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 Appropriations Subcommittee on Health and Human Services
BILL: SB 1712
INTRODUCER: Senators Burgess and Rodrigues
SUBJECT: Veteran Suicide Prevention Training Pilot Program
DATE: February 15, 2022
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Brown Caldwell MS Favorable
2. Gerbrandt Money AHS Recommend: Favorable
3. AP
I. Summary:
SB 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 department claims examiners
and county and city veteran service officers. The bill requires the department to contract with an
organization to develop the training curriculum.
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 must
provide information on the pilot program and recommend whether changes should be made to
increase its effectiveness. In the report to be submitted by June 30, 2026, the department must
recommend whether the pilot program should be continued.
A non-recurring appropriation of $500,000 is provided in the bill.
The bill takes effect on July I, 2022.
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 U.S.
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).
REVISED: BILL: SB 1712 Page 2
Department of Veteran Affairs (VA).
2
Third in veteran population to 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:
Post-traumatic 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 diagnosed mental health illness or substance use disorder are at a much
higher risk of suicide than veterans without these diagnoses.
7
Substance Use Disorder by Veterans
Substance use is considered to constitute a substance use disorder if the 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 by younger veterans and at a higher rate of misuse 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
Additionally,
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 a mental health illness or a substance use disorder was 57.2 patients per
100,000 population, more than double the rate amount those without these diagnoses. Ramchand, Rajeev, Suicide Among
Veterans: Veterans' Issues in Focus. Santa Monica, CA: RAND Corporation, 2021 available at:
https://www.rand.org/pubs/perspectives/PEA1363-1.html (last visited Feb. 8, 2022).
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. BILL: SB 1712 Page 3
prescription drugs, such as opioids are being prescribed to veterans at increasing rates. Despite
efforts by the VA and other agencies in recent decades to reduce substance use disorder among
veterans, rates continue to increase.
11
Veterans with substance use disorders often have co-
occurring medical conditions, other psychiatric disorders, poorer quality relationships, lower
overall quality of life, and increased rates of suicidal ideation, attempts, and completion.
12
Military Sexual Trauma
Military sexual trauma is an occurrence or occurrences of sexual harassment or sexual assault
that has taken place during military service. Researchers have found a clear association between
military sexual trauma and suicide. Early data finds that 1 out of 4 survivors of military sexual
trauma report non-suicidal self-injury. Relatedly, non-suicidal self-injury correlates to suicidal
ideation, planning, and attempts.
13
Suicide Rates Attributed to Service During Post 9/11 Conflicts
An estimated 30,177 active duty service members and veterans of the post 9/11 wars have died
by suicide, significantly more than the 7,057 service members that died in the post 9/11 war
operations.
14
Identified causes vary.
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.
15
As many as 20 percent of post-9/11 service members have experienced a TBI, with many
exposed to repetitive damage.
16
Suicide Rates 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.
17
Nationally, suicide rates are highest
11
Id. at 2.
12
Id. at 2.
13
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.
14
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).
15
Id. at 3-4.
16
Id. at 4.
17
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. BILL: SB 1712 Page 4
among young veterans, aged 18-29 years of age.
18
In comparing suicide death rates between the
veteran and non-veteran population, in 2019 the rate of suicide by the general population in
Florida was 19.6 per 100,000 persons while that for Florida veterans, was 35.7.
19
A similar
disparity exists at the national level, 18.0 suicide deaths per 100,000 for the general population
and 31.6 for veterans.
20
More than 70 percent of the time, a firearm was used to die by suicide.
21
It is well-documented that the Covid-19 pandemic has contributed to a significant increase in
feelings of loss, anxiety, and depression.
22
However, the impact of the pandemic on suicide is
unknown. Also, unknown at this time is whether the disparity in suicide rates 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 (VA). In
2018, the department implemented a 10-year strategy for preventing veteran suicide.
23
This
approach to suicide prevention involves a veteran’s family, peers, and community and includes
specific outreach to veterans who do not access services of the VA.
24
VA suicide prevention 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.
Helping families of veterans by telephone.
25
In implementing its suicide prevention strategy, the VA partners with other government agencies
and organizations at both the national and local level to share information and training on suicide
prevention.
26
To impact suicide prevention at the state level, the VA along with the Substance
Abuse and Mental Health Service Administration (SAMHSA), initiated the “Governor’s
18
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.
19
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.
20
Id.
21
Id.
22
See 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).
23
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.
24
Id. at 1.
25
Id. at 11.
26
Id. BILL: SB 1712 Page 5
Challenge to Prevent Suicide Among Service Members, Veterans, and their Families.”
27
The
goal of this initiative is to develop and implement a state-wide suicide prevention plan. To date,
35 states have joined the challenge, including Florida.
28,29
The Veterans COMPACT Act of 2020 (Act) enables the VA to implement programs, policies,
and reports related to transition assistance, suicide care, mental health education and treatment,
health care, and women veteran care. The Act also requires the VA to pay for providing veteran
emergent suicide care at VA and non-VA facilities.
30
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 service members and
veterans.
31
This plan has several priority goals:
Improve lethal means safety by inserting time and distance between a person in crisis and
access to lethal means, such as a firearm or medication.
Enhance crisis care and facilitating care transitions, including stabilization services.
Increase access to and delivery of evidence-based treatment.
Address upstream risk (leading up to crisis) and protective factors in furthering prevention
efforts.
Bridge interagency coordination.
32
State Programs
The 2021 Legislature created the Florida Veterans’ Care Coordination Program (program), to be
established by the Department of Veterans’ Affairs (department).
33
To provide services, the
department is authorized to contract with a nonprofit, accredited entity to provide dedicated
behavioral health care referral services, through the state’s 211 Network.
34
A key goal of the
program is to prevent suicide by veterans.
35
County and City Veteran Service Officers and Department Claims Examiners
County and city veteran service officers are responsible for assisting Veterans and their
dependents in securing all entitled benefits earned through honorable military service and to
27
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.
28
Id. at 14.
29
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 Service members, Veterans, and their Families, available at
https://www.samhsa.gov/smvf-ta-center/mayors-governors-challenges (last visited Jan. 14, 2022).
30
Veterans COMPACT Act of 2020 (Pub. L. No. 116-214).
31
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
32
Id. at 8-9.
33
Chapter 2021-198, Laws of Fla.; s. 394.9087, F.S.
34
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.)
35
Section 394.9087(2)(a), F.S. BILL: SB 1712 Page 6
advocate for Veteran’s interest in their community.
36
Current law authorizes each board of
county commissioners to employ a county veteran service officer.
37
Likewise, the governing
body of a city may employ a city veteran service officer.
38
The department provides the training program for county and city veteran service officers.
39
Every county or city veteran service officer must attend the training and successfully complete a
test administered by the department. The department is required to further establish periodic
training refresher courses, which must be completed as a condition of continued employment.
40
Similarly, the department employs veteran claims examiners to assist with questions and connect
veterans with their earned benefits. Veteran Claims Examiners are co-located at each VA
Medical Center and many VA outpatient clinics. To date, the department has on staff 89 veteran
claims examiners statewide.
41
III. Effect of Proposed Changes:
The 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 bill requires the
department to contract with an organization that has experience 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
its effectiveness. In the report to be submitted by June 30, 2026, the department must recommend
whether the pilot program should be continued.
A non-recurring appropriation of $500,000 is provided in the bill.
The bill takes effect on July 1, 2022.
36
Leon County Government, Veterans Services, available at https://cms.leoncountyfl.gov/Home/Departments/Office-of-
Human-Services-and-Community-Partnership/Veterans-Services (last visited Jan. 26, 2022).
37
Section 292.11(1), F.S.
38
Id.
39
Section 292.11(4), F.S.
40
Id.
41
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
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 7
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.
V. Fiscal Impact Statement:
A. Tax/Fee Issues:
None.
B. Private Sector Impact:
None.
C. Government Sector Impact:
SB 1712 includes a non-recurring appropriation of $500,000 from the General Revenue
Fund to the Department of Veterans’ Affairs.
VI. Technical Deficiencies:
None.
VII. Related Issues:
None.
VIII. Statutes Affected:
This bill creates section 394.9088 of the Florida Statutes. BILL: SB 1712 Page 8
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.