[House Report 115-687]
[From the U.S. Government Publishing Office]


115th Congress     }                                    {       Report
                        HOUSE OF REPRESENTATIVES
 2d Session        }                                    {      115-687

======================================================================

 
 TO DIRECT THE SECRETARY OF VETERANS AFFAIRS TO INCREASE THE NUMBER OF 
 PEER-TO-PEER COUNSELORS PROVIDING COUNSELING FOR WOMEN VETERANS, AND 
                           FOR OTHER PURPOSES

                                _______
                                

  May 18, 2018.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

    Mr. Roe of Tennessee, from the Committee on Veterans' Affairs, 
                        submitted the following

                              R E P O R T

                        [To accompany H.R. 4635]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Veterans' Affairs, to whom was referred 
the bill (H.R. 4635) to direct the Secretary of Veterans 
Affairs to increase the number of peer-to-peer counselors 
providing counseling for women veterans, and for other 
purposes, having considered the same, report favorably thereon 
with an amendment and recommend that the bill as amended do 
pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     3
Background and Need for Legislation..............................     3
Hearings.........................................................     4
Subcommittee Consideration.......................................     5
Committee Consideration..........................................     5
Committee Votes..................................................     5
Committee Oversight Findings.....................................     5
Statement of General Performance Goals and Objectives............     5
New Budget Authority, Entitlement Authority, and Tax Expenditures     5
Earmarks and Tax and Tariff Benefits.............................     6
Committee Cost Estimate..........................................     6
Congressional Budget Office Estimate.............................     6
Federal Mandates Statement.......................................     7
Advisory Committee Statement.....................................     7
Constitutional Authority Statement...............................     7
Applicability to Legislative Branch..............................     7
Statement on Duplication of Federal Programs.....................     7
Disclosure of Directed Rulemaking................................     7
Section-by-Section Analysis of the Legislation...................     7
Changes in Existing Law Made by the Bill as Reported.............     8

    The amendment is as follows:
    Strike all after the enacting clause and insert the 
following:

SECTION 1. PEER SUPPORT COUNSELING PROGRAM FOR WOMEN VETERANS.

  (a) In General.--Section 1720F(j) of title 38, United States Code, is 
amended by adding at the end the following new paragraph:
  ``(4)(A) As part of the counseling program under this subsection, the 
Secretary shall emphasize appointing peer support counselors for women 
veterans. To the degree practicable, the Secretary shall seek to 
recruit women peer support counselors with expertise in--
          ``(i) female gender-specific issues and services;
          ``(ii) the provision of information about services and 
        benefits provided under laws administered by the Secretary; or
          ``(iii) employment mentoring.
  ``(B) To the degree practicable, the Secretary shall emphasize 
facilitating peer support counseling for women veterans who are 
eligible for counseling and services under section 1720D of this title, 
have post-traumatic stress disorder or suffer from another mental 
health condition, are homeless or at risk of becoming homeless, or are 
otherwise at increased risk of suicide, as determined by the Secretary.
  ``(C) The Secretary shall conduct outreach to inform women veterans 
about the program and the assistance available under this paragraph.
  ``(D) In carrying out this paragraph, the Secretary shall coordinate 
with such community organizations, State and local governments, 
institutions of higher education, chambers of commerce, local business 
organizations, organizations that provide legal assistance, and other 
organizations as the Secretary considers appropriate.
  ``(E) In carrying out this paragraph, the Secretary shall provide 
adequate training for peer support counselors, including training 
carried out under the national program of training required by section 
304(c) of the Caregivers and Veterans Omnibus Health Services Act of 
2010 (38 U.S.C. 1712A note).''.
  (b) Funding.--The Secretary of Veterans Affairs shall carry out 
paragraph (4) of section 1720F(j) of title 38, United States Code, as 
added by subsection (a), using funds otherwise made available to the 
Secretary. No additional funds are authorized to be appropriated by 
reason of such paragraph.
  (c) Report to Congress.--Not later than two years after the date of 
the enactment of this Act, the Secretary of Veterans Affairs shall 
submit to the Committees on Veterans' Affairs of the Senate and House 
of Representatives a report on the peer support counseling program 
under section 1720F(j) of title 38, United States Code, as amended by 
this section. Such report shall include--
          (1) the number of peer support counselors in the program;
          (2) an assessment of the effectiveness of the program; and
          (3) a description of the oversight of the program.

  Amendment in the Nature of a Substitute to H.R. 4635 Offered by Mr. 
                          Coffman of Colorado


  Strike all after the enacting clause and insert the 
following:

SECTION 1. PEER SUPPORT COUNSELING PROGRAM FOR WOMEN VETERANS.

  (a) In General.--Section 1720F(j) of title 38, United States 
Code, is amended by adding at the end the following new 
paragraph:
  ``(4)(A) As part of the counseling program under this 
subsection, the Secretary shall emphasize appointing peer 
support counselors for women veterans. To the degree 
practicable, the Secretary shall seek to recruit women peer 
support counselors with expertise in--
          ``(i) female gender-specific issues and services;
          ``(ii) the provision of information about services 
        and benefits provided under laws administered by the 
        Secretary; or
          ``(iii) employment mentoring.
  ``(B) To the degree practicable, the Secretary shall 
emphasize facilitating peer support counseling for women 
veterans who are eligible for counseling and services under 
section 1720D of this title, have post-traumatic stress 
disorder or suffer from another mental health condition, are 
homeless or at risk of becoming homeless, or are otherwise at 
increased risk of suicide, as determined by the Secretary.
  ``(C) The Secretary shall conduct outreach to inform women 
veterans about the program and the assistance available under 
this paragraph.
  ``(D) In carrying out this paragraph, the Secretary shall 
coordinate with such community organizations, State and local 
governments, institutions of higher education, chambers of 
commerce, local business organizations, organizations that 
provide legal assistance, and other organizations as the 
Secretary considers appropriate.
  ``(E) In carrying out this paragraph, the Secretary shall 
provide adequate training for peer support counselors, 
including training carried out under the national program of 
training required by section 304(c) of the Caregivers and 
Veterans Omnibus Health Services Act of 2010 (38 U.S.C. 1712A 
note).''.
  (b) Funding.--The Secretary of Veterans Affairs shall carry 
out paragraph (4) of section 1720F(j) of title 38, United 
States Code, as added by subsection (a), using funds otherwise 
made available to the Secretary. No additional funds are 
authorized to be appropriated by reason of such paragraph.
  (c) Report to Congress.--Not later than two years after the 
date of the enactment of this Act, the Secretary of Veterans 
Affairs shall submit to the Committees on Veterans' Affairs of 
the Senate and House of Representatives a report on the peer 
support counseling program under section 1720F(j) of title 38, 
United States Code, as amended by this section. Such report 
shall include--
          (1) the number of peer support counselors in the 
        program;
          (2) an assessment of the effectiveness of the 
        program; and
          (3) a description of the oversight of the program.

                          Purpose and Summary

    H.R. 4635, as amended, would require the Department of 
Veterans Affairs (VA) to ensure that the existing peer support 
counseling program includes peer counselors for women veterans. 
Representative Mike Coffman of Colorado introduced H.R. 4635 on 
December 13, 2017.

                  Background and Need for Legislation

    With a population of almost 2 million and growing, women 
represent an increasingly significant segment of the veteran 
population.\1\ However, there are indications that military 
service and veteran status may affect women differently than 
men and that women veterans may lack equitable access to peer 
support opportunities during and after their transition from 
military service. For example, a 2014 report by the Disabled 
American Veterans (DAV) found that women face barriers to 
recognition as veterans and to VA services and benefits.\2\ 
According to DAV, ``[t]he vast majority of these deficiencies 
result from a disregard for the differing needs of women 
veterans and a focusing on the 80 percent solutions for men who 
dominate in both numbers and the public consciousness.''\3\
---------------------------------------------------------------------------
    \1\U.S. Department of Veterans Affairs, Office of Suicide 
Prevention. Suicide among Veterans and Other Americans 2001-2014. 
August 3, 2016. https://www.mentalhealth.va.gov/docs/
2016suicidedatareport.pdf
    \2\Disabled American Veterans. Women Veterans: The Long Journey 
Home. September 24, 2014. https://www.dav.org/wp-content/uploads/women-
veterans-study.pdf.
    \3\Ibid.
---------------------------------------------------------------------------
    Section 1720F(j) of title 38 United States Code (U.S.C.) 
requires VA's comprehensive program for suicide prevention 
among veterans to include a peer support counseling program 
under which veterans are allowed to volunteer to serve as peer 
counselors to assist other veterans with mental health and 
readjustment issues and to conduct outreach to veterans and 
their families. The Committee strongly supports this and other 
VA peer support programs and believes them to be beneficial in 
assisting veterans, particularly those who are struggling with 
mental health or substance abuse issues, achieve successful 
recovery and reintegration, reduce stigma, and increase 
adherence to plans of care. However, the Committee is concerned 
that the existing volunteer peer support counselor program may 
not include sufficient volunteer peer support counselors who 
are women veterans or who are fluent in issues important to 
woman veterans.
    Section 2 of the bill would require that, when carrying out 
the existing volunteer peer support counseling program, VA 
emphasize appointing volunteer peer support counselors for 
women veterans and, to the extent practicable, seek to recruit 
volunteer peer support counselors for women veterans with 
certain relevant expertise. To ensure such volunteer peer 
support counselors are paired with the veterans most in need of 
their services, section 2 of the bill would further require 
that VA emphasize assigning volunteer peer support counselors 
to women veterans who have experienced military sexual trauma, 
have been diagnosed with post-traumatic stress disorder (PTSD) 
or another mental health condition, are homeless or at-risk of 
homelessness, or are otherwise at an increased risk of suicide 
as determined by VA. VA would also be required to conduct 
outreach to women veterans regarding the availability of 
volunteer peer support counselors and to report to Congress on 
the volunteer peer support counseling program. It is the 
Committee's expectation that, to the extent possible, VA will 
make a reasonable effort to recruit a sufficient number of 
women volunteer peer support counselors to meet the demand for 
such counselors across the VA healthcare system, recognizing 
that such demand will vary from facility to facility and that 
VA's ability to recruit volunteers may also vary.

                                Hearings

    On April 17, 2018, the Subcommittee on Health conducted a 
legislative hearing on a number of bills including H.R. 4635.
    The following witnesses testified:
          The Honorable Beto O'Rourke, U.S. House of 
        Representatives, 16th District, Texas; The Honorable 
        Tim Walberg, U.S. House of Representatives, 7th 
        District; Michigan; The Honorable Neal Dunn, U.S. House 
        of Representatives, 2nd District, Florida; The 
        Honorable Luis Correa, U.S. House of Representatives, 
        46th District, California; The Honorable Mike Coffman, 
        U.S. House of Representatives, 6th District, Colorado; 
        Louis J. Celli, Director, National Veterans Affairs and 
        Rehabilitation Division, The American Legion; Adrian M. 
        Atizado, Deputy National Legislative Director, Disabled 
        American Veterans; Sarah S. Dean, Associate Legislative 
        Director, Paralyzed Veterans of America; and Kayda 
        Keleher, Associate Director, National Legislative 
        Service, Veterans of Foreign Wars of the United States.
    Statements for the record were submitted by:
          The Elizabeth Dole Foundation; the Independence Fund; 
        Veteran Cannabis Project; Wounded Warrior Project; and 
        Iraq and Afghanistan Veterans of America.

                       Subcommittee Consideration

    There was no Subcommittee consideration of H.R. 4635.

                        Committee Consideration

    On May 8, 2018, the full Committee met in open markup 
session, a quorum being present, and ordered H.R. 4635, as 
amended, to be reported favorably to the House of 
Representatives by voice vote. During consideration of the 
bill, the following amendment was considered and agreed to by 
voice vote:
          An amendment in the nature of a substitute offered by 
        Representative Mike Coffman of Colorado.

                            Committee Votes

    In compliance with clause 3(b) of rule XIII of the Rules of 
the House of Representatives, there were no recorded votes 
taken on amendments or in connection with ordering H.R. 4635, 
as amended, reported to the House. A motion by Representative 
Tim Walz of Minnesota, Ranking Member of the Committee on 
Veterans' Affairs, to report H.R. 4635, as amended, favorably 
to the House of Representatives was adopted by voice vote.

                      Committee Oversight Findings

    In compliance with clause 3(c)(1) of rule XIII and clause 
(2)(b)(1) of rule X of the Rules of the House of 
Representatives, the Committee's oversight findings and 
recommendations are reflected in the descriptive portions of 
this report.

         Statement of General Performance Goals and Objectives

    In accordance with clause 3(c)(4) of rule XIII of the Rules 
of the House of Representatives, the Committee's performance 
goals and objectives are to ensure that there is a sufficient 
availability of volunteer peer support counselors across the VA 
healthcare system to provide volunteer peer support counseling 
services to the growing population of women veterans.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee adopts as its 
own the estimate of new budget authority, entitlement 
authority, or tax expenditures or revenues contained in the 
cost estimate prepared by the Director of the Congressional 
Budget Office pursuant to section 402 of the Congressional 
Budget Act of 1974.

                  Earmarks and Tax and Tariff Benefits

    H.R. 4635, as amended, does not contain any Congressional 
earmarks, limited tax benefits, or limited tariff benefits as 
defined in clause 9 of rule XXI of the Rules of the House of 
Representatives.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate on H.R. 
4635, as amended, prepared by the Director of the Congressional 
Budget Office pursuant to section 402 of the Congressional 
Budget Act of 1974.

               Congressional Budget Office Cost Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
for H.R. 4635, as amended, provided by the Director of the 
Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                       Washington, DC, May 9, 2018.
Hon. Phil Roe, M.D.,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 4635, a bill to 
direct the Secretary of Veterans Affairs to increase the number 
of peer-to-peer counselors providing counseling for women 
veterans, and for other purposes.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Ann E. 
Futrell.
            Sincerely,
                                                Keith Hall,
                                                          Director.
    Enclosure.

H.R. 4635--A bill to direct the Secretary of Veterans Affairs to 
        increase the number of peer-to-peer counselors providing 
        counseling for women veterans, and for other purposes

    H.R. 4635 would require the Department of Veterans Affairs 
(VA) to attempt to recruit women as peer counselors. Under 
current law, VA operates the Peer Support Counseling Program 
where veterans voluntarily provide support to fellow veterans 
on issues related to mental health care and readjustment. The 
bill would direct VA to place an emphasis on appointing and 
training volunteer peer counselors for women veterans and to 
submit a report to the Congress providing an assessment of the 
program. On the basis of information from VA, CBO estimates 
that this bill would cost less than $500,000 over the 2019-2023 
period to expand the training curriculum and prepare a report 
on the program; that spending would be subject to the 
availability of appropriated funds.
    Enacting H.R. 4635 would not affect direct spending or 
revenues; therefore, pay-as-you-go procedures do not apply.
    CBO estimates that enacting H.R. 4635 would not increase 
net direct spending or on-budget deficits in any of the four 
consecutive 10-year periods beginning in 2029.
    H.R. 4635 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act.
    The CBO staff contact for this estimate is Ann E. Futrell. 
The estimate was reviewed by Leo Lex, Deputy Assistant Director 
for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates regarding H.R. 4635, as amended, prepared by the 
Director of the Congressional Budget Office pursuant to section 
423 of the Unfunded Mandates Reform Act.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act would be created by H.R. 
4635, as amended.

                 Statement of Constitutional Authority

    Pursuant to Article I, section 8 of the United States 
Constitution, H.R. 4635, as amended, is authorized by Congress' 
power to ``provide for the common Defense and general Welfare 
of the United States.''

                  Applicability to Legislative Branch

    The Committee finds that H.R. 4635, as amended, does not 
relate to the terms and conditions of employment or access to 
public services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

              Statement on Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that no provision 
of H.R. 4635, as amended, establishes or reauthorizes a program 
of the Federal Government known to be duplicative of another 
Federal program, a program that was included in any report from 
the Government Accountability Office to Congress pursuant to 
section 21 of Public Law 111-139, or a program related to a 
program identified in the most recent Catalog of Federal 
Domestic Assistance.

                   Disclosure of Directed Rulemaking

    Pursuant to section 3(i) of H. Res. 5, 115th Cong. (2017), 
the Committee estimates that H.R. 4635, as amended, contains no 
directed rulemaking that would require the Secretary to 
prescribe regulations.

             Section-by-Section Analysis of the Legislation


Section 1. Peer support counseling program for women veterans

    Section 1(a) of the bill would amend section 1720F(j) of 
title 38 U.S.C. by adding at the end a new paragraph 
1720F(j)(4).
    The new paragraph 1720F(j)(4)(A) would require VA, as part 
of the counseling program under this subsection, to emphasize 
appointing peer support counselors for women veterans and, to 
the degree practicable, to seek to recruit women peer support 
counselors with expertise in female gender specific issues and 
services, the provision of information about services and 
benefits provided under laws administered by VA, or employment 
mentoring.
    The new paragraph 1720F(j)(4)(B) would require VA, to the 
extent practicable, to emphasize facilitating peer support 
counseling for women veterans who are eligible for counseling 
and services under section 1720D of title 38 U.S.C., have PTSD 
or suffer from another mental health condition, are homeless or 
at risk of becoming homeless, or are otherwise at increased 
risk of suicide as determined by VA.
    The new paragraph 1720F(j)(4)(C) would require VA to 
conduct outreach to inform women veterans about the program and 
the assistance available under the volunteer peer support 
counseling program.
    The new paragraph 1720F(j)(4)(D) would require VA to 
coordinate with such community organizations, State and local 
governments, institutions of higher education, chambers of 
commerce, local business organizations, organizations that 
provide legal assistance, and other organizations as VA 
considers appropriate.
    The new paragraph 1720F(j)(4)(E) would require VA to 
provide adequate training for peer support counselors including 
training carried out under the national program of training 
required by section 304(c) of the Caregivers and Veterans 
Omnibus Health Services Act of 2010 (38 U.S.C. 1712A note).
    Section 1(b) of the bill would require VA to carry out 
paragraph (4) of section 1720F(j) of title 38 U.S.C. as added 
by subsection 1(a) of the bill using funds otherwise made 
available to VA and stipulate that no additional funds are 
authorized to be appropriated by reason of such paragraph.
    Section 1(c) of the bill would require VA, not later than 
two years after the date of enactment, to submit to the 
Committees on Veterans' Affairs of the Senate and House of 
Representatives a report on the peer support counseling program 
under section 1720F(j) of title 38 U.S.C. as amended by section 
1(a) of the bill and require such report to include the number 
of peer support counselors in the program, an assessment of the 
effectiveness of the program, and a description of the 
oversight of the program.

         Changes in Existing Law Made by the Bill, as Reported

    In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman):

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italic and existing law in which no change is 
proposed is shown in roman):

                      TITLE 38, UNITED STATES CODE




           *       *       *       *       *       *       *
PART II--GENERAL BENEFITS

           *       *       *       *       *       *       *


CHAPTER 17--HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE

           *       *       *       *       *       *       *



SUBCHAPTER II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL 
TREATMENT

           *       *       *       *       *       *       *



Sec. 1720F. Comprehensive program for suicide prevention among veterans

  (a) Establishment.--The Secretary shall develop and carry out 
a comprehensive program designed to reduce the incidence of 
suicide among veterans incorporating the components described 
in this section.
  (b) Staff Education.--In carrying out the comprehensive 
program under this section, the Secretary shall provide for 
mandatory training for appropriate staff and contractors 
(including all medical personnel) of the Department who 
interact with veterans. This training shall cover information 
appropriate to the duties being performed by such staff and 
contractors. The training shall include information on--
          (1) recognizing risk factors for suicide;
          (2) proper protocols for responding to crisis 
        situations involving veterans who may be at high risk 
        for suicide; and
          (3) best practices for suicide prevention.
  (c) Health Assessments of Veterans.--In carrying out the 
comprehensive program, the Secretary shall direct that medical 
staff offer mental health in their overall health assessment 
when veterans seek medical care at a Department medical 
facility (including a center established under section 1712A of 
this title) and make referrals, at the request of the veteran 
concerned, to appropriate counseling and treatment programs for 
veterans who show signs or symptoms of mental health problems.
  (d) Designation of Suicide Prevention Counselors.--In 
carrying out the comprehensive program, the Secretary shall 
designate a suicide prevention counselor at each Department 
medical facility other than centers established under section 
1712A of this title. Each counselor shall work with local 
emergency rooms, police departments, mental health 
organizations, and veterans service organizations to engage in 
outreach to veterans and improve the coordination of mental 
health care to veterans.
  (e) Best Practices Research.--In carrying out the 
comprehensive program, the Secretary shall provide for research 
on best practices for suicide prevention among veterans. 
Research shall be conducted under this subsection in 
consultation with the heads of the following entities:
          (1) The Department of Health and Human Services.
          (2) The National Institute of Mental Health.
          (3) The Substance Abuse and Mental Health Services 
        Administration.
          (4) The Centers for Disease Control and Prevention.
  (f) Sexual Trauma Research.--In carrying out the 
comprehensive program, the Secretary shall provide for research 
on mental health care for veterans who have experienced sexual 
trauma while in military service. The research design shall 
include consideration of veterans of a reserve component.
  (g) 24-Hour Mental Health Care.--In carrying out the 
comprehensive program, the Secretary shall provide for mental 
health care availability to veterans on a 24-hour basis.
  (h) Hotline.--In carrying out the comprehensive program, the 
Secretary may provide for a toll-free hotline for veterans to 
be staffed by appropriately trained mental health personnel and 
available at all times.
  (i) Outreach and Education for Veterans and Families.--In 
carrying out the comprehensive program, the Secretary shall 
provide for outreach to and education for veterans and the 
families of veterans, with special emphasis on providing 
information to veterans of Operation Iraqi Freedom and 
Operation Enduring Freedom and the families of such veterans. 
Education to promote mental health shall include information 
designed to--
          (1) remove the stigma associated with mental illness;
          (2) encourage veterans to seek treatment and 
        assistance for mental illness;
          (3) promote skills for coping with mental illness; 
        and
          (4) help families of veterans with--
                  (A) understanding issues arising from the 
                readjustment of veterans to civilian life;
                  (B) identifying signs and symptoms of mental 
                illness; and
                  (C) encouraging veterans to seek assistance 
                for mental illness.
  (j) Peer Support Counseling Program.--(1) In carrying out the 
comprehensive program, the Secretary shall establish and carry 
out a peer support counseling program, under which veterans 
shall be permitted to volunteer as peer counselors--
          (A) to assist other veterans with issues related to 
        mental health and readjustment; and
          (B) to conduct outreach to veterans and the families 
        of veterans.
  (2) In carrying out the peer support counseling program under 
this subsection, the Secretary shall provide adequate training 
for peer counselors, including training carried out under the 
national program of training required by section 304(c) of the 
Caregivers and Veterans Omnibus Health Services Act of 2010 (38 
U.S.C. 1712A note).
  (3) In addition to other locations the Secretary considers 
appropriate, the Secretary shall carry out the peer support 
program under this subsection at each Department medical 
center.
  (4)(A) As part of the counseling program under this 
subsection, the Secretary shall emphasize appointing peer 
support counselors for women veterans. To the degree 
practicable, the Secretary shall seek to recruit women peer 
support counselors with expertise in--
          (i) female gender-specific issues and services;
          (ii) the provision of information about services and 
        benefits provided under laws administered by the 
        Secretary; or
          (iii) employment mentoring.
  (B) To the degree practicable, the Secretary shall emphasize 
facilitating peer support counseling for women veterans who are 
eligible for counseling and services under section 1720D of 
this title, have post-traumatic stress disorder or suffer from 
another mental health condition, are homeless or at risk of 
becoming homeless, or are otherwise at increased risk of 
suicide, as determined by the Secretary.
  (C) The Secretary shall conduct outreach to inform women 
veterans about the program and the assistance available under 
this paragraph.
  (D) In carrying out this paragraph, the Secretary shall 
coordinate with such community organizations, State and local 
governments, institutions of higher education, chambers of 
commerce, local business organizations, organizations that 
provide legal assistance, and other organizations as the 
Secretary considers appropriate.
  (E) In carrying out this paragraph, the Secretary shall 
provide adequate training for peer support counselors, 
including training carried out under the national program of 
training required by section 304(c) of the Caregivers and 
Veterans Omnibus Health Services Act of 2010 (38 U.S.C. 1712A 
note).
  (k) Other Components.--In carrying out the comprehensive 
program, the Secretary may provide for other actions to reduce 
the incidence of suicide among veterans that the Secretary 
considers appropriate.

           *       *       *       *       *       *       *


                                  [all]