IB 

Union Calendar No. 417 

116TH CONGRESS 

2D SESSION H. R. 4564 

[Report No. 116–517] 

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 

SEPTEMBER 18, 2020 

Additional sponsors: Mr. MCADAMS, Mr. MOULTON, Ms. SLOTKIN, Ms. 

SPANBERGER, Mr. STEWART, Ms. FINKENAUER, Mr. HARDER of California, Mr. STIVERS, Ms. NORTON, Mr. BALDERSON, Mr. TRONE, Mr. 

SOTO, and Mr. DELGADO

SEPTEMBER 18, 2020 

Reported from the Committee on Energy and Commerce; committed to the 

Committee of the Whole House on the State of the Union and ordered 

to be printed 


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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. 


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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— 

9 (1) by redesignating subsection (c) as sub10 section (e); and 

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

13 ‘‘(c) PLAN.— 

14 ‘‘(1) IN GENERAL.—For purposes of maintain15 ing the suicide prevention hotline under subsection 

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

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

18 ‘‘(2) CONTENTS.—The plan required by para19 graph (1) shall include the following: 

20 ‘‘(A) Quality assurance provisions, includ21 ing— 

22 ‘‘(i) clearly defined and measurable 

23 performance indicators and objectives to 

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1 ance of the hotline, including at backup 

2 call centers; and 

3 ‘‘(ii) quantifiable timeframes to track 

4 the progress of the hotline in meeting such 

5 performance indicators and objectives. 

6 ‘‘(B) Standards that crisis centers and 

7 backup centers must meet— 

8 ‘‘(i) to participate in the network 

9 under subsection (b)(1); and 

10 ‘‘(ii) to ensure that each telephone 

11 call, online chat message, and other com12 munication received by the hotline, includ13 ing at backup call centers, is answered in 

14 a timely manner by a person, consistent 

15 with the guidance established by the Amer16 ican Association of Suicidology or other 

17 guidance determined by the Secretary to be 

18 appropriate. 

19 ‘‘(C) Guidelines for crisis centers and 

20 backup centers to implement evidence-based 

21 practices including with respect to followup and 

22 referral to other health and social services re23 sources. 

24 ‘‘(D) Guidelines to ensure that resources 

25 are available and distributed to individuals 


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1 using the hotline who are not personally in a 

2 time of crisis but know of someone who is. 

3 ‘‘(E) Guidelines to carry out periodic test4 ing of the hotline, including at crisis centers 

5 and backup centers, during each fiscal year to 

6 identify and correct any problems in a timely 

7 manner. 

8 ‘‘(F) Guidelines to operate in consultation 

9 with the State department of health, local gov10 ernments, Indian tribes, and tribal organiza11 tions. 

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

13 shall— 

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

15 date of enactment of the Suicide Prevention 

16 Lifeline Improvement Act of 2019, complete de17 velopment of the initial version of the plan re18 quired by paragraph (1), begin implementation 

19 of such plan, and make such plan publicly avail20 able; and 

21 ‘‘(B) periodically thereafter, update such 

22 plan and make the updated plan publicly avail23 able.’’. 

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

25 520E–3 of the Public Health Service Act (42 U.S.C. 


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1 290bb–36c) is amended by inserting after subsection (c) 

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

3 the following: 

4 ‘‘(d) TRANSMISSION OF DATA TO CDC.—The Sec5 retary shall formalize and strengthen agreements between 

6 the National Suicide Prevention Lifeline program and the 

7 Centers for Disease Control and Prevention to transmit 

8 any necessary epidemiological data from the program to 

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

10 Centers in suicide prevention efforts.’’. 

11 (c) AUTHORIZATION OF APPROPRIATIONS.—Sub12 section (e) of section 520E–3 of the Public Health Service 

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

14 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

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

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

17 for each of fiscal years 2020 through 2022. 

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

19 to be appropriated by paragraph (1) for each of fis20 cal years 2020 through 2022, at least 80 percent 

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

22 SEC. 3. PILOT PROGRAM ON INNOVATIVE TECHNOLOGIES. 

23 (a) PILOT PROGRAM.— 

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

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1 retary for Mental Health and Substance Use, shall 

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

3 employ various technologies and platforms of com4 munication (including social media platforms, 

5 texting platforms, and email platforms) for suicide 

6 prevention in addition to the telephone and online 

7 chat service provided by the Suicide Prevention Life8 line. 

9 (2) AUTHORIZATION OF APPROPRIATIONS.—To 

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

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

12 years 2020 and 2021. 

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

14 date on which the pilot program under subsection (a) com15 mences, the Secretary of Health and Human Services, act16 ing through the Assistant Secretary for Mental Health 

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

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

19 communication employed pursuant to the pilot program, 

20 the report shall include— 

21 (1) a full description of the program; 

22 (2) the number of individuals served by the pro23 gram; 

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

25 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). 


kjohnson on DSK79L0C42PROD with BILLS
Union Calendar No. 417 

116TH CONGRESS 

2D SESSION H. R. 4564 

[Report No. 116–517] 

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 18, 2020 

Reported from the Committee on Energy and Commerce; 

the State of the Union and ordered to be printed committed to the Committee of the Whole House on 


kjohnson on DSK79L0C42PROD with BILLS