BERKLEY SEEKS MORE RESOURCES TO AID SERVICE MEMBERS AND VETERANS COPING WITH COMBAT RELATED STRESS AND PTSD

(April 14, 2005 -- Washington, D.C.) Congresswoman Shelley Berkley (D-NV) cosponsored legislation this week that would provide more resources to address the effects of combat related stress on returning members of the armed services and veterans of the U.S. military. The Comprehensive Assistance for Veterans Exposed to Traumatic Stressors Act of 2005, introduced by Rep. Lane Evans (D-IL), seeks to increase awareness and education efforts and to provide greater access to mental health care for service members exposed to combat, including troops now returning from duty in Iraq and Afghanistan.

“Congress has an obligation to provide for the mental health needs of our deployed service members and returning veterans and Representative Evans' bill will provide data which can help us meet the needs of veterans who are disabled as the result of service-connected PTSD,” said Berkley, who serves as Ranking Democrat on the Veterans Affairs’ Subcommittee tasked with overseeing VA claims, including those from individuals suffering from post-traumatic stress disorder (PTSD) and other effects of exposure to combat related stress.

“We are already seeing large numbers of service members returning from Iraq and other combat zones who are showing signs of anxiety, depression and post-traumatic stress disorder. As we have learned from the aftermath of Vietnam, timely intervention and access to mental health services can prevent a chronic reaction to stress,” said Berkley.

The legislative package directs the Department of Veterans Affairs and the Department of Defense to engage in a variety of activities to ensure that veterans and service members are provided with the access to specialized mental health care they require, on the battlefield and once they return home to their families. One issue of particular concern to Berkley is the wide-ranging regional differences in the number of veterans diagnosed with PTSD, an issue that will be discussed before the Veterans Affairs’ Subcommittee where she serves as Ranking Member.

“I am concerned by recent reports demonstrating that there is a significant disparity in ratings and payment for disabilities associated with PTSD,” said Berkley. “For example, the VA Regional Office in Reno, which serves veterans in southern Nevada, pays about 18% of those with service-connected PTSD at the 100% rate. Compare that with the Wilmington, Delaware regional office where 34% of the veterans with PTSD are at the 100% rate or to Lincoln, Nebraska where only 10% of vets receive a 100% rating. It is clear that we need a better understanding of how PTSD claims are adjudicated and why different ratings are issued by different regional offices. We also need a better understanding of the barriers to employment which exist for veterans with PTSD.”

Bill Summary
"Comprehensive Assistance for Veterans Exposed to Traumatic Stressors Act of 2005"
1. Would extend eligibility for readjustment counseling services for Vietnam-Era Veterans to January 1, 2010.

2. Would establish a joint VA-DOD telecommunications initiative, including real-time access to clinical specialty support, Web-based information of treatment and diagnosis of PTSD and other mental health issues, and other educational materials to support forward-deployed clinicians and others coping with acute stages of post-traumatic stress disorder.

3. Would require the Department of Defense to share data relevant to VA for outreach and planning for post-deployment mental health treatment.

4. Would require VA to provide post-deployment outreach to small groups of returning service members shortly after their return from deployments to combat areas.

5. Would require VA to participate in demobilization and Transitional Assistance Program activities.

6. Would require the Secretary of Veterans Affairs to provide for a study to identify factors that decrease the likelihood of the development of chronic post-traumatic stress disorder (PTSD) in servicemembers and veterans who have had combat exposure, including exposure to guerilla warfare.

7. Would extend combat veterans' eligibility for VA health services from 2 to 5 years.

8. Would require VA to develop and disseminate, with the assistance of the Department of Defense, educational materials for veterans, their families and the general public, concerning post-deployment mental health issues and treatment options.

9. Would require the Department of Defense and the VA to jointly provide for the conduct of a demonstration project under which VA psychologists and psychiatrists are stationed at major demobilization sites and military treatment facilities.

10. Would require the VA to develop and implement a 'model care' plan for integrated mental health and primary care at three sites in order to identify 'best practices' for treatment of PTSD.

11. Would require DOD and VA to develop performance measures for VA regional health-care directors (referred to as VISN directors) and Department of Defense TRICARE regional managers to ensure the appropriate deployment of resources to implement the Iraq war clinical practice guidelines.

12. Would require VA and DOD to jointly establish a Council on Post-Deployment Mental Health to recommend any alterations in resources available to provide specialized treatment for post-traumatic stress disorder.

13. Would require VA to commit:
a. 100 additional full-time equivalent employees to Readjustment Counseling Service outstations.
b. A PTSD Clinical Team at every medical center of the Veterans Health Administration.
c. A family therapist at each Vet Center.
d. A PTSD Coordinator in each regional network referred to as a Veterans Integrated Service Network (VISN).
e. A PTSD coordinator in each regional office of the Readjustment Counseling Service whose duties shall include liaison with regional office staff and medical centers for veterans seeking service-connection for PTSD.

14. Would require VA to develop, in consultation with DOD, an integrated program to respond to a variety of mental health disorders prevalent among veterans of service in Operation Iraqi Freedom and Operation Enduring Freedom.

15. Would authorize VA to provide counseling to the immediate family members of veterans with service-connected disabilities and bereavement counseling to the immediate family members of members of the Armed Forces who are killed in action for up to one year after the initial services are delivered to eligible family members.

16. Would require VA and DOD to jointly develop a broad training program for all health-care providers to familiarize those providers with mental health-care issues that are likely to arise among persons deployed to combat theaters during the five years after such a deployment.

17. Would require VA to develop a curriculum and required protocols for cross-training to allow VA to screen for PTSD and, as appropriate, provide information and appropriate referral.

18. Would require VA and DOD to jointly develop a plan for the production and dissemination of publications to advise clinicians on state-of-the-art PTSD diagnosis and treatment, including any medical conditions associated with PTSD.

19. Would require VA and DOD to jointly develop protocols for pain management for PTSD and war-related pain.

20. Would require VA to develop clinical practice guidelines to ensure that clinicians are able to effectively distinguish between diagnoses with similar symptomatology that may manifest as post-traumatic stress disorder.

21. Would require the Joint Council on Post-Deployment Mental Health to appoint a National Steering Committee on PTSD Education to review training protocols for health-care providers and plans for dissemination of educational materials to veterans, their families, and other relevant parties and identify the resources available to provide for these purposes.

22. Would authorize VA's National Center for PTSD to assist in carrying out a joint educational initiative with the Uniformed Services University of the Health Sciences.

23. Would require VA to pursue a study of the evaluation of the quality and consistency of adjudication of claims for PTSD.

24. Would require the VA to develop criteria for determining which medical conditions are as likely as not to be associated with PTSD and standards for determining when secondary service-connection should be granted for those conditions.

25. Would require the VA to conduct an aggressive, comprehensive outreach program to enhance the awareness of veterans, and the public in general, of the symptoms of PTSD and of the services available for veterans with those symptoms.
Prepared by Democratic Staff of Committee on Veterans Affairs

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