II 

117TH CONGRESS 

2D SESSION S. 3937 

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 

MARCH 28, 2022 

Mr. ROUNDS (for himself, Ms. SMITH, Mr. THUNE, and Mr. BOOZMAN) 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 2022’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 


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1 (1) According to a 2020 report by the Centers 

2 for Disease Control and Prevention, titled ‘‘Mental 

3 Health, Substance Use and Suicidal Ideation during 

4 the COVID–19 Pandemic’’ (referred to in this sec5 tion as the ‘‘CDC report’’), elevated levels of adverse 

6 mental health conditions, substance use, and suicidal 

7 ideation were reported by adults in the United 

8 States in June 2020, after the onset of the COVID– 

9 19 pandemic. The prevalence of symptoms of anxiety 

10 disorder was 25.5 percent, compared to 8.1 percent 

11 in the second quarter of 2019. Additionally, 24.3 

12 percent of adults experienced depressive disorders in 

13 June 2020, 4 times the 6.5 percent reported in the 

14 second quarter of 2019. 

15 (2) According to the CDC report, approximately 

16 30 percent of rural adults who responded to a survey 

17 of the Centers for Disease Control and Prevention 

18 suffered from anxiety or depression, and approxi19 mately 10 percent of such adults seriously consid20 ered suicide in the past 30 days. 

21 (3) A 2016 study by the Centers for Disease 

22 Control and Prevention suggests that people in 

23 farming, fishing, and forestry occupations (referred 

24 to in this section as the ‘‘Triple–F’’ industry) in the 

25 United States experienced rates of 75 and 76 suiVerDate Sep 11 2014 02:41 Mar 29, 2022 Jkt 029200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3937.IS S3937

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1 cides per 100,000 people in 2012 and 2015, respec2 tively. 

3 (4) Such 2016 study by the Centers for Disease 

4 Control and Prevention indicates that suicide rates 

5 for male farmers, ranchers, and other agricultural 

6 managers were double the rate for the general popu7 lation in 2012. If farmers, ranchers, and agricultural 

8 managers were considered a major group for pur9 poses of such study, that group would rank first in 

10 suicides in 2012 and third in 2015. 

11 (5) According to a 2019 report of the National 

12 Survey on Drug Use and Health, 22.4 percent of 

13 residents in rural communities aged 18 or older who 

14 experienced mental illness perceived an unmet need 

15 for mental health services. Of these individuals, 17.9 

16 percent did not receive any mental health services in 

17 the prior year. 

18 (6) The COVID–19 pandemic put additional 

19 stress on people in the Triple–F population. In the 

20 early stages, the pandemic caused instability in the 

21 markets, especially as the virus caused a downturn 

22 in food service sales and closed meat processing 

23 plants across the Nation. Farmers were left with low 

24 commodity prices and loss of revenue. This commu25 nity has spent the last 2 years attempting to reVerDate Sep 11 2014 02:41 Mar 29, 2022 Jkt 029200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3937.IS S3937

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1 bound from the effects of the pandemic. Additional 

2 resources are needed to support the mental health 

3 needs of this population. 

4 (7) While the prevalence of mental illness is 

5 similar among rural and urban residents, the serv6 ices available to each population are very different. 

7 Mental health care needs are not met in rural com8 munities due to many challenges, including accessi9 bility issues due to transportation and geographic 

10 isolation, the stigma of needing or receiving mental 

11 health care, a lack of anonymity when seeking treat12 ment, shortages of mental health workforce profes13 sionals, and affordability due to a high rate of unin14 sured residents. 

15 (8) Telemental health, which is the delivery of 

16 mental health services using remote technologies 

17 when the patient and provider are separated by dis18 tance, shows promise in helping to alleviate the lack 

19 of mental health services in rural areas. Traditional 

20 telemental health models involve care delivered to a 

21 patient at an originating clinical site from a spe22 cialist working at a distant site. Having the ability 

23 to reach mental health professionals from a place of 

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


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1 reduce challenges faced in rural areas and amongst 

2 Triple–F workers. 

3 (9) A clinical trial of 241 depressed elderly vet4 erans, which was conducted by the Medical Univer5 sity of South Carolina and the Ralph H. Johnson 

6 Veterans Affairs Medical Center and reported in the 

7 Journal of Clinical Psychiatry, found that home8 based telemental health for depression is well re9 ceived by patients and delivers as good a quality of 

10 life as in-person visits. 

11 SEC. 3. MENTAL HEALTH SERVICES DELIVERED TO RURAL 

12 UNDERSERVED POPULATIONS VIA TELE13 MENTAL HEALTH CARE. 

14 Title III of the Public Health Service Act is amended 

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

16 following: 

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

18 RURAL UNDERSERVED POPULATIONS VIA 

19 TELEMENTAL HEALTH CARE. 

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

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

22 ‘‘(A) medically underserved populations in 

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

24 of the Social Security Act); or 


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

2 fishing, or forestry industry; 

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

4 nonprofit private telemental health provider network 

5 that offers services that include mental health serv6 ices provided by professionals trained in mental 

7 health; 

8 ‘‘(3) the term ‘farming, fishing, or forestry in9 dustry’ means an occupation defined as a farming, 

10 fishing, or forestry occupation by the Department of 

11 Labor in accordance with the Standard Occupational 

12 Classification System; 

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

14 the use of telemental health services where the pa15 tient is in his or her own home or other place of 

16 comfort; 

17 ‘‘(5) the term ‘medically underserved popu18 lation’ has the meaning given such term in section 

19 330(b); 

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

21 health’ means a psychiatrist, a qualified mental 

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

23 another mental health professional acting under the 

24 direction of a psychiatrist; 


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

2 such term by the Office of Rural Health Policy of 

3 the Health Resources and Services Administration; 

4 and 

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

6 of electronic information and telecommunications 

7 technologies to support long distance clinical health 

8 care, patient and professional health-related edu9 cation, public health, and health administration. 

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

11 through the Director of the Office for the Advancement 

12 of Telehealth of the Health Resources and Services Ad13 ministration and in coordination with the Rural Health 

14 Liaison of the Department of Agriculture, shall award 

15 grants to eligible entities to establish demonstration 

16 projects for the provision of mental health services to cov17 ered populations in their homes, as delivered remotely by 

18 professionals trained in mental health using telemental 

19 health care. 

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

21 this section shall use the grant funds to— 

22 ‘‘(1) deliver home-based telemental health serv23 ices to covered populations; and 

24 ‘‘(2) develop comprehensive metrics to measure 

25 the quality and impact of home-based telemental 


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1 health services compared to traditional in-person 

2 mental health care. 

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

4 the Secretary of Agriculture, not later than 3 years after 

5 the date on which the program under this section com6 mences, and 2 years thereafter, shall submit to the appro7 priate congressional committees reports on the impact and 

8 quality of care of home-based telemental health care serv9 ices for covered populations. 

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

11 amounts made available to the Secretary, up to 

12 $10,000,000 for each of fiscal years 2022 through 2026 

13 may be allocated to carrying out the program under this 

14 section.’’. 

Æ 


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