[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1077 Introduced in Senate (IS)]
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118th CONGRESS
1st Session
S. 1077
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 SENATE OF THE UNITED STATES
March 30, 2023
Mr. Rounds (for himself, Ms. Smith, Mr. Boozman, and Mr. Thune)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
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 2023
through 2027 may be allocated to carrying out the program under this
section.''.
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