VA Pilot Demonstration Update and ACTION CONOPS

What Can Clinics Do to Work with the VA and potentially be reimbursed for TBI/PTSD treatments?


Concept of Operations for

Delivery of HBOT-for-PTSD/TBI and

Update on VA’s HBOT Pilot Demonstration Program

SUMMARY: With the passage of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019, S.785, the battle shifts. The TreatNOW Coalition is working to expand the VA’s offering of HBOT for PTSD/TBI.  Based on current feedback from their HBOT Pilot Demonstration so far, results and data have demonstrated HBOT is safe and effective and uniformly successful in treating and helping to heal symptoms of PTSD (with or without TBI) and in treating wounds to the brain. With the suicide epidemic growing across all military services, the National Guard, the Reserves, the VA, Special Operations and in society, Congress should insist that HBOT be made available for all brain-wounded service members and veterans without delay. The MISSION Act anticipates the use of and payment for HBOT in the private sector, starting with the seven states which have already enacted legislation to make HBOT available to TBI/PTSD veterans, in addition to the the 100+ TreatNOW Coalition Clinics.
With the passage of S.785 in both the House and Senate, the stage is set for Congress and individual clinics to bring pressure on the VA to expand their Pilot to include both TBI/PTSD and to pay for treatments and ancillary costs.


I. ACTIONS everyone can take on several levels
II. Update on VA’s HBOT Pilot Demonstration Program
III. S.785 – A BILL To improve mental health care provided by the
Department of Veterans Affairs, and for other purposes.
IV.  VA PTSD Pilot: “How To” Steps for Veterans and Caregivers

I. Concept of Operations for ACTION Urging Congress and the VA to expand use of HBOT for TBI/PTSD

EXECUTIVE SUMMARY. Actions clinics and individuals can take, alone and in collaboration with others, to help end the suicide epidemic and get help to brain wounded service members and citizens.
  1. Your Senators and Congressional legislators are your best route to success in becoming part of the growing effort to employ HBOT, with reimbursement, to combat TBI/PTSD/PSC. The “model” is North Dakota where the delegation continues to work tirelessly to expand the program. There is simply no substitute for the effort you have to put in to educate local, state and especially federal legislators about HBOT. These elected officials can pressure the VA leadership to add your site.
  2. Strengthen your relationships with your local VA. It is highly likely that any expansion of the VA Pilot Demonstration Program will involve clinics that are integrated into working with their local VA. What does that mean? If you are not already on the VA approved vendor list, consider beginning the process to get added to their list.
  3. Become a Preferred Provider. Call your local VA and let them know you are an HBOT provider and that you would like to work with them to provide on-label and off-label services to veterans.
  4. Contact VA doctors who are authorized to diagnose and prescribe for use of HBOT for veterans. Invite them to the clinic. Do what you must to ensure that you and your clinic are known quantities.
  5. Contact the Center for Compassionate Innovation (CCI) [202-461-6969, and below] and speak with the staff conducting the Pilot to learn more about the Program. Become a known quantity to them.
  6. NOTE: The new legislation does not allocate any dollars to treatment. HBOT is still an off-label Indication that is uninsured. However, the VA will pay for treatment to providers who have contracts for services under the “meaningful use” contract between the VA and you the provider.

Congressional Actions: 

A separate set of names with contact information for Congressional members and their staffs is attached. A larger spread sheet of Committees and staff members is also available.
  1. Passage of S.785, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019, moves us to the next level of action required of Congress, the VA, the DoD, and the White House.
  2. Members must be contacted, educated and “encouraged” to demand that DoD, the VA and military medicine in general inform all brain-wounded service members about HBOT, and the availability and locations of treatment centers.
  3. Congress must ensure the President’s orders are followed, that insured coverage must be made available for HBOT treatment for all service members.
  4. POCs on Capitol Hill to contact, in addition to your US Senators and Legislators, include:
SEN John Hoeven (R-ND) (202) 224-2551
Staffer: Logan Skarphol

SEN Kevin Cramer (R-ND) (701) 205-6576
Staffer: Randy Richards
SEN Steve Daines (R-MT) (202) 224-2651
Staffers: Doug Pack
              Dillon Vaden
              Rachel Green
REP. Andrew Biggs (R-AZ) (202) 225-2635
         Staffer: Cesar Ybarra
         REP. Greg Murphy (R-NC) (202) 225-3415
Staffer: Ray Celeste
REP Ken Buck (R-CO) (202) 225-4676
Staffer: James Hampson
REP Mike Thompson (D-CA) (202) 225-3311
Staffer: Suzanne Dodge
Rep Steny Hoyer (D-MD) (202) 225-4131
Staffer: Jim Notter
  1. Congress can further demand that states be reimbursed for their own Hyperbaric Oxygen Treatments provided to TBI/PTSD veterans in the private or state sector under the Veterans Bureau Act of 1921. 

White House Actions: 

The President has said and acted repeatedly in ways that favor getting help to service members with brain wounds. In a variety of Executive Actions, he has mandated that more attention and funding must be paid to getting help immediately. Those Actions include:
  1. $10Million moved immediately to treat 1,000 veterans in clinics outside the VA. That plan, using a current Pilot Demonstration Program in the VA’s Compassionate Care Coalition, is spelled out in more detail below.
  2. Immediate use of DoD Hyperbaric facilities on Army, Navy, USAF and Marine properties, to treat active duty service members, augmented by private civilian clinics listed at: . There are over 1,150 hospitals across the country with one of more HBOT chambers with only 50% utilization rate that are available to treat today. We can provide a list of those hospitals by state.
  3. Immediate expansion of the VA Pilot Demonstration Project to fund treatments with HBOT in TreatNOW Coalition clinics and through local and regional hospitals.
  4. Orders to use Tricare funding to provide insured coverage outside DoD and the VA for HBOT for TBI/PTSD/PCS, where hyperbaric medicine is not practiced for brain wounds within the VA or DoD.
  5. Clarification of all signed Executive Orders mandating that the multiple epidemics afflicting the military – suicide, mental health, brain wounding – demand that military medicine is obligated under the doctrine of Informed Consent to inform service members about treatments that are safe, effective and available in the private sector.
  6. Insistence that the recent Executive Order, the Task force/National Roadmap to Empower Veterans and End Suicide, include proponents for Functional Medicine and alternative, non-drug interventions to arrest the suicide epidemic.
  7. Mandate that the FDA, CMS, CDC, VA and DoD fast-track approval of HBOT for insured coverage under rules that apply in times of epidemics. Justification is the existing nineteen HBOT clinical trials data collected since 2007.
  8. As with diabetic foot wounds, CMS/Medicare can approve HBOT for TBI under the Medicare Coverage with Evidence Program.

VA Actions:

  1. Contact the VA’s Center for Compassionate Innovation and insist that the VA expand and accelerate their Pilot Demonstration Project to fund TBI/PTSD/PCS patients using HBOT, with funds under Tricare and a portion of the drug budget. The current 5/6 sites should be expanded to dozens more clinics or hospitals that are already safely and effectively treating and healing TBI/PTSD/PCS using donated funds. The Pilot has shown near-total success with nearly 30 patients, using CCI standards.
  2. Insist that the VA inform all brain-wounded veterans that HBOT treatment is available that is safe, effective and nearly always leads to elimination of suicidal ideation, depression, and use of drugs.
  3. The VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018, signed into law by the President on June 6, 2018, appropriated $5.2 billion in mandatory funding for the Veterans Choice Program to continue to provide care to Veterans until the new, consolidated Veterans Community Care Program is operational. MISSION Act funds should be utilized to provide HBOT for TBI care, since the VA does not offer HBOT care for brain wounds. There is an extensive network of over 1,150 hospitals across the country with HBOT chambers, trained and qualified medical staff, technicians, and doctors available to treat today.
  4. Educate the VA’s primary doctor in charge of brain wounds, Dr. Richard A. Stone about HBOT’s mechanisms of action that heal brain wounds. See:
  5. We must light a fire under the VA’s Center for Compassionate Care Innovation (CCI) and their Demonstration Pilot. Contact CCI within the VA and demand expedited and expanded use of HBOT within the VA. [ pressrel/pressrelease.cfm?id=3978]. The Oklahoma State Center, allied with Muskogee VA, has treated a dozen patients, all successfully. The Travis AFB facility near to the Sacramento VA has treated no patients. San Antonio TX has successfully treated a handful and Tampa FL has treated none. The Fargo ND clinic has successfully treated over 14 and more are in the pipeline. CCI intended to evaluate processes for 200 patients. We have to increase their sense of urgency, along with their outreach and the acceptance of TBI patients. Contact CCI for information about the Demonstration Project at:  CCI Project Leads include Tracy Weistreich (541) 499-5945 and Jamie D. Davis .
         VA Pilot Demonstration POCs:
Dr. Joseph Dituri, Ph.D. Tampa
Mario Caruso, Tampa        
Dr Paul Rock, OSU             
Dr. Jason Kelly, Travis        
Dr. Ben Slade, Travis          
Dr. George Wolf, San Antonio
Dr. Daphne Denham Fargo ND
  1. Ensure that every Marine with TBI/PTSD/PCS knows to ask for HBOT for TBI/PTSD/PCS. Starting with Marines in the Wounded Warrior Battalion, provide every veteran with information about where HBOT clinics are and offer help in getting insured Tricare, or equivalent, coverage for treatments.
  2. Help every veteran understand that help is available immediately, irrespective of VA actions. Private sector clinics need to be put in contact with VSOs that will help fund HBOT treatments. See America’s Mighty Warriors and and other organizations that are currently helping to heal brain wounds with HBOT and alternative therapies.
  3. The VA should start immediately contracting with 1150+ across the country local hospitals for access to their HBOT chambers for internal use of HBOT for diabetic foot wounds (DFW), thus avoiding amputations. At a minimum, all DFW patients should be informed that HBOT is FDA-approved for their wounds since 2002 and that HBOT clinics and hospital Wound Care Centers across the country are available to treat those wounds. From 1989 through 2020, it is estimated 199,000 veterans have experienced Lower Limb Amputations (LLA’s), or on average of 6032 LLA’s per year at an estimated surgical total cost of $12.5B. 70.9% of these veterans die within three years. FDA approved HBOT for DFW could potentially lower this cost in half or more while saving as many lives yearly.
SpecOps Actions: USMC Command has repeatedly flirted with using HBOT for brain wounded Marines, SEALs and others. [See: starting at 4:00 minutes].
  1. A growing number of medical doctors are diagnosing and prescribing HBOT for their brain wounded: Wounded Warrior Battalion/East, Ft Bragg, Joint Base Sam Houston, Force Recon Marines. Chambers are available on bases across the services that can be employed today to treat brain wounded SpecOps. The private sector cannot and should not be expected to do DoD’s job for free.
  2. In addition to Suicide Prevention, mental health and TBI/PTSD, drug and substance abuse emergencies, SpecOps has front-line problems that HBOT can address, like High Altitude Mortality Reduction in Combat Casualty Care. Too many casualties die at altitude due to oxygen starvation.

DoD Actions:

  1. On October 1, 2018 the DEPSECDEF instituted the WARFIGHTER BRAIN HEALTH AND COUNTERING TRAUMATIC BRAIN INJURY Task Force. Dr. Terry Rauch, Acting Deputy Assistant Secretary of Defense for Health Readiness Policy and Oversight, was put in charge. DoD needs to be reminded that they can rapidly bring HBOT to bear on the TBI/Suicide/Drug Overdose problem, starting with using their own chambers to treat brain wounds. In parallel, they can insist that the Tricare, Choice/MISSION act insurance covers HBOT-for-TBI, and that all service members with brain wounds are told that a safe, effective and drug-free alternative is available to provide them what the DEPSECDEF articulated: “Our objective always must be to return the warfighter to full health and maximize each member’s quality of life in our military and civilian communities – no matter how long it takes.” Dr. Rauch can be reached at (703) 681-8472 or
  2. The Deputy Secretary of Defense Memorandum dated October 1, 2018 on a Comprehensive Strategy and Action Plan for Warfighter Brain Health stipulates on Page 3, “We must standardize our diagnostic and treatment protocols across the spectrum of medical and non-medical care options, to optimize the use of existing therapies, while rapidly translating emerging science into our methods and practice: improving access to care and clinical trial participation for warfighters who have sustained a TBI; and leveraging advanced diagnostic tools, promising breakthrough therapies, and long-term monitoring to fast-forward our ability to identify, care for, and treat those affected”. Simply put, engage with the medical industry and bring about that treatment that has a proven track record of healing TBI.

VSO Actions:

  1. Ensure all active duty, retired and veteran service members know about HBOT and know that they have a right via “informed consent” to be told about treatments and therapies like HBOT. To the extent possible, that should include VSA providing objective data documenting brain injury.
  2. Ensure Command is told about on-going pro-bono efforts with HBOT that work to heal brain wounds and restore patients to combat status in most cases.
  3. Brief Services Commanders and DoD on actions currently underway that continue to demonstrate the safety and efficacy of HBOT to treat and help heal brain wounds.
  4. Demand that service medical personnel know about worldwide science about HBOT that shows safety, efficacy and cost-effectiveness of using HBOT and alternative therapies.
  5. Brief all organization personnel on the need to find, inform, and assist brain-wounded service members to get hyperbaric oxygen therapy help ASAP.
  6. Collaborate with other VSOs to identify, inform, assist and ensure treatment for brain wounds using HBOT before it is too late.

State Legislative Actions: 

TreatNOW has a national coordinator for state legislation: Eric Koleda was instrumental in passing Kentucky legislation that calls for the use of HBOT for TBI/PTSD/PCS. Other states with similar legislation are Oklahoma, Texas, Indiana, Arizona, Florida, and North Carolina. [See:  ] Assistance is needed in every state to help in identifying members of the legislature amenable to helping heal brain wounds with HBOT. TreatNOW has many volunteer veterans crafting legislation and they are available to assist. Read about State Actions and call Eric for a start. Eric Koleda, (502) 938-1300.

II.   Update on VA’s HBOT Pilot Demonstration Program

The TreatNOW Coalition has been following the VA HBOT Pilot Demonstration from inception. After nearly three years, the data from the five sites is less than robust, though the results of treatments continue to be positive: all treated patients improved: 30 for 30 patients with significant medical improvement.

  1. OSU/Tulsa Wound Care Center at Oklahoma State University Medical Center: Twelve patients have completed 40 treatments each, for a total of 480 hours of treatments. They have evaluated and started treatment on 16 patients referred by the VA. Three stopped treatments for various personal reasons. One chose not to pursue treatment following the initial evaluation. One other has never showed up for the scheduled treatments following the initial evaluation. There are five patients that have been recently referred by the VA that are being scheduled for the initial evaluation. The VA has not found any problems with the referral process, and the OSU Wound Care Center and Hyperbaric Unit has been reimbursed for all the HBO treatments provided. The major difficulty, according to the VA is that patients worry about the length of treatment, two months. [Tulsa does not dive twice a day; other clinics will and do.]
  2. Travis AFB, CA: VA Northern California Health Care System in cooperation with David Grant Medical Center on Travis Air Force Base: A few phone calls, one referral, no treatments completed, no recent activity.
  3. San Antonio, the South Texas Veterans Health System, in cooperation with Nix Health and San Antonio Military Medical Center, Fort Sam Houston: Four treated successfully, others being assessed for the program.
  4. Tampa: James A. Haley Veterans’ Hospital and Undersea Oxygen Clinic and Florida Hospital. No referrals, even after several visits by VA staff.
  5. Fargo, ND: Fargo VA Health Care System and Healing with Hyperbarics, Fargo ND Fourteen complete, six in treatment, pipeline appears to be filling with referrals.

    NET NET: 30 successes out of 30 fully treated, no significant complications. But there is no sustained activity. This despite 2 clinics allegedly active for 2.9 years, 2 more at one year, and the 5th after several months.

  6. One thing was made clear to us at the beginning: this HBOT Pilot is not meant to be scientific research. Rather it is an opportunity for the VA to observe and learn what it can about how logistics surrounding HBOT treatment, and how HBOT is administered. [The logical extension of that line of reasoning is that the VA is learning in preparation for making HBOT available VA-wide. There is no indication of where the VA intends to go with whatever they learn. Nevertheless, it was good to read that data are meant to be recorded in the VA’s Computerized Patient Record System (CPRS).]
  7. One clinic told us about reimbursement for the Pilot. Under Local Coverage Determination (LCD), Medicare Code G0277 was approximately $80/unit, with each daily treatment 4 units = $320 per dive. Physician Code 99183 was $125. Invoices would be paid out of a Special Allocated Fund at the completion of 40 dives. Another clinic is receiving quite a bit less for each dive.
  8. It is TreatNOW’s position that there needs to be a defined tactical path forward, especially when there is a treatment protocol that is producing 80-100% positive results. A medium-term approach could transform the VA Pilot Program into an IRB study whereby the data collected under protocol could be published and shared among scientist and the medical profession in addition to the CMS and FDA.
  9. The question was raised early about the designation “PTSD-only” patients, and whether patients with TBI could get the help. The Protocol from the VA for the Pilot states: “This clinical demonstration project proposes to provide Veterans, with a history of posttraumatic stress disorder (PTSD), with or without a diagnosis of co-occurring traumatic brain injury (TBI), access to hyperbaric oxygen therapy (HBOT).” Our advice is that every veteran with evidence of brain injuries, irrespective of diagnosis, get in front of their mental health provider ASAP and: request a reevaluation for PTSD and/or TBI; and request HBOT treatment. Chances are the VA Health Provider will not have heard about the Pilot Demonstration Project.
  10. Another question is whether veterans outside the area of the five Pilot Sites are eligible for inclusion at one of the five sites, and whether the VA will pay for expenses like travel, per diem, etc. Here’s one answer we got from within the VA/CCI:

    “As I mentioned on the phone, we strongly encourage Veterans who are experiencing suicidal ideation to call the Veterans Crisis Line (800-273-8255, select 1) and to contact their VA mental health provider for acute care.

    “I also mentioned this morning that referrals for the HBOT for PTSD initiative are made by VA providers. Veterans who are not enrolled at one of the five facilities participating in the initiative should contact the VA mental health provider where they are enrolled to request a referral. The process is internal to VA and utilizes the Veteran’s VA electronic health record. You can read more about this internal process in VHA Directive 1232(2) Consult Processes and Procedures.

    “I would like to emphasize that, if a Veteran is not enrolled at one of the five VA facilities participating in this project, they should contact their VA mental health provider at the VA where they are enrolled to discuss a referral for treatment that is not available at their facility. Contacting the Fargo VA directly when the Veteran is enrolled at a VA facility in Iowa is not the appropriate process. Call the VA mental health provider at the VA where you are enrolled.

    “Placing a referral and approval of referrals is determined on an individual basis and depends on a number of factors. These factors are discussed between a Veteran and their VA provider when the Veteran expresses interest in or is recommended by the VA provider to try any treatment modality, including HBOT. Our office is not involved in the referral process or decisions on Veteran’s healthcare or benefits. VA facilities participating in the HBOT for PTSD initiative have established their own protocols for carrying out this initiative.

    “Veterans can speak to the VA staff where they are enrolled for more information on their eligibility and benefits. Veterans may seek out care at non-VA facilities at their discretion, however, they may not be reimbursed for expenses they pay out-of-pocket outside of the VA network.

    “For additional questions regarding the work we do in the Office of Community Engagement, you are very welcome to visit our website ( or send an email to”

  11. Another guidance email from within the VA states: “VA cannot refuse treatment for any eligible Veteran. The issue becomes the receiving facility’s willingness to provide this treatment for a Veteran not currently under their care. Eligibility for travel reimbursement for eligible Veterans also plays into the equation. If travel reimbursement eligible, the Veteran will receive this benefit, too.

    We leave these decisions up to the referring provider to coordinate with the provider who considers the request, as VA policy dictates. My suggestion is to have the VA … provider reach out to [one of the 5 sites]

    If the … provider is willing to make the referral and [one of the 5 sites] is also in agreement and willing to accept the referral, the patient meets all requirements for the demonstration, and the patient agrees to the referral, then it’s possible for a Veteran to be seen at a different facility than that from which s/he currently receives care.

    As for the payment of transportation to the referral site, that’s beyond my understanding. I would imagine that would be something that [the 5 sites] should be able to address…. I believe the referral site is generally responsible for travel (although I may be way off base). That’s how mental health residential treatment referrals were handled when they were out of state and I was an active VA clinician.

  12. To Summarize: Experience to this point tells us several things about the “PTSD-only” Pilot:
  1. The VA is not marketing HBOT inside the VA, not even at the 5 sites
  2. In at least one site, we know the VA has not told their PTSD patients about HBOT or the Program. “Informed consent” does not seem to be of any consideration to staff.
  3. The VA is already alerted to the request we made that veterans outside the 5 site areas [see list below] be allowed to request treatment in one of the 5 sites.
  4. Independent of the Pilot Program, Clinics that would like to become providers to the VA must become known to their local VA. In some cases, that means getting on a “preferred provider” list. In most cases that means being willing to accept on-label patients and work within the rules laid down by the VA. Suggest you get in touch with your local VA for specifics. And get to know the doctors in the VA who do the diagnoses and referrals. Educate them.
  5. In the short term, we would appreciate all clinics getting information to your networks about the Pilot and the need for veterans to contact their VA Mental Health Provider with the information provided in this email.
  6. Legislators at the federal and state levels need to be aware that 100+ private HBOT clinics exist throughout the US. They can and should all be used to deal with the tens of thousands of suffering brain wounded, whether on active duty or veteran/Reserve/National Guard. One of the major complaints about the VA making HBOT available at only 5 clinics is that it is extremely difficult for patients to take up to two months off work to attend treatment.
  7. Another complaint heard over and over is that veterans worry about losing their disability rating when they get better.
  8. Bottom line is that there is no VA advocate from within the VA system, either in HQ or at the individual facilities, committed to ensuring all brain wounded veterans are aware of the program, much less advocating for and spurring the patients to seek HBOT treatment. Veterans are simply not being encouraged and assisted to get HBOT.
  9. With the passage of S.785, the VA will be pressured to increase the number of clinics, and research will commence on the use of HBOT for TBI. You can be part of that plan. Call you national Senators and Congresspeople. Have their staffs come visit to learn more; they are the gate-keepers who can encourage their members to visit and become advocates. They can “encourage” the VA to make your clinic part of the Pilot. Think “squeaking wheel.”
m.  For Reference:
**VA Northern California Health Care System in cooperation with David Grant Medical Center on Travis Air Force Base
Drs. Jason Kelly, MD and Ben Slade, MD
60th Aerospace Medical Squadron
(707) 423-3987
** Eastern Oklahoma VA in cooperation with Tulsa Wound Care and Hyperbaric Center at Oklahoma State University Medical Center
Dr. Paul Rock, MD
Center for Aerospace and Hyperbaric Medicine
(918) 828-4066
**James A. Haley Veterans’ Hospital in Tampa, which is operated in cooperation with the Undersea Oxygen Clinic and Florida Hospital
Undersea Oxygen Clinic
Joe Dituri, PhD and Mario Caruso, CHT-A, DMT, EMT-P
701 North Westshore Blvd
Tampa, FL 33609
(813) 533-7093
**South Texas Veterans Health System in San Antonio, in cooperation with Nix Health and the San Antonio Military Medical Center at Fort Sam Houston.
Dr George Wolf, MD
Wolf, Earl George CTR USAF 59 MDW
**Fargo VA Health Care System and Healing with Hyperbarics, Fargo ND
Dr. Daphne Denham, MD
4487 Calico Drive S, Suite B, Fargo ND
C (847) 420-4833
POCs for Pilot Demonstrations
VHA Office of Community Engagement (10P10)
Center for Compassionate Innovation
Room 786, VA Central Office
Washington, DC 20420
Email to:
Jamie D. Davis, Ph.D.
Phone: 202-461-5296
Tracy L. Weistreich
Phone: 541-499-5945
Christine Eickhoff
Health System Specialist
10P10 Office of Community Engagement (OCE)
Washington, DC 20420
(202) 461-5751 

III.  ‘‘Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019’’

S.785 – A BILL To improve mental health care provided by the Department of Veterans Affairs, and for other purposes.


(1) USE OF PARTNERSHIPS.—The Secretary of Veterans Affairs, in consultation with the Center for Compassionate Innovation within the Office of Community Engagement of the Department of Veterans Affairs, may enter into partnerships with non-Federal Government entities to provide hyperbaric oxygen treatment to veterans to research the effectiveness of such therapy.
(2) TYPES OF PARTNERSHIPS.—Partnerships entered into under paragraph (1) may include the following:
(A) Partnerships to conduct research on hyperbaric oxygen therapy.
(B) Partnerships to review research on hyperbaric oxygen therapy provided to nonveterans. 
(C) Partnerships to create industry working groups to determine standards for research on hyperbaric oxygen therapy.
(D) Partnerships to provide to veterans hyperbaric oxygen therapy for the purposes of conducting research on the effectiveness of such therapy.
(3) LIMITATION ON FEDERAL FUNDING.—Federal Government funding may be used to coordinate and administer the partnerships under this subsection but may not be used to carry out activities conducted under such partnerships.
(b) REVIEW OF EFFECTIVENESS OF HYPERBARIC OXYGEN THERAPY.—Not later than 90 days after the date of the enactment of this Act, the Secretary, in consultation with the Center for Compassionate Innovation, shall begin using an objective and quantifiable method to review the effectiveness and applicability of hyperbaric oxygen therapy, such as through the use of a device approved or cleared by the Food and Drug Administration that assesses traumatic brain injury by tracking eye movement.
(1) IN GENERAL.—Not later than 90 days after the date of the enactment of this Act, the Secretary, in consultation with the Center for Compassionate Innovation, shall commence the conduct of a systematic review of published research literature on off label use of hyperbaric oxygen therapy to treat post traumatic stress disorder and traumatic brain injury among veterans and nonveterans.
(2) ELEMENTS.—The review conducted under paragraph (1) shall include the following:
(A) An assessment of the current parameters for research on the use by the Department of Veterans Affairs of hyperbaric oxygen therapy, including—
(i) tests and questionnaires used to determine the efficacy of such therapy; and
(ii) metrics for determining the success of such therapy.
(B) A comparative analysis of tests and questionnaires used to study post-traumatic stress disorder and traumatic brain injury in other research conducted by the Department of Veterans Affairs, other Federal agencies, and entities outside the Federal Government.
(3) COMPLETION OF REVIEW.—The review conducted under paragraph (1) shall be completed not later than 180 days after the date of the commencement of the review.
(4) REPORT.—Not later than 90 days after the completion of the review conducted under paragraph (1), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the results of the review.
(d) FOLLOW-UP STUDY.— IN GENERAL.—Not later than 120 days after the completion of the review conducted under subsection (c), the Secretary, in consultation with the Center for Compassionate Innovation, shall commence the conduct of a study on all individuals receiving hyperbaric oxygen therapy through the current pilot program of the Department for the provision of hyperbaric oxygen therapy to veterans to determine the efficacy and effectiveness of hyperbaric oxygen therapy for the treatment of post-traumatic stress disorder and traumatic brain injury.
(2) ELEMENTS.—The study conducted under paragraph (1) shall include the review and publication of any data and conclusions resulting from research conducted by an authorized provider of hyperbaric oxygen therapy for veterans through the pilot program described in such paragraph.
(3) COMPLETION OF STUDY.—The study conducted under paragraph (1) shall be completed not later than three years after the date of the commencement of the study.
(4) REPORT.— 23 (A) IN GENERAL.—Not later than 90 days 24 after completing the study conducted under paragraph (1), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the results of the study.
(B) ELEMENTS.—The report required under subparagraph (A) shall include the recommendation of the Secretary with respect to whether or not hyperbaric oxygen therapy should be made available to all veterans with traumatic brain injury or post-traumatic stress disorder.

IV. VA PTSD Pilot: “How To” Steps for Veterans and Caregivers

If you are a Veteran with PTSD, the VA has a Pilot Demo Program using HBOT to help treat PTSD. If you are considering HBOT please follow the steps listed below:

Step 1). You need to be in the VA System in the area where you reside. This means that you have been treated for Post-Traumatic Stress and other health concerns at your local VA. If you are in the VA Health Care System go to step 2.

If you are not in the VA Health Care System, you’ll need to schedule an appointment at the VA Health Care System that serves the area where you reside. Then you’ll begin the process that will allow you to qualify for this life-saving treatment.

You’ll start will the assignment of a Primary Care Physician. All of your referrals to other departments and treatment plans will be assigned by your Primary Care Physician. It’s very important to develop a professional relationship with your Primary Care Physician because he/she will be the key to your eventual participation in the HBOT Pilot Demonstration.

Step 2). Once you are part of your local VA Health Care System in your area you will begin the process by scheduling an appointment with your Primary Care Physician to discuss HBOT and to determine if you are a candidate for the HBOT Pilot Demonstration. [See Attached VHA Directive 1232(2) Consult Processes and Procedures for info that your local VA may not know about. It is also highly likely that they have never heard of HBOT or their own VA PTSD Pilot Demo Project. It is up to YOU to educate and work with them.]

There are general health requirements, and you will need a Post-Traumatic Stress Diagnosis to be to move to step 3. See qualification requirements below.

If you do not have a Post-Traumatic Stress diagnosis, you’ll need to work with your Primary Care Physician and the Neurology Department to determine if you are suffering from Post-Traumatic Stress. The likelihood of Post-Traumatic Stress for Veterans with Traumatic Brain Injuries is a high probability and that determination is realized very quickly after the consult with Neurology.

Step 3). Two things are a must for you to receive the treatment. The Post-Traumatic Stress diagnosis. And referral from your Primary Health Care Physician, or a referral from your Mental Health Care Team.

Step 4). You have a referral to the HBOT Pilot Demonstration. That referral with go to the Care in the Community department, of your local VA Health Care System, to get the billing and scheduling taken care of. This process may take some time depending on the number of outside referrals that are in the system. Referrals are prioritized according to the highest need. Veterans who are suffering from Post-Traumatic Stress are a high priority. If you are having suicidal thoughts, DO NOT DELAY getting in to the VA immediately!]

Step 5). Once your referral is processed by the Care in the Community department you will receive information regarding the facility and your initial consult with the MD will be scheduled.

All Veterans should consider the fact that they will be spending most of 30-45 days near the VA Health Care System that is participating in the HBOT Pilot Demonstration. Currently there are five cities across the United States participating in the Program.
The information provided by does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made.
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