[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5073 Introduced in House (IH)]
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117th CONGRESS
1st Session
H. R. 5073
To improve the Veterans Crisis Line of the Department of Veterans
Affairs, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
August 23, 2021
Mr. Delgado (for himself, Mr. Mann, Ms. Sherrill, and Mrs. Miller-
Meeks) introduced the following bill; which was referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To improve the Veterans Crisis Line of the Department of Veterans
Affairs, 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; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Revising and
Expediting Actions for the Crisis Hotline for Veterans Act'' or the
``REACH for Veterans Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
TITLE I--VETERANS CRISIS LINE TRAINING AND QUALITY MANAGEMENT
Subtitle A--Staff Training
Sec. 101. Review of training for Veterans Crisis Line call responders.
Sec. 102. Retraining guidelines for Veterans Crisis Line call
responders.
Subtitle B--Quality Review and Management
Sec. 111. Monitoring of calls on Veterans Crisis Line.
Sec. 112. Quality management processes for Veterans Crisis Line.
Sec. 113. Annual common cause analysis for callers to Veterans Crisis
Line who die by suicide.
Subtitle C--Guidance for High-Risk Callers
Sec. 121. Development of enhanced guidance and procedures for response
to calls related to substance use and
overdose risk.
Sec. 122. Review and improvement of standards for emergency dispatch.
Subtitle D--Oversight and Clarification of Staff Roles and
Responsibilities
Sec. 131. Oversight of training of social service assistants and
clarification of job responsibilities.
TITLE II--PILOT PROGRAMS AND RESEARCH ON VETERANS CRISIS LINE
Subtitle A--Pilot Programs
Sec. 201. Extended safety planning pilot program for Veterans Crisis
Line.
Sec. 202. Crisis line facilitation pilot program.
Subtitle B--Research on Effectiveness
Sec. 211. Authorization of appropriations for research on effectiveness
and opportunities for improvement of
Veterans Crisis Line.
TITLE III--TRANSITION OF CRISIS LINE NUMBER
Sec. 301. Feedback on transition of crisis line number.
SEC. 2. DEFINITIONS.
In this Act:
(1) Department.--The term ``Department'' means the
Department of Veterans Affairs.
(2) Secretary.--The term ``Secretary'' means the Secretary
of Veterans Affairs.
(3) Veterans crisis line.--The term ``Veterans Crisis
Line'' means the toll-free hotline for veterans established
under section 1720F(h) of title 38, United States Code.
TITLE I--VETERANS CRISIS LINE TRAINING AND QUALITY MANAGEMENT
Subtitle A--Staff Training
SEC. 101. REVIEW OF TRAINING FOR VETERANS CRISIS LINE CALL RESPONDERS.
(a) In General.--The Secretary shall enter into an agreement with
an organization outside the Department, such as the American
Association of Suicidology, to review the training for Veterans Crisis
Line call responders on assisting callers in crisis.
(b) Completion of Review.--The review conducted under subsection
(a) shall be completed not later than one year after the date of the
enactment of this Act.
(c) Elements of Review.--The review conducted under subsection (a)
shall consist of a review of the training provided by the Department on
subjects including risk assessment, lethal means assessment, substance
use and overdose risk assessment, safety planning, referrals to care,
supervisory consultation, and emergency dispatch.
(d) Update of Training.--If any deficiencies in the training for
Veterans Crisis Line call responders are found pursuant to the review
under subsection (a), the Secretary shall update such training and
associated standards of practice to correct those deficiencies not
later than one year after the completion of the review.
SEC. 102. RETRAINING GUIDELINES FOR VETERANS CRISIS LINE CALL
RESPONDERS.
(a) In General.--Not later than one year after the date of the
enactment of this Act, the Secretary shall develop guidelines on
retraining and quality management for when a Veterans Crisis Line call
responder has an adverse event or when a quality review check by a
supervisor of such a call responder denotes that the call responder
needs improvement.
(b) Elements of Guidelines.--The guidelines developed under
subsection (a) shall specify the subjects and quantity of retraining
recommended and how supervisors should implement increased use of
silent monitoring or other performance review mechanisms.
Subtitle B--Quality Review and Management
SEC. 111. MONITORING OF CALLS ON VETERANS CRISIS LINE.
(a) In General.--The Secretary shall require that not fewer than
two calls per month for each Veterans Crisis Line call responder be
subject to supervisory silent monitoring, which is used to monitor the
quality of conduct by such call responder during the call.
(b) Benchmarks.--The Secretary shall establish benchmarks for
requirements and performance of Veterans Crisis Line call responders on
supervisory silent monitored calls.
(c) Quarterly Reports.--Not less frequently than quarterly, the
Secretary shall submit to the Office of Mental Health and Suicide
Prevention of the Department of Veterans Affairs a report on occurrence
and outcomes of supervisory silent monitoring of calls on the Veterans
Crisis Line.
SEC. 112. QUALITY MANAGEMENT PROCESSES FOR VETERANS CRISIS LINE.
Not later than one year after the date of the enactment of this
Act, the leadership for the Veterans Crisis Line, in partnership with
the Office of Mental Health and Suicide Prevention of the Department
and the National Center for Patient Safety of the Department, shall
establish quality management processes and expectations for staff of
the Veterans Crisis Line, including with respect to reporting of
adverse events and close calls.
SEC. 113. ANNUAL COMMON CAUSE ANALYSIS FOR CALLERS TO VETERANS CRISIS
LINE WHO DIE BY SUICIDE.
(a) In General.--Not less frequently than annually, the Secretary
shall perform a common cause analysis for all identified callers to the
Veterans Crisis Line that died by suicide during the one-year period
preceding the conduct of the analysis before the caller received
contact with emergency services and in which the Veterans Crisis Line
was the last point of contact.
(b) Submittal of Results.--The Secretary shall submit to the Office
of Mental Health and Suicide Prevention of the Department the results
of each analysis conducted under subsection (a).
(c) Application of Themes or Lessons.--The Secretary shall apply
any themes or lessons learned under an analysis under subsection (a) to
updating training and standards of practice for staff of the Veterans
Crisis Line.
Subtitle C--Guidance for High-Risk Callers
SEC. 121. DEVELOPMENT OF ENHANCED GUIDANCE AND PROCEDURES FOR RESPONSE
TO CALLS RELATED TO SUBSTANCE USE AND OVERDOSE RISK.
Not later than one year after the date of the enactment of this
Act, the Secretary, in consultation with national experts within the
Department on substance use disorder and overdose, shall--
(1) develop enhanced guidance and procedures to respond to
calls to the Veterans Crisis Line related to substance use and
overdose risk;
(2) update training materials for staff of the Veterans
Crisis Line in response to such enhanced guidance and
procedures; and
(3) update criteria for monitoring compliance with such
enhanced guidance and procedures.
SEC. 122. REVIEW AND IMPROVEMENT OF STANDARDS FOR EMERGENCY DISPATCH.
(a) In General.--Not later than one year after the date of the
enactment of this Act, the Secretary shall--
(1) review the current emergency dispatch standard
operating procedure of the Veterans Crisis Line to identify any
additions to such procedure to strengthen communication
regarding--
(A) emergency dispatch for disconnected callers;
and
(B) the role of social service assistants in
requesting emergency dispatch and recording such
dispatches; and
(2) update such procedure to include the additions
identified under paragraph (1).
(b) Training.--The Secretary shall ensure that all staff of the
Veterans Crisis Line are trained on all updates made under subsection
(a)(2) to the emergency dispatch standard operating procedure of the
Veterans Crisis Line.
Subtitle D--Oversight and Clarification of Staff Roles and
Responsibilities
SEC. 131. OVERSIGHT OF TRAINING OF SOCIAL SERVICE ASSISTANTS AND
CLARIFICATION OF JOB RESPONSIBILITIES.
Not later than one year after the date of the enactment of this
Act, the Secretary shall--
(1) establish oversight mechanisms to ensure that social
service assistants and supervisory social service assistants
working with the Veterans Crisis Line are appropriately trained
and implementing guidance of the Department regarding the
Veterans Crisis Line; and
(2) refine standard operating procedures to delineate roles
and responsibilities for all levels of supervisory social
service assistants working with the Veterans Crisis Line.
TITLE II--PILOT PROGRAMS AND RESEARCH ON VETERANS CRISIS LINE
Subtitle A--Pilot Programs
SEC. 201. EXTENDED SAFETY PLANNING PILOT PROGRAM FOR VETERANS CRISIS
LINE.
(a) In General.--Commencing not later than 180 days after the date
of the enactment of this Act, the Secretary shall carry out a pilot
program to determine whether a lengthier, templated safety plan used in
clinical settings could be applied in call centers for the Veterans
Crisis Line.
(b) Briefing.--Not later than two years after the date of the
enactment of this Act, the Secretary shall brief Congress on the
findings of the Secretary under the pilot program under subsection (a),
including such recommendations as the Secretary may have for
continuation or discontinuation of the pilot program.
SEC. 202. CRISIS LINE FACILITATION PILOT PROGRAM.
(a) In General.--Commencing not later than one year after the date
of the enactment of this Act, the Secretary shall carry out a pilot
program on the use of crisis line facilitation to increase use of the
Veterans Crisis Line among high-risk veterans.
(b) Briefing.--Not later than two years after the date of the
enactment of this Act, the Secretary shall brief Congress on the
findings of the Secretary under the pilot program under subsection (a),
including such recommendations as the Secretary may have for
continuation or discontinuation of the pilot program.
(c) Definitions.--In this section:
(1) Crisis line facilitation.--The term ``crisis line
facilitation'', with respect to a high-risk veteran, means the
presentation by a therapist of psychoeducational information
about the Veterans Crisis Line and a discussion of the
perceived barriers and facilitators to future use of the
Veterans Crisis Line for the veteran, which culminates in the
veteran calling the Veterans Crisis Line with the therapist to
provide firsthand experiences that may counter negative
impressions of the Veterans Crisis Line.
(2) High-risk veteran.--The term ``high-risk veteran''
means a veteran receiving inpatient mental health care
following a suicidal crisis.
Subtitle B--Research on Effectiveness
SEC. 211. AUTHORIZATION OF APPROPRIATIONS FOR RESEARCH ON EFFECTIVENESS
AND OPPORTUNITIES FOR IMPROVEMENT OF VETERANS CRISIS
LINE.
There is authorized to be appropriated to the Secretary $5,000,000
for the Mental Illness Research, Education, and Clinical Centers of the
Department to conduct research on the effectiveness of the Veterans
Crisis Line and areas for improvement for the Veterans Crisis Line.
TITLE III--TRANSITION OF CRISIS LINE NUMBER
SEC. 301. FEEDBACK ON TRANSITION OF CRISIS LINE NUMBER.
(a) In General.--The Secretary shall solicit feedback from veterans
service organizations on how to conduct outreach to members of the
Armed Forces, veterans, their family members, and other members of the
military and veterans community on the move to 988 as the new, national
three-digit suicide and mental health crisis hotline, which is expected
to be implemented by July 2022, to minimize confusion and ensure
veterans are aware of their options for reaching the Veterans Crisis
Line.
(b) Nonapplication of FACA.--The Federal Advisory Committee Act (5
U.S.C. App.) shall not apply to any feedback solicited under subsection
(a).
(c) Veterans Service Organization Defined.--In this section, the
term ``veterans service organization'' means an organization recognized
by the Secretary for the representation of veterans under section 5902
of title 38, United States Code.
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