[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4557 Introduced in House (IH)]






108th CONGRESS
  2d Session
                                H. R. 4557

    To amend the Public Health Service Act to support the planning, 
   implementation, and evaluation of organized activities involving 
 statewide youth suicide early intervention and prevention strategies, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 14, 2004

  Mr. Gordon introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
    To amend the Public Health Service Act to support the planning, 
   implementation, and evaluation of organized activities involving 
 statewide youth suicide early intervention and prevention strategies, 
                        and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Youth Suicide Early Intervention and 
Prevention Expansion Act of 2004''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) More children and young adults die from suicide each 
        year than from cancer, heart disease, AIDS, birth defects, 
        stroke, and chronic lung disease combined.
            (2) Over 4,000 children and young adults tragically take 
        their lives every year, making suicide the third overall cause 
        of death between the ages of 10 and 24. According to the 
        Centers for Disease Control and Prevention suicide is the third 
        overall cause of death among college-age students.
            (3) According to the National Center for Injury Prevention 
        and Control of the Centers for Disease Control and Prevention, 
        children and young adults accounted for 15 percent of all 
        suicides completed in 2000.
            (4) From 1952 to 1995, the rate of suicide in children and 
        young adults has tripled.
            (5) From 1980 to 1997, the rate of suicide among young 
        adults ages 15 to 19 increased 11 percent.
            (6) From 1980 to 1997, the rate of suicide among children 
        ages 10 to 14 increased 109 percent.
            (7) According to the National Center of Health Statistics, 
        suicide rates among Native Americans range from 1.5 to 3 times 
        the national average for other groups, with young people ages 
        15 to 34 making up 64 percent of all suicides.
            (8) Congress has recognized that youth suicide is a public 
        health tragedy linked to underlying mental health problems and 
        that youth suicide early intervention and prevention activities 
        are national priorities.
            (9) Youth suicide early intervention and prevention have 
        been listed as urgent public health priorities by the 
        President's New Freedom Commission in Mental Health (2002), the 
        Institute of Medicine's Reducing Suicide: A National Imperative 
        (2002), the National Strategy for Suicide Prevention: Goals and 
        Objectives for Action (2001), and the Surgeon General's Call to 
        Action To Prevent Suicide (1999).
            (10) Many States have already developed comprehensive youth 
        suicide early intervention and prevention strategies that seek 
        to provide effective early intervention and prevention 
        services.

SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICES ACT.

    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:

``SEC. 399O. SUICIDE PREVENTION FOR CHILDREN AND ADOLESCENTS.

    ``(a) Youth Suicide Early Intervention and Prevention Strategies.--
            ``(1) In general.--The Secretary shall award grants or 
        cooperative agreements to eligible entities to--
                    ``(A) develop and implement statewide youth suicide 
                early intervention and prevention strategies in 
                schools, educational institutions, juvenile justice 
                systems, substance abuse programs, mental health 
                programs, foster care systems, and other child and 
                youth support organizations;
                    ``(B) collect and analyze data on statewide youth 
                suicide early intervention and prevention services that 
                can be used to monitor the effectiveness of such 
                services and for research, technical assistance, and 
                policy development; and
                    ``(C) assist States, through statewide youth 
                suicide early intervention and prevention strategies, 
                in achieving their targets for youth suicide reductions 
                under title V of the Social Security Act (42 U.S.C. 701 
                et seq.).
            ``(2) Eligible entity defined.--In this subsection, the 
        term `eligible entity' means a State, political subdivision of 
        a State, federally-recognized Indian tribe, tribal 
        organization, public organization, or private nonprofit 
        organization actively involved in youth suicide early 
        intervention and prevention activities and in the development 
        and continuation of statewide youth suicide early intervention 
        and prevention strategies.
            ``(3) Preference.--The Secretary shall give preference to 
        eligible entities that--
                    ``(A) provide early intervention services to youth 
                in, and that are integrated with, school systems, 
                educational institutions, juvenile justice systems, 
                substance abuse programs, mental health programs, 
                foster care systems, and other child and youth support 
                organizations;
                    ``(B) demonstrate collaboration among early 
                intervention and prevention services or certify that 
                entities will engage in future collaboration;
                    ``(C) employ or include in their applications a 
                commitment to engage in an evaluative process the best 
                evidence-based or promising youth suicide early 
                intervention and prevention practices and strategies 
                adapted to the local community;
                    ``(D) provide for the timely assessment of youth 
                who are at risk for emotional disorders which may lead 
                to suicide attempts;
                    ``(E) provide timely referrals for appropriate 
                community-based mental health care and treatment of 
                youth in all child-serving settings and agencies who 
                are at risk for suicide;
                    ``(F) provide immediate support and information 
                resources to families of youth who are at risk for 
                emotional behavioral disorders which may lead to 
                suicide attempts;
                    ``(G) offer equal access to services and care to 
                youth with diverse linguistic and cultural backgrounds;
                    ``(H) offer appropriate postvention services, care, 
                and information to families, friends, schools, 
                educational institutions, juvenile justice systems, 
                substance abuse programs, mental health programs, 
                foster care systems, and other child and youth support 
                organizations of youth who recently completed suicide;
                    ``(I) offer continuous and up-to-date information 
                and awareness campaigns that target parents, family 
                members, child care professionals, community care 
                providers, and the general public and highlight the 
                risk factors associated with youth suicide and the 
                life-saving help and care available from early 
                intervention and prevention services;
                    ``(J) ensure that information and awareness 
                campaigns on youth suicide risk factors, and early 
                intervention and prevention services, use effective 
                communication mechanisms that are targeted to and reach 
                youth, families, schools, educational institutions, and 
                youth organizations;
                    ``(K) provide a timely response system to ensure 
                that child-serving professionals and providers are 
                properly trained in youth suicide early intervention 
                and prevention strategies and that child-serving 
                professionals and providers involved in early 
                intervention and prevention services are properly 
                trained in effectively identifying youth who are at 
                risk for suicide;
                    ``(L) provide continuous training activities for 
                child care professionals and community care providers 
                on the latest best evidence-based youth suicide early 
                intervention and prevention services practices and 
                strategies; and
                    ``(M) work with interested families and advocacy 
                organizations to conduct annual self-evaluations of 
                outcomes and activities on the State level, according 
                to standards established by the Secretary.
    ``(b) Technical Assistance, Data Management, and Research.--
            ``(1) Technical assistance and data management.--
                    ``(A) In general.--The Secretary shall award 
                technical assistance grants and cooperative agreements 
                to State agencies to conduct assessments independently 
                or in collaboration with educational institutions 
                related to the development of statewide youth suicide 
                early intervention and prevention strategies.
                    ``(B) Authorized activities.--Grants awarded under 
                subparagraph (A) shall be used to establish programs 
                for the development of standardized procedures for data 
                management, such as--
                            ``(i) ensuring the quality surveillance of 
                        youth suicide early intervention and prevention 
                        strategies;
                            ``(ii) providing technical assistance on 
                        data collection and management;
                            ``(iii) studying the costs and 
                        effectiveness of statewide youth suicide early 
                        intervention and prevention strategies in order 
                        to answer relevant issues of importance to 
                        State and national policymakers;
                            ``(iv) further identifying and 
                        understanding causes of and associated risk 
                        factors for youth suicide;
                            ``(v) ensuring the quality surveillance of 
                        suicidal behaviors and nonfatal suicidal 
                        attempts;
                            ``(vi) studying the effectiveness of 
                        statewide youth suicide early intervention and 
                        prevention strategies on the overall wellness 
                        and health promotion strategies related to 
                        suicide attempts; and
                            ``(vii) promoting the sharing of data 
                        regarding youth suicide with Federal agencies 
                        involved with youth suicide early intervention 
                        and prevention, and statewide youth suicide 
                        early intervention and prevention strategies 
                        for the purpose of identifying previously 
                        unknown mental health causes and associated 
                        risk-factors for suicide in youth.
            ``(2) Research.--
                    ``(A) In general.--The Secretary shall conduct a 
                program of research and development on the efficacy of 
                new and existing youth suicide early intervention 
                techniques and technology, including clinical studies 
                and evaluations of early intervention methods, and 
                related research aimed at reducing youth suicide and 
                offering support for emotional and behavioral disorders 
                which may lead to suicide attempts.
                    ``(B) Disseminating research.--The Secretary shall 
                promote the sharing of research and development data 
                developed pursuant to subparagraph (A) with the Federal 
                agencies involved in youth suicide early intervention 
                and prevention, and entities involved in statewide 
                youth suicide early intervention and prevention 
                strategies for the purpose of applying and integrating 
                new techniques and technology into existing statewide 
                youth suicide early intervention and strategies 
                systems.
    ``(c) Coordination and Collaboration.--
            ``(1) In general.--In carrying out this section, the 
        Secretary shall collaborate and consult with--
                    ``(A) other Federal agencies and State and local 
                agencies, including agencies responsible for early 
                intervention and prevention services under title XIX of 
                the Social Security Act (42 U.S.C. 1396 et seq.), the 
                State Children's Health Insurance Program under title 
                XXI of the Social Security Act (42 U.S.C. 1397aa et 
                seq.), programs funded by grants under title V of the 
                Social Security Act (42 U.S.C. 701 et seq.), and 
                programs under part C of the Individuals with 
                Disabilities Education Act (20 U.S.C. 1431 et seq.), 
                and the National Strategy for Suicide Prevention 
                Federal Steering Group;
                    ``(B) local and national organizations that serve 
                youth at risk for suicide and their families;
                    ``(C) relevant national medical and other health 
                and education specialty organizations;
                    ``(D) youth who are at risk for suicide, who have 
                survived suicide attempts, or who are currently 
                receiving care from early intervention services;
                    ``(E) families and friends of youth who are at risk 
                for suicide, who have survived suicide attempts, who 
                are currently receiving care from early intervention 
                and prevention services, or who have completed suicide;
                    ``(F) qualified professionals who possess the 
                specialized knowledge, skills, experience, and relevant 
                attributes needed to serve youth at risk for suicide 
                and their families; and
                    ``(G) third-party payers, managed care 
                organizations, and related commercial industries.
            ``(2) Policy development.--The Secretary shall coordinate 
        and collaborate on policy development at the Federal and State 
        levels and with the private sector, including consumer, 
        medical, suicide prevention advocacy groups, and other health 
        and education professional-based organizations, with respect to 
        statewide youth suicide early intervention and prevention 
        strategies.
    ``(d) Rule of Construction; Religious Accommodation.--Nothing in 
this section shall be construed to preempt any State law, including any 
State law that does not require the suicide early intervention for 
youth whose parents or legal guardians object to such early 
intervention based on the parents' or legal guardians' religious 
beliefs.
    ``(e) Evaluation.--
            ``(1) In general.--The Secretary shall conduct an 
        evaluation to analyze the effectiveness and efficacy of the 
        activities conducted with grants under this section.
            ``(2) Report.--Not later than 2 years after the date of 
        enactment of this section, the Secretary shall submit to the 
        appropriate committees of Congress a report concerning the 
        results of the evaluation conducted under paragraph (1).
    ``(f) Definitions.--In this section:
            ``(1) Best evidence-based.--The term `best evidence-based' 
        with respect to programs, means programs that have undergone 
        scientific evaluation and have proven to be effective.
            ``(2) Early intervention.--The term `early intervention' 
        means a strategy or approach that is intended to prevent an 
        outcome or to alter the course of an existing condition.
            ``(3) Educational institution.--The term `educational 
        institution' means a high school, vocational school, or an 
        institution of higher education.
            ``(4) Prevention.--The term `prevention' means a strategy 
        or approach that reduces the likelihood or risk of onset, or 
        delays the onset, of adverse health problems or reduces the 
        harm resulting from conditions or behaviors.
            ``(5) School.--The term `school' means a nonprofit 
        institutional day or residential school that provides an 
        elementary, middle, or secondary education, as determined under 
        applicable State law, except that such term does not include 
        any education beyond the 12th grade.
            ``(6) Youth.--The term `youth' means individuals who are 
        between 6 and 24 years of age.
    ``(g) Authorization of Appropriations.--
            ``(1) Statewide youth suicide early intervention and 
        prevention strategies.--For the purpose of carrying out 
        subsection (a), there are authorized to be appropriated 
        $25,000,000 for fiscal year 2005, $25,000,000 for fiscal year 
        2006, $25,000,000 for fiscal year 2007, and such sums as may be 
        necessary for each subsequent fiscal year.
            ``(2) Technical assistance, data management, and 
        research.--For the purpose of carrying out subsection (b), 
        there are authorized to be appropriated $5,000,000 for fiscal 
        year 2005, $5,000,000 for fiscal year 2006, $5,000,000 for 
        fiscal year 2007, and such sums as may be necessary for each 
        subsequent fiscal year.''.
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