<?xml version="1.0"?>
<?xml-stylesheet type="text/xsl" href="billres.xsl"?>
<!DOCTYPE bill PUBLIC "-//US Congress//DTDs/bill.dtd//EN" "bill.dtd">
<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public" slc-id="S1-HEY21057-TGY-MK-WNX"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>117 S194 IS: Supporting Eating Disorders Recovery Through Vital Expansion Act</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2021-02-03</dc:date>
<dc:format>text/xml</dc:format>
<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>
</dublinCore>
</metadata>
<form>
<distribution-code display="yes">II</distribution-code><congress>117th CONGRESS</congress><session>1st Session</session><legis-num>S. 194</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20210203">February 3, 2021</action-date><action-desc><sponsor name-id="S324">Mrs. Shaheen</sponsor> (for herself, <cosponsor name-id="S384">Mr. Tillis</cosponsor>, <cosponsor name-id="S372">Mrs. Capito</cosponsor>, and <cosponsor name-id="S361">Ms. Hirono</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>A BILL</legis-type><official-title>To amend title 10, United States Code, to provide treatment for eating disorders for dependents of members of the uniformed services.</official-title></form><legis-body><section id="S1" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Supporting Eating Disorders Recovery Through Vital Expansion Act</short-title></quote> or the <quote><short-title>SERVE Act</short-title></quote>.</text></section><section id="id76F0777FF06842C2B02490D0950DB899"><enum>2.</enum><header>Findings</header><text display-inline="no-display-inline">Congress finds the following:</text><paragraph id="id066f288e557e4bc1bfa5f63498106958"><enum>(1)</enum><text>Eating disorders affect approximately 30,000,000 individuals in the United States, or nine percent of the population, during their lifetime, including individuals from every age, gender, body size, race, ethnicity, and socioeconomic status.</text></paragraph><paragraph id="id76f941e7a84144c4a55091401c7ee24e"><enum>(2)</enum><text>Eating disorders are severe, biologically based mental illnesses caused by a complex interaction of genetic, biological, social, behavioral, and psychological factors.</text></paragraph><paragraph id="id32e09ff4790e4d1798542dffe824de88"><enum>(3)</enum><text>Eating disorders result in the second highest case fatality rate of any psychiatric illness, with one death every 52 minutes as a direct result of an eating disorder due to serious medical comorbidities and suicide.</text></paragraph><paragraph id="id224fcc5b4375429f93b993e0f0d19886"><enum>(4)</enum><text>Untreated eating disorders cost the economy of the United States $64,700,000,000 annually, with individuals and their families experiencing an economic loss of $23,500,000,000 annually.</text></paragraph><paragraph id="idafd2265a01c14cc1a5745d9f893e0390"><enum>(5)</enum><text>A study from the Armed Forces Health Surveillance Branch found that diagnoses of eating disorders among military personnel increased by 26 percent from 2013 to 2016.</text></paragraph><paragraph id="idA8644F6BE2AA4EA8B78DB6092EAE6228"><enum>(6)</enum><text>Although accurate estimates are challenging due to underreporting, the prevalence of eating disorders among members of the Armed Forces is two to three times higher than in the civilian population.</text></paragraph><paragraph id="idF2EF89E73D514A9095A5231C1F3048BE"><enum>(7)</enum><text>The Defense Health Board found that women members of the Armed Forces on active duty experience high rates of eating disorders, which can adversely affect the readiness and health of such members.</text></paragraph><paragraph id="id5c77e0f2e13f465c8bb2b4ed6de0a5fd"><enum>(8)</enum><text>Risk factors for eating disorders among members of the Armed Forces include pressure to maintain weight and fitness standards, trauma, sexual harassment, weight stigmatization, and post-traumatic stress disorder.</text></paragraph><paragraph id="id6d0ca683197e417ca820073d512b5cb4"><enum>(9)</enum><text>Family members of members of the Armed Forces have a higher prevalence of eating disorders than the general population, with 21 percent of children and 26 percent of spouses of members of the Armed Forces found to be at risk of developing an eating disorder.</text></paragraph><paragraph id="id64fadf82d55c448f8be548441282bbe5"><enum>(10)</enum><text>Research demonstrates a strong correlation in the risk of developing an eating disorder between a military spouse and their adolescent child. An adolescent female dependent of a member of the Armed Forces is more likely to be at risk for an eating disorder if their nonmilitary parent is at risk for an eating disorder.</text></paragraph></section><section id="idb3b4884faad04cf38c4caf2ca179fbaf"><enum>3.</enum><header>Treatment for eating disorders for dependents of members of the uniformed services</header><text display-inline="no-display-inline">Section 1079 of title 10, United States Code, is amended—</text><paragraph id="id168bc54ecebb4e4ebb879300cfcdcdf1"><enum>(1)</enum><text>in subsection (a), by adding at the end the following new paragraph:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id1008e949208c43baab71235e96b31e31"><paragraph id="id623d0256834f440caf75964e7dedc30a"><enum>(18)</enum><text>Treatment for an eating disorder may be provided in accordance with subsection (r).</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph><paragraph id="id8a6abf5fc266492da0e236493a1828e3"><enum>(2)</enum><text>by adding at the end the following new subsection:</text><quoted-block style="OLC" display-inline="no-display-inline" id="ideeee1fa400c64539b6dcbd3f22355afa"><subsection id="id3d8f76ae88e1428586a4c99f8de89d6f"><enum>(r)</enum><paragraph commented="no" display-inline="yes-display-inline" id="id668b01957e924ccba84b085c90d23e81"><enum>(1)</enum><text>The provision of health care services for an eating disorder under subsection (a)(18) shall include treatment at facilities providing the following services:</text><subparagraph id="id0fcb5c47575a4a088c14848e751530d6" indent="up1"><enum>(A)</enum><text>Inpatient services, including residential services.</text></subparagraph><subparagraph id="id75446497eba640f4ae8e817fd8742372" indent="up1"><enum>(B)</enum><text>Outpatient services for in-person and telehealth care, including—</text><clause id="id71192836628d4d3889a7a4a8c6cc0586"><enum>(i)</enum><text>partial hospitalization services; and</text></clause><clause id="idf35640bd8e79464bbaed4366b843ee81"><enum>(ii)</enum><text>intensive outpatient services. </text></clause></subparagraph></paragraph><paragraph id="idbf0f330a28d04473ac611662cee6ee78" indent="up1"><enum>(2)</enum><text>A dependent may be provided health care services for an eating disorder under subsection (a)(18) without regard to the age of the dependent, except with respect to residential services under paragraph (1)(A), which may be provided only to a dependent who is not eligible for hospital insurance benefits under part A of title XVIII of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395c">42 U.S.C. 1395c</external-xref> et seq.).</text></paragraph><paragraph id="idb0481e8a6704435eb674bdbfd8d0157c" indent="up1"><enum>(3)</enum><text>In this section, the term <term>eating disorder</term> has the meaning given the term <term>feeding and eating disorders</term> in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (or successor edition), published by the American Psychiatric Association.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="idfb8a653d7dd04a6981fcbd07e8fb9948"><enum>4.</enum><header>Identification and treatment of eating disorders for members of the Armed Forces</header><subsection id="idBFA10953CAFA4C9C93A24657DBDF365F"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1090 of title 10, United States Code, is amended—</text><paragraph id="id01908b235fea4f36ab193edc3fbef52d"><enum>(1)</enum><text>by striking <quote>The Secretary of Defense</quote> and inserting the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idbf5395b46b35467ea91c16539ab74657"><subsection id="id9b9a31197a3d484595b9ad631e27542c"><enum>(a)</enum><header>Identification and treatment of eating disorders and drug and alcohol dependence</header><text>The Secretary of Defense</text></subsection><after-quoted-block>;</after-quoted-block></quoted-block></paragraph><paragraph id="id8da232f5257e4571a2fa9d30254b84c7"><enum>(2)</enum><text>by inserting <quote>have an eating disorder or</quote> before <quote>are dependent on drugs or alcohol</quote>;</text></paragraph><paragraph id="id9ccaf6c782f0473caffefe4f47006432"><enum>(3)</enum><text>by adding at the end the following new subsections:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idb541d5335a6b436a86ca4ec7d1921c08"><subsection id="id22360546d33843cb9258483c3434ef73"><enum>(b)</enum><header>Facilities available to individuals with eating disorders</header><text>For purposes of this section, necessary facilities described in subsection (a) shall include the facilities described in section 1079(r)(1) of this title.</text></subsection><subsection id="idcd8b12f9a63c45e19dcbcb1e2ce72a10"><enum>(c)</enum><header>Eating disorder defined</header><text>In this section, the term <term>eating disorder</term> has the meaning given that term in section 1079(r)(3) of this title.</text></subsection><after-quoted-block>; and </after-quoted-block></quoted-block></paragraph><paragraph id="id0F19D64B0EBA4055A99EFBDB82C221FB"><enum>(4)</enum><text>in the section heading, by inserting <quote><header-in-text style="USC" level="section">eating disorders and</header-in-text></quote> after <quote><header-in-text style="USC" level="section">treating</header-in-text></quote>.</text></paragraph></subsection><subsection id="id7C433B54A70C4B458923BD36597D8BDE"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of chapter 55 of such title is amended by striking the item relating to section 1090 and inserting the following new item:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idF96C424C693E4FB6B630167985FF544B"><toc><toc-entry level="section" idref="id92be10d602464616917887aa195e8480">1090. Identifying and treating eating disorders and drug and alcohol dependence.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section><section id="id92be10d602464616917887aa195e8480"><enum>5.</enum><header>Clinical practice criteria and guidelines on the identification and treatment of eating disorders</header><subsection id="idE37A025FC5554D9A819E85363D464CC6"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than two years after the date of the enactment of this Act, the Secretary of Defense and the Secretary of Veterans Affairs, in consultation with specialized stakeholders, shall jointly develop, publish, and disseminate clinical practice criteria and guidelines on the identification and treatment of eating disorders.</text></subsection><subsection id="id758E64DCC0FF45A39683D1D84505FA9B"><enum>(b)</enum><header>Inclusion of recommendations and guidelines</header><text display-inline="yes-display-inline">The criteria and guidelines developed, published, and disseminated under subsection (a) shall include—</text><paragraph id="idC8CFD07FAF414C53AEC5E4C7A60E4F8D"><enum>(1)</enum><text display-inline="yes-display-inline">recommendations and guidelines established by, and any guidance from, the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, and the National Institute of Mental Health; and</text></paragraph><paragraph id="idB5C545C8F00A49A79D4E9776D66D7684"><enum>(2)</enum><text display-inline="yes-display-inline">clinical practice guidelines developed by specialized nonprofit professional associations.</text></paragraph></subsection></section></legis-body></bill> 

