[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 3293 Introduced in Senate (IS)]
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117th CONGRESS
1st Session
S. 3293
To expand access of veterans to mental health care from the Department
of Veterans Affairs, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
December 1, 2021
Mr. Tester (for himself and Mr. Moran) introduced the following bill;
which was read twice and referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To expand access of veterans to mental health care from 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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Post-9/11
Veterans' Mental Health Care Improvement Act of 2021''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--ACCESS TO CARE
Sec. 101. Improvement of sleep disorder care furnished by Department of
Veterans Affairs.
Sec. 102. Mental health consultations.
Sec. 103. Study on inpatient mental health and substance use care from
Department of Veterans Affairs.
Sec. 104. Study on treatment from Department of Veterans Affairs for
co-occurring mental health and substance
use disorders.
TITLE II--MENTAL HEALTH WORKFORCE
Sec. 201. Expansion of Vet Center workforce.
Sec. 202. Expansion of mental health training for Department of
Veterans Affairs.
Sec. 203. Expansion of scholarships and loan repayment programs for
mental health providers.
Sec. 204. Study on workload of suicide prevention teams of Department
of Veterans Affairs.
TITLE III--MENTAL HEALTH RESEARCH
Sec. 301. Expansion of suicide prevention and mental health research.
Sec. 302. Study on mental health and suicide prevention support for
military families.
Sec. 303. Research on brain health.
Sec. 304. Study on efficacy of clinical and at-home resources for post-
traumatic stress disorder.
TITLE I--ACCESS TO CARE
SEC. 101. 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. 102. 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 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 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.''.
(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 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.''.
SEC. 103. 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. 104. 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.
TITLE II--MENTAL HEALTH WORKFORCE
SEC. 201. EXPANSION OF VET CENTER WORKFORCE.
(a) In General.--Not later than one year after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall hire an
additional 100 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. 202. 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, 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 500
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. 203. 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.
SEC. 204. 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
(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.
TITLE III--MENTAL HEALTH RESEARCH
SEC. 301. EXPANSION OF SUICIDE PREVENTION AND MENTAL HEALTH RESEARCH.
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. 302. 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) Military support organization.--The term
``military support organization'' has the meaning given
that term by the Secretary of Defense.
(B) Veterans service organization.--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. 303. 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
post-9/11 veterans with traumatic brain injury or post-traumatic stress
disorder.
SEC. 304. 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, 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.
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