[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2162 Reported in Senate (RS)]






                                                       Calendar No. 632
110th CONGRESS
  2d Session
                                S. 2162

                          [Report No. 110-281]

  To improve the treatment and services provided by the Department of 
 Veterans Affairs to veterans with post-traumatic stress disorder and 
            substance use disorders, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            October 15, 2007

  Mr. Akaka (for himself, Mr. Burr, Ms. Mikulski, Mr. Ensign, and Mr. 
 Rockefeller) introduced the following bill; which was read twice and 
             referred to the Committee on Veterans' Affairs

                             April 8, 2008

                Reported by Mr. Akaka, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
  To improve the treatment and services provided by the Department of 
 Veterans Affairs to veterans with post-traumatic stress disorder and 
            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,

<DELETED>SECTION 1. SHORT TITLE; TABLE OF CONTENTS.</DELETED>

<DELETED>    (a) Short Title.--This Act may be cited as the ``Veterans 
Mental Health Improvements Act of 2007''.</DELETED>
<DELETED>    (b) Table of Contents.--The table of contents for this Act 
is as follows:</DELETED>

<DELETED>Sec. 1. Short title; table of contents.
    <DELETED>TITLE I--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE

<DELETED>Sec. 101. Findings on substance use disorders and mental 
                            health.
<DELETED>Sec. 102. Expansion of substance use disorder treatment 
                            services at Department of Veterans Affairs 
                            Medical Centers.
<DELETED>Sec. 103. Care for veterans with mental health and substance 
                            use disorders by clinician teams.
<DELETED>Sec. 104. Program for enhanced treatment of substance use 
                            disorders and post-traumatic stress 
                            disorder in veterans.
<DELETED>Sec. 105. National centers of excellence on post-traumatic 
                            stress disorder and substance use 
                            disorders.
<DELETED>Sec. 106. Report on residential mental health care facilities 
                            of the Veterans Health Administration.
<DELETED>Sec. 107. Tribute to Justin Bailey.
      <DELETED>TITLE II--MENTAL HEALTH ACCESSIBILITY ENHANCEMENTS

<DELETED>Sec. 201. Pilot program on peer outreach and support for 
                            veterans and use of community mental health 
                            centers and Indian Health Service 
                            facilities.
                      <DELETED>TITLE III--RESEARCH

<DELETED>Sec. 301. Research program on comorbid post-traumatic stress 
                            disorder and substance use disorders.
<DELETED>Sec. 302. Extension of authorization for Special Committee on 
                            Post-Traumatic Stress Disorder.
         <DELETED>TITLE IV--ASSISTANCE FOR FAMILIES OF VETERANS

<DELETED>Sec. 401. Clarification of authority of Secretary of Veterans 
                            Affairs to provide mental health services 
                            to families of veterans.
<DELETED>Sec. 402. Pilot program on provision of readjustment and 
                            transition assistance to veterans and their 
                            families in cooperation with Vet Centers.

      <DELETED>TITLE I--SUBSTANCE USE DISORDERS AND MENTAL HEALTH 
                             CARE</DELETED>

<DELETED>SEC. 101. FINDINGS ON SUBSTANCE USE DISORDERS AND MENTAL 
              HEALTH.</DELETED>

<DELETED>    Congress makes the following findings:</DELETED>
        <DELETED>    (1) 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.</DELETED>
        <DELETED>    (2) 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.</DELETED>
        <DELETED>    (3) 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.</DELETED>
        <DELETED>    (4) 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.</DELETED>
        <DELETED>    (5) 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.</DELETED>
        <DELETED>    (6) 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.</DELETED>

<DELETED>SEC. 102. EXPANSION OF SUBSTANCE USE DISORDER TREATMENT 
              SERVICES AT DEPARTMENT OF VETERANS AFFAIRS MEDICAL 
              CENTERS.</DELETED>

<DELETED>    (a) Provision of Substance Use Disorder Treatment 
Services.--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:</DELETED>
        <DELETED>    (1) Short term motivational counseling 
        services.</DELETED>
        <DELETED>    (2) Intensive outpatient care services.</DELETED>
        <DELETED>    (3) Relapse prevention services.</DELETED>
        <DELETED>    (4) Ongoing aftercare and outpatient counseling 
        services.</DELETED>
        <DELETED>    (5) Opiate substitution therapy 
        services.</DELETED>
        <DELETED>    (6) Pharmacological treatments aimed at reducing 
        craving for drugs and alcohol.</DELETED>
        <DELETED>    (7) Detoxification and stabilization 
        services.</DELETED>
        <DELETED>    (8) Such other services as the Secretary considers 
        appropriate.</DELETED>
<DELETED>    (b) Exemptions.--</DELETED>
        <DELETED>    (1) In general.--The Secretary may exempt an 
        individual medical center or community based outpatient clinic 
        from providing all of the services otherwise required by 
        subsection (a).</DELETED>
        <DELETED>    (2) Annual report.--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.</DELETED>

<DELETED>SEC. 103. CARE FOR VETERANS WITH MENTAL HEALTH AND SUBSTANCE 
              USE DISORDERS BY CLINICIAN TEAMS.</DELETED>

<DELETED>    (a) In General.--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.</DELETED>
<DELETED>    (b) Team of Clinicians With Appropriate Expertise 
Defined.--In this section, the term ``team of clinicians with 
appropriate expertise'' means a team consisting of the 
following:</DELETED>
        <DELETED>    (1) Clinicians and health professionals with 
        expertise in treatment of substance use disorders and mental 
        health disorders.</DELETED>
        <DELETED>    (2) Such other professionals as the Secretary 
        considers appropriate for the provision of treatment to 
        veterans for substance use and mental health 
        disorders.</DELETED>

<DELETED>SEC. 104. PROGRAM FOR ENHANCED TREATMENT OF SUBSTANCE USE 
              DISORDERS AND POST-TRAUMATIC STRESS DISORDER IN 
              VETERANS.</DELETED>

<DELETED>    (a) In General.--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).</DELETED>
<DELETED>    (b) Allocation of Funds.--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).</DELETED>
<DELETED>    (c) Application.--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.</DELETED>
<DELETED>    (d) Use of Allocated Funds.--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:</DELETED>
        <DELETED>    (1) Programs that treat veterans with post-
        traumatic stress disorder and a substance use disorder through 
        a systematic integration of treatment for such 
        disorders.</DELETED>
        <DELETED>    (2) 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.</DELETED>
        <DELETED>    (3) Peer outreach programs that--</DELETED>
                <DELETED>    (A) 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</DELETED>
                <DELETED>    (B) are conducted--</DELETED>
                        <DELETED>    (i) through readjustment 
                        counseling centers;</DELETED>
                        <DELETED>    (ii) 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</DELETED>
                        <DELETED>    (iii) with appropriate regard for 
                        patient privacy.</DELETED>
        <DELETED>    (4) 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.</DELETED>
        <DELETED>    (5) 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.</DELETED>
        <DELETED>    (6) Evidence-based treatment of post-traumatic 
        stress disorder and substance use disorders.</DELETED>
<DELETED>    (e) Report.--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.</DELETED>
<DELETED>    (f) Funding.--</DELETED>
        <DELETED>    (1) In general.--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.</DELETED>
        <DELETED>    (2) Minimum funding.--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.</DELETED>
        <DELETED>    (3) Baseline.--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.</DELETED>

<DELETED>SEC. 105. NATIONAL CENTERS OF EXCELLENCE ON POST-TRAUMATIC 
              STRESS DISORDER AND SUBSTANCE USE DISORDERS.</DELETED>

<DELETED>    (a) In General.--Subchapter II of chapter 73 of title 38, 
United States Code, is amended by adding at the end the following new 
section:</DELETED>
<DELETED>``Sec. 7330A. National centers of excellence on post-traumatic 
              stress disorder and substance use disorders</DELETED>
<DELETED>    ``(a) Establishment of Centers.--(1) The Secretary shall 
establish not less than six national centers of excellence on post-
traumatic stress disorder and substance use disorders.</DELETED>
<DELETED>    ``(2) 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.</DELETED>
<DELETED>    ``(b) Location.--Each center established in accordance 
with subsection (a) shall be located at a medical center of the 
Department that--</DELETED>
        <DELETED>    ``(1) provides inpatient care;</DELETED>
        <DELETED>    ``(2) 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</DELETED>
        <DELETED>    ``(3) is capable of treating post-traumatic stress 
        disorder and substance use disorders.</DELETED>
<DELETED>    ``(c) Process of Referral and Transition to Step Down 
Diagnosis Rehabilitation Treatment Programs.--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.''.</DELETED>
<DELETED>    (b) Clerical Amendment.--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:</DELETED>

<DELETED>``7330A. National centers of excellence on post-traumatic 
                            stress disorder and substance use 
                            disorders.''.

<DELETED>SEC. 106. REPORT ON RESIDENTIAL MENTAL HEALTH CARE FACILITIES 
              OF THE VETERANS HEALTH ADMINISTRATION.</DELETED>

<DELETED>    (a) In General.--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--</DELETED>
        <DELETED>    (1) conduct a review of all residential mental 
        health care facilities, including domiciliary facilities, of 
        the Veterans Health Administration; and</DELETED>
        <DELETED>    (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.</DELETED>
<DELETED>    (b) Elements.--The report required by subsection (a)(2) 
shall include the following:</DELETED>
        <DELETED>    (1) A description of the availability of care in 
        residential mental health care facilities in each Veterans 
        Integrated Service Network (VISN).</DELETED>
        <DELETED>    (2) An assessment of the supervision and support 
        provided in the residential mental health care facilities of 
        the Veterans Health Administration.</DELETED>
        <DELETED>    (3) The ratio of staff members at each residential 
        mental health care facility to patients at such 
        facility.</DELETED>
        <DELETED>    (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.</DELETED>
        <DELETED>    (5) A description of the protocols at each 
        residential mental health care facility for handling missed 
        appointments.</DELETED>
        <DELETED>    (6) Any recommendations the Secretary considers 
        appropriate for improvements to such residential mental health 
        care facilities and the care provided in such 
        facilities.</DELETED>

<DELETED>SEC. 107. TRIBUTE TO JUSTIN BAILEY.</DELETED>

<DELETED>    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.</DELETED>

 <DELETED>TITLE II--MENTAL HEALTH ACCESSIBILITY ENHANCEMENTS</DELETED>

<DELETED>SEC. 201. PILOT PROGRAM ON PEER OUTREACH AND SUPPORT FOR 
              VETERANS AND USE OF COMMUNITY MENTAL HEALTH CENTERS AND 
              INDIAN HEALTH SERVICE FACILITIES.</DELETED>

<DELETED>    (a) Pilot Program Required.--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:</DELETED>
        <DELETED>    (1) Peer outreach services.</DELETED>
        <DELETED>    (2) Peer support services.</DELETED>
        <DELETED>    (3) Readjustment counseling services described in 
        section 1712A of title 38, United States Code.</DELETED>
        <DELETED>    (4) Other Mental health services.</DELETED>
<DELETED>    (b) Provision of Certain Services.--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:</DELETED>
        <DELETED>    (1) 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.</DELETED>
        <DELETED>    (2) 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.</DELETED>
<DELETED>    (c) Duration.--The pilot program shall be carried out 
during the three-year period beginning on the date of the commencement 
of the pilot program.</DELETED>
<DELETED>    (d) Program Locations.--</DELETED>
        <DELETED>    (1) In general.--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.</DELETED>
        <DELETED>    (2) Rural geographic locations.--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.</DELETED>
<DELETED>    (e) Participation in Program.--Each community mental 
health center or facility of the Indian Health Service participating in 
the pilot program under subsection (b) shall--</DELETED>
        <DELETED>    (1) 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;</DELETED>
        <DELETED>    (2) utilize best practices and technologies; 
        and</DELETED>
        <DELETED>    (3) meet such other requirements as the Secretary 
        shall require.</DELETED>
<DELETED>    (f) Compliance With Department Protocols.--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.</DELETED>
<DELETED>    (g) Provision of Clinical Information.--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.</DELETED>
<DELETED>    (h) Training.--</DELETED>
        <DELETED>    (1) Training of veterans.--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.</DELETED>
        <DELETED>    (2) Training of clinicians.--</DELETED>
                <DELETED>    (A) In general.--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).</DELETED>
                <DELETED>    (B) Participation in training.--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).</DELETED>
<DELETED>    (i) Annual Reports.--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--</DELETED>
        <DELETED>    (1) the number of--</DELETED>
                <DELETED>    (A) veterans served; and</DELETED>
                <DELETED>    (B) courses of treatment provided; 
                and</DELETED>
        <DELETED>    (2) demographic information for such services, 
        diagnoses, and courses of treatment.</DELETED>
<DELETED>    (j) Definitions.--In this section:</DELETED>
        <DELETED>    (1) The term ``community mental health center'' 
        has the meaning given such term in section 410.2 of title 42, 
        Code of Federal Regulations (as in effect on the day before the 
        date of the enactment of this Act).</DELETED>
        <DELETED>    (2) The term ``eligible veteran'' means a veteran 
        in need of mental health services who--</DELETED>
                <DELETED>    (A) is enrolled in the Department of 
                Veterans Affairs health care system; and</DELETED>
                <DELETED>    (B) 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.</DELETED>
        <DELETED>    (3) The term ``Indian Health Service'' means the 
        organization established by section 601(a) of the Indian Health 
        Care Improvement Act (25 U.S.C. 1661(a)).</DELETED>
<DELETED>    (k) Authorization of Appropriations.--There is authorized 
to be appropriated such sums as may be necessary to carry out the 
provisions of this section.</DELETED>

                 <DELETED>TITLE III--RESEARCH</DELETED>

<DELETED>SEC. 301. RESEARCH PROGRAM ON COMORBID POST-TRAUMATIC STRESS 
              DISORDER AND SUBSTANCE USE DISORDERS.</DELETED>

<DELETED>    (a) Program Required.--The Secretary of Veterans Affairs 
shall carry out a program of research into comorbid post-traumatic 
stress disorder (PTSD) and substance use disorder.</DELETED>
<DELETED>    (b) Discharge Through National Center for Posttraumatic 
Stress Disorder.--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--
</DELETED>
        <DELETED>    (1) develop protocols and goals with respect to 
        research under the program; and</DELETED>
        <DELETED>    (2) coordinate research, data collection, and data 
        dissemination under the program.</DELETED>
<DELETED>    (c) Research.--The program of research required by 
subsection (a) shall address the following:</DELETED>
        <DELETED>    (1) Comorbid post-traumatic stress disorder and 
        substance use disorder.</DELETED>
        <DELETED>    (2) The systematic integration of treatment for 
        post-traumatic stress disorder with treatment for substance use 
        disorder.</DELETED>
        <DELETED>    (3) 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.</DELETED>
<DELETED>    (d) Funding.--</DELETED>
        <DELETED>    (1) Authorization of appropriations.--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.</DELETED>
        <DELETED>    (2) Availability.--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.</DELETED>
        <DELETED>    (3) Supplement not supplant.--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.</DELETED>

<DELETED>SEC. 302. EXTENSION OF AUTHORIZATION FOR SPECIAL COMMITTEE ON 
              POST-TRAUMATIC STRESS DISORDER.</DELETED>

<DELETED>    Section 110(e)(2) of the Veterans' Health Care Act of 1984 
(38 U.S.C. 1712A note) is amended by striking ``through 2008'' and 
inserting ``through 2012''.</DELETED>

    <DELETED>TITLE IV--ASSISTANCE FOR FAMILIES OF VETERANS</DELETED>

<DELETED>SEC. 401. CLARIFICATION OF AUTHORITY OF SECRETARY OF VETERANS 
              AFFAIRS TO PROVIDE MENTAL HEALTH SERVICES TO FAMILIES OF 
              VETERANS.</DELETED>

<DELETED>    (a) In General.--Section 1701(5)(B) of title 38, United 
States Code, is amended--</DELETED>
        <DELETED>    (1) by inserting ``marriage and family 
        counseling,'' after ``professional counseling,''; and</DELETED>
        <DELETED>    (2) by striking ``as may be essential to'' and 
        inserting ``as the Secretary considers appropriate 
        for''.</DELETED>
<DELETED>    (b) Location.--Paragraph (5) of section 1701 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.</DELETED>

<DELETED>SEC. 402. PILOT PROGRAM ON PROVISION OF READJUSTMENT AND 
              TRANSITION ASSISTANCE TO VETERANS AND THEIR FAMILIES IN 
              COOPERATION WITH VET CENTERS.</DELETED>

<DELETED>    (a) Pilot Program.--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 section 
1712A of title 38, United States Code (commonly referred to as ``Vet 
Centers'').</DELETED>
<DELETED>    (b) Readjustment and Transition Assistance.--Readjustment 
and transition assistance described in this subsection is assistance as 
follows:</DELETED>
        <DELETED>    (1) Readjustment and transition assistance that is 
        preemptive, proactive, and principle-centered.</DELETED>
        <DELETED>    (2) Assistance and training for veterans and their 
        families in coping with the challenges associated with making 
        the transition from military to civilian life.</DELETED>
<DELETED>    (c) Non-Department of Veterans Affairs Entity.--</DELETED>
        <DELETED>    (1) In general.--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).</DELETED>
        <DELETED>    (2) Contract or agreement.--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.</DELETED>
<DELETED>    (d) Duration of Pilot Program.--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.</DELETED>
<DELETED>    (e) Location of Pilot Program.--</DELETED>
        <DELETED>    (1) In general.--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.</DELETED>
        <DELETED>    (2) Designations.--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.</DELETED>
<DELETED>    (f) Participation of Centers.--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--</DELETED>
        <DELETED>    (1) the facilities and other resources of such 
        center;</DELETED>
        <DELETED>    (2) the non-Department of Veterans Affairs entity 
        selected pursuant to subsection (c); and</DELETED>
        <DELETED>    (3) other appropriate mechanisms.</DELETED>
<DELETED>    (g) Additional Support.--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.</DELETED>
<DELETED>    (h) Report on Pilot Program.--</DELETED>
        <DELETED>    (1) Report required.--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.</DELETED>
        <DELETED>    (2) Elements.--Each report under paragraph (1) 
        shall include the following:</DELETED>
                <DELETED>    (A) 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.</DELETED>
                <DELETED>    (B) A current assessment of the 
                effectiveness of the pilot program.</DELETED>
                <DELETED>    (C) Any recommendations that the Secretary 
                considers appropriate for the extension or expansion of 
                the pilot program.</DELETED>
        <DELETED>    (3) Congressional veterans affairs committees 
        defined.--In this subsection, the term ``congressional veterans 
        affairs committees'' means--</DELETED>
                <DELETED>    (A) the Committees on Veterans' Affairs 
                and Appropriations of the Senate; and</DELETED>
                <DELETED>    (B) the Committees on Veterans' Affairs 
                and Appropriations of the House of 
                Representatives.</DELETED>
<DELETED>    (i) Authorization of Appropriations.--</DELETED>
        <DELETED>    (1) In general.--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.</DELETED>
        <DELETED>    (2) Availability.--Amounts authorized to be 
        appropriated by paragraph (1) shall remain available until 
        expended.</DELETED>

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans Mental 
Health Improvements Act of 2008''.
    (b) Table of Contents.--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 
                            provided by Department of Veterans Affairs.
Sec. 103. Care for veterans with mental health and substance use 
                            disorders.
Sec. 104. National centers of excellence on post-traumatic stress 
                            disorder and substance use disorders.
Sec. 105. Report on residential mental health care facilities of the 
                            Veterans Health Administration.
Sec. 106. 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.

        TITLE I--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE

SEC. 101. FINDINGS ON SUBSTANCE USE DISORDERS AND MENTAL HEALTH.

    Congress makes the following findings:
            (1) 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.
            (2) 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.
            (3) 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.
            (4) 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.
            (5) 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.
            (6) 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.

SEC. 102. EXPANSION OF SUBSTANCE USE DISORDER TREATMENT SERVICES 
              PROVIDED BY DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--The Secretary of Veterans Affairs shall ensure the 
provision of such services and treatment to each veteran enrolled in 
the health care system of the Department of Veterans Affairs who is in 
need of services and treatments for a substance use disorder as 
follows:
            (1) Short term motivational counseling services.
            (2) Intensive outpatient or residential care services.
            (3) Relapse prevention services.
            (4) Ongoing aftercare and outpatient counseling services.
            (5) Opiate substitution therapy services.
            (6) Pharmacological treatments aimed at reducing craving 
        for drugs and alcohol.
            (7) Detoxification and stabilization services.
            (8) Such other services as the Secretary considers 
        appropriate.
    (b) Provision of Services.--The services and treatments described 
in subsection (a) may be provided to a veteran described in such 
subsection--
            (1) at Department of Veterans Affairs medical centers or 
        clinics;
            (2) by referral to other facilities of the Department that 
        are accessible to such veteran; or
            (3) by contract or fee-form service payments with 
        community-based organizations for the provision of such 
        services and treatments.
    (c) Alternatives in Case of Services Denied Due to Clinical 
Necessity.--If the Secretary denies the provision to a veteran of 
services or treatment for a substance use disorder due to clinical 
necessity, the Secretary shall provide the veteran such other services 
or treatments as are medically appropriate.
    (d) Report.--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, for each 
medical facility of the Department, the availability of the following:
            (1) Medically supervised withdrawal management.
            (2) Programs for treatment of alcohol and other substance 
        use disorders that are--
                    (A) integrated with primary health care services; 
                or
                    (B) available as specialty substance use disorder 
                services.
            (3) Specialty programs for the treatment of post-traumatic 
        stress disorder.
            (4) Programs to treat veterans who are diagnosed with both 
        a substance use disorder and a mental health disorder.

SEC. 103. CARE FOR VETERANS WITH MENTAL HEALTH AND SUBSTANCE USE 
              DISORDERS.

    (a) In General.--If 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--
            (1) through a service provided by a clinician or health 
        professional who has training and expertise in treatment of 
        substance use disorders and mental health disorders;
            (2) by separate substance use disorder and mental health 
        disorder treatment services when there is appropriate 
        coordination, collaboration, and care management between such 
        treatment services; or
            (3) by a team of clinicians with appropriate expertise.
    (b) Team of Clinicians With Appropriate Expertise Defined.--In this 
section, the term ``team of clinicians with appropriate expertise'' 
means a team consisting of the following:
            (1) Clinicians and health professionals with expertise in 
        treatment of substance use disorders and mental health 
        disorders who act in coordination and collaboration with each 
        other.
            (2) Such other professionals as the Secretary considers 
        appropriate for the provision of treatment to veterans for 
        substance use and mental health disorders.

SEC. 104. NATIONAL CENTERS OF EXCELLENCE ON POST-TRAUMATIC STRESS 
              DISORDER AND SUBSTANCE USE DISORDERS.

    (a) In General.--Subchapter II of chapter 73 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 7330A. National centers of excellence on post-traumatic stress 
              disorder and substance use disorders
    ``(a) Establishment of Centers.--(1) The Secretary shall establish 
not less than six national centers of excellence on post-traumatic 
stress disorder and substance use disorders.
    ``(2) The purpose of the centers established under this section is 
to serve as Department facilities that provide comprehensive inpatient 
or residential treatment and recovery services for veterans diagnosed 
with both post-traumatic stress disorder and a substance use disorder.
    ``(b) Location.--Each center established in accordance with 
subsection (a) shall be located at a medical center of the Department 
that--
            ``(1) provides specialized care for veterans with post-
        traumatic stress disorder and a substance use disorder; and
            ``(2) 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.
    ``(c) Process of Referral and Transition to Step Down Diagnosis 
Rehabilitation Treatment Programs.--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.
    ``(d) Collaboration With the National Center for Post-Traumatic 
Stress Disorder.--The centers established under this section shall 
collaborate in the research of the National Center for Post-Traumatic 
Stress Disorder.''.
    (b) Clerical Amendment.--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:

``7330A. National centers of excellence on post-traumatic stress 
                            disorder and substance use disorders.''.

SEC. 105. REPORT ON RESIDENTIAL MENTAL HEALTH CARE FACILITIES OF THE 
              VETERANS HEALTH ADMINISTRATION.

    (a) Reviews.--The Secretary of Veterans Affairs shall, acting 
through the Office of Mental Health Services of the Department of 
Veterans Affairs--
            (1) not later than six months after the date of the 
        enactment of this Act, conduct a review of all residential 
        mental health care facilities, including domiciliary 
        facilities, of the Veterans Health Administration; and
            (2) not later than two years after the date of the 
        completion of the review required by paragraph (1), conduct a 
        follow-up review of such facilities to evaluate any 
        improvements made or problems remaining since the review under 
        paragraph (1) was completed.
    (b) Report.--Not later than 90 days after the completion of the 
review required by subsection (a)(1), 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 on such 
review. The report 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. 106. TRIBUTE TO JUSTIN BAILEY.

    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.

           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.

    (a) Pilot Program Required.--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:
            (1) Peer outreach services.
            (2) Peer support services provided by licensed providers of 
        peer support services or veterans who have personal experience 
        with mental illness.
            (3) Readjustment counseling services described in section 
        1712A of title 38, United States Code.
            (4) Other mental health services.
    (b) Provision of Certain Services.--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 
Mental Health Services and the Office of Rural Health, provide such 
services as follows:
            (1) Through community mental health centers or other 
        entities under contracts or other agreements for the provision 
        of such services that are entered into for purposes of the 
        pilot program.
            (2) 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.
    (c) Duration.--The pilot program shall be carried out during the 
three-year period beginning on the date of the commencement of the 
pilot program.
    (d) Program Locations.--
            (1) In general.--The pilot program shall be carried out 
        within areas selected by the Secretary for the purpose of the 
        pilot program in at least two Veterans Integrated Service 
        Networks (VISN).
            (2) Rural geographic locations.--The locations selected 
        shall be in rural geographic locations that, as determined by 
        the Secretary, lack access to comprehensive mental health 
        services through the Department of Veterans Affairs.
            (3) Qualified providers.--In selecting locations for the 
        pilot program, the Secretary shall select locations in which an 
        adequate number of licensed mental health care providers with 
        credentials equivalent to those of Department mental health 
        care providers are available in Indian Health Service 
        facilities, community mental health centers, and other entities 
        are available for participation in the pilot program.
    (e) Participation in Program.--Each community mental health center, 
facility of the Indian Health Service, or other entity participating in 
the pilot program under subsection (b) shall--
            (1) provide the services described in paragraphs (3) and 
        (4) of subsection (a) to eligible veterans, including, to the 
        extent practicable, telehealth services that link the center or 
        facility with Department of Veterans Affairs clinicians;
            (2) use the clinical practice guidelines of the Veterans 
        Health Administration or the Department of Defense in the 
        provision of such services; and
            (3) meet such other requirements as the Secretary shall 
        require.
    (f) Compliance With Department Protocols.--Each community mental 
health center, facility of the Indian Health Service, or other entity 
participating in the pilot program under subsection (b) shall comply 
with--
            (1) 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; and
            (2) access and quality standards of the Department relevant 
        to the provision of services as part of the pilot program.
    (g) Provision of Clinical Information.--Each community mental 
health center, facility of the Indian Health Service, or other entity 
participating in the pilot program under subsection (b) shall, in a 
timely fashion, 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.
    (h) Training.--
            (1) Training of veterans.--As part of the pilot program, 
        the Secretary shall carry out a program of training for 
        veterans described in subsection (a) to provide the services 
        described in paragraphs (1) and (2) of such subsection.
            (2) Training of clinicians.--
                    (A) In general.--The Secretary shall conduct a 
                training program for clinicians of community mental 
                health centers, Indian Health Service facilities, or 
                other entities 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).
                    (B) Participation in training.--Personnel of each 
                community mental health center, facility of the Indian 
                Health Service, or other entity participating in the 
                pilot program under subsection (b) shall participate in 
                the training program conducted pursuant to subparagraph 
                (A).
    (i) Annual Reports.--Each community mental health center, facility 
of the Indian Health Service, or other entity 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--
            (1) the number of--
                    (A) veterans served; and
                    (B) courses of treatment provided; and
            (2) demographic information for such services, diagnoses, 
        and courses of treatment.
    (j) Program Evaluation.--
            (1) In general.--The Secretary shall, through Department of 
        Veterans Affairs Mental Health Services investigators and in 
        collaboration with relevant program offices of the Department, 
        design and implement a strategy for evaluating the pilot 
        program.
            (2) Elements.--The strategy implemented under paragraph (1) 
        shall assess the impact that contracting with community mental 
        health centers, the Indian Health Service, and other entities 
        participating in the pilot program under subsection (b) has on 
        the following:
                    (A) Access to mental health care by veterans in 
                need of such care.
                    (B) The use of telehealth services by veterans for 
                mental health care needs.
                    (C) The quality of mental health care and substance 
                use disorder treatment services provided to veterans in 
                need of such care and services.
                    (D) The coordination of mental health care and 
                other medical services provided to veterans.
    (k) Definitions.--In this section:
            (1) The term ``community mental health center'' has the 
        meaning given such term in section 410.2 of title 42, Code of 
        Federal Regulations (as in effect on the day before the date of 
        the enactment of this Act).
            (2) The term ``eligible veteran'' means a veteran in need 
        of mental health services who--
                    (A) is enrolled in the Department of Veterans 
                Affairs health care system; and
                    (B) has received a referral from a health 
                professional of the Veterans Health Administration to a 
                community mental health center, a facility of the 
                Indian Health Service, or other entity for purposes of 
                the pilot program.
            (3) The term ``Indian Health Service'' means the 
        organization established by section 601(a) of the Indian Health 
        Care Improvement Act (25 U.S.C. 1661(a)).
    (l) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out the provisions 
of this section.

                          TITLE III--RESEARCH

SEC. 301. RESEARCH PROGRAM ON COMORBID POST-TRAUMATIC STRESS DISORDER 
              AND SUBSTANCE USE DISORDERS.

    (a) Program Required.--The Secretary of Veterans Affairs shall 
carry out a program of research into comorbid post-traumatic stress 
disorder (PTSD) and substance use disorder.
    (b) Discharge Through National Center for Posttraumatic Stress 
Disorder.--The research program required by subsection (a) shall be 
carried out by the National Center for Posttraumatic Stress Disorder. 
In carrying out the program, the Center shall--
            (1) develop protocols and goals with respect to research 
        under the program; and
            (2) coordinate research, data collection, and data 
        dissemination under the program.
    (c) Research.--The program of research required by subsection (a) 
shall address the following:
            (1) Comorbid post-traumatic stress disorder and substance 
        use disorder.
            (2) The systematic integration of treatment for post-
        traumatic stress disorder with treatment for substance use 
        disorder.
            (3) 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.
    (d) Funding.--
            (1) Authorization of appropriations.--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.
            (2) Availability.--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.
            (3) Supplement not supplant.--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.

SEC. 302. EXTENSION OF AUTHORIZATION FOR SPECIAL COMMITTEE ON POST-
              TRAUMATIC STRESS DISORDER.

    Section 110(e)(2) of the Veterans' Health Care Act of 1984 (38 
U.S.C. 1712A note; Public Law 98-528) is amended by striking ``through 
2008'' and inserting ``through 2012''.

             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.

    (a) In General.--Chapter 17 of title 38, United States Code, is 
amended--
            (1) in section 1701(5)(B)--
                    (A) by inserting ``marriage and family 
                counseling,'' after ``professional counseling,''; and
                    (B) by striking ``as may be essential to'' and 
                inserting ``as the Secretary considers appropriate 
                for''; and
            (2) in subsections (a) and (b) of section 1782, by 
        inserting ``marriage and family counseling,'' after 
        ``professional counseling,''.
    (b) Location.--Paragraph (5) of section 1701 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 
centers under section 1712A of such title (commonly referred to as 
``Vet 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.

SEC. 402. PILOT PROGRAM ON PROVISION OF READJUSTMENT AND TRANSITION 
              ASSISTANCE TO VETERANS AND THEIR FAMILIES IN COOPERATION 
              WITH VET CENTERS.

    (a) Pilot Program.--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 section 
1712A of title 38, United States Code (commonly referred to as ``Vet 
Centers'').
    (b) Readjustment and Transition Assistance.--Readjustment and 
transition assistance described in this subsection is assistance as 
follows:
            (1) Readjustment and transition assistance that is 
        preemptive, proactive, and principle-centered.
            (2) Assistance and training for veterans and their families 
        in coping with the challenges associated with making the 
        transition from military to civilian life.
    (c) Non-Department of Veterans Affairs Entity.--
            (1) In general.--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).
            (2) Contract or agreement.--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.
    (d) Duration of Pilot Program.--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.
    (e) Location of Pilot Program.--
            (1) In general.--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.
            (2) Designations.--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.
    (f) Participation of Centers.--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--
            (1) the facilities and other resources of such center;
            (2) the non-Department of Veterans Affairs entity selected 
        pursuant to subsection (c); and
            (3) other appropriate mechanisms.
    (g) Additional Support.--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.
    (h) Report on Pilot Program.--
            (1) Report required.--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.
            (2) Elements.--Each report under paragraph (1) shall 
        include the following:
                    (A) 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.
                    (B) A current assessment of the effectiveness of 
                the pilot program.
                    (C) Any recommendations that the Secretary 
                considers appropriate for the extension or expansion of 
                the pilot program.
            (3) Congressional veterans affairs committees defined.--In 
        this subsection, the term ``congressional veterans affairs 
        committees'' means--
                    (A) the Committees on Veterans' Affairs and 
                Appropriations of the Senate; and
                    (B) the Committees on Veterans' Affairs and 
                Appropriations of the House of Representatives.
    (i) Authorization of Appropriations.--
            (1) In general.--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.
            (2) Availability.--Amounts authorized to be appropriated by 
        paragraph (1) shall remain available until expended.
                                                       Calendar No. 632

110th CONGRESS

  2d Session

                                S. 2162

                          [Report No. 110-281]

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                                 A BILL

  To improve the treatment and services provided by the Department of 
 Veterans Affairs to veterans with post-traumatic stress disorder and 
            substance use disorders, and for other purposes.

_______________________________________________________________________

                             April 8, 2008

                       Reported with an amendment