69–006 

115TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 1st Session 115–197 

BUILDING SUPPORTIVE NETWORKS FOR WOMEN 

VETERANS ACT 

JUNE 28, 2017.—Committed to the Committee of the Whole House on the State of 

the Union and ordered to be printed 

Mr. ROE of Tennessee, from the Committee on Veterans’ Affairs, 

submitted the following 

R E P O R T 

[To accompany H.R. 91] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Veterans’ Affairs, to whom was referred the 

bill (H.R. 91) to amend title 38, United States Code, to make permanent the pilot program on counseling in retreat settings for 

women veterans newly separated from service in the Armed Forces, 

having considered the same, report favorably thereon without 

amendment and recommend that the bill do pass. 

CONTENTS 

Page 

Purpose and Summary ............................................................................................ 2 

Background and Need for Legislation .................................................................... 2 

Hearings ................................................................................................................... 3 

Subcommittee Consideration .................................................................................. 3 

Committee Consideration ........................................................................................ 3 

Committee Votes ...................................................................................................... 3 

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 .................................................................. 4 

Committee Cost Estimate ....................................................................................... 4 

Congressional Budget Office Estimate ................................................................... 4 

Federal Mandates Statement ................................................................................. 5 

Advisory Committee Statement .............................................................................. 5 

Constitutional Authority Statement ...................................................................... 5 

Applicability to Legislative Branch ........................................................................ 5 

Statement on Duplication of Federal Programs .................................................... 6 

Disclosure of Directed Rulemaking ........................................................................ 6 

Section-by-Section Analysis of the Legislation ...................................................... 6 

Changes in Existing Law Made by the Bill as Reported ...................................... 7 

2 

1 U.S. Department of Veterans Affairs, Office of Suicide Prevention. Suicide among Veterans 

and Other Americans 2001–2014. August 3, 2016. https://www.mentalhealth.va.gov/docs/ 

2016suicidedatareport.pdf. 2 Disabled American Veterans. Women Veterans: The Long Journey Home. September 24, 

2014. https://www.dav.org/wp-content/uploads/women-veterans-study.pdf. 3 Ibid. 

4 United States Cong. House Committee on Veterans’ Affairs Subcommittee on Health. Legislative Hearing. March 29, 2017. 115th Cong. 1st sess. Washington: GPO, 2017 (statement from 

Jennifer S. Lee, Deputy Under Secretary for Health for Policy and Services, Veterans Health 

Administration, U.S. Department of Veterans Affairs). 

PURPOSE AND SUMMARY

H.R. 91 was introduced by Representative Julia Brownley of 

California, the Ranking Member of the Committee on Veterans’ Affairs Subcommittee on Health, on January 3, 2017. 

H.R. 91 would require the Department of Veterans Affairs (VA) 

to carry out a permanent program to provide reintegration and readjustment services in group retreat settings to women veterans 

newly separated from service in the Armed Forces after a prolonged deployment. 

BACKGROUND AND NEED FOR LEGISLATION

Section 2. Counseling in retreat settings for women veterans newly 

separated from service in the Armed Forces 

While women have served in the military since the American 

Revolution, women have only relatively recently come to represent 

a sizable portion of the veteran population. Today, women veterans 

number almost 2 million out of 21.6 million total veterans in the 

United States.1

There are indications both that military service and veteran status may affect women differently than men and that women veterans may lack access to valuable peer support opportunities once 

they have separated from service. For example, a report by the Disabled American Veterans (DAV) found that women face barriers to 

full integration into military service, to recognition as veterans, 

and to VA services and benefits.2 According to DAV, ‘‘[t]he vast majority of these deficiencies result from a disregard for the differing 

needs of women veterans and a focusing on the 80 percent solutions for men who dominate in both numbers and the public consciousness.’’ 3

During the 111th Congress, the Caregivers and Veterans Omnibus Health Services Act of 2010 (P.L. 111–163, 124 Stat. 1130) required VA to conduct a pilot program through the Readjustment 

Counseling Service (RCS) to evaluate the feasibility and advisability of providing reintegration and readjustment services in 

group retreat settings to women veterans recently separated from 

service in the Armed Forces after a prolonged deployment. Each 

group retreat was required to include the following components: information and counseling on reintegration into the veteran’s family; 

employment and community; financial counseling; occupational 

counseling; information and counseling on stress reduction; and, information and counseling on conflict resolution. Over the course of 

the pilot program, a total of 12 retreats were provided to 272 

women veterans between 2011 and 2016.4 According to VA, the retreats held to-date have focused on building trust and developing 

peer support in a therapeutic environment and data has shown 

3 

5 Ibid. 

that retreat participants saw increased coping abilities and decreased symptoms associated with posttraumatic stress disorder. 

VA also found that 87 percent of retreat participants scored higher 

on the Ryff Scale of Psychological Well Being immediately post-retreat and 84 percent showed a decrease in stress symptoms that 

persisted two months post-retreat.5

In light of the positive outcomes of the current pilot program and 

the Committee’s commitment to ensuring that VA is properly addressing the unique needs of women veterans, section 2 of the bill 

would make the pilot program of counseling in retreat settings for 

women veterans newly separated from service a permanent part of 

VA’s programs for women veterans. 

HEARINGS

On March 29, 2017, the Subcommittee on Health conducted a 

legislative hearing on a number of bills including H.R. 91. 

The following witnesses testified: The Honorable David. P. Roe 

M.D. of Tennessee; The Honorable Jackie Walorski of Indiana; The 

Honorable Doug Collins of Georgia; The Honorable Mike Coffman 

of Colorado; The Honorable Stephen Knight of California; The Honorable Ann M. Kuster of New Hampshire; Jennifer S. Lee, M.D., 

the Deputy Under Secretary for Health for Policy and Services for 

the Veterans Health Administration of the U.S. Department of Veterans Affairs who was accompanied by Susan Blauert, the Chief 

Counsel for the Health Care Law Group of the Office of the General Counsel for the U.S. Department of Veterans Affairs; Kayda 

Keleher, Legislative Associate for the National Legislative Service 

of the Veterans of Foreign Wars of the United States; Shurhonda 

Y. Love, the Assistant National Legislative Director for the Disabled American Veterans; and, Sarah S. Dean, the Associate Legislative Director for the Paralyzed Veterans of America. 

Statements for the record were submitted by: The Honorable Lee 

Zeldin of New York; The American Legion; the National Association of State Veteran Homes; Swords to Plowshares; and, the 

Wounded Warrior Project. 

SUBCOMMITTEE CONSIDERATION

On April 6, 2017, the Subcommittee on Health met in an open 

markup session, a quorum being present, and ordered H.R. 91 to 

be reported favorably to the full Committee by voice vote. 

COMMITTEE CONSIDERATION

On May 17, 2017, the Full Committee met in open markup session, a quorum being present, and ordered H.R. 91 to be reported 

favorably to the House of Representatives by voice vote. A motion 

by Representative Tim Walz of Minnesota, Ranking Member of the 

Committee on Veterans’ Affairs, to report H.R. 91 favorably to the 

House of Representatives 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 on 

4 

amendments or in connection with ordering H.R. 91 reported to the 

House. 

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 to improve the provision of reintegration and readjustment services to women veterans who are recently separated 

from service after a prolonged deployment. 

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. 91 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. 91 

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. 91 

provided by the Director of the Congressional Budget Office pursuant to section 402 of the Congressional Budget Act of 1974: 

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, May 20, 2017. 

Hon. PHIL ROE, M.D., 

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. 91, the Building Supportive Networks for Women Veterans Act. 

5 

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. 91—Building Supportive Networks for Women Veterans Act 

H.R. 91 would require the Department of Veterans Affairs (VA) 

to establish a permanent program that provides counseling in 

group retreat settings to certain women veterans who have recently 

separated from military service. The bill also would require the VA 

to submit to the Congress a biennial report on the outcomes of the 

program. 

VA is completing the final year of a pilot program that provides 

similar services to women veterans. According to VA, roughly 270 

women participated in the program at 12 retreats over the 2011– 

2016 period at an average cost of $3,400 per participant. On the 

basis of information from VA, CBO expects that the department 

would use the authority provided under H.R. 91 to hold six retreats 

a year. CBO estimates that implementing this program would cost 

$3 million over the 2018–2022 period after accounting for anticipated inflation; such spending would be subject to the availability 

of appropriated funds. 

Enacting the legislation would not affect direct spending or revenues; therefore, pay-as-you-go procedures do not apply. CBO estimates that enacting H.R. 91 would not increase net direct spending 

or on-budget deficits in any of the four consecutive 10-year periods 

beginning in 2028. 

H.R. 91 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. 91 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. 91. 

STATEMENT OF CONSTITUTIONAL AUTHORITY

Pursuant to Article I, section 8 of the United States Constitution, 

H.R. 91 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 H.R. 91 does not relate to the terms 

and conditions of employment or access to public services or accomVerDate Sep 11 2014 04:05 Jun 29, 2017 Jkt 069006 PO 00000 Frm 00005 Fmt 6659 Sfmt 6602 E:\HR\OC\HR197.XXX HR197
6 

modations 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, 115th Cong. (2017), the 

Committee finds that no provision of H.R. 91 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, 115th Cong. (2017), the 

Committee estimates that H.R. 91 contains no directed rulemaking 

that would require the Secretary to prescribe regulations. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title 

Section 1 of the bill would provide a short title of the ‘‘Building 

Supportive Networks for Women Veterans Act’’. 

Section 2. Counseling in retreat settings for women veterans newly 

separated from service in the armed forces 

Section 2(a)(1) of the bill would amend chapter 17 of title 38, 

U.S.C., by inserting after section 1712C a new section, ‘‘1712D. 

Counseling in retreat settings for women veterans newly separated.’’ The new section 1712D would require the Secretary of Veterans Affairs, beginning on January 1, 2018, to carry out a program through the Readjustment Counseling Service (RCS) to provide reintegration and readjustment services in group retreat settings to women veterans who are newly separated from service in 

the Armed Forces after a prolonged deployment. A veteran’s participation in the program would be voluntary and services provided 

under the program would include: (1) information on reintegration 

into the family, employment, and community of the veteran; (2) financial counseling; (3) occupational counseling; (4) information and 

counseling on stress reduction; (5) information and counseling on 

conflict resolution; and, (6) such other information and counseling 

as the Secretary considers appropriate to assist the veteran in reintegrating into her family, job, and community. VA would be required to report to the Committees on Veterans’ Affairs of the 

House of Representatives and the Senate a report on the program 

by no later than December 31, 2018, and each even-numbered year 

thereafter. 

Section 2(a)(2) of the bill would amend the table of sections at 

the beginning of chapter 17 of title 38, U.S.C., by inserting after 

1712C the following new item: ‘‘1712D. Counseling in retreat settings for women veterans newly separated.’’. 

Section 2(b) of the bill would repeal section 203 of the Caregivers 

and Veterans Omnibus Health Services Act of 2010 (38 U.S.C. 

1712A note) effective December 31, 2017. 

7 

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 

* * * * * * * 

1712D. Counseling in retreat settings for women veterans newly separated. 

* * * * * * * 

SUBCHAPTER II—HOSPITAL, NURSING HOME, OR 

DOMICILIARY CARE AND MEDICAL TREATMENT 

* * * * * * * 

§ 1712D. Counseling in retreat settings for women veterans 

newly separated 

(a) PROGRAM.—(1) Commencing on January 1, 2018, the Secretary shall carry out, through the Readjustment Counseling Service 

of the Veterans Health Administration, a program to provide reintegration and readjustment services described in subsection (b) in 

group retreat settings to women veterans who are recently separated 

from service in the Armed Forces after a prolonged deployment. 

(2) The participation of a veteran in the program under paragraph (1) shall be at the election of the veteran. 

(b) COVERED SERVICES.—The services provided to a woman veteran under the program under subsection (a)(1) shall include the 

following: 

8 

(1) Information on reintegration into the family, employment, 

and community of the veteran. 

(2) Financial counseling. 

(3) Occupational counseling. 

(4) Information and counseling on stress reduction. 

(5) Information and counseling on conflict resolution. 

(6) Such other information and counseling as the Secretary 

considers appropriate to assist the veteran in reintegration into 

the family, employment, and community of the veteran. 

(c) BIENNIAL REPORTS.—Not later than December 31, 2018, and 

each even-numbered year thereafter, the Secretary shall submit to 

the Committees on Veterans’ Affairs of the House of Representatives 

and the Senate a report on the program under subsection (a)(1). 

* * * * * * * 

CAREGIVERS AND VETERANS OMNIBUS HEALTH 

SERVICES ACT OF 2010 

* * * * * * * 

TITLE II—WOMEN VETERANS HEALTH 

CARE MATTERS 

* * * * * * * 

øSEC. 203. PILOT PROGRAM ON COUNSELING IN RETREAT SETTINGS 

FOR WOMEN VETERANS NEWLY SEPARATED FROM SERVICE IN THE ARMED FORCES. 

ø(a) PILOT PROGRAM REQUIRED.— ø(1) IN GENERAL.—Commencing not later than 180 days after 

the date of the enactment of this Act, the Secretary of Veterans 

Affairs shall carry out, through the Readjustment Counseling 

Service of the Veterans Health Administration, a pilot program 

to evaluate the feasibility and advisability of providing reintegration and readjustment services described in subsection 

(b) in group retreat settings to women veterans who are recently separated from service in the Armed Forces after a prolonged deployment. 

ø(2) PARTICIPATION AT ELECTION OF VETERAN.—The participation of a veteran in the pilot program under this section 

shall be at the election of the veteran. 

ø(b) COVERED SERVICES.—The services provided to a woman veteran under the pilot program shall include the following: 

ø(1) Information on reintegration into the veteran’s family, 

employment, and community. 

ø(2) Financial counseling. 

ø(3) Occupational counseling. 

ø(4) Information and counseling on stress reduction. 

ø(5) Information and counseling on conflict resolution. 

ø(6) Such other information and counseling as the Secretary 

considers appropriate to assist a woman veteran under the 

pilot program in reintegration into the veteran’s family, employment, and community. 

9 

ø(c) LOCATIONS.—The Secretary shall carry out the pilot program 

at not fewer than three locations selected by the Secretary for purposes of the pilot program. 

ø(d) TERMINATION.—The authority to carry out a pilot program 

under this section shall terminate on December 31, 2017. 

ø(e) REPORT.—Not later than 180 days after the completion of 

the pilot program, the Secretary shall submit to Congress a report 

on the pilot program. The report shall contain the findings and conclusions of the Secretary as a result of the pilot program, and shall 

include such recommendations for the continuation or expansion of 

the pilot program as the Secretary considers appropriate. 

ø(f) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to 

be appropriated to the Secretary of Veterans Affairs for each of fiscal years 2010, 2011, 2015, 2016, and 2017, $2,000,000 to carry out 

the pilot program.¿ 

* * * * * * * 

Æ