[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 633 Introduced in Senate (IS)]







110th CONGRESS
  1st Session
                                 S. 633

To provide assistance to rural schools, hospitals, and communities for 
   the conduct of collaborative efforts to secure a progressive and 
 innovative system to improve access to mental health care for youth, 
                         seniors, and families.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 15, 2007

  Mr. Coleman introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To provide assistance to rural schools, hospitals, and communities for 
   the conduct of collaborative efforts to secure a progressive and 
 innovative system to improve access to mental health care for youth, 
                         seniors, and families.

    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 ``Working Together for Rural Access to 
Mental Health and Wellness for Children and Seniors Act''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress makes the following findings:
            (1) Providing adequate mental health care in rural 
        communities is a national problem. Mental health is an integral 
        part of a person's general health and well-being. In rural 
        areas, where specialized mental health services are scarce, 
        accessing mental health professional services is difficult. 
        Primary care is often the only system for delivering mental 
        health services.
            (2) Rural primary care providers are seeing an increase in 
        mental health issues in their clinics.
            (3) The need is overwhelming with the Surgeon General 
        estimating 21 percent of children experience the signs or 
        symptoms of a mental disorder. Left untreated, these problems 
        lead to rampant school failure, drug abuse, and often 
        incarceration.
            (4) The Department of Health and Human Services indicates 
        that 1 in 5 children and adolescents may have a diagnosable 
        disorder, yet 70 percent to 80 percent receive little or no 
        help.
            (5) Few schools have the resources to implement a full 
        range of school mental health interventions. Identifying 
        sustainable and flexible funding sources for these programs is 
        extremely important.
            (6) Health, and especially mental health, is a fundamental 
        cornerstone for ensuring that all youth have an equal 
        opportunity to succeed at school.
            (7) Promoting and expanding telemental health 
        collaborations to strengthen delivery of mental health services 
        in remote and underserved areas is needed.
            (8) Telemental health is an effective tool for diagnosing 
        and treating some mental health conditions. For rural and 
        remote areas, telemental health offers patients access and 
        care.
    (b) Purpose.--It is the purpose of this Act to--
            (1) provide assistance to rural schools, hospitals, and 
        communities for the conduct of collaborative efforts to secure 
        a progressive and innovative system to improve access to mental 
        health care for youth, seniors and families;
            (2) increase access of elementary and secondary school 
        students to mental health services in rural areas by operating 
        a mobile health services van program in such areas; or
            (3) increase access of individuals of all ages to mental 
        health services in rural areas by providing telemental health 
        services in such areas.

SEC. 3. RURAL ACCESS TO MENTAL HEALTH SERVICES GRANT PROGRAM.

    (a) State Grants.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary'') shall award grants 
to States to enable such States to award subgrants to carry out the 
purposes of this Act.
    (b) Eligibility and Amount.--
            (1) Eligibility.--To be eligible for a grant under 
        subsection (a), a State shall submit to the Secretary an 
        application at such time, in such manner, and containing such 
        information as the Secretary may require, including an 
        assurance that the State will designate a lead agency in 
        accordance with subsection (c) and submit a State plan in 
        accordance with subsection (d).
            (2) Amount.--The Secretary shall award a grant to a State 
        under this section in an amount that is based on the respective 
        number of critical access hospitals (as defined in section 1861 
        (mm)(1) of the Social Security Act (42 U.S.C. 1395x(mm)(1)) in 
        the State as such compares to the total number of critical 
        access hospitals in all States that are awarded grants under 
        this section.
    (c) State Lead Agency.--
            (1) In general.--To be eligible to receive a grant under 
        this section, the governor of a State shall select a lead 
        agency within the State to administer the State programs under 
        the grant. If the governor of the State selects a lead agency 
        other than the State Office of Rural Health, the governor shall 
        ensure the involvement of the State Office of Rural Health in 
        the development and administration of the State program under 
        this section.
            (2) Duties.--The lead agency of a State shall--
                    (A) administer, directly or through other 
                governmental or nongovernmental agencies, amounts 
                received under a grant under subsection (a); and
                    (B) develop the State plan under subsection (d) and 
                coordinate the expenditure of funds in consultation 
                with appropriate representatives of the State and local 
                educational agencies and the rural mental health 
                providers and State hospital associations.
    (d) State Plan.--To be eligible to receive a grant under subsection 
(a), a State shall submit to the Secretary a State plan that shall--
            (1) identify the lead agency of the State;
            (2) contain assurances that the State shall use the amounts 
        provided to the State under the grant to address--
                    (A) in the case of mobile van services, the mental 
                health needs of elementary school and secondary school 
                students; or
                    (B) in the case of telemental health services, the 
                mental health needs of individuals of all ages through 
                telemental health services, and to pay administrative 
                costs incurred in connection with providing the 
                assistance to grant recipients;
            (3) contain assurances that benefits and services under the 
        grant shall be available throughout the entire State; and
            (4) contain assurances that the lead agency shall consult 
        with rural mental health providers and hospital associations 
        that represent such providers in such State on the most 
        appropriate ways to use the funds received under the grant.
    (e) Awarding of Subgrants.--
            (1) In general.--The lead agency of the State shall use 
        amounts received under a grant under subsection (a) to award 
        subgrants to eligible entities on a competitive basis.
            (2) Eligibility.--To be eligible to receive a subgrant 
        under paragraph (1), a grant applicant shall be located in or 
        serving a rural area and be a government-owned or private 
        nonprofit hospital (or, in the case of a mobile van services 
        program, a governmental, tribal, or private nonprofit school 
        district or educational institution which provides elementary 
        education or secondary education (kindergarten through grade 
        12) and that collaborates with such a hospital), a community 
        mental health center, a primary care clinic, or other nonprofit 
        agency providing mental health services.
            (3) Selection criteria.--In establishing procedures for the 
        awarding of subgrants under paragraph (1), the lead agency of 
        the State shall provide for the use of the following selection 
        criteria:
                    (A) The extent to which a grant applicant 
                demonstrates a need to improve the access of mental 
                health services within the community served by such 
                applicant.
                    (B) The extent to which a grant applicant will 
                serve a rural community with a significant low-income 
                or other population that is underserved with respect to 
                the provision of mental health services.
            (4) Application and approval.--To be eligible to receive a 
        subgrant under paragraph (1), an entity shall submit an 
        application to the lead agency of the State that includes--
                    (A) a description of the manner in which the entity 
                intends to use amounts provided under the subgrant;
                    (B) such information as the lead agency may require 
                to apply the selection criteria under paragraph (3);
                    (C) measurable objectives for the use of funds 
                provided under the subgrant;
                    (D) a description of the manner in which the 
                applicant will evaluate the effectiveness of the 
                program carried out under the subgrant;
                    (E) an agreement to maintain such records, make 
                such reports, and cooperate with such reviews or audits 
                as the lead agency and the Secretary may find necessary 
                for purposes of oversight of program activities and 
                expenditures;
                    (F) a plan for sustaining activities and services 
                funded under the subgrant after Federal support for 
                such activities and services has ended; and
                    (G) such other information and assurances as the 
                Secretary may require.
            (5) Use of funds.--A recipient of a subgrant under 
        paragraph (1) shall use amounts awarded under the grant to--
                    (A) in the case of mobile van health services, 
                offset costs incurred after December 31, 2007, that are 
                related to operating a mobile van outreach program 
                under which a hospital and one or more elementary or 
                secondary schools provide mental health care services 
                to students of such schools in the rural area, which 
                may include the costs of--
                            (i) purchasing or leasing a mobile van in 
                        which mental health services are provided to 
                        elementary school or secondary school students;
                            (ii) repairs and maintenance for such a 
                        mobile van;
                            (iii) purchasing or leasing communications 
                        capabilities reasonable and necessary to 
                        operate the mobile van;
                            (iv) providing education and training to 
                        staff on operating the mobile van program; and
                            (v) providing for additional mental health 
                        services professional staff that are employed 
                        to provide mental health services as part of 
                        the mobile van program; and
                    (B) in the case of telemental health services, 
                offset costs incurred after December 31, 2007, that are 
                related to providing telemental health services to 
                persons of all ages in the rural area, which may 
                include the cost of--
                            (i) purchasing, leasing, repairing, 
                        maintaining, or upgrading telemental health 
                        services equipment;
                            (ii) operating telemental health services 
                        equipment, including telecommunications, 
                        utilities, and software costs;
                            (iii) providing education and training to 
                        staff concerning the provision of telemental 
                        health services; and
                            (iv) employing additional mental health 
                        services professional staff to provide 
                        telemental health services.
            (6) Limits.--The amount awarded to an entity as a subgrant 
        under paragraph (1) for any fiscal year shall not exceed 
        $300,000.
    (f) Reporting, Monitoring, and Evaluation.--The lead agency of each 
State that receives a grant under subsection (a) shall submit a report 
to the Secretary that contains--
            (1) the amounts received under the grant;
            (2) the amounts allocated as subgrants under subsection 
        (e);
            (3) the types of expenditures made by subgrant recipients 
        with such funds; and
            (4) such other information as may be required by the 
        Secretary to assist the Secretary in monitoring the 
        effectiveness of this section.
    (g) Review of Compliance With State Plan.--
            (1) In general.--The Secretary shall review and monitor 
        State compliance with the requirements of this section and the 
        State plan submitted under subsection (d).
            (2) Failure to comply.--If the Secretary, after reasonable 
        notice to a State and opportunity for a hearing, determines 
        that there has been a failure by the State to comply 
        substantially with any provision or requirement set forth in 
        the State plan or a requirement of this section, the Secretary 
        shall notify the lead agency of the State of such determination 
        and that no further payments to the State will be made with 
        respect to the State grant until the Secretary is satisfied 
        that there is no longer any failure to comply or that the 
        noncompliance will be promptly corrected.
    (h) Interaction of Federal and State Law.--Federal and State 
procurement laws shall be preempted to the extent necessary to carry 
out this section.
    (i) Definitions.--In this section:
            (1) Hospital.--The term ``hospital'' means a non-Federal 
        short-term general acute care facility located in or serving a 
        rural area.
            (2) Mobile van.--The term ``mobile van'' means a mobile 
        wellness center the purpose of which is to improve access to, 
        and focuses on, early intervention of mental health, and that 
        provides consultation, education, comprehensive 
        interdisciplinary education, and collaborative treatment 
        planning services.
            (3) Rural area.--The term ``rural area'', with respect to 
        the location of an eligible applicant, or with respect to the 
        location of mental health services, means that the entity or 
        services--
                    (A) is located in a rural census tract of a 
                metropolitan statistical area, as determined under the 
                most recent version of the Goldsmith Modification, the 
                Rural-Urban Commuting Area codes, as determined by the 
                Office of Rural Health Policy of the Health Resources 
                and Services Administration; or
                    (B) is located in an area designated by any law or 
                regulation of such State as a rural area (or, in the 
                case of a hospital, is designated by such State as a 
                rural hospital).
            (4) Telemental health services.--The term ``telemental 
        health services'' means mental health services that are 
        provided through the use of videoconferencing or similar means 
        of electronic communications and information technology.
            (5) Telemental health services equipment.--The term 
        ``telemental health services equipment'' includes 
        telecommunications and peripheral equipment used to provide 
        patient evaluations, case management, medication management, 
        crisis response, pre-admission and pre-discharge planning, 
        treatment planning, individual and group therapy, family 
        therapy, mental status evaluations, case conferences, family 
        visits, staff training, and administrative activities relating 
        to the mental health services.
    (j) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, $10,000,000 for each of fiscal 
years 2008 through 2010.
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