[Pages S12416-S12418]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  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.
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