II 110th CONGRESS 1st Session S. 1044 IN THE SENATE OF THE UNITED STATES March 29, 2007 Mr. Biden introduced the following bill; which was read twice and referred to the Committee on Armed Services A BILL To improve the medical care of members of the Armed Forces and veterans, and for other purposes.

1.

Short title

This Act may be cited as the Effective Care for the Armed Forces and Veterans Act of 2007.

2.

Prohibition on competitive sourcing of certain activities at medical facilities of the Department of Defense

(a)

Findings

Congress finds the following: (1)The health and recovery of wounded members of the Armed Forces may be risked by competitive sourcing of services at military medical facilities. (2)The provision of medical services to members and former members of the Armed Forces who were injured while serving in Operation Iraqi Freedom or Operation Enduring Freedom is a basic service that is the responsibility of the Government and any disruption is unacceptable when it risks the health of veterans and members of the Armed Forces. (3)The Department of Defense has attempted to implement competitive sourcing of services at military medical facilities despite the fact that doing so provides no improvement in the efficiency or effectiveness of such services. (b)

Prohibition on initiation of competitive sourcing activities at medical facilities of Department of Defense during period of major military conflict

(1)

In general

Except as provided in paragraph (2), during a period in which the Armed Forces are involved in a major military conflict, the Secretary of Defense shall not take any action under the Office of Management and Budget Circular A–76 or any other similar administrative regulation, directive, or policy— (A)to subject work performed by an employee of a medical facility of the Department of Defense or employee of a private contractor of such a medical facility to public-private competition; or (B)to convert such employee or the work performed by such employee to private contractor performance. (2)

Exception to prevent negative impact on provision of services

Paragraph (1) shall not apply to any action at a medical facility of the Department of Defense if the Secretary of Defense certifies to Congress that not initiating such action during such period would have a negative impact on the provision of services at such military medical facility. (c)

Study on competitive sourcing activities at medical facilities of Department of Defense

The Comptroller General of the United States shall assess the efficiency and advisability of subjecting work performed by an employee of a medical facility of the Department of Defense or a private contractor of such a medical facility to public-private competition, or converting such employee or the work performed by such employee to private contractor performance, under the Office of Management and Budget Circular A–76 or any other similar administrative regulation, directive, or policy.

3.

Minimum budget for medical services of the Armed Forces during period of major military conflict

(a)

Findings

Congress finds the following: (1)Pressure to reduce the budget for the medical services of the Department of Defense has contributed to many of the current problems at Walter Reed Army Medical Center. (2)It is inappropriate to reduce the budget for medical services of the Department of Defense or the Department of Veterans Affairs while such services are needed to treat members of the Armed Forces or veterans who were wounded in Iraq and Afghanistan. (b)

Minimum budget for medical services

(1)

In general

Except as provided in paragraph (2), if the Armed Forces are involved in a major military conflict at the time the President submits the budget for a fiscal year to Congress, the President shall not include in that budget a total aggregate amount allocated for medical services for the Department of Defense and the Department of Veterans Affairs that is less than the total aggregate amount allocated for such purposes in the budget submitted by the President to Congress for the previous fiscal year. (2)

Exception

Paragraph (1) shall not apply if the President— (A)certifies to Congress that submitting a total aggregate amount allocated for medical services for the Department of Defense and the Department of Veterans Affairs that is less than that required under paragraph (1) is in the national interest; and (B)submits to Congress a report on the reasons for the reduction described by subparagraph (A).

4.

Limitation on implementation of recommendation to close Walter Reed Army Medical Center

(a)

Findings

Congress finds the following: (1)The final recommendations of the Defense Base Closure and Realignment Commission under the 2005 round of defense base closure and realignment include recommendations to close Walter Reed Army Medical Center and to build new, modern facilities at the National Naval Medical Center at Bethesda and at Fort Belvoir to improve the overall quality of and access to health care for members of the Armed Forces. (2)These recommendations include the transfer of medical services from the Walter Reed Army Medical Center to the National Naval Medical Center at Bethesda and at Fort Belvoir, but they do not adequately provide for housing for the families of wounded members of the Armed Forces who will receive treatment at such new facilities. (3)The recommended closure of the Walter Reed Army Medical Center has impaired the ability of the Secretary of Defense to attract the personnel required to provide proper medical services at such medical center. (b)

Limitation on implementation of recommendations

The Secretary of Defense shall not take any action to implement the recommendations of the Defense Base Closure and Realignment Commission under the 2005 round of defense base closure and realignment relating to the transfer of medical services from Walter Reed Army Medical Center to the National Naval Medical Center at Bethesda and at Fort Belvoir during the period beginning on the date of the enactment of this Act and ending on the date that is 60 days after the date on which Congress receives the plan required under subsection (c). (c)

Plan required

Not later than one year after the date of the enactment of this Act, the Secretary of Defense shall submit to Congress a plan that includes an assessment of the following: (1)The feasibility and advisability of providing current or prospective employees at Walter Reed Army Medical Center a guarantee that their employment will continue in the Washington, DC, metropolitan area for more than two years after the date on which Walter Reed Army Medical Center is closed. (2)Detailed construction plans for new medical facilities and family housing at the National Naval Medical Center at Bethesda and at Fort Belvoir to accommodate the transfer of medical services from Walter Reed Army Medical Center to the National Naval Medical Center at Bethesda and at Fort Belvoir. (3)The costs, feasibility, and advisability of completing all of the construction planned for the transfer of medical services from Walter Reed Army Medical Center to the National Naval Medical Center at Bethesda and at Fort Belvoir before any patients are transferred to such new facilities from Walter Reed Army Medical Center as a result of the recommendations of the Defense Base Closure and Realignment Commission under the 2005 round of defense base closure and realignment.

5.

Improving case management services for members of the Armed Forces

(a)

Findings

Congress makes the following findings: (1)Case managers are important for scheduling appointments and making sure recovering servicemembers get the care they need. (2)Many case managers are overwhelmed by the large number of wounded members of the Armed Forces returning from deployment in Iraq and Afghanistan. (3)Regular contact between health care providers and members of the Armed Forces returning from deployment is important for the diagnosis of post traumatic stress disorder in such members. (4)It is inappropriate to require a wounded member of the Armed Forces or a family member of such member to provide a photo or a medal from deployment in Iraq or Afghanistan to prove that such member served in and was injured from such deployment. (5)Case managers are well qualified to assist recovering servicemembers and their families with the disability evaluation system and discharge procedures of the Department of Defense. (b)

Case managers

(1)

In general

The Secretary of Defense shall assign at least one case manager for every 20 recovering servicemembers to assist in the recovery of such recovering servicemember. (2)

Minimum contact

The Secretary of Defense shall ensure that case managers contact each of their assigned recovering servicemembers not less than once per week. (3)

Training

The Secretary of Defense shall ensure that case managers of the Department of Defense are familiar with the disability and discharge system of the Department of Defense and that such case managers are able to assist recovering servicemembers complete necessary and related forms. (c)

Recovering servicemember

In this section, the term recovering servicemember 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.

6.

Screening for traumatic brain injury

(a)

Findings

Congress finds the following: (1)Many of the members of the Armed Forces deployed in Iraq and Afghanistan have brain injuries. (2)In many cases, such injuries are not diagnosed because there is no external indication of such injury. (3)The Secretary of Veterans Affairs carries out programs to screen all recent combat veterans for traumatic brain injury; the Secretary of Defense does not do so. (b)

Screening required

The Secretary of Defense shall screen every member of the Armed Forces returning from deployment in Operation Iraqi Freedom or Operation Enduring Freedom for traumatic brain injury upon the return of each such member. (c)

Studies on treating traumatic brain injury as presumptive condition for disability compensation

(1)

Study by Secretary of Defense

(A)

In general

The Secretary of Defense shall conduct a study on the feasability and advisability of treating traumatic brain injury as a presumptive condition for members of the Armed Forces who served in Operation Iraqi Freedom or Operation Enduring Freedom for the qualification for disability compensation under laws administered by the Secretary of Defense. (B)

Report

Not later than 180 days after the date of the enactment of this Act, the Secretary of Defense shall submit to Congress a report on the results of the study required by subparagraph (A). (2)

Study by Secretary of Veterans Affairs

(A)

In general

The Secretary of Veterans Affairs shall conduct a study on the feasability and advisability of treating traumatic brain injury as a presumptive condition for veterans who served as members of the Armed Forces in Operation Iraqi Freedom or Operation Enduring Freedom for the qualification for disability compensation under laws administered by the Secretary of Veterans Affairs. (B)

Report

Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to Congress a report on the results of the study required by subparagraph (A). (3)

Study by Director of National Institutes of Health

(A)

In general

The Director of the National Institutes of Health shall conduct a study on traumatic brain injury, including the detection of traumatic brain injury and the measurement and classification of the severity of traumatic brain injury. (B)

Report

Not later than 180 days after the date of the enactment of this Act, the Director of the National Institutes of Health shall submit to Congress a report on the results of the study required by subparagraph (A).

7.

Requiring medical records management systems of Department of Defense to communicate with medical records management systems of Department of Veterans Affairs

(a)

Findings

Congress makes the following findings: (1)The electronic transfer of medical records of members of the Armed Forces from the medical records management systems of the Department of Defense to the medical records management systems of the Department of Veterans Affairs would be prudent. (2)The Department of Veterans Affairs has been a leader in the implementation of electronic medical records management systems. (b)

Electronic communication between medical records management systems required

(1)

In general

Not later than two years after the date of the enactment of this Act, the Secretary of Defense shall ensure that the medical records management systems of the Department of Defense are capable of transmitting medical records to and receiving medical records from the medical records management systems of the Department of Veterans Affairs electronically. (2)

Initiation of activities

Not later than one year after the date of the enactment of this Act, the Secretary of Defense shall begin any activities required to meet the requirements of paragraph (1).

8.

Department of Veterans Affairs assessment of long-term care needs of veterans

(a)

Findings

Congress makes the following findings: (1)Multiple studies show that, in the next five years, the Department of Veterans Affairs will add hundreds of thousands of new veterans to the medical records management systems of the Department of Veterans Affairs. (2)During such period, many veterans will have multiple medical care needs caused by complex medical conditions. (b)

Assessment of long-term care needs

The Secretary of Veterans Affairs shall assess the current ability of the Department of Veterans Affairs to meet long-term care needs of veterans during the 50-year period that begins on the date of the enactment of this Act. (c)

Determination of actions required To meet long-term care needs

The Secretary of Veterans Affairs shall determine what actions are required to ensure that the needs described in subsection (b) are satisfied. (d)

Report required

Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to Congress a report on the assessment required in subsection (b) and the determination required in subsection (c).