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[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 852 Introduced in Senate (IS)]

113th CONGRESS
  1st Session
                                 S. 852

To improve health care furnished by the Department of Veterans Affairs 
  by increasing access to complementary and alternative medicine and 
    other approaches to wellness and preventive care, and for other 
                               purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             April 25, 2013

  Mr. Sanders introduced the following bill; which was read twice and 
             referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL

 
To improve health care furnished by the Department of Veterans Affairs 
  by increasing access to complementary and alternative medicine and 
    other approaches to wellness and preventive care, 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.

    This Act may be cited as the ``Veterans' Health Promotion Act of 
2013''.

SEC. 2. DESIGNATION AND OPERATION OF CENTERS OF INNOVATION FOR 
              COMPLEMENTARY AND ALTERNATIVE MEDICINE IN HEALTH CARE 
              RESEARCH, EDUCATION, AND CLINICAL ACTIVITIES.

    (a) Designation and Operation of Centers of Innovation.--Subchapter 
II of chapter 73 of title 38, United States Code, is amended by adding 
at the end the following new section:
``Sec. 7330B. Centers of innovation for complementary and alternative 
              medicine in health care research, education, and clinical 
              activities
    ``(a) Designation and Operation.--The Secretary, acting through the 
Director of the Office of Patient Centered Care for Cultural 
Transformation, shall designate and operate at least one center of 
innovation for complementary and alternative medicine in health 
research, education, and clinical activities in each Veterans 
Integrated Service Networks.
    ``(b) Functions.--The functions of the centers of innovation 
designated and operated under subsection (a) are as follows:
            ``(1) To conduct research on the furnishing of 
        complementary and alternative medicine in health care.
            ``(2) To develop specific models to be used by the 
        Department in furnishing services to veterans consisting of 
        complementary and alternative medicine.
            ``(3) To provide education and training for health care 
        professionals of the Department on--
                    ``(A) the furnishing of services consisting of 
                complementary and alternative medicine to veterans; or
                    ``(B) providing referrals to veterans for the 
                receipt of such services.
            ``(4) To develop and implement innovative clinical 
        activities and systems of care for the Department for the 
        furnishing of services consisting of complementary and 
        alternative medicine to veterans.
    ``(c) Geographic Dispersion.--The Secretary shall ensure that the 
centers designated and operated under this section are located at 
health care facilities that are geographically dispersed throughout the 
United States.
    ``(d) Funding.--(1) There is authorized to be appropriated to the 
Secretary such sums as may be necessary for the support of the research 
and education activities of the centers operated under this section.
    ``(2) Activities of clinical and scientific investigation at each 
center operated under this section--
            ``(A) shall be eligible to compete for the award of funding 
        from funds appropriated for the Medical and Prosthetics 
        Research Account; and
            ``(B) shall receive priority in the award of funding from 
        such account to the extent that funds are awarded to projects 
        for research on the care of rural veterans.
    ``(e) Complimentary and Alternative Medicine Defined.--In this 
section, the term `complimentary and alternative medicine' shall have 
the meaning given that term in regulations the Secretary shall 
prescribe for purposes of this section, which shall, to the degree 
practicable, be consistent with the meaning given such term by the 
Secretary of Health and Human Services.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 of such title is amended by inserting after the item 
relating to section 7330A the following new item:

``7330B. Centers of Innovation for complementary and alternative 
                            medicine in health care research, 
                            education, and clinical activities.''.

SEC. 3. PILOT PROGRAM ON ESTABLISHMENT OF COMPLEMENTARY AND ALTERNATIVE 
              MEDICINE CENTERS WITHIN DEPARTMENT OF VETERANS AFFAIRS 
              MEDICAL CENTERS.

    (a) Pilot Program Required.--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 Office of Patient Centered Care 
and Cultural Transformation of the Department of Veterans Affairs, a 
pilot program to assess the feasibility and advisability of 
establishing complementary and alternative medicine centers within 
Department medical centers to promote the use and integration of 
complementary and alternative medicine services for mental health 
diagnoses and pain management.
    (b) Duration of Program.--The pilot program shall be carried out 
during the three-year period beginning on the date of the commencement 
of the pilot program.
    (c) Locations.--
            (1) In general.--The Secretary shall carry out the pilot 
        program by establishing not fewer than 15 complementary and 
        alternative medicine centers in 15 separate Department medical 
        centers as follows:
                    (A) Five Department medical centers designated by 
                the Secretary as polytrauma centers.
                    (B) Ten Department medical centers not designated 
                by Secretary as polytrauma centers.
            (2) Considerations.--In selecting locations for the pilot 
        program, the Secretary shall consider the feasibility and 
        advisability of selecting locations in--
                    (A) rural areas;
                    (B) areas that are not in close proximity to an 
                active duty military installation; and
                    (C) areas representing different geographic 
                locations, such as census tracts established by the 
                Bureau of the Census.
    (d) Provision of Services.--Under the pilot program, the Secretary 
shall provide covered services to covered veterans through the 
complementary and alternative medicine centers established under 
subsection (c)(1).
    (e) Covered Veterans.--For purposes of the pilot program, a covered 
veteran is any veteran who has--
            (1) a mental health condition diagnosed by a clinician of 
        the Department; or
            (2) a pain condition for which the veteran has received a 
        pain management plan from a clinician of the Department.
    (f) Covered Services.--
            (1) In general.--For purposes of the pilot program, covered 
        services are services consisting of complementary or 
        alternative medicine.
            (2) Administration of services.--Covered services shall be 
        administered under the pilot program as follows:
                    (A) Covered services shall be administered by 
                clinicians who exclusively provide services consisting 
                of complementary or alternative medicine.
                    (B) Covered services shall be included as part of 
                the Patient Aligned Care Teams initiative of the Office 
                of Patient Care Services, Primary Care Program Office.
                    (C) Covered services shall be made available to 
                both--
                            (i) covered veterans with mental health 
                        conditions or pain conditions described in 
                        subsection (e) who have received traditional 
                        treatments from the Department for such 
                        conditions; and
                            (ii) covered veterans with mental health 
                        conditions or pain conditions described in 
                        subsection (e) who have not received 
                        traditional treatments from the Department for 
                        such conditions.
    (g) Voluntary Participation.--The participation of a veteran in the 
pilot program shall be at the election of the veteran and in 
consultation with a clinician of the Department.
    (h) Reports to Congress.--
            (1) Quarterly reports.--Not later than 90 days after the 
        date of the commencement of the pilot program and not less 
        frequently than once every 90 days thereafter for the duration 
        of the pilot program, 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 efforts of the Secretary to carry out the pilot program, 
        including a description of the outreach conducted by the 
        Secretary to veterans and community organizations to inform 
        such organizations about the pilot program.
            (2) Final report.--
                    (A) In general.--Not later than 180 days after the 
                completion of the pilot program, 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 pilot program.
                    (B) Contents.--The report submitted under 
                subparagraph (A) shall include the following:
                            (i) The findings and conclusions of the 
                        Secretary with respect to the pilot program, 
                        including with respect to the utilization and 
                        efficacy of the complementary and alternative 
                        medicine centers established under the pilot 
                        program.
                            (ii) Such recommendations for the 
                        continuation or expansion of the pilot program 
                        as the Secretary considers appropriate.

SEC. 4. PILOT PROGRAM ON USE OF WELLNESS PROGRAMS AS COMPLEMENTARY 
              APPROACH TO MENTAL HEALTH CARE FOR VETERANS AND FAMILY 
              MEMBERS OF VETERANS.

    (a) Pilot Program Required.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        carry out a pilot program through the award of grants to public 
        or private nonprofit entities to assess the feasibility and 
        advisability of using wellness programs to complement the 
        provision of mental health care to veterans and family members 
        eligible for counseling under section 1712A(a)(1)(C) of title 
        38, United States Code.
            (2) Matters to be addressed.--The pilot program shall be 
        carried out so as to assess the following:
                    (A) Means of improving coordination between 
                Federal, State, local, and community providers of 
                health care in the provision of mental health care to 
                veterans and family members described in paragraph (1).
                    (B) Means of enhancing outreach, and coordination 
                of outreach, by and among providers of health care 
                referred to in subparagraph (A) on the mental health 
                care services available to veterans and family members 
                described in paragraph (1).
                    (C) Means of using wellness programs of providers 
                of health care referred to in subparagraph (A) as 
                complements to the provision by the Department of 
                Veterans Affairs of mental health care to veterans and 
                family members described in paragraph (1).
                    (D) Whether wellness programs described in 
                subparagraph (C) are effective in enhancing the quality 
                of life and well-being of veterans and family members 
                described in paragraph (1).
                    (E) Whether wellness programs described in 
                subparagraph (C) are effective in increasing the 
                adherence of veterans described in paragraph (1) to the 
                primary mental health services provided such veterans 
                by the Department.
                    (F) Whether wellness programs described in 
                subparagraph (C) have an impact on the sense of 
                wellbeing of veterans described in paragraph (1) who 
                receive primary mental health services from the 
                Department.
                    (G) Whether wellness programs described in 
                subparagraph (C) are effective in encouraging veterans 
                receiving health care from the Department to adopt a 
                more healthy lifestyle.
    (b) Duration.--The Secretary shall carry out the pilot program for 
a period of three years beginning on the date that is 90 days after the 
date of the enactment of this Act.
    (c) Locations.--The Secretary shall carry out the pilot program at 
facilities of the Department providing mental health care services to 
veterans and family members described in subsection (a)(1).
    (d) Grant Proposals.--
            (1) In general.--A public or private nonprofit entity 
        seeking the award of a grant under this section shall submit an 
        application therefor to the Secretary in such form and in such 
        manner as the Secretary may require.
            (2) Application contents.--Each application submitted under 
        paragraph (1) shall include the following:
                    (A) A plan to coordinate activities under the pilot 
                program, to the extent possible, with the Federal, 
                State, and local providers of services for veterans to 
                enhance the following:
                            (i) Awareness by veterans of benefits and 
                        health care services provided by the 
                        Department.
                            (ii) Outreach efforts to increase the use 
                        by veterans of services provided by the 
                        Department.
                            (iii) Educational efforts to inform 
                        veterans of the benefits of a healthy and 
                        active lifestyle.
                    (B) A statement of understanding from the entity 
                submitting the application that, if selected, such 
                entity will be required to report to the Secretary 
                periodically on standardized data and other performance 
                data necessary to evaluate individual outcomes and to 
                facilitate evaluations among entities participating in 
                the pilot program.
                    (C) Other requirements that the Secretary may 
                prescribe.
    (e) Grant Uses.--
            (1) In general.--A public or private nonprofit entity 
        awarded a grant under this section shall use the award for 
        purposes prescribed by the Secretary.
            (2) Eligible veterans and family.--In carrying out the 
        purposes prescribed by the Secretary in paragraph (1), a public 
        or private nonprofit entity awarded a grant under this section 
        shall use the award to furnish services only to individuals 
        specified in section 1712A(a)(1)(C) of title 38, United States 
        Code.
    (f) Reports.--
            (1) Periodic reports.--
                    (A) In general.--Not later than 180 days after the 
                date of the enactment of this Act, and every 180 days 
                thereafter, the Secretary shall submit to Congress a 
                report on the pilot program.
                    (B) Report elements.--Each report required by 
                subparagraph (A) shall include the following:
                            (i) The findings and conclusions of the 
                        Secretary with respect to the pilot program 
                        during the 180-day period preceding the report.
                            (ii) An assessment of the benefits of the 
                        pilot program to veterans and their family 
                        members during the 180-day period preceding the 
                        report.
            (2) Final report.--Not later than 180 days after the end of 
        the pilot program, the Secretary shall submit to Congress a 
        report detailing the recommendations of the Secretary as to the 
        advisability of continuing or expanding the pilot program.
    (g) Wellness Defined.--In this section, the term ``wellness'' shall 
have the meaning given that term in regulations prescribed by the 
Secretary.

SEC. 5. PILOT PROGRAM ON HEALTH PROMOTION FOR OVERWEIGHT AND OBESE 
              VETERANS THROUGH SUPPORT OF FITNESS CENTER MEMBERSHIP.

    (a) Pilot Program Required.--Commencing not later than 180 days 
after the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall, through the National Center for Preventive Health, carry 
out a pilot program to assess the feasibility and advisability of 
promoting health in covered veterans, including achieving a healthy 
weight and reducing risks of chronic disease, through support for 
fitness center membership.
    (b) Covered Veterans.--For purposes of this section, a covered 
veteran is any veteran who--
            (1) is determined by a clinician of the Department of 
        Veterans Affairs to be overweight or obese as of the date of 
        the commencement of the pilot program; and
            (2) resides in a location that is more than 15 minutes 
        driving distance from a fitness center at a facility of the 
        Department that would otherwise be available to the veteran for 
        at least eight hours per day during five or more days per week.
    (c) Duration of Pilot Program.--The pilot program shall be carried 
out during the two-year period beginning on the date of the 
commencement of the pilot program.
    (d) Locations.--
            (1) In general.--In carrying out the pilot program, the 
        Secretary shall select--
                    (A) not less than five medical centers of the 
                Department at which the Secretary shall cover the full 
                reasonable cost of a fitness center membership for 
                covered veterans within the catchment area of such 
                centers; and
                    (B) not less than five medical centers of the 
                Department at which the Secretary shall cover half the 
                reasonable cost of a fitness center membership for 
                covered veterans within the catchment area of such 
                centers.
            (2) Considerations.--In selecting locations for the pilot 
        program, the Secretary shall consider the feasibility and 
        advisability of selecting locations in the following areas:
                    (A) Rural areas.
                    (B) Areas that are not in close proximity to an 
                active duty military installation.
                    (C) Areas in different geographic locations.
    (e) Participation.--
            (1) Maximum number of participants.--The number of covered 
        veterans who may participate in the pilot program at a location 
        selected under subsection (d) may not exceed 100.
            (2) Voluntary participation.--The participation of a 
        covered veteran in the pilot program shall be at the election 
        of the covered veteran in consultation with a clinician of the 
        Department.
    (f) Membership Payment.--
            (1) In general.--Except as provided in paragraph (2), in 
        carrying out the pilot program, the Secretary shall pay the 
        following:
                    (A) The full reasonable cost of a fitness center 
                membership for covered veterans within the catchment 
                area of centers selected under subsection (b)(1)(A) who 
                are participating in the pilot program.
                    (B) Half the reasonable cost of a fitness center 
                membership for covered veterans within the catchment 
                area of centers selected under subsection (b)(1)(B) who 
                are participating in the pilot program.
            (2) Limitation.--Payment for a fitness center membership of 
        a covered veteran may not exceed $50 per month of membership.
    (g) Reports.--
            (1)  Periodic reports.--Not later than 90 days after the 
        date of the commencement of the pilot program and not less 
        frequently than once every 90 days 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 on activities carried out to implement 
        the pilot program, including outreach activities to veterans 
        and community organizations.
            (2) Final report.--Not later than 180 days after the date 
        of the completion of the pilot program, 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 pilot program detailing--
                    (A) the findings and conclusions of the Secretary 
                as a result of the pilot program; and
                    (B) recommendations for the continuation or 
                expansion of the pilot program.

SEC. 6. PILOT PROGRAM ON HEALTH PROMOTION FOR VETERANS THROUGH 
              ESTABLISHMENT OF DEPARTMENT OF VETERANS AFFAIRS FITNESS 
              FACILITIES.

    (a) Pilot Program Required.--Commencing not later than 180 days 
after the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall carry out a pilot program to assess the feasibility and 
advisability of promoting health in covered veterans, including 
achieving a healthy weight, through establishment of Department of 
Veterans Affairs fitness facilities.
    (b) Covered Veterans.--For purposes of this section, a covered 
veteran is any veteran who is enrolled in the system of annual patient 
enrollment established and operated by the Secretary under section 1705 
of title 38, United States Code.
    (c) Duration of Pilot Program.--The pilot program shall be carried 
out during the three-year period beginning on the date of the 
commencement of the pilot program.
    (d) Locations.--
            (1) In general.--The Secretary shall carry out the pilot 
        program by establishing fitness facilities in Department 
        facilities as follows:
                    (A) In not fewer than five Department of Veterans 
                Affairs medical centers selected by the Secretary for 
                purposes of the pilot program.
                    (B) In not fewer than five outpatient clinics of 
                the Department selected by the Secretary for purposes 
                of the pilot program.
            (2) Considerations.--In selecting locations for the pilot 
        program, the Secretary shall consider the feasibility and 
        advisability of selecting locations in the following areas:
                    (A) Rural areas.
                    (B) Areas that are not in close proximity to an 
                active duty military installation.
                    (C) Areas in different geographic locations.
    (e) Limitation on Expenses.--In establishing and supporting a 
fitness facility in a facility of the Department under the pilot 
program, the Secretary may expend amounts as follows:
            (1) For establishment and support of a fitness facility in 
        a Department of Veterans Affairs medical center, not more than 
        $60,000.
            (2) For establishment and support of a fitness facility in 
        an outpatient clinic of the Department, not more than $40,000.
    (f) Renovations and Purchases.--Subject to subsection (e), the 
Secretary may, in carrying out the pilot program, make such renovations 
to physical facilities of the Department and purchase such fitness 
equipment and supplies as the Secretary considers appropriate for 
purposes of the pilot program.
    (g) Prohibition on Assessment of User Fees.--The Secretary may not 
assess a fee upon a covered veteran for use of a fitness facility 
established under the pilot program.
    (h) Voluntary Participation.--The participation of a covered 
veteran in the pilot program shall be at the election of the covered 
veteran.
    (i) Reports.--
            (1) Periodic reports.--Not later than 90 days after the 
        date of the commencement of the pilot program and not less 
        frequently than once every 90 days 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 on activities carried out to implement 
        the pilot program, including outreach activities to veterans 
        and community organizations.
            (2) Final report.--Not later than 180 days after the date 
        of the completion of the pilot program, 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 pilot program detailing--
                    (A) the findings and conclusions of the Secretary 
                as a result of the pilot program; and
                    (B) recommendations for the continuation or 
                expansion of the pilot program.

SEC. 7. STUDY OF BARRIERS ENCOUNTERED BY VETERANS IN RECEIVING 
              COMPLEMENTARY AND ALTERNATIVE MEDICINE FROM DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) Study Required.--The Secretary of Veterans Affairs shall 
conduct a comprehensive study of the barriers encountered by veterans 
in receiving complementary and alternative medicine from the Department 
of Veterans Affairs. In conducting the study, the Secretary shall--
            (1) survey veterans who seek or receive hospital care or 
        medical services furnished by the Department, as well as 
        veterans who do not seek or receive such care or services;
            (2) administer the survey to a representative sample of 
        veterans from each Veterans Integrated Service Network; and
            (3) ensure that the sample of veterans surveyed is of 
        sufficient size for the study results to be statistically 
        significant.
    (b) Elements of Study.--In conducting the study required by 
subsection (a), the Secretary shall study the following:
            (1) The perceived barriers associated with obtaining 
        complementary and alternative medicine services from the 
        Department.
            (2) The satisfaction of veterans with complementary and 
        alternative medicine in primary care.
            (3) The degree to which veterans are aware of eligibility 
        requirements for, and the scope of services available under, 
        complementary and alternative medicine furnished by the 
        Department.
            (4) The effectiveness of outreach to veterans on the 
        availability of complementary and alternative medicine for 
        veterans.
            (5) Such other barriers as the Secretary considers 
        appropriate.
    (c) Discharge by Contract.--The Secretary shall enter into a 
contract with a qualified independent entity or organization to carry 
out the study required by this section.
    (d) Mandatory Review of Data by Certain Department Divisions.--
            (1) In general.--The Secretary shall ensure that the head 
        of each division of the Department specified in paragraph (2) 
        reviews the results of the study conducted under this section. 
        The head of each such division shall submit findings with 
        respect to the study to the Under Secretary for Health and to 
        other pertinent program offices within the Department with 
        responsibilities relating to health care services for veterans.
            (2) Specified divisions.--The divisions of the Department 
        specified in this paragraph are the following:
                    (A) The centers for innovation established under 
                section 7330B of title 38, United States Code, as added 
                by section 2.
                    (B) The Health Services Research and Development 
                Service Scientific Merit Review Board.
    (e) Reports.--
            (1) Report on implementation.--Not later than 180 days 
        after the date of the enactment of this Act, the Secretary 
        shall submit to Congress a report on the status of the 
        implementation of this section.
            (2) Report on study.--
                    (A) In general.--Not later than 45 days after the 
                date of the completion of the study, the Secretary 
                shall submit to Congress a report on the study required 
                by subsection (a).
                    (B) Contents.--The report required by subparagraph 
                (A) shall include the following:
                            (i) Recommendations for such administrative 
                        and legislative proposals and actions as the 
                        Secretary considers appropriate.
                            (ii) The findings of the head of each 
                        division of the Department specified under 
                        subsection (d)(2) and of the Under Secretary 
                        for Health.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary $2,000,000 to carry out this section.

SEC. 8. COMPLIMENTARY AND ALTERNATIVE MEDICINE DEFINED.

    In this Act, the term ``complimentary and alternative medicine'' 
shall have the meaning given such term under section 7330B of title 38, 
United States Code, as added by section 2.
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