SERVE Act

II 116TH CONGRESS 1ST SESSION S. 2673 To amend title 10, United States Code, to provide for eating disorders treatment for members and certain former members of the uniformed services, and dependents of such members, and for other purposes. IN THE SENATE OF THE UNITED STATES OCTOBER 23, 2019 Mrs. SHAHEEN (for herself, Ms. MCSALLY, Ms. HIRONO, and Mrs. CAPITO) introduced the following bill; which was read twice and referred to the Committee on Armed Services A BILL To amend title 10, United States Code, to provide for eating disorders treatment for members and certain former members of the uniformed services, and dependents of such members, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Supporting Eating 4 Disorders Recovery Through Vital Expansion Act’’ or the 5 ‘‘SERVE Act’’. 6 SEC. 2. FINDINGS. 7 Congress finds the following: 8 VerDate Sep 11 2014 04:25 Oct 25, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2673.IS S2673 kjohnson on DSK79L0C42 with BILLS 2 •S 2673 IS (1) Eating disorders affect approximately 1 30,000,000 Americans, including individuals from 2 every age, gender, body size, race, and socioeconomic 3 status. 4 (2) Eating disorders include anorexia nervosa, 5 bulimia nervosa, binge-eating disorder, avoidant re- 6 strictive intake disorder, and other specified feeding 7 or eating disorders. 8 (3) Eating disorders result in the highest mor- 9 tality rate of any psychiatric illness, and the suicide 10 rate for individuals with such disorders is 23 percent 11 higher than the suicide rate for the general popu- 12 lation. 13 (4) Research demonstrates that— 14 (A) eating disorders often co-occur with 15 complex medical conditions, mental illnesses, 16 and substance use disorders; and 17 (B) up to 35 percent of individuals with a 18 substance use disorder have a co-occurring eat- 19 ing disorder. 20 (5) Studies indicate that there is a higher prev- 21 alence of eating disorders among members of the 22 Armed Forces and veterans than among the general 23 population. 24 VerDate Sep 11 2014 04:25 Oct 25, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2673.IS S2673 kjohnson on DSK79L0C42 with BILLS 3 •S 2673 IS (6) Family members of members of the Armed 1 Forces have a higher prevalence of eating disorders 2 than the general population, with 20 percent of chil- 3 dren of members of the Armed Forces found at risk 4 of developing an eating disorder. 5 (7) Research has found a significant relation- 6 ship between eating disorders and members of the 7 Armed Forces and veterans with a history of post- 8 traumatic stress and sexual trauma. 9 (8) Female members of the Armed Forces have 10 a particularly high risk for an eating disorder, as 11 studies have found that 16 percent of such members 12 have an eating disorder and 34 percent of such 13 members are at risk of developing an eating dis- 14 order. 15 SEC. 3. EATING DISORDERS TREATMENT FOR DEPEND- 16 ENTS. 17 Section 1077 of title 10, United States Code, is 18 amended— 19 (1) in subsection (a)(5), by inserting ‘‘, includ- 20 ing, in accordance with subsection (i), eating dis- 21 orders’’ after ‘‘chronic conditions’’; and 22 (2) by adding at the end the following new sub- 23 section: 24 VerDate Sep 11 2014 04:25 Oct 25, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2673.IS S2673 kjohnson on DSK79L0C42 with BILLS 4 •S 2673 IS ‘‘(i)(1) The provision of health care services for an 1 eating disorder under subsection (a)(5) shall include treat- 2 ment at facilities providing the following hospital-based or 3 freestanding services: 4 ‘‘(A) Inpatient services. 5 ‘‘(B) Residential services. 6 ‘‘(C) Partial hospitalization services. 7 ‘‘(D) Intensive outpatient services. 8 ‘‘(E) Outpatient services. 9 ‘‘(2) A dependent may be provided health care serv- 10 ices for an eating disorder under subsection (a)(5) without 11 regard to the age of the dependent. 12 ‘‘(3) Treatment may be provided under paragraph (1) 13 at a freestanding facility only if the facility— 14 ‘‘(A) is certified to provide such treatment 15 under the TRICARE program; and 16 ‘‘(B) provides to the Secretary of Defense 17 verifiable outcome measurements demonstrating clin- 18 ical improvement of patients when reasonably pos- 19 sible to collect such measurements. 20 ‘‘(4) In this section, the term ‘eating disorder’ has 21 the meaning given that term in the Diagnostic and Statis- 22 tical Manual of Mental Disorders, 5th Edition (or suc- 23 cessor edition), published by the American Psychiatric As- 24 sociation.’’. 25 VerDate Sep 11 2014 04:25 Oct 25, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2673.IS S2673 kjohnson on DSK79L0C42 with BILLS 5 •S 2673 IS SEC. 4. IDENTIFICATION AND TREATMENT OF EATING DIS- 1 ORDERS FOR MEMBERS OF THE ARMED 2 FORCES. 3 Section 1090 of title 10, United States Code, is 4 amended— 5 (1) by striking ‘‘The Secretary of Defense’’ and 6 inserting the following: 7 ‘‘(a) IDENTIFICATION AND TREATMENT OF EATING 8 DISORDERS AND DRUG AND ALCOHOL DEPENDENCE.— 9 The Secretary of Defense’’; 10 (2) by inserting ‘‘have an eating disorder or’’ 11 before ‘‘are dependent on drugs or alcohol’’; and 12 (3) by adding at the end the following new sub- 13 sections: 14 ‘‘(b) FACILITIES AVAILABLE TO INDIVIDUALS WITH 15 EATING DISORDERS.—For purposes of this section, nec- 16 essary facilities described in subsection (a) shall include 17 the facilities described in section 1077(i)(1) of this title. 18 ‘‘(c) EATING DISORDER DEFINED.—In this section, 19 the term ‘eating disorder’ has the meaning given that term 20 in section 1077(i)(4) of this title.’’. 21 SEC. 5. MENTAL HEALTH EARLY IDENTIFICATION TRAIN- 22 ING. 23 Section 1090a of title 10, United States Code, is 24 amended— 25 (1) in subsection (b)— 26 VerDate Sep 11 2014 04:25 Oct 25, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2673.IS S2673 kjohnson on DSK79L0C42 with BILLS 6 •S 2673 IS (A) in paragraph (1), by striking ‘‘and’’ at 1 the end; 2 (B) in paragraph (2), by striking the pe- 3 riod at the end and inserting ‘‘; and’’; and 4 (C) by adding at the end the following new 5 paragraph: 6 ‘‘(3) require commanders and supervisory per- 7 sonnel to undertake mental health early identifica- 8 tion training.’’; and 9 (2) in subsection (e), by adding at the end the 10 following new paragraph: 11 ‘‘(4) The term ‘mental health early identifica- 12 tion training’ means training designed to educate 13 the trainee on— 14 ‘‘(A) warning signs and symptoms of men- 15 tal health illness, including an eating disorder; 16 and 17 ‘‘(B) how to refer an individual for mental 18 health treatment.’’. 19 Æ VerDate Sep 11 2014 04:25 Oct 25, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\S2673.IS S2673 kjohnson on DSK79L0C42 with BILLS