[Congressional Bills 110th Congress]
[From the U.S. Government Printing Office]
[H.R. 5554 Referred in Senate (RFS)]
2d Session
H. R. 5554
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 21, 2008
Received; read twice and referred to the Committee on Veterans' Affairs
_______________________________________________________________________
AN ACT
To amend title 38, United States Code, to expand and improve health
care services available to veterans from the Department of Veterans
Affairs for substance use disorders, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1 SHORT TITLE.
This Act may be cited as the ``Justin Bailey Veterans Substance Use
Disorders Prevention and Treatment Act of 2008''.
SEC. 2. EXPANSION OF VETERANS SUBSTANCE USE DISORDER PROGRAMS.
Subsection (d) of section 1720A of title 38, United States Code, is
amended by adding at the end the following new paragraph:
``(3)(A) Each plan under paragraph (1) shall ensure that the
medical center provides ready access to a full continuum of care for
substance use disorders for veterans in need of such care.
``(B) In this paragraph, the term `full continuum of care' includes
all of the following care, treatment, and services:
``(i) Screening for substance use disorder in all settings,
including primary care settings.
``(ii) Detoxification and stabilization services.
``(iii) Intensive outpatient care services.
``(iv) Relapse prevention services.
``(v) Outpatient counseling services.
``(vi) Residential substance use disorder treatment.
``(vii) Pharmacological treatment to reduce cravings, and
opioid substitution therapy referred to in paragraph (2).
``(viii) Coordination with groups providing peer to peer
counseling.
``(ix) Short-term, early interventions for substance use
disorders, such as motivational counseling, that are readily
available and provided in a manner to overcome stigma
associated with the provision of such interventions and related
care.
``(x) Marital and family counseling.
``(C) The Secretary shall provide for outreach to veterans who
served in Operation Enduring Freedom or Operation Iraqi Freedom to
increase awareness of the availability of care, treatment, and services
from the Department for substance use disorders.''.
SEC. 3. REQUIREMENT FOR ALLOCATION OF DEPARTMENT RESOURCES TO ENSURE
AVAILABILITY FOR ALL VETERANS REQUIRING TREATMENT FOR
SUBSTANCE USE DISORDERS.
(a) Equitable Allocation of Funding; Annual Report.--Section 1720A
of title 38, United States Code, as amended by section 2, is further
amended by adding at the end the following new subsection:
``(e)(1) The Secretary shall ensure that amounts made available for
care, treatment, and services provided under this section are allocated
in such a manner that a full continuum of care (as defined in
subsection (d)(3)(B)) is available to veterans seeking such care,
treatment, or services, without regard to the location of the residence
of any such veterans.
``(2)(A) In addition to the report required under section
1703(c)(1) of this title (relating to furnishing of contract care and
services under this section), the Secretary shall include in the budget
documents which the Secretary submits to Congress for any fiscal year a
detailed report on the care, treatment, and services furnished by the
Department under this section during the most recently completed fiscal
year.
``(B) Each report under subparagraph (A) shall include data on the
following for each medical facility of the Department:
``(i) The number of veterans who have been provided care,
treatment, or services under this section at the facility for
each 1,000 veterans who have received hospital care (if
applicable) or medical services at the facility.
``(ii) The number of veterans for whom substance use
disorder screening was carried out under subsection
(d)(3)(B)(i) at the facility.
``(iii) The number of veterans for whom a substance use
disorder was identified after a screening was carried out under
subsection (d)(3)(B)(i) at the facility.
``(iv) The number of veterans who were referred by the
facility for care, treatment, or services for substance use
disorders under this section.
``(v) The number of veterans who received care, treatment
or services at the facility for substance use disorders under
this section.
``(vi) Availability of the full continuum of care (as
defined in subsection (d)(3)(B)) at the facility.
``(C) Each report prepared under subparagraph (A) shall be reviewed
by the Committee on Care of Severely Chronically Mentally Ill Veterans
authorized by section 7321 of this title. The Committee shall provide
an independent assessment of the care, treatment, and services
furnished directly by the Department under this section to veterans.
Such assessment shall include a detailed analysis of the availability,
the barriers to access (if any), and the quality of such care,
treatment, and services.''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to fiscal years beginning on or after October 1, 2009.
SEC. 4. PILOT PROGRAM FOR INTERNET-BASED SUBSTANCE USE DISORDER
TREATMENT FOR VETERANS OF OPERATION IRAQI FREEDOM AND
OPERATION ENDURING FREEDOM.
(a) Findings.--Congress makes the following findings:
(1) Stigma associated with seeking treatment for mental
health disorders has been demonstrated to prevent some veterans
from seeking such treatment at a medical facility operated by
the Department of Defense or the Department of Veterans
Affairs.
(2) There is a significant incidence among veterans of
post-deployment mental health problems, especially among
members of a reserve component who return as veterans to
civilian life.
(3) Computer-based self-guided training has been
demonstrated to be an effective strategy for supplementing the
care of psychological conditions.
(4) Younger veterans, especially those who served in
Operation Enduring Freedom or Operation Iraqi Freedom, are
comfortable with and proficient at computer-based technology.
(5) Veterans living in rural areas find access to treatment
for substance use disorder limited.
(6) Self-assessment and treatment options for substance use
disorders through an Internet website may reduce stigma and
provides additional access for individuals seeking care and
treatment for such disorders.
(b) In General.--Not later than October 1, 2009, the Secretary of
Veterans Affairs shall initiate a pilot program to test the feasibility
and advisability of providing veterans who seek treatment for substance
use disorders access to a computer-based self-assessment, education,
and specified treatment program through a secure Internet website
operated by the Secretary. Participation in the pilot program is
available on a voluntary basis for those veterans who have served in
Operation Enduring Freedom or Operation Iraqi Freedom.
(c) Elements of Pilot Program.--
(1) In general.--In designing and carrying out the pilot
program under this section, the Secretary of Veterans Affairs
shall ensure that--
(A) access to the Internet website and the programs
available on the website by a veteran (or family
member) does not involuntarily generate an identifiable
medical record of that access by that veteran in any
medical database maintained by the Department;
(B) the Internet website is accessible from remote
locations, especially rural areas; and
(C) the Internet website includes a self-assessment
tool for substance use disorders, self-guided treatment
and educational materials for such disorders, and
appropriate information and materials for family
members of veterans.
(2) Consideration of similar projects.--In designing the
pilot program under this section, the Secretary of Veterans
Affairs shall consider similar pilot projects of the Department
of Defense for the early diagnosis and treatment of post-
traumatic stress disorder and other mental health conditions
established under section 741 of the John Warner National
Defense Authorization Act of Fiscal Year 2007 (Public Law 109-
364; 120 Stat. 2304).
(3) Location of pilot program.--The Secretary shall carry
out the pilot program through those medical centers of the
Department of Veterans Affairs that have established Centers
for Excellence for Substance Abuse Treatment and Education or
that have established a Substance Abuse Program Evaluation and
Research Center.
(4) Contract authority.--The Secretary of Veterans Affairs
may enter into contracts with qualified entities or
organizations to carry out the pilot program required under
this section.
(d) Duration of Pilot Program.--The pilot program required by
subsection (a) shall be carried out during the two-year period
beginning on the date of the commencement of the pilot program.
(e) Authorization of Appropriations.--There are authorized to be
appropriated to the Secretary of Veterans Affairs $1,500,000 for each
of fiscal years 2010 and 2011 to carry out the pilot program under this
section.
(f) Report.--Not later than six months after the completion of the
pilot program, the Secretary shall submit to Congress a report on the
pilot program, and shall include in that report an assessment of the
feasibility and advisability of the pilot program, of any cost savings
or other benefits associated with the pilot program, and
recommendations for the continuation or expansion of the pilot program.
SEC. 5. REPORT ON RESIDENTIAL MENTAL HEALTH CARE FACILITIES OF THE
VETERANS HEALTH ADMINISTRATION.
(a) Review and Report.--Not later than six months after the date of
the enactment of this Act, the Secretary of Veterans Affairs, acting
through the Office of the Medical Inspector of the Department of
Veterans Affairs, shall--
(1) conduct a review of all residential mental health care
facilities, including domiciliary facilities, of the Veterans
Health Administration; and
(2) submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report on the review conducted under
paragraph (1).
(b) Elements of Report.--The report required by subsection (a)(2)
shall include the following:
(1) A description of the availability of care in
residential mental health care facilities in each Veterans
Integrated Service Network (VISN).
(2) An assessment of the supervision and support provided
in the residential mental health care facilities of the
Veterans Health Administration.
(3) The ratio of staff members at each residential mental
health care facility to patients at such facility.
(4) An assessment of the appropriateness of rules and
procedures for the prescription and administration of
medications to patients in such residential mental health care
facilities.
(5) A description of the protocols at each residential
mental health care facility for handling missed appointments.
(6) Any recommendations the Secretary considers appropriate
for improvements to such residential mental health care
facilities and the care provided in such facilities.
SEC. 6. TRIBUTE TO JUSTIN BAILEY.
This Act is enacted in tribute to Justin Bailey, who, after
returning to the United States from service as a member of the Armed
Forces in Operation Iraqi Freedom, died in a domiciliary facility of
the Department of Veterans Affairs while receiving care for post-
traumatic stress disorder and a substance use disorder.
Passed the House of Representatives May 20, 2008.
Attest:
LORRAINE C. MILLER,
Clerk.