10 U.S.C. § 1071 — Purpose of this chapter

Page 962 TITLE 10—ARMED FORCES § 1071 1976—Pub. L. 94–464, § 1(b), Oct. 8, 1976, 90 Stat. 1986, added item 1089. 1970—Pub. L. 91–481, § 2(2), Oct. 21, 1970, 84 Stat. 1082, added item 1088. 1966—Pub. L. 89–614, § 2(9), Sept. 30, 1966, 80 Stat. 866, substituted ‘‘1087’’ for ‘‘1085’’ in items 1071 and 1073, ‘‘Medical care’’ and ‘‘authorized care in facilities of uniformed services’’ for ‘‘Medical and dental care’’ and ‘‘specific inclusions and exclusions’’ in item 1077, ‘‘Con- tracts for health care’’ for ‘‘Contracts for medical care for spouses and children’’ in item 1082, and added items 1086 and 1087. 1965—Pub. L. 89–264, § 2, Oct. 19, 1965, 79 Stat. 989, sub- stituted ‘‘executive department’’ for ‘‘uniformed serv- ice’’ in item 1085. 1958—Pub. L. 85–861, § 1(25)(A), (C), Sept. 2, 1958, 72 Stat. 1445, 1450, substituted ‘‘Medical and Dental Care’’ for ‘‘Voting by Members of Armed Forces’’ in heading of chapter, and substituted items 1071 to 1085 for former items 1071 to 1086. § 1071. Purpose of this chapter The purpose of this chapter is to create and maintain high morale in the uniformed services by providing an improved and uniform program of medical and dental care for members and cer- tain former members of those services, and for their dependents. (Added Pub. L. 85–861, § 1(25)(B), Sept. 2, 1958, 72 Stat. 1445; amended Pub. L. 89–614, § 2(1), Sept. 30, 1966, 80 Stat. 862; Pub. L. 96–513, title V, § 511(34)(A), (B), Dec. 12, 1980, 94 Stat. 2922.) HISTORICAL AND REVISION NOTES Revised section Source (U.S. Code) Source (Statutes at Large) 1071 ......... 37:401. June 7, 1956, ch. 374, § 101, 70 Stat. 250. The words ‘‘and certain former members’’ are in- serted to reflect the fact that many of the persons enti- tled to retired pay are former members only. The words ‘‘and dental’’ are inserted to reflect the fact that mem- bers and, in certain limited situations, dependents are entitled to dental care under sections 1071–1085 of this title. Editorial Notes PRIOR PROVISIONS A prior section 1071, act Aug. 10, 1956, ch. 1041, 70A Stat. 81, which stated the purpose of former sections 1071 to 1086 of this title, and provided for their con- struction, was repealed by Pub. L. 85–861, § 36B(5), Sept. 2, 1958, 72 Stat. 1570, as superseded by the Federal Vot- ing Assistance Act of 1955 which was classified to sub- chapter I–D (§ 1973cc et seq.) of chapter 20 of Title 42, The Public Health and Welfare, prior to repeal by Pub. L. 99–410, title II, § 203, Aug. 28, 1986, 100 Stat. 930. AMENDMENTS 1980—Pub. L. 96–513 substituted ‘‘Purpose of this chapter’’ for ‘‘Purpose of sections 1071–1087 of this title’’ in section catchline, and substituted reference to this chapter for reference to sections 1071–1087 of this title in text. 1966—Pub. L. 89–614 substituted ‘‘1087’’ for ‘‘1085’’ in section catchline and text. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1980 AMENDMENT Amendment by Pub. L. 96–513 effective Dec. 12, 1980, see section 701(b)(3) of Pub. L. 96–513, set out as a note under section 101 of this title. EFFECTIVE DATE OF 1966 AMENDMENT Pub. L. 89–614, § 3, Sept. 30, 1966, 80 Stat. 866, provided that: ‘‘The amendments made by this Act [see Short Title of 1966 Amendment note below] shall become ef- fective January 1, 1967, except that those amendments relating to outpatient care in civilian facilities for spouses and children of members of the uniformed serv- ices who are on active duty for a period of more than 30 days shall become effective on October 1, 1966.’’ SHORT TITLE OF 2008 AMENDMENT Pub. L. 110–181, div. A, title XVI, § 1601, Jan. 28, 2008, 122 Stat. 431, provided that: ‘‘This title [enacting sec- tions 1074l, 1216a, and 1554a of this title, amending sec- tions 1074, 1074f, 1074i, 1145, 1201, 1203, 1212, and 1599c of this title and section 6333 of Title 5, Government Orga- nization and Employees, and enacting provisions set out as notes under this section, sections 1074, 1074f, 1074i, 1074l, 1212, and 1554a of this title, and section 6333 of Title 5] may be cited as the ‘Wounded Warrior Act’.’’ SHORT TITLE OF 1987 AMENDMENT Pub. L. 100–180, div. A, title VII, § 701, Dec. 4, 1987, 101 Stat. 1108, provided that: ‘‘This title [enacting sections 1103, 2128 to 2130 [now 16201 to 16203], and 6392 of this title, amending sections 533, 591, 1079, 1086, 1251, 2120, 2122, 2123, 2124, 2127, 2172 [now 16302], 3353, 3855, 5600, 8353, and 8855 of this title, section 302 of Title 37, Pay and Allowances of the Uniformed Services, and section 3809 of Title 50, War and National Defense, enacting provisions set out as notes under sections 1073, 1074, 1079, 1092, 1103, 2121, 2124, 12201, and 16201 of this title, amending provisions set out as notes under sections 1073 and 1101 of this title, and repealing provisions set out as notes under sections 2121 and 2124 of this title] may be cited as the ‘Military Health Care Amendments of 1987’.’’ SHORT TITLE OF 1966 AMENDMENT Pub. L. 89–614, § 1, Sept. 30, 1966, 80 Stat. 862, provided: ‘‘That this Act [enacting sections 1086 and 1087 of this title, amending this section and sections 1072 to 1074, 1076 to 1079, 1082, and 1084 of this title, and enacting provisions set out as a note under this section] may be cited as the ‘Military Medical Benefits Amendments of 1966’.’’ PROGRAM TO PREVENT PERINATAL MENTAL HEALTH CONDITIONS IN PREGNANT AND POSTPARTUM MEMBERS OF THE ARMED FORCES Pub. L. 118–159, div. A, title VII, § 705, Dec. 23, 2024, 138 Stat. 1943, provided that: ‘‘(a) REQUIREMENT.—The Secretary of Defense, acting through the Under Secretary of Defense for Personnel and Readiness, shall carry out a program to improve clinical and nonclinical services targeting mental health conditions in pregnant and postpartum members of the Armed Forces and spouses of members during the perinatal period. ‘‘(b) ELEMENTS.—The Secretary shall ensure that the program under subsection (a) includes the following: ‘‘(1) Access to support resources during the perinatal period, including— ‘‘(A) identification of symptoms of perinatal men- tal health conditions, brief intervention by primary care providers, referral to care, and treatment; ‘‘(B) targeted nonmedical counseling services through the Department of Defense Military and Family Life Counseling Program of the Office of Military Family Readiness Policy under section 1781 of title 10, United States Code; ‘‘(C) existing parenting resiliency programs of the military departments; ‘‘(D) adherence to clinical practice guidelines in military medical treatment facilities in support of members of the uniformed services and dependents with a diagnosed mental health condition requiring clinical intervention, including through primary Page 963 TITLE 10—ARMED FORCES § 1071 care services and women’s health clinics, in col- laboration with behavioral health services; and ‘‘(E) prenatal and postnatal support programs at military medical treatment facilities that provide group counseling modeled after best clinical prac- tices, such as the Centering Pregnancy program. ‘‘(2) A process for informing pregnant and postpartum members of the Armed Forces and spouses of members of nonmedical and clinical sup- port services during the perinatal period. ‘‘(3) A communications strategy to increase aware- ness of the services available under the program. ‘‘(c) REPORT.—Not later than December 31, 2025, the Secretary shall submit to the Committees on Armed Services of the Senate and House of Representatives a report on the program under subsection (a) that in- cludes the following: ‘‘(1) A description of the range of activities in- cluded in the program and data assessing the effec- tiveness or shortcomings of such activities. ‘‘(2) How resources are allocated for the purpose of establishing and maintaining perinatal support pro- grams at military medical treatment facilities. ‘‘(3) Measurements for adherence to evidence-based protocols at military medical treatment facilities with respect to identifying potential mental health issues. ‘‘(4) Assessment of current training and credentials required for health care providers providing perinatal services and consideration for further certifications, such as the Perinatal Mental Health Certification. ‘‘(5) Feasibility and advisability of adding special- ized perinatal mental health support services via a helpline through Military One Source. ‘‘(6) Recommendations for administrative or legis- lative changes to improve the effectiveness of the program. ‘‘(d) PERINATAL PERIOD DEFINED.—In this section, the term ‘perinatal period’ means the period beginning with pregnancy through one year following childbirth.’’ ESTABLISHMENT OF DEFENSE INTREPID NETWORK FOR TRAUMATIC BRAIN INJURY AND BRAIN HEALTH AS PROGRAM OF RECORD Pub. L. 118–159, div. A, title VII, § 721, Dec. 23, 2024, 138 Stat. 1951, provided that: ‘‘(a) IN GENERAL.—Not later than January 1, 2026, the Secretary of Defense shall establish the Defense In- trepid Network for Traumatic Brain Injury and Brain Health (in this section referred to as the ‘Network’) headquartered at the National Intrepid Center of Excel- lence as a program of record subject to milestone re- views and compliance with the requirements under this section. ‘‘(b) DUTIES.—The duties of the Network are as fol- lows: ‘‘(1) To provide clinical care to prevent, diagnose, treat, and rehabilitate members of the Armed Forces with traumatic brain injury, post-traumatic stress disorder, symptoms from blast overpressure or blast exposure, and other mental health conditions. ‘‘(2) To promote standardization of care among the 10 Intrepid Spirit Centers throughout the continental United States, brain health clinics in Alaska and Ger- many, and other sites as designated by the Director of the Defense Health Agency as being a part of the long-term brain health strategy of the Department of Defense. ‘‘(3) To support and conduct research and education on traumatic brain injury, post-traumatic stress dis- order, blast overpressure or blast exposure, and other mental health conditions. ‘‘(c) ANNUAL BRIEFING.—Not later than one year after the date of the enactment of this Act [Dec. 23, 2024], and annually thereafter for a period of five years, the Secretary of Defense shall provide to the Committees on Armed Services of the Senate and the House of Rep- resentatives a briefing that shall include, for the year covered by the briefing— ‘‘(1) the number of individuals to whom the Net- work has provided services; ‘‘(2) the number of individuals who return to active duty in the Armed Forces after receiving services from the Network, and the stage in their career at which they seek treatment at the Network; ‘‘(3) the number of individuals whose families are able to participate in programs provided by the Net- work; and ‘‘(4) the number of individuals on a waitlist for treatment at the Network and the average period those individuals are on the waitlist.’’ BRAIN HEALTH AND TRAUMA PROGRAM Pub. L. 118–159, div. A, title VII, § 722, Dec. 23, 2024, 138 Stat. 1951, provided that: ‘‘(a) ESTABLISHMENT.—The Secretary of Defense shall establish an intensive comprehensive brain health and trauma program to— ‘‘(1) provide multidisciplinary specialist evalua- tions, treatment initiation, and aftercare for mem- bers of the Armed Forces and dependents of members; and ‘‘(2) make evidence-based improvements in such evaluations, treatment, and aftercare. ‘‘(b) PROGRAM ELEMENTS.—The Secretary shall ensure that the program under subsection (a) includes the fol- lowing: ‘‘(1) Initiatives of the Defense Health Agency that provide coordinated evaluations, treatment, and aftercare for traumatic brain injuries and related conditions, that incorporates specialized evaluations, innovative and evidence-based treatments, and com- prehensive follow-up care. ‘‘(2) Collaboration with private sector nonprofit health care organizations involved in innovative clin- ical activities in brain health and trauma care, in- cluding transitional and residential brain injury treatment programs. ‘‘(3) One or more pilot programs for demonstrating the effectiveness of intensive outpatient multidisci- plinary specialist treatment and care coordination. ‘‘(4) Incorporation of evidence-based therapy with complementary and alternative medicine approaches. ‘‘(5) Thorough evaluations of the effectiveness of in- novative activities for diagnosis, treatment, and aftercare of brain trauma and promotion of brain health. ‘‘(c) BRIEFING.—Not later than December 31, 2025, the Secretary shall provide to the Armed Services Commit- tees of the Senate and House of Representatives a brief- ing on the program under subsection (a). Such briefing shall include the following: ‘‘(1) A description of the range of activities in- cluded in the program and data assessing the effec- tiveness or shortcomings of such activities. ‘‘(2) The scope of each pilot program carried out under subsection (b)(3). ‘‘(3) Recommendations for administrative or legis- lative changes to improve the effectiveness of the program.’’ BLAST OVERPRESSURE AND TRAUMATIC BRAIN INJURY OVERSIGHT STRATEGY AND ACTION PLAN Pub. L. 118–159, div. A, title VII, § 724, Dec. 23, 2024, 138 Stat. 1954, provided that: ‘‘(a) STRATEGY AND PLAN REQUIRED.—The Secretary of Defense shall develop and implement a traumatic brain injury oversight strategy and action plan that in- cludes, at a minimum, the following: ‘‘(1) Assigned roles and responsibilities for the com- ponents of the Office of the Secretary of Defense for the mitigation, identification, and treatment of trau- matic brain injury and the monitoring and docu- mentation of blast overpressure exposure. ‘‘(2) Standardized monitoring, treatment, and refer- ral guidelines for traumatic brain injury programs across all covered Armed Forces. ‘‘(3) A review and update of the current brain injury diagnostic tools used by such programs. ‘‘(4) Standardized, 72-hour follow-up requirements for all traumatic brain injury patients, including pro- Page 964 TITLE 10—ARMED FORCES § 1071 tocols for the treatment and observation during such follow-up appointments. ‘‘(5) Oversight and documentation standards to aid in data collection. ‘‘(b) IMPLEMENTATION.—The Secretary shall imple- ment the oversight strategy and action plan under sub- section (a) not later than one year after the date of the enactment of this Act [Dec. 23, 2024]. ‘‘(c) SUBMISSION TO GAO.—Upon development of the oversight strategy and action plan under subsection (a), the Secretary shall submit to the Comptroller Gen- eral of the United States the oversight strategy and ac- tion plan. ‘‘(d) COVERED ARMED FORCES DEFINED.—In this sec- tion, the term ‘covered Armed Forces’ means the Army, Navy, Marine Corps, Air Force, and Space Force.’’ ESTABLISHMENT OF REQUIREMENTS RELATING TO BLAST OVERPRESSURE EXPOSURE Pub. L. 118–159, div. A, title VII, § 725, Dec. 23, 2024, 138 Stat. 1955, provided that: ‘‘Not later than two years after the date of the enactment of this Act [Dec. 23, 2024], the Secretary of Defense shall establish— ‘‘(1) performance parameters to minimize exposure to blast overpressure when drafting requirements for new weapon systems for the Department of Defense, taking into account the thresholds for blast exposure and overpressure safety identified pursuant to section 735(b)(1) of the James M. Inhofe National Defense Au- thorization Act for Fiscal Year 2023 (Public Law 117–263; 10 U.S.C. 1071 note), as amended by section 723; ‘‘(2) with respect to contractual agreements entered into by any entity and the Department of Defense as part of the defense weapon acquisition process on or after the date on which such parameters are estab- lished, a requirement that the entity shall provide to the Secretary blast overpressure measurements and safety data for a weapon system procured under such agreement that produces blast overpressure that ex- ceeds such thresholds; and ‘‘(3) a requirement that any test plan for a new weapon system shall incorporate testing for blast overpressure measurements and safety data.’’ MEDICAL COUNTERMEASURES FOR OVERSEAS PERSONNEL OF THE DEPARTMENT OF DEFENSE FOR ACUTE RADI- ATION SYNDROME AND THERMAL BURNS Pub. L. 118–159, div. A, title VII, § 734, Dec. 23, 2024, 138 Stat. 1956, provided that: ‘‘(a) PROGRAM REQUIRED.—Not later than one year after the date of the enactment of this Act [Dec. 23, 2024], the Secretary of Defense shall establish a pro- gram to develop requirements for the procurement, pre-positioning, and maintenance of medical counter- measures approved, cleared, licensed, or authorized by the Food and Drug Administration to diagnose, pre- vent, and treat acute radiation syndrome and thermal burns for use by covered personnel. ‘‘(b) PROGRAM SPECIFICATIONS.—In carrying out the program required by subsection (a), the Secretary of Defense shall consider, in coordination with the Chair- man of the Joint Chiefs of Staff and the commanders of the combatant commands, the following: ‘‘(1) The number of covered personnel in areas in which the use of tactical nuclear weapons is a sub- stantial threat. ‘‘(2) Peer-reviewed and published scientific studies regarding safety and efficacy of the potential coun- termeasures described in subsection (a). ‘‘(3) Operational requirements of the Department. ‘‘(4) Appropriate doctrine, training, and operational plans for effective use of such countermeasures. ‘‘(5) A feasible schedule for implementation of the program. ‘‘(c) COVERED PERSONNEL DEFINED.—In this section, the term ‘covered personnel’ means— ‘‘(1) members of the Armed Forces deployed outside the United States; and ‘‘(2) civilian employees of the Department of De- fense deployed outside the United States.’’ ACCOUNTABILITY FOR WOUNDED WARRIORS UNDERGOING DISABILITY EVALUATION Pub. L. 117–263, div. A, title VII, § 711, Dec. 23, 2022, 136 Stat. 2656, provided that: ‘‘(a) POLICY.—Not later than April 1, 2023, the Sec- retary of Defense, in consultation with the Secretaries concerned, shall establish a policy to ensure account- ability for actions taken under the authorities of the Defense Health Agency and the Armed Forces, respec- tively, concerning wounded, ill, and injured members of the Armed Forces during the integrated disability eval- uation system process. Such policy shall include the following: ‘‘(1) A restatement of the requirement that, in ac- cordance with section 1216(b) of title 10, United States Code, a determination of fitness for duty of a member of the Armed Forces under chapter 61 of title 10, United States Code, is the responsibility of the Secretary concerned. ‘‘(2) A description of the role of the Director of the Defense Health Agency in supporting the Secretaries concerned in carrying out determinations of fitness for duty as specified in paragraph (1). ‘‘(3) A description of how the medical evaluation board processes of the Armed Forces are integrated with the Defense Health Agency, including with re- spect to case management, appointments, and other relevant matters. ‘‘(4) A requirement that, in determining fitness for duty of a member of the Armed Forces under chapter 61 of title 10, United States Code, the Secretary con- cerned shall consider the results of any medical eval- uation of the member provided under the authority of the Defense Health Agency pursuant to section 1073c of title 10, United States Code. ‘‘(5) A description of how the Director of the De- fense Health Agency adheres to the medical evalua- tion processes of the Armed Forces, including an identification of each applicable regulation or policy to which the Director is required to so adhere. ‘‘(6) An assessment of the feasibility of affording various additional due process protections to mem- bers of the Armed Forces undergoing the medical evaluation board process. ‘‘(7) A restatement of the requirement that wound- ed, ill, and injured members of the Armed Forces may not be denied any due process protection afforded under applicable law or regulation of the Department of Defense or the Armed Forces. ‘‘(8) A description of the types of due process pro- tections specified in paragraph (7), including an iden- tification of each specific due process protection. ‘‘(b) CLARIFICATION OF RESPONSIBILITIES REGARDING MEDICAL EVALUATION BOARDS.—[Amended section 1073c of this title.] ‘‘(c) BRIEFING.—Not later than February 1, 2023, the Secretary of Defense shall provide to the Committees on Armed Services of the House of Representatives and the Senate a briefing on the status of the implementa- tion of subsections (a) and (b). ‘‘(d) REPORT.—Not later than one year after the date of the enactment of this Act [Dec. 23, 2022], the Sec- retary of Defense shall submit to the Committees on Armed Services of the House of Representatives and the Senate a report on the implementation of sub- sections (a) and (b), lessons learned as a result of such implementation, and the recommendations of the Sec- retary relating to the policy on wounded, ill, and in- jured members of the Armed Forces undergoing the in- tegrated disability evaluation system process. ‘‘(e) SECRETARY CONCERNED DEFINED.—In this section, the term ‘Secretary concerned’ has the meaning given that term in section 101 of title 10, United States Code.’’ ACCESS TO CERTAIN DEPENDENT MEDICAL RECORDS BY REMARRIED FORMER SPOUSES Pub. L. 117–263, div. A, title VII, § 721, Dec. 23, 2022, 136 Stat. 2663, provided that: Page 965 TITLE 10—ARMED FORCES § 1071 ‘‘(a) ACCESS.—The Secretary of Defense may author- ize a remarried former spouse who is a custodial parent of a dependent child to retain electronic access to the privileged medical records of such dependent child, not- withstanding that the former spouse is no longer a de- pendent under section 1072(2) of title 10, United States Code. ‘‘(b) DEFINITIONS.—In this section: ‘‘(1) The term ‘dependent’ has the meaning given that term in section 1072 of title 10, United States Code. ‘‘(2) The term ‘dependent child’ means a dependent child of a remarried former spouse and a member or former member of a uniformed service. ‘‘(3) The term ‘remarried former spouse’ means a re- married former spouse of a member or former mem- ber of a uniformed service.’’ BRAIN HEALTH INITIATIVE OF DEPARTMENT OF DEFENSE Pub. L. 117–263, div. A, title VII, § 735, Dec. 23, 2022, 136 Stat. 2668, as amended by Pub. L. 118–159, div. A, title VII, § 723, Dec. 23, 2024, 138 Stat. 1952, provided that: ‘‘(a) IN GENERAL.—The Secretary of Defense, in con- sultation with the Secretaries concerned, shall estab- lish a comprehensive initiative for brain health to be known as the ‘Warfighter Brain Health Initiative’ (in this section referred to as the ‘Initiative’) for the pur- pose of unifying efforts and programs across the De- partment of Defense to improve the cognitive perform- ance and brain health of members of the Armed Forces. ‘‘(b) OBJECTIVES.—The objectives of the Initiative shall be the following: ‘‘(1) To enhance, maintain, and restore the cog- nitive performance of members of the Armed Forces through education, training, prevention, protection, monitoring, detection, diagnosis, treatment, and re- habilitation, including through the following activi- ties: ‘‘(A) The establishment of a program to monitor cognitive brain health across the Department of Defense, with the goal of detecting any need for cognitive enhancement or restoration resulting from potential brain exposures of members of Armed Forces, to mitigate possible evolution of in- jury or disease progression. ‘‘(B) In accordance with subsection (c), the identi- fication and dissemination of thresholds for blast exposure and overpressure safety and associated emerging scientific evidence that— ‘‘(i) cover brain injury and impulse noise; ‘‘(ii) measure impact over 24-hour, 72-hour to 96- hour, monthly, annual, and lifetime periods; ‘‘(iii) are designed to prevent cognitive deficits after firing; ‘‘(iv) account for the cumulative impact of fir- ing multiple weapon systems during the same pe- riod; ‘‘(v) include minimum safe distances and levels of exposure for observers and instructors; and ‘‘(vi) address shoulder-fired heavy weapons. ‘‘(C) The modification of high-risk training and operational activities to mitigate the negative ef- fects of repetitive blast exposure. ‘‘(D) The identification of individuals who per- form high-risk training or occupational activities, for purposes of increased monitoring of the brain health of such individuals. ‘‘(E) The development and operational fielding of non-invasive, portable, point-of-care medical de- vices, to inform the diagnosis and treatment of traumatic brain injury. ‘‘(F) The establishment of a standardized moni- toring program that documents and analyzes blast exposures that may affect the brain health of mem- bers of the Armed Forces. ‘‘(G) The consideration of the findings and rec- ommendations of the report of the National Acad- emies of Science, Engineering, and Medicine titled ‘Traumatic Brain Injury: A Roadmap for Accel- erating Progress’ and published in 2022 (relating to the acceleration of progress in traumatic brain in- jury research and care), or any successor report, in relation to the activities of the Department relat- ing to brain health, as applicable. ‘‘(H) The establishment of a standardized treat- ment program based on interventions that have shown benefit to individuals with brain health issues after a brain injury and the provision of that treatment program to individuals with brain health issues after a brain injury resulting from a poten- tial brain exposure described in subparagraph (A) or high-risk training or occupational activities de- scribed in subparagraph (D). ‘‘(I) The establishment of policies to encourage members of the Armed Forces to seek medical treatment for brain health when needed, prevent re- taliation against such members who seek such med- ical treatment, and address other barriers to seek- ing medical treatment for brain health due to the impact of blast exposure, blast overpressure, or traumatic brain injury. ‘‘(J) The modification of existing weapons sys- tems to reduce blast exposure of the individual using the weapon and those within the minimum safe distance. ‘‘(2) To harmonize and prioritize the efforts of the Department of Defense into a single approach to brain health. ‘‘(c) THRESHOLDS FOR BLAST EXPOSURE AND OVER- PRESSURE SAFETY.— ‘‘(1) TIMING.— ‘‘(A) INITIAL THRESHOLDS.—Not later than Janu- ary 1, 2027, the Secretary of Defense shall identify and disseminate the thresholds for blast exposure and overpressure safety under subsection (b)(1)(B). ‘‘(B) PERIODIC UPDATES.—On a quinquennial basis, the Secretary shall review and, as necessary, up- date the thresholds for blast exposure and over- pressure safety under subsection (b)(1)(B). ‘‘(2) FORMAL TRAINING REQUIREMENT.—The Sec- retary shall ensure that training on the thresholds for blast exposure and overpressure safety is provided to members of the Armed Forces before training, de- ployment, or entering other high-risk environments where exposure to blast overpressure is likely. ‘‘(3) CENTRAL REPOSITORY.—Not later than January 1, 2027, the Secretary shall establish a central reposi- tory of blast-related characteristics, such as pressure profiles and common blast loads associated with spe- cific systems and the environments in which the sys- tems are used. ‘‘(4) WAIVERS.— ‘‘(A) PROTOCOLS.—The Secretary may waive the thresholds for blast exposure and overpressure safe- ty under subsection (b)(1)(B) for operational or training requirements that the Secretary deter- mines are essential to national security. The Sec- retary shall include in each such waiver a justifica- tion for exceeding such thresholds. ‘‘(B) TRACKING SYSTEM.—The Secretary shall es- tablish a Department of Defense-wide tracking sys- tem for waivers issued under subparagraph (A) that includes data contributed by the Secretary of each military department. ‘‘(C) REPORT ON WAIVERS.—Not later than one year after issuing a waiver under subparagraph (A) and annually thereafter for a period of five years, the Secretary of Defense shall submit to the Com- mittees on Armed Services of the Senate and the House of Representatives a report on such waivers that includes— ‘‘(i) the number of waivers issued, disaggregated by military department; and ‘‘(ii) a description of actions taken by the Sec- retary concerned to track the health effects of ex- ceeding thresholds for blast exposure and over- pressure safety on members of the Armed Forces, document such effects in medical records, and provide care to such members. ‘‘(d) PILOT PROGRAM RELATING TO MONITORING OF BLAST COVERAGE.— Page 966 TITLE 10—ARMED FORCES § 1071 ‘‘(1) AUTHORITY.—The Director of the Defense Health Agency may conduct, as part of the Initiative, a pilot program under which the Director shall mon- itor blast overpressure exposure through the use of commercially available, off-the-shelf, wearable sen- sors or other remote measurement technology, and document and evaluate data collected as a result of such monitoring. ‘‘(2) LOCATIONS.—Monitoring activities under a pilot program conducted pursuant to paragraph (1) shall be carried out in each training environment that the Director determines poses a risk for blast overpressure exposure. ‘‘(3) DOCUMENTATION AND SHARING OF DATA.—If the Director conducts a pilot program pursuant to para- graph (1), the Director shall— ‘‘(A) ensure that any data collected pursuant to such pilot program that is related to the health ef- fects of the blast overpressure exposure of a mem- ber of the Armed Forces who participated in the pilot program is documented and maintained by the Secretary of Defense in an electronic health record for the member; and ‘‘(B) to the extent practicable, and in accordance with applicable provisions of law relating to data privacy, make data collected pursuant to such pilot program available to other academic and medical researchers for the purpose of informing future re- search and treatment options. ‘‘(4) WEAPONS USE.—Monitoring activities under a pilot program conducted pursuant to paragraph (1) shall be carried out for any member of the Armed Forces firing tier 1 weapons in training or combat, as identified by the Secretary of Defense. ‘‘(e) REPORTS ON WARFIGHTER BRAIN HEALTH INITIA- TIVE.—Not later than December 31, 2025, and not less frequently than annually thereafter for a period of five years, the Secretary of Defense shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report that includes the fol- lowing: ‘‘(1) A description of the activities taken under the Initiative and resources expended under the Initia- tive during the prior fiscal year. ‘‘(2) The number of members of the Armed Forces impacted by blast overpressure and blast exposure in the prior fiscal year, including— ‘‘(A) the number of members who reported ad- verse health effects from blast overpressure or blast exposure; ‘‘(B) the number of members exposed to blast overpressure or blast exposure; ‘‘(C) the number of members who received treat- ment for injuries related to blast overpressure or blast exposure, including at facilities of the Depart- ment of Defense and at facilities in the private sec- tor; and ‘‘(D) the type of care that members receive from facilities of the Department of Defense and the type of care that members receive from facilities in the private sector. ‘‘(3) A summary of the progress made during the prior fiscal year with respect to the objectives of the Initiative under subsection (b). ‘‘(4) A description of the steps the Secretary is tak- ing to ensure that activities under the Initiative are being implemented across the Department of Defense and the military departments. ‘‘(f) SECRETARY CONCERNED DEFINED.—In this section, the term ‘Secretary concerned’ has the meaning given that term in section 101 of title 10, United States Code.’’ ESTABLISHMENT OF PARTNERSHIP PROGRAM BETWEEN UNITED STATES AND UKRAINE FOR MILITARY TRAUMA CARE AND RESEARCH Pub. L. 117–263, div. A, title VII, § 736, Dec. 23, 2022, 136 Stat. 2670, as amended by Pub. L. 118–31, div. A, title VII, § 721, Dec. 22, 2023, 137 Stat. 305, provided that: ‘‘Not later than February 24, 2023, the Secretary of Defense shall seek to enter into a partnership with the appro- priate counterpart from the Government of Ukraine for the establishment of a joint program on military trau- ma care and research. Such program shall consist of the following: ‘‘(1) The sharing of relevant lessons learned from the Russo-Ukraine War. ‘‘(2) The conduct of relevant joint conferences and exchanges with military medical professionals from Ukraine and the United States. ‘‘(3) Collaboration with the armed forces of Ukraine on matters relating to health policy, health adminis- tration, and medical supplies and equipment, includ- ing through knowledge exchanges. ‘‘(4) The conduct of joint research and development on the health effects of new and emerging weapons. ‘‘(5) The entrance into agreements with military medical schools of Ukraine for reciprocal education programs under which students at the Uniformed Services University of the Health Sciences receive specialized military medical instruction at the such military medical schools of Ukraine and military medical personnel of Ukraine receive specialized military medical instruction at the Uniformed Serv- ices University of the Health Sciences, pursuant to section 2114(f) of title 10, United States Code. ‘‘(6) The provision of support to Ukraine for the purpose of facilitating the establishment in Ukraine of a program substantially similar to the Wounded Warrior Program in the United States. ‘‘(7) The provision of training and support to Ukraine for the treatment of individuals with ex- tremity trauma, amputations, post-traumatic stress disorder, traumatic brain injuries, and any other mental health conditions associated with post-trau- matic stress disorder or traumatic brain injuries, in- cluding— ‘‘(A) the exchange of subject matter expertise; ‘‘(B) training and support relating to advanced clinical skills development; and ‘‘(C) training and support relating to clinical case management support. ‘‘(8) The provision of training to the armed forces of Ukraine in the following areas: ‘‘(A) Health matters relating to chemical, biologi- cal, radiological, nuclear and explosive weapons. ‘‘(B) Preventive medicine and infectious disease. ‘‘(C) Post traumatic stress disorder. ‘‘(D) Suicide prevention. ‘‘(9) The maintenance of a list of medical supplies and equipment needed. ‘‘(10) Such other elements as the Secretary of De- fense may determine appropriate.’’ BIENNIAL BRIEFING ON INDIVIDUAL LONGITUDINAL EXPOSURE RECORD Pub. L. 117–168, title VIII, § 802, Aug. 10, 2022, 136 Stat. 1801, provided that: ‘‘(a) IN GENERAL.—Not later than one year after the date on which the Individual Longitudinal Exposure Record achieves full operational capability, as deter- mined by the Secretary of Defense, and every two years thereafter, the Secretary of Defense, in consultation with the Secretary of Veterans Affairs, shall provide the appropriate committees of Congress a briefing on— ‘‘(1) the quality of the databases of the Department of Defense that provide the information presented in such Individual Longitudinal Exposure Record; and ‘‘(2) the usefulness of such Individual Longitudinal Exposure Record or system in supporting members of the Armed Forces and veterans in receiving health care and benefits from the Department of Defense and the Department of Veterans Affairs. ‘‘(b) ELEMENTS.—Each briefing required by subsection (a) shall include, for the period covered by the report, the following: ‘‘(1) An identification of potential exposures to oc- cupational or environmental hazards captured by the current systems of the Department of Defense for en- vironmental, occupational, and health monitoring, Page 967 TITLE 10—ARMED FORCES § 1071 and recommendations for how to improve those sys- tems. ‘‘(2) An analysis of the quality and accuracy of the location data used by the Department of Defense in determining potential exposures to occupational or environmental hazards by members of the Armed Forces and veterans, and recommendations for how to improve the quality of such data if necessary. ‘‘(c) DEFINITIONS.—In this section: ‘‘(1) APPROPRIATE COMMITTEES OF CONGRESS.—The term ‘appropriate committees of Congress’ means— ‘‘(A) the Committee on Armed Services and the Committee on Veterans’ Affairs of the Senate; and ‘‘(B) the Committee on Armed Services and the Committee on Veterans’ Affairs of the House of Representatives. ‘‘(2) INDIVIDUAL LONGITUDINAL EXPOSURE RECORD.— The term ‘Individual Longitudinal Exposure Record’ has the meaning given such term in section 1171 of title 38, United States Code, as added by section 202.’’ APPEALS TO PHYSICAL EVALUATION BOARD DETERMINATIONS OF FITNESS FOR DUTY Pub. L. 117–81, div. A, title V, § 524, Dec. 27, 2021, 135 Stat. 1687, provided that: ‘‘Not later than 90 days after the date of the enactment of this Act [Dec. 27, 2021], the Secretary of Defense shall incorporate a formal appeals process (including timelines established by the Sec- retary of Defense) into the policies and procedures ap- plicable to the implementation of the Integrated Dis- ability Evaluation System of the Department of De- fense. The appeals process shall include the following: ‘‘(1) The Secretary concerned shall ensure that a member of the Armed Forces may submit a formal appeal made with respect to determinations of fitness for duty to a Physical Evaluation Board of such Sec- retary. ‘‘(2) The appeals process shall include, at the re- quest of such member, an impartial hearing on a fit- ness for duty determination to be conducted by the Secretary concerned. ‘‘(3) Such member shall have the option to be rep- resented at a hearing by legal counsel.’’ IMPROVEMENT OF POSTPARTUM CARE FOR MEMBERS OF THE ARMED FORCES AND DEPENDENTS Pub. L. 117–81, div. A, title VII, § 707, Dec. 27, 2021, 135 Stat. 1782, provided that: ‘‘(a) CLINICAL PRACTICE GUIDELINES FOR POSTPARTUM CARE IN MILITARY MEDICAL TREATMENT FACILITIES.— Not later than 180 days after the date of the enactment of this Act [Dec. 27, 2021], the Secretary of Defense shall establish clinical practice guidelines for the pro- vision of postpartum care in military medical treat- ment facilities. Such guidelines shall take into account the recommendations of established professional med- ical associations and address the following matters: ‘‘(1) Postpartum mental health assessments, includ- ing the appropriate intervals for furnishing such as- sessments and screening questions for such assess- ments (including questions relating to postpartum anxiety and postpartum depression). ‘‘(2) Pelvic health evaluation and treatment, in- cluding the appropriate timing for furnishing a med- ical evaluation for pelvic health, considerations for providing consultations for physical therapy for pel- vic health (including pelvic floor health), and the ap- propriate use of telehealth services. ‘‘(3) Pelvic health rehabilitation services. ‘‘(4) Obstetric hemorrhage treatment, including through the use of pathogen reduced resuscitative products. ‘‘(b) POLICY ON SCHEDULING OF APPOINTMENTS FOR POSTPARTUM HEALTH CARE SERVICES.— ‘‘(1) POLICY REQUIRED.—Not later than 180 days after the date of the enactment of this Act, the Secretary shall establish a policy for the scheduling of appoint- ments for postpartum health care services in military medical treatment facilities. In developing the pol- icy, the Secretary shall consider the extent to which it is appropriate to facilitate concurrent scheduling of appointments for postpartum care with appoint- ments for well-baby care. ‘‘(2) PILOT PROGRAM AUTHORIZED.—The Secretary may carry out a pilot program in one or more mili- tary medical treatment facilities to evaluate the ef- fect of concurrent scheduling, to the degree clinically appropriate, of the appointments specified in para- graph (1). ‘‘(c) POLICY ON POSTPARTUM PHYSICAL FITNESS TESTS AND BODY COMPOSITION ASSESSMENTS.—Not later than 180 days after the date of enactment of this Act, the Secretary shall establish a policy, which shall be stand- ardized across each Armed Force to the extent prac- ticable, for the time periods after giving birth that a member of the Armed Forces (including the reserve components) may be excused from, or provided an al- ternative to, a physical fitness test or a body composi- tion assessment. ‘‘(d) BRIEFING.—Not later than 270 days after the date of enactment of this Act, the Secretary shall provide to the Committees on Armed Services of the House of Representatives and the Senate a briefing on the imple- mentation of the requirements under this section.’’ IMPLEMENTATION OF INTEGRATED PRODUCT FOR MAN- AGEMENT OF POPULATION HEALTH ACROSS MILITARY HEALTH SYSTEM Pub. L. 117–81, div. A, title VII, § 722, Dec. 27, 2021, 135 Stat. 1792, provided that: ‘‘(a) INTEGRATED PRODUCT.—The Secretary of Defense shall develop and implement an integrated product for the management of population health across the mili- tary health system. Such integrated product shall serve as a repository for the health care, demographic, and other relevant data of all covered beneficiaries, in- cluding with respect to data on health care services furnished to such beneficiaries through the purchased care and direct care components of the TRICARE pro- gram, and shall— ‘‘(1) be compatible with the electronic health record system maintained by the Secretary for members of the Armed Forces; ‘‘(2) enable the collection and stratification of data from multiple sources to measure population health goals, facilitate disease management programs of the Department, improve patient education, and inte- grate wellness services across the military health system; and ‘‘(3) enable predictive modeling to improve health outcomes for patients and to facilitate the identifica- tion and correction of medical errors in the treat- ment of patients, issues regarding the quality of health care services provided, and gaps in health care coverage. ‘‘(b) CONSIDERATIONS IN DEVELOPMENT.—In developing the integrated product under subsection (a), the Sec- retary shall harmonize such development with any policies of the Department relating to a digital health strategy (including the digital health strategy under section 723 [135 Stat. 1792]), coordinate with improve- ments to the electronic health record system specified in subsection (a)(1) to ensure the compatibility re- quired under such subsection, and consider methods to improve beneficiary interface. ‘‘(c) DEFINITIONS.—In this section: ‘‘(1) The terms ‘covered beneficiary’ and ‘TRICARE program’ have the meanings given such terms in sec- tion 1072 of title 10, United States Code. ‘‘(2) The term ‘integrated product’ means an elec- tronic system of systems (or solutions or products) that provides for the integration and sharing of data to meet the needs of an end user in a timely and cost- effective manner.’’ MANDATORY TRAINING ON HEALTH EFFECTS OF BURN PITS Pub. L. 117–81, div. A, title VII, § 725, Dec. 27, 2021, 135 Stat. 1795, provided that: ‘‘The Secretary of Defense Page 968 TITLE 10—ARMED FORCES § 1071 shall provide to each medical provider of the Depart- ment of Defense mandatory training with respect to the potential health effects of burn pits.’’ ACCESS BY COVERED INDIVIDUALS TO CERTAIN FACILI- TIES OF DEPARTMENT OF DEFENSE FOR ASSESSMENT AND TREATMENT OF ANOMALOUS HEALTH CONDITIONS Pub. L. 117–81, div. A, title VII, § 732, Dec. 27, 2021, 135 Stat. 1797, as amended by Pub. L. 117–263, div. A, title X, § 1044(b), Dec. 23, 2022, 136 Stat. 2772, provided that: ‘‘(a) ASSESSMENT.—The Secretary of Defense shall provide to covered individuals whom the Secretary de- termines are experiencing symptoms of certain anoma- lous health conditions, as defined by the Secretary for purposes of this section, timely access for medical as- sessment, subject to space availability, to the National Intrepid Center of Excellence, an Intrepid Spirit Cen- ter, or an appropriate military medical treatment facil- ity, as determined by the Secretary. ‘‘(b) TREATMENT.—With respect to an individual de- scribed in subsection (a) diagnosed with an anomalous health condition or a related affliction, whether diag- nosed under an assessment under subsection (a) or oth- erwise, the Secretary of Defense shall furnish to the in- dividual treatment for the condition or affliction, sub- ject to space availability, at the National Intrepid Cen- ter of Excellence, an Intrepid Spirit Center, or an ap- propriate military medical treatment facility, as deter- mined by the Secretary. ‘‘(c) DEVELOPMENT OF PROCESS.—The Secretary of De- fense, in consultation with the heads of such Federal agencies as the Secretary considers appropriate, shall develop a process to ensure that covered individuals are afforded timely access to the National Intrepid Center of Excellence, an Intrepid Spirit Center, or an appro- priate military medical treatment facility pursuant to subsection (a) by not later than 60 days after the date of the enactment of this Act [Dec. 27, 2021]. ‘‘(d) MODIFICATION OF DEPARTMENT OF DEFENSE TRAU- MA REGISTRY.—The Secretary of Defense shall modify the Trauma Registry of the Department of Defense to include data on the demographics, condition-producing event, diagnosis and treatment, and outcomes of anom- alous health conditions experienced by covered individ- uals assessed or treated under this section, subject to the consent of the covered individual and, if applicable, an agreement with the employing agency. ‘‘(e) COVERED INDIVIDUALS DEFINED.—In this section, the term ‘covered individuals’ means— ‘‘(1) current and former employees of the United States Government and their family members; and ‘‘(2) current and former members of the Armed Forces and their family members.’’ MILITARY HEALTH SYSTEM CLINICAL QUALITY MANAGEMENT PROGRAM Pub. L. 116–283, div. A, title VII, § 744, Jan. 1, 2021, 134 Stat. 3708, provided that: ‘‘(a) IN GENERAL.—The Secretary of Defense, acting through the Director of the Defense Health Agency, shall implement a comprehensive program to be known as the ‘Military Health System Clinical Quality Man- agement Program’ (in this section referred to as the ‘Program’). ‘‘(b) ELEMENTS OF PROGRAM.—The Program shall in- clude, at a minimum, the following: ‘‘(1) The implementation of systematic procedures to eliminate, to the extent feasible, risk of harm to patients at military medical treatment facilities, in- cluding through identification, investigation, and analysis of events indicating a risk of patient harm and corrective action plans to mitigate such risks. ‘‘(2) With respect to a potential sentinel event (in- cluding those involving members of the Armed Forces) at a military medical treatment facility— ‘‘(A) an analysis of such event, which shall occur and be documented as soon as possible after the event; ‘‘(B) use of such analysis for clinical quality man- agement; and ‘‘(C) reporting of such event to the National Prac- titioner Data Bank in accordance with guidelines of the Secretary of Health and Human Services under the Health Care Quality Improvement Act of 1986 (42 U.S.C. 11101 et seq.), giving special emphasis to the results of external peer reviews of the event. ‘‘(3) Validation of provider credentials and granting of clinical privileges by the Director of the Defense Health Agency for all health care providers at a mili- tary medical treatment facility. ‘‘(4) Accreditation of military medical treatment facilities by a recognized external accreditation body. ‘‘(5) Systematic measurement of indicators of health care quality, emphasizing clinical outcome measures, comparison of such indicators with bench- marks from leading health care quality improvement organizations, and transparency with the public of appropriate clinical measurements for military med- ical treatment facilities. ‘‘(6) Systematic activities emphasized by leadership at all organizational levels to use all elements of the Program to eliminate unwanted variance throughout the health care system of the Department of Defense and make constant improvements in clinical quality. ‘‘(7) A full range of procedures for productive com- munication between patients and health care pro- viders regarding actual or perceived adverse clinical events at military medical treatment facilities, in- cluding procedures— ‘‘(A) for full disclosure of such events (respecting the confidentiality of peer review information under a medical quality assurance program under section 1102 of title 10, United States Code); ‘‘(B) providing an opportunity for the patient to be heard in relation to quality reviews; and ‘‘(C) to resolve patient concerns by independent, neutral health care resolution specialists. ‘‘(c) ADDITIONAL CLINICAL QUALITY MANAGEMENT AC- TIVITIES.— ‘‘(1) IN GENERAL.—In addition to the elements of the Program set forth in subsection (b), the Secretary shall establish and maintain clinical quality manage- ment activities in relation to functions of the health care system of the Department separate from deliv- ery of health care services in military medical treat- ment facilities. ‘‘(2) HEALTH CARE DELIVERY OUTSIDE MILITARY MED- ICAL TREATMENT FACILITIES.—In carrying out para- graph (1), the Secretary shall maintain policies and procedures to promote clinical quality in health care delivery on ships and planes, in deployed settings, and in all other circumstances not covered by sub- section (b), with the objective of implementing stand- ards and procedures comparable, to the extent prac- ticable, to those under such subsection. ‘‘(3) PURCHASED CARE SYSTEM.—In carrying out paragraph (1), the Secretary shall maintain policies and procedures for health care services provided out- side the Department but paid for by the Department, reflecting best practices by public and private health care reimbursement and management systems.’’ WOUNDED WARRIOR SERVICE DOG PROGRAM Pub. L. 116–283, div. A, title VII, § 745, Jan. 1, 2021, 134 Stat. 3710, provided that: ‘‘(a) PROGRAM.—The Secretary of Defense shall estab- lish a program, to be known as the ‘Wounded Warrior Service Dog Program’, to provide assistance dogs to covered members and covered veterans. ‘‘(b) DEFINITIONS.—In this section: ‘‘(1) The term ‘assistance dog’ means a dog specifi- cally trained to perform physical tasks to mitigate the effects of a covered disability, except that the term does not include a dog specifically trained for comfort or personal defense. ‘‘(2) The term ‘covered disability’ means any of the following: ‘‘(A) Blindness or visual impairment. ‘‘(B) Loss of use of a limb, paralysis, or other sig- nificant mobility issues. Page 969 TITLE 10—ARMED FORCES § 1071 ‘‘(C) Loss of hearing. ‘‘(D) Traumatic brain injury. ‘‘(E) Post-traumatic stress disorder. ‘‘(F) Any other disability that the Secretary of Defense considers appropriate. ‘‘(3) The term ‘covered member’ means a member of the Armed Forces who is— ‘‘(A) receiving medical treatment, recuperation, or therapy under chapter 55 of title 10, United States Code; ‘‘(B) in medical hold or medical holdover status; or ‘‘(C) covered under section 1202 or 1205 of title 10, United States Code. ‘‘(4) The term ‘covered veteran’ means a veteran who is enrolled in the health care system established under section 1705(a) of title 38, United States Code.’’ INCLUSION OF BLAST EXPOSURE HISTORY IN MEDICAL RECORDS OF MEMBERS OF THE ARMED FORCES Pub. L. 116–92, div. A, title VII, § 717, Dec. 20, 2019, 133 Stat. 1453, provided that: ‘‘(a) REQUIREMENT.—If a covered incident occurs with respect to a member of the Armed Forces, the Sec- retary of Defense, in coordination with the Secretaries of the military departments, shall document blast ex- posure history in the medical record of the member to assist in determining whether a future illness or injury of the member is service-connected and inform future blast exposure risk mitigation efforts of the Depart- ment of Defense. ‘‘(b) ELEMENTS.—A blast exposure history under sub- section (a) shall include, at a minimum, the following: ‘‘(1) The date of the exposure. ‘‘(2) The duration of the exposure, and, if known, the measured blast pressure experienced by the indi- vidual during such exposure. ‘‘(3) Whether the exposure occurred during combat or training. ‘‘(c) REPORT.—Not later than one year after the date of the enactment of this Act [Dec. 20, 2019], the Sec- retary of Defense shall submit to the Committees on Armed Services of the Senate and the House of Rep- resentatives a report on the types of information in- cluded in a blast exposure history under subsection (a). ‘‘(d) COVERED INCIDENT DEFINED.—In this section, the term ‘covered incident’ means a concussive event or in- jury that requires a military acute concussive evalua- tion by a skilled health care provider.’’ MODIFICATION TO REFERRALS FOR MENTAL HEALTH SERVICES Pub. L. 116–92, div. A, title VII, § 722, Dec. 20, 2019, 133 Stat. 1457, provided that: ‘‘If the Secretary of Defense is unable to provide mental health services in a mili- tary medical treatment facility to a member of the Armed Forces within 15 days of the date on which such services are first requested by the member, the Sec- retary may refer the member to a provider under the TRICARE program (as that term is defined in section 1072 of title 10, United States Code) to receive such services.’’ MEDICAL SIMULATION TECHNOLOGY AND LIVE TISSUE TRAINING Pub. L. 115–232, div. A, title VII, § 718, Aug. 13, 2018, 132 Stat. 1816, provided that: ‘‘(a) IN GENERAL.— ‘‘(1) USE OF SIMULATION TECHNOLOGY.—Except as provided by paragraph (2), the Secretary of Defense shall use medical simulation technology, to the max- imum extent practicable, before the use of live tissue training to train medical professionals and combat medics of the Department of Defense. ‘‘(2) DETERMINATION.—The use of live tissue train- ing within the Department of Defense may be used as determined necessary by the medical chain of com- mand. ‘‘(b) BRIEFING.—Not later than 180 days after the date of the enactment of this Act [Aug. 13, 2018], the Sec- retary of Defense, in consultation with the Chairman of the Joint Chiefs of Staff and the Secretaries of the military departments, shall provide a briefing to the Committees on Armed Services of the House of Rep- resentatives and the Senate on the use and benefit of medical simulation technology and live tissue training within the Department of Defense to train medical pro- fessionals, combat medics, and members of the Special Operations Forces. ‘‘(c) ELEMENTS.—The briefing under subsection (b) shall include the following: ‘‘(1) A discussion of the benefits and needs of both medical simulation technology and live tissue train- ing. ‘‘(2) Ways and means to enhance and advance the use of simulation technologies in training. ‘‘(3) An assessment of current medical simulation technology requirements, gaps, and limitations. ‘‘(4) An overview of Department of Defense medical training programs, as of the date of the briefing, that use live tissue training and medical simulation tech- nologies. ‘‘(5) Any other matters the Secretary determines appropriate.’’ INCLUSION OF GAMBLING DISORDER IN HEALTH ASSESS- MENTS OF MEMBERS OF THE ARMED FORCES AND RE- LATED RESEARCH EFFORTS Pub. L. 115–232, div. A, title VII, § 733, Aug. 13, 2018, 132 Stat. 1818, provided that: ‘‘(a) INCLUSION IN NEXT ANNUAL PERIODIC HEALTH AS- SESSMENTS.—The Secretary of Defense shall incor- porate medical screening questions specific to gam- bling disorder into the Annual Periodic Health Assess- ments of members of the Armed Forces conducted by the Department of Defense during the one-year period beginning 180 days after the date of the enactment of this Act [Aug. 13, 2018]. ‘‘(b) INCLUSION IN CERTAIN SURVEYS.—The Secretary shall incorporate into ongoing research efforts of the Department questions on gambling disorder, as appro- priate, including by restoring such questions to the fol- lowing: ‘‘(1) The first Health Related Behaviors Survey of Active Duty Military Personnel conducted after the date of the enactment of this Act. ‘‘(2) The first Health Related Behaviors Survey of Reserve Component Personnel conducted after that date. ‘‘(c) REPORTS.—Not later than one year after the date of the completion of the assessment referred to in sub- section (a), and of each survey referred to in subsection (b), as modified pursuant to this section, the Secretary shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report on the findings of the assessment or survey in connec- tion with the prevalence of gambling disorder among members of the Armed Forces.’’ JOINT TRAUMA SYSTEM Pub. L. 114–328, div. A, title VII, § 707, Dec. 23, 2016, 130 Stat. 2208, provided that: ‘‘(a) PLAN.— ‘‘(1) IN GENERAL.—Not later than 180 days after the date of the enactment of this Act [Dec. 23, 2016], the Secretary of Defense shall submit to the Committees on Armed Services of the House of Representatives and the Senate an implementation plan to establish a Joint Trauma System within the Defense Health Agency that promotes improved trauma care to mem- bers of the Armed Forces and other individuals who are eligible to be treated for trauma at a military medical treatment facility. ‘‘(2) IMPLEMENTATION.—The Secretary shall imple- ment the plan under paragraph (1) after a 90-day pe- riod has elapsed following the date on which the Comptroller General of the United States is required to submit to the Committees on Armed Services of the House of Representatives and the Senate the re- Page 970 TITLE 10—ARMED FORCES § 1071 view under subsection (c). In implementing such plan, the Secretary shall take into account any rec- ommendation made by the Comptroller General under such review. ‘‘(b) ELEMENTS.—The Joint Trauma System described in subsection (a)(1) shall include the following ele- ments: ‘‘(1) Serve as the reference body for all trauma care provided across the military health system. ‘‘(2) Establish standards of care for trauma services provided at military medical treatment facilities. ‘‘(3) Coordinate the translation of research from the centers of excellence of the Department of Defense into standards of clinical trauma care. ‘‘(4) Coordinate the incorporation of lessons learned from the trauma education and training partnerships pursuant to section 708 into clinical practice. ‘‘(c) REVIEW.—Not later than 180 days after the date on which the Secretary submits to the Committees on Armed Services of the House of Representatives and the Senate the implementation plan under subsection (a)(1), the Comptroller General of the United States shall submit to such committees a review of such plan to determine if each element under subsection (b) is in- cluded in such plan. ‘‘(d) REVIEW OF MILITARY TRAUMA SYSTEM.—In estab- lishing a Joint Trauma System, the Secretary of De- fense may seek to enter into an agreement with a non- governmental entity with subject matter experts to— ‘‘(1) conduct a system-wide review of the military trauma system, including a comprehensive review of combat casualty care and wartime trauma systems during the period beginning on January 1, 2001, and ending on the date of the review, including an assess- ment of lessons learned to improve combat casualty care in future conflicts; and ‘‘(2) make publicly available a report containing such review and recommendations to establish a com- prehensive trauma system for the Armed Forces.’’ JOINT TRAUMA EDUCATION AND TRAINING DIRECTORATE Pub. L. 116–92, div. A, title VII, § 721, Dec. 20, 2019, 133 Stat. 1456, provided that: ‘‘(a) PARTNERSHIPS.— ‘‘(1) IN GENERAL.—The Secretary of Defense, through the Joint Trauma Education and Training Directorate established under section 708 of the Na- tional Defense Authorization Act for Fiscal Year 2017 (Public Law 114–328; 10 U.S.C. 1071 note), may develop partnerships with civilian academic medical centers and large metropolitan teaching hospitals to improve combat casualty care for personnel of the Armed Forces. ‘‘(2) PARTNERSHIPS WITH LEVEL I TRAUMA CENTERS.— In carrying out partnerships under paragraph (1), trauma surgeons and physicians of the Department of Defense may partner with level I civilian trauma cen- ters to provide training and readiness for the next generation of medical providers to treat critically in- jured burn patients. ‘‘(b) SUPPORT OF PARTNERSHIPS.—The Secretary of Defense may make every effort to support partnerships under the Joint Trauma Education and Training Direc- torate with academic institutions that have level I ci- vilian trauma centers, specifically those centers with a burn center, that offer burn rotations and clinical expe- rience to provide training and readiness for the next generation of medical providers to treat critically in- jured burn patients. ‘‘(c) LEVEL I CIVILIAN TRAUMA CENTER DEFINED.—In this section, the term ‘level I civilian trauma center’ has the meaning given that term in section 708 of the National Defense Authorization Act for Fiscal Year 2017 (Public Law 114–328; 10 U.S.C. 1071 note).’’ Pub. L. 114–328, div. A, title VII, § 708, Dec. 23, 2016, 130 Stat. 2209, as amended by Pub. L. 115–232, div. A, title VII, § 719, Aug. 13, 2018, 132 Stat. 1817; Pub. L. 117–81, div. A, title III, § 373(b), Dec. 27, 2021, 135 Stat. 1667, provided that: ‘‘(a) ESTABLISHMENT.—The Secretary of Defense shall establish a Joint Trauma Education and Training Di- rectorate (in this section referred to as the ‘Direc- torate’) to ensure that the traumatologists of the Armed Forces maintain readiness and are able to be rapidly deployed for future armed conflicts. The Sec- retary shall carry out this section in collaboration with the Secretaries of the military departments. ‘‘(b) DUTIES.—The duties of the Directorate are as fol- lows: ‘‘(1) To enter into and coordinate the partnerships under subsection (c). ‘‘(2) To establish the goals of such partnerships nec- essary for trauma teams led by traumatologists to maintain professional competency in trauma care. ‘‘(3) To establish metrics for measuring the per- formance of such partnerships in achieving such goals. ‘‘(4) To develop methods of data collection and analysis for carrying out paragraph (3). ‘‘(5) To communicate and coordinate lessons learned from such partnerships with the Joint Trau- ma System established under section 707 [set out as a note above]. ‘‘(6) To develop standardized combat casualty care instruction for all members of the Armed Forces, in- cluding the use of standardized trauma training plat- forms. ‘‘(7) To develop a comprehensive trauma care reg- istry to compile relevant data from point of injury through rehabilitation with respect to both members of the Armed Forces and military working dogs. ‘‘(8) To develop quality of care outcome measures for combat casualty care. ‘‘(9) To inform and advise the conduct of research on the leading causes of morbidity and mortality of members of the Armed Forces and military working dogs in combat. ‘‘(c) PARTNERSHIPS.— ‘‘(1) IN GENERAL.—The Secretary may enter into partnerships with civilian academic medical centers and trauma centers to provide integrated combat trauma teams, including forward surgical teams, with maximum exposure to a high volume of patients with critical injuries. ‘‘(2) TRAUMA TEAMS.—Under the partnerships en- tered into under paragraph (1), trauma teams of the Armed Forces led by traumatologists of the Armed Forces shall embed within trauma centers on an en- during basis. ‘‘(3) SELECTION.—The Secretary shall select civilian academic medical centers and trauma centers to enter into partnerships under paragraph (1) based on patient volume, acuity, and other factors the Sec- retary determines necessary to ensure that the traumatologists of the Armed Forces and the associ- ated clinical support teams have adequate and con- tinuous exposure to critically injured patients. ‘‘(4) CONSIDERATION.—In entering into partnerships under paragraph (1), the Secretary may consider the experiences and lessons learned by the military de- partments that have entered into memoranda of un- derstanding with civilian medical centers for trauma care. ‘‘(d) PERSONNEL MANAGEMENT PLAN.— ‘‘(1) PLAN.—The Secretary shall establish a per- sonnel management plan for the following wartime medical specialties: ‘‘(A) Emergency medical services and prehospital care. ‘‘(B) Trauma surgery. ‘‘(C) Critical care. ‘‘(D) Anesthesiology. ‘‘(E) Emergency medicine. ‘‘(F) Other wartime medical specialties the Sec- retary determines appropriate for purposes of the plan. ‘‘(2) ELEMENTS.—The elements of the plan estab- lished under paragraph (1) shall include, at a min- imum, the following: ‘‘(A) An accession plan for the number of quali- fied medical personnel to maintain wartime med- Page 971 TITLE 10—ARMED FORCES § 1071 ical specialties on an annual basis in order to main- tain the required number of trauma teams as deter- mined by the Secretary. ‘‘(B) The number of positions required in each such medical specialty. ‘‘(C) Crucial organizational and operational as- signments for personnel in each such medical spe- cialty. ‘‘(D) Career pathways for personnel in each such medical specialty. ‘‘(3) IMPLEMENTATION.—The Secretaries of the mili- tary departments shall carry out the plan established under paragraph (1). ‘‘(e) IMPLEMENTATION PLAN.—Not later than July 1, 2017, the Secretary of Defense shall submit to the Com- mittees on Armed Services of the House of Representa- tives and the Senate an implementation plan for estab- lishing the Joint Trauma Education and Training Di- rectorate under subsection (a), entering into partner- ships under subsection (c), and establishing the plan under subsection (d). ‘‘(f) LEVEL I CIVILIAN TRAUMA CENTER DEFINED.—In this section, the term ‘level I civilian trauma center’ means a comprehensive regional resource that is a ter- tiary care facility central to the trauma system and is capable of providing total care for every aspect of in- jury from prevention through rehabilitation.’’ STANDARDIZED SYSTEM FOR SCHEDULING MEDICAL APPOINTMENTS AT MILITARY TREATMENT FACILITIES Pub. L. 114–328, div. A, title VII, § 709, Dec. 23, 2016, 130 Stat. 2211, provided that: ‘‘(a) STANDARDIZED SYSTEM.— ‘‘(1) IN GENERAL.—Not later than January 1, 2018, the Secretary of Defense shall implement a system for scheduling medical appointments at military treatment facilities that is standardized throughout the military health system to enable timely access to care for covered beneficiaries. ‘‘(2) LACK OF VARIANCE.—The system implemented under paragraph (1) shall ensure that the appoint- ment scheduling processes and procedures used with- in the military health system do not vary among military treatment facilities. ‘‘(b) SOLE SYSTEM.—Upon implementation of the sys- tem under subsection (a), no military treatment facil- ity may use an appointment scheduling process other than such system. ‘‘(c) SCHEDULING OF APPOINTMENTS.— ‘‘(1) IN GENERAL.—Under the system implemented under subsection (a), each military treatment facility shall use a centralized appointment scheduling capa- bility for covered beneficiaries that includes the abil- ity to schedule appointments manually via telephone as described in paragraph (2) or automatically via a device that is connected to the Internet through an online scheduling system described in paragraph (3). ‘‘(2) TELEPHONE APPOINTMENT PROCESS.— ‘‘(A) IN GENERAL.—In the case of a covered bene- ficiary who contacts a military treatment facility via telephone to schedule an appointment under the system implemented under subsection (a), the Sec- retary shall implement standard processes to en- sure that the needs of the covered beneficiary are met during the first such telephone call. ‘‘(B) MATTERS INCLUDED.—The standard processes implemented under subparagraph (A) shall include the following: ‘‘(i) The ability of a covered beneficiary, during the telephone call to schedule an appointment, to also schedule wellness visits or follow-up appoint- ments during the 180-day period beginning on the date of the request for the visit or appointment. ‘‘(ii) The ability of a covered beneficiary to in- dicate the process through which the covered ben- eficiary prefers to be reminded of future appoint- ments, which may include reminder telephone calls, emails, or cellular text messages to the cov- ered beneficiary at specified intervals prior to ap- pointments. ‘‘(3) ONLINE SYSTEM.— ‘‘(A) IN GENERAL.—The Secretary shall implement an online scheduling system that is available 24 hours per day, seven days per week, for purposes of scheduling appointments under the system imple- mented under subsection (a). ‘‘(B) CAPABILITIES OF ONLINE SYSTEM.—The online scheduling system implemented under subpara- graph (A) shall have the following capabilities: ‘‘(i) An ability to send automated email and text message reminders, including repeat remind- ers, to patients regarding upcoming appoint- ments. ‘‘(ii) An ability to store appointment records to ensure rapid access by medical personnel to ap- pointment data. ‘‘(d) STANDARDS FOR PRODUCTIVITY OF HEALTH CARE PROVIDERS.— ‘‘(1) IN GENERAL.—The Secretary shall implement standards for the productivity of health care pro- viders at military treatment facilities. ‘‘(2) MATTERS CONSIDERED.—In developing standards under paragraph (1), the Secretary shall consider— ‘‘(A) civilian benchmarks for measuring the pro- ductivity of health care providers; ‘‘(B) the optimal number of medical appointments for each health care provider that would be re- quired, as determined by the Secretary, to main- tain access of covered beneficiaries to health care from the Department; and ‘‘(C) the readiness requirements of the Armed Forces. ‘‘(e) PLAN.— ‘‘(1) IN GENERAL.—Not later than January 1, 2017, the Secretary shall submit to the Committees on Armed Services of the Senate and the House of Rep- resentatives a comprehensive plan to implement the system required under subsection (a). ‘‘(2) ELEMENTS.—The plan required under paragraph (1) shall include the following: ‘‘(A) A description of the manual appointment process to be used at military treatment facilities under the system required under subsection (a). ‘‘(B) A description of the automated appointment process to be used at military treatment facilities under such system. ‘‘(C) A timeline for the full implementation of such system throughout the military health sys- tem. ‘‘(f) BRIEFING.—Not later than February 1, 2018, the Secretary shall brief the Committees on Armed Serv- ices of the Senate and the House of Representatives on the implementation of the system required under sub- section (a) and the standards for the productivity of health care providers required under subsection (d). ‘‘(g) REPORT ON MISSED APPOINTMENTS.— ‘‘(1) IN GENERAL.—Not later than March 1 each year, the Secretary of Defense shall submit to the Commit- tees on Armed Services of the Senate and the House of Representatives a report on the total number of medical appointments at military treatment facili- ties for which a covered beneficiary failed to appear without prior notification during the one-year period preceding the submittal of the report. ‘‘(2) ELEMENTS.—Each report under paragraph (1) shall include for each military treatment facility the following: ‘‘(A) An identification of the top five reasons for a covered beneficiary missing an appointment. ‘‘(B) A comparison of the number of missed ap- pointments for specialty care versus primary care. ‘‘(C) An estimate of the cost to the Department of Defense of missed appointments. ‘‘(D) An assessment of strategies to reduce the number of missed appointments. ‘‘(h) COVERED BENEFICIARY DEFINED.—In this section, the term ‘covered beneficiary’ has the meaning given that term in section 1072 of title 10, United States Code.’’ [For termination, effective Dec. 30, 2021, of reporting requirements in section 709(g) of Pub. L. 114–328, set out Page 972 TITLE 10—ARMED FORCES § 1071 above, see section 1702(a), (b), of Pub. L. 116–92, set out as a Termination of Reporting Requirements note under section 111 of this title.] EVALUATION AND TREATMENT OF VETERANS AND CIVILIANS AT MILITARY TREATMENT FACILITIES Pub. L. 114–328, div. A, title VII, § 717, Dec. 23, 2016, 130 Stat. 2223, as amended by Pub. L. 115–91, div. A, title VII, § 712, Dec. 12, 2017, 131 Stat. 1437, provided that: ‘‘(a) IN GENERAL.—The Secretary of Defense shall au- thorize a veteran (in consultation with the Secretary of Veterans Affairs) or civilian to be evaluated and treat- ed at a military treatment facility if the Secretary of Defense determines that— ‘‘(1) the evaluation and treatment of the individual is necessary to attain the relevant mix and volume of medical casework required to maintain medical read- iness skills and competencies of health care providers at the facility; ‘‘(2) the health care providers at the facility have the competencies, skills, and abilities required to treat the individual; and ‘‘(3) the facility has available space, equipment, and materials to treat the individual. ‘‘(b) PRIORITY OF COVERED BENEFICIARIES.— ‘‘(1) IN GENERAL.—Except as provided in paragraph (2), the evaluation and treatment of covered bene- ficiaries at military treatment facilities shall be prioritized ahead of the evaluation and treatment of veterans and civilians at such facilities under sub- section (a). ‘‘(2) WAIVER.—The Secretary may waive the re- quirement under paragraph (1) in order to provide timely evaluation and treatment for individuals who are— ‘‘(A) severely wounded or injured by acts of terror that occur in the United States; or ‘‘(B) residents of the United States who are se- verely wounded or injured by acts of terror outside the United States. ‘‘(c) REIMBURSEMENT FOR TREATMENT.— ‘‘(1) CIVILIANS.—A military treatment facility that evaluates or treats an individual (other than an indi- vidual described in paragraph (2)) under subsection (a) shall bill the individual and accept reimbursement from the individual or a third-party payer (as that term is defined in section 1095(h) of title 10, United States Code) on behalf of such individual for the costs of any health care services provided to the individual under such subsection. ‘‘(2) VETERANS.—The Secretary of Defense shall enter into a memorandum of agreement with the Sec- retary of Veterans Affairs under which the Secretary of Veterans Affairs will pay a military treatment fa- cility using a prospective payment methodology (in- cluding interagency transfers of funds or obligational authority and similar transactions) for the costs of any health care services provided at the facility under subsection (a) to individuals eligible for such health care services from the Department of Veterans Affairs. ‘‘(3) USE OF AMOUNTS.—The Secretary of Defense shall make available to a military treatment facility any amounts collected by such facility under para- graph (1) or (2) for health care services provided to an individual under subsection (a). ‘‘(d) COVERED BENEFICIARY DEFINED.—In this section, the term ‘covered beneficiary’ has the meaning given that term in section 1072 of title 10, United States Code.’’ ENHANCEMENT OF USE OF TELEHEALTH SERVICES IN MILITARY HEALTH SYSTEM Pub. L. 114–328, div. A, title VII, § 718, Dec. 23, 2016, 130 Stat. 2224, provided that: ‘‘(a) INCORPORATION OF TELEHEALTH.— ‘‘(1) IN GENERAL.—Not later than 18 months after the date of the enactment of this Act [Dec. 23, 2016], the Secretary of Defense shall incorporate, through- out the direct care and purchased care components of the military health system, the use of telehealth services, including mobile health applications— ‘‘(A) to improve access to primary care, urgent care, behavioral health care, and specialty care; ‘‘(B) to perform health assessments; ‘‘(C) to provide diagnoses, interventions, and su- pervision; ‘‘(D) to monitor individual health outcomes of covered beneficiaries with chronic diseases or con- ditions; ‘‘(E) to improve communication between health care providers and patients; and ‘‘(F) to reduce health care costs for covered bene- ficiaries and the Department of Defense. ‘‘(2) TYPES OF TELEHEALTH SERVICES.—The tele- health services required to be incorporated under paragraph (1) shall include those telehealth services that— ‘‘(A) maximize the use of secure messaging be- tween health care providers and covered bene- ficiaries to improve the access of covered bene- ficiaries to health care and reduce the number of visits to medical facilities for health care needs; ‘‘(B) allow covered beneficiaries to schedule ap- pointments; and ‘‘(C) allow health care providers, through video conference, telephone or tablet applications, or home health monitoring devices— ‘‘(i) to assess and evaluate disease signs and symptoms; ‘‘(ii) to diagnose diseases; ‘‘(iii) to supervise treatments; and ‘‘(iv) to monitor health outcomes. ‘‘(b) COVERAGE OF ITEMS OR SERVICES.—An item or service furnished to a covered beneficiary via a tele- communications system shall be covered under the TRICARE program to the same extent as the item or service would be covered if furnished in the location of the covered beneficiary. ‘‘(c) REIMBURSEMENT RATES FOR TELEHEALTH SERV- ICES.—The Secretary shall develop standardized pay- ment methods to reimburse health care providers for telehealth services provided to covered beneficiaries in the purchased care component of the TRICARE pro- gram, including by using reimbursement rates that incentivize the provision of telehealth services. ‘‘(d) REDUCTION OR ELIMINATION OF COPAYMENTS.—The Secretary shall reduce or eliminate, as the Secretary considers appropriate, copayments or cost shares for covered beneficiaries in connection with the receipt of telehealth services under the purchased care compo- nent of the TRICARE program. ‘‘(e) REPORTS.— ‘‘(1) INITIAL REPORT.— ‘‘(A) IN GENERAL.—Not later than 180 days after the date of the enactment of this Act [Dec. 23, 2016], the Secretary shall submit to the Committees on Armed Services of the Senate and the House of Rep- resentatives a report describing the full range of telehealth services to be available in the direct care and purchased care components of the military health system and the copayments and cost shares, if any, associated with those services. ‘‘(B) REIMBURSEMENT PLAN.—The report required under subparagraph (A) shall include a plan to de- velop standardized payment methods to reimburse health care providers for telehealth services pro- vided to covered beneficiaries in the purchased care component of the TRICARE program, as required under subsection (c). ‘‘(2) FINAL REPORT.— ‘‘(A) IN GENERAL.—Not later than three years after the date on which the Secretary begins incor- porating, throughout the direct care and purchased care components of the military health system, the use of telehealth services as required under sub- section (a), the Secretary shall submit to the Com- mittees on Armed Services of the Senate and the House of Representatives a report describing the Page 973 TITLE 10—ARMED FORCES § 1071 impact made by the use of telehealth services, in- cluding mobile health applications, to carry out the actions specified in subparagraphs (A) through (F) of subsection (a)(1). ‘‘(B) ELEMENTS.—The report required under sub- paragraph (A) shall include an assessment of the following: ‘‘(i) The satisfaction of covered beneficiaries with telehealth services furnished by the Depart- ment of Defense. ‘‘(ii) The satisfaction of health care providers in providing telehealth services furnished by the De- partment. ‘‘(iii) The effect of telehealth services furnished by the Department on the following: ‘‘(I) The ability of covered beneficiaries to ac- cess health care services in the direct care and purchased care components of the military health system. ‘‘(II) The frequency of use of telehealth serv- ices by covered beneficiaries. ‘‘(III) The productivity of health care pro- viders providing care furnished by the Depart- ment. ‘‘(IV) The reduction, if any, in the use by cov- ered beneficiaries of health care services in military treatment facilities or medical facili- ties in the private sector. ‘‘(V) The number and types of appointments for the receipt of telehealth services furnished by the Department. ‘‘(VI) The savings, if any, realized by the De- partment by furnishing telehealth services to covered beneficiaries. ‘‘(f) REGULATIONS.— ‘‘(1) INTERIM FINAL RULE.—Not later than 180 days after the date of the enactment of this Act [Dec. 23, 2016], the Secretary shall prescribe an interim final rule to implement this section. ‘‘(2) FINAL RULE.—Not later than 180 days after pre- scribing the interim final rule under paragraph (1) and considering public comments with respect to such interim final rule, the Secretary shall prescribe a final rule to implement this section. ‘‘(3) OBJECTIVES.—The regulations prescribed under paragraphs (1) and (2) shall accomplish the objectives set forth in subsection (a) and ensure quality of care, patient safety, and the integrity of the TRICARE program. ‘‘(g) Definitions.—In this section, the terms ‘covered beneficiary’ and ‘TRICARE program’ have the meaning given those terms in section 1072 of title 10, United States Code.’’ PROGRAM TO ELIMINATE VARIABILITY IN HEALTH OUT- COMES AND IMPROVE QUALITY OF HEALTH CARE SERVICES DELIVERED IN MILITARY MEDICAL TREAT- MENT FACILITIES Pub. L. 114–328, div. A, title VII, § 726, Dec. 23, 2016, 130 Stat. 2231, provided that: ‘‘(a) PROGRAM.—Beginning not later than January 1, 2018, the Secretary of Defense shall implement a pro- gram— ‘‘(1) to establish best practices for the delivery of health care services for certain diseases or conditions at military medical treatment facilities, as selected by the Secretary; ‘‘(2) to incorporate such best practices into the daily operations of military medical treatment facili- ties selected by the Secretary for purposes of the pro- gram, with priority in selection given to facilities that provide specialty care; and ‘‘(3) to eliminate variability in health outcomes and to improve the quality of health care services de- livered at military medical treatment facilities se- lected by the Secretary for purposes of the program. ‘‘(b) USE OF CLINICAL PRACTICE GUIDELINES.—In car- rying out the program under subsection (a), the Sec- retary shall develop, implement, monitor, and update clinical practice guidelines reflecting the best practices established under paragraph (1) of such subsection. ‘‘(c) DEVELOPMENT.—In developing the clinical prac- tice guidelines under subsection (b), the Secretary shall ensure that such development includes a baseline as- sessment of health care delivery and outcomes at mili- tary medical treatment facilities to evaluate and deter- mine evidence-based best practices, within the direct care component of the military health system and the private sector, for treating the diseases or conditions selected by the Secretary under subsection (a)(1). ‘‘(d) IMPLEMENTATION.—The Secretary shall imple- ment the clinical practice guidelines under subsection (b) in military medical treatment facilities selected by the Secretary under subsection (a)(2) using means de- termined appropriate by the Secretary, including by communicating with the relevant health care providers of the evidence upon which the guidelines are based and by providing education and training on the most appro- priate implementation of the guidelines. ‘‘(e) MONITORING.—The Secretary shall monitor the implementation of the clinical practice guidelines under subsection (b) using appropriate means, includ- ing by monitoring the results in clinical outcomes based on specific metrics included as part of the guide- lines. ‘‘(f) UPDATING.—The Secretary shall periodically up- date the clinical practice guidelines under subsection (b) based on the results of monitoring conducted under subsection (e) and by continuously assessing evidence- based best practices within the direct care component of the military health system and the private sector. ‘‘(g) CONTINUOUS CYCLE.—The Secretary shall estab- lish a continuous cycle of carrying out subsections (c) through (f) with respect to the clinical practice guide- lines established under subsection (a).’’ ADOPTION OF CORE QUALITY PERFORMANCE METRICS Pub. L. 114–328, div. A, title VII, § 728(a), Dec. 23, 2016, 130 Stat. 2233, provided that: ‘‘(a) ADOPTION.— ‘‘(1) IN GENERAL.—Not later than 180 days after the date of the enactment of this Act [Dec. 23, 2016], the Secretary of Defense shall adopt, to the extent appro- priate, the core quality performance metrics agreed upon by the Core Quality Measures Collaborative for use by the military health system and in contracts awarded to carry out the TRICARE program. ‘‘(2) CORE MEASURES.—The core quality performance metrics described in paragraph (1) shall include the following sets: ‘‘(A) Accountable care organizations, patient cen- tered medical homes, and primary care. ‘‘(B) Cardiology. ‘‘(C) Gastroenterology. ‘‘(D) HIV and hepatitis C. ‘‘(E) Medical oncology. ‘‘(F) Obstetrics and gynecology. ‘‘(G) Orthopedics. ‘‘(H) Such other sets of core quality performance metrics released by the Core Quality Measures Col- laborative as the Secretary considers appropriate.’’ [For definitions of terms used in section 728(a) of Pub. L. 114–328, set out above, see section 728(c) of Pub. L. 114–328, set out below.] ACCOUNTABILITY FOR THE PERFORMANCE OF THE MILI- TARY HEALTH SYSTEM OF CERTAIN LEADERS WITHIN THE SYSTEM Pub. L. 114–328, div. A, title VII, § 730, Dec. 23, 2016, 130 Stat. 2235, provided that: ‘‘(a) IN GENERAL.—Commencing not later than 180 days after the date of the enactment of this Act [Dec. 23, 2016], the Secretary of Defense, in consultation with the Secretaries of the military departments, shall in- corporate into the annual performance review of each military and civilian leader in the military health sys- tem, as determined by the Secretary of Defense, meas- ures of accountability for the performance of the mili- tary health system described in subsection (b). ‘‘(b) MEASURES OF ACCOUNTABILITY FOR PERFORM- ANCE.—The measures of accountability for the perform- Page 974 TITLE 10—ARMED FORCES § 1071 ance of the military health system incorporated into the annual performance review of an individual pursu- ant to this section shall include measures to assess per- formance and assure accountability for the following: ‘‘(1) Quality of care. ‘‘(2) Access of beneficiaries to care. ‘‘(3) Improvement in health outcomes for bene- ficiaries. ‘‘(4) Patient safety. ‘‘(5) Such other matters as the Secretary of De- fense, in consultation with the Secretaries of the military departments, considers appropriate. ‘‘(c) REPORT ON IMPLEMENTATION.— ‘‘(1) IN GENERAL.—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 Senate and the House of Representa- tives a report on the incorporation of measures of ac- countability for the performance of the military health system into the annual performance reviews of individuals as required by this section. ‘‘(2) ELEMENTS.—The report required by paragraph (1) shall include the following: ‘‘(A) A comprehensive plan for the use of meas- ures of accountability for performance in annual performance reviews pursuant to this section as a means of assessing and assuring accountability for the performance of the military health system. ‘‘(B) The identification of each leadership posi- tion in the military health system determined under subsection (a) and a description of the spe- cific measures of accountability for performance to be incorporated into the annual performance re- views of each such position pursuant to this sec- tion.’’ ESTABLISHMENT OF ADVISORY COMMITTEES FOR MILITARY TREATMENT FACILITIES Pub. L. 114–328, div. A, title VII, § 731, Dec. 23, 2016, 130 Stat. 2236, provided that: ‘‘(a) IN GENERAL.—The Secretary of Defense shall es- tablish, under such regulations as the Secretary may prescribe, an advisory committee for each military treatment facility. ‘‘(b) STATUS OF CERTAIN MEMBERS OF ADVISORY COM- MITTEES.—A member of an advisory committee estab- lished under subsection (a) who is not a member of the Armed Forces on active duty or an employee of the Federal Government shall, with the approval of the commanding officer or director of the military treat- ment facility concerned, be treated as a volunteer under section 1588 of title 10, United States Code, in carrying out the duties of the member under this sec- tion. ‘‘(c) DUTIES.—Each advisory committee established under subsection (a) for a military treatment facility shall provide to the commanding officer or director of such facility advice on the administration and activi- ties of such facility as it relates to the experience of care for beneficiaries at such facility.’’ PROVISION OF INFORMATION TO MEMBERS OF THE ARMED FORCES ON PRIVACY RIGHTS RELATING TO RE- CEIPT OF MENTAL HEALTH SERVICES Pub. L. 113–291, div. A, title V, § 523, Dec. 19, 2014, 128 Stat. 3361, provided that: ‘‘(a) PROVISION OF INFORMATION REQUIRED.—The Sec- retaries of the military departments shall ensure that the information described in subsection (b) is pro- vided— ‘‘(1) to each officer candidate during initial train- ing; ‘‘(2) to each recruit during basic training; and ‘‘(3) to other members of the Armed Forces at such times as the Secretary of Defense considers appro- priate. ‘‘(b) REQUIRED INFORMATION.—The information re- quired to be provided under subsection (a) shall include information on the applicability of the Department of Defense Instruction on Privacy of Individually Identifi- able Health Information in DoD Health Care Programs and other regulations regarding privacy prescribed pur- suant to the Health Insurance Portability and Account- ability Act of 1996 (Public Law 104–191) to records re- garding a member of the Armed Forces seeking and re- ceiving mental health services.’’ ANTIMICROBIAL STEWARDSHIP PROGRAM AT MEDICAL FACILITIES OF THE DEPARTMENT OF DEFENSE Pub. L. 113–291, div. A, title VII, § 727, Dec. 19, 2014, 128 Stat. 3420, required the Secretary of Defense, no later than 180 days after Dec. 19, 2014, to carry out and report to Congress on an antimicrobial stewardship program at medical facilities of the Department of Defense. COMPREHENSIVE POLICY ON IMPROVEMENTS TO CARE AND TRANSITION OF MEMBERS OF THE ARMED FORCES WITH UROTRAUMA Pub. L. 113–66, div. A, title VII, § 703, Dec. 26, 2013, 127 Stat. 791, required development and implementation of a comprehensive policy on improvements to the care, management, and transition of recovering Armed Forces members with urotrauma no later than 180 days after Dec. 26, 2013, with a report to Congress no later than one year after the implementation of the policy. ELECTRONIC HEALTH RECORDS OF THE DEPARTMENT OF DEFENSE AND THE DEPARTMENT OF VETERANS AFFAIRS Pub. L. 113–66, div. A, title VII, § 713, Dec. 26, 2013, 127 Stat. 794, which required the Secretaries of Defense and Veterans Affairs to ensure that the electronic health records systems of their departments were interoper- able and met certain standards and requirements and adhered to certain principles, was repealed by Pub. L. 116–92, div. A, title VII, § 715(i), Dec. 20, 2019, 133 Stat. 1453. See section 1635 of Pub. L. 110–181, set out in a note below. RESEARCH AND MEDICAL PRACTICE ON MENTAL HEALTH CONDITIONS Pub. L. 112–239, div. A, title VII, § 725, Jan. 2, 2013, 126 Stat. 1806, required the Secretary of Defense to create a policy on medical practices from research on the di- agnosis and treatment of mental health conditions and to submit a report to Congress no later than 180 days after Jan. 2, 2013. PLAN FOR REFORM OF THE ADMINISTRATION OF THE MILITARY HEALTH SYSTEM Pub. L. 112–239, div. A, title VII, § 731, Jan. 2, 2013, 126 Stat. 1815, required the Secretary of Defense to develop a detailed plan to carry out reforms to the governance of the military health system and to submit a series of reports to Congress, with the final report due on Sept. 30, 2013. PERFORMANCE METRICS AND REPORTS ON WARRIORS IN TRANSITION PROGRAMS OF THE MILITARY DEPARTMENTS Pub. L. 112–239, div. A, title VII, § 738, Jan. 2, 2013, 126 Stat. 1820, as amended by Pub. L. 115–91, div. A, title X, § 1051(r)(3), Dec. 12, 2017, 131 Stat. 1565, provided that: ‘‘(a) METRICS REQUIRED.—The Secretary of Defense shall establish a policy containing uniform perform- ance outcome measurements to be used by each Sec- retary of a military department in tracking and moni- toring members of the Armed Forces in Warriors in Transition programs. ‘‘(b) ELEMENTS.—The policy established under sub- section (a) shall identify outcome measurements with respect to the following: ‘‘(1) Physical health and behavioral health. ‘‘(2) Rehabilitation. ‘‘(3) Educational and vocational preparation. ‘‘(4) Such other matters as the Secretary considers appropriate. ‘‘(c) MILESTONES.—In establishing the policy under subsection (a), the Secretary of Defense shall establish Page 975 TITLE 10—ARMED FORCES § 1071 metrics and milestones for members in Warriors in Transition programs. Such metrics and milestones shall cover members throughout the course of care and rehabilitation in Warriors in Transitions programs by applying to the following occasions: ‘‘(1) When the member commences participation in the program. ‘‘(2) At least once each year the member partici- pates in the program. ‘‘(3) When the member ceases participation in the program or is transferred to the jurisdiction of the Secretary of Veterans Affairs. ‘‘(d) COHORT GROUPS AND PARAMETERS.—The policy established under subsection (a)— ‘‘(1) may differentiate among cohort groups within the population of members in Warriors in Transition programs, as appropriate; and ‘‘(2) shall include parameters for specific outcome measurements in each element under subsection (b) and each metric and milestone under subsection (c). ‘‘(e) WARRIORS IN TRANSITION PROGRAM DEFINED.—In this section, the term ‘Warriors in Transition program’ means any major support program of the Armed Forces for members of the Armed Forces with severe wounds, illnesses, or injuries that is intended to provide such members with nonmedical case management service and care coordination services, and includes the pro- grams as follows: ‘‘(1) Warrior Transition Units and the Wounded Warrior Program of the Army. ‘‘(2) The Wounded Warrior Safe Harbor program of the Navy. ‘‘(3) The Wounded Warrior Regiment of the Marine Corps. ‘‘(4) The Recovery Care Program and the Wounded Warrior programs of the Air Force. ‘‘(5) The Care Coalition of the United States Special Operations Command.’’ SUICIDE PREVENTION POLICIES AND PROGRAMS Pub. L. 114–92, div. A, title V, § 591, Nov. 25, 2015, 129 Stat. 832, provided that: ‘‘(a) DEVELOPMENT OF POLICY.—The Secretary of De- fense, in consultation with the Secretaries of the mili- tary departments, may develop a policy to coordinate the efforts of the Department of Defense and non-gov- ernment suicide prevention organizations regarding— ‘‘(1) the use of such non-government organizations to reduce the number of suicides among members of the Armed Forces by comprehensively addressing the needs of members of the Armed Forces who have been identified as being at risk of suicide; ‘‘(2) the delineation of the responsibilities within the Department of Defense regarding interaction with such organizations; ‘‘(3) the collection of data regarding the efficacy and cost of coordinating with such organizations; and ‘‘(4) the preparation and preservation of any report- ing material the Secretary determines necessary to carry out the policy. ‘‘(b) SUICIDE PREVENTION EFFORTS.—The Secretary of Defense is authorized to take any necessary measures to prevent suicides by members of the Armed Forces, including by facilitating the access of members of the Armed Forces to successful non-governmental treat- ment regimen.’’ Pub. L. 113–291, div. A, title V, § 567, Dec. 19, 2014, 128 Stat. 3385, provided that: ‘‘(a) POLICY FOR STANDARD SUICIDE DATA COLLECTION, REPORTING, AND ASSESSMENT.— ‘‘(1) POLICY REQUIRED.—The Secretary of Defense shall prescribe a policy for the development of a standard method for collecting, reporting, and assess- ing information regarding— ‘‘(A) any suicide or attempted suicide involving a member of the Armed Forces, including reserve components thereof; and ‘‘(B) any death that is reported as a suicide in- volving a dependent of a member of the Armed Forces. ‘‘(2) PURPOSE OF POLICY.—The purpose of the policy required by this subsection is to improve the consist- ency and comprehensiveness of— ‘‘(A) the suicide prevention policy developed pur- suant to section 582 of the National Defense Au- thorization Act for Fiscal Year 2013 (Public Law 112–239; 10 U.S.C. 1071 note); and ‘‘(B) the suicide prevention and resilience pro- gram for the National Guard and Reserves estab- lished pursuant to section 10219 of title 10, United States Code. ‘‘(3) CONSULTATION.—The Secretary of Defense shall develop the policy required by this subsection in con- sultation with the Secretaries of the military depart- ments and the Chief of the National Guard Bureau. ‘‘(b) SUBMISSION AND IMPLEMENTATION OF POLICY.— ‘‘(1) SUBMISSION.—Not later than 180 days after the date of the enactment of this Act [Dec. 19, 2014], the Secretary of Defense shall submit the policy devel- oped under subsection (a) to the Committees on Armed Services of the Senate and the House of Rep- resentatives. ‘‘(2) IMPLEMENTATION.—The Secretaries of the mili- tary departments shall implement the policy devel- oped under subsection (a) not later than 180 days after the date of the submittal of the policy under paragraph (1). ‘‘(c) DEPENDENT DEFINED.—In this section, the term ‘dependent’, with respect to a member of the Armed Forces, means a person described in section 1072(2) of title 10, United States Code, except that, in the case of a parent or parent-in-law of the member, the income requirements of subparagraph (E) of such section do not apply.’’ Pub. L. 112–239, div. A, title V, § 580, Jan. 2, 2013, 126 Stat. 1764, provided that: ‘‘(a) IN GENERAL.—The Secretary of Defense shall, acting through the Under Secretary of Defense for Per- sonnel and Readiness, establish within the Office of the Secretary of Defense a position with responsibility for oversight of all suicide prevention and resilience pro- grams of the Department of Defense (including those of the military departments and the Armed Forces). ‘‘(b) SCOPE OF RESPONSIBILITIES.—The individual serv- ing in the position established under subsection (a) shall have the responsibilities as follows: ‘‘(1) To establish a uniform definition of resiliency for use in the suicide prevention and resilience pro- grams and preventative behavioral health programs of the Department of Defense (including those of the military departments and the Armed Forces). ‘‘(2) To oversee the implementation of the com- prehensive policy on the prevention of suicide among members of the Armed Forces required by section 582.’’ Pub. L. 112–239, div. A, title V, § 582, Jan. 2, 2013, 126 Stat. 1766, provided that: ‘‘(a) COMPREHENSIVE POLICY REQUIRED.—Not later than 180 days after the date of the enactment of this Act [Jan. 2, 2013], the Secretary of Defense shall, acting through the Under Secretary of Defense for Personnel and Readiness, develop within the Department of De- fense a comprehensive policy on the prevention of sui- cide among members of the Armed Forces. In devel- oping the policy, the Secretary shall consider rec- ommendations from the operational elements of the Armed Forces regarding the feasibility of the imple- mentation and execution of particular elements of the policy. ‘‘(b) ELEMENTS.—The policy required by subsection (a) shall cover each of the following: ‘‘(1) Increased awareness among members of the Armed Forces about mental health conditions and the stigma associated with mental health conditions and mental health care. ‘‘(2) The means of identifying members who are at risk for suicide (including enhanced means for early identification and treatment of such members). ‘‘(3) The continuous access by members to suicide prevention services, including suicide crisis services. Page 976 TITLE 10—ARMED FORCES § 1071 ‘‘(4) The means to evaluate and assess the effective- ness of the suicide prevention and resilience pro- grams and preventative behavioral health programs of the Department of Defense (including those of the military departments and the Armed Forces), includ- ing the development of metrics for that purpose. ‘‘(5) The means to evaluate and assess the current diagnostic tools and treatment methods in the pro- grams referred to in paragraph (4) to ensure clinical best practices are used in such programs. ‘‘(6) The standard of care for suicide prevention to be used throughout the Department. ‘‘(7) The training of mental health care providers on suicide prevention. ‘‘(8) The training standards for behavioral health care providers to ensure that such providers receive training on clinical best practices and evidence-based treatments as information on such practices and treatments becomes available. ‘‘(9) The integration of mental health screenings and suicide risk and prevention for members into the delivery of primary care for such members. ‘‘(10) The standards for responding to attempted or completed suicides among members, including guid- ance and training to assist commanders in addressing incidents of attempted or completed suicide within their units. ‘‘(11) The means to ensure the protection of the pri- vacy of members seeking or receiving treatment re- lating to suicide. ‘‘(12) Such other matters as the Secretary considers appropriate in connection with the prevention of sui- cide among members.’’ Pub. L. 112–81, div. A, title V, § 533(a), (b), Dec. 31, 2011, 125 Stat. 1404, provided that: ‘‘(a) PROGRAM ENHANCEMENT.—The Secretary of De- fense shall take appropriate actions to enhance the sui- cide prevention program of the Department of Defense through the provision of suicide prevention informa- tion and resources to members of the Armed Forces from their initial enlistment or appointment through their final retirement or separation. ‘‘(b) COOPERATIVE EFFORT.—The Secretary of Defense shall develop suicide prevention information and re- sources in consultation with— ‘‘(1) the Secretary of Veterans Affairs, the National Institute of Mental Health, and the Substance Abuse and Mental Health Services Administration of the Department of Health and Human Services; and ‘‘(2) to the extent appropriate, institutions of high- er education and other public and private entities, in- cluding international entities, with expertise regard- ing suicide prevention.’’ TREATMENT OF WOUNDED WARRIORS Pub. L. 112–81, div. A, title VII, § 722, Dec. 31, 2011, 125 Stat. 1479, provided that: ‘‘The Secretary of Defense may establish a program to enter into partnerships to enable coordinated, rapid clinical evaluation and the application of evidence-based treatment strategies for wounded service members, with an emphasis on the most common musculoskeletal injuries, that will ad- dress the priorities of the Armed Forces with respect to retention and readiness.’’ COMPREHENSIVE PLAN ON PREVENTION, DIAGNOSIS, AND TREATMENT OF SUBSTANCE USE DISORDERS AND DIS- POSITION OF SUBSTANCE ABUSE OFFENDERS IN THE ARMED FORCES Pub. L. 111–84, div. A, title V, § 596, Oct. 28, 2009, 123 Stat. 2339, provided for a comprehensive review of pro- grams and policies regarding substance abuse disorders in members of the Armed Forces and the development of a plan for improvement and enhancement of such programs and policies by the Secretary of Defense and for a report to Congress on modification and improve- ments made following an independent study of the pro- grams that was to be completed no later than two years after Oct. 28, 2009. COMPREHENSIVE POLICY ON PAIN MANAGEMENT BY THE MILITARY HEALTH CARE SYSTEM Pub. L. 111–84, div. A, title VII, § 711, Oct. 28, 2009, 123 Stat. 2378, provided that: ‘‘(a) COMPREHENSIVE POLICY REQUIRED.—Not later than March 31, 2011, the Secretary of Defense shall de- velop and implement a comprehensive policy on pain management by the military health care system. ‘‘(b) SCOPE OF POLICY.—The policy required by sub- section (a) shall cover each of the following: ‘‘(1) The management of acute and chronic pain. ‘‘(2) The standard of care for pain management to be used throughout the Department of Defense. ‘‘(3) The consistent application of pain assessments throughout the Department of Defense. ‘‘(4) The assurance of prompt and appropriate pain care treatment and management by the Department when medically necessary. ‘‘(5) Programs of research related to acute and chronic pain, including pain attributable to central and peripheral nervous system damage characteristic of injuries incurred in modern warfare, brain injuries, and chronic migraine headache. ‘‘(6) Programs of pain care education and training for health care personnel of the Department. ‘‘(7) Programs of patient education for members suffering from acute or chronic pain and their fami- lies. ‘‘(c) UPDATES.—The Secretary shall revise the policy required by subsection (a) on a periodic basis in accord- ance with experience and evolving best practice guide- lines. ‘‘(d) ANNUAL REPORT.— ‘‘(1) IN GENERAL.—Not later than 180 days after the date of the commencement of the implementation of the policy required by subsection (a), and on October 1 each year thereafter through 2018, the Secretary shall submit to the Committee on Armed Services of the Senate and the Committee on Armed Services of the House of Representatives a report on the policy. ‘‘(2) ELEMENTS.—Each report required by paragraph (1) shall include the following: ‘‘(A) A description of the policy implemented under subsection (a), and any revisions to such pol- icy under subsection (c). ‘‘(B) A description of the performance measures used to determine the effectiveness of the policy in improving pain care for beneficiaries enrolled in the military health care system. ‘‘(C) An assessment of the adequacy of Depart- ment pain management services based on a current survey of patients managed in Department clinics. ‘‘(D) An assessment of the research projects of the Department relevant to the treatment of the types of acute and chronic pain suffered by members of the Armed Forces and their families. ‘‘(E) An assessment of the training provided to Department health care personnel with respect to the diagnosis, treatment, and management of acute and chronic pain. ‘‘(F) An assessment of the pain care education programs of the Department. ‘‘(G) An assessment of the dissemination of infor- mation on pain management to beneficiaries en- rolled in the military health care system.’’ PLAN TO INCREASE THE MENTAL HEALTH CAPABILITIES OF THE DEPARTMENT OF DEFENSE Pub. L. 111–84, div. A, title VII, § 714, Oct. 28, 2009, 123 Stat. 2381, as amended by Pub. L. 111–383, div. A, title X, § 1075(d)(8), Jan. 7, 2011, 124 Stat. 4373, directed each military department to increase by a specified amount the number of active duty mental health personnel no later than 180 days after Oct. 28, 2009, and required the Secretary of Defense to report on the appropriate num- ber of mental health personnel required to meet the mental health care needs of members of the Armed Forces, retired members, and dependents; to develop and implement a plan to significantly increase the Page 977 TITLE 10—ARMED FORCES § 1071 number of military and civilian mental health per- sonnel by Sept. 30, 2013; and to report on an assessment of the feasibility and advisability of establishing one or more military mental health specialties for officers or enlisted members of the Armed Forces. STUDY AND PLAN TO IMPROVE MILITARY HEALTH CARE Pub. L. 111–84, div. A, title VII, § 721, Oct. 28, 2009, 123 Stat. 2385, provided that: ‘‘(a) STUDY AND REPORT REQUIRED.—Not later than one year after the date of the enactment of this Act [Oct. 28, 2009], the Secretary of Defense shall submit to the congressional defense committees [Committees on Armed Services and Appropriations of the Senate and the House of Representatives] a report on the health care needs of dependents (as defined in section 1072(2) of title 10, United States Code). The report shall include, at a minimum, the following: ‘‘(1) With respect to both the direct care system and the purchased care system, an analysis of the type of health care facility in which dependents seek care. ‘‘(2) The 10 most common medical conditions for which dependents seek care. ‘‘(3) The availability of and access to health care providers to treat the conditions identified under paragraph (2), both in the direct care system and the purchased care system. ‘‘(4) Any shortfalls in the ability of dependents to obtain required health care services. ‘‘(5) Recommendations on how to improve access to care for dependents. ‘‘(6) With respect to dependents accompanying a member stationed at a military installation outside of the United States, the need for and availability of mental health care services. ‘‘(b) ENHANCED MILITARY HEALTH SYSTEM AND IM- PROVED TRICARE.— ‘‘(1) IN GENERAL.—The Secretary of Defense, in con- sultation with the other administering Secretaries, shall undertake actions to enhance the capability of the military health system and improve the TRICARE program. ‘‘(2) ELEMENTS.—In undertaking actions to enhance the capability of the military health system and im- prove the TRICARE program under paragraph (1), the Secretary shall consider the following actions: ‘‘(A) Actions to guarantee the availability of care within established access standards for eligible beneficiaries, based on the results of the study re- quired by subsection (a). ‘‘(B) Actions to expand and enhance sharing of health care resources among Federal health care programs, including designated providers (as that term is defined in section 721(5) of the National De- fense Authorization Act for Fiscal Year 1997 (Public Law 104–201; 110 Stat. 2593; 10 U.S.C. 1073 note)). ‘‘(C) Actions using medical technology to speed and simplify referrals for specialty care. ‘‘(D) Actions to improve regional or national staffing capabilities in order to enhance support provided to military medical treatment facilities facing staff shortages. ‘‘(E) Actions to improve health care access for members of the reserve components and their fami- lies, including such access with respect to mental health care and consideration of access issues for members and their families located in rural areas. ‘‘(F) Actions to ensure consistency throughout the TRICARE program to comply with access standards, which are applicable to both com- manders of military treatment facilities and man- aged care support contractors. ‘‘(G) Actions to create new budgeting and re- source allocation methodologies to fully support and incentivize care provided by military treat- ment facilities. ‘‘(H) Actions regarding additional financing op- tions for health care provided by civilian providers. ‘‘(I) Actions to reduce administrative costs. ‘‘(J) Actions to control the cost of health care and pharmaceuticals. ‘‘(K) Actions to audit the Defense Enrollment Eli- gibility Reporting System to improve system checks on the eligibility of TRICARE beneficiaries. ‘‘(L) Actions, including a comprehensive plan, for the enhanced availability of prevention and wellness care. ‘‘(M) Actions using technology to improve direct communication with beneficiaries regarding health and preventive care. ‘‘(N) Actions to create performance metrics by which to measure improvement in the TRICARE program. ‘‘(O) Such other actions as the Secretary, in con- sultation with the other administering Secretaries, considers appropriate. ‘‘(c) QUALITY ASSURANCE.—In undertaking actions under this section, the Secretary of Defense and the other administering Secretaries shall continue or en- hance the current level of quality health care provided by the Department of Defense and the military depart- ments with no adverse impact to cost, access, or care. ‘‘(d) CONSULTATION.—In considering actions to be un- dertaken under this section, and in undertaking such actions, the Secretary shall consult with a broad range of national health care and military advocacy organi- zations. ‘‘(e) REPORTS REQUIRED.— ‘‘(1) INITIAL REPORT.—Not later than 180 days after the date of the enactment of this Act [Oct. 28, 2009], the Secretary shall submit to the congressional de- fense committees [Committees on Armed Services and Appropriations of the Senate and the House of Representatives] an initial report on the progress made in undertaking actions under this section and future plans for improvement of the military health system. ‘‘(2) REPORT REQUIRED WITH FISCAL YEAR 2012 BUDGET PROPOSAL.—Together with the budget justification materials submitted to Congress in support of the De- partment of Defense budget for fiscal year 2012 (as submitted with the budget of the President under sec- tion 1105(a) of title 31, United States Code), the Sec- retary shall submit to the congressional defense com- mittees a report setting forth the following: ‘‘(A) Updates on the progress made in under- taking actions under this section. ‘‘(B) Future plans for improvement of the mili- tary health system. ‘‘(C) An explanation of how the budget submission may reflect such progress and plans. ‘‘(3) PERIODIC REPORTS.—The Secretary shall, on a periodic basis, submit to the congressional defense committees a report on the progress being made in the improvement of the TRICARE program under this section. ‘‘(4) ELEMENTS.—Each report under this subsection shall include the following: ‘‘(A) A description and assessment of the progress made as of the date of such report in the improve- ment of the TRICARE program. ‘‘(B) Such recommendations for administrative or legislative action as the Secretary considers appro- priate to expedite and enhance the improvement of the TRICARE program. ‘‘(f) DEFINITIONS.—In this section: ‘‘(1) The term ‘administering Secretaries’ has the meaning given that term in section 1072(3) of title 10, United States Code. ‘‘(2) The term ‘TRICARE program’ has the meaning given that term in section 1072(7) of title 10, United States Code.’’ PROGRAM FOR HEALTH CARE DELIVERY AT MILITARY INSTALLATIONS WITH PROJECTED GROWTH Pub. L. 110–417, [div. A], title VII, § 705, Oct. 14, 2008, 122 Stat. 4499, provided that: ‘‘(a) PROGRAM.—The Secretary of Defense is author- ized to develop a plan to establish a program to build cooperative health care arrangements and agreements between military installations projected to grow and local and regional non-military health care systems. Page 978 TITLE 10—ARMED FORCES § 1071 ‘‘(b) REQUIREMENTS OF PLAN.—In developing the plan, the Secretary of Defense shall— ‘‘(1) identify and analyze health care delivery op- tions involving the private sector and health care services in military facilities located on military in- stallations; ‘‘(2) develop methods for determining the cost avoidance or savings resulting from innovative part- nerships between the Department of Defense and the private sector; ‘‘(3) develop requirements for Department of De- fense health care providers to deliver health care in civilian community hospitals; and ‘‘(4) collaborate with State and local authorities to create an arrangement to share and exchange, be- tween the Department of Defense and nonmilitary health care systems, personal health information, and data of military personnel and their families. ‘‘(c) COORDINATION WITH OTHER ENTITIES.—The plan shall include requirements for coordination with Fed- eral, State, and local entities, TRICARE managed care support contractors, and other contracted assets around installations selected for participation in the program. ‘‘(d) CONSULTATION REQUIREMENTS.—The Secretary of Defense shall develop the plan in consultation with the Secretaries of the military departments. ‘‘(e) SELECTION OF MILITARY INSTALLATIONS.—Each se- lected military installation shall meet the following criteria: ‘‘(1) The military installation has members of the Armed Forces on active duty and members of reserve components of the Armed Forces that use the instal- lation as a training and operational base, with mem- bers routinely deploying in support of the global war on terrorism. ‘‘(2) The military population of an installation will significantly increase by 2013 due to actions related to either Grow the Force initiatives or recommenda- tions of the Defense Base Realignment and Closure Commission. ‘‘(3) There is a military treatment facility on the installation that has— ‘‘(A) no inpatient or trauma center care capabili- ties; and ‘‘(B) no current or planned capacity that would satisfy the proposed increase in military personnel at the installation. ‘‘(4) There is a civilian community hospital near the military installation, and the military treatment facility has— ‘‘(A) no inpatient services or limited capability to expand inpatient care beds, intensive care, and spe- cialty services; and ‘‘(B) limited or no capability to provide trauma care. ‘‘(f) REPORTS.—Not later than one year after the date of the enactment of this Act [Oct. 14, 2008], and every year thereafter, the Secretary of Defense shall submit to the Committees on Armed Services of the Senate and House of Representatives an annual report on any plan developed under subsection (a).’’ CENTER OF EXCELLENCE IN PREVENTION, DIAGNOSIS, MITIGATION, TREATMENT, AND REHABILITATION OF HEARING LOSS AND AUDITORY SYSTEM INJURIES Pub. L. 110–417, [div. A], title VII, § 721, Oct. 14, 2008, 122 Stat. 4506, provided that: ‘‘(a) IN GENERAL.—The Secretary of Defense shall es- tablish within the Department of Defense a center of excellence in the prevention, diagnosis, mitigation, treatment, and rehabilitation of hearing loss and audi- tory system injury to carry out the responsibilities specified in subsection (c). ‘‘(b) PARTNERSHIPS.—The Secretary shall ensure that the center collaborates to the maximum extent prac- ticable with the Secretary of Veterans Affairs, institu- tions of higher education, and other appropriate public and private entities (including international entities) to carry out the responsibilities specified in subsection (c). ‘‘(c) RESPONSIBILITIES.— ‘‘(1) IN GENERAL.—The center shall— ‘‘(A) implement a comprehensive plan and strat- egy for the Department of Defense, as developed by the Secretary of Defense, for a registry of informa- tion for the tracking of the diagnosis, surgical intervention or other operative procedure, other treatment, and follow up for each case of hearing loss and auditory system injury incurred by a mem- ber of the Armed Forces while serving on active duty; ‘‘(B) ensure the electronic exchange with the Sec- retary of Veterans Affairs of information obtained through tracking under subparagraph (A); and ‘‘(C) enable the Secretary of Veterans Affairs to access the registry and add information pertaining to additional treatments or surgical procedures and eventual hearing outcomes for veterans who were entered into the registry and subsequently received treatment through the Veterans Health Adminis- tration. ‘‘(2) DESIGNATION OF REGISTRY.—The registry under this subsection shall be known as the ‘Hearing Loss and Auditory System Injury Registry’ (hereinafter referred to as the ‘Registry’). ‘‘(3) CONSULTATION IN DEVELOPMENT.—The center shall develop the Registry in consultation with audi- ologists, speech and language pathologists, otolaryngologists, and other specialist personnel of the Department of Defense and the audiologists, speech and language pathologists, otolaryngologists, and other specialist personnel of the Department of Veterans Affairs. The mechanisms and procedures of the Registry shall reflect applicable expert research on military and other hearing loss. ‘‘(4) MECHANISMS.—The mechanisms of the Registry for tracking under paragraph (1)(A) shall ensure that each military medical treatment facility or other medical facility shall submit to the center for inclu- sion in the Registry information on the diagnosis, surgical intervention or other operative procedure, other treatment, and follow up for each case of hear- ing loss and auditory system injury described in that paragraph as follows (to the extent applicable): ‘‘(A) Not later than 30 days after surgery or other operative intervention, including a surgery or other operative intervention carried out as a result of a follow-up examination. ‘‘(B) Not later than 180 days after the hearing loss and auditory system injury is reported or recorded in the medical record. ‘‘(5) COORDINATION OF CARE AND BENEFITS.—(A) The center shall provide notice to the National Center for Rehabilitative Auditory Research (NCRAR) of the Department of Veterans Affairs and to the auditory system impairment services of the Veterans Health Administration on each member of the Armed Forces described in subparagraph (B) for purposes of ensur- ing the coordination of the provision of ongoing audi- tory system rehabilitation benefits and services by the Department of Veterans Affairs after the separa- tion or release of such member from the Armed Forces. ‘‘(B) A member of the Armed Forces described in this subparagraph is a member of the Armed Forces with significant hearing loss or auditory system in- jury incurred while serving on active duty, includ- ing a member with auditory dysfunction related to traumatic brain injury. ‘‘(d) UTILIZATION OF REGISTRY INFORMATION.—The Secretary of Defense and the Secretary of Veterans Af- fairs shall jointly ensure that information in the Reg- istry is available to appropriate audiologists, speech and language pathologists, otolaryngologists, and other specialist personnel of the Department of Defense and the Department of Veterans Affairs for purposes of en- couraging and facilitating the conduct of research, and the development of best practices and clinical edu- cation, on hearing loss or auditory system injury in- curred by members of the Armed Forces. Page 979 TITLE 10—ARMED FORCES § 1071 ‘‘(e) INCLUSION OF RECORDS OF OIF/OEF VETERANS.— The Secretary of Defense shall take appropriate ac- tions to include in the Registry such records of mem- bers of the Armed Forces who incurred a hearing loss or auditory system injury while serving on active duty on or after September 11, 2001, but before the establish- ment of the Registry, as the Secretary considers appro- priate for purposes of the Registry.’’ WOUNDED WARRIOR HEALTH CARE IMPROVEMENTS Pub. L. 115–232, div. A, title VII, § 717, Aug. 13, 2018, 132 Stat. 1815, provided that: ‘‘(a) IN GENERAL.—Not later than 180 days after the date of the enactment of this Act [Aug. 13, 2018], the Secretary of Defense shall review and update policies and procedures relating to the care and management of recovering service members. In conducting such review, the Secretary shall consider best practices— ‘‘(1) in the care of recovering service members; ‘‘(2) in the administrative management relating to such care; ‘‘(3) to carry out applicable provisions of Federal law; and ‘‘(4) recommended by the Comptroller General of the United States in the report titled ‘Army Needs to Improve Oversight of Warrior Transition Units’. ‘‘(b) SCOPE OF POLICY.—In carrying out subsection (a), the Secretary shall update policies of the Department of Defense with respect to each of the following: ‘‘(1) The case management coordination of members of the Armed Forces between the military depart- ments and the military medical treatment facilities administered by the Director of the Defense Health Agency pursuant to section 1073c of title 10, United States Code, including with respect to the coordina- tion of— ‘‘(A) appointments; ‘‘(B) rehabilitative services; ‘‘(C) recuperation in an outpatient status; ‘‘(D) contract care provided by a private health care provider outside of a military medical treat- ment facility; ‘‘(E) the disability evaluation system; and ‘‘(F) other administrative functions relating to the military department. ‘‘(2) The transition of a member of the Armed Forces who is retired under chapter 61 of title 10, United States Code, from receiving treatment fur- nished by the Secretary of Defense to treatment fur- nished by the Secretary of Veterans Affairs. ‘‘(3) Facility standards related to lodging and ac- commodations for recovering service members and the family members and non-medical attendants of recovering service members. ‘‘(c) REPORT.—Not later than one year after the date of the enactment of this Act [Aug. 13, 2018], the Sec- retary of Defense and Secretaries of the military de- partments shall jointly submit to the Committees on Armed Services of the Senate and the House of Rep- resentatives a report on the review conducted under subsection (a), including a description of the policies updated pursuant to subsection (b). ‘‘(d) DEFINITIONS.—In this section, the terms ‘dis- ability evaluation system’, ‘outpatient status’, and ‘re- covering service members’ have the meaning given those terms in section 1602 of the Wounded Warrior Act (title XVI of Public Law 110–181; 10 U.S.C. 1071 note).’’ Pub. L. 110–181, div. A, title XVI, §§ 1602, 1603, 1611–1614, 1616, 1618, 1621–1623, 1631, 1635, 1644, 1648, 1651, 1662, 1671, 1672, 1676, Jan. 28, 2008, 122 Stat. 431–443, 447, 450–455, 458, 460, 467, 473, 476, 479, 481, 484, as amended by Pub. L. 110–417, [div. A], title II, § 252, title VII, §§ 722, 724, title X, § 1061(b)(13), Oct. 14, 2008, 122 Stat. 4400, 4508, 4509, 4613; Pub. L. 111–84, div. A, title VI, § 632(h), Oct. 28, 2009, 123 Stat. 2362; Pub. L. 112–56, title II, § 231, Nov. 21, 2011, 125 Stat. 719; Pub. L. 112–81, div. A, title VI, § 631(f)(4)(B), title VII, § 707, Dec. 31, 2011, 125 Stat. 1465, 1474; Pub. L. 112–239, div. A, title X, § 1076(a)(9), Jan. 2, 2013, 126 Stat. 1948; Pub. L. 113–175, title I, § 105, Sept. 26, 2014, 128 Stat. 1903; Pub. L. 113–291, div. A, title V, § 591, title VII, § 724, Dec. 19, 2014, 128 Stat. 3394, 3418; Pub. L. 114–58, title II, § 204, title IV, § 411, Sept. 30, 2015, 129 Stat. 533, 536; Pub. L. 114–92, div. A, title X, § 1072(e), (f), Nov. 25, 2015, 129 Stat. 995; Pub. L. 114–228, title II, § 204, title IV, § 414, Sept. 29, 2016, 130 Stat. 938, 941; Pub. L. 115–62, title II, § 203, Sept. 29, 2017, 131 Stat. 1162; Pub. L. 115–251, title I, § 126, Sept. 29, 2018, 132 Stat. 3169; Pub. L. 116–92, div. A, title VII, § 715(a)–(g), Dec. 20, 2019, 133 Stat. 1446–1451, provided that: ‘‘SEC. 1602. GENERAL DEFINITIONS. ‘‘In this title [see Short Title of 2008 Amendment note above]: ‘‘(1) APPROPRIATE COMMITTEES OF CONGRESS.—The term ‘appropriate committees of Congress’ means— ‘‘(A) the Committees on Armed Services, Vet- erans’ Affairs, and Appropriations of the Senate; and ‘‘(B) the Committees on Armed Services, Vet- erans’ Affairs, and Appropriations of the House of Representatives. ‘‘(2) BENEFITS DELIVERY AT DISCHARGE PROGRAM.— The term ‘Benefits Delivery at Discharge Program’ means a program administered jointly by the Sec- retary of Defense and the Secretary of Veterans Af- fairs to provide information and assistance on avail- able benefits and other transition assistance to mem- bers of the Armed Forces who are separating from the Armed Forces, including assistance to obtain any dis- ability benefits for which such members may be eligi- ble. ‘‘(3) DISABILITY EVALUATION SYSTEM.—The term ‘Disability Evaluation System’ means the following: ‘‘(A) A system or process of the Department of Defense for evaluating the nature and extent of dis- abilities affecting members of the Armed Forces that is operated by the Secretaries of the military departments and is comprised of medical evalua- tion boards, physical evaluation boards, counseling of members, and mechanisms for the final disposi- tion of disability evaluations by appropriate per- sonnel. ‘‘(B) A system or process of the Coast Guard for evaluating the nature and extent of disabilities af- fecting members of the Coast Guard that is oper- ated by the Secretary of Homeland Security and is similar to the system or process of the Department of Defense described in subparagraph (A). ‘‘(4) ELIGIBLE FAMILY MEMBER.—The term ‘eligible family member’, with respect to a recovering service member, means a family member (as defined in [former] section 481h(b)(3)(B) of title 37, United States Code) who is on invitational travel orders or serving as a non-medical attendee while caring for the recovering service member for more than 45 days during a one-year period. ‘‘(5) MEDICAL CARE.—The term ‘medical care’ in- cludes mental health care. ‘‘(6) OUTPATIENT STATUS.—The term ‘outpatient sta- tus’, with respect to a recovering service member, means the status of a recovering service member as- signed to— ‘‘(A) a military medical treatment facility as an outpatient; or ‘‘(B) a unit established for the purpose of pro- viding command and control of members of the Armed Forces receiving medical care as out- patients. ‘‘(7) RECOVERING SERVICE MEMBER.—The term ‘re- covering service member’ means a member of the Armed Forces, including a member of the National Guard or a Reserve, who is undergoing medical treat- ment, recuperation, or therapy and is in an out- patient status while recovering from a serious injury or illness related to the member’s military service. ‘‘(8) SERIOUS INJURY OR ILLNESS.—The term ‘serious injury or illness’, in the case of a member of the Armed Forces, means an injury or illness incurred by the member in line of duty on active duty in the Armed Forces that may render the member medically Page 980 TITLE 10—ARMED FORCES § 1071 unfit to perform the duties of the member’s office, grade, rank, or rating. ‘‘(9) TRICARE PROGRAM.—The term ‘TRICARE pro- gram’ has the meaning given that term in section 1072(7) of title 10, United States Code. [As amended Pub. L. 110–417, [div. A], title X, § 1061(b)(13), Oct. 14, 2008, 122 Stat. 4613; Pub. L. 111–84, div. A, title VI, § 632(h), Oct. 28, 2009, 123 Stat. 2362; Pub. L. 112–81, div. A, title VI, § 631(f)(4)(B), Dec. 31, 2011, 125 Stat. 1465.] ‘‘SEC. 1603. CONSIDERATION OF GENDER-SPECIFIC NEEDS OF RECOVERING SERVICE MEMBERS AND VETERANS. ‘‘(a) IN GENERAL.—In developing and implementing the policy required by section 1611(a), and in otherwise carrying out any other provision of this title [see Short Title of 2008 Amendment note above] or any amend- ment made by this title, the Secretary of Defense and the Secretary of Veterans Affairs shall take into ac- count and fully address any unique gender-specific needs of recovering service members and veterans under such policy or other provision. ‘‘(b) REPORTS.—In submitting any report required by this title or an amendment made by this title, the Sec- retary of Defense and the Secretary of Veterans Affairs shall, to the extent applicable, include a description of the manner in which the matters covered by such re- port address the unique gender-specific needs of recov- ering service members and veterans. ‘‘SEC. 1611. COMPREHENSIVE POLICY ON IMPROVE- MENTS TO CARE, MANAGEMENT, AND TRANSI- TION OF RECOVERING SERVICE MEMBERS. ‘‘(a) COMPREHENSIVE POLICY REQUIRED.— ‘‘(1) IN GENERAL.—Not later than July 1, 2008, the Secretary of Defense and the Secretary of Veterans Affairs shall, to the extent feasible, jointly develop and implement a comprehensive policy on improve- ments to the care, management, and transition of re- covering service members. ‘‘(2) SCOPE OF POLICY.—The policy shall cover each of the following: ‘‘(A) The care and management of recovering service members. ‘‘(B) The medical evaluation and disability eval- uation of recovering service members. ‘‘(C) The return of service members who have re- covered to active duty when appropriate. ‘‘(D) The transition of recovering service mem- bers from receipt of care and services through the Department of Defense to receipt of care and serv- ices through the Department of Veterans Affairs. ‘‘(3) CONSULTATION.—The Secretary of Defense and the Secretary of Veterans Affairs shall develop the policy in consultation with the heads of other appro- priate departments and agencies of the Federal Gov- ernment and with appropriate non-governmental or- ganizations having an expertise in matters relating to the policy. ‘‘(4) UPDATE.—The Secretary of Defense and the Secretary of Veterans Affairs shall jointly update the policy on a periodic basis, but not less often than an- nually, in order to incorporate in the policy, as ap- propriate, the following: ‘‘(A) The results of the reviews required under subsections (b) and (c). ‘‘(B) Best practices identified through pilot pro- grams carried out under this title. ‘‘(C) Improvements to matters under the policy otherwise identified and agreed upon by the Sec- retary of Defense and the Secretary of Veterans Af- fairs. ‘‘(b) REVIEW OF CURRENT POLICIES AND PROCEDURES.— ‘‘(1) REVIEW REQUIRED.—In developing the policy re- quired by subsection (a), the Secretary of Defense and the Secretary of Veterans Affairs shall, to the extent necessary, jointly and separately conduct a review of all policies and procedures of the Department of De- fense and the Department of Veterans Affairs that apply to, or shall be covered by, the policy. ‘‘(2) PURPOSE.—The purpose of the review shall be to identify the most effective and patient-oriented approaches to care and management of recovering service members for purposes of— ‘‘(A) incorporating such approaches into the pol- icy; and ‘‘(B) extending such approaches, where applicable, to the care and management of other injured or ill members of the Armed Forces and veterans. ‘‘(3) ELEMENTS.—In conducting the review, the Sec- retary of Defense and the Secretary of Veterans Af- fairs shall— ‘‘(A) identify among the policies and procedures described in paragraph (1) best practices in ap- proaches to the care and management of recovering service members; ‘‘(B) identify among such policies and procedures existing and potential shortfalls in the care and management of recovering service members (in- cluding care and management of recovering service members on the temporary disability retired list), and determine means of addressing any shortfalls so identified; ‘‘(C) determine potential modifications of such policies and procedures in order to ensure consist- ency and uniformity, where appropriate, in the ap- plication of such policies and procedures— ‘‘(i) among the military departments; ‘‘(ii) among the Veterans Integrated Services Networks (VISNs) of the Department of Veterans Affairs; and ‘‘(iii) between the military departments and the Veterans Integrated Services Networks; and ‘‘(D) develop recommendations for legislative and administrative action necessary to implement the results of the review. ‘‘(4) DEADLINE FOR COMPLETION.—The review shall be completed not later than 90 days after the date of the enactment of this Act [Jan. 28, 2008]. ‘‘(c) CONSIDERATION OF EXISTING FINDINGS, REC- OMMENDATIONS, AND PRACTICES.—In developing the pol- icy required by subsection (a), the Secretary of Defense and the Secretary of Veterans Affairs shall take into account the following: ‘‘(1) The findings and recommendations of applica- ble studies, reviews, reports, and evaluations that ad- dress matters relating to the policy, including, but not limited, to the following: ‘‘(A) The Independent Review Group on Rehabili- tative Care and Administrative Processes at Walter Reed Army Medical Center and National Naval Medical Center, appointed by the Secretary of De- fense. ‘‘(B) The Secretary of Veterans Affairs Task Force on Returning Global War on Terror Heroes, appointed by the President. ‘‘(C) The President’s Commission on Care for America’s Returning Wounded Warriors. ‘‘(D) The Veterans’ Disability Benefits Commis- sion established by title XV of the National Defense Authorization Act for Fiscal Year 2004 (Public Law 108–136; 117 Stat. 1676; 38 U.S.C. 1101 note). ‘‘(E) The President’s Task Force to Improve Health Care Delivery for Our Nation’s Veterans, of March 2003. ‘‘(F) The Report of the Congressional Commission on Servicemembers and Veterans Transition Assist- ance, of 1999, chaired by Anthony J. Principi. ‘‘(G) The President’s Commission on Veterans’ Pensions, of 1956, chaired by General Omar N. Brad- ley. ‘‘(2) The experience and best practices of the De- partment of Defense and the military departments on matters relating to the policy. ‘‘(3) The experience and best practices of the De- partment of Veterans Affairs on matters relating to the policy. ‘‘(4) Such other matters as the Secretary of Defense and the Secretary of Veterans Affairs consider appro- priate. ‘‘(d) TRAINING AND SKILLS OF HEALTH CARE PROFES- SIONALS, RECOVERY CARE COORDINATORS, MEDICAL CARE Page 981 TITLE 10—ARMED FORCES § 1071 CASE MANAGERS, AND NON-MEDICAL CARE MANAGERS FOR RECOVERING SERVICE MEMBERS.— ‘‘(1) IN GENERAL.—The policy required by subsection (a) shall provide for uniform standards among the military departments for the training and skills of health care professionals, recovery care coordinators, medical care case managers, and non-medical care managers for recovering service members under sub- section (e) in order to ensure that such personnel are able to— ‘‘(A) detect early warning signs of post-traumatic stress disorder (PTSD), suicidal or homicidal thoughts or behaviors, and other behavioral health concerns among recovering service members; and ‘‘(B) promptly notify appropriate health care pro- fessionals following detection of such signs. ‘‘(2) TRACKING OF NOTIFICATIONS.—In providing for uniform standards under paragraph (1), the policy shall include a mechanism or system to track the number of notifications made by recovery care coor- dinators, medical care case managers, and non-med- ical care managers to health care professionals under paragraph (1)(A) regarding early warning signs of post-traumatic stress disorder and suicide in recov- ering service members. ‘‘(e) SERVICES FOR RECOVERING SERVICE MEMBERS.— The policy required by subsection (a) shall provide for improvements as follows with respect to the care, man- agement, and transition of recovering service members: ‘‘(1) COMPREHENSIVE RECOVERY PLAN FOR RECOV- ERING SERVICE MEMBERS.—The policy shall provide for uniform standards and procedures for the develop- ment of a comprehensive recovery plan for each re- covering service member that covers the full spec- trum of care, management, transition, and rehabili- tation of the service member during recovery. ‘‘(2) RECOVERY CARE COORDINATORS FOR RECOVERING SERVICE MEMBERS.— ‘‘(A) IN GENERAL.—The policy shall provide for a uniform program for the assignment to recovering service members of recovery care coordinators hav- ing the duties specified in subparagraph (B). ‘‘(B) DUTIES.—The duties under the program of a recovery care coordinator for a recovering service member shall include, but not be limited to, over- seeing and assisting the service member in the serv- ice member’s course through the entire spectrum of care, management, transition, and rehabilitation services available from the Federal Government, including services provided by the Department of Defense, the Department of Veterans Affairs, the Department of Labor, and the Social Security Ad- ministration. ‘‘(C) LIMITATION ON NUMBER OF SERVICE MEMBERS MANAGED BY COORDINATORS.—The maximum number of recovering service members whose cases may be assigned to a recovery care coordinator under the program at any one time shall be such number as the policy shall specify, except that the Secretary of the military department concerned may waive such limitation with respect to a given coordinator for not more than 120 days in the event of unfore- seen circumstances (as specified in the policy). ‘‘(D) TRAINING.—The policy shall specify standard training requirements and curricula for recovery care coordinators under the program, including a requirement for successful completion of the train- ing program before a person may assume the duties of such a coordinator. ‘‘(E) RESOURCES.—The policy shall include mecha- nisms to ensure that recovery care coordinators under the program have the resources necessary to expeditiously carry out the duties of such coordina- tors under the program. ‘‘(F) SUPERVISION.—The policy shall specify re- quirements for the appropriate rank or grade, and appropriate occupation, for persons appointed to head and supervise recovery care coordinators. ‘‘(3) MEDICAL CARE CASE MANAGERS FOR RECOVERING SERVICE MEMBERS.— ‘‘(A) IN GENERAL.—The policy shall provide for a uniform program among the military departments for the assignment to recovering service members of medical care case managers having the duties specified in subparagraph (B). ‘‘(B) DUTIES.—The duties under the program of a medical care case manager for a recovering service member (or the service member’s immediate family or other designee if the service member is incapable of making judgments about personal medical care) shall include, at a minimum, the following: ‘‘(i) Assisting in understanding the service member’s medical status during the care, recov- ery, and transition of the service member. ‘‘(ii) Assisting in the receipt by the service member of prescribed medical care during the care, recovery, and transition of the service mem- ber. ‘‘(iii) Conducting a periodic review of the med- ical status of the service member, which review shall be conducted, to the extent practicable, in person with the service member, or, whenever the conduct of the review in person is not practicable, with the medical care case manager submitting to the manager’s supervisor a written explanation why the review in person was not practicable (if the Secretary of the military department con- cerned elects to require such written explanations for purposes of the program). ‘‘(C) LIMITATION ON NUMBER OF SERVICE MEMBERS MANAGED BY MANAGERS.—The maximum number of recovering service members whose cases may be as- signed to a medical care case manager under the program at any one time shall be such number as the policy shall specify, except that the Secretary of the military department concerned may waive such limitation with respect to a given manager for not more than 120 days in the event of unforeseen circumstances (as specified in the policy). ‘‘(D) TRAINING.—The policy shall specify standard training requirements and curricula for medical care case managers under the program, including a requirement for successful completion of the train- ing program before a person may assume the duties of such a manager. ‘‘(E) RESOURCES.—The policy shall include mecha- nisms to ensure that medical care case managers under the program have the resources necessary to expeditiously carry out the duties of such managers under the program. ‘‘(F) SUPERVISION AT ARMED FORCES MEDICAL FA- CILITIES.—The policy shall specify requirements for the appropriate rank or grade, and appropriate oc- cupation, for persons appointed to head and super- vise the medical care case managers at each med- ical facility of the Armed Forces. Persons so ap- pointed may be appointed from the Army Medical Corps, Army Medical Service Corps, Army Nurse Corps, Navy Medical Corps, Navy Medical Service Corps, Navy Nurse Corps, Air Force Medical Serv- ice, or other corps or civilian health care profes- sional, as applicable, at the discretion of the Sec- retary of Defense. ‘‘(4) NON-MEDICAL CARE MANAGERS FOR RECOVERING SERVICE MEMBERS.— ‘‘(A) IN GENERAL.—The policy shall provide for a uniform program among the military departments for the assignment to recovering service members of non-medical care managers having the duties specified in subparagraph (B). ‘‘(B) DUTIES.—The duties under the program of a non-medical care manager for a recovering service member shall include, at a minimum, the following: ‘‘(i) Communicating with the service member and with the service member’s family or other in- dividuals designated by the service member re- garding non-medical matters that arise during the care, recovery, and transition of the service member. ‘‘(ii) Assisting with oversight of the service member’s welfare and quality of life. Page 982 TITLE 10—ARMED FORCES § 1071 ‘‘(iii) Assisting the service member in resolving problems involving financial, administrative, per- sonnel, transitional, and other matters that arise during the care, recovery, and transition of the service member. ‘‘(C) DURATION OF DUTIES.—The policy shall pro- vide that a non-medical care manager shall perform duties under the program for a recovering service member until the service member is returned to ac- tive duty or retired or separated from the Armed Forces. ‘‘(D) LIMITATION ON NUMBER OF SERVICE MEMBERS MANAGED BY MANAGERS.—The maximum number of recovering service members whose cases may be as- signed to a non-medical care manager under the program at any one time shall be such number as the policy shall specify, except that the Secretary of the military department concerned may waive such limitation with respect to a given manager for not more than 120 days in the event of unforeseen circumstances (as specified in the policy). ‘‘(E) TRAINING.—The policy shall specify standard training requirements and curricula among the military departments for non-medical care man- agers under the program, including a requirement for successful completion of the training program before a person may assume the duties of such a manager. ‘‘(F) RESOURCES.—The policy shall include mecha- nisms to ensure that non-medical care managers under the program have the resources necessary to expeditiously carry out the duties of such managers under the program. ‘‘(G) SUPERVISION AT ARMED FORCES MEDICAL FA- CILITIES.—The policy shall specify requirements for the appropriate rank and occupational speciality for persons appointed to head and supervise the non-medical care managers at each medical facility of the Armed Forces. ‘‘(5) ACCESS OF RECOVERING SERVICE MEMBERS TO NON-URGENT HEALTH CARE FROM THE DEPARTMENT OF DEFENSE OR OTHER PROVIDERS UNDER TRICARE.— ‘‘(A) IN GENERAL.—The policy shall provide for ap- propriate minimum standards for access of recov- ering service members to non-urgent medical care and other health care services as follows: ‘‘(i) In medical facilities of the Department of Defense. ‘‘(ii) Through the TRICARE program. ‘‘(B) MAXIMUM WAITING TIMES FOR CERTAIN CARE.— The standards for access under subparagraph (A) shall include such standards on maximum waiting times of recovering service members as the policy shall specify for care that includes, but is not lim- ited to, the following: ‘‘(i) Follow-up care. ‘‘(ii) Specialty care. ‘‘(iii) Diagnostic referrals and studies. ‘‘(iv) Surgery based on a physician’s determina- tion of medical necessity. ‘‘(C) WAIVER BY RECOVERING SERVICE MEMBERS.— The policy shall permit any recovering service member to waive a standard for access under this paragraph under such circumstances and conditions as the policy shall specify. ‘‘(6) ASSIGNMENT OF RECOVERING SERVICE MEMBERS TO LOCATIONS OF CARE.— ‘‘(A) IN GENERAL.—The policy shall provide for uniform guidelines among the military depart- ments for the assignment of recovering service members to a location of care, including guidelines that provide for the assignment of recovering serv- ice members, when medically appropriate, to care and residential facilities closest to their duty sta- tion or home of record or the location of their des- ignated care giver at the earliest possible time. ‘‘(B) REASSIGNMENT FROM DEFICIENT FACILITIES.— The policy shall provide for uniform guidelines and procedures among the military departments for the reassignment of recovering service members from a medical or medical-related support facility deter- mined by the Secretary of Defense to violate the standards required by section 1648 to another appro- priate medical or medical-related support facility until the correction of violations of such standards at the medical or medical-related support facility from which such service members are reassigned. ‘‘(7) TRANSPORTATION AND SUBSISTENCE FOR RECOV- ERING SERVICE MEMBERS.—The policy shall provide for uniform standards among the military departments on the availability of appropriate transportation and subsistence for recovering service members to facili- tate their obtaining needed medical care and serv- ices. ‘‘(8) WORK AND DUTY ASSIGNMENTS FOR RECOVERING SERVICE MEMBERS.—The policy shall provide for uni- form criteria among the military departments for the assignment of recovering service members to work and duty assignments that are compatible with their medical conditions. ‘‘(9) ACCESS OF RECOVERING SERVICE MEMBERS TO EDUCATIONAL AND VOCATIONAL TRAINING AND REHABILI- TATION.—The policy shall provide for uniform stand- ards among the military departments on the provi- sion of educational and vocational training and reha- bilitation opportunities for recovering service mem- bers at the earliest possible point in their recovery. ‘‘(10) TRACKING OF RECOVERING SERVICE MEMBERS.— The policy shall provide for uniform procedures among the military departments on tracking recov- ering service members to facilitate— ‘‘(A) locating each recovering service member; and ‘‘(B) tracking medical care appointments of re- covering service members to ensure timeliness and compliance of recovering service members with ap- pointments, and other physical and evaluation timelines, and to provide any other information needed to conduct oversight of the care, manage- ment, and transition of recovering service mem- bers. ‘‘(11) REFERRALS OF RECOVERING SERVICE MEMBERS TO OTHER CARE AND SERVICES PROVIDERS.—The policy shall provide for uniform policies, procedures, and criteria among the military departments on the re- ferral of recovering service members to the Depart- ment of Veterans Affairs and other private and public entities (including universities and rehabilitation hospitals, centers, and clinics) in order to secure the most appropriate care for recovering service mem- bers, which policies, procedures, and criteria shall take into account, but not be limited to, the medical needs of recovering service members and the geo- graphic location of available necessary recovery care services. ‘‘(f) SERVICES FOR FAMILIES OF RECOVERING SERVICE MEMBERS.—The policy required by subsection (a) shall provide for improvements as follows with respect to services for families of recovering service members: ‘‘(1) SUPPORT FOR FAMILY MEMBERS OF RECOVERING SERVICE MEMBERS.—The policy shall provide for uni- form guidelines among the military departments on the provision by the military departments of support for family members of recovering service members who are not otherwise eligible for care under section 1672 in caring for such service members during their recovery. ‘‘(2) ADVICE AND TRAINING FOR FAMILY MEMBERS OF RECOVERING SERVICE MEMBERS.—The policy shall pro- vide for uniform requirements and standards among the military departments on the provision by the military departments of advice and training, as ap- propriate, to family members of recovering service members with respect to care for such service mem- bers during their recovery. ‘‘(3) MEASUREMENT OF SATISFACTION OF FAMILY MEM- BERS OF RECOVERING SERVICE MEMBERS WITH QUALITY OF HEALTH CARE SERVICES.—The policy shall provide for uniform procedures among the military depart- ments on the measurement of the satisfaction of fam- Page 983 TITLE 10—ARMED FORCES § 1071 ily members of recovering service members with the quality of health care services provided to such serv- ice members during their recovery. ‘‘(4) JOB PLACEMENT SERVICES FOR FAMILY MEMBERS OF RECOVERING SERVICE MEMBERS.—The policy shall provide for procedures for application by eligible fam- ily members during a one-year period for job place- ment services otherwise offered by the Department of Defense. ‘‘(g) OUTREACH TO RECOVERING SERVICE MEMBERS AND THEIR FAMILIES ON COMPREHENSIVE POLICY.—The policy required by subsection (a) shall include procedures and mechanisms to ensure that recovering service members and their families are fully informed of the policies re- quired by this section, including policies on medical care for recovering service members, on the manage- ment and transition of recovering service members, and on the responsibilities of recovering service mem- bers and their family members throughout the con- tinuum of care and services for recovering service members under this section. ‘‘(h) APPLICABILITY OF COMPREHENSIVE POLICY TO RE- COVERING SERVICE MEMBERS ON TEMPORARY DISABILITY RETIRED LIST.—Appropriate elements of the policy re- quired by this section shall apply to recovering service members whose names are placed on the temporary dis- ability retired list in such manner, and subject to such terms and conditions, as the Secretary of Defense shall prescribe in regulations for purposes of this subsection. ‘‘SEC. 1612. MEDICAL EVALUATIONS AND PHYSICAL DISABILITY EVALUATIONS OF RECOVERING SERVICE MEMBERS. ‘‘(a) MEDICAL EVALUATIONS OF RECOVERING SERVICE MEMBERS.— ‘‘(1) IN GENERAL.—Not later than July 1, 2008, the Secretary of Defense shall develop a policy on im- provements to the processes, procedures, and stand- ards for the conduct by the military departments of medical evaluations of recovering service members. ‘‘(2) ELEMENTS.—The policy on improvements to processes, procedures, and standards required under this subsection shall include and address the fol- lowing: ‘‘(A) Processes for medical evaluations of recov- ering service members that— ‘‘(i) apply uniformly throughout the military departments; and ‘‘(ii) apply uniformly with respect to recovering service members who are members of the regular components of the Armed Forces and recovering service members who are members of the Na- tional Guard and Reserve. ‘‘(B) Standard criteria and definitions for deter- mining the achievement for recovering service members of the maximum medical benefit from treatment and rehabilitation. ‘‘(C) Standard timelines for each of the following: ‘‘(i) Determinations of fitness for duty of recov- ering service members. ‘‘(ii) Specialty care consultations for recovering service members. ‘‘(iii) Preparation of medical documents for re- covering service members. ‘‘(iv) Appeals by recovering service members of medical evaluation determinations, including de- terminations of fitness for duty. ‘‘(D) Procedures for ensuring that— ‘‘(i) upon request of a recovering service mem- ber being considered by a medical evaluation board, a physician or other appropriate health care professional who is independent of the med- ical evaluation board is assigned to the service member; and ‘‘(ii) the physician or other health care profes- sional assigned to a recovering service member under clause (i)— ‘‘(I) serves as an independent source for re- view of the findings and recommendations of the medical evaluation board; ‘‘(II) provides the service member with advice and counsel regarding the findings and rec- ommendations of the medical evaluation board; and ‘‘(III) advises the service member on whether the findings of the medical evaluation board adequately reflect the complete spectrum of in- juries and illness of the service member. ‘‘(E) Standards for qualifications and training of medical evaluation board personnel, including phy- sicians, case workers, and physical disability eval- uation board liaison officers, in conducting medical evaluations of recovering service members. ‘‘(F) Standards for the maximum number of med- ical evaluation cases of recovering service members that are pending before a medical evaluation board at any one time, and requirements for the estab- lishment of additional medical evaluation boards in the event such number is exceeded. ‘‘(G) Standards for information for recovering service members, and their families, on the medical evaluation board process and the rights and respon- sibilities of recovering service members under that process, including a standard handbook on such in- formation (which handbook shall also be available electronically). ‘‘(b) PHYSICAL DISABILITY EVALUATIONS OF RECOV- ERING SERVICE MEMBERS.— ‘‘(1) IN GENERAL.—Not later than July 1, 2008, the Secretary of Defense and the Secretary of Veterans Affairs shall develop a policy on improvements to the processes, procedures, and standards for the conduct of physical disability evaluations of recovering serv- ice members by the military departments and by the Department of Veterans Affairs. ‘‘(2) ELEMENTS.—The policy on improvements to processes, procedures, and standards required under this subsection shall include and address the fol- lowing: ‘‘(A) A clearly-defined process of the Department of Defense and the Department of Veterans Affairs for disability determinations of recovering service members. ‘‘(B) To the extent feasible, procedures to elimi- nate unacceptable discrepancies and improve con- sistency among disability ratings assigned by the military departments and the Department of Vet- erans Affairs, particularly in the disability evalua- tion of recovering service members, which proce- dures shall be subject to the following requirements and limitations: ‘‘(i) Such procedures shall apply uniformly with respect to recovering service members who are members of the regular components of the Armed Forces and recovering service members who are members of the National Guard and Reserve. ‘‘(ii) Under such procedures, each Secretary of a military department shall, to the extent feasible, utilize the standard schedule for rating disabil- ities in use by the Department of Veterans Af- fairs, including any applicable interpretation of such schedule by the United States Court of Ap- peals for Veterans Claims, in making any deter- mination of disability of a recovering service member, except as otherwise authorized by sec- tion 1216a of title 10, United States Code (as added by section 1642 of this Act). ‘‘(C) Uniform timelines among the military de- partments for appeals of determinations of dis- ability of recovering service members, including timelines for presentation, consideration, and dis- position of appeals. ‘‘(D) Uniform standards among the military de- partments for qualifications and training of phys- ical disability evaluation board personnel, includ- ing physical evaluation board liaison personnel, in conducting physical disability evaluations of recov- ering service members. ‘‘(E) Uniform standards among the military de- partments for the maximum number of physical Page 984 TITLE 10—ARMED FORCES § 1071 disability evaluation cases of recovering service members that are pending before a physical dis- ability evaluation board at any one time, and re- quirements for the establishment of additional physical disability evaluation boards in the event such number is exceeded. ‘‘(F) Uniform standards and procedures among the military departments for the provision of legal counsel to recovering service members while under- going evaluation by a physical disability evalua- tion board. ‘‘(G) Uniform standards among the military de- partments on the roles and responsibilities of non- medical care managers under section 1611(e)(4) and judge advocates assigned to recovering service members undergoing evaluation by a physical dis- ability board, and uniform standards on the max- imum number of cases involving such service mem- bers that are to be assigned to judge advocates at any one time. ‘‘(c) ASSESSMENT OF CONSOLIDATION OF DEPARTMENT OF DEFENSE AND DEPARTMENT OF VETERANS AFFAIRS DISABILITY EVALUATION SYSTEMS.— ‘‘(1) IN GENERAL.—The Secretary of Defense and the Secretary of Veterans Affairs shall jointly submit to the appropriate committees of Congress a report on the feasability [sic] and advisability of consolidating the disability evaluation systems of the military de- partments and the disability evaluation system of the Department of Veterans Affairs into a single dis- ability evaluation system. The report shall be sub- mitted together with the report required by section 1611(a). ‘‘(2) ELEMENTS.—The report required by paragraph (1) shall include the following: ‘‘(A) An assessment of the feasability [sic] and ad- visability of consolidating the disability evaluation systems described in paragraph (1) as specified in that paragraph. ‘‘(B) If the consolidation of the systems is consid- ered feasible and advisable— ‘‘(i) recommendations for various options for consolidating the systems as specified in para- graph (1); and ‘‘(ii) recommendations for mechanisms to evaluate and assess any progress made in consoli- dating the systems as specified in that paragraph. ‘‘SEC. 1613. RETURN OF RECOVERING SERVICE MEMBERS TO ACTIVE DUTY IN THE ARMED FORCES. ‘‘The Secretary of Defense shall establish standards for determinations by the military departments on the return of recovering service members to active duty in the Armed Forces. ‘‘SEC. 1614. TRANSITION OF RECOVERING SERVICE MEMBERS FROM CARE AND TREATMENT THROUGH THE DEPARTMENT OF DEFENSE TO CARE, TREATMENT, AND REHABILITATION THROUGH THE DEPARTMENT OF VETERANS AFFAIRS. ‘‘(a) IN GENERAL.—Not later than July 1, 2008, the Secretary of Defense and the Secretary of Veterans Af- fairs shall jointly develop and implement processes, procedures, and standards for the transition of recov- ering service members from care and treatment through the Department of Defense to care, treatment, and rehabilitation through the Department of Veterans Affairs. ‘‘(b) ELEMENTS.—The processes, procedures, and standards required under this section shall include the following: ‘‘(1) Uniform, patient-focused procedures to ensure that the transition described in subsection (a) occurs without gaps in medical care and in the quality of medical care, benefits, and services. ‘‘(2) Procedures for the identification and tracking of recovering service members during the transition, and for the coordination of care and treatment of re- covering service members during the transition, in- cluding a system of cooperative case management of recovering service members by the Department of De- fense and the Department of Veterans Affairs during the transition. ‘‘(3) Procedures for the notification of Department of Veterans Affairs liaison personnel of the com- mencement by recovering service members of the medical evaluation process and the physical dis- ability evaluation process. ‘‘(4) Procedures and timelines for the enrollment of recovering service members in applicable enrollment or application systems of the Department of Veterans Affairs with respect to health care, disability, edu- cation, vocational rehabilitation, or other benefits. ‘‘(5) Procedures to ensure the access of recovering service members during the transition to vocational, educational, and rehabilitation benefits available through the Department of Veterans Affairs. ‘‘(6) Standards for the optimal location of Depart- ment of Defense and Department of Veterans Affairs liaison and case management personnel at military medical treatment facilities, medical centers, and other medical facilities of the Department of Defense. ‘‘(7) Standards and procedures for integrated med- ical care and management of recovering service mem- bers during the transition, including procedures for the assignment of medical personnel of the Depart- ment of Veterans Affairs to Department of Defense facilities to participate in the needs assessments of recovering service members before, during, and after their separation from military service. ‘‘(8) Standards for the preparation of detailed plans for the transition of recovering service members from care and treatment by the Department of Defense to care, treatment, and rehabilitation by the Depart- ment of Veterans Affairs, which plans shall— ‘‘(A) be based on standardized elements with re- spect to care and treatment requirements and other applicable requirements; and ‘‘(B) take into account the comprehensive recov- ery plan for the recovering service member con- cerned as developed under section 1611(e)(1). ‘‘(9) Procedures to ensure that each recovering serv- ice member who is being retired or separated under chapter 61 of title 10, United States Code, receives a written transition plan, prior to the time of retire- ment or separation, that— ‘‘(A) specifies the recommended schedule and milestones for the transition of the service member from military service; ‘‘(B) provides for a coordinated transition of the service member from the Department of Defense disability evaluation system to the Department of Veterans Affairs disability system; and ‘‘(C) includes information and guidance designed to assist the service member in understanding and meeting the schedule and milestones specified under subparagraph (A) for the service member’s transition. ‘‘(10) Procedures for the transmittal from the De- partment of Defense to the Department of Veterans Affairs of records and any other required information on each recovering service member described in para- graph (9), which procedures shall provide for the transmission from the Department of Defense to the Department of Veterans Affairs of records and infor- mation on the service member as follows: ‘‘(A) The address and contact information of the service member. ‘‘(B) The DD–214 discharge form of the service member, which shall be transmitted under such procedures electronically. ‘‘(C) A copy of the military service record of the service member, including medical records and any results of a physical evaluation board. ‘‘(D) Information on whether the service member is entitled to transitional health care, a conversion health policy, or other health benefits through the Department of Defense under section 1145 of title 10, United States Code. Page 985 TITLE 10—ARMED FORCES § 1071 ‘‘(E) A copy of any request of the service member for assistance in enrolling in, or completed applica- tions for enrollment in, the health care system of the Department of Veterans Affairs for health care benefits for which the service member may be eligi- ble under laws administered by the Secretary of Veterans Affairs. ‘‘(F) A copy of any request by the service member for assistance in applying for, or completed applica- tions for, compensation and vocational rehabilita- tion benefits to which the service member may be entitled under laws administered by the Secretary of Veterans Affairs. ‘‘(11) A process to ensure that, before transmittal of medical records of a recovering service member to the Department of Veterans Affairs, the Secretary of Defense ensures that the service member (or an indi- vidual legally recognized to make medical decisions on behalf of the service member) authorizes the transfer of the medical records of the service member from the Department of Defense to the Department of Veterans Affairs pursuant to the Health Insurance Portability and Accountability Act of 1996 [Pub. L. 104–191, see Tables for classification]. ‘‘(12) Procedures to ensure that, with the consent of the recovering service member concerned, the address and contact information of the service member is transmitted to the department or agency for veterans affairs of the State in which the service member in- tends to reside after the retirement or separation of the service member from the Armed Forces. ‘‘(13) Procedures to ensure that, before the trans- mittal of records and other information with respect to a recovering service member under this section, a meeting regarding the transmittal of such records and other information occurs among the service member, appropriate family members of the service member, representatives of the Secretary of the mili- tary department concerned, and representatives of the Secretary of Veterans Affairs, with at least 30 days advance notice of the meeting being given to the service member unless the service member waives the advance notice requirement in order to accelerate transmission of the service member’s records and other information to the Department of Veterans Af- fairs. ‘‘(14) Procedures to ensure that the Secretary of Veterans Affairs gives appropriate consideration to a written statement submitted to the Secretary by a recovering service member regarding the transition. ‘‘(15) Procedures to provide access for the Depart- ment of Veterans Affairs to the military health records of recovering service members who are re- ceiving care and treatment, or are anticipating re- ceipt of care and treatment, in Department of Vet- erans Affairs health care facilities, which procedures shall be consistent with the procedures and require- ments in paragraphs (11) and (13). ‘‘(16) A process for the utilization of a joint separa- tion and evaluation physical examination that meets the requirements of both the Department of Defense and the Department of Veterans Affairs in connection with the medical separation or retirement of a recov- ering service member from military service and for use by the Department of Veterans Affairs in dis- ability evaluations. ‘‘(17) Procedures for surveys and other mechanisms to measure patient and family satisfaction with the provision by the Department of Defense and the De- partment of Veterans Affairs of care and services for recovering service members, and to facilitate appro- priate oversight by supervisory personnel of the pro- vision of such care and services. ‘‘(18) Procedures to ensure the participation of re- covering service members who are members of the National Guard or Reserve in the Benefits Delivery at Discharge Program, including procedures to ensure that, to the maximum extent feasible, services under the Benefits Delivery at Discharge Program are pro- vided to recovering service members at— ‘‘(A) appropriate military installations; ‘‘(B) appropriate armories and military family support centers of the National Guard; ‘‘(C) appropriate military medical care facilities at which members of the Armed Forces are sepa- rated or discharged from the Armed Forces; and ‘‘(D) in the case of a member on the temporary disability retired list under section 1202 or 1205 of title 10, United States Code, who is being retired under another provision of such title or is being dis- charged, at a location reasonably convenient to the member. ‘‘SEC. 1616. ESTABLISHMENT OF A WOUNDED WAR- RIOR RESOURCE CENTER. ‘‘(a) ESTABLISHMENT.—The Secretary of Defense shall establish a wounded warrior resource center (in this section referred to as the ‘center’) to provide wounded warriors, their families, and their primary caregivers with a single point of contact for assistance with re- porting deficiencies in covered military facilities, ob- taining health care services, receiving benefits infor- mation, receiving legal assistance referral information (where appropriate), receiving other appropriate refer- ral information, and any other difficulties encountered while supporting wounded warriors. The Secretary shall widely disseminate information regarding the ex- istence and availability of the center, including con- tact information, to members of the Armed Forces and their dependents. In carrying out this subsection, the Secretary may use existing infrastructure and organi- zations but shall ensure that the center has the ability to separately keep track of calls from wounded war- riors. ‘‘(b) ACCESS.—The center shall provide multiple methods of access, including at a minimum an Internet website and a toll-free telephone number (commonly referred to as a ‘hot line’) at which personnel are acces- sible at all times to receive reports of deficiencies or provide information about covered military facilities, health care services, or military benefits. ‘‘(c) CONFIDENTIALITY.— ‘‘(1) NOTIFICATION.—Individuals who seek to provide information through the center under subsection (a) shall be notified, immediately before they provide such information, of their option to elect, at their discretion, to have their identity remain confiden- tial. ‘‘(2) PROHIBITION ON FURTHER DISCLOSURE.—In the case of information provided through use of the toll- free telephone number by an individual who elects to maintain the confidentiality of his or her identity, any individual who, by necessity, has had access to such information for purposes of investigating or re- sponding to the call as required under subsection (d) may not disclose the identity of the individual who provided the information. ‘‘(d) FUNCTIONS.—The center shall perform the fol- lowing functions: ‘‘(1) CALL TRACKING.—The center shall be respon- sible for documenting receipt of a call, referring the call to the appropriate office within a military de- partment for answer or investigation, and tracking the formulation and notification of the response to the call. ‘‘(2) INVESTIGATION AND RESPONSE.—The center shall be responsible for ensuring that, not later than 96 hours after a call— ‘‘(A) if a report of deficiencies is received in a call— ‘‘(i) any deficiencies referred to in the call are investigated; ‘‘(ii) if substantiated, a plan of action for reme- diation of the deficiencies is developed and imple- mented; and ‘‘(iii) if requested, the individual who made the report is notified of the current status of the re- port; or ‘‘(B) if a request for information is received in a call— Page 986 TITLE 10—ARMED FORCES § 1071 ‘‘(i) the information requested by the caller is provided by the center; ‘‘(ii) all requests for information from the call are referred to the appropriate office or offices of a military department for response; and ‘‘(iii) the individual who made the report is no- tified, at a minimum, of the current status of the query. ‘‘(3) FINAL NOTIFICATION.—The center shall be re- sponsible for ensuring that, if requested, the caller is notified when the deficiency has been corrected or when the request for information has been fulfilled to the maximum extent practicable, as determined by the Secretary. ‘‘(e) DEFINITIONS.—In this section: ‘‘(1) COVERED MILITARY FACILITY.—The term ‘cov- ered military facility’ has the meaning provided in section 1648(b) of this Act. ‘‘(2) CALL.—The term ‘call’ means any query or re- port that is received by the center by means of the toll-free telephone number or other source. ‘‘(f) EFFECTIVE DATES.— ‘‘(1) TOLL-FREE TELEPHONE NUMBER.—The toll-free telephone number required to be established by sub- section (a), shall be fully operational not later than April 1, 2008. ‘‘(2) INTERNET WEBSITE.—The Internet website re- quired to be established by subsection (a), shall be fully operational not later than July 1, 2008. [As amended Pub. L. 110–417, [div. A], title VII, § 724, Oct. 14, 2008, 122 Stat. 4509.] ‘‘SEC. 1618. COMPREHENSIVE PLAN ON PREVEN- TION, DIAGNOSIS, MITIGATION, TREATMENT, AND REHABILITATION OF, AND RESEARCH ON, TRAUMATIC BRAIN INJURY, POST-TRAUMATIC STRESS DISORDER, AND OTHER MENTAL HEALTH CONDITIONS IN MEMBERS OF THE ARMED FORCES. ‘‘(a) COMPREHENSIVE STATEMENT OF POLICY.—The Sec- retary of Defense and the Secretary of Veterans Affairs shall direct joint planning among the Department of Defense, the military departments, and the Department of Veterans Affairs for the prevention, diagnosis, miti- gation, treatment, and rehabilitation of, and research on, traumatic brain injury, post-traumatic stress dis- order, and other mental health conditions in members of the Armed Forces, including planning for the seam- less transition of such members from care through the Department of Defense to care through the Department of Veterans Affairs. ‘‘(b) COMPREHENSIVE PLAN REQUIRED.—Not later than 180 days after the date of the enactment of this Act [Jan. 28, 2008], the Secretary of Defense shall, in con- sultation with the Secretary of Veterans Affairs, sub- mit to the congressional defense committees [Commit- tees on Armed Services and Appropriations of the Sen- ate and the House of Representatives] a comprehensive plan for programs and activities of the Department of Defense to prevent, diagnose, mitigate, treat, research, and otherwise respond to traumatic brain injury, post- traumatic stress disorder, and other mental health con- ditions in members of the Armed Forces, including— ‘‘(1) an assessment of the current capabilities of the Department for the prevention, diagnosis, mitigation, treatment, and rehabilitation of, and research on, traumatic brain injury, post-traumatic stress dis- order, and other mental health conditions in mem- bers of the Armed Forces; ‘‘(2) the identification of gaps in current capabili- ties of the Department for the prevention, diagnosis, mitigation, treatment, and rehabilitation of, and re- search on, traumatic brain injury, post-traumatic stress disorder, and other mental health conditions in members of the Armed Forces; and ‘‘(3) the identification of the resources required for the Department in fiscal years 2009 through 2013 to address the gaps in capabilities identified under para- graph (2). ‘‘(c) PROGRAM REQUIRED.—One of the programs con- tained in the comprehensive plan submitted under sub- section (b) shall be a Department of Defense program, developed in collaboration with the Department of Vet- erans Affairs, under which each member of the Armed Forces who incurs a traumatic brain injury or post- traumatic stress disorder during service in the Armed Forces— ‘‘(1) is enrolled in the program; and ‘‘(2) receives treatment and rehabilitation meeting a standard of care such that each individual who qualifies for care under the program shall— ‘‘(A) be provided the highest quality, evidence- based care in facilities that most appropriately meet the specific needs of the individual; and ‘‘(B) be rehabilitated to the fullest extent possible using up-to-date evidence-based medical tech- nology, and physical and medical rehabilitation practices and expertise. ‘‘(d) PROVISION OF INFORMATION REQUIRED.—The com- prehensive plan submitted under subsection (b) shall require the provision of information by the Secretary of Defense to members of the Armed Forces with trau- matic brain injury, post-traumatic stress disorder, or other mental health conditions and their families about their options with respect to the following: ‘‘(1) The receipt of medical and mental health care from the Department of Defense and the Department of Veterans Affairs. ‘‘(2) Additional options available to such members for treatment and rehabilitation of traumatic brain injury, post-traumatic stress disorder, and other mental health conditions. ‘‘(3) The options available, including obtaining a second opinion, to such members for a referral to an authorized provider under chapter 55 of title 10, United States Code, as determined under regulations prescribed by the Secretary of Defense. ‘‘(e) ADDITIONAL ELEMENTS OF PLAN.—The comprehen- sive plan submitted under subsection (b) shall include comprehensive proposals of the Department on the fol- lowing: ‘‘(1) LEAD AGENT.—The designation by the Sec- retary of Defense of a lead agent or executive agent for the Department to coordinate development and implementation of the plan. ‘‘(2) DETECTION AND TREATMENT.—The improvement of methods and mechanisms for the detection and treatment of traumatic brain injury, post-traumatic stress disorder, and other mental health conditions in members of the Armed Forces in the field. ‘‘(3) REDUCTION OF PTSD.—The development of a plan for reducing post traumatic-stress disorder, in- corporating evidence-based preventive and early- intervention measures, practices, or procedures that reduce the likelihood that personnel in combat will develop post-traumatic stress disorder or other stress-related conditions (including substance abuse conditions) into— ‘‘(A) basic and pre-deployment training for en- listed members of the Armed Forces, noncommis- sioned officers, and officers; ‘‘(B) combat theater operations; and ‘‘(C) post-deployment service. ‘‘(4) RESEARCH.—Requirements for research on trau- matic brain injury, post-traumatic stress disorder, and other mental health conditions including (in par- ticular) research on pharmacological and other ap- proaches to treatment for traumatic brain injury, post-traumatic stress disorder, or other mental health conditions, as applicable, and the allocation of priorities among such research. ‘‘(5) DIAGNOSTIC CRITERIA.—The development, adop- tion, and deployment of joint Department of Defense- Department of Veterans Affairs evidence-based diag- nostic criteria for the detection and evaluation of the range of traumatic brain injury, post-traumatic stress disorder, and other mental health conditions in members of the Armed Forces, which criteria shall be employed uniformly across the military departments in all applicable circumstances, including provision of clinical care and assessment of future deployability of members of the Armed Forces. Page 987 TITLE 10—ARMED FORCES § 1071 ‘‘(6) ASSESSMENT.—The development and deploy- ment of evidence-based means of assessing traumatic brain injury, post-traumatic stress disorder, and other mental health conditions in members of the Armed Forces, including a system of pre-deployment and post-deployment screenings of cognitive ability in members for the detection of cognitive impair- ment. ‘‘(7) MANAGING AND MONITORING.—The development and deployment of effective means of managing and monitoring members of the Armed Forces with trau- matic brain injury, post-traumatic stress disorder, or other mental health conditions in the receipt of care for traumatic brain injury, post-traumatic stress dis- order, or other mental health conditions, as applica- ble, including the monitoring and assessment of treatment and outcomes. ‘‘(8) EDUCATION AND AWARENESS.—The development and deployment of an education and awareness train- ing initiative designed to reduce the negative stigma associated with traumatic brain injury, post-trau- matic stress disorder, and other mental health condi- tions, and mental health treatment. ‘‘(9) EDUCATION AND OUTREACH.—The provision of education and outreach to families of members of the Armed Forces with traumatic brain injury, post-trau- matic stress disorder, or other mental health condi- tions on a range of matters relating to traumatic brain injury, post-traumatic stress disorder, or other mental health conditions, as applicable, including de- tection, mitigation, and treatment. ‘‘(10) RECORDING OF BLASTS.—A requirement that exposure to a blast or blasts be recorded in the records of members of the Armed Forces. ‘‘(11) GUIDELINES FOR BLAST INJURIES.—The develop- ment of clinical practice guidelines for the diagnosis and treatment of blast injuries in members of the Armed Forces, including, but not limited to, trau- matic brain injury. ‘‘(12) GENDER- AND ETHNIC GROUP-SPECIFIC SERVICES AND TREATMENT.—The development of requirements, as appropriate, for gender- and ethnic group-specific medical care services and treatment for members of the Armed Forces who experience mental health problems and conditions, including post-traumatic stress disorder, with specific regard to the avail- ability of, access to, and research and development requirements of such needs. ‘‘(f) COORDINATION IN DEVELOPMENT.—The comprehen- sive plan submitted under subsection (b) shall be devel- oped in coordination with the Secretary of the Army (who was designated by the Secretary of Defense as ex- ecutive agent for the prevention, mitigation, and treat- ment of blast injuries under section 256 of the National Defense Authorization Act for Fiscal Year 2006 (Public Law 109–163; 119 Stat. 3181; 10 U.S.C. 1071 note)). ‘‘SEC. 1621. CENTER OF EXCELLENCE IN THE PRE- VENTION, DIAGNOSIS, MITIGATION, TREAT- MENT, AND REHABILITATION OF TRAUMATIC BRAIN INJURY. ‘‘(a) IN GENERAL.—The Secretary of Defense shall es- tablish within the Department of Defense a center of excellence in the prevention, diagnosis, mitigation, treatment, and rehabilitation of traumatic brain in- jury, including mild, moderate, and severe traumatic brain injury, to carry out the responsibilities specified in subsection (c). ‘‘(b) PARTNERSHIPS.—The Secretary shall ensure that the Center collaborates to the maximum extent prac- ticable with the Department of Veterans Affairs, insti- tutions of higher education, and other appropriate pub- lic and private entities (including international enti- ties) to carry out the responsibilities specified in sub- section (c). ‘‘(c) RESPONSIBILITIES.—The Center shall have respon- sibilities as follows: ‘‘(1) To implement the comprehensive plan and strategy for the Department of Defense, required by section 1618 of this Act, for the prevention, diagnosis, mitigation, treatment, and rehabilitation of trau- matic brain injury, including research on gender and ethnic group-specific health needs related to trau- matic brain injury. ‘‘(2) To provide for the development, testing, and dissemination within the Department of best prac- tices for the treatment of traumatic brain injury. ‘‘(3) To provide guidance for the mental health sys- tem of the Department in determining the mental health and neurological health personnel required to provide quality mental health care for members of the Armed Forces with traumatic brain injury. ‘‘(4) To establish, implement, and oversee a com- prehensive program to train mental health and neu- rological health professionals of the Department in the treatment of traumatic brain injury. ‘‘(5) To facilitate advancements in the study of the short-term and long-term psychological effects of traumatic brain injury. ‘‘(6) To disseminate within the military medical treatment facilities of the Department best practices for training mental health professionals, including neurological health professionals, with respect to traumatic brain injury. ‘‘(7) To conduct basic science and translational re- search on traumatic brain injury for the purposes of understanding the etiology of traumatic brain injury and developing preventive interventions and new treatments. ‘‘(8) To develop programs and outreach strategies for families of members of the Armed Forces with traumatic brain injury in order to mitigate the nega- tive impacts of traumatic brain injury on such family members and to support the recovery of such mem- bers from traumatic brain injury. ‘‘(9) To conduct research on the mental health needs of families of members of the Armed Forces with traumatic brain injury and develop protocols to address any needs identified through such research. ‘‘(10) To conduct longitudinal studies (using imag- ing technology and other proven research methods) on members of the Armed Forces with traumatic brain injury to identify early signs of Alzheimer’s disease, Parkinson’s disease, or other manifestations of neurodegeneration, as well as epilepsy, in such members, in coordination with the studies authorized by section 721 of the John Warner National Defense Authorization Act for Fiscal Year 2007 (Public Law 109–364; 120 Stat. 2294) [10 U.S.C. 1074 note] and other studies of the Department of Defense and the Depart- ment of Veterans Affairs that address the connection between exposure to combat and the development of Alzheimer’s disease, Parkinson’s disease, and other neurodegenerative disorders, as well as epilepsy. ‘‘(11) To develop and oversee a long-term plan to in- crease the number of mental health and neurological health professionals within the Department in order to facilitate the meeting by the Department of the needs of members of the Armed Forces with trau- matic brain injury until their transition to care and treatment from the Department of Veterans Affairs. ‘‘(12) To develop a program on comprehensive pain management, including management of acute and chronic pain, to utilize current and develop new treatments for pain, and to identify and disseminate best practices on pain management related to trau- matic brain injury. ‘‘(13) Such other responsibilities as the Secretary shall specify. ‘‘SEC. 1622. CENTER OF EXCELLENCE IN PREVEN- TION, DIAGNOSIS, MITIGATION, TREATMENT, AND REHABILITATION OF POST-TRAUMATIC STRESS DISORDER AND OTHER MENTAL HEALTH CONDITIONS. ‘‘(a) IN GENERAL.—The Secretary of Defense shall es- tablish within the Department of Defense a center of excellence in the prevention, diagnosis, mitigation, treatment, and rehabilitation of post-traumatic stress disorder (PTSD) and other mental health conditions, Page 988 TITLE 10—ARMED FORCES § 1071 including mild, moderate, and severe post-traumatic stress disorder and other mental health conditions, to carry out the responsibilities specified in subsection (c). ‘‘(b) PARTNERSHIPS.—The Secretary shall ensure that the center collaborates to the maximum extent prac- ticable with the National Center on Post-Traumatic Stress Disorder of the Department of Veterans Affairs, institutions of higher education, and other appropriate public and private entities (including international en- tities) to carry out the responsibilities specified in sub- section (c). ‘‘(c) RESPONSIBILITIES.—The center shall have respon- sibilities as follows: ‘‘(1) To implement the comprehensive plan and strategy for the Department of Defense, required by section 1618 of this Act, for the prevention, diagnosis, mitigation, treatment, and rehabilitation of post- traumatic stress disorder and other mental health conditions, including research on gender- and ethnic group-specific health needs related to post-traumatic stress disorder and other mental health conditions. ‘‘(2) To provide for the development, testing, and dissemination within the Department of best prac- tices for the treatment of post-traumatic stress dis- order. ‘‘(3) To provide guidance for the mental health sys- tem of the Department in determining the mental health and neurological health personnel required to provide quality mental health care for members of the Armed Forces with post-traumatic stress disorder and other mental health conditions. ‘‘(4) To establish, implement, and oversee a com- prehensive program to train mental health and neu- rological health professionals of the Department in the treatment of post-traumatic stress disorder and other mental health conditions. ‘‘(5) To facilitate advancements in the study of the short-term and long-term psychological effects of post-traumatic stress disorder and other mental health conditions. ‘‘(6) To disseminate within the military medical treatment facilities of the Department best practices for training mental health professionals, including neurological health professionals, with respect to post-traumatic stress disorder and other mental health conditions. ‘‘(7) To conduct basic science and translational re- search on post-traumatic stress disorder for the pur- poses of understanding the etiology of post-traumatic stress disorder and developing preventive interven- tions and new treatments. ‘‘(8) To develop programs and outreach strategies for families of members of the Armed Forces with post-traumatic stress disorder and other mental health conditions in order to mitigate the negative impacts of post-traumatic stress disorder and other mental health conditions on such family members and to support the recovery of such members from post-traumatic stress disorder and other mental health conditions. ‘‘(9) To conduct research on the mental health needs of families of members of the Armed Forces with post-traumatic stress disorder and other mental health conditions and develop protocols to address any needs identified through such research. ‘‘(10) To develop and oversee a long-term plan to in- crease the number of mental health and neurological health professionals within the Department in order to facilitate the meeting by the Department of the needs of members of the Armed Forces with post- traumatic stress disorder and other mental health conditions until their transition to care and treat- ment from the Department of Veterans Affairs. ‘‘SEC. 1623. CENTER OF EXCELLENCE IN PREVEN- TION, DIAGNOSIS, MITIGATION, TREATMENT, AND REHABILITATION OF MILITARY EYE INJU- RIES. ‘‘(a) IN GENERAL.—The Secretary of Defense shall es- tablish within the Department of Defense a center of excellence in the prevention, diagnosis, mitigation, treatment, and rehabilitation of military eye injuries to carry out the responsibilities specified in subsection (c). ‘‘(b) PARTNERSHIPS.—The Secretary shall ensure that the center collaborates to the maximum extent prac- ticable with the Secretary of Veterans Affairs, institu- tions of higher education, and other appropriate public and private entities (including international entities) to carry out the responsibilities specified in subsection (c). ‘‘(c) RESPONSIBILITIES.— ‘‘(1) IN GENERAL.—The center shall— ‘‘(A) implement a comprehensive plan and strat- egy for the Department of Defense, as developed by the Secretary of Defense, for a registry of informa- tion for the tracking of the diagnosis, surgical intervention or other operative procedure, other treatment, and follow up for each case of signifi- cant eye injury incurred by a member of the Armed Forces while serving on active duty; ‘‘(B) ensure the electronic exchange with the Sec- retary of Veterans Affairs of information obtained through tracking under subparagraph (A); and ‘‘(C) enable the Secretary of Veterans Affairs to access the registry and add information pertaining to additional treatments or surgical procedures and eventual visual outcomes for veterans who were en- tered into the registry and subsequently received treatment through the Veterans Health Adminis- tration. ‘‘(2) DESIGNATION OF REGISTRY.—The registry under this subsection shall be known as the ‘Military Eye Injury Registry’ (hereinafter referred to as the ‘Reg- istry’). ‘‘(3) CONSULTATION IN DEVELOPMENT.—The center shall develop the Registry in consultation with the ophthalmological specialist personnel and optometric specialist personnel of the Department of Defense and the ophthalmological specialist personnel and opto- metric specialist personnel of the Department of Vet- erans Affairs. The mechanisms and procedures of the Registry shall reflect applicable expert research on military and other eye injuries. ‘‘(4) MECHANISMS.—The mechanisms of the Registry for tracking under paragraph (1)(A) shall ensure that each military medical treatment facility or other medical facility shall submit to the center for inclu- sion in the Registry information on the diagnosis, surgical intervention or other operative procedure, other treatment, and follow up for each case of eye injury described in that paragraph as follows (to the extent applicable): ‘‘(A) Not later than 30 days after surgery or other operative intervention, including a surgery or other operative intervention carried out as a result of a follow-up examination. ‘‘(B) Not later than 180 days after the significant eye injury is reported or recorded in the medical record. ‘‘(5) COORDINATION OF CARE AND BENEFITS.—(A) The center shall provide notice to the Blind Rehabilita- tion Service of the Department of Veterans Affairs and to the eye care services of the Veterans Health Administration on each member of the Armed Forces described in subparagraph (B) for purposes of ensur- ing the coordination of the provision of ongoing eye care and visual rehabilitation benefits and services by the Department of Veterans Affairs after the sepa- ration or release of such member from the Armed Forces. ‘‘(B) A member of the Armed Forces described in this subparagraph is a member of the Armed Forces as follows: ‘‘(i) A member with a significant eye injury in- curred while serving on active duty, including a member with visual dysfunction related to trau- matic brain injury. ‘‘(ii) A member with an eye injury incurred while serving on active duty who has a visual acuity of 20/ 200 or less in the injured eye. Page 989 TITLE 10—ARMED FORCES § 1071 ‘‘(iii) A member with an eye injury incurred while serving on active duty who has a loss of peripheral vision resulting in 20 degrees or less of visual field in the injured eye. ‘‘(d) UTILIZATION OF REGISTRY INFORMATION.—The Secretary of Defense and the Secretary of Veterans Af- fairs shall jointly ensure that information in the Reg- istry is available to appropriate ophthalmological and optometric personnel of the Department of Defense and the Department of Veterans Affairs for purposes of en- couraging and facilitating the conduct of research, and the development of best practices and clinical edu- cation, on eye injuries incurred by members of the Armed Forces. ‘‘(e) INCLUSION OF RECORDS OF OIF/OEF VETERANS.— The Secretary of Defense shall take appropriate ac- tions to include in the Registry such records of mem- bers of the Armed Forces who incurred an eye injury while serving on active duty on or after September 11, 2001, but before the establishment of the Registry, as the Secretary considers appropriate for purposes of the Registry. ‘‘(f) TRAUMATIC BRAIN INJURY POST TRAUMATIC VIS- UAL SYNDROME.—In carrying out the program at Walter Reed Army Medical Center, District of Columbia, on traumatic brain injury post traumatic visual syn- drome, the Secretary of Defense and the Department of Veterans Affairs shall jointly provide for the conduct of a cooperative program for members of the Armed Forces and veterans with traumatic brain injury by military medical treatment facilities of the Depart- ment of Defense and medical centers of the Department of Veterans Affairs selected for purposes of this sub- section for purposes of vision screening, diagnosis, re- habilitative management, and vision research, includ- ing research on prevention, on visual dysfunction re- lated to traumatic brain injury. [As amended Pub. L. 110–417, [div. A], title VII, § 722, Oct. 14, 2008, 122 Stat. 4508.] ‘‘SEC. 1631. MEDICAL CARE AND OTHER BENEFITS FOR MEMBERS AND FORMER MEMBERS OF THE ARMED FORCES WITH SEVERE INJURIES OR ILLNESSES. ‘‘(a) MEDICAL AND DENTAL CARE FOR FORMER MEM- BERS.— ‘‘(1) IN GENERAL.—Effective as of the date of the en- actment of this Act [Jan. 28, 2008] and subject to reg- ulations prescribed by the Secretary of Defense, the Secretary may authorize that any former member of the Armed Forces with a serious injury or illness may receive the same medical and dental care as a member of the Armed Forces on active duty for med- ical and dental care not reasonably available to such former member in the Department of Veterans Af- fairs. ‘‘(2) SUNSET.—The Secretary of Defense may not provide medical or dental care to a former member of the Armed Forces under this subsection after Decem- ber 31, 2012, if the Secretary has not provided medical or dental care to the former member under this sub- section before that date. ‘‘(b) REHABILITATION AND VOCATIONAL BENEFITS.—Ef- fective as of the date of the enactment of this Act [Jan. 28, 2008], a member of the Armed Forces with a severe injury or illness is entitled to such benefits (including rehabilitation and vocational benefits, but not includ- ing compensation) from the Secretary of Veterans Af- fairs to facilitate the recovery and rehabilitation of such member as the Secretary otherwise provides to veterans of the Armed Forces receiving medical care in medical facilities of the Department of Veterans Af- fairs facilities in order to facilitate the recovery and rehabilitation of such members. ‘‘(c) REHABILITATIVE EQUIPMENT FOR MEMBERS OF THE ARMED FORCES.— ‘‘(1) IN GENERAL.—Subject to the availability of ap- propriations for such purpose, the Secretary of De- fense may provide an active duty member of the Armed Forces with a severe injury or illness with re- habilitative equipment, including recreational sports equipment that provide an adaption or accommoda- tion for the member, regardless of whether such equipment is intentionally designed to be adaptive equipment. ‘‘(2) CONSULTATION.—In carrying out this sub- section, the Secretary of Defense shall consult with the Secretary of Veterans Affairs regarding similar programs carried out by the Secretary of Veterans Affairs. [As amended Pub. L. 112–56, title II, § 231, Nov. 21, 2011, 125 Stat. 719; Pub. L. 112–81, div. A, title VII, § 707, Dec. 31, 2011, 125 Stat. 1474; Pub. L. 112–239, div. A, title X, § 1076(a)(9), Jan. 2, 2013, 126 Stat. 1948; Pub. L. 113–291, div. A, title VII, § 724, Dec. 19, 2014, 128 Stat. 3418; Pub. L. 114–58, title II, § 204, Sept. 30, 2015, 129 Stat. 533; Pub. L. 114–228, title II, § 204, Sept. 29, 2016, 130 Stat. 938; Pub. L. 115–62, title II, § 203, Sept. 29, 2017, 131 Stat. 1162; Pub. L. 115–251, title I, § 126, Sept. 29, 2018, 132 Stat. 3169.] ‘‘SEC. 1635. FULLY INTEROPERABLE ELECTRONIC PERSONAL HEALTH INFORMATION FOR THE DEPARTMENT OF DEFENSE AND DEPARTMENT OF VETERANS AFFAIRS. ‘‘(a) IN GENERAL.—The Secretary of Defense and the Secretary of Veterans Affairs shall jointly— ‘‘(1) develop and implement electronic health record systems or capabilities that allow for full interoperability of personal health care information between the Department of Defense and the Depart- ment of Veterans Affairs; and ‘‘(2) accelerate the exchange of health care informa- tion between the Department of Defense and the De- partment of Veterans Affairs in order to support the delivery of health care by both Departments. ‘‘(b) DEPARTMENT OF DEFENSE-DEPARTMENT OF VET- ERANS AFFAIRS INTERAGENCY PROGRAM OFFICE.— ‘‘(1) IN GENERAL.—There is hereby established an interagency program office of the Department of De- fense and the Department of Veterans Affairs (in this section referred to as the ‘Office’) for the purposes de- scribed in paragraph (2). The Office shall carry out decision making authority delegated to the Office by the Secretary of Defense and the Secretary of Vet- erans Affairs with respect to the definition, coordina- tion, and management of functional, technical, and programmatic activities that are jointly used, car- ried out, and shared by the Departments. ‘‘(2) PURPOSES.—The purposes of the Office shall be as follows: ‘‘(A) To act as a single point of accountability for the Department of Defense and the Department of Veterans Affairs in the rapid development and im- plementation of electronic health record systems or capabilities that allow for full interoperability of personal health care information between the De- partment of Defense and the Department of Vet- erans Affairs. ‘‘(B) To accelerate the exchange of health care in- formation between the Department of Defense and the Department of Veterans Affairs in order to sup- port the delivery of health care by both Depart- ments. ‘‘(C) To develop and implement a comprehensive interoperability strategy, which shall include— ‘‘(i) the Electronic Health Record Moderniza- tion Program of the Department of Veterans Af- fairs; and ‘‘(ii) the Healthcare Management System Mod- ernization Program of the Department of Defense. ‘‘(D) To pursue the highest level of interoper- ability for the delivery of health care by the De- partment of Defense and the Department of Vet- erans Affairs. ‘‘(E) To accelerate the exchange of health care in- formation between the Departments, and advances in the health information technology marketplace, in order to support the delivery of health care by the Departments. ‘‘(F) To collect the operational and strategic re- quirements of the Departments relating to the Page 990 TITLE 10—ARMED FORCES § 1071 strategy under subsection (a) and communicate such requirements and activities to the Office of the National Coordinator for Health Information Technology of the Department of Health and Human Services for the purpose of implementing title IV of the 21st Century Cures Act (division A of Public Law 114–255) [see Tables for classification], and the amendments made by that title, and other objectives of the Office of the National Coordinator for Health Information Technology. ‘‘(G) To plan for and effectuate the broadest pos- sible implementation of standards, specifically with respect to the Fast Healthcare Interoperability Re- sources standard or successor standard, the evo- lution of such standards, and the obsolescence of such standards. ‘‘(H) To actively engage with national and inter- national health standards setting organizations, in- cluding by taking membership in such organiza- tions, to ensure that standards established by such organizations meet the needs of the Departments pursuant to the strategy under subsection (a), and oversee and approve adoption of and mapping to such standards by the Departments. ‘‘(I) To express the content and format of health data of the Departments using a common language to improve the exchange of data between the De- partments and with the private sector, and to en- sure that clinicians of the Departments have access to integrated, computable, comprehensive health records of patients. ‘‘(J) To inform the Chief Information Officer of the Department of Defense and the Chief Informa- tion Officer of the Department of Veterans Affairs of any activities of the Office affecting or relevant to cybersecurity. ‘‘(K) To establish an environment that will enable and encourage the adoption by the Departments of innovative technologies for health care delivery. ‘‘(L) To leverage data integration to advance health research and develop an evidence base for the health care programs of the Departments. ‘‘(M) To prioritize the use of open systems archi- tecture by the Departments. ‘‘(N) To ensure ownership and control by patients of personal health information and data in a man- ner consistent with applicable law. ‘‘(O) To prevent contractors of the Departments or other non-departmental entities from owning or having exclusive control over patient health data, for the purposes of protecting patient privacy and enhancing opportunities for innovation. ‘‘(P) To implement a single lifetime longitudinal personal health record between the Department of Defense and the Department of Veterans Affairs. ‘‘(Q) To attain interoperability capabilities— ‘‘(i) sufficient to enable the provision of seam- less health care by health care facilities and pro- viders of the Departments, as well as private sec- tor facilities and providers contracted by the De- partments; and ‘‘(ii) that are more adaptable and far reaching than those achievable through biodirectional in- formation exchange between electronic health records of the exchange of read-only data alone. ‘‘(R) To make maximum use of open-application program interfaces and the Fast Healthcare Inter- operability Resources standard (or successor stand- ard). ‘‘(c) LEADERSHIP.— ‘‘(1) DIRECTOR.—The Director of the Office shall be the head of the Office. ‘‘(2) DEPUTY DIRECTOR.—The Deputy Director of the Office shall be the deputy head of the Office and shall assist the Director in carrying out the duties of the Director. ‘‘(3) REPORTING.—The Director shall report directly to the Deputy Secretary of Defense and the Deputy Secretary of Veterans Affairs. ‘‘(4) APPOINTMENTS.— ‘‘(A) DIRECTOR.—The Director shall be appointed by the Secretary of Defense, with the concurrence of the Secretary of Veterans Affairs, for a fixed term of four years. For the subsequent term, the Secretary of Veterans Affairs, with the concurrence of the Secretary of Defense, shall appoint the Direc- tor for a fixed term of four years, and thereafter, the appointment of the Director for a fixed term of four years shall alternate between the Secretaries. ‘‘(B) DEPUTY DIRECTOR.—The Deputy Director shall be appointed by the Secretary of Veterans Af- fairs, with the concurrence of the Secretary of De- fense, for a fixed term of four years. For the subse- quent term, the Secretary of Defense, with the con- currence of the Secretary of Veterans Affairs, shall appoint the Deputy Director for a fixed term of four years, and thereafter, the appointment of the Dep- uty Director for a fixed term of four years shall al- ternate between the Secretaries. ‘‘(C) MINIMUM QUALIFICATIONS.—The Secretary of Defense and the Secretary of Veterans Affairs shall jointly develop qualification requirements for the Director and the Deputy Director. Such require- ments shall ensure that, at a minimum, the Direc- tor and Deputy Director, individually or together, meet the following qualifications: ‘‘(i) Significant experience at a senior manage- ment level fielding enterprise-wide technology in a health care setting, or business systems in the public or private sector. ‘‘(ii) Credentials for enterprise-wide program management. ‘‘(iii) Significant experience leading implemen- tation of complex organizational change by inte- grating the input of experts from various dis- ciplines, such as clinical, business, management, informatics, and technology. ‘‘(5) SUCCESSION.—The Secretary of Defense and the Secretary of Veterans Affairs shall jointly develop a leadership succession process for the Office. ‘‘(6) ADDITIONAL GUIDANCE.—The Department of Veterans Affairs-Department of Defense Joint Execu- tive Committee may provide guidance in the dis- charge of the functions of the Office under this sec- tion. ‘‘(7) INFORMATION TO CONGRESS.—Upon request by any of the appropriate committees of Congress, the Director and the Deputy Director shall testify before such committee, or provide a briefing or otherwise provide requested information to such committee, re- garding the discharge of the functions of the Office under this section. ‘‘(d) FUNCTION.—The function of the Office shall be to implement, by not later than September 30, 2009, elec- tronic health record systems or capabilities that allow for full interoperability of personal health care infor- mation between the Department of Defense and the De- partment of Veterans Affairs, which health records shall comply with applicable interoperability stand- ards, implementation specifications, and certification criteria (including for the reporting of quality meas- ures) of the Federal Government. ‘‘(e) IMPLEMENTATION MILESTONES.— ‘‘(1) EVALUATION.—With respect to the electronic health record systems of the Department of Defense and the Department of Veterans Affairs, the Office shall seek to enter into an agreement with an inde- pendent entity to conduct an evaluation by not later than October 1, 2021[,] of the following: ‘‘(A) Whether a clinician of the Department of De- fense, can access, and meaningfully interact with, a complete patient health record of a veteran, from a military medical treatment facility. ‘‘(B) Whether a clinician of the Department of Veterans Affairs can access, and meaningfully interact with, a complete patient health record of a member of the Armed Forces serving on active duty, from a medical center of the Department of Veterans Affairs. ‘‘(C) Whether clinicians of the Departments can access, and meaningfully interact with, the data Page 991 TITLE 10—ARMED FORCES § 1071 elements of the health record of a patient who is a veteran or is a member of the Armed Forces which are generated when the individual receives health care from a community care provider of the Depart- ment of Veterans Affairs or a TRICARE program provider of the Department of Defense. ‘‘(D) Whether a community care provider of the Department of the Veterans Affairs and a TRICARE program provider of the Department of Defense on a Health Information Exchange-supported elec- tronic health record can access patient health records of veterans and active-duty members of the Armed Forces from the system of the provider. ‘‘(E) An assessment of interoperability between the legacy electronic health record systems and the future electronic health record systems of the De- partment of Veterans Affairs and the Department of Defense. ‘‘(F) An assessment of the use of interoperable content between— ‘‘(i) the legacy electronic health record systems and the future electronic health record systems of the Department of Veterans Affairs and the De- partment of Defense; and ‘‘(ii) third-party applications. ‘‘(2) SYSTEM CONFIGURATION MANAGEMENT.—The Of- fice shall— ‘‘(A) maintain the common configuration baseline for the electronic health record systems of the De- partment of Defense and the Department of Vet- erans Affairs; and ‘‘(B) continually evaluate the state of configura- tion and the impacts on interoperability; and ‘‘(C) promote the enhancement of such electronic health records systems. ‘‘(3) CONSULTATION.— ‘‘(A) ANNUAL MEETING REQUIRED.—Not less than once per year, the Office shall convene a meeting of clinical staff from the Department of Defense, the Department of Veterans Affairs, the Coast Guard, community providers, and other leading clinical ex- perts, for the purpose of assessing the state of clin- ical use of the electronic health record systems and whether the systems are meeting clinical and pa- tient needs. ‘‘(B) RECOMMENDATIONS.—Clinical staff partici- pating in a meeting under subparagraph (A) shall make recommendations to the Office on the need for any improvements or concerns with the elec- tronic health record systems. ‘‘(4) CLINICAL AND PATIENT SATISFACTION SURVEY.— Beginning October 1, 2021, and on at least a biannual basis thereafter until 2025 at the earliest, the Office shall undertake a clinician and patient satisfaction survey regarding clinical use and patient experience with the electronic health record systems of the De- partment of Defense and the Department of Veterans Affairs. ‘‘(f) PILOT PROJECTS.— ‘‘(1) AUTHORITY.—In order to assist the Office in the discharge of its function under this section, the Sec- retary of Defense and the Secretary of Veterans Af- fairs may, acting jointly, carry out one or more pilot projects to assess the feasibility and advisability of various technological approaches to the achievement of the electronic health record systems or capabili- ties described in subsection (d). ‘‘(2) SHARING OF PROTECTED HEALTH INFORMATION.— For purposes of each pilot project carried out under this subsection, the Secretary of Defense and the Sec- retary of Veterans Affairs shall, for purposes of the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 [Pub. L. 104–191] (42 U.S.C. 1320d–2 note), en- sure the effective sharing of protected health infor- mation between the health care system of the De- partment of Defense and the health care system of the Department of Veterans Affairs as needed to pro- vide all health care services and other benefits al- lowed by law. ‘‘(g) STAFF AND OTHER RESOURCES.— ‘‘(1) IN GENERAL.—The Secretary of Defense and the Secretary of Veterans Affairs shall assign to the Of- fice such personnel and other resources of the Depart- ment of Defense and the Department of Veterans Af- fairs as are required for the discharge of its function under this section, including the assignment of clin- ical or technical personnel of the Department of De- fense or the Department of Veterans Affairs to the Office. ‘‘(2) ADDITIONAL SERVICES.—Subject to the approval of the Secretary of Defense and the Secretary of Vet- erans Affairs, the Director may utilize the services of private individuals and entities as consultants to the Office in the discharge of its function under this sec- tion. Amounts available to the Office shall be avail- able for payment for such services. ‘‘(3) COST SHARING.—The Secretary of Defense and the Secretary of Veterans shall enter into an agree- ment on cost sharing and providing resources for the operations and staffing of the Office. ‘‘(4) HIRING AUTHORITY.—The Secretary of Defense and the Secretary of Veterans Affairs shall delegate to the Director the authority under title 5, United States Code, regarding appointments in the competi- tive service to hire personnel of the Office. ‘‘(h) REPORTS.— ‘‘(1) ANNUAL REPORTS.—Not later than September 30, 2020, and each year thereafter through 2024, the Di- rector shall submit to the Secretary of Defense and the Secretary of Veterans Affairs, and to the appro- priate committees of Congress, a report on the activi- ties of the Office during the preceding calendar year. Each report shall include the following: ‘‘(A) A detailed description of the activities of the Office during the year covered by such report, in- cluding a detailed description of the amounts ex- pended and the purposes for which expended. ‘‘(B) With respect to the objectives of the strat- egy under paragraph (2)(C) of subsection (b), and the purposes of the Office under such subsection— ‘‘(i) a discussion, description, and assessment of the progress made by the Department of Defense and the Department of Veterans Affairs during the preceding calendar year; and ‘‘(ii) a discussion and description of the goals of the Department of Defense and the Department of Veterans Affairs for the following calendar year, including updates to strategies and plans. ‘‘(C) A detailed financial summary of the activi- ties of the Office, including the funds allocated to the Office by each Department, the expenditures made, and an assessment as to whether the current funding is sufficient to carry out the activities of the Office. ‘‘(D) A detailed description of the status of each of the implementation milestones, including the nature of the evaluation, methodology for testing, and findings with respect to each milestone under subsection (e). ‘‘(E) A detailed description of the state of the configuration baseline, including any activities which decremented or enhanced the state of con- figuration under subsection (e). ‘‘(F) With respect to the annual meeting required under subsection (e)(3)— ‘‘(i) a detailed description of activities, assess- ments, and recommendations relating to such meeting; and ‘‘(ii) the response of the Office to any such rec- ommendations. ‘‘(2) AVAILABILITY.—Each report under this sub- section shall be made publicly available. ‘‘(i) COMPTROLLER GENERAL ASSESSMENT OF IMPLE- MENTATION.—Not later than six months after the date of the enactment of this Act [Jan. 28, 2008] and every six months thereafter until the completion of the im- plementation of electronic health record systems or ca- pabilities described in subsection (d), the Comptroller General of the United States shall submit to the appro- Page 992 TITLE 10—ARMED FORCES § 1071 priate committees of Congress a report setting forth the assessment of the Comptroller General of the progress of the Department of Defense and the Depart- ment of Veterans Affairs in implementing electronic health record systems or capabilities described in sub- section (d). ‘‘(j) TECHNOLOGY-NEUTRAL GUIDELINES AND STAND- ARDS.—The Director, in consultation with industry and appropriate Federal agencies, shall develop, or shall adopt from industry, technology-neutral information technology infrastructure guidelines and standards for use by the Department of Defense and the Department of Veterans Affairs to enable those departments to ef- fectively select and utilize information technologies to meet the requirements of this section. ‘‘(k) DEFINITIONS.—In this section: ‘‘(1) The term ‘appropriate congressional commit- tees’ means— ‘‘(A) the congressional defense committees [Com- mittees on Armed Services and Appropriations of the Senate and the House of Representatives]; and ‘‘(B) the Committees on Veterans’ Affairs of the House of Representatives and the Senate. ‘‘(2) The term ‘configuration baseline’ means a fixed reference in the development cycle or an agreed-upon specification of a product at a point in time that serves as a documented basis for defining incremental change in all aspects of an information technology product. ‘‘(3) The term ‘Electronic Health Record Moderniza- tion Program’ has the meaning given that term in section 503 of the Veterans Benefits and Transition Act of 2018 (Public Law 115–407; 132 Stat. 5376) [38 U.S.C. note prec. 5701]. ‘‘(4) The term ‘interoperability’ means the ability of different information systems, devices, or applica- tions to connect, regardless of the technology plat- form or the location where care is provided— ‘‘(A) in a coordinated and secure manner, within and across organizational boundaries, and across the complete spectrum of care, including all appli- cable care settings; ‘‘(B) with relevant stakeholders, including the person whose information is being shared, to ac- cess, exchange, integrate, and use computable data regardless of the origin or destination of the data or the applications employed; ‘‘(C) with the capability to reliably exchange in- formation without error; ‘‘(D) with the ability to interpret and to make ef- fective use of such exchanged information; ‘‘(E) with the ability for information that can be used to advance patient care to move between health care entities; and ‘‘(F) without additional intervention by the end user. ‘‘(5) The term ‘meaningfully interact’ means the ability to view, consume, act upon, and edit informa- tion in a clinical setting to facilitate high-quality clinical decision making. ‘‘(6) The term ‘seamless health care’ means health care which is optimized through access by patients and clinicians to integrated, relevant, and complete information about the clinical experiences of the pa- tient, social and environmental determinants of health, and health trends over time, in order to en- able patients and clinicians to— ‘‘(A) move efficiently within and across organiza- tional boundaries; ‘‘(B) make high-quality decisions; and ‘‘(C) effectively carry out complete plans of care. ‘‘(7) The term ‘Secretary concerned’ means— ‘‘(A) the Secretary of Defense, with respect to matters concerning the Department of Defense; ‘‘(B) the Secretary of Veterans Affairs, with re- spect to matters concerning the Department of Vet- erans Affairs; and ‘‘(C) the Secretary of Homeland Security, with re- spect to matters concerning the Coast Guard when it is not operating as a service in the Department of the Navy. ‘‘(8) The term ‘TRICARE program’ has the meaning given that term in section 1072 of title 10, United States Code. [As amended Pub. L. 110–417, [div. A], title II, § 252, Oct. 14, 2008, 122 Stat. 4400; Pub. L. 113–175, title I, § 105, Sept. 26, 2014, 128 Stat. 1903; Pub. L. 114–58, title IV, § 411, Sept. 30, 2015, 129 Stat. 536; Pub. L. 114–228, title IV, § 414, Sept. 29, 2016, 130 Stat. 941; Pub. L. 116–92, div. A, title VII, § 715(a)–(g), Dec. 20, 2019, 133 Stat. 1446–1451.] ‘‘SEC. 1644. AUTHORIZATION OF PILOT PROGRAMS TO IMPROVE THE DISABILITY EVALUATION SYSTEM FOR MEMBERS OF THE ARMED FORCES. ‘‘(a) PILOT PROGRAMS.— ‘‘(1) PROGRAMS AUTHORIZED.—For the purposes set forth in subsection (c), the Secretary of Defense may establish and conduct pilot programs with respect to the system of the Department of Defense for the eval- uation of the disabilities of members of the Armed Forces who are being separated or retired from the Armed Forces for disability under chapter 61 of title 10, United States Code (in this section referred to as the ‘disability evaluation system’). ‘‘(2) TYPES OF PILOT PROGRAMS.—In carrying out this section, the Secretary of Defense may conduct one or more of the pilot programs described in para- graphs (1) through (3) of subsection (b) or such other pilot programs as the Secretary of Defense considers appropriate. ‘‘(3) CONSULTATION.—In establishing and conducting any pilot program under this section, the Secretary of Defense shall consult with the Secretary of Vet- erans Affairs. ‘‘(b) SCOPE OF PILOT PROGRAMS.— ‘‘(1) DISABILITY DETERMINATIONS BY DOD UTILIZING VA ASSIGNED DISABILITY RATING.—Under one of the pilot programs authorized by subsection (a), for pur- poses of making a determination of disability of a member of the Armed Forces under section 1201(b) of title 10, United States Code, for the retirement, sepa- ration, or placement of the member on the temporary disability retired list under chapter 61 of such title, upon a determination by the Secretary of the mili- tary department concerned that the member is unfit to perform the duties of the member’s office, grade, rank, or rating because of a physical disability as de- scribed in section 1201(a) of such title— ‘‘(A) the Secretary of Veterans Affairs may— ‘‘(i) conduct an evaluation of the member for physical disability; and ‘‘(ii) assign the member a rating of disability in accordance with the schedule for rating disabil- ities utilized by the Secretary of Veterans Affairs based on all medical conditions (whether individ- ually or collectively) that render the member unfit for duty; and ‘‘(B) the Secretary of the military department concerned may make the determination of dis- ability regarding the member utilizing the rating of disability assigned under subparagraph (A)(ii). ‘‘(2) DISABILITY DETERMINATIONS UTILIZING JOINT DOD/VA ASSIGNED DISABILITY RATING.—Under one of the pilot programs authorized by subsection (a), in making a determination of disability of a member of the Armed Forces under section 1201(b) of title 10, United States Code, for the retirement, separation, or placement of the member on the temporary disability retired list under chapter 61 of such title, the Sec- retary of the military department concerned may, upon determining that the member is unfit to per- form the duties of the member’s office, grade, rank, or rating because of a physical disability as described in section 1201(a) of such title— ‘‘(A) provide for the joint evaluation of the mem- ber for disability by the Secretary of the military department concerned and the Secretary of Vet- erans Affairs, including the assignment of a rating of disability for the member in accordance with the schedule for rating disabilities utilized by the Sec- Page 993 TITLE 10—ARMED FORCES § 1071 retary of Veterans Affairs based on all medical con- ditions (whether individually or collectively) that render the member unfit for duty; and ‘‘(B) make the determination of disability regard- ing the member utilizing the rating of disability as- signed under subparagraph (A). ‘‘(3) ELECTRONIC CLEARING HOUSE.—Under one of the pilot programs authorized by subsection (a), the Sec- retary of Defense may establish and operate a single Internet website for the disability evaluation system of the Department of Defense that enables partici- pating members of the Armed Forces to fully utilize such system through the Internet, with such Internet website to include the following: ‘‘(A) The availability of any forms required for the utilization of the disability evaluation system by members of the Armed Forces under the system. ‘‘(B) Secure mechanisms for the submission of such forms by members of the Armed Forces under the system, and for the tracking of the acceptance and review of any forms so submitted. ‘‘(C) Secure mechanisms for advising members of the Armed Forces under the system of any addi- tional information, forms, or other items that are required for the acceptance and review of any forms so submitted. ‘‘(D) The continuous availability of assistance to members of the Armed Forces under the system (in- cluding assistance through the caseworkers as- signed to such members of the Armed Forces) in submitting and tracking such forms, including as- sistance in obtaining information, forms, or other items described by subparagraph (C). ‘‘(E) Secure mechanisms to request and receive personnel files or other personnel records of mem- bers of the Armed Forces under the system that are required for submission under the disability evalua- tion system, including the capability to track re- quests for such files or records and to determine the status of such requests and of responses to such re- quests. ‘‘(4) OTHER PILOT PROGRAMS.—The pilot programs authorized by subsection (a) may also provide for the development, evaluation, and identification of such practices and procedures under the disability evalua- tion system as the Secretary considers appropriate for purposes set forth in subsection (c). ‘‘(c) PURPOSES.—A pilot program established under subsection (a) may have one or more of the following purposes: ‘‘(1) To provide for the development, evaluation, and identification of revised and improved practices and procedures under the disability evaluation sys- tem in order to— ‘‘(A) reduce the processing time under the dis- ability evaluation system of members of the Armed Forces who are likely to be retired or separated for disability, and who have not requested continu- ation on active duty, including, in particular, mem- bers who are severely wounded; ‘‘(B) identify and implement or seek the modifica- tion of statutory or administrative policies and re- quirements applicable to the disability evaluation system that— ‘‘(i) are unnecessary or contrary to applicable best practices of civilian employers and civilian healthcare systems; or ‘‘(ii) otherwise result in hardship, arbitrary, or inconsistent outcomes for members of the Armed Forces, or unwarranted inefficiencies and delays; ‘‘(C) eliminate material variations in policies, in- terpretations, and overall performance standards among the military departments under the dis- ability evaluation system; and ‘‘(D) determine whether it enhances the capa- bility of the Department of Veterans Affairs to re- ceive and determine claims from members of the Armed Forces for compensation, pension, hos- pitalization, or other veterans benefits. ‘‘(2) In conjunction with the findings and rec- ommendations of applicable Presidential and Depart- ment of Defense study groups, to provide for the eventual development of revised and improved prac- tices and procedures for the disability evaluation sys- tem in order to achieve the objectives set forth in paragraph (1). ‘‘(d) UTILIZATION OF RESULTS IN UPDATES OF COM- PREHENSIVE POLICY ON CARE, MANAGEMENT, AND TRANSI- TION OF RECOVERING SERVICE MEMBERS.—The Secretary of Defense and the Secretary of Veterans Affairs, act- ing jointly, may incorporate responses to any findings and recommendations arising under the pilot programs conducted under subsection (a) in updating the com- prehensive policy on the care and management of cov- ered service members under section 1611(a)(4). ‘‘(e) CONSTRUCTION WITH OTHER AUTHORITIES.— ‘‘(1) IN GENERAL.—Subject to paragraph (2), in car- rying out a pilot program under subsection (a)— ‘‘(A) the rules and regulations of the Department of Defense and the Department of Veterans Affairs relating to methods of determining fitness or unfitness for duty and disability ratings for mem- bers of the Armed Forces shall apply to the pilot program only to the extent provided in the report on the pilot program under subsection (g)(1); and ‘‘(B) the Secretary of Defense and the Secretary of Veterans Affairs may waive any provision of title 10, 37, or 38, United States Code, relating to meth- ods of determining fitness or unfitness for duty and disability ratings for members of the Armed Forces if the Secretaries determine in writing that the ap- plication of such provision would be inconsistent with the purpose of the pilot program. ‘‘(2) LIMITATION.—Nothing in paragraph (1) shall be construed to authorize the waiver of any provision of section 1216a of title 10, United States Code, as added by section 1642 of this Act. ‘‘(f) DURATION.—Each pilot program conducted under subsection (a) shall be completed not later than one year after the date of the commencement of such pilot program under that subsection. ‘‘(g) REPORTS.— ‘‘(1) INITIAL REPORT.—Not later than 90 days after the date of the enactment of this Act [Jan. 28, 2008], the Secretary of Defense shall submit to the appro- priate committees of Congress a report on each pilot program that has been commenced as of that date under subsection (a). The report shall include— ‘‘(A) a description of the scope and objectives of the pilot program; ‘‘(B) a description of the methodology to be used under the pilot program to ensure rapid identifica- tion under such pilot program of revised or im- proved practices under the disability evaluation system in order to achieve the objectives set forth in subsection (c)(1); and ‘‘(C) a statement of any provision described in subsection (e)(1)(B) that will not apply to the pilot program by reason of a waiver under that sub- section. ‘‘(2) INTERIM REPORT.—Not later than 180 days after the date of the submittal of the report required by paragraph (1) with respect to a pilot program, the Secretary shall submit to the appropriate commit- tees of Congress a report describing the current sta- tus of the pilot program. ‘‘(3) FINAL REPORT.—Not later than 90 days after the completion of all of the pilot programs conducted under subsection (a), the Secretary shall submit to the appropriate committees of Congress a report set- ting forth a final evaluation and assessment of the pilot programs. The report shall include such rec- ommendations for legislative or administrative ac- tion as the Secretary considers appropriate in light of such pilot programs. ‘‘SEC. 1648. STANDARDS FOR MILITARY MEDICAL TREATMENT FACILITIES, SPECIALTY MED- ICAL CARE FACILITIES, AND MILITARY QUAR- TERS HOUSING PATIENTS AND ANNUAL RE- PORT ON SUCH FACILITIES. ‘‘(a) ESTABLISHMENT OF STANDARDS.—The Secretary of Defense shall establish for the military facilities of Page 994 TITLE 10—ARMED FORCES § 1071 the Department of Defense and the military depart- ments referred to in subsection (b) standards with re- spect to the matters set forth in subsection (c). To the maximum extent practicable, the standards shall— ‘‘(1) be uniform and consistent for all such facili- ties; and ‘‘(2) be uniform and consistent throughout the De- partment of Defense and the military departments. ‘‘(b) COVERED MILITARY FACILITIES.—The military fa- cilities covered by this section are the following: ‘‘(1) Military medical treatment facilities. ‘‘(2) Specialty medical care facilities. ‘‘(3) Military quarters or leased housing for pa- tients. ‘‘(c) SCOPE OF STANDARDS.—The standards required by subsection (a) shall include the following: ‘‘(1) Generally accepted standards for the accredita- tion of medical facilities, or for facilities used to quarter individuals that may require medical super- vision, as applicable, in the United States. ‘‘(2) To the extent not inconsistent with the stand- ards described in paragraph (1), minimally acceptable conditions for the following: ‘‘(A) Appearance and maintenance of facilities generally, including the structure and roofs of fa- cilities. ‘‘(B) Size, appearance, and maintenance of rooms housing or utilized by patients, including furniture and amenities in such rooms. ‘‘(C) Operation and maintenance of primary and back-up facility utility systems and other systems required for patient care, including electrical sys- tems, plumbing systems, heating, ventilation, and air conditioning systems, communications systems, fire protection systems, energy management sys- tems, and other systems required for patient care. ‘‘(D) Compliance of facilities, rooms, and grounds, to the maximum extent practicable, with the Amer- icans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.). ‘‘(E) Such other matters relating to the appear- ance, size, operation, and maintenance of facilities and rooms as the Secretary considers appropriate. ‘‘(d) COMPLIANCE WITH STANDARDS.— ‘‘(1) DEADLINE.—In establishing standards under subsection (a), the Secretary shall specify a deadline for compliance with such standards by each facility referred to in subsection (b). The deadline shall be at the earliest date practicable after the date of the en- actment of this Act [Jan. 28, 2008], and shall, to the maximum extent practicable, be uniform across the facilities referred to in subsection (b). ‘‘(2) INVESTMENT.—In carrying out this section, the Secretary shall also establish guidelines for invest- ment to be utilized by the Department of Defense and the military departments in determining the alloca- tion of financial resources to facilities referred to in subsection (b) in order to meet the deadline specified under paragraph (1). ‘‘(e) REPORT ON DEVELOPMENT AND IMPLEMENTATION OF STANDARDS.— ‘‘(1) IN GENERAL.—Not later than March 1, 2008, the Secretary shall submit to the congressional defense committees [Committees on Armed Services and Ap- propriations of the Senate and the House of Rep- resentatives] a report on the actions taken to carry out subsection (a). ‘‘(2) ELEMENTS.—The report under paragraph (1) shall include the following: ‘‘(A) The standards established under subsection (a). ‘‘(B) An assessment of the appearance, condition, and maintenance of each facility referred to in sub- section (b), including— ‘‘(i) an assessment of the compliance of the fa- cility with the standards established under sub- section (a); and ‘‘(ii) a description of any deficiency or non- compliance in each facility with the standards. ‘‘(C) A description of the investment to be allo- cated to address each deficiency or noncompliance identified under subparagraph (B)(ii). [As amended Pub. L. 114–92, div. A, title X, § 1072(e), Nov. 25, 2015, 129 Stat. 995.] ‘‘SEC. 1651. HANDBOOK FOR MEMBERS OF THE ARMED FORCES ON COMPENSATION AND BENE- FITS AVAILABLE FOR SERIOUS INJURIES AND ILLNESSES. ‘‘(a) INFORMATION ON AVAILABLE COMPENSATION AND BENEFITS.—Not later than October 1, 2008, the Sec- retary of Defense shall develop and maintain, in hand- book and electronic form, a comprehensive description of the compensation and other benefits to which a member of the Armed Forces, and the family of such member, would be entitled upon the separation or re- tirement of the member from the Armed Forces as a re- sult of a serious injury or illness. The handbook shall set forth the range of such compensation and benefits based on grade, length of service, degree of disability at separation or retirement, and such other factors affect- ing such compensation and benefits as the Secretary considers appropriate. ‘‘(b) CONSULTATION.—The Secretary of Defense shall develop and maintain the comprehensive description required by subsection (a), including the handbook and electronic form of the description, in consultation with the Secretary of Veterans Affairs, the Secretary of Health and Human Services, and the Commissioner of Social Security. ‘‘(c) UPDATE.—The Secretary of Defense shall update the comprehensive description required by subsection (a), including the handbook and electronic form of the description, on a periodic basis, but not less often than annually. ‘‘(d) PROVISION TO MEMBERS.—The Secretary of the military department concerned shall provide the de- scriptive handbook under subsection (a) to each mem- ber of the Armed Forces described in that subsection as soon as practicable following the injury or illness qualifying the member for coverage under such sub- section. ‘‘(e) PROVISION TO REPRESENTATIVES.—If a member is incapacitated or otherwise unable to receive the de- scriptive handbook to be provided under subsection (a), the handbook shall be provided to the next of kin or a legal representative of the member, as determined in accordance with regulations prescribed by the Sec- retary of the military department concerned for pur- poses of this section. ‘‘SEC. 1662. ACCESS OF RECOVERING SERVICE MEMBERS TO ADEQUATE OUTPATIENT RESI- DENTIAL FACILITIES. ‘‘All quarters of the United States and housing facili- ties under the jurisdiction of the Armed Forces that are occupied by recovering service members shall be in- spected at least once every two years by the inspectors general of the regional medical commands. [As amend- ed Pub. L. 113–291, div. A, title V, § 591, Dec. 19, 2014, 128 Stat. 3394; Pub. L. 114–92, div. A, title X, § 1072(f), Nov. 25, 2015, 129 Stat. 995.] ‘‘SEC. 1671. PROHIBITION ON TRANSFER OF RE- SOURCES FROM MEDICAL CARE. ‘‘Neither the Secretary of Defense nor the Secretaries of the military departments may transfer funds or per- sonnel from medical care functions to administrative functions within the Department of Defense in order to comply with the new administrative requirements im- posed by this title [see Short Title of 2008 Amendment note above] or the amendments made by this title. ‘‘SEC. 1672. MEDICAL CARE FOR FAMILIES OF MEM- BERS OF THE ARMED FORCES RECOVERING FROM SERIOUS INJURIES OR ILLNESSES. ‘‘(a) MEDICAL CARE AT MILITARY MEDICAL FACILI- TIES.— ‘‘(1) MEDICAL CARE.—A family member of a recov- ering service member who is not otherwise eligible for medical care at a military medical treatment fa- cility may be eligible for such care at such facilities, on a space-available basis, if the family member is— Page 995 TITLE 10—ARMED FORCES § 1071 ‘‘(A) on invitational orders while caring for the service member; ‘‘(B) a non-medical attendee caring for the service member; or ‘‘(C) receiving per diem payments from the De- partment of Defense while caring for the service member. ‘‘(2) SPECIFICATION OF FAMILY MEMBERS.—The Sec- retary of Defense may prescribe in regulations the family members of recovering service members who shall be considered to be a family member of a serv- ice member for purposes of this subsection. ‘‘(3) SPECIFICATION OF CARE.—The Secretary of De- fense shall prescribe in regulations the medical care that may be available to family members under this subsection at military medical treatment facilities. ‘‘(4) RECOVERY OF COSTS.—The United States may recover the costs of the provision of medical care under this subsection as follows (as applicable): ‘‘(A) From third-party payers, in the same man- ner as the United States may collect costs of the charges of health care provided to covered bene- ficiaries from third-party payers under section 1095 of title 10, United States Code. ‘‘(B) As if such care was provided under the au- thority of section 1784 of title 38, United States Code. ‘‘(b) MEDICAL CARE AT DEPARTMENT OF VETERANS AF- FAIRS MEDICAL FACILITIES.— ‘‘(1) MEDICAL CARE.—When a recovering service member is receiving hospital care and medical serv- ices at a medical facility of the Department of Vet- erans Affairs, the Secretary of Veterans Affairs may provide medical care for eligible family members under this section when that care is readily available at that Department facility and on a space-available basis. ‘‘(2) REGULATIONS.—The Secretary of Veterans Af- fairs shall prescribe in regulations the medical care that may be available to family members under this subsection at medical facilities of the Department of Veterans Affairs. ‘‘SEC. 1676. MORATORIUM ON CONVERSION TO CON- TRACTOR PERFORMANCE OF DEPARTMENT OF DEFENSE FUNCTIONS AT MILITARY MEDICAL FACILITIES. ‘‘(a) MORATORIUM.—No study or competition may be begun or announced pursuant to section 2461 of title 10, United States Code, or otherwise pursuant to Office of Management and Budget circular A-76, relating to the possible conversion to performance by a contractor of any Department of Defense function carried out at a military medical facility until the Secretary of De- fense— ‘‘(1) submits the certification required by sub- section (b) to the Committee on Armed Services of the Senate and the Committee on Armed Services of the House of Representatives together with a descrip- tion of the steps taken by the Secretary in accord- ance with the certification; and ‘‘(2) submits the report required by subsection (c). ‘‘(b) CERTIFICATION.—The certification referred to in paragraph (a)(1) is a certification that the Secretary has taken appropriate steps to ensure that neither the quality of military medical care nor the availability of qualified personnel to carry out Department of Defense functions related to military medical care will be ad- versely affected by either— ‘‘(1) the process of considering a Department of De- fense function carried out at a military medical facil- ity for possible conversion to performance by a con- tractor; or ‘‘(2) the conversion of such a function to perform- ance by a contractor. ‘‘(c) REPORT REQUIRED.—Not later than 180 days after the date of the enactment of this Act [Jan. 28, 2008], the Secretary of Defense shall submit to the Committee on Armed Services of the Senate and the Committee on Armed Services of the House of Representatives a re- port on the public-private competitions being con- ducted for Department of Defense functions carried out at military medical facilities as of the date of the en- actment of this Act by each military department and defense agency. Such report shall include— ‘‘(1) for each such competition— ‘‘(A) the cost of conducting the public-private competition; ‘‘(B) the number of military personnel and civil- ian employees of the Department of Defense af- fected; ‘‘(C) the estimated savings identified and the sav- ings actually achieved; ‘‘(D) an evaluation whether the anticipated and budgeted savings can be achieved through a public- private competition; and ‘‘(E) the effect of converting the performance of the function to performance by a contractor on the quality of the performance of the function; and ‘‘(2) an assessment of whether any method of busi- ness reform or reengineering other than a public-pri- vate competition could, if implemented in the future, achieve any anticipated or budgeted savings.’’ DISEASE AND CHRONIC CARE MANAGEMENT Pub. L. 109–364, div. A, title VII, § 734, Oct. 17, 2006, 120 Stat. 2299, required the Secretary of Defense to develop a fully integrated program on disease and chronic care management for the military health care system with uniform policies and practices throughout the system and an implementation plan for the program and to re- port to Congress no later than Mar. 1, 2008. PREVENTION, MITIGATION, AND TREATMENT OF BLAST INJURIES Pub. L. 109–163, div. A, title II, § 256, Jan. 6, 2006, 119 Stat. 3181, as amended by Pub. L. 112–239, div. A, title X, § 1076(c)(2)(C), Jan. 2, 2013, 126 Stat. 1950, provided for medical research efforts and programs of the Depart- ment of Defense relating to the prevention, mitigation, and treatment of blast injuries, including the designa- tion of an executive agent to coordinate and manage such efforts and programs, conduct studies, and develop training protocols, and required an annual report to Congress through 2008. ACCESS TO HEALTH CARE SERVICES FOR BENEFICIARIES ELIGIBLE FOR TRICARE AND DEPARTMENT OF VET- ERANS AFFAIRS HEALTH CARE Pub. L. 107–314, div. A, title VII, § 708, Dec. 2, 2002, 116 Stat. 2585, provided that: ‘‘(a) REQUIREMENT TO ESTABLISH PROCESS.—(1) The Secretary of Defense shall prescribe in regulations a process for resolving issues relating to patient safety and continuity of care for covered beneficiaries who are concurrently entitled to health care under the TRICARE program and eligible for health care services provided by the Department of Veterans Affairs. The Secretary shall— ‘‘(A) ensure that the process provides for coordina- tion of, and access to, health care from the two sources in a manner that prevents diminution of ac- cess to health care from either source; and ‘‘(B) in consultation with the Secretary of Veterans Affairs, prescribe a clear definition of an ‘episode of care’ for use in the resolution of patient safety and continuity of care issues under such process. ‘‘(2) Not later than May 1, 2003, the Secretary shall submit to the Committees on Armed Services of the Senate and of the House of Representatives a report de- scribing the process prescribed under paragraph (1). ‘‘(3) While prescribing the process under paragraph (1) and upon completion of the report under paragraph (2), the Secretary shall provide to the Comptroller General information that would be relevant in carrying out the study required by subsection (b). ‘‘(b) COMPTROLLER GENERAL STUDY AND REPORT.—(1) The Comptroller General shall conduct a study of the health care issues of covered beneficiaries described in subsection (a). The study shall include the following: Page 996 TITLE 10—ARMED FORCES § 1071 ‘‘(A) An analysis of whether covered beneficiaries who seek services through the Department of Vet- erans Affairs are receiving needed health care serv- ices in a timely manner from the Department of Vet- erans Affairs, as compared to the timeliness of the care available to covered beneficiaries under TRICARE Prime (as set forth in access to care stand- ards under TRICARE program policy that are appli- cable to the care being sought). ‘‘(B) An evaluation of the quality of care for cov- ered beneficiaries who do not receive needed services from the Department of Veterans Affairs within a time period that is comparable to the time period provided for under such access to care standards and who then must seek alternative care under the TRICARE program. ‘‘(C) Recommendations to improve access to, and timeliness and quality of, care for covered bene- ficiaries described in subsection (a). ‘‘(D) An evaluation of the feasibility and advis- ability of making access to care standards applicable jointly under the TRICARE program and the Depart- ment of Veterans Affairs health care system. ‘‘(E) A review of the process prescribed by the Sec- retary of Defense under subsection (a) to determine whether the process ensures the adequacy and quality of the health care services provided to covered bene- ficiaries under the TRICARE program and through the Department of Veterans Affairs, together with timeliness of access to such services and patient safe- ty. ‘‘(2) Not later than 60 days after the congressional committees specified in subsection (a)(2) receive the re- port required under that subsection, the Comptroller General shall submit to those committees a report on the study conducted under this subsection. ‘‘(c) DEFINITIONS.—In this section: ‘‘(1) The term ‘covered beneficiary’ has the meaning provided by section 1072(5) of title 10, United States Code. ‘‘(2) The term ‘TRICARE program’ has the meaning provided by section 1072(7) of such title. ‘‘(3) The term ‘TRICARE Prime’ has the meaning provided by section 1097a(f) of such title.’’ PILOT PROGRAM PROVIDING FOR DEPARTMENT OF VET- ERANS AFFAIRS SUPPORT IN THE PERFORMANCE OF SEPARATION PHYSICAL EXAMINATIONS Pub. L. 107–107, div. A, title VII, § 734, Dec. 28, 2001, 115 Stat. 1170, authorized the Secretary of Defense and the Secretary of Veterans Affairs to jointly carry out a pilot program, to begin not later than July 1, 2002, and terminate on Dec. 31, 2005, under which the Secretary of Veterans Affairs, in one or more geographic areas, could perform the physical examinations required for separation of members from the uniformed services, and directed the Secretaries to jointly submit to Con- gress interim and final reports not later than Mar. 1, 2005. HEALTH CARE MANAGEMENT DEMONSTRATION PROGRAM Pub. L. 106–398, § 1 [[div. A], title VII, § 733], Oct. 30, 2000, 114 Stat. 1654, 1654A–191, as amended by Pub. L. 107–107, div. A, title VII, § 737, Dec. 28, 2001, 115 Stat. 1173, directed the Secretary of Defense to carry out a demonstration program on health care management, to begin not later than 180 days after Oct. 30, 2000, and ter- minate on Dec. 31, 2003, to explore opportunities for im- proving the planning, programming, budgeting sys- tems, and management of the Department of Defense health care system, and directed the Secretary to sub- mit a report on such program to committees of Con- gress not later than Mar. 15, 2004. PROCESSES FOR PATIENT SAFETY IN MILITARY AND VETERANS HEALTH CARE SYSTEMS Pub. L. 106–398, § 1 [[div. A], title VII, § 742], Oct. 30, 2000, 114 Stat. 1654, 1654A–192, provided that: ‘‘(a) ERROR TRACKING PROCESS.—The Secretary of De- fense shall implement a centralized process for report- ing, compilation, and analysis of errors in the provision of health care under the defense health program that endanger patients beyond the normal risks associated with the care and treatment of such patients. To the extent practicable, that process shall emulate the sys- tem established by the Secretary of Veterans Affairs for reporting, compilation, and analysis of errors in the provision of health care under the Department of Vet- erans Affairs health care system that endanger pa- tients beyond such risks. ‘‘(b) SHARING OF INFORMATION.—The Secretary of De- fense and the Secretary of Veterans Affairs— ‘‘(1) shall share information regarding the designs of systems or protocols established to reduce errors in the provision of health care described in subsection (a); and ‘‘(2) shall develop such protocols as the Secretaries consider necessary for the establishment and admin- istration of effective processes for the reporting, compilation, and analysis of such errors.’’ COOPERATION IN DEVELOPING PHARMACEUTICAL IDENTIFICATION TECHNOLOGY Pub. L. 106–398, § 1 [[div. A], title VII, § 743], Oct. 30, 2000, 114 Stat. 1654, 1654A–192, provided that: ‘‘The Sec- retary of Defense and the Secretary of Veterans Affairs shall cooperate in developing systems for the use of bar codes for the identification of pharmaceuticals in the health care programs of the Department of Defense and the Department of Veterans Affairs. In any case in which a common pharmaceutical is used in such pro- grams, the bar codes for those pharmaceuticals shall, to the maximum extent practicable, be identical.’’ PATIENT CARE REPORTING AND MANAGEMENT SYSTEM Pub. L. 106–398, § 1 [[div. A], title VII, § 754], Oct. 30, 2000, 114 Stat. 1654, 1654A–196, as amended by Pub. L. 109–163, div. A, title VII, § 741, Jan. 6, 2006, 119 Stat. 3360, provided that: ‘‘(a) ESTABLISHMENT.—The Secretary of Defense shall establish a patient care error reporting and manage- ment system. ‘‘(b) PURPOSES OF SYSTEM.—The purposes of the sys- tem are as follows: ‘‘(1) To study the occurrences of errors in the pa- tient care provided under chapter 55 of title 10, United States Code. ‘‘(2) To identify the systemic factors that are asso- ciated with such occurrences. ‘‘(3) To provide for action to be taken to correct the identified systemic factors. ‘‘(c) REQUIREMENTS FOR SYSTEM.—The patient care error reporting and management system shall include the following: ‘‘(1) A hospital-level patient safety center, within the quality assurance department of each health care organization of the Department of Defense, to collect, assess, and report on the nature and frequency of er- rors related to patient care. ‘‘(2) For each health care organization of the De- partment of Defense and for the entire Defense health program, patient safety standards that are necessary for the development of a full understanding of patient safety issues in each such organization and the entire program, including the nature and types of errors and the systemic causes of the errors. ‘‘(3) Establishment of a Department of Defense Pa- tient Safety Center, which shall have the following missions: ‘‘(A) To analyze information on patient care er- rors that is submitted to the Center by each mili- tary health care organization. ‘‘(B) To develop action plans for addressing pat- terns of patient care errors. ‘‘(C) To execute those action plans to mitigate and control errors in patient care with a goal of en- suring that the health care organizations of the De- partment of Defense provide highly reliable patient care with virtually no error. Page 997 TITLE 10—ARMED FORCES § 1071 ‘‘(D) To provide, through the Assistant Secretary of Defense for Health Affairs, to the Agency for Healthcare Research and Quality of the Depart- ment of Health and Human Services any reports that the Assistant Secretary determines appro- priate. ‘‘(E) To review and integrate processes for reduc- ing errors associated with patient care and for en- hancing patient safety. ‘‘(F) To contract with a qualified and objective external organization to manage the national pa- tient safety database of the Department of Defense. ‘‘(d) MEDICAL TEAM TRAINING PROGRAM.—The Sec- retary shall expand the health care team coordination program to integrate that program into all Department of Defense health care operations. In carrying out this subsection, the Secretary shall take the following ac- tions: ‘‘(1) Establish not less than two Centers of Excel- lence for the development, validation, proliferation, and sustainment of the health care team coordina- tion program, one of which shall support all fixed military health care organizations, the other of which shall support all combat casualty care organi- zations. ‘‘(2) Deploy the program to all fixed and combat casualty care organizations of each of the Armed Forces, at the rate of not less than 10 organizations in each fiscal year. ‘‘(3) Expand the scope of the health care team co- ordination program from a focus on emergency de- partment care to a coverage that includes care in all major medical specialties, at the rate of not less than one specialty in each fiscal year. ‘‘(4) Continue research and development invest- ments to improve communication, coordination, and team work in the provision of health care. ‘‘(e) CONSULTATION.—The Secretary shall consult with the other administering Secretaries (as defined in sec- tion 1072(3) of title 10, United States Code) in carrying out this section.’’ CONFIDENTIALITY OF COMMUNICATIONS WITH PROFES- SIONALS PROVIDING THERAPEUTIC OR RELATED SERV- ICES REGARDING SEXUAL OR DOMESTIC ABUSE Pub. L. 106–65, div. A, title V, § 585, Oct. 5, 1999, 113 Stat. 636, required the Secretary of Defense to prescribe in regulations policies and procedures to provide max- imum protections for the confidentiality of commu- nications between dependents of Armed Forces mem- bers and professionals providing therapeutic or related services regarding sexual or domestic abuse and to re- port to Congress no later than Jan. 21, 2000. HEALTH CARE QUALITY INFORMATION AND TECHNOLOGY ENHANCEMENT Pub. L. 106–65, div. A, title VII, § 723, Oct. 5, 1999, 113 Stat. 695, as amended by Pub. L. 106–398, § 1 [[div. A], title VII, § 753(a)], Oct. 30, 2000, 114 Stat. 1654, 1654A–195; Pub. L. 109–163, div. A, title VII, § 742, Jan. 6, 2006, 119 Stat. 3360; Pub. L. 109–364, div. A, title X, § 1046(e), Oct. 17, 2006, 120 Stat. 2394; Pub. L. 112–81, div. A, title X, § 1062(j)(1), Dec. 31, 2011, 125 Stat. 1585; Pub. L. 117–286, § 4(a)(47), Dec. 27, 2022, 136 Stat. 4310, provided that: ‘‘(a) PURPOSE.—The purpose of this section is to en- sure that the Department of Defense addresses issues of medical quality surveillance and implements solutions for those issues in a timely manner that is consistent with national policy and industry standards. ‘‘(b) DEPARTMENT OF DEFENSE PROGRAM FOR MEDICAL INFORMATICS AND DATA.—The Secretary of Defense shall establish a Department of Defense program, the purposes of which shall be the following: ‘‘(1) To develop parameters for assessing the quality of health care information. ‘‘(2) To develop the defense digital patient record. ‘‘(3) To develop a repository for data on quality of health care. ‘‘(4) To develop capability for conducting research on quality of health care. ‘‘(5) To conduct research on matters of quality of health care. ‘‘(6) To develop decision support tools for health care providers. ‘‘(7) To refine medical performance report cards. ‘‘(8) To conduct educational programs on medical informatics to meet identified needs. ‘‘(c) AUTOMATION AND CAPTURE OF CLINICAL DATA.—(1) Through the program established under subsection (b), the Secretary of Defense shall accelerate the efforts of the Department of Defense to automate, capture, and exchange controlled clinical data and present providers with clinical guidance using a personal information carrier, clinical lexicon, or digital patient record. ‘‘(2) The program shall serve as a primary resource for the Department of Defense for matters concerning the capture, processing, and dissemination of data on health care quality. ‘‘(d) MEDICAL INFORMATICS ADVISORY COMMITTEE.—(1) The Secretary of Defense shall establish a Medical Informatics Advisory Committee (hereinafter referred to as the ‘Committee’), the members of which shall be the following: ‘‘(A) The Assistant Secretary of Defense for Health Affairs. ‘‘(B) The Director of the TRICARE Management Activity of the Department of Defense. ‘‘(C) The Surgeon General of the Army. ‘‘(D) The Surgeon General of the Navy. ‘‘(E) The Surgeon General of the Air Force. ‘‘(F) Representatives of the Department of Veterans Affairs, designated by the Secretary of Veterans Af- fairs. ‘‘(G) Representatives of the Department of Health and Human Services, designated by the Secretary of Health and Human Services. ‘‘(H) Any additional members appointed by the Sec- retary of Defense to represent health care insurers and managed care organizations, academic health in- stitutions, health care providers (including represent- atives of physicians and representatives of hospitals), and accreditors of health care plans and organiza- tions. ‘‘(2) The primary mission of the Committee shall be to advise the Secretary on the development, deploy- ment, and maintenance of health care informatics sys- tems that allow for the collection, exchange, and proc- essing of health care quality information for the De- partment of Defense in coordination with other Federal departments and agencies and with the private sector. ‘‘(3) Specific areas of responsibility of the Committee shall include advising the Secretary on the following: ‘‘(A) The ability of the medical informatics systems at the Department of Defense and Department of Vet- erans Affairs to monitor, evaluate, and improve the quality of care provided to beneficiaries. ‘‘(B) The coordination of key components of med- ical informatics systems, including digital patient records, both within the Federal Government and be- tween the Federal Government and the private sec- tor. ‘‘(C) The development of operational capabilities for executive information systems and clinical deci- sion support systems within the Department of De- fense and Department of Veterans Affairs. ‘‘(D) Standardization of processes used to collect, evaluate, and disseminate health care quality infor- mation. ‘‘(E) Refinement of methodologies by which the quality of health care provided within the Depart- ment of Defense and Department of Veterans Affairs is evaluated. ‘‘(F) Protecting the confidentiality of personal health information. ‘‘(4) The Assistant Secretary of Defense for Health Affairs shall consult with the Committee on the issues described in paragraph (3). ‘‘(5) Members of the Committee shall not be paid by reason of their service on the Committee. ‘‘(6) Chapter 10 of title 5, United States Code, shall not apply to the Committee.’’ Page 998 TITLE 10—ARMED FORCES § 1071 [Section 1062(j)(1)(A) of Pub. L. 112–81, which directed the redesignation of pars. (6) and (7) as (5) and (6) of sec- tion 723(d) of Pub. L. 106–65, set out above, could not be executed due to the prior identical amendment by sec- tion 1046(e) of Pub. L. 109–364.] JOINT DEPARTMENT OF DEFENSE AND DEPARTMENT OF VETERANS AFFAIRS REPORTS RELATING TO INTER- DEPARTMENTAL COOPERATION IN DELIVERY OF MED- ICAL CARE Pub. L. 105–261, div. A, title VII, § 745, Oct. 17, 1998, 112 Stat. 2075, as amended by Pub. L. 106–65, div. A, title X, § 1067(3), Oct. 5, 1999, 113 Stat. 774; Pub. L. 108–136, div. A, title X, § 1031(g)(1), Nov. 24, 2003, 117 Stat. 1604, (1) di- rected the Secretary of Defense and the Secretary of Veterans Affairs to jointly conduct a survey of their re- spective medical care beneficiary populations to iden- tify the expectations of, requirements for, and behavior patterns of the beneficiaries with respect to medical care, and to submit a report on the results of the sur- vey to committees of Congress not later than Jan. 1, 2000; (2) directed the same Secretaries to jointly con- duct a review to identify impediments to cooperation between the Department of Defense and the Depart- ment of Veterans Affairs regarding the delivery of med- ical care and to submit a report on the results of the review to committees of Congress not later than Mar. 1, 1999; (3) directed the Secretary of Defense to review the TRICARE program to identify opportunities for in- creased participation by the Department of Veterans Affairs in that program; (4) directed the Department of Defense-Department of Veterans Affairs Federal Phar- macy Executive Steering Committee to examine exist- ing pharmaceutical benefits and programs for bene- ficiaries and review existing methods for contracting for and distributing medical supplies and services and to submit a report on the results of the examination to committees of Congress not later than 60 days after its completion; and (5) directed the Secretary of Defense and the Secretary of Veterans Affairs to jointly submit to committees of Congress a report, not later than Mar. 1, 1999, on the status of the efforts of the Department of Defense and the Department of Veterans Affairs to standardize physical examinations administered by the two departments for the purpose of determining or rat- ing disabilities. EXTERNAL PEER REVIEW FOR DEFENSE HEALTH PRO- GRAM EXTRAMURAL MEDICAL RESEARCH INVOLVING HUMAN SUBJECTS Pub. L. 104–201, div. A, title VII, § 742, Sept. 23, 1996, 110 Stat. 2600, provided that: ‘‘(a) ESTABLISHMENT OF EXTERNAL PEER REVIEW PROC- ESS.—The Secretary of Defense shall establish a peer review process that will use persons who are not offi- cers or employees of the Government to review the re- search protocols of medical research projects. ‘‘(b) PEER REVIEW REQUIREMENTS.—Funds of the De- partment of Defense may not be obligated or expended for any medical research project unless the research protocol for the project has been approved by the exter- nal peer review process established under subsection (a). ‘‘(c) MEDICAL RESEARCH PROJECT DEFINED.—For pur- poses of this section, the term ‘medical research project’ means a research project that— ‘‘(1) involves the participation of human subjects; ‘‘(2) is conducted solely by a non-Federal entity; and ‘‘(3) is funded through the Defense Health Program account. ‘‘(d) EFFECTIVE DATE.—The peer review requirements of subsection (b) shall take effect on October 1, 1996, and, except as provided in subsection (e), shall apply to all medical research projects proposed funded on or after that date, including medical research projects funded pursuant to any requirement of law enacted be- fore, on, or after that date. ‘‘(e) EXCEPTIONS.—Only the following medical re- search projects shall be exempt from the peer review requirements of subsection (b): ‘‘(1) A medical research project that the Secretary determines has been substantially completed by Oc- tober 1, 1996. ‘‘(2) A medical research project funded pursuant to any provision of law enacted on or after that date if the provision of law specifically refers to this section and specifically states that the peer review require- ments do not apply.’’ ANNUAL BENEFICIARY SURVEY Pub. L. 102–484, div. A, title VII, § 724, Oct. 23, 1992, 106 Stat. 2440, as amended by Pub. L. 103–337, div. A, title VII, § 717, Oct. 5, 1994, 108 Stat. 2804, provided that: ‘‘(a) SURVEY REQUIRED.—The administering Secre- taries shall conduct annually a formal survey of per- sons receiving health care under chapter 55 of title 10, United States Code, in order to determine the fol- lowing: ‘‘(1) The availability of health care services to such persons through the health care system provided for under that chapter, the types of services received, and the facilities in which the services were provided. ‘‘(2) The familiarity of such persons with the serv- ices available under that system and with the facili- ties in which such services are provided. ‘‘(3) The health of such persons. ‘‘(4) The level of satisfaction of such persons with that system and the quality of the health care pro- vided through that system. ‘‘(5) Such other matters as the administering Secre- taries determine appropriate. ‘‘(b) EXEMPTION.—An annual survey under subsection (a) shall be treated as not a collection of information for the purposes for which such term is defined in sec- tion 3502(4) of title 44, United States Code. ‘‘(c) DEFINITION.—For purposes of this section, the term ‘administering Secretaries’ has the meaning given such term in section 1072(3) of title 10, United States Code.’’ COMPREHENSIVE STUDY OF MILITARY MEDICAL CARE SYSTEM Pub. L. 102–190, div. A, title VII, § 733, Dec. 5, 1991, 105 Stat. 1408, as amended by Pub. L. 102–484, div. A, title VII, § 723, Oct. 23, 1992, 106 Stat. 2440, directed Secretary of Defense to conduct a comprehensive study of the military medical care system, not later than Dec. 15, 1992, to submit to congressional defense committees a detailed accounting on progress of the study, including preliminary results of the study, and not later than Dec. 15, 1993, submit to congressional defense commit- tees a final report on the study. IDENTIFICATION AND TREATMENT OF DRUG AND ALCOHOL DEPENDENT PERSONS IN THE ARMED FORCES Pub. L. 92–129, title V, § 501, Sept. 28, 1971, 85 Stat. 361, which directed Secretary of Defense to devise ways to identify, treat, and rehabilitate drug and alcohol de- pendent members of the armed forces, to identify, refuse admission to, and refer to civilian treatment fa- cilities such persons seeking entrance to the armed forces, and to report to Congress on and suggest addi- tional legislation concerning these matters, was re- pealed and restated as sections 978 and 1090 of this title by Pub. L. 97–295, §§ 1(14)(A), (15)(A), 6(b), Oct. 12, 1982, 96 Stat. 1289, 1290, 1314. DEFINITIONS Pub. L. 114–328, div. A, title VII, § 728(c), Dec. 23, 2016, 130 Stat. 2234, provided that: ‘‘In this section [amending section 1073b of this title and enacting provisions set out as a note under this section]: ‘‘(1) The term ‘Core Quality Measures Collabo- rative’ means the collaboration between the Centers for Medicare & Medicaid Services, major health in- surance companies, national physician organizations, and other entities to reach consensus on core per- formance measures reported by health care providers. ‘‘(2) The term ‘TRICARE program’ has the meaning given that term in section 1072 of title 10, United States Code.’’ Page 999 TITLE 10—ARMED FORCES § 1071 Executive Documents EX. ORD. NO. 13625. IMPROVING ACCESS TO MENTAL HEALTH SERVICES FOR VETERANS, SERVICE MEMBERS, AND MILITARY FAMILIES Ex. Ord. No. 13625, Aug. 31, 2012, 77 F.R. 54783, pro- vided: By the authority vested in me as President by the Constitution and the laws of the United States of America, I hereby order as follows: SECTION 1. Policy. Since September 11, 2001, more than two million service members have deployed to Iraq or Afghanistan. Long deployments and intense combat conditions require optimal support for the emotional and mental health needs of our service members and their families. The need for mental health services will only increase in the coming years as the Nation deals with the effects of more than a decade of conflict. Reit- erating and expanding upon the commitment outlined in my Administration’s 2011 report, entitled ‘‘Strength- ening Our Military Families,’’ we have an obligation to evaluate our progress and continue to build an inte- grated network of support capable of providing effec- tive mental health services for veterans, service mem- bers, and their families. Our public health approach must encompass the practices of disease prevention and the promotion of good health for all military popu- lations throughout their lifespans, both within the health care systems of the Departments of Defense and Veterans Affairs and in local communities. Our efforts also must focus on both outreach to veterans and their families and the provision of high quality mental health treatment to those in need. Coordination be- tween the Departments of Veterans Affairs and Defense during service members’ transition to civilian life is es- sential to achieving these goals. Ensuring that all veterans, service members (Active, Guard, and Reserve alike), and their families receive the support they deserve is a top priority for my Ad- ministration. As part of our ongoing efforts to improve all facets of military mental health, this order directs the Secretaries of Defense, Health and Human Services, Education, Veterans Affairs, and Homeland Security to expand suicide prevention strategies and take steps to meet the current and future demand for mental health and substance abuse treatment services for veterans, service members, and their families. SEC. 2. Suicide Prevention. (a) By December 31, 2012, the Department of Veterans Affairs, in continued col- laboration with the Department of Health and Human Services, shall expand the capacity of the Veterans Cri- sis Line by 50 percent to ensure that veterans have timely access, including by telephone, text, or online chat, to qualified, caring responders who can help ad- dress immediate crises and direct veterans to appro- priate care. Further, the Department of Veterans Af- fairs shall ensure that any veteran identifying him or herself as being in crisis connects with a mental health professional or trained mental health worker within 24 hours. The Department of Veterans Affairs also shall expand the number of mental health professionals who are available to see veterans beyond traditional busi- ness hours. (b) The Departments of Veterans Affairs and Defense shall jointly develop and implement a national suicide prevention campaign focused on connecting veterans and service members to mental health services. This 12- month campaign, which shall begin on September 1, 2012, will focus on the positive benefits of seeking care and encourage veterans and service members to proactively reach out to support services. (c) To provide the best mental health and substance abuse prevention, education, and outreach support to our military and their family members, the Depart- ment of Defense shall review all of its existing mental health and substance abuse prevention, education, and outreach programs across the military services and the Defense Health Program to identify the key program areas that produce the greatest impact on quality and outcomes, and rank programs within each of these pro- gram areas using metrics that assess their effective- ness. By the end of Fiscal Year 2014, existing program resources shall be realigned to ensure that highly ranked programs are implemented across all of the military services and less effective programs are re- placed. SEC. 3. Enhanced Partnerships Between the Department of Veterans Affairs and Community Providers. (a) Within 180 days of the date of this order, in those service areas where the Department of Veterans Affairs has faced challenges in hiring and placing mental health service providers and continues to have unfilled vacancies or long wait times, the Departments of Veterans Affairs and Health and Human Services shall establish pilot projects whereby the Department of Veterans Affairs contracts or develops formal arrangements with com- munity-based providers, such as community mental health clinics, community health centers, substance abuse treatment facilities, and rural health clinics, to test the effectiveness of community partnerships in helping to meet the mental health needs of veterans in a timely way. Pilot sites shall ensure that consumers of community-based services continue to be integrated into the health care systems of the Department of Vet- erans Affairs. No fewer than 15 pilot projects shall be established. (b) The Department of Veterans Affairs shall develop guidance for its medical centers and service networks that supports the use of community mental health services, including telehealth services and substance abuse services, where appropriate, to meet demand and facilitate access to care. This guidance shall include recommendations that medical centers and service net- works use community-based providers to help meet veterans’ mental health needs where objective criteria, which the Department of Veterans Affairs shall define in the form of specific metrics, demonstrate such needs. Such objective criteria should include estimates of wait-times for needed care that exceed established targets. (c) The Departments of Health and Human Services and Veterans Affairs shall develop a plan for a rural mental health recruitment initiative to promote oppor- tunities for the Department of Veterans Affairs and rural communities to share mental health providers when demand is insufficient for either the Department of Veterans Affairs or the communities to independ- ently support a full-time provider. SEC. 4. Expanded Department of Veterans Affairs Mental Health Services Staffing. The Secretary of Veterans Af- fairs shall, by December 31, 2013, hire and train 800 peer-to-peer counselors to empower veterans to support other veterans and help meet mental health care needs. In addition, the Secretary shall continue to use all ap- propriate tools, including collaborative arrangements with community-based providers, pay-setting authori- ties, loan repayment and scholarships, and partnerships with health care workforce training programs to ac- complish the Department of Veterans Affairs’ goal of recruiting, hiring, and placing 1,600 mental health pro- fessionals by June 30, 2013. The Department of Veterans Affairs also shall evaluate the reporting requirements associated with providing mental health services and reduce paperwork requirements where appropriate. In addition, the Department of Veterans Affairs shall up- date its management performance evaluation system to link performance to meeting mental health service demand. SEC. 5. Improved Research and Development. (a) The lack of full understanding of the underlying mecha- nisms of Post-Traumatic Stress Disorder (PTSD), other mental health conditions, and Traumatic Brain Injury (TBI) has hampered progress in prevention, diagnosis, and treatment. In order to improve the coordination of agency research into these conditions and reduce the number of affected men and women through better pre- vention, diagnosis, and treatment, the Departments of Defense, Veterans Affairs, Health and Human Services, and Education, in coordination with the Office of Science and Technology Policy, shall establish a Na- Page 1000 TITLE 10—ARMED FORCES § 1072 tional Research Action Plan within 8 months of the date of this order. (b) The National Research Action Plan shall include strategies to establish surrogate and clinically action- able biomarkers for early diagnosis and treatment ef- fectiveness; develop improved diagnostic criteria for TBI; enhance our understanding of the mechanisms re- sponsible for PTSD, related injuries, and neurological disorders following TBI; foster development of new treatments for these conditions based on a better un- derstanding of the underlying mechanisms; improve data sharing between agencies and academic and indus- try researchers to accelerate progress and reduce re- dundant efforts without compromising privacy; and make better use of electronic health records to gain in- sight into the risk and mitigation of PTSD, TBI, and related injuries. In addition, the National Research Ac- tion Plan shall include strategies to support collabo- rative research to address suicide prevention. (c) The Departments of Defense and Health and Human Services shall engage in a comprehensive longi- tudinal mental health study with an emphasis on PTSD, TBI, and related injuries to develop better pre- vention, diagnosis, and treatment options. Agencies shall continue ongoing collaborative research efforts, with an aim to enroll at least 100,000 service members by December 31, 2012, and include a plan for long-term follow-up with enrollees through a coordinated effort with the Department of Veterans Affairs. SEC. 6. Military and Veterans Mental Health Interagency Task Force. There is established an Interagency Task Force on Military and Veterans Mental Health (Task Force), to be co-chaired by the Secretaries of Defense, Veterans Affairs, and Health and Human Services, or their designated representatives. (a) Membership. In addition to the Co-Chairs, the Task Force shall consist of representatives from: (i) the Department of Education; (ii) the Office of Management and Budget; (iii) the Domestic Policy Council; (iv) the National Security Staff; (v) the Office of Science and Technology Policy; (vi) the Office of National Drug Control Policy; and (vii) such other executive departments, agencies, or offices as the Co-Chairs may designate. A member agency of the Task Force shall designate a full-time officer or employee of the Federal Govern- ment to perform the Task Force functions. (b) Mission. Member agencies shall review relevant statutes, policies, and agency training and guidance to identify reforms and take actions that facilitate imple- mentation of the strategies outlined in this order. Member agencies shall work collaboratively on these strategies and also create an inventory of mental health and substance abuse programs and activities to inform this work. (c) Functions. (i) Not later than 180 days after the date of this order, the Task Force shall submit recommendations to the President on strategies to improve mental health and substance abuse treatment services for veterans, serv- ice members, and their families. Every year thereafter, the Task Force shall provide to the President a review of agency actions to enhance mental health and sub- stance abuse treatment services for veterans, service members, and their families consistent with this order, as well as provide additional recommendations for ac- tion as appropriate. The Task Force shall define spe- cific goals and metrics that will aid in measuring progress in improving mental health strategies. The Task Force will include cost analysis in the develop- ment of all recommendations, and will ensure any new requirements are supported within existing resources. (ii) In addition to coordinating and reviewing agency efforts to enhance veteran and military mental health services pursuant to this order, the Task Force shall evaluate: (1) agency efforts to improve care quality and en- sure that the Departments of Defense and Veterans Affairs and community-based mental health pro- viders are trained in the most current evidence-based methodologies for treating PTSD, TBI, depression, related mental health conditions, and substance abuse; (2) agency efforts to improve awareness and reduce stigma for those needing to seek care; and (3) agency research efforts to improve the preven- tion, diagnosis, and treatment of TBI, PTSD, and re- lated injuries, and explore the need for an external research portfolio review. (iii) In performing its functions, the Task Force shall consult with relevant nongovernmental experts and or- ganizations as necessary. SEC. 7. General Provisions. (a) This order shall be im- plemented consistent with applicable law and subject to the availability of appropriations. (b) Nothing in this order shall be construed to impair or otherwise affect: (i) the authority granted by law to an executive de- partment or agency, or the head thereof; or (ii) the functions of the Director of the Office of Man- agement and Budget relating to budgetary, administra- tive, or legislative proposals. (c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforce- able at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person. BARACK OBAMA. [Reference to the National Security Staff deemed to be a reference to the National Security Council Staff, see Ex. Ord. No. 13657, set out as a note under section 3021 of Title 50, War and National Defense.] § 1072. Definitions In this chapter: (1) The term ‘‘uniformed services’’ means the armed forces and the Commissioned Corps of the National Oceanic and Atmospheric Ad- ministration and of the Public Health Service. (2) The term ‘‘dependent’’, with respect to a member or former member of a uniformed service, means— (A) the spouse; (B) the unremarried widow; (C) the unremarried widower; (D) a child who— (i) has not attained the age of 21; (ii) has not attained the age of 23, is en- rolled in a full-time course of study at an institution of higher learning approved by the administering Secretary and is, or was at the time of the member’s or former member’s death, in fact dependent on the member or former member for over one- half of the child’s support; or (iii) is incapable of self-support because of a mental or physical incapacity that oc- curs while a dependent of a member or former member under clause (i) or (ii) and is, or was at the time of the member’s or former member’s death, in fact dependent on the member or former member for over one-half of the child’s support; (E) a parent or parent-in-law who is, or was at the time of the member’s or former member’s death, in fact dependent on him for over one-half of his support and residing in his household; (F) the unremarried former spouse of a member or former member who (i) on the date of the final decree of divorce, dissolu- tion, or annulment, had been married to the member or former member for a period of at