I 

116TH CONGRESS 

2D SESSION H. R. 5619 

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 

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. 

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’’. 

2 

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1 SEC. 2. SYNDROMIC SURVEILLANCE OF SELF-HARM BEHAV2 IORS PROGRAM. 

3 Title III of the Public Health Service Act is amended 

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

5 247b–22) the following: 

6 ‘‘SEC. 317U. SYNDROMIC SURVEILLANCE OF SELF-HARM BE7 HAVIORS PROGRAM. 

8 ‘‘(a) IN GENERAL.—The Secretary, acting through 

9 the Director of the Centers for Disease Control and Pre10 vention, shall award grants to State, local, Tribal, and ter11 ritorial public health departments for the expansion of sur12 veillance of self-harm. 

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

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

15 shall agree to share with the Centers for Disease Control 

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

17 specified in the grant agreement, data on suicides and self18 harm for purposes of— 

19 ‘‘(1) tracking and monitoring self-harm to in20 form response activities to suicide clusters; 

21 ‘‘(2) informing prevention programming for 

22 identified at-risk populations; and 

23 ‘‘(3) conducting or supporting research. 

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

25 shall provide for the data collected through surveillance 

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

2 the following categories: 

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

4 ‘‘(2) Data on suicidal ideation. 

5 ‘‘(3) Data on self-harm where there is no evi6 dence, whether implicit or explicit, of suicidal intent. 

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

8 whether implicit or explicit, of suicidal intent. 

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

10 unclear based on the available evidence. 

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

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

13 are— 

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

15 rate of suicide death that is above the national sui16 cide mortality rate, as determined by the Director of 

17 the Centers for Disease Control and Prevention; 

18 ‘‘(2) serving an Indian Tribe (as defined in sec19 tion 4 of the Indian Self-Determination and Edu20 cation Assistance Act) with an age-adjusted rate of 

21 suicide deaths that is above the national suicide 

22 mortality rate, as determined through appropriate 

23 mechanisms determined by the Secretary in con24 sultation with Indian Tribes; or 

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1 ‘‘(3) located in a State with a high rate of cov2 erage of statewide (or Tribal) emergency department 

3 visits, as determined by the Director of the Centers 

4 for Disease Control and Prevention. 

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

6 grants under this section, the Secretary shall make an ef7 fort to ensure geographic distribution, taking into account 

8 the unique needs of rural communities, including— 

9 ‘‘(1) communities with an incidence of individ10 uals with serious mental illness, demonstrated suici11 dal ideation or behavior, or suicide rates that are 

12 above the national average, as determined by the As13 sistant Secretary for Mental Health and Substance 

14 Use; 

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

16 and treatment services, as determined by the Assist17 ant Secretary for Mental Health and Substance Use 

18 and the Administrator of the Health Resources and 

19 Services Administration; and 

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

21 and social determinants of health such as income, 

22 employment, and education. 

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

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

25 or territorial public health department shall agree to parVerDate Sep 11 2014 22:34 Jan 16, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5619.IH H5619
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1 ticipate in the program for a period of not less than 2 

2 years. 

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

4 provide technical assistance and training to grantees for 

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

6 ‘‘(h) DATA SHARING BY HHS.—Subject to sub7 section (b), the Secretary shall, with respect to data on 

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

9 and integrate such data through— 

10 ‘‘(1) the National Syndromic Surveillance Pro11 gram’s Early Notification of Community Epidemics 

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

13 ‘‘(2) the National Violent Death Reporting Sys14 tem, as appropriate; or 

15 ‘‘(3) another appropriate surveillance program, 

16 including such a program that collects data on sui17 cides and self-harm among special populations, such 

18 as members of the military and veterans. 

19 ‘‘(i) RULE OF CONSTRUCTION REGARDING APPLICA20 BILITY OF PRIVACY PROTECTIONS.—Nothing in this sec21 tion shall be construed to limit or alter the application 

22 of Federal or State law relating to the privacy of informa23 tion to data or information that is collected or created 

24 under this section. 

25 ‘‘(j) REPORT.— 

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

2 after the date of enactment of this Act, the Sec3 retary shall evaluate the suicide and self-harm 

4 syndromic surveillance systems at the Federal, 

5 State, and local levels and submit a report to Con6 gress on the data collected under subsections (b) and 

7 (c) in a manner that prevents the disclosure of indi8 vidually identifiable information, at a minimum, con9 sistent with all applicable privacy laws and regula10 tions. 

11 ‘‘(2) CONTENTS.—In addition to the data col12 lected under subsections (b) and (c), the report 

13 under paragraph (1) shall include— 

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

15 and reporting; 

16 ‘‘(B) recommendations to address such 

17 gaps and challenges; and 

18 ‘‘(C) a description of any public health re19 sponses initiated at the Federal, State, or local 

20 level in response to the data collected. 

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

22 carry out this section, there are authorized to be appro23 priated $10,000,000 for each of fiscal years 2021 through 

24 2025.’’. 

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

2 PREVENTION SERVICES. 

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

4 (42 U.S.C. 290aa et seq.) is amended by adding at the 

5 end the 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, acting through the Assistant Secretary 

10 for Mental Health and Substance Use, shall award grants 

11 to hospital emergency departments to provide self-harm 

12 and suicide prevention services. 

13 ‘‘(b) ACTIVITIES SUPPORTED.— 

14 ‘‘(1) IN GENERAL.—A hospital emergency de15 partment awarded a grant under subsection (a) shall 

16 use amounts under the grant to implement a pro17 gram or protocol to better prevent suicide attempts 

18 among hospital patients after discharge, which may 

19 include— 

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

21 suicide in accordance with the standards of 

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

23 standards of care established by appropriate 

24 medical and advocacy organizations; 

25 ‘‘(B) providing patients short-term self26 harm and suicide prevention services in accordVerDate Sep 11 2014 22:34 Jan 16, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5619.IH H5619
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1 ance with the results of the screenings de2 scribed in subparagraph (A); and 

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

4 a 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) 

13 may be used to hire clinical social workers, mental 

14 and behavioral health care professionals, and sup15 port staff as appropriate, and to train existing staff 

16 and newly hired staff to carry out the activities de17 scribed in 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 require22 ments of this section. 

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

25 an application to the Secretary at such time, in such manVerDate Sep 11 2014 22:34 Jan 16, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H5619.IH H5619
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1 ner, and accompanied by such information as the Sec2 retary 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 

6 Secretary shall develop standards of practice for 

7 screening patients for self-harm and suicide for pur8 poses of 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 

21 evaluating the activities supported by the grant. 

22 ‘‘(B) MATTERS TO BE INCLUDED.—The 

23 report required under subparagraph (A) shall 

24 include— 

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1 ‘‘(i) the number of patients receiv2 ing— 

3 ‘‘(I) screenings carried out at the 

4 hospital emergency department; 

5 ‘‘(II) short-term self-harm and 

6 suicide prevention services at the hos7 pital emergency department; and 

8 ‘‘(III) referrals to health care fa9 cilities for the purposes of receiving 

10 long-term self-harm and suicide pre11 vention; 

12 ‘‘(ii) information on the adherence of 

13 the hospital emergency department to the 

14 standards of practice described in sub15 section (f)(1); and 

16 ‘‘(iii) other information as the Sec17 retary determines appropriate to evaluate 

18 the use of grant funds. 

19 ‘‘(2) REPORTS TO CONGRESS AND IN THE DE20 PARTMENT OF HEALTH AND HUMAN SERVICES.— 

21 Not later than 2 years after the date of the enact22 ment of the Suicide Prevention Act, and biennially 

23 thereafter, the Secretary shall submit to the Com24 mittee on Health, Education, Labor, and Pensions 

25 of the Senate, the Committee on Energy and ComVerDate Sep 11 2014 22:34 Jan 16, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H5619.IH H5619
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1 merce of the House of Representatives, and the sub2 components of the Department of Health and 

3 Human Services described in paragraph (3) a report 

4 on the grant program 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 ‘‘(3) REPORTING IN THE DEPARTMENT OF

10 HEALTH AND HUMAN SERVICES.—The subcompo11 nents of the Department of Health and Human 

12 Services described in paragraph (2) are the Centers 

13 for Disease Control and Prevention and the National 

14 Institute of Mental Health. 

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

16 carry out this section, there are authorized to be appro17 priated $30,000,000 for each of fiscal years 2021 through 

18 2025.’’. 

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