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H.R. 5245 (ih) To amend the Railroad Retirement Act of 1974 to eliminate a limitation on benefits. [Introduced in House] ...


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108th CONGRESS
  2d Session
                                H. R. 5244

   To improve programs for the identification and treatment of Post-
Traumatic Stress Disorder in veterans and members of the Armed Forces, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 7, 2004

Mr. Evans (for himself, Mr. Filner, Mr. Gutierrez, Ms. Corrine Brown of 
    Florida, Mr. Rodriguez, Mr. Michaud, Ms. Hooley of Oregon, Mr. 
  Strickland, Mr. Udall of New Mexico, Mrs. Davis of California, Ms. 
   Herseth, Mr. Baird, Mr. Kennedy of Rhode Island, Mr. Emanuel, Mr. 
      Stenholm, Ms. Bordallo, Mr. Langevin, Mr. Faleomavaega, Mr. 
 Abercrombie, and Mr. Larson of Connecticut) introduced the following 
bill; which was referred to the Committee on Veterans' Affairs, and in 
    addition to the Committee on Armed Services, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
   To improve programs for the identification and treatment of Post-
Traumatic Stress Disorder in veterans and members of the Armed Forces, 
                        and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Comprehensive 
Assistance for Veterans Exposed to Traumatic Stressors Act of 2004''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Definition.
                 TITLE I--VETERANS OF PAST DEPLOYMENTS

Sec. 101. Extension of eligibility for readjustment counseling services 
                            for Vietnam-era veterans.
                       TITLE II--MILITARY ISSUES

Sec. 201. Department of Veterans Affairs-Department of Defense Health 
                            Care Sharing Incentive Fund.
Sec. 202. Collection of aggregate data from pre- and post-deployment 
                            health assessments.
Sec. 203. Telemedicine support for front-line Department of Defense 
                            providers.
  TITLE III--PREVENTION, EARLY DETECTION, AND TREATMENT FOR RETURNING 
                                 TROOPS

Sec. 301. Study to identify factors that decrease the likelihood of the 
                            development of chronic PTSD despite combat 
                            exposure.
Sec. 302. Extension of period of enhanced eligibility for VA health 
                            services for veterans who served in combat 
                            theater of operations.
Sec. 303. Department of Veterans Affairs to participate in all 
                            demobilizations and Transitional Assistance 
                            Program activities.
Sec. 304. Educational materials.
Sec. 305. Demonstration project to station Department of Veterans 
                            Affairs psychologists and psychiatrists at 
                            major demobilization sites and military 
                            treatment facilities.
Sec. 306. Model care plan for integrated mental health and a primary 
                            care model for PTSD practice.
Sec. 307. Performance measures for Department of Veterans Affairs 
                            health care administrators.
TITLE IV--DEPARTMENT OF DEFENSE/DEPARTMENT OF VETERANS AFFAIRS COUNCIL 
                    ON POST-DEPLOYMENT MENTAL HEALTH

Sec. 401. Establishment of Council.
Sec. 402. Duties of Council.
      TITLE V--CAPACITY BUILDING IN DEPARTMENT OF VETERANS AFFAIRS

Sec. 501. Plan for expansion of Department of Veterans Affairs system 
                            to expand access to specialized PTSD care.
Sec. 502. Additional Department of Veterans Affairs resources.
                        TITLE VI--FAMILY THERAPY

Sec. 601. Eligibility period for counseling and bereavement counseling.
                   TITLE VII--EDUCATIONAL INITIATIVES

Sec. 701. Training program for health-care providers.
Sec. 702. Curriculum and protocols for cross-training of Department of 
                            Veterans Affairs clinicians.
Sec. 703. Publication of state-of-the-art PTSD diagnosis and treatment.
Sec. 704. Protocols for pain management for PTSD and war-related pain.
Sec. 705. Case management techniques for VA PTSD clinicians.
       TITLE VIII--NATIONAL STEERING COMMITTEE ON PTSD EDUCATION

Sec. 801. National Steering Committee.
Sec. 802. Funding support for National Center for PTSD.
Sec. 803. Continuing education to mental health providers.
Sec. 804. Web-based curriculum to sponsor clinician training 
                            initiatives.
                           TITLE IX--BENEFITS

Sec. 901. Identification of deficiencies in PTSD disability 
                            examinations.
Sec. 902. Criteria for determining medical conditions associated with 
                            PTSD.
                       TITLE X--PUBLIC AWARENESS

Sec. 1001. Public awareness program.
Sec. 1002. Web site and materials for general campaign of awareness of 
                            PTSD.

SEC. 2. DEFINITION.

    In this Act, the term ``PTSD'' means post-traumatic stress 
disorder.

                 TITLE I--VETERANS OF PAST DEPLOYMENTS

SEC. 101. EXTENSION OF ELIGIBILITY FOR READJUSTMENT COUNSELING SERVICES 
              FOR VIETNAM-ERA VETERANS.

    Section 1712A(a)(1)(B)(ii) of title 38, United States Code, is 
amended by striking ``January 1, 2004'' and inserting ``January 1, 
2009''.

                       TITLE II--MILITARY ISSUES

SEC. 201. DEPARTMENT OF VETERANS AFFAIRS-DEPARTMENT OF DEFENSE HEALTH 
              CARE SHARING INCENTIVE FUND.

    (a) In General.--The Secretary of Veterans Affairs and the 
Secretary of Defense shall jointly take such steps as necessary to 
implement the proposal of the Center for the Study of Traumatic Stress 
at the Uniformed Services University of the Health Sciences for a 
Department of Veterans Affairs-Department of Defense Health Care 
Sharing Incentive Fund.
    (b) Telecommunications Support.--As part of the implementation of 
such proposal, the two Secretaries shall provide for a system of 
telecommunications to support the following:
            (1) Continuing education and support for front-line 
        (forward-deployed) providers of health-care services.
            (2) Enhanced treatment capacity for addressing acute 
        episodes of PTSD.

SEC. 202. COLLECTION OF AGGREGATE DATA FROM PRE- AND POST-DEPLOYMENT 
              HEALTH ASSESSMENTS.

    (a) Data Collection.--The Secretary of Defense shall take 
appropriate steps to assist the Secretary of Veterans Affairs with the 
collection of data from pre- and post-deployment health assessments of 
members of the Armed Forces that may be relevant for identification and 
treatment of PTSD.
    (b) Consent Forms.--The Secretary of Defense shall develop forms to 
obtain the written consent of members of the Armed Forces to allow the 
Department of Veterans Affairs to collect data contained on pre-
deployment and post-deployment health assessment forms with relevant 
treatment information concerning PTSD from those members of the Armed 
Forces to be discharged or demobilized within 90 days. Such forms shall 
be developed within 60 days of the date of the enactment of this Act.
    (c) Preventative Maintenance Post-Deployment Intervention.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        conduct routine preventative maintenance intervention for all 
        members of the Armed Forces returning from deployment in a 
        combat theater. Such intervention shall be conducted between 90 
        and 180 days after such members return from such deployment.
            (2) Personnel.--For purposes of such intervention, the 
        Secretary of Veterans Affairs may use staff of the Department 
        of Veterans Affairs, including readjustment counseling staff, 
        or persons trained by the Department of Veterans Affairs, 
        including volunteers from military unit associations, veteran 
        service organizations, or other nonprofit organizations.
            (3) Size.--Such intervention shall be conducted with no 
        more than 6 returning servicemembers at a time.
            (4) Purpose.--The purpose of such intervention shall be the 
        following:
                    (A) To identify and distinguish symptoms of 
                ``common'' acute stress reactions from those of chronic 
                and severe post-traumatic stress disorder.
                    (B) To discuss concerns of combat personnel and 
                those expressed by their family members.
                    (C) To refer returning servicemembers to 
                appropriate services, as necessary.
                    (D) To disseminate educational materials about PTSD 
                to servicemembers.
                    (E) To provide follow-up educational materials by 
                mail to family members.
    (d) Identification of Substance Use Disorders.--The Secretary of 
Defense shall add questions to pre-deployment and post-deployment 
screens to assist in identification of existing or potential substance 
use disorders among members of the Armed Forces.
    (e) Substance Use Disorder Treatment Protocols.--The Secretary of 
Defense shall develop appropriate substance use disorder treatment 
protocols for assistance in combat areas of operations and on return to 
the United States.

SEC. 203. TELEMEDICINE SUPPORT FOR FRONT-LINE DEPARTMENT OF DEFENSE 
              PROVIDERS.

    The Secretary of Defense shall, in conjunction with the Secretary 
of Veterans Affairs, establish a program to provide telemedicine 
support to Department of Defense health-care providers in combat 
theaters. Such telemedicine support shall include real-time access to 
clinical specialty support, Web-based information on state-of-the-art 
protocols for the treatment and diagnosis of PTSD, and educational 
programs concerning PTSD.

  TITLE III--PREVENTION, EARLY DETECTION, AND TREATMENT FOR RETURNING 
                                 TROOPS

SEC. 301. STUDY TO IDENTIFY FACTORS THAT DECREASE THE LIKELIHOOD OF THE 
              DEVELOPMENT OF CHRONIC PTSD DESPITE COMBAT EXPOSURE.

    (a) Study.--The Secretary of Veterans Affairs shall provide for a 
study, to be conducted by an entity other than the Department of 
Veterans Affairs and the Department of Defense, to identify factors 
that decrease the likelihood of the development of chronic post-
traumatic stress disorder (PTSD) in servicemembers and veterans who 
have had combat exposure, including exposure to guerilla warfare.
    (b) Report.--The Secretary shall provide for the entity conducting 
the study under subsection (a) to submit a report on the results of the 
study to the Secretary and the Congress not later than one year after 
the date of the enactment of this Act.

SEC. 302. EXTENSION OF PERIOD OF ENHANCED ELIGIBILITY FOR VA HEALTH 
              SERVICES FOR VETERANS WHO SERVED IN COMBAT THEATER OF 
              OPERATIONS.

    Section 1710(e)(3)(C) of title 38, United States Code, is amended 
by striking ``2 years'' and inserting ``5 years''.

SEC. 303. DEPARTMENT OF VETERANS AFFAIRS TO PARTICIPATE IN ALL 
              DEMOBILIZATIONS AND TRANSITIONAL ASSISTANCE PROGRAM 
              ACTIVITIES.

    (a) In General.--The Secretary of Defense shall provide for the 
Secretary of Veterans Affairs to participate in all demobilization and 
Transitional Assistance Program activities conducted within the 
Department of Defense so as to enhance the capability of the Secretary 
of Veterans Affairs to identify risk factors for development of chronic 
PTSD.
    (b) Homelessness Risk Awareness.--In any activity referred to in 
subsection (a), the Secretary of Defense and the Secretary of Veterans 
Affairs shall provide information concerning homelessness, including 
risk factors, awareness assessment, and contact information for 
preventative assistance associated with homelessness.

SEC. 304. EDUCATIONAL MATERIALS.

    The Secretary of Veterans Affairs shall develop educational 
materials concerning PTSD for members of the Armed Forces returning 
from deployments in combat theaters and their family members. The 
Secretary of Defense shall assist in making those materials available 
to such members and family members.

SEC. 305. DEMONSTRATION PROJECT TO STATION DEPARTMENT OF VETERANS 
              AFFAIRS PSYCHOLOGISTS AND PSYCHIATRISTS AT MAJOR 
              DEMOBILIZATION SITES AND MILITARY TREATMENT FACILITIES.

    (a) Demonstration Project.--The Secretary of Defense and the 
Secretary of Veterans Affairs shall jointly provide for the conduct of 
a demonstration project under which Department of Veterans Affairs 
psychologists and psychiatrists are stationed at major demobilization 
sites and military treatment facilities.
    (b) Purpose.--The purposes of the demonstration project shall be as 
follows:
            (1) Identify, on an aggregate level, need for mental health 
        services among active-duty, Reserve, and National Guard 
        members.
            (2) Provide such services or refer members for necessary 
        services.
            (3) Advise servicemembers of the need for continuous 
        services.
            (4) Identify the obstacles servicemembers have in seeking 
        appropriate mental health care.
    (c) Funding.--There is authorized to be appropriated such sums as 
may be necessary for each of fiscal years 2005, 2006, and 2007 for the 
conduct of the demonstration project. Amounts for the conduct of the 
project shall be provided equally by the Secretary of Veterans Affairs 
and the Secretary of Defense.
    (d) Report.--The Secretary of Veterans Affairs shall submit to the 
Committees on Veterans' Affairs of the Senate and House of 
Representatives a report providing the results of the demonstration 

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