Home-Based Telemental Health Care Act of 2020

II 116TH CONGRESS 2D SESSION S. 3917 To establish a home-based telemental health care demonstration program for purposes of increasing mental health services in rural medically underserved populations and for individuals in farming, fishing, and forestry occupations. IN THE SENATE OF THE UNITED STATES JUNE 9, 2020 Mr. ROUNDS (for himself, Ms. SMITH, Mr. CRAMER, Ms. COLLINS, Mr. MAR- KEY, Mr. BOOZMAN, Mrs. HYDE-SMITH, and Mr. BENNET) 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 demonstra- tion program for purposes of increasing mental health services in rural medically underserved populations and for individuals in farming, fishing, and forestry occupa- tions. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Home-Based Tele- 4 mental Health Care Act of 2020’’. 5 VerDate Sep 11 2014 04:59 Jun 24, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3917.IS S3917 kjohnson on DSK79L0C42PROD with BILLS 2 •S 3917 IS SEC. 2. FINDINGS. 1 Congress finds as follows: 2 (1) It is estimated that 46,600,000 adults expe- 3 rience mental illness in a given year in the United 4 States, with 7.1 percent of adults in the United 5 States living with major depression and 19.1 percent 6 of such adults living with anxiety disorders. 7 (2) According to the results from the 2017 Na- 8 tional Survey on Drug Use and Health, 19.1 percent 9 of residents in rural communities aged 18 or older 10 have any mental illness, or approximately 6,800,000 11 people; 4.9 percent, or nearly 1,700,000 rural resi- 12 dents experience serious thoughts of suicide. 13 (3) A study by the Centers for Disease Control 14 and Prevention suggests that people in farming, 15 fishing, and forestry occupations (referred to in this 16 section as the ‘‘Triple-F’’ industry) in the United 17 States experienced rates of 75 and 76 suicides per 18 100,000 people in 2012 and 2015, respectively. 19 (4) The COVID–19 pandemic has put addi- 20 tional stress on people in the Triple-F population. 21 The pandemic has caused instability in the markets, 22 especially as the virus has caused a downturn in 23 food service sales and has closed meat processing 24 plants across the Nation. This has left farmers with 25 low commodity prices and loss of revenue. Additional 26 VerDate Sep 11 2014 04:59 Jun 24, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3917.IS S3917 kjohnson on DSK79L0C42PROD with BILLS 3 •S 3917 IS resources are needed to support the mental health 1 needs of this population. 2 (5) While the prevalence of mental illness is 3 similar among rural and urban residents, the serv- 4 ices available to each population are very different. 5 Mental health care needs are not met in rural com- 6 munities due to many challenges, including accessi- 7 bility issues due to transportation and geographic 8 isolation, the stigma of needing or receiving mental 9 health care, a lack of anonymity when seeking treat- 10 ment, shortages of mental health workforce profes- 11 sionals, and affordability due to a high rate of unin- 12 sured residents. 13 (6) Telemental health, which is the delivery of 14 mental health services using remote technologies 15 when the patient and provider are separated by dis- 16 tance, shows promise in helping to alleviate the lack 17 of mental health services in rural areas. Traditional 18 telemental health models involve care delivered to a 19 patient at an originating clinical site from a spe- 20 cialist working at a distant site. Having the ability 21 to reach mental health professionals from a place of 22 comfort, such as home, from a personal device may 23 reduce challenges faced in rural areas and amongst 24 Triple-F workers. 25 VerDate Sep 11 2014 04:59 Jun 24, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3917.IS S3917 kjohnson on DSK79L0C42PROD with BILLS 4 •S 3917 IS (7) A clinical trial of 241 depressed elderly vet- 1 erans, which was conducted by the Medical Univer- 2 sity of South Carolina and the Ralph H. Johnson 3 Veterans Affairs Medical Center, and published in 4 the Journal of Clinical Psychiatry, found that home- 5 based telemental health for depression is well re- 6 ceived by patients and delivers as good a quality of 7 life as in-person visits. 8 SEC. 3. MENTAL HEALTH SERVICES DELIVERED TO RURAL 9 UNDERSERVED POPULATIONS VIA TELE- 10 MENTAL HEALTH CARE. 11 Title III of the Public Health Service Act is amended 12 by inserting after section 330K (42 U.S.C. 254c–16) the 13 following: 14 ‘‘SEC. 330K–1. MENTAL HEALTH SERVICES DELIVERED TO 15 RURAL UNDERSERVED POPULATIONS VIA 16 TELEMENTAL HEALTH CARE. 17 ‘‘(a) DEFINITIONS.—In this section— 18 ‘‘(1) the term ‘covered populations’ means— 19 ‘‘(A) medically underserved populations in 20 rural areas (as defined in section 1886(d)(2)(D) 21 of the Social Security Act); or 22 ‘‘(B) populations engaged in a farming, 23 fishing, or forestry industry; 24 VerDate Sep 11 2014 04:59 Jun 24, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3917.IS S3917 kjohnson on DSK79L0C42PROD with BILLS 5 •S 3917 IS ‘‘(2) the term ‘eligible entity’ means a public or 1 nonprofit private telemental health provider network 2 that offers services that include mental health serv- 3 ices provided by professionals trained in mental 4 health; 5 ‘‘(3) the term ‘farming, fishing, or forestry in- 6 dustry’ means an occupation defined as a farming, 7 fishing, or forestry occupation by the Department of 8 Labor in accordance with the Standard Occupational 9 Classification System; 10 ‘‘(4) the term ‘home-based telemental’ means 11 the use of telemental health services where the pa- 12 tient is in his or her own home or other place of 13 comfort; 14 ‘‘(5) the term ‘medically underserved popu- 15 lation’ has the meaning given such term in section 16 330(b); 17 ‘‘(6) the term ‘professional trained in mental 18 health’ means a psychiatrist, a qualified mental 19 health professional (as defined in section 330K), or 20 another mental health professional acting under the 21 direction of a psychiatrist; 22 ‘‘(7) the term ‘rural’ has the meaning given 23 such term by the Office of Rural Health Policy of 24 VerDate Sep 11 2014 04:59 Jun 24, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3917.IS S3917 kjohnson on DSK79L0C42PROD with BILLS 6 •S 3917 IS the Health Resources and Services Administration; 1 and 2 ‘‘(8) the term ‘telemental health’ means the use 3 of electronic information and telecommunications 4 technologies to support long distance clinical health 5 care, patient and professional health-related edu- 6 cation, public health, and health administration. 7 ‘‘(b) PROGRAM AUTHORIZED.—The Secretary, acting 8 through the Director of the Office for the Advancement 9 of Telehealth of the Health Resources and Services Ad- 10 ministration and in coordination with the Rural Health 11 Liaison of the Department of Agriculture, shall award 12 grants to eligible entities to establish demonstration 13 projects for the provision of mental health services to cov- 14 ered populations in their homes, as delivered remotely by 15 professionals trained in mental health using telemental 16 health care. 17 ‘‘(c) USE OF FUNDS.—Recipients of a grant under 18 this section shall use the grant funds to— 19 ‘‘(1) deliver home-based telemental health serv- 20 ices to covered populations; and 21 ‘‘(2) develop comprehensive metrics to measure 22 the quality and impact of home-based telemental 23 health services compared to traditional in-person 24 mental health care. 25 VerDate Sep 11 2014 04:59 Jun 24, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3917.IS S3917 kjohnson on DSK79L0C42PROD with BILLS 7 •S 3917 IS ‘‘(d) REPORT.—The Secretary, in consultation with 1 the Secretary of Agriculture, 3 years after the date on 2 which the program under this section commences, and 2 3 years thereafter, shall submit to the appropriate congres- 4 sional committees reports on the impact and quality of 5 care of home-based telemental health care services for cov- 6 ered populations. 7 ‘‘(e) AUTHORIZED USE OF FUNDS.—Out of any 8 amounts made available to the Secretary, up to 9 $10,000,000 for each of fiscal years 2021 through 2025 10 may be allocated to carrying out the program under this 11 section.’’. 12 Æ VerDate Sep 11 2014 04:59 Jun 24, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\S3917.IS S3917 kjohnson on DSK79L0C42PROD with BILLS