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H.R. 1448 — what changed

Puppies Assisting Wounded Servicemembers for Veterans Therapy Act

From Introduced in House to Reported in House. 2 sections amended and 1 removed between Introduced in House and Reported in House.

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)
added Duration; medical centers—

removed Congress makes the following findings:

(1)
removed 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)
changed 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)
changed 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)
removed 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)
removed 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)
changed 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)
changed 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)
added submits to the Secretary certification that the entity is an accredited service dog training organization;
(2)
added 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)
added 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)
added 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)
added agrees not to use shock collars or prong collars as training tools and to use positive reinforcement training; and
(6)
added agrees to provide any follow-up training support specified in subsection (e)(2), as applicable.
(e)
added Adoption of dog—
(1)
added 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)
added 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)
added 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)
added Collection of data— In carrying out this section, the Secretary shall—
(1)
added develop metrics and other appropriate means to measure, with respect to veterans participating in the pilot program under subsection (a)—
(A)
added the number of such veterans participating;
(B)
added the satisfaction of such veterans with the pilot program;
(C)
added 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)
added such other factors as the Secretary may determine appropriate; and
(2)
added establish processes to document and track the progress of such veterans under the pilot program with respect to health benefits and improvements.
(h)
added 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)
added whether to extend or make permanent the pilot program; and
(2)
added the feasibility and advisability of expanding the pilot program to address mental health conditions other than PTSD.
(i)
added GAO briefing and study—
(1)
added 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)
added 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)
added assisting veterans with PTSD; and
(B)
added measuring relevant metrics, such as reduction in scores under the Clinician Administered PTSD Scale (CAPS), improvement in psychosocial function, and therapeutic compliance.
(j)
added Definitions— In this section:
(1)
added 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)
added provides service dogs to veterans with PTSD; and
(B)
added 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)
added The term “eligible veteran” means a veteran who—
(A)
added is enrolled in the patient enrollment system in the Department of Veterans Affairs under section 1705 of title 38, United States Code; and
(B)
added 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)
added 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.

added “(f)

added “(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).

added “(2) A veteran described in this paragraph is a veteran who—

added “(A) is diagnosed with post-traumatic stress disorder or a visual, hearing, or substantial mobility impairment;

added “(B) has received a dog under subsection (b) or (c) in connection with such disorder or impairment; and

added “(C) meets such other requirements as the Secretary may prescribe.”

(b)
changed 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)
removed Conditions on receipt of grants— As a condition of receiving a grant under this section, a non-government entity shall—
(1)
removed 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)
removed provides service dogs to veterans with PTSD; and
(B)
removed 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)
removed agree to cover all costs in excess of the grant amount;
(3)
removed 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)
removed provide a wellness certification from a licensed veterinarian for any dog participating in the program;
(5)
removed employ at least one person with clinical experience related to mental health;
(6)
removed 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)
removed agree to provide both lectures on service dog training methodologies and practical hands-on training and grooming of service dogs;
(8)
removed 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)
removed agree not to use shock collars or prong collars as training tools and to use positive reinforcement training;
(10)
removed agree that upon the conclusion of training provided using the grant funds—
(A)
removed 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)
removed if the veteran does not opt to own the dog, the entity will be responsible for caring for and appropriately placing the dog;
(C)
removed the Department of Veterans Affairs will have no additional responsibility to provide for any benefits under this section; and
(D)
removed the Department of Veterans Affairs will have no liability with respect to the dog;
(11)
removed 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)
removed submit to the Secretary an application containing such information, certification, and assurances as the Secretary may require.
(d)
removed Veteran eligibility—
(1)
removed In general— For the purposes of this section, an eligible veteran is a veteran who—
(A)
removed is enrolled in the patient enrollment system in the Department of Veterans Affairs under section 1705 of title 38, United States Code;
(B)
removed 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)
removed agrees to successfully complete training provided by an eligible organization that receives a grant under this section.
(2)
removed 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)
removed 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)
removed 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)
removed 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)
removed 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)
removed GAO briefing and study—
(1)
removed 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)
removed 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)
removed reducing the dependence of participants on prescription narcotics and psychotropic medication.
(g)
removed 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.

Sec. 4 Authority of Secretary of Veterans Affairs to provide service dogs to veterans with mental illnesses who do not have mobility impairments

removed

removed Section 1714 of title 38, United States Code, is amended by adding at the end the following new subsection:

removed “(e) The Secretary may provide a service dog to a veteran under subsection (c)(3) regardless of whether the veteran has a mobility impairment.”