US Codex
Pub. L.
Notes

Title IV — Oversight of Mental Health Care and Related Services

116th Congress · Approved Oct 17, 2020 · 134 Stat. 778 · Lineage

TITLE IV Oversight of Mental Health Care and Related Services

SEC. 401. Study on Effectiveness of Suicide Prevention and Mental Health Outreach Programs of Department of Veterans Affairs.

(a)
In General.— Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall enter into an agreement with a non-Federal Government entity with expertise in conducting and evaluating research-based studies to conduct a study on the effectiveness of the suicide prevention and mental health outreach materials prepared by the Department of Veterans Affairs and the suicide prevention and mental health outreach campaigns conducted by the Department.
(b)
Use of Focus Groups.—
(1)
In general.— The Secretary shall convene not fewer than eight different focus groups to evaluate the effectiveness of the suicide prevention and mental health materials and campaigns as required under subsection (a).
(2)
Location of focus groups.— Focus groups convened under paragraph (1) shall be held in geographically diverse areas as follows:
(A)
Not fewer than two in rural or highly rural areas.
(B)
Not fewer than one in each of the four districts of the Veterans Benefits Administration.
(3)
Timing of focus groups.— Focus groups convened under paragraph (1) shall be held at a variety of dates and times to ensure an adequate representation of veterans with different work schedules.
(4)
Number of participants.— Each focus group convened under paragraph (1) shall include not fewer than five and not more than 12 participants.
(5)
Representation.— Each focus group convened under paragraph (1) shall, to the extent practicable, include veterans of diverse backgrounds, including—
(A)
veterans of all eras, as determined by the Secretary;
(B)
women veterans;
(C)
minority veterans;
(D)
Native American veterans, as defined in section 3765 of title 38, United States Code;
(E)
veterans who identify as lesbian, gay, bisexual, transgender, or queer (commonly referred to as “LGBTQ”);
(F)
veterans who live in rural or highly rural areas;
(G)
individuals transitioning from active duty in the Armed Forces to civilian life; and
(H)
other high-risk groups of veterans, as determined by the Secretary.
(c)
Report.—
(1)
In general.— Not later than 90 days after the last focus group meeting under subsection (b), 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 findings of the focus groups.
(2)
Elements.— The report required by paragraph (1) shall include the following:
(A)
Based on the findings of the focus groups, an assessment of the effectiveness of current suicide prevention and mental health materials and campaigns of the Department in reaching veterans as a whole as well as specific groups of veterans (for example, women veterans).
(B)
Based on the findings of the focus groups, recommendations for future suicide prevention and mental health materials and campaigns of the Department to target specific groups of veterans.
(C)
A plan to change the current suicide prevention and mental health materials and campaigns of the Department or, if the Secretary decides not to change the current materials and campaigns, an explanation of the reason for maintaining the current materials and campaigns.
(D)
A description of any dissenting or opposing viewpoints raised by participants in the focus group.
(E)
Such other issues as the Secretary considers necessary.
(d)
Representative Survey.—
(1)
In general.— Not later than one year after the last focus group meeting under subsection (b), the Secretary shall complete a representative survey of the veteran population that is informed by the focus group data in order to collect information about the effectiveness of the mental health and suicide prevention materials and campaigns conducted by the Department.
(2)
Veterans surveyed.—
(A)
In general.— Veterans surveyed under paragraph (1) shall include veterans described in subsection (b)(5).
(B)
Disaggregation of data.— Data of veterans surveyed under paragraph (1) shall be disaggregated by—
(i)
veterans who have received care from the Department during the two-year period preceding the survey; and
(ii)
veterans who have not received care from the Department during the two-year period preceding the survey.
(e)
Treatment of Contracts for Suicide Prevention and Mental Health Outreach Media.—
(1)
Focus groups.—
(A)
In general.— The Secretary shall include in each contract to develop media relating to suicide prevention and mental health materials and campaigns a requirement that the contractor convene focus groups of veterans to assess the effectiveness of suicide prevention and mental health outreach.
(B)
Representation.— Each focus group required under subparagraph (A) shall, to the extent practicable, include veterans of diverse backgrounds, including—
(i)
veterans of all eras, as determined by the Secretary;
(ii)
women veterans;
(iii)
minority veterans;
(iv)
Native American veterans, as defined in section 3765 of title 38, United States Code;
(v)
veterans who identify as lesbian, gay, bisexual, transgender, or queer (commonly referred to as “LGBTQ”);
(vi)
veterans who live in rural or highly rural areas;
(vii)
individuals transitioning from active duty in the Armed Forces to civilian life; and
(viii)
other high-risk groups of veterans, as determined by the Secretary.
(2)
Subcontracting.—
(A)
In general.— The Secretary shall include in each contract described in paragraph (1)(A) a requirement that, if the contractor subcontracts for the development of media, the contractor shall subcontract with a subcontractor that has experience creating impactful media campaigns that target individuals age 18 to 34.
(B)
Budget limitation.— Not more than two percent of the budget of the Office of Mental Health and Suicide Prevention of the Department for contractors for suicide prevention and mental health media outreach shall go to subcontractors described in subparagraph (A).
(f)
Paperwork Reduction Act Exemption.— Chapter 35 of title 44, United States Code (commonly known as the “Paperwork Reduction Act”) shall not apply to any rulemaking or information collection required under this section.
(g)
Rural and Highly Rural Defined.— In this section, with respect to an area, the terms “rural” and “highly rural” have the meanings given those terms in the Rural-Urban Commuting Areas coding system of the Department of Agriculture.

SEC. 402. Oversight of Mental Health and Suicide Prevention Media Outreach Conducted by Department of Veterans Affairs.

(a)
Establishment of Goals.—
(1)
In general.— The Secretary of Veterans Affairs shall establish goals for the mental health and suicide prevention media outreach campaigns of the Department of Veterans Affairs, which shall include the establishment of targets, metrics, and action plans to describe and assess those campaigns.
(2)
Use of metrics.—
(A)
In general.— The goals established under paragraph (1) shall be measured by metrics specific to different media types.
(B)
Factors to consider.— In using metrics under subparagraph (A), the Secretary shall determine the best methodological approach for each media type and shall consider the following:
(i)
Metrics relating to social media, which may include the following:
(I)
Impressions.
(II)
Reach.
(III)
Engagement rate.
(IV)
Such other metrics as the Secretary considers necessary.
(ii)
Metrics relating to television, which may include the following:
(I)
Nielsen ratings.
(II)
Such other metrics as the Secretary considers necessary.
(iii)
Metrics relating to email, which may include the following:
(I)
Open rate.
(II)
Response rate.
(III)
Click rate.
(IV)
Such other metrics as the Secretary considers necessary.
(C)
Update.— The Secretary shall periodically update the metrics under subparagraph (B) as more accurate metrics become available.
(3)
Targets.— The Secretary shall establish targets to track the metrics used under paragraph (2).
(4)
Consultation.— In establishing goals under paragraph (1), the Secretary shall consult with the following:
(A)
Relevant stakeholders, such as organizations that represent veterans, as determined by the Secretary.
(B)
Mental health and suicide prevention experts.
(C)
Such other persons as the Secretary considers appropriate.
(5)
Initial report.— Not later than 180 days after the date of the enactment of this Act, 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 detailing the goals established under paragraph (1) for the mental health and suicide prevention media outreach campaigns of the Department, including the metrics and targets for such metrics by which those goals are to be measured under paragraphs (2) and (3).
(6)
Annual report.— Not later than one year after the submittal of the report under paragraph (5), and annually thereafter, 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 detailing—
(A)
the progress of the Department in meeting the goals established under paragraph (1) and the targets established under paragraph (3); and
(B)
a description of action to be taken by the Department to modify mental health and suicide prevention media outreach campaigns if those goals and targets are not being met.
(b)
Report on Use of Funds by Office of Mental Health and Suicide Prevention.— Not later than 180 days after the date of the enactment of this Act, and semiannually thereafter, the Secretary shall submit to the Committee on Appropriations and the Committee on Veterans’ Affairs of the Senate and the Committee on Appropriations and the Committee on Veterans’ Affairs of the House of Representatives a report containing the expenditures and obligations of the Office of Mental Health and Suicide Prevention of the Veterans Health Administration during the period covered by the report.

SEC. 403. Comptroller General Management Review of Mental Health and Suicide Prevention Services of Department of Veterans Affairs.

(a)
In General.— Not later than three years after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a management review of the mental health and suicide prevention services provided by the Department of Veterans Affairs.
(b)
Elements.— The management review required by subsection (a) shall include the following:
(1)
An assessment of the infrastructure under the control of or available to the Office of Mental Health and Suicide Prevention of the Department of Veterans Affairs or available to the Department of Veterans Affairs for suicide prevention efforts not operated by the Office of Mental Health and Suicide Prevention.
(2)
A description of the management and organizational structure of the Office of Mental Health and Suicide Prevention, including roles and responsibilities for each position.
(3)
A description of the operational policies and processes of the Office of Mental Health and Suicide Prevention.
(4)
An assessment of suicide prevention practices and initiatives available from the Department and through community partnerships.
(5)
An assessment of the staffing levels at the Office of Mental Health and Suicide Prevention, disaggregated by type of position, and including the location of any staffing deficiencies.
(6)
An assessment of the Nurse Advice Line pilot program conducted by the Department.
(7)
An assessment of recruitment initiatives in rural areas for mental health professionals of the Department.
(8)
An assessment of strategic planning conducted by the Office of Mental Health and Suicide Prevention.
(9)
An assessment of the communication, and the effectiveness of such communication—
(A)
within the central office of the Office of Mental Health and Suicide Prevention;
(B)
between that central office and any staff member or office in the field, including chaplains, attorneys, law enforcement personnel, and volunteers; and
(C)
between that central office, local facilities of the Department, and community partners of the Department, including first responders, community support groups, and health care industry partners.
(10)
An assessment of how effectively the Office of Mental Health and Suicide Prevention implements operational policies and procedures.
(11)
An assessment of how the Department of Veterans Affairs and the Department of Defense coordinate suicide prevention efforts, and recommendations on how the Department of Veterans Affairs and Department of Defense can more effectively coordinate those efforts.
(12)
An assessment of such other areas as the Comptroller General considers appropriate to study.

SEC. 404. Comptroller General Report on Efforts of Department of Veterans Affairs to Integrate Mental Health Care into Primary Care Clinics.

(a)
Initial Report.—
(1)
In general.— Not later than two years after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the efforts of the Department of Veterans Affairs to integrate mental health care into primary care clinics of the Department.
(2)
Elements.— The report required by subsection (a) shall include the following:
(A)
An assessment of the efforts of the Department to integrate mental health care into primary care clinics of the Department.
(B)
An assessment of the effectiveness of such efforts.
(C)
An assessment of how the health care of veterans is impacted by such integration.
(D)
A description of how care is coordinated by the Department between specialty mental health care and primary care, including a description of the following:
(i)
How documents and patient information are transferred and the effectiveness of those transfers.
(ii)
How care is coordinated when veterans must travel to different facilities of the Department.
(iii)
How a veteran is reintegrated into primary care after receiving in-patient mental health care.
(E)
An assessment of how the integration of mental health care into primary care clinics is implemented at different types of facilities of the Department.
(F)
Such recommendations on how the Department can better integrate mental health care into primary care clinics as the Comptroller General considers appropriate.
(G)
An assessment of such other areas as the Comptroller General considers appropriate to study.
(b)
Community Care Integration Report.—
(1)
In general.— Not later than two years after the date on which the Comptroller General submits the report required under subsection (a)(1), the Comptroller General shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the efforts of the Department to integrate community-based mental health care into the Veterans Health Administration.
(2)
Elements.— The report required by paragraph (1) shall include the following:
(A)
An assessment of the efforts of the Department to integrate community-based mental health care into the Veterans Health Administration.
(B)
An assessment of the effectiveness of such efforts.
(C)
An assessment of how the health care of veterans is impacted by such integration.
(D)
A description of how care is coordinated between providers of community-based mental health care and the Veterans Health Administration, including a description of how documents and patient information are transferred and the effectiveness of those transfers between—
(i)
the Veterans Health Administration and providers of community-based mental health care; and
(ii)
providers of community-based mental health care and the Veterans Health Administration.
(E)
An assessment of any disparities in the coordination of community-based mental health care into the Veterans Health Administration by location and type of facility.
(F)
An assessment of the military cultural competency of health care providers providing community-based mental health care to veterans.
(G)
Such recommendations on how the Department can better integrate community-based mental health care into the Veterans Health Administration as the Comptroller General considers appropriate.
(H)
An assessment of such other areas as the Comptroller General considers appropriate to study.
(3)
Community-based mental health care defined.— In this subsection, the term “community-based mental health care” means mental health care paid for by the Department but provided by a non-Department health care provider at a non-Department facility, including care furnished under section 1703 of title 38, United States Code (as in effect on the date specified in section 101(b) of the Caring for Our Veterans Act of 2018 (title I of Public Law 115–182)).

SEC. 405. Joint Mental Health Programs by Department of Veterans Affairs and Department of Defense.

(a)
Report on Mental Health Programs.—
(1)
In general.— Not later than one year after the date of the enactment of this Act, and annually thereafter, the Secretary of Veterans Affairs and the Secretary of Defense shall submit to the Committee on Veterans’ Affairs and the Committee on Armed Services of the Senate and the Committee on Veterans’ Affairs and the Committee on Armed Services of the House of Representatives a report on mental health programs of the Department of Veterans Affairs and the Department of Defense and joint programs of the Departments.
(2)
Elements.— The report required by paragraph (1) shall include the following:
(A)
A description of mental health programs operated by the Department of Veterans Affairs, including the following:
(i)
Transition assistance programs.
(ii)
Clinical and non-clinical mental health initiatives, including centers of excellence of the Department of Veterans Affairs for traumatic brain injury and post-traumatic stress disorder.
(iii)
Programs that may secondarily improve mental health, including employment, housing assistance, and financial literacy programs.
(iv)
Research into mental health issues and conditions, to include post-traumatic stress disorder, depression, anxiety, bipolar disorder, traumatic brain injury, suicidal ideation, and any other issues or conditions as the Secretary of Veterans Affairs considers necessary.
(B)
A description of mental health programs operated by the Department of Defense, including the following:
(i)
Transition assistance programs.
(ii)
Clinical and non-clinical mental health initiatives, including the National Intrepid Center of Excellence and the Intrepid Spirit Centers.
(iii)
Programs that may secondarily improve mental health, including employment, housing assistance, and financial literacy programs.
(iv)
Research into mental health issues and conditions, to include post-traumatic stress disorder, depression, anxiety, bipolar disorder, traumatic brain injury, suicidal ideation, and any other issues or conditions as the Secretary of Defense considers necessary.
(C)
A description of mental health programs jointly operated by the Department of Veterans Affairs and the Department of Defense, including the following:
(i)
Transition assistance programs.
(ii)
Clinical and non-clinical mental health initiatives.
(iii)
Programs that may secondarily improve mental health, including employment, housing assistance, and financial literacy programs.
(iv)
Research into mental health issues and conditions, to include post-traumatic stress disorder, depression, anxiety, bipolar disorder, traumatic brain injury, suicidal ideation, and completed suicides, including through the use of the joint suicide data repository of the Department of Veterans Affairs and the Department of Defense, and any other issues or conditions as the Secretary of Veterans Affairs and the Secretary of Defense consider necessary.
(D)
Recommendations for coordinating mental health programs of the Department of Veterans Affairs and the Department of Defense to improve the effectiveness of those programs.
(E)
Recommendations for novel joint programming of the Department of Veterans Affairs and the Department of Defense to improve the mental health of members of the Armed Forces and veterans.
(b)
Evaluation of Collaborative Efforts of Department of Veterans Affairs and Department of Defense and Alternatives of Analysis to Establish a Joint VA/DOD Intrepid Spirit Center.—
(1)
In general.— The Secretary of Veterans Affairs, in coordination with the Secretary of Defense, shall evaluate the current ongoing collaborative efforts of the Department of Veterans Affairs and the Department of Defense related to post-traumatic stress disorder and traumatic brain injury care, research, and education to improve the quality of and access to such care and seek potential new collaborative efforts to improve and expand such care for veterans and members of the Armed Forces in a joint Department of Veterans Affairs/Department of Defense Intrepid Spirit Center that serves active duty members of the Armed Forces, members of the reserve components of the Armed Forces, and veterans for mutual benefit and growth in treatment and care.
(2)
Alternatives of analysis.—
(A)
In general.— The evaluation required under paragraph (1) shall include an alternatives of analysis to establish the joint Department of Veterans Affairs/Department of Defense Intrepid Spirit Center described in paragraph (1).
(B)
Elements.— The alternatives of analysis required under subparagraph (A) with respect to the establishment of the joint Department of Veterans Affairs/Department of Defense Intrepid Spirit Center described in paragraph (1) shall provide alternatives and recommendations that consider information including—
(i)
colocation of the center on an installation of the Department of Defense or property of a medical center of the Department of Veterans Affairs;
(ii)
consideration of a rural or highly rural area to establish the center that may include colocation described in clause (i);
(iii)
geographic distance from existing or planned Intrepid Spirit Centers of the Department of Defense or other such facilities of the Department of Veterans Affairs or the Department of Defense that furnish care for post-traumatic stress disorder or traumatic brain injury; and
(iv)
the potential role for private entities and philanthropic organizations in carrying out the activities of the center.
(3)
Report to congress.— Not later than 270 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report that includes—
(A)
a summary of the evaluation required under paragraph (1); and
(B)
the alternatives of analysis required under paragraph (2).
(4)
Rural and highly rural defined.— In this subsection, with respect to an area, the terms “rural” and “highly rural” have the meanings given those terms in the Rural-Urban Commuting Areas coding system of the Department of Agriculture.