II 118th CONGRESS 2d Session S. 4415 IN THE SENATE OF THE UNITED STATES May 23, 2024 Ms. Duckworth introduced the following bill; which was read twice and referred to the Committee on Armed Services A BILL To require the Secretary of Defense to establish a medical readiness program in the Indo-Pacific region, and for other purposes.

1. Short title This Act may be cited as the Access to Care for Overseas Military Act . 2. Medical readiness program of Department of Defense in Indo-Pacific region (a) Establishment (1) In general Not later than January 1, 2027, the Secretary of Defense shall establish a medical readiness program (referred to in this section as the Program ) to develop relationships with partner nations in the Indo-Pacific region and to facilitate engagement designed to improve medical care during peacetime and wartime and maintain strategies and policies of the Department of Defense for medical readiness in that region. (2) Organization The Secretary of Defense shall be responsible for and oversee the Program in consultation with the Secretary of each military department, the commanders of the combatant commands, the Director of the Defense Health Agency, and any other official the Secretary of Defense considers appropriate. (3) Objectives The objectives of the Program shall be to promote the medical readiness of the Armed Forces for missions during peacetime and wartime operations by— (A) reducing potential requirements for long-distance medical evacuation to receive definitive patient care in the Indo-Pacific region; (B) managing the patient medical evacuation enterprise during contingency operations, including planning, policies, resourcing, and coordination; (C) increasing the medical capacity and capabilities of the Department of Defense by expanding, where and when appropriate, patient access to public, private, and military foreign medical treatment facilities and foreign medical providers across the Indo-Pacific region; (D) in collaboration with partner nations, improving the standard of medical care by either— (i) accrediting foreign medical treatment facilities, which will standardize medical procedures, patient care, and policies similar to military medical treatment facilities of the Department of Defense; or (ii) developing standardized procedures for medical procedures, patient care, and policies when using foreign medical treatment facilities; and (E) enhancing and promoting interoperability and interchangeability, wherever feasible, through shared patient record management techniques, medical equipment commonality, and coordination of medical care. (4) Activities In carrying out the Program, the Secretary of Defense shall seek to conduct the following activities: (A) Assess and integrate current medical capabilities and capacities of the Department of Defense in the Indo-Pacific region into the Program. (B) Select a lead to coordinate the Program and activities associated with the functions of the Program. (C) Select an appropriate accreditation organization to either— (i) accredit a public, private, or military foreign medical treatment facility; or (ii) provide technical expertise to develop standardization procedures for medical procedures, patient care, and policies when using foreign medical treatment facilities. (D) Coordinate with partner nations to identify and evaluate medical facilities for the Program. (E) Establish agreements with foreign medical facilities for potential use of the Program. (F) To the greatest extent practicable, establish policies and procedures— (i) to reduce patient movement times in various countries in the Indo-Pacific region during peacetime and wartime operations; (ii) to standardize medical procedures, patient care, and policies; (iii) to securely share patient data with partner nations when appropriate to do so, such as during a contingency operation; (iv) with respect to medical equipment commonality and interchangeability; (v) with respect to the coordination of medical care; (vi) with respect to translators and language standardization; (vii) with respect to foreign blood products; and (viii) with respect to medical malpractice liability and procedures. (G) Integrate the Program into operational plans of the combatant commands. (H) Identify mutually beneficial training opportunities for military medical personnel. (b) Strategy (1) In general Not later than September 30, 2025, the Under Secretary of Defense for Personnel and Readiness shall submit to the Committees on Armed Services of the Senate and the House of Representatives a strategy for the implementation of the Program. (2) Elements The strategy required by paragraph (1) shall include the following: (A) A governance structure for the Program, including— (i) the officials tasked to oversee the Program; (ii) the format of the governing body of the Program; (iii) the functions and duties of such governing body with respect to establishing and maintaining the Program; and (iv) mechanisms for coordinating with partner countries selected to participate in the Program. (B) With respect to the initial selection of partner countries to participate in the Program— (i) an identification of each such country; (ii) the rationale for selecting each such country; and (iii) any other information the Secretary considers appropriate. (C) An identification of objectives for the first three fiscal years of the Program, including— (i) a description of, and a rational for selecting, such objectives; (ii) an identification of milestones toward achieving such objectives; and (iii) metrics for evaluating success in achieving such objectives. (D) A description of opportunities and potential timelines for future expansion of the Program, as appropriate. (E) A list of additional authorities, appropriations, or other legislative action necessary to ensure the success of the Program. (F) Any other information the Secretary considers appropriate. (3) Form The strategy required by paragraph (1) shall be submitted in unclassified form, but may include a classified annex. (c) Report (1) In general Not later than September 20th of each of 2025 through 2035, the Under Secretary of Defense for Personnel and Readiness shall submit to the congressional defense committees a report on the Program. (2) Elements Each report required by paragraph (1) shall include the following: (A) A narrative summary of activities conducted as part of the Program during the preceding fiscal year. (B) Except in the case of the initial report, an assessment of progress toward the objectives established for the preceding fiscal year described in the preceding report under this subsection using the metrics established in such report. (C) An identification of objectives for the three fiscal years following the date of submission of the report, including— (i) a description of, and a rational for selecting, such objectives; (ii) an identification of milestones toward achieving such objectives; and (iii) metrics for evaluating success in achieving such objectives. (D) A description of opportunities and potential timelines for future expansion of the Program, as appropriate. (E) Any other information the Under Secretary considers appropriate. (3) Form Each report required by paragraph (1) shall be submitted in unclassified form, but may include a classified annex.