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. MARKEY, 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 demonstration program for purposes of increasing mental health 

services in rural medically underserved populations and 

for individuals in farming, fishing, and forestry occupations. 

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 ‘‘Home-Based Tele5 mental Health Care Act of 2020’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds as follows: 

3 (1) It is estimated that 46,600,000 adults expe4 rience mental illness in a given year in the United 

5 States, with 7.1 percent of adults in the United 

6 States living with major depression and 19.1 percent 

7 of such adults living with anxiety disorders. 

8 (2) According to the results from the 2017 Na9 tional Survey on Drug Use and Health, 19.1 percent 

10 of residents in rural communities aged 18 or older 

11 have any mental illness, or approximately 6,800,000 

12 people; 4.9 percent, or nearly 1,700,000 rural resi13 dents experience serious thoughts of suicide. 

14 (3) A study by the Centers for Disease Control 

15 and Prevention suggests that people in farming, 

16 fishing, and forestry occupations (referred to in this 

17 section as the ‘‘Triple-F’’ industry) in the United 

18 States experienced rates of 75 and 76 suicides per 

19 100,000 people in 2012 and 2015, respectively. 

20 (4) The COVID–19 pandemic has put addi21 tional stress on people in the Triple-F population. 

22 The pandemic has caused instability in the markets, 

23 especially as the virus has caused a downturn in 

24 food service sales and has closed meat processing 

25 plants across the Nation. This has left farmers with 

26 low commodity prices and loss of revenue. Additional 


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1 resources are needed to support the mental health 

2 needs of this population. 

3 (5) While the prevalence of mental illness is 

4 similar among rural and urban residents, the serv5 ices available to each population are very different. 

6 Mental health care needs are not met in rural com7 munities due to many challenges, including accessi8 bility issues due to transportation and geographic 

9 isolation, the stigma of needing or receiving mental 

10 health care, a lack of anonymity when seeking treat11 ment, shortages of mental health workforce profes12 sionals, and affordability due to a high rate of unin13 sured residents. 

14 (6) Telemental health, which is the delivery of 

15 mental health services using remote technologies 

16 when the patient and provider are separated by dis17 tance, shows promise in helping to alleviate the lack 

18 of mental health services in rural areas. Traditional 

19 telemental health models involve care delivered to a 

20 patient at an originating clinical site from a spe21 cialist working at a distant site. Having the ability 

22 to reach mental health professionals from a place of 

23 comfort, such as home, from a personal device may 

24 reduce challenges faced in rural areas and amongst 

25 Triple-F workers. 


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1 (7) A clinical trial of 241 depressed elderly vet2 erans, which was conducted by the Medical Univer3 sity of South Carolina and the Ralph H. Johnson 

4 Veterans Affairs Medical Center, and published in 

5 the Journal of Clinical Psychiatry, found that home6 based telemental health for depression is well re7 ceived by patients and delivers as good a quality of 

8 life as in-person visits. 

9 SEC. 3. MENTAL HEALTH SERVICES DELIVERED TO RURAL 

10 UNDERSERVED POPULATIONS VIA TELE11 MENTAL HEALTH CARE. 

12 Title III of the Public Health Service Act is amended 

13 by inserting after section 330K (42 U.S.C. 254c–16) the 

14 following: 

15 ‘‘SEC. 330K–1. MENTAL HEALTH SERVICES DELIVERED TO 

16 RURAL UNDERSERVED POPULATIONS VIA 

17 TELEMENTAL HEALTH CARE. 

18 ‘‘(a) DEFINITIONS.—In this section— 

19 ‘‘(1) the term ‘covered populations’ means— 

20 ‘‘(A) medically underserved populations in 

21 rural areas (as defined in section 1886(d)(2)(D) 

22 of the Social Security Act); or 

23 ‘‘(B) populations engaged in a farming, 

24 fishing, or forestry industry; 


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1 ‘‘(2) the term ‘eligible entity’ means a public or 

2 nonprofit private telemental health provider network 

3 that offers services that include mental health serv4 ices provided by professionals trained in mental 

5 health; 

6 ‘‘(3) the term ‘farming, fishing, or forestry in7 dustry’ means an occupation defined as a farming, 

8 fishing, or forestry occupation by the Department of 

9 Labor in accordance with the Standard Occupational 

10 Classification System; 

11 ‘‘(4) the term ‘home-based telemental’ means 

12 the use of telemental health services where the pa13 tient is in his or her own home or other place of 

14 comfort; 

15 ‘‘(5) the term ‘medically underserved popu16 lation’ has the meaning given such term in section 

17 330(b); 

18 ‘‘(6) the term ‘professional trained in mental 

19 health’ means a psychiatrist, a qualified mental 

20 health professional (as defined in section 330K), or 

21 another mental health professional acting under the 

22 direction of a psychiatrist; 

23 ‘‘(7) the term ‘rural’ has the meaning given 

24 such term by the Office of Rural Health Policy of 


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1 the Health Resources and Services Administration; 

2 and 

3 ‘‘(8) the term ‘telemental health’ means the use 

4 of electronic information and telecommunications 

5 technologies to support long distance clinical health 

6 care, patient and professional health-related edu7 cation, public health, and health administration. 

8 ‘‘(b) PROGRAM AUTHORIZED.—The Secretary, acting 

9 through the Director of the Office for the Advancement 

10 of Telehealth of the Health Resources and Services Ad11 ministration and in coordination with the Rural Health 

12 Liaison of the Department of Agriculture, shall award 

13 grants to eligible entities to establish demonstration 

14 projects for the provision of mental health services to cov15 ered populations in their homes, as delivered remotely by 

16 professionals trained in mental health using telemental 

17 health care. 

18 ‘‘(c) USE OF FUNDS.—Recipients of a grant under 

19 this section shall use the grant funds to— 

20 ‘‘(1) deliver home-based telemental health serv21 ices to covered populations; and 

22 ‘‘(2) develop comprehensive metrics to measure 

23 the quality and impact of home-based telemental 

24 health services compared to traditional in-person 

25 mental health care. 


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1 ‘‘(d) REPORT.—The Secretary, in consultation with 

2 the Secretary of Agriculture, 3 years after the date on 

3 which the program under this section commences, and 2 

4 years thereafter, shall submit to the appropriate congres5 sional committees reports on the impact and quality of 

6 care of home-based telemental health care services for cov7 ered populations. 

8 ‘‘(e) AUTHORIZED USE OF FUNDS.—Out of any 

9 amounts made available to the Secretary, up to 

10 $10,000,000 for each of fiscal years 2021 through 2025 

11 may be allocated to carrying out the program under this 

12 section.’’. 

Æ 


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