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Appendix C
Sec. 596 of Public Law 111-84,
October 28, 2009
SEC. 596. > COMPREHENSIVE PLAN ON
PREVENTION, DIAGNOSIS, AND TREATMENT OF
SUBSTANCE USE DISORDERS AND DISPOSITION OF
SUBSTANCE ABUSE OFFENDERS IN THE ARMED
FORCES.
(a) Review and Assessment of Current Capabilities.--
(1) In general.-- > Not later than 180
days after the date of the enactment of this Act, the Secretary
of Defense, in consultation with the Secretaries of the military
departments, shall conduct a comprehensive review of the
following:
(A) The programs and activities of the Department of
Defense for the prevention, diagnosis, and treatment of
substance use disorders in members of the Armed Forces.
(B) The policies of the Department of Defense
relating to the disposition of substance abuse offenders
in the Armed Forces, including disciplinary action and
administrative separation.
(2) Elements.--The review conducted under paragraph (1)
shall include an assessment of each of the following:
(A) The current state and effectiveness of the
programs of the Department of Defense and the military
departments
[[Page 123 STAT. 2340]]
relating to the prevention, diagnosis, and treatment of
substance use disorders.
(B) The adequacy of the availability of care, and
access to care, for substance abuse in military medical
treatment facilities and under the TRICARE program.
297
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298 SUBSTANCE USE DISORDERS IN THE U.S. ARMED FORCES
(C) The adequacy of oversight by the Department of
Defense of programs relating to the prevention,
diagnosis, and treatment of substance abuse in members
of the Armed Forces.
(D) The adequacy and appropriateness of current
credentials and other requirements for healthcare
professionals treating members of the Armed Forces with
substance use disorders.
(E) The advisable ratio of physician and
nonphysician care providers for substance use disorders
to members of the Armed Forces with such disorders.
(F) The adequacy and appropriateness of protocols
and directives for the diagnosis and treatment of
substance use disorders in members of the Armed Forces
and for the disposition, including disciplinary action
and administrative separation, of members of the Armed
Forces for substance abuse.
(G) The adequacy of the availability of and access
to care for substance use disorders for members of the
reserve components of the Armed Forces, including an
identification of any obstacles that are unique to the
prevention, diagnosis, and treatment of substance use
disorders among members of the reserve components, and
the appropriate disposition, including disciplinary
action and administrative separation, of members of the
reserve components for substance abuse.
(H) The adequacy of the prevention, diagnosis, and
treatment of substance use disorders in dependents of
members of the Armed Forces.
(I) Any gaps in the current capabilities of the
Department of Defense for the prevention, diagnosis, and
treatment of substance use disorders in members of the
Armed Forces.
(3) Report.--Not later than 180 days 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 setting forth the findings and
recommendations of the Secretary as a result of the review
conducted under paragraph (1). The report shall--
(A) set forth the findings and recommendations of
the Secretary regarding each element of the review
specified in paragraph (2);
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APPENDIX C 299
(B) set forth relevant statistics on the frequency
of substance use disorders, disciplinary actions, and
administrative separations for substance abuse in
members of the regular components of the Armed Forces,
members of the reserve component of the Armed Forces,
and to the extent applicable, dependents of such members
(including spouses and children); and
[[Page 123 STAT. 2341]]
(C) include such other findings and recommendations
on improvements to the current capabilities of the
Department of Defense for the prevention, diagnosis, and
treatment of substance use disorders in members of the
Armed Forces and the policies relating to the
disposition, including disciplinary action and
administrative separation, of members of the Armed
Forces for substance abuse, as the Secretary considers
appropriate.
(b) Plan for Improvement and Enhancement of Programs and Policies.--
(1) Plan required.-- > Not later than 270
days after the date of the enactment of this Act, the Secretary
of Defense shall submit to the congressional defense committees
a comprehensive plan for the improvement and enhancement of the
following:
(A) The programs and activities of the Department of
Defense for the prevention, diagnosis, and treatment of
substance use disorders in members of the Armed Forces
and their dependents.
(B) The policies of the Department of Defense
relating to the disposition of substance abuse offenders
in the Armed Forces, including disciplinary action and
administrative separation.
(2) Basis.--The comprehensive plan required by paragraph (1)
shall take into account the following:
(A) The results of the review and assessment
conducted under subsection (a).
(B) Similar initiatives of the Secretary of Veterans
Affairs to expand and improve care for substance use
disorders among veterans, including the programs and
activities conducted under title I of the Veterans’
Mental Health and Other Care Improvements Act of 2008
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300 SUBSTANCE USE DISORDERS IN THE U.S. ARMED FORCES
(Public Law 110-387; 112 Stat. 4112).
(3) Comprehensive statement of policy.--The comprehensive
plan required by paragraph (1) shall include a comprehensive
statement of the following:
(A) The policy of the Department of Defense
regarding the prevention, diagnosis, and treatment of
substance use disorders in members of the Armed Forces
and their dependents.
(B) The policies of the Department of Defense
relating to the disposition of substance abuse offenders
in the Armed Forces, including disciplinary action and
administrative separation.
(4) Availability of services and treatment.--The
comprehensive plan required by paragraph (1) shall include
mechanisms to ensure the availability to members of the Armed
Forces and their dependents of a core of evidence-based
practices across the spectrum of medical and non-medial services
and treatments for substance use disorders, including the
reestablishment of regional long-term inpatient substance abuse
treatment programs. The Secretary may use contracted services
for not longer than three years after the date of the enactment
of this Act to perform such inpatient substance abuse treatment
until the Department of Defense reestablishes this capability
within the military health care system.
[[Page 123 STAT. 2342]]
(5) Prevention and reduction of disorders.--The
comprehensive plan required by paragraph (1) shall include
mechanisms to facilitate the prevention and reduction of
substance use disorders in members of the Armed Forces through
science-based initiatives, including education programs, for
members of the Armed Forces and their dependents.
(6) Specific instructions.--The comprehensive plan required
by paragraph (1) shall include each of the following:
(A) Substances of abuse.--Instructions on the
prevention, diagnosis, and treatment of substance abuse
in members of the Armed Forces, including the abuse of
alcohol, illicit drugs, and nonmedical use and abuse of
prescription drugs.
(B) Healthcare professionals.--Instructions on--
(i) appropriate training of healthcare
professionals in the prevention, screening,
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APPENDIX C 301
diagnosis, and treatment of substance use
disorders in members of the Armed Forces;
(ii) appropriate staffing levels for
healthcare professionals at military medical
treatment facilities for the prevention,
screening, diagnosis, and treatment of substance
use disorders in members of the Armed Forces; and
(iii) such uniform training and credentialing
requirements for physician and nonphysician
healthcare professionals in the prevention,
screening, diagnosis, and treatment of substance
use disorders in members of the Armed Forces as
the Secretary considers appropriate.
(C) Services for dependents.--Instructions on the
availability of services for substance use disorders for
dependents of members of the Armed Forces, including
instructions on making such services available to
dependents to the maximum extent practicable.
(D) Relationship between disciplinary action and
treatment.--Policy on the relationship between
disciplinary actions and administrative separation
processing and prevention and treatment of substance use
disorders in members of the Armed Forces.
(E) Confidentiality.--Recommendations regarding
policies pertaining to confidentiality for members of
the Armed Forces in seeking or receiving services or
treatment for substance use disorders.
(F) Participation of chain of command.--Policy on
appropriate consultation, reference to, and involvement
of the chain of command of members of the Armed Forces
in matters relating to the diagnosis and treatment of
substance abuse and disposition of members of the Armed
Forces for substance abuse.
(G) Consideration of gender.--Instructions on gender
specific requirements, if appropriate, in the
prevention, diagnosis, treatment, and management of
substance use disorders in members of the Armed Forces,
including gender specific care and treatment
requirements.
(H) Coordination with other healthcare
initiatives.--Instructions on the integration of efforts
on the
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302 SUBSTANCE USE DISORDERS IN THE U.S. ARMED FORCES
[[Page 123 STAT. 2343]]
prevention, diagnosis, treatment, and management of
substance use disorders in members of the Armed Forces
with efforts to address co-occurring health care
disorders (such as post-traumatic stress disorder and
depression) and suicide prevention.
(7) Other elements.--In addition to the matters specified in
paragraph (3), the comprehensive plan required by paragraph (1)
shall include the following:
(A) Implementation plan.--An implementation plan for
the achievement of the goals of the comprehensive plan,
including goals relating to the following:
(i) Enhanced education of members of the Armed
Forces and their dependents regarding substance
use disorders.
(ii) Enhanced and improved identification and
diagnosis of substance use disorders in members of
the Armed Forces and their dependents.
(iii) Enhanced and improved access of members
of the Armed Forces to services and treatment for
and management of substance use disorders.
(iv) Appropriate staffing of military medical
treatment facilities and other facilities for the
treatment of substance use disorders in members of
the Armed Forces.
(B) Best practices.--The incorporation of evidence-
based best practices utilized in current military and
civilian approaches to the prevention, diagnosis,
treatment, and management of substance use disorders.
(C) Available research.--The incorporation of
applicable results of available studies, research, and
academic reviews on the prevention, diagnosis,
treatment, and management of substance use disorders.
(8) Update in light of independent study.--Upon the
completion of the study required by subsection (c), the
Secretary of Defense shall--
(A) in consultation with the Secretaries of the
military departments, make such modifications and
improvements to the comprehensive plan required by
paragraph (1) as the Secretary of Defense considers
appropriate in light of the findings and recommendations
of the study; and
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APPENDIX C 303
(B) > submit to the congressional
defense committees a report setting forth the
comprehensive plan as modified and improved under
subparagraph (A).
(c) Independent Report on Substance Use Disorders Programs for
Members of the Armed Forces.--
(1) Study required.--Upon completion of the policy review
required by subsection (a), the Secretary of Defense shall
provide for a study on substance use disorders programs for
members of the Armed Forces to be conducted by the Institute of
Medicine of the National Academies of Sciences or such other
independent entity as the Secretary shall select for purposes of
the study.
(2) Elements.--The study required by paragraph (1) shall
include a review and assessment of the following:
(A) The adequacy and appropriateness of protocols
for the diagnosis, treatment, and management of
substance use disorders in members of the Armed Forces.
[[Page 123 STAT. 2344]]
(B) The adequacy of the availability of and access
to care for substance use disorders in military medical
treatment facilities and under the TRICARE program.
(C) The adequacy and appropriateness of current
credentials and other requirements for physician and
non-physician healthcare professionals treating members
of the Armed Forces with substance use disorders.
(D) The advisable ratio of physician and non-
physician care providers for substance use disorders to
members of the Armed Forces with such disorders.
(E) The adequacy of the availability of and access
to care for substance use disorders for members of the
reserve components of the Armed Forces when compared
with the availability of and access to care for
substance use disorders for members of the regular
components of the Armed Forces.
(F) The adequacy of the prevention, diagnosis,
treatment, and management of substance use disorders
programs for dependents of members of the Armed Forces,
whether such dependents suffer from their own substance
use disorder or because of the substance use disorder of
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304 SUBSTANCE USE DISORDERS IN THE U.S. ARMED FORCES
a member of the Armed Forces.
(G) Such other matters as the Secretary considers
appropriate for purposes of the study.
(3) Report.--Not later than two years after the date of the
enactment of this Act, the entity conducting the study required
by paragraph (1) shall submit to the Secretary of Defense and
the congressional defense committees a report on the results of
the study. The report shall set forth the findings and
recommendations of the entity as a result of the study.
