693 
SEC. 726. STUDY OF SUBSTANCE USE DISORDERS AMONG 
MEMBERS OF THE ARMED FORCES AND VET-
ERANS 
DURING 
THE 
COVID–19 
PUBLIC 
HEALTH EMERGENCY. 
(a) IN GENERAL.—The Secretaries shall conduct a 
study on substance use disorders among the relevant pop-
ulation before and during the COVID–19 public health 
emergency. The study shall include the following: 
(1) Analysis of data about the relevant popu-
lation who overdosed from opioids or other illicit 
substances during the public health emergency, 
using appropriate control samples and comparing to 
existing population data. 
(2) Analysis of fatal opioid and other illicit sub-
stances overdose deaths among the relevant popu-
lation during the public health emergency, using ap-
propriate control samples and comparing to existing 
population data. 
(3) Analysis of the prevalence of alcohol use 
disorder among the relevant population during the 
public health emergency, using existing data to iden-
tify any new trends. 
(4) Analysis of the association between overdose 
deaths and suicide among the relevant population. 
(5) An overview of the resources from relevant 
Federal agencies, including the Department of De-
694 
fense, the United States Department of Veterans Af-
fairs, the Substance Abuse and Mental Health Serv-
ices Administration, the Centers for Disease Control 
and Prevention, and the National Institutes of 
Health, that were distributed to the relevant popu-
lation during the public health emergency, including 
methods of dissemination. 
(6) An analysis of the utilization of recovery 
services and barriers to access the services at the 
Veterans Health Administration and the Military 
Health System by different modes of delivery, such 
as telehealth, inpatient, outpatient, intensive out-
patient, and residential services, during the public 
health emergency. 
(7) Identification of key areas in which relevant 
Federal agencies can improve their pandemic re-
sponse as it relates to substance use disorders and 
overdoses among the relevant population, including 
steps that can be taken to improve the preparedness 
of the agencies for future public health emergencies 
declared by the Secretary under section 319 of the 
Public Health Service Act. 
(b) REPORTS.— 
(1) INTERIM REPORT.—Within 120 days after 
the COVID–19 public health emergency ends, the
695 
Secretaries shall submit to the appropriate commit-
tees an interim report that contains an update on 
the status of the study required by subsection (a). 
(2) FINAL REPORT.—Not later than 2 years 
after the COVID–19 public health emergency ends, 
the Secretaries shall submit to the appropriate com-
mittees a final report that contains the results of the 
study. 
(c) DEFINITIONS.—In this section: 
(1) APPROPRIATE
COMMITTEES.—The term 
‘‘appropriate committees’’ means the Committee on 
Armed Services and the Committee on Veterans’ Af-
fairs of the House of Representatives and the Com-
mittee on Armed Services and the Committee on 
Veterans’ Affairs of the Senate. 
(2) COVID–19 PUBLIC HEALTH EMERGENCY.— 
The term ‘‘COVID–19 public health emergency’’ 
means the public health emergency declared by the 
Secretary of Health and Human Services on Janu-
ary 27, 2020, with respect to the 2019 Novel 
Coronavirus. 
(3) RELEVANT POPULATION.—The term ‘‘rel-
evant population’’ means members of the Armed 
Forces and veterans.
696 
(4) SECRETARIES.—The term ‘‘Secretaries’’ 
means the Secretary of Defense and the Secretary of 
Veterans Affairs. 
Subtitle D—Reports and Other 
Matters 
SEC. 731. MODIFICATIONS TO PILOT PROGRAM ON CIVIL-
IAN AND MILITARY PARTNERSHIPS TO EN-
HANCE INTEROPERABILITY AND MEDICAL 
SURGE CAPABILITY AND CAPACITY OF NA-
TIONAL DISASTER MEDICAL SYSTEM. 
Section 740 of the National Defense Authorization 
Act for Fiscal Year 2020 (Public Law 116–92) is amend-
ed— 
(1) in subsection (a)— 
(A) by striking ‘‘The Secretary of Defense 
may’’ and inserting ‘‘Beginning not later than 
180 days after the date of the enactment of the 
National Defense Authorization Act for Fiscal 
Year 2021, the Secretary of Defense shall’’; and 
(B) by striking ‘‘and the Secretary of 
Transportation’’ and inserting ‘‘the Secretary of 
Transportation, and the Administrator of the 
Federal Emergency Management Agency’’; 
(2) in subsection (d), by striking ‘‘and the Sec-
retary of Transportation’’ and inserting ‘‘the Sec-
697 
retary of Transportation, and the Administrator of 
the Federal Emergency Management Agency’’; and 
(3) in subsection (f)— 
(A) by striking ‘‘the Committees on Armed 
Services of the Senate and the House of Rep-
resentatives’’ each place it appears and insert-
ing ‘‘the appropriate congressional committees’’; 
(B) in paragraph (1)(B)(i), by inserting 
before the period the following: ‘‘, including a 
recommendation for at least one of the locations 
selected under subsection (c)’’; and 
(C) by adding at the end the following new 
paragraph: 
‘‘(3) APPROPRIATE
CONGRESSIONAL
COMMIT-
TEES DEFINED.—In this subsection, the term ‘ap-
propriate congressional committees’ means the fol-
lowing: 
‘‘(A) The Committee on Armed Services, 
the Committee on Transportation and Infra-
structure, the Committee on Veterans’ Affairs, 
the Committee on Homeland Security, and the 
Committee on Energy and Commerce of the 
House of Representatives. 
‘‘(B) The Committee on Armed Services, 
the Committee on Commerce, Science, and
698 
Transportation, the Committee on Veterans’ Af-
fairs, the Committee on Homeland Security and 
Governmental Affairs, and the Committee on 
Health, Education, Labor, and Pensions of the 
Senate.’’. 
SEC. 732. REPORTS ON SUICIDE AMONG MEMBERS OF THE 
ARMED FORCES AND SUICIDE PREVENTION 
PROGRAMS AND ACTIVITIES OF THE DEPART-
MENT OF DEFENSE. 
Section 741(a)(2) of the National Defense Authoriza-
tion Act for Fiscal Year 2020 (Public Law 116–92; 133 
Stat. 1467) is amended— 
(1) in subparagraph (B), by adding at the end 
the following new clause: 
‘‘(iii) The 1-year period following the 
date on which the member returns from 
such a deployment.’’; 
(2) 
by 
redesignating 
subparagraphs 
(D) 
through (H) as subparagraphs (E) through (I), re-
spectively; 
(3) by inserting after subparagraph (C) the fol-
lowing new subparagraph (D): 
‘‘(D) The number of suicides involving a 
member who was prescribed a medication to 
treat a mental health or behavioral health diag-
699 
nosis during the 1-year period preceding the 
death.’’; and 
(4) by adding at the end the following new sub-
paragraph: 
‘‘(J) A description of the programs carried 
out by the military departments to address and 
reduce the stigma associated with seeking as-
sistance 
for 
mental 
health 
or 
suicidal 
thoughts.’’. 
SEC. 733. CLARIFICATION OF RESEARCH UNDER JOINT 
TRAUMA EDUCATION AND TRAINING DIREC-
TORATE 
AND 
INCLUSION 
OF 
MILITARY 
WORKING DOGS. 
(a) IN GENERAL.—Subsection (b) of section 708 of 
the National Defense Authorization Act for Fiscal Year 
2017 (Public Law 114–328; 10 U.S.C. 1071 note) is 
amended— 
(1) in paragraph (7), by striking ‘‘of members 
of the Armed Forces’’ and inserting ‘‘with respect to 
both members of the Armed Forces and military 
working dogs’’; and 
(2) by striking paragraph (9) and inserting the 
following new paragraph: 
‘‘(9) To inform and advise the conduct of re-
search on the leading causes of morbidity and mor-
700 
tality of members of the Armed Forces and military 
working dogs in combat.’’. 
(b) VETERINARIANS IN PERSONNEL MANAGEMENT 
PLAN.—Subsection (d)(1) of such section is amended— 
(1) by redesignating subparagraph (F) as sub-
paragraph (G); and 
(2) by inserting after subparagraph (E) the fol-
lowing new subparagraph: 
‘‘(F) Veterinary care.’’. 
SEC. 734. EXTENSION OF THE JOINT DEPARTMENT OF DE-
FENSE-DEPARTMENT OF VETERANS AFFAIRS 
MEDICAL 
FACILITY 
DEMONSTRATION 
PROJECT. 
Section 1704(e) of the National Defense Authoriza-
tion Act for Fiscal Year 2010 (Public Law 111–84; 123 
Stat. 2567), as most recently amended by section 732 of 
the National Defense Authorization Act for Fiscal Year 
2020 (Public Law 116–92), is further amended by strik-
ing ‘‘September 30, 2021’’ and inserting ‘‘September 30, 
2023’’. 
SEC. 735. INFORMATION SHARING BY SECRETARY OF DE-
FENSE REGARDING PREVENTION OF INFANT 
AND MATERNAL MORTALITY. 
(a) AUTHORIZATION OF INFORMATION SHARING.— 
The Secretary of Defense may enter into memoranda of
701 
understanding with State and local health authorities to 
share the practices of, and lessons learned by, the military 
health system for the prevention of infant and maternal 
mortality. 
(b) STATE DEFINED.—In this section, the term 
‘‘State’’ means each State, the District of Columbia, each 
commonwealth, territory or possession of the United 
States, and each federally recognized Indian Tribe. 
SEC. 736. GRANT PROGRAM FOR INCREASED COOPERA-
TION 
ON 
POST-TRAUMATIC 
STRESS 
DIS-
ORDER RESEARCH BETWEEN UNITED STATES 
AND ISRAEL. 
(a) SENSE OF CONGRESS.—It is the sense of Con-
gress that the Secretary of Defense, acting through the 
Psychological Health and Traumatic Brain Injury Re-
search Program, should seek to explore scientific collabo-
ration between American academic institutions and non-
profit research entities, and Israeli institutions with exper-
tise in researching, diagnosing, and treating post-trau-
matic stress disorder. 
(b) GRANT PROGRAM.—The Secretary of Defense, in 
coordination with the Secretary of Veterans Affairs and 
the Secretary of State, shall award grants to eligible enti-
ties to carry out collaborative research between the United 
States and Israel with respect to post-traumatic stress dis-
702 
orders. The Secretary of Defense shall carry out the grant 
program under this section in accordance with the agree-
ment titled ‘‘Agreement Between the Government of the 
United States of America and the Government of Israel 
on the United States-Israel Binational Science Founda-
tion’’, dated September 27, 1972. 
(c) ELIGIBLE ENTITIES.—To be eligible to receive a 
grant under this section, an entity shall be an academic 
institution or a nonprofit entity located in the United 
States. 
(d) AWARD.—The Secretary shall award grants 
under this section to eligible entities that— 
(1) carry out a research project that— 
(A) addresses a requirement in the area of 
post-traumatic stress disorders that the Sec-
retary determines appropriate to research using 
such grant; and 
(B) is conducted by the eligible entity and 
an entity in Israel under a joint research agree-
ment; and 
(2) meet such other criteria that the Secretary 
may establish. 
(e) APPLICATION.—To be eligible to receive a grant 
under this section, an eligible entity shall submit an appli-
cation to the Secretary at such time, in such manner, and
703 
containing such commitments and information as the Sec-
retary may require. 
(f) GIFT AUTHORITY.—The Secretary may accept, 
hold, and administer, any gift of money made on the con-
dition that the gift be used for the purpose of the grant 
program under this section. Such gifts of money accepted 
under this subsection shall be deposited in the Treasury 
in the Department of Defense General Gift Fund and shall 
be available, subject to appropriation, without fiscal year 
limitation. 
(g) REPORTS.—Not later than 180 days after the 
date on which an eligible entity completes a research 
project using a grant under this section, the Secretary 
shall submit to Congress a report that contains— 
(1) a description of how the eligible entity used 
the grant; and 
(2) an evaluation of the level of success of the 
research project. 
(h) TERMINATION.—The authority to award grants 
under this section shall terminate on the date that is 7 
years after the date on which the first such grant is 
awarded.
704 
SEC. 737. 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 1 year after the retirement, 
separation, or release of the member from the 
Armed Forces. 
(2) 
CONTINUED
CRYOPRESERVATION
AND 
STORAGE.—At the end of the 1-year period specified 
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:
705 
(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 1- 
year period specified in paragraph (1) with re-
spect to the individual. 
(c) ADVANCE MEDICAL DIRECTIVE AND MILITARY 
TESTAMENTARY INSTRUMENT.—A member of the Armed 
Forces who elects to cryopreserve and store their gametes 
under this section shall complete an advance medical di-
rective described in section 1044c(b) of title 10, United 
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
706 
that provide cryopreservation and storage services for 
gametes. 
SEC. 738. PILOT PROGRAM ON PARENTS SERVING AS CER-
TIFIED NURSING ASSISTANTS FOR CHILDREN 
UNDER TRICARE PROGRAM. 
(a) PILOT PROGRAM.—The Director of the Defense 
Health Agency may carry out a pilot program under which 
an eligible parent serves as a certified nursing assistant 
under the TRICARE program with respect to providing 
personal care services to a covered child. 
(b) DURATION.—If the Director carries out the pilot 
program under subsection (a), the Director shall carry out 
the pilot program for a period of 18 months. 
(c) BRIEFING.—If the Director carries out the pilot 
program under subsection (a), not later than 1 year after 
the date of the enactment of this Act, the Director shall 
provide to the congressional defense committees a briefing 
on the pilot program. 
(d) REPORT.—If the Director carries out the pilot 
program under subsection (a), not later than 180 days 
after the date of the completion of the pilot program, the 
Director shall submit to the congressional defense commit-
tees a report on the pilot program. The report shall in-
clude— 
(1) the cost of the program;
707 
(2) an analysis of whether the pilot program 
met established performance metrics; 
(3) an analysis of whether the pilot program 
provided the standard of care to the patient that is 
required; and 
(4) the recommendation of the Director regard-
ing whether the pilot program should be made per-
manent. 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘covered child’’ means a covered 
beneficiary described in section 1072(2)(D) of title 
10, United States Code, who— 
(A) is the child of a member of the uni-
formed services serving on active duty; and 
(B) is eligible for private duty nursing 
under the Extended Care Health Option under 
subsections (d) through (f) of section 1079 of 
such title. 
(2) The term ‘‘eligible parent’’ means an indi-
vidual who is— 
(A) a certified nursing assistant; and 
(B) the parent of a covered child. 
(3) The term ‘‘personal care services’’ means 
personal care services prescribed by a medical doctor 
and provided by a certified nursing assistant under
708 
the supervision and guidance of a registered nurse 
case manager. 
(4) The term ‘‘TRICARE program’’ has the 
meaning given that term in section 1072 of title 10, 
United States Code. 
SEC. 739. STUDY ON INCIDENCE OF CANCER DIAGNOSIS 
AND MORTALITY AMONG PILOTS IN THE 
ARMED FORCES. 
(a) STUDY.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Defense 
shall seek to enter into an agreement with the National 
Academies of Sciences, Engineering, and Medicine to con-
duct a study to— 
(1) determine the incidence of cancer diagnosis 
and mortality among members, and former mem-
bers, of the Armed Forces who serve as pilots com-
pared to such members who do not serve as pilots, 
including by determining such incidence based on 
gender, age, flying hours, Armed Force, and type of 
aircraft; and 
(2) determine the appropriate age to begin 
screening such members for cancer, including by de-
termining such age based on gender, flying hours, 
Armed Force, and type of aircraft.
709 
(b) SUBMISSION.—Not later than 2 years after the 
date on which the Secretary enters into the agreement 
under subsection (a), the Secretary shall submit to the ap-
propriate congressional committees a report on the find-
ings from the study under such subsection. 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘appropriate congressional com-
mittees’’ means— 
(A) the Committees on Armed Services 
and Veterans’ Affairs of the House of Rep-
resentatives; and 
(B) the Committees on Armed Services 
and Veterans’ Affairs of the Senate. 
(2) The term ‘‘Armed Forces’’ means each 
Armed Force under the jurisdiction of the Secretary 
of a military department. 
(3) The term ‘‘pilot’’ includes an individual who 
frequently accompanies a pilot in a cockpit, such as 
a navigator. 
SEC. 740. REPORT ON DIET AND NUTRITION OF MEMBERS 
OF THE ARMED FORCES. 
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 on the
710 
diet and nutrition of members of the Armed Forces. The 
report shall describe the following: 
(1) The relationship between the diet and nutri-
tion of members and the health, performance, and 
combat effectiveness of members. 
(2) The relationship between diets high in 
Omega–3 fatty acids, or other diets that may lower 
inflammation and obesity, and improved mental 
health. 
(3) The extent to which the food and beverages 
offered at the dining halls of the Armed Forces as 
of the date of the report are designed to optimize 
the health, performance, and combat effectiveness of 
members according to science-based approaches. 
(4) The plan of the Secretary to improve the 
health, performance, and combat effectiveness of 
members by modifying the food and beverages of-
fered at the dining halls of the Armed Forces, in-
cluding in ways that minimize the change members. 
(5) Expected costs and timeline to implement 
such plan, including any expected savings from re-
duced medical costs.
711 
SEC. 741. REPORT ON COSTS AND BENEFITS OF ALLOWING 
RETIRED MEMBERS OF THE ARMED FORCES 
TO CONTRIBUTE TO HEALTH SAVINGS AC-
COUNTS. 
(a) REPORT.—Not later than 180 days after the date 
of the enactment of this Act, the Assistant Secretary of 
Defense for Health Affairs shall submit to the congres-
sional defense committees a report on the costs and bene-
fits of allowing covered individuals to make contributions 
to a health savings account. 
(b) MATTERS.—The report under subsection (a) shall 
include a description of the following: 
(1) Any anticipated cost savings as a result of 
allowing covered individuals to make contributions to 
health savings accounts. 
(2) Any anticipated increase in health care op-
tions available to covered individuals as a result of 
allowing such contributions. 
(3) Any anticipated disruption or delay in 
health services or benefits for covered individuals as 
a result of allowing such contributions. 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘covered individual’’— 
(A) means a beneficiary covered by sub-
section (c) of section 1086 of title 10, United 
States Code; and
712 
(B) includes a Medicare-eligible beneficiary 
described in subsection (d)(2) of such section. 
(2) The term ‘‘health savings account’’ has the 
meaning given that term in section 223(d) of the In-
ternal Revenue Code of 1986. 
SEC. 
742. 
STUDY 
ON 
TOXIC 
EXPOSURE 
AT 
KARSHI– 
KHANABAD AIR BASE, UZBEKISTAN. 
(a) STUDY.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall conduct a study on toxic exposure by members 
of the Armed Forces deployed to Karshi–Khanabad 
Air Base, Uzbekistan, at any time during the period 
beginning October 1, 2001, and ending December 
31, 2005. 
(2) MATTERS
INCLUDED.—The study under 
paragraph (1) shall include the following: 
(A) An assessment regarding the condi-
tions of Karshi–Khanabad Air Base, Uzbek-
istan, during the period beginning October 1, 
2001, and ending December 31, 2005, includ-
ing an identification of toxic substances con-
taminating the Air Base during such period. 
(B) An epidemiological study of the health 
consequences of a member of the Armed Forces 
deployed to the Air Base during such period.
713 
(C) An assessment of any association be-
tween exposure to toxic substances identified 
under subparagraph (A) and the health con-
sequences studied under subparagraph (B). 
(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. 743. AUDIT OF MEDICAL CONDITIONS OF TENANTS IN 
PRIVATIZED MILITARY HOUSING. 
(a) IN GENERAL.—Not later than 90 days after the 
date of the enactment of this Act, the Inspector General 
of the Department of Defense shall commence the conduct 
of an audit of the medical conditions of eligible individuals 
and the association between adverse exposures of such in-
dividuals in unsafe or unhealthy housing units and the 
health of such individuals. 
(b) CONTENT
OF AUDIT.—The audit conducted 
under subsection (a) shall— 
(1) determine the percentage of units of 
privatized military housing that are unsafe or 
unhealthy housing units; 
(2) study the adverse exposures of eligible indi-
viduals that relate to residing in an unsafe or
714 
unhealthy housing unit and the effect of such expo-
sures on the health of such individuals; and 
(3) determine the association, to the extent per-
mitted by available scientific data, and provide quan-
tifiable data on such association, between such ad-
verse exposures and the occurrence of a medical con-
dition in eligible individuals residing in unsafe or 
unhealthy housing units. 
(c) CONDUCT OF AUDIT.—The Inspector General of 
the Department shall conduct the audit under subsection 
(a) using the same privacy preserving guidelines used by 
the Inspector General in conducting other audits of health 
records. 
(d) SOURCE
OF DATA.—In conducting the audit 
under subsection (a), the Inspector General of the Depart-
ment shall use— 
(1) de-identified data from electronic health 
records of the Department; 
(2) records of claims under the TRICARE pro-
gram (as defined in section 1072(7) of title 10, 
United States Code); and 
(3) such other data as determined necessary by 
the Inspector General. 
(e) SUBMITTAL AND PUBLIC AVAILABILITY OF RE-
PORT.—Not later than 1 year after the commencement of
715 
the audit under subsection (a), the Inspector General of 
the Department shall— 
(1) submit to the Secretary of Defense and the 
Committees on Armed Services of the Senate and 
the House of Representatives a report on the results 
of the audit conducted under subsection (a); and 
(2) publish such report on a publicly available 
internet website of the Department of Defense. 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘eligible individual’’ means a 
member of the Armed Forces or a family member of 
a member of the Armed Forces who— 
(A) has resided in an unsafe or unhealthy 
housing unit; and 
(B) has registered under the Housing En-
vironmental Health Response Registry of the 
Army. 
(2) The term ‘‘privatized military housing’’ 
means military housing provided under subchapter 
IV of chapter 169 of title 10, United States Code. 
(3) The term ‘‘unsafe or unhealthy housing 
unit’’ means a unit of privatized military housing in 
which, at any given time, at least one of the fol-
lowing hazards is present:
716 
(A) Physiological hazards, including the 
following: 
(i) Dampness or microbial growth. 
(ii) Lead-based paint. 
(iii) Asbestos or manmade fibers. 
(iv) Ionizing radiation. 
(v) Biocides. 
(vi) Carbon monoxide. 
(vii) Volatile organic compounds. 
(viii) Infectious agents. 
(ix) Fine particulate matter. 
(B) Psychological hazards, including ease 
of access by unlawful intruders or lighting 
issues. 
(C) Poor ventilation. 
(D) Safety hazards. 
(E) Other hazards as determined by the 
Inspector General of the Department. 
SEC. 744. REPORT ON INTEGRATED DISABILITY EVALUA-
TION SYSTEM. 
(a) IN GENERAL.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary of Defense 
shall submit to Congress a report on the findings of a 
study, conducted by the Secretary for the purposes of the
717 
report, of the implementation and application of the Inte-
grated Disability Evaluation System. 
(b) MATTERS INCLUDED.—The report under sub-
section (a) shall include the following: 
(1) All changes to policies and procedures appli-
cable to the implementation of the Integrated Dis-
ability Evaluation System from the previous dis-
ability evaluation system. 
(2) The extent to which the Integrated Dis-
ability Evaluation System is the primary means of 
processing members of the Armed Forces through 
the disability evaluation system process. 
(3) The extent to which the military depart-
ments and the Defense Health Agency coordinate— 
(A) treatment of members of the Armed 
Forces; 
(B) referrals of members of the Armed 
Forces to a medical evaluation board; 
(C) appointing a convening authority and 
staffing a medical evaluation board; 
(D) the sharing of medical documentation 
with a medical evaluation board; 
(E) evaluations of members of the Armed 
Forces for initial or subsequent limited duty 
status; and
718 
(F) a medical evaluation board referral to 
a physical evaluation board. 
(4) The process for members of the Armed 
Forces to request an impartial medical review or 
rebut medical evaluation board findings. 
(5) The criteria a medical evaluation board con-
vening authority applies when considering such re-
quests under paragraph (4). 
(6) The average time to process Integrated Dis-
ability Evaluation System cases by both phase and 
stage (as defined in Department of Defense Manual 
1332.18) for both the active component and reserve 
component. 
SEC. 745. REVIEW AND REPORT ON PREVENTION OF SUI-
CIDE AMONG MEMBERS OF THE ARMED 
FORCES STATIONED AT REMOTE INSTALLA-
TIONS OUTSIDE THE CONTIGUOUS UNITED 
STATES. 
(a) REVIEW REQUIRED.—The Comptroller General 
of the United States shall conduct a review of efforts by 
the Department of Defense to prevent suicide among 
members of the Armed Forces stationed at covered instal-
lations.
719 
(b) ELEMENTS OF REVIEW.—The review conducted 
under subsection (a) shall include an assessment of each 
of the following: 
(1) Current policy guidelines of the Armed 
Forces on the prevention of suicide among members 
of the Armed Forces stationed at covered installa-
tions. 
(2) Current suicide prevention programs of the 
Armed Forces and activities for members of the 
Armed Forces stationed at covered installations and 
their dependents, including programs provided by 
the Defense Health Program and the Office of Sui-
cide Prevention. 
(3) The integration of mental health screenings 
and suicide risk and prevention efforts for members 
of the Armed Forces stationed at covered installa-
tions and their dependents into the delivery of pri-
mary care for such members and dependents. 
(4) The standards for responding to attempted 
or completed suicides among members of the Armed 
Forces stationed at covered installations and their 
dependents, including guidance and training to as-
sist commanders in addressing incidents of at-
tempted or completed suicide within their units.
720 
(5) The standards regarding data collection for 
members of the Armed Forces stationed at covered 
installations and their dependents, including related 
factors such as domestic violence and child abuse. 
(6) The means to ensure the protection of pri-
vacy of members of the Armed Forces stationed at 
covered installations and their dependents who seek 
or receive treatment related to suicide prevention. 
(7) The availability of information from indige-
nous populations on suicide prevention for members 
of the Armed Forces stationed at covered installa-
tions who are members of such a population. 
(8) The availability of information from grad-
uate research programs of institutions of higher edu-
cation on suicide prevention for members of the 
Armed Forces. 
(9) Such other matters as the Comptroller Gen-
eral considers appropriate in connection with the 
prevention of suicide among members of the Armed 
Forces stationed at covered installations and their 
dependents. 
(c) BRIEFING AND REPORT.—The Comptroller Gen-
eral shall— 
(1) not later than October 1, 2021, brief the 
Committees on Armed Services of the Senate and
721 
the House of Representatives on preliminary obser-
vations relating to the review conducted under sub-
section (a); and 
(2) not later than March 1, 2022, submit to the 
Committees on Armed Services of the Senate and 
the House of Representatives a report containing the 
results of such review. 
(d) COVERED INSTALLATION DEFINED.—In this sec-
tion, the term ‘‘covered installation’’ means a remote in-
stallation of the Department of Defense outside the con-
tiguous United States. 
SEC. 746. ANTIMICROBIAL STEWARDSHIP STAFFING AT 
MEDICAL TREATMENT FACILITIES OF THE 
DEPARTMENT OF DEFENSE. 
(a) DEVELOPMENT
OF RECOMMENDATIONS.—Not 
later than 90 days after the date of the enactment of this 
Act, the Secretary of Defense, in consultation with the 
Centers for Disease Control and Prevention and relevant 
medical societies, shall develop for its military medical 
treatment facilities— 
(1) 
stewardship 
staffing 
recommendations, 
based upon facility size and patient populations; and 
(2) diagnostics stewardship recommendations to 
improve antimicrobial stewardship programs.
873 
‘‘(B) requiring the small business concern 
to inform the contracting officer what duties 
and responsibilities the small business concern 
carried out as part of the joint venture.’’. 
(b) PAST PERFORMANCE RATINGS OF FIRST-TIER 
SMALL BUSINESS SUBCONTRACTORS.—Section 8(d)(17) 
of the Small Business Act (15 U.S.C. 637(d)(17)) is 
amended to read as follows: 
‘‘(17) PAST PERFORMANCE RATINGS FOR CER-
TAIN SMALL BUSINESS SUBCONTRACTORS.— 
‘‘(A) IN
GENERAL.—Upon request by a 
small business concern that performed as a first 
tier subcontractor on a covered contract (as de-
fined in paragraph 13(A)) that is submitting an 
offer for a solicitation, the prime contractor for 
such covered contract shall submit to the con-
tracting agency issuing the solicitation or to 
such small business concern a record of past 
performance for such small business concern 
with respect to such covered contract. 
‘‘(B) CONSIDERATION.—A contracting offi-
cer shall consider the record of past perform-
ance of a small business concern provided under 
subparagraph (A) when evaluating an offer for