IIB 

110TH CONGRESS 

2D SESSION H. R. 5554 

IN THE SENATE OF THE UNITED STATES 

MAY 21, 2008 

Received; read twice and referred to the Committee on Veterans’ Affairs 

AN ACT 

To amend title 38, United States Code, to expand and improve health care services available to veterans from the 

Department of Veterans Affairs for substance use disorders, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


erowe on PRODPC61 with BILLS
2 

HR 5554 RFS 

1 SECTION 1 SHORT TITLE. 

2 This Act may be cited as the ‘‘Justin Bailey Veterans 

3 Substance Use Disorders Prevention and Treatment Act 

4 of 2008’’. 

5 SEC. 2. EXPANSION OF VETERANS SUBSTANCE USE DIS6 ORDER PROGRAMS. 

7 Subsection (d) of section 1720A of title 38, United 

8 States Code, is amended by adding at the end the fol9 lowing new paragraph: 

10 ‘‘(3)(A) Each plan under paragraph (1) shall ensure 

11 that the medical center provides ready access to a full con12 tinuum of care for substance use disorders for veterans 

13 in need of such care. 

14 ‘‘(B) In this paragraph, the term ‘full continuum of 

15 care’ includes all of the following care, treatment, and 

16 services: 

17 ‘‘(i) Screening for substance use disorder in all 

18 settings, including primary care settings. 

19 ‘‘(ii) Detoxification and stabilization services. 

20 ‘‘(iii) Intensive outpatient care services. 

21 ‘‘(iv) Relapse prevention services. 

22 ‘‘(v) Outpatient counseling services. 

23 ‘‘(vi) Residential substance use disorder treat24 ment. 


erowe on PRODPC61 with BILLS
3 

HR 5554 RFS 

1 ‘‘(vii) Pharmacological treatment to reduce 

2 cravings, and opioid substitution therapy referred to 

3 in paragraph (2). 

4 ‘‘(viii) Coordination with groups providing peer 

5 to peer counseling. 

6 ‘‘(ix) Short-term, early interventions for sub7 stance use disorders, such as motivational coun8 seling, that are readily available and provided in a 

9 manner to overcome stigma associated with the pro10 vision of such interventions and related care. 

11 ‘‘(x) Marital and family counseling. 

12 ‘‘(C) The Secretary shall provide for outreach to vet13 erans who served in Operation Enduring Freedom or Op14 eration Iraqi Freedom to increase awareness of the avail15 ability of care, treatment, and services from the Depart16 ment for substance use disorders.’’. 

17 SEC. 3. REQUIREMENT FOR ALLOCATION OF DEPARTMENT 

18 RESOURCES TO ENSURE AVAILABILITY FOR 

19 ALL VETERANS REQUIRING TREATMENT FOR 

20 SUBSTANCE USE DISORDERS. 

21 (a) EQUITABLE ALLOCATION OF FUNDING; ANNUAL

22 REPORT.—Section 1720A of title 38, United States Code, 

23 as amended by section 2, is further amended by adding 

24 at the end the following new subsection: 


erowe on PRODPC61 with BILLS
4 

HR 5554 RFS 

1 ‘‘(e)(1) The Secretary shall ensure that amounts 

2 made available for care, treatment, and services provided 

3 under this section are allocated in such a manner that a 

4 full continuum of care (as defined in subsection (d)(3)(B)) 

5 is available to veterans seeking such care, treatment, or 

6 services, without regard to the location of the residence 

7 of any such veterans. 

8 ‘‘(2)(A) In addition to the report required under sec9 tion 1703(c)(1) of this title (relating to furnishing of con10 tract care and services under this section), the Secretary 

11 shall include in the budget documents which the Secretary 

12 submits to Congress for any fiscal year a detailed report 

13 on the care, treatment, and services furnished by the De14 partment under this section during the most recently com15 pleted fiscal year. 

16 ‘‘(B) Each report under subparagraph (A) shall in17 clude data on the following for each medical facility of the 

18 Department: 

19 ‘‘(i) The number of veterans who have been 

20 provided care, treatment, or services under this sec21 tion at the facility for each 1,000 veterans who have 

22 received hospital care (if applicable) or medical serv23 ices at the facility. 


erowe on PRODPC61 with BILLS
5 

HR 5554 RFS 

1 ‘‘(ii) The number of veterans for whom sub2 stance use disorder screening was carried out under 

3 subsection (d)(3)(B)(i) at the facility. 

4 ‘‘(iii) The number of veterans for whom a sub5 stance use disorder was identified after a screening 

6 was carried out under subsection (d)(3)(B)(i) at the 

7 facility. 

8 ‘‘(iv) The number of veterans who were referred 

9 by the facility for care, treatment, or services for 

10 substance use disorders under this section. 

11 ‘‘(v) The number of veterans who received care, 

12 treatment or services at the facility for substance 

13 use disorders under this section. 

14 ‘‘(vi) Availability of the full continuum of care 

15 (as defined in subsection (d)(3)(B)) at the facility. 

16 ‘‘(C) Each report prepared under subparagraph (A) 

17 shall be reviewed by the Committee on Care of Severely 

18 Chronically Mentally Ill Veterans authorized by section 

19 7321 of this title. The Committee shall provide an inde20 pendent assessment of the care, treatment, and services 

21 furnished directly by the Department under this section 

22 to veterans. Such assessment shall include a detailed anal23 ysis of the availability, the barriers to access (if any), and 

24 the quality of such care, treatment, and services.’’. 


erowe on PRODPC61 with BILLS
6 

HR 5554 RFS 

1 (b) EFFECTIVE DATE.—The amendment made by 

2 subsection (a) shall apply to fiscal years beginning on or 

3 after October 1, 2009. 

4 SEC. 4. PILOT PROGRAM FOR INTERNET-BASED SUB5 STANCE USE DISORDER TREATMENT FOR 

6 VETERANS OF OPERATION IRAQI FREEDOM 

7 AND OPERATION ENDURING FREEDOM. 

8 (a) FINDINGS.—Congress makes the following find9 ings: 

10 (1) Stigma associated with seeking treatment 

11 for mental health disorders has been demonstrated 

12 to prevent some veterans from seeking such treat13 ment at a medical facility operated by the Depart14 ment of Defense or the Department of Veterans Af15 fairs. 

16 (2) There is a significant incidence among vet17 erans of post-deployment mental health problems, 

18 especially among members of a reserve component 

19 who return as veterans to civilian life. 

20 (3) Computer-based self-guided training has 

21 been demonstrated to be an effective strategy for 

22 supplementing the care of psychological conditions. 

23 (4) Younger veterans, especially those who 

24 served in Operation Enduring Freedom or Operation 


erowe on PRODPC61 with BILLS
7 

HR 5554 RFS 

1 Iraqi Freedom, are comfortable with and proficient 

2 at computer-based technology. 

3 (5) Veterans living in rural areas find access to 

4 treatment for substance use disorder limited. 

5 (6) Self-assessment and treatment options for 

6 substance use disorders through an Internet website 

7 may reduce stigma and provides additional access 

8 for individuals seeking care and treatment for such 

9 disorders. 

10 (b) IN GENERAL.—Not later than October 1, 2009, 

11 the Secretary of Veterans Affairs shall initiate a pilot pro12 gram to test the feasibility and advisability of providing 

13 veterans who seek treatment for substance use disorders 

14 access to a computer-based self-assessment, education, 

15 and specified treatment program through a secure Inter16 net website operated by the Secretary. Participation in the 

17 pilot program is available on a voluntary basis for those 

18 veterans who have served in Operation Enduring Freedom 

19 or Operation Iraqi Freedom. 

20 (c) ELEMENTS OF PILOT PROGRAM.— 

21 (1) IN GENERAL.—In designing and carrying 

22 out the pilot program under this section, the Sec23 retary of Veterans Affairs shall ensure that— 

24 (A) access to the Internet website and the 

25 programs available on the website by a veteran 


erowe on PRODPC61 with BILLS
8 

HR 5554 RFS 

1 (or family member) does not involuntarily gen2 erate an identifiable medical record of that ac3 cess by that veteran in any medical database 

4 maintained by the Department; 

5 (B) the Internet website is accessible from 

6 remote locations, especially rural areas; and 

7 (C) the Internet website includes a self-as8 sessment tool for substance use disorders, self9 guided treatment and educational materials for 

10 such disorders, and appropriate information 

11 and materials for family members of veterans. 

12 (2) CONSIDERATION OF SIMILAR PROJECTS.— 

13 In designing the pilot program under this section, 

14 the Secretary of Veterans Affairs shall consider simi15 lar pilot projects of the Department of Defense for 

16 the early diagnosis and treatment of post-traumatic 

17 stress disorder and other mental health conditions 

18 established under section 741 of the John Warner 

19 National Defense Authorization Act of Fiscal Year 

20 2007 (Public Law 109–364; 120 Stat. 2304). 

21 (3) LOCATION OF PILOT PROGRAM.—The Sec22 retary shall carry out the pilot program through 

23 those medical centers of the Department of Veterans 

24 Affairs that have established Centers for Excellence 

25 for Substance Abuse Treatment and Education or 


erowe on PRODPC61 with BILLS
9 

HR 5554 RFS 

1 that have established a Substance Abuse Program 

2 Evaluation and Research Center. 

3 (4) CONTRACT AUTHORITY.—The Secretary of 

4 Veterans Affairs may enter into contracts with 

5 qualified entities or organizations to carry out the 

6 pilot program required under this section. 

7 (d) DURATION OF PILOT PROGRAM.—The pilot pro8 gram required by subsection (a) shall be carried out dur9 ing the two-year period beginning on the date of the com10 mencement of the pilot program. 

11 (e) AUTHORIZATION OF APPROPRIATIONS.—There 

12 are authorized to be appropriated to the Secretary of Vet13 erans Affairs $1,500,000 for each of fiscal years 2010 and 

14 2011 to carry out the pilot program under this section. 

15 (f) REPORT.—Not later than six months after the 

16 completion of the pilot program, the Secretary shall sub17 mit to Congress a report on the pilot program, and shall 

18 include in that report an assessment of the feasibility and 

19 advisability of the pilot program, of any cost savings or 

20 other benefits associated with the pilot program, and rec21 ommendations for the continuation or expansion of the 

22 pilot program. 


erowe on PRODPC61 with BILLS
10 

HR 5554 RFS 

1 SEC. 5. REPORT ON RESIDENTIAL MENTAL HEALTH CARE 

2 FACILITIES OF THE VETERANS HEALTH AD3 MINISTRATION. 

4 (a) REVIEW AND REPORT.—Not later than six 

5 months after the date of the enactment of this Act, the 

6 Secretary of Veterans Affairs, acting through the Office 

7 of the Medical Inspector of the Department of Veterans 

8 Affairs, shall— 

9 (1) conduct a review of all residential mental 

10 health care facilities, including domiciliary facilities, 

11 of the Veterans Health Administration; and 

12 (2) submit to the Committee on Veterans’ Af13 fairs of the Senate and the Committee on Veterans’ 

14 Affairs of the House of Representatives a report on 

15 the review conducted under paragraph (1). 

16 (b) ELEMENTS OF REPORT.—The report required by 

17 subsection (a)(2) shall include the following: 

18 (1) A description of the availability of care in 

19 residential mental health care facilities in each Vet20 erans Integrated Service Network (VISN). 

21 (2) An assessment of the supervision and sup22 port provided in the residential mental health care 

23 facilities of the Veterans Health Administration. 

24 (3) The ratio of staff members at each residen25 tial mental health care facility to patients at such fa26 cility. 


erowe on PRODPC61 with BILLS
11 

HR 5554 RFS 

1 (4) An assessment of the appropriateness of 

2 rules and procedures for the prescription and admin3 istration of medications to patients in such residen4 tial mental health care facilities. 

5 (5) A description of the protocols at each resi6 dential mental health care facility for handling 

7 missed appointments. 

8 (6) Any recommendations the Secretary con9 siders appropriate for improvements to such residen10 tial mental health care facilities and the care pro11 vided in such facilities. 

12 SEC. 6. TRIBUTE TO JUSTIN BAILEY. 

13 This Act is enacted in tribute to Justin Bailey, who, 

14 after returning to the United States from service as a 

15 member of the Armed Forces in Operation Iraqi Freedom, 

16 died in a domiciliary facility of the Department of Vet17 erans Affairs while receiving care for post-traumatic stress 

18 disorder and a substance use disorder. 

Passed the House of Representatives May 20, 2008. 

Attest: LORRAINE C. MILLER, 

Clerk. 


erowe on PRODPC61 with BILLS