Brief Summary of Substitute Bill

Requires the Department of Veterans Affairs to develop and implement a statewide plan to reduce suicide among service members, veterans, and their families.
Changes the name of the Suicide-Safer Homes Task Force to the Safer Homes, Suicide Aware Task Force (Task Force), extends its expiration date by two years, and establishes additional responsibilities for the Task Force.
Requires dissemination of suicide awareness and prevention materials prepared by the Task Force to firearms dealers and licensed pharmacies for distribution to firearms purchasers and pharmacy patients.
Requires the Pharmacy Quality Assurance Commission (PQAC) to conduct a survey of licensed pharmacist on methods to bridge the gap between practice and suicide awareness and prevention training.
Requires the PQAC to exempt pharmacists from required suicide assessment, treatment, and management training if they complete the training curriculum prior to being licensed.

Background:

Suicide-Safer Homes Task Force.

The Suicide-Safer Homes Task Force (Task Force) consists of a variety of stakeholders, including the Department of Health (DOH), representatives of suicide prevention organizations, the firearms industry and firearms rights organizations, individuals who have experienced suicide loss or survived suicide attempts, pharmacists and pharmacy organizations, the Department of Veterans Affairs, law enforcement, and others. Task Force membership is divided into a Suicide Prevention and Health Care Subcommittee and a Suicide Prevention and Firearms Subcommittee.

The Task Force is administered by the University of Washington School of Social Work, and its responsibilities include:

developing suicide awareness and prevention messages to be used by firearms dealers, firearms ranges, and pharmacies, and in hunter safety classes;
developing online trainings on suicide awareness and prevention for firearms dealers, firearms ranges, and their employees;
developing suicide awareness and prevention messages for training for the schools of pharmacy and providing input on training being developed for community pharmacists; and
engaging in public awareness campaigns and providing advocacy efforts and training to firearms dealers, pharmacies, health care providers, and law enforcement on pairing suicide awareness and prevention education with the provision of devices for safe storage of firearms and prescription medications.

The Task Force must submit annual reports to the Legislature and file a final report by December 1, 2019. The Task Force expires July 1, 2020.

Suicide Assessment, Treatment, and Management Training.

Licensed pharmacist must complete a one-time training on suicide assessment, treatment, and management. The training must include material regarding the assessment of issues related to imminent harm via lethal means. The training must be completed by the end of the pharmacist's first full continuing education reporting period after January 1, 2017, or during his or her first full continuing education reporting period after initial licensure, whichever is later.

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Summary of Substitute Bill:

The Department of Veterans Affairs (DVA) must develop and implement a statewide plan to reduce suicide among service members, veterans, and their families. In developing and implementing the plan, the DVA must:

collaborate with government and nongovernment agencies and organizations to establish promising best practices for suicide awareness and prevention materials, training, and outreach programs targeted to service members, veterans, and their families;
cultivate peer-led organizations serving veterans in transition and recovery;
create and deliver statewide suicide awareness and prevention training programs with content specific to service members, veterans, and their families; and
provide safer homes materials and trainings, and distribute safe firearms storage devices, to the Washington National Guard, the Washington State Patrol, allied veteran groups, and other organizations serving or employing veterans, following the recommendations of the Safer Homes, Suicide Aware Task Force.

The Suicide-Safer Homes Task Force is renamed the Safe Homes, Suicide Aware Task Force (Task Force) and its expiration date is extended until July 1, 2022. The co-chairs of the Healthcare Subcommittee and the Firearms Subcommittee must be elected by the respective subcommittee members, and some changes are made regarding the membership of the Task Force.

Additional responsibilities are given to the Task Force. The Task Force must incorporate into its materials and training information on how a person can obtain information on seeking an Extreme Risk Protection Order. The Task Force must develop a plan to provide resources to industries, professions, and workplaces impacted by high rates of suicide that includes:

development of customized trainings and consultation to workplaces in developing a comprehensive approach to workplace safety that incorporates mental health and suicide prevention, focusing first on construction, unions, and trade associations;
development of an online resource to disseminate best practices in workplace mental health and suicide prevention; and
hosting a biannual workplace summit.

The Task Force also must, during the 2019-2021 biennium:

deliver the Task Force's SAFER Homes intervention and firearms and medication locking devices in partnership with nongovernment organizations in 12 rural communities across Washington; and
develop and distribute a tool kit for suicide prevention and curriculum for firearms safety instructors for their inclusion in firearms safety courses.

Suicide awareness and prevention materials must be delivered to all firearms dealers by the Task Force and to all licensed pharmacies by the Pharmacy Quality Assurance Commission (PQAC). Firearms dealers are encouraged to post the materials on their premises and make the materials available to firearms purchasers and transferees. Licensed pharmacists must make these materials available to patients at the point of care when deemed appropriate.

The PQAC, in consultation with the Task Force, must survey each licensed pharmacist on methods to bridge the gap between practice and suicide awareness and prevention training, including barriers to putting the training into practice. The PQAC must compile and analyze the survey data and report the results to the Legislature by November 15, 2020. The PQAC must exempt pharmacists from required suicide assessment, treatment, and management training if they complete the training curriculum prior to being licensed.

Substitute Bill Compared to Original Bill:

The substitute bill extends the expiration date of the Safe Homes, Suicide Aware Task Force (Task Force) and makes some revisions to its membership and the method of selecting subcommittee co-chairs. The Task Force is given additional duties, including:

incorporating information on extreme risk protection orders into its materials and training;
developing a plan to provide resources to industries, professions, and workplaces impacted by high rates of suicide;
delivering the Task Force's SAFER Homes intervention and firearms and medication locking devices in partnership with nongovernment organizations in 12 rural communities across Washington; and
developing and distributing a tool kit for suicide prevention and curriculum for firearms safety instructors for their inclusion in firearms safety courses.

The substitute bill provides that the Task Force (rather than Department of Licensing) will provide firearms dealers with suicide awareness and prevention materials. It also allows the Pharmacy Quality Assurance Commission to provide suicide prevention materials to licensed pharmacies by electronic means and provides that licensed pharmacists must provide this information to patients at the point of care when deemed appropriate through patient evaluation.

Staff Summary of Public Testimony:

(In support) Washington's suicide rate is 11 percent higher than in other states. Last year the state lost 1,297 lives to suicide. Raising public awareness and removing access to lethal means are effective at reducing suicide. The Suicide-Safer Homes Task Force (Task Force) has been working to provide education and safe storage devices to communities in the state. The work of the Task Force has involved over 2,000 conversations with people talking about suicide prevention and safe storage practices and the distribution of over 1,300 safe storage devices for firearms. Legislative support to the Task Force has allowed it to greatly expand its efforts.

The suicide problem is more pronounced in rural areas, so the goal is to expand outreach efforts and focus on the demographics of those with the highest risk of suicide—veterans and men in their middle years. Restricting access to lethal means works. The Task Force's education and outreach program works. The Legislature needs to continue funding the Task Force so it can continue this great work. People who have tapped into the Task Force's resources find that they are well received and effective. This is a serious issue in the construction industry. Last year 77 construction workers died in Washington from suicide, compared to six who died due to workplace fatalities. We need to do more to reach out to the construction industry and labor groups with prevention efforts.

There are so many things that contribute to suicide, and we are not doing enough to address this huge epidemic in the state. The term "gun violence" is often used, but many people do not realize that four out of five gun fatalities are from suicide. The Task Force consists of a diverse group of partners dedicated to making an impact. The Task Force is trying to implement best practices that work in high-risk communities, but its work has barely scratched the surface. The construction industry, labor organizations, the Washington State Bar Association, and others are asking for help on this issue, and currently there is not enough funding to meet that demand.

(Opposed) Seventy percent of gun deaths in Washington are from suicide, and veterans and their families are in a high-risk category. There is an urgent and critical need for suicide prevention programs, but this bill lacks important components. Information on two important laws should be included: extreme risk protection orders (ERPOs) and the voluntary waiver of firearms rights. Both of these laws help to prevent suicide, but they are not currently included in the Task Force's materials. Leadership of the Task Force needs to be changed to remove the requirement that it is co-chaired by a representative of the National Rifle Association or the Second Amendment Foundation. These gun lobbies have opposed ERPOs, voluntary waiver of firearms rights, and safe storage legislation–measures that will likely save lives by restricting access to lethal means.

(Other) It is a common story to hear that a veteran has taken his or her life by suicide. Nationally, 20 veterans die each day by suicide. For each suicide, 135 people are exposed to the loss, and 45 of them will experience extreme disruption in their lives. The Department of Veterans Affairs does engage in robust suicide prevention efforts; however, most who die by suicide do not use these services. It is critical to develop a systemic and statewide approach that educates communities and providers about the needs of veterans.