SERVE Act
Bill: H.R.1309 | Sponsor: Rep. Moulton, Seth (D-MA)
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 (1) their age, except with respect to residential service; and (2) whether the eating disorder is their primary or secondary diagnosis.
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 for eating disorders 
  treatment for members of the Armed Forces and certain dependents of 
  members and former members of the uniformed services, and for other 
                               purposes.

    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. EATING DISORDERS TREATMENT FOR CERTAIN MEMBERS OF THE ARMED 
              FORCES AND DEPENDENTS.

    (a) Findings.--Congress finds the following:
            (1) Eating disorders affect approximately 30,000,000 
        Americans (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 mental illness, with one death occurring 
        every 52 minutes as a direct result of an eating disorder due 
        to serious medical co-morbidities and suicide.
            (4) Untreated eating disorders cost the economy of the 
        United States $64.70 billion annually, with families and 
        individuals experiencing an economic loss of $23.50 billion 
        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. Although 
        accurate estimates are challenging due to underreporting, the 
        prevalence of eating disorders in the military is two to three 
        times higher than in the civilian population.
            (6) The Defense Health Board found that female members of 
        the Armed Forces on active duty experience high rates of eating 
        disorders, which can adversely affect their readiness and 
        health.
            (7) Risk factors for eating disorders in the military 
        include pressure to maintain weight and fitness standards, 
        trauma, sexual harassment, weight stigmatization, and post-
        traumatic stress disorder.
            (8) 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 at risk of 
        developing an eating disorder.
            (9) Research demonstrates a strong correlation between a 
        military spouse and their adolescent child's risk for an eating 
        disorder. Adolescent female military dependents are more likely 
        to be at risk for an eating disorder if their non-military 
        parent is at risk for an eating disorder.
    (b) Eating Disorders Treatment for Certain Dependents.--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 eating disorders 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 the following services:
            ``(A) Inpatient services, including residential services.
            ``(B) Outpatient services for in-person or telehealth care, 
        including partial hospitalization services and intensive 
        outpatient services.
    ``(2) A dependent may be provided health care services for an 
eating disorder under subsection (a)(18) without regard to--
            ``(A) the age of the dependent, except with respect to 
        residential services under paragraph (1)(B), 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.); and
            ``(B) whether the eating disorder is the primary or 
        secondary diagnosis of the dependent.
    ``(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.''.
    (c) Identification and Treatment of Eating Disorders for Members of 
the Armed Forces.--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''; and
            (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, with respect to individuals who have an 
eating disorder, facilities that provide the services specified 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.''.
    (d) Clinical Practice Guidelines and Criteria Relating to Eating 
Disorders.--
            (1) Guidelines and criteria.--Not later than two years 
        after the date of the enactment of this Act, the Secretary of 
        Defense and the Secretary of Veterans Affairs shall jointly 
        develop, publish, and disseminate clinical practice guidelines 
        and criteria for the identification and treatment of eating 
        disorders. Such guidelines shall be consistent with generally 
        accepted standards of care.
            (2) Consultation.--In carrying out subsection (a), the 
        Secretaries shall consult with, and incorporate into the 
        guidelines and criteria developed under such subsection the 
        recommendations and guidelines of, the following:
                    (A) The Administrator of the Substance Abuse and 
                Mental Health Services Administration.
                    (B) The Director of the Centers for Disease Control 
                and Prevention.
                    (C) The Director of the National Institute of 
                Mental Health.
                    (D) Nonprofit clinical specialty associations and 
                any other organizations or associations determined 
                relevant by the Secretaries.
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