[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8107 Introduced in House (IH)]

<DOC>






116th CONGRESS
  2d Session
                                H. R. 8107

  To direct the Secretary of Veterans Affairs to submit to Congress a 
report on efforts by Department of Veterans Affairs to implement safety 
       planning in emergency departments, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            August 25, 2020

  Mr. Levin of Michigan (for himself and Mr. Stivers) introduced the 
   following bill; which was referred to the Committee on Veterans' 
                                Affairs

_______________________________________________________________________

                                 A BILL


 
  To direct the Secretary of Veterans Affairs to submit to Congress a 
report on efforts by Department of Veterans Affairs to implement safety 
       planning in emergency departments, and for other purposes.

    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 Emergency Department Safety 
Planning Act''.

SEC. 2. REPORT ON EFFORTS BY DEPARTMENT OF VETERANS AFFAIRS TO 
              IMPLEMENT SAFETY PLANNING IN EMERGENCY DEPARTMENTS.

    (a) Findings.--Congress makes the following findings:
            (1) The Department of Veterans Affairs must be more 
        effective in its approach to reducing the burden of veteran 
        suicide connected to mental health diagnoses, to include 
        expansion of treatment delivered via telehealth methods and in 
        rural areas.
            (2) An innovative project, known as Suicide Assessment and 
        Follow-up Engagement: Veteran Emergency Treatment (in this 
        subsection referred to as ``SAFE VET''), was designed to help 
        suicidal veterans seen at emergency departments within the 
        Veterans Health Administration and was successfully implemented 
        in five intervention sites beginning in 2010.
            (3) A 2018 study found that safety planning intervention 
        under SAFE VET was associated with 45 percent fewer suicidal 
        behaviors in the six-month period following emergency 
        department care and more than double the odds of a veteran 
        engaging in outpatient behavioral health care.
            (4) SAFE VET is a promising alternative and acceptable 
        delivery of care system that augments the treatment of suicidal 
        veterans in emergency departments of the Veterans Health 
        Administration and helps ensure that those veterans have 
        appropriate follow-up care.
            (5) Beginning in September 2018, the Veterans Health 
        Administration implemented a suicide prevention program based 
        on the findings of SAFE VET, known as the SPED program, for 
        veterans presenting to the emergency department who are 
        assessed to be at risk for suicide and are safe to be 
        discharged home.
            (6) The SPED program includes issuance and update of a 
        safety plan and post-discharge follow-up outreach for veterans 
        to facilitate engagement in outpatient mental health care.
    (b) Report.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall submit to the appropriate committees of Congress a report 
        on the efforts of the Secretary to implement a suicide 
        prevention program for veterans presenting to an emergency 
        department or urgent care center of the Veterans Health 
        Administration who are assessed to be at risk for suicide and 
        are safe to be discharged home, including a safety plan and 
        post-discharge outreach for veterans to facilitate engagement 
        in outpatient mental health care.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) An assessment of the implementation of the 
                current operational policies and procedures of the SPED 
                program at each medical center of the Department of 
                Veterans Affairs, including an assessment of the 
                following:
                            (i) Training provided to clinicians or 
                        other personnel administering protocols under 
                        the SPED program.
                            (ii) Any disparities in implementation of 
                        such protocols between medical centers.
                            (iii) Current criteria used to measure the 
                        quality of such protocols including--
                                    (I) methodology used to assess the 
                                quality of a safety plan and post-
                                discharge outreach for veterans; or
                                    (II) in the absence of such 
                                methodology, a proposed timeline and 
                                guidelines for creating a methodology 
                                to ensure compliance with the evidence-
                                based model used under the Suicide 
                                Assessment and Follow-up Engagement: 
                                Veteran Emergency Treatment (SAFE VET) 
                                program of the Department.
                    (B) An assessment of the implementation of the 
                policies and procedures described in subparagraph (A), 
                disaggregated by gender and by race and ethnicity, 
                including the following:
                            (i) An assessment of the quality and 
                        quantity of safety plans issued to veterans.
                            (ii) An assessment of the quality and 
                        quantity of post-discharge outreach provided to 
                        veterans.
                            (iii) The post-discharge rate of veteran 
                        engagement in outpatient mental health care, 
                        including attendance at not fewer than one 
                        individual mental health clinic appointment or 
                        admission to an inpatient or residential unit.
                            (iv) The number of veterans who decline 
                        safety planning efforts during protocols under 
                        the SPED program.
                            (v) The number of veterans who decline to 
                        participate in follow-up efforts within the 
                        SPED program.
                    (C) A description of how SPED primary coordinators 
                are deployed to support such efforts, including the 
                following:
                            (i) A description of the duties and 
                        responsibilities of such coordinators.
                            (ii) The number and location of such 
                        coordinators.
                            (iii) A description of training provided to 
                        such coordinators.
                            (iv) An assessment of the other 
                        responsibilities for such coordinators and, if 
                        applicable, differences in patient outcomes 
                        when such responsibilities are full-time duties 
                        as opposed to secondary duties.
                    (D) An assessment of the feasibility and 
                advisability of expanding the total number and 
                geographic distribution of SPED primary coordinators.
                    (E) An assessment of the feasibility and 
                advisability of providing services under the SPED 
                program via telehealth channels, including an analysis 
                of opportunities to leverage telehealth to better serve 
                veterans in rural areas.
                    (F) A description of the status of current 
                capabilities and utilization of tracking mechanisms to 
                monitor compliance, quality, and patient outcomes under 
                the SPED program.
                    (G) Such recommendations, including specific action 
                items, as the Secretary considers appropriate with 
                respect to how the Department can better implement the 
                SPED program, including recommendations with respect to 
                the following:
                            (i) A process to standardize training under 
                        such program.
                            (ii) Any resourcing requirements necessary 
                        to implement the SPED program throughout 
                        Veterans Health Administration, including by 
                        having a dedicated clinician responsible for 
                        administration of such program at each medical 
                        center.
                            (iii) An analysis of current statutory 
                        authority and any changes necessary to fully 
                        implement the SPED program throughout the 
                        Veterans Health Administration.
                            (iv) A timeline for the implementation of 
                        the SPED program through the Veterans Health 
                        Administration once full resourcing and an 
                        approved training plan are in place.
                    (H) Such other matters as the Secretary considers 
                appropriate.
    (c) Definitions.--In this section:
            (1) The term ``appropriate committees of Congress'' means--
                    (A) the Committee on Veterans' Affairs and the 
                Subcommittee on Military Construction, Veterans 
                Affairs, and Related Agencies of the Committee on 
                Appropriations of the Senate; and
                    (B) the Committee on Veterans' Affairs and the 
                Subcommittee on Military Construction, Veterans 
                Affairs, and Related Agencies of the Committee on 
                Appropriations of the House of Representatives.
            (2) The term ``SPED primary coordinator'' means the main 
        point of contact responsible for administering the SPED program 
        at a medical center of the Department.
            (3) The term ``SPED program'' means the Safety Planning in 
        Emergency Departments program of the Department of Veterans 
        Affairs established in September 2018 for veterans presenting 
        to the emergency department who are assessed to be at risk for 
        suicide and are safe to be discharged home, which extends the 
        evidence-based intervention for suicide prevention to all 
        emergency departments of the Veterans Health Administration.
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