Overview
Appropriations
Other Legislation

Overview

This State Policy Focus is devoted to state legislation relating to mental health and substance use treatment for veterans. A recent study found that U.S. soldiers are significantly more likely to report mental health problems six months after returning home from combat than on initial assessments. “The rates that we previously reported based on surveys taken immediately upon return from deployment substantially underestimate the mental health burden,” according to the Journal of the American Medical Association. These latest findings bolster efforts at the state and federal level to address the mental health and substance use treatment needs of veterans.

The Army administers a mental health assessment as soon as soldiers return home from combat, but after concerns that problems were being missed in the initial evaluation, the Army added a second assessment six months later. Veterans Affairs (VA) clinicians found some mental health risk among 17 percent of active-duty soldiers after the first assessment, but after the six months that number jumped to 27.1 percent.

Soldiers reported greater concern about interpersonal conflicts, post-traumatic stress, depression and alcohol problems in the second mental health screening, according to researchers. About 14 percent of active-duty soldiers reported those concerns after being home six months compared with only 3.5 percent immediately upon return.

Mental health problems and suicide rates have increased among U.S. troops who served in Iraq and Afghanistan, according to a string of studies released this year. Those studies, which include a Pentagon assessment, found the military has provided inadequate mental health resources to its service members.

The study suggests the need for more resources for the Defense Department mental health system to help soldiers before they leave duty and transition to the VA’s health system, and the need for the VA to increase its capacity to serve veterans. The National Council has pursued legislation that would direct the VA to partner with community providers in areas where veterans may be far from VA centers.

States are clearly feeling the urgency—20 states filed 59 pieces of legislation in 2007 to address the mental health and addictions treatment needs of veterans. Colorado, Hawaii, Iowa, Illinois, Massachusetts, Maryland, Minnesota, New Hampshire, New Jersey, New York, Texas, Utah and Wyoming enacted 23 bills.

Illinois, Massachusetts, New Jersey, Pennsylvania and Wisconsin are still in session and currently have 13 bills pending. The following states have adjourned but will carry over 2007 filed veteran legislation to 2008: Alaska, California, Iowa, Minnesota and Washington.

California Republican Gov. Arnold Schwarzenegger and New York Democratic Gov. Eliot Spitzer each vetoed one bill. The California bill would have, among other things, ensured that eligible parolees requiring veterans’ treatment and recovery services outside of their geographic location be given consideration for those needed services on a case-by-case basis. There has been no opportunity to override the veto as California is in recess. The New York bill would have required the state to develop a veteran’s geriatric mental health demonstration program. The program would have offered grants to providers of mental health care for geriatric (60 years or older) veterans.

Six bills died in Maryland, Oregon, Texas and West Virginia.

Tammy Seltzer
Director of State Policy

Hawaii HB 500 was signed by Republican Gov. Linda Lingle on June 27.  This bill appropriates $1,966,063 for fiscal year 2007-2008 and $1,674,075 for fiscal year 2008-2009 in general funds to the state’s Department of Defense.

The bill also requires that the department use the appropriated funds to conduct a comprehensive assessment of the adequacy of mental health services, medical and rehabilitative services, and job training and employment services for veterans of the conflicts in Iraq and Afghanistan who reside in the state, and prepare a report on its findings. The report will need to include:

• Statistics for the current and projected population of these veterans in Hawaii.
• Identification of gaps in services and recommendations on how to fill the gaps in service.
• Projections for average costs per veteran served for each type of service.
• Projections on the number of veterans that will require each type of service.
• Total cost projections for each type of service.
• Projected costs of failing to expand each type of service beyond existing levels due to lost productivity.
• A discussion on the level of federal funds available for each type of service and in aggregate, and the adequacy of federal funding dedicated to meet the needs of these veterans for services.

The department will need to submit a draft report to the legislature no later than 20 days prior to the convening of the 2008 regular session and a final report no later than February 1, 2008.

Iowa HF 909 was signed by Democratic Gov. Chet Culver on May 29. This bill appropriates the following funds to the Iowa Department of Veterans Affairs for the fiscal year beginning July 1, 2007:

• $50,000 for the implementation of the veterans counseling program established by HF 817 (reported below in the section titled “Other Legislation.”)
• $750,000 for providing matching grants to counties to provide improved veterans services.

This bill required the executive director of the department to prepare a report regarding the needs of veterans.  The report will need to include a comprehensive survey of existing benefits and services being provided to Iowa veterans at the local, state, and national levels, a comparison of Iowa veterans benefits and services programs with such programs offered in other states, the deficiencies in benefits and services identified by the department, and any recommendations for eliminating the deficiencies identified. The completed report will need to be approved by the Commission of Veterans Affairs prior to submission of the report to the General Assembly no later than October 15, 2008.

HF 909 also requires the Department of Public Health to work collaboratively with the Departments of Corrections, Education, Elder Affairs, and Human Services, and other state agencies, to enhance the workforce competencies of professional and direct care staff that provide behavioral health services, including treatment of veterans of U.S. or Iowa military service with mental health or substance use disorders. 

Illinois HB 3866 was signed by Democratic Gov. Rod Blagojevich on August 23 and became Public Act 95-0348. This bill contained many line-item vetoes which were overturned by the legislature.

HB 3866 will appropriate the following to the state’s Department of Veterans’ Affairs for fiscal year 2008:

• $8,000,000 for making grants, funding additional services, or conducting additional research projects relating to veterans’ post traumatic stress disorder (PTSD), homelessness, health insurance cost, disability benefits and long-term care.
• $750,000 for costs associated with PTSD outpatient counseling program.

Similar bill HB 3920 was signed by Governor Blagojevich and became Public Act 95-011 on July 2. This bill, which also appropriated $8 million for research projects related to veterans PTSD, was superseded by HB 3866. Identical bills HB 3860 and HB 4100 are currently pending in the Senate Rules and House Rules Committees respectively.

Massachusetts HB 4141 was signed Democratic Gov. Deval Patrick on July 12. This bill will appropriate the following funds to the Massachusetts Department of Veterans Services for fiscal year 2008:

• $1,943,222 for services to veterans, including the maintenance and operation of outreach centers. Some of the funds would be distributed to centers that provide counseling to incarcerated veterans.
• $42,282 for the women veterans’ outreach program.

The Department of Public Health’s Office of Health Services received $3.75 million. Some of those funds will be expended to establish a Veterans in Crisis Hotline for the use of veterans and/or concerned family members who seek counseling programs operated by the Department of Veterans Affairs so that they may be directed towards the programs and services offered by their local or regional VA office. The hotline will need to be staffed by counselors or outreach programs contracted by the department and trained in issues of mental health counseling and veteran services. Massachusetts HB 4000 and HB 4001 were written as amendments to the 2008 budget bill and were rolled into HB 4141.

Minnesota HF 2227, substituted for SF 1925, was signed by Republican Gov. Tim Pawlenty on May 4 and became Chapter 45 of the Laws of 2007. This omnibus Agriculture and Veterans Affairs appropriations bill appropriates $12,855,000 in fiscal year 2008 and $12,571,000 in fiscal year 2009 to the Minnesota Department of Veterans Affairs for various veterans programs.

Of those funds $80,000 was appropriated, on a onetime basis, for suicide prevention and psychological support for returning veterans. Of this amount, $50,000 is for a study by the commissioner and the adjutant general and $30,000 is for a telephone hotline to refer veterans to available psychological counseling services.

This bill also requires the MDVA commissioner and the adjutant general of the National Guard, by November 1, 2007, to report to the legislature regarding the psychological needs of returning soldiers and veterans, and recommend how best to address those needs. The report must also provide an overview of treatment resources available for veterans, with particular emphasis on the mental health facility being planned by the Veterans Home Board for Kandiyohi County.

New Jersey SB 3000 was signed by Democratic Gov. John Corzine on June 28. This bill appropriates $3,009,000 in grants-in-aid for veterans outreach and assistance to the New Jersey Department of Military and Veterans Affairs. Of those funds, $1.3 million will go toward PTSD services and $1 million will go toward support services for returning veterans.

New York SB 2100, which was substitute for AB 4300, was signed by Democratic Gov. Eliot Spitzer on April 9. The bill became Chapter 50 of the Laws of 2007. This bill appropriates $6,986,000 to the state Division of Veterans Affairs for the veteran counseling services program for the fiscal year which began April 1, 2007.

New York SB 2104, which was substitute for AB 4304, was also signed by Governor Spitzer on April 9. This bill became Chapter 54 of the Laws of 2007. SB 2104 appropriates $25.4 million to the Department of Mental Hygiene’s Office of Alcoholism and Substance Abuse Services for the acquisition of property, design, construction and rehabilitation of 100 intensive residential and/or community residential beds for veterans, to be developed for operation by voluntary-operated or local government operated chemical dependency treatment providers.

Utah SB 1, a bill to supplement appropriations for the fiscal year beginning July 1, 2006, was signed by Republican Gov. Jon Huntsman, Jr. on March 20. This bill appropriates $70,000 to the Department of Human Services, the Division of Substance Abuse and Mental Health so counseling services for families of veterans will not lapse at the close of fiscal year 2007.

Pennsylvania and Wisconsin have two bills pending. Pennsylvania HB 1589 is the Capital Budget Project Itemization Act of 2007-2008. This bill would appropriate $1,250,000 to the Lehigh Valley Economic Development Corporation for the acquisition and renovations of a facility to be used as a therapeutic community dedicated to providing addiction and mental health treatment for veterans. Wisconsin SB 1x would appropriate $75,000 in 2007-2008 and $50,000 in 2008-2009 to the Department of Veterans Affairs on a one-time basis for assistance to veterans with PTSD. The bill also requires an annual appropriation, through June 30, 2009, of $15,000 to the Center for Veterans Issues in Milwaukee for providing outreach services to homeless veterans with PTSD.

Minnesota companion bills HF 2480 and SF 2301 will carry-over to the 2008 legislative session. Both bills would appropriate funds from the bond proceeds fund to the board of directors of the Minnesota veterans homes to establish a veterans facility in Kandiyohi County that provides both veterans geriatric supervised living, and soldiers and veterans mental health services. These bills do not specify the amount being appropriated.

Other Legislation

Colorado SB 146 was signed by Democratic Gov. Bill Ritter on June 4. This bill creates a three-year pilot program for families of recently discharged veterans. The programs goal is to educate veterans and their families about mental health issues, including PTSD, encourage families to seek mental health services and provide mental health services to families who would otherwise not be able to receive such services.

Hawaii HR 171 was adopted on May 14. This resolution requests the U.S. Department of Defense to allow members of the National Guard and Reserves who are still recovering from illness, both physical and mental, or injuries incurred in the line of duty in Iraq or Afghanistan, and who have been either discharged for medical reasons or released from active duty, to continue to have access to department’s medical facilities on the same basis as active duty service members, or to receive Tricare coverage on the same basis as retirees.

Similar bill HCR 213 passed the House and is being held in the Senate Intergovernmental and Military Affairs Committee. The concurrent resolution does carry over to 2008.

Iowa HF 817 and HSB 233 were signed by Democratic Gov. Chet Culver on May 29. This bill will require the state Department of Veterans Affairs to coordinate with the Department of Public Health and U.S. Veterans Administration hospitals, health care facilities, and clinics to provide assistance to veterans and their families. The assistance program hopes to reduce the incidence of alcohol, chemical dependency and suicide among veterans and to make mental health counseling available to veterans.

The program must include public education, awareness programs and referral services to identify appropriate counseling and treatment programs for veterans in need of services.

The director of the Department of Veterans Affairs will need to submit a report to the members of the general assembly by January 15, 2008, regarding the administration of the veterans counseling program.

Illinois SB 8 was signed by Democratic Gov. Rod Blagojevich and became Public Act 95-0576 on August 31. This bill will require the Illinois Department of Veterans Affairs, in consultation with the Department of Human Services, to contract with professional counseling specialists to provide a range of confidential counseling and direct treatment services to war-affected veterans from Operations Desert Storm, Enduring Freedom, or Iraqi Freedom and their family members. Additional treatment services will also be provided to Vietnam War veterans for PTSD, particularly those veterans whose PTSD has intensified or initially emerged due to the war in the Middle East.

In consultation with the Department of Human Services, the Department of Veterans Affairs will:

• Develop an educational program designed to inform and train primary health care professionals, including mental health professionals, about the effects of war-related stress and trauma.
• Provide informational and counseling services for the purpose of establishing and fostering peer-support networks throughout the state for families of deployed members of the reserves and the Illinois National Guard.
• Provide a referral network for veterans’ families of mental health providers who are skilled in treating deployment stress, combat stress and post-traumatic stress.

Illinois HR 375 was adopted on June 14. This resolution urges the U.S. Congress to act on H.R. 612, H.R. 1268, H.R. 1538 and S. 713 for the safety and well-being of our returning veterans who face mental illness caused by the fulfillment of their duties.

Maryland HB 1181 was signed by Democratic Gov. Martin O’Malley on April 24 and became Chapter 198 of the Acts of 2007. This bill amends Chapter 290 of the Acts of 2006 by extending the effective period of the Task Force to Study State Assistance to Veterans. The task force will remain in effect for a period of three years, expiring on May 31, 2009. The bill became effective June 1, 2007.

Identical bill SB 873 was also signed by Governor O’Malley on April 24 and became Chapter 197 of the Acts of 2007.

New Hampshire HB 49 was signed by Democratic Gov. John Lynch on June 18. The bill became effective on July 1. This bill amends eligibility requirements for the state’s veterans’ home. The bill states that the one-year residency requirement will be waived for veterans who whose DD214 certificate or any document used by the veterans’ home for admission states a New Hampshire address as his or her home of record upon discharge from active duty. An active duty veteran who has a New Hampshire address as his or her home of record and who is being discharged directly from a medical facility will also be eligible.

Under this bill veteran care includes nursing care, assisted living, domiciliary, day care, dementia, chemical dependency and psychiatric services, and other related services and programs for any veteran otherwise eligible for admittance.

New Hampshire HJR 1 was signed by Governor Lynch on June 11. This resolution urges the General Court to continue funding for the Manchester Veterans’ Center and recommends and encourages the state congressional delegation to support funding for two additional veterans’ mental health counseling centers.

Texas HCR 1 was signed by Republican Gov. Rick Perry on June 15. This concurrent resolution urges the U.S. Congress to support legislation for veterans’ health care budget reform to assure funding for a wide range of specialized services to meet the unique needs of veterans, including treatment and care for spinal cord injury, blindness, traumatic brain injury, PTSD, amputation injuries, mental health and substance abuse, and conditions requiring long-term care. Identical resolution SR 594 was adopted on March 28.

Wyoming SF 76 was signed by Democratic Gov. Dave Freudenthal on March 9. This bill required the Department of Health, by October 1, 2007, to report to the select committee on the mental health needs of military service members serving or having served in Iraq and Afghanistan, and the families of those service members, which are not being met by programs offered by the Veterans Administration or other programs. The report needed to include cost estimates for any programs or services that the department proposes to be administered by the state.

The following bills are currently pending:

Illinois HB 579 would require the Secretary of Human Services to establish a two-year pilot program in three locations across the state to provide mental health services to veterans who do not qualify for mental health services under a federally funded or state-funded program and who do not have insurance coverage for mental health services.

Illinois HB 2179 would require the Department of Veterans Affairs to create and administer a suicide prevention program for veterans of the armed forces, including redeployed veterans of the Illinois National Guard. The program’s primary goal would be to address and reduce the incidence of suicide and PTSD among veterans of the military and the National Guard.

Illinois HR 397 urges the U.S. Congress to pass H.R. 327 and S.479 relating to veteran suicide prevention.

Massachusetts HB 4312 , substituted for HB 3728, would establish a special commission to investigate and study the mental health effects of war on soldiers returning from active duty. The commission would be responsible for creating a mandatory mental health treatment program for National Guard members who engage in combat. The commission would also create a statewide education training program to assist law enforcement, corrections officers and other first responders in recognizing the early warning signs of PTSD.

Identical New Jersey bills AB 2663 and SB 1496 would establish the “New Jersey Veterans Haven Support Fund” and provide for a designation on the state gross income tax return that would permit taxpayers to make voluntary contributions to the fund to support the efforts and initiatives of Veterans Haven. Veterans Haven is a state operated transitional housing facility dedicated to providing psychological, social and vocational rehabilitation to displaced veterans.

New Jersey AR 249 urges the U.S. Congress to address problems at military medical facilities and expresses dismay at treatment of soldiers and sailors returning home with physical and mental injuries.

New Jersey SR 100 urges the U.S. Department of Veterans Affairs to keep open the Patterson Army Health Clinic located at Fort Monmouth. The facility has a state-of-the-art psychology department and serves as a treatment facility for active duty personnel, retirees and veterans in the Monmouth and Ocean County areas. The clinic serves approximately 2,500 veterans and 23,000 military retirees.

The following bills will carry-over to 2008:

Alaska SJR 11 urges the U.S. Congress to ensure adequate funding for veterans’ health care including funding for a wide range of specialized services to meet the unique needs of veterans, including treatment and care for spinal cord injury, blindness, traumatic brain injury, PTSD, amputation injuries, mental health and substance abuse, and conditions requiring long-term care.

California AB 296 would require the Governor’s Advisory Council on Military Affairs to study the critical issues facing veterans and members of the National Guard, and make recommendations on actions that may be necessary to support and otherwise attend to the needs of those men and women, including the following subjects:

• Veteran and National Guard assistance and benefit programs.
• Health and mental health programs
• Educational and vocational programs.
• Employment and reemployment issues.
• Housing and homelessness issues.
• National Guard recruitment and retention issues.
• National Guard training and equipment issues.
• Veterans’ Home construction and facility conditions.

California AB 581 would require the military department to create a Combat Stress Support Team Program to provide emergency crisis counseling, referral and personal support, combat stress evaluations, and mental health support for state military personnel and their families.

Iowa HF 25 would require the Department of Veterans Affairs to establish a suicide prevention program. The program would need to include public education and awareness programs and referral services to appropriate suicide prevention counseling and treatment relative to reducing the incidence of suicide among veterans.

Minnesota SF 1541 would authorize a sentencing court to order defendants suffering from PTSD or other psychological problems into mental health treatment programs. The bill states that it is the intent of the legislature to extend the opportunity for an alternative sentencing to all combat veterans, regardless of where or when those veterans served our country, when those veterans are found by the court to be suffering from PTSD.

Washington SB 6116 would require the Department of Health to conduct a program of training and technical assistance for providers of primary care regarding care, including physical and mental health care, of veterans who have served in heavy combat zones and have chronic conditions.

California SB 851 was vetoed by Republican Gov. Arnold Schwarzenegger. This bill would have provided funds for mental health services and related medications, substance abuse services, supportive housing, vocational rehabilitation, and other non-medical programs necessary to stabilize mentally ill prisoners and parolees, reduce the risk of being homeless and ensured that eligible parolees requiring veterans’ treatment and recovery services outside of their geographic location would be given consideration for those needed services on a case-by-case basis. There has been no opportunity to override the veto as California is in recess.

New York AB 5154, which was substitute for SB 5170, was vetoed by Democratic Eliot Spitzer on July 3. The bill has been tabled. AB 5154 would have established the veteran geriatric mental health act.

This bill would have required the Commissioner of Mental Health and the Director of the State Office for the Aging, with the cooperation by the Division of Veterans’ Affairs to develop a veteran’s geriatric mental health demonstration program. The program would have offered grants to providers of mental health care for geriatric (60 years or older) veterans.

AB 5154 would have also established the Interagency Geriatric Veterans Mental Health Planning Council which would have developed annual recommendations regarding geriatric veteran’s mental health needs including, community integration, quality improvement, and integration of mental health services with services to address alcoholism, drug abuse, health care needs, workforce development, family support and finance.

Six pieces of legislation died pursuant to legislative adjournment in Maryland, Oregon, Texas and West Virginia. Two resolutions (Maryland SJ 4 and Texas SCR 37) would have supported U.S. veterans’ health care budget reform. Oregon HB 3196 and SB 999 would have allowed certain disabled veterans to qualify for the Oregon Health Plan and created a task force on providing improved mental health care for National Guard members respectively. Texas SB 1453 would have ensured the provision of assessment services, crisis services and intensive and comprehensive mental health services for veterans of Operation Enduring Freedom and Operation Iraqi Freedom and their families. West Virginia SCR 66 would have developed a study of the family support mechanisms for dealing with mental health, alcohol and substance abuse issues for veterans.

If you have any questions or comments on the State Policy Focus, please contact Tammy Seltzer, Director of State Policy, at TammyS@TheNationalCouncil.org.