Sec. 2
Department of Veterans Affairs pilot program on dog training therapy
(a)
added
In general— Not later than 180 days after the date of the enactment of the Act, the Secretary of Veterans Affairs shall commence the conduct of a pilot program to provide canine training to eligible veterans diagnosed with post-traumatic stress disorder (in this section referred to as “PTSD”) as an element of a complementary and integrative health program for such veterans.
(b)
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Duration; medical centers—
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Congress makes the following findings:
(1)
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According to the analyses of veteran suicide published by the Department of Veterans Affairs in August 2016 and titled “Suicide Among Veterans and Other Americans”, and in June 2018, titled “VA National Suicide Date Report”—
(1)
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Duration— an average The Secretary shall carry out the pilot program under subsection (a) for a five-year period beginning on the date of 20 veterans died by suicide each day in 2014;the commencement of the pilot program.
(2)
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Medical centers— mental health disorders, including major depression and other mood disorders, have been associated with increased risk for suicide;The Secretary shall ensure that such pilot program is carried out by not fewer than five medical centers of the Department of Veterans Affairs located in geographically diverse areas.
(C)
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since 2001, the proportion of users of the Veterans Health Administration with mental health conditions or substance use disorders has increased from approximately 27 percent in 2001 to more than 40 percent in 2014; and
(D)
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overall, suicide rates are highest among patients with mental health and substance use disorder diagnoses who are in treatment and lower among those who received a mental health diagnosis but were not at risk enough to require enhanced care from a mental health provider.
(c)
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Agreements with entities— The Department of Veterans Affairs must be more effective in its approach to reducing In carrying out the burden of veteran suicide connected to mental health disorders, including post-traumatic stress disorder (in this section referred to as “PTSD”), and new, rigorous scientific research provides persuasive weight to pilot program under subsection (a), the growing anecdotal evidence Secretary shall seek to enter into agreements with nongovernmental entities that service dogs ameliorate the symptoms associated with PTSD, and Secretary determines have the demonstrated ability to provide the canine training specified in particular, help prevent veteran suicide.subsection (a).
(d)
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Required conditions— Several organizations have proven track records of training service dogs for veterans with severe PTSD and dramatically improving those veterans’ quality of life, ability The Secretary shall include in any agreement under subsection (c) conditions requiring that the nongovernmental entity seeking to re-enter society, and, most importantly, their chances of survival.enter into the agreement—
(1)
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submits to the Secretary certification that the entity is an accredited service dog training organization;
(2)
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agrees to ensure that veterans participating in the pilot program under subsection (a) receive training from certified service dog training instructors for a period of time determined appropriate by the entity;
(3)
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agrees to ensure that veterans participating in such pilot program are prohibited from having access to a dog under such pilot program at any time during such participation without the supervision of a certified service dog training instructor;
(4)
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agrees to ensure that veterans participating in such pilot program receive training in skills unique to the needs of the veteran to address or alleviate PTSD symptoms of the veteran;
(5)
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agrees not to use shock collars or prong collars as training tools and to use positive reinforcement training; and
(6)
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agrees to provide any follow-up training support specified in subsection (e)(2), as applicable.
(e)
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Adoption of dog—
(1)
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In general— A veteran who has participated in the pilot program under subsection (a) may adopt a dog that the veteran assisted in training during such pilot program if the veteran and the veteran’s health provider (in consultation with the entity that provided the canine training with respect to the dog under such pilot program) determine that it is in the best interest of the veteran.
(2)
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Follow-up training support— If a veteran adopts a dog under paragraph (1), the entity that provided the canine training with respect to the dog under the pilot program shall provide follow-up training support for the life of the dog. Such support shall include the provision of a contact plan between the veteran and the entity that enables the veteran to seek and receive assistance from the entity to ensure the dog is being properly cared for.
(f)
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Eligibility for other care and treatment— Participation in the pilot program under subsection (a) may not preclude a veteran from receiving any other medical care or treatment for PTSD furnished by the Department, including therapy, for which the veteran is otherwise eligible.
(g)
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Collection of data— In carrying out this section, the Secretary shall—
(1)
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develop metrics and other appropriate means to measure, with respect to veterans participating in the pilot program under subsection (a)—
(A)
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the number of such veterans participating;
(B)
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the satisfaction of such veterans with the pilot program;
(C)
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whether participation in the pilot program resulted in any clinically relevant improvements for such veterans, as determined by the health care provider or clinical team that referred the veteran to participate in the pilot program; and
(D)
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such other factors as the Secretary may determine appropriate; and
(2)
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establish processes to document and track the progress of such veterans under the pilot program with respect to health benefits and improvements.
(h)
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Report by secretary— Not later than one year before the date on which the pilot program under subsection (a) terminates, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report containing the recommendations of the Secretary regarding—
(1)
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whether to extend or make permanent the pilot program; and
(2)
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the feasibility and advisability of expanding the pilot program to address mental health conditions other than PTSD.
(i)
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GAO briefing and study—
(1)
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Briefing— Not later than one year after the date of the commencement of the pilot program under subsection (a), the Comptroller General of the United States shall provide to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a briefing on the methodology established for the pilot program.
(2)
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Report— Not later than 270 days after the date on which the pilot program terminates, the Comptroller General shall submit to the committees specified in paragraph (1) a report on the pilot program. Such report shall include an evaluation of the approach and methodology used for the pilot program with respect to—
(A)
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assisting veterans with PTSD; and
(B)
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measuring relevant metrics, such as reduction in scores under the Clinician Administered PTSD Scale (CAPS), improvement in psychosocial function, and therapeutic compliance.
(j)
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Definitions— In this section:
(1)
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The term “accredited service dog training organization” means an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 that—
(A)
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provides service dogs to veterans with PTSD; and
(B)
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is accredited by an accrediting organization with demonstrated experience, national scope, and recognized leadership and expertise in the training of service dogs and education in the use of service dogs (as determined by the Secretary).
(2)
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The term “eligible veteran” means a veteran who—
(A)
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is enrolled in the patient enrollment system in the Department of Veterans Affairs under section 1705 of title 38, United States Code; and
(B)
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has been recommended for participation in the pilot program under subsection (a) by a qualified mental health care provider or clinical team based on medical judgment that the veteran may benefit from such participation with respect to the diagnosed PTSD of the veteran.
(3)
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The term “service dog training instructor” means an instructor who provides the direct training of veterans with PTSD in the art and science of service dog training and handling.
Sec. 3
Provision of service dogs and veterinary insurance benefits to veterans with post-traumatic stress disorder who do not have certain impairments
(a)
changed
In general— Commencing not later than 120 days after the date of the enactment of the Act, the Secretary Section 1714 of Veterans Affairs shall carry out a pilot program under which the Secretary shall make grants to one or more appropriate non-government entities for title 38, United States Code, is amended by adding at the purpose of assessing end the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder (in this section referred to as “PTSD”) symptoms through a therapeutic medium of training service dogs for veterans with disabilities.following new subsections:
added
“(e) The Secretary may provide a service dog to a veteran under subsection (c)(3) regardless of whether the veteran has a mobility impairment.
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“(f)
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“(1) The Secretary shall provide to any veteran described in paragraph (2) a commercially available veterinary insurance policy for each dog provided to such veteran under subsection (b) or (c).
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“(2) A veteran described in this paragraph is a veteran who—
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“(A) is diagnosed with post-traumatic stress disorder or a visual, hearing, or substantial mobility impairment;
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“(B) has received a dog under subsection (b) or (c) in connection with such disorder or impairment; and
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“(C) meets such other requirements as the Secretary may prescribe.”
(b)
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Duration of pilot program—Applicability— The pilot program required Section 1714(f) of title 38, United States Code, as added by subsection (a) (a), shall be carried out during apply with respect to a veteran provided a dog by the five-year period beginning on Secretary of Veterans Affairs regardless of whether the provision occurs before, on, or after the date of the commencement enactment of the pilot program.this Act.
(c)
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Conditions on receipt of grants— As a condition of receiving a grant under this section, a non-government entity shall—
(1)
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submit to the Secretary certification that the entity is an organization described in section 501(c)(3) of the Internal Revenue Code of 1986 that—
(A)
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provides service dogs to veterans with PTSD; and
(B)
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is accredited by, or adheres to standards comparable to those of, an accrediting organization with demonstrated experience, national scope, and recognized leadership and expertise in the training of service dogs and education in the use of service dogs;
(2)
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agree to cover all costs in excess of the grant amount;
(3)
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agree to reaccept or replace the service dog the organization provided to the veteran, if necessary, as determined by the organization and the veteran;
(4)
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provide a wellness certification from a licensed veterinarian for any dog participating in the program;
(5)
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employ at least one person with clinical experience related to mental health;
(6)
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ensure that veterans participating in the pilot program receive training from certified service dog training instructors for a period of time determined appropriate by the organization and the Secretary, including service skills to address or alleviate symptoms unique to veterans' needs;
(7)
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agree to provide both lectures on service dog training methodologies and practical hands-on training and grooming of service dogs;
(8)
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agree that in hiring service dog training instructors to carry out training under the pilot program, the non-government entity will give a preference to veterans who have successfully graduated from PTSD or other residential treatment program and who have received adequate certification in service dog training;
(9)
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agree not to use shock collars or prong collars as training tools and to use positive reinforcement training;
(10)
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agree that upon the conclusion of training provided using the grant funds—
(A)
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the veteran who received the training will keep the dog unless the veteran and the veteran’s health provider decide it is not in the best interest of the veteran;
(B)
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if the veteran does not opt to own the dog, the entity will be responsible for caring for and appropriately placing the dog;
(C)
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the Department of Veterans Affairs will have no additional responsibility to provide for any benefits under this section; and
(D)
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the Department of Veterans Affairs will have no liability with respect to the dog;
(11)
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provide follow-up support service for the life of the dog, including a contact plan between the veteran and the entity to allow the veteran to reach out for and receive adequate help with the service dog and the organization to communicate with the veteran to ensure the service dog is being properly cared for; and
(12)
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submit to the Secretary an application containing such information, certification, and assurances as the Secretary may require.
(d)
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Veteran eligibility—
(1)
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In general— For the purposes of this section, an eligible veteran is a veteran who—
(A)
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is enrolled in the patient enrollment system in the Department of Veterans Affairs under section 1705 of title 38, United States Code;
(B)
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has been recommended for the pilot program under this section by a qualified health care provider or clinical team based on the medical judgment that the veteran may potentially benefit from participating; and
(C)
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agrees to successfully complete training provided by an eligible organization that receives a grant under this section.
(2)
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Relationship to participation in other program— Veterans may participate in the pilot program in conjunction with the compensated work therapy program of the Department of Veterans Affairs.
(3)
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Continuing eligibility requirement— To remain eligible to participate in the program, a veteran shall see the health care provider or clinical team of the Department of Veterans Affairs treating the veteran for PTSD at least once every six months to determine, based on a clinical evaluation of efficacy, whether the veteran continues to benefit from the program.
(e)
removed
Collection of data— In carrying out this section, the Secretary shall—
(1)
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develop metrics and other appropriate means to measure, with respect to veterans participation in the program, the improvement in psychosocial function and therapeutic compliance of such veterans and changes with respect to the dependence on prescription narcotics and psychotropic medication of such veterans;
(2)
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establish processes to document and track the progress of such veterans under the program in terms of the benefits and improvements noted as a result of the program; and
(3)
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in addition, the Secretary shall continue to collect these data over the course of five years for each veteran who has continued with the dog he or she has personally trained.
(f)
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GAO briefing and study—
(1)
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Briefing— Not later than one year after the date of the commencement of the pilot program under subsection (a), the Comptroller General of the United States shall provide to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a briefing on the methodology established for the program.
(2)
removed
Report— Not later than 270 days after the date on which the program terminates, the Comptroller General shall submit to the committees specified in paragraph (1) a report on the program. Such report shall include an evaluation of the approach and methodology used for the program with respect to—
(A)
removed
helping veterans with severe PTSD return to civilian life;
(B)
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relevant metrics, including reduction in metrics such as reduction in scores under the PTSD check list (PCL–5), improvement in psychosocial function, and therapeutic compliance; and
(C)
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reducing the dependence of participants on prescription narcotics and psychotropic medication.
(g)
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Definition— For the purposes of this section, the term service dog training instructor means an instructor who provides the direct training of veterans with PTSD and other post-deployment issues in the art and science of service dog training and handling.