I 
116TH CONGRESS 
2D SESSION 
H. R. 8107 
To direct the Secretary of Veterans Affairs to submit to Congress a report 
on efforts by Department of Veterans Affairs to implement safety plan-
ning in emergency departments, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
AUGUST 25, 2020 
Mr. LEVIN of Michigan (for himself and Mr. STIVERS) introduced the 
following bill; which was referred to the Committee on Veterans’ Affairs 
A BILL 
To direct the Secretary of Veterans Affairs to submit to 
Congress a report on efforts by Department of Veterans 
Affairs to implement safety planning in emergency de-
partments, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘VA Emergency De-
partment Safety Planning Act’’. 
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SEC. 2. REPORT ON EFFORTS BY DEPARTMENT OF VET-
ERANS 
AFFAIRS 
TO 
IMPLEMENT 
SAFETY 
PLANNING IN EMERGENCY DEPARTMENTS. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(1) The Department of Veterans Affairs must 
be more effective in its approach to reducing the 
burden of veteran suicide connected to mental health 
diagnoses, to include expansion of treatment deliv-
ered via telehealth methods and in rural areas. 
(2) An innovative project, known as Suicide As-
sessment and Follow-up Engagement: Veteran 
Emergency Treatment (in this subsection referred to 
as ‘‘SAFE VET’’), was designed to help suicidal vet-
erans seen at emergency departments within the 
Veterans Health Administration and was success-
fully implemented in five intervention sites beginning 
in 2010. 
(3) A 2018 study found that safety planning 
intervention under SAFE VET was associated with 
45 percent fewer suicidal behaviors in the six-month 
period following emergency department care and 
more than double the odds of a veteran engaging in 
outpatient behavioral health care. 
(4) SAFE VET is a promising alternative and 
acceptable delivery of care system that augments the 
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treatment of suicidal veterans in emergency depart-
ments of the Veterans Health Administration and 
helps ensure that those veterans have appropriate 
follow-up care. 
(5) Beginning in September 2018, the Veterans 
Health Administration implemented a suicide pre-
vention program based on the findings of SAFE 
VET, known as the SPED program, for veterans 
presenting to the emergency department who are as-
sessed to be at risk for suicide and are safe to be 
discharged home. 
(6) The SPED program includes issuance and 
update of a safety plan and post-discharge follow-up 
outreach for veterans to facilitate engagement in 
outpatient mental health care. 
(b) REPORT.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of the enactment of this Act, the Sec-
retary of Veterans Affairs shall submit to the appro-
priate committees of Congress a report on the ef-
forts of the Secretary to implement a suicide preven-
tion program for veterans presenting to an emer-
gency department or urgent care center of the Vet-
erans Health Administration who are assessed to be 
at risk for suicide and are safe to be discharged 
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home, including a safety plan and post-discharge 
outreach for veterans to facilitate engagement in 
outpatient mental health care. 
(2) ELEMENTS.—The report required by para-
graph (1) shall include the following: 
(A) An assessment of the implementation 
of the current operational policies and proce-
dures of the SPED program at each medical 
center of the Department of Veterans Affairs, 
including an assessment of the following: 
(i) Training provided to clinicians or 
other personnel administering protocols 
under the SPED program. 
(ii) Any disparities in implementation 
of such protocols between medical centers. 
(iii) Current criteria used to measure 
the quality of such protocols including— 
(I) methodology used to assess 
the quality of a safety plan and post- 
discharge outreach for veterans; or 
(II) in the absence of such meth-
odology, a proposed timeline and 
guidelines for creating a methodology 
to ensure compliance with the evi-
dence-based model used under the 
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Suicide Assessment and Follow-up 
Engagement: 
Veteran 
Emergency 
Treatment (SAFE VET) program of 
the Department. 
(B) An assessment of the implementation 
of the policies and procedures described in sub-
paragraph (A), disaggregated by gender and by 
race and ethnicity, including the following: 
(i) An assessment of the quality and 
quantity of safety plans issued to veterans. 
(ii) An assessment of the quality and 
quantity of post-discharge outreach pro-
vided to veterans. 
(iii) The post-discharge rate of vet-
eran engagement in outpatient mental 
health care, including attendance at not 
fewer than one individual mental health 
clinic appointment or admission to an in-
patient or residential unit. 
(iv) The number of veterans who de-
cline safety planning efforts during proto-
cols under the SPED program. 
(v) The number of veterans who de-
cline to participate in follow-up efforts 
within the SPED program. 
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(C) A description of how SPED primary 
coordinators are deployed to support such ef-
forts, including the following: 
(i) A description of the duties and re-
sponsibilities of such coordinators. 
(ii) The number and location of such 
coordinators. 
(iii) A description of training provided 
to such coordinators. 
(iv) An assessment of the other re-
sponsibilities for such coordinators and, if 
applicable, differences in patient outcomes 
when such responsibilities are full-time du-
ties as opposed to secondary duties. 
(D) An assessment of the feasibility and 
advisability of expanding the total number and 
geographic distribution of SPED primary coor-
dinators. 
(E) An assessment of the feasibility and 
advisability of providing services under the 
SPED program via telehealth channels, includ-
ing an analysis of opportunities to leverage tele-
health to better serve veterans in rural areas. 
(F) A description of the status of current 
capabilities and utilization of tracking mecha-
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nisms to monitor compliance, quality, and pa-
tient outcomes under the SPED program. 
(G) Such recommendations, including spe-
cific action items, as the Secretary considers 
appropriate with respect to how the Depart-
ment can better implement the SPED program, 
including recommendations with respect to the 
following: 
(i) A process to standardize training 
under such program. 
(ii) Any resourcing requirements nec-
essary to implement the SPED program 
throughout Veterans Health Administra-
tion, including by having a dedicated clini-
cian responsible for administration of such 
program at each medical center. 
(iii) An analysis of current statutory 
authority and any changes necessary to 
fully 
implement 
the 
SPED 
program 
throughout the Veterans Health Adminis-
tration. 
(iv) A timeline for the implementation 
of the SPED program through the Vet-
erans Health Administration once full 
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resourcing and an approved training plan 
are in place. 
(H) Such other matters as the Secretary 
considers appropriate. 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘appropriate committees of Con-
gress’’ means— 
(A) the Committee on Veterans’ Affairs 
and the Subcommittee on Military Construc-
tion, Veterans Affairs, and Related Agencies of 
the Committee on Appropriations of the Senate; 
and 
(B) the Committee on Veterans’ Affairs 
and the Subcommittee on Military Construc-
tion, Veterans Affairs, and Related Agencies of 
the Committee on Appropriations of the House 
of Representatives. 
(2) The term ‘‘SPED primary coordinator’’ 
means the main point of contact responsible for ad-
ministering the SPED program at a medical center 
of the Department. 
(3) The term ‘‘SPED program’’ means the 
Safety Planning in Emergency Departments pro-
gram of the Department of Veterans Affairs estab-
lished in September 2018 for veterans presenting to 
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the emergency department who are assessed to be at 
risk for suicide and are safe to be discharged home, 
which extends the evidence-based intervention for 
suicide prevention to all emergency departments of 
the Veterans Health Administration. 
Æ 
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