What This Bill Does
This bill directs the Secretary of Veterans Affairs to establish a pilot program called the Zero Suicide Initiative. The program will use educational curriculum from the Zero Suicide Institute to improve how the VA treats and prevents suicide among veterans. The goal is to significantly reduce suicide rates among veterans.
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Who It Affects
- Veterans receiving care at VA medical centers
- Staff and leaders at VA medical centers
- The Secretary of Veterans Affairs
- The Department of Veterans Affairs
- The Secretary of Health and Human Services
- The National Institutes of Health
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Key Provisions
- The Secretary must establish the Zero Suicide Initiative pilot program within 180 days after the bill becomes law, using the Zero Suicide Institute's curriculum (Sec. 2(a), 2(b))
- The first year focuses on program development, planning and choosing which VA locations will participate (Sec. 2(c)(1))
- The program operates at five VA medical centers, with at least one serving veterans in rural and remote areas (Sec. 2(e)(1))
- Staff leaders at each site must complete at least 10 weeks of education including an organizational self-study, a two-day academy, and training on suicide screening, assessment, treatment and safety planning (Sec. 2(d))
- The Secretary must submit annual progress reports to Congress starting two years after the program begins, comparing suicide outcomes at program sites to other VA medical centers (Sec. 2(f))
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What Changes
If this bill becomes law, the VA will create a new pilot program at five of its medical centers focused on suicide prevention and care. These centers will train staff using a specific curriculum and collect data to measure whether the program reduces suicide rates among veterans. The program will last five years unless the Secretary extends it for up to two additional years.
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Important Definitions
- **Pilot program** (a test program running at specific locations before potentially expanding)
- **Lethal means counseling** (guidance to reduce access to methods of suicide)
- **Comprehensive assessment of suicidality** (a thorough evaluation of suicide risk)
- **Safety planning** (creating a specific plan to keep someone safe from suicide)
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Effective Date
The Secretary must establish the program within 180 days after the bill is enacted. Not specified in bill text when this occurs.
I
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. GONZA´LEZ-COLO´N, 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 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.
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(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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•HR 1639 IH
‘‘Zero Suicide Initiative’’ (referred to in this section as the
1
‘‘program’’).
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(b) CURRICULUM.—The program shall implement the
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curriculum of the Zero Suicide Institute of the Education
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Development Center (referred to in this section as the ‘‘In-
5
stitute’’) to improve safety and suicide care for veterans,
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thereby significantly reducing rates of suicide.
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(c) DEVELOPMENT.—
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(1) IN GENERAL.—The first year of the pro-
9
gram shall be dedicated to program development, in-
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cluding planning and site selection.
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(2) CONSULTATION.—In developing the pro-
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gram, the Secretary shall consult with—
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(A) the Secretary of Health and Human
14
Services;
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(B) the National Institutes of Health;
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(C) public and private institutions of high-
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er education;
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(D) educators;
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(E) experts in suicide assessment, treat-
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ment, and management;
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(F) veterans service organizations; and
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(G) professional associations the Secretary
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of Veterans Affairs determines relevant to the
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purposes of the program.
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(d) STAFF LEADERS; PROGRAM ELEMENTS.—The
1
program shall consist of not less than ten weeks of edu-
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cation regarding suicide care, beginning with the selection
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of five to ten staff leaders from each site selected under
4
subsection (e) who shall carry out the following program
5
elements:
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(1) Complete the organizational self-study of
7
the Institute as a team.
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(2) Attend the two-day Zero Suicide Academy
9
of the Institute.
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(3) Formulate a plan to collect data to support
11
evaluation and quality improvement using the data
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elements worksheet of the Institute.
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(4) Communicate to staff at the respective site
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the adoption of a specific suicide care approach.
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(5) Administer the workforce survey of the In-
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stitute to all staff at the respective site to learn
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more about perceived comfort with and competence
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in caring for patients at risk of suicide.
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(6) Review, develop, and implement training on
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processes and policies regarding patients at risk of
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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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(D) risk formulation;
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(E) treatment; and
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(F) care transition.
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(e) SITES.—
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(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
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serves veterans who live in rural and remote areas
8
as determined by the Secretary.
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(2) TIMELINE.—The Secretary shall select—
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(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
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(B) the final five sites not later than 270
14
days after the date of the enactment of this
15
Act.
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(3) CONSULTATION.—In selecting sites at which
17
to carry out the program, the Secretary shall consult
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with experts including officials of—
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(A) the National Institute of Mental
20
Health;
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(B) the Substance Abuse and Mental
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Health Services Administration of the Depart-
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ment of Health and Human Services;
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•HR 1639 IH
(C) the Office of Mental Health and Sui-
1
cide Prevention of the Department of Veterans
2
Affairs;
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(D) the Health Services Research Division
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of the Department of Veterans Affairs;
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(E) the Office of Health Care Trans-
6
formation of the Department of Veterans Af-
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fairs; and
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(F) the Zero Suicide Institute.
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(4) FACTORS.—In selecting sites for the pro-
10
gram, the Secretary shall consider the following fac-
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tors:
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(A) Interest in, and capacity of, the staff
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of the medical centers to implement the pro-
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gram.
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(B) Geographic variation.
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(C) Variations in size of medical centers.
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(D) Regional suicide rates of veterans.
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(E) Demographic and health characteris-
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tics of populations served by each medical cen-
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ter.
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(f) ANNUAL PROGRESS REPORT.—
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(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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•HR 1639 IH
of the program, the Secretary shall submit to the
1
Committee on Veterans’ Affairs of the Senate and
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the Committee on Veterans’ Affairs of the House of
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Representatives a report on the program.
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(2) ELEMENTS.—Each report under paragraph
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(1) shall include the following:
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(A) Progress of staff leaders at each site
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in carrying out tasks under paragraphs (1)
8
through (5) of subsection (d).
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(B) The percentage of staff at each site
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trained under paragraph (6) of subsection (d).
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(C) An assessment of whether policies and
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procedures implemented at each site align with
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standards of the Institute with regards to—
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(i) suicide screening;
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(ii) lethal means counseling;
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(iii) referrals for comprehensive as-
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sessment of suicidality;
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(iv) safety planning for patients re-
19
ceiving referrals under clause (iii);
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(v) risk management during care
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transitions; and
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(vi) outreach to high-risk patients.
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(D) A comparison of the suicide-related
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outcomes at program sites and those of other
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•HR 1639 IH
medical centers of the Department of Veterans
1
Affairs, including—
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(i) the percentage of patients screened
3
for suicide risk;
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(ii) the percentage of patients coun-
5
seled in lethal means safety;
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(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
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complete safety planning;
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(v) emergency department utilization;
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(vi) inpatient psychiatric hospitaliza-
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tions;
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(vii) the number of suicide attempts
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among all patients and among patients re-
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ferred for comprehensive assessment of
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suicidality; and
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(viii) the number of suicide deaths
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among all patients and among patients re-
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ferred for comprehensive assessment of
22
suicidality.
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(g) FINAL REPORT.—
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•HR 1639 IH
(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.
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(2) ELEMENTS.—The report under paragraph
6
(1) shall include the following:
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(A) A detailed analysis of information in
8
the annual reports under subsection (f).
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(B) An evaluation of the effectiveness and
10
outcomes of the program, including an evalua-
11
tion of all data collected during the program.
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(C) The determination of the Secretary
13
whether it is feasible to continue the program.
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(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.
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(h) TERMINATION; EXTENSION.—
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(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).
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(2) AUTHORITY
TO
EXTEND.—The Secretary
24
may extend the program for not more than two
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•HR 1639 IH
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).
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Æ
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