IB 

Union Calendar No. 420 

116TH CONGRESS 

2D SESSION H. R. 5619 

[Report No. 116–520] 

To authorize a pilot program to expand and intensify surveillance of selfharm 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. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 15, 2020 

Mr. STEWART (for himself and Ms. MATSUI) introduced the following bill; 

which was referred to the Committee on Energy and Commerce 

SEPTEMBER 18, 2020 

Additional sponsors: Mr. CICILLINE, Mr. HARDER of California, Mr. TRONE, 

and Mr. DELGADO

SEPTEMBER 18, 2020 

Reported with an amendment; committed to the Committee of the Whole 

House on the State of the Union and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on January 15, 2020] 


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A BILL 

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 Act’’. 

5 SEC. 2. SYNDROMIC SURVEILLANCE OF SELF-HARM BEHAV6 IORS PROGRAM. 

7 Title III of the Public Health Service Act is amended 

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

9 247b–23) the following: 

10 ‘‘SEC. 317V. SYNDROMIC SURVEILLANCE OF SELF-HARM BE11 HAVIORS PROGRAM. 

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

13 to State, local, Tribal, and territorial public health depart14 ments for the expansion of surveillance of self-harm. 

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

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

17 shall agree to share with the Centers for Disease Control 

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

19 specified in the grant agreement, data on suicides and self20 harm for purposes of— 

21 ‘‘(1) tracking and monitoring self-harm to in22 form response activities to suicide clusters; 

23 ‘‘(2) informing prevention programming for 

24 identified at-risk populations; and 

25 ‘‘(3) conducting or supporting research. 


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1 ‘‘(c) DISAGGREGATION OF DATA.—The Secretary shall 

2 provide for the data collected through surveillance of self3 harm under subsection (b) to be disaggregated by the fol4 lowing categories: 

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

6 ‘‘(2) Data on suicidal ideation. 

7 ‘‘(3) Data on self-harm where there is no evi8 dence, whether implicit or explicit, of suicidal intent. 

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

10 whether implicit or explicit, of suicidal intent. 

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

12 unclear based on the available evidence. 

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

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

15 are— 

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

17 of nonfatal suicidal behavior that is above the na18 tional rate of nonfatal suicidal behavior, as deter19 mined by the Director of the Centers for Disease Con20 trol and Prevention; 

21 ‘‘(2) serving an Indian Tribe (as defined in sec22 tion 4 of the Indian Self-Determination and Edu23 cation Assistance Act) with an age-adjusted rate of 

24 nonfatal suicidal behavior that is above the national 

25 rate of nonfatal suicidal behavior, as determined 


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1 through appropriate mechanisms determined by the 

2 Secretary in consultation with Indian Tribes; or 

3 ‘‘(3) located in a State with a high rate of cov4 erage of statewide (or Tribal) emergency department 

5 visits, as determined by the Director of the Centers for 

6 Disease Control and Prevention. 

7 ‘‘(e) GEOGRAPHIC DISTRIBUTION.—In making grants 

8 under this section, the Secretary shall make an effort to en9 sure geographic distribution, taking into account the unique 

10 needs of rural communities, including— 

11 ‘‘(1) communities with an incidence of individ12 uals with serious mental illness, demonstrated suici13 dal ideation or behavior, or suicide rates that are 

14 above the national average, as determined by the As15 sistant Secretary for Mental Health and Substance 

16 Use; 

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

18 and treatment services, as determined by the Assist19 ant Secretary for Mental Health and Substance Use 

20 and the Administrator of the Health Resources and 

21 Services Administration; and 

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

23 and social determinants of health such as income, em24 ployment, and education. 


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

2 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 years. 

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

6 provide technical assistance and training to grantees for 

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

8 ‘‘(h) DATA SHARING BY HHS.—Subject to subsection 

9 (b), the Secretary shall, with respect to data on self-harm 

10 that is collected pursuant to this section, share and inte11 grate such data through— 

12 ‘‘(1) the National Syndromic Surveillance Pro13 gram’s Early Notification of Community Epidemics 

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

15 ‘‘(2) the National Violent Death Reporting Sys16 tem, as appropriate; or 

17 ‘‘(3) another appropriate surveillance program, 

18 including such a program that collects data on sui19 cides and self-harm among special populations, such 

20 as members of the military and veterans. 

21 ‘‘(i) RULE OF CONSTRUCTION REGARDING APPLICA22 BILITY OF PRIVACY PROTECTIONS.—Nothing in this section 

23 shall be construed to limit or alter the application of Fed24 eral or State law relating to the privacy of information to 


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1 data or information that is collected or created under this 

2 section. 

3 ‘‘(j) REPORT.— 

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

5 the date of enactment of this Act, the Secretary shall 

6 evaluate the suicide and self-harm syndromic surveil7 lance systems at the Federal, State, and local levels 

8 and submit a report to Congress on the data collected 

9 under subsections (b) and (c) in a manner that pre10 vents the disclosure of individually identifiable infor11 mation, at a minimum, consistent with all applicable 

12 privacy laws and regulations. 

13 ‘‘(2) CONTENTS.—In addition to the data col14 lected under subsections (b) and (c), the report under 

15 paragraph (1) shall include— 

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

17 and reporting; 

18 ‘‘(B) recommendations to address such gaps 

19 and challenges; and 

20 ‘‘(C) a description of any public health re21 sponses initiated at the Federal, State, or local 

22 level in response to the data collected. 

23 ‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—To carry 

24 out this section, there are authorized to be appropriated 

25 $20,000,000 for each of fiscal years 2021 through 2025.’’. 


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1 SEC. 3. GRANTS TO PROVIDE SELF-HARM AND SUICIDE PRE2 VENTION SERVICES. 

3 Part B of title V of the Public Health Service Act (42 

4 U.S.C. 290aa et seq.) is amended by adding at the end the 

5 following: 

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

7 PREVENTION SERVICES. 

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

9 Human Services shall award grants to hospital emergency 

10 departments to provide self-harm and suicide prevention 

11 services. 

12 ‘‘(b) ACTIVITIES SUPPORTED.— 

13 ‘‘(1) IN GENERAL.—A hospital emergency de14 partment awarded a grant under subsection (a) shall 

15 use amounts under the grant to implement a program 

16 or protocol to better prevent suicide attempts among 

17 hospital patients after discharge, which may in18 clude— 

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

20 suicide in accordance with the standards of prac21 tice described in subsection (e)(1) and standards 

22 of care established by appropriate medical and 

23 advocacy organizations; 

24 ‘‘(B) providing patients short-term self25 harm and suicide prevention services in accordVerDate Sep 11 2014 01:04 Sep 19, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6203 E:\BILLS\H5619.RH H5619

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1 ance with the results of the screenings described 

2 in subparagraph (A); and 

3 ‘‘(C) referring patients, as appropriate, to a 

4 health care facility or provider for purposes of 

5 receiving long-term self-harm and suicide pre6 vention services, and providing any additional 

7 follow up services and care identified as appro8 priate as a result of the screenings and short9 term self-harm and suicide prevention services 

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

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

12 STAFF.—Amounts awarded under subsection (a) may 

13 be used to hire clinical social workers, mental and be14 havioral health care professionals, and support staff 

15 as appropriate, and to train existing staff and newly 

16 hired staff to carry out the activities described in 

17 paragraph (1). 

18 ‘‘(c) GRANT TERMS.—A grant awarded under sub19 section (a)— 

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

21 ‘‘(2) may be renewed subject to the requirements 

22 of this section. 

23 ‘‘(d) APPLICATIONS.—A hospital emergency depart24 ment seeking a grant under subsection (a) shall submit an 

25 application to the Secretary at such time, in such manner, 


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1 and accompanied by such information as the Secretary 

2 may require. 

3 ‘‘(e) STANDARDS OF PRACTICE.— 

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

5 after the date of the enactment of this section, the Sec6 retary shall develop standards of practice for screen7 ing patients for self-harm and suicide for purposes of 

8 carrying out subsection (b)(1)(C). 

9 ‘‘(2) CONSULTATION.—The Secretary shall de10 velop the standards of practice described in para11 graph (1) in consultation with individuals and enti12 ties with expertise in self-harm and suicide preven13 tion, including public, private, and non-profit enti14 ties. 

15 ‘‘(f) REPORTING.— 

16 ‘‘(1) REPORTS TO THE SECRETARY.— 

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

18 department awarded a grant under subsection 

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

20 the grant, submit to the Secretary a report eval21 uating the activities supported by the grant. 

22 ‘‘(B) MATTERS TO BE INCLUDED.—The re23 port required under subparagraph (A) shall in24 clude— 

25 ‘‘(i) the number of patients receiving— 


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1 ‘‘(I) screenings carried out at the 

2 hospital emergency department; 

3 ‘‘(II) short-term self-harm and 

4 suicide prevention services at the hos5 pital emergency department; and 

6 ‘‘(III) referrals to health care fa7 cilities for the purposes of receiving 

8 long-term self-harm and suicide pre9 vention; 

10 ‘‘(ii) information on the adherence of 

11 the hospital emergency department to the 

12 standards of practice described in subsection 

13 (f)(1); and 

14 ‘‘(iii) other information as the Sec15 retary determines appropriate to evaluate 

16 the use of grant funds. 

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

18 years after the date of the enactment of the Suicide 

19 Prevention Act, and biennially thereafter, the Sec20 retary shall submit to the Committee on Health, Edu21 cation, Labor and Pensions of the Senate and the 

22 Committee on Energy and Commerce of the House of 

23 Representatives a report on the grant program under 

24 this section, including— 


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

2 Secretary under paragraph (1); and 

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

4 Secretary. 

5 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—To carry 

6 out this section, there are authorized to be appropriated 

7 $30,000,000 for each of fiscal years 2021 through 2025.’’. 


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kjohnson on DSK79L0C42PROD with BILLS
Union Calendar No. 420 

116TH CONGRESS 

2D SESSION H. R. 5619 

[Report No. 116–520] 

A BILL 

To authorize a pilot program to expand and intendepartments, and for other purposes. suicide prevention services in hospital emergency tablish a grant program to provide self-harm and State and local public health departments, to es- sify surveillance of self-harm in partnership with 

SEPTEMBER 18, 2020 

Reported with an amendment; committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union 


kjohnson on DSK79L0C42PROD with BILLS