[House Report 116-542]
[From the U.S. Government Publishing Office]


116th Congress   }                                        {     Report
                        HOUSE OF REPRESENTATIVES
 2d Session      }                                        {    116-542

======================================================================



 
   SUICIDE TRAINING AND AWARENESS NATIONALLY DELIVERED FOR UNIVERSAL 
                         PREVENTION ACT OF 2020

                                _______
                                

 September 29, 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. 7293]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 7293) to amend the Public Health Service Act to 
provide best practices on student suicide awareness and 
prevention training and condition State educational agencies, 
local educational agencies, and tribal educational agencies 
receiving funds under section 520A of such Act to establish and 
implement a school-based student suicide awareness and 
prevention training policy, 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..............................................3
 II. Background and Need for the Legislation..........................3
III. Committee Hearings...............................................4
 IV. Committee Consideration..........................................5
  V. Committee Votes..................................................5
 VI. Oversight Findings...............................................5
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures5
VIII.Federal Mandates Statement.......................................5

 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......6
XIII.Advisory Committee Statement.....................................6

XIV. Applicability to Legislative Branch..............................6
 XV. Section-by-Section Analysis of the Legislation...................6
XVI. Changes in Existing Law Made by the Bill, as Reported............7

    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 Training and Awareness 
Nationally Delivered for Universal Prevention Act of 2020'' or the 
``STANDUP Act of 2020''.

SEC. 2. STUDENT SUICIDE AWARENESS AND PREVENTION TRAINING.

  (a) In General.--Title V of the Public Health Service Act is amended 
by inserting after section 520A of such Act (42 U.S.C. 290bb-32) the 
following:

``SEC. 520B. STUDENT SUICIDE AWARENESS AND PREVENTION TRAINING 
                    POLICIES.

  ``(a) In General.--As a condition on receipt of funds under section 
520A, each State educational agency, local educational agency, and 
Tribal educational agency that receives such funds, directly or through 
a State or Indian Tribe, for activities to be performed within 
secondary schools, including the Project AWARE State Education Agency 
Grant Program, shall--
          ``(1) establish and implement a school-based student suicide 
        awareness and prevention training policy;
          ``(2) consult with stakeholders (including principals, 
        teachers, parents, local Tribal officials, and other school 
        leaders) in the development of the policy under subsection 
        (a)(1); and
          ``(3) collect and report information in accordance with 
        subsection (c).
  ``(b) School-Based Student Suicide Awareness and Prevention Training 
Policy.--A school-based student suicide awareness and prevention 
training policy implemented pursuant to subsection (a)--
          ``(1) shall be evidence-based;
          ``(2) shall be culturally and linguistically appropriate;
          ``(3) shall provide evidence-based training to students in 
        grades 6 through 12, in coordination with school-based mental 
        health service providers as defined in section 4102(6) of the 
        Elementary and Secondary Education Act of 1965, if applicable, 
        regarding--
                  ``(A) suicide education and awareness, including 
                warning signs of self-harm or suicidal ideation;
                  ``(B) methods that students can use to seek help for 
                themselves and others; and
                  ``(C) student resources for suicide awareness and 
                prevention;
          ``(4) shall provide for retraining of such students every 
        school year;
          ``(5) may last for such period as the State educational 
        agency, local educational agency, or Tribal educational agency 
        involved determines to be appropriate;
          ``(6) may be implemented through any delivery method, 
        including in-person trainings, digital trainings, or train-the-
        trainer models; and
          ``(7) may include discussion of comorbidities or risk factors 
        for suicidal ideation or self-harm, including substance misuse, 
        sexual or physical abuse, mental illness, or other evidence-
        based comorbidities and risk factors.
  ``(c) Collection of Information and Reporting.--Each State 
educational agency, local educational agency, and Tribal educational 
agency that receives funds under section 520A shall, with respect to 
each school served by the agency, collect and report to the Secretary 
the following information:
          ``(1) The number of student trainings conducted.
          ``(2) The number of students trained, disaggregated by age 
        and grade level.
          ``(3) The number of help-seeking reports made by students 
        after implementation of such policy.
  ``(d) Evidence-Based Program Listing.--The Secretary of Health and 
Human Services shall coordinate with the Secretary of Education to make 
publicly available the policies established by State educational 
agencies, local educational agencies, and Tribal educational agencies 
pursuant to this section and the training that is available to students 
and teams pursuant to such policies, including identification of 
whether such training is available to trainees at no cost.
  ``(e) Implementation Timeline.--A State educational agency, local 
educational agency, or Tribal educational agency shall establish and 
begin implementation of the policies required by subsection (a)(1) not 
later than the beginning of the third fiscal year following the date of 
enactment of this section for which the agency receives funds under 
section 520A.
  ``(f) Definitions.--In this section and section 520B-1:
          ``(1) The term `evidence-based' has the meaning given to such 
        term in section 8101 of the Elementary and Secondary Education 
        Act of 1965.
          ``(2) The term `local educational agency' has the meaning 
        given to such term in section 8101 of the Elementary and 
        Secondary Education Act of 1965.
          ``(3) The term `State educational agency' has the meaning 
        given to such term in section 8101 of the Elementary and 
        Secondary Education Act of 1965.
          ``(4) The term `Tribal educational agency' has the meaning 
        given to the term `tribal educational agency' in section 6132 
        of the Elementary and Secondary Education Act of 1965.

``SEC. 520B-1. BEST PRACTICES FOR STUDENT SUICIDE AWARENESS AND 
                    PREVENTION TRAINING.

  ``The Secretary of Health and Human Services, in consultation with 
the Secretary of Education and the Bureau of Indian Education, shall--
          ``(1) publish best practices for school-based student suicide 
        awareness and prevention training, pursuant to section 520B, 
        that are based on--
                  ``(A) evidence-based practices; and
                  ``(B) input from relevant Federal agencies, national 
                organizations, Indian Tribes and Tribal organizations, 
                and related stakeholders;
          ``(2) publish guidance, based on the best practices under 
        paragraph (1), to provide State educational agencies, local 
        educational agencies, and Tribal educational agencies with 
        information on student suicide awareness and prevention best 
        practices;
          ``(3) disseminate such best practices to State educational 
        agencies, local educational agencies, and Tribal educational 
        agencies; and
          ``(4) provide technical assistance to State educational 
        agencies, local educational agencies, and Tribal educational 
        agencies.''.

SEC. 3. EFFECTIVE DATE.

  The amendments made by this Act shall only apply with respect to 
applications for assistance under section 520A of the Public Health 
Service Act (42 U.S.C. 290bb-32) that are submitted after the date of 
enactment of this Act.

                         I. Purpose and Summary

    H.R. 7293, the ``Suicide Training and Awareness Nationally 
Delivered for Universal Prevention Act of 2020'' or the 
``STANDUP Act of 2020'', was introduced by Representatives 
Scott Peters (D-CA), Gus Bilirakis (R-FL), Theodore E. Deutch 
(D-FL), and Brian K. Fitzpatrick (R-PA) on July 22, 2020. This 
bill would require State and Tribal educational agencies that 
receive certain mental health grants to establish and implement 
school-based student suicide awareness and prevention training 
policies and collect information on such activities. The 
training policies would be focused on grades six through 12 and 
would train students on self-harm and suicidal ideation. The 
bill also requires the publication of best practices for 
school-based student suicide awareness and prevention training.

              II. Background and Need for the Legislation

    Suicide is in the top ten leading causes of death in the 
United States.\1\ It is the second leading cause of death for 
young Americans between the age of 10 and 34.\2\ Data show that 
suicide rates among young people in Black communities are also 
on the rise.\3\ In testimony, Dr. Jeffery Geller, President of 
the American Psychiatric Association, highlighted that before 
the coronavirus pandemic, ``. . . the suicide rate was the 
highest it has been since the Second World War.''\4\ Now, 
recent data show that as many as one in four students are 
reporting having suicidal thoughts.\5\
---------------------------------------------------------------------------
    \1\National Center for Health Statistics, Leading Causes of Death 
(www.cdc.gov/nchs/fastats/leading-causes-of-death.htm) (accessed 
September 21, 2020).
    \2\National Center for Health Statistics, Leading Causes of Death 
Reports, 1981-2018 (accessed September 19, 2020).
    \3\`We're losing our kids': Black youth suicide rate rising far 
faster than for whites; coronavirus, police violence deepen trauma, USA 
Today (June 7, 2020) (www.usatoday.com/story/news/health/2020/06/07/
coronavirus-police-violence-boost-risksrising-black-youth-suicide/
2300765001/).
    \4\House Committee on Energy and commerce, Testimony of Jeffery L 
Geller, M.D., M.P.H., President, American Psychiatric Association (June 
30, 2020).
    \5\Czeisler ME, Lane RI, Petrosky E, et al. Mental Health, 
Substance Use, and Suicidal Ideation During the COVID-19 Pandemic--
United States, June 24--30, 2020. MMWR Morb Mortal Wkly.
---------------------------------------------------------------------------
    While the causes can be complicated, suicide and self-harm 
are often preventable. In fact, eight out of ten people 
considering suicide provided some sign of their intentions.\6\ 
The need to help students in preventing youth suicide and other 
self-harm was raised before the Committee by Arriana Gross, a 
high school student from Covington, Georgia, who argued in her 
testimony the importance of training students to recognize 
warning signs. She told the Committee, ``I recently had a 
friend who was struggling and didn't feel comfortable talking 
to her parents or a teacher. However, she was only comfortable 
talking to me.'' She said that because of her student mental 
health and wellness training, she ``knew how to have the 
conversation with her and make sure she was supported.'' 
Student mental health and wellness trainings similar to 
Arriana's training, which was provided by Sandy Hook Promise's 
SAVE Promise Club, have been used in more than 3,000 schools 
nationwide across 49 States.\7\
---------------------------------------------------------------------------
    \6\Mental Health America, Suicide (www.mhanational.org/conditions/
suicide) (accessed September 21, 2020).
    \7\Sandy Hook Promise, SAVE Promise Club (www.sandyhookpromise.org/
our-programs/save-promise-club/) (accessed September 21, 2020).
---------------------------------------------------------------------------
    H.R. 7293 would encourage schools to expand evidence-based 
suicide prevention training to students and make public best 
practices for such training as a condition of receiving funds 
under the Substance Abuse and Mental Health Services 
Administration (SAMHSA) Project AWARE grant program.

                        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. 7293:
    The Subcommittee on Health held a legislative hearing on 
June 30, 2020, to consider H.R. 7293, the ``Suicide Training 
and Awareness Nationally Delivered for Universal Prevention Act 
of 2020'' or the ``STANDUP Act of 2020'', and 21 other bills. 
The hearing was entitled ``High Anxiety and Stress: Legislation 
to Improve Mental Health During Crisis.'' The Subcommittee 
received testimony from the following witnesses:
           Former Representative Patrick J. Kennedy, 
        Founder, the Kennedy Forum
           Arthur C. Evans, Jr., Ph.D., Chief Executive 
        Officer, American Psychological Association
           Jeffrey L. Geller, M.D., M.P.H., President, 
        American Psychiatric Association, Professor of 
        Psychiatry and Director of Public Sector Psychiatry at 
        the University of Massachusetts Medical School 
        Worcester Recovery Center and Hospital
           Arriana Gross, National Youth Advisory Board 
        Member, Sandy Hook Promise Students Against Violence 
        Everywhere (SAVE) Promise Club

                      IV. Committee Consideration

    Representatives Peters (D-CA), Bilirakis (R-FL), Deutch (D-
FL), and Fitzpatrick (R-PA) introduced H.R. 7293, the ``Suicide 
Training and Awareness Nationally Delivered for Universal 
Prevention Act of 2020'' or the ``STANDUP Act of 2020'', on 
June 22, 2020, and the bill was referred to the Committee on 
Energy and Commerce. H.R. 7293 was then referred to the 
Subcommittee on Health on June 23, 2020. A legislative hearing 
was held on the bill on June 30, 2020.
    On September 9, 2020, H.R. 7293 was discharged from further 
consideration by the Subcommittee on Health as it was called up 
for markup by the full Committee on Energy and Commerce. The 
full Committee met in virtual open markup session on September 
9, 2020, pursuant to notice, to consider H.R. 7293. During 
consideration of the bill, a manager's amendment offered by Mr. 
Peters of California was agreed to by a voice vote. At the 
conclusion of markup of the bill, Mr. Pallone, Chairman of the 
committee, moved that H.R. 7293 be ordered reported favorably 
to the House, amended. The motion on final passage was agreed 
to by the Committee 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. 
7293, including the motion for 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 provide 
best practices on student suicide awareness and prevention 
training and condition State educational agencies, local 
educational agencies, and tribal educational agencies receiving 
funds under section 520A of the Public Health Service Act to 
establish and implement a school-based student suicide 
awareness and prevention training policy.

                   X. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 7293 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. 7293 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 Training and Awareness Nationally Delivered for 
Universal Prevention Act of 2020'' or the ``STANDUP Act of 
2020''.

Sec. 2. Student suicide awareness and prevention training

    Section 2 amends the Public Health Service Act to add two 
new sections 520B and 520B-1. The new section 520B requires 
State education agencies, local educational agencies, and 
Tribal educational agencies that receive Project AWARE grants 
from the Substance Abuse and Mental Health Administration 
(SAMHSA) to establish and implement school-based student 
suicide and prevention training policies. These policies must 
be developed in consultation with stakeholders and must include 
the collection and reporting of information on the impact of 
the policies.
    The policies implemented under this section must be 
evidence-based, culturally and linguistically appropriate, and 
target students in grades 6 through 12. The training must 
include suicide education and awareness, methods that students 
can use to seek help for themselves and others, and other 
student suicide awareness and prevention resources. The 
trainings must include retraining of students every school year 
and can be implemented through various means such as in-person 
trainings or digital trainings. These policies may also include 
discussion of comorbidities or other risk factors.
    The educational agencies under this section are required to 
collect and report certain information to the Secretary of 
Education, including the number of trainings conducted; the 
number of students trained, disaggregated by age and grade 
level; and the number of help-seeking reports after policy 
implementation.
    The Secretary of Health and Human Services, with the 
Secretary of Education, is directed to make publicly available 
the policies established by educational entities and the 
training available to students, including which training is 
available at no cost.
    The educational agencies under this section must begin 
implementation of the policies not later than three fiscal 
years after the day of enactment of this Act.
    The terms ``evidence-based'', ``local educational agency'', 
``State educational agency'', and ``Tribal educational agency'' 
all have the meaning given to those terms under the Elementary 
and Secondary Education Act of 1965.
    The new section 520B-1 requires the Secretary of Health and 
Human Services, in consultation with the Secretary of Education 
and the Bureau of Indian Education, to publish and disseminate 
best practices, guidance, and technical assistance for school-
based student suicide awareness and prevention training.

Sec. 3. Effective date

    Section 3 states that the amendments made by this bill only 
apply to applications for assistance under section 520A of the 
Public Health Serve Act that are submitted after enactment.

       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 V--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

           *       *       *       *       *       *       *



Part B--Centers and Programs

           *       *       *       *       *       *       *



Subpart 3--Center for Mental Health Services

           *       *       *       *       *       *       *


SEC. 520B. STUDENT SUICIDE AWARENESS AND PREVENTION TRAINING POLICIES.

  (a) In general.--As a condition on receipt of funds under 
section 520A, each State educational agency, local educational 
agency, and Tribal educational agency that receives such funds, 
directly or through a State or Indian Tribe, for activities to 
be performed within secondary schools, including the Project 
AWARE State Education Agency Grant Program, shall--
          (1) establish and implement a school-based student 
        suicide awareness and prevention training policy;
          (2) consult with stakeholders (including principals, 
        teachers, parents, local Tribal officials, and other 
        school leaders) in the development of the policy under 
        subsection (a)(1); and
          (3) collect and report information in accordance with 
        subsection (c).
  (b) School-Based student suicide awareness and prevention 
training policy.--A school-based student suicide awareness and 
prevention training policy implemented pursuant to subsection 
(a)--
          (1) shall be evidence-based;
          (2) shall be culturally and linguistically 
        appropriate;
          (3) shall provide evidence-based training to students 
        in grades 6 through 12, in coordination with school-
        based mental health service providers as defined in 
        section 4102(6) of the Elementary and Secondary 
        Education Act of 1965, if applicable, regarding--
                  (A) suicide education and awareness, 
                including warning signs of self-harm or 
                suicidal ideation;
                  (B) methods that students can use to seek 
                help for themselves and others; and
                  (C) student resources for suicide awareness 
                and prevention;
          (4) shall provide for retraining of such students 
        every school year;
          (5) may last for such period as the State educational 
        agency, local educational agency, or Tribal educational 
        agency involved determines to be appropriate;
          (6) may be implemented through any delivery method, 
        including in-person trainings, digital trainings, or 
        train-the-trainer models; and
          (7) may include discussion of comorbidities or risk 
        factors for suicidal ideation or self-harm, including 
        substance misuse, sexual or physical abuse, mental 
        illness, or other evidence-based comorbidities and risk 
        factors.
  (c) Collection of information and reporting.--Each State 
educational agency, local educational agency, and Tribal 
educational agency that receives funds under section 520A 
shall, with respect to each school served by the agency, 
collect and report to the Secretary the following information:
          (1) The number of student trainings conducted.
          (2) The number of students trained, disaggregated by 
        age and grade level.
          (3) The number of help-seeking reports made by 
        students after implementation of such policy.
  (d) Evidence-Based program listing.--The Secretary of Health 
and Human Services shall coordinate with the Secretary of 
Education to make publicly available the policies established 
by State educational agencies, local educational agencies, and 
Tribal educational agencies pursuant to this section and the 
training that is available to students and teams pursuant to 
such policies, including identification of whether such 
training is available to trainees at no cost.
  (e) Implementation timeline.--A State educational agency, 
local educational agency, or Tribal educational agency shall 
establish and begin implementation of the policies required by 
subsection (a)(1) not later than the beginning of the third 
fiscal year following the date of enactment of this section for 
which the agency receives funds under section 520A.
  (f) Definitions.--In this section and section 520B-1:
          (1) The term ``evidence-based'' has the meaning given 
        to such term in section 8101 of the Elementary and 
        Secondary Education Act of 1965.
          (2) The term ``local educational agency'' has the 
        meaning given to such term in section 8101 of the 
        Elementary and Secondary Education Act of 1965.
          (3) The term ``State educational agency'' has the 
        meaning given to such term in section 8101 of the 
        Elementary and Secondary Education Act of 1965.
          (4) The term ``Tribal educational agency'' has the 
        meaning given to the term ``tribal educational agency'' 
        in section 6132 of the Elementary and Secondary 
        Education Act of 1965.

SEC. 520B-1. BEST PRACTICES FOR STUDENT SUICIDE AWARENESS AND 
                    PREVENTION TRAINING.

  The Secretary of Health and Human Services, in consultation 
with the Secretary of Education and the Bureau of Indian 
Education, shall--
          (1) publish best practices for school-based student 
        suicide awareness and prevention training, pursuant to 
        section 520B, that are based on--
                  (A) evidence-based practices; and
                  (B) input from relevant Federal agencies, 
                national organizations, Indian Tribes and 
                Tribal organizations, and related stakeholders;
          (2) publish guidance, based on the best practices 
        under paragraph (1), to provide State educational 
        agencies, local educational agencies, and Tribal 
        educational agencies with information on student 
        suicide awareness and prevention best practices;
          (3) disseminate such best practices to State 
        educational agencies, local educational agencies, and 
        Tribal educational agencies; and
          (4) provide technical assistance to State educational 
        agencies, local educational agencies, and Tribal 
        educational agencies.

           *       *       *       *       *       *       *


                                  [all]