[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1538 Reported in House (RH)]






                                                  Union Calendar No. 39
110th CONGRESS
  1st Session
                                H. R. 1538

                      [Report No. 110-68, Part I]

  To amend title 10, United States Code, to improve the management of 
medical care, personnel actions, and quality of life issues for members 
  of the Armed Forces who are receiving medical care in an outpatient 
                    status, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 15, 2007

 Mr. Skelton (for himself, Mr. Hunter, Mr. Snyder, Mr. McHugh, and Mr. 
   Filner) introduced the following bill; which was referred to the 
   Committee on Armed Services, and in addition to the Committee on 
 Veterans' Affairs, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

                             March 23, 2007

    Reported from the Committee on Armed Services with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

                             March 23, 2007

 Additional sponsors: Mrs. Boyda of Kansas, Mr. Reyes, Mr. Johnson of 
   Georgia, Mr. Udall of Colorado, Mr. Abercrombie, Mr. Shuster, Mr. 
McIntyre, Mr. Miller of Florida, Mrs. Tauscher, Mr. Rogers of Alabama, 
 Mr. Saxton, Mrs. Davis of California, Mrs. Jo Ann Davis of Virginia, 
  Mr. Hayes, Mr. Delahunt, Mr. Graves, Mr. Bilbray, Ms. Berkley, Mr. 
 Souder, Mr. Gingrey, Mr. Walberg, Mr. Akin, Mr. Porter, and Ms. Harman

                             March 23, 2007

 Committee on Veterans' Affairs discharged; committed to the Committee 
 of the Whole House on the State of the Union and ordered to be printed
 [For text of introduced bill, see copy of bill as introduced on March 
                               15, 2007]

_______________________________________________________________________

                                 A BILL


 
  To amend title 10, United States Code, to improve the management of 
medical care, personnel actions, and quality of life issues for members 
  of the Armed Forces who are receiving medical care in an outpatient 
                    status, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Wounded Warrior 
Assistance Act of 2007''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Definitions.

                  TITLE I--WOUNDED WARRIOR ASSISTANCE

Sec. 101. Improvements to medical and dental care for members of the 
                            Armed Forces assigned to hospitals in an 
                            outpatient status.
Sec. 102. Establishment of toll-free hot line for reporting 
                            deficiencies in medical-related support 
                            facilities and expedited response to 
                            reports of deficiencies.
Sec. 103. Notification to Congress of hospitalization of combat wounded 
                            service members.
Sec. 104. Independent medical advocate for members before medical 
                            evaluation boards.
Sec. 105. Training and workload for physical evaluation board liaison 
                            officers.
Sec. 106. Standardized training program and curriculum for Department 
                            of Defense disability evaluation system.
Sec. 107. Improved training for health care professionals, medical care 
                            case managers, and service member advocates 
                            on particular conditions of recovering 
                            service members.
Sec. 108. Pilot program to establish an Army Wounded Warrior Battalion 
                            at an appropriate active duty base.
Sec. 109. Criteria for removal of member from temporary disability 
                            retired list.
Sec. 110. Improved transition of members of the Armed Forces to 
                            Department of Veterans Affairs upon 
                            retirement or separation.
Sec. 111. Establishment of Medical Support Fund for support of members 
                            of the Armed Forces returning to military 
                            service or civilian life.
Sec. 112. Oversight Board for Wounded Warriors.

                     TITLE II--STUDIES AND REPORTS

Sec. 201. Annual report on military medical facilities.
Sec. 202. Access of recovering service members to adequate outpatient 
                            residential facilities.
Sec. 203. Evaluation and report on Department of Defense and Department 
                            of Veterans Affairs disability evaluation 
                            systems.
Sec. 204. Study and report on support services for families of 
                            recovering service members.
Sec. 205. Report on traumatic brain injury classifications.
Sec. 206. Evaluation of the Polytrauma Liaison Officer/Non-Commissioned 
                            Officer Program.

                     TITLE III--GENERAL PROVISIONS

Sec. 301. Moratorium on conversion to contractor performance of 
                            Department of Defense functions at military 
                            medical facilities.
Sec. 302. Prohibition on transfer of resources from medical care.
Sec. 303. Increase in physicians at hospitals of the Department of 
                            Veterans Affairs.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Congressional defense committees.--The term 
        ``congressional defense committees'' has the meaning given that 
        term in section 101(a)(16) of title 10, United States Code.
            (2) Disability evaluation system.--The term ``disability 
        evaluation system'' means the Department of Defense system or 
        process for evaluating the nature of and extent of disabilities 
        affecting members of the armed forces (other than the Coast 
        Guard) and comprised of medical evaluation boards, physical 
        evaluation boards, counseling of members, and final disposition 
        by appropriate personnel authorities, as operated by the 
        Secretaries of the military departments, and, in the case of 
        the Coast Guard, a similar system or process operated by the 
        Secretary of Homeland Security.
            (3) Family member.--The term ``family member'', with 
        respect to a recovering service member, has the meaning given 
        that term in section 411h(b) of title 37, United States Code.
            (4) Recovering service member.--The term ``recovering 
        service member'' means a member of the Armed Forces, including 
        a member of the National Guard or a Reserve, who is undergoing 
        medical treatment, recuperation, or therapy, or is otherwise in 
        medical hold or holdover status, for an injury, illness, or 
        disease incurred or aggravated while on active duty in the 
        Armed Forces.

                  TITLE I--WOUNDED WARRIOR ASSISTANCE

SEC. 101. IMPROVEMENTS TO MEDICAL AND DENTAL CARE FOR MEMBERS OF THE 
              ARMED FORCES ASSIGNED TO HOSPITALS IN AN OUTPATIENT 
              STATUS.

    (a) Medical and Dental Care of Members Assigned to Hospitals in an 
Outpatient Status.--
            (1) In general.--Chapter 55 of title 10, United States 
        Code, is amended by inserting after section 1074k the following 
        new section:
``Sec. 1074l. Management of medical and dental care: members assigned 
              to receive care in an outpatient status
    ``(a) Medical Care Case Managers.--(1) A member in an outpatient 
status at a military medical treatment facility shall be assigned a 
medical care case manager.
    ``(2)(A) The duties of the medical care case manager shall include 
the following with respect to the member (or the member's immediate 
family if the member is incapable of making judgments about personal 
medical care):
            ``(i) To assist in understanding the member's medical 
        status.
            ``(ii) To assist in receiving prescribed medical care.
            ``(iii) To conduct a review, at least once a week, of the 
        member's medical status.
    ``(B) The weekly medical status review described in subparagraph 
(A)(iii) shall be conducted in person with the member. If such a review 
is not practicable, the medical care case manager shall provide a 
written statement to the case manager's supervisor indicating why an 
in-person medical status review was not possible.
    ``(3)(A) Except as provided in subparagraph (B), each medical care 
case manager shall be assigned to manage not more than 17 members in an 
outpatient status.
    ``(B) The Secretary concerned may waive for up to 120 days the 
requirement of subparagraph (A) if required due to unforeseen 
circumstances.
    ``(4)(A) The medical care case manager office at each facility 
shall be headed by a commissioned officer of appropriate rank and 
appropriate military occupation specialty, designator, or specialty 
code.
    ``(B) For purposes of subparagraph (A), an appropriate military 
occupation specialty, designator, or specialty code includes membership 
in the Army Medical Corps, Army Medical Service Corps, Army Nurse 
Corps, Navy Medical Corps, Navy Medical Service Corps, Navy Nurse 
Corps, or Air Force Medical Service.
    ``(5) The Secretary of Defense shall establish a standard training 
program and curriculum for medical care case managers. Successful 
completion of the training program is required before a person may 
assume the duties of a medical care case manager.
    ``(b) Service Member Advocate.--(1) A member in an outpatient 
status shall be assigned a service member advocate.
    ``(2) The duties of the service member advocate shall include--
            ``(A) communicating with the member and with the member's 
        family or other individuals designated by the member;
            ``(B) assisting with oversight of the member's welfare and 
        quality of life; and
            ``(C) assisting the member in resolving problems involving 
        financial, administrative, personnel, transitional, and other 
        matters.
    ``(3)(A) Except as provided in subparagraph (B), each service 
member advocate shall be assigned to not more than 30 members in an 
outpatient status.
    ``(B) The Secretary concerned may waive for up to 120 days the 
requirement of subparagraph (A) if required due to unforeseen 
circumstances.
    ``(4) The service member advocate office at each facility shall be 
headed by a commissioned officer of appropriate rank and appropriate 
military occupation specialty, designator, or specialty code in order 
to handle service-specific personnel and financial issues.
    ``(5) The Secretary of Defense shall establish a standard training 
program and curriculum for service member advocates. Successful 
completion of the training program is required before a person may 
assume the duties of a service member advocate.
    ``(6) A service member advocate shall continue to perform the 
duties described in paragraph (2) with respect to a member until the 
member is returned to duty or separated or retired from the armed 
forces.
    ``(c) Semiannual Surveys by Secretaries Concerned.--The Secretary 
concerned shall conduct a semiannual survey of members in an outpatient 
status at installations under the Secretary's supervision. The survey 
shall include, at a minimum, the members' assessment of the quality of 
medical care at the facility, the timeliness of medical care at the 
facility, the adequacy of living facilities and other quality of life 
programs, the adequacy of case management support, and the fairness and 
timeliness of the physical disability evaluation system. The survey 
shall be conducted in coordination with installation medical commanders 
and authorities, and shall be coordinated with such commanders and 
authorities before submission to the Secretary.
    ``(d) Definitions.--In this section:
            ``(1) The term `member in an outpatient status' means a 
        member of the armed forces assigned to a military medical 
        treatment facility as an outpatient or to a unit established 
        for the purpose of providing command and control of members 
        receiving medical care as outpatients.
            ``(2) The term `disability evaluation system' means the 
        Department of Defense system or process for evaluating the 
        nature of and extent of disabilities affecting members of the 
        armed forces (other than the Coast Guard) and comprised of 
        medical evaluation boards, physical evaluation boards, 
        counseling of members, and final disposition by appropriate 
        personnel authorities, as operated by the Secretaries of the 
        military departments, and, in the case of the Coast Guard, a 
        similar system or process operated by the Secretary of Homeland 
        Security.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of such chapter is amended by adding at the end the 
        following new item:

``1074l. Management of medical and dental care: members assigned to 
                            receive care in an outpatient status.''.
    (b) Effective Date.--Section 1074l of title 10, United States Code, 
as added by subsection (a), shall take effect 180 days after the date 
of the enactment of this Act.

SEC. 102. ESTABLISHMENT OF TOLL-FREE HOT LINE FOR REPORTING 
              DEFICIENCIES IN MEDICAL-RELATED SUPPORT FACILITIES AND 
              EXPEDITED RESPONSE TO REPORTS OF DEFICIENCIES.

    (a) Establishment.--Chapter 80 of title 10, United States Code, is 
amended by adding at the end the following new section:
``Sec. 1567. Identification and investigation of deficiencies in 
              adequacy, quality, and state of repair of medical-related 
              support facilities
    ``(a) Toll-Free Hot Line.--The Secretary of Defense shall establish 
and maintain a toll-free telephone number (commonly referred to as a 
`hot line') at which personnel are accessible at all times to collect, 
maintain, and update information regarding possible deficiencies in the 
adequacy, quality, and state of repair of medical-related support 
facilities. The Secretary shall widely disseminate information 
regarding the existence and availability of the toll-free telephone 
number to members of the armed forces and their dependents.
    ``(b) Investigation and Response Plan.--Not later than 96 hours 
after a report of deficiencies in the adequacy, quality, or state of 
repair of a medical-related support facility is received by way of the 
toll-free telephone number or other source, the Secretary of Defense 
shall ensure that--
            ``(1) the deficiencies referred to in the report are 
        investigated; and
            ``(2) if substantiated, a plan of action for remediation of 
        the deficiencies is developed and implemented.
    ``(c) Relocation.--If the Secretary of Defense determines, on the 
basis of the investigation conducted in response to a report of 
deficiencies at a medical-related support facility, that conditions at 
the facility violate health and safety standards, the Secretary shall 
relocate the occupants of the facility while the violations are 
corrected.
    ``(d) Medical-Related Support Facility Defined.--In this section, 
the term `medical-related support facility' means any facility of the 
Department of Defense that provides support to any of the following:
            ``(1) Members of the armed forces admitted for treatment to 
        a military medical treatment facility.
            ``(2) Members of the armed forces assigned to a military 
        medical treatment facility as an outpatient.
            ``(3) Family members accompanying any member described in 
        paragraph (1) or (2) as a nonmedical attendant.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding at the end the following new item:

``1567. Identification and investigation of deficiencies in adequacy, 
                            quality, and state of repair of medical-
                            related support facilities.''.
    (c) Effective Date.--The toll-free telephone number required to be 
established by section 1567 of title 10, United States Code, as added 
by subsection (a), shall be fully operational not later than 180 days 
after the date of the enactment of this Act.

SEC. 103. NOTIFICATION TO CONGRESS OF HOSPITALIZATION OF COMBAT WOUNDED 
              SERVICE MEMBERS.

    (a) Notification Required.--Chapter 55 of title 10, United States 
Code, is further amended by inserting after section 1074l the following 
new section:
``Sec. 1074m. Notification to Congress of hospitalization of combat 
              wounded members
    ``(a) Notification Required.--The Secretary concerned shall provide 
notification of the hospitalization of any member of the armed forces 
evacuated from a theater of combat to the appropriate Members of 
Congress.
    ``(b) Appropriate Members.--In this section, the term `appropriate 
Members of Congress', with respect to the member of the armed forces 
about whom notification is being made, means the Senators and the 
Members of the House of Representatives representing the States or 
districts, respectively, that include the member's home of record and, 
if different, the residence of the next of kin, or a different location 
as provided by the member.
    ``(c) Consent of Member Required.--The notification under 
subsection (a) may be provided only with the consent of the member of 
the armed forces about whom notification is to be made. In the case of 
a member who is unable to provide consent, information and consent may 
be provided by next of kin.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding at the end the following new item:

``1074m. Notification to Congress of hospitalization of combat wounded 
                            members.''.

SEC. 104. INDEPENDENT MEDICAL ADVOCATE FOR MEMBERS BEFORE MEDICAL 
              EVALUATION BOARDS.

    (a) Assignment of Independent Medical Advocate.--Section 1222 of 
title 10, United States Code, is amended by adding at the end the 
following new subsection:
    ``(d) Independent Medical Advocate for Members Before Medical 
Evaluation Boards.--(1) The Secretary of each military department shall 
ensure, in the case of any member of the armed forces being considered 
by a medical evaluation board under that Secretary's supervision, that 
the member has access to a physician or other appropriate health care 
professional who is independent of the medical evaluation board.
    ``(2) The physician or other health care professional assigned to a 
member shall--
            ``(A) serve as an advocate for the best interests of the 
        member; and
            ``(B) provide the member with advice and counsel regarding 
        the medical condition of the member and the findings and 
        recommendations of the medical evaluation board.''.
    (b) Clerical Amendments.--
            (1) Section heading.--The heading of such section is 
        amended to read as follows:
``Sec. 1222. Physical evaluation boards and medical evaluation 
              boards''.
            (2) Table of sections.--The table of sections at the 
        beginning of chapter 61 of such title is amended by striking 
        the item relating to section 1222 and inserting the following 
        new item:

``1222. Physical evaluation boards and medical evaluation boards.''.
    (c) Effective Date.--Subsection (d) of section 1222 of title 10, 
United States Code, as added by subsection (a), shall apply with 
respect to medical evaluation boards convened after the end of the 180-
day period beginning on the date of the enactment of this Act.

SEC. 105. TRAINING AND WORKLOAD FOR PHYSICAL EVALUATION BOARD LIAISON 
              OFFICERS.

    (a) Requirements.--Section 1222(b) of title 10, United States Code, 
is amended--
            (1) in paragraph (1)--
                    (A) by striking ``establishing--'' and all that 
                follows through ``a requirement'' and inserting 
                ``establishing a requirement''; and
                    (B) by striking ``that Secretary; and'' and all 
                that follows through the end of subparagraph (B) and 
                inserting ``that Secretary. A physical evaluation board 
                liaison officer may not be assigned more than 20 
                members at any one time, except that the Secretary 
                concerned may authorize the assignment of additional 
                members, for not more than 120 days, if required due to 
                unforeseen circumstances.'';
            (2) in paragraph (2), by inserting after ``(2)'' the 
        following new sentences: ``The Secretary of Defense shall 
        establish a standardized training program and curriculum for 
        physical evaluation board liaison officers. Successful 
        completion of the training program is required before a person 
        may assume the duties of a physical evaluation board liaison 
        officer.''; and
            (3) by adding at the end the following new paragraph:
    ``(3) In this subsection, the term `physical evaluation board 
liaison officer' includes any person designated as, or assigned the 
duties of, an assistant to a physical evaluation board liaison 
officer.''.
    (b) Effective Date.--The limitation on the maximum number of 
members of the Armed Forces who may be assigned to a physical 
evaluation board liaison officer shall take effect 180 days after the 
date of the enactment of this Act. The training program and curriculum 
for physical evaluation board liaison officers shall be implemented not 
later than 180 days after the date of the enactment of this Act.

SEC. 106. STANDARDIZED TRAINING PROGRAM AND CURRICULUM FOR DEPARTMENT 
              OF DEFENSE DISABILITY EVALUATION SYSTEM.

    (a) Training Program Required.--Section 1216 of title 10, United 
States Code, is amended by adding at the end the following new 
subsection:
    ``(e)(1) The Secretary of Defense shall establish a standardized 
training program and curriculum for persons described in paragraph (2) 
who are involved in the disability evaluation system. The training 
under the program shall be provided as soon as practicable in 
coordination with other training associated with the responsibilities 
of the person.
    ``(2) Persons covered by paragraph (1) include--
            ``(A) Commanders.
            ``(B) Enlisted members who perform supervisory functions.
            ``(C) Health care professionals.
            ``(D) Others persons with administrative, professional, or 
        technical responsibilities in the disability evaluation system.
    ``(3) In this subsection, the term `disability evaluation system' 
means the Department of Defense system or process for evaluating the 
nature of and extent of disabilities affecting members of the armed 
forces (other than the Coast Guard) and comprised of medical evaluation 
boards, physical evaluation boards, counseling of members, and final 
disposition by appropriate personnel authorities, as operated by the 
Secretaries of the military departments, and, in the case of the Coast 
Guard, a similar system or process operated by the Secretary of 
Homeland Security.''.
    (b) Effective Date.--The standardized training program and 
curriculum required by subsection (e) of section 1216 of title 10, 
United States Code, as added by subsection (a), shall be established 
not later than 180 days after the date of the enactment of this Act.

SEC. 107. IMPROVED TRAINING FOR HEALTH CARE PROFESSIONALS, MEDICAL CARE 
              CASE MANAGERS, AND SERVICE MEMBER ADVOCATES ON PARTICULAR 
              CONDITIONS OF RECOVERING SERVICE MEMBERS.

    (a) Recommendations.--Not later than 90 days after the date of the 
enactment of this Act, the Secretary of Defense shall submit to the 
appropriate congressional committees a report setting forth 
recommendations for the modification of the training provided to health 
care professionals, medical care case managers, and service member 
advocates who provide care for or assistance to recovering service 
members. The recommendations shall include, at a minimum, specific 
recommendations to ensure that such health care professionals, medical 
care case managers, and service member advocates are able to detect 
early warning signs of post-traumatic stress disorder (PTSD), suicidal 
tendencies, and other mental health conditions among recovering service 
members, and make prompt notification to the appropriate health care 
professionals.
    (b) Annual Review of Training.--Not later than 180 days after the 
date of the enactment of this Act and annually thereafter throughout 
the global war on terror, the Secretary shall submit to the appropriate 
congressional committees a report on the following:
            (1) The progress made in providing the training recommended 
        under subsection (a).
            (2) The quality of training provided to health care 
        professionals, medical care case managers, and service member 
        advocates, and the number of such professionals, managers, and 
        advocates trained.
    (c) Tracking System.--The Secretary shall develop a system to track 
the number of notifications made by medical care case managers and 
service member advocates to health care professionals regarding early 
warning signs of post-traumatic stress disorder and suicide in 
recovering service members assigned to the managers and advocates.

SEC. 108. PILOT PROGRAM TO ESTABLISH AN ARMY WOUNDED WARRIOR BATTALION 
              AT AN APPROPRIATE ACTIVE DUTY BASE.

    (a) Pilot Program Required.--
            (1) Establishment.--The Secretary of the Army shall 
        establish a pilot program, at an appropriate active duty base 
        with a major medical facility, based on the Wounded Warrior 
        Regiment program of the Marine Corps. The pilot program shall 
        be known as the Army Wounded Warrior Battalion.
            (2) Purpose.--Under the pilot program, the Battalion shall 
        track and assist members of the Armed Forces in an outpatient 
        status who are still in need of medical treatment through--
                    (A) the course of their treatment;
                    (B) medical and physical evaluation boards;
                    (C) transition back to their parent units; and
                    (D) medical retirement and subsequent transition 
                into the Department of Veterans Affairs medical system.
            (3) Organization.--The commanding officer of the Battalion 
        shall be selected by the Army Chief of Staff and shall be a 
        post-command, at O-5 or O-5 select, with combat experience in 
        Operation Iraqi Freedom or Operation Enduring Freedom. The 
        chain-of-command shall be filled by previously wounded junior 
        officers and non-commissioned officers when available and 
        appropriate.
            (4) Facilities.--The base selected for the pilot program 
        shall provide adequate physical infrastructure to house the 
        Army Wounded Warrior Battalion. Any funds necessary for 
        construction or renovation of existing facilities shall be 
        allocated from the Department of Defense Medical Support Fund 
        established under this Act.
            (5) Coordination.--The Secretary of the Army shall consult 
        with appropriate Marine Corps counterparts to ensure 
        coordination of best practices and lessons learned.
            (6) Period of pilot program.--The pilot program shall be in 
        effect for a period of one year.
    (b) Reporting Requirement.--Not later than 90 days after the end of 
the one-year period for the pilot project, the Secretary of the Army 
shall submit to Congress a report containing--
            (1) an evaluation of the results of the pilot project;
            (2) an assessment of the Army's ability to establish 
        Wounded Warrior Battalions at other major Army bases.
            (3) recommendations regarding--
                    (A) the adaptability of the Wounded Warrior 
                Battalion concept for the Army's larger wounded 
                population; and
                    (B) closer coordination and sharing of resources 
                with counterpart programs of the Marine Corps.
    (c) Effective Date.--The pilot program required by this section 
shall be implemented not later than 180 days after the date of the 
enactment of this Act.

SEC. 109. CRITERIA FOR REMOVAL OF MEMBER FROM TEMPORARY DISABILITY 
              RETIRED LIST.

    (a) Criteria.--Section 1210(e) of title 10, United States Code, is 
amended by inserting ``of a permanent nature and stable and is'' after 
``physical disability is''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to any case received for consideration by a physical evaluation 
board after the date of the enactment of this Act.

SEC. 110. IMPROVED TRANSITION OF MEMBERS OF THE ARMED FORCES TO 
              DEPARTMENT OF VETERANS AFFAIRS UPON RETIREMENT OR 
              SEPARATION.

    (a) Transition of Members Separated or Retired.--
            (1) Transition process.--Chapter 58 of title 10, United 
        States Code, is amended by inserting after section 1142 the 
        following new section:
``Sec. 1142a. Process for transition of members to health care and 
              physical disability systems of Department of Veterans 
              Affairs
    ``(a) Transition Plan.--(1) The Secretary of Defense shall ensure 
that each member of the armed forces who is being separated or retired 
under chapter 61 of this title receives a written transition plan 
that--
            ``(A) specifies the recommended schedule and milestones for 
        the transition of the member from military service; and
            ``(B) provides for a coordinated transition of the member 
        from the Department of Defense disability system to the 
        Department of Veterans Affairs.
    ``(2) A member being separated or retired under chapter 61 of this 
title shall receive the transition plan before the separation or 
retirement date of the member.
    ``(3) The transition plan for a member under this subsection shall 
include information and guidance designed to assist the member in 
understanding and meeting the schedule and milestones for the member's 
transition.
    ``(b) Formal Transition Process.--(1) The Secretary of Defense, in 
cooperation with the Secretary of Veterans Affairs, shall establish a 
formal process for the transmittal to the Secretary of Veterans Affairs 
of the records and other information described in paragraph (2) as part 
of the separation or retirement of a member of the armed forces under 
chapter 61 of this title.
    ``(2) The records and other information to be transmitted under 
paragraph (1) with respect to a member shall include, at a minimum, the 
following:
            ``(A) The member's address and contact information.
            ``(B) The member's DD-214 discharge form, which shall be 
        transmitted electronically.
            ``(C) A copy of the member's service record, including 
        medical records and any results of a Physical Evaluation Board.
            ``(D) Whether the member is entitled to transitional health 
        care, a conversion health policy, or other health benefits 
        through the Department of Defense under section 1145 of this 
        title.
            ``(E) Any requests by the 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 member may be eligible under 
        laws administered by the Secretary of Veterans Affairs.
            ``(F) Any requests by the member for assistance in applying 
        for, or completed applications for, compensation and vocational 
        rehabilitation benefits to which the member may be entitled 
        under laws administered by the Secretary of Veterans Affairs, 
        if the member is being medically separated or is being retired 
        under chapter 61 of this title.
    ``(3) The transmittal of information under paragraph (1) may be 
subject to the consent of the member, as required by statute.
    ``(4) With the consent of the member, the member's address and 
contact information shall also be submitted to the department or agency 
for veterans affairs of the State in which the member intends to reside 
after the separation or retirement of the member.
    ``(c) Meeting.--(1) The formal process required by subsection (b) 
for the transmittal of records and other information with respect to a 
member shall include a meeting between representatives of the Secretary 
concerned and the Secretary of Veterans Affairs, which shall take place 
at a location designated by the Secretaries. The member shall be 
informed of the meeting at least 30 days in advance of the meeting, 
except that the member may waive the notice requirement in order to 
accelerate transmission of the member's records and other information 
to the Department of Veterans Affairs.
    ``(2) A member shall be given an opportunity to submit a written 
statement for consideration by the Secretary of Veterans Affairs.
    ``(d) Time for Transmittal of Records.--The Secretary concerned 
shall provide for the transmittal to the Department of Veterans Affairs 
of records and other information with respect to a member at the 
earliest practicable date. In no case should the transmittal occur 
later than the date of the separation or retirement of the member.
    ``(e) Armed Forces.--In this section, the term `armed forces' means 
the Army, Navy, Air Force, and Marine Corps.''.
            (2) Table of sections.--The table of sections at the 
        beginning of such chapter is amended by inserting after the 
        item relating to section 1142 the following new item:

``1142a. Process for transition of members to health care and physical 
                            disability systems of Department of 
                            Veterans Affairs.''.
    (b) Uniform Separation and Evaluation Physical.--Section 1145 of 
such title is amended--
            (1) by redesignating subsections (d) and (e) as subsections 
        (e) and (f), respectively; and
            (2) by inserting after subsection (c) the following new 
        subsection:
    ``(d) Uniform Separation and Evaluation Physical.--The joint 
separation and evaluation physical, as described in DD-2808 and DD-
2697, shall be used by the Secretary of Defense in connection with the 
medical separation or retirement of all members of the armed forces, 
including members separated or retired under chapter 61 of this title. 
The Secretary of Veterans Affairs shall adopt the same separation and 
evaluation physical for use by the Department of Veterans Affairs.''.
    (c) Interoperability of Medical Information Systems and Bi-
Directional Access.--The Secretary of Defense and the Secretary of 
Veterans Affairs shall establish and implement a single medical 
information system for the Department of Defense and the Department of 
Veterans Affairs for the purpose of ensuring the complete 
interoperability and bi-directional, real-time exchange of critical 
medical information.
    (d) Co-Location of VA Benefit Teams.--
            (1) Co-location.--The Secretary of Defense and the 
        Secretary of Veterans Affairs shall jointly determine the 
        optimal locations for the deployment of Department of Veterans 
        Affairs benefits team to support recovering service members 
        assigned to military medical treatment facilities, medical-
        related support facilities, and community-based health care 
        organizations.
            (2) Military medical treatment facility defined.--In this 
        subsection, the term ``medical-related support facility'' has 
        the meaning given that term in subsection (b) of section 490 of 
        title 10, United States Code, as added by section 201(a) of 
        this Act.
    (e) Repeal of Superseded Chapter 61 Medical Record Transmittal 
Requirement.--
            (1) Repeal.--Section 1142 of such title is amended by 
        striking subsection (c).
            (2) Section heading.--The heading of such section is 
        amended to read as follows:
``Sec. 1142. Preseparation counseling''.
            (3) Table of sections.--The table of sections at the 
        beginning of chapter 58 of such title is amended by striking 
        the item relating to section 1142 and inserting the following 
        new item:

``1142. Preseparation counseling.''.
    (f) Effective Dates.--Section 1142a of title 10, United States 
Code, as added by subsection (a), and subsection (d) of section 1145 of 
such title, as added by subsection (b), shall apply with respect to 
members of the Armed Forces who are separated or retired from the Armed 
Forces on or after the first day of the eighth month beginning after 
the date of the enactment of this Act. The requirements of subsections 
(c) and (d), and the amendments made by subsection (e), shall take 
effect on the first day of such eighth month.

SEC. 111. ESTABLISHMENT OF MEDICAL SUPPORT FUND FOR SUPPORT OF MEMBERS 
              OF THE ARMED FORCES RETURNING TO MILITARY SERVICE OR 
              CIVILIAN LIFE.

    (a) Establishment and Purpose.--There is established on the books 
of the Treasury a fund to be known as the Department of Defense Medical 
Support Fund (hereinafter in this section referred to as the ``Fund''), 
which shall be administered by the Secretary of the Treasury.
    (b) Purposes.--The Fund shall be used--
            (1) to support programs and activities relating to the 
        medical treatment, care, rehabilitation, recovery, and support 
        of wounded and injured members of the Armed Forces and their 
        return to military service or transition to civilian society; 
        and
            (2) to support programs and facilities intended to support 
        the families of wounded and injured members of the Armed 
        Forces.
    (c) Assets of Fund.--There shall be deposited into the Fund any 
amount appropriated to the Fund, which shall constitute the assets of 
the Fund.
    (d) Transfer of Funds.--
            (1) Authority to transfer.--The Secretary of Defense may 
        transfer amounts in the Fund to appropriations accounts for 
        military personnel; operation and maintenance; procurement; 
        research, development, test, and evaluation; military 
        construction; and the Defense Health Program. Amounts so 
        transferred shall be merged with and available for the same 
        purposes and for the same time period as the appropriation 
        account to which transferred.
            (2) Addition to other authority.--The transfer authority 
        provided in paragraph (1) is in addition to any other transfer 
        authority available to the Department of Defense. Upon a 
        determination that all or part of the amounts transferred from 
        the Fund are not necessary for the purposes for which 
        transferred, such amounts may be transferred back to the Fund.
            (3) Notification.--The Secretary of Defense shall, not 
        fewer than five days before making a transfer from the Fund, 
        notify the congressional defense committees in writing of the 
        details of the transfer.
    (e) Authorization.--There is hereby authorized to be appropriated 
to the Medical Support Fund, from an emergency supplemental 
appropriation for fiscal year 2007 or 2008, $50,000,000, to remain 
available through September 30, 2008.

SEC. 112. OVERSIGHT BOARD FOR WOUNDED WARRIORS.

    (a) Establishment.--There is hereby established a board to be known 
as the Oversight Board for Wounded Warriors (in this section referred 
to as the ``Oversight Board'').
    (b) Composition.--The Oversight Board shall be composed of 12 
members, of whom--
            (1) two shall be appointed by the majority leader of the 
        Senate;
            (2) two shall be appointed by the minority leader of the 
        Senate;
            (3) two shall be appointed by the Speaker of the House of 
        Representatives;
            (4) two shall be appointed by the minority leader of the 
        House of Representatives;
            (5) two shall be appointed by the Secretary of Veterans 
        Affairs; and
            (6) two shall be appointed by the Secretary of Defense.
    (c) Qualifications.--All members of the Oversight Board shall have 
sufficient knowledge of, or experience with, the military healthcare 
system, the disability evaluation system, or the experience of a 
recovering service member or family member of a recovering service 
member.
    (d) Appointment.--
            (1) Term.--Each member of the Oversight Board shall be 
        appointed for a term of three years. A member may be 
        reappointed for one or more additional terms.
            (2) Vacancies.--Any vacancy in the Oversight Board shall be 
        filled in the same manner in which the original appointment was 
        made.
    (e) Duties.--
            (1) Advice and consultation.--The Oversight Board shall 
        provide advice and consultation to the Secretary of Defense and 
        the Committees on Armed Services of the Senate and the House of 
        Representatives regarding--
                    (A) the process for streamlining the disability 
                evaluation systems of the military departments;
                    (B) the process for correcting and improving the 
                ratios of case managers and service member advocates to 
                recovering service members;
                    (C) the need to revise Department of Defense 
                policies to improve the experience of recovering 
                service members while under Department of Defense care;
                    (D) the need to revise Department of Defense 
                policies to improve counseling, outreach, and general 
                services provided to family members of recovering 
                service members;
                    (E) the need to revise Department of Defense 
                policies regarding the provision of quality lodging to 
                recovering service members; and
                    (F) such other matters relating to the evaluation 
                and care of recovering service members, including 
                evaluation under disability evaluation systems, as the 
                Board considers appropriate.
            (2) Visits to military medical treatment facilities.--In 
        carrying out its duties, each member of the Oversight Board 
        shall visit not less than three military medical treatment 
        facilities each year, and the Board shall conduct each year one 
        meeting of all the members of the Board at a military medical 
        treatment facility.
    (f) Staff.--The Secretary shall make available the services of at 
least two officials or employees of the Department of Defense to 
provide support and assistance to members of the Oversight Board.
    (g) Travel Expenses.--Members of the Oversight Board shall be 
allowed travel expenses, including per diem in lieu of subsistence, at 
rates authorized for employees of agencies under subchapter I of 
chapter 57 of title 5, United States Code, while away from their homes 
or regular places of business in the performance of service for the 
Oversight Board.
    (h) Annual Reports.--The Oversight Board shall submit to the 
Secretary of Defense and the Committees on Armed Services of the Senate 
and the House of Representatives each year a report on its activities 
during the preceding year, including any findings and recommendations 
of the Oversight Board as a result of such activities.

                     TITLE II--STUDIES AND REPORTS

SEC. 201. ANNUAL REPORT ON MILITARY MEDICAL FACILITIES.

    (a) In General.--
            (1) Report requirement.--Chapter 23 of title 10, United 
        States Code, is amended by adding at the end the following new 
        section:
``Sec. 490. Annual report on military medical facilities
    ``(a) Annual Report.--Not later than the date on which the 
President submits the budget for a fiscal year to Congress pursuant to 
section 1105 of title 31, the Secretary of Defense shall submit to the 
Committees on Armed Services of the Senate and the House of 
Representatives a report on the adequacy, suitability, and quality of 
medical facilities and medical-related support facilities at each 
military installation within the Department of Defense.
    ``(b) Response to Hot-Line Information.--The Secretary of Defense 
shall include in each report information regarding--
            ``(1) any deficiencies in the adequacy, quality, or state 
        of repair of medical-related support facilities raised as a 
        result of information received during the period covered by the 
        report through the toll-free hot line maintained pursuant to 
        section 1567 of this title; and
            ``(2) the investigations conducted and plans of action 
        prepared under such section to respond to such deficiencies.
    ``(c) Medical-Related Support Facility.--In this section, the term 
`medical-related support facility' is any facility of the Department of 
Defense that provides support to any of the following:
            ``(1) Members of the armed forces admitted for treatment to 
        military medical treatment facilities.
            ``(2) Members of the armed forces assigned to military 
        medical treatment facilities as an outpatient.
            ``(3) Family members accompanying any member described in 
        paragraph (1) or (2) as a nonmedical attendant.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of such chapter is amended by adding at the end the 
        following new item:

``490. Annual report on military medical facilities.''.
    (b) Effective Date.--The first report under section 490 of title 
10, United States Code, as added by subsection (a), shall be submitted 
not later than the date of submission of the budget for fiscal year 
2009.

SEC. 202. ACCESS OF RECOVERING SERVICE MEMBERS TO ADEQUATE OUTPATIENT 
              RESIDENTIAL FACILITIES.

    (a) Required Inspections of 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 on a semiannual basis for the first two years after the 
enactment of this Act and annually thereafter by the inspectors general 
of the regional medical commands.
    (b) Inspector General Reports.--The inspector general for each 
regional medical command shall--
            (1) submit a report on each inspection of a facility 
        conducted under subsection (a) to the post commander at such 
        facility, the commanding officer of the hospital affiliated 
        with such facility, the surgeon general of the military 
        department that operates such hospital, the Secretary of the 
        military department concerned, the Assistant Secretary of 
        Defense for Health Affairs, the Oversight Board for Wounded 
        Warriors established pursuant to section 112, and the 
        appropriate congressional committees; and
            (2) post each such report on the Internet website of such 
        regional medical command.

SEC. 203. EVALUATION AND REPORT ON DEPARTMENT OF DEFENSE AND DEPARTMENT 
              OF VETERANS AFFAIRS DISABILITY EVALUATION SYSTEMS.

    (a) Evaluation.--The Secretary of Defense and the Secretary of 
Veterans Affairs shall conduct a joint evaluation of the disability 
evaluation systems used by the Department of Defense and the Department 
of Veterans Affairs for the purpose of--
            (1) improving the consistency of the two disability 
        evaluation systems; and
            (2) evaluating the feasibility of, and potential options 
        for, consolidating the two systems.
    (b) Relation to Veterans' Disability Benefits Commission.--In 
conducting the evaluation of the disability evaluation systems used by 
the Department of Defense and the Department of Veterans Affairs, the 
Secretary of Defense and the Secretary of Veterans Affairs shall 
consider the findings and recommendations of the Veterans' Disability 
Benefits Commission established pursuant to title XV of the National 
Defense Authorization Act for Fiscal Year 2004 (Public Law 108-136; 38 
U.S.C. 1101 note).
    (c) Report.--Not later than 180 days after the date of the 
submission of the final report of the Veterans' Disability Benefits 
Commission, the Secretary of Defense and the Secretary of Veterans 
Affairs shall submit to Congress a report containing--
            (1) the results of the evaluation; and
            (2) the recommendations of the Secretaries for improving 
        the consistency of the two disability evaluation systems and 
        such other recommendations as the Secretaries consider 
        appropriate.

SEC. 204. STUDY AND REPORT ON SUPPORT SERVICES FOR FAMILIES OF 
              RECOVERING SERVICE MEMBERS.

    (a) Study Required.--The Secretary of Defense shall conduct a study 
of the provision of support services for families of recovering service 
members.
    (b) Matters Covered.--The study under subsection (a) shall include 
the following:
            (1) A determination of the types of support services that 
        are currently provided by the Department of Defense to family 
        members described in subsection (c), and the cost of providing 
        such services.
            (2) A determination of additional types of support services 
        that would be feasible for the Department to provide to such 
        family members, and the costs of providing such services, 
        including the following types of services:
                    (A) The provision of medical care at military 
                medical treatment facilities.
                    (B) The provision of job placement services offered 
                by the Department of Defense to any family member 
                caring for a recovering service member for more than 45 
                days during a one-year period.
                    (C) The provision of meals without charge at 
                military medical treatment facilities.
            (3) A survey of military medical treatment facilities to 
        estimate the number of family members to whom the support 
        services would be provided.
            (4) A determination of any discrimination in employment 
        that such family members experience, including denial of 
        retention in employment, promotion, or any benefit of 
        employment by an employer on the basis of the person's absence 
        from employment as described in subsection (c), and a 
        determination, in consultation with the Secretary of Labor, of 
        the options available for such family members.
    (c) Covered Family Members.--A family member described in this 
subsection is a family member of a recovering service member who is--
            (1) on invitational orders while caring for the recovering 
        service member;
            (2) a non-medical attendee caring for the recovering 
        service member; or
            (3) receiving per diem payments from the Department of 
        Defense while caring for the recovering service member.
    (d) Report.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Defense shall submit to the 
Committees on Armed Services of the Senate and the House of 
Representatives a report on the results of the study, with such 
findings and recommendations as the Secretary considers appropriate.

SEC. 205. REPORT ON TRAUMATIC BRAIN INJURY CLASSIFICATIONS.

    (a) Interim Report.--Not later than 90 days after the date of the 
enactment of this Act, the Secretary of Defense shall submit to the 
Committees on Armed Services of the Senate and the House of 
Representatives an interim report describing the changes undertaken 
within the Department of Defense to ensure that traumatic brain injury 
victims receive a proper medical designation concomitant with their 
injury as opposed to the current medical designation which assigns a 
generic ``organic psychiatric disorder'' classification.
    (b) Final Report.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Defense shall submit to the 
Committees on Armed Services of the Senate and the House of 
Representatives a final report concerning traumatic brain injury 
classifications and an explanation and justification of the 
Department's use of the international classification of disease (ICD) 9 
designation, recommendations for transitioning to ICD 10 or 11, and the 
benefits the civilian community experiences from using ICD 10.

SEC. 206. EVALUATION OF THE POLYTRAUMA LIAISON OFFICER/NON-COMMISSIONED 
              OFFICER PROGRAM.

    (a) Evaluation Required.--The Secretary of Defense shall conduct an 
evaluation of the Polytrauma Liaison Officer/Non-Commissioned Officer 
program, which is the program operated by each of the military 
departments and the Department of Veterans Affairs for the purpose of--
            (1) assisting in the seamless transition of members of the 
        Armed Forces from the Department of Defense health care system 
        to the Department of Veterans Affairs system; and
            (2) expediting the flow of information and communication 
        between military treatment facilities and the Veterans Affairs 
        Polytrauma Centers.
    (b) Matters Covered.--The evaluation of the Polytrauma Liaison 
Officer/Non-Commissioned Officer program shall include evaluating the 
following areas:
            (1) The program's effectiveness in the following areas:
                    (A) Handling of military patient transfers.
                    (B) Ability to access military records in a timely 
                manner.
                    (C) Collaboration with Polytrauma Center treatment 
                teams.
                    (D) Collaboration with Veteran Service 
                Organizations.
                    (E) Functioning as the Polytrauma Center's subject-
                matter expert on military issues.
                    (F) Supporting and assisting family members.
                    (G) Providing education, information, and referrals 
                to members of the Armed Forces and their family 
                members.
                    (H) Functioning as uniformed advocates for members 
                of the Armed Forces and their family members.
                    (I) Inclusion in Polytrauma Center meetings.
                    (J) Completion of required administrative 
                reporting.
                    (K) Ability to provide necessary administrative 
                support to all members of the Armed Forces.
            (2) Manpower requirements to effectively carry out all 
        required functions of the Polytrauma Liaison Officer/Non-
        Commissioned Officer program given current and expected case 
        loads.
            (3) Expansion of the program to incorporate Navy and Marine 
        Corps officers and senior enlisted personnel.
    (c) Reporting Requirement.--Not later than 90 days after the date 
of the enactment of this Act, the Secretary of Defense shall submit to 
Congress a report containing--
            (1) the results of the evaluation; and
            (2) recommendations for any improvements in the program.

                     TITLE III--GENERAL PROVISIONS

SEC. 301. MORATORIUM ON CONVERSION TO CONTRACTOR PERFORMANCE OF 
              DEPARTMENT OF DEFENSE FUNCTIONS AT MILITARY MEDICAL 
              FACILITIES.

    (a) Findings.--Congress finds the following:
            (1) The conduct of public-private competitions for the 
        performance of Department of Defense functions, based on Office 
        of Management and Budget Circular A-76, can lead to dramatic 
        reductions in the workforce, undermining an agency's ability to 
        perform its mission.
            (2) The Army Garrison commander at the Walter Reed Army 
        Medical Center has stated that the extended A-76 competition 
        process contributed to the departure of highly skilled 
        administrative and maintenance personnel, which led to the 
        problems at the Walter Reed Army Medical Center.
    (b) Moratorium.--During the one-year period beginning on the date 
of the enactment of this Act, no study or competition may be begun or 
announced pursuant to section 2461 of title 10, United States Code, or 
otherwise pursuant to Office of Management and Budget Circular A-76 
relating to the possible conversion to performance by a contractor of 
any Department of Defense function carried out at a military medical 
facility .
    (c) Report Required.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Defense shall submit to the 
Committee on Armed Services of the Senate and the Committee on Armed 
Services of the House of Representatives a report on the public-private 
competitions being conducted for Department of Defense functions 
carried out at military medical facilities as of the date of the 
enactment of this Act by each military department and defense agency. 
Such report shall include--
            (1) for each such competition--
                    (A) the cost of conducting the public-private 
                competition;
                    (B) the number of military personnel and 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;
            (2) a description of any public-private competition the 
        Secretary would conduct if the moratorium under subsection (b) 
        were not in effect; and
            (3) 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.

SEC. 302. 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 Act or the amendments made by this Act.

SEC. 303. INCREASE IN PHYSICIANS AT HOSPITALS OF THE DEPARTMENT OF 
              VETERANS AFFAIRS.

    The Secretary of Veterans Affairs shall increase the number of 
resident physicians at hospitals of the Department of Veterans Affairs.
                                                  Union Calendar No. 39

110th CONGRESS

  1st Session

                               H. R. 1538

                      [Report No. 110-68, Part I]

_______________________________________________________________________

                                 A BILL

  To amend title 10, United States Code, to improve the management of 
medical care, personnel actions, and quality of life issues for members 
  of the Armed Forces who are receiving medical care in an outpatient 
                    status, and for other purposes.

_______________________________________________________________________

                             March 23, 2007

    Reported from the Committee on Armed Services with an amendment

                             March 23, 2007

 Committee on Veterans' Affairs discharged; committed to the Committee 
 of the Whole House on the State of the Union and ordered to be printed