I 118th CONGRESS 1st Session H. R. 3373 IN THE HOUSE OF REPRESENTATIVES May 16, 2023 Mrs. Kiggans of Virginia (for herself, Mr. Wittman , Mr. Panetta , Mr. Scott of Virginia , Ms. Tokuda , Mrs. McClellan , Mr. Fitzpatrick , and Mr. Joyce of Ohio ) introduced the following bill; which was referred to the Committee on Armed Services A BILL To direct the Secretary of the Navy to take certain actions relating to improved mental health care, and for other purposes.

1. Short title This Act may be cited as the Sailor Standard of Care Act of 2023 . 2. Actions by Secretary of the Navy relating to improved mental health care (a) Reforms relating to limited duty (1) Additional resources The Secretary of the Navy shall provide additional resources to any unit with greater than 15 members of the Navy designated for limited duty at a given time, including through the establishment of a new billet for a medical officer, chaplain, and civilian employee of the Department of Defense in a mental health position for such unit. (2) Mental health screening The Secretary of the Navy shall require that each member of the Navy designated for limited duty receives, upon such designation and once every 60 days thereafter for the duration of such designation, a mental health screening by a mental health professional of the Department. (3) Framework The Secretary of the Navy shall establish a framework to ensure— (A) centralized leadership for the management of members of the Navy designated for limited duty and centralized responsibility for the well-being of such members while so designated; and (B) a smooth transition for members of the Navy who have suicidal ideations or other mental health care needs during transfers between units or while designated for limited duty. (4) Report Not later than December 31, 2024, the Secretary of the Navy shall submit to the Committees on Armed Services of the House of Representatives and the Senate a report on— (A) whether timeliness standards applicable to the timing of appointments between medical providers and members of the Navy designated for limited duty are sufficient, as determined by the Secretary of the Navy, and the extent to which such standards are complied with; and (B) the number of databases used to track the status of such appointments and recommendations by the Secretary of the Navy regarding methods to simplify such tracking. (5) Briefing Not later than January 31, 2024, the Secretary of the Navy shall provide to the Committees on Armed Services of the House of Representatives and the Senate a briefing on— (A) the average number of days for the medical separation of a member of the Navy previously designated for limited duty; and (B) recommendations for steps the Secretary of the Navy may take to streamline and expedite applicable processes to ensure such separation is timely. (b) Resources dashboard Not later than December 31, 2024, the Assistant Secretary of the Navy for Manpower and Reserve Affairs shall establish and maintain a dashboard to track quality of life programs of the Department of the Navy (including such programs relating to childcare, healthcare, education, housing, and spouse employment) and the rate of usage of each such program. (c) Best practices in dealing with multiple suicides (1) Study The Secretary of the Navy shall conduct a study on recent cases in which multiple suicides occurred within 30 days of each other among members assigned to the same unit or command of the Department of the Navy. (2) Elements The study under paragraph (1) shall include an assessment of the following: (A) Any underlying quality of life issues that may have been prevalent among the unit or command leading up to the initial suicide. (B) The culture of the unit or command prior to such initial suicide. (C) The actions taken immediately following such initial suicide and preceding any subsequent suicides. (D) Whether the individuals who completed suicide had previously expressed suicide ideation and whether such individuals engaged with mental health resources available prior to completing suicide. (E) The mental health resources that were available to such individuals prior to the initial suicide, after the initial suicide, and after any subsequent suicides. (3) Report Not later than 180 days after the date of the enactment of this Act, the Secretary of the Navy shall submit to the Committees on Armed Services of the House of Representatives and the Senate a report containing the findings of the study under paragraph (1) and a standard operating procedure of the Department of the Navy for responding to multiple suicides. (d) Report on mental health care under TRICARE 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 containing the following: (1) An analysis of the average timeline to credential potential mental health care providers under the TRICARE program as compared to the timeline under Medicare and other major insurance networks, including quantitative data regarding, with respect to individuals applying for credentialing as mental health care providers under the TRICARE program, the following: (A) The denial of such applications. (B) The method and frequency of notifications regarding the application provided to such applicants. (C) With respect to denied applications, the method of feedback provided to such applicants, and the resolution processes available to such applicants. (2) The number of current and projected mental health care providers under the TRICARE program, as compared to the number of civilian mental health care providers outside of such program, and a description of any capacity shortfalls with respect to mental health care providers under the TRICARE program, taking into account the mental health crisis within the Armed Forces. (3) An analysis of the reimbursement rates for mental health care providers under the TRICARE program, disaggregated by TRICARE provider network region, as compared to the average reimbursement rates for such providers under private health insurance plans and Medicare. (4) An assessment of— (A) whether the Secretary of Defense, in carrying out the TRICARE program, has used the methods outlined in part 199.14 of title 32, Code of Federal Regulations, to increase reimbursement rates in certain geographic locations; and (B) what, if any, corrective measures have been taken since the publication by the Comptroller General of the United States of the report titled Defense Health Care: TRICARE Multiyear Surveys Indicate Problems with Access to Care for Nonenrolled Beneficiaries (GAO 13–364) on April 2, 2013, and in particular, corrective measures addressing the finding of such report dealing with civilian mental health care providers and reimbursement rates. (5) The status of implementing the recommendations contained in the report of the Inspector General of the Department of Defense published August 10, 2020, titled Evaluation of Access to Mental Health Care in the Department of Defense (DODIG–2020–112) (or any successor report) and the estimated implementation date for any such recommendations that have not been implemented as of the date of the submission of the report. (6) An assessment of what, if any, additional authorities and resources may be needed by the Department of Defense to effectively address the issue of timely access to mental healthcare for members of the Armed Forces on active duty and the dependents thereof.