I 
113TH CONGRESS 
1ST SESSION H. R. 2037 
To establish a demonstration grant program to recruit, train, deploy, and 
professionally support psychiatric physicians in Indian health programs. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 16, 2013 
Mr. SCHRADER introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Natural Resources, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To establish a demonstration grant program to recruit, train, 
deploy, and professionally support psychiatric physicians 
in Indian health programs. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Native American Psy-
chiatric and Mental Health Care Improvement Act’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
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(1) The Substance Abuse and Mental Health 
Services Administration concludes the rate of serious 
mental illness in American Indians and Alaska Na-
tives is twice that of any other race or ethnicity. 
(2) The Centers for Disease Control and Pre-
vention concludes the suicide rate among American 
Indian and Alaska Native youth is more than twice 
that of any other race or ethnicity. 
(3) The United States Surgeon General at-
tributes high rates of homelessness, incarceration, 
alcohol and drug abuse, stress, and trauma as prin-
cipal causes of mental illness in American Indians 
and Alaska Natives. 
(4) The Agency for Healthcare Research and 
Quality concludes in The National Health Disparity 
Report, 2011, that American Indians and Alaska 
Natives had worse care than Whites in 28 measures 
of health care quality and access. 
(5) The Indian Health Service reports that per 
capita spending on personal health care of American 
Indians and Alaska Natives was $2,741 in 2012— 
nearly two-thirds below the national average of 
$7,239. 
(6) The Department of Health and Human 
Services, Office of Inspector General, reports that a 
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shortage of psychiatrists at the Indian Health Serv-
ice and other tribal health facilities significantly lim-
its mental health access to American Indians and 
Alaska Natives. 
(7) The One Sky Center, the American Indian/ 
Alaska Native National Resource Center for Sub-
stance Abuse and Mental Health Services, identifies 
20 psychiatrists currently practicing in Indian coun-
try (out of approximately 60,000 psychiatrists prac-
ticing nationwide), and 2 Native American psychia-
trists currently practicing in Indian country (out of 
13 practicing nationwide). 
(8) According to the American Psychiatric As-
sociation, psychiatric physicians practicing in Amer-
ican Indian and Alaska Native population groups 
often face cultural competency challenges, profes-
sional isolation, high demand for medical and mental 
health services, relatively low compensation, and 
high burnout rates. 
(9) A legislative initiative is warranted to create 
a nationally-replicable workforce model that identi-
fies and incorporates best practices for recruiting, 
training, deploying, and professionally supporting 
Native American psychiatric physicians or non-Na-
tive American psychiatric physicians (or both), who 
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are fully integrated into existing medical, mental, 
and behavioral health systems in Indian health pro-
grams. 
SEC. 3. DEMONSTRATION GRANT PROGRAM TO RECRUIT, 
TRAIN, DEPLOY, AND PROFESSIONALLY SUP-
PORT PSYCHIATRIC PHYSICIANS IN INDIAN 
HEALTH PROGRAMS. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’), in consultation with the Director of the Indian 
Health Service and demonstration programs established 
under section 123 of the Indian Health Care Improvement 
Act (25 U.S.C. 1616p), shall award one 5-year grant to 
one eligible entity to carry out a demonstration program 
(in this Act referred to as the ‘‘Program’’) under which 
the eligible entity shall carry out the activities described 
in subsection (b). 
(b) ACTIVITIES TO BE CARRIED OUT BY RECIPIENT 
OF GRANT UNDER PROGRAM.—Under the Program, the 
grant recipient shall— 
(1) create a nationally-replicable workforce 
model that identifies and incorporates best practices 
for recruiting, training, deploying, and professionally 
supporting Native American and non-Native Amer-
ican psychiatric physicians to be fully integrated into 
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medical, mental, and behavioral health systems in 
Indian health programs; 
(2) recruit to participate in the Program Native 
American and non-Native American psychiatric phy-
sicians who demonstrate interest in providing spe-
cialty health care services (as defined in section 
313(a)(3) of the Indian Health Care Improvement 
Act (25 U.S.C. 1638g(a)(3))) and primary care serv-
ices to American Indians and Alaska Natives; 
(3) provide such psychiatric physicians partici-
pating in the Program with not more than 1 year of 
supplemental clinical and cultural competency train-
ing to enable such physicians to provide such spe-
cialty health care services and primary care services 
in Indian health programs; 
(4) with respect to such psychiatric physicians 
who are participating in the Program and trained 
under paragraph (3), deploy such physicians to prac-
tice specialty care or primary care in Indian health 
programs for a period of not less than 2 years and 
professionally support such physicians for such pe-
riod with respect to practicing such care in such pro-
grams; and 
(5) not later than 1 year after the last day of 
the 5-year period for which the grant is awarded 
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under subsection (a), submit to the Secretary and to 
the appropriate committees of Congress a report 
that shall include— 
(A) the workforce model created under 
paragraph (1); 
(B) strategies for disseminating the work-
force model to other entities with the capability 
of adopting it; and 
(C) recommendations for the Secretary and 
Congress with respect to supporting an effective 
and stable psychiatric and mental health work-
force that serves American Indians and Alaska 
Natives. 
(c) ELIGIBLE ENTITIES.— 
(1) REQUIREMENTS.—To be eligible to receive 
the grant under this section, an entity shall— 
(A) submit to the Secretary an application 
at such time, in such manner, and containing 
such information as the Secretary may require; 
(B) be a department of psychiatry within 
a medical school in the United States that is 
accredited by the Liaison Committee on Medical 
Education or a public or private non-profit enti-
ty affiliated with a medical school in the United 
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States that is accredited by the Liaison Com-
mittee on Medical Education; and 
(C) have in existence, as of the time of 
submission of the application under subpara-
graph (A), a relationship with Indian health 
programs in at least two States with a dem-
onstrated need for psychiatric physicians and 
provide assurances that the grant will be used 
to serve rural and non-rural American Indian 
and Alaska Native populations in at least two 
States. 
(2) PRIORITY
IN
SELECTING
GRANT
RECIPI-
ENT.—In awarding the grant under this section, the 
Secretary shall give priority to an eligible entity that 
satisfies each of the following: 
(A) Demonstrates sufficient infrastructure 
in size, scope, and capacity to undertake the 
supplemental clinical and cultural competency 
training of a minimum of 5 psychiatric physi-
cians, and to provide ongoing professional sup-
port to psychiatric physicians during the de-
ployment period to an Indian health program. 
(B) Demonstrates a record in successfully 
recruiting, training, and deploying physicians 
who are American Indians and Alaska Natives. 
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(C) Demonstrates the ability to establish a 
program advisory board, which may be pri-
marily composed of representatives of federally- 
recognized tribes, Alaska Natives, and Indian 
health programs to be served by the Program. 
(d) ELIGIBILITY OF PSYCHIATRIC PHYSICIANS TO 
PARTICIPATE IN THE PROGRAM.— 
(1) IN GENERAL.—To be eligible to participate 
in the Program, as described in subsection (b), a 
psychiatric physician shall— 
(A) be licensed or eligible for licensure to 
practice in the State to which the physician is 
to be deployed under subsection (b)(4); and 
(B) demonstrate a commitment beyond the 
one year of training described in subsection 
(b)(3) and two years of deployment described in 
subsection (b)(4) to a career as a specialty care 
physician or primary care physician providing 
mental health services in Indian health pro-
grams. 
(2) PREFERENCE.—In selecting physicians to 
participate under the Program, as described in sub-
section (b)(2), the grant recipient shall give pref-
erence to physicians who are American Indians and 
Alaska Natives. 
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(e) LOAN FORGIVENESS.—Under the Program, any 
psychiatric physician accepted to participate in the Pro-
gram shall, notwithstanding the provisions of subsection 
(b) of section 108 of the Indian Health Care Improvement 
Act (25 U.S.C. 1616a) and upon acceptance into the Pro-
gram, be deemed eligible and enrolled to participate in the 
Indian Health Service Loan Repayment Program under 
such section 108. Under such Loan Repayment Program, 
the Secretary shall pay on behalf of the physician for each 
year of deployment under the Program under this section 
up to $35,000 for loans described in subsection (g)(1) of 
such section 108. 
(f) DEFERRAL OF CERTAIN SERVICE.—The starting 
date of required service of individuals in the National 
Health Service Corps Service Program under title II of 
the Public Health Service Act (42 U.S.C. 202 et seq.) who 
are psychiatric physicians participating under the Pro-
gram under this section shall be deferred until the date 
that is 30 days after the date of completion of the partici-
pation of such a physician in the Program under this sec-
tion. 
(g) DEFINITIONS.—For purposes of this Act: 
(1) AMERICAN
INDIANS
AND
ALASKA
NA-
TIVES.—The term ‘‘American Indians and Alaska 
Natives’’ has the meaning given the term ‘‘Indian’’ 
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in section 447.50(b)(1) of title 42, Code of Federal 
Regulations, as in existence as of the date of the en-
actment of this Act. 
(2) INDIAN HEALTH PROGRAM.—The term ‘‘In-
dian health program’’ has the meaning given such 
term in section 104(12) of the Indian Health Care 
Improvement Act (25 U.S.C. 1603(12)). 
(3) PROFESSIONALLY
SUPPORT.—The term 
‘‘professionally support’’ means, with respect to psy-
chiatric physicians participating in the Program and 
deployed to practice specialty care or primary care 
in Indian health programs, the provision of com-
pensation to such physicians for the provision of 
such care during such deployment and may include 
the provision, dissemination, or sharing of best prac-
tices, field training, and other activities deemed ap-
propriate by the recipient of the grant under this 
section. 
(4) PSYCHIATRIC PHYSICIAN.—The term ‘‘psy-
chiatric physician’’ means a medical doctor or doctor 
of osteopathy in good standing who has successfully 
completed four-year psychiatric residency training or 
who is enrolled in four-year psychiatric residency 
training in a residency program accredited by the 
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Accreditation Council for Graduate Medical Edu-
cation. 
(h) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$1,000,000 for each of the fiscal years 2014 through 
2018. 
Æ 
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