[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 3340 Introduced in Senate (IS)]

112th CONGRESS
  2d Session
                                S. 3340

To improve and enhance the programs and activities of the Department of 
   Defense and the Department of Veterans Affairs regarding suicide 
 prevention and resilience and behavioral health disorders for members 
       of the Armed Forces and veterans, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 25, 2012

  Mrs. Murray introduced the following bill; which was read twice and 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
To improve and enhance the programs and activities of the Department of 
   Defense and the Department of Veterans Affairs regarding suicide 
 prevention and resilience and behavioral health disorders for members 
       of the Armed Forces and veterans, 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Mental Health 
Access to Continued Care and Enhancement of Support Services Act of 
2012'' or ``Mental Health ACCESS Act of 2012''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
                 TITLE I--DEPARTMENT OF DEFENSE MATTERS

Sec. 101. Enhancement of oversight and management of Department of 
                            Defense suicide prevention and resilience 
                            programs.
Sec. 102. Comprehensive program on prevention of suicide among members 
                            of the Armed Forces.
Sec. 103. Enhancement of training and education for physicians, mental 
                            health care providers, and related 
                            personnel on identification and treatment 
                            of behavioral health disorders.
Sec. 104. Limitation on disclosure of mental health conditions or 
                            treatment or requests for treatment of 
                            members of the Armed Forces.
Sec. 105. Sharing between Department of Defense and Department of 
                            Veterans Affairs of records and information 
                            retained under the medical tracking system 
                            for members of the Armed Forces deployed 
                            overseas.
Sec. 106. Participation of members of the Armed Forces in peer support 
                            counseling programs of the Department of 
                            Veterans Affairs.
Sec. 107. Research and medical practice on mental health conditions.
Sec. 108. Quality review of Medical Evaluation Boards, Physical 
                            Evaluation Boards, and Physical Evaluation 
                            Board Liaison Officers.
Sec. 109. Compliance of Department of Defense with requirement for use 
                            of Department of Veterans Affairs schedule 
                            for rating disabilities in determinations 
                            of disability of members of the Armed 
                            Forces.
Sec. 110. Disposal of controlled substances.
Sec. 111. Assessment of adequacy of mental health care benefits under 
                            the TRICARE program.
Sec. 112. Authority to exempt behavioral health care providers under 
                            the TRICARE program from State licensure 
                            requirements for provision of behavioral 
                            health care to members of the Armed Forces 
                            and dependents.
Sec. 113. Report on adequacy of capacity of the military medical 
                            treatment system regarding inpatient 
                            behavioral health care.
            TITLE II--DEPARTMENT OF VETERANS AFFAIRS MATTERS

Sec. 201. Transparency of mental health care services.
Sec. 202. Expansion of Vet Center program to include furnishing 
                            counseling to certain members of the Armed 
                            Forces and their family members.
Sec. 203. Authority for Secretary of Veterans Affairs to furnish mental 
                            health care through facilities other than 
                            Vet Centers to immediate family members of 
                            members of the Armed Forces deployed in 
                            connection with a contingency operation.
Sec. 204. Organization of the Readjustment Counseling Service in 
                            Department of Veterans Affairs.
Sec. 205. Recruiting mental health providers for furnishing of mental 
                            health services on behalf of the Department 
                            of Veterans Affairs without compensation 
                            from the Department.
Sec. 206. Reimbursement of physicians and dentists for expenses 
                            relating to board certification or 
                            recertification.
Sec. 207. Peer support.

                 TITLE I--DEPARTMENT OF DEFENSE MATTERS

SEC. 101. ENHANCEMENT OF OVERSIGHT AND MANAGEMENT OF DEPARTMENT OF 
              DEFENSE SUICIDE PREVENTION AND RESILIENCE PROGRAMS.

    (a) In General.--The Secretary of Defense shall, acting through the 
Under Secretary of Defense for Personnel and Readiness, establish 
within the Office of the Secretary of Defense a position with 
responsibility for oversight and management of all suicide prevention 
and resilience programs and all preventative behavioral health programs 
of the Department of Defense (including those of the military 
departments and the Armed Forces).
    (b) Scope of Responsibilities.--The individual serving in the 
position established pursuant to subsection (a) shall have the 
responsibilities as follows:
            (1) To establish a uniform definition of resiliency for use 
        in the suicide prevention and resilience programs and 
        preventative behavioral health programs of the Department of 
        Defense (including those of the military departments and the 
        Armed Forces).
            (2) In consultation with the National Center for Post 
        Traumatic Stress Disorder of the Department of Veterans Affairs 
        and other appropriate public and private agencies and entities, 
        to require the use of clinical best practices in mental health 
        care, suicide prevention programs, and resilience programs of 
        the Department of Defense, including the diagnosis and 
        treatment of behavioral health disorders.
            (3) To oversee and manage the comprehensive program on the 
        prevention of suicide among members of the Armed Forces 
        required by section 102.

SEC. 102. COMPREHENSIVE PROGRAM ON PREVENTION OF SUICIDE AMONG MEMBERS 
              OF THE ARMED FORCES.

    (a) Comprehensive Program Required.--The Secretary of Defense 
shall, acting through the Assistant Secretary of Defense for Health 
Affairs, develop and implement within the Department of Defense a 
comprehensive program on the prevention of suicide among members of the 
Armed Forces. In developing the program, the Secretary shall consider 
recommendations from the operational elements of the Armed Forces 
regarding the feasibility of the implementation and execution of 
particular elements of the program.
    (b) Elements.--The comprehensive program required by subsection (a) 
shall include elements to achieve the following:
            (1) To raise awareness among members of the Armed Forces 
        about mental health conditions and the stigma associated with 
        mental health conditions and mental health care.
            (2) To provide members of the Armed Forces generally, 
        members of the Armed Forces in supervisory positions (including 
        officers in command billets and non-commissioned officers), and 
        medical personnel of the Armed Forces and the Department of 
        Defense with effective means of identifying members of the 
        Armed Forces who are at risk for suicide (including enhanced 
        means for early identification and treatment of such members), 
        including through training required by section 103.
            (3) To provide members of the Armed Forces who are at risk 
        of suicide with continuous access to suicide prevention 
        services, including suicide crisis services.
            (4) To evaluate and assess the effectiveness of the suicide 
        prevention and resilience programs and preventative behavioral 
        health programs of the Department of Defense (including those 
        of the military departments and the Armed Forces), including 
        the development of metrics for that purpose.
            (5) To evaluate and assess the current diagnostic tools and 
        treatment methods in the programs referred to in paragraph (4) 
        in order to ensure clinical best practices are used in such 
        programs.
            (6) To ensure that the programs referred to in paragraph 
        (4) incorporate evidenced-based practices when available.
            (7) To provide for the training of mental health care 
        providers on evidence-based therapies in connection with 
        suicide prevention.
            (8) To establish training standards for behavioral health 
        care providers in order to ensure that such providers receive 
        training on clinical best practices and evidence-based 
        treatments as information on such practices and treatments 
        becomes available, and to ensure such standards are met.
            (9) To provide for the integration of mental health 
        screenings and suicide risk and prevention for members of the 
        Armed Forces into the delivery of primary care for such 
        members.
            (10) To ensure appropriate responses to attempted or 
        completed suicides among members of the Armed Forces, including 
        guidance and training to assist commanders in addressing 
        incidents of attempted or completed suicide within their units.
            (11) To ensure the protection of the privacy of members of 
        the Armed Forces seeking or receiving treatment relating to 
        suicide.
            (12) Such other matters as the Secretary of Defense 
        considers appropriate in connection with the prevention of 
        suicide among members of the Armed Forces.
    (c) Consultation.--In developing and implementing the comprehensive 
program required by subsection (a), the Assistant Secretary shall 
consult with appropriate officials and elements of the Department of 
Defense, appropriate centers of excellence within the Department of 
Defense, and other public and private entities with expertise in mental 
health and suicide prevention.
    (d) Implementation by the Armed Forces.--In implementing the 
comprehensive program required by subsection (a) with respect to an 
Armed Force, the Secretary of the military department concerned may, in 
consultation with the Assistant Secretary and with the approval of the 
Secretary of Defense, modify particular elements of the program in 
order to adapt the program appropriately to the unique culture and 
elements of that Armed Force.
    (e) Quality Assurance.--In developing and implementing the 
comprehensive program required by subsection (a), the Assistant 
Secretary shall develop and implement appropriate mechanisms to provide 
for the oversight and management of the program, including quality 
measures to assess the efficacy of the program in preventing suicide 
among members of the Armed Forces.

SEC. 103. ENHANCEMENT OF TRAINING AND EDUCATION FOR PHYSICIANS, MENTAL 
              HEALTH CARE PROVIDERS, AND RELATED PERSONNEL ON 
              IDENTIFICATION AND TREATMENT OF BEHAVIORAL HEALTH 
              DISORDERS.

    (a) Physicians.--The Secretary of Defense shall ensure that the 
continuing medical education provided physicians in the military 
medical treatment system includes education and training on the triage 
and referral of individuals with mental health conditions.
    (b) Mental Health Care Providers.--The Secretary of Defense shall 
develop and implement continuing education program requirements for 
mental health care providers and behavioral health care providers in 
the military medical treatment system in order to ensure that such 
providers keep current on best clinical practices for the diagnosis and 
treatment of behavioral health disorders in members of the Armed 
Forces.
    (c) Counselors and Related Personnel.--
            (1) In general.--The Secretary of Defense shall develop and 
        implement throughout the Armed Forces a program of training for 
        the members of the Armed Forces and personnel of the Department 
        of Defense described in paragraph (2) in order to familiarize 
        such members and personnel with the following:
                    (A) The signs and symptoms of behavioral health 
                disorders that manifest frequently in members of the 
                Armed Forces.
                    (B) The courses of action to be undertaken by such 
                personnel who detect such signs and symptoms in members 
                of the Armed Forces.
            (2) Covered members and personnel.--The members of the 
        Armed Forces and personnel of the Department of Defense 
        described in this paragraph are the following:
                    (A) Physician assistants in the military medical 
                treatment system.
                    (B) Medics.
                    (C) Military chaplains.
                    (D) Such other members of the Armed Forces or 
                civilian personnel of the Department of Defense as the 
                Secretary shall designate for purposes of this 
                subsection.

SEC. 104. LIMITATION ON DISCLOSURE OF MENTAL HEALTH CONDITIONS OR 
              TREATMENT OR REQUESTS FOR TREATMENT OF MEMBERS OF THE 
              ARMED FORCES.

    (a) Limitation.--A medical or mental health care provider in the 
military medical treatment system may not disclose a mental health 
condition of a member of the Armed Forces, treatment of a member for a 
mental health condition, or a request of a member for treatment of a 
mental health condition, except as provided in subsection (b).
    (b) Exceptions.--A medical or mental health care provider may make 
a disclosure described by subsection (a) if--
            (1) the disclosure to another covered entity (as that term 
        is defined for purposes of the Health Insurance Portability and 
        Accountability Act of 1996) is necessary;
            (2) the member concerned requests the disclosure;
            (3) the member concerned does not meet the minimum 
        standards for deployment prescribed under section 1074f(f) of 
        title 10, United States Code, at the time of the disclosure, 
        regardless of the deployment status or plans of the member; or
            (4) the disclosure is necessary in an emergency to protect 
        the life or safety of the member concerned or others.

SEC. 105. SHARING BETWEEN DEPARTMENT OF DEFENSE AND DEPARTMENT OF 
              VETERANS AFFAIRS OF RECORDS AND INFORMATION RETAINED 
              UNDER THE MEDICAL TRACKING SYSTEM FOR MEMBERS OF THE 
              ARMED FORCES DEPLOYED OVERSEAS.

    (a) In General.--The Secretary of Defense and the Secretary of 
Veterans Affairs shall jointly enter into a memorandum of understanding 
providing for the sharing by the Department of Defense with the 
Department of Veterans Affairs of the results of examinations and other 
records on members of the Armed Forces that are retained and maintained 
with respect to the medical tracking system for members deployed 
overseas under section 1074f(c) of title 10, United States Code.
    (b) Cessation Upon Implementation of Electronic Health Record.--The 
sharing required pursuant to subsection (a) shall cease on the date on 
which the Secretary of Defense and the Secretary of Veterans Affairs 
jointly certify to Congress that the Secretaries have fully implemented 
an integrated electronic health record for members of the Armed Forces 
that is fully interoperable between the Department of Defense and the 
Department of Veterans Affairs.

SEC. 106. PARTICIPATION OF MEMBERS OF THE ARMED FORCES IN PEER SUPPORT 
              COUNSELING PROGRAMS OF THE DEPARTMENT OF VETERANS 
              AFFAIRS.

    (a) Participation.--
            (1) In general.--The Secretary of Defense and the Secretary 
        of Veterans Affairs shall jointly enter into a memorandum of 
        understanding providing for members of the Armed Forces 
        described in subsection (b) to volunteer or be considered for 
        employment as peer counselors under the following:
                    (A) The peer support counseling program carried out 
                by the Secretary of Veterans Affairs under subsection 
                (j) of section 1720F of title 38, United States Code, 
                as part of the comprehensive program for suicide 
                prevention among veterans under subsection (a) of such 
                section.
                    (B) The peer support counseling program carried out 
                by the Secretary of Veterans Affairs under section 
                304(a)(1) of Caregivers and Veterans Omnibus Health 
                Services Act of 2010 (Public Law 111-163; 124 Stat. 
                1150; 38 U.S.C. 1712A note).
            (2) Training.--Any member participating in a peer support 
        counseling program under paragraph (1) shall receive the 
        training for peer counselors under section 1720F(j)(2) of title 
        38, United States Code, or section 304(c) of the Caregivers and 
        Veterans Omnibus Health Services Act of 2010, as applicable, 
        before performing peer support counseling duties under such 
        program.
    (b) Covered Members.--Members of the Armed Forces described in this 
subsection are the following:
            (1) Members of the reserve components of the Armed Forces 
        who are demobilizing after deployment in a theater of combat 
        operations, including, in particular, members who participated 
        in combat against the enemy while so deployed.
            (2) Members of the regular components of the Armed Forces 
        separating from active duty who have been deployed in a theater 
        of combat operations in which such members participated in 
        combat against the enemy.

SEC. 107. RESEARCH AND MEDICAL PRACTICE ON MENTAL HEALTH CONDITIONS.

    (a) Department of Defense Organization on Research and Practice.--
The Secretary of Defense shall establish within the Department of 
Defense an organization to carry out the responsibilities specified in 
subsection (b).
    (b) Responsibilities.--The organization established under 
subsection (a) shall--
            (1) carry out programs and activities designed to provide 
        for the translation of research on the diagnosis and treatment 
        of mental health conditions into policy on medical practices;
            (2) make recommendations to the Assistant Secretary of 
        Defense for Health Affairs on the translation of such research 
        into the policies of the Department of Defense on medical 
        practices with respect to members of the Armed Forces; and
            (3) discharge such other responsibilities relating to 
        research and medical practices on mental health conditions, and 
        the policies of the Department on such practices with respect 
        to members of the Armed Forces, as the Secretary or the 
        Assistant Secretary shall specify for purposes of this section.
    (c) Reports.--
            (1) Initial report.--Not later than 120 days after the date 
        of the enactment of this Act, the Secretary shall submit to 
        Congress a report on the organization required by subsection 
        (a). The report shall include a description of the organization 
        and a plan for implementing the requirements of this section.
            (2) Annual reports.--The Secretary shall submit to Congress 
        each year a report on the activities of the organization 
        established under subsection (a) during the preceding year. 
        Each report shall include the following:
                    (A) A summary description of the activities of the 
                organization during the preceding year.
                    (B) A description of the recommendations made by 
                the organization to the Assistant Secretary under 
                subsection (b)(2) during the year, and a description of 
                the actions undertaken (or to be undertaken) by the 
                Assistant Secretary in response to such 
                recommendations.
                    (C) Such other matters relating to the activities 
                of the organization, including recommendations for 
                additional legislative or administrative action, as the 
                Secretary, in consultation with the Assistant 
                Secretary, considers appropriate.

SEC. 108. QUALITY REVIEW OF MEDICAL EVALUATION BOARDS, PHYSICAL 
              EVALUATION BOARDS, AND PHYSICAL EVALUATION BOARD LIAISON 
              OFFICERS.

    (a) In General.--The Secretary of Defense shall standardize, 
assess, and monitor the quality assurance programs of the military 
departments to evaluate the following in the performance of their 
duties (including duties under chapter 61 of title 10, United States 
Code):
            (1) Medical Evaluation Boards (MEBs).
            (2) Physical Evaluation Boards (PEBs).
            (3) Physical Evaluation Board Liaison Officers (PEBLOs).
    (b) Objectives.--The objectives of the quality assurance program 
shall be as follows:
            (1) To ensure accuracy and consistency in the 
        determinations and decisions of Medical Evaluation Boards and 
        Physical Evaluation Boards.
            (2) To otherwise monitor and sustain proper performance of 
        the duties of Medical Evaluation Boards and Physical Evaluation 
        Boards, and of Physical Evaluation Board Liaison Officers.
            (3) Such other objectives as the Secretary shall specify 
        for purposes of the quality assurance program.

SEC. 109. COMPLIANCE OF DEPARTMENT OF DEFENSE WITH REQUIREMENT FOR USE 
              OF DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING 
              DISABILITIES IN DETERMINATIONS OF DISABILITY OF MEMBERS 
              OF THE ARMED FORCES.

    (a) Report Required.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Defense shall submit to 
Congress a report setting forth a comprehensive assessment whether the 
Secretaries of the military departments (and the policies, regulations, 
and directives of the military departments) are fully compliant with 
the requirement in section 1216a of title 10, United States Code, for 
the use of the Department of Veterans Affairs schedule for rating 
disabilities in making determinations of disability of members of the 
Armed Forces for purposes of chapter 61 of that title.
    (b) Additional Element Following Determination of Lack of Full 
Compliance.--If the assessment of the Secretary in the report required 
by subsection (a) is that the Secretaries of the military departments 
are not fully compliant with the requirement described in that 
subsection, the report shall include a comprehensive description of the 
actions to be undertaken by the Secretaries of the military departments 
to achieve full compliance with the requirement, including a schedule 
for such actions.

SEC. 110. DISPOSAL OF CONTROLLED SUBSTANCES.

    The Administrator of the Drug Enforcement Administration shall 
enter into a memorandum of understanding with the Secretary of Defense 
establishing procedures under which a member of the Armed Forces may 
deliver a controlled substance to a member of the Armed Forces or an 
employee of the Department of Defense to be disposed of in accordance 
with section 302(g) of the Controlled Substances Act (21 U.S.C. 
822(g)).

SEC. 111. ASSESSMENT OF ADEQUACY OF MENTAL HEALTH CARE BENEFITS UNDER 
              THE TRICARE PROGRAM.

    (a) Independent Assessment Required.--Not later than 180 days after 
the date of the enactment of this Act, the Secretary of Defense shall, 
in consultation with the Secretary of Health and Human Services, enter 
into a contract with an appropriate independent entity to assess 
whether the mental health care benefits available for members of the 
Armed Forces and other covered beneficiaries under the TRICARE program 
are adequate to meet the needs of such members and beneficiaries for 
mental health care.
    (b) Report.--The contract required by subsection (a) shall require 
the entity conducting the assessment required by the contract to submit 
to the Secretary of Defense, and to the congressional defense 
committees, a report setting forth the results of the assessment by not 
later than 180 days after the date of entry into the contract. If the 
entity determines pursuant to the assessment that the mental health 
care benefits available for members of the Armed Forces and other 
covered beneficiaries under the TRICARE program are not adequate to 
meet the needs of such members and beneficiaries for mental health 
care, the report shall include such recommendations for legislative or 
administrative action as the entity considers appropriate to remediate 
any identified inadequacy.
    (c) Definitions.--In this section:
            (1) The term ``congressional defense committees'' has the 
        meaning given that term in section 101(a)(16) of title 10, 
        United States Code.
            (2) The term ``covered beneficiaries'' has the meaning 
        given that term in section 1072(5) of title 10, United States 
        Code.
            (3) The term ``TRICARE program'' has the meaning given that 
        term in section 1072(7) of title 10, United States Code.

SEC. 112. AUTHORITY TO EXEMPT BEHAVIORAL HEALTH CARE PROVIDERS UNDER 
              THE TRICARE PROGRAM FROM STATE LICENSURE REQUIREMENTS FOR 
              PROVISION OF BEHAVIORAL HEALTH CARE TO MEMBERS OF THE 
              ARMED FORCES AND DEPENDENTS.

    (a) In General.--The Secretary of Defense may, subject to 
subsection (b), treat any licensed behavioral health care provider or 
category of licensed behavioral health care providers under the TRICARE 
program as a health-care professional or professionals exempt from laws 
regarding the licensure of health care professionals in accordance with 
section 1094(d) of title 10, United States Code, if the Secretary 
determines that such treatment is necessary for purposes as follows:
            (1) To ensure continuity in the provision of behavioral 
        health care to a member of the Armed Forces or the member's 
        dependents following a permanent change of station or other 
        relocation of the member and dependents to another State, 
        including through the provision of such care by tele-health or 
        other remote delivery mechanisms.
            (2) To ensure access to behavioral health care under the 
        TRICARE program in areas otherwise unserved or underserved by 
        behavioral health care providers under that program.
    (b) Limitation.--A behavioral health care provider may not be 
exempted under subsection (a) from laws described in that subsection 
unless the health care provider--
            (1) is licensed as a behavioral health care provider by a 
        State; and
            (2) is authorized under the TRICARE program to act as a 
        behavioral health care provider throughout the TRICARE program.
    (c) TRICARE Program Defined.--In this section, the term ``TRICARE 
program'' has the meaning given that term in section 1072(7) of title 
10, United States Code.

SEC. 113. REPORT ON ADEQUACY OF CAPACITY OF THE MILITARY MEDICAL 
              TREATMENT SYSTEM REGARDING INPATIENT BEHAVIORAL HEALTH 
              CARE.

    (a) Report Required.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Defense shall submit to the 
congressional defense committees a report setting forth an assessment 
by the Secretary of the adequacy of the capacity of the military 
medical treatment system to meet the needs of members of the Armed 
Forces for inpatient behavioral health care, with a particular focus on 
facilities under that system that support members of the Armed Forces 
on deployment rotation.
    (b) Congressional Defense Committees Defined.--In this section, the 
term ``congressional defense committees'' has the meaning given that 
term in section 101(a)(16) of title 10, United States Code.

            TITLE II--DEPARTMENT OF VETERANS AFFAIRS MATTERS

SEC. 201. TRANSPARENCY OF MENTAL HEALTH CARE SERVICES.

    (a) Measurement of Mental Health Care Services.--
            (1) In general.--Not later than December 31, 2013, the 
        Secretary of Veterans Affairs shall develop and implement a 
        comprehensive set of measures to assess mental health care 
        services furnished by the Department of Veterans Affairs.
            (2) Elements.--The measures developed and implemented under 
        paragraph (1) shall provide an accurate and comprehensive 
        assessment of the following:
                    (A) The timeliness of the furnishing of mental 
                health care by the Department.
                    (B) The satisfaction of patients who receive mental 
                health care services furnished by the Department.
                    (C) The capacity of the Department to furnish 
                mental health care.
                    (D) The availability and furnishing of evidence-
                based therapies by the Department.
    (b) Guidelines for Staffing Mental Health Care Services.--Not later 
than December 31, 2013, the Secretary shall develop and implement 
guidelines for the staffing of general and specialty mental health care 
services, including at community-based outpatient clinics. Such 
guidelines shall include productivity standards for providers of mental 
health care.
    (c) Study Committee.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        seek to enter into a contract with the National Academy of 
        Sciences to create a study committee--
                    (A) to consult with the Secretary on the 
                Secretary's development and implementation of the 
                measures and guidelines required by subsections (a) and 
                (b); and
                    (B) to conduct an assessment and provide an 
                analysis and recommendations on the state of Department 
                mental health services.
            (2) Functions.--In entering into the contract described in 
        paragraph (1), the Secretary shall, with respect to paragraph 
        (1)(B), include in such contract a provision for the study 
        committee--
                    (A) to conduct a comprehensive assessment of 
                barriers to access to mental health care by veterans 
                who served in the Armed Forces in Operation Enduring 
                Freedom, Operation Iraqi Freedom, or Operation New 
                Dawn;
                    (B) to assess the quality of the mental health care 
                being provided to such veterans (including the extent 
                to which veterans are afforded choices with respect to 
                modes of treatment) through site visits to facilities 
                of the Veterans Health Administration (including at 
                least one site visit in each Veterans Integrated 
                Service Network), evaluating studies of patient 
                outcomes, and other appropriate means;
                    (C) to assess whether, and the extent to which, 
                veterans who served in the Armed Forces in Operation 
                Enduring Freedom, Operation Iraqi Freedom, or Operation 
                New Dawn are being offered a full range of necessary 
                mental health services at Department health care 
                facilities, including early intervention services for 
                hazardous drinking, relationship problems, and other 
                behaviors that create a risk for the development of a 
                chronic mental health condition;
                    (D) to conduct surveys or have access to 
                Department-administered surveys of--
                            (i) providers of Department mental health 
                        services;
                            (ii) veterans who served in the Armed 
                        Forces in Operation Enduring Freedom, Operation 
                        Iraqi Freedom, or Operation New Dawn who are 
                        receiving mental health care furnished by the 
                        Department; and
                            (iii) eligible veterans who served in the 
                        Armed Forces in Operation Enduring Freedom, 
                        Operation Iraqi Freedom, or Operation New Dawn 
                        who are not using Department health care 
                        services to assess those barriers described in 
                        subparagraph (A); and
                    (E) to provide to the Secretary, on the basis of 
                its assessments as delineated in subparagraphs (A) 
                through (C), specific, detailed recommendations--
                            (i) for overcoming barriers, and improving 
                        access, to timely, effective mental health care 
                        at Department health care facilities (or, where 
                        Department facilities cannot provide such care, 
                        through contract arrangements under existing 
                        law); and
                            (ii) to improve the effectiveness and 
                        efficiency of mental health services furnished 
                        by the Secretary.
            (3) Participation by former officials and employees of 
        veterans health administration.--The Secretary shall ensure 
        that any contract entered into under paragraph (1) provides for 
        inclusion on any subcommittee which participates in conducting 
        the assessments and formulating the recommendations provided 
        for in paragraph (2) at least one former official of the 
        Veterans Health Administration and at least two former 
        employees of the Veterans Health Administration who were 
        providers of mental health care.
            (4) Periodic reports to secretary.--In entering into the 
        contract described in paragraph (1), the Secretary shall, with 
        respect to paragraph (1)(A), include in such contract a 
        provision for the submittal to the Secretary of periodic 
        reports and provision of other consultation to the Secretary by 
        the study committee to assist the Secretary in carrying out 
        subsections (a) and (b).
            (5) Reports to congress.--Not later than 30 days after 
        receiving a report under paragraph (4), 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 the plans of the Secretary to 
        implement such recommendations submitted to the Secretary by 
        the study committee as the Secretary considers appropriate. 
        Such report shall include a description of each recommendation 
        submitted to the Secretary that the Secretary does not plan to 
        carry out and an explanation of why the Secretary does not plan 
        to carry out such recommendation.
    (d) Publication.--
            (1) In general.--The Secretary shall make available to the 
        public on an Internet website of the Department the following:
                    (A) The measures and guidelines developed and 
                implemented under this section.
                    (B) An assessment of the performance of the 
                Department using such measures and guidelines.
            (2) Quarterly updates.--The Secretary shall update the 
        measures, guidelines, and assessment made available to the 
        public under paragraph (1) not less frequently than quarterly.
    (e) Semiannual Reports.--
            (1) In general.--Not later than June 30, 2013, and not less 
        frequently than twice each year thereafter, 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 the Secretary's progress in 
        developing and implementing the measures and guidelines 
        required by this section.
            (2) Elements.--Each report submitted under paragraph (1) 
        shall include the following:
                    (A) A description of the development and 
                implementation of the measures required by subsection 
                (a) and the guidelines required by subsection (b).
                    (B) A description of the progress made by the 
                Secretary in developing and implementing such measures 
                and guidelines.
                    (C) An assessment of the mental health care 
                services furnished by the Department of Veterans 
                Affairs, using the measures developed and implemented 
                under subsection (a).
                    (D) An assessment of the effectiveness of the 
                guidelines developed and implemented under subsection 
                (b).
                    (E) Such recommendations for legislative or 
                administrative action as the Secretary may have to 
                improve the effectiveness and efficiency of the mental 
                health care services furnished under laws administered 
                by the Secretary.
    (f) Implementation Report.--
            (1) In general.--Not later than 30 days before the date on 
        which the Secretary begins implementing the measures and 
        guidelines required by this section, the Secretary shall submit 
        to the committees described in subsection (e)(1) a report on 
        the Secretary's planned implementation of such measures and 
        guidelines.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) A detailed description of the measures and 
                guidelines that the Secretary plans to implement under 
                this section.
                    (B) A description of the rationale for each measure 
                and guideline the Secretary plans to implement under 
                this section.
                    (C) A discussion of each measure and guideline that 
                the Secretary considered under this section but chose 
                not to implement.
                    (D) The number of current vacancies in mental 
                health care provider positions in the Department.
                    (E) An assessment of how many additional positions 
                are needed to meet current or expected demand for 
                mental health services furnished by the Department.

SEC. 202. EXPANSION OF VET CENTER PROGRAM TO INCLUDE FURNISHING 
              COUNSELING TO CERTAIN MEMBERS OF THE ARMED FORCES AND 
              THEIR FAMILY MEMBERS.

    Section 1712A of title 38, United States Code, is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1)--
                            (i) in subparagraph (A), by striking ``Upon 
                        the request'' and all that follows through the 
                        period at the end and inserting the following: 
                        ``Upon the request of any individual referred 
                        to in subparagraph (C), the Secretary shall 
                        furnish counseling, including by furnishing 
                        counseling through a Vet Center, to the 
                        individual--
            ``(i) in the case of an individual referred to in clauses 
        (i) through (iv) of subparagraph (C), to assist the individual 
        in readjusting to civilian life; and
            ``(ii) in the case of an individual referred to in clause 
        (v) of such subparagraph who is a family member of a veteran or 
        member described in such clause--
                    ``(I) in the case of a member who is deployed in a 
                theater of combat operations or an area at a time 
                during which hostilities are occurring in that area, 
                during such deployment to assist such individual in 
                coping with such deployment; and
                    ``(II) in the case of a veteran or member who is 
                readjusting to civilian life, to the degree that 
                counseling furnished to such individual is found to aid 
                in the readjustment of such veteran or member to 
                civilian life.''; and
                            (ii) by striking subparagraph (B) and 
                        inserting the following new subparagraphs:
    ``(B) Counseling furnished to an individual under subparagraph (A) 
may include a comprehensive individual assessment of the individual's 
psychological, social, and other characteristics to ascertain whether--
            ``(i) in the case of an individual referred to in clauses 
        (i) through (iv) of subparagraph (C), such individual has 
        difficulties associated with readjusting to civilian life; and
            ``(ii) in the case of an individual referred to in clause 
        (v) of such subparagraph, such individual has difficulties 
        associated with--
                    ``(I) coping with the deployment of a member 
                described in subclause (I) of such clause; or
                    ``(II) readjustment to civilian life of a veteran 
                or member described in subclause (II) of such clause.
    ``(C) Subparagraph (A) applies to the following individuals:
            ``(i) Any individual who is a veteran or member of the 
        Armed Forces, including a member of a reserve component of the 
        Armed Forces, who served on active duty in a theater of combat 
        operations or an area at a time during which hostilities 
        occurred in that area.
            ``(ii) Any individual who is a veteran or member of the 
        Armed Forces, including a member of a reserve component of the 
        Armed Forces, who provided direct emergency medical or mental 
        health care, or mortuary services to the causalities of combat 
        operations or hostilities, but who at the time was located 
        outside the theater of combat operations or area of 
        hostilities.
            ``(iii) Any individual who is a veteran or member of the 
        Armed Forces, including a member of a reserve component of the 
        Armed Forces, who engaged in combat with an enemy of the United 
        States or against an opposing military force in a theater of 
        combat operations or an area at a time during which hostilities 
        occurred in that area by remotely controlling an unmanned 
        aerial vehicle, notwithstanding whether the physical location 
        of such veteran or member during such combat was within such 
        theater of combat operations or area.
            ``(iv) Any individual who received counseling under this 
        section before the date of the enactment of the Mental Health 
        Access to Continued Care and Enhancement of Support Services 
        Act of 2012.
            ``(v) Any individual who is a family member of any--
                    ``(I) member of the Armed Forces, including a 
                member of a reserve component of the Armed Forces, who 
                is serving on active duty in a theater of combat 
                operations or in an area at a time during which 
                hostilities are occurring in that area; or
                    ``(II) veteran or member of the Armed Forces 
                described in this subparagraph.'';
                    (B) by striking paragraph (2);
                    (C) by redesignating paragraph (3) as paragraph 
                (2); and
                    (D) in paragraph (2), as redesignated by 
                subparagraph (C)--
                            (i) by striking ``a veteran described in 
                        paragraph (1)(B)(iii)'' and inserting ``an 
                        individual described in paragraph (1)(C)''; and
                            (ii) by striking ``the veteran a 
                        preliminary general mental health assessment'' 
                        and inserting ``the individual a comprehensive 
                        individual assessment as described in paragraph 
                        (1)(B)'';
            (2) in subsection (b)(1), by striking ``physician or 
        psychologist'' each place it appears and inserting ``licensed 
        or certified mental health care provider'';
            (3) in subsection (g)--
                    (A) by amending paragraph (1) to read as follows:
            ``(1) The term `Vet Center' means a facility which is 
        operated by the Department for the provision of services under 
        this section and which is situated apart from Department 
        general health care facilities.''; and
                    (B) by adding at the end the following new 
                paragraph:
            ``(3) The term `family member', with respect to a veteran 
        or member of the Armed Forces, means an individual who--
                    ``(A) is a member of the family of the veteran or 
                member, including--
                            ``(i) a parent;
                            ``(ii) a spouse;
                            ``(iii) a child;
                            ``(iv) a step-family member; and
                            ``(v) an extended family member; or
                    ``(B) lives with the veteran or member but is not a 
                member of the family of the veteran or member.''; and
            (4) by redesignating subsection (g), as amended by 
        paragraph (3), as subsection (h) and inserting after subsection 
        (f) the following new subsection (g):
    ``(g) In carrying out this section and in furtherance of the 
Secretary's responsibility to carry out outreach activities under 
chapter 63 of this title, the Secretary may provide for and facilitate 
the participation of personnel employed by the Secretary to provide 
services under this section in recreational programs that are--
            ``(1) designed to encourage the readjustment of veterans 
        described in subsection (a)(1)(C); and
            ``(2) operated by any organization named in or approved 
        under section 5902 of this title.''.

SEC. 203. AUTHORITY FOR SECRETARY OF VETERANS AFFAIRS TO FURNISH MENTAL 
              HEALTH CARE THROUGH FACILITIES OTHER THAN VET CENTERS TO 
              IMMEDIATE FAMILY MEMBERS OF MEMBERS OF THE ARMED FORCES 
              DEPLOYED IN CONNECTION WITH A CONTINGENCY OPERATION.

    (a) Authority.--Subject to the availability of appropriations, the 
Secretary of Veterans Affairs, in addition to furnishing mental health 
care to family members of members of the Armed Forces through Vet 
Centers under section 1712A of title 38, United States Code, may 
furnish mental health care to immediate family members of members of 
the Armed Forces while such members are deployed in connection with a 
contingency operation (as defined in section 101 of title 10, United 
States Code) through Department of Veterans Affairs medical facilities, 
telemental health modalities, and such community, nonprofit, private, 
and other third parties as the Secretary considers appropriate.
    (b) No Eligibility for Travel Reimbursement.--A family member to 
whom the Secretary furnishes mental health care under subsection (a) 
shall not be eligible for payments or allowances under section 111 of 
title 38, United States Code, for such mental health care.
    (c) Vet Center Defined.--In this section, the term ``Vet Center'' 
has the meaning given the term in section 1712A(g) of title 38, United 
States Code, as amended by section 2(3).

SEC. 204. ORGANIZATION OF THE READJUSTMENT COUNSELING SERVICE IN 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Subchapter I of chapter 73 of title 38, United 
States Code, is amended by adding at the end the following new section:
``Sec. 7309. Readjustment Counseling Service
    ``(a) In General.--There is in the Veterans Health Administration a 
Readjustment Counseling Service. The Readjustment Counseling Service 
shall provide readjustment counseling and associated services to 
individuals in accordance with section 1712A of this title.
    ``(b) Chief Officer.--(1) The head of the Readjustment Counseling 
Service shall be the Chief Officer of the Readjustment Counseling 
Service (in this section the `Chief Officer'), who shall report 
directly to the Under Secretary for Health.
    ``(2) The Chief Officer shall be appointed by the Under Secretary 
for Health from among individuals who--
            ``(A)(i) are psychologists who hold a diploma as a 
        doctorate in clinical or counseling psychology from an 
        authority approved by the American Psychological Association 
        and who have successfully undergone an internship approved by 
        that association;
            ``(ii) are holders of a master in social work degree; or
            ``(iii) hold such other advanced degrees related to mental 
        health as the Secretary considers appropriate;
            ``(B) have at least three years of experience providing 
        direct counseling services or outreach services;
            ``(C) have at least three years of experience 
        administrating direct counseling services or outreach services;
            ``(D) meet the quality standards and requirements of the 
        Department; and
            ``(E) are veterans who served in combat as members of the 
        Armed Forces.
    ``(c) Structure.--(1) The Readjustment Counseling Service is a 
distinct organizational element within Veterans Health Administration.
    ``(2) The Service shall provide counseling and services as 
described in subsection (a).
    ``(3) The Chief Officer shall have direct authority over all 
Readjustment Counseling Service staff and assets, including Vet 
Centers.
    ``(d) Source of Funds.--(1) Amounts for the activities of the 
Readjustment Counseling Service, including the operations of its Vet 
Centers, shall be derived from amounts appropriated for the Veterans 
Health Administration for medical care.
    ``(2) Amounts for activities of the Readjustment Counseling 
Service, including the operations of its Vet Centers, shall not be 
allocated through the Veterans Equitable Resource Allocation system.
    ``(3) In each budget request submitted for the Department of 
Veterans Affairs by the President to Congress under section 1105 of 
title 31, the budget request for the Readjustment Counseling Service 
shall be listed separately.
    ``(e) Annual Report.--(1) Not later than March 15 of 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 on the activities of the Readjustment 
Counseling Service during the preceding calendar year.
    ``(2) Each report submitted under paragraph (1) shall include, with 
respect to the period covered by the report, the following:
            ``(A) A summary of the activities of the Readjustment 
        Counseling Service, including Vet Centers.
            ``(B) A description of the workload and additional 
        treatment capacity of the Vet Centers, including, for each Vet 
        Center, the ratio of the number of full-time equivalent 
        employees at such Vet Center and the number of individuals who 
        received services or assistance at such Vet Center.
            ``(C) A detailed analysis of demand for and unmet need for 
        readjustment counseling services and the Secretary's plan for 
        meeting such unmet need.
    ``(f) Vet Center Defined.--In this section, the term `Vet Center' 
has the meaning given the term in section 1712A(g) of this title.''.
    (b) Conforming Amendment.--Section 7305 of such title is amended--
            (1) by redesignating paragraph (7) as paragraph (8); and
            (2) by inserting after paragraph (6) the following new 
        paragraph (7):
            ``(7) A Readjustment Counseling Service.''.

SEC. 205. RECRUITING MENTAL HEALTH PROVIDERS FOR FURNISHING OF MENTAL 
              HEALTH SERVICES ON BEHALF OF THE DEPARTMENT OF VETERANS 
              AFFAIRS WITHOUT COMPENSATION FROM THE DEPARTMENT.

    (a) In General.--The Secretary of Veterans Affairs shall carry out 
a national program of outreach to societies, community organizations, 
or government entities in order to recruit mental health providers, who 
meet the quality standards and requirements of the Department of 
Veterans Affairs, to provide mental health services for the Department 
on a part-time, without-compensation basis, under section 7405 of title 
38, United States Code.
    (b) Partnering With and Developing Community Entities.--In carrying 
out the program required by subsection (a), the Secretary may partner 
with a community entity or assist in the development of a community 
entity, including by entering into an agreement under section 8153 of 
title 38, United States Code, that provides strategic coordination of 
the societies, community organizations, and government entities 
described in subsection (a) in order to maximize the availability and 
efficient delivery of mental health services to veterans by such 
societies, community organizations, and government entities.
    (c) Military Culture Training.--In carrying out the program 
required by subsection (a), the Secretary shall provide training to 
mental health providers to ensure that clinicians who provide mental 
health services as described in such subsection have sufficient 
understanding of military and service specific culture, combat 
experience, and other factors that are unique to the experience of 
veterans who served in Operation Enduring Freedom, Operating Iraqi 
Freedom, or Operation New Dawn.

SEC. 206. REIMBURSEMENT OF PHYSICIANS AND DENTISTS FOR EXPENSES 
              RELATING TO BOARD CERTIFICATION OR RECERTIFICATION.

    (a) In General.--Section 7411 of title 38, United States Code, is 
amended to read as follows:
``Sec. 7411. Full-time board-certified physicians and dentists: 
              reimbursement of certification or recertification and 
              continuing professional education expenses
    ``The Secretary shall reimburse any full-time board-certified 
physician or dentist appointed under section 7401(1) of this title for 
expenses incurred, up to $1,000 per year, for certification or 
recertification expenses, or continuing professional education. For 
physicians who are full-time psychiatrists, the Secretary may reimburse 
up to $4,000 per year.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 74 of such title is amended by striking the item relating to 
section 7411 and inserting the following new item:

``7411. Full-time board-certified physicians and dentists: 
                            reimbursement of certification or 
                            recertification and continuing professional 
                            education expenses.''.

SEC. 207. PEER SUPPORT.

    (a) Peer Support Counseling Program.--
            (1) Program required.--Paragraph (1) of section 1720F(j) of 
        title 38, United States Code, is amended in the matter before 
        subparagraph (A) by striking ``may'' and inserting ``shall''.
            (2) Training.--Paragraph (2) of such section is amended by 
        inserting after ``peer counselors'' the following: ``, 
        including training carried out under the national program of 
        training required by section 304(c) of the Caregivers and 
        Veterans Omnibus Health Services Act of 2010 (38 U.S.C. 1712A 
        note; Public Law 111-163)''.
            (3) Availability of program at department medical 
        centers.--Such section is amended by adding at the end the 
        following new paragraph:
    ``(3) In addition to other locations the Secretary considers 
appropriate, the Secretary shall carry out the peer support program 
under this subsection at each Department medical center.''.
            (4) Deadline for commencement of program.--The Secretary of 
        Veterans Affairs shall ensure that the peer support counseling 
        program required by section 1720F(j) of title 38, United States 
        Code, as amended by this subsection, commences at each 
        Department of Veterans Affairs medical center not later than 
        270 days after the date of the enactment of this Act.
    (b) Provision of Peer Outreach and Peer Support Services at 
Department Medical Centers Under Program on Readjustment and Mental 
Health Care Services for Veterans Who Served in Operation Enduring 
Freedom and Operation Iraqi Freedom.--
            (1) In general.--Section 304 of the Caregivers and Veterans 
        Omnibus Health Services Act of 2010 (38 U.S.C. 1712A note; 
        Public Law 111-163) is amended--
                    (A) by redesignating subsection (e) as subsection 
                (f); and
                    (B) by inserting after subsection (d) the following 
                new subsection (e):
    ``(e) Provision of Peer Outreach and Peer Support Services at 
Department Medical Centers.--The Secretary shall carry out the services 
required by subparagraphs (A) and (B) of subsection (a)(1) at each 
Department medical center.''.
            (2) Deadline.--The Secretary of Veterans Affairs shall 
        commence carrying out the services required by subparagraphs 
        (A) and (B) of subsection (a)(1) of such section at each 
        Department of Veterans Affairs medical center, as required by 
        subsection (e) of such section (as added by paragraph (1)), not 
        later than 270 days after the date of the enactment of this 
        Act.
                                 <all>