[House Report 115-197]
[From the U.S. Government Publishing Office]
115th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 115-197
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BUILDING SUPPORTIVE NETWORKS FOR WOMEN VETERANS ACT
_______
June 28, 2017.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Roe of Tennessee, from the Committee on Veterans' Affairs,
submitted the following
R E P O R T
[To accompany H.R. 91]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred
the bill (H.R. 91) 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....................................... 3
Committee Consideration.......................................... 3
Committee Votes.................................................. 3
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.......................................... 4
Congressional Budget Office Estimate............................. 4
Federal Mandates Statement....................................... 5
Advisory Committee Statement..................................... 5
Constitutional Authority Statement............................... 5
Applicability to Legislative Branch.............................. 5
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. 91 was introduced by Representative Julia Brownley of
California, the Ranking Member of the Committee on Veterans'
Affairs Subcommittee on Health, on January 3, 2017.
H.R. 91 would require the Department of Veterans Affairs
(VA) to carry out a permanent program to provide reintegration
and readjustment services in group retreat settings to women
veterans newly separated from service in the Armed Forces after
a prolonged deployment.
Background and Need for Legislation
Section 2. Counseling in retreat settings for women veterans newly
separated from service in the Armed Forces
While women have served in the military since the American
Revolution, women have only relatively recently come to
represent a sizable portion of the veteran population. Today,
women veterans number almost 2 million out of 21.6 million
total veterans in the United States.\1\
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\1\U.S. Department of Veterans Affairs, Office of Suicide
Prevention. Suicide among Veterans and Other Americans 2001-2014.
August 3, 2016. https://www.mentalhealth.va.gov/docs/
2016suicidedatareport.pdf.
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There are indications both that military service and
veteran status may affect women differently than men and that
women veterans may lack access to valuable peer support
opportunities once they have separated from service. For
example, a report by the Disabled American Veterans (DAV) found
that women face barriers to full integration into military
service, to recognition as veterans, and to VA services and
benefits.\2\ According to DAV, ``[t]he vast majority of these
deficiencies result from a disregard for the differing needs of
women veterans and a focusing on the 80 percent solutions for
men who dominate in both numbers and the public
consciousness.''\3\
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\2\ Disabled American Veterans. Women Veterans: The Long Journey
Home. September 24, 2014. https://www.dav.org/wp-content/uploads/women-
veterans-study.pdf.
\3\Ibid.
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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 a pilot program through the
Readjustment Counseling Service (RCS) 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. Each group retreat was required
to include the following components: 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. Over the
course of the pilot program, a total of 12 retreats were
provided to 272 women veterans between 2011 and 2016.\4\
According to VA, the retreats held to-date have focused on
building trust and developing peer support in a therapeutic
environment and data has shown that retreat participants saw
increased coping abilities and decreased symptoms associated
with posttraumatic stress disorder. VA also found that 87
percent of retreat participants scored higher on the Ryff Scale
of Psychological Well Being immediately post-retreat and 84
percent showed a decrease in stress symptoms that persisted two
months post-retreat.\5\
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\4\United States Cong. House Committee on Veterans' Affairs
Subcommittee on Health. Legislative Hearing. March 29, 2017. 115th
Cong. 1st sess. Washington: GPO, 2017 (statement from Jennifer S. Lee,
Deputy Under Secretary for Health for Policy and Services, Veterans
Health Administration, U.S. Department of Veterans Affairs).
\5\Ibid.
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In light of the positive outcomes of the current pilot
program and the Committee's commitment to ensuring that VA is
properly addressing the unique needs of women veterans, section
2 of the bill 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.
Hearings
On March 29, 2017, the Subcommittee on Health conducted a
legislative hearing on a number of bills including H.R. 91.
The following witnesses testified: The Honorable David. P.
Roe M.D. of Tennessee; The Honorable Jackie Walorski of
Indiana; The Honorable Doug Collins of Georgia; The Honorable
Mike Coffman of Colorado; The Honorable Stephen Knight of
California; The Honorable Ann M. Kuster of New Hampshire;
Jennifer S. Lee, M.D., the Deputy Under Secretary for Health
for Policy and Services for the Veterans Health Administration
of the U.S. Department of Veterans Affairs who was accompanied
by Susan Blauert, the Chief Counsel for the Health Care Law
Group of the Office of the General Counsel for the U.S.
Department of Veterans Affairs; Kayda Keleher, Legislative
Associate for the National Legislative Service of the Veterans
of Foreign Wars of the United States; Shurhonda Y. Love, the
Assistant National Legislative Director for the Disabled
American Veterans; and, Sarah S. Dean, the Associate
Legislative Director for the Paralyzed Veterans of America.
Statements for the record were submitted by: The Honorable
Lee Zeldin of New York; The American Legion; the National
Association of State Veteran Homes; Swords to Plowshares; and,
the Wounded Warrior Project.
Subcommittee Consideration
On April 6, 2017, the Subcommittee on Health met in an open
markup session, a quorum being present, and ordered H.R. 91 to
be reported favorably to the full Committee by voice vote.
Committee Consideration
On May 17, 2017, the Full Committee met in open markup
session, a quorum being present, and ordered H.R. 91 to be
reported favorably to the House of Representatives by voice
vote. A motion by Representative Tim Walz of Minnesota, Ranking
Member of the Committee on Veterans' Affairs, to report H.R. 91
favorably to the House of Representatives was agreed to by
voice vote.
Committee Votes
In compliance with clause 3(b) of rule XIII of the Rules of
the House of Representatives, there were no recorded votes
taken on amendments or in connection with ordering H.R. 91
reported to the House.
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 performance
goals and objectives are to improve the provision of
reintegration and readjustment services to women veterans who
are recently separated from service after a prolonged
deployment.
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. 91 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.
91 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. 91 provided by the Director of the Congressional
Budget Office pursuant to section 402 of the Congressional
Budget Act of 1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, May 20, 2017.
Hon. Phil Roe, M.D.,
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. 91, the Building
Supportive Networks for Women Veterans Act.
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. 91--Building Supportive Networks for Women Veterans Act
H.R. 91 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 to the Congress 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 270 women participated in the program at 12 retreats
over the 2011-2016 period at an average cost of $3,400 per
participant. On the basis of information from VA, CBO expects
that the department would use the authority provided under H.R.
91 to hold six retreats a year. CBO estimates that implementing
this program would cost $3 million over the 2018-2022 period
after accounting for anticipated inflation; such spending would
be subject to the availability of appropriated funds.
Enacting the legislation would not affect direct spending
or revenues; therefore, pay-as-you-go procedures do not apply.
CBO estimates that enacting H.R. 91 would not increase net
direct spending or on-budget deficits in any of the four
consecutive 10-year periods beginning in 2028.
H.R. 91 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. 91 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.
91.
Statement of Constitutional Authority
Pursuant to Article I, section 8 of the United States
Constitution, H.R. 91 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 H.R. 91 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, 115th Cong. (2017),
the Committee finds that no provision of H.R. 91 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, 115th Cong. (2017),
the Committee estimates that H.R. 91 contains no directed
rulemaking that would require the Secretary to prescribe
regulations.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 of the bill would provide a short title of the
``Building Supportive Networks for Women Veterans Act''.
Section 2. Counseling in retreat settings for women veterans newly
separated from service in the armed forces
Section 2(a)(1) of the bill would amend chapter 17 of title
38, U.S.C., by inserting after section 1712C a new section,
``1712D. Counseling in retreat settings for women veterans
newly separated.'' The new section 1712D would require the
Secretary of Veterans Affairs, beginning on January 1, 2018, to
carry out a program through the Readjustment Counseling Service
(RCS) 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. A veteran's participation in the program would be
voluntary and 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, 2018, and each
even-numbered year thereafter.
Section 2(a)(2) of the bill would amend the table of
sections at the beginning of chapter 17 of title 38, U.S.C., by
inserting after 1712C the following new item: ``1712D.
Counseling in retreat settings for women veterans newly
separated.''.
Section 2(b) of the bill would repeal section 203 of the
Caregivers and Veterans Omnibus Health Services Act of 2010 (38
U.S.C. 1712A note) effective December 31, 2017.
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, existing law in which no change is
proposed is shown in roman):
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
* * * * * * *
1712D. Counseling in retreat settings for women veterans newly
separated.
* * * * * * *
SUBCHAPTER II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL
TREATMENT
* * * * * * *
Sec. 1712D. Counseling in retreat settings for women veterans newly
separated
(a) Program.--(1) Commencing on January 1, 2018, 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, 2018, and
each even-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).
* * * * * * *
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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, 2017.
[(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, 2011, 2015, 2016, and 2017, $2,000,000 to
carry out the pilot program.]
* * * * * * *
[all]