[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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