A bill to amend title 38, United States Code, to require the establishment in the Department of Veterans' Affairs of mental illness research, education, and clinical centers, and for other purposes.

SECTION 1. MENTAL ILLNESS RESEARCH, EDUCATION, AND CLINICAL CENTERS.

    (a) In General.--Subchapter II of chapter 73 of title 38, United 
States Code, is amended by adding at the end the following:
``Sec. 7319. Mental illness research, education, and clinical centers
    ``(a) The purpose of this section is to improve the provision of 
health-care services and related counseling services to eligible 
veterans suffering from mental illness, especially mental illness 
related to service-related conditions, through research (including 
research on improving mental health service facilities of the 
Department and on improving the delivery of mental health services by 
the Department), education and training of personnel, and the 
development of improved models and systems for the furnishing of mental 
health services by the Department.
    ``(b)(1) In order to carry out the purpose of this section, the 
Secretary, upon the recommendation of the Under Secretary for Health 
and pursuant to the provisions of this subsection, shall--
            ``(A) designate not more than five health-care facilities 
        of the Department as the locations for a center of research on 
        mental health services, on the use by the Department of 
        specific models for furnishing such services, on education and 
        training, and on the development and implementation of 
        innovative clinical activities and systems of care with respect 
        to the delivery of such services by the Department; and
            ``(B) subject to the appropriation of funds for such 
        purpose, establish and operate such centers at such locations 
        in accordance with this section.
    ``(2) The Secretary shall designate at least one facility under 
paragraph (1) not later than January 1, 1994.
    ``(3) The Secretary shall, upon the recommendation of the Under 
Secretary for Health, ensure that the facilities designated for centers 
under paragraph (1) are located in various geographic regions.
    ``(4) The Secretary may not designate any health-care facility as a 
location for a center under paragraph (1) unless--
            ``(A) the peer review panel established under paragraph (5) 
        has determined under that paragraph that the proposal submitted 
        by such facility as a location for a new center under this 
        subsection is among those proposals which have met the highest 
        competitive standards of scientific and clinical merit; and
            ``(B) the Secretary, upon the recommendation of the Under 
        Secretary for Health, determines that the facility has 
        developed (or may reasonably be anticipated to develop)--
                    ``(i) an arrangement with an accredited medical 
                school which provides education and training in 
                psychiatry and with which the facility is affiliated 
                under which arrangement residents receive education and 
                training in psychiatry through regular rotation through 
                the facility so as to provide such residents with 
                training in the diagnosis and treatment of mental 
                illness;
                    ``(ii) an arrangement with an accredited graduate 
                school of psychology under which arrangement students 
                receive education and training in clinical, counseling, 
                or professional psychology through regular rotation 
                through the facility so as to provide such students 
                with training in the diagnosis and treatment of mental 
                illness;
                    ``(iii) an arrangement under which nursing, social 
                work, or allied health personnel receive training and 
                education in mental health care through regular 
                rotation through the facility;
                    ``(iv) the ability to attract scientists who have 
                demonstrated creativity and achievement in research--
                             ``(I) into the evaluation of innovative 
                        approaches to the design of mental health 
                        services; or
                            ``(II) into the causes, prevention, and 
                        treatment of mental illness;
                    ``(v) a policymaking advisory committee composed of 
                appropriate mental health-care and research personnel 
                of the facility and of the affiliated school or schools 
                to advise the directors of the facility and the center 
                on policy matters pertaining to the activities of the 
                center during the period of the operation of the 
                center; and
                    ``(vi) the capability to evaluate effectively the 
                activities of the center, including activities relating 
                to the evaluation of specific efforts to improve the 
                quality and effectiveness of mental health services 
                provided by the Department at or through individual 
                facilities.
    ``(5)(A) In order to provide advice to assist the Under Secretary 
for Health and the Secretary to carry out their responsibilities under 
this section, the official within the Central Office of the Veterans 
Health Administration responsible for mental health and behavioral 
sciences matters shall establish a panel to assess the scientific and 
clinical merit of proposals that are submitted to the Secretary for the 
establishment of new centers under this subsection.
    ``(B) The membership of the panel shall consist of experts in the 
fields of mental health research, education and training, and clinical 
care. Members of the panel shall serve as consultants to the Department 
for a period of no longer than six months.
    ``(C) The panel shall review each proposal submitted to the panel 
by the official referred to in subparagraph (A) and shall submit its 
views on the relative scientific and clinical merit of each such 
proposal to that official.
    ``(D) The panel shall not be subject to the Federal Advisory 
Committee Act (5 U.S.C. App.).
    ``(c) Clinical and scientific investigation activities at each 
center may compete for the award of funding from amounts appropriated 
for the Department of Veterans Affairs medical and prosthetics research 
account and shall receive priority in the award of funding from such 
account insofar as funds are awarded to projects and activities 
relating to mental illness.
    ``(d) The Under Secretary for Health shall ensure that at least 
three centers designated under subsection (b)(1)(A) emphasize research 
into means of improving the quality of care for veterans suffering from 
mental illness through the development of community-based alternatives 
to institutional treatment for such illness.
    ``(e) The Under Secretary for Health shall ensure that useful 
information produced by the research, education and training, and 
clinical activities of the centers established under subsection (b)(1) 
is disseminated throughout the Veterans Health Administration through 
publications and through programs of continuing medical and related 
education provided through regional medical education centers under 
subchapter VI of chapter 74 of this title and through other means.
    ``(f) The official within the Central Office of the Veterans Health 
Administration responsible for mental health and behavioral sciences 
matters shall be responsible for supervising the operation of the 
centers established pursuant to subsection (b)(1).
    ``(g)(1) There are authorized to be appropriated for the Department 
of Veterans Affairs for the basic support of the research and education 
and training activities of the centers established pursuant to 
subsection (b)(1) the following:
            ``(A) $3,125,000 for fiscal year 1994.
            ``(B) $6,250,000 for each of fiscal years 1995 through 
        1997.
    ``(2) In addition to the funds available under the authorization of 
appropriations in paragraph (1), the Under Secretary for Health shall 
allocate to such centers from other funds appropriated generally for 
the Department of Veterans Affairs medical care account and the 
Department of Veterans Affairs medical and prosthetics research account 
such amounts as the Under Secretary for Health determines appropriate 
in order to carry out the purposes of this section.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 of such title is amended by adding at the end of the matter 
relating to subchapter II the following:

``7319. Mental illness research, education, and clinical centers.''.
    (c) Reports.--Not later than February 1 of each of 1995, 1996, and 
1997, the Secretary of Veterans Affairs shall submit to the Committees 
on Veterans' Affairs of the Senate and House of Representatives a 
report on the status and activities during the previous fiscal year of 
the mental illness, research, education, and clinical centers 
established pursuant to section 7319 of title 38, United States Code 
(as added by subsection (a)). Each such report shall contain the 
following:
            (1) A description of--
                    (A) the activities carried out at each center and 
                the funding provided for such activities;
                    (B) the advances made at each center in research, 
                education and training, and clinical activities 
                relating to mental illness in veterans; and
                    (C) the actions taken by the Under Secretary for 
                Health pursuant to subsection (d) of such section (as 
                so added) to disseminate useful information derived 
                from such activities throughout the Veterans Health 
                Administration.
            (2) The Secretary's evaluations of the effectiveness of the 
        centers in fulfilling the purposes of the centers.
    (d) Technical Amendment.--Section 7314(d)(1) of such title is 
amended by striking out ``the Chief Medical Director'' and inserting in 
lieu thereof ``the Under Secretary for Health''.

            Passed the Senate March 24 (legislative day, February 22), 
      1994.

            Attest:

                                             WALTER J. STEWART,

                                                             Secretary.

Summary: Directs the Secretary of Veterans Affairs to: (1) designate not more than five facilities of the Department of Veterans Affairs as locations for centers of mental illness research, education and training, and clinical activities, (2) subject to appropriations, establish and operate such centers, (3) designate one such center by January 1, 1994. And (4) ensure that such centers are located in various geographic regions. Requires the official within the Central Office of the Veterans Health Administration responsible for mental health and behavioral science matters to establish a panel to assess the scientific and clinical merit of proposals submitted to the Secretary for the establishment of new centers. Requires at least three centers to emphasize research into improving the quality of care provided to mentally ill veterans through the development of community-based alternatives to institutional treatment. Requires the Under Secretary for Health of the Department to: (1) ensure that research conducted at such centers includes an appropriate emphasis on the psychosocial dimension of mental illness and on the means of furnishing care and treatment to veterans suffering from mental illness. And (2) disseminate information produced at such centers. Authorizes appropriations. Requires reports.