The Florida Senate
BILL ANALYSIS AND FISCAL IMPACT STATEMENT
(This document is based on the provisions contained in the legislation as of the latest date listed below.)
Prepared By: The Professional Staff of the Committee on Military and Veterans Affairs, Space, and Domestic Security
BILL: SB 1712
INTRODUCER: Senator Burgess
SUBJECT: Veteran Suicide Prevention Training Pilot Program
DATE: January 24, 2022
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Brown Caldwell MS Favorable
2. AHS
3. AP
I. Summary:
Senate Bill 1712 requires the Department of Veterans’ Affairs (department) to establish and
oversee the Veteran Suicide Prevention Training Pilot Program (program). The purpose of the
program is to provide training and certification in preventing veteran suicide to agency claims
examiners and county and city veteran service officers. To provide training curriculum, the
department will contract with an organization established in developing and implementing
veteran-relevant and evidence-based suicide prevention training.
Program participants must be trained in identifying indicators of elevated suicide risk and
providing emergency crisis referrals for veterans in emotional or psychological distress.
The bill requires the department to adopt rules, and 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 will provide
information on the pilot program and recommend whether changes should be made to increase
effectiveness. In the report to be submitted by June 30, 2026, the department will recommend
whether the pilot program should be continued.
A non-recurring appropriation of $500,000 is provided in the bill.
REVISED: BILL: SB 1712 Page 2
II. Present Situation:
Veteran Population and Suicide
Veteran Population and Demographics
As of 2017, 20 million veterans live in the United States, of which nearly 2 million are women.
1
Only about half of veterans nationally receive or access at least one benefit from the Veterans
Administration.
2
Third to only California and Texas, Florida has more than 1.5 million veterans.
3
Of these:
1.17 million are wartime veterans;
350,000 are peacetime veterans;
31,000 are World War II veterans;
105,000 are Korean War veterans;
498,000 are Vietnam-era veterans;
188,000 are Gulf War veterans; and
177,494 are Post-9/11 veterans.
4
Mental Health of Veterans
Veterans are known to have higher levels of mental distress than non-veterans. In a 2014 study,
almost 1 in 4 veterans showed symptoms of mental illness.
5
Predominant mental health
diagnoses among veterans are:
Posttraumatic Stress Disorder (PTSD) at a rate of 15 times that of the general population;
Depression at a rate of 5 times that of the general population; and
Traumatic Brain Injury (TBI).
6
Veterans who have a diagnosable mental health illness are at a much higher risk of suicide than
veterans without mental illness. A 2017 study of Veterans Health Administration patients (VHA)
shows a more than double rate of suicide among veterans with a mental health or substance use
disorder than persons without these diagnoses.
7
Substance Use Disorder by Veterans
Substance use is considered to constitute a substance use disorder if the:
1
U.S. Dep’t of Veterans Affairs, National Strategy for Preventing Veteran Suicide, 2018-2028, available at
https://www.mentalhealth.va.gov/suicide_prevention/docs/Office-of-Mental-Health-and-Suicide-Prevention-National-
Strategy-for-Preventing-Veterans-Suicide.pdf (pg. 5).
2
Id.
3
Florida Dep’t of Veterans’ Affairs, Fast Facts, available at https://www.floridavets.org/our-veterans/profilefast-facts/ (last
visited Jan. 13, 2022).
4
Id.
5
National Institute on Mental Illness (NAMI); Veterans & Active Duty (pg. 1), available at https://www.nami.org/Your-
Journey/Veterans-Active-Duty (last visited Jan. 14, 2022).
6
Id.
7
The rate of suicide among VHA patients with mental health illness at the time of the study was 57 patients per 100,000.
Rand Corporation, Suicide Among Veterans/Veterans’ Issues in Focus, available at
https://www.rand.org/pubs/perspectives/PEA1363-1.html (last visited Oct. 22, 2021) (pg. 4). BILL: SB 1712 Page 3
Recurrent use of alcohol and/or drugs causes clinically significant impairment,
including health problems, disability, and failure to meet major responsibilities at
work, school, or home.
8
Substance use disorder is marked among veterans, the most prevalent being alcohol binge
drinking and at a higher rate of use than by non-veterans.
9
The rate of illegal drug use, primarily
marijuana (marijuana use for recreational purposes is still illegal in most states) is about the same
for veterans and the general population.
10
Despite efforts by the VHA and other agencies in
recent decades to reduce substance use disorder among veterans, rates continue to increase.
11
This is especially so for prescription opioid use.
12
Substance use disorder is correlated to medical
ailments, other psychiatric disorders, relationship and employment impairment, and increased
rates of suicidal ideation, attempts, and completion.
13
In a study on military personnel,
researchers found that 30 percent of suicides were preceded by alcohol or drug use, while 20
percent of high-risk-behavior deaths were attributed to alcohol or drug overdose.
14
Military Sexual Trauma
Military sexual trauma is an occurrence or occurrences of sexual harassment or sexual assault
that has taken place during military service.
15
Researchers have found a clear association
between military sexual trauma and suicide.
16
Early data finds that 1 of 4 survivors of military
sexual trauma report non-suicidal self-injury.
17
Relatedly, non-suicidal self-injury correlates to
suicidal ideation, planning, and attempts.
18
Suicide Rates Attributed to Service During Post 9/11 Conflict
An estimated cumulative 7,057 servicemembers have died in service throughout the Post 9/11
era. A much higher rate of 30,000 active duty personnel and veterans who previously served
during the Post-9/11 era have died by suicide, or 4 times as many that died in service.
19
Identified causes vary.
8
Substance Abuse and Mental Health Services Administration, U.S. Dep’t of Health and Human Services, Mental Health
and Substance Use Disorders, available at https://www.samhsa.gov/find-help/disorders (last visited Oct. 25, 2021).
9
National Center for Biotechnology Information (NCBI), U.S. National Library of Medicine, Substance Use Disorders in
Military Veterans: Prevalence and Treatment Challenges, available at
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587184/ (pg. 3).
10
Id. at 4.
11
Id. at 2.
12
Id. at 4.
13
Id. at 2.
14
Id.
15
U.S. Dep’t of Veterans Affairs, Military Sexual Trauma -- A Risk Factor for Suicide, available at
https://www.mentalhealth.va.gov/suicide_prevention/docs/Literature-Review-Military-Sexual-Trauma-CLEARED-3-5-
19.pdf.
16
Id.
17
Id.
18
Id.
19
Thomas Howard Suitt, III, Watson Institute, International & Public Affairs, Brown University, High Suicide Rates among
United States Service Members and Veterans of the Post-9/11 Wars, available at
https://watson.brown.edu/costsofwar/files/cow/imce/papers/2021/Suitt_Suicides_Costs%20of%20War_June%2021%202021.
pdf (June 21, 2021) (pgs. 1, 3). BILL: SB 1712 Page 4
There are clear contributors to suicidal ideation like high exposure to trauma
[(mental, physical, moral, and sexual),] stress and burnout, the influence of the
military’s hegemonic masculine culture, continued access to guns, and the difficulty
of reintegrating into civilian life. … [W]e must also examine unique elements of the
U.S. post-9/11 wars. … [W]e have seen a tremendous rise of improvised explosive
devices (IEDs) in warfare, significantly increasing the number of traumatic brain
injuries (TBIs), and polytrauma cases among service members.
20
As many as 20 percent of post-9/11 servicemembers have experienced TBI’s, with many
exposed to repetitive damage.
21
Suicide Rates Disparity between Veterans and Non-Veterans
From the latest data reported for 2019, 553 veterans died by suicide in Florida, 524 men and 29
women, while nationally, 6,261 veterans died by suicide.
22
Suicide rates are highest among the
youngest veterans, aged 18-29 years of age.
23
In comparing suicide rates between the veteran and
non-veteran population, in 2019 the rate of suicide by the general population in Florida is 19.6
per 100,000 persons while that for Florida veterans, is 35.7.
24
A similar disparity exists at the
national level, 18.0 per 100,000 for the general population and 31.6 for veterans.
25
More than 70
percent of the time, a firearm was used to die by suicide.
26
That the Covid pandemic contributed to a significant increase in feelings of loss, anxiety, and
depression is well-documented.
27
Lesser known is the impact of the pandemic on suicide and if
there is one, any changes that occur over a period of time. Also, unknown at this time is whether
the marked disparity in rates of suicide between veterans and non-veterans will trend differently
in coming years.
Suicide Intervention Programs
Federal Programs
Suicide prevention is a top clinical priority of the U.S. Department of Veterans Affairs. In 2018,
the department implemented a 10-year strategy for preventing veteran suicide.
28
This approach to
suicide prevention involves a veteran’s family, peers, and community. The plan also includes
specific outreach to veterans who do not access services of the VA.
29
20
Id. at 3-4.
21
Id. at 4.
22
U.S. Dep’t of Veterans Affairs, Florida Veteran Suicide Data Sheet, 2019, available at
https://www.mentalhealth.va.gov/docs/data-sheets/2019/2019-State-Data-Sheet-Florida-508.pdf.
23
U.S. Dep’t of Veterans Affairs, National Strategy for Preventing Veteran Suicide, 2018-2028, supra note 1 at 7.
24
U.S. Dep’t of Veterans Affairs, Florida Veteran Suicide Data Sheet, 2019, supra note 22.
25
Id.
26
Id.
27
KFF, The Implications of COVID-19 for Mental Health and Substance Use (Feb. 10, 2021), available at
https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/
(last visited Nov. 3, 2021).
28
U.S. Dep’t of Veterans Affairs, National Strategy for Preventing Veteran Suicide, 2018-2028, supra note 1.
29
Id. at 1. BILL: SB 1712 Page 5
Initiatives include:
Enhancing mental health services for veterans who are women;
Broadening telehealth;
Developing free-of-charge mobile applications for veterans and their families;
Improving access to mental health care; and
Helping families of veterans by telephone.
30
In implementing its plans, the VA partners with other government agencies and organizations at
both the national and local level to share information and training on suicide prevention.
31
To
reach suicide prevention at the state level, the VA, along with the Substance Abuse and Mental
Health Service Administration (SAMHSA), initiated the “Governor’s Challenge to Prevent
Suicide Among Service Members, Veterans, and their Families.”
32
The goal of this program is to
implement a uniform comprehensive suicide prevention plan, from the national to the state level.
To date, 35 states have joined the challenge.
33
Florida is a member.
34
The Veterans COMPACT Act of 2020 enables the Veterans Administration to implement
programs providing mental health assistance to transitioning servicemembers and improving
services for veterans who are women. The law also authorizes a non-VA facility to get
reimbursed for providing a veteran emergent suicide care.
35
Most recently, in November 2021, the White House unveiled a plan to advance a comprehensive,
cross-sector, evidence-based strategy for reducing suicide rates among servicemembers and
veterans.
36
This plan adds several priority goals to the existing and ongoing comprehensive plan,
which are:
Improving lethal means safety, by inserting time and distance between a person in crisis and
access to lethal means, such as a firearm or medication;
Enhancing crisis care and facilitating care transitions, including stabilization services;
Increasing access to and delivery of evidence-based treatment;
Addressing upstream risk (leading up to crisis) and protective factors in furthering prevention
efforts; and
Bridging interagency coordination.
37
30
Id. at 11.
31
Id.
32
U.S. Dep’t of Veterans Affairs, 2021 National Veteran Suicide Prevention Report (Sept. 2021) (pg. 13), available at
https://www.mentalhealth.va.gov/docs/data-sheets/2021/2021-National-Veteran-Suicide-Prevention-Annual-Report-FINAL-
9-8-21.pdf.
33
Id. at 14.
34
Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Dep’t of Health & Human Services,
Governor’s and Mayor’s Challenges to Prevent Suicide Among Servicemembers, Veterans, and their Families, available at
https://www.samhsa.gov/smvf-ta-center/mayors-governors-challenges (last visited Jan. 14, 2022).
35
Veterans COMPACT Act of 2020 (Pub. L. No. 116-214).
36
The White House, Reducing Military and Veteran Suicide: Advancing a Comprehensive, Cross-sector, Evidence-informed
Public Health Strategy, available at https://www.whitehouse.gov/wp-content/uploads/2021/11/Military-and-Veteran-Suicide-
Prevention-Strategy.pdf
37
Id. at 8-9. BILL: SB 1712 Page 6
State Programs
The 2021 Legislature created the Florida Veterans’ Care Coordination Program (program), to be
established by the Department of Veterans’ Affairs (department).
38
To provide services, the
department may contract with a nonprofit, accredited entity to provide by phone dedicated
behavioral health care referral services, through the state’s 211 Network.
39
The program is
modelled after the proof-of-concept pilot program created in 2014 by the Crisis Center of Tampa
Bay and the Department of Veterans’ Affairs in Hillsborough, Paso, Pinellas, Polk, and Manatee
counties.
40
A key goal of the program is to prevent suicide by veterans.
41
County and City Veteran Service Officers and Agency Claims Examiners
Current law authorizes each board of county commissioners to approve the hire of a county
veteran service officer.
42
Likewise, the governing body of a city may employ a city veteran
service officer.
43
To qualify, an applicant must be a veteran who:
Served in the United States Armed Forces during a period of war;
Served at least 18 months’ active duty; and
Was discharged under honorable conditions.
44
A surviving spouse may instead be hired, provided that the veteran spouse met those
qualifications.
45
The applicant must additionally have a minimum of a 2-year degree from an accredited institute
of higher education, or a high school degree or its equivalent and 4 years of administrative
experience.
46
The Department of Veterans’ Affairs (department) provides the training program for county and
city veteran service officers.
47
Every county or city veteran service officer must attend training
and successfully complete a test administered by the department. The department shall further
establish periodic training refresher courses. Completion of these courses is a condition of
continuing employment.
48
To date, the department has on staff 89 veteran claims examiners statewide, typically sited at
U.S. Veterans Affairs Medical Facilities. Additionally, each county has at least one veteran
service officer.
49
38
Chapter 2021-198, Laws of Fla.; s. 394.9087, F.S.
39
Section 394.9087(1), F.S. The Florida 211 network, established in s. 408.918, F.S., operates as the single point of
coordination for information and referral of health and human services (s. 408.918(1), F.S.)
40
Id.
41
Section 394.9087(2)(a), F.S.
42
Section 292.11(1), F.S.
43
Id.
44
Id.
45
Id.
46
Id.
47
Section 291.11(4), F.S.
48
Id.
49
Dep’t of Veterans Affairs, 2022 Agency Legislative Bill Analysis, SB 1712 (Jan. 14, 2022) (on file with the Senate
Committee on Military and Veterans Affairs, Space, and Domestic Security). A veteran service officer at the city level may BILL: SB 1712 Page 7
III. Effect of Proposed Changes:
This bill requires the Department of Veterans’ Affairs (department) to establish and oversee the
Veteran Suicide Prevention Training Pilot Program (program). The purpose of the program is to
provide training and certification in preventing veteran suicide to agency claims examiners and
county and city veteran service officers. To provide training curriculum, the department will
contract with an organization established in developing and implementing veteran-relevant and
evidence-based suicide prevention training.
Program participants must be trained in identifying indicators of elevated suicide risk and
providing emergency crisis referrals for veterans in emotional or psychological distress.
The bill requires the Department to adopt rules, and 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 will provide
information on the pilot program and recommend whether changes should be made to increase
effectiveness. In the report to be submitted by June 30, 2026, the department will recommend
whether the pilot program should be continued.
A non-recurring appropriation of $500,000 is provided in the bill.
The bill takes effect July 1, 2022.
IV. Constitutional Issues:
A. Municipality/County Mandates Restrictions:
None.
B. Public Records/Open Meetings Issues:
None.
C. Trust Funds Restrictions:
None.
D. State Tax or Fee Increases:
None.
E. Other Constitutional Issues:
None identified.
be found in a city such as Jacksonville, which is consolidated with Duval county. Email from Christian Cochran, Department
of Veterans Affairs (Jan. 14, 2022) (on file with the Senate Committee on Military and Veterans Affairs, Space, and
Domestic Security). BILL: SB 1712 Page 8
V. Fiscal Impact Statement:
A. Tax/Fee Issues:
None.
B. Private Sector Impact:
None.
C. Government Sector Impact:
The bill includes a non-recurring appropriation of $500,000.
VI. Technical Deficiencies:
None.
VII. Related Issues:
None.
VIII. Statutes Affected:
This bill creates section 394.9088 of the Florida Statutes.
IX. Additional Information:
A. Committee Substitute – Statement of Changes:
(Summarizing differences between the Committee Substitute and the prior version of the bill.)
None.
B. Amendments:
None.
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.