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114th Congress    }                                   {         Report
                        HOUSE OF REPRESENTATIVES
 1st Session      }                                   {        114-365

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



 
                 FEMALE VETERAN SUICIDE PREVENTION ACT

                                _______
                                

December 3, 2015.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

    Mr. Miller of Florida, from the Committee on Veterans' Affairs, 
                        submitted the following

                              R E P O R T

                        [To accompany H.R. 2915]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Veterans' Affairs, to whom was referred 
the bill (H.R. 2915) to amend title 38, United States Code, to 
direct the Secretary of Veterans Affairs to identify mental 
health care and suicide prevention programs and metrics that 
are effective in treating women veterans as part of the 
evaluation of such programs by the Secretary, having considered 
the same, report favorably thereon with amendments and 
recommend that the bill as amended do pass.

                                CONTENTS

                                                                   Page
Amendment........................................................     2
Purpose and Summary..............................................     3
Background and Need for Legislation..............................     3
Hearings.........................................................     4
Subcommittee Consideration.......................................     5
Committee Consideration..........................................     5
Committee Votes..................................................     6
Committee Oversight Findings.....................................     6
Statement of General Performance Goals and Objectives............     6
New Budget Authority, Entitlement Authority, and Tax Expenditures     6
Earmarks and Tax and Tariff Benefits.............................     6
Committee Cost Estimate..........................................     6
Congressional Budget Office Estimate.............................     6
Federal Mandates Statement.......................................     7
Advisory Committee Statement.....................................     8
Constitutional Authority Statement...............................     8
Applicability to Legislative Branch..............................     8
Statement on Duplication of Federal Programs.....................     8
Disclosure of Directed Rulemaking................................     8
Section-by-Section Analysis of the Legislation...................     8
Changes in Existing Law Made by the Bill as Reported.............     9

                               Amendment

    The amendments are as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Female Veteran Suicide Prevention 
Act''.

SEC. 2. SPECIFIC CONSIDERATION OF WOMEN VETERANS IN EVALUATION OF 
                    DEPARTMENT OF VETERANS AFFAIRS MENTAL HEALTH CARE 
                    AND SUICIDE PREVENTION PROGRAMS.

  Section 1709B(a)(2) of title 38, United States Code, is amended--
          (1) in subparagraph (A), by inserting before the semicolon 
        the following: ``, including specific metrics applicable to 
        women'';
          (2) in subparagraph (D), by striking ``and'' at the end;
          (3) in subparagraph (E), by striking the period at the end 
        and inserting ``; and''; and
          (4) by adding at the end the following new subparagraph:
          ``(F) identify the mental health care and suicide prevention 
        programs conducted by the Secretary that are most effective for 
        women veterans and such programs with the highest satisfaction 
        rates among women veterans.''.

SEC. 3. MENTAL HEALTH TREATMENT FOR VETERANS WHO SERVED IN CLASSIFIED 
                    MISSIONS.

  (a) Sense of Congress.--It is the sense of Congress that veterans who 
experience combat-related mental health wounds should have immediate, 
appropriate, and consistent access to comprehensive mental health care.
  (b) In General.--Subchapter II of chapter 17 of title 38, United 
States Code, is amended by adding at the end the following section:

``Sec. 1720H. Mental health treatment for veterans who served in 
                    classified missions

  ``(a) Establishment of Standards.--(1) The Secretary shall establish 
standards and procedures to ensure that each covered veteran may access 
mental health care provided by the Secretary in a manner that fully 
accommodates the obligation of the veteran to not improperly disclose 
classified information.
  ``(2) The Secretary shall disseminate guidance to employees of the 
Veterans Health Administration, including mental health professionals, 
on the standards and procedures established under paragraph (1) and how 
to best engage covered veterans during the course of mental health 
treatment with respect to classified information.
  ``(b) Identification.--In carrying out this section, the Secretary 
shall ensure that a veteran may elect to identify as a covered veteran 
on an appropriate form.
  ``(c) Definitions.--In this section:
          ``(1) The term `classified information' means any information 
        or material that has been determined by an official of the 
        United States pursuant to law, an Executive order, or 
        regulation to require protection against unauthorized 
        disclosure for reasons of national security.
          ``(2) The term `covered veteran' means a veteran who--
                  ``(A) is enrolled in the health care system 
                established under section 1705(a) of this title;
                  ``(B) is seeking mental health treatment; and
                  ``(C) in the course of serving in the Armed Forces, 
                participated in a sensitive mission or served in a 
                sensitive unit.
          ``(3) The term `sensitive mission' means a mission of the 
        Armed Forces that, at the time at which a covered veteran seeks 
        treatment, is classified.
          ``(4) The term `sensitive unit' has the meaning given that 
        term in section 130b(c)(4) of title 10.''.
  (c) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding after the item relating to section 
1720G the following new item:

``1720H. Mental health treatment for veterans who served in classified 
missions.''.

    Amend the title so as to read:
    A bill to amend title 38, United States Code, to direct the 
Secretary of Veterans Affairs to identify mental health care 
and suicide prevention programs and metrics that are effective 
in treating women veterans as part of the evaluation of such 
programs by the Secretary, and for other purposes.

                          Purpose and Summary

    H.R. 2915, the Female Veteran Suicide Prevention Act, was 
introduced by Representative Julia Brownley of California on 
June 25, 2015. H.R. 2915, as amended, incorporates the text of 
H.R. 2915 and includes provisions from H.R. 421, which was 
introduced by Representative Kyrsten Sinema of Arizona on 
January 20, 2015.
    H.R. 2915, as amended, would: (1) direct the Department of 
Veterans Affairs (VA) to identify mental health care and 
suicide prevention programs that are most effective and have 
the highest satisfaction rates among women veterans; and, (2) 
require VA to establish and disseminate standards and 
procedures to ensure that a veteran who participated in a 
classified mission or served in a sensitive unit while in the 
Armed Forces may access VA mental health care in a manner that 
fully accommodates his/her obligation not to improperly 
disclose classified information.

                  Background and Need for Legislation


Section 2--Specific consideration of women veterans in evaluation of 
        Department of Veterans Affairs mental health care and suicide 
        prevention programs

    Congress has long recognized the unacceptable rates of 
suicide among the nation's veterans. Most recently, Congress 
passed the Clay Hunt Suicide Prevention for American Veterans 
Act (P.L. 114-2, 129 Stat. 30), which requires an independent 
third party to evaluate VA mental health care and suicide 
prevention programs, to include: (1) metrics that are common 
and useful for mental health and suicide prevention 
practitioners; (2) identify most effective programs; (3) 
identify the cost-effectiveness of each program; and (4) 
propose best practices.
    VA's most recent suicide data report was released on 
February 1, 2013.\1\ That report found that 18 to 22 veterans 
per day die as a result of suicide, a number that has remained 
stable since 1999 despite significant increases in VA's mental 
health and suicide prevention budget, programs, and staff. In 
January 2014, VA released an update to the 2012 Suicide Data 
Report that found increases in the suicide rate in female users 
of the VA health care system. Importantly, this update found 
increases in the suicide rate among female veterans who use the 
VA health care system.\2\ This finding echoes recent research 
that found female veterans commit suicide at nearly six times 
the rate of other women,\3\ and that women veterans are five 
times more likely to commit suicide than male veterans.\4\ 
These findings call into question the efficacy of VA's mental 
health and suicide prevention programs for female veterans and 
highlight the need for an increased focus on mental health care 
and suicide prevention efforts among women, who are one of the 
fastest growing subpopulations of veterans. However, most of 
VA's research regarding suicide has focused on male veterans, 
who account for more than 90% of the veteran population.
---------------------------------------------------------------------------
    \1\See, Suicide Data Report, 2012, Department of Veterans Affairs 
Mental Health Services Suicide Prevention Program, http://www.va.gov/
opa/docs/suicide-data-report-2012-final.pdf.
    \2\See, Suicide Rates in VHA Patients through 2011 with Comparisons 
with Other Americans and other Veterans through 2012, http://
www.mentalhealth.va.gov/docs/Suicide_Data_
Report_Update_January_2014.pdf.
    \3\See,``Suicide rate of female military veterans is called 
`staggering''', Los Angeles Times, June 8, 2015. http://
www.latimes.com/nation/la-na-female-veteran-suicide-20150608-
story.html.
    \4\See, ``Changes in Suicide Mortality for Veterans and Nonveterans 
by Gender and History of VHA Service Use, 2000--2010'', Psychiatric 
Services, Volume 66, Issue 9, September 01, 2015.
---------------------------------------------------------------------------
    Section 2 would amend the Clay Hunt Suicide Prevention for 
American Veterans Act to include, within the independent third 
party evaluation, specific metrics applicable to women and to 
identify the VA mental health care and suicide prevention 
programs that are most effective and have the highest patient 
satisfaction rates among women veterans.

Section 3--Mental health treatment of veterans who serve in classified 
        missions

    The Committee believes that providing veterans in need with 
accessible, high-quality, and responsive mental health care is 
one of VA's most important missions. The Department alleges 
that VA mental health providers treating veterans who served on 
sensitive or classified missions during their military service 
ensure that the treatment that is provided to these veterans 
does not compromise their need for confidentiality. However, 
serious concerns have been raised about the provision of mental 
health care to these veterans following the suicide death of 
Sergeant Daniel Somers, who had served on a number of 
classified missions and was enrolled in VA group therapy 
sessions despite his fears about inadvertently sharing 
classified information in that setting. Sergeant Somers' 
military service was largely classified and could not be 
discussed with anyone lacking appropriate clearance. Enrolling 
him in group therapy sessions over his objections created an 
environment in which he felt that he was unable to seek care 
due to his national security obligations. Tragically, Sergeant 
Somers committed suicide in June 2013.
    Section 3 of the bill would direct VA to establish 
standards and procedures to ensure that veterans who 
participated in classified missions or served in sensitive 
units may access mental health care in a manner that fully 
accommodates their obligation to not improperly disclose 
classified information. The Committee urges the Secretary to 
develop procedures to ensure that mental health professionals 
caring for these veterans have appropriate security clearances, 
as needed. VA would also be required to disseminate guidance to 
VA employees--including mental health professionals--on these 
standards and procedures and on how to best engage veterans 
during the course of their mental health treatment with respect 
to classified information. This provision would require the 
Department to find alternative methods of mental health 
treatment for veterans who need to access care without being 
put in a position where they may reveal information that should 
not be disclosed.

                                Hearings

    There were no full Committee hearings held on H.R. 2915.
    On July 14, 2015, the Subcommittee on Health conducted a 
legislative hearing on various bills introduced in the 114th 
Congress, including H.R. 2915 and H.R. 421. The following 
witnesses testified:
    The Honorable Tim Walberg, U.S. House of Representatives, 
7th Congressional District, Michigan; The Honorable Sean Duffy, 
U.S. House of Representatives, 7th Congressional District, 
Wisconsin; The Honorable Steve Stivers, U.S. House of 
Representatives, 15th Congressional District, Ohio; The 
Honorable Kyrsten Sinema, U.S. House of Representatives, 9th 
Congressional District, Arizona; The Honorable Doug Collins, 
U.S. House of Representatives, 9th Congressional District, 
Georgia; The Honorable Mike Coffman, U.S. House of 
Representatives, 6th Congressional District, Colorado; The 
Honorable Jeff Denham, U.S. House of Representatives, 10th 
Congressional District, California; The Honorable Charles 
Boustany, U.S. House of Representatives, 3rd Congressional 
District, Louisiana; The Honorable Brad Wenstrup, U.S. House of 
Representatives, 2nd Congressional District, Ohio; Ian de 
Planque, Legislative Director, American Legion; Adrian Atizado, 
Assistant National Legislative Director, Disabled American 
Veterans; Carlos Fuentes, Senior Legislative Associate, 
National Legislative Service, Veterans of Foreign Wars of the 
United States; and, Madhulika Agarwal, MD, MPH, Deputy Under 
Secretary for Health for Policy and Services, Veterans Health 
Administration, U.S. Department of Veterans Affairs, who was 
accompanied by Janet P. Murphy, MBA, Acting Deputy Under 
Secretary for Health for Operations and Management, Veterans 
Health Administration, U.S. Department of Veterans Affairs; and 
Jessica Tanner, General Attorney, Office of General Counsel, 
U.S. Department of Veterans Affairs.
    Statements for the Record were submitted by:
    The American Academy of Audiology and the American Speech-
Language Association; the Children of Vietnam Veterans Health 
Alliance, the International Hearing Society; Iraq and 
Afghanistan Veterans of America; the National Medical 
Association; Paralyzed Veterans of America; VetsFirst, a 
program of the United Spinal Association: Vietnam Veterans of 
America; Warrior Canine Connection; the American Academy of 
Ophthalmology; and, the American Medical Association.

                       Subcommittee Consideration

    On July 22, 2015, the Subcommittee on Health met in open 
markup session, a quorum being present, and favorably forwarded 
to the full Committee H.R. 2915 and H.R. 421, as amended, by 
voice vote. During consideration of the bills, the following 
amendment was considered:
    An amendment to H.R. 421 offered by Representative Julia 
Brownley of California, which provided a short title of ``The 
Sergeant Daniel Somers Classified Veterans Access to Care Act'' 
was agreed to by voice vote.

                        Committee Consideration

    On September 17, 2015, the full Committee met in open 
markup session, a quorum being present, and ordered H.R. 2915, 
as amended, reported favorably to the House of Representatives, 
by voice vote. During consideration of the bill, the following 
amendment was considered:
    An amendment in the nature of a substitute by 
Representative Julia Brownley of California, which combined the 
text of H.R. 2915, as introduced, and H.R. 421, as amended. The 
amendment in the nature of a substitute was agreed to by voice 
vote.

                            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 in connection with ordering H.R. 2915, as amended, 
reported to the House. A motion by Ranking Member Corrine Brown 
of Florida to report H.R. 2915, as amended, favorably to the 
House of Representatives was agreed to 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 that the Secretary will use these 
provisions to improve the mental health care provided to women 
veterans and to veterans who have served on classified missions 
or in sensitive units in the Armed Forces.

   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. 2915, 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. 
2915, 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. 2915, as amended, provided by the Congressional Budget 
Office pursuant to section 402 of the Congressional Budget Act 
of 1974:
                                     U.S. Congress,
                               Congressional Budget Office,
                                  Washington, DC, October 29, 2015.
Hon. Jeff Miller,
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. 2915, the Female 
Veterans Suicide Prevention Act.
    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.
    Enclosure.

H.R. 2915--Female Veterans Suicide Prevention Act

    H.R. 2915 would revise the requirements for an annual 
independent assessment to include metrics on suicide among 
female veterans. The assessment was recently established under 
the Clay Hunt SAV Act (Public Law 114-2) and requires a 
nongovernment entity to review and report on the mental health 
care provided by the Department of Veterans Affairs (VA). The 
bill also would require VA to establish and disseminate 
standards for providing mental health treatment to veterans who 
served on classified missions.
    Based on information from VA and independent entities who 
have prepared similar assessments, CBO expects that adding an 
additional metric would increase the cost of preparing the 
report on mental health care by an insignificant amount, as 
would preparing and disseminating standards for mental health 
treatment. On that basis, CBO estimates that implementing H.R. 
2915 would cost less than $500,000 over the 2016-2020 period. 
Any spending would be subject to the availability of 
appropriated funds.
    Enacting H.R. 2915 would not affect direct spending or 
revenues; therefore, pay-as-you-go procedures do not apply. CBO 
estimates that enacting H.R. 2915 would not increase net direct 
spending or on-budget deficits in any of the four consecutive 
10-year periods beginning in 2026.
    H.R. 2915 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act and 
would not affect the budgets of state, local, or tribal 
governments.
    The CBO staff contact for this estimate is Ann E. Futrell. 
The estimate was approved by H. Samuel Papenfuss, Deputy 
Assistant Director for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates regarding H.R. 2915, 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. 
2915, as amended.

                 Statement of Constitutional Authority

    Pursuant to Article I, section 8 of the United States 
Constitution, the reported bill 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 the legislation 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 section 3(g) of H. Res. 5, 114th Cong. (2015), 
the Committee finds that no provision of H.R. 2915, 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, 114th Cong. (2015), 
the Committee estimates that H.R. 2915, as amended, contains no 
directed rule making that would require the Secretary to 
prescribe regulations.

             Section-by-Section Analysis of the Legislation


Section 1--Short title

    Section 1 would provide a short title of H.R. 2915, as 
amended, as the ``Female Veteran Suicide Prevention Act.''

Section 2--Specific consideration of women veterans in evaluation of 
        Department of Veterans Affairs mental health care and suicide 
        prevention programs

    Section 2 would amend section 1709B(a)(2) of title 38 
U.S.C., in subparagraph (A) by inserting ``, including specific 
metrics applicable to women'' before the semicolon; in 
subparagraph (E) by striking the period at the end and 
inserting ``; and''; and, by adding at the end a new 
subparagraph (F) to read ``(F) identify the mental health care 
and suicide prevention programs conducted by the Secretary that 
are most effective for women veterans and such programs with 
the highest satisfaction rates among women veterans.''

Section 3--Mental health treatment of veterans who serve in classified 
        missions

    Section 3(a) would provide the sense of Congress that 
veterans who experience combat-related mental health wounds 
should have immediate, appropriate, and consistent access to 
comprehensive mental health care.
    Section 3(b) would amend subchapter II of chapter 17 of 
title 38 U.S.C., by adding at the end a new section entitled, 
``Sec. 1720H. Mental health treatment for veterans who served 
in classified missions.''
    Proposed sec. 1720H(a) would require the Secretary to 
establish standards and procedures to ensure that each covered 
veteran may access mental health care provided by the Secretary 
in a manner that fully accommodates the obligation of the 
veteran to not improperly disclose classified information and 
require the Secretary to disseminate guidance to Veterans 
Health Administration employees, including mental health 
professionals, on the standard and procedures established and 
how to best engage covered veterans during the course of mental 
health treatment with respect to classified information.
    Proposed sec. 1720H(b) would require the Secretary to 
ensure that a veteran may elect to identify as a covered 
veteran on an appropriate form.
    Proposed sec. 1720H(c) would define: the term ``classified 
information'' as any information or material that has been 
determined by an official of the United States pursuant to law, 
an Executive Order, or regulation to require protection against 
unauthorized disclosure for reasons of national security; the 
term ``covered veteran'' as a veteran enrolled in the health 
care system established under section 1705(a) of title 38 
U.S.C., who is seeking mental health treatment and, in the 
course of serving in the Armed Forces, participated in a 
sensitive mission or services in a sensitive unit; the term 
``sensitive mission'' as a mission of the Armed Forces that, at 
the time at which a covered veteran seeks treatment, is 
classified; and, the term ``sensitive unit'' as the meaning 
given that term in section 130b(c)(4) of title 10 U.S.C.
    Section 3(c) would amend the table of sections at the 
beginning of subchapter II of chapter 17 of title 38 U.S.C., by 
adding after the item relating to section 1720G the following 
new item, ``1720H. Mental health treatment for veterans who 
served in classified missions.''

         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 (existing law 
proposed to be omitted is enclosed in black brackets, 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 I--GENERAL

Sec.
1701. Definitions.
     * * * * * * *

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

     * * * * * * *
1720H. Mental health treatment for veterans who served in classified 
          missions.

SUBCHAPTER I--GENERAL

           *       *       *       *       *       *       *



Sec. 1709B. Evaluations of mental health care and suicide prevention 
                    programs

  (a) Evaluations.--(1) Not less frequently than once during 
each period specified in paragraph (3), the Secretary shall 
provide for the conduct of an evaluation of the mental health 
care and suicide prevention programs carried out under the laws 
administered by the Secretary.
  (2) Each evaluation conducted under paragraph (1) shall--
          (A) use metrics that are common among and useful for 
        practitioners in the field of mental health care and 
        suicide prevention, including specific metrics 
        applicable to women;
          (B) identify the most effective mental health care 
        and suicide prevention programs conducted by the 
        Secretary, including such programs conducted at a 
        Center of Excellence;
          (C) identify the cost-effectiveness of each program 
        identified under subparagraph (B);
          (D) measure the satisfaction of patients with respect 
        to the care provided under each such program; [and]
          (E) propose best practices for caring for individuals 
        who suffer from mental health disorders or are at risk 
        of suicide, including such practices conducted or 
        suggested by other departments or agencies of the 
        Federal Government, including the Substance Abuse and 
        Mental Health Services Administration of the Department 
        of Health and Human Services[.]; and
          (F) identify the mental health care and suicide 
        prevention programs conducted by the Secretary that are 
        most effective for women veterans and such programs 
        with the highest satisfaction rates among women 
        veterans.
  (3) The periods specified in this paragraph are the 
following:
          (A) The period beginning on the date on which the 
        Secretary awards the contract under paragraph (4) and 
        ending on September 30, 2018.
          (B) Each fiscal year beginning on or after October 1, 
        2018.
  (4) Not later than 180 days after the date of the enactment 
of this section, the Secretary shall seek to enter into a 
contract with an independent third party unaffiliated with the 
Department of Veterans Affairs to conduct evaluations under 
paragraph (1).
  (5) The independent third party that is awarded the contract 
under paragraph (4) shall submit to the Secretary each 
evaluation conducted under paragraph (1).
  (b) Annual Submission.--Not later than December 1, 2018, and 
each year thereafter, 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 
that contains the following:
          (1) The most recent evaluations submitted to the 
        Secretary under subsection (a)(5) that the Secretary 
        has not previously submitted to such Committees.
          (2) Any recommendations the Secretary considers 
        appropriate.

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

           *       *       *       *       *       *       *



Sec. 1720H. Mental health treatment for veterans who served in 
                    classified missions

  (a) Establishment of Standards.--(1) The Secretary shall 
establish standards and procedures to ensure that each covered 
veteran may access mental health care provided by the Secretary 
in a manner that fully accommodates the obligation of the 
veteran to not improperly disclose classified information.
  (2) The Secretary shall disseminate guidance to employees of 
the Veterans Health Administration, including mental health 
professionals, on the standards and procedures established 
under paragraph (1) and how to best engage covered veterans 
during the course of mental health treatment with respect to 
classified information.
  (b) Identification.--In carrying out this section, the 
Secretary shall ensure that a veteran may elect to identify as 
a covered veteran on an appropriate form.
  (c) Definitions.--In this section:
          (1) The term ``classified information'' means any 
        information or material that has been determined by an 
        official of the United States pursuant to law, an 
        Executive order, or regulation to require protection 
        against unauthorized disclosure for reasons of national 
        security.
          (2) The term ``covered veteran'' means a veteran 
        who--
                  (A) is enrolled in the health care system 
                established under section 1705(a) of this 
                title;
                  (B) is seeking mental health treatment; and
                  (C) in the course of serving in the Armed 
                Forces, participated in a sensitive mission or 
                served in a sensitive unit.
          (3) The term ``sensitive mission'' means a mission of 
        the Armed Forces that, at the time at which a covered 
        veteran seeks treatment, is classified.
          (4) The term ``sensitive unit'' has the meaning given 
        that term in section 130b(c)(4) of title 10.

           *       *       *       *       *       *       *


                                  [all]