[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.

                          ____________________