Summary
# Plain English Translation: S. 853 - VA Zero Suicide Demonstration Project Act of 2023
## WHAT THIS BILL DOES
This bill directs the Secretary of Veterans Affairs (the government official who runs the Veterans Affairs department) to create a pilot program called the Zero Suicide Initiative. The program will use training materials and methods from the Zero Suicide Institute to teach Veterans Affairs staff how to better care for veterans at risk of suicide and reduce suicide rates among veterans.
## WHO IT AFFECTS
- Veterans receiving care at Veterans Affairs medical centers
- Staff members at Veterans Affairs medical centers
- The Secretary of Veterans Affairs
- Congress (specifically the Senate and House Committees on Veterans' Affairs)
- The Secretary of Health and Human Services
- The National Institutes of Health
- Suicide prevention experts and veterans service organizations
## KEY PROVISIONS
- The Secretary must establish the Zero Suicide Initiative pilot program no later than 180 days after the law passes. (Sec. 2(a))
- The first year focuses on planning and choosing which Veterans Affairs sites will participate in the program. (Sec. 2(c)(1))
- The program will run for at least 10 weeks and include staff training, a two-day Academy, creating a plan to collect data, and training all staff on how to screen, assess and treat patients at risk of suicide. (Sec. 2(d))
- The program will operate at five Veterans Affairs medical centers, with one location primarily serving veterans in rural and remote areas. (Sec. 2(e)(1))
- The Secretary must report annually to Congress on the program's progress, including information about staff training, suicide screening rates, suicide attempts and suicide deaths. (Sec. 2(f))
## WHAT CHANGES
If this bill becomes law, Veterans Affairs will create a new pilot program teaching its medical center staff the Zero Suicide Institute's methods for identifying and caring for veterans at risk of suicide. Veterans Affairs will select five medical centers to test this program over five years and will track whether it reduces suicide attempts and deaths among veterans.
## IMPORTANT DEFINITIONS
- **Pilot program**: A test project run at a limited number of locations to see if something works before expanding it more widely
- **Zero Suicide Initiative**: A specific curriculum and set of methods created by the Zero Suicide Institute of the Education Development Center designed to improve suicide care and reduce suicide rates
- **Lethal means counseling**: Education about reducing access to methods people use to attempt suicide
- **Safety planning**: Creating a written plan with a patient to help keep them safe if they have thoughts of suicide
## EFFECTIVE DATE
Not specified in bill text
II
118TH CONGRESS
1ST SESSION
S. 853
To direct the Secretary of Veterans Affairs to establish the Zero Suicide
Initiative pilot program of the Department of Veterans Affairs.
IN THE SENATE OF THE UNITED STATES
MARCH 16, 2023
Ms. ROSEN (for herself and Mr. CRAMER) introduced the following bill; which
was read twice and 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 Representa-
1
tives of the United States of America in Congress assembled,
2
SECTION 1. SHORT TITLE.
3
This Act may be cited as the ‘‘VA Zero Suicide Dem-
4
onstration Project Act of 2023’’.
5
SEC. 2. ZERO SUICIDE INITIATIVE PILOT PROGRAM.
6
(a) ESTABLISHMENT.—Not later than 180 days after
7
the date of the enactment of this Act, the Secretary of
8
Veterans Affairs shall establish a pilot program called the
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•S 853 IS
‘‘Zero Suicide Initiative’’ (referred to in this section as the
1
‘‘program’’).
2
(b) CURRICULUM.—The program shall implement the
3
curriculum of the Zero Suicide Institute of the Education
4
Development Center (referred to in this section as the ‘‘In-
5
stitute’’) to improve safety and suicide care for veterans,
6
thereby significantly reducing rates of suicide.
7
(c) DEVELOPMENT.—
8
(1) IN GENERAL.—The first year of the pro-
9
gram shall be dedicated to program development, in-
10
cluding planning and site selection.
11
(2) CONSULTATION.—In developing the pro-
12
gram, the Secretary shall consult with—
13
(A) the Secretary of Health and Human
14
Services;
15
(B) the National Institutes of Health;
16
(C) public and private institutions of high-
17
er education;
18
(D) educators;
19
(E) experts in suicide assessment, treat-
20
ment, and management;
21
(F) veterans service organizations; and
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(G) professional associations the Secretary
23
of Veterans Affairs determines relevant to the
24
purposes of the program.
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•S 853 IS
(d) STAFF LEADERS; PROGRAM ELEMENTS.—The
1
program shall consist of not less than ten weeks of edu-
2
cation regarding suicide care, beginning with the selection
3
of five to ten staff leaders from each site selected under
4
subsection (e) who shall carry out the following program
5
elements:
6
(1) Complete the organizational self-study of
7
the Institute as a team.
8
(2) Attend the two-day Zero Suicide Academy
9
of the Institute.
10
(3) Formulate a plan to collect data to support
11
evaluation and quality improvement using the data
12
elements worksheet of the Institute.
13
(4) Communicate to staff at the respective site
14
the adoption of a specific suicide care approach.
15
(5) Administer the workforce survey of the In-
16
stitute to all staff at the respective site to learn
17
more about perceived comfort with and competence
18
in caring for patients at risk of suicide.
19
(6) Review, develop, and implement training on
20
processes and policies regarding patients at risk of
21
suicide, including—
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(A) screening;
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(B) assessment;
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(C) use of electronic health records;
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•S 853 IS
(D) risk formulation;
1
(E) treatment; and
2
(F) care transition.
3
(e) SITES.—
4
(1) NUMBER.—The Secretary shall carry out
5
the program at five medical centers of the Depart-
6
ment of Veterans Affairs, one of which primarily
7
serves veterans who live in rural and remote areas
8
as determined by the Secretary.
9
(2) TIMELINE.—The Secretary shall select—
10
(A) 15 candidate sites for the program not
11
later than 180 days after the date of the enact-
12
ment of this Act; and
13
(B) the final five sites not later than 270
14
days after the date of the enactment of this
15
Act.
16
(3) CONSULTATION.—In selecting sites at which
17
to carry out the program, the Secretary shall consult
18
with experts including officials of—
19
(A) the National Institute of Mental
20
Health;
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(B) the Substance Abuse and Mental
22
Health Services Administration of the Depart-
23
ment of Health and Human Services;
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•S 853 IS
(C) the Office of Mental Health and Sui-
1
cide Prevention of the Department of Veterans
2
Affairs;
3
(D) the Health Services Research Division
4
of the Department of Veterans Affairs;
5
(E) the Office of Health Care Trans-
6
formation of the Department of Veterans Af-
7
fairs; and
8
(F) the Zero Suicide Institute.
9
(4) FACTORS.—In selecting sites for the pro-
10
gram, the Secretary shall consider the following fac-
11
tors:
12
(A) Interest in, and capacity of, the staff
13
of the medical centers to implement the pro-
14
gram.
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(B) Geographic variation.
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(C) Variations in size of medical centers.
17
(D) Regional suicide rates of veterans.
18
(E) Demographic and health characteris-
19
tics of populations served by each medical cen-
20
ter.
21
(f) ANNUAL PROGRESS REPORT.—
22
(1) IN
GENERAL.—Not later than two years
23
after the date on which the Secretary establishes the
24
program, and annually thereafter until termination
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•S 853 IS
of the program, the Secretary shall submit to the
1
Committee on Veterans’ Affairs of the Senate and
2
the Committee on Veterans’ Affairs of the House of
3
Representatives a report on the program.
4
(2) ELEMENTS.—Each report under paragraph
5
(1) shall include the following:
6
(A) Progress of staff leaders at each site
7
in carrying out tasks under paragraphs (1)
8
through (5) of subsection (d).
9
(B) The percentage of staff at each site
10
trained under paragraph (6) of subsection (d).
11
(C) An assessment of whether policies and
12
procedures implemented at each site align with
13
standards of the Institute with regards to—
14
(i) suicide screening;
15
(ii) lethal means counseling;
16
(iii) referrals for comprehensive as-
17
sessment of suicidality;
18
(iv) safety planning for patients re-
19
ceiving referrals under clause (iii);
20
(v) risk management during care
21
transitions; and
22
(vi) outreach to high-risk patients.
23
(D) A comparison of the suicide-related
24
outcomes at program sites and those of other
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•S 853 IS
medical centers of the Department of Veterans
1
Affairs, including—
2
(i) the percentage of patients screened
3
for suicide risk;
4
(ii) the percentage of patients coun-
5
seled in lethal means safety;
6
(iii)
the
percentage
of
patients
7
screened for suicide risk referred for com-
8
prehensive assessment of suicidality;
9
(iv) the percentage of patients re-
10
ferred for comprehensive assessment who
11
complete safety planning;
12
(v) emergency department utilization;
13
(vi) inpatient psychiatric hospitaliza-
14
tions;
15
(vii) the number of suicide attempts
16
among all patients and among patients re-
17
ferred for comprehensive assessment of
18
suicidality; and
19
(viii) the number of suicide deaths
20
among all patients and among patients re-
21
ferred for comprehensive assessment of
22
suicidality.
23
(g) FINAL REPORT.—
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•S 853 IS
(1) IN
GENERAL.—Not later than one year
1
after the termination of the program, the Secretary
2
shall submit to the Committee on Veterans’ Affairs
3
of the Senate and the Committee on Veterans’ Af-
4
fairs of the House of Representatives a final report.
5
(2) ELEMENTS.—The report under paragraph
6
(1) shall include the following:
7
(A) A detailed analysis of information in
8
the annual reports under subsection (f).
9
(B) An evaluation of the effectiveness and
10
outcomes of the program, including an evalua-
11
tion of all data collected during the program.
12
(C) The determination of the Secretary
13
whether it is feasible to continue the program.
14
(D) The recommendations of the Secretary
15
whether to expand the program to additional
16
sites, extend the program, or make the program
17
permanent.
18
(h) TERMINATION; EXTENSION.—
19
(1) IN GENERAL.—Subject to paragraph (2),
20
the program shall terminate on the date that is five
21
years after the date on which the Secretary estab-
22
lishes the program under subsection (a).
23
(2) AUTHORITY
TO
EXTEND.—The Secretary
24
may extend the program for not more than two
25
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•S 853 IS
years if the Secretary notifies Congress in writing of
1
such extension not less than 180 days before the ter-
2
mination date under paragraph (1).
3
Æ
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