[Pages S5397-S5398]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              VETERANS MENTAL HEALTH CARE IMPROVEMENT ACT

  Mr. CASSIDY. Mr. President, I rise today to speak to a very important 
piece of legislation, which quietly passed this Chamber last week. It 
included several provisions I authored and offered based upon my 
experience as a physician that specifically provides mental health 
support to America's veterans.
  We all agree, we owe the men and women who fought and fight for this 
country a tremendous debt of gratitude for the sacrifices they made to 
preserve our freedom. It is dangerous, and our servicemembers answer 
the call. Many carry scars from injuries sustained during that service.
  But there are scars that we cannot see. Service can take a physical 
toll but also a mental one. Too many veterans struggle with mental 
health issues and suicidal thoughts. About 17 veterans per day from all 
of our wars put together take their own lives. For comparison, 22 
servicemembers were killed in combat in Afghanistan throughout all of 
2019. We are losing thousands more veterans at home than we are losing 
fighting men and women in the field. That is something to ponder.
  We must do a better job of leading the mental health needs of 
veterans. Thankfully, this Chamber took a big step forward last week 
when we passed the Commander John Scott Hannon Veterans Mental Health 
Care Improvement Act.
  The bill improves outreach to veterans and offers new mental 
healthcare options in five major ways: First, the bill bolsters the 
VA's mental health workforce to serve more veterans. It gives the VA 
direct hiring authority for mental health professionals. The VA can 
offer scholarships to mental health professionals to work at vet 
centers, and it provides for at least one suicide prevention 
coordinator at every Veterans' Administration Hospital.
  It improves rural veterans' access to mental healthcare by increasing 
the number of locations where veterans can access VA telehealth 
services. It also offers grants to non-VA organizations that provide 
mental health services or alternative treatments to veterans.
  The bill strengthens support and assistance for servicemembers 
transitioning out of the military by automatically giving every 
servicemember a full year of VA healthcare when they leave the 
military.
  By the way, this came to my mind: It turns out that most suicides 
occur within 6 weeks of one of our soldiers or sailors or marines 
leaving the service; within 6 months of that departure is when they 
tend to commit suicide. But it is about 6 months before they first 
access VA services. We have to have this kind of transition point 
tightened and one that makes sure they all know they have VA benefits 
for that first year.
  The Veterans Mental Healthcare Improvement Act also studies and 
invests in innovative and alternative science-based treatment options. 
It invests in research on the impact of living at high altitudes, on 
veterans' suicide risk, and on identifying and treating other risk 
factors for mental health illness.
  It holds the VA accountable for its mental healthcare and suicide 
prevention efforts. It does this by examining

[[Page S5398]]

how the VA manages suicide prevention resources and how the VA provides 
care and information sharing for veterans seeking mental healthcare 
from both VA and community providers.
  This bill takes a strong, evidence-based approach to meeting 
veterans' needs that haven't always been given priority. It is 
encouraging to me that is bipartisan. At a time when we don't appear to 
agree on very much, we are able to deliver for our heroes.
  I am proud to have worked with my Democratic colleagues to write 
bills that were included in this package. Senator Tester and I 
partnered on the Promoting Coordination for Veteran Suicide Prevention 
Act. This bill, this amendment, ensures that a thorough review of 
veterans who die by suicide within 1 year of separation from the Armed 
Services is conducted jointly by both the Department of Defense and by 
the VA.
  As I mentioned, most suicides occur within 6 months of separating 
from service. If that is the case, then the Department of Defense can 
do a review of what are those risk factors and have a warm handoff to 
the Veterans' Administration Hospital. And because we made automatic 
that first year of service within the VA, that warm handoff can be 
taken without any impediments of is there coverage or is there not.
  There is also going to be a partnership between the mental health and 
suicide prevention experts in both the VA and DOD that will contribute 
to improved information sharing and help further close the gap in 
ensuring high-quality, seamless care between these two Departments, 
focusing on the serviceperson who has now become a veteran.
  Senator Tester and I also worked together on the VA Research Approval 
Efficiency Act. This provision authorizes the Veterans Administration 
to leverage accredited commercial institutional review boards for use 
in connection with VA-sponsored clinical research. Getting the VA 
commercial options for approving clinical trials will add much-needed 
efficiencies and begin to reduce the disparity with academic and other 
institutions that, today, lead in clinical trial administration.
  If we know that our treatments for those with mental illness often 
need to be improved, we want to give our veterans access to those 
improved treatments as soon as possible, but we also want to make sure 
that those treatments suit the needs of the veteran. You can only do 
this by encouraging that research activity with full consent of the 
veteran--full consent--by which she or he may participate in these 
trials for her benefit, his benefit, but also for the benefit of us 
all. This reform enables the VA to increase the caliber care it 
delivers to veterans in a variety of clinical areas.
  Senator Sinema and I introduced the Improving Mental Health Care for 
Veterans Act. This provision requires VA and DOD to establish a joint 
clinical practice guideline for treatment of serious mental illness. 
This commonsense approach builds on an already robust library of 
clinical practice guidelines that serve to standardize and reinforce 
treatment procedures in other areas.
  Just as a point, if someone is found to be well-controlled in a 
certain medical regimen but then they transition to another different 
care with a different formulary, then all the hard work to find just 
the right clinical pharmaceutical treatment program to keep the person 
balanced now has to be changed because the second department has a 
different formulary--a different set of drugs with which they wish to 
treat--all the good work done here is lost there.
  We wish to eliminate that possibility by making sure there is a 
common set of clinical guidelines so that somebody with stress is 
passed off and it is seamless, both in terms of the clinical care, but 
also the medicines which they may take.
  The passage of the Commander John Scott Hannon Veterans Mental Health 
Care Improvement Act is the culmination of a lot of hard work from both 
Democratic and Republican Senators. It now goes to the House for 
consideration. I urge the House to swiftly pass this legislation so 
that President Trump can sign it into law.
  This bill will have a direct, positive impact in the care the VA 
delivers to American veterans. They answered the call to serve our 
Nation; now, Congress must answer the call to better serve them.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. BOOZMAN. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Cassidy). Without objection, it is so 
ordered.

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