Bill Overview
Title: Home-Based Telemental Health Care Act of 2022
Description: This bill establishes a grant program to fund demonstration projects to provide mental health services to medically underserved individuals in rural areas or in the farming, fishing, and forestry industries. Specifically, the Office for the Advancement of Telehealth within the Health Resources and Services Administration must award grants to public or nonprofit telemental health provider networks to deliver, and evaluate the impact of, home-based telemental services for such individuals. The office must coordinate activities with the Rural Health Liaison of the Department of Agriculture.
Sponsors: Sen. Rounds, Mike [R-SD]
Target Audience
Population: Medically underserved individuals in rural areas or in the farming, fishing, and forestry industries
Estimated Size: 5000000
- Medically underserved individuals are typically those who face economic, cultural, or linguistic barriers to healthcare access.
- Rural areas often have fewer healthcare facilities and professionals, leading to challenges in accessing healthcare services.
- The farming, fishing, and forestry industries often have workers who live in rural or remote areas.
- Mental health services are less available in rural areas, making telemental health a crucial service for these populations.
- Telemental health services can bridge the gap for individuals who cannot easily travel to access mental health services.
Reasoning
- To properly evaluate the impact of the Home-Based Telemental Health Care Act, we must consider the diversity of the rural population and the varying levels of access to current mental health resources. This includes acknowledging differences in socio-economic status, location, and specific industry-associated challenges.
- We must also pay attention to the budget limitations, which, although substantial over a ten-year period, will still require careful targeting to ensure the most underserved populations benefit first.
- The Wellbeing scores will be influenced by factors such as the initial availability of mental health services, the ease with which individuals can transition to telehealth, and the personal and communal stigma surrounding mental health in rural areas.
- Technology access and literacy are also critical, as the policy relies on telehealth platforms requiring internet access and a certain level of tech proficiency.
Simulated Interviews
farmer (rural Iowa)
Age: 45 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- I find it hard to find time or transportation to see a mental health professional.
- This program could make it easier to get the help I’ve been needing, especially through the winter months.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 5 |
fisherman (rural Alabama)
Age: 58 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- I’ve never really thought about getting mental health help, but if it was available at home, maybe I’d try it.
- There’s a big need here, but a lot of folks would need help understanding how to use the technology first.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 5 | 3 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 3 |
forestry worker (Northern California)
Age: 34 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- I feel the mental stress especially during off-seasons when work isn’t steady.
- Having regular access to talk to someone could really help during these times.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 4 |
nurse (Montana)
Age: 29 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 6/20
Statement of Opinion:
- I’ve seen first-hand how hard it is for my patients to access mental health care.
- This kind of policy could do a lot of good, if people are aware and willing to try it out.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 8 | 6 |
mechanic (Kansas)
Age: 40 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 15.0 years
Commonness: 8/20
Statement of Opinion:
- It’s hard to justify the cost and time to travel for appointments.
- If this could be done from home, it’d make a big difference for someone like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 3 |
farming (West Virginia)
Age: 52 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 10/20
Statement of Opinion:
- Many here have always dealt with stress and anxiety without much support.
- We need more of these programs, but it’s crucial they reach everyone, not just the ones who are tech-savvy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 4 |
retired logger (rural Texas)
Age: 61 | Gender: male
Wellbeing Before Policy: 2
Duration of Impact: 20.0 years
Commonness: 5/20
Statement of Opinion:
- Isolation has increased since I've retired, and I worry about my mental health.
- This program could help remove some of the barriers I face, especially related to distance.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 3 | 2 |
| Year 2 | 4 | 2 |
| Year 3 | 4 | 3 |
| Year 5 | 5 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 3 |
fishing boat captain (Oregon)
Age: 37 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- There are high stress periods when the crew and I are out at sea.
- Knowing I could have a direct line to mental health support when needed is a relief.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
rancher (rural Wyoming)
Age: 50 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 15.0 years
Commonness: 7/20
Statement of Opinion:
- The idea sounds good, but I’m not sure how I’d use all this new technology.
- If there’s support to get us set up, maybe it could help our community.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 4 | 3 |
| Year 3 | 4 | 3 |
| Year 5 | 5 | 3 |
| Year 10 | 5 | 4 |
| Year 20 | 4 | 3 |
tree farmer (Vermont)
Age: 42 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- It’s tough to get help for my husband where we live.
- This program could be a wonderful opportunity for him to get care more consistently.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Cost Estimates
Year 1: $25000000 (Low: $20000000, High: $30000000)
Year 2: $50000000 (Low: $45000000, High: $55000000)
Year 3: $75000000 (Low: $70000000, High: $80000000)
Year 5: $100000000 (Low: $95000000, High: $105000000)
Year 10: $120000000 (Low: $115000000, High: $125000000)
Year 100: $125000000 (Low: $120000000, High: $130000000)
Key Considerations
- Maintaining technological infrastructure in rural areas to support telemental health services.
- Potential need for training healthcare providers in telehealth delivery.
- Coordination between multiple government agencies and organizations to ensure successful implementation.