I 
108TH CONGRESS 
2D SESSION 
H. R. 4557
To amend the Public Health Service Act to support the planning, implementa-
tion, and evaluation of organized activities involving statewide youth 
suicide early intervention and prevention strategies, and for other pur-
poses. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 14, 2004
Mr. GORDON introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to support the 
planning, implementation, and evaluation of organized 
activities involving statewide youth suicide early interven-
tion and prevention strategies, 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 ‘‘Youth Suicide Early 
Intervention and Prevention Expansion Act of 2004’’. 
SEC. 2. FINDINGS. 
Congress finds the following:
(1) More children and young adults die from 
suicide each year than from cancer, heart disease, 
AIDS, birth defects, stroke, and chronic lung disease 
combined. 
(2) Over 4,000 children and young adults trag-
ically take their lives every year, making suicide the 
third overall cause of death between the ages of 10 
and 24. According to the Centers for Disease Con-
trol and Prevention suicide is the third overall cause 
of death among college-age students. 
(3) According to the National Center for Injury 
Prevention and Control of the Centers for Disease 
Control and Prevention, children and young adults 
accounted for 15 percent of all suicides completed in 
2000. 
(4) From 1952 to 1995, the rate of suicide in 
children and young adults has tripled. 
(5) From 1980 to 1997, the rate of suicide 
among young adults ages 15 to 19 increased 11 per-
cent. 
(6) From 1980 to 1997, the rate of suicide 
among children ages 10 to 14 increased 109 percent. 
(7) According to the National Center of Health 
Statistics, suicide rates among Native Americans 
range from 1.5 to 3 times the national average for
other groups, with young people ages 15 to 34 mak-
ing up 64 percent of all suicides. 
(8) Congress has recognized that youth suicide 
is a public health tragedy linked to underlying men-
tal health problems and that youth suicide early 
intervention and prevention activities are national 
priorities. 
(9) Youth suicide early intervention and preven-
tion have been listed as urgent public health prior-
ities by the President’s New Freedom Commission in 
Mental Health (2002), the Institute of Medicine’s 
Reducing Suicide: A National Imperative (2002), the 
National Strategy for Suicide Prevention: Goals and 
Objectives for Action (2001), and the Surgeon Gen-
eral’s Call to Action To Prevent Suicide (1999). 
(10) Many States have already developed com-
prehensive youth suicide early intervention and pre-
vention strategies that seek to provide effective early 
intervention and prevention services. 
SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICES 
ACT. 
Part P of title III of the Public Health Service Act 
(42 U.S.C. 280g et seq.) is amended by adding at the end 
the following:
‘‘SEC. 399O. SUICIDE PREVENTION FOR CHILDREN AND 
ADOLESCENTS. 
‘‘(a) YOUTH SUICIDE EARLY INTERVENTION AND 
PREVENTION STRATEGIES.—
‘‘(1) IN GENERAL.—The Secretary shall award 
grants or cooperative agreements to eligible entities 
to—
‘‘(A) develop and implement statewide 
youth suicide early intervention and prevention 
strategies in schools, educational institutions, 
juvenile justice systems, substance abuse pro-
grams, mental health programs, foster care sys-
tems, and other child and youth support organi-
zations; 
‘‘(B) collect and analyze data on statewide 
youth suicide early intervention and prevention 
services that can be used to monitor the effec-
tiveness of such services and for research, tech-
nical assistance, and policy development; and 
‘‘(C) assist States, through statewide youth 
suicide early intervention and prevention strate-
gies, in achieving their targets for youth suicide 
reductions under title V of the Social Security 
Act (42 U.S.C. 701 et seq.). 
‘‘(2) ELIGIBLE ENTITY DEFINED.—In this sub-
section, the term ‘eligible entity’ means a State, po-
‘‘(M) work with interested families and ad-
vocacy organizations to conduct annual self-
evaluations of outcomes and activities on the 
State level, according to standards established 
by the Secretary. 
‘‘(b) TECHNICAL ASSISTANCE, DATA MANAGEMENT, 
AND RESEARCH.—
‘‘(1) TECHNICAL ASSISTANCE AND DATA MAN-
AGEMENT.—
‘‘(A) IN
GENERAL.—The Secretary shall 
award technical assistance grants and coopera-
tive agreements to State agencies to conduct as-
sessments independently or in collaboration 
with educational institutions related to the de-
velopment of statewide youth suicide early 
intervention and prevention strategies. 
‘‘(B) AUTHORIZED
ACTIVITIES.—Grants 
awarded under subparagraph (A) shall be used 
to establish programs for the development of 
standardized procedures for data management, 
such as—
‘‘(i) ensuring the quality surveillance 
of youth suicide early intervention and pre-
vention strategies;
‘‘(ii) providing technical assistance on 
data collection and management; 
‘‘(iii) studying the costs and effective-
ness of statewide youth suicide early inter-
vention and prevention strategies in order 
to answer relevant issues of importance to 
State and national policymakers; 
‘‘(iv) further identifying and under-
standing causes of and associated risk fac-
tors for youth suicide; 
‘‘(v) ensuring the quality surveillance 
of suicidal behaviors and nonfatal suicidal 
attempts; 
‘‘(vi) studying the effectiveness of 
statewide youth suicide early intervention 
and prevention strategies on the overall 
wellness and health promotion strategies 
related to suicide attempts; and 
‘‘(vii) promoting the sharing of data 
regarding youth suicide with Federal agen-
cies involved with youth suicide early inter-
vention and prevention, and statewide 
youth suicide early intervention and pre-
vention strategies for the purpose of identi-
fying previously unknown mental health
causes and associated risk-factors for sui-
cide in youth. 
‘‘(2) RESEARCH.—
‘‘(A) IN
GENERAL.—The Secretary shall 
conduct a program of research and development 
on the efficacy of new and existing youth sui-
cide early intervention techniques and tech-
nology, including clinical studies and evalua-
tions of early intervention methods, and related 
research aimed at reducing youth suicide and 
offering support for emotional and behavioral 
disorders which may lead to suicide attempts. 
‘‘(B) 
DISSEMINATING
RESEARCH.—The 
Secretary shall promote the sharing of research 
and development data developed pursuant to 
subparagraph (A) with the Federal agencies in-
volved in youth suicide early intervention and 
prevention, and entities involved in statewide 
youth suicide early intervention and prevention 
strategies for the purpose of applying and inte-
grating new techniques and technology into ex-
isting statewide youth suicide early intervention 
and strategies systems. 
‘‘(c) COORDINATION AND COLLABORATION.—
‘‘(1) IN GENERAL.—In carrying out this sec-
tion, the Secretary shall collaborate and consult 
with—
‘‘(A) other Federal agencies and State and 
local agencies, including agencies responsible 
for early intervention and prevention services 
under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.), the State Children’s 
Health Insurance Program under title XXI of 
the Social Security Act (42 U.S.C. 1397aa et 
seq.), programs funded by grants under title V 
of the Social Security Act (42 U.S.C. 701 et 
seq.), and programs under part C of the Indi-
viduals with Disabilities Education Act (20 
U.S.C. 1431 et seq.), and the National Strategy 
for Suicide Prevention Federal Steering Group; 
‘‘(B) local and national organizations that 
serve youth at risk for suicide and their fami-
lies; 
‘‘(C) relevant national medical and other 
health and education specialty organizations; 
‘‘(D) youth who are at risk for suicide, 
who have survived suicide attempts, or who are 
currently receiving care from early intervention 
services;
‘‘(E) families and friends of youth who are 
at risk for suicide, who have survived suicide at-
tempts, who are currently receiving care from 
early intervention and prevention services, or 
who have completed suicide; 
‘‘(F) qualified professionals who possess 
the specialized knowledge, skills, experience, 
and relevant attributes needed to serve youth at 
risk for suicide and their families; and 
‘‘(G) third-party payers, managed care or-
ganizations, and related commercial industries. 
‘‘(2) POLICY
DEVELOPMENT.—The Secretary 
shall coordinate and collaborate on policy develop-
ment at the Federal and State levels and with the 
private sector, including consumer, medical, suicide 
prevention advocacy groups, and other health and 
education professional-based organizations, with re-
spect to statewide youth suicide early intervention 
and prevention strategies. 
‘‘(d) RULE OF CONSTRUCTION; RELIGIOUS ACCOM-
MODATION.—Nothing in this section shall be construed to 
preempt any State law, including any State law that does 
not require the suicide early intervention for youth whose 
parents or legal guardians object to such early interven-
tion based on the parents’ or legal guardians’ religious be-
liefs. 
‘‘(e) EVALUATION.—
‘‘(1) IN GENERAL.—The Secretary shall con-
duct an evaluation to analyze the effectiveness and 
efficacy of the activities conducted with grants under 
this section. 
‘‘(2) REPORT.—Not later than 2 years after the 
date of enactment of this section, the Secretary shall 
submit to the appropriate committees of Congress a 
report concerning the results of the evaluation con-
ducted under paragraph (1). 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) BEST EVIDENCE-BASED.—The term ‘best 
evidence-based’ with respect to programs, means 
programs that have undergone scientific evaluation 
and have proven to be effective. 
‘‘(2) EARLY INTERVENTION.—The term ‘early 
intervention’ means a strategy or approach that is 
intended to prevent an outcome or to alter the 
course of an existing condition. 
‘‘(3) EDUCATIONAL
INSTITUTION.—The term 
‘educational institution’ means a high school, voca-
tional school, or an institution of higher education.
‘‘(4) 
PREVENTION.—The 
term 
‘prevention’ 
means a strategy or approach that reduces the likeli-
hood or risk of onset, or delays the onset, of adverse 
health problems or reduces the harm resulting from 
conditions or behaviors. 
‘‘(5) SCHOOL.—The term ‘school’ means a non-
profit institutional day or residential school that pro-
vides an elementary, middle, or secondary education, 
as determined under applicable State law, except 
that such term does not include any education be-
yond the 12th grade. 
‘‘(6) YOUTH.—The term ‘youth’ means individ-
uals who are between 6 and 24 years of age. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) 
STATEWIDE
YOUTH
SUICIDE
EARLY 
INTERVENTION
AND
PREVENTION
STRATEGIES.—
For the purpose of carrying out subsection (a), there 
are authorized to be appropriated $25,000,000 for 
fiscal year 2005, $25,000,000 for fiscal year 2006, 
$25,000,000 for fiscal year 2007, and such sums as 
may be necessary for each subsequent fiscal year. 
‘‘(2) TECHNICAL ASSISTANCE, DATA MANAGE-
MENT, AND RESEARCH.—For the purpose of car-
rying out subsection (b), there are authorized to be 
appropriated $5,000,000 for fiscal year 2005,
$5,000,000 for fiscal year 2006, $5,000,000 for fis-
cal year 2007, and such sums as may be necessary 
for each subsequent fiscal year.’’.
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