,,ii  #aagth ,,congress  #b;d ,session  
,s4 #cicg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,march #bh1    
#bjbb,mr4 ,rounds 7for himself1 ,ms4    
,smith1 ,mr4 ,thune1 and ,mr4 ,boozman7 
introduced the following bill2 which was
 read twice and referred to the         
,committee on ,health1 ,education1      
,labor1 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 farming1        
fishing1 and forestry occupations4  #a4 
,short title ,this ,act may be cited as 
the ,home-,based ,telemental ,health    
,care ,act of #bjbb4  #b4 ,findings     
,congress finds as follows3 7#a7        
,according to a #bjbj report by the     
,centers for ,disease ,control and      
,prevention1 titled ,mental ,health1    
,substance ,use and ,suicidal ,ideation 
during the ,,covid-#ai ,pandemic        
7referred to in this section as the     

,,cdc report71 elevated levels of       
adverse mental health conditions1       
substance use1 and suicidal ideation    
were reported by adults in the ,united  
,states in ,june #bjbj1 after the onset 
of the ,,covid-#ai pandemic4 ,the       
prevalence of symptoms of anxiety       
disorder was #be4e percent1 compared to 
#h4a percent in the second quarter of   
#bjai4 ,additionally1 #bd4c percent of  
adults experienced depressive disorders 
in ,june #bjbj1 #d times the #f4e       
percent reported in the second quarter  
of #bjai4  7#b7 ,according to the ,,cdc 
report1 approximately #cj percent of    
rural adults who responded to a survey  
of the ,centers for ,disease ,control   
and ,prevention suffered from anxiety or
 depression1 and approximately #aj      
percent of such adults seriously        
considered suicide in the past #cj days4
  7#c7 ,a #bjaf study by the ,centers   
for ,disease ,control and ,prevention   
suggests that people in farming1        
fishing1 and forestry occupations       

7referred to in this section as the     
,triple-,f industry7 in the ,united     
,states experienced rates of #ge and #gf
 suicides per #ajj1jjj people in #bjab  
and #bjae1 respectively4  7#d7 ,such    
#bjaf study by the ,centers for ,disease
 ,control and ,prevention indicates that
 suicide rates for male farmers1        
ranchers1 and other agricultural        
managers were double the rate for the   
general population in #bjab4 ,if        
farmers1 ranchers1 and agricultural     
managers were considered a major group  
for purposes of such study1 that group  
would rank first in suicides in #bjab   
and third in #bjae4  7#e7 ,according to 
a #bjai report of the ,national ,survey 
on ,drug ,use and ,health1 #bb4d percent
 of residents in rural communities aged 
#ah or older who experienced mental     
illness perceived an unmet need for     
mental health services4 ,of these       
individuals1 #ag4i percent did not      
receive any mental health services in   
the prior year4  7#f7 ,the ,,covid-#ai  

pandemic put additional stress on people
 in the ,triple-,f population4 ,in the  
early stages1 the pandemic caused       
instability in the markets1 especially  
as the virus caused a downturn in food  
service sales and closed meat processing
 plants across the ,nation4 ,farmers    
were left with low commodity prices and 
loss of revenue4 ,this community has    
spent the last #b years attempting to   
rebound from the effects of the         
pandemic4 ,additional resources are     
needed to support the mental health     
needs of this population4  7#g7 ,while  
the prevalence of mental illness is     
similar among rural and urban residents1
 the services available to each         
population are very different4 ,mental  
health care needs are not met in rural  
communities due to many challenges1     
including accessibility issues due to   
transportation and geographic isolation1
 the stigma of needing or receiving     
mental health care1 a lack of anonymity 
when seeking treatment1 shortages of    

mental health workforce professionals1  
and affordability due to a high rate of 
uninsured residents4  7#h7 ,telemental  
health1 which is the delivery of mental 
health services using remote            
technologies when the patient and       
provider are separated by distance1     
shows promise in helping to alleviate   
the lack of mental health services in   
rural areas4 ,traditional telemental    
health models involve care delivered to 
a patient at an originating clinical    
site from a specialist working at a     
distant site4 ,having the ability to    
reach mental health professionals from a
 place of comfort1 such as home1 from a 
personal device may reduce challenges   
faced in rural areas and amongst        
,triple-,f workers4  7#i7 ,a clinical   
trial of #bda depressed elderly         
veterans1 which was conducted by the    
,medical ,university of ,south ,carolina
 and the ,ralph ,h4 ,johnson ,veterans  
,affairs ,medical ,center and reported  
in the ,journal of ,clinical            

,psychiatry1 found that home-based      
telemental health for depression is well
 received by patients and delivers as   
good a quality of life as in-person     
visits4  #c4 ,mental health services    
delivered to rural underserved          
populations via telemental health care  
,title ,,iii of the ,public ,health     
,service ,act is amended by inserting   
after section #ccj,k 7#db ,u4,s4,c4     
#bed;c-#af7 the following3  #ccj,k-#a4  
,mental health services delivered to    
rural underserved populations via       
telemental health care  7a7 ,definitions
 ,in this section-- 7#a7 the term       
covered populations means-- 7,a7        
medically underserved populations in    
rural areas 7as defined in section      
#ahhf7;d77#b77;,d7 of the ,social       
,security ,act72 or  7,b7 populations   
engaged in a farming1 fishing1 or       
forestry industry2  7#b7 the term       
eligible entity means a public or       
nonprofit private telemental health     
provider network that offers services   

that include mental health services     
provided by professionals trained in    
mental health2  7#c7 the term farming1  
fishing1 or forestry industry means an  
occupation defined as a farming1        
fishing1 or forestry occupation by the  
,department of ,labor in accordance with
 the ,standard ,occupational            
,classification ,system2  7#d7 the term 
home-based telemental means the use of  
telemental health services where the    
patient is in his or her own home or    
other place of comfort2  7#e7 the term  
medically underserved population has the
 meaning given such term in section     
#ccj7;b72  7#f7 the term professional   
trained in mental health means a        
psychiatrist1 a qualified mental health 
professional 7as defined in section     
#ccj,k71 or another mental health       
professional acting under the direction 
of a psychiatrist2  7#g7 the term rural 
has the meaning given such term by the  
,office of ,rural ,health ,policy of the
 ,health ,resources and ,services       

,administration2 and  7#h7 the term     
telemental health means the use of      
electronic information and              
telecommunications technologies to      
support long distance clinical health   
care1 patient and professional          
health-related education1 public health1
 and health administration4  7b7        
,program authorized ,the ,secretary1    
acting through the ,director of the     
,office for the ,advancement of         
,telehealth of the ,health ,resources   
and ,services ,administration and in    
coordination with the ,rural ,health    
,liaison of the ,department of          
,agriculture1 shall award grants to     
eligible entities to establish          
demonstration projects for the provision
 of mental health services to covered   
populations in their homes1 as delivered
 remotely by professionals trained in   
mental health using telemental health   
care4  7c7 ,use of funds ,recipients of 
a grant under this section shall use the
 grant funds to-- 7#a7 deliver          

home-based telemental health services to
 covered populations2 and  7#b7 develop 
comprehensive metrics to measure the    
quality and impact of home-based        
telemental health services compared to  
traditional in-person mental health     
care4  7d7 ,report ,the ,secretary1 in  
consultation with the ,secretary of     
,agriculture1 not later than #c years   
after the date on which the program     
under this section commences1 and #b    
years thereafter1 shall submit to the   
appropriate congressional committees    
reports on the impact and quality of    
care of home-based telemental health    
care services for covered populations4  
7e7 ,authorized use of funds ,out of any
 amounts made available to the          
,secretary1 up to #aj1jjj1jjj for each  
of fiscal years #bjbb through #bjbf may 
be allocated to carrying out the program
 under this section4  4