I 
118TH CONGRESS 
1ST SESSION H. R. 1639 
To direct the Secretary of Veterans Affairs to establish the Zero Suicide 
Initiative pilot program of the Department of Veterans Affairs. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 17, 2023 
Mrs. LEE of Nevada (for herself, Mr. TONY GONZALES of Texas, Mr. SABLAN, 
Mrs. GONZA´LEZ-COLO´N, Ms. BROWNLEY, Mr. HUDSON, Mr. ALLRED, 
and Ms. SLOTKIN) introduced the following bill; which was referred to the 
Committee on Veterans’ Affairs 
A BILL 
To direct the Secretary of Veterans Affairs to establish the 
Zero Suicide Initiative pilot program of the Department 
of Veterans Affairs. 
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 Zero Suicide Dem-
onstration Project Act of 2023’’. 
SEC. 2. ZERO SUICIDE INITIATIVE PILOT PROGRAM. 
(a) ESTABLISHMENT.—Not later than 180 days after 
the date of the enactment of this Act, the Secretary of 
Veterans Affairs shall establish a pilot program called the 
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‘‘Zero Suicide Initiative’’ (referred to in this section as the 
‘‘program’’). 
(b) CURRICULUM.—The program shall implement the 
curriculum of the Zero Suicide Institute of the Education 
Development Center (referred to in this section as the ‘‘In-
stitute’’) to improve safety and suicide care for veterans, 
thereby significantly reducing rates of suicide. 
(c) DEVELOPMENT.— 
(1) IN GENERAL.—The first year of the pro-
gram shall be dedicated to program development, in-
cluding planning and site selection. 
(2) CONSULTATION.—In developing the pro-
gram, the Secretary shall consult with— 
(A) the Secretary of Health and Human 
Services; 
(B) the National Institutes of Health; 
(C) public and private institutions of high-
er education; 
(D) educators; 
(E) experts in suicide assessment, treat-
ment, and management; 
(F) veterans service organizations; and 
(G) professional associations the Secretary 
of Veterans Affairs determines relevant to the 
purposes of the program. 
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(d) STAFF LEADERS; PROGRAM ELEMENTS.—The 
program shall consist of not less than ten weeks of edu-
cation regarding suicide care, beginning with the selection 
of five to ten staff leaders from each site selected under 
subsection (e) who shall carry out the following program 
elements: 
(1) Complete the organizational self-study of 
the Institute as a team. 
(2) Attend the two-day Zero Suicide Academy 
of the Institute. 
(3) Formulate a plan to collect data to support 
evaluation and quality improvement using the data 
elements worksheet of the Institute. 
(4) Communicate to staff at the respective site 
the adoption of a specific suicide care approach. 
(5) Administer the workforce survey of the In-
stitute to all staff at the respective site to learn 
more about perceived comfort with and competence 
in caring for patients at risk of suicide. 
(6) Review, develop, and implement training on 
processes and policies regarding patients at risk of 
suicide, including— 
(A) screening; 
(B) assessment; 
(C) use of electronic health records; 
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(D) risk formulation; 
(E) treatment; and 
(F) care transition. 
(e) SITES.— 
(1) NUMBER.—The Secretary shall carry out 
the program at five medical centers of the Depart-
ment of Veterans Affairs, one of which primarily 
serves veterans who live in rural and remote areas 
as determined by the Secretary. 
(2) TIMELINE.—The Secretary shall select— 
(A) 15 candidate sites for the program not 
later than 180 days after the date of the enact-
ment of this Act; and 
(B) the final five sites not later than 270 
days after the date of the enactment of this 
Act. 
(3) CONSULTATION.—In selecting sites at which 
to carry out the program, the Secretary shall consult 
with experts including officials of— 
(A) the National Institute of Mental 
Health; 
(B) the Substance Abuse and Mental 
Health Services Administration of the Depart-
ment of Health and Human Services; 
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(C) the Office of Mental Health and Sui-
cide Prevention of the Department of Veterans 
Affairs; 
(D) the Health Services Research Division 
of the Department of Veterans Affairs; 
(E) the Office of Health Care Trans-
formation of the Department of Veterans Af-
fairs; and 
(F) the Zero Suicide Institute. 
(4) FACTORS.—In selecting sites for the pro-
gram, the Secretary shall consider the following fac-
tors: 
(A) Interest in, and capacity of, the staff 
of the medical centers to implement the pro-
gram. 
(B) Geographic variation. 
(C) Variations in size of medical centers. 
(D) Regional suicide rates of veterans. 
(E) Demographic and health characteris-
tics of populations served by each medical cen-
ter. 
(f) ANNUAL PROGRESS REPORT.— 
(1) IN
GENERAL.—Not later than two years 
after the date on which the Secretary establishes the 
program, and annually thereafter until termination 
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of the program, the Secretary shall submit to the 
Committee on Veterans’ Affairs of the Senate and 
the Committee on Veterans’ Affairs of the House of 
Representatives a report on the program. 
(2) ELEMENTS.—Each report under paragraph 
(1) shall include the following: 
(A) Progress of staff leaders at each site 
in carrying out tasks under paragraphs (1) 
through (5) of subsection (d). 
(B) The percentage of staff at each site 
trained under paragraph (6) of subsection (d). 
(C) An assessment of whether policies and 
procedures implemented at each site align with 
standards of the Institute with regards to— 
(i) suicide screening; 
(ii) lethal means counseling; 
(iii) referrals for comprehensive as-
sessment of suicidality; 
(iv) safety planning for patients re-
ceiving referrals under clause (iii); 
(v) risk management during care 
transitions; and 
(vi) outreach to high-risk patients. 
(D) A comparison of the suicide-related 
outcomes at program sites and those of other 
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medical centers of the Department of Veterans 
Affairs, including— 
(i) the percentage of patients screened 
for suicide risk; 
(ii) the percentage of patients coun-
seled in lethal means safety; 
(iii) 
the 
percentage 
of 
patients 
screened for suicide risk referred for com-
prehensive assessment of suicidality; 
(iv) the percentage of patients re-
ferred for comprehensive assessment who 
complete safety planning; 
(v) emergency department utilization; 
(vi) inpatient psychiatric hospitaliza-
tions; 
(vii) the number of suicide attempts 
among all patients and among patients re-
ferred for comprehensive assessment of 
suicidality; and 
(viii) the number of suicide deaths 
among all patients and among patients re-
ferred for comprehensive assessment of 
suicidality. 
(g) FINAL REPORT.— 
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(1) IN
GENERAL.—Not later than one year 
after the termination of the program, the Secretary 
shall submit to the Committee on Veterans’ Affairs 
of the Senate and the Committee on Veterans’ Af-
fairs of the House of Representatives a final report. 
(2) ELEMENTS.—The report under paragraph 
(1) shall include the following: 
(A) A detailed analysis of information in 
the annual reports under subsection (f). 
(B) An evaluation of the effectiveness and 
outcomes of the program, including an evalua-
tion of all data collected during the program. 
(C) The determination of the Secretary 
whether it is feasible to continue the program. 
(D) The recommendations of the Secretary 
whether to expand the program to additional 
sites, extend the program, or make the program 
permanent. 
(h) TERMINATION; EXTENSION.— 
(1) IN GENERAL.—Subject to paragraph (2), 
the program shall terminate on the date that is five 
years after the date on which the Secretary estab-
lishes the program under subsection (a). 
(2) AUTHORITY
TO
EXTEND.—The Secretary 
may extend the program for not more than two 
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years if the Secretary notifies Congress in writing of 
such extension not less than 180 days before the ter-
mination date under paragraph (1). 
Æ 
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