I 
108TH CONGRESS 
2D SESSION 
H. R. 5244 
To improve programs for the identification and treatment of Post-Traumatic 
Stress Disorder in veterans and members of the Armed Forces, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 7, 2004 
Mr. EVANS (for himself, Mr. FILNER, Mr. GUTIERREZ, Ms. CORRINE BROWN 
of Florida, Mr. RODRIGUEZ, Mr. MICHAUD, Ms. HOOLEY of Oregon, Mr. 
STRICKLAND, Mr. UDALL of New Mexico, Mrs. DAVIS of California, Ms. 
HERSETH, Mr. BAIRD, Mr. KENNEDY of Rhode Island, Mr. EMANUEL, 
Mr. STENHOLM, Ms. BORDALLO, Mr. LANGEVIN, Mr. FALEOMAVAEGA, 
Mr. ABERCROMBIE, and Mr. LARSON of Connecticut) introduced the fol-
lowing bill; which was referred to the Committee on Veterans’ Affairs, 
and in addition to the Committee on Armed Services, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
of such provisions as fall within the jurisdiction of the committee con-
cerned 
A BILL 
To improve programs for the identification and treatment 
of Post-Traumatic Stress Disorder in veterans and mem-
bers of the Armed Forces, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Comprehensive Assistance for Veterans Exposed to 
Traumatic Stressors Act of 2004’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Definition. 
TITLE I—VETERANS OF PAST DEPLOYMENTS 
Sec. 101. Extension of eligibility for readjustment counseling services for Viet-
nam-era veterans. 
TITLE II—MILITARY ISSUES 
Sec. 201. Department of Veterans Affairs-Department of Defense Health Care 
Sharing Incentive Fund. 
Sec. 202. Collection of aggregate data from pre- and post-deployment health as-
sessments. 
Sec. 203. Telemedicine support for front-line Department of Defense providers. 
TITLE III—PREVENTION, EARLY DETECTION, AND TREATMENT 
FOR RETURNING TROOPS 
Sec. 301. Study to identify factors that decrease the likelihood of the develop-
ment of chronic PTSD despite combat exposure. 
Sec. 302. Extension of period of enhanced eligibility for VA health services for 
veterans who served in combat theater of operations. 
Sec. 303. Department of Veterans Affairs to participate in all demobilizations 
and Transitional Assistance Program activities. 
Sec. 304. Educational materials. 
Sec. 305. Demonstration project to station Department of Veterans Affairs psy-
chologists and psychiatrists at major demobilization sites and 
military treatment facilities. 
Sec. 306. Model care plan for integrated mental health and a primary care 
model for PTSD practice. 
Sec. 307. Performance measures for Department of Veterans Affairs health 
care administrators. 
TITLE IV—DEPARTMENT OF DEFENSE/DEPARTMENT OF VET-
ERANS 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 ex-
pand access to specialized PTSD care. 
Sec. 502. Additional Department of Veterans Affairs resources. 
TITLE VI—FAMILY THERAPY 
Sec. 601. Eligibility period for 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 Vet-
erans Affairs clinicians. 
Sec. 703. Publication of state-of-the-art PTSD diagnosis and treatment. 
Sec. 704. Protocols for pain management for PTSD and war-related pain. 
Sec. 705. Case management techniques for VA PTSD clinicians. 
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. 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 in-
serting ‘‘January 1, 2009’’.
TITLE II—MILITARY ISSUES 
SEC. 201. DEPARTMENT OF VETERANS AFFAIRS-DEPART-
MENT 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 such proposal, the two Secretaries 
shall provide for a system of telecommunications to sup-
port the following: 
(1) Continuing education and support for front- 
line (forward-deployed) providers of health-care serv-
ices. 
(2) Enhanced treatment capacity for addressing 
acute episodes of PTSD. 
SEC. 202. COLLECTION OF AGGREGATE DATA FROM PRE- 
AND POST-DEPLOYMENT HEALTH ASSESS-
MENTS. 
(a) DATA COLLECTION.—The Secretary of Defense 
shall take appropriate steps to assist the Secretary of Vet-
erans 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 of PTSD. 
(b) CONSENT FORMS.—The Secretary of Defense 
shall develop forms to obtain the written consent of mem-
bers of the Armed Forces to allow the Department of Vet-
erans Affairs to collect data contained on pre-deployment 
and post-deployment health assessment forms with rel-
evant treatment information concerning PTSD from those 
members of the Armed Forces to be discharged or demobi-
lized within 90 days. Such forms shall be developed within 
60 days of the date of the enactment of this Act. 
(c) PREVENTATIVE MAINTENANCE POST-DEPLOY-
MENT INTERVENTION.— 
(1) IN GENERAL.—The Secretary of Veterans 
Affairs shall conduct routine preventative mainte-
nance intervention for all members of the Armed 
Forces returning from deployment in a combat the-
ater. Such intervention shall be conducted between 
90 and 180 days after such members return from 
such deployment. 
(2) PERSONNEL.—For purposes of such inter-
vention, the Secretary of Veterans Affairs may use 
staff of the Department of Veterans Affairs, includ-
ing readjustment counseling staff, or persons trained 
by the Department of Veterans Affairs, including 
volunteers from military unit associations, veteran 
service organizations, or other nonprofit organiza-
tions. 
(3) SIZE.—Such intervention shall be conducted 
with no more than 6 returning servicemembers at a 
time. 
(4) PURPOSE.—The purpose of such interven-
tion shall be the following: 
(A) To identify and distinguish symptoms 
of ‘‘common’’ acute stress reactions from those 
of chronic and severe post-traumatic stress dis-
order. 
(B) To discuss concerns of combat per-
sonnel and those expressed by their family 
members. 
(C) To refer returning servicemembers to 
appropriate services, as necessary. 
(D) To disseminate educational materials 
about PTSD to servicemembers. 
(E) To provide follow-up educational mate-
rials by mail to family members. 
(d) IDENTIFICATION
OF
SUBSTANCE
USE
DIS-
ORDERS.—The Secretary of Defense shall add questions
to pre-deployment and post-deployment screens to assist 
in identification of existing or potential substance use dis-
orders among members of the Armed Forces. 
(e) SUBSTANCE USE DISORDER TREATMENT PROTO-
COLS.—The Secretary of Defense shall develop appro-
priate substance use disorder treatment protocols for as-
sistance in combat areas of operations and on return to 
the United States. 
SEC. 203. TELEMEDICINE SUPPORT FOR FRONT-LINE DE-
PARTMENT OF DEFENSE PROVIDERS. 
The Secretary of Defense shall, in conjunction with 
the Secretary of Veterans Affairs, establish a program to 
provide telemedicine support to Department of Defense 
health-care providers in combat theaters. Such telemedi-
cine support shall include real-time access to clinical spe-
cialty support, Web-based information on state-of-the-art 
protocols for the treatment and diagnosis of PTSD, and 
educational programs concerning PTSD.
TITLE III—PREVENTION, EARLY 
DETECTION, 
AND 
TREAT-
MENT 
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 Depart-
ment of Defense, to identify factors that decrease the like-
lihood 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 en-
tity 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 ELIGI-
BILITY FOR VA HEALTH SERVICES FOR VET-
ERANS WHO SERVED IN COMBAT THEATER 
OF OPERATIONS. 
Section 1710(e)(3)(C) of title 38, United States 
Code, is amended by striking ‘‘2 years’’ and inserting ‘‘5 
years’’. 
SEC. 303. DEPARTMENT OF VETERANS AFFAIRS TO PAR-
TICIPATE IN ALL DEMOBILIZATIONS AND 
TRANSITIONAL ASSISTANCE PROGRAM AC-
TIVITIES. 
(a) IN GENERAL.—The Secretary of Defense shall 
provide for the Secretary of Veterans Affairs to participate 
in all demobilization and Transitional Assistance Program 
activities conducted within the Department of Defense so 
as to enhance the capability of the Secretary of Veterans 
Affairs to identify risk factors for development of chronic 
PTSD. 
(b) HOMELESSNESS RISK AWARENESS.—In any ac-
tivity referred to in subsection (a), the Secretary of De-
fense and the Secretary of Veterans Affairs shall provide 
information concerning homelessness, including risk fac-
tors, awareness assessment, and contact information for 
preventative assistance associated with homelessness.
SEC. 304. EDUCATIONAL MATERIALS. 
The Secretary of Veterans Affairs shall develop edu-
cational materials concerning PTSD for members of the 
Armed Forces returning from deployments in combat the-
aters and their family members. The Secretary of Defense 
shall assist in making those materials available to such 
members and family members. 
SEC. 305. DEMONSTRATION PROJECT TO STATION DEPART-
MENT OF VETERANS AFFAIRS PSYCHOLO-
GISTS AND PSYCHIATRISTS AT MAJOR DEMO-
BILIZATION SITES AND MILITARY TREAT-
MENT 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 con-
tinuous services. 
(4) Identify the obstacles servicemembers have 
in seeking appropriate mental health care. 
(c) FUNDING.—There is authorized to be appro-
priated such sums as may be necessary for each of fiscal 
years 2005, 2006, and 2007 for the conduct of the dem-
onstration project. Amounts for the conduct of the project 
shall be provided equally by the Secretary of Veterans Af-
fairs and the Secretary of Defense. 
(d) REPORT.—The Secretary of Veterans Affairs 
shall submit to the Committees on Veterans’ Affairs of 
the Senate and House of Representatives a report pro-
viding 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. 306. MODEL CARE PLAN FOR INTEGRATED MENTAL 
HEALTH AND A PRIMARY CARE MODEL FOR 
PTSD PRACTICE. 
(a) MODEL CARE PLAN.—The Secretary of Veterans 
Affairs shall develop and implement a ‘‘model care’’ plan 
for integrated mental health and primary care model for 
PTSD practice. The plan shall be implemented at three 
sites selected by the Secretary.
(b) PURPOSE.—The purpose of the model care plan 
shall be as follows: 
(1) Develop training protocols for involved clini-
cians. 
(2) Identify medical conditions which may be 
associated with PTSD. 
(3) Identify ‘‘best practices’’ for treatment of 
PTSD. 
(4) Disseminate results to the Veterans Health 
Administration and the Veterans Benefits Adminis-
tration of the Department of Veterans Affairs. 
(c) AUTHORIZATION.—There is authorized to be ap-
propriated for the purposes of subsection (a) the amount 
of $1,000,000 for each of fiscal years 2005, 2006, and 
2007. 
SEC. 307. PERFORMANCE MEASURES FOR DEPARTMENT OF 
VETERANS AFFAIRS HEALTH CARE ADMINIS-
TRATORS. 
(a) PERFORMANCE MEASURES.—The Secretary of 
Defense and the Secretary of Veterans Affairs, acting 
through the Department of Defense/Department of Vet-
erans 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