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 certain former members of those services, and for their dependents.
Open Table| 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 inserted to reflect the fact that many of the persons entitled to retired pay are former members only. The words "and dental" are inserted to reflect the fact that members and, in certain limited situations, dependents are entitled to dental care under sections 1071–1085 of this title.
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81, which stated the purpose of former sections 1071 to 1086 of this title, and provided for their construction, was repealed by Pub. L. 85–861, §36B(5), Sept. 2, 1958, 72 Stat. 1570, as superseded by the Federal Voting Assistance Act of 1955 which was classified to subchapter I–D (§1973cc et seq.)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.
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 effective January 1, 1967, except that those amendments relating to outpatient care in civilian facilities for spouses and children of members of the uniformed services 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 sections 1074l, 1216a, and 1554a of this title, amending sections 1074, 1074f, 1074i, 1145, 1201, 1203, 1212, and 1599c of this title and section 6333 of Title 5, Government Organization 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'."
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)
"(b)
"(1) The date of the exposure.
"(2) The duration of the exposure, and, if known, the measured blast pressure experienced by the individual during such exposure.
"(3) Whether the exposure occurred during combat or training.
"(c)
"(d)
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 military 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 Secretary 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)
"(1)
"(2)
"(b)
"(c)
"(1) A discussion of the benefits and needs of both medical simulation technology and live tissue training.
"(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 technologies.
"(5) Any other matters the Secretary determines appropriate."
Inclusion of Gambling Disorder in Health Assessments of Members of the Armed Forces and Related Research Efforts
Pub. L. 115–232, div. A, title VII, §733, Aug. 13, 2018, 132 Stat. 1818, provided that:
"(a)
"(b)
"(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)
Joint Trauma System
Pub. L. 114–328, div. A, title VII, §707, Dec. 23, 2016, 130 Stat. 2208, provided that:
"(a)
"(1)
"(2)
"(b)
"(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)
"(d)
"(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 assessment 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 comprehensive 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)
"(1)
"(2)
"(b)
"(c)
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, provided that:
"(a)
"(b)
"(1) To enter into and coordinate the partnerships under subsection (c).
"(2) To establish the goals of such partnerships necessary for trauma teams led by traumatologists to maintain professional competency in trauma care.
"(3) To establish metrics for measuring the performance 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 Trauma 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, including the use of standardized trauma training platforms.
"(7) To develop a comprehensive trauma care registry to compile relevant data from point of injury through rehabilitation of members of the Armed Forces.
"(8) To develop quality of care outcome measures for combat casualty care.
"(9) To direct the conduct of research on the leading causes of morbidity and mortality of members of the Armed Forces in combat.
"(c)
"(1)
"(2)
"(3)
"(4)
"(d)
"(1)
"(A) Emergency medical services and prehospital care.
"(B) Trauma surgery.
"(C) Critical care.
"(D) Anesthesiology.
"(E) Emergency medicine.
"(F) Other wartime medical specialties the Secretary determines appropriate for purposes of the plan.
"(2)
"(A) An accession plan for the number of qualified medical personnel to maintain wartime medical specialties on an annual basis in order to maintain the required number of trauma teams as determined by the Secretary.
"(B) The number of positions required in each such medical specialty.
"(C) Crucial organizational and operational assignments for personnel in each such medical specialty.
"(D) Career pathways for personnel in each such medical specialty.
"(3)
"(e)
"(f)
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)
"(1)
"(2)
"(b)
"(c)
"(1)
"(2)
"(A)
"(B)
"(i) The ability of a covered beneficiary, during the telephone call to schedule an appointment, to also schedule wellness visits or follow-up appointments 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 indicate the process through which the covered beneficiary prefers to be reminded of future appointments, which may include reminder telephone calls, emails, or cellular text messages to the covered beneficiary at specified intervals prior to appointments.
"(3)
"(A)
"(B)
"(i) An ability to send automated email and text message reminders, including repeat reminders, to patients regarding upcoming appointments.
"(ii) An ability to store appointment records to ensure rapid access by medical personnel to appointment data.
"(d)
"(1)
"(2)
"(A) civilian benchmarks for measuring the productivity of health care providers;
"(B) the optimal number of medical appointments for each health care provider that would be required, as determined by the Secretary, to maintain access of covered beneficiaries to health care from the Department; and
"(C) the readiness requirements of the Armed Forces.
"(e)
"(1)
"(2)
"(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 system.
"(f)
"(g)
"(1)
"(2)
"(A) An identification of the top five reasons for a covered beneficiary missing an appointment.
"(B) A comparison of the number of missed appointments 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)
[For termination, effective Dec. 30, 2021, of reporting requirements in section 709(g) of Pub. L. 114–328, set out 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)
"(1) the evaluation and treatment of the individual is necessary to attain the relevant mix and volume of medical casework required to maintain medical readiness 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)
"(1)
"(2)
"(A) severely wounded or injured by acts of terror that occur in the United States; or
"(B) residents of the United States who are severely wounded or injured by acts of terror outside the United States.
"(c)
"(1)
"(2)
"(3)
"(d)
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)
"(1)
"(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 supervision;
"(D) to monitor individual health outcomes of covered beneficiaries with chronic diseases or conditions;
"(E) to improve communication between health care providers and patients; and
"(F) to reduce health care costs for covered beneficiaries and the Department of Defense.
"(2)
"(A) maximize the use of secure messaging between health care providers and covered beneficiaries to improve the access of covered beneficiaries to health care and reduce the number of visits to medical facilities for health care needs;
"(B) allow covered beneficiaries to schedule appointments; 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)
"(c)
"(d)
"(e)
"(1)
"(A)
"(B)
"(2)
"(A)
"(B)
"(i) The satisfaction of covered beneficiaries with telehealth services furnished by the Department of Defense.
"(ii) The satisfaction of health care providers in providing telehealth services furnished by the Department.
"(iii) The effect of telehealth services furnished by the Department on the following:
"(I) The ability of covered beneficiaries to access health care services in the direct care and purchased care components of the military health system.
"(II) The frequency of use of telehealth services by covered beneficiaries.
"(III) The productivity of health care providers providing care furnished by the Department.
"(IV) The reduction, if any, in the use by covered beneficiaries of health care services in military treatment facilities or medical facilities 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 Department by furnishing telehealth services to covered beneficiaries.
"(f)
"(1)
"(2)
"(3)
"(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 Outcomes and Improve Quality of Health Care Services Delivered in Military Medical Treatment Facilities
Pub. L. 114–328, div. A, title VII, §726, Dec. 23, 2016, 130 Stat. 2231, provided that:
"(a)
"(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 facilities selected by the Secretary for purposes of the program, 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 delivered at military medical treatment facilities selected by the Secretary for purposes of the program.
"(b)
"(c)
"(d)
"(e)
"(f)
"(g)
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)
"(1)
"(2)
"(A) Accountable care organizations, patient centered 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 Collaborative 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 Military 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)
"(b)
"(1) Quality of care.
"(2) Access of beneficiaries to care.
"(3) Improvement in health outcomes for beneficiaries.
"(4) Patient safety.
"(5) Such other matters as the Secretary of Defense, in consultation with the Secretaries of the military departments, considers appropriate.
"(c)
"(1)
"(2)
"(A) A comprehensive plan for the use of measures 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 position in the military health system determined under subsection (a) and a description of the specific measures of accountability for performance to be incorporated into the annual performance reviews of each such position pursuant to this section."
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)
"(b)
"(c)
Provision of Information to Members of the Armed Forces on Privacy Rights Relating to Receipt of Mental Health Services
Pub. L. 113–291, div. A, title V, §523, Dec. 19, 2014, 128 Stat. 3361, provided that:
"(a)
"(1) to each officer candidate during initial training;
"(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 appropriate.
"(b)
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 interoperable 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 diagnosis 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)
"(b)
"(1) Physical health and behavioral health.
"(2) Rehabilitation.
"(3) Educational and vocational preparation.
"(4) Such other matters as the Secretary considers appropriate.
"(c)
"(1) When the member commences participation in the program.
"(2) At least once each year the member participates 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)
"(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)
"(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)
"(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 reporting material the Secretary determines necessary to carry out the policy.
"(b)
Pub. L. 113–291, div. A, title V, §567, Dec. 19, 2014, 128 Stat. 3385, provided that:
"(a)
"(1)
"(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 involving a dependent of a member of the Armed Forces.
"(2)
"(A) the suicide prevention policy developed pursuant to section 582 of the National Defense Authorization Act for Fiscal Year 2013 (Public Law 112–239; 10 U.S.C. 1071 note); and
"(B) the suicide prevention and resilience program for the National Guard and Reserves established pursuant to section 10219 of title 10, United States Code.
"(3)
"(b)
"(1)
"(2)
"(c)
Pub. L. 112–239, div. A, title V, §580, Jan. 2, 2013, 126 Stat. 1764, provided that:
"(a)
"(b)
"(1) To establish a uniform definition of resiliency for use in the suicide prevention and resilience programs 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 comprehensive 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)
"(b)
"(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.
"(4) The means to evaluate and assess the effectiveness of the suicide prevention and resilience programs and preventative behavioral health programs of the Department of Defense (including those of the military departments and the Armed Forces), including the development of metrics for that purpose.
"(5) The means to evaluate and assess the current diagnostic tools and treatment methods in the programs 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 guidance 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 privacy of members seeking or receiving treatment relating to suicide.
"(12) Such other matters as the Secretary considers appropriate in connection with the prevention of suicide among members."
Pub. L. 112–81, div. A, title V, §533(a), (b), Dec. 31, 2011, 125 Stat. 1404, provided that:
"(a)
"(b)
"(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 higher education and other public and private entities, including international entities, with expertise regarding 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 address the priorities of the Armed Forces with respect to retention and readiness."
Comprehensive Plan on Prevention, Diagnosis, and Treatment of Substance Use Disorders and Disposition 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 programs 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 improvements made following an independent study of the programs 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)
"(b)
"(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 families.
"(c)
"(d)
"(1)
"(2)
"(A) A description of the policy implemented under subsection (a), and any revisions to such policy 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 Department 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 information on pain management to beneficiaries enrolled 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 number 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 number of military and civilian mental health personnel 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)
"(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)
"(1)
"(2)
"(A) Actions to guarantee the availability of care within established access standards for eligible beneficiaries, based on the results of the study required 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 Defense 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 families, 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 commanders of military treatment facilities and managed care support contractors.
"(G) Actions to create new budgeting and resource allocation methodologies to fully support and incentivize care provided by military treatment facilities.
"(H) Actions regarding additional financing options 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 Eligibility 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 consultation with the other administering Secretaries, considers appropriate.
"(c)
"(d)
"(e)
"(1)
"(2)
"(A) Updates on the progress made in undertaking actions under this section.
"(B) Future plans for improvement of the military health system.
"(C) An explanation of how the budget submission may reflect such progress and plans.
"(3)
"(4)
"(A) A description and assessment of the progress made as of the date of such report in the improvement of the TRICARE program.
"(B) Such recommendations for administrative or legislative action as the Secretary considers appropriate to expedite and enhance the improvement of the TRICARE program.
"(f)
"(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)
"(b)
"(1) identify and analyze health care delivery options involving the private sector and health care services in military facilities located on military installations;
"(2) develop methods for determining the cost avoidance or savings resulting from innovative partnerships between the Department of Defense and the private sector;
"(3) develop requirements for Department of Defense 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, between the Department of Defense and nonmilitary health care systems, personal health information, and data of military personnel and their families.
"(c)
"(d)
"(e)
"(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 installation as a training and operational base, with members 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 recommendations 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 capabilities; 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 specialty services; and
"(B) limited or no capability to provide trauma care.
"(f)
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)
"(b)
"(c)
"(1)
"(A) implement a comprehensive plan and strategy for the Department of Defense, as developed by the Secretary of Defense, for a registry of information 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 member of the Armed Forces while serving on active duty;
"(B) ensure the electronic exchange with the Secretary 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 Administration.
"(2)
"(3)
"(4)
"(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)
"(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 injury incurred while serving on active duty, including a member with auditory dysfunction related to traumatic brain injury.
"(d)
"(e)
Wounded Warrior Health Care Improvements
Pub. L. 115–232, div. A, title VII, §717, Aug. 13, 2018, 132 Stat. 1815, provided that:
"(a)
"(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)
"(1) The case management coordination of members of the Armed Forces between the military departments 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 coordination 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 treatment 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 furnished by the Secretary of Defense to treatment furnished by the Secretary of Veterans Affairs.
"(3) Facility standards related to lodging and accommodations for recovering service members and the family members and non-medical attendants of recovering service members.
"(c)
"(d)
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)
"(A) the Committees on Armed Services, Veterans' Affairs, and Appropriations of the Senate; and
"(B) the Committees on Armed Services, Veterans' Affairs, and Appropriations of the House of Representatives.
"(2)
"(3)
"(A) A system or process of the Department of Defense for evaluating the nature and extent of disabilities affecting members of the Armed Forces that is operated by the Secretaries of the military departments and is comprised of medical evaluation boards, physical evaluation boards, counseling of members, and mechanisms for the final disposition of disability evaluations by appropriate personnel.
"(B) A system or process of the Coast Guard for evaluating the nature and extent of disabilities affecting members of the Coast Guard that is operated by the Secretary of Homeland Security and is similar to the system or process of the Department of Defense described in subparagraph (A).
"(4)
"(5)
"(6)
"(A) a military medical treatment facility as an outpatient; or
"(B) a unit established for the purpose of providing command and control of members of the Armed Forces receiving medical care as outpatients.
"(7)
"(8)
"(9) TRICARE
"SEC. 1603. CONSIDERATION OF GENDER-SPECIFIC NEEDS OF RECOVERING SERVICE MEMBERS AND VETERANS.
"(a)
"(b)
"SEC. 1611. COMPREHENSIVE POLICY ON IMPROVEMENTS TO CARE, MANAGEMENT, AND TRANSITION OF RECOVERING SERVICE MEMBERS.
"(a)
"(1)
"(2)
"(A) The care and management of recovering service members.
"(B) The medical evaluation and disability evaluation of recovering service members.
"(C) The return of service members who have recovered to active duty when appropriate.
"(D) The transition of recovering service members from receipt of care and services through the Department of Defense to receipt of care and services through the Department of Veterans Affairs.
"(3)
"(4)
"(A) The results of the reviews required under subsections (b) and (c).
"(B) Best practices identified through pilot programs carried out under this title.
"(C) Improvements to matters under the policy otherwise identified and agreed upon by the Secretary of Defense and the Secretary of Veterans Affairs.
"(b)
"(1)
"(2)
"(A) incorporating such approaches into the policy; 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)
"(A) identify among the policies and procedures described in paragraph (1) best practices in approaches 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 (including 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 consistency and uniformity, where appropriate, in the application 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)
"(c)
"(1) The findings and recommendations of applicable studies, reviews, reports, and evaluations that address matters relating to the policy, including, but not limited, to the following:
"(A) The Independent Review Group on Rehabilitative Care and Administrative Processes at Walter Reed Army Medical Center and National Naval Medical Center, appointed by the Secretary of Defense.
"(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 Commission 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 Assistance, of 1999, chaired by Anthony J. Principi.
"(G) The President's Commission on Veterans' Pensions, of 1956, chaired by General Omar N. Bradley.
"(2) The experience and best practices of the Department of Defense and the military departments on matters relating to the policy.
"(3) The experience and best practices of the Department 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 appropriate.
"(d)
"(1)
"(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 professionals following detection of such signs.
"(2)
"(e)
"(1)
"(2)
"(A)
"(B)
"(C)
"(D)
"(E)
"(F)
"(3)
"(A)
"(B)
"(i) Assisting in understanding the service member's medical status during the care, recovery, 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 member.
"(iii) Conducting a periodic review of the medical 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 concerned elects to require such written explanations for purposes of the program).
"(C)
"(D)
"(E)
"(F)
"(4)
"(A)
"(B)
"(i) Communicating with the service member and with the service member's family or other individuals designated by the service member regarding 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.
"(iii) Assisting the service member in resolving problems involving financial, administrative, personnel, transitional, and other matters that arise during the care, recovery, and transition of the service member.
"(C)
"(D)
"(E)
"(F)
"(G)
"(5)
"(A)
"(i) In medical facilities of the Department of Defense.
"(ii) Through the TRICARE program.
"(B)
"(i) Follow-up care.
"(ii) Specialty care.
"(iii) Diagnostic referrals and studies.
"(iv) Surgery based on a physician's determination of medical necessity.
"(C)
"(6)
"(A)
"(B)
"(7)
"(8)
"(9)
"(10)
"(A) locating each recovering service member; and
"(B) tracking medical care appointments of recovering service members to ensure timeliness and compliance of recovering service members with appointments, and other physical and evaluation timelines, and to provide any other information needed to conduct oversight of the care, management, and transition of recovering service members.
"(11)
"(f)
"(1)
"(2)
"(3)
"(4)
"(g)
"(h)
"SEC. 1612. MEDICAL EVALUATIONS AND PHYSICAL DISABILITY EVALUATIONS OF RECOVERING SERVICE MEMBERS.
"(a)
"(1)
"(2)
"(A) Processes for medical evaluations of recovering 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 National Guard and Reserve.
"(B) Standard criteria and definitions for determining 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 recovering service members.
"(ii) Specialty care consultations for recovering service members.
"(iii) Preparation of medical documents for recovering service members.
"(iv) Appeals by recovering service members of medical evaluation determinations, including determinations of fitness for duty.
"(D) Procedures for ensuring that—
"(i) upon request of a recovering service member being considered by a medical evaluation board, a physician or other appropriate health care professional who is independent of the medical evaluation board is assigned to the service member; and
"(ii) the physician or other health care professional assigned to a recovering service member under clause (i)—
"(I) serves as an independent source for review of the findings and recommendations of the medical evaluation board;
"(II) provides the service member with advice and counsel regarding the findings and recommendations 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 injuries and illness of the service member.
"(E) Standards for qualifications and training of medical evaluation board personnel, including physicians, case workers, and physical disability evaluation board liaison officers, in conducting medical evaluations of recovering service members.
"(F) Standards for the maximum number of medical evaluation cases of recovering service members that are pending before a medical evaluation board at any one time, and requirements for the establishment 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 responsibilities of recovering service members under that process, including a standard handbook on such information (which handbook shall also be available electronically).
"(b)
"(1)
"(2)
"(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 eliminate unacceptable discrepancies and improve consistency among disability ratings assigned by the military departments and the Department of Veterans Affairs, particularly in the disability evaluation of recovering service members, which procedures 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 disabilities in use by the Department of Veterans Affairs, including any applicable interpretation of such schedule by the United States Court of Appeals for Veterans Claims, in making any determination of disability of a recovering service member, except as otherwise authorized by section 1216a of title 10, United States Code (as added by section 1642 of this Act).
"(C) Uniform timelines among the military departments for appeals of determinations of disability of recovering service members, including timelines for presentation, consideration, and disposition of appeals.
"(D) Uniform standards among the military departments for qualifications and training of physical disability evaluation board personnel, including physical evaluation board liaison personnel, in conducting physical disability evaluations of recovering service members.
"(E) Uniform standards among the military departments for the maximum number of physical disability evaluation cases of recovering service members that are pending before a physical disability evaluation board at any one time, and requirements 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 undergoing evaluation by a physical disability evaluation board.
"(G) Uniform standards among the military departments 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 disability board, and uniform standards on the maximum number of cases involving such service members that are to be assigned to judge advocates at any one time.
"(c)
"(1)
"(2)
"(A) An assessment of the feasability [sic] and advisability of consolidating the disability evaluation systems described in paragraph (1) as specified in that paragraph.
"(B) If the consolidation of the systems is considered feasible and advisable—
"(i) recommendations for various options for consolidating the systems as specified in paragraph (1); and
"(ii) recommendations for mechanisms to evaluate and assess any progress made in consolidating 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)
"(b)
"(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 recovering service members during the transition, including a system of cooperative case management of recovering service members by the Department of Defense and the Department of Veterans Affairs during the transition.
"(3) Procedures for the notification of Department of Veterans Affairs liaison personnel of the commencement by recovering service members of the medical evaluation process and the physical disability 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, education, 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 Department 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 medical care and management of recovering service members during the transition, including procedures for the assignment of medical personnel of the Department 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 Department of Veterans Affairs, which plans shall—
"(A) be based on standardized elements with respect to care and treatment requirements and other applicable requirements; and
"(B) take into account the comprehensive recovery plan for the recovering service member concerned as developed under section 1611(e)(1).
"(9) Procedures to ensure that each recovering service 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 retirement 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 Department of Defense to the Department of Veterans Affairs of records and any other required information on each recovering service member described in paragraph (9), which procedures shall provide for the transmission from the Department of Defense to the Department of Veterans Affairs of records and information 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.
"(E) A copy of any request of the service member for assistance in enrolling in, or completed applications for enrollment in, the health care system of the Department of Veterans Affairs for health care benefits for which the service member may be eligible 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 applications for, compensation and vocational rehabilitation 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 individual 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 intends to reside after the retirement or separation of the service member from the Armed Forces.
"(13) Procedures to ensure that, before the transmittal 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 military 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 Affairs.
"(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 Department of Veterans Affairs to the military health records of recovering service members who are receiving care and treatment, or are anticipating receipt of care and treatment, in Department of Veterans Affairs health care facilities, which procedures shall be consistent with the procedures and requirements in paragraphs (11) and (13).
"(16) A process for the utilization of a joint separation 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 recovering service member from military service and for use by the Department of Veterans Affairs in disability evaluations.
"(17) Procedures for surveys and other mechanisms to measure patient and family satisfaction with the provision by the Department of Defense and the Department of Veterans Affairs of care and services for recovering service members, and to facilitate appropriate oversight by supervisory personnel of the provision of such care and services.
"(18) Procedures to ensure the participation of recovering 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 provided 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 separated 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 discharged, at a location reasonably convenient to the member.
"SEC. 1616. ESTABLISHMENT OF A WOUNDED WARRIOR RESOURCE CENTER.
"(a)
"(b)
"(c)
"(1)
"(2)
"(d)
"(1)
"(2)
"(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 remediation of the deficiencies is developed and implemented; and
"(iii) if requested, the individual who made the report is notified of the current status of the report; or
"(B) if a request for information is received in a call—
"(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 notified, at a minimum, of the current status of the query.
"(3)
"(e)
"(1)
"(2)
"(f)
"(1)
"(2)
"SEC. 1618. COMPREHENSIVE PLAN ON PREVENTION, 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)
"(b)
"(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 disorder, and other mental health conditions in members of the Armed Forces;
"(2) the identification of gaps in current capabilities of the Department for the prevention, 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; 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 paragraph (2).
"(c)
"(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 technology, and physical and medical rehabilitation practices and expertise.
"(d)
"(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)
"(1)
"(2)
"(3)
"(A) basic and pre-deployment training for enlisted members of the Armed Forces, noncommissioned officers, and officers;
"(B) combat theater operations; and
"(C) post-deployment service.
"(4)
"(5)
"(6)
"(7)
"(8)
"(9)
"(10)
"(11)
"(12)
"(f)
"SEC. 1621. CENTER OF EXCELLENCE IN THE PREVENTION, DIAGNOSIS, MITIGATION, TREATMENT, AND REHABILITATION OF TRAUMATIC BRAIN INJURY.
"(a)
"(b)
"(c)
"(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 traumatic brain injury, including research on gender and ethnic group-specific health needs related to traumatic brain injury.
"(2) To provide for the development, testing, and dissemination within the Department of best practices for the treatment of traumatic brain injury.
"(3) To provide guidance for the mental health system 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 comprehensive program to train mental health and neurological 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 research 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 negative impacts of traumatic brain injury on such family members and to support the recovery of such members 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 imaging 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 Department 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 increase 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 traumatic 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 traumatic brain injury.
"(13) Such other responsibilities as the Secretary shall specify.
"SEC. 1622. CENTER OF EXCELLENCE IN PREVENTION, DIAGNOSIS, MITIGATION, TREATMENT, AND REHABILITATION OF POST-TRAUMATIC STRESS DISORDER AND OTHER MENTAL HEALTH CONDITIONS.
"(a)
"(b)
"(c)
"(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 practices for the treatment of post-traumatic stress disorder.
"(3) To provide guidance for the mental health system 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 comprehensive program to train mental health and neurological 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 research on post-traumatic stress disorder for the purposes of understanding the etiology of post-traumatic stress disorder and developing preventive interventions 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 increase 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 treatment from the Department of Veterans Affairs.
"SEC. 1623. CENTER OF EXCELLENCE IN PREVENTION, DIAGNOSIS, MITIGATION, TREATMENT, AND REHABILITATION OF MILITARY EYE INJURIES.
"(a)
"(b)
"(c)
"(1)
"(A) implement a comprehensive plan and strategy for the Department of Defense, as developed by the Secretary of Defense, for a registry of information for the tracking of the diagnosis, surgical intervention or other operative procedure, other treatment, and follow up for each case of significant eye injury incurred by a member of the Armed Forces while serving on active duty;
"(B) ensure the electronic exchange with the Secretary 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 entered into the registry and subsequently received treatment through the Veterans Health Administration.
"(2)
"(3)
"(4)
"(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)
"(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 incurred while serving on active duty, including a member with visual dysfunction related to traumatic 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.
"(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)
"(e)
"(f)
"SEC. 1631. MEDICAL CARE AND OTHER BENEFITS FOR MEMBERS AND FORMER MEMBERS OF THE ARMED FORCES WITH SEVERE INJURIES OR ILLNESSES.
"(a)
"(1)
"(2)
"(b)
"(c)
"(1)
"(2)
"SEC. 1635. FULLY INTEROPERABLE ELECTRONIC PERSONAL HEALTH INFORMATION FOR THE DEPARTMENT OF DEFENSE AND DEPARTMENT OF VETERANS AFFAIRS.
"(a)
"(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 Department of Veterans Affairs; and
"(2) accelerate the exchange of health care information between the Department of Defense and the Department of Veterans Affairs in order to support the delivery of health care by both Departments.
"(b)
"(1)
"(2)
"(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 implementation of electronic health record systems or capabilities that allow for full interoperability of personal health care information between the Department of Defense and the Department of Veterans Affairs.
"(B) To accelerate the exchange of health care information between the Department of Defense and the Department of Veterans Affairs in order to support the delivery of health care by both Departments.
"(C) To develop and implement a comprehensive interoperability strategy, which shall include—
"(i) the Electronic Health Record Modernization Program of the Department of Veterans Affairs; and
"(ii) the Healthcare Management System Modernization Program of the Department of Defense.
"(D) To pursue the highest level of interoperability for the delivery of health care by the Department of Defense and the Department of Veterans Affairs.
"(E) To accelerate the exchange of health care information 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 requirements of the Departments relating to the 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 possible implementation of standards, specifically with respect to the Fast Healthcare Interoperability Resources standard or successor standard, the evolution of such standards, and the obsolescence of such standards.
"(H) To actively engage with national and international health standards setting organizations, including by taking membership in such organizations, 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 Departments and with the private sector, and to ensure 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 Information 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 architecture by the Departments.
"(N) To ensure ownership and control by patients of personal health information and data in a manner 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 seamless health care by health care facilities and providers of the Departments, as well as private sector facilities and providers contracted by the Departments; and
"(ii) that are more adaptable and far reaching than those achievable through biodirectional information 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 Interoperability Resources standard (or successor standard).
"(c)
"(1)
"(2)
"(3)
"(4)
"(A)
"(B)
"(C)
"(i) Significant experience at a senior management 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 implementation of complex organizational change by integrating the input of experts from various disciplines, such as clinical, business, management, informatics, and technology.
"(5)
"(6)
"(7)
"(d)
"(e)
"(1)
"(A) Whether a clinician of the Department of Defense, 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 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 Department 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 electronic 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 Department 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 Department of Defense; and
"(ii) third-party applications.
"(2)
"(A) maintain the common configuration baseline for the electronic health record systems of the Department of Defense and the Department of Veterans Affairs; and
"(B) continually evaluate the state of configuration and the impacts on interoperability; and
"(C) promote the enhancement of such electronic health records systems.
"(3)
"(A)
"(B)
"(4)
"(f)
"(1)
"(2)
"(g)
"(1)
"(2)
"(3)
"(4)
"(h)
"(1)
"(A) A detailed description of the activities of the Office during the year covered by such report, including a detailed description of the amounts expended and the purposes for which expended.
"(B) With respect to the objectives of the strategy 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 activities 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 configuration under subsection (e).
"(F) With respect to the annual meeting required under subsection (e)(3)—
"(i) a detailed description of activities, assessments, and recommendations relating to such meeting; and
"(ii) the response of the Office to any such recommendations.
"(2)
"(i)
"(j)
"(k)
"(1) The term 'appropriate congressional committees' means—
"(A) the congressional defense committees [Committees 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 Modernization 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 applications to connect, regardless of the technology platform 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 applicable care settings;
"(B) with relevant stakeholders, including the person whose information is being shared, to access, 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 information without error;
"(D) with the ability to interpret and to make effective 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 information 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 patient, social and environmental determinants of health, and health trends over time, in order to enable patients and clinicians to—
"(A) move efficiently within and across organizational 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 respect to matters concerning the Department of Veterans Affairs; and
"(C) the Secretary of Homeland Security, with respect 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)
"(1)
"(2)
"(3)
"(b)
"(1)
"(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 disabilities utilized by the Secretary of Veterans Affairs based on all medical conditions (whether individually or collectively) that render the member unfit for duty; and
"(B) the Secretary of the military department concerned may make the determination of disability regarding the member utilizing the rating of disability assigned under subparagraph (A)(ii).
"(2)
"(A) provide for the joint evaluation of the member for disability by the Secretary of the military department concerned and the Secretary of Veterans Affairs, including the assignment of a rating of disability for the member in accordance with the schedule for rating disabilities utilized by the Secretary of Veterans Affairs based on all medical conditions (whether individually or collectively) that render the member unfit for duty; and
"(B) make the determination of disability regarding the member utilizing the rating of disability assigned under subparagraph (A).
"(3)
"(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 additional 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 (including assistance through the caseworkers assigned to such members of the Armed Forces) in submitting and tracking such forms, including assistance 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 members of the Armed Forces under the system that are required for submission under the disability evaluation system, including the capability to track requests for such files or records and to determine the status of such requests and of responses to such requests.
"(4)
"(c)
"(1) To provide for the development, evaluation, and identification of revised and improved practices and procedures under the disability evaluation system in order to—
"(A) reduce the processing time under the disability evaluation system of members of the Armed Forces who are likely to be retired or separated for disability, and who have not requested continuation on active duty, including, in particular, members who are severely wounded;
"(B) identify and implement or seek the modification of statutory or administrative policies and requirements 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, interpretations, and overall performance standards among the military departments under the disability evaluation system; and
"(D) determine whether it enhances the capability of the Department of Veterans Affairs to receive and determine claims from members of the Armed Forces for compensation, pension, hospitalization, or other veterans benefits.
"(2) In conjunction with the findings and recommendations of applicable Presidential and Department of Defense study groups, to provide for the eventual development of revised and improved practices and procedures for the disability evaluation system in order to achieve the objectives set forth in paragraph (1).
"(d)
"(e)
"(1)
"(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 members 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 methods of determining fitness or unfitness for duty and disability ratings for members of the Armed Forces if the Secretaries determine in writing that the application of such provision would be inconsistent with the purpose of the pilot program.
"(2)
"(f)
"(g)
"(1)
"(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 identification under such pilot program of revised or improved 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 subsection.
"(2)
"(3)
"SEC. 1648. STANDARDS FOR MILITARY MEDICAL TREATMENT FACILITIES, SPECIALTY MEDICAL CARE FACILITIES, AND MILITARY QUARTERS HOUSING PATIENTS AND ANNUAL REPORT ON SUCH FACILITIES.
"(a)
"(1) be uniform and consistent for all such facilities; and
"(2) be uniform and consistent throughout the Department of Defense and the military departments.
"(b)
"(1) Military medical treatment facilities.
"(2) Specialty medical care facilities.
"(3) Military quarters or leased housing for patients.
"(c)
"(1) Generally accepted standards for the accreditation of medical facilities, or for facilities used to quarter individuals that may require medical supervision, as applicable, in the United States.
"(2) To the extent not inconsistent with the standards described in paragraph (1), minimally acceptable conditions for the following:
"(A) Appearance and maintenance of facilities generally, including the structure and roofs of facilities.
"(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 systems, plumbing systems, heating, ventilation, and air conditioning systems, communications systems, fire protection systems, energy management systems, and other systems required for patient care.
"(D) Compliance of facilities, rooms, and grounds, to the maximum extent practicable, with the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.).
"(E) Such other matters relating to the appearance, size, operation, and maintenance of facilities and rooms as the Secretary considers appropriate.
"(d)
"(1)
"(2)
"(e)
"(1)
"(2)
"(A) The standards established under subsection (a).
"(B) An assessment of the appearance, condition, and maintenance of each facility referred to in subsection (b), including—
"(i) an assessment of the compliance of the facility with the standards established under subsection (a); and
"(ii) a description of any deficiency or noncompliance in each facility with the standards.
"(C) A description of the investment to be allocated 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 BENEFITS AVAILABLE FOR SERIOUS INJURIES AND ILLNESSES.
"(a)
"(b)
"(c)
"(d)
"(e)
"SEC. 1662. ACCESS OF RECOVERING SERVICE MEMBERS TO ADEQUATE OUTPATIENT RESIDENTIAL FACILITIES.
"All quarters of the United States and housing facilities under the jurisdiction of the Armed Forces that are occupied by recovering service members shall be inspected at least once every two years by the inspectors general of the regional medical commands. [As amended 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 RESOURCES FROM MEDICAL CARE.
"Neither the Secretary of Defense nor the Secretaries of the military departments may transfer funds or personnel from medical care functions to administrative functions within the Department of Defense in order to comply with the new administrative requirements imposed 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 MEMBERS OF THE ARMED FORCES RECOVERING FROM SERIOUS INJURIES OR ILLNESSES.
"(a)
"(1)
"(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 Department of Defense while caring for the service member.
"(2)
"(3)
"(4)
"(A) From third-party payers, in the same manner as the United States may collect costs of the charges of health care provided to covered beneficiaries from third-party payers under section 1095 of title 10, United States Code.
"(B) As if such care was provided under the authority of section 1784 of title 38, United States Code.
"(b)
"(1)
"(2)
"SEC. 1676. MORATORIUM ON CONVERSION TO CONTRACTOR PERFORMANCE OF DEPARTMENT OF DEFENSE FUNCTIONS AT MILITARY MEDICAL FACILITIES.
"(a)
"(1) submits the certification required by subsection (b) to the Committee on Armed Services of the Senate and the Committee on Armed Services of the House of Representatives together with a description of the steps taken by the Secretary in accordance with the certification; and
"(2) submits the report required by subsection (c).
"(b)
"(1) the process of considering a Department of Defense function carried out at a military medical facility for possible conversion to performance by a contractor; or
"(2) the conversion of such a function to performance by a contractor.
"(c)
"(1) for each such competition—
"(A) the cost of conducting the public-private competition;
"(B) the number of military personnel and civilian employees of the Department of Defense affected;
"(C) the estimated savings identified and the savings 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 business reform or reengineering other than a public-private 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 report 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 Department of Defense relating to the prevention, mitigation, and treatment of blast injuries, including the designation 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 Veterans Affairs Health Care
Pub. L. 107–314, div. A, title VII, §708, Dec. 2, 2002, 116 Stat. 2585, provided that:
"(a)
"(A) ensure that the process provides for coordination of, and access to, health care from the two sources in a manner that prevents diminution of access 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 describing 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)
"(A) An analysis of whether covered beneficiaries who seek services through the Department of Veterans Affairs are receiving needed health care services in a timely manner from the Department of Veterans Affairs, as compared to the timeliness of the care available to covered beneficiaries under TRICARE Prime (as set forth in access to care standards under TRICARE program policy that are applicable to the care being sought).
"(B) An evaluation of the quality of care for covered 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 beneficiaries described in subsection (a).
"(D) An evaluation of the feasibility and advisability of making access to care standards applicable jointly under the TRICARE program and the Department of Veterans Affairs health care system.
"(E) A review of the process prescribed by the Secretary of Defense under subsection (a) to determine whether the process ensures the adequacy and quality of the health care services provided to covered beneficiaries under the TRICARE program and through the Department of Veterans Affairs, together with timeliness of access to such services and patient safety.
"(2) Not later than 60 days after the congressional committees specified in subsection (a)(2) receive the report required under that subsection, the Comptroller General shall submit to those committees a report on the study conducted under this subsection.
"(c)
"(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) [now 1097a(e)] of such title."
Pilot Program Providing for Department of Veterans 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 Congress 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 terminate on Dec. 31, 2003, to explore opportunities for improving the planning, programming, budgeting systems, and management of the Department of Defense health care system, and directed the Secretary to submit a report on such program to committees of Congress 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)
"(b)
"(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 administration 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 Secretary 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 programs, 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)
"(b)
"(1) To study the occurrences of errors in the patient care provided under chapter 55 of title 10, United States Code.
"(2) To identify the systemic factors that are associated with such occurrences.
"(3) To provide for action to be taken to correct the identified systemic factors.
"(c)
"(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 errors related to patient care.
"(2) For each health care organization of the Department 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 Patient Safety Center, which shall have the following missions:
"(A) To analyze information on patient care errors that is submitted to the Center by each military health care organization.
"(B) To develop action plans for addressing patterns of patient care errors.
"(C) To execute those action plans to mitigate and control errors in patient care with a goal of ensuring that the health care organizations of the Department of Defense provide highly reliable patient care with virtually no error.
"(D) To provide, through the Assistant Secretary of Defense for Health Affairs, to the Agency for Healthcare Research and Quality of the Department of Health and Human Services any reports that the Assistant Secretary determines appropriate.
"(E) To review and integrate processes for reducing errors associated with patient care and for enhancing patient safety.
"(F) To contract with a qualified and objective external organization to manage the national patient safety database of the Department of Defense.
"(d)
"(1) Establish not less than two Centers of Excellence for the development, validation, proliferation, and sustainment of the health care team coordination program, one of which shall support all fixed military health care organizations, the other of which shall support all combat casualty care organizations.
"(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 coordination program from a focus on emergency department 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 investments to improve communication, coordination, and team work in the provision of health care.
"(e)
Confidentiality of Communications With Professionals Providing Therapeutic or Related Services 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 maximum protections for the confidentiality of communications between dependents of Armed Forces members and professionals providing therapeutic or related services regarding sexual or domestic abuse and to report 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, provided that:
"(a)
"(b)
"(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)
"(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)
"(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 Affairs.
"(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 Secretary of Defense to represent health care insurers and managed care organizations, academic health institutions, health care providers (including representatives of physicians and representatives of hospitals), and accreditors of health care plans and organizations.
"(2) The primary mission of the Committee shall be to advise the Secretary on the development, deployment, and maintenance of health care informatics systems that allow for the collection, exchange, and processing of health care quality information for the Department 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 Veterans Affairs to monitor, evaluate, and improve the quality of care provided to beneficiaries.
"(B) The coordination of key components of medical informatics systems, including digital patient records, both within the Federal Government and between the Federal Government and the private sector.
"(C) The development of operational capabilities for executive information systems and clinical decision support systems within the Department of Defense and Department of Veterans Affairs.
"(D) Standardization of processes used to collect, evaluate, and disseminate health care quality information.
"(E) Refinement of methodologies by which the quality of health care provided within the Department 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) The Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the Committee.
[Section 1062(j)(1)(A) of Pub. L. 112–81, which directed the redesignation of pars. (6) and (7) as (5) and (6) of section 723(d) of Pub. L. 106–65, set out above, could not be executed due to the prior identical amendment by section 1046(e) of Pub. L. 109–364.]
Joint Department of Defense and Department of Veterans Affairs Reports Relating to Interdepartmental Cooperation in Delivery of Medical 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) directed the Secretary of Defense and the Secretary of Veterans Affairs to jointly conduct a survey of their respective medical care beneficiary populations to identify 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 survey to committees of Congress not later than Jan. 1, 2000; (2) directed the same Secretaries to jointly conduct a review to identify impediments to cooperation between the Department of Defense and the Department of Veterans Affairs regarding the delivery of medical 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 increased participation by the Department of Veterans Affairs in that program; (4) directed the Department of Defense-Department of Veterans Affairs Federal Pharmacy Executive Steering Committee to examine existing pharmaceutical benefits and programs for beneficiaries 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 rating disabilities.
External Peer Review for Defense Health Program Extramural Medical Research Involving Human Subjects
Pub. L. 104–201, div. A, title VII, §742, Sept. 23, 1996, 110 Stat. 2600, provided that:
"(a)
"(b)
"(c)
"(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)
"(e)
"(1) A medical research project that the Secretary determines has been substantially completed by October 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 requirements 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)
"(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 services available under that system and with the facilities 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 provided through that system.
"(5) Such other matters as the administering Secretaries determine appropriate.
"(b)
"(c)
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 committees 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 dependent members of the armed forces, to identify, refuse admission to, and refer to civilian treatment facilities such persons seeking entrance to the armed forces, and to report to Congress on and suggest additional legislation concerning these matters, was repealed 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 Collaborative' means the collaboration between the Centers for Medicare & Medicaid Services, major health insurance companies, national physician organizations, and other entities to reach consensus on core performance 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."
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, provided:
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:
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 Administration. 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.
(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 Department 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 program areas using metrics that assess their effectiveness. 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 replaced.
(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 networks 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 opportunities 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 independently support a full-time provider.
(b) The National Research Action Plan shall include strategies to establish surrogate and clinically actionable biomarkers for early diagnosis and treatment effectiveness; develop improved diagnostic criteria for TBI; enhance our understanding of the mechanisms responsible for PTSD, related injuries, and neurological disorders following TBI; foster development of new treatments for these conditions based on a better understanding of the underlying mechanisms; improve data sharing between agencies and academic and industry researchers to accelerate progress and reduce redundant efforts without compromising privacy; and make better use of electronic health records to gain insight into the risk and mitigation of PTSD, TBI, and related injuries. In addition, the National Research Action Plan shall include strategies to support collaborative research to address suicide prevention.
(c) The Departments of Defense and Health and Human Services shall engage in a comprehensive longitudinal mental health study with an emphasis on PTSD, TBI, and related injuries to develop better prevention, 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.
(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 Government 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 implementation 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, service 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 substance abuse treatment services for veterans, service members, and their families consistent with this order, as well as provide additional recommendations for action as appropriate. The Task Force shall define specific goals and metrics that will aid in measuring progress in improving mental health strategies. The Task Force will include cost analysis in the development 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 ensure that the Departments of Defense and Veterans Affairs and community-based mental health providers 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 prevention, diagnosis, and treatment of TBI, PTSD, and related 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 organizations as necessary.
(b) Nothing in this order shall be construed to impair or otherwise affect:
(i) the authority granted by law to an executive department or agency, or the head thereof; or
(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable 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.]
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