Support the Resiliency of Our Nation’s Great Veterans Act of 2022
Summary
Report 117-382 of the 117th Congress, 2d Session, dated June 22, 2022, in which Mr. Takano reports for the Committee on Veterans' Affairs on H.R. 6411, the Support the Resiliency of Our Nation's Great Veterans Act of 2022, also called the STRONG VETERANS ACT. The bill would improve mental health care provided by the Department of Veterans Affairs, and the committee reports it favorably without amendment, recommending that it pass. Bill text near the end requires reports on peer specialists, including how many were hired at each medical center and an assessment of barriers to recruitment, training or retention, plus a final report due not later than one year after the Secretary determines the program is carried out at each medical center.
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“Support the Resiliency of Our Nation’s Great Veterans Act of 2022.”
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117TH CONGRESS REPORT
" HOUSE OF REPRESENTATIVES !
2d Session 117–382
SUPPORT THE RESILIENCY OF OUR NATION’S GREAT
VETERANS ACT OF 2022
JUNE 22, 2022.—Committed to the Committee of the Whole House on the State of
the Union and ordered to be printed
Mr. TAKANO, from the Committee on Veterans’ Affairs,
submitted the following
R E P O R T
[To accompany H.R. 6411]
The Committee on Veterans’ Affairs, to whom was referred the
bill (H.R. 6411) to amend title 38, United States Code, to make cer-
tain improvements in the mental health care provided by the De-
partment of Veterans Affairs, and for other purposes, having con-
sidered the same, reports favorably thereon without amendment
and recommends that the bill do pass.
STRONG VETERANS ACT
The Committee on Veterans’ Affairs, to which was referred the
bill (H.R. 6411) to improve mental health care services for vet-
erans, and for other purposes, having considered the same, report
favorably thereon and recommend that the bill do pass.
CONTENTS
Page
Purpose and Summary ............................................................................................ 2
Background and Need for Legislation .................................................................... 2
Hearings ................................................................................................................... 3
Subcommittee Consideration .................................................................................. 5
Committee Consideration ........................................................................................ 5
Committee Votes ......................................................................................................
Section-by-Section Description ............................................................................... 5
Congressional Budget Office Cost Estimate .......................................................... 9
Committee Oversight Findings ............................................................................... 10
Constitutional Authority Statement ...................................................................... 10
Earmark Statement ................................................................................................. 10
Federal Mandates Statement ................................................................................. 10
Advisory Committee Statement .............................................................................. 10
Performance Goals ................................................................................................... 10
Supplemental, Additional, Dissenting, and Minority Views ................................ 10
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29–006
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Applicability to Legislative Branch ........................................................................ 10
Statement on Duplication of Federal Programs .................................................... 10
Ramseyer Submission ............................................................................................. 11
PURPOSE AND SUMMARY
H.R. 6411, the ‘‘Supporting the Resiliency of Our Nation’s Great
Veterans Act’’ or ‘‘STRONG Veterans Act,’’ was introduced by Rep-
resentative Mark Takano, Chairman of the House Committee on
Veterans’ Affairs, on January 18, 2022. H.R. 6411 would improve
mental health care and suicide prevention for veterans through in-
creased provider training, expanded outreach and service delivery,
improvements to the Veterans Crisis Line, and additional research.
H.R. 6411 incorporates, in whole or in part, text of the following
eleven bills: H.R. 912 introduced by Representative Brownley of
California on February 8, 2021; S. 3293 introduced by Senator
Tester of Montana on December 1, 2021; H.R. 5073 introduced by
Representative Delgado of New York on August 23, 2021; H.R.
2819 introduced by Representative Slotkin of Michigan on April 22,
2021; S. 544 introduced by Senator Ernst of Iowa on March 2,
2021; H.R. 5529 introduced by Representative Miller-Meeks of Iowa
on October 8, 2021; H.R. 5317 introduced by Representative
Takano of California on September 21, 2021; H.R. 4575 introduced
by Representative Peters of California on July 20, 2021; H.R. 4233
introduced by Representative Murphy of North Carolina on June
29, 2021; H.R. 5029 introduced by Representative Rouzer of North
Carolina on August 13, 2021; and H.R. 5516 introduced by Rep-
resentative Ellzey of Texas on October 8, 2021.
BACKGROUND AND NEED FOR LEGISLATION
The rate of veteran suicide decreased in 2019, the most recent
year for which there are data, but suicide is preventable and one
death is too many. Veteran suicide prevention remains the number
one clinical priority for both the Department of Veterans Affairs
(VA) and this Committee. Within a public health model of preven-
tion, the Committee’s goal is for VA and its partners to mitigate
veterans’ suicide risks (ranging from mental health challenges to
interpersonal stressors, financial problems, housing/food/employ-
ment insecurity, and access to lethal means) and strengthen protec-
tive factors (including access to high-quality, effective, timely men-
tal health care). This legislation represents the Committee’s intent
to support VA in moving forward with improved mental health
workforce staffing and training, increased outreach to underserved
veteran populations, enhanced delivery of high-quality care, ex-
panded crisis response capacity, and renewed investment in re-
search that will guide the next decade of assessment, prevention,
and intervention.
Expanding VA’s workforce and ensuring it is well-trained in evi-
dence-based approaches to veteran suicide prevention and mental
health care provision is critical in meeting the demand from vet-
erans, who seek these services from VA in ever-increasing num-
bers. While the hiring sections in this legislation are subject to
availability of appropriations, it is the clear intent of Congress that
VA meet the metrics and timelines set forth herein. To this end,
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the Committee has included authorizations for VA to expand the
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3
number of Vet Center providers, mental health trainees, health
professional scholars, and peer specialists.
This legislation also seeks to ensure that VA and its partners
meet veterans ‘‘where they live,’’ both literally and figuratively, on
issues related to health and wellbeing. This focus must include
proactive efforts to identify and engage veterans who are not al-
ready served by VA in light of the increased risk for suicide in that
veteran subpopulation. Sections of this bill focus on directing VA
to more consistently and comprehensively seek out, partner with,
and provide care to Native veterans and to open VA’s Governors’
Challenge Program to tribes. Other sections expand access to Vet
Centers, close to where veterans live, study, and work. One section
also mandates that VA significantly increase the staffing and work
of its Veterans Justice Outreach program to better identify and
meet the needs of veterans involved with the criminal justice sys-
tem. In all of these sections, the Committee’s intent is to expedi-
tiously expand VA’s existing outreach efforts, given the known rela-
tionships between these factors and death by suicide.
The Committee included a section codifying VA’s existing Solid
Start program, given early data showing the program’s success in
reducing suicide rates during the notoriously high-risk one-year pe-
riod following separation from active duty. The Committee rec-
ommends that VA add texting capacity and recommendations to
the Solid Start protocols to potentially reach more veterans by in-
corporating multiple outreach formats.
One title of this legislation focuses on assessing and further
strengthening the Veterans Crisis Line (VCL), a critical component
of VA’s suicide prevention program providing crisis care and follow-
up to veterans at imminent risk of harm to self or others via phone/
text/chat. With the nationwide rollout of a new, three-digit crisis
hotline number in July of 2022, the Committee will continue rig-
orous oversight of VA’s planning and implementation to meet likely
surges in demand for VCL services and the need for increased VCL
responder and VA mental health provider capacity.
VA has been a leader in sponsoring research that has led to dra-
matic improvements in how we conceive of, prevent, and treat men-
tal illness and suicidality in veterans and society at large. Findings
from studies funded by VA’s Office of Research and Development
and the National Center for PTSD have led to fundamental
changes in how veterans’ suffering may be alleviated and elimi-
nated. The Committee’s intent in calling for more research by VA
and its partners is to push the boundaries of what we know and
to discover new and improved approaches to preventing suicide and
helping veterans thrive. The studies mandated in this bill call for
methodologically rigorous investigations of the interactions between
frequently co-occurring sleep problems, substance use, traumatic
brain injuries, and mental health challenges; VA’s capacity to treat
veterans with these co-occurring issues; and the promise of tech-
nology to vastly expand veterans’ access to effective treatments.
HEARINGS
Components of H.R. 6411 were considered in legislative hearings.
H.R. 912 was previously introduced in the 116th Congress as H.R.
8068. On September 10, 2020, the Subcommittee on Health of the
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House Committee on Veterans’ Affairs conducted a legislative hear-
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ing on various bills introduced during the 116th Congress. H.R.
8068 was among the bills considered during this hearing. The fol-
lowing witnesses testified: Ms. Lindsay Church, Executive Director,
Minority Veterans of America; Ms. Maureen Elias, Associate Legis-
lative Director, Paralyzed Veterans of America; Ms. Joy Ilem, Na-
tional Legislative Director, Disabled American Veterans; Mr. Pat-
rick Murray, Director, National Legislative Service, Veterans of
Foreign Wars; Dr. Russell Lemle, Senior Policy Analyst, Veterans
Healthcare Policy Institute; Lieutenant Colonel Jim Lorraine
(Ret.), President & CEO, America’s Warrior Partnership.
On July 14, 2021, the Subcommittee on Health of the House
Committee on Veterans’ Affairs conducted a legislative hearing
on various bills introduced during the 117th Congress. One bill
considered in this hearing, H.R. 4233, was incorporated into
H.R. 6411. The following witnesses testified: The Honorable
Mark Takano, U.S. House of Representatives, 41st District of
California; The Honorable Chris Pappas, U.S. House of Rep-
resentatives, 1st District of New Hampshire; The Honorable
Conor Lamb, U.S. House of Representatives, 17th District of
Pennsylvania; The Honorable Jason Crow, U.S. House of Rep-
resentatives, 6th District of Colorado; The Honorable Lauren
Underwood, U.S. House of Representatives, 14th District of Il-
linois; The Honorable Greg Murphy, U.S. House of Representa-
tives, 3rd District of North Carolina; Mr. David Perry, Chief
Officer, Workforce Management and Consulting, Veterans
Health Administration, U.S. Department of Veterans Affairs;
accompanied by Mr. Mike Fisher, MSW, Chief Officer, Read-
justment Counseling Service, Veterans Health Administration,
U.S. Department of Veterans Affairs; Mr. Marquis Barefield,
Assistant National Legislative Director, Disabled American
Veterans (DAV); Mr. Andy Blevins, Operations & Policy Direc-
tor, Minority Veterans of America (MVA); Ms. Tammy Barlet,
Deputy Director, National Legislative Service,Veterans of For-
eign Wars (VFW).
On October 13, 2021, the Subcommittee on Health of the
House Committee on Veterans’ Affairs conducted a legislative
hearing on various bills introduced during the 117th Congress.
Of the considered bills, the following were incorporated into
H.R. 6411: H.R. 2819, H.R. 4575, H.R. 5029, H.R. 5073, H.R.
5317, H.R. 5516, and H.R. 5529. The following witnesses testi-
fied: The Honorable Mark Takano, U.S. House of Representa-
tives, 41st District of California; The Honorable Elissa Slotkin,
U.S House of Representatives, 8th District of Michigan; The
Honorable Scott Peters, U.S. House of Representatives, 52nd
District of California; The Honorable David Rouzer, U.S. House
of Representatives, 7th District of North Carolina; The Honor-
able Antonio Delgado, U.S. House of Representatives, 19th Dis-
trict of New York; The Honorable Mikie Sherrill, U.S. House
of Representatives, 11th District of New Jersey; The Honorable
Josh Harder, U.S. House of Representatives, 10th District of
California; The Honorable Lauren Underwood, U.S House of
Representatives, 14th District of Illinois; The Honorable
Mariannette Miller-Meeks, U.S. House of Representatives, 2nd
District of Iowa; The Honorable Jake Ellzey, U.S. House of
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Representatives, 6th District of Texas; Dr. David Carroll, Exec-
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utive Director, Office of Mental Health & Suicide Prevention,
Veterans Health Administration, U.S. Department of Veterans
Affairs; accompanied by Dr. Robert Sherrier, Executive Direc-
tor, National Teleradiology Program, Veterans Health Admin-
istration, U.S. Department of Veterans Affairs; Karen M. Ott,
DNP, RN, Director for Policy, Legislation, and Professional
Standards; Office of Nursing Services, Veterans Health Admin-
istration, U.S. Department of Veterans Affairs; Mr. Michael
Fisher, Chief Readjustment Counseling Officer, Veterans
Health Administration, U.S. Department of Veterans Affairs;
Mr. Marquis Barefield, Assistant National Legislative Director,
Disabled American Veterans; Ms. Tammy Barlet, Deputy Di-
rector, National Legislative Service, Veterans of Foreign Wars;
Dr. Kaki York-Ward, President, Association of VA Psychology
Leaders.
On June 23, 2021, the Senate Committee on Veterans’ Af-
fairs conducted a hearing on pending legislation. One bill con-
sidered in this hearing, S. 544, was incorporated into H.R.
6411. The following witnesses testified: Mark Upton, MD, Act-
ing Assistant Under Secretary of Health for Community Care,
Veterans Health Administration, Department of Veterans Af-
fairs; accompanied by Gerard Cox, MD, Assistant Under Sec-
retary for Health for Quality & Patient Safety; Clifford Smith,
MD, Deputy Director, Office of Mental Health Operations; The-
resa Gleason, PhD, Director, Clinical Science Research & De-
velopment Service; Joy Ilem, National Legislative Director,
Disabled American Veterans; Kathryn Monet, Chief Executive
Officer, National Coalition for Homeless Veterans; Mario A.
Marquez, Director, Veterans Affairs and Rehabilitation Divi-
sion, The American Legion.
SUBCOMMITTEE CONSIDERATION
Component bills of H.R. 6411 were considered before the full
Committee
COMMITTEE CONSIDERATION
On February 2, 2022, the full Committee met in an open markup
session, a quorum being present, to consider H.R. 6411.
No amendments were offered on H.R. 6411. By a voice vote, the
Committee ordered that H.R. 6411, as introduced, be ordered favor-
ably reported to the House of Representatives.
SECTION-BY-SECTION DESCRIPTION
Section 1: Short Title; References to Title 38, United States Code;
Table of Contents.
This section includes a table of contents and specifies that this
Act may be cited as the ‘‘Strengthening the Resiliency of Our Na-
tion’s Great Veterans Act’’ or the ‘‘STRONG Veterans Act.’’
TITLE I—TRAINING TO SUPPORT VETERANS’ MENTAL HEALTH
Sec. 101. Mental health and suicide prevention outreach to minor-
ity veterans and American Indian and Alaska Native veterans.—
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While Native Americans serve in the US military in disproportion-
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ately high rates, Native American veterans die by suicide at dis-
proportionately high rates, as well. This section directs VA to en-
sure that every VA medical center has at least one minority vet-
eran coordinator, trained by VA in consultation with tribes and
tribal programs in culturally appropriate mental health promotion
and suicide prevention approaches. The minority veteran coordina-
tors must work with facility suicide prevention coordinators to doc-
ument and implement mental health outreach and services to
tribes in their catchment areas.
Sec. 102. Expansion of Vet Center workforce.—This section in-
creases Vet Center capacity by mandating the hiring of 50 addi-
tional full-time equivalent employees for Vet Centers.
Sec. 103. VA Mental Health Training Spots.—Within three years,
this section directs VA to add an additional 250 paid trainee slots
in covered mental health disciplines to the VA workforce. The term
‘‘covered mental health disciplines’’ refers to psychiatry, psychology,
advanced practice nursing (with a focus on mental health or sub-
stance use disorder), social work, licensed professional mental
health counseling, and marriage and family therapy.
Sec. 104. Scholarship Expansion.—This section directs VA to in-
clude not fewer than an additional (as compared to academic year
2021) 50 awards per academic year under the Department of Vet-
erans Affairs Health Professional Scholarship Program under sub-
chapter II of chapter 76 of title 38, United States Code, for appli-
cants otherwise eligible for such program who are pursuing degrees
or training in mental health disciplines, including advanced prac-
tice nursing (with a focus on mental health or substance use dis-
order), psychology, and social work.
TITLE II—VETERANS CRISIS LINE
• Sec. 201 Veterans Crisis Line.
» Subtitle A—Veterans Crisis Line Training and Quality
Management
■ Sec. 211. Staff training.
■ Sec. 212. Quality review and management.
■ Sec. 213. Guidance for high-Risk callers.
■ Sec. 214. Oversight of training of social service assist-
ants and clarification of job responsibilities.
» Subtitle B—Pilot Programs and Research on Veterans Cri-
sis Line
■ Sec. 221. Pilot programs.
■ Sec. 222. Authorization of appropriations for research
on effectiveness and opportunities for improvement of Vet-
erans Crisis Line.
» Subtitle C—Transition of Crisis Line Number
■ Sec. 231. Feedback on transition of crisis line number.
This section directs a series of actions to improve the Veterans
Crisis Line training and quality management, evaluate its effec-
tiveness, and ensure enough resources are available as the new 3-
digit crisis line number goes into effect in July, 2022.
TITLE III—OUTREACH TO VETERANS
Sec. 301. Solid Start program of the Department of Veterans Af-
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fairs.—This section authorizes in statute VA’s existing Solid Start
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program for proactively reaching out to veterans who have recently
separated from military service.
Sec. 302. Designation of Buddy Check Week by Secretary of Vet-
erans Affairs.—This directs the Secretary of VA to designate one
week each year to organize outreach events and educate veterans
on how to conduct peer wellness checks.
Sec. 303. Improvements to Veterans Justice Outreach Program.—
This provision requires VA to improve its outreach to justice-in-
volved veterans, Veterans Service Organizations, and stakeholders
in the criminal justice community (including law enforcement,
court officials, and jail administrators), to improve awareness of
VA’s Veterans Justice Outreach (VJO) program. It also requires VA
to increase the number of VJO specialists serving justice-involved
veterans in rural, remote, or underserved areas. In addition, VA is
directed to carry out mandatory annual training for VJO specialists
and establish performance goals, measures, and implementation
timelines for the VJO program and its outreach specialists.
Sec. 304. Department of Veterans Affairs Governors Challenge
Program.—VA’s Governors’ Challenge program is an existing, col-
laborative effort with the Substance Abuse and Mental Health
Services Administration (SAMHSA) to help states develop veteran
suicide prevention proposals. This bill gives VA two new authori-
ties within its existing Governors’ Challenge veteran suicide pre-
vention program: 1) it directs VA to treat tribes equal to states for
the purpose of inclusion in the program; and 2) it allows VA to pro-
vide not only technical assistance to states and tribes, but also
grants for actual implementation of state and tribal veteran suicide
prevention proposals.
TITLE IV—MENTAL HEALTH CARE DELIVERY
Sec. 401. Expansion of peer specialist support program of Depart-
ment of Veterans Affairs.—Peer specialists at VA are veterans in
recovery from their own challenges with mental illness and sub-
stance use, trained to help other veterans successfully engage in
treatment. They have been both popular with veterans and effec-
tive. This bill gradually expands the number of VA peer specialists
in all VA medical centers.
Sec. 402. Expansion of Vet Center services.—This section would
make certain student veterans eligible for using Vet Centers even
if they would not meet Vet Center eligibility criteria were they not
currently students (for example, through lack of combat deploy-
ments). Transitions—from military to veteran status, and from
non-student to student—are times of increased stress and suicide
risk, and it is crucial to support increased access to the mental
health and other services and benefits during this time.
Sec. 403. Eligibility for mental health services.—This section al-
lows Vet Centers to provide readjustment counseling and related
mental health services to family members of servicemembers or
veterans who died by suicide. The definition of ‘‘family member’’ in-
cludes individuals who are the parent, spouse, child, step-family
member, or extended family member of a veteran or servicemem-
ber; and someone who lives with the veteran or servicemember but
is not a family member.
Sec. 404. Mental Health Consults.—This section amends the US
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Code such that not later than thirty days after the date on which
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a veteran submits to the VA Secretary a claim for compensation
under this chapter for service-connected disability relating to a
mental health diagnosis, the Secretary shall offer the veteran a
mental health consultation to assess the mental health needs of
and care options for the veteran.
TITLE V—RESEARCH
Sec. 501. Veterans Integration to Academic Leadership (VITAL)
Assessment Act.—This provision requires VA to submit to Congress
within one year of enactment a report on the Veterans Integration
to Academic Leadership (VITAL) program. Specifically, VA must
assess the number of VA medical centers, institutions of higher
learning, non-college degree programs, and student veterans sup-
ported by the program. In addition, the report must evaluate rel-
evant trends since the program began, including the levels of staff
and resources allocated to the program and the outcomes and effec-
tiveness of the program. In addition, VA’s report must examine
barriers to expanding the program and how the Department plans
to address these barriers. Finally, VA’s report must assess whether
the program should be expanded outside of VHA’s Office of Mental
Health and Suicide Prevention to support student veterans with
needs unrelated to mental health or suicide.
Sec. 502. Improvement of sleep disorder care furnished by Depart-
ment of Veterans Affairs.—This section directs the Secretary of VA
to improve the assessment and treatment of veterans with sleep
disorders, including by conducting in home sleep studies for vet-
erans, following an analysis of the ability of VA to treat sleep dis-
orders among veterans, including—(1) assessment and treatment
options for such disorders; (2) barriers to care for such disorders,
such as wait time, travel time, and lack of staffing; (3) the efficacy
of the clinical practice guidelines of VA and the Department of De-
fense for such disorders; and (4) the availability of and efficacy of
the use by VA of cognitive behavioral therapy for insomnia.
Sec. 503. Study on inpatient mental health and substance use
care from Department of Veterans Affairs.—This section mandates
that not later than one year after the date of the enactment of this
Act, the Secretary of VA shall complete the conduct of a study on
access of veterans to care under the residential rehabilitation treat-
ment programs of the Department of Veterans Affairs to deter-
mine—(1) if there are sufficient geographic offerings of inpatient
mental health care, especially for veterans in rural and remote
communities; (2) if there are sufficient bed spaces at each location,
based on demand and drive time from the homes of veterans; (3)
if there are any workforce-related capacity limitations at each loca-
tion, including if beds are unable to be used because there are not
enough providers to care for additional patients; (4) if there are di-
agnosis-specific or sex-specific barriers to accessing care under such
programs; and (5) the average wait time for a bed in such a pro-
gram, broken out by—(A) Veterans Integrated Service Network; (B)
rural or urban area; (C) sex; and (D) specialty (general program,
substance use disorder program, military sexual trauma program,
etc.).
Sec. 504. Study on treatment from Department of Veterans Affairs
for co-occurring mental health and substance use disorders.—This
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section directs VA to conduct a study examining the availability of
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treatment programs for veterans with co-occurring mental health
and substance use disorders (including both inpatient and out-
patient care); any geographic disparities in access to such pro-
grams, such as for rural and remote veterans; and the average wait
times for care under such programs.
Sec. 505. Study on workload of suicide prevention teams of De-
partment of Veterans Affairs.—This provision directs VA to conduct
a study evaluating the workload of local suicide prevention teams
of the Department of Veterans Affairs. The study shall identify the
effects of the growth of the suicide prevention program of the De-
partment on the workload of suicide prevention teams; incorporate
key practices for staffing model design in determining suicide pre-
vention staffing needs; and determine which facilities of the De-
partment need increased suicide prevention coordinator staffing to
meet the needs of veterans, with an emphasis placed on facilities
with high patient volume and facilities located in States with high
rates of veteran suicide.
Sec. 506. Expansion of suicide prevention and mental health re-
search.—This section authorizes an additional $10,000,000 to be
used by VA’s Center of Excellence for Suicide Prevention of the De-
partment and the Rocky Mountain Mental Illness Research Edu-
cation and Clinical Center for the purposes of conducting research
on the factors impacting veteran suicide and best practices for
early intervention and support.
Sec. 507. Study on mental health and suicide prevention support
for military families.—This section directs the Secretary of VA, in
collaboration with the Secretary of Defense, to conduct a study on
secondary post-traumatic stress disorder and depression and its im-
pact on spouses, children, and caregivers of members of the Armed
Forces.
Sec. 508. Research on brain health.—This section authorizes an
additional $5,000,000 for ongoing and future research at VA’s
Translational Research Center for traumatic brain injury and
stress disorders to provide better understanding of and improved
treatment options for post 9/11 veterans with traumatic brain in-
jury or post-traumatic stress disorder.
Sec. 509. Study on efficacy of clinical and at-home resources for
post-traumatic stress disorder.—This section mandates that not
later than two years after the date of the enactment of this Act,
the Secretary of VA, through VA’s Office of Research and Develop-
ment, shall conduct a study on the efficacy of clinical and at-home
resources, such as mobile applications like COVID Coach, for pro-
viders, veterans, caregivers, and family members to use for dealing
with stressors; the feasibility and advisability of developing more
such resources; strategies for improving mental health care and
outcomes for veterans with post-traumatic stress disorder; and best
practices for helping family members of veterans deal with sec-
ondary post-traumatic stress disorder or mental health concerns.
CONGRESSIONAL BUDGET OFFICE COST ESTIMATE
A formal cost estimate was not provided in time for the filing of
this report. The Congressional Budget Office informed the Com-
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mittee that this legislation will have no direct budgetary effects.
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COMMITTEE OVERSIGHT FINDINGS
In compliance with clause 3(c)(1) of rule XIII and clause (2)(b)(1)
of rule X of the Rules of the House of Representatives, the Commit-
tee’s oversight findings and recommendations are reflected in the
descriptive portions of this report.
CONSTITUTIONAL AUTHORITY STATEMENT
Pursuant to Article I, section 8 of the United States Constitution,
H.R. 6411 is authorized by Congress’ power to ‘‘provide for the com-
mon Defense and general Welfare of the United States.’’
EARMARK STATEMENT
H.R. 6411 does not contain any Congressional earmarks, limited
tax benefits, or limited tariff benefits as defined in clause 9 of rule
XXI of the Rules of the House of Representatives.
FEDERAL MANDATES STATEMENT
The Committee adopts as its own the estimate of Federal man-
dates regarding H.R. 6411, prepared by the Director of the Con-
gressional Budget Office pursuant to section 423 of the Unfunded
Mandates Reform Act.
ADVISORY COMMITTEE STATEMENT
An advisory committee within the meaning of section 5(b) of the
Federal Advisory Committee Act would not be created by H.R.
6411.
PERFORMANCE GOALS
In accordance with clause 3(c)(4) of rule XIII of the Rules of the
House of Representatives, the Committee’s performance goals and
objectives are to increase access to quality and timely health care
and benefits to veterans.
SUPPLEMENTAL, ADDITIONAL, DISSENTING, AND MINORITY VIEWS
APPLICABILITY TO LEGISLATIVE BRANCH
The Committee finds that H.R. 6411 does not relate to the terms
and condition of employment or access to public services or accom-
modations within the meaning of section 102(b)(3) of the Congres-
sional Accountability Act.
STATEMENT ON DUPLICATION OF FEDERAL PROGRAMS
Pursuant to clause 3(c)(5) of rule XIII of the Rules of the House
of Representatives, the Committee finds that no provision of H.R.
6411 establishes or reauthorizes a program of the Federal Govern-
ment known to be duplicative of another Federal program, a pro-
gram that was included in any report from the Government Ac-
countability Office to Congress pursuant to section 21 of Public
Law 111–139, or a program related to a program identified in the
ctelli on DSK11ZRN23PROD with REPORTS
most recent Catalog of Federal Domestic Assistance.
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11
RAMSEYER SUBMISSION
CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED
In compliance with clause 3(e) of rule XIII of the Rules of the
House of Representatives, changes in existing law made by the bill,
as reported, are shown as follows (existing law proposed to be omit-
ted is enclosed in black brackets, new matter is printed in italics,
and existing law in which no change is proposed is shown in
roman):
TITLE 38, UNITED STATES CODE
* * * * * * *
PART II—GENERAL BENEFITS
* * * * * * *
CHAPTER 11—COMPENSATION FOR SERVICE-
CONNECTED DISABILITY OR DEATH
SUBCHAPTER I—GENERAL
Sec.
* * * * * * *
SUBCHAPTER VI—GENERAL COMPENSATION PROVISIONS
* * * * * * *
1167. Mental health consultations.
* * * * * * *
SUBCHAPTER VI—GENERAL COMPENSATION PROVISIONS
* * * * * * *
§ 1167. Mental health consultations
(a) IN GENERAL.—Not later than 30 days after the date on which
a veteran submits to the Secretary a claim for compensation under
this chapter for a service-connected disability relating to a mental
health diagnosis, the Secretary shall offer the veteran a mental
health consultation to assess the mental health needs of, and care
options for, the veteran.
(b) AVAILABILITY.—The Secretary shall—
(1) offer a veteran a consultation under subsection (a) without
regard to any previous denial or approval of a claim of that vet-
eran for a service-connected disability relating to a mental
health diagnosis; and
(2) ensure that a veteran offered a mental health consultation
under subsection (a) may elect to receive such consultation dur-
ing the one-year period beginning on the date on which the con-
sultation is offered or during such longer period beginning on
such date as the Secretary considers appropriate.
(c) RULE OF CONSTRUCTION.—A consultation provided to a vet-
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eran under this section shall not be construed as a determination
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12
that any disability of such veteran is service-connected for the pur-
poses of any benefit under the laws administered by the Secretary.
* * * * * * *
CHAPTER 17—HOSPITAL, NURSING HOME,
DOMICILIARY, AND MEDICAL CARE
* * * * * * *
SUBCHAPTER II—HOSPITAL, NURSING HOME, OR
DOMICILIARY CARE AND MEDICAL TREATMENT
* * * * * * *
§ 1712A. Eligibility for readjustment counseling and related
mental health services
(a)(1)(A) Upon the request of any individual referred to in sub-
paragraph (C), the Secretary shall furnish counseling, including by
furnishing counseling through a Vet Center, to the individual—
(i) in the case of an individual referred to in øclauses (i)
through (vi)¿ clauses (i) through (vii) of subparagraph (C), to
assist the individual in readjusting to civilian life; and
(ii) in the case of an individual referred to øin clause (vii)¿
in clause (viii) of such subparagraph who is a family member
of a veteran or member described in such clause—
(I) in the case of a member who is deployed in a theater
of combat operations or an area at a time during which
hostilities are occurring in that area, during such deploy-
ment to assist such individual in coping with such deploy-
ment; øand¿
(II) in the case of a veteran or member who is read-
justing to civilian life, to the degree that counseling fur-
nished to such individual is found to aid in the readjust-
ment of such veteran or member to civilian lifeø.¿; and
(III) in the case of a veteran or member who died by sui-
cide, to the degree that counseling furnished to such indi-
vidual is found to aid in coping with the effects of such sui-
cide.
(B)(i) Counseling furnished to an individual under subparagraph
(A) may include a comprehensive individual assessment of the indi-
vidual’s psychological, social, and other characteristics to ascertain
whether—
(I) in the case of an individual referred to in øclauses (i)
through (vi)¿ clauses (i) through (vii) of subparagraph (C), such
individual has difficulties associated with readjusting to civil-
ian life; and
(II) in the case of an individual referred to øin clause (vii)¿
in clause (viii) of such subparagraph, such individual has dif-
ficulties associated with—
(aa) coping with the deployment of a member described
in subclause (I) of such clause; øor¿
(bb) readjustment to civilian life of a veteran or member
described in subclause (II) of such clauseø.¿; or
(cc) coping with the effects of a suicide described in
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subclause (III) of such clause.
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13
(ii)(I) Except as provided in subclauses (IV) and (V), counseling
furnished to an individual under subparagraph (A) may include re-
integration and readjustment services described in subclause (II)
furnished in group retreat settings.
(II) Reintegration and readjustment services described in this
subclause are the following:
(aa) Information on reintegration of the individual into fam-
ily, employment, and community.
(bb) Financial counseling.
(cc) Occupational counseling.
(dd) Information and counseling on stress reduction.
(ee) Information and counseling on conflict resolution.
(ff) Such other information and counseling as the Secretary
considers appropriate to assist the individual in reintegration
into family, employment, and community.
(III) In furnishing reintegration and readjustment services under
subclause (I), the Secretary shall offer women the opportunity to
receive such services in group retreat settings in which the only
participants are women.
(IV) An individual described in subparagraph (C)(v) may receive
reintegration and readjustment services under subclause (I) of this
clause only if the individual receives such services with a family
member described in subclause (I) or (II) of such subparagraph.
(V) In each of fiscal years 2021 through 2025, the maximum
number of individuals to whom integration and readjustment serv-
ices may be furnished in group retreat settings under this sub-
clause (I) shall not exceed 1,200 individuals.
(C) Subparagraph (A) applies to the following individuals:
(i) Any individual who is a veteran or member of the Armed
Forces, including a member of a reserve component of the
Armed Forces, who served on active duty in a theater of com-
bat operations or an area at a time during which hostilities oc-
curred in that area.
(ii) Any individual who is a veteran or member of the Armed
Forces, including a member of a reserve component of the
Armed Forces, who provided direct emergency medical or men-
tal health care, or mortuary services to the causalities of com-
bat operations or hostilities, but who at the time was located
outside the theater of combat operations or area of hostilities.
(iii) Any individual who is a veteran or member of the Armed
Forces, including a member of a reserve component of the
Armed Forces, who engaged in combat with an enemy of the
United States or against an opposing military force in a the-
ater of combat operations or an area at a time during which
hostilities occurred in that area by remotely controlling an un-
manned aerial vehicle, notwithstanding whether the physical
location of such veteran or member during such combat was
within such theater of combat operations or area.
(iv) Any individual who is a veteran or member of the Armed
Forces, including a member of a reserve component of the
Armed Forces, who served—
(I) on active service in response to a national emergency
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or major disaster declared by the President; or
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14
(II) in the National Guard of a State under orders of the
chief executive of that State in response to a disaster or
civil disorder in such State.
(v) Any individual who participated in a drug interdiction op-
eration as a member of the Coast Guard, regardless of the loca-
tion of that operation.
(vi) Any individual who received counseling under this sec-
tion before the date of the enactment of the National Defense
Authorization Act for Fiscal Year 2013.
(vii) Any veteran or member of the Armed Forces pursuing a
course of education using covered educational assistance bene-
fits.
ø(vii)¿ (viii) Any individual who is a family member of any—
(I) member of the Armed Forces, including a member of
a reserve component of the Armed Forces, who is serving
on active duty in a theater of combat operations or in an
area at a time during which hostilities are occurring in
that area; øor¿
(II) veteran or member of the Armed Forces described in
this subparagraphø.¿; or
(III) veteran or member of the Armed Forces who died by
suicide.
(2)(A) Upon request of an individual described in paragraph
(1)(C), the Secretary shall provide the individual a comprehensive
individual assessment as described in paragraph (1)(B)(i) as soon
as practicable after receiving the request, but not later than 30
days after receiving the request.
(B) Upon the request of an individual described in paragraph
(1)(C), the Secretary shall furnish the individual reintegration and
readjustment services in group retreat settings under paragraph
(1)(B)(ii) if the Secretary determines the experience will be thera-
peutically appropriate.
(b)(1) If, on the basis of the assessment furnished under sub-
section (a) of this section, a licensed or certified mental health care
provider employed by the Department (or, in areas where no such
licensed or certified mental health care provider is available, a li-
censed or certified mental health care provider carrying out such
function under a contract or fee arrangement with the Secretary)
determines that the provision of mental health services to such vet-
eran is necessary to facilitate the successful readjustment of the
veteran to civilian life, such veteran shall, within the limits of De-
partment facilities, be furnished such services on an outpatient
basis. For the purposes of furnishing such mental health services,
the counseling furnished under subsection (a) of this section shall
be considered to have been furnished by the Department as a part
of hospital care. Any hospital care and other medical services con-
sidered necessary on the basis of the assessment furnished under
subsection (a) of this section shall be furnished only in accordance
with the eligibility criteria otherwise set forth in this chapter (in-
cluding the eligibility criteria set forth in section 1784 of this title).
(2) Mental health services furnished under paragraph (1) of this
subsection may, if determined to be essential to the effective treat-
ment and readjustment of the veteran, include such consultation,
counseling, training, services, and expenses as are described in sec-
ctelli on DSK11ZRN23PROD with REPORTS
tions 1782 and 1783 of this title.
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15
(c) Upon receipt of a request for counseling under this section
from any individual who has been discharged or released from ac-
tive military, naval, air, or space service but who is not otherwise
eligible for such counseling, the Secretary shall—
(1) provide referral services to assist such individual, to the
maximum extent practicable, in obtaining mental health care
and services from sources outside the Department; and
(2) if pertinent, advise such individual of such individual’s
rights to apply to the appropriate military, naval, air, or space
service, and to the Department, for review of such individual’s
discharge or release from such service.
(d) The Under Secretary for Health may provide for such training
of professional, paraprofessional, and lay personnel as is necessary
to carry out this section effectively, and, in carrying out this sec-
tion, may utilize the services of paraprofessionals, individuals who
are volunteers working without compensation, and individuals who
are veteran-students (as described in section 3485 of this title) in
initial intake and screening activities.
(e)(1) In furnishing counseling and related mental health services
under subsections (a) and (b) of this section, the Secretary shall
have available the same authority to enter into contracts or agree-
ments with private facilities that is available to the Secretary in
furnishing medical services to veterans suffering from total service-
connected disabilities.
(2) Before furnishing counseling or related mental health services
described in subsections (a) and (b) of this section through a con-
tract facility, as authorized by this subsection, the Secretary shall
approve (in accordance with criteria which the Secretary shall pre-
scribe by regulation) the quality and effectiveness of the program
operated by such facility for the purpose for which the counseling
or services are to be furnished.
(3) The authority of the Secretary to enter into contracts under
this subsection shall be effective for any fiscal year only to such ex-
tent or in such amounts as are provided in appropriation Acts.
(f) The Secretary, in cooperation with the Secretary of Defense,
shall take such action as the Secretary considers appropriate to no-
tify veterans who may be eligible for assistance under this section
of such potential eligibility.
(g) In carrying out this section and in furtherance of the Sec-
retary’s responsibility to carry out outreach activities under chap-
ter 63 of this title, the Secretary may provide for and facilitate the
participation of personnel employed by the Secretary to provide
services under this section in recreational programs that are—
(1) designed to encourage the readjustment of veterans de-
scribed in subsection (a)(1)(C); and
(2) operated by any organization named in or approved
under section 5902 of this title.
(h) For the purposes of this section:
(1) The term ‘‘Vet Center’’ means a facility which is operated
by the Department for the provision of services under this sec-
tion and which is situated apart from Department general
health care facilities.
(2) The term ‘‘Department general health-care facility’’
means a health-care facility which is operated by the Depart-
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ment for the furnishing of health-care services under this chap-
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16
ter, not limited to services provided through the program es-
tablished under this section.
(3) The term ‘‘family member’’, with respect to a veteran or
member of the Armed Forces, means an individual who—
(A) is a member of the family of the veteran or member,
including—
(i) a parent;
(ii) a spouse;
(iii) a child;
(iv) a step-family member; and
(v) an extended family member; or
(B) lives with the veteran or member but is not a mem-
ber of the family of the veteran or member.
(4) The term ‘‘active service’’ has the meaning given that
term in section 101 of title 10.
(5) The term ‘‘civil disorder’’ has the meaning given that
term in section 232 of title 18.
(6) The term ‘‘covered educational assistance benefits’’ means
educational assistance benefits provided pursuant to—
(A) chapter 30, 31, 32, or 33 of this title;
(B) chapter 1606 or 1607 of title 10;
(C) section 116 of the Harry W. Colmery Veterans Edu-
cational Assistance Act of 2017 (Public Law 115–48; 38
U.S.C. 3001 note); or
(D) section 8006 of the American Rescue Plan Act of 2021
(Public Law 117–2; 38 U.S.C. 3001 note prec.).
* * * * * * *
CHAPTER 20—BENEFITS FOR HOMELESS VETERANS
SUBCHAPTER I—PURPOSE; DEFINITIONS; ADMINISTRATIVE MATTERS
Sec.
* * * * * * *
SUBCHAPTER VII—OTHER PROVISIONS
* * * * * * *
2068. Mental health consultations.
* * * * * * *
SUBCHAPTER VII—OTHER PROVISIONS
* * * * * * *
§ 2068. Mental health consultations
(a) IN GENERAL.—Not later than two weeks after the date on
which a veteran described in subsection (b) enters into a program
administered by the Homeless Programs Office of the Department,
the Secretary shall offer the veteran a mental health consultation to
assess the health needs of, and care options for, the veteran.
(b) VETERAN DESCRIBED.—A veteran described in this subsection
is a veteran to whom a mental health consultation is not offered or
provided through the case management services of the program of
the Homeless Programs Office into which the veteran enters.
ctelli on DSK11ZRN23PROD with REPORTS
* * * * * * *
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17
PART IV—GENERAL ADMINISTRATIVE
PROVISIONS
* * * * * * *
CHAPTER 63—OUTREACH ACTIVITIES
Sec.
SUBCHAPTER I—OUTREACH SERVICES PROGRAM
* * * * * * *
SUBCHAPTER II—OTHER OUTREACH PROGRAMS AND ACTIVITIES
6320. Solid Start program.
Subchapter I—Outreach Services Program
§ 6301. Purpose; definitions
(a) PURPOSE.—The Congress declares that—
(1) the outreach services program authorized by øthis chap-
ter¿ this subchapter is for the purpose of ensuring that all vet-
erans (especially those who have been recently discharged or
released from active military, naval, air, or space service, or
from a reserve component, and those who are eligible for read-
justment or other benefits and services under laws adminis-
tered by the Department) are provided timely and appropriate
assistance to aid and encourage them in applying for and ob-
taining such benefits and services in order that they may
achieve a rapid social and economic readjustment to civilian
life and obtain a higher standard of living for themselves and
their dependents; and
(2) the outreach services program authorized by øthis chap-
ter¿ this subchapter is for the purpose of charging the Depart-
ment with the affirmative duty of seeking out eligible veterans
and eligible dependents and providing them with such services.
(b) DEFINITIONS.—For the purposes of øthis chapter¿ this sub-
chapter—
(1) the term ‘‘outreach’’ means the act or process of reaching
out in a systematic manner to proactively provide information,
services, and benefits counseling to veterans, and to the
spouses, children, and parents of veterans who may be eligible
to receive benefits under the laws administered by the Sec-
retary, to ensure that such individuals are fully informed
about, and receive assistance in applying for, such benefits;
(2) the term ‘‘other governmental programs’’ includes all pro-
grams under State or local laws as well as all programs under
Federal law other than those authorized by this title; and
(3) the term ‘‘eligible dependent’’ means a spouse, surviving
spouse, child, or dependent parent of a person who served in
the active military, naval, air, or space service.
* * * * * * *
§ 6303. Outreach services
(a) REQUIREMENT TO PROVIDE SERVICES.—In carrying out the
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purposes of øthis chapter¿ this subchapter, the Secretary shall pro-
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18
vide the outreach services specified in subsections (b) through (d).
In areas where a significant number of eligible veterans and eligi-
ble dependents speak a language other than English as their prin-
cipal language, such services shall, to the maximum feasible ex-
tent, be provided in the principal language of such persons.
(b) INDIVIDUAL NOTICE TO NEW VETERANS.—The Secretary shall
by letter advise each veteran at the time of the veteran’s discharge
or release from active military, naval, air, or space service (or as
soon as possible after such discharge or release) of all benefits and
services under laws administered by the Department for which the
veteran may be eligible. In carrying out this subsection, the Sec-
retary shall ensure, through the use of veteran-student services
under section 3485 of this title, that contact, in person or by tele-
phone, is made with those veterans who, on the basis of their mili-
tary service records, do not have a high school education or equiva-
lent at the time of discharge or release.
(c) DISTRIBUTION OF INFORMATION.—(1) The Secretary—
(A) shall distribute full information to eligible veterans and
eligible dependents regarding all benefits and services to which
they may be entitled under laws administered by the Sec-
retary; and
(B) may, to the extent feasible, distribute information on
other governmental programs (including manpower and train-
ing programs) which the Secretary determines would be bene-
ficial to veterans.
(2) Whenever a veteran or dependent first applies for any benefit
under laws administered by the Secretary (including a request for
burial or related benefits or an application for life insurance pro-
ceeds), the Secretary shall provide to the veteran or dependent in-
formation concerning benefits and health care services under pro-
grams administered by the Secretary. Such information shall be
provided not later than three months after the date of such applica-
tion.
(d) PROVISION OF AID AND ASSISTANCE.—The Secretary shall pro-
vide, to the maximum extent possible, aid and assistance (including
personal interviews) to members of the Armed Forces, veterans,
and eligible dependents with respect to subsections (b) and (c) and
in the preparation and presentation of claims under laws adminis-
tered by the Department.
(e) ASSIGNMENT OF EMPLOYEES.—In carrying out this section, the
Secretary shall assign such employees as the Secretary considers
appropriate to conduct outreach programs and provide outreach
services for homeless veterans. Such outreach services may include
site visits through which homeless veterans can be identified and
provided assistance in obtaining benefits and services that may be
available to them.
§ 6304. Veterans assistance offices
(a) IN GENERAL.—The Secretary shall establish and maintain
veterans assistance offices at such places throughout the United
States and its territories and possessions, and in the Common-
wealth of Puerto Rico, as the Secretary determines to be necessary
to carry out the purposes of øthis chapter¿ this subchapter. The
Secretary may maintain such offices on such military installations
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located elsewhere as the Secretary, after consultation with the Sec-
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19
retary of Defense and taking into account recommendations, if any,
of the Secretary of Labor, determines to be necessary to carry out
such purposes.
(b) LOCATION OF OFFICES.—In establishing and maintaining such
offices, the Secretary shall give due regard to—
(1) the geographical distribution of veterans recently dis-
charged or released from active military, naval, air, or space
service;
(2) the special needs of educationally disadvantaged veterans
(including their need for accessibility of outreach services); and
(3) the necessity of providing appropriate outreach services
in less populated areas.
§ 6305. Outstationing of counseling and outreach personnel
The Secretary may station employees of the Department at loca-
tions other than Department offices, including educational institu-
tions, to provide—
(1) counseling and other assistance regarding benefits under
this title to veterans and other persons eligible for benefits
under this title; and
(2) outreach services under øthis chapter¿ this subchapter.
§ 6306. Use of other agencies
(a) In carrying out øthis chapter¿ this subchapter, the Secretary
shall arrange with the Secretary of Labor for the State employment
service to match the particular qualifications of an eligible veteran
or eligible dependent with an appropriate job or job training oppor-
tunity, including, where possible, arrangements for outstationing
the State employment personnel who provide such assistance at ap-
propriate facilities of the Department.
(b) In carrying out øthis chapter¿ this subchapter, the Secretary
shall, in consultation with the Secretary of Labor, actively seek to
promote the development and establishment of employment oppor-
tunities, training opportunities, and other opportunities for vet-
erans, with particular emphasis on the needs of veterans with serv-
ice-connected disabilities and other eligible veterans, taking into
account applicable rates of unemployment and the employment em-
phases set forth in chapter 42 of this title.
(c) In carrying out øthis chapter¿ this subchapter, the Secretary
shall cooperate with and use the services of any Federal depart-
ment or agency or any State or local governmental agency or recog-
nized national or other organization.
(d) In carrying out øthis chapter¿ this subchapter, the Secretary
shall, where appropriate, make referrals to any Federal depart-
ment or agency or State or local governmental unit or recognized
national or other organization.
(e) In carrying out øthis chapter¿ this subchapter, the Secretary
may furnish available space and office facilities for the use of au-
thorized representatives of such governmental unit or other organi-
zation providing services.
(f) In carrying out øthis chapter¿ this subchapter, the Secretary
shall conduct and provide for studies, in consultation with appro-
priate Federal departments and agencies, to determine the most ef-
fective program design to carry out the purposes of øthis chapter¿
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this subchapter.
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20
§ 6307. Outreach for eligible dependents
(a) NEEDS OF DEPENDENTS.—In carrying out øthis chapter¿ this
subchapter, the Secretary shall ensure that the needs of eligible de-
pendents are fully addressed.
(b) INFORMATION AS TO AVAILABILITY OF OUTREACH SERVICES FOR
DEPENDENTS.—The Secretary shall ensure that the availability of
outreach services and assistance for eligible dependents under
øthis chapter¿ this subchapter is made known through a variety of
means, including the Internet, announcements in veterans publica-
tions, and announcements to the media.
* * * * * * *
SUBCHAPTER II—OTHER OUTREACH PROGRAMS AND
ACTIVITIES
§ 6320. Solid Start program
(a) IN GENERAL.—The Secretary shall carry out a program, to be
known as the ‘‘Solid Start program’’, under which the Secretary
shall—
(1) build the capacity of the Department to efficiently and ef-
fectively respond to the queries and needs of veterans who have
recently separated from the Armed Forces; and
(2) systemically integrate and coordinate efforts to assist vet-
erans, including efforts—
(A) to proactively reach out to newly separated veterans
to inform them of their eligibility for programs of and bene-
fits provided by the Department; and
(B) to connect veterans in crisis to resources that address
their immediate needs.
(b) ACTIVITIES OF THE SOLID START PROGRAM.—(1) The Secretary,
in coordination with the Secretary of Defense, shall carry out the
Solid Start program of the Department by—
(A) collecting up-to-date contact information during transi-
tion classes or separation counseling for all members of the
Armed Forces who are separating from the Armed Forces, while
explaining the existence and purpose of the Solid Start pro-
gram;
(B) calling each veteran, regardless of separation type or
characterization of service, three times within the first year
after separation of the veteran from the Armed Forces;
(C) providing information about the Solid Start program on
the website of the Department and in materials of the Depart-
ment, especially transition booklets and other resources;
(D) ensuring calls are truly tailored to the needs of each vet-
eran’s unique situation by conducting quality assurance tests;
(E) prioritizing outreach to veterans who have accessed men-
tal health resources prior to separation from the Armed Forces;
(F) providing women veterans with information that is tai-
lored to their specific health care and benefit needs;
(G) as feasible, providing information on access to State and
local resources, including Vet Centers and veterans service orga-
nizations; and
(H) gathering and analyzing data assessing the effectiveness
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of the Solid Start program.
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21
(2) The Secretary, in coordination with the Secretary of Defense,
may carry out the Solid Start program by—
(A) encouraging members of the Armed Forces who are
transitioning to civilian life to authorize alternate points of con-
tact who can be reached should the member be unavailable dur-
ing the first year following the separation of the member from
the Armed Forces;
(B) following up missed phone calls with tailored mailings to
ensure the veteran still receives similar information; and
(C) striving to reach out to veterans who separated prior to
the initiation of the Solid Start program to provide similar
services to those veterans, as feasible.
(3) In this subsection:
(A) The term ‘‘Vet Center’’ has the meaning given that term
in section 1712A(h) of this title.
(B) The term ‘‘veterans service organization’’ means an orga-
nization recognized by the Secretary for the representation of
veterans under section 5902 of this title.
(c) OBLIGATIONS OF AMOUNTS.—Subject to the availability of ap-
propriations, the Secretary may not, in a fiscal year, obligate an
amount to carry out the Solid Start program that is less than the
total amount obligated in the previous fiscal year to carry out the
program, unless the Secretary determines that increased efficiencies
of the program warrant the obligation of a lesser amount.
* * * * * * *
VA MISSION ACT OF 2018
* * * * * * *
TITLE V—OTHER MATTERS
* * * * * * *
SEC. 506. PROGRAM ON ESTABLISHMENT OF PEER SPECIALISTS IN PA-
TIENT ALIGNED CARE TEAM SETTINGS WITHIN MEDICAL
CENTERS OF DEPARTMENT OF VETERANS AFFAIRS.
(a) PROGRAM REQUIRED.—The Secretary of Veterans Affairs shall
carry out a program to establish not fewer than two peer special-
ists in patient aligned care teams at medical centers of the Depart-
ment of Veterans Affairs to promote the use and integration of
services for mental health, substance use disorder, and behavioral
health in a primary care setting. Each such peer specialist shall be
a full-time employee whose primary function is to serve as a peer
specialist and shall be in addition to all other employees of such
medical center.
(b) øTIMEFRAME¿ INITIAL TIMEFRAME FOR ESTABLISHMENT OF
PROGRAM.—The Secretary shall carry out the program at medical
centers of the Department as follows:
(1) Not later than May 31, 2019, at not fewer than 15 med-
ical centers of the Department.
(2) Not later than May 31, 2020, at not fewer than 30 med-
ical centers of the Department.
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(c) øSELECTION¿ INITIAL SELECTION OF LOCATIONS.—
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22
(1) IN GENERAL.—øThe Secretary shall¿ In establishing the
program at initial locations, the Secretary shall select medical
centers for the program as follows:
(A) Not fewer than five shall be medical centers of the
Department that are designated by the Secretary as
polytrauma centers.
(B) Not fewer than 10 shall be medical centers of the De-
partment that are not designated by the Secretary as
polytrauma centers.
(2) CONSIDERATIONS.—In selecting medical centers for the
program under paragraph (1), the Secretary shall consider the
feasibility and advisability of selecting medical centers in the
following areas:
(A) Rural areas and other areas that are underserved by
the Department.
(B) Areas that are not in close proximity to an active
duty military installation.
(C) Areas representing different geographic locations,
such as census tracts established by the Bureau of the
Census.
(d) TIMEFRAME FOR EXPANSION OF PROGRAM; SELECTION OF AD-
DITIONAL LOCATIONS.—
(1) TIMEFRAME FOR EXPANSION.—The Secretary shall make
permanent and expand the program to additional medical cen-
ters of the Department as follows:
(A) As of the date of the enactment of the STRONG Vet-
erans Act of 2021, the Secretary shall make such program
permanent at each medical center participating in the pro-
gram on the day before such date of enactment.
(B) During the seven-year period following such date of
enactment, the Secretary shall expand the program to an
additional 25 medical centers per year until the program is
carried out at each medical center of the Department.
(2) SELECTION OF ADDITIONAL LOCATIONS.—In selecting med-
ical centers for the expansion of the program under paragraph
(1)(B), until such time as each medical center of the Department
is participating in the program by establishing not fewer than
two peer specialists at the medical center, the Secretary shall
prioritize medical centers in the following areas:
(A) Rural areas and other areas that are underserved by
the Department.
(B) Areas that are not in close proximity to an active duty
military installation.
(C) Areas representing different geographic locations,
such as census tracts established by the Bureau of the Cen-
sus.
ø(d) GENDER-SPECIFIC SERVICES.—¿ (e) CONSIDERATIONS FOR
HIRING PEER SPECIALISTS.—In carrying out the program at each
ølocation selected under subsection (c)¿ medical center, the Sec-
retary shall ensure that—
(1) the needs of female veterans are specifically considered
and addressed; øand¿
ø(2) female peer specialists are made available to female vet-
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erans who are treated at each location.¿
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23
(2) female peer specialists are hired and made available to
support female veterans who are treated at each medical center;
and
(3) to the extent practical, peer specialists are hired in demo-
graphic percentages that reflect the racial and ethnic demo-
graphic percentages of the overall veterans population.
ø(e)¿ (f) ENGAGEMENT WITH COMMUNITY PROVIDERS.—At each lo-
cation selected under subsection (c), the Secretary shall consider
ways in which peer specialists can conduct outreach to health care
providers in the community who are known to be serving veterans
to engage with those providers and veterans served by those pro-
viders.
ø(f) REPORTS.—
ø(1) PERIODIC REPORTS.—
ø(A) IN GENERAL.—Not later than 180 days after the
date of the enactment of this Act, and not less frequently
than once every 180 days thereafter until the Secretary de-
termines that the program is being carried out at the last
location to be selected under subsection (c), the Secretary
shall submit to Congress a report on the program.
ø(B) ELEMENTS.—Each report required by subparagraph
(A) shall, with respect to the 180-day period preceding the
submittal of the report, include the following:
ø(i) The findings and conclusions of the Secretary
with respect to the program.
ø(ii) An assessment of the benefits of the program to
veterans and family members of veterans.
ø(iii) An assessment of the effectiveness of peer spe-
cialists in engaging under subsection (e) with health
care providers in the community and veterans served
by those providers.
ø(2) FINAL REPORT.—Not later than 180 days after the Sec-
retary determines that the program is being carried out at the
last location to be selected under subsection (c), the Secretary
shall submit to Congress a report detailing the recommenda-
tions of the Secretary as to the feasibility and advisability of
expanding the program to additional locations.¿
(g) REPORTS.—
(1) PERIODIC REPORTS.—
(A) IN GENERAL.—Not later than one year after the date
of the enactment of the STRONG Veterans Act of 2021, and
annually thereafter for five years, the Secretary shall sub-
mit to the Committees on Veterans’ Affairs of the House of
Representatives and the Senate a report on the program, in-
cluding the expansion of the program under subsection
(d)(1).
(B) ELEMENTS.—Each report under subparagraph (A)
shall include, with respect to the one-year period preceding
the submission of the report, the following:
(i) The findings and conclusions of the Secretary
with respect to the program.
(ii) An assessment of the benefits of the program to
veterans and family members of veterans.
(iii) An assessment of the effectiveness of peer special-
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ists in engaging under subsection (f) with health care
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24
providers in the community and veterans served by
such providers.
(iv) The name and location of each medical center
where new peer specialists were hired.
(v) The number of new peer specialists hired at each
medical center pursuant to this section and the total
number of peer specialists within the Department hired
pursuant to this section.
(vi) An assessment of any barriers confronting the re-
cruitment, training, or retention of peer specialists.
(2) FINAL REPORT.—Not later than one year after the Sec-
retary determines that the program is being carried out at each
medical center of the Department, the Secretary shall submit to
the Committees on Veterans’ Affairs of the House of Representa-
tives and the Senate a report notifying such committees of such
determination.
* * * * * * *
Æ
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