[House Report 111-490]
[From the U.S. Government Publishing Office]
111th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 111-490
======================================================================
VETERANS DOG TRAINING THERAPY ACT
_______
May 20, 2010.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Filner, from the Committee on Veterans' Affairs, submitted the
following
R E P O R T
[To accompany H.R. 3885]
[Including cost estimate of the Congressional Budget Office]
The Committee on Veterans' Affairs, to whom was referred
the bill (H.R. 3885) to direct the Secretary of Veterans
Affairs to carry out a pilot program on dog training therapy,
having considered the same, report favorably thereon without
amendment and recommend that the bill do pass.
CONTENTS
Page
Purpose and Summary.............................................. 1
Background and Need for Legislation.............................. 2
Hearings......................................................... 3
Subcommittee Consideration....................................... 4
Committee Consideration.......................................... 4
Committee Votes.................................................. 4
Committee Oversight Findings..................................... 4
Statement of General Performance Goals and Objectives............ 4
New Budget Authority, Entitlement Authority, and Tax Expenditures 4
Earmarks and Tax and Tariff Benefits............................. 5
Committee Cost Estimate.......................................... 5
Congressional Budget Office Estimate............................. 5
Federal Mandates Statement....................................... 6
Advisory Committee Statement..................................... 6
Constitutional Authority Statement............................... 6
Applicability to Legislative Branch.............................. 6
Section-by-Section Analysis of the Legislation................... 6
PURPOSE AND SUMMARY
H.R. 3885 was introduced by Representative Henry E. Brown,
Jr. of South Carolina, the Ranking Member of the Subcommittee
on Health of the Committee on Veterans' Affairs, on October 21,
2009. H.R. 3885, the Veterans Dog Training Therapy Act, would
require the Secretary of the U.S. Department of Veterans
Affairs (VA) to conduct a five-year pilot program in at least
three but not more than five VA medical centers assessing the
effectiveness of addressing post-deployment mental health and
post-traumatic stress disorder (PTSD) through a therapeutic
medium of training service dogs for veterans with disabilities.
The VA would be required to report to Congress annually on its
progress.
BACKGROUND AND NEED FOR LEGISLATION
Considerable attention has been given in recent years to
the invisible wounds of war including mental health illnesses
such as depression, PTSD, substance use disorder, and traumatic
brain injury. Unlike physical injuries, mental health issues
may not be readily apparent but can nonetheless have a harmful
effect on a veteran's quality of life by having a negative
impact upon an individual's mood, thoughts, and behavior.
Currently, VA provides mental health treatment through a
variety of inpatient and outpatient mental health programs in
VA medical centers, community-based outpatient clinics, and vet
centers. In fiscal year 2009, VA's budget for mental health was
approximately $4.5 billion.
Perhaps the most widely recognized mental health issue
affecting veterans, PTSD is a severe anxiety disorder that can
develop after exposure to a traumatic event in which grave
physical harm occurred or was threatened. Combat experience is
one type of event that may trigger PTSD. Experts indicate that
while PTSD is expected in 7 to 8 percent of the general
population, they expect to see the disorder in about 11 to 20
percent of Operation Enduring Freedom (OEF) and Operation Iraqi
Freedom (OIF) veterans, 10 percent of Gulf War veterans, and 30
percent of Vietnam veterans. VA provides nearly 200 specialized
PTSD treatment programs in facilities across the country.
Given the prevalence of PTSD among our veteran population,
Congress has recognized the need to provide veterans seeking
treatment for mental health issues with newer and more
innovative modes of therapy. In that vein, the Conference
Report (H. Rept. 111-366) that accompanied the Consolidated
Appropriations Act, 2010 (P.L. 111-117 (123 Stat. 3034))
included the recommendation that VA ``expand its partnership
with accredited nonprofit service dog organizations where
veterans with PTSD help to train service dogs.''
On March 24, 2008, a Memorandum of Understanding was signed
between the VA Palo Alto Health Care System (VAPAHCS) in Palo
Alto, California, and the Assistance Dog Program to establish a
specialized assistance dog training program for veterans. This
program, within the Recreational Therapy Service at the
VAPAHCS, is designed to create a therapeutic environment for
veterans with post-deployment mental health issues and symptoms
of PTSD to address their mental health needs. Veterans
participating in this program train service dogs for later
placement with veterans with hearing and physical disabilities.
A similar, privately-funded, pilot program is currently
underway at Walter Reed Army Medical Center (WRAMC) where
service dogs have been used in therapeutic settings since 2006.
Called the ``Paws for Purple Hearts'' Service Dog Training
Program, in this pilot Warriors in Transition (WTs) from the
battlefield to the home front volunteer to participate in a
specialized service dog training program. The objectives of the
program are to: improve a WT's emotional, cognitive, and
physical symptoms through purposeful interactions and
participation in a therapeutic occupation; provide an
opportunity for PTSD patients to participate in a goal-
directed, meaningful occupation that facilitates structure,
skill development, and community participation; and, the
successful placement of well-trained service dogs with fellow
servicemembers and/or veterans with significant physical
injuries resulting in mobility impairments.
The Walter Reed program has been so successful in meeting
its objectives that Department of Defense (DOD) officials are
moving to include similar therapeutic models in other service
areas. For example, a similar program will be included in the
National Intrepid Center of Excellence (NICoE) opening in late
June 2010 on the campus of the National Naval Center in
Bethesda, Maryland; the Army Surgeon General has created an
Animal Assisted Therapy task force to develop policies and
research related to dog therapy; and, the Army Family Action
Plan conference listed funding for service dogs for wounded
warriors as their second top issue of importance.
In each of the above programs, training service dogs for
fellow veterans is believed to be helping to address symptoms
associated with post-deployment mental health issues and PTSD
in a myriad of ways. Specifically, veterans participating in
the programs demonstrated improved emotional regulation, sleep
patterns, and sense of personal safety. They also experienced
reduced levels of anxiety and social isolation. Further,
participation in the pilot enabled them to actively instill or
re-establish a sense of purpose and meaning while providing an
opportunity to help fellow veterans and reintegrate healthfully
back into the community. However, despite the anecdotal
evidence of the therapeutic benefit of service dog training on
veterans with mental health issues and PTSD, there is a serious
dearth of scientific research on the value of such programs.
The goal of this legislation is to reach more veterans with
this innovative and successful mental health and PTSD treatment
model and provide a means of collecting important research data
to address the current lack of evidence-based research on the
effectiveness of the service dog training therapy model. The
pilot program created by this legislation has the added benefit
of providing a career path to veterans who successfully
graduate the program and are interested in becoming certified
dog trainers and making well-trained service dogs available to
other disabled veterans.
HEARINGS
On October 1, 2009, the Subcommittee on Health held a
legislative hearing on several bills introduced in the 111th
Congress, including draft legislation on psychiatric service
dogs. The following witnesses testified: The Honorable Bob
Filner of California; The Honorable Stephanie Herseth Sandlin
of South Dakota; The Honorable Phil Hare of Illinois; The
Honorable Ciro D. Rodriguez of Texas; The Honorable Glenn Nye
of Virginia; The Honorable Harry Teague of New Mexico; The
Honorable Michael A. Arcuri of New York; Mr. Joseph Wilson,
Deputy Director, Veterans Affairs and Rehabilitation
Commission, The American Legion; Mr. Justin Brown, Legislative
Associate, National Legislative Service, Veterans of Foreign
Wars; Mr. Rick Weidman, Executive Director, Policy and
Government Affairs, Vietnam Veterans of America; Mr. Blake C.
Ortner, Senior Associate Legislative Director, Paralyzed
Veterans of America; Mr. Peter H. Dougherty, Director, Homeless
Veterans Programs, U.S. Department of Veterans Affairs who was
accompanied by Mr. Paul E. Smits, Associate Chief Consultant,
Homeless and Residential Rehabilitation and Treatment Programs,
U.S. Department of Veterans Affairs; and, Ms. Jane Clare
Joyner, Deputy Assistant General Counsel, U.S. Department of
Veterans Affairs. Those submitting for the record included:
Rick A. McMichael, DC, President, American Chiropractic
Association; the American Physical Therapy Association; and,
the American Tinnitus Association.
SUBCOMMITTEE CONSIDERATION
On October 22, 2009, the Subcommittee on Health met in open
markup session and ordered H.R. 3885 favorably forwarded to the
full Committee by voice vote.
COMMITTEE CONSIDERATION
On May 12, 2010, the full Committee met in an open markup
session, a quorum being present, and ordered H.R. 3885 reported
favorably to the House of Representatives by voice vote.
COMMITTEE VOTES
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report the legislation and amendments thereto.
There were no record votes taken on amendments or in connection
with ordering H.R. 3885 reported to the House. A motion by Mr.
Stearns of Florida to order H.R. 3885 reported favorably to the
House of Representatives was agreed to by voice vote.
COMMITTEE OVERSIGHT FINDINGS
In compliance with clause 3(c)(1) of rule XIII and clause
2(b)(1) of rule X of the Rules of the House of Representatives,
the Committee's oversight findings and recommendations are
reflected in the descriptive portions of this report.
STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES
In accordance with clause 3(c)(4) of rule XIII of the Rules
of the House of Representatives, the Committee's performance
goals and objectives are reflected in the descriptive portions
of this report.
NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX EXPENDITURES
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee adopts as its
own the estimate of new budget authority, entitlement
authority, or tax expenditures or revenues contained in the
cost estimate prepared by the Director of the Congressional
Budget Office pursuant to section 402 of the Congressional
Budget Act of 1974.
EARMARKS AND TAX AND TARIFF BENEFITS
H.R. 3885 does not contain any congressional earmarks,
limited tax benefits, or limited tariff benefits as defined in
clause 9 of rule XXI of the Rules of the House of
Representatives.
COMMITTEE COST ESTIMATE
The Committee adopts as its own the cost estimate on H.R.
3885 prepared by the Director of the Congressional Budget
Office pursuant to section 402 of the Congressional Budget Act
of 1974.
CONGRESSIONAL BUDGET OFFICE COST ESTIMATE
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
for H.R. 3885 provided by the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, May 18, 2010.
Hon. Bob Filner,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 3885, the Veterans
Dog Training Therapy Act.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Sunita
D'Monte.
Sincerely,
Douglas W. Elmendorf.
Enclosure.
H.R. 3885--Veterans Dog Training Therapy Act
H.R. 3885 would require the Department of Veterans Affairs
(VA) to establish a pilot program through which veterans
diagnosed with post-traumatic stress disorder or other mental
health conditions would train service dogs for use by disabled
veterans. The pilot program would operate in three to five
medical centers over a five-year period. CBO estimates that
implementing the bill would cost $7 million over the 2011-2015
period, assuming appropriation of the necessary amounts.
Enacting this legislation would not affect direct spending or
revenues; therefore, pay-as-you-go procedures would not apply.
H.R. 3885 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act and
would not affect the budgets of state, local, or tribal
governments.
The estimated budgetary impact of H.R. 3885 is shown in the
following table. The costs of this legislation fall within
budget function 700 (veterans benefits and services).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
---------------------------------------------
2011 2012 2013 2014 2015 2011-2015
----------------------------------------------------------------------------------------------------------------
CHANGES IN SPENDING SUBJECT TO APPROPRIATION
Estimated Authorization Level..................................... 1 1 1 2 2 7
Estimated Outlays................................................. 1 1 1 2 2 7
----------------------------------------------------------------------------------------------------------------
Based on information from VA, CBO estimates that the
department would implement the pilot program in four medical
centers and would require two recreation therapists and one
certified dog trainer at each facility as well as one
recreation therapist and a director to oversee the program.
Based on a similar program at the VA facility in Palo Alto,
California, CBO further estimates that each facility would
train five service dogs every two years. Assuming the program
would be phased in over three years and that the necessary
amounts would be appropriated, CBO estimates that implementing
the bill would cost $1 million in 2011, growing to $2 million a
year by 2014.
The CBO staff contact for this estimate is Sunita D'Monte.
The estimate was approved by Theresa Gullo, Deputy Assistant
Director for Budget Analysis.
FEDERAL MANDATES STATEMENT
The Committee adopts as its own the estimate of Federal
mandates regarding H.R. 3885 prepared by the Director of the
Congressional Budget Office pursuant to section 423 of the
Unfunded Mandates Reform Act.
ADVISORY COMMITTEE STATEMENT
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act would be created by H.R.
3885.
CONSTITUTIONAL AUTHORITY STATEMENT
Pursuant to clause 3(d)(1) of rule XIII of the Rules of the
House of Representatives, the Committee finds that the
Constitutional authority for H.R. 3885 is provided by Article
I, section 8 of the Constitution of the United States.
APPLICABILITY TO LEGISLATIVE BRANCH
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION
Section 1. Short title
This section provides the short title of H.R. 3885 as the
``Veterans Dog Training Therapy Act.''
Section 2. Department of Veterans Affairs pilot program on dog training
therapy
Section 2(a) of the bill would require the Secretary of the
VA, beginning no later than 120 days after enactment, to carry
out a pilot program to assess the effectiveness of treating
post-deployment mental health issues and PTSD using the
therapeutic medium of training service dogs for veterans with
disabilities.
Section 2(b) of the bill would require the pilot described
in Section 2(a) be carried out in at least three but not more
than five VA medical centers during a five-year period
beginning on the date of commencement of the pilot.
Section 2(c) of the bill would require that each VA medical
center selected for participation in the pilot provide a
training area for educating participating veterans in dog
training and handling and that such training area include an
indoor space for grooming and training, be wheelchair
accessible, include a classroom or lecture space, include
office space, include storage space, provide for periodic use
of other training areas, include outdoor exercise and toileting
space, and provide for weekly field trips.
Section 2(d) of the bill would require the pilot program
set up under Section 2(a) be administered through the VA's
Recreation Therapy Service under the direction of a certified
recreational therapist, establish a qualified director of
service dog training, ensure that each site have certified dog
trainers, ensure that dogs used in the program be purpose-bred
for assistance dog work and have adequate temperament and
health, ensure that each dog be taught 90 basic commands,
ensure that each dog live at the program site or with a
volunteer foster home, ensure that the program include both
lecture and hands-on training/grooming components, and be
designed to maximize therapeutic benefits and provide well-
trained assistance dogs to veterans with disabilities.
Section 2(e) of the bill would define a veteran eligible
for the pilot program as a veteran with PTSD or another post-
deployment mental health issue who volunteers, if the Secretary
determines there are adequate resources available.
Section 2(f) of the bill would create a hiring preference
for service dog trainers who are veterans who have successfully
completed PTSD or other residential treatment programs and
received adequate dog training certification.
Section 2(g) of the bill would require the VA Secretary to
collect data to determine the effectiveness of the program and
include information on how it assists veterans with reducing
mental health stigma, improving emotional regulation, improving
patience, establishing a sense of purpose, providing an
opportunity to help fellow veterans, reintegrating back into
the community, reducing social isolation, building relationship
skills, relaxing their survival state, improving sleep
patterns, and decreasing medication use.
Section 2(h) of the bill would require a yearly report to
Congress on the program including the number of participating
veterans; a description of the program's services; the effects
of the pilot on symptoms of mental illness, relevant
physiological markers, family dynamics, insomnia, pain
management, and overall well-being; and, recommendations to
extend or expand the program.
Section 2(i) of the bill would define a ``service dog
training instructor'' as someone who provides direct training
of veterans with PTSD or other mental illness in assistance dog
training and handling.