[House Report 116-520]
[From the U.S. Government Publishing Office]


116th Congress }                                          { Report
                        HOUSE OF REPRESENTATIVES
  2d Session   }                                          { 116-520

======================================================================
 
                         SUICIDE PREVENTION ACT

                                _______
                                

 September 18, 2020.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Pallone, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 5619]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 5619) to authorize a pilot program to expand and 
intensify surveillance of self-harm in partnership with State 
and local public health departments, to establish a grant 
program to provide self-harm and suicide prevention services in 
hospital emergency departments, and for other purposes, having 
considered the same, reports favorably thereon with an 
amendment and recommends that the bill as amended do pass.

                                CONTENTS

                                                                   Page
  I. Purpose and Summary..............................................4
 II. Background and Need for the Legislation..........................4
III. Committee Hearings...............................................5
 IV. Committee Consideration..........................................5
  V. Committee Votes..................................................5
 VI. Oversight Findings...............................................6
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures6
VIII.Federal Mandates Statement.......................................6

 IX. Statement of General Performance Goals and Objectives............6
  X. Duplication of Federal Programs..................................6
 XI. Committee Cost Estimate..........................................6
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits......7
XIII.Advisory Committee Statement.....................................7

XIV. Applicability to Legislative Branch..............................7
 XV. Section-by-Section Analysis of the Legislation...................7
XVI. Changes in Existing Law Made by the Bill, as Reported............8

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Suicide Prevention Act''.

SEC. 2. SYNDROMIC SURVEILLANCE OF SELF-HARM BEHAVIORS PROGRAM.

  Title III of the Public Health Service Act is amended by inserting 
after section 317U of such Act (42 U.S.C. 247b-23) the following:

``SEC. 317V. SYNDROMIC SURVEILLANCE OF SELF-HARM BEHAVIORS PROGRAM.

  ``(a) In General.--The Secretary shall award grants to State, local, 
Tribal, and territorial public health departments for the expansion of 
surveillance of self-harm.
  ``(b) Data Sharing by Grantees.--As a condition of receipt of such 
grant under subsection (a), each grantee shall agree to share with the 
Centers for Disease Control and Prevention in real time, to the extent 
feasible and as specified in the grant agreement, data on suicides and 
self-harm for purposes of--
          ``(1) tracking and monitoring self-harm to inform response 
        activities to suicide clusters;
          ``(2) informing prevention programming for identified at-risk 
        populations; and
          ``(3) conducting or supporting research.
  ``(c) Disaggregation of Data.--The Secretary shall provide for the 
data collected through surveillance of self-harm under subsection (b) 
to be disaggregated by the following categories:
          ``(1) Nonfatal self-harm data of any intent.
          ``(2) Data on suicidal ideation.
          ``(3) Data on self-harm where there is no evidence, whether 
        implicit or explicit, of suicidal intent.
          ``(4) Data on self-harm where there is evidence, whether 
        implicit or explicit, of suicidal intent.
          ``(5) Data on self-harm where suicidal intent is unclear 
        based on the available evidence.
  ``(d) Priority.--In making awards under subsection (a), the Secretary 
shall give priority to eligible entities that are--
          ``(1) located in a State with an age-adjusted rate of 
        nonfatal suicidal behavior that is above the national rate of 
        nonfatal suicidal behavior, as determined by the Director of 
        the Centers for Disease Control and Prevention;
          ``(2) serving an Indian Tribe (as defined in section 4 of the 
        Indian Self-Determination and Education Assistance Act) with an 
        age-adjusted rate of nonfatal suicidal behavior that is above 
        the national rate of nonfatal suicidal behavior, as determined 
        through appropriate mechanisms determined by the Secretary in 
        consultation with Indian Tribes; or
          ``(3) located in a State with a high rate of coverage of 
        statewide (or Tribal) emergency department visits, as 
        determined by the Director of the Centers for Disease Control 
        and Prevention.
  ``(e) Geographic Distribution.--In making grants under this section, 
the Secretary shall make an effort to ensure geographic distribution, 
taking into account the unique needs of rural communities, including--
          ``(1) communities with an incidence of individuals with 
        serious mental illness, demonstrated suicidal ideation or 
        behavior, or suicide rates that are above the national average, 
        as determined by the Assistant Secretary for Mental Health and 
        Substance Use;
          ``(2) communities with a shortage of prevention and treatment 
        services, as determined by the Assistant Secretary for Mental 
        Health and Substance Use and the Administrator of the Health 
        Resources and Services Administration; and
          ``(3) other appropriate community-level factors and social 
        determinants of health such as income, employment, and 
        education.
  ``(f) Period of Participation.--To be selected as a grant recipient 
under this section, a State, local, Tribal, or territorial public 
health department shall agree to participate in the program for a 
period of not less than 4 years.
  ``(g) Technical Assistance.--The Secretary shall provide technical 
assistance and training to grantees for collecting and sharing the data 
under subsection (b).
  ``(h) Data Sharing by HHS.--Subject to subsection (b), the Secretary 
shall, with respect to data on self-harm that is collected pursuant to 
this section, share and integrate such data through--
          ``(1) the National Syndromic Surveillance Program's Early 
        Notification of Community Epidemics (ESSENCE) platform (or any 
        successor platform);
          ``(2) the National Violent Death Reporting System, as 
        appropriate; or
          ``(3) another appropriate surveillance program, including 
        such a program that collects data on suicides and self-harm 
        among special populations, such as members of the military and 
        veterans.
  ``(i) Rule of Construction Regarding Applicability of Privacy 
Protections.--Nothing in this section shall be construed to limit or 
alter the application of Federal or State law relating to the privacy 
of information to data or information that is collected or created 
under this section.
  ``(j) Report.--
          ``(1) Submission.--Not later than 3 years after the date of 
        enactment of this Act, the Secretary shall evaluate the suicide 
        and self-harm syndromic surveillance systems at the Federal, 
        State, and local levels and submit a report to Congress on the 
        data collected under subsections (b) and (c) in a manner that 
        prevents the disclosure of individually identifiable 
        information, at a minimum, consistent with all applicable 
        privacy laws and regulations.
          ``(2) Contents.--In addition to the data collected under 
        subsections (b) and (c), the report under paragraph (1) shall 
        include--
                  ``(A) challenges and gaps in data collection and 
                reporting;
                  ``(B) recommendations to address such gaps and 
                challenges; and
                  ``(C) a description of any public health responses 
                initiated at the Federal, State, or local level in 
                response to the data collected.
  ``(k) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated $20,000,000 for each of fiscal 
years 2021 through 2025.''.

SEC. 3. GRANTS TO PROVIDE SELF-HARM AND SUICIDE PREVENTION SERVICES.

  Part B of title V of the Public Health Service Act (42 U.S.C. 290aa 
et seq.) is amended by adding at the end the following:

``SEC. 520N. GRANTS TO PROVIDE SELF-HARM AND SUICIDE PREVENTION 
                    SERVICES.

  ``(a) In General.--The Secretary of Health and Human Services shall 
award grants to hospital emergency departments to provide self-harm and 
suicide prevention services.
  ``(b) Activities Supported.--
          ``(1) In general.--A hospital emergency department awarded a 
        grant under subsection (a) shall use amounts under the grant to 
        implement a program or protocol to better prevent suicide 
        attempts among hospital patients after discharge, which may 
        include--
                  ``(A) screening patients for self-harm and suicide in 
                accordance with the standards of practice described in 
                subsection (e)(1) and standards of care established by 
                appropriate medical and advocacy organizations;
                  ``(B) providing patients short-term self-harm and 
                suicide prevention services in accordance with the 
                results of the screenings described in subparagraph 
                (A); and
                  ``(C) referring patients, as appropriate, to a health 
                care facility or provider for purposes of receiving 
                long-term self-harm and suicide prevention services, 
                and providing any additional follow up services and 
                care identified as appropriate as a result of the 
                screenings and short-term self-harm and suicide 
                prevention services described in subparagraphs (A) and 
                (B).
          ``(2) Use of funds to hire and train staff.--Amounts awarded 
        under subsection (a) may be used to hire clinical social 
        workers, mental and behavioral health care professionals, and 
        support staff as appropriate, and to train existing staff and 
        newly hired staff to carry out the activities described in 
        paragraph (1).
  ``(c) Grant Terms.--A grant awarded under subsection (a)--
          ``(1) shall be for a period of 3 years; and
          ``(2) may be renewed subject to the requirements of this 
        section.
  ``(d) Applications.--A hospital emergency department seeking a grant 
under subsection (a) shall submit an application to the Secretary at 
such time, in such manner, and accompanied by such information as the 
Secretary may require.
  ``(e) Standards of Practice.--
          ``(1) In general.--Not later than 180 days after the date of 
        the enactment of this section, the Secretary shall develop 
        standards of practice for screening patients for self-harm and 
        suicide for purposes of carrying out subsection (b)(1)(C).
          ``(2) Consultation.--The Secretary shall develop the 
        standards of practice described in paragraph (1) in 
        consultation with individuals and entities with expertise in 
        self-harm and suicide prevention, including public, private, 
        and non-profit entities.
  ``(f) Reporting.--
          ``(1) Reports to the secretary.--
                  ``(A) In general.--A hospital emergency department 
                awarded a grant under subsection (a) shall, at least 
                quarterly for the duration of the grant, submit to the 
                Secretary a report evaluating the activities supported 
                by the grant.
                  ``(B) Matters to be included.--The report required 
                under subparagraph (A) shall include--
                          ``(i) the number of patients receiving--
                                  ``(I) screenings carried out at the 
                                hospital emergency department;
                                  ``(II) short-term self-harm and 
                                suicide prevention services at the 
                                hospital emergency department; and
                                  ``(III) referrals to health care 
                                facilities for the purposes of 
                                receiving long-term self-harm and 
                                suicide prevention;
                          ``(ii) information on the adherence of the 
                        hospital emergency department to the standards 
                        of practice described in subsection (f)(1); and
                          ``(iii) other information as the Secretary 
                        determines appropriate to evaluate the use of 
                        grant funds.
          ``(2) Reports to congress.--Not later than 2 years after the 
        date of the enactment of the Suicide Prevention Act, and 
        biennially thereafter, the Secretary shall submit to the 
        Committee on Health, Education, Labor and Pensions of the 
        Senate and the Committee on Energy and Commerce of the House of 
        Representatives a report on the grant program under this 
        section, including--
                  ``(A) a summary of reports received by the Secretary 
                under paragraph (1); and
                  ``(B) an evaluation of the program by the Secretary.
  ``(g) Authorization of Appropriations.--To carry out this section, 
there are authorized to be appropriated $30,000,000 for each of fiscal 
years 2021 through 2025.''.

                         I. Purpose and Summary

    H.R. 5619, the ``Suicide Prevention Act'', was introduced 
on January 15, 2020, by Representatives Chris Stewart (R-UT) 
and Doris O. Matsui (D-CA). H.R. 5619 establishes two grant 
programs to help prevent self-harm and suicide. The bill 
requires the Secretary of Health and Human Services (the 
Secretary) to award grants to State, local, Tribal, and 
territorial health departments to expand surveillance of self-
harm. The bill also requires the Secretary to award grants to 
hospital emergency departments for programs to prevent self-
harm and suicide attempts among patients after discharge.

                II. Background and Need for Legislation

    The United States does not currently have a complete count 
of suicide attempts.\1\ It is, however, estimated that 0.5 
percent of the adults aged 18 or older (1.4 million adults) 
made at least one suicide attempt.\2\ According to recent data, 
suicide is also among the leading causes of death in the 
Nation.\3\ In 2018, 10.7 million adults seriously contemplated 
suicide, 3.3 million of whom made suicide plans, and 1.4 
million made a nonfatal suicide attempt.\4\ Available data 
suggest that adult females reported a suicide attempt 1.5 times 
as often as males; further breakdown by gender and race are not 
available.\5\ H.R. 5619 would enhance data collection for 
State, local, Tribal, and territorial health departments and 
community organizations in order to help recognize suicide 
trends, intervene earlier, and save lives.
---------------------------------------------------------------------------
    \1\https://afsp.org/suicide-statistics/
    \2\https://www.samhsa.gov/data/release/2018-national-survey-drug-
use-and-health-nsduh-releases
    \3\National Center for Health Statistics, Leading Causes of Death 
(www.cdc.gov/nchs/fastats/leading-causes-of-death.htm) (accessed June 
5, 2020).
    \4\U.S. Department of Health and Human Services, Mental Health 
Myths and Fact (www.mentalhealth.gov) (accessed June 6, 2020).
    \5\Id.
---------------------------------------------------------------------------
    According to the American Foundation for Suicide 
Prevention, emergency departments present a key opportunity to 
identify and treat the individuals at the highest and most 
immediate risk for suicide because 39 percent of people who die 
by suicide make an emergency department visit in the year prior 
to their deaths.\6\ Further, studies indicate that the risk of 
a suicide attempt or death is highest within the first 30 days 
after discharge from an emergency department or inpatient 
psychiatric unit.\7\ Yet for many reasons, up to 70 percent of 
patients who leave the emergency department after a suicide 
attempt never attend their first outpatient follow-up 
appointment.\8\ H.R. 5619 would provide grants to emergency 
departments to establish or enhance their self-harm and suicide 
prevention services.
---------------------------------------------------------------------------
    \6\https://project2025.afsp.org/
    \7\Knesper, D.J. (2010). Continuity of care for suicide prevention 
and research: Suicide attempts and suicide deaths subsequent to 
discharge from the emergency department or psychiatry inpatient unit. 
Newton, MA: Suicide Prevention Resource Center.
    \8\Id.
---------------------------------------------------------------------------

                        III. Committee Hearings

    For the purposes of section 103(i) of H. Res. 6 of the 
116th Congress, the following hearing was used to develop or 
consider H.R. 5619:
    The Subcommittee on Health held a legislative hearing on 
June 30, 2020, entitled, ``High Anxiety and Stress: Legislation 
to Improve Mental Health During Crisis'' to consider H.R. 5619, 
the ``Suicide Prevention Act''. The Subcommittee received 
testimony from the following witnesses:
           The Honorable Patrick J. Kennedy, Founder of 
        the Kennedy Forum and former Member of Congress;
           Arthur C. Evans, Jr. Ph.D., Chief Executive 
        Officer, American Psychological Association;
           Jeffrey L. Geller, M.D., M.P.H., President, 
        American Psychiatric Association; and
           Ms. Arriana Gross, National Youth Advisory 
        Board Member, Sandy Hook Promise Students Against 
        Violence Everywhere (SAVE) Promise Club.

                      IV. Committee Consideration

    H.R. 5619, the ``Suicide Prevention Act'', was introduced 
by Representative Stewart (R-UT) and Matsui (D-CA) on January 
15, 2020 and was referred to the Committee on Energy and 
Commerce. The bill was then referred to the Subcommittee on 
Health on January 16, 2020. On June 30, 2020, the Subcommittee 
held a legislative hearing on the bill.
    On July 15, 2020, the Subcommittee on Health was discharged 
from further consideration of H.R. 5619 as the bill was called 
up for markup, pursuant to notice, by the full Committee on 
Energy and Commerce. During consideration and markup an 
amendment in the nature of a substitute (AINS) was offered by 
Ms. Matsui of California. The Matsui AINS was agreed to by a 
voice vote. The full Committee subsequently agreed to a motion 
on final passage offered by Mr. Pallone, Chairman of the 
committee, to order H.R. 5619 reported favorably to the House, 
amended, by a voice vote, a quorum being present.

                           V. Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. The 
Committee advises that there were no record votes taken on H.R. 
5619, including the motion on final passage of the bill.

                         VI. Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) 
of rule X of the Rules of the House of Representatives, the 
oversight findings and recommendations of the Committee are 
reflected in the descriptive portion of the report.

 VII. New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to 3(c)(2) of rule XIII of the Rules of the House 
of Representatives, the Committee adopts as its own the 
estimate of new budget authority, entitlement authority, or tax 
expenditures or revenues contained in the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.
    The Committee has requested but not received from the 
Director of the Congressional Budget Office a statement as to 
whether this bill contains any new budget authority, spending 
authority, credit authority, or an increase or decrease in 
revenues or tax expenditures.

                    VIII. Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

       IX. Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to expand 
and intensify surveillance of self-harm in partnership with 
State, local, Tribal, and territorial public health departments 
and to improve suicide prevention resources in hospital 
emergency departments.

                   X. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 5619 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

                      XI. Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

    XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 5619 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                   XIII. Advisory Committee Statement

    No advisory committee within the meaning of section 5(b) of 
the Federal Advisory Committee Act was created by this 
legislation.

                XIV. Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

           XV. Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the short title may be cited as 
the ``Suicide Prevention Act''.

Sec. 2. Syndromic surveillance of self harm behaviors program

    Section 2 amends the Public Health Service Act to direct 
the Secretary of Health and Human Services (the Secretary) to 
award grants to State, local, Tribal, and territorial public 
health departments for expansion of self-harm surveillance. 
Further, section 2 requires recipients of such grants to share 
these data with the Center for Disease Control and Prevention 
(CDC) for the purposes of nationwide tracking and monitoring on 
self-harm in order to inform prevention programming and 
research. These data shall be disaggregated by nonfatal self-
harm data; data on suicidal ideation; and data on suicidal 
intent.
    In awarding these grants, the Secretary shall give priority 
to eligible entities serving locations or populations with 
higher than national average rates of nonfatal suicidal 
behavior. The Secretary shall also try to ensure geographic 
distribution of funding is considered, including to communities 
with a shortage of prevention and treatment services. Grant 
recipients shall agree to participate in the program for no 
less than four years, and the Secretary shall provide technical 
assistance and training to grantees on collecting and sharing 
data. No later than 3 years after the date of enactment, the 
Secretary shall evaluate suicide and self-harm syndromic 
surveillance systems at the Federal, State, and local levels 
and submit a report to Congress on the data collected, any 
challenges and gaps in data collection and reporting, 
recommendations to address these challenges or gaps, and a 
description of public health responses initiated in response to 
the collected data.
    There is authorized to be appropriated $20 million for each 
of the fiscal years 2021 through 2025 to carry out section 2.

Sec. 3. Grants to provide self harm and suicide prevention services

    Section 3 amends the Public Health Service Act to direct 
the Secretary to award grants to hospital emergency departments 
to provide self-harm and suicide prevention services. Such 
grants shall be used to implement suicide prevention programs 
or protocols for hospital patients after discharge. Activities 
may include increased screening, additional short-term 
services, targeted referral services. These funds may also be 
used to hire and train staff to carry out these activities.
    Grants shall be for a period of three years, and grantees 
must report to the Secretary regarding the activities carried 
out with the grants. Not later than 180 days after the date of 
enactment, the Secretary shall, in consultation with 
individuals and entities with expertise in self-harm and 
suicide prevention, develop standards of practice for screening 
patients for self-harm and suicide. The Secretary must report 
to the relevant committees of jurisdiction a program evaluation 
no later than two years after enactment.
    There is authorized to be appropriated $30 million for each 
of the fiscal years 2021 through 2025 to carry out section 3.

       XVI. Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italics and existing law in which no change is 
proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



Part B--Federal-State Cooperation

           *       *       *       *       *       *       *



SEC. 317V. SYNDROMIC SURVEILLANCE OF SELF-HARM BEHAVIORS PROGRAM.

  (a) In General.--The Secretary shall award grants to State, 
local, Tribal, and territorial public health departments for 
the expansion of surveillance of self-harm.
  (b) Data Sharing by Grantees.--As a condition of receipt of 
such grant under subsection (a), each grantee shall agree to 
share with the Centers for Disease Control and Prevention in 
real time, to the extent feasible and as specified in the grant 
agreement, data on suicides and self-harm for purposes of--
          (1) tracking and monitoring self-harm to inform 
        response activities to suicide clusters;
          (2) informing prevention programming for identified 
        at-risk populations; and
          (3) conducting or supporting research.
  (c) Disaggregation of Data.--The Secretary shall provide for 
the data collected through surveillance of self-harm under 
subsection (b) to be disaggregated by the following categories:
          (1) Nonfatal self-harm data of any intent.
          (2) Data on suicidal ideation.
          (3) Data on self-harm where there is no evidence, 
        whether implicit or explicit, of suicidal intent.
          (4) Data on self-harm where there is evidence, 
        whether implicit or explicit, of suicidal intent.
          (5) Data on self-harm where suicidal intent is 
        unclear based on the available evidence.
  (d) Priority.--In making awards under subsection (a), the 
Secretary shall give priority to eligible entities that are--
          (1) located in a State with an age-adjusted rate of 
        nonfatal suicidal behavior that is above the national 
        rate of nonfatal suicidal behavior, as determined by 
        the Director of the Centers for Disease Control and 
        Prevention;
          (2) serving an Indian Tribe (as defined in section 4 
        of the Indian Self-Determination and Education 
        Assistance Act) with an age-adjusted rate of nonfatal 
        suicidal behavior that is above the national rate of 
        nonfatal suicidal behavior, as determined through 
        appropriate mechanisms determined by the Secretary in 
        consultation with Indian Tribes; or
          (3) located in a State with a high rate of coverage 
        of statewide (or Tribal) emergency department visits, 
        as determined by the Director of the Centers for 
        Disease Control and Prevention.
  (e) Geographic Distribution.--In making grants under this 
section, the Secretary shall make an effort to ensure 
geographic distribution, taking into account the unique needs 
of rural communities, including--
          (1) communities with an incidence of individuals with 
        serious mental illness, demonstrated suicidal ideation 
        or behavior, or suicide rates that are above the 
        national average, as determined by the Assistant 
        Secretary for Mental Health and Substance Use;
          (2) communities with a shortage of prevention and 
        treatment services, as determined by the Assistant 
        Secretary for Mental Health and Substance Use and the 
        Administrator of the Health Resources and Services 
        Administration; and
          (3) other appropriate community-level factors and 
        social determinants of health such as income, 
        employment, and education.
  (f) Period of Participation.--To be selected as a grant 
recipient under this section, a State, local, Tribal, or 
territorial public health department shall agree to participate 
in the program for a period of not less than 4 years.
  (g) Technical Assistance.--The Secretary shall provide 
technical assistance and training to grantees for collecting 
and sharing the data under subsection (b).
  (h) Data Sharing by HHS.--Subject to subsection (b), the 
Secretary shall, with respect to data on self-harm that is 
collected pursuant to this section, share and integrate such 
data through--
          (1) the National Syndromic Surveillance Program's 
        Early Notification of Community Epidemics (ESSENCE) 
        platform (or any successor platform);
          (2) the National Violent Death Reporting System, as 
        appropriate; or
          (3) another appropriate surveillance program, 
        including such a program that collects data on suicides 
        and self-harm among special populations, such as 
        members of the military and veterans.
  (i) Rule of Construction Regarding Applicability of Privacy 
Protections.--Nothing in this section shall be construed to 
limit or alter the application of Federal or State law relating 
to the privacy of information to data or information that is 
collected or created under this section.
  (j) Report.--
          (1) Submission.--Not later than 3 years after the 
        date of enactment of this Act, the Secretary shall 
        evaluate the suicide and self-harm syndromic 
        surveillance systems at the Federal, State, and local 
        levels and submit a report to Congress on the data 
        collected under subsections (b) and (c) in a manner 
        that prevents the disclosure of individually 
        identifiable information, at a minimum, consistent with 
        all applicable privacy laws and regulations.
          (2) Contents.--In addition to the data collected 
        under subsections (b) and (c), the report under 
        paragraph (1) shall include--
                  (A) challenges and gaps in data collection 
                and reporting;
                  (B) recommendations to address such gaps and 
                challenges; and
                  (C) a description of any public health 
                responses initiated at the Federal, State, or 
                local level in response to the data collected.
  (k) Authorization of Appropriations.--To carry out this 
section, there are authorized to be appropriated $20,000,000 
for each of fiscal years 2021 through 2025.

           *       *       *       *       *       *       *


TITLE V--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

           *       *       *       *       *       *       *



Part B--Centers and Programs

           *       *       *       *       *       *       *



Subpart 3--Center for Mental Health Services

           *       *       *       *       *       *       *



SEC. 520N. GRANTS TO PROVIDE SELF-HARM AND SUICIDE PREVENTION SERVICES.

  (a) In General.--The Secretary of Health and Human Services 
shall award grants to hospital emergency departments to provide 
self-harm and suicide prevention services.
  (b) Activities Supported.--
          (1) In general.--A hospital emergency department 
        awarded a grant under subsection (a) shall use amounts 
        under the grant to implement a program or protocol to 
        better prevent suicide attempts among hospital patients 
        after discharge, which may include--
                  (A) screening patients for self-harm and 
                suicide in accordance with the standards of 
                practice described in subsection (e)(1) and 
                standards of care established by appropriate 
                medical and advocacy organizations;
                  (B) providing patients short-term self-harm 
                and suicide prevention services in accordance 
                with the results of the screenings described in 
                subparagraph (A); and
                  (C) referring patients, as appropriate, to a 
                health care facility or provider for purposes 
                of receiving long-term self-harm and suicide 
                prevention services, and providing any 
                additional follow up services and care 
                identified as appropriate as a result of the 
                screenings and short-term self-harm and suicide 
                prevention services described in subparagraphs 
                (A) and (B).
          (2) Use of funds to hire and train staff.--Amounts 
        awarded under subsection (a) may be used to hire 
        clinical social workers, mental and behavioral health 
        care professionals, and support staff as appropriate, 
        and to train existing staff and newly hired staff to 
        carry out the activities described in paragraph (1).
  (c) Grant Terms.--A grant awarded under subsection (a)--
          (1) shall be for a period of 3 years; and
          (2) may be renewed subject to the requirements of 
        this section.
  (d) Applications.--A hospital emergency department seeking a 
grant under subsection (a) shall submit an application to the 
Secretary at such time, in such manner, and accompanied by such 
information as the Secretary may require.
  (e) Standards of Practice.--
          (1) In general.--Not later than 180 days after the 
        date of the enactment of this section, the Secretary 
        shall develop standards of practice for screening 
        patients for self-harm and suicide for purposes of 
        carrying out subsection (b)(1)(C).
          (2) Consultation.--The Secretary shall develop the 
        standards of practice described in paragraph (1) in 
        consultation with individuals and entities with 
        expertise in self-harm and suicide prevention, 
        including public, private, and non-profit entities.
  (f) Reporting.--
          (1) Reports to the secretary.--
                  (A) In general.--A hospital emergency 
                department awarded a grant under subsection (a) 
                shall, at least quarterly for the duration of 
                the grant, submit to the Secretary a report 
                evaluating the activities supported by the 
                grant.
                  (B) Matters to be included.--The report 
                required under subparagraph (A) shall include--
                          (i) the number of patients 
                        receiving--
                                  (I) screenings carried out at 
                                the hospital emergency 
                                department;
                                  (II) short-term self-harm and 
                                suicide prevention services at 
                                the hospital emergency 
                                department; and
                                  (III) referrals to health 
                                care facilities for the 
                                purposes of receiving long-term 
                                self-harm and suicide 
                                prevention;
                          (ii) information on the adherence of 
                        the hospital emergency department to 
                        the standards of practice described in 
                        subsection (f)(1); and
                          (iii) other information as the 
                        Secretary determines appropriate to 
                        evaluate the use of grant funds.
          (2) Reports to congress.--Not later than 2 years 
        after the date of the enactment of the Suicide 
        Prevention Act, and biennially thereafter, the 
        Secretary shall submit to the Committee on Health, 
        Education, Labor and Pensions of the Senate and the 
        Committee on Energy and Commerce of the House of 
        Representatives a report on the grant program under 
        this section, including--
                  (A) a summary of reports received by the 
                Secretary under paragraph (1); and
                  (B) an evaluation of the program by the 
                Secretary.
  (g) Authorization of Appropriations.--To carry out this 
section, there are authorized to be appropriated $30,000,000 
for each of fiscal years 2021 through 2025.

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