SERVE Act
Bill: S.194 | Sponsor: Sen. Shaheen, Jeanne (D-NH)
Policy area: Armed Forces and National Security

Summary:
Supporting Eating Disorders Recovery Through Vital Expansion Act or the SERVE Act
This bill provides for inpatient and outpatient treatment of eating disorders under TRICARE for dependents of members of the uniformed services. Dependents are eligible for such care regardless of their age, except with respect to residential service.
The bill also requires the Department of Defense (DOD) and the Department of Homeland Security (with respect to the Coast Guard) to identify, treat, and rehabilitate members of the armed forces who have an eating disorder.
Finally, DOD and the Department of Veterans Affairs must jointly develop, publish, and disseminate clinical practice criteria and guidelines on the identification and treatment of eating disorders.

To amend title 10, United States Code, to provide treatment for eating 
     disorders for dependents of members of the uniformed services.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Supporting Eating Disorders Recovery 
Through Vital Expansion Act'' or the ``SERVE Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Eating disorders affect approximately 30,000,000 
        individuals in the United States, or nine percent of the 
        population, during their lifetime, including individuals from 
        every age, gender, body size, race, ethnicity, and 
        socioeconomic status.
            (2) Eating disorders are severe, biologically based mental 
        illnesses caused by a complex interaction of genetic, 
        biological, social, behavioral, and psychological factors.
            (3) Eating disorders result in the second highest case 
        fatality rate of any psychiatric illness, with one death every 
        52 minutes as a direct result of an eating disorder due to 
        serious medical comorbidities and suicide.
            (4) Untreated eating disorders cost the economy of the 
        United States $64,700,000,000 annually, with individuals and 
        their families experiencing an economic loss of $23,500,000,000 
        annually.
            (5) A study from the Armed Forces Health Surveillance 
        Branch found that diagnoses of eating disorders among military 
        personnel increased by 26 percent from 2013 to 2016.
            (6) Although accurate estimates are challenging due to 
        underreporting, the prevalence of eating disorders among 
        members of the Armed Forces is two to three times higher than 
        in the civilian population.
            (7) The Defense Health Board found that women members of 
        the Armed Forces on active duty experience high rates of eating 
        disorders, which can adversely affect the readiness and health 
        of such members.
            (8) Risk factors for eating disorders among members of the 
        Armed Forces include pressure to maintain weight and fitness 
        standards, trauma, sexual harassment, weight stigmatization, 
        and post-traumatic stress disorder.
            (9) Family members of members of the Armed Forces have a 
        higher prevalence of eating disorders than the general 
        population, with 21 percent of children and 26 percent of 
        spouses of members of the Armed Forces found to be at risk of 
        developing an eating disorder.
            (10) Research demonstrates a strong correlation in the risk 
        of developing an eating disorder between a military spouse and 
        their adolescent child. An adolescent female dependent of a 
        member of the Armed Forces is more likely to be at risk for an 
        eating disorder if their nonmilitary parent is at risk for an 
        eating disorder.

SEC. 3. TREATMENT FOR EATING DISORDERS FOR DEPENDENTS OF MEMBERS OF THE 
              UNIFORMED SERVICES.

    Section 1079 of title 10, United States Code, is amended--
            (1) in subsection (a), by adding at the end the following 
        new paragraph:
            ``(18) Treatment for an eating disorder may be provided in 
        accordance with subsection (r).''; and
            (2) by adding at the end the following new subsection:
    ``(r)(1) The provision of health care services for an eating 
disorder under subsection (a)(18) shall include treatment at facilities 
providing the following services:
            ``(A) Inpatient services, including residential services.
            ``(B) Outpatient services for in-person and telehealth 
        care, including--
                    ``(i) partial hospitalization services; and
                    ``(ii) intensive outpatient services.
    ``(2) A dependent may be provided health care services for an 
eating disorder under subsection (a)(18) without regard to the age of 
the dependent, except with respect to residential services under 
paragraph (1)(A), which may be provided only to a dependent who is not 
eligible for hospital insurance benefits under part A of title XVIII of 
the Social Security Act (42 U.S.C. 1395c et seq.).
    ``(3) In this section, the term `eating disorder' has the meaning 
given the term `feeding and eating disorders' in the Diagnostic and 
Statistical Manual of Mental Disorders, 5th Edition (or successor 
edition), published by the American Psychiatric Association.''.

SEC. 4. IDENTIFICATION AND TREATMENT OF EATING DISORDERS FOR MEMBERS OF 
              THE ARMED FORCES.

    (a) In General.--Section 1090 of title 10, United States Code, is 
amended--
            (1) by striking ``The Secretary of Defense'' and inserting 
        the following:
    ``(a) Identification and Treatment of Eating Disorders and Drug and 
Alcohol Dependence.--The Secretary of Defense'';
            (2) by inserting ``have an eating disorder or'' before 
        ``are dependent on drugs or alcohol'';
            (3) by adding at the end the following new subsections:
    ``(b) Facilities Available to Individuals With Eating Disorders.--
For purposes of this section, necessary facilities described in 
subsection (a) shall include the facilities described in section 
1079(r)(1) of this title.
    ``(c) Eating Disorder Defined.--In this section, the term `eating 
disorder' has the meaning given that term in section 1079(r)(3) of this 
title.''; and
            (4) in the section heading, by inserting ``eating disorders 
        and'' after ``treating''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 55 of such title is amended by striking the item relating to 
section 1090 and inserting the following new item:

``1090. Identifying and treating eating disorders and drug and alcohol 
                            dependence.''.

SEC. 5. CLINICAL PRACTICE CRITERIA AND GUIDELINES ON THE IDENTIFICATION 
              AND TREATMENT OF EATING DISORDERS.

    (a) In General.--Not later than two years after the date of the 
enactment of this Act, the Secretary of Defense and the Secretary of 
Veterans Affairs, in consultation with specialized stakeholders, shall 
jointly develop, publish, and disseminate clinical practice criteria 
and guidelines on the identification and treatment of eating disorders.
    (b) Inclusion of Recommendations and Guidelines.--The criteria and 
guidelines developed, published, and disseminated under subsection (a) 
shall include--
            (1) recommendations and guidelines established by, and any 
        guidance from, the Substance Abuse and Mental Health Services 
        Administration, the Centers for Disease Control and Prevention, 
        and the National Institute of Mental Health; and
            (2) clinical practice guidelines developed by specialized 
        nonprofit professional associations.
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