Title: REACH for Veterans Act
Policy area: Armed Forces and National Security

Summary:
Revising and Expediting Actions for the Crisis Hotline for Veterans Act or the REACH for Veterans Act
This bill requires the Department of Veterans Affairs (VA) to update training and procedures for call responders of the Veterans Crisis Line.
Specifically, the VA must enter into an agreement with an outside organization to review the training for crisis line call responders. The VA must update the training if any deficiencies are identified after the review.
Among other requirements, the VA must
Each call responder must be subject to at least two calls per month that are silently monitored by a supervisor to check for quality of conduct.
The Veterans Crisis Line, Office of Mental Health and Suicide Prevention of the VA, and National Center for Patient Safety of the VA must establish quality management processes and expectations for staff of the crisis line.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 2283 Introduced in Senate (IS)]

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117th CONGRESS
  1st Session
                                S. 2283

   To improve the Veterans Crisis Line of the Department of Veterans 
                    Affairs, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 24, 2021

 Mr. Tester (for himself and Mr. Moran) introduced the following bill; 
which was read twice and referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To improve the Veterans Crisis Line of the Department of Veterans 
                    Affairs, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Revising and 
Expediting Actions for the Crisis Hotline for Veterans Act'' or the 
``REACH for Veterans Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
     TITLE I--VETERANS CRISIS LINE TRAINING AND QUALITY MANAGEMENT

                       Subtitle A--Staff Training

Sec. 101. Review of training for Veterans Crisis Line call responders.
Sec. 102. Retraining guidelines for Veterans Crisis Line call 
                            responders.
               Subtitle B--Quality Review and Management

Sec. 111. Monitoring of calls on Veterans Crisis Line.
Sec. 112. Quality management processes for Veterans Crisis Line.
Sec. 113. Annual common cause analysis for callers to Veterans Crisis 
                            Line who die by suicide.
               Subtitle C--Guidance for High-Risk Callers

Sec. 121. Development of enhanced guidance and procedures for response 
                            to calls related to substance use and 
                            overdose risk.
Sec. 122. Review and improvement of standards for emergency dispatch.
      Subtitle D--Oversight and Clarification of Staff Roles and 
                            Responsibilites

Sec. 131. Oversight of training of social service assistants and 
                            clarification of job responsibilities.
     TITLE II--PILOT PROGRAMS AND RESEARCH ON VETERANS CRISIS LINE

                       Subtitle A--Pilot Programs

Sec. 201. Extended safety planning pilot program for Veterans Crisis 
                            Line.
Sec. 202. Crisis line facilitation pilot program.
                 Subtitle B--Research on Effectiveness

Sec. 211. Authorization of appropriations for research on effectiveness 
                            and opportunities for improvement of 
                            Veterans Crisis Line.
              TITLE III--TRANSITION OF CRISIS LINE NUMBER

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

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Department.--The term ``Department'' means the 
        Department of Veterans Affairs.
            (2) Secretary.--The term ``Secretary'' means the Secretary 
        of Veterans Affairs.
            (3) Veterans crisis line.--the term ``Veterans Crisis 
        Line'' means the toll-free hotline for veterans established 
        under section 1720F(h) of title 38, United States Code.

     TITLE I--VETERANS CRISIS LINE TRAINING AND QUALITY MANAGEMENT

                       Subtitle A--Staff Training

SEC. 101. REVIEW OF TRAINING FOR VETERANS CRISIS LINE CALL RESPONDERS.

    (a) In General.--The Secretary shall enter into an agreement with 
an organization outside the Department, such as the American 
Association of Suicidology, to review the training for Veterans Crisis 
Line call responders on assisting callers in crisis.
    (b) Completion of Review.--The review conducted under subsection 
(a) shall be completed not later than one year after the date of the 
enactment of this Act.
    (c) Elements of Review.--The review conducted under subsection (a) 
shall consist of a review of the training provided by the Department on 
subjects including risk assessment, lethal means assessment, substance 
use and overdose risk assessment, safety planning, referrals to care, 
supervisory consultation, and emergency dispatch.
    (d) Update of Training.--If any deficiencies in the training for 
Veterans Crisis Line call responders are found pursuant to the review 
under subsection (a), the Secretary shall update such training and 
associated standards of practice to correct those deficiencies not 
later than one year after the completion of the review.

SEC. 102. RETRAINING GUIDELINES FOR VETERANS CRISIS LINE CALL 
              RESPONDERS.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary shall develop guidelines on 
retraining and quality management for when a Veterans Crisis Line call 
responder has an adverse event or when a quality review check by a 
supervisor of such a call responder denotes that the call responder 
needs improvement.
    (b) Elements of Guidelines.--The guidelines developed under 
subsection (a) shall specify the subjects and quantity of retraining 
recommended and how supervisors should implement increased use of 
silent monitoring or other performance review mechanisms.

               Subtitle B--Quality Review and Management

SEC. 111. MONITORING OF CALLS ON VETERANS CRISIS LINE.

    (a) In General.--The Secretary shall require that not fewer than 
two calls per month for each Veterans Crisis Line call responder be 
subject to supervisory silent monitoring, which is used to monitor the 
quality of conduct by such call responder during the call.
    (b) Benchmarks.--The Secretary shall establish benchmarks for 
requirements and performance of Veterans Crisis Line call responders on 
supervisory silent monitored calls.
    (c) Quarterly Reports.--Not less frequently than quarterly, the 
Secretary shall submit to the Office of Mental Health and Suicide 
Prevention of the Department of Veterans Affairs a report on occurrence 
and outcomes of supervisory silent monitoring of calls on the Veterans 
Crisis Line.

SEC. 112. QUALITY MANAGEMENT PROCESSES FOR VETERANS CRISIS LINE.

    Not later than one year after the date of the enactment of this 
Act, the leadership for the Veterans Crisis Line, in partnership with 
the Office of Mental Health and Suicide Prevention of the Department 
and the National Center for Patient Safety of the Department, shall 
establish quality management processes and expectations for staff of 
the Veterans Crisis Line, including with respect to reporting of 
adverse events and close calls.

SEC. 113. ANNUAL COMMON CAUSE ANALYSIS FOR CALLERS TO VETERANS CRISIS 
              LINE WHO DIE BY SUICIDE.

    (a) In General.--Not less frequently than annually, the Secretary 
shall perform a common cause analysis for all identified callers to the 
Veterans Crisis Line that died by suicide during the one-year period 
preceding the conduct of the analysis before the caller received 
contact with emergency services and in which the Veterans Crisis Line 
was the last point of contact.
    (b) Submittal of Results.--The Secretary shall submit to the Office 
of Mental Health and Suicide Prevention of the Department the results 
of each analysis conducted under subsection (a).
    (c) Application of Themes or Lessons.--The Secretary shall apply 
any themes or lessons learned under an analysis under subsection (a) to 
updating training and standards of practice for staff of the Veterans 
Crisis Line.

               Subtitle C--Guidance for High-Risk Callers

SEC. 121. DEVELOPMENT OF ENHANCED GUIDANCE AND PROCEDURES FOR RESPONSE 
              TO CALLS RELATED TO SUBSTANCE USE AND OVERDOSE RISK.

    Not later than one year after the date of the enactment of this 
Act, the Secretary, in consultation with national experts within the 
Department on substance use disorder and overdose, shall--
            (1) develop enhanced guidance and procedures to respond to 
        calls to the Veterans Crisis Line related to substance use and 
        overdose risk;
            (2) update training materials for staff of the Veterans 
        Crisis Line in response to such enhanced guidance and 
        procedures; and
            (3) update criteria for monitoring compliance with such 
        enhanced guidance and procedures.

SEC. 122. REVIEW AND IMPROVEMENT OF STANDARDS FOR EMERGENCY DISPATCH.

    (a) In General.--Not later than one year after the date of the 
enactment of this Act, the Secretary shall--
            (1) review the current emergency dispatch standard 
        operating procedure of the Veterans Crisis Line to identify any 
        additions to such procedure to strengthen communication 
        regarding--
                    (A) emergency dispatch for disconnected callers; 
                and
                    (B) the role of social service assistants in 
                requesting emergency dispatch and recording such 
                dispatches; and
            (2) update such procedure to include the additions 
        identified under paragraph (1).
    (b) Training.--The Secretary shall ensure that all staff of the 
Veterans Crisis Line are trained on all updates made under subsection 
(a)(2) to the emergency dispatch standard operating procedure of the 
Veterans Crisis Line.

      Subtitle D--Oversight and Clarification of Staff Roles and 
                            Responsibilites

SEC. 131. OVERSIGHT OF TRAINING OF SOCIAL SERVICE ASSISTANTS AND 
              CLARIFICATION OF JOB RESPONSIBILITIES.

    Not later than one year after the date of the enactment of this 
Act, the Secretary shall--
            (1) establish oversight mechanisms to ensure that social 
        service assistants and supervisory social service assistants 
        working with the Veterans Crisis Line are appropriately trained 
        and implementing guidance of the Department regarding the 
        Veterans Crisis Line; and
            (2) refine standard operating procedures to delineate roles 
        and responsibilities for all levels of supervisory social 
        service assistants working with the Veterans Crisis Line.

     TITLE II--PILOT PROGRAMS AND RESEARCH ON VETERANS CRISIS LINE

                       Subtitle A--Pilot Programs

SEC. 201. EXTENDED SAFETY PLANNING PILOT PROGRAM FOR VETERANS CRISIS 
              LINE.

    (a) In General.--Commencing not later than 180 days after the date 
of the enactment of this Act, the Secretary shall carry out a pilot 
program to determine whether a lengthier, templated safety plan used in 
clinical settings could be applied in call centers for the Veterans 
Crisis Line.
    (b) Briefing.--Not later than two years after the date of the 
enactment of this Act, the Secretary shall brief Congress on the 
findings of the Secretary under the pilot program under subsection (a), 
including such recommendations as the Secretary may have for 
continuation or discontinuation of the pilot program.

SEC. 202. CRISIS LINE FACILITATION PILOT PROGRAM.

    (a) In General.--Commencing not later than one year after the date 
of the enactment of this Act, the Secretary shall carry out a pilot 
program on the use of crisis line facilitation to increase use of the 
Veterans Crisis Line among high-risk veterans.
    (b) Briefing.--Not later than two years after the date of the 
enactment of this Act, the Secretary shall brief Congress on the 
findings of the Secretary under the pilot program under subsection (a), 
including such recommendations as the Secretary may have for 
continuation or discontinuation of the pilot program.
    (c) Definitions.--In this section:
            (1) Crisis line facilitation.--The term ``crisis line 
        facilitation'', with respect to a high-risk veteran, means the 
        presentation by a therapist of psychoeducational information 
        about the Veterans Crisis Line and a discussion of the 
        perceived barriers and facilitators to future use of the 
        Veterans Crisis Line for the veteran, which culminates in the 
        veteran calling the Veterans Crisis Line with the therapist to 
        provide firsthand experiences that may counter negative 
        impressions of the Veterans Crisis Line.
            (2) High-risk veteran.--The term ``high-risk veteran'' 
        means a veteran receiving inpatient mental health care 
        following a suicidal crisis.

                 Subtitle B--Research on Effectiveness

SEC. 211. AUTHORIZATION OF APPROPRIATIONS FOR RESEARCH ON EFFECTIVENESS 
              AND OPPORTUNITIES FOR IMPROVEMENT OF VETERANS CRISIS 
              LINE.

    There is authorized to be appropriated to the Secretary $5,000,000 
for the Mental Illness Research, Education, and Clinical Centers of the 
Department to conduct research on the effectiveness of the Veterans 
Crisis Line and areas for improvement for the Veterans Crisis Line.

              TITLE III--TRANSITION OF CRISIS LINE NUMBER

SEC. 301. FEEDBACK ON TRANSITION OF CRISIS LINE NUMBER.

    (a) In General.--The Secretary shall solicit feedback from veterans 
service organizations on how to conduct outreach to members of the 
Armed Forces, veterans, their family members, and other members of the 
military and veterans community on the move to 988 as the new, national 
three-digit suicide and mental health crisis hotline, which is expected 
to be implemented by July 2022, to minimize confusion and ensure 
veterans are aware of their options for reaching the Veterans Crisis 
Line.
    (b) Nonapplication of FACA.--The Federal Advisory Committee Act (5 
U.S.C. App.) shall not apply to any feedback solicited under subsection 
(a).
    (c) Veterans Service Organization Defined.--In this section, the 
term ``veterans service organization'' means an organization recognized 
by the Secretary for the representation of veterans under section 5902 
of title 38, United States Code.
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