110 HR 4053 IH: Mental Health Improvements Act
U.S. House of Representatives
2007-11-01
text/xml
EN
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.
1.Short title; table of
contents
(a)This Act may be cited
as the Mental Health Improvements Act
of 2007
.
(b)The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—Substance use disorders and mental health
care
Sec. 101. Findings on substance use disorders and mental
health.
Sec. 102. Expansion of substance use disorder treatment
services at Department of Veterans Affairs Medical Centers.
Sec. 103. Care for veterans with mental health and substance
use disorders by clinician teams.
Sec. 104. Program for enhanced treatment of substance use
disorders and post-traumatic stress disorder in veterans.
Sec. 105. National centers of excellence on post-traumatic
stress disorder and substance use disorders.
Sec. 106. Report on residential mental health care facilities
of the Veterans Health Administration.
Sec. 107. Tribute to Justin Bailey.
TITLE II—Mental health accessibility enhancements
Sec. 201. Pilot program on peer outreach and support for
veterans and use of community mental health centers and Indian Health Service
facilities.
TITLE III—Research
Sec. 301. Research program on comorbid post-traumatic stress
disorder and substance use disorders.
Sec. 302. Extension of authorization for Special Committee on
Post-Traumatic Stress Disorder.
TITLE IV—Assistance for families of veterans
Sec. 401. Clarification of authority of Secretary of Veterans
Affairs to provide mental health services to families of veterans.
Sec. 402. Pilot program on provision of readjustment and
transition assistance to veterans and their families in cooperation with Vet
Centers.
<enum>I</enum><header>Substance use
disorders and mental health care</header>
<section id="H3733EAA150774AAAB8C91F0027A108D" section-type="subsequent-section"><enum>101.</enum><header>Findings on
substance use disorders and mental health</header><text display-inline="no-display-inline">Congress makes the following
findings:</text>
<paragraph id="H0A1FF62C00E84546AB8622A22D87DC2"><enum>(1)</enum><text>More than 1,500,000
members of the Armed Forces have been deployed in Operation Iraqi Freedom and
Operation Enduring Freedom. The 2005 Department of Defense Survey of Health
Related Behaviors Among Active Duty Personnel reports that 23 percent of
members of the Armed Forces on active duty acknowledge a significant problem
with alcohol use, with similar rates of acknowledged problems with alcohol use
among members of the National Guard.</text>
</paragraph><paragraph id="HAD92C78D2C1D4552954043AC176EA3D7"><enum>(2)</enum><text>The effects of
substance abuse are wide ranging, including significantly increased risk of
suicide, exacerbation of mental and physical health disorders, breakdown of
family support, and increased risk of unemployment and homelessness.</text>
</paragraph><paragraph id="HE25EF67D972344DD8839BA4EFFF47581"><enum>(3)</enum><text>While veterans
suffering from mental health conditions, chronic physical illness, and
polytrauma may be at increased risk for development of a substance use
disorder, treatment for these veterans is complicated by the need to address
adequately the physical and mental symptoms associated with these conditions
through appropriate medical intervention.</text>
</paragraph><paragraph id="H2CADE0B139E14AD380EE1C53F1A63C1C"><enum>(4)</enum><text>While the Veterans
Health Administration has dramatically increased health services for veterans
from 1996 through 2006, the number of veterans receiving specialized substance
abuse treatment services decreased 18 percent during that time. No comparable
decrease in the national rate of substance abuse has been observed during that
time.</text>
</paragraph><paragraph id="H7660CFEA51F84F75934C835C680037D6"><enum>(5)</enum><text>While some
facilities of the Veterans Health Administration provide exemplary substance
use disorder treatment services, the availability of such treatment services
throughout the health care system of the Veterans Health Administration is
inconsistent.</text>
</paragraph><paragraph id="H1BF27B4274A645099E1B30FA185656E2"><enum>(6)</enum><text>According to the
Government Accountability Office, the Department of Veterans Affairs
significantly reduced its substance use disorder treatment and rehabilitation
services between 1996 and 2006, and has made little progress since in restoring
these services to their pre-1996 levels.</text>
</paragraph></section><section id="H8ED62ED71F964448B3578676BFB2C7A6"><enum>102.</enum><header>Expansion of
substance use disorder treatment services at Department of Veterans Affairs
Medical Centers</header>
<subsection id="H132E0A7F909241DA8520020778DFEC8D"><enum>(a)</enum><header>Provision of
substance use disorder treatment services</header><text>The Secretary of
Veterans Affairs shall ensure the provision, at each Department of Veterans
Affairs medical center and community based outpatient clinic, of the following
services and treatments with respect to substance use disorder for
veterans:</text>
<paragraph id="H8225441F162A4708B5C243FE996F93BD"><enum>(1)</enum><text>Short term
motivational counseling services.</text>
</paragraph><paragraph id="H0488A4582F8747B78FB69B8856B7C37D"><enum>(2)</enum><text>Intensive
outpatient care services.</text>
</paragraph><paragraph id="H36160C66D7A64A6DA5A04EE582A91442"><enum>(3)</enum><text>Relapse prevention
services.</text>
</paragraph><paragraph id="H12F01D015C514D2986B254B723894DF8"><enum>(4)</enum><text>Ongoing aftercare
and outpatient counseling services.</text>
</paragraph><paragraph id="HEF3C7DC64EB740219E5B320079E472A7"><enum>(5)</enum><text>Opiate
substitution therapy services.</text>
</paragraph><paragraph id="HE0EBEC43199C4D8D955ECE71F44377A1"><enum>(6)</enum><text>Pharmacological
treatments aimed at reducing craving for drugs and alcohol.</text>
</paragraph><paragraph id="HE8C781B8B5CB45C191A11B1860A3C595"><enum>(7)</enum><text>Detoxification and
stabilization services.</text>
</paragraph><paragraph id="HC9D6A4E0F0DB4E5E8C187303C86E3351"><enum>(8)</enum><text>Such other
services as the Secretary considers appropriate.</text>
</paragraph></subsection><subsection id="H8A8C7337CE17410186952818F1C5DA32"><enum>(b)</enum><header>Exemptions</header>
<paragraph id="H7C797B8858884921943C5FF0D7354707"><enum>(1)</enum><header>In
general</header><text>The Secretary may exempt an individual medical center or
community based outpatient clinic from providing all of the services otherwise
required by subsection (a).</text>
</paragraph><paragraph id="HBE039C67ABD140FEBE9522A32D9273B"><enum>(2)</enum><header>Annual
report</header><text>Each year, the Secretary shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the
House of Representatives a report setting forth the exemptions made under
paragraph (1) as of the date of the report and the reasons therefor.</text>
</paragraph></subsection></section><section id="HB11AE94A750244A6902C5D17B026FB89"><enum>103.</enum><header>Care for
veterans with mental health and substance use disorders by clinician
teams</header>
<subsection id="H1E4F95E9C8D04A46BADD3226344EBD43"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">In the event the
Secretary of Veterans Affairs provides a veteran inpatient or outpatient care
for a substance use disorder and a comorbid mental health disorder, the
Secretary shall ensure that treatment for such disorders is provided
concurrently by a team of clinicians with appropriate expertise.</text>
</subsection><subsection id="HCC593585DDEE47A498D1B63572B40000"><enum>(b)</enum><header>Team of
clinicians with appropriate expertise defined</header><text>In this section,
the term <term>team of clinicians with appropriate expertise</term> means a
team consisting of the following:</text>
<paragraph id="H9B931F44BA0842F5A4001D44A8F8BB98"><enum>(1)</enum><text>Clinicians and
health professionals with expertise in treatment of substance use disorders and
mental health disorders.</text>
</paragraph><paragraph id="H990D4A2027FD4D59AB8E16C9D6680EC"><enum>(2)</enum><text>Such other
professionals as the Secretary considers appropriate for the provision of
treatment to veterans for substance use and mental health disorders.</text>
</paragraph></subsection></section><section id="HE77806F4B89A4FD3B71972E8D8532AD"><enum>104.</enum><header>Program for
enhanced treatment of substance use disorders and post-traumatic stress
disorder in veterans</header>
<subsection id="H040D1B6BEA2E4DDCA3A96E2479D57FA5"><enum>(a)</enum><header>In
general</header><text>The Secretary of Veterans Affairs shall carry out a
program for the purpose of enhancing the care and treatment for veterans with
substance use disorders and post-traumatic stress disorder (PTSD).</text>
</subsection><subsection id="H1DB06EA809A44C2397704FD6F522088"><enum>(b)</enum><header>Allocation of
funds</header><text>The Secretary of Veterans Affairs shall carry out the
program through a competitive allocation of funds to facilities of the
Department of Veterans Affairs for the provision of care and treatment to
veterans described in subsection (a).</text>
</subsection><subsection id="HFFA6A88E75644234BB23AD6798701EB3"><enum>(c)</enum><header>Application</header><text>A
facility of the Department, including a medical center, a community based
outpatient clinic, or a readjustment counseling center, seeking an allocation
of funds under this section shall submit to the Secretary an application
therefor in such form and in such manner as the Secretary considers
appropriate.</text>
</subsection><subsection id="H7422303AA1DF408F986737A16C57D622"><enum>(d)</enum><header>Use of allocated
funds</header><text>Each Department facility receiving an allocation of funds
under this section shall use such funds for the purpose described in subsection
(a), including the establishment or improvement of the following:</text>
<paragraph id="H965BEB0919D44B77A3551C3D04662D00"><enum>(1)</enum><text>Programs that
treat veterans with post-traumatic stress disorder and a substance use disorder
through a systematic integration of treatment for such disorders.</text>
</paragraph><paragraph id="H51477FFDDFA14FCBBBE3BD19C8B4E9C9"><enum>(2)</enum><text>Programs that
treat veterans with substance use disorders through the development of
substance use disorder intervention strategies, including strategies developed
in collaboration with the families of veterans.</text>
</paragraph><paragraph id="HB37712E448E14B24AB8300D76CEE5EB0"><enum>(3)</enum><text>Peer outreach
programs that—</text>
<subparagraph id="HB98E9BDCF83D4957B516D2B4019736BC"><enum>(A)</enum><text>re-engage veterans
of Operation Iraqi Freedom and Operation Enduring Freedom who miss multiple
appointments for treatment of post-traumatic stress disorder or a substance use
disorder; and</text>
</subparagraph><subparagraph id="H3BF56EB0CC7E49BFAA705FFCBFB5C900"><enum>(B)</enum><text>are
conducted—</text>
<clause id="H0CB51ADD4231447EA55F9288A776E06"><enum>(i)</enum><text>through
readjustment counseling centers;</text>
</clause><clause id="HFA4EF89EF60A446F9043BACA3E38264"><enum>(ii)</enum><text>in
tandem with efforts of community-based outpatient clinics and post-traumatic
stress disorder and substance use disorder treatment teams based in Department
of Veterans Affairs medical centers; and</text>
</clause><clause id="HF9AE33E2F4E541A7AFF489352F030200"><enum>(iii)</enum><text>with appropriate
regard for patient privacy.</text>
</clause></subparagraph></paragraph><paragraph id="HC406855859A444CDA466EF1EC1DDEB46"><enum>(4)</enum><text>Collaboration
between urgent care clinicians at Department of Veterans Affairs medical
centers and substance use disorder and post-traumatic stress disorder treatment
professionals to ensure expedited referral of veterans who are diagnosed with
post-traumatic stress disorder or a substance use disorder.</text>
</paragraph><paragraph id="H4FD552EEEC714FF99D5154EEA8BB75DB"><enum>(5)</enum><text>Programs of
treatment or services for veterans with substance use disorders and
post-traumatic stress disorder that utilize innovative and flexible scheduling
of treatment and services by emphasizing scheduling of group meetings or
appointments in the evening and on weekends.</text>
</paragraph><paragraph id="H99BCB18688294F30BFE0661364BC1BEC"><enum>(6)</enum><text>Evidence-based
treatment of post-traumatic stress disorder and substance use disorders.</text>
</paragraph></subsection><subsection id="H1F052AF0C1D24478A0CFAC488CAAEFC7"><enum>(e)</enum><header>Report</header><text>Not
later than one year after the date of the enactment of this Act, the Secretary
shall submit to the Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of Representatives a report setting
forth the programs and facilities for which funds have been allocated under
this section as of the date of the report.</text>
</subsection><subsection id="H7F743241BA7242D5A6413F04AF614008"><enum>(f)</enum><header>Funding</header>
<paragraph id="H057911AF1BA74659838957A9E2D89FA"><enum>(1)</enum><header>In
general</header><text>In carrying out the program described in this section,
the Secretary shall allocate for each of fiscal years 2008, 2009, and 2010,
from funds available to the Department for medical care in such fiscal year, an
amount equal to not less than $50,000,000 to carry out the program.</text>
</paragraph><paragraph id="HFCF90CFF35014E9AA674A4C81C8390B3"><enum>(2)</enum><header>Minimum
funding</header><text>In allocating amounts under paragraph (1), the Secretary
shall ensure that, after funds are allocated under this section for a fiscal
year, the total expenditure for programs of the Department relating to the
treatment of post-traumatic stress disorder and substance use disorders is not
less than $50,000,000 in excess of the baseline amount in that fiscal
year.</text>
</paragraph><paragraph id="H2C5AC2EB8792416487D95331B41E9015"><enum>(3)</enum><header>Baseline</header><text>For
purposes of paragraph (2), the baseline amount is the amount of the total
expenditures on programs of the Department relating to the treatment of
post-traumatic stress disorder and substance use disorders for the most recent
fiscal year for which final expenditure amounts are known (except for amounts
made available to carry out this section), adjusted to reflect any subsequent
increase in applicable costs to deliver such programs.</text>
</paragraph></subsection></section><section id="HDDA9B3D0C47449468E5981F3FE522F4"><enum>105.</enum><header>National centers
of excellence on post-traumatic stress disorder and substance use
disorders</header>
<subsection id="H4600650208EE4649B59B6DD86DC2E317"><enum>(a)</enum><header>In
general</header><text>Subchapter II of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/73">chapter 73</external-xref> of title 38, United States
Code, is amended by adding at the end the following new section:</text>
<quoted-block display-inline="no-display-inline" id="HE01A795DFDEE47B084AEBB5276E0C77C" style="USC">
<section id="H6ADB7EB84AC748FCBD004B5DD8E645DF"><enum>7330A.</enum><header>National
centers of excellence on post-traumatic stress disorder and substance use
disorders</header>
<subsection id="HD137F1F348B74EFF93917516ABF2C14"><enum>(a)</enum><header>Establishment of
Centers</header><paragraph commented="no" display-inline="yes-display-inline" id="H721904E9E5754A4389B114939233F888"><enum>(1)</enum><text>The Secretary shall
establish not less than six national centers of excellence on post-traumatic
stress disorder and substance use disorders.</text>
</paragraph><paragraph id="H61DF187112D8494B8B4F4E43461099C3" indent="up1"><enum>(2)</enum><text>The purpose of the centers
established under this section is to serve as Department facilities that
provide comprehensive inpatient treatment and recovery services for veterans
newly diagnosed with both post-traumatic stress disorder and a substance use
disorder.</text>
</paragraph></subsection><subsection id="HF2B290D9071F406F96E0A40230656154"><enum>(b)</enum><header>Location</header><text>Each
center established in accordance with subsection (a) shall be located at a
medical center of the Department that—</text>
<paragraph id="H79E72B39F11F4B88BB00636F0922D68"><enum>(1)</enum><text>provides inpatient
care;</text>
</paragraph><paragraph id="H1FCF57CC76E5474BB323006704EF316D"><enum>(2)</enum><text>is geographically
situated in an area with a high number of veterans that have been diagnosed
with both post-traumatic stress disorder and substance use disorder; and</text>
</paragraph><paragraph id="H4DC5B9D1EA9748B4973E162EDEE8EDC6"><enum>(3)</enum><text>is capable of
treating post-traumatic stress disorder and substance use disorders.</text>
</paragraph></subsection><subsection id="H750D82C0869C40A4971FC64F78D9B1BD"><enum>(c)</enum><header>Process of
referral and transition to step down diagnosis rehabilitation treatment
programs</header><text>The Secretary shall establish a process to refer and aid
the transition of veterans from the national centers of excellence on
post-traumatic stress disorder and substance use disorders established pursuant
to subsection (a) to programs that provide step down rehabilitation treatment
for individuals with post-traumatic stress disorder and substance use
disorders.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H2458D47E4BA04CC7BB738D07C8E1C2EF"><enum>(b)</enum><header>Clerical
amendment</header><text>The table of sections at the beginning of chapter 73 of
such title is amended by inserting after the item relating to section 7330 the
following new item:</text>
<quoted-block display-inline="no-display-inline" id="HBC459D53F1114927A2DC32005734E03F" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">7330A. National centers of excellence on
post-traumatic stress disorder and substance use
disorders.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</subsection></section><section id="H2342AAF0C5F24FF283F881E4EB0057B4"><enum>106.</enum><header>Report on
residential mental health care facilities of the Veterans Health
Administration</header>
<subsection id="H76F5E21B14194092B9EE45BCA053898E"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Not later than six
months after the date of the enactment of this Act, the Secretary of Veterans
Affairs shall, acting through the Office of the Medical Inspector of the
Department of Veterans Affairs—</text>
<paragraph id="H8D167A9AA95D4CECA8C781406900C0ED"><enum>(1)</enum><text display-inline="yes-display-inline">conduct a review of all residential mental
health care facilities, including domiciliary facilities, of the Veterans
Health Administration; and</text>
</paragraph><paragraph id="H9BD144452264411792007024ED3F967"><enum>(2)</enum><text>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.</text>
</paragraph></subsection><subsection id="HD5D1EE60730B4C388CA942ED36EFF412"><enum>(b)</enum><header>Elements</header><text>The
report required by subsection (a)(2) shall include the following:</text>
<paragraph id="H15C6CC578F53442BA2A32492883FB28D"><enum>(1)</enum><text>A
description of the availability of care in residential mental health care
facilities in each Veterans Integrated Service Network (VISN).</text>
</paragraph><paragraph id="H3E3B9B63EBFB48C3A249020730CDA346"><enum>(2)</enum><text>An assessment of
the supervision and support provided in the residential mental health care
facilities of the Veterans Health Administration.</text>
</paragraph><paragraph id="H5C208D9C26234E9DB8E105593FA56550"><enum>(3)</enum><text>The ratio of staff
members at each residential mental health care facility to patients at such
facility.</text>
</paragraph><paragraph id="HF4B1E9AACA3D4ED99FAFF8A950E8F838"><enum>(4)</enum><text>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.</text>
</paragraph><paragraph id="HDFBBBC5A14F54F84909C042E96E8887F"><enum>(5)</enum><text>A
description of the protocols at each residential mental health care facility
for handling missed appointments.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H6317485C9DAD4485AA54C1EF25C1A1BC"><enum>(6)</enum><text>Any
recommendations the Secretary considers appropriate for improvements to such
residential mental health care facilities and the care provided in such
facilities.</text>
</paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="H6E06B9CC73F9411D896B8CC2F16DDCA6"><enum>107.</enum><header>Tribute to
Justin Bailey</header><text display-inline="no-display-inline">This title 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.</text>
</section><enum>II</enum><header>Mental health
accessibility enhancements</header>
<section id="H90399A0E56D247D3930072414DF74DBD"><enum>201.</enum><header>Pilot program
on peer outreach and support for veterans and use of community mental health
centers and Indian Health Service facilities</header>
<subsection id="H49BBAC064C914168932ED58CAB1E8F4F"><enum>(a)</enum><header>Pilot program
required</header><text>Commencing not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall carry out a
pilot program to assess the feasability and advisability of providing to
veterans of Operation Iraqi Freedom and Operation Enduring Freedom, and, in
particular, veterans who served in such operations as a member of the National
Guard or Reserve, the following:</text>
<paragraph id="H852C45BECDAE42438440E212F6A8A0F"><enum>(1)</enum><text>Peer outreach
services.</text>
</paragraph><paragraph id="HC5C242DA3F9548DCA65F8F35DB947DEE"><enum>(2)</enum><text>Peer support
services.</text>
</paragraph><paragraph id="H80F73A675C474C418301DA2D00A181DB"><enum>(3)</enum><text>Readjustment
counseling services described in <external-xref legal-doc="usc" parsable-cite="usc/38/1712A">section 1712A</external-xref> of title 38, United States
Code.</text>
</paragraph><paragraph id="H32B137287372424EB7CDED630095F2FC"><enum>(4)</enum><text>Other Mental
health services.</text>
</paragraph></subsection><subsection id="H8539932D52FA4F73899256214C881C00"><enum>(b)</enum><header>Provision of
certain services</header><text>In providing services described in paragraphs
(3) and (4) of subsection (a) under the pilot program to veterans who reside in
rural areas and do not have adequate access through the Department of Veterans
Affairs to the services described in such paragraphs, the Secretary shall,
acting through the Office of Rural Health, provide such services as
follows:</text>
<paragraph id="H1D94926A00A34A5C893D955DD282E227"><enum>(1)</enum><text>Through community
health centers under contracts or other agreements for the provision of such
services that are entered into for purposes of the pilot program.</text>
</paragraph><paragraph id="H3E25840B681B455B9F97BAAFFC3DD800"><enum>(2)</enum><text>Through the Indian
Health Service pursuant to a memorandum of understanding entered into by the
Secretary of Veterans Affairs and the Secretary of Health and Human Services
for purposes of the pilot program.</text>
</paragraph></subsection><subsection id="H55AE2AFDE82A44C19DFA72A6886E0039"><enum>(c)</enum><header>Duration</header><text>The
pilot program shall be carried out during the three-year period beginning on
the date of the commencement of the pilot program.</text>
</subsection><subsection id="HB8B5C47BC93E45A89978DEE33BAAF072"><enum>(d)</enum><header>Program
locations</header>
<paragraph id="H0BA3774ACCB042B79C851818B346317C"><enum>(1)</enum><header>In
general</header><text>The pilot program shall be carried out in at least two
Veterans Integrated Service Networks (VISN) selected by the Secretary for
purposes of the pilot program.</text>
</paragraph><paragraph id="H50F2DEADAA794A72B0DF709319BCCEC"><enum>(2)</enum><header>Rural geographic
locations</header><text>At least two of the locations selected shall be in
rural geographic locations that lack access to comprehensive mental health
services through the Department of Veterans Affairs.</text>
</paragraph></subsection><subsection id="H899CBFCFC0A844F4B241CC4C0C36D97"><enum>(e)</enum><header>Participation in
program</header><text>Each community mental health center or facility of the
Indian Health Service participating in the pilot program under subsection (b)
shall—</text>
<paragraph id="HA651FED9DBD94CC984DA67E4BBEDCE2"><enum>(1)</enum><text>provide the
services described in paragraphs (3) and (4) of subsection (a) to eligible
veterans, including, to the extent practicable, through the utilization of
telehealth services for the provision of such services;</text>
</paragraph><paragraph id="HFC4FF2BD7B0145B6BBEA3EB6251D3F57"><enum>(2)</enum><text>utilize best
practices and technologies; and</text>
</paragraph><paragraph id="HA14C0669CF7442D4B485B34F739A77D"><enum>(3)</enum><text>meet such other
requirements as the Secretary shall require.</text>
</paragraph></subsection><subsection id="HD31AA00C596A4142A9ADA4981DC1FC00"><enum>(f)</enum><header>Compliance with
Department protocols</header><text>Each community mental health center or
facility of the Indian Health Service participating in the pilot program under
subsection (b) shall comply with applicable protocols of the Department before
incurring any liability on behalf of the Department for the provision of
services as part of the pilot program.</text>
</subsection><subsection id="H6E2096A4E07748D486B69701C860493B"><enum>(g)</enum><header>Provision of
clinical information</header><text>Each community mental health center or
facility of the Indian Health Service participating in the pilot program under
subsection (b) shall provide the Secretary with such clinical information on
each veteran for whom such health center or facility provides mental health
services under the pilot program as the Secretary shall require.</text>
</subsection><subsection id="HE7C225DAF8854AD9990316537C295823"><enum>(h)</enum><header>Training</header>
<paragraph id="HC34209E4DF1D497CBDA46EFA8C99ACE"><enum>(1)</enum><header>Training of
veterans</header><text>As part of the pilot program, the Secretary shall carry
out a national program of training for veterans described in subsection (a) to
provide the services described in paragraphs (1) and (2) of such
subsection.</text>
</paragraph><paragraph id="H0F03CBA2FFBD452F86F0C4B481C8F6BC"><enum>(2)</enum><header>Training of
clinicians</header>
<subparagraph id="H6799733450434117A6C85144B03003DC"><enum>(A)</enum><header>In
general</header><text>The Secretary shall conduct a training program for
clinicians of community mental health centers or Indian Health Service
facilities participating in the pilot program under subsection (b) to ensure
that such clinicians can provide the services described in paragraphs (3) and
(4) of subsection (a) in a manner that accounts for factors that are unique to
the experiences of veterans who served on active duty in Operation Iraqi
Freedom or Operation Enduring Freedom (including their combat and military
training experiences).</text>
</subparagraph><subparagraph id="H51B66A181D9D468AACFF95FF101D00A0"><enum>(B)</enum><header>Participation in
training</header><text>Each community mental health center or facility of the
Indian Health Service participating in the pilot program under subsection (b)
shall participate in the training program conducted pursuant to subparagraph
(A).</text>
</subparagraph></paragraph></subsection><subsection id="H6D1C98031FD348BDBC986D6079C854D7"><enum>(i)</enum><header>Annual
reports</header><text>Each community mental health center or facility of the
Indian Health Service participating in the pilot program under subsection (b)
shall submit to the Secretary on an annual basis a report containing, with
respect to the provision of services under subsection (b) and for the last full
calendar year ending before the submission of such report—</text>
<paragraph id="HB7AF5F711C1B4CE686B301D74BCA8C2C"><enum>(1)</enum><text>the number
of—</text>
<subparagraph id="H81D956251F0F4DDCA6D422CDE76546A2"><enum>(A)</enum><text>veterans served;
and</text>
</subparagraph><subparagraph id="H9A1D69C10DF84E6989FADBDD301C0007"><enum>(B)</enum><text>courses of
treatment provided; and</text>
</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H7A2DAF5E6B864B0AA3A6B2FD618C0001"><enum>(2)</enum><text>demographic
information for such services, diagnoses, and courses of treatment.</text>
</paragraph></subsection><subsection id="H4496AD9D18BE42D7A256002F26A827AA"><enum>(j)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="HF18ADBF56891485D8866F9FF339CFD5B"><enum>(1)</enum><text>The term
<term>community mental health center</term> has the meaning given such term in
<external-xref legal-doc="regulation" parsable-cite="cfr/42/410.2">section 410.2</external-xref> of title 42, Code of Federal Regulations (as in effect on the day
before the date of the enactment of this Act).</text>
</paragraph><paragraph id="HFB3CA72DBC0B454AB74FA32100E01831"><enum>(2)</enum><text>The term
<term>eligible veteran</term> means a veteran in need of mental health services
who—</text>
<subparagraph id="H07AC28EC1001472DA2E14EA78FCC6F00"><enum>(A)</enum><text>is enrolled in the
Department of Veterans Affairs health care system; and</text>
</subparagraph><subparagraph id="H7D15DF86CFB44C80A89E00039E9992AD"><enum>(B)</enum><text>has received a
referral from a health professional of the Veterans Health Administration to a
community mental health center or to a facility of the Indian Health Service
for purposes of the pilot program.</text>
</subparagraph></paragraph><paragraph id="H5BB59CF57FAA487998DAE1AE3BAA7715"><enum>(3)</enum><text>The term
<term>Indian Health Service</term> means the organization established by
section 601(a) of the Indian Health Care Improvement Act (25 U.S.C.
1661(a)).</text>
</paragraph></subsection><subsection id="H2227F04EFA8746E9B1A1D5284831B43C"><enum>(k)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated such sums
as may be necessary to carry out the provisions of this section.</text>
</subsection></section><enum>III</enum><header>Research</header>
<section id="H37CF48AE04C94CD595C6DD96BDA55BDF"><enum>301.</enum><header>Research
program on comorbid post-traumatic stress disorder and substance use
disorders</header>
<subsection id="HB151B38C5D4341F1B74FB85BAEC847C8"><enum>(a)</enum><header>Program
required</header><text>The Secretary of Veterans Affairs shall carry out a
program of research into comorbid post-traumatic stress disorder (PTSD) and
substance use disorder.</text>
</subsection><subsection id="H2F65682F719C4FFD8D8DEC00BBFF12A3"><enum>(b)</enum><header>Discharge
through National Center for Posttraumatic Stress Disorder</header><text>The
research program required by subsection (a) shall be carried out and overseen
by the National Center for Posttraumatic Stress Disorder. In carrying out the
program, the Center shall—</text>
<paragraph id="H16A9D084231A4641A7DD7600D35C3106"><enum>(1)</enum><text>develop protocols
and goals with respect to research under the program; and</text>
</paragraph><paragraph id="H94A4501ADE0F4855A3FA53F5E2AA218F"><enum>(2)</enum><text>coordinate
research, data collection, and data dissemination under the program.</text>
</paragraph></subsection><subsection id="H02EBE49C7FA24E8386ABB6308879C5A6"><enum>(c)</enum><header>Research</header><text>The
program of research required by subsection (a) shall address the
following:</text>
<paragraph id="H16396FC39F464607BE05225FEEFA09FE"><enum>(1)</enum><text>Comorbid
post-traumatic stress disorder and substance use disorder.</text>
</paragraph><paragraph id="H743F41B6BA6448AE8D5B7E564467B121"><enum>(2)</enum><text>The systematic
integration of treatment for post-traumatic stress disorder with treatment for
substance use disorder.</text>
</paragraph><paragraph id="H7F352B5191A74EE900DAAD62F43558"><enum>(3)</enum><text>The
development of protocols to evaluate care of veterans with comorbid
post-traumatic stress disorder and substance use disorder and to facilitate
cumulative clinical progress of such veterans over time.</text>
</paragraph></subsection><subsection id="H92671B193F0845EBAFF4EDBEB584B77"><enum>(d)</enum><header>Funding</header>
<paragraph id="H8A0396A245224F1EB16C7E35BC176406"><enum>(1)</enum><header>Authorization of
appropriations</header><text>There is authorized to be appropriated for the
Department of Veterans Affairs for each of fiscal years 2008 through 2011,
$2,000,000 to carry out this section.</text>
</paragraph><paragraph id="H7282E642B20744C780D5BAA1E48BD8E6"><enum>(2)</enum><header>Availability</header><text>Amounts
authorized to be appropriated by paragraph (1) shall be made available to the
National Center on Posttraumatic Stress Disorder for the purpose specified in
that paragraph.</text>
</paragraph><paragraph id="H0229147632A44CA1831851F605016C73"><enum>(3)</enum><header>Supplement not
supplant</header><text>Any amount made available to the National Center on
Posttraumatic Stress Disorder for a fiscal year under paragraph (2) is in
addition to any other amounts made available to the National Center on
Posttraumatic Stress Disorder for such year under any other provision of
law.</text>
</paragraph></subsection></section><section id="H02557DC40CC94144B76897006768CEBD"><enum>302.</enum><header>Extension of
authorization for Special Committee on Post-Traumatic Stress
Disorder</header><text display-inline="no-display-inline">Section 110(e)(2) of
the Veterans' Health Care Act of 1984 (<external-xref legal-doc="usc" parsable-cite="usc/38/1712A">38 U.S.C. 1712A</external-xref> note) is amended by
striking <quote>through 2008</quote> and inserting <quote>through
2012</quote>.</text>
</section><enum>IV</enum><header>Assistance for
families of veterans</header>
<section id="H93AF8FF672F6438BB5A1A8B88DD824A2"><enum>401.</enum><header>Clarification
of authority of Secretary of Veterans Affairs to provide mental health services
to families of veterans</header>
<subsection id="H0A187945B084489891DAD1702D8D731F"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Section 1701(5)(B) of
title 38, United States Code, is amended—</text>
<paragraph id="H0235FE7647FA4E12B96546C027A3409F"><enum>(1)</enum><text display-inline="yes-display-inline">by inserting <quote>marriage and family
counseling,</quote> after <quote>professional counseling,</quote>; and</text>
</paragraph><paragraph id="HFE19A48A5CCE446CB6C0A5A6FC7761AC"><enum>(2)</enum><text>by striking
<quote>as may be essential to</quote> and inserting <quote>as the Secretary
considers appropriate for</quote>.</text>
</paragraph></subsection><subsection id="H3F74CD2D83FA4934B5F61DC2D63002B0"><enum>(b)</enum><header>Location</header><text>Paragraph
(5) of <external-xref legal-doc="usc" parsable-cite="usc/38/1701">section 1701</external-xref> of title 38, United States Code, shall not be construed to
prevent the Secretary of Veterans Affairs from providing services described in
subparagraph (B) of such paragraph to individuals described in such
subparagraph in Readjustment Counseling Centers, Department of Veterans Affairs
medical centers, community-based outpatient clinics, or in such other
facilities of the Department of Veterans Affairs as the Secretary considers
necessary.</text>
</subsection></section><section id="H2F235A8BA372420D995289B885F400C4" section-type="subsequent-section"><enum>402.</enum><header>Pilot program on
provision of readjustment and transition assistance to veterans and their
families in cooperation with Vet Centers</header>
<subsection id="HCB3EA73DEE8F4A0A8F53C71BDA243503"><enum>(a)</enum><header>Pilot
program</header><text display-inline="yes-display-inline">The Secretary of
Veterans Affairs shall carry out, through a non-Department of Veterans Affairs
entity, a pilot program to assess the feasability and advisability of providing
readjustment and transition assistance described in subsection (b) to veterans
and their families in cooperation with centers under <external-xref legal-doc="usc" parsable-cite="usc/38/1712A">section 1712A</external-xref> of title 38,
United States Code (commonly referred to as <quote>Vet Centers</quote>).</text>
</subsection><subsection id="HC763B8731C8F465193CF4C7600315BFB"><enum>(b)</enum><header>Readjustment and
transition assistance</header><text>Readjustment and transition assistance
described in this subsection is assistance as follows:</text>
<paragraph commented="no" id="H43CD895B013341219DF6EBB84CECB9DB"><enum>(1)</enum><text>Readjustment and
transition assistance that is preemptive, proactive, and
principle-centered.</text>
</paragraph><paragraph id="HE772D4EC227243BDA873CFEB7897E300"><enum>(2)</enum><text>Assistance and
training for veterans and their families in coping with the challenges
associated with making the transition from military to civilian life.</text>
</paragraph></subsection><subsection id="H9E7F23A3A6044E529390941D3B80FBE1"><enum>(c)</enum><header>Non-Department
of Veterans Affairs entity</header>
<paragraph id="H703AD73004EC415EB797EB71166100DF"><enum>(1)</enum><header>In
general</header><text>The Secretary shall carry out the pilot program through
any for-profit or non-profit organization selected by the Secretary for
purposes of the pilot program that has demonstrated expertise and experience in
the provision of assistance and training described in subsection (b).</text>
</paragraph><paragraph id="H0BE561B4F3074A3AB197FC00588FB8BB"><enum>(2)</enum><header>Contract or
agreement</header><text>The Secretary shall carry out the pilot program through
a non-Department entity described in paragraph (1) pursuant to a contract or
other agreement entered into by the Secretary and the entity for purposes of
the pilot program.</text>
</paragraph></subsection><subsection id="HE06B1780DC26416EA6D000E81DFE00A4"><enum>(d)</enum><header>Duration of
pilot program</header><text>The pilot program shall be carried out during the
three-year period beginning on the date of the enactment of this Act, and may
be carried out for additional one-year periods thereafter.</text>
</subsection><subsection id="HB826C8CE98F24B4893A1465CBE33ADF2"><enum>(e)</enum><header>Location of
pilot program</header>
<paragraph id="HA07B2CFAE2A443228D61B7C491145039"><enum>(1)</enum><header>In
general</header><text>The Secretary of Veterans Affairs shall provide
assistance under the pilot program in cooperation with 10 centers described in
subsection (a) designated by the Secretary for purposes of the pilot
program.</text>
</paragraph><paragraph id="H078E361F18B542C787009BC658003EBA"><enum>(2)</enum><header>Designations</header><text>In
designating centers described in subsection (a) for purposes of the pilot
program, the Secretary shall designate centers so as to provide a balanced
geographical representation of such centers throughout the United States,
including the District of Columbia, the Commonwealth of Puerto Rico, tribal
lands, and other territories and possessions of the United States.</text>
</paragraph></subsection><subsection id="H6ED580E9A63A48A6BEC9652D70F177B5"><enum>(f)</enum><header>Participation of
centers</header><text>A center described in subsection (a) that is designated
under subsection (e) for participation in the pilot program shall participate
in the pilot program by promoting awareness of the assistance and training
available to veterans and their families through—</text>
<paragraph id="H02E10BB3D08B4A638E00AEC3BD00084C"><enum>(1)</enum><text>the facilities and
other resources of such center;</text>
</paragraph><paragraph id="HBDC3B9A6B3E74CAFB6866C9C11A3601D"><enum>(2)</enum><text>the non-Department
of Veterans Affairs entity selected pursuant to subsection (c); and</text>
</paragraph><paragraph id="H2C453E9E6FC64AF7A0DFC34B129FF0C2"><enum>(3)</enum><text>other appropriate
mechanisms.</text>
</paragraph></subsection><subsection id="H50BB61EE37BF470890C8A08409D53494"><enum>(g)</enum><header>Additional
support</header><text>In carrying out the pilot program, the Secretary of
Veterans Affairs may enter into contracts or other agreements, in addition to
the contract or agreement described in subsection (c), with such other
non-Department of Veterans Affairs entities meeting the requirements of
subsection (c) as the Secretary considers appropriate for purposes of the pilot
program.</text>
</subsection><subsection id="HFC1F2A60052742E5A557EC94F5754EF5"><enum>(h)</enum><header>Report on pilot
program</header>
<paragraph id="H5E4BB8EAAD9D46D8BBA644A6E9AE4973"><enum>(1)</enum><header>Report
required</header><text>Not later than six months after the date of the
conclusion of the pilot program, the Secretary shall submit to the
congressional veterans affairs committees a report on the pilot program.</text>
</paragraph><paragraph id="H9A02198BFC314C9E9BC1F79CB540D62"><enum>(2)</enum><header>Elements</header><text>Each
report under paragraph (1) shall include the following:</text>
<subparagraph id="H800F49E21C5048F7B60844006F623094"><enum>(A)</enum><text>A description of
the activities under the pilot program as of the date of such report, including
the number of veterans and families provided assistance under the pilot program
and the scope and nature of the assistance so provided.</text>
</subparagraph><subparagraph id="HC9CA22BDAA304391A6FE278892B69F8"><enum>(B)</enum><text>A current
assessment of the effectiveness of the pilot program.</text>
</subparagraph><subparagraph id="HEA9D7D88D29440428D9F37433EA83CF"><enum>(C)</enum><text>Any recommendations
that the Secretary considers appropriate for the extension or expansion of the
pilot program.</text>
</subparagraph></paragraph><paragraph id="H27BC2B1D6F704890B6CB221DFB63453"><enum>(3)</enum><header>Congressional
veterans affairs committees defined</header><text>In this subsection, the term
<term>congressional veterans affairs committees</term> means—</text>
<subparagraph id="H96308288605F4EA500AF38D502E1E840"><enum>(A)</enum><text>the Committees on
Veterans' Affairs and Appropriations of the Senate; and</text>
</subparagraph><subparagraph id="H03B81A74B29C42698B9D691EAF270086"><enum>(B)</enum><text>the Committees on
Veterans' Affairs and Appropriations of the House of Representatives.</text>
</subparagraph></paragraph></subsection><subsection id="H54D2A3BB683A4448BF2739002EE058CF"><enum>(i)</enum><header>Authorization of
appropriations</header>
<paragraph id="H109900D710B64929BFA2C2C1770000A3"><enum>(1)</enum><header>In
general</header><text>There is authorized to be appropriated for the Department
of Veterans Affairs for each of fiscal years 2008 through 2010 $1,000,000 to
carry out this section.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H4207AA1CFDDB458BBF27002600002B83"><enum>(2)</enum><header>Availability</header><text>Amounts
authorized to be appropriated by paragraph (1) shall remain available until
expended.</text>
</paragraph></subsection></section>