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<dc:title>114 S587 IS: BEST Practices Act</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2015-02-26</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">II</distribution-code><congress display="yes">114th Congress</congress><session display="yes">1st Session</session><legis-num display="yes">S. 587</legis-num><current-chamber display="yes">IN THE SENATE OF THE UNITED STATES</current-chamber><action display="yes"><action-date date="20150226">February 26, 2015</action-date><action-desc><sponsor name-id="S247">Mr. Wyden</sponsor> (for himself and <cosponsor name-id="S380">Mr. Peters</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSAS00">Committee on Armed Services</committee-name></action-desc></action><legis-type display="yes">A BILL</legis-type><official-title display="yes">To amend title 10, United States Code, to require the Secretary of Defense to use only human-based
			 methods for training members of the Armed Forces in the treatment of
			 severe combat injuries, and for other purposes.</official-title></form>
	<legis-body display-enacting-clause="yes-display-enacting-clause" style="OLC">
 <section commented="no" display-inline="no-display-inline" id="S1" section-type="section-one"><enum>1.</enum><header display-inline="yes-display-inline">Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Battlefield Excellence through Superior Training Practices Act</short-title></quote> or <quote>BEST Practices Act</quote>.</text>
 </section><section commented="no" display-inline="no-display-inline" id="id08a3ee4f503b4b16b4289b4f35c691ac" section-type="subsequent-section"><enum>2.</enum><header display-inline="yes-display-inline">Findings</header><text display-inline="no-display-inline">Congress makes the following findings:</text> <paragraph commented="no" display-inline="no-display-inline" id="id7373c21b9b8d4e56bde76ef85761286c"><enum>(1)</enum><text display-inline="yes-display-inline">The Department of Defense has made impressive strides in the development and use of methods of medical training and troop protection, such as the use of tourniquets and improvements in body armor, that have led to decreased battlefield fatalities.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id49d08f65bc0a483d88982b44ecf69eb4"><enum>(2)</enum><text display-inline="yes-display-inline">The Department of Defense uses more than 8,500 live animals each year to train physicians, medics, corpsmen, and other personnel methods of responding to severe battlefield injuries.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id88240cdd04e047a9bbad3afe1624a60d"><enum>(3)</enum><text display-inline="yes-display-inline">The civilian sector has almost exclusively phased in the use of superior human-based training methods for numerous medical procedures currently taught in military courses using animals.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="ide003b6b3609e4994ab5d94e1886a7b41"><enum>(4)</enum><text display-inline="yes-display-inline">Human-based medical training methods such as simulators replicate human anatomy and can allow for repetitive practice and data collection.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idf4bafc52e78941ecae19e697aef3f568"><enum>(5)</enum><text display-inline="yes-display-inline">According to scientific, peer-reviewed literature, medical simulation increases patient safety and decreases errors by healthcare providers.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id272a71966ed64876a0865ec3a7f41008"><enum>(6)</enum><text display-inline="yes-display-inline">The Army Research, Development and Engineering Command and other entities of the Department of Defense have taken significant steps to develop methods to replace live animal-based training.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id471d28e9fa9a4dc79c067a8adf5b65d7"><enum>(7)</enum><text display-inline="yes-display-inline">According to the report by the Department of Defense titled <quote>Final Report on the use of Live Animals in Medical Education and Training Joint Analysis Team</quote>, published on July 12, 2009—</text> <subparagraph commented="no" display-inline="no-display-inline" id="id7f07830639d142e6839a0aac74ebe99d"><enum>(A)</enum><text display-inline="yes-display-inline">validated, high-fidelity simulators were to have been available for nearly every high-volume or high-value battlefield medical procedure by the end of 2011, and many were available as of 2009; and</text>
 </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idac844abe16204b68a7ac306b07d61217"><enum>(B)</enum><text display-inline="yes-display-inline">validated, high-fidelity simulators were to have been available to teach all other procedures to respond to common battlefield injuries by 2014.</text>
 </subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="idc74d3e7813894c479481dea3eec8bffe"><enum>(8)</enum><text display-inline="yes-display-inline">The Center for Sustainment of Trauma and Readiness Skills of the Air Force exclusively uses human-based training methods in its courses and does not use animals.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id4983d9382a304d42997cff231ce616e5"><enum>(9)</enum><text display-inline="yes-display-inline">In 2013, the Army instituted a policy forbidding non-medical personnel from participating in training courses involving the use of animals.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id24f62cb48ded48d298c1cebf628ce907"><enum>(10)</enum><text display-inline="yes-display-inline">In 2013, the medical school of the Department of Defense, part of the Uniformed Services University of the Health Sciences, replaced animal use within its medical student curriculum.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id994d3b3dda164dc89d7c25005c2ca1fe"><enum>(11)</enum><text display-inline="yes-display-inline">The Coast Guard announced in 2014 that it would reduce by half the number of animals it uses for combat trauma training courses but stated that animals would continue to be used in courses designed for Department of Defense personnel.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id1f025f593f0d46bf91e72dd4eee56104"><enum>(12)</enum><text display-inline="yes-display-inline">Effective January 1, 2015, the Department of Defense replaced animal use in six areas of medical training, including Advanced Trauma Life Support courses and the development and maintenance of surgical and critical care skills for field operational surgery and field assessment and skills tests for international students offered at the Defense Institute of Medical Operations.</text>
			</paragraph></section><section commented="no" display-inline="no-display-inline" id="id41b3ed28080b4d1a90cc89957dbee93e" section-type="subsequent-section"><enum>3.</enum><header display-inline="yes-display-inline">Requirement to use human-based methods for certain medical training</header>
 <subsection commented="no" display-inline="no-display-inline" id="idff451722298f4a7baa8a5b14ad6a474f"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline"><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/10/101">Chapter 101</external-xref> of title 10, United States Code, is amended by adding at the end the following new section:</text>
				<quoted-block display-inline="no-display-inline" id="id28D1A3A7A6EE4E888A4028822C4D1246" style="USC">
					<section commented="no" display-inline="no-display-inline" id="ida1dffbc4edfd4620bdd32e4583e9dbb5" section-type="subsequent-section"><enum>2017.</enum><header display-inline="yes-display-inline">Use of human-based methods for certain medical training</header>
 <subsection commented="no" display-inline="no-display-inline" id="id4a88df3dc77a4c0e9e6fe60063581117"><enum>(a)</enum><header display-inline="yes-display-inline">Combat trauma injuries</header><paragraph commented="no" display-inline="yes-display-inline" id="id4A69A049E01B4553AFC5FE4AF9899732"><enum>(1)</enum><text display-inline="yes-display-inline">Not later than October 1, 2018, the Secretary of Defense shall develop, test, and validate human-based training methods for the purpose of training members of the Armed Forces in the treatment of combat trauma injuries with the goal of replacing live animal-based training methods.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id156e2be45de04c93b325209dfedc6f5b" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">Not later than October 1, 2020, the Secretary—</text> <subparagraph commented="no" display-inline="no-display-inline" id="ida86fcdd7659e4a9da74a6f04396e94cc"><enum>(A)</enum><text display-inline="yes-display-inline">shall only use human-based training methods for the purpose of training members of the Armed Forces in the treatment of combat trauma injuries; and</text>
 </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id0e8e6663e870497d9e7106e706e1880d"><enum>(B)</enum><text display-inline="yes-display-inline">may not use animals for such purpose.</text> </subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id7e585f1f97fc440185e052e7f495228e"><enum>(b)</enum><header display-inline="yes-display-inline">Exception for particular commands and training methods</header><paragraph commented="no" display-inline="yes-display-inline" id="idF3A8E8BBCBA341D88F3120E624F17DF2"><enum>(1)</enum><text display-inline="yes-display-inline">The Secretary may exempt a particular command, particular training method, or both, from the requirement for human-based training methods under subsection (a)(2) if the Secretary determines that human-based training methods will not provide an educationally equivalent or superior substitute for live animal-based training methods for such command or training method, as the case may be.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id9f180cf73f4b4b80a958bd399e82a59d" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">Any exemption under this subsection shall be for such period, not more than one year, as the Secretary shall specify in granting the exemption. Any exemption may be renewed (subject to the preceding sentence).</text>
 </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id180b634039264aef84e1e568cb5f9ea1"><enum>(c)</enum><header display-inline="yes-display-inline">Annual reports</header><paragraph commented="no" display-inline="yes-display-inline" id="idD51C0F9CCB79414B94CFC0313903AAB5"><enum>(1)</enum><text display-inline="yes-display-inline">Not later than October 1, 2016, and each year thereafter, the Secretary shall submit to the congressional defense committees a report on the development and implementation of human-based training methods for the purpose of training members of the Armed Forces in the treatment of combat trauma injuries under this section.</text>
 </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id0831404f87124d2fbb74b3cf8114ac23" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">Each report under this subsection on or after October 1, 2020, shall include a description of any exemption under subsection (b) that is in force as the time of such report, and a current justification for such exemption.</text>
 </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idb09e1347a40b4340979ad45aaf9bd97c"><enum>(d)</enum><header display-inline="yes-display-inline">Definitions</header><text display-inline="yes-display-inline">In this section:</text> <paragraph commented="no" display-inline="no-display-inline" id="id5ddbe92b522c4497b3a76b1150090796"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>combat trauma injuries</term> means severe injuries likely to occur during combat, including—</text>
 <subparagraph commented="no" display-inline="no-display-inline" id="id1e461fa117b9496a8c8191467995303f"><enum>(A)</enum><text display-inline="yes-display-inline">hemorrhage;</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idacfe3648a15f43728bd1ca859578fc28"><enum>(B)</enum><text display-inline="yes-display-inline">tension pneumothorax;</text>
 </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="iddf99a62a7f17489c8cdc39b1dfaba099"><enum>(C)</enum><text display-inline="yes-display-inline">amputation resulting from blast injury;</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id8d7c65e516d348008a96ffd319049387"><enum>(D)</enum><text display-inline="yes-display-inline">compromises to the airway; and</text>
 </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idc7d9e7fcc76541369c83042cebb6c0ad"><enum>(E)</enum><text display-inline="yes-display-inline">other injuries.</text> </subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id680a1aa471aa401ba6ae3b56f3c2e30d"><enum>(2)</enum><text display-inline="yes-display-inline">The term <term>human-based training methods</term> means, with respect to training individuals in medical treatment, the use of systems and devices that do not use animals, including—</text>
 <subparagraph commented="no" display-inline="no-display-inline" id="id61deb2cbcc4e43ed926ae465b1d7e331"><enum>(A)</enum><text display-inline="yes-display-inline">simulators;</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idd0db9026e23c429e8d398bd4402ee4cd"><enum>(B)</enum><text display-inline="yes-display-inline">partial task trainers;</text>
 </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id4a165b151a4b4617b0e2256375f549ef"><enum>(C)</enum><text display-inline="yes-display-inline">moulage;</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idf2fa1727dca64c049a0aa2db5162a101"><enum>(D)</enum><text display-inline="yes-display-inline">simulated combat environments;</text>
 </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idafacb2198e1b4e0fb9381052a2997055"><enum>(E)</enum><text display-inline="yes-display-inline">human cadavers; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id56617d931bd24a3aaf08d0c23b9998cd"><enum>(F)</enum><text display-inline="yes-display-inline">rotations in civilian and military trauma centers.</text>
 </subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id15eb8ffd13a6490dbd25979d68796fa1"><enum>(3)</enum><text display-inline="yes-display-inline">The term <term>partial task trainers</term> means training aids that allow individuals to learn or practice specific medical procedures.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection commented="no" display-inline="no-display-inline" id="id47e8e761a5864748ad8a490b638bc668"><enum>(b)</enum><header display-inline="yes-display-inline">Clerical amendment</header><text display-inline="yes-display-inline">The table of sections at the beginning of chapter 101 of such title is amended by adding at the end the following new item:</text>
				<quoted-block display-inline="no-display-inline" id="id9bf4c755-04f3-40db-ba19-6eacc12e0c4d" style="USC"><toc><toc-entry bold="off" idref="ida1dffbc4edfd4620bdd32e4583e9dbb5" level="section">2017. Use of human-based methods for certain medical training.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section></legis-body></bill>


