89–006 

116TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 1st Session 116–70 

SUPPORT FOR SUICIDE PREVENTION COORDINATORS ACT 

MAY 17, 2019.—Committed to the Committee of the Whole House on the State of 

the Union and ordered to be printed 

Mr. TAKANO, from the Committee on Veterans’ Affairs, 

submitted the following 

R E P O R T 

[To accompany H.R. 2333] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Veterans’ Affairs, to whom was referred the 

bill (H.R. 2333) to direct the Comptroller General of the United 

States to conduct an assessment of the responsibilities, workload, 

and vacancy rates of Department of Veterans Affairs suicide prevention coordinators, and for other purposes, having considered the 

same, report favorably thereon without amendment and recommend that the bill do pass. 

CONTENTS 

Page 

Purpose and Summary ............................................................................................ 2 

Background and Need for Legislation .................................................................... 2 

Hearings ................................................................................................................... 3 

Subcommittee Consideration .................................................................................. 3 

Committee Consideration ........................................................................................ 4 

Committee Votes ...................................................................................................... 4 

Committee Oversight Findings ............................................................................... 4 

Statement of General Performance Goals and Objectives .................................... 4 

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 4 

Earmarks and Tax and Tariff Benefits .................................................................. 4 

Committee Cost Estimate ....................................................................................... 4 

Congressional Budget Office Estimate ................................................................... 4 

Federal Mandates Statement ................................................................................. 5 

Advisory Committee Statement .............................................................................. 6 

Constitutional Authority Statement ...................................................................... 6 

Applicability to Legislative Branch ........................................................................ 6 

Statement on Duplication of Federal Programs .................................................... 6 

Section-by-Section Analysis of the Legislation ...................................................... 6 


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1 VA National Suicide Data Report 2005–2016, Office of Mental Health and Suicide Prevention, U.S. Department of Veterans Affairs, September 2018. 2Department of Veterans Affairs, Department of Veterans Affairs Fiscal Years 2018–2024 

Strategic Plan (Washington, D.C.: Feb. 12, 2018). 3Testimony of Dr. Richard Stone, Executive in Charge, Veterans Health Administration during House Committee on Veterans’ Affairs oversight hearing ‘‘Tragic Trends: Suicide Prevention 

Among Veterans,’’ April 29, 2019. 

PURPOSE AND SUMMARY

H.R. 2333 would require the Comptroller General of the United 

States (GAO) to conduct an assessment of the responsibilities, 

workload, training, and vacancy rates of the Department of Veterans Affairs’ (VA) Suicide Prevention Coordinators (SPCs) and to 

report its findings to the Committees on Veterans’ Affairs of the 

Senate and House of Representatives, not later than one year after 

the date of the enactment of this act. 

Representative Anthony Brindisi of New York introduced H.R. 

2333 on April 18, 2019. 

BACKGROUND AND NEED FOR LEGISLATION

According to the National Suicide Data Report for 2005–2016,1

approximately 20 veterans, members of the National Guard, and 

reservists die by suicide each day. A disproportionately higher rate 

of suicide exists in the veteran population compared to that of the 

civilian population. In 2018, VA identified suicide prevention as its 

highest clinical priority.2

SPCs are the face of VA’s efforts to combat veteran suicide. The 

Veterans Health Administration (VHA) is the only healthcare system that has full-time employees dedicated to the issue of suicide 

prevention. SPCs identify high-risk veterans and ensure they receive appropriate care, conduct outreach, and promote awareness 

and suicide prevention best practices within VA, among other responsibilities. As of April 2019, VA has approximately 444 SPCs 

stationed at every medical center, who are managing care for almost 30,000 veterans who are at high risk for suicide, in addition 

to managing several other duties. In Fiscal Year 2018, SPCs conducted more than 20,000 outreach events, reaching almost 2 million people. During oversight trips to VA facilities, many Committee staff have heard from SPCs that they are overworked and 

unable to keep up with their many responsibilities. After an internal analysis in 2018, VHA determined the need for an additional 

246 SPCs.3 The REACH VET program, a predictive algorithm that 

produces a red flag in a patient’s health record, alerts the SPCs to 

do outreach to those veterans presenting as high risk in VA. The 

need for this tool is indicative of the heavy workload of SPCs as 

they try to meet and coordinate the needs of thousands of veterans. 

The current rate of vacancies in VHA mental health, among psychologists, psychiatrists, and social workers, remains steady at 

10%. Given the prevalence of the epidemic among veterans, and 

VA’s recent shift to a public health approach, SPCs are attempting 

groundbreaking work with a patient load, on average, of 90 veterans per SPC. As VA works to improve its mental health services, 

and as more veterans turn to VHA for care, the capacity of suicide 

prevention coordinators will continue to be a necessary and crucial 

function of addressing societal forces that cause suicidality in the 

veteran population. This measure will help to fully illustrate the 


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limitations and structure that SPCs currently operate in and identify what can be done to better enable them in their efforts. 

HEARINGS

For the purposes of section 103(i) of H. Res. 6 of the 116th Congress—(1) the following hearings were used to develop or consider 

H.R. 2333. 

On April 29, 2019, the Committee on Veterans’ Affairs conducted 

an oversight hearing titled, ‘‘Tragic Trends: Suicide Prevention 

Among Veterans’’ to explore actions the Department of Veterans 

Affairs and the House Committee on Veterans’ Affairs could take 

to combat the epidemic of suicide within the veteran population. 

The following witnesses testified: 

Shelli Avenevoli PhD, the Deputy Director of the National 

Institute of Mental Health within the National Institute of 

Health; Richard McKeon PhD, MPH, the Chief of the Suicide 

Prevention Branch within the Substance Abuse and Mental 

Health Services Administration; and Richard Stone M.D., the 

Executive-in-Charge of the Veterans Health Administration 

within the U.S. Department of Veterans Affairs, who was accompanied by Keita Franklin LCSW, PhD, the National Director of Suicide Prevention of the Office of Mental Health and 

Suicide Prevention within the U.S. Department of Veterans Affairs. 

Statements for the record were received by American Veterans, 

Disabled American Veterans, Iraq and Afghanistan Veterans of 

America, The American Legion, Vietnam Veterans of America, 

Wounded Warrior Project, Center for Disease Control, Veterans of 

Foreign Wars, and The Independence Fund. 

On April 30, 2019, the Subcommittee on Health conducted a legislative hearing on several bills including H.R. 2333. 

The following witnesses testified: 

The Honorable Earl Blumenauer, U.S. House of Representatives; The Honorable J. Luis Correa, U.S. House of Representatives; The Honorable Conor Lamb, U.S. House of Representatives; The Honorable Max Rose, U.S. House of Representatives; 

Keita Franklin LCSW, PhD, the National Director of Suicide 

Prevention of the Office of Mental Health and Suicide Prevention within the U.S. Department of Veterans Affairs, who was 

accompanied by Tracy Gaudet M.D., the Director of the Office 

of Patient Centered Care within the U.S. Department of Veterans Affairs and Larry Mole PharmD, the Chief Consultant 

on Population Health of the U.S. Department of Veterans Affairs; Stephanie Mullen, Research Director for Iraq and Afghanistan Veterans of America; Carlos Fuentes, the Director of 

the National Legislative Service within Veterans of Foreign 

Wars; and Joy Ilem, the National Legislative Director for Disabled American Veterans. 

No statements for the record were received. 

SUBCOMMITTEE CONSIDERATION

H.R. 2333 was not considered before the Subcommittee. 


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COMMITTEE CONSIDERATION

On May 8, 2019, the Committee on Veterans’ Affairs met in an 

open markup session, a quorum being present, and favorably reported H.R. 2333 to the House of Representatives by voice vote. 

COMMITTEE VOTES

In compliance with clause 3(b) of rule XIII of the Rules of the 

House of Representatives, there were no recorded votes taken on 

amendments or in connection with reporting H.R. 2333 to the 

House. A motion by Ranking Member David P. Roe of Tennessee 

to report H.R. 2333 favorably to the House of Representatives was 

adopted by voice vote. 

COMMITTEE OVERSIGHT FINDINGS

In compliance with clause 3(c)(1) of rule XIII and clause 2(b)(1) 

of rule X of the Rules of the House of Representatives, the Committee’s oversight findings and recommendations are reflected in the 

descriptive portions of this report. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

In accordance with clause 3(c)(4) of rule XIII of the Rules of the 

House of Representatives, the Committee’s performance goals and 

objectives are to expand access to high quality mental healthcare 

and related resources to curb the prevalence of suicide among veterans, servicemembers, Reservists, and members of the Coast 

Guard and National Guard. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

In compliance with clause 3(c)(2) of rule XIII of the Rules of the 

House of Representatives, the Committee adopts as its own the estimate of new budget authority, entitlement authority, or tax expenditures or revenues contained in the cost estimate prepared by 

the Director of the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

EARMARKS AND TAX AND TARIFF BENEFITS

H.R. 2333 does not contain any Congressional earmarks, limited 

tax benefits, or limited tariff benefits as defined in clause 9 of rule 

XXI of the Rules of the House of Representatives. 

COMMITTEE COST ESTIMATE

The Committee adopts as its own the cost estimate on H.R. 2333 

prepared by the Director of the Congressional Budget Office pursuant to section 402 of the Congressional Budget Act of 1974. 

CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

Pursuant to clause 3(c)(3) of rule XIII of the Rules of the House 

of Representatives, the following is the cost estimate for H.R. 2333 

provided by the Director of the Congressional Budget Office pursuant to section 402 of the Congressional Budget Act of 1974: 


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U.S. CONGRESS, CONGRESSIONAL BUDGET OFFICE, Washington, DC, May 15, 2019. 

Hon. MARK TAKANO, 

Chairman, Committee on Veterans’ Affairs, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 2333, the Support for Suicide Prevention Coordinators Act. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Ann E. Futrell. 

Sincerely, 

KEITH HALL, 

Director. 

Enclosure. 

H.R. 2333 would require the Government Accountability Office 

(GAO) to conduct an assessment of the responsibilities, workload, 

training, and vacancy rates of suicide prevention coordinators at 

the Department of Veterans Affairs. 

On the basis of information from GAO, CBO estimates that preparing the report would take about one year and require four fulltime employees at an average compensation of $130,000. As a result, CBO estimates that implementing the bill would cost $1 million over the 2020–2024 period; such spending would be subject to 

the availability of appropriated funds. 

The CBO staff contact for this estimate is Ann E. Futrell. The 

estimate was reviewed by Leo Lex, Deputy Assistant Director for 

Budget Analysis. 

FEDERAL MANDATES STATEMENT

The Committee adopts as its own the estimate of Federal mandates regarding H.R. 2333 prepared by the Director of the Congressional Budget Office pursuant to section 423 of the Unfunded Mandates Reform Act. 


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ADVISORY COMMITTEE STATEMENT

No advisory committees within the meaning of section 5(b) of the 

Federal Advisory Committee Act would be created by H.R. 2333. 

CONSTITUTIONAL AUTHORITY STATEMENT

Pursuant to Article I, section 8 of the United States Constitution, 

H.R. 2333 is authorized by Congress’ power to ‘‘provide for the common Defense and general Welfare of the United States.’’ 

APPLICABILITY TO LEGISLATIVE BRANCH

The Committee finds that H.R. 2333 does not relate to the terms 

and conditions of employment or access to public services or accommodations within the meaning of section 102(b)(3) of the Congressional Accountability Act. 

STATEMENT ON DUPLICATION OF FEDERAL PROGRAMS

Pursuant to clause 3(c)(5) of rule XIII of the Rules of the House 

of Representatives, the Committee finds that no provision of H.R. 

2333 establishes or reauthorizes a program of the Federal Government known to be duplicative of another Federal program, a program that was included in any report from the Government Accountability Office to Congress pursuant to section 21 of Public 

Law 111–139, or a program related to a program identified in the 

most recent Catalog of Federal Domestic Assistance. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title 

Section 1 of the bill establishes the short title of the measure as 

the ‘‘Support for Suicide Prevention Coordinators Act of 2019.’’ 

Section 2. Comptroller General assessment of responsibilities, workload, and vacancy rates of Department of Veterans Affairs suicide prevention coordinators 

Section 2(a) of the bill would require the GAO to conduct an assessment of the responsibilities, workload, training, and vacancy 

rates of the Department of Veterans Affairs suicide prevention coordinators. 

Section 2(b) would require the GAO to submit to the Committees 

on Veterans’ Affairs of the Senate and House of Representatives a 

report containing the findings of the assessment required by subsection (a) not later than one year after the date of the enactment. 

Æ 


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