II 

117TH CONGRESS 

1ST SESSION S. 2283 

To improve the Veterans Crisis Line of the Department of Veterans Affairs, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 24, 2021 

Mr. TESTER (for himself and Mr. MORAN) introduced the following bill; which 

was read twice and referred to the Committee on Veterans’ Affairs 

A BILL 

To improve the Veterans Crisis Line of 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, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

5 ‘‘Revising and Expediting Actions for the Crisis Hotline 

6 for Veterans Act’’ or the ‘‘REACH for Veterans Act’’. 

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

8 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Definitions. 

TITLE I—VETERANS CRISIS LINE TRAINING AND QUALITY 

MANAGEMENT 


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Subtitle A—Staff Training 

Sec. 101. Review of training for Veterans Crisis Line call responders. 

Sec. 102. Retraining guidelines for Veterans Crisis Line call responders. 

Subtitle B—Quality Review and Management 

Sec. 111. Monitoring of calls on Veterans Crisis Line. 

Sec. 112. Quality management processes for Veterans Crisis Line. 

Sec. 113. Annual common cause analysis for callers to Veterans Crisis Line 

who die by suicide. 

Subtitle C—Guidance for High-Risk Callers 

Sec. 121. Development of enhanced guidance and procedures for response to 

calls related to substance use and overdose risk. 

Sec. 122. Review and improvement of standards for emergency dispatch. 

Subtitle D—Oversight and Clarification of Staff Roles and Responsibilites 

Sec. 131. Oversight of training of social service assistants and clarification of 

job responsibilities. 

TITLE II—PILOT PROGRAMS AND RESEARCH ON VETERANS 

CRISIS LINE 

Subtitle A—Pilot Programs 

Sec. 201. Extended safety planning pilot program for Veterans Crisis Line. 

Sec. 202. Crisis line facilitation pilot program. 

Subtitle B—Research on Effectiveness 

Sec. 211. Authorization of appropriations for research on effectiveness and opportunities for improvement of Veterans Crisis Line. 

TITLE III—TRANSITION OF CRISIS LINE NUMBER 

Sec. 301. Feedback on transition of crisis line number. 

1 SEC. 2. DEFINITIONS. 

2 In this Act: 

3 (1) DEPARTMENT.—The term ‘‘Department’’ 

4 means the Department of Veterans Affairs. 

5 (2) SECRETARY.—The term ‘‘Secretary’’ means 

6 the Secretary of Veterans Affairs. 

7 (3) VETERANS CRISIS LINE.—the term ‘‘Vet8 erans Crisis Line’’ means the toll-free hotline for 


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

2 38, United States Code. 

3 TITLE I—VETERANS CRISIS LINE 

4 TRAINING AND QUALITY MAN5 AGEMENT 

6 Subtitle A—Staff Training 

7 SEC. 101. REVIEW OF TRAINING FOR VETERANS CRISIS 

8 LINE CALL RESPONDERS. 

9 (a) IN GENERAL.—The Secretary shall enter into an 

10 agreement with an organization outside the Department, 

11 such as the American Association of Suicidology, to review 

12 the training for Veterans Crisis Line call responders on 

13 assisting callers in crisis. 

14 (b) COMPLETION OF REVIEW.—The review conducted 

15 under subsection (a) shall be completed not later than one 

16 year after the date of the enactment of this Act. 

17 (c) ELEMENTS OF REVIEW.—The review conducted 

18 under subsection (a) shall consist of a review of the train19 ing provided by the Department on subjects including risk 

20 assessment, lethal means assessment, substance use and 

21 overdose risk assessment, safety planning, referrals to 

22 care, supervisory consultation, and emergency dispatch. 

23 (d) UPDATE OF TRAINING.—If any deficiencies in the 

24 training for Veterans Crisis Line call responders are found 

25 pursuant to the review under subsection (a), the Secretary 


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1 shall update such training and associated standards of 

2 practice to correct those deficiencies not later than one 

3 year after the completion of the review. 

4 SEC. 102. RETRAINING GUIDELINES FOR VETERANS CRISIS 

5 LINE CALL RESPONDERS. 

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

7 date of the enactment of this Act, the Secretary shall de8 velop guidelines on retraining and quality management for 

9 when a Veterans Crisis Line call responder has an adverse 

10 event or when a quality review check by a supervisor of 

11 such a call responder denotes that the call responder needs 

12 improvement. 

13 (b) ELEMENTS OF GUIDELINES.—The guidelines de14 veloped under subsection (a) shall specify the subjects and 

15 quantity of retraining recommended and how supervisors 

16 should implement increased use of silent monitoring or 

17 other performance review mechanisms. 

18 Subtitle B—Quality Review and 

19 Management 

20 SEC. 111. MONITORING OF CALLS ON VETERANS CRISIS 

21 LINE. 

22 (a) IN GENERAL.—The Secretary shall require that 

23 not fewer than two calls per month for each Veterans Cri24 sis Line call responder be subject to supervisory silent 


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1 monitoring, which is used to monitor the quality of con2 duct by such call responder during the call. 

3 (b) BENCHMARKS.—The Secretary shall establish 

4 benchmarks for requirements and performance of Vet5 erans Crisis Line call responders on supervisory silent 

6 monitored calls. 

7 (c) QUARTERLY REPORTS.—Not less frequently than 

8 quarterly, the Secretary shall submit to the Office of Men9 tal Health and Suicide Prevention of the Department of 

10 Veterans Affairs a report on occurrence and outcomes of 

11 supervisory silent monitoring of calls on the Veterans Cri12 sis Line. 

13 SEC. 112. QUALITY MANAGEMENT PROCESSES FOR VET14 ERANS CRISIS LINE. 

15 Not later than one year after the date of the enact16 ment of this Act, the leadership for the Veterans Crisis 

17 Line, in partnership with the Office of Mental Health and 

18 Suicide Prevention of the Department and the National 

19 Center for Patient Safety of the Department, shall estab20 lish quality management processes and expectations for 

21 staff of the Veterans Crisis Line, including with respect 

22 to reporting of adverse events and close calls. 


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1 SEC. 113. ANNUAL COMMON CAUSE ANALYSIS FOR CALL2 ERS TO VETERANS CRISIS LINE WHO DIE BY 

3 SUICIDE. 

4 (a) IN GENERAL.—Not less frequently than annually, 

5 the Secretary shall perform a common cause analysis for 

6 all identified callers to the Veterans Crisis Line that died 

7 by suicide during the one-year period preceding the con8 duct of the analysis before the caller received contact with 

9 emergency services and in which the Veterans Crisis Line 

10 was the last point of contact. 

11 (b) SUBMITTAL OF RESULTS.—The Secretary shall 

12 submit to the Office of Mental Health and Suicide Preven13 tion of the Department the results of each analysis con14 ducted under subsection (a). 

15 (c) APPLICATION OF THEMES OR LESSONS.—The 

16 Secretary shall apply any themes or lessons learned under 

17 an analysis under subsection (a) to updating training and 

18 standards of practice for staff of the Veterans Crisis Line. 

19 Subtitle C—Guidance for High-Risk 

20 Callers 

21 SEC. 121. DEVELOPMENT OF ENHANCED GUIDANCE AND 

22 PROCEDURES FOR RESPONSE TO CALLS RE23 LATED TO SUBSTANCE USE AND OVERDOSE 

24 RISK. 

25 Not later than one year after the date of the enact26 ment of this Act, the Secretary, in consultation with naVerDate Sep 11 2014 00:11 Jul 15, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2283.IS S2283

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1 tional experts within the Department on substance use 

2 disorder and overdose, shall— 

3 (1) develop enhanced guidance and procedures 

4 to respond to calls to the Veterans Crisis Line re5 lated to substance use and overdose risk; 

6 (2) update training materials for staff of the 

7 Veterans Crisis Line in response to such enhanced 

8 guidance and procedures; and 

9 (3) update criteria for monitoring compliance 

10 with such enhanced guidance and procedures. 

11 SEC. 122. REVIEW AND IMPROVEMENT OF STANDARDS FOR 

12 EMERGENCY DISPATCH. 

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

14 date of the enactment of this Act, the Secretary shall— 

15 (1) review the current emergency dispatch 

16 standard operating procedure of the Veterans Crisis 

17 Line to identify any additions to such procedure to 

18 strengthen communication regarding— 

19 (A) emergency dispatch for disconnected 

20 callers; and 

21 (B) the role of social service assistants in 

22 requesting emergency dispatch and recording 

23 such dispatches; and 

24 (2) update such procedure to include the addi25 tions identified under paragraph (1). 


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1 (b) TRAINING.—The Secretary shall ensure that all 

2 staff of the Veterans Crisis Line are trained on all updates 

3 made under subsection (a)(2) to the emergency dispatch 

4 standard operating procedure of the Veterans Crisis Line. 

5 Subtitle D—Oversight and Clari6 fication of Staff Roles and 

7 Responsibilites 

8 SEC. 131. OVERSIGHT OF TRAINING OF SOCIAL SERVICE AS9 SISTANTS AND CLARIFICATION OF JOB RE10 SPONSIBILITIES. 

11 Not later than one year after the date of the enact12 ment of this Act, the Secretary shall— 

13 (1) establish oversight mechanisms to ensure 

14 that social service assistants and supervisory social 

15 service assistants working with the Veterans Crisis 

16 Line are appropriately trained and implementing 

17 guidance of the Department regarding the Veterans 

18 Crisis Line; and 

19 (2) refine standard operating procedures to de20 lineate roles and responsibilities for all levels of su21 pervisory social service assistants working with the 

22 Veterans Crisis Line. 


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1 TITLE II—PILOT PROGRAMS AND 

2 RESEARCH ON VETERANS 

3 CRISIS LINE 

4 Subtitle A—Pilot Programs 

5 SEC. 201. EXTENDED SAFETY PLANNING PILOT PROGRAM 

6 FOR VETERANS CRISIS LINE. 

7 (a) IN GENERAL.—Commencing not later than 180 

8 days after the date of the enactment of this Act, the Sec9 retary shall carry out a pilot program to determine wheth10 er a lengthier, templated safety plan used in clinical set11 tings could be applied in call centers for the Veterans Cri12 sis Line. 

13 (b) BRIEFING.—Not later than two years after the 

14 date of the enactment of this Act, the Secretary shall brief 

15 Congress on the findings of the Secretary under the pilot 

16 program under subsection (a), including such rec17 ommendations as the Secretary may have for continuation 

18 or discontinuation of the pilot program. 

19 SEC. 202. CRISIS LINE FACILITATION PILOT PROGRAM. 

20 (a) IN GENERAL.—Commencing not later than one 

21 year after the date of the enactment of this Act, the Sec22 retary shall carry out a pilot program on the use of crisis 

23 line facilitation to increase use of the Veterans Crisis Line 

24 among high-risk veterans. 


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1 (b) BRIEFING.—Not later than two years after the 

2 date of the enactment of this Act, the Secretary shall brief 

3 Congress on the findings of the Secretary under the pilot 

4 program under subsection (a), including such rec5 ommendations as the Secretary may have for continuation 

6 or discontinuation of the pilot program. 

7 (c) DEFINITIONS.—In this section: 

8 (1) CRISIS LINE FACILITATION.—The term 

9 ‘‘crisis line facilitation’’, with respect to a high-risk 

10 veteran, means the presentation by a therapist of 

11 psychoeducational information about the Veterans 

12 Crisis Line and a discussion of the perceived bar13 riers and facilitators to future use of the Veterans 

14 Crisis Line for the veteran, which culminates in the 

15 veteran calling the Veterans Crisis Line with the 

16 therapist to provide firsthand experiences that may 

17 counter negative impressions of the Veterans Crisis 

18 Line. 

19 (2) HIGH-RISK VETERAN.—The term ‘‘high-risk 

20 veteran’’ means a veteran receiving inpatient mental 

21 health care following a suicidal crisis. 


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1 Subtitle B—Research on 

2 Effectiveness 

3 SEC. 211. AUTHORIZATION OF APPROPRIATIONS FOR RE4 SEARCH ON EFFECTIVENESS AND OPPORTU5 NITIES FOR IMPROVEMENT OF VETERANS 

6 CRISIS LINE. 

7 There is authorized to be appropriated to the Sec8 retary $5,000,000 for the Mental Illness Research, Edu9 cation, and Clinical Centers of the Department to conduct 

10 research on the effectiveness of the Veterans Crisis Line 

11 and areas for improvement for the Veterans Crisis Line. 

12 TITLE III—TRANSITION OF 

13 CRISIS LINE NUMBER 

14 SEC. 301. FEEDBACK ON TRANSITION OF CRISIS LINE NUM15 BER. 

16 (a) IN GENERAL.—The Secretary shall solicit feed17 back from veterans service organizations on how to con18 duct outreach to members of the Armed Forces, veterans, 

19 their family members, and other members of the military 

20 and veterans community on the move to 988 as the new, 

21 national three-digit suicide and mental health crisis hot22 line, which is expected to be implemented by July 2022, 

23 to minimize confusion and ensure veterans are aware of 

24 their options for reaching the Veterans Crisis Line. 


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1 (b) NONAPPLICATION OF FACA.—The Federal Advi2 sory Committee Act (5 U.S.C. App.) shall not apply to 

3 any feedback solicited under subsection (a). 

4 (c) VETERANS SERVICE ORGANIZATION DEFINED.— 

5 In this section, the term ‘‘veterans service organization’’ 

6 means an organization recognized by the Secretary for the 

7 representation of veterans under section 5902 of title 38, 

8 United States Code. 

Æ 


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