116TH CONGRESS 

2D SESSION S. 785 

AN ACT 

To improve mental health care provided by the Department 

of Veterans Affairs, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 
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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

2 (a) SHORT TITLE.—This Act may be cited as the 

3 ‘‘Commander John Scott Hannon Veterans Mental Health 

4 Care Improvement Act of 2019’’. 

5 (b) TABLE OF CONTENTS.—The table of contents for 

6 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—IMPROVEMENT OF TRANSITION OF INDIVIDUALS TO 

SERVICES FROM DEPARTMENT OF VETERANS AFFAIRS 

Sec. 101. Strategic plan on expansion of health care coverage for veterans 

transitioning from service in the Armed Forces. 

Sec. 102. Review of records of former members of the Armed Forces who die 

by suicide within one year of separation from the Armed 

Forces. 

Sec. 103. Report on REACH VET program of Department of Veterans Affairs. 

Sec. 104. Report on care for former members of the Armed Forces with other 

than honorable discharge. 

TITLE II—SUICIDE PREVENTION 

Sec. 201. Financial assistance to certain entities to provide or coordinate the 

provision of suicide prevention services for eligible individuals 

and their families. 

Sec. 202. Analysis on feasibility and advisability of the Department of Veterans 

Affairs providing certain complementary and integrative health 

services. 

Sec. 203. Pilot program to provide veterans access to complementary and integrative health programs through animal therapy, agritherapy, 

sports and recreation therapy, art therapy, and posttraumatic 

growth programs. 

Sec. 204. Department of Veterans Affairs study of all-cause mortality of veterans, including by suicide, and review of staffing levels of 

mental health professionals. 

Sec. 205. Comptroller General report on management by Department of Veterans Affairs of veterans at high risk for suicide. 

TITLE III—PROGRAMS, STUDIES, AND GUIDELINES ON MENTAL 

HEALTH 

Sec. 301. Study on connection between living at high altitude and suicide risk 

factors among veterans. 

Sec. 302. Establishment by Department of Veterans Affairs and Department of 

Defense of a clinical provider treatment toolkit and accompanying training materials for comorbidities. 

Sec. 303. Update of clinical practice guidelines for assessment and management 

of patients at risk for suicide. 
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Sec. 304. Establishment by Department of Veterans Affairs and Department of 

Defense of clinical practice guidelines for the treatment of serious mental illness. 

Sec. 305. Precision medicine initiative of Department of Veterans Affairs to 

identify and validate brain and mental health biomarkers. 

Sec. 306. Statistical analyses and data evaluation by Department of Veterans 

Affairs. 

TITLE IV—OVERSIGHT OF MENTAL HEALTH CARE AND RELATED 

SERVICES 

Sec. 401. Study on effectiveness of suicide prevention and mental health outreach programs of Department of Veterans Affairs. 

Sec. 402. Oversight of mental health and suicide prevention media outreach 

conducted by Department of Veterans Affairs. 

Sec. 403. Comptroller General management review of mental health and suicide 

prevention services of Department of Veterans Affairs. 

Sec. 404. Comptroller General report on efforts of Department of Veterans Affairs to integrate mental health care into primary care clinics. 

Sec. 405. Joint mental health programs by Department of Veterans Affairs and 

Department of Defense. 

TITLE V—IMPROVEMENT OF MENTAL HEALTH MEDICAL 

WORKFORCE 

Sec. 501. Staffing improvement plan for mental health providers of Department 

of Veterans Affairs. 

Sec. 502. Establishment of Department of Veterans Affairs Readjustment 

Counseling Service Scholarship Program. 

Sec. 503. Comptroller General report on Readjustment Counseling Service of 

Department of Veterans Affairs. 

Sec. 504. Expansion of reporting requirements on Readjustment Counseling 

Service of Department of Veterans Affairs. 

Sec. 505. Briefing on alternative work schedules for employees of Veterans 

Health Administration. 

Sec. 506. Suicide prevention coordinators. 

Sec. 507. Report on efforts by Department of Veterans Affairs to implement 

safety planning in emergency departments. 

TITLE VI—IMPROVEMENT OF CARE AND SERVICES FOR WOMEN 

VETERANS 

Sec. 601. Expansion of capabilities of Women Veterans Call Center to include 

text messaging. 

Sec. 602. Requirement for Department of Veterans Affairs internet website to 

provide information on services available to women veterans. 

TITLE VII—OTHER MATTERS 

Sec. 701. Expanded telehealth from Department of Veterans Affairs. 

Sec. 702. Partnerships with non-Federal Government entities to provide 

hyperbaric oxygen therapy to veterans and studies on the use 

of such therapy for treatment of post-traumatic stress disorder 

and traumatic brain injury. 

Sec. 703. Prescription of technical qualifications for licensed hearing aid specialists and requirement for appointment of such specialists. 
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Sec. 704. Use by Department of Veterans Affairs of commercial institutional 

review boards in sponsored research trials. 

Sec. 705. Creation of Office of Research Reviews within the Office of Information and Technology of the Department of Veterans Affairs. 

1 TITLE I—IMPROVEMENT OF 

2 TRANSITION OF INDIVIDUALS 

3 TO SERVICES FROM DEPART4 MENT OF VETERANS AFFAIRS 

5 SEC. 101. STRATEGIC PLAN ON EXPANSION OF HEALTH 

6 CARE COVERAGE FOR VETERANS 

7 TRANSITIONING FROM SERVICE IN THE 

8 ARMED FORCES. 

9 (a) STRATEGIC PLAN.— 

10 (1) IN GENERAL.—Not later than one year 

11 after the date of the enactment of this Act, the Sec12 retary of Veterans Affairs, in consultation with the 

13 Secretary of Defense, shall submit to the appro14 priate committees of Congress and publish on a 

15 website of the Department of Veterans Affairs a 

16 strategic plan for the provision by the Department 

17 of health care to any veteran during the one-year pe18 riod following the discharge or release of the veteran 

19 from active military, naval, or air service. 

20 (2) ELEMENTS.—The plan submitted under 

21 paragraph (1) shall include the following: 
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1 (A) An identification of general goals and 

2 objectives for the provision of health care to 

3 veterans described in such paragraph. 

4 (B) A description of how such goals and 

5 objectives are to be achieved, including— 

6 (i) a description of the use of existing 

7 personnel, information, technology, facili8 ties, public and private partnerships, and 

9 other resources of the Department of Vet10 erans Affairs; 

11 (ii) a description of the anticipated 

12 need for additional resources for the De13 partment; and 

14 (iii) an assessment of cost. 

15 (C) An analysis of the anticipated health 

16 care needs, including mental health care, for 

17 such veterans, disaggregated by geographic 

18 area. 

19 (D) An analysis of whether such veterans 

20 are eligible for enrollment in the system of an21 nual patient enrollment of the Department 

22 under section 1705(a) of title 38, United States 

23 Code. 

24 (E) A description of activities designed to 

25 promote the availability of health care from the 
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1 Department for such veterans, including out2 reach to members of the Armed Forces though 

3 the Transition Assistance Program under sec4 tions 1142 and 1144 of title 10, United States 

5 Code. 

6 (F) A description of legislative or adminis7 trative action required to carry out the plan. 

8 (G) A description of how the plan would 

9 further the ongoing initiatives under Executive 

10 Order 13822 (83 Fed. Reg. 1513; relating to 

11 supporting our veterans during their transition 

12 from uniformed service to civilian life) to pro13 vide seamless access to high-quality mental 

14 health care and suicide prevention resources to 

15 veterans as they transition, with an emphasis 

16 on the one-year period following separation. 

17 (b) DEFINITIONS.—In this section: 

18 (1) ACTIVE MILITARY, NAVAL, OR AIR SERV19 ICE.—The term ‘‘active military, naval, or air serv20 ice’’ has the meaning given that term in section 

21 101(24) of title 38, United States Code. 

22 (2) APPROPRIATE COMMITTEES OF CON23 GRESS.—The term ‘‘appropriate committees of Con24 gress’’ means— 
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1 (A) the Committee on Veterans’ Affairs 

2 and the Committee on Appropriations of the 

3 Senate; and 

4 (B) the Committee on Veterans’ Affairs 

5 and the Committee on Appropriations of the 

6 House of Representatives. 

7 SEC. 102. REVIEW OF RECORDS OF FORMER MEMBERS OF 

8 THE ARMED FORCES WHO DIE BY SUICIDE 

9 WITHIN ONE YEAR OF SEPARATION FROM 

10 THE ARMED FORCES. 

11 (a) REVIEW.— 

12 (1) IN GENERAL.—The Secretary of Defense 

13 and the Secretary of Veterans Affairs shall jointly 

14 review the records of each former member of the 

15 Armed Forces who died by suicide, as determined by 

16 the Secretary of Defense or the Secretary of Vet17 erans Affairs, within one year following the dis18 charge or release of the former member from active 

19 military, naval, or air service during the five-year pe20 riod preceding the date of the enactment of this Act. 

21 (2) RECORDS TO BE REVIEWED.—In completing 

22 the review required under paragraph (1), the Sec23 retary of Defense and the Secretary of Veterans Af24 fairs shall review the following records maintained 

25 by the Department of Defense: 
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1 (A) Health treatment records. 

2 (B) Fitness, medical, and dental records. 

3 (C) Ancillary training records. 

4 (D) Safety forms and additional duties sec5 tions of the personnel information files. 

6 (b) ELEMENTS.—The review required by subsection 

7 (a) with respect to a former member of the Armed Forces 

8 shall include consideration of the following: 

9 (1) Whether the Department of Defense had 

10 identified the former member as being at elevated 

11 risk during the 365-day period before separation of 

12 the member from the Armed Forces. 

13 (2) In the case that the member was identified 

14 as being at elevated risk as described in paragraph 

15 (1), whether that identification had been commu16 nicated to the Department of Veterans Affairs via 

17 the Solid Start initiative of the Department pursu18 ant to Executive Order 13822 (83 Fed. Reg. 1513; 

19 relating to supporting our veterans during their 

20 transition from uniformed service to civilian life), or 

21 any other means. 

22 (3) The presence of evidence-based and empiri23 cally-supported contextual and individual risk factors 

24 specified in subsection (c) with respect to the former 
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1 member and how those risk factors correlated to the 

2 circumstances of the death of the former member. 

3 (4) Demographic variables, including the fol4 lowing: 

5 (A) Sex. 

6 (B) Age. 

7 (C) Rank at separation from the Armed 

8 Forces. 

9 (D) Career field after separation from the 

10 Armed Forces. 

11 (E) State and county of residence one 

12 month prior to death. 

13 (F) Branch of service in the Armed 

14 Forces. 

15 (G) Marital status. 

16 (H) Reason for separation from the Armed 

17 Forces. 

18 (5) Support or medical services furnished to the 

19 former member through the Department of Defense, 

20 specified by the type of service or care provided. 

21 (6) Support or medical services furnished to the 

22 former member through the Department of Veterans 

23 Affairs, specified by the type of service or care pro24 vided. 
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1 (c) EVIDENCE-BASED AND EMPIRICALLY-SUPPORTED

2 CONTEXTUAL AND INDIVIDUAL RISK FACTORS.—Evi3 dence-based and empirically-supported contextual and in4 dividual risk factors specified in this subsection include 

5 the following: 

6 (1) Exposure to violence. 

7 (2) Exposure to suicide. 

8 (3) Housing instability. 

9 (4) Financial instability. 

10 (5) Vocational problems or insecurity. 

11 (6) Legal problems. 

12 (7) Highly acute or significantly chronic rela13 tional problems. 

14 (8) Limited access to health care. 

15 (d) REPORT.—Not later than three years after the 

16 date of the enactment of this Act, the Secretary of Defense 

17 and the Secretary of Veterans Affairs shall jointly submit 

18 to the appropriate committees of Congress an aggregated 

19 report on the results of the review conducted under sub20 section (a) with respect to the year-one cohort of former 

21 members of the Armed Forces covered by the review. 

22 (e) DEFINITIONS.—In this section: 

23 (1) ACTIVE MILITARY, NAVAL, OR AIR SERV24 ICE.—The term ‘‘active military, naval, or air serv-
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1 ice’’ has the meaning given that term in section 

2 101(24) of title 38, United States Code. 

3 (2) APPROPRIATE COMMITTEES OF CONGRESS

4 DEFINED.—The term ‘‘appropriate committees of 

5 Congress’’ means— 

6 (A) the Committee on Armed Services and 

7 the Committee on Veterans’ Affairs of the Sen8 ate; and 

9 (B) the Committee on Armed Services and 

10 the Committee on Veterans’ Affairs of the 

11 House of Representatives. 

12 SEC. 103. REPORT ON REACH VET PROGRAM OF DEPART13 MENT OF VETERANS AFFAIRS. 

14 (a) IN GENERAL.—Not later than 180 days after the 

15 date of the enactment of this Act, the Secretary of Vet16 erans Affairs shall submit to the Committee on Veterans’ 

17 Affairs of the Senate and the Committee on Veterans’ Af18 fairs of the House of Representatives a report on the 

19 REACH VET program. 

20 (b) ELEMENTS.—The report required by subsection 

21 (a) shall include the following: 

22 (1) An assessment of the impact of the REACH 

23 VET program on rates of suicide among veterans. 

24 (2) An assessment of how limits within the 

25 REACH VET program, such as caps on the number 
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1 of veterans who may be flagged as high risk, are ad2 justed for differing rates of suicide across the coun3 try. 

4 (3) A detailed explanation, with evidence, for 

5 why the conditions included in the model used by the 

6 REACH VET program were chosen, including an 

7 explanation as to why certain conditions, such as bi8 polar disorder II, were not included even though 

9 they show a similar rate of risk for suicide as other 

10 conditions that were included. 

11 (4) An assessment of the feasibility of incor12 porating certain economic data held by the Veterans 

13 Benefits Administration into the model used by the 

14 REACH VET program, including financial data and 

15 employment status, which research indicates may 

16 have an impact on risk for suicide. 

17 (c) REACH VET PROGRAM DEFINED.—In this sec18 tion, the term ‘‘REACH VET program’’ means the Recov19 ery Engagement and Coordination for Health—Veterans 

20 Enhanced Treatment program of the Department of Vet21 erans Affairs. 
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1 SEC. 104. REPORT ON CARE FOR FORMER MEMBERS OF 

2 THE ARMED FORCES WITH OTHER THAN 

3 HONORABLE DISCHARGE. 

4 Section 1720I(f) of title 38, United States Code, is 

5 amended— 

6 (1) in paragraph (1) by striking ‘‘Not less fre7 quently than once’’ and inserting ‘‘Not later than 

8 February 15’’; and 

9 (2) in paragraph (2)— 

10 (A) by redesignating subparagraph (C) as 

11 subparagraph (F); and 

12 (B) by inserting after subsection (B) the 

13 following new subparagraphs: 

14 ‘‘(C) The types of mental or behavioral health 

15 care needs treated under this section. 

16 ‘‘(D) The demographics of individuals being 

17 treated under this section, including— 

18 ‘‘(i) age; 

19 ‘‘(ii) era of service in the Armed Forces; 

20 ‘‘(iii) branch of service in the Armed 

21 Forces; and 

22 ‘‘(iv) geographic location. 

23 ‘‘(E) The average number of visits for an indi24 vidual for mental or behavioral health care under 

25 this section.’’. 
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1 TITLE II—SUICIDE PREVENTION 

2 SEC. 201. FINANCIAL ASSISTANCE TO CERTAIN ENTITIES 

3 TO PROVIDE OR COORDINATE THE PROVI4 SION OF SUICIDE PREVENTION SERVICES 

5 FOR ELIGIBLE INDIVIDUALS AND THEIR FAM6 ILIES. 

7 (a) PURPOSE; DESIGNATION.— 

8 (1) PURPOSE.—The purpose of this section is 

9 to reduce veteran suicide through a community10 based grant program to award grants to eligible en11 tities to provide or coordinate suicide prevention 

12 services to eligible individuals and their families. 

13 (2) DESIGNATION.—The grant program under 

14 this section shall be known as the ‘‘Staff Sergeant 

15 Parker Gordon Fox Suicide Prevention Grant Pro16 gram’’. 

17 (b) FINANCIAL ASSISTANCE AND COORDINATION.— 

18 The Secretary shall provide financial assistance to eligible 

19 entities approved under this section through the award of 

20 grants to such entities to provide or coordinate the provi21 sion of services to eligible individuals and their families 

22 to reduce the risk of suicide. The Secretary shall carry 

23 out this section in coordination with the President’s Road24 map to Empower Veterans and End a National Tragedy 

25 of Suicide Task Force and in consultation with the Office 
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1 of Mental Health and Suicide Prevention of the Depart2 ment, to the extent practicable. 

3 (c) AWARD OF GRANTS.— 

4 (1) IN GENERAL.—The Secretary shall award a 

5 grant to each eligible entity for which the Secretary 

6 has approved an application under subsection (f) to 

7 provide or coordinate the provision of suicide preven8 tion services under this section. 

9 (2) GRANT AMOUNTS, INTERVALS OF PAYMENT, 

10 AND MATCHING FUNDS.—In accordance with the 

11 services being provided under a grant under this sec12 tion and the duration of those services, the Secretary 

13 shall establish— 

14 (A) a maximum amount to be awarded 

15 under the grant of not more than $750,000 per 

16 grantee per fiscal year; and 

17 (B) intervals of payment for the adminis18 tration of the grant. 

19 (d) DISTRIBUTION OF GRANTS AND PREFERENCE.— 

20 (1) DISTRIBUTION.— 

21 (A) PRIORITY.—In compliance with sub22 paragraphs (B) and (C), in determining how to 

23 distribute grants under this section, the Sec24 retary may prioritize— 

25 (i) rural communities; 
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1 (ii) Tribal lands; 

2 (iii) territories of the United States; 

3 (iv) medically underserved areas; 

4 (v) areas with a high number or per5 centage of minority veterans or women vet6 erans; and 

7 (vi) areas with a high number or per8 centage of calls to the Veterans Crisis 

9 Line. 

10 (B) AREAS WITH NEED.—The Secretary 

11 shall ensure that, to the extent practicable, 

12 grants under this section are distributed— 

13 (i) to provide services in areas of the 

14 United States that have experienced high 

15 rates of suicide by eligible individuals, in16 cluding suicide attempts; and 

17 (ii) to eligible entities that can assist 

18 eligible individuals at risk of suicide who 

19 are not currently receiving health care fur20 nished by the Department. 

21 (C) GEOGRAPHY.—In distributing grants 

22 under this paragraph, the Secretary may pro23 vide grants to eligible entities that furnish serv24 ices to eligible individuals and their families in 

25 geographically dispersed areas. 
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1 (2) PREFERENCE.—The Secretary shall give 

2 preference to eligible entities that have demonstrated 

3 the ability to provide or coordinate suicide preven4 tion services. 

5 (e) REQUIREMENTS FOR RECEIPT OF GRANTS.— 

6 (1) NOTIFICATION THAT SERVICES ARE FROM

7 DEPARTMENT.—Each entity receiving a grant under 

8 this section to provide or coordinate suicide preven9 tion services to eligible individuals and their families 

10 shall notify the recipients of such services that such 

11 services are being paid for, in whole or in part, by 

12 the Department. 

13 (2) DEVELOPMENT OF PLAN WITH ELIGIBLE

14 INDIVIDUALS AND THEIR FAMILY.—Any plan devel15 oped with respect to the provision of suicide preven16 tion services for an eligible individual or their family 

17 shall be developed in consultation with the eligible 

18 individual and their family. 

19 (3) COORDINATION.—An entity receiving a 

20 grant under this section shall— 

21 (A) coordinate with the Secretary with re22 spect to the provision of clinical services to eli23 gible individuals in accordance with subsection 

24 (n) or any other provisions of the law regarding 

25 the delivery of health care by the Secretary; 
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1 (B) inform every veteran who receives as2 sistance under this section from the entity of 

3 the ability of the veteran to apply for enroll4 ment in the patient enrollment system of the 

5 Department under section 1705(a) of title 38, 

6 United States Code; and 

7 (C) if such a veteran wishes to so enroll, 

8 inform the veteran of a point of contact at the 

9 Department who can assist the veteran in such 

10 enrollment. 

11 (4) MEASUREMENT AND MONITORING.—An en12 tity receiving a grant under this section shall submit 

13 to the Secretary a description of such tools and as14 sessments the entity uses or will use to determine 

15 the effectiveness of the services furnished by the en16 tity, which shall include the measures developed 

17 under subsection (h)(2) and may include— 

18 (A) the effect of the services furnished by 

19 the entity on the financial stability of the eligi20 ble individual; 

21 (B) the effect of the services furnished by 

22 the entity on the mental health status, 

23 wellbeing, and suicide risk of the eligible indi24 vidual; and 
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1 (C) the effect of the services furnished by 

2 the entity on the social support of the eligible 

3 individuals receiving those services. 

4 (5) REPORTS.—The Secretary— 

5 (A) shall require each entity receiving a 

6 grant under this section to submit to the Sec7 retary an annual report that describes the 

8 projects carried out with such grant during the 

9 year covered by the report; 

10 (B) shall specify to each such entity the 

11 evaluation criteria and data and information to 

12 be submitted in such report; and 

13 (C) may require each such entity to submit 

14 to the Secretary such additional reports as the 

15 Secretary considers appropriate. 

16 (f) APPLICATION FOR GRANTS.— 

17 (1) IN GENERAL.—An eligible entity seeking a 

18 grant under this section shall submit to the Sec19 retary an application therefor in such form, in such 

20 manner, and containing such commitments and in21 formation as the Secretary considers necessary to 

22 carry out this section. 

23 (2) MATTERS TO BE INCLUDED.—Each applica24 tion submitted by an eligible entity under paragraph 

25 (1) shall contain the following: 
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1 (A) A description of the suicide prevention 

2 services proposed to be provided by the eligible 

3 entity and the identified need for those services. 

4 (B) A detailed plan describing how the eli5 gible entity proposes to coordinate or deliver 

6 suicide prevention services to eligible individ7 uals, including— 

8 (i) an identification of the community 

9 partners, if any, with which the eligible en10 tity proposes to work in delivering such 

11 services; 

12 (ii) a description of the arrangements 

13 currently in place between the eligible enti14 ty and such partners with regard to the 

15 provision or coordination of suicide preven16 tion services; 

17 (iii) an identification of how long such 

18 arrangements have been in place; 

19 (iv) a description of the suicide pre20 vention services provided by such partners 

21 that the eligible entity shall coordinate, if 

22 any; and 

23 (v) an identification of local suicide 

24 prevention coordinators of the Department 

25 and a description of how the eligible entity 
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1 will communicate with local suicide preven2 tion coordinators. 

3 (C) A description of the population of eligi4 ble individuals and their families proposed to be 

5 provided suicide prevention services. 

6 (D) Based on information and methods de7 veloped by the Secretary for purposes of this 

8 subsection, an estimate of the number of eligi9 ble individuals at risk of suicide and their fami10 lies proposed to be provided suicide prevention 

11 services, including the percentage of those eligi12 ble individuals who are not currently receiving 

13 care furnished by the Department. 

14 (E) Evidence of measurable outcomes re15 lated to reductions in suicide risk and mood-re16 lated symptoms utilizing validated instruments 

17 by the eligible entity (and the proposed partners 

18 of the entity, if any) in providing suicide pre19 vention services to individuals at risk of suicide, 

20 particularly to eligible individuals and their 

21 families. 

22 (F) A description of the managerial and 

23 technological capacity of the eligible entity— 
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1 (i) to coordinate the provision of sui2 cide prevention services with the provision 

3 of other services; 

4 (ii) to assess on an ongoing basis the 

5 needs of eligible individuals and their fami6 lies for suicide prevention services; 

7 (iii) to coordinate the provision of sui8 cide prevention services with the services of 

9 the Department for which eligible individ10 uals are also eligible; 

11 (iv) to tailor suicide prevention serv12 ices to the needs of eligible individuals and 

13 their families; 

14 (v) to seek continuously new sources 

15 of assistance to ensure the continuity of 

16 suicide prevention services for eligible indi17 viduals and their families as long as they 

18 are determined to be at risk of suicide; and 

19 (vi) to measure the effects of suicide 

20 prevention services provided by the eligible 

21 entity or partner organization, in accord22 ance with subsection (h)(2), on the lives of 

23 eligible individuals and their families who 

24 receive such services provided by the orga25 nization using pre- and post-evaluations on 
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1 validated measures of suicide risk and 

2 mood-related symptoms. 

3 (G) Clearly defined objectives for the provi4 sion of suicide prevention services. 

5 (H) A description and physical address of 

6 the primary location of the eligible entity. 

7 (I) A description of the geographic area 

8 the eligible entity plans to serve during the 

9 grant award period for which the application 

10 applies. 

11 (J) If the eligible entity is a State or local 

12 government or an Indian tribe, the amount of 

13 grant funds proposed to be made available to 

14 community partners, if any, through agree15 ments. 

16 (K) A description of how the eligible entity 

17 will assess the effectiveness of the provision of 

18 grants under this section. 

19 (L) An agreement to use the measures and 

20 metrics provided by the Department for the 

21 purposes of measuring the effectiveness of the 

22 programming as described in subsection (h)(2). 

23 (M) Such additional application criteria as 

24 the Secretary considers appropriate. 

25 (g) TRAINING AND TECHNICAL ASSISTANCE.— 
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1 (1) IN GENERAL.—The Secretary shall provide 

2 training and technical assistance, in coordination 

3 with the Centers for Disease Control and Preven4 tion, to eligible entities in receipt of grants under 

5 this section regarding— 

6 (A) suicide risk identification and manage7 ment; 

8 (B) the data required to be collected and 

9 shared with the Department; 

10 (C) the means of data collection and shar11 ing; 

12 (D) familiarization with and appropriate 

13 use of any tool to be used to measure the effec14 tiveness of the use of the grants provided; and 

15 (E) the requirements for reporting under 

16 subsection (e)(5) on services provided via such 

17 grants. 

18 (2) PROVISION OF TRAINING AND TECHNICAL

19 ASSISTANCE.—The Secretary may provide the train20 ing and technical assistance described in paragraph 

21 (1) directly or through grants or contracts with ap22 propriate public or nonprofit entities. 

23 (h) ADMINISTRATION OF GRANT PROGRAM.— 

24 (1) SELECTION CRITERIA.—The Secretary, in 

25 consultation with entities specified in paragraph (3), 
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1 shall establish criteria for the selection of eligible en2 tities that have submitted applications under sub3 section (f). 

4 (2) DEVELOPMENT OF MEASURES AND

5 METRICS.—The Secretary shall develop, in consulta6 tion with entities specified in paragraph (3), the fol7 lowing: 

8 (A) A framework for collecting and sharing 

9 information about entities in receipt of grants 

10 under this section for purposes of improving the 

11 services available for eligible individuals and 

12 their families, set forth by service type, locality, 

13 and eligibility criteria. 

14 (B) The measures and metrics to be used 

15 by each entity in receipt of grants under this 

16 section to determine the effectiveness of the 

17 programming being provided by such entity in 

18 improving mental health status, wellbeing, and 

19 reducing suicide risk and completed suicides of 

20 eligible individuals and their families, which 

21 shall include an existing measurement tool or 

22 protocol for the grant recipient to utilize when 

23 determining programmatic effectiveness. 

24 (3) COORDINATION.—In developing a plan for 

25 the design and implementation of the provision of 
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1 grants under this section, including criteria for the 

2 award of grants, the Secretary shall consult with the 

3 following: 

4 (A) Veterans service organizations. 

5 (B) National organizations representing 

6 potential community partners of eligible entities 

7 in providing supportive services to address the 

8 needs of eligible individuals and their families, 

9 including national organizations that— 

10 (i) advocate for the needs of individ11 uals with or at risk of behavioral health 

12 conditions; 

13 (ii) represent mayors; 

14 (iii) represent unions; 

15 (iv) represent first responders; 

16 (v) represent chiefs of police and sher17 iffs; 

18 (vi) represent governors; 

19 (vii) represent a territory of the 

20 United States; or 

21 (viii) represent a Tribal alliance. 

22 (C) National organizations representing 

23 members of the Armed Forces. 

24 (D) National organizations that represent 

25 counties. 
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1 (E) Organizations with which the Depart2 ment has a current memorandum of agreement 

3 or understanding related to mental health or 

4 suicide prevention. 

5 (F) State departments of veterans affairs. 

6 (G) National organizations representing 

7 members of the reserve components of the 

8 Armed Forces. 

9 (H) National organizations representing 

10 members of the Coast Guard. 

11 (I) Organizations, including institutions of 

12 higher education, with experience in creating 

13 measurement tools for purposes of advising the 

14 Secretary on the most appropriate existing 

15 measurement tool or protocol for the Depart16 ment to utilize. 

17 (J) The National Alliance on Mental Ill18 ness. 

19 (K) A labor organization (as such term is 

20 defined in section 7103(a)(4) of title 5, United 

21 States Code). 

22 (L) The Centers for Disease Control and 

23 Prevention, the Substance Abuse and Mental 

24 Health Services Administration, the President’s 

25 Roadmap to Empower Veterans and End a Na-
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1 tional Tragedy of Suicide Task Force, and such 

2 other organizations as the Secretary considers 

3 appropriate. 

4 (4) REPORT ON GRANT CRITERIA.—Not later 

5 than 30 days before notifying eligible entities of the 

6 availability of funding under this section, the Sec7 retary shall submit to the appropriate committees of 

8 Congress a report containing— 

9 (A) criteria for the award of a grant under 

10 this section; 

11 (B) the already developed measures and 

12 metrics to be used by the Department to meas13 ure the effectiveness of the use of grants pro14 vided under this section as described in sub15 section (h)(2); and 

16 (C) a framework for the sharing of infor17 mation about entities in receipt of grants under 

18 this section. 

19 (i) INFORMATION ON POTENTIAL ELIGIBLE INDIVID20 UALS.— 

21 (1) IN GENERAL.—The Secretary may make 

22 available to recipients of grants under this section 

23 certain information regarding potential eligible indi24 viduals who may receive services for which such 

25 grant is provided. 
29 

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1 (2) INFORMATION INCLUDED.—The information 

2 made available under paragraph (1) with respect to 

3 potential eligible individuals may include the fol4 lowing: 

5 (A) Confirmation of the status of a poten6 tial eligible individual as a veteran. 

7 (B) Confirmation of whether the potential 

8 eligible individual is enrolled in the patient en9 rollment system of the Department under sec10 tion 1705(a) of title 38, United States Code. 

11 (C) Confirmation of whether a potential el12 igible individual is currently receiving care fur13 nished by the Department or has recently re14 ceived such care. 

15 (3) OPT-OUT.—The Secretary shall allow an eli16 gible individual to opt out of having their informa17 tion shared under this subsection with recipients of 

18 grants under this section. 

19 (j) DURATION.—The authority of the Secretary to 

20 provide grants under this section shall terminate on the 

21 date that is three years after the date on which the first 

22 grant is awarded under this section. 

23 (k) REPORTING.— 

24 (1) INTERIM REPORT.— 
30 

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1 (A) IN GENERAL.—Not later than 18 

2 months after the date on which the first grant 

3 is awarded under this section, the Secretary 

4 shall submit to the appropriate committees of 

5 Congress a report on the provision of grants to 

6 eligible entities under this section. 

7 (B) ELEMENTS.—The report submitted 

8 under subparagraph (A) shall include the fol9 lowing: 

10 (i) An assessment of the effectiveness 

11 of the grant program under this section, 

12 including— 

13 (I) the effectiveness of grant re14 cipients and their community part15 ners, if any, in conducting outreach to 

16 eligible individuals; 

17 (II) the effectiveness of increas18 ing eligible individuals engagement in 

19 suicide prevention services; and 

20 (III) such other validated instru21 ments and additional measures as de22 termined by the Secretary and as de23 scribed in subsection (h)(2). 

24 (ii) A list of grant recipients and their 

25 partner organizations, if any, that deliv-
31 

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1 ered services funded by the grant and the 

2 amount of such grant received by each re3 cipient and partner organization. 

4 (iii) The number of eligible individuals 

5 supported by each grant recipient, includ6 ing through services provided to family 

7 members, disaggregated by— 

8 (I) all demographic characteris9 tics as determined necessary and ap10 propriate by the Secretary in coordi11 nation with the Centers for Disease 

12 Control and Prevention; 

13 (II) whether each such eligible 

14 individual is enrolled in the patient 

15 enrollment system of the Department 

16 under section 1705(a) of title 38, 

17 United States Code; 

18 (III) branch of service in the 

19 Armed Forces; 

20 (IV) era of service in the Armed 

21 Forces; 

22 (V) type of service received by 

23 the eligible individual; and 
32 

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1 (VI) whether each such eligible 

2 individual was referred to the Depart3 ment for care. 

4 (iv) The number of eligible individuals 

5 supported by grants under this section, in6 cluding through services provided to family 

7 members. 

8 (v) The number of eligible individuals 

9 described in clause (iv) who were not pre10 viously receiving care furnished by the De11 partment, with specific numbers for the 

12 population of eligible individuals described 

13 in subsection (q)(4)(B). 

14 (vi) The number of eligible individuals 

15 whose mental health status, wellbeing, and 

16 suicide risk received a baseline measure17 ment assessment under this section and 

18 the number of such eligible individuals 

19 whose mental health status, wellbeing, and 

20 suicide risk will be measured by the De21 partment or a community partner over a 

22 period of time for any improvements. 

23 (vii) The types of data the Depart24 ment was able to collect and share with 
33 

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1 partners, including a characterization of 

2 the benefits of that data. 

3 (viii) The number and percentage of 

4 eligible individuals referred to the point of 

5 contact at the Department under sub6 section (e)(3)(C). 

7 (ix) The number of eligible individuals 

8 newly enrolled in the patient enrollment 

9 system of the Department under section 

10 1705(a) of title 38, United States Code 

11 based on a referral to the Department 

12 from a grant recipient under subsection 

13 (e)(3)(C), disaggregated by grant recipient. 

14 (x) A detailed account of how the 

15 grant funds were used, including executive 

16 compensation, overhead costs, and other 

17 indirect costs. 

18 (xi) A description of any outreach ac19 tivities conducted by the eligible entity in 

20 receipt of a grant with respect to services 

21 provided using the grant. 

22 (xii) The number of individuals who 

23 seek services from the grant recipient who 

24 are not eligible individuals. 
34 

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1 (C) SUBMITTAL OF INFORMATION BY

2 GRANT RECIPIENTS.—The Secretary may re3 quire eligible entities receiving grants under 

4 this section to provide to Congress such infor5 mation as the Secretary determines necessary 

6 regarding the elements described in subpara7 graph (B). 

8 (2) FINAL REPORT.—Not later than three years 

9 after the date on which the first grant is awarded 

10 under this section, and annually thereafter for each 

11 year in which the program is in effect, the Secretary 

12 shall submit to the appropriate committees of Con13 gress— 

14 (A) a follow-up on the interim report sub15 mitted under paragraph (1) containing the ele16 ments set forth in subparagraph (B) of such 

17 paragraph; and 

18 (B) a report on— 

19 (i) the effectiveness of the provision of 

20 grants under this section, including the ef21 fectiveness of community partners in con22 ducting outreach to eligible individuals and 

23 their families and reducing the rate of sui24 cide among eligible individuals; 
35 

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1 (ii) an assessment of the increased ca2 pacity of the Department to provide serv3 ices to eligible individuals and their fami4 lies, set forth by State, as a result of the 

5 provision of grants under this section; 

6 (iii) the feasibility and advisability of 

7 extending or expanding the provision of 

8 grants consistent with this section; and 

9 (iv) such other elements as considered 

10 appropriate by the Secretary. 

11 (l) THIRD-PARTY ASSESSMENT.— 

12 (1) STUDY OF GRANT PROGRAM.— 

13 (A) IN GENERAL.—Not later than 180 

14 days after the commencement of the grant pro15 gram under this section, the Secretary shall 

16 seek to enter into a contract with an appro17 priate entity described in paragraph (3) to con18 duct a study of the grant program. 

19 (B) ELEMENTS OF STUDY.—In conducting 

20 the study under subparagraph (A), the appro21 priate entity shall— 

22 (i) evaluate the effectiveness of the 

23 grant program under this section in— 

24 (I) addressing the factors that 

25 contribute to suicides; 
36 

†S 785 ES

1 (II) increasing the use of suicide 

2 prevention services; 

3 (III) reducing mood-related 

4 symptoms that increase suicide and 

5 suicide risk; and 

6 (IV) where such information is 

7 available due to the time frame of the 

8 grant program, reducing suicidal idea9 tion, suicide attempts, self-harm, and 

10 deaths by suicide; and 

11 (V) reducing suicidal ideation, 

12 suicide attempts, self-harm, and 

13 deaths by suicide among eligible indi14 viduals through eligible entities lo15 cated in communities; and 

16 (ii) compare the results of the grant 

17 program with other national programs in 

18 delivering resources to eligible individuals 

19 in the communities where they live that ad20 dress the factors that contribute to suicide. 

21 (2) ASSESSMENT.— 

22 (A) IN GENERAL.—The contract under 

23 paragraph (1) shall provide that not later than 

24 24 months after the commencement of the 

25 grant program under this section, the appro-
37 

†S 785 ES

1 priate entity shall submit to the Secretary an 

2 assessment based on the study conducted pur3 suant to such contract. 

4 (B) SUBMITTAL TO CONGRESS.—Upon re5 ceipt of the assessment under subparagraph 

6 (A), the Secretary shall transmit to the appro7 priate committees of Congress a copy of the as8 sessment. 

9 (3) APPROPRIATE ENTITY.—An appropriate en10 tity described in this paragraph is a nongovernment 

11 entity with experience optimizing and assessing or12 ganizations that deliver services and assessing the 

13 effectiveness of suicide prevention programs. 

14 (m) REFERRAL FOR CARE.— 

15 (1) MENTAL HEALTH ASSESSMENT.—If an eli16 gible entity in receipt of a grant under this section 

17 determines that an eligible individual is at-risk of 

18 suicide or other mental or behavioral health condi19 tion pursuant to a baseline mental health screening 

20 conducted under subsection (q)(11)(A)(ii) with re21 spect to the individual, the entity shall refer the eli22 gible individual to the Department for additional 

23 care under subsection (n) or any other provision of 

24 law. 
38 

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1 (2) EMERGENCY TREATMENT.—If an eligible 

2 entity in receipt of a grant under this section deter3 mines that an eligible individual furnished clinical 

4 services for emergency treatment under subsection 

5 (q)(11)(A)(iv) requires ongoing services, the entity 

6 shall refer the eligible individual to the Department 

7 for additional care under subsection (n) or any other 

8 provision of law. 

9 (3) REFUSAL.—If an eligible individual refuses 

10 a referral by an entity under paragraph (1) or (2), 

11 any ongoing clinical services provided to the eligible 

12 individual by the entity shall be at the expense of 

13 the entity. 

14 (n) PROVISION OF CARE TO ELIGIBLE INDIVID15 UALS.—When the Secretary determines it is clinically ap16 propriate, the Secretary shall furnish to eligible individ17 uals who are receiving or have received suicide prevention 

18 services through grants provided under this section an ini19 tial mental health assessment and mental health or behav20 ioral health care services authorized under chapter 17 of 

21 title 38, United States Code, that are required to treat 

22 the mental or behavioral health care needs of the eligible 

23 individual, including risk of suicide. 

24 (o) AGREEMENTS WITH COMMUNITY PARTNERS.— 
39 

†S 785 ES

1 (1) IN GENERAL.—Subject to paragraph (2), an 

2 eligible entity may use grant funds to enter into an 

3 agreement with a community partner under which 

4 the eligible entity may provide funds to the commu5 nity partner for the provision of suicide prevention 

6 services to eligible individuals and their families. 

7 (2) LIMITATION.—The ability of a recipient of 

8 a grant under this section to provide grant funds to 

9 a community partner shall be limited to grant recipi10 ents that are a State or local government or an In11 dian tribe. 

12 (p) AUTHORIZATION OF APPROPRIATIONS.—There is 

13 authorized to be appropriated to the Secretary to carry 

14 out this section a total of $174,000,000 for fiscal years 

15 2021 through 2025. 

16 (q) DEFINITIONS.—In this section: 

17 (1) APPROPRIATE COMMITTEES OF CON18 GRESS.—The term ‘‘appropriate committees of Con19 gress’’ means— 

20 (A) the Committee on Veterans’ Affairs 

21 and the Subcommittee on Military Construc22 tion, Veterans Affairs, and Related Agencies of 

23 the Committee on Appropriations of the Senate; 

24 and 
40 

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1 (B) the Committee on Veterans’ Affairs 

2 and the Subcommittee on Military Construc3 tion, Veterans Affairs, and Related Agencies of 

4 the Committee on Appropriations of the House 

5 of Representatives. 

6 (2) DEPARTMENT.—The term ‘‘Department’’ 

7 means the Department of Veterans Affairs. 

8 (3) ELIGIBLE ENTITY.—The term ‘‘eligible enti9 ty’’ means— 

10 (A) an incorporated private institution or 

11 foundation— 

12 (i) no part of the net earnings of 

13 which incurs to the benefit of any member, 

14 founder, contributor, or individual; and 

15 (ii) that has a governing board that 

16 would be responsible for the operation of 

17 the suicide prevention services provided 

18 under this section; 

19 (B) a corporation wholly owned and con20 trolled by an organization meeting the require21 ments of clauses (i) and (ii) of subparagraph 

22 (A); 

23 (C) an Indian tribe; 

24 (D) a community-based organization that 

25 can effectively network with local civic organiza-
41 

†S 785 ES

1 tions, regional health systems, and other set2 tings where eligible individuals and their fami3 lies are likely to have contact; or 

4 (E) A State or local government. 

5 (4) ELIGIBLE INDIVIDUAL.—The term ‘‘eligible 

6 individual’’ includes a person at risk of suicide who 

7 is— 

8 (A) a veteran as defined in section 101 of 

9 title 38, United States Code; 

10 (B) an individual described in section 

11 1720I(b) of such title; or 

12 (C) an individual described in any of 

13 clauses (i) through (iv) of section 

14 1712A(a)(1)(C) of such title. 

15 (5) EMERGENCY TREATMENT.—Medical serv16 ices, professional services, ambulance services, ancil17 lary care and medication (including a short course of 

18 medication related to and necessary for the treat19 ment of the emergency condition that is provided di20 rectly to or prescribed for the patient for use after 

21 the emergency condition is stabilized and the patient 

22 is discharged) was rendered in a medical emergency 

23 of such nature that a prudent layperson would have 

24 reasonably expected that delay in seeking immediate 

25 medical attention would have been hazardous to life 
42 

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1 or health. This standard is met by an emergency 

2 medical condition manifesting itself by acute symp3 toms of sufficient severity (including severe pain) 

4 that a prudent layperson who possesses an average 

5 knowledge of health and medicine could reasonably 

6 expect the absence of immediate medical attention to 

7 result in placing the health of the individual in seri8 ous jeopardy, serious impairment to bodily functions, 

9 or serious dysfunction of any bodily organ or part. 

10 (6) FAMILY.—The term ‘‘family’’ means, with 

11 respect to an eligible individual, any of the following: 

12 (A) A parent. 

13 (B) A spouse. 

14 (C) A child. 

15 (D) A sibling. 

16 (E) A step-family member. 

17 (F) An extended family member. 

18 (G) Any other individual who lives with the 

19 eligible individual. 

20 (7) INDIAN TRIBE.—The term ‘‘Indian tribe’’ 

21 has the meaning given that term in section 4 of the 

22 Native American Housing Assistance and Self-De23 termination Act of 1996 (25 U.S.C. 4103). 

24 (8) RISK OF SUICIDE.— 
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1 (A) IN GENERAL.—The term ‘‘risk of sui2 cide’’ means exposure to, or the existence of, 

3 any of the following (to a degree determined by 

4 the Secretary pursuant to regulations): 

5 (i) Health risk factors, including the 

6 following: 

7 (I) Mental health challenges. 

8 (II) Substance abuse. 

9 (III) Serious or chronic health 

10 conditions or pain. 

11 (IV) Traumatic brain injury. 

12 (ii) Environmental risk factors, in13 cluding the following: 

14 (I) Prolonged stress. 

15 (II) Stressful life events. 

16 (III) Unemployment. 

17 (IV) Homelessness. 

18 (V) Recent loss. 

19 (VI) Legal or financial chal20 lenges. 

21 (iii) Historical risk factors, including 

22 the following: 

23 (I) Previous suicide attempts. 

24 (II) Family history of suicide. 
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1 (III) History of abuse, neglect, or 

2 trauma. 

3 (B) DEGREE OF RISK.—The Secretary 

4 may, by regulation, establish a process for de5 termining degrees of risk of suicide for use by 

6 grant recipients to focus the delivery of services 

7 using grant funds. 

8 (9) RURAL.—The term ‘‘rural’’, with respect to 

9 a community, has the meaning given that term in 

10 the Rural-Urban Commuting Areas coding system of 

11 the Department of Agriculture. 

12 (10) SECRETARY.—The term ‘‘Secretary’’ 

13 means the Secretary of Veterans Affairs. 

14 (11) SUICIDE PREVENTION SERVICES.— 

15 (A) IN GENERAL.—The term ‘‘suicide pre16 vention services’’ means services to address the 

17 needs of eligible individuals and their families 

18 and includes the following: 

19 (i) Outreach to identify those at risk 

20 of suicide with an emphasis on eligible in21 dividuals who are at highest risk or who 

22 are not receiving health care or other serv23 ices furnished by the Department. 

24 (ii) A baseline mental health screening 

25 for risk. 
45 

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1 (iii) Education on suicide risk and 

2 prevention to families and communities. 

3 (iv) Provision of clinical services for 

4 emergency treatment. 

5 (v) Case management services. 

6 (vi) Peer support services. 

7 (vii) Assistance in obtaining any bene8 fits from the Department that the eligible 

9 individual and their family may be eligible 

10 to receive, including— 

11 (I) vocational and rehabilitation 

12 counseling; 

13 (II) supportive services for home14 less veterans; 

15 (III) employment and training 

16 services; 

17 (IV) educational assistance; and 

18 (V) health care services. 

19 (viii) Assistance in obtaining and co20 ordinating the provision of other benefits 

21 provided by the Federal Government, a 

22 State or local government, or an eligible 

23 entity. 

24 (ix) Assistance with emergent needs 

25 relating to— 
46 

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1 (I) health care services; 

2 (II) daily living services; 

3 (III) personal financial planning 

4 and counseling; 

5 (IV) transportation services; 

6 (V) temporary income support 

7 services; 

8 (VI) fiduciary and representative 

9 payee services; 

10 (VII) legal services to assist the 

11 eligible individual with issues that 

12 may contribute to the risk of suicide; 

13 and 

14 (VIII) child care (not to exceed 

15 $5,000 per family of an eligible indi16 vidual per fiscal year). 

17 (x) Nontraditional and innovative ap18 proaches and treatment practices, as deter19 mined appropriate by the Secretary, in 

20 consultation with appropriate entities. 

21 (xi) Such other services necessary for 

22 improving the mental health status and 

23 wellbeing and reducing the suicide risk of 

24 eligible individuals and their families as 
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1 the Secretary considers appropriate, which 

2 may include— 

3 (I) adaptive sports, equine as4 sisted therapy, or in-place or outdoor 

5 recreational therapy; 

6 (II) substance use reduction pro7 gramming; 

8 (III) individual, group, or family 

9 counseling; and 

10 (IV) relationship coaching. 

11 (B) EXCLUSION.—The term ‘‘suicide pre12 vention services’’ does not include direct cash 

13 assistance to eligible individuals or their fami14 lies. 

15 (12) VETERANS CRISIS LINE.—The term ‘‘Vet16 erans Crisis Line’’ means the toll-free hotline for 

17 veterans established under section 1720F(h) of title 

18 38, United States Code. 

19 (13) VETERANS SERVICE ORGANIZATION.—The 

20 term ‘‘veterans service organization’’ means any or21 ganization recognized by the Secretary for the rep22 resentation of veterans under section 5902 of title 

23 38, United States Code. 
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1 SEC. 202. ANALYSIS ON FEASIBILITY AND ADVISABILITY OF 

2 THE DEPARTMENT OF VETERANS AFFAIRS 

3 PROVIDING CERTAIN COMPLEMENTARY AND 

4 INTEGRATIVE HEALTH SERVICES. 

5 (a) IN GENERAL.—Not later than 180 days after the 

6 date of the enactment of this Act, the Secretary of Vet7 erans Affairs shall complete an analysis on the feasibility 

8 and advisability of providing complementary and integra9 tive health treatments described in subsection (c) at all 

10 medical facilities of the Department of Veterans Affairs. 

11 (b) INCLUSION OF ASSESSMENT OF REPORT.—The 

12 analysis conducted under subsection (a) shall include an 

13 assessment of the final report of the Creating Options for 

14 Veterans’ Expedited Recovery Commission (commonly re15 ferred to as the ‘‘COVER Commission’’) established under 

16 section 931 of the Jason Simcakoski Memorial and Prom17 ise Act (title IX of Public Law 114–198; 38 U.S.C. 1701 

18 note) submitted under subsection (e)(2) of such section. 

19 (c) TREATMENTS DESCRIBED.—Complementary and 

20 integrative health treatments described in this subsection 

21 shall consist of the following: 

22 (1) Yoga. 

23 (2) Meditation. 

24 (3) Acupuncture. 

25 (4) Chiropractic care. 
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1 (5) Other treatments that show sufficient evi2 dence of efficacy at treating mental or physical 

3 health conditions, as determined by the Secretary. 

4 (d) REPORT.—The Secretary shall submit to the 

5 Committee on Veterans’ Affairs of the Senate and the 

6 Committee on Veterans’ Affairs of the House of Rep7 resentatives a report on the analysis completed under sub8 section (a), including— 

9 (1) the results of such analysis; and 

10 (2) such recommendations regarding the fur11 nishing of complementary and integrative health 

12 treatments described in subsection (c) as the Sec13 retary considers appropriate. 

14 SEC. 203. PILOT PROGRAM TO PROVIDE VETERANS ACCESS 

15 TO COMPLEMENTARY AND INTEGRATIVE 

16 HEALTH PROGRAMS THROUGH ANIMAL 

17 THERAPY, AGRITHERAPY, SPORTS AND 

18 RECREATION THERAPY, ART THERAPY, AND 

19 POSTTRAUMATIC GROWTH PROGRAMS. 

20 (a) IN GENERAL.—Not later than 180 days after the 

21 date on which the Creating Options for Veterans’ Expe22 dited Recovery Commission (commonly referred to as the 

23 ‘‘COVER Commission’’) established under section 931 of 

24 the Jason Simcakoski Memorial and Promise Act (title IX 

25 of Public Law 114–198; 38 U.S.C. 1701 note) submits 
50 

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1 its final report under subsection (e)(2) of such section, the 

2 Secretary of Veterans Affairs shall commence the conduct 

3 of a pilot program to provide complementary and integra4 tive health programs described in subsection (b) to eligible 

5 veterans from the Department of Veterans Affairs or 

6 through the use of non-Department entities for the treat7 ment of post-traumatic stress disorder, depression, anx8 iety, or other conditions as determined by the Secretary. 

9 (b) PROGRAMS DESCRIBED.—Complementary and in10 tegrative health programs described in this subsection 

11 may, taking into consideration the report described in sub12 section (a), consist of the following: 

13 (1) Equine therapy. 

14 (2) Other animal therapy. 

15 (3) Agritherapy. 

16 (4) Sports and recreation therapy. 

17 (5) Art therapy. 

18 (6) Posttraumatic growth programs. 

19 (c) ELIGIBLE VETERANS.—A veteran is eligible to 

20 participate in the pilot program under this section if the 

21 veteran— 

22 (1) is enrolled in the system of patient enroll23 ment of the Department under section 1705(a) of 

24 title 38, United States Code; and 
51 

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1 (2) has received health care under the laws ad2 ministered by the Secretary during the two-year pe3 riod preceding the initial participation of the veteran 

4 in the pilot program. 

5 (d) DURATION.— 

6 (1) IN GENERAL.—The Secretary shall carry 

7 out the pilot program under this section for a three8 year period beginning on the commencement of the 

9 pilot program. 

10 (2) EXTENSION.—The Secretary may extend 

11 the duration of the pilot program under this section 

12 if the Secretary, based on the results of the interim 

13 report submitted under subsection (f)(1), determines 

14 that it is appropriate to do so. 

15 (e) LOCATIONS.— 

16 (1) IN GENERAL.—The Secretary shall select 

17 not fewer than five facilities of the Department at 

18 which to carry out the pilot program under this sec19 tion. 

20 (2) SELECTION CRITERIA.—In selecting facili21 ties under paragraph (1), the Secretary shall ensure 

22 that— 

23 (A) the locations are in geographically di24 verse areas; and 
52 

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1 (B) not fewer than three facilities serve 

2 veterans in rural or highly rural areas (as de3 termined through the use of the Rural-Urban 

4 Commuting Areas coding system of the Depart5 ment of Agriculture). 

6 (f) REPORTS.— 

7 (1) INTERIM REPORT.— 

8 (A) IN GENERAL.—Not later than one year 

9 after the commencement of the pilot program 

10 under this section, the Secretary shall submit to 

11 the Committee on Veterans’ Affairs of the Sen12 ate and the Committee on Veterans’ Affairs of 

13 the House of Representatives a report on the 

14 progress of the pilot program. 

15 (B) ELEMENTS.—The report required by 

16 subparagraph (A) shall include the following: 

17 (i) The number of participants in the 

18 pilot program. 

19 (ii) The type or types of therapy of20 fered at each facility at which the pilot 

21 program is being carried out. 

22 (iii) An assessment of whether partici23 pation by a veteran in the pilot program 

24 resulted in any changes in clinically rel25 evant endpoints for the veteran with re-
53 

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1 spect to the conditions specified in sub2 section (a). 

3 (iv) An assessment of the quality of 

4 life of veterans participating in the pilot 

5 program, including the results of a satis6 faction survey of the participants in the 

7 pilot program, disaggregated by program 

8 under subsection (b). 

9 (v) The determination of the Sec10 retary with respect to extending the pilot 

11 program under subsection (d)(2). 

12 (vi) Any recommendations of the Sec13 retary with respect to expanding the pilot 

14 program. 

15 (2) FINAL REPORT.—Not later than 90 days 

16 after the termination of the pilot program under this 

17 section, the Secretary shall submit to the Committee 

18 on Veterans’ Affairs of the Senate and the Com19 mittee on Veterans’ Affairs of the House of Rep20 resentatives a final report on the pilot program. 
54 

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1 SEC. 204. DEPARTMENT OF VETERANS AFFAIRS STUDY OF 

2 ALL-CAUSE MORTALITY OF VETERANS, IN3 CLUDING BY SUICIDE, AND REVIEW OF 

4 STAFFING LEVELS OF MENTAL HEALTH PRO5 FESSIONALS. 

6 (a) STUDY OF DEATHS OF VETERANS BY SUICIDE.— 

7 (1) IN GENERAL.—The Secretary of Veterans 

8 Affairs shall seek to enter into an agreement with 

9 the National Academies of Sciences, Engineering, 

10 and Medicine under which the Secretary shall col11 laborate and coordinate with the National Academies 

12 on a revised study design to fulfill the goals of the 

13 2019 study design of the National Academies de14 scribed in the explanatory statement accompanying 

15 the Further Consolidated Appropriations Act, 2020 

16 (Public Law 116–94), as part of current and addi17 tional research priorities of the Department of Vet18 erans Affairs, to evaluate the effects of opioids and 

19 benzodiazepine on all-cause mortality of veterans, in20 cluding suicide, regardless of whether information 

21 relating to such deaths has been reported by the 

22 Centers for Disease Control and Prevention. 

23 (2) GOALS.—In carrying out the collaboration 

24 and coordination under paragraph (1), the Secretary 

25 shall seek as much as possible to achieve the same 
55 

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1 advancement of useful knowledge as the 2019 study 

2 design described in such paragraph. 

3 (b) REVIEW OF STAFFING LEVELS FOR MENTAL

4 HEALTH PROFESSIONALS.— 

5 (1) IN GENERAL.—Not later than 90 days after 

6 the date of the enactment of this Act, the Comp7 troller General of the United States shall conduct a 

8 review of the staffing levels for mental health profes9 sionals of the Department. 

10 (2) ELEMENTS.—The review required by para11 graph (1) shall include a description of the efforts 

12 of the Department to maintain appropriate staffing 

13 levels for mental health professionals, such as men14 tal health counselors, marriage and family thera15 pists, and other appropriate counselors, including 

16 the following: 

17 (A) A description of any impediments to 

18 carry out the education, training, and hiring of 

19 mental health counselors and marriage and 

20 family therapists under section 7302(a) of title 

21 38, United States Code, and strategies for ad22 dressing those impediments. 

23 (B) A description of the objectives, goals, 

24 and timing of the Department with respect to 

25 increasing the representation of such counselors 
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1 and therapists in the behavioral health work2 force of the Department, including— 

3 (i) a review of qualification criteria for 

4 such counselors and therapists and a com5 parison of such criteria to that of other be6 havioral health professions in the Depart7 ment; and 

8 (ii) an assessment of the participation 

9 of such counselors and therapists in the 

10 mental health professionals trainee pro11 gram of the Department and any impedi12 ments to such participation. 

13 (C) An assessment of the development by 

14 the Department of hiring guidelines for mental 

15 health counselors, marriage and family thera16 pists, and other appropriate counselors. 

17 (D) A description of how the Depart18 ment— 

19 (i) identifies gaps in the supply of 

20 mental health professionals; and 

21 (ii) determines successful staffing ra22 tios for mental health professionals of the 

23 Department. 

24 (E) A description of actions taken by the 

25 Secretary, in consultation with the Director of 
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1 the Office of Personnel Management, to create 

2 an occupational series for mental health coun3 selors and marriage and family therapists of the 

4 Department and a timeline for the creation of 

5 such an occupational series. 

6 (F) A description of actions taken by the 

7 Secretary to ensure that the national, regional, 

8 and local professional standards boards for 

9 mental health counselors and marriage and 

10 family therapists are comprised of only mental 

11 health counselors and marriage and family 

12 therapists and that the liaison from the Depart13 ment to such boards is a mental health coun14 selor or marriage and family therapist. 

15 (c) COMPILATION OF DATA.—The Secretary of Vet16 erans Affairs shall ensure that data under subsections (a) 

17 and (b) is compiled separately and disaggregated by year 

18 and compiled in a manner that allows it to be analyzed 

19 across all data fields for purposes of informing and updat20 ing clinical practice guidelines of the Department of Vet21 erans Affairs. 

22 (d) BRIEFINGS.—The Secretary of Veterans Affairs 

23 shall brief the Committee on Veterans’ Affairs of the Sen24 ate and the Committee on Veterans’ Affairs of the House 

25 of Representatives containing the interim results— 
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1 (1) with respect to the study under subsection 

2 (a)(1), not later than 24 months after entering into 

3 the agreement under such subsection; and 

4 (2) with respect to the review under subsection 

5 (b)(1), not later than 18 months after the date of 

6 the enactment of this Act. 

7 (e) REPORTS.— 

8 (1) REPORT ON STUDY.—Not later than 90 

9 days after the completion by the Secretary of Vet10 erans Affairs in coordination with the National 

11 Academies of Sciences, Engineering, and Medicine of 

12 the study required under subsection (a)(1), the Sec13 retary shall— 

14 (A) submit to the Committee on Veterans’ 

15 Affairs of the Senate and the Committee on 

16 Veterans’ Affairs of the House of Representa17 tives a report on the results of the study; and 

18 (B) make such report publicly available. 

19 (2) REPORT ON REVIEW.—Not later than 90 

20 days after the completion by the Comptroller Gen21 eral of the United States of the review required 

22 under subsection (b)(1), the Comptroller General 

23 shall— 

24 (A) submit to the Committee on Veterans’ 

25 Affairs of the Senate and the Committee on 
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1 Veterans’ Affairs of the House of Representa2 tives a report on the results of the review; and 

3 (B) make such report publicly available. 

4 SEC. 205. COMPTROLLER GENERAL REPORT ON MANAGE5 MENT BY DEPARTMENT OF VETERANS AF6 FAIRS OF VETERANS AT HIGH RISK FOR SUI7 CIDE. 

8 (a) IN GENERAL.—Not later than 18 months after 

9 the date of the enactment of this Act, the Comptroller 

10 General of the United States shall submit to the Com11 mittee on Veterans’ Affairs of the Senate and the Com12 mittee on Veterans’ Affairs of the House of Representa13 tives a report on the efforts of the Department of Veterans 

14 Affairs to manage veterans at high risk for suicide. 

15 (b) ELEMENTS.—The report required by subsection 

16 (a) shall include the following: 

17 (1) A description of how the Department identi18 fies patients as high risk for suicide, with particular 

19 consideration to the efficacy of inputs into the Re20 covery Engagement and Coordination for Health – 

21 Veterans Enhanced Treatment program (commonly 

22 referred to as the ‘‘REACH VET’’ program) of the 

23 Department, including an assessment of the efficacy 

24 of such identifications disaggregated by— 
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1 (A) all demographic characteristics as de2 termined necessary and appropriate by the Sec3 retary of Veterans Affairs in coordination with 

4 the Centers for Disease Control and Prevention; 

5 (B) Veterans Integrated Service Network; 

6 and 

7 (C) to the extent practicable, medical cen8 ter of the Department. 

9 (2) A description of how the Department inter10 venes when a patient is identified as high risk, in11 cluding an assessment of the efficacy of such inter12 ventions disaggregated by— 

13 (A) all demographic characteristics as de14 termined necessary and appropriate by the Sec15 retary in coordination with the Centers for Dis16 ease Control and Prevention; 

17 (B) Veterans Integrated Service Network; 

18 and 

19 (C) to the extent practicable, medical cen20 ter of the Department. 

21 (3) A description of how the Department mon22 itors patients who have been identified as high risk, 

23 including an assessment of the efficacy of such mon24 itoring and any follow-ups disaggregated by— 
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1 (A) all demographic characteristics as de2 termined necessary and appropriate by the Sec3 retary in coordination with the Centers for Dis4 ease Control and Prevention; 

5 (B) Veterans Integrated Service Network; 

6 and 

7 (C) to the extent practicable, medical cen8 ter of the Department. 

9 (4) A review of staffing levels of suicide preven10 tion coordinators across the Veterans Health Admin11 istration. 

12 (5) A review of the resources and programming 

13 offered to family members and friends of veterans 

14 who have a mental health condition in order to as15 sist that veteran in treatment and recovery. 

16 (6) An assessment of such other areas as the 

17 Comptroller General considers appropriate to study. 

18 TITLE III—PROGRAMS, STUDIES, 

19 AND GUIDELINES ON MENTAL 

20 HEALTH 

21 SEC. 301. STUDY ON CONNECTION BETWEEN LIVING AT 

22 HIGH ALTITUDE AND SUICIDE RISK FACTORS 

23 AMONG VETERANS. 

24 (a) IN GENERAL.—Not later than 180 days after the 

25 date of the enactment of this Act, the Secretary of Vet-
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1 erans Affairs, in consultation with Rural Health Resource 

2 Centers of the Office of Rural Health of the Department 

3 of Veterans Affairs, shall commence the conduct of a study 

4 on the connection between living at high altitude and the 

5 risk of developing depression or dying by suicide among 

6 veterans. 

7 (b) COMPLETION OF STUDY.—The study conducted 

8 under subsection (a) shall be completed not later than 

9 three years after the date of the commencement of the 

10 study. 

11 (c) INDIVIDUAL IMPACT.—The study conducted 

12 under subsection (a) shall be conducted so as to determine 

13 the effect of high altitude on suicide risk at the individual 

14 level, not at the State or county level. 

15 (d) REPORT.—Not later than 150 days after the com16 pletion of the study conducted under subsection (a), the 

17 Secretary shall submit to the Committee on Veterans’ Af18 fairs of the Senate and the Committee on Veterans’ Af19 fairs of the House of Representatives a report on the re20 sults of the study. 

21 (e) FOLLOW-UP STUDY.— 

22 (1) IN GENERAL.—If the Secretary determines 

23 through the study conducted under subsection (a) 

24 that living at high altitude is a risk factor for devel25 oping depression or dying by suicide, the Secretary 
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1 shall conduct an additional study to identify the fol2 lowing: 

3 (A) The most likely biological mechanism 

4 that makes living at high altitude a risk factor 

5 for developing depression or dying by suicide. 

6 (B) The most effective treatment or inter7 vention for reducing the risk of developing de8 pression or dying by suicide associated with liv9 ing at high altitude. 

10 (2) REPORT.—Not later than 150 days after 

11 completing the study conducted under paragraph 

12 (1), the Secretary shall submit to the Committee on 

13 Veterans’ Affairs of the Senate and the Committee 

14 on Veterans’ Affairs of the House of Representatives 

15 a report on the results of the study. 

16 SEC. 302. ESTABLISHMENT BY DEPARTMENT OF VETERANS 

17 AFFAIRS AND DEPARTMENT OF DEFENSE OF 

18 A CLINICAL PROVIDER TREATMENT TOOLKIT 

19 AND ACCOMPANYING TRAINING MATERIALS 

20 FOR COMORBIDITIES. 

21 (a) IN GENERAL.—Not later than two years after the 

22 date of the enactment of this Act, the Secretary of Vet23 erans Affairs, in consultation with the Secretary of De24 fense, shall develop a clinical provider treatment toolkit 

25 and accompanying training materials for the evidence- 
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1 based management of comorbid mental health conditions, 

2 comorbid mental health and substance use disorders, and 

3 a comorbid mental health condition and chronic pain. 

4 (b) MATTERS INCLUDED.—In developing the clinical 

5 provider treatment toolkit and accompanying training ma6 terials under subsection (a), the Secretary of Veterans Af7 fairs and the Secretary of Defense shall ensure that the 

8 toolkit and training materials include guidance with re9 spect to the following: 

10 (1) The treatment of patients with post-trau11 matic stress disorder who are also experiencing an 

12 additional mental health condition, a substance use 

13 disorder, or chronic pain. 

14 (2) The treatment of patients experiencing a 

15 mental health condition, including anxiety, depres16 sion, or bipolar disorder, who are also experiencing 

17 a substance use disorder or chronic pain. 

18 (3) The treatment of patients with traumatic 

19 brain injury who are also experiencing— 

20 (A) a mental health condition, including 

21 post-traumatic stress disorder, anxiety, depres22 sion, or bipolar disorder; 

23 (B) a substance use disorder; or 

24 (C) chronic pain. 
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1 SEC. 303. UPDATE OF CLINICAL PRACTICE GUIDELINES 

2 FOR ASSESSMENT AND MANAGEMENT OF PA3 TIENTS AT RISK FOR SUICIDE. 

4 (a) IN GENERAL.—In the first publication of the De5 partment of Veterans Affairs and Department of Defense 

6 Clinical Practice Guideline for Assessment and Manage7 ment of Patients at Risk for Suicide published after the 

8 date of the enactment of this Act, the Secretary of Vet9 erans Affairs and the Secretary of Defense, through the 

10 Assessment and Management of Patients at Risk for Sui11 cide Work Group (in this section referred to as the ‘‘Work 

12 Group’’), shall ensure the publication includes the fol13 lowing: 

14 (1) Enhanced guidance with respect to gender15 specific— 

16 (A) risk factors for suicide and suicidal 

17 ideation; 

18 (B) treatment efficacy for depression and 

19 suicide prevention; 

20 (C) pharmacotherapy efficacy; and 

21 (D) psychotherapy efficacy. 

22 (2) Guidance with respect to the efficacy of al23 ternative therapies, other than psychotherapy and 

24 pharmacotherapy, including the following: 

25 (A) Yoga therapy. 

26 (B) Meditation therapy. 
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1 (C) Equine therapy. 

2 (D) Other animal therapy. 

3 (E) Training and caring for service dogs. 

4 (F) Agritherapy. 

5 (G) Art therapy. 

6 (H) Outdoor sports therapy. 

7 (I) Music therapy. 

8 (J) Any other alternative therapy that the 

9 Work Group considers appropriate. 

10 (3) Guidance with respect to the findings of the 

11 Creating Options for Veterans’ Expedited Recovery 

12 Commission (commonly referred to as the ‘‘COVER 

13 Commission’’) established under section 931 of the 

14 Jason Simcakoski Memorial and Promise Act (title 

15 IX of Public Law 114–198; 38 U.S.C. 1701 note). 

16 (b) RULE OF CONSTRUCTION.—Nothing in this sec17 tion shall be construed to prevent the Secretary of Vet18 erans Affairs and the Secretary of Defense from consid19 ering all relevant evidence, as appropriate, in updating the 

20 Department of Veterans Affairs and Department of De21 fense Clinical Practice Guideline for Assessment and Man22 agement of Patients at Risk for Suicide, as required under 

23 subsection (a), or from ensuring that the final clinical 

24 practice guidelines updated under such subsection remain 
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1 applicable to the patient populations of the Department 

2 of Veterans Affairs and the Department of Defense. 

3 SEC. 304. ESTABLISHMENT BY DEPARTMENT OF VETERANS 

4 AFFAIRS AND DEPARTMENT OF DEFENSE OF 

5 CLINICAL PRACTICE GUIDELINES FOR THE 

6 TREATMENT OF SERIOUS MENTAL ILLNESS. 

7 (a) IN GENERAL.—Not later than two years after the 

8 date of the enactment of this Act, the Secretary of Vet9 erans Affairs, in consultation with the Secretary of De10 fense and the Secretary of Health and Human Services, 

11 shall complete the development of a clinical practice guide12 line or guidelines for the treatment of serious mental ill13 ness, to include the following conditions: 

14 (1) Schizophrenia. 

15 (2) Schizoaffective disorder. 

16 (3) Persistent mood disorder, including bipolar 

17 disorder I and II. 

18 (4) Any other mental, behavioral, or emotional 

19 disorder resulting in serious functional impairment 

20 that substantially interferes with major life activities 

21 as the Secretary of Veterans Affairs, in consultation 

22 with the Secretary of Defense and the Secretary of 

23 Health and Human Services, considers appropriate. 
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1 (b) MATTERS INCLUDED IN GUIDELINES.—The clin2 ical practice guideline or guidelines developed under sub3 section (a) shall include the following: 

4 (1) Guidance contained in the 2016 Clinical 

5 Practice Guidelines for the Management of Major 

6 Depressive Disorders of the Department of Veterans 

7 Affairs and the Department of Defense. 

8 (2) Guidance with respect to the treatment of 

9 patients with a condition described in subsection (a). 

10 (3) A list of evidence-based therapies for the 

11 treatment of conditions described in subsection (a). 

12 (4) An appropriate guideline for the administra13 tion of pharmacological therapy, psychological or be14 havioral therapy, or other therapy for the manage15 ment of conditions described in subsection (a). 

16 (c) ASSESSMENT OF EXISTING GUIDELINES.—Not 

17 later than two years after the date of the enactment of 

18 this Act, the Secretary of Veterans Affairs, in consultation 

19 with the Secretary of Defense and the Secretary of Health 

20 and Human Services, shall complete an assessment of the 

21 2016 Clinical Practice Guidelines for the Management of 

22 Major Depressive Disorders to determine whether an up23 date to such guidelines is necessary. 

24 (d) WORK GROUP.— 
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1 (1) ESTABLISHMENT.—The Secretary of Vet2 erans Affairs, the Secretary of Defense, and the Sec3 retary of Health and Human Services shall create a 

4 work group to develop the clinical practice guideline 

5 or guidelines under subsection (a) to be known as 

6 the ‘‘Serious Mental Illness Work Group’’ (in this 

7 subsection referred to as the ‘‘Work Group’’). 

8 (2) MEMBERSHIP.—The Work Group created 

9 under paragraph (1) shall be comprised of individ10 uals that represent Federal Government entities and 

11 non-Federal Government entities with expertise in 

12 the areas covered by the Work Group, including the 

13 following entities: 

14 (A) Academic institutions that specialize in 

15 research for the treatment of conditions de16 scribed in subsection (a). 

17 (B) The Health Services Research and De18 velopment Service of the Department of Vet19 erans Affairs. 

20 (C) The Office of the Assistant Secretary 

21 for Mental Health and Substance Use of the 

22 Department of Health and Human Services. 

23 (D) The National Institute of Mental 

24 Health. 

25 (E) The Indian Health Service. 
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1 (F) Relevant organizations with expertise 

2 in researching, diagnosing, or treating condi3 tions described in subsection (a). 

4 (3) RELATION TO OTHER WORK GROUPS.—The 

5 Work Group shall be created and conducted in the 

6 same manner as other work groups for the develop7 ment of clinical practice guidelines for the Depart8 ment of Veterans Affairs and the Department of De9 fense. 

10 (e) RULE OF CONSTRUCTION.—Nothing in this sec11 tion shall be construed to prevent the Secretary of Vet12 erans Affairs and the Secretary of Defense from consid13 ering all relevant evidence, as appropriate, in creating the 

14 clinical practice guideline or guidelines required under 

15 subsection (a) or from ensuring that the final clinical prac16 tice guideline or guidelines developed under such sub17 section and subsequently updated, as appropriate, remain 

18 applicable to the patient populations of the Department 

19 of Veterans Affairs and the Department of Defense. 

20 SEC. 305. PRECISION MEDICINE INITIATIVE OF DEPART21 MENT OF VETERANS AFFAIRS TO IDENTIFY 

22 AND VALIDATE BRAIN AND MENTAL HEALTH 

23 BIOMARKERS. 

24 (a) IN GENERAL.—Beginning not later than 18 

25 months after the date of the enactment of this Act, the 
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1 Secretary of Veterans Affairs shall develop and implement 

2 an initiative of the Department of Veterans Affairs to 

3 identify and validate brain and mental health biomarkers 

4 among veterans, with specific consideration for depression, 

5 anxiety, post-traumatic stress disorder, bipolar disorder, 

6 traumatic brain injury, and such other mental health con7 ditions as the Secretary considers appropriate. Such initia8 tive may be referred to as the ‘‘Precision Medicine for Vet9 erans Initiative’’. 

10 (b) MODEL OF INITIATIVE.—The initiative under 

11 subsection (a) shall be modeled on the All of Us Precision 

12 Medicine Initiative administered by the National Insti13 tutes of Health with respect to large-scale collection of 

14 standardized data and open data sharing. 

15 (c) METHODS.—The initiative under subsection (a) 

16 shall include brain structure and function measurements, 

17 such as functional magnetic resonance imaging and elec18 troencephalogram, and shall coordinate with additional bi19 ological methods of analysis utilized in the Million Vet20 erans Program of the Department of Veterans Affairs. 

21 (d) USE OF DATA.— 

22 (1) PRIVACY AND SECURITY.—In carrying out 

23 the initiative under subsection (a), the Secretary 

24 shall develop robust data privacy and security meas25 ures, consistent with section 552a of title 5, United 
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1 States Code (commonly known as the ‘‘Privacy Act 

2 of 1974’’), and regulations promulgated pursuant to 

3 the Health Insurance Portability and Accountability 

4 Act of 1996 (parts 160, 162, and 164 of title 45, 

5 Code of Federal Regulations, or successor regula6 tions) to ensure that information of veterans partici7 pating in the initiative is kept private and secure. 

8 (2) CONSULTATION WITH THE NATIONAL INSTI9 TUTES OF SCIENCE AND TECHNOLOGY.—The Sec10 retary may consult with the National Institute of 

11 Science and Technology in developing the data pri12 vacy and security measures described in paragraph 

13 (1). 

14 (3) ACCESS STANDARDS.—The Secretary shall 

15 provide access to information under the initiative 

16 consistent with the standards described in section 

17 552a(d)(1) of title 5, United States Code, and sec18 tion 164.524 of title 45, Code of Federal Regula19 tions, or successor regulations. 

20 (4) OPEN PLATFORM.— 

21 (A) AVAILABILITY OF DATA.—The Sec22 retary shall make de-identified data collected 

23 under the initiative available for research pur24 poses to Federal agencies. 
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1 (B) CONTRACT.—The Secretary shall con2 tract with nongovernment entities that comply 

3 with requisite data security measures to make 

4 available for research purposes de-identified 

5 data collected under the initiative. 

6 (C) ASSISTANCE.—The Secretary shall 

7 provide assistance to a Federal agency con8 ducting research using data collected under the 

9 initiative at the request of that agency. 

10 (D) PROHIBITION ON TRANSFER OF

11 DATA.—Federal agencies may not disclose, 

12 transmit, share, sell, license, or otherwise trans13 fer data collected under the initiative to any 

14 nongovernment entity other than as allowed 

15 under subparagraph (B). 

16 (5) STANDARDIZATION.— 

17 (A) IN GENERAL.—The Secretary shall en18 sure that data collected under the initiative is 

19 standardized. 

20 (B) CONSULTATION.—The Secretary shall 

21 consult with the National Institutes of Health 

22 and the Food and Drug Administration to de23 termine the most effective, efficient, and cost24 effective way of standardizing data collected 

25 under the initiative. 
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1 (C) MANNER OF STANDARDIZATION.—In 

2 consultation with the National Institute for 

3 Science and Technology, data collected under 

4 the initiative shall be standardized in the man5 ner in which it is collected, entered into the 

6 database, extracted, and recorded. 

7 (6) MEASURES OF BRAIN FUNCTION OR STRUC8 TURE.—Any measures of brain function or structure 

9 collected under the initiative shall be collected with 

10 a device that is approved by the Food and Drug Ad11 ministration. 

12 (7) DE-IDENTIFIED DATA DEFINED.—In this 

13 subsection, the term ‘‘de-identified data’’ means, 

14 with respect to data held by the Department of Vet15 erans Affairs, that the Department— 

16 (A) alters, anonymizes, or aggregates the 

17 data so that there is a reasonable basis for ex18 pecting that the data could not be linked as a 

19 practical matter to a specific individual; 

20 (B) publicly commits to refrain from at21 tempting to re-identify the data with a specific 

22 individual, and adopts controls to prevent such 

23 identification; and 

24 (C) causes the data to be covered by a con25 tractual or other legally enforceable prohibition 
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1 on each entity to which the Department dis2 closes the data from attempting to use the data 

3 to identify a specific individual and requires the 

4 same of all onward disclosures. 

5 (e) INCLUSION OF INITIATIVE IN PROGRAM.—The 

6 Secretary shall coordinate efforts of the initiative under 

7 subsection (a) with the Million Veterans Program of the 

8 Department. 

9 SEC. 306. STATISTICAL ANALYSES AND DATA EVALUATION 

10 BY DEPARTMENT OF VETERANS AFFAIRS. 

11 (a) IN GENERAL.—Chapter 1 of title 38, United 

12 States Code, is amended by adding at the end the fol13 lowing new section: 

14 ‘‘§ 119. Contracting for statistical analyses and data 

15 evaluation 

16 ‘‘(a) IN GENERAL.—The Secretary may enter into a 

17 contract or other agreement with an academic institution 

18 or other qualified entity, as determined by the Secretary, 

19 to carry out statistical analyses and data evaluation as re20 quired of the Secretary by law.’’. 

21 ‘‘(b) RULE OF CONSTRUCTION.—Nothing in this sec22 tion may be construed to limit the authority of the Sec23 retary to enter into contracts or other agreements for sta24 tistical analyses and data evaluation under any other pro25 vision of law.’’. 
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1 (b) CLERICAL AMENDMENT.—The table of sections 

2 at the beginning of chapter 1 of such title is amended by 

3 adding at the end the following new item: 

‘‘119. Contracting for statistical analyses and data evaluation.’’. 

4 TITLE IV—OVERSIGHT OF MEN5 TAL HEALTH CARE AND RE6 LATED SERVICES 

7 SEC. 401. STUDY ON EFFECTIVENESS OF SUICIDE PREVEN8 TION AND MENTAL HEALTH OUTREACH PRO9 GRAMS OF DEPARTMENT OF VETERANS AF10 FAIRS. 

11 (a) IN GENERAL.—Not later than 180 days after the 

12 date of the enactment of this Act, the Secretary of Vet13 erans Affairs shall enter into an agreement with a non14 Federal Government entity with expertise in conducting 

15 and evaluating research-based studies to conduct a study 

16 on the effectiveness of the suicide prevention and mental 

17 health outreach materials prepared by the Department of 

18 Veterans Affairs and the suicide prevention and mental 

19 health outreach campaigns conducted by the Department. 

20 (b) USE OF FOCUS GROUPS.— 

21 (1) IN GENERAL.—The Secretary shall convene 

22 not fewer than eight different focus groups to evalu23 ate the effectiveness of the suicide prevention and 

24 mental health materials and campaigns as required 

25 under subsection (a). 
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1 (2) LOCATION OF FOCUS GROUPS.—Focus 

2 groups convened under paragraph (1) shall be held 

3 in geographically diverse areas as follows: 

4 (A) Not fewer than two in rural or highly 

5 rural areas. 

6 (B) Not fewer than one in each of the four 

7 districts of the Veterans Benefits Administra8 tion. 

9 (3) TIMING OF FOCUS GROUPS.—Focus groups 

10 convened under paragraph (1) shall be held at a va11 riety of dates and times to ensure an adequate rep12 resentation of veterans with different work sched13 ules. 

14 (4) NUMBER OF PARTICIPANTS.—Each focus 

15 group convened under paragraph (1) shall include 

16 not fewer than five and not more than 12 partici17 pants. 

18 (5) REPRESENTATION.—Each focus group con19 vened under paragraph (1) shall, to the extent prac20 ticable, include veterans of diverse backgrounds, in21 cluding— 

22 (A) veterans of all eras, as determined by 

23 the Secretary; 

24 (B) women veterans; 

25 (C) minority veterans; 
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1 (D) Native American veterans, as defined 

2 in section 3765 of title 38, United States Code; 

3 (E) veterans who identify as lesbian, gay, 

4 bisexual, transgender, or queer (commonly re5 ferred to as ‘‘LGBTQ’’); 

6 (F) veterans who live in rural or highly 

7 rural areas; 

8 (G) individuals transitioning from active 

9 duty in the Armed Forces to civilian life; and 

10 (H) other high-risk groups of veterans, as 

11 determined by the Secretary. 

12 (c) REPORT.— 

13 (1) IN GENERAL.—Not later than 90 days after 

14 the last focus group meeting under subsection (b), 

15 the Secretary shall submit to the Committee on Vet16 erans’ Affairs of the Senate and the Committee on 

17 Veterans’ Affairs of the House of Representatives a 

18 report on the findings of the focus groups. 

19 (2) ELEMENTS.—The report required by para20 graph (1) shall include the following: 

21 (A) Based on the findings of the focus 

22 groups, an assessment of the effectiveness of 

23 current suicide prevention and mental health 

24 materials and campaigns of the Department in 

25 reaching veterans as a whole as well as specific 
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1 groups of veterans (for example, women vet2 erans). 

3 (B) Based on the findings of the focus 

4 groups, recommendations for future suicide pre5 vention and mental health materials and cam6 paigns of the Department to target specific 

7 groups of veterans. 

8 (C) A plan to change the current suicide 

9 prevention and mental health materials and 

10 campaigns of the Department or, if the Sec11 retary decides not to change the current mate12 rials and campaigns, an explanation of the rea13 son for maintaining the current materials and 

14 campaigns. 

15 (D) A description of any dissenting or op16 posing viewpoints raised by participants in the 

17 focus group. 

18 (E) Such other issues as the Secretary 

19 considers necessary. 

20 (d) REPRESENTATIVE SURVEY.— 

21 (1) IN GENERAL.—Not later than one year 

22 after the last focus group meeting under subsection 

23 (b), the Secretary shall complete a representative 

24 survey of the veteran population that is informed by 

25 the focus group data in order to collect information 
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1 about the effectiveness of the mental health and sui2 cide prevention materials and campaigns conducted 

3 by the Department. 

4 (2) VETERANS SURVEYED.— 

5 (A) IN GENERAL.—Veterans surveyed 

6 under paragraph (1) shall include veterans de7 scribed in subsection (b)(5). 

8 (B) DISAGGREGATION OF DATA.—Data of 

9 veterans surveyed under paragraph (1) shall be 

10 disaggregated by— 

11 (i) veterans who have received care 

12 from the Department during the two-year 

13 period preceding the survey; and 

14 (ii) veterans who have not received 

15 care from the Department during the two16 year period preceding the survey. 

17 (e) TREATMENT OF CONTRACTS FOR SUICIDE PRE18 VENTION AND MENTAL HEALTH OUTREACH MEDIA.— 

19 (1) FOCUS GROUPS.— 

20 (A) IN GENERAL.—The Secretary shall in21 clude in each contract to develop media relating 

22 to suicide prevention and mental health mate23 rials and campaigns a requirement that the 

24 contractor convene focus groups of veterans to 
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1 assess the effectiveness of suicide prevention 

2 and mental health outreach. 

3 (B) REPRESENTATION.—Each focus group 

4 required under subparagraph (A) shall, to the 

5 extent practicable, include veterans of diverse 

6 backgrounds, including— 

7 (i) veterans of all eras, as determined 

8 by the Secretary; 

9 (ii) women veterans; 

10 (iii) minority veterans; 

11 (iv) Native American veterans, as de12 fined in section 3765 of title 38, United 

13 States Code; 

14 (v) veterans who identify as lesbian, 

15 gay, bisexual, transgender, or queer (com16 monly referred to as ‘‘LGBTQ’’); 

17 (vi) veterans who live in rural or high18 ly rural areas; 

19 (vii) individuals transitioning from ac20 tive duty in the Armed Forces to civilian 

21 life; and 

22 (viii) other high-risk groups of vet23 erans, as determined by the Secretary. 

24 (2) SUBCONTRACTING.— 
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1 (A) IN GENERAL.—The Secretary shall in2 clude in each contract described in paragraph 

3 (1)(A) a requirement that, if the contractor 

4 subcontracts for the development of media, the 

5 contractor shall subcontract with a subcon6 tractor that has experience creating impactful 

7 media campaigns that target individuals age 18 

8 to 34. 

9 (B) BUDGET LIMITATION.—Not more than 

10 two percent of the budget of the Office of Men11 tal Health and Suicide Prevention of the De12 partment for contractors for suicide prevention 

13 and mental health media outreach shall go to 

14 subcontractors described in subparagraph (A). 

15 (f) PAPERWORK REDUCTION ACT EXEMPTION.— 

16 Chapter 35 of title 44, United States Code (commonly 

17 known as the ‘‘Paperwork Reduction Act’’) shall not apply 

18 to any rulemaking or information collection required 

19 under this section. 

20 (g) RURAL AND HIGHLY RURAL DEFINED.—In this 

21 section, with respect to an area, the terms ‘‘rural’’ and 

22 ‘‘highly rural’’ have the meanings given those terms in the 

23 Rural-Urban Commuting Areas coding system of the De24 partment of Agriculture. 
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1 SEC. 402. OVERSIGHT OF MENTAL HEALTH AND SUICIDE 

2 PREVENTION MEDIA OUTREACH CONDUCTED 

3 BY DEPARTMENT OF VETERANS AFFAIRS. 

4 (a) ESTABLISHMENT OF GOALS.— 

5 (1) IN GENERAL.—The Secretary of Veterans 

6 Affairs shall establish goals for the mental health 

7 and suicide prevention media outreach campaigns of 

8 the Department of Veterans Affairs, which shall in9 clude the establishment of targets, metrics, and ac10 tion plans to describe and assess those campaigns. 

11 (2) USE OF METRICS.— 

12 (A) IN GENERAL.—The goals established 

13 under paragraph (1) shall be measured by 

14 metrics specific to different media types. 

15 (B) FACTORS TO CONSIDER.—In using 

16 metrics under subparagraph (A), the Secretary 

17 shall determine the best methodological ap18 proach for each media type and shall consider 

19 the following: 

20 (i) Metrics relating to social media, 

21 which may include the following: 

22 (I) Impressions. 

23 (II) Reach. 

24 (III) Engagement rate. 

25 (IV) Such other metrics as the 

26 Secretary considers necessary. 
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1 (ii) Metrics relating to television, 

2 which may include the following: 

3 (I) Nielsen ratings. 

4 (II) Such other metrics as the 

5 Secretary considers necessary. 

6 (iii) Metrics relating to email, which 

7 may include the following: 

8 (I) Open rate. 

9 (II) Response rate. 

10 (III) Click rate. 

11 (IV) Such other metrics as the 

12 Secretary considers necessary. 

13 (C) UPDATE.—The Secretary shall periodi14 cally update the metrics under subparagraph 

15 (B) as more accurate metrics become available. 

16 (3) TARGETS.—The Secretary shall establish 

17 targets to track the metrics used under paragraph 

18 (2). 

19 (4) CONSULTATION.—In establishing goals 

20 under paragraph (1), the Secretary shall consult 

21 with the following: 

22 (A) Relevant stakeholders, such as organi23 zations that represent veterans, as determined 

24 by the Secretary. 
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1 (B) Mental health and suicide prevention 

2 experts. 

3 (C) Such other persons as the Secretary 

4 considers appropriate. 

5 (5) INITIAL REPORT.—Not later than 180 days 

6 after the date of the enactment of this Act, the Sec7 retary shall submit to the Committee on Veterans’ 

8 Affairs of the Senate and the Committee on Vet9 erans’ Affairs of the House of Representatives a re10 port detailing the goals established under paragraph 

11 (1) for the mental health and suicide prevention 

12 media outreach campaigns of the Department, in13 cluding the metrics and targets for such metrics by 

14 which those goals are to be measured under para15 graphs (2) and (3). 

16 (6) ANNUAL REPORT.—Not later than one year 

17 after the submittal of the report under paragraph 

18 (5), and annually thereafter, the Secretary shall sub19 mit to the Committee on Veterans’ Affairs of the 

20 Senate and the Committee on Veterans’ Affairs of 

21 the House of Representatives a report detailing— 

22 (A) the progress of the Department in 

23 meeting the goals established under paragraph 

24 (1) and the targets established under paragraph 

25 (3); and 
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1 (B) a description of action to be taken by 

2 the Department to modify mental health and 

3 suicide prevention media outreach campaigns if 

4 those goals and targets are not being met. 

5 (b) REPORT ON USE OF FUNDS BY OFFICE OF MEN6 TAL HEALTH AND SUICIDE PREVENTION.—Not later than 

7 180 days after the date of the enactment of this Act, and 

8 semiannually thereafter, the Secretary shall submit to the 

9 Committee on Appropriations and the Committee on Vet10 erans’ Affairs of the Senate and the Committee on Appro11 priations and the Committee on Veterans’ Affairs of the 

12 House of Representatives a report containing the expendi13 tures and obligations of the Office of Mental Health and 

14 Suicide Prevention of the Veterans Health Administration 

15 during the period covered by the report. 

16 SEC. 403. COMPTROLLER GENERAL MANAGEMENT REVIEW 

17 OF MENTAL HEALTH AND SUICIDE PREVEN18 TION SERVICES OF DEPARTMENT OF VET19 ERANS AFFAIRS. 

20 (a) IN GENERAL.—Not later than three years after 

21 the date of the enactment of this Act, the Comptroller 

22 General of the United States shall submit to the Com23 mittee on Veterans’ Affairs of the Senate and the Com24 mittee on Veterans’ Affairs of the House of Representa25 tives a management review of the mental health and sui-
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1 cide prevention services provided by the Department of 

2 Veterans Affairs. 

3 (b) ELEMENTS.—The management review required 

4 by subsection (a) shall include the following: 

5 (1) An assessment of the infrastructure under 

6 the control of or available to the Office of Mental 

7 Health and Suicide Prevention of the Department of 

8 Veterans Affairs or available to the Department of 

9 Veterans Affairs for suicide prevention efforts not 

10 operated by the Office of Mental Health and Suicide 

11 Prevention. 

12 (2) A description of the management and orga13 nizational structure of the Office of Mental Health 

14 and Suicide Prevention, including roles and respon15 sibilities for each position. 

16 (3) A description of the operational policies and 

17 processes of the Office of Mental Health and Suicide 

18 Prevention. 

19 (4) An assessment of suicide prevention prac20 tices and initiatives available from the Department 

21 and through community partnerships. 

22 (5) An assessment of the staffing levels at the 

23 Office of Mental Health and Suicide Prevention, 

24 disaggregated by type of position, and including the 

25 location of any staffing deficiencies. 
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1 (6) An assessment of the Nurse Advice Line 

2 pilot program conducted by the Department. 

3 (7) An assessment of recruitment initiatives in 

4 rural areas for mental health professionals of the 

5 Department. 

6 (8) An assessment of strategic planning con7 ducted by the Office of Mental Health and Suicide 

8 Prevention. 

9 (9) An assessment of the communication, and 

10 the effectiveness of such communication— 

11 (A) within the central office of the Office 

12 of Mental Health and Suicide Prevention; 

13 (B) between that central office and any 

14 staff member or office in the field, including 

15 chaplains, attorneys, law enforcement per16 sonnel, and volunteers; and 

17 (C) between that central office, local facili18 ties of the Department, and community part19 ners of the Department, including first respond20 ers, community support groups, and health care 

21 industry partners. 

22 (10) An assessment of how effectively the Office 

23 of Mental Health and Suicide Prevention implements 

24 operational policies and procedures. 
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1 (11) An assessment of how the Department of 

2 Veterans Affairs and the Department of Defense co3 ordinate suicide prevention efforts, and recommenda4 tions on how the Department of Veterans Affairs 

5 and Department of Defense can more effectively co6 ordinate those efforts. 

7 (12) An assessment of such other areas as the 

8 Comptroller General considers appropriate to study. 

9 SEC. 404. COMPTROLLER GENERAL REPORT ON EFFORTS 

10 OF DEPARTMENT OF VETERANS AFFAIRS TO 

11 INTEGRATE MENTAL HEALTH CARE INTO 

12 PRIMARY CARE CLINICS. 

13 (a) INITIAL REPORT.— 

14 (1) IN GENERAL.—Not later than two years 

15 after the date of the enactment of this Act, the 

16 Comptroller General of the United States shall sub17 mit to the Committee on Veterans’ Affairs of the 

18 Senate and the Committee on Veterans’ Affairs of 

19 the House of Representatives a report on the efforts 

20 of the Department of Veterans Affairs to integrate 

21 mental health care into primary care clinics of the 

22 Department. 

23 (2) ELEMENTS.—The report required by sub24 section (a) shall include the following: 
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1 (A) An assessment of the efforts of the 

2 Department to integrate mental health care 

3 into primary care clinics of the Department. 

4 (B) An assessment of the effectiveness of 

5 such efforts. 

6 (C) An assessment of how the health care 

7 of veterans is impacted by such integration. 

8 (D) A description of how care is coordi9 nated by the Department between specialty 

10 mental health care and primary care, including 

11 a description of the following: 

12 (i) How documents and patient infor13 mation are transferred and the effective14 ness of those transfers. 

15 (ii) How care is coordinated when vet16 erans must travel to different facilities of 

17 the Department. 

18 (iii) How a veteran is reintegrated 

19 into primary care after receiving in-patient 

20 mental health care. 

21 (E) An assessment of how the integration 

22 of mental health care into primary care clinics 

23 is implemented at different types of facilities of 

24 the Department. 
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1 (F) Such recommendations on how the De2 partment can better integrate mental health 

3 care into primary care clinics as the Comp4 troller General considers appropriate. 

5 (G) An assessment of such other areas as 

6 the Comptroller General considers appropriate 

7 to study. 

8 (b) COMMUNITY CARE INTEGRATION REPORT.— 

9 (1) IN GENERAL.—Not later than two years 

10 after the date on which the Comptroller General 

11 submits the report required under subsection (a)(1), 

12 the Comptroller General shall submit to the Com13 mittee on Veterans’ Affairs of the Senate and the 

14 Committee on Veterans’ Affairs of the House of 

15 Representatives a report on the efforts of the De16 partment to integrate community-based mental 

17 health care into the Veterans Health Administration. 

18 (2) ELEMENTS.—The report required by para19 graph (1) shall include the following: 

20 (A) An assessment of the efforts of the 

21 Department to integrate community-based men22 tal health care into the Veterans Health Admin23 istration. 

24 (B) An assessment of the effectiveness of 

25 such efforts. 
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1 (C) An assessment of how the health care 

2 of veterans is impacted by such integration. 

3 (D) A description of how care is coordi4 nated between providers of community-based 

5 mental health care and the Veterans Health 

6 Administration, including a description of how 

7 documents and patient information are trans8 ferred and the effectiveness of those transfers 

9 between— 

10 (i) the Veterans Health Administra11 tion and providers of community-based 

12 mental health care; and 

13 (ii) providers of community-based 

14 mental health care and the Veterans 

15 Health Administration. 

16 (E) An assessment of any disparities in the 

17 coordination of community-based mental health 

18 care into the Veterans Health Administration 

19 by location and type of facility. 

20 (F) An assessment of the military cultural 

21 competency of health care providers providing 

22 community-based mental health care to vet23 erans. 

24 (G) Such recommendations on how the De25 partment can better integrate community-based 
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1 mental health care into the Veterans Health 

2 Administration as the Comptroller General con3 siders appropriate. 

4 (H) An assessment of such other areas as 

5 the Comptroller General considers appropriate 

6 to study. 

7 (3) COMMUNITY-BASED MENTAL HEALTH CARE

8 DEFINED.—In this subsection, the term ‘‘commu9 nity-based mental health care’’ means mental health 

10 care paid for by the Department but provided by a 

11 non-Department health care provider at a non-De12 partment facility, including care furnished under 

13 section 1703 of title 38, United States Code (as in 

14 effect on the date specified in section 101(b) of the 

15 Caring for Our Veterans Act of 2018 (title I of Pub16 lic Law 115–182)). 

17 SEC. 405. JOINT MENTAL HEALTH PROGRAMS BY DEPART18 MENT OF VETERANS AFFAIRS AND DEPART19 MENT OF DEFENSE. 

20 (a) REPORT ON MENTAL HEALTH PROGRAMS.— 

21 (1) IN GENERAL.—Not later than one year 

22 after the date of the enactment of this Act, and an23 nually thereafter, the Secretary of Veterans Affairs 

24 and the Secretary of Defense shall submit to the 

25 Committee on Veterans’ Affairs and the Committee 
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1 on Armed Services of the Senate and the Committee 

2 on Veterans’ Affairs and the Committee on Armed 

3 Services of the House of Representatives a report on 

4 mental health programs of the Department of Vet5 erans Affairs and the Department of Defense and 

6 joint programs of the Departments. 

7 (2) ELEMENTS.—The report required by para8 graph (1) shall include the following: 

9 (A) A description of mental health pro10 grams operated by the Department of Veterans 

11 Affairs, including the following: 

12 (i) Transition assistance programs. 

13 (ii) Clinical and non-clinical mental 

14 health initiatives, including centers of ex15 cellence of the Department of Veterans Af16 fairs for traumatic brain injury and post17 traumatic stress disorder. 

18 (iii) Programs that may secondarily 

19 improve mental health, including employ20 ment, housing assistance, and financial lit21 eracy programs. 

22 (iv) Research into mental health 

23 issues and conditions, to include post-trau24 matic stress disorder, depression, anxiety, 

25 bipolar disorder, traumatic brain injury, 
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1 suicidal ideation, and any other issues or 

2 conditions as the Secretary of Veterans Af3 fairs considers necessary. 

4 (B) A description of mental health pro5 grams operated by the Department of Defense, 

6 including the following: 

7 (i) Transition assistance programs. 

8 (ii) Clinical and non-clinical mental 

9 health initiatives, including the National 

10 Intrepid Center of Excellence and the In11 trepid Spirit Centers. 

12 (iii) Programs that may secondarily 

13 improve mental health, including employ14 ment, housing assistance, and financial lit15 eracy programs. 

16 (iv) Research into mental health 

17 issues and conditions, to include post-trau18 matic stress disorder, depression, anxiety, 

19 bipolar disorder, traumatic brain injury, 

20 suicidal ideation, and any other issues or 

21 conditions as the Secretary of Defense con22 siders necessary. 

23 (C) A description of mental health pro24 grams jointly operated by the Department of 
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1 Veterans Affairs and the Department of De2 fense, including the following: 

3 (i) Transition assistance programs. 

4 (ii) Clinical and non-clinical mental 

5 health initiatives. 

6 (iii) Programs that may secondarily 

7 improve mental health, including employ8 ment, housing assistance, and financial lit9 eracy programs. 

10 (iv) Research into mental health 

11 issues and conditions, to include post-trau12 matic stress disorder, depression, anxiety, 

13 bipolar disorder, traumatic brain injury, 

14 suicidal ideation, and completed suicides, 

15 including through the use of the joint sui16 cide data repository of the Department of 

17 Veterans Affairs and the Department of 

18 Defense, and any other issues or conditions 

19 as the Secretary of Veterans Affairs and 

20 the Secretary of Defense consider nec21 essary. 

22 (D) Recommendations for coordinating 

23 mental health programs of the Department of 

24 Veterans Affairs and the Department of De-
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1 fense to improve the effectiveness of those pro2 grams. 

3 (E) Recommendations for novel joint pro4 gramming of the Department of Veterans Af5 fairs and the Department of Defense to improve 

6 the mental health of members of the Armed 

7 Forces and veterans. 

8 (b) EVALUATION OF COLLABORATIVE EFFORTS OF

9 DEPARTMENT OF VETERANS AFFAIRS AND DEPARTMENT

10 OF DEFENSE AND ALTERNATIVES OF ANALYSIS TO ES11 TABLISH A JOINT VA/DOD INTREPID SPIRIT CENTER.— 

12 (1) IN GENERAL.—The Secretary of Veterans 

13 Affairs, in coordination with the Secretary of De14 fense, shall evaluate the current ongoing collabo15 rative efforts of the Department of Veterans Affairs 

16 and the Department of Defense related to post-trau17 matic stress disorder and traumatic brain injury 

18 care, research, and education to improve the quality 

19 of and access to such care and seek potential new 

20 collaborative efforts to improve and expand such 

21 care for veterans and members of the Armed Forces 

22 in a joint Department of Veterans Affairs/Depart23 ment of Defense Intrepid Spirit Center that serves 

24 active duty members of the Armed Forces, members 

25 of the reserve components of the Armed Forces, and 
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1 veterans for mutual benefit and growth in treatment 

2 and care. 

3 (2) ALTERNATIVES OF ANALYSIS.— 

4 (A) IN GENERAL.—The evaluation required 

5 under paragraph (1) shall include an alter6 natives of analysis to establish the joint Depart7 ment of Veterans Affairs/Department of De8 fense Intrepid Spirit Center described in para9 graph (1). 

10 (B) ELEMENTS.—The alternatives of anal11 ysis required under subparagraph (A) with re12 spect to the establishment of the joint Depart13 ment of Veterans Affairs/Department of De14 fense Intrepid Spirit Center described in para15 graph (1) shall provide alternatives and rec16 ommendations that consider information includ17 ing— 

18 (i) colocation of the center on an in19 stallation of the Department of Defense or 

20 property of a medical center of the Depart21 ment of Veterans Affairs; 

22 (ii) consideration of a rural or highly 

23 rural area to establish the center that may 

24 include colocation described in clause (i); 
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1 (iii) geographic distance from existing 

2 or planned Intrepid Spirit Centers of the 

3 Department of Defense or other such fa4 cilities of the Department of Veterans Af5 fairs or the Department of Defense that 

6 furnish care for post-traumatic stress dis7 order or traumatic brain injury; and 

8 (iv) the potential role for private enti9 ties and philanthropic organizations in car10 rying out the activities of the center. 

11 (3) REPORT TO CONGRESS.—Not later than 

12 270 days after the date of the enactment of this Act, 

13 the Secretary of Veterans Affairs shall submit to the 

14 Committee on Veterans’ Affairs of the Senate and 

15 the Committee on Veterans’ Affairs of the House of 

16 Representatives a report that includes— 

17 (A) a summary of the evaluation required 

18 under paragraph (1); and 

19 (B) the alternatives of analysis required 

20 under paragraph (2). 

21 (4) RURAL AND HIGHLY RURAL DEFINED.—In 

22 this subsection, with respect to an area, the terms 

23 ‘‘rural’’ and ‘‘highly rural’’ have the meanings given 

24 those terms in the Rural-Urban Commuting Areas 

25 coding system of the Department of Agriculture. 
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1 TITLE V—IMPROVEMENT OF 

2 MENTAL HEALTH MEDICAL 

3 WORKFORCE 

4 SEC. 501. STAFFING IMPROVEMENT PLAN FOR MENTAL 

5 HEALTH PROVIDERS OF DEPARTMENT OF 

6 VETERANS AFFAIRS. 

7 (a) STAFFING PLAN.— 

8 (1) IN GENERAL.—Not later than one year 

9 after the date of the enactment of this Act, the Sec10 retary of Veterans Affairs, in consultation with the 

11 Inspector General of the Department of Veterans 

12 Affairs, shall submit to the Committee on Veterans’ 

13 Affairs of the Senate and the Committee on Vet14 erans’ Affairs of the House of Representatives a 

15 plan to address staffing of mental health providers 

16 of the Department of Veterans Affairs, including fill17 ing any open positions. 

18 (2) ELEMENTS.—The plan required by para19 graph (1) shall include the following: 

20 (A) An estimate of the number of positions 

21 for mental health providers of the Department 

22 that need to be filled to meet demand. 

23 (B) An identification of the steps that the 

24 Secretary will take to address mental health 

25 staffing for the Department. 
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1 (C) A description of any region-specific 

2 hiring incentives to be used by the Secretary in 

3 consultation with the directors of Veterans Inte4 grated Service Networks and medical centers of 

5 the Department. 

6 (D) A description of any local retention or 

7 engagement incentives to be used by directors 

8 of Veterans Integrated Service Networks. 

9 (E) Such recommendations for legislative 

10 or administrative action as the Secretary con11 siders necessary to aid in addressing mental 

12 health staffing for the Department. 

13 (3) REPORT.—Not later than one year after the 

14 submittal of the plan required by paragraph (1), the 

15 Secretary shall submit to the Committee on Vet16 erans’ Affairs of the Senate and the Committee on 

17 Veterans’ Affairs of the House of Representatives a 

18 report setting forth the number of mental health 

19 providers hired by the Department during the one20 year period preceding the submittal of the report. 

21 (b) OCCUPATIONAL SERIES FOR CERTAIN MENTAL

22 HEALTH PROVIDERS.—Not later than one year after the 

23 date of the enactment of this Act, the Secretary of Vet24 erans Affairs, in consultation with the Office of Personnel 

25 Management, shall develop an occupational series for li-
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1 censed professional mental health counselors and marriage 

2 and family therapists of the Department of Veterans Af3 fairs. 

4 SEC. 502. ESTABLISHMENT OF DEPARTMENT OF VETERANS 

5 AFFAIRS READJUSTMENT COUNSELING 

6 SERVICE SCHOLARSHIP PROGRAM. 

7 (a) IN GENERAL.—Chapter 76 of title 38, United 

8 States Code, is amended by inserting after subchapter 

9 VIII the following new subchapter: 

10 ‘‘SUBCHAPTER IX—READJUSTMENT 

11 COUNSELING SERVICE SCHOLARSHIP PROGRAM 

12 ‘‘§ 7698. Requirement for program 

13 ‘‘As part of the Educational Assistance Program, the 

14 Secretary shall carry out a scholarship program under this 

15 subchapter. The program shall be known as the Depart16 ment of Veterans Affairs Readjustment Counseling Serv17 ice Scholarship Program (in this subchapter referred to 

18 as the ‘Program’). 

19 ‘‘§ 7699. Eligibility; agreement 

20 ‘‘(a) IN GENERAL.—An individual is eligible to par21 ticipate in the Program, as determined by the Readjust22 ment Counseling Service of the Department, if the indi23 vidual— 

24 ‘‘(1) is accepted for enrollment or enrolled (as 

25 described in section 7602 of this title) in a program 
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1 of study at an accredited educational institution, 

2 school, or training program leading to a terminal de3 gree in psychology, social work, marriage and family 

4 therapy, or mental health counseling that would 

5 meet the education requirements for appointment to 

6 a position under section 7402(b) of this title; and 

7 ‘‘(2) enters into an agreement with the Sec8 retary under subsection (c). 

9 ‘‘(b) PRIORITY.—In selecting individuals to partici10 pate in the Program, the Secretary shall give priority to 

11 the following individuals: 

12 ‘‘(1) An individual who agrees to be employed 

13 by a Vet Center located in a community that is— 

14 ‘‘(A) designated as a medically underserved 

15 population under section 330(b)(3) of the Pub16 lic Health Service Act (42 U.S.C. 254b(b)(3)); 

17 and 

18 ‘‘(B) in a State with a per capita popu19 lation of veterans of more than five percent ac20 cording to the National Center for Veterans 

21 Analysis and Statistics and the Bureau of the 

22 Census. 

23 ‘‘(2) An individual who is a veteran. 

24 ‘‘(c) AGREEMENT.—An agreement between the Sec25 retary and a participant in the Program shall (in addition 
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1 to the requirements set forth in section 7604 of this title) 

2 include the following: 

3 ‘‘(1) An agreement by the Secretary to provide 

4 the participant with a scholarship under the Pro5 gram for a specified number of school years during 

6 which the participant pursues a program of study 

7 described in subsection (a)(1) that meets the re8 quirements set forth in section 7602(a) of this title. 

9 ‘‘(2) An agreement by the participant to serve 

10 as a full-time employee of the Department at a Vet 

11 Center for a six-year period following the completion 

12 by the participant of such program of study (in this 

13 subchapter referred to as the ‘period of obligated 

14 service’). 

15 ‘‘(d) VET CENTER DEFINED.—In this section, the 

16 term ‘Vet Center’ has the meaning given that term in sec17 tion 1712A(h) of this title. 

18 ‘‘§ 7699A. Obligated service 

19 ‘‘(a) IN GENERAL.—Each participant in the Program 

20 shall provide service as a full-time employee of the Depart21 ment at a Vet Center (as defined in section 7699(d) of 

22 this title) for the period of obligated service set forth in 

23 the agreement of the participant entered into under sec24 tion 7604 of this title. 
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1 ‘‘(b) DETERMINATION OF SERVICE COMMENCEMENT

2 DATE.—(1) Not later than 60 days before the service com3 mencement date of a participant, the Secretary shall no4 tify the participant of that service commencement date. 

5 ‘‘(2) The date specified in paragraph (1) with respect 

6 to a participant is the date for the beginning of the period 

7 of obligated service of the participant. 

8 ‘‘§ 7699B. Breach of agreement: liability 

9 ‘‘(a) LIQUIDATED DAMAGES.—(1) A participant in 

10 the Program (other than a participant described in sub11 section (b)) who fails to accept payment, or instructs the 

12 educational institution in which the participant is enrolled 

13 not to accept payment, in whole or in part, of a scholarship 

14 under the agreement entered into under section 7604 of 

15 this title shall be liable to the United States for liquidated 

16 damages in the amount of $1,500. 

17 ‘‘(2) Liability under paragraph (1) is in addition to 

18 any period of obligated service or other obligation or liabil19 ity under such agreement. 

20 ‘‘(b) LIABILITY DURING PROGRAM OF STUDY.—(1) 

21 Except as provided in subsection (d), a participant in the 

22 Program shall be liable to the United States for the 

23 amount which has been paid to or on behalf of the partici24 pant under the agreement if any of the following occurs: 
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1 ‘‘(A) The participant fails to maintain an ac2 ceptable level of academic standing in the edu3 cational institution in which the participant is en4 rolled (as determined by the educational institution 

5 under regulations prescribed by the Secretary). 

6 ‘‘(B) The participant is dismissed from such 

7 educational institution for disciplinary reasons. 

8 ‘‘(C) The participant voluntarily terminates the 

9 program of study in such educational institution be10 fore the completion of such program of study. 

11 ‘‘(2) Liability under this subsection is in lieu of any 

12 service obligation arising under the agreement. 

13 ‘‘(c) LIABILITY DURING PERIOD OF OBLIGATED

14 SERVICE.—(1) Except as provided in subsection (d), if a 

15 participant in the Program does not complete the period 

16 of obligated service of the participant, the United States 

17 shall be entitled to recover from the participant an amount 

18 determined in accordance with the following formula: A 

19 = 3Φ(t¥s/t). 

20 ‘‘(2) In the formula in paragraph (1): 

21 ‘‘(A) ‘A’ is the amount the United States is en22 titled to recover. 

23 ‘‘(B) ‘Φ’ is the sum of— 

24 ‘‘(i) the amounts paid under this sub25 chapter to or on behalf of the participant; and 
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1 ‘‘(ii) the interest on such amounts which 

2 would be payable if at the time the amounts 

3 were paid they were loans bearing interest at 

4 the maximum legal prevailing rate, as deter5 mined by the Treasurer of the United States. 

6 ‘‘(C) ‘t’ is the total number of months in the 

7 period of obligated service of the participant. 

8 ‘‘(D) ‘s’ is the number of months of such period 

9 served by the participant. 

10 ‘‘(d) LIMITATION ON LIABILITY FOR REDUCTIONS11 IN-FORCE.—Liability shall not arise under subsection (c) 

12 if the participant fails to maintain employment as a De13 partment employee due to a staffing adjustment. 

14 ‘‘(e) PERIOD FOR PAYMENT OF DAMAGES.—Any 

15 amount of damages that the United States is entitled to 

16 recover under this section shall be paid to the United 

17 States within the one-year period beginning on the date 

18 of the breach of the agreement.’’. 

19 (b) CONFORMING AND TECHNICAL AMENDMENTS.— 

20 (1) CONFORMING AMENDMENTS.— 

21 (A) ESTABLISHMENT OF PROGRAM.—Sec22 tion 7601(a) of such title is amended— 

23 (i) in paragraph (5), by striking 

24 ‘‘and’’; 
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1 (ii) in paragraph (6), by striking the 

2 period and inserting ‘‘; and’’; and 

3 (iii) by adding at the end the fol4 lowing new paragraph: 

5 ‘‘(7) the readjustment counseling service schol6 arship program provided for in subchapter IX of this 

7 chapter.’’. 

8 (B) ELIGIBILITY.—Section 7602 of such 

9 title is amended— 

10 (i) in subsection (a)(1)— 

11 (I) by striking ‘‘or VI’’ and in12 serting ‘‘VI, or IX’’; and 

13 (II) by striking ‘‘subchapter VI’’ 

14 and inserting ‘‘subchapter VI or IX’’; 

15 and 

16 (ii) in subsection (b), by striking ‘‘or 

17 VI’’ and inserting ‘‘VI, or IX’’. 

18 (C) APPLICATION.—Section 7603(a)(1) of 

19 such title is amended by striking ‘‘or VIII’’ and 

20 inserting ‘‘VIII, or IX’’. 

21 (D) TERMS OF AGREEMENT.—Section 

22 7604 of such title is amended by striking ‘‘or 

23 VIII’’ each place it appears and inserting 

24 ‘‘VIII, or IX’’. 
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1 (E) ANNUAL REPORT.—Section 7632 of 

2 such title is amended— 

3 (i) in paragraph (1), by striking ‘‘and 

4 the Specialty Education Loan Repayment 

5 Program’’ and inserting ‘‘the Specialty 

6 Education Loan Repayment Program, and 

7 the Readjustment Counseling Service 

8 Scholarship Program’’; and 

9 (ii) in paragraph (4), by striking ‘‘and 

10 per participant in the Specialty Education 

11 Loan Repayment Program’’ and inserting 

12 ‘‘per participant in the Specialty Education 

13 Loan Repayment Program, and per partic14 ipant in the Readjustment Counseling 

15 Service Scholarship Program’’. 

16 (2) TABLE OF SECTIONS.—The table of sections 

17 at the beginning of chapter 76 of such title is 

18 amended by inserting after the items relating to sub19 chapter VIII the following: 

‘‘SUBCHAPTER IX—READJUSTMENT COUNSELING SERVICE SCHOLARSHIP

PROGRAM

‘‘Sec. 

‘‘7698. Requirement for program. 

‘‘7699. Eligibility; agreement. 

‘‘7699A. Obligated service. 

‘‘7699B. Breach of agreement: liability.’’. 

20 (c) EFFECTIVE DATE.—The Secretary of Veterans 

21 Affairs shall begin awarding scholarships under sub22 chapter IX of chapter 76 of title 38, United States Code, 
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1 as added by subsection (a), for programs of study begin2 ning not later than one year after the date of the enact3 ment of this Act. 

4 SEC. 503. COMPTROLLER GENERAL REPORT ON READJUST5 MENT COUNSELING SERVICE OF DEPART6 MENT OF VETERANS AFFAIRS. 

7 (a) IN GENERAL.—Not later than one year after the 

8 date of the enactment of this Act, the Comptroller General 

9 of the United States shall submit to the Committee on 

10 Veterans’ Affairs of the Senate and the Committee on Vet11 erans’ Affairs of the House of Representatives a report 

12 on the Readjustment Counseling Service of the Depart13 ment of Veterans Affairs. 

14 (b) ELEMENTS.—The report required by subsection 

15 (a) shall include the following: 

16 (1) An assessment of the adequacy and types of 

17 treatment, counseling, and other services provided at 

18 Vet Centers, including recommendations on whether 

19 and how such treatment, counseling, and other serv20 ices can be expanded. 

21 (2) An assessment of the efficacy of outreach 

22 efforts by the Readjustment Counseling Service, in23 cluding recommendations for how outreach efforts 

24 can be improved. 
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1 (3) An assessment of barriers to care at Vet 

2 Centers, including recommendations for overcoming 

3 those barriers. 

4 (4) An assessment of the efficacy and frequency 

5 of the use of telehealth by counselors of the Read6 justment Counseling Service to provide mental 

7 health services, including recommendations for how 

8 the use of telehealth can be improved. 

9 (5) An assessment of the feasibility and advis10 ability of expanding eligibility for services from the 

11 Readjustment Counseling Service, including— 

12 (A) recommendations on what eligibility 

13 criteria could be expanded; and 

14 (B) an assessment of potential costs and 

15 increased infrastructure requirements if eligi16 bility is expanded. 

17 (6) An assessment of the use of Vet Centers by 

18 members of the reserve components of the Armed 

19 Forces who were never activated and recommenda20 tions on how to better reach those members. 

21 (7) An assessment of the use of Vet Centers by 

22 eligible family members of former members of the 

23 Armed Forces and recommendations on how to bet24 ter reach those family members. 
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1 (8) An assessment of the efficacy of group ther2 apy and the level of training of providers at Vet 

3 Centers in administering group therapy. 

4 (9) An assessment of the efficiency and effec5 tiveness of the task organization structure of Vet 

6 Centers. 

7 (10) An assessment of the use of Vet Centers 

8 by Native American veterans, as defined in section 

9 3765 of title 38, United States Code, and rec10 ommendations on how to better reach those vet11 erans. 

12 (c) VET CENTER DEFINED.—In this section, the 

13 term ‘‘Vet Center’’ has the meaning given that term in 

14 section 1712A(h) of title 38, United States Code. 

15 SEC. 504. EXPANSION OF REPORTING REQUIREMENTS ON 

16 READJUSTMENT COUNSELING SERVICE OF 

17 DEPARTMENT OF VETERANS AFFAIRS. 

18 (a) EXPANSION OF ANNUAL REPORT.—Paragraph 

19 (2)(C) of section 7309(e) of title 38, United States Code, 

20 is amended by inserting before the period at the end the 

21 following: ‘‘, including the resources required to meet such 

22 unmet need, such as additional staff, additional locations, 

23 additional infrastructure, infrastructure improvements, 

24 and additional mobile Vet Centers’’. 
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1 (b) BIENNIAL REPORT.—Such section is amended by 

2 adding at the end the following new paragraph: 

3 ‘‘(3) For each even numbered year in which the re4 port required by paragraph (1) is submitted, the Secretary 

5 shall include in such report a prediction of— 

6 ‘‘(A) trends in demand for care; 

7 ‘‘(B) long-term investments required with re8 spect to the provision of care; 

9 ‘‘(C) requirements relating to maintenance of 

10 infrastructure; and 

11 ‘‘(D) other capital investment requirements 

12 with respect to the Readjustment Counseling Serv13 ice, including Vet Centers, mobile Vet Centers, and 

14 community access points.’’. 

15 SEC. 505. BRIEFING ON ALTERNATIVE WORK SCHEDULES 

16 FOR EMPLOYEES OF VETERANS HEALTH AD17 MINISTRATION. 

18 (a) SURVEY OF VETERANS.— 

19 (1) IN GENERAL.—Not later than 180 days 

20 after the date of the enactment of this Act, the Sec21 retary of Veterans Affairs shall conduct a survey on 

22 the attitudes of eligible veterans toward the Depart23 ment of Veterans Affairs offering appointments out24 side the usual operating hours of facilities of the De-
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1 partment, including through the use of telehealth 

2 appointments. 

3 (2) ELIGIBLE VETERAN DEFINED.—In this sub4 section, the term ‘‘eligible veteran’’ means a veteran 

5 who— 

6 (A) is enrolled in the patient enrollment 

7 system of the Department under section 

8 1705(a) of title 38, United States Code; and 

9 (B) received health care from the Depart10 ment at least once during the two-year period 

11 ending on the date of the commencement of the 

12 survey under paragraph (1). 

13 (b) CONGRESSIONAL BRIEFING.— 

14 (1) IN GENERAL.—Not later than 270 days 

15 after the date of the enactment of this Act, the Sec16 retary shall brief the Committee on Veterans’ Affairs 

17 of the Senate and the Committee on Veterans’ Af18 fairs of the House of Representatives on the— 

19 (A) feasibility and advisability of offering 

20 appointments outside the usual operating hours 

21 of facilities of the Department that do not offer 

22 such appointments; and 

23 (B) effectiveness of offering appointments 

24 outside the usual operating hours of facilities of 
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1 the Department for those facilities that offer 

2 such appointments. 

3 (2) ELEMENTS.—The briefing required by 

4 paragraph (1) shall include the following: 

5 (A) The findings of the survey conducted 

6 under subsection (a); 

7 (B) Feedback from employees of the Vet8 erans Health Administration, including clinical, 

9 nonclinical, and support staff, with respect to 

10 offering appointments outside the usual oper11 ating hours of facilities of the Department, in12 cluding through the use of telehealth appoint13 ments; and 

14 (C) Any other matters the Secretary con15 siders relevant to a full understanding of the 

16 feasibility and advisability of offering appoint17 ments outside the usual operating hours of fa18 cilities of the Department. 

19 (c) PAPERWORK REDUCTION ACT EXEMPTION.— 

20 Chapter 35 of title 44, United States Code (commonly 

21 known as the ‘‘Paperwork Reduction Act’’) shall not apply 

22 to any rulemaking or information collection required 

23 under this section. 
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1 SEC. 506. SUICIDE PREVENTION COORDINATORS. 

2 (a) STAFFING REQUIREMENT.—Beginning not later 

3 than one year after the date of the enactment of this Act, 

4 the Secretary of Veterans Affairs shall ensure that each 

5 medical center of the Department of Veterans Affairs has 

6 not less than one suicide prevention coordinator. 

7 (b) STUDY ON REORGANIZATION.— 

8 (1) IN GENERAL.—Not later than one year 

9 after the date of the enactment of this Act, the Sec10 retary, in consultation with the Office of Mental 

11 Health and Suicide Prevention of the Department, 

12 shall commence the conduct of a study to determine 

13 the feasibility and advisability of— 

14 (A) the realignment and reorganization of 

15 suicide prevention coordinators within the Of16 fice of Mental Health and Suicide Prevention; 

17 and 

18 (B) the creation of a suicide prevention co19 ordinator program office. 

20 (2) PROGRAM OFFICE REALIGNMENT.—In con21 ducting the study under paragraph (1), the Sec22 retary shall assess the feasibility of advisability of, 

23 within the suicide prevention coordinator program 

24 office described in paragraph (1)(B), aligning suicide 

25 prevention coordinators and suicide prevention case 

26 managers within the organizational structure and 
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1 chart of the Suicide Prevention Program of the De2 partment, with the Director of the Suicide Preven3 tion program having ultimate supervisory oversight 

4 and responsibility over the suicide prevention coordi5 nator program office. 

6 (c) REPORT.—Not later than 90 days after the com7 pletion of the study under subsection (b), the Secretary 

8 shall submit to the Committee on Veterans’ Affairs of the 

9 Senate and the Committee on Veterans’ Affairs of the 

10 House of Representatives a report on such study, includ11 ing the following: 

12 (1) An assessment of the feasibility and advis13 ability of creating a suicide prevention coordinator 

14 program office to oversee and monitor suicide pre15 vention coordinators and suicide prevention case 

16 managers across all medical centers of the Depart17 ment. 

18 (2) A review of current staffing ratios for sui19 cide prevention coordinators and suicide prevention 

20 case managers in comparison with current staffing 

21 ratios for mental health providers within each med22 ical center of the Department. 

23 (3) A description of the duties and responsibil24 ities for suicide prevention coordinators across the 

25 Department to better define, delineate, and stand-
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1 ardize qualifications, performance goals, perform2 ance duties, and performance outcomes for suicide 

3 prevention coordinators and suicide prevention case 

4 managers. 

5 SEC. 507. REPORT ON EFFORTS BY DEPARTMENT OF VET6 ERANS AFFAIRS TO IMPLEMENT SAFETY 

7 PLANNING IN EMERGENCY DEPARTMENTS. 

8 (a) FINDINGS.—Congress makes the following find9 ings: 

10 (1) The Department of Veterans Affairs must 

11 be more effective in its approach to reducing the 

12 burden of veteran suicide connected to mental health 

13 diagnoses, to include expansion of treatment deliv14 ered via telehealth methods and in rural areas. 

15 (2) An innovative project, known as Suicide As16 sessment and Follow-up Engagement: Veteran 

17 Emergency Treatment (in this subsection referred to 

18 as ‘‘SAFE VET’’), was designed to help suicidal vet19 erans seen at emergency departments within the 

20 Veterans Health Administration and was success21 fully implemented in five intervention sites beginning 

22 in 2010. 

23 (3) A 2018 study found that safety planning 

24 intervention under SAFE VET was associated with 

25 45 percent fewer suicidal behaviors in the six-month 
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1 period following emergency department care and 

2 more than double the odds of a veteran engaging in 

3 outpatient behavioral health care. 

4 (4) SAFE VET is a promising alternative and 

5 acceptable delivery of care system that augments the 

6 treatment of suicidal veterans in emergency depart7 ments of the Veterans Health Administration and 

8 helps ensure that those veterans have appropriate 

9 follow-up care. 

10 (5) Beginning in September 2018, the Veterans 

11 Health Administration implemented a suicide pre12 vention program, known as the SPED program, for 

13 veterans presenting to the emergency department 

14 who are assessed to be at risk for suicide and are 

15 safe to be discharged home. 

16 (6) The SPED program includes issuance and 

17 update of a safety plan and post-discharge follow-up 

18 outreach for veterans to facilitate engagement in 

19 outpatient mental health care. 

20 (b) REPORT.— 

21 (1) IN GENERAL.—Not later than 180 days 

22 after the date of the enactment of this Act, the Sec23 retary of Veterans Affairs shall submit to the appro24 priate committees of Congress a report on the ef25 forts of the Secretary to implement a suicide preven-
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1 tion program for veterans presenting to an emer2 gency department or urgent care center of the Vet3 erans Health Administration who are assessed to be 

4 at risk for suicide and are safe to be discharged 

5 home, including a safety plan and post-discharge 

6 outreach for veterans to facilitate engagement in 

7 outpatient mental health care. 

8 (2) ELEMENTS.—The report required by para9 graph (1) shall include the following: 

10 (A) An assessment of the implementation 

11 of the current operational policies and proce12 dures of the SPED program at each medical 

13 center of the Department of Veterans Affairs, 

14 including an assessment of the following: 

15 (i) Training provided to clinicians or 

16 other personnel administering protocols 

17 under the SPED program. 

18 (ii) Any disparities in implementation 

19 of such protocols between medical centers. 

20 (iii) Current criteria used to measure 

21 the quality of such protocols including— 

22 (I) methodology used to assess 

23 the quality of a safety plan and post24 discharge outreach for veterans; or 
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1 (II) in the absence of such meth2 odology, a proposed timeline and 

3 guidelines for creating a methodology 

4 to ensure compliance with the evi5 dence-based model used under the 

6 Suicide Assessment and Follow-up 

7 Engagement: Veteran Emergency 

8 Treatment (SAFE VET) program of 

9 the Department. 

10 (B) An assessment of the implementation 

11 of the policies and procedures described in sub12 paragraph (A), including the following: 

13 (i) An assessment of the quality and 

14 quantity of safety plans issued to veterans. 

15 (ii) An assessment of the quality and 

16 quantity of post-discharge outreach pro17 vided to veterans. 

18 (iii) The post-discharge rate of vet19 eran engagement in outpatient mental 

20 health care, including attendance at not 

21 fewer than one individual mental health 

22 clinic appointment or admission to an in23 patient or residential unit. 
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1 (iv) The number of veterans who de2 cline safety planning efforts during proto3 cols under the SPED program. 

4 (v) The number of veterans who de5 cline to participate in follow-up efforts 

6 within the SPED program. 

7 (C) A description of how SPED primary 

8 coordinators are deployed to support such ef9 forts, including the following: 

10 (i) A description of the duties and re11 sponsibilities of such coordinators. 

12 (ii) The number and location of such 

13 coordinators. 

14 (iii) A description of training provided 

15 to such coordinators. 

16 (iv) An assessment of the other re17 sponsibilities for such coordinators and, if 

18 applicable, differences in patient outcomes 

19 when such responsibilities are full-time du20 ties as opposed to secondary duties. 

21 (D) An assessment of the feasibility and 

22 advisability of expanding the total number and 

23 geographic distribution of SPED primary coor24 dinators. 
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1 (E) An assessment of the feasibility and 

2 advisability of providing services under the 

3 SPED program via telehealth channels, includ4 ing an analysis of opportunities to leverage tele5 health to better serve veterans in rural areas. 

6 (F) A description of the status of current 

7 capabilities and utilization of tracking mecha8 nisms to monitor compliance, quality, and pa9 tient outcomes under the SPED program. 

10 (G) Such recommendations, including spe11 cific action items, as the Secretary considers 

12 appropriate with respect to how the Depart13 ment can better implement the SPED program, 

14 including recommendations with respect to the 

15 following: 

16 (i) A process to standardize training 

17 under such program. 

18 (ii) Any resourcing requirements nec19 essary to implement the SPED program 

20 throughout Veterans Health Administra21 tion, including by having a dedicated clini22 cian responsible for administration of such 

23 program at each medical center. 

24 (iii) An analysis of current statutory 

25 authority and any changes necessary to 
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1 fully implement the SPED program 

2 throughout the Veterans Health Adminis3 tration. 

4 (iv) A timeline for the implementation 

5 of the SPED program through the Vet6 erans Health Administration once full 

7 resourcing and an approved training plan 

8 are in place. 

9 (H) Such other matters as the Secretary 

10 considers appropriate. 

11 (c) DEFINITIONS.—In this section: 

12 (1) APPROPRIATE COMMITTEES OF CON13 GRESS.—The term ‘‘appropriate committees of Con14 gress’’ means— 

15 (A) the Committee on Veterans’ Affairs 

16 and the Subcommittee on Military Construc17 tion, Veterans Affairs, and Related Agencies of 

18 the Committee on Appropriations of the Senate; 

19 and 

20 (B) the Committee on Veterans’ Affairs 

21 and the Subcommittee on Military Construc22 tion, Veterans Affairs, and Related Agencies of 

23 the Committee on Appropriations of the House 

24 of Representatives. 
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1 (2) SPED PRIMARY COORDINATOR.—The term 

2 ‘‘SPED primary coordinator’’ means the main point 

3 of contact responsible for administering the SPED 

4 program at a medical center of the Department. 

5 (3) SPED PROGRAM.—The term ‘‘SPED pro6 gram’’ means the Safety Planning in Emergency De7 partments program of the Department of Veterans 

8 Affairs established in September 2018 for veterans 

9 presenting to the emergency department who are as10 sessed to be at risk for suicide and are safe to be 

11 discharged home, which extends the evidence-based 

12 intervention for suicide prevention to all emergency 

13 departments of the Veterans Health Administration. 

14 TITLE VI—IMPROVEMENT OF 

15 CARE AND SERVICES FOR 

16 WOMEN VETERANS 

17 SEC. 601. EXPANSION OF CAPABILITIES OF WOMEN VET18 ERANS CALL CENTER TO INCLUDE TEXT MES19 SAGING. 

20 The Secretary of Veterans Affairs shall expand the 

21 capabilities of the Women Veterans Call Center of the De22 partment of Veterans Affairs to include a text messaging 

23 capability. 
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1 SEC. 602. REQUIREMENT FOR DEPARTMENT OF VETERANS 

2 AFFAIRS INTERNET WEBSITE TO PROVIDE IN3 FORMATION ON SERVICES AVAILABLE TO 

4 WOMEN VETERANS. 

5 (a) IN GENERAL.—The Secretary of Veterans Affairs 

6 shall survey the internet websites and information re7 sources of the Department of Veterans Affairs in effect 

8 on the day before the date of the enactment of this Act 

9 and publish an internet website that serves as a central10 ized source for the provision to women veterans of infor11 mation about the benefits and services available to them 

12 under laws administered by the Secretary. 

13 (b) ELEMENTS.—The internet website published 

14 under subsection (a) shall provide to women veterans in15 formation regarding all services available in the district 

16 in which the veteran is seeking such services, including, 

17 with respect to each medical center and community-based 

18 outpatient clinic in the applicable Veterans Integrated 

19 Service Network— 

20 (1) the name and contact information of each 

21 women’s health coordinator; 

22 (2) a list of appropriate staff for other benefits 

23 available from the Veterans Benefits Administration, 

24 the National Cemetery Administration, and such 

25 other entities as the Secretary considers appropriate; 

26 and 
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1 (3) such other information as the Secretary 

2 considers appropriate. 

3 (c) UPDATED INFORMATION.—The Secretary shall 

4 ensure that the information described in subsection (b) 

5 that is published on the internet website required by sub6 section (a) is updated not less frequently than once every 

7 90 days. 

8 (d) OUTREACH.—In carrying out this section, the 

9 Secretary shall ensure that the outreach conducted under 

10 section 1720F(i) of title 38, United States Code, includes 

11 information regarding the internet website required by 

12 subsection (a). 

13 (e) DERIVATION OF FUNDS.—Amounts used by the 

14 Secretary to carry out this section shall be derived from 

15 amounts made available to the Secretary to publish inter16 net websites of the Department. 

17 TITLE VII—OTHER MATTERS 

18 SEC. 701. EXPANDED TELEHEALTH FROM DEPARTMENT OF 

19 VETERANS AFFAIRS. 

20 (a) IN GENERAL.—The Secretary of Veterans Affairs 

21 shall enter into agreements, and expand existing agree22 ments, with organizations that represent or serve veterans, 

23 nonprofit organizations, private businesses, and other in24 terested parties for the expansion of telehealth capabilities 
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1 and the provision of telehealth services to veterans 

2 through the award of grants under subsection (b). 

3 (b) AWARD OF GRANTS.— 

4 (1) IN GENERAL.—In carrying out agreements 

5 entered into or expanded under this section with en6 tities described in subsection (a), the Secretary shall 

7 award grants to those entities. 

8 (2) LOCATIONS.—To the extent practicable, the 

9 Secretary shall ensure that grants are awarded to 

10 entities that serve veterans in rural and highly rural 

11 areas (as determined through the use of the Rural12 Urban Commuting Areas coding system of the De13 partment of Agriculture) or areas determined to be 

14 medically underserved. 

15 (3) USE OF GRANTS.— 

16 (A) IN GENERAL.—Grants awarded to an 

17 entity under this subsection may be used for 

18 one or more of the following: 

19 (i) Purchasing, replacing or upgrading 

20 hardware or software necessary for the 

21 provision of secure and private telehealth 

22 services. 

23 (ii) Upgrading security protocols for 

24 consistency with the security requirements 

25 of the Department of Veterans Affairs. 
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1 (iii) Training of site attendants, in2 cluding payment of those attendants for 

3 completing that training, with respect to— 

4 (I) military and veteran cultural 

5 competence, if the entity is not an or6 ganization that represents veterans; 

7 (II) equipment required to pro8 vide telehealth services; 

9 (III) privacy, including the 

10 Health Insurance Portability and Ac11 countability Act of 1996 privacy rule 

12 under part 160 and subparts A and E 

13 of part 164 of title 45, Code of Fed14 eral Regulations, or successor regula15 tions, as it relates to health care for 

16 veterans; 

17 (IV) scheduling for telehealth 

18 services for veterans; or 

19 (V) any other unique training 

20 needs for the provision of telehealth 

21 services to veterans. 

22 (iv) Upgrading existing infrastructure 

23 owned or leased by the entity to make 

24 rooms more conducive to telehealth care, 

25 including— 
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1 (I) additions or modifications to 

2 windows or walls in an existing room, 

3 or other alterations as needed to cre4 ate a new, private room, including 

5 permits or inspections required in as6 sociation with space modifications; 

7 (II) soundproofing of an existing 

8 room; 

9 (III) new electrical, telephone, or 

10 internet outlets in an existing room; 

11 or 

12 (IV) aesthetic enhancements to 

13 establish a more suitable therapeutic 

14 environment. 

15 (v) Upgrading existing infrastructure 

16 to comply with the Americans with Disabil17 ities Act of 1990 (42 U.S.C. 12101 et 

18 seq.). 

19 (vi) Upgrading internet infrastructure 

20 and sustainment of internet services. 

21 (vii) Sustainment of telephone serv22 ices. 

23 (B) EXCLUSION.—Grants may not be used 

24 for the purchase of new property or for major 
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1 construction projects, as determined by the Sec2 retary. 

3 (c) AGREEMENT ON TELEHEALTH ACCESS

4 POINTS.— 

5 (1) IN GENERAL.—An entity described in sub6 section (a) that seeks to establish a telehealth access 

7 point for veterans but does not require grant fund8 ing under this section to do so may enter into an 

9 agreement with the Department for the establish10 ment of such an access point. 

11 (2) ADEQUACY OF FACILITIES.—An entity de12 scribed in paragraph (1) shall be responsible for en13 suring that any access point is adequately private, 

14 secure, clean, and accessible for veterans before the 

15 access point is established. 

16 (d) ASSESSMENT OF BARRIERS TO ACCESS.— 

17 (1) IN GENERAL.—Not later than 18 months 

18 after the date of the enactment of this Act, the Sec19 retary shall complete an assessment of barriers faced 

20 by veterans in accessing telehealth services. 

21 (2) ELEMENTS.—The assessment required by 

22 paragraph (1) shall include the following: 

23 (A) A description of the barriers veterans 

24 face in using telehealth while not on property of 

25 the Department. 
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1 (B) A description of how the Department 

2 plans to address the barriers described in sub3 paragraph (A). 

4 (C) Such other matters related to access 

5 by veterans to telehealth while not on property 

6 of the Department as the Secretary considers 

7 relevant. 

8 (3) REPORT.—Not later than 120 days after 

9 the completion of the assessment required by para10 graph (1), the Secretary shall submit to the Com11 mittee on Veterans’ Affairs of the Senate and the 

12 Committee on Veterans’ Affairs of the House of 

13 Representatives a report on the assessment, includ14 ing any recommendations for legislative or adminis15 trative action based on the results of the assessment. 

16 SEC. 702. PARTNERSHIPS WITH NON-FEDERAL GOVERN17 MENT ENTITIES TO PROVIDE HYPERBARIC 

18 OXYGEN THERAPY TO VETERANS AND STUD19 IES ON THE USE OF SUCH THERAPY FOR 

20 TREATMENT OF POST-TRAUMATIC STRESS 

21 DISORDER AND TRAUMATIC BRAIN INJURY. 

22 (a) PARTNERSHIPS TO PROVIDE HYPERBARIC OXY23 GEN THERAPY TO VETERANS.— 

24 (1) USE OF PARTNERSHIPS.—The Secretary of 

25 Veterans Affairs, in consultation with the Center for 
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1 Compassionate Innovation within the Office of Com2 munity Engagement of the Department of Veterans 

3 Affairs, may enter into partnerships with non-Fed4 eral Government entities to provide hyperbaric oxy5 gen treatment to veterans to research the effective6 ness of such therapy. 

7 (2) TYPES OF PARTNERSHIPS.—Partnerships 

8 entered into under paragraph (1) may include the 

9 following: 

10 (A) Partnerships to conduct research on 

11 hyperbaric oxygen therapy. 

12 (B) Partnerships to review research on 

13 hyperbaric oxygen therapy provided to non14 veterans. 

15 (C) Partnerships to create industry work16 ing groups to determine standards for research 

17 on hyperbaric oxygen therapy. 

18 (D) Partnerships to provide to veterans 

19 hyperbaric oxygen therapy for the purposes of 

20 conducting research on the effectiveness of such 

21 therapy. 

22 (3) LIMITATION ON FEDERAL FUNDING.—Fed23 eral Government funding may be used to coordinate 

24 and administer the partnerships under this sub-
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1 section but may not be used to carry out activities 

2 conducted under such partnerships. 

3 (b) REVIEW OF EFFECTIVENESS OF HYPERBARIC

4 OXYGEN THERAPY.—Not later than 90 days after the 

5 date of the enactment of this Act, the Secretary, in con6 sultation with the Center for Compassionate Innovation, 

7 shall begin using an objective and quantifiable method to 

8 review the effectiveness and applicability of hyperbaric ox9 ygen therapy, such as through the use of a device ap10 proved or cleared by the Food and Drug Administration 

11 that assesses traumatic brain injury by tracking eye move12 ment. 

13 (c) SYSTEMATIC REVIEW OF USE OF HYPERBARIC

14 OXYGEN THERAPY TO TREAT CERTAIN CONDITIONS.— 

15 (1) IN GENERAL.—Not later than 90 days after 

16 the date of the enactment of this Act, the Secretary, 

17 in consultation with the Center for Compassionate 

18 Innovation, shall commence the conduct of a system19 atic review of published research literature on off20 label use of hyperbaric oxygen therapy to treat post21 traumatic stress disorder and traumatic brain injury 

22 among veterans and nonveterans. 

23 (2) ELEMENTS.—The review conducted under 

24 paragraph (1) shall include the following: 
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1 (A) An assessment of the current param2 eters for research on the use by the Department 

3 of Veterans Affairs of hyperbaric oxygen ther4 apy, including— 

5 (i) tests and questionnaires used to 

6 determine the efficacy of such therapy; and 

7 (ii) metrics for determining the suc8 cess of such therapy. 

9 (B) A comparative analysis of tests and 

10 questionnaires used to study post-traumatic 

11 stress disorder and traumatic brain injury in 

12 other research conducted by the Department of 

13 Veterans Affairs, other Federal agencies, and 

14 entities outside the Federal Government. 

15 (3) COMPLETION OF REVIEW.—The review con16 ducted under paragraph (1) shall be completed not 

17 later than 180 days after the date of the commence18 ment of the review. 

19 (4) REPORT.—Not later than 90 days after the 

20 completion of the review conducted under paragraph 

21 (1), the Secretary shall submit to the Committee on 

22 Veterans’ Affairs of the Senate and the Committee 

23 on Veterans’ Affairs of the House of Representatives 

24 a report on the results of the review. 

25 (d) FOLLOW-UP STUDY.— 
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1 (1) IN GENERAL.—Not later than 120 days 

2 after the completion of the review conducted under 

3 subsection (c), the Secretary, in consultation with 

4 the Center for Compassionate Innovation, shall com5 mence the conduct of a study on all individuals re6 ceiving hyperbaric oxygen therapy through the cur7 rent pilot program of the Department for the provi8 sion of hyperbaric oxygen therapy to veterans to de9 termine the efficacy and effectiveness of hyperbaric 

10 oxygen therapy for the treatment of post-traumatic 

11 stress disorder and traumatic brain injury. 

12 (2) ELEMENTS.—The study conducted under 

13 paragraph (1) shall include the review and publica14 tion of any data and conclusions resulting from re15 search conducted by an authorized provider of 

16 hyperbaric oxygen therapy for veterans through the 

17 pilot program described in such paragraph. 

18 (3) COMPLETION OF STUDY.—The study con19 ducted under paragraph (1) shall be completed not 

20 later than three years after the date of the com21 mencement of the study. 

22 (4) REPORT.— 

23 (A) IN GENERAL.—Not later than 90 days 

24 after completing the study conducted under 

25 paragraph (1), the Secretary shall submit to the 
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1 Committee on Veterans’ Affairs of the Senate 

2 and the Committee on Veterans’ Affairs of the 

3 House of Representatives a report on the re4 sults of the study. 

5 (B) ELEMENTS.—The report required 

6 under subparagraph (A) shall include the rec7 ommendation of the Secretary with respect to 

8 whether or not hyperbaric oxygen therapy 

9 should be made available to all veterans with 

10 traumatic brain injury or post-traumatic stress 

11 disorder. 

12 SEC. 703. PRESCRIPTION OF TECHNICAL QUALIFICATIONS 

13 FOR LICENSED HEARING AID SPECIALISTS 

14 AND REQUIREMENT FOR APPOINTMENT OF 

15 SUCH SPECIALISTS. 

16 (a) TECHNICAL QUALIFICATIONS.— 

17 (1) IN GENERAL.—Not later than 180 days 

18 after the date of the enactment of this Act, the Sec19 retary of Veterans Affairs shall prescribe the tech20 nical qualifications required under section 

21 7402(b)(14) of title 38, United States Code, to be 

22 appointed as a licensed hearing aid specialist under 

23 section 7401(3) of such title. 

24 (2) ELEMENTS FOR QUALIFICATIONS.—In pre25 scribing the qualifications for licensed hearing aid 
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1 specialists under paragraph (1), the Secretary shall, 

2 at a minimum, ensure that such qualifications are 

3 consistent with— 

4 (A) the standards for licensure of hearing 

5 aid specialists that are required by a majority 

6 of States; 

7 (B) any competencies needed to perform 

8 tasks and services commonly performed by 

9 hearing aid specialists pursuant to such stand10 ards; and 

11 (C) any competencies needed to perform 

12 tasks specific to providing care to individuals 

13 under the laws administered by the Secretary. 

14 (b) AUTHORITY TO SET AND MAINTAIN DUTIES.— 

15 The Secretary shall retain the authority to set and main16 tain the duties for licensed hearing aid specialists ap17 pointed under section 7401(3) of title 38, United States 

18 Code, for the purposes of the employment of such special19 ists with the Department of Veterans Affairs. 

20 (c) APPOINTMENT.—Not later than September 30, 

21 2022, the Secretary shall appoint not fewer than one li22 censed hearing aid specialist at each medical center of the 

23 Department. 

24 (d) REPORT.—Not later than September 30, 2022, 

25 and annually thereafter, the Secretary shall submit to the 
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1 Committee on Veterans’ Affairs of the Senate and the 

2 Committee on Veterans’ Affairs of the House of Rep3 resentatives a report— 

4 (1) assessing the progress of the Secretary in 

5 appointing licensed hearing aid specialists under 

6 subsection (c); 

7 (2) assessing potential conflicts or obstacles 

8 that prevent the appointment of licensed hearing aid 

9 specialists; 

10 (3) assessing the factors that led to such con11 flicts or obstacles; 

12 (4) assessing access of patients to comprehen13 sive hearing health care services from the Depart14 ment consistent with the requirements under section 

15 4(b) of the Veterans Mobility Safety Act of 2016 

16 (Public Law 114–256; 38 U.S.C. 7401 note), includ17 ing an assessment of the impact of infrastructure 

18 and equipment limitations on wait times for 

19 audiologic care; and 

20 (5) indicating the medical centers of the De21 partment with vacancies for audiologists or licensed 

22 hearing aid specialists. 
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1 SEC. 704. USE BY DEPARTMENT OF VETERANS AFFAIRS OF 

2 COMMERCIAL INSTITUTIONAL REVIEW 

3 BOARDS IN SPONSORED RESEARCH TRIALS. 

4 (a) IN GENERAL.—Not later than 90 days after the 

5 date of the enactment of this Act, the Secretary of Vet6 erans Affairs shall complete all necessary policy revisions 

7 within the directive of the Veterans Health Administration 

8 numbered 1200.05 and titled ‘‘Requirements for the Pro9 tection of Human Subjects in Research’’, to allow spon10 sored clinical research of the Department of Veterans Af11 fairs to use accredited commercial institutional review 

12 boards to review research proposal protocols of the De13 partment. 

14 (b) IDENTIFICATION OF REVIEW BOARDS.—Not later 

15 than 90 days after the completion of the policy revisions 

16 under subsection (a), the Secretary shall— 

17 (1) identify accredited commercial institutional 

18 review boards for use in connection with sponsored 

19 clinical research of the Department; and 

20 (2) establish a process to modify existing ap21 provals in the event that a commercial institutional 

22 review board loses its accreditation during an ongo23 ing clinical trial. 

24 (c) REPORT.— 

25 (1) IN GENERAL.—Not later than 90 days after 

26 the completion of the policy revisions under sub-
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†S 785 ES

1 section (a), and annually thereafter, the Secretary 

2 shall submit to the Committee on Veterans’ Affairs 

3 of the Senate and the Committee on Veterans’ Af4 fairs of the House of Representatives a report on all 

5 approvals of institutional review boards used by the 

6 Department, including central institutional review 

7 boards and commercial institutional review boards. 

8 (2) ELEMENTS.—The report required by para9 graph (1) shall include, at a minimum, the following: 

10 (A) The name of each clinical trial with re11 spect to which the use of an institutional review 

12 board has been approved. 

13 (B) The institutional review board or insti14 tutional review boards used in the approval 

15 process for each clinical trial. 

16 (C) The amount of time between submis17 sion and approval. 

18 SEC. 705. CREATION OF OFFICE OF RESEARCH REVIEWS 

19 WITHIN THE OFFICE OF INFORMATION AND 

20 TECHNOLOGY OF THE DEPARTMENT OF VET21 ERANS AFFAIRS. 

22 (a) IN GENERAL.—Not later than one year after the 

23 date of the enactment of this Act, the Secretary of Vet24 erans Affairs shall establish within the Office of Informa25 tion and Technology of the Department of Veterans Af-
142 

†S 785 ES

1 fairs an Office of Research Reviews (in this section re2 ferred to as the ‘‘Office’’). 

3 (b) ELEMENTS.—The Office shall do the following: 

4 (1) Perform centralized security reviews and 

5 complete security processes for approved research 

6 sponsored outside the Department, with a focus on 

7 multi-site clinical trials. 

8 (2) Develop and maintain a list of commercially 

9 available software preferred for use in sponsored 

10 clinical trials of the Department and ensure such list 

11 is maintained as part of the official approved soft12 ware products list of the Department. 

13 (3) Develop benchmarks for appropriate 

14 timelines for security reviews conducted by the Of15 fice. 

16 (c) REPORT.— 

17 (1) IN GENERAL.—Not later than one year 

18 after the establishment of the Office, the Office shall 

19 submit to the Committee on Veterans’ Affairs of the 

20 Senate and the Committee on Veterans’ Affairs of 

21 the House of Representatives a report on the activity 

22 of the Office. 

23 (2) ELEMENTS.—The report required by para24 graph (1) shall include, at a minimum, the following: 
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1 (A) The number of security reviews com2 pleted. 

3 (B) The number of personnel assigned for 

4 performing the functions described in sub5 section (b). 

Passed the Senate August 5, 2020. 

Attest: 

Secretary. 
116TH CONGRESS 

2D SESSION S. 785 

AN ACT 

To improve mental health care provided by the Deposes. partment of Veterans Affairs, and for other pur-