[Congressional Record Volume 167, Number 81 (Tuesday, May 11, 2021)]
[House]
[Pages H2169-H2171]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  IMPROVING MENTAL HEALTH ACCESS FROM THE EMERGENCY DEPARTMENT ACT OF 
                                  2021

  Mr. PALLONE. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 1205) 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.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1205

       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 2021''.

     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:

[[Page H2170]]

  


     ``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 2022 through 2026.''.

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

                              {time}  1515


                             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. 1205.
  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.
  Madam Speaker, I rise today in support of H.R. 1205, the Improving 
Mental Health Access from the Emergency Department Act.
  I would like to begin by recognizing a member of our committee, 
Representative Ruiz, 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 patients in 
the ER.
  Among those 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. And since 2009, mental 
health emergency room visits have substantially increased, most of 
which is driven by adolescents and young adults. This is especially 
concerning given the recent report from the Government Accountability 
Office that found emergency department visits for suicide attempts from 
mid-March to mid-October 2020 were up 26 percent from 2019.
  Now, this bill would help to provide increased access to care for 
people who report to an 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 tele-psychiatric 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 illnesses is linked to fewer 
repeat emergency room visits and improved mental and physical health. 
So let's do our part to support the emergency room staff and patients 
in need by passing this bill today.
  Madam Speaker, again, I urge my colleagues to support H.R. 1205, and 
I reserve the balance of my time.
  Mr. GUTHRIE. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I rise today in support of H.R. 1205, Improving Mental 
Health Access from the Emergency Department Act of 2021, sponsored by 
Representative Ruiz.
  This bill authorizes the Substance Abuse and Mental Health Services 
Administration to award grants to emergency departments for the purpose 
of supporting follow-up services to patients that present in the 
emergency department in mental health crisis.
  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 patients experiencing a mental 
health crisis in the emergency department.
  If a patient comes in with appendicitis, the emergency room physician 
can call a surgeon. If the patient has a rash, the emergency department 
has a roster of dermatologists in clinics; and, in many cases, the 
physician can even make an appointment for the patient. These 
partnerships don't always exist for mental health illness.
  By authorizing grants to support programs that help those treated at 
emergency departments expeditiously transition to follow-on care, this 
bill will remove barriers to care for those experiencing an acute 
mental health crisis, reduce stigma, and ultimately save lives.
  Madam Speaker, one of the great things I have learned being a Member 
of the House of Representatives is that we have 435 people from all 
walks of life and they bring all their life experiences to us and 
create some important legislation.
  Dr. Ruiz is an emergency room physician. He knows this firsthand. We 
are colleagues on the Committee on Energy and Commerce. I know he is 
passionate about it because it does save lives if we get people the 
assistance they need.
  Madam Speaker, I urge my colleagues to vote for this bill, and I 
yield back the balance of my time.
  Mr. PALLONE. Madam Speaker, again, we are trying with these series of 
bills today to address mental and behavioral health problems, and this 
one deals with the emergency room. So that is very important, and I 
would urge my colleagues to support it on a bipartisan basis.

[[Page H2171]]

  Madam Speaker, 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. 1205.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. ROY. Madam Speaker, on that I demand the yeas and nays.
  The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution 
8, the yeas and nays are ordered.
  Pursuant to clause 8 of rule XX, further proceedings on this motion 
are postponed.

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