IIB 

116TH CONGRESS 

2D SESSION H. R. 4564 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 22, 2020 

Received; read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

AN ACT 

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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Suicide Prevention 

3 Lifeline Improvement Act of 2020’’. 

4 SEC. 2. SUICIDE PREVENTION LIFELINE. 

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

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

7 (1) by redesignating subsection (c) as sub8 section (e); and 

9 (2) by inserting after subsection (b) the fol10 lowing: 

11 ‘‘(c) PLAN.— 

12 ‘‘(1) IN GENERAL.—For purposes of maintain13 ing the suicide prevention hotline under subsection 

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

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

16 ‘‘(2) CONTENTS.—The plan required by para17 graph (1) shall include the following: 

18 ‘‘(A) Quality assurance provisions, includ19 ing— 

20 ‘‘(i) clearly defined and measurable 

21 performance indicators and objectives to 

22 improve the responsiveness and perform23 ance of the hotline, including at backup 

24 call centers; and 


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1 ‘‘(ii) quantifiable timeframes to track 

2 the progress of the hotline in meeting such 

3 performance indicators and objectives. 

4 ‘‘(B) Standards that crisis centers and 

5 backup centers must meet— 

6 ‘‘(i) to participate in the network 

7 under subsection (b)(1); and 

8 ‘‘(ii) to ensure that each telephone 

9 call, online chat message, and other com10 munication received by the hotline, includ11 ing at backup call centers, is answered in 

12 a timely manner by a person, consistent 

13 with the guidance established by the Amer14 ican Association of Suicidology or other 

15 guidance determined by the Secretary to be 

16 appropriate. 

17 ‘‘(C) Guidelines for crisis centers and 

18 backup centers to implement evidence-based 

19 practices including with respect to followup and 

20 referral to other health and social services re21 sources. 

22 ‘‘(D) Guidelines to ensure that resources 

23 are available and distributed to individuals 

24 using the hotline who are not personally in a 

25 time of crisis but know of someone who is. 


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1 ‘‘(E) Guidelines to carry out periodic test2 ing of the hotline, including at crisis centers 

3 and backup centers, during each fiscal year to 

4 identify and correct any problems in a timely 

5 manner. 

6 ‘‘(F) Guidelines to operate in consultation 

7 with the State department of health, local gov8 ernments, Indian tribes, and tribal organiza9 tions. 

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

11 shall— 

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

13 date of enactment of the Suicide Prevention 

14 Lifeline Improvement Act of 2020, complete de15 velopment of the initial version of the plan re16 quired by paragraph (1), begin implementation 

17 of such plan, and make such plan publicly avail18 able; and 

19 ‘‘(B) periodically thereafter, update such 

20 plan and make the updated plan publicly avail21 able.’’. 

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

23 520E–3 of the Public Health Service Act (42 U.S.C. 

24 290bb–36c) is amended by inserting after subsection (c) 


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

2 the following: 

3 ‘‘(d) TRANSMISSION OF DATA TO CDC.—The Sec4 retary shall formalize and strengthen agreements between 

5 the National Suicide Prevention Lifeline program and the 

6 Centers for Disease Control and Prevention to transmit 

7 any necessary epidemiological data from the program to 

8 the Centers, including local call center data, to assist the 

9 Centers in suicide prevention efforts.’’. 

10 (c) AUTHORIZATION OF APPROPRIATIONS.—Sub11 section (e) of section 520E–3 of the Public Health Service 

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

13 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

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

15 there are authorized to be appropriated $50,000,000 

16 for each of fiscal years 2021 through 2023. 

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

18 to be appropriated by paragraph (1) for each of fis19 cal years 2021 through 2023, at least 80 percent 

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

21 SEC. 3. PILOT PROGRAM ON INNOVATIVE TECHNOLOGIES. 

22 (a) PILOT PROGRAM.— 

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

24 Human Services, acting through the Assistant Sec25 retary for Mental Health and Substance Use, shall 


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

2 employ various technologies and platforms of com3 munication (including social media platforms, 

4 texting platforms, and email platforms) for suicide 

5 prevention in addition to the telephone and online 

6 chat service provided by the Suicide Prevention Life7 line. 

8 (2) AUTHORIZATION OF APPROPRIATIONS.—To 

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

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

11 years 2021 and 2022. 

12 (b) REPORT.—Not later than 24 months after the 

13 date on which the pilot program under subsection (a) com14 mences, the Secretary of Health and Human Services, act15 ing through the Assistant Secretary for Mental Health 

16 and Substance Use, shall submit to the Congress a report 

17 on the pilot program. With respect to each platform of 

18 communication employed pursuant to the pilot program, 

19 the report shall include— 

20 (1) a full description of the program; 

21 (2) the number of individuals served by the pro22 gram; 

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

24 receive a response; 


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

2 per individual served; and 

3 (5) any other information the Secretary deter4 mines appropriate. 

5 SEC. 4. HHS STUDY AND REPORT. 

6 Not later than 24 months after the Secretary of 

7 Health and Human Services begins implementation of the 

8 plan required by section 520E–3(c) of the Public Health 

9 Service Act, as added by section 2(a)(2) of this Act, the 

10 Secretary shall— 

11 (1) complete a study on— 

12 (A) the implementation of such plan, in13 cluding the progress towards meeting the objec14 tives identified pursuant to paragraph (2)(A)(i) 

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

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

17 such section 520E–3(c); and 

18 (B) in consultation with the Director of 

19 the Centers for Disease Control and Prevention, 

20 options to expand data gathering from calls to 

21 the Suicide Prevention Lifeline in order to bet22 ter track aspects of usage such as repeat calls, 

23 consistent with applicable Federal and State 

24 privacy laws; and 


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1 (2) submit a report to the Congress on the re2 sults of such study, including recommendations on 

3 whether additional legislation or appropriations are 

4 needed. 

5 SEC. 5. GAO STUDY AND REPORT. 

6 (a) IN GENERAL.—Not later than 24 months after 

7 the Secretary of Health and Human Services begins imple8 mentation of the plan required by section 520E–3(c) of 

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

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

11 shall— 

12 (1) complete a study on the Suicide Prevention 

13 Lifeline; and 

14 (2) submit a report to the Congress on the re15 sults of such study. 

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

17 subsection (a) shall address— 

18 (1) the feasibility of geolocating callers to direct 

19 calls to the nearest crisis center; 

20 (2) operation shortcomings of the Suicide Pre21 vention Lifeline; 

22 (3) geographic coverage of each crisis call cen23 ter; 

24 (4) the call answer rate of each crisis call cen25 ter; 


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

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

3 center; 

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

5 (8) the implementation of the plan under sec6 tion 520E–3(c) of the Public Health Service Act, as 

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

8 progress towards meeting the objectives identified 

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

10 520E–3(c) by the timeframes identified pursuant to 

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

12 (9) service to individuals requesting a foreign 

13 language speaker, including— 

14 (A) the number of calls or chats the Life15 line receives from individuals speaking a foreign 

16 language; 

17 (B) the capacity of the Lifeline to handle 

18 these calls or chats; and 

19 (C) the number of crisis centers with the 

20 capacity to serve foreign language speakers, in 

21 house. 

22 (c) RECOMMENDATIONS.—The report required by 

23 subsection (a) shall include recommendations for improv24 ing the Suicide Prevention Lifeline, including rec25 ommendations for legislative and administrative actions. 


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1 SEC. 6. DEFINITION. 

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

3 means the suicide prevention hotline maintained pursuant 

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

5 U.S.C. 290bb–36c). 

Passed the House of Representatives September 21, 

2020. 

Attest: CHERYL L. JOHNSON, 

Clerk. 


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