SEC. 721. PILOT PROGRAM FOR HEALTH CARE DELIVERY.
(a) PILOT PROGRAM.—The Secretary of Defense may conduct a pilot program at two or more military installations for purposes of testing initiatives that build cooperative health care arrange-ments and agreearrange-ments between military installations and local and regional non-military health care systems.
(b) REQUIREMENTS OFPILOTPROGRAM.—In conducting the pilot program, the Secretary of Defense shall—
(1) identify and analyze health care delivery options involving the private sector and health care services in military facilities located on the installation;
(2) determine the cost avoidance or savings resulting from innovative partnerships between the Department of Defense and the private sector;
(3) study the potential, viability, cost efficiency, and health care effectiveness of Department of Defense health care pro-viders delivering health care in civilian community hospitals;
and
(4) determine the opportunities for and barriers to coordi-nating and leveraging the use of existing health care resources, including Federal, State, local, and contractor assets.
(c) CONSULTATION REQUIREMENTS.—The Secretary of Defense shall develop the pilot program in consultation with the Secretaries of the military departments, representatives from the military installation selected for the pilot program, Federal, State, and local entities, and the TRICARE managed care support contractor with responsibility for that installation.
(d) SELECTION OF MILITARY INSTALLATION.—The pilot program may be implemented at two or more military installations selected by the Secretary of Defense. At least one of the selected military installations shall meet the following criteria:
(1) The military installation has members of the Armed Forces on active duty and members of reserve components of the Armed Forces that use the installation as a training and operational base, with members routinely deploying in support of the global war on terrorism.
(2) The number of members of the Armed Forces on active duty permanently assigned to the military installation is expected to increase over the next five years.
(3) One or more cooperative arrangements exist at the military installation with civilian health care entities in the form of specialty care services in the military medical treatment facility on the installation.
(4) There is a military treatment facility on the installation that does not have inpatient or trauma center care capabilities.
(5) There is a civilian community hospital near the military installation with—
(A) limited capability to expand inpatient care beds, intensive care, and specialty services; and
(B) limited or no capability to provide trauma care.
(e) DURATION OFPILOT PROGRAM.—Implementation of the pilot program developed under this section shall begin not later than May 1, 2005, and shall be conducted during fiscal years 2005, 2006, and 2007.
(f) REPORTS.—With respect to any pilot program conducted under this section, the Secretary of Defense shall submit to the Committees on Armed Services of the Senate and of the House of Representatives—
(1) an interim report on the program, not later than 60 days after commencement of the program; and
(2) a final report describing the results of the program with recommendations for a model health care delivery system for other military installations, not later than July 1, 2007.
SEC. 722. STUDY OF PROVISION OF TRAVEL REIMBURSEMENT TO HOS-PITALS FOR CERTAIN MILITARY DISABILITY RETIREES.
(a) STUDY.—The Secretary of Defense shall conduct a study of the feasibility, and of the desirability, of providing that a member of the uniformed services retired under chapter 61 of title 10, United States Code, shall be provided reimbursement for the travel expenses of such member for travel, during the two-year period beginning on the date of the retirement of the member, to a military treatment facility for medical care. The Secretary shall include in that study consideration of whether reimbursement under such a plan should, as nearly as practicable, be under the same terms and conditions, and at the same rate, as apply to beneficiary travel reimbursement provided by the Secretary of Veterans Affairs under section 111 of title 38, United States Code.
(b) REPORT.—The Secretary of Defense shall submit to the congressional defense committees a report providing the results of the study under subsection (a). Such report shall be submitted not later than March 1, 2005.
SEC. 723. STUDY OF MENTAL HEALTH SERVICES.
(a) STUDY REQUIRED.—The Comptroller General shall conduct a study of mental health services available to members of the Armed Forces.
(b) PERSONS COVERED.—The study shall evaluate the avail-ability and effectiveness of existing mental health treatment and screening resources—
(1) for members of the Armed Forces during a deployment to a combat theater;
(2) for members of the Armed Forces returning from a deployment to a combat theater, both—
(A) in the short-term, post-deployment period; and (B) in the long-term, following the post-deployment period;
(3) for the families of members of the Armed Forces who have been deployed to a combat theater during the time of the deployment;
(4) for the families of members of the Armed Forces who have been deployed to a combat theater after the member has returned from the deployment; and
(5) for members of the Armed Forces and their families described in this subsection who are members of reserve compo-nents.
(c) ASSESSMENT OF OBSTACLES.—The study shall provide an assessment of existing obstacles that prevent members of the Armed Forces and military families in need of mental health services from obtaining these services, including—
(1) the extent to which existing confidentiality regulations, or lack thereof, inhibit members of the Armed Forces from seeking mental health treatment;
(2) the implications that a decision to seek mental health services can have on a military career;
(3) the extent to which a social stigma exists within the Armed Forces that prevents members of the Armed Forces and military families from seeking mental health treatment within the Department of Defense and the individual Armed Forces;
(4) the extent to which logistical obstacles, particularly with respect to members of the Armed Forces and families residing in rural areas, deter members in need of mental health services from obtaining them; and
(5) the extent to which members of the Armed Forces and their families are prevented or hampered from obtaining mental health treatment due to the cost of such services.
(d) IDENTIFICATION OF PROBLEMS UNIQUE TO RESERVES.—The study shall identify potential problems in obtaining mental health treatment that are unique to members of Reserve components.
(e) REPORT.—The Comptroller General shall submit to Congress a report on the study conducted under this section not later than March 31, 2005. The report shall contain the results of the study and make specific recommendations—
(1) for improving the effectiveness and accessibility of mental health services provided by Department of Defense to the persons listed in subsection (b), including recommendations to ensure appropriate referrals and a seamless transition to the care of the Department of Veterans Affairs following separa-tion from the Armed Forces; and
(2) for removing or mitigating any obstacles identified under subsection (c) and problems identified under subsection (d).
SEC. 724. POLICY FOR TIMELY NOTIFICATION OF NEXT OF KIN OF MEMBERS SERIOUSLY ILL OR INJURED IN COMBAT ZONES.
(a) POLICYREQUIRED.—The Secretary of Defense shall prescribe the policy of the Department of Defense for providing, in the case of the serious illness or injury of a member of the Armed Forces in a combat zone, timely notification to the next of kin of the member regarding the illness or injury, including information on the condition of the member and the location at which the member is receiving treatment. In prescribing the policy, the Secretary shall ensure respect for the expressed desires of individual members of the Armed Forces regarding the notification of next of kin and shall include standards of timeliness for both the initial notification of next of kin under the policy and subsequent updates regarding the condition and location of the member.
(b) SUBMISSION OF POLICY.—Not later than 120 days after the date of the enactment of this Act, the Secretary of Defense shall submit to Congress a copy of the policy.
SEC. 725. REVISED FUNDING METHODOLOGY FOR MILITARY RETIREE HEALTH CARE BENEFITS.
(a) REVISION.—Section 1116 of title 10, United States Code, is amended to read as follows:
‘‘§ 1116. Payments into the Fund
‘‘(a) At the beginning of each fiscal year after September 30, 2005, the Secretary of the Treasury shall promptly pay into the Fund from the General Fund of the Treasury—
‘‘(1) the amount certified to the Secretary by the Secretary of Defense under subsection (c), which shall be the contribution to the Fund for that fiscal year required by section 1115;
and
‘‘(2) the amount determined by each administering Sec-retary under section 1111(c) as the contribution to the Fund on behalf of the members of the uniformed services under the jurisdiction of that Secretary.
‘‘(b) At the beginning of each fiscal year, the Secretary of Defense shall determine the sum of the following:
‘‘(1) The amount of the payment for that year under the amortization schedule determined by the Board of Actuaries under section 1115(a) of this title for the amortization of the original unfunded liability of the Fund.
‘‘(2) The amount (including any negative amount) of the Department of Defense contribution for that year as determined by the Secretary of Defense under section 1115(b) of this title.
‘‘(3) The amount (including any negative amount) for that year under the most recent amortization schedule determined by the Secretary of Defense under section 1115(c)(2) of this title for the amortization of any cumulative unfunded liability (or any gain) to the Fund resulting from changes in benefits.
‘(4) The amount (including any negative amount) for that year under the most recent amortization schedule determined by the Secretary of Defense under section 1115(c)(3) of this title for the amortization of any cumulative actuarial gain or loss to the Fund resulting from actuarial assumption changes.
‘‘(5) The amount (including any negative amount) for that year under the most recent amortization schedule determined by the Secretary of Defense under section 1115(c)(4) of this title for the amortization of any cumulative actuarial gain or loss to the Fund resulting from actuarial experience.
‘‘(c) The Secretary of Defense shall promptly certify the amount determined under subsection (b) each year to the Secretary of the Treasury.
‘‘(d) At the same time as the Secretary of Defense makes the certification under subsection (c), the Secretary shall submit to the Committees on Armed Services of the Senate and the House of Representatives the information provided to the Secretary of the Treasury under that subsection.’’.
(b) SENSE OF CONGRESS.—It is the sense of Congress that any unsubscribed discretionary budget authority that accrues within the national defense budget function as a result of the
amendments made by this section shall be applied to cover the unbudgeted costs of—
(1) increases in Army end strengths and modularization;
(2) increases in Marine Corps end strengths and necessary equipment; and
(3) Navy shipbuilding requirements.
(c) CONFORMING AMENDMENTS.—(1) Section 1111(c) of title 10, United States Code, is amended in the last sentence by striking
‘‘1116’’ and all that follows through the end of the sentence and inserting ‘‘1115(b) of this title, and such contributions shall be paid into the Fund as provided in section 1116(a).’’.
(2) Section 1115(a) of such title is amended by striking ‘‘1116(c)’’
and inserting ‘‘1116’’.
(3) Section 1115(b) of such title is amended—
(A) by striking ‘‘(1) The Secretary of Defense’’ and all that follows through ‘‘of this title.’’ and inserting ‘‘The Secretary of Defense shall determine, before the beginning of each fiscal year after September 30, 2005, the total amount of the Depart-ment of Defense contribution to be made to the Fund for that fiscal year for purposes of section 1116(b)(2).’’;
(B) by striking paragraph (2);
(C) by redesignating subparagraphs (A) and (B) as para-graphs (1) and (2), respectively;
(D) in each of paragraphs (1) and (2), as so redesignated, by redesignating clauses (i) and (ii) as subparagraphs (A) and (B), respectively; and
(E) in paragraph (2)(B), as so redesignated, by striking
‘‘subparagraph (A)(ii)’’ and inserting ‘‘paragraph (1)(B)’’.
(4) Section 1115(c)(1) of such title is amended by striking ‘‘and section 1116(a) of this title’’.
(5) Section 1115(c)(5) of such title is amended by striking
‘‘1116(c)’’ and inserting ‘‘1116’’.
(d) EFFECTIVE DATE.—The amendments made by this section shall take effect on October 1, 2005.
SEC. 726. GROUNDS FOR PRESIDENTIAL WAIVER OF REQUIREMENT FOR INFORMED CONSENT OR OPTION TO REFUSE REGARDING ADMINISTRATION OF DRUGS NOT APPROVED FOR GENERAL USE.
(a) INVESTIGATIONAL NEW DRUGS.—Section 1107(f) of title 10, United States Code, is amended—
(1) in paragraph (1), by striking ‘‘obtaining consent—’’ and all that follows through ‘‘(C) is’’ and inserting ‘‘obtaining consent is’’; and
(2) by striking paragraph (2) and inserting the following new paragraph:
‘‘(2) The waiver authority provided in paragraph (1) shall not be construed to apply to any case other than a case in which prior consent for administration of a particular drug is required by reason of a determination by the Secretary of Health and Human Services that such drug is subject to the investigational new drug requirements of section 505(i) of the Federal Food, Drug, and Cos-metic Act.’’.
(b) EMERGENCY USE DRUGS.—Section 1107a(a) of such title is amended—
(1) by inserting ‘‘(A)’’ after ‘‘PRESIDENT.—(1)’’;
(2) by striking ‘‘is not feasible,’’ and all that follows through
‘‘members affected, or’’; and
(3) by adding at the end the following new subparagraph:
‘‘(B) The waiver authority provided in subparagraph (A) shall not be construed to apply to any case other than a case in which an individual is required to be informed of an option to accept or refuse administration of a particular product by reason of a determination by the Secretary of Health and Human Services that emergency use of such product is authorized under section 564 of the Federal Food, Drug, and Cosmetic Act.’’.
SEC. 727. TRICARE PROGRAM REGIONAL DIRECTORS.
(a) RECOMMENDATIONS FOR SELECTION PROCESS FOR TRICARE PROGRAMREGIONALDIRECTORS.—(1) The Secretary of Defense shall develop recommendations for a process for the selection of regional directors for TRICARE program administrative regions from among nominees and applicants for the position in accordance with this section.
(2) The recommendations developed under paragraph (1) shall provide for a process for—
(A) the Secretary of each military department to nominate, for each regional director position, one commissioned officer in a grade above colonel, or, in the case of the Navy, captain, or member of the Senior Executive Service under the jurisdic-tion of that Secretary; and
(B) the Secretary of Defense to accept applications for assignment or appointment to each such position from any other qualified person.
(3) The recommendations developed under paragraph (1) shall also include recommendations with respect to—
(A) the qualifications for regional directors;
(B) the period of assignment of a commissioned officer as a regional director;
(C) procedures for ensuring that fair consideration is given to each nominee and each applicant; and
(D) such other requirements as considered appropriate by the Secretary.
(b) REPORT.—Not later than March 1, 2005, the Secretary of Defense shall submit to the Committees on Armed Services of the Senate and House of Representatives a report containing the recommendations developed by the Secretary under subsection (a).