IIB 

116TH CONGRESS 

2D SESSION H. R. 5619 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 22, 2020 

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

Labor, and Pensions 

AN ACT 

To authorize a pilot program to expand and intensify surveillance of self-harm in partnership with State and local 

public health departments, to establish a grant program 

to provide self-harm and suicide prevention services in 

hospital emergency departments, and for other purposes. 


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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 ‘‘Suicide Prevention 

5 Act’’. 

6 SEC. 2. SYNDROMIC SURVEILLANCE OF SELF-HARM BEHAV7 IORS PROGRAM. 

8 Title III of the Public Health Service Act is amended 

9 by inserting after section 317U of such Act (42 U.S.C. 

10 247b–23) the following: 

11 ‘‘SEC. 317V. SYNDROMIC SURVEILLANCE OF SELF-HARM BE12 HAVIORS PROGRAM. 

13 ‘‘(a) IN GENERAL.—The Secretary shall award 

14 grants to State, local, Tribal, and territorial public health 

15 departments for the expansion of surveillance of self-harm. 

16 ‘‘(b) DATA SHARING BY GRANTEES.—As a condition 

17 of receipt of such grant under subsection (a), each grantee 

18 shall agree to share with the Centers for Disease Control 

19 and Prevention in real time, to the extent feasible and as 

20 specified in the grant agreement, data on suicides and self21 harm for purposes of— 

22 ‘‘(1) tracking and monitoring self-harm to in23 form response activities to suicide clusters; 

24 ‘‘(2) informing prevention programming for 

25 identified at-risk populations; and 


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1 ‘‘(3) conducting or supporting research. 

2 ‘‘(c) DISAGGREGATION OF DATA.—The Secretary 

3 shall provide for the data collected through surveillance 

4 of self-harm under subsection (b) to be disaggregated by 

5 the following categories: 

6 ‘‘(1) Nonfatal self-harm data of any intent. 

7 ‘‘(2) Data on suicidal ideation. 

8 ‘‘(3) Data on self-harm where there is no evi9 dence, whether implicit or explicit, of suicidal intent. 

10 ‘‘(4) Data on self-harm where there is evidence, 

11 whether implicit or explicit, of suicidal intent. 

12 ‘‘(5) Data on self-harm where suicidal intent is 

13 unclear based on the available evidence. 

14 ‘‘(d) PRIORITY.—In making awards under subsection 

15 (a), the Secretary shall give priority to eligible entities that 

16 are— 

17 ‘‘(1) located in a State with an age-adjusted 

18 rate of nonfatal suicidal behavior that is above the 

19 national rate of nonfatal suicidal behavior, as deter20 mined by the Director of the Centers for Disease 

21 Control and Prevention; 

22 ‘‘(2) serving an Indian Tribe (as defined in sec23 tion 4 of the Indian Self-Determination and Edu24 cation Assistance Act) with an age-adjusted rate of 

25 nonfatal suicidal behavior that is above the national 


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1 rate of nonfatal suicidal behavior, as determined 

2 through appropriate mechanisms determined by the 

3 Secretary in consultation with Indian Tribes; or 

4 ‘‘(3) located in a State with a high rate of cov5 erage of statewide (or Tribal) emergency department 

6 visits, as determined by the Director of the Centers 

7 for Disease Control and Prevention. 

8 ‘‘(e) GEOGRAPHIC DISTRIBUTION.—In making 

9 grants under this section, the Secretary shall make an ef10 fort to ensure geographic distribution, taking into account 

11 the unique needs of rural communities, including— 

12 ‘‘(1) communities with an incidence of individ13 uals with serious mental illness, demonstrated suici14 dal ideation or behavior, or suicide rates that are 

15 above the national average, as determined by the As16 sistant Secretary for Mental Health and Substance 

17 Use; 

18 ‘‘(2) communities with a shortage of prevention 

19 and treatment services, as determined by the Assist20 ant Secretary for Mental Health and Substance Use 

21 and the Administrator of the Health Resources and 

22 Services Administration; and 

23 ‘‘(3) other appropriate community-level factors 

24 and social determinants of health such as income, 

25 employment, and education. 


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1 ‘‘(f) PERIOD OF PARTICIPATION.—To be selected as 

2 a grant recipient under this section, a State, local, Tribal, 

3 or territorial public health department shall agree to par4 ticipate in the program for a period of not less than 4 

5 years. 

6 ‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 

7 provide technical assistance and training to grantees for 

8 collecting and sharing the data under subsection (b). 

9 ‘‘(h) DATA SHARING BY HHS.—Subject to sub10 section (b), the Secretary shall, with respect to data on 

11 self-harm that is collected pursuant to this section, share 

12 and integrate such data through— 

13 ‘‘(1) the National Syndromic Surveillance Pro14 gram’s Early Notification of Community Epidemics 

15 (ESSENCE) platform (or any successor platform); 

16 ‘‘(2) the National Violent Death Reporting Sys17 tem, as appropriate; or 

18 ‘‘(3) another appropriate surveillance program, 

19 including such a program that collects data on sui20 cides and self-harm among special populations, such 

21 as members of the military and veterans. 

22 ‘‘(i) RULE OF CONSTRUCTION REGARDING APPLICA23 BILITY OF PRIVACY PROTECTIONS.—Nothing in this sec24 tion shall be construed to limit or alter the application 

25 of Federal or State law relating to the privacy of informaVerDate Sep 11 2014 03:57 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5619.RFS H5619

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1 tion to data or information that is collected or created 

2 under this section. 

3 ‘‘(j) REPORT.— 

4 ‘‘(1) SUBMISSION.—Not later than 3 years 

5 after the date of enactment of this Act, the Sec6 retary shall evaluate the suicide and self-harm 

7 syndromic surveillance systems at the Federal, 

8 State, and local levels and submit a report to Con9 gress on the data collected under subsections (b) and 

10 (c) in a manner that prevents the disclosure of indi11 vidually identifiable information, at a minimum, con12 sistent with all applicable privacy laws and regula13 tions. 

14 ‘‘(2) CONTENTS.—In addition to the data col15 lected under subsections (b) and (c), the report 

16 under paragraph (1) shall include— 

17 ‘‘(A) challenges and gaps in data collection 

18 and reporting; 

19 ‘‘(B) recommendations to address such 

20 gaps and challenges; and 

21 ‘‘(C) a description of any public health re22 sponses initiated at the Federal, State, or local 

23 level in response to the data collected. 

24 ‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—To 

25 carry out this section, there are authorized to be approVerDate Sep 11 2014 03:57 Sep 23, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H5619.RFS H5619

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1 priated $20,000,000 for each of fiscal years 2021 through 

2 2025.’’. 

3 SEC. 3. GRANTS TO PROVIDE SELF-HARM AND SUICIDE 

4 PREVENTION SERVICES. 

5 Part B of title V of the Public Health Service Act 

6 (42 U.S.C. 290aa et seq.) is amended by adding at the 

7 end the following: 

8 ‘‘SEC. 520N. GRANTS TO PROVIDE SELF-HARM AND SUICIDE 

9 PREVENTION SERVICES. 

10 ‘‘(a) IN GENERAL.—The Secretary of Health and 

11 Human Services shall award grants to hospital emergency 

12 departments to provide self-harm and suicide prevention 

13 services. 

14 ‘‘(b) ACTIVITIES SUPPORTED.— 

15 ‘‘(1) IN GENERAL.—A hospital emergency de16 partment awarded a grant under subsection (a) shall 

17 use amounts under the grant to implement a pro18 gram or protocol to better prevent suicide attempts 

19 among hospital patients after discharge, which may 

20 include— 

21 ‘‘(A) screening patients for self-harm and 

22 suicide in accordance with the standards of 

23 practice described in subsection (e)(1) and 

24 standards of care established by appropriate 

25 medical and advocacy organizations; 


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1 ‘‘(B) providing patients short-term self2 harm and suicide prevention services in accord3 ance with the results of the screenings de4 scribed in subparagraph (A); and 

5 ‘‘(C) referring patients, as appropriate, to 

6 a health care facility or provider for purposes of 

7 receiving long-term self-harm and suicide pre8 vention services, and providing any additional 

9 follow up services and care identified as appro10 priate as a result of the screenings and short11 term self-harm and suicide prevention services 

12 described in subparagraphs (A) and (B). 

13 ‘‘(2) USE OF FUNDS TO HIRE AND TRAIN

14 STAFF.—Amounts awarded under subsection (a) 

15 may be used to hire clinical social workers, mental 

16 and behavioral health care professionals, and sup17 port staff as appropriate, and to train existing staff 

18 and newly hired staff to carry out the activities de19 scribed in paragraph (1). 

20 ‘‘(c) GRANT TERMS.—A grant awarded under sub21 section (a)— 

22 ‘‘(1) shall be for a period of 3 years; and 

23 ‘‘(2) may be renewed subject to the require24 ments of this section. 


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1 ‘‘(d) APPLICATIONS.—A hospital emergency depart2 ment seeking a grant under subsection (a) shall submit 

3 an application to the Secretary at such time, in such man4 ner, and accompanied by such information as the Sec5 retary may require. 

6 ‘‘(e) STANDARDS OF PRACTICE.— 

7 ‘‘(1) IN GENERAL.—Not later than 180 days 

8 after the date of the enactment of this section, the 

9 Secretary shall develop standards of practice for 

10 screening patients for self-harm and suicide for pur11 poses of carrying out subsection (b)(1)(C). 

12 ‘‘(2) CONSULTATION.—The Secretary shall de13 velop the standards of practice described in para14 graph (1) in consultation with individuals and enti15 ties with expertise in self-harm and suicide preven16 tion, including public, private, and non-profit enti17 ties. 

18 ‘‘(f) REPORTING.— 

19 ‘‘(1) REPORTS TO THE SECRETARY.— 

20 ‘‘(A) IN GENERAL.—A hospital emergency 

21 department awarded a grant under subsection 

22 (a) shall, at least quarterly for the duration of 

23 the grant, submit to the Secretary a report 

24 evaluating the activities supported by the grant. 


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1 ‘‘(B) MATTERS TO BE INCLUDED.—The 

2 report required under subparagraph (A) shall 

3 include— 

4 ‘‘(i) the number of patients receiv5 ing— 

6 ‘‘(I) screenings carried out at the 

7 hospital emergency department; 

8 ‘‘(II) short-term self-harm and 

9 suicide prevention services at the hos10 pital emergency department; and 

11 ‘‘(III) referrals to health care fa12 cilities for the purposes of receiving 

13 long-term self-harm and suicide pre14 vention; 

15 ‘‘(ii) information on the adherence of 

16 the hospital emergency department to the 

17 standards of practice described in sub18 section (f)(1); and 

19 ‘‘(iii) other information as the Sec20 retary determines appropriate to evaluate 

21 the use of grant funds. 

22 ‘‘(2) REPORTS TO CONGRESS.—Not later than 

23 2 years after the date of the enactment of the Sui24 cide Prevention Act, and biennially thereafter, the 

25 Secretary shall submit to the Committee on Health, 


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1 Education, Labor and Pensions of the Senate and 

2 the Committee on Energy and Commerce of the 

3 House of Representatives a report on the grant pro4 gram under this section, including— 

5 ‘‘(A) a summary of reports received by the 

6 Secretary under paragraph (1); and 

7 ‘‘(B) an evaluation of the program by the 

8 Secretary. 

9 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—To 

10 carry out this section, there are authorized to be appro11 priated $30,000,000 for each of fiscal years 2021 through 

12 2025.’’. 

Passed the House of Representatives September 21, 

2020. 

Attest: CHERYL L. JOHNSON, 

Clerk. 


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