What This Bill Does
This bill creates a demonstration program that provides mental health and substance use services to rural communities and people who work in farming, fishing, and forestry through telemental health services (using technology to connect patients with providers remotely). The program specifically allows patients to receive these services from their own homes instead of traveling to a clinic.
Who It Affects
Rural residents in medically underserved areas, people who work in farming, fishing, or forestry occupations, public and nonprofit telemental health provider networks that receive grant money, and the U.S. Department of Health and Human Services.
Key Provisions
- The Secretary of Health and Human Services must award grants to eligible telemental health organizations to start demonstration projects that deliver mental health and substance use services to rural and underserved populations in their homes (Sec. 3(b))
- Grant recipients must provide home-based telemental health services to covered populations and create measurements to track the quality and impact of these services compared to traditional in-person care (Sec. 3(c))
- The Secretary must submit reports to Congress 3 years after the program starts and every 2 years after that describing how well the home-based telemental health services work for the populations served (Sec. 3(d))
- Up to $10,000,000 per year for fiscal years 2023 through 2027 can be used to run this program (Sec. 3(e))
What Changes
If this becomes law, eligible organizations can receive federal grant money to offer mental health and substance use services to rural residents and people in farming, fishing, and forestry jobs through remote technology services delivered to people's homes.
Important Definitions
- Covered populations: people living in rural health professional shortage areas or people who work in farming, fishing, or forestry
- Home-based telemental: mental health services provided when the patient is at home or another comfortable location
- Eligible entity: a public or nonprofit private telemental health provider network offering mental health and substance use services by trained professionals
- Telemental health: using electronic information and communication technologies to provide health care services from a distance
Effective Date
Not specified in bill text
II
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) intro-
duced the following bill; which was read twice and referred to the Com-
mittee 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
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 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 2023’’.
5
SEC. 2. FINDINGS.
6
Congress finds as follows:
7
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(1) According to a 2020 report by the Centers
1
for Disease Control and Prevention, titled ‘‘Mental
2
Health, Substance Use and Suicidal Ideation during
3
the COVID–19 Pandemic’’ (referred to in this sec-
4
tion as the ‘‘CDC report’’), elevated levels of adverse
5
mental health conditions, substance use, and suicidal
6
ideation were reported by adults in the United
7
States in June 2020, after the onset of the COVID–
8
19 pandemic. The prevalence of symptoms of anxiety
9
disorder was 25.5 percent, compared to 8.1 percent
10
in the second quarter of 2019. Additionally, 24.3
11
percent of adults experienced depressive symptoms
12
in June 2020, 4 times the 6.5 percent reported in
13
the second quarter of 2019.
14
(2) According to the CDC report, approximately
15
30 percent of rural adults who responded to a survey
16
of the Centers for Disease Control and Prevention
17
suffered from symptoms of anxiety or depression,
18
and approximately 10 percent of rural adults seri-
19
ously considered suicide in the past 30 days.
20
(3) A 2020 study by the Centers for Disease
21
Control and Prevention suggests that people in
22
farming, fishing, and forestry occupations (referred
23
to in this section as the ‘‘Triple–F’’ industry) in the
24
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•S 1077 IS
United States experienced rates of 31.4 suicides per
1
100,000 people in 2016.
2
(4) Such 2020 study by the Centers for Disease
3
Control and Prevention indicates that suicide rates
4
for farmers, ranchers, and other agricultural man-
5
agers were 58 percent higher than the rate for the
6
general population in 2016.
7
(5) According to a 2019 report of the National
8
Survey on Drug Use and Health, 22.4 percent of
9
residents in rural communities aged 18 or older who
10
experienced mental illness perceived an unmet need
11
for mental health services. Of these individuals, 17.9
12
percent did not receive any mental health services in
13
the prior year.
14
(6) The COVID–19 pandemic put additional
15
stress on people in the Triple–F population. In the
16
early stages, the pandemic caused instability in the
17
markets, especially as the virus caused a downturn
18
in food service sales and closed meat processing
19
plants across the Nation. Farmers were left with low
20
commodity prices and loss of revenue. This commu-
21
nity has spent the last 2 years attempting to re-
22
bound from the effects of the pandemic. Additional
23
resources are needed to support the mental health
24
needs of this population.
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(7) While the prevalence of mental illness is
1
similar among rural and urban residents, the serv-
2
ices available to each population are very different.
3
Mental health care needs are not met in rural com-
4
munities due to many challenges, including accessi-
5
bility issues due to transportation and geographic
6
isolation, the stigma of needing or receiving mental
7
health care, a lack of anonymity when seeking treat-
8
ment, shortages of mental health workforce profes-
9
sionals, and affordability due to a high rate of unin-
10
sured residents.
11
(8) Telemental health, which is the delivery of
12
mental health services using remote technologies
13
when the patient and provider are separated by dis-
14
tance, shows promise in helping to alleviate the lack
15
of mental health services in rural areas. Traditional
16
telemental health models involve care delivered to a
17
patient at an originating clinical site from a spe-
18
cialist working at a distant site. Having the ability
19
to reach mental health professionals from a place of
20
comfort, such as home, from a personal device may
21
reduce challenges faced in rural areas and amongst
22
Triple–F workers.
23
(9) A clinical trial of 241 depressed elderly vet-
24
erans, which was conducted by the Medical Univer-
25
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•S 1077 IS
sity of South Carolina and the Ralph H. Johnson
1
Veterans Affairs Medical Center and reported in the
2
Journal of Clinical Psychiatry, found that home-
3
based telemental health for depression is well re-
4
ceived by patients and delivers as good a quality of
5
life as in-person visits.
6
SEC. 3. MENTAL HEALTH AND SUBSTANCE USE SERVICES
7
DELIVERED TO RURAL UNDERSERVED POPU-
8
LATIONS VIA TELEMENTAL HEALTH CARE.
9
Title III of the Public Health Service Act is amended
10
by inserting after section 330K (42 U.S.C. 254c–16) the
11
following:
12
‘‘SEC. 330K–1. MENTAL HEALTH AND SUBSTANCE USE SERV-
13
ICES DELIVERED TO RURAL UNDERSERVED
14
POPULATIONS
VIA
TELEMENTAL
HEALTH
15
CARE.
16
‘‘(a) DEFINITIONS.—In this section—
17
‘‘(1) the term ‘covered populations’ means—
18
‘‘(A) health professional shortage areas (as
19
defined in section 332(a)(1)) in rural areas; or
20
‘‘(B) populations engaged in a farming,
21
fishing, or forestry industry;
22
‘‘(2) the term ‘eligible entity’ means a public or
23
nonprofit private telemental health provider network
24
that offers services that include mental health and
25
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substance use services provided by professionals
1
trained in mental health and substance use;
2
‘‘(3) the term ‘farming, fishing, or forestry in-
3
dustry’ means an occupation defined as a farming,
4
fishing, or forestry occupation by the Department of
5
Labor in accordance with the Standard Occupational
6
Classification System;
7
‘‘(4) the term ‘home-based telemental’ means
8
the use of telemental health services where the pa-
9
tient is in his or her own home or other place of
10
comfort;
11
‘‘(5) the term ‘professional trained in mental
12
health’ means a psychiatrist, a qualified mental
13
health professional (as defined in section 330K), or
14
another mental health professional acting under the
15
direction of a psychiatrist;
16
‘‘(6) the term ‘rural’ has the meaning given
17
such term by the Office of Rural Health Policy of
18
the Health Resources and Services Administration;
19
and
20
‘‘(7) the term ‘telemental health’ means the use
21
of electronic information and telecommunications
22
technologies to support long distance clinical health
23
care, patient and professional health-related edu-
24
cation, public health, and health administration.
25
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‘‘(b) PROGRAM AUTHORIZED.—The Secretary, in
1
consultation with the Rural Health Liaison of the Depart-
2
ment of Agriculture, shall award grants to eligible entities
3
to establish demonstration projects for the provision of
4
mental health and substance use services to covered popu-
5
lations in their homes, as delivered remotely by profes-
6
sionals trained in mental health and substance use using
7
telemental health care.
8
‘‘(c) USE OF FUNDS.—Recipients of a grant under
9
this section shall use the grant funds to—
10
‘‘(1) deliver home-based telemental health serv-
11
ices to covered populations; and
12
‘‘(2) develop comprehensive metrics to measure
13
the quality and impact of home-based telemental
14
health services compared to traditional in-person
15
mental health and substance use care.
16
‘‘(d) REPORT.—The Secretary, in consultation with
17
the Secretary of Agriculture, not later than 3 years after
18
the date on which the program under this section com-
19
mences, and 2 years thereafter, shall submit to the appro-
20
priate congressional committees reports on the impact and
21
quality of care of home-based telemental health care serv-
22
ices for covered populations.
23
‘‘(e) AUTHORIZED USE
OF FUNDS.—Out of any
24
amounts made available to the Secretary, up to
25
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$10,000,000 for each of fiscal years 2023 through 2027
1
may be allocated to carrying out the program under this
2
section.’’.
3
Æ
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