Short title

This Act may be cited as the

Justin Bailey Veterans Substance Use Disorders Prevention and Treatment Act of 2008

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.

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.

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.

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.

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.