[Congressional Record Volume 153, Number 29 (Thursday, February 15, 2007)]
[Senate]
[Pages S2080-S2082]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. COLEMAN:
  S. 633. 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; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. COLEMAN. Mr. President, I ask unanimous consent that the text of 
the bill I introduce today, the Working Together for Rural Access to 
Mental Health and Wellness for Children and Seniors Act, be printed in 
the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 633

       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.

[[Page S2081]]

       (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.

[[Page S2082]]

       (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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