`[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 2245 Reported in Senate (RS)]







                                                       Calendar No. 412
109th CONGRESS
  2d Session
                                S. 2245

                          [Report No. 109-250]

 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

                             April 24, 2006

               Reported by Mr. McCain, without amendment

_______________________________________________________________________

                                 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.

    In this Act:
            (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.

    (a) Authorization.--
            (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--
                    (A) psychotherapy;
                    (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--
                    (A) suicide prevention;
                    (B) suicide education;
                    (C) suicide screening;
                    (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.
                                                       Calendar No. 412

109th CONGRESS

  2d Session

                                S. 2245

                          [Report No. 109-250]

_______________________________________________________________________

                                 A BILL

 To establish an Indian youth telemental health demonstration project.

_______________________________________________________________________

                             April 24, 2006

                       Reported without amendment`