S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 1195--A

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                            January 27, 2009
                               ___________

Introduced  by Sens. FUSCHILLO, ADAMS, ALESI, DeFRANCISCO, DUANE, FLANA-
  GAN, GOLDEN,  GRIFFO,  HANNON,  O. JOHNSON,  LANZA,  LARKIN,  LAVALLE,
  LEIBELL,  LIBOUS, LITTLE, MAZIARZ, MONSERRATE, MORAHAN, ONORATO, PADA-
  VAN, PARKER, RANZENHOFER, ROBACH, SERRANO, STACHOWSKI, VOLKER, WINNER,
  YOUNG -- read twice and  ordered  printed,  and  when  printed  to  be
  committed to the Committee on Veterans, Homeland Security and Military
  Affairs  --  committee  discharged, bill amended, ordered reprinted as
  amended and recommitted to said committee

AN ACT to create a course of instruction to train mental health  provid-
  ers in veteran specific mental health issues

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Short title. This act shall be known and may  be  cited  as
the "veterans mental health training initiative".
  S  2.  Legislative intent. The legislature finds and declares that the
state of New York and the country at large are facing a formidable chal-
lenge in serving the mental health  needs  of  veterans  returning  from
active  duty  in Iraq and Afghanistan.  Since the beginning of Operation
Enduring Freedom and Operation  Iraqi  Freedom,  over  one  and  a  half
million  active  duty  and reserve members of the United States military
have been deployed to Iraq or Afghanistan, and nearly  one-half  million
have been redeployed. With each deployment, our service members encount-
er  extreme  strains on their physical and mental health, which, in many
cases have resulted in unprecedented rates of health and  mental  health
problems,  most  notably post-traumatic stress disorder (PTSD) and trau-
matic brain injury (TBI). Equally  alarming,  are  numerous  reports  of
increased  suicide,  addiction  and  homelessness  among  our  returning
soldiers. Further, family members are struggling with the  ramifications
of  extended and/or multiple deployments, resulting in serious emotional
and psychological tolls.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03301-05-9

              

S. 1195--A                          2

  In addition to high rates of PTSD,  providers  in  the  mental  health
community  have  also begun reporting increased cases of traumatic brain
injury sustained in the Iraq and Afghanistan theatres of combat  due  in
large  part  to  the  use of improvised explosive devices (IED). Equally
disturbing  is  the  rate  at  which  TBI has been misdiagnosed as PTSD.
Numerous reports have told the story of soldiers returning from Iraq and
Afghanistan with brain trauma, but because there  are  no  visible  head
wounds, symptoms such as memory loss and confusion are often mistaken as
indicators of PTSD.
  Many  returning  service  members,  particularly  National  Guard  and
Reserves, are not accessing services from the federal veterans  adminis-
tration or through the department of defense tricare system upon return-
ing  home;  but  rather, through community-based organizations and agen-
cies. Therefore, community-based providers are experiencing an influx of
returning service members for whom they are  not  entirely  prepared  to
provide treatment.
  To  assure  that such care be provided by an adequately trained mental
health workforce, the state shall, through an open grant process, engage
associations of social workers to design and conduct,  in  collaboration
with  an  association  of psychiatrists and associations of physicians a
multi-disciplinary educational and training program  for  mental  health
providers  to  assist such providers, within their lawful scope of prac-
tice, to identify, diagnose, and put forward a course of  treatment  for
combat  related  PTSD,  TBI  and  other  mental health issues, including
substance abuse. This course shall also serve to educate service members
and family members of service members in  accessing  mental  health  and
related social services.
  S  3. The office of mental health in consultation with the division of
veterans' affairs shall:
  a. through an open and competitive process award a grant  of  no  less
than  $500,000.00  for the purpose of developing and deploying an educa-
tion and training program for health, mental  health,  and  other  human
service providers. Such program will also provide training and education
to  veterans  and family members of veterans on navigating mental health
systems of care.
  Such program will be designed to maximize the treatment  and  recovery
from  combat  related  post-traumatic  stress disorder (PTSD), traumatic
brain injury (TBI)  and  other  combat  related  mental  health  issues,
including  substance  abuse.    This  grant  shall be distributed in the
amount of $250,000.00 at the beginning of each state  fiscal  year,  for
two  years,  starting  in  2009;  however, a sum to be determined by the
office of mental health may be forwarded for future years'  expenditures
if it is determined to be necessary for the proper implementation of the
program;
  b.  require  such  association  of  social  workers  to  implement the
purposes of such grant in collaboration with an association of  psychia-
trists,  an  association  of physicians and such other statewide associ-
ations, as the office of mental health in consultation with the division
of veterans' affairs shall deem appropriate; and
  c. have the power to audit  such  association  to  ensure  the  proper
expenditure of state funds.
  S 4. The association receiving such grant pursuant to section three of
this act shall:
  a.  develop and deploy an education and training program as prescribed
in  section  three  of  this  act. Such program shall be consistent with
national and state guidelines regarding the diagnosis and  treatment  of

S. 1195--A                          3

PTSD,  TBI  and  combat related mental health issues including substance
abuse;
  b. conduct such program in multiple locations across the state;
  c.    establish an advisory committee to include experts in the fields
of neurology and psychiatry, to be recommended by the statewide  associ-
ation  of physicians and the statewide association of psychiatrists. The
advisory committee will also include experts in traumatology, PTSD, TBI,
military  mental  health,  veterans'  health  and  administration,   and
licensed  social  work  practitioners  with  a demonstrated expertise in
veterans mental health. The advisory  committee  shall  also  include  a
combat veteran and a family member of a combat veteran;
  d.  contract  with  an association of physicians and an association of
psychiatrists to (1) advise and assist with the design  and  development
of  core  content  with  respect  to matters relating to the practice of
medicine; and (2) provide physician  experts  in  PTSD,  TBI  and  other
combat related psychiatric and neurological disorders for the program;
  e.  produce a yearly report to the legislature, the division of veter-
ans' affairs, office of mental health and the office of  alcoholism  and
substance abuse services regarding the progress, expenditures and effec-
tiveness of the program;
  f.  conduct  the  program  in  direct  consultation with the office of
mental health and the division of veterans' affairs; and
  g. provide a certified continuing education course on veteran specific
mental health issues, to be made available online.
  S 5. The office of alcoholism and substance abuse services shall:
  a. consult with the office of mental health and the division of veter-
ans' affairs and provide guidelines necessary for the proper design  and
implementation of this program; and
  b.  have  the  power  to  make recommendations to the office of mental
health and the division of veterans' affairs and legislature as  to  the
effectiveness and future need for such a program.
  S  6.  Nothing  in  this act shall be construed to affect the scope of
practice of any profession licensed pursuant to the laws of  this  state
or to authorize or compel any change therein.
  S  7.  This  act  shall take effect on the sixtieth day after it shall
have become a law and shall expire and be deemed  repealed  three  years
after  such  effective  date.  Effective immediately such rules or regu-
lations as may be necessary for the implementation of this  act  on  its
effective  date  are  authorized  to be made on or before such effective
date.