,,ii  #aae? ,,congress  #a/ ,session    
,s4 #iib  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,may #a1 #bjag,mr4     
,mc,cain 7= himself1 ,ms4 ,baldw91 ,mr4 
,van ,holl51 ,mr4 ,tillis1 & ,mr4       
,sullivan7 introduc$ ! foll[+ bill2 :i* 
0 read twice & ref]r$ to ! ,committee on
 ,vet]ans' ,affairs  ,a ,,bill  ,to     
direct ! ,secret>y ( ,vet]ans ,affairs  
to conduct an indep5d5t review ( ! dea?s
 ( c]ta9 vet]ans by suicide1 & = o!r    
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,vet]an ,ov]m$ication      
,prev5tion ,act ( #bjag4  #b4 ,dep>tm5t 
( ,vet]ans ,affairs indep5d5t review (  
c]ta9 dea?s ( vet]ans by suicide  7a7   
,review requir$  7#a7 ,9 g5]al ,n lat]  
?an #ij days aft] ! date ( ! enactm5t ( 
?is ,act1 ! ,secret>y ( ,vet]ans        
,affairs %all seek to ent] into an      
agreem5t ) ! ,national ,academies (     
,sci5ces1 ,eng9e]+1 & ,m$ic9e "u :i* !  
,national ,academies %all conduct a     
review ( ! dea?s ( all cov]$ vet]ans :o 
di$ by suicide dur+ ! five-ye> p]iod    

end+ on ! date ( ! enactm5t ( ?is ,act1 
reg>dless ( :e!r in=mation relat+ to su*
 dea?s has be5 report$ by ! ,c5t]s =    
,disease ,control & ,prev5tion4  7#b7   
,elem5ts ,! review requir$ by p>agraph  
7#a7 %all include ! foll[+3 7,a7 ,!     
total numb] ( cov]$ vet]ans :o di$ by   
suicide dur+ ! five-ye> p]iod end+ on ! 
date ( ! enactm5t ( ?is ,act4  7,b7 ,!  
total numb] ( cov]$ vet]ans :o di$ by a 
viol5t dea? dur+ su* five-ye> p]iod4    
7,c7 ,! total numb] ( cov]$ vet]ans :o  
di$ by an accid5tal dea? dur+ su*       
five-ye> p]iod4  7,d7 ,a description (  
ea* cov]$ vet]an describ$ 9 subp>agraphs
 7,a7 ?r\gh 7,c71 includ+ age1 g5d]1    
race1 & e?nicity4  7,e7 ,a compreh5sive 
li/ ( prescrib$ m$ications & legal or   
illegal sub/ances z annotat$ on         
toxicology reports ( cov]$ vet]ans      
describ$ 9 subp>agraphs 7,a7 ?r\gh 7,c71
 specifically li/+ any m$ications t     
c>ri$ a black box w>n+1 7 prescrib$ =   
(f-label use1 7 psy*otropic1 or c>ri$   
w>n+s t includ$ suicidal ideation4  7,f7

 ,a summ>y ( m$ical diagnoses by        
physicians ( ! ,dep>tm5t ( ,vet]ans     
,affairs or physicians provid+ s]vices  
to cov]$ vet]ans ?r\gh programs ( !     
,dep>tm5t t l$ to ! prescrib+ (         
m$ications ref]r$ to 9 subp>agraph 7,e7 
9 cases ( po/-traumatic /ress disord]1  
traumatic bra9 injury1 milit>y sexual   
trauma1 & o!r anxiety & depressive      
disord]s4  7,g7 ,! numb] ( in/ances 9   
:i* a cov]$ vet]an describ$ 9           
subp>agraph 7,a71 7,b71 or 7,c7 0       
concurr5tly on multiple m$ications      
prescrib$ by physicians ( ! ,dep>tm5t or
 physicians provid+ s]vices to vet]ans  
?r\gh programs ( ! ,dep>tm5t to treat   
po/-traumatic /ress disord]1 traumatic  
bra9 injury1 milit>y sexual trauma1 o!r 
anxiety & depressive disord]s1 or       
in/ances ( comorbidity4  7,h7 ,! numb] (
 cov]$ vet]ans describ$ 9 subp>agraphs  
7,a7 ?r\gh 7,c7 :o 7 n tak+ any         
m$ication prescrib$ by a physician ( !  
,dep>tm5t or a physician provid+ s]vices
 to vet]ans ?r\gh a program ( !         

,dep>tm5t4  7,i7 ,) respect to !        
treatm5t ( po/-traumatic /ress disord]1 
traumatic bra9 injury1 milit>y sexual   
trauma1 or o!r anxiety & depressive     
disord]s1 ! p]c5tage ( cov]$ vet]ans    
describ$ 9 subp>agraphs 7,a7 ?r\gh 7,c7 
:o receiv$ a non-m$ication fir/-l9e     
treatm5t comp>$ to ! p]c5tage ( su*     
vet]ans :o receiv$ m$ication only4  7,j7
 ,) respect to ! treatm5t ( cov]$       
vet]ans describ$ 9 subp>agraphs 7,a7    
?r\gh 7,c7 = po/-traumatic /ress        
disord]1 traumatic bra9 injury1 milit>y 
sexual trauma1 or o!r anxiety &         
depressive disord]s1 ! numb] ( in/ances 
9 :i* a non-m$ication fir/-l9e treatm5t 
7su* z cognitive behavioral !rapy7 0    
attempt$ & det]m9$ to be ineffective =  
su* a vet]an1 :i* subsequ5tly l$ to !   
prescrib+ ( a m$ication ref]r$ to 9     
subp>agraph 7,e74  7,k7 ,a description &
 example ( h[ ! ,dep>tm5t det]m9es &    
cont9ually updates ! cl9ical practice   
guidel9es gov]n+ ! prescrib+ (          
m$ications4  7,l7 ,an analysis ( ! use  

by ! ,dep>tm5t1 includ+ protocols or    
practices at m$ical facilities ( !      
,dep>tm5t1 ( sy/ematically measur+ pa9  
scores dur+ cl9ical enc\nt]s "u ! ,pa9 z
 ! #e? ,vital ,sign ,toolkit ( !        
,dep>tm5t & an evaluation ( !           
relation%ip betwe5 ! use ( su*          
measurem5ts & ! numb] ( vet]ans         
concurr5tly on multiple m$ications      
prescrib$ by physicians ( ! ,dep>tm5t4  
7,m7 ,a description ( ! ef=ts ( !       
,dep>tm5t to ma9ta9 appropriate /aff+   
levels = m5tal heal? pr(essionals1 su* z
 m5tal heal? c\nselors1 m>riage & family
 !rapi/s1 & o!r appropriate c\nselors1  
includ+--  7i7 a description ( any      
imp$im5ts to c>ry out ! education1      
tra9+1 & hir+ ( m5tal heal? c\nselors & 
m>riage & family !rapi/s "u section     
#gcjb7;a7 ( title #ch1 ,unit$ ,/ates    
,code1 & /rategies = address+ ^?        
imp$im5ts2  7ii7 a description ( !      
objectives1 goals1 & tim+ ( ! ,dep>tm5t 
) respect to increas+ ! repres5tation ( 
su* c\nselors & !rapi/s 9 ! behavioral  

heal? work=ce ( ! ,dep>tm5t1 includ+--  
7,i7 a review ( eligibility crit]ia =   
su* c\nselors & !rapi/s & a comp>ison ( 
su* crit]ia to t ( o!r behavioral heal? 
pr(essions 9 ! ,dep>tm5t2 &  7,,ii7 an  
assessm5t ( ! p>ticipation ( su*        
c\nselors & !rapi/s 9 ! m5tal heal?     
pr(essionals tra9ee program ( !         
,dep>tm5t & any imp$im5ts to su*        
p>ticipation2  7iii7 an assessm5t ( !   
developm5t by ! ,dep>tm5t ( hir+        
guidel9es = m5tal heal? c\nselors1      
m>riage & family !rapi/s1 & o!r         
appropriate c\nselors2  7iv7 a          
description ( h[ ! ,dep>tm5t--  7,i7    
id5tifies gaps 9 ! supply ( m5tal heal? 
pr(essionals2 &  7,,ii7 det]m9es        
successful /aff+ ratios = m5tal heal?   
pr(essionals ( ! ,dep>tm5t2  7v7 a      
description ( actions tak5 by !         
,secret>y1 9 consultation ) ! ,director 
( ! ,(fice ( ,p]sonnel ,managem5t1 to   
create an occupational s]ies = m5tal    
heal? c\nselors & m>riage & family      
!rapi/s ( ! ,dep>tm5t & a timel9e = !   

creation ( su* an occupational s]ies2 & 
7vi7 a description ( actions tak5 by !  
,secret>y to ensure t ! national1       
regional1 & local pr(essional /&>ds     
bo>ds = m5tal heal? c\nselors & m>riage 
& family !rapi/s are compris$ ( only    
m5tal heal? c\nselors & m>riage & family
 !rapi/s & t ! liaison f ! ,dep>tm5t to 
su* bo>ds is a m5tal heal? c\nselor or  
m>riage & family !rapi/4  7,n7 ,!       
p]c5tage ( cov]$ vet]ans describ$ 9     
subp>agraphs 7,a7 ?r\gh 7,c7 ) combat   
exp]i5ce or trauma relat$ to combat     
exp]i5ce 7includ+ milit>y sexual trauma1
 traumatic bra9 injury1 & po/-traumatic 
/ress74  7,o7 ,an id5tification ( !     
m$ical facilities ( ! ,dep>tm5t ) m>k$ly
 high prescription rates & suicide rates
 = vet]ans receiv+ treatm5t at ^?       
facilities4  7,p7 ,an analysis1 by      
,/ate1 ( programs ( ! ,dep>tm5t t       
collaborate ) ,/ate ,m$icaid ag5cies & !
 ,c5t]s = ,m$ic>e & ,m$icaid ,s]vices1  
includ+ ! foll[+3  7i7 ,an analysis ( ! 
%>+ ( prescription & behavioral heal?   

data = vet]ans4  7ii7 ,an analysis (    
:e!r ,dep>tm5t /aff *eck ) ,/ate        
prescription drug monitor+ programs be=e
 prescrib+ m$ications to vet]ans4  7iii7
 ,a description ( ! proc$ures ( !       
,dep>tm5t = coord9at+ ) prescrib]s      
outside ( ! ,dep>tm5t to ensure t       
vet]ans are n ov]prescrib$4  7iv7 ,a    
description ( actions t ! ,dep>tm5t     
takes :5 a vet]an is det]m9$ to be      
ov]prescrib$4  7,q7 ,an analysis ( !    
collaboration ( m$ical c5t]s ( !        
,dep>tm5t ) m$ical exam9]s' (fices or   
local jurisdictions to det]m9e vet]an   
mortality & cause ( dea?4  7,r7 ,an     
id5tification & det]m9ation ( a be/     
practice model to collect & %>e vet]an  
dea? c]tificate data betwe5 ! ,dep>tm5t 
( ,vet]ans ,affairs1 ! ,dep>tm5t (      
,def5se1 ,/ates1 & tribal entities4     
7,s7 ,a description ( h[ data relat+ to 
dea? c]tificates ( vet]ans is collect$1 
det]m9$1 & report$ by ! ,dep>tm5t (     
,vet]ans ,affairs4  7,t7 ,an assessm5t (
 any patt]ns app>5t to ! ,national      

,academies ( ,sci5ces1 ,eng9e]+1 &      
,m$ic9e bas$ on ! review conduct$ "u    
p>agraph 7#a74  7,u7 ,su* recomm5dations
 = fur!r action t w\ld improve ! safety 
& well-be+ ( vet]ans z ! ,national      
,academies ( ,sci5ces1 ,eng9e]+1 &      
,m$ic9e det]m9e appropriate4  7#c7      
,compilation ( data  7,a7 ,=m (         
compilation ,! ,secret>y ( ,vet]ans     
,affairs %all ensure t data compil$ "u  
p>agraph 7#b7 is compil$ 9 a mann] t    
all[s x to be analyz$ across all data   
fields = purposes ( in=m+ & updat+      
cl9ical practice guidel9es ( ! ,dep>tm5t
 ( ,vet]ans ,affairs4  7,b7 ,compilation
 ( data reg>d+ cov]$ vet]ans ,9 compil+ 
data "u p>agraph 7#b7 reg>d+ cov]$      
vet]ans describ$ 9 subp>agraphs 7,a7    
?r\gh 7,c7 ( su* p>agraph1 data reg>d+  
vet]ans describ$ 9 ea* su* subp>agraph  
%all be compil$ sep>ately & disaggregat$
 by ye>4  7#d7 ,completion ( review &   
report ,! agreem5t ent]$ into "u        
p>agraph 7#a7 %all require t ! ,national
 ,academies ( ,sci5ces1 ,eng9e]+1 &     

,m$ic9e complete ! review "u su*        
p>agraph & submit to ! ,secret>y (      
,vet]ans ,affairs a report conta9+ !    
results ( ! review n lat] ?an #ahj days 
aft] ent]+ into ! agreem5t4  7b7 ,report
 ,n lat] ?an #cj days aft] ! completion 
by ! ,national ,academies ( ,sci5ces1   
,eng9e]+1 & ,m$ic9e ( ! review requir$  
"u subsection 7a71 ! ,secret>y (        
,vet]ans ,affairs %all--  7#a7 submit to
 ! ,committee on ,vet]ans' ,affairs ( ! 
,s5ate & ! ,committee on ,vet]ans'      
,affairs ( ! ,h\se ( ,repres5tatives a  
report on ! results ( ! review2 &  7#b7 
make su* report publicly available4  7c7
 ,def9itions ,9 ?is section3  7#a7 ,!   
t]m black box w>n+ means a w>n+ display$
 on ! label ( a prescription drug t is  
design$ to call att5tion to ! s]i\s or  
life-?reat5+ risk ( ! prescription drug4
  7#b7 ,! t]m cov]$ vet]an means a      
vet]an :o receiv$ hospital c>e or m$ical
 s]vices furni%$ by ! ,dep>tm5t (       
,vet]ans ,affairs dur+ ! five-ye> p]iod 
prec$+ ! dea? ( ! vet]an4  7#c7 ,! t]m  

fir/-l9e treatm5t means a pot5tial      
int]v5tion t has be5 evaluat$ & assign$ 
a high score )9 cl9ical practice        
guidel9es4  7#d7 ,! t]m ,/ate means ea* 
( ! ,/ates1 t]ritories1 & possessions ( 
! ,unit$ ,/ates1 ! ,di/rict ( ,columbia1
 & ! ,commonweal? ( ,pu]to ,rico4