[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5554 Reported in House (RH)]






                                                 Union Calendar No. 400
110th CONGRESS
  2d Session
                                H. R. 5554

                          [Report No. 110-639]

  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.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 6, 2008

   Mr. Michaud (for himself, Mr. Filner, Mr. Miller of Florida, Ms. 
 Corrine Brown of Florida, Mr. Allen, Mr. Bishop of Georgia, Mr. Lewis 
  of Georgia, and Mr. Cohen) introduced the following bill; which was 
             referred to the Committee on Veterans' Affairs

                              May 15, 2008

   Additional sponsors: Ms. Bordallo, Mr. Levin, Mr. Hinojosa, Mrs. 
  Napolitano, Ms. Berkley, Mr. Kennedy, Mr. Hinchey, Ms. McCollum of 
                       Minnesota, and Mr. Capuano

                              May 15, 2008

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
 [For text of introduced bill, see copy of bill as introduced on March 
                                6, 2008]

_______________________________________________________________________

                                 A BILL


 
  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.
                                                 Union Calendar No. 400

110th CONGRESS

  2d Session

                               H. R. 5554

                          [Report No. 110-639]

_______________________________________________________________________

                                 A BILL

  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.

_______________________________________________________________________

                              May 15, 2008

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed