[Congressional Record Volume 163, Number 181 (Tuesday, November 7, 2017)]
[House]
[Pages H8550-H8553]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
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VETERAN URGENT ACCESS TO MENTAL HEALTHCARE ACT
Mr. BILIRAKIS. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 918) to amend title 38, United States Code, to direct the
Secretary of Veterans Affairs to furnish mental health care to certain
former members of the Armed Forces who are not otherwise eligible to
receive such care, and for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 918
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 ``Veteran Urgent Access to
Mental Healthcare Act''.
SEC. 2. EXPANSION OF MENTAL HEALTH CARE FOR CERTAIN FORMER
MEMBERS OF THE ARMED FORCES.
(a) In General.--Chapter 17 of title 38, United States
Code, is amended by inserting after section 1720H the
following new section:
``Sec. 1720I. Expansion of mental health care for certain
former members of the Armed Forces
``(a) In General.--The Secretary shall furnish to former
members of the Armed Forces described in subsection (b)--
``(1) an initial mental health assessment; and
``(2) the mental health care services authorized under this
chapter that the Secretary determines are required to treat
the mental health care needs of the former member, including
risk of suicide or harming others.
``(b) Former Members of the Armed Forces Described.--A
former member of the Armed Forces described in this
subsection is an individual who meets the following criteria:
``(1) The individual is a former member of the Armed
Forces, including the reserve components, who--
``(A) served in the active military, naval, or air service,
and was discharged or released therefrom under a condition
that is not honorable except--
``(i) dishonorable; or
``(ii) bad conduct discharge;
``(B) has applied for a character of service determination
and such determination has not been made; and
``(C) is not otherwise eligible to enroll in the health
care system established by section 1705 of this title by
reason of such discharge or release not meeting the
requirements of section 101(2) of this title.
``(2) While serving in the Armed Forces--
``(A) the former member was deployed in a theater of combat
operations or an area at a time during which hostilities
occurred in that area;
``(B) participated in or experienced such combat operations
or hostilities, including by controlling an unmanned aerial
vehicle from a location other than such theater or area; or
``(C) was the victim of a physical assault of a sexual
nature, battery of a sexual nature, or sexual harassment (as
defined in section 1720D(f) of this title).
``(c) Non-Department Care.--(1) In furnishing mental health
care services to an individual under this section, the
Secretary may provide such mental health care services at a
non-Department facility if--
``(A) in the judgment of a mental health professional
employed by the Department, the receipt of mental health care
services by that individual in facilities of the Department
would be clinically inadvisable; or
``(B) facilities of the Department are not capable of
furnishing such mental health care services to that
individual economically because of geographical
inaccessibility.
``(2) The Secretary shall carry out paragraph (1) pursuant
to section 1703 of this title or any other provision of law
authorizing the Secretary to enter into contracts or
agreements to furnish hospital care and medical services to
veterans at non-Department facilities.
``(d) Setting and Referrals.--In furnishing mental health
care services to an individual under this section, the
Secretary shall--
``(1) seek to ensure that such mental health care services
are furnished in a setting that is therapeutically
appropriate, taking into account the circumstances that
resulted in the need for such mental health care services;
and
``(2) provide referral services to assist former members
who are not eligible for services under this chapter to
obtain services from sources outside the Department.
``(e) Information.--The Secretary shall provide information
on the mental health care services available under this
section. Efforts by the Secretary to provide such
information--
``(1) shall include availability of a toll-free telephone
number (commonly referred to as an 800 number);
``(2) shall ensure that information about the mental health
care services available under this section--
``(A) is revised and updated as appropriate;
``(B) is made available and visibly posted at appropriate
facilities of the Department; and
``(C) is made available to State veteran agencies and
through appropriate public information services; and
``(3) shall include coordination with the Secretary of
Defense seeking to ensure that members of the Armed Forces
and individuals who are being separated from active military,
naval, or air service are provided appropriate information
about programs, requirements, and procedures for applying for
mental health care services under this section.
``(f) Annual Reports.--Each year, the Secretary shall
submit to Congress an annual report on the mental health care
services provided pursuant to this section. Each report shall
include data for the year covered by the report with respect
to each of the following:
``(1) The number of individuals who received mental health
care services under subsection (a), disaggregated by the
number of men who received such services and the number of
women who received such services.
``(2) Such other information as the Secretary considers
appropriate.''.
(b) Clerical Amendment.--The table of sections at the
beginning of chapter 17 of title 38, United States Code, is
amended by inserting after the item relating to section 1720H
the following new item:
``1720I. Expansion of mental health care for certain former members of
the Armed Forces.''.
SEC. 3. CHARACTER OF SERVICE DETERMINATIONS.
(a) In General.--Chapter 53 of title 38, United States
Code, is amended by inserting after section 5303A the
following new section:
``Sec. 5303B. Character of service determinations
``(a) Determination.--The Secretary shall establish a
process by which an individual who served in the Armed Forces
and was discharged or dismissed therefrom may seek a
determination from the Secretary with respect to whether such
discharge or release was under a condition that bars the
right of such individual to a benefit under the laws
administered by the Secretary based upon the period of
service from which discharged or dismissed.
``(b) Provision of Information.--If the Secretary
determines under subsection (a) that an individual is barred
to a benefit under the laws administered by the Secretary,
the Secretary shall provide to such individual information
regarding the ability of the individual to address such
condition, including pursuant to section 5303 of this title
and chapter 79 of title 10.''.
(b) Clerical Amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item relating to section 5303A the following new item:
``5303B. Character of service determinations.''.
[[Page H8551]]
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Florida (Mr. Bilirakis) and the gentleman from Minnesota (Mr. Walz)
each will control 20 minutes.
The Chair recognizes the gentleman from Florida.
General Leave
Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that all Members
have 5 legislative days to revise and extend their remarks and to
include extraneous material on H.R. 918, as amended.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Florida?
There was no objection.
Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise today in support of H.R. 918, as amended, which
was introduced by my friend and longtime committee member, the
gentleman from Colorado (Mr. Coffman).
Mr. Speaker, there have been a number of different names for stress-
related military health conditions throughout our Nation's history:
battle fatigue, combat stress reaction, shell shock, post-traumatic
stress disorder.
Too often we see military personnel returning home with difficulties
adjusting to civilian life. For many returning servicemembers, these
stressors affect one's postdeployment, especially those receiving other
than honorable discharges.
Under current law, military personnel who separate under this status
are not eligible for healthcare benefits or general services typically
offered to honorable or generally discharged veterans through the
Department of Veterans Affairs.
Mr. Speaker, I want to be clear, I firmly believe that discharge
status is an important tool for military leadership, a tool which helps
preserve order and discipline among the ranks. Removing the proverbial
bad apples from the bushel is key to maintaining a cohesive unit
structure.
However, there also seems to be an evolving trend of soldiers who
receive other than honorable discharges as a result of their military
experience, rather than simply being a bad or ineffective soldier.
In fact, according to the Medal of Honor Society, there are no fewer
than eight Medal of Honor recipients who have received other than
honorable discharges. H.R. 918, as amended, would provide that those
combat veterans who receive other than honorable discharge statuses
would be eligible to receive critical mental health assessments and
services from the Department of Veterans Affairs. It is only right, Mr.
Speaker.
Again, I appreciate the hard work and forward thinking of my friend
from Colorado, who is also a veteran, Mr. Coffman. I urge my colleagues
to support this measure.
Mr. Speaker, I reserve the balance of my time.
Mr. WALZ. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I would like to thank the gentleman from Florida for his
long service to this Nation's veterans, as well as his family's service
to our veterans. It is appropriate we are here the week of Veterans Day
bringing important legislation to the floor once again, a committee
that understands our responsibility, is not political or partisan, it
is to this Nation's veterans in keeping the promise.
Mr. Speaker, I do rise in strong support of H.R. 918, as amended, the
Veteran Urgent Access to Mental Healthcare Act offered by Mr. Coffman.
I would also like to take note of the work that Mr. Coffman has done
on many issues. This one, in particular, is near and dear to my heart.
His leadership has helped get us to the point where we are making
progress on this.
As you heard the gentleman from Florida say, the issues that come
with service in this Nation's military can be physical injury or they
can be the mental injuries of war. We also understand that with that
comes changes in behavior, and there are reasons that people are
removed from service, and I am incredibly proud that this committee has
taken this issue head-on. Of those who are removed because of issues
that they started to acquire from their service in uniform, this
legislation is going to ensure that those people with less than
honorable discharges get the care; specifically, focusing on military
sexual trauma, the idea that we have warriors in uniform who are
assaulted, in many cases, by fellow servicemembers, and because of the
inability to reintegrate in that unit, they are discharged with less
than honorable paper, precluding them from getting the services that
they have earned.
With more than 20 veterans a day--and I think those numbers are
probably low--taking their own lives, this issue of making sure that
all servicemembers and all veterans have access to mental healthcare,
removing those barriers, is of prime importance.
Secretary Shulkin has made the first step in this. Mr. Coffman has
continued to make sure that this committee stays focused on this,
continuing to add more and more access. For that, this legislation
ensures the initiative becomes permanent. It puts it into law and it
takes us the next step forward. For that, I am grateful.
Mr. Speaker, I reserve the balance of my time.
Mr. BILIRAKIS. Mr. Speaker, I agree with the ranking member 100
percent. This needs to be done. It is long overdue, and thanks to my
good friend, Mr. Coffman, it is going to get done.
Mr. Speaker, I yield 5 minutes to the gentleman from Colorado (Mr.
Coffman).
Mr. COFFMAN. Mr. Speaker, as we approach Veterans Day, our Nation is
still faced with the epidemic of veteran suicide. And while the VA has
made it a priority to address this problem, there are still many combat
veterans left without access to VA mental healthcare services.
Here is what we know. An average of 20 veterans commit suicide daily.
VA evidence suggests a decrease in suicide risk among those who have
received VA healthcare services. In May 2017, the Government
Accountability Office found that 62 percent of the over
91,000 servicemembers who were separated for misconduct from 2011 to
2015 had been diagnosed with PTSD, TBI, or other conditions that would
be associated with misconduct.
Of those veterans, 23 percent, or 13,282, received an other than
honorable discharge, leaving them without access to VA's critical
mental healthcare services.
As a Marine Corps combat veteran, I like to live by the rule that we
never leave anyone behind. Unfortunately, the military routinely used
the other than honorable discharge to rid itself of combat veterans who
were designated as having disciplinary problems and who often had
documented medical histories of PTSD, rather than providing them with
the treatment and rehabilitation they so desperately needed.
While the correlation between their mental health condition and minor
misconduct could be linked, this fact made no difference to their
character of discharge.
Mr. Speaker, my legislation, H.R. 918, the Veteran Urgent Access to
Mental Healthcare Act, seeks to correct this. Historically, a veteran
with an other than honorable discharge has been able to seek VA care
for a service-connected disability. However, due to the way these
combat veterans were discharged and because of a failure to connect the
dots between their minor misconduct and their mental health condition,
the Department of Defense has failed to recognize this as a problem.
H.R. 918 will stay with tradition and correct this disconnect by
authorizing mental healthcare services for these other than honorably
discharged combat veterans. This bill also requires an initial mental
health assessment and directs the VA Secretary to establish a formal
character of service determination process to trigger reviews of their
discharges for potential eligibility for VA benefits.
Mr. Speaker, before the rate of veteran suicides increases any more,
it is time to right this wrong and permanently authorize mental
healthcare services for some of our Nation's most vulnerable veterans.
When someone puts on the uniform, they take an oath to defend our
freedoms. We, in turn, as a nation, promise to make sure they receive
the care and the services they need after returning from the
battlefield.
As we approach Veterans Day, I encourage my colleagues to keep that
promise for these combat veterans with other than honorable discharges
and to
[[Page H8552]]
support the passage of H.R. 918. I thank Chairman Roe and Ranking
Member Walz for their support of this legislation.
Mr. WALZ. Mr. Speaker, I yield 3 minutes to the gentleman from Texas
(Mr. O'Rourke), the ranking member of the Subcommittee on Economic
Opportunity, but, more importantly, probably the most effective voice
in this Congress on veterans' mental health and suicide.
Mr. O'ROURKE. Mr. Speaker, I thank the gentleman from Minnesota, our
ranking member on the committee, for yielding.
Mr. Speaker, we have a crisis in suicide among veterans today in this
country. The official estimate, which I agree with the ranking member,
is probably an estimate that is too low: 20. I think the real number is
much higher than that, but 20 a day, we know for sure, are taking their
own lives in this country after they have put those same lives on the
line for this country.
Amidst that crisis, we know that those veterans who have an other
than honorable discharge are taking their lives at twice the rate of
those veterans who have an honorable discharge.
Thanks to Mr. Coffman, my colleague from across the aisle, thanks to
the bipartisan support of the House Veterans' Affairs Committee, and
the leadership from the chairman and the ranking member, we are
beginning to address that, in ensuring that the 22,000 veterans who
have an other than honorable discharge since 2009, who incurred post-
traumatic stress disorder or military sexual trauma while in service to
this country will now be able to see mental healthcare providers.
Before this, they were precluded from that.
I want to thank the Trump administration and especially Secretary
Shulkin for doing the most that they could administratively to see
these veterans in crisis in emergency rooms, but we need to take the
next step and ensure that they have preventative care, continuous care,
and continuity in that care going forward so that we save more of these
lives.
Given what these veterans have laid down for this country, what they
have done for the United States, making us stronger and better, serving
at less than 1 percent since 9/11 so that so many others do not have to
serve, the least we can do is to make sure that they have access to the
care that they have earned.
I want to thank Mr. Coffman and his team, the minority and the
majority staffs for incorporating the best ideas from both sides of the
aisle to make sure that we have a bill that will become law that
ensures that we do our best for our veterans.
Mr. Speaker, I also want to thank our colleagues on the other side of
the Capitol, in the Senate, especially Senator Murphy, who worked on
the companion legislation of this, to make sure that we have something
to bring to the President's desk.
Mr. BILIRAKIS. Mr. Speaker, I am prepared to close, and I reserve the
balance of my time.
Mr. WALZ. Mr. Speaker, I have two more speakers.
Mr. Speaker, I yield 3 minutes to the gentlewoman from Hawaii (Ms.
Gabbard), a veteran herself, a veteran of the conflicts in Iraq, and a
strong voice for our veterans and specifically for our veterans with
mental health issues.
Ms. GABBARD. Mr. Speaker, I would like to thank my fellow veteran and
friend and colleague from Minnesota for being such a strong advocate on
this issue. I also thank our friends on the other side of the aisle who
have been pushing this issue forward constantly year after year, as we
will continue to do so until this issue is resolved.
So many of our servicemembers have selflessly put their lives on the
line to protect and defend our country. Our country owes them a debt of
gratitude, something we are often reminded of every year around this
time as we head into Veterans Day.
Unfortunately, too often, our fellow servicemembers are coming home
and they are being prevented from receiving the care that they have
earned through their service. They bear the brunt of the human cost of
war with an average of 20 veterans committing suicide every single day.
Their families carry this sacrifice and this cost throughout their
lives.
The rate of mental health and substance use disorders has been
steadily rising since 2001. This legislation is bipartisan and would
require the VA to provide urgent mental healthcare services, including
an initial mental health assessment to veterans who have participated
in combat operations or who have survived sexual assault or harassment.
It would also expand those services to those who received a discharge
under certain other than honorable conditions who haven't received the
character of service or discharge determination yet.
We have heard already about the high numbers of veterans who fall
into this category and about how negatively this discharge has affected
their lives. When they come home, they are working on their transition
to a successful civilian life. This discharge takes away their access
to healthcare. It takes away their access to services and benefits that
they have earned through, many times, multiple deployments, services
that are in place to help set our veterans up for success upon their
return home.
In addition, this bill would require the VA to provide services at
non-VA facilities for veterans who live in rural or underserved
communities.
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I can't state enough how important this is because it affects those
veterans in my district, and on different islands in the State of
Hawaii, who are separated literally by a body of water from the VA
clinic.
The Veteran Urgent Access to Mental Healthcare Act would also mandate
the VA to provide additional information for mental health services for
veterans and to ensure that they provide annual reports to Congress on
those services that they have been providing to our veterans.
This is such an important piece of legislation. I urge all of our
colleagues to stand up and support its passage and see it through to
its enactment. We cannot afford to leave our men and women in uniform
behind.
Mr. BILIRAKIS. Mr. Speaker, I reserve the balance of my time.
Mr. WALZ. Mr. Speaker, I yield 2 minutes to the gentleman from
Washington (Mr. Kilmer), who, since coming to Congress, has focused on
the issues of care for veterans, and for that I am grateful.
Mr. KILMER. Mr. Speaker, I thank the gentleman for yielding, and I
thank my colleagues across the aisle for working on this issue.
I think it is particularly powerful when what happens in this marble
building isn't some distant theoretical policy conversation. This
actually affects people in each of our districts.
I first learned about this issue about a year and a half ago. I was
at home talking to a group of veterans at the University of Washington
Tacoma. We were discussing their service to our Nation and some of the
challenges that they had experienced in coming home.
Then the conversation took an unexpected turn. One of the veterans
talked about a servicemember, who is a friend, who had gone overseas,
and, in his words: Had seen quite a lot. He said when that veteran came
home, he wasn't quite the same person that he had been. Unfortunately,
those challenges led to some substance issues, and then to an other
than honorable discharge.
As a consequence, as he explained, that veteran was unable to get
mental healthcare treatment through the Veterans Administration. Here
was a veteran, someone who sacrificed for his country, who was unable
to get the services he earned, due to a condition that he most likely
developed through that service.
Coming back to this Washington, I was honored to cosponsor this bill,
and I appreciate the work of Representative Coffman, and other
colleagues, in advancing this important bill.
This bill is simple. It allows veterans discharged in an other than
honorable status to be screened for urgent mental health conditions and
are found to be eligible for treatment.
While I appreciate the fact that the VA has voluntarily adopted this
policy on its own, we need to make sure that this becomes law to ensure
that future administrations help the thousands of veterans who have
served our Nation and might otherwise be denied needed treatment.
[[Page H8553]]
Mr. Speaker, I urge my colleagues to support this legislation.
Mr. WALZ. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, in closing, I want to thank all of the speakers here who
laid out exactly what this bill does. It is the right thing to do. It
is something that needs to move forward.
I would also suggest that, as we approach Veterans Day, one of the
best ways we can honor those who gave service to this country is
conduct our business in the House of Representatives the way it was
done on this piece of legislation: in a bipartisan manner, with common
goals, common values, smart thinking that was put into it to move this
forward for the care of a fellow citizen, and doing the right thing.
So, for that, I thank everyone involved with this, and I urge my
colleagues to support H.R. 918.
Mr. Speaker, I yield back the balance of my time.
Mr. BILIRAKIS. Mr. Speaker, in closing, once again, I encourage all
Members to support this legislation. Let's get it through the Senate,
as well, and get it on the President's desk, as he supports it.
Mr. Speaker, I yield back the balance of my time
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Florida (Mr. Bilirakis) that the House suspend the rules
and pass the bill, H.R. 918, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
____________________