[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1177 Introduced in Senate (IS)]







109th CONGRESS
  1st Session
                                S. 1177

 To improve mental health services at all facilities of the Department 
                          of Veterans Affairs.


_______________________________________________________________________


                   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.

    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 ``Veterans Mental Health Care Capacity 
Enhancement Act of 2005''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) 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.
            (2) 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.
            (3) 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.
            (4) 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.

SEC. 3. REQUIRED CAPACITY FOR COMMUNITY-BASED OUTPATIENT CLINICS.

    (a) 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:
    ``(D) The Under Secretary shall include, as goals in the 
performance contracts entered into with Network Directors to prioritize 
mental health services--
            ``(i) establishing appropriate staff-patient ratio levels 
        for various programs (including mental health services at 
        community-based outpatient clinics);
            ``(ii) fostering collaborative environments for providers; 
        and
            ``(iii) encouraging clinicians to conduct mental health 
        consultations during primary care visits.''.
    (b) Inflationary Indexing of Capacity Requirements.--Section 
1706(b) of title 38, United States Code, is amended by adding at the 
end the following:
    ``(7) 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.''.
    (c) Mental Health and Substance Abuse Services.--Section 1706(c) of 
title 38, United States Code, is amended--
            (1) by inserting ``(1)'' before ``The Secretary''; and
            (2) by adding at the end the following:
    ``(2) 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--
            ``(A) for at least 10 percent of all clinic visits by not 
        later than September 30, 2006; and
            ``(B) for at least 15 percent of all clinic visits by not 
        later than September 30, 2007.
    ``(3) The Secretary shall ensure that not less than 2 years after 
the date of enactment of this paragraph--
            ``(A) 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
            ``(B) a case manager is assigned to coordinate follow up 
        outpatient services at each community-based outpatient 
        clinic.''.
    (d) Reporting Requirement.--Not later than January 31, 2008, the 
Secretary of Veterans Affairs shall submit a report to Congress that--
            (1) describes the status and availability of mental health 
        services at community-based outpatient clinics;
            (2) describes the substance of services available at such 
        clinics;
            (3) includes the ratios between mental health staff and 
        patients at such clinics; and
            (4) includes the certification of the Inspector General of 
        the Department of Veterans Affairs.

SEC. 4. COOPERATION ON MENTAL HEALTH AWARENESS AND PREVENTION.

    (a) Agreement.--The Secretary of Defense and the Secretary of 
Veterans Affairs shall enter into a Memorandum of Understanding--
            (1) to ensure that separating servicemembers receive 
        standardized individual mental health and sexual trauma 
        assessments as part of separation exams; and
            (2) includes the development of shared guidelines on how to 
        conduct the assessments.
    (b) Establishment of Joint VA-DoD Workgroup on Mental Health.--
            (1) 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.
            (2) 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--
                    (A) 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;
                    (B) 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;
                    (C) 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
                    (D) 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).
            (3) 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.

SEC. 5. PRIMARY CARE CONSULTATIONS FOR MENTAL HEALTH.

    (a) Guidelines.--The Under Secretary for Health, Veterans Health 
Administration, shall establish systemwide guidelines for screening 
primary care patients for mental health disorders and illnesses.
    (b) 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.
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