IIB 

116TH CONGRESS 

2D SESSION H. R. 4861 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 30 (legislative day, SEPTEMBER 29), 2020 

Received; read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

AN ACT 

To amend the Public Health Service Act to establish a program to improve the identification, assessment, and 

treatment of patients in the emergency department who 

are at risk of suicide, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


kjohnson on DSK79L0C42PROD with BILLS
2 

HR 4861 RFS

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Effective Suicide 

3 Screening and Assessment in the Emergency Department 

4 Act of 2020’’. 

5 SEC. 2. PROGRAM TO IMPROVE THE CARE PROVIDED TO 

6 PATIENTS IN THE EMERGENCY DEPARTMENT 

7 WHO ARE AT RISK OF SUICIDE. 

8 Part P of title III of the Public Health Service Act 

9 (42 U.S.C. 280g et seq.) is amended by adding at the end 

10 the following new section: 

11 ‘‘SEC. 399V–7. PROGRAM TO IMPROVE THE CARE PROVIDED 

12 TO PATIENTS IN THE EMERGENCY DEPART13 MENT WHO ARE AT RISK OF SUICIDE. 

14 ‘‘(a) IN GENERAL.—The Secretary shall establish a 

15 program (in this section referred to as the ‘Program’) to 

16 improve the identification, assessment, and treatment of 

17 patients in emergency departments who are at risk for sui18 cide, including by— 

19 ‘‘(1) developing policies and procedures for 

20 identifying and assessing individuals who are at risk 

21 of suicide; and 

22 ‘‘(2) enhancing the coordination of care for 

23 such individuals after discharge. 

24 ‘‘(b) GRANT ESTABLISHMENT AND PARTICIPA25 TION.— 


kjohnson on DSK79L0C42PROD with BILLS
3 

HR 4861 RFS

1 ‘‘(1) IN GENERAL.—In carrying out the Pro2 gram, the Secretary shall award grants on a com3 petitive basis to not more than 40 eligible health 

4 care sites described in paragraph (2). 

5 ‘‘(2) ELIGIBILITY.—To be eligible for a grant 

6 under this section, a health care site shall— 

7 ‘‘(A) submit an application to the Sec8 retary at such time, in such manner, and con9 taining such information as the Secretary may 

10 specify; 

11 ‘‘(B) be a hospital (as defined in section 

12 1861(e) of the Social Security Act); 

13 ‘‘(C) have an emergency department; and 

14 ‘‘(D) deploy onsite health care or social 

15 service professionals to help connect and inte16 grate patients who are at risk of suicide with 

17 treatment and mental health support services. 

18 ‘‘(3) PREFERENCE.—In awarding grants under 

19 this section, the Secretary may give preference to eli20 gible health care sites described in paragraph (2) 

21 that meet at least one of the following criteria: 

22 ‘‘(A) The eligible health care site is a crit23 ical access hospital (as defined in section 

24 1861(mm)(1) of the Social Security Act). 


kjohnson on DSK79L0C42PROD with BILLS
4 

HR 4861 RFS

1 ‘‘(B) The eligible health care site is a sole 

2 community hospital (as defined in section 

3 1886(d)(5)(D)(iii) of the Social Security Act). 

4 ‘‘(C) The eligible health care site is oper5 ated by the Indian Health Service, by an Indian 

6 tribe or tribal organization (as such terms are 

7 defined in section 4 of the Indian Self-Deter8 mination and Education Assistance Act), or by 

9 an urban Indian organization (as defined in 

10 section 4 of the Indian Health Care Improve11 ment Act). 

12 ‘‘(D) The eligible health care site is located 

13 in a geographic area with a suicide rate that is 

14 higher than the national rate, as determined by 

15 the Secretary based on the most recent data 

16 from the Centers for Disease Control and Pre17 vention. 

18 ‘‘(c) PERIOD OF GRANT.—A grant awarded to an eli19 gible health care site under this section shall be for a pe20 riod of at least 2 years. 

21 ‘‘(d) GRANT USES.— 

22 ‘‘(1) REQUIRED USES.—A grant awarded under 

23 this section to an eligible health care site shall be 

24 used for the following purposes: 


kjohnson on DSK79L0C42PROD with BILLS
5 

HR 4861 RFS

1 ‘‘(A) To train emergency department 

2 health care professionals to identify, assess, and 

3 treat patients who are at risk of suicide. 

4 ‘‘(B) To establish and implement policies 

5 and procedures for emergency departments to 

6 improve the identification, assessment and 

7 treatment of individuals who are at risk of sui8 cide. 

9 ‘‘(C) To establish and implement policies 

10 and procedures with respect to care coordina11 tion, integrated care models, or referral to evi12 dence-based treatment to be used upon the dis13 charge from the emergency department of pa14 tients who are at risk of suicide. 

15 ‘‘(2) ADDITIONAL PERMISSIBLE USES.—In ad16 dition to the required uses listed in paragraph (1), 

17 a grant awarded under this section to an eligible 

18 health care site may be used for any of the following 

19 purposes: 

20 ‘‘(A) To hire emergency department psy21 chiatrists, psychologists, nurse practitioners, 

22 counselors, therapists, or other licensed health 

23 care and behavioral health professionals special24 izing in the treatment of individuals at risk of 

25 suicide. 


kjohnson on DSK79L0C42PROD with BILLS
6 

HR 4861 RFS

1 ‘‘(B) To develop and implement best prac2 tices for the follow-up care and long-term treat3 ment of individuals who are at risk of suicide. 

4 ‘‘(C) To increase the availability of and ac5 cess to evidence-based treatment for individuals 

6 who are at risk of suicide, including through 

7 telehealth services and strategies to reduce the 

8 boarding of these patients in emergency depart9 ments. 

10 ‘‘(D) To offer consultation with and refer11 ral to other supportive services that provide evi12 dence-based treatment and recovery for individ13 uals who are at risk of suicide. 

14 ‘‘(e) REPORTING REQUIREMENTS.— 

15 ‘‘(1) REPORTS BY GRANTEES.—Each eligible 

16 health care site receiving a grant under this section 

17 shall submit to the Secretary an annual report for 

18 each year for which the grant is received on the 

19 progress of the program funded through the grant. 

20 Each such report shall include information on— 

21 ‘‘(A) the number of individuals screened in 

22 the site’s emergency department for being at 

23 risk of suicide; 

24 ‘‘(B) the number of individuals identified 

25 in the site’s emergency department as being— 


kjohnson on DSK79L0C42PROD with BILLS
7 

HR 4861 RFS

1 ‘‘(i) survivors of an attempted suicide; 

2 or 

3 ‘‘(ii) are at risk of suicide; 

4 ‘‘(C) the number of individuals who are 

5 identified in the site’s emergency department as 

6 being at risk of suicide by a health care or be7 havioral health professional hired pursuant to 

8 subsection (d)(2)(A); 

9 ‘‘(D) the number of individuals referred by 

10 the site’s emergency department to other treat11 ment facilities, the types of such other facilities, 

12 and the number of such individuals admitted to 

13 such other facilities pursuant to such referrals; 

14 ‘‘(E) the effectiveness of programs and ac15 tivities funded through the grant in preventing 

16 suicides and suicide attempts; and 

17 ‘‘(F) any other relevant additional data re18 garding the programs and activities funded 

19 through the grant. 

20 ‘‘(2) REPORT BY SECRETARY.—Not later than 

21 one year after the end of fiscal year 2025, the Sec22 retary shall submit to Congress a report that in23 cludes— 

24 ‘‘(A) findings on the Program; 


kjohnson on DSK79L0C42PROD with BILLS
8 

HR 4861 RFS

1 ‘‘(B) overall patient outcomes achieved 

2 through the Program; 

3 ‘‘(C) an evaluation of the effectiveness of 

4 having a trained health care or behavioral 

5 health professional onsite to identify, assess, 

6 and treat patients who are at risk of suicide; 

7 and 

8 ‘‘(D) a compilation of policies, procedures, 

9 and best practices established, developed, or im10 plemented by grantees under this section. 

11 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

12 is authorized to be appropriated to carry out this section 

13 $20,000,000 for the period of fiscal years 2021 through 

14 2025.’’. 

Passed the House of Representatives September 29, 

2020. 

Attest: CHERYL L. JOHNSON, 

Clerk. 


kjohnson on DSK79L0C42PROD with BILLS