I 
116TH CONGRESS 
2D SESSION 
H. R. 5619 
To authorize a pilot program to expand and intensify surveillance of self- 
harm in partnership with State and local public health departments, 
to establish a grant program to provide self-harm and suicide prevention 
services in hospital emergency departments, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 15, 2020 
Mr. STEWART (for himself and Ms. MATSUI) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
A BILL 
To authorize a pilot program to expand and intensify surveil-
lance of self-harm in partnership with State and local 
public health departments, to establish a grant program 
to provide self-harm and suicide prevention services in 
hospital emergency departments, 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 
Act’’. 
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SEC. 2. SYNDROMIC SURVEILLANCE OF SELF-HARM BEHAV-
IORS PROGRAM. 
Title III of the Public Health Service Act is amended 
by inserting after section 317T of such Act (42 U.S.C. 
247b–22) the following: 
‘‘SEC. 317U. SYNDROMIC SURVEILLANCE OF SELF-HARM BE-
HAVIORS PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall award grants to State, local, Tribal, and ter-
ritorial public health departments for the expansion of sur-
veillance of self-harm. 
‘‘(b) DATA SHARING BY GRANTEES.—As a condition 
of receipt of such grant under subsection (a), each grantee 
shall agree to share with the Centers for Disease Control 
and Prevention in real time, to the extent feasible and as 
specified in the grant agreement, data on suicides and self- 
harm for purposes of— 
‘‘(1) tracking and monitoring self-harm to in-
form response activities to suicide clusters; 
‘‘(2) informing prevention programming for 
identified at-risk populations; and 
‘‘(3) conducting or supporting research. 
‘‘(c) DISAGGREGATION
OF DATA.—The Secretary 
shall provide for the data collected through surveillance 
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of self-harm under subsection (b) to be disaggregated by 
the following categories: 
‘‘(1) Nonfatal self-harm data of any intent. 
‘‘(2) Data on suicidal ideation. 
‘‘(3) Data on self-harm where there is no evi-
dence, whether implicit or explicit, of suicidal intent. 
‘‘(4) Data on self-harm where there is evidence, 
whether implicit or explicit, of suicidal intent. 
‘‘(5) Data on self-harm where suicidal intent is 
unclear based on the available evidence. 
‘‘(d) PRIORITY.—In making awards under subsection 
(a), the Secretary shall give priority to eligible entities that 
are— 
‘‘(1) located in a State with an age-adjusted 
rate of suicide death that is above the national sui-
cide mortality rate, as determined by the Director of 
the Centers for Disease Control and Prevention; 
‘‘(2) serving an Indian Tribe (as defined in sec-
tion 4 of the Indian Self-Determination and Edu-
cation Assistance Act) with an age-adjusted rate of 
suicide deaths that is above the national suicide 
mortality rate, as determined through appropriate 
mechanisms determined by the Secretary in con-
sultation with Indian Tribes; or 
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‘‘(3) located in a State with a high rate of cov-
erage of statewide (or Tribal) emergency department 
visits, as determined by the Director of the Centers 
for Disease Control and Prevention. 
‘‘(e) 
GEOGRAPHIC
DISTRIBUTION.—In 
making 
grants under this section, the Secretary shall make an ef-
fort to ensure geographic distribution, taking into account 
the unique needs of rural communities, including— 
‘‘(1) communities with an incidence of individ-
uals with serious mental illness, demonstrated suici-
dal ideation or behavior, or suicide rates that are 
above the national average, as determined by the As-
sistant Secretary for Mental Health and Substance 
Use; 
‘‘(2) communities with a shortage of prevention 
and treatment services, as determined by the Assist-
ant Secretary for Mental Health and Substance Use 
and the Administrator of the Health Resources and 
Services Administration; and 
‘‘(3) other appropriate community-level factors 
and social determinants of health such as income, 
employment, and education. 
‘‘(f) PERIOD OF PARTICIPATION.—To be selected as 
a grant recipient under this section, a State, local, Tribal, 
or territorial public health department shall agree to par-
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ticipate in the program for a period of not less than 2 
years. 
‘‘(g) TECHNICAL ASSISTANCE.—The Secretary shall 
provide technical assistance and training to grantees for 
collecting and sharing the data under subsection (b). 
‘‘(h) DATA SHARING
BY HHS.—Subject to sub-
section (b), the Secretary shall, with respect to data on 
self-harm that is collected pursuant to this section, share 
and integrate such data through— 
‘‘(1) the National Syndromic Surveillance Pro-
gram’s Early Notification of Community Epidemics 
(ESSENCE) platform (or any successor platform); 
‘‘(2) the National Violent Death Reporting Sys-
tem, as appropriate; or 
‘‘(3) another appropriate surveillance program, 
including such a program that collects data on sui-
cides and self-harm among special populations, such 
as members of the military and veterans. 
‘‘(i) RULE OF CONSTRUCTION REGARDING APPLICA-
BILITY OF PRIVACY PROTECTIONS.—Nothing in this sec-
tion shall be construed to limit or alter the application 
of Federal or State law relating to the privacy of informa-
tion to data or information that is collected or created 
under this section. 
‘‘(j) REPORT.— 
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‘‘(1) SUBMISSION.—Not later than 3 years 
after the date of enactment of this Act, the Sec-
retary shall evaluate the suicide and self-harm 
syndromic surveillance systems at the Federal, 
State, and local levels and submit a report to Con-
gress on the data collected under subsections (b) and 
(c) in a manner that prevents the disclosure of indi-
vidually identifiable information, at a minimum, con-
sistent with all applicable privacy laws and regula-
tions. 
‘‘(2) CONTENTS.—In addition to the data col-
lected under subsections (b) and (c), the report 
under paragraph (1) shall include— 
‘‘(A) challenges and gaps in data collection 
and reporting; 
‘‘(B) recommendations to address such 
gaps and challenges; and 
‘‘(C) a description of any public health re-
sponses initiated at the Federal, State, or local 
level in response to the data collected. 
‘‘(k) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated $10,000,000 for each of fiscal years 2021 through 
2025.’’. 
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SEC. 3. GRANTS TO PROVIDE SELF-HARM AND SUICIDE 
PREVENTION SERVICES. 
Part B of title V of the Public Health Service Act 
(42 U.S.C. 290aa et seq.) is amended by adding at the 
end the following: 
‘‘SEC. 520N. GRANTS TO PROVIDE SELF-HARM AND SUICIDE 
PREVENTION SERVICES. 
‘‘(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Assistant Secretary 
for Mental Health and Substance Use, shall award grants 
to hospital emergency departments to provide self-harm 
and suicide prevention services. 
‘‘(b) ACTIVITIES SUPPORTED.— 
‘‘(1) IN GENERAL.—A hospital emergency de-
partment awarded a grant under subsection (a) shall 
use amounts under the grant to implement a pro-
gram or protocol to better prevent suicide attempts 
among hospital patients after discharge, which may 
include— 
‘‘(A) screening patients for self-harm and 
suicide in accordance with the standards of 
practice described in subsection (e)(1) and 
standards of care established by appropriate 
medical and advocacy organizations; 
‘‘(B) providing patients short-term self- 
harm and suicide prevention services in accord-
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ance with the results of the screenings de-
scribed in subparagraph (A); and 
‘‘(C) referring patients, as appropriate, to 
a health care facility or provider for purposes of 
receiving long-term self-harm and suicide pre-
vention services, and providing any additional 
follow up services and care identified as appro-
priate as a result of the screenings and short- 
term self-harm and suicide prevention services 
described in subparagraphs (A) and (B). 
‘‘(2) USE
OF
FUNDS
TO
HIRE
AND
TRAIN 
STAFF.—Amounts awarded under subsection (a) 
may be used to hire clinical social workers, mental 
and behavioral health care professionals, and sup-
port staff as appropriate, and to train existing staff 
and newly hired staff to carry out the activities de-
scribed in paragraph (1). 
‘‘(c) GRANT TERMS.—A grant awarded under sub-
section (a)— 
‘‘(1) shall be for a period of 3 years; and 
‘‘(2) may be renewed subject to the require-
ments of this section. 
‘‘(d) APPLICATIONS.—A hospital emergency depart-
ment seeking a grant under subsection (a) shall submit 
an application to the Secretary at such time, in such man-
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