13806 Federal Register / Vol. 87, No. 47 / Thursday, March 10, 2022 / Rules and Regulations 

DEPARTMENT OF VETERANS 

AFFAIRS 

38 CFR Part 78 

RIN 2900–AR16 

Staff Sergeant Parker Gordon Fox 

Suicide Prevention Grant Program 

AGENCY: Department of Veterans Affairs. 

ACTION: Interim final rule. 

SUMMARY: The Department of Veterans 

Affairs (VA) is issuing this interim final 

rule to implement a new authority 

requiring VA to implement a three-year 

community-based grant program to 

award grants to eligible entities to 

provide or coordinate the provision of 

suicide prevention services to eligible 

individuals and their families for the 

purpose of reducing veteran suicide. 

This rulemaking specifies grant 

eligibility criteria, application 

requirements, scoring criteria, 

constraints on the allocation and use of 

the funds, and other requirements 

necessary to implement this grant 

program. 

DATES: 

Effective date: This interim final rule 

is effective on April 11, 2022. 

Comments: Comments must be 

received on or before May 9, 2022. 

ADDRESSES: Comments must be 

submitted through 

www.Regulations.gov. Comments 

received will be available at 

regulations.gov for public viewing, 

inspection or copies. 

FOR FURTHER INFORMATION CONTACT: 

Sandra Foley, Supervisory Grants 

Manager—Suicide Prevention Program, 

Office of Mental Health and Suicide 

Prevention, 11MHSP, 810 Vermont 

Avenue NW, Washington, DC 20420, 

202–502–0002 (This is not a toll-free 

telephone number), VASSGFoxGrants@

va.gov. 

SUPPLEMENTARY INFORMATION: 

Background on Governing Statute and 

Public Input 

On October 17, 2020, the Commander 

John Scott Hannon Veterans Mental 

Health Care Improvement Act of 2019, 

Public Law (Pub. L.) 116–171 (the Act), 

was enacted in law. Section 201 of the 

Act, codified as a note to section 1720F 

of title 38, United States Code (U.S.C.), 

mandated VA establish the Staff 

Sergeant Parker Gordon Fox Suicide 

Prevention Grant Program (SSG Fox 

SPGP), a community-based grant 

program that would support certain 

eligible entities to provide or coordinate 

the provision of suicide prevention 

services to eligible individuals and their 

families. Section 201 of the Act 

specified which entities are eligible for 

grants and those individuals eligible to 

receive suicide prevention services, 

defined the suicide prevention services 

that may be provided, described grant 

application requirements, and explained 

instances in which eligible entities must 

refer individuals to VA for additional 

care, among other requirements. This 

grant program is authorized for a period 

of three years starting on the date on 

which the first grant is awarded. The 

maximum amount per grant is capped 

by section 201(c)(2) of the Act at 

$750,000 per fiscal year. 

Section 201 of the Act required that 

VA consult with certain entities to assist 

in developing a plan for the design and 

implementation of the provision of 

grants; establishing criteria for the 

selection of eligible entities; developing 

a framework for collecting and sharing 

information about grantees; and 

developing measures and metrics to be 

used by grantees to determine the 

effectiveness of programming provided 

pursuant to the suicide prevention 

services grant. 

Section 201(h)(3) of the Act 

specifically required VA consult with 

the following entities: (1) Veterans 

service organizations; (2) National 

organizations (including national 

organizations that advocate for the 

needs of individuals with or at risk of 

behavioral health conditions; and those 

that represent mayors, unions, first 

responders, chiefs of police and sheriffs, 

governors, a territory of the United 

States, or a Tribal alliance) representing 

potential community partners of eligible 

entities in providing supportive services 

to address the needs of eligible 

individuals and their families; (3) 

National organizations representing 

members of the Armed Forces; (4) 

National organizations that represent 

counties; (5) Organizations with which 

VA has a current memorandum of 

agreement or understanding related to 

mental health or suicide prevention; (6) 

State departments of veterans affairs; (7) 

National organizations representing 

members of the Reserve Components of 

the Armed Forces; (8) National 

organizations representing members of 

the Coast Guard; (9) Organizations, 

including institutions of higher 

education, with experience in creating 

measurement tools for purposes of 

advising the Secretary on the most 

appropriate existing measurement tool 

or protocol for VA to utilize; (10) The 

National Alliance on Mental Illness; (11) 

A labor organization (as such term is 

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

U.S.C.); (12) The Centers for Disease 

Control and Prevention (CDC), the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA), 

and the President’s Roadmap to 

Empower Veterans and End a National 

Tragedy of Suicide (PREVENTS) Task 

Force; and such other organizations as 

the Secretary deems appropriate. 

On April 1, 2021, VA published a 

Notice of Request for Information on the 

Department of Veterans Affairs’ Staff 

Sergeant Parker Gordon Fox Suicide 

Prevention Grant Program (RIN 2900– 

AR16) in the Federal Register (FR), 

requesting information and comments 

from the public to meet the 

requirements for consultation in the 

Act. 86 FR 17268 (April 1, 2021). 

Through this notice, VA asked the 

public, including those organizations 

listed in the previous paragraph, to 

comment on various aspects of the 

suicide prevention services grant 

program, such as distribution and 

selection of grants; administration of the 

grant program, including development 

of measures and metrics; training and 

technical assistance; referrals for care; 

degrees of risk of suicide and processes 

for determining degrees of risk of 

suicide; and nontraditional and 

innovative approaches and treatment 

practices that may be appropriate under 

this grant program. VA directly 

contacted various organizations that met 

the categories of organizations listed 

under section 201(h)(3) of the Act to 

notify them that VA was seeking input 

through this FR notice. VA received 124 

comments, including comments outside 

the scope of the questions posed. Many 

commenters expressed support for 

awarding grants to entities with prior 

relevant experience. Many commenters 

also provided suggestions for training 

and technical assistance related to 

suicide prevention, evaluation and 

reporting requirements, and referrals to 

VA for further care. Additionally, 

numerous commenters provided 

suggestions for non-traditional and 

innovative treatment and services under 

this grant program. The comments 

received from this notice are publicly 

available online at www.regulations.gov. 

On May 11, 2021, VA published a 

Notice of Listening Sessions on the 

Department of Veterans Affairs Staff 

Sergeant Parker Gordon Fox Suicide 

Prevention Grant Program (RIN 2900– 

AR16) in the FR notifying the public of 

two related listening sessions, which 

were held on May 25, 2021 and May 26, 

2021. 86 FR 25938 (May 11, 2021). The 

topics for the first listening session 

included distribution and selection of 

grants, administration of the grant 

program, and training and technical 

assistance. The topics for the second 

listening session included referrals for 


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care, risk of suicide, and suicide 

prevention services. Similar to the April 

1, 2021 notice, this second notice 

included specific questions for the 

public to consider and upon which to 

comment at the listening session. VA 

directly contacted various organizations 

that met the categories of organizations 

listed under section 201(h)(3) of the Act 

to notify them that VA was seeking 

input through these listening sessions. 

Thirty-two individuals presented oral 

comments at these listening sessions. 

Many of these comments were similar to 

those received in response to the April 

1, 2021 notice. Commenters expressed 

support for awarding grants to entities 

with demonstrated experiences and 

capacity to implement evidence-based 

programs. Commenters also expressed 

support for awarding grants to entities 

that have experience working with 

veterans at risk of suicide and have or 

plan to have culturally competent care. 

Additionally, commenters supported 

awarding grants to entities that utilized 

validated assessment tools and entities 

that had area partnerships (including at 

local, regional, and national levels) as 

well as with VA. Many commenters also 

provided suggestions for training and 

for assessment tools. Additionally, 

numerous commenters provided 

suggestions for non-traditional and 

innovative treatment and services under 

this grant program. The transcript for 

these listening sessions is publicly 

available online at www.regulations.gov. 

VA appreciates the time and attention 

from commenters who shared their 

opinions on how to implement section 

201 of the Act. In developing this 

interim final rule, VA considered the 

feedback received from the April 1, 

2021, Notice of Request for Information 

on the Department of Veterans Affairs’ 

Staff Sergeant Parker Gordon Fox 

Suicide Prevention Grant Program (RIN 

2900–AR16) and the listening sessions 

held on May 25, 2021, and May 26, 

2021. 

Part 78 of Title 38, Code of Federal 

Regulations 

Through this interim final rule, VA is 

establishing and implementing, in new 

part 78 of title 38, Code of Federal 

Regulations (CFR), SSG Fox SPGP 

required by section 201 of the Act. 

Establishment of this new part ensures 

organization and clarity for 

implementation of this new grant 

program. The interim final rule is 

establishing regulations authorizing VA 

to award suicide prevention services 

grants to eligible entities who will 

provide or coordinate the provision of 

suicide prevention services to eligible 

individuals and their families. 

Consistent with section 201 of the 

Act, part 78 is titled the Staff Sergeant 

Parker Gordon Fox Suicide Prevention 

Grant Program. 

78.0 Purpose and Scope 

Section 78.0 of this IFR explains the 

purpose and scope of new part 78. 

Paragraph (a) states that this part 

implements SSG Fox SPGP with the 

purpose of reducing veteran suicide by 

expanding suicide prevention programs 

for veterans through the award of 

suicide prevention services grants to 

eligible entities to provide or coordinate 

the provision of suicide prevention 

services to eligible individuals and their 

families. This purpose is consistent with 

section 201(a)(1) and (b) of the Act. 

Section 201(a)(1) states that its purpose 

is to reduce veteran suicide through a 

community-based grant program to 

award grants to eligible entities to 

provide or coordinate suicide 

prevention services to eligible 

individuals and their families. Section 

201(b) states that the Secretary shall 

provide financial assistance through 

grants to eligible entities to provide or 

coordinate the provision of services to 

eligible individuals and their families to 

reduce the risk of suicide. 

Paragraph (b) states that suicide 

prevention services covered by this part 

are those services that address the needs 

of eligible individuals and their families 

and are necessary for improving the 

mental health status and wellbeing and 

reducing the suicide risk of eligible 

individuals and their families. This 

broadly defines the intended effects of 

the program, is consistent with the 

intent of the law, and ensures that those 

services authorized under this grant 

program are those that meet the purpose 

of this grant program—to reduce suicide 

risk. 

78.5 Definitions 

Section 78.5 contains the definitions 

for key terms that apply to new part 78 

and to any Notice of Funding 

Opportunity (NOFO) for this grant 

program. The definitions are listed in 

alphabetical order, beginning with the 

definition of applicant. 

VA is defining applicant to mean an 

eligible entity that submits an 

application for a suicide prevention 

services grant announced in a NOFO. 

VA is defining applicant in this manner 

since only an eligible entity (as that 

term is defined later in this rulemaking) 

that submits an application for a suicide 

prevention services grant under part 78 

will be able to apply for such a grant. 

This is based on a plain language 

understanding of the term ‘‘applicant’’ 

and is consistent with how VA defines 

this in the Supportive Services for 

Veteran Families (SSVF) Program. See 

38 CFR 62.2. As explained in § 78.15, 

VA will require submission of an 

application similar to other grant 

programs that VA administers. 

Direct Federal financial assistance 

means Federal financial assistance 

received by an entity selected by the 

Government or a pass-through entity as 

defined in 38 CFR 50.1(d) to provide or 

carry out a service (e.g., by contract, 

grant, or cooperative agreement). This is 

used for purposes of § 78.130 and is 

consistent with how VA defines this in 

the Homeless Providers Grant and Per 

Diem Program and the SSVF Program 

(see §§ 61.64(b)(2) and 62.62, 

respectively). 

Eligible child care provider is defined 

to mean a provider of child care services 

for compensation, including a provider 

of care for a school-age child during 

non-school hours, that (1) is licensed, 

regulated, registered, or otherwise 

legally operating, under State and local 

law; and (2) satisfies the State and local 

requirements, applicable to the child 

care services the provider provides. This 

is consistent with the definition of 

eligible child care provider that VA uses 

in the SSVF Program. See 38 CFR 62.2. 

This definition of eligible child care 

provider is also consistent with the 

broader definition used by the 

Department of Health and Human 

Services (HHS) for its Child Care and 

Development Block grant. See 42 U.S.C. 

9859(2). 

This term is used for purposes of 

§ 78.80(h), which includes among 

suicide prevention services certain child 

care services. Pursuant to section 

201(q)(11)(A)(ix)(VIII) of the Act, child 

care services (not to exceed $5,000 per 

family of an eligible individual per 

fiscal year) are authorized as assistance 

with emergent needs under this grant 

program, and VA explains in § 78.80(h) 

the limitations on such services and 

payments. 

Eligible entity is defined to mean an 

entity that meets the definition of an 

eligible entity in section 201(q) of Public 

Law 116–171. VA refers to section 

201(q) of Public Law 116–171 rather 

than include the exact definition from 

subsection (q)(3) of section 201, as this 

would allow VA to immediately 

implement any changes made by 

Congress to that definition without 

requiring amendment to these 

regulations. Currently, under section 

201(q)(3) of the Act, an eligible entity 

must be one of the following: (1) An 

incorporated private institution or 

foundation (i) no part of the net earnings 

of which incurs to the benefit of any 

member, founder, contributor, or 


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individual, and (ii) that has a governing 

board that would be responsible for the 

operation of the suicide prevention 

services provided under this part; (2) a 

corporation wholly owned and 

controlled by an organization meeting 

the requirements of clauses (i) and (ii) 

above; (3) an Indian tribe; (4) a 

community-based organization that can 

effectively network with local civic 

organizations, regional health systems, 

and other settings where eligible 

individuals and their families are likely 

to have contact; or (5) a State or local 

government. 

Eligible individual is defined to mean 

an individual that meets the 

requirements of § 78.10(a). As discussed 

later in this rulemaking, § 78.10(a) 

describes the eligibility criteria to be an 

eligible individual under part 78. These 

criteria are consistent with section 

201(q)(4) of the Act. 

Family is defined to mean any of the 

following: A parent, spouse, child, 

sibling, step-family member, extended 

family member, and any other 

individual who lives with the eligible 

individual. This is consistent with 

section 201(q)(6) of the Act. 

Grantee is defined to mean an eligible 

entity that is awarded a suicide 

prevention services grant under part 78. 

This is consistent with how VA defines 

grantee for other VA grant programs and 

the plain meaning of this term. See, e.g., 

38 CFR 62.2; 38 CFR 61.1. 

Indian tribe is defined to mean an 

Indian tribe as defined in 25 U.S.C. 

4103. Section 4103(13)(A) of title 25, 

U.S.C., defines Indian tribe in general to 

mean a tribe that is a Federally or a 

State recognized tribe. Section 

4103(13)(B) of title 25, U.S.C., further 

defines Federally recognized tribe to 

mean any Indian tribe, band, nation, or 

other organized group or community of 

Indians, including any Alaska Native 

village or regional or village corporation 

as defined in or established pursuant to 

the Alaska Native Claims Settlement Act 

(43 U.S.C. 1601 et seq.), that is 

recognized as eligible for the special 

programs and services provided by the 

United States to Indians because of their 

status as Indians pursuant to the Indian 

Self-Determination and Education 

Assistance Act (25 U.S.C. 450 et seq.). 

Section 4103(13)(C) of title 25, U.S.C., 

also defines State recognized tribe to 

mean any tribe, band, nation, pueblo, 

village, or community—(1) that has been 

recognized as an Indian tribe by any 

State; and (2) for which an Indian 

Housing Authority has, before the 

effective date under section 705, entered 

into a contract with the Secretary of 

Housing and Urban Development 

pursuant to the United States Housing 

Act of 1937 (42 U.S.C. 1437 et seq.) for 

housing for Indian families and has 

received funding pursuant to such 

contract within the 5-year period ending 

upon such effective date. This definition 

also includes certain conditions set 

forth in 25 U.S.C. 4103(13)(C)(ii). This 

definition of Indian tribe is consistent 

with section 201(q)(7) of the Act. 

Indirect Federal financial assistance 

means Federal financial assistance in 

which a service provider receives 

program funds through a voucher, 

certificate, agreement or other form of 

disbursement, as a result of the genuine, 

independent choice of a participant. 

This is used for purposes of § 78.130 

and is consistent with how VA defines 

this in the VA Homeless Providers Grant 

and Per Diem Program and the SSVF 

Program. See §§ 61.64(b)(2) and 62.62, 

respectively. 

Section 201(d)(1)(A)(iv) of the Act 

authorizes VA to prioritize distribution 

of grants to medically underserved 

areas. While section 201 of the Act does 

not define medically underserved areas, 

VA is defining medically underserved 

areas consistent with the definition of 

medically underserved population that 

is set forth in other Federal law. Section 

254b(b)(3)(A) of 42 U.S.C. defines 

medically underserved population to 

mean the population of an urban or 

rural area designated by the HHS 

Secretary as an area with a shortage of 

personal health services or a population 

group designated by the HHS Secretary 

as having a shortage of such services. 

While section 254b(b)(3)(A) uses the 

term medically underserved population, 

section 254b(b)(3) generally establishes 

a process for identifying medically 

underserved areas that are designated by 

the United States Health Resources and 

Services Administration (HRSA), the 

HHS sub-agency responsible for issuing 

data and maps on medically 

underserved populations and areas in a 

combined manner. See HRSA’s maps on 

medically underserved areas/ 

populations at https://www.hrsa.gov/ 

maps/quick-maps?config=mapconfig/ 

MUA.jsondevelops. See also, https://

data.hrsa.gov/tools/shortage-area/muafind. Because 42 U.S.C. 254b(b)(3) may 

be amended in the future, VA is not 

incorporating the actual definition in 

proposed § 78.5. Rather, VA is defining 

medically underserved areas to mean an 

area that is designated as a medically 

underserved population under 42 U.S.C. 

254b(b)(3). This term is defined 

consistently with its use in 38 U.S.C. 

7601 note, and is widely known, 

commonplace, and established. It also 

allows VA to defer to the expertise of 

another agency that specializes in 

analyzing and identifying medically 

underserved areas and populations. 

VA is defining Notice of Funding 

Opportunity (NOFO) to mean a Notice 

of Funding Opportunity published on 

grants.gov in accordance with § 78.110. 

This is consistent with how VA defines 

a similar term, Notice of Funding 

Availability (NOFA), in other grant 

regulations and with the plain meaning 

of this term. This definition references 

§ 78.110, which explains that VA will 

publish a NOFO when funds for suicide 

prevention services grants are available 

and indicates the type of information 

that must be included in the application 

for this program. Pursuant to 2 CFR 

200.203, all NOFOs must be posted on 

grants.gov. 

Participant is defined to mean an 

eligible individual or their family who 

is receiving suicide prevention services 

for which they are eligible from a 

grantee. This definition is necessary for 

purposes of understanding part 78 and 

SSG Fox SPGP. 

VA is defining rural communities to 

mean those communities considered 

rural according to the Rural-Urban 

Commuting Area (RUCA) system as 

determined by the United States 

Department of Agriculture (USDA). This 

is consistent with section 201(q)(9) of 

the Act. VA will use this term and its 

definition in § 78.30 for purposes of 

prioritizing the distribution of grants to 

rural communities pursuant to section 

201(d)(1)(A)(i) of the Act. For more 

information on RUCA, please refer to 

https://www.ers.usda.gov/dataproducts/rural-urban-commuting-areacodes/. 

VA is defining State to mean any of 

the several States of the United States, 

the District of Columbia, the 

Commonwealth of Puerto Rico, any 

territory or possession of the United 

States, or any agency or instrumentality 

of a State exclusive of local 

governments. This is identical to most 

of the definition of the same term for the 

SSVF Program (see § 62.2), except that 

we do not include here the exception 

that is present in the SSVF regulations 

to public and Indian housing agencies 

under the United States Housing Act of 

1937, as that portion of the definition is 

not relevant to the suicide prevention 

grant program established under these 

regulations. This definition is 

understood by VA and grantees. 

Suicide prevention services is defined 

consistent with the definition of this 

term in section 201(q)(11) of the Act. VA 

is setting forth each of the suicide 

prevention services in their own 

individual sections (see 38 CFR 78.45 

through 78.90) for clarity. Thus, VA is 

defining suicide prevention services to 


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include the following services provided 

to address the needs of a participant: (1) 

Outreach as specified under § 78.45, (2) 

baseline mental health screening as 

specified under § 78.50, (3) education as 

specified under § 78.55, (4) clinical 

services for emergency treatment as 

specified under § 78.60, (5) case 

management services as specified under 

§ 78.65, (6) peer support services as 

specified under § 78.70, (7) assistance in 

obtaining VA benefits as specified under 

§ 78.75, (8) assistance in obtaining and 

coordinating other public benefits and 

assistance with emergent needs as 

specified under § 78.80, (9) 

nontraditional and innovative 

approaches and treatment practices as 

specified under § 78.85, and (10) other 

services as specified under § 78.90. 

VA is defining suicide prevention 

services grant to mean a grant awarded 

under part 78. This definition is based 

on the plain language understanding of 

this term. 

VA is defining suicide prevention 

services grant agreement to mean the 

agreement executed between VA and a 

grantee as specified under § 78.115. This 

definition is based on the plain language 

understanding of this term and is 

consistent with the definition of similar 

terms in other VA regulations. See 

§ 62.2. 

Suspension is defined to mean an 

action by VA that temporarily 

withdraws VA funding under a suicide 

prevention services grant, pending 

corrective action by the grantee or 

pending a decision to terminate the 

suicide prevention services grant by VA. 

Suspension of a suicide prevention 

services grant is a separate action from 

suspension under VA regulations or 

guidance implementing Executive 

Orders 12549 and 12689, ‘‘Debarment 

and Suspension.’’ This definition is 

consistent with the SSVF grant 

program’s definition for this term. See 

§ 62.2. However, with regards to 

implementing Executive Orders 12549 

and 12689, VA has added the language, 

guidance, as not all of VA’s 

implementations of Executive Orders 

are regulatory. 

Territories is defined to mean the 

territories of the United States, 

including Puerto Rico, Guam, the U.S. 

Virgin Islands, American Samoa, and 

the Northern Mariana Islands. This is 

consistent with how the Federal 

government commonly describes U.S. 

territories (in comparison to States). 

This term is necessary to define as it is 

used in the Act, although not defined 

within section 201, and in § 78.30. VA 

is defining this term as VA has authority 

under section 201(d)(1)(A)(iii) of the Act 

to prioritize distribution of grants to 

territories of the United States. As 

explained in § 78.30, VA may prioritize 

territories, along with other areas such 

as medically underserved areas and 

tribal lands, for purposes of this grant 

program. While there is some overlap 

between this definition and the 

definition of State above—all territories 

are considered States under part 78 (as 

provided for under 38 U.S.C. 101(20)), 

but not all States are territories—the 

specific application of this potential 

priority under § 78.30(d)(2)(iii) reflects 

the only meaningful distinction between 

the two terms. 

Veteran is defined to mean veteran 

under 38 U.S.C. 101(2). This is based on 

section 201(q)(4)(A) of the Act. Section 

101 of title 38, U.S.C., defines veteran as 

a person who served in the active 

military, naval, air, or space service, and 

who was discharged or released 

therefrom under conditions other than 

dishonorable. This term is used for 

purposes of peer support services in 

part 78. 

The term Veterans Crisis Line is 

defined to mean the toll-free hotline for 

veterans in crisis and their families and 

friends established under 38 U.S.C. 

1720F(h). This is consistent with section 

201(q)(12) of the Act. This term is used 

in § 78.30(d)(2)(vi) for purposes of 

prioritizing selection of applicants for 

this grant program. 

VA is defining withholding to mean 

that payment of a suicide prevention 

services grant will not be paid until 

such time as VA determines that the 

grantee provides sufficiently adequate 

documentation and/or actions to correct 

a deficiency for the suicide prevention 

services grant. This term is defined in 

this manner, as it is intended to provide 

a general description of how this term 

is used in 2 CFR part 200, which 

governs VA grant programs including 

the SSG Fox SPGP. This term relates to 

withholding payment of a suicide 

prevention services grant pursuant to 

§ 78.160, described later in this 

rulemaking. 

78.10 Eligible Individuals 

Section 78.10 explains the criteria for 

determining the eligibility of 

individuals under part 78 consistent 

with the definition of eligible individual 

in section 201(q)(4) of the Act. As 

explained in the definitions section, an 

eligible individual is an individual that 

meets the requirements of § 78.10(a). 

Paragraph (a) states that to be an 

eligible individual under this part, a 

person must meet criteria that 

determine that person is at risk of 

suicide and further meet the definition 

of eligible individual in section 201 of 

Public Law 116–171. VA refers to 

section 201(q) of Public Law 116–171 

rather than include the exact definition 

from subsection (q)(4), as this would 

allow VA to immediately implement 

any changes made by Congress to that 

definition without requiring amendment 

to these regulations. Subsection (q)(4) of 

section 201 currently states that an 

eligible individual must be one of the 

following: (1) A veteran as defined in 38 

U.S.C. 101, (2) an individual described 

in 38 U.S.C. 1720I(b), or (3) an 

individual described in 38 U.S.C. 

1712A(a)(1)(C)(i) through (iv). 

Section 101(2) of title 38, U.S.C. 

defines veteran as a person who served 

in the active military, naval, air, or 

space service, and who was discharged 

or released therefrom under conditions 

other than dishonorable. Section 

1720I(b) requires VA furnish to certain 

former member of the Armed Forces (1) 

an initial mental health assessment and 

(2) mental health care or behavioral 

health care services authorized under 38 

U.S.C. chapter 17 that are required to 

treat the mental or behavioral health 

care needs of these former service 

members, including risk of suicide or 

harming others. Such former members 

of the Armed Forces, including reserve 

components, are those who (1) while 

serving in the active military, naval, air, 

or space service, were discharged or 

released therefrom under a condition 

that is not honorable but not a 

dishonorable discharge or a discharge 

by court-martial; (2) are not enrolled in 

VA health care; and either served in the 

Armed Forces for a period of more than 

100 cumulative days and were deployed 

in a theater of combat operations, in 

support of a contingency operation, or 

in an area at a time during which 

hostilities were occurring in that area 

during such service, including by 

controlling an unmanned aerial vehicle 

from a location other than such theater 

or area; or (3) while serving in the 

Armed Forces, were the victim of a 

physical assault of a sexual nature, a 

battery of a sexual nature, or sexual 

harassment. Section 1712A details the 

individuals to whom VA is required to 

furnish readjustment counseling. These 

include any individual who is a veteran 

or member of the Armed Forces, 

including a member of a reserve 

component of the Armed Forces, who 

served on active duty in a theater of 

combat operations or an area at a time 

during which hostilities occurred in that 

area; any individual who is a veteran or 

member of the Armed Forces, including 

a member of a reserve component of the 

Armed Forces, who provided direct 

emergency medical or mental health 

care, or mortuary services to the 


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causalities of combat operations or 

hostilities, but who at the time was 

located outside the theater of combat 

operations or area of hostilities; any 

individual who is a veteran or member 

of the Armed Forces, including a 

member of a reserve component of the 

Armed Forces, who engaged in combat 

with an enemy of the United States or 

against an opposing military force in a 

theater of combat operations or an area 

at a time during which hostilities 

occurred in that area by remotely 

controlling an unmanned aerial vehicle, 

notwithstanding whether the physical 

location of such veteran or member 

during such combat was within such 

theater of combat operations or area; 

and any individual who is a veteran or 

member of the Armed Forces, including 

a member of a reserve component of the 

Armed Forces, who served on active 

service in response to a national 

emergency or major disaster declared by 

the President or in the National Guard 

of a State under orders of the chief 

executive of that State in response to a 

disaster or civil disorder in such State. 

For purposes of eligible individuals, 

paragraph (b) defines risk of suicide. 

Consistent with section 201(q)(8) of the 

Act, risk of suicide means exposure to, 

or the existence of, any of the following 

factors, to any degree, that increase the 

risk of suicidal ideation and/or 

behaviors: (1) Health risk factors, 

including mental health challenges, 

substance use disorder, serious or 

chronic health conditions or pain, and 

traumatic brain injury; (2) 

environmental risk factors, including 

prolonged stress, stressful life events, 

unemployment, homelessness, recent 

loss, and legal or financial challenges; 

and (3) historical risk factors, including 

previous suicide attempts, family 

history of suicide, and history of abuse, 

neglect or trauma, including military 

sexual trauma. 

While section 201(q)(8) uses the 

language, substance abuse, VA instead 

uses the language, substance use 

disorder, in paragraph (b) to reduce 

stigma and discrimination related to 

substance use. For purposes of 

paragraph (b), an individual will not be 

required to have a diagnosis of 

substance use disorder. This definition 

is necessary to meet the intent and 

purpose of the program to provide 

grants to eligible entities to provide or 

coordinate the provision of suicide 

prevention services to eligible 

individuals who are considered at risk 

of suicide and is consistent with 

feedback received from commenters 

during consultation. This provision is 

thus used for determining eligibility of 

eligible individuals for receipt of 

suicide prevention services under this 

grant program. VA notes that this 

definition is overly inclusive, as to 

define this term otherwise could 

exclude individuals who may need 

these critical services prior to a crisis. 

Section 201(q)(8)(iii)(III) includes a 

history of trauma as a potential 

historical risk factor for suicide. VA 

interprets this, for purposes of this grant 

program, to include military sexual 

trauma. VA notes that survivors of 

military sexual trauma are at higher risk 

of suicide. See the National Military and 

Veteran Suicide Prevention Strategy 

(https://www.whitehouse.gov/wpcontent/uploads/2021/11/Military-andVeteran-Suicide-PreventionStrategy.pdf). This reference is not 

intended to exclude other forms of 

trauma, but rather serves as an example 

of how this language is interpreted by 

VA. 

As noted in the previous paragraph, 

section 201(q)(8) of the Act defines risk 

of suicide based on exposure to, or the 

existence of, certain factors, to a degree 

determined by the Secretary pursuant to 

regulations. Thus, section 201(q)(8)(A) 

of the Act authorized VA to determine 

the degree required for these risk 

factors, and VA will require that 

grantees use the health, environmental, 

and historical risk factors just described 

and the impact thereof to determine the 

degree of risk of suicide for eligible 

individuals. This is explained in a note 

to paragraph (b). The note also explains 

that the degree of risk depends on the 

presence of one or more suicide risk 

factors and the impact of those factors 

on an individual’s mental health and 

wellbeing. 

VA will require grantees determine an 

individual’s degree of risk of suicide 

through the use of a screening tool 

approved by the Department. To assist 

grantees in determining risk of suicide 

(and thus an individual’s eligibility for 

suicide prevention services), VA will 

provide grantees with a screening tool 

that will determine the presence of 

suicide risk. This tool will be a 

validated tool that can be administered 

by non-clinical staff and/or a self-report 

tool such as the Columbia Suicide 

Severity Rating Scale. See https://

cssrs.columbia.edu. VA is not 

identifying the specific tool in 

regulation, as the screening tool may 

change due to an evolving field of study 

and VA may approve the use of several 

tools. This tool is subject to the 

Paperwork Reduction Act because it is 

an information collection. As such, the 

public may comment on this screening 

tool as part of the information 

collections associated with this 

rulemaking, and VA welcomes public 

comment on use of this screening tool. 

VA will ensure that grantees are 

provided this tool before providing or 

coordinating suicide prevention services 

under this grant program and have 

access to publicly available training 

materials to support the grantees’ use of 

this tool. 

VA would not require a clinical tool 

to be used to determine eligibility 

because many of the authorized suicide 

prevention services are not clinical in 

nature. To require a clinical tool to 

determine the degree of risk of suicide 

would severely limit the number of 

applicants and grantees for this grant 

program, which VA does not believe 

was the intent of section 201 of the Act. 

This screening tool is not the same as 

the tool that will be used for purposes 

of the baseline mental health screening 

conduct pursuant to § 78.50, which is 

described later in this discussion. This 

screening tool will assess health, 

environmental, and historical risk 

factors and the impact thereof. An 

individual’s degree of risk of suicide can 

vary hour to hour, day to day, and thus, 

requiring a certain degree of risk of 

suicide to be eligible for services could 

result in the ineligibility of individuals 

whom this program was intended to 

cover. This is a non-clinical tool that 

will be used by grantees regardless of 

whether their staff are licensed, 

independent clinical providers. 

78.15 Applications for Suicide 

Prevention Services Grants 

Under § 78.15(a), applicants must 

submit a complete application package 

for a suicide prevention services grant 

under this new part 78, as described in 

the NOFO. Paragraph (a) also explains 

the information that must be included 

in the application to be considered a 

complete suicide prevention services 

grant application package. This list of 

items described in paragraph (a) is 

derived from section 201(d)(2), (f), and 

(h)(2) of the Act, and it ensures that VA 

can adequately evaluate applicants for 

the purposes of this grant program (that 

is, to provide or coordinate the 

provision of suicide prevention services 

to reduce the risk of suicide among 

eligible individuals). 

The following information must be 

included in the application package: (1) 

Documentation evidencing the 

experience of the applicant and any 

identified community partners in 

providing or coordinating the provision 

of suicide prevention services to eligible 

individuals and their families; (2) a 

description of the suicide prevention 

services proposed to be provided by the 

applicant and the identified need for 

those services; (3) a detailed plan 


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describing how the applicant proposes 

to coordinate or deliver suicide 

prevention services to eligible 

individuals, including (i) if the 

applicant is a State or local government 

or an Indian tribe, an identification of 

the community partners, if any, with 

which the applicant proposes to work in 

delivering such services, (ii) a 

description of the arrangements 

currently in place between the applicant 

and such partners with regard to the 

provision or coordination of the 

provision of suicide prevention services, 

(iii) an identification of how long such 

arrangements have been in place, (iv) a 

description of the suicide prevention 

services provided by such partners that 

the applicant must coordinate, if any, 

and (v) an identification of local VA 

suicide prevention coordinators and a 

description of how the applicant will 

communicate with local VA suicide 

prevention coordinators; (4) a 

description of the location and 

population of eligible individuals and 

their families proposed to be provided 

suicide prevention services; (5) an 

estimate of the number of eligible 

individuals at risk of suicide and their 

families proposed to be provided 

suicide prevention services, including 

the percentage of those eligible 

individuals who are not currently 

receiving care furnished by VA; (6) 

evidence of measurable outcomes 

related to reductions in suicide risk and 

mood-related symptoms utilizing 

validated instruments by the applicant 

(and the proposed partners of the 

applicant, if any) in providing suicide 

prevention services to individuals at 

risk of suicide, particularly to eligible 

individuals and their families; (7) a 

description of the managerial and 

technological capacity of the applicant 

to (i) coordinate the provision of suicide 

prevention services with the provision 

of other services, (ii) assess on an 

ongoing basis the needs of eligible 

individuals and their families for 

suicide prevention services, (iii) 

coordinate the provision of suicide 

prevention services with VA services for 

which eligible individuals are also 

eligible, (iv) tailor (i.e., provide 

individualized) suicide prevention 

services to the needs of eligible 

individuals and their families, (v) seek 

continuously new sources of assistance 

to ensure the continuity of suicide 

prevention services for eligible 

individuals and their families as long as 

the eligible individuals are determined 

to be at risk of suicide, and (vi) measure 

the effects of suicide prevention services 

provided by the applicant or partner 

organization on the lives of eligible 

individuals and their families who 

receive such services provided by the 

organization using pre- and postevaluations on validated measures of 

suicide risk and mood-related 

symptoms; (8) clearly defined objectives 

for the provision of suicide prevention 

services; (9) a description and physical 

address of the primary location of the 

applicant; (10) a description of the 

geographic area the applicant plans to 

serve during the grant award period for 

which the application applies; (11) if 

the applicant is a State or local 

government or an Indian tribe, the 

amount of grant funds proposed to be 

made available to community partners, 

if any, through agreements; (12) a 

description of how the applicant will 

assess the effectiveness of the provision 

of grants under this part; (13) an 

agreement to use the measures and 

metrics provided by VA for the 

purposes of measuring the effectiveness 

of the programming to be provided in 

improving mental health status, 

wellbeing, and reducing suicide risk 

and suicide deaths of eligible 

individuals and their families; (14) an 

agreement to comply with and 

implement the requirements of this part 

throughout the term of the suicide 

prevention services grant; and (15) any 

additional information as deemed 

appropriate by VA. 

The items in paragraph (a) generally 

are consistent with requirements in 

section 201(f) and (h)(2) of the Act and 

are necessary for VA to properly 

evaluate whether applicants will be able 

to meet the requirements in this part to 

provide or coordinate suicide 

prevention services if they are awarded 

a grant under this new part 78. While 

language similar to paragraph (a)(1) does 

not appear in section 201(f) or (h)(2) of 

the Act, it does appear in section 

201(d)(2) of the Act, where VA is 

instructed to give preference to eligible 

entities that have demonstrated the 

ability to provide or coordinate suicide 

prevention services. Paragraph (a)(14) 

similarly does not appear explicitly in 

section 201(f) or (h)(2) of the Act, but 

section 201(f)(1) authorizes the 

Secretary to include such commitments 

as the Secretary considers necessary to 

carry out this section. Compliance with 

the requirements of the new part 78 is 

such a commitment. Section 

201(f)(2)(M) also authorizes the 

Secretary to include additional 

application criteria as the Secretary 

considers appropriate. Again, an 

agreement to comply with the 

requirements of this part is an 

appropriate obligation. VA notes that 

technical assistance with completing 

applications will be available for 

applicants, including how to determine 

the required estimates under paragraph 

(a)(5). 

For purposes of paragraph (a)(7)(iv), 

VA notes that tailoring (i.e., providing 

individualized) suicide prevention 

services to the needs of eligible 

individuals and their families, includes 

how services would be tailored 

(provided) to priority sub-populations, 

including but not limited to survivors of 

military sexual trauma, women veterans 

under the age of 35, and other groups 

identified in the National Military and 

Veteran Suicide Prevention Strategy. 

See, https://www.whitehouse.gov/wpcontent/uploads/2021/11/Military-andVeteran-Suicide-PreventionStrategy.pdf. Such services may include 

but not be limited to care and support 

with military sexual trauma, 

employment, and housing. 

For purposes of paragraphs (a)(4) and 

(a)(10) of this section, as well as for 

other sections of this rule, VA is 

requiring applicants to provide 

information regarding the location of 

eligible individuals and a description of 

the geographic area the applicant plans 

to serve. Section 201(d)(1)(C) of the Act 

permits VA to provide grants to eligible 

entities that furnish services to eligible 

individuals and their families in 

geographically dispersed areas; this 

authority is discretionary. At this time, 

VA is choosing not to exercise this 

authority. While there may be some 

applicants who desire to serve a 

population that is geographically 

dispersed, it would be logistically 

difficult for such organizations to 

provide necessary services, and a 

number of other provisions in section 

201 of the Act clearly state requirements 

related to geographic locations. For 

example, section 201(d)(1)(A) and (B) of 

the Act permit and require, respectively, 

VA to prioritize grants to geographic 

areas, such as rural communities, Tribal 

lands, territories of the United States, 

medically underserved areas, areas with 

a high number or percentage of minority 

veterans or women veterans, areas with 

a high number or percentage of calls to 

the Veterans Crisis Line, and areas that 

have experienced high rates of suicide 

by eligible individuals. Each of these 

descriptions clearly requires a 

geographic description or scope. Other 

provisions of section 201 of the Act also 

clearly refer to geographic areas. For 

example, section 201(f)(2)(I) requires 

applicants to provide ‘‘a description of 

the geographic area the eligible entity 

plans to serve during the grant award 

period for which the application 

applies.’’ Section 201(h)(2)(A) requires 

the Secretary to develop a framework for 


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collecting and sharing information 

about grantees for purposes of 

improving the services available for 

eligible individuals and their families 

set forth by locality, among other 

factors. Section 201(q)(11)(A)(iv), which 

defines suicide prevention services, 

includes the provision of clinical 

services for emergency treatment as a 

suicide prevention service, and these 

services would generally need to be 

furnished in-person. Additionally, 

applicants seeking grant funds to 

support non-geographically focused 

populations would likely have higher 

overhead and administrative costs due 

to the need to conduct outreach across 

a broader area, maintain information 

and connections with more VA facilities 

and other entities, and deliver services 

in different locations. Higher overhead 

costs mean fewer available resources 

dedicated to the delivery of suicide 

prevention services, which, given the 

population being served by this 

program, would be less than ideal as 

those resources could be better utilized 

elsewhere to serve this unique 

population. Given the short period of 

time in which VA is authorized to 

operate this program, only three years 

from the date of the first grant award 

(see section 201(j) of the Act), it would 

be prudent to ensure these resources are 

used to maximal effect. 

This does not prohibit organizations 

that function at a national level or in 

multiple geographic areas from applying 

for a grant in one or more location as 

long as they meet the requirements 

necessary to implement suicide 

prevention services for the specific 

geographic area. However, VA notes that 

many of the suicide prevention services, 

particularly emergent services for those 

at immediate risk of suicide, could not 

be furnished by entities without a 

physical presence in the area or could 

only be furnished at a greater risk of the 

loss of life of a participant and the 

services required by law and by the 

targeted population require engagement 

with local VA medical centers and 

community. 

Paragraph (b) states that subject to 

funding availability, grantees may 

submit an application for renewal of a 

suicide prevention services grant if the 

grantee’s program will remain 

substantially the same. To apply for 

renewal of a suicide prevention services 

grant, a grantee must submit to VA a 

complete suicide prevention services 

grant renewal application package, as 

described in the NOFO. This is 

consistent with how VA administers the 

SSVF Program under part 62 and will 

allow VA to renew grants in an efficient 

and timely manner so that there will be 

no lapse in the provision or 

coordination of the provision of suicide 

prevention services by grantees to 

participants from year to year. 

Paragraph (c) establishes that VA may 

request in writing that an applicant or 

grantee, as applicable, submit other 

information or documentation relevant 

to the suicide prevention services grant 

application. This is authorized by 

section 201(f)(1) of the Act, which 

permits VA to require such 

commitments and information as the 

Secretary considers necessary to carry 

out this section. This provides VA with 

the authority to request additional 

information that may not be in the 

initial or renewal application but will be 

necessary for VA to properly evaluate 

the applicant or grantee for a suicide 

prevention services grant. 

78.20 Threshold Requirements Prior 

To Scoring Suicide Prevention Services 

Grant Applicants 

Pursuant to section 201(h) of the Act, 

VA, in consultation with various 

entities listed in the Act, is required to 

establish selection criteria for this new 

grant program. As explained earlier in 

this rulemaking, VA conducted this 

consultation through an FR notice and 

through listening sessions. See 86 FR 

17268 (April 1, 2021); 86 FR 25938 (May 

11, 2021). Section 78.20 sets forth the 

threshold requirements for further 

scoring applicants pursuant to § 78.25. 

Section 78.20 explains that VA will 

only score applicants for suicide 

prevention services grants if they meet 

certain threshold requirements as set 

forth in paragraphs (a) through (g). 

These threshold requirements in 

paragraphs (a) through (g) include that 

the application is filed within the time 

period established in the NOFO, and 

any additional information or 

documentation requested by VA under 

§ 78.15(c) is provided within the time 

frame established by VA; the 

application is completed in all parts; the 

activities for which the suicide 

prevention services grant is requested 

are eligible for funding under this part; 

the applicant’s proposed participants 

are eligible to receive suicide prevention 

services under this part; the applicant 

agrees to comply with the requirements 

of this part; the applicant does not have 

an outstanding obligation to the Federal 

government that is in arrears and does 

not have an overdue or unsatisfactory 

response to an audit; and the applicant 

is not in default by failing to meet the 

requirements for any previous Federal 

assistance. 

These are minimum requirements that 

must be met before VA will score 

applications, and applicants will be able 

to understand whether they meet these 

threshold requirements in advance of 

application submission. VA anticipates 

this will reduce the amount of time and 

resources that VA will dedicate to 

evaluating and scoring applicants for 

suicide prevention services grants. 

These requirements are authorized by 

section 201(f)(1) of the Act, which 

permits VA to include such 

commitments and information as the 

Secretary considers necessary to carry 

out section 201. These threshold 

requirements are consistent with other 

VA grant programs, such as the 

Homeless Providers Grant and Per Diem 

Program and the SSVF Program (See 

§§ 61.12 and 62.21, respectively). 

78.25 Scoring Criteria for Awarding 

Grants 

Section 201(h)(1) of the Act requires 

the VA Secretary to establish criteria for 

the selection of eligible entities that 

have submitted applications for a 

suicide prevention services grant. 

Consistent with that authority, in 

§ 78.25, VA sets forth the criteria to be 

used to score applicants who are 

applying for a suicide prevention 

services grant, as the amount of funds 

available for grants each year will be 

limited and VA may receive a higher 

number of applicants than there are 

available grant funds. Scoring criteria 

will allow VA to award grants to those 

who are most qualified and will ensure 

that VA administers grants in a manner 

consistent with the intent and purpose 

of SSG Fox SPGP. The scoring criteria 

were developed based on the scoring 

criteria used for other VA grant 

programs, such as the SSVF Program (38 

CFR 62.22) and Homeless Providers 

Grant and Per Diem Program (38 CFR 

61.13), but tailored to the purpose and 

requirements of section 201 of the Act. 

These criteria are consistent with 

feedback received from commenters 

during consultation that expressed 

support for awarding grants to entities 

with prior experience working with 

veterans, including those at risk of 

suicide, entities that had partnerships 

within the area and with VA, and 

entities that have or plan to have 

culturally competent care related to 

veterans. 

While this section does not include 

specific point values for each criterion, 

the regulation provides that such point 

values will be set forth in the NOFO. 

This will allow VA to retain flexibility 

in determining those point values each 

year of the grant program in the event 

that such point values need to change. 

At all times, VA will comply with the 

requirements in section 201(d) of the 

Act regarding prioritization of and 


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preference for certain applicants. VA 

will establish in each NOFO a minimum 

number of points that an applicant must 

be awarded, both in each category and 

in total, to ensure that all applicants 

who are awarded a grant can perform all 

necessary elements of the program, and 

that their program as a whole is likely 

to be successful. These dual 

requirements will ensure that VA is 

giving preference to applicants that have 

demonstrated the ability to provide or 

coordinate suicide prevention services, 

as required by section 201(d)(2) of the 

Act. 

Paragraph (a) explains that VA will 

award points based on the background, 

qualifications, experience, and past 

performance, of the applicant and any 

community partners identified by the 

applicant in the suicide prevention 

services grant application, as 

demonstrated by the following: (1) 

Background and organizational history, 

(2) staff qualifications, and (3) 

organizational qualifications and past 

performance, including experience with 

veterans services. These scoring criteria 

are important to determine whether 

applicants have the necessary and 

relevant background and experience to 

administer a suicide prevention services 

program consistent with section 201 of 

the Act and 38 CFR part 78. 

In scoring an applicant’s background 

and organizational history under 

paragraph (a)(1), VA will consider the 

applicant’s, and any identified 

community partners’, background and 

organizational history that are relevant 

to the program; whether the applicant, 

and any identified community partners, 

maintain organizational structures with 

clear lines of reporting and defined 

responsibilities; and whether the 

applicant, and any identified 

community partners, have a history of 

complying with agreements and not 

defaulting on financial obligations. 

Under paragraph (a)(2), VA will score 

applications based on staff 

qualifications. This includes 

determining the applicant’s staff’s, and 

any identified community partners’ 

staff’s, experience providing to, or 

coordinating services for, eligible 

individuals and their families; and the 

applicant’s staff’s, and any identified 

community partners’ staff’s, experience 

administering programs similar to SSG 

Fox SPGP. 

VA will score applicants’ 

organizational qualifications and past 

performance, including experience with 

veterans services, under paragraph (a)(3) 

based on the applicant’s, and any 

identified community partners’, 

organizational experience providing 

suicide prevention services to or 

coordinating suicide prevention services 

for eligible individuals and their 

families; the applicant’s, and any 

identified community partners’, 

organizational experience coordinating 

services for eligible individuals and 

their families among multiple 

organizations and Federal, State, local, 

and tribal governmental entities; the 

applicant’s, and any identified 

community partners’, organizational 

experience administering a program 

similar in type and scale to SSG Fox 

SPGP to eligible individuals and their 

families; and the applicant’s, and any 

identified community partners’, 

organizational experience working with 

veterans and their families. 

Examples of experience VA will 

consider under paragraph (a) may 

include but are not limited to 

participation in VA–SAMHSA’s 

Governors’ and Mayors’ Challenges to 

Prevent Suicide among service 

members, veterans, and their families; 

endorsement by a local or State public 

health agency or State Department of 

Veterans Affairs recognizing care 

coordination experience; and 

participation in the SSVF Program and 

Homeless Providers Grant and Per Diem 

Program. 

While experience providing suicide 

prevention services to eligible 

individuals and their families is an 

important scoring criterion, we 

acknowledge that some organizations 

may not have such experience. 

However, they may have experience 

working with veterans and their families 

(other than those eligible under this 

grant program) for purposes other than 

those related to this grant program. 

Having an understanding of the veteran 

population as a whole and 

demonstrating related military cultural 

competency is critical for ensuring that 

the needs of eligible individuals and 

their families are met through this grant 

program. This is consistent with the 

feedback received through consultation 

as described earlier. This also allows VA 

the ability to award points at various 

levels (local, regional, State) since the 

types of experience entities at those 

levels may have can vary. Thus, 

pursuant to paragraph (a), VA will score 

applicants not only based on their 

experience administering similar 

programs to the suicide prevention grant 

programs and providing or coordinating 

services to eligible individuals, but also 

based on their experience working with 

veterans and their families. 

Paragraph (b) explains that VA will 

award points based on the applicant’s 

program concept and suicide prevention 

services plan. The scoring criteria under 

this paragraph are important for VA to 

use to determine whether the applicant 

has a fully developed program concept 

and plan that will meet the 

requirements of section 201 of the Act 

and 38 CFR part 78. 

VA will award points based on the 

applicant’s program concept and suicide 

prevention services plan, as 

demonstrated by the (1) need for the 

program, (2) outreach and screening 

plan, (3) program concept, (4) program 

implementation timeline, (5) 

coordination with VA, (6) ability to 

meet VA’s requirements, goals and 

objectives for SSG Fox SPGP, and (7) 

capacity to undertake the program. 

VA will score the need for the 

program under paragraph (b)(1) based 

on whether the applicant has shown a 

need amongst eligible individuals and 

their families in the area where the 

program will be based and whether the 

applicant demonstrates an 

understanding of the unique needs for 

suicide prevention services of eligible 

individuals and their families. 

VA will score the outreach and 

screening plan under paragraph (b)(2) 

based on whether the applicant has a 

feasible plan for outreach, consistent 

with § 78.45, and referral to identify and 

assist individuals and their families that 

may be eligible for suicide prevention 

services and are most in need of suicide 

prevention services, has a feasible plan 

to process and receive participant 

referrals, and has a feasible plan to 

assess and accommodate the needs of 

incoming participants. As part of 

scoring the application based on 

whether the applicant has a feasible 

plan to assess and accommodate the 

needs of incoming participants, VA 

notes that this may include but not be 

limited to addressing language 

assistance needs of limited English 

proficient individuals, physical 

accommodation needs, and 

transportation needs. 

Pursuant to paragraph (b)(3), VA will 

score the program concept based on 

whether the applicant’s program 

concept, size, scope, and staffing plan 

are feasible; and that the applicant’s 

program is designed to meet the needs 

of eligible individuals and their 

families. 

VA will score the program 

implementation timeline under 

paragraph (b)(4) based on whether the 

applicant’s program will be 

implemented in a timely manner and 

suicide prevention services will be 

delivered to participants as quickly as 

possible and within a specified 

timeline. VA will also score this based 

on whether the applicant has a feasible 

staffing plan in place to meet the 


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applicant’s program timeline or has 

existing staff to meet such timeline. 

Pursuant to paragraph (b)(5), VA will 

score applications based on whether the 

applicant has a feasible plan to 

coordinate outreach and services with 

local VA facilities. 

In paragraph (b)(6), scoring criteria 

will include the applicant’s ability to 

meet VA’s requirements, goals, and 

objectives for SSG Fox SPGP. This will 

be based on whether the applicant 

demonstrates commitment to ensuring 

that its program meets VA’s 

requirements, goals, and objectives for 

SSG Fox SPGP as identified in this part 

and the NOFO. 

Under paragraph (b)(7), VA will score 

the applicant’s capacity, including staff 

resources, to undertake its program. 

Paragraph (c) states that VA will 

award points based on the applicant’s 

quality assurance and evaluation plan, 

as demonstrated by (1) program 

evaluation, (2) monitoring, (3) 

remediation, and (4) management and 

reporting. This scoring criterion is 

important to ensure that applicants can 

meet any requirements for evaluation, 

monitoring, and reporting contained in 

section 201 of the Act and in 38 CFR 

part 78, will help VA ensure that grant 

funds are being used appropriately, and 

will assist in the overall assessment of 

the grant program. 

Pursuant to paragraph (c)(1), VA will 

evaluate whether the applicant has 

created clear, realistic, and measurable 

goals that reflect SSG Fox SPGP’s aim of 

reducing and preventing suicide among 

veterans against which the applicant’s 

program performance can be evaluated; 

and the applicant has a clear plan to 

continually assess the program. 

The scoring criterion regarding 

monitoring in paragraph (c)(2) will be 

based on whether the applicant has 

adequate controls in place to regularly 

monitor the program, including any 

community partners, for compliance 

with all applicable laws, regulations, 

and guidelines; whether the applicant 

has adequate financial and operational 

controls in place to ensure the proper 

use of suicide prevention services grant 

funds; and the applicant has a feasible 

plan for ensuring that the applicant’s 

staff and any community partners are 

appropriately trained and stay informed 

of SSG Fox SPGP policy, evidenceinformed suicide prevention practices, 

and the requirements of 38 CFR part 78. 

Paragraph (c)(3) includes the scoring 

criterion of remediation. This will be 

based on whether the applicant has an 

appropriate plan to establish a system to 

remediate non-compliant aspects of the 

program if and when they are identified. 

Under paragraph (c)(4), VA will score 

the applicant’s management and 

reporting, based on whether the 

applicant’s program management team 

has the capability and a system in place 

to provide to VA timely and accurate 

reports at the frequency set by VA. 

Paragraph (d) explains that VA will 

award points based on the applicant’s 

financial capability and plan, as 

demonstrated by (1) organizational 

finances (based on whether the 

applicant, and any identified 

community partners, are financially 

stable); and (2) financial feasibility of 

the program (based on whether the 

applicant has a realistic plan for 

obtaining all funding required to operate 

the program for the time period of the 

suicide prevention services grant; and 

whether the applicant’s program is costeffective and can be effectively 

implemented on-budget). These are 

important to ensure that funds are not 

provided to an applicant that is 

financially unstable and that the 

applicant has considered the costs and 

necessary funding for administering a 

suicide prevention services program. 

Paragraph (e) states that VA will 

award points based on the applicant’s 

area linkages and relations, as 

demonstrated by the (1) area linkages, 

(2) past working relationships, (3) local 

presence and knowledge, and (4) 

integration of linkages and program 

concept. This is important for ensuring 

success of the suicide prevention 

services program. VA acknowledges that 

applicants may not have these existing 

linkages and relationships, but they may 

develop them over time. VA also 

acknowledges that certain applicants 

without these existing linkages and 

relationships may obtain them through 

community partners with which they 

enter into agreements (to the extent 

permitted under section 201 of the Act). 

Area linkages under paragraph (e)(1) 

will include whether the applicant has 

a feasible plan for developing or relying 

on existing linkages with Federal 

(including VA), State, local, and tribal 

government agencies, and private 

entities for the purposes of providing 

additional services to participants 

within a given geographic area. 

Past working relationships under 

paragraph (e)(2) will include whether 

the applicant (or applicant’s staff), and 

any identified community partners (or 

community partners’ staff), have 

fostered similar and successful working 

relationships and linkages with public 

and private organizations providing 

services to veterans or their families in 

need of services. These may include but 

not be limited to housing assistance 

non-profits and agencies, housing crisis 

centers, local food banks, employment 

assistance non-profits and agencies, 

rape crisis centers, and sexual assault 

and domestic violence programs with a 

history of serving veterans and militaryconnected victims of sexual trauma and 

abuse. 

Local presence and knowledge under 

paragraph (e)(3) will be based on 

whether the applicant has a presence in 

the area to be served by the applicant 

and understands the dynamics of the 

area to be served by the applicant. This 

presence and knowledge does not 

necessarily mean the applicant has an 

address or physical office in the area, 

but rather that they are operating in the 

area such that they have sufficient 

knowledge of the area and that their 

staff has a presence in the area. For 

example, staff may travel from a nearby 

area to serve eligible individuals in the 

targeted area, or a national organization 

may have a local office through which 

it intends to make services available. 

Evaluation of whether an applicant 

understands the dynamics of the area to 

be served by the applicant will be based 

on information including but not 

limited to the applicant’s description of 

the area, including mental health 

centers, and relationships with local 

mental health centers. These criteria 

under paragraph (e)(3) may be met 

through letters of support and 

documented coordination of care. 

Integration of linkages and program 

concept under paragraph (e)(4) will be 

based on whether the applicant’s 

linkages to the area to be served by the 

applicant enhance the effectiveness of 

the applicant’s program. 

78.30 Selection of Grantees 

Section 201(c) of the Act requires the 

VA Secretary to award a grant to each 

eligible entity for which the Secretary 

has approved an application to provide 

or coordinate the provision of suicide 

prevention services. Section 201(d) of 

the Act sets forth how VA may and shall 

distribute grants based on certain 

priorities, areas, and geography. Section 

201(d)(2) requires the Secretary give 

preference to eligible entities that have 

demonstrated the ability to provide or 

coordinate suicide prevention services. 

Section 201(h) of the Act requires the 

Secretary to establish criteria for the 

selection of eligible entities that have 

submitted applications for a suicide 

prevention services grant. In accordance 

with these subsections of section 201 of 

the Act, 38 CFR 78.30 sets forth the 

process for selecting applicants for 

suicide prevention services grants, 

which will be a process similar to that 

of the SSVF Program (38 CFR 62.23) and 

the Homeless Providers Grant and Per 


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Diem Program (38 CFR 61.14 and 61.94). 

However, the selection process under 

§ 78.30 will also incorporate preference, 

priority, and distribution requirements 

from section 201(d) of the Act. 

As part of the process for selecting 

applicants to receive suicide prevention 

services grants, paragraph (a) explains 

that VA will first score all applicants 

that meet the threshold requirements set 

forth in § 78.20 using the scoring criteria 

set forth in § 78.25. 

Next, paragraph (b) states that VA will 

group applicants within the applicable 

funding priorities if any are set forth in 

the NOFO. As funding priorities can 

change annually, VA will set forth any 

funding priorities in the NOFO, which 

will allow VA flexibility in updating 

priorities in a quick and efficient 

manner every year that funds are 

available under this grant program. 

Then, as set forth in paragraph (c), VA 

will rank those applicants that receive at 

least the minimum amount of total 

points and points per category set forth 

in the NOFO, within their respective 

funding priority group, if any. As noted 

above, VA will set forth the minimum 

amount of total points and points per 

category in the NOFO as these can 

change annually. Setting forth these 

points in the NOFO will provide VA 

flexibility in updating the minimum 

amount of points in an efficient and 

quick manner. The applicants will be 

ranked in order from highest to lowest 

scores, within their respective funding 

priority group, if any. 

Paragraph (d) explains that VA will 

use the applicant’s ranking as the 

primary basis for selection for funding. 

However, consistent with section 

201(d)(1) and (d)(2) of the Act, 

paragraph (d) further explains that VA: 

(1) Will give preference to applicants 

that have demonstrated the ability to 

provide or coordinate suicide 

prevention services; (2) may prioritize 

the distribution of suicide prevention 

services grants to rural communities, 

Tribal lands, territories of the United 

States, medically underserved areas, 

areas with a high number or percentage 

of minority veterans or women veterans, 

and areas with a high number or 

percentage of calls to the Veterans Crisis 

Line; and (3) to the extent practicable, 

will ensure that suicide prevention 

services grants are distributed to 

provide services in areas of the United 

States that have experienced high rates 

of suicide by eligible individuals, 

including suicide attempts, to eligible 

entities that can assist eligible 

individuals at risk of suicide who are 

not currently receiving health care 

furnished by VA, and to ensure services 

are provided in as many areas as 

possible. 

As explained above, pursuant to 

section 201(d)(2) of the Act, in 

paragraph (d)(1), VA will give 

preference to applicants that have 

demonstrated the ability to provide or 

coordinate suicide prevention services. 

This preference may be met by such 

experience that includes but is not 

limited to entities that are part of VA– 

SAMHSA’s Governors’ and Mayors’ 

Challenge to Prevent Suicide among 

service members, veterans, and their 

families; entities that are part of local or 

State coalitions for suicide prevention; 

and entities that support suicide 

prevention services through receipt of 

local, State, and Federal funding. 

Additionally, entities may demonstrate 

this ability if they are currently 

providing or coordinating suicide 

prevention services that align with the 

National Strategy for Preventing Veteran 

Suicide, VA-Department of Defense 

(DoD) Clinical Practice Guideline for the 

Assessment and Management of Patients 

at Risk for Suicide, or CDC’s Preventing 

Suicide: A Technical Package of Policy, 

Programs, and Practices. This is 

consistent with feedback received from 

commenters during consultation in 

which several commenters suggested 

awarding grants, or providing 

preference for grants, to entities with 

prior experience providing or 

coordinating suicide prevention services 

and programs, including those who are 

part of Governors’ Challenges. 

Pursuant to section 201(d)(1), VA has 

discretionary authority to prioritize the 

distribution of grants to rural 

communities, Tribal lands, territories of 

the United States, medically 

underserved areas, areas with a high 

number or percentage of minority 

veterans or women veterans, and areas 

with a high number or percentage of 

calls to the Veterans Crisis Line. This 

will be a consideration for the 

distribution of grants, as described in 

paragraph (d)(2), and is consistent with 

feedback received from commenters 

during consultation. 

Due to funding limitations, VA may 

choose to utilize this discretionary 

authority in distributing grants. 

However, VA does not want to mandate 

use of this discretionary authority 

because it is important to ensure that 

grants can be distributed equitably 

across the country and provided to areas 

where the grants may be best utilized. 

If VA prioritized these areas for all 

awarded grants for this program, it may 

exhaust all of its funding annually with 

none of the grants being distributed to 

any other grantees that may also be 

deserving. VA does not want to limit 

itself by mandating this, but rather 

retain the discretion to distribute to 

these areas as warranted. As explained 

in paragraph (b) of § 78.35 and in 

§ 78.110, VA would establish any 

priorities in a NOFO. 

For purposes of this discretionary 

authority, VA will use the definitions 

for rural communities, Tribal lands, 

territories of the United States, and 

medically underserved areas in § 78.5. 

In determining areas with a high 

number or percentage of minority 

veterans or women veterans, VA will 

base such determinations on the veteran 

population data from VA’s National 

Center for Veterans Analysis and 

Statistics (NCVAS). VA will use the 

most recent data that NCVAS has 

published, which is made publicly 

available at https://www.va.gov/vetdata/ 

veteran_population.asp. In determining 

areas with a high number or percentage 

of calls to the Veterans Crisis Line, VA 

will use internal data that VA maintains 

to determine where these areas are and 

will consider the most recent data VA 

has for purposes of using this 

discretionary authority when making 

these annual funding determinations. 

VA anticipates making this information 

available to the public and through 

technical assistance to grantees. 

Consistent with section 201(d)(1)(B) 

of the Act, paragraph (d)(3) explains that 

to the extent practicable, VA will ensure 

that suicide prevention services grants 

are distributed to (1) provide services in 

areas of the United States that have 

experienced high rates of suicide by 

eligible individuals, including suicide 

attempts; and to (2) applicants that can 

assist eligible individuals at risk of 

suicide who are not currently receiving 

health care furnished by VA. Paragraph 

(d)(3) also explains that to the extent 

practicable, VA will ensure that suicide 

prevention services grants are 

distributed to ensure services are 

provided in as many areas as possible. 

While the Act requires, to the extent 

practicable, distribution of grants to 

provide services in areas with high rates 

of suicide, including suicide attempts, 

by eligible individuals, VA notes that 

data on suicide attempts is generally 

insufficient, incomplete, and generally 

unavailable for purposes of determining 

areas with high rates of suicide. This is 

because this data is collected only when 

veterans report suicide attempts, and 

there is no requirement to report such 

attempts. Given the issues with the data 

on suicide attempts as explained above, 

for purposes of implementing section 

201(d)(1)(B), VA will not utilize data on 

suicide attempts solely. If such data 

become available in a sufficient and 

complete manner, VA will utilize such 


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data to determine areas with high rates 

of suicide attempts. 

Until and if such data become 

available, in order to meet the 

requirement of section 201(d)(1)(B) of 

the Act, VA will determine areas with 

high rates of suicide based on VA’s most 

recently published National Veteran 

Suicide Prevention Annual Report, 

which is based on CDC’s mortality and 

death index. This report is published 

annually, and the most recent report 

will be utilized by VA for purposes of 

paragraph (d)(3)(i). 

For purposes of paragraph (d)(3)(ii) 

and determining whether applicants can 

assist eligible individuals at risk of 

suicide who are not currently receiving 

VA health care, VA will consider the 

information included in applicants’ 

applications for this grant program. 

Such information could include, but not 

be limited to, existing arrangements 

(such as Memorandums of 

Understanding) with, or linkages to, VA 

and/or community partners in providing 

services to these individuals, plans on 

how the entity would coordinate with 

local VA medical facilities to identify 

these individuals, and plans to include 

these individuals as part of the 

population to be provided suicide 

prevention services if awarded a grant. 

VA will consider past and current 

actions as well as future plans to serve 

these individuals when determining 

whether to distribute a grant to an 

applicant that can assist eligible 

individuals at risk of suicide who are 

not currently receiving health care 

furnished by VA. 

Paragraph (d)(3)(iii) allows VA, to the 

extent practicable, to ensure grants are 

distributed to provide services in as 

many areas as possible. This will allow 

VA to consider geographic location, in 

some cases, when determining 

distribution of grant awards. VA 

anticipates receiving applications from 

numerous applicants in the same 

location or serving the same population, 

and VA will not be able to award grants 

to every applicant due to funding 

limitations. If VA received five highscoring applications from applicants 

proposing to serve eligible individuals 

in the same location, but one of those 

applicants alone can provide or 

coordinate suicide prevention services 

to the eligible population in that 

location, VA will be able to use this 

discretionary authority to distribute 

grants to applicants in other locations 

that can provide or coordinate services 

to eligible individuals and their 

families. This will allow VA to ensure 

that as many veterans as possible 

throughout the country are able to 

receive services under this grant 

program. 

VA notes that suicide prevention 

services grant applications must include 

applicants’ identification of the target 

populations and the area the applicant 

proposes to serve. VA will use this 

information in determining the 

distribution of suicide prevention 

services grants consistent with 

paragraph (d). 

Paragraph (e) explains that subject to 

paragraph (d) of this section, which sets 

forth the preference and distribution 

requirements and considerations, VA 

will fund the highest-ranked applicants 

for which funding is available, within 

the highest funding priority group, if 

any. Under § 78.110 (discussed later in 

this interim final rule), in order to meet 

the requirements of section 201 of the 

Act and the goals of SSG Fox SPGP, VA 

will be able to choose to include 

funding priorities in the NOFO. If VA 

establishes funding priorities in the 

NOFO, to the extent funding is available 

and subject to paragraph (d) of this 

section, VA will select applicants in the 

next highest funding priority group 

based on their rank within that group. 

Similar to existing processes in other 

VA grant programs, such as the 

Homeless Providers Grant and Per Diem 

Program (38 CFR 61.63) and the SSVF 

Program (38 CFR 62.61), paragraph (f) 

authorizes VA to select an applicant for 

funding if that applicant is not selected 

because of a procedural error by VA. An 

applicant would not be required to 

submit a new application in this 

situation. This will ease any 

administrative burden on applications 

and could be used in situations where 

there is no material change in the 

information that would have resulted in 

the applicant’s selection for a grant 

under this part. 

78.35 Scoring Criteria for Grantees 

Applying for Renewal of Suicide 

Prevention Services Grants 

Section 201(h) of the Act requires the 

VA Secretary to establish criteria for the 

selection of eligible entities that have 

submitted applications for a suicide 

prevention services grant. Based on this 

requirement, § 78.35 describes the 

criteria that VA will use to score those 

grantees who are applying for renewal 

of a grant. Such criteria will assist with 

VA’s review and evaluation of grantees 

to ensure that those grantees have 

successful existing programs using the 

previously awarded grant funds and that 

they have complied with the 

requirements of this part and section 

201 of the Act. The criteria in 

paragraphs (a) through (c) ensure that 

renewals of grants are awarded based on 

the grantee’s program’s success, costeffectiveness, and compliance with VA 

goals and requirements for this grant 

program. This is consistent with how 

VA awards renewals of grants in the 

SSVF Program (38 CFR 62.24). 

While this section does not include 

specific point values for the criteria, 

such point values will be set forth in the 

NOFO. This will allow VA to retain 

flexibility in determining those point 

values each year of the grant program. 

Under paragraph (a), VA will award 

points based on the success of the 

grantee’s program, as demonstrated by 

the following: (1) The grantee made 

progress in reducing veteran suicide 

deaths and attempts, reducing all-cause 

mortality, reducing suicidal ideation, 

increasing financial stability; improving 

mental health status, well-being, and 

social supports; and, engaging in best 

practices for suicide prevention 

services; (2) participants were satisfied 

with the suicide prevention services 

provided or coordinated by the grantee, 

as reflected by the satisfaction survey 

conducted under § 78.95(d); (3) the 

grantee implemented the program by 

delivering or coordinating suicide 

prevention services to participants in a 

timely manner, consistent with SSG Fox 

SPGP policy, the NOFO, and the grant 

agreement; and (4) the grantee was 

effective in conducting outreach to 

eligible individuals and their families 

and increasing engagement of eligible 

individuals and their families in suicide 

prevention services, as assessed through 

an SSG Fox SPGP grant evaluation. VA 

notes that for purposes of paragraph 

(a)(1), best practices for suicide 

prevention services will include, but not 

be limited to, best practices 

recommended by the National Strategy 

for Preventing Veteran Suicide, VA-DoD 

Clinical Practice Guideline for the 

Assessment and Management of Patients 

at Risk for Suicide VA, CDC’s 

Preventing Suicide: A Technical 

Package of Policy, Programs, and 

Practices, and the Surgeon General’s 

Call to Action to Implement the 

National Strategy for Suicide 

Prevention. 

Paragraph (b) states that points will be 

awarded based on the cost-effectiveness 

of the grantee’s program, as 

demonstrated by the following: The cost 

per participant was reasonable and the 

grantee’s program was effectively 

implemented on-budget. This criterion 

is important as it will assist with VA’s 

review and evaluation of grantees to 

ensure that grantees have been fiscally 

responsible. This is also consistent with 

similar criterion used in the SSVF 

program. See 38 CFR 62.24. 


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Paragraph (c) states that VA will 

award points based on the extent to 

which the grantee’s program complies 

with SSG Fox SPGP goals and 

requirements, as demonstrated by the 

following: The grantee’s program was 

administered in accordance with VA’s 

goals for SSG Fox SPGP as noted in the 

NOFO; the grantee’s program was 

administered in accordance with all 

applicable laws, regulations, and 

guidelines; and the grantee’s program 

was administered in accordance with 

the grantee’s suicide prevention services 

grant agreement. This criterion is 

important to ensure that renewals of 

grants are awarded to those who comply 

with VA’s goals and requirements for 

SSG Fox SPGP and who have shown 

competence regarding grant program 

implementation. This criterion is 

consistent with how VA awards 

renewals in the SSVF program. See 38 

CFR 62.24. 

78.40 Selection of Grantees for 

Renewal of Suicide Prevention Services 

Grants 

Section 201(c) of the Act requires the 

VA Secretary to award a grant to each 

eligible entity for which the Secretary 

has approved an application to provide 

or coordinate the provision of suicide 

prevention services. Section 201(h) of 

the Act requires the Secretary to 

establish criteria for the selection of 

eligible entities that have submitted 

applications for a suicide prevention 

services grant. Based on these sections 

of the Act, section 78.40 describes the 

process for selecting grantees that have 

received suicide prevention services 

grants and are applying for renewal of 

such grants. It is important to note that 

this is a simpler process than awarding 

the initial grant. This is consistent with 

how VA awards renewals of grants in 

the SSVF Program (38 CFR 62.25). 

Paragraph (a) explains that so long as 

grantees meet the threshold 

requirements in § 78.20, VA will score 

the grantee using the scoring criteria set 

forth in § 78.35. This ensures that 

grantees are still eligible to participate 

in the program. 

Under paragraph (b), VA will rank 

those grantees who receive at least the 

minimum amount of total points and 

points per category set forth in the 

NOFO, and such grantees will be ranked 

in order from highest to lowest scores. 

Paragraph (c) explains that VA will 

use the grantee’s ranking as the basis for 

selection for funding, and that VA will 

fund the highest-ranked grantees for 

which funding is available. 

In paragraph (d), at its discretion, VA 

may award any non-renewed funds to 

an applicant or existing grantee. If VA 

chooses to award non-renewed funds to 

an applicant or existing grantee, VA will 

first offer to award the non-renewed 

funds to the applicant or grantee with 

the highest grant score under the 

relevant NOFO that applies for, or is 

awarded a renewal grant in, the same 

area as, or a proximate area to, the 

affected area if available. Such applicant 

or grantee will be required to have the 

capacity and agree to provide prompt 

services to the affected area. Under 

§ 78.40, the relevant NOFO is the most 

recently published NOFO that covers 

the affected area, or for multi-year grant 

awards, the NOFO for which the 

grantee, who is offered the additional 

funds, received the multi-year award. If 

the first such applicant or grantee 

offered the non-renewed funds refuses 

the funds, VA will then offer to award 

the funds to the next highest-ranked 

such applicant or grantee, per the 

criteria in paragraph (d)(1) of this 

section, and continue in rank order until 

the non-renewed funds are awarded. VA 

notes that it does not anticipate offering 

multi-year awards at this time, but may 

choose to do so at a later point. To avoid 

the need for further rulemaking to 

authorize multi-year awards, such 

language is included now to allow for 

future flexibility. 

Similar to existing processes in other 

VA grant programs, such as the 

Homeless Providers Grant and Per Diem 

Program (38 CFR 61.63) and the SSVF 

Program (38 CFR 62.61), paragraph (e) 

authorizes VA to select an existing 

grantee for available funding, based on 

the grantee’s previously submitted 

renewal application, if that grantee is 

not selected for renewal because of a 

procedural error by VA. A grantee 

would not be required to submit a new 

renewal application in this situation. 

This will ease any administrative 

burden on grantees and could be used 

in situations where there is no material 

change in the renewal application that 

would have resulted in the grantee’s 

selection for renewal of a grant under 

this part. 

78.45 Suicide Prevention Services: 

Outreach 

As indicated in the definition of 

suicide prevention services, there are 

ten categories of suicide prevention 

services that can be provided or 

coordinated under this grant program. 

Each one has its own separate section in 

this regulation, and each will be 

discussed subsequently for clarity and 

readability. 

In accordance with section 

201(q)(11)(A)(i) of the Act, 38 CFR 78.45 

describes outreach, which is the first of 

ten sections describing the types of 

suicide prevention services that grantees 

may be approved to provide or 

coordinate the provision of through this 

grant program. 

In paragraph (a), grantees providing or 

coordinating the provision of outreach 

must use their best efforts to ensure that 

eligible individuals, including those 

who are at highest risk of suicide or who 

are not receiving health care or other 

services furnished by VA, and their 

families are identified, engaged, and 

provided suicide prevention services. 

This is consistent with how outreach 

services are addressed in the definition 

of suicide prevention services in section 

201(q)(11)(A)(i) of the Act. Based on the 

assessment of suicide risk conducted by 

grantees to determine eligibility for 

services, eligible individuals that should 

be considered at highest risk of suicide 

are those with a recent suicide attempt, 

an active plan or preparatory behavior 

for suicide, or a recent hospitalization 

for suicidality. 

Paragraph (b) explains that outreach 

must include active liaison with local 

VA facilities; State, local, or tribal 

government (if any); and private 

agencies and organizations providing 

suicide prevention services to eligible 

individuals and their families in the 

area to be served by the grantee. This 

can include, for example, local mental 

health and emergency or urgent care 

departments in local hospitals or 

clinics. Paragraph (b) effectively 

requires grantees to have a presence in 

the area to meet with individuals and 

organizations to create referral processes 

to the grantee, similar to VA’s suicide 

prevention coordinators. 

This section is consistent with how 

VA defines outreach in the SSVF 

Program (38 CFR 62.30). Outreach is 

important for ensuring that eligible 

individuals and families receive suicide 

prevention services to reduce the risk of 

suicide. Outreach also ensures that 

grantees are able to identify participants 

that may be eligible and in need of 

suicide prevention services. Working 

with local entities, including VA, that 

serve eligible individuals and their 

families can help grantees identify and 

reach potential participants. 

78.50 Suicide Prevention Services: 

Baseline Mental Health Screening 

In accordance with section 

201(q)(11)(A)(ii) of the Act, under 

§ 78.50(a), grantees must provide or 

coordinate the provision of a baseline 

mental health screening to all 

participants they serve at the time those 

services begin. For purposes of this 

grant program, all grantees will be 

required to provide, or coordinate the 

provision of, a baseline mental 


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screening to participants. This baseline 

mental health screening ensures that 

participants’ mental health needs can be 

properly determined, and that suicide 

prevention services can be further 

tailored to meet the individual’s needs. 

This baseline mental health screening 

must be provided using a validated 

screening tool that assesses suicide risk 

and mental and behavioral health 

conditions. Information on the specific 

tools to be used will be included in the 

NOFO, as the tools VA will approve for 

baseline mental health screenings may 

vary from year to year as the screening 

tools may evolve over time due to 

emerging evidence through research. VA 

will provide these tools to grantees 

providing or coordinating the provision 

of baseline mental health screenings. 

These tools will be those that a nonclinician can administer, as many 

grantees may not be clinicians and may 

not be able to administer a clinical 

screening for suicide risk and mental or 

behavioral health conditions. These 

tools will also indicate when a 

participant must be referred for 

additional care, as explained in 

paragraph (b) of this section. These tools 

will ensure consistent screening and 

reporting of suicide risk and the need 

for referral for additional care or care 

coordination. It is also important to note 

that this is consistent with feedback VA 

received through consultation. These 

tools used to conduct the baseline 

mental health screening are different 

than the tool used to determine risk of 

suicide for purposes of eligibility and 

will be administered to participants 

after they have been deemed an eligible 

individual pursuant to § 78.10. 

Paragraph (b) states that if an eligible 

individual is at risk of suicide or other 

mental or behavioral health condition 

pursuant to the baseline mental health 

screening conducted under paragraph 

(a) of this section, the grantee must refer 

such individual to VA for care. If the 

eligible individual refuses the grantee’s 

referral to VA, any ongoing clinical 

services provided to the eligible 

individual by the grantee is at the 

expense of the grantee. This is based on 

section 201(m)(1) and (3) of the Act, 

which explain that if a grantee 

determines that an eligible individual is 

at-risk of suicide or other mental or 

behavioral health condition pursuant to 

a baseline mental health screening, the 

grantee must refer the eligible 

individual to VA for additional care as 

authorized under the Act or any other 

provision of law, and if the eligible 

individual refuses the referral, any 

ongoing clinical services provided to the 

individual by the grantee will be at the 

grantee’s expense. It is important to note 

that this is only required for eligible 

individuals and not the family of 

eligible individuals. 

Section 201(m)(1) of the Act requires 

referral when the grantee determines 

that an eligible individual is at-risk of 

suicide or other mental health or 

behavioral health condition, consistent 

with the language in paragraph (b). This 

reflects Congressional intent that these 

referrals for care be required for those 

eligible individuals who are not only at 

risk of suicide but also those who have 

additional needs that require further 

evaluation by VA for additional care. 

Whether an eligible individual has 

additional needs that require referral for 

further evaluation by VA for additional 

care will be determined pursuant to the 

baseline mental health screening 

conducted under paragraph (a). For 

example, should the baseline mental 

health screening indicate a potential 

mental health disorder related to 

depression, the participant would need 

to be referred for further evaluation for 

diagnosis and treatment. 

This baseline mental health screening 

will be performed by grantees using 

various VA-approved validated tools. 

These tools will indicate to the grantee 

if the eligible individual must be 

referred for additional evaluation and 

care based on the outcome of the 

screening for mental or behavioral 

health and suicide risk. 

When referrals are made by grantees 

to VA, to the extent practicable, those 

referrals are required to be a ‘‘warm 

hand-off’’ to ensure that the eligible 

individual receives necessary care. This 

‘‘warm hand-off’’ may include providing 

any necessary transportation to the 

nearest VA facility, assisting the eligible 

individual with scheduling an 

appointment with VA, and any other 

similar activities that may be necessary 

to ensure the eligible individual 

receives necessary care in a timely 

manner. This is consistent with 

feedback received from commenters 

during consultation. This ‘‘warm handoff’’ is also consistent with other suicide 

prevention services that grantees may 

provide, such as assistance in obtaining 

any VA benefits and assistance with 

emergent needs, authorized under 

section 201(q)(11)(A)(vii) and (ix), 

respectively. 

To the extent that a veteran referred 

to VA for care is eligible for care in the 

community through VA’s Community 

Care Program, that veteran may elect to 

receive care in the community under 

VA’s Community Care Program 

regulations located at 38 CFR 17.4000 

through 17.4040. For purposes of 

section 201(m)(3), this election would 

not be considered a refusal to receive 

care from VA. 

Paragraph (b) further explains that if 

an eligible individual refuses referral to 

VA for care by a grantee, any ongoing 

clinical services provided to the eligible 

individual by the grantee are at the 

grantee’s expense. This is based on 

section 201(m)(3) of the Act and ensures 

that grantees understand their 

responsibilities regarding the baseline 

mental health screening of an eligible 

individual. 

Similar to the language in paragraph 

(b), paragraph (c) explains that if a 

participant other than an eligible 

individual is at risk of suicide or other 

mental or behavioral health condition 

pursuant to the baseline mental health 

screening conducted under paragraph 

(a) of this section, the grantee must refer 

such participant to appropriate health 

care services in the area. To the extent 

that the grantee is able to furnish such 

appropriate health care services on an 

ongoing basis and has available funding 

separate from funds provided under this 

grant program to do so, they would be 

able to furnish such services using those 

non-VA funds without being required to 

refer such participants to other services. 

VA requires that grantees refer those 

individuals (that is, families of eligible 

individuals) for further care as 

appropriate and will codify this in 

paragraph (c) to ensure that grantees do 

so. This ensures that those individuals’ 

needs can be met by further care as 

needed. 

Under paragraph (d), except as 

provided for under § 78.60(a), funds 

provided under this grant program may 

not be used to provide clinical services 

to participants, and any clinical services 

provided to such individuals by the 

grantee are at the expense of the grantee. 

Paragraph (d) explicitly states that any 

clinical services provided by the grantee 

are at its expense and not VA’s. Further, 

this language in the Act and in the 

regulation clarifies that grantees may 

not charge, bill, or otherwise hold liable 

eligible individuals for the receipt of 

such care or services; we interpret the 

phrase ‘‘at the expense of the entity’’ in 

section 201(m)(3) to bar the entity from 

billing, charging, or holding liable 

eligible individuals for the receipt of 

such care or services. This will also 

ensure that the relationship between the 

grantee and the eligible individual is not 

adversely affected through collections or 

other efforts. It also provides an 

incentive for grantees to work with 

eligible individuals to refer them to VA 

for their health care needs. 

While grantees that provide 

participants ongoing clinical services 

pursuant to paragraphs (b) and (c) do so 


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at their own expense, this does not 

preclude the grantee from seeking to 

cover those expenses through other 

sources of funding and existing 

agreements. For example, a grantee that 

provides a participant with ongoing 

clinical services may bill a third-party 

payor, such as the participant’s other 

health insurance, for the ongoing 

clinical services provided by the 

grantee. However, as explained in the 

previous paragraph, the grantee may not 

charge, bill, or otherwise hold liable 

participants for the receipt of ongoing 

clinical services under § 78.50. In the 

instance that a grantee bills a third-party 

payor (e.g., health insurance) for 

ongoing clinical services provided to the 

participant, certain cost-sharing, such as 

copayments, imposed on the participant 

by a third-party payor, may be covered 

by the grantee at its discretion. VA does 

not interpret the language ‘‘at the 

expense of the entity’’ in section 

201(m)(3) to preclude grantees from 

covering such copayments for 

participants for ongoing clinical 

services. VA would not require that 

grantees cover such costs, but rather, 

would permit grantees to do so if it 

chooses and has the funds to do so. 

However, as noted above, section 

201(m)(3) bars the entity from billing, 

charging, or holding liable eligible 

individuals for the receipt of such care 

or services. Pursuant to § 78.50(a), the 

grantee would be unable to use grant 

funds to cover such costs. 

VA notes that while section 201(m)(3) 

is specific to eligible individuals, 

paragraph (d) applies to all participants 

because this would ensure that the 

potential liabilities of a family member 

would not deter a veteran from seeking 

services from a grantee and to make 

administration easier. VA has authority 

to extend this protection to include 

participants other than eligible 

individuals pursuant to section 201(f)(1) 

of the Act, which authorizes VA to 

require grantees to make such 

commitments as the Secretary considers 

necessary to carry out this section. 

78.55 Suicide Prevention Services: 

Education 

In accordance with section 

201(q)(11)(A)(iii), under § 78.55, 

grantees providing or coordinating the 

provision of education must provide or 

coordinate the provision of suicide 

prevention education programs to 

educate communities, veterans, and 

families on how to identify those at risk 

of suicide, how and when to make 

referrals for care, and the types of 

suicide prevention resources available 

within the area. Education can include 

gatekeeper training, lethal means safety 

training, or specific education programs 

that assist with identification, 

assessment, or prevention of suicide. 

Gatekeeper training generally refers to 

programs that seek to develop 

individuals’ knowledge, attitudes, and 

skills to prevent suicide. Gatekeeper 

training is an educational course 

designed to teach clinical and nonclinical professionals or gatekeepers the 

warning signs of a suicide crisis and 

how to respond and refer individuals for 

care. For more information, see: http:// 

www.sprc.org/sites/default/files/ 

migrate/library/SPRC_Gatekeeper_

matrix_Jul2013update.pdf. 

Defining education in this manner is 

consistent with how education is 

administered in the community and is 

commonly understood by those in the 

community who work in the area of 

suicide prevention. Education is 

important because learning the signs of 

suicide risk, how to reduce access to 

lethal means, and to connect those at 

risk of suicide to care can improve 

understanding of suicide and has the 

potential to reduce suicide. 

78.60 Suicide Prevention Services: 

Clinical Services for Emergency 

Treatment 

In accordance with section 

201(q)(11)(A)(iv) of the Act, § 78.60(a) 

requires that grantees providing or 

coordinating the provision of clinical 

services for emergency treatment must 

provide or coordinate the provision of 

clinical services for emergency 

treatment of a participant. 

Consistent with section 201(m)(2) and 

(3) of the Act, paragraph (b) explains 

that if an eligible individual is furnished 

clinical services for emergency 

treatment under paragraph (a) of this 

section and the grantee determines that 

the eligible individual requires ongoing 

services, the grantee must refer the 

eligible individual to VA for additional 

care. If the eligible individual refuses 

the grantee’s referral to VA, any ongoing 

clinical services provided to the eligible 

individual by the grantee is at the 

expense of the grantee. This aligns with 

section 201(m)(2) of the Act, which 

explains that if a grantee furnishes 

clinical services for emergency 

treatment to an eligible individual and 

determines ongoing services are 

required, the grantee must refer the 

eligible individual to VA for additional 

care as authorized under the Act or any 

other provision of law. VA notes that 

this is only required for eligible 

individuals, not the family of eligible 

individuals. To the extent that an 

eligible individual referred to VA for 

care is eligible for care in the 

community through VA’s Community 

Care Program, that eligible individual 

may elect to receive care in the 

community under VA’s Community 

Care Program regulations located at 38 

CFR 17.4000 through 17.4040. As stated 

above, such election is not considered a 

refusal to receive care from VA. 

Subsection (m)(3) of section 201 of the 

Act further states that if an eligible 

individual refuses a referral by a 

grantee, any ongoing clinical services 

provided to the eligible individual by 

the grantee is at the grantee’s expense. 

That is codified in paragraph (b) to 

ensure that grantees understand their 

responsibilities regarding clinical 

services of an eligible individual. 

Paragraph (b) further includes the same 

language as § 78.50(d) regarding 

limitations on charging, billing, or 

otherwise holding liable eligible 

individuals for the receipt of such care. 

As explained in the discussion on 

§ 78.50(d), a grantee is not precluded 

from seeking to cover those expenses 

through other sources of funding and 

existing agreements. 

In paragraph (c), if a participant other 

than an eligible individual (that is, the 

family member of an eligible individual) 

is furnished clinical services for 

emergency treatment under paragraph 

(a) of this section and the grantee 

determines that the participant requires 

ongoing services, the grantee must refer 

the participant to appropriate health 

care services in the area for additional 

care. Except as provided for under 

paragraph (a) of this section, funds 

provided under this grant program may 

not be used to provide ongoing clinical 

services to family, and any ongoing 

clinical services provided to the family 

by the grantee is at the expense of the 

grantee. VA expects that grantees will 

refer those participants for further care 

as appropriate and is codifying this 

requirement in this paragraph to ensure 

that grantees do so. This ensures that 

these participants’ needs can be met by 

further care as needed. Except as 

provided for under § 78.60(a), funds 

provided under this grant program may 

not be used to provide clinical services 

to such participants, and any ongoing 

clinical services provided to the 

participant by the grantee is at the 

expense of the grantee. This is because 

VA does not have authority to cover 

such expenses under this grant program. 

However, to the extent that a grantee 

can and desires to provide ongoing 

clinical services to such participants, 

they may do so, but it will be at their 

expense. As explained in discussion on 

§ 78.50(d), this language does not 

preclude the grantee from seeking to 

cover those expenses through other 

sources of funding and existing 


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agreements (for example, billing a 

participant’s health insurance). Grantees 

also are not precluded from covering 

any copayments imposed on 

participants by their health insurance 

for ongoing clinical services provided 

by the grantee if the grantee so chooses 

and has the funds to cover such costs. 

However, the grantee may not charge, 

bill, or otherwise hold liable such 

participants for the receipt of such care 

or services. This is consistent with 

similar language in paragraph (b) 

relating to eligible individuals. 

Consistent with section 201(q)(5) of 

the Act, paragraph (d) explains that for 

purposes of this section, emergency 

treatment means medical services, 

professional services, ambulance 

services, ancillary care and medication 

(including a short course of medication 

related to and necessary for the 

treatment of the emergency condition 

that is provided directly to or prescribed 

for the patient for use after the 

emergency condition is stabilized and 

the patient is discharged) was rendered 

in a medical emergency of such nature 

that a prudent layperson would have 

reasonably expected that delay in 

seeking immediate medical attention 

would have been hazardous to life or 

health. This standard is met by an 

emergency medical condition 

manifesting itself by acute symptoms of 

sufficient severity (including severe 

pain) that a prudent layperson who 

possesses an average knowledge of 

health and medicine could reasonably 

expect the absence of immediate 

medical attention to result in placing 

the health of the individual in serious 

jeopardy, serious impairment to bodily 

functions, or serious dysfunction of any 

bodily organ or part. 

The description and standard are 

consistent with VA’s description of 

medical emergency for purposes of 

payment or reimbursement for 

emergency treatment furnished by nonVA providers to certain veterans with 

service-connected disabilities pursuant 

to 38 CFR 17.120 and for nonserviceconnected disabilities pursuant to 38 

CFR 17.1000 et seq. It is important to 

note that emergency medical conditions 

includes emergency mental health 

conditions. 

Paragraph (e) explains that the direct 

provision of clinical services for 

emergency treatment by grantees under 

this section is not prohibited by 

§ 78.80(a). As explained later in this 

discussion, § 78.80(a) prohibits grantees 

from directly providing health care 

services, which include health 

insurance and referral to a governmental 

entity or grantee that provides certain 

services. As clinical services for 

emergency treatment under § 78.60 are 

considered health care services and 

section 201 of the Act specifically 

authorizes the provision of clinical 

services for emergency treatment, 

paragraph (e) clarifies that such services 

do not fall under the prohibition in 

§ 78.80(a). VA acknowledges that while 

some grantees may not be able to 

provide these services directly, others 

will. This ensures that if a grantee is 

capable of furnishing emergency 

treatment and needs to do so, there will 

be no delay in the delivery of such 

services. 

78.65 Suicide Prevention Services: 

Case Management Services 

In accordance with section 

201(q)(11)(A)(v), case management 

services are described in § 78.65. These 

definitions are similar to case 

management services in the SSVF 

Program (see 38 CFR 62.31), but they are 

focused on suicide prevention to 

effectively assist participants at risk of 

suicide. The SSVF Program derived its 

definition from similar definitions of 

case management services provided in 

other Federal programs, such as the 

Department of Health and Human 

Services’ Medicare and Medicaid 

Services Program, the Department of 

Housing and Urban Development’s 

Congregate Housing Services Program, 

and the Housing and Urban 

Development—Veterans Affairs 

Supported Housing (see 42 CFR 440.169 

and 24 CFR 700.105). 75 FR 24514, 

24518 (May 5, 2010). This description of 

case management services is also 

consistent with VA-DoD Clinical 

Practice Guidelines for the Assessment 

and Management of Patients at Risk for 

Suicide (see https://

www.healthquality.va.gov/guidelines/ 

MH/srb/VADoDSuicideRisk

FullCPGFinal5088212019.pdf). 

Grantees providing or coordinating 

the provision of case management 

services must provide or coordinate the 

provision of such services that include, 

at a minimum: (a) Performing a careful 

assessment of participants, and 

developing and monitoring case plans 

in coordination with a formal 

assessment of suicide prevention 

services needed, including necessary 

follow-up activities, to ensure that the 

participant’s needs are adequately 

addressed; (b) establishing linkages with 

appropriate agencies and service 

providers in the area to help 

participants obtain needed suicide 

prevention services; (c) providing 

referrals to participants and related 

activities (such as scheduling 

appointments for participants) to help 

participants obtain needed suicide 

prevention services, such as medical, 

social, and educational assistance or 

other suicide prevention services to 

address participants’ identified needs 

and goals; (d) deciding how resources 

and services are allocated to 

participants on the basis of need; (e) 

educating participants on issues, 

including, but not limited to, suicide 

prevention services availability and 

participant rights; and, (f) other 

activities, as approved by VA, to serve 

the comprehensive needs of participants 

for the purpose of reducing suicide risk. 

This list ensures that grantees have the 

same understanding of what activities 

are considered case management 

services, but it also provides VA 

authority to approve other activities that 

may be considered case management 

services. Such other activities will be 

included in any NOFO published as 

well as incorporated into any agreement 

with grantees. 

78.70 Suicide Prevention Services: 

Peer Support Services 

Consistent with section 

201(q)(11)(A)(vi) of the Act, 38 CFR 

78.70 explains the peer support services 

authorized under this grant program. 

Paragraph (a) explains that grantees 

providing or coordinating the provision 

of peer support services must provide or 

coordinate the provision of peer support 

services to help participants understand 

what resources and supports are 

available in their area for suicide 

prevention. Peer support services must 

be provided by veterans trained in peer 

support with similar lived experiences 

related to suicide or mental health. Peer 

support specialists serve as role models 

and a resource to assist participants 

with their mental health recovery. Peer 

support specialists function as 

interdisciplinary team members, 

assisting physicians and other 

professional and non-professional 

personnel in a rehabilitation treatment 

program. This is consistent with how 

VA defines peer support services for its 

programs, including its peer support 

program pursuant to 38 U.S.C. 1720F(j). 

Paragraph (b) further explains that 

each grantee providing or coordinating 

the provision of peer support services 

must ensure that veterans providing 

such services to participants meet the 

requirements of 38 U.S.C. 7402(b)(13) 

and meet qualification standards for 

appointment or have completed peer 

support training, are pursuing 

credentials to meet the minimum 

qualification standards for appointment, 

and are under the supervision of an 

individual who meets the requirements 

of 38 U.S.C. 7402(b)(13). Section 

7402(b)(13) establishes standards for 


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appointment as a VA peer support 

specialist. Qualification standards 

include that the individual is (1) a 

veteran who has recovered or is 

recovering from a mental health 

condition, and (2) certified by (i) a notfor-profit entity engaged in peer support 

specialist training as having met such 

criteria as the Secretary shall establish 

for a peer support specialist position, or 

(ii) a State as having satisfied relevant 

State requirements for a peer support 

specialist position. VA has further set 

forth qualifications for its peer support 

specialists in VA Handbook 5005, 

Staffing (last updated July 17, 2012). See 

https://vaww.va.gov/OHRM/DirectivesHandbooks/Documents/5005.pdf. 

Meeting minimum qualification 

standards for appointment under 38 

U.S.C. 7402(b)(13) ensures that 

participants receive peer support 

services in a safe and effective manner 

consistent with VA’s standards and with 

those required by law. However, VA 

would also allow grantees to provide 

peer support services through veterans 

who have completed peer support 

training, are pursuing credentials to 

meet the minimum qualification 

standards for appointment, and are 

under the supervision of an individual 

who meets the minimum qualification 

standards. VA would allow this as a 

way to build capacity in the community 

for peer support services, particularly as 

there are individuals who may be 

supervised and working toward meeting 

the requirements of 38 U.S.C. 

7402(b)(13), but who have not yet met 

those conditions. Grant funds may be 

used to provide education and training 

for employees of the grantee or the 

community partner who provide peer 

support services based on the terms set 

forth in the grant agreement. VA 

believes the use of these funds to 

support education and training for peer 

support specialists is authorized by 

section 201(b) of the Act, which directs 

VA to provide financial assistance to 

eligible entities approved under this 

section to provide or coordinate the 

provision of suicide prevention services 

to eligible individuals and their 

families. Because the requirements to be 

a VA peer support specialist, as 

generally described above, are more 

specific than many community 

organizations might require, we believe 

the use of grant funds to support 

education and training is appropriate as 

it may be necessary to ensure these 

services are provided by appropriately 

qualified individuals. VA would set 

forth conditions regarding the use of 

funds, such as any limits on the amount 

of funds that may be used for these 

purposes or documentation 

requirements, in the NOFO and terms of 

the grant agreement. 

These appointment requirements for 

those veterans providing peer support 

services would be included in the 

NOFO so that those applicants who 

apply to provide peer support services 

understand and know the applicable 

requirements for purposes of providing 

or coordinating such services. These 

requirements would also be included in 

any program guides developed for 

purposes of administering services 

under this grant program. 

78.75 Suicide Prevention Services: 

Assistance in Obtaining VA Benefits 

In accordance with section 

201(q)(11)(A)(vii), § 78.75 sets forth the 

requirements associated with suicide 

prevention services authorized under 

this grant program related to assistance 

in obtaining VA benefits. The provision 

of this assistance will provide grantees 

with additional means by which VA can 

notify participants of available VA 

benefits and is consistent with the SSVF 

Program (see 38 CFR 62.32). 

Paragraph (a) requires grantees 

assisting participants in obtaining VA 

benefits to assist participants in 

obtaining any benefits from VA for 

which the participants are eligible. Such 

benefits include but are not limited to: 

(1) Vocational and rehabilitation 

counseling; (2) supportive services for 

homeless veterans; (3) employment and 

training services; (4) educational 

assistance; and, (5) health care services. 

Under paragraph (b), grantees will not 

be permitted to represent participants 

before VA with respect to a claim for VA 

benefits unless they are recognized for 

that purpose pursuant to 38 U.S.C. 5902. 

Employees and members of grantees are 

not permitted to provide such 

representation unless the individual 

providing representation is accredited 

pursuant to 38 U.S.C. chapter 59. 

Consistent with 38 U.S.C. 5902, VA 

does not interpret section 201 of the Act 

to allow grantees to represent veterans 

in benefit claims before VA unless they 

are recognized under 38 U.S.C. 5902. 

VA also does not interpret section 201 

of the Act as requiring that grantees 

become recognized organizations 

pursuant to 38 U.S.C. 5092 or that their 

employees or members become 

accredited service organization 

representatives, claims agents, or 

attorneys. Instead, assistance in 

obtaining benefits may include 

providing information about available 

benefits, helping individuals locate a 

recognized veterans services 

organization or other accredited 

individual, and other services short of 

actual representation before VA, unless 

the grantee is accredited pursuant to 38 

CFR 14.629 (that is, VA’s regulation 

implementing 38 U.S.C. 5902), which 

sets forth requirements for accreditation 

of service organization representatives, 

agents, and attorneys. 

78.80 Suicide Prevention Services: 

Assistance in Obtaining and 

Coordinating Other Public Benefits and 

Assistance With Emergent Needs 

Consistent with section 

201(q)(11)(A)(viii) and (ix) of the Act, 

under § 78.80, grantees assisting in 

obtaining and coordinating other public 

benefits or assisting with emergent 

needs will be required to assist 

participants to obtain and coordinate 

the provision of other public benefits. 

For purposes of this section, VA 

considers other public benefits and 

emergent needs to be the same types of 

benefits. At a minimum, grantees are 

required to assist participants in 

obtaining and coordinating the 

provision of benefits listed in 

paragraphs (a) through (h) of § 78.80 that 

are being provided by Federal, State, 

local, or tribal agencies, or any other 

grantee in the area served by the grantee 

by referring the participant to and 

coordinating with such entity. If a 

public benefit is not being provided by 

Federal, State, local, or tribal agencies, 

or any other grantee in the area, the 

grantee is not required to obtain, 

coordinate, or provide such public 

benefit. Grantees may elect to provide 

directly to participants the public 

benefits identified in paragraphs (c) 

through (h) of § 78.80. 

In accordance with section 

201(q)(11)(A)(ix)(I) of the Act, paragraph 

(a) describes health care services, which 

include: (1) Health insurance, and (2) 

referral to a governmental entity or 

grantee that provides any of the 

following services: (i) Hospital care, 

nursing home care, outpatient care, 

mental health care, preventive care, 

habilitative and rehabilitative care, case 

management, respite care, and home 

care; (ii) the training of any eligible 

individual’s family in the care of any 

eligible individual; and (iii) the 

provision of pharmaceuticals, supplies, 

equipment, devices, appliances, and 

assistive technology. This is consistent 

with how VA administers the SSVF 

Program (see 38 CFR 62.33(a)). VA 

believes services in paragraph (a) should 

not be provided directly by grantees as 

these services are commonly available 

in the area, including at VA. It also 

would be cost-prohibitive for grantees to 

provide these directly and would thus 

impact grantees’ ability to provide 


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suicide prevention services to 

participants. 

In accordance with section 

201(q)(11)(A)(ix)(II) of the Act, 

paragraph (b) describes referral of a 

participant, as appropriate, to an entity 

that provides daily living services 

relating to the functions or tasks for selfcare usually performed in the normal 

course of a day, including, but not 

limited to, eating, bathing, grooming, 

dressing, and home management 

activities. This is identical to how VA 

administers the SSVF Program (See 38 

CFR 62.33(b)). VA believes that daily 

living services should not be provided 

directly by grantees as these services are 

commonly available in the community, 

including at VA. It also would be costprohibitive for grantees to provide these 

directly and would thus impact 

grantees’ ability to provide suicide 

prevention services to participants. 

Thus, referrals for these services would 

be appropriate. 

In accordance with section 

201(q)(11)(A)(ix)(III) of the Act, 

paragraph (c) describes personal 

financial planning services, which 

include, at a minimum, providing 

recommendations regarding day-to-day 

finances and achieving long-term 

budgeting and financial goals. Grant 

funds may pay for credit counseling and 

other services necessary to assist 

participants with critical skills related 

to household budgeting, managing 

money, accessing a free personal credit 

report, and resolving credit problems. 

This is consistent with how VA 

administers the SSVF Program (see 38 

CFR 62.33(c)). 

In accordance with section 

201(q)(11)(A)(ix)(IV) of the Act, 

paragraph (d) describes transportation 

services. Paragraph (d)(1) explains that 

the grantee may provide temporary 

transportation services directly to 

participants if the grantee determines 

such assistance is necessary; however, 

the preferred method of direct provision 

of transportation services is the 

provision of tokens, vouchers, or other 

appropriate instruments so that 

participants may use available public 

transportation options. Paragraph (d)(2) 

explains that if public transportation 

options are not sufficient within an area, 

costs related to the lease of vehicle(s) 

may be included in a suicide prevention 

services grant application if the 

applicant or grantee, as applicable, 

agrees that: (i) The vehicle(s) will be 

safe, accessible, and equipped to meet 

the needs of the participants; (ii) the 

vehicle(s) will be maintained in 

accordance with the manufacturer’s 

recommendations; and (iii) all 

transportation personnel (employees 

and community partners) will be 

licensed, insured, and trained in 

managing any special needs of 

participants and handling emergency 

situations. This is consistent with how 

VA administers the SSVF Program (see 

38 CFR 62.33(d)). However, unlike 

§ 62.33(d) which refers to 

subcontractors, VA refers to community 

partners under paragraph (d)(2)(iii). 

Paragraph (d)(3) permits grantees to 

provide transportation services through 

reimbursement for transportation 

furnished through ride-sharing services, 

taxi services, or other similar sources if 

two conditions are met: First, the 

participant must lack any other means 

of transportation, including 

transportation or reimbursement for 

transportation from VA under part 70 of 

this title, and second, the grantee must 

document the participant’s lack of other 

means. Such documentation would be 

maintained as part of the participant’s 

case file, and consistent with the 

recordkeeping requirements in § 78.150. 

VA includes this provision to allow for 

flexibility in situations where 

transportation options may be limited, 

but the two conditions are intended to 

limit this support as a matter of last 

resort given that the expenses for such 

transportation are likely higher than 

other methods of transportation, and VA 

does not believe it would be an optimal 

use of grant funds. If beneficiary travel 

under subpart A of part 70 of title 38, 

Code of Federal Regulations, or 

transportation through the Veterans 

Transportation Service under subpart B 

of part 70 of title 38, Code of Federal 

Regulations, are available to the 

participant, the participant would be 

ineligible for assistance under paragraph 

(d)(3). 

In accordance with section 

201(q)(11)(A)(ix)(V) of the Act, 

paragraph (e) describes temporary 

income support services, which may 

consist of providing assistance in 

obtaining other Federal, State, tribal, 

and local assistance, in the form of, but 

not limited to, mental health benefits, 

food assistance, housing assistance, 

employment counseling, medical 

assistance, veterans’ benefits, and 

income support assistance. This is 

consistent with how VA administers the 

SSVF Program (see 38 CFR 62.33(e)). 

However, unlike the SSVF Program, this 

suicide prevention services grant 

program will include food assistance 

because of the correlation between food 

insecurity and mental health issues 

including suicide risk. See Bergmans, 

R.S., Jannausch, M. and Ilgen, M.A. 

(2020), Prevalence of suicide ideation, 

planning and attempts among 

Supplemental Nutrition Assistance 

Program participants in the United 

States. Journal of Affective Disorders, 

277, 99–103. The suicide prevention 

services grant program also expressly 

includes housing assistance, which does 

not appear in § 62.33(e) because part 62 

is designed in general to provide 

housing assistance and supportive 

services for very low-income veteran 

families who are occupying permanent 

housing. 

In accordance with section 

201(q)(11)(A)(ix)(VI) of the Act, 

paragraph (f) describes fiduciary and 

representative payee services, which 

may consist of acting on behalf of a 

participant by receiving the 

participant’s paychecks, benefits or 

other income, and using those funds for 

the current and foreseeable needs of the 

participant and saving any remaining 

funds for the participant’s future use in 

an interest-bearing account or saving 

bonds. This is consistent with how VA 

administers the SSVF Program (see 38 

CFR 62.33(f)). 

In accordance with section 

201(q)(11)(A)(ix)(VII) of the Act, 

paragraph (g) explains that legal services 

includes those services to assist an 

eligible individual with issues that may 

contribute to the risk of suicide, 

including issues that interfere with the 

eligible individual’s ability to obtain or 

retain permanent housing, cover basic 

needs such as food, transportation, 

medical care, and issues that affect the 

eligible individual’s employability and 

financial security (such as debt, credit 

problems, and the lack of a driver’s 

license). These bio-psychosocial 

stressors are suicide risk factors noted 

within the VA/DoD Clinical Practice 

Guidelines for the Assessment and 

Management of Patients at Risk for 

Suicide. See https://www.health

quality.va.gov/guidelines/MH/srb/ 

VADoDSuicideRiskFullCPGFinal508821

2019.pdf. 

However, with the exception of legal 

assistance with resolving outstanding 

warrants, fines, expungements, and 

drivers’ license revocations 

symptomatic of reentry obstacles in 

employment or housing, authorized 

legal services do not include legal 

assistance with criminal matters nor 

matters in which the eligible individual 

is taking or has taken any adversarial 

legal action against the United States 

(that is, the Federal government). 

Authorized legal services also do not 

include legal assistance with matters in 

which the United States (that is, the 

Federal government) is prosecuting an 

eligible individual. Thus, even with 

respect to the limited legal assistance for 

certain criminal matters otherwise 

permitted (for example, legal assistance 


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with resolving outstanding warrants), 

legal services do not include legal 

assistance in those criminal matters in 

which the United States is prosecuting 

the eligible individual. 

Legal services under § 78.80(g) are 

described in this manner to include 

those types of services VA believes are 

most relevant and applicable to the legal 

needs of eligible individuals. VA will 

limit these legal services to issues that 

contribute to the risk of suicide, which 

is consistent with the overall intent of 

this grant program. VA will authorize 

those services that support the legal 

needs of the eligible individual to 

address those issues that contribute to 

their risk of suicide, such as issues with 

housing, employability, and financial 

security. 

With certain exceptions as noted and 

explained above, VA excludes legal 

assistance with most criminal matters 

and excludes all matters in which the 

eligible individual is taking or has taken 

any adversarial legal action against the 

United States, as VA does not believe it 

is reasonable to expect VA to pay for 

such services, especially for those 

situations in which an eligible 

individual takes adversarial legal action 

against the Federal government, 

including VA and other Federal 

agencies or in situations in which the 

Federal government is prosecuting an 

eligible individual. If VA covered such 

legal services, it could result in conflicts 

of interest. This restriction does not 

include non-adversarial legal assistance 

provided in pursuit of VA benefits or 

appeals to the Board of Veterans’ 

Appeals. If legal assistance is needed 

with a matter for which grant funds are 

not authorized, the grantee should make 

referrals to other organizations, such as 

Legal Aid and local Bar Associations, to 

ensure that legal needs can be met. 

In accordance with section 

201(q)(11)(A)(ix)(VIII) of the Act, 

paragraph (h) describes the provision of 

child care, consistent with how VA 

administers these services in the SSVF 

Program (see 38 CFR 62.33(h)). Child 

care will be authorized for children 

under the age of 13, unless the child is 

disabled. Disabled children must be 

under the age of 18 to receive assistance 

under this paragraph. This is consistent 

with the SSVF Program’s regulations at 

§ 62.33(h) as well as similar regulations 

issued by the Department of Housing 

and Urban Development. See 24 CFR 

576.102(a)(1)(ii). 

Child care includes the: (1) Referral of 

a participant, as appropriate, to an 

eligible child care provider that 

provides child care with sufficient 

hours of operation and serves 

appropriate ages, as needed by the 

participant; and (2) payment by a 

grantee on behalf of a participant for 

child care by an eligible child care 

provider. Consistent with the financial 

cap in section 201(q)(11)(A)(ix)(VIII) of 

the Act, payment may not exceed $5,000 

per family of an eligible individual per 

Federal fiscal year. 

In paragraphs (h)(2)(i) through (iii), 

certain limitations for payments for 

child care services are identified, which 

is consistent with the SSVF Program’s 

regulations at 38 CFR 62.33(h). Pursuant 

to paragraph (h)(2)(i), payments for 

child care services must be paid by the 

grantee directly to an eligible child care 

provider. Unlike § 62.33(h), VA would 

not include the language that payments 

for child care services cannot exceed a 

maximum of 6 months in a 12-month 

period, and 10 months during a 2-year 

period. As payments are capped at 

$5,000 per family per Federal fiscal year 

under section 201(q)(11)(A)(ix)(VIII) of 

the Act, VA believes the financial cap 

imposed by the statute is a sufficient 

constraint to ensure proper use of 

resources for these services. 

Under paragraph (h)(2)(ii), payments 

for child care services will not be 

provided on behalf of participants for 

the same period of time and for the 

same cost types that are being provided 

through another Federal (including VA), 

State or local subsidy program. The 

reference to the ‘‘same period of time’’ 

means the same dates and times in 

which child care benefits are being 

provided under another program. For 

example, a participant may be eligible 

for Arkansas’s Child Care Assistance 

Program, which provides financial 

assistance for quality child care to 

certain individuals. If that participant 

was using those benefits under 

Arkansas’s Child Care Assistance 

Program on a specific date and time, it 

would not render the participant 

ineligible for child care support 

generally under the suicide prevention 

services grant program. The only result 

would be that the individual could not 

receive a subsidy under VA’s program 

for the same period of time for which 

child care services were being provided 

under the Arkansas program. 

Paragraph (h)(2)(iii) further explains 

that as a condition of providing 

payments for child care services, the 

grantee must help the participant 

develop a reasonable plan to address the 

participant’s future ability to pay for 

child care services. Grantees must assist 

the participant to implement such plan 

by providing any necessary assistance or 

helping the participant to obtain any 

necessary public or private benefits or 

services. Because the payments for child 

care services provided under paragraph 

(h) are intended to be temporary, VA 

would require that grantees assist in 

developing and implementing such plan 

to ensure that participants are able to 

plan for such services in the long-term 

as needed. 

78.85 Suicide Prevention Services: 

Nontraditional and Innovative 

Approaches and Treatment Practices 

Section 78.85 explains that grantees 

providing or coordinating the provision 

of nontraditional and innovative 

approaches and treatment practices may 

provide or coordinate the provision of 

nontraditional and innovative 

approaches and treatment, including but 

not limited to complementary or 

alternative interventions with some 

evidence for effectiveness of improving 

mental health or mitigating a risk factor 

for suicidal thoughts and behavior, as 

set forth in the NOFO or as approved by 

VA that are consistent with SSG Fox 

SPGP. Applicants may propose 

nontraditional and innovative 

approaches and treatment practices in 

their suicide prevention services grant 

application, and grantees may propose 

these additional approaches and 

treatment practices by submitting a 

written request to modify the suicide 

prevention services grant in accordance 

with § 78.125. 

VA is authorized under section 

201(f)(1) of the Act to include such 

commitments as it considers necessary 

to carry out this section. VA is 

exercising this authority here by 

reserving the right to approve or 

disapprove nontraditional and 

innovative approaches and treatment 

practices to be provided or coordinated 

to be provided using funds authorized 

under SSG Fox SPGP. These approaches 

and treatment practices can evolve, and 

by maintaining the right to approve or 

disapprove these treatment practices or 

approaches, VA can ensure that 

participants receive approaches and 

treatment practices that are safe and 

effective. VA is not providing a broad 

list of approved innovative approaches 

and treatment practices to allow for 

emerging services with some evidence 

in suicide risk reduction the 

opportunity for review and selection. It 

is also important for VA to note that any 

approaches and treatment practices 

approved will need to be consistent 

with applicable Federal law. For 

example, the use of grant funds to 

provide or coordinate the provision of 

marijuana to eligible individuals and 

their families will be prohibited, as 

marijuana is currently illegal under 

Federal law. 


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78.90 Suicide Prevention Services: 

Other Services 

The definition of suicide prevention 

services in section 201(q)(11)(A)(xi) of 

the Act includes other services 

necessary for improving the mental 

health status and wellbeing and 

reducing the suicide risk of eligible 

individuals and their families as the 

Secretary considers appropriate. 

Consistent with section 

201(q)(11)(A)(xi) of the Act, section 

78.90(a) explains general suicide 

prevention assistance that may be 

provided under this grant program. 

Pursuant to paragraph (a), a grantee may 

pay directly to a third party (and not to 

a participant), in an amount not to 

exceed $750 per participant during any 

1-year period, beginning on the date that 

the grantee first submits a payment to a 

third party, the following types of 

expenses: (i) Expenses associated with 

gaining or keeping employment, such as 

uniforms, tools, certificates, and 

licenses; and (ii) expenses associated 

with lethal means safety and secure 

storage, such as gun locks and locked 

medication storage. 

A limit of $750 per participant per 

year is an appropriate amount because 

such items as gun storage and locks can 

cost anywhere from $20 to several 

hundred dollars. Similarly, for purposes 

of employment, licenses and uniforms 

can range from several dollars to several 

hundred dollars. The amount of $750 

per year also is consistent with the 

amount of similar assistance authorized 

under the SSVF program of $1,500 every 

2 years. See 38 CFR 62.34(e)(2). 

VA would allow payment for 

expenses associated with gaining or 

keeping employment as extended 

unemployment may lead to mental 

health issues and financial hardship. 

See Haw, C., K. Hawton, D. Gunnell, 

and S. Platt. 2015. Economic recession 

and suicidal behavior: Possible 

mechanisms and ameliorating factors. 

International Journal of Social 

Psychiatry 61, no. 1:73–81. Thus, it 

would be appropriate to cover these as 

other services as these would be 

necessary for improving the mental 

health status and wellbeing and 

reducing the suicide risk of eligible 

individuals and their families. 

VA would also allow payment for 

expenses associated with lethal means 

safety and secure storage, as these 

would also be services necessary for 

improving the wellbeing and reducing 

the suicide risk of eligible individuals 

and their families. In 2018, 68.2 percent 

of Veteran suicide deaths were due to a 

self-inflicted firearm injury, while 48.2 

percent of non-Veteran adult suicides 

resulted from a firearm injury. In 2018, 

69.4 percent of male veteran suicide 

deaths and 41.9 percent of female 

veteran suicide deaths resulted from a 

firearm injury. In 2018, firearms were 

used in 41.9 percent of suicide deaths 

among women veterans, compared to 

31.7 percent of suicide deaths among 

non-veteran women. See VA’s 2020 

National Veteran Suicide Prevention 

Annual Report. (Available online: 

https://www.mentalhealth.va.gov/docs/ 

data-sheets/2020/2020-NationalVeteran-Suicide-Prevention-AnnualReport-11-2020-508.pdf.) Research has 

shown that when lethal means are made 

less accessible or lethal, suicide rates by 

those means decline. See, Gunnell D 

and Eddleston M. Suicide by intentional 

ingestion of pesticides: A continuing 

tragedy in developing countries. 

International Journal of Epidemiology. 

2003;32:902–909; Gunnell D, Fernando 

R, Hewagama M, Priyangika WD, 

Konradsen F, Eddleston M. The impact 

of pesticide regulations on suicide in Sri 

Lanka. Int J Epidemiol. 

2007;36(6):1235–42; Kreitman N. The 

coal gas story. United Kingdom suicide 

rates, 1960–71. Br J Prev Soc Med. 1976 

Jun;30(2):86–93; Hawton K. United 

Kingdom legislation on pack sizes of 

analgesics: Background, rationale, and 

effects on suicide and deliberate selfharm. Suicide and Life-Threatening 

Behavior. 2002;32(3):223–229. 

Furthermore, increasing time and space 

between individuals facing a suicidal 

crisis and a firearm has been shown to 

prevent suicide. Lubin, G., Werbeloff, 

N., Halperin, D., Shmushkevitch, M., 

Weise, M, & Knobler, H. (2010), Suicide 

& Life-Threatening Behavior, 40(5), 421– 

424. Thus, VA believes it is appropriate 

to allow payment for expenses 

associated with lethal means safety and 

secure storage, as these would also be 

services necessary for improving the 

wellbeing and reducing the suicide risk 

of eligible individuals and their 

families. 

Paragraph (b) explains that grantees 

providing or coordinating the provision 

of other suicide prevention services may 

provide or coordinate the provision of 

other services as set forth in the NOFO 

or as approved by VA that are consistent 

with SSG Fox SPGP. Applicants may 

propose additional services in their 

suicide prevention services grant 

application, and grantees may propose 

additional services by submitting a 

written request to modify the suicide 

prevention services grant program in 

accordance with § 78.125. VA reserves 

the right to approve or disapprove other 

suicide prevention services to be 

provided or coordinated to be provided 

using funds authorized under SSG Fox 

SPGP. This is consistent with how VA 

authorizes additional services for the 

SSVF Program (see 38 CFR 62.34) and 

is authorized by the statute as noted 

above. 

Section 201(q)(11)(A)(xi) includes as 

examples of services the Secretary may 

include adaptive sports, equine assisted 

therapy, or in-place or outdoor 

recreational therapy; substance use 

reduction programming; individual, 

group, or family counseling; and 

relationship coaching. VA is not 

identifying these services as expressly 

covered in its regulations, but 

applicants may propose these services 

in their grant application. VA believes 

Congress included these as examples of 

other services to ensure that applicants 

proposing to furnish these services 

would be able to do so if VA determines 

that such services are appropriate and 

likely for the purpose of reducing 

veteran suicide. VA believes the list in 

section 201(q)(11)(A)(xi) also is 

indicative of the types of other services 

that may be approved. VA believes the 

intent of this section of law is to provide 

flexibility for different approaches; thus, 

VA is not regulating these services 

further to preserve that flexibility. 

Paragraph (b) will control the 

disposition of any requests by 

applicants and grantees to offer these or 

other services. 

78.95 General Operation Requirements 

In § 78.95, VA establishes 

requirements for the general operation 

of suicide prevention services programs. 

Paragraph (a) explains that prior to 

providing suicide prevention services, 

grantees must verify, document, and 

classify each participant’s eligibility for 

suicide prevention services and 

determine and document each 

participant’s degree of risk of suicide 

using tools identified in the suicide 

prevention services grant agreement. 

Such documentation must be 

maintained consistent with § 78.150. 

This ensures that grantees are providing 

services and using grant funds for those 

who are eligible for such services under 

this grant program and consistent with 

the Act. 

Paragraph (b) explains that prior to 

services ending, grantees must provide 

or coordinate the provision of a mental 

health screening to all participants they 

serve, when possible. This screening 

must be conducted with the same tool 

used to conduct the baseline mental 

health screening under § 78.50. Having 

this screening occur at the beginning 

(pursuant to § 78.50) and prior to 

services ending is important in 

evaluating the effectiveness of the 


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services provided, when possible. VA 

acknowledges that some participants 

may leave services early or opt out of 

screening so meeting this requirement 

may not always be possible. Thus, the 

language ‘‘when possible’’ is included 

in paragraph (b). 

Under paragraph (c), for each 

participant who receives suicide 

prevention services from the grantee, 

the grantee must document the suicide 

prevention services provided or 

coordinated, how such services are 

provided or coordinated, the duration of 

the services provided or coordinated, 

and any goals for the provision or 

coordination of such services. Such 

documentation must be maintained 

consistent with § 78.150. This is 

information eligible entities typically 

maintain regarding the provision or 

coordination of these or similar services. 

Additionally, this information may be 

requested by VA for purposes of 

monitoring the grantee’s operation and 

compliance with these regulations 

(under §§ 78.135 and 78.145), will be 

collected as part of the grantee’s 

reporting requirements in § 78.145, and 

will be required to be maintained for at 

least three years (consistent with the 

recordkeeping requirements in 

§ 78.150), and may be requested by VA 

for auditing and evaluation purposes. 

Consistent with section 201(e) of the 

Act, in paragraph (d)(1), prior to 

initially providing or coordinating 

suicide prevention services to an 

eligible individual and their family, the 

grantee is required to notify each 

eligible individual and their family that 

the suicide prevention services are 

being paid for, in whole or in part, by 

VA; the suicide prevention services 

available to the eligible individual and 

their family through the grantee’s 

program; any conditions or restrictions 

on the receipt of suicide prevention 

services by the eligible individual and 

their family; and in the instance of an 

eligible individual who receives 

assistance from the grantee under this 

program, that the eligible individual is 

able to apply for enrollment in VA 

health care pursuant to 38 CFR 17.36. If 

the eligible individual wishes to enroll 

in VA health care, the grantee must 

inform the eligible individual of a VA 

point of contact for assistance in 

enrollment. These requirements 

concerning information about 

enrollment are consistent with section 

201(e)(3) of the Act. While not every 

eligible individual may be able to enroll 

in VA health care under § 17.36, they 

can apply to determine their eligibility. 

It may not be possible to know at the 

time the eligible individual expresses an 

interest in enrolling in VA health care 

whether or not the person is a veteran 

under 38 U.S.C. 101(2), so VA is using 

the term eligible individual, as it is 

more inclusive and potentially a more 

accurate description of the person at the 

point of time this information is 

provided. Other than members of the 

Armed Forces who are included as an 

eligible individual through reference to 

38 U.S.C. 1712A(a)(1)(C)(i)–(iv), eligible 

individuals may be able to enroll in VA 

health care. Consequently, VA includes 

an exception in paragraph (d)(1)(iv) 

stating that the requirements in this 

clause do not apply to eligible 

individuals who are members of the 

Armed Forces described in section 

1712A(a)(1)(C)(i)–(iv) of title 38, United 

States Code. 

In paragraph (d)(2), grantees must 

provide each participant with a 

satisfaction survey, which the 

participant can submit directly to VA, 

within 30 days of such participant’s 

pending exit from the grantee’s program. 

This is required to assist VA in 

evaluating grantees’ performance and 

participants’ satisfaction with the 

suicide prevention services they receive. 

This is consistent with the SSVF 

Program (see 38 CFR 62.36(c)(2)). 

Paragraph (e) requires that grantees 

regularly assess how suicide prevention 

services grant funds can be used in 

conjunction with other available funds 

and services to assist participants. This 

is consistent with the SSVF Program 

(see § 62.36(d)) and encourages grantees 

to leverage other financial resources to 

ensure continuity of program operations 

and assistance to participants. 

Paragraph (f) requires that for each 

participant, grantees must develop and 

document an individualized a plan with 

respect to the provision of suicide 

prevention services provided under this 

part. Consistent with section 201(e)(2) of 

the Act, this plan must be developed in 

consultation with the participant and 

must be maintained consistent with 

§ 78.150. This requirement would 

ensure that a plan is developed to 

address the needs of participants. Such 

plan would include, but not be limited 

to, the suicide prevention services 

needed, the goals and objectives of the 

plan, and the applicable services. This 

plan would allow grantees and VA to 

monitor the delivery of suicide 

prevention services to participants. VA 

would include information about the 

suicide prevention services plan in the 

program guide developed for grantees. 

This requirement for a suicide 

prevention services plan is also 

authorized under section 201(f)(1) of the 

Act, as VA has authority to include such 

commitments as it considers necessary 

to carry out this section. 

In paragraph (g), VA requires grantees 

to coordinate with VA with respect to 

the provision of health care and other 

services to eligible individuals under 38 

U.S.C. Chapters 17 and 20. This is 

consistent with the requirements in 

section 201(e)(3)(A), (m), and (n) of the 

Act. VA expects that grantees will work 

with local VA facilities on a regular 

basis to coordinate care when needed 

for eligible individuals. 

Consistent with section 201(e)(4) of 

the Act, VA requires in paragraph (h) 

that the grantee submit to VA a 

description of the tools and assessments 

the grantee uses or will use to determine 

the effectiveness of the suicide 

prevention services furnished by the 

grantee. These include any measures 

and metrics developed and provided by 

VA for the purposes of measuring the 

effectiveness of the programming to be 

provided in improving mental health 

status and wellbeing, and reducing 

suicide risk and suicide deaths of 

eligible individuals. While the Act uses 

the phrase ‘‘completed suicides’’, VA 

uses the term ‘‘suicide deaths’’, as that 

is the terminology commonly used by 

VA. VA recognizes that messaging and 

language around suicide attempts and 

suicide death has an impact on beliefs 

and attitudes related to suicide. Thus, 

VA has developed a Safe Messaging Best 

Practices guide for public use regarding 

this topic. See https://www.mental

health.va.gov/suicide_prevention/docs/ 

OMH-086-VA-OMHSP-Safe-MessagingFactsheet-4-9-2019.pdf. 

Consistent with section 201(o) of the 

Act, under paragraph (i), only grantees 

that are a State or local government or 

an Indian tribe are able to use grant 

funds to enter into an agreement with a 

community partner under which the 

grantee may provide funds to the 

community partner for the provision of 

suicide prevention services to eligible 

individuals and their families. 

Paragraph (j) explains that grantees 

may enter into contracts for goods or 

services under this part. Section 

201(o)(2) of the Act states that the 

ability of a grantee to provide grant 

funds to a community partner is limited 

to grantees that are a State or local 

government or an Indian tribe. VA does 

not interpret section 201(o)(2) of the Act 

to prohibit a grantee from using funds 

provided under this part to pay vendors 

or contractors for certain services, as VA 

does not interpret the term ‘‘community 

partner’’ to limit such arrangements. 

Indeed, VA believes that if the term 

‘‘community partner’’ prohibited the use 

of grant funds to be used to pay vendors 

and other contractors, section 201(o)(2) 

of the Act would effectively bar any 

entity that was not a State or local 


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government, or an Indian tribe, from 

participating in the grant program, or at 

least from providing many of the suicide 

prevention services defined in this rule. 

VA understands that the intent behind 

section 201(o)(2) of the Act was to 

clarify that only State or local 

governments and Indian tribes are able 

to provide sub-grants to community 

partners. VA’s interpretation, which 

permits grantees to use grant funds to 

pay vendors and contractors for goods 

and services, is consistent with this 

intent and is necessary for effective 

operation of the program. No nongovernmental entity, and likely no 

governmental entity, would be able to 

provide the full range of services 

identified as suicide prevention services 

in section 201(q)(11) of the Act absent 

the ability to pay vendors and 

contractors for goods and services. For 

example, assistance with emergent 

needs related to transportation services 

under section 201(q)(11)(A)(ix) often 

involves the provision of tokens or 

vouchers for use of transportation 

services such as buses or rail. However, 

no non-governmental entity, and few 

governmental entities, actually operate 

the transportation systems that would 

be needed to provide this assistance, so 

any effort to provide support with 

transportation services would require 

the use of grant funds to obtain goods 

or services from another party that is not 

a community partner. Similarly, 

Congress authorized up to $5,000 in 

assistance per family of an eligible 

individual per fiscal year for child care 

in section 201(q)(11)(A)(ix)(VIII) of the 

Act. Including a cap on the amount of 

funds that could be used for such 

services would not make sense unless 

Congress intended for grantees to be 

able to use grant funds to purchase 

goods and services like child care. 

Taken to its logical extreme, if section 

201(o)(2) of the Act were to prohibit 

non-governmental grantees from 

providing any grant funds to any other 

party, these grantees would be 

prohibited from using grant funds to pay 

their utility bills, purchase office 

supplies, or pay rent. VA does not 

believe that such a result could possibly 

have been intended by Congress. 

VA further believes that existing 

Federal regulations concerning the use 

of grants, set forth in 2 CFR part 200, 

support VA’s interpretation. For 

example, 2 CFR 200.1 provides 

definitions applicable to the uniform 

administrative requirements, cost 

principles, and audit requirements for 

Federal awards. These regulations 

define the term ‘‘contract’’, for purposes 

of Federal financial assistance, as a legal 

instrument by which a recipient or 

subrecipient purchases property or 

services needed to carry out the project 

or program under a Federal award. This 

is clearly distinguished from a 

subaward, which is an award provided 

by a pass-through entity to a 

subrecipient for the subrecipient to 

carry out part of a Federal award 

received by the pass-through entity; 

subawards do not include payments to 

a contractor or payments to an 

individual that is a beneficiary of a 

Federal program. In this context, VA 

interprets section 201(o)(2) of the Act as 

limiting the use of subawards but not 

contracts by grantees. Grantees may 

choose to enter into contracts because in 

some situations, resources may be more 

readily available at a lower cost, or they 

may only be available, from another 

party in the community. 

Lastly, in paragraph (k), VA requires 

grantees to ensure that suicide 

prevention services grants are 

administered in accordance with the 

requirements of part 78, the suicide 

prevention services grant agreement, 

and other applicable Federal, State, and 

local laws and regulations, including 

Federal civil rights laws. Grantees must 

ensure that any community partners 

carry out activities in compliance with 

this part. This is consistent with how 

VA administers the SSVF Program (see 

§ 62.36(e)). 

78.100 Fee Prohibition 

In § 78.100, VA prohibits grantees 

from charging a fee to participants for 

providing suicide prevention services 

that are funded with amounts from a 

suicide prevention services grant. VA 

believes this prohibition is appropriate 

because charging a fee could be a barrier 

to receiving care and services. There 

may be eligible individuals who may 

not be able to afford to pay any fees or 

those who do not otherwise seek care 

and services under this grant program 

because they do not want to pay a fee. 

Because of the importance of the 

services, including referrals to VA care 

as appropriate, provided under this 

grant program to eligible individuals at 

risk of suicide, VA does not want 

financial liability for fees to result in an 

eligible individual not receiving such 

critical services that may save such 

individual’s life, as doing so would be 

inconsistent with the purpose of this 

grant program under section 201 of the 

Act to reduce suicide among veterans. 

This prohibition is authorized by 

section 201(f)(1) of the Act, which 

permits VA to include such 

commitments as the Secretary considers 

necessary to carry out this section. This 

is also similar to other prohibitions that 

have been implemented for other, 

similar grant programs, such as the 

SSVF Program (see 38 CFR 62.37). VA 

also notes that collecting and processing 

fees would increase administrative costs 

and time for the grantee, which would 

negatively affect the provision of 

services to eligible individuals. 

78.105 Ineligible Activities 

Section 78.105 sets forth certain 

activities for which grantees will not be 

authorized to use suicide prevention 

services grant funds. Pursuant to section 

201(q)(11)(B) of the Act, direct cash 

assistance to participants is prohibited, 

which is reflected in paragraph (a). 

Other prohibited activities are set forth 

in paragraphs (b) through (d) to include 

those legal services prohibited pursuant 

to § 78.80(g); medical or dental care and 

medicines except for clinical services 

for emergency treatment authorized 

pursuant to § 78.60; and any activities 

considered illegal under Federal law. 

Some of the items on this list of 

ineligible activities are consistent with 

those prohibited under the SSVF 

Program (see 38 CFR 62.38). However, 

VA does not feel it is necessary to 

include all of the activities that are 

ineligible under the SSVF program as 

these programs have distinct purposes, 

and many of those ineligible activities 

(for example, mortgage costs) are not 

necessarily applicable to the suicide 

prevention grant program. If VA wanted 

to include any of those activities under 

this grant program, such activities 

would be subject to § 78.90. Similarly, 

VA does not think it is necessary to list 

every ineligible activity as all activities 

would be subject to the requirements in 

part 78. VA also notes that 2 CFR part 

200 prohibits the use of grant awards for 

certain activities, such as entertainment. 

Such prohibitions are applicable to 

suicide prevention services grants 

awarded under part 78. However, it is 

unnecessary to include that language in 

§ 78.105 because 2 CFR part 200 

controls the administration of these 

grants regardless of whether explicit 

language exists in part 78. 

78.110 Notice of Funding Opportunity 

Consistent with existing processes for 

other VA grant programs, VA will notify 

the public, through a NOFO, when 

funds for this grant program are 

available. Section 78.110 explains that 

when funds are available for the grant 

program, VA will publish a NOFO on 

grants.gov. It also describes the 

information that will be included in 

such NOFO, including the location for 

obtaining suicide prevention services 

grant applications; the date, time, and 

place for submitting completed suicide 


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prevention services grant applications; 

the estimated amount and type of 

suicide prevention services grant 

funding available; any priorities for or 

exclusions from funding to meet the 

statutory mandates of section 201 of the 

Act and VA’s goals for SSG Fox SPGP; 

the length of term for the suicide 

prevention services grant award; the 

minimum number of total points and 

points per category that an applicant or 

grantee, as applicable, must receive for 

a suicide prevention services grant to be 

funded; any maximum uses of suicide 

prevention services grant funds for 

specific suicide prevention services; the 

timeframes and manner for payments 

under the suicide prevention services 

grant; and other information necessary 

for the suicide prevention services grant 

application process as determined by 

VA. 

This is consistent with the 

requirements and recommendations 

within 2 CFR part 200 regarding notices 

of funding opportunity (see 2 CFR 

200.204). 

78.115 Suicide Prevention Services 

Grant Agreements 

Consistent with other the SSVF 

Program (see 38 CFR 62.50) and 2 CFR 

200.201, section 78.115 explains that 

VA and the selected applicant will enter 

into an agreement prior to obligating 

funds under part 78 and sets forth 

requirements that will be included in 

such agreement. Section 200.201 

requires that Federal awarding agencies 

must decide on the appropriate 

instrument for Federal awards. Such 

appropriate instruments include grant 

agreements, which VA uses for the 

SSVF Program (see 38 CFR 62.50). This 

is also authorized by section 201(f)(1) of 

the Act, which permits VA to include 

such commitments as the Secretary 

considers necessary to carry out this 

section. 

This agreement will be enforceable 

against the grantee, providing VA 

assurance that the grantee will use the 

suicide prevention services grant funds 

in the manner described in the 

application and in accordance with the 

requirements of part 78. 

Paragraph (a) states that after an 

applicant is selected for a suicide 

prevention services grant in accordance 

with § 78.30, VA will draft a suicide 

prevention services grant agreement to 

be executed by VA and the applicant. 

Upon execution of the suicide 

prevention services grant agreement, VA 

will obligate suicide prevention services 

grant funds to cover the amount of the 

approved suicide prevention services 

grant, subject to the availability of 

funding. Such agreement will provide 

that the grantee agrees, and will ensure 

that each community partner agrees, to 

operate the program in accordance with 

the provisions of part 78 and the 

applicant’s suicide prevention services 

grant application; comply with such 

other terms and conditions, including 

recordkeeping and reports for program 

monitoring and evaluation purposes, as 

VA may establish for purposes of 

carrying out SSG Fox SPGP, in an 

effective and efficient manner; and 

provide such additional information as 

deemed appropriate by VA. 

Paragraph (b) explains that after a 

grantee is selected for renewal of a 

suicide prevention services grant in 

accordance with § 78.40, VA will draft 

a suicide prevention services grant 

agreement to be executed by VA and the 

grantee. Upon execution of the suicide 

prevention services grant agreement, VA 

will obligate suicide prevention services 

grant funds to cover the amount of the 

approved suicide prevention services 

grant, subject to the availability of 

funding. Such grant agreement will 

contain the same provisions described 

in paragraph (a) of this section. 

Pursuant to paragraph (c), no funds 

provided under part 78 may be used to 

replace Federal, State, tribal, or local 

funds previously used, or designated for 

use, to assist eligible individuals and 

their families. 

78.120 Amount and Payment of Grants 

Consistent with section 201(c)(2)(A) 

of the Act, § 78.120(a) states that the 

maximum funding that a grantee may be 

awarded under part 78 is $750,000 per 

fiscal year. VA may provide less than 

$750,000 per award per its discretion 

under section 201 of the Act. As 

explained in § 78.110, the NOFO will 

identify the estimated amount of grant 

funding available. However, because of 

the statutory restriction, VA will not 

provide more than $750,000 per grantee 

per fiscal year. 

Section 78.120(b) explains that 

grantees are to be paid in accordance 

with the timeframes and manner set 

forth in the NOFO. Section 201(c)(2)(B) 

of the Act authorizes VA to establish 

intervals of payment for purposes of this 

grant program, and VA will do so in the 

NOFO, which is consistent with how 

VA establishes payment in other grant 

programs. See 38 CFR 62.51. Including 

such information in the NOFO provides 

VA with the flexibility to determine the 

time and manner of payment for suicide 

prevention services grants that is 

appropriate for each funding cycle. 

78.125 Program or Budget Changes 

and Corrective Action Plans 

Section 78.125 sets forth the 

requirements if there are changes to the 

program or budget that alter the 

grantee’s suicide prevention services 

grant program. This section is consistent 

with 2 CFR 200.308 which establishes 

policy and processes for revision of 

budget and program plans for Federal 

awards. These requirements are 

authorized by section 201(f)(1) of the 

Act, which permits VA to include such 

commitments as the Secretary considers 

necessary to carry out this section. 

These requirements are also consistent 

with how VA handles program and 

budget changes and corrective action 

plans in the SSVF Program (see 62 CFR 

62.60) and allow VA to ensure that grant 

funds are used appropriately and to 

maintain control over the quality of 

suicide prevention services provided by 

the grantee. 

Paragraph (a) states that a grantee 

must submit to VA a written request to 

modify a suicide prevention services 

grant for any proposed significant 

change that will alter the suicide 

prevention services grant program. It 

further explains that if VA approves 

such change, it will issue a written 

amendment to the suicide prevention 

services grant agreement. A grantee 

must receive VA’s approval prior to 

implementing a significant change. 

Significant changes include, but are not 

limited to, a change in the grantee or 

any community partners identified in 

the suicide prevention services grant 

agreement; a change in the area served 

by the grantee; additions or deletions of 

suicide prevention services provided by 

the grantee; a change in category of 

participants to be served; and a change 

in budget line items that are more than 

10 percent of the total suicide 

prevention services grant award. VA’s 

approval of changes will be contingent 

upon the grantee’s amended application 

retaining a sufficient rank to have been 

competitively selected for funding in 

the year that the application was 

granted, and each suicide prevention 

services grant modification request will 

be required to contain a description of, 

and justification for, the revised 

proposed use of suicide prevention 

services grant funds. 

Under paragraph (b), VA may require 

that the grantee initiate, develop, and 

submit to VA for approval a Corrective 

Action Plan (CAP) if, on a quarterly 

basis, actual suicide prevention services 

grant expenditures vary from the 

amount disbursed to a grantee for that 

same quarter or actual suicide 

prevention services grant activities vary 


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from the grantee’s program description 

provided in the suicide prevention 

services grant agreement. Paragraph (b) 

also sets forth specific requirements 

related to the CAP. These include that 

the CAP must identify the expenditure 

or activity source that has caused the 

deviation, describe the reason(s) for the 

variance, provide specific proposed 

corrective action(s), and provide a 

timetable for accomplishment of the 

corrective action. After receipt of the 

CAP, VA will send a letter to the grantee 

indicating that the CAP is approved or 

disapproved. If disapproved, VA will 

make beneficial suggestions to improve 

the proposed CAP and request 

resubmission or take other actions in 

accordance with this part. 

Paragraph (c) explains that grantees 

are required to inform VA in writing of 

any key personnel changes (e.g., new 

executive director, suicide prevention 

services grant program director, or chief 

financial officer) and grantee address 

changes within 30 days of the change. 

78.130 Faith-Based Organizations 

As VA anticipates that religious or 

faith-based organizations may apply for 

grants under part 78, § 78.130 explains 

that religious or faith-based 

organizations are eligible for suicide 

prevention services grants and describes 

the conditions for use of these grants as 

they relate to religious activities. This is 

similar to the language used in the 

Homeless Providers Grant and Per Diem 

Program (38 CFR 61.64) and the SSVF 

Program (38 CFR 61.62). However, VA 

has moved the definitions of indirect 

financial assistance and direct federal 

financial assistance to the definitions 

section of part 78. 

Under paragraph (a), organizations 

that are faith-based will be eligible, on 

the same basis as any other 

organization, to participate in SSG Fox 

SPGP under part 78. Decisions about 

awards of Federal financial assistance 

must be free from political interference 

or even the appearance of such 

interference and must be made on the 

basis of merit, not on the basis of 

religion or religious belief or lack 

thereof. 

Paragraph (b)(1) states that no 

organization may use direct financial 

assistance from VA under this part to 

pay for any of the following: (i) 

Explicitly religious activities such as, 

religious worship, instruction, or 

proselytization; or (ii) equipment or 

supplies to be used for any of those 

activities. Paragraph (b)(2) states that 

references to financial assistance are 

deemed to be references to direct 

Federal financial assistance, unless the 

referenced assistance meets the 

definition of indirect Federal financial 

assistance in part 78. 

Under paragraph (c), organizations 

that engage in explicitly religious 

activities, such as worship, religious 

instruction, or proselytization, must 

offer those services separately in time or 

location from any programs or services 

funded with direct financial assistance 

from VA under this part, and 

participation in any of the 

organization’s explicitly religious 

activities must be voluntary for the 

participants in a program or service 

funded by direct financial assistance 

from VA under part 78. 

Paragraph (d) states that a faith-based 

organization that participates in SSG 

Fox SPGP under part 78 will retain its 

independence from Federal, State, or 

local governments. It further states that 

such organizations may continue to 

carry out its mission, including the 

definition, practice and expression of its 

religious beliefs, so long as the 

organization does not use direct 

financial assistance from VA under part 

78 to support any explicitly religious 

activities, such as worship, religious 

instruction, or proselytization. Faithbased organizations may use space in 

their facilities to provide VA-funded 

services under part 78, without 

concealing, removing, or altering 

religious art, icons, scripture, or other 

religious symbols. In addition, a VAfunded faith-based organization retains 

its authority over its internal 

governance, and it may retain religious 

terms in its organization’s name, select 

its board members and otherwise govern 

itself on a religious basis, and include 

religious reference in its organization’s 

mission statements and other governing 

documents. 

Under paragraph (e), an organization 

that participates in a VA program under 

this part must not, in providing direct 

program assistance, discriminate against 

a program participant or prospective 

program participant on the basis of 

religion or religious belief. 

Under paragraph (f), if a State or local 

government voluntarily contributes its 

own funds to supplement Federally 

funded activities, the State or local 

government has the option to segregate 

the Federal funds or commingle them. 

However, if the funds are commingled, 

this provision applies to all of the 

commingled funds. 

Under paragraph (g), to the extent 

otherwise permitted by Federal law, the 

restrictions on explicitly religious 

activities set forth in this section do not 

apply where VA funds are provided to 

faith-based organizations through 

indirect assistance as a result of a 

genuine and independent private choice 

of a participant, provided the faithbased organizations otherwise satisfy 

the requirements of this part. A faithbased organization may receive such 

funds as the result of a participant’s 

genuine and independent choice if, for 

example, a participant redeems a 

voucher, coupon, or certificate, allowing 

the participant to direct where funds are 

to be paid, or a similar funding 

mechanism provided to that participant 

and designed to give that participant a 

choice among providers. 

78.135 Visits to Monitor Operation 

and Compliance 

Section 78.135(a) authorizes VA, at all 

reasonable times, to make visits to all 

grantee locations where a grantee is 

using suicide prevention services grant 

funds to review grantee 

accomplishments and management 

control systems and to provide such 

technical assistance as may be required. 

VA may also conduct inspections of all 

program locations and records of a 

grantee at such times as are deemed 

necessary to determine compliance with 

the provisions of this part. In the event 

that a grantee delivers services in a 

participant’s home, or at a location away 

from the grantee’s place of business, VA 

may accompany the grantee. If the 

grantee’s visit is to the participant’s 

home, VA will only accompany the 

grantee with the consent of the 

participant. If any visit is made by VA 

on the premises of the grantee or a 

community partner under the suicide 

prevention services grant, the grantee 

must provide, and must require its 

community partners to provide, all 

reasonable facilities and assistance for 

the safety and convenience of the VA 

representatives in the performance of 

their duties. All visits and evaluations 

will be performed in such a manner as 

will not unduly delay services. 

Paragraph (b) explains that the 

authority to inspect carries with it no 

authority over the management or 

control of any applicant or grantee 

under this part. 

These provisions are critical for VA 

oversight over suicide prevention 

services grants and are consistent with 

how VA administers other grant 

programs (see 38 CFR 61.65 and 62.63). 

These provisions are authorized by 

section 201(f)(1) and 201(g) of the Act, 

which authorize VA to require eligible 

entities seeking grants to provide such 

commitments and information as VA 

considers necessary and require VA to 

provide training and technical 

assistance to eligible entities in receipt 

of grants. These provisions are also 

consistent with 2 CFR 200.329 regarding 


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monitoring and reporting program 

performance for Federal awards. 

78.140 Financial Management and 

Administrative Costs 

Section 78.140 sets forth requirements 

with which grantees must comply and 

ensures that grantees are aware of these 

requirements. These requirements are 

consistent with other grant programs, 

such as the SSVF Program (see 38 CFR 

62.70) and the Homeless Providers 

Grant and Per Diem Program (see 38 

CFR 61.66). 

Paragraph (a) requires grantees to 

comply with applicable requirements of 

the Uniform Administrative 

Requirements, Cost Principles, and 

Audit Requirements for Federal Awards 

under 2 CFR part 200. Part 200 of 2 CFR 

establishes the uniform administrative 

requirements, cost principles, and audit 

requirements for Federal awards to nonFederal entities. 

Paragraph (b) requires grantees use a 

financial management system that 

provides adequate fiscal control and 

accounting records and meets the 

requirements set forth in 2 CFR part 

200. 

Under paragraph (c), payment up to 

the amount specified in the suicide 

prevention services grant must be made 

only for allowable, allocable, and 

reasonable costs in conducting the work 

under the suicide prevention services 

grant, and the determination of 

allowable costs must be made in 

accordance with the applicable Federal 

Cost Principles set forth in 2 CFR part 

200. 

Paragraph (d) prohibits costs for 

administration by a grantee from 

exceeding 10 percent of the total 

amount of the suicide prevention 

services grant. Administrative costs 

include all costs associated with the 

management of the program and include 

the administrative costs of community 

partners. 

VA has determined this limitation on 

administrative costs to be reasonable 

and consistent with the purpose of SSG 

Fox SPGP, as VA believes it is important 

that almost all of funding provided by 

VA goes towards providing services for 

participants. This requirement ensures 

that the vast majority of suicide 

prevention services grant funds (at least 

90 percent) are used to provide suicide 

prevention services to participants. 

These requirements are also consistent 

with the SSVF Program, which allows 

only 10 percent of the grant funds to be 

used for specified administrative costs. 

See 38 CFR 62.10. VA has not identified 

any issues with this limitation in the 

context of the SSVF program. VA 

believes that 10 percent is a reasonable 

maximum for administrative costs, and 

any additional funds needed by grantees 

to administer the suicide prevention 

services should be provided by non-VA 

funds. 

78.145 Grantee Reporting 

Requirements 

Section 78.145 sets forth reporting 

requirements regarding the projects 

carried out using grant funds provided 

under part 78. Such reporting 

requirements ensure that grants funds 

are being properly used in accordance 

with the Act and with part 78, and that 

VA is being a good fiscal steward of the 

taxpayer dollar. These reporting 

requirements are consistent with 

subsections (e)(5) and (k) of section 201 

of the Act. Section 201(e)(5)(A) 

mandates that VA require each entity 

receiving a suicide prevention services 

grant to submit to VA an annual report 

that describes the projects carried out 

with such grant during the year covered 

by the report. Section 201(e)(5)(C) 

further authorizes VA to require each 

such entity to submit to VA such 

additional reports as VA considers 

appropriate. Section 201(k) of the Act 

requires VA to submit an interim report 

and final report on the provision of 

grants to eligible entities under part 78 

to the appropriate committees of 

Congress. Subsection (k)(1)(C) further 

provides VA with the authority to 

require eligible entities to provide to 

Congress such information as VA 

determines necessary regarding certain 

information that must be included in 

such reports. These provisions of 

section 201 of the Act are implemented 

in paragraphs (b) and (c), as explained 

in more detail below. Additionally, 

these reporting requirements are 

consistent with how VA administers the 

SSVF Program. See 38 CFR 62.71. 

In paragraph (a), VA reserves the right 

to require grantees to provide, in any 

form as may be prescribed, such reports 

or answers in writing to specific 

questions, surveys, or questionnaires as 

VA determines necessary to carry out 

SSG Fox SPGP. 

Consistent with section 201(e)(5)(A) 

of the Act, paragraph (b) requires that at 

least once per year, each grantee must 

submit to VA a report that describes the 

projects carried out with such grant 

during the year covered by the report; 

and information relating to operational 

effectiveness, fiscal responsibility, 

suicide prevention services grant 

agreement compliance, and legal and 

regulatory compliance, including a 

description of the use of suicide 

prevention grant funds, the number of 

participants assisted, the types of 

suicide prevention services provided, 

and any other information that VA may 

request. The information gathered in 

this report should also support VA in 

carrying out its responsibilities under 

section 201(k) of the Act in providing 

necessary information to Congress to 

facilitate its oversight of this program. 

Under paragraph (c), VA retains the 

discretion to request additional reports 

or information to be able to fully assess 

the provision or coordination of the 

provision of suicide prevention services 

under part 78. This is a catch-all 

provision to allow VA to request 

additional reports or information that it 

may need to further assess the project 

and the pilot program. These will vary 

on a case-by-case basis dependent on 

the project and its progression. 

Additionally, if VA is required to 

submit additional reports to Congress on 

this pilot program, VA reserves the right 

under this paragraph to request such 

information as needed to respond to 

Congress. This also provides a safeguard 

in instances where there may be 

confusing, misleading, inconsistent, or 

unclear statements in submitted reports. 

VA reserves the right to request 

additional reports to clarify any such 

information it receives in other reports 

that are submitted by a grantee. This 

requirement is authorized by section 

201(f)(1) of the Act, which authorizes 

VA to require applicants to provide 

such commitments and information as 

VA considers necessary, and by section 

201(e)(5)(C) of the Act, which authorizes 

VA to require eligible entities to submit 

to VA such additional reports as VA 

considers appropriate. 

Paragraph (d) requires that all pages of 

the reports must cite the assigned 

suicide prevention services grant 

number and be submitted in a timely 

manner as set forth in the grant 

agreement. Including the assigned grant 

number on each page of the report is 

important for tracking reports and to 

ensure that all pages of the relevant 

report are received by VA for each grant. 

Paragraph (e) further requires that 

grantees provide VA with consent to 

post information from reports on the 

internet and use such information in 

other ways deemed appropriate by VA. 

Grantees shall clearly mark information 

that is confidential to individual 

participants. This is consistent with the 

SSVF program (see 38 CFR 62.71(f)). 

78.150 Recordkeeping 

Section 78.150 requires grantees, 

consistent with 2 CFR 200.334, to keep 

records and maintain such records for at 

least a three-year period, to document 

compliance with SSG Fox SPGP 

requirements in part 78. Grantees will 

need to produce these records at VA’s 


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request. This will assist VA in providing 

oversight of grantees and is consistent 

with section 201(k)(1)(B)(i) of the Act, 

which requires VA to assess the 

effectiveness of this grant program, as 

well as the requirements for 

recordkeeping in 2 CFR 200.334. 

78.155 Technical Assistance 

Consistent with section 201(g) of the 

Act, § 78.155 explains that VA will 

provide technical assistance, as 

necessary, to applicants and grantees to 

meet the requirements of part 78. 

Section 201(g) of the Act specifically 

requires VA to provide training and 

technical assistance, in coordination 

with the Centers for Disease Control and 

Prevention (CDC), to grantees regarding 

(1) suicide risk identification and 

management, (2) the data required to be 

collected and shared with VA, (3) the 

means of data collection and sharing, (4) 

familiarization with and appropriate use 

of any tool to be used to measure the 

effectiveness of the use of grants, and (5) 

the requirements for reporting on 

services provided via such grants. 

Section 78.155 further explains that 

such technical assistance will be 

provided either directly by VA or 

through contracts with appropriate 

public or non-profit private entities. 

Technical assistance may consist of 

activities related to the planning, 

development, and provision of suicide 

prevention services to participants. 

In addition to other forms of technical 

assistance that will be provided, such as 

training and assistance with the five 

categories described above, VA will 

develop a program guide to be used by 

applicants, grantees, VA staff members, 

and other interested third parties to 

assist with understanding and 

implementing SSG Fox SPGP. This 

technical assistance will be conducted 

in coordination with the CDC, as 

required by section 201(g)(1) of the Act. 

CDC will be available on technical 

assistance calls, including those relating 

to the availability of data on suicide in 

grantees’ local areas. This is consistent 

with the technical assistance VA 

provides in the SSVF Program. See 38 

CFR 62.73. 

78.160 Withholding, Suspension, 

Deobligation, Termination, and 

Recovery of Funds by VA 

Section 78.160 explains that VA will 

enforce part 78 through such actions as 

may be appropriate. Appropriate actions 

include withholding, suspension, 

deobligation, termination, recovery of 

funds by VA, and actions in accordance 

with 2 CFR part 200. 

As suicide prevention services grants 

are subject to the requirements of 2 CFR 

part 200, VA explicitly references 2 CFR 

part 200 in § 78.160 to ensure that 

grantees understand and know where to 

locate these requirements related to 

withholding, suspension, deobligation, 

termination, and recovery of funds. The 

specific sections of 2 CFR part 200 on 

withholding, suspension, deobligation, 

termination, and recovery of funds are 

2 CFR 200.208, 200.305, and 200.339 

through 200.343, and 200.346, 

respectively. VA refers to 2 CFR part 

200 rather than include those 

requirements in this section as those 

requirements in 2 CFR part 200 may 

change. Referencing 2 CFR part 200 

provides VA the ability to implement 

those changes without having to 

conduct further rulemaking. 

VA acknowledges that when certain 

actions (such as suspension and 

termination) are taken against grantees 

pursuant to this section and 2 CFR part 

200, a disruption in services to 

participants may occur. While VA is not 

regulating responsibilities for grantees 

to continue to provide services or to 

coordinate the transfer of participants to 

other sources of support, VA will 

include such requirements and 

responsibilities in the grant agreement 

that VA and the grantee enter into 

pursuant to this part. This will ensure 

that the disruption and impact upon 

participants is minimized as much as 

possible. 

78.165 Suicide Prevention Services 

Grant Closeout Procedures 

Section 78.165 explains that suicide 

prevention services grants will be closed 

out in accordance with 2 CFR part 200. 

Procedures for closing out Federal 

awards are currently located at 2 CFR 

200.344 and 200.345. As suicide 

prevention services grants are subject to 

the requirements of 2 CFR part 200, VA 

explicitly references 2 CFR part 200 in 

§ 78.165 to ensure that grantees 

understand and know where to locate 

these requirements. VA refers to 2 CFR 

part 200 rather than include those 

requirements in this section as those 

requirements in 2 CFR part 200 may 

change, and referencing 2 CFR part 200 

provides VA ability to implement those 

changes without having to conduct 

further rulemaking. 

Administrative Procedure Act 

The Administrative Procedure Act 

(APA), codified in part at 5 U.S.C. 553, 

generally requires agencies publish 

substantive rules in the Federal Register 

for notice and comment. These notice 

and comment requirements generally do 

not apply to ‘‘a matter relating to agency 

management or personnel or to public 

property, loans, grants, benefits or 

contracts.’’ 5 U.S.C. 553(a)(2). However, 

38 U.S.C. 501(d) requires VA comply 

with the notice and comment 

requirements in 5 U.S.C. 553 for matters 

relating to grants, notwithstanding 

section 553(a)(2). Thus, as this 

rulemaking relates to the grant program 

required by section 201 of the Act, VA 

is required to comply with the notice 

and comment requirements of 5 U.S.C. 

553. 

However, pursuant to 5 U.S.C. 

553(b)(B), general notice and the 

opportunity for public comment are not 

required with respect to a rulemaking 

when an ‘‘agency for good cause finds 

(and incorporates the finding and a brief 

statement of reasons therefor in the 

rules issued) that notice and public 

procedure thereon are impracticable, 

unnecessary, or contrary to the public 

interest.’’ 

In accordance with 5 U.S.C. 553(b)(B), 

the Secretary has concluded that there 

is good cause to publish this rule 

without prior opportunity for public 

comment. This rule implements the 

mandates of section 201 of the Act to 

establish a new suicide prevention 

services grant program. This new grant 

program, SSG Fox SPGP, will provide 

eligible individuals and their families 

with suicide prevention services that 

will aim to reduce and prevent suicide 

by providing outreach, mental health 

screenings, education on suicide risk 

and prevention, clinical services for 

emergency treatment, case management 

services, peer support services, and 

assistance with obtaining VA and other 

government benefits, among other 

services. 

Suicide is a national public health 

concern, and it is preventable. The rate 

of veteran suicide in the United States 

remains high, despite great effort. It is 

critical that this rulemaking publish 

without delay, as these grants will result 

in increased engagement with a specific 

population at risk of suicide, which is 

especially needed during the 

Coronavirus Disease–2019 (COVID–19) 

pandemic and the immediate period 

following this pandemic. The COVID– 

19 pandemic has caused significant 

psychological distress related to 

economic hardships, physical safety 

concerns, illness, and death of family 

and friends, uncertainty about the 

future, and isolation from social 

supports. See Panchal, N., Kamal, R., 

Orgera, K., Cox, C., Garfield, R., Hamel, 

L., Mun ̃ ana, C. & Chidambaram, P. 

(2021). The implications of COVID–19 

for mental health and substance use. 

Kaiser Family Foundation. https://

www.kff.org/coronavirus-covid-19/ 

issuebrief/the-implications-of-covid-19- 

for-mental-health-and-substance-use; 


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Federal Register / Vol. 87, No. 47 / Thursday, March 10, 2022 / Rules and Regulations 13831 

See also, Brooks, S.K., Webster, R.K., 

Smith, L.E., Woodland, L., Wessely, S., 

Greenberg, N., & Rubin, G.J., (2020). The 

psychological impact of quarantine and 

how to reduce it: Rapid review of the 

evidence. Lancet, 395, 912–920. 

COVID–19 has had a detrimental effect 

on mental health in the United States. 

See id.; see also, Czeisler, ME ́, Lane, RI, 

Petroski, E, et al. Mental Health, 

Substance Use, and Suicidal Ideation 

During the COVID–19 Pandemic— 

United States, June 24–30, 2020. 

MMWR Morb Mortal Wkly Rep 

2020;69:1049; See also, National Center 

for Health Statistics (2021). Anxiety and 

depression: Household Pulse Survey. 

U.S. Centers for Disease Control and 

Prevention. https://www.cdc.gov/nchs/ 

covid19/pulse/mental-health.htm (Last 

accessed May 17, 2021). 

According to a recent CDC report, 

more Americans are reporting negative 

mental health impacts, including higher 

rates of suicidal thoughts, during the 

COVID–19 pandemic. Czeisler ME ́, Lane 

RI, Petrosky E, et al. Mental Health, 

Substance Use, and Suicidal Ideation 

During the COVID–19 Pandemic— 

United States, June 24–30, 2020. 

MMWR Morb Mortal Wkly Rep 

2020;69:1049–1057. DOI: http://

dx.doi.org/10.15585/mmwr.mm6932a1. 

While this report examined the general 

population of America, there is also 

evidence of increased distress among 

the veteran population. For instance, 

there has been an increase in call 

volume to the Veterans Crisis Line 

(VCL). In fiscal year (FY) 2019, VCL 

answered an average daily call volume 

of 1590.67 calls compared with 1765.02 

FY 2020 and 1807.52 in FY 2021, with 

VCL call volume increasing over 22% in 

direct-date comparisons from FY 2019 

to FY 2021. 

Veterans, in particular, may be 

uniquely vulnerable to negative mental 

health effects of the pandemic such as 

suicidality due to their older age, 

previous trauma exposures, and higher 

pre-pandemic prevalence of physical 

and psychiatric risk factors and 

conditions. Na, P.J., Tsai, J., Hill, M.L., 

Nichter, B., Norman, S.B., Southwick, 

S.M., & Pietrzak, R.H. (2021). 

Prevalence, risk and protective factors 

associated with suicidal ideation during 

the COVID–19 pandemic in U.S. 

military veterans with pre-existing 

psychiatric conditions. Journal of 

Psychiatric Research, 137, 351–359. In 

an analysis of data from the National 

Health and Resilience in Veterans 

Study, researchers found that 19.2% of 

veterans screened positive for suicidal 

ideation peri-pandemic, and such 

veterans had lower income, were more 

likely to have been infected with 

COVID–19, reported greater COVID–19- 

related financial and social restriction 

stress, and increases in psychiatric 

symptoms and loneliness during the 

pandemic when compared to veterans 

without suicidal ideation. Id. 

Additionally, they found that among 

veterans who were infected with 

COVID–19, those aged 45 or older and 

who reported lower purpose in life were 

more likely to endorse suicidal ideation. 

Id. These researchers noted that 

monitoring for suicide risk and 

worsening psychiatric symptoms in 

older veterans who have been infected 

with COVID–19 may be important, and 

that interventions that enhance purpose 

in life may help protect against suicidal 

ideation in this population. Consistent 

with the recommendations of this 

research, SSG Fox SPGP will support 

monitoring for suicide risk and 

worsening psychiatric symptoms by 

providing support to more organizations 

who can reach veterans who do not seek 

or obtain care through VA. Through this 

grant program, organizations’ efforts can 

also help protect this population against 

suicidal ideation by enhancing purpose 

in life. 

Furthermore, studies have shown 

increased suicide after pandemics such 

as the 1918 Influenza (H1N1) pandemic 

and the 2003 Severe Acute Respiratory 

Syndrome (SARS) outbreak, in which 

increased risk factors associated with 

negative impacts of epidemics were 

believed to contribute to suicide. See 

Wasserman IM. The impact of epidemic, 

war, prohibition and media on suicide: 

United States, 1910–1920. Suicide Life 

Threat Behav. 1992 Summer;22(2):240– 

54. PMID: 1626335.; See also, Cheung 

YT., Chau PH., and Yip PS. A revisit on 

older adults suicides and severe acute 

respiratory syndrome (SARS) epidemic 

in Hong Kong. Int J Geriatr Psychiatry. 

2008; 23: 1231–1238. Thus, increased 

suicide death could occur after the 

COVID–19 pandemic unless action is 

taken. See Gunnell, D., Appleby, L., 

Arensman, E., Hawton, K., John, A., 

Kapur, N., Khan, M., O’Connor, R.C., & 

Pirkis, J. (2020). Suicide risk and 

prevention during the COVID–19 

pandemic. The Lancet Psychiatry, 7(6), 

468–471. 

It is therefore critical that VA publish 

this rulemaking without delay to ensure 

the services provided through this grant 

program will assist the growing number 

of eligible individuals who are suffering 

from mental health concerns and may 

be at risk of suicide as a result of the 

COVID–19 pandemic, particularly as the 

period immediately following a 

pandemic can result in elevated risk of 

suicide. Publishing this rulemaking 

without delay will help ensure that 

services under this grant program can be 

provided to eligible individuals during 

the pandemic or in the immediate 

aftermath of it when they can have the 

most impact. As noted earlier in this 

section, efforts and actions supported 

through this grant program will be 

consistent with recent findings and 

recommendations on the impact of the 

COVID–19 pandemic on veterans and 

can help protect this population against 

suicidal ideation. See, Na, P.J., Tsai, J., 

Hill, M.L., Nichter, B., Norman, S.B., 

Southwick, S.M., & Pietrzak, R.H. 

(2021). Prevalence, risk and protective 

factors associated with suicidal ideation 

during the COVID–19 pandemic in U.S. 

military veterans with pre-existing 

psychiatric conditions. Journal of 

Psychiatric Research, 137, 351–359. 

VA believes that increased 

engagement with veterans and their 

families from VA and community 

partners through this grant program will 

help prevent veteran suicide. As 

detailed in VA’s 2021 National Veteran 

Suicide Prevention Annual Report, the 

average number of veteran suicide 

deaths per day in 2019 was 17.2. 

(Available online: https://www.mental

health.va.gov/docs/data-sheets/2021/ 

2021-National-Veteran-SuicidePrevention-Annual-Report-FINAL-9-8- 

21.pdf). Of those, 6.8 were veterans who 

recently used VA health care (that is, 

these veterans had received VA health 

care services within the preceding two 

years) and 10.4 were veterans who had 

not recently used VA health care. See 

id. Furthermore, from 2005 to 2018, 

suicide rates fell among veterans with 

depression, anxiety, and substance use 

disorders who were in VA care. See 

VA’s 2020 National Veteran Suicide 

Prevention Annual Report. (Available 

online: https://www.mentalhealth.

va.gov/docs/data-sheets/2020/2020- 

National-Veteran-Suicide-PreventionAnnual-Report-11-2020-508.pdf. In 

addition to VA engagement and services 

reducing suicide rates, studies have 

shown that community-based and 

public health suicide prevention have 

been effective in reducing suicide rates 

in diverse communities. See Hegerl, U., 

Althaus, D., Schmidtke, A., & 

Niklewski, G. (2006); The alliance 

against depression: 2-year evaluation of 

a community-based intervention to 

reduce suicidality. Psychological 

Medicine, 36(9), 1225–1233. These 

statistics and studies support VA’s 

contention that increased engagement 

from VA and community partners 

through this grant program can help 

reduce suicide risk among eligible 

individuals by providing critical 


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services connecting veterans with VA 

care and services. 

Additionally, this rulemaking is not 

entirely without public input. VA 

reiterates that as described earlier in this 

document, VA published a request for 

information on this rulemaking and 

held multiple listening sessions to 

obtain input from the public as part of 

the consultation required by section 201 

of the Act. Conducting consultation in 

this manner is consistent with VA’s past 

practice and interpretation of 

consultation requirements under 

Federal law. VA received 124 comments 

in response to the request for 

information and had 32 speakers at the 

listening sessions. This public input has 

been reviewed and incorporated, as 

appropriate, into this rulemaking. 

For these reasons, the Secretary has 

concluded that ordinary notice and 

comment procedures would be 

impracticable and contrary to the public 

interest and is accordingly issuing this 

rule as an interim final rule. The 

Secretary will consider and address 

comments that are received within 60 

days after the date that this interim final 

rule is published in the Federal Register 

and address them in a subsequent 

Federal Register document announcing 

a final rule incorporating any changes 

made in response to the public 

comments. 

Executive Orders 12866 and 13563 

Executive Orders 12866 and 13563 

direct agencies to assess the costs and 

benefits of available regulatory 

alternatives and, when regulation is 

necessary, to select regulatory 

approaches that maximize net benefits 

(including potential economic, 

environmental, public health and safety 

effects, and other advantages; 

distributive impacts; and equity). 

Executive Order 13563 (Improving 

Regulation and Regulatory Review) 

emphasizes the importance of 

quantifying both costs and benefits, 

reducing costs, harmonizing rules, and 

promoting flexibility. The Office of 

Information and Regulatory Affairs has 

determined that this rule is a significant 

regulatory action under Executive Order 

12866. The Regulatory Impact Analysis 

associated with this rulemaking can be 

found as a supporting document at 

www.regulations.gov. 

Regulatory Flexibility Act 

The Regulatory Flexibility Act, 5 

U.S.C. 601–612, is not applicable to this 

rulemaking because notice of proposed 

rulemaking is not required. 5 U.S.C. 

601(2), 603(a), 604(a). 

Unfunded Mandates 

The Unfunded Mandates Reform Act 

of 1995 requires, at 2 U.S.C. 1532, that 

agencies prepare an assessment of 

anticipated costs and benefits before 

issuing any rule that may result in the 

expenditure by State, local, and tribal 

governments, in the aggregate, or by the 

private sector, of $100 million or more 

(adjusted annually for inflation) in any 

one year. This interim final rule will 

have no such effect on State, local, and 

tribal governments, or on the private 

sector. 

Paperwork Reduction Act 

This interim final rule includes 

provisions constituting new collections 

of information under the Paperwork 

Reduction Act of 1995 (44 U.S.C. 3501– 

3521) that require approval by the Office 

of Management and Budget (OMB). 

Accordingly, under 44 U.S.C. 3507(d), 

VA has submitted a copy of this 

rulemaking action to OMB for review. 

OMB assigns control numbers to 

collections of information it approves. 

VA may not conduct or sponsor, and a 

person is not required to respond to, a 

collection of information unless it 

displays a currently valid OMB control 

number. Sections 78.10, 78.15, 78.95, 

78.125, 78.145 contain new collections 

of information under the Paperwork 

Reduction Act of 1995. If OMB does not 

approve the collections of information 

as requested, VA will immediately 

remove the provisions containing a 

collection of information or take such 

other action as is directed by OMB. 

Comments on the new collection of 

information contained in this 

rulemaking should be submitted 

through www.regulations.gov. 

Comments should indicate that they are 

submitted in response to ‘‘RIN 2900– 

AR16—Staff Sergeant Parker Gordon 

Fox Suicide Prevention Grant Program’’ 

and should be sent within 30 days of 

publication of this rulemaking. The 

collection of information associated 

with this rulemaking can be viewed at: 

www.reginfo.gov/public/do/PRAMain. 

A comment to OMB is best assured of 

having its full effect if OMB receives it 

within 30 days of publication. This does 

not affect the deadline for the public to 

comment on the interim final rule. 

The Department considers comments 

by the public on proposed collections of 

information in— 

• Evaluating whether the proposed 

collections of information are necessary 

for the proper performance of the 

functions of the Department, including 

whether the information will have 

practical utility; 

• Evaluating the accuracy of the 

Department’s estimate of the burden of 

the proposed collections of information, 

including the validity of the 

methodology and assumptions used; 

• Enhancing the quality, usefulness, 

and clarity of the information to be 

collected; and 

• Minimizing the burden of the 

collections of information on those who 

are to respond, including through the 

use of appropriate automated, 

electronic, mechanical, or other 

technological collection techniques or 

other forms of information technology, 

e.g., permitting electronic submission of 

responses. 

The collections of information 

contained in 38 CFR 78.10, 78.15, 78.95, 

78.125, and 78.145 are described 

immediately following this paragraph, 

under their respective titles. 

Title: Eligibility Screening. 

OMB Control No: 2900–TBD (New). 

CFR Provision: 38 CFR 78.10. 

• Summary of collection of 

information: This new collection of 

information in 38 CFR 78.10 requires 

grantees to determine eligibility for 

purposes of this grant program using 

screening tools. 

• Description of need for information 

and proposed use of information: This 

collection of information is necessary to 

evaluate and determine eligibility for 

suicide prevention services and ensure 

that VA resources are directed at the 

intended population, in an efficient 

equitable method. 

• Description of likely respondents: 

Grantees. 

• Estimated number of respondents: 

90. 

• Estimated frequency of responses: 

67. 

• Estimated average burden per 

response: 30 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 3,015 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $81,616.05. 

Title: Suicide Risk Screening. 

OMB Control No: 2900–TBD (New). 

CFR Provision: 38 CFR 78.10. 

• Summary of collection of 

information: This new collection of 

information in 38 CFR 78.10 requires 

grantees to use screening tools to assess 

risk of suicide among program 

participants for purposes of 

implementing this grant program. 

• Description of need for information 

and proposed use of information: This 

collection of information is necessary to 

assess risk of suicide and ensure that 

VA resources are directed at the 

intended population, in an efficient 

equitable method. 

• Description of likely respondents: 

Grantees. 


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• Estimated number of respondents: 

90. 

• Estimated frequency of responses: 

67. 

• Estimated average burden per 

response: 15 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 1,507.5 

hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $40,808.03. 

Title: Application Provisions for the 

Staff Sergeant Gordon Parker Fox 

Suicide Prevention Grant Program. 

OMB Control No: 2900–TBD (New). 

CFR Provision: 38 CFR 78.15. 

• Summary of collection of 

information: The new collection of 

information in 38 CFR 78.15 requires 

applications be submitted to be 

evaluated and considered for a grant 

under this new part 78. Applications 

require specific information so that VA 

can properly evaluate such applications 

for grants. 

• Description of need for information 

and proposed use of information: This 

collection of information is necessary to 

award suicide prevention services 

grants to eligible entities. 

• Description of likely respondents: 

Eligible entities. 

• Estimated number of respondents: 

250. 

• Estimated frequency of responses: 

1. 

• Estimated average burden per 

response: 2,100 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 8,750 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $236,862.50. 

Title: Suicide Prevention Services 

Grant Renewal Applications. 

OMB Control No: 2900–TBD (New). 

CFR Provision: 38 CFR 78.15. 

• Summary of collection of 

information: The new collection of 

information in 38 CFR 78.15 requires 

that renewal applications be submitted 

to be evaluated and receive a renewal of 

a grant under this new part 78. 

Applications require specific 

information so that VA can properly 

evaluate such applications for renewal 

of grants. 

• Description of need for information 

and proposed use of information: This 

collection of information is necessary to 

award suicide prevention services 

grants to eligible entities. 

• Description of likely respondents: 

Grantees that seek renewal of their 

grants. 

• Estimated number of respondents: 

90. 

• Estimated frequency of responses: 

1. 

• Estimated average burden per 

response: 600 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 900 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $24,363. 

Title: Participant Satisfaction Surveys. 

OMB Control No: 2900–TBD (New). 

CFR Provision: 38 CFR 78.95. 

• Summary of collection of 

information: The new collection of 

information in 38 CFR 78.95 requires 

grantees to conduct satisfaction surveys 

from participants. 

• Description of need for information 

and proposed use of information: The 

collection of information is necessary to 

evaluate whether participants are 

satisfied with the suicide prevention 

services provided by the grantee and the 

effectiveness of such services. 

• Description of likely respondents: 

Eligible individuals and their families 

who receive suicide prevention services. 

• Estimated number of respondents: 

5,000. 

• Estimated frequency of responses: 

1. 

• Estimated average burden per 

response: 15 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 1,250 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $33,837.50. 

Title: Intake Form. 

OMB Control No: 2900–TBD (New). 

CFR Provision: 38 CFR 78.95. 

• Summary of collection of 

information: The new collection of 

information in 38 CFR 78.95 requires 

grantees to use tools and assessments 

(that is, an intake form) to determine the 

effectiveness of the suicide prevention 

services furnished by the grantee. 

• Description of need for information 

and proposed use of information: The 

collection of information is necessary to 

ensure that the appropriate services are 

offered to participants, and the data 

collected will be used by VA to 

determine the participant’s baseline 

with regards to mood-related symptoms, 

overall wellbeing, and financial 

stressors and social supports. This will 

enable VA to measure the effectiveness 

of the programming provided in 

improving mental health status, 

wellbeing, and reducing suicide risk 

and suicide deaths of eligible 

individuals. 

• Description of likely respondents: 

Grantees. 

• Estimated number of respondents: 

90. 

• Estimated frequency of responses: 

67. 

• Estimated average burden per 

response: 30 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 3,015 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $81,616.05. 

Title: Program Exit Checklist. 

OMB Control No: 2900–TBD (New). 

CFR Provision: 38 CFR 78.95. 

• Summary of collection of 

information: The new collection of 

information in 38 CFR 78.95 requires 

grantees to use tools and assessments 

(that is, a program exit checklist) to 

determine the effectiveness of the 

suicide prevention services furnished by 

the grantee. 

• Description of need for information 

and proposed use of information: The 

collection of information is necessary to 

determine whether there was a 

reduction of the participant’s moodrelated symptoms, an overall improved 

wellbeing, and mitigation of any 

financial and social support stressors. 

This will enable VA to measure the 

effectiveness of the programming 

provided in improving mental health 

status, wellbeing, and reducing suicide 

risk and suicide deaths of eligible 

individuals. 

• Description of likely respondents: 

Grantees. 

• Estimated number of respondents: 

90. 

• Estimated frequency of responses: 

67. 

• Estimated average burden per 

response: 30 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 3,015 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $81,616.05. 

Title: Program and Budget Changes. 

OMB Control No: 2900–TBD (New). 

CFR Provision: 38 CFR 78.125. 

• Summary of collection of 

information: The new collection of 

information in 38 CFR 78.125 requires 

certain grantees to provide VA with 

program and/or budget changes. 

• Description of need for information 

and proposed use of information: 

Reporting of program/budget changes is 

necessary for VA to approve and ensure 

that such changes are consistent with 

proposed 38 CFR part 78 and the goals 

and intent of the Staff Sergeant Parker 

Gordon Fox Suicide Prevention Grant 

Program. These collections are not 

required of every grantee and are 

needed only in limited instances. 

• Description of likely respondents: 

Grantees. 


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• Estimated number of respondents: 

90. 

• Estimated frequency of responses: 

2. 

• Estimated average burden per 

response: 15 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 45 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $1,218.15. 

Title: Annual Performance 

Compliance Reports for Suicide 

Prevention Services Program. 

OMB Control No: 2900–TBD (New). 

CFR Provision: 38 CFR 78.145. 

• Summary of collection of 

information: The new collection of 

information in 38 CFR 78.145 requires 

grantees to provide annual reports to 

assess the provision of services under 

this grant program. 

• Description of need for information 

and proposed use of information: The 

collection of information is necessary to 

determining compliance with the 

requirements for a suicide prevention 

services grant and to assess the 

provision of services under this grant 

program. 

• Description of likely respondents: 

Grantees. 

• Estimated number of respondents: 

90. 

• Estimated frequency of responses: 

1. 

• Estimated average burden per 

response: 45 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 67.50 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $1,827.23. 

Title: Other Performance Compliance 

Reports for Suicide Prevention Services 

Program. 

OMB Control No.: 2900–TBD (New). 

CFR Provision: 38 CFR 78.145. 

• Summary of collection of 

information: The new collection of 

information in 38 CFR 78.145 requires 

grantees to provide two performance 

reports to assess the provision of 

services under this grant program. 

• Description of need for information 

and proposed use of information: The 

collection of information is necessary to 

determining compliance with the 

requirements for a suicide prevention 

services grant and to assess the 

provision of services under this grant 

program. 

• Description of likely respondents: 

Grantees. 

• Estimated number of respondents: 

90. 

• Estimated frequency of responses: 

2. 

• Estimated average burden per 

response: 30 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 90 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $2,436.30. 

Title: Other Financial Compliance 

Reports for Suicide Prevention Services 

Program. 

OMB Control No.: 2900–TBD (New). 

CFR Provision: 38 CFR 78.145. 

• Summary of collection of 

information: The new collection of 

information in 38 CFR 78.145 requires 

grantees to provide two reports to assess 

financial compliance under this grant 

program. 

• Description of need for information 

and proposed use of information: The 

collection of information is necessary to 

determining compliance with the 

financial requirements for a suicide 

prevention services grant. 

• Description of likely respondents: 

Grantees. 

• Estimated number of respondents: 

90. 

• Estimated frequency of responses: 

2. 

• Estimated average burden per 

response: 30 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 90 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $2,436.30. 

Title: Annual Financial Expenditure 

Reports for Suicide Prevention Services 

Program. 

OMB Control No.: 2900–TBD (New). 

CFR Provision: 38 CFR 78.145. 

• Summary of collection of 

information: The new collection of 

information in 38 CFR 17.145 requires 

grantees to provide annual reports to 

assess financial expenditure compliance 

under this grant program. 

• Description of need for information 

and proposed use of information: The 

collection of information is necessary to 

determining compliance with the 

financial expenditure requirements for a 

suicide prevention services grant. 

• Description of likely respondents: 

Grantees. 

• Estimated number of respondents: 

90. 

• Estimated frequency of responses: 

1. 

• Estimated average burden per 

response: 45 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 67.5 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $1,827.23. 

Title: Compliance—Corrective Action 

Plan. 

OMB Control No.: 2900–TBD (New). 

CFR Provision: 38 CFR 17.145. 

• Summary of collection of 

information: The new collection of 

information in 38 CFR 78.145 requires 

grantees to provide ad hoc compliance 

corrective action plans under this grant 

program. 

• Description of need for information 

and proposed use of information: The 

collection of information is necessary to 

determining compliance with any 

necessary corrective action plans for a 

suicide prevention services grant. 

• Description of likely respondents: 

Grantees. 

• Estimated number of respondents: 

25. 

• Estimated frequency of responses: 

1. 

• Estimated average burden per 

response: 30 minutes. 

• Estimated total annual reporting 

and recordkeeping burden: 12.5 hours. 

• * Estimated annual cost to 

respondents for the hour burdens for 

collections of information: $338.38. 

* To estimate the total information 

collection burden cost, VA used the 

Bureau of Labor Statistics (BLS) median 

hourly wage for hourly wage for ‘‘all 

occupations’’ of $27.07 per hour. This 

information is available at https://

www.bls.gov/oes/current/oes_

nat.htm#13-0000. 

Assistance Listing 

The Assistance Listing number and 

title for the program affected by this 

document is 64.009, Veterans Medical 

Care Benefits. 

Congressional Review Act 

Pursuant to Subtitle E of the Small 

Business Regulatory Enforcement 

Fairness Act of 1996, also known as the 

Congressional Review Act (5 U.S.C. 801 

et seq.), the Office of Information and 

Regulatory Affairs designated this rule 

as not a major rule, as defined by 5 

U.S.C. 804(2). 

List of Subjects in 38 CFR Part 78 

Administrative practice and 

procedure; Grant programs—health; 

Grant programs—veterans; Health care; 

Mental health programs; Reporting and 

recordkeeping requirements; Veterans. 

Signing Authority 

Denis McDonough, Secretary of 

Veterans Affairs, approved this 

document on November 24, 2021, and 

authorized the undersigned to sign and 

submit the document to the Office of the 

Federal Register for publication 


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Federal Register / Vol. 87, No. 47 / Thursday, March 10, 2022 / Rules and Regulations 13835 

electronically as an official document of 

the Department of Veterans Affairs. 

Jeffrey M. Martin, 

Assistant Director, Office of Regulation Policy 

& Management, Office of General Counsel, 

Department of Veterans Affairs. 

■ For the reasons stated in the preamble, 

the Department of Veterans Affairs 

amends 38 CFR chapter I by adding part 

78 to read as follows: 

PART 78—STAFF SERGEANT PARKER 

GORDON FOX SUICIDE PREVENTION 

GRANT PROGRAM 

Sec. 

78.0 Purpose and scope. 

78.5 Definitions. 

78.10 Eligible individuals. 

78.15 Applications for suicide prevention 

services grants. 

78.20 Threshold requirements prior to 

scoring suicide prevention services grant 

applicants. 

78.25 Scoring criteria for awarding grants. 

78.30 Selection of grantees. 

78.35 Scoring criteria for grantees applying 

for renewal of suicide prevention 

services grants. 

78.40 Selection of grantees for renewal of 

suicide prevention services grants. 

78.45 Suicide prevention services: 

Outreach. 

78.50 Suicide prevention services: Baseline 

mental health screening. 

78.55 Suicide prevention services: 

Education. 

78.60 Suicide prevention services: Clinical 

services for emergency treatment. 

78.65 Suicide prevention services: Case 

management services. 

78.70 Suicide prevention services: Peer 

support services. 

78.75 Suicide prevention services: 

Assistance in obtaining VA benefits. 

78.80 Suicide prevention services: 

Assistance in obtaining and coordinating 

other public benefits and assistance with 

emergent needs. 

78.85 Suicide prevention services: 

Nontraditional and innovative 

approaches and treatment practices. 

78.90 Suicide prevention services: Other 

services. 

78.95 General operation requirements. 

78.100 Fee prohibition. 

78.105 Ineligible activities. 

78.110 Notice of Funding Opportunity. 

78.115 Suicide prevention services grant 

agreements. 

78.120 Amount and payment of grants. 

78.125 Program or budget changes and 

corrective action plans. 

78.130 Faith-based organizations. 

78.135 Visits to monitor operation and 

compliance. 

78.140 Financial management and 

administrative costs. 

78.145 Grantee reporting requirements. 

78.150 Recordkeeping. 

78.155 Technical assistance. 

78.160 Withholding, suspension, 

deobligation, termination, and recovery 

of funds by VA. 

78.165 Suicide prevention services grant 

closeout procedures. 

Authority: 38 U.S.C. 501, 38 U.S.C. 1720F 

(note), sec. 201, Pub. L. 116–171, and as 

noted in specific sections. 

§ 78.0 Purpose and scope. 

(a) Purpose. This part implements the 

Staff Sergeant Parker Gordon Fox 

Suicide Prevention Grant Program (SSG 

Fox SPGP) with the purpose of reducing 

veteran suicide by expanding suicide 

prevention programs for veterans 

through the award of suicide prevention 

services grants to eligible entities to 

provide or coordinate the provision of 

suicide prevention services to eligible 

individuals and their families. 

(b) Scope. Suicide prevention services 

covered by this part are those services 

that address the needs of eligible 

individuals and their families and are 

necessary for improving the mental 

health status and wellbeing and 

reducing the suicide risk of eligible 

individuals and their families. 

§ 78.5 Definitions. 

For purposes of this part and any 

Notice of Funding Opportunity (NOFO) 

issued under this part: 

Applicant means an eligible entity 

that submits an application for a suicide 

prevention services grant announced in 

a NOFO. 

Direct Federal financial assistance 

means Federal financial assistance 

received by an entity selected by the 

Government or a pass-through entity as 

defined in 38 CFR 50.1(d) to provide or 

carry out a service (e.g., by contract, 

grant, or cooperative agreement). 

Eligible child care provider means a 

provider of child care services for 

compensation, including a provider of 

care for a school-age child during nonschool hours, that— 

(1) Is licensed, regulated, registered, 

or otherwise legally operating, under 

State and local law; and 

(2) Satisfies the State and local 

requirements, applicable to the child 

care services the provider providers. 

Eligible entity means an entity that 

meets the definition of an eligible entity 

in section 201(q) of Public Law 116– 

171. 

Eligible individual means an 

individual that meets the requirements 

of § 78.10(a). 

Family means any of the following: A 

parent, spouse, child, sibling, stepfamily member, extended family 

member, and any other individual who 

lives with the eligible individual. 

Grantee means an eligible entity that 

is awarded a suicide prevention services 

grant under this part. 

Indian tribe means an Indian tribe as 

defined in 25 U.S.C. 4103. 

Indirect Federal financial assistance 

means Federal financial assistance in 

which a service provider receives 

program funds through a voucher, 

certificate, agreement or other form of 

disbursement, as a result of the genuine, 

independent choice of a participant. 

Medically underserved area means an 

area that is designated as a medically 

underserved population under 42 U.S.C. 

254b(b)(3). 

Notice of Funding Opportunity 

(NOFO) means a Notice of Funding 

Opportunity published on grants.gov in 

accordance with § 78.110. 

Participant means an eligible 

individual or their family who is 

receiving suicide prevention services for 

which they are eligible from a grantee. 

Rural communities means those 

communities considered rural according 

to the Rural-Urban Commuting Area 

(RUCA) system as determined by the 

United States Department of 

Agriculture. 

State means any of the several States 

of the United States, the District of 

Columbia, the Commonwealth of Puerto 

Rico, any territory or possession of the 

United States, or any agency or 

instrumentality of a State exclusive of 

local governments. 

Suicide prevention services includes 

the following services provided to 

address the needs of a participant: 

(1) Outreach as specified under 

§ 78.45. 

(2) Baseline mental health screening 

as specified under § 78.50. 

(3) Education as specified under 

§ 78.55. 

(4) Clinical services for emergency 

treatment as specified under § 78.60. 

(5) Case management services as 

specified under § 78.65. 

(6) Peer support services as specified 

under § 78.70. 

(7) Assistance in obtaining VA 

benefits as specified under § 78.75. 

(8) Assistance in obtaining and 

coordinating other public benefits and 

assistance with emergent needs as 

specified under § 78.80. 

(9) Nontraditional and innovative 

approaches and treatment practices as 

specified under § 78.85. 

(10) Other services as specified under 

§ 78.90. 

Suicide prevention services grant 

means a grant awarded under this part. 

Suicide prevention services grant 

agreement means the agreement 

executed between VA and a grantee as 

specified under § 78.115. 

Suspension means an action by VA 

that temporarily withdraws VA funding 

under a suicide prevention services 

grant, pending corrective action by the 

grantee or pending a decision to 


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terminate the suicide prevention 

services grant by VA. Suspension of a 

suicide prevention services grant is a 

separate action from suspension under 

VA regulations or guidance 

implementing Executive Orders 12549 

and 12689, ‘‘Debarment and 

Suspension.’’ 

Territories means the territories of the 

United States, including Puerto Rico, 

Guam, the U.S. Virgin Islands, 

American Samoa, and the Northern 

Mariana Islands. 

Veterans means a veteran as defined 

under 38 U.S.C. 101(2). 

Veterans Crisis Line means the tollfree hotline for veterans in crisis and 

their families and friends established 

under 38 U.S.C. 1720F(h). 

Withholding means that payment of a 

suicide prevention services grant will 

not be paid until such time as VA 

determines that the grantee provides 

sufficiently adequate documentation 

and/or actions to correct a deficiency for 

the suicide prevention services grant. 

§ 78.10 Eligible individuals. 

(a) To be an eligible individual under 

this part, a person must be at risk of 

suicide and further meet the definition 

of eligible individual in section 201(q) 

of Public Law 116–171. 

(b) For purposes of paragraph (a) of 

this section, risk of suicide means 

exposure to, or the existence of, any of 

the following factors, to any degree, that 

increase the risk for suicidal ideation 

and/or behaviors: 

(1) Health risk factors, including 

mental health challenges, substance use 

disorder, serious or chronic health 

conditions or pain, and traumatic brain 

injury. 

(2) Environmental risk factors, 

including prolonged stress, stressful life 

events, unemployment, homelessness, 

recent loss, and legal or financial 

challenges. 

(3) Historical risk factors, including 

previous suicide attempts, family 

history of suicide, and history of abuse, 

neglect, or trauma, including military 

sexual trauma. 

Note 1 to paragraph (b): Grantees must use 

these risk factors and the impact thereof to 

determine the degree of risk of suicide for 

eligible individuals using a screening tool 

approved by the Department. The degree of 

risk depends on the presence of one or more 

suicide risk factors and the impact of those 

factors on an individual’s mental health and 

wellbeing. 

(The Office of Management and Budget 

has approved the information collection 

provisions in this section under control 

number 2900–TBD.) 

§ 78.15 Applications for suicide prevention 

services grants. 

(a) To apply for a suicide prevention 

services grant, an applicant must submit 

to VA a complete suicide prevention 

services grant application package, as 

described in the NOFO. A complete 

suicide prevention services grant 

application package includes the 

following: 

(1) Documentation evidencing the 

experience of the applicant and any 

identified community partners in 

providing or coordinating the provision 

of suicide prevention services to eligible 

individuals and their families. 

(2) A description of the suicide 

prevention services proposed to be 

provided or coordinated by the 

applicant and the identified need for 

those services. 

(3) A detailed plan describing how the 

applicant proposes to coordinate or 

deliver suicide prevention services to 

eligible individuals, including: 

(i) If the applicant is a State or local 

government or an Indian tribe, an 

identification of the community 

partners, if any, with which the 

applicant proposes to work in delivering 

such services; 

(ii) A description of the arrangements 

currently in place between the applicant 

and such partners with regard to the 

provision or coordination the provision 

of suicide prevention services; 

(iii) An identification of how long 

such arrangements have been in place; 

(iv) A description of the suicide 

prevention services provided by such 

partners that the applicant must 

coordinate, if any; and 

(v) An identification of local VA 

suicide prevention coordinators and a 

description of how the applicant will 

communicate with local VA suicide 

prevention coordinators. 

(4) A description of the location and 

population of eligible individuals and 

their families proposed to be provided 

suicide prevention services. 

(5) An estimate of the number of 

eligible individuals at risk of suicide 

and their families proposed to be 

provided suicide prevention services, 

including the percentage of those 

eligible individuals who are not 

currently receiving care furnished by 

VA. 

(6) Evidence of measurable outcomes 

related to reductions in suicide risk and 

mood-related symptoms utilizing 

validated instruments by the applicant 

(and the proposed partners of the 

applicant, if any) in providing suicide 

prevention services to individuals at 

risk of suicide, particularly to eligible 

individuals and their families. 

(7) A description of the managerial 

and technological capacity of the 

applicant to: 

(i) Coordinate the provision of suicide 

prevention services with the provision 

of other services; 

(ii) Assess on an ongoing basis the 

needs of eligible individuals and their 

families for suicide prevention services; 

(iii) Coordinate the provision of 

suicide prevention services with VA 

services for which eligible individuals 

are also eligible; 

(iv) Tailor (i.e., provide 

individualized) suicide prevention 

services to the needs of eligible 

individuals and their families; 

(v) Seek continuously new sources of 

assistance to ensure the continuity of 

suicide prevention services for eligible 

individuals and their families as long as 

the eligible individuals are determined 

to be at risk of suicide; and 

(vi) Measure the effects of suicide 

prevention services provided by 

applicant or partner organization on the 

lives of eligible individuals and their 

families who receive such services 

provided by the organization using preand post-evaluations on validated 

measures of suicide risk and moodrelated symptoms. 

(8) Clearly defined objectives for the 

provision of suicide prevention services. 

(9) A description and physical 

address of the primary location of the 

applicant. 

(10) A description of the geographic 

area the applicant plans to serve during 

the grant award period for which the 

application applies. 

(11) If the applicant is a State or local 

government or an Indian tribe, the 

amount of grant funds proposed to be 

made available to community partners, 

if any, through agreements. 

(12) A description of how the 

applicant will assess the effectiveness of 

the provision of grants under this part. 

(13) An agreement to use the 

measures and metrics provided by VA 

for the purposes of measuring the 

effectiveness of the programming to be 

provided in improving mental health 

status, wellbeing, and reducing suicide 

risk and suicide deaths of eligible 

individuals and their families. 

(14) An agreement to comply with 

and implement the requirements of this 

part throughout the term of the suicide 

prevention services grant. 

(15) Any additional information as 

deemed appropriate by VA. 

(b) Subject to funding availability, 

grantees may submit an application for 

renewal of a suicide prevention services 

grant if the grantee’s program will 

remain substantially the same. To apply 

for renewal of a suicide prevention 


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services grant, a grantee must submit to 

VA a complete suicide prevention 

services grant renewal application 

package, as described in the NOFO. 

(c) VA may request in writing that an 

applicant or grantee, as applicable, 

submit other information or 

documentation relevant to the suicide 

prevention services grant application. 

(The Office of Management and Budget 

has approved the information collection 

provisions in this section under control 

number 2900–TBD.) 

§ 78.20 Threshold requirements prior to 

scoring suicide prevention services grant 

applicants. 

VA will only score applicants who 

meet the following threshold 

requirements: 

(a) The application is filed within the 

time period established in the NOFO, 

and any additional information or 

documentation requested by VA under 

§ 78.15(c) is provided within the time 

frame established by VA; 

(b) The application is completed in all 

parts; 

(c) The activities for which the 

suicide prevention services grant is 

requested are eligible for funding under 

this part; 

(d) The applicant’s proposed 

participants are eligible to receive 

suicide prevention services under this 

part; 

(e) The applicant agrees to comply 

with the requirements of this part; 

(f) The applicant does not have an 

outstanding obligation to the Federal 

government that is in arrears and does 

not have an overdue or unsatisfactory 

response to an audit; and 

(g) The applicant is not in default by 

failing to meet the requirements for any 

previous Federal assistance. 

§ 78.25 Scoring criteria for awarding 

grants. 

VA will score applicants who are 

applying for a suicide prevention 

services grant. VA will set forth specific 

point values to be awarded for each 

criterion in the NOFO. VA will use the 

following criteria to score these 

applicants: 

(a) VA will award points based on the 

background, qualifications, experience, 

and past performance of the applicant, 

and any community partners identified 

by the applicant in the suicide 

prevention services grant application, as 

demonstrated by the following: 

(1) Background and organizational 

history. (i) Applicant’s, and any 

identified community partners’, 

background and organizational history 

are relevant to the program. 

(ii) Applicant, and any identified 

community partners, maintain 

organizational structures with clear 

lines of reporting and defined 

responsibilities. 

(iii) Applicant, and any identified 

community partners, have a history of 

complying with agreements and not 

defaulting on financial obligations. 

(2) Staff qualifications. (i) Applicant’s 

staff, and any identified community 

partners’ staff, have experience 

providing services to, or coordinating 

services for, eligible individuals and 

their families. 

(ii) Applicant’s staff, and any 

identified community partners’ staff, 

have experience administering programs 

similar to SSG Fox SPGP. 

(3) Organizational qualifications and 

past performance, including experience 

with veterans services. (i) Applicant, 

and any identified community partners, 

have organizational experience 

providing suicide prevention services 

to, or coordinating suicide prevention 

services for, eligible individuals and 

their families. 

(ii) Applicant, and any identified 

community partners, have 

organizational experience coordinating 

services for eligible individuals and 

their families among multiple 

organizations, and Federal, State, local 

and tribal governmental entities. 

(iii) Applicant, and any identified 

community partners, have 

organizational experience administering 

a program similar in type and scale to 

SSG Fox SPGP to eligible individuals 

and their families. 

(iv) Applicant, and any identified 

community partners, have 

organizational experience working with 

veterans and their families. 

(b) VA will award points based on the 

applicant’s program concept and suicide 

prevention services plan, as 

demonstrated by the following: 

(1) Need for program. (i) Applicant 

has shown a need amongst eligible 

individuals and their families in the 

area where the program will be based. 

(ii) Applicant demonstrates an 

understanding of the unique needs for 

suicide prevention services of eligible 

individuals and their families. 

(2) Outreach and screening plan. (i) 

Applicant has a feasible plan for 

outreach, consistent with § 78.45, and 

referral to identify and assist 

individuals and their families that may 

be eligible for suicide prevention 

services and are most in need of suicide 

prevention services. 

(ii) Applicant has a feasible plan to 

process and receive participant referrals. 

(iii) Applicant has a feasible plan to 

assess and accommodate the needs of 

incoming participants, including 

language assistance needs of limited 

English proficient individuals. 

(3) Program concept. (i) Applicant’s 

program concept, size, scope, and 

staffing plan are feasible. 

(ii) Applicant’s program is designed to 

meet the needs of eligible individuals 

and their families. 

(4) Program implementation timeline. 

(i) Applicant’s program will be 

implemented in a timely manner and 

suicide prevention services will be 

delivered to participants as quickly as 

possible and within a specified 

timeline. 

(ii) Applicant has a feasible staffing 

plan in place to meet the applicant’s 

program timeline or has existing staff to 

meet such timeline. 

(5) Coordination with VA. Applicant 

has a feasible plan to coordinate 

outreach and services with local VA 

facilities. 

(6) Ability to meet VA’s requirements, 

goals, and objectives for SSG Fox SPGP. 

Applicant demonstrates commitment to 

ensuring that its program meets VA’s 

requirements, goals, and objectives for 

SSG Fox SPGP as identified in this part 

and the NOFO. 

(7) Capacity to undertake program. 

Applicant has sufficient capacity, 

including staff resources, to undertake 

the program. 

(c) VA will award points based on the 

applicant’s quality assurance and 

evaluation plan, as demonstrated by the 

following: 

(1) Program evaluation. (i) Applicant 

has created clear, realistic, and 

measurable goals that reflect SSG Fox 

SPGP’s aim of reducing and preventing 

suicide among veterans against which 

the applicant’s program performance 

can be evaluated. 

(ii) Applicant has a clear plan to 

continually assess the program. 

(2) Monitoring. (i) Applicant has 

adequate controls in place to regularly 

monitor the program, including any 

community partners, for compliance 

with all applicable laws, regulations, 

and guidelines. 

(ii) Applicant has adequate financial 

and operational controls in place to 

ensure the proper use of suicide 

prevention services grant funds. 

(iii) Applicant has a feasible plan for 

ensuring that the applicant’s staff and 

any community partners are 

appropriately trained and stay informed 

of SSG Fox SPGP policy, evidenceinformed suicide prevention practices, 

and the requirements of this part. 

(3) Remediation. Applicant has an 

appropriate plan to establish a system to 

remediate non-compliant aspects of the 

program if and when they are identified. 


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(4) Management and reporting. 

Applicant’s program management team 

has the capability and a system in place 

to provide to VA timely and accurate 

reports at the frequency set by VA. 

(d) VA will award points based on the 

applicant’s financial capability and 

plan, as demonstrated by the following: 

(1) Organizational finances. 

Applicant, and any identified 

community partners, are financially 

stable. 

(2) Financial feasibility of program. (i) 

Applicant has a realistic plan for 

obtaining all funding required to operate 

the program for the time period of the 

suicide prevention services grant. 

(ii) Applicant’s program is costeffective and can be effectively 

implemented on-budget. 

(e) VA will award points based on the 

applicant’s area linkages and relations, 

as demonstrated by the following: 

(1) Area linkages. Applicant has a 

feasible plan for developing or relying 

on existing linkages with Federal 

(including VA), State, local, and tribal 

government agencies, and private 

entities for the purposes of providing 

additional services to participants 

within a given geographic area. 

(2) Past working relationships. 

Applicant (or applicant’s staff), and any 

identified community partners (or 

community partners’ staff), have 

fostered similar and successful working 

relationships and linkages with public 

and private organizations providing 

services to veterans or their families in 

need of services. 

(3) Local presence and knowledge. (i) 

Applicant has a presence in the area to 

be served by the applicant. 

(ii) Applicant understands the 

dynamics of the area to be served by the 

applicant. 

(4) Integration of linkages and 

program concept. Applicant’s linkages 

to the area to be served by the applicant 

enhance the effectiveness of the 

applicant’s program. 

§ 78.30 Selection of grantees. 

VA will use the following process to 

select applicants to receive suicide 

prevention services grants: 

(a) VA will score all applicants that 

meet the threshold requirements set 

forth in § 78.20 using the scoring criteria 

set forth in § 78.25. 

(b) VA will group applicants within 

the applicable funding priorities if 

funding priorities are set forth in the 

NOFO. 

(c) VA will rank those applicants that 

receive at least the minimum amount of 

total points and points per category set 

forth in the NOFO, within their 

respective funding priority group, if 

any. The applicants will be ranked in 

order from highest to lowest scores, 

within their respective funding priority 

group, if any. 

(d) VA will use the applicant’s 

ranking as the primary basis for 

selection for funding. However, VA will 

also use the following considerations to 

select applicants for funding: 

(1) VA will give preference to 

applicants that have demonstrated the 

ability to provide or coordinate suicide 

prevention services; 

(2) VA may prioritize the distribution 

of suicide prevention services grants to: 

(i) Rural communities; 

(ii) Tribal lands; 

(iii) Territories of the United States; 

(iv) Medically underserved areas; 

(v) Areas with a high number or 

percentage of minority veterans or 

women veterans; and 

(vi) Areas with a high number or 

percentage of calls to the Veterans Crisis 

Line. 

(3) To the extent practicable, VA will 

ensure that suicide prevention services 

grants are distributed to: 

(i) Provide services in areas of the 

United States that have experienced 

high rates of suicide by eligible 

individuals, including suicide attempts; 

and 

(ii) Applicants that can assist eligible 

individuals at risk of suicide who are 

not currently receiving health care 

furnished by VA. 

(iii) Ensure services are provided in as 

many areas as possible. 

(e) Subject to paragraph (d) of this 

section, VA will fund the highestranked applicants for which funding is 

available, within the highest funding 

priority group, if any. If funding 

priorities have been established, to the 

extent funding is available and subject 

to paragraph (d) of this section, VA will 

select applicants in the next highest 

funding priority group based on their 

rank within that group. 

(f) If an applicant would have been 

selected but for a procedural error 

committed by VA, VA may select that 

applicant for funding when sufficient 

funds become available if there is no 

material change in the information that 

would have resulted in the applicant’s 

selection. A new application will not be 

required for this purpose. 

§ 78.35 Scoring criteria for grantees 

applying for renewal of suicide prevention 

service grants. 

VA will score grantees who are 

applying for a renewal of suicide 

prevention services grant. VA will set 

forth specific point values to be 

awarded for each criterion in the NOFO. 

VA will use the following criteria to 

score grantees applying for renewal of a 

suicide prevention services grant: 

(a) VA will award points based on the 

success of the grantee’s program, as 

demonstrated by the following: 

(1) The grantee made progress in 

reducing veteran suicide deaths and 

attempts, reducing all-cause mortality, 

reducing suicidal ideation, increasing 

financial stability; improving mental 

health status, well-being, and social 

supports; and engaging in best practices 

for suicide prevention services. 

(2) Participants were satisfied with 

the suicide prevention services 

provided or coordinated by the grantee, 

as reflected by the satisfaction survey 

conducted under § 78.95(d). 

(3) The grantee implemented the 

program by delivering or coordinating 

suicide prevention services to 

participants in a timely manner 

consistent with SSG Fox SPGP policy, 

the NOFO, and the grant agreement. 

(4) The grantee was effective in 

conducting outreach to eligible 

individuals and their families and 

increasing engagement of eligible 

individuals and their families in suicide 

prevention services, as assessed through 

SSG Fox SPGP grant evaluation. 

(b) VA will award points based on the 

cost-effectiveness of the grantee’s 

program, as demonstrated by the 

following: 

(1) The cost per participant was 

reasonable. 

(2) The grantee’s program was 

effectively implemented on-budget. 

(c) VA will award points based on the 

extent to which the grantee’s program 

complies with SSG Fox SPGP goals and 

requirements, as demonstrated by the 

following: 

(1) The grantee’s program was 

administered in accordance with VA’s 

goals for SSG Fox SPGP as noted in the 

NOFO. 

(2) The grantee’s program was 

administered in accordance with all 

applicable laws, regulations, and 

guidelines. 

(3) The grantee’s program was 

administered in accordance with the 

grantee’s suicide prevention services 

grant agreement. 

§ 78.40 Selection of grantees for renewal 

of suicide prevention services grants. 

VA will use the following process to 

select grantees applying for renewal of 

suicide prevention services grants: 

(a) So long as the grantee continues to 

meet the threshold requirements set 

forth in § 78.20, VA will score the 

grantee using the scoring criteria set 

forth in § 78.35. 

(b) VA will rank those grantees who 

receive at least the minimum amount of 


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total points and points per category set 

forth in the NOFO. The grantees will be 

ranked in order from highest to lowest 

scores. 

(c) VA will use the grantee’s ranking 

as the basis for selection for funding. VA 

will fund the highest-ranked grantees 

for which funding is available. 

(d) At its discretion, VA may award 

any non-renewed funds to an applicant 

or existing grantee. If VA chooses to 

award non-renewed funds to an 

applicant or existing grantee, funds will 

be awarded as follows: 

(1) VA will first offer to award the 

non-renewed funds to the applicant or 

grantee with the highest grant score 

under the relevant NOFO that applies 

for, or is awarded a renewal grant in, the 

same area as, or a proximate area to, the 

affected area if available. Such applicant 

or grantee must have the capacity and 

agree to provide prompt services to the 

affected area. Under this section, the 

relevant NOFO is the most recently 

published NOFO which covers the 

affected area, or for multi-year grant 

awards, the NOFO for which the 

grantee, who is offered the additional 

funds, received the multi-year award. 

(2) If the first such applicant or 

grantee offered the non-renewed funds 

refuses the funds, VA will offer to award 

the funds to the next highest-ranked 

such applicant or grantee, per the 

criteria in paragraph (d)(1) of this 

section, and continue on in rank order 

until the non-renewed funds are 

awarded. 

(e) If an applicant would have been 

selected but for a procedural error 

committed by VA, VA may select that 

applicant for funding when sufficient 

funds become available if there is no 

material change in the information that 

would have resulted in the applicant’s 

selection. A new application will not be 

required for this purpose. 

§ 78.45 Suicide prevention services: 

Outreach. 

(a) Grantees providing or coordinating 

the provision of outreach must use their 

best efforts to ensure that eligible 

individuals, including those who are at 

highest risk of suicide or who are not 

receiving health care or other services 

furnished by VA, and their families are 

identified, engaged, and provided 

suicide prevention services. 

(b) Outreach must include active 

liaison with local VA facilities; State, 

local, or tribal government (if any); and 

private agencies and organizations 

providing suicide prevention services to 

eligible individuals and their families in 

the area to be served by the grantee. 

§ 78.50 Suicide prevention services: 

Baseline mental health screening. 

(a) Grantees must provide or 

coordinate the provision of a baseline 

mental health screening to all 

participants they serve at the time those 

services begin. This mental health 

screening must be provided using a 

validated screening tool that assesses 

suicide risk and mental and behavioral 

health conditions. Information on the 

specific tool or tools to be used will be 

included in the NOFO. 

(b) If an eligible individual is at risk 

of suicide or other mental or behavioral 

health condition pursuant to the 

baseline mental health screening 

conducted under paragraph (a) of this 

section, the grantee must refer such 

individual to VA for care. If the eligible 

individual refuses the grantee’s referral 

to VA, any ongoing clinical services 

provided to the eligible individual by 

the grantee is at the expense of the 

grantee. 

(c) If a participant other than an 

eligible individual is at risk of suicide 

or other mental or behavioral health 

condition pursuant to the baseline 

mental health screening conducted 

under paragraph (a) of this section, the 

grantee must refer such participant to 

appropriate health care services in the 

area unless the grantee is capable of 

furnishing such care. Any ongoing 

clinical services provided to the 

participant by the grantee is at the 

expense of the grantee. 

(d) Except as provided for under 

§ 78.60(a), funds provided under this 

grant program may not be used to 

provide clinical services to participants, 

and any ongoing clinical services 

provided to such individuals by the 

grantee is at the expense of the grantee. 

The grantee may not charge, bill, or 

otherwise hold liable participants for 

the receipt of such care or services. 

§ 78.55 Suicide prevention services: 

Education. 

Grantees providing or coordinating 

the provision of education must provide 

or coordinate the provision of suicide 

prevention education programs to 

educate communities, veterans, and 

families on how to identify those at risk 

of suicide, how and when to make 

referrals for care, and the types of 

suicide prevention resources available 

within the area. Education can include 

gatekeeper training, lethal means safety 

training, or specific educations 

programs that assist with identification, 

assessment, or prevention of suicide. 

§ 78.60 Suicide prevention services: 

Clinical services for emergency treatment. 

(a) Grantees providing or coordinating 

the provision of clinical services for 

emergency treatment must provide or 

coordinate the provision of clinical 

services for emergency treatment of a 

participant. 

(b) If an eligible individual is 

furnished clinical services for 

emergency treatment under paragraph 

(a) of this section and the grantee 

determines that the eligible individual 

requires ongoing services, the grantee 

must refer the eligible individual to VA 

for additional care. If the eligible 

individual refuses the grantee’s referral 

to VA, any ongoing clinical services 

provided to the eligible individual by 

the grantee is at the expense of the 

grantee. The grantee may not charge, 

bill, or otherwise hold liable eligible 

individuals for the receipt of such care 

or services. 

(c) If a participant other than an 

eligible individual is furnished clinical 

services for emergency treatment under 

paragraph (a) of this section and the 

grantee determines that the participant 

requires ongoing services, the grantee 

must refer the participant to appropriate 

health care services in the area for 

additional care. Except as provided for 

under paragraph (a) of this section, 

funds provided under this grant 

program may not be used to provide 

ongoing clinical services to such 

participants, and any ongoing clinical 

services provided to the participant by 

the grantee is at the expense of the 

grantee. The grantee may not charge, 

bill, or otherwise hold liable such 

participants for the receipt of such care 

or services. 

(d) For purposes of this section, 

emergency treatment means medical 

services, professional services, 

ambulance services, ancillary care and 

medication (including a short course of 

medication related to and necessary for 

the treatment of the emergency 

condition that is provided directly to or 

prescribed for the patient for use after 

the emergency condition is stabilized 

and the patient is discharged) was 

rendered in a medical emergency of 

such nature that a prudent layperson 

would have reasonably expected that 

delay in seeking immediate medical 

attention would have been hazardous to 

life or health. This standard is met by 

an emergency medical condition 

manifesting itself by acute symptoms of 

sufficient severity (including severe 

pain) that a prudent layperson who 

possesses an average knowledge of 

health and medicine could reasonably 

expect the absence of immediate 

medical attention to result in placing 


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the health of the individual in serious 

jeopardy, serious impairment to bodily 

functions, or serious dysfunction of any 

bodily organ or part. 

(e) The direct provision of clinical 

services for emergency treatment by 

grantees under this section is not 

prohibited by § 78.80(a). 

§ 78.65 Suicide prevention services: Case 

management services. 

Grantees providing or coordinating 

the provision of case management 

services must provide or coordinate the 

provision of case management services 

that include, at a minimum: 

(a) Performing a careful assessment of 

participants, and developing and 

monitoring case plans in coordination 

with a formal assessment of suicide 

prevention services needed, including 

necessary follow-up activities, to ensure 

that the participant’s needs are 

adequately addressed; 

(b) Establishing linkages with 

appropriate agencies and service 

providers in the area to help 

participants obtain needed suicide 

prevention services; 

(c) Providing referrals to participants 

and related activities (such as 

scheduling appointments for 

participants) to help participants obtain 

needed suicide prevention services, 

such as medical, social, and educational 

assistance or other suicide prevention 

services to address participants’ 

identified needs and goals; 

(d) Deciding how resources and 

services are allocated to participants on 

the basis of need; 

(e) Educating participants on issues, 

including, but not limited to, suicide 

prevention services availability and 

participant rights; and 

(f) Other activities, as approved by 

VA, to serve the comprehensive needs 

of participants for the purpose of 

reducing suicide risk. 

§ 78.70 Suicide prevention services: Peer 

support services. 

(a) Grantees providing or coordinating 

the provision of peer support services 

must provide or coordinate the 

provision of peer support services to 

help participants understand what 

resources and supports are available in 

their area for suicide prevention. Peer 

support services must be provided by 

veterans trained in peer support with 

similar lived experiences related to 

suicide or mental health. Peer support 

specialists serve as role models and a 

resource to assist participants with their 

mental health recovery. 

(b) Each grantee providing or 

coordinating the provision of peer 

support services must ensure that 

veterans providing such services to 

participants meet the requirements of 38 

U.S.C. 7402(b)(13) and meet 

qualification standards for appointment; 

or have completed peer support 

training, are pursuing credentials to 

meet the minimum qualification 

standards for appointment, and are 

under the supervision of an individual 

who meets the requirements of 38 

U.S.C. 7402(b)(13). Grant funds may be 

used to provide education and training 

for employees of the grantee or the 

community partner who provide peer 

support services consistent with the 

terms set forth in the grant agreement. 

§ 78.75 Suicide prevention services: 

Assistance in obtaining VA benefits. 

(a) Grantees assisting participants in 

obtaining VA benefits must assist 

participants in obtaining any benefits 

from VA for which the participants are 

eligible. Such benefits include but are 

not limited to: 

(1) Vocational and rehabilitation 

counseling; 

(2) Supportive services for homeless 

veterans; 

(3) Employment and training services; 

(4) Educational assistance; and 

(5) Health care services. 

(b) Grantees are not permitted to 

represent participants before VA with 

respect to a claim for VA benefits unless 

they are recognized for that purpose 

pursuant to 38 U.S.C. 5902. Employees 

and members of grantees are not 

permitted to provide such 

representation unless the individual 

providing representation is accredited 

pursuant to 38 U.S.C. chapter 59. 

§ 78.80 Suicide prevention services: 

Assistance in obtaining and coordinating 

other public benefits and assistance with 

emergent needs. 

Grantees assisting in obtaining and 

coordinating other public benefits or 

assisting with emergent needs must 

assist participants with obtaining and 

coordinating the provision of other 

public benefits, including at a minimum 

those listed in paragraphs (a) through 

(h) of this section, that are being 

provided by Federal, State, local, or 

tribal agencies, or any other grantee in 

the area served by the grantee by 

referring the participant to and 

coordinating with such entity. If a 

public benefit is not being provided by 

Federal, State, local, or tribal agencies, 

or any other grantee in the area, the 

grantee is not required to obtain, 

coordinate, or provide such public 

benefit. Grantees may elect to provide 

directly to participants the public 

benefits identified in paragraphs (c) 

through (h) of this section. 

(a) Health care services, which 

include: 

(1) Health insurance; and 

(2) Referral to a governmental entity 

or grantee that provides any of the 

following services: 

(i) Hospital care, nursing home care, 

outpatient care, mental health care, 

preventive care, habilitative and 

rehabilitative care, case management, 

respite care, and home care; 

(ii) The training of any eligible 

individual’s family in the care of any 

eligible individual; and 

(iii) The provision of pharmaceuticals, 

supplies, equipment, devices, 

appliances, and assistive technology. 

(b) Referral of a participant, as 

appropriate, to an entity that provides 

daily living services relating to the 

functions or tasks for self-care usually 

performed in the normal course of a 

day, including, but not limited to, 

eating, bathing, grooming, dressing, and 

home management activities. 

(c) Personal financial planning 

services, which include, at a minimum, 

providing recommendations regarding 

day-to-day finances and achieving longterm budgeting and financial goals. 

Grant funds may pay for credit 

counseling and other services necessary 

to assist participants with critical skills 

related to household budgeting, 

managing money, accessing a free 

personal credit report, and resolving 

credit problems. 

(d) Transportation services: 

(1) The grantee may provide 

temporary transportation services 

directly to participants if the grantee 

determines such assistance is necessary; 

however, the preferred method of direct 

provision of transportation services is 

the provision of tokens, vouchers, or 

other appropriate instruments so that 

participants may use available public 

transportation options. 

(2) If public transportation options are 

not sufficient within an area, costs 

related to the lease of vehicle(s) may be 

included in a suicide prevention 

services grant application if the 

applicant or grantee, as applicable, 

agrees that: 

(i) The vehicle(s) will be safe, 

accessible, and equipped to meet the 

needs of the participants; 

(ii) The vehicle(s) will be maintained 

in accordance with the manufacturer’s 

recommendations; and 

(iii) All transportation personnel 

(employees and community partners) 

will be licensed, insured, and trained in 

managing any special needs of 

participants and handling emergency 

situations. 

(3) Transportation services furnished 

under this paragraph may include 


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reimbursement for transportation 

furnished through ride sharing services, 

taxi services, or similar sources, but 

only if: 

(i) The participant lacks any other 

means of transportation, including 

transportation or reimbursement for 

transportation from the Department 

under part 70 of this title; and 

(ii) The grantee documents the 

participant’s lack of other means. 

(e) Temporary income support 

services, which may consist of 

providing assistance in obtaining other 

Federal, State, tribal and local 

assistance, in the form of, but not 

limited to, mental health benefits, food 

assistance, housing assistance, 

employment counseling, medical 

assistance, veterans’ benefits, and 

income support assistance. 

(f) Fiduciary and representative payee 

services, which may consist of acting on 

behalf of a participant by receiving the 

participant’s paychecks, benefits or 

other income, and using those funds for 

the current and foreseeable needs of the 

participant and saving any remaining 

funds for the participant’s future use in 

an interest bearing account or saving 

bonds. 

(g) Legal services to assist eligible 

individuals with issues that may 

contribute to the risk of suicide. This 

may include issues that interfere with 

the eligible individual’s ability to obtain 

or retain permanent housing, cover 

basic needs such as food, transportation, 

medical care, and issues that affect the 

eligible individual’s employability and 

financial security (such as debt, credit 

problems, and lacking a driver’s 

license). 

(1) Except for legal assistance with 

resolving outstanding warrants, fines, 

expungements, and drivers’ license 

revocations symptomatic of reentry 

obstacles in employment or housing, 

legal services do not include legal 

assistance with criminal matters nor 

matters in which the eligible individual 

is taking or has taken any adversarial 

legal action against the United States. 

(2) Legal services do not include 

matters in which the United States is 

prosecuting an eligible individual. 

(h) Child care for children under the 

age of 13, unless the child is disabled. 

Disabled children must be under the age 

of 18 to receive assistance under this 

paragraph. Child care includes the: 

(1) Referral of a participant, as 

appropriate, to an eligible child care 

provider that provides child care with 

sufficient hours of operation and serves 

appropriate ages, as needed by the 

participant; and 

(2) Payment by a grantee on behalf of 

a participant for child care by an eligible 

child care provider. Payment may not 

exceed $5,000 per family of an eligible 

individual per Federal fiscal year. 

(i) Payments for child care services 

must be paid by the grantee directly to 

an eligible child care provider. 

(ii) Payments for child care services 

cannot be provided on behalf of 

participants for the same period of time 

and for the same cost types that are 

being provided through another Federal 

(including VA), State or local subsidy 

program. 

(iii) As a condition of providing 

payments for child care services, the 

grantee must help the participant 

develop a reasonable plan to address the 

participant’s future ability to pay for 

child care services. Grantees must assist 

the participant to implement such plan 

by providing any necessary assistance or 

helping the participant to obtain any 

necessary public or private benefits or 

services. 

§ 78.85 Suicide prevention services: 

Nontraditional and innovative approaches 

and treatment practices. 

Grantees providing or coordinating 

the provision of nontraditional and 

innovative approaches and treatment 

practices may provide or coordinate the 

provision of nontraditional and 

innovative approaches and treatment, 

including but not limited to 

complementary or alternative 

interventions with some evidence for 

effectiveness of improving mental 

health or mitigating a risk factor for 

suicidal thoughts and behaviors, as set 

forth in the NOFO or as approved by VA 

that are consistent with SSG Fox SPGP. 

Applicants may propose nontraditional 

and innovative approaches and 

treatment practices in their suicide 

prevention services grant application, 

and grantees may propose these 

additional approaches and treatment 

practices by submitting a written 

request to modify the suicide prevention 

services grant in accordance with 

§ 78.125. VA reserves the right to 

approve or disapprove nontraditional 

and innovative approaches and 

treatment practices to be provided or 

coordinate to be provided using funds 

authorized under SSG Fox SPGP. VA 

will only approve approaches and 

treatment practices consistent with 

applicable Federal law. 

§ 78.90 Suicide prevention services: Other 

services. 

(a) General suicide prevention 

assistance. A grantee may pay directly 

to a third party (and not to a 

participant), in an amount not to exceed 

$750 per participant during any 1-year 

period, beginning on the date that the 

grantee first submits a payment to a 

third party, the following types of 

expenses: 

(i) Expenses associated with gaining 

or keeping employment, such as 

uniforms, tools, certificates, and 

licenses. 

(ii) Expenses associated with lethal 

means safety and secure storage, such as 

gun locks and locked medication 

storage. 

(b) Other. Grantees providing or 

coordinating the provision of other 

suicide prevention services may provide 

or coordinate the provision of the other 

services as set forth in the NOFO or as 

approved by VA that are consistent with 

SSG Fox SPGP. Applicants may propose 

additional services in their suicide 

prevention services grant application, 

and grantees may propose additional 

services by submitting a written request 

to modify the suicide prevention 

services grant program in accordance 

with § 78.125. VA reserves the right to 

approve or disapprove other suicide 

prevention services to be provided or 

coordinate to be provided using funds 

authorized under SSG Fox SPGP. 

§ 78.95 General operation requirements. 

(a) Eligibility documentation. Prior to 

providing suicide prevention services, 

grantees must verify, document, and 

classify each participant’s eligibility for 

suicide prevention services, and 

determine and document each 

participant’s degree of risk of suicide 

using tools identified in the suicide 

prevention services grant agreement. 

Documentation must be maintained 

consistent with § 78.150. 

(b) Required screening prior to 

services ending. Prior to services 

ending, grantees must provide or 

coordinate the provision of a mental 

health screening using the screening 

tool described in § 78.50(a) to all 

participants they serve, when possible. 

(c) Suicide prevention services 

documentation. For each participant 

who receives suicide prevention 

services from the grantee, the grantee 

must document the suicide prevention 

services provided or coordinated, how 

such services are provided or 

coordinated, the duration of the services 

provided or coordinated, and any goals 

for the provision or coordination of such 

services. Such documentation must be 

maintained consistent with § 78.150. 

(d) Notifications to participants. (1) 

Prior to initially providing or 

coordinating suicide prevention services 

to an eligible individual and their 

family, the grantee must notify each 

eligible individual and their family of 

the following: 


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(i) The suicide prevention services are 

being paid for, in whole or in part, by 

VA; 

(ii) The suicide prevention services 

available to the eligible individual and 

their family through the grantee’s 

program; 

(iii) Any conditions or restrictions on 

the receipt of suicide prevention 

services by the eligible individual and 

their family; and 

(iv) In the instance of an eligible 

individual who receives assistance from 

the grantee under this program, that the 

eligible individual is able to apply for 

enrollment in VA health care pursuant 

to 38 CFR 17.36. If the eligible 

individual wishes to enroll in VA health 

care, the grantee must inform the 

eligible individual of a VA point of 

contact for assistance with enrollment. 

The requirements in this clause do not 

apply to eligible individuals who are 

members of the Armed Forces described 

in 38 U.S.C. 1712A(a)(1)(C)(i)–(iv). 

(2) The grantee must provide each 

participant with a satisfaction survey, 

which the participant can submit 

directly to VA, within 30 days of such 

participant’s pending exit from the 

grantee’s program. 

(e) Assessment of funds. Grantees 

must regularly assess how suicide 

prevention services grant funds can be 

used in conjunction with other available 

funds and services to assist participants. 

(f) Development of a suicide 

prevention services plan. For each 

participant, grantees must develop and 

document an individualized plan with 

respect to the provision of suicide 

prevention services provided under this 

part. This plan must be developed in 

consultation with the participant and 

must be maintained consistent with 

§ 78.150. 

(g) Coordination with VA. The grantee 

will coordinate with VA with respect to 

the provision of health care and other 

services to eligible individuals pursuant 

to 38 U.S.C. chapters 17 and 20. 

(h) Measurement and monitoring. The 

grantee will submit to VA a description 

of the tools and assessments the grantee 

uses or will use to determine the 

effectiveness of the suicide prevention 

services furnished by the grantee. These 

will include any measures and metrics 

developed and provided by VA for the 

purposes of measuring the effectiveness 

of the programming to be provided in 

improving mental health status, 

wellbeing, and reducing suicide risk 

and suicide deaths of eligible 

individuals. 

(i) Agreements with community 

partners. Only grantees that are a State 

or local government or an Indian tribe 

may use grant funds to enter into an 

agreement with a community partner 

under which the grantee may provide 

funds to the community partner for the 

provision of suicide prevention services 

to eligible individuals and their 

families. 

(j) Contracts for goods and services 

under this part. Grantees may enter into 

contracts for good or services under this 

part. 

(k) Administration of suicide 

prevention services grants. Grantees 

must ensure that suicide prevention 

services grants are administered in 

accordance with the requirements of 

this part, the suicide prevention services 

grant agreement, and other applicable 

Federal, State, and local laws and 

regulations, including Federal civil 

rights laws. Grantees are responsible for 

ensuring that any community partners 

carry out activities in compliance with 

this part. 

(The Office of Management and Budget 

has approved the information collection 

provisions in this section under control 

number 2900–TBD.) 

§ 78.100 Fee prohibition. 

Grantees must not charge a fee to 

participants for providing suicide 

prevention services that are funded with 

amounts from a suicide prevention 

services grant. 

§ 78.105 Ineligible activities. 

Notwithstanding any other section in 

this part, grantees are not authorized to 

use suicide prevention services grant 

funds to pay for the following: 

(a) Direct cash assistance to 

participants. 

(b) Those legal services prohibited 

pursuant to § 78.80(g). 

(c) Medical or dental care and 

medicines except for clinical services 

authorized pursuant to § 78.60. 

(d) Any activities considered illegal 

under Federal law. 

§ 78.110 Notice of Funding Opportunity. 

When funds are available for suicide 

prevention services grants, VA will 

publish a NOFO on grants.gov. The 

NOFO will identify: 

(a) The location for obtaining suicide 

prevention services grant applications; 

(b) The date, time, and place for 

submitting completed suicide 

prevention services grant applications; 

(c) The estimated amount and type of 

suicide prevention services grant 

funding available; 

(d) Any priorities for or exclusions 

from funding to meet the statutory 

mandates of section 201 of Public Law 

116–171 and VA’s goals for SSG Fox 

SPGP; 

(e) The length of term for the suicide 

prevention services grant award; 

(f) The minimum number of total 

points and points per category that an 

applicant or grantee, as applicable, must 

receive for a suicide prevention services 

grant to be funded; 

(g) Any maximum uses of suicide 

prevention services grant funds for 

specific suicide prevention services; 

(h) The timeframes and manner for 

payments under the suicide prevention 

services grant; and 

(i) Other information necessary for the 

suicide prevention services grant 

application process as determined by 

VA. 

§ 78.115 Suicide prevention services grant 

agreements. 

(a) After an applicant is selected for 

a suicide prevention services grant in 

accordance with § 78.30, VA will draft 

a suicide prevention services grant 

agreement to be executed by VA and the 

applicant. Upon execution of the 

suicide prevention services grant 

agreement, VA will obligate suicide 

prevention services grant funds to cover 

the amount of the approved suicide 

prevention services grant, subject to the 

availability of funding. The suicide 

prevention services grant agreement will 

provide that the grantee agrees, and will 

ensure that each community partner 

agrees, to: 

(1) Operate the program in accordance 

with the provisions of this part and the 

applicant’s suicide prevention services 

grant application; 

(2) Comply with such other terms and 

conditions, including recordkeeping 

and reports for program monitoring and 

evaluation purposes, as VA may 

establish for purposes of carrying out 

SSG Fox SPGP, in an effective and 

efficient manner; and 

(3) Provide such additional 

information as deemed appropriate by 

VA. 

(b) After a grantee is selected for 

renewal of a suicide prevention services 

grant in accordance with § 78.40, VA 

will draft a suicide prevention services 

grant agreement to be executed by VA 

and the grantee. Upon execution of the 

suicide prevention services grant 

agreement, VA will obligate suicide 

prevention services grant funds to cover 

the amount of the approved suicide 

prevention services grant, subject to the 

availability of funding. The suicide 

prevention services grant agreement will 

contain the same provisions described 

in paragraph (a) of this section. 

(c) No funds provided under this part 

may be used to replace Federal, State, 

tribal, or local funds previously used, or 

designated for use, to assist eligible 

individuals and their families. 


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§ 78.120 Amount and payment of grants. 

(a) Amount of grants. The maximum 

funding that a grantee may be awarded 

under this part is $750,000 per fiscal 

year. 

(b) Payment of grants. Grantees are to 

be paid in accordance with the 

timeframes and manner set forth in the 

NOFO. 

§ 78.125 Program or budget changes and 

corrective action plans. 

(a) A grantee must submit to VA a 

written request to modify a suicide 

prevention services grant for any 

proposed significant change that will 

alter the suicide prevention services 

grant program. If VA approves such 

change, VA will issue a written 

amendment to the suicide prevention 

services grant agreement. A grantee 

must receive VA’s approval prior to 

implementing a significant change. 

Significant changes include, but are not 

limited to, a change in the grantee or 

any community partners identified in 

the suicide prevention services grant 

agreement; a change in the area served 

by the grantee; additions or deletions of 

suicide prevention services provided by 

the grantee; a change in category of 

participants to be served; and a change 

in budget line items that are more than 

10 percent of the total suicide 

prevention services grant award. 

(1) VA’s approval of changes is 

contingent upon the grantee’s amended 

application retaining a sufficient rank to 

have been competitively selected for 

funding in the year that the application 

was granted. 

(2) Each suicide prevention services 

grant modification request must contain 

a description of, and justification for, 

the revised proposed use of suicide 

prevention services grant funds. 

(b) VA may require that the grantee 

initiate, develop, and submit to VA for 

approval a Corrective Action Plan (CAP) 

if, on a quarterly basis, actual suicide 

prevention services grant expenditures 

vary from the amount disbursed to a 

grantee for that same quarter or actual 

suicide prevention services grant 

activities vary from the grantee’s 

program description provided in the 

suicide prevention services grant 

agreement. 

(1) The CAP must identify the 

expenditure or activity source that has 

caused the deviation, describe the 

reason(s) for the variance, provide 

specific proposed corrective action(s), 

and provide a timetable for 

accomplishment of the corrective 

action. 

(2) After receipt of the CAP, VA will 

send a letter to the grantee indicating 

that the CAP is approved or 

disapproved. If disapproved, VA will 

make beneficial suggestions to improve 

the proposed CAP and request 

resubmission or take other actions in 

accordance with this part. 

(c) Grantees must inform VA in 

writing of any key personnel changes 

(e.g., new executive director, the suicide 

prevention services grant program 

director, or chief financial officer) and 

grantee address changes within 30 days 

of the change. 

(The Office of Management and Budget 

has approved the information collection 

provisions in this section under control 

number 2900–TBD.) 

§ 78.130 Faith-based organizations. 

(a) Organizations that are faith-based 

are eligible, on the same basis as any 

other organization, to participate in SSG 

Fox SPGP under this part. Decisions 

about awards of Federal financial 

assistance must be free from political 

interference or even the appearance of 

such interference and must be made on 

the basis of merit, not on the basis of 

religion or religious belief or lack 

thereof. 

(b)(1) No organization may use direct 

financial assistance from VA under this 

part to pay for any of the following: 

(i) Explicitly religious activities such 

as, religious worship, instruction, or 

proselytization; or 

(ii) Equipment or supplies to be used 

for any of those activities. 

(2) References to ‘‘financial 

assistance’’ will be deemed to be 

references to direct Federal financial 

assistance, unless the referenced 

assistance meets the definition of 

‘‘indirect Federal financial assistance’’ 

in this part. 

(c) Organizations that engage in 

explicitly religious activities, such as 

worship, religious instruction, or 

proselytization, must offer those 

services separately in time or location 

from any programs or services funded 

with direct financial assistance from VA 

under this part, and participation in any 

of the organization’s explicitly religious 

activities must be voluntary for the 

participants of a program or service 

funded by direct financial assistance 

from VA under this part. 

(d) A faith-based organization that 

participates in SSG Fox SPGP under this 

part will retain its independence from 

Federal, State, or local governments and 

may continue to carry out its mission, 

including the definition, practice and 

expression of its religious beliefs, 

provided that it does not use direct 

financial assistance from VA under this 

part to support any explicitly religious 

activities, such as worship, religious 

instruction, or proselytization. Among 

other things, faith-based organizations 

may use space in their facilities to 

provide VA-funded services under this 

part, without concealing, removing, or 

altering religious art, icons, scripture, or 

other religious symbols. In addition, a 

VA-funded faith-based organization 

retains its authority over its internal 

governance, and it may retain religious 

terms in its organization’s name, select 

its board members and otherwise govern 

itself on a religious basis, and include 

religious reference in its organization’s 

mission statements and other governing 

documents. 

(e) An organization that participates 

in a VA program under this part must 

not, in providing direct program 

assistance, discriminate against a 

program participant or prospective 

program participant on the basis of 

religion or religious belief. 

(f) If a State or local government 

voluntarily contributes its own funds to 

supplement Federally funded activities, 

the State or local government has the 

option to segregate the Federal funds or 

commingle them. However, if the funds 

are commingled, this provision applies 

to all of the commingled funds. 

(g) To the extent otherwise permitted 

by Federal law, the restrictions on 

explicitly religious activities set forth in 

this section do not apply where VA 

funds are provided to faith-based 

organizations through indirect 

assistance as a result of a genuine and 

independent private choice of a 

participant, provided the faith-based 

organizations otherwise satisfy the 

requirements of this part. A faith-based 

organization may receive such funds as 

the result of a participant’s genuine and 

independent choice if, for example, a 

participant redeems a voucher, coupon, 

or certificate, allowing the participant to 

direct where funds are to be paid, or a 

similar funding mechanism provided to 

that participant and designed to give 

that participant a choice among 

providers. 

§ 78.135 Visits to monitor operation and 

compliance. 

(a) VA has the right, at all reasonable 

times, to make visits to all grantee 

locations where a grantee is using 

suicide prevention services grant funds 

to review grantee accomplishments and 

management control systems and to 

provide such technical assistance as 

may be required. VA may conduct 

inspections of all program locations and 

records of a grantee at such times as are 

deemed necessary to determine 

compliance with the provisions of this 

part. In the event that a grantee delivers 

services in a participant’s home, or at a 


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13844 Federal Register / Vol. 87, No. 47 / Thursday, March 10, 2022 / Rules and Regulations 

location away from the grantee’s place 

of business, VA may accompany the 

grantee. If the grantee’s visit is to the 

participant’s home, VA will only 

accompany the grantee with the consent 

of the participant. If any visit is made 

by VA on the premises of the grantee or 

a community partner under the suicide 

prevention services grant, the grantee 

must provide, and must require its 

community partners to provide, all 

reasonable facilities and assistance for 

the safety and convenience of the VA 

representatives in the performance of 

their duties. All visits and evaluations 

will be performed in such a manner as 

will not unduly delay services. 

(b) The authority to inspect carries 

with it no authority over the 

management or control of any applicant 

or grantee under this part. 

§ 78.140 Financial management and 

administrative costs. 

(a) Grantees must comply with 

applicable requirements of the Uniform 

Administrative Requirements, Cost 

Principles, and Audit Requirements for 

Federal Awards under 2 CFR part 200. 

(b) Grantees must use a financial 

management system that provides 

adequate fiscal control and accounting 

records and meets the requirements set 

forth in 2 CFR part 200. 

(c) Payment up to the amount 

specified in the suicide prevention 

services grant must be made only for 

allowable, allocable, and reasonable 

costs in conducting the work under the 

suicide prevention services grant. The 

determination of allowable costs must 

be made in accordance with the 

applicable Federal Cost Principles set 

forth in 2 CFR part 200. 

(d) Costs for administration by a 

grantee must not exceed 10 percent of 

the total amount of the suicide 

prevention services grant. 

Administrative costs will consist of all 

costs associated with the management of 

the program. These costs will include 

the administrative costs of community 

partners. 

§ 78.145 Grantee reporting requirements. 

(a) VA may require grantees to 

provide, in any form as may be 

prescribed, such reports or answers in 

writing to specific questions, surveys, or 

questionnaires as VA determines 

necessary to carry out SSG Fox SPGP. 

(b) At least once per year, each 

grantee must submit to VA a report that 

describes the projects carried out with 

such grant during the year covered by 

the report; and information relating to 

operational effectiveness, fiscal 

responsibility, suicide prevention 

services grant agreement compliance, 

and legal and regulatory compliance, 

including a description of the use of 

suicide prevention grant funds, the 

number of participants assisted, the 

types of suicide prevention services 

provided, and any other information 

that VA may request. 

(c) VA may request additional reports 

or information to allow VA to fully 

assess the provision or coordination of 

the provision of suicide prevention 

services under this part. 

(d) All pages of the reports must cite 

the assigned suicide prevention services 

grant number and be submitted in a 

timely manner as set forth in the grant 

agreement. 

(e) Grantees must provide VA with 

consent to post information from reports 

on the internet and use such 

information in other ways deemed 

appropriate by VA. Grantees shall 

clearly mark information that is 

confidential to individual participants. 

(The Office of Management and Budget 

has approved the information collection 

provisions in this section under control 

number 2900–TBD.) 

§ 78.150 Recordkeeping. 

Grantees must ensure that records are 

maintained for at least a 3-year period 

to document compliance with this part. 

Grantees must produce such records at 

VA’s request. 

§ 78.155 Technical assistance. 

VA will provide technical assistance, 

as necessary, to applicants and grantees 

to meet the requirements of this part. 

Such technical assistance will be 

provided either directly by VA or 

through contracts with appropriate 

public or non-profit private entities. 

§ 78.160 Withholding, suspension, 

deobligation, termination, and recovery of 

funds by VA. 

VA will enforce this part through 

such actions as may be appropriate. 

Appropriate actions include 

withholding, suspension, deobligation, 

termination, recovery of funds by VA, 

and actions in accordance with 2 CFR 

part 200. 

§ 78.165 Suicide prevention services grant 

closeout procedures. 

Suicide prevention services grants 

will be closed out in accordance with 2 

CFR part 200. 

[FR Doc. 2022–04477 Filed 3–9–22; 8:45 am] 

BILLING CODE 8320–01–P 


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