[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1639 Introduced in House (IH)]
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118th CONGRESS
1st Session
H. R. 1639
To direct the Secretary of Veterans Affairs to establish the Zero
Suicide Initiative pilot program of the Department of Veterans Affairs.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 17, 2023
Mrs. Lee of Nevada (for herself, Mr. Tony Gonzales of Texas, Mr.
Sablan, Mrs. Gonzalez-Colon, Ms. Brownley, Mr. Hudson, Mr. Allred, and
Ms. Slotkin) introduced the following bill; which was referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To direct the Secretary of Veterans Affairs to establish the Zero
Suicide Initiative pilot program of the Department of Veterans Affairs.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``VA Zero Suicide Demonstration
Project Act of 2023''.
SEC. 2. ZERO SUICIDE INITIATIVE PILOT PROGRAM.
(a) Establishment.--Not later than 180 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall
establish a pilot program called the ``Zero Suicide Initiative''
(referred to in this section as the ``program'').
(b) Curriculum.--The program shall implement the curriculum of the
Zero Suicide Institute of the Education Development Center (referred to
in this section as the ``Institute'') to improve safety and suicide
care for veterans, thereby significantly reducing rates of suicide.
(c) Development.--
(1) In general.--The first year of the program shall be
dedicated to program development, including planning and site
selection.
(2) Consultation.--In developing the program, the Secretary
shall consult with--
(A) the Secretary of Health and Human Services;
(B) the National Institutes of Health;
(C) public and private institutions of higher
education;
(D) educators;
(E) experts in suicide assessment, treatment, and
management;
(F) veterans service organizations; and
(G) professional associations the Secretary of
Veterans Affairs determines relevant to the purposes of
the program.
(d) Staff Leaders; Program Elements.--The program shall consist of
not less than ten weeks of education regarding suicide care, beginning
with the selection of five to ten staff leaders from each site selected
under subsection (e) who shall carry out the following program
elements:
(1) Complete the organizational self-study of the Institute
as a team.
(2) Attend the two-day Zero Suicide Academy of the
Institute.
(3) Formulate a plan to collect data to support evaluation
and quality improvement using the data elements worksheet of
the Institute.
(4) Communicate to staff at the respective site the
adoption of a specific suicide care approach.
(5) Administer the workforce survey of the Institute to all
staff at the respective site to learn more about perceived
comfort with and competence in caring for patients at risk of
suicide.
(6) Review, develop, and implement training on processes
and policies regarding patients at risk of suicide, including--
(A) screening;
(B) assessment;
(C) use of electronic health records;
(D) risk formulation;
(E) treatment; and
(F) care transition.
(e) Sites.--
(1) Number.--The Secretary shall carry out the program at
five medical centers of the Department of Veterans Affairs, one
of which primarily serves veterans who live in rural and remote
areas as determined by the Secretary.
(2) Timeline.--The Secretary shall select--
(A) 15 candidate sites for the program not later
than 180 days after the date of the enactment of this
Act; and
(B) the final five sites not later than 270 days
after the date of the enactment of this Act.
(3) Consultation.--In selecting sites at which to carry out
the program, the Secretary shall consult with experts including
officials of--
(A) the National Institute of Mental Health;
(B) the Substance Abuse and Mental Health Services
Administration of the Department of Health and Human
Services;
(C) the Office of Mental Health and Suicide
Prevention of the Department of Veterans Affairs;
(D) the Health Services Research Division of the
Department of Veterans Affairs;
(E) the Office of Health Care Transformation of the
Department of Veterans Affairs; and
(F) the Zero Suicide Institute.
(4) Factors.--In selecting sites for the program, the
Secretary shall consider the following factors:
(A) Interest in, and capacity of, the staff of the
medical centers to implement the program.
(B) Geographic variation.
(C) Variations in size of medical centers.
(D) Regional suicide rates of veterans.
(E) Demographic and health characteristics of
populations served by each medical center.
(f) Annual Progress Report.--
(1) In general.--Not later than two years after the date on
which the Secretary establishes the program, and annually
thereafter until termination of the program, 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 program.
(2) Elements.--Each report under paragraph (1) shall
include the following:
(A) Progress of staff leaders at each site in
carrying out tasks under paragraphs (1) through (5) of
subsection (d).
(B) The percentage of staff at each site trained
under paragraph (6) of subsection (d).
(C) An assessment of whether policies and
procedures implemented at each site align with
standards of the Institute with regards to--
(i) suicide screening;
(ii) lethal means counseling;
(iii) referrals for comprehensive
assessment of suicidality;
(iv) safety planning for patients receiving
referrals under clause (iii);
(v) risk management during care
transitions; and
(vi) outreach to high-risk patients.
(D) A comparison of the suicide-related outcomes at
program sites and those of other medical centers of the
Department of Veterans Affairs, including--
(i) the percentage of patients screened for
suicide risk;
(ii) the percentage of patients counseled
in lethal means safety;
(iii) the percentage of patients screened
for suicide risk referred for comprehensive
assessment of suicidality;
(iv) the percentage of patients referred
for comprehensive assessment who complete
safety planning;
(v) emergency department utilization;
(vi) inpatient psychiatric
hospitalizations;
(vii) the number of suicide attempts among
all patients and among patients referred for
comprehensive assessment of suicidality; and
(viii) the number of suicide deaths among
all patients and among patients referred for
comprehensive assessment of suicidality.
(g) Final Report.--
(1) In general.--Not later than one year after the
termination of the program, 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 final
report.
(2) Elements.--The report under paragraph (1) shall include
the following:
(A) A detailed analysis of information in the
annual reports under subsection (f).
(B) An evaluation of the effectiveness and outcomes
of the program, including an evaluation of all data
collected during the program.
(C) The determination of the Secretary whether it
is feasible to continue the program.
(D) The recommendations of the Secretary whether to
expand the program to additional sites, extend the
program, or make the program permanent.
(h) Termination; Extension.--
(1) In general.--Subject to paragraph (2), the program
shall terminate on the date that is five years after the date
on which the Secretary establishes the program under subsection
(a).
(2) Authority to extend.--The Secretary may extend the
program for not more than two years if the Secretary notifies
Congress in writing of such extension not less than 180 days
before the termination date under paragraph (1).
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