36C10X23R0006 Amendment 0007 Signed.pdf

5. PROJECT NUMBER (if applicable)

CODE 7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER 3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

FACILITY CODE CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR

ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

1 112

OMHSP22-1

36C10X

Strategic Acquisition Center - Frederick

Department of Veterans Affairs

5202 Presidents Court, Suite 103

Frederick MD 21703

36C10X

Strategic Acquisition Center - Frederick

Department of Veterans Affairs

To all Offerors/Bidders

36C10X23R0006

X

X X

The purpose of this amendment is to add FAR Clause 52.204-27 Prohibition on a Bytedance Covered Application as highlighted in the solicitation amendment.

Melissa Ramirez

Contracting Officer

12-Jun-2023

12-Jun-2023

36C10X23R0006 Amendment 0007

White House Priority Goal Support to Safeguard Against Veteran Suicide

STATEMENT OF OBJECTIVES (SOO) DEPARTMENT OF VETERANS AFFAIRS

White House Priority Goal Support to

Safeguard Against Veteran Suicide

TABLE OF CONTENTS

Contents

STATEMENT OF OBJECTIVES (SOO) DEPARTMENT OF VETERANS AFFAIRS

1 INTRODUCTION

2 REFERENCE DOCUMENTS

3 BACKGROUND

4 CONTRACT/ORDER TYPE

5 PERIOD OF PERFORMANCE

6 OVERARCHING OBJECTIVES

6.1 GUIDING PRINCIPLES

6.1.1 PRIORITY GOAL 1: IMPROVE LETHAL MEANS SAFETY

6.1.2 INTEGRATED MEDIA PLANNING

6.1.3 LETHAL MEANS SAFETY EDUCATION

6.1.4 PRIORITY GOAL 2: ENHANCE CRISIS CARE AND FACILITATE CARE TRANSITIONS

6.1.5 TECHNOLOGY FOCUSED SOLUTIONS

6.1.6 PRIORITY GOAL 3: INCREASE ACCESS TO AND DELIVERY OF EFFECTIVE CARE .. 18

6.1.7 INTERVENTION IDENTIFICATION AND DEVELOPMENT FOR UNDERREPRESENTED

VETERAN POPULATIONS

6.1.8 THERAPY TRAINING

6.1.9 SUICIDE RISK REDUCTION FOR PTSD PATIENTS

7 OVERARCHING REQUIREMENTS

8 TRANSITION PLANNING

8.1 TRANSITION PLANNING

SECTION C - CONTRACT CLAUSES

C.3 52.204-27 PROHIBITION ON A BYTEDANCE COVERED APPLICATION (JUN 2023)… 33

C.4 52.227-14 RIGHTS IN DATA – GENERAL (MAY 2014)

C.5 52.227-16 ADDITIONAL DATA REQUIREMENTS (JUN 1987)

C.6 52.227-17 RIGHTS IN DATA-SPECIAL WORKS (DEC 2007)

C.7 52.232-16 PROGRESS PAYMENTS (NOV 2021) ALTERNATE I (MAR 2000)

C.8 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF

COMMERCIAL ITEMS (APR 2020)

C.9 VAAR 852.219-73 VA NOTICE OF TOTAL SET-ASIDE FOR CERTIFIED SERVICE-

DISABLED VETERAN-OWNED SMALL BUSINESSES (JAN 2023) (DEVIATION)

C.10 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023)

(DEVIATION)

C.11 VAAR 852.237-75 KEY PERSONNEL (OCT 2019)

C.12 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020)

C.13 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.14 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (DEC 2022)

C.15 MANDATORY WRITTEN DISCLOSURES

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

VOLUME IV –SIGNED OFFER AND OTHER REQUIRED SUBMITTALS:

E.2 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

(NOV 2021)

1.1 Technical Evaluation Approach

1.2 Price Evaluation Approach

1.3 Past Performance Evaluation Approach

E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND

VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)

E.4 52.204-26 COVERED TELECOMMUNICATIONS EQUIPMENT OR SERVICES-

REPRESENTATION. (OCT 2020)

E.5 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.5 52.212-3 OFFEROR REPRESENTATION AND CERTIFICATIONS – COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES (DEC 2022)

E.6 52.216-1 TYPE OF CONTRACT (APR 1984)

E.7 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.8 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) 111

1 INTRODUCTION

Suicide among service members and Veterans is a public health and national security crisis.

Since 2010, more than 65,000 Veterans have died by suicide – more than the total number of deaths from combat during the Vietnam War and the operations in Iraq and Afghanistan combined. Women Veterans die by suicide at almost twice the rate than non-Veteran women, and from 2001 – 2020, the unadjusted suicide rate among Veterans between the ages of 18 and

34 increased by 95.3% (almost three times higher than non-Veterans the same age). Veterans are at increased risk in the 13 months following separation from active military service, and across multiple Veteran subpopulation groups: geographically remote Veterans, Asian American

Pacific Islander Veterans, American Indian and Alaska Native Veterans, women Veterans, and

LGBTQ+ Veterans, to name just a few. In the military, those under 30 years of age and enlisted service members are at heightened risk. As with the general population, among service members, Veterans and their family members, firearms are the most common method of suicide (71%) compared to non-Veteran U.S. adults (50%).

Suicide is preventable and Veterans are at higher risk for suicide compared to the general population. In 2020, the rate of deaths by suicide was 57.3% higher for Veterans than that of non-Veteran adults. As General Colin L. Powell stated in 1989, “The nation owes a great debt to its Veterans, whose service to the nation spans every decade, every year, every day of our country's existence.”

The Department of Veterans Affairs’ (VA) 2018-2028 National Strategy for Preventing Veteran

Suicide outlines a broad vision for implementation of a public health approach to end suicide. In

2020, VA translated the vision offered in the 10-year National Strategy into operational plans via three mechanisms employed by the Veterans Health Administration (VHA): Suicide Prevention

2.0 Initiative (SP 2.0), Suicide Prevention Now initiative (Now), and the President’s Roadmap to

Empower Veterans and End a National Tragedy of Suicide (PREVENTS). Taken together, OMHSP maintains a crosswalk of SP 2.0, Now, and PREVENTS targets, objectives, and actions to ensure that each are clearly linked to the National Strategy for Preventing Veteran Suicide and are unique yet complementary and contributory to the mission.

Through a series of interagency discussions and based upon the progress made in implementing the 2020 PREVENTS Roadmap, a series of priority goals were identified in the White House

Plan for Reducing Military and Veteran Suicide: Advancing a Comprehensive, Cross-Sector, Evidence-Informed Public Health Strategy to help organize a focused set of agency actions that will advance evidence-based approaches to reduce military and veteran suicide. The White

House Plan includes several requirements charged to VA “create and implement systemic changes in how we support service members, Veterans, and their families across the full continuum of risk and wellness,” including:

• The establishment of “a Feasibility Analysis and Implementation Plan for broad implementation of evidence-based suicide risk assessment and safety planning within emergency care settings (emergency transport, urgent care, and emergency departments) throughout the United States. The analysis will include evaluation of ways in which https://www.whitehouse.gov/wp-content/uploads/2021/11/Military-and-Veteran-Suicide-Prevention-Strategy.pdf https://www.whitehouse.gov/wp-content/uploads/2021/11/Military-and-Veteran-Suicide-Prevention-Strategy.pdf federal policy and funding may be implemented to reinforce wide-scale implementation of evidence-based suicide risk assessment, safety planning, and post discharge follow-up care coordination across healthcare systems...”

• The evaluation of “access and engagement barriers to evidence-based mental health care for service members, Veterans, and their family members at elevated risk for suicide.”

• The creation and implementation of “a plan for addressing lethal means safety awareness, education, training, and program evaluation”, including (but not limited to)

“identifying, developing, and testing “tailored messaging for a coordinated lethal means safety public education campaign.”

• The implementation of “federal, state, territorial, Tribal, and local public and private partnerships with a specific focus on addressing risk and protective factors for suicide.

This will include increased emphasis on promoting economic well-being and addressing the full spectrum of the social determinants of health for service members, veterans, and their families. It will also entail efforts to implement safe messaging and adopt appropriate strategies in the aftermath of suicide (known as postvention).”

The goal of this entire effort is to not only Reduce Military and Veteran Suicide, but to ensure we are reaching out, educating, partnering, studying, and communicating effectively across multiple lanes of effort, partnerships, and settings. OMHSP, SPP is seeking Industry Partner support to identify the current and future states of a robust, industry leading suicide prevention program that considers what is close to Veteran hearts, outlines potential hurdles, paints a complete picture, and designs a trusted legacy of care for our nation’s finest volunteers.

2 REFERENCE DOCUMENTS

In the performance of the tasks associated with this SOO, the Contractor shall comply with the

Applicable Documents included in Section 13.0 below.

• 44 U.S.C. § 3541, “Federal Information Security Management Act (FISMA) of 2002”

• FIPS Pub 201-2, “Personal Identity Verification of Federal Employees and Contractors,”

August 2013

• 5 U.S.C. § 552a, as amended, “The Privacy Act of 1974”

• Public Law 109-461, Veterans Benefits, Health Care, and Information Technology Act of

2006, title IX Information Security Matters

• 10 U.S.C. § 2224, "Defense Information Assurance Program"

• 42 U.S.C. § 2000d, “Title VI of the Civil Rights Act of 1964”

• Department of Veterans Affairs (VA) Directive 0710 Personnel Security and Suitability

Program dated June 04, 2010 (https://www.voa.va.gov/)

• Department of Veterans Affairs (VA) Directive 6102 (Internet/Intranet Services)

(https://www.voa.va.gov/)

• Department of Veterans Affairs (VA) Handbook 6102 (Internet/Intranet Services)

(https://www.voa.va.gov/)

• Health Insurance Portability and Accountability Act (HIPAA); 45 CFR Part 160, 162, and

164; Health Insurance Reform: Security Standards; Final Rule dated February 20, 2003

• 36 C.F.R. Part 1194, “Electronic and Information Technology Accessibility Standards,”

July 1, 2003

• Office of Management and Budget (OMB) Circular A-130, “Management of Federal

Information Resources,” November 28, 2000

• VA Handbook 6500.6, “Contract Security,” February 24, 2021

• National Institute of Standards and Technology (NIST) Special Publication 800-53, “Recommended Security Controls for Federal Information Systems and

Organizations”(https://www.voa.va.gov/)

• Federal Travel Regulation (FTR) (www.gsa.gov/federaltravelregulation)

• VA Directive 6300, Records and Information Management, September 21, 2018

• VA Directive 6221, Accessible Information and Communication Technology (ICT).

• VA Handbook, 6300.1, Records Management Procedures, March 24, 2010

• The Paperwork Reduction Act of 1980 (Pub. L. No. 96-511, 94 Stat. 2812, codified at 44

U.S.C. §§ 3501 – 3521)

• Mission, Vision, Core Values & Goals for the US Department of Veteran Affairs

(https://www.va.gov/about_va/mission.asp)

• S.785 - Commander John Scott Hannon Veterans Mental Health Care Improvement Act of

• White House Plan for Reducing Military and Veteran Suicide

(https://www.whitehouse.gov/wp-content/uploads/2021/11/Military-and-Veteran-Suicide-

Prevention-Strategy.pdf)

3 BACKGROUND

In the Department of Veterans Affairs (VA) Fiscal Year 2018–2024 Strategic Plan, preventing

Veteran suicide is identified as the highest clinical priority. The VA National Strategy for

Preventing Suicide (2018 – 2028) and the White House Plan for Reducing Military and Veteran

Suicide (released on November 2, 2021) provide additional guidance for implementation of a public health approach to end suicide.

In 2012, Executive Order 13625: “Improving Access to Mental Health Services for Veterans, Service Members, and Military Families” established the Interagency Task Force on Military and

Veterans Mental Health. The early work of this Interagency Task Force had a specific emphasis on facilitating interagency collaboration, expanding staffing capacity at the Veteran Crisis Line, and joint development of a national suicide prevention campaign focused on connecting Veterans and service members to resources and support. Further, the Veterans Health Administration (VHA) has made mental healthcare access and suicide prevention a critical part of its strategic goals. Through early intervention and full access to mental health and suicide prevention services, VHA aims to

“lead the nation in caring for people with Post-Traumatic Stress Disorder (PTSD) and associated mental health challenges.” This effort is aligned with President Biden’s National Mental Health

Strategy, which is taking executive action to address aspects of suicide prevention.

The White House Plan includes a VA charge to "create a Feasibility Analysis and Implementation https://www.va.gov/about_va/mission.asp https://www.whitehouse.gov/wp-content/uploads/2021/11/Military-and-Veteran-Suicide-Prevention-Strategy.pdf https://www.whitehouse.gov/wp-content/uploads/2021/11/Military-and-Veteran-Suicide-Prevention-Strategy.pdf

Plan for broad implementation of evidence-based suicide risk assessment and safety planning within emergency care settings (emergency transport, urgent care, and emergency departments) throughout the United States." This differs significantly from the VA/DOD Clinical Practice

Guidelines, which are designed to reduce treatment variation, address the needs of specific patient cohorts, and establish consistent quality standards across VA/DOD care settings.

In order to create a Feasibility Analysis and Implementation Plan, the VA seeks industry support to help define clear, evidence based methods for increasing care coordination and collaboration across settings – whether Federal, State, or community, including, but not limited to:

• VA Safety Planning in the Emergency Department (SPED): national evaluation of community practices, processes, and an implementation plan to expand.

• Tailored technologies to facilitate engagement of Veterans transitioning from active duty

• Development of a national resource website that integrates multiple LMS resources, research, messaging, and talking points to coordinate Federal, State, and private industry

LMS assets.

• Lethal Means Safety education / awareness public service announcements to update educational and outreach assets

• Develop a clear set of Regional and State-wide out-of-home secure storage LMS resources resulting in safe storage maps that are accessible nearest to Veterans in need.

• Develop, pilot, and facilitate the implementation of community-based brief, intensive, residential PTSD care.

• Develop and / or update evidence-based suicide prevention guidelines – and ensure those guidelines are tailored to the specific drivers of risk among high-risk Veteran subpopulations.

• Develop and disseminate community training for evidence-based suicide prevention strategies, including: CBT-SP, DBT-SP, and PST-SP for know high-risk Veteran subpopulation groups.

• Evaluate and pilot optimized mental health access models that factor NASEM conclusions and expand capacity to ensure Veteran access to evidence-based suicide prevention services.

• Develop, pilot, and evaluate a Smart responder automated system for VCL Chat and Text to optimize speed of response, access, and evidence-based early interventions / prevention services.

• Establish Buddy Check week training for Veteran support networks and provide a comprehensive distribution strategy to foster the success of Buddy Check Week.

4 CONTRACT/ORDER TYPE

This non-severable contract shall be issued on a performance-based, Firm Fixed Price (FFP) basis.

5 PERIOD OF PERFORMANCE

The total period of performance for this effort, to include delivery of one (1) Final Feasibility

Analysis and proposed Implementation Plan, , shall not exceed 30 months.

6 OVERARCHING OBJECTIVES

The Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Office of

Mental Health and Suicide Prevention (OMHSP), Suicide Prevention Program (SPP) has a requirement for support services to assist VA in reducing and preventing suicide within the military and veteran populations through an evidence-based approach to integrated care models that address medical, behavioral, and social health. This environmental study shall detail a careful analysis of the internal and external environment of VHA to detect opportunities, threats, trends, important lessons, and weaknesses which can impact the current and future strategies of the organization’s mission to reduce Military and Veteran Suicide.

This acquisition shall assist the VA in developing a Feasibility Analysis and Implementation Plan for reducing and preventing suicide within the military and veteran populations. This shall be performed to develop an evidence-based approach to integrated care models that address medical, behavioral, and social health. This support shall focus specifically on Priority Goals outlined in the

White House Plan for Reducing Military and Veteran Suicide.

In furtherance of meeting these objectives, VA seeks support from an industry partner with a broad comprehension of diverse populations of Veterans and the various factors that impact suicide and mental health concerns across diverse populations and societal levels. This will assist VA in its efforts to create and implement a broad plan to fit specific settings and meet the diverse Veterans across settings, including new settings and groups that may be identified in the future.

At contract awards Section 6.1 will be replaced with the Awardee’s Performance Work Statement.

6.1 GUIDING PRINCIPLES

The Contractor shall develop an evidence-based approach to integrated care models that address medical, behavioral, and social health. This support shall focus specifically on Priority Goals outlined in the White House Plan for Reducing Military and Veteran Suicide released on November 2, 2021.

The contractor shall enter into all work with the understanding that no “sustainment or continuous operations” is to be performed and is considered out of scope of this contract. All evidence based methods must draw upon rigorous suicide prevention science, data driven, and evidence-based improvement proposals, outcome and results evaluation, and emerging best practices in suicide prevention and communication strategies.

The VA seeks to develop a Feasibility Analysis and Implementation plan that will raise community awareness and educate healthcare and mental health providers engaging in the assessment and care of

Veterans (within and outside of VHA); lay persons including Veterans, family members, faith-based supports, caregivers, peer specialists, and community members engaging at-risk Veterans. Education and training materials shall also consider drivers of risk for Veterans, including the unique needs of

Veterans in the following groups:

1. Women Veterans under the age of 35

2. American Indian / Alaska Native Veterans

3. LGBTQ+ Veterans

4. Survivors of Military Sexual Trauma

5. White-male Veterans over the age of 55

6. Geographically remote Veterans

7. Enlisted Service members under the age of 30

These groups should be considered in all aspects of the following objectives.

VA realizes and accepts that the various VA communities’ desires have similarities, differences and overlaps, but the analysis requirements outlined below should address the evidence based methods identified in the Background section of this solicitation. Offerors shall address all sections of the

Statement of Objectives. However, Offerors may include additional areas of interest in order to meet the overall objective to reduce Veteran suicide. . VA desires an end state that integrates the approach across the Department incorporating the following:

6.1.1 PRIORITY GOAL 1: IMPROVE LETHAL MEANS SAFETY

VA seeks to focus on increasing time and space between a person in crisis and their access to lethal means, including firearms and medications. The goal is to develop interventions that aim to address lethal means safety, such as lethal means safety training, safe storage options, or safety planning care, are clinically indicated for populations at risk of suicide. Efforts to promote protective environments and enhance organizational culture about lethal means safety can also lead to changes in safe storage behaviors.

VA is charged with advancing several national suicide prevention priorities that we are seeking support in achieving. In reference to page 11 of the White House Plan to Reduce Military and

Veteran Suicide released on November 2, 2021, VA seeks support in the creation of “a plan for addressing lethal means safety awareness, education, training, and program evaluation. VA seeks support in the identification, development, and testing of a tailored messaging for a coordinated lethal means safety public education campaign. It is VA’s goal to base their activities on expert guidance (including from suicide prevention experts and law enforcement professionals) and data.”

The VA seeks to develop strategies and interventions that aim to address lethal means safety.

These strategies shall be clinically indicated for populations at risk of suicide that include plans to:

• Educate the public on lethal means safety, secure storage practices, safety planning, and a broad range of resources to facilitate prevention, early intervention, and behavioral changes to facilitate suicide risk reduction. This includes the development, piloting, and evaluation of broadcast-quality Lethal Means Safety Public Service

Announcements (PSAs)

• Significantly increase Lethal Means Safety training, awareness, and training completion rates, including training of VA Community Care Network providers; and

• Conduct a national study of Suicide Prevention safety evaluation and planning processes within community Emergency Departments and Urgent Care Centers. VA is charged with the expansion of evidence-based models, including VA’s Safety

Planning in the Emergency Department (SPED), to increase care management and coordination for high-risk Veterans, regardless of where they receive care. The expansion effort shall include training of non-governmental health care providers, family members, and other support systems as identified, on how to use safety plans

(outlined in 6.1.4)

It is VA’s goal to perform research and evaluation tasks essential for guiding best practices and continuous quality improvement to enhance lethal means safety as a major priority for the VA

National Strategy for Suicide Prevention.

• VA seeks to conduct a national study on Veteran preferred safe storage options (gun locks, lock boxes, safes, etc.) and determine if there are differences in utilization rates between genders, different socio-economic groups, ethnic groups, geographically remote populations. The purpose of this study is to inform the development of a global, out-of-home, safe storage options.

• It is VA’s goal to provide a comprehensive analysis of funding requirements, policy and legislative needs to facilitate the expansion of both in-home, and out-of-home secure storage options. VA seeks to develop recommendations to clarify potential liability and cost concerns of off-site safe storage facilities.

• VA seeks to develop a comprehensive suicide prevention : Lethal Means Safety website that fosters collaboration within and across partner organizations (federal, state, private industry, academic, and community partners) to serve as a central access point for organizing and disseminating LMS related information and resources across the nation.

VA seeks to create multiple coordinated advertising, promotional, and publicity campaigns relating to suicide prevention, with a particular focus on firearms and other Lethal Means Safety

(LMS) calls to action. Campaigns shall be based on the VA National Strategy for Preventing

Suicide (2018 – 2028) and the White House Plan for Reducing Military and Veteran Suicide

(2021). VHA seeks to develop, plan, execute, track, and evaluate the impacts of creative assets and educational materials on Veteran suicide rates over time.

VA is seeking industry support to accomplish the priorities set forth within the VA National

Strategy for Preventing Suicide (2018 – 2028) and the White House Plan for Reducing Military and Veteran Suicide (2021). The contractor will design, create, and test new Lethal Means

Safety outreach prototypes, evaluate effectiveness of those prototypes, and articulate a comprehensive distribution plan for future efforts that accounts for the varied methods necessary to engage a wide-range of at-risk military and Veteran populations including already identified targeted segments. VA may use this plan to accomplish aligned priorities set forth within the aforementioned VA National Strategy and White House Plan for Military and Veteran suicide reduction. Considering Attachment 1, some examples of potential pilot activities the contractor may utilize to assist VA in its efforts to maximize suicide prevention and LMS messaging awareness among target audiences could include, but are not limited to, the following:

Conduct a national study of Veteran preferred safe storage options , Develop a Lethal Means Safety

Website, Develop, pilot, and evaluate broadcast-quality PSAs, development and delivery of new educational / awareness creative assets, Identifying appropriate storage of all video and photo assets of new and preexisting digital media content, Developing advertising material for national Lethal

Means Safety campaign, Still photography for suicide prevention efforts

6.1.2 INTEGRATED MEDIA PLANNING

The VA seeks to develop an integrated media plan. The Government has considered including earned, owned, paid, and donated (integrated) media to reach its intended audiences. The VA seeks guidance regarding media planning that includes, but is not limited to, the following:

• Target Audiences. Similar to the creative asset content, the target demographics include all at-risk military and Veterans. However, the plan shall also contain recommendations for addressing important Veteran subpopulations, particularly those at higher risk for suicide including (but not limited to) women Veterans under 35, Veterans 18 - 34 years old, American Indian/Alaska Native Veterans, Asian American Pacific Islander (AAPI)

Veterans, LGBTQ+ Veterans, survivors of military sexual trauma, white male Veterans over the age of 55, and geographically remote Veterans.

• Logic Framework. The proposed strategic media planning should include a Logic

Framework showing inputs, activities, short and mid-term outcomes, and long-term impacts. The objective of this strategic plan (rolling over a few years) shall show a broad range of options designed to communicate impactful, action-oriented messaging across multiple price points. VHA seeks to create an integrated media plan promoting VA care and flexible enough to work within fiscally constrained years.

• Suggested Plan Objectives. The VA seeks to develop data-driven evidence to support each recommendation in its media plan. The suggested objectives of the integrated media plan include key performance indicators (KPI) included in Attachment 2. This attachment was designed with the intent of driving website actions, awareness, and message amplification of Lethal Means Safety for all media efforts.

VA, in seeking industry support to accomplish the priorities set forth within the VA National and Veteran Suicide (2021), anticipates the support contractor will undertake a variety of methods to gather sufficient data to formulate and provide guidance to VA who will develop an integrated media distribution plan for reducing and preventing suicide within the military and veteran populations. VA anticipates contractor use of pilot activities as part of this effort, with the desired goal of the contractor assessing and advising VA on the potential effectiveness of different outreach modalities which VA may use in its efforts to reduce suicide among military and Veteran groups. . Considering Attachment 2, some examples of potential pilot activities the contractor may utilize to assist VA in its efforts to maximize suicide prevention and paid media planning among target audiences include, but are not limited to, the following:

Strategic Media Plan Suggestions, Regional and demographic testing of prototypes and messaging, campaign metrics and tracking

6.1.3 LETHAL MEANS SAFETY EDUCATION

VA seeks to develop new suicide prevention and LMS education assets. These assets are to include clear implementation strategies, recommended execution timelines, and methodologies for ensuring engagement with common support networks (generally), and at-risk military and Veteran subpopulations (more specifically). The suicide prevention and LMS education plan shall consider and include, but is not limited to, the following:

• Target Audiences. The target demographics include non-medical providers of care, crisis responders, health care professionals, family members, peers, faith-community supports, and others (as identified) , both within the government and within non-government community service delivery systems. Training and materials should incorporate tailored messaging to coordinate suicide prevention care and LMS public education across various populations, to include (but not limited to): first responders (law enforcement, emergency medical services, firefighters, correctional officers, public safety telecommunicators), service workers, construction workers, firearm owners, gun shop employees, gun shop patrons, hunting organizations, or other identifiable groups or organizations likely to serve a high concentration of Veteran patrons.

• Plan Objectives. The objectives of the education materials and plan are to educate the

Veterans, providers, lay persons and the public on suicide prevention and LMS, and in turn encourage suicide prevention and safer storage practices, safety planning, and time and space behavioral measures for crisis response.

VHA seeks to identify and develop Suicide Prevention and LMS training opportunities and materials required for the engagement of Veterans, family members, and caregivers and providers with resources to effectively engage in lethal means reduction, mitigation, and intervention.

Materials and opportunities shall also raise awareness of Veteran-specific drivers of risk, military culture, and the wide range of resources available to support Veterans.

The materials shall include: Development of content intended to change attitudes, increase knowledge, clarify calls to action, and raise awareness of the behaviors for suicide prevention and

LMS through educational print, digital and video materials (including print, digital, video, and other training platforms such as VA educational systems and public facing websites). Materials should also address certain careers and organizations with high likelihood of engaging at-risk

Veteran populations such as: first responders (law enforcement, emergency medical services, firefighters, correctional officers, public safety telecommunicators, etc.), service workers, construction workers, firearm owners, gun shop employees, hunting organizations, or other identifiable groups or organizations that may have a high-veteran-gun-owner population.

Education and training materials shall be developed to raise awareness and educate healthcare and mental health providers engaging in the assessment and care of Veterans (within and outside of

VHA); lay persons including Veterans, family members, faith-based supports, caregivers, peer specialists, and community members engaging at-risk Veterans. Education and training materials shall also consider drivers of risk for Veterans, including the unique needs of Veterans in the following groups:

1. Women Veterans under the age of 35

2. American Indian / Alaska Native Veterans

3. LGBTQ+ Veterans

4. Survivors of Military Sexual Trauma

5. White-male Veterans over the age of 55

6. Geographically remote Veterans

7. Enlisted Service members under the age of 30

Strategy for Preventing Suicide (2018 – 2028) and the White House Plan for Reducing Military and

Veteran Suicide (2021), anticipates the support contractor will undertake a variety of methods to gather sufficient data to formulate and submit to VA a set of recommendations for reducing and preventing suicide within the military and Veteran populations. VA anticipates contractor use of pilot activities as part of this effort, with the desired goal of the contractor assessing and advising

VA on the effectiveness of different outreach modalities which VA may use in its efforts to accomplish the priorities set forth within the aforementioned VA National Strategy and White

House Plan. Examples of potential pilot activities the contractor may utilize to assist VA in its efforts to maximize suicide prevention and lethal means safety education among target audiences include, but are not limited to, the following:

Toolkits with industry partners designed to amplify paid media campaign calls to action, Technical

Assistance (TA) materials, Development of evidence-based, Veteran and stakeholder informed, educational and training materials, Developing a national education plan, Development of an outcome-focused reporting system for trainings, Multi-state map for out-of-home storage of firearms

6.1.4 PRIORITY GOAL 2: ENHANCE CRISIS CARE AND FACILITATE CARE

TRANSITIONS

In the White House Strategy for Reducing Military and Veteran Suicide (2021), VA is charged with “create(ing) a Feasibility Analysis and Implementation Plan for broad implementation of evidence-based suicide risk assessment and safety planning within emergency care settings (emergency transport, urgent care, and emergency departments) throughout the United States. The analysis will include evaluation of ways in which federal policy and funding may be implemented to reinforce wide-scale implementation of evidence-based suicide risk assessment, safety planning, and post discharge follow-up care coordination across healthcare systems.” (pg. 12)

It is VHA’s goal to achieve all aspects of Priority Goal 2. This priority focuses on improving care in emergency settings and implementing efforts to ensure appropriate care and support as individuals transition from crisis care into follow-on settings, including other stabilization services and outpatient care. VHA seeks to address the following objectives:

• Ensuring access to critical, emergent services for individuals in crisis as an important variable for addressing a given community’s suicide rate.

• Improve transitions between acute and emergent care for mental health crises and follow-up mental health care which is commonly identified as a period of elevated risk for individuals.

• Increasing population access to emergent suicide crisis services that are effective paired with improved facilitation of follow-up care to lower suicide rates at the population level.

• Managing the expected outcomes of 988 services, a nationwide three-digit mental health crisis hotline, that will offer a pivotal access point for the nation to deliver effective and efficient suicide prevention crisis services.

• When launched fully, all calls will run through a national network of distributed crisis call centers with increased capacity and quality. It will also help create a system of care that facilitates recovery and wellness beyond the crisis point instead of reinforcing an

“emergency cycle” of care engagement.

VA is seeking support in developing the following initiative and is requesting a clear plan of action to accomplish, and evaluate the effectiveness of, the following objectives:

• Implementation of 988, the new mental health crisis line, the ability of HHS, Indian Health

Service (IHS), and VA capacity to create American Indian/Alaska Native (AI/AN) -specific crisis call centers to meet the mental health needs of Tribes and AI/AN populations; as well as coordination with 911.

• Implementation and expansion VA Safety Planning in the Emergency Department (SPED).

Training is to include processes, resources, and timelines for completion of suicide risk assessments, safety planning when risk is identified, competencies for various disciplines, and follow-up care coordination procedures to all healthcare systems including within all

DoD Military Treatment Facilities and IHS points of emergency and urgent care.

• Implementation processes for the incorporation of machine learning models within the

Military and Veterans Crisis Lines operations to improve and augment risk prediction and safety planning.

VA seeks to develop case studies that assess the impact of efforts on Veterans Crisis Line plans, current utilization, estimated future demand, workforce capacity, service levels and operations to assist the VA in addressing operational impacts related to potential expansion due to other initiatives described in this project as well as ongoing implementation of the new national 988 suicide prevention line phone number. Consistent with the SAMHSA Operational Readiness

Assessment playbooks and activities already underway with contact centers in states and localities, the contractor shall consider the following while building the monthly VCL Operational Impacts

Reports:

1. Universal and convenient access to crisis support, including target audience awareness and engagement; resources for to foster self-help and de-escalation, develop coping skills, and build resiliency; multi-channel availability based on individual needs through a unified platform; reliable and timely responses so that all Veterans contacting 988 will be connected to professionally trained individuals via phone, text, or chat.

2. High-quality and personalized experience that optimizes consistency in line with best practices. For example, the SAMHSA 988 readiness playbooks.

3. Connection to resources and follow-up to ensure that all Veterans contacting 988 can reach helpline support and additional local community resources.

4. Develop understanding of Veterans’ Crisis Line current state of coordination with local public health and safety services, including public safety answering points (911), and plans to ensure appropriate and timely follow-up services to facilitate on-going support and safety in the case of warm transfers from 911.

Consistent with National Guidelines for Community Based Crisis Care, VA seeks to assess the availability of community-based crisis services across the continuum of care, potentially sizing the opportunity for increased access to mobile crisis, 24/7 crisis receiving facilities, and short-term crisis beds. The Contractor shall report findings and recommendations to VA leadership. Upon approval of recommendations, the Contractor shall develop an implementation strategy and workplan taking into consideration best practices from translational research and implementation science. Upon approval of implementation plan, and in consultation with SAMHSA, the

Contractor shall transfer knowledge to the Government such that they will be successful in launching pilots into production and operations.

VA seeks to evaluate current and optimized mental health access to care by leveraging recommendations from the National Academies of Sciences, Engineering, and Medicine (NASEM) and by modeling access possibilities ensuring urgent, initial, and sustained access to care. VA seeks to develop implementation models, assess access optimization via simulation studies, and pilot optimal models of access to maximize tripartite access to mental health care.

VA seeks to develop participatory system dynamic models that incorporate clinical expertise, data, and simulation of implementation plans prior to piloting attempted system change. The following activities shall be outlined in the case studies developed for the Government:

1. In addition to the NASEM recommendations, the Contractor shall identify other access to care models from SAMHSA, national associations, and international healthcare systems.

2. The Contractor shall develop and statistically test the models using synthetic data to determine which of the models is best for access.

3. The Contractor shall identify data elements and methods of analysis that can be used to determine optimal access.

4. The Contractor shall provide metrics to determine if access is effective and equitable.

5. The Contractor shall evaluate which models of access minimize wait times, provide critical access to rapid engagement, and provide optimal episode of care access.

6. Upon Government approval, the Contractor shall pilot the optimal model and assess mental health outcomes.

7. Assess the availability of community-based crisis services across the continuum of care, including the connectivity between community crisis service and VHA care, potentially sizing the opportunity for increased access to mobile crisis, 24/7 crisis receiving facilities, and short-term crisis beds.

8. Evaluate and Test models of access to crisis, initial and evidence-based services for

Veterans Access and Delivery of Effective Care

9. Develop and implement a simulation model within one year of award on actions taken to improve access to mental health care.

10. Subject to Government approval, pilot selected model based upon simulation data at least four (4) VISNs (one from each geographic VHA consortium).

11. Report on identified outcomes and impact of optimal access model on wait times, and quality metrics.

12. Report on full implementation costs and resources required for national roll-out including a timeline and recommendation implementation plan.

Veteran Suicide (2021), anticipates the support contractor will undertake a variety of methods to gather sufficient data to formulate and submit to VA a plan for reducing and preventing suicide within the military and veteran populations. VA anticipates contractor use of pilot activities as part of this effort, with the desired goal of the contractor assessing and advising VA on the effectiveness of different outreach modalities which VA may use in its efforts to accomplish the priorities set forth within the aforementioned VA National Strategy and White House Plan. Examples of potential pilot activities the contractor may utilize to assist VA in its efforts to maximize suicide prevention and Enhance Crisis Care among target audiences include, but are not limited to, the following:

Participatory system dynamic models that incorporate clinical expertise, data, and simulation of implementation plans prior to piloting attempted system change and resulting case studies

6.1.5 TECHNOLOGY FOCUSED SOLUTIONS

Suicide is one of the leading causes of death globally and is notably a significant cause of death amongst young people. A suicide outcome is a complex combination of personal, social, and health factors, and therefore suicide prevention is a challenge, requiring a systems approach incorporating public health strategies, screening at-risk individuals, targeted interventions, and follow-up for suicide survivors and those bereaved by suicide. VA seeks to identify technological developments which offer new opportunities in suicide prevention and the potential to reduce the number of deaths by suicide. It is VA’s goal to outline technological developments which are facilitating research in the field of suicide prevention, including multiple modes of screening such as network analysis of mobile phone collected connectivity data, automatic detection of suicidality from social media content, and crisis detection from acoustic variability in speech patterns. VA seeks to identify and assess the current field of suicide prevention, including recently released innovative apps, and other technological solutions, for reducing suicide among at-risk military and Veteran populations .

Veteran Suicide (2021), anticipates the support contractor will undertake a variety of methods to gather sufficient data to formulate and submit to VA a plan for reducing and preventing suicide within the military and Veteran populations. VA anticipates contractor use of pilot activities as part of this effort, with the desired goal of the contractor assessing and advising VA on the effectiveness of different outreach modalities which VA may use in its efforts to accomplish the priorities set forth within the aforementioned VA National Strategy and White House Plan.

Examples of potential pilot activities the contractor may utilize to assist VA in its efforts to maximize suicide prevention and Technology Focused Solutions among target audiences include, but are not limited to, the following:

Referring back to the White House Plan: Reducing Military and Veteran Suicide, some ideas could include a Suicide Prevention App (and other technological solutions) that integrates biometrics to facilitate tracking of high risk for Transitional Service Members (TSMs), Referring back to the White House Plan: Reducing Military and Veteran Suicide, some ideas could include a smart responder / bot system for suicide prevention chat and text (inclusive of appropriate responses in English and Spanish)

6.1.6 PRIORITY GOAL 3: INCREASE ACCESS TO AND DELIVERY OF

EFFECTIVE CARE

It is VHA’s goal to achieve all aspects of Priority Goal 3. VA “will collaborate to evaluate access and engagement barriers to evidence-based mental health care for service members, veterans, and their family members at elevated risk for suicide. Together, these agencies plan to produce a report within one year on actions taken to improve access to mental health care along with additional recommendations for future action.” (pg. 13) This priority aims to reduce barriers to care, including those that can promote and encourage help-seeking among service members, Veterans, and their families.

• Ensuring access to evidence-based care for mental health has been shown to greatly reduce suicide risk among those with behavioral health problems, including depression, post-traumatic stress disorder, and addiction.

• Increasing access to and delivery of mental health care to help prevent suicide, especially among those with mental health treatment needs.

• Utilize prior research and program evaluation data which indicates that access to mental health care should be considered across three dimensions: emergency/same day care, non-emergent engagement in care, and follow-up care.

o Within each of these dimensions, the delivery of evidence-based, high-quality care has been shown to maximize recovery and promote wellness.

o Efforts should be designed to increase capacity, ease access to, and improve the delivery of evidence-based care are an essential component of suicide prevention efforts.

VA seeks support in increasing access to and delivery of mental health care in order to help prevent suicide, especially among those with mental health treatment needs.

VA seeks to identify strategies to increase access to and delivery of mental health care that can help to prevent suicide, especially among those with mental health treatment needs.