,i #aacth ,,congress #ast ,session ,h4 ,r4 #bjcg ,,in ,,the ,,house ,,of ,,representatives ,may #af1 #bjac ,mr4 ,schrader introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,natural ,resources1 for a period to be subsequently determined by the ,speaker1 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 recruit1 train1 deploy1 and professionally support psychiatric physicians in ,indian health programs4 #a4 ,short title ,this ,act may be cited as the ,native ,american ,psychiatric and ,mental ,health ,care ,improvement ,act4 #b4 ,findings ,congress makes the following findings3 7#a7 ,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 ethnicity4 7#b7 ,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 ethnicity4 7#c7 ,the ,united ,states ,surgeon ,general attributes high rates of homelessness1 incarceration1 alcohol and drug abuse1 stress1 and trauma as principal causes of mental illness in ,american ,indians and ,alaska ,natives4 7#d7 ,the ,agency for ,healthcare ,research and ,quality concludes in ,the ,national ,health ,disparity ,report1 #bjaa1 that ,american ,indians and ,alaska ,natives had worse care than ,whites in #bh measures of health care quality and access4 7#e7 ,the ,indian ,health ,service reports that per capita spending on personal health care of ,american ,indians and ,alaska ,natives was #b1gda in #bjab--nearly two-thirds below the national average of #g1bci4 7#f7 ,the ,department of ,health and ,human ,services1 ,office of ,inspector ,general1 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 ,natives4 7#g7 ,the ,one ,sky ,center1 the ,american ,indian_/,alaska ,native ,national ,resource ,center for ,substance ,abuse and ,mental ,health ,services1 identifies #bj psychiatrists currently practicing in ,indian country 7out of approximately #fj1jjj psychiatrists practicing nationwide71 and #b ,native ,american psychiatrists currently practicing in ,indian country 7out of #ac practicing nationwide74 7#h7 ,according to the ,american ,psychiatric ,association1 psychiatric physicians practicing in ,american ,indian and ,alaska ,native population groups often face cultural competency challenges1 professional isolation1 high demand for medical and mental health services1 relatively low compensation1 and high burnout rates4 7#i7 ,a legislative initiative is warranted to create a nationally-replicable workforce model that identifies and incorporates best practices for recruiting1 training1 deploying1 and professionally supporting ,native ,american psychiatric physicians or non-,native ,american psychiatric physicians 7or both71 who are fully integrated into existing medical1 mental1 and behavioral health systems in ,indian health programs4 #c4 ,demonstration grant program to recruit1 train1 deploy1 and professionally support psychiatric physicians in ,indian health programs 7a7 ,establishment ,the ,secretary of ,health and ,human ,services 7in this section referred to as the ,secretary71 in consultation with the ,director of the ,indian ,health ,service and demonstration programs established under section #abc of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afafp71 shall award one #e-year grant to one eligible entity to carry out a demonstration program 7in this ,act referred to as the ,program7 under which the eligible entity shall carry out the activities described in subsection 7b74 7b7 ,activities ,to be carried out by recipient of grant under ,program ,under the ,program1 the grant recipient shall-- 7#a7 create a nationally-replicable workforce model that identifies and incorporates best practices for recruiting1 training1 deploying1 and professionally supporting ,native ,american and non-,native ,american psychiatric physicians to be fully integrated into medical1 mental1 and behavioral health systems in ,indian health programs2 7#b7 recruit to participate in the ,program ,native ,american and non-,native ,american psychiatric physicians who demonstrate interest in providing specialty health care services 7as defined in section #cac7;a77#c7 of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afch;g7a77#c777 and primary care services to ,american ,indians and ,alaska ,natives2 7#c7 provide such psychiatric physicians participating in the ,program with not more than #a 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 programs2 7#d7 with respect to such psychiatric physicians who are participating in the ,program and trained under paragraph 7#c71 deploy such physicians to practice specialty care or primary care in ,indian health programs for a period of not less than #b years and professionally support such physicians for such period with respect to practicing such care in such programs2 and 7#e7 not later than #a year after the last day of the #e-year period for which the grant is awarded under subsection 7a71 submit to the ,secretary and to the appropriate committees of ,congress a report that shall include-- 7,a7 the workforce model created under paragraph 7#a72 7,b7 strategies for disseminating the workforce model to other entities with the capability of adopting it2 and 7,c7 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 ,natives4 7c7 ,eligible entities 7#a7 ,requirements ,to be eligible to receive the grant under this section1 an entity shall-- 7,a7 submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require2 7,b7 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 ,education2 and 7,c7 have in existence1 as of the time of submission of the application under subparagraph 7,a71 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 ,states4 7#b7 ,priority in selecting grant recipient ,in awarding the grant under this section1 the ,secretary shall give priority to an eligible entity that satisfies each of the following3 7,a7 ,demonstrates sufficient infrastructure in size1 scope1 and capacity to undertake the supplemental clinical and cultural competency training of a minimum of #e psychiatric physicians1 and to provide ongoing professional support to psychiatric physicians during the deployment period to an ,indian health program4 7,b7 ,demonstrates a record in successfully recruiting1 training1 and deploying physicians who are ,american ,indians and ,alaska ,natives4 7,c7 ,demonstrates the ability to establish a program advisory board1 which may be primarily composed of representatives of federally-recognized tribes1 ,alaska ,natives1 and ,indian health programs to be served by the ,program4 7d7 ,eligibility of psychiatric physicians ,to participate in the ,program 7#a7 ,in general ,to be eligible to participate in the ,program1 as described in subsection 7b71 a psychiatric physician shall-- 7,a7 be licensed or eligible for licensure to practice in the ,state to which the physician is to be deployed under subsection 7b77#d72 and 7,b7 demonstrate a commitment beyond the one year of training described in subsection 7b77#c7 and two years of deployment described in subsection 7b77#d7 to a career as a specialty care physician or primary care physician providing mental health services in ,indian health programs4 7#b7 ,preference ,in selecting physicians to participate under the ,program1 as described in subsection 7b77#b71 the grant recipient shall give preference to physicians who are ,american ,indians and ,alaska ,natives4 7e7 ,loan forgiveness ,under the ,program1 any psychiatric physician accepted to participate in the ,program shall1 notwithstanding the provisions of subsection 7b7 of section #ajh of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afaf;a7 and upon acceptance into the ,program1 be deemed eligible and enrolled to participate in the ,indian ,health ,service ,loan ,repayment ,program under such section #ajh4 ,under such ,loan ,repayment ,program1 the ,secretary shall pay on behalf of the physician for each year of deployment under the ,program under this section up to #ce1jjj for loans described in subsection 7g77#a7 of such section #ajh4 7f7 ,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 7#db ,u4,s4,c4 #bjb et seq47 who are psychiatric physicians participating under the ,program under this section shall be deferred until the date that is #cj days after the date of completion of the participation of such a physician in the ,program under this section4 7g7 ,definitions ,for purposes of this ,act3 7#a7 ,american ,indians and ,alaska ,natives ,the term ,american ,indians and ,alaska ,natives has the meaning given the term ,indian in section #ddg4ej7;b77#a7 of title #db1 ,code of ,federal ,regulations1 as in existence as of the date of the enactment of this ,act4 7#b7 ,indian health program ,the term ,indian health program has the meaning given such term in section #ajd7ab7 of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc7ab774 7#c7 ,professionally support ,the term professionally support means1 with respect to psychiatric physicians participating in the ,program and deployed to practice specialty care or primary care in ,indian health programs1 the provision of compensation to such physicians for the provision of such care during such deployment and may include the provision1 dissemination1 or sharing of best practices1 field training1 and other activities deemed appropriate by the recipient of the grant under this section4 7#d7 ,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 ,education4 7h7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #a1jjj1jjj for each of the fiscal years #bjad through #bjah4