This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h1315a.LAV
DATE: 2/7/2022
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/HB 1315 Veteran Suicide Prevention Training
SPONSOR(S): Local Administration & Veterans Affairs Subcommittee, Diamond and others
TIED BILLS: IDEN./SIM. BILLS: SB 1712
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Local Administration & Veterans Affairs
Subcommittee
18 Y, 0 N, As CS Mwakyanjala Miller
2) Health Care Appropriations Subcommittee
3) State Affairs Committee
SUMMARY ANALYSIS
The United States Department of Veterans Affairs (VA) partners with hundreds of organizations to raise
awareness of the VA’s suicide prevention resources and to educate people about how they may support
veterans and servicemembers in their communities. The VA also partners with community mental health
providers to expand the network of local treatment resources available to veterans. Although the VA
emphasizes mental health care for veterans, many do not reach out to the VA but rely instead on local
hospitals and health clinics. However, community health providers are not always prepared to address the
needs of veterans. Studies have found that most are unfamiliar with deployment-related stressors and unsure
how to refer patients to the VA.
Florida has taken numerous steps to combat veteran suicide including joining the “Governor’s Challenge to
Prevent Suicide Among Service Members, Veterans and their Families,” launching the Florida Veterans
Support Line, establishing the Florida Veterans Foundation, and establishing the Florida Veterans’ Care
Coordination Program.
The bill creates s. 292.115, F.S., providing that the Florida Department of Veterans Affairs is to establish the
Veteran Suicide Prevention Training Pilot Program (Program). The Program is to offer each department claims
examiner, county, and city veteran service specialized training and certification in the prevention of veteran
suicide.
The bill provides an appropriation of $500,000.00 in nonrecurring funds from the General Revenue Fund to
FDVA for the purpose of implementing the act.
STORAGE NAME: h1315a.LAV PAGE: 2
DATE: 2/7/2022
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Present Situation
Veterans and Mental Health and Substance Abuse
There are approximately 19,100,000 veterans in the United States,
1
with more than 1.5 million veterans
in Florida.
2
Veterans face unique challenges and some struggle with mental health and substance
abuse.
Posttraumatic stress disorder (PTSD) is a psychiatric disorder that can occur in people who have
experienced or witnessed a traumatic event, including war or combat.
3
The National Center for PTSD,
within the United States Department of Veterans Affairs (VA), lists the percentage of veterans with
PTSD by service era:
Between 11 and 20 percent of veterans who served in Operations Enduring Freedom
4
and Iraqi
Freedom
5
were diagnosed with PTSD in a given year.
About 12 percent of veterans who served in the Persian Gulf War
6
were diagnosed with PTSD
in a given year.
About 15 percent of veterans of the Vietnam War
7
were diagnosed with PTSD at the time of the
most recent study in the late 1980s. However, the National Center for PTSD estimates that
about 30 percent of veterans of the Vietnam War have had PTSD in their lifetimes.
8
A strong association exists between PTSD and substance abuse disorders (SUD) among veterans.
Statistics show:
9
More than two in 10 veterans with PTSD also have SUD.
Almost one in three veterans seeking treatment for SUD also has PTSD.
About one in 10 veterans returning from the wars in Iraq and Afghanistan has a problem with
alcohol or other drugs.
Veterans and Suicide
In 2016, the VA completed the largest analysis of veteran suicide to date and the work has continued
every year since. The 2021 report examines mortality records for the period between 2001 and 2019
(the latest data available), and provides information regarding veteran suicide counts, averages per
day, rates, and differences in rates of suicide.
10
1
United States Department of Veterans Affairs (VA), National Center for Veterans Analysis and Statistics,
https://www.va.gov/vetdata/veteran_population.asp (last visited February 4, 2022).
2
Florida Department of Veterans’ Affairs, Our Veterans, Fast Facts, https://floridavets.org/our-veterans/profilefast-facts/
(last visited February 4, 2022).
3
American Psychiatric Association, What is Posttraumatic Stress Disorder?, https://www.psychiatry.org/patients-
families/ptsd/what-is-ptsd (last visited February 4, 2022).
4
October 7, 2001, ending on the date prescribed by presidential proclamation or by law. See s. 1.01(14)(h), F.S.
5
March 19, 2003, ending on the date prescribed by presidential proclamation or by law. See s. 1.01(14)(i), F.S.
6
August 2, 1990, to January 2, 1992. See s. 1.01(14)(g), F.S.
7
February 28, 1961, to May 7, 1975. See s. 1.01(14)(f), F.S.
8
National Center for PTSD, VA, How Common is PTSD in Veterans?,
https://www.ptsd.va.gov/understand/common/common_veterans.asp (last visited February 4, 2022).
9
National Center for PTSD, VA, PTSD and Substance Abuse in Veterans,
https://www.ptsd.va.gov/understand/related/substance_abuse_vet.asp (last visited February 4, 2022).
10
VA, Office of Mental Health and Suicide Prevention, 2021 National Veteran Suicide Prevention Annual Report,
https://www.mentalhealth.va.gov/docs/data-sheets/2021/2021-National-Veteran-Suicide-Prevention-Annual-Report-
FINAL-9-8-21.pdf (last visited February 4, 2022). STORAGE NAME: h1315a.LAV PAGE: 3
DATE: 2/7/2022
In 2019, 6,261 veterans died by suicide, which represented 13.7 percent of suicides among U.S.
adults.
11
The average number of veteran suicide deaths per day rose from 16.4 in 2001 to 17.2 in
2019.
12
In 2019, of the average 17.2 veteran suicides per day, an estimated 6.8 suicides per day were
among those with Veterans Health Administration (VHA)
13
encounters in 2018 or 2019, compared with
10.4 suicides per day for those veterans with no VHA encounter.
14
In 2019, Florida had 553 veteran suicide deaths.
15
Many risk factors may affect veteran suicide rates including the following:
16
Economic disparities
o Some veterans report difficulty transitioning to civilian positions and difficulty translating
military-related skills to higher-paying civilian jobs.
o Veterans enrolled in VHA care are less likely to be employed and more likely to have
lower income levels than veterans not receiving VHA care.
o Unemployment and poverty are correlated with homelessness among veterans.
Race, ethnicity, and sexual orientation
o Racial and ethnic groups differ in experiences of discrimination and historical trauma
and in access to culturally appropriate mental health treatment.
o Veterans with LGBT or related identities may be at an elevated risk for suicide.
Homelessness
o In 2019, about 37,000 veterans were homeless and about 14,000 were living on the
street or unsheltered.
Service connection
o VHA patients with military service-connected disability status may have lower risk of
suicide than other VHA patients.
Social connection and isolation
o Among VHA patients, suicide rates are highest among those who are divorced,
widowed, or never married.
o Suicide rates are elevated among individuals living in rural areas.
Health and well-being
o VHA patients who died by suicide are more likely to have sleep disorders, traumatic
brain injury, or a pain diagnosis than other VHA patients.
VA Strategy for Suicide Prevention
In 2007, the Joshua Omvig Veterans Suicide Prevention Act (Act) was signed into law.
17
The Act
directed the Secretary of the VA to develop and carry out a comprehensive program designed to
reduce the incidence of suicide among veterans. The Act requires the program to include the following:
Mandatory training for appropriate staff and contractors of the VA who interact with veterans;
Mental health assessments of veterans;
Designation of a suicide prevention counselor at each VA medical facility;
Research on best practices for suicide prevention;
11
Id.
12
Id. at 5.
13
The VHA is the largest integrated healthcare system and provides care at 1,255 healthcare facilities, including 170
medical centers and 1,074 outpatient clinics. See VA, Veterans Health Administration, https://www.va.gov/health/ (last
visited February 4, 2022).
14
Id.
15
VA, Florida Veteran Suicide Data Sheet, 2019, https://www.mentalhealth.va.gov/docs/data-sheets/2019/2019-State-
Data-Sheet-Florida-508.pdf (last visited February 4, 2022).
16
VA, Office of Mental Health and Suicide Prevention, 2020 National Veteran Suicide Prevention Annual Report,
https://www.mentalhealth.va.gov/docs/data-sheets/2020/2020-National-Veteran-Suicide-Prevention-Annual-Report-11-
2020-508.pdf (last visited February 4, 2022) at 9-11. The 2021 National Veteran Suicide Prevention Annual Report was
shorter than previous reports due to the impact of COVID-19. The Office of Mental Health and Suicide Prevention in the
VA is still going through data from the year 2020, therefore some information has been gathered from the 2020 Annual
Report.
17
Joshua Omvig Veterans Suicide Prevention Act, Pub. L. No. 110-110, H.R. 327, 110
th
Cong. (Nov. 5, 2007). STORAGE NAME: h1315a.LAV PAGE: 4
DATE: 2/7/2022
Mental health care for veterans who have experienced sexual trauma while in military service;
Twenty-four hour veterans’ mental health care availability;
A toll-free hotline; and
Outreach and education for veterans and their families.
18
Since the passage of the Act, the VA has worked to expand suicide prevention initiatives, including:
Bolstering mental health services for women veterans;
Broadening telehealth services;
Developing free mobile apps to help veterans and their families;
Improving access to care by providing mental health screening and treatment services through
Vet Centers and readjustment counselors; and
Using telephone coaching to assist families of veterans.
19
In 2007, the VA also launched the Veterans Crisis Line. The program connects veterans and current
servicemembers in crisis and their families and friends with information from qualified responders
through a confidential toll-free hotline, online chat, and text messaging service.
20
The program has
answered more than 5 million calls and initiated the dispatch of emergency services to callers in crisis
more than 167,000 times.
The VA partners with hundreds of organizations to raise awareness of the VA’s suicide prevention
resources and to educate people about how they may support veterans and servicemembers in their
communities. The VA also partners with community mental health providers to expand the network of
local treatment resources available to veterans and with veterans service organizations because they
help veterans find employment, manage claims and benefits, and stay socially connected.
21
While the VA has focused on mental health care for veterans, many veterans do not reach out to the
VA for help. Most use local hospitals and health clinics. However, community health providers are not
always prepared to address the needs of veterans. Studies have found that most are unfamiliar with
deployment-related stressors and unsure how to refer patients to the VA.
22
Florida Veterans
The Florida Department of Veterans Affairs (FDVA) employs claims examiners to assist with claims for
all state and federal VA programs. Claims examiners are located within the VA regional office in Bay
Pines, in each VA Medical Center, and in VA outpatient clinics throughout the state.
23
Boards of county commissioners and governing bodies of municipalities may employ veteran service
officers and prescribe their duties, compensation, and terms of employment.
24
A veteran service officer
must:
25
18
Congress.gov, H.R. 327 Summary, https://www.congress.gov/bill/110th-congress/house-bill/327 (last visited February
4, 2022).
19
VA, National Strategy for Preventing Veteran Suicide, 2018-2028, p. 11, https://sprc.org/sites/default/files/resource-
program/VA_National-Strategy-for-Preventing-Veterans-Suicide2018.pdf (last visited February 4, 2022).
20
VA Veterans Crisis Line, What to Expect, https://www.veteranscrisisline.net/about/what-to-expect (last visited February
4, 2022).
21
Supra note 22.
22
RAND Review, How Private Health Care Providers Could Better Service Veterans, Nov. 7, 2018,
https://www.rand.org/blog/rand-review/2018/11/how-private-health-care-providers-could-better-serve-veterans.html (last
visited February 4, 2022).
23
National Resource Directory, Florida Department of Veterans Affairs, available at
https://nrd.gov/resource/detail/8781281/Florida+Department+of+Veterans+Affairs (last visited February 4, 2022). FDVA
provides a complete list of claims examiner sites. FDVA, Claim Examiner Sites, available at
https://floridavets.org/locations/claim-examiner-sites/ (last visited on February 4, 2022).
24
S. 292.11, F.S.
25
S. 292.11(1), F.S. STORAGE NAME: h1315a.LAV PAGE: 5
DATE: 2/7/2022
Be a veteran who served as a member of the Armed Forces of the United States during a period
of war;
26
Served at least 18 months’ active duty in the Armed Forces; and
Was separated from such service under honorable conditions.
Suicide Prevention in Florida
Florida has taken numerous steps to combat veteran suicide including, but not limited to:
Joining the “Governor’s Challenge to Prevent Suicide Among Service Members, Veterans and
their Families,” a national call to action asking state, military, and civil interagency teams to
embark on a process of collaborating, planning, and implementing suicide prevention best
practices and policies for servicemembers, veterans, and their families statewide;
27
Launching the Florida Veterans Support Line, a peer-based service allowing veterans to speak
to fellow veterans to receive assistance and support;
28
Establishing the Florida Veterans Foundation, a statewide organization that provides direct
services and partners with state and local governments, veteran service organizations, and
education institutions to improve a veteran’s physical, mental, and emotional well-being;
29
and
Establishing the Florida Veterans’ Care Coordination Program, providing behavioral care
referral and coordination services for veterans and their families.
30
Effect of the Bill
The bill creates s. 292.115, F.S., providing that FDVA is to establish the Veteran Suicide Prevention
Training Pilot Program (Program). The bill provides that the Program is to offer each department claims
examiner and county and city veteran service officer specialized training and certification in the
prevention of veteran suicide.
The bill provides that those who participate in the Program must be trained to identify indicators of
elevated suicide risk and provide emergency crisis referral for veterans expressing or exhibiting
symptoms of emotional or psychological distress. FDVA is to contract with organizations specializing in
veteran-related suicide prevention training in order to develop the curriculum of the Program. FDVA is
to establish and oversee the administration of training and the certification of the participants of the
Program. The bill provides that FDVA may adopt rules as necessary in order to implement the
Program.
The bill requires FDVA to submit a report to the President of the Senate and the Speaker of the House
of Representatives by June 30 of each year. The report is to include information concerning the
Program and whether any changes should be made in order to increase the Program’s effectiveness.
The bill provides that the report submitted by FDVA by June 30, 2026, is to include a recommendation
of whether the Program should be continued.
The bill provides that a sum of $500,000.00 in nonrecurring funds is to be appropriated from the
General Revenue Fund to FDVA for the purpose of implementing the act.
B. SECTION DIRECTORY:
26
Period of war is defined as the Spanish-American War, the Mexican border period, World War I, World War II, the
Korean conflict, the Vietnam era, the Persian Gulf War, and the period beginning on the date of any declaration of war by
the Congress and ending on the date prescribed by Presidential proclamation or concurrent resolution of the Congress.
38 U.S.C. s. 101.
27
Florida Department of Veterans’ Affairs, Governor Signs Florida Veteran Suicide Prevention Month Proclamation,
https://www.floridavets.org/governor-signs-florida-veteran-suicide-prevention-month-proclamation/ (last visited February 4,
2022).
28
Florida Veterans Support Line, About, https://www.myflvet.com/about-1, (last visited February 4, 2022).
29
Florida Veterans Foundation, About FVF, https://helpflvets.org/about/ (last visited February 4, 2022).
30
Ch. 2021-198, Laws of Fla., creating s. 394.9087, F.S. STORAGE NAME: h1315a.LAV PAGE: 6
DATE: 2/7/2022
Section 1: Creates s. 292.115, F.S., providing that the Florida Department of Veterans Affairs is to
establish the Veteran Suicide Prevention Training Pilot Program. Provides that the
Florida Department of Veterans Affairs is to contract with organizations specializing in
veteran-related suicide prevention training in order to develop the curriculum of the pilot
program. Provides that the Florida Department of Veterans Affairs is to adopt rules
necessary to implement the pilot program. Provides that the Florida Department of
Veterans Affairs is to submit a report concerning the pilot program and whether any
changes should be made in order to increase the Program’s effectiveness to the
President of the Senate and the Speaker of the House of Representatives by June 30 of
each year.
Section 2: Provides that a sum of $500,000.00 in nonrecurring funds is to be appropriated from the
General Revenue Fund to FDVA for the purpose of implementing the act.
Section 3: Provides an effective date.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
$500,000.00 in nonrecurring funds is to be appropriated from the General Revenue Fund to FDVA.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
None.
D. FISCAL COMMENTS:
None.
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not applicable. This bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
The bill authorizes the Florida Department of Veterans Affairs to adopt rules necessary to implement
the pilot program. STORAGE NAME: h1315a.LAV PAGE: 7
DATE: 2/7/2022
C. DRAFTING ISSUES OR OTHER COMMENTS:
None.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES
On February 7, 2022, the Local Administration and Veterans Affairs Subcommittee adopted a strike-all
amendment and reported the bill favorably as a committee substitute. The strike-all amendment places the
Veteran Suicide Prevention Training Pilot Program in chapter 292, F.S., the chapter for the Florida
Department of Veterans Affairs. The amendment creates s. 292.115, F.S., conforms the text of the bill to
the change in the statute, and retains all the substance of the pilot program as stated in the original bill.
This analysis is drafted to the committee substitute adopted by the Local Administration and Veterans
Affairs Subcommittee.