((a)) ** .—** The Secretary of Defense shall establish a system to assess the medical condition of members of the armed forces (including members of the reserve components) who are deployed outside the United States or its territories or possessions as part of a contingency operation (including a humanitarian operation, peacekeeping operation, or similar operation) or combat operation.
((b)) ** .—**
((1))
((A)) The system described in subsection (a) shall include the use of predeployment medical examinations and postdeployment medical examinations (including the assessment of mental health and the drawing of blood samples) and postdeployment health reassessments to—
((i)) accurately record the health status of members before their deployment;
((ii)) accurately record any changes in their health status during the course of their deployment;
((iii)) identify health concerns, including mental health concerns, that may become manifest several months following their deployment; and
((iv)) accurately record any exposure to occupational and environmental health risks during the course of their deployment.
((B)) The postdeployment medical examination shall be conducted when the member is redeployed or otherwise leaves an area in which the system is in operation (or as soon as possible thereafter).
((C)) The postdeployment health reassessment shall be conducted at an appropriate time during the period beginning 90 days after the member is redeployed and ending 180 days after the member is redeployed.
((2)) The predeployment medical examination, postdeployment medical examination, and postdeployment health reassessment of a member of the armed forces required under paragraph (1) shall include the following:
((A)) An assessment of the current treatment of the member and any use of psychotropic medications by the member for a mental health condition or disorder.
((B)) An assessment of traumatic brain injury.
((C)) An assessment of post-traumatic stress disorder.
((D)) An assessment of whether the member was—
((i)) based or stationed at a location where an open burn pit, as defined in subsection (c) of section 201 of the Dignified Burial and Other Veterans’ Benefits Improvement Act of 2012 (; note), was used; or
((ii)) exposed to toxic airborne chemicals or other airborne contaminants, including any information recorded as part of the registry established by the Secretary of Veterans Affairs under such section 201.
((3))
((A)) The Secretary shall establish for purposes of subparagraphs (B) and (C) of paragraph (2) a protocol for the predeployment assessment and documentation of the cognitive (including memory) functioning of a member who is deployed outside the United States in order to facilitate the assessment of the postdeployment cognitive (including memory) functioning of the member.
((B)) The protocol under subparagraph (A) shall include appropriate mechanisms to permit the differential diagnosis of traumatic brain injury in members returning from deployment in a combat zone.
((c)) ** .—** The results of all medical examinations and reassessments conducted under the system, records of all health care services (including immunizations and the prescription and administration of psychotropic medications) received by members described in subsection (a) in anticipation of their deployment or during the course of their deployment, and records of events occurring in the deployment area (including the results of any assessment performed by the Secretary of occupational and environmental health risks for such area) that may affect the health of such members shall be retained and maintained in a centralized location to improve future access to the records.
((d)) ** .—**
((1)) The Secretary of Defense shall establish a quality assurance program to evaluate the success of the system in ensuring that members described in subsection (a) receive predeployment medical examinations, postdeployment medical examinations, and postdeployment health reassessments and that the recordkeeping requirements with respect to the system are met.
((2)) The quality assurance program established under paragraph (1) shall also include the following elements:
((A)) The types of healthcare providers conducting postdeployment health assessments and reassessments.
((B)) The training received by such providers applicable to the conduct of such assessments and reassessments, including training on assessments and referrals relating to mental health.
((C)) The guidance available to such providers on how to apply the clinical practice guidelines developed under subsection (e)(1) in determining whether to make a referral for further evaluation of a member of the armed forces relating to mental health.
((D)) The effectiveness of the tracking mechanisms required under this section in ensuring that members who receive referrals for further evaluations relating to mental health receive such evaluations and obtain such care and services as are warranted.
((E)) Programs established for monitoring the mental health of each member who, after deployment to a combat operation or contingency operations, is known—
((i)) to have a mental health condition or disorder; or
((ii)) to be receiving treatment, including psychotropic medications, for a mental health condition or disorder.
((F)) The diagnosis and treatment of traumatic brain injury and post-traumatic stress disorder.
((e)) ** .—** The system described in subsection (a) shall include—
((1)) development of clinical practice guidelines to be utilized by healthcare providers in determining whether to refer a member of the armed forces for further evaluation relating to mental health (including traumatic brain injury);
((2)) mechanisms to ensure that healthcare providers are trained in the application of such clinical practice guidelines; and
((3)) mechanisms for oversight to ensure that healthcare providers apply such guidelines consistently.
((f)) ** .—**
((1)) The Secretary of Defense shall prescribe in regulations minimum standards for mental health for the eligibility of a member of the armed forces for deployment to a combat operation or contingency operation.
((2)) The standards required by paragraph (1) shall include the following:
((A)) A specification of the mental health conditions, treatment for such conditions, and receipt of psychotropic medications for such conditions that preclude deployment of a member of the armed forces to a combat operation or contingency operation, or to a specified type of such operation.
((B)) Guidelines for the deployability and treatment of members of the armed forces diagnosed with a severe mental illness, traumatic brain injury, or post traumatic stress disorder.
((3)) The Secretary shall take appropriate actions to ensure the utilization of the standards prescribed under paragraph (1) in the making of determinations regarding the deployability of members of the armed forces to a combat operation or contingency operation.
((g)) ** .—**
((1)) The Secretary of Defense shall standardize and make available to a provider that conducts a postdeployment medical examination or reassessment under the system described in subsection (a) questions relating to occupational and environmental health exposure.
((2)) The Secretary, to the extent practicable, shall ensure that the medical record of a member includes information on the external cause relating to a diagnosis of the member, including by associating an external cause code (as issued under the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (or any successor revision)).
