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[House Report 111-490]
[From the U.S. Government Publishing Office]

111th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     111-490

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

 
                   VETERANS DOG TRAINING THERAPY ACT

                                _______
                                

  May 20, 2010.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

  Mr. Filner, from the Committee on Veterans' Affairs, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 3885]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Veterans' Affairs, to whom was referred 
the bill (H.R. 3885) to direct the Secretary of Veterans 
Affairs to carry out a pilot program on dog training therapy, 
having considered the same, report favorably thereon without 
amendment and recommend that the bill do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     1
Background and Need for Legislation..............................     2
Hearings.........................................................     3
Subcommittee Consideration.......................................     4
Committee Consideration..........................................     4
Committee Votes..................................................     4
Committee Oversight Findings.....................................     4
Statement of General Performance Goals and Objectives............     4
New Budget Authority, Entitlement Authority, and Tax Expenditures     4
Earmarks and Tax and Tariff Benefits.............................     5
Committee Cost Estimate..........................................     5
Congressional Budget Office Estimate.............................     5
Federal Mandates Statement.......................................     6
Advisory Committee Statement.....................................     6
Constitutional Authority Statement...............................     6
Applicability to Legislative Branch..............................     6
Section-by-Section Analysis of the Legislation...................     6

                          PURPOSE AND SUMMARY

    H.R. 3885 was introduced by Representative Henry E. Brown, 
Jr. of South Carolina, the Ranking Member of the Subcommittee 
on Health of the Committee on Veterans' Affairs, on October 21, 
2009. H.R. 3885, the Veterans Dog Training Therapy Act, would 
require the Secretary of the U.S. Department of Veterans 
Affairs (VA) to conduct a five-year pilot program in at least 
three but not more than five VA medical centers assessing the 
effectiveness of addressing post-deployment mental health and 
post-traumatic stress disorder (PTSD) through a therapeutic 
medium of training service dogs for veterans with disabilities. 
The VA would be required to report to Congress annually on its 
progress.

                  BACKGROUND AND NEED FOR LEGISLATION

    Considerable attention has been given in recent years to 
the invisible wounds of war including mental health illnesses 
such as depression, PTSD, substance use disorder, and traumatic 
brain injury. Unlike physical injuries, mental health issues 
may not be readily apparent but can nonetheless have a harmful 
effect on a veteran's quality of life by having a negative 
impact upon an individual's mood, thoughts, and behavior. 
Currently, VA provides mental health treatment through a 
variety of inpatient and outpatient mental health programs in 
VA medical centers, community-based outpatient clinics, and vet 
centers. In fiscal year 2009, VA's budget for mental health was 
approximately $4.5 billion.
    Perhaps the most widely recognized mental health issue 
affecting veterans, PTSD is a severe anxiety disorder that can 
develop after exposure to a traumatic event in which grave 
physical harm occurred or was threatened. Combat experience is 
one type of event that may trigger PTSD. Experts indicate that 
while PTSD is expected in 7 to 8 percent of the general 
population, they expect to see the disorder in about 11 to 20 
percent of Operation Enduring Freedom (OEF) and Operation Iraqi 
Freedom (OIF) veterans, 10 percent of Gulf War veterans, and 30 
percent of Vietnam veterans. VA provides nearly 200 specialized 
PTSD treatment programs in facilities across the country.
    Given the prevalence of PTSD among our veteran population, 
Congress has recognized the need to provide veterans seeking 
treatment for mental health issues with newer and more 
innovative modes of therapy. In that vein, the Conference 
Report (H. Rept. 111-366) that accompanied the Consolidated 
Appropriations Act, 2010 (P.L. 111-117 (123 Stat. 3034)) 
included the recommendation that VA ``expand its partnership 
with accredited nonprofit service dog organizations where 
veterans with PTSD help to train service dogs.''
    On March 24, 2008, a Memorandum of Understanding was signed 
between the VA Palo Alto Health Care System (VAPAHCS) in Palo 
Alto, California, and the Assistance Dog Program to establish a 
specialized assistance dog training program for veterans. This 
program, within the Recreational Therapy Service at the 
VAPAHCS, is designed to create a therapeutic environment for 
veterans with post-deployment mental health issues and symptoms 
of PTSD to address their mental health needs. Veterans 
participating in this program train service dogs for later 
placement with veterans with hearing and physical disabilities.
    A similar, privately-funded, pilot program is currently 
underway at Walter Reed Army Medical Center (WRAMC) where 
service dogs have been used in therapeutic settings since 2006. 
Called the ``Paws for Purple Hearts'' Service Dog Training 
Program, in this pilot Warriors in Transition (WTs) from the 
battlefield to the home front volunteer to participate in a 
specialized service dog training program. The objectives of the 
program are to: improve a WT's emotional, cognitive, and 
physical symptoms through purposeful interactions and 
participation in a therapeutic occupation; provide an 
opportunity for PTSD patients to participate in a goal-
directed, meaningful occupation that facilitates structure, 
skill development, and community participation; and, the 
successful placement of well-trained service dogs with fellow 
servicemembers and/or veterans with significant physical 
injuries resulting in mobility impairments.
    The Walter Reed program has been so successful in meeting 
its objectives that Department of Defense (DOD) officials are 
moving to include similar therapeutic models in other service 
areas. For example, a similar program will be included in the 
National Intrepid Center of Excellence (NICoE) opening in late 
June 2010 on the campus of the National Naval Center in 
Bethesda, Maryland; the Army Surgeon General has created an 
Animal Assisted Therapy task force to develop policies and 
research related to dog therapy; and, the Army Family Action 
Plan conference listed funding for service dogs for wounded 
warriors as their second top issue of importance.
    In each of the above programs, training service dogs for 
fellow veterans is believed to be helping to address symptoms 
associated with post-deployment mental health issues and PTSD 
in a myriad of ways. Specifically, veterans participating in 
the programs demonstrated improved emotional regulation, sleep 
patterns, and sense of personal safety. They also experienced 
reduced levels of anxiety and social isolation. Further, 
participation in the pilot enabled them to actively instill or 
re-establish a sense of purpose and meaning while providing an 
opportunity to help fellow veterans and reintegrate healthfully 
back into the community. However, despite the anecdotal 
evidence of the therapeutic benefit of service dog training on 
veterans with mental health issues and PTSD, there is a serious 
dearth of scientific research on the value of such programs.
    The goal of this legislation is to reach more veterans with 
this innovative and successful mental health and PTSD treatment 
model and provide a means of collecting important research data 
to address the current lack of evidence-based research on the 
effectiveness of the service dog training therapy model. The 
pilot program created by this legislation has the added benefit 
of providing a career path to veterans who successfully 
graduate the program and are interested in becoming certified 
dog trainers and making well-trained service dogs available to 
other disabled veterans.

                                HEARINGS

    On October 1, 2009, the Subcommittee on Health held a 
legislative hearing on several bills introduced in the 111th 
Congress, including draft legislation on psychiatric service 
dogs. The following witnesses testified: The Honorable Bob 
Filner of California; The Honorable Stephanie Herseth Sandlin 
of South Dakota; The Honorable Phil Hare of Illinois; The 
Honorable Ciro D. Rodriguez of Texas; The Honorable Glenn Nye 
of Virginia; The Honorable Harry Teague of New Mexico; The 
Honorable Michael A. Arcuri of New York; Mr. Joseph Wilson, 
Deputy Director, Veterans Affairs and Rehabilitation 
Commission, The American Legion; Mr. Justin Brown, Legislative 
Associate, National Legislative Service, Veterans of Foreign 
Wars; Mr. Rick Weidman, Executive Director, Policy and 
Government Affairs, Vietnam Veterans of America; Mr. Blake C. 
Ortner, Senior Associate Legislative Director, Paralyzed 
Veterans of America; Mr. Peter H. Dougherty, Director, Homeless 
Veterans Programs, U.S. Department of Veterans Affairs who was 
accompanied by Mr. Paul E. Smits, Associate Chief Consultant, 
Homeless and Residential Rehabilitation and Treatment Programs, 
U.S. Department of Veterans Affairs; and, Ms. Jane Clare 
Joyner, Deputy Assistant General Counsel, U.S. Department of 
Veterans Affairs. Those submitting for the record included: 
Rick A. McMichael, DC, President, American Chiropractic 
Association; the American Physical Therapy Association; and, 
the American Tinnitus Association.

                       SUBCOMMITTEE CONSIDERATION

    On October 22, 2009, the Subcommittee on Health met in open 
markup session and ordered H.R. 3885 favorably forwarded to the 
full Committee by voice vote.

                        COMMITTEE CONSIDERATION

    On May 12, 2010, the full Committee met in an open markup 
session, a quorum being present, and ordered H.R. 3885 reported 
favorably to the House of Representatives by voice vote.

                            COMMITTEE VOTES

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report the legislation and amendments thereto. 
There were no record votes taken on amendments or in connection 
with ordering H.R. 3885 reported to the House. A motion by Mr. 
Stearns of Florida to order H.R. 3885 reported 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 reflected in the descriptive portions 
of this report.

   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. 3885 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. 
3885 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. 3885 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, May 18, 2010.
Hon. Bob Filner,
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. 3885, the Veterans 
Dog Training Therapy Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Sunita 
D'Monte.
            Sincerely,
                                              Douglas W. Elmendorf.
    Enclosure.

H.R. 3885--Veterans Dog Training Therapy Act

    H.R. 3885 would require the Department of Veterans Affairs 
(VA) to establish a pilot program through which veterans 
diagnosed with post-traumatic stress disorder or other mental 
health conditions would train service dogs for use by disabled 
veterans. The pilot program would operate in three to five 
medical centers over a five-year period. CBO estimates that 
implementing the bill would cost $7 million over the 2011-2015 
period, assuming appropriation of the necessary amounts. 
Enacting this legislation would not affect direct spending or 
revenues; therefore, pay-as-you-go procedures would not apply.
    H.R. 3885 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 estimated budgetary impact of H.R. 3885 is shown in the 
following table. The costs of this legislation fall within 
budget function 700 (veterans benefits and services).

----------------------------------------------------------------------------------------------------------------
                                                                      By fiscal year, in millions of dollars--
                                                                   ---------------------------------------------
                                                                     2011   2012   2013   2014   2015  2011-2015
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATION

Estimated Authorization Level.....................................      1      1      1      2      2         7
Estimated Outlays.................................................      1      1      1      2      2         7
----------------------------------------------------------------------------------------------------------------

    Based on information from VA, CBO estimates that the 
department would implement the pilot program in four medical 
centers and would require two recreation therapists and one 
certified dog trainer at each facility as well as one 
recreation therapist and a director to oversee the program. 
Based on a similar program at the VA facility in Palo Alto, 
California, CBO further estimates that each facility would 
train five service dogs every two years. Assuming the program 
would be phased in over three years and that the necessary 
amounts would be appropriated, CBO estimates that implementing 
the bill would cost $1 million in 2011, growing to $2 million a 
year by 2014.
    The CBO staff contact for this estimate is Sunita D'Monte. 
The estimate was approved by Theresa Gullo, Deputy Assistant 
Director for Budget Analysis.

                       FEDERAL MANDATES STATEMENT

    The Committee adopts as its own the estimate of Federal 
mandates regarding H.R. 3885 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. 
3885.

                   CONSTITUTIONAL AUTHORITY STATEMENT

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that the 
Constitutional authority for H.R. 3885 is provided by Article 
I, section 8 of the Constitution 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.

             SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title

    This section provides the short title of H.R. 3885 as the 
``Veterans Dog Training Therapy Act.''

Section 2. Department of Veterans Affairs pilot program on dog training 
        therapy

    Section 2(a) of the bill would require the Secretary of the 
VA, beginning no later than 120 days after enactment, to carry 
out a pilot program to assess the effectiveness of treating 
post-deployment mental health issues and PTSD using the 
therapeutic medium of training service dogs for veterans with 
disabilities.
    Section 2(b) of the bill would require the pilot described 
in Section 2(a) be carried out in at least three but not more 
than five VA medical centers during a five-year period 
beginning on the date of commencement of the pilot.
    Section 2(c) of the bill would require that each VA medical 
center selected for participation in the pilot provide a 
training area for educating participating veterans in dog 
training and handling and that such training area include an 
indoor space for grooming and training, be wheelchair 
accessible, include a classroom or lecture space, include 
office space, include storage space, provide for periodic use 
of other training areas, include outdoor exercise and toileting 
space, and provide for weekly field trips.
    Section 2(d) of the bill would require the pilot program 
set up under Section 2(a) be administered through the VA's 
Recreation Therapy Service under the direction of a certified 
recreational therapist, establish a qualified director of 
service dog training, ensure that each site have certified dog 
trainers, ensure that dogs used in the program be purpose-bred 
for assistance dog work and have adequate temperament and 
health, ensure that each dog be taught 90 basic commands, 
ensure that each dog live at the program site or with a 
volunteer foster home, ensure that the program include both 
lecture and hands-on training/grooming components, and be 
designed to maximize therapeutic benefits and provide well-
trained assistance dogs to veterans with disabilities.
    Section 2(e) of the bill would define a veteran eligible 
for the pilot program as a veteran with PTSD or another post-
deployment mental health issue who volunteers, if the Secretary 
determines there are adequate resources available.
    Section 2(f) of the bill would create a hiring preference 
for service dog trainers who are veterans who have successfully 
completed PTSD or other residential treatment programs and 
received adequate dog training certification.
    Section 2(g) of the bill would require the VA Secretary to 
collect data to determine the effectiveness of the program and 
include information on how it assists veterans with reducing 
mental health stigma, improving emotional regulation, improving 
patience, establishing a sense of purpose, providing an 
opportunity to help fellow veterans, reintegrating back into 
the community, reducing social isolation, building relationship 
skills, relaxing their survival state, improving sleep 
patterns, and decreasing medication use.
    Section 2(h) of the bill would require a yearly report to 
Congress on the program including the number of participating 
veterans; a description of the program's services; the effects 
of the pilot on symptoms of mental illness, relevant 
physiological markers, family dynamics, insomnia, pain 
management, and overall well-being; and, recommendations to 
extend or expand the program.
    Section 2(i) of the bill would define a ``service dog 
training instructor'' as someone who provides direct training 
of veterans with PTSD or other mental illness in assistance dog 
training and handling.

                                  
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