II 

Calendar No. 128 

117TH CONGRESS 

1ST SESSION S. 2425 

To amend the Public Health Service Act to ensure the provision of highquality service through the Suicide Prevention Lifeline, and for other 

purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 21, 2021 

Mr. REED (for himself, Mr. MORAN, Mr. LUJA ́N, and Ms. MURKOWSKI) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

SEPTEMBER 21, 2021 

Reported by Mrs. MURRAY, with an amendment 

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

A BILL 

To amend the Public Health Service Act to ensure the provision of high-quality service through the Suicide Prevention Lifeline, 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 Lifeline Improvement Act of 2021’’. 


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1 SEC. 2. SUICIDE PREVENTION LIFELINE. 

2 (a) PLAN.—Section 520E–3 of the Public Health 

3 Service Act (42 U.S.C. 290bb–36c) is amended— 

4 (1) by redesignating subsection (c) as sub5 section (e); and 

6 (2) by inserting after subsection (b) the fol7 lowing: 

8 ‘‘(c) PLAN.— 

9 ‘‘(1) IN GENERAL.—For purposes of maintain10 ing the suicide prevention hotline under subsection 

11 (b)(2), the Secretary shall develop and implement a 

12 plan to ensure the provision of high-quality service. 

13 ‘‘(2) CONTENTS.—The plan required by para14 graph (1) shall include the following: 

15 ‘‘(A) Quality assurance provisions, includ16 ing— 

17 ‘‘(i) clearly defined and measurable 

18 performance indicators and objectives to 

19 improve the responsiveness and perform20 ance of the hotline, including at backup 

21 call centers; and 

22 ‘‘(ii) quantifiable timeframes to track 

23 the progress of the hotline in meeting such 

24 performance indicators and objectives. 

25 ‘‘(B) Standards that crisis centers and 

26 backup centers must meet— 


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1 ‘‘(i) to participate in the network 

2 under subsection (b)(1); and 

3 ‘‘(ii) to ensure that each telephone 

4 call, online chat message, and other com5 munication received by the hotline, includ6 ing at backup call centers, is answered in 

7 a timely manner by a person, consistent 

8 with the guidance established by the Amer9 ican Association of Suicidology or other 

10 guidance determined by the Secretary to be 

11 appropriate. 

12 ‘‘(C) Guidelines for crisis centers and 

13 backup centers to implement evidence-based 

14 practices including with respect to followup and 

15 referral to other health and social services re16 sources. 

17 ‘‘(D) Guidelines to ensure that resources 

18 are available and distributed to individuals 

19 using the hotline who are not personally in a 

20 time of crisis but know of someone who is. 

21 ‘‘(E) Guidelines to carry out periodic test22 ing of the hotline, including at crisis centers 

23 and backup centers, during each fiscal year to 

24 identify and correct any problems in a timely 

25 manner. 


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1 ‘‘(F) Guidelines to operate in consultation 

2 with the State department of health, local gov3 ernments, Indian tribes, and tribal organiza4 tions. 

5 ‘‘(3) INITIAL PLAN; UPDATES.—The Secretary 

6 shall— 

7 ‘‘(A) not later than 6 months after the 

8 date of enactment of the Suicide Prevention 

9 Lifeline Improvement Act of 2021, complete de10 velopment of the initial version of the plan re11 quired by paragraph (1), begin implementation 

12 of such plan, and make such plan publicly avail13 able; and 

14 ‘‘(B) periodically thereafter, update such 

15 plan and make the updated plan publicly avail16 able.’’. 

17 (b) TRANSMISSION OF DATA TO CDC.—Section 

18 520E–3 of the Public Health Service Act (42 U.S.C. 

19 290bb–36c) is amended by inserting after subsection (c) 

20 of such section, as added by subsection (a) of this section, 

21 the following: 

22 ‘‘(d) TRANSMISSION OF DATA TO CDC.—The Sec23 retary shall formalize and strengthen agreements between 

24 the National Suicide Prevention Lifeline program and the 

25 Centers for Disease Control and Prevention to transmit 


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1 any necessary epidemiological data from the program to 

2 the Centers for Disease Control and Prevention, including 

3 local call center data, to assist the Centers in suicide pre4 vention efforts.’’. 

5 (c) AUTHORIZATION OF APPROPRIATIONS.—Sub6 section (e) of section 520E–3 of the Public Health Service 

7 Act (42 U.S.C. 290bb–36c) is amended to read as follows: 

8 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

9 ‘‘(1) IN GENERAL.—To carry out this section, 

10 there are authorized to be appropriated 

11 $113,600,000 for each of fiscal years 2022 through 

12 2024. 

13 ‘‘(2) ALLOCATION.—Of the amount authorized 

14 to be appropriated by paragraph (1) for each of fis15 cal years 2022 through 2024, at least 80 percent 

16 shall be made available to crisis centers.’’. 

17 SEC. 3. PILOT PROGRAM ON INNOVATIVE TECHNOLOGIES. 

18 (a) PILOT PROGRAM.— 

19 (1) IN GENERAL.—The Secretary of Health and 

20 Human Services, acting through the Assistant Sec21 retary for Mental Health and Substance Use, shall 

22 carry out a pilot program to research, analyze, and 

23 employ various technologies and platforms of com24 munication (including social media platforms, 

25 texting platforms, and email platforms) for suicide 


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1 prevention in addition to the telephone and online 

2 chat service provided by the Suicide Prevention Life3 line. 

4 (2) AUTHORIZATION OF APPROPRIATIONS.—To 

5 carry out paragraph (1), there is authorized to be 

6 appropriated $5,000,000 for the period of fiscal 

7 years 2022 and 2023. 

8 (b) REPORT.—Not later than 2 years after the date 

9 on which the pilot program under subsection (a) com10 mences, the Secretary of Health and Human Services, act11 ing through the Assistant Secretary for Mental Health 

12 and Substance Use, shall submit to Congress a report on 

13 the pilot program. With respect to each platform of com14 munication employed pursuant to the pilot program, the 

15 report shall include— 

16 (1) a full description of the program; 

17 (2) the number of individuals served by the pro18 gram; 

19 (3) the average wait time for each individual to 

20 receive a response; 

21 (4) the cost of the program, including the cost 

22 per individual served; and 

23 (5) any other information the Secretary deter24 mines appropriate. 


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1 SEC. 4. HHS STUDY AND REPORT. 

2 Not later than 2 years after the Secretary of Health 

3 and Human Services begins implementation of the plan 

4 required by section 520E–3(c) of the Public Health Serv5 ice Act, as added by section 2(a)(2) of this Act, the Sec6 retary shall— 

7 (1) complete a study on— 

8 (A) the implementation of such plan, in9 cluding the progress towards meeting the objec10 tives identified pursuant to paragraph (2)(A)(i) 

11 of such section 520E–3(c) by the timeframes 

12 identified pursuant to paragraph (2)(A)(ii) of 

13 such section 520E–3(c); and 

14 (B) in consultation with the Director of 

15 the Centers for Disease Control and Prevention, 

16 options to expand data gathering from calls to 

17 the Suicide Prevention Lifeline in order to bet18 ter track aspects of usage such as repeat calls, 

19 consistent with applicable Federal and State 

20 privacy laws; and 

21 (2) submit a report to Congress on the results 

22 of such study, including recommendations on wheth23 er additional legislation or appropriations are need24 ed. 


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1 SEC. 5. GAO STUDY AND REPORT. 

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

3 Secretary of Health and Human Services begins imple4 mentation of the plan required by section 520E–3(c) of 

5 the Public Health Service Act, as added by section 2(a)(2) 

6 of this Act, the Comptroller General of the United States 

7 shall— 

8 (1) complete a study on the Suicide Prevention 

9 Lifeline; and 

10 (2) submit a report to Congress on the results 

11 of such study. 

12 (b) ISSUES TO BE STUDIED.—The study required by 

13 subsection (a) shall address— 

14 (1) the feasibility of geolocating callers to direct 

15 calls to the nearest crisis center; 

16 (2) operation shortcomings of the Suicide Pre17 vention Lifeline; 

18 (3) geographic coverage of each crisis call cen19 ter; 

20 (4) the call answer rate of each crisis call cen21 ter; 

22 (5) the call wait time of each crisis call center; 

23 (6) the hours of operation of each crisis call 

24 center; 

25 (7) funding avenues of each crisis call center; 


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1 (8) the implementation of the plan under sec2 tion 520E–3(c) of the Public Health Service Act, as 

3 added by section 2(a) of this Act, including the 

4 progress towards meeting the objectives identified 

5 pursuant to paragraph (2)(A)(i) of such section 

6 520E–3(c) by the timeframes identified pursuant to 

7 paragraph (2)(A)(ii) of such section 520E–3(c); and 

8 (9) service to individuals requesting a foreign 

9 language speaker, including— 

10 (A) the number of calls or chats the Life11 line receives from individuals speaking a foreign 

12 language; 

13 (B) the capacity of the Lifeline to handle 

14 these calls or chats; and 

15 (C) the number of crisis centers with the 

16 capacity to serve foreign language speakers, in 

17 house. 

18 (c) RECOMMENDATIONS.—The report required by 

19 subsection (a) shall include recommendations for improv20 ing the Suicide Prevention Lifeline, including rec21 ommendations for legislative and administrative actions. 

22 SEC. 6. DEFINITION. 

23 In this Act, the term ‘‘Suicide Prevention Lifeline’’ 

24 means the suicide prevention hotline maintained pursuant 


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1 to section 520E–3 of the Public Health Service Act (42 

2 U.S.C. 290bb–36c). 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Suicide Prevention Life5 line Improvement Act of 2021’’. 

6 SEC. 2. SUICIDE PREVENTION LIFELINE. 

7 (a) ACTIVITIES.—Section 520E–3(b) of the Public 

8 Health Service Act (42 U.S.C. 290bb–36c(b)) is amended— 

9 (1) in paragraph (1)— 

10 (A) by inserting ‘‘supporting and’’ before 

11 ‘‘coordinating’’; and 

12 (B) by striking ‘‘crisis intervention serv13 ices’’ and inserting ‘‘mental health crisis inter14 vention services, including appropriate follow-up 

15 services,’’; 

16 (2) in paragraph (2), by striking ‘‘; and’’ and 

17 inserting a semicolon; 

18 (3) in paragraph (3), by striking the period and 

19 inserting a semicolon; and 

20 (4) by adding at the end the following: 

21 ‘‘(4) improving awareness of the program for 

22 suicide prevention and mental health crisis interven23 tion services, including by conducting an awareness 

24 initiative and ongoing outreach to the public; and 


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1 ‘‘(5) improving the collection and analysis of de2 mographic information, in a manner that protects 

3 personal privacy, consistent with applicable Federal 

4 and State privacy laws, in order to understand dis5 parities in access to the program among individuals 

6 who are seeking help.’’. 

7 (b) PLAN.—Section 520E–3 of the Public Health Serv8 ice Act (42 U.S.C. 290bb–36c) is amended— 

9 (1) by redesignating subsection (c) as subsection 

10 (e); and 

11 (2) by inserting after subsection (b) the fol12 lowing: 

13 ‘‘(c) PLAN.— 

14 ‘‘(1) IN GENERAL.—For purposes of supporting 

15 the crisis centers under subsection (b)(1) and main16 taining the suicide prevention hotline under sub17 section (b)(2), the Secretary shall develop and imple18 ment a plan to ensure the provision of high-quality 

19 services. 

20 ‘‘(2) CONTENTS.—The plan required by para21 graph (1) shall include the following: 

22 ‘‘(A) Program evaluation, including per23 formance measures to assess progress toward the 

24 goals and objectives of the program and to imVerDate Sep 11 2014 23:55 Sep 21, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6203 E:\BILLS\S2425.RS S2425

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1 prove the responsiveness and performance of the 

2 hotline, including at backup call centers. 

3 ‘‘(B) Requirements that crisis centers and 

4 backup centers must meet— 

5 ‘‘(i) to participate in the network 

6 under subsection (b)(1); and 

7 ‘‘(ii) to ensure that each telephone call 

8 and applicable other communication re9 ceived by the hotline, including at backup 

10 call centers, is answered in a timely man11 ner, consistent with evidence-based guidance 

12 or other guidance or best practices, as ap13 propriate. 

14 ‘‘(C) Specific recommendations and strate15 gies for implementing evidence-based practices, 

16 including with respect to follow-up and commu17 nicating the availability of resources in the com18 munity for individuals in need. 

19 ‘‘(D) Criteria for carrying out periodic test20 ing of the hotline during each fiscal year, includ21 ing at crisis centers and backup centers, to iden22 tify and address any problems in a timely man23 ner. 

24 ‘‘(3) CONSULTATION.—In developing require25 ments under paragraph (2)(B), the Secretary shall 


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1 consult with State departments of health, local gov2 ernments, Indian Tribes, and Tribal organizations. 

3 ‘‘(4) INITIAL PLAN; UPDATES.—The Secretary 

4 shall— 

5 ‘‘(A) not later than 1 year after the date of 

6 enactment of the Suicide Prevention Lifeline Im7 provement Act of 2021, complete development of 

8 the initial plan under paragraph (1) and make 

9 such plan publicly available; and 

10 ‘‘(B) periodically thereafter, update such 

11 plan and make the updated plan publicly avail12 able.’’. 

13 (c) DATA TO ASSIST STATE AND LOCAL AGENCIES.— 

14 Section 520E–3 of the Public Health Service Act (42 U.S.C. 

15 290bb-36c) is amended by inserting after subsection (c) of 

16 such section, as added by subsection (b) of this section, the 

17 following: 

18 ‘‘(d) DATA TO ASSIST STATE AND LOCAL SUICIDE

19 PREVENTION ACTIVITIES.—The Secretary shall ensure that 

20 the aggregated information collected and any applicable 

21 analyses conducted under subsection (b)(5), including from 

22 local call centers, as applicable, are made available in a 

23 useable format to State and local agencies in order to in24 form suicide prevention activities.’’. 


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1 (d) AUTHORIZATION OF APPROPRIATIONS.—Sub2 section (e) of section 520E–3 of the Public Health Service 

3 Act (42 U.S.C. 290bb–36c), as redesignated by subsection 

4 (b)(1), is amended by striking ‘‘$7,198,000 for each of fiscal 

5 years 2018 through 2022’’ and inserting ‘‘such sums as may 

6 be necessary for each of fiscal years 2023 through 2027’’. 

7 SEC. 3. HHS REPORT. 

8 Not later than 2 years after the Secretary of Health 

9 and Human Services submits the plan under subsection 

10 (c)(1) of section 520E–3 of the Public Health Service Act, 

11 as added by section 2(b)(2) of this Act, the Secretary shall 

12 submit a report to Congress on the progress made on meet13 ing the objectives identified pursuant to subsection 

14 (c)(2)(A)(i) of such section 520E–3 and recommendations 

15 on improving the program, including improvements to en16 hance data collection and usage. 

17 SEC. 4. GAO STUDY AND REPORT. 

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

19 Secretary of Health and Human Services begins implemen20 tation of the plan required by section 520E–3(c)(1) of the 

21 Public Health Service Act, as added by section 2(b)(2) of 

22 this Act, the Comptroller General of the United States shall 

23 complete a study on the Suicide Prevention Lifeline and 

24 submit a report to Congress on the results of such study. 


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1 (b) CONTENT.—The study required by subsection (a) 

2 shall include what is known about— 

3 (1) the feasibility of routing calls to the Suicide 

4 Prevention Lifeline to the nearest appropriate crisis 

5 center based on the physical location of the contact; 

6 (2) capacity of the Suicide Prevention Lifeline; 

7 (3) State and regional variation with respect to 

8 access to crisis call centers described in section 520E– 

9 3(b)(1) of the Public Health Service Act (42 U.S.C. 

10 290bb–36c(b)(1)), including wait times, answer times, 

11 hours of operation, and funding sources; 

12 (4) the implementation of the plan under section 

13 520E–3(c) of the Public Health Service Act, as added 

14 by section 2(b)(2) of this Act, including the progress 

15 toward meeting the objectives in such plan; and 

16 (5) capacity of the Suicide Prevention Lifeline to 

17 handle calls from individuals with limited English 

18 proficiency. 

19 SEC. 5. DEFINITION. 

20 In this Act, the term ‘‘Suicide Prevention Lifeline’’ 

21 means the suicide prevention hotline maintained pursuant 

22 to section 520E–3 of the Public Health Service Act (42 

23 U.S.C. 290bb–36c). 


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Calendar No. 128 

117TH CONGRESS 

1ST SESSION S. 2425 

A BILL 

To amend the Public Health Service Act to ensure 

poses. Suicide Prevention Lifeline, and for other purthe provision of high-quality service through the 

SEPTEMBER 21, 2021 

Reported with an amendment 


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