Topic: Health — Insurance
Subject: Armed forces and national security
Date: 2007-03-15 00:00:00

Dignified Treatment of Wounded Warriors Act - Title I: Wounded Warrior Matters - Subtitle A: Policy on Care, Management, and Transition of Servicemembers With Serious Injuries or Illnesses - (Sec. 111) Directs the Secretaries of Defense and Veterans Affairs (Secretaries) to: (1) jointly develop and implement a comprehensive policy on the care and management of members of the Armed Forces (members) who are undergoing medical treatment, recuperation, or therapy, are in medical hold or holdover status, or are otherwise on the temporary disability retired list for a serious injury or illness (recovering members); (2) jointly update the policy on a periodic basis (at least annually); and (3) jointly and separately review all policies and procedures of the Department of Defense (DOD) and Department of Veterans Affairs (VA) that apply to, or are covered by, the comprehensive policy. Requires such review to be completed within 90 days after the enactment of this Act. Directs the Secretaries, in developing the policy, to take into account specified findings, recommendations, and practices, including those of the Independent Review Group on Rehabilitative Care and Administrative Processes at Walter Reed Army Medical Center and National Naval Medical Center. Requires the policy developed to include: (1) mechanisms to ensure responsibility for recovering members in medical hold or holdover status or on the temporary disability retired list; (2) processes, procedures, and standards for medical evaluations and physical disability evaluations of recovering members; (3) standards for determinations of the return of recovering members to active duty; (4) standards for the transition of recovering members from care and treatment by DOD to care and treatment by the VA before, during, and after separation from service; (5) VA access to military health records of recovering members; and (6) surveys and other mechanisms to measure patient and family satisfaction with the DOD and VA provision of care and services. Requires a report from: (1) the Secretary of Defense (Secretary) to the congressional defense committees on instances when a disability rating assigned to a member by an informal physical evaluation board of DOD was reduced upon appeal, and the reasons for such reduction; (2) the Secretaries to the defense and veterans committees on the policy developed, as well as on policy updates; and (3) the Comptroller General (CG) annually to the defense and veterans committees assessing DOD and VA progress in developing and implementing the policy. (Sec. 112) Requires the Secretaries, in developing and implementing the policy, to: (1) take into account and fully address any unique needs of women members and women veterans; and (2) include a description of such needs, and the manner in which they are addressed, in any reports required under the previous section. Subtitle B: Health Care - Part I: Enhanced Availability of Care for Servicemembers - (Sec. 121) Entitles any recovering member and any former member with a severe injury or illness to medical and dental care in any military medical facility or through any civilian health care provider authorized by the Secretary to provide health and mental health services, including services for traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Authorizes such medical and dental care for three years beginning on the date: (1) of enactment of this Act, for those whose injury or illness was incurred on or after October 7, 2001, and before the enactment of this Act; and (2) on which the injury or illness is incurred, for those whose injury or illness occurs on or after the enactment of this Act. Authorizes the Secretary to waive any limitation on the provision of such care if considered appropriate to assure the maximum feasible recovery and rehabilitation of the member or former member. Prohibits the Secretary from providing such medical and dental care after December 31, 2012, if the Secretary has not provided such care to such member or former member before that date. Entitles members with a severe injury or illness to rehabilitation and vocational benefits from the Secretary of Veterans Affairs. Authorizes the Secretary of the military department concerned (Secretary concerned) to reimburse recovering members and former members with a severe injury or illness for certain expenses incurred in connection with the receipt of required medical care. (Sec. 122) Requires the Secretary to provide reimbursement for reasonable travel expenses for follow-on specialty care and related services of a former member who incurred a disability while on active duty in a combat zone or in combat-related operations, is entitled to retired or retainer pay, and requires follow-up care, services, or supplies at a specific military treatment facility located more than 100 miles away from the member's residence. Part II: Care and Services for Dependents - (Sec. 126) Makes a family member of a recovering member eligible for medical care at a military treatment facility if the family member is: (1) on invitational orders while caring for the member; (2) a non-medical attendee caring for the member; or (3) receiving per-diem payments from DOD while caring for the member. Makes a family member who is eligible for medical care under (1), above, for more than 45 days during a one-year period also eligible for job placement services offered by DOD. Requires a report from the Secretary to the defense committees on the need for additional employment services and job protection for family members who are placed on leave or displaced from employment while caring for a recovering member. (Sec. 127) Provides extended benefits under TRICARE (a DOD managed care program) for the primary caregivers of members who incur a serious injury or illness while on active duty. Part III: Traumatic Brain Injury and Post-Traumatic Stress Disorder - (Sec. 131) Directs the Secretary to submit to the defense committees one or more comprehensive plans for DOD programs and activities to prevent, diagnose, mitigate, treat, and otherwise respond to TBI and PTSD in members. (Sec. 132) Directs the Secretary to: (1) establish a protocol for the predeployment assessment and documentation of the cognitive functioning of a member who is deployed outside the United States, in order to facilitate the assessment of the postdeployment cognitive functioning of such member; (2) conduct up to three pilot projects to evaluate various mechanisms for use in the protocol; (3) report to the defense and veterans committees on the pilot projects; and (4) after completion of the pilot projects, establish the appropriate mechanism for use in the protocol. Authorizes appropriations. (Sec. 133) Requires the Secretary to establish in DOD a center of excellence in the prevention, diagnosis, mitigation, treatment, and rehabilitation of: (1) TBI; and (2) PTSD. Requires reports from the Secretary to Congress on the establishment and operation of each center. Authorizes appropriations. (Sec. 134) Directs the Secretaries to jointly: (1) conduct a comprehensive review of the need for mental health treatment and services, and the adequacy of existing treatment and services, for female members and veterans; (2) report to the defense and veterans committees on the review; and (3) develop a comprehensive policy to address the treatment and care of female members and veterans who experience mental health problems and conditions, including PTSD. (Sec. 135) Authorizes appropriations to DOD for FY2008 for activities related to the improved diagnosis, treatment, and rehabilitation of members with: (1) TBI; or (2) PTSD. (Sec. 136) Requires a report from the Secretary to the defense committees on progress in implementing requirements under the John Warner National Defense Authorization Act for Fiscal Year 2007 relating to: (1) a study on TBI incurred by members participating in Operations Iraqi Freedom and Enduring Freedom; (2) enhanced mental health screening and services for members; and (3) early diagnosis and treatment of PTSD and other mental health conditions of members. Requires an annual report to such committees, during 2008 through 2013, on amounts expended by DOD for the diagnosis, treatment, and rehabilitation of members with TBI or PTSD. Part IV: Other Matters - (Sec. 141) Directs the Secretaries to: (1) develop and implement a joint electronic health record (joint record) for use by DOD and VA; and (2) accelerate the exchange of health care information between the two departments. Establishes the Department of Defense-Department of Veterans Affairs Interagency Program Office for a Joint Electronic Health Record, with a Director and Deputy Director. Requires the Office to develop and prepare for deployment by September 30, 2010, a joint record which complies with applicable federal interoperability standards. Authorizes the Secretaries to carry out pilot projects of various technological approaches to the achievement of the joint record. Requires: (1) annual reports from the Office Director to the Secretaries and the defense and veterans committees on Office activities (to be made available to the public); and (2) semiannual reports, until joint record implementation, from the CG to the defense and veterans committees on DOD-VA progress in developing and implementing the joint record. Provides funding. (Sec. 142) Allows the Secretary to exercise any DOD authority for the appointment and pay of health care personnel in order to provide or enhance DOD capacity to provide care and treatment for members who are wounded or injured on active duty, and to support ongoing DOD patient care and medical readiness, education, and training requirements. Directs the military department Secretaries to: (1) develop a strategy of best practices for the recruitment of such medical and health professionals within their department; and (2) report on such strategy to the defense committees. (Sec. 143) Requires the Secretary to: (1) recommend to the defense committees legislative or administrative actions to address shortages in health care professionals within DOD; and (2) implement programs to recruit qualified individuals to serve as health care and mental health care personnel. Subtitle C: Disability Matters - Part I: Disability Evaluations - (Sec. 151) Authorizes the retirement or separation for disability of members on active duty for more than 30 days if the member has six months or more of active service and the disability was not noted at the time of the member's entrance into active duty, unless compelling medical evidence or judgment warrants a finding that the disability existed before the member's entrance into active duty. (Sec. 152) Requires the Secretary concerned, in making disability determinations, to: (1) utilize the schedule for rating disabilities in use by the VA; and (2) not deviate from such schedule. Authorizes the Secretary concerned to utilize criteria other than the VA schedule if the criteria will result in a determination of a greater percentage of disability than in the use of the schedule. (Sec. 153) Directs the Secretary to establish within DOD the Physical Disability Board of Review to review disability determinations made by DOD physical evaluation boards of members who, during the period beginning on September 11, 2001, and ending on December 31, 2009, are: (1) separated from the Armed Forces as unfit for duty due to a medical condition with a disability rating of 20% disabled or less; and (2) found to be ineligible for retirement. Authorizes the Secretary concerned to correct the military records of such individuals in light of any Board of Review findings. (Sec. 154) Directs the Secretary to carry out pilot programs on the revision and improvement of the disability evaluation system for members. Requires under one of the pilot programs that: (1) the Secretary of Veterans Affairs assign a member a VA-schedule rating of disability, upon which the Secretary concerned shall make a disability determination of the member; (2) disability determinations are made utilizing joint DOD/VA-assigned disability ratings; and (3) the Secretary establishes and operates a single Internet website for the DOD disability evaluation system that enables participating members to utilize such system through the website. Outlines related pilot program purposes. Requires the Secretaries to jointly incorporate any findings and recommendations arising under the pilot programs when updating the comprehensive policy on the care and management of recovering members as required under section 111. Requires: (1) each pilot program to be completed within one year after its commencement; and (2) an interim and final report on the pilot programs from the Secretary to the defense and veterans committees. (Sec. 155) Requires quarterly reports from the Secretary to the defense committees, until March 1, 2009, on the implementation of DOD corrective measures with respect to the physical disability evaluation system in response to the report of: (1) the Inspector General of the Army on that system; (2) the Independent Review Group on Rehabilitation Care and Administrative Processes at Walter Reed Army Medical Center and National Naval Medical Center; and (3) the Department of Veterans Affairs Task Force on Returning Global War on Terror Heroes. Part II: Other Disability Matters - (Sec. 161) Increases from 12 to 19 the maximum number of years of service authorized to be used as a multiplier to determine military disability severance pay. Provides minimum years of service for purposes of such determination. Prohibits any deduction from disability severance pay due to payments received as veterans' disability compensation in the case of disability severance pay received by a member for a disability incurred in the line of duty in a combat zone or in combat-related operations as designated by the Secretary. (Sec. 162) Requires the Secretary to develop a form for member designation of a recipient of Servicemembers' Group Life Insurance proceeds in cases where the member is medically incapacitated or experiencing an extended loss of consciousness. (Sec. 163) Directs the Secretaries to jointly develop and implement a mechanism to provide for the electronic transfer from DOD to VA of any DOD documents necessary to establish or support the eligibility of a member for benefits under laws administered by the VA at the time of the member's retirement, separation, or release from service. (Sec. 164) Requires the Secretary and the CG to report to the defense committees an assessment of the continuing utility of the temporary disability retired list in satisfying the purposes for which it was established. Subtitle D: Improvement of Facilities Housing Patients (Sec. 171) Directs the Secretary to establish standards for the accreditation of medical facilities with respect to DOD military medical treatment facilities, specialty medical care facilities, and military quarters or leased housing for patients. Requires that such standards be uniform and consistent across such facilities and across DOD and the military departments. Directs the Secretary to: (1) specify a deadline for standards compliance for each facility; and (2) report to the defense committees on actions taken to carry out this section. (Sec. 172) Requires quarterly reports from the Secretary to the defense committees, until March 1, 2009, on implementation of the action plan of the Army to correct deficiencies identified in the condition of facilities, and in the administration of outpatients in medical hold or holdover status, at Walter Reed Army Medical Center and other applicable Army installations. (Sec. 173) Directs the Secretary to: (1) assess the feasibility of accelerating the construction and completion of new facilities required to facilitate the closure of Walter Reed Army Medical Center, as directed under the 2005 round of defense base closures and realignments under the Defense Base Closure and Realignment Act of 1990; (2) develop and carry out a plan for the construction and completion of the replacement facilities; (3) submit such plan to the defense committees; and (4) make certain certifications to such committees with respect to the plan submitted. Subtitle E: Outreach and Related Information on Benefits - (Sec. 181) Requires the Secretary to develop, maintain, and update at least annually in handbook and electronic form a description of the compensation and other benefits available to a member (and his or her family members) upon the member's separation or retirement as a result of a serious injury or illness. Directs the Secretary concerned to furnish the handbook to a member (or, if incapacitated, their next of kin) as soon as practicable following such an injury or illness. Subtitle F: Other Matters - (Sec. 191) Directs the Secretary to enter into an agreement with the National Academy of Sciences (NAS) for a study on the physical and mental health and other readjustment needs of members and former members who deployed in Operations Iraqi Freedom or Enduring Freedom (and their families) as a result of such deployment. Requires the: (1) NAS to report to the Secretaries upon the completion of each of the two phases of such study; (2) the Secretaries to develop a preliminary and final DOD-VA plan to address the NAS report findings and recommendations; (3) Secretaries to report each plan to Congress; and (4) CG to submit to Congress an assessment of each plan. Authorizes appropriations. Title II: Veterans Matters - (Sec. 201) Expresses the sense of Congress concerning VA efforts toward the rehabilitation and community reintegration of veterans with TBI. (Sec. 202) Directs the Secretary of Veterans Affairs (Secretary, for purposes of this title only), for each veteran or member who receives inpatient or outpatient rehabilitation care from the VA for a TBI, to: (1) develop an individualized plan for the rehabilitation of such individual and their reintegration into the community; and (2) provide such plan to such individual before their discharge from inpatient care, following transition from active duty to the VA for outpatient care, or as soon as practicable following diagnosis. Requires each developed plan to be based upon the physical, cognitive, vocational, and neuropsychological and social impairments of such individual, as well as their family education and support needs after discharge from inpatient care. Directs the Secretary to: (1) designate a case manager for each individual; (2) ensure that such case manager has appropriate skills; (3) involve each individual in the development of their rehabilitation and reintegration plan; (4) periodically review the effectiveness of each plan; and (5) conduct a plan review if requested by the individual. (Sec. 203) Requires the Secretary to use non-VA facilities to implement the TBI rehabilitation and reintegration plans described in the previous section when the Secretary: (1) is unable to provide the treatment or services at the frequency or for the duration prescribed in such plan; or (2) determines it to be the best option with respect to the recovery and rehabilitation of the individual. Requires the facilities used to maintain appropriate standards for the provision of such treatment or services. (Sec. 204) Directs the Secretary to establish a program of research, education, and clinical care to provide intensive neuro-rehabilitation to veterans with a severe TBI, including veterans in a minimally conscious state who would otherwise receive only long-term residential care. Authorizes appropriations. Requires a program report from the Secretary to Congress. (Sec. 205) Requires the Secretary, in collaboration with the Defense and Veterans Brain Injury Center, to carry out a five-year pilot program to assess the effectiveness of providing assisted living services to veterans with TBI to enhance their rehabilitation, quality of life, and community integration. Requires: (1) at least one part of the pilot program to be carried out in a region of the Veterans Health Administration that contains a VA polytrauma center; (2) special consideration to be given to veterans in rural areas; and (3) the Secretary to report to the veterans committees on the pilot program. Authorizes appropriations. (Sec. 206) Directs the Secretary, in carrying out specified VA research programs and activities, to ensure that such programs and activities include research on the sequelae (aftereffects) of mild to severe forms of TBI. (Sec. 207) Requires the Secretary to ensure that veterans' nursing home care is provided in an age-appropriate manner. (Sec. 208) Extends from two to five years after their release from service the period of eligibility for hospital care, medical services, and nursing home care in the case of veterans who served on active duty in a theater of combat operations during a period of war after the Persian Gulf War, or in combat against a hostile force after November 11, 1998. (Sec. 209) Replaces the word "psychosis" with "mental illness" as it pertains to the presumption of service-connection for veterans' disability compensation purposes. Directs the Secretary, upon request of a veteran described in the previous section, to provide such veteran with a preliminary mental health evaluation as soon as practicable, but no later than 30 days after the request. (Sec. 210) Authorizes outpatient dental services for veterans with a service-connected dental condition or disability as long as the veteran's certificate of discharge or release does not include a certification that such veteran was provided a complete dental examination within 180 (under current law, 90) days before such discharge or release. (Sec. 211) Requires the Secretary to carry out, in at least three locations, a demonstration program on preventing veterans at-risk of homelessness from becoming homeless. Terminates program authority at the end of FY2011. Authorizes appropriations. (Sec. 212) Includes recently released members of the National Guard or Reserves under a program of outreach services on the availability of VA readjustment and other benefits and services. Title III - Waives the scheduled FY2008 pay increases for members of the uniformed services and, instead, provides a higher increase, effective January 1, 2008, that will increase by 3.5% the rates of basic pay for members of the uniformed services.