II 

110TH CONGRESS 

1ST SESSION S. 322 

To establish an Indian youth telemental health demonstration project. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 17, 2007 

Mr. DORGAN (for himself, Ms. MURKOWSKI, Mr. MCCAIN, Mr. CONRAD, Mr. 

BINGAMAN, Mr. BAUCUS, Mr. SMITH, and Mr. INOUYE) 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. 

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 2007’’. 

6 SEC. 2. FINDINGS AND PURPOSE. 

7 (a) FINDINGS.—Congress finds that— 

8 (1) suicide for Indians and Alaska Natives is 

21 9 ⁄2 times higher than the national average and the 

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


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

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

3 through 24, according to data for 2002; 

4 (2) according to national data for 2004, suicide 

5 was the second-leading cause of death for Indians 

6 and Alaska Natives of both sexes aged 10 through 

7 34; 

8 (3) the suicide rates of Indian and Alaska Na9 tive males aged 15 through 24 are nearly 4 times 

10 greater than suicide rates of Indian and Alaska Na11 tive females of that age group; 

12 (4)(A) 90 percent of all teens who die by sui13 cide suffer from a diagnosable mental illness at the 

14 time of death; and 

(B) more than 1 15 ⁄2 of the people who commit 

16 suicide in Indian Country have never been seen by 

17 a mental health provider; 

18 (5) death rates for Indians and Alaska Natives 

19 are statistically underestimated; 

20 (6) suicide clustering in Indian Country affects 

21 entire tribal communities; and 

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

23 carried out a National Suicide Prevention Initiative 

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

25 programs. 


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1 (b) PURPOSE.—The purpose of this Act is to author2 ize the Secretary to carry out a demonstration project to 

3 test the use of telemental health services in suicide preven4 tion, intervention, and treatment of Indian youth, includ5 ing through— 

6 (1) the use of psychotherapy, psychiatric assess7 ments, diagnostic interviews, therapies for mental 

8 health conditions predisposing to suicide, and alcohol 

9 and substance abuse treatment; 

10 (2) the provision of clinical expertise to, con11 sultation services with, and medical advice and train12 ing for frontline health care providers working with 

13 Indian youth; 

14 (3) training and related support for community 

15 leaders, family members and health and education 

16 workers who work with Indian youth; 

17 (4) the development of culturally-relevant edu18 cational materials on suicide; and 

19 (5) data collection and reporting. 

20 SEC. 3. DEFINITIONS. 

21 In this Act: 

22 (1) DEMONSTRATION PROJECT.—The term 

23 ‘‘demonstration project’’ means the Indian youth 

24 telemental health demonstration project authorized 

25 under section 4(a). 


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

2 means the Department of Health and Human Serv3 ices. 

4 (3) INDIAN.—The term ‘‘Indian’’ means any in5 dividual who is a member of an Indian tribe or is 

6 eligible for health services under the Indian Health 

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

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

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

10 Indian Self-Determination and Education Assistance 

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

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

13 the Secretary of Health and Human Services. 

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

15 Indian Health Service. 

16 (7) TELEMENTAL HEALTH.—The term ‘‘tele17 mental health’’ means the use of electronic informa18 tion and telecommunications technologies to support 

19 long distance mental health care, patient and profes20 sional-related education, public health, and health 

21 administration. 

22 (8) TRIBAL ORGANIZATION.—The term ‘‘tribal 

23 organization’’ has the meaning given the term in 

24 section 4 of the Indian Self-Determination and Edu25 cation Assistance Act (25 U.S.C. 450b). 


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1 SEC. 4. INDIAN YOUTH TELEMENTAL HEALTH DEMONSTRA2 TION PROJECT. 

3 (a) AUTHORIZATION.— 

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

5 to carry out a demonstration project to award grants 

6 for the provision of telemental health services to In7 dian youth who— 

8 (A) have expressed suicidal ideas; 

9 (B) have attempted suicide; or 

10 (C) have mental health conditions that in11 crease or could increase the risk of suicide. 

12 (2) ELIGIBILITY FOR GRANTS.—Grants de13 scribed in paragraph (1) shall be awarded to Indian 

14 tribes and tribal organizations that operate 1 or 

15 more facilities— 

16 (A) located in Alaska and part of the Alas17 ka Federal Health Care Access Network; 

18 (B) reporting active clinical telehealth ca19 pabilities; or 

20 (C) offering school-based telemental health 

21 services relating to psychiatry to Indian youth. 

22 (3) GRANT PERIOD.—The Secretary shall 

23 award grants under this section for a period of up 

24 to 4 years. 

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

26 than 5 grants shall be provided under paragraph 


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

2 and tribal organizations that— 

3 (A) serve a particular community or geo4 graphic area in which there is a demonstrated 

5 need to address Indian youth suicide; 

6 (B) enter into collaborative partnerships 

7 with Service or other tribal health programs or 

8 facilities to provide services under this dem9 onstration project; 

10 (C) serve an isolated community or geo11 graphic area which has limited or no access to 

12 behavioral health services; or 

13 (D) operate a detention facility at which 

14 Indian youth are detained. 

15 (b) USE OF FUNDS.— 

16 (1) IN GENERAL.—An Indian tribe or tribal or17 ganization shall use a grant received under sub18 section (a) for the following purposes: 

19 (A) To provide telemental health services 

20 to Indian youth, including the provision of— 

21 (i) psychotherapy; 

22 (ii) psychiatric assessments and diag23 nostic interviews, therapies for mental 

24 health conditions predisposing to suicide, 

25 and treatment; and 


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1 (iii) alcohol and substance abuse 

2 treatment. 

3 (B) To provide clinician-interactive medical 

4 advice, guidance and training, assistance in di5 agnosis and interpretation, crisis counseling and 

6 intervention, and related assistance to Service 

7 or tribal clinicians and health services providers 

8 working with youth being served under the 

9 demonstration project. 

10 (C) To assist, educate, and train commu11 nity leaders, health education professionals and 

12 paraprofessionals, tribal outreach workers, and 

13 family members who work with the youth re14 ceiving telemental health services under the 

15 demonstration project, including with identifica16 tion of suicidal tendencies, crisis intervention 

17 and suicide prevention, emergency skill develop18 ment, and building and expanding networks 

19 among those individuals and with State and 

20 local health services providers. 

21 (D) To develop and distribute culturally22 appropriate community educational materials 

23 on— 

24 (i) suicide prevention; 

25 (ii) suicide education; 


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1 (iii) suicide screening; 

2 (iv) suicide intervention; and 

3 (v) ways to mobilize communities with 

4 respect to the identification of risk factors 

5 for suicide. 

6 (E) To conduct data collection and report7 ing relating to Indian youth suicide prevention 

8 efforts. 

9 (2) TRADITIONAL HEALTH CARE PRACTICES.— 

10 In carrying out the purposes described in paragraph 

11 (1), an Indian tribe or tribal organization may use 

12 and promote the traditional health care practices of 

13 the Indian tribes of the youth to be served. 

14 (c) APPLICATIONS.—To be eligible to receive a grant 

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

16 shall prepare and submit to the Secretary an application, 

17 at such time, in such manner, and containing such infor18 mation as the Secretary may require, including— 

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

20 tribe or tribal organization will carry out using the 

21 funds provided under the grant; 

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

23 project funded under the grant would— 


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1 (A) meet the telemental health care needs 

2 of the Indian youth population to be served by 

3 the project; or 

4 (B) improve the access of the Indian youth 

5 population to be served to suicide prevention 

6 and treatment services; 

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

8 local community to be served by the project; 

9 (4) a description of how the families and leader10 ship of the communities or populations to be served 

11 by the project would be involved in the development 

12 and ongoing operations of the project; 

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

14 the youth who are provided services by the project 

15 in planning and evaluating the mental health care 

16 and suicide prevention efforts provided, in order to 

17 ensure the integration of community, clinical, envi18 ronmental, and cultural components of the treat19 ment; and 

20 (6) a plan for sustaining the project after Fed21 eral assistance for the demonstration project has ter22 minated. 

23 (d) COLLABORATION.—The Secretary, acting 

24 through the Service, shall encourage Indian tribes and 

25 tribal organizations receiving grants under this section to 


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1 collaborate to enable comparisons about best practices 

2 across projects. 

3 (e) ANNUAL REPORT.—Each grant recipient shall 

4 submit to the Secretary an annual report that— 

5 (1) describes the number of telemental health 

6 services provided; and 

7 (2) includes any other information that the Sec8 retary may require. 

9 (f) REPORT TO CONGRESS.—Not later than 270 days 

10 after the date of termination of the demonstration project, 

11 the Secretary shall submit to the Committee on Indian Af12 fairs of the Senate and the Committee on Resources and 

13 the Committee on Energy and Commerce of the House 

14 of Representatives a final report that— 

15 (1) describes the results of the projects funded 

16 by grants awarded under this section, including any 

17 data available that indicate the number of attempted 

18 suicides; 

19 (2) evaluates the impact of the telemental 

20 health services funded by the grants in reducing the 

21 number of completed suicides among Indian youth; 

22 (3) evaluates whether the demonstration project 

23 should be— 

24 (A) expanded to provide more than 5 

25 grants; and 


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1 (B) designated a permanent program; and 

2 (4) evaluates the benefits of expanding the 

3 demonstration project to include urban Indian orga4 nizations. 

5 (g) AUTHORIZATION OF APPROPRIATIONS.—There is 

6 authorized to be appropriated to carry out this section 

7 $1,500,000 for each of fiscal years 2008 through 2011. 

Æ 


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