Native American Psychiatric and Mental Health Care Improvement Act

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Native American Psychiatric and 
Mental Health Care Improvement Act''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) The Substance Abuse and Mental Health Services 
        Administration concludes the rate of serious mental illness in 
        American Indians and Alaska Natives is twice that of any other 
        race or ethnicity.
            (2) The Centers for Disease Control and Prevention 
        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 attributes high rates 
        of homelessness, incarceration, alcohol and drug abuse, stress, 
        and trauma as principal 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 shortage of psychiatrists at 
        the Indian Health Service and other tribal health facilities 
        significantly limits mental health access to American Indians 
        and Alaska Natives.
            (7) The One Sky Center, the American Indian/Alaska Native 
        National Resource Center for Substance Abuse and Mental Health 
        Services, identifies 20 psychiatrists currently practicing in 
        Indian country (out of approximately 60,000 psychiatrists 
        practicing nationwide), and 2 Native American psychiatrists 
        currently practicing in Indian country (out of 13 practicing 
        nationwide).
            (8) According to the American Psychiatric Association, 
        psychiatric physicians practicing in American Indian and Alaska 
        Native population groups often face cultural competency 
        challenges, professional 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 identifies and 
        incorporates best practices for recruiting, training, 
        deploying, and professionally supporting Native American 
        psychiatric physicians or non-Native American psychiatric 
        physicians (or both), who are fully integrated into existing 
        medical, mental, and behavioral health systems in Indian health 
        programs.

SEC. 3. DEMONSTRATION GRANT PROGRAM TO RECRUIT, TRAIN, DEPLOY, AND 
              PROFESSIONALLY SUPPORT PSYCHIATRIC PHYSICIANS IN INDIAN 
              HEALTH PROGRAMS.

    (a) Establishment.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary''), 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 American psychiatric physicians to be 
        fully integrated into medical, mental, and behavioral health 
        systems in Indian health programs;
            (2) recruit to participate in the Program Native American 
        and non-Native American psychiatric physicians who demonstrate 
        interest in providing specialty 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 
        services to American Indians and Alaska Natives;
            (3) provide such psychiatric physicians participating in 
        the Program with not more than 1 year of supplemental clinical 
        and cultural competency training to enable such physicians to 
        provide such specialty 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 practice 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 
        period with respect to practicing such care in such programs; 
        and
            (5) not later than 1 year after the last day of the 5-year 
        period for which the grant is awarded 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 workforce 
                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 workforce 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 entity affiliated with a medical 
                school in the United States that is accredited by the 
                Liaison Committee on Medical Education; and
                    (C) have in existence, as of the time of submission 
                of the application under subparagraph (A), a 
                relationship with Indian health programs in at least 
                two States with a demonstrated 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 recipient.--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 physicians, and to provide ongoing 
                professional support to psychiatric physicians during 
                the deployment period to an Indian health program.
                    (B) Demonstrates a record in successfully 
                recruiting, training, and deploying physicians who are 
                American Indians and Alaska Natives.
                    (C) Demonstrates the ability to establish a program 
                advisory board, which may be primarily 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 programs.
            (2) Preference.--In selecting physicians to participate 
        under the Program, as described in subsection (b)(2), the grant 
        recipient shall give preference to physicians who are American 
        Indians and Alaska Natives.
    (e) Loan Forgiveness.--Under the Program, any psychiatric physician 
accepted to participate in the Program 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 Program, 
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 Program 
under this section shall be deferred until the date that is 30 days 
after the date of completion of the participation of such a physician 
in the Program under this section.
    (g) Definitions.--For purposes of this Act:
            (1) American indians and alaska natives.--The term 
        ``American Indians and Alaska Natives'' has the meaning given 
        the term ``Indian'' in section 447.50(b)(1) of title 42, Code 
        of Federal Regulations, as in existence as of the date of the 
        enactment of this Act.
            (2) Indian health program.--The term ``Indian 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 psychiatric physicians 
        participating in the Program and deployed to practice specialty 
        care or primary care in Indian health programs, the provision 
        of compensation to such physicians for the provision of such 
        care during such deployment and may include the provision, 
        dissemination, or sharing of best practices, field training, 
        and other activities deemed appropriate by the recipient of the 
        grant under this section.
            (4) Psychiatric physician.--The term ``psychiatric 
        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 Accreditation Council for Graduate Medical 
        Education.
    (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.

Summary: Native American Psychiatric and Mental Health Care Improvement Act - Directs the Secretary of Health and Human Services (HHS) to award a five-year grant to one department of psychiatry in, or one non-profit entity affiliated with, an accredited medical school in this country to carry out a demonstration program to recruit, train, deploy, and professionally support psychiatric physicians who agree to provide primary and specialty health care services in Indian health programs for at least two years. Requires the grantee to: (1) create a nationally-replicable workforce model that identifies and incorporates best practices for carrying out such activities, and (2) provide participating psychiatric physicians with up to one year of supplemental clinical and cultural competency training that enables them to provide primary and specialty health care services in Indian health programs. Requires participating psychiatric physicians to: (1) be licensed or eligible for licensure to practice in the state to which they will be deployed; and (2) demonstrate a commitment, beyond the one year of training and two years of deployment, to a career as a specialty care or primary care physician providing mental health services in Indian health programs. Gives a preference to psychiatric physicians who are American Indians or Alaska Natives. Directs the Secretary to make a repayment, under the Indian Health Service Loan Repayment Program, of the educational loans of participating psychiatric physicians for each year of their deployment to an Indian health program.