[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4861 Introduced in House (IH)]

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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 program 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 Representatives 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''.

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 DEPARTMENT WHO ARE AT RISK OF SUICIDE.

    ``(a) In General.--The Secretary shall establish a program (in this 
Act referred to as the `Program') to improve the identification, 
assessment, and treatment of patients in emergency departments who are 
at risk for suicide, 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 Participation.--
            ``(1) In general.--In carrying out the Program, the 
        Secretary shall award grants on a competitive basis to not more 
        than 40 eligible health care sites described in paragraph (2).
            ``(2) Eligibility.--To be eligible for a grant under this 
        section, a health care site shall--
                    ``(A) submit an application to the Secretary at 
                such time, in such manner, and containing 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 integrate 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 eligible health care sites 
        described in paragraph (2) that meet at least one of the 
        following criteria:
                    ``(A) The eligible health care site is a critical 
                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 operated by 
                the Indian Health Service, by an Indian tribe or tribal 
                organization (as such terms are defined in section 4 of 
                the Indian Self-Determination and Education Assistance 
                Act), or by an urban Indian organization (as defined in 
                section 4 of the Indian Health Care Improvement 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 Prevention.
    ``(c) Period of Grant.--A grant awarded to an eligible health care 
site under this section shall be for a period 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 treatment of individuals 
                who are at risk of suicide.
                    ``(C) To establish and implement policies and 
                procedures with respect to care coordination, 
                integrated care models, or referral to evidence-based 
                treatment to be used upon the discharge from the 
                emergency department of patients who are at risk of 
                suicide.
            ``(2) Additional permissible uses.--In addition 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 psychiatrists, 
                psychologists, nurse practitioners, counselors, 
                therapists, or other licensed health care and 
                behavioral health professionals specializing in the 
                treatment of individuals at risk of suicide.
                    ``(B) To develop and implement best practices for 
                the follow-up care and long-term treatment of 
                individuals who are at risk of suicide.
                    ``(C) To increase the availability of and access to 
                evidence-based treatment for individuals who are at 
                risk of suicide, including through telehealth services 
                and strategies to reduce the boarding of these patients 
                in emergency departments.
                    ``(D) To offer consultation with and referral to 
                other supportive services that provide evidence-based 
                treatment and recovery for individuals 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 behavioral health 
                professional hired pursuant to subsection (d)(2)(A);
                    ``(D) the number of individuals referred by the 
                site's emergency department to other treatment 
                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 activities 
                funded through the grant in preventing suicides and 
                suicide attempts; and
                    ``(F) any other relevant additional data regarding 
                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 Secretary shall submit to 
        Congress a report that includes--
                    ``(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
                    ``(D) a compilation of policies, procedures, and 
                best practices established, developed, or implemented 
                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.''.
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