II 

117TH CONGRESS 

2D SESSION S. 4871 

To establish an office to coordinate work relating to behavioral health crisis 

care and to improve the National Suicide Prevention Lifeline program, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 15, 2022 

Ms. BALDWIN (for herself and Ms. COLLINS) introduced the following bill; 

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

A BILL 

To establish an office to coordinate work relating to behavioral health crisis care and to improve the National Suicide Prevention Lifeline program, 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 ‘‘988 Coordination and 

5 Improvement Act’’. 


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1 SEC. 2. BEHAVIORAL HEALTH CRISIS COORDINATING OF2 FICE. 

3 Part A 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. 506B. BEHAVIORAL HEALTH CRISIS COORDINATING 

7 OFFICE. 

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

9 within the Substance Abuse and Mental Health Services 

10 Administration, an office to coordinate work relating to 

11 behavioral health crisis care across the operating divisions 

12 and agencies of the Department of Health and Human 

13 Services, including the Substance Abuse and Mental 

14 Health Services Administration, the Centers for Medicare 

15 & Medicaid Services, and the Health Resources and Serv16 ices Administration, and other Federal Government and 

17 external stakeholders. 

18 ‘‘(b) DUTY.—The office established under subsection 

19 (a) shall— 

20 ‘‘(1) convene Federal, State, Tribal, local, and 

21 private partners; 

22 ‘‘(2) launch and manage Federal workgroups 

23 charged with making recommendations regarding be24 havioral health crisis issues, including with respect 

25 to health care best practices, workforce development, 

26 mental health disparities, data collection, technology, 


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1 geolocation and call routing, program oversight, pub2 lic education, and engagement; and 

3 ‘‘(3) support technical assistance, data analysis, 

4 and evaluation functions in order to assist States, 

5 local governmental entities, territories, Indian 

6 Tribes, and Tribal communities in developing crisis 

7 care systems and establish nationwide best practices 

8 with the objective of expanding the capacity of, and 

9 access to, local 988 Suicide and Crisis Lifeline call 

10 centers, mobile crisis care, crisis stabilization, psy11 chiatric emergency services, rapid post-crisis follow12 up care, and essential community services provided 

13 by— 

14 ‘‘(A) the National Suicide Prevention and 

15 Mental Health Crisis Hotline and Response 

16 System; 

17 ‘‘(B) the Veterans Crisis Line; 

18 ‘‘(C) community mental health centers (as 

19 defined in section 1861(ff)(3)(B) of the Social 

20 Security Act); 

21 ‘‘(D) Federally qualified health centers (as 

22 defined in section 1861(aa) of the Social Secu23 rity Act); 


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1 ‘‘(E) certified community behavioral health 

2 clinics, as described in section 223 of the Pro3 tecting Access to Medicare Act of 2014; and 

4 ‘‘(F) other community mental health, sub5 stance use disorder, and essential community 

6 service providers, as determined by the Sec7 retary. 

8 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

9 is authorized to be appropriated to carry out this section 

10 $10,000,000 for each of fiscal years 2023 through 2027.’’. 

11 SEC. 3. NATIONAL SUICIDE PREVENTION LIFELINE PRO12 GRAM ACCESS TO SPECIALIZED SERVICES. 

13 Section 520E–3 of the Public Health Service Act 

14 (290bb–36c) is amended— 

15 (1) in subsection (b)— 

16 (A) in paragraph (2)— 

17 (i) by inserting after ‘‘suicide preven18 tion hotline’’ the following: ‘‘, under the 

19 universal telephone number designated 

20 under section 251(e)(4) of the Communica21 tions Act of 1934,’’; and 

22 (ii) by striking ‘‘; and’’ at the end and 

23 inserting a semicolon; 

24 (B) in paragraph (3), by striking the pe25 riod at the end and inserting ‘‘; and’’; and 


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1 (C) by adding at the end the following: 

2 ‘‘(4) supporting access by high-risk populations, 

3 including LGBTQ+ youth and other members of the 

4 LGBTQ+ community, American Indian and Alaska 

5 Natives, individuals who reside in rural counties, 

6 veterans, racial and ethnic minorities, and other 

7 high-risk populations, to specialized services through 

8 the program, in accordance with subsection (c) and 

9 as determined by the Office of the Assistant Sec10 retary.’’; 

11 (2) by redesignating subsection (c) as sub12 section (d); and 

13 (3) by inserting after subsection (b) the fol14 lowing: 

15 ‘‘(c) ACCESS TO SPECIALIZED SERVICES.— 

16 ‘‘(1) CONSULTATION.—Wherever possible, the 

17 Office of the Assistant Secretary shall, in deter18 mining which approaches to use to support access to 

19 specialized services under subsection (b)(4) to the 

20 populations described in such subsection, consult 

21 with organizations that have— 

22 ‘‘(A) experience working with such popu23 lations; or 


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1 ‘‘(B) technological expertise in effective 

2 crisis response using such digital and tech3 nology approaches. 

4 ‘‘(2) EXAMPLES OF SPECIALIZED SERVICES.— 

5 Efforts to support access to specialized services 

6 under subsection (b)(4) may include— 

7 ‘‘(A) updates and development of training 

8 resources that can help crisis counselors better 

9 address the needs of high-risk populations; 

10 ‘‘(B) adapting the program network center 

11 membership processes to incorporate organiza12 tions providing specialized services for high-risk 

13 populations; 

14 ‘‘(C) designing and implementing transfer 

15 processes; 

16 ‘‘(D) providing additional technical assist17 ance to centers participating in the program to 

18 ensure compliance with the training expecta19 tions in working with high-risk populations; and 

20 ‘‘(E) the use of digital and technology ap21 proaches to improve access for high risk popu22 lations.’’. 


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1 SEC. 4. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

2 REPORT. 

3 (a) IN GENERAL.—Not later than 2 years after the 

4 date of enactment of this Act, the Secretary of Health and 

5 Human Services shall submit a report to Congress assess6 ing the progress of the Department of Health and Human 

7 Services in implementation of the 9–8–8 dialing code for 

8 the 988 Suicide and Crisis Lifeline operated pursuant to 

9 the program under section 520E–3 of the Public Health 

10 Service Act (42 U.S.C. 290bb–36c). 

11 (b) CONTENT.—The report required under subsection 

12 (a) shall include— 

13 (1) an assessment of the performance of the 

14 988 Suicide and Crisis Lifeline and any partner or15 ganizations of the Lifeline; 

16 (2) an update on efforts to provide specialized 

17 resources to high-risk populations, including 

18 LGBTQ+ youth and other members of the 

19 LGBTQ+ community, American Indian and Alaska 

20 Natives, individuals who reside in rural counties, 

21 veterans, racial and ethnic minorities, and other 

22 high-risk populations; 

23 (3) State and regional variation with respect to 

24 access to crisis call centers, including average speed 

25 to answer, answer rates, hours of operation, and 

26 funding sources; 


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1 (4) the capacity of the 988 Suicide and Crisis 

2 Lifeline to handle texts and chats; 

3 (5) any needed programmatic or technological 

4 enhancements to connect callers to local services; 

5 and 

6 (6) obstacles identified by States, political sub7 divisions of States, Indian Tribes, or villages or re8 gional corporations serving a region established pur9 suant to the Alaska Native Claims Settlement Act 

10 (43 U.S.C. 1601 et seq.) in collection and distribu11 tion of fees and charges described by section 4(a)(1) 

12 of the National Suicide Hotline Designation Act of 

13 2020 (Public Law 116–172). 

Æ 


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