To provide for improved medical readiness of the members of the Armed Forces, and for other purposes.

1. Adds TITLE XIII--MEDICAL READINESS TRACKING AND HEALTH SURVEILLANCE on page 296, between lines 14 and 15

   Adds a titlePrinted page

   Inserted: TITLE XIII--MEDICAL READINESS TRACKING AND HEALTH SURVEILLANCE

   Inserted: SEC. 1301. ANNUAL MEDICAL READINESS PLAN AND JOINT MEDICAL READINESS OVERSIGHT COMMITTEE.

   Inserted: (a) Requirement for Plan.--The Secretary of Defense shall develop a comprehensive plan to improve medical readiness, and Department of Defense tracking of the health status, of members of the Armed Forces throughout their service in the Armed Forces, and to strengthen medical readiness and tracking before, during, and after deployment of the personnel overseas. The matters covered by the comprehensive plan shall include all elements that are described in this title and the amendments made by this title and shall comply with requirements in law.

   Inserted: (b) Joint Medical Readiness Oversight Committee.--

   Inserted: (1) Establishment.--The Secretary of Defense shall establish a Joint Medical Readiness Oversight Committee.

   Inserted: (2) Composition.--The members of the Committee are as follows:

   Inserted: (A) The Under Secretary of Defense for Personnel and Readiness, who shall chair the Committee.

   Inserted: (B) The Assistant Secretary of Defense for Health Affairs.

   Inserted: (C) The Assistant Secretary of Defense for Reserve Affairs.

   Inserted: (D) The Surgeons General of the Armed Forces.

   Inserted: (E) The Assistant Secretary of the Army for Manpower and Reserve Affairs.

   Inserted: (F) The Assistant Secretary of the Navy for Manpower and Reserve Affairs.

   Show 154 more inserted paragraphsShow less

   Inserted: (G) The Assistant Secretary of the Air Force for Manpower, Reserve Affairs, Installations, and Environment.

   Inserted: (H) The Chief of the National Guard Bureau.

   Inserted: (I) The Chief of Army Reserve.

   Inserted: (J) The Chief of Naval Reserve.

   Inserted: (K) The Chief of Air Force Reserve.

   Inserted: (L) The Commander, Marine Corps Reserve.

   Inserted: (M) The Director of the Defense Manpower Data Center.

   Inserted: (N) A representative of the Department of Veterans Affairs designated by the Secretary of Veterans Affairs.

   Inserted: (O) Representatives of veterans and military health advocacy organizations appointed to the Committee by the Secretary of Defense.

   Inserted: (P) An individual from civilian life who is recognized as an expert on military health care treatment, including research relating to such treatment.

   Inserted: (3) Duties.--The duties of the Committee are as follows:

   Inserted: (A) To advise the Secretary of Defense on the medical readiness and health status of the members of the active and reserve components of the Armed Forces.

   Inserted: (B) To advise the Secretary of Defense on the compliance of the Armed Forces with the medical readiness tracking and health surveillance policies of the Department of Defense.

   Inserted: (C) To oversee the development and implementation of the comprehensive plan required by subsection (a) and the actions required by this title and the amendments made by this title, including with respect to matters relating to--

   Inserted: (i) the health status of the members of the reserve components of the Armed Forces;

   Inserted: (ii) accountability for medical readiness;

   Inserted: (iii) medical tracking and health surveillance;

   Inserted: (iv) declassification of information on environmental hazards;

   Inserted: (v) postdeployment health care for members of the Armed Forces; and

   Inserted: (vi) compliance with Department of Defense and other applicable policies on blood serum repositories.

   Inserted: (D) To ensure unity and integration of efforts across functional and organizational lines within the Department of Defense with regard to medical readiness tracking and health status surveillance of members of the Armed Forces.

   Inserted: (E) To establish and monitor compliance with the medical readiness standards that are applicable to members and those that are applicable to units.

   Inserted: (F) To improve continuity of care in coordination with the Secretary of Veterans Affairs, for members of the Armed Forces separating from active service with service-connected medical conditions.

   Inserted: (G) To prepare and submit to the Secretary of Defense and to the Committees on Armed Services of the Senate and the House of Representatives, not later than February 1 of each year, a report on--

   Inserted: (i) the health status and medical readiness of the members of the Armed Forces, including the members of reserve components, based on the comprehensive plan required under subsection (a) and the actions required by this title and the amendments made by this title; and

   Inserted: (ii) compliance with Department of Defense policies on medical readiness tracking and health surveillance.

   Inserted: (4) First meeting.--The first meeting of the Committee shall be held not later than 90 days after the date of the enactment of this Act.

   Inserted: SEC. 1302. MEDICAL READINESS OF RESERVES.

   Inserted: (a) Comptroller General Study of Health of Reserves Ordered to Active Duty for Operations Enduring Freedom and Iraqi Freedom.--

   Inserted: (1) Requirement for study.--The Comptroller General of the United States shall carry out a study of the health of the members of the reserve components of the Armed Forces who have been called or ordered to active duty for a period of more than 30 days in support of Operation Enduring Freedom and Operation Iraqi Freedom. The Comptroller General shall commence the study not later than 180 days after the date of the enactment of this Act.

   Inserted: (2) Purposes.--The purposes of the study under this subsection are as follows:

   Inserted: (A) To review the health status and medical fitness of the activated Reserves when they were called or ordered to active duty.

   Inserted: (B) To review the effects, if any, on logistics planning and the deployment schedules for the operations referred to in paragraph (1) that resulted from deficiencies in the health or medical fitness of activated Reserves.

   Inserted: (C) To review compliance of military personnel with Department of Defense policies on medical and physical fitness examinations and assessments that are applicable to the reserve components of the Armed Forces.

   Inserted: (3) Report.--The Comptroller General shall, not later than one year after the date of the enactment of this Act, submit a report on the results of the study under this subsection to the Committees on Armed Services of the Senate and the House of Representatives. The report shall include the following matters:

   Inserted: (A) With respect to the matters reviewed under subparagraph (A) of paragraph (2)--

   Inserted: (i) the percentage of activated Reserves who were determined to be medically unfit for deployment, together with an analysis of the reasons why the member was unfit, including medical illnesses or conditions most commonly found among the activated Reserves that were grounds for determinations of medical unfitness for deployment; and

   Inserted: (ii) the percentage of the activated Reserves who, before being deployed, needed medical care for health conditions identified when called or ordered to active duty, together with an analysis of the types of care that were provided for such conditions and the reasons why such care was necessary.

   Inserted: (B) With respect to the matters reviewed under subparagraph (B) of paragraph (2)--

   Inserted: (i) the delays and other disruptions in deployment schedules that resulted from deficiencies in the health status or medical fitness of activated Reserves; and

   Inserted: (ii) an analysis of the extent to which it was necessary to merge units or otherwise alter the composition of units, and the extent to which it was necessary to merge or otherwise alter objectives, in order to compensate for limitations on the deployability of activated Reserves resulting from deficiencies in the health status or medical fitness of activated Reserves.

   Inserted: (C) With respect to the matters reviewed under subparagraph (C) of paragraph (2), an assessment of the extent of the compliance of reserve component personnel with Department of Defense policies on routine medical and physical fitness examinations that are applicable to the reserve components of the Armed Forces.

   Inserted: (D) An analysis of the extent to which the medical care, if any, provided to activated Reserves in each theater of operations referred to in paragraph (1) related to preexisting conditions that were not adequately addressed before the deployment of such personnel to the theater.

   Inserted: (4) Definitions.--In this subsection:

   Inserted: (A) The term "activated Reserves" means the members of the Armed Forces referred to in paragraph (1).

   Inserted: (B) The term "active duty for a period of more than 30 days" has the meaning given such term in section 101(d) of title 10, United States Code.

   Inserted: (C) The term "health condition" includes a mental health condition and a dental condition.

   Inserted: (D) The term "reserve components of the Armed Forces" means the reserve components listed in section 10101 of title 10, United States Code.

   Inserted: (b) Accountability for Individual and Unit Medical Readiness.--

   Inserted: (1) Policy.--The Secretary of Defense shall issue a policy to ensure that individual members and commanders of reserve component units fulfill their responsibilities for medical and dental readiness of members of the units on the basis of--

   Inserted: (A) frequent periodic health assessment of members (not less frequently than once every two years) using the predeployment assessment procedure required under section 1074f of title 10, United States Code, as the minimum standard of medical readiness; and

   Inserted: (B) any other information on the health status of the members that is available to the commanders.

   Inserted: (2) Review and followup care.--The regulations under this subsection shall provide for review of the health assessments under paragraph (1) by a medical professional and for any followup care and treatment that is needed for medical or dental readiness.

   Inserted: (3) Modification of predeployment health assessment survey.--In meeting the policy under paragraph (1), the Secretary shall--

   Inserted: (A) to the extent practicable, modify the predeployment health assessment survey to bring such survey into conformity with the detailed postdeployment health assessment survey in use as of October 1, 2004; and

   Inserted: (B) ensure the use of the predeployment health assessment survey, as so modified, for predeployment health assessments after that date.

   Inserted: (c) Uniform Policy on Deferral of Medical Treatment Pending Deployment to Theaters of Operations.--

   Inserted: (1) Requirement for policy.--The Secretary of Defense shall prescribe, for uniform applicability throughout the Armed Forces, a policy on deferral of medical treatment of members pending deployment.

   Inserted: (2) Content.--The policy prescribed under paragraph (1) shall specify the following matters:

   Inserted: (A) The circumstances under which treatment for medical conditions may be deferred to be provided within a theater of operations in order to prevent delay or other disruption of a deployment to that theater.

   Inserted: (B) The circumstances under which medical conditions are to be treated before deployment to that theater.

   Inserted: SEC. 1303. BASELINE HEALTH DATA COLLECTION PROGRAM.

   Inserted: (a) Requirement for Program.--

   Inserted: (1) In general.--Chapter 55 of title 10, United States Code, is amended by inserting after section 1092 the following new section:

   Inserted: "Sec. 1092a. Persons entering the armed forces: baseline health data

   Inserted: "(a) Program Required.--The Secretary of Defense shall carry out a program--

   Inserted: "(1) to collect baseline health data from all persons entering the armed forces;

   Inserted: "(2) to provide for computerized compilation and maintenance of the baseline health data; and

   Inserted: "(3) to analyze the data.

   Inserted: "(b) Purposes.--The program under this section shall be designed to achieve the following purposes:

   Inserted: "(1) To facilitate understanding of how exposures related to service in the armed forces affect health.

   Inserted: "(2) To facilitate development of early intervention and prevention programs to protect health and readiness.".

   Inserted: (2) Clerical amendment.--The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 1092 the following new item:

   Inserted: "1092a. Persons entering the armed forces: baseline health data.".

   Inserted: (3) Time for implementation.--The Secretary of Defense shall implement the program required under section 1092a of title 10, United States Code (as added by paragraph (1)), not later than two years after the date of the enactment of this Act.

   Inserted: (b) Interim Standards for Blood Sampling.--The Secretary of Defense shall require under the medical tracking system administered under section 1074f of title 10, United States Code, that--

   Inserted: (1) the blood samples necessary for the predeployment medical examination of a member of the Armed Forces required under subsection (b) of such section be drawn not earlier than 60 days before the date of the deployment; and

   Inserted: (2) the blood samples necessary for the postdeployment medical examination of a member of the Armed Forces required under such subsection be drawn not later than 30 days after the date on which the deployment ends.

   Inserted: SEC. 1304. MEDICAL CARE AND TRACKING AND HEALTH SURVEILLANCE IN THE THEATER OF OPERATIONS.

   Inserted: (a) Recordkeeping Policy.--The Secretary of Defense shall prescribe a policy that requires the records of all medical care provided to a member of the Armed Forces in a theater of operations to be maintained as part of a complete health record for the member.

   Inserted: (b) In-Theater Medical Tracking and Health Surveillance.--

   Inserted: (1) Requirement for evaluation.--The Secretary of Defense shall evaluate the system for the medical tracking and health surveillance of members of the Armed Forces in theaters of operations and take such actions as may be necessary to improve the medical tracking and health surveillance.

   Inserted: (2) Report.--Not later than one year after the date of the enactment of this Act, the Secretary of Defense shall submit a report on the actions taken under paragraph (1) to the Committees on Armed Services of the Senate and the House of Representatives. The report shall include the following matters:

   Inserted: (A) An analysis of the strengths and weaknesses of the medical tracking system administered under section 1074f of title 10, United States Code.

   Inserted: (B) An analysis of the efficacy of health surveillance systems as a means of detecting--

   Inserted: (i) any health problems (including mental health conditions) of members of the Armed Forces contemporaneous with the performance of the assessment under the system; and

   Inserted: (ii) exposures of the assessed members to environmental hazards that potentially lead to future health problems.

   Inserted: (C) An analysis of the strengths and weaknesses of such medical tracking and surveillance systems as a means for supporting future research on health issues.

   Inserted: (D) Recommended changes to such medical tracking and health surveillance systems.

   Inserted: (E) A summary of scientific literature on blood sampling procedures used for detecting and identifying exposures to environmental hazards.

   Inserted: (F) An assessment of whether there is a need for changes to regulations and standards for drawing blood samples for effective tracking and health surveillance of the medical conditions of personnel before deployment, upon the end of a deployment, and for a followup period of appropriate length.

   Inserted: (c) Plan To Obtain Health Care Records From Allies.--The Secretary of Defense shall develop a plan for obtaining all records of medical treatment provided to members of the Armed Forces by allies of the United States in Operation Enduring Freedom and Operation Iraqi Freedom. The plan shall specify the actions that are to be taken to obtain all such records.

   Inserted: (d) Policy on In-Theater Personnel Locator Data.--Not later than one year after the date of the enactment of this Act, the Secretary of Defense shall prescribe a Department of Defense policy on the collection and dissemination of in-theater individual personnel location data.

   Inserted: SEC. 1305. DECLASSIFICATION OF INFORMATION ON EXPOSURES TO ENVIRONMENTAL HAZARDS.

   Inserted: (a) Requirement for Review.--The Secretary of Defense shall review and, as determined appropriate, revise the classification policies of the Department of Defense with a view to facilitating the declassification of data that is potentially useful for the monitoring and assessment of the health of members of the Armed Forces who have been exposed to environmental hazards during deployments overseas, including the following data:

   Inserted: (1) In-theater injury rates.

   Inserted: (2) Data derived from environmental surveillance.

   Inserted: (3) Health tracking and surveillance data.

   Inserted: (b) Consultation With Commanders of Theater Combatant Commands.--The Secretary shall, to the extent that the Secretary considers appropriate, consult with the senior commanders of the in-theater forces of the combatant commands in carrying out the review and revising policies under subsection (a).

   Inserted: SEC. 1306. ENVIRONMENTAL HAZARDS.

   Inserted: (a) Report on Training of Field Medical Personnel.--

   Inserted: (1) Requirement for report.--Not later than one year 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 training on environmental hazards that is provided by the Armed Forces to medical personnel of the Armed Forces who are deployable to the field in direct support of combat personnel.

   Inserted: (2) Content.--The report under paragraph (1) shall include the following:

   Inserted: (A) An assessment of the adequacy of the training regarding--

   Inserted: (i) the identification of common environmental hazards and exposures to such hazards; and

   Inserted: (ii) the prevention and treatment of adverse health effects of such exposures.

   Inserted: (B) A discussion of the actions taken and to be taken to improve such training.

   Inserted: (c) Report on Responses to Health Concerns of Members.--

   Inserted: (1) Requirement for report.--Not later than 180 days after the date of the enactment of this Act, the Assistant Secretary of Defense for Health Affairs shall submit to the Secretary of Defense and the Committees on Armed Services of the Senate and the House of Representatives a report on Department of Defense responses to concerns expressed by members of the Armed Forces during post-deployment health assessments about possibilities that the members were exposed to environmental hazards deleterious to the members' health during a deployment overseas.

   Inserted: (2) Content.--The report regarding health concerns submitted under paragraph (1) shall include the following:

   Inserted: (A) A discussion of the actions taken by Department of Defense officials to investigate the circumstances underlying such concerns in order to determine the validity of the concerns.

   Inserted: (B) A discussion of the actions taken by Department of Defense officials to evaluate or treat members and former members of the Armed Forces who are confirmed to have been exposed to environmental hazards deleterious to their health during deployments of the Armed Forces.

   Inserted: SEC. 1307. POST-DEPLOYMENT MEDICAL CARE RESPONSIBILITIES OF INSTALLATION COMMANDERS.

   Inserted: (a) Requirement for Regulations.--The Secretary of Defense shall prescribe a policy that requires the commander of each military installation at which members of the Armed Forces are to be processed upon redeployment from an overseas deployment--

   Inserted: (1) to identify and analyze the anticipated health care needs of such members before the arrival of such members at that installation; and

   Inserted: (2) to report such needs to the Secretary.

   Inserted: (b) Health Care To Meet Needs.--The policy under this section shall include procedures for the commander of each military installation described in subsection (a) to meet the anticipated health care needs that are identified by the commander in the performance of duties under the regulations, including the following:

   Inserted: (1) Arrangements for health care provided by the Secretary of Veterans Affairs.

   Inserted: (2) Procurement of services from local health care providers.

   Inserted: (3) Temporary employment of health care personnel to provide services at such installation.

   Inserted: SEC. 1308. FULL IMPLEMENTATION OF MEDICAL READINESS TRACKING AND HEALTH SURVEILLANCE PROGRAM AND FORCE HEALTH PROTECTION AND READINESS PROGRAM.

   Inserted: (a) Implementation at All Levels.--The Secretary of Defense, in conjunction with the Secretaries of the military departments, shall take such actions as are necessary to ensure that the Army, Navy, Air Force, and Marine Corps fully implement at all levels--

   Inserted: (1) the Medical Readiness Tracking and Health Surveillance Program under this title and the amendments made by this title; and

   Inserted: (2) the Force Health Protection and Readiness Program of the Department of Defense (relating to the prevention of injury and illness and the reduction of disease and noncombat injury threats).

   Inserted: (b) Action Official.--The Secretary of Defense may act through the Under Secretary of Defense for Personnel and Readiness in carrying out subsection (a).

   Inserted: SEC. 1309. OTHER MATTERS.

   Inserted: (a) Annual Reports.--

   Inserted: (1) Requirement for reports.--

   Inserted: (A) Chapter 55 of title 10, United States Code, is amended by inserting after section 1073a the following new section:

   Inserted: "Sec. 1073b. Recurring reports

   Inserted: "(a) Annual Report on Health Protection Quality.--(1) The Secretary of Defense shall submit to the Committees on Armed Services of the Senate and the House of Representatives each year a report on the Force Health Protection Quality Assurance Program of the Department of Defense. The report shall include the following matters:

   Inserted: "(A) The results of an audit of the extent to which the serum samples required to be obtained from members of the armed forces before and after a deployment are stored in the serum repository of the Department of Defense.

   Inserted: "(B) The results of an audit of the extent to which the health assessments required for members of the armed forces before and after a deployment are being maintained in the electronic database of the Defense Medical Surveillance System.

   Inserted: "(C) An analysis of the actions taken by the Department of Defense personnel to respond to health concerns expressed by members of the armed forces upon return from a deployment.

   Inserted: "(D) An analysis of the actions taken by the Secretary to evaluate or treat members and former members of the armed forces who are confirmed to have been exposed to occupational or environmental hazards deleterious to their health during a deployment.

   Inserted: "(2) The Secretary of Defense shall act through the Assistant Secretary of Defense for Health Affairs in carrying out this subsection.

   Inserted: "(b) Annual Report on Recording of Health Assessment Data in Military Personnel Records.--The Secretary of Defense shall issue each year a report on the compliance by the military departments with applicable policies on the recording of health assessment data in military personnel records. The report shall include a discussion of the extent to which immunization status and

   Inserted: predeployment and postdeployment health care data is being recorded in such records.".

   Inserted: (B) The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 1073a the following new item:

   Inserted: "1073b. Recurring reports.".

   Inserted: (2) Initial report.--The first report under section 1073b(a) of title 10, United States Code (as added by paragraph (1)), shall be completed not later than 180 days after the date of the enactment of this Act.

   Inserted: (b) Internet Accessibility of Health Assessment Information for Members of the Armed Forces.--Not later than one year after the date of the enactment of this Act, the Chief Information Officer of each military department shall ensure that the online portal website of that military department includes the following information relating to health assessments:

   Inserted: (1) Information on the Department of Defense policies regarding predeployment and postdeployment health assessments, including policies on the following matters:

   Inserted: (A) Health surveys.

   Inserted: (B) Physical examinations.

   Inserted: (C) Collection of blood samples and other tissue samples.

   Inserted: (2) Procedural information on compliance with such policies, including the following information:

   Inserted: (A) Information for determining whether a member is in compliance.

   Inserted: (B) Information on how to comply.

   Inserted: (3) Health assessment surveys that are either--

   Inserted: (A) web-based; or

   Inserted: (B) accessible (with instructions) in printer-ready form by download.

   Inserted: SEC. 1310. USE OF CIVILIAN EXPERTS AS CONSULTANTS.

   Inserted: Nothing in this title or an amendment made by this title shall be construed to limit the authority of the Secretary of Defense to procure the services of experts outside the Federal Government for performing any function to comply with requirements for readiness tracking and health surveillance of members of the Armed Forces that are applicable to the Department of Defense.

   Original wording

   On page 296, between lines 14 and 15, insert the following:

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As printed