I
119THCONGRESS
1
STSESSION 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
JANUARY3, 2025
Mr. B
UCHANAN(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 Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Veteran Overmedica-4
tion and Suicide Prevention Act of 2025’’. 5
SEC. 2. DEPARTMENT OF VETERANS AFFAIRS INDE-6
PENDENT REVIEW OF CERTAIN DEATHS OF 7
VETERANS BY SUICIDE. 8
(a) R
EVIEWREQUIRED.— 9
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(1) IN GENERAL.—Not later than 90 days after 1
the date of the enactment of this Act, the Secretary 2
of Veterans Affairs shall seek to enter into an agree-3
ment with the National Academies of Sciences, En-4
gineering, and Medicine under which the National 5
Academies shall conduct a review of the deaths of all 6
covered veterans who died by suicide during the five- 7
year period ending on the date of the enactment of 8
this Act, regardless of whether information relating 9
to such deaths has been reported by the Centers for 10
Disease Control and Prevention. 11
(2) E
LEMENTS.—The review required by para-12
graph (1) shall include the following: 13
(A) The total number of covered veterans 14
who died by suicide during the five-year period 15
ending on the date of the enactment of this Act. 16
(B) The total number of covered veterans 17
who died by a violent death during such five- 18
year period. 19
(C) The total number of covered veterans 20
who died by an accidental death during such 21
five-year period. 22
(D) A description of each covered veteran 23
described in subparagraphs (A) through (C), in-24
cluding age, gender, race, and ethnicity. 25
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(E) A comprehensive list of prescribed 1
medications and legal or illegal substances as 2
annotated on toxicology reports of covered vet-3
erans described in subparagraphs (A) through 4
(C), specifically listing any medications that 5
carried a black box warning, were prescribed for 6
off-label use, were psychotropic, or carried 7
warnings that included suicidal ideation. 8
(F) A summary of medical diagnoses by 9
physicians of the Department of Veterans Af-10
fairs or physicians providing services to covered 11
veterans through programs of the Department 12
that led to the prescribing of medications re-13
ferred to in subparagraph (E) in cases of post- 14
traumatic stress disorder, traumatic brain in-15
jury, military sexual trauma, and other anxiety 16
and depressive disorders. 17
(G) The number of instances in which a 18
covered veteran described in subparagraph (A), 19
(B), or (C) was concurrently on multiple medi-20
cations prescribed by physicians of the Depart-21
ment or physicians providing services to vet-22
erans through programs of the Department to 23
treat post-traumatic stress disorder, traumatic 24
brain injury, military sexual trauma, other anx-25
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iety and depressive disorders, or instances of 1
comorbidity. 2
(H) The number of covered veterans de-3
scribed in subparagraphs (A) through (C) who 4
were not taking any medication prescribed by a 5
physician of the Department or a physician pro-6
viding services to veterans through a program 7
of the Department. 8
(I) With respect to the treatment of post- 9
traumatic stress disorder, traumatic brain in-10
jury, military sexual trauma, or other anxiety 11
and depressive disorders, the percentage of cov-12
ered veterans described in subparagraphs (A) 13
through (C) who received a non-medication 14
first-line treatment compared to the percentage 15
of such veterans who received medication only. 16
(J) With respect to the treatment of cov-17
ered veterans described in subparagraphs (A) 18
through (C) for post-traumatic stress disorder, 19
traumatic brain injury, military sexual trauma, 20
or other anxiety and depressive disorders, the 21
number of instances in which a non-medication 22
first-line treatment (such as cognitive behav-23
ioral therapy) was attempted and determined to 24
be ineffective for such a veteran, which subse-25
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quently led to the prescribing of a medication 1
referred to in subparagraph (E). 2
(K) A description and example of how the 3
Department determines and continually updates 4
the clinical practice guidelines governing the 5
prescribing of medications. 6
(L) An analysis of the use by the Depart-7
ment, including protocols or practices at med-8
ical facilities of the Department, of systemati-9
cally measuring pain scores during clinical en-10
counters under the Pain as the 5th Vital Sign 11
Toolkit of the Department and an evaluation of 12
the relationship between the use of such meas-13
urements and the number of veterans concur-14
rently on multiple medications prescribed by 15
physicians of the Department. 16
(M) A description of the efforts of the De-17
partment to maintain appropriate staffing levels 18
for mental health professionals, such as mental 19
health counselors, marriage and family thera-20
pists, and other appropriate counselors, includ-21
ing— 22
(i) a description of any impediments 23
to carry out the education, training, and 24
hiring of mental health counselors and 25
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marriage and family therapists under sec-1
tion 7302(a) of title 38, United States 2
Code, and strategies for addressing those 3
impediments; 4
(ii) a description of the objectives, 5
goals, and timing of the Department with 6
respect to increasing the representation of 7
such counselors and therapists in the be-8
havioral health workforce of the Depart-9
ment, including— 10
(I) a review of eligibility criteria 11
for such counselors and therapists and 12
a comparison of such criteria to that 13
of other behavioral health professions 14
in the Department; and 15
(II) an assessment of the partici-16
pation of such counselors and thera-17
pists in the mental health profes-18
sionals trainee program of the De-19
partment and any impediments to 20
such participation; 21
(iii) an assessment of the development 22
by the Department of hiring guidelines for 23
mental health counselors, marriage and 24
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family therapists, and other appropriate 1
counselors; 2
(iv) a description of how the Depart-3
ment— 4
(I) identifies gaps in the supply 5
of mental health professionals; and 6
(II) determines successful staff-7
ing ratios for mental health profes-8
sionals of the Department; 9
(v) a description of actions taken by 10
the Secretary, in consultation with the Di-11
rector of the Office of Personnel Manage-12
ment, to create an occupational series for 13
mental health counselors and marriage and 14
family therapists of the Department and a 15
timeline for the creation of such an occu-16
pational series; and 17
(vi) a description of actions taken by 18
the Secretary to ensure that the national, 19
regional, and local professional standards 20
boards for mental health counselors and 21
marriage and family therapists are com-22
prised of only mental health counselors and 23
marriage and family therapists and that 24
the liaison from the Department to such 25
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boards is a mental health counselor or 1
marriage and family therapist. 2
(N) The percentage of covered veterans de-3
scribed in subparagraphs (A) through (C) with 4
combat experience or trauma related to combat 5
experience (including military sexual trauma, 6
traumatic brain injury, and post-traumatic 7
stress). 8
(O) An identification of the medical facili-9
ties of the Department with markedly high pre-10
scription rates and suicide rates for veterans re-11
ceiving treatment at those facilities. 12
(P) An analysis, by State, of programs of 13
the Department that collaborate with State 14
Medicaid agencies and the Centers for Medicare 15
and Medicaid Services, including the following: 16
(i) An analysis of the sharing of pre-17
scription and behavioral health data for 18
veterans. 19
(ii) An analysis of whether Depart-20
ment staff check with State prescription 21
drug monitoring programs before pre-22
scribing medications to veterans. 23
(iii) A description of the procedures of 24
the Department for coordinating with pre-25
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scribers outside of the Department to en-1
sure that veterans are not overprescribed. 2
(iv) A description of actions that the 3
Department takes when a veteran is deter-4
mined to be overprescribed. 5
(Q) An analysis of the collaboration of 6
medical centers of the Department with medical 7
examiners’ offices or local jurisdictions to deter-8
mine veteran mortality and cause of death. 9
(R) An identification and determination of 10
a best practice model to collect and share vet-11
eran death certificate data between the Depart-12
ment of Veterans Affairs, the Department of 13
Defense, States, and tribal entities. 14
(S) A description of how data relating to 15
death certificates of veterans is collected, deter-16
mined, and reported by the Department of Vet-17
erans Affairs. 18
(T) An assessment of any patterns appar-19
ent to the National Academies of Sciences, En-20
gineering, and Medicine based on the review 21
conducted under paragraph (1). 22
(U) Such recommendations for further ac-23
tion that would improve the safety and well- 24
being of veterans as the National Academies of 25
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Sciences, Engineering, and Medicine determine 1
appropriate. 2
(3) C
OMPILATION OF DATA.— 3
(A) F
ORM OF COMPILATION .—The Sec-4
retary of Veterans Affairs shall ensure that 5
data compiled under paragraph (2) is compiled 6
in a manner that allows it to be analyzed across 7
all data fields for purposes of informing and 8
updating clinical practice guidelines of the De-9
partment of Veterans Affairs. 10
(B) C
OMPILATION OF DATA REGARDING 11
COVERED VETERANS .—In compiling data under 12
paragraph (2) regarding covered veterans de-13
scribed in subparagraphs (A) through (C) of 14
such paragraph, data regarding veterans de-15
scribed in each such subparagraph shall be 16
compiled separately and disaggregated by year. 17
(4) C
OMPLETION OF REVIEW AND REPORT .— 18
The agreement entered into under paragraph (1) 19
shall require that the National Academies of 20
Sciences, Engineering, and Medicine complete the 21
review under such paragraph and submit to the Sec-22
retary of Veterans Affairs a report containing the 23
results of the review not later than 180 days after 24
entering into the agreement. 25
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(b) REPORT.—Not later than 30 days after the com-1
pletion by the National Academies of Sciences, Engineer-2
ing, and Medicine of the review required under subsection 3
(a), the Secretary of Veterans Affairs shall— 4
(1) submit to the Committee on Veterans’ Af-5
fairs of the Senate and the Committee on Veterans’ 6
Affairs of the House of Representatives a report on 7
the results of the review; and 8
(2) make such report publicly available. 9
(c) D
EFINITIONS.—In this section: 10
(1) The term ‘‘black box warning’’ means a 11
warning displayed on the label of a prescription drug 12
that is designed to call attention to the serious or 13
life-threatening risk of the prescription drug. 14
(2) The term ‘‘covered veteran’’ means a vet-15
eran who received hospital care or medical services 16
furnished by the Department of Veterans Affairs 17
during the five-year period preceding the death of 18
the veteran. 19
(3) The term ‘‘first-line treatment’’ means a po-20
tential intervention that has been evaluated and as-21
signed a high score within clinical practice guide-22
lines. 23
(4) The term ‘‘State’’ means each of the States, 24
territories, and possessions of the United States, the 25
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District of Columbia, and the Commonwealth of 1
Puerto Rico. 2
Æ
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