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[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 3984 Introduced in Senate (IS)]

109th CONGRESS
  2d Session
                                S. 3984

   To improve programs for the identification and treatment of post-
 deployment mental health conditions, including post-traumatic stress 
 disorder, in veterans and members of the Armed Forces, and for other 
                               purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                           September 28, 2006

   Mr. Harkin (for himself, Mr. Leahy, Ms. Mikulski, and Mr. Kerry) 
introduced the following bill; which was read twice and referred to the 
                     Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL

 
   To improve programs for the identification and treatment of post-
 deployment mental health conditions, including post-traumatic stress 
 disorder, in veterans and members of the Armed Forces, 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.

    (a) Short Title.--This Act may be cited as the ``Comprehensive 
Assistance for Veterans Exposed to Traumatic Stressors Act of 2006''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title.
Sec. 2. Definition.
                 TITLE I--VETERANS OF PAST DEPLOYMENTS

Sec. 101. Six-year extension of eligibility for readjustment counseling 
                            services for Vietnam-era veterans.
                       TITLE II--MILITARY ISSUES

Sec. 201. Department of Veterans Affairs-Department of Defense Health 
                            Care Sharing Incentive Fund.
Sec. 202. Collection of data from pre- and post-deployment health 
                            assessments.
Sec. 203. Preventative maintenance post-deployment intervention.
  TITLE III--PREVENTION, EARLY DETECTION, AND TREATMENT FOR RETURNING 
                                 TROOPS

Sec. 301. Study to identify factors that decrease the likelihood of the 
                            development of chronic PTSD despite combat 
                            exposure.
Sec. 302. Extension of period of enhanced eligibility for VA health 
                            services for veterans who served in combat 
                            theaters of operations.
Sec. 303. Demonstration project to station Department of Veterans 
                            Affairs psychologists and psychiatrists at 
                            major demobilization sites and military 
                            treatment facilities.
Sec. 304. Peer counseling program.
Sec. 305. Model programs for post-deployment mental health practice.
Sec. 306. Performance measures for Department of Veterans Affairs 
                            health care administrators.
TITLE IV--DEPARTMENT OF DEFENSE/DEPARTMENT OF VETERANS AFFAIRS COUNCIL 
                    ON POST-DEPLOYMENT MENTAL HEALTH

Sec. 401. Establishment of Council.
Sec. 402. Duties of Council.
      TITLE V--CAPACITY BUILDING IN DEPARTMENT OF VETERANS AFFAIRS

Sec. 501. Plan for expansion of Department of Veterans Affairs system 
                            to expand access to specialized PTSD care.
Sec. 502. Additional Department of Veterans Affairs resources.
                        TITLE VI--FAMILY THERAPY

Sec. 601. Eligibility for family counseling and bereavement counseling.
                   TITLE VII--EDUCATIONAL INITIATIVES

Sec. 701. Training program for health-care providers.
Sec. 702. Curriculum and protocols for cross-training of Department of 
                            Veterans Affairs clinicians.
Sec. 703. Publication of state-of-the-art post-deployment mental health 
                            problems diagnosis and treatment.
Sec. 704. Protocols for pain management for PTSD and war-related pain.
Sec. 705. Protocols for treatment of substance use disorders.
Sec. 706. Protocols for diagnosis of post-traumatic stress disorder.
       TITLE VIII--NATIONAL STEERING COMMITTEE ON PTSD EDUCATION

Sec. 801. National steering committee.
Sec. 802. Funding support for National Center for PTSD.
Sec. 803. Continuing education to mental health providers.
Sec. 804. Web-based curriculum to sponsor clinician training 
                            initiatives.
                           TITLE IX--BENEFITS

Sec. 901. Identification of deficiencies in PTSD disability 
                            examinations.
Sec. 902. Criteria for determining medical conditions associated with 
                            PTSD.
                       TITLE X--PUBLIC AWARENESS

Sec. 1001. Public awareness program.
Sec. 1002. Web site and materials for general campaign of awareness of 
                            PTSD.

SEC. 2. DEFINITION.

    In this Act, the term ``PTSD'' means post-traumatic stress 
disorder.

                 TITLE I--VETERANS OF PAST DEPLOYMENTS

SEC. 101. SIX-YEAR EXTENSION OF ELIGIBILITY FOR READJUSTMENT COUNSELING 
              SERVICES FOR VIETNAM-ERA VETERANS.

    Section 1712A(a)(1)(B)(ii) of title 38, United States Code, is 
amended by striking ``January 1, 2004'' and inserting ``January 1, 
2010''.

                       TITLE II--MILITARY ISSUES

SEC. 201. DEPARTMENT OF VETERANS AFFAIRS-DEPARTMENT OF DEFENSE HEALTH 
              CARE SHARING INCENTIVE FUND.

    (a) In General.--The Secretary of Veterans Affairs and the 
Secretary of Defense shall jointly take such steps as necessary to 
implement the proposal of the Center for the Study of Traumatic Stress 
at the Uniformed Services University of the Health Sciences for a 
Department of Veterans Affairs-Department of Defense Health Care 
Sharing Incentive Fund.
    (b) Telecommunications Support.--As part of the implementation of 
the proposal referred to in subsection (a), the two Secretaries shall 
provide for a system of telecommunications to support the following:
            (1) Continuing education and support for front-line 
        (forward-deployed) providers of health-care services.
            (2) Enhanced treatment capacity for addressing acute 
        episodes of PTSD and other mental health disorders in combat 
        theaters, including--
                    (A) real-time access to clinical specialty support;
                    (B) web-based information on state-of-the-art 
                protocols for the treatment and diagnosis of PTSD and 
                other mental health disorders; and
                    (C) educational programs concerning PTSD and other 
                mental health disorders commonly associated with 
                deployment.

SEC. 202. COLLECTION OF DATA FROM PRE- AND POST-DEPLOYMENT HEALTH 
              ASSESSMENTS.

    (a) Data Collection.--The Secretary of Defense shall take 
appropriate steps to assist the Secretary of Veterans Affairs with the 
collection of data from pre- and post-deployment health assessments of 
members of the Armed Forces that may be relevant for identification and 
treatment by the Secretary of Veterans Affairs of PTSD and other post-
deployment mental health issues. The Secretary of Defense may provide 
such information in aggregate, unidentified format and may provide such 
information on a monthly basis or on such other schedule as the two 
Secretaries may agree to.
    (b) Consent Forms.--The Secretary of Defense shall develop forms 
for use in obtaining the written consent of members of the Armed Forces 
to allow the Department of Veterans Affairs to collect data contained 
on pre-deployment and post-deployment health assessment forms with 
relevant treatment information concerning PTSD and other mental health 
problems that may be associated with combat stress or readjustment to 
civilian life from those members of the Armed Forces to be discharged 
or demobilized within 90 days. Such consent forms shall be developed 
and made available for use by members of the Armed Forces covered by 
the preceding sentence not later than 60 days after the date of the 
enactment of this Act.
    (c) Identification of Substance Use Disorders.--The Secretary of 
Defense shall include in pre-deployment and post-deployment health 
assessments questions to assist in identification of existing or 
potential substance use disorders among members of the Armed Forces.

SEC. 203. PREVENTATIVE MAINTENANCE POST-DEPLOYMENT INTERVENTION.

    (a) In General.--The Secretary of Veterans Affairs shall conduct 
routine preventative maintenance intervention for all members of the 
Armed Forces returning from deployment in a combat theater. Such 
intervention shall be conducted between 90 and 180 days after such 
members return from such deployment.
    (b) Personnel.--For purposes of such intervention, the Secretary of 
Veterans Affairs may use--
            (1) staff of the Department of Veterans Affairs, including 
        readjustment counseling staff; and
            (2) persons trained by the Department of Veterans Affairs, 
        including volunteers from military unit associations, veteran 
        service organizations, or other nonprofit organizations.
    (c) Size.--Such intervention shall be conducted with no more than 
six returning servicemembers at a time.
    (d) Purpose.--The purpose of such intervention shall be the 
following:
            (1) To identify and distinguish symptoms of ``common'' 
        acute stress reactions from those of chronic and severe post-
        traumatic stress disorder.
            (2) To discuss concerns of combat personnel and those 
        expressed by their family members.
            (3) To refer returning servicemembers to appropriate 
        services, as necessary.
            (4) To disseminate educational materials about post-
        deployment mental health issues, including PTSD to 
        servicemembers.
            (5) To provide follow-up educational materials by mail to 
        family members.
            (6) To provide information concerning homelessness, 
        including risk factors, awareness assessment, and contact 
        information for preventative assistance associated with 
        homelessness.
    (e) VA Participation in Additional Demobilization Activities.--The 
Secretary of Defense shall provide for the Secretary of Veterans 
Affairs to participate in additional demobilization activities, 
including the Transitional Assistance Program, that are conducted 
within the Department of Defense for the purposes specified in 
subsection (d).

  TITLE III--PREVENTION, EARLY DETECTION, AND TREATMENT FOR RETURNING 
                                 TROOPS

SEC. 301. STUDY TO IDENTIFY FACTORS THAT DECREASE THE LIKELIHOOD OF THE 
              DEVELOPMENT OF CHRONIC PTSD DESPITE COMBAT EXPOSURE.

    (a) Study.--The Secretary of Veterans Affairs shall provide for a 
study, to be conducted by an entity other than the Department of 
Veterans Affairs and the Department of Defense, to identify factors 
that decrease the likelihood of the development of chronic post-
traumatic stress disorder (PTSD) in servicemembers and veterans who 
have had combat exposure, including exposure to guerilla warfare.
    (b) Report.--The Secretary shall provide for the entity conducting 
the study under subsection (a) to submit a report on the results of the 
study to the Secretary and the Congress not later than one year after 
the date of the enactment of this Act.

SEC. 302. EXTENSION OF PERIOD OF ENHANCED ELIGIBILITY FOR VA HEALTH 
              SERVICES FOR VETERANS WHO SERVED IN COMBAT THEATERS OF 
              OPERATIONS.

    Section 1710(e)(3)(C) of title 38, United States Code, is amended 
by striking ``2 years'' and inserting ``five years''.

SEC. 303. DEMONSTRATION PROJECT TO STATION DEPARTMENT OF VETERANS 
              AFFAIRS PSYCHOLOGISTS AND PSYCHIATRISTS AT MAJOR 
              DEMOBILIZATION SITES AND MILITARY TREATMENT FACILITIES.

    (a) Demonstration Project.--The Secretary of Defense and the 
Secretary of Veterans Affairs shall jointly provide for the conduct of 
a demonstration project under which Department of Veterans Affairs 
psychologists and psychiatrists are stationed at major demobilization 
sites and military treatment facilities.
    (b) Purpose.--The purposes of the demonstration project shall be as 
follows:
            (1) Identify, on an aggregate level, need for mental health 
        services among active-duty, Reserve, and National Guard 
        members.
            (2) Provide such services or refer members for necessary 
        services.
            (3) Advise servicemembers of the need for continuous 
        services.
            (4) Identify the obstacles servicemembers have in seeking 
        appropriate mental health care.
    (c) Funding.--There is authorized to be appropriated such sums as 
may be necessary for each of fiscal years [2006, 2007, and 2008] for 
the conduct of the demonstration project. Amounts for the conduct of 
the project shall be provided equally by the Secretary of Veterans 
Affairs and the Secretary of Defense.
    (d) Eligibility Criteria.--Based on the results of the 
demonstration project, the Secretaries shall identify appropriate 
eligibility criteria for programs to best respond to the needs of 
veterans, servicemembers, and their families for post-deployment mental 
health services. The criteria identified shall be included in the 
report under subsection (e).
    (e) Report.--The Secretary of Veterans Affairs shall submit to the 
Committees on Veterans' Affairs of the Senate and House of 
Representatives a report providing the results of the demonstration 
project. The report shall be submitted not later than 18 months after 
the date of the enactment of this Act.

SEC. 304. PEER COUNSELING PROGRAM.

    (a) Program Required.--The Secretary of Veterans Affairs shall 
carry out a program to facilitate the provision by veterans of peer 
counseling services to other veterans on mental health matters.
    (b) Peer Counseling as Supplemental Service.--Any support provided 
by peer counseling under the program required by subsection (a) shall 
be in addition to any other mental health services provided by the 
Department of Veterans Affairs, including any services provided under 
other provisions of this Act.

SEC. 305. MODEL PROGRAMS FOR POST-DEPLOYMENT MENTAL HEALTH PRACTICE.

    (a) Model Programs.--The Secretary of Veterans Affairs, in 
consultation with the Secretary of Defense, shall develop model 
programs to respond to a variety of mental health disorders prevalent 
among veterans of service in Operation Iraqi Freedom and Operation 
Enduring Freedom. The program shall be implemented at three sites 
selected by the Secretary, of which--
            (1) at least one site shall assign case managers to 
        veterans receiving care under such program; and
            (2) at least one site shall use an integrated mental health 
        and primary care model for post-deployment mental health 
        practice.
    (b) Purpose.--The purpose of the model program shall be as follows:
            (1) Development of training protocols for involved 
        clinicians.
            (2) Identification of medical conditions which may be 
        associated with post-deployment mental health problems 
        including PTSD.
            (3) Identification of ``best practices'' for treatment of 
        post-deployment mental health problems including PTSD.
            (4) Dissemination of results to the Veterans Health 
        Administration and the Veterans Benefits Administration of the 
        Department of Veterans Affairs.
    (c) Authorization.--There is authorized to be appropriated for the 
purposes of subsection (a) the amount of $5,000,000 for each of fiscal 
years [2006, 2007, and 2008].

SEC. 306. PERFORMANCE MEASURES FOR DEPARTMENT OF VETERANS AFFAIRS 
              HEALTH CARE ADMINISTRATORS.

    (a) Performance Measures.--The Secretary of Defense and the 
Secretary of Veterans Affairs, acting through the Department of 
Defense/Department of Veterans Affairs Council on Post-Deployment 
Mental Health established under section 401, shall develop performance 
measures for Department of Veterans Affairs regional health-care 
directors (referred to as VISN directors) and Department of Defense 
TRICARE regional managers to ensure the appropriate deployment of 
resources to implement the treatment protocols referred to as ``Iraq 
War Clinical Practice Guidelines''.
    (b) Use of Performance Measures.--The performance measures under 
subsection (a) shall be designed to assess--
            (1) access and availability of PTSD treatment for 
        servicemembers returned from deployment in a combat theater; 
        and
            (2) implementation of protocols referred to in subsection 
        (a).

TITLE IV--DEPARTMENT OF DEFENSE/DEPARTMENT OF VETERANS AFFAIRS COUNCIL 
                    ON POST-DEPLOYMENT MENTAL HEALTH

SEC. 401. ESTABLISHMENT OF COUNCIL.

    The Secretary of Defense and the Secretary of Veterans Affairs 
shall jointly establish a council to be known as the Department of 
Defense/Department of Veterans Affairs Council on Post-Deployment 
Mental Health. The council shall be composed of leadership of the two 
departments in the areas of mental health, PTSD, substance abuse, and 
military sexual trauma. The council shall be established not later than 
120 days after the date of the enactment of this Act.

SEC. 402. DUTIES OF COUNCIL.

    (a) Duties.--The Department of Defense/Department of Veterans 
Affairs Council on Post-Deployment Mental Health shall have the 
following duties:
            (1) Review of the continuum of care between the Department 
        of Defense and the Department of Veterans Affairs for mental 
        health, PTSD, substance abuse, and military sexual trauma.
            (2) Identification of gaps in the treatment capability of 
        the health-care systems of the Department of Defense and 
        Department of Veterans Affairs for mental health, PTSD, 
        substance abuse, and military sexual trauma and expected gaps 
        in such continuum, with emphasis on access to services in rural 
        areas, to meet the expected demand from current users and 
        servicemembers returning from Operation Iraqi Freedom and 
        Operation Enduring Freedom and other deployments.
            (3) Promotion, within both systems, of an educational 
        program to implement the jointly developed Iraq War Clinical 
        Practice Guidelines.
            (4) Development of outcome monitors and quality improvement 
        instruments to ensure that internal policy regarding PTSD is 
        implemented (including TRICARE and VISN directors' performance 
        measures under section 307).
            (5) Recommendation of policies to reduce the stigma 
        associated with the seeking of mental health care by active-
        duty, Reserve, and National Guard members.
            (6) Identification of the highest post-deployment mental 
        health research priorities for the two departments.
            (7) Communications to inform active-duty servicemembers and 
        veterans of matters relating to PTSD.
    (b) Annual Meeting With Stakeholders.--The Council shall meet at 
least annually with stakeholder groups comprised of veterans, veterans 
service organizations, and family members of veterans receiving care 
from the Department of Veterans Affairs mental health programs, and 
mental health associations.
    (c) Report.--The Council shall prepare a report based on the 
reviews under paragraphs (1) and (2) of subsection (a) to identify the 
necessary resources to create or enhance PTSD treatment capabilities. 
The report shall be made available to the Secretary of both Departments 
for comment. The Secretaries shall indicate recommendations in which 
they concur or disagree and include specific plans for implementation 
of any recommendations accepted. The report, with the comments and 
recommendations of the two Secretaries shall be submitted to the 
Committees on Veterans' Affairs and the Committees on Armed Services of 
the Senate and House of Representatives not later than one year after 
the date of the enactment of this Act. The report shall include 
priority listing of sites which require investments according to the 
greatest perceived need for PTSD services.

      TITLE V--CAPACITY BUILDING IN DEPARTMENT OF VETERANS AFFAIRS

SEC. 501. PLAN FOR EXPANSION OF DEPARTMENT OF VETERANS AFFAIRS SYSTEM 
              TO EXPAND ACCESS TO SPECIALIZED PTSD CARE.

    (a) Development of Plan.--Based upon the report under section 
402(b), the Secretary of Veterans Affairs shall develop a plan for the 
Department of Veterans Affairs to expand access to specialized PTSD 
care through--
            (1) Readjustment Counseling Service centers operated under 
        section 1712A of title 38, United States Code;
            (2) community-based outpatient clinics; and
            (3) telemedicine.
    (b) Inspector General Investigation.--The Inspector General of the 
Department of Veterans Affairs shall investigate specialized programs 
of the Department of Veterans Affairs for the treatment of post-
traumatic stress disorder in order to determine--
            (1) the current workloads of those programs;
            (2) staff associated with each of those programs;
            (3) funds obligated for those programs; and
            (4) any waiting times associated with those programs.
    (c) Report.--The Inspector General shall submit to the Committees 
on Veterans' Affairs of the Senate and House of Representatives a 
report containing the Inspector General's findings under subsection 
(b), together with an assessment of the ability of the Department of 
Veterans Affairs to address such findings, along with recommendations 
for accommodating--
            (1) the current workload of the Department in specialized 
        treatment program;
            (2) 102 percent of the current workload of the Department; 
        and
            (3) 110 percent of the current workload of the Department.

SEC. 502. ADDITIONAL DEPARTMENT OF VETERANS AFFAIRS RESOURCES.

    In order to improve access to mental health services, the Secretary 
of Veterans Affairs shall provide the following:
            (1) 100 additional full-time equivalent employees to 
        Readjustment Counseling Service outstations.
            (2) A PTSD clinical team at every medical center of the 
        Veterans Health Administration.
            (3) A family therapist at each Vet Center under section 
        1712A of title 38, United States Code.
            (4) A PTSD coordinator in each regional network referred to 
        as a Veterans Integrated Service Network (VISN ) whose duties 
        shall include--
                    (A) development of plans for meeting PTSD and other 
                post-deployment mental health treatment needs 
                consistent with the report under section 402(b);
                    (B) assurance of implementation of clinical 
                practice guidelines throughout the VISN;
                    (C) liaison among all health-care sites in the VISN 
                and the Department Central Office on matters relating 
                to PTSD.
            (5) A PTSD coordinator in each regional office of the 
        Readjustment Counseling Service whose duties shall include 
        liaison with regional office staff and medical centers for 
        veterans seeking service-connection for PTSD.

                        TITLE VI--FAMILY THERAPY

SEC. 601. ELIGIBILITY FOR FAMILY COUNSELING AND BEREAVEMENT COUNSELING.

    (a) Counseling for Family Members of Veterans Being Treated for 
Service-Connected Disabilities.--Section 1782(a) of title 38, United 
States Code, is amended by adding at the end the following new 
sentence: ``In addition, the Secretary shall provide to an individual 
described in subsection (c) such professional counseling and mental 
health services as are necessary as a consequence of a disability of a 
veteran described in the preceding sentence. Counseling and mental 
health services under the preceding sentence shall be provided (if so 
requested by the individual) for a period of two years from the date on 
which the individual first receives such counseling or mental health 
services under the preceding sentence.''.
    (b) Bereavement Counseling.--Section 1783 of such title is 
amended--
            (1) by striking ``may provide'' in subsections (a) and (b) 
        and inserting ``shall, upon request, provide'';
            (2) by redesignating subsection (c) as subsection (d); and
            (3) by inserting after subsection (b) the following new 
        subsection (c):
    ``(c) Duration of Counseling.--Counseling under subsection (a) or 
with respect to the death of a veteran or under subsection (b) with 
respect to the death of a member who dies in the active military, 
naval, or air service shall be provided to an individual eligible for 
such counseling (if so requested by that individual) for a period of 
two years from the date on which the individual first receives 
counseling under this section with respect to that death.''.

                   TITLE VII--EDUCATIONAL INITIATIVES

SEC. 701. TRAINING PROGRAM FOR HEALTH-CARE PROVIDERS.

    (a) In General.--The Secretary of Veterans Affairs and the 
Secretary of Defense shall jointly develop a broad training program for 
all health-care providers in the Department of Veterans Affairs and the 
Department of Defense to familiarize those providers with mental 
health-care issues that are likely to arise among persons deployed to 
combat theaters during the five years after such a deployment.
    (b) Family Education.--Training under the program required by 
subsection (a) shall include training to assist family members of 
veterans in--
            (1) understanding issues that arise in the readjustment of 
        veterans to civilian life;
            (2) identifying signs and symptoms of mental health 
        problems; and
            (3) encouraging veterans to seek assistance for such 
        problems.

SEC. 702. CURRICULUM AND PROTOCOLS FOR CROSS-TRAINING OF DEPARTMENT OF 
              VETERANS AFFAIRS CLINICIANS.

    The Secretary of Veterans Affairs shall develop a curriculum and 
required protocols for cross-training to allow the following clinicians 
of the Department of Veterans Affairs to screen for post-deployment 
mental health problems, including PTSD, and, as appropriate, provide 
information and appropriate referral to--
            (1) primary care providers;
            (2) practitioners assigned as Gulf War points-of-contact; 
        and
            (3) clinicians assigned as case managers.

SEC. 703. PUBLICATION OF STATE-OF-THE-ART POST-DEPLOYMENT MENTAL HEALTH 
              PROBLEMS DIAGNOSIS AND TREATMENT.

    The Secretary of Veterans Affairs and the Secretary of Defense 
shall jointly develop a plan for the production and dissemination of 
publications to advise clinicians on state-of-the-art diagnosis and 
treatment of PTSD and other mental health disorders experienced after 
deployment, including any medical conditions associated with such 
disorders.

SEC. 704. PROTOCOLS FOR PAIN MANAGEMENT FOR PTSD AND WAR-RELATED PAIN.

    The Secretary of Veterans Affairs and the Secretary of Defense 
shall jointly develop protocols for pain management for PTSD and war-
related pain.

SEC. 705. PROTOCOLS FOR TREATMENT OF SUBSTANCE USE DISORDERS.

    The Secretary of Defense shall develop appropriate substance use 
disorder treatment protocols for assistance in combat areas of 
operations and on return to the United States.

SEC. 706. PROTOCOLS FOR DIAGNOSIS OF POST-TRAUMATIC STRESS DISORDER.

    (a) Findings.--Congress makes the following findings:
            (1) The symptoms of post-traumatic stress disorder are 
        often similar to those of traumatic brain injury and some 
        neurological disorders.
            (2) Some veterans with PTSD have co-morbidities that may 
        mask or compound the symptoms associated with PTSD.
            (3) Correct diagnosis of PTSD and other disorders is 
        critical to effective treatment of those disorders.
    (b) Clinical Practice Guidelines.--The Secretary of Veterans 
Affairs shall develop clinical practice guidelines to ensure that 
clinicians are able to effectively distinguish between diagnoses with 
similar symptoms that may manifest as post-traumatic stress disorder.

       TITLE VIII--NATIONAL STEERING COMMITTEE ON PTSD EDUCATION

SEC. 801. NATIONAL STEERING COMMITTEE.

    (a) Establishment.--There is a National Steering Committee on PTSD 
Education, to be appointed by the joint council established under 
section 401. The committee shall be comprised of mental health and 
other health professionals and health educators involved in the care of 
veterans of a deployment to a theater of combat on or after the date of 
the enactment of this Act.
    (b) Purpose.--The committee shall review training protocols for 
health-care providers and plans for dissemination of educational 
materials to veterans, their families, and other relevant parties and 
shall identify the resources available to provide for those purposes.
    (c) Meetings.--The committee shall meet at least once annually.

SEC. 802. FUNDING SUPPORT FOR NATIONAL CENTER FOR PTSD.

    There is authorized to be appropriated to the Secretary of Veterans 
Affairs for the National Center for PTSD to assist in carrying out a 
joint educational initiative with the Uniformed Services University of 
the Health Sciences the amount of $5,000,000 for each of fiscal years 
[2005 through 2014].

SEC. 803. CONTINUING EDUCATION TO MENTAL HEALTH PROVIDERS.

    The National Steering Committee established under section 801 shall 
provide continuing education to mental health providers in the 
Department of Veterans Affairs and the Department of Defense.

SEC. 804. WEB-BASED CURRICULUM TO SPONSOR CLINICIAN TRAINING 
              INITIATIVES.

    The National Steering Committee established under section 801 shall 
develop a Web-based curriculum to sponsor clinician training 
initiatives.

                           TITLE IX--BENEFITS

SEC. 901. IDENTIFICATION OF DEFICIENCIES IN PTSD DISABILITY 
              EXAMINATIONS.

    (a) Evaluation of Adjudication of Claims.--The Secretary of 
Veterans Affairs, in consultation with the National Center for PTSD, 
shall obtain an evaluation of the quality and consistency of 
adjudication of claims for PTSD, including the adequacy of service-
connected compensation examinations for rating purposes and the extent 
to which veterans who are service-connected for PTSD are actually 
employed and employable.
    (b) Report.--Not later than 12 months after the date of the 
enactment of this Act, the Secretary shall submit to the Committees on 
Veterans Affairs of the Senate and House of Representatives a report 
that includes the following information and recommendations:
            (1) The types of evidence sufficient to confirm combat 
        experience for veterans filing claims for PTSD based on combat.
            (2) The policies and procedures used to obtain confirmation 
        of a stressor, including documentation of service in combat for 
        claims based on PTSD.
            (3) Based on a representative national sample, the number 
        and percentage of veterans for each period of war whose claims 
        for PTSD have been denied based upon the lack of a credible 
        stressor.
            (4) Based on a representative national sample, the number 
        and percentage of veterans for each period of war whose claims 
        for PTSD have been denied based upon the lack of a diagnosis of 
        PTSD.
            (5) Based on a representative national sample, the number 
        and percentage of veterans for each period of war whose claims 
        for PTSD have been granted and the rating which was initially 
        awarded for that claim.
            (6) The number of initial and subsequent claims and average 
        time to process claims for PTSD which have been granted 
        (including the rating assigned and any determination as to 
        employability) and denied for each regional office for a 
        consecutive six month period.
            (7) The number and percentage of initial claims for PTSD 
        selected from a representative national sample during a 
        consecutive six month period which had a compensation and 
        pension examination conducted in compliance with best practices 
        for PTSD examinations.
            (8) The number and percentage of examinations selected from 
        a representative national sample during a consecutive six month 
        period in which the compensation and pension examinations for 
        PTSD were judged to be inadequate.
            (9) The number and percentage of claims for PTSD selected 
        from a representative national sample during that consecutive 
        six month period for which the examination was returned as 
        inadequate.
            (10) The maximum, minimum and average time based upon a 
        representative national sample allocated for completion of an 
        initial compensation and pension examination for PTSD.
            (11) An assessment comparing the employment of veterans 
        rated for psychiatric impairments with similar ratings based 
        upon physical impairments including, the number of veterans in 
        each sample who are employed on a full time or part time basis, 
        the average time such veterans have been unemployed and a 
        comparison of the amount of work lost from employment due to 
        disability and the average earnings of veterans in each group.
            (12) Taking into account criteria such as the information 
        in the Dictionary of Occupational Titles (DOT), including its 
        companion publication, the Selected Characteristics of 
        Occupations Defined in the Revised Dictionary of Occupational 
        Titles (SCO), published by the Department of Labor, examples of 
        the types of employment that an average veteran rated at 30 
        percent, at 50 percent, and at 70 percent disabled for PTSD can 
        be expected to obtain and retain.
            (13) The number of claims for PTSD appealed to the Board of 
        Veterans Appeals during fiscal year [2005], including the 
        specific issue appealed (service-connection, effective date, 
        rating) and the results of such appeals (affirmed, denied, 
        remanded, other disposition).
            (14) Recommendations for improving the accuracy and 
        consistency of PTSD examinations, claim development and 
        decisions.
            (15) Barriers to successful employment for veterans who 
        have been service-connected for PTSD.
            (16) Recommendations for removing barriers to employment 
        for veterans who have been service-connected for PTSD.
            (17) Recommendations for legislative changes which could 
        improve the potential for vocational rehabilitation and 
        employment of persons service-connected for PTSD.

SEC. 902. CRITERIA FOR DETERMINING MEDICAL CONDITIONS ASSOCIATED WITH 
              PTSD.

    The Secretary of Veterans Affairs shall develop--
            (1) criteria for determining those medical conditions that 
        are as likely as not to be associated with PTSD; and
            (2) standards for determining when secondary service-
        connection should be granted for those conditions.

                       TITLE X--PUBLIC AWARENESS

SEC. 1001. PUBLIC AWARENESS PROGRAM.

    (a) Program Required.--The Secretary of Veterans Affairs shall 
conduct an aggressive, comprehensive outreach program to enhance the 
awareness of veterans, and the public in general, of the symptoms of 
PTSD and of the services available for veterans with those symptoms. 
The Secretary of Defense shall provide the Secretary of Veterans 
Affairs with such assistance as may be required for the purposes of 
such program. To the extent practicable, the program shall be conducted 
through the joint council established under section 401.
    (b) Program on De-Stigmatization of Mental Health.--
            (1) In general.--The program required by subsection (a) 
        shall include a national mental health campaign to increase 
        awareness in the veteran community that mental health is 
        essential to overall health and that very effective modern 
        treatments can promote recovery from mental illness.
            (2) Elements.--The campaign under this subsection may 
        include the following:
                    (A) Activities targeted at veterans of Operation 
                Iraqi Freedom and Operation Enduring Freedom and the 
                families of such veterans.
                    (B) Monthly messages on the Internet website of the 
                Department of Veterans Affairs that express the theme 
                that mental health is essential to overall health.
                    (C) Inclusion of the theme described in 
                subparagraph (B) in public addresses, speeches, and 
                veterans service organization convention addresses by 
                the Secretary of Veterans Affairs and other senior 
                officials of the Department.

SEC. 1002. WEB SITE AND MATERIALS FOR GENERAL CAMPAIGN OF AWARENESS OF 
              PTSD.

    As part of the program under this title, the Secretary of Veterans 
Affairs shall develop and continually update a Web site and materials, 
including pamphlets, news releases, fact sheets, and other materials, 
for the purposes of a general campaign of awareness of post-traumatic 
stress disorder.
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