Loren Data's SAM Daily™

FBO DAILY - FEDBIZOPPS ISSUE OF SEPTEMBER 22, 2016 FBO #5417
DOCUMENT

R -- Veterans telephone interviews Amendment to Combined Solicitation Questions and Answers - Attachment

Notice Date

9/20/2016
 

Notice Type

Attachment
 

NAICS

541910 — Marketing Research and Public Opinion Polling
 

Contracting Office

Department of Veterans Affairs;Network Contracting Office 1;718 Smyth Road;Manchester NH 03104
 

ZIP Code

03104
 

Solicitation Number

VA24116Q0784
 

Response Due

9/23/2016
 

Archive Date

10/23/2016
 

Point of Contact

Lorrie A Baines
 

E-Mail Address

4-4366
 

Small Business Set-Aside

Veteran-Owned Small Business
 

Description

Questions and Answers for VA241-16-Q-0784, Veterans Outcomes Assessment (VOA) Program Calls and Data Collection 1. Can you share a copy of the instrument? Attached 2. Who did the pilot test of the instrument? (VA?) We did, but was it a 'pilot'? Yes, we called it a pilot. Its pretty much semantics. However, the instrument has been in use for several years collecting data that we are using for program evaluation so its not a "draft" of an instrument. 3. What is the rationale for LPTA? We believe this to be the most advantageous method. 4. Will the government share any of the findings of the pilot? I don't think we should share anything we haven't told the other[S], and anyway none of it has been cleared. Depends on what they mean by findings though-if they are referring to hit rates, follow-up rates, things like that, we can provide some of that data (its in the description I wrote so I believe it should be in the solicitation). 5. What is the duration of the follow-up call/instrument? The follow-up is slightly shorter in terms of number of questions, but not by much 6.In addition to data collection and the services associated that specific service, Block 20 of the solicitation cover page (Form 1449) states the contractor will also provide "expert guidance on scale development, data analytic strategies, and interpretation of statistical findings." Is support on scale development and data analytics and interpretation required? We only ask because these services are not mentioned anywhere else in the solicitation. There is no scale development or data analysis needed for this contract. 7.Approximately how many eligible Veterans will be included in each of the digital sample files provided by the VHA every two weeks? The plan is to provide about 2,000 Veterans. However, this number can be made flexible at any time-if the contractor finds that they need more, for example. 8.Regarding the call protocol the Government will provide, approximately how many call attempts per Veteran does the Government feel is appropriate? We understand this number is negotiable, but for budgeting purposes, we want to know if the VHA has an estimate in mind. Somewhere between 3 and 5 is what usually works (up to 7-8 if a Veteran is being contacted for a follow-up). Its most important to try contacts at times when Veterans are most likely to answer. 9.Based on B.2 Price/Cost Schedule, it appears annual pricing is being requested for years through 9/26/2020 although the confirmed budgeting is through the first year only. Please clarify whether bids are indeed being requested for (A) only first year (i.e., through 9/26/2017) or (B) for the baseline and for each of the subsequent three years as well (i.e., through 9/26/2020). We cannot guarantee funding beyond the current base period. 10.Assuming that some Veterans will have multiple mental health appointments during the 12-month project period, should we expect that some Veterans may appear multiple times in the provided samples? If so, it is acceptable to re-interview them, or should we de-duplicate the sample files prior to fielding? Alternatively, if they have appeared previously but did not complete a Baseline interview, should we retain them in the sample and try again? Veterans will be identified as being relatively new to mental health treatment. They would not be in multiple pulled samples during the year. The 10,000 pairs of interviews must also be with 10,000 unique Veterans. We would like the baseline to be completed within a few weeks of the mental health visit that triggered being included in the sample, so it would not be helpful to retain Veterans after that window has passed. 11.During the Base Year period, there will be some startup effort required prior to fielding. Is the goal still to complete 10,000 paired interviews (by accelerating the sampling rate), or would the Base Year quota be reduced proportionally? Ideally there would be 10,000 completed within a year of the contract being awarded. Lorrie, does the money have to be spent within the year? Can extend into a second year to complete the first 10,000 if that were really necessary? 12.The Follow-up interview is six to eight weeks following the Baseline. In the final year of the project (assuming contract renewals), should we stop Baseline interviewing early such that we still have time to complete all Follow-Up interviews? If so, would this reduce the quota from 10,000 to a lesser number, or would we accelerate sampling earlier in that period in order to obtain the full 10,000 paired cases? Baselines should be stopped in time to complete follow-ups, as the data are not useful to us without follow-up data. The sampling would have to be accelerated in order to account for this. 13.An important component of cost is the number of call attempts required by the protocol. For budgeting purposes, what number should we use? Between 3 and 5 attempts for baselines and 7-8 attempts for follow-ups. These are rough guidelines, sometimes there are clearly reasons for stopping attempts or trying another time (e.g. the Veteran answers but wants to talk at another time). 14.We have found a postal mailing of a pre-notification letter to be useful in improving response rates. Should we include this component, and will mailing addresses be available? We can provide mailing addresses as they are recorded in the medical records. It is unclear whether such a mailing would be able to be done, as well as contacts and baselines conducted, within two weeks of the date of the sample. This could be discussed 15.Please clarify some of the statements regarding response rates and loss-to-follow-up rates. The RFP states that 65% of Baseline cases complete a Follow-Up interview. Since only fully-paired cases count toward the 10,000 case quota, should we assume that it will be necessary to complete 10000/0.65 = 15,385 Baseline cases? The RFP also says to expect a 10% response rate for the Baseline. Does this imply that 10% of the initially-provided sample will result in a completed Baseline interview? If we do need 15,385 Baseline cases, does that imply that the Government will supply at least 153,850 initial sample records over the year, or approximately 5,917 sample records in each two week period? The RFP also includes a statement that 50,000 Baseline cases must be completed in order to ensure sufficient paired cases at the conclusion; please clarify the origin of the 50,000 figure. The answer is yes to all questions. The 50,000 may have been a calculation error or typo, I am not sure. As of today the response rates at baseline are ranging between 13-15%. I believe a contractor could increase the rate with the ability to contact at multiple time points during the day/week. However, it will take a substantial number of contacts to achieve baselines. Of the baselines, not everybody will be able to do a follow-up. So the target is 10,000 follow-ups, with the requisite number of calls and baselines to accomplish that. Although we internally have been able to accomplish about 65% follow-up rates, this could also be increased by a contractor for the same reasons as above. 16.Is there a page limit for the proposal or other formatting requirements? If there is a page limit, do appendices/attachments count toward this page limit? Are there appendices/attachments that are expected to be included? This is an RFQ Technical' Past Performance and Price Although there is not a strict limit I would strongly suggest not more than 20 pages to document how you would be technically capable of meeting the technical requirements of the PWS. I would suggest highlighting number of trained staff, mix of staff and ability to work a national contract of this size. Past Performance working a contract of this size and scope of Mental Health Surveys should be identified along with Government Contracts of this size and nature that you have had in the past 5 years. 17.Is there an incumbent for this project? What firm conducted the earlier study? There was no previous contractor this is the first contract for this requirement. VA conducted the pilot. 18.Can the Government provide guidance on available budget for this project or the anticipated labor categories and labor hours required to complete the work? We cannot disclose our Independent Government Cost Estimate. 19.On the cover page, it states "the contract shall provide expert guidance with respect to scale development, data analytic strategies, and interpretation of statistical findings." However, throughout the proposal (for example, on p. 5, section 1.1, in the objectives (section 1.3), and in the scope (section 1.4) the language consistently refers only to "contact, scheduling, collection, and provision of datasets." No additional mention of developing scales, analytic strategizing, or interpreting findings is made. Could you clarify? This is an error. No scale development or data analyses are needed for this contract. Veterans Outcomes Assessment VA Form 10-211017 The Paperwork Reduction Act of 1995: This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Accordingly, we may not conduct or sponsor and you are not required to respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who complete this survey will average 30 minutes. This includes the time it will take to follow instructions, gather the necessary facts and respond to questions asked. Customer satisfaction is used to gauge customer perceptions of VA services as well as customer expectations and desires. The results of this telephone/mail survey will lead to improvements in the quality of service delivery by helping to achieve improved mental health services. Participation in this survey is voluntary and failure to respond will have no impact on benefits to which you may be entitled. Veterans Outcomes Assessment Interview Date:Time Started: Opening text of initial call: 1.Hello, my name is [Interviewer] and I'm calling from the Department of Veterans Affairs Central Office. I'm trying to reach [Veterans' name] today. Is he/she available? [If no, ask if this is the best number to call and for a good time to try to reach him/her.] [If yes, confirm Veteran's identity by asking for his/her date of birth.] 2.a) I'm calling today because we're conducting a survey to help us improve the services that VA offers to you and Veterans like you. We're asking you to participate because you recently attended a mental health appointment at a VA facility, and your experience can help us understand which programs are helpful to Veterans and how to better meet Veterans' needs. Congress authorized us to obtain this information in the 2013 National Defense Authorization Act. b)I want to emphasize that your participation is completely voluntary, and your decision to participate will have no effect on your entitlement to VHA benefits or the services you receive. The entire survey should take less than 30 minutes including the time it will take for instructions and for you to respond to the questions. We'd like to contact you again in 3 months to see how you are doing at that point and how you feel about the services you have received. Information obtained now and in the follow-up interview in 3 months will allow us to tell program staff how their clients, as a group, are doing in their program and how they feel about the program. We will work with programs to improve in areas where Veterans are reporting problems. c)The information that you provide in this survey will be kept confidential and is protected by the Privacy Act of 1974. Your individual responses will not be disclosed to anyone outside VA. In VA reports, the findings will be described for groups of Veterans where individual participants cannot be identified. The exception to these privacy protections is that we are required to report situations where a Veteran is a danger to self or others. In such cases, we will notify mental health treatment staff or the suicide prevention coordinator at your local VA facility to ensure the necessary support is available. d)In order to collect this information VA is required to have a valid OMB Control Number, which is 2900-0825. I can repeat that number if you would like to write it down. Would you like more information about this requirement? [If yes, read Paperwork Reduction Act statement on page 1 of script.] Do you have any questions? Would you be willing to answer this survey about yourself and how you're doing? 3a. If no, continue with: VA staff want to be sure that the services they provide are beneficial for Veterans like you. It would therefore help us to know about your overall health, how you are doing now, and your experience with VA care. Can we set up another time to talk that is convenient for you? What day and time works best for you? 3b. If still no, discontinue and thank them for their time. 4. If yes, proceed: If calling a Veteran back for a scheduled assessment: 1.Confirm Veteran's identity, as above. 2.When we spoke recently you said this would be a good time to talk. Would you be willing to answer some questions about yourself and how you're doing? 3.If yes, proceed with step 2, as above. If no, attempt to schedule another time to talk. If still no, discontinue and thank them for their time. This interview has three parts covering a variety of topics, all of which can be influenced by effective mental health treatment. "First, we have a few questions about your general health and well-being. "Then we have some more specific questions about common mental health symptoms and feelings you might be experiencing. "Finally, we have a few questions about your experience with VA health care. The possible responses vary between questions, so if you have a pencil and paper to make notes, that might help you keep track. I'd like to start with 4 questions about your health. The first question is about your health now. 1.In general, would you say your health is: Excellent [1] Very good [2] Good [3] Fair [4], or Poor [5]? Refused [-99] I don't know OR N/A [-98] 2.Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good? Number of days [0-30] Refused [-99] I don't know OR N/A [-98] 3.Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good? Number of days [0-30] Refused [-99] I don't know OR N/A [-98] 4.During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care (things like eating or bathing), work, or recreation? Number of days [0-30] Refused [-99] I don't know OR N/A [-98] The next four questions ask about difficulties due to health conditions. Health conditions include diseases or illnesses, injuries, mental or emotional problems, and problems with alcohol or drugs. Think back over the past 30 days and for each question, choose the one answer that best describes how much difficulty you had. Your choices are: None, Mild, Moderate, Severe, and Extreme or cannot do. In the past 30 days, how much difficulty did you have in ¦ 5.Learning a new task, for example, learning how to get to a new place? None [1] Mild [2] Moderate [3] Severe [4] Extreme or cannot do [5] Refused [-99] I don't know OR N/A [-98] 6.Concentrating on doing something for ten minutes? None [1] Mild [2] Moderate [3] Severe [4] Extreme or cannot do [5] Refused [-99] I don't know OR N/A [-98] 7.Dealing with people you do not know? None [1] Mild [2] Moderate [3] Severe [4] Extreme or cannot do [5] Refused [-99] I don't know OR N/A [-98] 8.How much have you been emotionally affected by your health problems? None [1] Mild [2] Moderate [3] Severe [4] Extreme [5] Refused [-99] I don't know OR N/A [-98] Now I have some questions that are specific to your mental health functioning. The following questions ask about how you have been feeling during the past 30 days. Your choices are that you have had this feeling: All of the time, most of the time, some of the time, a little of the time, or none of the time. During the past 30 days, about how often did you feel ¦ 9. ¦nervous? All of the time [1] Most of the time [2] Some of the time [3] A little of the time [4] None of the time [5] Refused [-99] I don't know OR N/A [-98] 10. ¦hopeless? All of the time [1] Most of the time [2] Some of the time [3] A little of the time [4] None of the time [5] Refused [-99] I don't know OR N/A [-98] 11. ¦restless or fidgety? All of the time [1] Most of the time [2] Some of the time [3] A little of the time [4] None of the time [5] Refused [-99] I don't know OR N/A [-98] 12. ¦so depressed that nothing could cheer you up? All of the time [1] Most of the time [2] Some of the time [3] A little of the time [4] None of the time [5] Refused [-99] I don't know OR N/A [-98] During the past 30 days, about how often did you feel ¦ 13. ¦that everything was an effort? All of the time [1] Most of the time [2] Some of the time [3] A little of the time [4] None of the time [5] Refused [-99] I don't know OR N/A [-98] 14. ¦worthless? All of the time [1] Most of the time [2] Some of the time [3] A little of the time [4] None of the time [5] Refused [-99] I don't know OR N/A [-98] Patient Health Questionnaire (PHQ-9) 15.Over the last 2 weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself? Here your choices are Not at all, Several days, More than half the days, or Nearly every day. Not at all [0] Several days [1] * More than half the days [2] * Nearly every day [3] * Refused [-99] * I don't know OR N/A [-98] * If "Not at all [0]", go directly to question 16. * Any response other than "Not at all [0]" Thank you for letting me know. That concerns me. I'd like to go on with the standard questions, but when we complete the survey, I want to discuss further steps we can take to ensure your safety. Is it okay to come back to that at the end, or would you prefer to do that now? If you want to do the risk screener immediately, go to page 13. Now, I have a couple of questions about your alcohol and drug use in the last 30 days. 16.In the past 30 days, how many days did you have at least 5 drinks (if you are a man) or at least 4 drinks (if you are a woman)? One drink is considered one shot of hard liquor (1.5 oz.) or 12-ounce sof beer or 5 ounce glass of wine. Days [0-30] Refused [-99] I don't know OR N/A [-98] 17.In the past 30 days, how many days did you use any illegal or street drugs or abuse any prescription medications? Prescription medications include opiates like Vicodin or sedatives such as Xanax. Please include any medications that were not prescribed to you. Days [0-30] Refused [-99] I don't know OR N/A [-98] For the next 5 statements, please respond with how much you disagree or agree with the statement at this point in your life. Indicate whether you strongly disagree, disagree, are not sure, agree, or strongly agree with these statements. 18.I have my own plan for how to stay or become well. Strongly disagree [1] Disagree [2] Not sure [3] Agree [4] Strongly agree [5] Refused [-99] I don't know OR N/A [-98] 19.I have goals in life that I want to reach. Strongly disagree [1] Disagree [2] Not sure [3] Agree [4] Strongly agree [5] Refused [-99] I don't know OR N/A [-98] 20.Coping with my mental illness or emotional problems is no longer the main focus of my life. Strongly disagree [1] Disagree [2] Not sure [3] Agree [4] Strongly agree [5] Refused [-99] I don't know OR N/A [-98] 21.I have people in the community I can count on. Strongly disagree [1] Disagree [2] Not sure [3] Agree [4] Strongly agree [5] Refused [-99] I don't know OR N/A [-98] 22.I am encouraged by my mental health providers to take the lead in setting my personal treatment and life goals. Strongly disagree [1] Disagree [2] Not sure [3] Agree [4] Strongly agree [5] Refused [-99] I don't know OR N/A [-98] For the next 10 statements, please respond by indicating the response number that best fits how you have been feeling about your life over the last week. The response numbers range from 0-Never in the last week, to 6-All of the time or nearly all of the time in the last week. 23.Given my current physical condition, I am satisfied with what I can do. Never [0][1][2][3][4][5]All of the time or nearly all of the time [6] Refused [-99]I don't know OR N/A [-98] 24.I have confidence in my ability to sustain important relationships. Never [0][1][2][3][4][5]All of the time or nearly all of the time [6] Refused [-99]I don't know OR N/A [-98] 25.I feel hopeful about my future. Never [0][1][2][3][4][5]All of the time or nearly all of the time [6] Refused [-99]I don't know OR N/A [-98] 26.I am often interested and excited about things in my life. Never [0][1][2][3][4][5]All of the time or nearly all of the time [6] Refused [-99]I don't know OR N/A [-98] 27.I am able to have fun. Never [0][1][2][3][4][5]All of the time or nearly all of the time [6] Refused [-99]I don't know OR N/A [-98] 28.I am generally satisfied with my psychological health. Never [0][1][2][3][4][5]All of the time or nearly all of the time [6] Refused [-99]I don't know OR N/A [-98] 29.I am able to forgive myself for my failures. Never [0][1][2][3][4][5]All of the time or nearly all of the time [6] Refused [-99]I don't know OR N/A [-98] 30.My life is progressing according to my expectations. Never [0][1][2][3][4][5]All of the time or nearly all of the time [6] Refused [-99]I don't know OR N/A [-98] 31.I am able to handle conflicts with others. Never [0][1][2][3][4][5]All of the time or nearly all of the time [6] Refused [-99]I don't know OR N/A [-98] 32.I have peace of mind. Never [0][1][2][3][4][5]All of the time or nearly all of the time [6] Refused [-99]I don't know OR N/A [-98] The next two questions ask about how well you are managing now. 33.How well do you feel like you are coping with your mental or emotional illness from day to day? The choices are: Not well at all [1] Not very well [2] Alright [3] Well [4] Very well [5] Refused [-99] I don't know OR N/A [-98] Has your doctors prescribed any medication for you? If no, select "-98 | I don't know OR N/A" for Question 34 and skip to next question. If yes, ask Question 34. 34.How often do you take your medication as prescribed? The choices are Never [1] Occasionally [2] About half of the time [3] Most of the time [4] Every day [5] Refused [-99] I don't know OR N/A [-98] Please choose any number between 0 and 10 that best describes your overall quality of life. 0 indicates an extremely bad quality of life and 10 indicates a perfect quality of life, so, for example, 5 would be an average quality of life. 35. Quality of Life (Number between 0 - 10 Refused [-99] I don't know OR N/A [-98] 36.Please choose the response that best describes how your mental health condition is now, compared with how it was before your most recent episode of mental health treatment at the VA. Your choices are: Very much better [1] Much better [2] A little better [3] No change [4] A little worse [5] Much worse [6] Very much worse [7] Refused [-99] I don't know OR N/A [-98] The next 5 questions ask about the counseling or mental health treatment you received from the VA in the last 3 months. The choices are Never, Sometimes, Usually, or Always. Do not include non-VA counseling or mental health treatment. 37.In the last 3 months, not counting times you needed counseling or treatment right away, how often did you get an appointment for counseling or treatment as soon as you wanted? For this question, do not include treatment received during an overnight stay or self-help groups. Never [1] Sometimes [2] Usually [3] Always [4] Refused [-99] I don't know OR N/A [-98] The next questions are about all the counseling or mental health treatment you got in the last 3 months during office, clinic, and emergency room visits at the VA, as well as over the phone. Do the best you can to include all the different people you went to for counseling or mental health treatment in your answers. 38.In the last 3 months, how often did the people you went to for counseling or treatment explain things in a way you could understand? Never [1] Sometimes [2] Usually [3] Always [4] Refused [-99] I don't know OR N/A [-98] 39.In the last 3 months, how often did the people you went to for counseling or treatment show respect for what you had to say? Never [1] Sometimes [2] Usually [3] Always [4] Refused [-99] I don't know OR N/A [-98] 40.In the last 3 months, how much were you helped by the counseling or treatment you got? Here the choices are Not at all, A little, Somewhat, or A lot. Not at all [1] A little [2] Somewhat [3] A lot [4] Refused [-99] I don't know OR N/A [-98] 41.In the past 3 months, how sensitive do you feel your mental health care providers were with respect to your race and cultural heritage? Here are the choices are Not at all, A little, Somewhat, or Very sensitive. Not at all sensitive [1] A little sensitive [2] Somewhat sensitive [3] Very sensitive [4] Refused [-99] I don't know OR N/A [-98] I am going to read a list of race and ethnicity groups. Please indicate any of these groups that you consider yourself to be. [Check all that apply.] First, do you consider yourself to be: Hispanic or Latino? And do you consider yourself to be: American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Now, indicate how strongly you DISAGREE or AGREE with the following statement about the mental health treatment you have received at the VA. Please indicate whether you disagree strongly, disagree, are uncertain, agree, or agree strongly. 42.You are satisfied with your treatment team. Disagree Strongly [1] Disagree [2] Uncertain [3] Agree [4] Agree Strongly [5] Refused [-99] I don't know OR N/A [-98] 43.Thinking about your current or most recent VA mental health treatment, is there anything else you would like to tell me about your experience? ***VERY IMPORTANT*** If the answer to question 15 is anything other than "not at all [0]", now complete the P4 Screener for Assessing Suicide Risk on the next page. For those free of suicide ideation and for others after above warm transfer protocol: We're finished with the survey. I want to thank you very much for taking the time to do this interview and to ask whether we can call you again in about 12 weeks to see how you're doing? If yes: Is this the best number to call? What is the best time of day to reach you If no: Would you be willing to tell me why you do not want to be called again in 12 weeks? Thanks again - the feedback you gave me today will help the VA understand how it can better meet the needs of Veterans like you.THE END! Date and time survey completed P4 Screener for Assessing Suicide Risk[FOR ANSWERS 1, 2, 3, -98, -99 ON Q15] If the answer to question 15 is anything other than "not at all [0]": Now I'd like to get back to what you said about thoughts that you would be better off dead, or of hurting yourself. [P4Stem] Have you had thoughts about actually hurting yourself? Yes [1]* No [0] Refused [-99]* I don't know OR N/A [-98]* If "No [0]", proceed where you left off (either item 16 on page 7 or the end of the survey on the page above). * If "Yes [1]," Refused [-99], or I don't know OR N/A [-98], ask all of the following multiple-choice questions. [P4PAST] 1. Have you ever attempted to harm yourself in the past? Yes [1] No [0] [P4PLAN] 2. Have you thought about how you might actually hurt yourself? Yes [1] No [0] [P4PLANHOW] If Yes, how? [P4PROB] 3. There's a big difference between having a thought and acting on a thought. How likely do you think it is that you will act on these thoughts about hurting yourself or ending your life some time over the next month? Not at all likely [0] [P4PREVENT] 4. Is there anything that would prevent or keep you from harming yourself? Yes [0] **reverse coded** [P4PREVENTWHAT] If Yes, what? VETERAN'S CURRENT RISK IS (see chart below) RISK CATEGORYITEMS 1 AND 2ITEMS 3 AND 4 P4 STEM negative or MINIMALNo highlighted answers "both answers are No [0] "neither answer is -99 or -98No highlighted answers "Q3 is Not at all [0], Q4 is Yes [0] "neither answer is -99 or -98 LOWER1 or more highlighted answers "one answer is Yes [1] or "one answer is -99 or -98No highlighted answers "Q3 is Not at all [0], Q4 is Yes [0] "neither answer is -99 or -98 HIGHER1 or more highlighted answers "one answer Yes [1] or "one answer is -99 or -981 or more highlighted answers "Q3 is Somewhat [1] or Very [2] likely or "Q4 is No [1] or "one answer is -99 or -98 [Results of risk assessment]Minimal [0]Lower [1]Higher [2]Undetermined [3] [For those with suicide ideation and "no" response to P4 stem or with minimal risk] You mentioned earlier that you have been thinking about harming yourself. I want to encourage you to talk with your doctor or mental health provider about these thoughts, and I'll send him or her a message about it. I also want to remind you that the Veterans Crisis Line number is 1-800-273-TALK and is available whenever you might need it. [For those with suicide ideation and lower risk] You mentioned earlier that you have been thinking about harming yourself and have tried to do so in the past or have plans for how you would do so in the future. I want to encourage you to talk with your doctor or mental health provider about these thoughts. As I mentioned, I will be notifying the Suicide Prevention Coordinator at your local facility that you have expressed these concerns, and they may contact you to discuss them further. In addition, I can transfer you to someone at the Veterans Crisis Line so that you can talk further right now with someonewho is qualified to help you in this situation. [If Veteran refuses] I'd like to encourage you to call the Crisis Line whenever you need to. Their number is 1-800-273-TALK. [For those with suicide ideation and higher risk] You mentioned earlier that you have been thinking about harming yourself and have tried to do so in the past or have plans for how you would do so in the future. As I mentioned, I will be notifying the Suicide Prevention Coordinator at your local facility that you have expressed these concerns, and they may contact you to discuss these concerns further. We'll also let the mental health provider know that you have been having these thoughts about harming yourself. In addition, I can transfer you to someone at the Veterans Crisis Line so that you can talk further right now with someone who is qualified to help you in this situation. [If Veteran refuses] I'd like to encourage you to contact your doctor or mental health provider and to call the Crisis Line whenever you need to. Their number is 1-800-273-TALK. Complete warm transfer if participant has agreed to it. Veteran [WARMTRS] a warm transfer to the Veterans Crisis Line. DECLINED [0] ACCEPTED [1] WAS NOT OFFERED [2]
 

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