VA Zero Suicide Demonstration Project Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 7541 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 JULY 9, 2020 Mrs. LEE of Nevada (for herself, Mr. BERGMAN, Mr. CISNEROS, Mr. LEVIN of California, and Mr. ROSE of New York) 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 2020’’. 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 9 VerDate Sep 11 2014 01:16 Jul 29, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H7541.IH H7541 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 7541 IH ‘‘Zero Suicide Initiative’’ (referred to in this section as the 1 ‘‘program’’). 2 (b) PURPOSE.—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.—The first year of the program 8 shall be dedicated to program development, including 9 planning and site selection. In developing the program, the 10 Secretary shall consult with— 11 (1) the Secretary of Health and Human Serv- 12 ices; 13 (2) the National Institutes of Health; 14 (3) public and private institutions of higher 15 education; 16 (4) educators; 17 (5) experts in suicide assessment, treatment, 18 and management; 19 (6) veterans service organizations; and 20 (7) professional associations the Secretary de- 21 termines relevant to the purposes of the program. 22 (d) STAFF LEADERS; PROGRAM ELEMENTS.—The 23 program shall consist of not less than 10 weeks of edu- 24 cation regarding suicide care, beginning with the selection 25 VerDate Sep 11 2014 01:16 Jul 29, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H7541.IH H7541 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 7541 IH of five to ten staff leaders from each site selected under 1 subsection (e) who shall carry out the following program 2 elements: 3 (1) Complete the organizational self-study of 4 the Institute as a team. 5 (2) Attend the two-day Zero Suicide Academy 6 of the Institute. 7 (3) Formulate a plan to collect data to support 8 evaluation and quality improvement using the data 9 elements worksheet of the Institute. 10 (4) Communicate to staff at the respective site 11 the adoption of a specific suicide care approach. 12 (5) Administer the workforce survey of the In- 13 stitute to all staff at the respective site to learn 14 more about perceived comfort with and competence 15 in caring for patients at risk of suicide. 16 (6) Review, develop, and implement training on 17 processes and policies regarding patients at risk of 18 suicide, including— 19 (A) screening; 20 (B) assessment; 21 (C) use of electronic health records; 22 (D) risk formulation; 23 (E) treatment; and 24 (F) care transition. 25 VerDate Sep 11 2014 01:16 Jul 29, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H7541.IH H7541 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 7541 IH (e) SITES.— 1 (1) NUMBER.—The Secretary shall carry out 2 the program at five medical centers of the Depart- 3 ment of Veterans Affairs, one of which primarily 4 serves veterans who live in rural and remote areas 5 as determined by the Secretary. 6 (2) TIMELINE.—The Secretary shall select— 7 (A) 15 candidate sites for the program not 8 later than 180 days after the date of the enact- 9 ment of this Act; and 10 (B) the final five sites not later than 270 11 days after the date of the enactment of this 12 Act. 13 (3) CONSULTATION.—In selecting sites at which 14 to carry out the program, the Secretary shall consult 15 with experts including officials of— 16 (A) the National Institute of Mental 17 Health; 18 (B) the Substance Abuse and Mental 19 Health Services Administration of the Depart- 20 ment of Health and Human Services; 21 (C) the Office of Mental Health and Sui- 22 cide Prevention of the Department of Veterans 23 Affairs; 24 VerDate Sep 11 2014 01:16 Jul 29, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H7541.IH H7541 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 7541 IH (D) the Health Services Research Division 1 of the Department of Veterans Affairs; 2 (E) the Office of Health Care Trans- 3 formation of the Department of Veterans Af- 4 fairs; and 5 (F) the Zero Suicide Institute. 6 (4) FACTORS.—In selecting sites for the pro- 7 gram, the Secretary shall consider the following fac- 8 tors: 9 (A) Interest in, and capacity of, the staff 10 of the medical centers to implement the pro- 11 gram. 12 (B) Geographic variation. 13 (C) Variations in size of medical centers. 14 (D) Regional suicide rates of veterans. 15 (E) Demographic and health characteris- 16 tics of populations served by each medical cen- 17 ter. 18 (f) ANNUAL PROGRESS REPORT.— 19 (1) IN GENERAL.—Not later than two years 20 after the date on which the Secretary establishes the 21 program, and annually thereafter until termination 22 of the program, the Secretary shall submit to the 23 Committees on Veterans’ Affairs of the Senate and 24 VerDate Sep 11 2014 01:16 Jul 29, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H7541.IH H7541 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 7541 IH the House of Representatives a report on the pro- 1 gram. 2 (2) ELEMENTS.—Each report under paragraph 3 (1) shall include the following: 4 (A) Progress of staff leaders at each site 5 in carrying out tasks under paragraphs (1) 6 through (5) of subsection (d). 7 (B) The percentage of staff at each site 8 trained under paragraph (6) of subsection (d). 9 (C) An assessment of whether policies and 10 procedures implemented at each site align with 11 standards of the Institute with regards to— 12 (i) suicide screening; 13 (ii) lethal means counseling; 14 (iii) referrals for comprehensive as- 15 sessment of suicidality; 16 (iv) safety planning for patients re- 17 ceiving referrals under clause (iii); 18 (v) risk management during care 19 transitions; and 20 (vi) outreach to high-risk patients. 21 (D) A comparison of the suicide-related 22 outcomes at program sites and those of other 23 medical centers of the Department of Veterans 24 Affairs, including— 25 VerDate Sep 11 2014 01:16 Jul 29, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H7541.IH H7541 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 7541 IH (i) the percentage of patients screened 1 for suicide risk; 2 (ii) the percentage of patients coun- 3 seled in lethal means safety; 4 (iii) the percentage of patients 5 screened for suicide risk referred for com- 6 prehensive assessment of suicidality; 7 (iv) the percentage of patients re- 8 ferred for comprehensive assessment who 9 complete safety planning; 10 (v) emergency department utilization; 11 (vi) inpatient psychiatric hospitaliza- 12 tions; 13 (vii) the number of suicide attempts 14 among all patients and among patients re- 15 ferred for comprehensive assessment of 16 suicidality; and 17 (viii) the number of suicide deaths 18 among all patients and among patients re- 19 ferred for comprehensive assessment of 20 suicidality. 21 (g) FINAL REPORT.— 22 (1) IN GENERAL.—Not later than one year 23 after the termination of the program, the Secretary 24 shall submit to the Committees on Veterans’ Affairs 25 VerDate Sep 11 2014 01:16 Jul 29, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H7541.IH H7541 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 7541 IH of the Senate and House of Representatives a final 1 report. 2 (2) ELEMENTS.—The report under this sub- 3 section shall include the following: 4 (A) A detailed analysis of information in 5 the annual reports under subsection (f). 6 (B) The determination of the Secretary 7 whether it is feasible to continue the program. 8 (C) The recommendation of the Secretary 9 whether to extend the program or make the 10 program permanent. 11 (h) TERMINATION; EXTENSION.— 12 (1) IN GENERAL.—Subject to paragraph (2), 13 the program shall terminate on the date that is five 14 years after the date on which the Secretary estab- 15 lishes the program under subsection (a). 16 (2) AUTHORITY TO EXTEND.—The Secretary 17 may extend the program for not more than two 18 years if the Secretary notifies Congress in writing of 19 such extension not less than 180 days before the ter- 20 mination date under paragraph (1). 21 Æ VerDate Sep 11 2014 01:16 Jul 29, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\H7541.IH H7541 pamtmann on DSKBC07HB2PROD with BILLS