 
TRICARE program; and 
(ii) the Department of Veterans Af-
fairs and community health care providers 
pursuant to sections 1703 and 1703A of 
title 38, United States Code, and other 
provisions of law administered by the Sec-
retary of Veterans Affairs. 
(b) CONTENT.—The strategy under subsection (a) 
shall— 
(1) include, but shall not be limited to, the 
Electronic Health Record Modernization Program 
and the Healthcare Management System Moderniza-
tion Program of the Armed Forces; and 
(2) consist of— 
(A) elements formulated and implemented 
jointly by the Secretary of Defense and the Sec-
retary of Veterans Affairs; and 
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(B) elements that are unique to either De-
partment and are formulated and implemented 
separately by either Secretary. 
(c) SUBMISSION OF STRATEGY.— 
(1) STRATEGY.—Not later than 180 days after 
the date of the enactment of this Act, the Director 
shall submit to each Secretary concerned, and to the 
appropriate congressional committees, the strategy 
under subsection (a), including any accompanying or 
associated implementation plans and supporting in-
formation. 
(2) UPDATED STRATEGY.—Not later than De-
cember 31, 2024, the Director shall submit to each 
Secretary concerned, and to the appropriate congres-
sional committees, an update to the strategy under 
subsection (a), including any accompanying or asso-
ciated implementation plans and supporting infor-
mation. 
(3) AVAILABILITY.—The Secretaries concerned 
shall make available to the public the strategy sub-
mitted under paragraphs (1) and (2), including by 
posting such strategy on the internet websites of the 
Secretaries that is available to the public. 
(d) DEFINITIONS.—In this section: 
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(1) The term ‘‘appropriate congressional com-
mittees’’ means the following: 
(A) The congressional defense committees. 
(B) The Committees on Veterans’ Affairs 
of the House of Representatives and the Sen-
ate. 
(2) The term ‘‘Director’’ means the Director of 
the office established by section 1635(b) of the 
Wounded Warrior Act (title XVI of Public Law 
110–181; 10 U.S.C. 1071 note). 
(3) The term ‘‘Electronic Health Record Mod-
ernization Program’’ has the meaning given that 
term in section 503 of the Veterans Benefits and 
Transition Act of 2018 (Public Law 115–407; 132 
Stat. 5376). 
(4) The term ‘‘interoperability’’ means the abil-
ity of different information systems, devices, or ap-
plications to connect in a coordinated and secure 
manner, within and across organizational bound-
aries, across the complete spectrum of care, includ-
ing all applicable care settings, and with relevant 
stakeholders, including the person whose information 
is being shared, to access, exchange, integrate, and 
use computable data regardless of the data’s origin 
or destination or the applications employed, and 
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without additional intervention by the end user, in-
cluding— 
(A) the capability to reliably exchange in-
formation without error; 
(B) the ability to interpret and to make ef-
fective use of the information so exchanged; and 
(C) the ability for information that can be 
used to advance patient care to move between 
health care entities, regardless of the technology 
platform in place or the location where care was 
provided. 
(5) The term ‘‘seamless health care’’ means 
health care which is optimized through access by pa-
tients and clinicians to integrated, relevant, and 
complete information about the patient’s clinical ex-
periences, social and environmental determinants of 
health, and health trends over time in order to en-
able patients and clinicians to move from task to 
task and encounter to encounter, within and across 
organizational boundaries, such that high-quality de-
cisions may be formed easily and complete plans of 
care may be carried out smoothly. 
(6) The term ‘‘Secretary concerned’’ means— 
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(A) the Secretary of Defense, with respect 
to matters concerning the Department of De-
fense; 
(B) the Secretary of Veterans Affairs, with 
respect to matters concerning the Department 
of Veterans Affairs; and 
(C) the Secretary of Homeland Security, 
with respect to matters concerning the Coast 
Guard when it is not operating as a service in 
the Department of the Navy. 
(7) The term ‘‘TRICARE program’’ has the 
meaning given that term in section 1072 of title 10, 
United States Code. 
SEC. 715. DEMONSTRATION OF INTEROPERABILITY MILE-
STONES. 
(a) MILESTONES.— 
(1) EVALUATION.—To demonstrate increasing 
levels of interoperability, functionality, and seamless 
health care within the electronic health record sys-
tems of the Department of Defense and the Depart-
ment of Veterans Affairs, the Office shall seek to 
enter into an agreement with an independent entity 
to conduct an evaluation of the following use cases 
of such systems: 
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(A) By not later than 18 months after the 
date of the enactment of this Act, whether a cli-
nician of the Department of Defense can access 
and meaningfully interact with a complete vet-
eran patient health record from a military med-
ical treatment facility. 
(B) By not later than 18 months after the 
date of the enactment of this Act, whether a cli-
nician of the Department of Veterans Affairs 
can access and meaningfully interact with a 
complete patient health record of a member of 
the Armed Forces serving on active duty from 
a medical center of the Department of Veterans 
Affairs. 
(C) By not later than two years after the 
date of the enactment of this Act, whether a cli-
nician in the Department of Defense and the 
Department of Veterans Affairs can access and 
meaningfully interact with the data elements of 
the health record of a veteran patient or mem-
ber of the Armed Forces which are generated 
when the veteran patient or member of the 
Armed Forces receives health care from a com-
munity care provider of the Department of Vet-
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erans Affairs or a TRICARE provider of the 
Department of Defense 
(D) By not later than two years after the 
date of the enactment of this Act, whether a 
community care provider of the Department of 
the Veterans Affairs and a TRICARE provider 
on a Health Information Exchange-supported 
electronic health record can access a veteran 
and active-duty member patient health record 
from the provider’s system. 
(E) By not later than two years after the 
enactment of this Act, and subsequently after 
each significant implementation wave, an as-
sessment of interoperability between the legacy 
electronic health record systems and the future 
electronic health record systems of the Depart-
ment of Veterans Affairs and the Department 
of Defense. 
(F) By not later than two years after the 
enactment of this Act, and subsequently after 
each significant implementation wave, an as-
sessment of the use of interoperable content be-
tween the legacy electronic health record sys-
tems and the future electronic health record 
systems of the Department of Veterans Affairs 
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and the Department of Defense, and third- 
party applications. 
(2) SUBMISSION.—The Office shall submit to 
the appropriate congressional committees a report 
detailing the evaluation, methodology for testing, 
and findings for each milestone demonstration under 
paragraph (1) by not later than the date specified 
under such paragraph. 
(b) SYSTEM CONFIGURATION MANAGEMENT.—The 
Office shall— 
(1) maintain the common configuration baseline 
for the electronic health record systems of the De-
partment of Defense and the Department of Vet-
erans Affairs; and 
(2) continually evaluate the state of configura-
tion, the impacts on interoperability, and shall pro-
mote the enhancement of such electronic health 
records systems. 
(c) REGULAR CLINICAL CONSULTATION.—The Office 
shall convene at least annually a clinical workshop to in-
clude clinical staff from the Department of Defense, the 
Department of Veterans Affairs, the Coast Guard, com-
munity providers, and other leading clinical experts to as-
sess the state of clinical use of the electronic health record 
systems and whether the systems are meeting clinical and 
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patient needs. The clinical workshop shall make rec-
ommendations to the Office on the need for any improve-
ments or concerns with the electronic health record sys-
tems. 
(d) CLINICIAN AND PATIENT SATISFACTION SUR-
VEY.—Beginning October 1, 2021, on at least a biannual 
basis, the Office shall undertake a clinician and patient 
satisfaction survey regarding clinical use and patient expe-
rience with the electronic health record systems of the De-
partment of Defense and the Department of Veterans Af-
fairs. 
(e) ANNUAL REPORTS.—Not later than September 
30, 2020, and annually thereafter, the Office shall submit 
to the appropriate congressional committees a report on— 
(1) the state of the configuration baseline under 
subsection (b) and any activities which decremented 
or enhanced the state of configuration; and 
(2) the activities, assessments and recommenda-
tions of the clinical workshop under subsection (c) 
and the response of the Office to the workshop rec-
ommendations and any action plans to implement 
the recommendations. 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘appropriate congressional com-
mittees’’ means the following: 
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(A) The congressional defense committees. 
(B) The Committees on Veterans’ Affairs 
of the House of Representatives and the Sen-
ate. 
(2) The term ‘‘configuration baseline’’ means a 
fixed reference in the development cycle or an 
agreed-upon specification of a product at a point in 
time. It serves as a documented basis for defining 
incremental change in all aspects of an information 
technology product. 
(3) The term ‘‘interoperability’’ means the abil-
ity of different information systems, devices, or ap-
plications to connect in a coordinated and secure 
manner, within and across organizational bound-
aries, across the complete spectrum of care, includ-
ing all applicable care settings, and with relevant 
stakeholders, including the person whose information 
is being shared, to access, exchange, integrate, and 
use computable data regardless of the data’s origin 
or destination or the applications employed, and 
without additional intervention by the end user, in-
cluding— 
(A) the capability to reliably exchange in-
formation without error; 
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(B) the ability to interpret and to make ef-
fective use of the information so exchanged; and 
(C) the ability for information that can be 
used to advance patient care to move between 
health care entities, regardless of the technology 
platform in place or the location where care was 
provided. 
(4) The term ‘‘meaningfully interact’’ means 
that information can be viewed, consumed, acted 
upon, and edited in a clinical setting to facilitate 
high quality clinical decision making in a clinical set-
ting. 
(5) The term ‘‘Office’’ means the office estab-
lished by section 1635(b) of the Wounded Warrior 
Act (title XVI of Public Law 110–181; 10 U.S.C. 
1071 note). 
(6) The term ‘‘seamless health care’’ means 
health care which is optimized through access by pa-
tients and clinicians to integrated, relevant, and 
complete information about the patient’s clinical ex-
periences, social and environmental determinants of 
health, and health trends over time in order to en-
able patients and clinicians to move from task to 
task and encounter to encounter, within and across 
organizational boundaries, such that high-quality de-
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cisions may be formed easily and complete plans of 
care may be carried out smoothly. 
(7) The term ‘‘TRICARE program’’ has the 
meaning given that term in section 1072 of title 10, 
United States Code. 
SEC. 716. INCLUSION OF BLAST EXPOSURE HISTORY IN 
MEDICAL RECORDS OF MEMBERS OF THE 
ARMED FORCES. 
(a) REQUIREMENT.—The Secretary of Defense, in 
coordination with the Secretaries of the military depart-
ments, shall document blast exposure history in the med-
ical record of a member of the Armed Forces to— 
(1) assist in determining whether a future ill-
ness or injury of the member is service-connected; 
and 
(2) inform future blast exposure risk mitigation 
efforts of the Department of Defense. 
(b) ELEMENTS.—A blast exposure history under sub-
section (a) shall include, at a minimum, the following: 
(1) The date of the exposure. 
(2) The duration of the exposure, and, if 
known, the measured blast pressure experienced by 
the individual during such exposure. 
(3) Whether the exposure occurred during com-
bat or training. 
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(4) Such other information relating to the expo-
sure as the Secretary of Defense may specify pursu-
ant to the guidance described in subsection (c)(1). 
(c) COLLECTION OF EXPOSURE INFORMATION.—The 
Secretary of Defense shall collect blast exposure informa-
tion with respect to a member of the Armed Forces in 
a manner— 
(1) consistent with blast exposure measurement 
training guidance of the Department, including any 
new guidance developed pursuant to— 
(A) the study on blast pressure exposure 
required by section 734 of the National Defense 
Authorization Act for Fiscal Year 2018 (Public 
Law 115–91; 131 Stat. 1444); and 
(B) the review of guidance on blast expo-
sure during training required by section 253 of 
the John S. McCain National Defense Author-
ization Act for Fiscal Year 2019 (Public Law 
115–232; 132 Stat. 1704, 10 U.S.C. 2001 
note); 
(2) compatible with training and operational ob-
jectives; and 
(3) that is automated, to the extent practicable, 
to minimize the reporting burden of unit com-
manders. 
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(d) REPORT.—Not later than one year after the date 
of the enactment of this Act, the Secretary of Defense 
shall submit to the Committees on Armed Services of the 
Senate and the House of Representatives a report on the 
types of information included in a blast exposure history 
under subsection (a). 
SEC. 717. COMPREHENSIVE POLICY FOR PROVISION OF 
MENTAL HEALTH CARE TO MEMBERS OF THE 
ARMED FORCES. 
(a) POLICY REQUIRED.—Not later than 180 days 
after the date of the enactment of this Act, the Secretary 
of Defense, acting through the Under Secretary of De-
fense for Personnel and Readiness, shall develop and im-
plement a comprehensive policy for the provision of mental 
health care to members of the Armed Forces. 
(b) ELEMENTS.—The policy under subsection (a) 
shall address each of the following: 
(1) The compliance of health professionals in 
the military health system engaged in the provision 
of health care services to members with clinical prac-
tice guidelines for— 
(A) suicide prevention; 
(B) medication-assisted therapy for alcohol 
use disorders; and 
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(C) medication-assisted therapy for opioid 
use disorders. 
(2) The access and availability of mental health 
care services to members who are victims of sexual 
assault or domestic violence. 
(3) The availability of naloxone reversal capa-
bility on military installations. 
(4) The promotion of referrals of members by 
civilian health care providers to military medical 
treatment facilities when such members are— 
(A) at high risk for suicide and diagnosed 
with a psychiatric disorder; or 
(B) receiving treatment for opioid use dis-
orders. 
(5) The provision of comprehensive behavioral 
health treatment to members of the reserve compo-
nents that takes into account the unique challenges 
associated with the deployment pattern of such 
members and the difficulty such members encounter 
post-deployment with respect to accessing such 
treatment in civilian communities. 
(c) CONSIDERATION.—In developing the policy under 
subsection (a), the Secretary of Defense shall solicit and 
consider recommendations from the Secretaries of the 
military departments and the Chairman of the Joint 
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Chiefs of Staff regarding the feasibility of implementation 
and execution of particular elements of the policy. 
(d) REPORT.—Not later than 18 months after the 
date of the enactment of this Act, the Secretary of Defense 
shall submit to the Committees on Armed Services of the 
Senate and the House of Representatives a report on the 
implementation of the policy under subsection (a). 
SEC. 718. LIMITATION ON THE REALIGNMENT OR REDUC-
TION OF MILITARY MEDICAL MANNING END 
STRENGTH. 
(a) LIMITATION.—Except as provided by subsection 
(d), the Secretary of Defense and the Secretaries con-
cerned may not realign or reduce military medical end 
strength authorizations until— 
(1) each review is conducted under paragraph 
(1) of subsection (b); 
(2) each analysis is conducted under paragraph 
(2) of such subsection; 
(3) the measurement is developed under para-
graph (3) of such subsection; 
(4) each plan and forum is provided under 
paragraph (4) of such subsection; and 
(5) a period of 90 days elapses following the 
date on which the Secretary submits the report 
under subsection (c). 
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(b) REVIEWS, ANALYSES, AND OTHER INFORMA-
TION.— 
(1) REVIEW.—Each Secretary concerned, in co-
ordination with the Chairman of the Joint Chiefs of 
Staff, shall conduct a review of the medical man-
power requirements of the military department of 
the Secretary that accounts for all national defense 
strategy scenarios. 
(2) ANALYSES.—With respect to each military 
medical treatment facility that would be affected by 
a proposed military medical end strength realign-
ment or reduction, the Secretary concerned shall 
conduct an analysis that— 
(A) identifies affected billets; and 
(B) includes a plan for mitigating any po-
tential gap in health care services caused by 
such realignment or reduction. 
(3) MEASUREMENT.—The Secretary of Defense 
shall— 
(A) develop a standard measurement for 
network adequacy to determine the capacity of 
the local health care network to provide care for 
covered beneficiaries in the area of a military 
medical treatment facility that would be af-
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fected by a proposed military medical end 
strength realignment or reduction; and 
(B) use such measurement in carrying out 
this section and otherwise evaluating proposed 
military medical end strength realignment or 
reductions. 
(4) OUTREACH.—The Secretary of Defense 
shall provide to each member of the Armed Forces 
and covered beneficiary located in the area of a mili-
tary medical treatment facility that would be af-
fected by a proposed military medical end strength 
realignment or reduction the following: 
(A) A transition plan for continuity of 
health care services. 
(B) A public forum to discuss the concerns 
of the member and covered beneficiary regard-
ing such proposed realignment or reduction. 
(c) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Defense 
shall submit to the Committees on Armed Services of the 
House of Representatives and the Senate a report on the 
proposed military medical end strength realignments or 
reductions, including— 
(1) the reviews, analyses, and other information 
developed under subsection (b); and 
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(2) a description of the actions the Secretary 
plans to take with respect to such proposed realign-
ments or reductions. 
(d) EXCEPTION.—The limitation in subsection (a) 
shall not apply to billets of a medical department of a mili-
tary department that have remained unfilled since at least 
October 1, 2018. The Secretary concerned may realign or 
reduce such a billet if the Secretary determines that such 
realignment or reduction does not affect the provision of 
health care services to members of the Armed Forces or 
covered beneficiaries. 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘covered beneficiary’’ has the 
meaning given that term in section 1072 of title 10, 
United States Code. 
(2) The term ‘‘proposed military medical end 
strength realignment or reduction’’ means a realign-
ment or reduction of military medical end strength 
authorizations as proposed by the budget of the 
President for fiscal year 2020 submitted to Congress 
pursuant to section 1105 of title 31, United States 
Code. 
(3) The term ‘‘Secretary concerned’’ means— 
(A) the Secretary of the Army, with re-
spect to matters concerning the Army; 
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(B) the Secretary of the Navy, with re-
spect to matters concerning the Navy, the Ma-
rine Corps, and the Coast Guard when it is op-
erating as a service in the Department of the 
Navy; and 
(C) the Secretary of the Air Force, with 
respect to matters concerning the Air Force. 
SEC. 719. STRATEGY TO RECRUIT AND RETAIN MENTAL 
HEALTH PROVIDERS. 
Not later than 180 days after the date of the enact-
ment of this Act, the Secretary of Defense shall submit 
to the congressional defense committees a report that— 
(1) describes the shortage of mental health pro-
viders of the Department of Defense; 
(2) explains the reasons for such shortage; 
(3) explains the effect of such shortage on 
members of the Armed Forces; and 
(4) contains a strategy to better recruit and re-
tain mental health providers, including with respect 
to psychiatrists, psychologists, mental health nurse 
practitioners, licensed social workers, and other li-
censed providers of the military health system, in a 
manner that addresses the need for cultural com-
petence and diversity among such mental health pro-
viders. 
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SEC. 720. MONITORING MEDICATION PRESCRIBING PRAC-
TICES FOR THE TREATMENT OF POST-TRAU-
MATIC STRESS DISORDER. 
(a) REPORT.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of 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 report on the practices for prescribing 
medication during the period beginning January 1, 
2012, and ending December 31, 2017, that were in-
consistent with the post-traumatic stress disorder 
medication guidelines developed by the Department 
of Defense and the Veterans Health Administration. 
(2) CONTENTS.—The report under this sub-
section shall include the following: 
(A) A summary of the practices of the 
Army, Navy, and the Air Force, for prescribing 
medication during the period referred to in 
paragraph (1) that were inconsistent with the 
post-traumatic stress disorder medication guide-
lines developed by the Department of Defense 
and the Veterans Health Administration. 
(B) Identification of medical centers serv-
ing members of the Armed Forces found to 
having higher than average incidences of pre-
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scribing medication during the period referred 
to in paragraph (1) that were inconsistent with 
the post-traumatic stress disorder guidelines. 
(C) A plan for such medical centers to re-
duce the prescribing of medications that are in-
consistent with the post-traumatic stress dis-
order guidelines. 
(D) A plan for ongoing monitoring of med-
ical centers found to have higher than average 
incidences of prescribing medication that were 
inconsistent with the post-traumatic stress dis-
order guidelines by the Department of Defense 
and the Veterans Health Administration. 
(b) MONITORING PROGRAM.—Based on the findings 
of the report under subsection (a), the Secretaries of the 
Army, the Navy, and the Air Force shall each establish 
a monitoring program carried out with respect to such 
branch of the Armed Forces that shall provide as follows: 
(1) The monitoring program shall provide for 
the conduct of periodic reviews, beginning October 1, 
2019, of medication prescribing practices of its own 
providers. 
(2) The monitoring program shall provide for 
regular reports, beginning October 1, 2020, to the 
Department of Defense and the Veterans Health Ad-
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ministration, of the results of the periodic reviews 
pursuant to paragraph (1) of this subsection. 
(3) The monitoring program shall establish in-
ternal procedures, not later than October 1, 2020, to 
address practices for prescribing medication that are 
inconsistent with the post-traumatic stress disorder 
medication guidelines developed by the Department 
of Defense and the Veterans Health Administration. 
(c) REPORT ON IMPLEMENTATION OF GUIDANCE ON 
OPIOID PRESCRIPTIONS FOR PAIN FROM MINOR OUT-
PATIENT PROCEDURES.—Not later than 6 months after 
the date of enactment of this Act, the Secretary of De-
fense, acting in conjunction with the Director of the De-
fense Health Agency, shall submit to the Committees on 
Armed Services of the House of Representatives and the 
Senate a report on the implementation and results of the 
Defense Health Agency’s guidance on opioid prescriptions 
for pain from minor outpatient procedures in Guidance 
Report entitled ‘‘Pain Management and Opioid Safety in 
the Military Health System (MHS)’’ (DHA–PI 6025.04, 
issued on June 8, 2018). 
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SEC. 720A. MAINTENANCE OF CERTAIN MEDICAL SERVICES 
AT MILITARY MEDICAL TREATMENT FACILI-
TIES AT SERVICE ACADEMIES. 
Section 1073d of title 10, United States Code, is 
amended by adding at the end the following new sub-
section: 
‘‘(f) MAINTENANCE OF CERTAIN MEDICAL SERVICES 
AT SERVICE ACADEMIES.—(1) In carrying out subsection 
(a), the Secretary of Defense shall ensure that each mili-
tary medical treatment facility located at a Service Acad-
emy (as defined in section 347 of this title) provides each 
covered medical service unless the Secretary determines 
that a civilian health care facility located not fewer than 
five miles from the Service Academy provides the covered 
medical service. 
‘‘(2) In this subsection, the term ‘covered medical 
service’ means the following: 
‘‘(A) Emergency room services. 
‘‘(B) Orthopedic services. 
‘‘(C) General surgery services. 
‘‘(D) Ear, nose, and throat services. 
‘‘(E) Gynecological services. 
‘‘(F) Ophthalmology services. 
‘‘(G) In-patient services. 
‘‘(H) Any other medical services that the rel-
evant Superintendent of the Service Academy deter-
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mines necessary to maintain the readiness and 
health of the cadets or midshipmen and members of 
the armed forces at the Service Academy.’’. 
SEC. 720B. DEVELOPMENT OF PARTNERSHIPS TO IMPROVE 
COMBAT CASUALTY CARE FOR PERSONNEL 
OF THE ARMED FORCES. 
(a) PARTNERSHIPS.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall, through the Joint Trauma Education and 
Training Directorate established under section 708 
of the National Defense Authorization Act for Fiscal 
Year 2017 (Public Law 114–328; 10 U.S.C. 1071 
note), develop partnerships with civilian academic 
medical centers and large metropolitan teaching hos-
pitals to improve combat casualty care for personnel 
of the Armed Forces. 
(2) PARTNERSHIPS
WITH
LEVEL
I
TRAUMA 
CENTERS.—In carrying out partnerships under para-
graph (1), trauma surgeons and physicians of the 
Department of Defense shall partner with level I ci-
vilian trauma centers to provide adequate training 
and readiness for the next generation of medical 
providers to treat critically injured burn patients. 
(b) SUPPORT OF PARTNERSHIPS.—The Secretary of 
Defense shall make every effort to support partnerships 
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under the Joint Trauma Education and Training Direc-
torate with academic institutions that have level I civilian 
trauma centers, specifically those centers with a burn cen-
ter, that offer burn rotations and clinical experience to 
provide adequate training and readiness for the next gen-
eration of medical providers to treat critically injured burn 
patients. 
(c) LEVEL I CIVILIAN TRAUMA CENTER DEFINED.— 
In this section, the term ‘‘level I civilian trauma center’’ 
has the meaning given that term in section 708 of the 
National Defense Authorization Act for Fiscal Year 2017 
(Public Law 114–328; 10 U.S.C. 1071 note). 
(d) EFFECTIVE DATE.—This section shall take effect 
on October 1, 2020. 
SEC. 720C. MODIFICATION TO REFERRALS FOR MENTAL 
HEALTH SERVICES. 
If the Secretary of Defense is unable to provide men-
tal health services in a military medical treatment facility 
to a member of the Armed Forces within 15 days of the 
date on which such services are first requested by the 
member, the Secretary may refer the member to a pro-
vider under the TRICARE program (as that term is de-
fined in section 1072 of title 10, United States Code) to 
receive such services. 
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Subtitle C—Reports and Other 
Matters 
SEC. 721. ESTABLISHMENT OF MILITARY DENTAL RE-
SEARCH PROGRAM. 
(a) IN GENERAL.—Chapter 104 of title 10, United 
States Code, is amended by inserting after section 2116 
the following new section: 
‘‘§ 2116a. Military dental research 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) The term ‘military dental research’ means 
research on the furnishing of dental care and serv-
ices by dentists in the armed forces. 
‘‘(2) The term ‘TriService Dental Research 
Program’ means the program of military dental re-
search authorized under this section. 
‘‘(b) PROGRAM AUTHORIZED.—The Secretary of De-
fense may establish at the University a program of mili-
tary dental research. 
‘‘(c) 
TRISERVICE
RESEARCH
GROUP.—The 
TriService Dental Research Program shall be adminis-
tered by a TriService Dental Research Group composed 
of Army, Navy, and Air Force dentists who are involved 
in military dental research and are designated by the Sec-
retary concerned to serve as members of the group. 
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‘‘(d) DUTIES OF GROUP.—The TriService Dental Re-
search Group described in subsection (c) shall— 
‘‘(1) develop for the Department of Defense 
recommended guidelines for requesting, reviewing, 
and funding proposed military dental research 
projects; and 
‘‘(2) make available to Army, Navy, and Air 
Force dentists and officials of the Department of 
Defense who conduct military dental research— 
‘‘(A) information about dental research 
projects that are being developed or carried out 
in the Army, Navy, and Air Force; and 
‘‘(B) expertise and information beneficial 
to the encouragement of meaningful dental re-
search. 
‘‘(e) RESEARCH TOPICS.—For purposes of this sec-
tion, military dental research includes research on the fol-
lowing issues: 
‘‘(1) Issues regarding how to ensure the readi-
ness of members of the armed forces on active duty 
and in the reserve components with respect to the 
provision of dental care and services. 
‘‘(2) Issues regarding preventive dentistry and 
disease management, including early detection of 
needs. 
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‘‘(3) Issues regarding how to improve the re-
sults of dental care and services provided in the 
armed forces in time of peace. 
‘‘(4) Issues regarding how to improve the re-
sults of dental care and services provided in the 
armed forces in time of war. 
‘‘(5) Issues regarding minimizing or eliminating 
emergent dental conditions and dental disease and 
non-battle injuries in deployed settings. 
‘‘(6) Issues regarding how to prevent complica-
tions associated with dental-related battle injuries. 
‘‘(7) Issues regarding how to prevent complica-
tions associated with the transportation of dental pa-
tients in the military medical evacuation system. 
‘‘(8) Issues regarding the use of technological 
advances, including teledentistry. 
‘‘(9) Issues regarding psychological distress in 
receiving dental care and services. 
‘‘(10) Issues regarding how to improve methods 
of training dental personnel, including dental assist-
ants and dental extenders. 
‘‘(11) Wellness issues relating to dental care 
and services. 
‘‘(12) Case management issues relating to den-
tal care and services. 
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‘‘(13) Issues regarding the use of alternate den-
tal care delivery systems, including the employment 
of interprofessional practice models incorporating 
multiple health professions.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of chapter 104 of such title is amended 
by inserting after the item relating to section 2116 the 
following new item: 
‘‘2116a. Military dental research.’’. 
SEC. 722. 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 to a combat zone. 
(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 a contract under subsection (d) 
until the date that is one year after the retirement, 
separation, or release of the member from the 
Armed Forces. 
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(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 that paragraph to select, including pursuant to an 
advance medical directive or military testamentary 
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-
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rective described in section 1044c(b) of title 10, United 
States Code, and a military testamentary instrument de-
scribed 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. 
(d) AGREEMENTS.—To carry out this section, the 
Secretary may enter into agreements with private entities 
that provide cryopreservation and storage services for 
gametes. 
SEC. 723. ENCOURAGEMENT OF PARTICIPATION IN WOM-
EN’S HEALTH TRANSITION TRAINING PILOT 
PROGRAM. 
(a) ENCOURAGEMENT OF PARTICIPATION.—The Sec-
retaries of the military departments shall encourage fe-
male members of the Armed Forces who are separating 
or retiring from the Armed Forces during fiscal year 2020 
to participate in the Women’s Health Transition Training 
pilot program (in this section referred to as the ‘‘pilot pro-
gram’’) administered by the Secretary of Veterans Affairs. 
(b) SELECTION.—Each Secretary of a military de-
partment shall select at least one location at which the 
pilot program is offered and encourage participation in the 
pilot program at such location. 
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(c) REPORT.—Not later than September 30, 2020, 
the Secretary of Defense, in consultation with the Sec-
retary of Veterans Affairs, shall submit to the Committees 
on Armed Services of the Senate and the House of Rep-
resentatives and the Committees on Veterans’ Affairs of 
the Senate and House of Representatives a report on the 
pilot program that includes the following: 
(1) For the period since the commencement of 
the pilot program— 
(A) the number of courses held under the 
pilot program; 
(B) the locations at which such courses 
were held; and 
(C) for each location identified in subpara-
graph (B)— 
(i) the number of female members by 
military department (with respect to De-
partment of the Navy, separately for the 
Navy and Marine Corps) who participated 
in the pilot program; and 
(ii) the number of seats available 
under the pilot program. 
(2) Data relating to— 
(A) satisfaction with courses held under 
the pilot program; 
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(B) improved awareness of health care 
services administered by the Secretary of Vet-
erans Affairs; and 
(C) any other available statistics regarding 
the pilot program. 
(3) A discussion of regulatory, legal, or resource 
barriers to— 
(A) making the pilot program permanent 
to enable access by a greater number of female 
members at locations throughout the United 
States; 
(B) offering the pilot program online for 
female members who are unable to attend 
courses held under the pilot program in person; 
and 
(C) providing for automatic enrollment of 
participants in the pilot program in the patient 
enrollment system of the Department of Vet-
erans Affairs established and operated under 
section 1705 of title 38, United States Code. 
SEC. 724. NATIONAL GUARD SUICIDE PREVENTION PILOT 
PROGRAM. 
(a) PILOT PROGRAM AUTHORIZED.—The Chief of 
the National Guard Bureau may carry out a pilot program 
to expand suicide prevention and intervention efforts at 
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the community level through the use of a mobile applica-
tion that provides the capability for a member of the Na-
tional Guard to receive prompt support, including access 
to a behavioral health professional, on a smartphone, tab-
let computer, or other handheld mobile device. 
(b) ELEMENTS.—The pilot program shall include, 
subject to such conditions as the Secretary may pre-
scribe— 
(1) the use by members of the National Guard 
of an existing mobile application that provides the 
capability described in subsection (a); or 
(2) the development and use of a new mobile 
application that provides such capability. 
(c) ELIGIBILITY
AND
PARTICIPATION
REQUIRE-
MENTS.—The Chief of the National Guard Bureau shall 
establish requirements with respect to eligibility and par-
ticipation in the pilot program. 
(d) ASSESSMENT PRIOR TO PILOT PROGRAM COM-
MENCEMENT.—Prior to commencement of the pilot pro-
gram, the Chief of the National Guard Bureau shall— 
(1) conduct an assessment of existing preven-
tion and intervention efforts of the National Guard 
in each State that include the use of mobile applica-
tions that provide the capability described in sub-
section (a) to determine best practices for providing 
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immediate and localized care through the use of 
such mobile applications; and 
(2) determine the feasibility of expanding exist-
ing programs on a national scale. 
(e) RESPONSIBILITIES OF ENTITIES PARTICIPATING 
IN PILOT PROGRAM.—Each entity that participates in the 
pilot program shall— 
(1) share best practices with other entities par-
ticipating in the program; and 
(2) annually assess outcomes with respect to 
members of the National Guard. 
(f) TERM.—The pilot program shall terminate on the 
date that is three years after the date on which the pilot 
program commenced. 
(g) REPORTS.— 
(1) INITIAL REPORT.—If the Chief of the Na-
tional Guard Bureau commences the pilot program 
authorized under subsection (a), not later than 180 
days after the date of the commencement of such 
program, the Chief shall submit to the Committees 
on Armed Services of the Senate and the House of 
Representatives a report containing a description of 
the pilot program and such other matters as the 
Chief considers appropriate. 
(2) FINAL REPORT.— 
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(A) IN
GENERAL.—Not later than 180 
days after the termination of the pilot program, 
the Chief of the National Guard Bureau shall 
submit to the Committees on Armed Services of 
the Senate and the House of Representatives a 
report on such pilot program. 
(B) MATTERS
INCLUDED.—The report 
under subparagraph (A) shall include the fol-
lowing: 
(i) A description of the pilot program, 
including any partnerships entered into by 
the Chief of the National Guard Bureau 
under the program. 
(ii) An assessment of the effectiveness 
of the pilot program. 
(iii) A description of costs associated 
with the implementation of the pilot pro-
gram. 
(iv) The estimated costs of making 
the pilot program permanent. 
(v) A recommendation as to whether 
the pilot program should be extended or 
made permanent. 
(vi) Such other recommendations for 
legislative or administrative action as the 
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Chief of the National Guard Bureau con-
siders appropriate. 
(h) FUNDING.— 
(1) INCREASE.—Notwithstanding the amounts 
set forth in the funding tables in division D, the 
amount authorized to be appropriated in section 301 
for operation and maintenance, as specified in the 
corresponding funding table in section 4301, for op-
eration and maintenance, Defense-wide, administra-
tive and service-wide activities, Office of the Sec-
retary of Defense, line 460 is hereby increased by 
$5,000,000 (with the amount of such increase to be 
made available for the Defense Suicide Prevention 
Office and National Guard suicide prevention pilot 
program under this section). 
(2) OFFSET.—Notwithstanding the amounts set 
forth in the funding tables in division D, the amount 
authorized to be appropriated in section 101 for pro-
curement, as specified in the corresponding funding 
table in section 4101, for shipbuilding and conver-
sion, Navy, ship to shore connector, line 024 is here-
by reduced by $5,000,000. 
(i) STATE DEFINED.—In this section, the term 
‘‘State’’ means each of the several States, the District of 
Columbia, the Commonwealth of Puerto Rico, American 
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Samoa, Guam, the United States Virgin Islands, and the 
Commonwealth of the Northern Mariana Islands. 
SEC. 725. REPORTS ON SUICIDE AMONG MEMBERS OF THE 
ARMED FORCES. 
(a) REPORTS.—Not later than 90 days after the date 
of the enactment of this Act, and annually thereafter 
through January 31, 2021, the Secretary of Defense shall 
submit to the Committees on Armed Services of the House 
of Representatives and the Senate a report on suicide 
among members of the Armed Forces during the year pre-
ceding the date of the report. 
(b) MATTERS INCLUDED.—Each report under sub-
section (a) shall include the following with respect to the 
year covered by the report: 
(1) The number of suicides, attempted suicides, 
and occurrences of suicidal ideation involving a 
member of the Armed Forces, including the reserve 
components thereof, listed by Armed Force. 
(2) The number of suicides, attempted suicides, 
or suicidal ideation identified under paragraph (1) 
that occurred during each of the following periods: 
(A) The first 180 days of the member 
serving in the Armed Forces. 
(B) The period in which the member is de-
ployed in support of a contingency operation. 
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(3) With respect to the number of suicides, at-
tempted suicides, or suicidal ideation identified 
under paragraph (2)(A), the initial recruit training 
location of the member. 
(4) The number of suicides involving a depend-
ent of a member. 
(5) A description of any research collaborations 
and data sharing by the Department of Defense with 
the Department of Veterans Affairs, other depart-
ments or agencies of the Federal Government, aca-
demic institutions, or nongovernmental organiza-
tions. 
(6) Identification of a research agenda for the 
Department of Defense to improve the evidence base 
on effective suicide prevention treatment and risk 
communication. 
(7) The availability and usage of the assistance 
of chaplains, houses of worship, and other spiritual 
resources for members of the Armed Forces who 
identify as religiously affiliated and have attempted 
suicide, have suicidal ideation, or are at risk of sui-
cide, and metrics on the impact these resources have 
in assisting religiously-affiliated members who have 
access to and utilize them compared to religiously- 
affiliated members who do not. 
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(8) A description of the effectiveness of the 
policies developed pursuant to section 567 of the 
Carl Levin and Howard P. ‘‘Buck’’ McKeon Na-
tional Defense Authorization Act for Fiscal Year 
2015 (Public Law 113–291; 10 U.S.C. 1071 note) 
and section 582 of the National Defense Authoriza-
tion Act for Fiscal Year 2013 (Public Law 112–239; 
10 U.S.C. 1071 note), including with respect to— 
(A) metrics identifying effective treatment 
modalities for members of the Armed Forces 
who are at risk for suicide (including any clin-
ical interventions involving early identification 
and treatment of such members); 
(B) metrics for the rate of integration of 
mental health screenings and suicide risk and 
prevention for members during the delivery of 
primary care for such members; 
(C) metrics relating to the effectiveness of 
suicide prevention and resilience programs and 
preventative behavioral health programs of the 
Department of Defense (including those of the 
military departments and the Armed Forces); 
and 
(D) metrics evaluating the training stand-
ards for behavioral health care providers to en-
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sure that such providers have received training 
on clinical best practices and evidence-based 
treatments. 
SEC. 726. STUDY ON MILITARY-CIVILIAN INTEGRATED 
HEALTH DELIVERY SYSTEMS. 
(a) STUDY.—The Secretary of Defense shall conduct 
a study on the use of local integrated military-civilian inte-
grated health delivery systems pursuant to section 706 of 
the National Defense Authorization Act for Fiscal Year 
2017 (Public Law 114–328; 10 U.S.C. 1096 note). The 
study shall examine the following: 
(1) Geographic locations where military medical 
treatment facilities have existing contractual rela-
tionships with local civilian health care networks, in-
cluding Fort Drum, New York, Joint Base McGuire- 
Dix-Lakehurst, New Jersey, Joint Base Lewis- 
McCord, Washington, Fort Leonard Wood, Missouri, 
Elmendorf Air Force Base, Alaska, Fort Sill, Okla-
homa, Tripler Army Medical Center, Hawaii, the 
National Capital Region, and similar locations. 
(2) Health care activities that promote value- 
based care, measurable health outcomes, patient 
safety, timeliness of referrals, and transparent com-
munication with covered beneficiaries. 
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(3) Locations where health care providers of the 
Department of Defense may be able to attain critical 
wartime readiness skills in a local integrated mili-
tary-civilian integrated health delivery system. 
(4) The cost of providing care under an inte-
grated military-civilian integrated health delivery 
system as compared to health care provided by a 
managed care support contractor. 
(b) SUBMISSION.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary of Defense 
shall submit to the Committees on Armed Services of the 
House of Representatives and the Senate a report on the 
results of the study under subsection (a). 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘covered beneficiaries’’ has the 
meaning given that term in section 1072 of title 10, 
United States Code. 
(2) The term ‘‘National Capital Region’’ has 
the meaning given that term in section 2674 of title 
10, United States Code. 
SEC. 727. STUDY ON CASE MANAGEMENT AT MILITARY 
MEDICAL TREATMENT FACILITIES. 
(a) STUDY.—The Secretary of Defense shall conduct 
a study on the effectiveness of case management practices 
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at military medical treatment facilities. The study shall 
include the following: 
(1) A standardized definition of case manage-
ment. 
(2) An evaluation of case management practices 
provided by the military departments before and 
during the transition of the administration of mili-
tary medical treatment facilities to the Defense 
Health Agency pursuant to section 1073c of title 10, 
United States Code. 
(3) A discussion of the metrics involved with 
determining the effectiveness of case management 
and the cost of case management. 
(4) A review of case management best practices 
in the private sector, including with respect to— 
(A) the intervals at which patients should 
be contacted; 
(B) the role of the case manager in coordi-
nation; 
(C) the approximate number of patients 
managed by a case manager; and 
(D) any other best practices relating to 
case management that would improve the expe-
rience of care within the military health system. 
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(5) The results of a discussion with covered 
beneficiaries (as defined in section 1072 of title 10, 
United States Code) in a public forum on case man-
agement in military medical treatment facilities ad-
ministered by the Defense Health Agency. 
(b) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Defense 
shall submit to the Committees on Armed Services of the 
House of Representatives and the Senate a report on the 
results of the study under subsection (a). 
SEC. 728. STUDY ON INFERTILITY AMONG MEMBERS OF 
THE ARMED FORCES. 
(a) STUDY.—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 study on the 
incidence of infertility among members of the Armed 
Forces, including the reserve components thereof. 
(b) MATTERS INCLUDED.—The study shall include 
the following: 
(1) The number of members of the Armed 
Forces serving as of the date of the study who are 
diagnosed with common causes of infertility, such as 
polycystic ovary syndrome, pelvic inflammatory dis-
ease, uterine fibroids, endometriosis, sexually trans-
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mitted disease, testicular disorders, and male endo-
crine disorders. 
(2) The number of members serving as of the 
date of the study whose infertility has no known 
cause. 
(3) The incidence of miscarriage among women 
members, listed by Armed Force and military occu-
pation. 
(4) A comparison of the rates of infertility and 
miscarriage in the Armed Forces to such rates in 
the civilian population, as reported by the Centers 
for Disease Control and Prevention. 
(5) Demographic information of the members 
described in paragraphs (1), (2), and (3), include 
with respect to race, ethnicity, sex, age, military oc-
cupation, and possible exposures during military 
service to hazardous elements such as chemical and 
biologic agents. 
(6) An assessment of the ease or delay for 
members in obtaining treatment for infertility, in-
cluding in vitro fertilization, including— 
(A) the wait times at each military medical 
treatment facility that has community partner-
ships to provide in vitro fertilization; 
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(B) the number of members described in 
paragraph (1) who are candidates for in vitro 
fertilization or other infertility treatments but 
cannot obtain such treatments because of the 
location at which the member is stationed or 
the duties of the member; and 
(C) a discussion of the reasons members 
cease seeking such treatments through the mili-
tary health system. 
(7) Criteria used by the Secretary to determine 
service connection for infertility, including whether 
screenings for levels of toxins are undertaken when 
the cause of infertility cannot be determined. 
(8) The policy of the Department of Defense, 
as of the date of the study, for ensuring geographic 
stability during treatment of women members under-
going in vitro fertilization for either service-con-
nected or non-service-connected infertility. 
SEC. 729. ALLOWING CLAIMS AGAINST THE UNITED STATES 
FOR INJURY AND DEATH OF MEMBERS OF 
THE ARMED FORCES CAUSED BY IMPROPER 
MEDICAL CARE. 
(a) IN GENERAL.—Chapter 171 of title 28, United 
States Code, is amended by adding at the end the fol-
lowing: 
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‘‘§ 2681. Claims against the United States for injury 
and death of members of the Armed 
Forces of the United States 
‘‘(a) A claim may be brought against the United 
States under this chapter for damages relating to the per-
sonal injury or death of a member of the Armed Forces 
of the United States arising out of a negligent or wrongful 
act or omission in the performance of medical, dental, or 
related health care functions (including clinical studies 
and investigations) that is provided at a covered military 
medical treatment facility by a person acting within the 
scope of the office or employment of that person by or 
at the direction of the Government of the United States. 
‘‘(b) A claim under this section shall not be reduced 
by the amount of any benefit received under subchapter 
III (relating to Servicemembers’ Group Life Insurance) of 
chapter 19 of title 38. 
‘‘(c) Notwithstanding section 2401(b), a claim 
brought under this section shall have a three-year statute 
of limitations beginning on the date the claimant discov-
ered or by reasonable diligence should have discovered the 
injury and the cause of the injury. 
‘‘(d) For purposes of claims brought under this sec-
tion— 
‘‘(1) subsections (j) and (k) of section 2680 do 
not apply; and 
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‘‘(2) in the case of an act or omission occurring 
outside the United States, the law of the place where 
the act or omission occurred shall be deemed to be 
the law of the State of domicile of the claimant. 
‘‘(e) In this section, the term ‘covered military med-
ical treatment facility’ means the facilities described in 
subsections (b), (c), and (d) of section 1073d of title 10, 
regardless of whether the facility is located in or outside 
the United States. The term does not include battalion 
aid stations or other medical treatment locations deployed 
in an area of armed conflict. 
‘‘(f) Not later than two years after the date of the 
enactment of this section, and every two years thereafter, 
the Secretary of Defense shall submit to Congress a report 
on the number of claims filed under this section.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
for chapter 171 of title 28, United States Code, is amend-
ed by adding at the end the following: 
‘‘2681. Claims against the United States for injury and death of members of 
the Armed Forces of the United States.’’. 
(c) EFFECTIVE DATE.—This Act and the amend-
ments made by this Act shall apply to— 
(1) a claim filed on or after the date of the en-
actment of this Act; and 
(2) a claim that— 
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(A) is pending as of the date of the enact-
ment of this Act; and 
(B) arises from an incident occurring not 
more than two years before the claim was filed. 
(d) RULE OF CONSTRUCTION.—Nothing in this Act 
or the amendments made by this Act shall be construed 
to limit the application of the administrative process and 
procedures of chapter 171 of title 28, United States Code, 
to claims permitted under section 2681 of such chapter, 
as amended by this section. 
SEC. 730. STUDY ON EXTENDING PARENT’S LEVEL OF 
TRICARE HEALTH COVERAGE TO NEWBORN 
CHILD. 
(a) STUDY.—The Secretary of Defense shall conduct 
a study on extending a parent’s level of TRICARE health 
coverage to the newborn child of the parent. 
(b) COORDINATION.—In conducting the study under 
subsection (a), the Secretary shall, with respect to mem-
bers of the Coast Guard, coordinate with the Secretary 
of the Department in which the Coast Guard is operating 
when it is not operating as a service in the Department 
of the Navy. 
(c) ELEMENTS.—In conducting the study under sub-
section (a), the Secretary shall study— 
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(1) the feasibility and the cost of automatically 
extending the parent’s level of TRICARE coverage 
to the newborn child for the remainder of the first 
year of the child’s life after the first 90 days; and 
(2) the current notification system for parents 
to change their children’s health care plan during 
the first 90 days of the newborn’s life. 
(d) SUBMISSION.—Not later than 120 days after the 
date of the enactment of this Act, the Secretary shall sub-
mit to the congressional defense committees a report on 
the study conducted under subsection (a). 
SEC. 731. REPORT ON GLOBAL HEALTH SECURITY STRAT-
EGY AND THE NATIONAL BIODEFENSE SECU-
RITY. 
(a) REPORT.—Not later than 180 days after the date 
on which the Comptroller General of the United States 
publishes a review of the National Biodefense Strategy, 
the Secretary of Defense shall submit to the appropriate 
congressional committees a report on the implementation 
of the Global Health Security Strategy and the National 
Biodefense Strategy. 
(b) ELEMENTS.—The report under subsection (a) 
shall, at a minimum— 
(1) designate the individual and offices respon-
sible for overseeing the implementation of each 
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strategy referred to in subsection (a) within the De-
partment of Defense; 
(2) detail actions that the Department is taking 
to support implementation of the Global Health Se-
curity Agenda; 
(3) detail actions taken to coordinate the efforts 
of the Department with the other agencies respon-
sible for the Global Health Security Strategy and 
National Biodefense Strategy; and 
(4) with respect to the review of the National 
Biodefense Strategy conducted by the Comptroller 
General— 
(A) detail the recommendations in the re-
view that the Secretary plans on or is currently 
implementing; 
(B) specify the official implementing such 
recommendations and the actions the official is 
taking to implement the recommendations; 
(C) specify the recommendations in the re-
view that the Secretary has determined not to 
implement; and 
(D) explain the rationale of the Secretary 
with respect to not implementing such rec-
ommendations. 
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(c) APPROPRIATE CONGRESSIONAL COMMITTEES DE-
FINED.—In this section, the term ‘‘appropriate congres-
sional committees’’ means— 
(1) the congressional defense committees; 
(2) the Committee on Foreign Affairs and the 
Committee on Energy and Commerce of the House 
of Representatives; and 
(3) the Committee on Foreign Relations and 
the Committee on Health, Education, Labor, and 
Pensions of the Senate. 
SEC. 732. REPORT ON MENTAL HEALTH ASSESSMENTS. 
(a) REPORT.—Not later than one year after the date 
of the enactment of this Act, the Comptroller General of 
the United States shall submit to the Committee on 
Armed Services and the Committee on Veterans’ Affairs 
of the Senate and the Committee on Armed Services and 
the Committee on Veterans’ Affairs of the House of Rep-
resentatives a publicly available report on the Department 
of Defense’s implementation section 1074n of title 10, 
United States Code. The report shall include the following: 
(1) An evaluation of the implementation of such 
section across the Armed Forces. 
(2) An evaluation of the efficacy of the mental 
health assessments under such section in helping to 
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identify mental health conditions among members of 
the Armed Forces in order to prevent suicide. 
(3) An evaluation of the tools and processes 
used to provide the annual mental health assess-
ments of members of the Armed Forces conducted 
pursuant to such section. 
(4) An analysis of how lessons learned from the 
annual mental health assessments can be used with-
in the Department of Veterans Affairs to prevent 
veteran suicide. 
(5) An analysis of potential policy options to 
improve the monitoring and reporting required and 
to achieve a more robust implementation of such 
section. 
(6) Such other information as the Comptroller 
General determines appropriate. 
(b) INTERIM BRIEFING.—Not later than March 1, 
2020, the Comptroller General shall provide to the Com-
mittee on Armed Services of the Senate and the Com-
mittee on Armed Services of the House of Representatives 
a briefing on the topics to be covered by the report under 
subsection (a), including and preliminary data and any 
issues or concerns of the Comptroller General relating to 
the report. 
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(c) ACCESS TO RELEVANT DATA.—For purposes of 
this section, the Secretary of Defense shall ensure that 
the Comptroller General has access to all relevant data. 
SEC. 733. STUDY AND REPORT ON MENTAL HEALTH AS-
SESSMENTS FOR MEMBERS OF THE ARMED 
FORCES DEPLOYED IN SUPPORT OF A CON-
TINGENCY OPERATION. 
(a) STUDY.—Each Secretary concerned, with respect 
to the military department concerned, shall conduct a 
study on the mental health assessments provided to mem-
bers of the Armed Forces deployed in connection with a 
contingency operation. 
(b) ELEMENTS.—The study under subsection (a) 
shall include a discussion and evaluation of the following: 
(1) The mental health assessments provided 
under section 1074m of title 10, United States 
Code, including any written guidance prescribed by 
the Secretary of Defense or the Secretaries con-
cerned with respect to such mental health assess-
ments. 
(2) The extent to which waivers for mental 
health assessments are granted by the Secretary of 
Defense under subsection (a)(2) and (a)(3) of such 
section (as amended by this Act), and the most com-
mon reasons why such waivers are granted. 
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(3) For each mental health assessment specified 
in subsection (a)(1) of such section, the effectiveness 
of such assessment with respect to the detection and 
initiation of treatment, when appropriate, of mem-
bers for behavioral health conditions. 
(4) With respect to a mental health assessment 
provided to members that is determined by the Sec-
retary concerned under paragraph (3) to have low 
effectiveness, the medical evidence supporting such 
determination. 
(5) The health impacts on members provided 
mental health assessments under such section, in-
cluding the extent to which such members— 
(A) are prescribed medication as a result 
of an assessment; 
(B) seek post-deployment treatment, other 
than treatment required under such section, for 
a behavioral health condition; and 
(C) commit suicide or engage in other 
harmful activities. 
(c) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, each Secretary concerned 
shall submit to the congressional defense committees a re-
port containing the results of the study conducted under 
subsection (a). 
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(d) SECRETARY CONCERNED.—In this section, the 
term ‘‘Secretary concerned’’ has the meaning given that 
term in section 101(a)(9) of title 10, United States Code. 
SEC. 734. EDUCATION ON FAMILY PLANNING FOR MEM-
BERS OF THE ARMED FORCES. 
(a) EDUCATION PROGRAMS.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, the Sec-
retary of Defense, in consultation with the Secretary 
of the Department in which the Coast Guard is op-
erating, shall establish a uniform standard cur-
riculum to be used in education programs on family 
planning for all members of the Armed Forces, in-
cluding both men and women members. Such edu-
cation programs shall be provided to members as fol-
lows: 
(A) During the first year of service of the 
member. 
(B) At such other times as each Secretary 
of a military department determines appro-
priate. 
(2) SENSE OF CONGRESS.—It is the sense of 
Congress that the education programs under para-
graph (1) should be evidence-informed and use the 
latest technology available to efficiently and effec-
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tively deliver information to members of the Armed 
Forces. 
(b) ELEMENTS.—The uniform standard curriculum 
under subsection (a) shall include the following: 
(1) Information for members of the Armed 
Forces on active duty to make informed decisions re-
garding family planning. 
(2) Information about the prevention of unin-
tended pregnancy and sexually transmitted infec-
tions, including human immunodeficiency virus 
(commonly known as ‘‘HIV’’). 
(3) Information on— 
(A) the importance of providing com-
prehensive family planning for members, includ-
ing commanding officers; and 
(B) the positive impact family planning 
can have on the health and readiness of the 
Armed Forces. 
(4) Current, medically accurate information. 
(5) Clear, user-friendly information on— 
(A) the full range of methods of contracep-
tion approved by the Food and Drug Adminis-
tration; and 
(B) where members can access their cho-
sen method of contraception. 
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(6) Information on all applicable laws and poli-
cies so that members are informed of their rights 
and obligations. 
(7) Information on patients’ rights to confiden-
tiality. 
(8) Information on the unique circumstances 
encountered by members and the effects of such cir-
cumstances on the use of contraception. 
SEC. 735. FUNDING FOR CDC ATSDR PFAS HEALTH STUDY 
INCREMENT. 
(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 the CDC ATSDR PFAS 
health study increment is hereby increased by $5,000,000. 
(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, Admin and Service-wide Activities, line 460, Of-
fice of the Secretary of Defense, as specified in the cor-
responding funding table in section 4301, is hereby re-
duced by $5,000,000. 
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SEC. 736. SENSE OF THE HOUSE OF REPRESENTATIVES ON 
INCREASING RESEARCH AND DEVELOPMENT 
IN BIOPRINTING AND FABRICATION IN AUS-
TERE MILITARY ENVIRONMENTS. 
It is the sense of the House of Representatives that 
the Defense Health Agency should take appropriate ac-
tions to increase efforts focused on research and develop-
ment in the areas of bioprinting and fabrication in austere 
military environments. 
SEC. 737. 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. 
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(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). 
(c) OFFSET.—Notwithstanding the amounts set forth 
in the funding tables in division D, the amount authorized 
to be appropriated for operation and maintenance, De-
fense-wide, as specified in the corresponding funding table 
in section 4301, for Operation and Maintenance, Defense- 
wide is hereby reduced by $10,000,000. 
SEC. 738. 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 for operation and maintenance, De-
fense-wide, as specified in the corresponding funding table 
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