[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]




                              {time}  1445
             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.

                              {time}  1500

  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.

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