(a) The Secretary, in consultation with the Secretary of Labor and the Director of the Office of Personnel Management, may take appropriate steps to (1) urge all Federal agencies and appropriate private and public firms, organizations, agencies, and persons to provide appropriate employment and training opportunities for veterans who have been provided treatment and rehabilitative services under this title for alcohol or drug dependence or abuse disabilities and have been determined by competent medical authority to be sufficiently rehabilitated to be employable, and (2) provide all possible assistance to the Secretary of Labor in placing such veterans in such opportunities.
(b) Upon receipt of an application for treatment and rehabilitative services under this title for an alcohol or drug dependence or abuse disability from any individual who has been discharged or released from active military, naval, or air service but who is not eligible for such treatment and services, the Secretary shall-
(1) provide referral services to assist such individual, to the maximum extent practicable, in obtaining treatment and rehabilitative services from sources outside the Department; and
(2) if pertinent, advise such individual of such individual's rights to apply to the appropriate military, naval, or air service and the Department for review of such individual's discharge or release from such service.
(c)(1) Any person serving in the active military, naval, or air service who is determined by the Secretary concerned to have an alcohol or drug dependence or abuse disability may be transferred to any facility in order for the Secretary to furnish care or treatment and rehabilitative services for such disability. Care and services provided to a member so transferred shall be provided as if such member were a veteran. Any transfer of any such member for such care and services shall be made pursuant to such terms as may be agreed upon by the Secretary concerned and the Secretary, subject to the provisions of sections 1535 and 1536 of title 31.
(2) No person serving in the active military, naval, or air service may be transferred pursuant to an agreement made under paragraph (1) of this subsection unless such person requests such transfer in writing for a specified period of time. No such person transferred pursuant to such a request may be furnished such care and services by the Secretary beyond the period of time specified in such request unless such person requests in writing an extension for a further specified period of time and such request is approved by the Secretary.
(d)(1) The Secretary shall ensure that each medical center of the Department develops and carries out a plan to provide treatment for substance use disorders, either through referral or direct provision of services, to veterans who require such treatment.
(2) Each plan under paragraph (1) shall make available clinically proven substance abuse treatment methods, including opioid substitution therapy, to veterans with respect to whom a qualified medical professional has determined such treatment methods to be appropriate.
(Added
2001-Subsec. (d).
2000-Subsec. (c)(1).
1999-Subsec. (c)(1).
Subsec. (c)(2).
1997-
Subsecs. (a) to (d).
"(a)(1) The Secretary, in furnishing hospital, nursing home, and domiciliary care and medical and rehabilitative services under this chapter, may contract for care and treatment and rehabilitative services in halfway houses, therapeutic communities, psychiatric residential treatment centers, and other community-based treatment facilities for eligible veterans suffering from alcohol or drug dependence or abuse disabilities.
"(2) Before furnishing such care and services to any veteran through a contract facility as authorized by paragraph (1) of 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 such veteran is to be furnished such care and services."
Subsecs. (e) to (g).
"(e) The Secretary may not furnish care and treatment and rehabilitative services under subsection (a) of this section after December 31, 1997.
"(f)(1) During the period beginning on December 1, 1988, and ending on October 1, 1997, the Secretary shall conduct an ongoing clinical evaluation in order to determine the long-term results of drug and alcohol abuse treatment furnished to veterans in contract residential treatment facilities under this section.
"(2) The evaluation shall include an assessment of the following:
"(A) The long-term results of treatment referred to in paragraph (1) of this subsection on drug and alcohol use by veterans who may have received such treatment.
"(B) The need for hospitalization of such veterans for drug and alcohol abuse after completion of the residential treatment.
"(C) The employment status and income of such veterans.
"(D) The extent of any criminal activity of such veterans.
"(E) Whether certain models and methods of residential treatment for drug and alcohol abuse are more successful for veterans with specific abuses, specific levels of resources available to them, and specific needs than are other models and methods.
"(3) To the extent feasible, the Secretary shall select for consideration in the evaluation veterans whose treatment for drug and alcohol abuse in contract residential treatment facilities under such section represents a variety of models and methods of residential drug and alcohol abuse treatment.
"(4) The Secretary shall submit to the Committees on Veterans' Affairs of the Senate and House of Representatives the following reports on the evaluation under this subsection:
"(A) Not later than February 1, 1993, an interim report containing information obtained during the first four years of the evaluation and any conclusions that the Secretary has drawn on the basis of that information.
"(B) Not later than March 31, 1998, a final report containing information obtained during the evaluation and the determinations and conclusions of the Secretary based on that information.
"(g) The authority of the Secretary to enter into contracts under this section shall be effective for any fiscal year only to such extent or in such amounts as are provided in appropriation Acts."
1996-Subsec. (e).
1994-Subsec. (e).
1991-
Subsecs. (a), (b).
Subsec. (c).
Subsec. (d).
Subsec. (e).
Subsec. (f).
Subsec. (g).
1988-Subsec. (e).
Subsec. (f).
"(1) The Administrator shall monitor the performance of each contract facility furnishing care and services under the program carried out under subsection (a) of this section.
"(2) The Administrator shall use the results of such monitoring to determine-
"(A) with respect to the program, the medical advantages and cost-effectiveness that result from furnishing such care and services; and
"(B) with respect to such contract facilities generally, the level of success under the program, considering-
"(i) the rate of successful rehabilitation for veterans furnished care and services under the program;
"(ii) the rate of readmission to contract facilities under the program or to Veterans' Administration health-care facilities by such veterans for care or services for disabilities referred to in subsection (a) of this section;
"(iii) whether the care and services furnished under the program obviated the need of such veterans for hospitalization for such disabilities;
"(iv) the average duration of the care and services furnished such veterans under the program;
"(v) the ability of the program to aid in the transition of such veterans back into their communities; and
"(vi) any other factor that the Administrator considers appropriate.
"(3) The Administrator shall maintain records of-
"(A) the total cost for the care and services furnished by each contract facility under the program;
"(B) the average cost per veteran for the care and services furnished under the program; and
"(C) the appropriateness of such costs, by comparison to-
"(i) the average charges for the same types of care and services furnished generally by other comparable halfway houses, therapeutic communities, psychiatric residential treatment centers, and other community-based treatment facilities; and
"(ii) the historical costs for such care and services for the period of time that the program carried out under subsection (a) of this section was a pilot program, taking into account economic inflation.
"(4) Not later than February 1, 1988, the Administrator shall submit to the Committees on Veterans' Affairs of the Senate and House of Representatives a report on the experience under the program carried out under this section during fiscal years 1984 through 1987. The report shall include-
"(A) a description of the care and services furnished;
"(B) the matters referred to in paragraphs (1), (2), and (3) of this subsection; and
"(C) the Administrator's findings, assessment, and recommendations regarding the program under this section."
Subsec. (f)(1).
1985-
Subsec. (a)(1).
Subsec. (e).
Subsec. (f).
1982-Subsec. (d)(1).
Subsec. (f).
1979-Subsec. (a)(1).
Subsec. (d)(2).
Amendment by
Section effective Oct. 1, 1979, see section 107 of
"Congress makes the following findings:
"(1) More than 1,500,000 members of the Armed Forces have been deployed in Operation Iraqi Freedom and Operation Enduring Freedom. The 2005 Department of Defense Survey of Health Related Behaviors Among Active Duty Personnel reports that 23 percent of members of the Armed Forces on active duty acknowledge a significant problem with alcohol use disorder, with similar rates of acknowledged problems with alcohol use disorder among members of the National Guard.
"(2) The effects of substance use disorder are wide ranging, including significantly increased risk of suicide, exacerbation of mental and physical health disorders, breakdown of family support, and increased risk of unemployment and homelessness.
"(3) While veterans suffering from mental health conditions, chronic physical illness, and polytrauma may be at increased risk for development of a substance use disorder, treatment for these veterans is complicated by the need to address adequately the physical and mental symptoms associated with these conditions through appropriate medical intervention.
"(4) While the Veterans Health Administration has dramatically increased health services for veterans from 1996 through 2006, the number of veterans receiving specialized substance use disorder treatment services decreased 18 percent during that time. No comparable decrease in the national rate of substance use disorder has been observed during that time.
"(5) While some facilities of the Veterans Health Administration provide exemplary substance use disorder treatment services, the availability of such treatment services throughout the health care system of the Veterans Health Administration is inconsistent.
"(6) According to a 2006 report by the Government Accountability Office, the Department of Veterans Affairs significantly reduced its substance use disorder treatment and rehabilitation services between 1996 and 2006, and the Fiscal Year 2007 National Mental Health Program Monitoring System report shows that little progress has been made in restoring these services to their pre-1996 levels.
"(a)
"(1) Screening for substance use disorder in all settings, including primary care settings.
"(2) Short term motivational counseling services.
"(3) Marital and family counseling.
"(4) Intensive outpatient or residential care services.
"(5) Relapse prevention services.
"(6) Ongoing aftercare and outpatient counseling services.
"(7) Opiate substitution therapy services.
"(8) Pharmacological treatments aimed at reducing craving for drugs and alcohol.
"(9) Detoxification and stabilization services.
"(10) Coordination with groups providing peer to peer counseling.
"(11) Such other services as the Secretary considers appropriate.
"(b)
"(1)
"(2)
"(A) at Department of Veterans Affairs medical centers or clinics;
"(B) by referral to other facilities of the Department that are accessible to such veteran; or
"(C) by contract or fee-for-service payments with community-based organizations for the provision of such services and treatments.
"(c)
"(a)
"(1) through a service provided by a clinician or health professional who has training and expertise in treatment of substance use disorders and mental health disorders;
"(2) by separate substance use disorder and mental health disorder treatment services when there is appropriate coordination, collaboration, and care management between such treatment services; or
"(3) by a team of clinicians with appropriate expertise.
"(b)
"(1) Clinicians and health professionals with expertise in treatment of substance use disorders and mental health disorders who act in coordination and collaboration with each other.
"(2) Such other professionals as the Secretary considers appropriate for the provision of treatment to veterans for substance use and mental health disorders.
"(a)
"(1) Stigma associated with seeking treatment for mental health disorders has been demonstrated to prevent some veterans from seeking such treatment at a medical facility operated by the Department of Defense or the Department of Veterans Affairs.
"(2) There is a significant incidence among veterans of post-deployment mental health problems, especially among members of a reserve component who return as veterans to civilian life.
"(3) Computer-based self-guided training has been demonstrated to be an effective strategy for supplementing the care of psychological conditions.
"(4) Younger veterans, especially those who served in Operation Enduring Freedom or Operation Iraqi Freedom, are comfortable with and proficient at computer-based technology.
"(5) Veterans living in rural areas may find access to treatment for substance use disorder limited.
"(6) Self-assessment and treatment options for substance use disorders through an Internet website may reduce stigma and provides additional access for individuals seeking care and treatment for such disorders.
"(b)
"(c)
"(1)
"(A) access to the Internet website and the programs available on the website by a veteran (or family member) does not involuntarily generate an identifiable medical record of that access by that veteran in any medical database maintained by the Department of Veterans Affairs;
"(B) the Internet website is accessible from remote locations, especially rural areas; and
"(C) the Internet website includes a self-assessment tool for substance use disorders, self-guided treatment and educational materials for such disorders, and appropriate information and materials for family members of veterans.
"(2)
"(3)
"(4)
"(d)
"(e)
"(f)
Any action taken by Secretary of Veterans Affairs before Feb. 13, 1996, under provision of law amended by title I of
"(1) The alcohol and drug abuse contract care program under section 1720A of title 38, United States Code.
"(2) The program to provide community-based residential care to homeless chronically mentally ill veterans under section 115 of the Veterans' Benefits and Services Act of 1988 [
"(3) The demonstration program under section 7 of
"(a)
"(b)
"(1) each loan is repaid within two years after the date on which the loan is made;
"(2) each loan is repaid through monthly installments and that a reasonable penalty is assessed for each failure to pay an installment by the date specified in the loan agreement involved; and
"(3) each loan is made only to a nonprofit private entity which agrees that, in the operation of each residence established with the assistance of the loan-
"(A) the use of alcohol or any illegal drug in the residence will be prohibited;
"(B) any resident who violates the prohibition in subclause (A) of this clause will be expelled from the residence;
"(C) the costs of maintaining the residence, including fees for rent and utilities, will be paid by the residents;
"(D) the residents will, through a majority vote of the residents, otherwise establish policies governing the conditions of residence, including the manner in which applications for residence are approved; and
"(E) the residence will be operated solely as a residence for not less than six veterans.
"(c)
"(d)
"(e)
"(1) The default rate on loans extended under this section.
"(2) The manner in which loan payments are collected.
"(3) The number of facilities at which loans have been extended.
"(4) The adequacy of the amount of funds in the special account referred to in subsection (c)."