This bill mandates the Secretary of Veterans Affairs to establish a pilot program known as the Zero Suicide Initiative within 180 days of enactment. The primary goal of this program is to improve safety and suicide care for veterans, thereby significantly reducing their suicide rates by implementing the curriculum developed by the Zero Suicide Institute of the Education Development Center. The first year of the program will focus on development, including planning and site selection, with consultation from various entities such as the Department of Health and Human Services, the National Institutes of Health, and experts in suicide assessment and treatment. The initiative requires selected staff leaders from each site to undergo extensive education and training, covering organizational self-study, data collection for quality improvement, and the adoption of a specific suicide care approach. The program will be carried out at five VA medical centers, with one specifically serving veterans in rural and remote areas. Site selection involves a rigorous process considering factors like staff interest, geographic variation, medical center size, regional veteran suicide rates, and demographic characteristics, with consultation from various mental health and VA offices. The Secretary is required to submit annual progress reports to Congress, detailing staff training, policy alignment with Institute standards for suicide care, and a comparison of suicide-related outcomes at program sites versus other VA medical centers. These outcomes include screening rates, lethal means counseling, referrals for assessment, safety planning, emergency department utilization, hospitalizations, suicide attempts, and deaths. The program is set to terminate five years after its establishment, though the Secretary has the authority to extend it for up to two additional years with congressional notification. Upon termination, a final report will be submitted to Congress, providing a detailed analysis of the program's effectiveness, outcomes, and recommendations regarding its continuation, expansion, or permanency.