S.Amdt. 2883

SA 2883. Ms. STABENOW (for herself, Mr. Kerry, and Mr. Brown)
submitted an amendment intended to be proposed to amendment SA 2786
proposed by Mr. Reid (for himself, Mr. Baucus, Mr. Dodd, and Mr.
Harkin) to the bill H.R. 3590, to amend the Internal Revenue Code of
1986 to modify the first-time homebuyers credit in the case of members
of the Armed Forces and certain other Federal employees, and for other
purposes; which was ordered to lie on the table; as follows:

In subtitle C of title IV, insert the following at the end:

SEC. 4208. CENTERS OF EXCELLENCE FOR DEPRESSION.

(a) Short Title.--This section may be cited as the
``Establishing a Network of Health-Advancing National Centers
of Excellence for Depression Act of 2009'' or the ``ENHANCED
Act of 2009''.
(b) Centers of Excellence for Depression.--Subpart 3 of
part B of title V of the Public Health Service Act (42 U.S.C.
290bb et

[[Page S12417]]

seq.) is amended by inserting after section 520A the
following:

``SEC. 520B. NATIONAL CENTERS OF EXCELLENCE FOR DEPRESSION.

``(a) Depressive Disorder Defined.--In this section, the
term `depressive disorder' means a mental or brain disorder
relating to depression, including major depression, bipolar
disorder, and related mood disorders.
``(b) Grant Program.--
``(1) In general.--The Secretary, acting through the
Administrator, shall award grants on a competitive basis to
eligible entities to establish national centers of excellence
for depression (referred to in this section as `centers of
excellence'), which shall engage in activities related to the
treatment of depressive disorders.
``(2) Allocation of awards.--If the funds authorized under
subsection (f) are appropriated in the amounts provided for
under such subsection, the Secretary shall allocate such
amounts so that--
``(A) not later than 1 year after the date of enactment of
the ENHANCED Act of 2009, not more than 20 centers of
excellence may be established; and
``(B) not later than September 30, 2016, not more than 30
centers of excellence may be established.
``(3) Grant period.--
``(A) In general.--A grant awarded under this section shall
be for a period of 5 years.
``(B) Renewal.--A grant awarded under subparagraph (A) may
be renewed, on a competitive basis, for 1 additional 5-year
period, at the discretion of the Secretary. In determining
whether to renew a grant, the Secretary shall consider the
report cards issued under subsection (e)(2).
``(4) Use of funds.--Grant funds awarded under this
subsection shall be used for the establishment and ongoing
activities of the recipient of such funds.
``(5) Eligible entities.--
``(A) Requirements.--To be eligible to receive a grant
under this section, an entity shall--
``(i) be an institution of higher education or a public or
private nonprofit research institution; and
``(ii) submit an application to the Secretary at such time
and in such manner as the Secretary may require, as described
in subparagraph (B).
``(B) Application.--An application described in
subparagraph (A)(ii) shall include--
``(i) evidence that such entity--

``(I) provides, or is capable of coordinating with other
entities to provide, comprehensive medical services with a
focus on mental health services and subspecialty expertise
for depressive disorders;
``(II) collaborates with--

``(aa) other medical subspecialists to address co-occurring
mental illnesses;
``(bb) community organizations; and
``(cc) other members of the network;

``(III) is capable of training health professionals about
mental health; and

``(ii) such other information, as the Secretary may
require.
``(C) Priorities.--In awarding grants under this section,
the Secretary shall give priority to eligible entities that
meet 1 or more of the following criteria:
``(i) Demonstrated capacity and expertise to serve the
targeted population.
``(ii) Existing infrastructure or expertise to provide
appropriate, evidence-based and culturally competent
services.
``(iii) A location in a geographic area with
disproportionate numbers of underserved and at-risk
populations in medically underserved areas and health
professional shortage areas.
``(iv) A history of serving the population described in
clause (iii).
``(v) Proposed innovative approaches for outreach to
initiate or expand services.
``(vi) Use of the most up-to-date science, practices, and
interventions available.
``(vii) Demonstrated coordination and collaboration, or
having a viable plan to coordinate, with a community mental
health center or other community mental health resources.
``(viii) Capacity to establish cooperative agreements with
other community entities to provide social and human services
to individuals with depressive disorders.
``(ix) Demonstrated potential for replication and
dissemination of evidence-based research and practices.
``(6) Specialty centers.--Of the centers of excellence
receiving a grant under this section, the Secretary may
select 1 or more such centers to specialize in--
``(A) subspecialties such as prepartum and postpartum
depression, traumatic stress disorder, suicidal tendency,
bipolar disorder, and depression; and
``(B) providing mental health services to communities with
problems of access, such as rural communities and
economically depressed communities.
``(7) National coordinating center.--
``(A) In general.--The Secretary, acting through the
Administrator, shall designate 1 recipient of a grant under
this section to be the coordinating center of excellence for
depression (referred to in this section as the `coordinating
center'). The Secretary shall select such coordinating center
on a competitive basis, based upon the demonstrated capacity
of such center to perform the duties described in
subparagraph (C).
``(B) Application.--A center of excellence that has been
awarded a grant under paragraph (1) may apply for designation
as the coordinating center by submitting an application to
the Secretary at such time, in such manner, and containing
such information as the Secretary may require.
``(C) Duties.--The coordinating center shall--
``(i) develop, administer, and coordinate the network of
centers of excellence under this section;
``(ii) oversee and coordinate the national database
described in subsection (d);
``(iii) lead a strategy to disseminate the findings and
activities of the centers of excellence through such
database;
``(iv) serve as a liaison with the Administration, the
National Registry of Evidence-based Programs and Practices of
the Administration, and any Federal interagency or
interagency forum on mental health; and
``(v) establish a common network infrastructure to advance
services provided by the centers of excellence and
demonstrate effectiveness in fostering a collaborative
community among such centers for sharing knowledge and
skills.
``(8) Matching funds.--The Secretary may not award a grant
or contract under this section to an entity unless the entity
agrees that it will make available (directly or through
contributions from other public or private entities) non-
Federal contributions toward the activities to be carried out
under the grant or contract in an amount equal to $1 for each
$5 of Federal funds provided under the grant or contract.
Such non-Federal matching funds may be provided directly or
through donations from public or private entities and may be
in cash or in-kind, fairly evaluated, including plant,
equipment, or services.
``(c) Activities of the Centers of Excellence.--Each center
of excellence shall carry out the following activities:
``(1) General activities.--Each center of excellence
shall--
``(A) integrate basic, clinical, or health services
interdisciplinary research and practice in the development of
evidence-based interventions;
``(B) involve a broad cross-section of stakeholders, such
as researchers, clinicians, consumers, families of consumers,
and voluntary health organizations, to develop the research
agenda and disseminate the research findings of such center,
and to provide support in the implementation of evidence-
based practices;
``(C) provide training and technical assistance to mental
health professionals, and engage in and disseminate
translational research with a focus on meeting the needs of
individuals with depressive disorders;
``(D) facilitate the dissemination and communication of
research findings and depressive disorder-related information
from the institutions of higher education to the public; and
``(E) educate policy makers, employers, community leaders,
and the general public about depressive disorders to reduce
stigma and raise awareness of available treatments for such
disorders.
``(2) Improved treatment standards, clinical guidelines,
and diagnostic protocols.--Each center of excellence shall
collaborate with other centers of excellence in the network
to--
``(A) develop and implement treatment standards, clinical
guidelines, and protocols to improve the accuracy and
timeliness of diagnosis of depressive disorders; and
``(B) develop and implement treatment standards that
emphasize early intervention and treatment for, primary
prevention and the prevention of recurrences of, and recovery
from, depressive disorders.
``(3) Coordination and integration of physical, mental, and
social care.--Each center of excellence shall--
``(A) incorporate principles of chronic care coordination
and integration of services that address physical, mental,
and social conditions in the treatment of depressive
disorders;
``(B) foster communication with other providers attending
to co-occurring physical health conditions such as
cardiovascular, diabetes, cancer, and substance abuse
disorders;
``(C) identify how treatment for depression interacts with
such co-occurring illnesses to improve overall health
outcomes;
``(D) leverage available community resources, develop and
implement improved self-management programs, and, when
appropriate, involve family and other providers of social
support in the development and implementation of care plans;
and
``(E) use electronic health records and telehealth
technology to better coordinate and manage, and improve
access to, care, as determined by the coordinating center.
``(4) Translational research through collaboration of
centers of excellence and community-based organizations.--
Each center of excellence shall--
``(A) demonstrate effective use of a public-private
partnership to foster collaborations among members of the
network and community-based organizations such as community
mental health centers and other social and human services
providers;
``(B) expand multidisciplinary, translational, and patient-
oriented research and treatment by fostering such
collaborations; and
``(C) coordinate with accredited academic programs to
provide ongoing opportunities, in academic and in community
settings, for the professional and continuing education of
mental health providers.
``(d) National Database.--

[[Page S12418]]

``(1) In general.--The coordinating center shall establish
and maintain a national, publicly available database to
improve prevention programs, evidence-based interventions,
and disease management programs for depressive disorders,
using data collected from the centers of excellence, as
described in paragraph (2).
``(2) Data collection.--
``(A) Data.--Each center of excellence shall submit data
gathered at such center, as appropriate, to the coordinating
center regarding--
``(i) the prevalence and incidence of depressive disorders;
``(ii) the health and social outcomes of individuals with
depressive disorders;
``(iii) the effectiveness of interventions designed,
tested, and evaluated;
``(iv) the progress in the prevention of, and recovery
from, depressive disorders; and
``(v) the economic impact of the activities of such center.
``(B) Financial information.--Each center of excellence
shall provide to the coordinating center appropriately
summarized financial information to enable the coordinating
center to assess the efficiency and financial sustainability
of such center.
``(3) Submission of data to the administrator.--The
coordinating center shall submit to the Administrator the
data and financial information gathered under paragraph (2).
``(4) Publication using data from the database.--A center
of excellence, or an individual affiliated with a center of
excellence, may publish findings using the data described in
paragraph (2)(A) only if such center submits such data to the
coordinating center, as required under such paragraph.
``(e) Establishment of Standards; Report Cards and
Recommendations; Third Party Review.--
``(1) Establishment of standards.--The Secretary, acting
through the Administrator, shall establish performance
standards for--
``(A) each center of excellence; and
``(B) the network of centers of excellence as a whole.
``(2) Report cards.--The Secretary, acting through the
Administrator, shall--
``(A) for each center of excellence, not later than 3 years
after the date on which such center of excellence is
established and annually thereafter, issue a report card to
the coordinating center to rate the performance of such
center of excellence; and
``(B) not later than 3 years after the date on which the
first grant is awarded under subsection (b)(1) and annually
thereafter, issue a report card to Congress to rate the
performance of the network of centers of excellence as a
whole.
``(3) Recommendations.--Based upon the report cards
described in paragraph (1), the Secretary shall, not later
than September 30, 2015--
``(A) make recommendations to the centers of excellence
regarding improvements such centers shall make; and
``(B) make recommendations to Congress for expanding the
centers of excellence to serve individuals with other types
of mental disorders.
``(4) Third party review.--Not later than 3 years after the
date on which the first grant is awarded under subsection
(b)(1) and annually thereafter, the Secretary shall arrange
for an independent third party to conduct an evaluation of
the network of centers of excellence to ensure that such
centers are meeting the goals of this section.
``(f) Authorization of Appropriations.--
``(1) In general.--To carry out this section, there are
authorized to be appropriated--
``(A) $100,000,000 for each of the fiscal years 2011
through 2015; and
``(B) $150,000,000 for each of the fiscal years 2016
through 2020.
``(2) Allocation of funds authorized.--Of the amount
appropriated under paragraph (1) for a fiscal year, the
Secretary shall determine the allocation of each center of
excellence receiving a grant under this section, but in no
case may the allocation be more than $5,000,000, except that
the Secretary may allocate not more than $10,000,000 to the
coordinating center.''.
(c) Sense of the Senate.--It is the sense of the Senate
that the knowledge and research developed by the centers of
excellence for depression established under section 520B of
the Public Health Service Act should be disseminated broadly
within the medical community and the Federal Government,
particularly to agencies with an interest in mental health,
including other agencies within the Department of Health and
Human Services and the Departments of Justice, Defense,
Labor, and Veterans Affairs.
______