II 

117TH CONGRESS 

1ST SESSION S. 3293 

To expand access of veterans to mental health care from the Department 

of Veterans Affairs, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 1, 2021 

Mr. TESTER (for himself and Mr. MORAN) introduced the following bill; which 

was read twice and referred to the Committee on Veterans’ Affairs 

A BILL 

To expand access of veterans to mental health care from 

the Department of Veterans Affairs, 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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Post-9/11 Veterans’ Mental Health Care Improvement 

6 Act of 2021’’. 

7 (b) TABLE OF CONTENTS.—The table of contents for 

8 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—ACCESS TO CARE 


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Sec. 101. Improvement of sleep disorder care furnished by Department of Veterans Affairs. 

Sec. 102. Mental health consultations. 

Sec. 103. Study on inpatient mental health and substance use care from Department of Veterans Affairs. 

Sec. 104. Study on treatment from Department of Veterans Affairs for co-occurring mental health and substance use disorders. 

TITLE II—MENTAL HEALTH WORKFORCE 

Sec. 201. Expansion of Vet Center workforce. 

Sec. 202. Expansion of mental health training for Department of Veterans Affairs. 

Sec. 203. Expansion of scholarships and loan repayment programs for mental 

health providers. 

Sec. 204. Study on workload of suicide prevention teams of Department of Veterans Affairs. 

TITLE III—MENTAL HEALTH RESEARCH 

Sec. 301. Expansion of suicide prevention and mental health research. 

Sec. 302. Study on mental health and suicide prevention support for military 

families. 

Sec. 303. Research on brain health. 

Sec. 304. Study on efficacy of clinical and at-home resources for post-traumatic 

stress disorder. 

1 TITLE I—ACCESS TO CARE 

2 SEC. 101. IMPROVEMENT OF SLEEP DISORDER CARE FUR3 NISHED BY DEPARTMENT OF VETERANS AF4 FAIRS. 

5 (a) IN GENERAL.—Pursuant to the analysis con6 ducted under subsection (b), the Secretary of Veterans Af7 fairs shall take such action as the Secretary considers ap8 propriate to improve the assessment and treatment of vet9 erans with sleep disorders, including by conducting in10 home sleep studies for veterans. 

11 (b) ANALYSIS.—The Secretary shall conduct an anal12 ysis of the ability of the Department of Veterans Affairs 

13 to treat sleep disorders among veterans, including— 


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1 (1) assessment and treatment options for such 

2 disorders; 

3 (2) barriers to care for such disorders, such as 

4 wait time, travel time, and lack of staffing; 

5 (3) the efficacy of the clinical practice guide6 lines of the Department of Veterans Affairs and the 

7 Department of Defense for such disorders; and 

8 (4) the availability of and efficacy of the use by 

9 the Department of Veterans Affairs of cognitive be10 havioral therapy for insomnia. 

11 (c) REPORT.—Not later than two years after the date 

12 of the enactment of this Act, the Secretary shall submit 

13 to the Committee on Veterans’ Affairs of the Senate and 

14 the Committee on Veterans’ Affairs of the House of Rep15 resentatives a report on— 

16 (1) the findings from the analysis conducted 

17 under subsection (b); and 

18 (2) any actions taken under subsection (a) to 

19 improve the assessment and treatment of veterans 

20 with sleep disorders. 

21 (d) AUTHORIZATION OF APPROPRIATIONS FOR IN22 HOME SLEEP STUDIES.—There is authorized to be appro23 priated to the Secretary of Veterans Affairs $5,000,000 

24 to be used to conduct in-home sleep studies for veterans, 


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1 as part of sleep disorder assessment and treatment con2 ducted by the Department of Veterans Affairs. 

3 SEC. 102. MENTAL HEALTH CONSULTATIONS. 

4 (a) MENTAL HEALTH CONSULTATIONS FOR VET5 ERANS FILING FOR COMPENSATION.— 

6 (1) IN GENERAL.—Subchapter VI of chapter 11 

7 of title 38, United States Code, is amended by add8 ing at the end the following new section: 

9 ‘‘§ 1167. Mental health consultations 

10 ‘‘(a) IN GENERAL.—Not later than 30 days after the 

11 date on which a veteran submits to the Secretary a claim 

12 for compensation under this chapter for service-connected 

13 disability relating to a mental health diagnosis, the Sec14 retary shall offer the veteran a mental health consultation 

15 to assess the mental health needs of and care options for 

16 the veteran. 

17 ‘‘(b) AVAILABILITY.—The Secretary shall ensure that 

18 a veteran offered a mental health consultation under sub19 section (a) may elect to receive such consultation during 

20 the one-year period beginning on the date on which the 

21 consultation is offered or during such longer period begin22 ning on such date as the Secretary considers appro23 priate.’’. 

24 (2) CLERICAL AMENDMENT.—The table of sec25 tions at the beginning of chapter 11 of such title is 


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1 amended by adding at the end the following new 

2 item: 

‘‘1167. Mental health consultations.’’. 

3 (b) MENTAL HEALTH CONSULTATIONS FOR VET4 ERANS ENTERING HOMELESS PROGRAMS OFFICE PRO5 GRAMS.— 

6 (1) IN GENERAL.—Subchapter VII of chapter 

7 20 of title 38, United States Code, is amended by 

8 adding at the end the following new section: 

9 ‘‘§ 2068. Mental health consultations 

10 ‘‘(a) IN GENERAL.—Not later than two weeks after 

11 the date on which a veteran described in subsection (b) 

12 enters into a program administered by the Homeless Pro13 grams Office of the Department, the Secretary shall offer 

14 the veteran a mental health consultation to assess the 

15 health needs of and care options for the veteran. 

16 ‘‘(b) VETERAN DESCRIBED.—A veteran described in 

17 this subsection is a veteran to whom a mental health con18 sultation is not offered or provided through the case man19 agement services of the program of the Homeless Pro20 grams Office into which the veteran enters.’’. 

21 (2) CLERICAL AMENDMENT.—The table of sec22 tions at the beginning of chapter 20 of such title is 

23 amended by adding at the end the following new 

24 item: 

‘‘2068. Mental health consultations.’’. 


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1 SEC. 103. STUDY ON INPATIENT MENTAL HEALTH AND SUB2 STANCE USE CARE FROM DEPARTMENT OF 

3 VETERANS AFFAIRS. 

4 (a) IN GENERAL.—Not later than one year after the 

5 date of the enactment of this Act, the Secretary of Vet6 erans Affairs shall complete the conduct of a study on ac7 cess of veterans to care under the residential rehabilitation 

8 treatment programs of the Department of Veterans Af9 fairs to determine— 

10 (1) if there are sufficient geographic offerings 

11 of inpatient mental health care, especially for vet12 erans in rural and remote communities; 

13 (2) if there are sufficient bed spaces at each lo14 cation, based on demand and drive time from the 

15 homes of veterans; 

16 (3) if there are any workforce-related capacity 

17 limitations at each location, including if beds are un18 able to be used because there are not enough pro19 viders to care for additional patients; 

20 (4) if there are diagnosis-specific or sex-specific 

21 barriers to accessing care under such programs; and 

22 (5) the average wait time for a bed in such a 

23 program, broken out by— 

24 (A) Veterans Integrated Service Network; 

25 (B) rural or urban area; 

26 (C) sex; and 


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1 (D) specialty (general program, substance 

2 use disorder program, military sexual trauma 

3 program, etc.). 

4 (b) RECOMMENDATIONS FOR MODIFICATIONS TO

5 TREATMENT PROGRAMS.—Using the results from the 

6 study conducted under subsection (a), the Secretary shall 

7 make recommendations for— 

8 (1) new locations for opening facilities to par9 ticipate in the residential rehabilitation treatment 

10 programs of the Department; 

11 (2) facilities under such programs at which new 

12 beds can be added; and 

13 (3) any additional specialty tracks to be added 

14 to such programs, such as substance use disorder or 

15 military sexual trauma, in order to meet veteran 

16 need and demand. 

17 (c) REPORT.—Not later than 180 days after comple18 tion of the study under subsection (a), the Secretary shall 

19 submit to the Committee on Veterans’ Affairs of the Sen20 ate and the Committee on Veterans’ Affairs of the House 

21 of Representatives a report on the findings of the study 

22 conducted under subsection (a) and the recommendations 

23 made by the Secretary under subsection (b). 


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1 SEC. 104. STUDY ON TREATMENT FROM DEPARTMENT OF 

2 VETERANS AFFAIRS FOR CO-OCCURRING 

3 MENTAL HEALTH AND SUBSTANCE USE DIS4 ORDERS. 

5 (a) IN GENERAL.—Not later than one year after the 

6 date of the enactment of this Act, the Secretary of Vet7 erans Affairs shall conduct a study examining— 

8 (1) the availability of treatment programs for 

9 veterans with co-occurring mental health and sub10 stance use disorders (including both inpatient and 

11 outpatient care); 

12 (2) any geographic disparities in access to such 

13 programs, such as for rural and remote veterans; 

14 and 

15 (3) the average wait times for care under such 

16 programs. 

17 (b) REPORT.— 

18 (1) IN GENERAL.—Not later than two years 

19 after the date of the enactment of this Act, the Sec20 retary shall submit to the Committee on Veterans’ 

21 Affairs of the Senate and the Committee on Vet22 erans’ Affairs of the House of Representatives a re23 port on the findings of the study conducted under 

24 subsection (a). 

25 (2) ELEMENTS.—The report required by para26 graph (1) shall include— 


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1 (A) any recommendations resulting from 

2 the study conducted under subsection (a) with 

3 respect to improving timeliness and quality of 

4 care and meeting treatment preferences for vet5 erans with co-occurring mental health and sub6 stance use disorders; and 

7 (B) a description of any actions taken by 

8 the Secretary to improve care for such veterans. 

9 TITLE II—MENTAL HEALTH 

10 WORKFORCE 

11 SEC. 201. EXPANSION OF VET CENTER WORKFORCE. 

12 (a) IN GENERAL.—Not later than one year after the 

13 date of the enactment of this Act, the Secretary of Vet14 erans Affairs shall hire an additional 100 full-time equiva15 lent employees for Vet Centers to bolster the workforce 

16 of Vet Centers and to provide expanded mental health care 

17 to veterans, members of the Armed Forces, and their fam18 ilies through outreach, community access points, 

19 outstations, and Vet Centers. 

20 (b) VET CENTER DEFINED.—In this section, the 

21 term ‘‘Vet Center’’ has the meaning given that term in 

22 section 1712A(h) of title 38, United States Code. 


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1 SEC. 202. EXPANSION OF MENTAL HEALTH TRAINING FOR 

2 DEPARTMENT OF VETERANS AFFAIRS. 

3 (a) IN GENERAL.—Not later than three years after 

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

5 Veterans Affairs, in collaboration with the Office of Men6 tal Health and Suicide Prevention and the Office of Aca7 demic Affiliations, shall add an additional 500 paid trainee 

8 slots in covered mental health disciplines to the workforce 

9 of the Department of Veterans Affairs. 

10 (b) COVERED MENTAL HEALTH DISCIPLINES DE11 FINED.—In this section, the term ‘‘covered mental health 

12 disciplines’’ means psychiatry, psychology, advanced prac13 tice nursing (with a focus on mental health or substance 

14 use disorder), social work, licensed professional mental 

15 health counseling, and marriage and family therapy. 

16 SEC. 203. EXPANSION OF SCHOLARSHIPS AND LOAN REPAY17 MENT PROGRAMS FOR MENTAL HEALTH PRO18 VIDERS. 

19 (a) EXPANSION OF HEALTH PROFESSIONAL SCHOL20 ARSHIP PROGRAM.—Beginning in academic year 2022, 

21 the Secretary of Veterans Affairs shall include not fewer 

22 than an additional (as compared to academic year 2021) 

23 50 awards per academic year under the Department of 

24 Veterans Affairs Health Professional Scholarship Pro25 gram under subchapter II of chapter 76 of title 38, United 

26 States Code, for applicants otherwise eligible for such proVerDate Sep 11 2014 23:56 Dec 07, 2021 Jkt 029200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S3293.IS S3293

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1 gram who are pursuing degrees or training in mental 

2 health disciplines, including advanced practice nursing 

3 (with a focus on mental health or substance use disorder), 

4 psychology, and social work. 

5 (b) EXPANSION OF EDUCATION DEBT REDUCTION

6 PROGRAM.— 

7 (1) IN GENERAL.—Beginning in fiscal year 

8 2022, the Secretary shall provide not fewer than an 

9 additional (as compared to fiscal year 2021) 200 

10 debt reduction awards per year under the Depart11 ment of Veterans Affairs Education Debt Reduction 

12 Program under subchapter VII of chapter 76 of title 

13 38, United States Code, to be used to recruit mental 

14 health professionals to the Department of Veterans 

15 Affairs in disciplines that include psychiatry, psy16 chology, advanced practice nursing (with a focus on 

17 mental health or substance use disorder), and social 

18 work. 

19 (2) AUTHORIZATION OF APPROPRIATIONS.— 

20 There is authorized to be appropriated to the Sec21 retary of Veterans Affairs $8,000,000 per year to 

22 carry out the additional awards under paragraph 

23 (1). 

24 (c) OUTREACH.— 


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1 (1) IN GENERAL.—Not later than one year 

2 after the date of the enactment of this Act, the Sec3 retary shall develop a public awareness campaign to 

4 encourage veterans and mental health professionals 

5 to choose the Department for their mental health ca6 reer. 

7 (2) ELEMENTS.—The campaign required under 

8 paragraph (1)— 

9 (A) shall advertise the paid trainee, schol10 arship, and loan repayment opportunities of11 fered by the Department; and 

12 (B) may highlight the new graduate med13 ical education residencies available at the De14 partment for medical students entering resi15 dency. 

16 SEC. 204. STUDY ON WORKLOAD OF SUICIDE PREVENTION 

17 TEAMS OF DEPARTMENT OF VETERANS AF18 FAIRS. 

19 (a) IN GENERAL.—The Secretary of Veterans Af20 fairs, acting through the Under Secretary for Health and 

21 the Office of Mental Health and Suicide Prevention, shall 

22 conduct a study evaluating the workload of local suicide 

23 prevention teams of the Department of Veterans Affairs. 

24 (b) ELEMENTS.—The study conducted under sub25 section (a) shall— 


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1 (1) identify the effects of the growth of the sui2 cide prevention program of the Department on the 

3 workload of suicide prevention teams; 

4 (2) incorporate key practices for staffing model 

5 design in determining suicide prevention staffing 

6 needs; and 

7 (3) determine which facilities of the Depart8 ment need increased suicide prevention coordinator 

9 staffing to meet the needs of veterans, with an em10 phasis placed on facilities with high patient volume 

11 and facilities located in States with high rates of vet12 eran suicide. 

13 (c) REPORT.—Not later than one year after the date 

14 of the enactment of this Act, the Secretary shall submit 

15 to the Committee on Veterans’ Affairs of the Senate and 

16 the Committee on Veterans’ Affairs of the House of Rep17 resentatives a report— 

18 (1) on the findings of the study conducted 

19 under subsection (a); and 

20 (2) indicating any changes made to the staffing 

21 of suicide prevention teams of the Department re22 sulting from the determinations made under sub23 section (b)(3), including a list of facilities of the De24 partment where staffing was adjusted. 


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1 TITLE III—MENTAL HEALTH 

2 RESEARCH 

3 SEC. 301. EXPANSION OF SUICIDE PREVENTION AND MEN4 TAL HEALTH RESEARCH. 

5 There is authorized to be appropriated to the Depart6 ment of Veterans Affairs an additional $10,000,000 to be 

7 used by the Center of Excellence for Suicide Prevention 

8 of the Department and the Rocky Mountain Mental Illness 

9 Research Education and Clinical Center for purposes of 

10 conducting research on the factors impacting veteran sui11 cide and best practices for early intervention and support. 

12 SEC. 302. STUDY ON MENTAL HEALTH AND SUICIDE PRE13 VENTION SUPPORT FOR MILITARY FAMILIES. 

14 (a) IN GENERAL.—The Secretary of Veterans Af15 fairs, in collaboration with the Secretary of Defense, shall 

16 conduct a study on secondary post-traumatic stress dis17 order and depression and its impact on spouses, children, 

18 and caregivers of members of the Armed Forces. 

19 (b) REPORT.— 

20 (1) IN GENERAL.—Not later than three years 

21 after the date of the enactment of this Act, the Sec22 retary of Veterans Affairs, in collaboration with the 

23 Secretary of Defense, shall submit to Congress, vet24 erans service organizations, and military support orVerDate Sep 11 2014 23:56 Dec 07, 2021 Jkt 029200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\S3293.IS S3293

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1 ganizations a report on the findings of the study 

2 conducted under subsection (a). 

3 (2) DEFINITIONS.—In this subsection: 

4 (A) MILITARY SUPPORT ORGANIZATION.— 

5 The term ‘‘military support organization’’ has 

6 the meaning given that term by the Secretary 

7 of Defense. 

8 (B) VETERANS SERVICE ORGANIZATION.— 

9 The term ‘‘veterans service organization’’ 

10 means an organization recognized by the Sec11 retary of Veterans Affairs for the representa12 tion of veterans under section 5902 of title 38, 

13 United States Code. 

14 SEC. 303. RESEARCH ON BRAIN HEALTH. 

15 There is authorized to be appropriated to the Depart16 ment of Veterans Affairs an additional $5,000,000 for on17 going and future research at the Translational Research 

18 Center of the Department of Veterans Affairs for trau19 matic brain injury and stress disorders to provide better 

20 understanding of and improved treatment options for 

21 post-9/11 veterans with traumatic brain injury or post22 traumatic stress disorder. 


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1 SEC. 304. STUDY ON EFFICACY OF CLINICAL AND AT-HOME 

2 RESOURCES FOR POST-TRAUMATIC STRESS 

3 DISORDER. 

4 Not later than two years after the date of the enact5 ment of this Act, the Secretary of Veterans Affairs, 

6 through the Office of Research and Development of the 

7 Department of Veterans Affairs, shall conduct a study 

8 on— 

9 (1) the efficacy of clinical and at-home re10 sources, such as mobile applications like COVID 

11 Coach, for providers, veterans, caregivers, and fam12 ily members to use for dealing with stressors; 

13 (2) the feasibility and advisability of developing 

14 more such resources; 

15 (3) strategies for improving mental health care 

16 and outcomes for veterans with post-traumatic stress 

17 disorder; and 

18 (4) best practices for helping family members of 

19 veterans deal with secondary post-traumatic stress 

20 disorder or mental health concerns. 

Æ 


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