[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6534 Introduced in House (IH)]

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118th CONGRESS
  1st Session
                                H. R. 6534

To establish a home-based telemental health care demonstration program 
for purposes of increasing mental health and substance use services in 
rural medically underserved populations and for individuals in farming, 
                   fishing, and forestry occupations.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           November 30, 2023

Ms. Salinas (for herself and Mrs. Harshbarger) introduced the following 
    bill; which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To establish a home-based telemental health care demonstration program 
for purposes of increasing mental health and substance use services in 
rural medically underserved populations and for individuals in farming, 
                   fishing, and forestry occupations.

    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 ``Home-Based Telemental Health Care 
Act of 2023''.

SEC. 2. FINDINGS.

    Congress finds as follows:
            (1) According to a 2020 report by the Centers for Disease 
        Control and Prevention, titled ``Mental Health, Substance Use 
        and Suicidal Ideation during the COVID-19 Pandemic'' (referred 
        to in this section as the ``CDC report''), elevated levels of 
        adverse mental health conditions, substance use, and suicidal 
        ideation were reported by adults in the United States in June 
        2020, after the onset of the COVID-19 pandemic. The prevalence 
        of symptoms of anxiety disorder was 25.5 percent, compared to 
        8.1 percent in the second quarter of 2019. Additionally, 24.3 
        percent of adults experienced depressive symptoms in June 2020, 
        4 times the 6.5 percent reported in the second quarter of 2019.
            (2) According to the CDC report, approximately 30 percent 
        of rural adults who responded to a survey of the Centers for 
        Disease Control and Prevention suffered from symptoms of 
        anxiety or depression, and approximately 10 percent of rural 
        adults seriously considered suicide in the past 30 days.
            (3) A 2020 study by the Centers for Disease Control and 
        Prevention suggests that people in farming, fishing, and 
        forestry occupations (referred to in this section as the 
        ``Triple-F'' industry) in the United States experienced rates 
        of 31.4 suicides per 100,000 people in 2016.
            (4) Such 2020 study by the Centers for Disease Control and 
        Prevention indicates that suicide rates for farmers, ranchers, 
        and other agricultural managers were 58 percent higher than the 
        rate for the general population in 2016.
            (5) According to a 2019 report of the National Survey on 
        Drug Use and Health, 22.4 percent of residents in rural 
        communities aged 18 or older who experienced mental illness 
        perceived an unmet need for mental health services. Of these 
        individuals, 17.9 percent did not receive any mental health 
        services in the prior year.
            (6) The COVID-19 pandemic put additional stress on people 
        in the Triple-F population. In the early stages, the pandemic 
        caused instability in the markets, especially as the virus 
        caused a downturn in food service sales and closed meat 
        processing plants across the Nation. Farmers were left with low 
        commodity prices and loss of revenue. This community has spent 
        the last 2 years attempting to rebound from the effects of the 
        pandemic. Additional resources are needed to support the mental 
        health needs of this population.
            (7) While the prevalence of mental illness is similar among 
        rural and urban residents, the services available to each 
        population are very different. Mental health care needs are not 
        met in rural communities due to many challenges, including 
        accessibility issues due to transportation and geographic 
        isolation, the stigma of needing or receiving mental health 
        care, a lack of anonymity when seeking treatment, shortages of 
        mental health workforce professionals, and affordability due to 
        a high rate of uninsured residents.
            (8) Telemental health, which is the delivery of mental 
        health services using remote technologies when the patient and 
        provider are separated by distance, shows promise in helping to 
        alleviate the lack of mental health services in rural areas. 
        Traditional telemental health models involve care delivered to 
        a patient at an originating clinical site from a specialist 
        working at a distant site. Having the ability to reach mental 
        health professionals from a place of comfort, such as home, 
        from a personal device may reduce challenges faced in rural 
        areas and amongst Triple-F workers.
            (9) A clinical trial of 241 depressed elderly veterans, 
        which was conducted by the Medical University of South Carolina 
        and the Ralph H. Johnson Veterans Affairs Medical Center and 
        reported in the Journal of Clinical Psychiatry, found that 
        home-based telemental health for depression is well received by 
        patients and delivers as good a quality of life as in-person 
        visits.

SEC. 3. MENTAL HEALTH AND SUBSTANCE USE SERVICES DELIVERED TO RURAL 
              UNDERSERVED POPULATIONS VIA TELEMENTAL HEALTH CARE.

    Title III of the Public Health Service Act is amended by inserting 
after section 330K (42 U.S.C. 254c-16) the following:

``SEC. 330K-1. MENTAL HEALTH AND SUBSTANCE USE SERVICES DELIVERED TO 
              RURAL UNDERSERVED POPULATIONS VIA TELEMENTAL HEALTH CARE.

    ``(a) Definitions.--In this section--
            ``(1) the term `covered populations' means--
                    ``(A) health professional shortage areas (as 
                defined in section 332(a)(1)) in rural areas; or
                    ``(B) populations engaged in a farming, fishing, or 
                forestry industry;
            ``(2) the term `eligible entity' means a public or 
        nonprofit private telemental health provider network that 
        offers services that include mental health and substance use 
        services provided by professionals trained in mental health and 
        substance use;
            ``(3) the term `farming, fishing, or forestry industry' 
        means an occupation defined as a farming, fishing, or forestry 
        occupation by the Department of Labor in accordance with the 
        Standard Occupational Classification System;
            ``(4) the term `home-based telemental' means the use of 
        telemental health services where the patient is in his or her 
        own home or other place of comfort;
            ``(5) the term `professional trained in mental health' 
        means a psychiatrist, a qualified mental health professional 
        (as defined in section 330K), or another mental health 
        professional acting under the direction of a psychiatrist;
            ``(6) the term `rural' has the meaning given such term by 
        the Office of Rural Health Policy of the Health Resources and 
        Services Administration; and
            ``(7) the term `telemental health' 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.
    ``(b) Program Authorized.--The Secretary, in consultation with the 
Rural Health Liaison of the Department of Agriculture, shall award 
grants to eligible entities to establish demonstration projects for the 
provision of mental health and substance use services to covered 
populations in their homes, as delivered remotely by professionals 
trained in mental health and substance use using telemental health 
care.
    ``(c) Use of Funds.--Recipients of a grant under this section shall 
use the grant funds to--
            ``(1) deliver home-based telemental health services to 
        covered populations; and
            ``(2) develop comprehensive metrics to measure the quality 
        and impact of home-based telemental health services compared to 
        traditional in-person mental health and substance use care.
    ``(d) Report.--The Secretary, in consultation with the Secretary of 
Agriculture, not later than 3 years after the date on which the program 
under this section commences, and 2 years thereafter, shall submit to 
the appropriate congressional committees reports on the impact and 
quality of care of home-based telemental health care services for 
covered populations.
    ``(e) Authorized Use of Funds.--Out of any amounts made available 
to the Secretary, up to $10,000,000 for each of fiscal years 2024 
through 2028 may be allocated to carrying out the program under this 
section.''.
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