1.This Act may be cited as the
Indian Youth Telemental Health
Demonstration Project Act of 2006
.
2.
(a)Congress finds that—
(1)suicide for
Indians and Alaska Natives is 21/2 times higher than the
national average and the highest for all ethnic groups in the United States, at
a rate of more than 16 per 100,000 males of all age groups, and 27.9 per
100,000 for males aged 15 through 24, according to data for 2002;
(2)according to
national data for 2002, suicide was the second-leading cause of death for
Indians and Alaska Natives aged 15 through 34 and the fourth-leading cause of
death for Indians and Alaska Natives aged 10 through 14;
(3)the suicide rates
of Indian and Alaska Native males aged 15 through 24 are nearly 4 times greater
than suicide rates of Indian and Alaska Native females of that age
group;
(4)(A)90 percent of all teens
who die by suicide suffer from a diagnosable mental illness at the time of
death; and
(B)more than 1/2 of
the people who commit suicide in Indian Country have never been seen by a
mental health provider;
(5)death rates for
Indians and Alaska Natives are statistically underestimated;
(6)suicide
clustering in Indian Country affects entire tribal communities; and
(7)since 2003, the
Indian Health Service has carried out a National Suicide Prevention Initiative
to work with Service, tribal, and urban Indian health programs.
(b)The purpose of this Act is to authorize the
Secretary to carry out a demonstration project to test the use of telemental
health services in suicide prevention, intervention, and treatment of Indian
youth, including through—
(1)the use of
psychotherapy, psychiatric assessments, diagnostic interviews, therapies for
mental health conditions predisposing to suicide, and alcohol and substance
abuse treatment;
(2)the provision of
clinical expertise to, consultation services with, and medical advice and
training for frontline health care providers working with Indian youth;
(3)training and
related support for community leaders, family members and health and education
workers who work with Indian youth;
(4)the development
of culturally-relevant educational materials on suicide; and
(5)data collection
and reporting.
3.In this Act:
(1)The term demonstration project means the
Indian youth telemental health demonstration project authorized under section
4(a).
(2)The
term Department means the Department of Health and Human
Services.
(3)The
term Indian means any individual who is a member of an Indian
tribe or is eligible for health services under the Indian Health Care
Improvement Act (25 U.S.C. 1601 et seq.).
(4)The term Indian tribe has the meaning given
the term in section 4 of the Indian
Self-Determination and Education Assistance Act (25 U.S.C.
450b).
(5)The
term Secretary means the Secretary of Health and Human
Services.
(6)The
term Service means the Indian Health Service.
(7)The term telemental health means the use of
electronic information and telecommunications technologies to support long
distance mental health care, patient and professional-related education, public
health, and health administration.
(8)Traditional
health care practicesThe term traditional health care
practices means the application by Native healing practitioners of the
Native healing sciences (as opposed or in contradistinction to Western healing
sciences) that—
(A)embody the
influences or forces of innate Tribal discovery, history, description,
explanation and knowledge of the states of wellness and illness; and
(B)call upon those
influences or forces in the promotion, restoration, preservation, and
maintenance of health, well-being, and life’s harmony.
(9)The term tribal organization has the
meaning given the term in section 4 of the Indian Self-Determination and Education Assistance
Act (25 U.S.C. 450b).
4.Indian youth
telemental health demonstration project
(a)
(1)The Secretary is authorized to carry out a demonstration
project to award grants for the provision of telemental health services to
Indian youth who—
(A)have expressed
suicidal ideas;
(B)have attempted
suicide; or
(C)have mental
health conditions that increase or could increase the risk of suicide.
(2)Grants described in paragraph (1) shall be awarded to
Indian tribes and tribal organizations that operate 1 or more
facilities—
(A)located in Alaska
and part of the Alaska Federal Health Care Access Network;
(B)reporting active
clinical telehealth capabilities; or
(C)offering
school-based telemental health services relating to psychiatry to Indian
youth.
(3)The Secretary shall award grants under this section for a
period of up to 4 years.
(4)Not more than 5 grants shall be provided under
paragraph (1), with priority consideration given to Indian tribes and tribal
organizations that—
(A)serve a
particular community or geographic area in which there is a demonstrated need
to address Indian youth suicide;
(B)enter into
collaborative partnerships with Service or other tribal health programs or
facilities to provide services under this demonstration project;
(C)serve an isolated
community or geographic area which has limited or no access to behavioral
health services; or
(D)operate a
detention facility at which Indian youth are detained.
(b)An Indian tribe or tribal organization shall use a grant
received under subsection (a) for the following purposes:
(1)To provide
telemental health services to Indian youth, including the provision of—
(A)psychotherapy;
(B)psychiatric
assessments and diagnostic interviews, therapies for mental health conditions
predisposing to suicide, and treatment; and
(C)alcohol and
substance abuse treatment.
(2)To provide
clinician-interactive medical advice, guidance and training, assistance in
diagnosis and interpretation, crisis counseling and intervention, and related
assistance to Service or tribal clinicians and health services providers
working with youth being served under the demonstration project.
(3)To assist,
educate, and train community leaders, health education professionals and
paraprofessionals, tribal outreach workers, and family members who work with
the youth receiving telemental health services under the demonstration project,
including with identification of suicidal tendencies, crisis intervention and
suicide prevention, emergency skill development, and building and expanding
networks among those individuals and with State and local health services
providers.
(4)To develop and
distribute culturally-appropriate community educational materials on—
(A)suicide
prevention;
(B)suicide
education;
(C)suicide
screening;
(D)suicide
intervention; and
(E)ways to mobilize
communities with respect to the identification of risk factors for
suicide.
(5)To conduct data
collection and reporting relating to Indian youth suicide prevention
efforts.
(c)To
be eligible to receive a grant under subsection (a), an Indian tribe or tribal
organization shall prepare and submit to the Secretary an application, at such
time, in such manner, and containing such information as the Secretary may
require, including—
(1)a description of
the project that the Indian tribe or tribal organization will carry out using
the funds provided under the grant;
(2)a description of
the manner in which the project funded under the grant would—
(A)meet the
telemental health care needs of the Indian youth population to be served by the
project; or
(B)improve the
access of the Indian youth population to be served to suicide prevention and
treatment services;
(3)evidence of
support for the project from the local community to be served by the
project;
(4)a description of
how the families and leadership of the communities or populations to be served
by the project would be involved in the development and ongoing operations of
the project;
(5)a plan to involve
the tribal community of the youth who are provided services by the project in
planning and evaluating the mental health care and suicide prevention efforts
provided, in order to ensure the integration of community, clinical,
environmental, and cultural components of the treatment; and
(6)a plan for
sustaining the project after Federal assistance for the demonstration project
has terminated.
(d)Traditional
health care practicesThe Secretary, acting through the Service,
shall ensure that the demonstration project involves the use and promotion of
the traditional health care practices of the Indian tribes of the youth to be
served.
(e)The
Secretary, acting through the Service, shall encourage Indian tribes and tribal
organizations receiving grants under this section to collaborate to enable
comparisons about best practices across projects.
(f)Each grant recipient shall submit to the Secretary an
annual report that—
(1)describes the
number of telemental health services provided; and
(2)includes any
other information that the Secretary may require.
(g)Not later than 270
days after the date of termination of the demonstration project, the Secretary
shall submit to the Committee on Indian Affairs of the Senate and the Committee
on Resources and the Committee on Energy and Commerce of the House of
Representatives a final report that—
(1)describes the
results of the projects funded by grants awarded under this section, including
any data available that indicate the number of attempted suicides;
(2)evaluates the
impact of the telemental health services funded by the grants in reducing the
number of completed suicides among Indian youth;
(3)evaluates whether
the demonstration project should be—
(A)expanded to
provide more than 5 grants; and
(B)designated a
permanent program; and
(4)evaluates the
benefits of expanding the demonstration project to include urban Indian
organizations.
(h)Authorization
of appropriationsThere is authorized to be appropriated to carry
out this section $1,500,000 for each of fiscal years 2007 through 2010.
April 24, 2006
Reported without amendment