I 118th CONGRESS 1st Session H. R. 5246 IN THE HOUSE OF REPRESENTATIVES August 22, 2023 Ms. Caraveo (for herself, Mr. Tony Gonzales of Texas , and Mr. Davis of North Carolina ) introduced the following bill; which was referred to the Committee on Agriculture A BILL To amend the Food, Conservation, and Energy Act of 2008 to reauthorize the Farm and Ranch Stress Assistance Network and establish a national agricultural crisis hotline, and for other purposes.

1. Short title This Act may be cited as the National Agricultural Crisis Hotline Act of 2023 . 2. Findings Congress finds that— (1) the suicide rate for farmers is 3.5 times higher than the suicide rate of the general population; (2) male farmers and ranchers have significantly higher rates of suicide (43.2 per 100,000) compared to the average rate of suicide across other professions (27.4 per 100,000); (3) the percentage of adults ages 26 and older that live in completely rural areas has increased between 2019 and 2020, making completely rural areas the most afflicted county types with respect to alcohol abuse; and (4) evidence suggests that the stigma surrounding mental health in farming and ranching communities has decreased but still plays a significant role in influencing behavior. 3. Farm and Ranch Stress Assistance Network Section 7522 of the Food, Conservation, and Energy Act of 2008 ( 7 U.S.C. 5936 ) is amended— (1) in subsection (b)(1)— (A) by redesignating subparagraphs (C) and (D) as subparagraphs (D) and (E), respectively; and (B) by inserting after subparagraph (B) the following: (C) mental health training for agriculture professionals (including farm loan officers, extension agents, and State department of agriculture staff); ; (2) by redesignating subsections (d) through (f) as subsections (e) through (g), respectively; (3) by inserting after subsection (c) the following: (d) National agricultural crisis hotline (1) In general As part of the Farm and Ranch Stress Assistance Network established under subsection (a), the Secretary shall establish, and maintain directly or by grant or contract, a national agricultural crisis hotline (referred to in this subsection as the national agricultural crisis hotline ) to provide emotional support, information, suicide crisis intervention, mental health and substance use disorder, and agricultural support resources to— (A) farmers, farm managers, farm workers, and ranchers affected by mental health and substance use disorders; and (B) families or household members of those farmers, farm managers, farm workers, and ranchers. (2) Requirements The national agricultural crisis hotline shall— (A) provide 24/7 real-time live assistance by voice and through a mobile texting application; (B) be staffed 24/7 in accordance with paragraph (4); (C) provide referral services to meet the needs of family and household members of farmers, ranchers, and related professionals; (D) offer 24-hour follow-up calls to callers; (E) provide standardized translation services that meet the needs of the agricultural population; and (F) comply with all Federal, State, and local laws, including the Health Insurance Portability and Accountability Act of 1996 ( Public Law 104–191 ; 110 Stat. 1936). (3) Data collection The national agricultural crisis hotline shall collect the following data: (A) Call data, including total calls, calls queued, calls answered, calls dropped, and average speed of answer. (B) Rescue data, including next steps suggested and information provided to the caller. (C) Follow-up calls. (D) Caller information, including— (i) whether the caller is calling for the first time or is a repeat caller; (ii) the living situation of the caller; and (iii) demographic information of the caller. (E) Reason for call and caller needs and concerns. (F) Referrals provided, including resources provided and strategies employed with respect to addressing the needs and concerns of callers. (4) Staffing Call responders and supervisors of call responders operating the national agricultural crisis hotline shall— (A) be crisis intervention specialists, licensed health care professionals, or licensed mental health professionals who— (i) are trained in providing culturally and linguistically appropriate support; (ii) have awareness training with respect to farm stress and the farming identity; and (iii) have credentials that enable them to provide evidence-based suicide intervention hotline care, including accreditation from the American Association of Suicidology and the Alliance of Information and Referral Systems; and (B) meet training requirements developed by the Secretary or the entity maintaining the hotline, as applicable, which, at a minimum, shall include— (i) at least 80 hours of interactive training and content, which shall include— (I) elements of applied suicide intervention skills training; (II) information and training on providing trauma informed support; and (III) training and content on other relevant clinical topics; (ii) foundational agriculture mental stress training that includes metrics that demonstrate competency; (iii) a minimum of 24 hours of direct supervised shifts before answering calls independently; and (iv) ongoing training on specialized topics on at least a quarterly basis. (5) Partnerships (A) Existing hotlines The Secretary or an entity receiving a grant or contract under paragraph (1), as applicable, shall form partnerships between the national agricultural crisis hotline and existing farm telephone helplines and websites. (B) USDA and other Federal programs The Secretary shall coordinate with— (i) the Federal Office of Rural Health Policy and offices of the Department of Agriculture that administer financial assistance programs to farmers and ranchers to provide information about the national agricultural crisis hotline to participants of those programs; and (ii) the Substance Abuse and Mental Health Services Administration to refer agriculture related calls received through the 988 Suicide and Crisis Lifeline to the national agricultural crisis hotline. (6) Directory The Secretary or an entity receiving a grant or contract under paragraph (1), as applicable, shall develop, and periodically update, a directory of organizations to which staff of the national agricultural crisis hotline can make referrals. (7) Outreach The Secretary shall, in consultation with the Department of Health and Human Services, the Substance Abuse and Mental Health Services Administration, any other relevant Federal agencies, and State departments of health and agriculture, conduct a public awareness campaign for the national agricultural crisis hotline. (8) Report The Secretary shall submit to Congress and make publicly available an annual report on the effectiveness of the national agricultural crisis hotline. ; and (4) in subsection (e) (as so redesignated), by striking $10,000,000 for each of fiscal years 2019 through 2023 and inserting $19,000,000 for each of fiscal years 2024 through 2028, of which $4,000,000 each fiscal year shall be used to carry out subsection (d) .