[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.
                                 ______