#aaf? ,,congress #b;d ,session ,s4 #ghe ,,an ,,act ,to improve m5tal heal? c>e provid$ by ! ,dep>tm5t ( ,vet]ans ,affairs1 & = o!r purposes4 #a4 ,%ort title2 table ( cont5ts 7a7 ,%ort title ,?is ,act may be cit$ z ! ,comm&] ,john ,scott ,hannon ,vet]ans ,m5tal ,heal? ,c>e ,improvem5t ,act ( #bjai4 7b7 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 table ( cont5ts4,,title ,i--,improvem5t ( transition ( individuals to s]vices f ,dep>tm5t ( ,vet]ans ,affairs,sec4 #aja4 ,/rategic plan on expansion ( heal? c>e cov]age = vet]ans transition+ f s]vice 9 ! ,arm$ ,=ces4,sec4 #ajb4 ,review ( records ( =m] memb]s ( ! ,arm$ ,=ces :o die by suicide )9 "o ye> ( sep>ation f ! ,arm$ ,=ces4,sec4 #ajc4 ,report on ,,rea* ,,vet program ( ,dep>tm5t ( ,vet]ans ,affairs4,sec4 #ajd4 ,report on c>e = =m] memb]s ( ! ,arm$ ,=ces ) o!r ?an honorable dis*>ge4,,title ,,ii--,suicide prevention,sec4 #bja4 ,f9ancial assi/ance to c]ta9 entities to provide or coord9ate ! provision ( suicide prev5tion s]vices = eligible individuals & _! families4,sec4 #bjb4 ,analysis on feasibility & advisability ( ! ,dep>tm5t ( ,vet]ans ,affairs provid+ c]ta9 complem5t>y & integrative heal? s]vices4,sec4 #bjc4 ,pilot program to provide vet]ans access to complem5t>y & integrative heal? programs ?r\gh animal !rapy1 agri!rapy1 sports & recreation !rapy1 art !rapy1 & po/traumatic gr[? programs4,sec4 #bjd4 ,dep>tm5t ( ,vet]ans ,affairs /udy ( all-cause mortality ( vet]ans1 includ+ by suicide1 & review ( /aff+ levels ( m5tal heal? pr(essionals4,sec4 #bje4 ,comptroll] ,g5]al report on managem5t by ,dep>tm5t ( ,vet]ans ,affairs ( vet]ans at high risk = suicide4,,title ,,iii--,programs1 /udies1 & guidel9es on m5tal health,sec4 #cja4 ,/udy on connection betwe5 liv+ at high altitude & suicide risk factors among vet]ans4,sec4 #cjb4 ,e/abli%m5t by ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se ( a cl9ical provid] treatm5t toolkit & accompany+ tra9+ mat]ials = comorbidities4,sec4 #cjc4 ,update ( cl9ical practice guidel9es = assessm5t & managem5t ( pati5ts at risk = suicide4,sec4 #cjd4 ,e/abli%m5t by ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se ( cl9ical practice guidel9es = ! treatm5t ( s]i\s m5tal illness4,sec4 #cje4 ,precision m$ic9e initiative ( ,dep>tm5t ( ,vet]ans ,affairs to id5tify & validate bra9 & m5tal heal? biom>k]s4,sec4 #cjf4 ,/ati/ical analyses & data evaluation by ,dep>tm5t ( ,vet]ans ,affairs4,,title ,,iv--,ov]sight ( m5tal heal? c>e & relat$ services,sec4 #dja4 ,/udy on effectiv5ess ( suicide prev5tion & m5tal heal? outrea* programs ( ,dep>tm5t ( ,vet]ans ,affairs4,sec4 #djb4 ,ov]sight ( m5tal heal? & suicide prev5tion m$ia outrea* conduct$ by ,dep>tm5t ( ,vet]ans ,affairs4,sec4 #djc4 ,comptroll] ,g5]al managem5t review ( m5tal heal? & suicide prev5tion s]vices ( ,dep>tm5t ( ,vet]ans ,affairs4,sec4 #djd4 ,comptroll] ,g5]al report on ef=ts ( ,dep>tm5t ( ,vet]ans ,affairs to integrate m5tal heal? c>e into prim>y c>e cl9ics4,sec4 #dje4 ,jo9t m5tal heal? programs by ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se4,,title ,v--,improvem5t ( m5tal heal? m$ical workforce,sec4 #eja4 ,/aff+ improvem5t plan = m5tal heal? provid]s ( ,dep>tm5t ( ,vet]ans ,affairs4,sec4 #ejb4 ,e/abli%m5t ( ,dep>tm5t ( ,vet]ans ,affairs ,readju/m5t ,c\nsel+ ,s]vice ,s*ol>%ip ,program4,sec4 #ejc4 ,comptroll] ,g5]al report on ,readju/m5t ,c\nsel+ ,s]vice ( ,dep>tm5t ( ,vet]ans ,affairs4,sec4 #ejd4 ,expansion ( report+ requirem5ts on ,readju/m5t ,c\nsel+ ,s]vice ( ,dep>tm5t ( ,vet]ans ,affairs4,sec4 #eje4 ,brief+ on alt]native "w s*$ules = employees ( ,vet]ans ,heal? ,adm9i/ration4,sec4 #ejf4 ,suicide prev5tion coord9ators4,sec4 #ejg4 ,report on ef=ts by ,dep>tm5t ( ,vet]ans ,affairs to implem5t safety plann+ 9 em]g5cy dep>tm5ts4,,title ,,vi--,improvem5t ( c>e & s]vices = wom5 veterans,sec4 #fja4 ,expansion ( capabilities ( ,wom5 ,vet]ans ,call ,c5t] to include text messag+4,sec4 #fjb4 ,requirem5t = ,dep>tm5t ( ,vet]ans ,affairs int]net website to provide in=mation on s]vices available to wom5 vet]ans4,,title ,,vii--,o!r matters,sec4 #gja4 ,exp&$ teleheal? f ,dep>tm5t ( ,vet]ans ,affairs4,sec4 #gjb4 ,p>tn]%ips ) non-,f$]al ,gov]nm5t entities to provide hyp]b>ic oxyg5 !rapy to vet]ans & /udies on ! use ( su* !rapy = treatm5t ( po/-traumatic /ress disord] & traumatic bra9 injury4,sec4 #gjc4 ,prescription ( te*nical qualifications = lic5s$ he>+ aid speciali/s & requirem5t = appo9tm5t ( su* speciali/s4,sec4 #gjd4 ,use by ,dep>tm5t ( ,vet]ans ,affairs ( comm]cial in/itutional review bo>ds 9 sponsor$ rese>* trials4,sec4 #gje4 ,creation ( ,(fice ( ,rese>* ,reviews )9 ! ,(fice ( ,in=mation & ,te*nology ( ! ,dep>tm5t ( ,vet]ans ,affairs4 ,i ,improvem5t ( transition ( individuals to s]vices f ,dep>tm5t ( ,vet]ans ,affairs #aja4 ,/rategic plan on expansion ( heal? c>e cov]age = vet]ans transition+ f s]vice 9 ! ,arm$ ,=ces 7a7 ,/rategic plan 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,secret>y ( ,def5se1 %all submit to ! appropriate committees ( ,congress & publi% on a website ( ! ,dep>tm5t ( ,vet]ans ,affairs a /rategic plan = ! provision by ! ,dep>tm5t ( heal? c>e to any vet]an dur+ ! "o-ye> p]iod foll[+ ! dis*>ge or release ( ! vet]an f active milit>y1 naval1 or air s]vice4 7#b7 ,elem5ts ,! plan submitt$ "u p>agraph 7#a7 %all include ! foll[+3 7,a7 ,an id5tification ( g5]al goals & objectives = ! provision ( heal? c>e to vet]ans describ$ 9 su* p>agraph4 7,b7 ,a description ( h[ su* goals & objectives are to be a*iev$1 includ+-- 7i7 a description ( ! use ( exi/+ p]sonnel1 in=mation1 te*nology1 facilities1 public & private p>tn]%ips1 & o!r res\rces ( ! ,dep>tm5t ( ,vet]ans ,affairs2 7ii7 a description ( ! anticipat$ ne$ = additional res\rces = ! ,dep>tm5t2 & 7iii7 an assessm5t ( co/4 7,c7 ,an analysis ( ! anticipat$ heal? c>e ne$s1 includ+ m5tal heal? c>e1 = su* vet]ans1 disaggregat$ by geographic area4 7,d7 ,an analysis ( :e!r su* vet]ans are eligible = enrollm5t 9 ! sy/em ( annual pati5t enrollm5t ( ! ,dep>tm5t "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code4 7,e7 ,a description ( activities design$ to promote ! availability ( heal? c>e f ! ,dep>tm5t = su* vet]ans1 includ+ outrea* to memb]s ( ! ,arm$ ,=ces ?\gh ! ,transition ,assi/ance ,program "u sections #aadb & #aadd ( title #aj1 ,unit$ ,/ates ,code4 7,f7 ,a description ( legislative or adm9i/rative action requir$ to c>ry out ! plan4 7,g7 ,a description ( h[ ! plan w\ld fur!r ! ongo+ initiatives "u ,executive ,ord] #achbb 7#hc ,f$4 ,reg4 #aeac2 relat+ to support+ our vet]ans dur+ _! transition f uni=m$ s]vice to civilian life7 to provide seamless access to high-quality m5tal heal? c>e & suicide prev5tion res\rces to vet]ans z !y transition1 ) an emphasis on ! "o-ye> p]iod foll[+ sep>ation4 7b7 ,def9itions ,9 ?is section3 7#a7 ,active milit>y1 naval1 or air s]vice ,! t]m active milit>y1 naval1 or air s]vice has ! mean+ giv5 t t]m 9 section #aja7bd7 ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,appropriate committees ( ,congress ,! t]m appropriate committees ( ,congress means-- 7,a7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,s5ate2 & 7,b7 ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 #ajb4 ,review ( records ( =m] memb]s ( ! ,arm$ ,=ces :o die by suicide )9 "o ye> ( sep>ation f ! ,arm$ ,=ces 7a7 ,review 7#a7 ,9 g5]al ,! ,secret>y ( ,def5se & ! ,secret>y ( ,vet]ans ,affairs %all jo9tly review ! records ( ea* =m] memb] ( ! ,arm$ ,=ces :o di$ by suicide1 z det]m9$ by ! ,secret>y ( ,def5se or ! ,secret>y ( ,vet]ans ,affairs1 )9 "o ye> foll[+ ! dis*>ge or release ( ! =m] memb] f active milit>y1 naval1 or air s]vice dur+ ! five-ye> p]iod prec$+ ! date ( ! enactm5t ( ?is ,act4 7#b7 ,records ,to be review$ ,9 complet+ ! review requir$ "u p>agraph 7#a71 ! ,secret>y ( ,def5se & ! ,secret>y ( ,vet]ans ,affairs %all review ! foll[+ records ma9ta9$ by ! ,dep>tm5t ( ,def5se3 7,a7 ,heal? treatm5t records4 7,b7 ,fitness1 m$ical1 & d5tal records4 7,c7 ,ancill>y tra9+ records4 7,d7 ,safety =ms & additional duties sections ( ! p]sonnel in=mation files4 7b7 ,elem5ts ,! review requir$ by subsection 7a7 ) respect to a =m] memb] ( ! ,arm$ ,=ces %all include consid]ation ( ! foll[+3 7#a7 ,:e!r ! ,dep>tm5t ( ,def5se _h id5tifi$ ! =m] memb] z be+ at elevat$ risk dur+ ! #cfe-;day p]iod be=e sep>ation ( ! memb] f ! ,arm$ ,=ces4 7#b7 ,9 ! case t ! memb] 0 id5tifi$ z be+ at elevat$ risk z describ$ 9 p>agraph 7#a71 :e!r t id5tification _h be5 communicat$ to ! ,dep>tm5t ( ,vet]ans ,affairs via ! ,solid ,/>t initiative ( ! ,dep>tm5t pursuant to ,executive ,ord] #achbb 7#hc ,f$4 ,reg4 #aeac2 relat+ to support+ our vet]ans dur+ _! transition f uni=m$ s]vice to civilian life71 or any o!r means4 7#c7 ,! pres5ce ( evid5ce-bas$ & empirically-support$ contextual & individual risk factors specifi$ 9 subsection 7c7 ) respect to ! =m] memb] & h[ ^? risk factors correlat$ to ! circum/ances ( ! dea? ( ! =m] memb]4 7#d7 ,demographic v>iables1 includ+ ! foll[+3 7,a7 ,sex4 7,b7 ,age4 7,c7 ,rank at sep>ation f ! ,arm$ ,=ces4 7,d7 ,c>e] field aft] sep>ation f ! ,arm$ ,=ces4 7,e7 ,/ate & c\nty ( resid5ce "o mon? prior to dea?4 7,f7 ,bran* ( s]vice 9 ! ,arm$ ,=ces4 7,g7 ,m>ital /atus4 7,h7 ,reason = sep>ation f ! ,arm$ ,=ces4 7#e7 ,support or m$ical s]vices furni%$ to ! =m] memb] ?r\gh ! ,dep>tm5t ( ,def5se1 specifi$ by ! type ( s]vice or c>e provid$4 7#f7 ,support or m$ical s]vices furni%$ to ! =m] memb] ?r\gh ! ,dep>tm5t ( ,vet]ans ,affairs1 specifi$ by ! type ( s]vice or c>e provid$4 7c7 ,evid5ce-bas$ & empirically-support$ contextual & individual risk factors ,evid5ce-bas$ & empirically-support$ contextual & individual risk factors specifi$ 9 ?is subsection include ! foll[+3 7#a7 ,exposure to viol5ce4 7#b7 ,exposure to suicide4 7#c7 ,h\s+ in/ability4 7#d7 ,f9ancial in/ability4 7#e7 ,vocational problems or insecurity4 7#f7 ,legal problems4 7#g7 ,highly acute or significantly *ronic relational problems4 7#h7 ,limit$ access to heal? c>e4 7d7 ,report ,n lat] ?an ?ree ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,def5se & ! ,secret>y ( ,vet]ans ,affairs %all jo9tly submit to ! appropriate committees ( ,congress an aggregat$ report on ! results ( ! review conduct$ "u subsection 7a7 ) respect to ! ye>-"o cohort ( =m] memb]s ( ! ,arm$ ,=ces cov]$ by ! review4 7e7 ,def9itions ,9 ?is section3 7#a7 ,active milit>y1 naval1 or air s]vice ,! t]m active milit>y1 naval1 or air s]vice has ! mean+ giv5 t t]m 9 section #aja7bd7 ( title #ch1 ,unit$ ,/ates ,code4 7#b7 ,appropriate committees ( ,congress def9$ ,! t]m appropriate committees ( ,congress means-- 7,a7 ! ,committee on ,arm$ ,s]vices & ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate2 & 7,b7 ! ,committee on ,arm$ ,s]vices & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives4 #ajc4 ,report on ,,rea* ,,vet program ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! ,,rea* ,,vet program4 7b7 ,elem5ts ,! report requir$ by subsection 7a7 %all include ! foll[+3 7#a7 ,an assessm5t ( ! impact ( ! ,,rea* ,,vet program on rates ( suicide among vet]ans4 7#b7 ,an assessm5t ( h[ limits )9 ! ,,rea* ,,vet program1 su* z caps on ! numb] ( vet]ans :o may be flagg$ z high risk1 are adju/$ = diff]+ rates ( suicide across ! c\ntry4 7#c7 ,a detail$ explanation1 ) evid5ce1 = :y ! conditions includ$ 9 ! model us$ by ! ,,rea* ,,vet program 7 *os51 includ+ an explanation z to :y c]ta9 conditions1 su* z bipol> disord] ,,ii1 7 n includ$ ev5 ?\gh !y %[ a simil> rate ( risk = suicide z o!r conditions t 7 includ$4 7#d7 ,an assessm5t ( ! feasibility ( incorporat+ c]ta9 economic data held by ! ,vet]ans ,b5efits ,adm9i/ration into ! model us$ by ! ,,rea* ,,vet program1 includ+ f9ancial data & employm5t /atus1 :i* rese>* indicates may h an impact on risk = suicide4 7c7 ,,rea* ,,vet program def9$ ,9 ?is section1 ! t]m ,,rea* ,,vet program means ! ,recov]y ,engagem5t & ,coord9ation = ,heal?--,vet]ans ,enhanc$ ,treatm5t program ( ! ,dep>tm5t ( ,vet]ans ,affairs4 #ajd4 ,report on c>e = =m] memb]s ( ! ,arm$ ,=ces ) o!r ?an honorable dis*>ge ,section #agbj;,i7f7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$-- 7#a7 9 p>agraph 7#a7 by /rik+ ,n less frequ5tly ?an once & ins]t+ ,n lat] ?an ,febru>y #ae2 & 7#b7 9 p>agraph 7#b7-- 7,a7 by r$esignat+ subp>agraph 7,c7 z subp>agraph 7,f72 & 7,b7 by ins]t+ aft] subsection 7,b7 ! foll[+ new subp>agraphs3 7,c7 ,! types ( m5tal or behavioral heal? c>e ne$s treat$ "u ?is section4 7,d7 ,! demographics ( individuals be+ treat$ "u ?is section1 includ+-- 7i7 age2 7ii7 era ( s]vice 9 ! ,arm$ ,=ces2 7iii7 bran* ( s]vice 9 ! ,arm$ ,=ces2 & 7iv7 geographic location4 7,e7 ,! av]age numb] ( visits = an individual = m5tal or behavioral heal? c>e "u ?is section4 4 ,,ii ,suicide prev5tion #bja4 ,f9ancial assi/ance to c]ta9 entities to provide or coord9ate ! provision ( suicide prev5tion s]vices = eligible individuals & _! families 7a7 ,purpose2 designation 7#a7 ,purpose ,! purpose ( ?is section is to r$uce vet]an suicide ?r\gh a community-bas$ grant program to aw>d grants to eligible entities to provide or coord9ate suicide prev5tion s]vices to eligible individuals & _! families4 7#b7 ,designation ,! grant program "u ?is section %all be kn[n z ! ,/aff ,s]geant ,p>k] ,gordon ,fox ,suicide ,prev5tion ,grant ,program4 7b7 ,f9ancial assi/ance & coord9ation ,! ,secret>y %all provide f9ancial assi/ance to eligible entities approv$ "u ?is section ?r\gh ! aw>d ( grants to su* entities to provide or coord9ate ! provision ( s]vices to eligible individuals & _! families to r$uce ! risk ( suicide4 ,! ,secret>y %all c>ry out ?is section 9 coord9ation ) ! ,presid5t's ,roadmap to ,emp[] ,vet]ans & ,end a ,national ,trag$y ( ,suicide ,task ,=ce & 9 consultation ) ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion ( ! ,dep>tm5t1 to ! ext5t practicable4 7c7 ,aw>d ( grants 7#a7 ,9 g5]al ,! ,secret>y %all aw>d a grant to ea* eligible entity = :i* ! ,secret>y has approv$ an application "u subsection 7f7 to provide or coord9ate ! provision ( suicide prev5tion s]vices "u ?is section4 7#b7 ,grant am\nts1 int]vals ( paym5t1 & mat*+ funds ,9 accordance ) ! s]vices be+ provid$ "u a grant "u ?is section & ! duration ( ^? s]vices1 ! ,secret>y %all e/abli%-- 7,a7 a maximum am\nt to be aw>d$ "u ! grant ( n m ?an #gej1jjj p] grantee p] fiscal ye>2 & 7,b7 int]vals ( paym5t = ! adm9i/ration ( ! grant4 7d7 ,di/ribution ( grants & pref]5ce 7#a7 ,di/ribution 7,a7 ,priority ,9 compliance ) subp>agraphs 7,b7 & 7,c71 9 det]m9+ h[ to di/ribute grants "u ?is section1 ! ,secret>y may prioritize-- 7i7 rural communities2 7ii7 ,tribal l&s2 7iii7 t]ritories ( ! ,unit$ ,/ates2 7iv7 m$ically und]s]v$ areas2 7v7 areas ) a high numb] or p]c5tage ( m9ority vet]ans or wom5 vet]ans2 & 7vi7 areas ) a high numb] or p]c5tage ( calls to ! ,vet]ans ,crisis ,l9e4 7,b7 ,areas ) ne$ ,! ,secret>y %all ensure t1 to ! ext5t practicable1 grants "u ?is section are di/ribut$-- 7i7 to provide s]vices 9 areas ( ! ,unit$ ,/ates t h exp]i5c$ high rates ( suicide by eligible individuals1 includ+ suicide attempts2 & 7ii7 to eligible entities t c assi/ eligible individuals at risk ( suicide :o are n curr5tly receiv+ heal? c>e furni%$ by ! ,dep>tm5t4 7,c7 ,geography ,9 di/ribut+ grants "u ?is p>agraph1 ! ,secret>y may provide grants to eligible entities t furni% s]vices to eligible individuals & _! families 9 geographically disp]s$ areas4 7#b7 ,pref]5ce ,! ,secret>y %all give pref]5ce to eligible entities t h demon/rat$ ! ability to provide or coord9ate suicide prev5tion s]vices4 7e7 ,requirem5ts = receipt ( grants 7#a7 ,notification t s]vices are f ,dep>tm5t ,ea* entity receiv+ a grant "u ?is section to provide or coord9ate suicide prev5tion s]vices to eligible individuals & _! families %all notify ! recipi5ts ( su* s]vices t su* s]vices are be+ paid =1 9 :ole or 9 "p1 by ! ,dep>tm5t4 7#b7 ,developm5t ( plan ) eligible individuals & _! family ,any plan develop$ ) respect to ! provision ( suicide prev5tion s]vices = an eligible individual or _! family %all be develop$ 9 consultation ) ! eligible individual & _! family4 7#c7 ,coord9ation ,an entity receiv+ a grant "u ?is section %all-- 7,a7 coord9ate ) ! ,secret>y ) respect to ! provision ( cl9ical s]vices to eligible individuals 9 accordance ) subsection 7n7 or any o!r provisions ( ! law reg>d+ ! deliv]y ( heal? c>e by ! ,secret>y2 7,b7 in=m e vet]an :o receives assi/ance "u ?is section f ! entity ( ! ability ( ! vet]an to apply = enrollm5t 9 ! pati5t enrollm5t sy/em ( ! ,dep>tm5t "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code2 & 7,c7 if su* a vet]an wi%es to s enroll1 in=m ! vet]an ( a po9t ( contact at ! ,dep>tm5t :o c assi/ ! vet]an 9 su* enrollm5t4 7#d7 ,measurem5t & monitor+ ,an entity receiv+ a grant "u ?is section %all submit to ! ,secret>y a description ( su* tools & assessm5ts ! entity uses or w use to det]m9e ! effectiv5ess ( ! s]vices furni%$ by ! entity1 :i* %all include ! measures develop$ "u subsection 7h77#b7 & may include-- 7,a7 ! effect ( ! s]vices furni%$ by ! entity on ! f9ancial /ability ( ! eligible individual2 7,b7 ! effect ( ! s]vices furni%$ by ! entity on ! m5tal heal? /atus1 wellbe+1 & suicide risk ( ! eligible individual2 & 7,c7 ! effect ( ! s]vices furni%$ by ! entity on ! social support ( ! eligible individuals receiv+ ^? s]vices4 7#e7 ,reports ,! ,secret>y-- 7,a7 %all require ea* entity receiv+ a grant "u ?is section to submit to ! ,secret>y an annual report t describes ! projects c>ri$ out ) su* grant dur+ ! ye> cov]$ by ! report2 7,b7 %all specify to ea* su* entity ! evaluation crit]ia & data & in=mation to be submitt$ 9 su* report2 & 7,c7 may require ea* su* entity to submit to ! ,secret>y su* additional reports z ! ,secret>y consid]s appropriate4 7f7 ,application = grants 7#a7 ,9 g5]al ,an eligible entity seek+ a grant "u ?is section %all submit to ! ,secret>y an application !re= 9 su* =m1 9 su* mann]1 & conta9+ su* commitm5ts & in=mation z ! ,secret>y consid]s necess>y to c>ry out ?is section4 7#b7 ,matt]s to be includ$ ,ea* application submitt$ by an eligible entity "u p>agraph 7#a7 %all conta9 ! foll[+3 7,a7 ,a description ( ! suicide prev5tion s]vices propos$ to be provid$ by ! eligible entity & ! id5tifi$ ne$ = ^? s]vices4 7,b7 ,a detail$ plan describ+ h[ ! eligible entity proposes to coord9ate or deliv] suicide prev5tion s]vices to eligible individuals1 includ+-- 7i7 an id5tification ( ! community p>tn]s1 if any1 ) :i* ! eligible entity proposes to "w 9 deliv]+ su* s]vices2 7ii7 a description ( ! arrangem5ts curr5tly 9 place betwe5 ! eligible entity & su* p>tn]s ) reg>d to ! provision or coord9ation ( suicide prev5tion s]vices2 7iii7 an id5tification ( h[ long su* arrangem5ts h be5 9 place2 7iv7 a description ( ! suicide prev5tion s]vices provid$ by su* p>tn]s t ! eligible entity %all coord9ate1 if any2 & 7v7 an id5tification ( local suicide prev5tion coord9ators ( ! ,dep>tm5t & a description ( h[ ! eligible entity w communicate ) local suicide prev5tion coord9ators4 7,c7 ,a description ( ! population ( eligible individuals & _! families propos$ to be provid$ suicide prev5tion s]vices4 7,d7 ,bas$ on in=mation & me?ods develop$ by ! ,secret>y = purposes ( ?is subsection1 an e/imate ( ! numb] ( eligible individuals at risk ( suicide & _! families propos$ to be provid$ suicide prev5tion s]vices1 includ+ ! p]c5tage ( ^? eligible individuals :o are n curr5tly receiv+ c>e furni%$ by ! ,dep>tm5t4 7,e7 ,evid5ce ( measurable outcomes relat$ to r$uctions 9 suicide risk & mood-relat$ symptoms utiliz+ validat$ in/rum5ts by ! eligible entity 7& ! propos$ p>tn]s ( ! entity1 if any7 9 provid+ suicide prev5tion s]vices to individuals at risk ( suicide1 p>ticul>ly to eligible individuals & _! families4 7,f7 ,a description ( ! manag]ial & te*nological capacity ( ! eligible entity-- 7i7 to coord9ate ! provision ( suicide prev5tion s]vices ) ! provision ( o!r s]vices2 7ii7 to assess on an ongo+ basis ! ne$s ( eligible individuals & _! families = suicide prev5tion s]vices2 7iii7 to coord9ate ! provision ( suicide prev5tion s]vices ) ! s]vices ( ! ,dep>tm5t = :i* eligible individuals are also eligible2 7iv7 to tailor suicide prev5tion s]vices to ! ne$s ( eligible individuals & _! families2 7v7 to seek cont9u\sly new s\rces ( assi/ance to ensure ! cont9uity ( suicide prev5tion s]vices = eligible individuals & _! families z long z !y are det]m9$ to be at risk ( suicide2 & 7vi7 to measure ! effects ( suicide prev5tion s]vices provid$ by ! eligible entity or p>tn] organization1 9 accordance ) subsection 7h77#b71 on ! lives ( eligible individuals & _! families :o receive su* s]vices provid$ by ! organization us+ pre- & po/-evaluations on validat$ measures ( suicide risk & mood-relat$ symptoms4 7,g7 ,cle>ly def9$ objectives = ! provision ( suicide prev5tion s]vices4 7,h7 ,a description & physical address ( ! prim>y location ( ! eligible entity4 7,i7 ,a description ( ! geographic area ! eligible entity plans to s]ve dur+ ! grant aw>d p]iod = :i* ! application applies4 7,j7 ,if ! eligible entity is a ,/ate or local gov]nm5t or an ,indian tribe1 ! am\nt ( grant funds propos$ to be made available to community p>tn]s1 if any1 ?r\gh agreem5ts4 7,k7 ,a description ( h[ ! eligible entity w assess ! effectiv5ess ( ! provision ( grants "u ?is section4 7,l7 ,an agreem5t to use ! measures & metrics provid$ by ! ,dep>tm5t = ! purposes ( measur+ ! effectiv5ess ( ! programm+ z describ$ 9 subsection 7h77#b74 7,m7 ,su* additional application crit]ia z ! ,secret>y consid]s appropriate4 7g7 ,tra9+ & te*nical assi/ance 7#a7 ,9 g5]al ,! ,secret>y %all provide tra9+ & te*nical assi/ance1 9 coord9ation ) ! ,c5t]s = ,disease ,control & ,prev5tion1 to eligible entities 9 receipt ( grants "u ?is section reg>d+-- 7,a7 suicide risk id5tification & managem5t2 7,b7 ! data requir$ to be collect$ & %>$ ) ! ,dep>tm5t2 7,c7 ! means ( data collection & %>+2 7,d7 famili>ization ) & appropriate use ( any tool to be us$ to measure ! effectiv5ess ( ! use ( ! grants provid$2 & 7,e7 ! requirem5ts = report+ "u subsection 7e77#e7 on s]vices provid$ via su* grants4 7#b7 ,provision ( tra9+ & te*nical assi/ance ,! ,secret>y may provide ! tra9+ & te*nical assi/ance describ$ 9 p>agraph 7#a7 directly or ?r\gh grants or contracts ) appropriate public or nonpr(it entities4 7h7 ,adm9i/ration ( grant program 7#a7 ,selection crit]ia ,! ,secret>y1 9 consultation ) entities specifi$ 9 p>agraph 7#c71 %all e/abli% crit]ia = ! selection ( eligible entities t h submitt$ applications "u subsection 7f74 7#b7 ,developm5t ( measures & metrics ,! ,secret>y %all develop1 9 consultation ) entities specifi$ 9 p>agraph 7#c71 ! foll[+3 7,a7 ,a framework = collect+ & %>+ in=mation ab\t entities 9 receipt ( grants "u ?is section = purposes ( improv+ ! s]vices available = eligible individuals & _! families1 set =? by s]vice type1 locality1 & eligibility crit]ia4 7,b7 ,! measures & metrics to be us$ by ea* entity 9 receipt ( grants "u ?is section to det]m9e ! effectiv5ess ( ! programm+ be+ provid$ by su* entity 9 improv+ m5tal heal? /atus1 wellbe+1 & r$uc+ suicide risk & complet$ suicides ( eligible individuals & _! families1 :i* %all include an exi/+ measurem5t tool or protocol = ! grant recipi5t to utilize :5 det]m9+ programmatic effectiv5ess4 7#c7 ,coord9ation ,9 develop+ a plan = ! design & implem5tation ( ! provision ( grants "u ?is section1 includ+ crit]ia = ! aw>d ( grants1 ! ,secret>y %all consult ) ! foll[+3 7,a7 ,vet]ans s]vice organizations4 7,b7 ,national organizations repres5t+ pot5tial community p>tn]s ( eligible entities 9 provid+ supportive s]vices to address ! ne$s ( eligible individuals & _! families1 includ+ national organizations t-- 7i7 advocate = ! ne$s ( individuals ) or at risk ( behavioral heal? conditions2 7ii7 repres5t mayors2 7iii7 repres5t unions2 7iv7 repres5t fir/ respond]s2 7v7 repres5t *iefs ( police & %]iffs2 7vi7 repres5t gov]nors2 7vii7 repres5t a t]ritory ( ! ,unit$ ,/ates2 or 7viii7 repres5t a ,tribal alliance4 7,c7 ,national organizations repres5t+ memb]s ( ! ,arm$ ,=ces4 7,d7 ,national organizations t repres5t c\nties4 7,e7 ,organizations ) :i* ! ,dep>tm5t has a curr5t memor&um ( agreem5t or und]/&+ relat$ to m5tal heal? or suicide prev5tion4 7,f7 ,/ate dep>tm5ts ( vet]ans affairs4 7,g7 ,national organizations repres5t+ memb]s ( ! res]ve compon5ts ( ! ,arm$ ,=ces4 7,h7 ,national organizations repres5t+ memb]s ( ! ,coa/ ,gu>d4 7,i7 ,organizations1 includ+ in/itutions ( high] education1 ) exp]i5ce 9 creat+ measurem5t tools = purposes ( advis+ ! ,secret>y on ! mo/ appropriate exi/+ measurem5t tool or protocol = ! ,dep>tm5t to utilize4 7,j7 ,! ,national ,alliance on ,m5tal ,illness4 7,k7 ,a labor organization 7z su* t]m is def9$ 9 section #gajc7;a77#d7 ( title #e1 ,unit$ ,/ates ,code74 7,l7 ,! ,c5t]s = ,disease ,control & ,prev5tion1 ! ,sub/ance ,abuse & ,m5tal ,heal? ,s]vices ,adm9i/ration1 ! ,presid5t's ,roadmap to ,emp[] ,vet]ans & ,end a ,national ,trag$y ( ,suicide ,task ,=ce1 & su* o!r organizations z ! ,secret>y consid]s appropriate4 7#d7 ,report on grant crit]ia ,n lat] ?an #cj days be=e notify+ eligible entities ( ! availability ( fund+ "u ?is section1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report conta9+-- 7,a7 crit]ia = ! aw>d ( a grant "u ?is section2 7,b7 ! already develop$ measures & metrics to be us$ by ! ,dep>tm5t to measure ! effectiv5ess ( ! use ( grants provid$ "u ?is section z describ$ 9 subsection 7h77#b72 & 7,c7 a framework = ! %>+ ( in=mation ab\t entities 9 receipt ( grants "u ?is section4 7i7 ,in=mation on pot5tial eligible individuals 7#a7 ,9 g5]al ,! ,secret>y may make available to recipi5ts ( grants "u ?is section c]ta9 in=mation reg>d+ pot5tial eligible individuals :o may receive s]vices = :i* su* grant is provid$4 7#b7 ,in=mation includ$ ,! in=mation made available "u p>agraph 7#a7 ) respect to pot5tial eligible individuals may include ! foll[+3 7,a7 ,confirmation ( ! /atus ( a pot5tial eligible individual z a vet]an4 7,b7 ,confirmation ( :e!r ! pot5tial eligible individual is enroll$ 9 ! pati5t enrollm5t sy/em ( ! ,dep>tm5t "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code4 7,c7 ,confirmation ( :e!r a pot5tial eligible individual is curr5tly receiv+ c>e furni%$ by ! ,dep>tm5t or has rec5tly receiv$ su* c>e4 7#c7 ,opt-out ,! ,secret>y %all all[ an eligible individual to opt out ( hav+ _! in=mation %>$ "u ?is subsection ) recipi5ts ( grants "u ?is section4 7j7 ,duration ,! au?ority ( ! ,secret>y to provide grants "u ?is section %all t]m9ate on ! date t is ?ree ye>s aft] ! date on :i* ! fir/ grant is aw>d$ "u ?is section4 7k7 ,report+ 7#a7 ,int]im report 7,a7 ,9 g5]al ,n lat] ?an #ah mon?s aft] ! date on :i* ! fir/ grant is aw>d$ "u ?is section1 ! ,secret>y %all submit to ! appropriate committees ( ,congress a report on ! provision ( grants to eligible entities "u ?is section4 7,b7 ,elem5ts ,! report submitt$ "u subp>agraph 7,a7 %all include ! foll[+3 7i7 ,an assessm5t ( ! effectiv5ess ( ! grant program "u ?is section1 includ+-- 7,i7 ! effectiv5ess ( grant recipi5ts & _! community p>tn]s1 if any1 9 conduct+ outrea* to eligible individuals2 7,,ii7 ! effectiv5ess ( increas+ eligible individuals engagem5t 9 suicide prev5tion s]vices2 & 7,,iii7 su* o!r validat$ in/rum5ts & additional measures z det]m9$ by ! ,secret>y & z describ$ 9 subsection 7h77#b74 7ii7 ,a li/ ( grant recipi5ts & _! p>tn] organizations1 if any1 t deliv]$ s]vices fund$ by ! grant & ! am\nt ( su* grant receiv$ by ea* recipi5t & p>tn] organization4 7iii7 ,! numb] ( eligible individuals support$ by ea* grant recipi5t1 includ+ ?r\gh s]vices provid$ to family memb]s1 disaggregat$ by-- 7,i7 all demographic *>act]i/ics z det]m9$ necess>y & appropriate by ! ,secret>y 9 coord9ation ) ! ,c5t]s = ,disease ,control & ,prev5tion2 7,,ii7 :e!r ea* su* eligible individual is enroll$ 9 ! pati5t enrollm5t sy/em ( ! ,dep>tm5t "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code2 7,,iii7 bran* ( s]vice 9 ! ,arm$ ,=ces2 7,,iv7 era ( s]vice 9 ! ,arm$ ,=ces2 7,v7 type ( s]vice receiv$ by ! eligible individual2 & 7,,vi7 :e!r ea* su* eligible individual 0 ref]r$ to ! ,dep>tm5t = c>e4 7iv7 ,! numb] ( eligible individuals support$ by grants "u ?is section1 includ+ ?r\gh s]vices provid$ to family memb]s4 7v7 ,! numb] ( eligible individuals describ$ 9 clause 7iv7 :o 7 n previ\sly receiv+ c>e furni%$ by ! ,dep>tm5t1 ) specific numb]s = ! population ( eligible individuals describ$ 9 subsection 7q77#d77;,b74 7vi7 ,! numb] ( eligible individuals ^: m5tal heal? /atus1 wellbe+1 & suicide risk receiv$ a basel9e measurem5t assessm5t "u ?is section & ! numb] ( su* eligible individuals ^: m5tal heal? /atus1 wellbe+1 & suicide risk w be measur$ by ! ,dep>tm5t or a community p>tn] ov] a p]iod ( "t = any improvem5ts4 7vii7 ,! types ( data ! ,dep>tm5t 0 able to collect & %>e ) p>tn]s1 includ+ a *>act]ization ( ! b5efits ( t data4 7viii7 ,! numb] & p]c5tage ( eligible individuals ref]r$ to ! po9t ( contact at ! ,dep>tm5t "u subsection 7e77#c77;,c74 7ix7 ,! numb] ( eligible individuals newly enroll$ 9 ! pati5t enrollm5t sy/em ( ! ,dep>tm5t "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code bas$ on a ref]ral to ! ,dep>tm5t f a grant recipi5t "u subsection 7e77#c77;,c71 disaggregat$ by grant recipi5t4 7x7 ,a detail$ acc\nt ( h[ ! grant funds 7 us$1 includ+ executive comp5sation1 ov]head co/s1 & o!r indirect co/s4 7xi7 ,a description ( any outrea* activities conduct$ by ! eligible entity 9 receipt ( a grant ) respect to s]vices provid$ us+ ! grant4 7xii7 ,! numb] ( individuals :o seek s]vices f ! grant recipi5t :o are n eligible individuals4 7,c7 ,submittal ( in=mation by grant recipi5ts ,! ,secret>y may require eligible entities receiv+ grants "u ?is section to provide to ,congress su* in=mation z ! ,secret>y det]m9es necess>y reg>d+ ! elem5ts describ$ 9 subp>agraph 7,b74 7#b7 ,f9al report ,n lat] ?an ?ree ye>s aft] ! date on :i* ! fir/ grant is aw>d$ "u ?is section1 & annually !reaft] = ea* ye> 9 :i* ! program is 9 effect1 ! ,secret>y %all submit to ! appropriate committees ( ,congress-- 7,a7 a foll[-up on ! int]im report submitt$ "u p>agraph 7#a7 conta9+ ! elem5ts set =? 9 subp>agraph 7,b7 ( su* p>agraph2 & 7,b7 a report on-- 7i7 ! effectiv5ess ( ! provision ( grants "u ?is section1 includ+ ! effectiv5ess ( community p>tn]s 9 conduct+ outrea* to eligible individuals & _! families & r$uc+ ! rate ( suicide among eligible individuals2 7ii7 an assessm5t ( ! increas$ capacity ( ! ,dep>tm5t to provide s]vices to eligible individuals & _! families1 set =? by ,/ate1 z a result ( ! provision ( grants "u ?is section2 7iii7 ! feasibility & advisability ( ext5d+ or exp&+ ! provision ( grants consi/5t ) ?is section2 & 7iv7 su* o!r elem5ts z consid]$ appropriate by ! ,secret>y4 7l7 ,?ird-p>ty assessm5t 7#a7 ,/udy ( grant program 7,a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! comm5cem5t ( ! grant program "u ?is section1 ! ,secret>y %all seek to ent] into a contract ) an appropriate entity describ$ 9 p>agraph 7#c7 to conduct a /udy ( ! grant program4 7,b7 ,elem5ts ( /udy ,9 conduct+ ! /udy "u subp>agraph 7,a71 ! appropriate entity %all-- 7i7 evaluate ! effectiv5ess ( ! grant program "u ?is section 9-- 7,i7 address+ ! factors t contribute to suicides2 7,,ii7 increas+ ! use ( suicide prev5tion s]vices2 7,,iii7 r$uc+ mood-relat$ symptoms t increase suicide & suicide risk2 & 7,,iv7 :]e su* in=mation is available due to ! "t frame ( ! grant program1 r$uc+ suicidal ideation1 suicide attempts1 self-h>m1 & dea?s by suicide2 & 7,v7 r$uc+ suicidal ideation1 suicide attempts1 self-h>m1 & dea?s by suicide among eligible individuals ?r\gh eligible entities locat$ 9 communities2 & 7ii7 comp>e ! results ( ! grant program ) o!r national programs 9 deliv]+ res\rces to eligible individuals 9 ! communities :]e !y live t address ! factors t contribute to suicide4 7#b7 ,assessm5t 7,a7 ,9 g5]al ,! contract "u p>agraph 7#a7 %all provide t n lat] ?an #bd mon?s aft] ! comm5cem5t ( ! grant program "u ?is section1 ! appropriate entity %all submit to ! ,secret>y an assessm5t bas$ on ! /udy conduct$ pursuant to su* contract4 7,b7 ,submittal to ,congress ,^u receipt ( ! assessm5t "u subp>agraph 7,a71 ! ,secret>y %all transmit to ! appropriate committees ( ,congress a copy ( ! assessm5t4 7#c7 ,appropriate entity ,an appropriate entity describ$ 9 ?is p>agraph is a nongov]nm5t entity ) exp]i5ce optimiz+ & assess+ organizations t deliv] s]vices & assess+ ! effectiv5ess ( suicide prev5tion programs4 7m7 ,ref]ral = c>e 7#a7 ,m5tal heal? assessm5t ,if an eligible entity 9 receipt ( a grant "u ?is section det]m9es t an eligible individual is at-risk ( suicide or o!r m5tal or behavioral heal? condition pursuant to a basel9e m5tal heal? scre5+ conduct$ "u subsection 7q77#aa77;,a77ii7 ) respect to ! individual1 ! entity %all ref] ! eligible individual to ! ,dep>tm5t = additional c>e "u subsection 7n7 or any o!r provision ( law4 7#b7 ,em]g5cy treatm5t ,if an eligible entity 9 receipt ( a grant "u ?is section det]m9es t an eligible individual furni%$ cl9ical s]vices = em]g5cy treatm5t "u subsection 7q77#aa77;,a77iv7 requires ongo+ s]vices1 ! entity %all ref] ! eligible individual to ! ,dep>tm5t = additional c>e "u subsection 7n7 or any o!r provision ( law4 7#c7 ,refusal ,if an eligible individual refuses a ref]ral by an entity "u p>agraph 7#a7 or 7#b71 any ongo+ cl9ical s]vices provid$ to ! eligible individual by ! entity %all be at ! exp5se ( ! entity4 7n7 ,provision ( c>e to eligible individuals ,:5 ! ,secret>y det]m9es x is cl9ically appropriate1 ! ,secret>y %all furni% to eligible individuals :o are receiv+ or h receiv$ suicide prev5tion s]vices ?r\gh grants provid$ "u ?is section an initial m5tal heal? assessm5t & m5tal heal? or behavioral heal? c>e s]vices au?oriz$ "u *apt] #ag ( title #ch1 ,unit$ ,/ates ,code1 t are requir$ to treat ! m5tal or behavioral heal? c>e ne$s ( ! eligible individual1 includ+ risk ( suicide4 7o7 ,agreem5ts ) community p>tn]s 7#a7 ,9 g5]al ,subject to p>agraph 7#b71 an eligible entity may use grant funds to ent] into an agreem5t ) a community p>tn] "u :i* ! eligible entity may provide funds to ! community p>tn] = ! provision ( suicide prev5tion s]vices to eligible individuals & _! families4 7#b7 ,limitation ,! ability ( a recipi5t ( a grant "u ?is section to provide grant funds to a community p>tn] %all be limit$ to grant recipi5ts t are a ,/ate or local gov]nm5t or an ,indian tribe4 7p7 ,au?orization ( appropriations ,!re is au?oriz$ to be appropriat$ to ! ,secret>y to c>ry out ?is section a total ( #agd1jjj1jjj = fiscal ye>s #bjba ?r\gh #bjbe4 7q7 ,def9itions ,9 ?is section3 7#a7 ,appropriate committees ( ,congress ,! t]m appropriate committees ( ,congress means-- 7,a7 ! ,committee on ,vet]ans' ,affairs & ! ,subcommittee on ,milit>y ,con/ruction1 ,vet]ans ,affairs1 & ,relat$ ,ag5cies ( ! ,committee on ,appropriations ( ! ,s5ate2 & 7,b7 ! ,committee on ,vet]ans' ,affairs & ! ,subcommittee on ,milit>y ,con/ruction1 ,vet]ans ,affairs1 & ,relat$ ,ag5cies ( ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 7#b7 ,dep>tm5t ,! t]m ,dep>tm5t means ! ,dep>tm5t ( ,vet]ans ,affairs4 7#c7 ,eligible entity ,! t]m eligible entity means-- 7,a7 an incorporat$ private in/itution or f\ndation-- 7i7 no "p ( ! net e>n+s ( :i* incurs to ! b5efit ( any memb]1 f\nd]1 contributor1 or individual2 & 7ii7 t has a gov]n+ bo>d t w\ld be responsible = ! op]ation ( ! suicide prev5tion s]vices provid$ "u ?is section2 7,b7 a corporation :olly own$ & controll$ by an organization meet+ ! requirem5ts ( clauses 7i7 & 7ii7 ( subp>agraph 7,a72 7,c7 an ,indian tribe2 7,d7 a community-bas$ organization t c effectively network ) local civic organizations1 regional heal? sy/ems1 & o!r sett+s :]e eligible individuals & _! families are likely to h contact2 or 7,e7 ,a ,/ate or local gov]nm5t4 7#d7 ,eligible individual ,! t]m eligible individual includes a p]son at risk ( suicide :o is-- 7,a7 a vet]an z def9$ 9 section #aja ( title #ch1 ,unit$ ,/ates ,code2 7,b7 an individual describ$ 9 section #agbj;,i7b7 ( su* title2 or 7,c7 an individual describ$ 9 any ( clauses 7i7 ?r\gh 7iv7 ( section #agab;,a7a77#a77;,c7 ( su* title4 7#e7 ,em]g5cy treatm5t ,m$ical s]vices1 pr(essional s]vices1 ambulance s]vices1 ancill>y c>e & m$ication 7includ+ a %ort c\rse ( m$ication relat$ to & necess>y = ! treatm5t ( ! em]g5cy condition t is provid$ directly to or prescrib$ = ! pati5t = use aft] ! em]g5cy condition is /abiliz$ & ! pati5t is dis*>g$7 0 r5d]$ 9 a m$ical em]g5cy ( su* nature t a prud5t layp]son w\ld h reasonably expect$ t delay 9 seek+ imm$iate m$ical att5tion w\ld h be5 haz>d\s to life or heal?4 ,?is /&>d is met by an em]g5cy m$ical condition manife/+ itself by acute symptoms ( suffici5t sev]ity 7includ+ sev]e pa97 t a prud5t layp]son :o possesses an av]age k ( heal? & m$ic9e c\ld reasonably expect ! abs5ce ( imm$iate m$ical att5tion to result 9 plac+ ! heal? ( ! individual 9 s]i\s jeop>dy1 s]i\s impairm5t to bodily functions1 or s]i\s dysfunction ( any bodily organ or "p4 7#f7 ,family ,! t]m family means1 ) respect to an eligible individual1 any ( ! foll[+3 7,a7 ,a p>5t4 7,b7 ,a sp\se4 7,c7 ,a *ild4 7,d7 ,a sibl+4 7,e7 ,a /ep-family memb]4 7,f7 ,an ext5d$ family memb]4 7,g7 ,any o!r individual :o lives ) ! eligible individual4 7#g7 ,indian tribe ,! t]m ,indian tribe has ! mean+ giv5 t t]m 9 section #d ( ! ,native ,am]ican ,h\s+ ,assi/ance & ,self-,det]m9ation ,act ( #aiif 7#be ,u4,s4,c4 #dajc74 7#h7 ,risk ( suicide 7,a7 ,9 g5]al ,! t]m risk ( suicide means exposure to1 or ! exi/5ce (1 any ( ! foll[+ 7to a degree det]m9$ by ! ,secret>y pursuant to regulations73 7i7 ,heal? risk factors1 includ+ ! foll[+3 7,i7 ,m5tal heal? *all5ges4 7,,ii7 ,sub/ance abuse4 7,,iii7 ,s]i\s or *ronic heal? conditions or pa94 7,,iv7 ,traumatic bra9 injury4 7ii7 ,environm5tal risk factors1 includ+ ! foll[+3 7,i7 ,prolong$ /ress4 7,,ii7 ,/ressful life ev5ts4 7,,iii7 ,unemploym5t4 7,,iv7 ,homelessness4 7,v7 ,rec5t loss4 7,,vi7 ,legal or f9ancial *all5ges4 7iii7 ,hi/orical risk factors1 includ+ ! foll[+3 7,i7 ,previ\s suicide attempts4 7,,ii7 ,family hi/ory ( suicide4 7,,iii7 ,hi/ory ( abuse1 neglect1 or trauma4 7,b7 ,degree ( risk ,! ,secret>y may1 by regulation1 e/abli% a process = det]m9+ degrees ( risk ( suicide = use by grant recipi5ts to focus ! deliv]y ( s]vices us+ grant funds4 7#i7 ,rural ,! t]m rural1 ) respect to a community1 has ! mean+ giv5 t t]m 9 ! ,rural-,urban ,commut+ ,areas cod+ sy/em ( ! ,dep>tm5t ( ,agriculture4 7#aj7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ,vet]ans ,affairs4 7#aa7 ,suicide prev5tion s]vices 7,a7 ,9 g5]al ,! t]m suicide prev5tion s]vices means s]vices to address ! ne$s ( eligible individuals & _! families & includes ! foll[+3 7i7 ,outrea* to id5tify ^? at risk ( suicide ) an emphasis on eligible individuals :o are at highe/ risk or :o are n receiv+ heal? c>e or o!r s]vices furni%$ by ! ,dep>tm5t4 7ii7 ,a basel9e m5tal heal? scre5+ = risk4 7iii7 ,education on suicide risk & prev5tion to families & communities4 7iv7 ,provision ( cl9ical s]vices = em]g5cy treatm5t4 7v7 ,case managem5t s]vices4 7vi7 ,pe] support s]vices4 7vii7 ,assi/ance 9 obta9+ any b5efits f ! ,dep>tm5t t ! eligible individual & _! family may be eligible to receive1 includ+-- 7,i7 vocational & rehabilitation c\nsel+2 7,,ii7 supportive s]vices = homeless vet]ans2 7,,iii7 employm5t & tra9+ s]vices2 7,,iv7 educational assi/ance2 & 7,v7 heal? c>e s]vices4 7viii7 ,assi/ance 9 obta9+ & coord9at+ ! provision ( o!r b5efits provid$ by ! ,f$]al ,gov]nm5t1 a ,/ate or local gov]nm5t1 or an eligible entity4 7ix7 ,assi/ance ) em]g5t ne$s relat+ to-- 7,i7 heal? c>e s]vices2 7,,ii7 daily liv+ s]vices2 7,,iii7 p]sonal f9ancial plann+ & c\nsel+2 7,,iv7 transportation s]vices2 7,v7 tempor>y income support s]vices2 7,,vi7 fiduci>y & repres5tative payee s]vices2 7,,vii7 legal s]vices to assi/ ! eligible individual ) issues t may contribute to ! risk ( suicide2 & 7,,viii7 *ild c>e 7n to exce$ #e1jjj p] family ( an eligible individual p] fiscal ye>74 7x7 ,nontraditional & innovative approa*es & treatm5t practices1 z det]m9$ appropriate by ! ,secret>y1 9 consultation ) appropriate entities4 7xi7 ,su* o!r s]vices necess>y = improv+ ! m5tal heal? /atus & wellbe+ & r$uc+ ! suicide risk ( eligible individuals & _! families z ! ,secret>y consid]s appropriate1 :i* may include-- 7,i7 adaptive sports1 equ9e assi/$ !rapy1 or 9-place or outdoor recreational !rapy2 7,,ii7 sub/ance use r$uction programm+2 7,,iii7 individual1 gr\p1 or family c\nsel+2 & 7,,iv7 relation%ip coa*+4 7,b7 ,exclusion ,! t]m suicide prev5tion s]vices does n include direct ca% assi/ance to eligible individuals or _! families4 7#ab7 ,vet]ans crisis l9e ,! t]m ,vet]ans ,crisis ,l9e means ! toll-free hotl9e = vet]ans e/abli%$ "u section #agbj;,f7h7 ( title #ch1 ,unit$ ,/ates ,code4 7#ac7 ,vet]ans s]vice organization ,! t]m vet]ans s]vice organization means any organization recogniz$ by ! ,secret>y = ! repres5tation ( vet]ans "u section #eijb ( title #ch1 ,unit$ ,/ates ,code4 #bjb4 ,analysis on feasibility & advisability ( ! ,dep>tm5t ( ,vet]ans ,affairs provid+ c]ta9 complem5t>y & integrative heal? s]vices 7a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all complete an analysis on ! feasibility & advisability ( provid+ complem5t>y & integrative heal? treatm5ts describ$ 9 subsection 7c7 at all m$ical facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,inclusion ( assessm5t ( report ,! analysis conduct$ "u subsection 7a7 %all include an assessm5t ( ! f9al report ( ! ,creat+ ,options = ,vet]ans' ,exp$it$ ,recov]y ,commission 7commonly ref]r$ to z ! ,,cov] ,commission7 e/abli%$ "u section #ica ( ! ,jason ,simcakoski ,memorial & ,promise ,act 7title ,,ix ( ,public ,law #aad-aih2 #ch ,u4,s4,c4 #agja note7 submitt$ "u subsection 7e77#b7 ( su* section4 7c7 ,treatm5ts describ$ ,complem5t>y & integrative heal? treatm5ts describ$ 9 ?is subsection %all consi/ ( ! foll[+3 7#a7 ,yoga4 7#b7 ,m$itation4 7#c7 ,acupuncture4 7#d7 ,*iropractic c>e4 7#e7 ,o!r treatm5ts t %[ suffici5t evid5ce ( efficacy at treat+ m5tal or physical heal? conditions1 z det]m9$ by ! ,secret>y4 7d7 ,report ,! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! analysis complet$ "u subsection 7a71 includ+-- 7#a7 ! results ( su* analysis2 & 7#b7 su* recomm5dations reg>d+ ! furni%+ ( complem5t>y & integrative heal? treatm5ts describ$ 9 subsection 7c7 z ! ,secret>y consid]s appropriate4 #bjc4 ,pilot program to provide vet]ans access to complem5t>y & integrative heal? programs ?r\gh animal !rapy1 agri!rapy1 sports & recreation !rapy1 art !rapy1 & po/traumatic gr[? programs 7a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date on :i* ! ,creat+ ,options = ,vet]ans' ,exp$it$ ,recov]y ,commission 7commonly ref]r$ to z ! ,,cov] ,commission7 e/abli%$ "u section #ica ( ! ,jason ,simcakoski ,memorial & ,promise ,act 7title ,,ix ( ,public ,law #aad-aih2 #ch ,u4,s4,c4 #agja note7 submits its f9al report "u subsection 7e77#b7 ( su* section1 ! ,secret>y ( ,vet]ans ,affairs %all comm5ce ! conduct ( a pilot program to provide complem5t>y & integrative heal? programs describ$ 9 subsection 7b7 to eligible vet]ans f ! ,dep>tm5t ( ,vet]ans ,affairs or ?r\gh ! use ( non-,dep>tm5t entities = ! treatm5t ( po/-traumatic /ress disord]1 depression1 anxiety1 or o!r conditions z det]m9$ by ! ,secret>y4 7b7 ,programs describ$ ,complem5t>y & integrative heal? programs describ$ 9 ?is subsection may1 tak+ into consid]ation ! report describ$ 9 subsection 7a71 consi/ ( ! foll[+3 7#a7 ,equ9e !rapy4 7#b7 ,o!r animal !rapy4 7#c7 ,agri!rapy4 7#d7 ,sports & recreation !rapy4 7#e7 ,art !rapy4 7#f7 ,po/traumatic gr[? programs4 7c7 ,eligible vet]ans ,a vet]an is eligible to p>ticipate 9 ! pilot program "u ?is section if ! vet]an-- 7#a7 is enroll$ 9 ! sy/em ( pati5t enrollm5t ( ! ,dep>tm5t "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code2 & 7#b7 has receiv$ heal? c>e "u ! laws adm9i/]$ by ! ,secret>y dur+ ! two-ye> p]iod prec$+ ! initial p>ticipation ( ! vet]an 9 ! pilot program4 7d7 ,duration 7#a7 ,9 g5]al ,! ,secret>y %all c>ry out ! pilot program "u ?is section = a ?ree-ye> p]iod beg9n+ on ! comm5cem5t ( ! pilot program4 7#b7 ,ext5sion ,! ,secret>y may ext5d ! duration ( ! pilot program "u ?is section if ! ,secret>y1 bas$ on ! results ( ! int]im report submitt$ "u subsection 7f77#a71 det]m9es t x is appropriate to d s4 7e7 ,locations 7#a7 ,9 g5]al ,! ,secret>y %all select n few] ?an five facilities ( ! ,dep>tm5t at :i* to c>ry out ! pilot program "u ?is section4 7#b7 ,selection crit]ia ,9 select+ facilities "u p>agraph 7#a71 ! ,secret>y %all ensure t-- 7,a7 ! locations are 9 geographically div]se areas2 & 7,b7 n few] ?an ?ree facilities s]ve vet]ans 9 rural or highly rural areas 7z det]m9$ ?r\gh ! use ( ! ,rural-,urban ,commut+ ,areas cod+ sy/em ( ! ,dep>tm5t ( ,agriculture74 7f7 ,reports 7#a7 ,int]im report 7,a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! comm5cem5t ( ! pilot program "u ?is section1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! progress ( ! pilot program4 7,b7 ,elem5ts ,! report requir$ by subp>agraph 7,a7 %all include ! foll[+3 7i7 ,! numb] ( p>ticipants 9 ! pilot program4 7ii7 ,! type or types ( !rapy (f]$ at ea* facility at :i* ! pilot program is be+ c>ri$ out4 7iii7 ,an assessm5t ( :e!r p>ticipation by a vet]an 9 ! pilot program result$ 9 any *anges 9 cl9ically relevant endpo9ts = ! vet]an ) respect to ! conditions specifi$ 9 subsection 7a74 7iv7 ,an assessm5t ( ! quality ( life ( vet]ans p>ticipat+ 9 ! pilot program1 includ+ ! results ( a satisfaction survey ( ! p>ticipants 9 ! pilot program1 disaggregat$ by program "u subsection 7b74 7v7 ,! det]m9ation ( ! ,secret>y ) respect to ext5d+ ! pilot program "u subsection 7d77#b74 7vi7 ,any recomm5dations ( ! ,secret>y ) respect to exp&+ ! pilot program4 7#b7 ,f9al report ,n lat] ?an #ij days aft] ! t]m9ation ( ! pilot program "u ?is section1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a f9al report on ! pilot program4 #bjd4 ,dep>tm5t ( ,vet]ans ,affairs /udy ( all-cause mortality ( vet]ans1 includ+ by suicide1 & review ( /aff+ levels ( m5tal heal? pr(essionals 7a7 ,/udy ( dea?s ( vet]ans by suicide 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all seek to ent] into an agreem5t ) ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e "u :i* ! ,secret>y %all collaborate & coord9ate ) ! ,national ,academies on a revis$ /udy design to fulfill ! goals ( ! #bjai /udy design ( ! ,national ,academies describ$ 9 ! explanatory /atem5t accompany+ ! ,fur!r ,consolidat$ ,appropriations ,act1 #bjbj 7,public ,law #aaf-id71 z "p ( curr5t & additional rese>* priorities ( ! ,dep>tm5t ( ,vet]ans ,affairs1 to evaluate ! effects ( opioids & b5zodiazep9e on all-cause mortality ( vet]ans1 includ+ suicide1 reg>dless ( :e!r in=mation relat+ to su* dea?s has be5 report$ by ! ,c5t]s = ,disease ,control & ,prev5tion4 7#b7 ,goals ,9 c>ry+ out ! collaboration & coord9ation "u p>agraph 7#a71 ! ,secret>y %all seek z mu* z possible to a*ieve ! same advancem5t ( useful k z ! #bjai /udy design describ$ 9 su* p>agraph4 7b7 ,review ( /aff+ levels = m5tal heal? pr(essionals 7#a7 ,9 g5]al ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all conduct a review ( ! /aff+ levels = m5tal heal? pr(essionals ( ! ,dep>tm5t4 7#b7 ,elem5ts ,! review requir$ by p>agraph 7#a7 %all include 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+ ! foll[+3 7,a7 ,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$im5ts4 7,b7 ,a description ( ! objectives1 goals1 & tim+ ( ! ,dep>tm5t ) respect to increas+ ! repres5tation ( su* c\nselors & !rapi/s 9 ! behavioral heal? work=ce ( ! ,dep>tm5t1 includ+-- 7i7 a review ( qualification crit]ia = su* c\nselors & !rapi/s & a comp>ison ( su* crit]ia to t ( o!r behavioral heal? pr(essions 9 ! ,dep>tm5t2 & 7ii7 an assessm5t ( ! p>ticipation ( su* c\nselors & !rapi/s 9 ! m5tal heal? pr(essionals tra9ee program ( ! ,dep>tm5t & any imp$im5ts to su* p>ticipation4 7,c7 ,an assessm5t ( ! developm5t by ! ,dep>tm5t ( hir+ guidel9es = m5tal heal? c\nselors1 m>riage & family !rapi/s1 & o!r appropriate c\nselors4 7,d7 ,a description ( h[ ! ,dep>tm5t-- 7i7 id5tifies gaps 9 ! supply ( m5tal heal? pr(essionals2 & 7ii7 det]m9es successful /aff+ ratios = m5tal heal? pr(essionals ( ! ,dep>tm5t4 7,e7 ,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]ies4 7,f7 ,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 7c7 ,compilation ( data ,! ,secret>y ( ,vet]ans ,affairs %all ensure t data "u subsections 7a7 & 7b7 is compil$ sep>ately & disaggregat$ by ye> & 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 7d7 ,brief+s ,! ,secret>y ( ,vet]ans ,affairs %all brief ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives conta9+ ! int]im results-- 7#a7 ) respect to ! /udy "u subsection 7a77#a71 n lat] ?an #bd mon?s aft] ent]+ into ! agreem5t "u su* subsection2 & 7#b7 ) respect to ! review "u subsection 7b77#a71 n lat] ?an #ah mon?s aft] ! date ( ! enactm5t ( ?is ,act4 7e7 ,reports 7#a7 ,report on /udy ,n lat] ?an #ij days aft] ! completion by ! ,secret>y ( ,vet]ans ,affairs 9 coord9ation ) ! ,national ,academies ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e ( ! /udy requir$ "u subsection 7a77#a71 ! ,secret>y %all-- 7,a7 submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! results ( ! /udy2 & 7,b7 make su* report publicly available4 7#b7 ,report on review ,n lat] ?an #ij days aft] ! completion by ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates ( ! review requir$ "u subsection 7b77#a71 ! ,comptroll] ,g5]al %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 #bje4 ,comptroll] ,g5]al report on managem5t by ,dep>tm5t ( ,vet]ans ,affairs ( vet]ans at high risk = suicide 7a7 ,9 g5]al ,n lat] ?an #ah mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! ef=ts ( ! ,dep>tm5t ( ,vet]ans ,affairs to manage vet]ans at high risk = suicide4 7b7 ,elem5ts ,! report requir$ by subsection 7a7 %all include ! foll[+3 7#a7 ,a description ( h[ ! ,dep>tm5t id5tifies pati5ts z high risk = suicide1 ) p>ticul> consid]ation to ! efficacy ( inputs into ! ,recov]y ,engagem5t & ,coord9ation = ,heal? - ,vet]ans ,enhanc$ ,treatm5t program 7commonly ref]r$ to z ! ,,rea* ,,vet program7 ( ! ,dep>tm5t1 includ+ an assessm5t ( ! efficacy ( su* id5tifications disaggregat$ by-- 7,a7 all demographic *>act]i/ics z det]m9$ necess>y & appropriate by ! ,secret>y ( ,vet]ans ,affairs 9 coord9ation ) ! ,c5t]s = ,disease ,control & ,prev5tion2 7,b7 ,vet]ans ,integrat$ ,s]vice ,network2 & 7,c7 to ! ext5t practicable1 m$ical c5t] ( ! ,dep>tm5t4 7#b7 ,a description ( h[ ! ,dep>tm5t int]v5es :5 a pati5t is id5tifi$ z high risk1 includ+ an assessm5t ( ! efficacy ( su* int]v5tions disaggregat$ by-- 7,a7 all demographic *>act]i/ics z det]m9$ necess>y & appropriate by ! ,secret>y 9 coord9ation ) ! ,c5t]s = ,disease ,control & ,prev5tion2 7,b7 ,vet]ans ,integrat$ ,s]vice ,network2 & 7,c7 to ! ext5t practicable1 m$ical c5t] ( ! ,dep>tm5t4 7#c7 ,a description ( h[ ! ,dep>tm5t monitors pati5ts :o h be5 id5tifi$ z high risk1 includ+ an assessm5t ( ! efficacy ( su* monitor+ & any foll[-ups disaggregat$ by-- 7,a7 all demographic *>act]i/ics z det]m9$ necess>y & appropriate by ! ,secret>y 9 coord9ation ) ! ,c5t]s = ,disease ,control & ,prev5tion2 7,b7 ,vet]ans ,integrat$ ,s]vice ,network2 & 7,c7 to ! ext5t practicable1 m$ical c5t] ( ! ,dep>tm5t4 7#d7 ,a review ( /aff+ levels ( suicide prev5tion coord9ators across ! ,vet]ans ,heal? ,adm9i/ration4 7#e7 ,a review ( ! res\rces & programm+ (f]$ to family memb]s & fri5ds ( vet]ans :o h a m5tal heal? condition 9 ord] to assi/ t vet]an 9 treatm5t & recov]y4 7#f7 ,an assessm5t ( su* o!r areas z ! ,comptroll] ,g5]al consid]s appropriate to /udy4 ,,iii ,programs1 /udies1 & guidel9es on m5tal heal? #cja4 ,/udy on connection betwe5 liv+ at high altitude & suicide risk factors among vet]ans 7a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ,rural ,heal? ,res\rce ,c5t]s ( ! ,(fice ( ,rural ,heal? ( ! ,dep>tm5t ( ,vet]ans ,affairs1 %all comm5ce ! conduct ( a /udy on ! connection betwe5 liv+ at high altitude & ! risk ( develop+ depression or dy+ by suicide among vet]ans4 7b7 ,completion ( /udy ,! /udy conduct$ "u subsection 7a7 %all be complet$ n lat] ?an ?ree ye>s aft] ! date ( ! comm5cem5t ( ! /udy4 7c7 ,individual impact ,! /udy conduct$ "u subsection 7a7 %all be conduct$ s z to det]m9e ! effect ( high altitude on suicide risk at ! individual level1 n at ! ,/ate or c\nty level4 7d7 ,report ,n lat] ?an #aej days aft] ! completion ( ! /udy conduct$ "u subsection 7a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! results ( ! /udy4 7e7 ,foll[-up /udy 7#a7 ,9 g5]al ,if ! ,secret>y det]m9es ?r\gh ! /udy conduct$ "u subsection 7a7 t liv+ at high altitude is a risk factor = develop+ depression or dy+ by suicide1 ! ,secret>y %all conduct an additional /udy to id5tify ! foll[+3 7,a7 ,! mo/ likely biological me*anism t makes liv+ at high altitude a risk factor = develop+ depression or dy+ by suicide4 7,b7 ,! mo/ effective treatm5t or int]v5tion = r$uc+ ! risk ( develop+ depression or dy+ by suicide associat$ ) liv+ at high altitude4 7#b7 ,report ,n lat] ?an #aej days aft] complet+ ! /udy conduct$ "u p>agraph 7#a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! results ( ! /udy4 #cjb4 ,e/abli%m5t by ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se ( a cl9ical provid] treatm5t toolkit & accompany+ tra9+ mat]ials = comorbidities 7a7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,secret>y ( ,def5se1 %all develop a cl9ical provid] treatm5t toolkit & accompany+ tra9+ mat]ials = ! evid5ce-bas$ managem5t ( comorbid m5tal heal? conditions1 comorbid m5tal heal? & sub/ance use disord]s1 & a comorbid m5tal heal? condition & *ronic pa94 7b7 ,matt]s includ$ ,9 develop+ ! cl9ical provid] treatm5t toolkit & accompany+ tra9+ mat]ials "u subsection 7a71 ! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se %all ensure t ! toolkit & tra9+ mat]ials include guidance ) respect to ! foll[+3 7#a7 ,! treatm5t ( pati5ts ) po/-traumatic /ress disord] :o are also exp]i5c+ an additional m5tal heal? condition1 a sub/ance use disord]1 or *ronic pa94 7#b7 ,! treatm5t ( pati5ts exp]i5c+ a m5tal heal? condition1 includ+ anxiety1 depression1 or bipol> disord]1 :o are also exp]i5c+ a sub/ance use disord] or *ronic pa94 7#c7 ,! treatm5t ( pati5ts ) traumatic bra9 injury :o are also exp]i5c+-- 7,a7 a m5tal heal? condition1 includ+ po/-traumatic /ress disord]1 anxiety1 depression1 or bipol> disord]2 7,b7 a sub/ance use disord]2 or 7,c7 *ronic pa94 #cjc4 ,update ( cl9ical practice guidel9es = assessm5t & managem5t ( pati5ts at risk = suicide 7a7 ,9 g5]al ,9 ! fir/ publication ( ! ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se ,cl9ical ,practice ,guidel9e = ,assessm5t & ,managem5t ( ,pati5ts at ,risk = ,suicide publi%$ aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se1 ?r\gh ! ,assessm5t & ,managem5t ( ,pati5ts at ,risk = ,suicide ,"w ,gr\p 79 ?is section ref]r$ to z ! ,"w ,gr\p71 %all ensure ! publication includes ! foll[+3 7#a7 ,enhanc$ guidance ) respect to g5d]-specific-- 7,a7 risk factors = suicide & suicidal ideation2 7,b7 treatm5t efficacy = depression & suicide prev5tion2 7,c7 ph>maco!rapy efficacy2 & 7,d7 psy*o!rapy efficacy4 7#b7 ,guidance ) respect to ! efficacy ( alt]native !rapies1 o!r ?an psy*o!rapy & ph>maco!rapy1 includ+ ! foll[+3 7,a7 ,yoga !rapy4 7,b7 ,m$itation !rapy4 7,c7 ,equ9e !rapy4 7,d7 ,o!r animal !rapy4 7,e7 ,tra9+ & c>+ = s]vice dogs4 7,f7 ,agri!rapy4 7,g7 ,art !rapy4 7,h7 ,outdoor sports !rapy4 7,i7 ,music !rapy4 7,j7 ,any o!r alt]native !rapy t ! ,"w ,gr\p consid]s appropriate4 7#c7 ,guidance ) respect to ! f9d+s ( ! ,creat+ ,options = ,vet]ans' ,exp$it$ ,recov]y ,commission 7commonly ref]r$ to z ! ,,cov] ,commission7 e/abli%$ "u section #ica ( ! ,jason ,simcakoski ,memorial & ,promise ,act 7title ,,ix ( ,public ,law #aad-aih2 #ch ,u4,s4,c4 #agja note74 7b7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ to prev5t ! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se f consid]+ all relevant evid5ce1 z appropriate1 9 updat+ ! ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se ,cl9ical ,practice ,guidel9e = ,assessm5t & ,managem5t ( ,pati5ts at ,risk = ,suicide1 z requir$ "u subsection 7a71 or f ensur+ t ! f9al cl9ical practice guidel9es updat$ "u su* subsection rema9 applicable to ! pati5t populations ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se4 #cjd4 ,e/abli%m5t by ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se ( cl9ical practice guidel9es = ! treatm5t ( s]i\s m5tal illness 7a7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,secret>y ( ,def5se & ! ,secret>y ( ,heal? & ,human ,s]vices1 %all complete ! developm5t ( a cl9ical practice guidel9e or guidel9es = ! treatm5t ( s]i\s m5tal illness1 to include ! foll[+ conditions3 7#a7 ,s*izophr5ia4 7#b7 ,s*izoaffective disord]4 7#c7 ,p]si/5t mood disord]1 includ+ bipol> disord] ,i & ,,ii4 7#d7 ,any o!r m5tal1 behavioral1 or emotional disord] result+ 9 s]i\s functional impairm5t t sub/antially int]f]es ) major life activities z ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,secret>y ( ,def5se & ! ,secret>y ( ,heal? & ,human ,s]vices1 consid]s appropriate4 7b7 ,matt]s includ$ 9 guidel9es ,! cl9ical practice guidel9e or guidel9es develop$ "u subsection 7a7 %all include ! foll[+3 7#a7 ,guidance conta9$ 9 ! #bjaf ,cl9ical ,practice ,guidel9es = ! ,managem5t ( ,major ,depressive ,disord]s ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se4 7#b7 ,guidance ) respect to ! treatm5t ( pati5ts ) a condition describ$ 9 subsection 7a74 7#c7 ,a li/ ( evid5ce-bas$ !rapies = ! treatm5t ( conditions describ$ 9 subsection 7a74 7#d7 ,an appropriate guidel9e = ! adm9i/ration ( ph>macological !rapy1 psy*ological or behavioral !rapy1 or o!r !rapy = ! managem5t ( conditions describ$ 9 subsection 7a74 7c7 ,assessm5t ( exi/+ guidel9es ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,secret>y ( ,def5se & ! ,secret>y ( ,heal? & ,human ,s]vices1 %all complete an assessm5t ( ! #bjaf ,cl9ical ,practice ,guidel9es = ! ,managem5t ( ,major ,depressive ,disord]s to det]m9e :e!r an update to su* guidel9es is necess>y4 7d7 ,"w gr\p 7#a7 ,e/abli%m5t ,! ,secret>y ( ,vet]ans ,affairs1 ! ,secret>y ( ,def5se1 & ! ,secret>y ( ,heal? & ,human ,s]vices %all create a "w gr\p to develop ! cl9ical practice guidel9e or guidel9es "u subsection 7a7 to be kn[n z ! ,s]i\s ,m5tal ,illness ,"w ,gr\p 79 ?is subsection ref]r$ to z ! ,"w ,gr\p74 7#b7 ,memb]%ip ,! ,"w ,gr\p creat$ "u p>agraph 7#a7 %all be compris$ ( individuals t repres5t ,f$]al ,gov]nm5t entities & non-,f$]al ,gov]nm5t entities ) exp]tise 9 ! areas cov]$ by ! ,"w ,gr\p1 includ+ ! foll[+ entities3 7,a7 ,academic in/itutions t specialize 9 rese>* = ! treatm5t ( conditions describ$ 9 subsection 7a74 7,b7 ,! ,heal? ,s]vices ,rese>* & ,developm5t ,s]vice ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7,c7 ,! ,(fice ( ! ,assi/ant ,secret>y = ,m5tal ,heal? & ,sub/ance ,use ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7,d7 ,! ,national ,in/itute ( ,m5tal ,heal?4 7,e7 ,! ,indian ,heal? ,s]vice4 7,f7 ,relevant organizations ) exp]tise 9 rese>*+1 diagnos+1 or treat+ conditions describ$ 9 subsection 7a74 7#c7 ,relation to o!r "w gr\ps ,! ,"w ,gr\p %all be creat$ & conduct$ 9 ! same mann] z o!r "w gr\ps = ! developm5t ( cl9ical practice guidel9es = ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se4 7e7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ to prev5t ! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se f consid]+ all relevant evid5ce1 z appropriate1 9 creat+ ! cl9ical practice guidel9e or guidel9es requir$ "u subsection 7a7 or f ensur+ t ! f9al cl9ical practice guidel9e or guidel9es develop$ "u su* subsection & subsequ5tly updat$1 z appropriate1 rema9 applicable to ! pati5t populations ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se4 #cje4 ,precision m$ic9e initiative ( ,dep>tm5t ( ,vet]ans ,affairs to id5tify & validate bra9 & m5tal heal? biom>k]s 7a7 ,9 g5]al ,beg9n+ n lat] ?an #ah mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all develop & implem5t an initiative ( ! ,dep>tm5t ( ,vet]ans ,affairs to id5tify & validate bra9 & m5tal heal? biom>k]s among vet]ans1 ) specific consid]ation = depression1 anxiety1 po/-traumatic /ress disord]1 bipol> disord]1 traumatic bra9 injury1 & su* o!r m5tal heal? conditions z ! ,secret>y consid]s appropriate4 ,su* initiative may be ref]r$ to z ! ,precision ,m$ic9e = ,vet]ans ,initiative4 7b7 ,model ( initiative ,! initiative "u subsection 7a7 %all be model$ on ! ,all ( ,u ,precision ,m$ic9e ,initiative adm9i/]$ by ! ,national ,in/itutes ( ,heal? ) respect to l>ge-scale collection ( /&>diz$ data & op5 data %>+4 7c7 ,me?ods ,! initiative "u subsection 7a7 %all include bra9 /ructure & function measurem5ts1 su* z functional magnetic resonance imag+ & electro5cephalogram1 & %all coord9ate ) additional biological me?ods ( analysis utiliz$ 9 ! ,million ,vet]ans ,program ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7d7 ,use ( data 7#a7 ,privacy & security ,9 c>ry+ out ! initiative "u subsection 7a71 ! ,secret>y %all develop robu/ data privacy & security measures1 consi/5t ) section #eeb;a ( title #e1 ,unit$ ,/ates ,code 7commonly kn[n z ! ,privacy ,act ( #aigd71 & regulations promulgat$ pursuant to ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif 7p>ts #afj1 #afb1 & #afd ( title #de1 ,code ( ,f$]al ,regulations1 or successor regulations7 to ensure t in=mation ( vet]ans p>ticipat+ 9 ! initiative is kept private & secure4 7#b7 ,consultation ) ! national in/itutes ( sci5ce & te*nology ,! ,secret>y may consult ) ! ,national ,in/itute ( ,sci5ce & ,te*nology 9 develop+ ! data privacy & security measures describ$ 9 p>agraph 7#a74 7#c7 ,access /&>ds ,! ,secret>y %all provide access to in=mation "u ! initiative consi/5t ) ! /&>ds describ$ 9 section #eeb;a7d77#a7 ( title #e1 ,unit$ ,/ates ,code1 & section #afd4ebd ( title #de1 ,code ( ,f$]al ,regulations1 or successor regulations4 7#d7 ,op5 plat=m 7,a7 ,availability ( data ,! ,secret>y %all make de-id5tifi$ data collect$ "u ! initiative available = rese>* purposes to ,f$]al ag5cies4 7,b7 ,contract ,! ,secret>y %all contract ) nongov]nm5t entities t comply ) requisite data security measures to make available = rese>* purposes de-id5tifi$ data collect$ "u ! initiative4 7,c7 ,assi/ance ,! ,secret>y %all provide assi/ance to a ,f$]al ag5cy conduct+ rese>* us+ data collect$ "u ! initiative at ! reque/ ( t ag5cy4 7,d7 ,prohibition on transf] ( data ,f$]al ag5cies may n disclose1 transmit1 %>e1 sell1 lic5se1 or o!rwise transf] data collect$ "u ! initiative to any nongov]nm5t entity o!r ?an z all[$ "u subp>agraph 7,b74 7#e7 ,/&>dization 7,a7 ,9 g5]al ,! ,secret>y %all ensure t data collect$ "u ! initiative is /&>diz$4 7,b7 ,consultation ,! ,secret>y %all consult ) ! ,national ,in/itutes ( ,heal? & ! ,food & ,drug ,adm9i/ration to det]m9e ! mo/ effective1 effici5t1 & co/-effective way ( /&>diz+ data collect$ "u ! initiative4 7,c7 ,mann] ( /&>dization ,9 consultation ) ! ,national ,in/itute = ,sci5ce & ,te*nology1 data collect$ "u ! initiative %all be /&>diz$ 9 ! mann] 9 :i* x is collect$1 ent]$ into ! database1 extract$1 & record$4 7#f7 ,measures ( bra9 function or /ructure ,any measures ( bra9 function or /ructure collect$ "u ! initiative %all be collect$ ) a device t is approv$ by ! ,food & ,drug ,adm9i/ration4 7#g7 ,de-id5tifi$ data def9$ ,9 ?is subsection1 ! t]m de-id5tifi$ data means1 ) respect to data held by ! ,dep>tm5t ( ,vet]ans ,affairs1 t ! ,dep>tm5t-- 7,a7 alt]s1 anonymizes1 or aggregates ! data s t !re is a reasonable basis = expect+ t ! data c\ld n be l9k$ z a practical matt] to a specific individual2 7,b7 publicly commits to refra9 f attempt+ to re-id5tify ! data ) a specific individual1 & adopts controls to prev5t su* id5tification2 & 7,c7 causes ! data to be cov]$ by a contractual or o!r legally en=ceable prohibition on ea* entity to :i* ! ,dep>tm5t discloses ! data f attempt+ to use ! data to id5tify a specific individual & requires ! same ( all onw>d disclosures4 7e7 ,inclusion ( initiative 9 program ,! ,secret>y %all coord9ate ef=ts ( ! initiative "u subsection 7a7 ) ! ,million ,vet]ans ,program ( ! ,dep>tm5t4 #cjf4 ,/ati/ical analyses & data evaluation by ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,*apt] #a ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by add+ at ! end ! foll[+ new section3 #aai4 ,contract+ = /ati/ical analyses & data evaluation 7a7 ,9 g5]al ,! ,secret>y may ent] into a contract or o!r agreem5t ) an academic in/itution or o!r qualifi$ entity1 z det]m9$ by ! ,secret>y1 to c>ry out /ati/ical analyses & data evaluation z requir$ ( ! ,secret>y by law4 4 7b7 ,rule ( con/ruction ,no?+ 9 ?is section may be con/ru$ to limit ! au?ority ( ! ,secret>y to ent] into contracts or o!r agreem5ts = /ati/ical analyses & data evaluation "u any o!r provision ( law4 4 7b7 ,cl]ical am5dm5t ,! table ( sections at ! beg9n+ ( *apt] #a ( su* title is am5d$ by add+ at ! end ! foll[+ new item3 #aai4 ,contract+ = /ati/ical analyses & data evaluation4 4 ,,iv ,ov]sight ( m5tal heal? c>e & relat$ s]vices #dja4 ,/udy on effectiv5ess ( suicide prev5tion & m5tal heal? outrea* programs ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all ent] into an agreem5t ) a non-,f$]al ,gov]nm5t entity ) exp]tise 9 conduct+ & evaluat+ rese>*-bas$ /udies to conduct a /udy on ! effectiv5ess ( ! suicide prev5tion & m5tal heal? outrea* mat]ials prep>$ by ! ,dep>tm5t ( ,vet]ans ,affairs & ! suicide prev5tion & m5tal heal? outrea* campaigns conduct$ by ! ,dep>tm5t4 7b7 ,use ( focus gr\ps 7#a7 ,9 g5]al ,! ,secret>y %all conv5e n few] ?an eight diff]5t focus gr\ps to evaluate ! effectiv5ess ( ! suicide prev5tion & m5tal heal? mat]ials & campaigns z requir$ "u subsection 7a74 7#b7 ,location ( focus gr\ps ,focus gr\ps conv5$ "u p>agraph 7#a7 %all be held 9 geographically div]se areas z foll[s3 7,a7 ,n few] ?an two 9 rural or highly rural areas4 7,b7 ,n few] ?an "o 9 ea* ( ! f\r di/ricts ( ! ,vet]ans ,b5efits ,adm9i/ration4 7#c7 ,tim+ ( focus gr\ps ,focus gr\ps conv5$ "u p>agraph 7#a7 %all be held at a v>iety ( dates & times to ensure an adequate repres5tation ( vet]ans ) diff]5t "w s*$ules4 7#d7 ,numb] ( p>ticipants ,ea* focus gr\p conv5$ "u p>agraph 7#a7 %all include n few] ?an five & n m ?an #ab p>ticipants4 7#e7 ,repres5tation ,ea* focus gr\p conv5$ "u p>agraph 7#a7 %all1 to ! ext5t practicable1 include vet]ans ( div]se backgr\nds1 includ+-- 7,a7 vet]ans ( all eras1 z det]m9$ by ! ,secret>y2 7,b7 wom5 vet]ans2 7,c7 m9ority vet]ans2 7,d7 ,native ,am]ican vet]ans1 z def9$ 9 section #cgfe ( title #ch1 ,unit$ ,/ates ,code2 7,e7 vet]ans :o id5tify z lesbian1 gay1 bisexual1 transg5d]1 or que] 7commonly ref]r$ to z ,,lgbtq72 7,f7 vet]ans :o live 9 rural or highly rural areas2 7,g7 individuals transition+ f active duty 9 ! ,arm$ ,=ces to civilian life2 & 7,h7 o!r high-risk gr\ps ( vet]ans1 z det]m9$ by ! ,secret>y4 7c7 ,report 7#a7 ,9 g5]al ,n lat] ?an #ij days aft] ! la/ focus gr\p meet+ "u subsection 7b71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! f9d+s ( ! focus gr\ps4 7#b7 ,elem5ts ,! report requir$ by p>agraph 7#a7 %all include ! foll[+3 7,a7 ,bas$ on ! f9d+s ( ! focus gr\ps1 an assessm5t ( ! effectiv5ess ( curr5t suicide prev5tion & m5tal heal? mat]ials & campaigns ( ! ,dep>tm5t 9 rea*+ vet]ans z a :ole z well z specific gr\ps ( vet]ans 7= example1 wom5 vet]ans74 7,b7 ,bas$ on ! f9d+s ( ! focus gr\ps1 recomm5dations = future suicide prev5tion & m5tal heal? mat]ials & campaigns ( ! ,dep>tm5t to t>get specific gr\ps ( vet]ans4 7,c7 ,a plan to *ange ! curr5t suicide prev5tion & m5tal heal? mat]ials & campaigns ( ! ,dep>tm5t or1 if ! ,secret>y decides n to *ange ! curr5t mat]ials & campaigns1 an explanation ( ! reason = ma9ta9+ ! curr5t mat]ials & campaigns4 7,d7 ,a description ( any diss5t+ or oppos+ viewpo9ts rais$ by p>ticipants 9 ! focus gr\p4 7,e7 ,su* o!r issues z ! ,secret>y consid]s necess>y4 7d7 ,repres5tative survey 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! la/ focus gr\p meet+ "u subsection 7b71 ! ,secret>y %all complete a repres5tative survey ( ! vet]an population t is in=m$ by ! focus gr\p data 9 ord] to collect in=mation ab\t ! effectiv5ess ( ! m5tal heal? & suicide prev5tion mat]ials & campaigns conduct$ by ! ,dep>tm5t4 7#b7 ,vet]ans survey$ 7,a7 ,9 g5]al ,vet]ans survey$ "u p>agraph 7#a7 %all include vet]ans describ$ 9 subsection 7b77#e74 7,b7 ,disaggregation ( data ,data ( vet]ans survey$ "u p>agraph 7#a7 %all be disaggregat$ by-- 7i7 vet]ans :o h receiv$ c>e f ! ,dep>tm5t dur+ ! two-ye> p]iod prec$+ ! survey2 & 7ii7 vet]ans :o h n receiv$ c>e f ! ,dep>tm5t dur+ ! two-ye> p]iod prec$+ ! survey4 7e7 ,treatm5t ( contracts = suicide prev5tion & m5tal heal? outrea* m$ia 7#a7 ,focus gr\ps 7,a7 ,9 g5]al ,! ,secret>y %all include 9 ea* contract to develop m$ia relat+ to suicide prev5tion & m5tal heal? mat]ials & campaigns a requirem5t t ! contractor conv5e focus gr\ps ( vet]ans to assess ! effectiv5ess ( suicide prev5tion & m5tal heal? outrea*4 7,b7 ,repres5tation ,ea* focus gr\p requir$ "u subp>agraph 7,a7 %all1 to ! ext5t practicable1 include vet]ans ( div]se backgr\nds1 includ+-- 7i7 vet]ans ( all eras1 z det]m9$ by ! ,secret>y2 7ii7 wom5 vet]ans2 7iii7 m9ority vet]ans2 7iv7 ,native ,am]ican vet]ans1 z def9$ 9 section #cgfe ( title #ch1 ,unit$ ,/ates ,code2 7v7 vet]ans :o id5tify z lesbian1 gay1 bisexual1 transg5d]1 or que] 7commonly ref]r$ to z ,,lgbtq72 7vi7 vet]ans :o live 9 rural or highly rural areas2 7vii7 individuals transition+ f active duty 9 ! ,arm$ ,=ces to civilian life2 & 7viii7 o!r high-risk gr\ps ( vet]ans1 z det]m9$ by ! ,secret>y4 7#b7 ,subcontract+ 7,a7 ,9 g5]al ,! ,secret>y %all include 9 ea* contract describ$ 9 p>agraph 7#a77;,a7 a requirem5t t1 if ! contractor subcontracts = ! developm5t ( m$ia1 ! contractor %all subcontract ) a subcontractor t has exp]i5ce creat+ impactful m$ia campaigns t t>get individuals age #ah to #cd4 7,b7 ,budget limitation ,n m ?an two p]c5t ( ! budget ( ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion ( ! ,dep>tm5t = contractors = suicide prev5tion & m5tal heal? m$ia outrea* %all g to subcontractors describ$ 9 subp>agraph 7,a74 7f7 ,pap]work ,r$uction ,act exemption ,*apt] #ce ( title #dd1 ,unit$ ,/ates ,code 7commonly kn[n z ! ,pap]work ,r$uction ,act7 %all n apply to any rulemak+ or in=mation collection requir$ "u ?is section4 7g7 ,rural & highly rural def9$ ,9 ?is section1 ) respect to an area1 ! t]ms rural & highly rural h ! mean+s giv5 ^? t]ms 9 ! ,rural-,urban ,commut+ ,areas cod+ sy/em ( ! ,dep>tm5t ( ,agriculture4 #djb4 ,ov]sight ( m5tal heal? & suicide prev5tion m$ia outrea* conduct$ by ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,e/abli%m5t ( goals 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all e/abli% goals = ! m5tal heal? & suicide prev5tion m$ia outrea* campaigns ( ! ,dep>tm5t ( ,vet]ans ,affairs1 :i* %all include ! e/abli%m5t ( t>gets1 metrics1 & action plans to describe & assess ^? campaigns4 7#b7 ,use ( metrics 7,a7 ,9 g5]al ,! goals e/abli%$ "u p>agraph 7#a7 %all be measur$ by metrics specific to diff]5t m$ia types4 7,b7 ,factors to consid] ,9 us+ metrics "u subp>agraph 7,a71 ! ,secret>y %all det]m9e ! be/ me?odological approa* = ea* m$ia type & %all consid] ! foll[+3 7i7 ,metrics relat+ to social m$ia1 :i* may include ! foll[+3 7,i7 ,impressions4 7,,ii7 ,rea*4 7,,iii7 ,engagem5t rate4 7,,iv7 ,su* o!r metrics z ! ,secret>y consid]s necess>y4 7ii7 ,metrics relat+ to television1 :i* may include ! foll[+3 7,i7 ,niels5 rat+s4 7,,ii7 ,su* o!r metrics z ! ,secret>y consid]s necess>y4 7iii7 ,metrics relat+ to email1 :i* may include ! foll[+3 7,i7 ,op5 rate4 7,,ii7 ,response rate4 7,,iii7 ,click rate4 7,,iv7 ,su* o!r metrics z ! ,secret>y consid]s necess>y4 7,c7 ,update ,! ,secret>y %all p]iodically update ! metrics "u subp>agraph 7,b7 z m accurate metrics become available4 7#c7 ,t>gets ,! ,secret>y %all e/abli% t>gets to track ! metrics us$ "u p>agraph 7#b74 7#d7 ,consultation ,9 e/abli%+ goals "u p>agraph 7#a71 ! ,secret>y %all consult ) ! foll[+3 7,a7 ,relevant /akehold]s1 su* z organizations t repres5t vet]ans1 z det]m9$ by ! ,secret>y4 7,b7 ,m5tal heal? & suicide prev5tion exp]ts4 7,c7 ,su* o!r p]sons z ! ,secret>y consid]s appropriate4 7#e7 ,initial report ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report detail+ ! goals e/abli%$ "u p>agraph 7#a7 = ! m5tal heal? & suicide prev5tion m$ia outrea* campaigns ( ! ,dep>tm5t1 includ+ ! metrics & t>gets = su* metrics by :i* ^? goals are to be measur$ "u p>agraphs 7#b7 & 7#c74 7#f7 ,annual report ,n lat] ?an "o ye> aft] ! submittal ( ! report "u p>agraph 7#e71 & annually !reaft]1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report detail+-- 7,a7 ! progress ( ! ,dep>tm5t 9 meet+ ! goals e/abli%$ "u p>agraph 7#a7 & ! t>gets e/abli%$ "u p>agraph 7#c72 & 7,b7 a description ( action to be tak5 by ! ,dep>tm5t to modify m5tal heal? & suicide prev5tion m$ia outrea* campaigns if ^? goals & t>gets are n be+ met4 7b7 ,report on use ( funds by ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 & semiannually !reaft]1 ! ,secret>y %all submit to ! ,committee on ,appropriations & ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,appropriations & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report conta9+ ! exp5ditures & obligations ( ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion ( ! ,vet]ans ,heal? ,adm9i/ration dur+ ! p]iod cov]$ by ! report4 #djc4 ,comptroll] ,g5]al managem5t review ( m5tal heal? & suicide prev5tion s]vices ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,n lat] ?an ?ree ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a managem5t review ( ! m5tal heal? & suicide prev5tion s]vices provid$ by ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,elem5ts ,! managem5t review requir$ by subsection 7a7 %all include ! foll[+3 7#a7 ,an assessm5t ( ! infra/ructure "u ! control ( or available to ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion ( ! ,dep>tm5t ( ,vet]ans ,affairs or available to ! ,dep>tm5t ( ,vet]ans ,affairs = suicide prev5tion ef=ts n op]at$ by ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion4 7#b7 ,a description ( ! managem5t & organizational /ructure ( ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion1 includ+ roles & responsibilities = ea* position4 7#c7 ,a description ( ! op]ational policies & processes ( ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion4 7#d7 ,an assessm5t ( suicide prev5tion practices & initiatives available f ! ,dep>tm5t & ?r\gh community p>tn]%ips4 7#e7 ,an assessm5t ( ! /aff+ levels at ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion1 disaggregat$ by type ( position1 & includ+ ! location ( any /aff+ defici5cies4 7#f7 ,an assessm5t ( ! ,nurse ,advice ,l9e pilot program conduct$ by ! ,dep>tm5t4 7#g7 ,an assessm5t ( recruitm5t initiatives 9 rural areas = m5tal heal? pr(essionals ( ! ,dep>tm5t4 7#h7 ,an assessm5t ( /rategic plann+ conduct$ by ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion4 7#i7 ,an assessm5t ( ! communication1 & ! effectiv5ess ( su* communication-- 7,a7 )9 ! c5tral (fice ( ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion2 7,b7 betwe5 t c5tral (fice & any /aff memb] or (fice 9 ! field1 includ+ *apla9s1 attorneys1 law en=cem5t p]sonnel1 & volunte]s2 & 7,c7 betwe5 t c5tral (fice1 local facilities ( ! ,dep>tm5t1 & community p>tn]s ( ! ,dep>tm5t1 includ+ fir/ respond]s1 community support gr\ps1 & heal? c>e indu/ry p>tn]s4 7#aj7 ,an assessm5t ( h[ effectively ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion implem5ts op]ational policies & proc$ures4 7#aa7 ,an assessm5t ( h[ ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se coord9ate suicide prev5tion ef=ts1 & recomm5dations on h[ ! ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se c m effectively coord9ate ^? ef=ts4 7#ab7 ,an assessm5t ( su* o!r areas z ! ,comptroll] ,g5]al consid]s appropriate to /udy4 #djd4 ,comptroll] ,g5]al report on ef=ts ( ,dep>tm5t ( ,vet]ans ,affairs to integrate m5tal heal? c>e into prim>y c>e cl9ics 7a7 ,initial report 7#a7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! ef=ts ( ! ,dep>tm5t ( ,vet]ans ,affairs to integrate m5tal heal? c>e into prim>y c>e cl9ics ( ! ,dep>tm5t4 7#b7 ,elem5ts ,! report requir$ by subsection 7a7 %all include ! foll[+3 7,a7 ,an assessm5t ( ! ef=ts ( ! ,dep>tm5t to integrate m5tal heal? c>e into prim>y c>e cl9ics ( ! ,dep>tm5t4 7,b7 ,an assessm5t ( ! effectiv5ess ( su* ef=ts4 7,c7 ,an assessm5t ( h[ ! heal? c>e ( vet]ans is impact$ by su* integration4 7,d7 ,a description ( h[ c>e is coord9at$ by ! ,dep>tm5t betwe5 specialty m5tal heal? c>e & prim>y c>e1 includ+ a description ( ! foll[+3 7i7 ,h[ docum5ts & pati5t in=mation are transf]r$ & ! effectiv5ess ( ^? transf]s4 7ii7 ,h[ c>e is coord9at$ :5 vet]ans mu/ travel to diff]5t facilities ( ! ,dep>tm5t4 7iii7 ,h[ a vet]an is re9tegrat$ into prim>y c>e aft] receiv+ 9-pati5t m5tal heal? c>e4 7,e7 ,an assessm5t ( h[ ! integration ( m5tal heal? c>e into prim>y c>e cl9ics is implem5t$ at diff]5t types ( facilities ( ! ,dep>tm5t4 7,f7 ,su* recomm5dations on h[ ! ,dep>tm5t c bett] integrate m5tal heal? c>e into prim>y c>e cl9ics z ! ,comptroll] ,g5]al consid]s appropriate4 7,g7 ,an assessm5t ( su* o!r areas z ! ,comptroll] ,g5]al consid]s appropriate to /udy4 7b7 ,community c>e integration report 7#a7 ,9 g5]al ,n lat] ?an two ye>s aft] ! date on :i* ! ,comptroll] ,g5]al submits ! report requir$ "u subsection 7a77#a71 ! ,comptroll] ,g5]al %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! ef=ts ( ! ,dep>tm5t to integrate community-bas$ m5tal heal? c>e into ! ,vet]ans ,heal? ,adm9i/ration4 7#b7 ,elem5ts ,! report requir$ by p>agraph 7#a7 %all include ! foll[+3 7,a7 ,an assessm5t ( ! ef=ts ( ! ,dep>tm5t to integrate community-bas$ m5tal heal? c>e into ! ,vet]ans ,heal? ,adm9i/ration4 7,b7 ,an assessm5t ( ! effectiv5ess ( su* ef=ts4 7,c7 ,an assessm5t ( h[ ! heal? c>e ( vet]ans is impact$ by su* integration4 7,d7 ,a description ( h[ c>e is coord9at$ betwe5 provid]s ( community-bas$ m5tal heal? c>e & ! ,vet]ans ,heal? ,adm9i/ration1 includ+ a description ( h[ docum5ts & pati5t in=mation are transf]r$ & ! effectiv5ess ( ^? transf]s betwe5-- 7i7 ! ,vet]ans ,heal? ,adm9i/ration & provid]s ( community-bas$ m5tal heal? c>e2 & 7ii7 provid]s ( community-bas$ m5tal heal? c>e & ! ,vet]ans ,heal? ,adm9i/ration4 7,e7 ,an assessm5t ( any disp>ities 9 ! coord9ation ( community-bas$ m5tal heal? c>e into ! ,vet]ans ,heal? ,adm9i/ration by location & type ( facility4 7,f7 ,an assessm5t ( ! milit>y cultural compet5cy ( heal? c>e provid]s provid+ community-bas$ m5tal heal? c>e to vet]ans4 7,g7 ,su* recomm5dations on h[ ! ,dep>tm5t c bett] integrate community-bas$ m5tal heal? c>e into ! ,vet]ans ,heal? ,adm9i/ration z ! ,comptroll] ,g5]al consid]s appropriate4 7,h7 ,an assessm5t ( su* o!r areas z ! ,comptroll] ,g5]al consid]s appropriate to /udy4 7#c7 ,community-bas$ m5tal heal? c>e def9$ ,9 ?is subsection1 ! t]m community-bas$ m5tal heal? c>e means m5tal heal? c>e paid = by ! ,dep>tm5t b provid$ by a non-,dep>tm5t heal? c>e provid] at a non-,dep>tm5t facility1 includ+ c>e furni%$ "u section #agjc ( title #ch1 ,unit$ ,/ates ,code 7z 9 effect on ! date specifi$ 9 section #aja7;b7 ( ! ,c>+ = ,our ,vet]ans ,act ( #bjah 7title ,i ( ,public ,law #aae-ahb774 #dje4 ,jo9t m5tal heal? programs by ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se 7a7 ,report on m5tal heal? programs 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 & annually !reaft]1 ! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se %all submit to ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,arm$ ,s]vices ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs & ! ,committee on ,arm$ ,s]vices ( ! ,h\se ( ,repres5tatives a report on m5tal heal? programs ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se & jo9t programs ( ! ,dep>tm5ts4 7#b7 ,elem5ts ,! report requir$ by p>agraph 7#a7 %all include ! foll[+3 7,a7 ,a description ( m5tal heal? programs op]at$ by ! ,dep>tm5t ( ,vet]ans ,affairs1 includ+ ! foll[+3 7i7 ,transition assi/ance programs4 7ii7 ,cl9ical & non-cl9ical m5tal heal? initiatives1 includ+ c5t]s ( excell5ce ( ! ,dep>tm5t ( ,vet]ans ,affairs = traumatic bra9 injury & po/-traumatic /ress disord]4 7iii7 ,programs t may second>ily improve m5tal heal?1 includ+ employm5t1 h\s+ assi/ance1 & f9ancial lit]acy programs4 7iv7 ,rese>* into m5tal heal? issues & conditions1 to include po/-traumatic /ress disord]1 depression1 anxiety1 bipol> disord]1 traumatic bra9 injury1 suicidal ideation1 & any o!r issues or conditions z ! ,secret>y ( ,vet]ans ,affairs consid]s necess>y4 7,b7 ,a description ( m5tal heal? programs op]at$ by ! ,dep>tm5t ( ,def5se1 includ+ ! foll[+3 7i7 ,transition assi/ance programs4 7ii7 ,cl9ical & non-cl9ical m5tal heal? initiatives1 includ+ ! ,national ,intrepid ,c5t] ( ,excell5ce & ! ,intrepid ,_s ,c5t]s4 7iii7 ,programs t may second>ily improve m5tal heal?1 includ+ employm5t1 h\s+ assi/ance1 & f9ancial lit]acy programs4 7iv7 ,rese>* into m5tal heal? issues & conditions1 to include po/-traumatic /ress disord]1 depression1 anxiety1 bipol> disord]1 traumatic bra9 injury1 suicidal ideation1 & any o!r issues or conditions z ! ,secret>y ( ,def5se consid]s necess>y4 7,c7 ,a description ( m5tal heal? programs jo9tly op]at$ by ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se1 includ+ ! foll[+3 7i7 ,transition assi/ance programs4 7ii7 ,cl9ical & non-cl9ical m5tal heal? initiatives4 7iii7 ,programs t may second>ily improve m5tal heal?1 includ+ employm5t1 h\s+ assi/ance1 & f9ancial lit]acy programs4 7iv7 ,rese>* into m5tal heal? issues & conditions1 to include po/-traumatic /ress disord]1 depression1 anxiety1 bipol> disord]1 traumatic bra9 injury1 suicidal ideation1 & complet$ suicides1 includ+ ?r\gh ! use ( ! jo9t suicide data repository ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se1 & any o!r issues or conditions z ! ,secret>y ( ,vet]ans ,affairs & ! ,secret>y ( ,def5se consid] necess>y4 7,d7 ,recomm5dations = coord9at+ m5tal heal? programs ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se to improve ! effectiv5ess ( ^? programs4 7,e7 ,recomm5dations = novel jo9t programm+ ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se to improve ! m5tal heal? ( memb]s ( ! ,arm$ ,=ces & vet]ans4 7b7 ,evaluation ( collaborative ef=ts ( ,dep>tm5t ( ,vet]ans ,affairs & ,dep>tm5t ( ,def5se & alt]natives ( analysis to e/abli% a jo9t ,,va_/,do,d ,intrepid ,_s ,c5t] 7#a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs1 9 coord9ation ) ! ,secret>y ( ,def5se1 %all evaluate ! curr5t ongo+ collaborative ef=ts ( ! ,dep>tm5t ( ,vet]ans ,affairs & ! ,dep>tm5t ( ,def5se relat$ to po/-traumatic /ress disord] & traumatic bra9 injury c>e1 rese>*1 & education to improve ! quality ( & access to su* c>e & seek pot5tial new collaborative ef=ts to improve & exp& su* c>e = vet]ans & memb]s ( ! ,arm$ ,=ces 9 a jo9t ,dep>tm5t ( ,vet]ans ,affairs_/,dep>tm5t ( ,def5se ,intrepid ,_s ,c5t] t s]ves active duty memb]s ( ! ,arm$ ,=ces1 memb]s ( ! res]ve compon5ts ( ! ,arm$ ,=ces1 & vet]ans = mutual b5efit & gr[? 9 treatm5t & c>e4 7#b7 ,alt]natives ( analysis 7,a7 ,9 g5]al ,! evaluation requir$ "u p>agraph 7#a7 %all include an alt]natives ( analysis to e/abli% ! jo9t ,dep>tm5t ( ,vet]ans ,affairs_/,dep>tm5t ( ,def5se ,intrepid ,_s ,c5t] describ$ 9 p>agraph 7#a74 7,b7 ,elem5ts ,! alt]natives ( analysis requir$ "u subp>agraph 7,a7 ) respect to ! e/abli%m5t ( ! jo9t ,dep>tm5t ( ,vet]ans ,affairs_/,dep>tm5t ( ,def5se ,intrepid ,_s ,c5t] describ$ 9 p>agraph 7#a7 %all provide alt]natives & recomm5dations t consid] in=mation includ+-- 7i7 colocation ( ! c5t] on an in/allation ( ! ,dep>tm5t ( ,def5se or prop]ty ( a m$ical c5t] ( ! ,dep>tm5t ( ,vet]ans ,affairs2 7ii7 consid]ation ( a rural or highly rural area to e/abli% ! c5t] t may include colocation describ$ 9 clause 7i72 7iii7 geographic di/ance f exi/+ or plann$ ,intrepid ,_s ,c5t]s ( ! ,dep>tm5t ( ,def5se or o!r su* facilities ( ! ,dep>tm5t ( ,vet]ans ,affairs or ! ,dep>tm5t ( ,def5se t furni% c>e = po/-traumatic /ress disord] or traumatic bra9 injury2 & 7iv7 ! pot5tial role = private entities & philan?ropic organizations 9 c>ry+ out ! activities ( ! c5t]4 7#c7 ,report to ,congress ,n lat] ?an #bgj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report t includes-- 7,a7 a summ>y ( ! evaluation requir$ "u p>agraph 7#a72 & 7,b7 ! alt]natives ( analysis requir$ "u p>agraph 7#b74 7#d7 ,rural & highly rural def9$ ,9 ?is subsection1 ) respect to an area1 ! t]ms rural & highly rural h ! mean+s giv5 ^? t]ms 9 ! ,rural-,urban ,commut+ ,areas cod+ sy/em ( ! ,dep>tm5t ( ,agriculture4 ,v ,improvem5t ( m5tal heal? m$ical work=ce #eja4 ,/aff+ improvem5t plan = m5tal heal? provid]s ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,/aff+ plan 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,inspector ,g5]al ( ! ,dep>tm5t ( ,vet]ans ,affairs1 %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a plan to address /aff+ ( m5tal heal? provid]s ( ! ,dep>tm5t ( ,vet]ans ,affairs1 includ+ fill+ any op5 positions4 7#b7 ,elem5ts ,! plan requir$ by p>agraph 7#a7 %all include ! foll[+3 7,a7 ,an e/imate ( ! numb] ( positions = m5tal heal? provid]s ( ! ,dep>tm5t t ne$ to be fill$ to meet dem&4 7,b7 ,an id5tification ( ! /eps t ! ,secret>y w take to address m5tal heal? /aff+ = ! ,dep>tm5t4 7,c7 ,a description ( any region-specific hir+ inc5tives to be us$ by ! ,secret>y 9 consultation ) ! directors ( ,vet]ans ,integrat$ ,s]vice ,networks & m$ical c5t]s ( ! ,dep>tm5t4 7,d7 ,a description ( any local ret5tion or engagem5t inc5tives to be us$ by directors ( ,vet]ans ,integrat$ ,s]vice ,networks4 7,e7 ,su* recomm5dations = legislative or adm9i/rative action z ! ,secret>y consid]s necess>y to aid 9 address+ m5tal heal? /aff+ = ! ,dep>tm5t4 7#c7 ,report ,n lat] ?an "o ye> aft] ! submittal ( ! plan requir$ by p>agraph 7#a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report sett+ =? ! numb] ( m5tal heal? provid]s hir$ by ! ,dep>tm5t dur+ ! "o-ye> p]iod prec$+ ! submittal ( ! report4 7b7 ,occupational s]ies = c]ta9 m5tal heal? provid]s ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,(fice ( ,p]sonnel ,managem5t1 %all develop an occupational s]ies = lic5s$ pr(essional m5tal heal? c\nselors & m>riage & family !rapi/s ( ! ,dep>tm5t ( ,vet]ans ,affairs4 #ejb4 ,e/abli%m5t ( ,dep>tm5t ( ,vet]ans ,affairs ,readju/m5t ,c\nsel+ ,s]vice ,s*ol>%ip ,program 7a7 ,9 g5]al ,*apt] #gf ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ aft] sub*apt] ,,viii ! foll[+ new sub*apt]3 ,,ix ,readju/m5t ,c\nsel+ ,s]vice ,s*ol>%ip ,program #gfih4 ,requirem5t = program ,z "p ( ! ,educational ,assi/ance ,program1 ! ,secret>y %all c>ry out a s*ol>%ip program "u ?is sub*apt]4 ,! program %all be kn[n z ! ,dep>tm5t ( ,vet]ans ,affairs ,readju/m5t ,c\nsel+ ,s]vice ,s*ol>%ip ,program 79 ?is sub*apt] ref]r$ to z ! ,program74 #gfii4 ,eligibility2 agreem5t 7a7 ,9 g5]al ,an individual is eligible to p>ticipate 9 ! ,program1 z det]m9$ by ! ,readju/m5t ,c\nsel+ ,s]vice ( ! ,dep>tm5t1 if ! individual-- 7#a7 is accept$ = enrollm5t or enroll$ 7z describ$ 9 section #gfjb ( ?is title7 9 a program ( /udy at an accr$it$ educational in/itution1 s*ool1 or tra9+ program lead+ to a t]m9al degree 9 psy*ology1 social "w1 m>riage & family !rapy1 or m5tal heal? c\nsel+ t w\ld meet ! education requirem5ts = appo9tm5t to a position "u section #gdjb7;b7 ( ?is title2 & 7#b7 ent]s into an agreem5t ) ! ,secret>y "u subsection 7c74 7b7 ,priority ,9 select+ individuals to p>ticipate 9 ! ,program1 ! ,secret>y %all give priority to ! foll[+ individuals3 7#a7 ,an individual :o agrees to be employ$ by a ,vet ,c5t] locat$ 9 a community t is-- 7,a7 designat$ z a m$ically und]s]v$ population "u section #ccj7;b77#c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #bed;b7b77#c772 & 7,b7 9 a ,/ate ) a p] capita population ( vet]ans ( m ?an five p]c5t accord+ to ! ,national ,c5t] = ,vet]ans ,analysis & ,/ati/ics & ! ,bureau ( ! ,c5sus4 7#b7 ,an individual :o is a vet]an4 7c7 ,agreem5t ,an agreem5t betwe5 ! ,secret>y & a p>ticipant 9 ! ,program %all 79 addition to ! requirem5ts set =? 9 section #gfjd ( ?is title7 include ! foll[+3 7#a7 ,an agreem5t by ! ,secret>y to provide ! p>ticipant ) a s*ol>%ip "u ! ,program = a specifi$ numb] ( s*ool ye>s dur+ :i* ! p>ticipant pursues a program ( /udy describ$ 9 subsection 7a77#a7 t meets ! requirem5ts set =? 9 section #gfjb7;a7 ( ?is title4 7#b7 ,an agreem5t by ! p>ticipant to s]ve z a full-"t employee ( ! ,dep>tm5t at a ,vet ,c5t] = a six-ye> p]iod foll[+ ! completion by ! p>ticipant ( su* program ( /udy 79 ?is sub*apt] ref]r$ to z ! p]iod ( obligat$ s]vice74 7d7 ,vet c5t] def9$ ,9 ?is section1 ! t]m ,vet ,c5t] has ! mean+ giv5 t t]m 9 section #agab;,a7h7 ( ?is title4 #gfii;,a4 ,obligat$ s]vice 7a7 ,9 g5]al ,ea* p>ticipant 9 ! ,program %all provide s]vice z a full-"t employee ( ! ,dep>tm5t at a ,vet ,c5t] 7z def9$ 9 section #gfii7;d7 ( ?is title7 = ! p]iod ( obligat$ s]vice set =? 9 ! agreem5t ( ! p>ticipant ent]$ into "u section #gfjd ( ?is title4 7b7 ,det]m9ation ( s]vice comm5cem5t date 7#a7 ,n lat] ?an #fj days be=e ! s]vice comm5cem5t date ( a p>ticipant1 ! ,secret>y %all notify ! p>ticipant ( t s]vice comm5cem5t date4 7#b7 ,! date specifi$ 9 p>agraph 7#a7 ) respect to a p>ticipant is ! date = ! beg9n+ ( ! p]iod ( obligat$ s]vice ( ! p>ticipant4 #gfii;,b4 ,brea* ( agreem5t3 liability 7a7 ,liquidat$ damages 7#a7 ,a p>ticipant 9 ! ,program 7o!r ?an a p>ticipant describ$ 9 subsection 7b77 :o fails to accept paym5t1 or in/ructs ! educational in/itution 9 :i* ! p>ticipant is enroll$ n to accept paym5t1 9 :ole or 9 "p1 ( a s*ol>%ip "u ! agreem5t ent]$ into "u section #gfjd ( ?is title %all be liable to ! ,unit$ ,/ates = liquidat$ damages 9 ! am\nt ( #a1ejj4 7#b7 ,liability "u p>agraph 7#a7 is 9 addition to any p]iod ( obligat$ s]vice or o!r obligation or liability "u su* agreem5t4 7b7 ,liability dur+ program ( /udy 7#a7 ,except z provid$ 9 subsection 7d71 a p>ticipant 9 ! ,program %all be liable to ! ,unit$ ,/ates = ! am\nt :i* has be5 paid to or on behalf ( ! p>ticipant "u ! agreem5t if any ( ! foll[+ occurs3 7,a7 ,! p>ticipant fails to ma9ta9 an acceptable level ( academic /&+ 9 ! educational in/itution 9 :i* ! p>ticipant is enroll$ 7z det]m9$ by ! educational in/itution "u regulations prescrib$ by ! ,secret>y74 7,b7 ,! p>ticipant is dismiss$ f su* educational in/itution = discipl9>y reasons4 7,c7 ,! p>ticipant volunt>ily t]m9ates ! program ( /udy 9 su* educational in/itution be=e ! completion ( su* program ( /udy4 7#b7 ,liability "u ?is subsection is 9 lieu ( any s]vice obligation aris+ "u ! agreem5t4 7c7 ,liability dur+ p]iod ( obligat$ s]vice 7#a7 ,except z provid$ 9 subsection 7d71 if a p>ticipant 9 ! ,program does n complete ! p]iod ( obligat$ s]vice ( ! p>ticipant1 ! ,unit$ ,/ates %all be entitl$ to recov] f ! p>ticipant an am\nt det]m9$ 9 accordance ) ! foll[+ =mula3 ,a #c7ts_/t74 7#b7 ,9 ! =mula 9 p>agraph 7#a73 7,a7 ,a is ! am\nt ! ,unit$ ,/ates is entitl$ to recov]4 7,b7 is ! sum (-- 7i7 ! am\nts paid "u ?is sub*apt] to or on behalf ( ! p>ticipant2 & 7ii7 ! int]e/ on su* am\nts :i* w\ld be payable if at ! "t ! am\nts 7 paid !y 7 loans be>+ int]e/ at ! maximum legal prevail+ rate1 z det]m9$ by ! ,treasur] ( ! ,unit$ ,/ates4 7,c7 t is ! total numb] ( mon?s 9 ! p]iod ( obligat$ s]vice ( ! p>ticipant4 7,d7 s is ! numb] ( mon?s ( su* p]iod s]v$ by ! p>ticipant4 7d7 ,limitation on liability = r$uctions-9-=ce ,liability %all n arise "u subsection 7c7 if ! p>ticipant fails to ma9ta9 employm5t z a ,dep>tm5t employee due to a /aff+ adju/m5t4 7e7 ,p]iod = paym5t ( damages ,any am\nt ( damages t ! ,unit$ ,/ates is entitl$ to recov] "u ?is section %all be paid to ! ,unit$ ,/ates )9 ! "o-ye> p]iod beg9n+ on ! date ( ! brea* ( ! agreem5t4 4 7b7 ,con=m+ & te*nical am5dm5ts 7#a7 ,con=m+ am5dm5ts 7,a7 ,e/abli%m5t ( program ,section #gfja7;a7 ( su* title is am5d$-- 7i7 9 p>agraph 7#e71 by /rik+ &2 7ii7 9 p>agraph 7#f71 by /rik+ ! p]iod & ins]t+ 2 &2 & 7iii7 by add+ at ! end ! foll[+ new p>agraph3 7#g7 ! readju/m5t c\nsel+ s]vice s*ol>%ip program provid$ = 9 sub*apt] ,,ix ( ?is *apt]4 4 7,b7 ,eligibility ,section #gfjb ( su* title is am5d$-- 7i7 9 subsection 7a77#a7-- 7,i7 by /rik+ or ,,vi & ins]t+ ,,vi1 or ,,ix2 & 7,,ii7 by /rik+ sub*apt] ,,vi & ins]t+ sub*apt] ,,vi or ,,ix2 & 7ii7 9 subsection 7b71 by /rik+ or ,,vi & ins]t+ ,,vi1 or ,,ix4 7,c7 ,application ,section #gfjc7;a77#a7 ( su* title is am5d$ by /rik+ or ,,viii & ins]t+ ,,viii1 or ,,ix4 7,d7 ,t]ms ( agreem5t ,section #gfjd ( su* title is am5d$ by /rik+ or ,,viii ea* place x appe>s & ins]t+ ,,viii1 or ,,ix4 7,e7 ,annual report ,section #gfcb ( su* title is am5d$-- 7i7 9 p>agraph 7#a71 by /rik+ & ! ,specialty ,education ,loan ,repaym5t ,program & ins]t+ ! ,specialty ,education ,loan ,repaym5t ,program1 & ! ,readju/m5t ,c\nsel+ ,s]vice ,s*ol>%ip ,program2 & 7ii7 9 p>agraph 7#d71 by /rik+ & p] p>ticipant 9 ! ,specialty ,education ,loan ,repaym5t ,program & ins]t+ p] p>ticipant 9 ! ,specialty ,education ,loan ,repaym5t ,program1 & p] p>ticipant 9 ! ,readju/m5t ,c\nsel+ ,s]vice ,s*ol>%ip ,program4 7#b7 ,table ( sections ,! table ( sections at ! beg9n+ ( *apt] #gf ( su* title is am5d$ by ins]t+ aft] ! items relat+ to sub*apt] ,,viii ! foll[+3 ,,sub*apt] ,,ix--,readju/m5t ,c\nsel+ ,s]vice ,s*ol>%ip ,program ,sec4 #gfih4 ,requirem5t = program4 #gfii4 ,eligibility2 agreem5t4 #gfii;,a4 ,obligat$ s]vice4 #gfii;,b4 ,brea* ( agreem5t3 liability4 4 7c7 ,effective date ,! ,secret>y ( ,vet]ans ,affairs %all beg9 aw>d+ s*ol>%ips "u sub*apt] ,,ix ( *apt] #gf ( title #ch1 ,unit$ ,/ates ,code1 z add$ by subsection 7a71 = programs ( /udy beg9n+ n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act4 #ejc4 ,comptroll] ,g5]al report on ,readju/m5t ,c\nsel+ ,s]vice ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! ,readju/m5t ,c\nsel+ ,s]vice ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7b7 ,elem5ts ,! report requir$ by subsection 7a7 %all include ! foll[+3 7#a7 ,an assessm5t ( ! adequacy & types ( treatm5t1 c\nsel+1 & o!r s]vices provid$ at ,vet ,c5t]s1 includ+ recomm5dations on :e!r & h[ su* treatm5t1 c\nsel+1 & o!r s]vices c be exp&$4 7#b7 ,an assessm5t ( ! efficacy ( outrea* ef=ts by ! ,readju/m5t ,c\nsel+ ,s]vice1 includ+ recomm5dations = h[ outrea* ef=ts c be improv$4 7#c7 ,an assessm5t ( b>ri]s to c>e at ,vet ,c5t]s1 includ+ recomm5dations = ov]com+ ^? b>ri]s4 7#d7 ,an assessm5t ( ! efficacy & frequ5cy ( ! use ( teleheal? by c\nselors ( ! ,readju/m5t ,c\nsel+ ,s]vice to provide m5tal heal? s]vices1 includ+ recomm5dations = h[ ! use ( teleheal? c be improv$4 7#e7 ,an assessm5t ( ! feasibility & advisability ( exp&+ eligibility = s]vices f ! ,readju/m5t ,c\nsel+ ,s]vice1 includ+-- 7,a7 recomm5dations on :at eligibility crit]ia c\ld be exp&$2 & 7,b7 an assessm5t ( pot5tial co/s & increas$ infra/ructure requirem5ts if eligibility is exp&$4 7#f7 ,an assessm5t ( ! use ( ,vet ,c5t]s by memb]s ( ! res]ve compon5ts ( ! ,arm$ ,=ces :o 7 nev] activat$ & recomm5dations on h[ to bett] rea* ^? memb]s4 7#g7 ,an assessm5t ( ! use ( ,vet ,c5t]s by eligible family memb]s ( =m] memb]s ( ! ,arm$ ,=ces & recomm5dations on h[ to bett] rea* ^? family memb]s4 7#h7 ,an assessm5t ( ! efficacy ( gr\p !rapy & ! level ( tra9+ ( provid]s at ,vet ,c5t]s 9 adm9i/]+ gr\p !rapy4 7#i7 ,an assessm5t ( ! effici5cy & effectiv5ess ( ! task organization /ructure ( ,vet ,c5t]s4 7#aj7 ,an assessm5t ( ! use ( ,vet ,c5t]s by ,native ,am]ican vet]ans1 z def9$ 9 section #cgfe ( title #ch1 ,unit$ ,/ates ,code1 & recomm5dations on h[ to bett] rea* ^? vet]ans4 7c7 ,vet c5t] def9$ ,9 ?is section1 ! t]m ,vet ,c5t] has ! mean+ giv5 t t]m 9 section #agab;,a7h7 ( title #ch1 ,unit$ ,/ates ,code4 #ejd4 ,expansion ( report+ requirem5ts on ,readju/m5t ,c\nsel+ ,s]vice ( ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,expansion ( annual report ,p>agraph 7#b77;,c7 ( section #gcji7;e7 ( title #ch1 ,unit$ ,/ates ,code1 is am5d$ by ins]t+ be=e ! p]iod at ! end ! foll[+3 1 includ+ ! res\rces requir$ to meet su* unmet ne$1 su* z additional /aff1 additional locations1 additional infra/ructure1 infra/ructure improvem5ts1 & additional mobile ,vet ,c5t]s4 7b7 ,bi5nial report ,su* section is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#c7 ,= ea* ev5 numb]$ ye> 9 :i* ! report requir$ by p>agraph 7#a7 is submitt$1 ! ,secret>y %all include 9 su* report a pr$iction (-- 7,a7 tr5ds 9 dem& = c>e2 7,b7 long-t]m inve/m5ts requir$ ) respect to ! provision ( c>e2 7,c7 requirem5ts relat+ to ma9t5ance ( infra/ructure2 & 7,d7 o!r capital inve/m5t requirem5ts ) respect to ! ,readju/m5t ,c\nsel+ ,s]vice1 includ+ ,vet ,c5t]s1 mobile ,vet ,c5t]s1 & community access po9ts4 4 #eje4 ,brief+ on alt]native "w s*$ules = employees ( ,vet]ans ,heal? ,adm9i/ration 7a7 ,survey ( vet]ans 7#a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all conduct a survey on ! attitudes ( eligible vet]ans t[>d ! ,dep>tm5t ( ,vet]ans ,affairs (f]+ appo9tm5ts outside ! usual op]at+ h\rs ( facilities ( ! ,dep>tm5t1 includ+ ?r\gh ! use ( teleheal? appo9tm5ts4 7#b7 ,eligible vet]an def9$ ,9 ?is subsection1 ! t]m eligible vet]an means a vet]an :o-- 7,a7 is enroll$ 9 ! pati5t enrollm5t sy/em ( ! ,dep>tm5t "u section #agje7;a7 ( title #ch1 ,unit$ ,/ates ,code2 & 7,b7 receiv$ heal? c>e f ! ,dep>tm5t at lea/ once dur+ ! two-ye> p]iod end+ on ! date ( ! comm5cem5t ( ! survey "u p>agraph 7#a74 7b7 ,congressional brief+ 7#a7 ,9 g5]al ,n lat] ?an #bgj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all brief ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives on !-- 7,a7 feasibility & advisability ( (f]+ appo9tm5ts outside ! usual op]at+ h\rs ( facilities ( ! ,dep>tm5t t d n (f] su* appo9tm5ts2 & 7,b7 effectiv5ess ( (f]+ appo9tm5ts outside ! usual op]at+ h\rs ( facilities ( ! ,dep>tm5t = ^? facilities t (f] su* appo9tm5ts4 7#b7 ,elem5ts ,! brief+ requir$ by p>agraph 7#a7 %all include ! foll[+3 7,a7 ,! f9d+s ( ! survey conduct$ "u subsection 7a72 7,b7 ,fe$back f employees ( ! ,vet]ans ,heal? ,adm9i/ration1 includ+ cl9ical1 noncl9ical1 & support /aff1 ) respect to (f]+ appo9tm5ts outside ! usual op]at+ h\rs ( facilities ( ! ,dep>tm5t1 includ+ ?r\gh ! use ( teleheal? appo9tm5ts2 & 7,c7 ,any o!r matt]s ! ,secret>y consid]s relevant to a full und]/&+ ( ! feasibility & advisability ( (f]+ appo9tm5ts outside ! usual op]at+ h\rs ( facilities ( ! ,dep>tm5t4 7c7 ,pap]work ,r$uction ,act exemption ,*apt] #ce ( title #dd1 ,unit$ ,/ates ,code 7commonly kn[n z ! ,pap]work ,r$uction ,act7 %all n apply to any rulemak+ or in=mation collection requir$ "u ?is section4 #ejf4 ,suicide prev5tion coord9ators 7a7 ,/aff+ requirem5t ,beg9n+ n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all ensure t ea* m$ical c5t] ( ! ,dep>tm5t ( ,vet]ans ,affairs has n less ?an "o suicide prev5tion coord9ator4 7b7 ,/udy on reorganization 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y1 9 consultation ) ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion ( ! ,dep>tm5t1 %all comm5ce ! conduct ( a /udy to det]m9e ! feasibility & advisability (-- 7,a7 ! realignm5t & reorganization ( suicide prev5tion coord9ators )9 ! ,(fice ( ,m5tal ,heal? & ,suicide ,prev5tion2 & 7,b7 ! creation ( a suicide prev5tion coord9ator program (fice4 7#b7 ,program (fice realignm5t ,9 conduct+ ! /udy "u p>agraph 7#a71 ! ,secret>y %all assess ! feasibility ( advisability (1 )9 ! suicide prev5tion coord9ator program (fice describ$ 9 p>agraph 7#a77;,b71 align+ suicide prev5tion coord9ators & suicide prev5tion case manag]s )9 ! organizational /ructure & *>t ( ! ,suicide ,prev5tion ,program ( ! ,dep>tm5t1 ) ! ,director ( ! ,suicide ,prev5tion program hav+ ultimate sup]visory ov]sight & responsibility ov] ! suicide prev5tion coord9ator program (fice4 7c7 ,report ,n lat] ?an #ij days aft] ! completion ( ! /udy "u subsection 7b71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on su* /udy1 includ+ ! foll[+3 7#a7 ,an assessm5t ( ! feasibility & advisability ( creat+ a suicide prev5tion coord9ator program (fice to ov]see & monitor suicide prev5tion coord9ators & suicide prev5tion case manag]s across all m$ical c5t]s ( ! ,dep>tm5t4 7#b7 ,a review ( curr5t /aff+ ratios = suicide prev5tion coord9ators & suicide prev5tion case manag]s 9 comp>ison ) curr5t /aff+ ratios = m5tal heal? provid]s )9 ea* m$ical c5t] ( ! ,dep>tm5t4 7#c7 ,a description ( ! duties & responsibilities = suicide prev5tion coord9ators across ! ,dep>tm5t to bett] def9e1 del9eate1 & /&>dize qualifications1 p]=mance goals1 p]=mance duties1 & p]=mance outcomes = suicide prev5tion coord9ators & suicide prev5tion case manag]s4 #ejg4 ,report on ef=ts by ,dep>tm5t ( ,vet]ans ,affairs to implem5t safety plann+ 9 em]g5cy dep>tm5ts 7a7 ,f9d+s ,congress makes ! foll[+ f9d+s3 7#a7 ,! ,dep>tm5t ( ,vet]ans ,affairs mu/ be m effective 9 its approa* to r$uc+ ! burd5 ( vet]an suicide connect$ to m5tal heal? diagnoses1 to include expansion ( treatm5t deliv]$ via teleheal? me?ods & 9 rural areas4 7#b7 ,an innovative project1 kn[n z ,suicide ,assessm5t & ,foll[-up ,engagem5t3 ,vet]an ,em]g5cy ,treatm5t 79 ?is subsection ref]r$ to z ,,safe ,,vet71 0 design$ to help suicidal vet]ans se5 at em]g5cy dep>tm5ts )9 ! ,vet]ans ,heal? ,adm9i/ration & 0 successfully implem5t$ 9 five int]v5tion sites beg9n+ 9 #bjaj4 7#c7 ,a #bjah /udy f\nd t safety plann+ int]v5tion "u ,,safe ,,vet 0 associat$ ) #de p]c5t few] suicidal behaviors 9 ! six-mon? p]iod foll[+ em]g5cy dep>tm5t c>e & m ?an d\ble ! odds ( a vet]an engag+ 9 outpati5t behavioral heal? c>e4 7#d7 ,,safe ,,vet is a promis+ alt]native & acceptable deliv]y ( c>e sy/em t augm5ts ! treatm5t ( suicidal vet]ans 9 em]g5cy dep>tm5ts ( ! ,vet]ans ,heal? ,adm9i/ration & helps ensure t ^? vet]ans h appropriate foll[-up c>e4 7#e7 ,beg9n+ 9 ,septemb] #bjah1 ! ,vet]ans ,heal? ,adm9i/ration implem5t$ a suicide prev5tion program1 kn[n z ! ,,sp$ program1 = vet]ans pres5t+ to ! em]g5cy dep>tm5t :o are assess$ to be at risk = suicide & are safe to be dis*>g$ home4 7#f7 ,! ,,sp$ program includes issuance & update ( a safety plan & po/-dis*>ge foll[-up outrea* = vet]ans to facilitate engagem5t 9 outpati5t m5tal heal? c>e4 7b7 ,report 7#a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all submit to ! appropriate committees ( ,congress a report on ! ef=ts ( ! ,secret>y to implem5t a suicide prev5tion program = vet]ans pres5t+ to an em]g5cy dep>tm5t or urg5t c>e c5t] ( ! ,vet]ans ,heal? ,adm9i/ration :o are assess$ to be at risk = suicide & are safe to be dis*>g$ home1 includ+ a safety plan & po/-dis*>ge outrea* = vet]ans to facilitate engagem5t 9 outpati5t m5tal heal? c>e4 7#b7 ,elem5ts ,! report requir$ by p>agraph 7#a7 %all include ! foll[+3 7,a7 ,an assessm5t ( ! implem5tation ( ! curr5t op]ational policies & proc$ures ( ! ,,sp$ program at ea* m$ical c5t] ( ! ,dep>tm5t ( ,vet]ans ,affairs1 includ+ an assessm5t ( ! foll[+3 7i7 ,tra9+ provid$ to cl9icians or o!r p]sonnel adm9i/]+ protocols "u ! ,,sp$ program4 7ii7 ,any disp>ities 9 implem5tation ( su* protocols betwe5 m$ical c5t]s4 7iii7 ,curr5t crit]ia us$ to measure ! quality ( su* protocols includ+-- 7,i7 me?odology us$ to assess ! quality ( a safety plan & po/-dis*>ge outrea* = vet]ans2 or 7,,ii7 9 ! abs5ce ( su* me?odology1 a propos$ timel9e & guidel9es = creat+ a me?odology to ensure compliance ) ! evid5ce-bas$ model us$ "u ! ,suicide ,assessm5t & ,foll[-up ,engagem5t3 ,vet]an ,em]g5cy ,treatm5t 7,,safe ,,vet7 program ( ! ,dep>tm5t4 7,b7 ,an assessm5t ( ! implem5tation ( ! policies & proc$ures describ$ 9 subp>agraph 7,a71 includ+ ! foll[+3 7i7 ,an assessm5t ( ! quality & quantity ( safety plans issu$ to vet]ans4 7ii7 ,an assessm5t ( ! quality & quantity ( po/-dis*>ge outrea* provid$ to vet]ans4 7iii7 ,! po/-dis*>ge rate ( vet]an engagem5t 9 outpati5t m5tal heal? c>e1 includ+ att5dance at n few] ?an "o individual m5tal heal? cl9ic appo9tm5t or admission to an inpati5t or resid5tial unit4 7iv7 ,! numb] ( vet]ans :o decl9e safety plann+ ef=ts dur+ protocols "u ! ,,sp$ program4 7v7 ,! numb] ( vet]ans :o decl9e to p>ticipate 9 foll[-up ef=ts )9 ! ,,sp$ program4 7,c7 ,a description ( h[ ,,sp$ prim>y coord9ators are deploy$ to support su* ef=ts1 includ+ ! foll[+3 7i7 ,a description ( ! duties & responsibilities ( su* coord9ators4 7ii7 ,! numb] & location ( su* coord9ators4 7iii7 ,a description ( tra9+ provid$ to su* coord9ators4 7iv7 ,an assessm5t ( ! o!r responsibilities = su* coord9ators &1 if applicable1 diff]5ces 9 pati5t outcomes :5 su* responsibilities are full-"t duties z oppos$ to second>y duties4 7,d7 ,an assessm5t ( ! feasibility & advisability ( exp&+ ! total numb] & geographic di/ribution ( ,,sp$ prim>y coord9ators4 7,e7 ,an assessm5t ( ! feasibility & advisability ( provid+ s]vices "u ! ,,sp$ program via teleheal? *annels1 includ+ an analysis ( opportunities to lev]age teleheal? to bett] s]ve vet]ans 9 rural areas4 7,f7 ,a description ( ! /atus ( curr5t capabilities & utilization ( track+ me*anisms to monitor compliance1 quality1 & pati5t outcomes "u ! ,,sp$ program4 7,g7 ,su* recomm5dations1 includ+ specific action items1 z ! ,secret>y consid]s appropriate ) respect to h[ ! ,dep>tm5t c bett] implem5t ! ,,sp$ program1 includ+ recomm5dations ) respect to ! foll[+3 7i7 ,a process to /&>dize tra9+ "u su* program4 7ii7 ,any res\rc+ requirem5ts necess>y to implem5t ! ,,sp$ program ?r\gh\t ,vet]ans ,heal? ,adm9i/ration1 includ+ by hav+ a d$icat$ cl9ician responsible = adm9i/ration ( su* program at ea* m$ical c5t]4 7iii7 ,an analysis ( curr5t /atutory au?ority & any *anges necess>y to fully implem5t ! ,,sp$ program ?r\gh\t ! ,vet]ans ,heal? ,adm9i/ration4 7iv7 ,a timel9e = ! implem5tation ( ! ,,sp$ program ?r\gh ! ,vet]ans ,heal? ,adm9i/ration once full res\rc+ & an approv$ tra9+ plan are 9 place4 7,h7 ,su* o!r matt]s z ! ,secret>y consid]s appropriate4 7c7 ,def9itions ,9 ?is section3 7#a7 ,appropriate committees ( congress ,! t]m appropriate committees ( ,congress means-- 7,a7 ! ,committee on ,vet]ans' ,affairs & ! ,subcommittee on ,milit>y ,con/ruction1 ,vet]ans ,affairs1 & ,relat$ ,ag5cies ( ! ,committee on ,appropriations ( ! ,s5ate2 & 7,b7 ! ,committee on ,vet]ans' ,affairs & ! ,subcommittee on ,milit>y ,con/ruction1 ,vet]ans ,affairs1 & ,relat$ ,ag5cies ( ! ,committee on ,appropriations ( ! ,h\se ( ,repres5tatives4 7#b7 ,,sp$ prim>y coord9ator ,! t]m ,,sp$ prim>y coord9ator means ! ma9 po9t ( contact responsible = adm9i/]+ ! ,,sp$ program at a m$ical c5t] ( ! ,dep>tm5t4 7#c7 ,,sp$ program ,! t]m ,,sp$ program means ! ,safety ,plann+ 9 ,em]g5cy ,dep>tm5ts program ( ! ,dep>tm5t ( ,vet]ans ,affairs e/abli%$ 9 ,septemb] #bjah = vet]ans pres5t+ to ! em]g5cy dep>tm5t :o are assess$ to be at risk = suicide & are safe to be dis*>g$ home1 :i* ext5ds ! evid5ce-bas$ int]v5tion = suicide prev5tion to all em]g5cy dep>tm5ts ( ! ,vet]ans ,heal? ,adm9i/ration4 ,,vi ,improvem5t ( c>e & s]vices = wom5 vet]ans #fja4 ,expansion ( capabilities ( ,wom5 ,vet]ans ,call ,c5t] to include text messag+ ,! ,secret>y ( ,vet]ans ,affairs %all exp& ! capabilities ( ! ,wom5 ,vet]ans ,call ,c5t] ( ! ,dep>tm5t ( ,vet]ans ,affairs to include a text messag+ capability4 #fjb4 ,requirem5t = ,dep>tm5t ( ,vet]ans ,affairs int]net website to provide in=mation on s]vices available to wom5 vet]ans 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all survey ! int]net websites & in=mation res\rces ( ! ,dep>tm5t ( ,vet]ans ,affairs 9 effect on ! day be=e ! date ( ! enactm5t ( ?is ,act & publi% an int]net website t s]ves z a c5traliz$ s\rce = ! provision to wom5 vet]ans ( in=mation ab\t ! b5efits & s]vices available to !m "u laws adm9i/]$ by ! ,secret>y4 7b7 ,elem5ts ,! int]net website publi%$ "u subsection 7a7 %all provide to wom5 vet]ans in=mation reg>d+ all s]vices available 9 ! di/rict 9 :i* ! vet]an is seek+ su* s]vices1 includ+1 ) respect to ea* m$ical c5t] & community-bas$ outpati5t cl9ic 9 ! applicable ,vet]ans ,integrat$ ,s]vice ,network-- 7#a7 ! "n & contact in=mation ( ea* wom5's heal? coord9ator2 7#b7 a li/ ( appropriate /aff = o!r b5efits available f ! ,vet]ans ,b5efits ,adm9i/ration1 ! ,national ,cemet]y ,adm9i/ration1 & su* o!r entities z ! ,secret>y consid]s appropriate2 & 7#c7 su* o!r in=mation z ! ,secret>y consid]s appropriate4 7c7 ,updat$ in=mation ,! ,secret>y %all ensure t ! in=mation describ$ 9 subsection 7b7 t is publi%$ on ! int]net website requir$ by subsection 7a7 is updat$ n less frequ5tly ?an once e #ij days4 7d7 ,outrea* ,9 c>ry+ out ?is section1 ! ,secret>y %all ensure t ! outrea* conduct$ "u section #agbj;,f7i7 ( title #ch1 ,unit$ ,/ates ,code1 includes in=mation reg>d+ ! int]net website requir$ by subsection 7a74 7e7 ,d]ivation ( funds ,am\nts us$ by ! ,secret>y to c>ry out ?is section %all be d]iv$ f am\nts made available to ! ,secret>y to publi% int]net websites ( ! ,dep>tm5t4 ,,vii ,o!r matt]s #gja4 ,exp&$ teleheal? f ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,! ,secret>y ( ,vet]ans ,affairs %all ent] into agreem5ts1 & exp& exi/+ agreem5ts1 ) organizations t repres5t or s]ve vet]ans1 nonpr(it organizations1 private bus9esses1 & o!r int]e/$ p>ties = ! expansion ( teleheal? capabilities & ! provision ( teleheal? s]vices to vet]ans ?r\gh ! aw>d ( grants "u subsection 7b74 7b7 ,aw>d ( grants 7#a7 ,9 g5]al ,9 c>ry+ out agreem5ts ent]$ into or exp&$ "u ?is section ) entities describ$ 9 subsection 7a71 ! ,secret>y %all aw>d grants to ^? entities4 7#b7 ,locations ,to ! ext5t practicable1 ! ,secret>y %all ensure t grants are aw>d$ to entities t s]ve vet]ans 9 rural & highly rural areas 7z det]m9$ ?r\gh ! use ( ! ,rural-,urban ,commut+ ,areas cod+ sy/em ( ! ,dep>tm5t ( ,agriculture7 or areas det]m9$ to be m$ically und]s]v$4 7#c7 ,use ( grants 7,a7 ,9 g5]al ,grants aw>d$ to an entity "u ?is subsection may be us$ = "o or m ( ! foll[+3 7i7 ,pur*as+1 replac+ or upgrad+ h>dw>e or s(tw>e necess>y = ! provision ( secure & private teleheal? s]vices4 7ii7 ,upgrad+ security protocols = consi/5cy ) ! security requirem5ts ( ! ,dep>tm5t ( ,vet]ans ,affairs4 7iii7 ,tra9+ ( site att5dants1 includ+ paym5t ( ^? att5dants = complet+ t tra9+1 ) respect to-- 7,i7 milit>y & vet]an cultural compet5ce1 if ! entity is n an organization t repres5ts vet]ans2 7,,ii7 equipm5t requir$ to provide teleheal? s]vices2 7,,iii7 privacy1 includ+ ! ,heal? ,insurance ,portability & ,acc\ntability ,act ( #aiif privacy rule "u "p #afj & subp>ts ,a & ,e ( "p #afd ( title #de1 ,code ( ,f$]al ,regulations1 or successor regulations1 z x relates to heal? c>e = vet]ans2 7,,iv7 s*$ul+ = teleheal? s]vices = vet]ans2 or 7,v7 any o!r unique tra9+ ne$s = ! provision ( teleheal? s]vices to vet]ans4 7iv7 ,upgrad+ exi/+ infra/ructure own$ or leas$ by ! entity to make rooms m conducive to teleheal? c>e1 includ+-- 7,i7 additions or modifications to w9d[s or walls 9 an exi/+ room1 or o!r alt]ations z ne$$ to create a new1 private room1 includ+ p]mits or inspections requir$ 9 association ) space modifications2 7,,ii7 s\ndpro(+ ( an exi/+ room2 7,,iii7 new electrical1 telephone1 or int]net outlets 9 an exi/+ room2 or 7,,iv7 ae/hetic enhancem5ts to e/abli% a m suitable !rapeutic environm5t4 7v7 ,upgrad+ exi/+ infra/ructure to comply ) ! ,am]icans ) ,disabilities ,act ( #aiij 7#db ,u4,s4,c4 #abaja et seq474 7vi7 ,upgrad+ int]net infra/ructure & su/a9m5t ( int]net s]vices4 7vii7 ,su/a9m5t ( telephone s]vices4 7,b7 ,exclusion ,grants may n be us$ = ! pur*ase ( new prop]ty or = major con/ruction projects1 z det]m9$ by ! ,secret>y4 7c7 ,agreem5t on teleheal? access po9ts 7#a7 ,9 g5]al ,an entity describ$ 9 subsection 7a7 t seeks to e/abli% a teleheal? access po9t = vet]ans b does n require grant fund+ "u ?is section to d s may ent] into an agreem5t ) ! ,dep>tm5t = ! e/abli%m5t ( su* an access po9t4 7#b7 ,adequacy ( facilities ,an entity describ$ 9 p>agraph 7#a7 %all be responsible = ensur+ t any access po9t is adequately private1 secure1 clean1 & accessible = vet]ans be=e ! access po9t is e/abli%$4 7d7 ,assessm5t ( b>ri]s to access 7#a7 ,9 g5]al ,n lat] ?an #ah mon?s aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all complete an assessm5t ( b>ri]s fac$ by vet]ans 9 access+ teleheal? s]vices4 7#b7 ,elem5ts ,! assessm5t requir$ by p>agraph 7#a7 %all include ! foll[+3 7,a7 ,a description ( ! b>ri]s vet]ans face 9 us+ teleheal? :ile n on prop]ty ( ! ,dep>tm5t4 7,b7 ,a description ( h[ ! ,dep>tm5t plans to address ! b>ri]s describ$ 9 subp>agraph 7,a74 7,c7 ,su* o!r matt]s relat$ to access by vet]ans to teleheal? :ile n on prop]ty ( ! ,dep>tm5t z ! ,secret>y consid]s relevant4 7#c7 ,report ,n lat] ?an #abj days aft] ! completion ( ! assessm5t requir$ by p>agraph 7#a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! assessm5t1 includ+ any recomm5dations = legislative or adm9i/rative action bas$ on ! results ( ! assessm5t4 #gjb4 ,p>tn]%ips ) non-,f$]al ,gov]nm5t entities to provide hyp]b>ic oxyg5 !rapy to vet]ans & /udies on ! use ( su* !rapy = treatm5t ( po/-traumatic /ress disord] & traumatic bra9 injury 7a7 ,p>tn]%ips to provide hyp]b>ic oxyg5 !rapy to vet]ans 7#a7 ,use ( p>tn]%ips ,! ,secret>y ( ,vet]ans ,affairs1 9 consultation ) ! ,c5t] = ,compassionate ,innovation )9 ! ,(fice ( ,community ,engagem5t ( ! ,dep>tm5t ( ,vet]ans ,affairs1 may ent] into p>tn]%ips ) non-,f$]al ,gov]nm5t entities to provide hyp]b>ic oxyg5 treatm5t to vet]ans to rese>* ! effectiv5ess ( su* !rapy4 7#b7 ,types ( p>tn]%ips ,p>tn]%ips ent]$ into "u p>agraph 7#a7 may include ! foll[+3 7,a7 ,p>tn]%ips to conduct rese>* on hyp]b>ic oxyg5 !rapy4 7,b7 ,p>tn]%ips to review rese>* on hyp]b>ic oxyg5 !rapy provid$ to nonvet]ans4 7,c7 ,p>tn]%ips to create indu/ry work+ gr\ps to det]m9e /&>ds = rese>* on hyp]b>ic oxyg5 !rapy4 7,d7 ,p>tn]%ips to provide to vet]ans hyp]b>ic oxyg5 !rapy = ! purposes ( conduct+ rese>* on ! effectiv5ess ( su* !rapy4 7#c7 ,limitation on ,f$]al fund+ ,f$]al ,gov]nm5t fund+ may be us$ to coord9ate & adm9i/] ! p>tn]%ips "u ?is subsection b may n be us$ to c>ry out activities conduct$ "u su* p>tn]%ips4 7b7 ,review ( effectiv5ess ( hyp]b>ic oxyg5 !rapy ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y1 9 consultation ) ! ,c5t] = ,compassionate ,innovation1 %all beg9 us+ an objective & quantifiable me?od to review ! effectiv5ess & applicability ( hyp]b>ic oxyg5 !rapy1 su* z ?r\gh ! use ( a device approv$ or cle>$ by ! ,food & ,drug ,adm9i/ration t assesses traumatic bra9 injury by track+ eye movem5t4 7c7 ,sy/ematic review ( use ( hyp]b>ic oxyg5 !rapy to treat c]ta9 conditions 7#a7 ,9 g5]al ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y1 9 consultation ) ! ,c5t] = ,compassionate ,innovation1 %all comm5ce ! conduct ( a sy/ematic review ( publi%$ rese>* lit]ature on (f-label use ( hyp]b>ic oxyg5 !rapy to treat po/-traumatic /ress disord] & traumatic bra9 injury among vet]ans & nonvet]ans4 7#b7 ,elem5ts ,! review conduct$ "u p>agraph 7#a7 %all include ! foll[+3 7,a7 ,an assessm5t ( ! curr5t p>amet]s = rese>* on ! use by ! ,dep>tm5t ( ,vet]ans ,affairs ( hyp]b>ic oxyg5 !rapy1 includ+-- 7i7 te/s & que/ionnaires us$ to det]m9e ! efficacy ( su* !rapy2 & 7ii7 metrics = det]m9+ ! success ( su* !rapy4 7,b7 ,a comp>ative analysis ( te/s & que/ionnaires us$ to /udy po/-traumatic /ress disord] & traumatic bra9 injury 9 o!r rese>* conduct$ by ! ,dep>tm5t ( ,vet]ans ,affairs1 o!r ,f$]al ag5cies1 & entities outside ! ,f$]al ,gov]nm5t4 7#c7 ,completion ( review ,! review conduct$ "u p>agraph 7#a7 %all be complet$ n lat] ?an #ahj days aft] ! date ( ! comm5cem5t ( ! review4 7#d7 ,report ,n lat] ?an #ij days aft] ! completion ( ! review conduct$ "u p>agraph 7#a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! results ( ! review4 7d7 ,foll[-up /udy 7#a7 ,9 g5]al ,n lat] ?an #abj days aft] ! completion ( ! review conduct$ "u subsection 7c71 ! ,secret>y1 9 consultation ) ! ,c5t] = ,compassionate ,innovation1 %all comm5ce ! conduct ( a /udy on all individuals receiv+ hyp]b>ic oxyg5 !rapy ?r\gh ! curr5t pilot program ( ! ,dep>tm5t = ! provision ( hyp]b>ic oxyg5 !rapy to vet]ans to det]m9e ! efficacy & effectiv5ess ( hyp]b>ic oxyg5 !rapy = ! treatm5t ( po/-traumatic /ress disord] & traumatic bra9 injury4 7#b7 ,elem5ts ,! /udy conduct$ "u p>agraph 7#a7 %all include ! review & publication ( any data & conclusions result+ f rese>* conduct$ by an au?oriz$ provid] ( hyp]b>ic oxyg5 !rapy = vet]ans ?r\gh ! pilot program describ$ 9 su* p>agraph4 7#c7 ,completion ( /udy ,! /udy conduct$ "u p>agraph 7#a7 %all be complet$ n lat] ?an ?ree ye>s aft] ! date ( ! comm5cem5t ( ! /udy4 7#d7 ,report 7,a7 ,9 g5]al ,n lat] ?an #ij days aft] complet+ ! /udy conduct$ "u p>agraph 7#a71 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! results ( ! /udy4 7,b7 ,elem5ts ,! report requir$ "u subp>agraph 7,a7 %all include ! recomm5dation ( ! ,secret>y ) respect to :e!r or n hyp]b>ic oxyg5 !rapy %\ld be made available to all vet]ans ) traumatic bra9 injury or po/-traumatic /ress disord]4 #gjc4 ,prescription ( te*nical qualifications = lic5s$ he>+ aid speciali/s & requirem5t = appo9tm5t ( su* speciali/s 7a7 ,te*nical qualifications 7#a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all prescribe ! te*nical qualifications requir$ "u section #gdjb7;b77#ad7 ( title #ch1 ,unit$ ,/ates ,code1 to be appo9t$ z a lic5s$ he>+ aid speciali/ "u section #gdja7c7 ( su* title4 7#b7 ,elem5ts = qualifications ,9 prescrib+ ! qualifications = lic5s$ he>+ aid speciali/s "u p>agraph 7#a71 ! ,secret>y %all1 at a m9imum1 ensure t su* qualifications are consi/5t )-- 7,a7 ! /&>ds = lic5sure ( he>+ aid speciali/s t are requir$ by a majority ( ,/ates2 7,b7 any compet5cies ne$$ to p]=m tasks & s]vices commonly p]=m$ by he>+ aid speciali/s pursuant to su* /&>ds2 & 7,c7 any compet5cies ne$$ to p]=m tasks specific to provid+ c>e to individuals "u ! laws adm9i/]$ by ! ,secret>y4 7b7 ,au?ority to set & ma9ta9 duties ,! ,secret>y %all reta9 ! au?ority to set & ma9ta9 ! duties = lic5s$ he>+ aid speciali/s appo9t$ "u section #gdja7c7 ( title #ch1 ,unit$ ,/ates ,code1 = ! purposes ( ! employm5t ( su* speciali/s ) ! ,dep>tm5t ( ,vet]ans ,affairs4 7c7 ,appo9tm5t ,n lat] ?an ,septemb] #cj1 #bjbb1 ! ,secret>y %all appo9t n few] ?an "o lic5s$ he>+ aid speciali/ at ea* m$ical c5t] ( ! ,dep>tm5t4 7d7 ,report ,n lat] ?an ,septemb] #cj1 #bjbb1 & annually !reaft]1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report-- 7#a7 assess+ ! progress ( ! ,secret>y 9 appo9t+ lic5s$ he>+ aid speciali/s "u subsection 7c72 7#b7 assess+ pot5tial conflicts or ob/acles t prev5t ! appo9tm5t ( lic5s$ he>+ aid speciali/s2 7#c7 assess+ ! factors t l$ to su* conflicts or ob/acles2 7#d7 assess+ access ( pati5ts to compreh5sive he>+ heal? c>e s]vices f ! ,dep>tm5t consi/5t ) ! requirem5ts "u section #d7;b7 ( ! ,vet]ans ,mobility ,safety ,act ( #bjaf 7,public ,law #aad-bef2 #ch ,u4,s4,c4 #gdja note71 includ+ an assessm5t ( ! impact ( infra/ructure & equipm5t limitations on wait times = audiologic c>e2 & 7#e7 indicat+ ! m$ical c5t]s ( ! ,dep>tm5t ) vacancies = audiologi/s or lic5s$ he>+ aid speciali/s4 #gjd4 ,use by ,dep>tm5t ( ,vet]ans ,affairs ( comm]cial in/itutional review bo>ds 9 sponsor$ rese>* trials 7a7 ,9 g5]al ,n lat] ?an #ij days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all complete all necess>y policy revisions )9 ! directive ( ! ,vet]ans ,heal? ,adm9i/ration numb]$ #abjj4je & titl$ ,requirem5ts = ! ,protection ( ,human ,subjects 9 ,rese>*1 to all[ sponsor$ cl9ical rese>* ( ! ,dep>tm5t ( ,vet]ans ,affairs to use accr$it$ comm]cial in/itutional review bo>ds to review rese>* proposal protocols ( ! ,dep>tm5t4 7b7 ,id5tification ( review bo>ds ,n lat] ?an #ij days aft] ! completion ( ! policy revisions "u subsection 7a71 ! ,secret>y %all-- 7#a7 id5tify accr$it$ comm]cial in/itutional review bo>ds = use 9 connection ) sponsor$ cl9ical rese>* ( ! ,dep>tm5t2 & 7#b7 e/abli% a process to modify exi/+ approvals 9 ! ev5t t a comm]cial in/itutional review bo>d loses its accr$itation dur+ an ongo+ cl9ical trial4 7c7 ,report 7#a7 ,9 g5]al ,n lat] ?an #ij days aft] ! completion ( ! policy revisions "u subsection 7a71 & annually !reaft]1 ! ,secret>y %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on all approvals ( in/itutional review bo>ds us$ by ! ,dep>tm5t1 includ+ c5tral in/itutional review bo>ds & comm]cial in/itutional review bo>ds4 7#b7 ,elem5ts ,! report requir$ by p>agraph 7#a7 %all include1 at a m9imum1 ! foll[+3 7,a7 ,! "n ( ea* cl9ical trial ) respect to :i* ! use ( an in/itutional review bo>d has be5 approv$4 7,b7 ,! in/itutional review bo>d or in/itutional review bo>ds us$ 9 ! approval process = ea* cl9ical trial4 7,c7 ,! am\nt ( "t betwe5 submission & approval4 #gje4 ,creation ( ,(fice ( ,rese>* ,reviews )9 ! ,(fice ( ,in=mation & ,te*nology ( ! ,dep>tm5t ( ,vet]ans ,affairs 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,vet]ans ,affairs %all e/abli% )9 ! ,(fice ( ,in=mation & ,te*nology ( ! ,dep>tm5t ( ,vet]ans ,affairs an ,(fice ( ,rese>* ,reviews 79 ?is section ref]r$ to z ! ,(fice74 7b7 ,elem5ts ,! ,(fice %all d ! foll[+3 7#a7 ,p]=m c5traliz$ security reviews & complete security processes = approv$ rese>* sponsor$ outside ! ,dep>tm5t1 ) a focus on multi-site cl9ical trials4 7#b7 ,develop & ma9ta9 a li/ ( comm]cially available s(tw>e pref]r$ = use 9 sponsor$ cl9ical trials ( ! ,dep>tm5t & ensure su* li/ is ma9ta9$ z "p ( ! (ficial approv$ s(tw>e products li/ ( ! ,dep>tm5t4 7#c7 ,develop b5*m>ks = appropriate timel9es = security reviews conduct$ by ! ,(fice4 7c7 ,report 7#a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! e/abli%m5t ( ! ,(fice1 ! ,(fice %all submit to ! ,committee on ,vet]ans' ,affairs ( ! ,s5ate & ! ,committee on ,vet]ans' ,affairs ( ! ,h\se ( ,repres5tatives a report on ! activity ( ! ,(fice4 7#b7 ,elem5ts ,! report requir$ by p>agraph 7#a7 %all include1 at a m9imum1 ! foll[+3 7,a7 ,! numb] ( security reviews complet$4 7,b7 ,! numb] ( p]sonnel assign$ = p]=m+ ! functions describ$ 9 subsection 7b74 ,pass$ ! ,s5ate ,augu/ #e1 #bjbj4,secret>y