I 
116TH CONGRESS 
1ST SESSION H. R. 4564 
To amend the Public Health Service Act to ensure the provision of high- 
quality 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 provi-
sion of high-quality service through the Suicide Preven-
tion Lifeline, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Suicide Prevention 
Lifeline Improvement Act of 2019’’. 
SEC. 2. SUICIDE PREVENTION LIFELINE. 
(a) PLAN.—Section 520E–3 of the Public Health 
Service Act (42 U.S.C. 290bb–36c) is amended— 
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(1) by redesignating subsection (c) as sub-
section (e); and 
(2) by inserting after subsection (b) the fol-
lowing: 
‘‘(c) PLAN.— 
‘‘(1) IN GENERAL.—For purposes of maintain-
ing the suicide prevention hotline under subsection 
(b)(2), the Secretary shall develop and implement a 
plan to ensure the provision of high-quality service. 
‘‘(2) CONTENTS.—The plan required by para-
graph (1) shall include the following: 
‘‘(A) Quality assurance provisions, includ-
ing— 
‘‘(i) clearly defined and measurable 
performance indicators and objectives to 
improve the responsiveness and perform-
ance of the hotline, including at backup 
call centers; and 
‘‘(ii) quantifiable timeframes to track 
the progress of the hotline in meeting such 
performance indicators and objectives. 
‘‘(B) Standards that crisis centers and 
backup centers must meet— 
‘‘(i) to participate in the network 
under subsection (b)(1); and 
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‘‘(ii) to ensure that each telephone 
call, online chat message, and other com-
munication received by the hotline, includ-
ing at backup call centers, is answered in 
a timely manner by a person, consistent 
with the guidance established by the Amer-
ican Association of Suicidology or other 
guidance determined by the Secretary to be 
appropriate. 
‘‘(C) Guidelines for crisis centers and 
backup centers to implement evidence-based 
practices including with respect to followup and 
referral to other health and social services re-
sources. 
‘‘(D) Guidelines to ensure that resources 
are available and distributed to individuals 
using the hotline who are not personally in a 
time of crisis but know of someone who is. 
‘‘(E) Guidelines to carry out periodic test-
ing of the hotline, including at crisis centers 
and backup centers, during each fiscal year to 
identify and correct any problems in a timely 
manner. 
‘‘(F) Guidelines to operate in consultation 
with the State department of health, local gov-
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ernments, Indian tribes, and tribal organiza-
tions. 
‘‘(3) INITIAL PLAN; UPDATES.—The Secretary 
shall— 
‘‘(A) not later than 6 months after the 
date of enactment of the Suicide Prevention 
Lifeline Improvement Act of 2019, complete de-
velopment of the initial version of the plan re-
quired by paragraph (1), begin implementation 
of such plan, and make such plan publicly avail-
able; and 
‘‘(B) periodically thereafter, update such 
plan and make the updated plan publicly avail-
able.’’. 
(b) TRANSMISSION
OF DATA
TO CDC.—Section 
520E–3 of the Public Health Service Act (42 U.S.C. 
290bb–36c) is amended by inserting after subsection (c) 
of such section, as added by subsection (a) of this section, 
the following: 
‘‘(d) TRANSMISSION OF DATA TO CDC.—The Sec-
retary shall formalize and strengthen agreements between 
the National Suicide Prevention Lifeline program and the 
Centers for Disease Control and Prevention to transmit 
any necessary epidemiological data from the program to 
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the Centers, including local call center data, to assist the 
Centers in suicide prevention efforts.’’. 
(c) AUTHORIZATION
OF
APPROPRIATIONS.—Sub-
section (e) of section 520E–3 of the Public Health Service 
Act (42 U.S.C. 290bb–36c) is amended to read as follows: 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—To carry out this section, 
there are authorized to be appropriated $50,000,000 
for each of fiscal years 2020 through 2022. 
‘‘(2) ALLOCATION.—Of the amount authorized 
to be appropriated by paragraph (1) for each of fis-
cal years 2020 through 2022, at least 80 percent 
shall be made available to crisis centers.’’. 
SEC. 3. PILOT PROGRAM ON INNOVATIVE TECHNOLOGIES. 
(a) PILOT PROGRAM.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Assistant Sec-
retary for Mental Health and Substance Use, shall 
carry out a pilot program to research, analyze, and 
employ various technologies and platforms of com-
munication 
(including 
social 
media 
platforms, 
texting platforms, and email platforms) for suicide 
prevention in addition to the telephone and online 
chat service provided by the Suicide Prevention Life-
line. 
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(2) AUTHORIZATION OF APPROPRIATIONS.—To 
carry out paragraph (1), there is authorized to be 
appropriated $5,000,000 for the period of fiscal 
years 2020 and 2021. 
(b) REPORT.—Not later than 24 months after the 
date on which the pilot program under subsection (a) com-
mences, the Secretary of Health and Human Services, act-
ing through the Assistant Secretary for Mental Health 
and Substance Use, shall submit to the Congress a report 
on the pilot program. With respect to each platform of 
communication employed pursuant to the pilot program, 
the report shall include— 
(1) a full description of the program; 
(2) the number of individuals served by the pro-
gram; 
(3) the average wait time for each individual to 
receive a response; 
(4) the cost of the program, including the cost 
per individual served; and 
(5) any other information the Secretary deter-
mines appropriate. 
SEC. 4. HHS STUDY AND REPORT. 
Not later than 24 months after the Secretary of 
Health and Human Services begins implementation of the 
plan required by section 520E–3(c) of the Public Health 
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Service Act, as added by section 2(a)(2) of this Act, the 
Secretary shall— 
(1) complete a study on— 
(A) the implementation of such plan, in-
cluding the progress towards meeting the objec-
tives identified pursuant to paragraph (2)(A)(i) 
of such section 520E–3(c) by the timeframes 
identified pursuant to paragraph (2)(A)(ii) of 
such section 520E–3(c); and 
(B) in consultation with the Director of 
the Centers for Disease Control and Prevention, 
options to expand data gathering from calls to 
the Suicide Prevention Lifeline in order to bet-
ter track aspects of usage such as repeat calls, 
consistent with applicable Federal and State 
privacy laws; and 
(2) submit a report to the Congress on the re-
sults of such study, including recommendations on 
whether additional legislation or appropriations are 
needed. 
SEC. 5. GAO STUDY AND REPORT. 
(a) IN GENERAL.—Not later than 24 months after 
the Secretary of Health and Human Services begins imple-
mentation of the plan required by section 520E–3(c) of 
the Public Health Service Act, as added by section 2(a)(2) 
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of this Act, the Comptroller General of the United States 
shall— 
(1) complete a study on the Suicide Prevention 
Lifeline; and 
(2) submit a report to the Congress on the re-
sults of such study. 
(b) ISSUES TO BE STUDIED.—The study required by 
subsection (a) shall address— 
(1) the feasibility of geolocating callers to direct 
calls to the nearest crisis center; 
(2) operation shortcomings of the Suicide Pre-
vention Lifeline; 
(3) geographic coverage of each crisis call cen-
ter; 
(4) the call answer rate of each crisis call cen-
ter; 
(5) the call wait time of each crisis call center; 
(6) the hours of operation of each crisis call 
center; 
(7) funding avenues of each crisis call center; 
(8) the implementation of the plan under sec-
tion 520E–3(c) of the Public Health Service Act, as 
added by section 2(a) of this Act, including the 
progress towards meeting the objectives identified 
pursuant to paragraph (2)(A)(i) of such section 
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