[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4887 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 4887
To expand the research and education on and delivery of complementary
and alternative medicine to veterans, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 18, 2014
Ms. Brownley of California introduced the following bill; which was
referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To expand the research and education on and delivery of complementary
and alternative medicine to veterans, 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.
This Act may be cited as the ``Expanding Care for Veterans Act''.
SEC. 2. EXPANSION OF RESEARCH AND EDUCATION ON AND DELIVERY OF
COMPLEMENTARY AND ALTERNATIVE MEDICINE TO VETERANS.
(a) Development of Plan To Expand Research, Education, and
Delivery.--Not later than six months after the effective date specified
in subsection (f), the Secretary of Veterans Affairs shall develop a
plan to expand materially and substantially the scope of research and
education on, and delivery and integration of, complementary and
alternative medicine services into the health care services provided to
veterans.
(b) Elements.--The plan required by subsection (a) shall provide
for the following:
(1) Research on the following:
(A) The comparative effectiveness of various
complementary and alternative medicine therapies.
(B) Approaches to integrating complementary and
alternative medicine services into other health care
services provided by the Department.
(2) Education and training for health care professionals of
the Department on the following:
(A) Complementary and alternative medicine services
selected by the Secretary for purposes of the plan.
(B) Appropriate uses of such services.
(C) Integration of such services into the delivery
of health care to veterans.
(3) Research, education, and clinical activities on
complementary and alternative medicine at centers of innovation
at Department medical centers.
(4) Identification or development of metrics and outcome
measures to evaluate the provision and integration of
complementary and alternative medicine services into the
delivery of health care to veterans.
(5) Integration and delivery of complementary and
alternative medicine services with other health care services
provided by the Department.
(c) Consultation.--
(1) In general.--In carrying out subsection (a), the
Secretary shall consult with the following:
(A) The Director of the National Center on
Complementary and Alternative Medicine of the National
Institutes of Health.
(B) The Commissioner of Food and Drugs.
(C) Institutions of higher education, private
research institutes, and individual researchers with
extensive experience in complementary and alternative
medicine and the integration of complementary and
alternative medicine practices into the delivery of
health care.
(D) Nationally recognized providers of
complementary and alternative medicine.
(E) Such other officials, entities, and individuals
with expertise on complementary and alternative
medicine as the Secretary considers appropriate.
(2) Scope of consultation.--The Secretary shall undertake
consultation under paragraph (1) in carrying out subsection (a)
with respect to the following:
(A) To develop the plan.
(B) To identify specific complementary and
alternative medicine practices that, on the basis of
research findings or promising clinical interventions,
are appropriate to include as services to veterans.
(C) To identify barriers to the effective provision
and integration of complementary and alternative
medicine services into the delivery of health care to
veterans, and to identify mechanisms for overcoming
such barriers.
(d) Funding.--There is authorized to be appropriated to the
Secretary such sums as may be necessary to carry out this section.
(e) Complementary and Alternative Medicine Defined.--In this
section, the term ``complementary and alternative medicine'' shall have
the meaning given that term in regulations the Secretary shall
prescribe for purposes of this section, which shall, to the degree
practicable, be consistent with the meaning given such term by the
Secretary of Health and Human Services.
(f) Effective Date.--This section shall take effect on the date
that is one year after the date of the enactment of this Act.
SEC. 3. PROGRAM ON INTEGRATION OF COMPLEMENTARY AND ALTERNATIVE
MEDICINE WITHIN DEPARTMENT OF VETERANS AFFAIRS MEDICAL
CENTERS.
(a) Program Required.--The Secretary of Veterans Affairs shall--
(1) carry out, through the Office of Patient Centered Care
and Cultural Transformation of the Department of Veterans
Affairs, a program to assess the feasibility and advisability
of integrating the delivery of complementary and alternative
medicine services selected by the Secretary with other health
care services provided by the Department for veterans with
mental health conditions, chronic pain conditions, other
chronic conditions, and such other conditions as the Secretary
determines appropriate; and
(2) in developing the program, identify and resolve
barriers to the provision of complementary and alternative
medicine services selected by the Secretary and the integration
of those services with other health care services provided by
the Department.
(b) Duration of Program.--The program shall be carried out during
the three-year period beginning on the effective date specified in
subsection (j).
(c) Locations.--
(1) In general.--The Secretary shall carry out the program
at not fewer than 15 separate Department medical centers.
(2) Polytrauma centers.--Not less than two of the medical
centers designated under paragraph (1) shall be located at
polytrauma rehabilitation centers of the Department.
(3) Selection of locations.--In carrying out the program,
the Secretary shall select locations that include the following
areas:
(A) Rural areas.
(B) Areas that are not in close proximity to an
active duty military installation.
(C) Areas representing different geographic
locations, such as census tracts established by the
Bureau of the Census.
(d) Provision of Services.--Under the program, the Secretary shall
provide covered services to covered veterans by integrating
complementary and alternative medicine services with other services
provided by the Department at the medical centers designated under
subsection (c)(1).
(e) Covered Veterans.--For purposes of the program, a covered
veteran is any veteran who--
(1) has a mental health condition diagnosed by a clinician
of the Department;
(2) experiences chronic pain; or
(3) has a chronic condition being treated by a clinician of
the Department.
(f) Covered Services.--
(1) In general.--For purposes of the program, covered
services are services consisting of complementary and
alternative medicine as selected by the Secretary.
(2) Administration of services.--Covered services shall be
administered under the program as follows:
(A) Covered services shall be administered by
clinicians employed by the Secretary for purposes of
this section who, to the extent practicable, shall
provide services consisting of complementary and
alternative medicine, including those clinicians who
solely provide such services.
(B) Covered services shall be included as part of
the Patient Aligned Care Teams initiative of the Office
of Patient Care Services, Primary Care Program Office,
in coordination with the Office of Patient Centered
Care and Cultural Transformation.
(C) Covered services shall be made available to
both--
(i) covered veterans with mental health
conditions, pain conditions, or chronic
conditions described in subsection (e) who have
received conventional treatments from the
Department for such conditions; and
(ii) covered veterans with mental health
conditions, pain conditions, or chronic
conditions described in subsection (e) who have
not received conventional treatments from the
Department for such conditions.
(g) Voluntary Participation.--The participation of a veteran in the
program shall be at the election of the veteran and in consultation
with a clinician of the Department.
(h) Reports to Congress.--
(1) Quarterly reports.--Not later than 90 days after the
date of the commencement of the program and not less frequently
than once every 90 days thereafter for the duration of the
program, the Secretary shall submit to the Committee on
Veterans' Affairs of the Senate and the Committee on Veterans'
Affairs of the House of Representatives a report on the efforts
of the Secretary to carry out the program, including a
description of the outreach conducted by the Secretary to
veterans and community organizations to inform such
organizations about the program.
(2) Final report.--
(A) In general.--Not later than 180 days after the
completion of the program, the Secretary shall submit
to the Committee on Veterans' Affairs of the Senate and
the Committee on Veterans' Affairs of the House of
Representatives a report on the program.
(B) Contents.--The report submitted under
subparagraph (A) shall include the following:
(i) The findings and conclusions of the
Secretary with respect to the program,
including with respect to--
(I) the utilization and efficacy of
the complementary and alternative
medicine services established under the
program;
(II) an assessment of the benefit
of the program to covered veterans in
mental health diagnoses, pain
management, and treatment of chronic
illness; and
(III) the comparative effectiveness
of various complementary and
alternative medicine therapies.
(ii) Barriers identified under subsection
(a)(2) that were not resolved.
(iii) Such recommendations for the
continuation or expansion of the program as the
Secretary considers appropriate.
(i) Complementary and Alternative Medicine Defined.--In this
section, the term ``complementary and alternative medicine'' shall have
the meaning given that term in section 2(e) of this Act.
(j) Effective Date.--This section shall take effect on the date
that is one year after the date of the enactment of this Act.
SEC. 4. STUDIES OF BARRIERS ENCOUNTERED BY VETERANS IN RECEIVING, AND
ADMINISTRATORS AND CLINICIANS IN PROVIDING, COMPLEMENTARY
AND ALTERNATIVE MEDICINE SERVICES FURNISHED BY THE
DEPARTMENT OF VETERANS AFFAIRS.
(a) Studies Required.--
(1) In general.--The Secretary of Veterans Affairs shall
conduct comprehensive studies of the barriers encountered by
veterans in receiving, and administrators and clinicians in
providing, complementary and alternative medicine services
furnished by the Department of Veterans Affairs.
(2) Studies conducted.--
(A) Veterans.--In conducting the study of veterans,
the Secretary shall--
(i) survey veterans who seek or receive
hospital care or medical services furnished by
the Department, as well as veterans who do not
seek or receive such care or services;
(ii) administer the survey to a
representative sample of veterans from each
Veterans Integrated Service Network; and
(iii) ensure that the sample of veterans
surveyed is of sufficient size for the study
results to be statistically significant.
(B) Administrators and clinicians.--In conducting
the study of clinicians and administrators, the
Secretary shall--
(i) survey administrators of the Department
who are involved in the provision of health
care services;
(ii) survey clinicians that have provided
complementary and alternative medicine services
through the program established under section 3
of this Act, after those clinicians have
provided those services through such program
for at least 90 days; and
(iii) administer the survey to
administrators under clause (i)--
(I) before the introduction of
complementary and alternative medicine
services through such program; and
(II) not earlier than 90 days after
the introduction of complementary and
alternative medicine services through
such program.
(b) Elements of Studies.--
(1) Veterans.--In conducting the study of veterans required
by subsection (a), the Secretary shall study the following:
(A) The perceived barriers associated with
obtaining complementary and alternative medicine
services from the Department.
(B) The satisfaction of veterans with complementary
and alternative medicine services in primary care.
(C) The degree to which veterans are aware of
eligibility requirements for, and the scope of services
available under, complementary and alternative medicine
services furnished by the Department.
(D) The effectiveness of outreach to veterans on
the availability of complementary and alternative
medicine for veterans.
(E) Such other barriers as the Secretary considers
appropriate.
(2) Administrators and clinicians.--In conducting the study
of administrators and clinicians required by subsection (a),
the Secretary shall study the following:
(A) The extent of the integration of complementary
and alternative medicine services within the services
provided by the Department.
(B) The perception by administrators and clinicians
of the structural and attitudinal barriers to the
delivery of high quality complementary and alternative
medicine services by the Department.
(C) Strategies that have been used to reduce or
eliminate such barriers and the results of such
strategies.
(D) The satisfaction of administrators and
clinicians regarding the integration of complementary
and alternative medicine services within the services
provided by the Department.
(E) The perception by administrators and clinicians
of the value of specific complementary and alternative
medicine services for inpatient and outpatient veteran
populations.
(c) Discharge by Contract.--The Secretary shall enter into a
contract with a qualified independent entity or organization to carry
out the studies required by this section.
(d) Mandatory Review of Data by the National Research Advisory
Council.--
(1) In general.--The Secretary shall ensure that the head
of the National Research Advisory Council reviews the results
of the studies conducted under this section.
(2) Submittal of findings.--The head of the National
Research Advisory Council shall submit findings with respect to
the studies to the Under Secretary for Health and to other
pertinent program offices within the Department with
responsibilities relating to health care services for veterans.
(e) Reports.--
(1) Report on implementation.--Not later than one year
after the date of the enactment of this Act, the Secretary
shall submit to Congress a report on the status of the
implementation of this section.
(2) Report on study.--
(A) In general.--Not later than 45 days after the
date of the completion of the study, the Secretary
shall submit to Congress a report on the study required
by subsection (a).
(B) Contents.--The report required by subparagraph
(A) shall include the following:
(i) Recommendations for such administrative
and legislative proposals and actions as the
Secretary considers appropriate.
(ii) The findings of the head of the
National Research Advisory Council and of the
Under Secretary for Health.
(f) Authorization of Appropriations.--There is authorized to be
appropriated for fiscal year 2015 for the Department of Veterans
Affairs, $2,000,000 to carry out this section.
(g) Complementary and Alternative Medicine Defined.--In this
section, the term ``complementary and alternative medicine'' shall have
the meaning given that term in section 2(e) of this Act.
SEC. 5. PROGRAM ON USE OF WELLNESS PROGRAMS AS COMPLEMENTARY APPROACH
TO MENTAL HEALTH CARE FOR VETERANS AND FAMILY MEMBERS OF
VETERANS.
(a) Program Required.--
(1) In general.--The Secretary of Veterans Affairs shall
carry out a program through the award of grants to public or
private nonprofit entities to assess the feasibility and
advisability of using wellness programs to complement the
provision of mental health care to veterans and family members
eligible for counseling under section 1712A(a)(1)(C) of title
38, United States Code.
(2) Matters to be addressed.--The program shall be carried
out so as to assess the following:
(A) Means of improving coordination between
Federal, State, local, and community providers of
health care in the provision of mental health care to
veterans and family members described in paragraph (1).
(B) Means of enhancing outreach, and coordination
of outreach, by and among providers of health care
referred to in subparagraph (A) on the mental health
care services available to veterans and family members
described in paragraph (1).
(C) Means of using wellness programs of providers
of health care referred to in subparagraph (A) as
complements to the provision by the Department of
Veterans Affairs of mental health care to veterans and
family members described in paragraph (1).
(D) Whether wellness programs described in
subparagraph (C) are effective in enhancing the quality
of life and well-being of veterans and family members
described in paragraph (1).
(E) Whether wellness programs described in
subparagraph (C) are effective in increasing the
adherence of veterans described in paragraph (1) to the
primary mental health services provided such veterans
by the Department.
(F) Whether wellness programs described in
subparagraph (C) have an impact on the sense of
wellbeing of veterans described in paragraph (1) who
receive primary mental health services from the
Department.
(G) Whether wellness programs described in
subparagraph (C) are effective in encouraging veterans
receiving health care from the Department to adopt a
more healthy lifestyle.
(b) Duration.--The Secretary shall carry out the program for a
period of three years beginning on the date that is one year after the
date of the enactment of this Act.
(c) Locations.--The Secretary shall carry out the program at
facilities of the Department providing mental health care services to
veterans and family members described in subsection (a)(1).
(d) Grant Proposals.--
(1) In general.--A public or private nonprofit entity
seeking the award of a grant under this section shall submit an
application therefor to the Secretary in such form and in such
manner as the Secretary may require.
(2) Application contents.--Each application submitted under
paragraph (1) shall include the following:
(A) A plan to coordinate activities under the
program, to the extent possible, with the Federal,
State, and local providers of services for veterans to
enhance the following:
(i) Awareness by veterans of benefits and
health care services provided by the
Department.
(ii) Outreach efforts to increase the use
by veterans of services provided by the
Department.
(iii) Educational efforts to inform
veterans of the benefits of a healthy and
active lifestyle.
(B) A statement of understanding from the entity
submitting the application that, if selected, such
entity will be required to report to the Secretary
periodically on standardized data and other performance
data necessary to evaluate individual outcomes and to
facilitate evaluations among entities participating in
the program.
(C) Other requirements that the Secretary may
prescribe.
(e) Grant Uses.--
(1) In general.--A public or private nonprofit entity
awarded a grant under this section shall use the award for
purposes prescribed by the Secretary.
(2) Eligible veterans and family.--In carrying out the
purposes prescribed by the Secretary in paragraph (1), a public
or private nonprofit entity awarded a grant under this section
shall use the award to furnish services only to individuals
specified in section 1712A(a)(1)(C) of title 38, United States
Code.
(f) Reports.--
(1) Periodic reports.--
(A) In general.--Not later than 180 days after the
date of the commencement of the program, and every 180
days thereafter, the Secretary shall submit to Congress
a report on the program.
(B) Report elements.--Each report required by
subparagraph (A) shall include the following:
(i) The findings and conclusions of the
Secretary with respect to the program during
the 180-day period preceding the report.
(ii) An assessment of the benefits of the
program to veterans and their family members
during the 180-day period preceding the report.
(2) Final report.--Not later than 180 days after the end of
the program, the Secretary shall submit to Congress a report
detailing the recommendations of the Secretary as to the
advisability of continuing or expanding the program.
(g) Wellness Defined.--In this section, the term ``wellness'' has
the meaning given that term in regulations prescribed by the Secretary.
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