US Codex
Pub. L.
Notes

Title II — Suicide Prevention

116th Congress · Approved Dec 5, 2020 · 134 Stat. 1026

TITLE II Suicide Prevention

SEC. 201. Department of Veterans Affairs Provision of Emergent Suicide Care.

(a)
In General.— Subchapter II of chapter 17 of title 38, United States Code, is amended by adding at the end the following new section:

Ҥ 1720J. Emergent suicide care

“(a) Emergent Suicide Care.—Pursuant to this section, the Secretary shall—

“(1) furnish emergent suicide care to an eligible individual at a medical facility of the Department;

“(2) pay for emergent suicide care provided to an eligible individual at a non-Department facility; and

“(3) reimburse an eligible individual for emergent suicide care provided to the eligible individual at a non-Department facility.

“(b) Eligibility.—An individual is eligible for emergent suicide care under subsection (a) if the individual is in an acute suicidal crisis and is either of the following:

“(1) A veteran (as defined in section 101).

“(2) An individual described in section 1720I(b) of this title.

“(c) Period of Care.—

(1) Emergent suicide care provided under subsection (a) shall be furnished to an eligible individual—

“(A) through inpatient or crisis residential care, for a period not to exceed 30 days; or

“(B) if care under subparagraph (A) is unavailable, or if such care is not clinically appropriate, as outpatient care for a period not to exceed 90 days.

“(2) If, upon the expiration of a period under paragraph (1), the Secretary determines that the eligible individual remains in an acute suicidal crisis, the Secretary may extend such period as the Secretary determines appropriate.

“(d) Notification.—An eligible individual who receives emergent suicide care under subsection (a) at a non-Department facility (or a person acting on behalf of the individual) shall notify the Secretary of such care within seven days of admission to such facility.

“(e) Outreach.—During any period when an eligible individual is receiving emergent suicide care under subsection (a), the Secretary shall—

“(1) ensure that—

“(A) in the case of an eligible individual whom the Veterans Crisis Line recommends to seek emergent suicide care at a medical facility of the Department, the Veterans Crisis Line notifies the Suicide Prevention Coordinator of such medical facility;

“(B) in the case of an eligible individual who presents at a medical facility of the Department in an acute suicidal crisis without a recommendation by the Veterans Crisis Line, the Secretary notifies the Suicide Prevention Coordinator;

“(C) in the case of an eligible individual whom the Veterans Crisis Line recommends to seek treatment at a non-Department facility, the Veterans Crisis Line notifies the Suicide Prevention Coordinator and the Office of Community Care at the medical facility of the Department located nearest to the eligible individual; and

“(D) in the case of an eligible individual who presents at a non-Department facility in an acute suicidal crisis without a recommendation by the Veterans Crisis Line and for whom the Secretary receives a notification under subsection (d), the Secretary notifies the Suicide Prevention Coordinator and the Office of Community Care at the medical facility of the Department located nearest to the eligible individual;

“(2) determine the eligibility of the eligible individual for other programs and benefits under the laws administered by the Secretary (or shall make such determination as soon as practicable following the period of such emergent suicide care); and

“(3) make referrals for care following the period of such emergent suicide care, as the Secretary determines appropriate.

“(f) Prohibition on Charge.—

(1) If the Secretary provides emergent suicide care to an eligible individual under subsection (a), the Secretary—

“(A) may not charge the eligible individual for any cost of such emergent suicide care; and

“(B) shall pay for any costs of emergency transportation to a facility for such emergent suicide care (as such costs are determined pursuant to section 1725 of this title, to the extent practicable).

“(2)

(A) In addition to the requirements of paragraph (1), if the Secretary pays for emergent suicide care provided under subsection (a) to an eligible individual at a non-Department facility, the Secretary shall reimburse the facility for the reasonable value of such emergent suicide care.

“(B)

(i) In carrying out subparagraph (A), the Secretary may determine the amount to reimburse a non-Department facility in a similar manner to the manner in which the Secretary determines reimbursement amounts for that non-Department facility for medical care and services provided under another provision of this chapter.

“(ii) The requirements of section 1725(c)(3) of this title shall apply with respect to payments made under subparagraph (A) of this paragraph.

“(3) In the case of an eligible individual who receives emergent suicide care under this section and who is entitled to emergent suicide care (or payment for emergent suicide care) under a health-plan contract, the Secretary may recover the costs of such emergent suicide care provided under this section, other than for such care for a service-connected disability.

“(4) In carrying out subsection (d), the Secretary may not charge an eligible individual for any cost of emergent suicide care provided under subsection (a) solely by reason of the Secretary not having been notified of such care pursuant to such subsection.

“(g) Annual Report.—Not less than once each year, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on emergent suicide care provided under subsection (a). Each such report shall include, for the year covered by the report—

“(1) the number of eligible individuals who received emergent suicide care under subsection (a);

“(2) demographic information regarding eligible individuals described in paragraph (1);

“(3) the types of care furnished or paid for this section; and

“(4) the total cost of providing care under subsection (a).

“(h) Definitions.—In this section:

“(1) The term ‘acute suicidal crisis’ means that an individual was determined to be at imminent risk of self-harm by a trained crisis responder or health care provider.

“(2) The term ‘crisis residential care’ means crisis stabilization care provided—

“(A) in a residential setting; and

“(B) in a facility other than a hospital.

“(3) The term ‘crisis stabilization care’ includes, with respect to an individual in acute suicidal crisis, care that ensures, to the extent practicable, immediate safety and reduces—

“(A) the severity of distress;

“(B) the need for urgent care; or

“(C) the likelihood that the distress under subparagraph (A) or need under subparagraph (B) will increase during the transfer of that individual from a facility at which the individual has received care for that acute suicidal crisis.

“(4) The term ‘emergent suicide care’ means crisis stabilization care provided to an eligible individual—

“(A) pursuant to a recommendation of the eligible individual from the Veterans Crisis Line; or

“(B) who presents at a medical facility in an acute suicidal crisis.

“(5) The term ‘health-plan contract’ has the meaning given such term in section 1725 of this title.

“(6) The term ‘Veterans Crisis Line’ means the hotline under section 1720F(h) of this title.”

(b)
Clerical Amendment.— The table of sections at the beginning of such chapter is amended by inserting after the item relation to section 1720I the following new item:

“1720J. Emergent suicide care.”.

(c)
Effective Date.— The Secretary shall furnish or pay for emergent suicide care under section 1720J of title 38, United States Code, as added by subsection (a), beginning on the date that is 270 days after the date of the enactment of this Act.

SEC. 202. Education Program for Family Members and Caregivers of Veterans with Mental Health Disorders.

(a)
Establishment.— Not later than 270 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall establish an education program (in this section referred to as the “education program”) for the education and training of caregivers and family members of eligible veterans with mental health disorders.
(b)
Education Program.—
(1)
In general.— Under the education program, the Secretary shall provide a course of education to caregivers and family members of eligible veterans on matters relating to coping with mental health disorders in veterans.
(2)
Duration.— The Secretary shall carry out the education program during the four-year period beginning on the date of the commencement of the education program.
(3)
Scope.—
(A)
Caregivers.— The Secretary, with respect to the component of the education program that relates to the education and training of caregivers, shall—
(i)
include such component in the training provided pursuant to the program of comprehensive assistance for family caregivers of the Department of Veterans Affairs established under section 1720G(a) of title 38, United States Code; and
(ii)
make such component available on the Internet website of the Department that relates to caregiver training.
(B)
Family members.— The Secretary shall carry out the component of the education program that relates to the education and training of non-caregiver family members at facilities of the Department as follows:
(i)
Not less than five medical centers of the Department.
(ii)
Not less than five clinics of the Department.
(iii)
Not less than five Vet Centers (as defined in section 1712A(h) of title 38, United States Code).
(C)
Solicitation of applications.— In selecting locations pursuant to subparagraph (B), the Secretary shall solicit applications from eligible facilities of the Department that are interested in carrying out the education program.
(D)
Considerations.— In selecting locations pursuant to subparagraph (B), the Secretary shall consider the feasibility and advisability of selecting locations in the following areas:
(i)
Rural areas.
(ii)
Areas that are not in close proximity to an active duty installation.
(iii)
Areas in different geographic locations.
(4)
Contracts.—
(A)
In general.— In carrying out the education program, the Secretary shall enter into contracts with qualified entities described in subparagraph (B) to offer the course of education described in paragraph (5) to family members and caregivers of eligible veterans and covered veterans.
(B)
Qualified entity described.— A qualified entity described in this subparagraph is a non-profit entity with experience in mental health education and outreach, including work with children, teens, and young adults, that—
(i)
uses high quality, relevant, and age-appropriate information in educational programming, materials, and coursework, including such programming, materials, and coursework for children, teens, and young adults; and
(ii)
works with agencies, departments, nonprofit mental health organizations, early childhood educators, and mental health providers to develop educational programming, materials, and coursework.
(C)
Priority.— In entering into contracts under this paragraph, the Secretary shall give priority to qualified entities that have demonstrated cultural competence in serving military and veteran populations, and, to the extent practicable, use internet technology for the delivery of course content in an effort to expand the availability of support services, especially in rural areas.
(5)
Course of education described.— The course of education described in this paragraph shall consist of curriculum that includes the following:
(A)
General education on different mental health disorders, including information to improve understanding of the experiences of individuals suffering from such disorders.
(B)
Techniques for handling crisis situations and administering mental health first aid to individuals suffering from a mental health disorder.
(C)
Techniques for coping with the stress of living with an individual suffering from a mental health disorder.
(D)
Information on additional services available for family members and caregivers through the Department or community organizations and providers related to mental health disorders.
(E)
Such other matters as the Secretary considers appropriate.
(c)
Surveys.—
(1)
In general.— The Secretary shall conduct a comprehensive survey of the satisfaction of individuals that have participated in the course of education described in subsection (b)(5). Such survey shall include a solicitation of feedback on the following:
(A)
The general satisfaction of those individuals with the education and assistance provided under the education program.
(B)
The perceived effectiveness of the education program in providing education and assistance that is useful for those individuals.
(C)
The applicability of the education program to the issues faced by those individuals.
(D)
Such other matters as the Secretary considers appropriate.
(2)
Compilation of information.— The information compiled as a result of the surveys conducted under paragraph (1) shall be—
(A)
disaggregated by facility type at which the education program was carried out; and
(B)
included in the annual reports under subsection (d)(1).
(d)
Reports.—
(1)
Annual reports.—
(A)
In general.— Not later than one year after the date of the commencement of the education program and not later than September 30 each year thereafter until 2024, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on—
(i)
the education program; and
(ii)
the feasibility and advisability of expanding the education program to include the establishment of a peer support program composed of individuals who complete the education program (in this section referred to as a “peer support program”).
(B)
Elements.— Each report submitted under subparagraph (A) shall include the following:
(i)
The number of individuals that participated in the course of education described in subsection (b)(5) during the year preceding the submission of the report.
(ii)
A detailed analysis of the surveys conducted under subsection (c) with respect to the individuals described in clause (i).
(iii)
Any plans for expansion of the education program.
(iv)
An analysis of the feasibility and advisability of establishing a peer support program.
(v)
The interim findings and conclusions of the Secretary with respect to the success of the education program and the feasibility and advisability of establishing a peer support program.
(2)
Final report.—
(A)
In general.— Not later than one year after the completion of the education program, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a final report on the feasibility and advisability of continuing the education program.
(B)
Elements.— The final report under subparagraph (A) shall include the following:
(i)
A detailed analysis of the surveys conducted under subsection (c).
(ii)
An analysis of the feasibility and advisability of continuing the education program without entering into contracts for the course of education described in subsection (b)(5).
(iii)
An analysis of the feasibility and advisability of expanding the education program.
(iv)
An analysis of the feasibility and advisability of establishing a peer support program.
(e)
Monitoring of Program.— The Secretary shall select mental health care providers of the Department to monitor the progress of the instruction provided under the education program.
(f)
Definitions.— In this section:
(1)
The term “eligible veteran” means a veteran who is enrolled in the health care system established under section 1705(a) of title 38, United States Code.
(2)
The terms “caregiver” and “family member” have the meaning given those terms in section 1720G(d) of title 38, United States Code.

SEC. 203. Interagency Task Force on Outdoor Recreation for Veterans.

(a)
Establishment.— Not later than 18 months after the date on which the national emergency declared by the President pursuant to the National Emergencies Act (50 U.S.C. 1601 et seq.) with respect to the Coronavirus Disease 2019 (COVID–19) expires, the Secretary of Veterans Affairs shall establish a task force to be known as the “Task Force on Outdoor Recreation for Veterans” (in this section referred to as the “Task Force”).
(b)
Composition.— The Task Force shall be composed of the following members or their designees:
(1)
The Secretary of Veterans Affairs.
(2)
The Secretary of the Interior.
(3)
The Secretary of Health and Human Services.
(4)
The Secretary of Agriculture.
(5)
The Secretary of Defense.
(6)
The Secretary of Homeland Security.
(7)
The Chief of the Army Corps of Engineers.
(8)
At least two representatives from veterans service organizations.
(9)
Any other member that the Secretary of Veterans Affairs determines to be appropriate.
(c)
Chairpersons.— The Secretary of Veterans Affairs and the Secretary of the Interior shall serve as co-chairpersons of the Task Force (in this section referred to as the “Chairpersons”).
(d)
Duties.—
(1)
Task force.— The duties of the Task Force shall be—
(A)
to identify opportunities to formalize coordination between the Department of Veterans Affairs, public land agencies, and partner organizations regarding the use of public lands and other outdoor spaces for facilitating health and wellness for veterans;
(B)
to identify barriers that exist to providing veterans with opportunities to augment the delivery of services for health and wellness through the use of outdoor recreation on public lands and other outdoor spaces; and
(C)
to develop recommendations to better facilitate the use of public lands and other outdoor spaces for promoting wellness and facilitating the delivery of health care and therapeutic interventions for veterans.
(2)
Consultation.— The Task Force shall carry out the duties under paragraph (1) in consultation with appropriate veterans outdoor recreation groups.
(e)
Reports.—
(1)
Preliminary report.— Not later than one year after the date on which the Task Force is established, the Chairpersons shall submit to Congress a report on the preliminary findings of the Task Force.
(2)
Final report.— Not later than one year after the date of the submission of the preliminary report under paragraph (1), the Chairpersons shall submit to Congress a report on the findings of the Task Force, which shall include the recommendations developed under subsection (d)(1)(C).
(f)
Duration.— The Task Force shall terminate on the date that is one year after the date of the submission of the final report in subsection (e)(2).
(g)
Nonapplicability of Federal Advisory Committee Act.— The Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the Task Force.
(h)
Public Lands Defined.— In this section, the term “public lands” means any recreational lands under the jurisdiction of the Federal Government or a State or local government.

SEC. 204. Contact of Certain Veterans to Encourage Receipt of Comprehensive Medical Examinations.

(a)
Notice.— Not later than 90 days after the date of the enactment of this Act, the Under Secretary of Health of the Department of Veterans Affairs shall seek to contact each covered veteran by mail, telephone, or email to encourage each covered veteran to receive medical examinations including the following:
(1)
A comprehensive physical examination.
(2)
A comprehensive mental health examination.
(3)
A comprehensive eye examination if the covered veteran has not received such an examination in the year immediately preceding the date of such examination.
(4)
A comprehensive audiological examination if the covered veteran has not received such an examination in the year immediately preceding the date of such examination.
(b)
Examinations.—
(1)
Va health care facilities.— If a covered veteran elects to receive more than one examination described in subsection (a) at a health care facility of the Department of Veterans Affairs, the Under Secretary of Health shall seek to furnish all such scheduled examinations on the same day.
(2)
Community care.— Pursuant to subsection (d) or (e) of section 1703 of title 38, United States Code, a covered veteran may receive an examination described in subsection (a) from a health care provider described in subsection (c) of that section.
(c)
Transportation.—
(1)
Beneficiary travel program.— Pursuant to section 111 of title 38, United States Code, the Secretary of Veterans Affairs may pay for a rural covered veteran to travel to a health care facility to receive an examination described in subsection (a).
(2)
Shuttle service.— The Under Secretary of Health shall seek to enter into agreements with non-profit organizations to provide shuttle service to rural covered veterans for examinations described in subsection (a).
(d)
Report Required.— Not later than 18 months after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to Congress a report regarding how many covered veterans scheduled examinations described in subsection (a) after receiving a letter, telephone call, or email under that subsection.
(e)
Definitions.— In this section:
(1)
The term “covered veteran” means a veteran who—
(A)
is enrolled in the patient enrollment system of the Department of Veterans Affairs under section 1705 of title 38, United States Code; and
(B)
has not received health care furnished or paid for by the Secretary of Veterans Affairs during the two years immediately preceding the date in subsection (a)(1).
(2)
The term “rural covered veteran” means a covered veteran—
(A)
who lives in an area served by the Office of Rural Health of the Department of Veterans Affairs; and
(B)
whom the Under Secretary of Health determines requires assistance to travel to a health care facility to receive an examination described in subsection (a).
(3)
The term “veteran” has the meaning given that term in section 101 of title 38, United States Code.

SEC. 205. Police Crisis Intervention Training of Department of Veterans Affairs.

(a)
Training.— The Secretary of Veterans Affairs shall provide to Department police officers an annual training on the prevention of suicide among the population served by the Department police officers.
(b)
Curriculum.— In carrying out subsection (a), the Secretary shall update any similar training provided before the date of the enactment of this Act to ensure that the curriculum for the training addresses, at a minimum, the following:
(1)
Effective behavioral science procedures for suicide prevention and risk mitigation.
(2)
Crisis intervention and de-escalation skills, including through the use of interactive training.
(3)
Information about mental health and substance abuse disorders.
(4)
Information about local law enforcement crisis intervention teams and other resources for veterans experiencing mental health crises available by the Department of Veterans Affairs, other elements of the Federal Government, and the community in which the police officers serve.
(c)
Consultation.— The Secretary shall ensure that the annual training provided to Department police officers at a medical facility of the Department under subsection (a) is provided in consultation with law enforcement training accreditation organizations and the mental health experts at such facility.
(d)
Plan on Community Partnerships.— The Secretary shall ensure that each police force of a facility of the Department develops a plan to enter into partnerships with—
(1)
local community mental health organizations and experts, local community veterans organizations, and local community criminal justice organizations and experts; and
(2)
local police departments, including by facilitating the sharing of training resources with crisis intervention teams of the local police departments.
(e)
Report.— Not later than one year after the date of the enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report on the annual training under subsection (a), including—
(1)
a description of the curriculum of such training;
(2)
with respect to the year preceding the date of the report—
(A)
the number of facilities of the Department that conducted such training;
(B)
the number of Department police officers who received such training; and
(C)
any barriers to ensuring that each Department police officer receives such training;
(3)
any recommendations to address the barriers identified under paragraph (2)(C); and
(4)
the number of facilities of the Department that have entered into partnerships pursuant to subsection (d).
(f)
Department Police Officer Defined.— In this section, the term “Department police officer” means an employee of the Department of Veterans Affairs specified in section 902(a) of title 38, United States Code.