[Federal Register Volume 86, Number 61 (Thursday, April 1, 2021)]
[Notices]
[Pages 17268-17270]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-06392]


-----------------------------------------------------------------------

DEPARTMENT OF VETERANS AFFAIRS


AR16--Notice of Request for Information on the Department of 
Veterans Affairs' Staff Sergeant Parker Gordon Fox Suicide Prevention 
Grant Program

AGENCY: Department of Veterans Affairs.

ACTION: Request for information.

-----------------------------------------------------------------------

SUMMARY: The Department of Veterans Affairs (VA) is requesting 
information to assist in implementing the requirements of section 201 
of the Commander John Scott Hannon Veterans Mental Health Care 
Improvement Act of 2019. The Act mandates VA to establish the Staff 
Sergeant Parker Gordon Fox Suicide Prevention Grant Program (SSG Fox 
SPGP) to reduce veteran suicide through a three-year community-based 
grant program that would provide financial assistance to eligible 
entities to provide or coordinate providing suicide prevention services 
to eligible veterans and their families. VA is required to consult with 
certain entities related to administering this new grant program, and 
through this request for information, VA seeks comments on various 
topics to help inform VA's development of the SSG Fox SPGP and its 
implementing regulations.

DATES: Comments are due on or before April 22, 2021.

ADDRESSES: Comments must be submitted through www.Regulations.gov and 
will be available for public viewing, inspection or copies.

FOR FURTHER INFORMATION CONTACT: Juliana Hallows, Associate Director 
for Policy and Planning--Suicide Prevention Program, Office of Mental 
Health and Suicide Prevention (OMHSP), 11MHSP, 810 Vermont Avenue NW, 
Washington, DC 20420, 202-266-4653 (This is not a toll-free telephone 
number).

SUPPLEMENTARY INFORMATION:

Background

    Section 201 of the Commander John Scott Hannon Veterans Mental 
Health Care Improvement Act of 2019 (the Act), Public Law 116-171, 
enacted on October 17, 2020, created a new community-based suicide 
prevention grant program to reduce veteran suicide. Section 201 
authorizes the award of grants for no more than $750,000 per grantee 
per fiscal year to eligible entities to provide or coordinate providing 
suicide prevention services to eligible individuals and their families. 
An eligible individual is a person at risk of suicide who is a veteran 
as defined in 38 U.S.C. 101, an individual described in 38 U.S.C. 
1720I(b), or an individual described in 38 U.S.C. 1712A(a)(1)(C)(i)-
(iv).
    The Secretary is required to implement the SSG Fox SPGP in 
coordination with the President's Roadmap to Empower Veterans and End a 
National Tragedy of Suicide (PREVENTS) Task Force and in consultation 
with VA's OMHSP.

Consultation With Interested Parties

    In administering the SSG Fox SPGP, VA is required to consult with 
certain entities to:
    1. Establish the criteria for selecting eligible entities that have 
submitted applications;
    2. Develop a framework for collecting and sharing information about 
eligible entities receiving grants; and
    3. Develop the measures and metrics eligible entities receiving 
grants will use to determine the effectiveness of programming provided 
to improve mental health status, well-being and reduce suicide risk and 
deaths by suicide.
    VA is also required to consult with entities in developing a plan 
for the design and implementing the provision of grants, including 
criteria for awarding such grants, and on non-traditional and 
innovative approaches and treatment practices. The Act requires VA to 
specifically consult with the following entities: (1) Veterans Service 
Organizations; (2) National organizations representing potential 
community partners in providing supportive services to address the 
needs of veterans and their families, including national organizations 
that advocate for the needs of individuals with or at risk of 
behavioral health conditions; represent mayors, unions, first 
responders, chiefs of police and sheriffs, governors, a territory of 
the United States or represent a Tribal alliance; (3) National 
organizations representing members of the Armed Forces; (4) National 
organizations that represent counties; (5) Organizations with which VA 
has a current memorandum of agreement or understanding related to 
mental health or suicide prevention; (6) State Departments of Veterans 
Affairs; (7) National organizations representing members of the Reserve 
Components of the Armed Forces; (8) National organizations representing 
members of the Coast Guard; (9) Organizations, including institutions 
of higher education, with experience in creating measurement tools for 
purposes of advising the Secretary on the most appropriate existing 
measurement tool or protocol for VA to utilize; (10) The National 
Alliance on Mental Illness; (11) a labor organization (as such term is 
defined in 5 U.S.C. 7103(a)(4)); (12) The Centers for Disease Control 
and Prevention (CDC), the Substance Abuse and Mental Health Services 
Administration and PREVENTS; and such other organizations as the 
Secretary deems appropriate.
    This request for information, described in more detail below, 
serves as VA's consultation as required by the Act. Responses to this 
request for information will be used to inform developing the SSG Fox 
SPGP and its implementing regulations. This notice and request for 
information has a comment period of 21 days, during which VA invites 
individuals, groups and entities to reply to the questions presented 
below. VA believes that 21 days is sufficient to provide comments, as 
the individuals, groups and entities interested in this program likely 
have information and opinions readily available or can quickly compile 
and submit such information. Commenters are encouraged to provide 
complete but concise responses to the questions outlined below. Please 
note that VA will not respond to comments or other questions regarding 
policy plans, decisions or issues regarding this notice. Comments 
received in response to this notice will be evaluated and, as 
appropriate, incorporated into a proposed rulemaking for grants under 
this law.
    VA will also be holding virtual public listening sessions to 
provide these groups and entities an opportunity to share additional 
information. VA will publish information for these listening sessions 
in a future notice in the Federal Register.

[[Page 17269]]

Request for Information

    To design and implement the SSG Fox SPGP consistent with, and 
pursuant to, section 201 of the Act, the Secretary seeks information on 
the topics and issues listed below. Commenters do not need to address 
every question and should focus on those that relate to their expertise 
or perspectives. To the extent possible, please clearly indicate which 
topics and issues you address in your response.

A. Distribution and Selection of Grants (Section 201(d)(h)(1) of the 
Act)

    1. What criteria should VA establish for the selection of eligible 
entities that will submit applications under SSG Fox SPGP?
    a. How should VA weigh organizations that have worked extensively 
with the veteran populations versus organizations with limited suicide 
prevention work with veterans?
    b. How should VA consider prior experience working with vulnerable 
and disenfranchised populations?
    2. Pursuant to the Act, the Secretary shall give preference to 
eligible entities that have demonstrated the ability to provide or 
coordinate suicide prevention services. How should VA weigh evidence of 
demonstrated ability to provide or coordinate suicide prevention 
services, in giving preference to eligible entities that have 
demonstrated such ability?
    3. Pursuant to the Act, the Secretary may prioritize rural 
communities, Tribal Lands, territories of the United States, medically 
underserved areas, areas with a high number or percentage of minority 
veterans or women veterans, and the areas with a high number or 
percentage of calls to the Veterans Crisis Line. How should VA consider 
these factors in selecting applicants?

B. Administration of Grant Program: Development of Measures and Metrics 
(Section 201(h)(2) of the Act)

    1. How should VA collect and share information about entities in 
receipt of grants under the SSG Fox SPGP? For example, should VA create 
a public grantee roster with services noted and contact information of 
each grantee?
    2. How can shared information about entities be used to improve the 
provision or coordination of suicide prevention services for eligible 
individuals and families?
    a. What measures and metrics should eligible entities, who are in 
receipt of grants under the SSG Fox SPGP, use to determine the 
effectiveness of the programs they are providing?
    b. What existing measurements tool or protocols are available to 
determine program effectiveness?
    c. Which of these should be used for purposes of measuring 
effectiveness of programs provided through this grant program?
    3. Should VA consider measures or metrics to evaluate how grantees 
identify or eliminate barriers for eligible individuals seeking or 
obtaining suicide prevention services?

C. Training and Technical Assistance (Section 201(g) of the Act)

    Section 201(g) of the Act provides that the Secretary, in 
coordination with the CDC, shall provide training and technical 
assistance to grant recipients. The required training and technical 
assistance will cover suicide risk identification and management, data 
required to be collected and shared with VA, the means of data 
collection and sharing, use of tools to be used to measure the 
effectiveness of the grants and the reporting requirements. The 
Secretary may provide the training and technical assistance directly or 
through grants or contracts with appropriate public or nonprofit 
entities.
    1. What training and technical assistance programs and tools 
currently exist for the specified subject areas described above that 
could be utilized by VA?
    2. What data collection tools and training currently exist for the 
specified subject areas that could be utilized by VA?
    3. What tools and training currently exist for measuring the 
effectiveness of grants that could be utilized by VA?
    4. What tools and training currently exist for managing reporting 
requirements that could be utilized by VA?
    5. Should VA provide training and/or technical assistance directly, 
through grants or contracts with appropriate public or nonprofit 
entities, or a combination of both?

D. Referral for Care (Section 201(m) of the Act)

    Section 201(m) of the Act provides that if an eligible entity in 
receipt of a grant under the SSG Fox SPGP determines that an eligible 
individual is at-risk of suicide or other mental or behavioral health 
condition pursuant to a baseline mental health screening conducted 
under subsection (q)(11)(A)(ii) of the Act with respect to the 
individual, the entity shall refer the eligible individual to VA for 
additional care under subsection (n) of the Act or any other provision 
of law. Section 201(m) of the Act also provides that if an eligible 
entity in receipt of a grant under the SSG Fox SPGP determines that an 
eligible individual furnished clinical services for emergency treatment 
under subsection (q)(11)(A)(iv) of the Act requires ongoing services, 
the entity shall refer the eligible individual to VA for additional 
care under subsection (n) of the Act or any other provision of law.
    1. When an eligible entity in receipt of a grant under the SSG Fox 
SPGP determines that an eligible individual is at-risk of suicide or 
other mental or behavioral health condition pursuant to a qualifying 
baseline mental health screening, by what mechanism should the eligible 
entity refer the eligible individual to VA for additional care?
    2. When an eligible entity in receipt of a grant under the SSG Fox 
SPGP determines that an eligible individual furnished clinical services 
for emergency treatment requires ongoing services, by what mechanism 
should the eligible entity refer the eligible individual to VA for 
additional care?
    3. How should referrals to VA for additional care be tracked and 
reported by eligible entities?

E. Risk of Suicide

    Section 201(q)(8) of the Act directs the Secretary to determine by 
regulation the degrees of risk of suicide using health, environmental, 
and historical risk factors enumerated in section 201(q)(8)(A)(i)-
(iii). For health, these are: Mental health challenges, substance abuse 
(that is, substance use disorder), serious or chronic conditions or 
pain, or traumatic brain injury. Environmental risks factors include: 
Prolonged stress, stressful life events, unemployment, homelessness, 
recent loss, and legal or financial challenges. Historical risk factors 
include: Previous suicide attempts; family history of suicide; and 
history of abuse, neglect, or trauma. Section 201(q)(8) also provides 
that the Secretary may, through regulation, establish a process for 
determining the degrees of risk of suicide for use by grant recipients 
to focus the delivery of suicide prevention services.
    1. What degree(s) of exposure to, or the existence of, the health, 
environmental, and historical risk factors enumerated in section 
201(q)(8)(A)(i)-(iii) should VA utilize in determining degrees of risk 
of suicide?
    2. What process should VA establish for use by grant recipients in 
determining the degrees of risk of suicide to focus the delivery of 
services using grant funds?
    3. Are there existing measurement tools for assessing 
environmental, historical, and health risk factors that

[[Page 17270]]

grant recipients could utilize as part of their determination of degree 
of suicide risk?

F. Suicide Prevention Services

    Section 201(q)(11)(A)(x) of the Act notes that suicide prevention 
services include non-traditional and innovative approaches and 
treatment practices, as determined appropriate by the Secretary, in 
consultation with appropriate entities.
    1. What non-traditional and innovative approaches and treatment 
practices should VA consider?

Paperwork Reduction Act

    This request for information constitutes a general solicitation of 
public comments as stated in the implementing regulations of the 
Paperwork Reduction Act of 1995 at 5 CFR 1320.3(h)(4). Therefore, this 
request for information does not impose information collection 
requirements (i.e., reporting, recordkeeping or third-party disclosure 
requirements). Consequently, there is no need for review by the Office 
of Management and Budget under the authority of the Paperwork Reduction 
Act of 1995 (44 U.S.C. 3501, et seq.).

Signing Authority

    Denis McDonough, Secretary of Veterans Affairs, approved this 
document on March 11, 2021, and authorized the undersigned to sign and 
submit the document to the Office of the Federal Register for 
publication electronically as an official document of the Department of 
Veterans Affairs.

Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy & Management, Office of 
the Secretary, Department of Veterans Affairs.
[FR Doc. 2021-06392 Filed 3-31-21; 8:45 am]
BILLING CODE 8320-01-P