[Federal Register Volume 77, Number 172 (Wednesday, September 5, 2012)]
[Presidential Documents]
[Pages 54783-54786]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-22062]
Presidential Documents
Federal Register / Vol. 77 , No. 172 / Wednesday, September 5, 2012 /
Presidential Documents
[[Page 54783]]
Executive Order 13625 of August 31, 2012
Improving Access to Mental Health Services for
Veterans, Service Members, and Military Families
By the authority vested in me as President by the
Constitution and the laws of the United States of
America, I hereby order as follows:
Section 1. Policy. Since September 11, 2001, more than
two million service members have deployed to Iraq or
Afghanistan. Long deployments and intense combat
conditions require optimal support for the emotional
and mental health needs of our service members and
their families. The need for mental health services
will only increase in the coming years as the Nation
deals with the effects of more than a decade of
conflict. Reiterating and expanding upon the commitment
outlined in my Administration's 2011 report, entitled
``Strengthening Our Military Families,'' we have an
obligation to evaluate our progress and continue to
build an integrated network of support capable of
providing effective mental health services for
veterans, service members, and their families. Our
public health approach must encompass the practices of
disease prevention and the promotion of good health for
all military populations throughout their lifespans,
both within the health care systems of the Departments
of Defense and Veterans Affairs and in local
communities. Our efforts also must focus on both
outreach to veterans and their families and the
provision of high quality mental health treatment to
those in need. Coordination between the Departments of
Veterans Affairs and Defense during service members'
transition to civilian life is essential to achieving
these goals.
Ensuring that all veterans, service members (Active,
Guard, and Reserve alike), and their families receive
the support they deserve is a top priority for my
Administration. As part of our ongoing efforts to
improve all facets of military mental health, this
order directs the Secretaries of Defense, Health and
Human Services, Education, Veterans Affairs, and
Homeland Security to expand suicide prevention
strategies and take steps to meet the current and
future demand for mental health and substance abuse
treatment services for veterans, service members, and
their families.
Sec. 2. Suicide Prevention. (a) By December 31, 2012,
the Department of Veterans Affairs, in continued
collaboration with the Department of Health and Human
Services, shall expand the capacity of the Veterans
Crisis Line by 50 percent to ensure that veterans have
timely access, including by telephone, text, or online
chat, to qualified, caring responders who can help
address immediate crises and direct veterans to
appropriate care. Further, the Department of Veterans
Affairs shall ensure that any veteran identifying him
or herself as being in crisis connects with a mental
health professional or trained mental health worker
within 24 hours. The Department of Veterans Affairs
also shall expand the number of mental health
professionals who are available to see veterans beyond
traditional business hours.
(b) The Departments of Veterans Affairs and Defense
shall jointly develop and implement a national suicide
prevention campaign focused on connecting veterans and
service members to mental health services. This 12-
month campaign, which shall begin on September 1, 2012,
will focus on the positive benefits of seeking care and
encourage veterans and service members to proactively
reach out to support services.
(c) To provide the best mental health and substance
abuse prevention, education, and outreach support to
our military and their family members,
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the Department of Defense shall review all of its
existing mental health and substance abuse prevention,
education, and outreach programs across the military
services and the Defense Health Program to identify the
key program areas that produce the greatest impact on
quality and outcomes, and rank programs within each of
these program areas using metrics that assess their
effectiveness. By the end of Fiscal Year 2014, existing
program resources shall be realigned to ensure that
highly ranked programs are implemented across all of
the military services and less effective programs are
replaced.
Sec. 3. Enhanced Partnerships Between the Department of
Veterans Affairs and Community Providers. (a) Within
180 days of the date of this order, in those service
areas where the Department of Veterans Affairs has
faced challenges in hiring and placing mental health
service providers and continues to have unfilled
vacancies or long wait times, the Departments of
Veterans Affairs and Health and Human Services shall
establish pilot projects whereby the Department of
Veterans Affairs contracts or develops formal
arrangements with community-based providers, such as
community mental health clinics, community health
centers, substance abuse treatment facilities, and
rural health clinics, to test the effectiveness of
community partnerships in helping to meet the mental
health needs of veterans in a timely way. Pilot sites
shall ensure that consumers of community-based services
continue to be integrated into the health care systems
of the Department of Veterans Affairs. No fewer than 15
pilot projects shall be established.
(b) The Department of Veterans Affairs shall
develop guidance for its medical centers and service
networks that supports the use of community mental
health services, including telehealth services and
substance abuse services, where appropriate, to meet
demand and facilitate access to care. This guidance
shall include recommendations that medical centers and
service networks use community-based providers to help
meet veterans' mental health needs where objective
criteria, which the Department of Veterans Affairs
shall define in the form of specific metrics,
demonstrate such needs. Such objective criteria should
include estimates of wait-times for needed care that
exceed established targets.
(c) The Departments of Health and Human Services
and Veterans Affairs shall develop a plan for a rural
mental health recruitment initiative to promote
opportunities for the Department of Veterans Affairs
and rural communities to share mental health providers
when demand is insufficient for either the Department
of Veterans Affairs or the communities to independently
support a full-time provider.
Sec. 4. Expanded Department of Veterans Affairs Mental
Health Services Staffing. The Secretary of Veterans
Affairs shall, by December 31, 2013, hire and train 800
peer-to-peer counselors to empower veterans to support
other veterans and help meet mental health care needs.
In addition, the Secretary shall continue to use all
appropriate tools, including collaborative arrangements
with community-based providers, pay-setting
authorities, loan repayment and scholarships, and
partnerships with health care workforce training
programs to accomplish the Department of Veterans
Affairs' goal of recruiting, hiring, and placing 1,600
mental health professionals by June 30, 2013. The
Department of Veterans Affairs also shall evaluate the
reporting requirements associated with providing mental
health services and reduce paperwork requirements where
appropriate. In addition, the Department of Veterans
Affairs shall update its management performance
evaluation system to link performance to meeting mental
health service demand.
Sec. 5. Improved Research and Development. (a) The lack
of full understanding of the underlying mechanisms of
Post-Traumatic Stress Disorder (PTSD), other mental
health conditions, and Traumatic Brain Injury (TBI) has
hampered progress in prevention, diagnosis, and
treatment. In order to improve the coordination of
agency research into these conditions and reduce the
number of affected men and women through better
prevention, diagnosis, and treatment, the Departments
of Defense, Veterans Affairs, Health and Human
Services, and Education, in coordination with the
Office of
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Science and Technology Policy, shall establish a
National Research Action Plan within 8 months of the
date of this order.
(b) The National Research Action Plan shall include
strategies to establish surrogate and clinically
actionable biomarkers for early diagnosis and treatment
effectiveness; develop improved diagnostic criteria for
TBI; enhance our understanding of the mechanisms
responsible for PTSD, related injuries, and
neurological disorders following TBI; foster
development of new treatments for these conditions
based on a better understanding of the underlying
mechanisms; improve data sharing between agencies and
academic and industry researchers to accelerate
progress and reduce redundant efforts without
compromising privacy; and make better use of electronic
health records to gain insight into the risk and
mitigation of PTSD, TBI, and related injuries. In
addition, the National Research Action Plan shall
include strategies to support collaborative research to
address suicide prevention.
(c) The Departments of Defense and Health and Human
Services shall engage in a comprehensive longitudinal
mental health study with an emphasis on PTSD, TBI, and
related injuries to develop better prevention,
diagnosis, and treatment options. Agencies shall
continue ongoing collaborative research efforts, with
an aim to enroll at least 100,000 service members by
December 31, 2012, and include a plan for long-term
follow-up with enrollees through a coordinated effort
with the Department of Veterans Affairs.
Sec. 6. Military and Veterans Mental Health Interagency
Task Force. There is established an Interagency Task
Force on Military and Veterans Mental Health (Task
Force), to be co-chaired by the Secretaries of Defense,
Veterans Affairs, and Health and Human Services, or
their designated representatives.
(a) Membership. In addition to the Co-Chairs, the
Task Force shall consist of representatives from:
(i) the Department of Education;
(ii) the Office of Management and Budget;
(iii) the Domestic Policy Council;
(iv) the National Security Staff;
(v) the Office of Science and Technology Policy;
(vi) the Office of National Drug Control Policy; and
(vii) such other executive departments, agencies, or offices as the Co-
Chairs may designate.
A member agency of the Task Force shall designate a
full-time officer or employee of the Federal Government
to perform the Task Force functions.
(b) Mission. Member agencies shall review relevant
statutes, policies, and agency training and guidance to
identify reforms and take actions that facilitate
implementation of the strategies outlined in this
order. Member agencies shall work collaboratively on
these strategies and also create an inventory of mental
health and substance abuse programs and activities to
inform this work.
(c) Functions.
(i) Not later than 180 days after the date of this order, the Task Force
shall submit recommendations to the President on strategies to improve
mental health and substance abuse treatment services for veterans, service
members, and their families. Every year thereafter, the Task Force shall
provide to the President a review of agency actions to enhance mental
health and substance abuse treatment services for veterans, service
members, and their families consistent with this order, as well as provide
additional recommendations for action as appropriate. The Task Force shall
define specific goals and metrics that will aid in measuring progress in
improving mental health strategies. The Task Force will include cost
analysis in the development of all recommendations, and will ensure any new
requirements are supported within existing resources.
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(ii) In addition to coordinating and reviewing agency efforts to enhance
veteran and military mental health services pursuant to this order, the
Task Force shall evaluate:
(1) agency efforts to improve care quality and ensure that the Departments
of Defense and Veterans Affairs and community-based mental health providers
are trained in the most current evidence-based methodologies for treating
PTSD, TBI, depression, related mental health conditions, and substance
abuse;
(2) agency efforts to improve awareness and reduce stigma for those needing
to seek care; and
(3) agency research efforts to improve the prevention, diagnosis, and
treatment of TBI, PTSD, and related injuries, and explore the need for an
external research portfolio review.
(iii) In performing its functions, the Task Force shall consult with
relevant nongovernmental experts and organizations as necessary.
Sec. 7. General Provisions. (a) This order shall be
implemented consistent with applicable law and subject
to the availability of appropriations.
(b) Nothing in this order shall be construed to
impair or otherwise affect:
(i) the authority granted by law to an executive department or agency, or
the head thereof; or
(ii) the functions of the Director of the Office of Management and Budget
relating to budgetary, administrative, or legislative proposals.
(c) This order is not intended to, and does not,
create any right or benefit, substantive or procedural,
enforceable at law or in equity by any party against
the United States, its departments, agencies, or
entities, its officers, employees, or agents, or any
other person.
(Presidential Sig.)
THE WHITE HOUSE,
August 31, 2012.
[FR Doc. 2012-22062
Filed 9-4-12; 2:00 pm]
Billing code 3295-F2-P