H. R. 1585—477 
members under this section when that care is readily available 
at that Department facility and on a space-available basis. 
(2) REGULATIONS.—The Secretary of Veterans Affairs shall 
prescribe in regulations the medical care that may be available 
to family members under this subsection at medical facilities 
of the Department of Veterans Affairs. 
SEC. 1673. IMPROVEMENT OF MEDICAL TRACKING SYSTEM FOR MEM-
BERS OF THE ARMED FORCES DEPLOYED OVERSEAS. 
(a) PROTOCOL FOR ASSESSMENT OF COGNITIVE FUNCTIONING.— 
(1) PROTOCOL REQUIRED.—Subsection (b) of section 1074f 
of title 10, United States Code, is amended— 
(A) in paragraph (2), by adding at the end the following 
new subparagraph: 
‘‘(C) An assessment of post-traumatic stress disorder.’’; and 
(B) by adding at the end the following new paragraph: 
‘‘(3)(A) The Secretary shall establish for purposes of subpara-
graphs (B) and (C) of paragraph (2) a protocol for the predeployment 
assessment and documentation of the cognitive (including memory) 
functioning of a member who is deployed outside the United States 
in order to facilitate the assessment of the postdeployment cognitive 
(including memory) functioning of the member. 
‘‘(B) The protocol under subparagraph (A) shall include appro-
priate mechanisms to permit the differential diagnosis of traumatic 
brain injury in members returning from deployment in a combat 
zone.’’. 
(2) PILOT
PROJECTS.—(A) In developing the protocol 
required by paragraph (3) of section 1074f(b) of title 10, United 
States Code (as amended by paragraph (1) of this subsection), 
for purposes of assessments for traumatic brain injury, the 
Secretary of Defense shall conduct up to three pilot projects 
to evaluate various mechanisms for use in the protocol for 
such purposes. One of the mechanisms to be so evaluated 
shall be a computer-based assessment tool which shall, at a 
minimum, include the following: 
(i) Administration of computer-based neurocognitive 
assessment. 
(ii) 
Pre-deployment 
assessments 
to 
establish 
a 
neurocognitive baseline for members of the Armed Forces 
for future treatment. 
(B) Not later than 60 days after the completion of the 
pilot projects conducted under this paragraph, the Secretary 
shall submit to the appropriate committees of Congress a report 
on the pilot projects. The report shall include— 
(i) a description of the pilot projects so conducted; 
(ii) an assessment of the results of each such pilot 
project; and 
(iii) a description of any mechanisms evaluated under 
each such pilot project that will be incorporated into the 
protocol. 
(C) Not later than 180 days after completion of the pilot 
projects conducted under this paragraph, the Secretary shall 
establish a means for implementing any mechanism evaluated 
under such a pilot project that is selected for incorporation 
in the protocol.
H. R. 1585—478 
(b) QUALITY ASSURANCE.—Subsection (d)(2) of section 1074f 
of title 10, United States Code, is amended by adding at the end 
the following new subparagraph: 
‘‘(F) The diagnosis and treatment of traumatic brain injury 
and post-traumatic stress disorder.’’. 
(c) STANDARDS FOR DEPLOYMENT.—Subsection (f) of such section 
is amended— 
(1) in the subsection heading, by striking ‘‘MENTAL 
HEALTH’’; and 
(2) in paragraph (2)(B), by striking ‘‘or’’ and inserting ‘‘, 
traumatic brain injury, or’’. 
SEC. 1674. GUARANTEED FUNDING FOR WALTER REED ARMY MEDICAL 
CENTER, DISTRICT OF COLUMBIA. 
(a) MINIMUM FUNDING.—The amount of funds available for 
the commander of Walter Reed Army Medical Center, District of 
Columbia, for a fiscal year shall be not less than the amount 
expended by the commander of Walter Reed Army Medical Center 
in fiscal year 2006 until the first fiscal year beginning after the 
date on which the Secretary of Defense submits to the congressional 
defense committees a plan for the provision of health care for 
military beneficiaries and their dependents in the National Capital 
Region. 
(b) MATTERS COVERED.—The plan under subsection (a) shall 
at a minimum include— 
(1) the manner in which patients, staff, bed capacity, and 
functions will move from the Walter Reed Army Medical Center 
to expanded facilities; 
(2) a timeline, including milestones, for such moves; 
(3) projected budgets, including planned budget transfers, 
for military treatment facilities within the region; 
(4) the management or disposition of real property of mili-
tary treatment facilities within the region; and 
(5) staffing projections for the region. 
(c) CERTIFICATION.—After submission of the plan under sub-
section (a) to the congressional defense committees, the Secretary 
shall certify to such committees on a quarterly basis that patients, 
staff, bed capacity, functions, or parts of functions at Walter Reed 
Army Medical Center have not been moved or disestablished until 
the expanded facilities at the National Naval Medical Center, 
Bethesda, Maryland, and DeWitt Army Community Hospital, Fort 
Belvoir, Virginia, are completed, equipped, and staffed with suffi-
cient capacity to accept and provide, at a minimum, the same 
level of and access to care as patients received at Walter Reed 
Army Medical Center during fiscal year 2006. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘expanded facilities’’ means the other two 
military hospitals/medical centers within the National Capital 
Region, namely— 
(A) the National Naval Medical Center, Bethesda, 
Maryland (or its successor resulting from implementation 
of the recommendations of the 2005 Defense Base Closure 
and Realignment Commission); and 
(B) the DeWitt Army Community Hospital, Fort 
Belvoir, Virginia.
H. R. 1585—479 
(2) The term ‘‘National Capital Region’’ has the meaning 
given that term in section 2674(f) of title 10, United States 
Code. 
SEC. 1675. USE OF LEAVE TRANSFER PROGRAM BY WOUNDED VET-
ERANS WHO ARE FEDERAL EMPLOYEES. 
(a) IN GENERAL.—Section 6333(b) of title 5, United States Code, 
is amended— 
(1) by striking ‘‘(b)’’ and inserting ‘‘(b)(1)’’; and 
(2) by adding at the end the following new paragraph: 
‘‘(2)(A) The requirement under paragraph (1) relating to exhaus-
tion of annual and sick leave shall not apply in the case of a 
leave recipient who— 
‘‘(i) sustains a combat-related disability while a member 
of the armed forces, including a reserve component of the 
armed forces; and 
‘‘(ii) is undergoing medical treatment for that disability. 
‘‘(B) Subparagraph (A) shall apply to a member described in 
such subparagraph only so long as the member continues to undergo 
medical treatment for the disability, but in no event for longer 
than 5 years from the start of such treatment. 
‘‘(C) For purposes of this paragraph— 
‘‘(i) the term ‘combat-related disability’ has the meaning 
given such term by section 1413a(e) of title 10; and 
‘‘(ii) the term ‘medical treatment’ has such meaning as 
the Office of Personnel Management shall by regulation pre-
scribe.’’. 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 
shall take effect on the date of the enactment of this Act, except 
that, in the case of a leave recipient who is undergoing medical 
treatment on such date of enactment, section 6333(b)(2)(B) of title 
5, United States Code (as amended by this section) shall be applied 
as if it had been amended by inserting ‘‘or the date of the enactment 
of this subsection, whichever is later’’ after ‘‘the start of such 
treatment’’. 
SEC. 1676. MORATORIUM ON CONVERSION TO CONTRACTOR PERFORM-
ANCE OF DEPARTMENT OF DEFENSE FUNCTIONS AT MILI-
TARY MEDICAL FACILITIES. 
(a) MORATORIUM.—No study or competition may be begun or 
announced pursuant to section 2461 of title 10, United States 
Code, or otherwise pursuant to Office of Management and Budget 
circular A-76, relating to the possible conversion to performance 
by a contractor of any Department of Defense function carried 
out at a military medical facility until the Secretary of Defense— 
(1) submits the certification required by subsection (b) to 
the Committee on Armed Services of the Senate and the Com-
mittee on Armed Services of the House of Representatives 
together with a description of the steps taken by the Secretary 
in accordance with the certification; and 
(2) submits the report required by subsection (c). 
(b) CERTIFICATION.—The certification referred to in paragraph 
(a)(1) is a certification that the Secretary has taken appropriate 
steps to ensure that neither the quality of military medical care 
nor the availability of qualified personnel to carry out Department 
of Defense functions related to military medical care will be 
adversely affected by either—
H. R. 1585—480 
(1) the process of considering a Department of Defense 
function carried out at a military medical facility for possible 
conversion to performance by a contractor; or 
(2) the conversion of such a function to performance by 
a contractor. 
(c) REPORT REQUIRED.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Defense shall submit 
to the Committee on Armed Services of the Senate and the Com-
mittee on Armed Services of the House of Representatives a report 
on the public-private competitions being conducted for Department 
of Defense functions carried out at military medical facilities as 
of the date of the enactment of this Act by each military department 
and defense agency. Such report shall include— 
(1) for each such competition— 
(A) the cost of conducting the public-private competi-
tion; 
(B) the number of military personnel and civilian 
employees of the Department of Defense affected; 
(C) the estimated savings identified and the savings 
actually achieved; 
(D) an evaluation whether the anticipated and budg-
eted savings can be achieved through a public-private com-
petition; and 
(E) the effect of converting the performance of the 
function to performance by a contractor on the quality 
of the performance of the function; and 
(2) an assessment of whether any method of business 
reform or reengineering other than a public-private competition 
could, if implemented in the future, achieve any anticipated 
or budgeted savings. 
TITLE XVII—VETERANS MATTERS 
Sec. 1701. Sense of Congress on Department of Veterans Affairs efforts in the reha-
bilitation and reintegration of veterans with traumatic brain injury. 
Sec. 1702. Individual rehabilitation and community reintegration plans for vet-
erans and others with traumatic brain injury. 
Sec. 1703. Use of non-Department of Veterans Affairs facilities for implementation 
of rehabilitation and community reintegration plans for traumatic brain 
injury. 
Sec. 1704. Research, education, and clinical care program on traumatic brain in-
jury. 
Sec. 1705. Pilot program on assisted living services for veterans with traumatic 
brain injury. 
Sec. 1706. Provision of age-appropriate nursing home care. 
Sec. 1707. Extension of period of eligibility for health care for veterans of combat 
service during certain periods of hostilities and war. 
Sec. 1708. Service-connection and assessments for mental health conditions in vet-
erans. 
Sec. 1709. Modification of requirements for furnishing outpatient dental services to 
veterans with service-connected dental conditions or disabilities. 
Sec. 1710. Clarification of purpose of outreach services program of Department of 
Veterans Affairs. 
Sec. 1711. Designation of fiduciary or trustee for purposes of Traumatic 
Servicemembers’ Group Life Insurance. 
SEC. 1701. SENSE OF CONGRESS ON DEPARTMENT OF VETERANS 
AFFAIRS EFFORTS IN THE REHABILITATION AND RE-
INTEGRATION OF VETERANS WITH TRAUMATIC BRAIN 
INJURY. 
It is the sense of Congress that—
H. R. 1585—481 
(1) the Department of Veterans Affairs is a leader in the 
field of traumatic brain injury care and coordination of such 
care; 
(2) the Department of Veterans Affairs should have the 
capacity and expertise to provide veterans who have a trau-
matic brain injury with patient-centered health care, rehabilita-
tion, and community integration services that are comparable 
to or exceed similar care and services available to persons 
with such injuries in the academic and private sector; 
(3) rehabilitation for veterans who have a traumatic brain 
injury should be individualized, comprehensive, and inter-
disciplinary with the goals of optimizing the independence of 
such veterans and reintegrating them into their communities; 
(4) family support is integral to the rehabilitation and 
community reintegration of veterans who have sustained a 
traumatic brain injury, and the Department should provide 
the families of such veterans with education and support; 
(5) the Department of Defense and the Department of 
Veterans Affairs have made efforts to provide a smooth transi-
tion of medical care and rehabilitative services to individuals 
as they transition from the health care system of the Depart-
ment of Defense to that of the Department of Veterans Affairs, 
but more can be done to assist veterans and their families 
in the continuum of the rehabilitation, recovery, and reintegra-
tion of wounded or injured veterans into their communities; 
(6) in planning for rehabilitation and community reintegra-
tion of veterans who have a traumatic brain injury, it is nec-
essary for the Department of Veterans Affairs to provide a 
system for life-long case management for such veterans; and 
(7) in such system for life-long case management, it is 
necessary to conduct outreach and to tailor specialized trau-
matic brain injury case management and outreach to the unique 
needs of veterans with traumatic brain injury who reside in 
urban and non-urban settings. 
SEC. 1702. INDIVIDUAL REHABILITATION AND COMMUNITY RE-
INTEGRATION PLANS FOR VETERANS AND OTHERS WITH 
TRAUMATIC BRAIN INJURY. 
(a) IN GENERAL.—Subchapter II of chapter 17 of title 38, United 
States Code, is amended by inserting after section 1710B the fol-
lowing new sections: 
‘‘§ 1710C. Traumatic brain injury: plans for rehabilitation 
and reintegration into the community 
‘‘(a) PLAN REQUIRED.—The Secretary shall, for each individual 
who is a veteran or member of the Armed Forces who receives 
inpatient or outpatient rehabilitative hospital care or medical serv-
ices provided by the Department for a traumatic brain injury— 
‘‘(1) develop an individualized plan for the rehabilitation 
and reintegration of the individual into the community; and 
‘‘(2) provide such plan in writing to the individual— 
‘‘(A) in the case of an individual receiving inpatient 
care, before the individual is discharged from inpatient 
care or after the individual’s transition from serving on 
active duty as a member of the Armed Forces to receiving 
outpatient care provided by the Department; or
H. R. 1585—482 
‘‘(B) as soon as practicable following a diagnosis of 
traumatic brain injury by a Department health care pro-
vider. 
‘‘(b) CONTENTS OF PLAN.—Each plan developed under subsection 
(a) shall include, for the individual covered by such plan, the fol-
lowing: 
‘‘(1) Rehabilitation objectives for improving the physical, 
cognitive, and vocational functioning of the individual with 
the goal of maximizing the independence and reintegration 
of such individual into the community. 
‘‘(2) Access, as warranted, to all appropriate rehabilitative 
components of the traumatic brain injury continuum of care, 
and where appropriate, to long-term care services. 
‘‘(3) A description of specific rehabilitative treatments and 
other services to achieve the objectives described in paragraph 
(1), which shall set forth the type, frequency, duration, and 
location of such treatments and services. 
‘‘(4) The name of the case manager designated in accord-
ance with subsection (d) to be responsible for the implementa-
tion of such plan. 
‘‘(5) Dates on which the effectiveness of such plan will 
be reviewed in accordance with subsection (f). 
‘‘(c) COMPREHENSIVE ASSESSMENT.—(1) Each plan developed 
under subsection (a) shall be based on a comprehensive assessment, 
developed in accordance with paragraph (2), of— 
‘‘(A) the physical, cognitive, vocational, and neuropsycholog-
ical and social impairments of the individual; and 
‘‘(B) the family education and family support needs of the 
individual after the individual is discharged from inpatient 
care or at the commencement of and during the receipt of 
outpatient care and services. 
‘‘(2) The comprehensive assessment required under paragraph 
(1) with respect to an individual is a comprehensive assessment 
of the matters set forth in that paragraph by a team, composed 
by the Secretary for purposes of the assessment, of individuals 
with expertise in traumatic brain injury, including any of the fol-
lowing: 
‘‘(A) A neurologist. 
‘‘(B) A rehabilitation physician. 
‘‘(C) A social worker. 
‘‘(D) A neuropsychologist. 
‘‘(E) A physical therapist. 
‘‘(F) A vocational rehabilitation specialist. 
‘‘(G) An occupational therapist. 
‘‘(H) A speech language pathologist. 
‘‘(I) A rehabilitation nurse. 
‘‘(J) An educational therapist. 
‘‘(K) An audiologist. 
‘‘(L) A blind rehabilitation specialist. 
‘‘(M) A recreational therapist. 
‘‘(N) A low vision optometrist. 
‘‘(O) An orthotist or prosthetist. 
‘‘(P) An assistive technologist or rehabilitation engineer. 
‘‘(Q) An otolaryngology physician. 
‘‘(R) A dietician. 
‘‘(S) An opthamologist. 
‘‘(T) A psychiatrist.
H. R. 1585—483 
‘‘(d) CASE MANAGER.—(1) The Secretary shall designate a case 
manager for each individual described in subsection (a) to be respon-
sible for the implementation of the plan developed for that indi-
vidual under that subsection and the coordination of the individual’s 
medical care. 
‘‘(2) The Secretary shall ensure that each case manager has 
specific expertise in the care required by the individual for whom 
the case manager is designated, regardless of whether the case 
manager obtains such expertise through experience, education, or 
training. 
‘‘(e) PARTICIPATION AND COLLABORATION IN DEVELOPMENT OF 
PLANS.—(1) The Secretary shall involve each individual described 
in subsection (a), and the family or legal guardian of such indi-
vidual, in the development of the plan for such individual under 
that subsection to the maximum extent practicable. 
‘‘(2) The Secretary shall collaborate in the development of a 
plan for an individual under subsection (a) with a State protection 
and advocacy system if— 
‘‘(A) the individual covered by the plan requests such 
collaboration; or 
‘‘(B) in the case of such an individual who is incapacitated, 
the family or guardian of the individual requests such collabora-
tion. 
‘‘(3) In the case of a plan required by subsection (a) for a 
member of the Armed Forces who is serving on active duty, the 
Secretary shall collaborate with the Secretary of Defense in the 
development of such plan. 
‘‘(4) In developing vocational rehabilitation objectives required 
under subsection (b)(1) and in conducting the assessment required 
under subsection (c), the Secretary shall act through the Under 
Secretary for Health in coordination with the Vocational Rehabilita-
tion and Employment Service of the Department of Veterans Affairs. 
‘‘(f) EVALUATION.— 
‘‘(1) PERIODIC REVIEW BY SECRETARY.—The Secretary shall 
periodically review the effectiveness of each plan developed 
under subsection (a). The Secretary shall refine each such plan 
as the Secretary considers appropriate in light of such review. 
‘‘(2) REQUEST FOR REVIEW BY VETERANS.—In addition to 
the periodic review required by paragraph (1), the Secretary 
shall conduct a review of the plan for an individual under 
paragraph (1) at the request of the individual, or in the case 
of an individual who is incapacitated, at the request of the 
guardian or designee of the individual. 
‘‘(g) STATE DESIGNATED PROTECTION AND ADVOCACY SYSTEM 
DEFINED.—In this section, the term ‘State protection and advocacy 
system’ means a system established in a State under subtitle C 
of the Developmental Disabilities Assistance and Bill of Rights 
Act of 2000 (42 U.S.C. 15041 et seq.) to protect and advocate 
for the rights of persons with development disabilities. 
‘‘§ 1710D. Traumatic brain injury: comprehensive program 
for long-term rehabilitation 
‘‘(a) COMPREHENSIVE PROGRAM.—In developing plans for the 
rehabilitation and reintegration of individuals with traumatic brain 
injury under section 1710C of this title, the Secretary shall develop 
and carry out a comprehensive program of long-term care for post- 
acute traumatic brain injury rehabilitation that includes residential,