[House Report 114-319] [From the U.S. Government Publishing Office] 114th Congress } { Report HOUSE OF REPRESENTATIVES 1st Session } { 114-319 ====================================================================== TO AMEND TITLE 38, UNITED STATES CODE, TO MAKE PERMANENT THE PILOT PROGRAM ON COUNSELING IN RETREAT SETTINGS FOR WOMEN VETERANS NEWLY SEPARATED FROM SERVICE IN THE ARMED FORCES _______ November 2, 2015.--Committed to the Committee of the Whole House on the State of the Union and ordered to be printed _______ Mr. Miller of Florida, from the Committee on Veterans' Affairs, submitted the following R E P O R T [To accompany H.R. 1575] [Including cost estimate of the Congressional Budget Office] The Committee on Veterans' Affairs, to whom was referred the bill (H.R. 1575) to amend title 38, United States Code, to make permanent the pilot program on counseling in retreat settings for women veterans newly separated from service in the Armed Forces, having considered the same, report favorably thereon without amendment and recommend that the bill do pass. CONTENTS Page Purpose and Summary.............................................. 2 Background and Need for Legislation.............................. 2 Hearings......................................................... 3 Subcommittee Consideration....................................... 4 Committee Consideration.......................................... 4 Committee Votes.................................................. 4 Committee Oversight Findings..................................... 4 Statement of General Performance Goals and Objectives............ 4 New Budget Authority, Entitlement Authority, and Tax Expenditures 4 Earmarks and Tax and Tariff Benefits............................. 4 Committee Cost Estimate.......................................... 5 Congressional Budget Office Estimate............................. 5 Federal Mandates Statement....................................... 6 Advisory Committee Statement..................................... 6 Constitutional Authority Statement............................... 6 Applicability to Legislative Branch.............................. 6 Statement on Duplication of Federal Programs..................... 6 Disclosure of Directed Rulemaking................................ 6 Section-by-Section Analysis of the Legislation................... 6 Changes in Existing Law Made by the Bill as Reported............. 7 Purpose and Summary H.R. 1575, to amend title 38, U.S.C., to make permanent the pilot program on counseling in retreat settings for women veterans newly separated from service in the Armed Forces, was introduced on March 24, 2015, by Representative Corrine Brown of Florida. It was ordered to be favorably reported to the full House on May 21, 2015, by voice vote. H.R. 1575 would require the Department of Veterans Affairs (VA) to make permanent a pilot program on counseling in retreat settings for women veterans newly separated from service in the Armed Forces and to report to Congress biennially on the program. Background and Need for Legislation While women have served in the military since the American Revolution and have been officially recognized as permanent members of the Armed Forces since 1948, women have only relatively recently come to represent a significant portion of the veteran population. Today, there are more than 2 million women veterans in the United States, representing 9.2 percent of the total veteran population. By 2020, women are expected to encompass 10.5 percent of the total veteran population. Women veterans transitioning from active duty experience readjustment issues such as post-traumatic stress disorder (PTSD), military sexual trauma, substance abuse, and homelessness similar to their male counterparts, yet there are indications that military service may affect women differently than men. Research has shown that women exposed to stressful situations like combat or military sexual trauma react differently than their male counterparts, and female veterans commit suicide at nearly six times the rate of other women.\1\ In addition, women veterans differ from their male counterparts in that they often lack access to peer support opportunities with fellow women veterans once they have separated from service. --------------------------------------------------------------------------- \1\LA Times ``Suicide rate of female military veterans is called `staggering''' http://www.latimes.com/nation/la-na-female-veteran- suicide-20150608-story.html#page=1, June 8, 2015. --------------------------------------------------------------------------- Ensuring that VA is properly addressing the unique needs of women veterans is an essential component of the Committee's oversight efforts. During the 111th Congress, the Caregivers and Veterans Omnibus Health Services Act of 2010 (P.L. 111-163, 124 Stat. 1130) required VA to conduct, through the Readjustment Counseling Service Vet Center Program (RCS), a pilot program to evaluate the feasibility and advisability of providing reintegration and readjustment services in group retreat settings to women veterans recently separated from service in the Armed Forces after a prolonged deployment. To be included in each group retreat were:Information and counseling on reintegration into the veteran's family; employment and community; Financial counseling; Occupational counseling; Information and counseling on stress reduction; and Information and counseling on conflict resolution. The pilot program ran for two years. According to the mandated report, VA conducted six retreats in 2011 and 2012. A total of 134 women veterans from 37 states and territories, including Alaska, Hawaii, and Guam, and ranging in age from 21 to 69 years old participated in the six retreats. Over the course of the pilot program, evaluation data was gathered pre-retreat, immediately post-retreat, and 2-month post-retreat. Written feedback from the veteran participants immediately after the retreats was unanimously positive for both years and RCS received several letters from participants expressing their gratitude for the opportunity. More importantly, the majority of the women veterans who participated in the retreats showed improvements in their psychological well-being, decreased stress symptoms, improved stress coping skills, and a reduction in the severity of their PTSD symptoms immediately both following the retreat and 2- months post retreat.\2\ --------------------------------------------------------------------------- \2\See, Department of Veterans Affairs Report on the Pilot Program on Counseling in Retreat Settings for Women Veterans Newly Separated from Service in the Armed Forces Pursuant to the Requirements of Public Law 111-163, Section 203. --------------------------------------------------------------------------- Given these positive outcomes, VA agreed in testimony before the Subcommittee on Health, on April 23, 2015, that providing counseling in retreat settings is beneficial for newly-separated women veterans and authorization to provide them should be made permanent. The Committee concurs. H.R. 1575 would make the pilot program of counseling in retreat settings for women veterans newly separated from service a permanent part of VA's programs for women veterans and would require VA to report to Congress biennially on the retreats. Hearings On April 23, 2015, the Subcommittee on Health conducted a legislative hearing on: draft legislation to improve reproductive treatment provided to certain disabled veterans; draft legislation to direct VA to submit an annual report on the Veterans Health Administration; H.R. 271; H.R. 627; H.R. 1369; H.R. 1575; and H.R. 1769. The following witnesses testified: The Honorable Gus Bilirakis of Florida; the Honorable Janice Hahn of California; the Honorable Jackie Walorski of Indiana; Blake Ortner, the Deputy Government Relations Director of the Paralyzed Veterans of America; Louis J. Celli Jr., the Director of the National Veterans Affairs and Rehabilitation Division for the American Legion; John Rowan, the National President of the Vietnam Veterans of America; Adrian Atizado, the Assistant National Legislative Director for the Disabled American Veterans; and, Rajiv Jain M.D., the Assistant Deputy Under Secretary for Health for Patient Care Services for the Veterans Health Administration of the U.S. Department of Veterans Affairs. Dr. Jain was accompanied by Janet Murphy, the Acting Deputy Under Secretary for Health for Operations and Management for the Veterans Health Administration of the U.S. Department of Veterans Affairs, and Jennifer Gray, Attorney for the Office of the General Counsel of the U.S. Department of Veterans Affairs. Statements for the Record were submitted by: The Honorable Corrine Brown of Florida, the Ranking Member of the Full Committee; the American Health Care Association; the American Society for Reproductive Medicine; Concerned Veterans for America; RESOLVE: National Infertility Association; Veterans of Foreign Wars of the United States; and, Wounded Warrior Project. Subcommittee Consideration On May 15, 2015, the Subcommittee on Health met in an open markup session, a quorum being present, and favorably forwarded H.R. 1575 to the full Committee by voice vote. Committee Consideration On May 21, 2015, the full Committee met in an open markup session, a quorum being present, and ordered H.R. 1575 reported favorably to the House of Representatives by voice vote. Committee Votes Clause 3(b) of rule XIII of the Rules of the House of Representatives requires the Committee to list the recorded votes on the motion to report the legislation and amendments thereto. There were no recorded votes in connection with ordering H.R. 1575 reported to the House. A motion by Ranking Member Corrine Brown of Florida to report H.R. 1575 favorably to the House of Representatives was agreed to by voice vote. 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 Committee's oversight findings and recommendations are reflected in the descriptive portions of this report. Statement of General Performance Goals and Objectives In accordance with clause 3(c)(4) of rule XIII of the Rules of the House of Representatives, the Committee's establishes the following performance related goals and objectives for this legislation: The Secretary of the Department of Veterans' Affairs will make the pilot program on counseling in retreat settings for women veterans newly separated from service permanent and report to Congress on a biennial basis on the program's status, outcomes, and costs. New Budget Authority, Entitlement Authority, and Tax Expenditures In compliance with clause 3(c)(2) of rule XIII of the Rules of the House of Representatives, the Committee adopts as its own the estimate of new budget authority, entitlement authority, or tax expenditures or revenues contained in the cost estimate prepared by the Director of the Congressional Budget Office pursuant to section 402 of the Congressional Budget Act of 1974. Earmarks and Tax and Tariff Benefits H.R. 1575 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. Committee Cost Estimate The Committee adopts as its own the cost estimate on H.R. 1575 prepared by the Director of the Congressional Budget Office pursuant to section 402 of the Congressional Budget Act of 1974. Congressional Budget Office Cost Estimate Pursuant to clause 3(c)(3) of rule XIII of the Rules of the House of Representatives, the following is the cost estimate for H.R. 1575 provided by the Congressional Budget Office pursuant to section 402 of the Congressional Budget Act of 1974: U.S. Congress, Congressional Budget Office, Washington, DC, June 9, 2015. Hon. Jeff Miller, Chairman, Committee on Veterans' Affairs, House of Representatives, Washington, DC. Dear Mr. Chairman: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 1575, a bill to amend title 38, United States Code, to make permanent the pilot program on counseling in retreat settings for women veterans newly separated from service in the Armed Forces. If you wish further details on this estimate, we will be pleased to provide them. The CBO staff contact is Ann E. Futrell. Sincerely, Keith Hall. Enclosure. H.R. 1575--A bill to amend title 38, United States Code, to make permanent the pilot program on counseling in retreat settings for women veterans newly separated from service in the Armed Forces H.R. 1575 would require the Department of Veterans Affairs (VA) to establish a permanent program that provides counseling in group retreat settings to certain women veterans who have recently separated from military service. The bill also would require the VA to submit a biennial report on the outcomes of the program. VA is completing the final year of a pilot program that provides similar services to women veterans. According to VA, roughly 130 women participated in the program at six retreats over a two-year period, and three more retreats are planned for 2015. VA reported annual spending for the pilot program of roughly $66,000 for each retreat. Based on information from VA on their intent to use the authority provided under H.R. 1575 to hold six retreats a year, CBO estimates that implementing this program would cost $3 million over the 2016-2020 period, assuming appropriation of the necessary amounts. Enacting H.R. 1575 would not affect direct spending or revenues; therefore, pay-as-you-go procedures do not apply. H.R. 1575 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act and would not affect the budgets of state, local, or tribal governments. The CBO staff contact for this estimate is Ann E. Futrell. The estimate was approved by H. Samuel Papenfuss, Deputy Assistant Director for Budget Analysis. Federal Mandates Statement The Committee adopts as its own the estimate of Federal mandates regarding H.R. 1575 prepared by the Director of the Congressional Budget Office pursuant to section 423 of the Unfunded Mandates Reform Act. Advisory Committee Statement No advisory committees within the meaning of section 5(b) of the Federal Advisory Committee Act would be created by H.R. 1575. Statement of Constitutional Authority Pursuant to Article I, section 8 of the United States Constitution, the reported bill is authorized by Congress' power to ``provide for the common Defense and general Welfare of the United States.'' Applicability to Legislative Branch The Committee finds that the legislation does not relate to the terms and conditions of employment or access to public services or accommodations within the meaning of section 102(b)(3) of the Congressional Accountability Act. Statement on Duplication of Federal Programs Pursuant to section 3(g) of H. Res. 5, 114th Cong. (2015), the Committee finds that no provision of H.R. 1575, establishes or reauthorizes a program of the Federal Government known to be duplicative of another Federal program, a program that was included in any report from the Government Accountability Office to Congress pursuant to section 21 of Public Law 111- 139, or a program related to a program identified in the most recent Catalog of Federal Domestic Assistance. Disclosure of Directed Rulemaking Pursuant to section 3(i) of H. Res. 5, 114th Cong. (2015), the Committee estimates that H.R. 1575 does not require directed rule making. Section-by-Section Analysis of the Legislation Section 1. Counseling in retreat settings for women veterans newly separated from service in the Armed Forces Section 1(a) of the bill would amend chapter 17 of title 38, U.S.C., by inserting a new section 1712C. This section would require VA, beginning on January 1, 2016, to carry out, through the Readjustment Counseling Service (RCS), a program to provide reintegration and readjustment services in group retreat settings to women veterans who are newly separated from service in the Armed Forces after a prolonged deployment. Veteran's participation in the program would be voluntary. Services provided under the program would include: (1) information on reintegration into the family, employment, and community of the veteran; (2) financial counseling; (3) occupational counseling; (4) information and counseling on stress reduction; (5) information and counseling on conflict resolution; and, (6) such other information and counseling as the Secretary considers appropriate to assist the veteran in reintegrating into her family, job, and community. VA would be required to report to the Committees on Veterans' Affairs of the House of Representatives and the Senate a report on the program by no later than December 31, 2017, and each odd- numbered year thereafter. Section 1(b) of the bill would amend the table of sections at the beginning of chapter 17 of title 38, U.S.C., by inserting after 1712B the following new item, as added by section 1(a) of the bill: ``1712C. Counseling in retreat settings for women veterans newly separated.'' Section 1(c) of the bill would, effective December 31, 2015, repeal section 201 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (38 U.S.C. 1712A note). 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 omitted is enclosed in black brackets, new matter is printed in italic, and existing law in which no change is proposed is shown in roman): TITLE 38, UNITED STATES CODE * * * * * * * PART II--GENERAL BENEFITS * * * * * * * CHAPTER 17--HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE SUBCHAPTER I--GENERAL Sec. 1701. Definitions. * * * * * * * SUBCHAPTER II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL TREATMENT * * * * * * * 1712C. Counseling in retreat settings for women veterans newly separated. * * * * * * * Subchapter II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL TREATMENT * * * * * * * Sec. 1712C. Counseling in retreat settings for women veterans newly separated (a) Program.--(1) Commencing on January 1, 2016, the Secretary shall carry out, through the Readjustment Counseling Service of the Veterans Health Administration, a program to provide reintegration and readjustment services described in subsection (b) in group retreat settings to women veterans who are recently separated from service in the Armed Forces after a prolonged deployment. (2) The participation of a veteran in the program under paragraph (1) shall be at the election of the veteran. (b) Covered Services.--The services provided to a woman veteran under the program under subsection (a)(1) shall include the following: (1) Information on reintegration into the family, employment, and community of the veteran. (2) Financial counseling. (3) Occupational counseling. (4) Information and counseling on stress reduction. (5) Information and counseling on conflict resolution. (6) Such other information and counseling as the Secretary considers appropriate to assist the veteran in reintegration into the family, employment, and community of the veteran. (c) Biennial Reports.--Not later than December 31, 2017, and each odd-numbered year thereafter, the Secretary shall submit to the Committees on Veterans' Affairs of the House of Representatives and the Senate a report on the program under subsection (a)(1). * * * * * * * ---------- CAREGIVERS AND VETERANS OMNIBUS HEALTH SERVICES ACT OF 2010 * * * * * * * TITLE II--WOMEN VETERANS HEALTH CARE MATTERS * * * * * * * [SEC. 203. PILOT PROGRAM ON COUNSELING IN RETREAT SETTINGS FOR WOMEN VETERANS NEWLY SEPARATED FROM SERVICE IN THE ARMED FORCES. [(a) Pilot Program Required.-- [(1) In general.-- Commencing not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall carry out, through the Readjustment Counseling Service of the Veterans Health Administration, a pilot program to evaluate the feasibility and advisability of providing reintegration and readjustment services described in subsection (b) in group retreat settings to women veterans who are recently separated from service in the Armed Forces after a prolonged deployment. [(2) Participation at election of veteran.-- The participation of a veteran in the pilot program under this section shall be at the election of the veteran. [(b) Covered Services.--The services provided to a woman veteran under the pilot program shall include the following: [(1) Information on reintegration into the veteran's family, employment, and community. [(2) Financial counseling. [(3) Occupational counseling. [(4) Information and counseling on stress reduction. [(5) Information and counseling on conflict resolution. [(6) Such other information and counseling as the Secretary considers appropriate to assist a woman veteran under the pilot program in reintegration into the veteran's family, employment, and community. [(c) Locations.--The Secretary shall carry out the pilot program at not fewer than three locations selected by the Secretary for purposes of the pilot program. [(d) Termination.--The authority to carry out a pilot program under this section shall terminate on December 31, 2015. [(e) Report.--Not later than 180 days after the completion of the pilot program, the Secretary shall submit to Congress a report on the pilot program. The report shall contain the findings and conclusions of the Secretary as a result of the pilot program, and shall include such recommendations for the continuation or expansion of the pilot program as the Secretary considers appropriate. [(f) Authorization of Appropriations.--There is authorized to be appropriated to the Secretary of Veterans Affairs for each of fiscal years 2010 and 2011, $2,000,000 to carry out the pilot program.] * * * * * * * [all]