[Congressional Record Volume 167, Number 81 (Tuesday, May 11, 2021)]
[House]
[Pages H2171-H2172]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
EFFECTIVE SUICIDE SCREENING AND ASSESSMENT IN THE EMERGENCY DEPARTMENT
ACT OF 2021
Mr. PALLONE. Madam Speaker, I move to suspend the rules and pass the
bill (H.R. 1324) to amend the Public Health Service Act to establish a
program to improve the identification, assessment, and treatment of
patients in hospital emergency departments who are at risk of suicide,
and for other purposes.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 1324
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 2021''.
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 later than one year after
the end of fiscal year 2026, 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 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.
General Leave
Mr. PALLONE. Madam Speaker, I ask unanimous consent that all Members
have 5 legislative days in which to revise and extend their remarks and
include extraneous material on H.R. 1324.
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. 1324, the Effective
Suicide Screening and Assessment in the Emergency Department Act.
The COVID-19 pandemic has caused tremendous suffering in our country
over the past year and has negatively impacted the mental health of so
many Americans. In fact, rates of mental health disorders, like
depression and anxiety, that may lead to suicide have gone up almost
fourfold.
According to the National Centers for Health Statistics, over 44,000
people died from suicide last year. However, these numbers may not
fully reflect the deaths that occurred secondary to despair from the
pandemic. Suicide is the second leading cause of death for people
between the ages of 10 and 34, impacting children and people in the
prime of their lives.
[[Page H2172]]
We also saw this during the pandemic with a spike in suicide deaths
for first responders. For example, who can forget the story of Dr.
Lorna Breen, an emergency room physician in New York, who dedicated
herself to fighting the pandemic, but then tragically died from suicide
after experiencing extreme burnout?
To counter these unnecessary deaths, we need to provide more
resources to our providers on the front lines of emergency departments
across the country. It is particularly important that we focus on those
with limited resources, including Critical Access Hospitals, facilities
serving Native Americans, and emergency departments in communities with
high rates of suicide.
Resources for healthcare providers in the emergency department are
important since they are often in the position of providing for
patients at the highest risk for suicide with approximately 10 percent
of emergency department patients presenting for treatment of suicidal
ideations. Unfortunately, almost 40 percent of patients visiting an
emergency department following a suicide attempt will go on to
reattempt suicide within a year.
Madam Speaker, this bill will assist emergency departments by
providing better training to emergency healthcare providers,
establishing policies to improve identification and treatment of
individuals at risk for suicide, employing additional behavioral health
professionals, and improving access to care for patients.
I thank Representatives Bilirakis and Soto and their staff for their
tireless effort on this bill. Again, bipartisan.
Madam Speaker, suicide deaths are a preventable tragedy that
negatively impact families and loved ones and rob us of young people in
the prime of their lives. So whatever we can do to prevent this is
going to be so important.
Madam Speaker, I urge my colleagues to support H.R. 1324, 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 strong support of H.R. 1324, the
Effective Suicide Screening and Assessment in the Emergency Department
Act of 2021, introduced by Representatives Bilirakis, Soto, and
Burgess.
This legislation will authorize the grant program to improve the
identification, screening, assessment, and treatment of patients in
emergency departments who are at risk for suicide.
Consideration of this bill could not come at a more pressing time.
The COVID-19 pandemic and resulting economic downturn have impacted the
mental health of many Americans. Due to the pandemic, tens of thousands
of additional Americans have died from suicide or substance misuse.
Emergency departments are key locations to intervene and assist those
who may be contemplating suicide. Past research has identified one in
every eight emergency department visits in the United States were
related to a mental health or substance use disorder.
By creating grants for emergency departments to develop policies for
screening those at risk of suicide, and enhancing their post-discharge
care coordination, this bill will improve our frontline providers'
ability to intervene when someone is in crisis, ultimately reducing
deaths from despair during this difficult time.
Madam Speaker, I reserve the balance of my time.
Mr. PALLONE. Madam Speaker, I reserve the balance of my time.
Mr. GUTHRIE. Madam Speaker, I yield 4 minutes to the gentleman from
Florida (Mr. Bilirakis), my friend.
Mr. BILIRAKIS. Madam Speaker, this is a real problem in this country.
We have a mental health crisis, and, collectively, these bills address
that. So I thank the chairman and the ranking member for bringing these
bills to the floor. Let's get them through today, and then passed in
the Senate and have the President sign because it will make a real
difference in the lives of these people who are suffering with mental
illness.
Madam Speaker, our Nation remains in the midst of a suicide crisis.
Over the past several decades, the suicide rate has risen sharply,
increasing by 31 percent since 2001, making suicide the 10th leading
cause of death, and claiming an estimated 47,000 lives annually.
A 2016 study found that 11 percent of all emergency department
patients exhibited suicidal ideation. However, only 3 percent of those
patients were diagnosed by current screening tools. Furthermore, about
70 percent of patients who leave the emergency department after a
suicide attempt never attend their first outpatient follow-up
appointment. This is just reality, and we have got to do something
about this.
The Effective Suicide Screening and Assessment in the Emergency
Department Act creates a voluntary HHS grant program to assist
emergency departments in developing protocols for identifying,
assessing, and treating individuals at risk for suicide with preference
given to either critical access hospitals or hospitals located in a
geographic area with a suicide risk that is higher than the national
average rate.
Grants last for 2 years and grantees must submit a report annually on
their efforts to improve the identification, assessment, and discharge
policies for individuals who are at risk for suicide. This proactive
approach is vital because emergency departments often are the first--
and, sadly, too often the only--point of contact within the healthcare
system for those most at risk for suicide.
Madam Speaker, I appreciate, again, the bipartisan support of my
colleague, and I worked on this with Congressman Soto.
Madam Speaker, I urge my colleagues to pass H.R. 1324, the Effective
Suicide Screening and Assessment in the Emergency Department Act, to
further equip our health providers to recognize and assist these
patients in crisis.
Mr. PALLONE. Madam Speaker, I reserve the balance of my time.
Mr. GUTHRIE. Madam Speaker, I am prepared to close, and I would just
say that these series of bills is so important in dealing with the
suicide and prevention, in preventing this tragic epidemic from
becoming a pandemic as well.
Madam Speaker, I urge the support, and I yield back the balance of my
time.
Mr. PALLONE. Madam Speaker, I also urge support for this bill. Again,
this is dealing with trying to alert potential problems or potential
for suicide in the emergency department, a very important part of this
package.
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. 1324.
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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