[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6211 Introduced in House (IH)]

111th CONGRESS
  2d Session
                                H. R. 6211

   To direct the Secretary of Veterans Affairs to establish a pilot 
program to evaluate the effectiveness of treating veterans with spinal, 
    back, and musculoskeletal injuries and pain using non-invasive 
                              techniques.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 23, 2010

    Ms. Markey of Colorado introduced the following bill; which was 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To direct the Secretary of Veterans Affairs to establish a pilot 
program to evaluate the effectiveness of treating veterans with spinal, 
    back, and musculoskeletal injuries and pain using non-invasive 
                              techniques.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans Back and Spinal Therapy 
Act''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) One in five members of the Armed Forces who were 
        wounded and evacuated from Afghanistan during the summer and 
        early fall of 2009 suffered a spinal injury, and at least 14 of 
        such members were left paralyzed or with loss of sensation.
            (2) In Afghanistan, members of the Armed Forces routinely 
        carry up to 33 percent more than the suggested maximum weight 
        and up to nearly 75 percent of a member's own body weight--
        routinely hefting combat gear that can exceed 120 pounds, 
        causing large numbers of spinal, back, and musculoskeletal 
        injuries and pain.
            (3) The use of massive improvised explosive devices by 
        insurgents against heavily armed mine resistant ambush 
        protected vehicles has significantly increased the number of 
        spinal, back, and musculoskeletal injuries and pain.
            (4) Advances in both body armor protection and medical 
        treatment have drastically decreased the number of deaths among 
        deployed members of the Armed Forces, but there has been an 
        increase in the number of members with spinal, back, and 
        musculoskeletal injuries and long-term pain.
            (5) Members of the Armed Forces returning from Iraq are 
        more likely to suffer lingering, debilitating injuries from 
        back and musculoskeletal pain than from battle wounds, 
        according to statistics compiled by the Secretary of Veterans 
        Affairs.
            (6) Diagnoses of ruptured spinal discs, compressed discs, 
        degenerative disc disease, and myofascial pain syndrome are 
        common in members of the Armed Forces returning from 
        Afghanistan and Iraq.
            (7) Spinal and back injuries are the most expensive 
        musculoskeletal disorder to treat.
            (8) Certain facilities of the Department of Veterans 
        Affairs offer outstanding non-invasive technologies for 
        treating spinal, back, and musculoskeletal injuries as well as 
        any accompanying mental health issues.
            (9) Traditional medical approaches to spinal, back, and 
        musculoskeletal injuries typically involve a combination of 
        long-term medication, surgery, and short-term physical therapy.
            (10) Using non-invasive techniques to treat veterans with 
        spinal, back, and musculoskeletal injuries can improve the 
        health outcomes for such veterans and drastically reduce the 
        long-term costs of care for such veterans by breaking the cycle 
        of expensive surgery followed by long-term pain medication that 
        often leads to addiction, depression, anxiety, and weight gain.
            (11) Non-invasive techniques that are not widely available 
        in medical facilities of the Department of Veterans Affairs, 
        including manual physical therapy, core strengthening and 
        stabilization therapy, water exercise therapy, group exercise 
        therapy, and pain management therapy, should be evaluated in an 
        evidence-based medicine framework to assess their 
        effectiveness.

SEC. 3. PILOT PROGRAM TO PROVIDE VETERANS WITH NON-INVASIVE TECHNIQUES 
              FOR SPINAL, BACK, AND MUSCULOSKELETAL INJURIES.

    (a) Establishment.--The Secretary of Veterans Affairs shall 
establish a pilot program to--
            (1) provide covered veterans with non-invasive techniques 
        to treat spinal, back, and musculoskeletal injuries and pain; 
        and
            (2) use an evidence-based medicine framework to assess the 
        effectiveness of such non-invasive techniques.
    (b) Scope.--
            (1) Size.--The pilot program shall include a representative 
        sample of covered veterans that is of sufficient size for the 
        Secretary to determine--
                    (A) the effectiveness and feasibility of providing 
                veterans with non-invasive techniques to treat spinal, 
                back, and musculoskeletal injuries and pain; and
                    (B) the unique considerations that exist with 
                respect to providing such treatment--
                            (i) to female veterans;
                            (ii) to veterans of various ages; and
                            (iii) to veterans located in various 
                        regions of the United States, including both 
                        urban and rural locations.
            (2) Preference.--In selecting covered veterans to 
        participate in the pilot program, the Secretary shall give 
        preference to covered veterans who served in Operation Enduring 
        Freedom, Operation Iraqi Freedom, or Operation New Dawn.
    (c) Administration.--In administering the pilot program, the 
Secretary shall--
            (1) determine the type of non-invasive technique to provide 
        to a covered veteran;
            (2) determine the effect of allowing self-referral by a 
        veteran to receive non-invasive techniques compared with 
        requiring a veteran to receive a referral from a physician for 
        non-invasive techniques; and
            (3) ensure the use of telehealth technology to provide 
        covered veterans who reside in rural locations (as determined 
        by the Secretary) with non-invasive techniques to treat spinal, 
        back, and musculoskeletal injuries and pain.
    (d) Partnership.--
            (1) University.--In administering the pilot program, the 
        Secretary shall seek to enter into an agreement with a 
        university affiliated with the Department of Veterans Affairs 
        to carry out the pilot program.
            (2) Selection.--In entering into an agreement with a 
        university under paragraph (1), the Secretary shall ensure that 
        the individuals who treat covered veterans with non-invasive 
        techniques for spinal, back, and musculoskeletal injuries and 
        pain--
                    (A) are trained to--
                            (i) effectively treat such veterans; and
                            (ii) recognize the unique experiences of 
                        such veterans, including experiences related to 
                        serving in Operation Enduring Freedom, 
                        Operation Iraqi Freedom, or Operation New Dawn; 
                        and
                    (B) use best practices and technologies with 
                respect to the non-invasive technique being used to 
                treat such veterans.
    (e) Duration.--The pilot program shall begin not later than March 
1, 2011, and shall continue for two years.
    (f) Reports.--
            (1) Initial report.--Not later than June 1, 2012, the 
        Secretary shall submit to the Committee on Veterans' Affairs of 
        the House of Representatives and the Committee on Veterans' 
        Affairs of the Senate a report on the pilot program, 
        including--
                    (A) an analysis of the effectiveness and cost-
                effectiveness of each non-invasive technique provided 
                under the pilot program;
                    (B) an analysis of how the Secretary would 
                incorporate non-invasive techniques to treat spinal, 
                back, and musculoskeletal injuries and pain at medical 
                facilities of the Department of Veterans Affairs;
                    (C) the amount of cost-savings, if any, created by 
                providing veterans with non-invasive techniques to 
                treat spinal, back, and musculoskeletal injuries and 
                pain;
                    (D) a comparison of the non-invasive techniques 
                provided under the pilot program with other methods 
                used by the Secretary to treat spinal, back, and 
                musculoskeletal injuries and pain; and
                    (E) recommendations of the Secretary with respect 
                to--
                            (i) continuing or expanding the pilot 
                        program; and
                            (ii) any legislation or other actions to 
                        improve treating veterans with spinal, back, 
                        and musculoskeletal injuries and pain.
            (2) Final report.--Not later than June 1, 2013, the 
        Secretary shall submit to the Committee on Veterans' Affairs of 
        the House of Representatives and the Committee on Veterans' 
        Affairs of the Senate a report containing updated information 
        to the report submitted under paragraph (1).
    (g) Definitions.--In this section:
            (1) The term ``covered veteran'' means a veteran who--
                    (A) has a service-connected spinal, back, or 
                musculoskeletal injury; or
                    (B) is eligible for hospital care, medical 
                services, and nursing home care by virtue of section 
                1710(e)(1)(D) of title 38, United States Code.
            (2) The term ``non-invasive techniques'' means methods of 
        treatment for spinal, back, and musculoskeletal injuries and 
        pain other than surgery, including--
                    (A) manual physical therapy, core strengthening and 
                stabilization therapy, water exercise therapy, group 
                exercise therapy, and pain management therapy;
                    (B) such methods (including recreational therapy) 
                used by the War Related Illness and Injury Study Center 
                of the Department of Veterans Affairs located in Palo 
                Alto, California, and the mindfulness based stress 
                reduction program of the Puget Sound Health Care System 
                of the Department of Veterans Affairs that the 
                Secretary determines to have been successful; and
                    (C) such other methods not widely available in 
                medical facilities of the Department of Veterans 
                Affairs.
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