II 117th CONGRESS 2d Session S. 4871 IN THE SENATE OF THE UNITED STATES September 15, 2022 Ms. Baldwin (for herself and Ms. Collins ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To establish an office to coordinate work relating to behavioral health crisis care and to improve the National Suicide Prevention Lifeline program, and for other purposes.

1. Short title This Act may be cited as the 988 Coordination and Improvement Act . 2. Behavioral Health Crisis Coordinating Office Part A 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: 506B. Behavioral Health Crisis Coordinating Office (a) In general The Secretary shall establish, within the Substance Abuse and Mental Health Services Administration, an office to coordinate work relating to behavioral health crisis care across the operating divisions and agencies of the Department of Health and Human Services, including the Substance Abuse and Mental Health Services Administration, the Centers for Medicare & Medicaid Services, and the Health Resources and Services Administration, and other Federal Government and external stakeholders. (b) Duty The office established under subsection (a) shall— (1) convene Federal, State, Tribal, local, and private partners; (2) launch and manage Federal workgroups charged with making recommendations regarding behavioral health crisis issues, including with respect to health care best practices, workforce development, mental health disparities, data collection, technology, geolocation and call routing, program oversight, public education, and engagement; and (3) support technical assistance, data analysis, and evaluation functions in order to assist States, local governmental entities, territories, Indian Tribes, and Tribal communities in developing crisis care systems and establish nationwide best practices with the objective of expanding the capacity of, and access to, local 988 Suicide and Crisis Lifeline call centers, mobile crisis care, crisis stabilization, psychiatric emergency services, rapid post-crisis follow-up care, and essential community services provided by— (A) the National Suicide Prevention and Mental Health Crisis Hotline and Response System; (B) the Veterans Crisis Line; (C) community mental health centers (as defined in section 1861(ff)(3)(B) of the Social Security Act); (D) Federally qualified health centers (as defined in section 1861(aa) of the Social Security Act); (E) certified community behavioral health clinics, as described in section 223 of the Protecting Access to Medicare Act of 2014; and (F) other community mental health, substance use disorder, and essential community service providers, as determined by the Secretary. (c) Authorization of appropriations There is authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2023 through 2027. . 3. National Suicide Prevention Lifeline program access to specialized services Section 520E–3 of the Public Health Service Act (290bb–36c) is amended— (1) in subsection (b)— (A) in paragraph (2)— (i) by inserting after suicide prevention hotline the following: , under the universal telephone number designated under section 251(e)(4) of the Communications Act of 1934, ; and (ii) by striking ; and at the end and inserting a semicolon; (B) in paragraph (3), by striking the period at the end and inserting ; and ; and (C) by adding at the end the following: (4) supporting access by high-risk populations, including LGBTQ+ youth and other members of the LGBTQ+ community, American Indian and Alaska Natives, individuals who reside in rural counties, veterans, racial and ethnic minorities, and other high-risk populations, to specialized services through the program, in accordance with subsection (c) and as determined by the Office of the Assistant Secretary. ; (2) by redesignating subsection (c) as subsection (d); and (3) by inserting after subsection (b) the following: (c) Access to specialized services (1) Consultation Wherever possible, the Office of the Assistant Secretary shall, in determining which approaches to use to support access to specialized services under subsection (b)(4) to the populations described in such subsection, consult with organizations that have— (A) experience working with such populations; or (B) technological expertise in effective crisis response using such digital and technology approaches. (2) Examples of specialized services Efforts to support access to specialized services under subsection (b)(4) may include— (A) updates and development of training resources that can help crisis counselors better address the needs of high-risk populations; (B) adapting the program network center membership processes to incorporate organizations providing specialized services for high-risk populations; (C) designing and implementing transfer processes; (D) providing additional technical assistance to centers participating in the program to ensure compliance with the training expectations in working with high-risk populations; and (E) the use of digital and technology approaches to improve access for high risk populations. . 4. Department of Health and Human Services report (a) In general Not later than 2 years after the date of enactment of this Act, the Secretary of Health and Human Services shall submit a report to Congress assessing the progress of the Department of Health and Human Services in implementation of the 9–8–8 dialing code for the 988 Suicide and Crisis Lifeline operated pursuant to the program under section 520E–3 of the Public Health Service Act ( 42 U.S.C. 290bb–36c ). (b) Content The report required under subsection (a) shall include— (1) an assessment of the performance of the 988 Suicide and Crisis Lifeline and any partner organizations of the Lifeline; (2) an update on efforts to provide specialized resources to high-risk populations, including LGBTQ+ youth and other members of the LGBTQ+ community, American Indian and Alaska Natives, individuals who reside in rural counties, veterans, racial and ethnic minorities, and other high-risk populations; (3) State and regional variation with respect to access to crisis call centers, including average speed to answer, answer rates, hours of operation, and funding sources; (4) the capacity of the 988 Suicide and Crisis Lifeline to handle texts and chats; (5) any needed programmatic or technological enhancements to connect callers to local services; and (6) obstacles identified by States, political subdivisions of States, Indian Tribes, or villages or regional corporations serving a region established pursuant to the Alaska Native Claims Settlement Act ( 43 U.S.C. 1601 et seq. ) in collection and distribution of fees and charges described by section 4(a)(1) of the National Suicide Hotline Designation Act of 2020 ( Public Law 116–172 ).