H. R. 3118—23
tive operations of the readjustment counseling centers in
particular.
(D) Any other matter that the Secretary considers appro-
priate.
(c) RULE OF CONSTRUCTION.—Nothing in this section is intended
to preclude the Secretary, during the period before the submission
of the reports under this section, from providing limited health
care services at Vet Centers.
SEC. 333. ADVISORY COMMITTEE ON THE READJUSTMENT OF
VETERANS.
(a) IN GENERAL.—(1) Subchapter III of chapter 5 is amended
by inserting after section 544 the following new section:
‘‘§ 545. Advisory Committee on the Readjustment of Veterans
‘‘(a)(1) There is in the Department the Advisory Committee
on the Readjustment of Veterans (hereafter in this section referred
to as the ‘Committee’).
‘‘(2) The Committee shall consist of not more than 18 members
appointed by the Secretary from among individuals who—
‘‘(A) have demonstrated significant civic or professional
achievement; and
‘‘(B) have experience with the provision of veterans benefits
and services by the Department.
‘‘(3) The Secretary shall seek to ensure that members appointed
to the Committee include individuals from a wide variety of
geographic areas and ethnic backgrounds, individuals from veterans
service organizations, individuals with combat experience, and
women.
‘‘(4) The Secretary shall determine the terms of service and
pay and allowances of the members of the Committee, except that
a term of service may not exceed two years. The Secretary may
reappoint any member for additional terms of service.
‘‘(b)(1) The Secretary shall, on a regular basis, consult with
and seek the advice of the Committee with respect to the provision
by the Department of benefits and services to veterans in order
to assist veterans in the readjustment to civilian life.
‘‘(2)(A) In providing advice to the Secretary under this sub-
section, the Committee shall—
‘‘(i) assemble and review information relating to the needs
of veterans in readjusting to civilian life;
‘‘(ii) provide information relating to the nature and char-
acter of psychological problems arising from service in the
Armed Forces;
‘‘(iii) provide an on-going assessment of the effectiveness
of the policies, organizational structures, and services of the
Department in assisting veterans in readjusting to civilian
life; and
‘‘(iv) provide on-going advice on the most appropriate means
of responding to the readjustment needs of veterans in the
future.
‘‘(B) In carrying out its duties under subparagraph (A), the
Committee shall take into special account the needs of veterans
who have served in a theater of combat operations.
‘‘(c)(1) Not later than March 31 of each year, the Committee
shall submit to the Secretary a report on the programs and activities
H. R. 3118—24
of the Department that relate to the readjustment of veterans
to civilian life. Each such report shall include—
‘‘(A) an assessment of the needs of veterans with respect
to readjustment to civilian life;
‘‘(B) a review of the programs and activities of the Depart-
ment designed to meet such needs; and
‘‘(C) such recommendations (including recommendations for
administrative and legislative action) as the Committee consid-
ers appropriate.
‘‘(2) Not later than 90 days after the receipt of a report under
paragraph (1), the Secretary shall transmit to the Committees
on Veterans’ Affairs of the Senate and House of Representatives
a copy of the report, together with any comments and recommenda-
tions concerning the report that the Secretary considers appropriate.
‘‘(3) The Committee may also submit to the Secretary such
other reports and recommendations as the Committee considers
appropriate.
‘‘(4) The Secretary shall submit with each annual report submit-
ted to the Congress pursuant to section 529 of this title a summary
of all reports and recommendations of the Committee submitted
to the Secretary since the previous annual report of the Secretary
submitted pursuant to that section.
‘‘(d)(1) Except as provided in paragraph (2), the provisions
of the Federal Advisory Committee Act (5 U.S.C. App.) shall apply
to the activities of the Committee under this section.
‘‘(2) Section 14 of such Act shall not apply to the Committee.’’.
(2) The table of sections at the beginning of chapter 5 is
amended by inserting after the item relating to section 544 the
following new item:
‘‘545. Advisory Committee on the Readjustment of Veterans.’’.
(b) ORIGINAL MEMBERS.—(1) Notwithstanding subsection (a)(2)
of section 545 of title 38, United States Code (as added by subsection
(a)), the members of the Advisory Committee on the Readjustment
of Vietnam and Other War Veterans on the date of the enactment
of this Act shall be the original members of the advisory committee
recognized under such section.
(2) The original members shall so serve until the Secretary
of Veterans Affairs carries out appointments under such subsection
(a)(2). The Secretary of Veterans Affairs shall carry out such
appointments as soon after such date as is practicable. The Sec-
retary may make such appointments from among such original
members.
SEC. 334. CENTERS FOR MENTAL ILLNESS RESEARCH, EDUCATION,
AND CLINICAL ACTIVITIES.
(a) IN GENERAL.—(1) Subchapter II of chapter 73 is amended
by adding after section 7319, as added by section 321(a)(1), the
following new section:
‘‘§ 7320. Centers for mental illness research, education, and
clinical activities
‘‘(a) The purpose of this section is to provide for the improve-
ment of 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—
‘‘(1) the conduct of research (including research on improv-
ing mental health service facilities of the Department and
H. R. 3118—25
on improving the delivery of mental health services by the
Department);
‘‘(2) the education and training of health care personnel
of the Department; and
‘‘(3) the development of improved models and systems for
the furnishing of mental health services by the Department.
‘‘(b)(1) The Secretary shall establish and operate centers for
mental illness research, education, and clinical activities. Such cen-
ters shall be established and operated by collaborating Department
facilities as provided in subsection (c)(1). Each such center shall
function as a center for—
‘‘(A) research on mental health services;
‘‘(B) the use by the Department of specific models for
furnishing services to treat serious mental illness;
‘‘(C) education and training of health-care professionals
of the Department; and
‘‘(D) the development and implementation of innovative
clinical activities and systems of care with respect to the deliv-
ery of such services by the Department.
‘‘(2) The Secretary shall, upon the recommendation of the Under
Secretary for Health, designate the centers under this section. In
making such designations, the Secretary shall ensure that the cen-
ters designated are located in various geographic regions of the
United States. The Secretary may designate a center under this
section only if—
‘‘(A) the proposal submitted for the designation of the center
meets the requirements of subsection (c);
‘‘(B) the Secretary makes the finding described in sub-
section (d); and
‘‘(C) the peer review panel established under subsection
(e) makes the determination specified in subsection (e)(3) with
respect to that proposal.
‘‘(3) Not more than five centers may be designated under this
section.
‘‘(4) The authority of the Secretary to establish and operate
centers under this section is subject to the appropriation of funds
for that purpose.
‘‘(c) A proposal submitted for the designation of a center under
this section shall—
‘‘(1) provide for close collaboration in the establishment
and operation of the center, and for the provision of care and
the conduct of research and education at the center, by a
Department facility or facilities in the same geographic area
which have a mission centered on care of the mentally ill
and a Department facility in that area which has a mission
of providing tertiary medical care;
‘‘(2) provide that no less than 50 percent of the funds
appropriated for the center for support of clinical care, research,
and education will be provided to the collaborating facility
or facilities that have a mission centered on care of the mentally
ill; and
‘‘(3) provide for a governance arrangement between the
collaborating Department facilities which ensures that the cen-
ter will be established and operated in a manner aimed at
improving the quality of mental health care at the collaborating
facility or facilities which have a mission centered on care
of the mentally ill.
H. R. 3118—26
‘‘(d) The finding referred to in subsection (b)(2)(B) with respect
to a proposal for designation of a site as a location of a center
under this section is a finding by the Secretary, upon the rec-
ommendation of the Under Secretary for Health, that the facilities
submitting the proposal have developed (or may reasonably be
anticipated to develop) each of the following:
‘‘(1) An arrangement with an accredited medical school
that provides education and training in psychiatry and with
which one or more of the participating Department facilities
is affiliated under which medical residents receive education
and training in psychiatry through regular rotation through
the participating Department facilities so as to provide such
residents with training in the diagnosis and treatment of men-
tal illness.
‘‘(2) An arrangement with an accredited graduate program
of psychology under which students receive education and train-
ing in clinical, counseling, or professional psychology through
regular rotation through the participating Department facilities
so as to provide such students with training in the diagnosis
and treatment of mental illness.
‘‘(3) An arrangement under which nursing, social work,
counseling, or allied health personnel receive training and edu-
cation in mental health care through regular rotation through
the participating Department facilities.
‘‘(4) The ability to attract scientists who have demonstrated
achievement in research—
‘‘(A) into the evaluation of innovative approaches to
the design of mental health services; or
‘‘(B) into the causes, prevention, and treatment of men-
tal illness.
‘‘(5) 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.
‘‘(e)(1) In order to provide advice to assist the Secretary and
the Under Secretary for Health 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 peer review panel
to assess the scientific and clinical merit of proposals that are
submitted to the Secretary for the designation of centers under
this section.
‘‘(2) 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.
‘‘(3) The panel shall review each proposal submitted to the
panel by the official referred to in paragraph (1) and shall submit
to that official its views on the relative scientific and clinical merit
of each such proposal. The panel shall specifically determine with
respect to each such proposal whether that proposal is among
those proposals which have met the highest competitive standards
of scientific and clinical merit.
‘‘(4) The panel shall not be subject to the Federal Advisory
Committee Act (5 U.S.C. App.).
‘‘(f) Clinical and scientific investigation activities at each center
established under this section—
H. R. 3118—27
‘‘(1) may compete for the award of funding from amounts
appropriated for the Department of Veterans Affairs medical
and prosthetics research account; and
‘‘(2) shall receive priority in the award of funding from
such account insofar as funds are awarded to projects and
activities relating to mental illness.
‘‘(g) The Under Secretary for Health shall ensure that at least
three centers designated under this section 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.
‘‘(h) The Under Secretary for Health shall ensure that informa-
tion produced by the research, education and training, and clinical
activities of centers established under this section that may be
useful for other activities of the Veterans Health Administration
is disseminated throughout the Veterans Health Administration.
Such dissemination shall be made through publications, 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. Such programs
of continuing medical education shall receive priority in the award
of funding.
‘‘(i) 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 this section and shall provide
for ongoing evaluation of the centers and their compliance with
the requirements of this section.
‘‘(j)(1) There are authorized to be appropriated to the Depart-
ment of Veterans Affairs for the basic support of the research
and education and training activities of centers established pursu-
ant to this section amounts as follows:
‘‘(A) $3,125,000 for fiscal year 1998.
‘‘(B) $6,250,000 for each of fiscal years 1999 through 2001.
‘‘(2) In addition to funds appropriated for a fiscal year pursuant
to the authorization of appropriations in paragraph (1), the Under
Secretary for Health shall allocate to such centers from other funds
appropriated for that fiscal year generally for the Department of
Veterans Affairs medical care account and the Department of Veter-
ans Affairs medical and prosthetics research account such amounts
as the Under Secretary for Health determines appropriate to carry
out the purposes of this section.’’.
(2) The table of sections at the beginning of chapter 73 is
amended by inserting after the item relating to section 7319, as
added by section 321(a)(2), the following new item:
‘‘7320. Centers for mental illness research, education, and clinical activities.’’.
(b) ANNUAL REPORTS.—Not later than February 1 of each of
1999, 2000, 2001, and 2002, 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 centers for mental illness
research, education, and clinical activities established pursuant to
section 7320 of title 38, United States Code (as added by subsection
(a)). Each such report shall include the following:
(1) A description of the activities carried out at each center
and the funding provided for such activities.
H. R. 3118—28
(2) A description of the advances made at each of the
participating facilities of the center in research, education and
training, and clinical activities relating to mental illness in
veterans.
(3) A description of the actions taken by the Under Sec-
retary for Health pursuant to subsection (h) of that section
(as so added) to disseminate information derived from such
activities throughout the Veterans Health Administration.
(4) The Secretary’s evaluations of the effectiveness of the
centers in fulfilling the purposes of the centers.
(c) IMPLEMENTATION.—The Secretary of Veterans Affairs shall
designate at least one center under section 7320 of title 38, United
States Code, not later than January 1, 1998.
SEC. 
335. 
COMMITTEE 
ON 
CARE 
OF 
SEVERELY 
CHRONICALLY
MENTALLY ILL VETERANS.
(a) ESTABLISHMENT.—Subchapter II of chapter 73 is amended
by adding after section 7320, as added by section 334(a)(1), the
following new section:
‘‘§ 7321. Committee on Care of Severely Chronically Mentally
Ill Veterans
‘‘(a) The Secretary, acting through the Under Secretary for
Health, shall establish in the Veterans Health Administration a
Committee on Care of Severely Chronically Mentally Ill Veterans.
The Under Secretary shall appoint employees of the Department
with expertise in the care of the chronically mentally ill to serve
on the committee.
‘‘(b) The committee shall assess, and carry out a continuing
assessment of, the capability of the Veterans Health Administration
to meet effectively the treatment and rehabilitation needs of men-
tally ill veterans whose mental illness is severe and chronic and
who are eligible for health care furnished by the Department,
including the needs of such veterans who are women. In carrying
out that responsibility, the committee shall—
‘‘(1) evaluate the care provided to such veterans through
the Veterans Health Administration;
‘‘(2) identify systemwide problems in caring for such veter-
ans in facilities of the Veterans Health Administration;
‘‘(3) identify specific facilities within the Veterans Health
Administration at which program enrichment is needed to
improve treatment and rehabilitation of such veterans; and
‘‘(4) identify model programs which the committee considers
to have been successful in the treatment and rehabilitation
of such veterans and which should be implemented more widely
in or through facilities of the Veterans Health Administration.
‘‘(c) The committee shall—
‘‘(1) advise the Under Secretary regarding the development
of policies for the care and rehabilitation of severely chronically
mentally ill veterans; and
‘‘(2) make recommendations to the Under Secretary—
‘‘(A) for improving programs of care of such veterans
at specific facilities and throughout the Veterans Health
Administration;
‘‘(B) for establishing special programs of education and
training relevant to the care of such veterans for employees
of the Veterans Health Administration;
H. R. 3118—29
‘‘(C) regarding research needs and priorities relevant
to the care of such veterans; and
‘‘(D) regarding the appropriate allocation of resources
for all such activities.
‘‘(d)(1) Not later than April 1, 1997, the Secretary shall submit
to the Committees on Veterans’ Affairs of the Senate and House
of Representatives a report on the implementation of this section.
The report shall include the following:
‘‘(A) A list of the members of the committee.
‘‘(B) The assessment of the Under Secretary for Health,
after review of the initial findings of the committee, regarding
the capability of the Veterans Health Administration, on a
systemwide and facility-by-facility basis, to meet effectively the
treatment and rehabilitation needs of severely chronically men-
tally ill veterans who are eligible for Department care.
‘‘(C) The plans of the committee for further assessments.
‘‘(D) The findings and recommendations made by the
committee to the Under Secretary for Health and the views
of the Under Secretary on such findings and recommendations.
‘‘(E) A description of the steps taken, plans made (and
a timetable for their execution), and resources to be applied
toward improving the capability of the Veterans Health
Administration to meet effectively the treatment and rehabilita-
tion needs of severely chronically mentally ill veterans who
are eligible for Department care.
‘‘(2) Not later than February 1, 1998, and February 1 of each
of the three following years, the Secretary shall submit to the
Committees on Veterans’ Affairs of the Senate and House of Rep-
resentatives a report containing information updating the reports
submitted under this subsection before the submission of such
report.’’.
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of chapter 73 is amended by inserting after the item relating
to section 7320, as added by section 334(a)(2), the following new
item:
‘‘7321. Committee on Care of Severely Chronically Mentally Ill Veterans.’’.
Subtitle D—Other Provisions
SEC. 341. HOSPICE CARE STUDY.
(a) STUDY REQUIRED.—The Secretary of Veterans Affairs shall
conduct a research study to determine the desirability of the Sec-
retary furnishing hospice care to terminally ill veterans and to
evaluate the most cost-effective and efficient way to do so. The
Secretary shall carry out the study using resources and personnel
of the Department.
(b) CONDUCT OF STUDY.—In carrying out the study required
by subsection (a), the Secretary shall—
(1) evaluate the programs, and the program models,
through which the Secretary furnishes hospice care services
within or through facilities of the Department of Veterans
Affairs and the programs and program models through which
non-Department facilities provide such services;
(2) assess the satisfaction of patients, and family members
of patients, in each of the program models covered by paragraph
(1);
H. R. 3118—30
(3) compare the costs (or range of costs) of providing care
through each of the program models covered by paragraph
(1); and
(4) identify any barriers to providing, procuring, or coordi-
nating hospice services through any of the program models
covered by paragraph (1).
(c) PROGRAM MODELS.—For purposes of subsection (b)(1), the
Secretary shall evaluate a variety of types of models for delivery
of hospice care, including the following:
(1) Direct furnishing of full hospice care by the Secretary.
(2) Direct furnishing of some hospice services by the
Secretary.
(3) Contracting by the Secretary for the furnishing of hos-
pice care, with a commitment that the Secretary will provide
any further required hospital care for the patient.
(4) Contracting for all required care to be furnished outside
the Department.
(5) Referral of the patient for hospice care without a
contract.
(d) REPORT.—Not later than April 1, 1998, the Secretary shall
submit to the Committees on Veterans’ Affairs of the Senate and
House of Representatives a report on the research study. The report
shall set forth the Secretary’s findings and recommendations. The
Secretary shall include in the report information on the extent
to which the Secretary advises veterans concerning their eligibility
for hospice care and information on the number of veterans (as
of the time of the report) who are in each model of hospice care
described in subsection (c) and the average cost per patient of
hospice care for each such model.
SEC. 342. PAYMENT TO STATES OF PER DIEM FOR VETERANS
RECEIVING ADULT DAY HEALTH CARE.
(a) PAYMENT OF PER DIEM FOR VETERANS RECEIVING ADULT
DAY CARE.—Section 1741 is amended—
(1) by inserting ‘‘(1)’’ after ‘‘(a)’’;
(2) by redesignating paragraphs (1) and (2) as subpara-
graphs (A) and (B), respectively; and
(3) by adding at the end the following new paragraph
(2):
‘‘(2) The Secretary may pay each State per diem at a rate
determined by the Secretary for each veteran receiving adult day
health care in a State home, if such veteran is eligible for such
care under laws administered by the Secretary.’’.
(b) ASSISTANCE TO STATES FOR CONSTRUCTION OF ADULT DAY
CARE FACILITIES.—(1) Section 8131(3) is amended by inserting
‘‘adult day health,’’ before ‘‘or hospital care’’.
(2) Section 8132 is amended by inserting ‘‘adult day health,’’
before ‘‘or hospital care’’.
(3) Section 8135(b) is amended—
(A) in paragraph (2)(C), by inserting ‘‘or adult day health
care facilities’’ after ‘‘domiciliary beds’’; and
(B) in paragraph (3)(A), by inserting ‘‘or construction (other
than new construction) of adult day health care buildings’’
before the semicolon.
H. R. 3118—31
SEC. 343. RESEARCH CORPORATIONS.
(a) RENEWAL OF AUTHORITY.—Section 7368 is amended by strik-
ing out ‘‘December 31, 1992’’ and inserting in lieu thereof ‘‘December
31, 2000’’.
(b) CLARIFICATION OF TAX-EXEMPT STATUS.—Sections 7361(b)
and 7363(c) are amended by striking out ‘‘section 501(c)(3) of’’.
(c) PERIODIC AUDITS.—Subsection (b) of section 7366 is amended
by striking out ‘‘The corporation’’ in the second sentence and all
that follows through ‘‘shall include that report’’ and inserting in
lieu thereof the following: ‘‘A corporation with revenues in excess
of $300,000 for any year shall obtain an audit of the corporation
for that year. A corporation with annual revenues between $10,000
and $300,000 shall obtain an independent audit of the corporation
at least once every three years. Any audit under the preceding
sentences shall be performed by an independent auditor. The cor-
poration shall include the most recent such audit’’.
(d) COMPLIANCE WITH CONFLICT OF INTEREST LAWS AND REGU-
LATIONS.—Subsection (c)(2) of section 7366 is amended by striking
out ‘‘an annual statement signed by the director or employee certify-
ing that the director or’’ and inserting in lieu thereof ‘‘a statement
signed by the executive director of the corporation certifying that
each director and’’.
(e) REVISED REPORTING REQUIREMENT.—Subsection (d) of sec-
tion 7366 is amended to read as follows:
‘‘(d) The Secretary shall submit to the Committees on Veterans’
Affairs of the Senate and House of Representatives an annual
report on the corporations established under this subchapter. The
report shall set forth the following information:
‘‘(1) The location of each corporation.
‘‘(2) The amount received by each corporation during the
previous year, including—
‘‘(A) the total amount received;
‘‘(B) the amount received from governmental entities;
‘‘(C) the amount received from all other sources; and
‘‘(D) if the amount received from a source referred
to in subparagraph (C) exceeded $25,000, information that
identifies the source.
‘‘(3) The amount expended by each corporation during the
year, including—
‘‘(A) the amount expended for salary for research staff
and for salary for support staff;
‘‘(B) the amount expended for direct support of
research; and
‘‘(C) if the amount expended with respect to any payee
exceeded $35,000, information that identifies the payee.’’.
SEC. 344. VETERANS HEALTH ADMINISTRATION HEADQUARTERS.
Section 7306 is amended by adding at the end the following
new subsection:
‘‘(f) In organizing the Office and appointing persons to positions
in the Office, the Under Secretary shall ensure that—
‘‘(1) the Office is staffed so as to provide the Under
Secretary, through a designated clinician in the appropriate
discipline in each instance, with expertise and direct policy
guidance on—
‘‘(A) unique programs operated by the Administration
to provide for the specialized treatment and rehabilitation