1.This Act may be cited as
the Working Together for Rural Access
to Mental Health and Wellness for Children and Seniors
Act
.
2.
(a)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)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.
3.Rural access to
mental health services grant program
(a)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)
(1)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)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)
(1)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)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)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)
(1)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)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)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)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)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)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 evaluationThe 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)The Secretary shall review and monitor State compliance
with the requirements of this section and the State plan submitted under
subsection (d).
(2)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 lawFederal and State procurement laws shall be
preempted to the extent necessary to carry out this section.
(i)In
this section:
(1)The
term hospital means a non-Federal short-term general acute care
facility located in or serving a rural area.
(2)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)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 servicesThe 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 equipmentThe 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 appropriationsThere are authorized to be appropriated to
carry out this section, $10,000,000 for each of fiscal years 2008 through
2010.