CONGRESSWOMAN ELISE STEFANIK
On Tuesday, October 11, 2011, the House is scheduled to consider H.R. 2074, the Veterans Sexual Assault Prevention Act, under a suspension of the rules requiring a two-thirds majority for passage. H.R. 2074 was introduced by Rep. Ann Marie Buerkle (R-NY) on June 1, 2011, and was referred to the House Committee on Veterans Affairs.
H.R. 2074 would require the Department of Veterans Affairs (VA) to develop a comprehensive policy for tracking and reporting sexual assault incidents and make other changes to health care services.
The bill would require VA to prepare and implement a comprehensive policy on tracking and reporting sexual assault incidents and other safety incidents.
The bill would also require VA to enter into a contract or agreement with each State Veterans Home (SVH) for payment of nursing home care provided to veterans with a service-connected disability rated at 70 percent or greater or in need of such care because of a service-connected condition.
The bill would direct VA to focus on maximizing independence and improving behavioral and mental health functioning within a program of individualized rehabilitation and reintegration for veterans with traumatic brain injury (TBI) and require rehabilitative services be included within VA’s comprehensive programs of long-term care for veterans with TBI.
The bill would also clarify the access rights of service dogs on VA property and in VA facilities.
The bill would also require VA to establish a pilot program through which veterans diagnosed with post-traumatic stress disorder or other mental health conditions would train service dogs for use by disabled veterans. The pilot program would operate for three years in one to three VA medical centers and require one certified dog trainer at each facility. Based on a similar program at the VA facility in Palo Alto, California, CBO estimates that each facility would train five service dogs every two years.
Section 2--Comprehensive policy regarding sexual assault and other safety incidents
In analyzing VA's national police files from January 2007 through July 2010, GAO identified 284 incidents of alleged sexual assault. Included in that total are 67 incidents of alleged rape, 185 incidents of alleged inappropriate touching, 8 incidents of alleged forceful medical examinations, 13 incidents of alleged forced or inappropriate oral sex, and 11 other alleged sexual assaults. There were 89 allegations of patient-on-patient sexual assaults, 85 allegations of patient-on-employee sexual assaults, 46 allegations of employee-on-patient sexual assaults, 28 allegations of persons-with-unknown-affiliation-on patient sexual assaults, 15 allegations of employee-on-employee sexual assaults, and 21 other allegations of sexual assault involving patients, employees, visitors, and outsiders.
Section 3--Increased flexibility in establishing payment rates for nursing home care provided by State Veterans Homes
The VA nursing home program provides institutional long term care for such qualified veterans in various settings including VA owned and operated Community Living Centers, contract purchased care in Community Nursing Homes, and State Veterans Homes (SVHs).
Prior to the enactment of the Veterans Benefits, Health Care, and Information Technology Act of 2006, P.L. 109-461, 120 Stat. 3403, VA could only pay one per diem rate for care in a SVH. This per diem amounted to approximately one-third of the total cost of care. VA could not pay the full cost of care for a veteran in a SVH, even if that veteran qualified for VA-paid nursing home care under the Veterans Millenium Health Care and Benefits Act, P.L. 106-117. However, VA would pay the full cost of care for that veteran in a VA or community nursing home.
Section 3 of the bill would resolve the unintended issues created by P.L. 109-461 by allowing for greater flexibility in VA payments to SVHs under the 70% program by requiring VA to enter into a contract or agreement separately with each SVH based on the particular needs of the veteran population in a given SVH.
Section 4--Rehabilitative services for veterans with traumatic brain injury (TBI)
Current law governing rehabilitative care for veterans with TBI within VA, which is codified in sections 1710C and 1710D of title 38, U.S.C. These sections direct VA to provide comprehensive care in accord with individualized rehabilitation plans to veterans with TBI. Although these sections of law do not provide a definition of the word `rehabilitation,' the phrase `rehabilitative services' is defined in section 1701(8) of title 38, U.S.C. for VA health-care purposes as `such professional, counseling, and guidance services and treatment programs as are necessary to restore, to the maximum extent possible, the physical, mental, and psychological functioning of an ill or disabled person.'
Concerns have been raised that VA has interpreted the law as limited only to those services that restore function. By limiting rehabilitative care in such a manner, individuals with TBI may risk losing out on therapy that may prove vital in maintaining physical, cognitive, and other progress. Further, they may risk losing out on services necessary for a successful reintegration into community and civilian life but which fall outside of a strictly medical model.
Section 5--Use of service dogs on property of the Department of Veterans Affairs
Service dogs, which are classified by VA as a prosthetic appliance and are provided to veterans through the VA Prosthetics and Sensory Aid Service, have a significant role in maintaining functionality and promoting maximum independence of veterans with disabilities. However, as a result of current regulation, disabled veterans may be denied entrance to VA medical facilities if accompanied by their VA-approved service dog.
There has been growing frustration among veterans and veterans service organizations about VA's outdated regulation and the access rights of service dogs on VA campuses.
Section 5 of the bill would eliminate any inconsistencies between VA policy and practice and better fit the needs of today's veterans who rely on service dogs for needed aid and assistance by amending current law to mandate that service dogs have access to any VA facility consistent with the same terms and conditions, and subject to the same regulations, as generally govern the admittance of guide dogs to VA property.
Section 6--Pilot program on dog training therapy
Currently, there are therapy dog training programs in use at the VA Palo Alto Health Care System in Palo Alto, California, and the National Intrepid Center of Excellence in Bethesda, Maryland, reporting positive and promising outcomes. In each of the above programs, training service dogs for fellow veterans is believed to help address symptoms associated with post-deployment mental health issues and PTSD. Veterans participating in the programs have demonstrated improved emotional regulation, sleep patterns, and sense of personal safety. They also experienced reduced levels of anxiety and social isolation. Further, participation in the pilot enabled them to actively instill or re-establish a sense of purpose and meaning while also providing an opportunity to help fellow veterans and reintegrate healthfully back into the community. However, despite the anecdotal evidence of the therapeutic benefit of service dog training on veterans with mental health issues and PTSD, there is a serious dearth of scientific research on the value of such programs.
Section 6 of the bill would enable VA to reach more veterans with this innovative treatment model.
According to Congressional Budget Office (CBO) estimates, the bill would have discretionary costs of $1 million over the 2012-2016 period, assuming the availability of appropriated funds. Enacting this legislation would not affect direct spending or revenues; therefore, pay-as-you-go procedures do not apply.