I 
116TH CONGRESS 
1ST SESSION H. R. 4861 
To amend the Public Health Service Act to establish a program to improve 
the identification, assessment, and treatment of patients in the emergency 
department who are at risk of suicide, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 28, 2019 
Mr. BILIRAKIS (for himself and Mr. ENGEL) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to establish a pro-
gram to improve the identification, assessment, and 
treatment of patients in the emergency department who 
are at risk of suicide, 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 ‘‘Effective Suicide 
Screening and Assessment in the Emergency Department 
Act of 2019’’. 
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SEC. 2. PROGRAM TO IMPROVE THE CARE PROVIDED TO 
PATIENTS IN THE EMERGENCY DEPARTMENT 
WHO ARE AT RISK OF SUICIDE. 
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 new section: 
‘‘SEC. 399V–7. PROGRAM TO IMPROVE THE CARE PROVIDED 
TO PATIENTS IN THE EMERGENCY DEPART-
MENT WHO ARE AT RISK OF SUICIDE. 
‘‘(a) IN GENERAL.—The Secretary shall establish a 
program (in this Act referred to as the ‘Program’) to im-
prove the identification, assessment, and treatment of pa-
tients in emergency departments who are at risk for sui-
cide, including by— 
‘‘(1) developing policies and procedures for 
identifying and assessing individuals who are at risk 
of suicide; and 
‘‘(2) enhancing the coordination of care for 
such individuals after discharge. 
‘‘(b) GRANT
ESTABLISHMENT
AND
PARTICIPA-
TION.— 
‘‘(1) IN GENERAL.—In carrying out the Pro-
gram, the Secretary shall award grants on a com-
petitive basis to not more than 40 eligible health 
care sites described in paragraph (2). 
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‘‘(2) ELIGIBILITY.—To be eligible for a grant 
under this section, a health care site shall— 
‘‘(A) submit an application to the Sec-
retary at such time, in such manner, and con-
taining such information as the Secretary may 
specify; 
‘‘(B) be a hospital (as defined in section 
1861(e) of the Social Security Act); 
‘‘(C) have an emergency department; and 
‘‘(D) deploy onsite health care or social 
service professionals to help connect and inte-
grate patients who are at risk of suicide with 
treatment and mental health support services. 
‘‘(3) PREFERENCE.—In awarding grants under 
this section, the Secretary may give preference to eli-
gible health care sites described in paragraph (2) 
that meet at least one of the following criteria: 
‘‘(A) The eligible health care site is a crit-
ical access hospital (as defined in section 
1861(mm)(1) of the Social Security Act). 
‘‘(B) The eligible health care site is a sole 
community hospital (as defined in section 
1886(d)(5)(D)(iii) of the Social Security Act). 
‘‘(C) The eligible health care site is oper-
ated by the Indian Health Service, by an Indian 
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tribe or tribal organization (as such terms are 
defined in section 4 of the Indian Self-Deter-
mination and Education Assistance Act), or by 
an urban Indian organization (as defined in 
section 4 of the Indian Health Care Improve-
ment Act). 
‘‘(D) The eligible health care site is located 
in a geographic area with a suicide rate that is 
higher than the national rate, as determined by 
the Secretary based on the most recent data 
from the Centers for Disease Control and Pre-
vention. 
‘‘(c) PERIOD OF GRANT.—A grant awarded to an eli-
gible health care site under this section shall be for a pe-
riod of at least 2 years. 
‘‘(d) GRANT USES.— 
‘‘(1) REQUIRED USES.—A grant awarded under 
this section to an eligible health care site shall be 
used for the following purposes: 
‘‘(A) To train emergency department 
health care professionals to identify, assess, and 
treat patients who are at risk of suicide. 
‘‘(B) To establish and implement policies 
and procedures for emergency departments to 
improve the identification, assessment and 
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treatment of individuals who are at risk of sui-
cide. 
‘‘(C) To establish and implement policies 
and procedures with respect to care coordina-
tion, integrated care models, or referral to evi-
dence-based treatment to be used upon the dis-
charge from the emergency department of pa-
tients who are at risk of suicide. 
‘‘(2) ADDITIONAL PERMISSIBLE USES.—In ad-
dition to the required uses listed in paragraph (1), 
a grant awarded under this section to an eligible 
health care site may be used for any of the following 
purposes: 
‘‘(A) To hire emergency department psy-
chiatrists, psychologists, nurse practitioners, 
counselors, therapists, or other licensed health 
care and behavioral health professionals special-
izing in the treatment of individuals at risk of 
suicide. 
‘‘(B) To develop and implement best prac-
tices for the follow-up care and long-term treat-
ment of individuals who are at risk of suicide. 
‘‘(C) To increase the availability of and ac-
cess to evidence-based treatment for individuals 
who are at risk of suicide, including through 
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telehealth services and strategies to reduce the 
boarding of these patients in emergency depart-
ments. 
‘‘(D) To offer consultation with and refer-
ral to other supportive services that provide evi-
dence-based treatment and recovery for individ-
uals who are at risk of suicide. 
‘‘(e) REPORTING REQUIREMENTS.— 
‘‘(1) REPORTS
BY
GRANTEES.—Each eligible 
health care site receiving a grant under this section 
shall submit to the Secretary an annual report for 
each year for which the grant is received on the 
progress of the program funded through the grant. 
Each such report shall include information on— 
‘‘(A) the number of individuals screened in 
the site’s emergency department for being at 
risk of suicide; 
‘‘(B) the number of individuals identified 
in the site’s emergency department as being— 
‘‘(i) survivors of an attempted suicide; 
or 
‘‘(ii) are at risk of suicide; 
‘‘(C) the number of individuals who are 
identified in the site’s emergency department as 
being at risk of suicide by a health care or be-
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havioral health professional hired pursuant to 
subsection (d)(2)(A); 
‘‘(D) the number of individuals referred by 
the site’s emergency department to other treat-
ment facilities, the types of such other facilities, 
and the number of such individuals admitted to 
such other facilities pursuant to such referrals; 
‘‘(E) the effectiveness of programs and ac-
tivities funded through the grant in preventing 
suicides and suicide attempts; and 
‘‘(F) any other relevant additional data re-
garding the programs and activities funded 
through the grant. 
‘‘(2) REPORT BY SECRETARY.—Not less than 
one year after the end of fiscal year 2024, the Sec-
retary shall submit to Congress a report that in-
cludes— 
‘‘(A) findings on the Program; 
‘‘(B) overall patient outcomes achieved 
through the Program; 
‘‘(C) an evaluation of the effectiveness of 
having a trained health care or behavioral 
health professional onsite to identify, assess, 
and treat patients who are at risk of suicide; 
and 
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‘‘(D) a compilation of policies, procedures, 
and best practices established, developed, or im-
plemented by grantees under this section. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$20,000,000 for the period of fiscal years 2020 through 
2024.’’. 
Æ 
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