II 117TH CONGRESS 1ST SESSION S. 467 To amend the Public Health Service Act to establish a program to improve the identification, assessment, and treatment of patients in hospital emer- gency departments who are at risk of suicide, and for other purposes. IN THE SENATE OF THE UNITED STATES FEBRUARY 25, 2021 Ms. MURKOWSKI (for herself and Mr. KING) introduced the following bill; which was read twice and referred to the Committee on Health, Edu- cation, Labor, and Pensions A BILL To amend the Public Health Service Act to establish a pro- gram to improve the identification, assessment, and treatment of patients in hospital emergency departments who are at risk of suicide, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Effective Suicide 4 Screening and Assessment in the Emergency Department 5 Act of 2021’’. 6 VerDate Sep 11 2014 01:13 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S467.IS S467 kjohnson on DSK79L0C42PROD with BILLS 2 •S 467 IS SEC. 2. PROGRAM TO IMPROVE THE CARE PROVIDED TO 1 PATIENTS IN THE EMERGENCY DEPARTMENT 2 WHO ARE AT RISK OF SUICIDE. 3 Part P of title III of the Public Health Service Act 4 (42 U.S.C. 280g et seq.) is amended by adding at the end 5 the following new section: 6 ‘‘SEC. 399V–7. PROGRAM TO IMPROVE THE CARE PROVIDED 7 TO PATIENTS IN THE EMERGENCY DEPART- 8 MENT WHO ARE AT RISK OF SUICIDE. 9 ‘‘(a) IN GENERAL.—The Secretary shall establish a 10 program (in this Act referred to as the ‘Program’) to im- 11 prove the identification, assessment, and treatment of pa- 12 tients in emergency departments who are at risk for sui- 13 cide, including by— 14 ‘‘(1) developing policies and procedures for 15 identifying and assessing individuals who are at risk 16 of suicide; and 17 ‘‘(2) enhancing the coordination of care for 18 such individuals after discharge. 19 ‘‘(b) GRANT ESTABLISHMENT AND PARTICIPA- 20 TION.— 21 ‘‘(1) IN GENERAL.—In carrying out the Pro- 22 gram, the Secretary shall award grants on a com- 23 petitive basis to not more than 40 eligible health 24 care sites described in paragraph (2). 25 VerDate Sep 11 2014 01:13 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S467.IS S467 kjohnson on DSK79L0C42PROD with BILLS 3 •S 467 IS ‘‘(2) ELIGIBILITY.—To be eligible for a grant 1 under this section, a health care site shall— 2 ‘‘(A) submit an application to the Sec- 3 retary at such time, in such manner, and con- 4 taining such information as the Secretary may 5 specify; 6 ‘‘(B) be a hospital (as defined in section 7 1861(e) of the Social Security Act); 8 ‘‘(C) have an emergency department; and 9 ‘‘(D) deploy onsite health care or social 10 service professionals to help connect and inte- 11 grate patients who are at risk of suicide with 12 treatment and mental health support services. 13 ‘‘(3) PREFERENCE.—In awarding grants under 14 this section, the Secretary may give preference to eli- 15 gible health care sites described in paragraph (2) 16 that meet at least one of the following criteria: 17 ‘‘(A) The eligible health care site is a crit- 18 ical access hospital (as defined in section 19 1861(mm)(1) of the Social Security Act). 20 ‘‘(B) The eligible health care site is a sole 21 community hospital (as defined in section 22 1886(d)(5)(D)(iii) of the Social Security Act). 23 ‘‘(C) The eligible health care site is oper- 24 ated by the Indian Health Service, by an Indian 25 VerDate Sep 11 2014 01:13 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S467.IS S467 kjohnson on DSK79L0C42PROD with BILLS 4 •S 467 IS Tribe or Tribal organization (as such terms are 1 defined in section 4 of the Indian Self-Deter- 2 mination and Education Assistance Act), or by 3 an urban Indian organization (as defined in 4 section 4 of the Indian Health Care Improve- 5 ment Act). 6 ‘‘(D) The eligible health care site is located 7 in a geographic area with a suicide rate that is 8 higher than the national rate, as determined by 9 the Secretary based on the most recent data 10 from the Centers for Disease Control and Pre- 11 vention. 12 ‘‘(c) PERIOD OF GRANT.—A grant awarded to an eli- 13 gible health care site under this section shall be for a pe- 14 riod of at least 2 years. 15 ‘‘(d) GRANT USES.— 16 ‘‘(1) REQUIRED USES.—A grant awarded under 17 this section to an eligible health care site shall be 18 used for the following purposes: 19 ‘‘(A) To train emergency department 20 health care professionals to identify, assess, and 21 treat patients who are at risk of suicide. 22 ‘‘(B) To establish and implement policies 23 and procedures for emergency departments to 24 improve the identification, assessment, and 25 VerDate Sep 11 2014 01:13 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S467.IS S467 kjohnson on DSK79L0C42PROD with BILLS 5 •S 467 IS treatment of individuals who are at risk of sui- 1 cide. 2 ‘‘(C) To establish and implement policies 3 and procedures with respect to care coordina- 4 tion, integrated care models, or referral to evi- 5 dence-based treatment to be used upon the dis- 6 charge from the emergency department of pa- 7 tients who are at risk of suicide. 8 ‘‘(2) ADDITIONAL PERMISSIBLE USES.—In ad- 9 dition to the required uses listed in paragraph (1), 10 a grant awarded under this section to an eligible 11 health care site may be used for any of the following 12 purposes: 13 ‘‘(A) To hire emergency department psy- 14 chiatrists, psychologists, nurse practitioners, 15 counselors, therapists, or other licensed health 16 care and behavioral health professionals special- 17 izing in the treatment of individuals at risk of 18 suicide. 19 ‘‘(B) To develop and implement best prac- 20 tices for the follow-up care and long-term treat- 21 ment of individuals who are at risk of suicide. 22 ‘‘(C) To increase the availability of, and 23 access to, evidence-based treatment for individ- 24 uals who are at risk of suicide, including 25 VerDate Sep 11 2014 01:13 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S467.IS S467 kjohnson on DSK79L0C42PROD with BILLS 6 •S 467 IS through telehealth services and strategies to re- 1 duce the boarding of these patients in emer- 2 gency departments. 3 ‘‘(D) To offer consultation with and refer- 4 ral to other supportive services that provide evi- 5 dence-based treatment and recovery for individ- 6 uals who are at risk of suicide. 7 ‘‘(e) REPORTING REQUIREMENTS.— 8 ‘‘(1) REPORTS BY GRANTEES.—Each eligible 9 health care site receiving a grant under this section 10 shall submit to the Secretary an annual report for 11 each year for which the grant is received on the 12 progress of the program funded through the grant. 13 Each such report shall include information on— 14 ‘‘(A) the number of individuals screened in 15 the site’s emergency department for being at 16 risk of suicide; 17 ‘‘(B) the number of individuals identified 18 in the site’s emergency department as being— 19 ‘‘(i) survivors of an attempted suicide; 20 or 21 ‘‘(ii) are at risk of suicide; 22 ‘‘(C) the number of individuals who are 23 identified in the site’s emergency department as 24 being at risk of suicide by a health care or be- 25 VerDate Sep 11 2014 01:13 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S467.IS S467 kjohnson on DSK79L0C42PROD with BILLS 7 •S 467 IS havioral health professional hired pursuant to 1 subsection (d)(2)(A); 2 ‘‘(D) the number of individuals referred by 3 the site’s emergency department to other treat- 4 ment facilities, the types of such other facilities, 5 and the number of such individuals admitted to 6 such other facilities pursuant to such referrals; 7 ‘‘(E) the effectiveness of programs and ac- 8 tivities funded through the grant in preventing 9 suicides and suicide attempts; and 10 ‘‘(F) any other relevant additional data re- 11 garding the programs and activities funded 12 through the grant. 13 ‘‘(2) REPORT BY SECRETARY.—Not later than 14 one year after the end of fiscal year 2026, the Sec- 15 retary shall submit to Congress a report that in- 16 cludes— 17 ‘‘(A) findings on the Program; 18 ‘‘(B) overall patient outcomes achieved 19 through the Program; 20 ‘‘(C) an evaluation of the effectiveness of 21 having a trained health care or behavioral 22 health professional onsite to identify, assess, 23 and treat patients who are at risk of suicide; 24 and 25 VerDate Sep 11 2014 01:13 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S467.IS S467 kjohnson on DSK79L0C42PROD with BILLS 8 •S 467 IS ‘‘(D) a compilation of policies, procedures, 1 and best practices established, developed, or im- 2 plemented by grantees under this section. 3 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 4 is authorized to be appropriated to carry out this section 5 $20,000,000 for the period of fiscal years 2022 through 6 2026.’’. 7 Æ VerDate Sep 11 2014 01:13 Mar 19, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\S467.IS S467 kjohnson on DSK79L0C42PROD with BILLS