,i  #aafth ,,congress  #b;d ,session    
,h4 ,r4 #hajg  ,,in ,,the ,,house ,,of  
,,representatives  ,august #be1         
#bjbj,mr4 ,levin of ,michigan 7for      
himself and ,mr4 ,stivers7 introduced   
the following bill2 which was referred  
to the ,committee on ,veterans' ,affairs
  ,a ,,bill  ,to direct the ,secretary  
of ,veterans ,affairs to submit to      
,congress a report on efforts by        
,department of ,veterans ,affairs to    
implement safety planning in emergency  
departments1 and for other purposes4    
#a4 ,short title ,this ,act may be cited
 as the ,,va ,emergency ,department     
,safety ,planning ,act4  #b4 ,report on 
efforts by ,department of ,veterans     
,affairs to implement safety planning in
 emergency departments  7a7 ,findings   
,congress makes the following findings3 
7#a7 ,the ,department of ,veterans      
,affairs must be more effective in its  
approach to reducing the burden of      
veteran suicide connected to mental     
health diagnoses1 to include expansion  

of treatment delivered via telehealth   
methods and in rural areas4  7#b7 ,an   
innovative project1 known as ,suicide   
,assessment and ,follow-up ,engagement3 
,veteran ,emergency ,treatment 7in this 
subsection referred to as ,,safe ,,vet71
 was designed to help suicidal veterans 
seen at emergency departments within the
 ,veterans ,health ,administration and  
was successfully implemented in five    
intervention sites beginning in #bjaj4  
7#c7 ,a #bjah study found that safety   
planning intervention under ,,safe ,,vet
 was associated with #de percent fewer  
suicidal behaviors in the six-month     
period following emergency department   
care and more than double the odds of a 
veteran engaging in outpatient          
behavioral health care4  7#d7 ,,safe    
,,vet is a promising alternative and    
acceptable delivery of care system that 
augments the treatment of suicidal      
veterans in emergency departments of the
 ,veterans ,health ,administration and  
helps ensure that those veterans have   

appropriate follow-up care4  7#e7       
,beginning in ,september #bjah1 the     
,veterans ,health ,administration       
implemented a suicide prevention program
 based on the findings of ,,safe ,,vet1 
known as the ,,sped program1 for        
veterans presenting to the emergency    
department who are assessed to be at    
risk for suicide and are safe to be     
discharged home4  7#f7 ,the ,,sped      
program includes issuance and update of 
a safety plan and post-discharge        
follow-up outreach for veterans to      
facilitate engagement in outpatient     
mental health care4  7b7 ,report  7#a7  
,in general ,not later than #ahj days   
after the date of the enactment of this 
,act1 the ,secretary of ,veterans       
,affairs shall submit to the appropriate
 committees of ,congress a report on the
 efforts of the ,secretary to implement 
a suicide prevention program for        
veterans presenting to an emergency     
department or urgent care center of the 
,veterans ,health ,administration who   

are assessed to be at risk for suicide  
and are safe to be discharged home1     
including a safety plan and             
post-discharge outreach for veterans to 
facilitate engagement in outpatient     
mental health care4  7#b7 ,elements ,the
 report required by paragraph 7#a7 shall
 include the following3 7,a7 ,an        
assessment of the implementation of the 
current operational policies and        
procedures of the ,,sped program at each
 medical center of the ,department of   
,veterans ,affairs1 including an        
assessment of the following3 7i7        
,training provided to clinicians or     
other personnel administering protocols 
under the ,,sped program4  7ii7 ,any    
disparities in implementation of such   
protocols between medical centers4      
7iii7 ,current criteria used to measure 
the quality of such protocols           
including-- 7,i7 methodology used to    
assess the quality of a safety plan and 
post-discharge outreach for veterans2 or
  7,,ii7 in the absence of such         

methodology1 a proposed timeline and    
guidelines for creating a methodology to
 ensure compliance with the             
evidence-based model used under the     
,suicide ,assessment and ,follow-up     
,engagement3 ,veteran ,emergency        
,treatment 7,,safe ,,vet7 program of the
 ,department4  7,b7 ,an assessment of   
the implementation of the policies and  
procedures described in subparagraph    
7,a71 disaggregated by gender and by    
race and ethnicity1 including the       
following3 7i7 ,an assessment of the    
quality and quantity of safety plans    
issued to veterans4  7ii7 ,an assessment
 of the quality and quantity of         
post-discharge outreach provided to     
veterans4  7iii7 ,the post-discharge    
rate of veteran engagement in outpatient
 mental health care1 including          
attendance at not fewer than one        
individual mental health clinic         
appointment or admission to an inpatient
 or residential unit4  7iv7 ,the number 
of veterans who decline safety planning 

efforts during protocols under the      
,,sped program4  7v7 ,the number of     
veterans who decline to participate in  
follow-up efforts within the ,,sped     
program4  7,c7 ,a description of how    
,,sped primary coordinators are deployed
 to support such efforts1 including the 
following3 7i7 ,a description of the    
duties and responsibilities of such     
coordinators4  7ii7 ,the number and     
location of such coordinators4  7iii7 ,a
 description of training provided to    
such coordinators4  7iv7 ,an assessment 
of the other responsibilities for such  
coordinators and1 if applicable1        
differences in patient outcomes when    
such responsibilities are full-time     
duties as opposed to secondary duties4  
7,d7 ,an assessment of the feasibility  
and advisability of expanding the total 
number and geographic distribution of   
,,sped primary coordinators4  7,e7 ,an  
assessment of the feasibility and       
advisability of providing services under
 the ,,sped program via telehealth      

channels1 including an analysis of      
opportunities to leverage telehealth to 
better serve veterans in rural areas4   
7,f7 ,a description of the status of    
current capabilities and utilization of 
tracking mechanisms to monitor          
compliance1 quality1 and patient        
outcomes under the ,,sped program4  7,g7
 ,such recommendations1 including       
specific action items1 as the ,secretary
 considers appropriate with respect to  
how the ,department can better implement
 the ,,sped program1 including          
recommendations with respect to the     
following3 7i7 ,a process to standardize
 training under such program4  7ii7 ,any
 resourcing requirements necessary to   
implement the ,,sped program throughout 
,veterans ,health ,administration1      
including by having a dedicated         
clinician responsible for administration
 of such program at each medical center4
  7iii7 ,an analysis of current         
statutory authority and any changes     
necessary to fully implement the ,,sped 

program throughout the ,veterans ,health
 ,administration4  7iv7 ,a timeline for 
the implementation of the ,,sped program
 through the ,veterans ,health          
,administration once full resourcing and
 an approved training plan are in place4
  7,h7 ,such other matters as the       
,secretary considers appropriate4  7c7  
,definitions ,in this section3 7#a7 ,the
 term appropriate committees of         
,congress means-- 7,a7 the ,committee on
 ,veterans' ,affairs and the            
,subcommittee on ,military              
,construction1 ,veterans ,affairs1 and  
,related ,agencies of the ,committee on 
,appropriations of the ,senate2 and     
7,b7 the ,committee on ,veterans'       
,affairs and the ,subcommittee on       
,military ,construction1 ,veterans      
,affairs1 and ,related ,agencies of the 
,committee on ,appropriations of the    
,house of ,representatives4  7#b7 ,the  
term ,,sped primary coordinator means   
the main point of contact responsible   
for administering the ,,sped program at 

a medical center of the ,department4    
7#c7 ,the term ,,sped program means the 
,safety ,planning in ,emergency         
,departments program of the ,department 
of ,veterans ,affairs established in    
,september #bjah for veterans presenting
 to the emergency department who are    
assessed to be at risk for suicide and  
are safe to be discharged home1 which   
extends the evidence-based intervention 
for suicide prevention to all emergency 
departments of the ,veterans ,health    
,administration4