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110th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 1st Session                                                     110-55

======================================================================



 
              JOSHUA OMVIG VETERANS SUICIDE PREVENTION ACT

                                _______
                                

 March 20, 2007.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

  Mr. Filner, from the Committee on Veterans' Affairs, submitted the 
                               following

                              R E P O R T

                             together with

                            ADDITIONAL VIEWS

                        [To accompany H.R. 327]

      [Including cost estimate of the Congressional Budget Office]

  The Committee on Veterans' Affairs, to whom was referred the 
bill (H.R. 327) to direct the Secretary of Veterans Affairs to 
develop and implement a comprehensive program designed to 
reduce the incidence of suicide among veterans, having 
considered the same, report favorably thereon with amendments 
and recommend that the bill as amended do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     3
Background and Need for Legislation..............................     3
Legislative History..............................................     4
Section-by-Section...............................................     4
Committee Consideration..........................................     5
Rollcall Votes...................................................     6
Application of Law to the Legislative Branch.....................     6
Statement of Oversight Findings and Recommendations of the 
  Committee......................................................     6
Statement of General Performance Goals and Objectives............     6
Constitutional Authority Statement...............................     6
Federal Advisory Committee Act...................................     6
Unfunded Mandate Statement.......................................     6
Earmark Identification...........................................     6
Committee Estimate...............................................     6
Budget Authority and Congressional Budget Office Cost Estimate...     7
Changes in Existing Law Made by the Bill as Reported.............     8
Additional Views.................................................    11
Committee Correspondence.........................................    13

  The amendments are as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Joshua Omvig Veterans Suicide 
Prevention Act''.

SEC. 2. SENSE OF CONGRESS.

  It is the sense of Congress that--
          (1) suicide among veterans suffering from post-traumatic 
        stress disorder (in this section referred to as ``PTSD'') is a 
        serious problem; and
          (2) the Secretary of Veterans Affairs should take into 
        consideration the special needs of veterans suffering from PTSD 
        and the special needs of elderly veterans who are at high risk 
        for depression and experience high rates of suicide in 
        developing and implementing the comprehensive program under 
        this Act.

SEC. 3. COMPREHENSIVE PROGRAM FOR SUICIDE PREVENTION AMONG VETERANS.

  (a) In General.--
          (1) Comprehensive program for suicide prevention among 
        veterans.--Chapter 17 of title 38, United States Code, is 
        amended by adding at the end the following new section:

``Sec. 1720F. Comprehensive program for suicide prevention among 
                    veterans

  ``(a) Establishment.--The Secretary shall develop and carry out a 
comprehensive program designed to reduce the incidence of suicide among 
veterans incorporating the components described in this section.
  ``(b) Staff Education.--In carrying out the comprehensive program 
under this section, the Secretary shall provide for mandatory training 
for appropriate staff and contractors (including all medical personnel) 
of the Department who interact with veterans. This training shall cover 
information appropriate to the duties being performed by such staff and 
contractors. The training shall include information on--
          ``(1) recognizing risk factors for suicide;
          ``(2) proper protocols for responding to crisis situations 
        involving veterans who may be at high risk for suicide; and
          ``(3) best practices for suicide prevention.
  ``(c) Screening of Veterans Receiving Medical Care.--In carrying out 
the comprehensive program, the Secretary shall provide for screening of 
veterans who receive medical care at a Department medical facility 
(including a center established under section 1712A of this title) for 
risk factors for suicide.
  ``(d) Tracking of Veterans.--In carrying out the comprehensive 
program, the Secretary shall provide for appropriate tracking of 
veterans.
  ``(e) Counseling and Treatment of Veterans.--In carrying out the 
comprehensive program, the Secretary shall provide for referral of 
veterans at risk for suicide for appropriate counseling and treatment.
  ``(f) Designation of Suicide Prevention Counselors.--In carrying out 
the comprehensive program, the Secretary shall designate a suicide 
prevention counselor at each Department medical facility other than 
centers established under section 1712A of this title. Each counselor 
shall work with local emergency rooms, police departments, mental 
health organizations, and veterans service organizations to engage in 
outreach to veterans and improve the coordination of mental health care 
to veterans.
  ``(g) Best Practices Research.--In carrying out the comprehensive 
program, the Secretary shall provide for research on best practices for 
suicide prevention among veterans. Research shall be conducted under 
this subsection in consultation with the heads of the following 
entities:
          ``(1) The Department of Health and Human Services.
          ``(2) The National Institute of Mental Health.
          ``(3) The Substance Abuse and Mental Health Services 
        Administration.
          ``(4) The Centers for Disease Control and Prevention.
  ``(h) Sexual Trauma Research.--In carrying out the comprehensive 
program, the Secretary shall provide for research on mental health care 
for veterans who have experienced sexual trauma while in military 
service. The research design shall include consideration of veterans of 
a reserve component.
  ``(i) 24-Hour Mental Health Care.--In carrying out the comprehensive 
program, the Secretary shall provide for mental health care 
availability to veterans on a 24-hour basis.
  ``(j) Hotline.--In carrying out the comprehensive program, the 
Secretary may provide for a toll-free hotline for veterans to be 
staffed by appropriately trained mental health personnel and available 
at all times.
  ``(k) Outreach and Education for Veterans and Families.--In carrying 
out the comprehensive program, the Secretary shall provide for outreach 
to and education for veterans and the families of veterans, with 
special emphasis on providing information to veterans of Operation 
Iraqi Freedom and Operation Enduring Freedom and the families of such 
veterans. Education to promote mental health shall include information 
designed to--
          ``(1) remove the stigma associated with mental illness;
          ``(2) encourage veterans to seek treatment and assistance for 
        mental illness;
          ``(3) promote skills for coping with mental illness; and
          ``(4) help families of veterans with--
                  ``(A) understanding issues arising from the 
                readjustment of veterans to civilian life;
                  ``(B) identifying signs and symptoms of mental 
                illness; and
                  ``(C) encouraging veterans to seek assistance for 
                mental illness.
  ``(l) Peer Support Counseling Program.--(1) In carrying out the 
comprehensive program, the Secretary shall establish and carry out a 
peer support counseling program, under which veterans shall be 
permitted to volunteer as peer counselors--
                  ``(A) to assist other veterans with issues related to 
                mental health and readjustment; and
                  ``(B) to conduct outreach to veterans and the 
                families of veterans.
  ``(2) In carrying out the peer support counseling program under this 
subsection, the Secretary shall provide adequate training for peer 
counselors.
  ``(m) Other Components.--In carrying out the comprehensive program, 
the Secretary may provide for other actions to reduce the incidence of 
suicide among veterans that the Secretary deems appropriate.''.
          (2) Clerical amendment.--The table of sections at the 
        beginning of such chapter is amended by adding at the end the 
        following new item:

``1720F. Comprehensive program for suicide prevention among 
veterans.''.

  (b) Report to Congress.--
          (1) Report required.--Not later than 90 days after the date 
        of the enactment of this Act, the Secretary of Veterans Affairs 
        shall submit to Congress a report on the comprehensive program 
        under section 1720A of title 38, United States Code, as added 
        by subsection (a).
          (2) Contents of report.--The report shall contain the 
        following:
                  (A) Information on the status of the implementation 
                of such program.
                  (B) Information on the time line and costs for 
                complete implementation of the program within two 
                years.
                  (C) A plan for additional programs and activities 
                designed to reduce the occurrence of suicide among 
                veterans.
                  (D) Recommendations for further legislation or 
                administrative action that the Secretary considers 
                appropriate to improve suicide prevention programs 
                within the Department of Veterans Affairs.

  Amend the title so as to read:

    A bill to amend title 38, United States Code, to direct the 
Secretary of Veterans Affairs to develop and implement a 
comprehensive program designed to reduce the incidence of 
suicide among veterans.

                          Purpose and Summary

    H.R. 327, the Joshua Omvig Veterans Suicide Prevention Act, 
was introduced on January 9, 2007, by Representative Leonard L. 
Boswell. The legislation would improve the ability of the 
Department of Veterans Affairs to develop and implement a 
comprehensive program designed to reduce the incidence of 
suicide among veterans.

                  Background and Need for Legislation

    Over the course of combat operations in Afghanistan 
(Operation Enduring Freedom--OEF) and Iraq (Operation Iraqi 
Freedom--OIF), there has been a growing concern with the number 
of suicides that have occurred in the OEF/OIF soldier and 
veteran population. The Mental Health Advisory Team (MHAT--
III), established by the Office of the Surgeon General, United 
States Army Medical Command, at the request of the Office of 
the Surgeon, Multinational Force-Iraq, issued a report on May 
29, 2006, that found that for calendar year 2005, the suicide 
rate for the OIF area of operations was 19.9 per 100,000 
soldiers. That rate is considerably higher than the national 
average, and the Army's overall reported rate of 13.1 per 
100,000.
    The stress of combat, along with the stigma that exists for 
soldiers and veterans seeking mental health care, can intensify 
and trigger a complex set of behaviors that may lead to 
thoughts of suicide. It is vital that suicide prevention, 
education, and awareness programs be strengthened throughout 
the VA health care system. Just recently, VA announced that 
research concerning suicides among OEF/OIF returnees was 
underway and that it was implementing a comprehensive education 
and training effort within local communities, as well as at VA 
facilities.
    H.R. 327 addresses this need to strengthen suicide 
prevention, education, and awareness programs within the VA by 
mandating a comprehensive program for suicide prevention among 
veterans.

                          Legislative History

    H.R. 327, the Joshua Omvig Veterans Suicide Prevention Act, 
was introduced by Representative Leonard Boswell, on January 9, 
2007, and was referred to the Committee on Veterans' Affairs. 
H.R. 327 resembles legislation introduced in the 109th Congress 
in both the House and the Senate. Senator Harkin of Iowa has 
also introduced a version of the Joshua Omvig Suicide 
Prevention Act, S. 479, on February 1, 2007.
    On March 13, 2007, the Subcommittee on Health reported H.R. 
327 to the full Committee on Veterans' Affairs.
    The Committee held a markup to consider H.R. 327 on March 
15, 2007, and ordered the bill reported by a voice vote.

                           Section-by-Section

    This bill would direct the Department of Veterans Affairs 
(VA) to develop and implement a comprehensive program to reduce 
the incidence of suicide among veterans.

Section 1. Short title

    This section would provide the short title of H.R. 327 as 
the ``Joshua Omvig Veterans Suicide Prevention Act.''

Section 2. Sense of Congress

    This section would express the sense of Congress that 
suicide among veterans suffering from post-traumatic stress 
disorder (PTSD) is a serious problem. This section also 
expresses that it is the sense of Congress that the Secretary 
of Veterans Affairs should take into consideration the special 
needs of veterans suffering from PTSD and the special needs of 
elderly veterans who are at a high risk for depression and 
experience high rates of suicide in developing and implementing 
the comprehensive program under this Act

Section 3. Comprehensive program for suicide prevention among veterans

    This section would provide that VA shall develop a 
comprehensive program that includes the components described in 
Section 4.

Section 4. Components of program

    Subsection (a) would require the VA to provide education 
and training for VA staff, contractors, and medical personnel 
who have interaction with veterans.
    Subsection (b) would direct the VA to regularly screen and 
monitor all veterans who receive medical care in the VA health 
care system for risk factors for suicide and to provide for 
referral of veterans at risk for suicide for appropriate 
counseling and treatment.
    Subsection (c) would require the VA to provide for the 
appropriate tracking of veterans.
    Subsection (d) would direct the VA to provide for referral 
of veterans at risk for suicide for appropriate counseling and 
treatment.
    Subsection (e) would require the VA to designate a suicide 
prevention counselor at each VAMC.
    Subsection (f) would mandate that VA to research the best 
practices for suicide prevention among veterans, including best 
practices for helping veterans who have experienced military 
sexual trauma. It requires the VA to work with the Department 
of Health and Human Services, the National Institutes of 
Health, the Centers for Disease Control, and the Substance 
Abuse and Mental Health Service Administration when conducting 
research.
    Subsection (g) would require the VA to conduct mental 
health research on veterans who have experienced military 
sexual trauma.
    Subsection (h) would require the VA to provide for the 
availability of 24-hour mental health care for veterans.
    Subsection (i) would provide for a toll-free hotline to be 
available at all times.
    Subsection (j) would provide outreach and education for 
veterans and their families to promote mental health.
    Subsection (k) would create a peer support-counseling 
program where veterans can volunteer as peer counselors to 
assist other veterans with mental health and readjustment 
problems.
    Subsection (l) would mandate that the Secretary may 
provide, as the Secretary deems appropriate, for other actions 
to reduce the incidence of suicide among veterans.

Section 5. Report to Congress

    This section would require the VA to report, not later than 
90 days after enactment, on the status of implementation, 
timeline and costs for complete implementation of the program 
within two years, a plan for additional programs and activities 
designed to reduce the occurrence of suicide among veterans, 
and recommendations by the VA for further legislation to 
improve suicide prevention programs.

                        Committee Consideration

    On Thursday, March 15, 2007, the Committee ordered the bill 
reported to the House by a voice vote.

                             Rollcall Votes

    The Committee held no rollcall votes on this bill.

              Application of Law to the Legislative Branch

    Section 102(b)(3) of Public Law 104-1 requires a 
description of the application of this bill to the legislative 
branch where the bill relates to the terms and conditions of 
employment or access to public services and accommodations. 
This bill does not relate to employment or access to public 
services and accommodations.

  Statement of Oversight Findings and Recommendations of the Committee

    In compliance with clause 3(c)(1) of rule XIII and clause 
(2)(b)(1) of rule X of the Rules of the House of 
Representatives, the Committee's oversight findings and 
recommendations are reflected in the descriptive portions of 
this report.

         Statement of General Performance Goals and Objectives

    In accordance with clause (3)(c)(4) of rule XIII of the 
Rules of the House of Representatives, the Committee's 
performance goals and objectives are reflected in the 
descriptive portions of this report.

                   Constitutional Authority Statement

    Under clause 3(d)(1) of rule XIII of the Rules of the House 
of Representatives, the Committee must include a statement 
citing the specific powers granted to Congress to enact the law 
proposed by H.R. 327. Article 1, Section 8 of the Constitution 
of the United States grants Congress the power to enact this 
law.

                     Federal Advisory Committee Act

    The Committee finds that the legislation does not establish 
or authorize the establishment of an advisory committee within 
the definition of 5 U.S.C. App., Section 5(b).

                       Unfunded Mandate Statement

    Section 423 of the Congressional Budget and Impoundment 
Control Act (as amended by Section 101(a)(2) of the Unfunded 
Mandate Reform Act, P.L. 104-4) requires a statement whether 
the provisions of the reported bill include unfunded mandates. 
In compliance with this requirement the Committee has received 
a letter from the Congressional Budget Office that is included 
herein.

                         Earmark Identification

    H.R. 327 does not contain any congressional earmarks, 
limited tax benefits, or limited tariff benefits as defined in 
clause 9(d), 9(e), or 9(f) of rule XXI of the Rules of the 
House of Representatives.

                           Committee Estimate

    Clause 3(d)(2) of rule XIII of the Rules of the House of 
Representatives requires an estimate and a comparison by the 
Committee of the costs that would be incurred in carrying out 
H.R. 327. However, clause 3(d)(3)(B) of that rule provides that 
this requirement does not apply when the Committee has included 
in its report a timely submitted cost estimate of the bill 
prepared by the Director of the Congressional Budget Office 
under Section 402 of the Congressional Budget Act.

     Budget Authority and Congressional Budget Office Cost Estimate

                                     U.S. Congress,
                               Congressional Budget Office,
                                    Washington, DC, March 19, 2007.
Hon. Bob Filner,
Chairman, Committee on Veterans' Affairs,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 327, the Joshua 
Omvig Veterans Suicide Prevention Act.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Michelle S. 
Patterson.
            Sincerely,
                                           Peter R. Orszag,
                                                          Director.
    Enclosure.

H.R. 327--Joshua Omvig Veterans Suicide Prevention Act

    H.R. 327 would require the Secretary of Veterans Affairs 
(VA) to develop and implement a comprehensive program to reduce 
the incidence of suicide among veterans. This bill would 
require that the program have specific components, including 
training for all staff who interact with veterans, annual 
screenings of veterans for risk factors for suicide, a suicide 
prevention counselor at each medical facility, and outreach and 
education for veterans and their families.
    According to VA, most of those requirements are already in 
place or will be implemented before the end of the year. For 
example, training seminars have recently begun for all 
employees and peer-support groups are a regular facet of 
veterans' rehabilitation centers. Annual screenings for suicide 
risk factors such as depression and alcohol abuse are routinely 
performed by primary care physicians. Two medical centers are 
focused on research and education about suicide and its 
prevention. In addition, VA works with other medical providers 
in the community to reach veterans who may not use the VA 
health care system. VA also plans to hire suicide-prevention 
professionals at each of its hospitals. The bill would 
authorize VA to create a toll-free hotline staffed by mental 
health personnel, and the agency is currently considering the 
feasibility of doing this.
    CBO estimates, therefore, that implementing this bill would 
have little, if any, cost because VA already has or soon will 
implement all the specific requirements of the bill. Enacting 
the bill would not affect direct spending or receipts.
    H.R. 327 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act and 
would not affect the budgets of state, local, or tribal 
governments.
    The CBO staff contact for this estimate is Michelle S. 
Patterson. This estimate was approved by Robert A. Sunshine, 
Assistant Director for Budget Analysis.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italic and existing law in which no change is 
proposed is shown in roman):

               CHAPTER 17 OF TITLE 38, UNITED STATES CODE


   CHAPTER 17--HOSPITAL, NURSING HOME, DOMICILIARY, AND MEDICAL CARE


                          SUBCHAPTER I--GENERAL

Sec.
1701.  Definitions.
     * * * * * * *

 SUBCHAPTER II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL 
                                TREATMENT

     * * * * * * *
1720F.  Comprehensive program for suicide prevention among veterans.

           *       *       *       *       *       *       *


SUBCHAPTER II--HOSPITAL, NURSING HOME, OR DOMICILIARY CARE AND MEDICAL 
TREATMENT

           *       *       *       *       *       *       *


Sec. 1720F. Comprehensive program for suicide prevention among veterans

  (a) Establishment.--The Secretary shall develop and carry out 
a comprehensive program designed to reduce the incidence of 
suicide among veterans incorporating the components described 
in this section.
  (b) Staff Education.--In carrying out the comprehensive 
program under this section, the Secretary shall provide for 
mandatory training for appropriate staff and contractors 
(including all medical personnel) of the Department who 
interact with veterans. This training shall cover information 
appropriate to the duties being performed by such staff and 
contractors. The training shall include information on--
          (1) recognizing risk factors for suicide;
          (2) proper protocols for responding to crisis 
        situations involving veterans who may be at high risk 
        for suicide; and
          (3) best practices for suicide prevention.
  (c) Screening of Veterans Receiving Medical Care.--In 
carrying out the comprehensive program, the Secretary shall 
provide for screening of veterans who receive medical care at a 
Department medical facility (including a center established 
under section 1712A of this title) for risk factors for 
suicide.
  (d) Tracking of Veterans.--In carrying out the comprehensive 
program, the Secretary shall provide for appropriate tracking 
of veterans.
  (e) Counseling and Treatment of Veterans.--In carrying out 
the comprehensive program, the Secretary shall provide for 
referral of veterans at risk for suicide for appropriate 
counseling and treatment.
  (f) Designation of Suicide Prevention Counselors.--In 
carrying out the comprehensive program, the Secretary shall 
designate a suicide prevention counselor at each Department 
medical facility other than centers established under section 
1712A of this title. Each counselor shall work with local 
emergency rooms, police departments, mental health 
organizations, and veterans service organizations to engage in 
outreach to veterans and improve the coordination of mental 
health care to veterans.
  (g) Best Practices Research.--In carrying out the 
comprehensive program, the Secretary shall provide for research 
on best practices for suicide prevention among veterans. 
Research shall be conducted under this subsection in 
consultation with the heads of the following entities:
          (1) The Department of Health and Human Services.
          (2) The National Institute of Mental Health.
          (3) The Substance Abuse and Mental Health Services 
        Administration.
          (4) The Centers for Disease Control and Prevention.
  (h) Sexual Trauma Research.--In carrying out the 
comprehensive program, the Secretary shall provide for research 
on mental health care for veterans who have experienced sexual 
trauma while in military service. The research design shall 
include consideration of veterans of a reserve component.
  (i) 24-Hour Mental Health Care.--In carrying out the 
comprehensive program, the Secretary shall provide for mental 
health care availability to veterans on a 24-hour basis.
  (j) Hotline.--In carrying out the comprehensive program, the 
Secretary may provide for a toll-free hotline for veterans to 
be staffed by appropriately trained mental health personnel and 
available at all times.
  (k) Outreach and Education for Veterans and Families.--In 
carrying out the comprehensive program, the Secretary shall 
provide for outreach to and education for veterans and the 
families of veterans, with special emphasis on providing 
information to veterans of Operation Iraqi Freedom and 
Operation Enduring Freedom and the families of such veterans. 
Education to promote mental health shall include information 
designed to--
          (1) remove the stigma associated with mental illness;
          (2) encourage veterans to seek treatment and 
        assistance for mental illness;
          (3) promote skills for coping with mental illness; 
        and
          (4) help families of veterans with--
                  (A) understanding issues arising from the 
                readjustment of veterans to civilian life;
                  (B) identifying signs and symptoms of mental 
                illness; and
                  (C) encouraging veterans to seek assistance 
                for mental illness.
  (l) Peer Support Counseling Program.--(1) In carrying out the 
comprehensive program, the Secretary shall establish and carry 
out a peer support counseling program, under which veterans 
shall be permitted to volunteer as peer counselors--
                  (A) to assist other veterans with issues 
                related to mental health and readjustment; and
                  (B) to conduct outreach to veterans and the 
                families of veterans.
  (2) In carrying out the peer support counseling program under 
this subsection, the Secretary shall provide adequate training 
for peer counselors.
  (m) Other Components.--In carrying out the comprehensive 
program, the Secretary may provide for other actions to reduce 
the incidence of suicide among veterans that the Secretary 
deems appropriate.

           *       *       *       *       *       *       *


                  ADDITIONAL VIEWS OF HON. STEVE BUYER

    In my letter of March 8, 2007, objecting to the markup on 
the bills, including H.R. 327, H.R. 612, H.R. 797, and H.R. 
1284 (letter attached), I strongly urged legislative hearings 
on these bills prior to the markup. Had the Committee followed 
regular order in holding legislative hearings on H.R. 327, the 
Committee could have explored what actions the Department of 
Veterans Affairs (VA) has taken or is planning in the area of 
suicide prevention. We could also have had the benefit of VA 
recommendations for improvements or technical corrections to 
the legislation, and would have had Congressional Budget Office 
cost analysis for the bill prior to markup.
    VA has provided at my request information about the plans 
of the Veterans Health Administration to reduce the incidence 
of suicide among our veterans. According to this information, 
VHA has already formulated a comprehensive strategy for suicide 
prevention focusing on the needs of both new veterans from 
Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) 
and those from prior conflicts. The specific program for 
suicide prevention is based on public health and clinical 
models, and activities both within VA facilities and the 
medical community.
     Structural elements of the program are to include:
           Designation of March 1, 2007 as the first annual VA 
        National Suicide Prevention Awareness Day with 
        educational activities for all staff, clinical and non-
        clinical
           Designation of two Centers of Excellence focused on 
        suicide prevention that will provide technical 
        assistance to the system as a whole
           Designation of the Serious Mental Illness Treatment 
        Research and Evaluation Center (SMITREC) to maintain 
        data on suicide rates and risk factors, nationally, 
        regionally, and locally, to guide prevention strategies
           Funding for Suicide Prevention Coordinators within 
        each VA medical center as of April 1, 2007
           Creation of a suicide prevention hotline for 
        veterans by the end of this calendar year
     Public health oriented components of the program, 
to be accelerated during the coming year, include:
           Ongoing messages and education for the community 
        about the availability of services and the 
        effectiveness of treatment
           Continued outreach to returning veterans to support 
        awareness of VA resources and identification of mental 
        health concerns
           Increasing training for those who are in contact 
        with veterans about the recognition of signs and risk 
        factors for suicide, and process for helping veterans 
        engage in treatment
           Strengthening collaborations with other local, 
        regional, and national suicide prevention activities
     Clinical components of the program are to include:
           Education and training for all VA staff about signs 
        and risk factors of suicide, and of opportunities to 
        help veterans in need engage in treatment
           Programs organized and directed by the Suicide 
        Prevention Coordinators to identify veterans at high 
        risk for suicide and to ensure that the intensity of 
        their clinical monitoring and care are enhanced
           Training for all mental health providers on 
        evidence-based interventions shown to prevent suicide
    Clearly, VA is addressing suicide prevention. I expect that 
the Committee will be fully engaged in the oversight of VA's 
suicide planning and implementation of those plans. H.R. 327 
complements VA's approach to suicide prevention, and I support 
the bill.
                                                       Steve Buyer.