I

103D CONGRESS

2D SESSION S. 1512

IN THE HOUSE OF REPRESENTATIVES

APRIL 12, 1994

Referred to the Committee on Veterans’ Affairs

AN ACT

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.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. MENTAL ILLNESS RESEARCH, EDUCATION, AND

2 CLINICAL CENTERS.

3 (a) IN GENERAL.—Subchapter II of chapter 73 of

4 title 38, United States Code, is amended by adding at the

5 end the following:

6 ‘‘§ 7319. Mental illness research, education, and clini7 cal centers

8 ‘‘(a) The purpose of this section is to improve the

9 provision of health-care services and related counseling

10 services to eligible veterans suffering from mental illness,

11 especially mental illness related to service-related condi12 tions, through research (including research on improving

13 mental health service facilities of the Department and on

14 improving the delivery of mental health services by the De15 partment), education and training of personnel, and the

16 development of improved models and systems for the fur17 nishing of mental health services by the Department.

18 ‘‘(b)(1) In order to carry out the purpose of this sec19 tion, the Secretary, upon the recommendation of the

20 Under Secretary for Health and pursuant to the provi21 sions of this subsection, shall—

22 ‘‘(A) designate not more than five health-care

23 facilities of the Department as the locations for a

24 center of research on mental health services, on the

25 use by the Department of specific models for fur26 nishing such services, on education and training, and
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1 on the development and implementation of innova2 tive clinical activities and systems of care with re3 spect to the delivery of such services by the Depart4 ment; and

5 ‘‘(B) subject to the appropriation of funds for

6 such purpose, establish and operate such centers at

7 such locations in accordance with this section.

8 ‘‘(2) The Secretary shall designate at least one facil9 ity under paragraph (1) not later than January 1, 1994.

10 ‘‘(3) The Secretary shall, upon the recommendation

11 of the Under Secretary for Health, ensure that the facili12 ties designated for centers under paragraph (1) are lo13 cated in various geographic regions.

14 ‘‘(4) The Secretary may not designate any health15 care facility as a location for a center under paragraph

16 (1) unless—

17 ‘‘(A) the peer review panel established under

18 paragraph (5) has determined under that paragraph

19 that the proposal submitted by such facility as a lo20 cation for a new center under this subsection is

21 among those proposals which have met the highest

22 competitive standards of scientific and clinical merit;

23 and

24 ‘‘(B) the Secretary, upon the recommendation

25 of the Under Secretary for Health, determines that
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1 the facility has developed (or may reasonably be an2 ticipated to develop)—

3 ‘‘(i) an arrangement with an accredited

4 medical school which provides education and

5 training in psychiatry and with which the facil6 ity is affiliated under which arrangement resi7 dents receive education and training in psychia8 try through regular rotation through the facility

9 so as to provide such residents with training in

10 the diagnosis and treatment of mental illness;

11 ‘‘(ii) an arrangement with an accredited

12 graduate school of psychology under which ar13 rangement students receive education and train14 ing in clinical, counseling, or professional psy15 chology through regular rotation through the

16 facility so as to provide such students with

17 training in the diagnosis and treatment of men18 tal illness;

19 ‘‘(iii) an arrangement under which nursing,

20 social work, or allied health personnel receive

21 training and education in mental health care

22 through regular rotation through the facility;

23 ‘‘(iv) the ability to attract scientists who

24 have demonstrated creativity and achievement

25 in research—
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1 ‘‘(I) into the evaluation of innovative

2 approaches to the design of mental health

3 services; or

4 ‘‘(II) into the causes, prevention, and

5 treatment of mental illness;

6 ‘‘(v) a policymaking advisory committee

7 composed of appropriate mental health-care and

8 research personnel of the facility and of the af9 filiated school or schools to advise the directors

10 of the facility and the center on policy matters

11 pertaining to the activities of the center during

12 the period of the operation of the center; and

13 ‘‘(vi) the capability to evaluate effectively

14 the activities of the center, including activities

15 relating to the evaluation of specific efforts to

16 improve the quality and effectiveness of mental

17 health services provided by the Department at

18 or through individual facilities.

19 ‘‘(5)(A) In order to provide advice to assist the Under

20 Secretary for Health and the Secretary to carry out their

21 responsibilities under this section, the official within the

22 Central Office of the Veterans Health Administration re23 sponsible for mental health and behavioral sciences mat24 ters shall establish a panel to assess the scientific and clin-
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1 ical merit of proposals that are submitted to the Secretary

2 for the establishment of new centers under this subsection.

3 ‘‘(B) The membership of the panel shall consist of

4 experts in the fields of mental health research, education

5 and training, and clinical care. Members of the panel shall

6 serve as consultants to the Department for a period of

7 no longer than six months.

8 ‘‘(C) The panel shall review each proposal submitted

9 to the panel by the official referred to in subparagraph

10 (A) and shall submit its views on the relative scientific

11 and clinical merit of each such proposal to that official.

12 ‘‘(D) The panel shall not be subject to the Federal

13 Advisory Committee Act (5 U.S.C. App.).

14 ‘‘(c) Clinical and scientific investigation activities at

15 each center may compete for the award of funding from

16 amounts appropriated for the Department of Veterans Af17 fairs medical and prosthetics research account and shall

18 receive priority in the award of funding from such account

19 insofar as funds are awarded to projects and activities re20 lating to mental illness.

21 ‘‘(d) The Under Secretary for Health shall ensure

22 that at least three centers designated under subsection

23 (b)(1)(A) emphasize research into means of improving the

24 quality of care for veterans suffering from mental illness
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1 through the development of community-based alternatives

2 to institutional treatment for such illness.

3 ‘‘(e) The Under Secretary for Health shall ensure

4 that useful information produced by the research, edu5 cation and training, and clinical activities of the centers

6 established under subsection (b)(1) is disseminated

7 throughout the Veterans Health Administration through

8 publications and through programs of continuing medical

9 and related education provided through regional medical

10 education centers under subchapter VI of chapter 74 of

11 this title and through other means.

12 ‘‘(f) The official within the Central Office of the Vet13 erans Health Administration responsible for mental health

14 and behavioral sciences matters shall be responsible for

15 supervising the operation of the centers established pursu16 ant to subsection (b)(1).

17 ‘‘(g)(1) There are authorized to be appropriated for

18 the Department of Veterans Affairs for the basic support

19 of the research and education and training activities of

20 the centers established pursuant to subsection (b)(1) the

21 following:

22 ‘‘(A) $3,125,000 for fiscal year 1994.

23 ‘‘(B) $6,250,000 for each of fiscal years 1995

24 through 1997.
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1 ‘‘(2) In addition to the funds available under the au2 thorization of appropriations in paragraph (1), the Under

3 Secretary for Health shall allocate to such centers from

4 other funds appropriated generally for the Department of

5 Veterans Affairs medical care account and the Depart6 ment of Veterans Affairs medical and prosthetics research

7 account such amounts as the Under Secretary for Health

8 determines appropriate in order to carry out the purposes

9 of this section.’’.

10 (b) CLERICAL AMENDMENT.—The table of sections

11 at the beginning of chapter 73 of such title is amended

12 by adding at the end of the matter relating to subchapter

13 II the following:

‘‘7319. Mental illness research, education, and clinical centers.’’.

14 (c) REPORTS.—Not later than February 1 of each of

15 1995, 1996, and 1997, the Secretary of Veterans Affairs

16 shall submit to the Committees on Veterans’ Affairs of

17 the Senate and House of Representatives a report on the

18 status and activities during the previous fiscal year of the

19 mental illness, research, education, and clinical centers es20 tablished pursuant to section 7319 of title 38, United

21 States Code (as added by subsection (a)). Each such re22 port shall contain the following:

23 (1) A description of—

24 (A) the activities carried out at each center

25 and the funding provided for such activities;
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1 (B) the advances made at each center in

2 research, education and training, and clinical

3 activities relating to mental illness in veterans;

4 and

5 (C) the actions taken by the Under Sec6 retary for Health pursuant to subsection (d) of

7 such section (as so added) to disseminate useful

8 information derived from such activities

9 throughout the Veterans Health Administra10 tion.

11 (2) The Secretary’s evaluations of the effective12 ness of the centers in fulfilling the purposes of the

13 centers.

14 (d) TECHNICAL AMENDMENT.—Section 7314(d)(1)

15 of such title is amended by striking out ‘‘the Chief Medical

16 Director’’ and inserting in lieu thereof ‘‘the Under Sec17 retary for Health’’.

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

Attest: WALTER J. STEWART,

Secretary.