I 
118TH CONGRESS 
1ST SESSION H. R. 4851 
To provide for improvements in the implementation of the National Suicide 
Prevention Lifeline, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 25, 2023 
Mr. CA´RDENAS (for himself, Mr. FITZPATRICK, Ms. BLUNT ROCHESTER, Mr. 
MOULTON, Ms. MATSUI, Mrs. NAPOLITANO, Mr. BEYER, Mr. RASKIN, 
Ms. STRICKLAND, Mr. GOMEZ, Mr. POCAN, Mr. TONKO, Ms. MOORE of 
Wisconsin, Ms. BARRAGA´N, Ms. UNDERWOOD, Ms. CLARKE of New York, 
Mr. TRONE, Ms. BALINT, Mr. LYNCH, Ms. SCHRIER, Ms. CRAIG, and Ms. 
JAYAPAL) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
Ways and Means, Armed Services, Veterans’ Affairs, and Oversight and 
Accountability, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To provide for improvements in the implementation of the 
National Suicide Prevention 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. 
(a) SHORT TITLE.—This Act may be cited as the ‘‘9– 
8–8 Implementation Act of 2023’’. 
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(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title. 
TITLE I—SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES 
ADMINISTRATION 
Sec. 101. Regional and local lifeline call center program. 
Sec. 102. Mental Health Crisis Response Partnership Pilot Program. 
Sec. 103. National suicide prevention media campaign. 
TITLE II—HEALTH RESOURCES AND SERVICES ADMINISTRATION 
Sec. 201. Health center capital grants. 
Sec. 202. Expanding behavioral health workforce training programs. 
TITLE III—BEHAVIORAL HEALTH CRISIS SERVICES EXPANSION 
Sec. 301. Coverage of crisis response services. 
Sec. 302. Incident reporting. 
TITLE IV—MEDICAID AMENDMENTS 
Sec. 401. Revisions to the State option to provide qualifying community-based 
mobile crisis intervention services and other services under 
State plans under the Medicaid program. 
Sec. 402. Revisions to the IMD exclusion under Medicaid. 
TITLE 
I—SUBSTANCE 
ABUSE 
AND MENTAL HEALTH SERV-
ICES ADMINISTRATION 
SEC. 101. REGIONAL AND LOCAL LIFELINE CALL CENTER 
PROGRAM. 
Part B of title V of the Public Health Service Act 
(42 U.S.C. 290bb et seq.) is amended by inserting after 
section 520E–4 (42 U.S.C. 290bb-36d) the following: 
‘‘SEC. 520E–5. REGIONAL AND LOCAL LIFELINE CALL CEN-
TER PROGRAM. 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants to crisis call centers to— 
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‘‘(1) purchase or upgrade call center tech-
nology; 
‘‘(2) provide for training of call center staff; 
‘‘(3) improve call center operations; and 
‘‘(4) hiring of call center staff. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$441,000,000 for fiscal year 2024, to remain available 
until expended.’’. 
SEC. 102. MENTAL HEALTH CRISIS RESPONSE PARTNER-
SHIP PILOT PROGRAM. 
Section 520F(e) of the Public Health Service Act (42 
U.S.C. 290bb–37(e)) is amended by striking ‘‘section, 
$10,000,000 for each of fiscal years 2023 through 2027’’ 
and inserting the following: ‘‘section— 
‘‘(1) $10,000,000 for fiscal year 2023; and 
‘‘(2) $100,000,000 for each of fiscal years 2024 
through 2027’’. 
SEC. 103. NATIONAL SUICIDE PREVENTION MEDIA CAM-
PAIGN. 
Subpart 3 of part B of title V of the Public Health 
Service Act (42 U.S.C. 290bb–31 et seq.) is amended by 
adding at the end the following: 
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‘‘SEC. 5200. NATIONAL SUICIDE PREVENTION MEDIA CAM-
PAIGN. 
‘‘(a) NATIONAL SUICIDE PREVENTION MEDIA CAM-
PAIGN.— 
‘‘(1) IN
GENERAL.—Not later than the date 
that is 3 years after the date of the enactment of 
this Act, the Secretary, in consultation with the As-
sistant Secretary for Mental Health and Substance 
Use and the Director of the Centers for Disease 
Control and Prevention (referred to in this section 
as the ‘Director’), shall conduct a national suicide 
prevention media campaign (referred to in this sec-
tion as the ‘national media campaign’), for purposes 
of— 
‘‘(A) preventing suicide in the United 
States; 
‘‘(B) educating families, friends, and com-
munities on how to address suicide and suicidal 
thoughts, including when to encourage individ-
uals with suicidal risk to seek help; and 
‘‘(C) increasing awareness of suicide pre-
vention resources of the Centers for Disease 
Control and Prevention and the Substance 
Abuse and Mental Health Services Administra-
tion (including the suicide prevention hotline 
maintained under section 520E–3, any suicide 
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prevention mobile application of the Centers for 
Disease Control and Prevention or the Sub-
stance Abuse Mental Health Services Adminis-
tration, and other support resources determined 
appropriate by the Secretary). 
‘‘(2) ADDITIONAL CONSULTATION.—In addition 
to consulting with the Assistant Secretary and the 
Director under this section, the Secretary shall con-
sult with, as appropriate, State, local, Tribal, and 
territorial health departments, primary health care 
providers, hospitals with emergency departments, 
mental and behavioral health services providers, cri-
sis response services providers, paramedics, law en-
forcement, suicide prevention and mental health pro-
fessionals, patient advocacy groups, survivors of sui-
cide attempts, and representatives of television and 
social media platforms in planning the national 
media campaign to be conducted under paragraph 
(1). 
‘‘(b) TARGET AUDIENCES.— 
‘‘(1) TAILORING ADVERTISEMENTS AND OTHER 
COMMUNICATIONS.—In 
conducting 
the 
national 
media campaign under subsection (a)(1), the Sec-
retary may tailor culturally competent advertise-
ments and other communications of the campaign 
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across all available media for a target audience 
(such as a particular geographic location or demo-
graphic) across the lifespan. 
‘‘(2) TARGETING CERTAIN LOCAL AREAS.—The 
Secretary shall, to the maximum extent practicable, 
use amounts made available under subsection (f) for 
media that targets certain local areas or populations 
at disproportionate risk for suicide. 
‘‘(c) USE OF FUNDS.— 
‘‘(1) REQUIRED USES.— 
‘‘(A) IN GENERAL.—The Secretary shall, if 
reasonably feasible with the funds made avail-
able under subsection (f), carry out the fol-
lowing, with respect to the national media cam-
paign: 
‘‘(i) Testing and evaluation of adver-
tising. 
‘‘(ii) Evaluation of the effectiveness of 
the national media campaign. 
‘‘(iii) Operational and management 
expenses. 
‘‘(iv) The creation of an educational 
toolkit for television and social media plat-
forms to use in discussing suicide and rais-
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ing awareness about how to prevent sui-
cide. 
‘‘(B) SPECIFIC REQUIREMENTS.— 
‘‘(i) TESTING
AND
EVALUATION
OF 
ADVERTISING.—In testing and evaluating 
advertising under subparagraph (A)(i), the 
Secretary shall test all advertisements 
after use in the national media campaign 
to evaluate the extent to which such adver-
tisements have been effective in carrying 
out the purposes of the national media 
campaign. 
‘‘(ii) EVALUATION OF EFFECTIVENESS 
OF NATIONAL MEDIA CAMPAIGN.—In eval-
uating the effectiveness of the national 
media 
campaign 
under 
subparagraph 
(A)(ii), the Secretary shall— 
‘‘(I) take into account the num-
ber of unique calls that are made to 
the suicide prevention hotline main-
tained under section 520E–3 and as-
sess whether there are any State and 
regional variations with respect to the 
capacity to answer such calls; 
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‘‘(II) take into account the num-
ber of unique encounters with suicide 
prevention and support resources of 
the Centers for Disease Control and 
Prevention and the Substance Abuse 
and Mental Health Services Adminis-
tration and assess engagement with 
such suicide prevention and support 
resources; 
‘‘(III) assess whether the na-
tional media campaign has contrib-
uted to increased awareness that sui-
cidal individuals should be engaged, 
rather than ignored; and 
‘‘(IV) take into account such 
other measures of evaluation as the 
Secretary determines are appropriate. 
‘‘(2) OPTIONAL USES.—The Secretary may use 
amounts made available under subsection (f) for the 
following, with respect to the national media cam-
paign: 
‘‘(A) Partnerships with professional and 
civic groups, community-based organizations, 
including faith-based organizations, and Fed-
eral agencies or Tribal organizations that the 
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Secretary determines have experience in suicide 
prevention, including the Substance Abuse and 
Mental Health Services Administration and the 
Centers for Disease Control and Prevention. 
‘‘(B) Entertainment industry outreach, 
interactive outreach, media projects and activi-
ties, the dissemination of public information, 
news media outreach, outreach through tele-
vision programs, and corporate sponsorship and 
participation. 
‘‘(d) PROHIBITIONS.—None of the amounts made 
available under subsection (f) may be obligated or ex-
pended for any of the following: 
‘‘(1) To supplant Federal suicide prevention 
campaigns in effect as of the date of the enactment 
of this section. 
‘‘(2) For partisan political purposes, or to ex-
press advocacy in support of or to defeat any clearly 
identified candidate, clearly identified ballot initia-
tive, or clearly identified legislative or regulatory 
proposal. 
‘‘(e) REPORT
TO CONGRESS.—Not later than 18 
months after implementation of the national media cam-
paign has begun, the Secretary, in coordination with the 
Assistant Secretary and the Director, shall, with respect 
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to the first year of the national media campaign, submit 
to Congress a report that describes— 
‘‘(1) the strategy of the national media cam-
paign and whether specific objectives of such cam-
paign were accomplished, including whether such 
campaign impacted the number of calls made to life-
line crisis centers and the capacity of such centers 
to manage such calls; 
‘‘(2) steps taken to ensure that the national 
media campaign operates in an effective and effi-
cient manner consistent with the overall strategy 
and focus of the national media campaign; 
‘‘(3) plans to purchase advertising time and 
space; 
‘‘(4) policies and practices implemented to en-
sure that Federal funds are used responsibly to pur-
chase advertising time and space and eliminate the 
potential for waste, fraud, and abuse; and 
‘‘(5) all contracts entered into with a corpora-
tion, a partnership, or an individual working on be-
half of the national media campaign. 
‘‘(f) AUTHORIZATION
OF
APPROPRIATIONS.—For 
purposes of carrying out this section, there is authorized 
to be appropriated $10,000,000 for each of fiscal years 
2024 through 2028.’’. 
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TITLE II—HEALTH RESOURCES 
AND SERVICES ADMINISTRA-
TION 
SEC. 201. HEALTH CENTER CAPITAL GRANTS. 
Subpart 1 of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.) is amended by adding 
at the end the following: 
‘‘SEC. 330Q. HEALTH CENTER CAPITAL GRANTS. 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants to eligible entities for capital projects. 
‘‘(b) ELIGIBLE ENTITY.—In this section, the term 
‘eligible entity’ is an entity that is— 
‘‘(1) a health center funded under section 330, 
or in the case of a Tribe or Tribal organization, eli-
gible, to be awarded without regard to the time limi-
tation 
in 
subsection 
(e)(3) 
and 
subsections 
(e)(6)(A)(iii), (e)(6)(B)(iii), and (r)(2)(B) of such 
section; or 
‘‘(2) a mental health and substance use crisis 
receiving and stabilization program and crisis call 
center that have a working relationship with one or 
more local community mental health and substance 
use organizations, community mental health centers, 
and certified community behavioral health clinics, or 
other local mental health and substance use care 
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providers, including inpatient and residential treat-
ment settings. 
‘‘(c) USE OF FUNDS.—Amounts made available to a 
recipient of a grant or cooperative agreement pursuant to 
subsection (a) shall be used for crisis response program 
facility alteration, renovation, remodeling, expansion, con-
struction, and other capital improvement costs, including 
the costs of amortizing the principal of, and paying inter-
est on, loans for such purposes. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$1,000,000,000, to remain available until expended.’’. 
SEC. 202. EXPANDING BEHAVIORAL HEALTH WORKFORCE 
TRAINING PROGRAMS. 
(a) NATIONAL HEALTH SERVICE CORPS.—Section 
331(a)(3)(E)(i) of the Public Health Service Act 
(254d(a)(3)(E)(i)) is amended by striking ‘‘and psychia-
trists’’ and inserting ‘‘psychiatrists and professionals who 
provide crisis management services (such as at a crisis call 
center, as part of a mobile crisis team, or through crisis 
receiving and stabilization program)’’. 
(b) MINORITY
FELLOWSHIP
PROGRAM.—Section 
597(b) of the Public Health Service Act (42 U.S.C. 
290ll(b)) is amended by inserting ‘‘crisis management 
services (such as at a crisis call center, as part of a mobile 
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crisis team, or through crisis receiving and stabilization 
program),’’ after ‘‘mental health counseling,’’. 
(c) BEHAVIORAL HEALTH WORKFORCE EDUCATION 
AND TRAINING.—Section 756 of the Public Health Service 
Act (42 U.S.C. 294e–1) is amended— 
(1) in subsection (a)— 
(A) in paragraph (1), by inserting ‘‘crisis 
management (such as at a crisis call center, as 
part of a mobile crisis team, or through crisis 
receiving and stabilization program),’’ after 
‘‘occupational therapy,’’; 
(B) in paragraph (2), by inserting ‘‘and 
providing crisis management services (such as 
at a crisis call center, as part of a mobile crisis 
team, or through crisis receiving and stabiliza-
tion program)’’ after ‘‘treatment services,’’; 
(C) in paragraph (3), by inserting ‘‘and 
providing crisis management services (such as 
at a crisis call center, as part of a mobile crisis 
team, or through crisis receiving and stabiliza-
tion program),’’ after ‘‘behavioral health serv-
ices’’; and 
(D) in paragraph (4), by inserting ‘‘includ-
ing for the provision of crisis management serv-
ices (such as at a crisis call center, as part of 
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