II
109th CONGRESS
1st Session
S. 1177
IN THE SENATE OF THE UNITED STATES
June 7, 2005
Mr. Akaka introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs
A BILL
To improve mental health services at all facilities of the Department of Veterans Affairs.
Short title
This Act may be cited as
the Veterans Mental Health Care
Capacity Enhancement Act of 2005
.
Findings
Congress makes the following findings:
Mental health treatment capacity at community-based outpatient clinics remains inadequate and inconsistent, despite the requirement under section 1706(c) of title 38, United States Code, that every primary care health care facility of the Department of Veterans Affairs develop and carry out a plan to meet the mental health care needs of veterans who require such services.
In 2001, the minority staff of the Committee on Veterans' Affairs of the Senate conducted a survey of community-based outpatient clinics and found that there was no established systemwide baseline of acceptable mental health service levels at such clinics.
In 2004, the Department of Veterans Affairs workgroup on mental health care, which developed and submitted a Comprehensive Mental Health Strategic Plan to the Secretary of Veterans Affairs, found service and funding gaps within the Department of Veterans Affairs health care system, and made numerous recommendations for improvements. As of May 2005, Congress had not received a final report on the workgroup's findings.
In February 2005, the Government Accountability Office reported that the Department of Veterans Affairs had not fully met any of the 24 clinical care and education recommendations made in 2004 by the Special Committee on Post-Traumatic Stress Disorder of the Under Secretary for Health, Veterans Health Administration.
Required capacity for community-Based outpatient clinics
Strengthening of performance measures for mental health programs
Section 1706(b)(6) of title 38, United States Code, is amended by adding at the end the following:
The Under Secretary shall include, as goals in the performance contracts entered into with Network Directors to prioritize mental health services—
establishing appropriate staff-patient ratio levels for various programs (including mental health services at community-based outpatient clinics);
fostering collaborative environments for providers; and
encouraging clinicians to conduct mental health consultations during primary care visits.
.
Inflationary indexing of capacity requirements
Section 1706(b) of title 38, United States Code, is amended by adding at the end the following:
For the purposes of meeting and reporting on the capacity requirements under paragraph (1), the Secretary shall ensure that the funding levels allocated for specialized treatment and rehabilitative services for disabled veterans are adjusted for inflation each fiscal year.
.
Mental health and substance abuse services
Section 1706(c) of title 38, United States Code, is amended—
by inserting
(1)
before The Secretary
; and
by adding at the end the following:
The Secretary shall ensure that not less than 90 percent of community-based outpatient clinics have the capacity to provide onsite, contract-referral, or tele-mental health services—
for at least 10 percent of all clinic visits by not later than September 30, 2006; and
for at least 15 percent of all clinic visits by not later than September 30, 2007.
The Secretary shall ensure that not less than 2 years after the date of enactment of this paragraph—
each primary care health care facility of the Department has the capacity and resources to provide not less than 5 days of inpatient, residential detoxification services onsite or at a nearby contracted or Department facility; and
a case manager is assigned to coordinate follow up outpatient services at each community-based outpatient clinic.
.
Reporting requirement
Not later than January 31, 2008, the Secretary of Veterans Affairs shall submit a report to Congress that—
describes the status and availability of mental health services at community-based outpatient clinics;
describes the substance of services available at such clinics;
includes the ratios between mental health staff and patients at such clinics; and
includes the certification of the Inspector General of the Department of Veterans Affairs.
Cooperation on mental health awareness and prevention
Agreement
The Secretary of Defense and the Secretary of Veterans Affairs shall enter into a Memorandum of Understanding—
to ensure that separating servicemembers receive standardized individual mental health and sexual trauma assessments as part of separation exams; and
includes the development of shared guidelines on how to conduct the assessments.
Establishment of joint VA–DoD workgroup on mental health
In general
Not later than 180 days after the date of enactment of this Act, the Secretary of Defense and the Secretary of Veterans Affairs shall establish a joint workgroup on mental health, which shall be comprised of not less than 7 leaders in the field of mental health appointed from their respective departments.
Study
Not later than 1 year after the establishment of the workgroup under paragraph (1), the workgroup shall analyze the feasibility, content, and scope of initiatives related to—
combating stigmas and prejudices associated with servicemembers who suffer from mental health disorders or readjustment issues, through the use of peer counseling programs or other educational initiatives;
ways in which the Department of Veterans Affairs can make their expertise in treating mental health disorders more readily available to Department of Defense mental health care providers;
family and spousal education to assist family members of veterans and servicemembers to recognize and deal with signs of potential readjustment issues or other mental health disorders; and
seamless transition of servicemembers who have been diagnosed with mental health disorders from active duty to veteran status (in consultation with the Seamless Transition Task Force and other entities assisting in this effort).
Report
Not later than June 30, 2007, the Secretary of Defense and the Secretary of Veterans Affairs shall submit a report to Congress containing the findings and recommendations of the workgroup established under this subsection.
Primary care consultations for mental health
Guidelines
The Under Secretary for Health, Veterans Health Administration, shall establish systemwide guidelines for screening primary care patients for mental health disorders and illnesses.
Training
Based upon the guidelines established under subsection (a), the Under Secretary for Health, Veterans Health Administration, shall conduct appropriate training for clinicians of the Department of Veterans Affairs to carry out mental health consultations.