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Title IX — Servicemembers and Veterans Mental Health

H.R. 4574 · 113th Congress · May 6, 2014 · Lineage

IX Servicemembers and Veterans Mental Health

Sec. 901 Preliminary mental health assessments

(a)
In general— Chapter 31 of title 10, United States Code, is amended by adding at the end the following new section:

“520d. Preliminary mental health assessments

“(a) Provision of mental health assessment—Before any individual enlists in an Armed Force or is commissioned as an officer in an Armed Force, the Secretary concerned shall provide the individual with a mental health assessment. The Secretary shall use such results as a baseline for any subsequent mental health examinations, including such examinations provided under sections 1074f and 1074m of this title.

“(b) Use of assessment—The Secretary may not consider the results of a mental health assessment conducted under subsection (a) in determining the assignment or promotion of a member of the Armed Forces.

“(c) Application of privacy laws—With respect to applicable laws and regulations relating to the privacy of information, the Secretary shall treat a mental health assessment conducted under subsection (a) in the same manner as the medical records of a member of the Armed Forces.”

(b)
Clerical amendment— The table of sections at the beginning of such chapter is amended by adding after the item relating to section 520c the following new item:
(c)
Report—
(1)
In general— 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 preliminary mental health assessments of members of the Armed Forces.
(2)
Matters included— The report under paragraph (1) shall include the following:
(A)
Recommendations with respect to establishing a preliminary mental health assessment of members of the Armed Forces to bring mental health screenings to parity with physical screenings of members.
(B)
Recommendations with respect to the composition of the mental health assessment, best practices, and how to track assessment changes relating to traumatic brain injuries, post-traumatic stress disorder, and other conditions.
(3)
Coordination— The Secretary shall carry out paragraph (1) in coordination with the Secretary of Veterans Affairs, the Uniformed Services University of the Health Sciences, the surgeons general of the military departments, and other relevant experts.

Sec. 902 Unlimited eligibility for health care for mental illnesses for veterans of combat service during certain periods of hostilities and war

(a)
Eligibility— Section 1710(e)(1) of title 38, United States Code, is amended by adding at the end the following new subparagraph:

“(G) Notwithstanding paragraphs (2) and (3), a veteran who served on active duty in a theater of combat operations (as determined by the Secretary in consultation with the Secretary of Defense) during World War II, the Korean conflict, the Vietnam Era, the Persian Gulf war, Operation Iraqi Freedom, Operation Enduring Freedom, or any other period of war after the Persian Gulf war, or in combat against a hostile force during a period of hostilities (as defined in section 1712A(a)(2)(B) of this title), is eligible for hospital care, medical services, and nursing home care under subsection (a)(2)(F) for any mental illness, notwithstanding that there is insufficient medical evidence to conclude that such illness is attributable to such service.”

(b)
Effective date— Subparagraph (G) of section 1710(e)(1) of title 38, United States Code, as added by subsection (a), shall apply with respect to hospital care, medical services, and nursing home care provided on or after the date of the enactment of this Act.

Sec. 903 Timeline for implementing integrated electronic health records

(a)
Establishment of timeline— Section 1635 of the Wounded Warrior Act (10 U.S.C. 1071 note) is amended by adding at the end the following new subsection:

“(k) Timeline—In carrying out this section, the Secretary of Defense and the Secretary of Veterans Affairs shall ensure that—

“(1) the creation of a health data authoritative source is achieved by not later than 180 days after the date of the enactment of this subsection;

“(2) the ability of patients of both the Department of Defense and the Department of Veterans Affairs to download the medical records of the patient (commonly referred to as the “Blue Button Initiative”) is achieved by not later than 365 days after the date of the enactment of this subsection;

“(3) the seamless integration of personal health care information between the Departments is achieved by not later than 365 days after the date of the enactment of this subsection;

“(4) the standardization of health care data of the Departments is achieved by not later than 365 days after the date of the enactment of this subsection;

“(5) the acceleration of the exchange of real-time data between the Departments is achieved by not later than 365 days after the date of the enactment of this subsection;

“(6) the upgrade of the graphical user interface to display the new standardized health care data of the Departments is achieved by not later than 365 days after the date of the enactment of this subsection;

“(7) each incoming member of the Armed Forces and the dependent of such a member may elect to receive an electronic copy of the health care record of the individual beginning not later than October 1, 2014; and

“(8) each current member of the Armed Forces and the dependent of such a member may elect to receive an electronic copy of the health care record of the individual beginning not later than October 1, 2015.”

(b)
Cloud storage— Section 1635 of such Act is further amended by adding at the end the following new subsection:

“(l) Cloud storage—The Secretary of Defense and the Secretary of Veterans Affairs shall study the feasibility of establishing a secure, remote, network-accessible computer storage system (commonly referred to as “cloud storage”) to—

“(1) provide members of the Armed Forces and veterans the ability to upload the health care records of the member or veteran if the member or veteran elects to do so; and

“(2) allow medical providers of the Department of Defense and the Department of Veterans Affairs to access such records in the course of providing care to the member or veteran.”

(c)
Conforming amendments— Section 1635 of such Act is further amended—
(1)
in subsection (a), by striking “The Secretary” and inserting “In accordance with the timeline described in subsection (k), the Secretary”; and
(2)
in the matter preceding paragraph (1) of subsection (e), by inserting “in accordance with subsection (k)” after “under this section”.

Sec. 904 Pilot program for repayment of educational loans for certain psychiatrists of Veterans Health Administration

(a)
Pilot program—
(1)
Establishment— The Secretary of Veterans Affairs shall carry out a pilot program to repay a loan of an individual described in paragraph (2) that—
(A)
was used by the individual to finance education regarding psychiatric medicine, including education leading to an undergraduate degree and education leading to the degree of doctor of medicine or of doctor of osteopathy; and
(B)
was obtained from a governmental entity, private financial institution, school, or other authorized entity, as determined by the Secretary.
(2)
Eligible individuals— To be eligible to obtain a loan repayment under this subsection, an individual shall—
(A)
either—
(i)
be licensed or eligible for licensure to practice psychiatric medicine in the Veterans Health Administration of the Department of Veterans Affairs; or
(ii)
be enrolled in the final year of a residency program leading to a specialty qualification in psychiatric medicine that is approved by the Accreditation Council for Graduate Medical Education; and
(B)
as determined appropriate by the Secretary, demonstrate a commitment to a long-term career as a psychiatrist in the Veterans Health Administration, including by requiring a set number of years of obligated service.
(3)
Selection— The Secretary shall select not less than 10 individuals described in paragraph (2) to participate in the pilot program for each year in which the Secretary carries out the pilot program.
(4)
Loan repayments—
(A)
Amounts— Subject to the limits established by subparagraph (B), a loan repayment under this subsection may consist of payment of the principal, interest, and related expenses of a loan obtained by an individual described in paragraph (2) for all educational expenses (including tuition, fees, books, and laboratory expenses) relating to a degree described in paragraph (1)(A).
(B)
Limit— For each year of obligated service that an individual agrees to serve in an agreement described in paragraph (2)(B), the Secretary may pay not more than $60,000 on behalf of the individual.
(5)
Breach—
(A)
Liability— An individual who participates in the pilot program under paragraph (1) who fails to satisfy the commitment described in paragraph (2)(B) shall be liable to the United States, in lieu of any service obligation arising from such participation, for the amount which has been paid or is payable to or on behalf of the individual under the program, reduced by the proportion that the number of days served for completion of the service obligation bears to the total number of days in the period of obligated service of the individual.
(B)
Repayment period— Any amount of damages which the United States is entitled to recover under this paragraph shall be paid to the United States within the one-year period beginning on the date of the breach of the agreement.
(6)
Prohibition on simultaneous eligibility— An individual who is participating in any other program of the Federal Government that repays the educational loans of the individual may not participate in the pilot program under paragraph (1).
(7)
Report— Not later than 90 days after the date on which the pilot program terminates under paragraph (7), the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report on the pilot program. The report shall include the overall effect of the pilot program on the psychiatric workforce shortage of the Veterans Health Administration, the long-term stability of such workforce, and overall workforce strategies of the Veterans Health Administration that seek to promote the physical and mental resiliency of all veterans.
(8)
Regulations— The Secretary shall prescribe regulations to carry out this subsection, including standards for qualified loans and authorized payees and other terms and conditions for the making of loan repayments.
(9)
Termination— The authority to carry out the pilot program shall expire on the date that is three years after the date on which the Secretary commences the pilot program.
(b)
Comptroller general study on pay disparities of psychiatrists of veterans health administration—
(1)
Study— Not later than one year after the date of the enactment of this Act, the Comptroller General of the United States shall conduct a study of pay disparities among psychiatrists of the Veterans Health Administration of the Department of Veterans Affairs. The study shall include—
(A)
an examination of laws, regulations, practices, and policies, including salary flexibilities, that contribute to such disparities; and
(B)
recommendations with respect to legislative or regulatory actions to improve equity in pay among such psychiatrists.
(2)
Report— Not later than one year after the date on which the Comptroller General completes the study under paragraph (1), the Comptroller General shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report containing the results of the study.