; (4) local health departments; (5) hospitals that serve covered individuals; (6) institutions of higher education; (7) the Department of Veterans Affairs; (8) Federal firearms license dealers and instructors; and (9) other individuals or entities, as determined by the Secretary. 5. Definitions In this Act: (1) Covered individual The term covered individual means an individual who has not attained 26 years of age. (2) Covered risk factors The term covered risk factors means factors that increase the risk of suicide or self-harm with respect to a covered individual, including the following: (A) Alcohol abuse or other substance use disorder. (B) Sexual or physical abuse. (C) A diagnosis of a psychiatric condition associated with an increased risk of suicide or self-harm. (D) Being lesbian, gay, bisexual, trans­gen­der, or queer. (E) Being from a racial or ethnic group with a high rate of suicide or self-harm. (F) Previous attempts of suicide or self-harm. (G) Other factors supported by scientific evidence to be linked to an increased risk of suicide or self-harm, including family factors and bullying. (3) Institution of higher education The term institution of higher education has the meaning given such term in section 101 of the Higher Education Act of 1965 ( 20 U.S.C. 1001 ). (4) Secretary The term Secretary means the Secretary of Health and Human Services. (5) Secure gun storage or safety device The term secure storage or safety device has the meaning given to such term in subparagraphs (A) and (B) of section 921(a)(34) of title 18, United States Code. (6) State The term State means— (A) each of the 50 States; (B) the District of Columbia and any territory or possession of the United States; (C) Indian tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 5304 )); and (D) Urban Indian organizations (as such term is defined in section 4 of the Indian Health Care Improvement Act ( 25 U.S.C. 1603 )).