[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 4545 Introduced in Senate (IS)]

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116th CONGRESS
  2d Session
                                S. 4545

   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

                           September 9, 2020

 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 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 2020''.

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) Purpose.--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.--The first year of the program shall be dedicated 
to program development, including planning and site selection. In 
developing the program, the Secretary shall consult with--
            (1) the Secretary of Health and Human Services;
            (2) the National Institutes of Health;
            (3) public and private institutions of higher education;
            (4) educators;
            (5) experts in suicide assessment, treatment, and 
        management;
            (6) veterans service organizations; and
            (7) professional associations the Secretary determines 
        relevant to the purposes of the program.
    (d) Staff Leaders; Program Elements.--The program shall consist of 
not less than 10 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 Committees on Veterans' Affairs of the 
        Senate and 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 
        Committees on Veterans' Affairs of the Senate and House of 
        Representatives a final report.
            (2) Elements.--The report under this subsection shall 
        include the following:
                    (A) A detailed analysis of information in the 
                annual reports under subsection (f).
                    (B) The determination of the Secretary whether it 
                is feasible to continue the program.
                    (C) The recommendation of the Secretary whether to 
                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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