[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6411 Reported in House (RH)]

<DOC>





                                                 Union Calendar No. 292
117th CONGRESS
  2d Session
                                H. R. 6411

                          [Report No. 117-382]

To amend title 38, United States Code, to make certain improvements in 
the mental health care provided by the Department of Veterans Affairs, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 18, 2022

 Mr. Takano (for himself and Mr. Bost) introduced the following bill; 
        which was referred to the Committee on Veterans' Affairs

                             June 22, 2022

   Additional sponsors: Mr. Gallego, Ms. Slotkin, Ms. Underwood, Mr. 
Mrvan, Mr. Sablan, Ms. Brownley, Ms. Lofgren, Mr. Swalwell, Mr. Pappas, 
 Ms. Titus, Mr. Fitzpatrick, Ms. Kaptur, Mr. Moulton, Mr. Schiff, Mr. 
Trone, Ms. Stansbury, Mr. Allred, Mr. Levin of California, Mr. Raskin, 
  Mr. Lamb, Mr. Malinowski, Ms. DelBene, Mr. Kilmer, Ms. Manning, Mr. 
 Costa, Ms. Lois Frankel of Florida, Mr. Ellzey, Mr. Welch, Mr. Soto, 
   Mr. Ryan, Mrs. Watson Coleman, Mrs. Miller-Meeks, Ms. Williams of 
 Georgia, Mr. Casten, Mrs. Cherfilus-McCormick, Mr. Ruiz, Mr. Rouzer, 
                       Mr. Peters, and Mrs. Luria

                             June 22, 2022

  Reported from the Committee on Veterans' Affairs; committed to the 
 Committee of the Whole House on the State of the Union and ordered to 
                               be printed


_______________________________________________________________________

                                 A BILL


 
To amend title 38, United States Code, to make certain improvements in 
the mental health care provided by the Department of Veterans Affairs, 
                        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 ``Support The 
Resiliency of Our Nation's Great Veterans Act of 2022'' or the ``STRONG 
Veterans Act of 2022''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
          TITLE I--TRAINING TO SUPPORT VETERANS' MENTAL HEALTH

Sec. 101. Mental health and suicide prevention outreach to minority 
                            veterans and American Indian and Alaska 
                            Native veterans.
Sec. 102. Expansion of Vet Center workforce.
Sec. 103. Expansion of mental health training for Department of 
                            Veterans Affairs.
Sec. 104. Expansion of scholarships and loan repayment programs for 
                            mental health providers.
                     TITLE II--VETERANS CRISIS LINE

Sec. 201. Veterans Crisis Line.
    Subtitle A--Veterans Crisis Line Training and Quality Management

Sec. 211. Staff training.
Sec. 212. Quality review and management.
Sec. 213. Guidance for high-risk callers.
Sec. 214. Oversight of training of social service assistants and 
                            clarification of job responsibilities.
    Subtitle B--Pilot Programs and Research on Veterans Crisis Line

Sec. 221. Pilot programs.
Sec. 222. Authorization of appropriations for research on effectiveness 
                            and opportunities for improvement of 
                            Veterans Crisis Line.
              Subtitle C--Transition of Crisis Line Number

Sec. 231. Feedback on transition of crisis line number.
                    TITLE III--OUTREACH TO VETERANS

Sec. 301. Solid Start program of the Department of Veterans Affairs.
Sec. 302. Designation of Buddy Check Week by Secretary of Veterans 
                            Affairs.
Sec. 303. Improvements to Veterans Justice Outreach Program.
Sec. 304. Department of Veterans Affairs Governors Challenge Program.
                 TITLE IV--MENTAL HEALTH CARE DELIVERY

Sec. 401. Expansion of peer specialist support program of Department of 
                            Veterans Affairs.
Sec. 402. Expansion of Vet Center services.
Sec. 403. Eligibility for mental health services.
Sec. 404. Mental health consultations.
                           TITLE V--RESEARCH

Sec. 501. Veterans integration to academic leadership program of the 
                            Department of Veterans Affairs.
Sec. 502. Improvement of sleep disorder care furnished by Department of 
                            Veterans Affairs.
Sec. 503. Study on inpatient mental health and substance use care from 
                            Department of Veterans Affairs.
Sec. 504. Study on treatment from Department of Veterans Affairs for 
                            co-occurring mental health and substance 
                            use disorders.
Sec. 505. Study on workload of suicide prevention teams of Department 
                            of Veterans Affairs.
Sec. 506. Expansion of suicide prevention and mental health research.
Sec. 507. Study on mental health and suicide prevention support for 
                            military families.
Sec. 508. Research on brain health.
Sec. 509. Study on efficacy of clinical and at-home resources for post-
                            traumatic stress disorder.

          TITLE I--TRAINING TO SUPPORT VETERANS' MENTAL HEALTH

SEC. 101. MENTAL HEALTH AND SUICIDE PREVENTION OUTREACH TO MINORITY 
              VETERANS AND AMERICAN INDIAN AND ALASKA NATIVE VETERANS.

    (a) Staffing Requirement.--Beginning not later than 90 days after 
the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall ensure that each medical center of the Department of 
Veterans Affairs has no fewer than one full-time employee whose 
responsibility is serving as a minority veteran coordinator.
    (b) Training.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary, in consultation with the Indian 
Health Service and the Director of the Office of Mental Health and 
Suicide Prevention of the Department of Veterans Affairs, shall ensure 
that all minority veteran coordinators receive training in delivery of 
culturally appropriate mental health and suicide prevention services to 
American Indian and Alaska Native veterans, especially with respect to 
the identified populations and tribes within the coordinators' 
catchment areas.
    (c) Coordination With Suicide Prevention Coordinators.--Not later 
than 180 days after the date of the enactment of this Act, the 
Secretary, in consultation with the Director of the Office of Mental 
Health and Suicide Prevention, shall ensure that the suicide prevention 
coordinator and minority veteran coordinator of each medical center of 
the Department have developed and disseminated to the director of the 
medical center a written plan for conducting mental health and suicide 
prevention outreach to all tribes and urban Indian health organizations 
within the catchment area of the medical center. Each such plan shall 
include for each tribe covered by the plan--
            (1) contact information for tribal leadership and the 
        tribal health facility or Indian Health Service facility 
        serving that tribe;
            (2) a schedule for and list of outreach plans (including 
        addressing any barriers to accessing Department mental health 
        care);
            (3) documentation of any conversation with tribal leaders 
        that may guide culturally appropriate delivery of mental health 
        care to American Indian or Alaska Native veterans;
            (4) documentation of any progress in incorporating 
        traditional healing practices into mental health and suicide 
        prevention protocols and options available for veterans who are 
        members of such tribe; and
            (5) documentation of any coordination among the Department, 
        the Indian Health Service, urban Indian health organizations, 
        and the Substance Abuse and Mental Health Services 
        Administration for the purpose of improving suicide prevention 
        efforts tailored to veterans who are members of such tribe and 
        the provision of culturally competent mental health care to 
        such veterans.
    (d) Report.--Not later than one year after 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 on outreach efforts to minority veterans and 
American Indian and Alaska Native veterans. Such report shall include 
each of the following:
            (1) The number of minority veteran coordinators within the 
        Department.
            (2) The number and percentage of minority veteran 
        coordinators who are women.
            (3) The number and percentage of minority veteran 
        coordinators who are persons of color.
            (4) The number and percentage of Department medical centers 
        with minority veteran coordinators.
            (5) The number and percentage of Department mental health 
        providers who are enrolled members of a federally recognized 
        Indian tribe or self-identify as Native American.
            (6) The number and percentage of Department mental health 
        providers who speak a second language.
            (7) A review of the outreach plans developed and submitted 
        to all Department medical centers for outreach to American 
        Indian and Alaska Native veterans.
            (8) A review of mental health care provided annually by the 
        Department to American Indian and Alaska Native veterans for 
        the past three years, including number of appointments, and an 
        assessment of any barriers to providing this care.

SEC. 102. EXPANSION OF VET CENTER WORKFORCE.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall hire an 
additional 100 full-time equivalent employees for Vet Centers to 
bolster the workforce of Vet Centers and to provide expanded mental 
health care to veterans, members of the Armed Forces, and their 
families through outreach, community access points, outstations, and 
Vet Centers.
    (b) Vet Center Defined.--In this section, the term ``Vet Center'' 
has the meaning given that term in section 1712A(h) of title 38, United 
States Code.

SEC. 103. EXPANSION OF MENTAL HEALTH TRAINING FOR DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) In General.--Not later than three years after the date of the 
enactment of this Act, the Secretary of Veterans Affairs, in 
collaboration with the Office of Mental Health and Suicide Prevention 
and the Office of Academic Affiliations, shall add an additional 500 
paid trainee slots in covered mental health disciplines to the 
workforce of the Department of Veterans Affairs.
    (b) Covered Mental Health Disciplines Defined.--In this section, 
the term ``covered mental health disciplines'' means psychiatry, 
psychology, advanced practice nursing (with a focus on mental health or 
substance use disorder), social work, licensed professional mental 
health counseling, and marriage and family therapy.

SEC. 104. EXPANSION OF SCHOLARSHIPS AND LOAN REPAYMENT PROGRAMS FOR 
              MENTAL HEALTH PROVIDERS.

    (a) Expansion of Health Professional Scholarship Program.--
Beginning in academic year 2022, the Secretary of Veterans Affairs 
shall include not fewer than an additional (as compared to academic 
year 2021) 50 awards per academic year under the Department of Veterans 
Affairs Health Professional Scholarship Program under subchapter II of 
chapter 76 of title 38, United States Code, for applicants otherwise 
eligible for such program who are pursuing degrees or training in 
mental health disciplines, including advanced practice nursing (with a 
focus on mental health or substance use disorder), psychology, and 
social work.
    (b) Expansion of Education Debt Reduction Program.--
            (1) In general.--Beginning in fiscal year 2022, the 
        Secretary shall provide not fewer than an additional (as 
        compared to fiscal year 2021) 200 debt reduction awards per 
        year under the Department of Veterans Affairs Education Debt 
        Reduction Program under subchapter VII of chapter 76 of title 
        38, United States Code, to be used to recruit mental health 
        professionals to the Department of Veterans Affairs in 
        disciplines that include psychiatry, psychology, advanced 
        practice nursing (with a focus on mental health or substance 
        use disorder), and social work.
            (2) Authorization of appropriations.--There is authorized 
        to be appropriated to the Secretary of Veterans Affairs 
        $8,000,000 per year to carry out the additional awards under 
        paragraph (1).
    (c) Outreach.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary shall develop a public 
        awareness campaign to encourage veterans and mental health 
        professionals to choose the Department for their mental health 
        career.
            (2) Elements.--The campaign required under paragraph (1)--
                    (A) shall advertise the paid trainee, scholarship, 
                and loan repayment opportunities offered by the 
                Department; and
                    (B) may highlight the new graduate medical 
                education residencies available at the Department for 
                medical students entering residency.

                     TITLE II--VETERANS CRISIS LINE

SEC. 201. VETERANS CRISIS LINE.

    In this title, the term ``Veterans Crisis Line'' means the toll-
free hotline for veterans established under section 1720F(h) of title 
38, United States Code.

    Subtitle A--Veterans Crisis Line Training and Quality Management

SEC. 211. STAFF TRAINING.

    (a) Review of Training for Veterans Crisis Line Call Responders.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        enter into an agreement with an organization outside the 
        Department of Veterans Affairs to review the training for 
        Veterans Crisis Line call responders on assisting callers in 
        crisis.
            (2) Completion of review.--The review conducted under 
        paragraph (1) shall be completed not later than one year after 
        the date of the enactment of this Act.
            (3) Elements of review.--The review conducted under 
        paragraph (1) shall consist of a review of the training 
        provided by the Department on subjects including risk 
        assessment, lethal means assessment, substance use and overdose 
        risk assessment, safety planning, referrals to care, 
        supervisory consultation, and emergency dispatch.
            (4) Update of training.--If any deficiencies in the 
        training for Veterans Crisis Line call responders are found 
        pursuant to the review under paragraph (1), the Secretary shall 
        update such training and associated standards of practice to 
        correct those deficiencies not later than one year after the 
        completion of the review.
    (b) Retraining Guidelines for Veterans Crisis Line Call 
Responders.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary shall develop 
        guidelines on retraining and quality management for when a 
        Veterans Crisis Line call responder has an adverse event or 
        when a quality review check by a supervisor of such a call 
        responder denotes that the call responder needs improvement.
            (2) Elements of guidelines.--The guidelines developed under 
        paragraph (1) shall specify the subjects and quantity of 
        retraining recommended and how supervisors should implement 
        increased use of silent monitoring or other performance review 
        mechanisms.

SEC. 212. QUALITY REVIEW AND MANAGEMENT.

    (a) Monitoring of Calls on Veterans Crisis Line.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        require that not fewer than two calls per month for each 
        Veterans Crisis Line call responder be subject to supervisory 
        silent monitoring, which is used to monitor the quality of 
        conduct by such call responder during the call.
            (2) Benchmarks.--The Secretary shall establish benchmarks 
        for requirements and performance of Veterans Crisis Line call 
        responders on supervisory silent monitored calls.
            (3) Quarterly reports.--Not less frequently than quarterly, 
        the Secretary shall submit to the Office of Mental Health and 
        Suicide Prevention of the Department of Veterans Affairs a 
        report on occurrence and outcomes of supervisory silent 
        monitoring of calls on the Veterans Crisis Line.
    (b) Quality Management Processes for Veterans Crisis Line.--Not 
later than one year after the date of the enactment of this Act, the 
leadership for the Veterans Crisis Line, in partnership with the Office 
of Mental Health and Suicide Prevention of the Department and the 
National Center for Patient Safety of the Department, shall establish 
quality management processes and expectations for staff of the Veterans 
Crisis Line, including with respect to reporting of adverse events and 
close calls.
    (c) Annual Common Cause Analysis for Callers to Veterans Crisis 
Line Who Die by Suicide.--
            (1) In general.--Not less frequently than annually, the 
        Secretary shall perform a common cause analysis for all 
        identified callers to the Veterans Crisis Line that died by 
        suicide during the one-year period preceding the conduct of the 
        analysis before the caller received contact with emergency 
        services and in which the Veterans Crisis Line was the last 
        point of contact.
            (2) Submittal of results.--The Secretary shall submit to 
        the Office of Mental Health and Suicide Prevention of the 
        Department the results of each analysis conducted under 
        paragraph (1).
            (3) Application of themes or lessons.--The Secretary shall 
        apply any themes or lessons learned under an analysis under 
        paragraph (1) to updating training and standards of practice 
        for staff of the Veterans Crisis Line.

SEC. 213. GUIDANCE FOR HIGH-RISK CALLERS.

    (a) Development of Enhanced Guidance and Procedures for Response to 
Calls Related to Substance Use and Overdose Risk.--Not later than one 
year after the date of the enactment of this Act, the Secretary of 
Veterans Affairs, in consultation with national experts within the 
Department of Veterans Affairs on substance use disorder and overdose, 
shall--
            (1) develop enhanced guidance and procedures to respond to 
        calls to the Veterans Crisis Line related to substance use and 
        overdose risk;
            (2) update training materials for staff of the Veterans 
        Crisis Line in response to such enhanced guidance and 
        procedures; and
            (3) update criteria for monitoring compliance with such 
        enhanced guidance and procedures.
    (b) Review and Improvement of Standards for Emergency Dispatch.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Secretary shall--
                    (A) review the current emergency dispatch standard 
                operating procedure of the Veterans Crisis Line to 
                identify any additions to such procedure to strengthen 
                communication regarding--
                            (i) emergency dispatch for disconnected 
                        callers; and
                            (ii) the role of social service assistants 
                        in requesting emergency dispatch and recording 
                        such dispatches; and
                    (B) update such procedure to include the additions 
                identified under subparagraph (A).
            (2) Training.--The Secretary shall ensure that all staff of 
        the Veterans Crisis Line are trained on all updates made under 
        paragraph (1)(B) to the emergency dispatch standard operating 
        procedure of the Veterans Crisis Line.

SEC. 214. OVERSIGHT OF TRAINING OF SOCIAL SERVICE ASSISTANTS AND 
              CLARIFICATION OF JOB RESPONSIBILITIES.

    Not later than one year after the date of the enactment of this 
Act, the Secretary of Veterans Affairs shall--
            (1) establish oversight mechanisms to ensure that social 
        service assistants and supervisory social service assistants 
        working with the Veterans Crisis Line are appropriately trained 
        and implementing guidance of the Department regarding the 
        Veterans Crisis Line; and
            (2) refine standard operating procedures to delineate roles 
        and responsibilities for all levels of supervisory social 
        service assistants working with the Veterans Crisis Line.

    Subtitle B--Pilot Programs and Research on Veterans Crisis Line

SEC. 221. PILOT PROGRAMS.

    (a) Extended Safety Planning Pilot Program for Veterans Crisis 
Line.--
            (1) In general.--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 determine 
        whether a lengthier, templated safety plan used in clinical 
        settings could be applied in call centers for the Veterans 
        Crisis Line.
            (2) Briefing.--Not later than two years after the date of 
        the enactment of this Act, the Secretary shall provide to 
        Congress a briefing on the findings of the Secretary under the 
        pilot program conducted under paragraph (1), which shall 
        include any recommendations of the Secretary with respect to 
        the continuation or discontinuation of the pilot program.
    (b) Crisis Line Facilitation Pilot Program.--
            (1) In general.--Commencing not later than one year after 
        the date of the enactment of this Act, the Secretary shall 
        carry out a pilot program on the use of crisis line 
        facilitation to increase use of the Veterans Crisis Line among 
        high-risk veterans.
            (2) Briefing.--Not later than two years after the date of 
        the enactment of this Act, the Secretary shall provide to 
        Congress a briefing on the findings of the Secretary under the 
        pilot program under paragraph (1), including any 
        recommendations of the Secretary with respect to the 
        continuation or discontinuation of the pilot program.
            (3) Definitions.--In this section:
                    (A) The term ``crisis line facilitation'', with 
                respect to a high-risk veteran, means the presentation 
                by a therapist of psychoeducational information about 
                the Veterans Crisis Line and a discussion of the 
                perceived barriers and facilitators to future use of 
                the Veterans Crisis Line for the veteran, which 
                culminates in the veteran calling the Veterans Crisis 
                Line with the therapist to provide firsthand 
                experiences that may counter negative impressions of 
                the Veterans Crisis Line.
                    (B) The term ``high-risk veteran'' means a veteran 
                receiving inpatient mental health care following a 
                suicidal crisis.

SEC. 222. AUTHORIZATION OF APPROPRIATIONS FOR RESEARCH ON EFFECTIVENESS 
              AND OPPORTUNITIES FOR IMPROVEMENT OF VETERANS CRISIS 
              LINE.

    There is authorized to be appropriated to the Secretary of Veterans 
Affairs for fiscal years 2022 and 2023, a total of $5,000,000 for the 
Mental Illness Research, Education, and Clinical Centers of the 
Department of Veterans Affairs to conduct research on the effectiveness 
of the Veterans Crisis Line and areas for improvement for the Veterans 
Crisis Line. Amounts made available pursuant to the authorization of 
appropriations under this section shall remain available until 
September 30, 2024.

              Subtitle C--Transition of Crisis Line Number

SEC. 231. FEEDBACK ON TRANSITION OF CRISIS LINE NUMBER.

    (a) In General.--The Secretary of Veterans Affairs shall solicit 
feedback from veterans service organizations on how to conduct outreach 
to members of the Armed Forces, veterans, their family members, and 
other members of the military and veterans community on the move to 988 
as the new, national three-digit suicide and mental health crisis 
hotline, which is expected to be implemented by July 2022, to minimize 
confusion and ensure veterans are aware of their options for reaching 
the Veterans Crisis Line.
    (b) Nonapplication of FACA.--The Federal Advisory Committee Act (5 
U.S.C. App.) shall not apply to any feedback solicited under subsection 
(a).
    (c) Veterans Service Organization Defined.--In this section, the 
term ``veterans service organization'' means an organization recognized 
by the Secretary for the representation of veterans under section 5902 
of title 38, United States Code.

                    TITLE III--OUTREACH TO VETERANS

SEC. 301. SOLID START PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Chapter 63 of title 38, United States Code, is 
amended by adding at the end the following new subchapter:

        ``SUBCHAPTER II--OTHER OUTREACH PROGRAMS AND ACTIVITIES

``Sec. 6320. Solid Start program
    ``(a) In General.--The Secretary shall carry out a program, to be 
known as the `Solid Start program', under which the Secretary shall--
            ``(1) build the capacity of the Department to efficiently 
        and effectively respond to the queries and needs of veterans 
        who have recently separated from the Armed Forces; and
            ``(2) systemically integrate and coordinate efforts to 
        assist veterans, including efforts--
                    ``(A) to proactively reach out to newly separated 
                veterans to inform them of their eligibility for 
                programs of and benefits provided by the Department; 
                and
                    ``(B) to connect veterans in crisis to resources 
                that address their immediate needs.
    ``(b) Activities of the Solid Start Program.--(1) The Secretary, in 
coordination with the Secretary of Defense, shall carry out the Solid 
Start program of the Department by--
            ``(A) collecting up-to-date contact information during 
        transition classes or separation counseling for all members of 
        the Armed Forces who are separating from the Armed Forces, 
        while explaining the existence and purpose of the Solid Start 
        program;
            ``(B) calling each veteran, regardless of separation type 
        or characterization of service, three times within the first 
        year after separation of the veteran from the Armed Forces;
            ``(C) providing information about the Solid Start program 
        on the website of the Department and in materials of the 
        Department, especially transition booklets and other resources;
            ``(D) ensuring calls are truly tailored to the needs of 
        each veteran's unique situation by conducting quality assurance 
        tests;
            ``(E) prioritizing outreach to veterans who have accessed 
        mental health resources prior to separation from the Armed 
        Forces;
            ``(F) providing women veterans with information that is 
        tailored to their specific health care and benefit needs;
            ``(G) as feasible, providing information on access to State 
        and local resources, including Vet Centers and veterans service 
        organizations; and
            ``(H) gathering and analyzing data assessing the 
        effectiveness of the Solid Start program.
    ``(2) The Secretary, in coordination with the Secretary of Defense, 
may carry out the Solid Start program by--
            ``(A) encouraging members of the Armed Forces who are 
        transitioning to civilian life to authorize alternate points of 
        contact who can be reached should the member be unavailable 
        during the first year following the separation of the member 
        from the Armed Forces;
            ``(B) following up missed phone calls with tailored 
        mailings to ensure the veteran still receives similar 
        information; and
            ``(C) striving to reach out to veterans who separated prior 
        to the initiation of the Solid Start program to provide similar 
        services to those veterans, as feasible.
    ``(3) In this subsection:
            ``(A) The term `Vet Center' has the meaning given that term 
        in section 1712A(h) of this title.
            ``(B) The term `veterans service organization' means an 
        organization recognized by the Secretary for the representation 
        of veterans under section 5902 of this title.
    ``(c) Obligations of Amounts.--Subject to the availability of 
appropriations, the Secretary may not, in a fiscal year, obligate an 
amount to carry out the Solid Start program that is less than the total 
amount obligated in the previous fiscal year to carry out the program, 
unless the Secretary determines that increased efficiencies of the 
program warrant the obligation of a lesser amount.''.
    (b) Conforming Amendments.--Chapter 63 of such title, as amended by 
subsection (a), is further amended--
            (1) by inserting before section 6301 the following:

              ``Subchapter I--Outreach Services Program'';

        and
            (2) in sections 6301, 6303, 6304, 6305, 6306, and 6307, by 
        striking ``this chapter'' each place it appears and inserting 
        ``this subchapter''.
    (c) Clerical Amendments.--The table of sections at the beginning of 
chapter 63 of such title is amended--
            (1) by inserting before the item relating to section 6301 
        the following new item:

              ``subchapter i--outreach services program'';

        and
            (2) by adding at the end the following new items:

         ``subchapter ii--other outreach programs and activities

``6320. Solid Start program.''.

SEC. 302. DESIGNATION OF BUDDY CHECK WEEK BY SECRETARY OF VETERANS 
              AFFAIRS.

    (a) In General.--The Secretary of Veterans Affairs shall designate 
one week each year to organize outreach events and educate veterans on 
how to conduct peer wellness checks, which shall be known as ``Buddy 
Check Week''.
    (b) Educational Opportunities.--
            (1) In general.--During Buddy Check Week, the Secretary, in 
        consultation with organizations that represent veterans, 
        nonprofits that serve veterans, mental health experts, members 
        of the Armed Forces, and such other entities and individuals as 
        the Secretary considers appropriate, shall collaborate with 
        organizations that represent veterans to provide educational 
        opportunities for veterans to learn how to conduct peer 
        wellness checks.
            (2) Training matters.--As part of the educational 
        opportunities provided under paragraph (1), the Secretary shall 
        provide the following:
                    (A) A script for veterans to use to conduct peer 
                wellness checks that includes information on 
                appropriate referrals to resources veterans might need.
                    (B) Online and in-person training, as appropriate, 
                on how to conduct a peer wellness check.
                    (C) Opportunities for members of organizations that 
                represent veterans to learn how to train individuals to 
                conduct peer wellness checks.
                    (D) Training for veterans participating in Buddy 
                Check Week on how to transfer a phone call directly to 
                the Veterans Crisis Line.
                    (E) Resiliency training for veterans participating 
                in Buddy Check Week on handling a veteran in crisis.
            (3) Online materials.--All training materials provided 
        under the educational opportunities under paragraph (1) shall 
        be made publicly available on a website of the Department of 
        Veterans Affairs.
    (c) Outreach.--The Secretary, in collaboration with organizations 
that represent veterans, may conduct outreach regarding educational 
opportunities under subsection (b) at--
            (1) public events where many veterans are expected to 
        congregate;
            (2) meetings of organizations that represent veterans;
            (3) facilities of the Department; and
            (4) such other locations as the Secretary, in collaboration 
        with organizations that represent veterans, considers 
        appropriate.
    (d) Veterans Crisis Line Plan.--
            (1) In general.--The Secretary shall ensure that a plan 
        exists for handling the potential increase in the number of 
        calls into the Veterans Crisis Line that may occur during Buddy 
        Check Week.
            (2) Submittal of plan.--The head of the Veterans Crisis 
        Line shall submit to the Secretary a plan for how to handle 
        excess calls during Buddy Check Week, which may include the 
        following:
                    (A) Additional hours for staff.
                    (B) The use of a backup call center.
                    (C) Any other plan to ensure that calls from 
                veterans in crisis are being answered in a timely 
                manner by an individual trained at the same level as a 
                Veterans Crisis Line responder.
    (e) Definitions.--In this section:
            (1) The term ``organization that represents veterans'' 
        means an organization recognized by the Secretary for the 
        representation of veterans under section 5902 of title 38, 
        United States Code.
            (2) The term ``veteran'' has the meaning given that term in 
        section 101 of such title.
            (3) The term ``Veterans Crisis Line'' means the toll-free 
        hotline for veterans provided by the Secretary under section 
        1720F(h) of such title.

SEC. 303. IMPROVEMENTS TO VETERANS JUSTICE OUTREACH PROGRAM.

    (a) Outreach Requirement.--The Secretary of Veterans Affairs shall 
conduct outreach regarding the Veterans Justice Outreach Program to 
justice-involved veterans, military and veterans service organizations, 
and relevant stakeholders in the criminal justice community, including 
officials from local law enforcement, court, and jail systems and 
others as determined appropriate by the Secretary. Such outreach--
            (1) shall be designed--
                    (A) to spread awareness and understanding of the 
                Program;
                    (B) to spread awareness and understanding of 
                veteran eligibility for the Program, including the 
                eligibility of veterans who were discharged from 
                service in the Armed Forces under conditions other than 
                honorable; and
                    (C) to improve the identification of justice-
                involved veterans; and
            (2) may be conducted in person, virtually, or through other 
        means, including by the dissemination of informational 
        materials and contact information.
    (b) Strategic Plan.--The Secretary of Veterans Affairs shall 
develop a strategic plan for the Veterans Justice Outreach Program. In 
developing such plan, the Secretary shall conduct--
            (1) an assessment of barriers to working with justice-
        involved veterans in rural, remote, and underserved areas, 
        including potential steps to address such barriers; and
            (2) a workforce gap analysis for the Program.
    (c) Increase in Number of VJO Specialists.--
            (1) Increase.--The Secretary of Veterans Affairs shall 
        increase the number of Veterans Justice Outreach specialists 
        responsible for supporting justice-involved veterans in rural, 
        remote, or underserved areas, including areas located far from 
        Department of Veterans Affairs medical centers, as determined 
        by the Secretary, through--
                    (A) the hiring of additional Veterans Justice 
                Outreach specialists;
                    (B) the reallocation of existing Veterans Justice 
                Outreach specialists; or
                    (C) such other means as may be determined 
                appropriate by the Secretary.
            (2) Determination.--The Secretary shall determine the 
        number of Veterans Justice Outreach specialists required, and 
        the locations of such specialists, under paragraph (1) by 
        taking into account--
                    (A) such number and locations needed to achieve the 
                mission and strategic goals of the Veterans Justice 
                Outreach Program;
                    (B) any gaps in the workforce of the Program, 
                including such gaps identified pursuant to subsection 
                (b)(2); and
                    (C) strategies to address such gaps.
            (3) Use of technology.--In carrying out paragraph (1), the 
        Secretary shall consider the use of virtual technology.
    (d) Performance Goals and Implementation Plans.--
            (1) Establishment.--The Secretary of Veterans Affairs shall 
        establish performance goals and implementation plans for--
                    (A) the Veterans Justice Outreach Program;
                    (B) Veterans Justice Outreach Specialists; and
                    (C) providing support for research regarding 
                justice-involved veterans.
            (2) Consistency with strategic plan.--The Secretary shall 
        ensure that the performance goals and implementation plans 
        under paragraph (1) are consistent with the strategic plan 
        under subsection (b) and include--
                    (A) qualitative and quantitative milestones, 
                measures, and metrics, and associated timelines for 
                completion of the plans under paragraph (1) and 
                barriers to such completion;
                    (B) an identification of relevant staff; and
                    (C) an estimate of resource needs and sources.
            (3) Performance data.--The Secretary shall establish a 
        process to regularly collect and analyze performance data to 
        assess the efficiency and effectiveness of implementing the 
        plans under paragraph (1).
    (e) Training Requirement.--The Secretary shall ensure that all 
Veterans Justice Outreach Specialists receive training not less 
frequently than annually on--
            (1) best practices for identifying and conducting outreach 
        to justice-involved veterans and relevant stakeholders in the 
        criminal justice community; and
            (2) veteran eligibility for the Veterans Justice Outreach 
        Program, including with respect to consistently communicating 
        changes regarding eligibility (including through the use of a 
        script or other reference materials).
    (f) Reports on Implementation.--
            (1) First report.--Not later than one year after the date 
        of the enactment of this Act, the Secretary shall submit to 
        Congress a report on the following:
                    (A) An assessment of implementing subsection (c), 
                including--
                            (i) strategies to increase Veterans Justice 
                        Outreach specialists responsible for supporting 
                        justice-involved veterans in rural, remote, or 
                        underserved areas; and
                            (ii) the progress of the Secretary in 
                        addressing gaps in the workforce of the 
                        Veterans Justice Outreach Program identified 
                        pursuant to paragraph (2) of such subsection.
                    (B) The performance goals and implementation plans 
                established under subsection (d)(1).
            (2) Subsequent report.--Not later than three years after 
        the date on which the first report is submitted under paragraph 
        (1), the Secretary shall submit to Congress a report on the 
        progress of the Secretary in meeting the performance goals and 
        carrying out activities under the implementation plans 
        established under subsection (d)(1).
    (g) Report on Veterans Treatment Courts.--Not later than one year 
after the date of the enactment of this Act, the Secretary, in 
consultation with the Attorney General, shall submit to Congress a 
report on the engagement of the Department of Veterans Affairs with 
veterans treatment courts, including--
            (1) the availability and efficacy of veterans treatment 
        courts in meeting the needs of justice-involved veterans;
            (2) best practices for Department of Veterans Affairs staff 
        and justice-involved veterans in working with veterans 
        treatment courts; and
            (3) the ability of justice-involved veterans to access 
        veterans treatment courts, including any barriers that exist to 
        increasing such access.
    (h) Definitions.--In this section:
            (1) The term ``justice-involved veteran'' means a veteran 
        with active, ongoing, or recent contact with some component of 
        a local criminal justice system.
            (2) The term ``Veterans Justice Outreach Program'' means 
        the program through which the Department of Veterans Affairs 
        identifies justice-involved veterans and provides such veterans 
        with access to Department services.
            (3) The term ``Veterans Justice Outreach Specialist'' means 
        an employee of the Department of Veterans Affairs who serves as 
        a liaison between the Department and the local criminal justice 
        system on behalf of a justice-involved veteran.
            (4) The term ``veterans treatment court'' means a State or 
        local court that is participating in the veterans treatment 
        court program (as defined in section 2991(i)(1) of the Omnibus 
        Crime Control and Safe Streets Act of 1968 (42 U.S.C. 
        3797aa(i)(1))).

SEC. 304. DEPARTMENT OF VETERANS AFFAIRS GOVERNORS CHALLENGE PROGRAM.

    The Secretary of Veterans Affairs may enter into agreements with 
States, territories, and American Indian and Alaska Native tribes for 
the development and implementation of veteran suicide prevention 
proposals through the Governors Challenge Program.

                 TITLE IV--MENTAL HEALTH CARE DELIVERY

SEC. 401. EXPANSION OF PEER SPECIALIST SUPPORT PROGRAM OF DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) Expansion.--Section 506 of the VA MISSION Act of 2018 (Public 
Law 115-182; 38 U.S.C. 1701 note) is amended--
            (1) by redesignating subsections (d) through (f) as 
        subsections (e) through (g);
            (2) in subsection (a), by adding at the end the following 
        new sentence: ``Each such peer specialist shall be a full-time 
        employee whose primary function is to serve as a peer 
        specialist and shall be in addition to all other employees of 
        such medical center.'';
            (3) in the heading of subsection (b), by striking 
        ``Timeframe'' and inserting ``Initial Timeframe'';
            (4) in subsection (c)--
                    (A) in the heading, by striking ``Selection'' and 
                inserting ``Initial Selection''; and
                    (B) in paragraph (1), by striking ``The Secretary 
                shall'' and inserting ``In establishing the program at 
                initial locations, the Secretary shall'';
            (5) by inserting after subsection (c) the following new 
        subsection:
    ``(d) Timeframe for Expansion of Program; Selection of Additional 
Locations.--
            ``(1) Timeframe for expansion.--The Secretary shall make 
        permanent and expand the program to additional medical centers 
        of the Department as follows:
                    ``(A) As of the date of the enactment of the STRONG 
                Veterans Act of 2021, the Secretary shall make such 
                program permanent at each medical center participating 
                in the program on the day before such date of 
                enactment.
                    ``(B) During the seven-year period following such 
                date of enactment, the Secretary shall expand the 
                program to an additional 25 medical centers per year 
                until the program is carried out at each medical center 
                of the Department.
            ``(2) Selection of additional locations.--In selecting 
        medical centers for the expansion of the program under 
        paragraph (1)(B), until such time as each medical center of the 
        Department is participating in the program by establishing not 
        fewer than two peer specialists at the medical center, the 
        Secretary shall prioritize medical centers in the following 
        areas:
                    ``(A) Rural areas and other areas that are 
                underserved by the Department.
                    ``(B) Areas that are not in close proximity to an 
                active duty military installation.
                    ``(C) Areas representing different geographic 
                locations, such as census tracts established by the 
                Bureau of the Census.'';
            (6) in subsection (e), as redesignated by paragraph (1)--
                    (A) in the heading, by striking ``Gender-specific 
                Services'' and inserting ``Considerations for Hiring 
                Peer Specialists'';
                    (B) in the matter preceding paragraph (1), by 
                striking ``location selected under subsection (c)'' and 
                inserting ``medical center'';
                    (C) in paragraph (1), by striking ``and'' at the 
                end; and
                    (D) by striking paragraph (2) and inserting the 
                following new paragraphs:
            ``(2) female peer specialists are hired and made available 
        to support female veterans who are treated at each medical 
        center; and
            ``(3) to the extent practical, peer specialists are hired 
        in demographic percentages that reflect the racial and ethnic 
        demographic percentages of the overall veterans population.''; 
        and
            (7) by amending subsection (g), as redesignated by 
        paragraph (1), to read as follows:
    ``(g) Reports.--
            ``(1) Periodic reports.--
                    ``(A) In general.--Not later than one year after 
                the date of the enactment of the STRONG Veterans Act of 
                2021, and annually thereafter for five years, the 
                Secretary shall submit to the Committees on Veterans' 
                Affairs of the House of Representatives and the Senate 
                a report on the program, including the expansion of the 
                program under subsection (d)(1).
                    ``(B) Elements.--Each report under subparagraph (A) 
                shall include, with respect to the one-year period 
                preceding the submission of the report, the following:
                            ``(i) The findings and conclusions of the 
                        Secretary with respect to the program.
                            ``(ii) An assessment of the benefits of the 
                        program to veterans and family members of 
                        veterans.
                            ``(iii) An assessment of the effectiveness 
                        of peer specialists in engaging under 
                        subsection (f) with health care providers in 
                        the community and veterans served by such 
                        providers.
                            ``(iv) The name and location of each 
                        medical center where new peer specialists were 
                        hired.
                            ``(v) The number of new peer specialists 
                        hired at each medical center pursuant to this 
                        section and the total number of peer 
                        specialists within the Department hired 
                        pursuant to this section.
                            ``(vi) An assessment of any barriers 
                        confronting the recruitment, training, or 
                        retention of peer specialists.
            ``(2) Final report.--Not later than one year after the 
        Secretary determines that the program is being carried out at 
        each medical center of the Department, the Secretary shall 
        submit to the Committees on Veterans' Affairs of the House of 
        Representatives and the Senate a report notifying such 
        committees of such determination.''.
    (b) Authorization of Appropriations.--There is authorized to be 
appropriated to the Department of Veterans Affairs to implement section 
506 of the VA MISSION Act of 2018 (Public Law 115-182; 38 U.S.C. 1701 
note), as amended by subsection (a), the following amounts:
            (1) $3,600,000 for fiscal year 2022.
            (2) $7,200,000 for fiscal year 2023.
            (3) $10,800,000 for fiscal year 2024.
            (4) $14,400,000 for fiscal year 2025.
            (5) $18,000,000 for fiscal year 2026.
            (6) $21,600,000 for fiscal year 2027.
            (7) $25,000,000 for fiscal year 2028.

SEC. 402. EXPANSION OF VET CENTER SERVICES.

    (a) Veterans and Members Using Educational Assistance Benefits.--
Section 1712A of title 38, United States Code, is amended--
            (1) by striking ``clauses (i) through (vi)'' both places it 
        appears and inserting ``clauses (i) through (vii)'';
            (2) by striking ``in clause (vii)'' both places it appears 
        and inserting ``in clause (viii)'';
            (3) in subsection (a)(1)(C)--
                    (A) by redesignating clause (vii) as clause (viii); 
                and
                    (B) by inserting after clause (vi) the following 
                new clause:
            ``(vii) Any veteran or member of the Armed Forces pursuing 
        a course of education using covered educational assistance 
        benefits.''; and
            (4) in subsection (h), by adding at the end the following 
        new paragraph:
            ``(6) The term `covered educational assistance benefits' 
        means educational assistance benefits provided pursuant to--
                    ``(A) chapter 30, 31, 32, or 33 of this title;
                    ``(B) chapter 1606 or 1607 of title 10;
                    ``(C) section 116 of the Harry W. Colmery Veterans 
                Educational Assistance Act of 2017 (Public Law 115-48; 
                38 U.S.C. 3001 note); or
                    ``(D) section 8006 of the American Rescue Plan Act 
                of 2021 (Public Law 117-2; 38 U.S.C. 3001 note 
                prec.).''.
    (b) GAO Report.--Not later than one year after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to the Committees on Veterans' Affairs of the House of 
Representatives and the Senate a report assessing--
            (1) the mental health needs of veterans pursuing a course 
        of education using covered educational assistance benefits (as 
        defined in section 1712A(h)(6) of title 38, United States Code, 
        as added by subsection (a)); and
            (2) the efforts of the Department of Veterans Affairs to 
        address such mental health needs.

SEC. 403. ELIGIBILITY FOR MENTAL HEALTH SERVICES.

    (a) In General.--Section 1712A(a)(1) of title 38, United States 
Code, as amended by section 402, is further amended--
            (1) in subparagraph (A)(ii)--
                    (A) in subclause (I), by striking ``and'';
                    (B) in subclause (II), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by adding at the end the following:
                    ``(III) in the case of a veteran or member who died 
                by suicide, to the degree that counseling furnished to 
                such individual is found to aid in coping with the 
                effects of such suicide.'';
            (2) in subparagraph (B)(i)(II)--
                    (A) in item (aa), by striking ``or'';
                    (B) in item (bb), by striking the period at the end 
                and inserting ``; or''; and
                    (C) by adding at the end the following;
                            ``(cc) coping with the effects of a suicide 
                        described in subclause (III) of such clause.''; 
                        and
            (3) in subparagraph (C)(vii)--
                    (A) in subclause (I), by striking ``or'' at the 
                end;
                    (B) in subclause (II), by striking the period at 
                the end and inserting ``; or''; and
                    (C) by adding at the end the following:
                    ``(III) veteran or member of the Armed Forces who 
                died by suicide.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply with respect to family members of a member or veteran who died by 
suicide before, on, or after the date of the enactment of this Act.

SEC. 404. MENTAL HEALTH CONSULTATIONS.

    (a) Mental Health Consultations for Veterans Filing for 
Compensation.--
            (1) In general.--Subchapter VI of chapter 11 of title 38, 
        United States Code, is amended by adding at the end the 
        following new section:
``Sec. 1167. Mental health consultations
    ``(a) In General.--Not later than 30 days after the date on which a 
veteran submits to the Secretary a claim for compensation under this 
chapter for a service-connected disability relating to a mental health 
diagnosis, the Secretary shall offer the veteran a mental health 
consultation to assess the mental health needs of, and care options 
for, the veteran.
    ``(b) Availability.--The Secretary shall--
            ``(1) offer a veteran a consultation under subsection (a) 
        without regard to any previous denial or approval of a claim of 
        that veteran for a service-connected disability relating to a 
        mental health diagnosis; and
            ``(2) ensure that a veteran offered a mental health 
        consultation under subsection (a) may elect to receive such 
        consultation during the one-year period beginning on the date 
        on which the consultation is offered or during such longer 
        period beginning on such date as the Secretary considers 
        appropriate.
    ``(c) Rule of Construction.--A consultation provided to a veteran 
under this section shall not be construed as a determination that any 
disability of such veteran is service-connected for the purposes of any 
benefit under the laws administered by the Secretary.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 11 of such title is amended by adding at 
        the end the following new item:

``1167. Mental health consultations.''.
    (b) Mental Health Consultations for Veterans Entering Homeless 
Programs Office Programs.--
            (1) In general.--Subchapter VII of chapter 20 of title 38, 
        United States Code, is amended by adding at the end the 
        following new section:
``Sec. 2068. Mental health consultations
    ``(a) In General.--Not later than two weeks after the date on which 
a veteran described in subsection (b) enters into a program 
administered by the Homeless Programs Office of the Department, the 
Secretary shall offer the veteran a mental health consultation to 
assess the health needs of, and care options for, the veteran.
    ``(b) Veteran Described.--A veteran described in this subsection is 
a veteran to whom a mental health consultation is not offered or 
provided through the case management services of the program of the 
Homeless Programs Office into which the veteran enters.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 20 of such title is amended by adding at 
        the end the following new item:

``2068. Mental health consultations.''.

                           TITLE V--RESEARCH

SEC. 501. VETERANS INTEGRATION TO ACADEMIC LEADERSHIP PROGRAM OF THE 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) Report.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall submit 
to the Committees on Veterans' Affairs of the House of Representatives 
and the Senate a report on the Veterans Integration to Academic 
Leadership program of the Department of Veterans Affairs. The report 
shall include the following:
            (1) The number of medical centers of the Department, 
        institutions of higher learning, non-college degree programs, 
        and student veterans supported by the program, and relevant 
        trends since the program began.
            (2) The staff and resources allocated to the program, and 
        relevant trends since the program began.
            (3) An assessment of the outcomes and effectiveness of the 
        program in--
                    (A) supporting student veterans;
                    (B) connecting student veterans to needed services 
                of the Department or services provided by non-
                Department entities;
                    (C) addressing the mental health needs of student 
                veterans;
                    (D) lowering the suicide risk of student veterans; 
                and
                    (E) helping student veterans achieve educational 
                goals.
            (4) An assessment of barriers to expanding the program and 
        how the Secretary intends to address such barriers.
            (5) An assessment of whether the program should be expanded 
        outside of the Office of Mental Health and Suicide Prevention 
        to support students veterans with needs unrelated to mental 
        health or suicide.
    (b) Uniform Best Practices, Goals, and Measures.--The Secretary 
shall establish best practices, goals, and measures for the Veterans 
Integration to Academic Leadership program of the Department that are 
uniform among the medical centers of the Department.
    (c) Outreach.--The Secretary shall conduct outreach among the Armed 
Forces, veterans service organizations, institutions of higher 
learning, and non-college degree programs with respect to the Veterans 
Integration to Academic Leadership program of the Department.
    (d) Assessment.--The Secretary shall assess the feasibility and 
advisability of including the suicide rate for student veterans in the 
National Veteran Suicide Prevention Annual Report of the Office of 
Mental Health and Suicide Prevention of the Department.
    (e) Definitions.--In this section:
            (1) The term ``institution of higher learning'' has the 
        meaning given that term in section 3452 of title 38, United 
        States Code.
            (2) The term ``student veteran'' means the following:
                    (A) A veteran or member of the Armed Forces using 
                educational assistance under any of the following 
                provisions of law:
                            (i) Chapter 30, 31, 32, or 33 of title 38, 
                        United States Code, or chapter 1606 or 1607 of 
                        title 10, United States Code.
                            (ii) Section 116 of the Harry W. Colmery 
                        Veterans Educational Assistance Act of 2017 
                        (Public Law 115-48; 38 U.S.C. 3001 note).
                            (iii) Section 8006 of the American Rescue 
                        Plan Act of 2021 (Public Law 117-2; 38 U.S.C. 
                        3001 note prec.).
                    (B) A veteran who is enrolled in an institution of 
                higher learning or other training program, without 
                regard to whether the veteran is using educational 
                assistance specified in subparagraph (A).

SEC. 502. IMPROVEMENT OF SLEEP DISORDER CARE FURNISHED BY DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) In General.--Pursuant to the analysis conducted under 
subsection (b), the Secretary of Veterans Affairs shall take such 
action as the Secretary considers appropriate to improve the assessment 
and treatment of veterans with sleep disorders, including by conducting 
in-home sleep studies for veterans.
    (b) Analysis.--The Secretary shall conduct an analysis of the 
ability of the Department of Veterans Affairs to treat sleep disorders 
among veterans, including--
            (1) assessment and treatment options for such disorders;
            (2) barriers to care for such disorders, such as wait time, 
        travel time, and lack of staffing;
            (3) the efficacy of the clinical practice guidelines of the 
        Department of Veterans Affairs and the Department of Defense 
        for such disorders; and
            (4) the availability of and efficacy of the use by the 
        Department of Veterans Affairs of cognitive behavioral therapy 
        for insomnia.
    (c) Report.--Not later than two years 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 on--
            (1) the findings from the analysis conducted under 
        subsection (b); and
            (2) any actions taken under subsection (a) to improve the 
        assessment and treatment of veterans with sleep disorders.
    (d) Authorization of Appropriations for In-Home Sleep Studies.--
There is authorized to be appropriated to the Secretary of Veterans 
Affairs $5,000,000 to be used to conduct in-home sleep studies for 
veterans, as part of sleep disorder assessment and treatment conducted 
by the Department of Veterans Affairs.

SEC. 503. STUDY ON INPATIENT MENTAL HEALTH AND SUBSTANCE USE CARE FROM 
              DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall complete 
the conduct of a study on access of veterans to care under the 
residential rehabilitation treatment programs of the Department of 
Veterans Affairs to determine--
            (1) if there are sufficient geographic offerings of 
        inpatient mental health care, especially for veterans in rural 
        and remote communities;
            (2) if there are sufficient bed spaces at each location, 
        based on demand and drive time from the homes of veterans;
            (3) if there are any workforce-related capacity limitations 
        at each location, including if beds are unable to be used 
        because there are not enough providers to care for additional 
        patients;
            (4) if there are diagnosis-specific or sex-specific 
        barriers to accessing care under such programs; and
            (5) the average wait time for a bed in such a program, 
        broken out by--
                    (A) Veterans Integrated Service Network;
                    (B) rural or urban area;
                    (C) sex; and
                    (D) specialty (general program, substance use 
                disorder program, military sexual trauma program, 
                etc.).
    (b) Recommendations for Modifications to Treatment Programs.--Using 
the results from the study conducted under subsection (a), the 
Secretary shall make recommendations for--
            (1) new locations for opening facilities to participate in 
        the residential rehabilitation treatment programs of the 
        Department;
            (2) facilities under such programs at which new beds can be 
        added; and
            (3) any additional specialty tracks to be added to such 
        programs, such as substance use disorder or military sexual 
        trauma, in order to meet veteran need and demand.
    (c) Report.--Not later than 180 days after completion of the study 
under subsection (a), 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 findings of the study 
conducted under subsection (a) and the recommendations made by the 
Secretary under subsection (b).

SEC. 504. STUDY ON TREATMENT FROM DEPARTMENT OF VETERANS AFFAIRS FOR 
              CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDERS.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall conduct 
a study examining--
            (1) the availability of treatment programs for veterans 
        with co-occurring mental health and substance use disorders 
        (including both inpatient and outpatient care);
            (2) any geographic disparities in access to such programs, 
        such as for rural and remote veterans; and
            (3) the average wait times for care under such programs.
    (b) Report.--
            (1) In general.--Not later than two years 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 
        on the findings of the study conducted under subsection (a).
            (2) Elements.--The report required by paragraph (1) shall 
        include--
                    (A) any recommendations resulting from the study 
                conducted under subsection (a) with respect to 
                improving timeliness and quality of care and meeting 
                treatment preferences for veterans with co-occurring 
                mental health and substance use disorders; and
                    (B) a description of any actions taken by the 
                Secretary to improve care for such veterans.

SEC. 505. STUDY ON WORKLOAD OF SUICIDE PREVENTION TEAMS OF DEPARTMENT 
              OF VETERANS AFFAIRS.

    (a) In General.--The Secretary of Veterans Affairs, acting through 
the Under Secretary for Health and the Office of Mental Health and 
Suicide Prevention, shall conduct a study evaluating the workload of 
local suicide prevention teams of the Department of Veterans Affairs.
    (b) Elements.--The study conducted under subsection (a) shall--
            (1) identify the effects of the growth of the suicide 
        prevention program of the Department on the workload of suicide 
        prevention teams;
            (2) incorporate key practices for staffing model design in 
        determining suicide prevention staffing needs; and
            (3) determine which facilities of the Department need 
        increased suicide prevention coordinator staffing to meet the 
        needs of veterans, with an emphasis placed on facilities with 
        high patient volume and facilities located in States with high 
        rates of veteran suicide.
    (c) 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--
            (1) on the findings of the study conducted under subsection 
        (a); and
            (2) indicating any changes made to the staffing of suicide 
        prevention teams of the Department resulting from the 
        determinations made under subsection (b)(3), including a list 
        of facilities of the Department where staffing was adjusted.

SEC. 506. EXPANSION OF SUICIDE PREVENTION AND MENTAL HEALTH RESEARCH.

    (a) Research on Moral Injury.--The Secretary of Veterans Affairs, 
acting through the Office of Research and Development of the Department 
of Veterans Affairs, shall conduct suicide prevention and mental health 
care improvement research on how moral injury relates to the mental 
health needs of veterans who served in the Armed Forces after September 
11, 2001, and best practices for mental health treatment for such 
veterans.
    (b) Authorization of Appropriations.--There is authorized to be 
appropriated to the Department of Veterans Affairs an additional 
$10,000,000 to be used by the Center of Excellence for Suicide 
Prevention of the Department and the Rocky Mountain Mental Illness 
Research Education and Clinical Center for purposes of conducting 
research on the factors impacting veteran suicide and best practices 
for early intervention and support.

SEC. 507. STUDY ON MENTAL HEALTH AND SUICIDE PREVENTION SUPPORT FOR 
              MILITARY FAMILIES.

    (a) In General.--The Secretary of Veterans Affairs, in 
collaboration with the Secretary of Defense, shall conduct a study on 
secondary post-traumatic stress disorder and depression and its impact 
on spouses, children, and caregivers of members of the Armed Forces.
    (b) Report.--
            (1) In general.--Not later than three years after the date 
        of the enactment of this Act, the Secretary of Veterans 
        Affairs, in collaboration with the Secretary of Defense, shall 
        submit to Congress, veterans service organizations, and 
        military support organizations a report on the findings of the 
        study conducted under subsection (a).
            (2) Definitions.--In this subsection:
                    (A) The term ``military support organization'' has 
                the meaning given that term by the Secretary of 
                Defense.
                    (B) The term ``veterans service organization'' 
                means an organization recognized by the Secretary of 
                Veterans Affairs for the representation of veterans 
                under section 5902 of title 38, United States Code.

SEC. 508. RESEARCH ON BRAIN HEALTH.

    There is authorized to be appropriated to the Department of 
Veterans Affairs an additional $5,000,000 for ongoing and future 
research at the Translational Research Center of the Department of 
Veterans Affairs for traumatic brain injury and stress disorders to 
provide better understanding of, and improved treatment options for, 
veterans who served in the Armed Forces after September 11, 2001, and 
who have traumatic brain injury or post-traumatic stress disorder.

SEC. 509. STUDY ON EFFICACY OF CLINICAL AND AT-HOME RESOURCES FOR POST-
              TRAUMATIC STRESS DISORDER.

    Not later than two years after the date of the enactment of this 
Act, the Secretary of Veterans Affairs, acting through the Office of 
Research and Development of the Department of Veterans Affairs, shall 
conduct a study on--
            (1) the efficacy of clinical and at-home resources, such as 
        mobile applications like COVID Coach, for providers, veterans, 
        caregivers, and family members to use for dealing with 
        stressors;
            (2) the feasibility and advisability of developing more 
        such resources;
            (3) strategies for improving mental health care and 
        outcomes for veterans with post-traumatic stress disorder; and
            (4) best practices for helping family members of veterans 
        deal with secondary post-traumatic stress disorder or mental 
        health concerns.
                                                 Union Calendar No. 292

117th CONGRESS

  2d Session

                               H. R. 6411

                          [Report No. 117-382]

_______________________________________________________________________

                                 A BILL

To amend title 38, United States Code, to make certain improvements in 
the mental health care provided by the Department of Veterans Affairs, 
                        and for other purposes.

_______________________________________________________________________

                             June 22, 2022

Committed to the Committee of the Whole House on the State of the Union 
                       and ordered to be printed