Assignment

1

Bill HR 4861

H.R.4861: Effective Suicide Screening and Assessment in the Emergency Department Act of 2019

Nikeesha Gowkaran

Nova Southeastern University

NSG 5130

Professor Theresa Kyle

April 4, 2022

Introduction

The selected bill is the HP 4861. The title of this bill is the “Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 of 2020”. The bill was proposed and discussed in congress between 2019 to 2020 in the hundredth and sixteenth congress. This bill was introduced into the Senate by Representative Bilirakis and Gus and then read in the house energy and Commerce Committee and the senate in the education, health, labor and pension committees. The bill number was 4861 and was introduced to the house in 2019 and passed in 2020.

Area of concern

The first concern is the limited capability of this bill, according to congress gov “This law creates a competitive funding program for up to 40 hospitals with emergency departments and specified on-site experts to help connect individuals in emergency departments who are suicidal with therapy and mental health services. Grant money could train emergency room staff and establish rules and processes for identifying, assessing, and treating people at risk of suicide and coordinating care for them (All Info - H.R.4861 - 116th Congress, 2020)”. The Department of Health and Human Services may prioritize certain types of hospitals when awarding the funding, such as critical access hospitals and hospitals in areas where suicide rates are greater than the national average.

Background

The main reason why this bill was introduced is to improve the identification, treatment and assessment of patients within an emergency department at risk of suicide. Suicidal patients in the United States have no program that can help note and help manage and avoid the occurrence of such suicides. With a well-planned program, it is possible to prevent and solve concerns that lead some patients to suicide. This bill is effective in areas with large cases of suicide, and it is possible to find solutions to such concerns by teaching, financing and establishing solutions through assistance programs.

Effects of issues in the bill

Some of the economic processes that led to the writing of the bill are to allow the program to get funding that would allow there to be effective staff training, recruitment, and development. This ensures that there are experts where needed to support and help suicide patients (Shand et al., 2018). With this program in place, it will be possible to prevent the high rate of suicide in some areas that already experience increased rates of suicide. The bill will allow easy and legal access to grants that help support this program.

Stakeholders

The HR 4861 bills stakeholders are the majorly the hospital and the nurse. The bill is established to provide grants to the hospital and to fund and ensure complete training of the nurses to help handle cases of suicide for patients in the emergency section in hospitals. The patients and communities that will benefit from this are the secondary benefactors of the bill; hence are also stakeholders of the HR4861 bill.

Patients, suppliers, and financial entities such as the government and health insurance providers are examples of external stakeholders. External stakeholders contribute significantly to the success of change implementation by providing the necessary resources (Text of HR 4861 (116th), 2020). For example, the government provides healthcare infrastructure by giving funding for the construction of health facilities, enacting regulations to guarantee that the entire population has access to affordable and high-quality care, and enabling the training and recruiting of healthcare professionals. Patients are the ultimate users of healthcare services, and their cooperation is vital to the successful execution of the evidence-based initiative.

Having bipartisan support indicates that the measure has a larger power base than previously assumed. Republican Senators Bilirakis, G. Katko, and J. Davis, as well as Democrats Eligel and E. Tonko and Representatives P. Gabbard, T. Luria, E. Titus, D. Rush, and B. Krishanooprithi, endorsed healthcare bill 4861.

Strengths

1. To develop and implement best practices for the long-term treatment and follow-up care of people at risk of suicide.

2. To improve the availability and accessibility of evidence-based treatment for people at risk of suicide in the health care system and minimize people boarding in emergency rooms.

3. To provide consultation and referrals to alternative supporting services that provide evidence-based treatment and rehabilitation for people who are suicidal.

Weakness

1. Due to the shift from one hospital to another, it's difficult to discover hospitals and localities with a high number of suicides in emergency rooms

2. The bill's implementation is complicated by unprofessional nurses and others who work at these hospitals.

Opportunities

1. To teach emergency room doctors how to recognize, assess, and treat patients who are at risk of suicide

2. To improve the identification, assessment, and treatment of people at risk of suicide, design and execute rules and procedures for emergency departments.

3. To develop and execute policies and procedures for care coordination, integrated care models, and referral to evidence-based treatment for patients at risk of suicide who are discharged from the emergency department.

Threats

1. Over time, legislative changes will render advances in the practice of minimizing suicide in emergencies obsolete.

2. Grants may not be sufficient to reach every hospital in the country; as a result, some persons and locations with suicidal patients may not receive the same training and funding.

The interrelationships among healthcare stakeholders are complicated. Pharmaceutical companies and insurance companies are two publicly traded stakeholders on the stock exchange. Their principal task is to maximize stockholders’ wealth (Vaughn, 2020). Similarly, companies' primary purpose is to make money, yet, providing health insurance to employees is a perk, not a source of profit. Physicians have direct fiduciary obligations and responsibilities to their patients, unlike the other stakeholders. The doctor-patient connection is a sacred trust that transcends monetary compensation, even though they are paid for their services. Patients have rights, responsibilities, and duties. Finally, democratic governments have duties and responsibilities to their citizens, but how they are defined in providing healthcare is a matter of debate.

Conclusion

The “Effective Suicide Screening and Assessment in the Emergency Department Act of 2019” takes crucial steps to help hospitals improve their care for high-risk patients. This bill would create a new grant program to help emergency departments develop policies and procedures for identifying, assessing, and treating people at high risk of suicide and discharge protocols and follow-up care for such patients.

Additionally, funds from the program can be utilized to hire more behavioral health specialists and improve training for emergency medical personnel on how to identify and treat high-risk patients. The grants can provide telehealth services to hospitals to improve access to evidence-based therapies. Individuals who are depressed or suicidal always seek treatment in the emergency department (ED). Healthcare professionals should detect patients at threat of depression and suicide with specialized training to identify these symptoms. Collaboration between outpatient and inpatient facilities is crucial to ensure that the same quality of care is provided to suicidal patients in both environments.

Reference

All Info - H.R.4861 - 116th Congress (2019-2020): “Effective Suicide Screening and Assessment in the Emergency Department Act of 2019 to 2020. (2020, the 30th of September). https://www.congress.gov/bill/116th-congress/house-bill/4861/all-info

HR 4861 (116th): “Effective Suicide Screening and Assessment in the Emergency Department Act 2019 to 2020”. (2019). GovTrack.Us. https://www.govtrack.us/congress/bills/116/hr4861

Shand, F. L., Batterham , P. J., Chan,. K. Y., Pirkis, J., Spittal, M. J., Woodward, A., & Christensen, H. (2018, December). Experience of health care services after https://pubmed.ncbi.nlm.nih.gov/28960505/

Text of HR 4861 (116th): “effective Screening and Assessment in the Emergency Department Act of 2019 to 2020 (Referred to Senate Committee version). (2019). GovTrack.Us. https://www.govtrack.us/congress/bills/116/hr4861/text

Vaughn, L. M., Sunny, C. E., Lindquist-Grantz, R., King, C., Brent, D., Boyd, S., & Grupp-Phelan, J.. Successful suicide screening in the pediatric emergency department: youth, parent, researcher, and clinician perspectives (2020). Archives of suicide research, 24(sup1), 124-141.