IB 

Union Calendar No. 443 

116TH CONGRESS 

2D SESSION H. R. 4861 

[Report No. 116–543] 

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 

SEPTEMBER 29, 2020 

Additional sponsors: Mr. TONKO, Mr. KATKO, Ms. GABBARD, Mrs. LURIA, Mr. 

RODNEY DAVIS of Illinois, Ms. TITUS, Mr. RUSH, Mr. KRISHNAMOORTHI, 

Mr. TRONE, Ms. BONAMICI, Mrs. NAPOLITANO, Ms. UNDERWOOD, and 

Mr. DELGADO

SEPTEMBER 29, 2020 

Reported from the Committee on Energy and Commerce; committed to the 

Committee of the Whole House on the State of the Union and ordered 

to be printed 


kjohnson on DSK79L0C42PROD with BILLS
2 

•HR 4861 RH

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. 


kjohnson on DSK79L0C42PROD with BILLS
3 

•HR 4861 RH

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’’. 

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

8 PATIENTS IN THE EMERGENCY DEPARTMENT 

9 WHO ARE AT RISK OF SUICIDE. 

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

11 (42 U.S.C. 280g et seq.) is amended by adding at the end 

12 the following new section: 

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

14 TO PATIENTS IN THE EMERGENCY DEPART15 MENT WHO ARE AT RISK OF SUICIDE. 

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

17 program (in this Act referred to as the ‘Program’) to im18 prove the identification, assessment, and treatment of pa19 tients in emergency departments who are at risk for sui20 cide, including by— 

21 ‘‘(1) developing policies and procedures for 

22 identifying and assessing individuals who are at risk 

23 of suicide; and 

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

25 such individuals after discharge. 


kjohnson on DSK79L0C42PROD with BILLS
4 

•HR 4861 RH

1 ‘‘(b) GRANT ESTABLISHMENT AND PARTICIPA2 TION.— 

3 ‘‘(1) IN GENERAL.—In carrying out the Pro4 gram, the Secretary shall award grants on a com5 petitive basis to not more than 40 eligible health 

6 care sites described in paragraph (2). 

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

8 under this section, a health care site shall— 

9 ‘‘(A) submit an application to the Sec10 retary at such time, in such manner, and con11 taining such information as the Secretary may 

12 specify; 

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

14 1861(e) of the Social Security Act); 

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

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

17 service professionals to help connect and inte18 grate patients who are at risk of suicide with 

19 treatment and mental health support services. 

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

21 this section, the Secretary may give preference to eli22 gible health care sites described in paragraph (2) 

23 that meet at least one of the following criteria: 


kjohnson on DSK79L0C42PROD with BILLS
5 

•HR 4861 RH

1 ‘‘(A) The eligible health care site is a crit2 ical access hospital (as defined in section 

3 1861(mm)(1) of the Social Security Act). 

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

5 community hospital (as defined in section 

6 1886(d)(5)(D)(iii) of the Social Security Act). 

7 ‘‘(C) The eligible health care site is oper8 ated by the Indian Health Service, by an Indian 

9 tribe or tribal organization (as such terms are 

10 defined in section 4 of the Indian Self-Deter11 mination and Education Assistance Act), or by 

12 an urban Indian organization (as defined in 

13 section 4 of the Indian Health Care Improve14 ment Act). 

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

16 in a geographic area with a suicide rate that is 

17 higher than the national rate, as determined by 

18 the Secretary based on the most recent data 

19 from the Centers for Disease Control and Pre20 vention. 

21 ‘‘(c) PERIOD OF GRANT.—A grant awarded to an eli22 gible health care site under this section shall be for a pe23 riod of at least 2 years. 

24 ‘‘(d) GRANT USES.— 


kjohnson on DSK79L0C42PROD with BILLS
6 

•HR 4861 RH

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

2 this section to an eligible health care site shall be 

3 used for the following purposes: 

4 ‘‘(A) To train emergency department 

5 health care professionals to identify, assess, and 

6 treat patients who are at risk of suicide. 

7 ‘‘(B) To establish and implement policies 

8 and procedures for emergency departments to 

9 improve the identification, assessment and 

10 treatment of individuals who are at risk of sui11 cide. 

12 ‘‘(C) To establish and implement policies 

13 and procedures with respect to care coordina14 tion, integrated care models, or referral to evi15 dence-based treatment to be used upon the dis16 charge from the emergency department of pa17 tients who are at risk of suicide. 

18 ‘‘(2) ADDITIONAL PERMISSIBLE USES.—In ad19 dition to the required uses listed in paragraph (1), 

20 a grant awarded under this section to an eligible 

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

22 purposes: 

23 ‘‘(A) To hire emergency department psy24 chiatrists, psychologists, nurse practitioners, 

25 counselors, therapists, or other licensed health 


kjohnson on DSK79L0C42PROD with BILLS
7 

•HR 4861 RH

1 care and behavioral health professionals special2 izing in the treatment of individuals at risk of 

3 suicide. 

4 ‘‘(B) To develop and implement best prac5 tices for the follow-up care and long-term treat6 ment of individuals who are at risk of suicide. 

7 ‘‘(C) To increase the availability of and ac8 cess to evidence-based treatment for individuals 

9 who are at risk of suicide, including through 

10 telehealth services and strategies to reduce the 

11 boarding of these patients in emergency depart12 ments. 

13 ‘‘(D) To offer consultation with and refer14 ral to other supportive services that provide evi15 dence-based treatment and recovery for individ16 uals who are at risk of suicide. 

17 ‘‘(e) REPORTING REQUIREMENTS.— 

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

19 health care site receiving a grant under this section 

20 shall submit to the Secretary an annual report for 

21 each year for which the grant is received on the 

22 progress of the program funded through the grant. 

23 Each such report shall include information on— 


kjohnson on DSK79L0C42PROD with BILLS
8 

•HR 4861 RH

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

2 the site’s emergency department for being at 

3 risk of suicide; 

4 ‘‘(B) the number of individuals identified 

5 in the site’s emergency department as being— 

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

7 or 

8 ‘‘(ii) are at risk of suicide; 

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

10 identified in the site’s emergency department as 

11 being at risk of suicide by a health care or be12 havioral health professional hired pursuant to 

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

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

15 the site’s emergency department to other treat16 ment facilities, the types of such other facilities, 

17 and the number of such individuals admitted to 

18 such other facilities pursuant to such referrals; 

19 ‘‘(E) the effectiveness of programs and ac20 tivities funded through the grant in preventing 

21 suicides and suicide attempts; and 

22 ‘‘(F) any other relevant additional data re23 garding the programs and activities funded 

24 through the grant. 


kjohnson on DSK79L0C42PROD with BILLS
9 

•HR 4861 RH

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

2 one year after the end of fiscal year 2024, the Sec3 retary shall submit to Congress a report that in4 cludes— 

5 ‘‘(A) findings on the Program; 

6 ‘‘(B) overall patient outcomes achieved 

7 through the Program; 

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

9 having a trained health care or behavioral 

10 health professional onsite to identify, assess, 

11 and treat patients who are at risk of suicide; 

12 and 

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

14 and best practices established, developed, or im15 plemented by grantees under this section. 

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

17 is authorized to be appropriated to carry out this section 

18 $20,000,000 for the period of fiscal years 2020 through 

19 2024.’’. 


kjohnson on DSK79L0C42PROD with BILLS
Union Calendar No. 443 

116TH CONGRESS 

2D SESSION H. R. 4861 

[Report No. 116–543] 

A BILL 

To amend the Public Health Service Act to estabfor other purposes. gency department who are at risk of suicide, and sessment, and treatment of patients in the emer- lish a program to improve the identification, asSEPTEMBER 29, 2020 

Reported from the Committee on Energy and Commerce; 

the State of the Union and ordered to be printed committed to the Committee of the Whole House on 


kjohnson on DSK79L0C42PROD with BILLS