1.This Act may be cited as the
Veterans Back and Spinal Therapy Act
.
2.Congress finds the following:
(1)One in five members of the Armed Forces who
were wounded and evacuated from Afghanistan during the summer and early fall of
2009 suffered a spinal injury, and at least 14 of such members were left
paralyzed or with loss of sensation.
(2)In Afghanistan, members of the Armed Forces
routinely carry up to 33 percent more than the suggested maximum weight and up
to nearly 75 percent of a member’s own body weight—routinely hefting combat
gear that can exceed 120 pounds, causing large numbers of spinal, back, and
musculoskeletal injuries and pain.
(3)The use of massive improvised explosive
devices by insurgents against heavily armed mine resistant ambush protected
vehicles has significantly increased the number of spinal, back, and
musculoskeletal injuries and pain.
(4)Advances in both body armor protection and
medical treatment have drastically decreased the number of deaths among
deployed members of the Armed Forces, but there has been an increase in the
number of members with spinal, back, and musculoskeletal injuries and long-term
pain.
(5)Members of the Armed Forces returning from
Iraq are more likely to suffer lingering, debilitating injuries from back and
musculoskeletal pain than from battle wounds, according to statistics compiled
by the Secretary of Veterans Affairs.
(6)Diagnoses of
ruptured spinal discs, compressed discs, degenerative disc disease, and
myofascial pain syndrome are common in members of the Armed Forces returning
from Afghanistan and Iraq.
(7)Spinal and back injuries are the most
expensive musculoskeletal disorder to treat.
(8)Certain facilities
of the Department of Veterans Affairs offer outstanding non-invasive
technologies for treating spinal, back, and musculoskeletal injuries as well as
any accompanying mental health issues.
(9)Traditional
medical approaches to spinal, back, and musculoskeletal injuries typically
involve a combination of long-term medication, surgery, and short-term physical
therapy.
(10)Using non-invasive techniques to treat
veterans with spinal, back, and musculoskeletal injuries can improve the health
outcomes for such veterans and drastically reduce the long-term costs of care
for such veterans by breaking the cycle of expensive surgery followed by
long-term pain medication that often leads to addiction, depression, anxiety,
and weight gain.
(11)Non-invasive techniques that are not widely
available in medical facilities of the Department of Veterans Affairs,
including manual physical therapy, core strengthening and stabilization
therapy, water exercise therapy, group exercise therapy, and pain management
therapy, should be evaluated in an evidence-based medicine framework to assess
their effectiveness.
3.Pilot program to
provide veterans with non-invasive techniques for spinal, back, and
musculoskeletal injuries
(a)The Secretary of Veterans Affairs shall
establish a pilot program to—
(1)provide covered
veterans with non-invasive techniques to treat spinal, back, and
musculoskeletal injuries and pain; and
(2)use an evidence-based medicine framework to
assess the effectiveness of such non-invasive techniques.
(b)
(1)The
pilot program shall include a representative sample of covered veterans that is
of sufficient size for the Secretary to determine—
(A)the effectiveness and feasibility of
providing veterans with non-invasive techniques to treat spinal, back, and
musculoskeletal injuries and pain; and
(B)the unique
considerations that exist with respect to providing such treatment—
(i)to
female veterans;
(ii)to
veterans of various ages; and
(iii)to
veterans located in various regions of the United States, including both urban
and rural locations.
(2)In selecting covered veterans to
participate in the pilot program, the Secretary shall give preference to
covered veterans who served in Operation Enduring Freedom, Operation Iraqi
Freedom, or Operation New Dawn.
(c)In administering the pilot program, the
Secretary shall—
(1)determine the type
of non-invasive technique to provide to a covered veteran;
(2)determine the
effect of allowing self-referral by a veteran to receive non-invasive
techniques compared with requiring a veteran to receive a referral from a
physician for non-invasive techniques; and
(3)ensure the use of telehealth technology to
provide covered veterans who reside in rural locations (as determined by the
Secretary) with non-invasive techniques to treat spinal, back, and
musculoskeletal injuries and pain.
(d)
(1)In administering the pilot program, the
Secretary shall seek to enter into an agreement with a university affiliated
with the Department of Veterans Affairs to carry out the pilot program.
(2)In entering into an agreement with a
university under paragraph (1), the Secretary shall ensure that the individuals
who treat covered veterans with non-invasive techniques for spinal, back, and
musculoskeletal injuries and pain—
(A)are trained
to—
(i)effectively treat
such veterans; and
(ii)recognize the unique experiences of such
veterans, including experiences related to serving in Operation Enduring
Freedom, Operation Iraqi Freedom, or Operation New Dawn; and
(B)use best practices
and technologies with respect to the non-invasive technique being used to treat
such veterans.
(e)The pilot program shall begin not later
than March 1, 2011, and shall continue for two years.
(f)
(1)Not later than June 1, 2012, the Secretary shall submit to
the Committee on Veterans’ Affairs of the House of Representatives and the
Committee on Veterans’ Affairs of the Senate a report on the pilot program,
including—
(A)an analysis of the effectiveness and
cost-effectiveness of each non-invasive technique provided under the pilot
program;
(B)an analysis of how
the Secretary would incorporate non-invasive techniques to treat spinal, back,
and musculoskeletal injuries and pain at medical facilities of the Department
of Veterans Affairs;
(C)the amount of
cost-savings, if any, created by providing veterans with non-invasive
techniques to treat spinal, back, and musculoskeletal injuries and pain;
(D)a comparison of the non-invasive techniques
provided under the pilot program with other methods used by the Secretary to
treat spinal, back, and musculoskeletal injuries and pain; and
(E)recommendations of the Secretary with
respect to—
(i)continuing or
expanding the pilot program; and
(ii)any legislation or other actions to improve
treating veterans with spinal, back, and musculoskeletal injuries and
pain.
(2)Not later than June 1,
2013, the Secretary shall submit to the Committee on Veterans’ Affairs of the
House of Representatives and the Committee on Veterans’ Affairs of the Senate a
report containing updated information to the report submitted under paragraph
(1).
(g)In
this section:
(1)The term
covered veteran means a veteran who—
(A)has a
service-connected spinal, back, or musculoskeletal injury; or
(B)is eligible for hospital care, medical
services, and nursing home care by virtue of section 1710(e)(1)(D) of title 38,
United States Code.
(2)The term non-invasive
techniques means methods of treatment for spinal, back, and
musculoskeletal injuries and pain other than surgery, including—
(A)manual physical therapy, core strengthening
and stabilization therapy, water exercise therapy, group exercise therapy, and
pain management therapy;
(B)such methods
(including recreational therapy) used by the War Related Illness and Injury
Study Center of the Department of Veterans Affairs located in Palo Alto,
California, and the mindfulness based stress reduction program of the Puget
Sound Health Care System of the Department of Veterans Affairs that the
Secretary determines to have been successful; and
(C)such other methods
not widely available in medical facilities of the Department of Veterans
Affairs.