Vet Centers, 46197-46200 [2015-18988]

Agencies

• DEPARTMENT OF VETERANS AFFAIRS

[Federal Register Volume 80, Number 149 (Tuesday, August 4, 2015)]
[Rules and Regulations]
[Pages 46197-46200]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-18988]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AP21


Vet Centers

AGENCY: Department of Veterans Affairs.

ACTION: Interim final rule.

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SUMMARY: The Department of Veterans Affairs (VA) is amending its 
medical regulation that governs Vet Center services. The National 
Defense Authorization Act for Fiscal Year 2013 (the 2013 Act) requires 
Vet Centers to provide readjustment counseling services to broader 
groups of veterans, members of the Armed Forces, including a member of 
a reserve component of the Armed Forces, and family members of such 
veterans and members. This interim final rule amends regulatory 
criteria to conform to the 2013 Act, to include new and revised 
definitions.

DATES: Effective date: This rule is effective on August 4, 2015.
    Comment date: Comments must be received by VA on or before October 
5, 2015.

ADDRESSES: Written comments may be submitted through 
www.Regulations.gov; by mail or hand-delivery to Director, Regulation 
Policy and Management (02REG), Department of Veterans Affairs, 810 
Vermont Avenue NW., Room 1068, Washington, DC 20420; or by fax to (202) 
273-9026. Comments should indicate that they are submitted in response 
to ``RIN 2900-AP21--Vet Centers.'' Copies of comments received will be 
available for public inspection in the Office of Regulation Policy and 
Management, Room 1068, between the hours of 8:00 a.m. and 4:30 p.m., 
Monday through Friday (except holidays). Please call (202) 461-4902 for 
an appointment. (This is not a toll-free number.) In addition, during 
the comment period, comments may be viewed online through the Federal 
Docket Management System (FDMS) at www.Regulations.gov.

FOR FURTHER INFORMATION CONTACT: Michael Fisher, Readjustment 
Counseling Service (10RCS), Veterans Health Administration, Department 
of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420; 
(202) 461-6525. (This is not a toll-free number.)

SUPPLEMENTARY INFORMATION: On September 17, 2013, VA promulgated 38 CFR 
17.2000, which implemented VA's authority to provide readjustment 
counseling services through Vet Centers based on 38 U.S.C. 1712A, as 
amended by the Caregivers and Veterans Omnibus Health Services Act of 
2010 (the 2010 Act), Public Law 111-163, sec. 304, 401(a) and (b). The 
2010 Act amended section 1712A to require VA to provide readjustment 
counseling services to certain servicemembers and veterans who served 
on active duty in specific theaters of combat operations, or in certain 
areas in which hostilities occurred. The 2010 Act also mandated that VA 
provide readjustment counseling to veterans and servicemembers of 
Operation Enduring Freedom and Operation Iraqi Freedom, and the family 
members of such veterans and servicemembers after the veterans and 
servicemembers return from deployment. Although not expressly stated in 
the 2010 Act, VA also considered veterans, servicemembers, and the 
family members of such veterans and servicemembers who participated in 
Operation New Dawn as eligible for readjustment counseling. In 
promulgating Sec.  17.2000, VA implemented the mandates in the 2010 
Act, as well as interpreted section 1712A to permit VA to provide 
readjustment counseling to family members of all veterans that were 
themselves eligible for readjustment counseling. See 77 FR 14707 and 78 
FR 57067. The term ``servicemembers'' as used in Sec.  17.2000 means a 
member of the Armed Forces, including a member of a reserve component 
of the Armed Forces. We note, however, that the terms servicemembers 
and member of the Armed Forces, including a member

[[Page 46198]]

of a reserve component of the Armed Forces, are not used consistently 
in Sec.  17.2000. We are, therefore, amending Sec.  17.2000 to reflect 
the statutory language, which is member of the Armed Forces, including 
a member of a reserve component of the Armed Forces. This change in 
term will not affect or otherwise change the types of individuals who 
are eligible to receive care in Vet Centers.
    On January 2, 2013, Congress enacted the National Defense 
Authorization Act for Fiscal Year 2013, Public Law 112-239 (Jan. 2, 
2013) (the 2013 Act), section 727 of the 2013 Act amended section 1712A 
to broaden the groups of individuals who are eligible to receive 
readjustment counseling from VA. Section 17.2000 is revised to conform 
to these amendments. Section 1712A(a)(1)(C)(i) requires VA to provide 
readjustment counseling to veterans and members of the Armed Forces, 
including a member of a reserve component of the Armed Forces, who 
served on active duty in a theater of combat operations or an area at a 
time during which hostilities occurred in that area, without 
restricting eligibility to any specific theater during combat 
operations, or any specific area of hostilities. Paragraph (a) of Sec.  
17.2000 is revised to restate this statutory eligibility in new Sec.  
17.2000(a)(1)(i). We note that Sec.  17.2000(a)(1)(i), as revised by 
this rulemaking, encompasses the categories of eligible veterans and 
members of the Armed Forces, including a member of a reserve component 
of the Armed Forces, that are listed in current Sec.  17.2000(a)(1) 
through (a)(4). The revisions made by this rulemaking merely restate 
and reorganize the existing language to clarify that the listed 
individuals have been and will continue to be eligible for readjustment 
counseling. Section 1712A(a)(1)(C)(ii) requires that VA provide 
readjustment counseling to a veteran or member of the Armed Forces, 
including a member of a reserve component of the Armed Forces, who 
provided direct emergency medical or mental health care, or mortuary 
services to the casualties of combat operations or hostilities, but who 
at the time was located outside the theater of combat operations or 
area of hostilities. Paragraph (a) of Sec.  17.2000 is revised to 
restate this statutory eligibility in new Sec.  17.2000(a)(1)(ii). 
Section 1712A(a)(C)(1)(iii) states that VA shall provide readjustment 
counseling to a veteran or member of the Armed Forces, including a 
member of a reserve component of the Armed Forces, who engaged in 
combat with an enemy of the United States or against an opposing 
military force in a theater of combat operations or an area at a time 
during which hostilities occurred in that area by remotely controlling 
an unmanned aerial vehicle, notwithstanding whether the physical 
location of such veteran or member during such combat was within such 
theater of combat operations or area. Paragraph (a) of Sec.  17.2000 is 
revised to restate this statutory eligibility in new Sec.  
17.2000(a)(1)(iii).
    VA consulted with the Department of Defense (DoD) to clarify the 
individuals who are considered as remotely controlling an unmanned 
aerial vehicle. DoD indicated that individuals who remotely control 
unmanned aerial vehicles includes, but is not limited to, individuals 
who pilot the unmanned aerial vehicle as well as individuals who are 
crew members of the unmanned aerial vehicle and participate in combat 
related missions. The crew members could include, but are not limited 
to, intelligence analysts or weapons specialists who control the 
cameras, engage the weapon systems, as well as those individuals who 
are directly responsible for the mission of the unmanned aerial 
vehicle. We defer to DoD's expertise in classifying the individuals who 
remotely control an unmanned aerial vehicle because they are the 
ultimate subject matter experts in this field. We are not restricting 
who VA considers to control an unmanned aerial vehicle, we are merely 
clarifying who is eligible for readjustment counseling services. This 
clarifying language is included in paragraph (a)(1)(iii).
    Section 1712A(1)(C)(iv) requires that VA provide readjustment 
counseling to any individual who received counseling under this section 
before the date of the enactment of the National Defense Authorization 
Act for Fiscal Year 2013. We are revising Sec.  17.2000(a) to include 
these individuals as eligible to receive readjustment counseling under 
new Sec.  17.2000(a)(2). New paragraph (a)(2) is added to clearly state 
that VA will continue to provide readjustment counseling to individuals 
who had been receiving such counseling prior to the 2013 Act.
    Section 1712A(a)(1)(C)(v)(I) requires that readjustment counseling 
shall be provided to the family members of a member of the Armed 
Forces, including a member of a reserve component of the Armed Forces, 
who is serving on active duty in a theater of combat operations or in 
an area at a time during which hostilities are occurring in that area. 
Readjustment counseling shall also be provided to family members of 
veterans and members of the Armed Forces, including a member of a 
reserve component of the Armed Forces, who are eligible to receive 
readjustment counseling under section 1712A, namely those previously 
listed in this rulemaking. See 38 U.S.C. 1712A(a)(1)(C)(v)(II). 
Paragraph (a) of Sec.  17.2000 is revised to restate this statutory 
eligibility in new Sec.  17.2000(a)(3), which uses the broader language 
in section 1712A (a)(1)(C)(v)(II), because it encompasses the 
eligibility in (a)(1)(C)(v)(I). Current Sec.  17.2000(a)(5) already 
provides readjustment counseling broadly to all family members, and new 
Sec.  17.2000(a)(3) is merely a renumbering of current Sec.  
17.2000(a)(5).
    Section 1712A provides a definition of the term ``family member'' 
that is substantively identical to the definition of ``family member'' 
in current Sec.  17.2000(a)(5), and this definition will be restated in 
new Sec.  17.2000(a)(3).
    Current paragraph (d) of Sec.  17.2000 contains a list of the 
readjustment counseling services provided by the Vet Centers, defines a 
``psychosocial assessment,'' and generally states that readjustment 
counseling may be provided to eligible veterans and servicemembers, and 
to their family members when such services would aid in the 
readjustment of a veteran or servicemember. Section 1712A(a)(1)(B) of 
38 U.S.C. uses the term ``comprehensive individual assessment'' with a 
definition identical to ``psychosocial assessment'' as it is currently 
used in Sec.  17.2000. We will continue to use the term ``psychosocial 
assessment'' because it is the term most widely used in VA. We do not 
interpret the term ``psychosocial assessment'' to have a different 
meaning than the statutory term ``comprehensive individual 
assessment.'' We are adding paragraphs (d)(1) through (d)(3) to Sec.  
17.2000(d) to better explain when readjustment counseling is provided 
to veterans, members of the Armed Forces, including a member of a 
reserve component of the Armed Forces, and their family members, 
consistent with subsections (a)(1)(B)(i) and (a)(1)(B)(ii) of section 
1712A. New Sec.  17.2000(d)(1) states that readjustment counseling is 
provided for the readjustment of veterans and members of the Armed 
Forces, including a member of a reserve component of the Armed Forces, 
to civilian life or readjustment to continued military service 
following participation in or in support of operations in a combat 
theater or area of hostility. New Sec.  17.2000(d)(2) states that 
readjustment counseling is provided for the readjustment of a family 
member of a member of the Armed Forces,

[[Page 46199]]

including a member of a reserve component of the Armed Forces, to aid 
the family member in coping with such member's deployment. We had 
previously stated in a proposed rulemaking that readjustment counseling 
was provided to the veteran's or servicemember's family to assist such 
veteran in readjusting to civilian life, and further that the 
readjustment counseling provided to the family members is only to the 
extent that such readjustment relates to the veteran's or 
servicemember's military experience. 77 FR 14707, Mar. 13, 2012. The 
2013 Act also states that readjustment counseling is provided to such 
individuals to assist the individual in coping with the veteran's or 
member's of the Armed Forces, including a member of a reserve component 
of the Armed Forces, deployment, to assist in the readjustment of the 
veteran or member to civilian life. We are amending Sec.  17.2000 by 
adding a new paragraph (d)(3) to conform with the 2013 Act and current 
VA policy by stating that readjustment counseling is provided to a 
family member of a veteran or member of the Armed Forces, including a 
member of a reserve component of the Armed Forces, to aid in a 
veteran's or member's readjustment to civilian or continued military 
service following participation in or in support of operations in a 
combat theater or area of hostility, only as it relates to the 
veteran's or member's military experience.
    Section 1712A(h)(1) defines the term ``Vet Center.'' We add a 
substantively identical definition of ``Vet Center'' as the last 
sentence in Sec.  17.2000(e), to mean ``a facility that is operated by 
VA for the provision of services under this section and that is 
situated apart from a VA general health care facility.'' Section 
17.2000(e) deals with the confidentiality of Vet Center records and 
this definition will reassure the individuals who receive readjustment 
counseling that VA maintains the confidentiality of records associated 
with readjustment counseling.
    The authority citation at the end of Sec.  17.2000 is currently 38 
U.S.C. 501, 1712A, 1782, and 1783; Pub. L. 111-163, sec. 304, 401, and 
402. Because the 2013 Act supersedes the 2010 Act, we amend the 
authority citation at the end of Sec.  17.2000 to simply state 38 
U.S.C. 501, 1712A, 1782, and 1783.

Administrative Procedure Act

    In accordance with U.S.C. 553(b)(B) and (d)(3), the Secretary of 
Veterans Affairs concluded that there was good cause to publish this 
rule without prior opportunity for public comment and to publish this 
rule with an immediate effective date. This interim final rule 
incorporates a specific program requirement mandated by Congress in 
Public Law 112-239. The Secretary finds that it is impracticable and 
contrary to the public interest to delay this rule for the purpose of 
soliciting advance public comment or to have a delayed effective date. 
This rule will increase the pool of individuals who are eligible to 
receive mental health care at Vet Centers. This rule will also increase 
access to much needed mental health care services in Vet Centers. For 
the above reason, the Secretary issues this rule as an interim final 
rule. VA will consider and address comments that are received within 60 
days of the date this interim final rule is published in the Federal 
Register.

Effect of Rulemaking

    Title 38 of the Code of Federal Regulations, as revised by this 
interim final rulemaking, represents VA's implementation of its legal 
authority on this subject. Other than future amendments to this 
regulation or governing statutes, no contrary guidance or procedures 
are authorized. All existing or subsequent VA guidance must be read to 
conform with this rulemaking if possible or, if not possible, such 
guidance is superseded by this rulemaking.

Paperwork Reduction Act

    Although this action contains provisions constituting collections 
of information, at 38 CFR 17.2000, under the Paperwork Reduction Act of 
1995 (44 U.S.C. 3501-3521), no new or proposed revised collections of 
information are associated with this final rule. The information 
collection requirements for Sec.  17.2000 are currently approved by the 
Office of Management and Budget (OMB) and have been assigned OMB 
control number 2900-0787.

Regulatory Flexibility Act

    The Secretary hereby certifies that this interim final rule will 
not have a significant economic impact on a substantial number of small 
entities as they are defined in the Regulatory Flexibility Act, 5 
U.S.C. 601-612. This interim final rule directly affects only 
individuals and will not directly affect small entities. Therefore, 
pursuant to 5 U.S.C. 605(b), this rulemaking is exempt from the initial 
and final regulatory flexibility analysis requirements of 5 U.S.C. 603 
and 604.

Executive Orders 12866 and 13563

    Executive Orders 12866 and 13563 direct agencies to assess the 
costs and benefits of available regulatory alternatives and, when 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety effects, and other advantages; distributive impacts; 
and equity). Executive Order 13563 (Improving Regulation and Regulatory 
Review) emphasizes the importance of quantifying both costs and 
benefits, reducing costs, harmonizing rules, and promoting flexibility. 
Executive Order 12866 (Regulatory Planning and Review) defines a 
``significant regulatory action'' requiring review by OMB, unless OMB 
waives such review, as ``any regulatory action that is likely to result 
in a rule that may: (1) Have an annual effect on the economy of $100 
million or more or adversely affect in a material way the economy, a 
sector of the economy, productivity, competition, jobs, the 
environment, public health or safety, or State, local, or tribal 
governments or communities; (2) Create a serious inconsistency or 
otherwise interfere with an action taken or planned by another agency; 
(3) Materially alter the budgetary impact of entitlements, grants, user 
fees, or loan programs or the rights and obligations of recipients 
thereof; or (4) Raise novel legal or policy issues arising out of legal 
mandates, the President's priorities, or the principles set forth in 
this Executive Order.''
    The economic, interagency, budgetary, legal, and policy 
implications of this regulatory action have been examined, and it has 
been determined not to be a significant regulatory action under 
Executive Order 12866. VA's impact analysis can be found as a 
supporting document at https://www.regulations.gov, usually within 48 
hours after the rulemaking document is published. Additionally, a copy 
of the rulemaking and its impact analysis are available on VA's Web 
site at https://www.va.gov/orpm/, by following the link for VA 
Regulations Published from Fiscal Year 2004 to Fiscal Year to Date.

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in the expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more

[[Page 46200]]

(adjusted annually for inflation) in any one year. This interim final 
rule will have no such effect on State, local, and tribal governments, 
or on the private sector.

Catalog of Federal Domestic Assistance

    The Catalog of Federal Domestic Assistance numbers and titles for 
the programs affected by this document are as follows: 64.009, Veterans 
Medical Care Benefits; 64.018, Sharing Specialized Medical Resources; 
64.019, Veterans Rehabilitation Alcohol and Drug Dependence; and 
64.024, VA Homeless Providers Grant and Per Diem Program.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Robert L. 
Nabors, II, Chief of Staff, approved this document on July 29, 2015, 
for publication.

List of Subjects in 38 CFR Part 17

    Administrative practice and procedure, Alcohol abuse, Alcoholism, 
Drug abuse, Health care, Health facilities, Homeless, Mental health 
programs, Veterans.

    Dated: July 29, 2015.
William F. Russo,
Acting Director, Office of Regulation Policy & Management, US 
Department of Veterans Affairs.

    For the reasons set forth in the preamble, the Department of 
Veterans Affairs amends 38 CFR part 17 as follows:

PART 17--MEDICAL

0
1. The authority citation for part 17 continues to read as follows:

    Authority:  38 U.S.C. 501, and as noted in specific sections.


0
2. Amend Sec.  17.2000 by:
0
a. Revising paragraph (a).
0
b. In paragraph (b) introductory text, removing the term 
``servicemember's'' and adding in its place ``member's of the Armed 
Forces, including a member of a reserve component of the Armed 
Forces,''.
0
b. Revising paragraph (d).
0
c. Revising paragraph (e).
0
d. Revising the authority citation at the end of the section.
    The revisions read as follows:


Sec.  17.2000  Vet Center services.

    (a) Eligibility for readjustment counseling. Upon request, VA will 
provide readjustment counseling to any individual who:
    (1) Is a veteran or member of the Armed Forces, including a member 
of a reserve component of the Armed Forces, who:
    (i) Served on active duty in a theater of combat operations or an 
area of hostilities (i.e., an area at a time during which hostilities 
occurred in that area); or
    (ii) Provided direct emergency medical or mental health care, or 
mortuary services, to the causalities of combat operations or 
hostilities, but who at the time was located outside the theater of 
combat operations or area of hostilities; or
    (iii) Engaged in combat with an enemy of the United States or 
against an opposing military force in a theater of combat operations or 
an area at a time during which hostilities occurred in that area by 
remotely controlling an unmanned aerial vehicle operations, 
notwithstanding whether the physical location of such veteran or member 
during such combat was within such theater of combat operations or 
area. Individuals who remotely control unmanned aerial vehicles 
includes, but is not limited to, individuals who pilot the unmanned 
aerial vehicle as well as individuals who are crew members of the 
unmanned aerial vehicle and participate in combat related missions. The 
crew members include, but are not limited to, intelligence analysts or 
weapons specialists who control the cameras, engage the weapon systems, 
as well as those individuals who are directly responsible for the 
mission of the unmanned aerial vehicle.
    (2) Received counseling under this section before January 2, 2013.
    (3) Is a family member of a veteran or member of the Armed Forces, 
including a member of a reserve component of the Armed Forces, who is 
eligible for readjustment counseling under paragraphs (a)(1) or (a)(2) 
of this section. For purposes of this section, family member includes, 
but is not limited to, the spouse, parent, child, step-family member, 
extended family member, and any individual who lives with the veteran 
or member of the Armed Forces, including a member of a reserve 
component of the Armed Forces, but is not a member of the veteran's or 
member's family.
* * * * *
    (d) Readjustment counseling defined. For the purposes of this 
section, readjustment counseling includes, but is not limited to: 
Psychosocial assessment, individual counseling, group counseling, 
marital and family counseling for military-related readjustment issues, 
substance abuse assessments, medical referrals, referral for additional 
VA benefits, employment assessment and referral, military sexual trauma 
counseling and referral, bereavement counseling, and outreach. A 
``psychosocial assessment'' under this paragraph means the holistic 
assessing of an individual's psychological, social, and functional 
capacities as it relates to their readjustment from combat theaters. 
Readjustment counseling is provided to:
    (1) Veterans and members of the Armed Forces, including a member of 
a reserve component of the Armed Forces, for the purpose of readjusting 
to civilian life or readjustment to continued military service 
following participation in or in support of operations in a combat 
theater or area of hostility.
    (2) A family member of a member of the Armed Forces, including a 
member of a reserve component of the Armed Forces, for the purpose of 
coping with such member's deployment.
    (3) A family member of a veteran or member of the Armed Forces, 
including a member of a reserve component of the Armed Forces, to aid 
in a veteran's or member's readjustment to civilian or continued 
military service following participation in or in support of operations 
in a combat theater or area of hostility, only as it relates to the 
veteran's or member's military experience.
* * * * *
    (e) Confidentiality. Benefits under this section are furnished 
solely by VA Vet Centers, which maintain confidential records 
independent from any other VA or Department of Defense medical records 
and which will not disclose such records without either the veteran's 
or member's of the Armed Forces, including a member of a reserve 
component of the Armed Forces, voluntary, signed authorization, or a 
specific exception permitting their release. For more information, see 
5 U.S.C. 552a, 38 U.S.C. 5701 and 7332, 45 CFR parts 160 and 164, and 
VA's System of Records 64VA15, ``Readjustment Counseling Service Vet 
Center Program.'' The term Vet Center means a facility that is operated 
by VA for the provision of services under this section and that is 
situated apart from a VA general health care facility.

(Authority: 38 U.S.C. 501, 1712A, 1782, and 1783)


(The Office of Management and Budget has approved the information 
collection requirement in this section under control number 2900-
0787.)

[FR Doc. 2015-18988 Filed 8-3-15; 8:45 am]
 BILLING CODE 8320-01-P