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Title IV — Developing the Behavioral Health Workforce

H.R. 4574 · 113th Congress · May 6, 2014 · Lineage

IV Developing the Behavioral Health Workforce

Sec. 401 National health service corps scholarship and loan repayment funding for behavioral and mental health professionals

Section 338H of the Public Health Service Act (42 U.S.C. 254q) is amended—
(1)
by redesignating subsections (b) and (c) as subsections (c) and (d), respectively; and
(2)
by inserting after subsection (a) the following:

“(b) Additional funding for behavioral and mental health professionals—In addition to the amounts authorized to be appropriated under subsection (a), and in addition to the amounts appropriated under section 10503 of Public Law 111–148, there are authorized to be appropriated such sums as may be necessary for fiscal years 2015 through 2019 for scholarships and loan repayments under this subpart for ensuring, as described in sections 338A(a) and 338B(a), an adequate supply of behavioral and mental health professionals.”

Sec. 402 Reauthorization of HRSA’s mental and behavioral health education and training program

Subsection (e) of section 756 of the Public Health Service Act (42 U.S.C. 294e–1) is amended to read as follows:

“(e) Authorization of appropriations—To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2015 through 2019.”

Sec. 403 SAMHSA grant program for development and implementation of curricula for continuing education on serious mental illness

Title V of the Public Health Service Act is amended by inserting after section 520I (42 U.S.C. 290bb–40) the following:

“520I–1. Curricula for continuing education on serious mental illness

“(a) Grants—The Secretary may award grants to eligible entities for the development and implementation of curricula for providing continuing education and training to health care professionals on identifying, referring, and treating individuals with serious mental illness.

“(b) Eligible entities—To be eligible to seek a grant under this section, an entity shall be a public or nonprofit entity that—

“(1) provides continuing education or training to health care professionals; or

“(2) applies for the grant in partnership with another entity that provides such education and training.

“(c) Preference—In awarding grants under this section, the Secretary shall give preference to eligible entities proposing to develop and implement curricula for providing continuing education and training to—

“(1) health care professionals in primary care specialities; or

“(2) health care professionals who are required, as a condition of State licensure, to participate in continuing education or training specific to mental health.

“(d) Authorization of appropriations—To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2015 through 2019.”

Sec. 404 Demonstration grant program to recruit, train, deploy, and professionally support psychiatric physicians in Indian health programs

(a)
Short title— This section may be cited as the “Native American Psychiatric and Mental Health Care Improvement Act”.
(b)
Demonstration grant program To recruit, train, deploy, and professionally support psychiatric physicians in Indian health programs—
(1)
Establishment— The Secretary of Health and Human Services (in this subsection 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 paragraph (2).
(2)
Activities To be carried out by recipient of grant under Program— Under the Program, the grant recipient shall—
(A)
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;
(B)
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;
(C)
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;
(D)
with respect to such psychiatric physicians who are participating in the Program and trained under subparagraph (C), 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
(E)
not later than 1 year after the last day of the 5-year period for which the grant is awarded under paragraph (1), submit to the Secretary and to the appropriate committees of Congress a report that shall include—
(i)
the workforce model created under subparagraph (A);
(ii)
strategies for disseminating the workforce model to other entities with the capability of adopting it; and
(iii)
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.
(3)
Eligible entities—
(A)
Requirements— To be eligible to receive the grant under this section, an entity shall—
(i)
submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require;
(ii)
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 nonprofit entity affiliated with a medical school in the United States that is accredited by the Liaison Committee on Medical Education; and
(iii)
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.
(B)
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:
(i)
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.
(ii)
Demonstrates a record in successfully recruiting, training, and deploying physicians who are American Indians and Alaska Natives.
(iii)
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.
(4)
Eligibility of psychiatric physicians To participate in the Program—
(A)
In general— To be eligible to participate in the Program, as described in paragraph (2), a psychiatric physician shall—
(i)
be licensed or eligible for licensure to practice in the State to which the physician is to be deployed under paragraph (2)(D); and
(ii)
demonstrate a commitment beyond the one year of training described in paragraph (2)(C) and two years of deployment described in paragraph (2)(D) to a career as a specialty care physician or primary care physician providing mental health services in Indian health programs.
(B)
Preference— In selecting physicians to participate under the Program, as described in paragraph (2)(B), the grant recipient shall give preference to physicians who are American Indians and Alaska Natives.
(5)
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.
(6)
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.
(7)
Definitions— For purposes of this Act:
(A)
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.
(B)
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)).
(C)
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.
(D)
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.
(8)
Authorization of appropriations— There is authorized to be appropriated to carry out this section $1,000,000 for each of the fiscal years 2015 through 2019.

Sec. 405 Including occupational therapists as behavioral and mental health professionals for purposes of the National Health Service Corps

(a)
Inclusion of Occupational Therapist— Section 331(a)(3)(E)(i) of the Public Health Service Act (42 U.S.C. 254d(a)(3)(E)(i)) is amended by inserting “subject to section 405(b)(2) of the Strengthening Mental Health in Our Communities Act of 2014, occupational therapists,” after “psychiatric nurse specialists;”.
(b)
Effective date; contingent implementation—
(1)
Effective date— Subject to paragraph (2), the amendment made by subsection (a) shall apply beginning on October 1, 2014.
(2)
Contingent implementation— The amendment made by subsection (a) shall apply with respect to obligations entered into for a fiscal year after fiscal year 2014 only if the total amount made available for the purpose of carrying out subparts II and III of part D of title III of the Public Health Service Act (42 U.S.C. 254d et seq.) for such fiscal year is greater than the total amount made available for such purpose for fiscal year 2014.

Sec. 406 Extension of certain health care workforce loan repayment programs through fiscal year 2019

Section 775(e) of the Public Health Service Act (42 U.S.C. 295f(e)) is amended—
(1)
by striking “2014” and inserting “2019”; and
(2)
by striking “2013” and inserting “2019”.