[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5867 Introduced in House (IH)]
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116th CONGRESS
2d Session
H. R. 5867
To direct the Secretary of Veterans Affairs to establish or update
certain clinical practice guidelines of the Department of Veterans
Affairs, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 12, 2020
Mr. Cisneros (for himself and Mr. Mast) introduced the following bill;
which was referred to the Committee on Veterans' Affairs, and in
addition to the Committees on Armed Services, and Energy and Commerce,
for a period to be subsequently determined by the Speaker, in each case
for consideration of such provisions as fall within the jurisdiction of
the committee concerned
_______________________________________________________________________
A BILL
To direct the Secretary of Veterans Affairs to establish or update
certain clinical practice guidelines of the Department of Veterans
Affairs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Setting Treatment Options and
Practices for Veteran Suicide and Substance Abuse Act'' or the ``STOP
Veteran Suicide and Substance Abuse Act''.
SEC. 2. ESTABLISHMENT BY DEPARTMENT OF VETERANS AFFAIRS AND DEPARTMENT
OF DEFENSE OF CLINICAL PRACTICE GUIDELINES FOR COMORBID
MENTAL HEALTH CONDITIONS SUCH AS PTSD, MST, AND/OR TBI.
(a) In General.--Not later than two years after the date of the
enactment of this Act, the Secretary of Veterans Affairs, in
consultation with the Secretary of Defense and the Secretary of Health
and Human Services, shall complete the development of clinical practice
guidelines for the treatment of post-traumatic stress disorder,
military sexual trauma, and traumatic brain injury that is comorbid
with substance use disorder or chronic pain.
(b) Work Group.--
(1) Establishment.--In carrying out subsection (a), the
Secretary of Veterans Affairs, the Secretary of Defense, and
the Secretary of Health and Human Services shall create a
Trauma and Comorbid Substance Use Disorder or Chronic Pain Work
Group (in this section referred to as the ``Work Group'').
(2) Membership.--The work group created under paragraph (1)
shall be comprised of individuals that represent Federal
Government entities and non-Federal Government entities with
expertise in the areas covered by the work group, including the
following:
(A) Academic institutions that specialize in
research for the treatment of conditions described in
subsection (a).
(B) The National Center for Posttraumatic Stress
Disorder of the Department of Veterans Affairs.
(C) The Office of the Assistant Secretary for
Mental Health and Substance Use of the Department of
Health and Human Services.
(3) Relation to other work groups.--The Work Group shall be
created and conducted in the same manner as other work groups
for the development of clinical practice guidelines for the
Department of Veterans Affairs and the Department of Defense.
(c) Matters Included.--In developing the clinical practice
guidelines under subsection (a), the Work Group, in consultation with
the Post Traumatic Stress Disorder Work Group, Concussion-mTBI Work
Group, Opioid Therapy for Chronic Pain Work Group, and Substance Use
Work Group, shall ensure that the clinical practice guidelines include
the following:
(1) Guidance with respect to the following:
(A) The treatment of patients with post-traumatic
stress disorder who are also experiencing a substance
use disorder or chronic pain.
(B) The treatment of patients experiencing a mental
health condition, including anxiety, depression, or
post-traumatic stress disorder as a result of military
sexual trauma who are also experiencing a substance use
disorder or chronic pain.
(C) The treatment of patients with traumatic brain
injury who are also experiencing a substance use
disorder or chronic pain.
(2) Guidance with respect to the following:
(A) Appropriate case management for patients
experiencing post-traumatic stress disorder that is
comorbid with substance use disorder or chronic pain
who transition from receiving care while on active duty
in the Armed Forces to care from health care networks
outside of the Department of Defense.
(B) Appropriate case management for patients
experiencing a mental health condition, including
anxiety, depression, or post-traumatic stress disorder
as a result of military sexual trauma that is comorbid
with substance use disorder or chronic pain who
transition from receiving care while on active duty in
the Armed Forces to care from health care networks
outside of the Department of Defense.
(C) Appropriate case management for patients
experiencing traumatic brain injury that is comorbid
with substance use disorder or chronic pain who
transition from receiving care while on active duty in
the Armed Forces to care from health care networks
outside of the Department of Defense.
(3) Guidance with respect to the treatment of patients who
are still members of the Armed Forces and are experiencing a
mental health condition, including anxiety, depression, or
post-traumatic stress disorder as a result of military sexual
trauma that is comorbid with substance use disorder or chronic
pain.
(4) Guidance with respect to the assessment by the National
Academies of Sciences, Engineering, and Medicine of the
potential overmedication of veterans, as required pursuant to
the Senate report accompanying S. 1557, 115th Congress (Senate
Report 115-130), under the heading ``Overprescription
Prevention Report'' under the heading ``committee
recommendation''.
(d) Rule of Construction.--Nothing in this section shall be
construed to prevent the Secretary of Veterans Affairs and the
Secretary of Defense from considering all relevant evidence, as
appropriate, in creating the clinical practice guidelines required
under subsection (a) or from ensuring that the final clinical practice
guidelines developed under such subsection and subsequently updated, as
appropriate, remain applicable to the patient populations of the
Department of Veterans Affairs and the Department of Defense.
SEC. 3. UPDATE OF CLINICAL PRACTICE GUIDELINES FOR ASSESSMENT AND
MANAGEMENT OF PATIENTS AT RISK FOR SUICIDE BY TAKING INTO
CONSIDERATION GENDER- AND AGE-SPECIFIC RISK FACTORS AND
GENDER- AND AGE-SPECIFIC TREATMENT EFFICACY OF
PHARMACOTHERAPY AND PSYCHOTHERAPY.
(a) In General.--Not later than two years after the date of the
enactment of this Act, the Secretary of Veterans Affairs and the
Secretary of Defense, through the Assessment and Management of Patients
at Risk for Suicide Work Group (in this section referred to as the
``Work Group''), shall issue an update to the VA/DOD Clinical Practice
Guideline for Assessment and Management of Patients at Risk for
Suicide.
(b) Matters Included.--In carrying out the update under subsection
(a), the Work Group shall ensure that the clinical practice guidelines
updated under such subsection includes the following:
(1) Enhanced guidance with respect to the following:
(A) Gender- and age-specific risk factors for
suicide and suicidal ideation.
(B) Gender- and age-specific treatment efficacy for
depression and suicide prevention.
(C) Gender- and age-specific pharmacotherapy
efficacy.
(D) Gender- and age-specific psychotherapy
efficacy.
(2) Guidance with respect to the efficacy of alternative
therapies, other than psychotherapy and pharmacotherapy,
including the following:
(A) Yoga therapy.
(B) Meditation therapy.
(C) Equine therapy.
(D) Other animal therapy.
(E) Training and caring for service dogs.
(F) Agri-therapy.
(G) Art therapy.
(H) Outdoor sports therapy.
(I) Music therapy.
(J) Any other alternative therapy that the Work
Group considers appropriate.
(3) Guidance with respect to the findings of the Creating
Options for Veterans' Expedited Recovery Commission (commonly
referred to as the ``COVER Commission'') established under
section 931 of the Jason Simcakoski Memorial and Promise Act
(title IX of Public Law 114-198; 38 U.S.C. 1701 note).
(c) Rule of Construction.--Nothing in this section shall be
construed to prevent the Secretary of Veterans Affairs and the
Secretary of Defense from considering all relevant evidence, as
appropriate, in updating the VA/DOD Clinical Practice Guideline for
Assessment and Management of Patients at Risk for Suicide, as required
under subsection (a), or from ensuring that the final clinical practice
guidelines updated under such subsection remain applicable to the
patient populations of the Department of Veterans Affairs and the
Department of Defense.
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