38 U.S.C. § 1712A: Eligibility for readjustment counseling and related mental health services

in the case of an individual referred to in clauses (i) through (vii) of subparagraph (C), to assist the individual in readjusting to civilian life; and 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; 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; and in the case of a veteran or member who died by suicide, to the degree that counseling furnished to such individual is found to aid in coping with the effects of such suicide. in the case of an individual referred to in clauses (i) through (vii) of subparagraph (C), such individual has difficulties associated with readjusting to civilian life; and coping with the deployment of a member described in subclause (I) of such clause; readjustment to civilian life of a veteran or member described in subclause (II) of such clause; or coping with the effects of a suicide described in subclause (III) of such clause. Except as provided in subclauses (IV) and (V), counseling furnished to an individual under subparagraph (A) may include reintegration and readjustment services described in subclause (II) furnished in group retreat settings. Information on reintegration of the individual into family, employment, and community. Financial counseling. Occupational counseling. Information and counseling on stress reduction. Information and counseling on conflict resolution. Such other information and counseling as the Secretary considers appropriate to assist the individual in reintegration into family, employment, and community. In furnishing reintegration and readjustment services under subclause (I), the Secretary shall offer women the opportunity to receive such services in group retreat settings in which the only participants are women. An individual described in subparagraph (C)(v) may receive reintegration and readjustment services under subclause (I) of this clause only if the individual receives such services with a family member described in subclause (I) or (II) of such subparagraph. In each of fiscal years 2021 through 2025, the maximum number of individuals to whom integration and readjustment services may be furnished in group retreat settings under this subclause (I) shall not exceed 1,200 individuals. 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. 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. 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. on active service in response to a national emergency or major disaster declared by the President; or 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. Any individual who participated in a drug interdiction operation as a member of the Coast Guard, regardless of the location of that operation. Any individual who received counseling under this section before the date of the enactment of the National Defense Authorization Act for Fiscal Year 2013. Any veteran or member of the Armed Forces pursuing a course of education using covered educational assistance benefits. 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; veteran or member of the Armed Forces described in this subparagraph; or veteran or member of the Armed Forces who died by suicide. The Secretary, in consultation with the Secretary of Defense, may furnish to any member of the reserve components of the Armed Forces who has a behavioral health condition or psychological trauma, counseling under subparagraph (A)(i), which may include a comprehensive individual assessment under subparagraph (B)(i). A member of the reserve components of the Armed Forces described in clause (i) shall not be required to obtain a referral before being furnished counseling or an assessment under this subparagraph. 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)(i) as soon as practicable after receiving the request, but not later than 30 days after receiving the request. Upon the request of an individual described in paragraph (1)(C), the Secretary shall furnish the individual reintegration and readjustment services in group retreat settings under paragraph (1)(B)(ii) if the Secretary determines the experience will be therapeutically appropriate. If, on the basis of the assessment furnished to an individual 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 individual is necessary to facilitate the successful readjustment of the individual to civilian life, such individual 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 ). Mental health services furnished under paragraph (1) of this subsection may, if determined to be essential to the effective treatment and readjustment of the individual, include such consultation, counseling, training, services, and expenses as are described in sections 1782 and 1783 of this title. 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 if pertinent, advise such individual of such individual’s rights to apply to the appropriate military, naval, air, or space service, and to the Department, for review of such individual’s discharge or release from such service. 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. 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 or agreements with private facilities that is available to the Secretary in furnishing medical services to veterans suffering from total service-connected disabilities. 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. 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. 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. designed to encourage the readjustment of veterans described in subsection (a)(1)(C); and operated by any organization named in or approved under section 5902 of this title . 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. 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. a parent; a spouse; a child; a step-family member; and an extended family member; or lives with the veteran or member but is not a member of the family of the veteran or member. The term “active service” has the meaning given that term in section 101 of title 10 . The term “civil disorder” has the meaning given that term in section 232 of title 18 . chapter 30, 31, 32, or 33 of this title; chapter 1606 or 1607 of title 10; section 116 of the Harry W. Colmery Veterans Educational Assistance Act of 2017 ( Public Law 115–48 ; 38 U.S.C. 3001 note); or section 8006 of the American Rescue Plan Act of 2021 ( Public Law 117–2 ; 38 U.S.C. 3001 note prec.). Beginning not later than 90 days after the date of the enactment of this Act [ Dec. 29, 2022 ], the Secretary of Veterans Affairs shall ensure that each medical center of the Department of Veterans Affairs has no fewer than one full-time employee whose responsibility is serving as a minority veteran coordinator. Not later than 180 days after the date of the enactment of this Act, the Secretary, in consultation with the Indian Health Service and the Director of the Office of Mental Health and Suicide Prevention of the Department of Veterans Affairs, shall ensure that all minority veteran coordinators receive training in delivery of mental health and suicide prevention services culturally appropriate for American Indian and Alaska Native veterans, especially with respect to the identified populations and tribes within the coordinators’ catchment areas. contact information for tribal leadership and the tribal health facility or Indian Health Service facility serving that tribe; a schedule for and list of outreach plans (including addressing any barriers to accessing Department mental health care); documentation of any conversation with tribal leaders that may guide culturally appropriate delivery of mental health care to American Indian or Alaska Native veterans; documentation of any progress in incorporating traditional healing practices into mental health and suicide prevention protocols and options available for veterans who are members of such tribe; and documentation of any coordination among the Department, the Indian Health Service, urban Indian health organizations, and the Substance Abuse and Mental Health Services Administration for the purpose of improving suicide prevention efforts tailored to veterans who are members of such tribe and the provision of culturally competent mental health care to such veterans.” Not later than one year after the date of the enactment of this Act [ Dec. 29, 2022 ] and subject to the availability of appropriations, the Secretary of Veterans Affairs shall hire an additional 50 full-time equivalent employees for Vet Centers to bolster the workforce of Vet Centers and to provide expanded mental health care to veterans, members of the Armed Forces, and their families through outreach, community access points, outstations, and Vet Centers. In this section, the term ‘Vet Center’ has the meaning given that term in section 1712A(h) of title 38 , United States Code.” The Secretary of Veterans Affairs shall designate one week each year to organize outreach events and educate veterans on how to conduct peer wellness checks, which shall be known as ‘Buddy Check Week’. During Buddy Check Week, the Secretary, in consultation with organizations that represent veterans, nonprofits that serve veterans, mental health experts, members of the Armed Forces, and such other entities and individuals as the Secretary considers appropriate, shall collaborate with organizations that represent veterans to provide educational opportunities for veterans to learn how to conduct peer wellness checks. A script for veterans to use to conduct peer wellness checks that includes information on appropriate referrals to resources veterans might need. Online and in-person training, as appropriate, on how to conduct a peer wellness check. Opportunities for members of organizations that represent veterans to learn how to train individuals to conduct peer wellness checks. Training for veterans participating in Buddy Check Week on how to transfer a phone call directly to the Veterans Crisis Line. Resiliency training for veterans participating in Buddy Check Week on handling a veteran in crisis. All training materials provided under the educational opportunities under paragraph (1) shall be made publicly available on a website of the Department of Veterans Affairs. public events where many veterans are expected to congregate; meetings of organizations that represent veterans; facilities of the Department; and such other locations as the Secretary, in collaboration with organizations that represent veterans, considers appropriate. The Secretary shall ensure that a plan exists for handling the potential increase in the number of calls into the Veterans Crisis Line that may occur during Buddy Check Week. Additional hours for staff. The use of a backup call center. Any other plan to ensure that calls from veterans in crisis are being answered in a timely manner by an individual trained at the same level as a Veterans Crisis Line responder. The term ‘organization that represents veterans’ means an organization recognized by the Secretary for the representation of veterans under section 5902 of title 38 , United States Code. The term ‘veteran’ has the meaning given that term in section 101 of such title. The term ‘Veterans Crisis Line’ means the toll-free hotline for veterans provided by the Secretary under section 1720F(h) of such title.” The Secretary of Veterans Affairs shall establish and maintain three new centers of the RANGE Program. the need for additional mental health care for rural veterans in such areas; and interest expressed by personnel at facilities of the Department in such areas. The Secretary shall establish the centers under subsection (a) during fiscal year 2022. There is authorized to be appropriated $1,200,000 for each of fiscal years 2022 through 2026 to carry out this section. The term ‘covered mental health care’ means mental health care that is more intensive than traditional outpatient therapy. The term ‘PRR center’ means a psychosocial rehabilitation and recovery center of the Department of Veterans Affairs. The term ‘RANGE Program’ means the Rural Access Network for Growth Enhancement Program of the Department of Veterans Affairs. The term ‘rural veteran’ means a veteran who lives in a rural or highly rural area (including such an area in a Tribal or insular area), as determined through the use of the Rural-Urban Commuting Areas coding system of the Department of Agriculture.” The Secretary of Veterans Affairs shall carry out a pilot program to assess the feasibility and advisability of providing, subject to paragraph (2), assistance to qualified veterans described in paragraph (3) to obtain child care so that such veterans can receive readjustment counseling and related mental health services. Assistance may be provided to a qualified veteran under the pilot program for receipt of child care only during the period that the qualified veteran receives readjustment counseling and related health care services at a Vet Center. is the primary caretaker of a child or children; and receives from the Department regular readjustment counseling and related mental health services; or is in need of regular readjustment counseling and related mental health services from the Department, and but for lack of child care services, would receive such counseling and services from the Department. The Secretary shall carry out the pilot program in not fewer than three Readjustment Counseling Service Regions selected by the Secretary for purposes of the pilot program. Stipends for the payment of child care offered by a licensed child care center (either directly or through a voucher program) that shall be, to the extent practicable, modeled after the Department of Veterans Affairs Child Care Subsidy Program established pursuant to section 630 of the Treasury and General Government Appropriations Act, 2002 ( Public Law 107–67 ; 115 Stat. 552 ) [now 40 U.S.C. 590(g) ]. Payments to private child care agencies. Collaboration with facilities or programs of other Federal agencies. Such other forms of assistance as the Secretary considers appropriate. In providing child care assistance under the pilot program, the child care needs of the local area shall be considered and the head of each Vet Center may select the type of care that is most appropriate or feasible for such Vet Center. In the case that child care assistance under the pilot program is provided as a stipend under subparagraph (A)(i), such stipend shall cover the full cost of such child care. The pilot program shall be carried out during the two-year period beginning on the date of the commencement of the pilot program. 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 required by subparagraph (A) shall include the findings and conclusions of the Secretary regarding the pilot program, and shall include such recommendations for the continuation or expansion of the pilot program as the Secretary considers appropriate. In this subsection, the term ‘Vet Center’ has the meaning given that term in section 1712A(h) of title 38 , United States Code.” Not later than 180 days after the date on which the Creating Options for Veterans’ Expedited Recovery Commission (commonly referred to as the ‘COVER Commission’) established under section 931 of the Jason Simcakoski Memorial and Promise Act (title IX of Public Law 114–198 ; 38 U.S.C. 1701 note) submits its final report under subsection (e)(2) of such section, the Secretary of Veterans Affairs shall commence the conduct of a pilot program to provide complementary and integrative health programs described in subsection (b) to eligible veterans from the Department of Veterans Affairs or through the use of non-Department entities for the treatment of post-traumatic stress disorder, depression, anxiety, or other conditions as determined by the Secretary. Equine therapy. Other animal therapy. Agritherapy. Sports and recreation therapy. Art therapy. Posttraumatic growth programs. is enrolled in the system of patient enrollment of the Department under section 1705(a) of title 38 , United States Code; and has received health care under the laws administered by the Secretary during the two-year period preceding the initial participation of the veteran in the pilot program. The Secretary shall carry out the pilot program under this section until September 30, 2025 . The Secretary may extend the duration of the pilot program under this section if the Secretary, based on the results of the interim report submitted under subsection (f)(1), determines that it is appropriate to do so. The Secretary shall select not fewer than five facilities of the Department at which to carry out the pilot program under this section. the locations are in geographically diverse areas; and not fewer than three facilities serve veterans in rural or highly rural areas (as determined through the use of the Rural-Urban Commuting Areas coding system of the Department of Agriculture). Not later than one year after the commencement of the pilot program under this section, 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 progress of the pilot program. The number of participants in the pilot program. The type or types of therapy offered at each facility at which the pilot program is being carried out. An assessment of whether participation by a veteran in the pilot program resulted in any changes in clinically relevant endpoints for the veteran with respect to the conditions specified in subsection (a). An assessment of the quality of life of veterans participating in the pilot program, including the results of a satisfaction survey of the participants in the pilot program, disaggregated by program under subsection (b). The determination of the Secretary with respect to extending the pilot program under subsection (d)(2). Any recommendations of the Secretary with respect to expanding the pilot program. Not later than 90 days after the termination of the pilot program under this section, 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 final report on the pilot program.” Not later than two years after the date of the enactment of this Act [ Oct. 17, 2020 ], the Secretary of Veterans Affairs, in consultation with the Secretary of Defense, shall develop a clinical provider treatment toolkit and accompanying training materials for the evidence-based management of comorbid mental health conditions, comorbid mental health and substance use disorders, and a comorbid mental health condition and chronic pain. The treatment of patients with post-traumatic stress disorder who are also experiencing an additional mental health condition, a substance use disorder, or chronic pain. The treatment of patients experiencing a mental health condition, including anxiety, depression, or bipolar disorder, who are also experiencing a substance use disorder or chronic pain. a mental health condition, including post-traumatic stress disorder, anxiety, depression, or bipolar disorder; a substance use disorder; or chronic pain.” Schizophrenia. Schizoaffective disorder. Persistent mood disorder, including bipolar disorder I and II. Any other mental, behavioral, or emotional disorder resulting in serious functional impairment that substantially interferes with major life activities as the Secretary of Veterans Affairs, in consultation with the Secretary of Defense and the Secretary of Health and Human Services, considers appropriate. Guidance contained in the 2016 Clinical Practice Guidelines for the Management of Major Depressive Disorders of the Department of Veterans Affairs and the Department of Defense. Guidance with respect to the treatment of patients with a condition described in subsection (a). A list of evidence-based therapies for the treatment of conditions described in subsection (a). An appropriate guideline for the administration of pharmacological therapy, psychological or behavioral therapy, or other therapy for the management of conditions described in subsection (a). Not later than two years after the date of the enactment of this Act [ Oct. 17, 2020 ], the Secretary of Veterans Affairs, in consultation with the Secretary of Defense and the Secretary of Health and Human Services, shall complete an assessment of the 2016 Clinical Practice Guidelines for the Management of Major Depressive Disorders to determine whether an update to such guidelines is necessary. The Secretary of Veterans Affairs, the Secretary of Defense, and the Secretary of Health and Human Services shall create a work group to develop the clinical practice guideline or guidelines under subsection (a) to be known as the ‘Serious Mental Illness Work Group’ (in this subsection referred to as the ‘Work Group’). Academic institutions that specialize in research for the treatment of conditions described in subsection (a). The Health Services Research and Development Service of the Department of Veterans Affairs. The Office of the Assistant Secretary for Mental Health and Substance Use of the Department of Health and Human Services. The National Institute of Mental Health. The Indian Health Service. Relevant organizations with expertise in researching, diagnosing, or treating conditions described in subsection (a). The Work Group shall be created and conducted in the same manner as other work groups for the development of clinical practice guidelines for the Department of Veterans Affairs and the Department of Defense. Nothing in this section shall be construed to prevent the Secretary of Veterans Affairs and the Secretary of Defense from considering all relevant evidence, as appropriate, in creating the clinical practice guideline or guidelines required under subsection (a) or from ensuring that the final clinical practice guideline or guidelines developed under such subsection and subsequently updated, as appropriate, remain applicable to the patient populations of the Department of Veterans Affairs and the Department of Defense.” Beginning not later than 18 months after the date of the enactment of this Act [ Oct. 17, 2020 ], the Secretary of Veterans Affairs shall develop and implement an initiative of the Department of Veterans Affairs to identify and validate brain and mental health biomarkers among veterans, with specific consideration for depression, anxiety, post-traumatic stress disorder, bipolar disorder, traumatic brain injury, and such other mental health conditions as the Secretary considers appropriate. Such initiative may be referred to as the ‘Precision Medicine for Veterans Initiative’. The initiative under subsection (a) shall be modeled on the All of Us Precision Medicine Initiative administered by the National Institutes of Health with respect to large-scale collection of standardized data and open data sharing. The initiative under subsection (a) shall include brain structure and function measurements, such as functional magnetic resonance imaging and electroencephalogram, and shall coordinate with additional biological methods of analysis utilized in the Million Veterans Program of the Department of Veterans Affairs. In carrying out the initiative under subsection (a), the Secretary shall develop robust data privacy and security measures, consistent with section 552a of title 5 , United States Code (commonly known as the ‘Privacy Act of 1974’), and regulations promulgated pursuant to the Health Insurance Portability and Accountability Act of 1996 [ Pub. L. 104–191 ] (parts 160, 162, and 164 of title 45, Code of Federal Regulations, or successor regulations) to ensure that information of veterans participating in the initiative is kept private and secure. The Secretary may consult with the National Institute of Science and Technology in developing the data privacy and security measures described in paragraph (1). The Secretary shall provide access to information under the initiative consistent with the standards described in section 552a(d)(1) of title 5 , United States Code, and section 164.524 of title 45, Code of Federal Regulations, or successor regulations. The Secretary shall make de-identified data collected under the initiative available for research purposes to Federal agencies. The Secretary shall contract with nongovernment entities that comply with requisite data security measures to make available for research purposes de-identified data collected under the initiative. The Secretary shall provide assistance to a Federal agency conducting research using data collected under the initiative at the request of that agency. Federal agencies may not disclose, transmit, share, sell, license, or otherwise transfer data collected under the initiative to any nongovernment entity other than as allowed under subparagraph (B). The Secretary shall ensure that data collected under the initiative is standardized. The Secretary shall consult with the National Institutes of Health and the Food and Drug Administration to determine the most effective, efficient, and cost-effective way of standardizing data collected under the initiative. In consultation with the National Institute for Science and Technology, data collected under the initiative shall be standardized in the manner in which it is collected, entered into the database, extracted, and recorded. Any measures of brain function or structure collected under the initiative shall be collected with a device that is approved by the Food and Drug Administration. alters, anonymizes, or aggregates the data so that there is a reasonable basis for expecting that the data could not be linked as a practical matter to a specific individual; publicly commits to refrain from attempting to re-identify the data with a specific individual, and adopts controls to prevent such identification; and causes the data to be covered by a contractual or other legally enforceable prohibition on each entity to which the Department discloses the data from attempting to use the data to identify a specific individual and requires the same of all onward disclosures. The Secretary shall coordinate efforts of the initiative under subsection (a) with the Million Veterans Program of the Department.” Notwithstanding any other provision of law, the Secretary of Veterans Affairs may enter into short-term agreements or contracts with telecommunications companies to provide temporary, complimentary or subsidized, fixed and mobile broadband services for the purposes of providing expanded mental health services to isolated veterans through telehealth or VA Video Connect during a public health emergency. The Secretary may expand eligibility for services described in subsection (a) from the Department of Veterans Affairs to include veterans already receiving care from the Department who may not be eligible for mental health services or other health care services delivered through telehealth or VA Video Connect. veterans who are in unserved and underserved areas; veterans who reside in rural and highly rural areas, as defined in the Rural-Urban Commuting Areas coding system of the Department of Agriculture; low-income veterans; and any other veterans that the Secretary considers to be at a higher risk for suicide and mental health concerns during isolation periods due to a public health emergency. The term ‘telehealth’ means the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health, and health administration. For purposes of subparagraph (A), telecommunications technologies include videoconferencing, the internet, streaming media, and terrestrial and wireless communications. The term ‘VA Video Connect’ means the program of the Department of Veterans Affairs to connect veterans with their health care team from anywhere, using encryption to ensure a secure and private session.” Using funds made available to the Secretary of Veterans Affairs to publish the Internet websites of the Department of Veterans Affairs, the Secretary shall survey the existing Internet websites and information resources of the Department to publish an Internet website that serves as a centralized source to provide veterans with information regarding all of the mental health care services provided by the Secretary. the name and contact information of each social work office; the name and contact information of each mental health clinic; a list of appropriate staff; and any other information the Secretary determines appropriate. The Secretary shall ensure that the information described in subsection (b) that is published on the Internet website under subsection (a) is updated not less than once every 90 days. In carrying out this section, the Secretary shall ensure that the outreach conducted under section 1720F(i) of title 38 , United States Code, includes information regarding the Internet website published under subsection (a).” The Secretary of Veterans Affairs shall establish a pilot program to assist veterans transitioning from serving on active duty and to improve the access of veterans to mental health services. served in the reserve components of the Armed Forces; or are transitioning into communities with an established population of veterans after having recently separated from the Armed Forces. establishes peer support training guidelines; develops a network of veteran peer support counselors to meet the demands of the communities in the Veterans Integrated Service Network; conducts training of veteran peer support counselors; a designated peer support specialist who acts as a liaison to the community oriented veteran peer network; and a certified mental health professional designated as the community oriented veteran peer network mentor; and is readily available to veterans, including pursuant to the Veterans Integrated Service Network cooperating and working with State and local governments and appropriate entities. assists veterans transitioning into communities; establishes a veteran transition advisory group to facilitate outreach activities; includes the participation of appropriate community organizations, State and local governments, colleges and universities, chambers of commerce and other local business organizations, and organizations that provide legal aid or advice; coordinates with the Veterans Integrated Service Network regarding the Veterans Integrated Service Network carrying out an annual mental health summit to assess the status of veteran mental health care in the community and to develop new or innovative means to provide mental health services to veterans; and conducts outreach to individuals transitioning from serving on active duty in the Armed Forces who are participating in the Transition Assistance Program of the Department of Defense or other similar transition programs to inform such individuals of the community oriented veteran peer support network under paragraph (1) and other support programs and opportunities that are available to such individuals. a full description of the peer support model implemented under the pilot program, participation data, and data pertaining to past and current mental health related hospitalizations and fatalities; recommendations on implementing peer support networks throughout the Department; whether the mental health resources made available under the pilot program for members of the reserve components of the Armed Forces is effective; a full description of the activities and effectiveness of community outreach coordinating teams under the pilot program, including partnerships that have been established with appropriate entities; and received outreach from the Department of Veterans Affairs while serving on active duty as a member of the Armed Forces; and participated in a peer support program under the pilot program for veterans transitioning from serving on active duty. Not later than 90 days before the date on which the pilot program terminates under subsection (e), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives an update to the report submitted under paragraph (1). This section may not be construed to authorize the Secretary to hire additional employees of the Department to carry out the pilot program under subsection (a). The authority of the Secretary to carry out the pilot program under subsection (a) shall terminate on the date that is 3 years after the date on which the pilot program commences.” The peer support counseling program carried out by the Secretary of Veterans Affairs under subsection (j) of section 1720F of title 38 , United States Code, as part of the comprehensive program for suicide prevention among veterans under subsection (a) of such section. The peer support counseling program carried out by the Secretary of Veterans Affairs under section 304(a)(1) of the Caregivers and Veterans Omnibus Health Services Act of 2010 ( Public Law 111–163 ; 124 Stat. 1150 ; 38 U.S.C. 1712A note). Any member participating in a peer support counseling program under paragraph (1) shall receive the training for peer counselors under section 1720F(j)(2) of title 38 , United States Code, or section 304(c) of the Caregivers and Veterans Omnibus Health Services Act of 2010, as applicable, before performing peer support counseling duties under such program. Members of the reserve components of the Armed Forces who are demobilizing after deployment in a theater of combat operations, including, in particular, members who participated in combat against the enemy while so deployed. Members of the regular components of the Armed Forces separating from active duty who have been deployed in a theater of combat operations in which such members participated in combat against the enemy.” Not later than December 31, 2013 , the Secretary of Veterans Affairs shall develop and implement a comprehensive set of measures to assess mental health care services furnished by the Department of Veterans Affairs. The timeliness of the furnishing of mental health care by the Department. The satisfaction of patients who receive mental health care services furnished by the Department. The capacity of the Department to furnish mental health care. The availability and furnishing of evidence-based therapies by the Department. Not later than December 31, 2013 , the Secretary shall develop and implement guidelines for the staffing of general and specialty mental health care services, including at community-based outpatient clinics. Such guidelines shall include productivity standards for providers of mental health care. to consult with the Secretary on the Secretary’s development and implementation of the measures and guidelines required by subsections (a) and (b); and to conduct an assessment and provide an analysis and recommendations on the state of Department mental health services. to conduct a comprehensive assessment of barriers to access to mental health care by veterans who served in the Armed Forces in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn; to assess the quality of the mental health care being provided to such veterans (including the extent to which veterans are afforded choices with respect to modes of treatment) through site visits to facilities of the Veterans Health Administration (including at least one site visit in each Veterans Integrated Service Network), evaluating studies of patient outcomes, and other appropriate means; to assess whether, and the extent to which, veterans who served in the Armed Forces in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn are being offered a full range of necessary mental health services at Department health care facilities, including early intervention services for hazardous drinking, relationship problems, and other behaviors that create a risk for the development of a chronic mental health condition; providers of Department mental health services; veterans who served in the Armed Forces in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn who are receiving mental health care furnished by the Department; and eligible veterans who served in the Armed Forces in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn who are not using Department health care services to assess those barriers described in subparagraph (A); and for overcoming barriers, and improving access, to timely, effective mental health care at Department health care facilities (or, where Department facilities cannot provide such care, through contract arrangements under existing law); and to improve the effectiveness and efficiency of mental health services furnished by the Secretary. The Secretary shall ensure that any contract entered into under paragraph (1) provides for inclusion on any subcommittee which participates in conducting the assessments and formulating the recommendations provided for in paragraph (2) at least one former official of the Veterans Health Administration and at least two former employees of the Veterans Health Administration who were providers of mental health care. In entering into the contract described in paragraph (1), the Secretary shall, with respect to paragraph (1)(A), include in such contract a provision for the submittal to the Secretary of periodic reports and provision of other consultation to the Secretary by the study committee to assist the Secretary in carrying out subsections (a) and (b). Not later than 30 days after receiving a report under paragraph (4), 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 plans of the Secretary to implement such recommendations submitted to the Secretary by the study committee as the Secretary considers appropriate. Such report shall include a description of each recommendation submitted to the Secretary that the Secretary does not plan to carry out and an explanation of why the Secretary does not plan to carry out such recommendation. The measures and guidelines developed and implemented under this section. An assessment of the performance of the Department using such measures and guidelines. The Secretary shall update the measures, guidelines, and assessment made available to the public under paragraph (1) not less frequently than quarterly. Not later than June 30, 2013 , and not less frequently than twice each year thereafter, the Secretary shall submit to the committees of Congress specified in subsection (c)(5) a report on the Secretary’s progress in developing and implementing the measures and guidelines required by this section. A description of the development and implementation of the measures required by subsection (a) and the guidelines required by subsection (b). A description of the progress made by the Secretary in developing and implementing such measures and guidelines. An assessment of the mental health care services furnished by the Department, using the measures developed and implemented under subsection (a). An assessment of the effectiveness of the guidelines developed and implemented under subsection (b). Such recommendations for legislative or administrative action as the Secretary may have to improve the effectiveness and efficiency of the mental health care services furnished under laws administered by the Secretary. Not later than 30 days before the date on which the Secretary begins implementing the measures and guidelines required by this section, the Secretary shall submit to the committees of Congress specified in subsection (c)(5) a report on the Secretary’s planned implementation of such measures and guidelines. A detailed description of the measures and guidelines that the Secretary plans to implement under this section. A description of the rationale for each measure and guideline the Secretary plans to implement under this section. A discussion of each measure and guideline that the Secretary considered under this section but chose not to implement. The number of current vacancies in mental health care provider positions in the Department. An assessment of how many additional positions are needed to meet current or expected demand for mental health services furnished by the Department.” Commencing not later than 180 days after the date of the enactment of this Act [ May 5, 2010 ], 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. The participation of a veteran in the pilot program under this section shall be at the election of the veteran. Information on reintegration into the veteran’s family, employment, and community. Financial counseling. Occupational counseling. Information and counseling on stress reduction. Information and counseling on conflict resolution. 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. The Secretary shall carry out the pilot program at not fewer than three locations selected by the Secretary for purposes of the pilot program. The authority to carry out a pilot program under this section shall terminate on September 30, 2022 . Not later than March 31, 2018 , 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. There is authorized to be appropriated to the Secretary of Veterans Affairs for each of fiscal years 2010, 2011, 2015, 2016, 2017, 2018, 2019, 2020, 2021, and 2022, $2,000,000 to carry out the pilot program.” peer outreach services; peer support services; readjustment counseling and services described in section 1712A of title 38 , United States Code; and mental health services; and the readjustment of such veterans to civilian life; in the case such veterans have an injury or illness incurred during such deployment, the recovery of such veterans from such injury or illness; and the readjustment of the family following the return of such veterans. to the extent practicable, to use telehealth services for the delivery of services required by subsection (a); to the extent practicable, to employ veterans trained under subsection (c) in the provision of services covered by that subsection; to participate in the training program conducted in accordance with subsection (d); to comply with applicable protocols of the Department before incurring any liability on behalf of the Department for the provision of services required by subsection (a); for each veteran for whom a community mental health center or other qualified entity provides mental health services under such contract, to provide the Department with such clinical summary information as the Secretary shall require; the number of the veterans served, veterans diagnosed, and courses of treatment provided to veterans as part of the program required by subsection (a); and demographic information for such services, diagnoses, and courses of treatment; and to meet such other requirements as the Secretary shall require. In carrying out the program required by subsection (a), the Secretary shall contract with a national not-for-profit mental health organization to carry out a national program of training for veterans described in subsection (a) to provide the services described in subparagraphs (A) and (B) of paragraph (1) of such subsection. recognizes factors that are unique to the experience of veterans who served on active duty in Operation Enduring Freedom or Operation Iraqi Freedom (including their combat and military training experiences); and uses best practices and technologies. The Secretary shall carry out the services required by subparagraphs (A) and (B) of subsection (a)(1) at each Department medical center. In this section, the term ‘vet center’ means a center for readjustment counseling and related mental health services for veterans under section 1712A of title 38 , United States Code.” Any member of the Armed Forces, including a member of the National Guard or Reserve, who serves on active duty in the Armed Forces in Operation Enduring Freedom or Operation Iraqi Freedom is eligible for readjustment counseling and related mental health services under section 1712A of title 38 , United States Code, through the Readjustment Counseling Service of the Veterans Health Administration. A member of the Armed Forces who meets the requirements for eligibility for counseling and services under subsection (a) is entitled to counseling and services under that subsection regardless of whether or not the member is currently on active duty in the Armed Forces at the time of receipt of counseling and services under that subsection. The eligibility of members of the Armed Forces for counseling and services under subsection (a) shall be subject to such regulations as the Secretary of Defense and the Secretary of Veterans Affairs shall jointly prescribe for purposes of this section. The provision of counseling and services under subsection (a) shall be subject to the availability of appropriations for such purpose.” Peer outreach services. Peer support services provided by licensed providers of peer support services or veterans who have personal experience with mental illness. Readjustment counseling services described in section 1712A of title 38 , United States Code. Other mental health services. Through community mental health centers under contracts or other agreements if entered into by the Secretary of Veterans Affairs and the Secretary of Health and Human Services for the provision of such services for purposes of the pilot program. Through the Indian Health Service, or an Indian tribe or tribal organization that has entered into an agreement with the Indian Health Service pursuant to the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 450 et seq.) [now 25 U.S.C. 5301 et seq.], if a memorandum of understanding is entered into by the Secretary of Veterans Affairs and the Secretary of Health and Human Services for purposes of the pilot program. Through other appropriate entities under contracts or other agreements entered into by the Secretary of Veterans Affairs for the provision of such services for purposes of the pilot program. The pilot program shall be carried out during the three-year period beginning on the date of the commencement of the pilot program. The pilot program shall be carried out within areas selected by the Secretary for the purpose of the pilot program in at least three Veterans Integrated Service Networks (VISNs). The locations selected shall be in rural geographic locations that, as determined by the Secretary, lack access to comprehensive mental health services through the Department of Veterans Affairs. In selecting locations for the pilot program, the Secretary shall select locations in which an adequate number of licensed mental health care providers with credentials equivalent to those of Department mental health care providers are available in Indian Health Service facilities, community mental health centers, and other entities for participation in the pilot program. provide the services described in paragraphs (3) and (4) of subsection (a) to eligible veterans, including, to the extent practicable, telehealth services that link the center or facility with Department of Veterans Affairs clinicians; use the clinical practice guidelines of the Veterans Health Administration or the Department of Defense in the provision of such services; and meet such other requirements as the Secretary shall require. applicable protocols of the Department before incurring any liability on behalf of the Department for the provision of services as part of the pilot program; and access and quality standards of the Department relevant to the provision of services as part of the pilot program. Each community mental health center, facility of the Indian Health Service, or other entity participating in the pilot program under subsection (b) shall, in a timely fashion, provide the Secretary with such clinical information on each veteran for whom such health center or facility provides mental health services under the pilot program as the Secretary shall require. As part of the pilot program, the Secretary shall carry out a program of training for veterans described in subsection (a) to provide the services described in paragraphs (1) and (2) of such subsection. The Secretary shall conduct a training program for clinicians of community mental health centers, Indian Health Service facilities, or other entities participating in the pilot program under subsection (b) to ensure that such clinicians can provide the services described in paragraphs (3) and (4) of subsection (a) in a manner that accounts for factors that are unique to the experiences of veterans who served on active duty in Operation Iraqi Freedom or Operation Enduring Freedom (including their combat and military training experiences). Personnel of each community mental health center, facility of the Indian Health Service, or other entity participating in the pilot program under subsection (b) shall participate in the training program conducted pursuant to subparagraph (A). veterans served; and courses of treatment provided; and demographic information for such services, diagnoses, and courses of treatment. The Secretary shall, through Department of Veterans Affairs Mental Health Services investigators and in collaboration with relevant program offices of the Department, design and implement a strategy for evaluating the pilot program. Access to mental health care by veterans in need of such care. The use of telehealth services by veterans for mental health care needs. The quality of mental health care and substance use disorder treatment services provided to veterans in need of such care and services. The coordination of mental health care and other medical services provided to veterans. The term ‘community mental health center’ has the meaning given such term in section 410.2 of title 42, Code of Federal Regulations (as in effect on the day before the date of the enactment of this Act [ Oct. 10, 2008 ]). is enrolled in the Department of Veterans Affairs health care system; and has received a referral from a health professional of the Veterans Health Administration to a community mental health center, a facility of the Indian Health Service, or other entity for purposes of the pilot program. The term ‘Indian Health Service’ means the organization established by section 601(a) of the Indian Health Care Improvement Act ( 25 U.S.C. 1661(a) ). There is authorized to be appropriated such sums as may be necessary to carry out the provisions of this section.” The Secretary of Veterans Affairs shall, through the Office of Research and Development, carry out a program of research into comorbid post-traumatic stress disorder (PTSD) and substance use disorder. develop protocols and goals with respect to research under the program; and coordinate research, data collection, and data dissemination under the program. Comorbid post-traumatic stress disorder and substance use disorder. The systematic integration of treatment for post-traumatic stress disorder with treatment for substance use disorder. The development of protocols to evaluate care of veterans with comorbid post-traumatic stress disorder and substance use disorder. There is authorized to be appropriated for the Department of Veterans Affairs for each of fiscal years 2009 through 2012, $2,000,000 to carry out this section. Amounts authorized to be appropriated by paragraph (1) shall be made available to the National Center on Posttraumatic Stress Disorder for the purpose specified in that paragraph. Any amount made available to the National Center on Posttraumatic Stress Disorder for a fiscal year under paragraph (2) is in addition to any other amounts made available to the National Center on Posttraumatic Stress Disorder for such year under any other provision of law.” The Secretary of Veterans Affairs shall carry out, through a non-Department of Veterans Affairs entity, a pilot program to assess the feasability [sic] and advisability of providing readjustment and transition assistance described in subsection (b) to veterans and their families in cooperation with centers under section 1712A of title 38 , United States Code (commonly referred to as ‘Vet Centers’). Readjustment and transition assistance that is preemptive, proactive, and principle-centered. Assistance and training for veterans and their families in coping with the challenges associated with making the transition from military to civilian life. The Secretary shall carry out the pilot program through any for-profit or non-profit organization selected by the Secretary for purposes of the pilot program that has demonstrated expertise and experience in the provision of assistance and training described in subsection (b). The Secretary shall carry out the pilot program through a non-Department entity described in paragraph (1) pursuant to a contract or other agreement entered into by the Secretary and the entity for purposes of the pilot program. The pilot program shall commence not later than 180 days after the date of the enactment of this Act [ Oct. 10, 2008 ]. The pilot program shall be carried out during the three-year period beginning on the date of the commencement of the pilot program, and may be carried out for additional one-year periods thereafter. The Secretary shall provide assistance under the pilot program in cooperation with 10 centers described in subsection (a) designated by the Secretary for purposes of the pilot program. In designating centers described in subsection (a) for purposes of the pilot program, the Secretary shall designate centers so as to provide a balanced geographical representation of such centers throughout the United States, including the District of Columbia, the Commonwealth of Puerto Rico, tribal lands, and other territories and possessions of the United States. the facilities and other resources of such center; the non-Department of Veterans Affairs entity selected pursuant to subsection (c); and other appropriate mechanisms. In carrying out the pilot program, the Secretary may enter into contracts or other agreements, in addition to the contract or agreement described in subsection (c), with such other non-Department of Veterans Affairs entities meeting the requirements of subsection (c) as the Secretary considers appropriate for purposes of the pilot program. Not later than three years after the date of the enactment of this Act [ Oct. 10, 2008 ], the Secretary shall submit to the congressional veterans affairs committees a report on the pilot program. A description of the activities under the pilot program as of the date of such report, including the number of veterans and families provided assistance under the pilot program and the scope and nature of the assistance so provided. A current assessment of the effectiveness of the pilot program. Any recommendations that the Secretary considers appropriate for the extension or expansion of the pilot program. the Committees on Veterans’ Affairs and Appropriations of the Senate; and the Committees on Veterans’ Affairs and Appropriations of the House of Representatives. There is authorized to be appropriated for the Department of Veterans Affairs for each of fiscal years 2009 through 2011 $1,000,000 to carry out this section. Amounts authorized to be appropriated by paragraph (1) shall remain available until expended.” The Secretary of Veterans Affairs shall ensure that each community-based outpatient clinic of the Department of Veterans Affairs has the capacity to provide, or monitor the provision of, mental health services to enrolled veterans who, as determined by the Secretary, are in need of such services. a community-based outpatient clinic of the Department by an employee of the Department; referral to another facility of the Department; contract with an appropriate mental health professional in the community; or telemental health services. to enhance the clinical skills of military clinicians on matters relating to post-traumatic stress disorder through training, treatment protocols, web-based interventions, and the development of evidence-based interventions; and to promote pre-deployment resilience and post-deployment readjustment among members of the Armed Forces serving in Operation Iraqi Freedom and Operation Enduring Freedom. There are authorized to be appropriated for the Department of Veterans Affairs for fiscal year 2007 $2,000,000 to carry out this subsection. develop additional educational materials on post-traumatic stress disorder; and undertake additional efforts to educate veterans about post-traumatic stress disorder. review the clinical guidelines of the Department of Veterans Affairs on post-traumatic stress disorder and all appropriate protocols related to post-traumatic stress disorder; revise such guidelines and protocols as the Secretary considers appropriate to ensure that clinicians are able to effectively distinguish between diagnoses with similar symptoms that may manifest as post-traumatic stress disorder, including traumatic brain injury; and develop performance measures for the treatment of post-traumatic stress disorder among veterans.” The Secretary of Veterans Affairs shall increase the number of facilities of the Readjustment Counseling Service that are capable of providing health services and counseling through telehealth linkages with facilities of the Veterans Health Administration. Not later than July 1, 2007 , 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 plan to implement the requirement in subsection (a). The plan shall specify which facilities of the Readjustment Counseling Service will have the capabilities described in subsection (a) as of the end of each of fiscal years 2007, 2008, and 2009.” The Secretary of Veterans Affairs shall employ not fewer than 100 veterans for the purpose of providing outreach to veterans on the availability of readjustment counseling and related mental health services for veterans under section 1712A of title 38 , United States Code. The veterans employed under subsection (a) are in addition to any veterans employed by the Secretary for the purpose described in that subsection under the February 2004 program of the Department of Veterans Affairs to provide outreach described in that subsection. The Secretary may assign any veteran employed under subsection (a) to any center for the provision of readjustment counseling and related mental health services under section 1712A of title 38 , United States Code, that the Secretary considers appropriate in order to meet the purpose described in that subsection. Any limitation on the duration of employment of veterans under the program described in subsection (b) is hereby terminated and shall not apply to veterans employed under such program or under this section. Veterans employed under subsection (a) shall be employed in career conditional status, which is the employment status in which veterans are employed under the program described in subsection (b).” Not later than 10 months after the date of the enactment of this Act [ Nov. 1, 2000 ], the Secretary of Veterans Affairs shall enter into a contract with an appropriate entity to carry out a study on post-traumatic stress disorder. The contract under subsection (a) shall provide for a follow-up study to the study conducted in accordance with section 102 of the Veterans Health Care Amendments of 1983 ( Public Law 98–160 ) [set out as a note below]. Such follow-up study shall use the data base and sample of the previous study. the long-term course of post-traumatic stress disorder; any long-term medical consequences of post-traumatic stress disorder; whether particular subgroups of veterans are at greater risk of chronic or more severe problems with such disorder; and the services used by veterans who have post-traumatic stress disorder and the effect of those services on the course of the disorder. The Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the results of the study under this section. The report shall be submitted no later than October 1, 2004 .” The Secretary [of Veterans Affairs], in furtherance of the responsibilities of the Secretary under section 1706(b) of title 38 , United States Code, shall carry out a program to expand and improve the provision of specialized mental health services to veterans. The Secretary shall establish the program in consultation with the Committee on Care of Severely Chronically Mentally Ill Veterans established pursuant to section 7321 of title 38 , United States Code. the treatment of post-traumatic stress disorder; and substance use disorders. In carrying out the program described in subsection (a), the Secretary shall identify, from funds available to the Department [of Veterans Affairs] for medical care, an amount of not less than $25,000,000 in each of fiscal years 2004, 2005, and 2006 to be available to carry out the program and to be allocated to facilities of the Department pursuant to subsection (d). In identifying available amounts pursuant to paragraph (1), the Secretary shall ensure that, after the allocation of those funds under subsection (d), the total expenditure for programs relating to (A) the treatment of post-traumatic stress disorder, and (B) substance use disorders is not less than $25,000,000 in excess of the baseline amount. For purposes of paragraph (2), the baseline amount is the amount of the total expenditures on such programs for the most recent fiscal year for which final expenditure amounts are known, adjusted to reflect any subsequent increase in applicable costs to deliver such services in the Veterans Health Administration, as determined by the Committee on Care of Severely Chronically Mentally Ill Veterans. For purposes of this paragraph, in fiscal years 2004, 2005, and 2006, the fiscal year used to determine the baseline amount shall be fiscal year 2003. In each of fiscal years 2004, 2005, and 2006, the Secretary shall allocate funds identified pursuant to subsection (c)(1) to individual medical facilities of the Department as the Secretary determines appropriate based upon proposals submitted by those facilities for the use of those funds for improvements to specialized mental health services. not less than $10,000,000 is allocated by direct grants to programs that are identified by the Mental Health Strategic Health Care Group and the Committee on Care of Severely Chronically Mentally Ill Veterans; not less than $5,000,000 is allocated for programs on post-traumatic stress disorder; and not less than $5,000,000 is allocated for programs on substance use disorder. The Secretary shall provide that the funds to be allocated under this section during each of fiscal years 2004, 2005, and 2006 are funds for a special purpose program for which funds are not allocated through the Veterans Equitable Resource Allocation system. Not later than 12 months after the date of the enactment of this Act [ Nov. 30, 1999 ], the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report describing the implementation of this section. The Secretary shall include in the report information on the allocation of funds to facilities of the Department under the program and a description of the improvements made with those funds to specialized mental health services for veterans.” Subject to the availability of funds appropriated pursuant to the authorization in subsection (g), the Secretary shall conduct a program to furnish to the persons referred to in subsection (b) the marriage and family counseling services referred to in subsection (c). The authority to conduct the program shall expire on September 30, 1994 . veterans who were awarded a campaign medal for active-duty service during the Persian Gulf War and the spouses and children of such veterans; and veterans who are or were members of the reserve components who were called or ordered to active duty during the Persian Gulf War and the spouses and children of such members. Under the program, the Secretary may provide marriage and family counseling that the Secretary determines, based on an assessment by a mental-health professional employed by the Department and designated by the Secretary (or, in an area where no such professional is available, a mental-health professional designated by the Secretary and performing services under a contract or fee arrangement with the Secretary), is necessary for the amelioration of psychological, marital, or familial difficulties that result from the active duty service referred to in subsection (b)(1) or (2). by personnel of the Department of Veterans Affairs who are qualified to provide such counseling services; by appropriately certified marriage and family counselors employed by the Department; and by qualified mental health professionals pursuant to contracts with the Department, when Department facilities are not capable of furnishing economical medical services because of geographical inaccessibility or are not capable of furnishing the services required. The Secretary shall establish the qualifications required of personnel under subparagraphs (A) and (C) of paragraph (1) and shall prescribe the training, experience, and certification required of appropriately certified marriage and family counselors under subparagraph (B) of such paragraph. The Secretary may employ licensed or certified marriage and family counselors to provide counseling under paragraph (1)(B) and may classify the positions in which they are employed at levels determined appropriate by the Secretary, taking into consideration the training, experience, and licensure or certification required of such counselors. For a period of not more than 15 days beginning on the date of the commencement of the furnishing of such services to the person. the mental health professional submits to the Secretary a treatment plan with respect to the person not later than 15 days after such date; and the treatment plan and the assessment made under subsection (c) are approved by an appropriate mental health professional of the Department designated for that purpose by the Under Secretary for Health. not more than 30 days before the expiration of the 90-day period referred to in subparagraph (B) (or any subsequent 90-day period), the mental health professional submits to the Secretary a revised treatment plan containing a justification of the need of the person for additional counseling services; and the plan is approved in accordance with the provisions of subparagraph (B)(ii). A mental health professional referred to in paragraph (1) who assesses the need of any person for services for the purposes of subsection (c) may not furnish counseling services to that person. The Secretary may waive the prohibition referred to in subparagraph (A) for locations (as determined by the Secretary) in which the Secretary is unable to obtain the assessment referred to in that subparagraph from a mental health professional other than the mental health professional with whom the Secretary enters into contracts under subsection (d)(1)(C) for the furnishing of counseling services. The Secretary shall reimburse mental health professionals for the reasonable cost (as determined by the Secretary) of furnishing counseling services under paragraph (1). In the event of the disapproval of a treatment plan of a person submitted by a mental health professional under paragraph (1)(B)(i), the Secretary shall reimburse the mental health professional for the reasonable cost (as so determined) of furnishing counseling services to the person for the period beginning on the date of the commencement of such services and ending on the date of the disapproval. The Secretary may authorize the furnishing of counseling in an individual case for a period shorter than the 90-day period specified in subparagraph (B) or (C) of paragraph (1) and, upon further consideration, extend the shorter period to the full 90 days. an assessment by the mental health professional submitting the plan of the counseling needs of the person described in the plan on the date of the submittal of the plan; and a description of the counseling services to be furnished to the person by the mental health professional during the 90-day period covered by the plan, including the number of counseling sessions proposed as part of such services. The Secretary shall prescribe an appropriate form for the treatment plan. For the purposes of section 1729 of title 38 , United States Code, marriage and family counseling services furnished under the program shall be deemed to be care and services furnished by the Department under chapter 17 of such title, and the United States shall be entitled to recover or collect the reasonable cost of such services in accordance with that section. There is authorized to be appropriated $10,000,000 for each of fiscal years 1993 and 1994 to carry out this section. the number of such persons, stated as a total number and separately for each eligibility status referred to in subsection (b); the age and gender of such persons; the manner in which such persons were furnished such services under the program; and the number of counseling sessions furnished to such persons. For the purposes of this section, the terms ‘veteran’, ‘child’, ‘active duty’, ‘reserve component’, ‘spouse’, and ‘Persian Gulf War’ have the meanings given such terms in paragraphs 101(2), (4), (21), (27), (31), and (33) of section 101 of title 38 , United States Code, respectively.” to ensure, to the maximum extent practicable, that veterans suffering from post-traumatic stress disorder related to active duty are provided appropriate treatment and rehabilitative services for that condition in a timely manner; to expand and improve the services available for veterans suffering from post-traumatic stress disorder related to active duty; to eliminate waiting lists for inpatient treatment and other modes of treatment for post-traumatic stress disorder; to enhance outreach activities carried out to inform combat-area veterans of the availability of treatment for post-traumatic stress disorder; and to ensure, to the extent practicable, that there are Department post-traumatic stress disorder treatment units in locations that are readily accessible to veterans residing in rural areas of the United States. the numbers of veterans suffering from post-traumatic stress disorder related to active duty, as indicated by relevant studies, scientific and clinical reports, and other pertinent information; the numbers of veterans who would likely seek post-traumatic stress disorder treatment from the Department if waiting times for treatment were eliminated and outreach activities to combat-area veterans with post-traumatic stress disorder were enhanced; the current and projected capacity of the Department to provide appropriate treatment and rehabilitative services for post-traumatic stress disorder; the level and geographic accessibility of inpatient and outpatient care available through the Department for veterans suffering from post-traumatic stress disorder across the United States; the desirability of providing that inpatient and outpatient post-traumatic stress disorder care be furnished in facilities of the Department that are physically independent of general psychiatric wards of the medical facilities of the Department; the treatment needs of veterans suffering from post-traumatic stress disorder who are women, of such veterans who are ethnic minorities (including Native Americans, Native Hawaiians, Asian-Pacific Islanders, and Native Alaskans), and of such veterans who suffer from substance abuse problems in addition to post-traumatic stress disorder; and the recommendations of the Special Committee on Post-Traumatic-Stress Disorder with respect to (A) specialized inpatient and outpatient programs of the Department for the treatment of post-traumatic stress disorder, and (B) with respect to the establishment of educational programs that are designed for each of the various levels of education, training, and experience of the various mental health professionals involved in the treatment of veterans suffering from post-traumatic stress disorder. Not later than six months after the date of the enactment of this Act [ Oct. 9, 1992 ], the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the plan developed pursuant to subsection (a). The report shall include specific information relating to the consideration given to the matters described in subsection (b). The term ‘active duty’ has the meaning given that term in section 101(21) of title 38 , United States Code. The term ‘veteran’ has the meaning given that term in section 101(2) of such title. The term ‘combat-area veteran’ means a veteran who served on active duty in an area at a time during which hostilities (as defined in [former] section 1712A(a)(2)(B) of such title) occurred in such area.” The Under Secretary for Health of the Department of Veterans Affairs may designate special programs within the Veterans Health Administration for the diagnosis and treatment of post-traumatic-stress disorder (hereinafter in this section referred to as ‘PTSD’). The Under Secretary for Health shall direct (A) that (in addition to providing diagnostic and treatment services for PTSD) Department programs designated under paragraph (1) (hereinafter in this section referred to as ‘designated PTSD programs’) carry out activities to promote the education and training of health-care personnel (including health-care personnel not working for the Department or the Federal Government) in the causes, diagnosis, and treatment of PTSD, and (B) that (when appropriate) the provision of treatment services under such program be coordinated with the provision of readjustment counseling services under section 1712A of title 38 , United States Code. The Under Secretary for Health shall establish in the Veterans Health Administration a Special Committee on Post-Traumatic-Stress Disorder (hereinafter in this section referred to as the ‘Special Committee’). The Under Secretary for Health shall appoint qualified employees of the Veterans Health Administration to serve on the Special Committee. The Special Committee shall assess, and carry out a continuing assessment of, the capacity of the Department to provide diagnostic and treatment services for PTSD to veterans eligible for health care furnished by the Department. The Special Committee shall also advise the Under Secretary for Health regarding the development of policies, the provision of guidance, and the coordination of services for the diagnosis and treatment of PTSD (A) in designated PTSD programs, (B) in inpatient psychiatric programs and outpatient mental health programs other than designated PTSD programs, and (C) in readjustment counseling programs of the Department. appropriate diagnostic and treatment methods; referral for and coordination of followup care; the evaluation of PTSD treatment programs; the conduct of research concerning such diagnosis and treatment (taking into account the provisions of subsection (c)); special programs of education and training for employees of the Veterans Health Administration and the Veterans Benefits Administration (also taking into account such provisions); the appropriate allocation of resources for all such activities; and any specific steps that should be taken to improve such diagnosis and treatment and to correct any deficiencies in the operations of designated PTSD programs. The Under Secretary for Health shall establish and operate in the Veterans Health Administration a National Center on Post-Traumatic-Stress Disorder. The National Center (1) shall carry out and promote the training of health care and related personnel in, and research into, the causes and diagnosis of PTSD and the treatment of veterans for PTSD, and (2) shall serve as a resource center for, and promote and seek to coordinate the exchange of information regarding, all research and training activities carried out by the Department, and by other Federal and non-Federal entities, with respect to PTSD. The Under Secretary for Health shall regularly compile and publish the results of research that has been conducted relating to PTSD. A list of the members of the Special Committee. A list of all designated PTSD programs and other programs providing treatment for PTSD, together with a description of the resources that have been allocated for the development and operation of each such program, a description of the education and training that has been provided for Department health-care personnel in such programs and elsewhere within the Department in the diagnosis and treatment of PTSD, and specification of the funding that has been allocated to each such program and elsewhere within the Department to support research relating to PTSD. The assessment of the Under Secretary for Health of the Department, after consultation with the Special Committee, regarding the capability of the Department to meet the needs for inpatient and outpatient PTSD diagnosis and treatment (both through designated PTSD programs and otherwise) of veterans who served in the Republic of Vietnam during the Vietnam era, former prisoners of war, and other veterans eligible for health care from the Department and the efficacy of the treatment so provided, as well as a description of the results of any evaluations that have been made of PTSD treatment programs. The plans of the Special Committee for further assessments of the capability of the Department to diagnose and treat veterans with PTSD. The recommendations made by the Special Committee to the Under Secretary for Health and the views of the Under Secretary for Health on such recommendations. A summary of the results of research conducted by the Department relating to PTSD. A description of the steps taken, plans made (and a timetable for their execution), and resources to be applied to implement subsections (b) and (c). The assessment of the Administrator [now Secretary] of the capacity of the Department to meet in all geographic areas of the United States the needs described in subparagraph (C) and any plans and timetable for increasing that capacity (including the costs of such action). Not later than February 1, 2001 , and May 1 of each year through 2016, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report containing information updating the reports submitted under this subsection since the enactment of the Veterans’ Millennium Health Care and Benefits Act [ Nov. 30, 1999 ].”