[Congressional Record Volume 166, Number 169 (Tuesday, September 29, 2020)]
[House]
[Pages H5016-H5017]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]





  IMPROVING MENTAL HEALTH ACCESS FROM THE EMERGENCY DEPARTMENT ACT OF 
                                  2020

  Mr. PALLONE. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 2519) to authorize the Secretary of Health and Human 
Services, acting through the Director of the Center for Mental Health 
Services of the Substance Abuse and Mental Health Services 
Administration, to award grants to implement innovative approaches to 
securing prompt access to appropriate follow-on care for individuals 
who experience an acute mental health episode and present for care in 
an emergency department, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 2519

       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 ``Improving Mental Health 
     Access from the Emergency Department Act of 2020''.

     SEC. 2. SECURING APPROPRIATE FOLLOW-ON CARE FOR ACUTE MENTAL 
                   HEALTH ILLNESS AFTER AN EMERGENCY DEPARTMENT 
                   ENCOUNTER.

       The Public Health Service Act is amended by inserting after 
     section 520J of such Act (42 U.S.C. 290bb-31) the following 
     new section:

     ``SEC. 520J-1. SECURING APPROPRIATE FOLLOW-ON CARE FOR ACUTE 
                   MENTAL HEALTH ILLNESS AFTER AN EMERGENCY 
                   DEPARTMENT ENCOUNTER.

       ``(a) In General.--The Secretary may award grants on a 
     competitive basis to qualifying health providers to implement 
     innovative approaches to securing prompt access to 
     appropriate follow-on care for individuals who experience an 
     acute mental health episode and present for care in an 
     emergency department.
       ``(b) Eligible Grant Recipients.--In this section, the term 
     `qualifying health provider' means a health care facility 
     licensed under applicable law that--
       ``(1) has an emergency department;
       ``(2) is staffed by medical personnel (such as emergency 
     physicians, psychiatrists, psychiatric registered nurses, 
     mental health technicians, clinical social workers, 
     psychologists, and therapists) capable of providing treatment 
     focused on stabilizing acute mental health conditions and 
     assisting patients to access resources to continue treatment 
     in the least restrictive appropriate setting; and
       ``(3) has arrangements in place with other providers of 
     care that can provide a full range of medically appropriate, 
     evidence-based services for the treatment of acute mental 
     health episodes.
       ``(c) Use of Funds.--A qualifying health provider receiving 
     funds under this section shall use such funds to create, 
     support, or expand programs or projects intended to assist 
     individuals who are treated at the provider's emergency 
     department for acute mental health episodes and to 
     expeditiously transition such individuals to an appropriate 
     facility or setting for follow-on care. Such use of funds may 
     support the following:
       ``(1) Expediting placement in appropriate facilities 
     through activities such as expanded coordination with 
     regional service providers, assessment, peer navigators, bed 
     availability tracking and management, transfer protocol 
     development, networking infrastructure development, and 
     transportation services.
       ``(2) Increasing the supply of inpatient psychiatric beds 
     and alternative care settings such as regional emergency 
     psychiatric facilities.
       ``(3) Use of alternative approaches to providing 
     psychiatric care in the emergency department setting, 
     including through tele-psychiatric support and other remote 
     psychiatric consultation, implementation of peak period 
     crisis clinics, or creation of psychiatric emergency service 
     units.
       ``(4) Use of approaches that include proactive followup 
     such as telephone check-ins, telemedicine, or other 
     technology-based outreach to individuals during the period of 
     transition.
       ``(5) Such other activities as are determined by the 
     Secretary to be appropriate, consistent with subsection (a).
       ``(d) Application.--A qualifying health provider desiring a 
     grant under this section shall prepare and submit an 
     application to the Secretary at such time and in such manner 
     as the Secretary may require. At a minimum, the application 
     shall include the following:
       ``(1) A description of identified need for acute mental 
     health services in the provider's service area.
       ``(2) A description of the existing efforts of the provider 
     to meet the need for acute mental health services in the 
     service area, and identified gaps in the provision of such 
     services.
       ``(3) A description of the proposed use of funds to meet 
     the need and gaps identified pursuant to paragraph (2).
       ``(4) A description of how the provider will coordinate 
     efforts with Federal, State, local, and private entities 
     within the service area.
       ``(5) A description of program objectives, how the 
     objectives are proposed to be met, and how the provider will 
     evaluate outcomes relative to objectives.
       ``(e) Authorization of Appropriations.--To carry out this 
     section, there is authorized to be appropriated $15,000,000 
     for each of fiscal years 2021 through 2025.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Oregon (Mr. Walden) each 
will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material on H.R. 2519.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Madam Speaker, I yield myself such time as I may 
consume.
  I rise today in support of H.R. 2519, the Improving Mental Health 
Access from the Emergency Department Act of 2020.
  I thank Representative Raul Ruiz, a member of our committee, and his 
staff for their work on this important legislation. As an emergency 
room physician himself, Dr. Ruiz knows firsthand the needs of both the 
medical professional and the patients in the ER.
  One of these increasing needs is support for mental health services. 
Research has shown that one in every eight emergency department visits 
in the U.S. is related to a mental health issue. Since 2009, mental 
health emergency room visits have substantially increased, most of 
which were driven by adolescents and young adults.
  This is especially concerning, given recent data from the Centers for 
Disease Control and Prevention that found that, in 2019, more than one 
in seven Americans experienced some level of anxiety and nearly one in 
five reported depression.
  These studies were conducted before COVID-19, and we know that this 
pandemic is likely to have both long- and short-term implications for 
mental health, and this anticipated increase in need is reason to act 
now. H.R. 2519 would help to provide increased access to care for 
people who report to the emergency department for acute mental health 
episodes.
  Under the bill, the Secretary of Health and Human Services is 
authorized to award grants to support innovative approaches for 
providing follow-on care for individuals treated in the emergency 
department for acute mental health issues. This includes increasing the 
number of inpatient psychiatric beds and alternative care settings, 
supporting a patient's transition to appropriate mental health 
services, or the use of telepsychiatric support or other remote 
psychiatric consultation methods.
  Madam Speaker, emergency departments can sometimes feel like a 
stressful place, especially for people in crisis; however, they are 
often the last remaining safety net in many communities. We know that 
follow-up care for people with mental illness is linked to fewer repeat 
emergency room visits and improved mental and physical health. Let's do 
our part to support the emergency room staff and patients in need.
  Madam Speaker, I urge my colleagues to support this bill, and I 
reserve the balance of my time.
  Mr. WALDEN. Madam Speaker, I yield myself such time as I may consume.
  I rise in support of H.R. 2519. This is the Improving Mental Health 
Access from the Emergency Department Act of 2020 sponsored by our 
colleague from California, Dr. Ruiz.
  The bill authorizes Substance Abuse and Mental Health Services 
Administration award grants to emergency departments for the purpose of 
supporting follow-up services to patients who present in the emergency 
department experiencing a mental health crisis.
  Now, according to SAMHSA's National Guidelines for Behavioral Health 
Crisis Care, there is a disconnect in the provision of follow-up 
services regarding what comes next for a patient experiencing a mental 
health crisis in an emergency department. If a patient comes in with 
appendicitis, the emergency physician can call a surgeon. If the 
patient has a rash, the emergency department has a roster of 
dermatologists and clinics, and, in many cases, the physician can even 
make an appointment for that patient.

[[Page H5017]]

  Sadly, tragically, these same partnerships don't always exist if the 
patient has mental health issues. By authorizing grants to support 
programs that help those treated at the emergency department 
expeditiously transition to follow-up care, this bill would remove 
those barriers to care for those who experience an acute mental health 
crisis. And we think it will reduce the stigma, and, ultimately, it 
will save lives.
  I ask my colleagues to join us in supporting this legislation.
  Madam Speaker, I don't believe we have any other speakers on this 
legislation, and I yield back the balance of my time.
  Mr. PALLONE. Madam Speaker, I urge support of the legislation, and I 
yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the bill, H.R. 2519, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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