I 

116TH CONGRESS 

1ST SESSION H. R. 4564 

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 HOUSE OF REPRESENTATIVES 

SEPTEMBER 27, 2019 

Mr. KATKO (for himself, Mr. BEYER, and Mrs. NAPOLITANO) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

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 2019’’. 

6 SEC. 2. SUICIDE PREVENTION LIFELINE. 

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

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


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1 (1) by redesignating subsection (c) as sub2 section (e); and 

3 (2) by inserting after subsection (b) the fol4 lowing: 

5 ‘‘(c) PLAN.— 

6 ‘‘(1) IN GENERAL.—For purposes of maintain7 ing the suicide prevention hotline under subsection 

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

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

10 ‘‘(2) CONTENTS.—The plan required by para11 graph (1) shall include the following: 

12 ‘‘(A) Quality assurance provisions, includ13 ing— 

14 ‘‘(i) clearly defined and measurable 

15 performance indicators and objectives to 

16 improve the responsiveness and perform17 ance of the hotline, including at backup 

18 call centers; and 

19 ‘‘(ii) quantifiable timeframes to track 

20 the progress of the hotline in meeting such 

21 performance indicators and objectives. 

22 ‘‘(B) Standards that crisis centers and 

23 backup centers must meet— 

24 ‘‘(i) to participate in the network 

25 under subsection (b)(1); and 


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1 ‘‘(ii) to ensure that each telephone 

2 call, online chat message, and other com3 munication received by the hotline, includ4 ing at backup call centers, is answered in 

5 a timely manner by a person, consistent 

6 with the guidance established by the Amer7 ican Association of Suicidology or other 

8 guidance determined by the Secretary to be 

9 appropriate. 

10 ‘‘(C) Guidelines for crisis centers and 

11 backup centers to implement evidence-based 

12 practices including with respect to followup and 

13 referral to other health and social services re14 sources. 

15 ‘‘(D) Guidelines to ensure that resources 

16 are available and distributed to individuals 

17 using the hotline who are not personally in a 

18 time of crisis but know of someone who is. 

19 ‘‘(E) Guidelines to carry out periodic test20 ing of the hotline, including at crisis centers 

21 and backup centers, during each fiscal year to 

22 identify and correct any problems in a timely 

23 manner. 

24 ‘‘(F) Guidelines to operate in consultation 

25 with the State department of health, local govVerDate Sep 11 2014 02:15 Oct 03, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4564.IH H4564

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1 ernments, Indian tribes, and tribal organiza2 tions. 

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

4 shall— 

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

6 date of enactment of the Suicide Prevention 

7 Lifeline Improvement Act of 2019, complete de8 velopment of the initial version of the plan re9 quired by paragraph (1), begin implementation 

10 of such plan, and make such plan publicly avail11 able; and 

12 ‘‘(B) periodically thereafter, update such 

13 plan and make the updated plan publicly avail14 able.’’. 

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

16 520E–3 of the Public Health Service Act (42 U.S.C. 

17 290bb–36c) is amended by inserting after subsection (c) 

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

19 the following: 

20 ‘‘(d) TRANSMISSION OF DATA TO CDC.—The Sec21 retary shall formalize and strengthen agreements between 

22 the National Suicide Prevention Lifeline program and the 

23 Centers for Disease Control and Prevention to transmit 

24 any necessary epidemiological data from the program to 


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

2 Centers in suicide prevention efforts.’’. 

3 (c) AUTHORIZATION OF APPROPRIATIONS.—Sub4 section (e) of section 520E–3 of the Public Health Service 

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

6 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

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

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

9 for each of fiscal years 2020 through 2022. 

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

11 to be appropriated by paragraph (1) for each of fis12 cal years 2020 through 2022, at least 80 percent 

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

14 SEC. 3. PILOT PROGRAM ON INNOVATIVE TECHNOLOGIES. 

15 (a) PILOT PROGRAM.— 

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

17 Human Services, acting through the Assistant Sec18 retary for Mental Health and Substance Use, shall 

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

20 employ various technologies and platforms of com21 munication (including social media platforms, 

22 texting platforms, and email platforms) for suicide 

23 prevention in addition to the telephone and online 

24 chat service provided by the Suicide Prevention Life25 line. 


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1 (2) AUTHORIZATION OF APPROPRIATIONS.—To 

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

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

4 years 2020 and 2021. 

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

6 date on which the pilot program under subsection (a) com7 mences, the Secretary of Health and Human Services, act8 ing through the Assistant Secretary for Mental Health 

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

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

11 communication employed pursuant to the pilot program, 

12 the report shall include— 

13 (1) a full description of the program; 

14 (2) the number of individuals served by the pro15 gram; 

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

17 receive a response; 

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

19 per individual served; and 

20 (5) any other information the Secretary deter21 mines appropriate. 

22 SEC. 4. HHS STUDY AND REPORT. 

23 Not later than 24 months after the Secretary of 

24 Health and Human Services begins implementation of the 

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


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

2 Secretary shall— 

3 (1) complete a study on— 

4 (A) the implementation of such plan, in5 cluding the progress towards meeting the objec6 tives identified pursuant to paragraph (2)(A)(i) 

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

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

9 such section 520E–3(c); and 

10 (B) in consultation with the Director of 

11 the Centers for Disease Control and Prevention, 

12 options to expand data gathering from calls to 

13 the Suicide Prevention Lifeline in order to bet14 ter track aspects of usage such as repeat calls, 

15 consistent with applicable Federal and State 

16 privacy laws; and 

17 (2) submit a report to the Congress on the re18 sults of such study, including recommendations on 

19 whether additional legislation or appropriations are 

20 needed. 

21 SEC. 5. GAO STUDY AND REPORT. 

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

23 the Secretary of Health and Human Services begins imple24 mentation of the plan required by section 520E–3(c) of 

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


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

2 shall— 

3 (1) complete a study on the Suicide Prevention 

4 Lifeline; and 

5 (2) submit a report to the Congress on the re6 sults of such study. 

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

8 subsection (a) shall address— 

9 (1) the feasibility of geolocating callers to direct 

10 calls to the nearest crisis center; 

11 (2) operation shortcomings of the Suicide Pre12 vention Lifeline; 

13 (3) geographic coverage of each crisis call cen14 ter; 

15 (4) the call answer rate of each crisis call cen16 ter; 

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

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

19 center; 

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

21 (8) the implementation of the plan under sec22 tion 520E–3(c) of the Public Health Service Act, as 

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

24 progress towards meeting the objectives identified 

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


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1 520E–3(c) by the timeframes identified pursuant to 

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

3 (9) service to individuals requesting a foreign 

4 language speaker, including— 

5 (A) the number of calls or chats the Life6 line receives from individuals speaking a foreign 

7 language; 

8 (B) the capacity of the Lifeline to handle 

9 these calls or chats; and 

10 (C) the number of crisis centers with the 

11 capacity to serve foreign language speakers, in 

12 house. 

13 (c) RECOMMENDATIONS.—The report required by 

14 subsection (a) shall include recommendations for improv15 ing the Suicide Prevention Lifeline, including rec16 ommendations for legislative and administrative actions. 

17 SEC. 6. DEFINITION. 

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

19 means the suicide prevention hotline maintained pursuant 

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

21 U.S.C. 290bb–36c). 

Æ 


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