[Congressional Record Volume 168, Number 107 (Thursday, June 23, 2022)]
[House]
[Pages H5845-H5853]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SUPPORT THE RESILIENCY OF OUR NATION'S GREAT VETERANS ACT OF 2022
Mr. LEVIN of California. Madam Speaker, I move to suspend the rules
and pass the bill (H.R. 6411) to amend title 38, United States Code, to
make certain improvements in the mental health care provided by the
Department of Veterans Affairs, and for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 6411
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Support
The Resiliency of Our Nation's Great Veterans Act of 2022''
or the ``STRONG Veterans Act of 2022''.
(b) Table of Contents.--The table of contents for this Act
is as follows:
Sec. 1. Short title; table of contents.
TITLE I--TRAINING TO SUPPORT VETERANS' MENTAL HEALTH
Sec. 101. Mental health and suicide prevention outreach to minority
veterans and American Indian and Alaska Native veterans.
Sec. 102. Expansion of Vet Center workforce.
Sec. 103. Expansion of mental health training for Department of
Veterans Affairs.
Sec. 104. Expansion of scholarships and loan repayment programs for
mental health providers.
TITLE II--VETERANS CRISIS LINE
Sec. 201. Veterans Crisis Line.
Subtitle A--Veterans Crisis Line Training and Quality Management
Sec. 211. Staff training.
Sec. 212. Quality review and management.
Sec. 213. Guidance for high-risk callers.
Sec. 214. Oversight of training of social service assistants and
clarification of job responsibilities.
Subtitle B--Pilot Programs and Research on Veterans Crisis Line
Sec. 221. Pilot programs.
Sec. 222. Authorization of appropriations for research on effectiveness
and opportunities for improvement of Veterans Crisis
Line.
Subtitle C--Transition of Crisis Line Number
Sec. 231. Feedback on transition of crisis line number.
TITLE III--OUTREACH TO VETERANS
Sec. 301. Solid Start program of the Department of Veterans Affairs.
Sec. 302. Designation of Buddy Check Week by Secretary of Veterans
Affairs.
Sec. 303. Improvements to Veterans Justice Outreach Program.
Sec. 304. Department of Veterans Affairs Governors Challenge Program.
TITLE IV--MENTAL HEALTH CARE DELIVERY
Sec. 401. Expansion of peer specialist support program of Department of
Veterans Affairs.
Sec. 402. Expansion of Vet Center services.
Sec. 403. Eligibility for mental health services.
Sec. 404. Mental health consultations.
TITLE V--RESEARCH
Sec. 501. Veterans integration to academic leadership program of the
Department of Veterans Affairs.
Sec. 502. Improvement of sleep disorder care furnished by Department of
Veterans Affairs.
Sec. 503. Study on inpatient mental health and substance use care from
Department of Veterans Affairs.
Sec. 504. Study on treatment from Department of Veterans Affairs for
co-occurring mental health and substance use disorders.
Sec. 505. Study on workload of suicide prevention teams of Department
of Veterans Affairs.
Sec. 506. Expansion of suicide prevention and mental health research.
Sec. 507. Study on mental health and suicide prevention support for
military families.
Sec. 508. Research on brain health.
Sec. 509. Study on efficacy of clinical and at-home resources for post-
traumatic stress disorder.
TITLE I--TRAINING TO SUPPORT VETERANS' MENTAL HEALTH
SEC. 101. MENTAL HEALTH AND SUICIDE PREVENTION OUTREACH TO
MINORITY VETERANS AND AMERICAN INDIAN AND
ALASKA NATIVE VETERANS.
(a) Staffing Requirement.--Beginning not later than 90 days
after the date of the enactment of this Act, the Secretary of
Veterans Affairs shall ensure that each medical center of the
Department of Veterans Affairs has no fewer than one full-
time employee whose responsibility is serving as a minority
veteran coordinator.
(b) Training.--Not later than 180 days after the date of
the enactment of this Act, the Secretary, in consultation
with the Indian Health Service and the Director of the Office
of Mental Health and Suicide Prevention of the Department of
Veterans Affairs, shall ensure that all minority veteran
coordinators receive training in delivery of mental health
and suicide prevention services culturally appropriate for
American Indian and Alaska Native veterans, especially with
respect to the identified populations and tribes within the
coordinators' catchment areas.
(c) Coordination With Suicide Prevention Coordinators.--Not
later than 180 days after the date of the enactment of this
Act, the Secretary, in consultation with the Director of the
Office of Mental Health and Suicide Prevention, shall ensure
that the suicide prevention coordinator and minority veteran
coordinator of each medical center of the Department have
developed and disseminated to the director of the medical
center a written plan for conducting mental health and
suicide prevention outreach to all tribes and urban Indian
health organizations within the catchment area of the medical
center. Each such plan shall include for each tribe covered
by the plan--
(1) contact information for tribal leadership and the
tribal health facility or Indian Health Service facility
serving that tribe;
(2) a schedule for and list of outreach plans (including
addressing any barriers to accessing Department mental health
care);
(3) documentation of any conversation with tribal leaders
that may guide culturally appropriate delivery of mental
health care to American Indian or Alaska Native veterans;
(4) documentation of any progress in incorporating
traditional healing practices into mental health and suicide
prevention protocols and options available for veterans who
are members of such tribe; and
(5) documentation of any coordination among the Department,
the Indian Health Service, urban Indian health organizations,
and the Substance Abuse and Mental Health Services
Administration for the purpose of improving suicide
prevention efforts tailored to veterans who are members of
such tribe and the provision of culturally competent mental
health care to such veterans.
(d) Report.--Not later than one year after the enactment of
this Act, the Secretary shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on
Veterans' Affairs of the House of Representatives a report on
outreach efforts to minority veterans and American Indian and
Alaska Native veterans. Such report shall include each of the
following:
(1) The number of minority veteran coordinators within the
Department.
[[Page H5846]]
(2) The number and percentage of minority veteran
coordinators who are women.
(3) The number and percentage of minority veteran
coordinators who are persons of color.
(4) The number and percentage of Department medical centers
with minority veteran coordinators.
(5) The number and percentage of Department mental health
providers who are enrolled members of a federally recognized
Indian tribe or self-identify as Native American.
(6) The number and percentage of Department mental health
providers who speak a second language.
(7) A review of the outreach plans developed and submitted
to all Department medical centers for outreach to American
Indian and Alaska Native veterans.
(8) A review of mental health care provided annually by the
Department to American Indian and Alaska Native veterans for
the past three years, including number of appointments, and
an assessment of any barriers to providing this care.
SEC. 102. EXPANSION OF VET CENTER WORKFORCE.
(a) In General.--Not later than one year after the date of
the enactment of this Act and subject to the availability of
appropriations, the Secretary of Veterans Affairs shall hire
an additional 50 full-time equivalent employees for Vet
Centers to bolster the workforce of Vet Centers and to
provide expanded mental health care to veterans, members of
the Armed Forces, and their families through outreach,
community access points, outstations, and Vet Centers.
(b) Vet Center Defined.--In this section, the term ``Vet
Center'' has the meaning given that term in section 1712A(h)
of title 38, United States Code.
SEC. 103. EXPANSION OF MENTAL HEALTH TRAINING FOR DEPARTMENT
OF VETERANS AFFAIRS.
(a) In General.--Not later than three years after the date
of the enactment of this Act and subject to the availability
of appropriations, the Secretary of Veterans Affairs, in
collaboration with the Office of Mental Health and Suicide
Prevention and the Office of Academic Affiliations, shall add
an additional 250 paid trainee slots in covered mental health
disciplines to the workforce of the Department of Veterans
Affairs.
(b) Covered Mental Health Disciplines Defined.--In this
section, the term ``covered mental health disciplines'' means
psychiatry, psychology, advanced practice nursing (with a
focus on mental health or substance use disorder), social
work, licensed professional mental health counseling, and
marriage and family therapy.
SEC. 104. EXPANSION OF SCHOLARSHIPS AND LOAN REPAYMENT
PROGRAMS FOR MENTAL HEALTH PROVIDERS.
(a) Expansion of Health Professional Scholarship Program.--
Beginning in academic year 2022, the Secretary of Veterans
Affairs shall include not fewer than an additional (as
compared to academic year 2021) 50 awards per academic year
under the Department of Veterans Affairs Health Professional
Scholarship Program under subchapter II of chapter 76 of
title 38, United States Code, for applicants otherwise
eligible for such program who are pursuing degrees or
training in mental health disciplines, including advanced
practice nursing (with a focus on mental health or substance
use disorder), psychology, and social work.
(b) Expansion of Education Debt Reduction Program.--
(1) In general.--Beginning in fiscal year 2022, the
Secretary shall provide not fewer than an additional (as
compared to fiscal year 2021) 200 debt reduction awards per
year under the Department of Veterans Affairs Education Debt
Reduction Program under subchapter VII of chapter 76 of title
38, United States Code, to be used to recruit mental health
professionals to the Department of Veterans Affairs in
disciplines that include psychiatry, psychology, advanced
practice nursing (with a focus on mental health or substance
use disorder), and social work.
(2) Authorization of appropriations.--There is authorized
to be appropriated to the Secretary of Veterans Affairs
$8,000,000 per year to carry out the additional awards under
paragraph (1).
(c) Outreach.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Secretary shall develop a
public awareness campaign to encourage veterans and mental
health professionals to choose the Department for their
mental health career.
(2) Elements.--The campaign required under paragraph (1)--
(A) shall advertise the paid trainee, scholarship, and loan
repayment opportunities offered by the Department; and
(B) may highlight the new graduate medical education
residencies available at the Department for medical students
entering residency.
TITLE II--VETERANS CRISIS LINE
SEC. 201. VETERANS CRISIS LINE.
In this title, the term ``Veterans Crisis Line'' means the
toll-free hotline for veterans established under section
1720F(h) of title 38, United States Code.
Subtitle A--Veterans Crisis Line Training and Quality Management
SEC. 211. STAFF TRAINING.
(a) Review of Training for Veterans Crisis Line Call
Responders.--
(1) In general.--The Secretary of Veterans Affairs shall
enter into an agreement with an organization outside the
Department of Veterans Affairs to review the training for
Veterans Crisis Line call responders on assisting callers in
crisis.
(2) Completion of review.--The review conducted under
paragraph (1) shall be completed not later than one year
after the date of the enactment of this Act.
(3) Elements of review.--The review conducted under
paragraph (1) shall consist of a review of the training
provided by the Department on subjects including risk
assessment, lethal means assessment, substance use and
overdose risk assessment, safety planning, referrals to care,
supervisory consultation, and emergency dispatch.
(4) Update of training.--If any deficiencies in the
training for Veterans Crisis Line call responders are found
pursuant to the review under paragraph (1), the Secretary
shall update such training and associated standards of
practice to correct those deficiencies not later than one
year after the completion of the review.
(b) Retraining Guidelines for Veterans Crisis Line Call
Responders.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Secretary shall develop
guidelines on retraining and quality management for when a
Veterans Crisis Line call responder has an adverse event or
when a quality review check by a supervisor of such a call
responder denotes that the call responder needs improvement.
(2) Elements of guidelines.--The guidelines developed under
paragraph (1) shall specify the subjects and quantity of
retraining recommended and how supervisors should implement
increased use of silent monitoring or other performance
review mechanisms.
SEC. 212. QUALITY REVIEW AND MANAGEMENT.
(a) Monitoring of Calls on Veterans Crisis Line.--
(1) In general.--The Secretary of Veterans Affairs shall
require that not fewer than two calls per month for each
Veterans Crisis Line call responder be subject to supervisory
silent monitoring, which is used to monitor the quality of
conduct by such call responder during the call.
(2) Benchmarks.--The Secretary shall establish benchmarks
for requirements and performance of Veterans Crisis Line call
responders on supervisory silent monitored calls.
(3) Quarterly reports.--Not less frequently than quarterly,
the Secretary shall submit to the Office of Mental Health and
Suicide Prevention of the Department of Veterans Affairs a
report on occurrence and outcomes of supervisory silent
monitoring of calls on the Veterans Crisis Line.
(b) Quality Management Processes for Veterans Crisis
Line.--Not later than one year after the date of the
enactment of this Act, the leadership for the Veterans Crisis
Line, in partnership with the Office of Mental Health and
Suicide Prevention of the Department and the National Center
for Patient Safety of the Department, shall establish quality
management processes and expectations for staff of the
Veterans Crisis Line, including with respect to reporting of
adverse events and close calls.
(c) Annual Common Cause Analysis for Callers to Veterans
Crisis Line Who Die by Suicide.--
(1) In general.--Not less frequently than annually, the
Secretary shall perform a common cause analysis for all
identified callers to the Veterans Crisis Line that died by
suicide during the one-year period preceding the conduct of
the analysis before the caller received contact with
emergency services and in which the Veterans Crisis Line was
the last point of contact.
(2) Submittal of results.--The Secretary shall submit to
the Office of Mental Health and Suicide Prevention of the
Department the results of each analysis conducted under
paragraph (1).
(3) Application of themes or lessons.--The Secretary shall
apply any themes or lessons learned under an analysis under
paragraph (1) to updating training and standards of practice
for staff of the Veterans Crisis Line.
SEC. 213. GUIDANCE FOR HIGH-RISK CALLERS.
(a) Development of Enhanced Guidance and Procedures for
Response to Calls Related to Substance Use and Overdose
Risk.--Not later than one year after the date of the
enactment of this Act, the Secretary of Veterans Affairs, in
consultation with national experts within the Department of
Veterans Affairs on substance use disorder and overdose,
shall--
(1) develop enhanced guidance and procedures to respond to
calls to the Veterans Crisis Line related to substance use
and overdose risk;
(2) update training materials for staff of the Veterans
Crisis Line in response to such enhanced guidance and
procedures; and
(3) update criteria for monitoring compliance with such
enhanced guidance and procedures.
(b) Review and Improvement of Standards for Emergency
Dispatch.--
(1) In general.--Not later than one year after the date of
the enactment of this Act, the Secretary shall--
(A) review the current emergency dispatch standard
operating procedure of the Veterans Crisis Line to identify
any additions to such procedure to strengthen communication
regarding--
[[Page H5847]]
(i) emergency dispatch for disconnected callers; and
(ii) the role of social service assistants in requesting
emergency dispatch and recording such dispatches; and
(B) update such procedure to include the additions
identified under subparagraph (A).
(2) Training.--The Secretary shall ensure that all staff of
the Veterans Crisis Line are trained on all updates made
under paragraph (1)(B) to the emergency dispatch standard
operating procedure of the Veterans Crisis Line.
SEC. 214. OVERSIGHT OF TRAINING OF SOCIAL SERVICE ASSISTANTS
AND CLARIFICATION OF JOB RESPONSIBILITIES.
Not later than one year after the date of the enactment of
this Act, the Secretary of Veterans Affairs shall--
(1) establish oversight mechanisms to ensure that social
service assistants and supervisory social service assistants
working with the Veterans Crisis Line are appropriately
trained and implementing guidance of the Department regarding
the Veterans Crisis Line; and
(2) refine standard operating procedures to delineate roles
and responsibilities for all levels of supervisory social
service assistants working with the Veterans Crisis Line.
Subtitle B--Pilot Programs and Research on Veterans Crisis Line
SEC. 221. PILOT PROGRAMS.
(a) Extended Safety Planning Pilot Program for Veterans
Crisis Line.--
(1) In general.--Commencing not later than 180 days after
the date of the enactment of this Act, the Secretary of
Veterans Affairs shall carry out a pilot program to determine
whether a lengthier, templated safety plan used in clinical
settings could be applied in call centers for the Veterans
Crisis Line.
(2) Briefing.--Not later than two years after the date of
the enactment of this Act, the Secretary shall provide to
Congress a briefing on the findings of the Secretary under
the pilot program conducted under paragraph (1), which shall
include any recommendations of the Secretary with respect to
the continuation or discontinuation of the pilot program.
(b) Crisis Line Facilitation Pilot Program.--
(1) In general.--Commencing not later than one year after
the date of the enactment of this Act, the Secretary shall
carry out a pilot program on the use of crisis line
facilitation to increase use of the Veterans Crisis Line
among high-risk veterans.
(2) Briefing.--Not later than two years after the date of
the enactment of this Act, the Secretary shall provide to
Congress a briefing on the findings of the Secretary under
the pilot program under paragraph (1), including any
recommendations of the Secretary with respect to the
continuation or discontinuation of the pilot program.
(3) Definitions.--In this section:
(A) The term ``crisis line facilitation'', with respect to
a high-risk veteran, means the presentation by a therapist of
psychoeducational information about the Veterans Crisis Line
and a discussion of the perceived barriers and facilitators
to future use of the Veterans Crisis Line for the veteran,
which culminates in the veteran calling the Veterans Crisis
Line with the therapist to provide firsthand experiences that
may counter negative impressions of the Veterans Crisis Line.
(B) The term ``high-risk veteran'' means a veteran
receiving inpatient mental health care following a suicidal
crisis.
SEC. 222. AUTHORIZATION OF APPROPRIATIONS FOR RESEARCH ON
EFFECTIVENESS AND OPPORTUNITIES FOR IMPROVEMENT
OF VETERANS CRISIS LINE.
There is authorized to be appropriated to the Secretary of
Veterans Affairs for fiscal years 2022 and 2023, a total of
$5,000,000 for the Mental Illness Research, Education, and
Clinical Centers of the Department of Veterans Affairs to
conduct research on the effectiveness of the Veterans Crisis
Line and areas for improvement for the Veterans Crisis Line.
Subtitle C--Transition of Crisis Line Number
SEC. 231. FEEDBACK ON TRANSITION OF CRISIS LINE NUMBER.
(a) In General.--The Secretary of Veterans Affairs shall
solicit feedback from veterans service organizations on how
to conduct outreach to members of the Armed Forces, veterans,
their family members, and other members of the military and
veterans community on the move to 988 as the new, national
three-digit suicide and mental health crisis hotline, which
is expected to be implemented by July 2022, to minimize
confusion and ensure veterans are aware of their options for
reaching the Veterans Crisis Line.
(b) Nonapplication of FACA.--The Federal Advisory Committee
Act (5 U.S.C. App.) shall not apply to any feedback solicited
under subsection (a).
(c) Veterans Service Organization Defined.--In this
section, the term ``veterans service organization'' means an
organization recognized by the Secretary for the
representation of veterans under section 5902 of title 38,
United States Code.
TITLE III--OUTREACH TO VETERANS
SEC. 301. SOLID START PROGRAM OF THE DEPARTMENT OF VETERANS
AFFAIRS.
(a) In General.--Chapter 63 of title 38, United States
Code, is amended by adding at the end the following new
subchapter:
``SUBCHAPTER II--OTHER OUTREACH PROGRAMS AND ACTIVITIES
``Sec. 6320. Solid Start program
``(a) In General.--The Secretary shall carry out a program,
to be known as the `Solid Start program', under which the
Secretary shall--
``(1) build the capacity of the Department to efficiently
and effectively respond to the queries and needs of veterans
who have recently separated from the Armed Forces; and
``(2) systemically integrate and coordinate efforts to
assist veterans, including efforts--
``(A) to proactively reach out to newly separated veterans
to inform them of their eligibility for programs of and
benefits provided by the Department; and
``(B) to connect veterans in crisis to resources that
address their immediate needs.
``(b) Activities of the Solid Start Program.--(1) The
Secretary, in coordination with the Secretary of Defense,
shall carry out the Solid Start program of the Department
by--
``(A) collecting up-to-date contact information during
transition classes or separation counseling for all members
of the Armed Forces who are separating from the Armed Forces,
while explaining the existence and purpose of the Solid Start
program;
``(B) calling each veteran, regardless of separation type
or characterization of service, three times within the first
year after separation of the veteran from the Armed Forces;
``(C) providing information about the Solid Start program
on the website of the Department and in materials of the
Department, especially transition booklets and other
resources;
``(D) ensuring calls are truly tailored to the needs of
each veteran's unique situation by conducting quality
assurance tests;
``(E) prioritizing outreach to veterans who have accessed
mental health resources prior to separation from the Armed
Forces;
``(F) providing women veterans with information that is
tailored to their specific health care and benefit needs;
``(G) as feasible, providing information on access to State
and local resources, including Vet Centers and veterans
service organizations; and
``(H) gathering and analyzing data assessing the
effectiveness of the Solid Start program.
``(2) The Secretary, in coordination with the Secretary of
Defense, may carry out the Solid Start program by--
``(A) encouraging members of the Armed Forces who are
transitioning to civilian life to authorize alternate points
of contact who can be reached should the member be
unavailable during the first year following the separation of
the member from the Armed Forces;
``(B) following up missed phone calls with tailored
mailings to ensure the veteran still receives similar
information; and
``(C) striving to reach out to veterans who separated prior
to the initiation of the Solid Start program to provide
similar services to those veterans, as feasible.
``(3) In this subsection:
``(A) The term `Vet Center' has the meaning given that term
in section 1712A(h) of this title.
``(B) The term `veterans service organization' means an
organization recognized by the Secretary for the
representation of veterans under section 5902 of this
title.''.
(b) Conforming Amendments.--Chapter 63 of such title, as
amended by subsection (a), is further amended--
(1) by inserting before section 6301 the following:
``Subchapter I--Outreach Services Program'';
and
(2) in sections 6301, 6303, 6304, 6305, 6306, and 6307, by
striking ``this chapter'' each place it appears and inserting
``this subchapter''.
(c) Clerical Amendments.--The table of sections at the
beginning of chapter 63 of such title is amended--
(1) by inserting before the item relating to section 6301
the following new item:
``subchapter i--outreach services program'';
and
(2) by adding at the end the following new items:
``subchapter ii--other outreach programs and activities
``6320. Solid Start program.''.
SEC. 302. DESIGNATION OF BUDDY CHECK WEEK BY SECRETARY OF
VETERANS AFFAIRS.
(a) In General.--The Secretary of Veterans Affairs shall
designate one week each year to organize outreach events and
educate veterans on how to conduct peer wellness checks,
which shall be known as ``Buddy Check Week''.
(b) Educational Opportunities.--
(1) In general.--During Buddy Check Week, the Secretary, in
consultation with organizations that represent veterans,
nonprofits that serve veterans, mental health experts,
members of the Armed Forces, and such other entities and
individuals as the Secretary considers appropriate, shall
collaborate with organizations that represent veterans to
provide educational opportunities for veterans to learn how
to conduct peer wellness checks.
(2) Training matters.--As part of the educational
opportunities provided under paragraph (1), the Secretary
shall provide the following:
[[Page H5848]]
(A) A script for veterans to use to conduct peer wellness
checks that includes information on appropriate referrals to
resources veterans might need.
(B) Online and in-person training, as appropriate, on how
to conduct a peer wellness check.
(C) Opportunities for members of organizations that
represent veterans to learn how to train individuals to
conduct peer wellness checks.
(D) Training for veterans participating in Buddy Check Week
on how to transfer a phone call directly to the Veterans
Crisis Line.
(E) Resiliency training for veterans participating in Buddy
Check Week on handling a veteran in crisis.
(3) Online materials.--All training materials provided
under the educational opportunities under paragraph (1) shall
be made publicly available on a website of the Department of
Veterans Affairs.
(c) Outreach.--The Secretary, in collaboration with
organizations that represent veterans, may conduct outreach
regarding educational opportunities under subsection (b) at--
(1) public events where many veterans are expected to
congregate;
(2) meetings of organizations that represent veterans;
(3) facilities of the Department; and
(4) such other locations as the Secretary, in collaboration
with organizations that represent veterans, considers
appropriate.
(d) Veterans Crisis Line Plan.--
(1) In general.--The Secretary shall ensure that a plan
exists for handling the potential increase in the number of
calls into the Veterans Crisis Line that may occur during
Buddy Check Week.
(2) Submittal of plan.--The head of the Veterans Crisis
Line shall submit to the Secretary a plan for how to handle
excess calls during Buddy Check Week, which may include the
following:
(A) Additional hours for staff.
(B) The use of a backup call center.
(C) Any other plan to ensure that calls from veterans in
crisis are being answered in a timely manner by an individual
trained at the same level as a Veterans Crisis Line
responder.
(e) Definitions.--In this section:
(1) The term ``organization that represents veterans''
means an organization recognized by the Secretary for the
representation of veterans under section 5902 of title 38,
United States Code.
(2) The term ``veteran'' has the meaning given that term in
section 101 of such title.
(3) The term ``Veterans Crisis Line'' means the toll-free
hotline for veterans provided by the Secretary under section
1720F(h) of such title.
SEC. 303. IMPROVEMENTS TO VETERANS JUSTICE OUTREACH PROGRAM.
(a) Outreach Requirement.--The Secretary of Veterans
Affairs shall conduct outreach regarding the Veterans Justice
Outreach Program to justice-involved veterans, military and
veterans service organizations, and relevant stakeholders in
the criminal justice community, including officials from
local law enforcement, court, and jail systems and others as
determined appropriate by the Secretary. Such outreach--
(1) shall be designed--
(A) to spread awareness and understanding of the Program;
(B) to spread awareness and understanding of veteran
eligibility for the Program, including the eligibility of
veterans who were discharged from service in the Armed Forces
under conditions other than honorable; and
(C) to improve the identification of justice-involved
veterans; and
(2) may be conducted in person, virtually, or through other
means, including by the dissemination of informational
materials and contact information.
(b) Strategic Plan.--The Secretary of Veterans Affairs
shall develop a strategic plan for the Veterans Justice
Outreach Program. In developing such plan, the Secretary
shall conduct--
(1) an assessment of barriers to working with justice-
involved veterans in rural, remote, and underserved areas,
including potential steps to address such barriers; and
(2) a workforce gap analysis for the Program.
(c) Increase in Number of VJO Specialists.--
(1) Increase.--The Secretary of Veterans Affairs shall
increase the number of Veterans Justice Outreach specialists
responsible for supporting justice-involved veterans in
rural, remote, or underserved areas, including areas located
far from Department of Veterans Affairs medical centers, as
determined by the Secretary, through--
(A) the hiring of additional Veterans Justice Outreach
specialists;
(B) the reallocation of existing Veterans Justice Outreach
specialists; or
(C) such other means as may be determined appropriate by
the Secretary.
(2) Determination.--The Secretary shall determine the
number of Veterans Justice Outreach specialists required, and
the locations of such specialists, under paragraph (1) by
taking into account--
(A) such number and locations needed to achieve the mission
and strategic goals of the Veterans Justice Outreach Program;
(B) any gaps in the workforce of the Program, including
such gaps identified pursuant to subsection (b)(2); and
(C) strategies to address such gaps.
(3) Use of technology.--In carrying out paragraph (1), the
Secretary shall consider the use of virtual technology.
(d) Performance Goals and Implementation Plans.--
(1) Establishment.--The Secretary of Veterans Affairs shall
establish performance goals and implementation plans for--
(A) the Veterans Justice Outreach Program;
(B) Veterans Justice Outreach Specialists; and
(C) providing support for research regarding justice-
involved veterans.
(2) Consistency with strategic plan.--The Secretary shall
ensure that the performance goals and implementation plans
under paragraph (1) are consistent with the strategic plan
under subsection (b) and include--
(A) qualitative and quantitative milestones, measures, and
metrics, and associated timelines for completion of the plans
under paragraph (1) and barriers to such completion;
(B) an identification of relevant staff; and
(C) an estimate of resource needs and sources.
(3) Performance data.--The Secretary shall establish a
process to regularly collect and analyze performance data to
assess the efficiency and effectiveness of implementing the
plans under paragraph (1).
(e) Training Requirement.--The Secretary shall ensure that
all Veterans Justice Outreach Specialists receive training
not less frequently than annually on--
(1) best practices for identifying and conducting outreach
to justice-involved veterans and relevant stakeholders in the
criminal justice community; and
(2) veteran eligibility for the Veterans Justice Outreach
Program, including with respect to consistently communicating
changes regarding eligibility (including through the use of a
script or other reference materials).
(f) Reports on Implementation.--
(1) First report.--Not later than one year after the date
of the enactment of this Act, the Secretary shall submit to
Congress a report on the following:
(A) An assessment of implementing subsection (c),
including--
(i) strategies to increase Veterans Justice Outreach
specialists responsible for supporting justice-involved
veterans in rural, remote, or underserved areas; and
(ii) the progress of the Secretary in addressing gaps in
the workforce of the Veterans Justice Outreach Program
identified pursuant to paragraph (2) of such subsection.
(B) The performance goals and implementation plans
established under subsection (d)(1).
(2) Subsequent report.--Not later than three years after
the date on which the first report is submitted under
paragraph (1), the Secretary shall submit to Congress a
report on the progress of the Secretary in meeting the
performance goals and carrying out activities under the
implementation plans established under subsection (d)(1).
(g) Report on Veterans Treatment Courts.--Not later than
one year after the date of the enactment of this Act, the
Secretary, in consultation with the Attorney General, shall
submit to Congress a report on the engagement of the
Department of Veterans Affairs with veterans treatment
courts, including--
(1) the availability and efficacy of veterans treatment
courts in meeting the needs of justice-involved veterans;
(2) best practices for Department of Veterans Affairs staff
and justice-involved veterans in working with veterans
treatment courts; and
(3) the ability of justice-involved veterans to access
veterans treatment courts, including any barriers that exist
to increasing such access.
(h) Definitions.--In this section:
(1) The term ``justice-involved veteran'' means a veteran
with active, ongoing, or recent contact with some component
of a local criminal justice system.
(2) The term ``Veterans Justice Outreach Program'' means
the program through which the Department of Veterans Affairs
identifies justice-involved veterans and provides such
veterans with access to Department services.
(3) The term ``Veterans Justice Outreach Specialist'' means
an employee of the Department of Veterans Affairs who serves
as a liaison between the Department and the local criminal
justice system on behalf of a justice-involved veteran.
(4) The term ``veterans treatment court'' means a State or
local court that is participating in the veterans treatment
court program (as defined in section 2991(i)(1) of the
Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C.
3797aa(i)(1))).
SEC. 304. DEPARTMENT OF VETERANS AFFAIRS GOVERNORS CHALLENGE
PROGRAM.
The Secretary of Veterans Affairs may enter into agreements
with States, territories, and American Indian and Alaska
Native tribes for the development and implementation of
veteran suicide prevention proposals through the Governors
Challenge Program.
TITLE IV--MENTAL HEALTH CARE DELIVERY
SEC. 401. EXPANSION OF PEER SPECIALIST SUPPORT PROGRAM OF
DEPARTMENT OF VETERANS AFFAIRS.
(a) Expansion.--Section 506 of the VA MISSION Act of 2018
(Public Law 115-182; 38 U.S.C. 1701 note) is amended--
[[Page H5849]]
(1) by redesignating subsections (d) through (f) as
subsections (e) through (g);
(2) in subsection (a), by adding at the end the following
new sentence: ``Each such peer specialist shall be a full-
time employee whose primary function is to serve as a peer
specialist and shall be in addition to all other employees of
such medical center.'';
(3) in the heading of subsection (b), by striking
``Timeframe'' and inserting ``Initial Timeframe'';
(4) in subsection (c)--
(A) in the heading, by striking ``Selection'' and inserting
``Initial Selection''; and
(B) in paragraph (1), by striking ``The Secretary shall''
and inserting ``In establishing the program at initial
locations, the Secretary shall'';
(5) by inserting after subsection (c) the following new
subsection:
``(d) Timeframe for Expansion of Program; Selection of
Additional Locations.--
``(1) Timeframe for expansion.--The Secretary shall make
permanent and expand the program to additional medical
centers of the Department as follows:
``(A) As of the date of the enactment of the STRONG
Veterans Act of 2021, the Secretary shall make such program
permanent at each medical center participating in the program
on the day before such date of enactment.
``(B) During the seven-year period following such date of
enactment, the Secretary shall expand the program to an
additional 25 medical centers per year until the program is
carried out at each medical center of the Department.
``(2) Selection of additional locations.--In selecting
medical centers for the expansion of the program under
paragraph (1)(B), until such time as each medical center of
the Department is participating in the program by
establishing not fewer than two peer specialists at the
medical center, the Secretary shall prioritize medical
centers in the following areas:
``(A) Rural areas and other areas that are underserved by
the Department.
``(B) Areas that are not in close proximity to an active
duty military installation.
``(C) Areas representing different geographic locations,
such as census tracts established by the Bureau of the
Census.'';
(6) in subsection (e), as redesignated by paragraph (1)--
(A) in the heading, by striking ``Gender-specific
Services'' and inserting ``Considerations for Hiring Peer
Specialists'';
(B) in the matter preceding paragraph (1), by striking
``location selected under subsection (c)'' and inserting
``medical center'';
(C) in paragraph (1), by striking ``and'' at the end; and
(D) by striking paragraph (2) and inserting the following
new paragraphs:
``(2) female peer specialists are hired and made available
to support female veterans who are treated at each medical
center; and
``(3) to the extent practical, peer specialists are hired
in demographic percentages that reflect the racial and ethnic
demographic percentages of the overall veterans
population.''; and
(7) by amending subsection (g), as redesignated by
paragraph (1), to read as follows:
``(g) Reports.--
``(1) Periodic reports.--
``(A) In general.--Not later than one year after the date
of the enactment of the STRONG Veterans Act of 2021, and
annually thereafter for five years, the Secretary shall
submit to the Committees on Veterans' Affairs of the House of
Representatives and the Senate a report on the program,
including the expansion of the program under subsection
(d)(1).
``(B) Elements.--Each report under subparagraph (A) shall
include, with respect to the one-year period preceding the
submission of the report, the following:
``(i) The findings and conclusions of the Secretary with
respect to the program.
``(ii) An assessment of the benefits of the program to
veterans and family members of veterans.
``(iii) An assessment of the effectiveness of peer
specialists in engaging under subsection (f) with health care
providers in the community and veterans served by such
providers.
``(iv) The name and location of each medical center where
new peer specialists were hired.
``(v) The number of new peer specialists hired at each
medical center pursuant to this section and the total number
of peer specialists within the Department hired pursuant to
this section.
``(vi) An assessment of any barriers confronting the
recruitment, training, or retention of peer specialists.
``(2) Final report.--Not later than one year after the
Secretary determines that the program is being carried out at
each medical center of the Department, the Secretary shall
submit to the Committees on Veterans' Affairs of the House of
Representatives and the Senate a report notifying such
committees of such determination.''.
(b) Authorization of Appropriations.--There is authorized
to be appropriated to the Department of Veterans Affairs to
implement section 506 of the VA MISSION Act of 2018 (Public
Law 115-182; 38 U.S.C. 1701 note), as amended by subsection
(a), the following amounts:
(1) $3,600,000 for fiscal year 2022.
(2) $7,200,000 for fiscal year 2023.
(3) $10,800,000 for fiscal year 2024.
(4) $14,400,000 for fiscal year 2025.
(5) $18,000,000 for fiscal year 2026.
(6) $21,600,000 for fiscal year 2027.
(7) $25,000,000 for fiscal year 2028.
SEC. 402. EXPANSION OF VET CENTER SERVICES.
(a) Veterans and Members Using Educational Assistance
Benefits.--Section 1712A of title 38, United States Code, is
amended--
(1) by striking ``clauses (i) through (vi)'' both places it
appears and inserting ``clauses (i) through (vii)'';
(2) by striking ``in clause (vii)'' both places it appears
and inserting ``in clause (viii)'';
(3) in subsection (a)(1)(C)--
(A) by redesignating clause (vii) as clause (viii); and
(B) by inserting after clause (vi) the following new
clause:
``(vii) Any veteran or member of the Armed Forces pursuing
a course of education using covered educational assistance
benefits.''; and
(4) in subsection (h), by adding at the end the following
new paragraph:
``(6) The term `covered educational assistance benefits'
means educational assistance benefits provided pursuant to--
``(A) chapter 30, 31, 32, or 33 of this title;
``(B) chapter 1606 or 1607 of title 10;
``(C) section 116 of the Harry W. Colmery Veterans
Educational Assistance Act of 2017 (Public Law 115-48; 38
U.S.C. 3001 note); or
``(D) section 8006 of the American Rescue Plan Act of 2021
(Public Law 117-2; 38 U.S.C. 3001 note prec.).''.
(b) GAO Report.--Not later than one year after the date of
the enactment of this Act, the Comptroller General of the
United States shall submit to the Committees on Veterans'
Affairs of the House of Representatives and the Senate a
report assessing--
(1) the mental health needs of veterans pursuing a course
of education using covered educational assistance benefits
(as defined in section 1712A(h)(6) of title 38, United States
Code, as added by subsection (a)); and
(2) the efforts of the Department of Veterans Affairs to
address such mental health needs.
SEC. 403. ELIGIBILITY FOR MENTAL HEALTH SERVICES.
(a) In General.--Section 1712A(a)(1) of title 38, United
States Code, as amended by section 402, is further amended--
(1) in subparagraph (A)(ii)--
(A) in subclause (I), by striking ``and'';
(B) in subclause (II), by striking the period at the end
and inserting ``; and''; and
(C) by adding at the end the following:
``(III) in the case of a veteran or member who died by
suicide, to the degree that counseling furnished to such
individual is found to aid in coping with the effects of such
suicide.'';
(2) in subparagraph (B)(i)(II)--
(A) in item (aa), by striking ``or'';
(B) in item (bb), by striking the period at the end and
inserting ``; or''; and
(C) by adding at the end the following;
``(cc) coping with the effects of a suicide described in
subclause (III) of such clause.''; and
(3) in subparagraph (C)(vii)--
(A) in subclause (I), by striking ``or'' at the end;
(B) in subclause (II), by striking the period at the end
and inserting ``; or''; and
(C) by adding at the end the following:
``(III) veteran or member of the Armed Forces who died by
suicide.''.
(b) Effective Date.--The amendments made by subsection (a)
shall apply with respect to family members of a member or
veteran who died by suicide before, on, or after the date of
the enactment of this Act.
SEC. 404. MENTAL HEALTH CONSULTATIONS.
(a) Mental Health Consultations for Veterans Filing for
Compensation.--
(1) In general.--Subchapter VI of chapter 11 of title 38,
United States Code, is amended by adding at the end the
following new section:
``Sec. 1167. Mental health consultations
``(a) In General.--Not later than 30 days after the date on
which a veteran submits to the Secretary a claim for
compensation under this chapter for a service-connected
disability relating to a mental health diagnosis, the
Secretary shall offer the veteran a mental health
consultation to assess the mental health needs of, and care
options for, the veteran.
``(b) Availability.--The Secretary shall--
``(1) offer a veteran a consultation under subsection (a)
without regard to any previous denial or approval of a claim
of that veteran for a service-connected disability relating
to a mental health diagnosis; and
``(2) ensure that a veteran offered a mental health
consultation under subsection (a) may elect to receive such
consultation during the one-year period beginning on the date
on which the consultation is offered or during such longer
period beginning on such date as the Secretary considers
appropriate.
``(c) Rule of Construction.--A consultation provided to a
veteran under this section shall not be construed as a
determination that any disability of such veteran is service-
connected for the purposes of any benefit under the laws
administered by the Secretary.''.
(2) Clerical amendment.--The table of sections at the
beginning of chapter 11 of such title is amended by adding at
the end the following new item:
``1167. Mental health consultations.''.
(b) Mental Health Consultations for Veterans Entering
Homeless Programs Office Programs.--
(1) In general.--Subchapter VII of chapter 20 of title 38,
United States Code, is amended
[[Page H5850]]
by adding at the end the following new section:
``Sec. 2068. Mental health consultations
``(a) In General.--Not later than two weeks after the date
on which a veteran described in subsection (b) enters into a
program administered by the Homeless Programs Office of the
Department, the Secretary shall offer the veteran a mental
health consultation to assess the health needs of, and care
options for, the veteran.
``(b) Veteran Described.--A veteran described in this
subsection is a veteran to whom a mental health consultation
is not offered or provided through the case management
services of the program of the Homeless Programs Office into
which the veteran enters.''.
(2) Clerical amendment.--The table of sections at the
beginning of chapter 20 of such title is amended by adding at
the end the following new item:
``2068. Mental health consultations.''.
TITLE V--RESEARCH
SEC. 501. VETERANS INTEGRATION TO ACADEMIC LEADERSHIP PROGRAM
OF THE DEPARTMENT OF VETERANS AFFAIRS.
(a) Report.--Not later than one year after the date of the
enactment of this Act, the Secretary of Veterans Affairs
shall submit to the Committees on Veterans' Affairs of the
House of Representatives and the Senate a report on the
Veterans Integration to Academic Leadership program of the
Department of Veterans Affairs. The report shall include the
following:
(1) The number of medical centers of the Department,
institutions of higher learning, non-college degree programs,
and student veterans supported by the program, and relevant
trends since the program began.
(2) The staff and resources allocated to the program, and
relevant trends since the program began.
(3) An assessment of the outcomes and effectiveness of the
program in--
(A) supporting student veterans;
(B) connecting student veterans to needed services of the
Department or services provided by non-Department entities;
(C) addressing the mental health needs of student veterans;
(D) lowering the suicide risk of student veterans; and
(E) helping student veterans achieve educational goals.
(4) An assessment of barriers to expanding the program and
how the Secretary intends to address such barriers.
(5) An assessment of whether the program should be expanded
outside of the Office of Mental Health and Suicide Prevention
to support students veterans with needs unrelated to mental
health or suicide.
(b) Uniform Best Practices, Goals, and Measures.--The
Secretary shall establish best practices, goals, and measures
for the Veterans Integration to Academic Leadership program
of the Department that are uniform among the medical centers
of the Department.
(c) Outreach.--The Secretary shall conduct outreach among
the Armed Forces, veterans service organizations,
institutions of higher learning, and non-college degree
programs with respect to the Veterans Integration to Academic
Leadership program of the Department.
(d) Assessment.--The Secretary shall assess the feasibility
and advisability of including the suicide rate for student
veterans in the National Veteran Suicide Prevention Annual
Report of the Office of Mental Health and Suicide Prevention
of the Department.
(e) Definitions.--In this section:
(1) The term ``institution of higher learning'' has the
meaning given that term in section 3452 of title 38, United
States Code.
(2) The term ``student veteran'' means the following:
(A) A veteran or member of the Armed Forces using
educational assistance under any of the following provisions
of law:
(i) Chapter 30, 31, 32, or 33 of title 38, United States
Code, or chapter 1606 or 1607 of title 10, United States
Code.
(ii) Section 116 of the Harry W. Colmery Veterans
Educational Assistance Act of 2017 (Public Law 115-48; 38
U.S.C. 3001 note).
(iii) Section 8006 of the American Rescue Plan Act of 2021
(Public Law 117-2; 38 U.S.C. 3001 note prec.).
(B) A veteran who is enrolled in an institution of higher
learning or other training program, without regard to whether
the veteran is using educational assistance specified in
subparagraph (A).
SEC. 502. IMPROVEMENT OF SLEEP DISORDER CARE FURNISHED BY
DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Pursuant to the analysis conducted under
subsection (b), the Secretary of Veterans Affairs shall take
such action as the Secretary considers appropriate to improve
the assessment and treatment of veterans with sleep
disorders, including by conducting in-home sleep studies for
veterans.
(b) Analysis.--The Secretary shall conduct an analysis of
the ability of the Department of Veterans Affairs to treat
sleep disorders among veterans, including--
(1) assessment and treatment options for such disorders;
(2) barriers to care for such disorders, such as wait time,
travel time, and lack of staffing;
(3) the efficacy of the clinical practice guidelines of the
Department of Veterans Affairs and the Department of Defense
for such disorders; and
(4) the availability of and efficacy of the use by the
Department of Veterans Affairs of cognitive behavioral
therapy for insomnia.
(c) Report.--Not later than two years after the date of the
enactment of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives a report on--
(1) the findings from the analysis conducted under
subsection (b); and
(2) any actions taken under subsection (a) to improve the
assessment and treatment of veterans with sleep disorders.
(d) Authorization of Appropriations for In-Home Sleep
Studies.--There is authorized to be appropriated to the
Secretary of Veterans Affairs $5,000,000 to be used to
conduct in-home sleep studies for veterans, as part of sleep
disorder assessment and treatment conducted by the Department
of Veterans Affairs.
SEC. 503. STUDY ON INPATIENT MENTAL HEALTH AND SUBSTANCE USE
CARE FROM DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--Not later than one year after the date of
the enactment of this Act, the Secretary of Veterans Affairs
shall complete the conduct of a study on access of veterans
to care under the residential rehabilitation treatment
programs of the Department of Veterans Affairs to determine--
(1) if there are sufficient geographic offerings of
inpatient mental health care, especially for veterans in
rural and remote communities;
(2) if there are sufficient bed spaces at each location,
based on demand and drive time from the homes of veterans;
(3) if there are any workforce-related capacity limitations
at each location, including if beds are unable to be used
because there are not enough providers to care for additional
patients;
(4) if there are diagnosis-specific or sex-specific
barriers to accessing care under such programs; and
(5) the average wait time for a bed in such a program,
broken out by--
(A) Veterans Integrated Service Network;
(B) rural or urban area;
(C) sex; and
(D) specialty (general program, substance use disorder
program, military sexual trauma program, etc.).
(b) Recommendations for Modifications to Treatment
Programs.--Using the results from the study conducted under
subsection (a), the Secretary shall make recommendations
for--
(1) new locations for opening facilities to participate in
the residential rehabilitation treatment programs of the
Department;
(2) facilities under such programs at which new beds can be
added; and
(3) any additional specialty tracks to be added to such
programs, such as substance use disorder or military sexual
trauma, in order to meet veteran need and demand.
(c) Report.--Not later than 180 days after completion of
the study under subsection (a), the Secretary shall submit to
the Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives a report on the findings of the study
conducted under subsection (a) and the recommendations made
by the Secretary under subsection (b).
SEC. 504. STUDY ON TREATMENT FROM DEPARTMENT OF VETERANS
AFFAIRS FOR CO-OCCURRING MENTAL HEALTH AND
SUBSTANCE USE DISORDERS.
(a) In General.--Not later than one year after the date of
the enactment of this Act, the Secretary of Veterans Affairs
shall conduct a study examining--
(1) the availability of treatment programs for veterans
with co-occurring mental health and substance use disorders
(including both inpatient and outpatient care);
(2) any geographic disparities in access to such programs,
such as for rural and remote veterans; and
(3) the average wait times for care under such programs.
(b) Report.--
(1) In general.--Not later than two years after the date of
the enactment of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives a report on the findings of the study
conducted under subsection (a).
(2) Elements.--The report required by paragraph (1) shall
include--
(A) any recommendations resulting from the study conducted
under subsection (a) with respect to improving timeliness and
quality of care and meeting treatment preferences for
veterans with co-occurring mental health and substance use
disorders; and
(B) a description of any actions taken by the Secretary to
improve care for such veterans.
SEC. 505. STUDY ON WORKLOAD OF SUICIDE PREVENTION TEAMS OF
DEPARTMENT OF VETERANS AFFAIRS.
(a) In General.--The Secretary of Veterans Affairs, acting
through the Under Secretary for Health and the Office of
Mental Health and Suicide Prevention, shall conduct a study
evaluating the workload of local suicide prevention teams of
the Department of Veterans Affairs.
(b) Elements.--The study conducted under subsection (a)
shall--
(1) identify the effects of the growth of the suicide
prevention program of the Department on the workload of
suicide prevention teams;
(2) incorporate key practices for staffing model design in
determining suicide prevention staffing needs; and
[[Page H5851]]
(3) determine which facilities of the Department need
increased suicide prevention coordinator staffing to meet the
needs of veterans, with an emphasis placed on facilities with
high patient volume and facilities located in States with
high rates of veteran suicide.
(c) Report.--Not later than one year after the date of the
enactment of this Act, the Secretary shall submit to the
Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of
Representatives a report--
(1) on the findings of the study conducted under subsection
(a); and
(2) indicating any changes made to the staffing of suicide
prevention teams of the Department resulting from the
determinations made under subsection (b)(3), including a list
of facilities of the Department where staffing was adjusted.
SEC. 506. EXPANSION OF SUICIDE PREVENTION AND MENTAL HEALTH
RESEARCH.
(a) Research on Moral Injury.--The Secretary of Veterans
Affairs, acting through the Office of Research and
Development of the Department of Veterans Affairs, shall
conduct suicide prevention and mental health care improvement
research on how moral injury relates to the mental health
needs of veterans who served in the Armed Forces after
September 11, 2001, and best practices for mental health
treatment for such veterans.
(b) Authorization of Appropriations.--There is authorized
to be appropriated to the Department of Veterans Affairs an
additional $10,000,000 to be used by the Center of Excellence
for Suicide Prevention of the Department and the Rocky
Mountain Mental Illness Research Education and Clinical
Center for purposes of conducting research on the factors
impacting veteran suicide and best practices for early
intervention and support.
SEC. 507. STUDY ON MENTAL HEALTH AND SUICIDE PREVENTION
SUPPORT FOR MILITARY FAMILIES.
(a) In General.--The Secretary of Veterans Affairs, in
collaboration with the Secretary of Defense, shall conduct a
study on secondary post-traumatic stress disorder and
depression and its impact on spouses, children, and
caregivers of members of the Armed Forces.
(b) Report.--
(1) In general.--Not later than three years after the date
of the enactment of this Act, the Secretary of Veterans
Affairs, in collaboration with the Secretary of Defense,
shall submit to Congress, veterans service organizations, and
military support organizations a report on the findings of
the study conducted under subsection (a).
(2) Definitions.--In this subsection:
(A) The term ``military support organization'' has the
meaning given that term by the Secretary of Defense.
(B) The term ``veterans service organization'' means an
organization recognized by the Secretary of Veterans Affairs
for the representation of veterans under section 5902 of
title 38, United States Code.
SEC. 508. RESEARCH ON BRAIN HEALTH.
There is authorized to be appropriated to the Department of
Veterans Affairs an additional $5,000,000 for ongoing and
future research at the Translational Research Center of the
Department of Veterans Affairs for traumatic brain injury and
stress disorders to provide better understanding of, and
improved treatment options for, veterans who served in the
Armed Forces after September 11, 2001, and who have traumatic
brain injury or post-traumatic stress disorder.
SEC. 509. STUDY ON EFFICACY OF CLINICAL AND AT-HOME RESOURCES
FOR POST-TRAUMATIC STRESS DISORDER.
Not later than two years after the date of the enactment of
this Act, the Secretary of Veterans Affairs, acting through
the Office of Research and Development of the Department of
Veterans Affairs, shall conduct a study on--
(1) the efficacy of clinical and at-home resources, such as
mobile applications like COVID Coach, for providers,
veterans, caregivers, and family members to use for dealing
with stressors;
(2) the feasibility and advisability of developing more
such resources;
(3) strategies for improving mental health care and
outcomes for veterans with post-traumatic stress disorder;
and
(4) best practices for helping family members of veterans
deal with secondary post-traumatic stress disorder or mental
health concerns.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
California (Mr. Levin) and the gentleman from Illinois (Mr. Bost) each
will control 20 minutes.
The Chair recognizes the gentleman from California.
General Leave
Mr. LEVIN of California. Madam Speaker, I ask unanimous consent that
all Members may have 5 legislative days in which to revise and extend
their remarks and to insert extraneous material on H.R. 6411, as
amended.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman?
There was no objection.
Mr. LEVIN of California. Madam Speaker, I yield myself such time as I
may consume.
Madam Speaker, I rise today in support of H.R. 6411, as amended, the
Support The Resilience of Our Nation's Great Veterans Act, or STRONG
Veterans Act.
Chairman Takano introduced this bill with Ranking Member Bost, and we
are grateful to them and their staff for working together over many
months to bring this vital package to the House floor. This represents
a true bipartisan effort to address a pressing issue.
Although we all were glad to see the veteran suicide rate drop in the
last year for which we have data, one death is one too many, and
suicide is preventable. We must honor our veterans' service by getting
them the care they have earned and deserve now.
Preventing veteran suicide and strengthening veterans' mental health
and well-being remains a top priority not only of the Biden
administration and the Department of Veterans Affairs but also of our
committee. There are prevention approaches and treatments that work,
and we must expand all veterans' access to these lifesaving and life-
improving services.
Madam Speaker, while we are talking about access, I want to make sure
everyone listening today has the Veterans Crisis Line phone number. If
you or somebody you care about is in distress, call 1-800-273-TALK--
that is 1-800-273-8255--and press 1 for responders with military and
veteran expertise. There is no reason to suffer alone.
Along with our colleagues in the Senate, we have advanced bipartisan
bills over the past year that now make up the 22 sections of the STRONG
Veterans Act.
I want to especially thank our colleagues both on and off the
committee for their individual legislative contributions to this
omnibus package.
Congresswoman Brownley, who chairs our Veterans' Affairs Health
Subcommittee, introduced what we consider a cornerstone of STRONG--her
American Indian and Alaska Native Veterans Mental Health Act. This
provision mandates that VA hire full-time minority veteran coordinators
at every VA medical center to provide culturally competent mental
health and suicide prevention outreach to our Tribal veterans.
Congresswoman Slotkin's Solid Start Act is included in STRONG and
will ensure that VA continues to contact and check in with veterans
following their transition from Active Duty during what we know is a
very high-risk time for stress, mental health challenges, and even
suicide.
The committee also was pleased to include the Veteran Peer Specialist
Act from Congressman Scott Peters. This is an important provision
directing VA to expand its peer specialist program which is extremely
popular with veterans.
Although our colleague, former Congressman Delgado, recently left the
House to become Lieutenant Governor of New York, I thank him for
introducing the REACH for Veterans Act in the House. It is a critical
component of STRONG and will strengthen VA's Veterans Crisis Line.
Finally, Chairman Takano's bill in STRONG, the VA Governor's
Challenge Expansion Act, mandates, for the first time, VA-included
Tribes in addition to States in the successful Governors' Challenge
program to prevent veteran suicide. No sovereign nation should have to
wait to be invited to a State Governor's Challenge team. Instead,
Tribes selected for the program will work directly with VA to tailor
innovative suicide prevention ideas to the needs of their own Native
veterans.
Overall, STRONG will give VA important new authorities and resources
to support veterans' mental health and well-being through increased
training, outreach, mental health care delivery, and research in line
with the committee's public health approach and President Biden's
strategy to address veteran suicide.
It addresses gaps along the spectrum of prevention and care by
expanding mental health outreach to traditionally underserved veterans,
developing and delivering the most effective treatments, better
equipping VA's workforce to provide care, and further strengthening
VA's crisis response system.
[[Page H5852]]
With this legislation, we will help VA better meet veterans where
they are--literally. STRONG directs VA to hire more mental health staff
at vet centers close to where veterans live and work.
STRONG also directs VA to assess and improve how well it serves
veterans on college campuses. It requires VA to more consistently and
comprehensively reach out and provide mental health services to
veterans who have been involved with the criminal justice system.
STRONG mandates that as the new three-digit crisis hotline number
goes live across the country in July, VA further strengthen its
Veterans Crisis Line to meet the predicted surge in demand for
emergency care and followup.
STRONG lays out important guidance for VA's research program related
to suicide, substance use challenges, and other mental health issues.
While caring for veterans today, VA must always be investing in science
and looking for tomorrow's innovative solutions to improve veterans'
lives.
STRONG and its component bills are endorsed by too many veterans
service organizations and health organizations to list, but, Madam
Speaker, let me leave you with these words from Andrew Marshall,
National Commander of Disabled American Veterans, ``There is simply no
greater or more urgent challenge within the veteran community right now
than addressing mental health concerns and ensuring our Nation's heroes
have access to the support they need to both prevent and mitigate
crisis.
``DAV is pleased to support the STRONG Veterans Act, and we urge its
swift passage and signing into law.''
In closing, Madam Speaker, Chairman Takano and I support this
important piece of legislation, and we urge our colleagues to support
H.R. 6411, as amended.
Madam Speaker, I reserve the balance of my time.
Mr. BOST. Madam Speaker, I yield myself such time as I may consume.
Madam Speaker, I rise today in support of H.R. 6411, as amended, the
Support The Resiliency of Our Nation's Great, STRONG, Veterans Act.
This bill would improve VA's mental health and suicide prevention
strategies by doing a number of things. It would expand the Vet Center
workforce, and it would also allow student veterans the opportunity to
seek counseling at Vet Centers during what can be yet another stressful
time in that period of transitioning into civilian life.
{time} 1315
Additionally, the bill would allow family members of veterans who
died by suicide to seek bereavement counseling at Vet Centers. This
support, from counselors who know veterans and the challenges that
their families often face, would be a valuable resource for those in
mourning.
This bill would expand training, scholarship, and loan repayment
programs for the VA mental health providers. It would direct a series
of actions to improve the Veterans Crisis Line, including enhanced
training and oversight. It would codify an existing VA program that
reaches out to veterans in their first year out of the military to
provide them with information about relevant resources.
This bill would require VA to conduct numerous studies with the goals
of improving care for veterans with sleep disorders, refining inpatient
care for veterans struggling with addiction, identifying treatments for
veterans suffering from both mental health and substance use disorders,
and assessing the possible secondary impacts PTSD and depression may
have on veterans' families.
This bill is the product of bipartisan, bicameral negotiations
between the Veterans Affairs' Committee leaders. I thank Chairman
Takano for working with me to introduce this bill and move it forward
today.
I thank Senate colleagues Chairman Tester and Ranking Member Moran
for their work on this bill.
This bill contains many provisions that were in standalone bills
introduced by many of our other Members, and I recognize them today. I
send a particular thank-you to Dr. Murphy, Congressman Rouzer, and to
two of my fellow committee members, veterans themselves, Dr. Miller-
Meeks and Congressman Ellzey. Each of them spearheaded vital pieces of
this legislation that will help veterans and their families thrive for
years to come.
I encourage any veteran listening to this who is struggling and in
need of support to contact the veterans hotline by calling 1-800-273-
8825 and pressing 1. Once again, that is 1-800-273-8825 and pressing 1.
Or you can also get there by texting 838255. That is 838255. Or you can
actually visit the Veterans Crisis Line at veteranscrisisline.net, all
one word.
There is absolutely no shame in asking for help if you need it.
I urge my colleagues to join me in supporting this bill.
Madam Speaker, I reserve the balance of my time.
Mr. LEVIN of California. Madam Speaker, I have no further speakers,
and I am prepared to close. I reserve the balance of my time.
Mr. BOST. Madam Speaker, I yield 2 minutes to the gentleman from
North Carolina (Mr. Murphy), my good friend.
Mr. MURPHY of North Carolina. Madam Speaker, I rise today in
enthusiastic support of H.R. 6411, the Support The Resiliency of Our
Nation's Great Veterans Act, commonly known as the STRONG Act.
I am proud that this legislation includes language from my bill, H.R.
4233, the Student Veterans Counseling Centers Eligibility Act. I
introduced this bill alongside Ranking Member Bost to aid veteran
transition back to civilian life, especially for those looking to
further their education.
Far too often, we see the tragedy of our selfless defenders losing
their battle to mental health issues when returning from service. The
intention of our provision is to aid more of our veterans who are
readjusting to civilian lives by providing them with overdue access to
vital mental health resources.
This is especially personal to my district, as I represent 89,000
veterans, many of whom are or will be receiving benefits via the Post-
9/11 GI Bill.
Regardless of which side of the aisle we sit on, we have an
obligation to make sure that our counseling services are more
accessible for our veterans, and I am glad that the STRONG Act focuses
on this obligation.
My provision would expand counseling and mental health support to
student veterans through the VA's readjustment counseling centers, also
known as Vet Centers. These centers provide individual, group,
marriage, and family counseling, as well as peer support opportunities
for Active-Duty servicemembers, veterans, members of the National Guard
and Reserve, and certain military family members. Vet Centers are
community based, confidential, and free.
A recent RAND study shows that 20 percent of veterans on the GI Bill
face feelings of depression from PTSD. That 20 percent amounts to over
170,000 veterans, double the number of veterans in my district.
Currently, the option of student veterans using school psychologists,
in actuality, provides very little relief for our veterans. The
director of policy and advocacy for the National Association of School
Psychologists has reported that the national ratio of school
psychologists to students is anywhere from 1 to 2,000 to 1 to 5,000.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. BOST. Madam Speaker, I yield an additional 2 minutes to the
gentleman from North Carolina (Mr. Murphy).
Mr. MURPHY of North Carolina. I have heard personal stories from
student veterans who have had to wait weeks or even months for a mental
health appointment if their mental health crisis was not deemed in need
of ``immediate attention.'' Unfortunately, many of our veterans do not
have the luxury of weeks or months to see a mental health provider.
In addition, many of our universities' mental health counselors are
actually not licensed professionals but, instead, graduate or doctoral
students. Our veterans deserve better than this. They deserve the best
healthcare from qualified professionals.
Helping students succeed in school and their civilian lives is one of
the most important ways we can thank them for their service.
Tragically, the suicide rate among our veterans now is estimated to
be anywhere from 17 to 22 suicides a day. Forty-six percent of military
students
[[Page H5853]]
have reported suicidal thoughts, compared with only 6 percent of their
nonmilitary peers.
If we can provide mental health services that are able to assist just
a single veteran who is contemplating suicide to choose to live, I
believe it is our sworn duty to do so. We have that opportunity now.
I am proud to support the STRONG Veterans Act, and I am very grateful
to Chairman Takano and Ranking Member Bost for including my bill, the
Student Veterans Counseling Center Eligibility Act. I urge my
colleagues to vote ``yes'' on H.R. 6411 in support of our Nation's
veterans.
Mr. LEVIN of California. Madam Speaker, I reserve the balance of my
time.
Mr. BOST. Madam Speaker, I yield 2 minutes to the gentleman from
North Carolina (Mr. Rouzer).
Mr. ROUZER. Madam Speaker, after hearing from my constituent whose
veteran spouse tragically died by suicide, and learning of the
obstacles they faced when trying to receive critical mental health
support for themselves and their children following his death, I
introduced a bill to ensure veteran families struggling from such a
loss have access to the support they need and deserve.
My legislative language, included in this bill before us today, the
STRONG Veterans Act, expands Vet Center eligibility for counseling and
mental health services to families of servicemembers or veterans who
died by suicide. This expansion of services is necessary so that these
families can receive the critical mental health support needed to help
them heal and move forward.
We all know that grief can be extremely isolating, and the families
of servicemembers and veterans who have died by suicide should not have
to worry about enduring this difficult journey alone.
Our military families who support a loved one who is serving, or has
served, make a tremendous sacrifice for our country, as well. We must
ensure they have access to the care that they deserve and the help that
they need when trying to move forward after a suicide has devastated
them and their family.
Madam Speaker, I thank the chairman and the ranking member for
working with me to include this very important piece of legislation in
this package, and I encourage my colleagues to support it.
Mr. LEVIN of California. Madam Speaker, I am prepared to close. I
reserve the balance of my time.
Mr. BOST. Madam Speaker, I yield myself the balance of my time.
First off, I say thank you to all the people who have worked on this
important piece of legislation for the support that it is has received.
The important thing is that we get the care, treatment, and support
for all the veterans who are considering suicide and the families who
suffer from the fact that they have done it.
Madam Speaker, I encourage all of my colleagues to support this bill,
and I yield back the balance of my time.
Mr. LEVIN of California. Madam Speaker, again, I ask all of my
colleagues to join me in passing H.R. 6411, as amended, and I yield
back the balance of my time.
Ms. JACKSON LEE. Madam Speaker, I rise in support of H.R. 6411, known
as the STRONG Veterans Act of 2022.
As a senior member of the House Committees on Judiciary and Homeland
Security, I care deeply about our veterans.
I offer my deepest gratitude to our Nation's troops and reservists,
their families, and the 21.6 million veterans, including 29,126 in the
18th Congressional District of Texas that I proudly represent.
In Congress, I have sponsored many legislative proposals and co-
sponsored well over 50 pieces of legislation that will positively
benefit our veterans and their families.
Veterans with mental health diagnoses have a significantly elevated
suicide risk. Suicide rates of veterans are at an all-time high, rising
25 percent in 2021 over the previous year. Veterans continue to have a
50 percent higher risk of suicide than their peers who have not served.
More than 80 percent of post-9/11 veterans say that the public does
not understand the problems that veterans face when transitioning to
civilian life.
Current resources to help the mental health of our veterans are
inadequate. Our veterans need our support when transitioning back to
civilian life.
The STRONG Veterans Act will:
Open eligibility for more student veterans at Vet Centers;
Expand culturally competent suicide prevention at VA for native
veterans;
Significantly increase mental health staffing and training at VA
medical centers and Vet Centers;
Further strengthen the Veterans Crisis Line;
Allow more veterans to benefit from engaging with peer specialists;
and
Collect data for VA to guide expansion of inpatient mental health and
substance use treatment.
I urge my colleagues to vote in favor of H.R. 6411.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from California (Mr. Levin) that the House suspend the rules
and pass the bill, H.R. 6411, 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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