119-hr136

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 136 Introduced in House

    (IH) ]

<DOC>

119th CONGRESS
 1st Session
 H. R. 136

 To direct the Secretary of Veterans Affairs to conduct an independent 
 review of the deaths of certain veterans by suicide, and for other 
 purposes.

_______________________________________________________________________

 IN THE HOUSE OF REPRESENTATIVES

 January 3, 2025

 Mr. Buchanan (for himself and Mr. Connolly) introduced the following 
 bill; which was referred to the Committee on Veterans' Affairs

_______________________________________________________________________

 A BILL

 To direct the Secretary of Veterans Affairs to conduct an independent 
 review of the deaths of certain veterans by suicide, 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.

 This Act may be cited as the ``Veteran Overmedication and Suicide 
Prevention Act of 2025''.

SEC. 2. DEPARTMENT OF VETERANS AFFAIRS INDEPENDENT REVIEW OF CERTAIN 
 DEATHS OF VETERANS BY SUICIDE.

    (a) Review Required.--

    (1) In general.--Not later than 90 days after the date of 
 the enactment of this Act, the Secretary of Veterans Affairs 
 shall seek to enter into an agreement with the National 
 Academies of Sciences, Engineering, and Medicine under which 
 the National Academies shall conduct a review of the deaths of 
 all covered veterans who died by suicide during the five-year 
 period ending on the date of the enactment of this Act, 
 regardless of whether information relating to such deaths has 
 been reported by the Centers for Disease Control and 
 Prevention.

    (2) Elements.--The review required by paragraph

    (1) shall 
 include the following:
        (A) The total number of covered veterans who died 
 by suicide during the five-year period ending on the 
 date of the enactment of this Act.
        (B) The total number of covered veterans who died 
 by a violent death during such five-year period.
            (C) The total number of covered veterans who died 
 by an accidental death during such five-year period.
            (D) A description of each covered veteran described 
 in subparagraphs
        (A) through
            (C) , including age, 
 gender, race, and ethnicity.
        (E) A comprehensive list of prescribed medications 
 and legal or illegal substances as annotated on 
 toxicology reports of covered veterans described in 
 subparagraphs
        (A) through
            (C) , specifically listing any 
 medications that carried a black box warning, were 
 prescribed for off-label use, were psychotropic, or 
 carried warnings that included suicidal ideation.
        (F) A summary of medical diagnoses by physicians of 
 the Department of Veterans Affairs or physicians 
 providing services to covered veterans through programs 
 of the Department that led to the prescribing of 
 medications referred to in subparagraph
        (E) in cases of 
 post-traumatic stress disorder, traumatic brain injury, 
 military sexual trauma, and other anxiety and 
 depressive disorders.
        (G) The number of instances in which a covered 
 veteran described in subparagraph
        (A) ,
        (B) , or
            (C) was 
 concurrently on multiple medications prescribed by 
 physicians of the Department or physicians providing 
 services to veterans through programs of the Department 
 to treat post-traumatic stress disorder, traumatic 
 brain injury, military sexual trauma, other anxiety and 
 depressive disorders, or instances of comorbidity.
        (H) The number of covered veterans described in 
 subparagraphs
        (A) through
            (C) who were not taking any 
 medication prescribed by a physician of the Department 
 or a physician providing services to veterans through a 
 program of the Department.
            (I) With respect to the treatment of post-traumatic 
 stress disorder, traumatic brain injury, military 
 sexual trauma, or other anxiety and depressive 
 disorders, the percentage of covered veterans described 
 in subparagraphs
        (A) through
            (C) who received a non-
 medication first-line treatment compared to the 
 percentage of such veterans who received medication 
 only.
        (J) With respect to the treatment of covered 
 veterans described in subparagraphs
        (A) through
            (C) for 
 post-traumatic stress disorder, traumatic brain injury, 
 military sexual trauma, or other anxiety and depressive 
 disorders, the number of instances in which a non-
 medication first-line treatment (such as cognitive 
 behavioral therapy) was attempted and determined to be 
 ineffective for such a veteran, which subsequently led 
 to the prescribing of a medication referred to in 
 subparagraph
        (E) .
        (K) A description and example of how the Department 
 determines and continually updates the clinical 
 practice guidelines governing the prescribing of 
 medications.
            (L) An analysis of the use by the Department, 
 including protocols or practices at medical facilities 
 of the Department, of systematically measuring pain 
 scores during clinical encounters under the Pain as the 
 5th Vital Sign Toolkit of the Department and an 
 evaluation of the relationship between the use of such 
 measurements and the number of veterans concurrently on 
 multiple medications prescribed by physicians of the 
 Department.
            (M) A description of the efforts of the Department 
 to maintain appropriate staffing levels for mental 
 health professionals, such as mental health counselors, 
 marriage and family therapists, and other appropriate 
 counselors, including--
            (i) a description of any impediments to 
 carry out the education, training, and hiring 
 of mental health counselors and marriage and 
 family therapists under 

section 7302

    (a) of 
 title 38, United States Code, and strategies 
 for addressing those impediments;
            (ii) a description of the objectives, 
 goals, and timing of the Department with 
 respect to increasing the representation of 
 such counselors and therapists in the 
 behavioral health workforce of the Department, 
 including--
            (I) a review of eligibility 
 criteria for such counselors and 
 therapists and a comparison of such 
 criteria to that of other behavioral 
 health professions in the Department; 
 and
            (II) an assessment of the 
 participation of such counselors and 
 therapists in the mental health 
 professionals trainee program of the 
 Department and any impediments to such 
 participation;
            (iii) an assessment of the development by 
 the Department of hiring guidelines for mental 
 health counselors, marriage and family 
 therapists, and other appropriate counselors;
            (iv) a description of how the Department--
            (I) identifies gaps in the supply 
 of mental health professionals; and
            (II) determines successful staffing 
 ratios for mental health professionals 
 of the Department;
            (v) a description of actions taken by the 
 Secretary, in consultation with the Director of 
 the Office of Personnel Management, to create 
 an occupational series for mental health 
 counselors and marriage and family therapists 
 of the Department and a timeline for the 
 creation of such an occupational series; and
            (vi) a description of actions taken by the 
 Secretary to ensure that the national, 
 regional, and local professional standards 
 boards for mental health counselors and 
 marriage and family therapists are comprised of 
 only mental health counselors and marriage and 
 family therapists and that the liaison from the 
 Department to such boards is a mental health 
 counselor or marriage and family therapist.
        (N) The percentage of covered veterans described in 
 subparagraphs
        (A) through
            (C) with combat experience or 
 trauma related to combat experience (including military 
 sexual trauma, traumatic brain injury, and post-
 traumatic stress).
        (O) An identification of the medical facilities of 
 the Department with markedly high prescription rates 
 and suicide rates for veterans receiving treatment at 
 those facilities.
        (P) An analysis, by State, of programs of the 
 Department that collaborate with State Medicaid 
 agencies and the Centers for Medicare and Medicaid 
 Services, including the following:
            (i) An analysis of the sharing of 
 prescription and behavioral health data for 
 veterans.
            (ii) An analysis of whether Department 
 staff check with State prescription drug 
 monitoring programs before prescribing 
 medications to veterans.
            (iii) A description of the procedures of 
 the Department for coordinating with 
 prescribers outside of the Department to ensure 
 that veterans are not overprescribed.
            (iv) A description of actions that the 
 Department takes when a veteran is determined 
 to be overprescribed.
        (Q) An analysis of the collaboration of medical 
 centers of the Department with medical examiners' 
 offices or local jurisdictions to determine veteran 
 mortality and cause of death.
        (R) An identification and determination of a best 
 practice model to collect and share veteran death 
 certificate data between the Department of Veterans 
 Affairs, the Department of Defense, States, and tribal 
 entities.
        (S) A description of how data relating to death 
 certificates of veterans is collected, determined, and 
 reported by the Department of Veterans Affairs.
        (T) An assessment of any patterns apparent to the 
 National Academies of Sciences, Engineering, and 
 Medicine based on the review conducted under paragraph

    (1) .
        (U) Such recommendations for further action that 
 would improve the safety and well-being of veterans as 
 the National Academies of Sciences, Engineering, and 
 Medicine determine appropriate.

    (3) Compilation of data.--
        (A) Form of compilation.--The Secretary of Veterans 
 Affairs shall ensure that data compiled under paragraph

    (2) is compiled in a manner that allows it to be 
 analyzed across all data fields for purposes of 
 informing and updating clinical practice guidelines of 
 the Department of Veterans Affairs.
        (B) Compilation of data regarding covered 
 veterans.--In compiling data under paragraph

    (2) regarding covered veterans described in subparagraphs
        (A) through
            (C) of such paragraph, data regarding 
 veterans described in each such subparagraph shall be 
 compiled separately and disaggregated by year.

    (4) Completion of review and report.--The agreement entered 
 into under paragraph

    (1) shall require that the National 
 Academies of Sciences, Engineering, and Medicine complete the 
 review under such paragraph and submit to the Secretary of 
 Veterans Affairs a report containing the results of the review 
 not later than 180 days after entering into the agreement.

    (b) Report.--Not later than 30 days after the completion by the 
National Academies of Sciences, Engineering, and Medicine of the review 
required under subsection

    (a) , the Secretary of Veterans Affairs 
shall--

    (1) 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 results of the review; and

    (2) make such report publicly available.
            (c) === Definitions. ===
-In this section:

    (1) The term ``black box warning'' means a warning 
 displayed on the label of a prescription drug that is designed 
 to call attention to the serious or life-threatening risk of 
 the prescription drug.

    (2) The term ``covered veteran'' means a veteran who 
 received hospital care or medical services furnished by the 
 Department of Veterans Affairs during the five-year period 
 preceding the death of the veteran.

    (3) The term ``first-line treatment'' means a potential 
 intervention that has been evaluated and assigned a high score 
 within clinical practice guidelines.

    (4) The term ``State'' means each of the States, 
 territories, and possessions of the United States, the District 
 of Columbia, and the Commonwealth of Puerto Rico.
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