I 

116TH CONGRESS 

1ST SESSION H. R. 4861 

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. 

IN THE HOUSE OF REPRESENTATIVES 

OCTOBER 28, 2019 

Mr. BILIRAKIS (for himself and Mr. ENGEL) introduced the following bill; 

which was referred to the Committee on Energy and Commerce 

A BILL 

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, 

3 SECTION 1. SHORT TITLE. 

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

5 Screening and Assessment in the Emergency Department 

6 Act of 2019’’. 


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

2 PATIENTS IN THE EMERGENCY DEPARTMENT 

3 WHO ARE AT RISK OF SUICIDE. 

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

5 (42 U.S.C. 280g et seq.) is amended by adding at the end 

6 the following new section: 

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

8 TO PATIENTS IN THE EMERGENCY DEPART9 MENT WHO ARE AT RISK OF SUICIDE. 

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

11 program (in this Act referred to as the ‘Program’) to im12 prove the identification, assessment, and treatment of pa13 tients in emergency departments who are at risk for sui14 cide, including by— 

15 ‘‘(1) developing policies and procedures for 

16 identifying and assessing individuals who are at risk 

17 of suicide; and 

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

19 such individuals after discharge. 

20 ‘‘(b) GRANT ESTABLISHMENT AND PARTICIPA21 TION.— 

22 ‘‘(1) IN GENERAL.—In carrying out the Pro23 gram, the Secretary shall award grants on a com24 petitive basis to not more than 40 eligible health 

25 care sites described in paragraph (2). 


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

2 under this section, a health care site shall— 

3 ‘‘(A) submit an application to the Sec4 retary at such time, in such manner, and con5 taining such information as the Secretary may 

6 specify; 

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

8 1861(e) of the Social Security Act); 

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

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

11 service professionals to help connect and inte12 grate patients who are at risk of suicide with 

13 treatment and mental health support services. 

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

15 this section, the Secretary may give preference to eli16 gible health care sites described in paragraph (2) 

17 that meet at least one of the following criteria: 

18 ‘‘(A) The eligible health care site is a crit19 ical access hospital (as defined in section 

20 1861(mm)(1) of the Social Security Act). 

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

22 community hospital (as defined in section 

23 1886(d)(5)(D)(iii) of the Social Security Act). 

24 ‘‘(C) The eligible health care site is oper25 ated by the Indian Health Service, by an Indian 


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1 tribe or tribal organization (as such terms are 

2 defined in section 4 of the Indian Self-Deter3 mination and Education Assistance Act), or by 

4 an urban Indian organization (as defined in 

5 section 4 of the Indian Health Care Improve6 ment Act). 

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

8 in a geographic area with a suicide rate that is 

9 higher than the national rate, as determined by 

10 the Secretary based on the most recent data 

11 from the Centers for Disease Control and Pre12 vention. 

13 ‘‘(c) PERIOD OF GRANT.—A grant awarded to an eli14 gible health care site under this section shall be for a pe15 riod of at least 2 years. 

16 ‘‘(d) GRANT USES.— 

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

18 this section to an eligible health care site shall be 

19 used for the following purposes: 

20 ‘‘(A) To train emergency department 

21 health care professionals to identify, assess, and 

22 treat patients who are at risk of suicide. 

23 ‘‘(B) To establish and implement policies 

24 and procedures for emergency departments to 

25 improve the identification, assessment and 


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1 treatment of individuals who are at risk of sui2 cide. 

3 ‘‘(C) To establish and implement policies 

4 and procedures with respect to care coordina5 tion, integrated care models, or referral to evi6 dence-based treatment to be used upon the dis7 charge from the emergency department of pa8 tients who are at risk of suicide. 

9 ‘‘(2) ADDITIONAL PERMISSIBLE USES.—In ad10 dition to the required uses listed in paragraph (1), 

11 a grant awarded under this section to an eligible 

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

13 purposes: 

14 ‘‘(A) To hire emergency department psy15 chiatrists, psychologists, nurse practitioners, 

16 counselors, therapists, or other licensed health 

17 care and behavioral health professionals special18 izing in the treatment of individuals at risk of 

19 suicide. 

20 ‘‘(B) To develop and implement best prac21 tices for the follow-up care and long-term treat22 ment of individuals who are at risk of suicide. 

23 ‘‘(C) To increase the availability of and ac24 cess to evidence-based treatment for individuals 

25 who are at risk of suicide, including through 


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1 telehealth services and strategies to reduce the 

2 boarding of these patients in emergency depart3 ments. 

4 ‘‘(D) To offer consultation with and refer5 ral to other supportive services that provide evi6 dence-based treatment and recovery for individ7 uals who are at risk of suicide. 

8 ‘‘(e) REPORTING REQUIREMENTS.— 

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

10 health care site receiving a grant under this section 

11 shall submit to the Secretary an annual report for 

12 each year for which the grant is received on the 

13 progress of the program funded through the grant. 

14 Each such report shall include information on— 

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

16 the site’s emergency department for being at 

17 risk of suicide; 

18 ‘‘(B) the number of individuals identified 

19 in the site’s emergency department as being— 

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

21 or 

22 ‘‘(ii) are at risk of suicide; 

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

24 identified in the site’s emergency department as 

25 being at risk of suicide by a health care or beVerDate Sep 11 2014 03:52 Nov 01, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H4861.IH H4861

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1 havioral health professional hired pursuant to 

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

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

4 the site’s emergency department to other treat5 ment facilities, the types of such other facilities, 

6 and the number of such individuals admitted to 

7 such other facilities pursuant to such referrals; 

8 ‘‘(E) the effectiveness of programs and ac9 tivities funded through the grant in preventing 

10 suicides and suicide attempts; and 

11 ‘‘(F) any other relevant additional data re12 garding the programs and activities funded 

13 through the grant. 

14 ‘‘(2) REPORT BY SECRETARY.—Not less than 

15 one year after the end of fiscal year 2024, the Sec16 retary shall submit to Congress a report that in17 cludes— 

18 ‘‘(A) findings on the Program; 

19 ‘‘(B) overall patient outcomes achieved 

20 through the Program; 

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

22 having a trained health care or behavioral 

23 health professional onsite to identify, assess, 

24 and treat patients who are at risk of suicide; 

25 and 


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

2 and best practices established, developed, or im3 plemented by grantees under this section. 

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

5 is authorized to be appropriated to carry out this section 

6 $20,000,000 for the period of fiscal years 2020 through 

7 2024.’’. 

Æ 


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