Effective Suicide Screening and Assessment in the Emergency Department Act of 2020

IIB 116TH CONGRESS 2D SESSION H. R. 4861 IN THE SENATE OF THE UNITED STATES SEPTEMBER 30 (legislative day, SEPTEMBER 29), 2020 Received; read twice and referred to the Committee on Health, Education, Labor, and Pensions AN ACT To amend the Public Health Service Act to establish a pro- gram to improve the identification, assessment, and treatment of patients in the emergency department 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 VerDate Sep 11 2014 05:54 Oct 01, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H4861.RFS H4861 kjohnson on DSK79L0C42PROD with BILLS 2 HR 4861 RFS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Effective Suicide 2 Screening and Assessment in the Emergency Department 3 Act of 2020’’. 4 SEC. 2. PROGRAM TO IMPROVE THE CARE PROVIDED TO 5 PATIENTS IN THE EMERGENCY DEPARTMENT 6 WHO ARE AT RISK OF SUICIDE. 7 Part P of title III of the Public Health Service Act 8 (42 U.S.C. 280g et seq.) is amended by adding at the end 9 the following new section: 10 ‘‘SEC. 399V–7. PROGRAM TO IMPROVE THE CARE PROVIDED 11 TO PATIENTS IN THE EMERGENCY DEPART- 12 MENT WHO ARE AT RISK OF SUICIDE. 13 ‘‘(a) IN GENERAL.—The Secretary shall establish a 14 program (in this section referred to as the ‘Program’) to 15 improve the identification, assessment, and treatment of 16 patients in emergency departments who are at risk for sui- 17 cide, including by— 18 ‘‘(1) developing policies and procedures for 19 identifying and assessing individuals who are at risk 20 of suicide; and 21 ‘‘(2) enhancing the coordination of care for 22 such individuals after discharge. 23 ‘‘(b) GRANT ESTABLISHMENT AND PARTICIPA- 24 TION.— 25 VerDate Sep 11 2014 05:54 Oct 01, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4861.RFS H4861 kjohnson on DSK79L0C42PROD with BILLS 3 HR 4861 RFS ‘‘(1) IN GENERAL.—In carrying out the Pro- 1 gram, the Secretary shall award grants on a com- 2 petitive basis to not more than 40 eligible health 3 care sites described in paragraph (2). 4 ‘‘(2) ELIGIBILITY.—To be eligible for a grant 5 under this section, a health care site shall— 6 ‘‘(A) submit an application to the Sec- 7 retary at such time, in such manner, and con- 8 taining such information as the Secretary may 9 specify; 10 ‘‘(B) be a hospital (as defined in section 11 1861(e) of the Social Security Act); 12 ‘‘(C) have an emergency department; and 13 ‘‘(D) deploy onsite health care or social 14 service professionals to help connect and inte- 15 grate patients who are at risk of suicide with 16 treatment and mental health support services. 17 ‘‘(3) PREFERENCE.—In awarding grants under 18 this section, the Secretary may give preference to eli- 19 gible health care sites described in paragraph (2) 20 that meet at least one of the following criteria: 21 ‘‘(A) The eligible health care site is a crit- 22 ical access hospital (as defined in section 23 1861(mm)(1) of the Social Security Act). 24 VerDate Sep 11 2014 05:54 Oct 01, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4861.RFS H4861 kjohnson on DSK79L0C42PROD with BILLS 4 HR 4861 RFS ‘‘(B) The eligible health care site is a sole 1 community hospital (as defined in section 2 1886(d)(5)(D)(iii) of the Social Security Act). 3 ‘‘(C) The eligible health care site is oper- 4 ated by the Indian Health Service, by an Indian 5 tribe or tribal organization (as such terms are 6 defined in section 4 of the Indian Self-Deter- 7 mination and Education Assistance Act), or by 8 an urban Indian organization (as defined in 9 section 4 of the Indian Health Care Improve- 10 ment Act). 11 ‘‘(D) The eligible health care site is located 12 in a geographic area with a suicide rate that is 13 higher than the national rate, as determined by 14 the Secretary based on the most recent data 15 from the Centers for Disease Control and Pre- 16 vention. 17 ‘‘(c) PERIOD OF GRANT.—A grant awarded to an eli- 18 gible health care site under this section shall be for a pe- 19 riod of at least 2 years. 20 ‘‘(d) GRANT USES.— 21 ‘‘(1) REQUIRED USES.—A grant awarded under 22 this section to an eligible health care site shall be 23 used for the following purposes: 24 VerDate Sep 11 2014 05:54 Oct 01, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4861.RFS H4861 kjohnson on DSK79L0C42PROD with BILLS 5 HR 4861 RFS ‘‘(A) To train emergency department 1 health care professionals to identify, assess, and 2 treat patients who are at risk of suicide. 3 ‘‘(B) To establish and implement policies 4 and procedures for emergency departments to 5 improve the identification, assessment and 6 treatment of individuals who are at risk of sui- 7 cide. 8 ‘‘(C) To establish and implement policies 9 and procedures with respect to care coordina- 10 tion, integrated care models, or referral to evi- 11 dence-based treatment to be used upon the dis- 12 charge from the emergency department of pa- 13 tients who are at risk of suicide. 14 ‘‘(2) ADDITIONAL PERMISSIBLE USES.—In ad- 15 dition to the required uses listed in paragraph (1), 16 a grant awarded under this section to an eligible 17 health care site may be used for any of the following 18 purposes: 19 ‘‘(A) To hire emergency department psy- 20 chiatrists, psychologists, nurse practitioners, 21 counselors, therapists, or other licensed health 22 care and behavioral health professionals special- 23 izing in the treatment of individuals at risk of 24 suicide. 25 VerDate Sep 11 2014 05:54 Oct 01, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H4861.RFS H4861 kjohnson on DSK79L0C42PROD with BILLS 6 HR 4861 RFS ‘‘(B) To develop and implement best prac- 1 tices for the follow-up care and long-term treat- 2 ment of individuals who are at risk of suicide. 3 ‘‘(C) To increase the availability of and ac- 4 cess to evidence-based treatment for individuals 5 who are at risk of suicide, including through 6 telehealth services and strategies to reduce the 7 boarding of these patients in emergency depart- 8 ments. 9 ‘‘(D) To offer consultation with and refer- 10 ral to other supportive services that provide evi- 11 dence-based treatment and recovery for individ- 12 uals who are at risk of suicide. 13 ‘‘(e) REPORTING REQUIREMENTS.— 14 ‘‘(1) REPORTS BY GRANTEES.—Each eligible 15 health care site receiving a grant under this section 16 shall submit to the Secretary an annual report for 17 each year for which the grant is received on the 18 progress of the program funded through the grant. 19 Each such report shall include information on— 20 ‘‘(A) the number of individuals screened in 21 the site’s emergency department for being at 22 risk of suicide; 23 ‘‘(B) the number of individuals identified 24 in the site’s emergency department as being— 25 VerDate Sep 11 2014 05:54 Oct 01, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H4861.RFS H4861 kjohnson on DSK79L0C42PROD with BILLS 7 HR 4861 RFS ‘‘(i) survivors of an attempted suicide; 1 or 2 ‘‘(ii) are at risk of suicide; 3 ‘‘(C) the number of individuals who are 4 identified in the site’s emergency department as 5 being at risk of suicide by a health care or be- 6 havioral health professional hired pursuant to 7 subsection (d)(2)(A); 8 ‘‘(D) the number of individuals referred by 9 the site’s emergency department to other treat- 10 ment facilities, the types of such other facilities, 11 and the number of such individuals admitted to 12 such other facilities pursuant to such referrals; 13 ‘‘(E) the effectiveness of programs and ac- 14 tivities funded through the grant in preventing 15 suicides and suicide attempts; and 16 ‘‘(F) any other relevant additional data re- 17 garding the programs and activities funded 18 through the grant. 19 ‘‘(2) REPORT BY SECRETARY.—Not later than 20 one year after the end of fiscal year 2025, the Sec- 21 retary shall submit to Congress a report that in- 22 cludes— 23 ‘‘(A) findings on the Program; 24 VerDate Sep 11 2014 05:54 Oct 01, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H4861.RFS H4861 kjohnson on DSK79L0C42PROD with BILLS 8 HR 4861 RFS ‘‘(B) overall patient outcomes achieved 1 through the Program; 2 ‘‘(C) an evaluation of the effectiveness of 3 having a trained health care or behavioral 4 health professional onsite to identify, assess, 5 and treat patients who are at risk of suicide; 6 and 7 ‘‘(D) a compilation of policies, procedures, 8 and best practices established, developed, or im- 9 plemented by grantees under this section. 10 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 11 is authorized to be appropriated to carry out this section 12 $20,000,000 for the period of fiscal years 2021 through 13 2025.’’. 14 Passed the House of Representatives September 29, 2020. Attest: CHERYL L. JOHNSON, Clerk. VerDate Sep 11 2014 05:54 Oct 01, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H4861.RFS H4861 kjohnson on DSK79L0C42PROD with BILLS