[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 859 Introduced in Senate (IS)]







107th CONGRESS
  1st Session
                                 S. 859

  To amend the Public Health Service Act to establish a mental health 
          community education program, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 10, 2001

  Mr. Thomas (for himself, Mr. Conrad, Mr. Domenici, Mr. Johnson, Mr. 
  Roberts, and Mr. Nelson of Nebraska) introduced the following bill; 
     which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To amend the Public Health Service Act to establish a mental health 
          community education program, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rural Mental Health Accessibility 
Act of 2001''.

SEC. 2. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    Subpart I of part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.) is amended by adding at the end the following:

``SEC. 330I. MENTAL HEALTH COMMUNITY EDUCATION PROGRAM.

    ``(a) Program Authorized.--The Director of the Office of Rural 
Health Policy (of the Health Resources and Services Administration) 
shall award grants to eligible entities to conduct mental health 
community education programs.
    ``(b) Definitions.--In this section:
            ``(1) Eligible entity.--The term `eligible entity' includes 
        a State entity, public or private school, mental health clinic, 
        rural health clinic, local public health department, nonprofit 
        private entity, federally qualified health center, Rural Area 
        Health Education Center, Indian tribe and tribal organization, 
        and any other entity deemed eligible by the Secretary.
            ``(2) Mental health community education program.--The term 
        `mental health community education program' means a program 
        regarding mental illness, mental retardation, suicide 
        prevention and co-occurring mental illness and substance abuse 
        disorder.
    ``(c) Preference.--In awarding grants under subsection (a), the 
Director shall give a preference to eligible entities that are or 
propose to be in a network, or work in collaboration, with other 
eligible entities to carry out the programs under this section, such as 
a rural public or nonprofit private entity that represents a network of 
local health care providers or other entities that provide or support 
delivery of health care services, and a State office of rural health or 
other appropriate State entity.
    ``(d) Duration.--The Director shall award grants under subsection 
(a) for a period of 3 years.
    ``(e) Amount.--Each grant awarded under this section shall not be 
greater than $200,000 each fiscal year.
    ``(f) Use of Funds.--An eligible entity that receives a grant under 
subsection (a) shall use funds received through such grant to 
administer a mental health community education program to rural 
populations that provides information to dispel myths regarding mental 
illness and to reduce any stigma associated with mental illness.
    ``(g) Application.--An eligible entity desiring a grant under 
subsection (a) shall submit an application to the Director at such 
time, in such manner, and containing such information as the Director 
may reasonably require, including--
            ``(1) a description of the activities which the eligible 
        entity intends to carry out using amounts provided under the 
        grant;
            ``(2) a plan for continuing the project after Federal 
        support is ended;
            ``(3) a description of the manner in which the educational 
        activities funded under the grant will meet the mental health 
        care needs of underserved rural populations within the State; 
        and
            ``(4) a description of how the local community or region to 
        be served by the network or proposed network, if the eligible 
        entity is in such a network, will be involved in the 
        development and ongoing operations of the network.
    ``(h) Evaluations; Report.--Each eligible entity that receives a 
grant under this section shall submit to the Director of the Office of 
Rural Health Policy (of the Health Resources and Services 
Administration) an evaluation describing the programs authorized under 
this section and any other information that the Director deems 
appropriate. After receiving such evaluations, the Director shall 
submit to the appropriate committees of Congress a report describing 
such evaluations.
    ``(i) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $50,000,000 for fiscal year 
2002, and such sums as may be necessary for fiscal years 2003 through 
2006.

``SEC. 330J. INTERDISCIPLINARY GRANT PROGRAM.

    ``(a) Program Authorized.--The Director of the Office of Rural 
Health Policy (of the Health Resources and Services Administration) 
shall award grants to eligible entities to establish interdisciplinary 
training programs that include significant mental health training in 
rural areas for certain health care providers.
    ``(b) Definitions.--In this section:
            ``(1) Eligible entity.--The term `eligible entity' means a 
        public university or other educational institution that 
        provides training for mental health care providers or primary 
        health care providers.
            ``(2) Mental health care provider.--The term `mental health 
        care provider' means--
                    ``(A) a physician with postgraduate training in a 
                residency program of psychiatry;
                    ``(B) a licensed psychologist (as defined by the 
                Secretary for purposes of section 1861(ii) of such Act 
                (42 U.S.C. 1395x(ii)));
                    ``(C) a clinical social worker (as defined in 
                section 1861(hh)(1) of such Act (42 U.S.C. 
                1395x(hh)(1)); or
                    ``(D) a clinical nurse specialist (as defined in 
                section 1861(aa)(5)(B) of such Act (42 U.S.C. 
                1395x(aa)(5)(B))).
            ``(3) Primary health care provider.--The term `primary 
        health care provider' includes family practice, internal 
        medicine, pediatrics, obstetrics and gynecology, geriatrics, 
        and emergency medicine physicians as well as physician 
        assistants and nurse practitioners.
            ``(4) Rural area.--The term `rural area' means a rural area 
        as defined in section 1886(d)(2)(D) of the Social Security Act, 
        or such an area in a rural census tract of a metropolitan 
        statistical area (as determined under the most recent 
        modification of the Goldsmith Modification, originally 
        published in the Federal Register on February 27, 1992 (57 Fed. 
        Reg. 6725)), or any other geographical area that the Director 
        designates as a rural area.
    ``(c) Duration.--Grants awarded under subsection (a) shall be 
awarded for a period of 5 years.
    ``(d) Use of Funds.--An eligible entity that receives a grant under 
subsection (a) shall use funds received through such grant to 
administer an interdisciplinary, side-by-side training program for 
mental health care providers and primary health care providers, that 
includes providing, under appropriate supervision, health care services 
to patients in underserved, rural areas without regard to patients' 
ability to pay for such services.
    ``(e) Application.--An eligible entity desiring a grant under 
subsection (a) shall submit an application to the Director at such 
time, in such manner, and containing such information as the Director 
may reasonably require, including--
            ``(1) a description of the activities which the eligible 
        entity intends to carry out using amounts provided under the 
        grant;
            ``(2) a description of the manner in which the activities 
        funded under the grant will meet the mental health care needs 
        of underserved rural populations within the State; and
            ``(3) a description of the network agreement with 
        partnering facilities.
    ``(f) Evaluations; Report.--Each eligible entity that receives a 
grant under this section shall submit to the Director of the Office of 
Rural Health Policy (of the Health Resources and Services 
Administration) an evaluation describing the programs authorized under 
this section and any other information that the Director deems 
appropriate. After receiving such evaluations, the Director shall 
submit to the appropriate committees of Congress a report describing 
such evaluations.
    ``(g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $100,000,000 for fiscal year 
2002 and such sums as may be necessary for each of the fiscal years 
2003 through 2006.

``SEC. 330K. STUDY OF MENTAL HEALTH SERVICES DELIVERED WITH TELEHEALTH 
              TECHNOLOGIES.

    ``(a) In General.--The Director of the National Institute of Mental 
Health, in consultation with the Director of the Office of Rural Health 
Policy, shall carry out activities to research the efficacy and 
effectiveness of mental health services delivered remotely by a 
qualified mental health professional (psychiatrist or doctoral level 
psychologist) using telehealth technologies.
    ``(b) Mandatory Activities.--Research described in subsection (a) 
shall include--
            ``(1) objective measurement of treatment outcomes for 
        individuals with mental illness treated remotely using 
        telehealth technologies as compared to individuals with mental 
        illness treated face-to-face;
            ``(2) objective measurement of treatment compliance by 
        individuals with mental illness treated remotely using 
        telehealth technologies as compared to individuals with mental 
        illness treated face-to-face; and
            ``(3) any other variables as determined by the Director.
    ``(c) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary.

``SEC. 330L. MENTAL HEALTH SERVICES DELIVERED VIA TELEHEALTH.

    ``(a) Program Authorized.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the Office for the Advancement of Telehealth of the 
        Health Resources and Services Administration, shall award 
        grants to eligible entities to establish demonstration projects 
        for the provision of mental health services to special 
        populations as delivered remotely by qualified mental health 
        professionals using telehealth and for the provision of 
        education regarding mental illness as delivered remotely by 
        qualified mental health professionals and qualified mental 
        health education professionals using telehealth.
            ``(2) Number of demonstration projects.--Ten grants shall 
        be awarded under paragraph (1) to provide services for the 
        children and adolescents described in subsection (d)(1)(A) and 
        not less than 6 of such grants shall be for services rendered 
        to individuals in rural areas. Ten grants shall also be awarded 
        under paragraph (1) to provide services for the elderly 
        described in subsection (d)(1)(B) in rural areas. If the 
        maximum number of grants to be awarded under paragraph (1) is 
        not awarded, the Secretary shall award the remaining grants in 
        a manner that is equitably distributed between the populations 
        described in subparagraphs (A) and (B) of subsection (d)(1).
    ``(b) Definitions.--In this section:
            ``(1) Eligible entity.--The term `eligible entity' means a 
        public or nonprofit private telehealth provider network which 
        has as part of its services mental health services provided by 
        qualified mental health providers.
            ``(2) Qualified mental health education professionals.--The 
        term `qualified mental health education professionals' refers 
        to teachers, community mental health professionals, nurses, and 
        other entities as determined by the Secretary who have 
        additional training in the delivery of information on mental 
        illness to children and adolescents or who have additional 
training in the delivery of information on mental illness to the 
elderly.
            ``(3) Qualified mental health professionals.--The term 
        `qualified mental health professionals' refers to providers of 
        mental health services currently reimbursed under medicare who 
        have additional training in the treatment of mental illness in 
        children and adolescents or who have additional training in the 
        treatment of mental illness in the elderly.
            ``(4) Special populations.--The term `special populations' 
        refers to the following 2 distinct groups:
                    ``(A) Children and adolescents located in primary 
                and secondary public schools in mental health 
                underserved rural areas or in mental health underserved 
                urban areas.
                    ``(B) Elderly individuals located in long-term care 
                facilities in mental health underserved rural areas.
            ``(5) Telehealth.--The term `telehealth' means the use of 
        electronic information and telecommunications technologies to 
        support long-distance clinical health care, patient and 
        professional health-related education, public health, and 
        health administration.
    ``(c) Amount.--Each entity that receives a grant under subsection 
(a) shall receive not less than $1,500,000 with no more than 40 percent 
of the total budget outlined for equipment.
    ``(d) Use of Funds.--
            ``(1) In general.--An eligible entity that receives a grant 
        under this section shall use such funds--
                    ``(A) for the populations described in subsection 
                (b)(3)(A)--
                            ``(i) to provide mental health services, 
                        including diagnosis and treatment of mental 
                        illness, in primary and secondary public 
                        schools as delivered remotely by qualified 
                        mental health professionals using telehealth;
                            ``(ii) to provide education regarding 
                        mental illness (including suicide and violence) 
                        in primary and secondary public schools as 
                        delivered remotely by qualified mental health 
                        professionals and qualified mental health 
                        education professionals using telehealth, 
                        including early recognition of the signs and 
                        symptoms of mental illness, and instruction on 
                        coping and dealing with stressful experiences 
                        of childhood and adolescence (such as violence, 
                        social isolation, and depression); and
                            ``(iii) to collaborate with local public 
                        health entities and the eligible entity to 
                        provide the mental health services; and
                    ``(B) for the populations described in subsection 
                (b)(3)(B)--
                            ``(i) to provide mental health services, 
                        including diagnosis and treatment of mental 
                        illness, in long-term care facilities as 
                        delivered remotely by qualified mental health 
                        professionals using telehealth;
                            ``(ii) to provide education regarding 
                        mental illness to primary staff (including 
                        physicians, nurses, and nursing aides) as 
                        delivered remotely by qualified mental health 
                        professionals and qualified mental health 
                        education professionals using telehealth, 
                        including early recognition of the signs and 
                        symptoms of mental illness, and instruction on 
                        coping and dealing with stressful experiences 
                        of old age (such as loss of physical and 
                        cognitive capabilities, death of loved ones and 
                        friends, social isolation, and depression); and
                            ``(iii) to collaborate with local public 
                        health entities and the eligible entity to 
                        provide mental health services.
            ``(2) Other uses.--An eligible entity receiving a grant 
        under this section may also use funds to--
                    ``(A) acquire telehealth equipment to use in 
                primary and secondary public schools and long-term care 
                facilities for the purposes of this section;
                    ``(B) develop curriculum to support activities 
                described in subsections (d)(1)(A)(ii) and 
                (d)(1)(B)(ii);
                    ``(C) pay telecommunications costs; and
                    ``(D) pay qualified mental health professionals and 
                qualified mental health education professionals on a 
                reasonable cost basis as determined by the Secretary 
                for services rendered.
            ``(3) Prohibited uses.--An eligible entity that receives a 
        grant under this section shall not use funds received through 
        such grant to--
                    ``(A) purchase or install transmission equipment 
                (other than such equipment used by qualified mental 
                health professionals to deliver mental health services 
                using telehealth under the project); or
                    ``(B) build upon or acquire real property (except 
                for minor renovations related to the installation of 
                reimbursable equipment).
    ``(e) Equitable Distribution.--In awarding grants under this 
section, the Secretary shall ensure, to the greatest extent possible, 
that such grants are equitably distributed among geographical regions 
of the United States.
    ``(f) Application.--An entity that desires a grant under this 
section shall submit an application to the Secretary at such time, in 
such manner, and containing such information as the Secretary 
determines to be reasonable.
    ``(g) Report.--Not later than 5 years after the date of enactment 
of this section, the Secretary shall prepare and submit a report to the 
appropriate committees of Congress that shall evaluate activities 
funded with grants under this section.
    ``(h) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $30,000,000 for fiscal year 
2002 and such sums that are required to carry out this program for 
fiscal years 2003 through 2009.
    ``(i) Sunset Provision.--This section shall be effective for 7 
years from the date of enactment of this section.''.
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