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<bill bill-stage="Introduced-in-House" dms-id="H1CCCB723E2C7466E9A3E9ABBDBD189B0" public-private="public" key="H" bill-type="olc"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
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<dc:title>114 HR 5867 IH: Setting Treatment Options and Practices for Veteran Suicide and Substance Abuse Act</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2020-02-12</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">116th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">H. R. 5867</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20200212">February 12, 2020</action-date><action-desc><sponsor name-id="C001123">Mr. Cisneros</sponsor> (for himself and <cosponsor name-id="M001199">Mr. Mast</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HVR00">Committee on Veterans' Affairs</committee-name>, and in addition to the Committees on <committee-name committee-id="HAS00">Armed Services</committee-name>, and <committee-name committee-id="HIF00">Energy and Commerce</committee-name>, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To direct the Secretary of Veterans Affairs to establish or update certain clinical practice guidelines of the Department of Veterans Affairs, and for other purposes.</official-title></form><legis-body id="HA2AFEDF9F7FD4CD5BA11F1DA795EB8DB" style="OLC"><section id="HD089D418E23A4A7EB39E9F94E546C3D2" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Setting Treatment Options and Practices for Veteran Suicide and Substance Abuse Act</short-title></quote> or the <quote><short-title>STOP Veteran Suicide and Substance Abuse Act</short-title></quote>.</text></section><section id="HF825A20E69C3461EB15D477AAC300892" section-type="subsequent-section"><enum>2.</enum><header>Establishment by Department of Veterans Affairs and Department of Defense of clinical practice guidelines for comorbid mental health conditions such as PTSD, MST, and/or TBI</header><subsection id="HD3373D34EFA944928CF82C27946D7F57"><enum>(a)</enum><header>In general</header><text>Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs, in consultation with the Secretary of Defense and the Secretary of Health and Human Services, shall complete the development of clinical practice guidelines for the treatment of post-traumatic stress disorder, military sexual trauma, and traumatic brain injury that is comorbid with substance use disorder or chronic pain.</text></subsection><subsection id="H755AF3BE1AA9487EB160DE9A3F0CA89B"><enum>(b)</enum><header>Work group</header><paragraph id="H19E3B39C9734425BB04F43A56D8CB08B"><enum>(1)</enum><header>Establishment</header><text>In carrying out subsection (a), the Secretary of Veterans Affairs, the Secretary of Defense, and the Secretary of Health and Human Services shall create a Trauma and Comorbid Substance Use Disorder or Chronic Pain Work Group (in this section referred to as the <quote>Work Group</quote>).</text></paragraph><paragraph id="HA089397135974DA398B3F4943276DE15"><enum>(2)</enum><header>Membership</header><text>The work group created under paragraph (1) shall be comprised of individuals that represent Federal Government entities and non-Federal Government entities with expertise in the areas covered by the work group, including the following:</text><subparagraph id="H45F03A995FF8477B8D0AFFDC99C9E6A9"><enum>(A)</enum><text>Academic institutions that specialize in research for the treatment of conditions described in subsection (a).</text></subparagraph><subparagraph id="HC6C8B38D636443F9A04821B0A6649E40"><enum>(B)</enum><text>The National Center for Posttraumatic Stress Disorder of the Department of Veterans Affairs.</text></subparagraph><subparagraph id="H6A2C5F797B4445FE802DA790D7018313"><enum>(C)</enum><text>The Office of the Assistant Secretary for Mental Health and Substance Use of the Department of Health and Human Services.</text></subparagraph></paragraph><paragraph id="H142BAE0A6D404BDCA65562ABD69E302E"><enum>(3)</enum><header>Relation to other work groups</header><text>The Work Group shall be created and conducted in the same manner as other work groups for the development of clinical practice guidelines for the Department of Veterans Affairs and the Department of Defense.</text></paragraph></subsection><subsection id="HF07C9F5AB4134F2A80C9E1E43381A8BB"><enum>(c)</enum><header>Matters included</header><text>In developing the clinical practice guidelines under subsection (a), the Work Group, in consultation with the Post Traumatic Stress Disorder Work Group, Concussion-mTBI Work Group, Opioid Therapy for Chronic Pain Work Group, and Substance Use Work Group, shall ensure that the clinical practice guidelines include the following:</text><paragraph id="H5149C6C326D048A58FF6F5D1FA681191"><enum>(1)</enum><text>Guidance with respect to the following:</text><subparagraph id="H2EF82F8824414CB58202D5C0E0E1930E"><enum>(A)</enum><text>The treatment of patients with post-traumatic stress disorder who are also experiencing a substance use disorder or chronic pain.</text></subparagraph><subparagraph id="HFD49924F62544F4DBC1FAD667334F238"><enum>(B)</enum><text>The treatment of patients experiencing a mental health condition, including anxiety, depression, or post-traumatic stress disorder as a result of military sexual trauma who are also experiencing a substance use disorder or chronic pain.</text></subparagraph><subparagraph id="H66A5F106320C4D3CA2646CC41AD09EDE"><enum>(C)</enum><text>The treatment of patients with traumatic brain injury who are also experiencing a substance use disorder or chronic pain.</text></subparagraph></paragraph><paragraph id="H6ADCD29738864AC69669629D0B51F988"><enum>(2)</enum><text>Guidance with respect to the following:</text><subparagraph id="H9E19736067AD4646AA0D08852AD3CF04"><enum>(A)</enum><text>Appropriate case management for patients experiencing post-traumatic stress disorder that is comorbid with substance use disorder or chronic pain who transition from receiving care while on active duty in the Armed Forces to care from health care networks outside of the Department of Defense.</text></subparagraph><subparagraph id="HFEF3A8745DC74B90A16ADDDF5C9CB11B"><enum>(B)</enum><text>Appropriate case management for patients experiencing a mental health condition, including anxiety, depression, or post-traumatic stress disorder as a result of military sexual trauma that is comorbid with substance use disorder or chronic pain who transition from receiving care while on active duty in the Armed Forces to care from health care networks outside of the Department of Defense.</text></subparagraph><subparagraph id="HF7FAA1B0AB684E3CB1F5F3B1BFAC3A05"><enum>(C)</enum><text>Appropriate case management for patients experiencing traumatic brain injury that is comorbid with substance use disorder or chronic pain who transition from receiving care while on active duty in the Armed Forces to care from health care networks outside of the Department of Defense.</text></subparagraph></paragraph><paragraph id="HC8364CF85B7B4E99893B5C083D998890"><enum>(3)</enum><text>Guidance with respect to the treatment of patients who are still members of the Armed Forces and are experiencing a mental health condition, including anxiety, depression, or post-traumatic stress disorder as a result of military sexual trauma that is comorbid with substance use disorder or chronic pain.</text></paragraph><paragraph id="H137B91934F794402AE569DB6C340C2F6"><enum>(4)</enum><text>Guidance with respect to the assessment by the National Academies of Sciences, Engineering, and Medicine of the potential overmedication of veterans, as required pursuant to the Senate report accompanying S. 1557, 115th Congress (Senate Report 115–130), under the heading <quote>Overprescription Prevention Report</quote> under the heading <quote><header-in-text level="appropriations-small" style="OLC">COMMITTEE RECOMMENDATION</header-in-text></quote>.</text></paragraph></subsection><subsection id="HB24ECB8CCD1B4E81BC3401D14E83CCA5"><enum>(d)</enum><header>Rule of construction</header><text>Nothing in this section shall be construed to prevent the Secretary of Veterans Affairs and the Secretary of Defense from considering all relevant evidence, as appropriate, in creating the clinical practice guidelines required under subsection (a) or from ensuring that the final clinical practice guidelines developed under such subsection and subsequently updated, as appropriate, remain applicable to the patient populations of the Department of Veterans Affairs and the Department of Defense.</text></subsection></section><section id="H8E7873DF5C6144C8AF4BEC0C47D4F99E"><enum>3.</enum><header>Update of clinical practice guidelines for assessment and management of patients at risk for suicide by taking into consideration gender- and age-specific risk factors and gender- and age-specific treatment efficacy of pharmacotherapy and psychotherapy</header><subsection id="HB4EB99903CB9433188219A49C884A4D1"><enum>(a)</enum><header>In general</header><text>Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs and the Secretary of Defense, through the Assessment and Management of Patients at Risk for Suicide Work Group (in this section referred to as the <quote>Work Group</quote>), shall issue an update to the VA/DOD Clinical Practice Guideline for Assessment and Management of Patients at Risk for Suicide.</text></subsection><subsection id="HAFFC7FF07A7F4B048C7E5F3BE5B45955"><enum>(b)</enum><header>Matters included</header><text>In carrying out the update under subsection (a), the Work Group shall ensure that the clinical practice guidelines updated under such subsection includes the following:</text><paragraph id="H549BF1B987294724A3DD72B498ED1B91"><enum>(1)</enum><text>Enhanced guidance with respect to the following:</text><subparagraph id="HB9FD1F70E24B4A7284CA0A1928FAD8B7"><enum>(A)</enum><text>Gender- and age-specific risk factors for suicide and suicidal ideation.</text></subparagraph><subparagraph id="HA37E7F1A67584DC280BE96CC268D44D0"><enum>(B)</enum><text>Gender- and age-specific treatment efficacy for depression and suicide prevention.</text></subparagraph><subparagraph id="HB8E5C8C2B2F14AF29389DDE556D10120"><enum>(C)</enum><text>Gender- and age-specific phar­ma­co­ther­a­py efficacy.</text></subparagraph><subparagraph id="H9606199682E84DEABE7FE61BD87C317F"><enum>(D)</enum><text>Gender- and age-specific psy­cho­ther­a­py efficacy.</text></subparagraph></paragraph><paragraph id="HE4E6B2BC7C404F6CBE0B63E11383B313"><enum>(2)</enum><text>Guidance with respect to the efficacy of alternative therapies, other than psychotherapy and pharmacotherapy, including the following:</text><subparagraph id="H826DE20EF829471CACC6A42F45A604C4" display-inline="no-display-inline"><enum>(A)</enum><text>Yoga therapy.</text></subparagraph><subparagraph id="HCEE76A94D2FD484C9E3A5E3D614DE85E"><enum>(B)</enum><text>Meditation therapy.</text></subparagraph><subparagraph id="H77E0A76D3BE343A788DF9FB62472EB02"><enum>(C)</enum><text>Equine therapy.</text></subparagraph><subparagraph id="HA175C563A8FA4881BA6911523780E158"><enum>(D)</enum><text>Other animal therapy.</text></subparagraph><subparagraph id="HB7FE573460524DBEBDE3DFADC0AF2D1B"><enum>(E)</enum><text>Training and caring for service dogs.</text></subparagraph><subparagraph id="HFFD5653E69EC48DC9D0CA26F596E0F87"><enum>(F)</enum><text>Agri-therapy.</text></subparagraph><subparagraph id="H6732DA7EDB4C4838911B33362C2E36A5"><enum>(G)</enum><text>Art therapy.</text></subparagraph><subparagraph id="HF2036133CD744130AEAEA665F0159ED4"><enum>(H)</enum><text>Outdoor sports therapy.</text></subparagraph><subparagraph id="HDED4B9E5CD2D48C58CDE0C51690D6564"><enum>(I)</enum><text>Music therapy.</text></subparagraph><subparagraph id="H7E8B6C23E5714C0093DD45AE758E68ED"><enum>(J)</enum><text>Any other alternative therapy that the Work Group considers appropriate.</text></subparagraph></paragraph><paragraph id="H7EEAB6BE85494C428EAA911A0AB4220E"><enum>(3)</enum><text>Guidance with respect to the findings of the Creating Options for Veterans’ Expedited Recovery Commission (commonly referred to as the <quote>COVER Commission</quote>) established under section 931 of the Jason Simcakoski Memorial and Promise Act (title IX of <external-xref legal-doc="public-law" parsable-cite="pl/114/198">Public Law 114–198</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1701">38 U.S.C. 1701</external-xref> note).</text></paragraph></subsection><subsection id="HCB48830EACA246EFBFD6FF8DEF086C6F"><enum>(c)</enum><header>Rule of construction</header><text>Nothing in this section shall be construed to prevent the Secretary of Veterans Affairs and the Secretary of Defense from considering all relevant evidence, as appropriate, in updating the VA/DOD Clinical Practice Guideline for Assessment and Management of Patients at Risk for Suicide, as required under subsection (a), or from ensuring that the final clinical practice guidelines updated under such subsection remain applicable to the patient populations of the Department of Veterans Affairs and the Department of Defense.</text></subsection></section></legis-body></bill> 

