1.Short title; table of
contents
(a)This Act may be cited
as the Comprehensive Cancer Care
Improvement Act of 2009
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Title I—Comprehensive cancer care under the Medicare
program
Sec. 101. Coverage of cancer care planning
services.
Sec. 102. Demonstration project to provide comprehensive cancer
care symptom management services under Medicare.
Title II—Comprehensive palliative care and symptom management
programs
Sec. 201. Grants for comprehensive palliative care and symptom
management programs.
Title III—Provider education regarding palliative care and
symptom management
Sec. 301. Grants to improve health professional
education.
Sec. 302. Grants to improve Continuing Professional
Education.
Title IV—Research on end-of-life topics for cancer
patients
Sec. 401. Research program.
2.The Congress makes the following
findings:
(1)Individuals with
cancer often do not have access to a cancer care system that provides
comprehensive and coordinated care of high quality.
(2)The cancer care
system has not traditionally offered individuals with cancer a prospective and
comprehensive plan for treatment and symptom management, strategies for
updating and evaluating such plan with the assistance of a health care
professional, and a follow-up plan for monitoring and treating possible late
effects of cancer and its treatment.
(3)Cancer survivors often experience the
under-diagnosis and under-treatment of the symptoms of cancer, a problem that
begins at the time of diagnosis and often becomes more severe at the end of
life. The failure to treat the symptoms, side effects, and late effects of
cancer and its treatment may have a serious adverse impact on the health,
well-being, and quality of life of cancer survivors.
(4)Cancer survivors who are members of racial
and ethnic minority groups may face special obstacles in receiving cancer care
that is coordinated and includes appropriate management of cancer symptoms and
treatment side effects.
(5)Individuals with
cancer are sometimes put in the untenable position of choosing between
potentially curative therapies and palliative care instead of being assured
access to comprehensive care that includes appropriate treatment and symptom
management.
(6)Comprehensive
cancer care should incorporate access to psychosocial services and management
of the symptoms of cancer (and the symptoms of its treatment), including pain,
nausea and vomiting, fatigue, and depression.
(7)Comprehensive
cancer care should include a means for providing cancer survivors with a
comprehensive care summary and a plan for follow-up care after primary
treatment to ensure that cancer survivors have access to follow-up monitoring
and treatment of possible late effects of cancer and cancer treatment.
(8)The Institute of
Medicine report, Ensuring Quality Cancer Care
, described the
elements of quality care for an individual with cancer to include—
(A)the development of
initial treatment recommendations by an experienced health care
provider;
(B)the development of
a plan for the course of treatment of the individual and communication of the
plan to the individual;
(C)access to the
resources necessary to implement the course of treatment;
(D)access to
high-quality clinical trials;
(E)a mechanism to
coordinate services for the treatment of the individual; and
(F)psychosocial
support services and compassionate care for the individual.
(9)In its report,
From Cancer Patient to Cancer Survivor: Lost in Transition
, the
Institute of Medicine recommended that individuals with cancer completing
primary treatment be provided a comprehensive summary of their care along with
a follow-up survivorship plan of treatment.
(10)Since more than
half of all cancer diagnoses occur among elderly Medicare beneficiaries, the
problems of providing cancer care are problems of the Medicare program.
(11)Shortcomings in
providing cancer care, resulting in inadequate management of cancer symptoms
and insufficient monitoring and treatment of late effects of cancer and its
treatment, are related to problems of Medicare payments for such care,
inadequate professional training, and insufficient investment in research on
symptom management.
(12)Changes in
Medicare payment for comprehensive cancer care, enhanced public and
professional education regarding symptom management, and more research related
to symptom management and palliative care will enhance patient decision-making
about treatment options and will contribute to improved care for individuals
with cancer from the time of diagnosis of the individual through the end of the
life of the individual.
<enum>I</enum><header>Comprehensive
cancer care under the Medicare program</header>
<section id="HF6B9190ACBC846A199A079B55B1DC1B7"><enum>101.</enum><header>Coverage of
cancer care planning services</header>
<subsection id="HB1C2A3E78B41456AB017366BCD83335D"><enum>(a)</enum><header>In
general</header><text>Section 1861 of the Social Security Act (42 U.S.C. 1395x)
is amended—</text>
<paragraph id="HB5DC8AD5D34C441187FF13F654F23DBA"><enum>(1)</enum><text>in subsection
(s)(2)—</text>
<subparagraph id="HA5AFB7C5C85747BCAA76AF133AF6505"><enum>(A)</enum><text>by striking
<quote>and</quote> at the end of subparagraph (DD);</text>
</subparagraph><subparagraph id="HAC2C023EAA9F40D48409C92073C64557"><enum>(B)</enum><text>by adding
<quote>and</quote> at the end of subparagraph (EE); and</text>
</subparagraph><subparagraph id="HAA34D2CD61B1428DAAC055934CDFEB96"><enum>(C)</enum><text>by adding at the
end the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H9692BD47261A4A64930014FF3D007015" style="OLC">
<subparagraph id="H045DED64D220496285BAD35FDB15E29D" indent="up1"><enum>(FF)</enum><text>comprehensive cancer care planning
services (as defined in subsection
(hhh));</text>
</subparagraph><after-quoted-block>;
and</after-quoted-block></quoted-block>
</subparagraph></paragraph><paragraph id="H3CAE7C97245746348B521C9D72C0010"><enum>(2)</enum><text>by
adding at the end the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H258DF3D6B2AA42B29F84E8B3440079FF" other-style="archaic" style="other">
<subsection id="HA973D79B73F84224ADACF01CA862CD5C"><enum>(hhh)</enum><header>Comprehensive cancer care planning
services</header><paragraph commented="no" display-inline="yes-display-inline" id="HD95475C0DBD54240BF0048CE3CDB3E6C"><enum>(1)</enum><text>The term
<term>comprehensive cancer care planning services</term> means—</text>
<subparagraph display-inline="no-display-inline" id="H88D163F206F34707BB7F17D95CA68537"><enum>(A)</enum><text>with respect to an
individual who is diagnosed with cancer, the development of a plan of care
that—</text>
<clause id="H1523FEB056084A5FAEC0DA67F3CFCE"><enum>(i)</enum><text>details, to the
greatest extent practicable, all aspects of the care to be provided to the
individual, with respect to the treatment of such cancer, including any
curative treatment and comprehensive symptom management (such as palliative
care) involved;</text>
</clause><clause id="H9EF095F9E95F458A887DBB3F00EBA5C8"><enum>(ii)</enum><text>is furnished in
written form to the individual in person within a period specified by the
Secretary that is as soon as practicable after the date on which the individual
is so diagnosed;</text>
</clause><clause id="H53B6E6ACA83F45AAA276B7FDEB270757"><enum>(iii)</enum><text display-inline="yes-display-inline">is furnished, to the greatest extent
practicable, in a form that appropriately takes into account cultural and
linguistic needs of the individual in order to make the plan accessible to the
individual; and</text>
</clause><clause id="H93F19C40871B4220B1412871EA5B227C"><enum>(iv)</enum><text display-inline="yes-display-inline">is in accordance with standards determined
by the Secretary to be appropriate;</text>
</clause></subparagraph><subparagraph id="HA0E4C598C0004C00AFB176A162791CC"><enum>(B)</enum><text display-inline="yes-display-inline">with respect to an individual for whom a
plan of care has been developed under subparagraph (A), the revision of such
plan of care as necessary to account for any substantial change in the
condition of the individual, if such revision—</text>
<clause id="H301ADC2894A64FB0BF99EA3167685C66"><enum>(i)</enum><text>is
in accordance with clauses (i) and (iii) of such subparagraph; and</text>
</clause><clause id="H59318B367DC24BC68450BC6311FA4DD"><enum>(ii)</enum><text>is
furnished in written form to the individual within a period specified by the
Secretary that is as soon as practicable after the date of such
revision;</text>
</clause></subparagraph><subparagraph id="H825DD7631EDA4F5CA9912D3BA382BDAE"><enum>(C)</enum><text>with respect to an
individual who has completed the primary treatment for cancer, as defined by
the Secretary (such as completion of chemotherapy or radiation treatment), the
development of a follow-up cancer care plan that—</text>
<clause id="H57D07A59334C4B3BABAC8E14CFF2394E"><enum>(i)</enum><text>describes the
elements of the primary treatment, including symptom management, furnished to
such individual;</text>
</clause><clause id="HED3A0142AFFF4B8CBF7F2E9F00C2A180"><enum>(ii)</enum><text>provides
recommendations for the subsequent care of the individual with respect to the
cancer involved;</text>
</clause><clause id="H8C8A2E22F93D41AA8E7F3D865390B232"><enum>(iii)</enum><text display-inline="yes-display-inline">is furnished in written form to the
individual in person within a period specified by the Secretary that is as soon
as practicable after the completion of such primary treatment;</text>
</clause><clause id="H12522C5D879048A1A5C25100EB464272"><enum>(iv)</enum><text display-inline="yes-display-inline">is furnished, to the greatest extent
practicable, in a form that appropriately takes into account cultural and
linguistic needs of the individual in order to make the plan accessible to the
individual; and</text>
</clause><clause id="H0D8B231F887D48ECB691386938EB7D5D"><enum>(v)</enum><text display-inline="yes-display-inline">is in accordance with standards determined
by the Secretary to be appropriate; and</text>
</clause></subparagraph><subparagraph id="HE27FF4DFF9C844269E9FE561487E9E92"><enum>(D)</enum><text display-inline="yes-display-inline">with respect to an individual for whom a
follow-up cancer care plan has been developed under subparagraph (C), the
revision of such plan as necessary to account for any substantial change in the
condition of the individual, if such revision—</text>
<clause id="H26290C8408394647AA1DF3B90000304F"><enum>(i)</enum><text>is
in accordance with clauses (i), (ii), and (iv) of such subparagraph; and</text>
</clause><clause id="H2E58CA9F478C4994ADB7D4E4FF4751C5"><enum>(ii)</enum><text>is furnished in
written form to the individual within a period specified by the Secretary that
is as soon as practicable after the date of such revision.</text>
</clause></subparagraph></paragraph><paragraph id="H64C6D8CD594343AEA5E67BA2633FDE93" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">The Secretary shall establish standards to
carry out paragraph (1) in consultation with appropriate organizations
representing providers of services related to cancer treatment and
organizations representing survivors of cancer. Such standards shall include
standards for determining the need and frequency for revisions of the plans of
care and follow-up plans based on changes in the condition of the individual
and standards for the communication of the plan to the
patient.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H47D7C97E88774680AD28008FE201C23D"><enum>(b)</enum><header>Payment</header><text display-inline="yes-display-inline">Section 1833(a)(1) of the Social Security
Act (42 U.S.C. 1395l(a)(1)) is amended by striking <quote>and</quote> before
<quote>(W)</quote> and inserting before the semicolon at the end the following:
<quote>, and (X) with respect to comprehensive cancer care planning services
described in any of subparagraphs (A) through (D) of section 1861(hhh)(1), the
amount paid shall be an amount equal to the sum of (i) the national average
amount under the physician fee schedule established under section 1848 for a
new patient office consultation of the highest level of service in the
non-facility setting, and (ii) the national average amount under such fee
schedule for a physician certification described in section 1814(a)(2) for home
health services furnished to an individual by a home health agency under a home
health plan of care</quote>.</text>
</subsection><subsection id="H9527469753594D9EAD4B56938042CFB3"><enum>(c)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to services
furnished on or after the first day of the first calendar year that begins
after the date of the enactment of this Act.</text>
</subsection></section><section display-inline="no-display-inline" id="HBCD2DE738F114C6F89806D961832B093" section-type="subsequent-section"><enum>102.</enum><header>Demonstration
project to provide comprehensive cancer care symptom management services under
Medicare</header>
<subsection id="HCA0B327D1F294E3F91EB630DB94FE51"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Beginning not later
than 180 days after the date of the enactment of this Act, the Secretary of
Health and Human Services (in this section referred to as the
<quote>Secretary</quote>) shall conduct a two-year demonstration project (in
this section referred to as the <quote>demonstration project</quote>) under
title XVIII of the Social Security Act under which payment shall be made under
such title for comprehensive cancer care symptom management services, including
items and services described in subparagraphs (A) through (I) of section
1861(dd)(1) of the Social Security Act, furnished by an eligible entity, in
accordance with a plan developed under subparagraph (A) or (C) of section
1861(hhh)(1) of such Act, as added by section 101(a). Sections 1812(d) and
1814(a)(7) of such Act (42 U.S.C. 1395d(d), 1395f(a)(7)) are not applicable to
items and services furnished under the demonstration project. Participation of
Medicare beneficiaries in the demonstration project shall be voluntary.</text>
</subsection><subsection id="H49A9C7A2ACE84ABF9C6B0950D45782BE"><enum>(b)</enum><header>Qualifications
and selection of eligible entities</header>
<paragraph id="HEE67CAE76CD745CABEB22DB010A3B58"><enum>(1)</enum><header>Qualifications</header><text>For
purposes of subsection (a), the term <term>eligible entity</term> means an
entity (such as a cancer center, hospital, academic health center, hospice
program, physician practice, school of nursing, visiting nurse association, or
other home health agency) that the Secretary determines is capable, directly or
through an arrangement with a hospice program (as defined in section
1861(dd)(2) of the Social Security Act (42 U.S.C. 1395x(dd)(2))), of providing
the items and services described in such subsection.</text>
</paragraph><paragraph id="H8EA40C603B214CD29D241D59A400221F"><enum>(2)</enum><header>Selection</header><text>The
Secretary shall select not more than 10 eligible entities to participate in the
demonstration project. Such entities shall be selected in a manner so that the
demonstration project is conducted in different regions across the United
States and in urban and rural locations.</text>
</paragraph></subsection><subsection id="HC72FEA7AC2B449F28C1C3D106210EF6"><enum>(c)</enum><header>Evaluation and
report</header>
<paragraph id="H0E4C5EDCA1CC4C7C96AAACE8FE5134AE"><enum>(1)</enum><header>Evaluation</header><text>The
Secretary shall conduct a comprehensive evaluation of the demonstration project
to determine—</text>
<subparagraph id="H97647B8030424904B763D4FE5E1697C7"><enum>(A)</enum><text>the effectiveness
of the project in improving patient outcomes;</text>
</subparagraph><subparagraph id="H802583FD551141BAA9668B18BC29172"><enum>(B)</enum><text>the cost of
providing comprehensive symptom management, including palliative care, from the
time of diagnosis;</text>
</subparagraph><subparagraph id="HA1F73A2677954813003DDBD711FBCDBF"><enum>(C)</enum><text>the effect of
comprehensive cancer care planning and the provision of comprehensive symptom
management on patient outcomes, cancer care expenditures, and the utilization
of hospitalization and emergent care services; and</text>
</subparagraph><subparagraph id="HA0A0E20958A84D1CB99169A985C5F874"><enum>(D)</enum><text>potential savings
to the Medicare program demonstrated by the project.</text>
</subparagraph></paragraph><paragraph id="H2C902A5A294E4B5389DDE84149EED3BB"><enum>(2)</enum><header>Report</header><text>Not
later than the date that is one year after the date on which the demonstration
project concludes, the Secretary shall submit to Congress a report on the
evaluation conducted under paragraph (1).</text>
</paragraph></subsection></section><enum>II</enum><header>Comprehensive
palliative care and symptom management programs</header>
<section id="HC61A780D27A747CC9E00899F31981C02"><enum>201.</enum><header>Grants for
comprehensive palliative care and symptom management programs</header>
<subsection id="HE2D2A5E4C3FE493186F079FBB20676FD"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall make
grants to eligible entities for the purpose of—</text>
<paragraph display-inline="no-display-inline" id="HDC2524E7908542A49D9757520006A25B"><enum>(1)</enum><text display-inline="yes-display-inline">establishing a new palliative care and
symptom management program for cancer patients; or</text>
</paragraph><paragraph id="HC51E52ED2963402B909F6D23C44700CD"><enum>(2)</enum><text>expanding an
existing palliative care and symptom management program for cancer
patients.</text>
</paragraph></subsection><subsection id="H3E5988F004EF4C2BB05393C4176B2E00"><enum>(b)</enum><header>Authorized
activities</header><text>Activities funded through a grant under this section
may include—</text>
<paragraph id="H3F59AC883841488FA207AE16E593842B"><enum>(1)</enum><text>securing
consultative services and advice from institutions with extensive experience in
developing and managing comprehensive palliative care and symptom management
programs;</text>
</paragraph><paragraph id="H6EAFC09015B24F41A0384D45A4B6805B"><enum>(2)</enum><text display-inline="yes-display-inline">expanding an existing program to serve more
patients or enhance the range or quality of services, including cancer
treatment patient education services, that are provided;</text>
</paragraph><paragraph id="HE3FE16B5487D4D8E9100E758A6BF6DC"><enum>(3)</enum><text display-inline="yes-display-inline">developing a program that would ensure the
inclusion of cancer treatment patient education in the coordinated cancer care
model; and</text>
</paragraph><paragraph id="H0140898B9C6B402EA75E03F819A692C"><enum>(4)</enum><text>establishing an
outreach program to partner with an existing comprehensive care program and
obtain expert consultative services and advice.</text>
</paragraph></subsection><subsection id="H2614D2C262774D91915643534C1E30CA"><enum>(c)</enum><header>Distribution of
funds</header><text>In making grants and distributing the funds under this
section, the Secretary shall ensure that—</text>
<paragraph id="H79FEDE482BBB44608DD37BA8915CAC45"><enum>(1)</enum><text display-inline="yes-display-inline">two-thirds of the funds appropriated to
carry out this section for each fiscal year are used for establishing new
palliative care and symptom management programs, of which not less than half of
such two-thirds shall be for programs in medically underserved communities to
address issues of racial and ethnic disparities in access to cancer care;
and</text>
</paragraph><paragraph id="H9086FE7D4AEF4624AEC70422AAC0A8C4"><enum>(2)</enum><text>one-third of the
funds appropriated to carry out this section for each fiscal year are used for
expanding existing palliative care and symptom management programs.</text>
</paragraph></subsection><subsection id="H9833C55D4E014F90BDB1ACF6395E5D95"><enum>(d)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="HF89E17EAE94244FB8E003BB12A6B49D"><enum>(1)</enum><text>The term
<term>eligible entity</term> includes—</text>
<subparagraph id="HEE9AF55E61BA4451A288AD1663BCA2A6"><enum>(A)</enum><text>an academic
medical center, a cancer center, a hospital, a school of nursing, or a health
system capable of administering a palliative care and symptom management
program for cancer patients;</text>
</subparagraph><subparagraph id="HA409CD74B99A419FB5BD3BFEEA3733E1"><enum>(B)</enum><text>a physician
practice with care teams, including nurses and other professionals trained in
palliative care and symptom management;</text>
</subparagraph><subparagraph id="H36E3EF5ABE8444369B61E89BF7C137D"><enum>(C)</enum><text>a visiting nurse
association or other home care agency with experience administering a
palliative care and symptom management program;</text>
</subparagraph><subparagraph id="H5A6A98D1F7FA45D6BF351C4ECFE0A930"><enum>(D)</enum><text>a hospice;
and</text>
</subparagraph><subparagraph id="H02BCC88557334C8700FDC59CF290B030"><enum>(E)</enum><text>any other health
care agency or entity, as the Secretary determines appropriate.</text>
</subparagraph></paragraph><paragraph id="H731629C6EEA84898935D6FAF15B52042"><enum>(2)</enum><text>The term
<term>medically underserved community</term> has the meeting given to that term
in section 799B(6) of the Public Health Service Act (42 U.S.C. 295p(6)).</text>
</paragraph><paragraph id="HCADE5203202E486599943D44829ED02"><enum>(3)</enum><text>The term
<term>Secretary</term> means the Secretary of Health and Human Services.</text>
</paragraph></subsection><subsection id="HC147EFDD5C2744E9BB2DA15E4596136B"><enum>(e)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated such sums as may be necessary for each of the fiscal years 2010
through 2014.</text>
</subsection></section><enum>III</enum><header>Provider
education regarding palliative care and symptom management</header>
<section id="H6369712F81C642EDB2BAA64114CAD900"><enum>301.</enum><header>Grants to
improve health professional education</header>
<subsection id="H3586A1674BE64C629EE200E5CA12EDE2"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall make
grants to eligible entities to enable the entities to improve the quality of
graduate and postgraduate training of physicians, nurses, and other health care
providers in palliative care and symptom management for cancer patients.</text>
</subsection><subsection id="H0D226A3AC6F448F2BB62C3F588C1F6F2"><enum>(b)</enum><header>Application</header><text>To
seek a grant under this section, an eligible entity shall submit an application
at such time, in such manner, and containing such information as the Secretary
may require. At a minimum, the Secretary shall require that each such
application demonstrate—</text>
<paragraph id="H6D9136E5B87D4AD5842C2C449F8142EB"><enum>(1)</enum><text>the ability to
incorporate palliative care and symptom management into training programs;
and</text>
</paragraph><paragraph id="H708AFC4C7A7B4C34A1E0421DE8431EAF"><enum>(2)</enum><text>the ability to
collect and analyze data related to the effectiveness of educational
efforts.</text>
</paragraph></subsection><subsection id="HEA96D773F2B3445A98A072825B45D2A6"><enum>(c)</enum><header>Evaluation</header><text>The
Secretary shall develop and implement a plan for evaluating the effects of
professional training programs funded through this section.</text>
</subsection><subsection id="H8717039E1D7A41189379E0F48829C753"><enum>(d)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H762AD7810F2D47949E995FF935F5E4DA"><enum>(1)</enum><text>The term
<term>eligible entity</term> means a cancer center (including an NCI-designated
cancer center), an academic health center, a physician practice, a school of
nursing, or a visiting nurse association or other home care agency.</text>
</paragraph><paragraph id="H145ACBA80BD54769916C86D6B4E7B2FA"><enum>(2)</enum><text>The term
<term>NCI-designated cancer center</term> means a cancer center receiving funds
through a P30 Cancer Center Support Grant of the National Cancer
Institute.</text>
</paragraph><paragraph id="H82668CB87B7748179CF26D4014861B94"><enum>(3)</enum><text>The term
<term>Secretary</term> means the Secretary of Health and Human Services.</text>
</paragraph></subsection><subsection id="HAB3DFB47C0A04D578D5DA9E14AF5461"><enum>(e)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated such sums as may be necessary for each of the fiscal years 2010
through 2014.</text>
</subsection></section><section id="HC19759E7D8A94110A802B3DE1F128981"><enum>302.</enum><header>Grants to
improve Continuing Professional Education</header>
<subsection id="HBEF88FF61D774C288BF59CD3ED860139"><enum>(a)</enum><header>In
general</header><text>The Secretary of Health and Human Services shall make
grants to eligible entities to improve the quality of continuing professional
education provided to qualified individuals regarding palliative care and
symptom management.</text>
</subsection><subsection id="H2693DCC968A7439287B05929D14EC5F3"><enum>(b)</enum><header>Application</header><text>To
seek a grant under this section, an eligible entity shall submit an application
at such time, in such manner, and containing such information as the Secretary
may require. At a minimum, the Secretary shall require that each such
application demonstrate—</text>
<paragraph id="H64C420F0F36643239D5C70AAFCC300B1"><enum>(1)</enum><text>experience in
sponsoring continuing professional education programs;</text>
</paragraph><paragraph id="HD4830C1B7AF34A188437759C57A12B36"><enum>(2)</enum><text>the ability to
reach health care providers and other professionals who are engaged in cancer
care;</text>
</paragraph><paragraph id="H00350F00C3D6468F88A58349BBE71FC0"><enum>(3)</enum><text>the capacity to
develop innovative training programs; and</text>
</paragraph><paragraph id="H4A1D852EC231485CBD168D24B11FFF6B"><enum>(4)</enum><text>the ability to
evaluate the effectiveness of educational efforts.</text>
</paragraph></subsection><subsection id="HEAE557A726144897AC9D2EACD9DA1DB7"><enum>(c)</enum><header>Evaluation</header><text>The
Secretary shall develop and implement a plan for evaluating the effects of
continuing professional education programs funded through this section.</text>
</subsection><subsection id="HD8EF0F5C11BA43F000DFC4D1B6E4E07F"><enum>(d)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="H0428CA86938C48B9BFAFCCBAF6FB3E14"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>eligible entity</term> means
a cancer center (including an NCI-designated cancer center), an academic health
center, a school of nursing, or a professional society that supports continuing
professional education programs.</text>
</paragraph><paragraph display-inline="no-display-inline" id="H816D13D7A7AE4B0CBF498300C8A7B684"><enum>(2)</enum><text>The term
<term>NCI-designated cancer center</term> means a cancer center receiving funds
through a P30 Cancer Center Support Grant of the National Cancer
Institute.</text>
</paragraph><paragraph id="HBBCE6A29576D4016B13BCC86E075DFAA"><enum>(3)</enum><text>The term
<term>qualified individual</term> means a physician, nurse, social worker,
chaplain, psychologist, or other individual who is involved in providing
palliative care and symptom management services to cancer patients.</text>
</paragraph><paragraph id="H02C9AB77C9DF4460BE18A54319A11F78"><enum>(4)</enum><text>The term
<term>Secretary</term> means the Secretary of Health and Human Services.</text>
</paragraph></subsection><subsection id="H7AE182FC72764D2D8B2091D328BDFA6F"><enum>(e)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated such sums as may be necessary for each of the fiscal years 2010
through 2014.</text>
</subsection></section><enum>IV</enum><header>Research on
end-of-life topics for cancer patients</header>
<section id="HA90FAC9BFFD64E958D28FE6D5136C583"><enum>401.</enum><header>Research
program</header>
<subsection id="H992BA626D44B4DA681CBEEA91C432B5"><enum>(a)</enum><header>In
general</header><text>The Director of the National Institutes of Health shall
establish a program of grants for research on palliative care, symptom
management, communication skills, and other end-of-life topics for cancer
patients.</text>
</subsection><subsection id="HFC17C7BCF8DE4B880016006C19E332ED"><enum>(b)</enum><header>Inclusion of
national research institutes</header><text>In carrying out the program
established under this section, the Director should provide for the
participation of the National Cancer Institute, the National Institute of
Nursing Research, and any other national research institute that has been
engaged in research described in subsection (a).</text>
</subsection><subsection id="H67021ACA2D8047FCAE031DCCD7F0A16D"><enum>(c)</enum><header>Definitions</header><text>In
this section:</text>
<paragraph id="HDA187AEC401D4E6E81EEC426E950500"><enum>(1)</enum><text>The term
<term>Director</term> means the Director of the National Institutes of
Health.</text>
</paragraph><paragraph id="H59D138A7D78F4E95B4DA64FA00503E00"><enum>(2)</enum><text>The term
<term>national research institute</term> has the meaning given to that term in
section 401(g) of the Public Health Service Act (42 U.S.C. 281(g)).</text>
</paragraph></subsection><subsection id="HEF0F3991D87844139544FDA3CFFD6626"><enum>(d)</enum><header>Authorization of
appropriations</header><text>To carry out this section, there are authorized to
be appropriated such sums as may be necessary for each of the fiscal years 2010
through 2014.</text>
</subsection></section>