[Congressional Record Volume 154, Number 129 (Thursday, July 31, 2008)]
[Senate]
[Pages S7909-S7914]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SMITH (for himself and Mr. Wyden):
  S. 3374. A bill to establish a commission on veterans and members of 
the Armed Forces with post traumatic

[[Page S7910]]

stress disorder, traumatic brain injury, or other mental health 
disorders, to enhance the capacity of mental health providers to assist 
such veterans and members, and for other purposes; to the Committee on 
Veterans' Affairs.
  Mr. SMITH. Mr. President, I rise today with my colleague Senator Ron 
Wyden to introduce a bill that will help improve the lives of our 
veterans who are suffering from a mental illness. The Healing Our 
Nation's Heroes Act of 2008 is an important bill and I look forward to 
its passage. Senator Wyden has been an ally for me in the struggle to 
ensure veterans, particularly those who are struggling with a mental 
illness, get the care that they need. It is an honor for me to work him 
to ensure our Nation's heroes are not forgotten.
  Our work together on this bill began last summer when I called a 
Special Committee on Aging field hearing at the Portland Veterans 
Affairs Medical Center in our home state of Oregon. At that hearing, 
Senator Wyden and I heard the testimony of officials from the 
Department of Veterans Affairs, VA, as well as local leaders who 
operate programs that support our veterans' mental and physical health 
needs. I also held roundtables in my state on the issue and a follow-up 
hearing in Washington, DC in October, 2007 to further examine the scope 
of the issues and barriers facing our veterans in need of care. At this 
hearing, we were fortunate to have former Senator and World War II 
veteran Bob Dole testify. Senator Dole is a decorated war hero who has 
fought for decades to ensure that our servicemembers and veterans have 
the proper supports they need. His insight and knowledge of the issues 
facing our veterans, both young and old, were instrumental in helping 
us to draft this legislation. Without the input of countless people who 
told us of the problems faced by their loved ones and their own 
struggles with the current system, we could not have made this bill 
possible.
  In our Nation today, we have nearly 24 million veterans, about 40 
percent of whom are age 65 and older. The Veterans Health 
Administration serves about 5.5 million of them each year and employs 
247,000 employees to attend to their care. I draw attention to these 
numbers to emphasize not only the scale of the system--and therefore 
the noted difficulties in meeting all needs at all times--but also to 
reiterate that there are a large number of veterans to whom we owe an 
enormous debt.
  Unfortunately, we are not doing well enough by our veterans. We know 
that nationally 23 percent of all homeless persons are veterans. In 
Portland, Oregon, that number could be as high as 30 percent. They 
suffer disproportionately from poor health, including mental health and 
substance abuse challenges. We are fortunate to have wonderful 
community-based groups, such as the Central City Concern in Portland, 
working to help those who are homeless to get the help and support they 
need; but we must do more.
  As was reported at the hearing I held in October of 2007, Dr. Kaplan 
from Portland State University found that veterans in our nation are at 
twice the risk of suicide as non-veterans. With the number and needs of 
veterans ever-increasing in our nation, we must ensure that our mental 
health infrastructure is prepared to handle their unique needs.
  What we now refer to as post-traumatic stress disorder, PTSD, once 
was described as ``soldier's heart'' in the Civil War, ``shell shock'' 
in World War I, and ``combat fatigue'' in World War II. Whatever the 
name, they are serious mental illnesses and deserve equal attention and 
care as a physical wound. A system must be in place to help our 
veterans as they adjust back to life with their families and within 
their communities.
  So many of our veterans from previous conflicts in Korea, Vietnam and 
around the globe in World War II, needed similar programs once they 
returned home. Yet, I fear that we did not do enough to help them. With 
proper and early support systems in place, we can work to prevent the 
more serious and chronic mental health issues that come from a lack of 
intervention.
  There is no greater obligation than caring for those who have served 
this country with their military service. We would be remiss if we did 
not ensure that the health care provided to our heroes in arms is the 
finest medicine has to offer. A lack of culturally sensitive mental 
health professionals, an inability to reach rural areas, stigma related 
to mental illness within the military, bureaucratic run-arounds and 
long waiting times are just a few of the problems that we hear about--
both in the news and directly from constituents. These are problems 
that must be addressed and can only be addressed if we all work 
together to find solutions.
  As our country faces new waves of veterans with mental health 
illnesses, many of whose issues arise from combat stress, we must 
ensure that we learn from the lessons of the past. We must ensure that 
they are cared for, and we must not leave behind those who fought for 
our nation in previous generations.
  This bill has three important parts that will improve mental health 
services to our veterans. First, it will establish a commission charged 
with oversight of outreach and services offered to veterans and members 
of the Armed Forces with post traumatic stress disorder and other 
disorders that affect mental health. This commission will be a long-
term body that will ensure that our veterans have the support that they 
need. They will report to Congress, make recommendations to the 
Departments of Veterans Affairs and Defense, and look for innovative 
ways that the two bodies can work together to better ensure our 
servicemembers have the proper supports while they are in the Armed 
Forces, during their time of transition back to their communities, and 
as they live their lives as veterans in their communities.
  This bill also will establish the Heroes-to-Healers Program, which we 
have created to build on the successes of the Troops-to-Teachers 
Program. In addition to the wonderful work that the Troops-to-Teachers 
program does in training former servicemembers to work in high-need 
school districts, the Heroes-to-Healers Program will train former 
servicemembers to become a part of the mental health workforce. We know 
that major complaints from servicemembers and veterans working to gain 
needed mental health services are the wait times for care that they 
experience due to lack of available staff and their desire to work with 
professionals who understand, first-hand, the difficult things that 
they have seen and type of experiences they have had serving overseas 
in combat zones. Through this program, participants will receive 
financial support to gain the training and licensing they need to 
become a mental health professional, while ensuring there is a minimum 
amount of time that they will then serve their fellow veterans in their 
new profession.
  To further help recruitment and retention efforts for mental health 
service providers, the third part of this bill will provide a new grant 
program to state and local mental health agencies, as well as non-
profit organizations to establish, expand or enhance mental health 
provider recruitment and retention efforts. These efforts will be 
targeted at supporting mid-career professionals who are looking to work 
in the mental health profession.
  We know that we must do a better job of helping our veterans. We can 
do better at ensuring they can remain stable in their communities, that 
they can live healthy lives and that they can prosper as persons to 
whom we owe a great deal of gratitude and compassion.
  I look forward to working with my colleagues to ensure its passage. I 
urge my colleagues on both sides of the aisle to support this bill.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 3374

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Healing Our Nation's Heroes 
     Act of 2008''.

     SEC. 2. FINDINGS.

       Congress finds the following:
       (1) Since October 2001, approximately 1,640,000 members of 
     the Armed Forces have been deployed as part of Operation 
     Enduring Freedom or Operation Iraqi Freedom.
       (2) 300,000 members of the Armed Forces are suffering from 
     major depression or post traumatic stress because of service 
     in Operation Enduring Freedom or Operation Iraqi Freedom.

[[Page S7911]]

       (3) 320,000 of the members of the Armed Forces who served 
     in Operation Enduring Freedom or Operation Iraqi Freedom, or 
     19 percent of such members, have received brain injuries from 
     such service.
       (4) Only 43 percent of members of the Armed Forces with a 
     probable traumatic brain injury have reported receiving a 
     medical evaluation for their head injury.
       (5) Records of the Department of Veterans Affairs show that 
     120,000 members of the Armed Forces who are no longer on 
     active duty have been diagnosed with mental health problems, 
     approximately half of whom suffer from post traumatic stress 
     disorder (PTSD).
       (6) In the last year, only 53 percent of those members of 
     the Armed Forces with post traumatic stress disorder or 
     depression have sought professional help from a mental health 
     care provider.
       (7) Rates of post traumatic stress disorder and depression 
     are highest among members of the Armed Forces who are women 
     or members of the Reserves.
       (8) Efforts to improve access to quality mental health care 
     are integral to supporting and treating both active duty 
     members of the Armed Forces and veterans.
       (9) Without quality mental health care, members of the 
     Armed Forces and veterans may experience lower work 
     productivity, which negatively affects their physical health, 
     mental health, and family and social relationships.
       (10) Cultural and personal stigmas are factors that 
     contribute to low rates of veterans of Operation Enduring 
     Freedom and Operation Iraqi Freedom who seek mental health 
     care from qualified mental health care providers.
       (11) The capacity of mental health care providers and 
     access to such providers must be improved to meet the needs 
     of members of the Armed Forces who are returning from 
     deployment in Operation Enduring Freedom or Operation Iraqi 
     Freedom.
       (12) Community-based providers of mental health care are 
     invaluable assets in addressing the needs of such members and 
     should not be overlooked.
       (13) Coordination of care among government agencies as well 
     as nongovernmental agencies is integral to the successful 
     treatment of members of the Armed Forces returning from 
     deployment.

     SEC. 3. COMMISSION ON VETERANS AND MEMBERS OF THE ARMED 
                   FORCES WITH POST TRAUMATIC STRESS DISORDER, 
                   TRAUMATIC BRAIN INJURY, OR OTHER MENTAL HEALTH 
                   DISORDERS CAUSED BY SERVICE IN THE ARMED 
                   FORCES.

       (a) Establishment of Commission.--There is established a 
     commission on veterans and members of the Armed Forces with 
     post traumatic stress disorder (PTSD), traumatic brain 
     injury, or other mental health disorders caused by service in 
     the Armed Forces.
       (b) Membership.--
       (1) Composition.--The commission shall be composed of a 
     chair and members appointed jointly by the Secretary of 
     Veterans Affairs and the Secretary of Defense, including not 
     less than one of each of the following:
       (A) Members of the Armed Forces on active duty.
       (B) Veterans who are retired from the Armed Forces.
       (C) Employees of the Department of Veterans Affairs.
       (D) Employees of the Department of Defense.
       (E) Recognized medical or scientific authorities in fields 
     relevant to the commission, including psychiatry and medical 
     care.
       (F) Mental health professionals who are not physicians.
       (G) Veterans who have undergone treatment for post 
     traumatic stress disorder, traumatic brain injury, or other 
     mental health disorders.
       (2) Consideration of recommendations.--In appointing 
     members of the commission, the Secretary of Veterans Affairs 
     and the Secretary of Defense shall consult with 
     nongovernmental organizations that represent veterans, 
     members of the Armed Forces, and families of such veterans 
     and members.
       (c) Duties.--
       (1) In general.--The commission shall--
       (A) oversee the monitoring and treatment of veterans and 
     members of the Armed Forces with post traumatic stress 
     disorder, traumatic brain injury, or other mental health 
     disorders caused by service in the Armed Forces; and
       (B) conduct a thorough study of all matters relating to the 
     long-term adverse consequences of such disorders for such 
     veterans and members, including an analysis of--
       (i) the information gathered from rescreening data obtained 
     from post deployment interviews; and
       (ii) treatments that have been shown to be effective in the 
     treatment of post traumatic stress disorder, traumatic brain 
     injury, or other mental health disorders caused by service in 
     the Armed Forces.
       (2) Recommendations.--The commission shall develop 
     recommendations on the development of initiatives--
       (A) to mitigate the adverse consequences studied under 
     paragraph (1)(B); and
       (B) to reduce cultural stigmas associated with treatment of 
     post traumatic stress disorder, traumatic brain injury, or 
     other mental health disorders of veterans and members of the 
     Armed Forces.
       (3) Annual reports.--Not later than September 30 each year, 
     the commission shall submit to the appropriate committees of 
     Congress a report containing the following:
       (A) A detailed statement of the findings and conclusions of 
     the commission as a result of its activities under paragraph 
     (1).
       (B) The recommendations of the commission developed under 
     paragraph (2).
       (d) Powers of the Commission.--
       (1) Site visits.--The commission may visit locations where 
     veterans and members of the Armed Forces with post traumatic 
     stress disorder, traumatic brain injury, or other mental 
     health disorders caused by service in the Armed Forces 
     receive treatment for such disorders to carry out the 
     oversight and monitoring required by subsection (c)(1)(A).
       (2) Information from federal agencies.--The commission may 
     secure directly from any Federal department or agency such 
     information as the commission considers necessary to carry 
     out the provisions of this Act. Upon request of the chair of 
     the commission, the head of such department or agency shall 
     furnish such information to the commission.
       (e) Termination.--The commission shall be terminated at the 
     joint discretion of the Secretary of Defense and the 
     Secretary of Veterans Affairs.
       (f) Appropriate Committees of Congress Defined.--In this 
     section, the term ``appropriate committees of Congress'' 
     means--
       (1) the Committee on Armed Services and the Committee on 
     Veterans' Affairs of the Senate; and
       (2) the Committee on Armed Services and the Committee on 
     Veterans' Affairs of the House of Representatives.

     SEC. 4. HEROES-TO-HEALERS PROGRAM.

       (a) In General.--Part III of title 38, United States Code, 
     is amended by adding at the end the following:

                ``CHAPTER 44--HEROES-TO-HEALERS PROGRAM

``Sec.
``4400. Purposes.
``4401. Definitions.
``4402. Authorization of Heroes-to-Healers Program.
``4403. Recruitment and selection of Program participants.
``4404. Participation agreement and financial assistance.
``4405. Participation by States.
``4406. Reporting requirements.
``4407. Authorization of appropriations.

     ``Sec. 4400. Purposes

       ``The purposes of this chapter are--
       ``(1) to encourage veterans and members of the Armed Forces 
     separating from the Armed Forces--
       ``(A) to obtain certification or licensing as mental health 
     care providers; and
       ``(B) to obtain employment with Federal, State, and local 
     agencies and nongovernmental organizations that provide 
     mental health care to members of the Armed Forces, veterans, 
     or the families of such members or veterans; and
       ``(2) to enhance the capacity of such agencies and 
     organizations to provide such care, by increasing the number 
     of individuals seeking employment for the provision of such 
     care.

     ``Sec. 4401. Definitions

       ``In this chapter:
       ``(1) The term `mental health care provider', with respect 
     to an individual, means a psychiatrist, psychologist, social 
     worker, psychiatric nurse, mental health counselor, or 
     marriage and family therapist.
       ``(2) The term `Program' means the Heroes-to-Healers 
     Program authorized by section 4402 of this title and 
     described in this chapter.

     ``Sec. 4402. Authorization of Heroes-to-Healers Program

       ``(a) Purpose.--The purpose of this section is to 
     authorize--
       ``(1) the Heroes-to-Healers Program; and
       ``(2) a mechanism for the funding and administration of 
     such program.
       ``(b) Program Authorized.--(1) The Secretary may carry out 
     a program--
       ``(A) to assist eligible individuals described in section 
     4403 of this title in obtaining certification or licensing 
     (as prescribed for under applicable State law) as mental 
     health care providers; and
       ``(B) to facilitate the employment of such individuals, by 
     Federal, State, and local agencies and nongovernmental 
     organizations that provide mental health care to members of 
     the Armed Forces, veterans, or the families of such members 
     or veterans, to provide such care.
       ``(2) The program authorized by paragraph (1) and described 
     in this chapter shall be known as the `Heroes-to-Healers 
     Program'.
       ``(c) Administration of Program.--The Secretary shall 
     administer the Program in consultation with the Secretary of 
     Defense.
       ``(d) Information Regarding Program.--The Secretary shall 
     provide to the Secretary of Defense information regarding the 
     Program and applications for participation in the Program, 
     for distribution as part of preseparation counseling provided 
     under section 1142 of title 10 to members of the Armed Forces 
     described in section 4403 of this title.
       ``(e) Placement Assistance and Referral Services.--The 
     Secretary may, with the agreement of the Secretary of 
     Defense, provide placement assistance and referral services 
     to individuals who meet the criteria described in section 
     4403 of this title.

     ``Sec. 4403. Recruitment and selection of Program 
       participants

       ``(a) Eligible Individuals.--The following individuals are 
     eligible for selection to participate in the Program:

[[Page S7912]]

       ``(1) Any individual who--
       ``(A) was a member of the Armed Forces and becomes entitled 
     to retired or retainer pay in the manner provided in title 10 
     or title 14; or
       ``(B) has an approved date of retirement from service in 
     the Armed Forces.
       ``(2) Any individual who--
       ``(A)(i) is separated or released from active duty in the 
     Armed Forces after two or more years of continuous active 
     duty in the Armed Forces immediately before the separation or 
     release; or
       ``(ii) has completed a total of at least--
       ``(I) three years of active duty service in the Armed 
     Forces;
       ``(II) three years of service computed under section 12732 
     of title 10; or
       ``(III) three years of any combination of such service; and
       ``(B) executes a reserve commitment agreement for a period 
     of not less than 3 years under subsection (e)(2).
       ``(3) Any individual who is retired or separated for 
     physical disability under chapter 61 of title 10.
       ``(b) Submission of Applications.--(1) Selection of 
     eligible individuals to participate in the Program shall be 
     made on the basis of applications submitted to the Secretary 
     within the time periods specified in paragraph (2). An 
     application shall be in such form and contain such 
     information as the Secretary may require.
       ``(2) An application of an individual shall be considered 
     to be submitted on a timely basis under paragraph (1) if the 
     application is submitted not later than five years after the 
     date on which the individual is retired, separated, or 
     released from active duty in the Armed Forces, as the case 
     may be.
       ``(c) Selection Criteria.--(1) The Secretary shall 
     prescribe the criteria to be used to select eligible 
     individuals to participate in the Program.
       ``(2) An individual is eligible to participate in the 
     Program only if the individual's last period of service in 
     the Armed Forces was honorable, as characterized by the 
     Secretary concerned. An individual selected to participate in 
     the Program before the retirement of the individual or the 
     separation or release of the individual from active duty in 
     the Armed Forces may continue to participate in the Program 
     after the retirement, separation, or release only if the 
     individual's last period of service is characterized as 
     honorable by the Secretary concerned.
       ``(d) Selection Priorities.--In selecting eligible 
     individuals to receive assistance under the Program, the 
     Secretary shall give priority to individuals who engaged in 
     combat while serving in the Armed Forces.
       ``(e) Other Conditions on Selection.--(1) The Secretary may 
     not select an eligible individual to participate in the 
     Program under this section and receive financial assistance 
     under section 4404 of this title unless the Secretary has 
     sufficient appropriations for the Program available at the 
     time of the selection to satisfy the obligations to be 
     incurred by the United States under section 4404 of this 
     title with respect to the individual.
       ``(2) The Secretary may not select an eligible individual 
     described in subsection (a)(2)(A) to participate in the 
     Program under this section and receive financial assistance 
     under section 4404 of this title unless--
       ``(A) the Secretary notifies the Secretary concerned and 
     the individual that the Secretary has reserved a full stipend 
     or bonus under section 4404 of this title for the individual; 
     and
       ``(B) the individual executes a written agreement with the 
     Secretary concerned to serve as a member of the Selected 
     Reserve of a reserve component of the Armed Forces for a 
     period of not less than three years (in addition to any other 
     reserve commitment the individual may have).

     ``Sec. 4404. Participation agreement and financial assistance

       ``(a) Participation Agreement.--(1) An eligible individual 
     selected to participate in the Program under section 4403 of 
     this title and receive financial assistance under this 
     section shall be required to enter into an agreement with the 
     Secretary in which the individual agrees--
       ``(A) within such time as the Secretary may require, to 
     obtain certification or licensing as a mental health care 
     provider; and
       ``(B) to accept an offer of full-time employment as a 
     mental health care provider for not less than five years with 
     a Federal, State, or local agency or nongovernmental 
     organization that provides mental health care to members of 
     the Armed Forces, veterans, or the families of such members 
     or veterans.
       ``(2) The Secretary may waive the five-year commitment 
     described in paragraph (1)(B) for a participant if the 
     Secretary determines such waiver to be appropriate. If the 
     Secretary provides the waiver, the participant shall not be 
     considered to be in violation of the agreement and shall not 
     be required to provide reimbursement under subsection (f), 
     for failure to meet the five-year commitment.
       ``(3) The Secretary shall encourage eligible individuals to 
     seek employment with mental health care providers located 
     more than 75 miles from a Department medical center.
       ``(b) Violation of Participation Agreement; Exceptions.--A 
     participant in the Program shall not be considered to be in 
     violation of the participation agreement entered into under 
     subsection (a) during any period in which the participant--
       ``(1) is pursuing a full-time course of study related to 
     the field of mental health care at an institution of higher 
     education;
       ``(2) is serving on active duty as a member of the Armed 
     Forces;
       ``(3) is temporarily totally disabled for a period of time 
     not to exceed three years as established by sworn affidavit 
     of a qualified physician;
       ``(4) is unable to secure employment for a period not to 
     exceed 12 months by reason of the care required by a spouse 
     who is disabled;
       ``(5) is a mental health care provider who is seeking and 
     unable to find full-time employment as a mental health care 
     provider in a Federal, State, or local agency or 
     nongovernmental organization that provides mental health care 
     to members of the Armed Forces, veterans, or the families of 
     such members or veterans for a single period not to exceed 27 
     months; or
       ``(6) satisfies the provisions of additional reimbursement 
     exceptions that may be prescribed by the Secretary.
       ``(c) Stipend for Participants.--(1) Subject to paragraph 
     (2), the Secretary may pay to a participant in the Program 
     selected under section 4403 of this title a stipend in an 
     amount of not more than $5,000 per year of participation in 
     the Program.
       ``(2) The total number of stipends that may be paid under 
     paragraph (1) in any fiscal year may not exceed 2,500.
       ``(d) Bonus for Participants.--(1) Subject to paragraph 
     (2), the Secretary of Education may, in lieu of paying a 
     stipend under subsection (c), pay a bonus of up to $10,000 to 
     a participant in the Program selected under section 4403 of 
     this title who agrees in the participation agreement under 
     subsection (a) to become a mental health care provider and to 
     accept full-time employment as a mental health care provider 
     for not less than five years in a Federal, State, or local 
     agency or nongovernmental organization that provides mental 
     health care to members of the Armed Forces, veterans, or the 
     families of such members or veterans.
       ``(2) The total number of bonuses that may be paid under 
     paragraph (1) in any fiscal year may not exceed 2,000.
       ``(e) Treatment of Stipend and Bonus.--A stipend or bonus 
     paid under this section to a participant in the Program shall 
     not be taken into account in determining the eligibility of 
     the participant for Federal student financial assistance 
     provided under title IV of the Higher Education Act of 1965 
     (20 U.S.C. 1070 et seq.).
       ``(f) Reimbursement Under Certain Circumstances.--(1) A 
     participant in the Program who is paid a stipend or bonus 
     under this section shall be required to repay the stipend or 
     bonus under the following circumstances:
       ``(A) The participant fails to obtain mental health care 
     provider certification or licensing, to become a mental 
     health care provider, or to obtain employment as a mental 
     health care as required by the participation agreement under 
     subsection (a).
       ``(B) The participant voluntarily leaves, or is terminated 
     for cause from, employment as a mental health care provider 
     during the five years of required service in violation of the 
     participation agreement.
       ``(C) The participant executed a written agreement with the 
     Secretary concerned under section 4403(e)(2) of this title to 
     serve as a member of a reserve component of the Armed Forces 
     for a period of three years and fails to complete the 
     required term of service.
       ``(2) A participant required to reimburse the Secretary for 
     a stipend or bonus paid to the participant under this section 
     shall pay an amount that bears the same ratio to the amount 
     of the stipend or bonus as the unserved portion of required 
     service bears to the five years of required service. Any 
     amount owed by the participant shall bear interest at the 
     rate equal to the highest rate being paid by the United 
     States on the day on which the reimbursement is determined to 
     be due for securities having maturities of 90 days or less 
     and such interest shall accrue from the day on which the 
     participant is first notified of the amount due.
       ``(3) The obligation to reimburse the Secretary under this 
     subsection is, for all purposes, a debt owing the United 
     States. A discharge in bankruptcy under title 11 shall not 
     release a participant from the obligation to reimburse the 
     Secretary under this subsection.
       ``(4) A participant shall be excused from reimbursement 
     under this subsection if the participant becomes permanently 
     totally disabled as established by sworn affidavit of a 
     qualified physician. The Secretary may also waive the 
     reimbursement in cases of extreme hardship to the 
     participant, as determined by the Secretary.
       ``(g) Relationship to Educational Assistance Under Titles 
     10 and 38.--The receipt by a participant in the Program of a 
     stipend or bonus under this section shall not reduce or 
     otherwise affect the entitlement of the participant to any 
     benefits under chapters 30, 31, 33, or 35 of this title or 
     chapters 1606 or 1607 of title 10.

     ``Sec. 4405. Participation by States

       ``(a) Discharge of State Activities Through Consortia of 
     States.--The Secretary may permit States participating in the 
     Program to carry out activities authorized for such States 
     under the Program through one or more consortia of such 
     States.

[[Page S7913]]

       ``(b) Assistance to States.--(1) Subject to paragraph (2), 
     the Secretary may make grants to States participating in the 
     Program, or to consortia of such States, in order to permit 
     such States or consortia of States to operate offices for 
     purposes of recruiting eligible individuals for participation 
     in the Program and facilitating the employment of 
     participants in the Program as a mental health care provider.
       ``(2) The total amount of grants made under paragraph (1) 
     in any fiscal year may not exceed $5,000,000.

     ``Sec. 4406. Reporting requirements

       ``(a) Annual Report Required.--Not later than 180 days 
     after the date of the enactment of this chapter and annually 
     thereafter, the Secretary shall, in consultation with the 
     Secretary of Defense, the Secretary of Homeland Security, and 
     the Comptroller General of the United States, submit to 
     Congress a report on the effectiveness of the Program in the 
     recruitment and retention of qualified personnel by Federal, 
     State, and local agencies and nongovernmental organizations 
     that provide mental health care to members of the Armed 
     Forces, veterans, or the families of such members or 
     veterans.
       ``(b) Elements of Report.--The report submitted under 
     subsection (a) shall include information on the following:
       ``(1) The number of participants in the Program.
       ``(2) The types of positions in which the participants are 
     employed.
       ``(3) The populations served by the participants.
       ``(4) The agencies and organizations in which the 
     participants are employed as mental health care providers.
       ``(5) The types of agencies and organizations with which 
     the participants are employed.
       ``(6) The geographic distribution of the agencies and 
     organizations with which participants are employed.
       ``(7) The rates of retention of the participants by the 
     Federal, State, and local agencies and nongovernmental 
     organizations employing the participants.
       ``(8) Such other matters as the Secretary considers to be 
     appropriate.

     ``Sec. 4407. Authorization of appropriations

       ``There are authorized to be appropriated to the Secretary 
     to carry out the provisions of this chapter $10,000,000 for 
     fiscal year 2009 and each fiscal year thereafter.''.
       (b) Clerical Amendments.--The tables of chapters at the 
     beginning of title 38, United States Code, and at the 
     beginning of part III of such title, are each amended by 
     inserting after the item relating to chapter 43 the following 
     new item:

``44. Heroes-to-Healers Program............................4400.''.....

     SEC. 5. GRANT PROGRAM TO ENCOURAGE STATE AND LOCAL MENTAL 
                   HEALTH AGENCIES TO ESTABLISH, EXPAND, OR 
                   ENHANCE MENTAL HEALTH PROVIDER RECRUITMENT AND 
                   RETENTION EFFORTS.

       (a) Purposes.--It is the purpose of this section to 
     establish a program to recruit and retain highly qualified 
     mid-career professionals and recent graduates of an 
     institution of higher education, as psychiatrists, 
     psychologists, social workers, psychiatric nurses, mental 
     health counselors, or marriage and family therapists.
       (b) Definitions.--In this section:
       (1) Eligible entity.--The term ``eligible entity'' means an 
     entity described in subsection (c)(2).
       (2) Eligible participant.--The term ``eligible 
     participant'' means--
       (A) an individual with substantial, demonstrable career 
     experience; or
       (B) an individual who has graduated from an institution of 
     higher education not more than 3 years prior to applying to 
     an eligible entity to become to be a mental health provider 
     under this section.
       (3) Mental health provider.--The term ``mental health 
     provider'' means a psychiatrist, psychologist, social worker, 
     psychiatric nurse, mental health counselor, marriage or 
     family therapist, or any other provider determined 
     appropriate by the Secretary.
       (4) Secretary.--The term ``Secretary'' means the Secretary 
     of Education.
       (c) Grant Program.--
       (1) In general.--The Secretary may, in consultation with 
     the Secretary of Defense, the Secretary of Health and Human 
     Services, and the Secretary of Veterans Affairs, establish a 
     program to award grants, on a competitive basis, to eligible 
     entities to encourage State and local mental health agencies 
     or other entities to establish, expand, or enhance mental 
     health provider recruitment and retention efforts. The 
     Secretary may establish tiered grant award amounts based on 
     criteria including specific need for highly qualified mental 
     health providers by profession within a high demand area, 
     geographic location, and existing compensation rates.
       (2) Eligible entities.--To be eligible to receive a grant 
     under this section, an entity shall be--
       (A) a State health agency;
       (B) a high-need local health agency;
       (C) a for-profit or nonprofit organization that has a 
     proven record of effectively recruiting and retaining highly 
     qualified mental health providers, that has entered into a 
     partnership with a high-need local health agency or with a 
     State health agency;
       (D) an institution of higher education that has entered 
     into a partnership with a high-need local health agency or 
     with a State health agency;
       (E) a regional consortium of State health agencies; or
       (F) a consortium of high-need local health agencies.
       (3) Priority.--In awarding a grant under this subsection, 
     the Secretary shall give priority to a partnership or 
     consortium that includes a high-need State agency or local 
     health agency.
       (4) Application.--
       (A) In general.--To be eligible to receive a grant under 
     this section, an eligible entity shall submit an application 
     to the Secretary at such time, in such manner, and containing 
     such information as the Secretary may require.
       (B) Contents.--An application submitted under subparagraph 
     (A) shall include a description of--
       (i) one or more target recruitment groups on which the 
     applicant will focus its recruitment efforts under the grant;
       (ii) the characteristics of each such target group that--

       (I) demonstrate the knowledge and experience of the group's 
     members; and
       (II) demonstrate that the members are eligible to achieve 
     the purposes of this section;

       (iii) the manner in which the applicant will use funds 
     received under the grant to develop a cadre of mental health 
     providers, or other programs to recruit and retain highly 
     qualified midcareer professionals, recent college graduates, 
     and recent graduate school graduates, as highly qualified 
     mental health providers, in high-need military or veterans 
     communities, or as part of entities providing care to 
     military or veterans in medical facilities;
       (iv) the manner in which the program carried out under the 
     grant will comply with relevant State laws related to mental 
     health provider certification or licensing and facilitate the 
     certification or licensing of such mental health providers;
       (v) the manner in which activities under the grant will 
     increase the number of highly qualified mental health 
     providers, in high-need Federal, State and local agencies (in 
     urban or rural areas), and in high-need mental health 
     professions, in the jurisdiction served by the applicant; and
       (vi) the manner in which the applicant will collaborate, as 
     needed, with other institutions, agencies, or organizations 
     to recruit (particularly through activities that have proven 
     effective in retaining highly qualified mental health 
     providers), train, place, support, and provide mental health 
     induction programs to eligible participants under this 
     section, including providing evidence of the commitment of 
     the institutions, agencies, or organizations to the 
     applicant's programs.
       (5) Duration of grant.--The Secretary may award grants 
     under this subsection for periods of 5 years. At the end of 
     the 5-year period for such a grant, the grant recipient may 
     apply for an additional grant under this section.
       (6) Equitable distribution.--To the extent practicable, the 
     Secretary shall ensure an equitable geographic distribution 
     of grants under this subsection among the regions of the 
     United States.
       (7) Use of funds.--
       (A) In general.--An entity shall use amounts received under 
     a grant under this subsection to develop a cadre of mental 
     health providers in order to establish, expand, or enhance 
     mental health provider recruitment and retention programs for 
     highly qualified mid-career professionals, and recent 
     graduates of an institution of higher education, who are 
     eligible participants.
       (B) Authorized activities.--A program carried out under 
     subparagraph (A) shall include 2 or more of the following 
     activities:
       (i) To provide scholarships, stipends, bonuses, and other 
     financial incentives, that are linked to participation in 
     activities that have proven effective in retaining mental 
     health providers in high-need areas operated by Federal, 
     State and local health agencies, to all eligible 
     participants, in an amount that shall not be less than 
     $5,000, nor more than $20,000, per participant.
       (ii) To carry out pre- and post-placement induction or 
     support activities that have proven effective in recruiting 
     and retaining mental health providers, such as--

       (I) mentoring;
       (II) providing internships;
       (III) providing high-quality, preservice coursework; and
       (IV) providing high-quality, sustained inservice 
     professional development.

       (iii) To make payments to pay the costs associated with 
     accepting mental health providers under this section from 
     among eligible participants or to provide financial 
     incentives to prospective mental health providers who are 
     eligible participants.
       (iv) To collaborate with institutions of higher education 
     in the development and implementation of programs to 
     facilitate mental health provider recruitment (including 
     credentialing and licensing) and mental health retention 
     programs.
       (v) To carry out other programs, projects, and activities 
     that are designed and have proven to be effective in 
     recruiting and retaining mental health providers, and that 
     the Secretary determines to be appropriate.
       (vi) To develop long-term mental health provider 
     recruitment and retention strategies, including developing--

       (I) a national, statewide or regionwide clearinghouse for 
     the recruitment and placement of mental health providers;
       (II) reciprocity agreements between or among States for the 
     certification or licensing of mental health providers; or

[[Page S7914]]

       (III) other long-term teacher recruitment and retention 
     strategies.

       (C) Effective programs.--An entity shall use amounts 
     received under a grant under this subsection only for 
     programs that have proven to be effective in both recruiting 
     and retaining mental health providers (as determined by the 
     Secretary).
       (8) Requirements.--
       (A) Targeting.--An entity that receives a grant under this 
     subsection shall ensure that participants in the program 
     carried out under the grant who are recruited with funds made 
     available under the grant are placed in high-need areas 
     operated by high-need Federal, State, and local health 
     agencies. In placing such participants in mental health 
     facilities, such entity shall give priority to facilities 
     that are located in--
       (i) rural under served areas; or
       (ii) urban areas with high percentages of individuals who 
     are members of the Armed Forces or veterans.
       (B) Supplement, not supplant.--Amounts made available under 
     this section shall be used to supplement, and not supplant, 
     State and local public funds expended for mental health 
     provider recruitment and retention programs.
       (C) Partnerships and consortia of local health agencies.--
     In the case of a partnership established by a Federal, State, 
     or local health agency to carry out a program under this 
     section, or a consortium of such agencies established to 
     carry out such a program, the Federal, State, or local health 
     agency or consortium shall not be eligible to receive funds 
     through a State program under this section.
       (9) Period of service.--A participant in a program under 
     this subsection who receives training through the program 
     shall serve at a high-need medical facility or an agency 
     operated by a high-need Federal, State, or local health 
     agency for a term of not less than 3 years.
       (10) Repayment.--The Secretary shall establish such 
     requirements as the Secretary determines to be appropriate to 
     ensure that a participant in a program under this section who 
     receives a stipend or other financial incentive as provided 
     for in paragraph (7)(B)(i), but who fails to complete their 
     service obligation under paragraph (9), repays all or a 
     portion of such stipend or other incentive.
       (11) Administrative funds.--An entity that receives a grant 
     under this subsection shall not use more than 5 percent of 
     the funds made available under the grant for the 
     administration of a program under this subsection.
       (12) Authorization of appropriations.--There is authorized 
     to be appropriated such sums as may be necessary in each 
     fiscal year to carry out this subsection.
       (d) Evaluation and Accountability for Recruiting and 
     Retaining Mental Health Providers.--
       (1) Evaluation.--An entity that receives a grant under this 
     section shall--
       (A) within 30 days of the end of the 3rd year of the grant 
     period, conduct an interim evaluation of the program funded 
     under the grant; and
       (B) within 30 days of the end of the 5th year of the grant 
     period, conduct a final evaluation of the program funded 
     under the grant.
       (2) Contents.--In conducting an evaluation under paragraph 
     (1), an entity shall describe the extent to which State and 
     local agencies that received funds through the grant have met 
     the goals relating to mental health provider recruitment and 
     retention described in the application submitted by the 
     entity under paragraph (4).
       (3) Reports.--An entity that receives a grant under this 
     Act shall prepare and submit to the Secretary and the 
     appropriate committees of Congress, an interim and final 
     report that contains the results of the interim and final 
     evaluations carried out under subparagraphs (A) and (B) of 
     paragraph (1), respectively.
       (4) Revocation.--If the Secretary determines that the 
     recipient of a grant under this section has not made 
     substantial progress in meeting the goals and the objectives 
     of the grant by the end of the 3rd year of the grant period, 
     the Secretary shall--
       (A) revoke any payments made for the 4th year of the grant 
     period; and
       (B) not make any payment for the 5th year of the grant 
     period.

  Mr. WYDEN. Mr. President, over the past 7 years, hundreds of 
thousands of members of our armed forces have gone to war and returned 
home alive, but suffering. Advances in protective equipment and 
improvements made in battlefield care mean that fewer troops than ever 
before suffer from obvious physical wounds. But many more of these 
service members have returned with less obvious injuries--invisible 
injuries like post-traumatic stress disorder or traumatic brain injury.
  Our armed forces have seen a surge in diagnosed cases of post-
traumatic stress disorder and traumatic brain injury, commonly known as 
PTSD and TBI. And soldiers in the National Guard and Reserves are much 
more likely to suffer from PTSD and depression when they return from 
battle, a fact that is very important in Oregon where almost all of our 
servicemembers serve in the Guard and Reserves.
  While no less real and no less serious than physical wounds of war, 
PTSD and TBI require a specialized kind of diagnosis and treatment. 
Unfortunately, only half of the soldiers and veterans who suffer from 
PTSD or TBI are receiving care for their wounds, according to a RAND 
Corporation study.
  To help our service men and women suffering from PTSD, TBI and other 
mental health conditions, we are introducing a bill today that's 
designed to address some of the overwhelming difficulties faced by many 
of our nation's warriors. This bill, the ``Healing Our Nation's Heroes 
Act of 2008,'' has within it provisions to help improve mental health 
care, and access to care, for service members who suffer from the 
invisible wounds of war.
  First, this legislation would create a standing commission to study 
and oversee mental health treatment of our veterans. This commission 
would make recommendations on methods to improve mental health care 
and, just as importantly, overcome the cultural stigma attached to 
seeking help for mental health disorders. As an ongoing body, this 
commission will continue to help guide Congress and the agencies for 
years, instead of just making recommendations and disappearing.
  Secondly, the bill would create a ``Heroes-to-Healers Program'' which 
would provide financial incentives for veterans and members of the 
armed forces who are separating or retiring to obtain certification or 
licensing as mental health providers. It also encourages them to seek 
employment with organizations that provide mental health care to 
members of the armed forces, veterans and their families.
  One of the more heartbreaking truths surrounding PTSD is that service 
members are often reluctant to seek help from mental health 
professionals who don't share their experiences. This reluctance 
creates the sort of self-isolation that leads to increased risk of 
suicide.
  By increasing the number of veterans working as mental health 
providers, this bill will allow more servicemembers and veterans to get 
treatment from those who truly understand what combat is like.
  Our bill would also create a grant program to help state and local 
mental health agencies recruit and retain mental health professionals. 
Some service members and veterans don't feel comfortable seeking mental 
health care from the Department of Defense or VA. But mental health 
agencies are already being stretched thin, especially in rural areas. 
This legislation will provide help in recruiting and retaining the 
mental health providers our wounded heroes so desperately need.
  Surviving the trauma of combat shouldn't sentence our forces to a 
lifetime of mental and emotional pain. They paid the price bravely for 
serving our country in battle. This bill will help them move beyond the 
invisible scars of the battlefield and rebuild their lives at home.
                                 ______