[Congressional Record Volume 167, Number 190 (Thursday, October 28, 2021)]
[Senate]
[Pages S7491-S7492]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 3985. Mr. TESTER submitted an amendment intended to be proposed by
him to the bill H.R. 4350, to authorize appropriations for fiscal year
2022 for military activities of the Department of Defense, for military
construction, and for defense activities of the Department of Energy,
to prescribe military personnel strengths for such fiscal year, and for
other purposes; which was ordered to lie on the table; as follows:
At the end of title X, add the following:
Subtitle H--Improvement of Veterans Crisis Line
SEC. 1070. SHORT TITLE.
This subtitle may be cited as the ``Revising and Expediting
Actions for the Crisis Hotline for Veterans Act'' or the
``REACH for Veterans Act''.
SEC. 1071. DEFINITIONS.
In this subtitle:
(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.
PART I--VETERANS CRISIS LINE TRAINING AND QUALITY MANAGEMENT
Subpart A--Staff Training
SEC. 1072. 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. 1073. 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.
Subpart B--Quality Review and Management
SEC. 1074. 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. 1075. 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. 1076. 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.
Subpart C--Guidance for High-Risk Callers
SEC. 1077. 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. 1078. 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.
Subpart D--Oversight and Clarification of Staff Roles and
Responsibilites
SEC. 1079. 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.
PART II--PILOT PROGRAMS AND RESEARCH ON VETERANS CRISIS LINE
Subpart A--Pilot Programs
SEC. 1080. 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. 1081. 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.
[[Page S7492]]
Subpart B--Research on Effectiveness
SEC. 1082. 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.
PART III--TRANSITION OF CRISIS LINE NUMBER
SEC. 1083. 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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