109th CONGRESS
2d Session
S. 2245
To establish an Indian youth telemental health demonstration project.
IN THE SENATE OF THE UNITED STATES
February 6, 2006
Mr. DORGAN (for himself, Mr. CONRAD, Mr. BINGAMAN, Ms. MURKOWSKI, Mr. MCCAIN,
Mr. JOHNSON, and Mr. SMITH) introduced the following bill; which was read
twice and referred to the Committee on Indian Affairs
A BILL
To establish an Indian youth telemental health demonstration project.
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 `Indian Youth Telemental Health Demonstration
Project Act of 2006'.
SEC. 2. FINDINGS AND PURPOSE.
(a) Findings- Congress finds that--
(1) suicide for Indians and Alaska Natives is 2 1/2 times higher than
the national average and the highest for all ethnic groups in the United
States, at a rate of more than 16 per 100,000 males of all age groups,
and 27.9 per 100,000 for males aged 15 through 24, according to data for
2002;
(2) according to national data for 2002, suicide was the second-leading
cause of death for Indians and Alaska Natives aged 15 through 34 and the
fourth-leading cause of death for Indians and Alaska Natives aged 10 through
14;
(3) the suicide rates of Indian and Alaska Native males aged 15 through
24 are nearly 4 times greater than suicide rates of Indian and Alaska
Native females of that age group;
(4)(A) 90 percent of all teens who die by suicide suffer from a diagnosable
mental illness at the time of death; and
(B) more than 1/2 of the people who commit suicide in Indian Country have
never been seen by a mental health provider;
(5) death rates for Indians and Alaska Natives are statistically underestimated;
(6) suicide clustering in Indian Country affects entire tribal communities;
and
(7) since 2003, the Indian Health Service has carried out a National Suicide
Prevention Initiative to work with Service, tribal, and urban Indian health
programs.
(b) Purpose- The purpose of this Act is to authorize the Secretary to carry
out a demonstration project to test the use of telemental health services
in suicide prevention, intervention, and treatment of Indian youth, including
through--
(1) the use of psychotherapy, psychiatric assessments, diagnostic interviews,
therapies for mental health conditions predisposing to suicide, and alcohol
and substance abuse treatment;
(2) the provision of clinical expertise to, consultation services with,
and medical advice and training for frontline health care providers working
with Indian youth;
(3) training and related support for community leaders, family members
and health and education workers who work with Indian youth;
(4) the development of culturally-relevant educational materials on suicide;
and
(5) data collection and reporting.
SEC. 3. DEFINITIONS.
(1) DEMONSTRATION PROJECT- The term `demonstration project' means the
Indian youth telemental health demonstration project authorized under
section 4(a).
(2) DEPARTMENT- The term `Department' means the Department of Health and
Human Services.
(3) INDIAN- The term `Indian' means any individual who is a member of
an Indian tribe or is eligible for health services under the Indian Health
Care Improvement Act (25 U.S.C. 1601 et seq.).
(4) INDIAN TRIBE- The term `Indian tribe' has the meaning given the term
in section 4 of the Indian Self-Determination and Education Assistance
Act (25 U.S.C. 450b).
(5) SECRETARY- The term `Secretary' means the Secretary of Health and
Human Services.
(6) SERVICE- The term `Service' means the Indian Health Service.
(7) TELEMENTAL HEALTH- The term `telemental health' means the use of electronic
information and telecommunications technologies to support long distance
mental health care, patient and professional-related education, public
health, and health administration.
(8) TRADITIONAL HEALTH CARE PRACTICES- The term `traditional health care
practices' means the application by Native healing practitioners of the
Native healing sciences (as opposed or in contradistinction to Western
healing sciences) that--
(A) embody the influences or forces of innate Tribal discovery, history,
description, explanation and knowledge of the states of wellness and
illness; and
(B) call upon those influences or forces in the promotion, restoration,
preservation, and maintenance of health, well-being, and life's harmony.
(9) TRIBAL ORGANIZATION- The term `tribal organization' has the meaning
given the term in section 4 of the Indian Self-Determination and Education
Assistance Act (25 U.S.C. 450b).
SEC. 4. INDIAN YOUTH TELEMENTAL HEALTH DEMONSTRATION PROJECT.
(1) IN GENERAL- The Secretary is authorized to carry out a demonstration
project to award grants for the provision of telemental health services
to Indian youth who--
(A) have expressed suicidal ideas;
(B) have attempted suicide; or
(C) have mental health conditions that increase or could increase the
risk of suicide.
(2) ELIGIBILITY FOR GRANTS- Grants described in paragraph (1) shall be
awarded to Indian tribes and tribal organizations that operate 1 or more
facilities--
(A) located in Alaska and part of the Alaska Federal Health Care Access
Network;
(B) reporting active clinical telehealth capabilities; or
(C) offering school-based telemental health services relating to psychiatry
to Indian youth.
(3) GRANT PERIOD- The Secretary shall award grants under this section
for a period of up to 4 years.
(4) MAXIMUM NUMBER OF GRANTS- Not more than 5 grants shall be provided
under paragraph (1), with priority consideration given to Indian tribes
and tribal organizations that--
(A) serve a particular community or geographic area in which there is
a demonstrated need to address Indian youth suicide;
(B) enter into collaborative partnerships with Service or other tribal
health programs or facilities to provide services under this demonstration
project;
(C) serve an isolated community or geographic area which has limited
or no access to behavioral health services; or
(D) operate a detention facility at which Indian youth are detained.
(b) Use of Funds- An Indian tribe or tribal organization shall use a grant
received under subsection (a) for the following purposes:
(1) To provide telemental health services to Indian youth, including the
provision of--
(B) psychiatric assessments and diagnostic interviews, therapies for
mental health conditions predisposing to suicide, and treatment; and
(C) alcohol and substance abuse treatment.
(2) To provide clinician-interactive medical advice, guidance and training,
assistance in diagnosis and interpretation, crisis counseling and intervention,
and related assistance to Service or tribal clinicians and health services
providers working with youth being served under the demonstration project.
(3) To assist, educate, and train community leaders, health education
professionals and paraprofessionals, tribal outreach workers, and family
members who work with the youth receiving telemental health services under
the demonstration project, including with identification of suicidal tendencies,
crisis intervention and suicide prevention, emergency skill development,
and building and expanding networks among those individuals and with State
and local health services providers.
(4) To develop and distribute culturally-appropriate community educational
materials on--
(D) suicide intervention; and
(E) ways to mobilize communities with respect to the identification
of risk factors for suicide.
(5) To conduct data collection and reporting relating to Indian youth
suicide prevention efforts.
(c) Applications- To be eligible to receive a grant under subsection (a),
an Indian tribe or tribal organization shall prepare and submit to the Secretary
an application, at such time, in such manner, and containing such information
as the Secretary may require, including--
(1) a description of the project that the Indian tribe or tribal organization
will carry out using the funds provided under the grant;
(2) a description of the manner in which the project funded under the
grant would--
(A) meet the telemental health care needs of the Indian youth population
to be served by the project; or
(B) improve the access of the Indian youth population to be served to
suicide prevention and treatment services;
(3) evidence of support for the project from the local community to be
served by the project;
(4) a description of how the families and leadership of the communities
or populations to be served by the project would be involved in the development
and ongoing operations of the project;
(5) a plan to involve the tribal community of the youth who are provided
services by the project in planning and evaluating the mental health care
and suicide prevention efforts provided, in order to ensure the integration
of community, clinical, environmental, and cultural components of the
treatment; and
(6) a plan for sustaining the project after Federal assistance for the
demonstration project has terminated.
(d) Traditional Health Care Practices- The Secretary, acting through the
Service, shall ensure that the demonstration project involves the use and
promotion of the traditional health care practices of the Indian tribes
of the youth to be served.
(e) Collaboration- The Secretary, acting through the Service, shall encourage
Indian tribes and tribal organizations receiving grants under this section
to collaborate to enable comparisons about best practices across projects.
(f) Annual Report- Each grant recipient shall submit to the Secretary an
annual report that--
(1) describes the number of telemental health services provided; and
(2) includes any other information that the Secretary may require.
(g) Report to Congress- Not later than 270 days after the date of termination
of the demonstration project, the Secretary shall submit to the Committee
on Indian Affairs of the Senate and the Committee on Resources and the Committee
on Energy and Commerce of the House of Representatives a final report that--
(1) describes the results of the projects funded by grants awarded under
this section, including any data available that indicate the number of
attempted suicides;
(2) evaluates the impact of the telemental health services funded by the
grants in reducing the number of completed suicides among Indian youth;
(3) evaluates whether the demonstration project should be--
(A) expanded to provide more than 5 grants; and
(B) designated a permanent program; and
(4) evaluates the benefits of expanding the demonstration project to include
urban Indian organizations.
(h) Authorization of Appropriations- There is authorized to be appropriated
to carry out this section $1,500,000 for each of fiscal years 2007 through
2010.
END
