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[From the Congressional Record, Vol. 130, No. 13, pp. S1185-S1186--Senate, February 8,

1984]

8. 2278. A bill entitled the "Care for Chemically Dependent Veterans Act": to the Committee on Veterans' Affairs.

CARE FOR CHEMICALLY DEPENDENT VETERANS

ACT

Mr. BOSCHWITZ. Mr. President, today I am introducing legislation that will make permanent the Veteran's Administration's authority to place chemically dependent veterans in nonVA community facilities.

Currently, this program is operating under a pilot authority that is due to expire September 30, 1985. The program was begun in 1979 in response to inadequacies in the VA's chemical-dependency program.

Mr. President, I have been in contact with VA officials in medical facilities around Minnesota concerning this program. And their response to my questions about how well it is working have been overwhelming. The typical com. ment has been: "It's the best thing ever to happen to the VA's chemicaldependency program." Veterans who have been through it have made the same sort of comment.

The VA, and the rest of us, have come a long way in our willingness to treat those who suffer from alcohol or drug dependencies. It was not so long ago that alcoholics were considered willful malingerers, and medical treat ment consisted of drunk tanks only. Today, we recognize that chemical dependency is a disease, and should receive medical care accordingly.

I believe the VA's current halfway. house approach of treatment and rehabilitation should be encouraged and continued. And that is why I am introducing my bill today. I hope we on the Committee on Veterans' Affairs can address this issue this year, and remove any uncertainty about the program's future."

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I am pleased to respond to your request for the views of the
Veterans Administration (VA) on S. 2278, 98th Congress, a
bill entitled "Care for Chemically Dependent Veterans Act."
The VA supports the enactment of this proposal.

This bill would make permanent the VA's pilot program to
contract for care, treatment, and rehabilitative services
in halfway houses, therapeutic communities, psychiatric
residential treatment centers, and other community-based
treatment facilities for eligible veterans suffering from
alcohol or drug dependence or abuse disabilities. That
authority expires on September 30, 1985. While the VA
favors this provision, we would recommend that the authority
only be extended for an additional three years.

Our evaluation of this program, which included a followup of veterans eighteen months after treatment, has shown that the contract authority has been, and would continue to be, a valuable, cost-effective modality to supplement VA treatment and rehabilitation of certain veterans. VA treatment program directors, as well as non-VA community program directors, enthusiastically endorse the continuation of this program. Since April 1980, the VA has operated a program authorized by Public Law 96-22 which provides treatment and rehabilitation in community contract facilities, such as halfway houses, to certain veterans suffering from alcohol and drug dependence. In authorizing the establishment of this pilot program, Congress called for the VA to plan and operate a pilot program in order to demonstrate both the medical advantages and cost effectiveness of such care in contrast to comparable care rendered in VA facilities. Congress also directed that VA report by March 31, 1984, on the operation of this pilot program.

Our study has shown that this program has been of greatest benefit to veterans who are essentially alienated from society, deficient in job skills, and without family support. Not only does this program reduce costs to the VA by providing treatment to a veteran in a residential environment rather

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than in a hospital, but it appears to have resulted in reductions in expenditures for additional treatment. In fact, this benefit shall increase with time due to the reduced recidivism rate among the halfway house group. Furthermore, this program is also proving that the halfway house is more successful as a treatment modality than a hospital in facilitating the reentry of the veteran into the community and job market and in the acquisition of self-help and job skills.

Veterans who have been outplaced into community facilities under this program have been more seriously addicted and less able to function independently in society than the VA's substance abuse population as a whole. Following the treatment of eligible veterans at halfway houses under VA contracts, a number of important improvements occurred, including maintenance of a drug-free environment, employment, self-help, and coping skills.

We estimate that the cost of continuing this program to be $6.1 million for fiscal year 1986 and approximately $24.4 million for fiscal years 1986-1989.

We are advised by the Office of Management and Budget that there is no objection to the presentation of this report from the standpoint of the Administration's program.

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II

98TH CONGRESS
2D SESSION

S. 2514

To amend title 38, United States Code, to enhance the management of Veterans' Administration medical treatment programs by providing for the referral of veterans to non-Veterans' Administration entities and arrangements for additional necessary services, to revise and clarify the authority for the furnishing of care for veterans suffering from alcohol or drug dependence, to require the Administrator to establish the position of Associate Director for Post Traumatic Stress Disorder, to require the Administrator to submit a report to Congress regarding programs of the Veterans' Administration providing hospice and respite care to certain veterans, and to authorize the Administrator of Veterans' Affairs to provide telecaption television decoders to totally deaf veterans in certain cases, and for other purposes.

IN THE SENATE OF THE UNITED STATES

MARCH 30 (legislative day, MARCH 26), 1984

Mr. SIMPSON introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs

A BILL

To amend title 38, United States Code, to enhance the management of Veterans' Administration medical treatment programs by providing for the referral of veterans to nonVeterans' Administration entities and arrangements for additional necessary services, to revise and clarify the authority for the furnishing of care for veterans suffering from alcohol or drug dependence, to require the Administrator to establish the position of Associate Director for Post Traumatic Stress Disorder, to require the Administrator to submit a report to Congress regarding programs of the

37-524 0-84-5

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Veterans' Administration providing hospice and respite care to certain veterans, and to authorize the Administrator of Veterans' Affairs to provide telecaption television decoders to totally deaf veterans in certain cases, and for other purposes.

Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 That (a) this Act may be cited as the "Veterans' Administra

4 tion Health Care Amendments of 1984".

5

(b) Except as otherwise specifically provided whenever 6 in this Act an amendment or repeal is expressed in terms of 7 an amendment to, or repeal of, a section or other provision, 8 the reference shall be considered to be made to a section or 9 other provision of title 38, United States Code.

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REFERRALS AND ARRANGEMENTS FOR COMMUNITY

SERVICES

SEC. 2. (a) Chapter 73 is amended by adding at the end

13 of subchapter 1 the following new section:

14 "§ 4120. Referrals and arrangements for community

15

services

16 "In order to enhance the management of Veterans' Ad17 ministration care and treatment programs, the Administrator 18 shall designate one office in each Veterans' Administration 19 health care facility and in central office to coordinate and 20 make arrangements for the provision of referral services to

21 assist veterans, to the maximum extent practicable, in obtain

S 2514 IS

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