II 

117TH CONGRESS 

2D SESSION S. 4448 

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 SENATE OF THE UNITED STATES 

JUNE 22, 2022 

Mr. REED (for himself and Mr. MORAN) introduced the following bill; which 

was read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

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’’. 


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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 317U of such Act (42 U.S.C. 

5 247b–23) the following: 

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

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

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

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

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

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

13 shall agree to share with the Centers for Disease Control 

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

15 specified in the grant agreement, data on suicides and self16 harm for purposes of— 

17 ‘‘(1) tracking and monitoring self-harm to in18 form response activities to suicide clusters; 

19 ‘‘(2) informing prevention programming for 

20 identified at-risk populations; and 

21 ‘‘(3) conducting or supporting research. 

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

23 shall provide for the data collected through surveillance 

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

25 the following categories: 

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


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1 ‘‘(2) Data on suicidal ideation. 

2 ‘‘(3) Data on self-harm where there is no evi3 dence, whether implicit or explicit, of suicidal intent. 

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

5 whether implicit or explicit, of suicidal intent. 

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

7 unclear based on the available evidence. 

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

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

10 are— 

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

12 rate of nonfatal suicidal behavior that is above the 

13 national rate of nonfatal suicidal behavior, as deter14 mined by the Director of the Centers for Disease 

15 Control and Prevention; 

16 ‘‘(2) serving an Indian Tribe (as defined in sec17 tion 4 of the Indian Self-Determination and Edu18 cation Assistance Act) with an age-adjusted rate of 

19 nonfatal suicidal behavior that is above the national 

20 rate of nonfatal suicidal behavior, as determined 

21 through appropriate mechanisms determined by the 

22 Secretary in consultation with Indian Tribes; or 

23 ‘‘(3) located in a State with a high rate of cov24 erage of statewide (or Tribal) emergency department 


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1 visits, as determined by the Director of the Centers 

2 for Disease Control and Prevention. 

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

4 grants under this section, the Secretary shall make an ef5 fort to ensure geographic distribution, taking into account 

6 the unique needs of rural communities, including— 

7 ‘‘(1) communities with an incidence of individ8 uals with serious mental illness, demonstrated suici9 dal ideation or behavior, or suicide rates that are 

10 above the national average, as determined by the As11 sistant Secretary for Mental Health and Substance 

12 Use; 

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

14 and treatment services, as determined by the Assist15 ant Secretary for Mental Health and Substance Use 

16 and the Administrator of the Health Resources and 

17 Services Administration; and 

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

19 and social determinants of health such as income, 

20 employment, and education. 

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

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

23 or territorial public health department shall agree to par24 ticipate in the program for a period of not less than 4 

25 years. 


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

2 provide technical assistance and training to grantees for 

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

4 ‘‘(h) DATA SHARING BY HHS.—Subject to sub5 section (b), the Secretary shall, with respect to data on 

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

7 and integrate such data through— 

8 ‘‘(1) the platform of the National Syndromic 

9 Surveillance Program Early Notification of Commu10 nity Epidemics (ESSENCE) (or any successor plat11 form); 

12 ‘‘(2) the National Violent Death Reporting Sys13 tem, as appropriate; or 

14 ‘‘(3) another appropriate surveillance program, 

15 including such a program that collects data on sui16 cides and self-harm among special populations, such 

17 as members of the military and veterans. 

18 ‘‘(i) RULE OF CONSTRUCTION REGARDING APPLICA19 BILITY OF PRIVACY PROTECTIONS.—Nothing in this sec20 tion shall be construed to limit or alter the application 

21 of Federal or State law relating to the privacy of informa22 tion to data or information that is collected or created 

23 under this section. 

24 ‘‘(j) REPORT.— 


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

2 after the date of enactment of the Suicide Preven3 tion Act, the Secretary shall evaluate the suicide and 

4 self-harm syndromic surveillance systems at the Fed5 eral, State, and local levels and submit a report to 

6 Congress on the data collected under subsections (b) 

7 and (c) in a manner that prevents the disclosure of 

8 individually identifiable information, at a minimum, 

9 consistent with all applicable privacy laws and regu10 lations. 

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 $20,000,000 for each of fiscal years 2023 through 

24 2027.’’. 


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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. 290bb 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 shall award 

9 grants to hospital emergency departments to provide self10 harm and suicide prevention services. 

11 ‘‘(b) ACTIVITIES SUPPORTED.— 

12 ‘‘(1) IN GENERAL.—A hospital emergency de13 partment awarded a grant under subsection (a) shall 

14 use amounts under the grant to implement a pro15 gram or protocol to better prevent suicide attempts 

16 among hospital patients after discharge, which may 

17 include— 

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

19 suicide in accordance with the standards of 

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

21 standards of care established by appropriate 

22 medical and advocacy organizations; 

23 ‘‘(B) providing patients short-term self24 harm and suicide prevention services in accord25 ance with the results of the screenings de26 scribed in subparagraph (A); and 


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

2 a health care facility or provider for purposes of 

3 receiving long-term self-harm and suicide pre4 vention services, and providing any additional 

5 follow up services and care identified as appro6 priate as a result of the screenings and short7 term self-harm and suicide prevention services 

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

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

10 STAFF.—Amounts awarded under subsection (a) 

11 may be used to hire clinical social workers, mental 

12 and behavioral health care professionals, and sup13 port staff as appropriate, and to train existing staff 

14 and newly hired staff to carry out the activities de15 scribed in paragraph (1). 

16 ‘‘(c) GRANT TERMS.—A grant awarded under sub17 section (a)— 

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

19 ‘‘(2) may be renewed subject to the require20 ments of this section. 

21 ‘‘(d) APPLICATIONS.—A hospital emergency depart22 ment seeking a grant under subsection (a) shall submit 

23 an application to the Secretary at such time, in such man24 ner, and accompanied by such information as the Sec25 retary may require. 


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1 ‘‘(e) STANDARDS OF PRACTICE.— 

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

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

4 Secretary shall develop standards of practice for 

5 screening patients for self-harm and suicide for pur6 poses of carrying out subsection (b)(1)(C). 

7 ‘‘(2) CONSULTATION.—The Secretary shall de8 velop the standards of practice described in para9 graph (1) in consultation with individuals and enti10 ties with expertise in self-harm and suicide preven11 tion, including public, private, and nonprofit entities. 

12 ‘‘(f) REPORTING.— 

13 ‘‘(1) REPORTS TO THE SECRETARY.— 

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

15 department awarded a grant under subsection 

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

17 the grant, submit to the Secretary a report 

18 evaluating the activities supported by the grant. 

19 ‘‘(B) MATTERS TO BE INCLUDED.—The 

20 report required under subparagraph (A) shall 

21 include— 

22 ‘‘(i) the number of patients receiv23 ing— 

24 ‘‘(I) screenings carried out at the 

25 hospital emergency department; 


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1 ‘‘(II) short-term self-harm and 

2 suicide prevention services at the hos3 pital emergency department; and 

4 ‘‘(III) referrals to health care fa5 cilities for the purposes of receiving 

6 long-term self-harm and suicide pre7 vention; 

8 ‘‘(ii) information on the adherence of 

9 the hospital emergency department to the 

10 standards of practice described in sub11 section (f)(1); and 

12 ‘‘(iii) other information as the Sec13 retary determines appropriate to evaluate 

14 the use of grant funds. 

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

16 2 years after the date of the enactment of the Sui17 cide Prevention Act, and biennially thereafter, the 

18 Secretary shall submit to the Committee on Health, 

19 Education, Labor, and Pensions of the Senate and 

20 the Committee on Energy and Commerce of the 

21 House of Representatives a report on the grant pro22 gram under this section, including— 

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

24 Secretary under paragraph (1); and 


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

2 Secretary. 

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

4 carry out this section, there are authorized to be appro5 priated $30,000,000 for each of fiscal years 2023 through 

6 2027.’’. 

Æ 


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