Statements on Introduced Bills and Joint Resolutions

Floor Speech

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Mr. BLUMENTHAL. Mr. President, in 2013, the VA estimated that about 1.5 million veterans required mental health services, which VA provides in a variety of settings. In addition to the traditional VA medical centers, veterans may access mental health services and support through Vet Centers--which often appeal to veterans because of their welcoming, home-like environment; Community Based Outpatient Clinics, which play an important role in telehealth delivery by connecting rural veterans to psychiatry services from the medical center home-base, a Veterans Crisis Line, VA staff on college and university campuses, and other outreach efforts. Another important means of delivering mental health services has been the inclusion of mental health professionals within primary care delivery through VA's Patient Aligned Care Teams, which improves the screening process and allows providers to recognize and treat mental health issues occurring among those veterans who present in their primary care locations.

In addition to providing ongoing care to veterans with mental health needs, VA plays a role in suicide risk assessment and prevention among veterans. According to VA, about one-quarter of the 18 to 22 veterans who die by suicide each day were receiving care through VA. Suicide rates are even higher among those veterans who do not use VA for the health care services. Given the stigma and reluctance of some veterans to seek mental health treatment, veterans using VA for primary care may be missing a key entry point to the peer support model of care. Expanding this effective model into the primary care setting could provide another opportunity for veterans to access mental health services through VA. That is why, today, I am introducing--with my cosponsors Senators BALDWIN and MARKEY--the Veteran Partners' Efforts to Enhance Reintegration, Veteran PEER Act, a bill that would expand the peer support model of care for mental health services within the VA system to help ensure that veterans receive the effective and timely care they deserve.

VA has begun a program to co-locate mental health care providers within primary care settings in an effort to promote effective treatment of common mental health conditions in the primary care environment. This is a positive step; however, the peer support model of care for mental health services has not been similarly integrated. Research on the use of the peer support model of care for mental health services within the VA has shown that Peer Specialists helped patients become more active in treatment, which can promote recovery. Peer support was recognized by the Centers for Medicare and Medicaid Services as an evidence-based practice in 2007; and over 20 states have Medicaid reimbursement for peer support services. In response to the President's August 2014 Executive Orders to improve mental health services for veterans, VA committed to integrating and expanding the peer support model of care beyond traditional mental health settings into primary care clinics in order to better connect with veterans wherever they seek care. However, progress toward placing Peer Specialists in primary care teams has been slow.

The Veteran PEER bill would require VA to expand its use of Peer Specialists--VA employees who promote veterans' recovery by sharing their own recovery stories, providing encouragement, and teaching skills needed for successful recovery. These professionals may also provide case management assistance, help with accessing the right mental health care, and teach coping and self-advocacy skills. In general, peer support programs aim to develop veterans' self-management skills and restore participation in work and other social roles. Recognizing this effective model of care, this bill would require VA to establish Peer Specialists in Patient Aligned Care Teams within VA medical centers to promote the use and integration of mental health services into the primary care setting. Over a two year period, the program would be carried out in 25 locations.

The bill directs VA to take into consideration the needs of female veterans when establishing peer support programs, ensure that female Peer Specialists are made available to veterans through the program, and consider rural and underserved areas when selecting program locations. VA would be required to regularly report to Congress on the progress of the program including on its benefits to veterans and their family members and data on the gender of clients served by the program. Given that VA is one of the largest employers of Peer Specialists, VA's regular reporting on the program would not only allow Congress to conduct appropriate oversite of the activities, but could also provide important insights for the wider peer support community.

Given the pressing need for mental health services, it is imperative that we equip VA with the resources and organizational structure it needs to care for veterans who access these services and to find ways to reach more veterans with effective mental health services when they need them. Expanding the peer support model into the primary care setting could provide another opportunity for veterans to access mental health services through VA. As a nation we have asked more of these individuals than most of us can comprehend. We must now honor the promise we made as a nation--to take care of those who have taken care of us.

Mr. President, I ask unanimous consent that the text of the bill and letters of support be printed in the RECORD.

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