[House Report 116-75]
[From the U.S. Government Publishing Office]
116th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 116-75
======================================================================
VET CENTER ELIGIBILITY EXPANSION ACT
_______
May 20, 2019.--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. 1812]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred
the bill (H.R. 1812) to amend title 38, United States Code, to
furnish Vet Center readjustment counseling and related mental
health services to certain individuals, having considered the
same, report favorably thereon with an amendment and recommend
that the bill as amended do pass.
CONTENTS
Page
Amendment........................................................ 2
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Hearings......................................................... 3
Subcommittee Consideration....................................... 3
Committee Consideration.......................................... 3
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.......................................... 4
Congressional Budget Office Estimate............................. 4
Federal Mandates Statement....................................... 6
Advisory Committee Statement..................................... 6
Constitutional Authority Statement............................... 6
Applicability to Legislative Branch.............................. 6
Statement on Duplication of Federal Programs..................... 6
Section-by-Section Analysis of the Legislation................... 6
Changes in Existing Law Made by the Bill as Reported............. 7
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Vet Center Eligibility Expansion
Act''.
SEC. 2. EXPANSION OF VET CENTER SERVICES.
Section 1712A of title 38, United States Code, is amended--
(1) by striking ``clauses (i) through (iv)'' both places it
appears and inserting ``clauses (i) through (vi)'';
(2) by striking ``in clause (v)'' both places it appears and
inserting ``in clause (vii)'';
(3) in subsection (a)(1)(C)--
(A) by redesignating clauses (iv) and (v) as clauses
(vi) and (vii), respectively; and
(B) by inserting after clause (iii) the following new
clauses:
``(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 or major disaster declared by the President;
or
``(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
operation as a member of the Coast Guard, regardless of the
location of that operation.''; and
(4) in subsection (h), by adding at the end the following new
paragraphs:
``(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.''.
SEC. 3. PLAN TO PROVIDE VET CENTER SERVICES TO VETERANS LIVING IN AREAS
WHERE NO VET CENTER IS LOCATED.
The Secretary of Veterans Affairs shall submit to the Committees on
Veterans' Affairs of the Senate and House of Representatives a plan to
provide Vet Center services to veterans living in geographic areas
where no Vet Center is located, including in the United States insular
areas.
Purpose and Summary
H.R. 1812, as amended, would expand eligibility for the
provision of readjustment counseling and other mental
healthcare from Vet Centers to certain members of the Coast
Guard and members of the National Guard and Reservists that
served in the United States but never deployed. H.R. 1812, as
amended, would also require the U.S. Department of Veterans
Affairs (VA) to submit to the Committees on Veterans' Affairs
of both the House and Senate a plan to provide Vet Center
services to those geographical areas in which no Vet Centers
are located, including the insular areas of the United States.
Representative David P. Roe of Tennessee introduced H.R.
1812 on March 18, 2019.
Background and Need for Legislation
According to VA, approximately 20 servicemembers and
veterans take their lives every day. However, statistics show
that on average, only 6 out of those 20 sought care from VA in
the two years preceding their death. Of the remaining 14 who
did not seek VA care, as many as 4 of those suicides occur
among never-deployed National Guard or Reserve members.\1\
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\1\VA National Suicide Data Report 2005-2016, Office of Mental
Health and Suicide Prevention, U.S. Department of Veterans Affairs.
---------------------------------------------------------------------------
VA is authorized to provide counseling through Vet Centers
to veterans, servicemembers, and National Guard and Reserve
members who served on active military duty in any combat
theater or area of hostility, experienced military sexual
trauma, provided direct emergent medical care or mortuary
services to casualties of war, served as a member of an
unmanned aerial vehicle crew that provided direct support to
operations in a combat zone or area of hostility, or served in
other capacities.\2\ However, members of the National Guard,
Reserve, or Coast Guard who participated in a drug
interdiction, or who served in response to a President or state
chief executive declared national emergency, major disaster, or
civil disorder are not currently eligible to receive Vet Center
care despite the serious consequences such service can have on
mental health. The Vet Center Eligibility Expansion Act would
correct this oversight by extending eligibility for Vet Center
care to these individuals.
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\2\38 USC Sec. 1712A(a)(1)(C).
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In addition, the Vet Center Eligibility Expansion Act would
require VA to submit to the Committees of jurisdiction a plan
to expand access to services provided by Vet Centers to areas
not currently served by a Vet Center. This plan should properly
consider not only rural areas, but also territories and insular
areas. By assessing the steps necessary to providing access to
Vet Centers for veterans living in these underserved areas, the
Vet Center Eligibility Expansion Act is ensuring veterans,
servicemembers, Reservists and members of the Coast Guard and
National Guard are allowed access to the lifesaving services
Vet Centers provide.
Hearings
For the purposes of section 103(i) of H.Res. 6 of the 116th
Congress--(1) the following hearing was used to develop or
consider H.R. 1812:
H.R. 1812 was considered by the Committee on Veterans'
Affairs on May 8, 2019.
Subcommittee Consideration
H.R. 1812 was not considered before the Subcommittee on
Health.
Committee Consideration
On May 8, 2019, the Committee on Veterans' Affairs met in
an open markup session, a quorum being present, and favorably
reported H.R. 1812, as amended, to the House of Representatives
by voice vote. During consideration of the bill, the following
amendment was considered and agreed to by voice vote:
An amendment offered by Representative Gregorio
Sablan of Northern Mariana Islands that would require
VA to submit a plan for expansion of Vet Center
services to areas not currently serviced by a Vet
Center, including insular areas of the U.S., to the
Committees on Veterans' Affairs of the House and
Senate.
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 reporting H.R. 1812,
as amended, to the House. A motion by Ranking Member David P.
Roe of Tennessee to report H.R. 1812, as amended, favorably to
the House of Representatives was adopted 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 performance
goals and objectives are to expand access to high quality
mental healthcare and related resources to curb the prevalence
of suicide among veterans, servicemembers, Reservists, and
members of the Coast Guard and National Guard.
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. 1812 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.
1812 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. 1812 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 17, 2019.
Hon. Mark Takano,
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. 1812, the Vet
Center Eligibility Expansion 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,
Director.
Enclosure.
H.R. 1812 would require the Department of Veterans Affairs
(VA) to provide mental health counseling at Vet Centers for the
following individuals:
Veterans or members of the armed forces
(including reservists) who respond to national
emergencies or disasters declared by the President;
Members of the National Guard who respond to
disasters or civil disorders in a state; or
Members of the Coast Guard who participate
in drug interdiction operations.
Vet Centers are facilities where VA provides social and
psychological counseling to help veterans and service members
cope with the stress of military service and the difficulties
of adjusting to civilian life after that service. VA provides
that counseling to individuals who served on active duty in
combat and in several other circumstances. In 2018, VA spent an
average of $1,900 per patient to provide such counseling to
134,000 veterans and active-duty service members at 300 Vet
Centers nationwide. On the basis of information from VA and the
Department of Defense, CBO estimates that roughly 5,000
individuals would receive counseling each year under the bill.
Thus, CBO estimates that implementing H.R. 1812 would cost $55
million over the 2020-2024 period; subject to the availability
of appropriated funds (see Table 1).
TABLE 1.--ESTIMATED INCREASES IN SPENDING SUBJECT TO APPROPRIATION UNDER H.R. 1812
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By fiscal year, millions of dollars--
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2019 2020 2021 2022 2023 2024 2019-2024
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Estimated Authorization........................ 0 11 11 11 11 12 56
Estimated Outlays.............................. 0 10 11 11 11 12 55
----------------------------------------------------------------------------------------------------------------
The CBO staff contact for this estimate is Ann E. Futrell.
The estimate was reviewed by Theresa Gullo, Assistant Director
for Budget Analysis.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates regarding H.R. 1812 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.
1812, as amended.
Constitutional Authority Statement
Pursuant to Article I, section 8 of the United States
Constitution, H.R. 1812, as amended, 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. 1812, as amended, 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 clause 3(c)(5) of rule XIII of the Rules of the
House of Representatives, the Committee finds that no provision
of H.R. 1812, as amended, 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.
Section-by-Section Analysis of the Legislation
Sec. 1. Short title
Section 1 states H.R. 1812, as amended, may be cited as the
``Vet Center Eligibility Expansion Act.''
Sec. 2. Expansion of Vet Center services
Section 2 expands eligibility for Vet Center services to
certain members of the National Guard, members of the Coast
Guard and Reservists. Those newly eligible for Vet Center
services are: (1) members of a reserve component of the Armed
Forces who served on active service, as defined in section 101
of title 10, in response to a national emergency or major
disaster declared by the President; (2) members of the National
Guard of a State activated in response to a disaster or civil
disorder, as defined in section 232 of title 18; and (3)
members of the Coast Guard who participated in a drug
interdiction operation.
Sec. 3. Plan to provide Vet Center services to veterans living in areas
where no Vet Center is located
Section 3 requires VA to submit to the Committees on
Veterans' Affairs of the House and Senate a plan to provide Vet
Center services to veterans living in areas with no access to a
Vet Center including insular areas of the United States.
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 II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL
TREATMENT
* * * * * * *
Sec. 1712A. Eligibility for readjustment counseling and related mental
health services
(a)(1)(A) Upon the request of any individual referred to in
subparagraph (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
[clauses (i) through (iv)] clauses (i) through (vi) of
subparagraph (C), to assist the individual in
readjusting to civilian life; and
(ii) in the case of an individual referred to [in
clause (v)] in clause (vii) 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 deployment to assist
such individual in coping with such deployment;
and
(II) in the case of a veteran or member who
is readjusting to civilian life, to the degree
that counseling furnished to such individual is
found to aid in the readjustment of such
veteran or member to civilian life.
(B) Counseling furnished to an individual under subparagraph
(A) may include a comprehensive individual assessment of the
individual's psychological, social, and other characteristics
to ascertain whether--
(i) in the case of an individual referred to in
[clauses (i) through (iv)] clauses (i) through (vi) of
subparagraph (C), such individual has difficulties
associated with readjusting to civilian life; and
(ii) in the case of an individual referred to [in
clause (v)] in clause (vii) of such subparagraph, such
individual has difficulties associated with--
(I) coping with the deployment of a member
described in subclause (I) of such clause; or
(II) readjustment to civilian life of a
veteran or member described in subclause (II)
of such clause.
(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 combat operations or an area at a time
during which hostilities occurred 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 mental health care, or mortuary services to
the causalities of combat 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 theater of combat
operations or an area at a time during which
hostilities occurred in that area by remotely
controlling an unmanned 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 or major disaster declared
by the President; or
(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 operation as a member of the Coast Guard,
regardless of the location of that operation.
[(iv)] (vi) Any individual who received counseling
under this section before the date of the enactment of
the National Defense Authorization Act for Fiscal Year
2013.
[(v)] (vii) 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; or
(II) veteran or member of the Armed Forces
described in this subparagraph.
(2) 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) as soon as practicable after receiving the request, but
not later than 30 days after receiving the request.
(b)(1) If, on the basis of the assessment furnished under
subsection (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 licensed 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 veteran is necessary to
facilitate the successful readjustment of the veteran to
civilian life, such veteran shall, within the limits of
Department 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 considered 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 (including 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 treatment and readjustment of the veteran, include
such consultation, counseling, training, services, and expenses
as are described in sections 1782 and 1783 of this title.
(c) Upon receipt of a request for counseling under this
section from any individual who has been discharged or released
from active military, naval, or air 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, or air 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 section, 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 with private facilities that is available to the
Secretary (under sections 1703(a)(2) and 1710(a)(1)(B) of this
title) 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 contract facility, as authorized by this subsection,
the Secretary shall approve (in accordance with criteria which
the Secretary shall prescribe 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 extent 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 notify 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
Secretary's responsibility to carry out outreach activities
under chapter 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 described 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 section 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 Department for the furnishing of
health-care services under this chapter, not limited to
services provided through the program established 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 member 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.
* * * * * * *