109TH CONGRESS

2D SESSION S. 2245

AN ACT

To establish an Indian youth telemental health demonstration

project.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Indian Youth Tele5 mental Health Demonstration Project Act of 2006’’.
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1 SEC. 2. FINDINGS AND PURPOSE.

2 (a) FINDINGS.—Congress finds that—

3 (1) suicide for Indians and Alaska Natives is

21 4 ⁄2 times higher than the national average and the

5 highest for all ethnic groups in the United States, at

6 a rate of more than 16 per 100,000 males of all age

7 groups, and 27.9 per 100,000 for males aged 15

8 through 24, according to data for 2002;

9 (2) according to national data for 2002, suicide

10 was the second-leading cause of death for Indians

11 and Alaska Natives aged 15 through 34 and the

12 fourth-leading cause of death for Indians and Alaska

13 Natives aged 10 through 14;

14 (3) the suicide rates of Indian and Alaska Na15 tive males aged 15 through 24 are nearly 4 times

16 greater than suicide rates of Indian and Alaska Na17 tive females of that age group;

18 (4)(A) 90 percent of all teens who die by sui19 cide suffer from a diagnosable mental illness at the

20 time of death; and

(B) more than 1 21 ⁄2 of the people who commit

22 suicide in Indian Country have never been seen by

23 a mental health provider;

24 (5) death rates for Indians and Alaska Natives

25 are statistically underestimated;
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1 (6) suicide clustering in Indian Country affects

2 entire tribal communities; and

3 (7) since 2003, the Indian Health Service has

4 carried out a National Suicide Prevention Initiative

5 to work with Service, tribal, and urban Indian health

6 programs.

7 (b) PURPOSE.—The purpose of this Act is to author8 ize the Secretary to carry out a demonstration project to

9 test the use of telemental health services in suicide preven10 tion, intervention, and treatment of Indian youth, includ11 ing through—

12 (1) the use of psychotherapy, psychiatric assess13 ments, diagnostic interviews, therapies for mental

14 health conditions predisposing to suicide, and alcohol

15 and substance abuse treatment;

16 (2) the provision of clinical expertise to, con17 sultation services with, and medical advice and train18 ing for frontline health care providers working with

19 Indian youth;

20 (3) training and related support for community

21 leaders, family members and health and education

22 workers who work with Indian youth;

23 (4) the development of culturally-relevant edu24 cational materials on suicide; and

25 (5) data collection and reporting.
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1 SEC. 3. DEFINITIONS.

2 In this Act:

3 (1) DEMONSTRATION PROJECT.—The term

4 ‘‘demonstration project’’ means the Indian youth

5 telemental health demonstration project authorized

6 under section 4(a).

7 (2) DEPARTMENT.—The term ‘‘Department’’

8 means the Department of Health and Human Serv9 ices.

10 (3) INDIAN.—The term ‘‘Indian’’ means any in11 dividual who is a member of an Indian tribe or is

12 eligible for health services under the Indian Health

13 Care Improvement Act (25 U.S.C. 1601 et seq.).

14 (4) INDIAN TRIBE.—The term ‘‘Indian tribe’’

15 has the meaning given the term in section 4 of the

16 Indian Self-Determination and Education Assistance

17 Act (25 U.S.C. 450b).

18 (5) SECRETARY.—The term ‘‘Secretary’’ means

19 the Secretary of Health and Human Services.

20 (6) SERVICE.—The term ‘‘Service’’ means the

21 Indian Health Service.

22 (7) TELEMENTAL HEALTH.—The term ‘‘tele23 mental health’’ means the use of electronic informa24 tion and telecommunications technologies to support

25 long distance mental health care, patient and profes-
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1 sional-related education, public health, and health

2 administration.

3 (8) TRADITIONAL HEALTH CARE PRACTICES.—

4 The term ‘‘traditional health care practices’’ means

5 the application by Native healing practitioners of the

6 Native healing sciences (as opposed or in contra7 distinction to Western healing sciences) that—

8 (A) embody the influences or forces of in9 nate Tribal discovery, history, description, ex10 planation and knowledge of the states of

11 wellness and illness; and

12 (B) call upon those influences or forces in

13 the promotion, restoration, preservation, and

14 maintenance of health, well-being, and life’s

15 harmony.

16 (9) TRIBAL ORGANIZATION.—The term ‘‘tribal

17 organization’’ has the meaning given the term in

18 section 4 of the Indian Self-Determination and Edu19 cation Assistance Act (25 U.S.C. 450b).

20 SEC. 4. INDIAN YOUTH TELEMENTAL HEALTH DEMONSTRA21 TION PROJECT.

22 (a) AUTHORIZATION.—

23 (1) IN GENERAL.—The Secretary is authorized

24 to carry out a demonstration project to award grants
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1 for the provision of telemental health services to In2 dian youth who—

3 (A) have expressed suicidal ideas;

4 (B) have attempted suicide; or

5 (C) have mental health conditions that in6 crease or could increase the risk of suicide.

7 (2) ELIGIBILITY FOR GRANTS.—Grants de8 scribed in paragraph (1) shall be awarded to Indian

9 tribes and tribal organizations that operate 1 or

10 more facilities—

11 (A) located in Alaska and part of the Alas12 ka Federal Health Care Access Network;

13 (B) reporting active clinical telehealth ca14 pabilities; or

15 (C) offering school-based telemental health

16 services relating to psychiatry to Indian youth.

17 (3) GRANT PERIOD.—The Secretary shall

18 award grants under this section for a period of up

19 to 4 years.

20 (4) MAXIMUM NUMBER OF GRANTS.—Not more

21 than 5 grants shall be provided under paragraph

22 (1), with priority consideration given to Indian tribes

23 and tribal organizations that—
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1 (A) serve a particular community or geo2 graphic area in which there is a demonstrated

3 need to address Indian youth suicide;

4 (B) enter into collaborative partnerships

5 with Service or other tribal health programs or

6 facilities to provide services under this dem7 onstration project;

8 (C) serve an isolated community or geo9 graphic area which has limited or no access to

10 behavioral health services; or

11 (D) operate a detention facility at which

12 Indian youth are detained.

13 (b) USE OF FUNDS.—An Indian tribe or tribal orga14 nization shall use a grant received under subsection (a)

15 for the following purposes:

16 (1) To provide telemental health services to In17 dian youth, including the provision of—

18 (A) psychotherapy;

19 (B) psychiatric assessments and diagnostic

20 interviews, therapies for mental health condi21 tions predisposing to suicide, and treatment;

22 and

23 (C) alcohol and substance abuse treatment.

24 (2) To provide clinician-interactive medical ad25 vice, guidance and training, assistance in diagnosis
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1 and interpretation, crisis counseling and interven2 tion, and related assistance to Service or tribal clini3 cians and health services providers working with

4 youth being served under the demonstration project.

5 (3) To assist, educate, and train community

6 leaders, health education professionals and para7 professionals, tribal outreach workers, and family

8 members who work with the youth receiving tele9 mental health services under the demonstration

10 project, including with identification of suicidal ten11 dencies, crisis intervention and suicide prevention,

12 emergency skill development, and building and ex13 panding networks among those individuals and with

14 State and local health services providers.

15 (4) To develop and distribute culturally-appro16 priate community educational materials on—

17 (A) suicide prevention;

18 (B) suicide education;

19 (C) suicide screening;

20 (D) suicide intervention; and

21 (E) ways to mobilize communities with re22 spect to the identification of risk factors for sui23 cide.

24 (5) To conduct data collection and reporting re25 lating to Indian youth suicide prevention efforts.
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1 (c) APPLICATIONS.—To be eligible to receive a grant

2 under subsection (a), an Indian tribe or tribal organization

3 shall prepare and submit to the Secretary an application,

4 at such time, in such manner, and containing such infor5 mation as the Secretary may require, including—

6 (1) a description of the project that the Indian

7 tribe or tribal organization will carry out using the

8 funds provided under the grant;

9 (2) a description of the manner in which the

10 project funded under the grant would—

11 (A) meet the telemental health care needs

12 of the Indian youth population to be served by

13 the project; or

14 (B) improve the access of the Indian youth

15 population to be served to suicide prevention

16 and treatment services;

17 (3) evidence of support for the project from the

18 local community to be served by the project;

19 (4) a description of how the families and leader20 ship of the communities or populations to be served

21 by the project would be involved in the development

22 and ongoing operations of the project;

23 (5) a plan to involve the tribal community of

24 the youth who are provided services by the project

25 in planning and evaluating the mental health care
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1 and suicide prevention efforts provided, in order to

2 ensure the integration of community, clinical, envi3 ronmental, and cultural components of the treat4 ment; and

5 (6) a plan for sustaining the project after Fed6 eral assistance for the demonstration project has ter7 minated.

8 (d) TRADITIONAL HEALTH CARE PRACTICES.—The

9 Secretary, acting through the Service, shall ensure that

10 the demonstration project involves the use and promotion

11 of the traditional health care practices of the Indian tribes

12 of the youth to be served.

13 (e) COLLABORATION.—The Secretary, acting through

14 the Service, shall encourage Indian tribes and tribal orga15 nizations receiving grants under this section to collaborate

16 to enable comparisons about best practices across projects.

17 (f) ANNUAL REPORT.—Each grant recipient shall

18 submit to the Secretary an annual report that—

19 (1) describes the number of telemental health

20 services provided; and

21 (2) includes any other information that the Sec22 retary may require.

23 (g) REPORT TO CONGRESS.—Not later than 270 days

24 after the date of termination of the demonstration project,

25 the Secretary shall submit to the Committee on Indian Af-
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1 fairs of the Senate and the Committee on Resources and

2 the Committee on Energy and Commerce of the House

3 of Representatives a final report that—

4 (1) describes the results of the projects funded

5 by grants awarded under this section, including any

6 data available that indicate the number of attempted

7 suicides;

8 (2) evaluates the impact of the telemental

9 health services funded by the grants in reducing the

10 number of completed suicides among Indian youth;

11 (3) evaluates whether the demonstration project

12 should be—

13 (A) expanded to provide more than 5

14 grants; and

15 (B) designated a permanent program; and

16 (4) evaluates the benefits of expanding the

17 demonstration project to include urban Indian orga18 nizations.
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1 (h) AUTHORIZATION OF APPROPRIATIONS.—There is

2 authorized to be appropriated to carry out this section

3 $1,500,000 for each of fiscal years 2007 through 2010.

Passed the Senate May 11, 2006.

Attest:

Secretary.
109TH CONGRESS

2D SESSION S. 2245

AN ACT

To establish an Indian youth telemental health

demonstration project.