I 
118TH CONGRESS 
1ST SESSION H. R. 5514 
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 
SEPTEMBER 14, 2023 
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’’. 
VerDate Sep 11 2014 
05:08 Sep 16, 2023
Jkt 039200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H5514.IH
H5514
kjohnson on DSK7ZCZBW3PROD with $$_JOB
SEC. 2. SYNDROMIC SURVEILLANCE OF SELF-HARM BEHAV-
IORS PROGRAM. 
Title III of the Public Health Service Act is amended 
by inserting after section 317U of such Act (42 U.S.C. 
247b–23) the following: 
‘‘SEC. 317W. SYNDROMIC SURVEILLANCE OF SELF-HARM 
BEHAVIORS PROGRAM. 
‘‘(a) IN
GENERAL.—The Secretary shall award 
grants to State, local, Tribal, and territorial public health 
departments for the expansion of surveillance of self-harm. 
‘‘(b) DATA SHARING BY GRANTEES.—As a condition 
of receipt of such grant under subsection (a), each grantee 
shall agree to share with the Centers for Disease Control 
and Prevention in real time, to the extent feasible and as 
specified in the grant agreement, data on suicides and self- 
harm for purposes of— 
‘‘(1) tracking and monitoring self-harm to in-
form response activities to suicide clusters; 
‘‘(2) informing prevention programming for 
identified at-risk populations; and 
‘‘(3) conducting or supporting research. 
‘‘(c) DISAGGREGATION
OF DATA.—The Secretary 
shall provide for the data collected through surveillance 
of self-harm under subsection (b) to be disaggregated by 
the following categories: 
‘‘(1) Nonfatal self-harm data of any intent. 
VerDate Sep 11 2014 
05:08 Sep 16, 2023
Jkt 039200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H5514.IH
H5514
kjohnson on DSK7ZCZBW3PROD with $$_JOB
‘‘(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 nonfatal suicidal behavior that is above the 
national rate of nonfatal suicidal behavior, as deter-
mined 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 
nonfatal suicidal behavior that is above the national 
rate of nonfatal suicidal behavior, as determined 
through appropriate mechanisms determined by the 
Secretary in consultation with Indian Tribes; or 
‘‘(3) located in a State with a high rate of cov-
erage of statewide (or Tribal) emergency department 
VerDate Sep 11 2014 
05:08 Sep 16, 2023
Jkt 039200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H5514.IH
H5514
kjohnson on DSK7ZCZBW3PROD with $$_JOB
visits, as determined by the Director of the Centers 
for Disease Control and Prevention. 
‘‘(e) 
GEOGRAPHIC
DISTRIBUTION.—In 
making 
grants under this section, the Secretary shall make an ef-
fort to ensure geographic distribution, taking into account 
the unique needs of rural communities, including— 
‘‘(1) communities with an incidence of individ-
uals with serious mental illness, demonstrated suici-
dal ideation or behavior, or suicide rates that are 
above the national average, as determined by the As-
sistant Secretary for Mental Health and Substance 
Use; 
‘‘(2) communities with a shortage of prevention 
and treatment services, as determined by the Assist-
ant Secretary for Mental Health and Substance Use 
and the Administrator of the Health Resources and 
Services Administration; and 
‘‘(3) other appropriate community-level factors 
and social determinants of health such as income, 
employment, and education. 
‘‘(f) PERIOD OF PARTICIPATION.—To be selected as 
a grant recipient under this section, a State, local, Tribal, 
or territorial public health department shall agree to par-
ticipate in the program for a period of not less than 4 
years. 
VerDate Sep 11 2014 
05:08 Sep 16, 2023
Jkt 039200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H5514.IH
H5514
kjohnson on DSK7ZCZBW3PROD with $$_JOB
‘‘(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.— 
‘‘(1) SUBMISSION.—Not later than 3 years 
after the date of enactment of this Act, the Sec-
VerDate Sep 11 2014 
05:08 Sep 16, 2023
Jkt 039200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H5514.IH
H5514
kjohnson on DSK7ZCZBW3PROD with $$_JOB
retary shall evaluate the suicide and self-harm 
syndromic surveillance systems at the Federal, 
State, and local levels and submit a report to Con-
gress on the data collected under subsections (b) and 
(c) in a manner that prevents the disclosure of indi-
vidually identifiable information, at a minimum, con-
sistent with all applicable privacy laws and regula-
tions. 
‘‘(2) CONTENTS.—In addition to the data col-
lected under subsections (b) and (c), the report 
under paragraph (1) shall include— 
‘‘(A) challenges and gaps in data collection 
and reporting; 
‘‘(B) recommendations to address such 
gaps and challenges; and 
‘‘(C) a description of any public health re-
sponses initiated at the Federal, State, or local 
level in response to the data collected. 
‘‘(k) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated $20,000,000 for each of fiscal years 2024 through 
2028.’’. 
VerDate Sep 11 2014 
05:08 Sep 16, 2023
Jkt 039200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H5514.IH
H5514
kjohnson on DSK7ZCZBW3PROD with $$_JOB