IB 

Union Calendar No. 400 

110TH CONGRESS 

2D SESSION H. R. 5554 

[Report No. 110–639] 

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. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 6, 2008 

Mr. MICHAUD (for himself, Mr. FILNER, Mr. MILLER of Florida, Ms. 

CORRINE BROWN of Florida, Mr. ALLEN, Mr. BISHOP of Georgia, Mr. 

LEWIS of Georgia, and Mr. COHEN) introduced the following bill; which 

was referred to the Committee on Veterans’ Affairs 

MAY 15, 2008 

Additional sponsors: Ms. BORDALLO, Mr. LEVIN, Mr. HINOJOSA, Mrs. 

NAPOLITANO, Ms. BERKLEY, Mr. KENNEDY, Mr. HINCHEY, Ms. MCCOLLUM of Minnesota, and Mr. CAPUANO

MAY 15, 2008 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on March 6, 2008] 

A BILL 

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


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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, 

3 SECTION 1 SHORT TITLE. 

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

5 Substance Use Disorders Prevention and Treatment Act of 

6 2008’’. 

7 SEC. 2. EXPANSION OF VETERANS SUBSTANCE USE DIS8 ORDER PROGRAMS. 

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

10 States Code, is amended by adding at the end the following 

11 new paragraph: 

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

13 that the medical center provides ready access to a full con14 tinuum of care for substance use disorders for veterans in 

15 need of such care. 

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

17 care’ includes all of the following care, treatment, and serv18 ices: 

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

20 settings, including primary care settings. 

21 ‘‘(ii) Detoxification and stabilization services. 

22 ‘‘(iii) Intensive outpatient care services. 

23 ‘‘(iv) Relapse prevention services. 

24 ‘‘(v) Outpatient counseling services. 


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1 ‘‘(vi) Residential substance use disorder treat2 ment. 

3 ‘‘(vii) Pharmacological treatment to reduce 

4 cravings, and opioid substitution therapy referred to 

5 in paragraph (2). 

6 ‘‘(viii) Coordination with groups providing peer 

7 to peer counseling. 

8 ‘‘(ix) Short-term, early interventions for sub9 stance use disorders, such as motivational counseling, 

10 that are readily available and provided in a manner 

11 to overcome stigma associated with the provision of 

12 such interventions and related care. 

13 ‘‘(x) Marital and family counseling. 

14 ‘‘(C) The Secretary shall provide for outreach to vet15 erans who served in Operation Enduring Freedom or Oper16 ation Iraqi Freedom to increase awareness of the avail17 ability of care, treatment, and services from the Department 

18 for substance use disorders.’’. 

19 SEC. 3. REQUIREMENT FOR ALLOCATION OF DEPARTMENT 

20 RESOURCES TO ENSURE AVAILABILITY FOR 

21 ALL VETERANS REQUIRING TREATMENT FOR 

22 SUBSTANCE USE DISORDERS. 

23 (a) EQUITABLE ALLOCATION OF FUNDING; ANNUAL

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


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1 as amended by section 2, is further amended by adding at 

2 the end the following new subsection: 

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

4 available for care, treatment, and services provided under 

5 this section are allocated in such a manner that a full con6 tinuum of care (as defined in subsection (d)(3)(B)) is avail7 able to veterans seeking such care, treatment, or services, 

8 without regard to the location of the residence of any such 

9 veterans. 

10 ‘‘(2)(A) In addition to the report required under sec11 tion 1703(c)(1) of this title (relating to furnishing of con12 tract care and services under this section), the Secretary 

13 shall include in the budget documents which the Secretary 

14 submits to Congress for any fiscal year a detailed report 

15 on the care, treatment, and services furnished by the De16 partment under this section during the most recently com17 pleted fiscal year. 

18 ‘‘(B) Each report under subparagraph (A) shall in19 clude data on the following for each medical facility of the 

20 Department: 

21 ‘‘(i) The number of veterans who have been pro22 vided care, treatment, or services under this section at 

23 the facility for each 1,000 veterans who have received 

24 hospital care (if applicable) or medical services at the 

25 facility. 


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1 ‘‘(ii) The number of veterans for whom substance 

2 use disorder screening was carried out under sub3 section (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 sub10 stance use disorders under this section. 

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

12 treatment or services at the facility for substance use 

13 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 fur21 nished directly by the Department under this section to vet22 erans. Such assessment shall include a detailed analysis of 

23 the availability, the barriers to access (if any), and the 

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


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1 (b) EFFECTIVE DATE.—The amendment made by sub2 section (a) shall apply to fiscal years beginning on or after 

3 October 1, 2009. 

4 SEC. 4. PILOT PROGRAM FOR INTERNET-BASED SUBSTANCE 

5 USE DISORDER TREATMENT FOR VETERANS 

6 OF OPERATION IRAQI FREEDOM AND OPER7 ATION ENDURING FREEDOM. 

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

9 (1) Stigma associated with seeking treatment for 

10 mental health disorders has been demonstrated to pre11 vent some veterans from seeking such treatment at a 

12 medical facility operated by the Department of De13 fense or the Department of Veterans Affairs. 

14 (2) There is a significant incidence among vet15 erans of post-deployment mental health problems, es16 pecially among members of a reserve component who 

17 return as veterans to civilian life. 

18 (3) Computer-based self-guided training has been 

19 demonstrated to be an effective strategy for 

20 supplementing the care of psychological conditions. 

21 (4) Younger veterans, especially those who served 

22 in Operation Enduring Freedom or Operation Iraqi 

23 Freedom, are comfortable with and proficient at com24 puter-based technology. 


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

2 treatment for substance use disorder limited. 

3 (6) Self-assessment and treatment options for 

4 substance use disorders through an Internet website 

5 may reduce stigma and provides additional access for 

6 individuals seeking care and treatment for such dis7 orders. 

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

9 Secretary of Veterans Affairs shall initiate a pilot program 

10 to test the feasibility and advisability of providing veterans 

11 who seek treatment for substance use disorders access to a 

12 computer-based self-assessment, education, and specified 

13 treatment program through a secure Internet website oper14 ated by the Secretary. Participation in the pilot program 

15 is available on a voluntary basis for those veterans who 

16 have served in Operation Enduring Freedom or Operation 

17 Iraqi Freedom. 

18 (c) ELEMENTS OF PILOT PROGRAM.— 

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

20 out the pilot program under this section, the Sec21 retary of Veterans Affairs shall ensure that— 

22 (A) access to the Internet website and the 

23 programs available on the website by a veteran 

24 (or family member) does not involuntarily gen25 erate an identifiable medical record of that acVerDate Aug 31 2005 00:42 May 16, 2008 Jkt 069200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6203 E:\BILLS\H5554.RH H5554

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1 cess by that veteran in any medical database 

2 maintained by the Department; 

3 (B) the Internet website is accessible from 

4 remote locations, especially rural areas; and 

5 (C) the Internet website includes a self-as6 sessment tool for substance use disorders, self7 guided treatment and educational materials for 

8 such disorders, and appropriate information and 

9 materials for family members of veterans. 

10 (2) CONSIDERATION OF SIMILAR PROJECTS.—In 

11 designing the pilot program under this section, the 

12 Secretary of Veterans Affairs shall consider similar 

13 pilot projects of the Department of Defense for the 

14 early diagnosis and treatment of post-traumatic stress 

15 disorder and other mental health conditions estab16 lished under section 741 of the John Warner National 

17 Defense Authorization Act of Fiscal Year 2007 (Pub18 lic Law 109–364; 120 Stat. 2304). 

19 (3) LOCATION OF PILOT PROGRAM.—The Sec20 retary shall carry out the pilot program through those 

21 medical centers of the Department of Veterans Affairs 

22 that have established Centers for Excellence for Sub23 stance Abuse Treatment and Education or that have 

24 established a Substance Abuse Program Evaluation 

25 and Research Center. 


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1 (4) CONTRACT AUTHORITY.—The Secretary of 

2 Veterans Affairs may enter into contracts with quali3 fied entities or organizations to carry out the pilot 

4 program required under this section. 

5 (d) DURATION OF PILOT PROGRAM.—The pilot pro6 gram required by subsection (a) shall be carried out during 

7 the two-year period beginning on the date of the commence8 ment of the pilot program. 

9 (e) AUTHORIZATION OF APPROPRIATIONS.—There are 

10 authorized to be appropriated to the Secretary of Veterans 

11 Affairs $1,500,000 for each of fiscal years 2010 and 2011 

12 to carry out the pilot program under this section. 

13 (f) REPORT.—Not later than six months after the com14 pletion of the pilot program, the Secretary shall submit to 

15 Congress a report on the pilot program, and shall include 

16 in that report an assessment of the feasibility and advis17 ability of the pilot program, of any cost savings or other 

18 benefits associated with the pilot program, and rec19 ommendations for the continuation or expansion of the pilot 

20 program. 

21 SEC. 5. REPORT ON RESIDENTIAL MENTAL HEALTH CARE 

22 FACILITIES OF THE VETERANS HEALTH AD23 MINISTRATION. 

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

25 after the date of the enactment of this Act, the Secretary 


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1 of Veterans Affairs, acting through the Office of the Medical 

2 Inspector of the Department of Veterans Affairs, shall— 

3 (1) conduct a review of all residential mental 

4 health care facilities, including domiciliary facilities, 

5 of the Veterans Health Administration; and 

6 (2) submit to the Committee on Veterans’ Affairs 

7 of the Senate and the Committee on Veterans’ Affairs 

8 of the House of Representatives a report on the review 

9 conducted under paragraph (1). 

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

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

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

13 residential mental health care facilities in each Vet14 erans Integrated Service Network (VISN). 

15 (2) An assessment of the supervision and support 

16 provided in the residential mental health care facili17 ties of the Veterans Health Administration. 

18 (3) The ratio of staff members at each residential 

19 mental health care facility to patients at such facil20 ity. 

21 (4) An assessment of the appropriateness of rules 

22 and procedures for the prescription and administra23 tion of medications to patients in such residential 

24 mental health care facilities. 


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1 (5) A description of the protocols at each residen2 tial mental health care facility for handling missed 

3 appointments. 

4 (6) Any recommendations the Secretary con5 siders appropriate for improvements to such residen6 tial mental health care facilities and the care pro7 vided in such facilities. 

8 SEC. 6. TRIBUTE TO JUSTIN BAILEY. 

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

10 after returning to the United States from service as a mem11 ber of the Armed Forces in Operation Iraqi Freedom, died 

12 in a domiciliary facility of the Department of Veterans Af13 fairs while receiving care for post-traumatic stress disorder 

14 and a substance use disorder. 


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Union Calendar No. 400 

110TH CONGRESS 

2D SESSION H. R. 5554 

[Report No. 110

–639] 

A BILL 

To amend title 38, United States Code, to expand 

poses. for substance use disorders, and for other purerans from the Department of Veterans Affairs and improve health care services available to vetMAY 15, 2008 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union, 


wwoods2 on PRODPC68 with BILLS