[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5867 Introduced in House (IH)]

<DOC>






116th CONGRESS
  2d Session
                                H. R. 5867

  To direct the Secretary of Veterans Affairs to establish or update 
  certain clinical practice guidelines of the Department of Veterans 
                    Affairs, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 12, 2020

Mr. Cisneros (for himself and Mr. Mast) introduced the following bill; 
   which was referred to the Committee on Veterans' Affairs, and in 
addition to the Committees on Armed Services, and Energy and Commerce, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of 
                        the committee concerned

_______________________________________________________________________

                                 A BILL


 
  To direct the Secretary of Veterans Affairs to establish or update 
  certain clinical practice guidelines of the Department of Veterans 
                    Affairs, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Setting Treatment Options and 
Practices for Veteran Suicide and Substance Abuse Act'' or the ``STOP 
Veteran Suicide and Substance Abuse Act''.

SEC. 2. ESTABLISHMENT BY DEPARTMENT OF VETERANS AFFAIRS AND DEPARTMENT 
              OF DEFENSE OF CLINICAL PRACTICE GUIDELINES FOR COMORBID 
              MENTAL HEALTH CONDITIONS SUCH AS PTSD, MST, AND/OR TBI.

    (a) In General.--Not later than two years after the date of the 
enactment of this Act, the Secretary of Veterans Affairs, in 
consultation with the Secretary of Defense and the Secretary of Health 
and Human Services, shall complete the development of clinical practice 
guidelines for the treatment of post-traumatic stress disorder, 
military sexual trauma, and traumatic brain injury that is comorbid 
with substance use disorder or chronic pain.
    (b) Work Group.--
            (1) Establishment.--In carrying out subsection (a), the 
        Secretary of Veterans Affairs, the Secretary of Defense, and 
        the Secretary of Health and Human Services shall create a 
        Trauma and Comorbid Substance Use Disorder or Chronic Pain Work 
        Group (in this section referred to as the ``Work Group'').
            (2) Membership.--The work group created under paragraph (1) 
        shall be comprised of individuals that represent Federal 
        Government entities and non-Federal Government entities with 
        expertise in the areas covered by the work group, including the 
        following:
                    (A) Academic institutions that specialize in 
                research for the treatment of conditions described in 
                subsection (a).
                    (B) The National Center for Posttraumatic Stress 
                Disorder of the Department of Veterans Affairs.
                    (C) The Office of the Assistant Secretary for 
                Mental Health and Substance Use of the Department of 
                Health and Human Services.
            (3) Relation to other work groups.--The Work Group shall be 
        created and conducted in the same manner as other work groups 
        for the development of clinical practice guidelines for the 
        Department of Veterans Affairs and the Department of Defense.
    (c) Matters Included.--In developing the clinical practice 
guidelines under subsection (a), the Work Group, in consultation with 
the Post Traumatic Stress Disorder Work Group, Concussion-mTBI Work 
Group, Opioid Therapy for Chronic Pain Work Group, and Substance Use 
Work Group, shall ensure that the clinical practice guidelines include 
the following:
            (1) Guidance with respect to the following:
                    (A) The treatment of patients with post-traumatic 
                stress disorder who are also experiencing a substance 
                use disorder or chronic pain.
                    (B) The treatment of patients experiencing a mental 
                health condition, including anxiety, depression, or 
                post-traumatic stress disorder as a result of military 
                sexual trauma who are also experiencing a substance use 
                disorder or chronic pain.
                    (C) The treatment of patients with traumatic brain 
                injury who are also experiencing a substance use 
                disorder or chronic pain.
            (2) Guidance with respect to the following:
                    (A) Appropriate case management for patients 
                experiencing post-traumatic stress disorder that is 
                comorbid with substance use disorder or chronic pain 
                who transition from receiving care while on active duty 
                in the Armed Forces to care from health care networks 
                outside of the Department of Defense.
                    (B) Appropriate case management for patients 
                experiencing a mental health condition, including 
                anxiety, depression, or post-traumatic stress disorder 
                as a result of military sexual trauma that is comorbid 
                with substance use disorder or chronic pain who 
                transition from receiving care while on active duty in 
                the Armed Forces to care from health care networks 
                outside of the Department of Defense.
                    (C) Appropriate case management for patients 
                experiencing traumatic brain injury that is comorbid 
                with substance use disorder or chronic pain who 
                transition from receiving care while on active duty in 
                the Armed Forces to care from health care networks 
                outside of the Department of Defense.
            (3) Guidance with respect to the treatment of patients who 
        are still members of the Armed Forces and are experiencing a 
        mental health condition, including anxiety, depression, or 
        post-traumatic stress disorder as a result of military sexual 
        trauma that is comorbid with substance use disorder or chronic 
        pain.
            (4) Guidance with respect to the assessment by the National 
        Academies of Sciences, Engineering, and Medicine of the 
        potential overmedication of veterans, as required pursuant to 
        the Senate report accompanying S. 1557, 115th Congress (Senate 
        Report 115-130), under the heading ``Overprescription 
        Prevention Report'' under the heading ``committee 
        recommendation''.
    (d) Rule of Construction.--Nothing in this section shall be 
construed to prevent the Secretary of Veterans Affairs and the 
Secretary of Defense from considering all relevant evidence, as 
appropriate, in creating the clinical practice guidelines required 
under subsection (a) or from ensuring that the final clinical practice 
guidelines developed under such subsection and subsequently updated, as 
appropriate, remain applicable to the patient populations of the 
Department of Veterans Affairs and the Department of Defense.

SEC. 3. UPDATE OF CLINICAL PRACTICE GUIDELINES FOR ASSESSMENT AND 
              MANAGEMENT OF PATIENTS AT RISK FOR SUICIDE BY TAKING INTO 
              CONSIDERATION GENDER- AND AGE-SPECIFIC RISK FACTORS AND 
              GENDER- AND AGE-SPECIFIC TREATMENT EFFICACY OF 
              PHARMACOTHERAPY AND PSYCHOTHERAPY.

    (a) In General.--Not later than two years after the date of the 
enactment of this Act, the Secretary of Veterans Affairs and the 
Secretary of Defense, through the Assessment and Management of Patients 
at Risk for Suicide Work Group (in this section referred to as the 
``Work Group''), shall issue an update to the VA/DOD Clinical Practice 
Guideline for Assessment and Management of Patients at Risk for 
Suicide.
    (b) Matters Included.--In carrying out the update under subsection 
(a), the Work Group shall ensure that the clinical practice guidelines 
updated under such subsection includes the following:
            (1) Enhanced guidance with respect to the following:
                    (A) Gender- and age-specific risk factors for 
                suicide and suicidal ideation.
                    (B) Gender- and age-specific treatment efficacy for 
                depression and suicide prevention.
                    (C) Gender- and age-specific pharmacotherapy 
                efficacy.
                    (D) Gender- and age-specific psychotherapy 
                efficacy.
            (2) Guidance with respect to the efficacy of alternative 
        therapies, other than psychotherapy and pharmacotherapy, 
        including the following:
                    (A) Yoga therapy.
                    (B) Meditation therapy.
                    (C) Equine therapy.
                    (D) Other animal therapy.
                    (E) Training and caring for service dogs.
                    (F) Agri-therapy.
                    (G) Art therapy.
                    (H) Outdoor sports therapy.
                    (I) Music therapy.
                    (J) Any other alternative therapy that the Work 
                Group considers appropriate.
            (3) Guidance with respect to the findings of the Creating 
        Options for Veterans' Expedited Recovery Commission (commonly 
        referred to as the ``COVER Commission'') established under 
        section 931 of the Jason Simcakoski Memorial and Promise Act 
        (title IX of Public Law 114-198; 38 U.S.C. 1701 note).
    (c) Rule of Construction.--Nothing in this section shall be 
construed to prevent the Secretary of Veterans Affairs and the 
Secretary of Defense from considering all relevant evidence, as 
appropriate, in updating the VA/DOD Clinical Practice Guideline for 
Assessment and Management of Patients at Risk for Suicide, as required 
under subsection (a), or from ensuring that the final clinical practice 
guidelines updated under such subsection remain applicable to the 
patient populations of the Department of Veterans Affairs and the 
Department of Defense.
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